Losing A member of Your "Family"

Yesterday something was taken from me. Something that has recently brought a lot of joy into my everyday life, and a smile when ever I am with it. But now it is gone.

Yesterday my vintage single speed coaster brake cruiser was stolen from me. It was almost in mint condition, it was super fun to ride, and it made me love cycling again. It was so much fun that I made me want to get back on my road bike and it made me want to explore the cross country trails near by on my cyclocross bike. It made me love seeing the world from a bike again, something I haven't felt in two years.

That bike gave me a sense of freedom from the pain, from what happened in the past, and from the heartbreak of learning I can never race a bike again.

But now it is gone. They cut a cable lock. Then the cut a u-lock. Then they took away a part of my family.

RIP

The only photo I have to remember her by.

Honouring My Ancestors

The cool thing about learning medicine as that it isn't just about diseases, physical exams, histories, tests and prescriptions.  It is about people. Its about learning about people, what makes them tick and what makes them sick. But I feel like at most schools, all you learn about is what makes them sick. So I guess that makes me pretty lucky because I also get to learn about what makes people tick.

I got to spend 4 weeks for my last module of first year living on an urban reserve in North Western Ontario. It was amazing, eye opening, educational and challenging all at the same time, which is what I was expecting. But what I wasn't expecting was to learn a lot about myself, who I am and who I want to be.

I actually made these, even the bead work!

I got to spend one month living with the most amazing Anishinaabe women. She taught me a lot about traditional medicines, traditional way of life, the struggles and hardships that she and her people have been through, and what it means to be a strong women. And during this period of learning I came to understand a lot about myself, and the kind of doctor that I want to be.

I don't know a lot about my ancestry, and a large part of Anishinaabe and other aboriginal culture is about thanking and giving offerings to your ancestors and honouring them and asking for their help. And by honouring your ancestors you also honour the Creator. For me this is a struggle because I don't know who my ancestors are on one side of my family, so  I always felt very fake and ingenuine when participating in ceremonies.

But I came to learn during my 4 weeks that the part of me that has always a question mark does not have to be, and that I can take my own journey of discovery to find the part of me that is missing and make it whole again. Instead of merely learning tradition teachings, I thought deeply about them and about my own life and past, and slowly I felt like I had permission to ask my ancestors for help. I wanted for the first time to really be a part of aboriginal culture, which is a part of me that I never took ownership of.

I have carried on some of the traditional practices that I got to participate in such as smudging when I am having a particularly rough time with pain, or just having a tough day. Placing cedar in my shoes to help keep me safe in my journey through medicine and my walk through life. And honouring the ground with saama when I take something from it.

All the teachings that I have learned have given me a deep sense of pride in who I am, and who some of my ancestors are. And while it was merely 4 weeks of learning and living in a new place, I want to try and continue my journey of discovery and exploring my traditions.

After leaving the sweat lodge on my last night, I felt literally like a new person, that a piece of me had been given back and I finally found what my soul was searching for.

I hope that this experience will help me become a compassionate, thoughtful, and knowledgable healer in the future, even if I am becoming a healer in the modern, not traditional sense.

If I wasn't at the school I am at, I would not have had the opportunity to find myself. So Chi Miigwetch to the No Ordinary School of Medicine.

OMC! (Oh My Creator)

Anatomy Woes

I really like anatomy. But I real don't like having to teach it to myself. I know I can already out perform a lot of M1 students from different schools in clinical skills and clinical judgement, but if a surgeon in the OR started throwing questions at me I would be a blank slate.

I just ordered Netter's flash cards off of Amazon and a Netter's colouring book...I need all the help I can get. Also, if anybody knows how to slow time down so that I have enough time to learn anatomy plus everything else that I need to know, that would be much appreciated. (Time turners anyone?)

A Longing for Home

The first time I packed up my life and drove away from my home was at the age of 14, the first year I went off to boarding school. I remember that day clearly in my mind, looking back at my family's home out of the back window of my parents car, my bike seat blocking the view of the tree in the front yard. I was so incredibly excited at that moment to be starting a new life, one that would hopefully help me find my path in life and get me where I needed to be. I can say truthfully that it did, and that I wouldn't be sitting here surrounded by medical text books and frantically scribbled notes about the heart. I don't know where I would be.

The three years I spent at boarding school were incredible, and I look back with almost all fond memories. But I can't say there weren't days that I didn't miss home, my family, my town or the mountains. There were plenty of those days, but as each month, term and year rolled on, I had less and less days of longing for home. I started to feel like my school was my home, and that my friends and teachers were my family.

I also recall that during my first year of University there were intense days of longing to go home, mostly during the first semester of school when I was fighting to save my leg from amputation. Over the last two years of my undergrad, I could have gone home every weekend, but in total over two years I spent 4 weeks at home. I chose not to, I loved where I was living, what I was doing and my friends. I had no reason to go home really.

But since starting medical school, I don't think I have ever had so many days where from the core of my being I just want to go home. Sometimes I miss home, my family and the mountains so much that it almost hurts. Maybe it is because I have been sick since returning from Tanzania that I want to go home so badly. Maybe it is because I don't see myself sticking around this city after I graduate. I don't know what it is, all I know, is that I want to go home.

18 days and one exam to go. 

No Power to Change

We have community placements in our first and second year for 3 hours every week. As a first year, I essentially know nothing at all. I might know a bit more than some of my classmates because my background/bad luck with my body experiences, but over all, I don't know anything. The lack of knowledge and experience makes me feel completely powerless to say anything about things that bother me.

For example, I was observing in a specialized clinic that deals with very specific issues, and a patient asked if the doctor would be able to prescribe her an inhaler for her bronchitis, even though it was well outside the scope of the clinic. It wasn't however outside the scope of a very experienced family doctor. I saw the look on the patients face of frustration, anger, neglect and disappointment when the doc said that she couldn't and walked out of the room. I don't know if the doc saw it, but it felt like I was being punched in the gut to see her face and then to walk away like it wasn't a big deal.

Obviously, on the level of medical neglect, not being prescribed an inhaler for a non-emergent situation is not a big deal. Possibly the doc didn't feel comfortable prescribing an inhaler given she didn't know the patient's medical background. I don't think the doc should have given the patient the inhaler given the scope of the practice, but I do think she should have addressed it in a better way. Ask why the patient wanted one, explain in a less abrupt way why it couldn't be prescribed, and at least acknowledge that the patient was suffering. I don't think I will ever forget the look on the patient's face and in her eyes, you could tell she was upset, and wanted to say something, but didn't know how. I felt the same.

Maybe this experience resonated with me more because the very same day, just hours before I was observing at the clinic, the same thing happened to me. I had an appointment with my family doc to talk about a chronic GI issue that I have had since returning from Tanzania in June. Back in September I had been referred to one of the two GI docs in town, and I expected from what my doc told me that the wait time would be 3-5months. I could live with that. But when I called the GI's booking nurse to ask roughly where I was on the list, I was told I was number 500, and I would be lucky I would get in by May. I'm not going to be in the city from May-Sept because of a placement and then I'm going home for the summer. So I wanted to talk about that and what my options were. I also wanted to talk about the fact my symptoms had gotten worse and that I now had nose bleeds and abdo pain that I had never had before. She didn't acknowledge it at all. I had to FIFE (Feelings, Ideas, Function and Expectations) myself to try to get her to understand what I was going through. Even though I was trying to spell it out clear as day for her, she just brushed it off like it wasn't her problem, which is what the doc I was observing later that day did to her patient.

I wanted to tell my doc I wasn't sure if I could make it through another 6 months of school with these symptoms, but considering she graduated 4 years ago from the same school I am attending, I felt like I would be judged for being too weak to handle being in medicine. I honestly thought she was going to be a really great doctor, I keep being told that the docs coming out of my school are different and practice patient centred care, but now I am wondering. Now I am not only worried that I won't make it through the year, but if I make it through the next 4 years that I am going to do the same thing to my own patients.

I think being a patient is harder than training to become a doctor. Acknowledging that might not only make doctors more compassionate, but give patients permission to be sick.

Learning to Talk

Med school is a fascinating thing. In the words of my preceptor, "medical schools accept people who are generally very good at talking, interacting with people and are naturally patient centred individuals, and we turn them into biomedical machines who get stuck in conversations."

I am actually afraid of interviewing patients. Before medical school, I loved talking to people and getting them to tell me about their lives. That is honestly one of the reasons I like to fly so much, you never know who will be sitting next to you for the next 4 hrs. But now, I am paranoid that I will forget to ask something, ask too many closed questions, ask too many vague questions, say something wrong, or make an inappropriate facial expression. Talking to people just became one of the most difficult and nerve racking things I have ever done.

It's not the workload that is overwhelming, it's learning how to talk, act and essentially be another person almost overnight. And being a former athlete and somebody who has not had to struggle much to do really well in school or other things I have taken up, so I'm not used to being awful at things. Somedays it makes me question whether or not I am cut out to be a doctor. Everybody has told me for such a long time that I would make  a "great doctor" but not being good at the actual doctoring bit is really hard. (Note: nobody has told me I am awful, I just feel awful because it is such a struggle to do such a simple thing.)

Med school isn't hard because of what you need to study, it is hard because of what you need to learn to become.

This is how I feel all the time in clinical skills.

How to be a medical student and a patient

Basically my dilemma is summed up in the title.

I am not yet sure how to bridge the issue of me being somebody with chronic medical needs and me becoming somebody who will eventually be caring for others with chronic medical needs.

I think, right now, at this very moment I want to be a Neurologist. So, last night, when perusing "Access Medicine," there was a video on the side demonstrating a Lumbar Puncture. So I watched it.

I almost vomited. It wasn't the actual procedure that made me feel ill, it was the fact that I couldn't stop thinking about my own experiences. The procedure filmed looked like there was a lot of CSF that leaked out onto the drape (or what I would call "wasted CSF"), and all I could think of was the raging headache that the patient might have for the next few days.

I don't understand how I am ever going to be able to do procedures like this without being able to disconnect myself from my patients.