Courtney Collins, G.P.

These are my motivations in life: to understand and appreciate the human spirit; to learn about myself and the world around me; to exist in health and balance; and to be a responsible citizen. I believe they influence all that I do.
- From one of my personal statements, November 2008

That's right. I applied to 36 family practice programs, and 0 pediatrics programs. I had to decide. Here is (the very short version of) what I came up with:

I really love pediatrics (convincing opening, I know), and if I am to be honest, a part of me is sad to be letting it go; however, I have been growing increasingly excited about family practice. I am excited specifically about providing primary care to a diversity of patients - this has become the most important thing for me. I am really looking forward to forming relationships with patients, and being able to advocate for them effectively. I am eager to be able to watch families grow-up and grow old, and I know I will be able to incorporate pediatrics into what I am doing. I am also excited that my career and residency should be flexible in where and how I work.

And now I am sounding too much like those personal letters.

I heard its going to snow here next week. I am pretty excited about that too.

the boss of the world.

Today an appointed representative of the QUEEN prorogued (new word for me) our parliament until January 26, 2009, and I am blogging for the first time since September 15, 2008. To add one more dated fact, this year will be my first since December 1999 that I will not write an exam (or several) on my last day of school before the winter holidays.

But, back to blogging. As with most breaks I have taken - I have been THINKING a great deal about blogging, and my lack of posts are not at all correlated with a lack of goings on. I'm blaming CaRMS (the Canadian Residency Matching Service) mostly. In the last few months, my reflective energies have been sucked dry by my necessary authorship of approximately nine different versions of my "personal statement." These are 500-1500 word essays required by the residency programs in which you are to talk about yourself, career goals, reason for choosing the program, why they should choose you etc.etc.etc. Despite the fact that the politics of writing about yourself as a part of an application makes it a bit of a chore - I don't hate it. I actually found that being forced to really consider my qualities, and motivations and goals, was quite a clarifying process.

Ready for another date? I submitted my 36 applications to family practice residency programs all over Canada on December 1, 2008 - freeing up plenty of writing time and energy. I am determined to use it to keep this page going and prevent it from ending up in the same state as the dozen or so decorated, spiral bound notebooks of my childhood, each with one or two entries outlining how my mom made me eat a piece of ham with fat on it, or I had to practice piano instead of playing road hockey or other important and dramatic events.

I can't promise drama, but I going to aim for consistency.

summer part 2: the best place on earth

“I woke up this morning and it was the last day again. But today I didn’t have to wear “professional clothes”, or write and exam, or ask for references. Rather, today I was required to don my sandals and my sunscreen along with my uniform tee-shirt, my examination was one of my own values, and my referencing was to everything I have learned during this camp session, and during this year...”
-From my journal on the last day of camp - August 2008

Every time I have been to Camp, the campers, staff and environment provide me with a stimulus for personal growth and reflections on life that no other experience in my life has created. It never fails to be a grueling, intoxicating, in-your-face reminder of the positivity of the human spirit, and I predictably gain more from camp than I have ever left behind. This is an amazing and humbling experience. Before I left I had no doubts, nor do I have any now that the exhaustion and exhilaration that camp provides inspires me to be a better friend, colleague and care provider.

I just wish that the whole world could run like camp - where everyone is accepted for who they are and included in whatever capacity they can be. And if you feel like you need to wear a cape one day to feel a little more super – why not! I think I should start carrying one in my hospital bag.

summer part 1: the last day

The fact that I was finished my third year didn’t really dawn on me until about dawn on the day I finished third year. And, I think that was good timing, as along with the realization came a really big wave, a tsunami really, of emotion, and there was no way that I would have been able to accomplish any studying in the state I was in. Mostly it was excitement and relief, but as is usually the case with such challenging and rewarding tasks, the end was accompanied by a potpourri of positive and negative emotions. As I left the house for one more morning ophthalmology clinic, and then one more afternoon exam, I felt like I could burst into tears if I let myself – tears of what? I am not really sure. I went to the clinic (my experience there could actually be symbolic of the year as a whole, but that is another story) and then I wrote the exam. I got to share the moment of being finished with my classmate Maya, who I had also shared the terrifying first moments of the first day of the year with. We were acquaintances in September, but since then had survived Internal Medicine, Psychiatry, Emergency, Orthopedics, Dermatology and Ophthalmology together and are now incredible friends. I dropped off a couple pieces of remaining paperwork I had to hand in. And that was that. I was done.

I rode my bike home from VGH just the same as any other time this year – except for the fact that I felt like there was a marching band parading from my chest to my abdomen. I imagine that what I was feeling just then is similar to what you feel in that time between when you find out that you are pregnant, and when you start telling other people. I wanted to just yell out “I made it! I made it! Waaaahhooooooo!” But I didn’t. And to everyone else I looked the same as I did riding home the day before. I am fairly certain I wasn’t actually glowing. “Just don’t get run-over,” I thought to myself – “what a waste that would be.” But as I think about it now, I am not sure that I wasted too much at all last year, although it didn’t always feel that way. I learned a lot about myself and about life, and I developed many skills and observed many more that I would like to develop. It was a very useful year.

Kyle was very congratulatory, but it was actually quite challenging for the two of us – who are usually very in sync. While I was getting ready to finish my year and start my vacation at camp, Kyle still had two weeks of Obs/Gyn left – which included a few call shifts with no sleep, an oral exam and a written board exam. With two weeks left in the year for everyone else, there was no party or gathering, and I was left with time to myself to try to identify the whirl of thoughts and emotions in my head.

The feeling that predominated the most was that of accomplishment. There were times in the year, especially at the beginning, when I didn’t know how I was possibly going to make it. But I did – and I was proud of myself for all the sweat and tears it took. I also felt that not only had I survived, but I had learned and more importantly I had grown. I do (thank goodness) know more about prevention, diagnosis, and treatment of disease. This is a good thing. I am also more confident because of this knowledge, but also in my ability to learn things, and my potential to impact the people that I work with (patients and colleagues). I realize that I have strengths – I am good at procedures that require composure and dexterity, I am good at working as a member of a team, I am a good listener, people appreciate my practical thinking and my down to earth style of interacting with patients. I have weaknesses – I don’t know all the details of pathological processes, nor am I that motivated to learn them a lot of the time, I am bad at remembering antibiotics, I second-guess my knowledge too often, I allow my mood/ sense of success to be swayed too much by what other people think/say, I function best with a decent sleep. There are things I like – kids, taking care of patients, multi-disciplinary teams, procedures, variety, flexibility. There are things I am not so fond of – internal medicine, not being able to follow-up with patients, respiratory secretions, academic minutiae, discharge summaries, lack of ownership for one’s own health. I am braver and tougher physically and emotionally. I feel lucky that I get to meet people from every walk of life. I am in a positive place. I am eager to learn more.

what i did on my summer vacation. intro

from the Merritt dock, Christina Lake, BC
photo by Kyle

written August 25, 2008.
It is mid-morning, and I am sitting on a couch over looking the water of Christina Lake. The weekend cottagers have gone home, and the lake is quiet – no boats out yet. The cabin is also quiet – everyone is up, but snoozing or reading, talking in whispers and gingerly making tea as if we don’t want to wake up the day. I like that – trying to sneak-up on the beginning of the day. I am realizing that it has been maybe five weeks since I have written anything. It is the first time that I have really been in front of a computer screen for any length of time in almost as long. I semi-finished my third year just over four weeks ago (I still had two weeks of elective time left, but it was spent at camp) and since then I have been to the Okanagan for a week at camp, to Clayoquot Sound for a 5 day kayaking trip, and to the Kootneys for ten, soon to be eleven days of time at Christina Lake/Castlegar with a variety of Kyle’s immediate/extended family and friends. I have had many the adventure, sleeping arrangement, reflection, interaction. Almost all of my time has been outside – in all kinds of weather, and I can count the number of showers I have had in the whole time on my fingers – and I can probably do the same with the number of days I have had access to a flushing toilet. I am feeling positive. I haven’t thought of the hospital or a patient in weeks. For the most part, my time has been low stress, save for the barrage of wedding questions, and the fact that in order to sanely accomplish what we need to in our time off, we needed to be back in Vancouver yesterday instead of tomorrow. On the list of things to do is clean and pack the apartment for the sub-letter, find a place to live in Duncan and Mayne Island for October, organize paperwork for school, buy a car, attend a wedding (after finding something to wear) and, spend some time with my own family before leaving town for another two months. Alas, our departure back home at 5:00am tomorrow morning, along with the return to high-paced-stress-filled-flushing-toilet reality of life will come soon enough. For now, I can still get away with sipping tea and writing about what I did on my summer vacation.

spoons work best for soup.

I am in Halifax! In the last 5 weeks I have spent a total of about 7 days in Vancouver. Most of them spent doing laundry and running (literally) errands to get ready for the next time away from home. Reasonably, I went to camp in the Okanagan, sea kayaked in Clayoquot Sound, spent an extended period of time in the Kootneys, booked a wedding, tried to buy a car, and traveled across the country.

And now Halifax is going to be my home for the next 4 weeks! I will we working in the local hospitals here, doing two weeks of pediatric palliative care and two weeks of pediatric radiology...and eating lots of seafood. So far the general public as lived up to their reputation of being extremely friendly, while the restaurant workers have...not.

Today we plan to do a little exploring around the city, and tomorrow I start the next round of first days.

nematode delivery.

On the phone earlier today:

Mom: Oh, hang on a sec, I have to check the other line in case it is the lady from Grouse Mountain calling me back.
Me: Okay.
-flash-
Mom: Hello.
Me: Was it the Grouse Mountain Lady?
Mom: Nope, my nematodes are in. They wanted to let me know.

Today when I left the Eye Care Centre, I noticed smoke coming out of the little garden at the entrance. Kind of weird. Is it really smoke? Is it just steam? It does smell suspiciously like camp fire out here, but no one seems to worked up. Upon closer investigation, it became apparent that there was indeed smoke. There was smoke because the bark mulch was smoldering, and the bark mulch was smoldering (my detective self thinks) because of the smoldering cigarette butt lying in the middle of it.

There was no one left at the receptionist station inside, so instead of being able to go back in and mention that someone might want to do something about the fact that the garden was on fire, I had to take matters into my own hands, and douse the blaze with not one, but TWO Nalgene bottles of water. The drama. I know, I know - with keen awareness and safety know-how like that - I just might find myself in the 'more-than-just-a-pretty-face' club.

And, if the rhododendron on Willow and 10th grows ovaries, we'll know this BPA stuff is for real.

joy!

Eight more sleeps until I AM GOING TO CAMP!

I had to fill out an online application for my volunteer position. One of the questions asked what brought me joy. Here is my list (in progress).


My family. My Kyle. My friends. My patients. Interacting in general. Sunny mornings. Fresh air. Running in the rain. Learning. Being with children. Swedish Berries. Tea. Snail mail. Quiet Time. Working with a team. Growing stuff. Hugs…

ninth and tenth first days - prologue.

My most recent two rotations (orthopedics and anesthesiology) were back at Royal Columbian Hospital. I hadn't had any work at RCH since my Internal Medicine Rotation, which was the very first rotation of my entire year and seemed like a long, long time ago even though less than one year had passed.

Returning to the to the same skytrain stop, same uphill walk, same locker, same smells of RCH provided a strong reminder of my first, first day, and how strikingly different it was, and I found myself reflecting on how much had happened between then and my ninth first day of the year. I have learned SO MUCH since then - about medicine, and myself, and the combination of these things. That first morning in September was one of the most anxiety-filled times of maybe my whole life - I had absolutely no idea what to expect, what my role would be, how to talk to patients, how the hospital worked, how to read a chart, or find a lab value or how to find anything for that matter. Perhaps most significantly, I had no idea why I even wanted to be doing this whole medicine thing in the first place - and whether I would make it through to even my second first day. It seems dramatic to say that now, but I don't think I am embellishing the fact that I was lost in more ways than one.

Fast forward ten months, six rotations, seven hospitals, and many a call shift, break-down and break through. I am now a pro at first days. I found the place and the person, asked the right questions to get the right information. I knew how to find the OR, and how the get scrubs, and the difference between the blue things for your shoes and the ones for your head. I knew how to find the slate (and what it was), and what room I should go to, how to introduce myself to the nurses, and what gloves size I was. I didn't know how to find the surgeon I was working with - but I knew how to figure that out, and how to answer questions, and how not to cry (on the outside or even the inside) when I felt stupid - which was inevitable. I could 'scrub in' and even suture if someone asked me. I got asked to do a consult - and I knew what that meant too! I knew how to find out where the patient was and how to find out where their chart was, and what to ask, and what my staff would ask me, and how to talk to the ER doc that saw them.

I also knew that even though I didn't want to be an orthopedic surgeon, that I would still learn very useful things by participating fully in my rotation, I knew I enjoy meeting patients, and trying to make them as comfortable as possible. I knew that I love the operating room, but not enough to spend my life there, and, I knew that even if my ninth first day was disasterous, I would survive, and then there would be a tenth first day... and then hundreds more.

Lastly, I knew that I am going to enjoy a career in medicine. Good.

just do it.

It's been awhile (again) and lots has happened (again) - updates are to follow. The first update gets its own post.

Kyle and I are getting married!

In our usual style, our decision resulted from many in-depth, analytical, lengthy, honest and wonderful dialogues, and became official when we shared the news with our families last weekend. No romantic proposal or engagement ring (you know me) just plans for a celebration next April/May/June. I am excited, and certain and contented.

My conversations with my mom for the last week and a half have mostly consisted of her trying to get me to articulate what kind of space we envision, and how many people... and what kind of food, and WHAT DAY; and me trying to convince her that wearing flip-flops with a wedding dress is entirely legitimate (as long as they are white of course). I think we are going to be an effective planning team. But seriously, I am lucky that she is willing to put a bunch of time into researching for two very picky and relatively indecisive lovers.

Oh, and I'm not pregnant - that seems to be high on the the FAQs.

wanted: j. vanderploof

I am thinking of going to camp for my elective.

It doesn't have to be clinical, it just has to help us to become better physicians. I will have no problem making that case - it just feels so irresponsible...and exciting.

ohhhhh dilemma.

five more minutes.

My name is Courtney, and I am a studyholic. I had been on top of my habit for four years until yesterday (June 16, 2008).

I had a "study day" for my first day of orthopedics after a 3-day weekend, and it was sunny, and my first day in a few that I wasn't either coughing or blowing my nose steadily - so my mood was high, and I was feeling eager. These internal factors in combination with a chewable amount of information to know and a plan of how to go about knowing it (a finite list of 75 cases on which our exam is based) - made me want to study - and not stop. This has happened to me before. My thought process will go something like, "Today I should try to get through 8 cases - if I do that each day I should be through them all by the middle of next week. Oh, but what if I do 10 or 11 today - then I could get ahead of schedule..." at the end of case 4 I have to pee, " I really need to pee - I should go at the end of this next case" - next case - "oh I should just look at the topic for the next one, maybe I should take it with me (to pee? it takes less than one minute...) oh - well I have already read half of it, so I might as well just finish this next one, and then pee..." and so on and so forth. Then I start wishing that my study time could be extended - if only I didn't have to have stimulating and rewarding interactions with real people. Maybe I will have time for a few cases during the break in my day tommorrow? And then I start reminding myself that my recently relaxed approach to studying has been more than sufficient, and much more enjoyable, and I should not fall into the medical school/career trap of trying to know everything.

Sometimes it is hard work not to work so hard.

eighth first day

Over the course of the year I have found increasing comfort in my chosen route to be a medical doctor - of some sort. What I appreciate the most is the patients and their stories and the privilege I have, of knowing them for however short the while.

Here is one of my recent favourites:

The other evening I picked up a chart in the ER. The triage form read "lower extremity injury: mild-moderate pain +/- deformity" - so far pretty standard for the area of emergency I was working in. A quick glance at the patient information informed me that this was a 78 year-old male, which made me worried about a fall...and a hip. My next step, before I see the patient is to glance at the nurses notes, for the vitals signs - stable, and any history they might have taken during their assessment. This went something along the lines of: Was pushing car in reverse when he was knocked down by the car door and run over by the front tire. No loss of consciousness...Now, the fact that this person had been triaged to the Treatment side of emergency meant that he was pretty stable - but run-over at 78? I need to see this man right now!

I went to see him and verify his story, and sure enough, he was unable to get out of his alley because of a construction crew, and so when he put his car in reverse, and it wouldn't work, he thought that he would just get out and give it a little help. Well, then the care started to roll a little but faster than he could push, and it was getting away from him. With real concern for the neighbors fences, he thought that he had better try to jump in the car and hit the brakes - there is no way that this could turn out badly - right? He managed to get one leg in the car, but then he got knocked over. As he saw that the car was still rolling, and about to roll over him, he managed to get out of the way - almost. The front wheel still went over is arm and leg. Then the car continued down the alley and was stopped (gently it seems) by a telephone poll. He was fine apparently. Reluctant to let the construction workers call 9-1-1 - and then when they arrived, he arranged for them to follow him back up to his house, as he drove the car back (couldn't leave it at the end of the alley of course).

Turned out he was fine, other than some scrapes and bruises. All of his 78-year old bones were intact. The only thing left to fix was that reverse.

may flowers.

Lots has happened (well, a month's worth) since I last posted. I feel like a need to update before posting about anything specific.

Since the last time I posted...

I passed Obstetrics and Gynecology.
I had my last day of my Psychiatry rotation, which included writing the last of my board exams for this year, and
I had the first day of my Emergency rotation.

Shannon came to visit with her tiny little Kieran, who over the 4 weeks they were here, became significantly less tiny.


Chelsea had a baby girl who came out the same size as 3 month old Kieran. Here she is in some hand-hooked items.

Kyle had a birthday, and we hosted a party at the Vine! A real party with a keg and everything. Everyone (including me) was impressed with how many people we had comfortable in our little space. I got Kyle a slackline for his birthday, which has been put to good use during our occasionally sunny Vancouver weather. Including on Sunday, when I launched myself literally face first into the sand. Lucky for me it was sand or it could have been a lot worse than the whiplash feeling I have had for the last two days.
We went to the cabin for an absolutely fantastic May long weekend getaway. The weather was beautiful, as was the company, and quiet fresh air. The only hassle of the weekend was arranging the rental car, which has sparked the first serious discussion about household vehicle acquisition.
Brittney got a job working for Vancouver 2010, and Alex is featured in Women's Health Magazine this month. I decided that I was going to be a rural family doctor...or a pediatrician...no, a family doctor...definitely a pediatrician...except maybe a family doctor... I feel such relief having that all worked out.

human powered.

Tuesday morning, the brilliant sunshine, and the fact that it was Earth Day helped me to decide to ride my bike to West Vancouver for the first time. I left super early in case I got lost or run over on the way, and ended up arriving at my approximate destination with about 45 minutes to spare. I used it to sit on the beach, eat my peanut butter sandwich, and stare at the water. I'm lucky.

seventh first day.

It's been  little while (both since I posted, and since I have had to say that). Probably, mostly because there hasn't been any big happenings in my world recently. That is always the way isn't it? We always want to tell everyone about things that are stressing us out, but we don't feel the same urge to announce that, in fact, we are feeling pretty good. That's why my blog is so boring really...my life is not very drama-full. And, I suppose, because if there ever is drama, I am reluctant to write about it on the internet. If you are going to be an interesting blogger you need to be willing to put confidentiality and the integrity of your personal relationships behind you for the reading enjoyment of your fans really. Since my fans consist mostly (ok, entirely) of my personal relations...you know.

But anyway, I finished obs/gyn, and started psychiatry. My first day was two weeks ago, but all my days have been so uneventful so far. I have done lots of waiting around, and when I am not, I have a mix between extremely interesting and extremely boring moments. Only a few observations so far: (1) sometimes when I leave for the day, I am feeling a little crazy myself - it is hard to spend so much time around people with such altered realities (2) I really feel like psychiatry has the most hopeless patients, which is hard to handle. I don't mean that the patients feel hopeless, although there is also that, but rather that the medical profession has kind of given up on making some of them functional  - maybe because it's impossible? and resigned to the fact that they will be chronic patients for as long as they live. From my perspective, in its severe presentations, mental illness can be the worst kind (3) to make a general comment, psychiatrists are quirky folk.  I'm still trying to figure out if that is what makes them attracted to psych, or if psych makes them this way. Maybe I should do a study.

i agree.

I rode past another display of flowers a different day a little while ago. The letters are all made from the same yellow flowers that were in the pots underneath. And, it was indeed a pretty darn super fun thing to have in the middle of the city. I checked out the website (www.superfunthing.blogspot.com) which led me to another website (www.learningtoloveyoumore.com).

Yes for positive energy, that's what I think.

the first little signs.

I have been meaning to post about these amazing flowers that I saw on my ride to work a couple of weeks ago. I have been riding the same route to BC Women's Hospital pretty much everyday, and I hadn't noticed anything different, and then one morning - wabalammo - there are like three-thousand purple and white crocuses covering the front grass of this corner house I ride by. Even though it was still very chilly, I felt cheerful and hopeful knowing the spring was on it's way. The rest of my ride was filled with fond memories of Nannie, who loves crocuses, and used to describe them always as, "the first sign of spring."

Somehow all these crocuses came up in a conversation I was having with Britt - who told me that crocuses always remind her of Nannie, and "the first sign of spring" before I had mentioned my own connection between the two. It's fun how we independently share the same wonderful memory of our Nannie.

sixth first day

My first day of Obstetrics was actually my tenth first day if I count all my sub-rotations. In fact, life in third year is kind of like one big perpetual, first day, because even within one rotation, you go to so many different clinics, and operating rooms, and hospitals where you are always working with different people. You are always showing up at the wrong time (usually too early) and trying to figure out where you should put your stuff, and what stuff they want you to be carrying, and if you are wearing the right kind of clothes, and if you are supposed to read the chart only, read the chart and see the patient on your own, or just follow the doctor around doing your best not to slow them down. Often, you are surprising the professional that you are supposed to be working with, as they come in to work in the morning, or back from lunch. And, always you start with, "Hi there, are you Dr. (fill in name on schedule)? I am Courtney Collins, the third year (fill in rotation) MSI. I am scheduled to work with you (fill in amount of time on schedule)".

Last Friday, when I met the surgeon that I was going to be working, I started with the usual - "Hi, Are you Dr. F? I am Courtney Collins one of the third year... ...um...ah...errr..." I couldn't remember the word for the type of medicine I was rotating through (which was Gynecology) all I could think of was the word "uterus" which was not going to work in the sentence I had already started to contruct - "...medical students" I finished. "That went really well - good first impression Courtney. I am sure this doctor who you have just dazzled with your confidence is going to be really eager to let you do way more than simply hold retractors today" I thought. But it turned out that she was extremely nice to me all day, and even let me open the abdomen for the third case. That meant I got to use the scalpel and the caudery, which made me very excited.

Back to my first all shift of Obstetrics though. I had to laugh at myself Wednesday morning as I was using a very awkward and flimsy hook made of two wire coat hangers straightened and twisted together to try and retrieve my bike clothes from the shaft of nothing that I had dropped them into earlier that morning. I found the wire-retriever-thingy already assembled which comforted me with the thought that I wasn't the first person to do this. As I mentioned previously, it is always a challenge to figure out where the best place to leave your stuff is. Usually, when you have to change into scrubs, you end up stashing your clothes on the very dusty tops of the lockers that are assigned to more permanent people. That's what I did Wednesday morning, and then, the instant that I let them go, I realized that I hadn't set them on anything, and 0.5 seconds later I heard them hit the floor. There were two row of lockers (one on each wall) that met in the corner of the room, except they actually met just before the corner of the room, leaving a space, as high as a full length locker, for me to drop my clothes into. Sigh. I got them out though. Thank goodness for the wire-retriever-thingy.

kits lifestyle.

The alternative title for this post is, "Are you kidding me? C'mon, for serious. Stop yanking my chain - I know you must be joking because what you just said is ridiculous talk."

When I got home on Tuesday night there was a notice from the strata that had been slipped under the door. It was advising residents that any vehicles left in the underground parkade after 8:30am today were done so at the owner's risk, as a company was coming to power wash the floor. WHAT? The building has only been open for 4 months - only like 25% of the units even have people living in them. WHAT COULD POSSIBLY BE ON THE FLOOR? There are approximately eleven cars parked in that thing.

This morning when I left I was skeptical, and then this afternoon when I got home...I was still skeptical. In fact, I totally forgot until I had walked across our apparently sparkling clean parkade and back up to the apartment where I saw the flyer again.

Maybe I am ignorant to something. I hope someone enlightens me.

rights and prerogatives.

Early in your clerkship (the first day of orientation) they tell you to 'be nice' to nurses (good thing, because, naturally, I was planning on being downright nasty) because they have the power to be very unkind back to you as a wee little medical student (paging you all night, ignoring the fact that you exist, unnecessarily making you inspect various bodily fluids).

What they don't tell you, but everyone else does is that you need to be particularly wary of OR nurses and labour and delivery nurses, which is tricky, because you often have the least opportunity to 'be nice' to them...meaning, apparently, that if they treat you nicely it is entirely of their own prerogative .

I just wanted to announce that both these populations of powerful nurses have been extremely nice to me, despite the fact my charming smile is hidden under a surgical mask when I meet them. I really appreciate it.

spring forward.

Come head on, full circle
Our arms fill with miracles
Play hearts, kid, they work well
Like classics play aces
Stay with me, go places
Once more for the ages
- The New Pornographers, Go Places

I am feeling recharged. It's amazing how different time can feel when you are not studying.

This weekend I could have (should have) been studying obstetrics and gynecology, but I found my other-than-studying to do list quite long as well, and decided to focus on the latter. And I did it! I completed every item but one...oh, two actually I am just remembering. Shoot.

Anyway, apart from some frustrations with elective applications on Saturday morning, I had a glorious weekend - one that made me feel lucky, very lucky to be me. I filled out elective applications, crocheted a toque and booties set for Shannon's new little tiny Kieran. Made a series of easter/spring cards, and wrote and addressed all of them, had a delightful dinner (at Vij's) and movie (Michael Clayton) with Kyle, finished my book, had good sleeps, had lunch with my aunt, uncle and cousins, made cookies, had dinner with my Dad, talked to Mom on the phone, paid some bills, cleaned the bathroom, got to the bottom of the laundry bin AND enjoyed one more hour of daylight this evening. Also, I did some thinking, and it was positive.

Kyle left for a two week elective in Nelson this morning, so I am going to be a little lonely for a while. I plan to make up for it by leaving my yarn all over the living room, and my stationary all over the flex room floor. It won't make up for snuggles, but I have to try something.

Onward and upward my friends.

fifth first day

Last week I finished my pediatrics rotation. The first four weeks was spent on the medical ward at Children’s Hospital, and the last four at various outpatient clinics. The whole thing was my favourite.

As I wrote to my dear friend Fiona just after I finished the in-patient portion, my experience in pediatrics was my most challenging, exhausting, rewarding, emotional experience in medicine so far, and it is left me oh so confused about what I am going to do with the rest of my life. I really feel like it was close to the first time in my medical experiences that my heart and soul was interested in my work, and not just my brain. I loved the kids (obviously), but I also loved the challenge of working with their families, and all the social issues that accompany their little units (often far more important and substantial than the medical issues). I realized part way through that I actually LOVED all my patients and their families, not just "loved" working with them, but emotionally attached to them - which was incredibly exhausting, but ultimately made the work even more worthwhile.

On top of that, the medicine is more interesting because it is often the first presentation of symptoms, and you have to actually think about making a diagnosis, instead of adult medicine in which you are managing diagnoses that have been made 30-40 years ago. (Kyle and another classmate liken it to rearranging deck chairs on the titanic).

I had some of my happiest and saddest moments of the year so far. My fifth first day brought with it one that will stay with me forever. I met a lovely 12 year old girl who was doing very well despite the fact that her kidneys had stopped working. In the afternoon we talked about playing the piano, and in the early hours of the next morning I held her unconscious head, while, as we found out later, her brain was filling up with blood. She never regained consciousness, and eventually died from her massive brain injuries. I was OK that day until I got home, where I became a bawling mess of questions that don't have answers. I met lots amazing patients and families, and foster families, and friendship families who I will think about in the future. And, I was involved in lots of stories with happy little endings (and cute ones too). I also met many very good, very dedicated professionals.

All have left me with some big thinking to do.

almost

I am at home right now for a few moments. This morning I performed the OSCE (objective standardized clinical examination) for my pediatrics rotation, and in a couple hours I will be writing the NMBE (National Medical Board Exam). And then, as of 4:30 this afternoon, I will be half-way through my clerkship. I am getting pretty excited that I only have to contain my excitement for another 5 hours. It's ok if you can't contain yours, I'll understand.

rollercoaster! (of love).

1. I love children so much that I want to work to include working with them and their families for the rest of my life.

2. I love children so much that I also would like to have a few of my own, and have time and energy to spend with them for the rest of my life.

I am having a considerable amount of trouble reconciling these two facts. There are, of course, a few other contributing factors. For example: I love sleep so much that I would like to include some of that in the rest of my life as well.

More to follow.

festivity and recreation.

"This is not a gong show...a gong show is a thing where things aren't organized."
- my Mom, Holidays 2007

Ahh the holidays.

I am always excited for some time off of school/work to sleep/read/craft/socialize guilt free, and this year was certainly no exception.

Kyle had to head back to Castlegar the day after I finished surgery, which was a bit of a bummer, but Alex and Mom were back from the big apple, and it was so very nice to have them close by (ie. under the same roof) again.

As usual, the time flew by, taking with it dreams of finishing 8 novels and 14 crochet projects. I didn't mind though, instead I had wonderful visits with family and friends, and I realized that looking forward to 'accomplishing' all those other projects is as important to my mental health than actually executing them. My family even emerged from the 07/08 holidays relatively free from major disasters, and for that I am extremely grateful.

After Christmas the task at hand became getting The Vine ready for living in. Blah blah home depot blah blah IKEA blah blah closet organizers. Kyle and I rang in the new year moving the last of our loads from Burnaby to Vancouver, and we are actually now relatively set-up, minus living room furniture (which turns out to be a handy situation for storing stuff until we acquire a few more shelves). It is absolutely fantastic to be back in the city, closer to the hospitals, yes, and also closer to the essential-to-survival friends we know and love.

present.

I am still existing.

Those who know me well know that I often tend to think more thoughts than I actually verbalize. I have operated like this as long as I can remember. Sometimes its a good thing, as I can analyze and reflect, and sort things out independently, without having to jabber on to someone else who may or may not be interested in what I have to say. Sometimes it earns me a, "poor communicator. " And, other times it frustrates me because I find myself unable to articulate the volume or complexity of thoughts in my noggin. (Ironically, as I type I can't remember if I have blogged about this before, or just thought about it).

Anywhoo, the above paragraph is my long-winded way of saying that since my last post, I have thought lots, and typed little. Tonight I will start my effort to get caught up.

Between my last post and Christmas time, I finished my surgery rotation, which made me 1/3 of the way through clerkship, and 2/3 of the way through "the big three" rotations. I continued to love surgery more and more. I enjoy the precision and problem solving - it's like arts and crafts with the human body. Also, I really loved the guts for some reason that I hope doesn't mean I am totally weird. Simultaneously I confirmed that I could never be a surgeon. I can't make work my undisputed first priority for the rest of my career. It's too bad really.

I was tired, and proud, and relieved to have made it to my holiday break. I remember my first days in September when I didn't know how I was going to survive that long, but knew somehow I would. I did. Yesssss.

Entries left to catch up:
festivity and recreation.
2007 (the year).
fifth first day.

goodnight.