Wednesday 21 November 2007

Je me souviens

So I arrived back in Montreal, yesterday morning to find- it had snowed! Except it was like London snow- thin and patch with grey slush on the streets- after the three foot of powdery white in Banff it seems a bit disappointing!

Am spending my last couple of days here buying souvenirs, packing, saying goodbye to people, and saying goodbye to Montreal. I really really don't want to leave, but I suppose it's time to come home, when you see a Birmingham Punjabi family getting ready to board a BA flight to London, and you feel homesick (despite being neither from Birmingham nor Punjabi!).

If I'm being absolutely honest, the thing that scares me most is the 'come-down', like the one I had the last time I went abroad for a long time. Not the initial slap-in-the-face of the first few days, which can usually be overcome with the bustle of unpacking and catching up but the longer-term one which comes on over the next few weeks and months, which feels like slowly drowning. Everything feels grey. Everything feels the same, routine, predictable, except about half the pace. You trudge from home to hospital, home to hospital, walk, bus, walk, tube, walk, with your mind on nothing.

But- I'm hoping this time will be different. I hope i can recognise it before it happens and try and get out of it-taking walks, seeing friends, going to the cinema and watching old films. Although it doesn't help that when I return I'm temporarily homeless and all I have in the next six or seven months to think about is finals. No, that's not true. I am looking forward to seeing family and friends, and I am looking forward to finishing this degree finally and being MLM MBBS BSc. I just have to focus on getting there.

Anyway, this was meant to be about Montreal and what an amazing time I've had here. I really have. This city is incredibe- it really welcomes you and takes you into it's heart. You can go to any kind of restuarant, any kind of market, you can sit by the port or climb the mountain. You can come for music, for art, for shopping, or for nature. You can eat poutine. The hospitals have been excellent, and if I could apply for a job in one now, I'd do it without hestitation.

I have met some wonderful people, some from here, others from all over Canada and all over the world. I have spoken some good French and some bad French, and I can now recognise a Quebecois accent! I have bought clothes at ridiculously cheap prices, and I have had two Thanksgivings. I have seen not just Montreal but all over Canada, and I love it and the people in it. I recommend Canada to anyone, but certianly I recommend Montreal most highly of all. I will return, I don't know when it will be, but I will be back...

As I won't be continuing this blog when I return (not enough of interest to say, sadly) I'd like to say a huge thank you to everyone for reading, and for the lovely comments.

Merci beaucoup, et groses bises,


Maple Leaf Medic,

xxx

Sunday 18 November 2007

On The Road

Travelling this week, on the other side of the country. I decided to do away with my "European thinking" and not think that a 6 hour flight was too long. Turns out it was, at least too long for the 4 Valium I had taken to last through the very turbulent period due to storms over Vancouver that day. I resorted to my usual combination of swearing and praying. I must thank my very lovely doctor for prescribing them though, they helped a bit (Our conversation before I left: "I get nervous flying, can I have something?" "Sure, what would you like?" VIH: "Oooh free license to choose my own medication...maybe I should ask for some morphine...." Real voice: "Errr...benzo?")

Anyway I made it, had a brief stop in Vancouver before heading to the Rockies. We did lots of hiking, sight-seeing and snowball fighting. My best purchase has been my $10 hiking boots from a dead guy (or 'estate sale' as they're known, you go to a house and everything, from the lampshades to the clothes to the cutlery, is for sale) and my $10 woolley gloves from Dollarama.

I proudly persuaded a bunch of Aussies and a Canadian to hike 2 miles across a snow field to a glacier in temperatures of minus. I got snowballed until I had snow in my eyes and my teeth. I saw a wolf and a herd of elk (separately). I climbed a Rocky Mountain (but only a small one-1690m). I went to a hockey game, and left in the middle (I got bored!) I cooked spaghetti bolognese for the group (minus the vegan). I sat in a hot tub looking up at the stars, and I watched the sunrise over the lake. I sped past mountains that were wrapped in clouds and rivers that were white with ice.

I return to Montreal tomorrow for a couple of days before going home, and will write one last post then.

Sunday 11 November 2007

Manic episode

So I've finished my work here, and am off for a week of travelling. I can't say I'm too sad. It's been interesting, but it's also made me question whether I can do this for the rest of my working life. Just as when you do a Dermatology firm, you examine every flaw and blemish on your skin, doing Psychiatry makes me acutely aware of my mental state-my moods, my personality traits, my anxieties, and I'm not sure that's a good thing (I wonder if Gastro would be a better metaphor...). If I could get over that, I think I'd be good at it though. We'll see.


Anyway, I'm off travelling tomorrow, and at the moment am trying to organise warm clothes, toiletries, fig rolls and so on, before my 8 o'clock flight (4am wake up!). So I thought I'd write a few things that have made me smile lately.

1. I went to see a friend of a friend's reggae-jazz band this week. My hopes were not high; I'm not a huge reggae fan, jazz is my least favourite musical genre ever, and when you say yes to seeing your friend's friend's band, it usually translates as "OK, I'll come as it's your friend's band. I know they won't be very good, but I'll have to pretend they are anyway, so as not to upset anyone."

Actually they were really good. Really fun. And what was also funny were the people who came to see them. The Montreal trendy types, who want to look like 60s beat poets. There was this one guy- beret, beard, wire-rimmed glasses....and a red fleece. Soooo Canadian! He looked like he might go into the woods, pitch a tent, fight with a bear, and then write a poem about it, smoking Gaulloises.



2. I bought some lovely boots last week. They were cowboy boots (which I never thought I'd wear, but they're very Mtl), half price. Unfortunately they were also Vegetarian.

"They're not leather!" I wailed to my companion, who I had dragged along for a second opinion

"But that's a desirable thing here!" She replied.

Love this city and it's hippies!



3. I love the Anglicism used in Quebecois French. It's very common for patients with depression to describe their symptoms with the statement "Je ne feel pas". Similarly, the family of a schizophrenic patient might be asked "Est-ce qu'il vous a watché au maniere suspicieux?"

Others include "Luncher" (to have lunch), "un char" (car) and "une blonde" (woman, girlfriend)



4. I went to Quebec city yesterday and spent some time with the international students here. Never have I felt more European than when sat at a table with 2 German guys, one Dutch guy, and two Australian girls, one shouting "OK, guys! Let's play ice-breaker games! What's everyone's favourite food? Go go go!" as us Europeans sat in awkward, repressed-European silence! It was a fun day though.


5. Over the last few days I have eaten: Arabic sharwarma, Jewish smoked meat sandwich, French onion soup, Belgian waffles, Greek gyros and Canadian crepes. I love the diversity of this city (but it's not good for my waistline!)

I will be travelling for the next week, so I don't know when I'll next write. Oooh, exciting!

Thursday 8 November 2007

Hyperthymia

I submitted my MTAS form today! Hurrah! In the end I got so sick of it: I would look at my answers to questions I had read a thousand times and have absolutely no idea if they were any good or not. I ummed and ahhed about one question but in the end just thought I wanted to get rid of it well before the deadline (i.e. before the inevitable system crash, esp. with my terrible internet connection here).

I applied to somewhere I had said I definitely wouldn't put as my first choice! Basically it had a really great selection of jobs I'd like to do, and, even though I hadn't intended to leave the city I'm in, isn't too far away. I think it was a good decision.

I left the house this morning feeling really happy. I'd just clicked the 'submit' button (which by the way, was a huge anti-climax-'thank you. Your application has been submitted'-I don't know what I was expecting (fireworks?) but it was a bit disappointing), I walked outside and it was snowing for the first time this year. I actually skipped to the tube station- not metaphorically, I really did skip, jump off the kerb in a one-legged hop, and grinned at passers-by inanely.

Well, anyway, my fate for the next two years (and yours, should you be one of my patients!) is now in the hands of an NHS computer somewhere...ah, doesn't that just fill you with confidence? :-p

Monday 5 November 2007

Confabulation

There comes a time, in fact several times, in a medical student’s career, where your heart sinks in a consultation. Often when you realise: The Patient Has Been Lying to You (less melodramatically-they're not a very good historian). Your Super Cool Utterly Self-Assured Resident (or SHO or Reg), whose first word was probably “psychosomatic”, asks you to see a patient, take the history, report back, and then you’ll go and see the patient together.

The dialogue goes something like this:

SCUSAR: So Jane, I understand you’ve been feeling a bit low since your boyfriend split up with you?
Jane: No we didn’t split up, we just had a really big fight, but it’s OK now.

SCUSAR: I see. And you’ve been feeling very down for about a month now, but not had any thoughts of suicide.
Jane: Actually I did think about it quite a bit, but decided I had too much good stuff in my life to do it.

At which point, a third party enters the dialogue, my internal voice, let’s call it Voice in Head.

VIH: Jane! You’re making me look bad! I look like either a) I got the details wrong when I reported back to SCUSAR, or b) worse, I forgot to ask the question. I asked you the exact same question and you said, no, you hadn’t had any thoughts of suicide.

SCUSAR: And I believe there’s no history of psychiatric problems in your family?
Jane: Actually my uncle has depression.

VIH: I wonder if this is what it’s like to be a parent when your kid starts screaming and throwing things in the supermarket...

SCUSAR: I see. And you work as a travel agent?
Jane: Yes, I do.

VIH: Yesssss! Thank you, Jane.

SCUSAR: OK, great, well thanks for talking to us today Jane. Before we go, is there anything you’d like to tell us we’ve forgotten to ask?

Jane: Yes. I have a rare condition which means I’m completely unable to tell the same story twice….

Sunday 4 November 2007

Fake Blood, Real Life

I've been a bit sad this past week. Not because I'm having a bad time, if anything it's becuase I'm having such a great time and don't want to leave. My time here is fast coming to an end, and I know that once I return there's nothing between me and the huge chasm of finals coming to swallow me up 'til June....

Anyway, weekends are good! On Friday I went to this party. It was a ridiculously trendy party, held in a loft in a converted warehouse in a very fashionable old industrial party of town. Everyone there looked like they should be an extra member of the Scissor Sisters, or at the very least, be attending drama school. Because the theme was still Halloween, there were drag queens, fairies with wings, body paint and fangs. And because everyone was so trendy, there was lots of 'ironic' dancing, 80s music and $100 haircuts made to look as if they'd been done by a blind man with a pair of blunt scissors.

It was kind of intimidating at first, but I ended up having a really good night. The only 'funny' moment was when a girl who I have been introduced to once before, but wouldn't say I 'know' was sitting at the bar with me (they charged for entry and drinks but it was all pretty cheap).

As it was a Halloween party, we spotted a tube of 'fake blood' on the table. She was playing with it, then she said "Hey, we should put fake blood on our wrists!"

I said "No, thanks" , thinking of the real patient I'd seen earlier that day, whose wrists did not have fake blood on them.

"Go on" She said, drawing it on her own, and grabbing my wrist.

"No, really" I said, shuddering inwardly, and went to get another drink.


Yesterday was nice, I spent the day at the market and the little shops on Bernard (vintage/local designers-bit like Spitalfields), wanting to buy *everything* in sight, then said goodbye to a British friend in the evening by going to a club (my weekends are much more fun than my weeks!) and eating cheap pizza slices on the way home, as the cold winds seeped through our toes like water. Today I'm going to go to the park and then maybe return to some shops where I asked them to keep a few things for me....!

And in other news, I think, finally, I'm almost certain about where I'm applying for my foundation posts. Fingers crossed!

Thursday 1 November 2007

I can't really think of a suitable title for this one...

When you tell people you're doing a Paediatrics firm, people often say "Sick kids....that must be hard."

These are (mostly) non-medics, who've been watching Children's Hospital. They're thinking about kids with cancer on chemo, kids desparately awaiting heart transplants, kids who are marked for life by a missing amino acid, through the random misfortunate combination of their parents' genes.

My Paeds rotation wasn't like that. I saw mostly gastroenteritis, asthma attacks, and the odd tonsilitis. Mostly things that could be fixed easily and that I could leave behind when I walked out the door at the end of the day.

But having spent some time in Child Psych clinic, that I'm finding hard. Seven year olds who run in front of cars because they want to join their dead sibling. Sixteen year olds on their fourth admission for psychosis, with who knows what life ahead of them. Parental neglect. Parental abuse. Every thing you could think of, it happens. It breaks my heart to hear it.

Kids on medication (often multiple). I watched a video (albeit American) where a doctor was telling the parents of an 11 year old with ADHD whose parents weren't keen on medication "The best you can hope for is that she'll smoke [if she's not medicated]. Otherwise, she'll self-medicate, with cannabis, cocaine, opioids, basically every type of drug except the hallucinogens."

OK, that was an American video. But I've seen a 6 year old on olanzepine, a 14 year old on lithium. A 13 year old with a personality disorder (aren't we all a bit personality disordered at 13?). A suicide attempt in a twelve year old. And I think: I can't stand this. I can't do this. It's just too hard.


After one particularly draining session, I went out and bought some CDs to make me feel a bit better. Which was probably the best I could have hoped for. Well, at least it wasn't crack cocaine.