When I say yesterday, I am not trying to poetically refer to the past or history. I mean, yesterday quite literally. There was an urge to write, so I did it on a piece of paper with a pencil at Starbucks.
Just before I relay that entry, I wanted to tell you that today, as a volunteer with Project Genesis (which I have discussed in previous entries), I accompanied the woman I work with to interview a nurse who works for Medecins du Monde for a mini-documentary she's doing on healthcare rights, etc. This nurse, through MM, which also has psychologists, a couple of volunteer doctors and probably some social workers, actually goes on the streets of Montreal with a small suitcase on wheels and a backpack, to deliver basic care (vaccines, UTI medicine, etc) out of a little 'clinic' to communities that have been marginalized by the healthcare system -mainly people who live on the street / street workers, prostitutes, and Natives/First Nations people. Really, it was amazing to hear about her story and heartening that there are actually so many people like her and so many organizations like this one in Montreal, that don't even exist in other parts of Canada. This is why I am proud to be a Montrealer.
Anyway, this was what I had to say yesterday (my thoughts on Obama's glorious win, and on delicious food).
Caramel apple cider is delicious. I don't think many people know about it or realize how wonderful it is, but really... apple pie in a cup. Life is good today, the world is sweet. Yes, I'm going on four hours of sleep, renal is kicking my ass so far and I don't feel like studying, but it's a beautiful, warm, sunny day in November. And last night Obama made history -first elected African-American President of the United States of America. The media at least keeps framing it this race-way. But it is really so much more than that, like charcoal-grey, thick, cottony clouds blowing away, out of the way, and beneath, the glow of a vibrant world with hope renewed all around. He is a man with a vision of peace, justice, alliances and prosperity for his people; he has spirit and his charisma is infused in every poetic world uttered, words that will move more than hearts, and, inshallah, will summon more than tears from the people's eyes -joy, hope and real, profound change. Not overnight of course, and not without many a grueling challenge, but slow, gradual positive transformation. It is amazing.
I have been wishing everyone 'Happy Obama Day' today, and I wish you the same. At the very least, you must concede that he is a reasonable, intelligent man who brings good will, which is refreshing in itself in American political leadership at the highest levels (I refuse to contaminate the manuscript of my soul with unworthy names, but we all know who I refer to here). And as I've said to many of my friends today, if our idiotic Canadian Prime Minister insists on kissing the Americans' ass, well, at least it's worth kissing now.
Speaking of kissing, I miss it. I also miss a capella and choir concerts, the Kirkland House JCR and courtyard, walking past Widener and Au Bon Pain in the morning, and concoting new culinary experiences out of ready-made dining hall food to the admiration and envy of my beloved blockmates. I was reminded of this last yesterday night in particular.
We had a potluck dinner meeting for Physicianship Apprenticeship that though fabulous, went a little later than I would have liked (from 6:30-11:30. yeah. for reals.). However, the company and conversation was great. And oh, the food! Copious amounts of baguette, Brie, Camembert, goat cheese and Swiss. Plentiful Italian red wine (no worries -water, jasmine and pear green teas were my choice of beverages). Bruschetta with pesto. Mixed greens with baby tomatoes, kalamata olives, bocconcini (tiny mozzarella balls) and balsamic vinaigrette. Green string beans cooked with tomato, garlic, sauteed onions and parmesan. Pasta primavera -fusilli with tomato, onion, zucchini, garlic and mozzarella. And to round out our Italian-themed night... butter chicken! Yup, one of my favourite South Asian dishes (speaking of which, after a 4-month-long craving, I finally managed to get some quality jelabi, which is an Indian fried sweet that is bright orange from sugar, lemon juice and saffron -really yummy). The butter chicken though -random, but impressively tasty. And for dessert: strawberries, pineapple and apple with dark chocolate fondue, and mango-peach sorbet swirled with vanilla ice cream. I know. No wonder it took five hours!
This week is very meeting-heavy on the whole though. But also fun plans with friends. Also, I did quite well on my respirology midterm (shukar), so the med school life is moving along. During Physicanship today we discussed homosexuality, heterosexism, homophobia and gender, in society more broadly, and in the context of the doctor-patient relationship. Very interesting, especially at the end when two patients talked to us about their experiences and answered questions. One was a 40-something married lesbian woman with three young children (sperm from anonymous donors), and the other was a 60-year-old gay man, from a Catholic-to-the-bone Quebecois family, who has been a teacher for forty years.
Anyway, time to catch up on that renal [I said this in the original entry yesterday, and it remains true today]. As they say on Grey's, seriously.
Thursday, November 6, 2008
Thursday, October 23, 2008
Taking a Breath: Real Patients, Real Medicine and Real Life
Yes, we have progressed from cardio to respiratory. Puns are not as lowly as you might think. They can even be witty. My gchat status has lately been alternating between "turbulent flow", "physiological dead space", "just dead space" and my latest one: "everybody needs a little TLC -that is "Total Lung Capacity"". I know. I am such a nerd (but you love me for it).
Anyway, this is a long post, so for your convenience, I have subtitles throughout so you can read only what you're interested in (and I'll save you the agonizing anticipation -there is no hot romance discussed below ;).
Cool stuff in the books.
So I'm learning about lungs, hemoglobin and partial pressures of CO2 and O2 lately. I won't bore you with any doc-talk (or med-student talk), but I will just briefly mention that respir actually does have a "really cool thing" analagous to the cardio "really cool thing" which was "Venous Return" (if you recollect). Basically, just like how the blood returning to the heart from the veins is one of the biggest determinants of blood circulation (rather than pure cardiac output), similarly, it is not low oxygen but high carbondioxide that decides whether or not someone is hyper- or hypo-ventilating (and other important things relating to breathing). It's always the counter-intuitive stuff that's coolest if you ask me. That is, counter-intuitive, but still understandable (unlike some of my lectures of late).
Brief meeting with 'Real Medicine'.
I recently had the following thought though: "Okay friends, med school was a fun adventure and I'm ready to go home now..." Except there is no home. This is home. And it is strange that the fact that this is my life and a lot more to come from now on, has only hit me now. Don't get me wrong, I am learning a lot, getting excited, getting bored, then excited again. I am still mainly starry-eyed about medicine -hopeful, momentarily discouraged, and then hopeful again. I pulled out my back, limped around for a week, and then healing and walking normally again, but during the limping around phase, I shadowed my former CEGEP orgo lab partner (who is now a Med-4) during his neurology clerkship. It was pretty awesome to visit patients with him, see a doc (well not technically I guess) actually do the reflex tests they always show them doing in kindergarten picture books, apply hand sanitizer 8 times in 20 minutes, do a little investigative work on uptodate.com, watch a "team" analyze CT scans of a stroke patient in radiology, and most excitingly: watching a real-live LP ("lumbar puncture" = spinal tap, the purpose of which was to test cerebrospinal fluid for encephalitis or menengitis) for the first time!
Keeping it 'Real': Life Pseudo-Outside the Med Bubble (okay, not really, but outside the book-worming bubble!)
This past weekend, I found out that I got the volunteer position I wanted with an organization in Montreal that advocates for public health care and immigrant rights, particularly fighting against a Quebec bi-law that denies healthcare coverage for newly-landed immigrants for the first 3 months. The organization -Project Genesis -also works with the local immigrant community providing various social services, advice (like helping find loop-holes in the law), etc. So I am looking forward to making my med school life actually mean something in the real world where the people live.
The noteworthy, traditionally heavily Med-1-attended Osler Banquet is coming up next week, and I have been involved in some small ways (like postering -Steiny and Chi, I finally know what your crazy postering lives were like -and some ticket distro next week right before). The guest lecturer is Richard Horton, editor-in-chief of the Lancet, who will be talking about doctors and their social responsibilities in a global health context. Should be pretty awesome. My Resp midterm is 2 days later.
Today I registered for MedGames, which is this:
Med students from across the country get together and compete in real sports like hockey, swimming and volleyball, as well as 'parasports' like DDR, Rock Band and Capture the Flag, and then 'bond' during various night-time social events. It is for a weekend in January, and every year is hosted by a different med school. Luckily for moi, the 2009 MedGames are being hosted by Universite de Montreal (UdeM), so it is just here at home, nice and cheap and convenient.
'Real Patient': First Official Clinical Encounter
I had my first official clinical encounter yesterday at the Royal Victoria Hospital, in our Osler Fellow's Hematology Department, a woman in her 40s with leukemia (sudden and acute -not the most optimistic prognosis) who was just about to have her first bone marrow stem cells transplant... what really struck me was a couple of things: firstly, she was super athletic and active and now suddenly has been bed-ridden in a hospital for 4 months. BUT it was so touching to see the amazing support system she has. 3 WHOLE WALLS COVERED in well-wishing, get well cards, family and friends by her side all the time (love was palpable in that room!). Also, the patient told such a wonderful story about how her brothers and sisters were all hoping that they could all be a match to donate their stem cells to her, literally "fighting over" who could give their dear sister their stem cells... and not only was 1 match found, but 2! Imagine finding 2 potential donors amongst sibilings of a stem cell recipient, when to find just 1 is a blessing. However, just as love was palpable in that room, so was the overwhelming sense of mortality, of feeling that life had been snatched away so quickly... imagine having to write your will when you're in your forties. That encounter will stay with me always I think. She is a beautiful person, and all medical reasoning aside, I will keep her in my prayers, my thoughts and my heart. I want her to be well. Too bad my wanting it that way alone cannot just make it be that way.
Anyway, this is a long post, so for your convenience, I have subtitles throughout so you can read only what you're interested in (and I'll save you the agonizing anticipation -there is no hot romance discussed below ;).
Cool stuff in the books.
So I'm learning about lungs, hemoglobin and partial pressures of CO2 and O2 lately. I won't bore you with any doc-talk (or med-student talk), but I will just briefly mention that respir actually does have a "really cool thing" analagous to the cardio "really cool thing" which was "Venous Return" (if you recollect). Basically, just like how the blood returning to the heart from the veins is one of the biggest determinants of blood circulation (rather than pure cardiac output), similarly, it is not low oxygen but high carbondioxide that decides whether or not someone is hyper- or hypo-ventilating (and other important things relating to breathing). It's always the counter-intuitive stuff that's coolest if you ask me. That is, counter-intuitive, but still understandable (unlike some of my lectures of late).
Brief meeting with 'Real Medicine'.
I recently had the following thought though: "Okay friends, med school was a fun adventure and I'm ready to go home now..." Except there is no home. This is home. And it is strange that the fact that this is my life and a lot more to come from now on, has only hit me now. Don't get me wrong, I am learning a lot, getting excited, getting bored, then excited again. I am still mainly starry-eyed about medicine -hopeful, momentarily discouraged, and then hopeful again. I pulled out my back, limped around for a week, and then healing and walking normally again, but during the limping around phase, I shadowed my former CEGEP orgo lab partner (who is now a Med-4) during his neurology clerkship. It was pretty awesome to visit patients with him, see a doc (well not technically I guess) actually do the reflex tests they always show them doing in kindergarten picture books, apply hand sanitizer 8 times in 20 minutes, do a little investigative work on uptodate.com, watch a "team" analyze CT scans of a stroke patient in radiology, and most excitingly: watching a real-live LP ("lumbar puncture" = spinal tap, the purpose of which was to test cerebrospinal fluid for encephalitis or menengitis) for the first time!
Keeping it 'Real': Life Pseudo-Outside the Med Bubble (okay, not really, but outside the book-worming bubble!)
This past weekend, I found out that I got the volunteer position I wanted with an organization in Montreal that advocates for public health care and immigrant rights, particularly fighting against a Quebec bi-law that denies healthcare coverage for newly-landed immigrants for the first 3 months. The organization -Project Genesis -also works with the local immigrant community providing various social services, advice (like helping find loop-holes in the law), etc. So I am looking forward to making my med school life actually mean something in the real world where the people live.
The noteworthy, traditionally heavily Med-1-attended Osler Banquet is coming up next week, and I have been involved in some small ways (like postering -Steiny and Chi, I finally know what your crazy postering lives were like -and some ticket distro next week right before). The guest lecturer is Richard Horton, editor-in-chief of the Lancet, who will be talking about doctors and their social responsibilities in a global health context. Should be pretty awesome. My Resp midterm is 2 days later.
Today I registered for MedGames, which is this:
Med students from across the country get together and compete in real sports like hockey, swimming and volleyball, as well as 'parasports' like DDR, Rock Band and Capture the Flag, and then 'bond' during various night-time social events. It is for a weekend in January, and every year is hosted by a different med school. Luckily for moi, the 2009 MedGames are being hosted by Universite de Montreal (UdeM), so it is just here at home, nice and cheap and convenient.
'Real Patient': First Official Clinical Encounter
I had my first official clinical encounter yesterday at the Royal Victoria Hospital, in our Osler Fellow's Hematology Department, a woman in her 40s with leukemia (sudden and acute -not the most optimistic prognosis) who was just about to have her first bone marrow stem cells transplant... what really struck me was a couple of things: firstly, she was super athletic and active and now suddenly has been bed-ridden in a hospital for 4 months. BUT it was so touching to see the amazing support system she has. 3 WHOLE WALLS COVERED in well-wishing, get well cards, family and friends by her side all the time (love was palpable in that room!). Also, the patient told such a wonderful story about how her brothers and sisters were all hoping that they could all be a match to donate their stem cells to her, literally "fighting over" who could give their dear sister their stem cells... and not only was 1 match found, but 2! Imagine finding 2 potential donors amongst sibilings of a stem cell recipient, when to find just 1 is a blessing. However, just as love was palpable in that room, so was the overwhelming sense of mortality, of feeling that life had been snatched away so quickly... imagine having to write your will when you're in your forties. That encounter will stay with me always I think. She is a beautiful person, and all medical reasoning aside, I will keep her in my prayers, my thoughts and my heart. I want her to be well. Too bad my wanting it that way alone cannot just make it be that way.
Friday, October 10, 2008
Right in the "Heart" of it: Cardio, Delicious Autumn Days
So, for the last 3 weeks, I have been learning all about the heart. Cardio is pretty awesome. Just had the midterm for it today -hopefully that went well. But I loved this first part of the second unit. I mean sure, it's just a pump -not a crazy, amorphous, mysterious brain or anything -but it is an amazing pump.
One of the coolest concepts, in my opinion, is the fact that venous return (which is the flow of blood from your veins back to your heart) is a stronger determinant of cardiac output (which is how much blood your heart pumps out and how fast) than almost any other factor. This is why if a patient has low blood pressure, giving them IV saline brings their blood pressure back up: you've increased blood volume in the veins, and thus increased venous return. Maybe this seems common-sensical to some of you, but I think it's amazing how learning about all this stuff teaches you to see medical "problems" and "solutions" in a completely different way. I mean, who would naturally think, "oh your heart is pumping too slowly/not hard enough, but if we give you fluid, we'll get it back up to normal". I'm telling you, these Frank-Starling people (the ones who said that cardiac output is equal to venous return, or put more simply, the heart will pump out what comes in)... geniuses.
Also, there are a ton of regulatory "reflexes" that we have, which really shows that our bodies are just really smart (most of the time). Like, why we don't faint everytime we stand up, or why atheletes have a lower heart rate than normal people, but this is okay, whereas if you're not an athlete and have a low heart rate, this could be very bad. Or what a heart murmur sounds like, and what it tells us, and when we should worry about it, and when it's okay. All those things we commonly "know", but don't really, really, really, fully, completely, understandingly know. And even the body's "stupidities" make sense, when you understand some of this crazy theory stuff (like venous return!) -I love medical school. And I am so happy that I am learning most of this for the first time now (rather than being "bored out of my tree", like some of the anatomy majors in my class).
This weekend is Canadian Thanksgiving. It is supposed to be a perfectly beautiful weekend and I am so excited for it -easy "hiking" at St. Bruno with my parents tomorrow, apple picking with some med school friends on Monday, catching up on sleep, movies, non-medical reading and writing. Even a couple of "chores". Met up with a dear friend after my midterm at this cute little place on Monkland, in N.D.G., called Gryphon D'Or. Tried it out a few weeks ago for high tea -Early Grey Cream tea, hot scones, Devon cream, lemon curd, fresh raspberry jam, cucumber and egg sandwiches, date squares, brownies, shortbread... delicious and non-pretentious -heavenly, really. So naturally, had to go back today, for Ginger Peach tea, scones, potato-leak soup and pleasant conversation. Today, I am in love with the world, the people in it, my city, and my life. I wish the same for you.
One of the coolest concepts, in my opinion, is the fact that venous return (which is the flow of blood from your veins back to your heart) is a stronger determinant of cardiac output (which is how much blood your heart pumps out and how fast) than almost any other factor. This is why if a patient has low blood pressure, giving them IV saline brings their blood pressure back up: you've increased blood volume in the veins, and thus increased venous return. Maybe this seems common-sensical to some of you, but I think it's amazing how learning about all this stuff teaches you to see medical "problems" and "solutions" in a completely different way. I mean, who would naturally think, "oh your heart is pumping too slowly/not hard enough, but if we give you fluid, we'll get it back up to normal". I'm telling you, these Frank-Starling people (the ones who said that cardiac output is equal to venous return, or put more simply, the heart will pump out what comes in)... geniuses.
Also, there are a ton of regulatory "reflexes" that we have, which really shows that our bodies are just really smart (most of the time). Like, why we don't faint everytime we stand up, or why atheletes have a lower heart rate than normal people, but this is okay, whereas if you're not an athlete and have a low heart rate, this could be very bad. Or what a heart murmur sounds like, and what it tells us, and when we should worry about it, and when it's okay. All those things we commonly "know", but don't really, really, really, fully, completely, understandingly know. And even the body's "stupidities" make sense, when you understand some of this crazy theory stuff (like venous return!) -I love medical school. And I am so happy that I am learning most of this for the first time now (rather than being "bored out of my tree", like some of the anatomy majors in my class).
This weekend is Canadian Thanksgiving. It is supposed to be a perfectly beautiful weekend and I am so excited for it -easy "hiking" at St. Bruno with my parents tomorrow, apple picking with some med school friends on Monday, catching up on sleep, movies, non-medical reading and writing. Even a couple of "chores". Met up with a dear friend after my midterm at this cute little place on Monkland, in N.D.G., called Gryphon D'Or. Tried it out a few weeks ago for high tea -Early Grey Cream tea, hot scones, Devon cream, lemon curd, fresh raspberry jam, cucumber and egg sandwiches, date squares, brownies, shortbread... delicious and non-pretentious -heavenly, really. So naturally, had to go back today, for Ginger Peach tea, scones, potato-leak soup and pleasant conversation. Today, I am in love with the world, the people in it, my city, and my life. I wish the same for you.
Thursday, September 25, 2008
"Sophie"
Two very exciting things happened this week:
1) my favourite cousin/uncle has been in town and we have been catching up just about every day after school -that has been wonderful. so really, friends, come and visit me -it'll make my week =)
2) We started anatomy this unit (the post-first-final madness has begun!)... which means that I have started having labs with cadavers. I am holding nothing back because if only everyone could start to try to understand some of the mysteries of the human body, I think the world would be a better place. To try to understand, and to love your own body, your own person, your own mortality even, and to see it in others -even if only felt for a moment, should not be kept a secret.
The first encounter is pretty much branded in my memory (for now anyway). Tuesday, 1:30 p.m. I am nervous as hell. Walking up the last couple of steps to the second floor of Strathcona, my heart decides to take a little bounce on some invisible emotional strings, and I am surprised it did not lodge itself in my trachea. They told us that how we are with our cadaver, this former person who in death has become our first patient, will tell us a lot of how we will be with our future patients, what kinds of doctors we will be. That's enough pressure to give your heart springs, forget the fact that you will actually be using a scalpel (after today, I will have used both a 15- and 20-blade, forceps, bone clippers and my fingers, obvi) and cutting through human flesh.
We walk into a big room with over 40 bodies covered with forest green shrouds. I walk over to #39 -the one to which I was assigned, along with three of my peers. The Prof. does her demo and we watch on the screens and rise onto our tiptoes to see it "for real". And then, we remove the cover, and cut open the clear plastic encasement. I look at her hair and notice the grey roots, and short auburn-dyed locks, there is a cloth on her face, but I know she's a woman. Some of the others are not sure though (hey, obese and even overweight men might appear to have larger breasts, so this is not as obvious as it may seem). One of the lab techs comes around and pulls the green cover lower to "check" -yes, she is a woman... probably died about 60-something, but how is a mystery to us. Her abdomen is a redish-brown discolour, and her skin is tough and leathery. All I could think about was "What was her name?" I think they don't tell us for confidentiality purposes. Anyway, I am the first one to suggest a name for her. I am in awe of her. I want to know who she is, what she did, did she love, how amazing that she would donate her body to us, so that we could learn from her even in her death. She may not have been a teacher in real life, but to be teaching us now... Our anatomy Prof. is obsessed with telling us about the Greek and Latin origins of all the words we're learning, so I'm also remembering Greg Nagy's "Greek Heroes".
"I think I'm going to call her 'Sophie'", I say. It just felt right. Sophie from 'sophos' or 'wise' -like the greatest 'teachers' in history.
I made the first cut, going from the right-most part of the clavicle medially down to the sternum, then down the middle, and then laterally again from the sixth rib. I thank Sophie for what we're going to learn from her. You don't know how thick skin is until you know how tough it is to cut through it. It really is an amazing organ and no wonder it protects us from so many pathogens. I am not scared, and unlike some of the others, I do not feel badly or guilty for cutting -Sophie wanted us to learn from her body, including any mistakes along the way. It would be okay. I quickly learn how much pressure to apply so that I can penetrate the skin, without going too deeply, but also without going too shallow. I am completely focused -this is how I can honour her, to be fully present with her, and do my best by her.
We were supposed to peel off the layer of skin, but bright orangey-yellow adipose tissue (fat tissue) provides us with a challenge. It is tough to get through, and there is a lot of fascia, lots of connective tissue before you hit any muscle. As we make our way through it, I feel a sudden sharp jab on my left index finger, there is a slit in my glove and blood seeps out -one of my teammates has accidentally cut me. I am told to wash it under cold water and am given a Band-Aid. I had been so worried about cutting myself. How ironic that it should happen by someone else's blade. I come back and we are starting to see some muscle. We are all working systematically, more or less professionally, but it hits me here hard: it looks like meat. Just like red meat. Meat, meat. Human muscle. Meat, meat. The bones of the ribcage are shiny, covered in some kind of connective tissue. But the muscles -and we identify pectoralis major and minor, and the small muscles along the side of the rib cage, and a couple of nerves. And then we are done. Close up shop and wash the scalpels and forceps.
But all I can think of is how strange I feel in my own body. This human body, this human animal body. I keep running my hands over my skin, pinching it, making it tight. Does it feel like leather? And all I see is the meat meat that's inside, Sophie had meat meat inside. And all I can smell still is the formaldehyde, which reminds me of the meat meat inside Sophie. You don't realize the concept that humans are animals, just like other animals, so viscerally until you've seen it. We are so very mortal. So very, very mortal. And Sophie, in her mortal life, and in death, gave us this special, special gift -she did not know me, but she gave it to me anyway, she trusted me anyway, and taught me anyway -that we're all going to die one day, and that our muscles will look like meat, meat. And our 'who we are' will no longer be there, and if we all had the good sense of not only being helpful and useful in life, but to be useful in death too -to serve even in death -that is special indeed. I was such a daze. Did I even know what it meant to really make it count in this life and this world? Sophie, sophos. If it was ever possible to feel 'mortality', I felt it on Tuesday.
1) my favourite cousin/uncle has been in town and we have been catching up just about every day after school -that has been wonderful. so really, friends, come and visit me -it'll make my week =)
2) We started anatomy this unit (the post-first-final madness has begun!)... which means that I have started having labs with cadavers. I am holding nothing back because if only everyone could start to try to understand some of the mysteries of the human body, I think the world would be a better place. To try to understand, and to love your own body, your own person, your own mortality even, and to see it in others -even if only felt for a moment, should not be kept a secret.
The first encounter is pretty much branded in my memory (for now anyway). Tuesday, 1:30 p.m. I am nervous as hell. Walking up the last couple of steps to the second floor of Strathcona, my heart decides to take a little bounce on some invisible emotional strings, and I am surprised it did not lodge itself in my trachea. They told us that how we are with our cadaver, this former person who in death has become our first patient, will tell us a lot of how we will be with our future patients, what kinds of doctors we will be. That's enough pressure to give your heart springs, forget the fact that you will actually be using a scalpel (after today, I will have used both a 15- and 20-blade, forceps, bone clippers and my fingers, obvi) and cutting through human flesh.
We walk into a big room with over 40 bodies covered with forest green shrouds. I walk over to #39 -the one to which I was assigned, along with three of my peers. The Prof. does her demo and we watch on the screens and rise onto our tiptoes to see it "for real". And then, we remove the cover, and cut open the clear plastic encasement. I look at her hair and notice the grey roots, and short auburn-dyed locks, there is a cloth on her face, but I know she's a woman. Some of the others are not sure though (hey, obese and even overweight men might appear to have larger breasts, so this is not as obvious as it may seem). One of the lab techs comes around and pulls the green cover lower to "check" -yes, she is a woman... probably died about 60-something, but how is a mystery to us. Her abdomen is a redish-brown discolour, and her skin is tough and leathery. All I could think about was "What was her name?" I think they don't tell us for confidentiality purposes. Anyway, I am the first one to suggest a name for her. I am in awe of her. I want to know who she is, what she did, did she love, how amazing that she would donate her body to us, so that we could learn from her even in her death. She may not have been a teacher in real life, but to be teaching us now... Our anatomy Prof. is obsessed with telling us about the Greek and Latin origins of all the words we're learning, so I'm also remembering Greg Nagy's "Greek Heroes".
"I think I'm going to call her 'Sophie'", I say. It just felt right. Sophie from 'sophos' or 'wise' -like the greatest 'teachers' in history.
I made the first cut, going from the right-most part of the clavicle medially down to the sternum, then down the middle, and then laterally again from the sixth rib. I thank Sophie for what we're going to learn from her. You don't know how thick skin is until you know how tough it is to cut through it. It really is an amazing organ and no wonder it protects us from so many pathogens. I am not scared, and unlike some of the others, I do not feel badly or guilty for cutting -Sophie wanted us to learn from her body, including any mistakes along the way. It would be okay. I quickly learn how much pressure to apply so that I can penetrate the skin, without going too deeply, but also without going too shallow. I am completely focused -this is how I can honour her, to be fully present with her, and do my best by her.
We were supposed to peel off the layer of skin, but bright orangey-yellow adipose tissue (fat tissue) provides us with a challenge. It is tough to get through, and there is a lot of fascia, lots of connective tissue before you hit any muscle. As we make our way through it, I feel a sudden sharp jab on my left index finger, there is a slit in my glove and blood seeps out -one of my teammates has accidentally cut me. I am told to wash it under cold water and am given a Band-Aid. I had been so worried about cutting myself. How ironic that it should happen by someone else's blade. I come back and we are starting to see some muscle. We are all working systematically, more or less professionally, but it hits me here hard: it looks like meat. Just like red meat. Meat, meat. Human muscle. Meat, meat. The bones of the ribcage are shiny, covered in some kind of connective tissue. But the muscles -and we identify pectoralis major and minor, and the small muscles along the side of the rib cage, and a couple of nerves. And then we are done. Close up shop and wash the scalpels and forceps.
But all I can think of is how strange I feel in my own body. This human body, this human animal body. I keep running my hands over my skin, pinching it, making it tight. Does it feel like leather? And all I see is the meat meat that's inside, Sophie had meat meat inside. And all I can smell still is the formaldehyde, which reminds me of the meat meat inside Sophie. You don't realize the concept that humans are animals, just like other animals, so viscerally until you've seen it. We are so very mortal. So very, very mortal. And Sophie, in her mortal life, and in death, gave us this special, special gift -she did not know me, but she gave it to me anyway, she trusted me anyway, and taught me anyway -that we're all going to die one day, and that our muscles will look like meat, meat. And our 'who we are' will no longer be there, and if we all had the good sense of not only being helpful and useful in life, but to be useful in death too -to serve even in death -that is special indeed. I was such a daze. Did I even know what it meant to really make it count in this life and this world? Sophie, sophos. If it was ever possible to feel 'mortality', I felt it on Tuesday.
Thursday, September 11, 2008
Whatcha' learnin' anyway?
I keep meaning to mention this and always forget whenever I post -to tell you the overall themes of what I'm learning in any given week. So, you should know that this week we've been learning about Cancer (the Big C -that's right, at the level of oncogenes, tumor suppressors, tyrosine kinases, and clinical experiences of practicing physicians).
We have looked at Skin (or should I say, "Integument", which is skin and its appendages -i.e. nails, hair, etc. -which we have been particularly examining in a histological context -read, "labs where we look at tissues under microscopes", as well as "why/how tatoos work", "how hair regrows your skin after a 3rd degree burn", "what happens when you get goosebumps", why Collagen is the shiz, and of course how all of the above can be related back to, as our professor put it, "all the great sex you're having").
Embryology continues (as always -one of my faves, I have to admit), and we start on Nervous tissues tomorrow.
Also we have been studying genetics / epigenetics (like if this male has this disease, what is the probability that his parents were carriers -varies whether the disease is sex-linked or not -and what is the probability that his aunt and cousins will have the disease; and if he marries someone whose family history is totally unknown, then based on the population statistic and combined with the "penetrance" of the disease, what are the odds for his 3-kids to-be?).
Yeah. For reals. I can't believe our first final is next Friday. Allegedly, of our 95 multiple-choice Qs (of which none are -thank goodness -"type B" multiple choice questions -these are the multiple-choice-within-the-multiple-choice types: Blablabla. Statements 1,2,3,4. A: 1,2,3,4 B:1 and 2 only C: 2 and 3 only D: None of the above -I hate these) -some are bozo-easy, and others to quote the unit 1 director "rival War and Peace" -yes, this is a Tolstoy reference. Yes. Doctors apparently read Tolstoy (or at least know how long and complex it is!)...
We have looked at Skin (or should I say, "Integument", which is skin and its appendages -i.e. nails, hair, etc. -which we have been particularly examining in a histological context -read, "labs where we look at tissues under microscopes", as well as "why/how tatoos work", "how hair regrows your skin after a 3rd degree burn", "what happens when you get goosebumps", why Collagen is the shiz, and of course how all of the above can be related back to, as our professor put it, "all the great sex you're having").
Embryology continues (as always -one of my faves, I have to admit), and we start on Nervous tissues tomorrow.
Also we have been studying genetics / epigenetics (like if this male has this disease, what is the probability that his parents were carriers -varies whether the disease is sex-linked or not -and what is the probability that his aunt and cousins will have the disease; and if he marries someone whose family history is totally unknown, then based on the population statistic and combined with the "penetrance" of the disease, what are the odds for his 3-kids to-be?).
Yeah. For reals. I can't believe our first final is next Friday. Allegedly, of our 95 multiple-choice Qs (of which none are -thank goodness -"type B" multiple choice questions -these are the multiple-choice-within-the-multiple-choice types: Blablabla. Statements 1,2,3,4. A: 1,2,3,4 B:1 and 2 only C: 2 and 3 only D: None of the above -I hate these) -some are bozo-easy, and others to quote the unit 1 director "rival War and Peace" -yes, this is a Tolstoy reference. Yes. Doctors apparently read Tolstoy (or at least know how long and complex it is!)...
Monday, September 8, 2008
Red Carpets and Firemen: T Dot Break
For those of you who are not down with the Canadian abbrevs, T Dot (or T. or T.O.) refers to the great rival city, Toronto. I was there this past weekend visiting some very good friends whom I had not seen in 3 whole years! The occasion now was for a 25th surprise birthday part which was a huge hit and an amazing experience (picture this: a city scavenger hunt via limosines, meeting up with mutual friends whom I also had not seen in a long while, hovering around the Red Carpet of the Toronto Film Festival, and seeing Deepah Mehta, almost seeing MJ Fox, Brian Adams, James Cameron and Steve Nash -we missed them by 15 minutes! -taking a photo inside a firetruck and having a really hot fireman ask you for a kiss... does it get any better than that? actually, it does -the company was fabulous throughout, and the food delish -my friends know how to eat! Remember this for life: if you don't enjoy food, spectacularly yummy food, we can't hang out anymore).
So... totally worth the 7-hour bus-ride each way.
Also, today I had the most amazing coincidence, running into an old friend that I had been thinking about this past week, when I was on the third floor of Mac Med ("Mac" being local shorthand for the McIntyre Medical Building at McGill). We will hopefully have tea soon (though not bubble tea, which I am still craving and missing very much).
I watched "House" for the first time this evening. No verdict yet -but leaning towards "I think it's kinda dumb".
By the way, I never actually kissed the fireman. Probably my biggest regret of the weekend. But let's be serious, this weekend had very little regret at all on the whole -a nice, escapey break indeed!
On a related note though, I've been trying to work on a new short story for the last few days and it's been so hard actually getting the time I need to write -so frustrating, because I started it and am in love with it already and just want to finish up the first draft already! Oh well, lots of cool meetings and more free lunch (tomorrow) this week to look forward to... and 3 histology labs 3 days in a row starting Wednesday. I know. Woohoo.
So... totally worth the 7-hour bus-ride each way.
Also, today I had the most amazing coincidence, running into an old friend that I had been thinking about this past week, when I was on the third floor of Mac Med ("Mac" being local shorthand for the McIntyre Medical Building at McGill). We will hopefully have tea soon (though not bubble tea, which I am still craving and missing very much).
I watched "House" for the first time this evening. No verdict yet -but leaning towards "I think it's kinda dumb".
By the way, I never actually kissed the fireman. Probably my biggest regret of the weekend. But let's be serious, this weekend had very little regret at all on the whole -a nice, escapey break indeed!
On a related note though, I've been trying to work on a new short story for the last few days and it's been so hard actually getting the time I need to write -so frustrating, because I started it and am in love with it already and just want to finish up the first draft already! Oh well, lots of cool meetings and more free lunch (tomorrow) this week to look forward to... and 3 histology labs 3 days in a row starting Wednesday. I know. Woohoo.
Tuesday, September 2, 2008
Rising Up
The title of this post is inspired by Yves Larock: "My dream is to fly, Over the Rainbow, So High..." -what a fab song, and he doesn't say much more than that (he does say, "Rise Up" though, surprisingly). Also, I am loving my new Dell XPS M1530.
Ah, indeed. I have survived Week 1. I have made some 'core friends' and hope to continue doing so -it's too soon to be hitting the 'meeting new people' plateau. I have adjusted somewhat to the idea of many hours of class in a day, and the idea of 19 Lectures in one week. Also public transportation is really not that bad -I'm getting used to waking up at 6:15 a.m. everyday, and I thank the powers that be for having class start an hour later tomorrow morning -an extra precious hour of sleep (well, actually, I'm using it right now, let's be serious -I'd be in bed already if it weren't for the late start!). What am I learning? Biochemistry, Nutrition (fascinating!), Embryology -essentially, reductionist science combined with clinical correlates for the study of "Molecules, Cells and Tissues".
I promised a "character" story for this post: well, firstly, I have identified "that kid" in our class -I've been trying to feel sorry for her rather than get annoyed by her. Today was a scorcher in Montreal though, as one of my friends so aptly put it, "It's Sweat-ember weather" -30 Celsius (that's about 90 F, folks) -and our afternoon class was in Strathcona, which has no AC or significantly openable windows, so we were more or less lulled to semi-consciousness during lectures -the annoyance with "that kid" was thus mitigated.
The weather on the long weekend however, was perfect. Dad and I went hiking up Mont Tremblant -it's been years since we'd done that, and it was wonderful. Fresh air, quality exercise, such satisfaction when you reach the top (much better than if you just took the gondola up, and incidentally, we caught a free ride back down). I had some delicious la tire in the Tremblant village (a ski-resort village, not a rural thing), which is boiled maple syrup poured onto a patch of snowy-ice, which you then roll onto a popsicle stick. We had some St. Hubert chicken and chicken wings for dinner -so hearty and yummy. And the best part (well, false, the parts I already mentioned were the best parts): I didn't open a single textbook or med school notes binder the whole day (and night)! The best holiday, really.
Anyway, I should get to bed now, it's getting late. Tomorrow should be a fun day though -Physicianship and bioethics stuff -"break day" as some like to call it. Hey, there are only so many molecular pathways and enzyme mechanisms one can enjoy looking at in any given day (this is not true of sperm, oocyte and embryo diagrams, which I have been finding very interesting, despite seeming-redundancy and increasing complexity). Keep cool and don't stress, friends.
Ah, indeed. I have survived Week 1. I have made some 'core friends' and hope to continue doing so -it's too soon to be hitting the 'meeting new people' plateau. I have adjusted somewhat to the idea of many hours of class in a day, and the idea of 19 Lectures in one week. Also public transportation is really not that bad -I'm getting used to waking up at 6:15 a.m. everyday, and I thank the powers that be for having class start an hour later tomorrow morning -an extra precious hour of sleep (well, actually, I'm using it right now, let's be serious -I'd be in bed already if it weren't for the late start!). What am I learning? Biochemistry, Nutrition (fascinating!), Embryology -essentially, reductionist science combined with clinical correlates for the study of "Molecules, Cells and Tissues".
I promised a "character" story for this post: well, firstly, I have identified "that kid" in our class -I've been trying to feel sorry for her rather than get annoyed by her. Today was a scorcher in Montreal though, as one of my friends so aptly put it, "It's Sweat-ember weather" -30 Celsius (that's about 90 F, folks) -and our afternoon class was in Strathcona, which has no AC or significantly openable windows, so we were more or less lulled to semi-consciousness during lectures -the annoyance with "that kid" was thus mitigated.
The weather on the long weekend however, was perfect. Dad and I went hiking up Mont Tremblant -it's been years since we'd done that, and it was wonderful. Fresh air, quality exercise, such satisfaction when you reach the top (much better than if you just took the gondola up, and incidentally, we caught a free ride back down). I had some delicious la tire in the Tremblant village (a ski-resort village, not a rural thing), which is boiled maple syrup poured onto a patch of snowy-ice, which you then roll onto a popsicle stick. We had some St. Hubert chicken and chicken wings for dinner -so hearty and yummy. And the best part (well, false, the parts I already mentioned were the best parts): I didn't open a single textbook or med school notes binder the whole day (and night)! The best holiday, really.
Anyway, I should get to bed now, it's getting late. Tomorrow should be a fun day though -Physicianship and bioethics stuff -"break day" as some like to call it. Hey, there are only so many molecular pathways and enzyme mechanisms one can enjoy looking at in any given day (this is not true of sperm, oocyte and embryo diagrams, which I have been finding very interesting, despite seeming-redundancy and increasing complexity). Keep cool and don't stress, friends.
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