Cold cold feet

Sooo, Canada's East coast is without power due to an ice storm. The family medicine program in Ontario only includes one (optional) week of ICU time. Ontario has a strict Return-of-Service contract. In summer, they have West Nile Virus. I've fled the province once before. I have good friends who live there. I miss Canada. I miss my family.

Christchurch is surrounded by mountains. Christchurch hospital would love me to do a mixed surgical/medical year next year that includes Emergency, ICU and anaesthetics. It is currently 26 degrees and sunny there. In winter, you can buy a season's pass to amazing snow for roughly 300 bucks. The population is only slightly larger than Guelph's.

I have a meeting with the St V's heads of ED training tomorrow. They would like me to train at St V's, and even if I'm only around for half of next year, they'd like to offer me a job. It was sunny, 27 degrees and breezy today. I spent yesterday at a local beach. I eat sandwiches with beetroot. I love my friends and family here.

No specific points here. Just musings. Just sayin'...

I'm dreaming of a white Christmas...

I have returned from the wards where we assaulted very sick people with a relentless cacophony of off-key carols. I have made Eggs Benedict with Dave and we're preparing fruit salad to take to Gran & Pa's. It's a beautiful day. I am only slightly home-sick.

I think Tim Minchin says it best.

We'll be drinking white wine in the sun.

Merry Christmas.

Bliss!

I have peaked. My life will never get better than it did this morning.

I was putting the final stitch in a half-meter long leg wound (saphenous vein graft site, if you're interested) when two spotlights suddenly hit the needle. My senior boss and registrar had both turned to look at my work.

(They wear headlamps for surgery, hence the lighting. It's a lot like I'm a rabbit in the headlights, frozen and waiting for imminent death. But I digress.)

"Sam, that looks beautiful", my Senior Boss said.

"Sam, I never thought this day would come, but you're not embarrassing me", Registrar said.

I realise that this may be an indication of my low expectations, but this might be the best day of my year. Definitely the best day of my surgical rotation. My Reg let me close the chest alone, and as we were applying the dressings, we were both singing along with Elvis, "Dreaming of a White Christmas". A rare moment of harmony.

Combine that with a sunny half-day (I'm not wearing pants!) and buying flights (MEL-YVR-YOL-YVZ-DCA-YVR-MEL, phew...) I am flying high. And I get to go meet my lovely girls for burgers and gossip.

Happiness, thy name is Sam.

Sloth & God

I don't want to get up. I'm blogging from the softness of my crisp cotton sheets. I've just had nine and a half hours of unbroken sleep and I feel re-born.

Gone is the pain of hearing my boss say, "No matter how you do your hair, you're still the same shitty intern". Gone is the tension from seeing my supreme boss roll his eyes during my ward audit. Fatigue and ennui? Washed away. Hunger and rage? Melted into happiness.

Sleep has knitted my ravelled sleeve of care, and just in time; I have to go Christmas shopping today.

The thing about being in Australia for Christmas is that it doesn't feel right. Sure, the shops have decorations up and people are singing carols, but it's bright. Sunny. The days are long and hot. According to my internal clock, Christmas is a time of dark, cold and wearing soft sweaters. Hence, it's not Christmas.

Yesterday, as I was bent over a patient trying to coax a drip into his arm, I heard a choir singing carols. St V's being a Catholic hospital, they go all out; our ward is decorated, our website says "Merry Christmas" and all the Jews are working Christmas day. My patient, who has air bubbles collecting under his skin from a previous lung rupture, started singing along to "Silent Night" as I finally got blood. That was the moment I thought, "Oh it's Christmas."

And then immediately thought, "Shit, I have to go shopping".

Anyways, I suppose there are two points to this:

1. I have to readjust my perception of what Christmas is.

2. I really really love my sleep.

From the land down under, where presents are delivered by Skippy the Bush Kangaroo, Happy Christmas.

lurgy

Cardiothoracics is a plague-ridden speciality, probably due to the long hours we work.

This is especially apparent on Wednesday mornings, when we attend the "Heart Meeting", a collaboration between the cardiologists (who try and fix the heart with pills) and us (who try to fix the heart with knives). The meeting starts at 7, which is a sleep-in for us. We arrive early, dark circles under our eyes, wild-haired and untucked. At least one of us will be audibly sniffing/coughing/sneezing/bleeding from the ears. We slump into our seats and wait for the cardiologists to arrive.

Around 7:10 they start bouncing through the door. Well dressed, well ironed, bright eyed and bushy tailed. They make small talk about their tennis games, new cars and lives.

This week, one of the Cardio registrars sat down next to me. At the front of the room, my Reg sneezed. Then I sneezed. Cardio Reg looked at both of us and slowy, subtly, moved to another seat. I heard him whispering to a colleague, "The surgeons are sick again..."

I don't blame him. We are sick.

My tonsils are so swollen it feels like something must have laid eggs in them. Every time I swallow, I expect a torrent of spiders/maggots/plague monkeys to erupt from the tonsils and spill down my throat, mercifully ending the pain.

Of course, my GP just laughed at me. "Sam, you don't need antibiotics, you have a mild viral URTI. Get some rest, drink lots of fluids and take it easy."

I'm pretty sure my GP just told me to quit my job. Right? Right.

Out of Context

"Get in and suck that, Sam!"

Ahem.

The testosterone level in Theatre One runs fairly high. Alpha males at alpha work create an environment where every second sentence is met with a snigger. Seriously, if someone uses the word "size" they giggle into their masks like school-boys. It would be adorable if I wasn't on the receiving end of so much mockery.

"It's big. And size matters."

"Really pull on that thing..."

"Give it a good shake"

Etc, etc.

The most senior surgeon looks like a cross between Santa Claus and an Ewok, and comes out with the best lines of the bunch.

"Just cos a man's dick swells up when he puts a condom on doesn't mean he has a latex allergy."

"Hey Sam, look at that new valve. It's a walrus' delight!"

"Sorry, sir?"

" A walrus' delight; a nice tight seal..."

I get annoyed, but I have some perspective after today. Our patient died on-table. These men worked for 5 hours to try and save him despite all the odds. When they finally conceded defeat and let him go, they had to get up and get on with the rest of their work.

So I have respect for them. Disturbing, grudging, confused respect.

Acopia

Sometimes people come to hospital who aren't, strictly speaking, sick. These people are often old, crumbly, living alone, not eating very much or very well. They're often a bit whiffy, wearing bizarre clothing and rambling or confused.

They get admitted to Gen Med with a very special St Vincent's diagnosis: Acopia.

As in, not coping.

I had an acopic moment this afternoon.

I'd arrived at work AT 6:30 this morning, toured the ICU so I could update our patient statuses, presented a ward audit in front of the entire team of Cardiothoracic surgeons (to quiet derision and open scorn), done the ward round, gone to clinic, come back to find that every other doctor (in a team of 6) was in theatre and run the ward alone for 5 hours.

Halfway through our evening round I cracked it. My co-resident had just turned up and said, "Aw, you can go if you like Sam." I think he meant once the ward round was done. Oh well.

I thrust my patient list into his hands, turned on my heel and left. Walked straight past the senior boss and, picking up my bag, straight into the lift.

I am at home and it's still light out. I've eaten. I'm wearing soft pants. Acopia is not so bad.

Look, my job is still awesome (I got to put in a chest tube yesterday, which involved inserting my finger into a patient's ribcage and wiggling it till I felt a lung) but it's also exhausting. When a girl gets a bit whiffy, confused and starts rambling, it's time to go home.

As a side note, our acopic patients often do really well. With a good feed, some clean clothes and a bit of TLC, they perk up nicely. Then we send them to nursing homes to live out their days. Something to look forward to.