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.

Goals for 2014

Here we go, the cliche post that all bloggers do every year.

10 things I hope to accomplish in 2014 (in order of priority):

1. Learn more about Buddhism and start practicing more mindful living
2. Go with the flow - what ever happens after graduation will happen and it will be awesome
3. Swim across the Strait of Georgia (more on that later, its a legit thing, stay tuned for more info)
4. Spend less time on facebook
5. Complete my 4th year with a 4.0 (so far so good)
6. Focus less on what I need to do to get into med school and just enjoy being 21.
7. Dance more
8. Eat salad for dinner at least once a weak
9. Bake something at least once a month and share it with others
10. Eat less sugar

Just swimming a long in a glacier fed lake in the Canadian wilderness

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.

The Wounded Healer

I am taking a class called "Psychosocial Oncology" and today's lecture was about palliative care. The two instructors giving the lecture were what most people would consider in medicine to have opposing jobs. One had a doctorate and was a member of the spiritual care team, the other was a physician and the director of the acute-intensive palliative care unit. Together, they helped me to redefine my notions of adult palliative care, and I was astounded by their abilities to interconnect their roles. Needless to say, I learned a lot about the process of dying, both from a medical perspective and spiritual one. 

5 things I learned today about dying:
1. 93% of palliative care patients ranked maintaining a sense of humour to the end as one of the most important things
2. 0.5% of people in Oregon choose physician assisted suicide despite it being a readily available option
3. Palliative Care physicians are often more influential and important in the life of a person who is dying than any of their "active treatment" physicians
4. Palliative Care medicine actually involves a lot of "real medicine," its not just about pain control
5. Most people who are dying have little desire to confess their sins or wrongdoings  at the end, people do not consider them to be important to them any more.


When we were discussing the importance of physicians and members of the palliative care team to let down their barriers, show their emotions and connect with patients, this quote was on the slide:

"The doctor is effective only when he himself is affected. Only the wounded physician heals." - Carl Jung

I'm not sure how I have made it almost 21 years now with out ever seeing this quote from Carl Jung. I have been beginning to doubt whether or not I can make other well if I am not entirely free of illness myself. But I now feel again that strong sense of purpose, and what I guess you could label as "my calling" to medicine. I don't believe that everything happens for a reason, but I am grateful that this quote was on the slide today, it was exactly what I needed. Perhaps me being in pain, will allow me to heal somebody that others cannot. 

I will someday be a Wounder Healer.

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.)