Lions and Tigers and Bears...Oh My!

I'm only 1 day late for Medical Mondays...oops. But, I have been really busy with pre-trip preparations (aka packing and seminars) for my trip to Tanzania and we leave this Thursday! But I thought I should drop by seeing as I have been a bit MIA lately.

Headed to Ngorongoro Conservation Area to the University of Calgary Field School

Finishing up my 4th year of undergrad (senior year for the American's in the crowd) was seriously difficult. In the past 4 months, I have have interviewed in 4 different cities in 3 different countries. In the month of March alone, I spent a total of 24 hours on planes and I watched every single movie Air Canada had to offer. I am also now a co-author on a Nature paper that was published a few weeks ago (first publication!), and I successfully defended my honours thesis.

As you may remember, one of my goals this year was to get a 4.0 in my 4th year, and mission accomplished!! Some how I actually managed to get 100% on the last undergrad paper that I submitted, and in my opinion it was one of he worst because I was only aiming for 77% in order to get an A in the class. Aim low and you will land among the stars?

I have not yet been accepted into medical school sadly, and the stress is kind of getting to me. I was wait listed at VCU (which was an absolutely amazing school) and people have been started to be accepted off of the wait list...but not me. The two Canadian schools I interviewed at release decisions next week when I am in the middle of no where in Tanzania looking at stool samples. Graduating feels great, but it also kinda feels like crap because I just want to get in.

Today and tomorrow I am shadowing my lab supervisor, who is on neurology service this week, on morning rounds. It is sort of a goodbye and thank you gift for being "the best undergraduate student he has ever had." All of the residents have been amazing, and are going out of their way to teach me and help me understand what is going on, and it is absolutely a fantastic experience. (I also got to see the inside of the docs lounge...they have their own flippin cafeteria!!) But, it also makes me even more anxious about getting in, I just want to start training for a job I have always dreamed about doing. I look forward to late nights in the library and being on call. These are things most people dread, but I honestly can't wait. Shadowing only confirms this, and will make the disappointment even harder.
I might be crushed next week if I am not accepted into a Canadian school. I have already started my AMCAS application again. But because I will be in Tanzania with likely no internet access, I am not going to be able to submit it one the June 1st opening day, and I am going to have to phone home to parents so see what the results of my other applications are.

So great to graduate, yet soooo stressful.

Also, I am still training for the 35km swim, which has also meant swimming 9x a week for the past 3.5 weeks...so ready for a break!

Thanks for stopping by, and I hope I have good news in September for y'all (and for my emotional wellbeing). 

Interview Hopping

I missed the last Medical Monday because I was desperately trying to get to Richmond, Virginia before my interview at VCU. But lets back up a bit to get you up to speed about what has been going on for the last few months.

In January, I received interview invitations for 3 different schools in a span of three days. One for VCU on Feb 4th (my top US choice), one for Michigan State on Mar 28 (second choice), and one for Northern Ontario School of Medicine on Mar 29th (that one was a shocker). In that same week, I received an invitation to write the subject test for the Neuroscience MSc/PhD program in Göttingen, Germany. 7 days later I received an invitation for THE interview that I really wanted, which was at my home school, the University of Calgary.

February 3rd I left the frozen Canadian waste land to fly to Richmond, Virginia for my interview at VCU. Except, my flight out of Calgary was delayed an hour and half due to a mysterious light being on. When we landed in Minneapolis I abandoned my Canadian manners and full out sprinted about 2km from gate A to gate F where my flight to Richmond was departing from. I got to the gate, and the women in Delta colours told me the plane had just closed its doors, and wouldn't re-open them, and that I had been rebooked on a flight that would get me to Richmond at 12:30pm the next day. I had to be at VCU by 11am for the interview.

Me: "But I have to be there at 11!."
Delta woman: "Well, you won't be."
Me: "This is literally my future we are talking about, the results of tomorrow may very well dictate the rest of my life."
Delta woman: Fake smile
Me: "What about a flight to DC tonight?"
Delta woman: "Oh, yes. We could do that. The last flight closes its doors in 7 minutes. Its back at gate A."

So, I full out sprinted back to the exact same place I had just come from, but managed to sequester a nice man driving a Delta cart to get me there a little faster. I get to the gate just on time, and I get handed a boarding pass which indicates a 1st class seat (score!). I hurried on to the plane (nobody checked my passport by the way...I guess flights to DC aren't as secure as we thought), I was sweating buckets, clearly didn't belong in first class, and when I arrived at my seat, I noticed it was a window seat....right next to a very nicely dressed US Senator. I have never gotten such a severe death stare in my life. Upon arriving in DC (which is the scariest runway ever, it looks like you are going directly into the river), I was provided with a $300 taxi voucher to get me to Richmond, Virginia. I made it to my hotel by 1 am, after having to spend half of the taxi ride on the phone with the driver's daughter in order to get directions to my hotel because my taxi driver didn't know where he was going. End of story, I made it, I think my interview went well, and VCU blew my mind. I didn't think such amazing schools even existed. As an aside, if Delta had waited 3 minutes, they would have saved them approximately $700, and reduced my cortisol levels about 2 fold...this is why we Canadians love Westjet...they wait for everybody.

This past Saturday I did my interview for Calgary, I think I nailed 9/12 MMI stations, completely blew 1 (had an awkward 2 minutes of silence because you can't leave the room until the 7 minutes are up and I was totally done discussing the question), and 2 stations that I am a little unsure about. I hope it evens out...on to May 15th!

Next up on the interview schedule is Göttingen, Germany next Monday. I didn't study for the subject test, and figured my chances of getting an interview were pretty much 0 as I guessed my way through the 40 physics and chemistry questions. But apparently not...or I just failed less than the other 300 people who wrote the test. The program is paying for my travel and accommodation, which is awesome, worst case scenario is that I have a free trip to Germany :).

But here is my dilemma. The only reason I applied to the program in Germany is because I thought I had no chance of getting into any medical schools that I actually wanted to go to after not hearing from VCU, Michigan and being rejected from UBC. Now I am worried that I will get into a top choice medical school (or any at all), plus the program in Germany. I was hoping to not have to make any decisions. It will be hard to turn down a 3 year PhD program at one of the top scientific institutes in the world (and in Germany), but I also don't know how I could possibly turn down medical school. Best case scenario, I get to defer for 2 years and do an MSc in Germany and come back to a medical school spot. But, its pretty rare to get more than a 1 year deferral.

Also, my thesis is due in 18 days and I am no where near finished. I don't have time for Germany...but I can't not go...

Side note: check our Waves for Women blog, which my friend Caryn and myself will be chronicling our training and fundraising journey for our 35km open water ocean swim in July to raise money for Women's Cancer Research.

The first week of the end of my degree

I think title says it all, but this is the first week of classes of the last semester of my undergrad degree. Come June I will be happily not walking across the stage to receive my degree in Health Sciences because I will likely still be in Tanzania. (Who would want to sit in stuffy gymnasium for three hours when they could be deep in the Maasai region of Tanzania at a field camp with giraffes walking around?) Needless to say, I am pretty excited that this is the end of my first degree and that I get to finish off with a pretty awesome global health research studentship to Tanzania.

The unfortunate part is that I will be starting yet another semester with post-concussion syndrome. You may remember this post from October, well the saga continues. I still have daily headaches, yet they are mainly orthostatic (I get them when I sit up or stand up, but if I lie down they go away). This has led the concussion specialist physiatrist that I am seeing to suspect I may have a CSF leak (which is what I asked about a week after my concussion when I threw up every time I stood up and the ER doc told me it was impossible to occur unless there was a skull fracture). Soo... I have to do a radionucleotide cisternogram (say that thee times fast) in two weeks, which essentially involves a lumbar puncture, an injection of some radioactive nucleotides and me lying on a table in the angiogram suit for 6 hours. I'm not excited...and I think that if it shows I don't have a CSF leak, I likely will have one after this procedure (every time a needle goes into my epidural space I end up with a CSF leak that doesn't resolve its own). From what I am told, this the best test to check for a CSF leak, and apparently they can't do a blood patch (the procedure done to stop CSF leaks) unless there is indication of leak, which there will be no matter what after this procedure because I am 100% certain (based on past experience) that I will end up with one. Some rules and systems don't make any sense and in this case will likely cause unnecessary patient suffering. This procedure seems pointlessly expensive (to taxpayers of course, GO CANADA) and I am fairly certain I will end up needing a blood patch in the end regardless of the test outcome.

And for further updates, I got wait-listed at Wayne State SOM (which was better than I though based on the strangeness of my interview) and rejected pre-interview by UBC by 0.5 (they give you your application score and the cutoff score for interviews). The UBC thing really upset me because BC has a huge shortage of doctors in rural areas, yet they reject rural applicants at higher rates than those from urban areas (they publish these stats). It has to be recognized that opportunities to build up extracurricular activities in a small town are limited (like there are none), I made some of my own, but even that was a struggle. Anyway, if i don't get in anywhere this year, I know my GPA will be high enough to put me above the interview cutoff for next year for UBC.

On another note I spontaneously decided to apply for graduate school in Gottingen, Germany. But sadly if they like me I essentially have to repeat the a German version of the MCAT (in English thankfully) so now I have go back to studying plant ecology, physics and chemistry.

Who wouldn't want to get a MSc or PhD from here? 

Despite all of these emotional up and downs, and headaches caused by the physical ups and downs, I'm excited for what 2014 has in store. This year represents a void of the unknown and not knowing what is going to happen is always exciting. It also represents long hours in the lab trying to finish my honours thesis on time (so I can actually graduate) and the challenge of fulfilling these 10 goals. 

I hope your 2014 is filled with moments of joy but also full challenges that help you realize its okay to not be in control, and of course, many Medical Mondays (12 to be exact).

Thanks for stopping by!!

(I should also share that I get to snag link up spot 1 because I am in a different time zone,  so technically it is still Sunday here. There are some perks of living in mountain time, in addition to the mountains and -20°C weather.) 

21 Reasons

Today is a big day for me.

Today is the day I turn 21, and to honour this day in history, I thought I should make a list of 21 reasons why my life is awesome right now.

1. Today is my birthday, which just makes today great despite what may happen today.
2. I got a Macbook Pro for my Birthday, now I don't have to stress about having a computer that keeps crashing.
3. I have an amazing family, and they drove all the way to Calgary this past weekend just to celebrate my Birthday.
4. I have interview at Wayne State School of Medicine on Nov. 27th!
5. The global health conference that I have been planning for almost a year happens this weekend, Nov 9-11th. This is the biggest project I have ever attempted to pull off, and I am excited to help other students become passionate about global health.
6. I have some pretty amazing friends who are not only there for the ups in life, but who are also there for the downs.
7. All of my medical school applications are done!!
8. I got mounds of chocolate and food for my Birthday, so now I'm good until Christmas.
9. I've come to accept the fact I will likely never really race a bike again, and that cycling will become a pastime, rather than a lifeline, and I am okay with that.
10. I might be going to Tanzania in May!
11. I have super comfortable bed (this is actually pretty important).
12. I am completely okay with not getting to medical school this cycle. My plans for next year are actually awesome no matter what. If I don't get in, I'm going to work, and then travel to as many countries in as many continents as I can. Sounds better than dissecting cadavers right?
13. I have GF cake left over from my family Birthday party yesterday (cake makes life better no matter what).
14. I am actually doing pretty well in gross anatomy, even if it does feel a bit overwhelming sometimes.
15. I might be really behind on my research for my honours thesis, but my lab members are awesome, and I know that they will support me through it.
16. I don't have life figured out yet, and I think that is just fine, we don't always need a plan.
17. My parents brought my guitar from home. I haven't played since grade 9, but I am excited to get some more music back in my life.
18. It snowed this weekend! While winter is not as pleasant as summer, I like to appreciate all seasons for what they are and the gifts that they bring, like skiing!!!
19. I'm thankful that I decided to take the plunge and transfer from UoGuelph to uCalgary a year ago, it was one of the best decisions I ever made. I don't regret going to Guelph, I don't think I would be where I am today had I not started out there. Everything works out as it should in the end.
20. I'm a strong person, I've been through more than I should have after only being on this earth for 21 years, and I appreciate everything that I have learned about life through trials and struggles. It will make me a better doctor.
21. Being able to dance like nobody is watching. We can all do this, and doing it makes life way more awesome. You should try it sometime.

Life is great, even when it sucks sometimes, it is still pretty great.

Still Concussed

My last Medical Monday's post was back in August, and it was about the "little" crash I had at a local bike race.

I still have symptoms of an "acute concussion." I don't quite understand how it can be considered "acute" when it is over 2 months past the date of injury. But I'm not a doctor (yet). I can't ride a bike, or do any form of exercise, and school is more challenging than it should be. (Although, I think I did pretty well on my anatomy peripatetic today.) This is a really bad way to be starting off my final year of undergrad, with applications to finish, scholarships to apply for, 4.0s to maintain, a conference to plan and oh yeah, this thing called an Honour's Thesis.

Its going to be a long semester of headaches, concussion physio (I didn't even know that was a thing, and you think with this being my 6th concussion, somebody would have told me about this by now) and trips to the sport medicine clinic. I have a referral to "complex concussion physiatrist," I didn't even know that was a specialty. (Look all the things I am learning about medicine by having a concussion!!) The not exercising part is the worst because exercises is how I deal with pain, no exercise, worse pain, worse pain, worse grades. Apparently physiatrists have solutions for these kinds of dilemmas? I'm not sure if I will ever race a bike again...but I have other plans if I can't.

I hope you are all having a bettter Medical Monday than I am, one not filled with headaches and cadavers with pins in them and pages of anatomy questions. Now back to studying for the written portion of my anatomy exam which is on Wednesday (don't y'all just miss school??).

This is almost exactly what my concussion looked like (but with a helmet), conveniently thanks to Anatomy class I can identify all the structures in this diagram. Yipee!

The Crash and the Road Rash

I went to a local criterium race last Tuesday, like I do every Tuesday, only this time, things went horribly wrong. I was working late in the lab trying to finish up nerve conduction on my mice and didn't finish until about 6:30. I debated whether or not to go to the race because it started at 7:30, and I didn't have much time.I ended up deciding to go, because I have been feeling pretty down lately and trying to internally work things through as they relate to cycling. I ran home, scarfed down a bowl of cereal, changed into my kit, and jumped on my bike.

Well, folks, on the second lap of the race, I crashed. And it wasn't just a little crash. I don't really remember what happened, but I know my wheels just went out from underneath me, I don't know why, or how, but they did. I hit my head pretty hard and smashed the front of my helmet in. All I remember is that sickening feeling when your bike starts to move out from underneath you, sliding along the pavement, and then sitting up to check my helmet. Then somehow was lying on the grass with all of these people looking around me. I don't know if I just can't remember how I got to the grass, or if I lost consciousness...either way, I ended up being surrounded by about 10 people lying on the grass at the side of the road.

Some nice guy drove me to the hospital, which was less than 5 minutes from the race, and the race organizer called my room-mate to come meet me. (We conveniently live directly across the street from the largest trauma centre in Alberta.) I spent 7 hours in emerg, 5.5 of which I was waiting to be seen by a doctor. I just sat there, shivering, bleeding and trying not to throw up on the person next to me. Eventually, when I was seen, I was declared to have concussion (duh) and severe road rash (double duh). They gave me a Percoset, referred me to the burn clinic and sent me home. They didn't even attempt to clean my road rash or put any sort of dressing on it. Normally I am a big advocate of Canadian Healthcare, but I'm seriously a bit pissed off right now.

I am super thankful that the ER doc had the sense to refer me to the burn clinic, otherwise I would be in so much pain. When I went to the burn clinic on Wednesday, and the nurse saw that I didn't have any dressings on any of the road rash (which is covering 10% of my body) and that it hadn't been cleaned she went ape sh**t.  The two worst burns that I have are on my upper right arm and right hip/pelvic bone. Because they didn't clean anything, or really look at the burns, nobody noticed that I had bone exposed on my right hip. (Yes folks, I spent 20 hours with a bone exposed from road rash without it being cleaned or bandaged.)Lets just say that the cleaning of the burns definitely makes my top 10 list of most painful experiences (and I have chronic pain...).

Canadian healthcare has both failed me and saved me since my injuries on Tuesday. I am grateful that I get to wear $200 worth of silver bandages, and that I get to have them changed and cleaned everyday other day without paying a dime. But also super pissed off that the ER doc didn't do the job that I waited 7 hours for him to do.I get that they were busy, but come on, you still have to provide necessary care.

I also feel really awful about the fact that I caused the crash, and the the woman behind me who is an amazing bike racer broke her wrist and can't race this weekend. She didn't seem up set about the fact that I was the reason she broke her wrist, which is good, but I still feel awful about it. Crashing is an unfortunate part of cycling. 

For a long while I have been thinking about giving up cycling for good. It is insanely hard to try and train and race at the level I need to be at without having a functioning lower right leg. It is like I am riding on jello. I might be eligible for para-cycling, but I have essentially been waiting about 9 months to get medical documentation and a proper neuro assessment. I still want to ride my bike because I love it, (well, not at this moment) but racing is not something that I can do right now. (The Tuesday night criterium series doesn't count as racing because it's just for fun.) I am getting super depressed about not going to Canada Games (which are going on right now), as it has been my goal for the past few years, and that goal has essentially been crushed. I am not at the level I need to be to competitive at Canada Games, and I am fully aware of that, it just sucks that it is all because of a medically unnecessary surgery when I was 15. In a way the concussion makes me feel a bit better that I am not going to Canada Games, because even if I was set to fly to Quebec next Saturday, I wouldn't be able to compete with a concussion.

I guess all this time I am spending sleeping and not exercising will give me more time to reflect on what I want to do with cycling, and also time to finish up my application for UBC's School of Medicine. It's just unfortunate that somebody had to break their wrist, and I had to lose a lot of skin and smash my head into the pavement to take this time to reflect.

(This is also concussion number 6 for me, so I should probably get off this computer.)

Shadowing

I had a pretty impressive morning of shadowing last Wednesday, followed by a somewhat less exciting afternoon of looking at mice in square boxes, cleaning up their excretions and testing their grip strength. But I am sure, you don't want to hear about what I do with mice...back to shadowing.

I shadowed my PI in the neuromuscular clinic, and it was needless to say a really great learning experience. I wasn't too sure how good of a teacher he would be, but he turned out to be pretty great. He explained all the cases to me, what each part of the neuro-exam looks for, the EMG results, and patient histories (some which were more complicated than mine). The first patient we saw was a younger women (early 40's) who had massive file and extensive history. I empathized with her because it seemed like she had been through a similar experience as me when I first got sick. She has seen pretty much every specialist in the city (a neuroimmunologist? I didn't even know that existed), has had extensive testing, has been "combative" towards doctors demanding tests/medications, and at one point wanted to go to the Mayo clinic. Her story seems kinda like mine (I was never combative though, but definitely frustrated). I almost wanted to just give her a hug, and I really wanted to tell her that I truly understood what she was going through, but alas, I was but a mere shadow.

The last patient we saw was a woman in her 50s who had an ethanol induced neuropathy. She doesn't take the vitamins that she needs (B1) which can reverse the neuropathy, she continues to consume alcohol, won't go to physiotherapy and doesn't have a family doctor. She had so much muscle wasting that she looked like a person with muscular dystrophy, and she can no longer straighten her legs so she is wheelchair bound. Non-compliance has committed her to a death sentence from a curable disease. Because of her, I witnessed for the first time what it is like to tell somebody that they will die, and soon, from a condition that is in fact reversible.

It is going to be interesting when I finally become a doctor, I think I am going to see myself reflected back to me in the experience of patients. In almost every patient we saw, I recognized something of my own story in the story of the patients. I empathized with the frustrations of one, the research tenacity of another, the ability of one patient to push through the pain, and realization of a grim future of another. I hope I never lose this empathy. At the same time though, I would give anything for my condition to just disappear by taking some vitamins, most people would, so I don't know how I am going to react when I encounter non-compliant patients. I see non-compliance as selfish, and I feel it makes the role of a doctor almost meaningless.


Needless to say, shadowing was an enlightening experience, which motivated me to submit my AMCAS application on Friday (even though I am still waiting for one transcript to arrive at AMCAS). I also started my application for UBC and the rest of the Canadian applications open up in a couple of weeks. The ball is rolling, and I have started to have nightmares since I submitted my AMCAS application. Looks like it is going to be a long wait until May 15, 2014....


PS Happy Canada Day!!!

The AMCAS Dilemma

On Wednesday, May 8th, just two days from now, I will be able to start my AMCAS application. This is the summer where I officially apply to donate the rest of my life to the practice of medicine, to the art of healing. I'm almost more scared of what will happen if I do get in than if I don't, and if I get into an American school, and not a Canadian one.

Most Canadian schools (or the ones I am applying to at least) drop your worst academic year. The University of Calgary drops your worst year if you have completed 3 full time years (yippee for me!), and UBC will drop your worst year if you have 120 credits (ie, you have completed 4 years). This is where the problem begins. I am in third year, so uCalgary will drop my worst year, but UBC will not. My best chances for admission are at UBC (if I had my worst year dropped, ie the year I spent in the hospital), which would only happen if I applied in the NEXT cycle, not this one.

So, if I complete my AMCAS application, and I apply to the 10-12 schools I have a chance at in the US, and I get into one of them, but not a Canadian school, do I go, or do I wait a year and reapply? If I wait a year, UBC will drop my first year and my GPA will increase (likely) to above admission averages, but my GPA alone won't guarantee me admission. But UBC has a large rural assessment component to the application (which is very much in my favour as I grew up in a town of less than 4000 people), and my extra curricular activities will only improve with the addition of one more year on my application. So, my application, if I were to apply in the 2014/2015 cycle would likely be much stronger, and my chances for admission are higher.

Back to the dilemma, do I submit an AMCAS application? If I get in only to an American school, do I go? My intentions for the past year was that I would apply to US schools, but that was on the thought that UBC would be dropping my worst year, and now that they won't be, I am second guessing. I want to cover all of my bases in Canada, and ensure I have the strongest application possible submitted to Canadian schools before I hop across our southern border.

I want the best chance possible at becoming a doctor and I don't want to miss an opportunity to fulfill my dream, but waiting one more year and getting in to a Canadian school would mean that I would be at least $200,000 less in debt and be able to get a residency spot in Canada. (Plus, I don't have to write step 1, or go through the silly basic science courses that US medical schools force you to go through.)

WHAT DO I DO??? I just want to be a doctor! (Preferably in Canada, and if not Canada, Washington or Oregon state because they are the most similar places to Canada other than of course Canada itself and New Zealand.)

Global Health

Welcome to my Medical Mondays Post!

I'm pretty exhausted today after spending my entire day at the Children's Hospital and then going to class...I don't understand how doctors actually make through the day. I guess now is as good a time as any to start improving my stamina and work on looking enthusiastic about everything and my all day happy face.

Anyway, in two weeks time, I will be heading over to Montreal to attend MonWHO, a World Health Organization Simulation conference. I went last year with my previous university, and this year I obtained funding for myself and 5 other students from Calgary to fly out to Montreal to spend 3 days debating, learning and sometimes fighting about global health issues. The theme of this year's conference is "Corruption in Health Care Systems," and I am the Transparency International delegate, which should prove to be a very interesting and involved role. I am also pretty excited about being able to see some of my friends from Guelph who are going and whom I haven't seen in almost year.

The main reason that I was actually able to get funding to go, is because next fall, we will be hosting the first conference of its kind in Western Canada. We are calling it CalWHO, which coincidentally sounds like "Yahoo" which is actually the traditional Calgary Stampede exclamatory phrase (it is not "yehaw" like everybody thinks). Myself and my friend U are the co-Executive Directors, founders and first ever presidents of CalWHO. Before Christmas we had an application process to select 4 more students to form our core secretariat responsible for putting on CalWHO next fall. So while we are headed to Montreal to attend the conference (and eat awesome food, potentially go shopping and maybe hit up one of Montreal's famous night clubs), we are mostly there to learn everything about the conference so that we can recreate it here in Calgary.

This is a massive under taking, as it will be the first student led conference in my faculty and one of two in the entire university (the other is hosted by the faculty of education students, most of whom already have at least 1 degree). I am a bit scared....but at this moment,  I am just really excited to go to Montreal and spend a weekend trying to solve problems that affect the health of people world wide.

Also, happy March from Calgary! I love Canadian weather! (Said no one ever.)

Medical Extremes

I think this is my 4th  Medical Monday blog post, and thought I would write about an interesting medical contrast that I experienced today, which I feel really reflects on my own personal experience as a patient. If you are thinking I'm going to tell you about some really cool medical condition, then you should probably navigate yourself away from this page and check this out instead.

This afternoon I spent time in the emergency department of our city's children's hospital as part of the Pediatric Emergency Medicine Research Team, but prior to that I spent the morning volunteering in the palliative/respite care area of the very same hospital. I went from an area that was focused on ensuring that kids who have terminal illness have the best times of their lives while they still can, to an area that was focused on getting kids in and out of the department as fast as possible.

The energy between the two places was extremely different, and while you may not expect this, the doctors, nurses and parents who are taking care of kids in respite care (none of the kids currently under palliative care are actively dying) were way more cheerful, happy, fun loving and honestly just more kid friendly. People were focused on enjoying life, and making sure the kids laughed more than they cried. But in emerg, it is the exact opposite. Nobody is focused on making a kid smile, rather just figuring out what is wrong with them, treating them and moving on to the next patient. We expect that when we set foot in an ER, a doctor will asses us, treat us with modern medicine and then send us home cured of what ever aliment brought us to the door.

As I stood and waited for the bus to take me back to school today (by waiting I mean pacing, I'm a pacer) I began to think about these comparisons and how I have started to shift my own expectations of what medicine can do for me. I'm palliative, not in the dying sense, but in the sense that there is basically nothing anybody can do that will "fix" me, only make the pain a little less intense. Yet, I still expect that a doctor will be able to "fix" me, on the outside I portray that what I am looking for is a diagnosis and curative treatment. But deep down, I'm not. There isn't a cure, there isn't away to fix the pain I have all night and all day. The only thing I require from medicine now is for it to help me live the best life that I can, for it to help me give everyday %110. 

Looming Medical School Applications

On Christmas eve we had some family friends from the US come for our Christmas dinner (they are originally from Poland, but the used to live in our small town about fifteen years ago). Both of their kids are in medical school (one is in OD school I believe) and they told me that there are a fair number of Canadian students in their class. This gives me hope, because I will be applying to the US (lets face it, I only really have any chance at 3/11 Canadian schools, and that doesn't leave for many options).

It was interesting talking to them about the application process and I was surprised to learn that they both applied to about 30 schools! We don't even have 30 schools in Canada! My plan was to apply to 10 US schools and 6 Canadian schools, which would total to 16 applications. Basically, I will be spending what ever I earn this summer on medical school applications. I also found out that in the US, you might receive offers of admission before the end of October!! Our applications don't even close until October. 

I wouldn't mind going to an American school, it would be better than the Caribbean...I will just be paying student loans until I die....and health insurance might be a bit of an issue for me.

I feel like I am steadily starting to build up my application though, even if I am about a year too late. I was just accepted in a program called PEMRAP - Pediatric Emergency Medicine Research Associates Program. After I go through training all of this month and next month I will be enrolling patients in emergency medicine related studies. I'm pretty excited about it, but it does mean I will be spending 8 hours of every Monday at the Children's Hospital. Good times!

Cycling also going pretty good too, I just spent the last week in Tucson at a provincial team training camp. We rode a lot...and I'm exhausted, but ready for the first day of classes tomorrow. For some reason we start the semester on a Tuesday...but I'm all for it! I spent the entire day yesterday travelling, and I haven't unpacked my bike yet...I hope it still resembles a bike after the whatever trauma United Air inflicted upon it.

Team photo on the last day at Colossal Cave Park

Will they see it?

I feel like I am constantly working my tush off to try an impress people I don't know and likely will never meet. I study as hard as I can for everything, 10% tests get as much attention as a 30% test would because everything counts, there is no room for error. I don't skip a training session for any reason, not for pain and not for school because maybe, just maybe tomorrow will be the day that will mean the difference between 3rd and 4th. I try to balance my family, friends, volunteering and goals with my own sanity, but the scales always seemed to be slanted this way or that.

Is this what the rest of my life will be like? Yes I realize that I am trying to get into medical school in the very near yet distant future, but will it always be like this? Once, or if, I am in medical school I know I will be doing everything possible to match into the residency spot that I want, and then I will be trying to match into the fellowship that I want, and the secure a job, and then publish amazing papers....it doesn't end!!!

Right now, my concern is that my medical school applications won't show how hard I have been working. My first year of university shows a GPA that is less than stellar, but an admission committee won't see that I spent all day everyday in hospitals, clinics, doctor appointments, dressing changes, pharmacy line ups, on buses and trains trying to get to far off specialists to prevent my right leg from being amputated. I didn't go to class because I couldn't, so I stayed up every night until the wee hours of the morning copying out notes from my friends and studying for quizzes, midterms, and exams. I worked harder than I have ever worked before, but my GPA doesn't reflect that, and I wasn't involved in the community because I was completely absorbed with trying to save my leg without sacrificing my life. Will the admission committee see that? My guess is not, and if I talk it about, it will seem like I am making up excuses for my grades or trying to seek pity. 

I have for the past 2 tests in  human physiology gotten 96%, which you might be thinking is impressive, and normally I would also think that, however, my school only puts letter grades on your transcript. In the Faculty of Medicine, and A is 90-96 and an A+ is 97-100. When I apply to UBC school of medicine next year, they will see my A, and translate it to 87%. Which is almost 10% lower than my actual grade, so I might as well study less, put less effort in and get 90%. Or if I study that much harder (which when you have chronic pain, there is a distinct line which you cannot cross because your mind doesn't function after a while) and get 97%, and achieve that A+ (which UBC translates to a 95). The whole grading system makes me angry, I work as hard as I possibly can, and nobody will see that.

Is this the life I am choosing? Work yourself until you bleed and nobody even notices that you are bleeding? I know you will say that they will notice, but I disagree, nobody will see how much I achieved in the face of the challenges I have overcome or am still struggling with. They will see my grades, ones that don't even reflect my actual grades, they will see I had no extra-curricular activities for two years and they will judge me against other students who haven't gone through what I have.

I am choosing a life that is against me in every way.

Medical Monday 1

Hey everybody! So this my first Medical Monday, and it is also my first Monday not being a teenager! Yup, I turned 20 yesterday, so I am officially old. I know a lot of people reading this are probably older than me, but I just joined the club.

Today's Medical Monday is going to be about hands. We can do a lot with our hands, we can make things, we can use them as a musical instrument and among other things, we can use them to comfort somebody. I will never forget the moment when my GP put his hand on my back to help me sit up after an exam a few years ago when I was dealing with a pretty severe illness. It was a simple gesture, but that moment he went from being a doctor to being a friend, from being the person with the prescription pad to being a comforting presence. Its a pretty incredible thing that we can do with our hands.

On Friday, I went to my volunteer shift at the Children's Hospital. For about an hour, I just held this four year old boy (he was about the size of a two year old, and developmentally a year). We read stories, but mostly we just cuddled, and he would smile and giggle. There was an other girl, B, and she has her good days and her bad days. Friday was a bad day and on bad days, B doesn't stop yelling, screaming and crying (she is a non-verbal communicator). The morning was actually going pretty good until music therapy...then it all went down hill. So I took her to the sun-room, where she continued to scream until I started to gently rub her back, and then she stopped. As soon as I removed my had, she would start crying again, so I kept rubbing her back until she fell asleep, and then once she was asleep I wheeled her back to her room as quiet as humanly possible.

People seem to have this notion that medicine is about learning about diseases and treatments, and that patients are their disease. I am even guilty of this thinking and I'm not even in medical school yet, but there is something more to medicine than just that. People say that their doctor is amazing because they not only make correct diagnosis but they actually listen, and don't get me wrong, that definitely adds up to some respect points in my book. I think though, that we easily forget that sometimes all people really need from medicine is a comforting hand.

I encourage you, if you are a doctor, want to be a doctor or have anything remotely do with the lives of people who are ill, terminal or are just having a crappy day to extend your hand to them and bring them a sense of comfort that drugs and other treatments cannot. That is real medicine.