thinking of: my last day here

It's hard to believe how quickly the past 4 weeks have whizzed by! It feels just like yesterday that I was arriving, fresh and wide-eyed for my rural practice experience. Now, I leave with a wealth of experiences, still wide-eyed, and eager to apply some of the things I've learned from my time here. My preceptor has really been excellent in teaching and showing me the ropes. I've learned a tremendous amount from him, not only clinically from a medicine perspective, but also from a compassion perspective - he really takes the time to listen to his patients. This is the way I want to practice one day - not rushed, and not pressured to get through "x" number of patients per day.

A few nights ago, I got to watch another delivery, and today the young newborn was circumcised. I'm not too sure on my thoughts about the procedure because I haven't really had to think about it very much. But after watching a couple of them, I can say that I don't think I would want my kid to go through that procedure, even though anaesthetic was administered! I guess I'll have to read up more about it before I can make an informed decision, as with many other things.

I leave DC thinking about the issue of abortion and where I stand. It's a really difficult and contentious issue because I've seen there are medical reasons for it. But my view of it now hasn't changed from what it was before - I don't agree with it for the majority of circumstances, and the rights of the fetus needs to be considered too. This is a living being we are talking about here...and some may disagree. It gets really complicated I know, and I haven't got it all figured out - I'm not sure people get it all figured out. But I'll continue my training upholding my faith and beliefs and see how my perspective matures.

photos of the day

On this, my penultimate day here, I walked around town and took pictures of anything that caught my eye - check them out...

Punk

Sunbathing

Reaching for the Skies

wrinkles

photo for the day

Field of Dreams


Wispy clouds cover the rich yellow fields of Canola plants....please forgive the phone lines - we were driving at 100km/h!

interesting lamp post decorations

While walking the streets of the downtown, I noticed these cool decorations on some of the lamp posts - pretty cool...

the circle of life

Ecclesiastes 3 - A Time for Everything

1 There is a time for everything, and a season for every activity under heaven:
2 a time to be born and a time to die, a time to plant and a time to uproot,
3 a time to kill and a time to heal, a time to tear down and a time to build,
4 a time to weep and a time to laugh, a time to mourn and a time to dance,
5 a time to scatter stones and a time to gather them, a time to embrace and a time to refrain,
6 a time to search and a time to give up, a time to keep and a time to throw away,
7 a time to tear and a time to mend, a time to be silent and a time to speak,
8 a time to love and a time to hate, a time for war and a time for peace.

I was awoken at 6am (Sunday) by a phone call from the maternity ward for a delivery, and dopey-eyed, I washed up quickly and made my way up to the ward. The delivery went really well, although it was the first delivery I've been to where an epidural wasn't given - let's just say it is times like these that I am grateful for being a male! The baby was healthy and mom was doing fairly well. Birth - the start of a new life is always such an incredible experience.

Afterwards, I went to the ward to check up on some of our patients and found out that one of them, an older gentleman I had been following, had passed away this very same morning at about the same time I was assisting with the delivery. It was really sad because we were hoping he would recover sufficiently from his illness to go home. But it didn't happen. Death is an ever sobering reminder that life is short and that our time here on earth is limited. A reminder to live wisely, love God, cherish loved ones, and make the most of all your opportunities to experience all the world has to offer.

And such is the circle of life - a time for life and new birth, and a time for death and leaving this world. It stops for no man and rolls on inexorably for time infinitum.

first time for everything...

After another long 15hr shift in the ER, I got to do my first sutures! - 3 stitches on the occiput - the back of the head. It was pretty nerve wracking - my hands were shaking because I've only worked on synthetic materials and tissue paper, but it was pretty cool, and my preceptor approved. I've finally taken the next step - so goodbye and thank you paper towels for being my practice. Later on, I did another 3 sutures on a gentleman who cut his hand - so a total of 6 sutures in the end! The hardest part I find is actuallly not the suturing part - it's the injection of the anaesthetic into the tissue because that's when the patient flinches and feels pain. I think it just makes me jump because they jerk away on entry with the needle, even though the needle is the smallest one, and...well.....I guess in some ways I feel the pain. It's just not the most comfortable feeling.

My first cast of a broken bone took a long time, but I think it was a good job. I don't think the nurses appreciated the mess I left at the end, but I came back the next day to clean it all up! I also tried a couple of IV's on some older folks, but those tiny veins were like tiny worms and I couldn't start them. I guess practice makes perfect - anyone willing to get poked out there??

Also, I syringed my first ear out - even though it did take...hmm....more than 5 flushes...actually, more than 10........~ to tell you the truth, more like 20-30 flushes.... BUT I did eventually get it out. Man, you really have to apply some serious pressure - after my preceptor came in to assess how I was doing, I realized I was way too gentle with the pressure. Either I need to eat my porridge in the morning, or just be more decisive and assertive with the flushes. Anyone need their ears flushed???

photo for the day

Clouds point to the Alberta Pool Elevator, which houses the town's Art Gallery

med reflections: in the OR

"I don't think I hear anything wrong..."


Today I was in the Operating Room with a visiting urologist, where I got to see a circumcision, a hernia repair with orchidopexy, two prostate resections and a pyelogram. I was fortunate to be able scrub in and assist the surgeon, although I probably was more of a hindrance because I had no clue what I was doing! Definitely a learning experience. I attempted starting the IV on one of the patients twice, but without success. I didn't feel too bad though because the doc couldn't get it on his first 2 tries, then the nurse didn't get it, and finally the doc got it on his 3rd attempt. Pretty tricky stuff sometimes! I also got to do my first "real" intubation, which involves placing the breathing tube down the person's throat to help ventilate the patient, then hooking it up to the machine. That was really cool because I struggled with it the first time I tried it a few days ago. The craziest of all has to be doing my first spinal (injecting an anesthetic into the subarachnoid space to numb the lower body). Of course it was all guided by the anesthetist who was an excellent teacher - but the whole process was somewhat surreal and it happened all so quickly. Won't forget that experience!

I think it's important that I keep track of what I've done and what I've seen, so I can look back at the end of my 4 weeks and say "whoaaa.....I can't believe I saw this...did that". I guess it also helps slow me down to think and reflect on medicine in general and how this process of learning is affecting my life and my thoughts. Anaesthesia is a field that continues to make me wonder if I would enjoy it as a career - I know what my buddy Keith would say! The parts that are most interesting are the start and the end of procedures, and a little inbetween with the maintenance of drugs. But that little inbetween also seems to be somewhat.....um.......to put it politely, less engaging that the rest. And sometimes these surgeries can go on for several hours. don't get me wrong, it's not all just sitting around and waiting. The lifestyle is certainly appealing. I just wonder if I want to commit so much of my study time to be anesthetist, only to find out that I'm getting bored and not very interested. It certainly doesn't make sense if I've switched from another profession where I was feeling exactly that.

The surgical specialties are attractive in the sense that they are the Cowboys of the show. They do the major work, get alot of respect because they "fix" problems, and get to play with cool toys and gadgets. It's been fun assisting surgeries during my time in the OR. But from what I hear, it's not the lifestyle that I want to live. I don't want to be on call all the time or be called in at 3am for surgeries. I don't think I could live a balanced life as a surgeon. Maybe I'm wrong and just speaking to biased people, but this is what consensus has been from a variety of sources. Anyways, just some random med thoughts running thru my head...

Med enthusiasm

It's 2:43am, and you can tell that I'm still early into my program after voluntarily getting up to watch two emergency C-sections tonight. Med student enthusiasm??? Must be!! I wonder how long this will last for and whether I'll always be jumping up like this. I don't know. What I know is that OB GYNE is not something I want to do as a career down the road - these hours are just crazy! Anyways, an experience indeed, and that brings a total of 4 C-sections observed thus far....pretty cool. I'm so nerdy sometimes....

Exploring Rural BC

This past weekend, I travelled with my med classmate Venetia (who is in Mackenzie - 3 hrs away) around Dawson Creek to do some exploring of Rural BC. Apart from the car not starting once and the engine light coming on during the road trip, it was an eye-opening experience - rural BC is truly beautiful! Here are some of the places we checked out...


Kinuseo falls...at the end of one long gravel road


That ain't Sasquatch - that's a Moose in the fields...


Beautiful scenery en route to Tumbler Ridge

Dogwood

WAC Bennett Dam

top ten things I've learned...on the maternity ward

In the short two weeks that I've been here, I've been fortunate to see two c-sections and two live births. In fact, on my second day for the first C-section I got to be the 2nd assist, which means getting scrubbed in and holding back retractors etc. It was pretty cool....until the MD made his incision into the sac and out "sprayed" the amniotic fluid over you know who. Now I know why both the doctors pulled their heads back - I thought they were giving me space to look in!! The nurses laughed and said I got "baptised", and in some ways it was kind of a baptism into this world of maternity. From my experiences on the maternity ward, I've been amazed at the whole birthing process - truly incredible when you think about it. I've also learned a few things, which I've summarized here in my "top 10" list for maternity...


10. During contractions, do not be the person holding the basin for the woman to throw up in to

9. Wear appropriate gowning and gloves!

8. Bring a book – this may take a while...

7. If you’re the dad, bring a camera!

6. Encourage the mom during contractions as much as possible

5. Epidurals are amazing drugs

4. If you offer your hand during contractions for the mom to hold, make sure you’re willing to have it crushed

3. Always follow up with your patients the next day – they really appreciate it!

2. Baby to mom skin contact after deliver is best (whenever possible)

1. Deliveries are terrifying, but exhilarating at the same time!

Study in Black & White

The Ties that Bind

Criss-Cross

Wicker Detail I

Wicker Detail II

Study in Black & White

The Maze

Ridges and Grooves

thinking of: my wedding...

The countdown is on! 61 more days (or so my fiance says) till our special day, and 19 more days till I return to Vancouver! This day, which has crept up slowly over the past year and a bit, is now picking up steam and rolling along! We sure have had alot of good memories along the way, and I'm sure there will be more to come. Thanks to all our helpers who are helping make this special day possible - can't wait!

And who says that we can't cook? The proof is in the picture!

thinking of: my family...

After meeting so many South African ex-pats here in Dawson Creek, I sit and think to myself "Whoaa....Dawson Creek is a long way from South Africa." Indeed, Canada is a long way from South Africa...... I've been thinking of our family's journey here and how I am ever so grateful for my parents and their wisdom in the heart-wrenching decision to move here. To leave stable jobs, friends, and most importantly family, all for their children must have been the most difficult decision of their lives. And now, my bro's and I have been afforded incredible opportunities here in Canada that we could not have had in SA. Words cannot express my gratitude to them for all their sacrifices....thanks mom & dad!

My Crazy bro's have also been a major source of encouragement - from eating lunch together in high school because we had no friends when we first came here, to sharing rooms because our place was so tight, to teaching me to drive, to being groomsman & Best man for them - my "wacky" bro's and I have grown up as a "tight" bunch who can sometimes be possessed by Mario Kart. Sometimes..

Rita & Alfred's Wedding - May 27, 2006

One Strong Woman

Look at those muscles! Look at that Power! That's my girl!!

Seattle Library March 5, 2006

Focal length: 18.3mm; 1/250sec - F/4.5
Multi-Pattern metering

Mile Zero - lets get started!

The town of Dawson Creek is the start of the world famous "Mile Zero" of the Alaska highway - the start of the road that eventually leads to Alaska. It is here that I find myself for my rural practice rotation, 1182km from "home" in Vancouver. And it is also "Mile Zero" for the start of my blog - as I try to capture some of my thoughts and pictures that fly through my head. I was totally choked when my laptop was stolen just prior to coming out here - all my journal entries, pictures and memories - gone! I had backed them up till about a year ago when things got really crazy and I didn't have time to burn them to CD - much to my regret. So this blog in some respects is an opportunity to keep my thoughts recorded, even if my computer is stolen!