Wednesday, May 30, 2012

Homeward Bound

Thanks to one very large box and lots of packing tape, I've somehow managed to find space for all of my newly acquired souvenirs*.  I'm now left with just an hour and a half until my cab arrives and I start my trip back home.  Home!  Where my cats and my friends and my family and my kitchen (oh, my kitchen!) and my tree-shaded running trails await me.

Although I am admittedly eager to get home, it's been a good month here.  From a career perspective, I've met with a lot of key people, made (presumably) a good impression, and been offered a reference letter for the upcoming fellowship applications**.  My knowledge of what a career as an oncologist entails has grown substantially, putting me in a much better position to make that dreaded oncology vs hepatology vs unemployed couch surfer career decision.  And I've enjoyed the region, from exploring the nearby park to visiting Niagara-On-The-Lake to hiking in the Bruce Peninsula (post to come).

Of everything that's come out of the past month, I think two things are most important.  First is some level of excitement about possibly moving away next year.  A huge part of me has been dreading the thought of leaving my city, as I've been focused on all of the beloved things and people that I'd be leaving behind.  Being here and being exposed to different work and recreational opportunities has reminded me that there's also a huge gain to living somewhere else.  And I'm still young and independent enough that perhaps I should be striving for the exciting life experience of moving away, rather than trying to dig my roots deeper and more permanently into my home town.

Even more importantly, I've come to appreciate that the options that are open to me right now are really, really good.  I'm not stuck in a position of choosing between two crappy alternatives, but rather between two careers that would both be satisfying in their own way.  I love the patients in oncology, love being the go-to person for patients during times of great need, and I could see myself being satisfied in that role for many years.  Regardless of which career I end up choosing, it's encouraging to know that I'm picking between two good options, rather than trying to identify the lesser of two evils.  It's something for me to remember during my pissy moments when I'm lamenting how difficult it is to arrange electives or how hard a decision it is to make.

*  Mostly wine.  And some maple syrup and maple syrup-derived food stuffs. 
**  A major prize in the game of medicine.

Monday, May 28, 2012

Long Weekend Travels - Part Two

I am quickly approaching the end of my away elective, and I've accumulated a large number of photos I want to share, so I thought I'd finish up my story of the Victoria Day Long Weekend instead of going for a run in the miserable heat.  (I miss home where the temperature is less than 30 C and the humidity is measured using only two digits.)

Starting from where I left off, after arriving back at the bed and breakfast from the vineyard tour on Sunday evening, I decided to make an evening trip to Niagara Falls so as to leave more time on Monday for other things.  It was a wise decision indeed, as making my way through the traffic/finding parking/walking to the falls from my distant parking spot took much longer than I had anticipated.  While the falls themselves are spectacular and absolutely worth seeing, the city of Niagara Falls is a horrible place for anyone like me who hates crowds and chaos.  Cars, children, street vendors, tacky souvenirs - all of the things that I abhor about tourist traps.

But these were pretty (recycled photo from previous post, as all of my Niagara Falls pics look exactly the same):


These were pretty too (American falls):


It is really impossible to grasp the enormity of the falls from still pictures.  Standing at the mouth of the falls, virtually all you can hear is the sound of the water cascading over the side.  I experienced a bit of panic just looking at it.



I found the following sign kinda funny, because really - do people need to be told not to climb over the railing at Niagara Falls?


Of course, the very next day someone tried to commit suicide by jumping over the side...

Anyway...on to happier thoughts.  My visit to Niagara Falls marked the end of a long day, and I was very happy to make my way through the traffic back to the bed and breakfast to sleep.  The next morning, I had my second lovely breakfast that I didn't have to make for myself, and then I headed out to explore Niagara-On-The-Lake.  It's a really beautiful village filled with historical homes and beautiful gardens, but for some reason I went shopping instead of photographing much of it.  Here are some of the few pics I did take.



One place where I did take a lot of pictures was the Apothecary Museum, which was my last stop in Niagara-On-The-Lake.  The descriptions were not nearly as informative or well-developed as those at the New Orleans Pharmacy Museum, but the displays were interesting enough to make it worthwhile










After the museum tour, I headed back to my home base, stopping on the way to visit an old friend whom I hadn't seen in eleven years.  She has two adorable kids, one of whom (the five-year-old) was very suspicious of the strange person in her house, and the other of whom (the two-year-old) fell in love with me after only a few minutes of playing with Play-Doh with her.  Apparently for days afterwards she kept asking "Momma?  When is that girly friend of yours going to come play with me again?"

It was a lovely, lovely weekend.

Sunday, May 27, 2012

Room for One

In re-reading my previous post, I realize that it was a bit harsh, and I really hope that I didn't offend anyone with it.  It was my late-night attempt to purge some unhappy thoughts from my mind so that I could fall asleep, rather than stare at the ceiling reliving a day of sad brain tumour cases.  It was really not intended to be disrespectful of anyone else's beliefs, no matter how different from my own they may be.

Now that that's out of the way, it brings me to my current situation, which is nestled into a cheap motel in the Georgian Bay, anticipating a day filled with steep cliffs and falling water.  As I've been traveling these last few weeks, I've noticed once again that I seem to be the only person around who is traveling by herself.  The only person renting a hotel room solo, the only person sitting alone in restaurants, the only person hiking trails alone while hoping not to get eaten by a bear/attacked by a rapist/hopelessly lost a la Blaire Witch Project.  And it leaves me wondering if other single people simply don't travel, or if they always find a friend/sibling/parent with whom to travel.  Or if maybe their numbers are just so small that they get lost amongst the seemingly endless crowds of smiley happy couples.

For all of the solo people out there, including those who are in relationships but sometimes find themselves apart from their significant other, what do you do about travel?  Do you ever travel alone, and if so, do you feel as much of an anomaly as I sometimes do?

Saturday, May 26, 2012

Moments of Doubt

Despite having recently declared myself an atheist, there are still moments that leave me questioning whether there may in fact be a god.

On Thursday morning, as I sat in my hotel room eating Mini Wheats before work, I read a blog post about sunrises written by a missionary and physician in Uganda.  It spoke of how each sunrise is unique, the work of an artist, and about how this is evidence for the existence of god.  While I appreciated the point about the beauty of sunrises, I dismissed the idea that there was a higher power behind them.  In my typical atheist fashion, I credited their existence to physics rather than divinity, an interaction between waves of light and the Earth's atmosphere.  Something easily explained by science and book learning.

And then, less than an hour later, as I walked through the hospital on my way to early morning tumour board, a set of paintings that I had passed by daily but never before noticed caught my attention.  The subject?  Sunrises.  A whole series of them, all from the same vantage point, painted to illustrate the uniqueness and beauty of each sunrise.  While my rational mind attributed this to coincidence, the deeper and more mysterious parts of my mind couldn't help but flash to the thought that maybe this was something more, a sign perhaps.

A small part of me held on to that idea for a few more hours, until my first new consult of the day.  As I read through the patient's chart, reviewing yet another story of another previously healthy person who was found to have an incurable and rapidly fatal tumour, I was reminded of why I lost any shred of belief that I ever had.  While I would love to be a person of faith, to believe in something greater than me that is compassionate and kind, I still can't reconcile that concept with the patients I see in front of me.  I can't grasp how a being that is supposedly all-powerful would afflict people with such horrible diseases and then provide them with only fallible human beings such as myself to fight them.  While I commend people of faith for being able to believe in spite of this, the cognitive dissonance is simply too much for me to handle.

So despite brief glimpses of something bigger, I continue to cling to my non-belief.  My belief that all of this is random, that cancer is just an unlucky ticket in the great cosmic lottery, is the only thing that allows me to do my work without being in a constant state of rage.

Friday, May 25, 2012

Long Weekend Travels - Part One

I keep trying to write an interesting and insightful post about my trip last weekend, but there really isn't much to say.  I traveled through Southern Ontario, I saw some pretty things, I drank some good wine - that pretty much sums it all up.  So instead of struggling unsuccessfully to write something profound about the experience, here are pictures!  (And a few words by way of explanation)

On Saturday, I visited the St. Jacobs' Farmers' Market, which is apparently the largest in Canada.  I had visited it years ago while I was at a geek camp nearby, and I've always wanted to go back.  Not sure it was worth driving an hour out of my way and then getting lost in Kingston, but it was fun to see regardless.  Many of the stands are operated by old order Mennonites, who still use horse and buggy to bring their goods to the market.


While there, in addition to drooling over the maple syrup and devouring the tastiest brisket I've ever had in my life, I took a horse-drawn carriage tour of a nearby Mennonite farm.  The family that owns the farm lives according to old order traditions, meaning no television, no radio, no internet, and no cars.  I can hardly imagine!


After visiting St. Jacob, I headed on to Niagara-On-The-Lake, where I spent my evening on a ghost tour.  Sadly, there are no pictures, and there were no ghosts sighted.

The next day, I had a leisurely breakfast made by one of the owners of the bed and breakfast, which made me really miss having access to a kitchen.  Mini Wheats just can't compare to baked eggs and homemade muffins.  Once again, there are no pictures, as I was already feeling awkward as the one single person at the table, and didn't want to add to my awkwardness by pulling out my camera.

After breakfast, I headed out on a winery tour.  I had originally planned to do a bike tour of the wineries, but after realizing that 1) it was ridiculously hot and humid in Southern Ontario and 2) I start having balance problems after half a glass of wine, I opted to do a van tour instead.  Very wise, I think.  We visited five different vineyards and sampled some truly amazing wine. 


I may have spent a ridiculous amount of money on a tiny bottle of ice wine from a really amazing independent winery that only sells wine from its own store.  It's one of my birthday presents to myself.


In addition to sampling the wine, we got to tour one of the vineyards.



I had visions of photographing bunches of grapes weighing down the vines, but unfortunately when I visited the grapes looked like this:


We also got to see the inside of the winery.  Where the magic happens!



It was a very lovely day, and I look forward to remembering it next weekend as I enjoy my winery purchases with friends and/or family.  Or just my cats if no one is around.

Thursday, May 24, 2012

Mild Panic

I thought I had my elective for the month of August worked out, with 2.5 weeks of hepatology tentatively booked and 1.5 weeks of palliative care definitely booked (despite sending an email to the palliative care program director entitled "Visiting Elective in Hepatology").  Unfortunately, I just received an email indicating that the hepatology portion isn't going to work.  Gaaaah.

I really don't know what to do.  I can try to switch my ICU rotation from September to August to enable me to do a hepatology elective in September, but that would mean that I would be doing an elective in hepatology after my fellowship applications are due.  I can try to scramble to find a hepatology elective at another school for August, but that's cutting it really close, and I don't know if I'd be able to find anything.  I can do one week of hepatology and three weeks of palliative care (still an option at the school to which I had originally applied), but I don't think it would provide me with enough exposure to hepatology to help with my decision-making process.

I really wish that my decision about fellowship wasn't so hard.  When I left for my current elective, my hope was that I would either fall madly in love with oncology or passionately hate it, such that my decision would be easy.  Neither has happened.  I'm enjoying my time in oncology and could see myself doing it for the rest of my career, but I don't feel driven or compelled to make it my life's work.  I can still see myself leaving it behind for another career path without pining over it forever.  But I don't know how I'm going to feel about hepatology if and when I actually manage to find a rotation in it.

Why, oh why, didn't I try to start figuring this out earlier instead of leaving it for two months before the fellowship application process starts?

Monday, May 21, 2012

Weekend To Do List Almost Completed

1)  Major landmark photographed:


For anyone who doesn't recognize it, it's Niagara Falls.  My long weekend destination was Niagara-On-The-Lake, a village about 45 minutes north of the falls that is known for its quiet streets and quaint historical buildings.  And access to the many vineyards of the Niagara wine region.  Mmmm.

2)  Pharmacy Museum toured:


3)  Haunted buildings seen on a ghost walk (Photo from during the day, not in the dark of night while on the walk):
 

4)   Friend and her adorable babies visited, despite getting hopelessly lost on the way.

5)  Laundry done, thanks to the laundromat owner who gave up closing early in exchange for my $11 in quarters and loonies.

Amazingly, the only things I missed out on were the butterfly museum and the historical fort, which will just have to wait for another time.  All in all, it was an enjoyable and restful weekend, and I will share more over the next few days.  For now, it's late at night, and I have the final episode of Treme to watch before sleep, so I will say goodnight.

I hope all my Canadian friends enjoyed their long weekends as much as I did.  Happy Victoria Day!

Saturday, May 19, 2012

On The Road Again

I have the long weekend off, and the weather here is beautiful.  So what to do with myself?

Road Trip!

I rented a car this morning and am now a few hundred kilometers away from my usual location, settled comfortably into a bed and breakfast that is way fancier than my utilitarian work accommodations.  I would tell you where I am, but I'm hoping to get a picture that will speak a thousand words and tell you for me.  I do promise to tell you the secret eventually, regardless of whether or not I'm able to get the aforementioned picture, even though it means making the location of my oncology elective even less secret.  (Here's hoping that there aren't any oncology program directors sneaking around the internet looking for reasons to not let me into their fellowship programs.)

The thing I always struggle with when traveling - heck, the thing I struggle with every day of my life - is trying to fit everything in.  I have a long list of places I'd like to see and things I'd like to do*, but there simply isn't any way of doing it all.  It doesn't stop me from trying though, such that I've spent a good chunk of my evening typing out a schedule in a Word document and trying to cram as many activities as possible into it.  One of my schemes involves spending the afternoon drinking and then getting in a car and driving myself across the US/Canada border, so clearly my attempts to do everything aren't going to work.

I'm lucky to have so many choices here, so much abundance that I can't possibly enjoy it all.  And yet, just as is the case with my life, I don't know how to let go of the things that I don't have time for.  It feels like the things that I don't get to do often take up more mental space that the things that I do get to do, which is sad to me.  I want to find a way to accept the limited nature of time so that I can be present in what I am doing, instead of always dreaming about the things that didn't make the cut.  If anyone knows the secret to this, please feel free to share it here.

*  Included in this list are a butterfly museum, a historical fort, a haunted house, another pharmacy museum, a major landmark (for the photo), a friend who lives nearby whom I haven't seen in about 10 years, and a laundromat (so that my clothes don't smell at work next week).  The laundromat will likely get deferred until I'm back in my base city, which will mean walking 2.6 km carrying a suitcase full of laundry on Tuesday evening.  Joy!

Friday, May 18, 2012

Where the Wild Things Are

This past week, much of my mental space has been devoted to future thoughts.  Oncology vs Hepatology.  Stay vs Go.  Medical Education vs Research.  I keep flipping the thoughts around in my head, examining them, weighing them against each other.  Hoping that the best answer to the question of "What do I want to be when I grow up?" will become clear to me.

After work tonight, in an attempt to get away from the incessant thinking, I went wandering through a local park that is just minutes from my hotel.  Despite walking past it every day, it's taken me nearly two weeks to actually set foot in it.  I'm pretty sure that I was the only human being there, as the parking lot was empty, and once I got a few feet in the only noises I could hear were coming from the animals.  Most of the park is accessible only by a winding, unpredictable series of unpaved paths, and it occurred to me as I began walking down one of the paths that I was setting myself up to be a story on the weekend news.  Single woman.  Walking alone at dusk.  No identification.  No one informed of where I was going or when I'd be back.  Really bright.

So instead of exploring the depths of the park and putting myself at risk of getting lost/attacked/eaten by a coyote, I stayed at the pond that is within a few meters of the parking lot.  Hard to believe that this is hidden amidst the traffic and strip malls of suburbia:





It was so unbelievably peaceful, with the sounds of the nearby highway almost completely blocked out by the trees, and a veritable symphony of animal noises.  Chirping birds, croaking bullfrogs, splashing fish jumping from the water.  It was one of those perfectly calm and wonderful moments that come along so rarely.  I stood there for a long time, listening to the sounds around me and watching the colours change as the sun set.


And then, as I turned to go, I was greeted by this coming towards me:


I had a brief moment of anxiety when I realized that the geese (and their babies) were standing between me and the exit.  For a moment, I imagined being attacked by the mommy and daddy geese, as recently almost happened to Red Stethoscope, but then I got over my Alfred Hitchcock-inspired paranoia and just watched the goose family making its way to the pond.




As I watched, it occurred to me that this is what makes life so sweet - these simple, unexpected moments of beauty and calm amidst life's ordinary chaos.  And I realized that these moments will still be present in whatever future I choose, whether it's as an oncologist living in my hometown or a hepatologist living many provinces away.


 As a good friend said to me earlier this week, there is no wrong choice.

Wednesday, May 16, 2012

Happy Birthday to Me!

If I've learned anything from many years of being single, it's to never let the fact that you're alone keep you from enjoying yourself.  Alone in a strange province on your birthday?

Sit at a table for one and eat sushi.


Not as nice as dinner with friends and family, but a totally acceptable way to celebrate.  Here's to being officially of "advanced maternal age"!

Monday, May 14, 2012

Autocomplete Fail

Thanks to the autocomplete function on my email program, I just sent an email entitled "Visiting Elective in Hepatology" to the Director of Palliative Care at a university where I'm hoping to do an elective (in palliative care) over the summer.

Brilliant.

Of course, it's not quite as embarrassing as when I was applying to graduate schools years ago and sent an email to a professor at the University of Alberta saying that I was interested in doing my graduate studies at the University of Calgary.  He quite graciously responded that he would be happy to discuss research opportunities in his laboratory, assuming of course that I was in fact interested in studying at the University of Alberta.

Ironically, I made my living proofreading for almost four years.

Sunday, May 13, 2012

Wisdom

Whenever I'm feeling down, as I have been this past week, I have this terribly bad habit of slacking off.  There's a voice in my head that tells me that, if I just lounge around watching tv and surfing the internet long enough, everything will work itself out and I'll start feeling better again.

The voice lies.

The older I get, the more I realize that lazing around is the absolute worst thing that I can do when I'm feeling unhappy.  For one thing, television isn't all that amusing in large quantities, particularly when one is watching a blurry hotel cathode ray tube television with basic cable.  For another, one of the main sources of unhappiness in my life is often feeling overwhelmed by work, and oddly enough checking out of life for days at a time doesn't make that any better.  At least not until I capture an internal medicine gnome that will submit elective applications and prepare research posters for me while I sit around eating bon bons.

I finally kinda sorta got my act together today and started doing some of the things that I need to do while I'm here.  I started reviewing the NCCN guidelines for the management of common cancers, and although it was terrifying (164 pages just for breast cancer!), I did manage to cram a few pieces of useful information into my brain*.  I also went for a run, and it felt pretty good despite the direct midday sun and the drenching humidity.  I really should do that much more, given how much unstructured time I have in my days.

By the end of the day, I felt the best that I have since coming here.  And I knew that I would - I know that working, accomplishing things, knocking items off my to do list is the best way to make myself feel better.  I just need to remember this tidbit of knowledge when I come home at the end of a long day and want nothing more than to lie on the couch and be a lazy person.

*Hopefully someone will ask me about chemotherapy for colon cancer in GI clinic tomorrow, because I think I finally understand the different regimens.  FOLFOX, FOLFIRI, FLOX, CapeOX, bevacizumab, panitumumab - bring it on!

Friday, May 11, 2012

Friday Night

I keep starting and then deleting posts tonight.  My brain is filled with thoughts about oncology, self doubt, moving to a different city, decision making, and many other things, but I don't seem to be able to develop any one of my thoughts into a coherent and somewhat interesting post.  Perhaps it's the large quantity of takeout that I've consumed today - I suspect trans fat washed down with sugar water isn't really brain food.  Or maybe it's just that I feel slightly muddled, a mix of emotions and anxieties that refuse to settle just yet.  Whatever it is, the words just aren't flowing.

Lest this come across as yet another negative post, I will say that the days keep getting better.  The oncologists I'm working with are absolutely wonderful, and they've gone out of their way to make me feel welcome and included.  They've helped me get full access to the hospital systems, spent an abundance of time teaching, and emailed me references to read so that in the future, when I'm asked about the classic triad of symptoms in carcinoid syndrome, I won't ever again embarrass myself by giving the symptoms of a pheochromocytoma*.


I've also really been enjoying the work.  As a visiting resident, I've had the honour of being given all the interesting cases, so I've seen two carcinoid syndromes, metastatic testicular cancer that's now in remission, and my first homonymous hemianopsia in just four clinics.  I suddenly understand why I've spent so much time checking bloody visual fields - sometimes there's a deficit!  Which...really kinda sucks for the patient...but I must confess to being somewhat impressed with myself for picking it up.  Even if I couldn't remember the location of the lesion until I sat down and drew the neural pathways for vision on a piece of scrap paper.      

All this to say that life is looking up, and I suspect that I may even enjoy some of the next 19 days.  I certainly hope to tomorrow, as I'm heading to the farmers market and to explore some of the city's downtown.  If the fates align again, I will end my day with a meal with P and a glass or two of wine.  Hopefully it'll be a good way to unwind from the self-induced stress of the past week.

And maybe it'll even inspire a more interesting blog post.  My readers can only dream.

*  The former being flushing, wheezing, and diarrhea; the latter being diaphoresis, hypertension, and palpitations.  Gah.  I still shudder thinking about my mix up.

Wednesday, May 9, 2012

A Message from Theodor Geisel

Today was mostly better.  My hospital approval came through at about 10 am, enabling me to actually speak to and examine patients like a real doctor.  The attending I worked with was laid back and willing to teach, so the time went by quickly, despite my rumbling stomach reminding me that I had missed lunch by more than three hours.  It felt much like any day at work back home, and it was comforting to be immersed in a familiar routine once again.

And then the end of the day came around, and I found myself facing the 2-km trek back to my hotel through drizzling rain, followed by a completely unstructured evening on my own.  I didn't expect the evenings here to be as challenging as they have been, as I am used to an abundance of alone time in my home city, but there is something different and difficult about not even having the option of calling up a friend for coffee.  It's a whole new level of aloneness, and one that thankfully is only temporary.

To pass the time, I headed out to explore the neighbourhood after dinner, and because I am staying in the middle of an endless suburban strip mall, I soon stumbled upon my favourite refuge from the world - a bookstore.  (A large, impersonal, corporate-run bookstore, but a bookstore nonetheless.)  I wasn't really looking to buy anything, as I brought a small library with me in my suitcase, so I just poked aimlessly through the displays of books and scented candles and yoga mats.   Dr. Seuss's "Oh the Places You'll Go!" was on display, and, looking for a bit of inspiration, I decided to pick it up.  The section I opened to read as follows:
 
I'm afraid that some times

you'll play lonely games too.
Games you can't win
'cause you'll play against you.

All Alone!

Whether you like it or not,
Alone will be something
you'll be quite a lot.


So much for inspiration.  But perhaps the message here is just that this is part of life, and I need to find ways of making it not so bad.  Or maybe it was just a moment of randomness that I overinterpreted, and I'm entitled to continue writing a seemingly endless series of brooding, self-indulgent posts on my blog.  Either way, this too shall pass.

Tuesday, May 8, 2012

Change

It took me less than 24 hours to start missing home.

Last night was a temporary reprieve, but then this morning I awoke to the reality of being mostly alone in a strange city without any of the normal comforts of home.  There were no cats to wake me at sunrise*,  my schedule for the day was unknown beyond "9 am orientation", and work was a humid 2-km walk from where I'm staying, rather than the usual short jaunt in my air conditioned car.  In the grand scheme of things nothing serious, but all still contributing to a general sense of dis-ease.

The rest of the day continued much the same, with a seemingly endless series of things that weren't as easy or as pleasant as things are at home.  I miss knowing my way around and knowing how things operate and having people to talk to who aren't in a position of authority over me.  And I miss having permission to work, as due to some miscommunications I do not yet have full hospital access and am allowed to function only in an observational role.  Nothing makes a second-year resident feel quite as inferior to others as being forced to job shadow.

Ahhhhh....I know it will get better.  My approval will come through and I'll figure things out and I'll reach an equilibrium with my situation once again.  But in the meantime, life feels unfamiliar and unwelcome, and I find myself wishing that I had been content to live small and had stayed at home where everything is known and comfortable.  Living big is a lot harder than it looks.

*  Not entirely a bad thing.

Monday, May 7, 2012

The Unbearable Lightness of Being

Being an internet whore, I posted my location on Facebook immediately upon arriving in my new city.  When I checked back a few hours later, there was a response to my status update from my good friend P, saying that he happens to be in the same city on elective.  Small world.  P and I were very close in medical school, but he chose to do his residency at a big fancy medical school while I stayed behind, and I've missed him ever since.  It was therefore an easy choice when he invited me to go for dinner with him, as appealing as my tomato sandwich option was.

As neither of us knew the city, we relied on Urban Spoon to pick a restaurant for us, and we ended up downtown at an eponymous French bistro with a 91% approval rating.  The bistro was small and lit by candlelight, the perfect place for a romantic evening or just for two close friends to get caught up on everything.  We ate impeccably cooked Arctic char for dinner, followed by my first souffle (divine and chocolatey), and we talked and talked as if no time had passed since we last saw each other.  It was pure gastronomic and social delight, and I'm eagerly awaiting doing it again this weekend before he heads back to his home city.

I never cease to be amazed by the people who have come into my life through medicine.  For much of my life, I have sought a community of like-minded people to belong to, but I never found it until I started medical school.  If I were a person of faith, I would say that I have been blessed.

Settling In

I've arrived safely in "different Canadian city", as it shall henceforth by called, and I'm slowly getting things set up for the next three and a half weeks here.  I've unpacked, I've completed the last of the endless paperwork and online forms required to work in a different province*, and I've scoped out the nearby options for food.  Luckily for me, I'm less than five minutes by foot from a Middle Eastern deli (mmm...shawarma...), two discount grocery stores, and a seemingly endless assortment of fast food restaurants.  I definitely won't starve, and in fact I may need to purchase some larger clothes by the time I get home.

Here's what my kitchen looks like for the next 24 days:



I won't be making any gourmet meals, but at least I'll have my Mini Wheats and tomato sandwiches.

Aaand....that's all I have for now.  I'm somewhat bored, in case you can't tell from my rather uninspired post, so I should probably move on to doing something productive like studying.  Or maybe I'll go soak in the hot tub.  Ahhhh.

*  I think.  Periodically I get an urgent email telling me that I won't be able to start tomorrow because I haven't completed something very essential like online training on how to put on a face mask properly, so there are no guarantees.

Sunday, May 6, 2012

May Goal - Immersion

In less than 24 hours, I'll be getting on yet another plane and traveling halfway across the country to do a three-and-a-half-week-long elective in medical oncology. 

I have to admit to some ambivalence about this.  While this is something I chose, and it's a good opportunity for me to get exposure to a different school and a different approach to oncology, there is a part of me that would prefer to stay in my familiar city and do something that is easier and more comfortable.  It takes a tremendous amount of energy to exchange the comforts of home for a small hotel room with only a microwave and bar fridge to provide sustenance.  As much as I should be excited about this opportunity, I'm mostly feeling anxiety and dread.

When thinking about my goals for this month, I've been trying to figure out how to superimpose them on top of the unpredictable working and living situation that I will face in my new city.  It turns out that it's very hard to imagine running a certain number of times per week or adopting such and such a study routine when you don't know if or when you'll be on call or what your days will look like or where on earth you're going to get food.  So instead of trying to come up with some sort of self-improvement goal for the month, I've decided to make May about immersing myself in my new city and my new rotation. 

For the next three-and-a-half weeks, I want to work on being as engaged with the experience as possible.  I want to focus on my work and get to know the staff and patients and really be present in what I'm doing every day.  I want to come back to my lonely hotel room in the evenings and study about the things I'm seeing and doing so that I really benefit academically and clinically from the experience.  And most importantly, I want to forget about my thoughts about hepatology as an alternative career path so that I can experience oncology for what it is, rather than experiencing it in comparison to something else.  I'm hoping to have more clarity about what I want to do with my life by the end of the month, and I think the only way to do that is to really engage in the process, without constantly thinking about the decision that I will soon have to make.

Wish me luck.

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On another note, for the next month my kitchen will consist of the following:

-  one microwave
-  one bar fridge
-  a cutting board and paring knife
-  one bottle opener and one can opener
-  one fork, knife, spoon, plate, bowl, and cup
-  two or three Ziplock storage containers

Any suggestions on how to feed myself for a reasonable price and without a huge amount of effort?  Anything else I should be taking along with me to outfit my temporary kitchen?  I've gotten very spoiled with my well-stocked kitchen, so I'm not sure how I'm going to handle such limited resources while I'm away.

Friday, May 4, 2012

Diverging Roads

Anyone who knew me seven years ago knows that my decision to go to medical school was an exceedingly difficult one.  For almost an entire year before I decided to apply, all I could talk about was the relative merits of my current, known, secure life as compared to a future, vaguely imaginable life in medical school.  It got to the point where people were telling me to just apply to medical school, dammit, so that I would stop talking obsessively about it.  And so I did, and here I am.

Every once in a while, usually on a good day as was the case today, it will suddenly strike me that I could've made a different decision.  That I could still, seven years later, be living in my former city and working at the same soul-sucking job that motivated me to go back to school.  I could be married to the man I was dating at the time, who was completely not right for me, and I could also quite possibly have a brood of offspring running around.  If I hadn't had the guts to jump, to do something that terrified me in a way that nothing has before or since, my life could have been completely different from what it is.

Every single day, I'm thankful that it isn't.

Thursday, May 3, 2012

Attention to Detail

Solitary Diner to attending:  Dr. Kidney?  I just got paged by the medicine resident, and he asked me to tell you that Mr. Smith just died.

Attending (in stunned voice):  Mr. Smith?  But, how?   I didn't hear a code called!  He was totally fine when I saw him this morning.  What on earth happened?

Solitary Diner:  Um.  I'm not sure.  The resident said it was an expected death.

Attending:  An EXPECTED DEATH?  Not at all!  I need to get to the ward and find out what happened.  (Disappears in direction of ward in panic)

(Beep Beep Beep)

Solitary Diner returning page:  Hi, this is Solitary Diner from Nephrology.....What?....It was Mr. Jones the palliative patient who died and you got the name wrong?  (Looking in direction of attending who just disappeared)  Um....I think you get to tell her yourself this time.