Halifax Day 14

Today marks my last Saturday in Halifax, as I fly out to Ottawa next Saturday. Jessi left early this morning, so my travelling buddy has left! I have a feeling this week will be much more low key. I went to the market to explore a little more this morning, and that was a lot of fun. I got some nice havarti, some fresh pitas and some very tasty hummus. I also checked out the handblown glass and crystal store on the harbour walk, but everything in there was over $100.00, so needless to say I never picked up anything! Then I got completely absorbed into a used book store on Barrington--I am not sure how long I was in there. I found a copy of Anna Karina, and two Chaim Potok novels, so I bought those three books, and I am actually very excited to read them. Although I plan on finishing Brothers Karamazov first, as I have been working on that for a while. That is the project for this week, as Jessi is gone- start running again, and finish some good novels.

The rest of the day has been spent working on a presentation that I have to give on Tuesday at Endocrinology clinical rounds. This is the "oh yah, I am still a student" reminder. My entire bed is covered with books, and I have spent most of the day reading journal articles. Yet, nerdy as this sounds, I much prefer reading journal articles when they are in attempts to answer a real clinical question. Yes I am a geek, sa la vie.

I was talking with one of Sharon and Cal's friends last night (they had company over), and we wer just talking about life, the things we enjoy, you know the sort of stuff you talk about with a person when you have just met them. At one point she remarked, "your life sounds so exciting!" This was an interesting persepective. To outsiders, the fact that I get to travel across the country on electives is famously exciting. Most days I dont feel like my life is exciting at all! Especially days like today when I am working, burried in medical literature all day. But on the whole I guess it is quite lively. Its more like short burst of excitement interspersed between large volumes of hard work. Most people probably have a very dramatacized, glamorous view of life in medicine, thanks to tv shows like Gray's Anatomy. I was thinking about this the other day, and about how if I really knew what medicine entailed before I started, I dont know if I would have done it. I would have thought the sacrifices were too great. But I also wouldnt have appreciated how rewarding it is, so on the whole I am glad I am here. God truly only does reveal to us what we need to know at the time.

Delicate voice

I have been reading non-medical books at an embarrassingly slow pace these days. Alack. However, I am nicely into Go In Peace by John Paul II, and it is rich with Truth and Wisdom. I decided to quote from what I read yesterday as I found it to be so well written.

"Truth cannot be disregarded in order to place the blame for an individual's sins on external factors such as structures, systems, or other people. Above all, this would be to deny the person's dignity and freedom, which are manifested --even though in a negative and disasterous way--in his responsibility for the sin committed. There is nothing so personal and nontransferable in each individual as merit for virtue or responsibility for sin. Like all things human, the conscience can fail and encounter illusions and errors. It is a delicate voice that can be overpowered by a noisy, distracted way of life, or almost suffocated by a long-lasting and serious habit of sin.

Conscience needs to be nurtured and educated, and the preferred way to form it--at least for those who have the grace of faith--is to relate it to the biblical revelation of the moral law, authoritatively interpreted with the help of the Church and the Holy Spirit."

Go In Peace, John Paul II


This is why it is so important for us to guard our lives, to ensure that we do not become so distracted that our conscience fails, falling into illusions and errors. The still small voice inside of us can so easily be lost in the chaotic noise. This is one of the primary reasons why for the past four years I have not had cable tv in my house---it too easily becomes a near constant source of background noise that gunks up my filter.

Halifax Day 9

Victoria Day in Nova Scotia!

We had an early start to the day, at the Citadel for its opening and we caught the first tour. They did a 21 gun salute at noon for Queen Victoria as it is Victoria Day and all today. Wow was it cold out today. The citadel was really interesting, it made me think that the two World Wars would have seemed much more tangible here in Halifax than at home as they were a major port to ship out troops. The system of defenses for the harbour are simply astounding. Did you know the Halifax harbour is the second deepest natural harbour in the world?





The view from atop the Citadel, overlooking the Harbour.










We also toured the Alexander Keith's Brewery
today. Established in 1820, it is the oldest working brewery in North America. The tour was really well done, with actors dressed as characters from 1863, taking us through the brewery and its courtyard and the old inn, singing and dancing for us too. They gave us beer samples at the end of the tour. The id-ed Jessi Matt and I! I totally thought they were joking but oh no, they seriously wanted to see our id! And I sampled my first mug of beer. They let us try the new Keiths Amber Red Ale. I actually didnt mind it, I could enjoy having a glass of it. I didnt finish it mind you, and I think at best all I could ever drink would be half a pint. Anyways it didnt have the nasty bitter taste that all other beers I have tasted have. Although I am not about to have a 'beer of choice', as red ale is only sold in the maritimes!


































And with Eddie in Edmonton, and I in Halifax, we video conference every night to stay in touch. Its not nearly as good as being in the same place, but it does make things a little easier.

Halifax Day 8

Another day out exploring in Halifax. Today's adventure included a sail on a real honest to goodness sailboat! How cool is that!


The boat we took while it was docked...















Practicing my pirate face











Jessi and I on deck....













The three muskateers










So I definitely do want to learn how to sail one day! It was so much fun being out on the water on the boat, no motors or engine noises, just the wind and the sea!



So Ottawa used to be my favorite Canadian city outside of Saskatchewan, but I think Halifax now has the edge over Ottawa. A charming, picturesque city, with a wealth of history, lots of parks and green spaces, fun exciting things to do, outdoor adventures at your doorstep, fresh seafood and the city is not monsterously large.

We went for supper on the wharf tonight, and the restaurant had live jazz music tonight! So great.

Halifax Day 7

Jessi, Matt and I spent the day touring around Halifax and the Nova Scotia coast. I will let the photos do most of the narrating...

Peggy's Cove











































The sea side town of Mahone Bay...













A scenic golf course we saw from across the cove at Lundenburg...









Ferry ride across the harbour to Dartmouth.






















Supper at MacAskills in the Darmouth Ferry terminal overlooking the harbour at sunset. Matt tackled a huge lobster and succeeded.













The harbour at night on the ferry ride back to Halifax...

Halifax Day 5

I had a good day today--other than the fact that I am still sick!

I received really positive feedback from the preceptor I was with today, in fact he told me I was fantastic! It was the first day where I have felt like there is hope for me and I will become a quality internist. Its so nice to get a 'gold star', when you know it is genuinely being given.

Then after work today, Jessi and Matt (Jessi's boyfriend who arrived in town today, he is here for the long weekend), and I went walking downtown, and out for supper. The only unfortunate thing is that it was SO FOGGY! We could barely see 3 meters infront of us, and it was also really icy cold too. Oh well, we had fabulously tasty fish and chips at Pineau's Cafe (thank you Kelly and Sarah for recommending it). A quaint little restaurant that looks like it was an old two storey house at one time, and had darling little tables, bright red walls, white trim, and flowers inside. And the best fish and chips I have ever tasted for $7.50! Such a good deal. We also walked to the Citadel, but the fort closes at 1700h everyday, so we will have to go back on the weekend.







Pineau's Cafe..

























Jessi and Matt on the Harbour Walk.










Here we are trying to find our way through the fog, with the Citadel in the background. The city is very erie when it is laden with dense fog!










Speaking of erie, there are graveyards every couple blocks downtown it seems! This is the graveyard I walk past every day to on my way to and from the hospital.

Halifax Day 4

Interesting day today. First off at the hospital I saw a case of Paget's Disease of the bone today. I have never seen that before! It was pretty interesting. Every case we see has very marked pathology, so I will have a good array of patient characactures in my head for the different diseases.

There are also tonnes of patients on insulin pumps for diabetes here, and I was speaking with the "pump trainer" today, and she says that there are only 20 pumps that are sold to Saskatchewan patients every year, and hundreds to Nova Scotia, and the populations are about the same size. I think this is partly because there are almost no endocrinologists in the province!

Jessi and I went for a walk down Barrington street tonight after supper. The town was much more lively today because there was no rain. Although, wow is it cold here! The crisp ocean winds cut right to the bone. I am wearing longsleeved shirts, a fleece and a wind-breaker and still chilled.

Anyways, we wound up at a Free Trade coffee shop for warm drinks, and sat down to relax. Just so happens that a poetry open mike started moments after we got there, so we stayed for the hour of poetry. There was actually a guy there by invitation from Vancouver so that was cool. The creative energy of the people we heard tonight amazed me. It is as though there was so much energy bubbling forth from them it was only their skin holding them in. So alive, so vibrant. On one hand it reminded me of how I feel as though my creative side has run dry, and on the other hand, if I am parched, it is refreshing to sit and bask in the vivid imaginations of others.

I am really enjoying the city. The biggest force pulling me back to the prairie is and will always be the people there, the family and friends with whom my soul is at ease, because those people are unique to Saskatchewan.

Halifax Day 3

I am settling into the Endocrinology department nicely here. Today I was doing follow-ups on consults that are in-patient, and saw one new consult. Every patient that we see is wickedly complicated with multiple endocrine pathologies, as well as long standing comorbidities. I think that it was a really good choice as I am learning LOTS, and well we have all of about two endocrinologists in Saskatchewan right now. I see at several complicated diabetics every single day, so I think I will likely achieve my objective of being more comfortable with diabetes managment before I go home.

There is definitely a difference between being a 'clinical clerk' and a JURSI. Here we cant sign any orders on our own, so it really doesnt feel like I am really contributing to patient care at all. We definitely have more responsibility at home. It really is a fine balance between enough responsibility and independence with enough teaching and senior support.

Then after supper Jessi and I went walking about the city. We explored the Harbour Walk along the waterfront which is rich with character. It was deary and rainy when we started, and proceeded to torrential downpour. The pier was very quiet, but full of shops, mueseums, boat tour wickets and lots of fun things to do. I think we will go back in better weather, and then I think it will be teeming with bustling activity. We then walked past the Citadel which was covered in dense fog, so we could not see it, and then on to Spring Garden Road (a larger version of Broadway Ave) and stopped at a gelato cafe for a treat. It was a lot of fun, but by the time I got home it was thundering and lightening, and I was sopping wet up to my waist, with several hundred mls of water in my shoes!

No pictures today as I wasnt going to take my camera out in the flood!

Halifax Day 1

Jessi is also here on elective so we spent the afternoon exploring downtown Halifax.




Public gardens in downtown Halifax...

























Faculty of Medicine building at Dalhousie University.








Beautiful houses in the charming downtown...













































Jessi and I at Pleasant Point Park...










Atlantic Ocean!




So tomorrow I start my first day at the hospital. I am a little nervous, but it will be ok. Its tempting to just go sight-seeing for three weeks, but I guess I will have to go do some learning while I am here too!

Halifax Day 0

Today I arrived in Halifax. Well after flying first to Calgary, then Calgary to Halifax. It definitely was a long plane ride!

My host graciously picked me up at the airport. Cal is an attending Hematopathologist, and Sharon is a PT. They then took me with them to a house warming party for a couple they work with. Really nice people, laid back. We spent the evening dining, playing foosball and singing kareokee. I have a nice big room to myself with internet access, and they have a lovely appartment blocks away from the hospital.

I arrived here at night, so I have yet to appreciate the city fully, but what I have seen so far is wonderful. Very picturesque, old character homes beautiful trees. I have yet to see the water, but I plan to go exploring tomorrow. Too bad it didnt take so long to get here from home. The people already are very welcoming and are making me feel right at home, and the city is not monstrously large, and its extremely charming.

This week is the last week Eddie and I will be together in the same city until basically November. Groan. We will have brief spots of time intermittently between now and then, but it will be a long expanse of time I think.

These past three weeks have been bitter sweet--I have realized even more reasons why I love this man, and how blessed I am that we are in relationship. Yet, now going away on electives is no longer just an adventure. It means being apart from someone dear to me. Sigh. But the sorrow of separation is worth the joy of relationship in the end.
More reasons Eddie is fabulous:
1) when we were at Jerry's for supper, and I suggested we should play a boardgame, his response was, "Lets make one up right here!" So he proceeded to make a modified chess game with the salt and pepper shakers, the glasses and other condiments. Of course this made me release peals of laugher.
2)He suggested the Chewbacca noises would be an appropriate ring tone for his calls to my phone.
3)He let me pick out the "Here without you" song by three doors down as the ring tone on his phone for my calls...its so cheesy but true, and yet he has it on his phone!
4)He bought me a pedicure at Ethos as a "just because I thought you would really enjoy it gift".
5) He is exceedingly patient with me even when I am irritable and irrational.

I could go on, but I wont. Basically I really appreciate him, and I will miss him a lot.

"What we need to foster, in ourselves and in others, is a contemplative outlook. Such an outlook arises from faith in the God of life, who has created every individual as a wonder. It is the outlook of those whos ee life in its deeper meaning, who grasp its gratuitousness, its beauty, and its invitation to freedom and responsibility. It is the outlook of those who do not presume to take possesion of reality, but instead accept it as a gift, discovering in all things the reflection of the Creator and seeing in every person their own living image. "
~ Pope John Paul II

I havent had much time for contemplating these past few weeks--or I havent made or set aside time, however you decide to look at it. Either way, as I started to read Go in Peace by the late Pope this weekend, I found the first few pages refreshing to my soul. Most days I feel as though my brain is stretched taut, and there is no more room to give. The weekend comes and relieves some of the tension, but by monday my brain will go back on the stretching rack. I need to develop more discipline in setting aside my time for contemplating and for studying (separate times), even when I am exhausted. In the long run avoiding the things I should do only makes everything worse later on!

change is in the wind...

My time in Saskatoon is rapidly coming to a close! Just one more week here in the Toon Town.
I start my electives after that--Halifax is my first destination. I am a little bit nervous, especially about how I will get around in these other citys sans auto. But countless students before me have done it, and I will do it too.

Honestly though, I feel as though I am atrophying in everyother area of my life some days. I have almost nothing to talk about other than medicine--how boring is that? Sigh. The perpetual strive for balance sometimes takes a back seat as I try to keep my nose above water. So I appologize to my friends and family for my lack of conversational ability this last little while. And I really appreciate the people who have made extra efforts to get me outside of my med bubble these past few weeks.

not much to report

This week I am on General Internal Medicine at City Hospital. I really enjoy it. But I have nothing much to report! I go to the hospital, then I come home and do it over the next day. I think residency will be very busy, and I hope that I am able to retain my other interests while I get further into this 'training to be a doctor' business.

Eddie and I went to a swanky benefit dinner and silent auction for the Children's Health and Hospital Foundation on the weekend. Eddie was given the tickets by the Pediatrics department, so we got to go for a fancy dinner for free. It was a lot of fun, and we got to just hang out with the peds residents afterward and see them interact in a non-hospital setting. Eddie is totally 'in' with the peds dept. All the attendings who were there were trying to convince him to do pediatrics! I was really proud of him; he has made a very good impression on docs, and he will be an excellent pediatrician.

Other than that, just going to work, and trying to learn about internal medicine. I really like internal patients, and when I think that I am not even half finished my training, I am re-assured that I will eventually learn what I need to know to be a good doc.

Celebrating

So the group of us Saskatchewan girls threw a bridal shower for the lovely BC born Erin, just before she flies home to marry our very own Saskatchewan boy Tim E this summer. To our good fortune they will be making Saskatchewan their home after this summer!





We played a game where all the guests brought some of their own sleepware, and Erin had to figure out who sleeps in what. She was quite perplexed to as she tried to guess who sleeps in a tiny pink fuzzy thing!












As is custom, we 'showered' the bride with gifts...





And as is also custom, some of the gifts made her the 'blushing bride'!









And these are the gorgeous Gerbers and lilies that Eddie gave me to celebrate my arrival to Saskatoon, and getting to spend four weeks together in toon town. They filled Tin's appartment with their heavenly fragrance for over a week.

How do you eat an elephant?

One bite at a time.

Last week was somewhat overwhelming for me in many respects. However, as always, in the place of feeling pressed on all sides, God revealed Himself yet again, and the Holy Spirit shed some light on a few things for me:

1) I am not nearing the end of the woods in terms of knowledge of medicine. This past week I think I only started to realize how deep the forest really is, and how far I have yet to go. But its just like every other time that I have encountered a new learning curve--it is intimidating at first, and seems insurmountable, but as I set back, and decide to go one day at a time, I eventually learn to function at that next level; although it takes a lot of steep uphill climbing to get there. The last time I can recall this sort of scenario was the year I started medical school. I really shouldnt be surprised that it would get harder again! But He will see me through. It is a humbling thing to be reminded that on my OWN, I CANT do it. Through HIM I can. This is a seemingly subtle, but oh so key distinction.

2) Christ is my Savior--not any of the things He blesses me with. Those are His to give and take away. I am not saved or 'held together' by the ways He blesses me. Those are Graces He has afforded me. Its the old addage "God is more concerned with your character than with your comfort". I have been frequently uncomfortable these past few months. God is stretching me. It is unpleasant a lot of the time, sometimes down right painful. But there is also a lot of joy He has brought me too.

3) Do I trust Him? He has been faithful in all things, working out the details of my life with exacting precision, in ways beyond anything I could ask or imagine. He has brought me this far, He will not leave me here. He will see me through. I will reach the other side.

Funny, none of these things are truly 'new' realizations, but like all important lessons in life, they are often repeated.

A day in the Life

Wow. Saskatoon JURSI is a different flavor than Regina.

First of all, the attending I am with this week knows EVERYTHING about everything. Seriously. She is an Infectious Disease specialist, ran hospitals in Africa for years, knows everything about almost all specialities. She's brilliant. So naturally, my own lack of knowledge becomes painfully obvious when viewed in that light.

Second, we actually do real rounds here--I see my patients on my own in the morning, then in the afternoon the team rounds -- the attending, two residents, two JURSIs, a pharmacist and a pharmacy student. And thus on rounds the grilling of JURSIs happens. Quizzed and questioned, having to say all to often, "I dont know". This is a STRONG motivator to go home and study.

Third--its exhausting tromping around feeling as though you are incompetent ALL day. I think its that chronic feeling of "man I dont know ANYTHING, I have GOT to study more" that is really exhausting. Its not the physical walking around all day. Its mental exhaustion.

Fourth I realize I am going to be exhausted everyday for the next five to six years.

But even with all that--its still fun. Go figure.

He Is Risen

He Is Risen Indeed.

Today is the day that Christians celebrate the Resurrection--the empty tomb. Our Jesus not only died on the Cross, but three days later He Rose again. Praise be to God!

It amazes me, but doesnt really surprise me, that the rest of our society thinks that this holiday is only about eggs and bunnies. Its sad really, how the real meaning of this celebration has been lost in a heap of chocolate. Why do we endorse the comercialization of our sacred Holy Days?

But that said, there is a remnant of the faithful--to whom today is a profoundly joyous day. The day that changed all of human history forever, is celebrated around the world by those who acknowledge Him as Lord and Saviour.

Happy Easter!

Welcome Back

I arrived in Saskatoon on Thursday, and my soul feels so much more at ease. Back into the place where I am surrounded with the familiar, and with the people whom I love to spend my time with. Already phone calls with Heather, Camille, Erin making plans to visit--delightful. Oh, Regina is an adventure alright--but so is JURSI by itself. It will be very nice to have four weeks in a familar place before I take off all over for electives. And nice to be in the same city as Eddie--even if his parents have a cat!

Grim Reaper

"Medicine is by definition a moral activity" ~ John Patrick

I had my first death of a patient this week. I wasnt actually in the room when he died, but all the same, the experience has affected me. These are the things they do not teach you in medical school--what to do when you are there as a family is being told their loved one is now terminally ill, with days or even only hours to live. Watching a wife and 12 year old son as they cry, overcome with grief, at losing their husband and father. How to discuss the "CT films with good teaching points"---while the family is meters away in another room, and the patient lies at death's door a few meters in the other direction. Seeing streams of relatives, brothers, sisters, tiny young nephews come in to say their final goodbyes. What to do as your insides become liquid, your heart pounds in your ears, your eyes sting with tears, and you feel like you cant breathe.

How to remain "professional" and still be human?

Even with our best medicines, we cant save everybody--it is one thing to cognitively know this, another to experience it. As I read about the condition that was the cause of death for my patient today, the 25% mortality rate was more than just a number. 1 in 4. And the worst part is, for this patient--it was devastating misfortune. He had absolutely no risk factors for the disease that was his demise, the doctors still dont know why he got it--and he went from normal and healthy, to a few minor symptoms in a month, then minor symptoms to dead in less than a week.

I can see how without Jesus many doctors loose their hope.