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. 

Future MDs are Pretty Cool

I started medical school on August 25th, 2014.

Well, that was a weird sentence I honestly thought I would never to get to write. It all still seems like a a dream and that eventually I will wake up, and go back to just be regular old me. But I keep waking up in a room that feels foreign in a city I hardly know.

So far, the only medical school related things I have done were a part of Orientation Week. So these are the following things I have learned so far in medical school:
1. Med students seem to have an endless ability to party
2. As a whole, med students have an above average liquor tolerance
3. Med students are still above average humans when hungover, and surprisingly good at playing quiddich.
4. I feel like every single member of my class (there are only 64 of us...) have amazing talents, incredible life stories and are overall just amazing people that I am excited to spend the next four years of my life getting to know and learning from.
5. Upper Year Med students are kinda crazy.
6. Amazon Prime for students is officially the best way to buy text books in the history of man.
7. Medical schools feed you a lot...and I have decided that they do this to make you too full to ever try to run away.
8. Med School swag is awesome.
9. Getting dressed in the morning and trying to decide if what you are wearing is "Casual," "Business Casual," or "Smart Casual," and which kind of cloths belongs to which category, and whether or not adding a scarf to your outfit makes you "Smart Casual" or "Business Casual," essentially leads to a morning crisis everyday.

This is Smart Casual...

Can somebody please point out  the difference???

   

And this is Business Casual...

10. I'm like the only single person in my class...

Check back in the future to see if I have actually learned anything about medicine!!

The Doctor Shortage

Finding a Family Doctor in Canada is tough. I have never really had to try that hard to find one, until now that is. Growing up, my Dad always had some sort of business relationship with every doctor in the vicinity, so we never had problems finding one. But then I left the nest at 15, and it was challenging, but my school had a doctor (although, not the best) who I could see before school or in the evenings. Then I went to University, and I had the University Clinic, and then when I changed schools, and a clinic 300m from my house had just hired a new doctor. So far, things have worked out for me, which is really great because you know, the whole chronic pain thing tends to require doctoring.

But, now that I am going to school in a "northern" community, and in Canada north = nobody wants to live in places that are freezing cold. So naturally, well educated people who can practice anywhere in the country, don't generally choose northern or rural communities. (Hence the formation of my school...). But, in any event, I am having a lot of trouble finding a doctor, especially because I am an out of province student. Being out of province shouldn't matter, given the whole Canada Health Act thingy, but it seems to pose barriers to accessing health care for me in Ontario (another problem to add to problems with the health system/health practices notebook I have been keeping since the 11th grade).

So in conclusion, the doctor shortage is really affecting me. And to add to another problem, because the community I am studying in only has a population of 110,000, pretty much all of the doctors in the City will be my professors and instructors in the very immediate future.

It is very strange all of a sudden switching from just being the patient, to being the provider (a very green and IdontKnowAnythingAtAll provider), but still being the patient at the same time. I feel like I am stuck in the middle!!!!

I never thought about my situation as being both a patient and a physician at the same time, and it is stressing me out. 

A Tuition Slap in the Face

Why is that medical schools expect students to say "how high" when they ask you to "jump?"

We got sent our tuition cost August 1st (we only had estimates before then), and were told it was due on August 15th...There were no mention of due dates before this.

I thought that after you got into medical school, they would stop throwing unreasonable curve balls at you and expecting you to catch them with your eyes closed. I was clearly wrong on that one.

I don't know about you, but I don't have $21,300 just chillin' in my bank account at all times. I have enough for the year, but not currently in bank account. And I can't access the majority of it until August 12th plus 2-3days for fund transferring...sweet!

And to finish off the email, they said "We hope you have a relaxing and enjoyable long weekend!"....yeah, thanks, I will have a great time trying to figure out how to rob a bank.