this hankerchief will help you look more gangster

I want to dream
And then I want to wake up
I want a break
But I don't want to break up
Face Of The Earth, Joel Plaskett

Just finished a pretty long Saturday on-call. The resident coming on to relieve me this morning is in Psych and I felt pretty bad for her having to do medicine call. There are benefits of having a broad background in medicine, but it must be hard to be interested in adjusting insulin orders when that will really have nothing to do with your future job.

As I was reviewing the 3rd intentional overdose patient on our list, she says

"Yeah, well, it's November".

It's obvious, but November kind of sucks. No more pretty fall. No pretty winter yet. Snow sports are usually still pending. Daylight savings kicks in and you start walking home in the dark. The only holiday involves standing around outside thinking about how brutal humans can be to each other. It rains, it snows, it rains again.

Bleh.

Sorry to be such a downer. Only one more day of November.

Just so no one thinks I'm going to be number 4 on the list tomorrow, I will reassure you by talking about some of the fun things I've done recently.

We actually went snowboarding at Powder King last weekend. There was lots of snow. It was fun and a good workout.

I've been swimming more. There is a sweet steam room at the public pool here, and I find I can usually motivate myself to awkwardly move myself through the water for half an hour if I know a sweet steam room is my immediate reward.

We have booked holiday time for mid-January. No sure what we will do yet.

pants!

Yeah, it's overwhelming
But what else can we do?
Get jobs at offices and wake up for the morning commute
-Time to Pretend, MGMT

It snowed here pretty heavily last night. I enjoyed the crunch beneath my feet as I made my way back and forth to the hospital at all hours of the night. I try to concentrate on small pleasures during those times or it's easy to start disliking the state of affairs.

We've started playing on an indoor soccer team with some colleagues and friends. It sure is nice to meet some people who aren't doctors, nurses or patients. When you're married to a doctor, your best friends are doctors and you find yourself working 80 hour work weeks, it can be a little overwhelming. I find people who are not doctors or patients very interesting as a rule. Patients are cool sometimes but the way they are always telling you about their problems and expecting to be cared for appropriately often gets in the way of enjoying getting to know them.

I just started watching the TV show, Mad Men. That's a good show. I haven't been sucked into a TV program like that since Sopranos. While watching the Sopranos, I learned Italian swear words and a variety of ways of making money illegally. From watching Mad Men, I've learned that rich Anglo-Saxon men used to have alot of fun smoking, drinking, sexually harassing women and not feeling guilty about it.

Time for bed. Haven't had a chance to put snow tires on our car yet. Luckily our commute is a 3-block walk.

Goodnight.

a scrabble of high-fives

On Thanksgiving day we acknowledge our dependence
-William Jennings Bryan

On my way back to Prince George after a very relaxing thanksgiving with my family in the Rockies. My parents have been going to Fairmont Hot Springs, BC for Thanksgiving for about 15 years now. I haven't been in a long time, but I had the weekend off this year and my parents generously offered to fly me there. Tory and Katelyn were there as well as our family friend John "Hammy" Hamilton. We had fun together and ate alot. My parents took care of me. It was great.

I lost my camera a few months ago and haven't been able to replace it just yet. Hence, no photos. The Rockies were spectacular.

I'm heading into a long stretch of continuous days at work and am dreading it a little bit. We really don't have our next vacation planned and the next couple of months looks like a long tunnel now. I've really been enjoying my Emergency rotation, and still have a week of this left before i hit Pediatrics again.

max barbers stikes again

(lifting and dropping the arm of dead Westley)
-I've seen worse

-Miracle Max, The Princess Bride

Sigh.

Residency is a busy time. I will definitely do more call this year than my 3rd (or 4th) year of medicine, and there is more responsibility to be sure, but it's still way better. In general, things are good here, and I continue to feel that despite being prone to sharp pangs of nostalgia, life gets better and better as it goes on.

I'm sure there is a time when this ends. Sometimes when I am done seeing some poor elderly patient with myriad medical problems and the medications to match, I get a little discouraged and think to myself- "Note to self- don't get too old".

But for now, things are good.

Here are a few reasons why residency is better than medical school.

1. Everything makes a little more sense. Clinical work is much easier because you have more knowledge.

2. Money. It actually is a little easier to be awake all night when I know I'm getting paid for it.

3. Teaching. We have new medical students and we teach them little bits and pieces as we see patients together. It's fun.

4. Belonging. It's probably more a function of being in Prince George, but I feel like I'm a part of the medical community here.

5. Long White Jackets. Way cooler than Short White Jackets.


Other than work, life has been relatively minimal. Went canoeing down the Nechako on Labour day with Cortney.

push it for me! huh!

You got some back pain?
Hey man, this will relieve it
Two of those and two beers
You better believe it.
-Nice Train, The Donkeys

I'm on obstetrics now and doing 24 hours on, 24 hours off. This kind of messes with your circadian rhythm and I often wake up feeling really hot, or woozy or sick. In general, a "call hangover" is relatively common, regardless of what rotation you're on.

When I was still on Peds, I woke up with a bad headache after being on call and had to hurry into work. As I crashed around the kitchen making breakfast, I went and grabbed a few Tylenol from our medicine rubbermaid.

I found the medication to be quite effective but I was feeling woozy all morning. My preceptor was pimping me in the Neonatal ICU and I just couldn't work through the physiology we were discussing. The headache returned at lunch time and I took some more Tylenol. By the early afternoon I was feeling woozy again and actually quite unwell. I finished seeing my patients, did my dictations and then took off. It wasn't until Courtney came home and offered to get me more Tylenol, did we realize that I had been taking Tylenol #1's (with 8mg of codeine) all day. This revelation neatly explained the effectiveness of the medication and the subsequent brain fog.

It was pretty embarrassing. There is probably a lesson in there for me about how easy it is for patients to make medication errors.

Prince George is still good. Tory came to visit me last weekend which was lots of fun. A week from tomorrow we go to Christina Lake for a week.

rico's rubbermaid roughnecks

Dr Julian Bashir: So what do you want me to do?
Dr. Zimmerman: Just stand there and look like a doctor- if you can
-Doctor Bashir, I Presume?, Deep Space Nine

I'm currently on my last 12 hours or so of a 72 hour stint of call for pediatrics. It has been busy at times, but overall quite reasonable. Our house is just 3 blocks from the hospital, and peds is home-call, so it's really not so bad.

I've been loving residency so far, and am very happy about our choice to train in Prince George. In short, it's great to be in a small town again, and it's great to be working in a smaller hospital for residency. It's amazing how much more fun work can be when you aren't constantly having to learn in a place where everyone is annoyed with you as a default condition.

Since I've started, other than thinking a lot about how rusty I am, and how much I have to learn, I've been considering how to make myself seem more like a doctor, and in general how people identify doctors in the hospital. The first patient I saw as a doctor just stared at me after I introduced myself and exclaimed "How OLD are you?"

Nowadays, almost everyone wears scrubs, and it's often impossible to figure out what roles people play in the hospital. Courtney saw one of the family doctors that works in the office a few days ago and called out- "Hey, you must be Bill!", as she thought he was one of the IT support people.

I'll save a discussion on the merits of using titles and dress to decide how much deference to use with someone for another time.

For now, I will just make a list of ways to make yourself seem more like a doctor.

1. Call yourself Doctor. I find I still introduce myself by my first name, but if the situation warrants it, I now say that I am "one of the resident doctors working tonight". I think this adequately explains that I am in fact a doctor, but still training.

2. Wear a white lab coat. Unfortunately, this is not done on pediatrics rotation so I am unable to use this obvious boost to my ward cred.

3. Wear a stethoscope. Many people in a hospital wear a stethoscope, however, if you asked the average person to list 3 words when you show them a picture of a stethoscope, I would guess "doctor" would come up before "respiratory technician".

4. Be an (old) man. Despite the fact that medical school enrollments have typically had more females than males for quite a while, there are still more men in medicine. This will change soon however. Someone recently told me that in a few years, there will be more female doctors in Canada than male.

5. Wear a collared shirt. If you've hit some of the other criteria, this is not always necessary, but tends to be one of the most reliable indicators of whether someone you are meeting is a doctor or not. Add a tie and you are gold.

6. Look disheveled. Especially while on call. This may not get you any respect from the people you are working with, but typically the more unshaven and haggard, the better.

7. Discuss physiology. Combine one organ and one hormone in a sentence and this tends to impress people.

8. Drink coffee. Making a joke about maintaining your serum levels of caffeine "in the therapeutic window" gets you extra points.

Last night, as I was leaving the hospital in scrubs and carrying a skateboard at 0400hrs, I overheard a woman in early labour who was pacing the halls remark....

"Hey, that doctor rides a skateboard"

So I must be doing something right.

a porch full of boxes

Make a point of having fun
It'll help you get through life
"Life sucks and love is dumb"
Golly, that's a real lie
Born Ruffians, Foxes Mate For Life

We've been home since tuesday and are getting organized and packed up for our move to Prince George. We get our rented UHaul on friday and are driving up saturday. Residency starts on July 2nd with an orientation and then we'll be right into it. We just got our call shifts and Courtney will be doing internal medicine call on the weekend before our regular rotations begin. This sort of thing always happens to her and the reality of residency will soon be upon us it seems.

For now, however, it's been a very relaxing time in Vancouver actually and we've been enjoying it. The nights are cool and we never have to set an alarm for anything. Katelyn lives here now and we have been able to see her almost every day over a meal or just hanging out.

There have been a lot of little errands we have managed to accomplish with all of our spare time, one of which was to pick up our wedding photos from the photographer. I was very impressed with her on the day of our wedding, but even more so now that I see the finished product. Here are 5 of the 1500 photos we received from her (whittled down from the 3000 she actually took). Oh the wonders of the digital age. We went through them last night and I don't think I've ever looked at myself so much before (from so many different angles). I'm thankful now for the people who recommended I get my hair cut.

I hope to have time to pare down the photos we have into a slideshow of a few hundred perhaps. If you're interested in getting a copy of this, let me know ( I already know of a few interested parties). I imagine Courtney might post a few on her blog as well.

crispy brits smoking topless

Blake's got a new face
Blake's got a new face
-One (Blake's got a new face), Vampire Weekend

We´ve been recovering for the past couple of days in our hotel room in Benalmadena, Spain. It´s actually more of suite with a little kitchen and living room. My parents have these timeshare weeks and they used one to get us this place. It has been really nice to do nothing but hang out. I´m pretty sure we will just take it easy the whole time we´re here.

As I may have mentioned before, this part of Spain is a big destination for British people. To this group, let me make a suggestion here- your skin is not designed for tanning. Give it up. Furthermore, chain smoking while you do this can only make me think you are trying to coat your insides in carcinogens as you try to soak up as much solar radiation as possible. I can almost see the free radicals mutating your DNA.

Here are a few photos of our time so far.

The rooftop terrace at La Tangerina in Tangier

On another rooftop in Fez

Taking the train in Morocco

The Sunset Beach Club

the water in spain

He doesn´t speak the language

He holds no currency

-You Can Call Me Al, Paul Simon

We made it back to Spain! Here was what we did yesterday.

Walk-Taxi-Train-Taxi-Ferry-Run-Bus-Walk-Burger King.

We were both a little virusey and we barely ate, but we made it to our resort by around midnight and checked in. We managed to squeak by with the money we had, although we might´ve had a less stressful time if we had decided to pack a few more Euros.

From what we´ve seen, the whole southern coast of Spain is resorts that cater mostly to northern Europeans, so there is alot of English and things that English people like. There is a Burger King across the street from our resort, so I had a Whopper with fries last night after we got here. We have a nice room on the 7th floor overlooking the ocean. Our apartmendido has a little kitchen and I went grocery shopping this morning and got some regular food.

We spent our last day in Morocco eating good Moroccan food and generally wandering around the Medina. There was a big music festival in Fez while were there and we managed to take in a performance in a the courtyard of one of the museums. It was beautiful and easily worth the 100 dirhams admission.

We´ll be here for a week and we are really looking forward to the R&R. I think it will be lots of laying by the pool.

It´s back to Madrid next friday and then home on Monday.

I´ll bring my camera next time and post some photos.

hoy nous walk shokran

A man walks down the street

It´s a street in a strange world

-You Can Call Me Al, Paul Simon

A quick blog from the medina in Fes, Morocco.

We left Vancouver on friday and arrived in Spain at about the same time the following day after a layover in Toronto. We didn't sleep much on the flight, but Air Canada's entertainment systems and phototherapy lighting was appreciated. After one night in Madrid, we took a train down to the Southern port city of Algeciras and found a ferry to take us across the Straight of Gibraltar. We survived some hassles at customs in Tangier and managed to navigate our way to our hotel in the Kasbah in Fez. The hotel was lovely and had a rooftop terrace to relax on with views over the Straight and the medina (old city). After a day in Tangier and another train ride, we've settled in Fez for a few days.

It's taken us a little while to adapt to our new surroundings. Although many people speak English, the language aspect of things has been tricky, as we've had to try to switch between Spanish and French. The common language here is Arabic (and Berber), but most educated people speak French. Sometimes, as I'm attempting French, I end up throwing in some Spanish words, which makes them think we are Spanish and then they try to use that, seeing as how our French is pretty atrocious. Eventually, it is usually apparent they speak better English than my French or Spanish and we go from there. I've only managed a few words in Arabic so far.

It's been a great trip so far and Moroccco has certainly proved exotic. We've spent most of our time in the narrow lanes and alleyways of the medinas with the various vendors, donkeys and stray cats. In guidebooks it's described as an "assault on the senses" and I would agree. We've seen some amazing sights, and have had our fair share of mint tea and couscous, but I think we will really appreciate the resort in Spain when we get back there in a few days. Still not sure how we are gonna get there, but we'll figure it out.

We'll likely be more communicative once we get to Spain.

my dar el meina

A sympathetic friend can be quite dear as a brother
-Homer

I will do a proper wedding blog sometime, but I will say now that everyone was right. It was an incredible day and I enjoyed all of it. I have a hard time using superlatives, so talking about my wedding is difficult for me. I can say I felt the love, and cried alot. I am lucky to have such a group of friends and families. I wish I could've done a better job of honouring them on the day.

Thank you everyone.

We're off to Spain/Morocco tomorrow. Hopefully I'll do some blogging on the road.

Love
Kyle

a perfect day on the grass

I don't know if I want to be a leader
-Joe the Plumber

Update.

Well, I finished my last clinical rotation of medical school with little fanfare. I was done on a wednesday and everyone else was still working, so I think I may have vacuumed the apartment or something.

I completed an Advanced Cardiac Life Saving (ACLS) course soon thereafter as it is a requirement of our (and most) residency programs. This is the time when you learn how and when to shock people who are dead. It's actually weird that it's not part of medical school curriculum. It was kind of fun though, and made me feel much more able to participate in code situations. It was an enjoyable course, mostly because it is taught by nurses who in general tend to have a different method of teaching/learning than is used in medical school. I won't go into the detail of the differences I've perceived, but most notably, nurses actually explain what you are supposed to do, let you practice and then examine you gently. In medical school, this was not always the case.

I like describing my time in medical school in the past tense. That's nice.

We ended up taking off to Christina lake after our ACLS course was done. My mom and dad came out for the day. Despite multiple boat, bbq and plumbing issues, we had a great visit and they treated me to an early birthday dinner. We were then joined by Trish, Cortney and Steph and hung out few days. The weather was cold and grey, so it was a time for fires and hot drinks, puzzles and boardgames.

During our time at the cabin, I developped a mild upper respiratory tract infection, thought by some to perhaps be the Swine Flu. Courtney did have a real flu-like illness while we were at the lake, but we are all okay, I think. Because of this, my birthday was pretty low-key, but I was treated very well and got some sweet gifts and nice birthday messages.

We write our MCCQE exams tomorrow which is kind of a wrap-up exam for everything we have learned in medical school. It is a standardized exam adminstered by an independant body and is kind of like a stamp of approval to go out and become a (supervised) doctor. It's almost impossible to study for, and almost everyone passes, but it's a long (8 hour) exam. I'm looking forward to that being checked off my list.

Then it's just the fun of wedding planning to keep us busy as all of our friends go surfing in Nicaragua

perilous pedestrians

Won't you come outside, love?
Won't you come outside?
-Kurt Vonnegut, Born Ruffians

The weather has been nice here for the past couple of days. I'm always amazed at how quickly the seasons can change. I insured my motorcycle, got it tuned up and went for a quick ride out around UBC. I cleaned up our porch, ran a few errands and went over to Cortney's to watch the Canuck's play their first playoff game.

Today, I've done much less and stayed at home for most of the day. It's a bit overcast and I've been trying, unsuccessfully, to study a little for our upcoming LMCC exams.

Courtney's home.

ways to keep people alive

It's not a good idea to shock a patient who's wide-awake
-Dr Kerry Weaver, ER

Emergency departments are interesting places to work. They really receive the whole gamut of medical issues. Hyperacute to super-chronic. Clear cut diagnoses to medical mystery. Life threatening to totally benign.

In most major emergency departments I've worked in, there are two different sections. One section is for sick people who are likely to need investigations and potentially admission to hospital. The other side is for people with minor or chronic complaints who can be seen quickly and likely discharged in a few hours. Working on the "Acute" side of the department can be scary but is interesting. This is where you see heart attacks, strokes, major trauma, appendicitis, etc. Working on the "Treatment" or "Fast Track" side is also fast-paced and challenging, but is often more difficult, as the amount of investigation need to be done is often unclear to me. People have vague complaints like a "head delay" associated with hearing their pulse in the right ear, back pain described as sharp, achey, and pressure-like all at the same time, or sudden onset of vomitting with no associated symptoms that has been happening for the past 7 years.

The ER doctors that work at VGH are specialists that only do emergency medicine. Everyone I've worked with has been very accomplished, but when I'm on the Treatment side of the ER, I sometimes find it difficult. There is an underlying premise in the ER that because someone came to the emergency department, they are probably very sick, or else they would have just waited to see their family doctor in the office. Unfortunately, many people don't have their own family doctor or perhaps don't have a good perspective on the the role of the ER in our healthcare system. Hence, we see many people who are quite well and have minor complaints. If they were being seen in an office, they would likely be reassured, and perhaps prescribed some medication. When they present to a major emergency department with many lab tests and sophisticated imaging available, they often get quite a smorgasbord of investigations to rule out various things that are unlikely. These tests can be useful, but are also often expensive, painful for patients and involve large doses of radiation. It's tricky, as the ER docs are trained to rule out life-threatening issues but it's hard not to feel like we are sometimes doing too much, especially when you see what is routinely done in smaller hospitals or in the office.

People should not be scared away from coming to the ER if they are sick or injured, but maybe a good rule is to ask yourself if what is going on is an "Emergency". If the answer is no, go to your family doctor or walk-in clinic. You will likely be seen in a more timely fashion and receive more appropriate care and follow-up.

tina and alec

sleep till you're hungry. eat till you're sleepy.

-unknown

When I've had to work through the night before, I had this theory that if I had enough time to adjust my circadian rhythm, night shifts would actually be a sweet way to work. Get your work done at night, take a little nap, and then have the whole afternoon and some of the evening to get things done and relax. I'm inbetween my 3rd and 4th night shifts of my ER rotation now and I'm realizing that the aforementioned theory is bogus. Yesterday wasn't too bad, but today I woke up at noon and have been feeling nauseous, lazy and downright apathetic. I'm still in my pajamas, and don't think I'll be getting out of them again until I have to go to work again at midnight.

Meals get screwed up as well when you work overnight. Today so far I've had 2.5 cookies, a mug of earl grey tea, one package ichiban noodles, one orange and a handful of tortilla chips. Actually, that would pretty much explain how I'm feeling now.

I'm going to go for a walk.

rando brando, f-cells and the lychee nut

the characters don't talk or move around
-Every Name Is My Name, Matthew Good Band

Things seem to be more or less in a holding pattern.

Med school post-CaRMS is bizarre. Well, maybe it's just been this march that has been weird. Many people are out of town on electives and Courtney has been extremely busy on her vascular surgery rotation. The weather has been volatile and cold. Hematology has been interesting but I'm over it (tomorrow is my last day). I knew this already, but I'm not someone who could do a sub-speciality. I'm already bored by seeing the same thing over and over again.

I start an emergency rotation at VGH on monday. I'm looking forward to improving my skills and seeing some sick people hopefully.

mr pg

As we know, there are known knowns. There are things we know we know. We also know there are known unknowns. That is to say we know there are some things we do not know. But there are also unknown unknowns, the ones we don't know we don't know.
-Donald Rumsfeld

In follow-up to today's earlier post.

We matched to the UBC Prince George Family Medicine program. No matter what, getting the results is a bit of a shock, but we're really happy with what we got.

CaRMS is a funny system because when you match- that's it. You painstakingly put together your application, spend lots of money travelling around the country and deliberate over a list, but once you submit that list (which we did a few weeks ago), there isn't anything left to do. This morning, we opened up our online file and got our match results. It's not like an offer we can accept or decline, it just means we're going to Prince George for 2 years. In the words of CaRMS, it is a "binding contract".

So I think no matter what result you get, it's kind of a weird moment, because your relatively immediate future, which a few seconds previous had looked relatively fuzzy, suddenly becomes quite clear. CaRMS just messes with you a bit because they force you to rank your choices. I think it's a good system that they have, but once you actually make a numbered list, it's hard not to feel a little dissapointed when you don't get your top choice.

Our first two choices were Kelowna and Prince George Rural (which means your travel around for the 2nd year) and because we were couples matching, we weren't really expecting to get our top choice, as the Kelowna program is quite competitive. The PG Rural program only had 3 spots, so that was kind of dicey as well.

At any rate, this is turning kind of rambly. The point is that after an initial adjustment period, we are quite excited about what we got. There are alot of positives to the program we got, which include

- Not having to move around during the 2nd year
- Having medical students around to teach
- Good family practice clinic set up
- ICU rotation in 2nd year
- It is a new place for both of us

It was number 3 on long list of 40+ possibilities, so we are stoked.

2 bedrooms and a den

Match results are in. We are going to Prince George for residency. It was our 3rd choice.

parallel parking as painful entertainment

I don't believe one grows older. I think that what happens early on in life is that at a certain age one stands still and stagnates.
-T.S. Eliot

"So, do you feel older?"

You may have gotten this question before on one of your birthdays and been less than impressed with your interviewer.

When you're a kid, I think you identify strongly with your age. Despite this, I don't remember ever answering 'yes' to that question when I was in grade school. Once you get past your mid-twenties, however, I think age becomes less of an issue, and consequently you don't think about it as much. I often end up having a hard time remembering if I'm 27 or still 26. Sometimes I have to do the math. Anyhow, because of this, I end up thinking more about my age on my birthday, and it usually surprises me to realize how old I actually am. As a result, I've actually answered yes to that silly question on my last few birthdays.

I've been thinking about this because even though my birthday is still pretty far off, I'm feeling older these days. I don't mean more tired or jaded or whatever, just....older. There have been signs that are hard to ignore. I've noticed my friends have started wearing collared shirts even when they don't have to. I've been astonished by the number of times the word "like" is peppered in the conversations of teenagers, and how removed I feel from the stuff they're talking about. I've started wondering about my salary next year, and how best to pay off my debt.

And then there are the obvious things. I'm getting married. I will no longer be a student (I paid my last installment of tuition, and took my last major exam this month). I'm getting some different letters in front of (or behind) my name in a few months. Other people's expectations and your own self-image change with all this.

So I actually have this sensation of aging somewhat rapidly. It's weird I guess, but not unwelcome. Since being a teenager, I've worried that I might stop evolving. So I'm happy things are changing and I'm growing older. We'll see how I feel at my next birthday.

what's up super-penel? not much wolfman

I believe every human has a finite number of heart-beats.
-Buzz Aldrich

It's been a great week back in Vancouver. The sunshine held out and it was a full-on faux february spring here. We had lots of time to catch up with friends and get outside to enjoy the mild weather. I hate to think of myself as a Weekend Warrior, but that is more or less what I've become. I was almost entirely sedentary during my interview tour. Except for lugging my bags and a short stint on a treadmill, I did zero physical activity for 3 weeks. Upon my return to Vancouver, I started riding my bike every day to UBC, and then Yoga or Soccer or Ultimate in the afternoon/evenings. It was fun to get back into everything, but as I've posted earlier, this sort of behaviour leaves me more or less crippled. I'm going to try and play squash tomorrow, but I'm a little bit afraid....usually my first squash game after a rest makes me wish I had a wheelchair and a parking pass for the next couple of days. I'm not sure if I'm ready for that kind of pain again so soon.

Also, we have our OSCE (clinical exam with actors playing patients) next weekend and I should probably start exercising the old noggin a little as well.

the private parts of our lives

To be a remain, remain, remain, remainder
-Long Division, Death Cab for Cutie

Ahhhhhh.... it's nice to be home again. Whatever you might like to say about Vancouver, when it's nice here, it's really nice. Arriving home on a flight from Toronto yesterday, it felt like instant spring. I have missed having proper winters since being in Vancouver, but it would be a stretch to say that I'm not usually sick of winter by the end of january.

Anyhow, we had a great tour. It was awesome to see so much of my family and friends and after seeing all those people, I've been feeling lucky to have such an amazing crew of people in my life. Thanks to everyone who housed, fed and ferried us around for the past couple of weeks. Having you around made the whole trip enjoyable and worthwhile.

As for the residency interviews, things went about as we expected. We now have to rank UBC, U of C, U of T, Ottawa, Queen's, Dalhousie and Memorial and all the sub programs within each of them. We have a good chance of going somewhere within the top 3 programs we rank, and probably the top 5-7 are important in terms of what order they go in. We're still undecided about how the ranking will go (read: we're still not sure if we'll be in BC, Ontario or the maritimes) but it has to done in 2 weeks or so, and then we find out where we'll be going on March 9th. We'll post the results here after we match.

chickety chickety pow pow

but never more 'here'

expanse getting broader
though bigger boats been
done by less water
-The Tragically Hip, The Dire Wolf

Courtney has been blogging up a relative storm lately. Go check it out if you are interested in reading some of what we've been up to.

Right now, we're in Ottawa, staying with my Aunt and Uncle. It's about halfway through our interview tour, after our Ottawa U interview taking place tomorrow, we will be done 6/8 of our interviews.

So far we've been to Calgary, Edmonton, St John's, & Ottawa. We go to Kingston on friday and then finish up in Toronto before flying home on the 13th.

The interviews have gotten easier as we get more experienced. I don't think I'm necessarily getting any better, but I'm getting less anxious about them. We have learned a lot about the different programs, but don't feel that much closer to figuring out where we would like to be next year. Everywhere has it's pros and cons, and we'll haveto really decide what's important to us.

The best part of the tour is being able to get around and visit with people. By the end of these 3 weeks, I'll have had the opportunity to see most of my extended family and friends across the country. It is also a nice opportunity for people to meet Courtney before the wedding.

We've also had the chance to do some cool touristy stuff. We went to West Edmonton Mall Waterpark, stood on the most Eastern point in North America (Cape Spear), been taken on an impromptu tour of the Battery in St John's, toured the parliament buildings in Ottawa, and ran into friends in most major airports in the country. Except for the occasional stress of interviews, it's actually been a sweet vacation and a great opportunity for Courtney and I to see this big country of ours.

alternate title: uncertainty

The only thing we have to fear is fear itself
-Franklin D Roosevelt

My week at BC Children's Hospital doing Pediatric Urology was awesome. I learned some practical things (how to treat phimosis) and some not so practical things (how to do an epispadias repair). Actually, probably the most practical thing was that I got back in the swing of dictating notes again.

Anyhow, that's neither here, nor there. What is here is CaRMS interview season. It starts on tuesday when I do my Dalhousie interview and streeeeeches all the way to Feb 11th when I end with my Queen's interview in Kingston. This year, Dal is actually moving around and doing interviews in a variety of locations, including Vancouver. If we hadn't recently been to Halifax, I think I would be more keen on actually going there for the interview to suss it out, but for us, it's perfect that they are coming here. Also, Dalhousie isn't very high on our list, so it's nice that we get one warm up interview before UBC next weekend.

I've always had a problem with interview anxiety. I really shouldn't be that anxious, considering that Courtney and I are both good candidates, we would be happy doing our residency in a variety of different places, and we are both applying to family medicine, which along with with internal medicine and psychiatry, is not very competitive. People say that for Family Practice, it's really you that is going around and interviewing the programs, and that they should be trying to win you over. Unfortunately, however, I'm still nervous, which is bad, because what makes me nervous is that they will ask me a question that I won't have a good answer for. And when I'm nervous, I'm much more likely to blank out on a question. So it's a vicious cycle, or circle or whatever. It's not that I'm worried that I will screw everything up and have to live in northern manitoba for two years, it's just that moment of not being able to answer that is so excruciating for me.

In reality, the interviews will go fine. Some will be better than others, but there isn't too much I can do to change it. Right now I'm trying to forget about my interview fear and focus on the fact that this is a good excuse to fly around the country, see old friends and visit new places.

poaching lions

So this is the new year
and I don't feel any different.

-The New Year, Death Cab For Cutie

I went home again for the holidays this year. I again felt lucky to have such a nice place to go home to, and such nice people there to welcome me back. I had stuck around for a few extra days in Vancouver after classes ended and did some stuff with Courtney's family. I was driving home by myself on the 23rd, so I offered a ride on craiglist and found someone from Rossland who needed a lift.

At home, I managed to get in quite a few days up at Red Mountain, a day of cross country skiing and spent new years at our cabin on Christina Lake for the first time. I was lucky to be visited by my cousin Dante, his girlfriend Ashley and their dog Jasper. I hadn't seem him in a number of years, so it was cool that he was able to come for a visit. We were also visited by a few of our classmates who were in the area, and I had the privilege of showing them around the ski hill on sunny day. Courtney attempted to fly in Dec 29th, but (pretty much as can be expected in Cancelgar), was unable to due the weather. Luckily she was diverted to Cranbrook instead of being taken back to Vancouver and Air Canada even provided a charted bus to finish the trip. Needless to say it was great that she got in the same day she was trying to, and it was fun to have her see a Castlegar winter for the first time.

Tomorrow, I start a 2-week elective in Urology. I haven't done inpatient medicine in quite a while, heck, I haven't even seen a patient of any kind in a month and half, so I'm feeling a little rusty. I reviewed some basic urology, but if this is like any other surgical rotation, I'm probably in for a shock.

Interviews are rapidly approaching. Let me give you an idea of when I will be visiting you.

Jan 24/25-Calgary
Jan 26/27-Edmonton
Jan 29- Newfoundland
Feb 5- Ottawa
Feb 9- Toronto
Feb 11- Kingston

There may be a few more coming, but that is the core of the tour.

Here are some photos.

This is me in some fresh pow at Red.

The Merritt "Children"

Dante and I chillin' on the porch at the lake

Cortney (the boy) and I making a fresh start to the New Year.

The view from the walk in.

Courtney being herself

Compliments to Trisha for learning to use her new camera so quickly, and letting me have the files.