Hello Lamppost

Good Days and Bad Days

2011-12-21T22:01:00.006-05:00

Residency has been all about ups and downs. Now that I'm at the halfway mark of my first year, I wanted to think about some of those highlights and "lowlights" of these past 6 months. It's gone by ridiculously quickly, and I'm surprisingly happy nowadays, but, you know, it's always good to reflect.

The Good:
- Assessing, then operating on that woman who came in with an SDH. Her family was near tears with worry at her sudden decline. I didn't follow her post-operatively, but I ran into her husband in the hallway. He was telling me how well she was after the surgery. She was getting discharged soon. It made my heart sing.
- My first tonsil. Yummy. That's why I'm here : )
- Debriding the ears. Even if I have a subspecialty practice in the future, I don't know if I can give it up.
- Sewing the eyelids post-blepharoplasty. Mmm, I love sewing. I'd also like to think that I'm reasonably slick with the needle driver.
- Doing the approach for an ACDF. The planes of the neck are beautiful and were just lying there, wanting to be dissected. Yummy.
- Sucking out some brain tumour. I was post-call and on my ~32nd hour of not sleeping/barely eating, but it was worth it. I was in the nose, just where I wanted to be.
- Pulling that FB from that kid's nose. Oh, man, was it stuck. And, man, was it satisfying to get that thing out.
- Seeing that patient that had coded on me transferred back onto the floor. He looked almost as good as he did before the code. Sometimes these things turn out all right.
- Being offered the scalpel by an attending that I was intimidated by. Turns out he liked me in the end.

The Bad:
- Calling the family of a patient that didn't make it through a code. Basically, it was a frustrating conversation in a way that it shouldn't have been.
- Missing a vasospasm on a patient. I'd like to say that I was across town heading to a trauma, but there were better ways I could've handled the situation.
- Getting berated about things, whether it was my fault/warranted or not. Sometimes it's just about taking the abuse in stride - they just want to make you better, after all.

The I Don't Know:
- Finding out about some really bad domestic violence, after following a haunch I had. I think about her every now and then, and pray that she's in a better situation, standing up as that strong and intelligent woman I know her to be.

And that's the first 10% of residency, in a nutshell. So much learning, so much growing. Maybe one day I will be the poised, all-knowing, gifted surgeon like the ones I look up to so much now. 90% more to go.

2011-11-20T22:41:00.003-05:00

We got the cutest and sweetest puppy to foster yesterday. Sure, he doesn't know how to use his legs, but he's so quiet and affectionate. Now Godfrey is trying to teach him to sit. It's been about 30 minutes and I don't think he quite gets it yet. We'll see how long this takes - maybe a day or two? D'awwwwww...

2011-11-03T21:10:00.003-04:00

Sometimes, while I'm standing there in the OR, I suddenly realize that one day, barring catastrophe, I'm going to be a freaking surgeon. Sometimes, it feels awesome. Sometimes, it feels ominous. How can I tidily take someone's thyroid out when I can't even tidily laparoscopically cut a gauze circle?

We'll see if 5 years can turn a clumsy fingered medical student into a surgeon. Half that time is already used up : /

Pockets

2011-10-04T19:46:00.002-04:00

Today, I was lectured by some stranger at Shoppers while I was walking around, waiting to fill my presciption. This older lady basically yelled at me for walking around with my hands in my pockets (I think she said "For God's sake! Get your hands out of your pockets!"). She then continued on to tell me how people started to put their hands in their pockets because they wore their pants too low - their hands were in their pockets essentially to keep the pants up.

I was surprised by her outrage, to say the least, and pulled my hands out of my pockets until I ducked into the next aisle and resumed my previous posture. But guys do it when they're posing in suits, and Napoleon stuck his hand in his vest all the time...why can't I put my hands in my pockets?

Hospital Fun

2011-08-20T08:25:00.002-04:00

Next month I'll be on call Tuesday, Thursday and Saturday the week after Labour Day weekend. I guess that tells me what I am going to do for Labour Day: sleep in, sit around, and try to squeeze all the relaxation out of the day.

At least they gave me Labour Day weekend off - I can't complain : )

So exciting

2011-07-13T16:52:00.000-04:00

Omg, omg, omg.

Ramble

2011-06-10T05:43:00.002-04:00

Time marches on, waiting for no one. And it's the day before my wedding day. I've spent all night awake, making last minute preparations.

How can this be fun for anyone? Never again.

No time to think; no time for unnatural reflections; I'll just surrender myself to the relentless march - it'll be over soon enough. Then I can just retreat back into my little hole of obscurity, now with my husband at my side.

On a brighter note, I passed my licensing examination : ) I am so much more in my element in academia.

And back to this all night party that is wedding planning...

Nostalgia

2011-05-11T23:33:00.000-04:00

This poster thing really brings me back to the days of bristol board presentations in elementary school. Finding nice, relevant clip art from those now antiquated libraries (I used to love browsing through this Corel catalogue my dad had somewhere. It had Sylvester Stallone. SYLVESTER STALLONE CLIP ART!). Carefully cutting out printed paragraphs, neatly mounting it on construction paper with a gluestick, then placing it all nicely on.

It was so fun. Now this is so fun : ) Fiddling with colour schemes, style sheets, table formats. Then placing the content on, arranging it in a document...I suppose the only difference is that it's going to cost lots of money to print, and I'm going to be left with a poster the same height as me. I suppose if my hotel falls through, I can use it as a blanket and sleep under the stars?

So, my first day/evening of "freedom" and this is what I talk about? I suppose a reflection on the last four years is TBA.

Knit purl knit purl

2011-05-02T02:52:00.001-04:00

My thenar eminence is sore. Ouch. However, a sweater is imminent. Onwards and forwards!

ACLS

2011-03-27T21:16:00.005-04:00

It was only several weekends ago that I spent a Saturday doing CPR, running Megacodes instead of sleeping in. There we were, in casual clothes (which happens so rarely - I go from clinic clothes/scrubs to pajamas pretty much everyday of my life), around rubber torsos, trying to bring them back to "life". The task seemed daunting at first, but after awhile, you get into the rhythm. Running through the algorithms seemed just like routine, and slowly is starting to become second nature. By the end of the day, my arms and hands were sore, but I felt that if someone had an arrest in front of me, I wouldn't be totally lost. (In fact, I had a dream a couple nights ago in which someone went brady and I ran through the code beautifully.)

So anyway, my grandmother was recently admitted to the hospital. Visiting over the weekend, I could tell that she was headed that way. Chest wall pain from a recent fall compounded with chronic constipation and some type of interstitial lung disease meant that it was almost guaranteed that she'd get some atelectasis. I knew it was probably just a matter of time before she'd have a pneumonia and there would be no way she could fight that off herself. To be honest, I was not surprised, but of course still upset when I heard that she was admitted. It came as a bit more a shock when she went into CCU.

I sent my "contact" out to check things out. I wanted to know how she was getting her oxygen, was she sedated, how she was getting her antibiotics, and just generally how she looked. I was assured by a good report and rumours that discharge back to the ward was imminent. It took me by surprise, then, when I received news that she had been admitted to the ICU. Getting news second hand, there was something about CO2 retention and a cardiac arrest. It took 3 defibrillations before they shocked her back into some type of rhythm. Interestingly, they were only going to try three times before they stopped.

I can't help but think what was going through the physician's head when they were running this code. What did they think about running a full code on a late 80's woman with multiple comorbidities, with a relatively recent history of multiple resuscitations? And how did they feel after the first two shocks were delivered with no response? What was the conversation during the last cycles of CPR? How did they react/feel when that last shock was delivered?

And then I remember: though she is my grandmother and I love her dearly, to these people attending the code, she is just another patient with whom they had likely not met before she went unconscious. They are just running a code, going through the algorithms just as I had that weekend (probably with a bit more feeling since this was a real person).

I realize, that when you're doing the same job day in and day out, it's easy to get into that routine and not remember what patients/families are going through. In a busy clinic, I probably see about 15 patients, but each patient sees one doctor (and a bumbling medical student, of course). On a daily basis, it's hard to resolve that difference, but I suppose, every so often, I need to take a step back and remember what it is like to be a patient to keep myself in check.

Maybe I've gotten the algorithms for ACLS (almost) in my crystallized memory, but the thing I haven't mastered is talking to families, arguably the most crucial part. And again it becomes apparent - medicine is both art and science.

Cheers

2011-03-23T08:20:00.001-04:00

Geez - that Diane Chambers is enough to get me to stop watching. Maybe they can kill her off into the next season? Thank goodness for Coach and Woody to offset the awful.

Networking

2011-03-17T16:33:00.006-04:00

Networking has always been something at which I do not excel. Being from a long line of bank workers, business(wo)men, and engineers, I came into medicine with almost no connections. To be honest, I wanted to believe that, since I was not in the business field, I did not need to rely to heavily on connections. I felt that my hard work, personality, talents could do all the speaking for me. I was happy to find that, whatever it was, I got into the residency programme of my choice, in the city of my choice. To be honest, I did try my best, worked hard, and felt my higher-ups got to know my personality and talents well. Through this entire process, though, I didn't realize just how much people talking behind your back matters. Maybe that's my backwards, passive aggressive way of networking - getting people to "gossip" about me.

So it started with an undergraduate supervisor talking with his colleague over some surgery, asking if he'd take me under for a summer. Then, it was this new supervisor, talking about me to the other attendings in the city. On a slight tangent, I remember seeing from the corner of my eye an attending I worked with, whispering something into his wife's ear as he looked at me. And, throughout my electives, hearing about my neurosurgically related past (which I had not disclosed myself), confirmed that people were still talking.

But, it wasn't until I got back into Kingston that I realized more fully how much people talk. Yes, otolaryngology is a smaller discipline/residency program, but that small? Today, I ran into an attending that I had minimal contact with. I enjoyed my time in clinic with him (1-2 half days) as well as a half day in the OR. Despite this limited exposure, he knew I wanted to get into ENT and that London was amongst my top choices. So, in the middle of his rounds, I took a second to talk to him, letting him know that I'd be spending the next 5 years in London. He was so excited! Now, this is a guy who doesn't really recognize your presence when you're in clinic with him. I was surprised (and flattered) that he even remembered my name! Today, I was even more taken aback when he gave me a hug. A HUG! He then told me that he was not surprised...because he had been talking to some important people in London.

Yep, people talk. People talk about you. And no matter how little of an impact you feel you've made, you can't take it for granted. And perhaps I found a great, tight knit community, where in spite my inability to network, people have done it for me. To be honest, probably due to my ISTJ personality, I'm going to ride this wave as far as I can go.

Everything Went Better Than Expected

2011-03-08T09:27:00.003-05:00

Look out! This girl's going to be cleaning out your ears, stopping your nosebleeds, and taking your tonsils out, among other things :)

The Match

2011-03-07T06:43:00.013-05:00

Well, the day has finally come. Being one of the most (more) important days in my life, I just wanted to do a short post before everything went down.

To be honest, unlike some, this day crept up on me. I was pre-occupied with the yearbook until Friday, and then with a last minute visit by Godfrey. Of course, when I took the time to think about it a bit, I realized just how close today was getting. And now we're here - 5 hours before knowing where I'll be spending the next (hopefully) 5 years.

I remember this time last year (I think I blogged about it before). I was in Winnipeg. The staff and other student were busy flitting around, trying to get clinic done as soon as possible so they could be poised at the computer at noon to check the results. I felt so much sympathetic sympathetic activation (haha - who knew I'd be able to use that word TWO TIMES IN A ROW?). Though it felt remote (I was on electives at that time), I knew it really wasn't that far away for me.

Today, I feel indubitably nervous, and a little excited. I was lucky, realizing that I wanted to be an Otolaryngologist-Head and Neck Surgeon since the summer of first year (and perhaps earlier). It may have taken some time to rule out other disciplines as back-up, but it was since then that I was really "gunning" to get into the specialty. I picked up research projects early (I was addicted), and "fortuitously" took some good advice and made important connections. I worked hard - allowing research take over my spare time during school, and sacrificing my summers for my aspirations. I've tried my best to get good letters, write eloquent personal letters, fill up my CV, and impress at my interviews. Basically, I have been dreaming about being an ENT resident for a very long time. I feel that I've put in the effort, done the work, tried hard. Of course, I am not very strategic, nor am I a charmer, but within my realm of comfort, I pushed as much as I could.

And right now, I am at the cusp of aspiration and reality. It is like the intersection of two vectors in space, where I am on the first, and the second vectors's projection unknown. Slowly, I crawl towards that place - right now I don't know, in about 5 hours, I will. Then, suddenly, all the last 4 years of aspiration will become reality - whether it is projecting at the same angle, or if I need to take a sharp turn somewhere. As a one dimensional point in this imaginary space, I both dread and welcome what is ahead. This is where dreams can no longer be dreams, where hopes are either dashed or fulfilled. It is a binary place, where I can be happy or sad, but no longer blissfully unaware.

It's funny - I have no control over anything at this time. There is nothing I can do or say to prolong the limbo in which I currently reside. There is nothing that exists in my power to change the outcome. I just march, as the Orange Blossom Special, towards the intersection.

The butterflies in my stomach remind me of this: (Caution! This is Match Day!) I wonder what I'll be saying 10-12 hours from now : ) Ok, now time for clinic.

2011-03-03T16:50:00.002-05:00

Holy crap. I'm in love. Even moreso than when Ryan North did an AMA. Sorry Ryan, I love you too.

Aside from the Watson Jeopardy episodes recently, I haven't seen this guy in ages. It was summer of second year. I spent evenings in front of the TV watching this guy with JT. It brings back memories. Sadly, I think my desktop wallpaper was Ken Jennings for a little while, but don't tell. This AMA is awesome - I want to be BFFs with this guy in real life.

Relativity

2011-02-28T17:13:00.002-05:00

On the one hand, time is passing too slow and I want Match Day to be today.

On the other hand, time is passing by too quickly and I would really prefer more time before the yearbook deadline, my oral examinations, and other important deadlines.

I guess I ought to be thankful that I have a load of stuff to be working on to occupy my mind between now and next week. There seem to be so many that are just watching the clock tick by, waiting for the final verdict on their/our lives. Then again, life is getting so busy, it's just slightly out of control.

I think I can make it. And with a nice weekend spacer between the rush and the exciting news, I think I can take a breath. I guess I'll just have to suffer from hypoxia until then.

96% on 3L O2 via nasal prongs. Hopefully I won't get a septal perforation. I can doooo eeeet.

Eastward and Onward!

2011-02-07T13:05:00.003-05:00

It's been a tiring and hectic two weeks, but I think I'm getting into the groove of things. I wonder when the next time I will be flying all over Canada, staying in hotels just for the bed and warm room to sleep in, and lugging my small pack of belongings everywhere. It's been a wonderful experience so far, meeting new people, making new friends, and hopefully moving one step closer to realizing my aspirations. Of course, the interviews themselves aren't a cakewalk, but everything is going better than expected.

Now to stick my nose back into Pasha (I'm so tempted to buy the new edition :) ) and to bring some extra finesse/polish to my interview answers. Just a quick breath before some eastwardly interviews, and hopefully a big celebration at the end.

CaRMS, I both love you and hate you.

2011-01-24T23:24:00.000-05:00

Scared. And nervous.

Dingoes

2010-12-08T09:12:00.004-05:00

A coworker was recounting her recent trip to Australia where she was fortunate enough to see almost all of the animals on her list. The only two she missed were a Tasmanian devil and a dingo.

All I could think of, for the next several hours, was Elaine saying, "Maybe the dingo ate your baby!"

Inappropriate thoughts that just come automatically on an L&D shift.

2010-12-06T00:55:00.003-05:00

So, I was looking at my grad photos again. I was in a bit of a rush that day, got a little bit of makeup on, but forgot any lip gloss at the last minute.

Anyway, I look like a zombie because I am so pale. I don't wear make-up ever. Does this mean I always look like a zombie?

I am especially pale in the early mornings. I can imagine waking up patients on rounds at 6 am saying "braiiiinnssss, I need more braiiiiiinnnnnss....". I am sure this will bode well on the neurosurgery floor.

Encarta

2010-11-26T09:45:00.004-05:00

I'm not sure what it is lately, but I've been thinking about Encarta a lot. The other day, I got a version of Encarta 98 installed on my computer just so I could play MindMaze all night instead of sleep. It was nice, because I actually knew the answers to some of the questions, rather than just blind guessing. Sadly, I finished the game quite quickly.

Anyway, I woke up this morning thinking about Schubert's Trout Quintet. I remember hearing it for the first time as a kid on Encarta. Of course, it was just the first 30 seconds of the song, but I fell in love with it. As this was before the times of Napster, Audiogalaxy (can you believe I used that?), IRC and torrents, I had to be happy with that 30 seconds. I would listen to it over and over again, but after a few weeks, it was quickly forgotten.

Welp, just today I remembered it again, searched the YouTubes and found it with ease. It was beautiful, just like I remembered it to be. It made me think about those days of Encarta, when I, being the very precocious child I was, would spend hours, perusing its articles. It was Encarta that first introduced me to Arthur Miller's Death of Salesman, one of my favourite plays. Because of Encarta, both me and my sister can recite some of Martin Luther King Jr's "I Have a Dream" speeches. My first exposures to organic chemistry, a subject in which I certainly do not excel, were playing with simple molecules on Encarta.

I was thinking, the other day, what the heck I was doing as a kid instead of watching Care Bears, Transformers, or the Smurfs, because when people talk about their childhood, I feel strangely out of touch. Now I remember. I was on Encarta, or reading the encyclopedia, carefully avoiding pictures of insects. I am kind of embarrassed. Hopefully that doesn't come up on an interview.

A Bolus of Self-Esteem

2010-11-24T18:20:00.003-05:00

I think the most generous and ego-boosting comment I've had lately was from my preceptor in family medicine. I had been doing some procedures, and was surprised by the second or third day that he was handing me the scalpel and I was doing the procedures from local to dressing. I even did an excision of a sebaceous cyst on some guy's face right by his eye :)

Anyway, at midterm review, he said "I don't feel nervous when you do procedures." Man, that really boosted my ego. I love working with my hands, doing procedures. I love getting things out of people's bodies. Neck dissections, parotidectomies, thyroidectomies, etc. get me so happy when that last little bit of connective tissue is cut and out comes the specimen. There is some crazy link in my brain between procedures and my dopamine pathway.

On another note, I saw the juiciest tonsils today. Man, I just wanted to pick them out of her tonsillar bed. Of course, it'd be an ugly surgery since there was an active infection, but, you know, I could wait a week or two. I'd never done a tonsillectomy myself but that satisfaction of removal occur by proxy. Because I haven't seen a T & A in ages, just the thought of those coming out made me happy enough.

Bah - put me back into ENT please.

Remembering

2010-11-11T16:55:00.005-05:00

When I was a child, I remember the somber tone as we marched, quietly, in lines towards to gymnasium for the annual Remembrance Day Assembly. There would be a veteran on the stage, and some hand picked students reading poetry. A trumpet player would go up on stage. We'd have a moment of silence, then the haunting melody of Taps would break the silence.

Now, as a child, I had no idea what I was remembering. I was very obedient back then and would stand still for those two minutes wondering what was supposed to happen. The World Wars were never very real to me. My relatives were in China at the time, and though they had suffered tremendously, either my Chinese was never good enough to understand their stories, or they never told their stories because they did not want to relive their painful pasts.

So I stood there, imagining war, trying to imagine the significance this day was for others. I wanted an emotional epiphany, to be able to relate to those who had lost someone to the war, just so I could understand the suffering of those times. Instead, I stood there quietly, respectfully, but regretfully, without empathy.

As I grew older, I cam to understand Canadian history more, learned more about my family's past, and Remembrance Day became a little more real for me. When war in the Middle East started affecting Canadians more, I saw war's devastating effects in a more modern context. But, to be honest, it wasn't until I recently became very interested in WWII history that things really hit home.

Yes, war is horrible. War cuts short the lives of youth with bright futures ahead of them. War sucks. But looking at WWII, I realize that sometimes negotiations and diplomatic discussions isn't enough. Sometimes war needs to take place.

I thank all the veterans, on either side, because, to be honest, I am just too cowardly to go to war. And despite my fears, I am able to live in this luxury of Canada, no matter how flawed.

Spontaneity

2010-11-09T21:49:00.003-05:00

It may have been a slip of the finger, or perhaps a deliberate click but I've just submitted my application for CaRMS. I was getting a bit obsessive so I decided to just go with it and not look back.

Bah! Scary! I suppose I will know the result in several months' time. This year is passing much too quickly. I'm not ready to let go of my most important application thus far. However, I suppose "readiness" will never come, and I'll just have to take that leap of faith.

2010-11-01T02:34:00.004-04:00

Getting a little bit obsessive about these tracking numbers and the document tracking page on CaRMS. I'm not even sure why I'm still awake.

Canada Post, don't fail me now!

At least the anxiety of it all kept me up so I could drive back into Brockville - an uneventful, but longer than desired drive. I prefer to travel by Transporter, personally.

Today I am Thankful For..

2010-10-26T23:37:00.001-04:00

Garbage day - because my house smells like the turkey I had to throw out because I couldn't eat it fast enough after Thanksgiving. I need some help in leftover rationing.

Reminders

2010-10-13T15:32:00.003-04:00

CaRMS is giving me heartburn worse than no other. I think about personal letters and I get nauseated. I am obsessively checking my CaRMS account to see if any new reference letters have been submitted. Life in the midst of CaRMS sucks.

Then, I get e-mails about research and I remember why I love what I love. The rotations I am looking forward to offer me limited or no time in the OR and minimal exposure to even minor procedures. I miss working with my hands desperately. Then, coming home and looking at my data, doing minor literature searches, thinking about abstracts makes me so happy. I think about attending the conference again this coming year and the very thought of sitting around talking about ears, noses, throats, and research makes me happy despite my subpar days and the heaviness of CaRMS.

I remember that no matter how crummy one day may be, I love my "job". Medicine makes me so happy.

My Everest

2010-10-08T16:30:00.002-04:00

So, the sweater is all knit up and ready to steek. If you don't know about steeking, it's about the scariest thing I can think of doing to this sweater that I've been knitting for the last several months. I have been assured time and time again that there is nothing to be afraid of...but cutting into my knitting? How can I NOT be afraid?

Because I elected to use a Superwash wool, I can't use the crochet steek I was looking forward to (it looks so nice!). Instead, I'll take it home and subject it my hand knit, all wool, natural goodness to the terror of a sewing machine. I am scared. I don't even know how to work a sewing machine. (After cutting out Family Studies in Grade 8, I've been left with many important life skills unlearned. Yes, I am bitter.)

Anyway, my stream of consciousness is broken by some neighbour's very loud Michael Buble. It's funny - it's always Michael Buble, and it's playing all the time. Let me cover that up with some Atul Gawande.

And...next time on Inane Blogs from an Inane Blogger - more inane thoughts! Stay tuned!

Latin

2010-10-03T12:50:00.003-04:00

So, I'm in the process of writing some personal statements for my upcoming applications. It's scary as zombies, and makes me nauseated, but I suppose it's a rite of passage. Because of this, I've been thinking a lot about my past, the things I have done, the things that I have given up.

There are small things that come to mind. I remember my elementary school French teacher making me promise her I'd take French all throughout high school. However, since I was in grad 5 or 6, I dreamed about learning Latin (I don't know why - I'm a nerdy kid, ok?). Because I was in the Arts York programme, I couldn't take both French AND Latin in grade 10, so I had to give up one...and it ended up being French. Sure, the utility of Latin is quite limited today. I could maybe translate mottos and short liturgical texts for you, but that's pretty much it. Despite its limited utility, I am so happy to have Latin in my life.

Latin opened my eyes up to language and grammar. Whereas French conjugates verbs, Latin also "conjugates" nouns (called declensions). This means that a single word contains grammatical information that could only be conveyed in English using word order. Taking the burden of grammatical information out of syntax allows for more freedom and expression in word ordering.

I have friends that also loved Latin, but often, it's because of the Roman culture (don't get me wrong, I loved I, Claudius as much as anyone). I love Latin plainly because of its grammatical structure. Subsequently taking linguistics at a university level just delighted me. It's an amazingly complex yet systematic framework that underlies language - yet the speakers are so unaware and take it as second nature.

....and that's why I want to study Otolaryngology : )

Teehee

2010-09-30T02:02:00.004-04:00

I've got the biggest crush on day[9]. I love watching his dailies, and one time, Godfrey and I spent our "together time" watching one of my favourite episodes (#100).

I guess this officially makes me the geekiest ever : / Then again, crushing on day[9] is almost a universal geek trait. I mean, how could you not?

Out of my Comfort Zone

2010-09-06T22:53:00.009-04:00

Sorry for the cliche title - I couldn't think of anything better. Anyway, I have been wanting to blog a bit about my knitting for a while. Outside of medicine, this is likely my number one hobby. It used to be so bad that I'd get anxious when I didn't have some needles and wool in my hands while I was sitting around.

Anyway, most of my knitting stuff goes to (one of my favourite site on the Internets) Ravelry. However, my most recent project has been causing me a bit of grief, and I wanted a bigger place to track my progress. So here, the Saddle Shoulder Cardigan.

When I first saw this sweater, I fell in love with it. I blame it on the Sheepfold cables. I have been thinking about knitting this for about a year. I bought the yarn back around January and its been sitting in my box ever since. The major reason why I've been putting it off is that it was a complicated sweater AND it was an EZ pattern.

Now,in my opinion, Elizabeth Zimmerman is a genius knitter. Her novel clothing construction ideas never cease to amaze me. The thing is, though, she won't hold your hand through a pattern. She'll give you an approximate idea of things, but won't tell you stitch by stitch what to do. When I first saw the saddle shoulder cardigan, I had never knit a large project like a sweater, let alone an EZ sweater, so I put if off...after my mom's sweater, after my dad's vest, after a few baby sweaters. When I was mentally ready, I went to buy the pattern, but shipping was double the cost of the actual pattern. Sorry, I'm a cheapskate, but I had access to the general sweater design and patterns for the cables, and I knew the actual pattern would give me little more. I decided to work off of EZ's Knitting Without Tears and some Barbara Walker Pattern Treasuries. I was pretty much designing my own sweater.

Things were difficult because my boyfriend is the size of a small twig with disproportionately broad shoulders, but after a bunch of hemming and hawing, flipping through cable patterns, and playing with panels on Excel, I finally had something I could swatch. And swatch I did (excuse the crappy picture. I did block, but I also tried to put it through the dryer to see how this Superwash wool would stand up to the test - it did pretty well).

I was also agonizing about the wool. I didn't LOVE the Cascade 220 Superwash when I had used it for my mom's sweater, but I had a whole bunch of skeins set out for this project. To complicate matters, I was pretty sure I didn't have enough yarn (probably one or two skeins short). Bah. So, I likely spent 2-3 sleepless nights debating whether to use the wool for something else or to just bite the bullet, see how much I could finish with what I had, and buy more if needed. Despite likely not being able to get the same dyelot again, I chose the latter one (I didn't have another project in mind for the wool and didn't want to stash it all).

So I cast on. Here's how things are so far. I am reasonably happy with it.

I'm excited : ) A project to really push my knitterbility.

Whoosh!

2010-09-05T12:17:00.003-04:00

I haven't been outdoors in a while, but walking home from work today really felt like fall. I have so many good thoughts about fall, and if pressed, I'd likely name it my favourite season.

Fall meant a new school year. New classes, new teachers, new things to learn. I've always been a bit hungry for knowledge, so I loved going back to school. Fall meant new backpack, a new organizer, and new stationery. The thought of writing on clean, new, Hilroy (I insisted on this) college lined paper with my then extremely particular pen taste (it used to be RSVP blue in fine...I've converted to BIC roundgrip fine in black for economic and hospital administration reasons). And I've always loved the sterility of fall. Yes, not as sterile as winter, but less insects about, less humidity in the air, and less things that are growing (e.g. flowers).

But this year, summer has passed me by without even letting me know. I'm clinging desperately onto time, but it still rushes by, refusing to let me enjoy it. Yet, when I have a chance to breathe, all I can think about it what I ought to be doing - whether it be research, reading, or even just chores around the house.

I think I've lost my ability to savour the moment. I'm just shoveling all of them down my throat as quickly as I can so I can get onto the next thing. It's exhausting but I don't know how to do otherwise.

Study Break!

2010-08-25T21:17:00.005-04:00

In between studying for my upcoming examination, I write discharge summaries and check up on my patients' blood work. Occasionally I will sift through the pictures submitted for yearbook and label some faces. Then, back to work.

I have no life -_- Let me drink some juice to make me feel better.

Yay!

2010-08-22T18:03:00.002-04:00

Sorry, I have to show off : ) I made it to PubMed, finally! I can't believe it's taken me four years of (intermittent) research to do this, when it often takes people much less. Either way - I'm proud : ) Two of my papers, hopefully adding to the scientific community.

In the End

2010-08-16T01:03:00.004-04:00

On the bus ride home today, I couldn't sleep and my mind was plague with so many inane thoughts - embarrassing moments in my last 20 years and how I could have better responded to them, research research research, and things to blog about. I guess a part of me just loves to blog - I don't really write anything aside from abstracts and research papers any more, so this casual, inconsequential nature of my posting is quite relaxing. Also, there was a time when I enjoyed writing for fun (imagine!) and perhaps this satisfies that part of me a bit.

Anyway, I was thinking about things I could blog about:
- one titled "Down and Out in Paris and London" where I'd discuss freedom, guilt and the burden of research...along with a rediscovery of myself I had made about a year ago
- another titled "Meta-Blogging" in which I would discuss what I usually talk about and what I want to blog about in the future (perhaps this is it? A meta-meta-blog?
- lastly, a yet untitled (excruciatingly) detailed post about my progress so far on my "boyfriend sweater" and the extensive and likely very unnecessary agonizing I've done trying to figure out how this gentleman can fit any heart or lungs in that puny thorax of his...and how to best adjust my stitches to flatter his figure.

But, after a long bus ride, I think I'll just go to sleep and defer those posts for another time in the future. Some how I bring an image of Clau-Clau-Claudius to mind again. And, look! Patrick Stewart with hair!

Overalls

2010-08-10T19:47:00.002-04:00

Were they cool at one point? Really? Besides a possible functional advantage of decreased likelihood of falling off your waist...and perhaps the ability to put stuff in that top part thingy...they really don't look flattering. At all.

But in the end, I remember loving my pair so dearly, when I had them. I was (am) so uncool.

At the End of the Day...

2010-07-30T19:13:00.004-04:00

It's the Friday before a long weekend, during the last case, while we were closing, the count was found to be off - we were off by one 4"x8" sponge during an ear surgery (there is no way the sponge could have been left inside...you'd have to be a magician to fit it in there).

But people are tired and a bit giddy to get home, so things get inappropriate. It starts with ear love and just continues on.

...and to think it all started with an ear drop concoction : ) I love this place. I ear love this place.

Gloves

2010-07-27T22:30:00.002-04:00

Mmmmmmm...so, is it weird if I love the smell of my hands after they've been in gloves for a few hours in the OR? Yummy...reason #184 of why I can't live with never being in the OR again.

On the other hand, I've had a bad run with needle drivers today. I looked high and low of a needle driver on the floor, but I didn't want to open an entire chest tube tray, so I ended up trying to sew the trach in place with some clamp on a ++ agitated gentleman. A repeat happened tonight, with another super "slippy" needle driver and forceps the length of my forearm.

Bah - less than ideal situations are frustrating, but they occur frequently. One thing I can do is ensure there's a nearby standing stool so I'm not eye level with everyone's sterile zone.

The next couple weeks will be GIM for me. I am going to be itching to get back into the OR like an early adopter itches for the newest gadgetry. Wait, that's what they itch for, right?

Relief

2010-07-19T22:26:00.002-04:00

Oh my goodness. It feels soooo good to be in scrubs again. Unluckily, I have another several weeks of GIM/FM/Psych to get through until I can dress within my comfort zone.

Godfrey's been having tons of hard times trying to shop for clothes for me. I guess I can do my part by matching into a surgical subspecialty and convert my entire wardrobe to scrubs. It'll cut down on laundry too!

It's too darn hot!

2010-07-05T17:45:00.002-04:00

Actually, embarrassingly, I had my heat on until last night, when I finally unplugged it to make more room on my floor. Today, I wore long pants and a sweater to work (over a dress shirt).

Maybe it's my hypothalamus, but my temperature regulation is a little bit funny of late. Then again, that hasn't really changed much, right? I'll blame it on my high surface area to volume ratio.

Surprise!

2010-06-24T23:06:00.001-04:00

What? You can have ectopic endometrial tissue in the nasal cavity causing epistaxis?

That is one rarely cited cause of epistaxis. Now to deposit this nifty piece of data into the bank of esoteric facts about otolaryngology-head and neck surgery.

Elective time coming up - time to read up : )

2010-06-17T10:19:00.002-04:00

It's been 30 hours since I've slept; likely 26 since I've smelled air not put through hospital's air filters. Work work work - endless days on my feet are inevitable.

And though I ache all over; though my eyes are heavy; there is something inside me that wants to sit up until this afternoon's seminar to write my paper.

I'm addicted to productivity...is there a such thing as a healthy addiction?

The Tale of the Dozen Eggs

2010-06-11T19:08:00.002-04:00

I recommend you not do this, but, based on a recent CPS ad (likely not the most reliable resource) an egg a day doesn't increase your risk for cardiac disease.

Anyway, Godfrey had bought a dozen eggs one weekend while he was over and failed to cook ANY of them while he was here. So, he left them with me, encouraging me to poach some with the new poacher we had obtained. Due to my lack of culinary motivation (i.e. I don't think I've cooked anything since I was away on electives, and even then just pasta, and I really don't feel like it),however, I didn't.

So, the burden of a dozen eggs in the fridge hung on my shoulders, week after week, but I refused to do anything about it...until, I checked it out last week and realized they expire JUNE 4. "BAH!" I thought "I have three days to eat a dozen eggs! What the heck am I going to do?" The following was my solution:

Day 1:
Soft boil 6 eggs
Bring 3 eggs to work - eat one for breakfast, two for lunch

- Eggs consumed: 3
- Eggs remaining: 9

Day 2:
Repeat meal regimen as outline above

- Eggs consumed: 6
- Eggs remaining: 6

Day 3:
Think: leaving for the weekend, not hungry...soft boil the remaining 6 eggs to buy some time.
Eat one egg for breakfast, one for lunch.

- Eggs consumed: 8
- Eggs remaining: 4

Day 4-5:
Out for the weekend. No eggs consumed.

- Eggs consumed: 8
- Eggs remaining: 4

Days 6-9:
Obtained leftover from a barbecue attended. Have other food requiring prompt consumption before expiry. Taper dosage to 1 egg q day.

- Eggs consumed: 12
- Eggs remaining: 0

In conclusion, I freaking ate a dozen eggs in a week. This is a superb accomplishment on my behalf, as I never tired of a soft boiled egg to munch on while doing rounds or seeing consults. Perhaps I should take a look at my lipid levels because I'm sure I had a transient hypercholesterolemia, but, I mean, this is my annual bolus.

Lesson learned: don't buy eggs. I really won't eat them unless under dire circumstances.

Alternative solution: move boyfriend to area of closer proximity such that egg-related meals could be served in a regular basis, thereby increasing length of egg infusion and avoiding high peaks and low troughs of serum egg levels.

Slippers

2010-06-03T17:36:00.002-04:00

Last night, my slippers broke, and though they still worked (i.e. protected my feet from the floor), it was difficult to walk in them.

So, today, after a (tiring) day on infectious diseases, I whipped out my needle driver and toothed, open a pack of 0-Silk and stitched away (just a simple running). Yes, I sutured by slippers together.

Am I taking this too far? I guess at least I didn't try to repair it subcuticularly.

In Love

2010-05-26T18:06:00.002-04:00

is what I am. At the end of the long weekend plus one day, I didn't want to leave. I had to pull myself from the table, and even missed dessert (!).

When will I be back again? When will I see you all again? Hopefully in January, I suppose? I'll miss you all in the meantime.

Inconsistency

2010-05-21T16:32:00.004-04:00

One day I am poking and tubing people with utmost precision. The next I am gumming up the simplest IV.

This is unacceptable to me. If I'm not on my A game everyday, there really is no point. I can make up many excuses (no lunch, throbbing headache, anxiety about the upcoming weekend) but what good would that do? I think I need some sport psychology classes or something. I need to up my concentration so my performance is nothing but my best at all times, and especially when the pressure is on.

I demand my own perfection. I will not allow myself to accept anything less. Yet, onwards and forwards. I can't do anything about the past, but heck, I can make sure I don't trip up on the simple things again.

Yummy

2010-05-19T23:41:00.005-04:00

Today I was on an anesthesia list in an ENT room. When assessing the Mallampati scores, I, admittedly, wanted to pluck all those pretty little kissing tonsils out of the kids mouth myself (or cauter them out, I guess). Later in the day, intubating past those little suckers was about as close as I'd get, but I suppose I was somewhat satisfied.

Anesthesia allows me to spend some time with oral cavities, pharynxes, and vocal folds. Even though I'm not operating on them, catching a glimpse of a ridiculously cute epiglottis makes me happy enough.

People have told me time and time again, that when they saw the head and neck oncology stuff, they finally understood why I loved ENT. Yes, I really love ablations and neck surgery, but, to be honest, I'd be happy taking out tonsils, putting in tubes, debriding ears, or doing ESS for the rest of my life.

What I can't understand is why not everyone is in love with ENT. (This is a lie. I do know, but I can't sympathize. Sorry.)

I'm so Hungary!

2010-05-06T10:36:00.002-04:00

Whoops. Due to lack of time, I have been running on pure celery derived ATP for the last 18 hours. Wait, haven't I heard somewhere that celery actually results in a net loss of calories, when factoring in digestion? Hrrmmmm.

I've always felt that lunch was a priviledge, rather than a right (while working at the hospital). I've been told that many attendings don't eat lunch, and that some believe that "lunch is for the weak". By extension, while on call, dinner seems to also be an optional meal. So, I guess residents run on energy extracted from the air?

Then again, I dipped my celery in some dressing, so I suppose I'm cheating :/ Either way, this is likely not a good habit to develop, given my already disordered eating. Now, to munch on some real food, courtesy some guy with fat lips.

First Days

2010-05-04T00:18:00.002-04:00

So, that was my first day in a non-surgical rotation. Also, my first day in about 2.5 months NOT in ENT (though there were several epistaxis that rolled in as I was leaving).

What is the heart again? Thank goodness shiftwork lets me read, read, read.

Majestic

2010-04-20T05:53:00.004-04:00

His tympanic membranes were beautiful - sitting there in the canal - unadulterated by infection. I could see all the way back to his stapes - this was out of a textbook.

I then asked him to Valsalva to check his Eustachian tube function.

I know it sounds like I'm exaggerating, but my heart really skipped a beat as the TM billowed and relaxed. It was a breathtaking sight.

Surprise

2010-04-16T00:31:00.003-04:00

An unexpected interview leaves me shaking in my boots. I wonder - who pulled what strings?

I can only infer that an off hand comment made a big impact, and at 20:30 the night before, I get a surprise e-mail calling me to the office of the someone who I greatly admire and wholly fear (in a respectful way).

Now - do I read up on head and neck? Or...polish up my CV? I have no idea what this is about, or what to expect.

I can't sleep. Just like the night before, knowing that I would get a parking ticket for keeping my car out on the street due to a full driveway. It'll be a restless night.

Palpitations start now.

FYI

2010-04-08T17:50:00.003-04:00

So, endoscopic sinus surgery is much harder than it looks. I have yet to master the rigid scope, let alone also suction out the nasopharynx (the most basic of endoscopic moves).

The future is exciting. In a talk by Dr. Kellman, he mentioned that he still did subcondylar mandibular fracture repairs endoscopically because it was like playing video games. Hopefully it'll become like that for me.

I now feel comfortable with the flexible scope; next step is the rigid; then, maybe, onto FESS! Kennedy, I'm going to read your heart out of your textbook!

I feel bad that I always talk about ENT on this blog. I mean, I don't feel bad, so much...more like boring. I'm sorry, but this passion that has been put into the my heart is just all consuming. I lurve it! I can't even think about something I could love more! Ok, maybe God, my boyfriend, my family, maybe? And that's why it's always on my mind. In my orthopedics and general surgery rotations, I was just itching to get my tongue depressors into someone's mouth and my otoscopes into someone's ears. While I did two weeks of family medicine, all I read about was otology/neurotology, rhinology, and thyroids.

So sorry, I guess it'll just continue. Unless life become significantly more interesting, all you'll be hearing about it ears, noses, throats, heads and necks.

Research Season

2010-04-08T05:46:00.002-04:00

With conferences fast approaching and electives nearing an end, research season is picking up again. Let's see if I can stand the likely antepenultimate task of multitasking - clerkship and several research projects (the penultimate being residency and life; then career and life). Hopefully I haven't bitten more than I can handle.

Two new projects, two/three presentations and a pending manuscript to be written...I can DO this.

Oh wait - am I also supposed to be writing my personal letters now? Gah!

Hospitality is...

2010-04-04T17:31:00.001-04:00

Inviting a complete stranger to your house to spend an Easter lunch with you and your family. Honestly, I was thinking I'd maybe skip lunch and sleep instead, but the offer was too good to pass. The food was amazing as well.

I've eaten about an average of one meal a day for the last several days and I'm making it up in nines today.

Yummy. Now to AYCE sushi with the residents : )

Von Recklinghausen...by proxy

2010-03-08T19:14:00.003-05:00

(In reference to an unfortunate mistake a professor made during lecture)

I am having tachycardia, tachypnea, palpitations, a feeling of impending doom, xerostomia (haha, another funny mix-up), distractability..., just by imagining what terror I will be feeling in exactly one year today. Really, time has passed by way too fast. I don't feel ready for the responsibility at this point, but maybe (I sure hope) twelve months will make a difference.

Then, on the other hand, I was promised today, by my attending, that if I was good, I'd match. He promised.

Then he said I was a superstar medical student. Is that a good sign?

2010-02-15T23:01:00.002-05:00

"When decannulation is impossible, use of an expiratory speaking valve may reduce aspiration. This strategy is doomed for failure when the tracheotomy tube is too large or the cuff has not been deflated completely."

Bailey - you are so dramatic : )

On Taking Criticism

2010-01-07T18:32:00.003-05:00

It's been a week since this happened, so, sorry, you aren't getting any genuine emotion. Not that I really have that much emotion left in me, anyway. I feel like a robot most of the time - I can put on my smile easily enough, then cleanly wipe it all off when I turn my head. Stealthy.

Anyway, the other day I was in the OR while on call, retracting away. It was a pretty interesting case - both bone forearm # ORIF with possible NV compromise - and I was having a grand ol' time (I'm not even being sarcastic: there a few places I'd rather be than in the OR watching a cool case in the middle of the night). So, of course, there was the usual drilling, and I think I did alright, considering I hadn't read up much on forearm #'s. Other than that, I manned the suction and a parade of retractors.

When it came to close, however, it seemed that everything that could have gone wrong did:

1. I've found I'm a bit ambidextrous when it comes to scissor usage, and have somehow come to favour using my left hand for cutting, but only during surgery. Of course, these are right-handed scissors and, biomechanically, not designed for lefty's. It took me about 10 seconds to cut the suture. It felt like eternity. I was chewed out.

2. It has been a while since I've sewn (in terms of real flesh, likely not since the summer). Honestly, the wrist isn't quite used to the motions and my motor memory is a bit rusty. I sewed slow. I get chewed out.

3. I'm a lefty. We were working on the wound together. His arm in is my way, mine in his. I get chewed out and told I need to change my hand preference if I want to become a surgeon.

4. Tails are about 3mm too long. Really, this is totally my fault - this should NOT ever happen. I feel like crap, apologize, but still get chewed out.

5. Put the medication doses in the PMHx rather than meds list as I was being rushed out of the room. Got told that it would be better if I don't write anything at all next time.

To be honest, none of 1 to 5 should have happened - I'd like to think that I am more competent than that. Maybe it was because it was a late night, or because it was a while since I've been in the OR, but man, it sucked. At the end of the night, I felt like total crap, but I still had to suck it up, smile, and thank the physician for a great night of learning. I grumbled home and let myself off of readings for the night (what a treat!) and went straight to bed.

The next morning, however, I felt much better. I was in the OR again, that morning, and this time did it all right. Maybe it was the subsequent success, but I had such a different perspective on that crappy night as I left the hospital that day.

They say humiliation based learning is no good? They lie. It works. It works freaking well. This guy, no matter his methods, gave me honest and unedited feedback. I need that at this point in my career, no matter how it hurts. He tells me what he cannot accept, and I can change it. Heck, because of the shame and guilt I feel after he berates me, I want nothing more than to change it.

With the vigorous training and perfectionist ideals of surgical training programmes, I can only expect more of such treatment. In fact, that night was gentle in comparison to the degradation I can expect in the future. I feel now, however small the criticism was in the grand scale of things, that I can take it. I can suck it up, fix my mistakes, and move on. And, I wouldn't want anything less than perfectionism in a surgeon, so I must expect it of myself.

...if I become a surgeon, I guess...

Funny Dreams

2009-12-13T14:39:00.002-05:00

This afternoon, I decided to take a well-deserved afternoon nap (somehow an inevitable end to a day of church). This was the first time in a while I have been able to remember my dreams, possibly due to the fact that I've barely been able to sleep these past couple days/weeks. As a result, I had a particularly funny dream:

I was checking my e-mail (epic, huh?)and I got an e-mail from my supervisor. Opening it up, I saw a one-liner IM-esque e-mail stating, "Hmmm....noticed something funny up there. Has it always been there?" Somehow knowing precisely to what he was referring, I looked at the e-mail header and noticed we were accidentally CC-ing some gentleman with the name "Durango G" to all our e-mails in that thread. I am not usually a "reply all" type, but I guess the two of us continued to reply all and this guy was CC-ed to all our unexciting e-mails about research revisions. This got me quite anxious, thinking that maybe this guy was going to steal all of our highly novel ideas, and more so, that it was likely my fault, and I had accidentally wronged my supervisor.

Anyway, in my dream, mirroring reality, I was extremely tired and even this rousing e-mail was unable to keep me from sleep. I went back to sleep and awoke a little while later, to more e-mails from my supervisor. I checked the one "we can kiss this review by-by [sic]" first (my supervisor usually has impeccable grammar/spelling and is able to create concise and relevant subject headings for e-mails, unlike this). It stated basically that our mini review had little chance of getting published now due to our CC-ing blunder; Durango G was the editor in chief for the Journal of Geriatric Medicine (unlikely to be true).

This didn't make sense to me. The project we were working on was only minutely related to geriatrics (i.e. the problem may be more prevalent in the geriatric population, but isn't pretty much everything?). So I opened the previous message, where my supervisor asked me to run a study on how elderly people were "unable to feel a coin when it touched their skin, but were able to sense its presence". He asked me to choose a journal to submit to.

So at about that point, I woke up,and thought about what just happened. The entire thing was pretty preposterous. I mean, who would passively receive a whole gamut e-mails jabbering on about text revisions, and not want out of that mailing list? Secondly, who would EVER do a study like the one suggested? How does that even make sense? Why would it be significant whether or not the geriatric population can feel coins specifically? And what is this "presence"? Are coins sentient beings or something?

So, as dreams mirror reality, so does reality mirror my dreams. I got up and checked my e-mail. Sitting in my inbox, instead of an e-mail from my supervisor, was a letter from the editor in chief of the journal to which I had submitted one of my projects. Unfortunately, we've been having a string of rejections for a kind of quirky paper we had written for another project and I was bracing for the worst. I breathed a sigh of relief when I saw the words "accepted with minor revisions" : ) Then, scrolling down, I saw that the reviewer just wanted some sentences changed - SCORE!

And now, I'm one step closer to publishing the project that is completely mine: ethics to paper. Also, we've broken this rejection trend - hopefully I'll receive some more good news in the near future (waddaya say, Skull Base?).

An Insatiable Beast

2009-10-13T12:05:00.003-04:00

As school goes huffing and puffing along, I feel as if I am falling farther and father behind, wrestling with this humongous beast called "research". Now, don't get me wrong, I love research. It keeps an otherwise dull school term lively, ennumerating my to-do lists, filling my spare thoughts, taking up real estate on my desktop.

The thing is I've never been that great of a writer. Sure, maybe I did decently on those elementary/high school essays on occasion, but these papers are a different species. There's a specific lexicon I haven't quite adapted. I am reluctant to let go of my imperfect drafts for review by supervisors. Then, when edits and comments come in, I am not confident in my revisions.

Draft after draft, insecurity after insecurity...finally, the day comes to submit. It is, to me, like taking that jump off the diving board. No, I haven't quite adequately mentally prepared, but with the 7 kids in line behind me, I have nowhere to go but forward. Then, while in the air, all I can think about is the eventual impact of hitting the water (i.e. accepted, accepted with revisions, rejected). Then, research never ends. After every submission, I breathe a sigh of relief (yay! I can knit for a night as a reward now!), but am quickly snapped back to reality: there's another project that needs to be done yesterday.

For the sake of balance, I have tried to pace myself. I think of it like some mob on WoW. You get close enough to aggro it, but since you want to pull it elsewhere, you run in front of it - just fast enough to keep 'em coming without accruing too much damage, but just slow enough that it doesn't run away. Of course, since I am meanwhile not paying any attention exactly where I'm running, I aggro another mob I like to call "school".

Then as an aside, I planned to talk about personality disorders and my schizoid tendencies, but this is getting too long. Basically, my boyfriend has been bugging me about getting Facebook for a little while. One night, he decided it was time to sign up, so we did it (I made him stay with me while I did it - it was scary). Then I got much too stressed out, looking at all those familiar faces, and deactivated the account. I relayed this to my sister a little while later, sheepishly, and she demanded I let her make me an account. She bugged me for 12 hours. I swear, she actually kept insisting until I relented. And thus, I have Facebook now. It still took me two weeks to let it sink in before I added my first friends. Really, this in uncharted territory for me, I am terrified.

TL;DR: I got Facebook. Add me if you'd like.

Point of No Return

2009-09-25T03:13:00.003-04:00

I remember when my parents first taught me about the point of no return (PONR) while I was learning to drive. I think it is a funny term, based on how resolute it sounds (I imagine a Benjamin Franklin-esque gentleman, waving his frilly sleeve, declaring, "Hereafter, I shalt not return!"). Also, the acronym, said phonetically, is kind of funny (I pronounce it "pawner").

Anyway, the reason why I am talking about this is because of a late night social Coke I drank which renders me uncomfortably alert, even in early hours such as this. I usually drink water, juice or milk, and, despite dating an "ex-Starbucks barista but continuing faithful patron", I can't handle my caffeine. I feel I have reached my point of no return tonight: I used to wake up this early in the summer when I wanted to do work - it doesn't make sense to sleep now.

The interesting thing about these caffeine-induced periods of wakefulness is that the wakefulness is not correlated with productivity. I have sat at this desk, clicky-clicking away at random news events; knitting more and more rows of this wonderfully addictive and satisfying mitten (yummy...stranded knitting...); typing this blog. Meanwhile, there is a pile of papers, patiently waiting to be read, and a long list of citations waiting to be filtered.

These papers need to be read so I can write the paper that needs to be written...gwar - time to buckle down.

In other news, I have a shift in labour and delivery this weekend. I have so far enjoyed gynecology a lot (the anatomy is, to me, wonderfully difficult to memorize - all those branches off the internal iliacs? I need to review them yet again...). Maybe/hopefully, I'll be able to welcome some babies into the world - yay, childbirth?

Freedom

2009-09-16T11:58:00.002-04:00

Today marks the first day in half a year that I don't have to take my medications (or have to feel guilty about missing it). I know - a half year course does not compare to the medications for chronic conditions some patients need to take indefinitely, but it still feels good : )

Through these months, I have learned a couple things:
- I am horrible at keeping a regular schedule, especially when it involves doing anything between the hours of 8am and 9pm. Mealtimes are very variable, both in their timing and presence. Medications to be taken at the same time - often forgotten.
- Getting bloodwork while working at a hospital is difficult. you wouldn't expect it, seeing that you easily order in-house bloodwork on all the patients, but, most often, you can't get it done in-house. Getting regular bloodwork done is very inconvenient given my nomadic habits.

Not having to pop those pills and get the subsequent bloodwork feels great. I don't mind getting poked now and then, but, as said before - real life happens while one is in class. Last term, there was A LOT of unavoidable missing of classes for appointments. Now I'll have no excuse (good or bad?).

Freedom is wonderful. Now, to binge on broccoli! No, that probably wouldn't be a good idea, I guess...

A Summer's Worth of Change

2009-09-11T22:13:00.002-04:00

Not so surprisingly, summer has come to an end. I knew it when it was getting close, but didn't realize just how fast time passes, especially when you spend day and night thinking about papers. And so, a requisite "summer reflection" is in order. Yes, a week late, but maybe it takes me that much time to think, right?

My summer has been awesome. I have loved pretty much every moment of it and I can't think of a better way to spend my time. I have learned so much, met so many people, had the privilege to do so many things. At the beginning of the summer, one of my supervisors advised me to surround myself with positive people, to make sure my summer was a positive experience. The people I have spent time with are far more than positive - understanding, supportive, encouraging.

Coming back to school, I feel like I have so much free time - time to sit around and do nothing, time to buy groceries, time to do pleasure reading (read: ENT textbook) - what a luxury. I feel like this is the second term of school, rather than a whole new year. It feels great to be at "home". And I can see the ways the summer has changed me.

1. Since waking up for round in London, I have really come to appreciate early morning productivity. Back in London, I was waking up at 4am to do work on my paper because I was often too tired after the day's worth of learning to get much work done. Admittedly, I have been waking up later and later here, but even giving myself an hour or two before I need to start getting ready for school is wonderful. By the time class starts, I have already been productive with my day. Who knew that a life-long self-admitted night person could so rapidly change into a morning person?

2. I am much more decided about ENT. It is difficult to pinpoint exactly what it is, but I think it is the broad and flexible nature of the specialty, the intricacies and beauty of the surgeries, and the patient outcomes that I love (how vague - that's pretty much everything). I remember a straight forward, unilateral FESS where the resident was suctioning a pus filled maxillary sinus. It's a funny angle so sometimes it's difficult to be effective with the suction, but he got the perfect angle and a whole bunch came out. There was a room-wide sigh of satisfaction - yummy. Something about these surgeries is so viscerally satisfying. Something about this specialty is just so appealing.

3. I met with my supervisor today. I am not sure whether it was because of the conference, me being more sure that I want to go into ENT, or just the fact that we've been working together for a bit, but I felt much more collegial with him. He talked to me about ENT like I understood it, and I did. And we "caught up" - weird - I "caught up" with my supervisor. It makes me happy.

4.5 months of holiday, spent exactly how I didn't expect to spend it. Loved every minutes of it; have been changed by it. And I haven't even talked about Manitoba...another post for another day.

The Surgery was Cancelled

2009-07-31T18:13:00.003-04:00

Upon reflecting, this has been probably one of the busiest summers ever. In fact, I feel as if this summer has been busier even than my busiest school term. During school, I enjoyed many extracurricular activities, could commit to things outside of medicine, and had time to knit constantly. Now, however, I have little time to even collect myself at the end of the day and read up on the next day's cases. I've been running around trying to meet self-imposed deadlines so I can get some manuscripts and abstracts by the end of the summer, in hopes of a couple publications and presentations.

I am by no means complaining. I love this summer. Sure, the schedule of "rounds, clinic/OR, rounds" each day is a bit exhausting, especially when I am such a slow dictator, but despite this, I am excited each morning. I have met some wonderful people who have encouraged me in their own ways, and I feel much surer that this is what I want to do with my life. I love the anatomy, am curious and eager to treat the pathology, enjoy the patient population, am motivated to do the research. I felt so much joy seeing stapedotomies, debridements, laser excisions in the larynx...even tonsillectomies, myringotomies - but had a significantly smaller visceral reaction when the pit tumour came out, or when those odontoid screws went in.

I was a bit unlucky today (or lucky?) - a case got cancelled because of some administrative mess-up, the library was closed, and the next bus to Toronto isn't until 8:30 - I guess someone was telling me to take things a little easy today. Friday of the long weekend - my time to catch up on research - but first, a moment to bask in the joy of why I am here in the first place.

Rhinology the next 2.5 weeks - looking forward to some ESS and polypectomies - yummy : )

A Biased Courtship

2009-06-18T20:23:00.003-04:00

I am loving things here in London. Admittedly, the 45 min commute renders the reasonable 7am rounds a bit unbearable and VH is by no means for the faint of heart to navigate, but I really do want to be here for 5 post-grad years. The programme here is (?seems) wonderful - there's this feeling in me that wishes it was a physical object so I could give it a good hug (like that giant chicken in peds U/S - what was that doing there?).

Alas, but CaRMs demands a mutual relationship. Will they love me as much as I love them?

I have been told that each encounter is an interview - treat it as such. But it's tough - sometimes I'm dumb and really can't figure out the answer (well, then read more); sometimes I'm tired and can't stifle that yawn (tired now? Wait until clerkship. Tired in clerkship? Wait until residency); sometimes, somehow, I really don't know/hear it when they are talking to me (hmmm...harder...read some books about social norms, listening maybe?).

And so, a perhaps one-sided courtship begins. I will, admittedly, be a bit promiscuous about it (who is to say I won't be attracted to other folks (read: programs) as well?), but maybe this "first love" will always have a special place in my heart. I need to pretty myself (and my CV).

I await eagerly the day when my love(s) finally give me a yea or nay. Then I can venture into the treachery of maintaining that relationship.

Steps and Missteps

2009-05-13T01:59:00.007-04:00

It has been a whirlwind of a conference these last three days. Three days of poster presentations, podium presentations, workshops; three days of trying to figure out the politics of all this stuff.

I have to say, in general, I had a wonderful time at this conference. I had no idea that I loved otology so much, or experienced how much innovation was involved in reconstructions. I felt so honoured to be in the presence of some of the biggest ENT researchers in Canada and the world, and in the same room as some of the budding "big shots" of the future. I loved listening to some extremely innovative research (though most of its significance is probably still lost to me).

But, I really felt like the absolute bottom of the totem pole here. Not only am I currently a medical student - I haven't even started clerkship. I knew no one, and, as predicted, there were many awkward moments spent standing alone in corners, obviously uncomfortable. I know that conferences such as these are a wonderful time to network, but, honestly, that is not my forte. I did introduce myself to a couple near peers, however, I am so appreciative for my supervisor, my near mentor, a peer who willingly introduced me to so many important people. I feel that it is so difficult to navigate this hierarchy called medicine - I might venture to say I'd rather do 10 OSCEs or write a week's worth of exams.

Anyway, a summary:

1. The presentation. From the moment I walked into that room (about 2h before my presentation), I was tachycardic. All these people: so intelligent, so well-read, so put together, standing up there presenting beautifully crafted studies. How could I compare? Were they going to cook me alive with those amazingly relevant questions that I never think of? The moment right before my presentation, I took a deep breath, ignored my nervousness and proceeded. I don't actually really know how it went. How many "ah's" or "uhms" did I say? Was I clear? Did I mumble? Did I talk too fast? Did I look put together? Did people even care?

All I have to go on is the reassurances from a few very generous individuals. One assured me that my presentation was well received, and I got a few congratulations and pats on my back. At least my presentation was drastically different from all the others in that paper session, and, being the only student presenting at that particular session, I stuck out like a sore thumb. I am now "that girl" who presented "that paper" : ) I can't complain.

Having this opportunity was such a blessing. I feel so indebted to my supervisor for pulling his strings for me like this. Really, how can you thank someone who is willing to help me in my career so much?

2. The learning. Yup, I still love ENT. A lot of hearing and speech sciences came back - I even saw a speech spectrogram! There were a few barium swallows (a personal favourite), beautiful TM's, elegant neck dissections. Given my lack of training, I am surprised that I enjoyed myself as much as I did.

I also found that I love otology (the research there seems very interesting). Whelp, I guess that pretty much means that I like every subspecialty of ENT. I guess that's a start : )

3. The people. As I said earlier: I really struggled with this. There were great times (one guy took a special liking to me, since I have an interest in community ENT, and gave me a bag of magazines and books to read), but there were bad times (hmm, what do I do now? I know nobody...I'll just sit here for 15 minutes in an empty room). But I have to admit, if I didn't attend this conference, I would have missed so many networking opportunities. And, if anything, at least my name has made it out there - a bit (hopefully in a positive way). I do regret, slightly, not going out to the bar a couple of times to network. The refuge of my hotel room is just so tempting sometimes.

And now, with some conference experience under my belt, I think next time will go better. I feel so blessed with this unique opportunity - none of this was my doing or my effort.

My dearest memory when someone, perhaps indirectly, showed me that he was really on my side. This person has really gone out of his way to help me in the ways he can towards a possible career in ENT. Of course, this doesn't render me a shoo-in, but it's so encouraging that someone would believe in me so much to vouch for me.

And thus I stagger my way into the unknown future.

Quick, Batman, to the East Coast!

2009-05-09T23:14:00.002-04:00

Yes, I think I have some kind of inner attraction to this side of Canada - I just can't stay away for too long. Of course, it's a different city and different purpose this time.

Halifax.

It was coated in darkness when I arrived. The fog eventually cleared and I could make out some buildings, but I have yet to see the full glory of this downtown. I suppose that sight to behold is meant for tomorrow morning.

I am currently sitting on the superfluous bed in this absolutely superfluous suite. I feel strangely out of place, staying at this hotel, and slightly disconcerted at it's luxury. But beyond those worldly (dis)comforts, I feel a bit anxious as I look towards the day ahead.

What am I supposed to do? How am I supposed to act? Will I end up standing awkwardly in the corner, as I often visualize myself doing? I am not one naturally blessed with social graces, and consider myself slightly inept in those skills. Not being a smooth-talker or outgoing, I wonder how things will pan out. I am the bottom of the barrel at this conference, and barely have a right to be here. I can imagine myself: What am I supposed to do with my hands? Did I dress appropriately for the occasion? Was my laugh a bit too loud/inappropriate? Am I taking this sarcasm too far? Did I really just say that? What did that look mean? Was that a sigh or a loud breath? Do I look/present myself like a medical student instead of somebody's kid?

On a slightly related note, I ended up sharing a cab with a stranger to get here - I wonder if it was a dangerous move. In the end, it was fine - this gentleman was headed to the same conference I was, and we had a bit of a discussion in the car. I was so encouraged to hear about his predictions for my "mentor" - up and coming soon to be big shot. I feel so proud of him and so proud to be tangentially related to him. I think about all these people that have been so generous and kind to me - what have I done to deserve it? I am not a genius, shining star of my class, but just another medical student (or even then, a pre-med). Yet, these people have shown me such grace: accepting my faults, still giving me opportunities, wanting to actually be a part of my career. I feel so blessed, and cannot thank God for how He has placed these people in my life. Maybe one day, if I am ever destined to be that up and coming big shot, I will be able to extend the same grace to that shy but bright-eyed student who might not be able to strategically navigate this world of admissions, but is in absolute love with medicine.

Time is an hour ahead here. Time to hit the sack...and figure out this "Sleep Number" business...honestly, I don't deserve this.

The Dilemma of the Keen Medical Student

2009-04-27T11:45:00.005-04:00

I must admit - I love medicine. Now, you may want to take this statement with a grain of salt. Along with medicine, I also love linguistics, neon gummy worms, perfectly designed RCTs and tiny Erlenmeyer flasks (to list a few). But, as I venture closer to real clinical practice, I realize that there is nothing more that I would want to do as an occupation.

Every clinical experience, thus far, has brought me great joy. I guess you could succinctly label me a "fresh faced medical student, yet to be disillusioned by the horrors of real practice".

And thus, the dilemma. On the one hand, I love medicine and have a currently insatiable desire to do more. On the other hand, I am painfully conscious of the fact that I have decades of practice ahead of me (that's not so bad, right?) and physicians are quite susceptible to burnout. So, do I do tons now, to satiate my hunger in the short term? Or, do I abstain and rest now, such that I can retain my sanity in the future?

A "near-mentor" told me that his strategy to get into our common desired specialty is to work his butt off now. He puts it well: he has never worked so hard in his life, but yet also has never been so sure of what he wants. It's true. Audiograms have a special place in my heart, and peering into a freshly cleared EAM is somehow delightful (look at all the cerumen he got out of that thing!). Stroboscopic laryngoscopy? Enchanting. And I can't wait to see my first choanal polyp, peritonsillar abscess drainage, branchial mass removal...

And so he advised that this summer was not to be a holiday, but an extra elective block. Study the anatomy, know common clinical presentations, make connections, play this wholly unentertaining game called clerkship.

I guess the dilemma is not so much a dilemma as a paradox - two seemingly contradictory statements that can both be true. What if I love working very hard when I have the time to relax? And, what if my passion can continue throughout my career? What if I just do what I love, then hope that them program directors let me continue doing what I love?

...is that the realist or idealist speaking?

Non Sequitur: The entry with no purpose but to update this empty space

2009-04-23T13:29:00.005-04:00

A million drafts, none published. I've been trying to rouse myself to post on this blog for a while now, but I just don't know what to say. Examinations ended on Thursday last week for me, and I have been now occupied in a different sense. Of course, I have been relieved from the examination stress and the "impending sense of doom" (atypical AMI presentation?), but there is this nagging sense of duty always at the back of my head.

My presentation is going to be in about 3 weeks and I am sorely unprepared. I had thought results would be done, but sometimes these things slip people's minds. I am looking forward to this "query vacation", but also have a sense of apprehension about it all. I feel that I need to be so careful about making a good impression and have little idea what to do with myself. How do I infiltrate this possibly close knit group of friends? Will I like the culture of the specialty? Will I fit in? I guess my initial approach to this was that it was a once-in-a-medical-school-career's chance and I might as well jump in with both feet. When it's all over, I'll let you know.

The summer has been unfolding well, with a lot of top heavy spending. I will try to be more thrifty later? I have been really taking things as they come, but will probably regret this laissez-faire attitude as deadlines come up. London is taking it's form - I cannot even express how thankful I am for this mentor of mine and I can't believe how highly he regards me. The pressure is always trying to live up to all the hype. I am looking forward to FINALLY getting that book I ordered so I can study up (does it really take that long to process an order?). I am excited to be there, but utterly ill prepared.

Alas, there are other commitments that I haven't really placed in as much priority but should. I also wanted to make this ugly thing a bit prettier. But, there is this lazy bit of me that just wants to sit around and knit swatches all day.

Also regarding knitting: Last night I have a very vivid dream about exams. We were in a room waiting to enter into the exam room (that never really happens) and I was trying to cram respirology. Unfortunately, I was also knitting at the same time and couldn't cram fast enough (it has to do with the fact that you can't turn pages with both hands on the needles). This made me really anxious. It was then announced that the exam would begin and I woke up while I was looking around for my water bottle.

And that is my requisite post-examination blog. I have nothing much I wanted to say but that I'm glad it's all over (the blog or the term?). And, in the memory of that wonderful series I've been recently addicted to: Write no more, Claudius, write no more [curtains are drawn as main character dies, obviously poisoned].

Prototypical Type A Behaviour

2009-03-30T13:06:00.005-04:00

I remember the first week every year of my undergrad. I would have a deliciously productive summer, flowing beautifully into the start of classes. My boss would usually give me the first week of school off to "settle in". With no assignments, no work, no deadlines, I felt constantly edgy - I had no idea what to do with myself. "Relaxing" was not satisfying, and I always felt a tug to do something "useful".

Now, I know I thrive on productivity. I love the feeling of checking things off my numerous To-Do lists so much I sometimes check off items prematurely to motivate me to work harder. I feel strangely satisfied when I spend hours on hand sitting unmoving in the library. Seeing a perfectly planned schedule brings me so much pleasure. Having multiple deadlines crashing towards me is somewhat daunting, but yet, when I look deeper, I see that I actually like that kind of pressure.

Of course, this hasn't always been optimal for my health. I definitely would rather spend hours in front of an open Word document than eating a proper meal. Physical activity? Quite low on the list. Sleep could be sacrificed if things were getting good with the assignment.

About a month ago, I took another hit to my health. I can't be sure if it had to do with my preferred lifestyle (see above) - Internal Medicine will tell. At the time, I was hoping the magical injections would cure me instantly, but I still had good days and bad days. I had a good week a few weeks ago and thought I was back to 100%. Nope, still feel like crap some days (e.g. today). The funny thing, though, is that I've become an obsessive pulse-checker.

I remember talking to a physician, who told me that it will take a while for my body to readjust, but that there may also a component of anxiety. As I've said before, I'm not an anxious person. Sure, I may have a lot on my plate at times, but it doesn't really stress me out. When I quiet down and listen to my thoughts, I'm not thinking about how I'm not going to make it to the next deadline.

I examine myself: I see that I am neither overtly nor inwardly (at least intellectually) anxious. However, I wonder if it's possible to, without the feeling of anxiety, have psychosomatic manifestations of anxiety. Is there a way that sympathetic stimulation can be evoked by emotions suppressed by the "host"? Is it possible that I am emotionally stressed but am absolutely ignorant of it?

To be honest, I want a quick fix, a quick diagnosis, but medicine is so rarely like that. Instead, I'll wake up each morning, not knowing if it'll be a good or bad day. And even if it's a bad one, I'll press on with the day, wishing every moment that I could just stay in bed and sulk. But, I mean, that wouldn't be very productive, would it?

Your Dreams are a Wish Your Heart Makes

2009-03-20T15:40:00.004-04:00

This weekend has been great. I'll admit that I got embarassingly little work done, and I didn't get to spend a lot of time with my friends living in Toronto, but it was fun hanging out with two of my sisters, who conveniently are also on March Break.

Sometimes it boggles my mind to think how young they are. In grade 8, I wanted to become a neurosurgeon, felt so self-important, and was excited but apprehensive about going into a high school where I knew almost no one. I was afraid to leave my friends and promised to keep in touch (predictably, I've broken that promise). When I was in grade 10, I was so energetic, shameless, and felt invincible. I had dreams to become famous one day, picked up so many "hobbies" that I later deserted, and struggled with the fact that I wasn't guaranteed to always be top of my class. I think I came to terms at that time that I just wasn't "cool".

Throughout my life, I had wanted to be: a window washer, the Prime Minister of Canada, a cancer researcher, an astronaut...and more recently, an SLP, the owner of a vinyl and plush toy store, a physician. It's fun and exciting to see my sisters develop their aspirations. I remember I had asked one of them when they were in grade 3 what she wanted to be when she was a "grown-up" and she immediately said "a dinosaur". Since then, there have been whisperings from the both of them dreams to become an engineer, a lawyer, an accountant, and maybe even a doctor.

This break, I had so much fun teaching them how to take blood pressures, feel for pulses, look into people's ears. They seemed to have lots of fun playing with my "toys". I showed one of them an endoscopic sinus surgery where they cleared a fungal infection from the maxillary sinus, and then the majesty of a mitral valve replacement. She cringed every minute of it and didn't hesitate to remind me that there was a person under that drape. Another stated that she might want to be a doctor, but maybe only a pathologist because she couldn't take the stress of another person's life in her hands. Of couse, I would and could never push them into a career in medicine, but I feel so happy to share with them this career path I have come to love.

I imagine what they think about as they walk through the halls of their schools, giggling with their friends. Who do they see themselves as? Who do they dream to become? Do I seem like an old fogey to them? I feel so blessed to be able to take part in and observe their development into adults. I cannot even begin to imagine where they'll be in 10 years, in my stage of life. Will they even think about these precious weeks I am able to spend with them? What will they dream of then? It's funny to think that I'll forever have a decade on them.

Then they leave me for a ski trip with their cousins. O well, I guess that's life for you.

And now for something completely different: Last night I had a dream about a totally exaggerated pulsus parvus et tardus. It was the most obviously abnormal pulse contour I've ever palpated. Maybe too much cardiology these past few days?

Through the Linen Curtain

2009-03-17T11:32:00.004-04:00

It's been a funny month. The routine of school is something I am used to, comfortable with - I mean, I've been a student all my life, how could it be different? But of course, curve balls always come hurtling at you as you daydream, awakening you as they hit you painfully in the face. And that's where I was - going through life with everything in place: my research project was going well, school was kind of under control, life outside of such responsibilities was going better that I expected.

Suddenly, I find myself on the wrong side of observerships, somewhere I am quite unaccustomed to being. I was relating yesterday, after spending time with a friend in the ED, how weird it was to be on that side. I have had little experience in ED's, to be frank, but I feel like I have a sense of how it's run. As a student in a clinic, we'd look at the charts, then take a peek at the labs and imaging. I'd discuss with the attending/resident/clerk (or, more honestly, they would tell me) our plan. I would enter into the room, having an (good) idea about the patient, and, more importantly for me, a good idea of what was going on in the department. Being on the other side, I have no idea what is going on, haven't seen my imaging or lab values, and I really don't know what's keeping the physicians.

As a medical student I feel that I know enough that I know, and am self conscious of, how ignorant I am. I feel so stupid in these ED's, clinics, urgent care centres, not having a good grasp of what is going on. I don't have a clue what's wrong with me, my friends - the incompetence is overwhelming. I feel like I've worked so hard to get where I am now, but I look back and see that I've only made a few meters of progress up this millions high mountain.

I wait for and work towards this thing called "mastery", currently but a point on the horizon. I hope one day I'll be close enough to at least distinguish whether it is a serene stag, calmly munching on today's serving of grass, or an angry bear, hungry to eat me once I get close enough. Either way, I'll still be drawn towards it. Maybe the bear will be little more calm if I offer him my potato chips.

On Clerkship, the Match and Me

2009-03-12T00:36:00.003-04:00

I would consider myself a pretty laid back individual. I'm not too stressed out about anything, I like to allot myself time to do things outside of study, I wouldn't consider myself overly competitive for anything.

And yet a find myself in a funny position - just about head over heels in love with a reasonably competitive specialty. I mean, I am no specialist in otolaryngology, nor have I done a million and two observerships in the clinic or OR. I don't joke over lunch with all the ENTs at school, or call them up to have a casual chat. Instead, I have often suppressed desires to clean out everyone's ear canals, found myself eerily satisfied at the end of a tonsillectomy/adenoidectomy, and a strange YouTube fed attraction to nasal and sinus endoscopic surgery (extreme nose-picking, I like to call it).

But, to these things people call "competition", I am quite ignorant. I don't know how to "get the edge". I have no strategies on getting the best chances for a match. I am slow on the uptake and definitely not always the best informed about all the "word of mouth" information floating around.

I have itchings to become more "competitively aware" but yet feel overwhelmed with apprehension because it is so outside my nature (i.e. I have no idea how to do it). Seeing Match statistics, I wonder about my numerous (well, not that numerous) amount of colleagues that are gunning for the exact same thing as me. I find it difficult to believe all of us will make it, and I feel that I lack the competitive initiative or charm needed to secure a spot.

Yet I know that I am not in medicine for fame, glory, comfort, or to spend the rest of my life (no matter how much I want to) picking at people's ears, noses, throats. I got in here due to the providence of the Lord and I know that He has a plan. I have been so far blessed with a wonderful clerkship schedule/group, and I guess I can just wait to see what He has in store.

(Not so secretly, I don't want to wait - let me scope some noses already!)

It took a while

2009-03-07T11:14:00.006-05:00

So, back after 3+ years. It's taken a while. I stopped this blog originally so I could figure out why I blogged and what my purpose for blogging was. Why did I want my sometimes deepest thoughts and insecurities to be posted for the world wide web to read? Who wanted to know about my inane daily activities? If I was going to post so sporadically, why should I do it at all?

I started blogging again this school year with a group of girls from fellowship, just so we could keep up with one another in between meetings. It was nice to have somewhere to post things, so when we got together, it wasn't a whole week to catch up on, just a day or two. Since that blog was on Blogger as well, I stopped by my own blog and quickly perused some of my old posts. I found interesting, deep posts, along with silly ones, whose significance is now beyond me. I thought back on these last few years when I stopped blogging. In a way, those memories have evaporated - existing somewhere in my indiscernible past. The only remnant of it left is who I've become today.

It's true - I'm bad at journaling. I've never kept a diary for more than a week. In terms of keeping my friends up to date with my life, I hang my head in shame, time and time again. In terms to daily social activities, I shy away from them, preferring the comfort of my own private cocoon.

Now, I've realized that a blog doesn't have to be a burden. I don't need to post regularly, meeting any demands of some imaginary audience - I'll just do it as I'm comfortable with. It's a place where people, if they care, can see what I've been up to. My slightly deeper, darker secrets can be left unpublished, or in the e-mail inboxes of those to whom it may concern. But when I want, I have this tiny blip in the virtual world to share my thoughts, experiences, hopes, dreams.

And of course, now I can track my now-unforgotten inside jokes and embarrassingly juvenile grammatical quirks. Let's see if I can type in full sentences now, with proper capitalization, and take all that extra time to type "you" instead of "u".

P.S. I know it's kind of ugly right now - I'm going for the "notepad.exe" look. When it gets on my nerves and I have a spare moment, I'll fix it up.

2005-09-18T00:24:00.000-04:00

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2005-09-15T00:32:00.000-04:00

ah fine, i suppose i'll post...perhaps only because i just finished a wad of work and i'm feeling productive. and plus, despite what many think, this blog is not quite dead. yes, there's no pulse, but some brain waves have been detected on the electroencephalograph i used just the other day so technically not dead.

and i suppose i have some...slightly entertaining comments to communicate via this comatose webspace.

so just what have i been up to? well, nothing much, but i'm happy. somehow, perhaps not voluntarily, i'm slowly emerging out of my cyber-cocoon (or anti-cyber?).
look at me: i'm blogging and i wrote possibly 5 e-mails today (though they were all in reply to some business that needed to take care of). perhaps soon, i may venture out onto msn (gasp) though i highly doubt that i would do something so drastic.

and since school started, i've had the opportunity to network with 3 strangers. imagine! (though one of them has not replied to my message so perhaps that does not count) so, fine...2 wonderful opportunities, the second of which is a ridiculous blessing...i'm praying that we'll be able to foster this "chance" "meeting" into something of a friendship, or at least that i'll be able to meet her and actually talk about real stuff.

but the start of the year has not been what i expected whatsoever. for the antisocial/geeky/nerdy me, i had imagined a conscientious start full of textbooks and lectures (not that i mind that at all). so yay God. He's more. i like that.

and an added bonus: i got right into those cryptoquips. i think i may be able to achieve my 10 mins or less goal this year. i expected some loss during the summer, but somehow that did not occur. man, did i miss those. man, am i happy to have them back.

2005-07-19T13:01:00.000-04:00

2005-07-07T03:48:00.000-04:00

i sit up at 3 am, quickly realizing that i cannot sleep. i had tossed and turned to no avail. i roll over onto my tummy and prop my head up with my forearms, staring into the foreign darkness. i imagine looking up towards a night sky filled with stars and other wonders. i turn on the lights and begin to read. slowly, my insides stop their own tossing and turning and i feel kind of nice inside.

something inside tugs at the dvd lying on my bedside. i slowly make my way to the computer and start it up. i pop the disk in and the screen changes, stirring a certain happiness inside.

physiology, couldn't you at least wait until the sun got up?

2005-06-15T19:29:00.001-04:00

i stare intensely at my plate
as the ice cream melts into an indiscernible mush
the busy-ness flits around me
i sip my sweet soup.

they talk over and around me
as i reach for a conversation,
they have turned away
the words i spoke evaporate as if they had no weight.

suddenly, i realize that i’m whispering into an empty room
no one here to listen and i can barely hear myself
i slowly sink to my knees. loneliness

i reach my hand out to be held
everyone is already holding onto somebody else’s

finally, it dawns: i am not needed here
they are neither better nor worse without

i feel like a voyeur, blatant espionage.

with one last breath, i reluctantly steal into the darkness
the night devours me willingly

strangely, i feel needed by this void.

2005-06-07T18:17:00.000-04:00

hmm....rogue like abilities would be convenient at times...or maybe all the time.

welp, i'm a bum and haven't been trying to make that status any different...so i've been cleaning around the house. it's enjoyable, for sure. so far i've only got the kitchen and dining room. the fridge took ages...and the microwave is a bother. i can't stand the fact that it smells like the last thing i ate. ew. i hate the smell of food when i'm not hungry. unless it's a juicy juicy steak

but otherwise, perhalps i'll start a WoW character of my own, though i don't really like the fact that it's a(n?) mmo. heh: i don't like people. beda! but i guess it just can't be helped! male taurens are so cute when they sit down and drink, of course when simultaneously adorned with a nice mask...

oh, this is nice. a welcome break between studying physio and french. a nice, quiet, reflective break.

2005-05-10T13:27:00.000-04:00

T.M Lennon

it was my third essay due that week. i was...at least a little frazzled, and perhaps stressed, but i had really been blessed. i had been praying about this course a lot because i knew i didn't really belong there and i was in the lowest echelon in terms of knowledge about the subject of study.

i remember being blessed that day at my Taylor cubicle. suddenly, i began scribbling the sudden burst of thoughts on my now illegible brainstorming sheet. i decided to meet with the professor.

he seemed busy that day, behind on his appointments (mainly because of the american guest he was entertaining for the week) but it was so wonderful to sit there and discourse concerning these philosophers that i had come to appreciate. i noticed that day the spark that was in his eye, seemingly seeing the epiphanies i was having about the texts. he loved these historical figures and he loved teaching.

it was that day, walking up to nat sci, that i really realized what a blessing university was. as i looked up at the social sciences center, i saw not the bland concrete and ugly architecture; instead, i saw a place bursting with knowledge. this was an opportunity that did not come often: that is, this was a time to learn. it wasn't a time to just scrape by, mustering marks high enough to get into grad school...it was a time to explore.

i saw then that taking an elective in philosophy wasn't a stupid mistake at all. in fact, it was a wonderful chance to step out of the paradigms i grew up with to open my mind up to a whole new way of thinking. yes, modern science has made us all (ok, maybe just me) into reductivists...but it's not that we are only confined to occasionally step back to look at the big picture. sometimes macro makes more sense.

2005-05-05T01:02:00.000-04:00

yay: images back up....maybe i can start anew :D

and perhaps, to launch this re-opening, i will start a multi-part tribute to the professors whom i love. but perhaps no one will be interested in my not-so-escapade-ish "adventures" with my academic models, and perhaps you will all lose faith in my blog, but this time not due to the lack of updates, but due to the immense volume of imformation no one cares the slightest about.

but fear not, kind sirs! for i shall embellish...or at least attempt to entertain and update...or only attempt not to bore the wits out of you all...and maybe none of the above. ehhhh.....

2005-04-27T20:31:00.000-04:00

the rain that
streams down my cheeks
because i lack an umbrella.

hahaha.

2005-04-24T10:59:00.000-04:00

to the bestest jon, this is just for you...
so everytime you visit this little cyber nook u'll see ur name at the top of the page : D

perhaps i'll start blogging...after i get that titlebar back up...hahaha

2005-02-13T21:23:00.000-05:00

was feeling a bit discouraged earlier today and decided to look at some creative writing i did in the past (boy...i do love to write. i miss it dearly). this little, i suppose for lack of a better term, journal entry really encouraged me...

it was during a bad time for me, and God just gave me this encouragement/vision and i could not help but write it down. my mind wonders back at the imagery and i wish i could paint...it was so beautiful...

April 16, 2004…6:23 AM

“But the high places were not taken away out of Israel” 2 Chron 15:17

dirty, filthy….unworthy
yes, those are all things that are so close to my heart right now…

and the worst part is that it’s not just the high places, but also the big things in life

I feel so wrong, so gross, and

I feel like I’m not clothed in the raiment worthy of the Lord’s presence

And yet he beckons to me: saying “come to me and I will clothe you in fine linens”

When I come into His courts, He does not send me away, but rushes to hold me.
I ask myself why I forsook this holy temple for the world outside. Here my Lord clothes me well, feeds me well, and together we celebrate daily,
Why do I run from these gates only to dirty myself and mourn?

I come again to you now, ashamed, but I know that there is no lye that will cleanse me as you do. Let me be cleansed by you, be washed in a bath of your blood. You did away with sin, yet why do I cling to it? Why does my heart wander back to Sodom and Gomorrah?

Yea, I have become a new being in Christ. I need not sin. Let me dwell in your temple Lord, for it is here that my heart belongs. Cut the strings, Lord, which bind my heart elsewhere. Let me turn to you alone.

2004-12-11T20:41:00.000-05:00

eto...eto...eto...eto...champru!

teehee: despite the fact that the library is so much more conducive to studying, the dining room table is so convenient...hop out of bed...i don't even need to change out of my pj's

and it's such a good time to "bond" with my roomies

and the other day i stuck a candy cane in my mouth and realized that christmas was almost here :D ooooh: can't wait to see ppl i miss. but first i gotta get over this (minor) hump in the road first...gah...

(oh, and carol, i put on my boots the other day and while i was walking to the bus stop, i thought of those "whomp" drawings>>teehee :D )

2004-12-06T19:56:00.000-05:00

ai: 4gigs. burner-chan, doko desu ka?

made me so happy to see sol and jon. if only sol would stop lying to me...maybe i can have a normal conversation with him. and that jonjon. what an interesting guy. i can't believe that he changed so much, stopped talking to me, and then started to open up again.

and it all reminded me that there are so many friends close to my heart i should be praying more diligently for.

and when i wake from my mental slumber, there are many e-mails to be returned (ahhh: sorry carol!). sumimasen~

2004-11-23T02:08:00.000-05:00

wow: God provides sooo abundantly
final coupla months before first yr were a bit hard: looking around for money to fund education...but things were ok because of some "security" money

but RESP ran out first yr (our family has bad investing luck) so second yr, we were on our own, using whatever savings we had to fund me thru school (man, if only i was a genius...then i can get sponsored to study)

but praise God i was able to get a nice loan frm the government (though i kno the interest will kill me)
and praise him even more for the "free money": i had given up hope...but friday night i got a nice friendly "ur bursury application has been processed and we are glad to inform you that you have been granted a bursury for..." what? yes! yes!

carol: hahah: yeah, that pencil case sure got some interesting comments :D esp frm mr lim...tho i remember none of them...
the coolest thing about cows is their 4 stomachs...nice big rumen to break all those beta (1->4) bonds~ if only...then we could eat...trees...or something: haha

sindy: thanks for that crazy ridiculous pencil case: haha: i had the pleasure of dissecting a cow EVERY SINGLE DAY! now who can beat that?

2004-11-18T01:18:00.000-05:00

chee: thanks pneumatos :D teehee: i was wondering who lived at the listed address, looked it up on mapquest...and the query returned 0 results...

hmm...??

i luv the eyeball: that's one dialated pupil :D

and the note was mighty encouraging!

(and my roomie had fun popping the bubbles in the packaging)

luv/miss you all.

2004-11-17T17:12:00.000-05:00

woke up around 6 this morning to what in my dream seemed like electrical buzzing...only to find out in real life it was the fattest fly ever

i hate bugs.

therefore i couldn't sleep the rest of the morning (kept waking up fearing the bug would be beside my face...in my eye...) and opted for the later bus which = late for class.

at least japan day was interesting :D but too bad we didn't get to dress up

and here i am, 8 hours later: that fat fly is having a field day crashing into my lightbulb. too bad it wasn't incandescent: then it'd burn the stupid thing...

wait...
the cat just ate it :D i love u kitty...

2004-11-16T01:21:00.000-05:00

i was looking at the sky one clear night, admiring the beauty of the twinkling stars, so delicate, as if they were pinpricks in the sheet of darkness called the night sky...

and then it hit me...what am i actually looking at?

great balls of "fire" (after all, combustion requires oxygen which is lacking in outer space) billions of miles away, at the very least, suspended in this vast universe

gah: my head is aching at the thought of all the vector forces that must be acting to keep these celestial bodies where they are (tho they are all but static) and the ends of the universe...

and then i think about how incredible this universe is, created by God...(and how much greater eternity will be.) can u imagine? thousands of years ago, God was thinking about how an atom should work, how photosynthesis will occur and what gravity would be. wow....wow...

2004-11-15T14:41:00.000-05:00

when i said slightly, i meant that in the least degree~
yeah: i don't love courier, but it looks nerdy, kinda

well, at least it's something: no imagination nor time to do anything...pretty...

but, i wonder if u got that joke on the side-bar: basic? get it?
...the colours were inspired by litmus paper...isn't it wonderful?

2004-11-04T23:38:00.000-05:00

ew: firefox makes my layout sooo ugly

i have no heart to blog until i at least make this page slightly sightly (haha)
or...unless i totally forget what it looks like...

but at least until sunday, ciao, sir blog: u need some renovations.

si: bleah: yeah: i miss u man, haven't seen u since...er...sept? one more month, though, mister...sorry...but it'll come sooner than u think

carol: e-mail coming soon! teehee: i'm looking forward to writing to u: it'll be like a reward after my biochem midterm :D

2004-10-26T02:36:00.000-04:00

teehee: my insides are itching to get studying on biochem: chee :D
amino acids on the window, trioses, pentoses and hexoses randomly scattered around the room...

i wonder why school is sooo enjoyable...and...i have no clue...maybe i'm just retarded.
yeah, i'm probably retarded.

2004-10-24T02:01:00.000-04:00

back to ground zero...this'll be tough...

2004-10-23T02:09:00.000-04:00

oh: dining room study sessions: evidence that midterms fry your brain:

I=PV where I=imp P=pride and V=victory (or victoire!)
in order to calculate the precise number of imps in the room, take the total sum of pride and multiply by the victory factor. it's quite simple, you see

and why is there a puddle of water there?

and of course, random outbursts of: tsukirimashou, tsukirimashou, sate sate nani ga de kiru ka na :)

midterms tomorrow: at least i'm going to bed with happy thoughts in my head...and by happy, i don't necessarily mean rotating stereoisomers mentally...though that sounds slightly fun too...

2004-10-19T23:35:00.000-04:00

"you don't need to thank me...if anything, i should be thanking you"

wow: what an unexpected response.

it's been extra productive these coupla days. i have a strange suspicion that i enjoy this busy-ness...though i guess when the midterms inch closer my feelings may change...

i wonder why i'm not dying with anxiety. maybe i've just gone crazy due to an ultra inconsistant sleeping and eating schedule, but the midterms just don't seem pressing. i suppose i ought to be thankful : )

and when i'm sitting here typing this, i realize, when i need to move on out of school, it'll be tough. he told me office politics will kill me and there isn't much of a way for me to avoid it...gah: growing up has its pros and cons. i'm gonna miss school.

another inane post: i guess i don't have a heart to commit to really posting recently : P

2004-10-07T22:02:00.000-04:00

because we are so addicted to the internet, when it went down yesterday, we all ended up crowded up in the laundry area flicking pennies at each other.

we is sooo geeky...

2004-10-05T18:59:00.000-04:00

heh: i guess coming back from hk give me no shame in sharing tables with complete strangers. i thought it would only be the three of us sitting there, not being bothersome, but it ended up with 6 people plus the two newly met sisters. it was interesting: i mean, who plays the name game at "meetings" like that?

it's gonna be a fun (but busy) week leading up to thanksgiving, which'll be just as busy...on saturday at least. the eye appointment and the ortho appointment ARE three hours apart, but busing across town is a bit...not fast. i'm looking forward, though, to see certain missed people and my family. i wonder if cathy's grown up, going to a new school, or if rachel's a bit more mature now that she's a preteen and danielle more responsible since she's a senior now. i wonder if i'll get in the door and get hit with a million pillows or whether they'll steal all of mine so i can't hit them.

and most importantly, i wonder if we'll have roast beef this thanksgiving. i don't care if it's "non-traditional" but beef in large slabs beats out pieces of poultry any day. mmmm...and gravy to top it all off...i should call home to place a request : )

2004-09-25T04:27:00.000-04:00

it is my sincerest wish that none of you will have to ever go through this.

i have small shoulders and my muscles are all atrophied, but i have to take this one on...i mumble the words of truth, not willingly, but more knowingly: the joy of the Lord will be my strength...

2004-09-25T02:23:00.000-04:00

it was ending the day with Grave of the Fireflies that gives the previous 24 hours such a grey tone. but i'm sure i had a great week, if i can remember properly.

hopefully i'll be performing some alchemy in the near future: that phone call really reminded me just how God provides.

and when he tried to remind me again visually about what happened that night, and told me of all the things that went right... it's been an interesting year and i think God is trying to tell me that it's time to grow up a bit. it's hard leaving childhood and it's lack of responsibility behind...but i suppose/know it's inevitable. but the future is bright and exciting : )

...looking back at this calender year: i think i'm almost positive that God is really urging me to take up responsibility for the people that i love. things have really been shaken up these past months, and man, am i uncomfortable. praise God that i have a father here on earth to show me what great faith is and confidence in the Lord.