It's my first call as a resident. I've always been told that as a junior resident you have backup. You won't be on your own because everyone knows you're basically useless. Yet I have no senior here because this small program doesn't have seniors on off service with you. There are no specialist residents here.
Given how unprepared I am to take on call, I'm surprisingly disappointed by how little everyone is calling on me. Despite me going around to ER, swithboard and the wards today telling everyone that I'm the resident on call, to call me instead of staff, no one has seemed inclined. Instead I got called in for a consult by my staff, and I'm otherwise sitting around and kicking my feet.
What I should be doing is sleeping, since this is home call and I have to go to work tomorrow.
While rushing into the hospital earlier for consult, I went into ER in a white lace dress to see the patient first, then got changed into scrubs in case it turned surgical. As I was going into the ER again, someone behind me muttered 'I told you she's a doctor'. I guess white lace doesn't scream doctor on call.
Thursday, July 5, 2018
Sunday, July 1, 2018
Small towns and being satisfied
For my family medicine core I was placed in one of Mac's most rural locations: Rockwood. It's a little town about 25mins out from Guelph, which most people in the GTA consider to already be a small town.
I had an amazing rotation, with kind preceptors, great staff at the clinic, and interesting patients. My favourite part of the day, by far, was coming in 30 mins early to sit down, make a cup of coffee/tea, and look through my patient list for the day. I could go through their history, make some notes for myself, and read on the chief complaint the receptionist took down. I got to do some hands on things like remove moles, punch biopsies, cauterizing, and home visits. But it didn't feel like enough. Rockwood wasn't rural enough for me. Not enough hands on, and it sounds unbelievably selfish and spoiled, but too many resources.
In the same way that surgeons crave hands on, trauma, big open surgeries, I craved the wild west of family medicine. One where I didn't have a radiologist on my speed dial (yes we called the poor man on a near regular basis). Where there aren't 7 allergists at my beck and call to send someone with the mildest rash after eating a very hippy hemp granola whatever bar. The surgeons know that minimally invasive surgery with cameras and keyholes are better for patient outcomes. I know that patients in well supplied resource centers have higher quality of health. But I can't help but feel like if there are still spots where a dermatologist wait list is a year long, shouldn't I be there instead?
On an elective in family medicine, I went to northern Ontario's Petawawa. It's a Canadian forces base, and the town that built around it to service it. I didn't tend to the active military, but all the retired, the families, and the local population. It was - and still is - one of my favourite experiences on record. I got to do ER shifts, home visits, geriatric clinics. But I still missed how much hands on experience some rural physicians are able to get. Although I was a mere first year clerk at the time, and I doubt my staff trusted me to remove an SCC from someone's face.
Despite the wonderful amenities of semi rural areas like Rockwood, it wasn't enough. I don't even know what satisfies me in a practice at this point, and I'm afraid what I'm looking for might not exist. At the very least it won't coexist with my love for good and varied food in a place.
On particularly Canada Day, I'm missing home desperately. There are no fireworks in town tonight. Meanwhile Toronto has a list of top 10 places to see fireworks. I miss going to the ballet because a show or company I like is in town. I miss casually meeting friends for Spanish paella, Mexican tequilas and soft tacos, Korean hotpot, or Chicago style pizza. I definitely miss being able to call an Uber or skipthedishes, and have sushi delivered to my lap.
I thought I could trade all the amenities for small town life, but it turns out the small towns I've experienced until now are remarkably urban compared to my current location. This is more than small town, it's full blown remote, but still remains one of the biggest cities in the province.
Time will tell just how much I'm willing to change my lifestyle for the practice I want, I guess, and if that practice even exists. Two more days until I start doctoring.
I had an amazing rotation, with kind preceptors, great staff at the clinic, and interesting patients. My favourite part of the day, by far, was coming in 30 mins early to sit down, make a cup of coffee/tea, and look through my patient list for the day. I could go through their history, make some notes for myself, and read on the chief complaint the receptionist took down. I got to do some hands on things like remove moles, punch biopsies, cauterizing, and home visits. But it didn't feel like enough. Rockwood wasn't rural enough for me. Not enough hands on, and it sounds unbelievably selfish and spoiled, but too many resources.
In the same way that surgeons crave hands on, trauma, big open surgeries, I craved the wild west of family medicine. One where I didn't have a radiologist on my speed dial (yes we called the poor man on a near regular basis). Where there aren't 7 allergists at my beck and call to send someone with the mildest rash after eating a very hippy hemp granola whatever bar. The surgeons know that minimally invasive surgery with cameras and keyholes are better for patient outcomes. I know that patients in well supplied resource centers have higher quality of health. But I can't help but feel like if there are still spots where a dermatologist wait list is a year long, shouldn't I be there instead?
On an elective in family medicine, I went to northern Ontario's Petawawa. It's a Canadian forces base, and the town that built around it to service it. I didn't tend to the active military, but all the retired, the families, and the local population. It was - and still is - one of my favourite experiences on record. I got to do ER shifts, home visits, geriatric clinics. But I still missed how much hands on experience some rural physicians are able to get. Although I was a mere first year clerk at the time, and I doubt my staff trusted me to remove an SCC from someone's face.
Despite the wonderful amenities of semi rural areas like Rockwood, it wasn't enough. I don't even know what satisfies me in a practice at this point, and I'm afraid what I'm looking for might not exist. At the very least it won't coexist with my love for good and varied food in a place.
On particularly Canada Day, I'm missing home desperately. There are no fireworks in town tonight. Meanwhile Toronto has a list of top 10 places to see fireworks. I miss going to the ballet because a show or company I like is in town. I miss casually meeting friends for Spanish paella, Mexican tequilas and soft tacos, Korean hotpot, or Chicago style pizza. I definitely miss being able to call an Uber or skipthedishes, and have sushi delivered to my lap.
I thought I could trade all the amenities for small town life, but it turns out the small towns I've experienced until now are remarkably urban compared to my current location. This is more than small town, it's full blown remote, but still remains one of the biggest cities in the province.
Time will tell just how much I'm willing to change my lifestyle for the practice I want, I guess, and if that practice even exists. Two more days until I start doctoring.
Saturday, June 30, 2018
Adapting to less pleasant things
I'm back inland of the island now, and the weather is significantly nicer. It's a warm and breezy 20 something Saturday, except I'm sitting in bed and kicking my feet. Rarely do I sit around on such a nice day, but there are no good hiking trails in this neck of woods, only one little park that is swamped with children and their families on such a day. That and I have no one to go with, which sucks a little.
Yesterday I went grocery shopping properly for the first time and almost broke down in the store. I've never seen such a poorly stocked store. It looked like a hurricane went through, only there was minimal selection to begin with. No such thing as the summer fruits that I've associated with this time of year. No fresh strawberries, no local cherries, no plums or peaches or nectarines. No pineapples, no watermelons, and certainly none of the more exotic features I had at home: dragon fruit, star fruit, guava, etc.
The vegetables all looked like they were picked 6 months ago and shipped on a slow boat over (which let's be fair, they probably were). I've seen more vegetables in winter in communist China, and that's not an exaggeration. Spinach? Hello? Lettuce more brown than green.
On the other hand I'm starting to see how it would be hard to maintain a sustainable, healthy diet here. $6 for a head of cauliflower? Are you kidding me? Apparently I'm paying for the airfare from California for that cauliflower. At some point it's probably cheaper to fly to Halifax, pack a suitcase of vegetables, and fly back.
I was expecting to lose some of my comfort luxury-ish foods, like freshly imported Italian cured meats, pate from France, and more spices than I can shake a salt shaker at. I wasn't expecting to not find tomatoes, or bananas, or potatoes, or brown rice (there's an entire selection of instant rice though).
It hurts me a little. Food is my one, favourite comfort. I cook a pot of bucatini alla amatriciana after a hard day on the wards. I make coq au vin when I have guests over. Fashion and shopping is my other comfort, but there isn't a single viable store in the whole town. The nearest Loft is off the island. The closest, proper mall is in St. John's. While I've been known to travel distances for clothes, 4 hours of driving is pushing it.
It sucks. It sucks losing both of my top go to comforts in one of the most stressful and lonely times of my life so far. It sucks not having friends nearby. It sucks that my boyfriend isn't here. It sucks that everyone else on my social media is settling nicely into their new homes of Kingston, Toronto, London and Hamilton, and I'm still trying to figure out how to not get scurvy from the food here.
The one thing I'm repeating is that I chose this. I didn't come here for the lifestyle. I definitely didn't come for the food. I came for the training, and that's what I'll do in 3 days. A couple people have also proposed I treat this like a cooking show challenge: figure out a diet for locals to survive on that is affordable yet healthy. So far my plan involves annexing Florida in the name of Newfoundland.
Yesterday I went grocery shopping properly for the first time and almost broke down in the store. I've never seen such a poorly stocked store. It looked like a hurricane went through, only there was minimal selection to begin with. No such thing as the summer fruits that I've associated with this time of year. No fresh strawberries, no local cherries, no plums or peaches or nectarines. No pineapples, no watermelons, and certainly none of the more exotic features I had at home: dragon fruit, star fruit, guava, etc.
The vegetables all looked like they were picked 6 months ago and shipped on a slow boat over (which let's be fair, they probably were). I've seen more vegetables in winter in communist China, and that's not an exaggeration. Spinach? Hello? Lettuce more brown than green.
On the other hand I'm starting to see how it would be hard to maintain a sustainable, healthy diet here. $6 for a head of cauliflower? Are you kidding me? Apparently I'm paying for the airfare from California for that cauliflower. At some point it's probably cheaper to fly to Halifax, pack a suitcase of vegetables, and fly back.
I was expecting to lose some of my comfort luxury-ish foods, like freshly imported Italian cured meats, pate from France, and more spices than I can shake a salt shaker at. I wasn't expecting to not find tomatoes, or bananas, or potatoes, or brown rice (there's an entire selection of instant rice though).
It hurts me a little. Food is my one, favourite comfort. I cook a pot of bucatini alla amatriciana after a hard day on the wards. I make coq au vin when I have guests over. Fashion and shopping is my other comfort, but there isn't a single viable store in the whole town. The nearest Loft is off the island. The closest, proper mall is in St. John's. While I've been known to travel distances for clothes, 4 hours of driving is pushing it.
It sucks. It sucks losing both of my top go to comforts in one of the most stressful and lonely times of my life so far. It sucks not having friends nearby. It sucks that my boyfriend isn't here. It sucks that everyone else on my social media is settling nicely into their new homes of Kingston, Toronto, London and Hamilton, and I'm still trying to figure out how to not get scurvy from the food here.
The one thing I'm repeating is that I chose this. I didn't come here for the lifestyle. I definitely didn't come for the food. I came for the training, and that's what I'll do in 3 days. A couple people have also proposed I treat this like a cooking show challenge: figure out a diet for locals to survive on that is affordable yet healthy. So far my plan involves annexing Florida in the name of Newfoundland.
Tuesday, June 26, 2018
This weather...
It's a typical Canadian thing to meet up and complain about the weather. I swear I will never complain about the weather in Ontario again. In the same vein that I looked down on southern residents of the US freaking out over a few centimeters of snow, I now can't say I was ever cold in Ontario.
It's snowing. It's June 26th. We're days from Canada Day. IT IS FRIGGING SNOWING HERE IN NEWFOUNDLAND. SEND HELP.
I feel like it's time to start planning life as a snow bird. Fly back to Ontario for winters. I assume they'll seem much more mild, considering even summer is winter around these parts.
That's all. Just needed to let someone else know about this nutjob weather.
It's snowing. It's June 26th. We're days from Canada Day. IT IS FRIGGING SNOWING HERE IN NEWFOUNDLAND. SEND HELP.
I feel like it's time to start planning life as a snow bird. Fly back to Ontario for winters. I assume they'll seem much more mild, considering even summer is winter around these parts.
That's all. Just needed to let someone else know about this nutjob weather.
Thursday, June 21, 2018
Certification is not competency
I can't tell you how many times that has been repeated to me. I'm most of the way through my orientation weeks of mind numbing amounts of paperwork, training modules, managing labor and delivery emergencies and resuscitating babies. I kind of got that doing a pretest of a couple multiple choice and one day of blitzing through CPR on babies isn't really going to make me a neonatal intensivist, yet regularly the staff are reminding us that at a rural site, it might be just us. Just me as the primary physician?! Maybe don't come into hospital for a few more years. I still can't believe there may come the day when I'm the most senior person on.
On another note, today the captain left back for Ontario. I'm devastated in some ways, but relieved in others. This feels like a finale and a fresh start, rather than the tentative past few days of we-know-it's-ending-but-it-hasn't-sunk-in. I've planned to do a little St. John's trapezing on my own, especially The Rooms. I hate exploring museums with other people, it's rather like someone reading over your shoulder. I also intend to get some personal time with the botiques downtown.
But I miss him. I'm missing him desperately and not knowing when I'll next see him. In nearly 6 years of being together we've never been more than a month apart. We've been lucky that way, I guess.
On another note, today the captain left back for Ontario. I'm devastated in some ways, but relieved in others. This feels like a finale and a fresh start, rather than the tentative past few days of we-know-it's-ending-but-it-hasn't-sunk-in. I've planned to do a little St. John's trapezing on my own, especially The Rooms. I hate exploring museums with other people, it's rather like someone reading over your shoulder. I also intend to get some personal time with the botiques downtown.
But I miss him. I'm missing him desperately and not knowing when I'll next see him. In nearly 6 years of being together we've never been more than a month apart. We've been lucky that way, I guess.
Wednesday, June 13, 2018
2 days to go - for me
I went to my new gym today. I'm still very intimidated by gyms despite multiple assurances from everyone that go more than me that no one is judging. Except I'm totally judging. I'm a bad person, I know. Mostly I judge me, if that helps. I couldn't bring myself to step into the weight room so I hid in the safety of cardio machines and failed at using a stationary bike. (Why are they so high off the ground? Why is nothing easy to adjust? Why does my crotch like to fall on the bars?)
But I'm starting to get out of the apartment at least, and alone for the first time. Trial run as I'll be dropping off my boyfriend of almost 6 years (nicknamed the captain) a short week from now. Then I'll be truly alone. I've been a bit weepy about it.
What I try to remember is that I'm doing this for me. Most decisions in my life I've made on the basis of family and other relationships. Convenience's sake. Comfort. This time it's for me. I stayed close to home for undergrad for financial and family reasons. My parents wanted me close by. I stayed close for medical school despite the chance to go west for family and boyfriend and friends. This time I'm going where I want and without so much as a by your leave from anyone else. This decision I made for only what I want.
But I'm starting to get out of the apartment at least, and alone for the first time. Trial run as I'll be dropping off my boyfriend of almost 6 years (nicknamed the captain) a short week from now. Then I'll be truly alone. I've been a bit weepy about it.
What I try to remember is that I'm doing this for me. Most decisions in my life I've made on the basis of family and other relationships. Convenience's sake. Comfort. This time it's for me. I stayed close to home for undergrad for financial and family reasons. My parents wanted me close by. I stayed close for medical school despite the chance to go west for family and boyfriend and friends. This time I'm going where I want and without so much as a by your leave from anyone else. This decision I made for only what I want.
Yes, faith, it is my cousin’s duty to make curtsy and say,
“Father, as it please you.”
But yet for all that, cousin, let him be a handsome fellow, or else make another curtsy and
say, “Father, as it please me."
- Much Ado About Nothing
Tuesday, June 12, 2018
3 days till it begins - moving in
I've officially made landing in St. John's after a long journey across Canada. It feels like the first time in a long journey that I'm finally waking up and going to sleep in the same place, and in my own bed. Well, own is relative here.
I had ordered furniture from IKEA but they canceled my order without explanation, blaming my bank. I called my bank who said they did no such thing. Best I can figure IKEA decided they didn't want to ship to Newfoundland so just cancelled my order. Another classmate has his delayed until who knows when, and he's coming with a baby in tow. I sent out a call for help on the local Facebook group. Credits to that Newfoundland hospitality (southerners got nothing on us): everyone responded by recommending a million places to go, things they were selling, stuff they wanted to give to me for free. Everyone wanted to help move me in, no one wanted to be paid for it in money or craft beers (stopped at Quidi Vidi brewery for iceburg made beers).
Thanks to everyone's kindness, I now have a bed (although the frame cracked after the first day, so now I'm on box springs and falling out of bed), couches, coffee table (!!), and dining set. I never realized it was a luxury to eat and sit at the same time. Not too bad an introduction to my home for the next few months.
While here we dropped by my future home: a lonesome but beautiful tourist/fishing village up in northern Newfoundland. Despite the freezing location, it sells itself as the mildest winters in Canada...hm. I'll report back. So far a group of seals greeted me there by flipping around and sticking their heads at me. No moose welcoming party yet. Good. I'm still scared of them for mostly inane reasons.
Today I dropped my parents off at the airport. It's starting to feel real now. This feels like my own moving-out-for-college thing. I stayed at home during undergrad, and stayed close by for medical school. I never did the big move thing, even though I only visited home maybe once a month. Suddenly I feel like I'm on my way, even though the boyfriend is still here for a week or so.
Paperwork is still piling. I have not made a dent. I guess it's time to actually get to work now.
I had ordered furniture from IKEA but they canceled my order without explanation, blaming my bank. I called my bank who said they did no such thing. Best I can figure IKEA decided they didn't want to ship to Newfoundland so just cancelled my order. Another classmate has his delayed until who knows when, and he's coming with a baby in tow. I sent out a call for help on the local Facebook group. Credits to that Newfoundland hospitality (southerners got nothing on us): everyone responded by recommending a million places to go, things they were selling, stuff they wanted to give to me for free. Everyone wanted to help move me in, no one wanted to be paid for it in money or craft beers (stopped at Quidi Vidi brewery for iceburg made beers).
Thanks to everyone's kindness, I now have a bed (although the frame cracked after the first day, so now I'm on box springs and falling out of bed), couches, coffee table (!!), and dining set. I never realized it was a luxury to eat and sit at the same time. Not too bad an introduction to my home for the next few months.
While here we dropped by my future home: a lonesome but beautiful tourist/fishing village up in northern Newfoundland. Despite the freezing location, it sells itself as the mildest winters in Canada...hm. I'll report back. So far a group of seals greeted me there by flipping around and sticking their heads at me. No moose welcoming party yet. Good. I'm still scared of them for mostly inane reasons.
Today I dropped my parents off at the airport. It's starting to feel real now. This feels like my own moving-out-for-college thing. I stayed at home during undergrad, and stayed close by for medical school. I never did the big move thing, even though I only visited home maybe once a month. Suddenly I feel like I'm on my way, even though the boyfriend is still here for a week or so.
Paperwork is still piling. I have not made a dent. I guess it's time to actually get to work now.
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