The Culture Train

One of the most noticeable thing between the North American culture and my Mediterranean culture is the distance people keep from one another. Mediterraneans speak in an exaggerated cartoon like way. We talk louder, move our hands as if juggling invisible balls, and stand a lot closer than our North American counterparts. In North America, it seems like everyone keeps distant from everyone else. On the bus, train, etc. people sit at least 1 seat away from each other and then avoid eye contact. People also seem less touchy than in the Mediterranean culture. If a Mediterranean person is having a conversation, chances are they'll touch your shoulder or arm when making a point or gesturing at something. While this is just a normal and automatic part of the way we act, it's definitely not as common in Canada. Last year, I remember walking towards a door at the same time as a classmate. The door was narrow, so naturally I let the girl go ahead first. To gesture this, I stuck one hand out (as if pointing to the doorway) and the other on her shoulder very briefly and said "go ahead first". She gave me a talk about how I seem very touchy and how that makes people uncomfortable. That little lecturing she gave me threw me off. It felt as if a doctor told you that you had a disease you never knew you had. It hits you hard, makes your heart stop as you try to collect your thoughts, and you don't know what you're supposed to do next. I ignored it. I kept a mental note to keep an exaggerated distance away from her. Other than that, I'm not changing. I may sound stubborn, but this is how I grew up, and I know my way is better. I'm right. In fact, the two Mediterranean doctors I did electives with this summer act EXACTLY the same way with their patients, and they love it. I have never seen any of the Caucasian doctors get this many hugs, kisses, and patients teasingly slapping their shoulder for their witty/teasing remarks. I love it. I embrace it.
A couple of days ago I took the train to visit my parents for the weekend. Naturally, everyone boarding looked for an empty seat. People like their oversized North American bubble of space. I avoided the empty seat, and sat beside a stranger. It confuses them. It's amusing. I then begin to chat with them about their life, their travels, family, relationships. It's amazing to see a person who once segregated themselves away from other passengers suddenly open up when they find someone to listen to and be fascinated by their life. The first passenger I talked to was a young lady (about my age) in criminology, but is aspiring to be a lawyer. She told me how her career goals get in the way of wanting to have a family and lots of kids [a common theme with some of the girls in our med class]. She taught me about the importance of unions, women's rights in the workplace, and her travels across the world. She was once on a plane that had to make an emergency landing because it was about to catch on fire! That day I also learned that there are blond Italians (every Italian I have met is short and has dark dark hair).
The second passenger I met was a 24 year old girl who worked in health care management. She initially confused me. She was opening all these templates in a microsoft program and closing them...for an hour. So I asked what she was working on and then I teased her that I thought she was going crazy with her work. This opened up the conversation, where I got to learn about her work, why she thought I should be a nephrologist, and then we chatted about relationships. I then asked her how she met her boyfriend [it's always amusing to hear these stories & the things guys go through to ask a girl out!]. Her boyfriend story wasn't very climatic though - she met him through a mutual friend. But whoever he is, he's one lucky guy, she was smart, beautiful, and was fun to talk to.
The train arrived to its destination. Like everyone else, we all went our separate ways. Unlike everyone else, we went away with a unique memory instead of what could have been a boring 2 hour train ride otherwise.

edit note (March 13, 2008) : I don't think I'd hug a patient unless they initiate it. Although we are not swamped with lawsuits like in America, who knows what the situation will be like by the time I graduate. I remember reading the newspaper this week about a man who was sued for hugging someone..apparently it was considered as an assault. Maybe the man misunderstood what a bear hug was supposed to be...what a world!

Interpret this!

I like to be entertained. Life is full of routines. Those ideas often clash together, especially with most of life revolving around school, faculty meetings and various presidential duties. As much as I love being in med school, this year feels too routine. Start a block, slack the first couple of weeks, work on an assignment, cram for the exam, do well on the midterm, and repeat with another block. However, I finally had the chance to do something a bit unusual with the GI block's assignment. Each group chose a GI related topic and was asked to create a presentation to show during a symposium for students, professors, and drug rep.
Once we had our topic chosen, we brainstormed for ideas, and then I jokingly mentioned we should do an interpretive dance of our topic - Meckel's Diverticulum (for info about this, see our website).
Soon it was the big symposium day. It was very hectic. Students, profs, drug reps walking around everywhere, visiting every station. We didn't know when we could break out into our surprise presentation. We were pumped. I was ready to make a fool of myself. We got everyone's attention, we told them to sit down for an interpretive dance of this disease. It was funny to see people's reaction at our statement. Some laughed, dismissing it as a joke, some looked at each other, thinking "are they serious?", others just followed our request and sat down.
Then the dance began. I'm not really sure what the class' reaction was because I was trying to focus as hard as I could to not laugh at how silly this presentation was. But by judging the laughter in the video (see below) it was obvious everyone enjoyed it.
Then last week, one of the professors who was present at the symposium came up to me and said "thank you for that presentation. Every year I teach, I see how routine things are and I wonder what's wrong with people, but you broke out from it, you put a creative touch and made us laugh. I've never laughed this hard in a long time, and I had to tell my wife about it when I got home!" I guess, I'm not the only one constantly looking for an escape from the daily mundane routines.

It's In You To Give

"It's In You To Give" is the quote of the Canadian Blood Services [the Canadian Red Cross no longer collects blood]. I learned this motto today when I went to donate blood for the first time! I was excited for a while to do this, I just never got around to do it. I put it off for years by telling myself that I'll do it later repeatedly. But I finally did it! Now my blood will save 3 patients somewhere in Canada, and all I had to go through was a little questionnaire [about risky behavior and travel destinations] and a needle!
Next time I go again (56 more days!), I hope that it's as exciting as it was this time. It's truly gratifying to know that you're saving someone's life. The other thing I have to keep in in mind is to not squeeze my fist so hard, no matter what the nurse says. As she prepared my arm for the needle, she said squeeze hard [so she can find my vein], so I figured I'd be helpful and squeeze as hard as I would while weight lifting. That vein popped out as if it was begging to be popped by that needle. I then proceeded to go back chatting with this girl donating blood...until my peripheral vision caught something in the air..and then the nurse saying "UH Oh". So apparently you can squeeze your fist too hard and end up having blood squirting all over you when she puts the needle in! Of course Murphy's Law would dictate that the day you get a messy shirt, is the day that you happen to be in your nice dress shirt [that I wore at the clinic that morning]. So that day I proudly walked away, knowing I did something good, with a blood drop shaped sticker on one side of my shirt that said "First Time Donor", and with a blood stain on my other side of my shirt. Quite the walking advertisement I must say!

V - is for vagrant

A couple days ago I had a chat with the upper year class president about something we're both experiencing. It's a feeling that I like to describe as class president vagrantism. What in the world does that mean? Well my friend, it means that being class president often means that you get along with everyone, you don't really have enemies, and you spread out your time & love for the class. This seems wonderful at first because you get to know everyone, and everyone knows you. However, there's a price to pay for this - vagrantism. I really don't belong to anyone; I'm a vagrant, a floater, a wanderer. I'm not part of the keeners, I'm not part of the brown town/brown crew, the jocks, the not so socials, etc. I suppose that it can be argued that I partially belong to all of them? One of the vagrant phenomena is that any invitation to a social crews' events feels welcoming, yet like you don't fully belong. The crew is happy to see you, but at the same time you know that you don't know them as well as you would like.

I do have some very close friends, however, it's definitely not as many as I would have with a dedicated social crew. At times I miss the opportunity of being able to have memories with a consistent social circle. At other times, I realize that I am pretty lucky in that I get to know everyone in my class as well as the upper & lower year classes! There are even some people in my class who don't even know everyone's name in our class because they only stay with their crew! I suppose it's one of those "the grass is greener on the other side" type of thought. But you know, I don't even like grass - when I own a house one day, I'll make sure it has as minimal amount of grass as possible. But that's a rant for another day.

Uncle Leo, why are you so angry!

Remember that Seinfeld episode where Uncle Leo has his eyebrows burnt off accidentally and ends having some eyebrows (badly) drawn on. He ended up looking angry at everyone, which made the episode a classic. While that episode was funny, the reality is...eyebrows do bother me. No no, not in the sense that they should be removed. My pet peeve is seeing so many butchered eyebrows! Honestly, there's a limit to how much you can pluck them! I'm getting the hunch that these people are going for an eyebrow look that falls in between a transvestite and porno star.
So let's start with what I call the McDonald Arch eyebrows. These eyebrows have an unnatural semi-circular shape that makes you look like you're constantly surprised. The picture above is the best I could google at the moment, but I've seen worse..
Next, there's the "I glued on a piece of string" for eyebrows. These ones are literally as thin as a piece of string. I'm not really sure what to make of it because it doesn't look natural at all. I think Pamela Anderson is a good example of that.
The last one on my mind is what I call the "mini chopsticks" - these ones are excessively trimmed, to the point that it just looks like a straight line hovering above your eyes.
Whether you believe it or not, there's a science about how eyebrows are shaped. For example, forensic experts can figure out the width of your lips (when you're not smiling) based on where your eye pupils (the dark spot) are. Similarly, the eyebrow has a science as well. The eyebrow starting positions is roughly where your eye starts (towards your nose that is!). It then slopes up almost in a straight line until it gets to its peak. The arch (peak of the eyebrow) is found by drawing a line from the side of your nose, across the eye pupil and then towards the upslope of your eyebrows. Afterwards, the eyebrow slopes down so that if you draw a line from the side of your nose again, past the outside of your eye, it'll meet up where it should end. Here's an example of what I'm talking about, I drew some lines to make it clearer. Well that's the end of my rant about bad eyebrow jobs.

Where's her face!?

Some people think bigger is better. I just never thought that it would apply to sunglasses to the extent I saw today. As I sat peacefully on the bus this morning, a young lady boarded, and if it wasn't for my common sense, I could have confused her for a gigantic fly. Her sunglasses covered I would say 2/3 or more of her face! I understand that the current fashion is the big sunglasses look (which is recycled, since my grandma has the same glasses), but it seems that this fashion is getting out of hands! The glasses I saw today covered half of her forehead and went down to nearly her mouth. Which brings me to the next point - fashion trends are usually followed to look attractive, but when you can only see someone's chin and some of their forehead, then what are you showing off? Well, we'll see what the next fashion trend will be...sunglasses at night anyone?

Human Nature - Broken

So yesterday I had the privilege of learning that a friend of mine blocked me on msn. I really don't know whether to consider them as a friend any more, simply because our friendship was fragile by this point of time already. It's kind of like those "Jenga" towers, and my friend's final move toppled everything over. Am I bothered because I was blocked? Not fully, I just find it immature. What does bother me though is that one week ago, that person said that they would never do something like that. I trusted those words. Now I have no trust.

Why would I trust someone if the friendship was so fragile? It is because it didn't used to be fragile. That person used to be my closest friend. However, a long time ago, I made a mistake towards this person - I bottled up some issues I had involving this person because I didn't want to risk losing what we had. That bottling up ended up hurting both of us, and despite my best intentions, I ended up losing the person anyways. It was inevitable. I could only delay it for so long. However, all was not lost. There was one last strand of friendship between us. We kept distance, but I thought we still trusted and respected each other. I thought wrong. Now, I move on. The last strand was cut.

Does all of this bother me? A bit; but I can't let things linger within me. Life is too short. But deep down inside, like any human being, I'm looking for reason and understanding of this situation. More importantly, was this situation incidental, or is it reflective of those around me, those that I will meet and human nature as a whole?

Propoganda 101

Watch the news lately, and tell me what you notice. Is there a new theme? Not sure yet? What if I gave you a clue -- China. Now what goes through your mind? For the last several months, I've noticed an abundance of anti-China themed news throughout the media. The most recent case involved the lead tainted toys (for which the Chinese Boss killed himself), the toxic toothpastes, toxic pet food, unsafe toy parts, defective tires, etc. While I never really had the highest expectations of a product if it said 'made in China' (you get what you pay for), I was surprised by the sudden burst of media focused on China's products in what seemed like a fear mongering propaganda fest.

I fully agree with the fact that products that can harm people should be banned. However, I don't think there's a surge of unsafe products from China, which leaves me wondering why there's a dramatic anti-Chinese product hype. Either there's a surge of more defective products from China, or it's a strategic move to compromise China's economy, or lastly - a new tactic to distract the public from the failed attempt to free Iraq.

China's economy has been growing rapidly. Of course, it shouldn't come as a surprise to anyone considering how much of our capitalistic world depends on them. In short, China is on its way to become the new world power and USA knows this. You can't attack China militarily (especially for no reason), so how do you compromise such a big nation? The only logical thing I can speculate is to do so using economics. By making millions of consumers paranoid about any product with a 'made in China' label on it, China's industry would feel the pressure.

So is China a victim of its own success? Is China responsible for the quality of its products? To answer both questions at the same time, I'll use a Spiderman movie quote - "with great power comes great responsibility". As a potential new world power, China has to step up as a leader, taking full responsibility for its decisions and its impact on the world. Unlike the previous century, China cannot sit quietly behind its walls from the world's eyes. As a leader, China has to take responsiblity for the quality of its products, it has to pay attention to the vast pollution it creates (especially as the world's greatest oil consumer), it has to pay attention to its role in maintaining world peace, it has to play a protective role with the United Nations etc. As a new leader, the world has its eyes set on you and will analyze all of your actions. Just remember - with great power, comes great responsibility.

Summer Medical Electives

Like a man with bipolar disorder (minus the depression phase), I figured signing up to MedQuest for a summer elective wasn’t enough; so I signed up for another elective right after! As I type this little article away, I still don’t know what I was thinking, or why I was so keen about keeping myself so busy this summer.

For those who don't know, MedQuest is a program run by medical students with the intention to encourage highschool students to choose a career in healthcare. One of the main problems is that Southwestern Ontario lacks many healthcare workers, and to compound this problem, students are 3x less likely to apply to such programs in comparison to urban regions such as Toronto. MedQuest intends to encourage more students to go towards such careers and to hopefully comeback to their hometown one day as a healthcare worker.

For my first elective, Marielos, Ahraaz and I went to Leamington to organize the MedQuest camp. Leamington, known as the Tomato Capital of Canada, is a little town that’s about a 45 minute drive from Windsor. One of the first things you notice about the town is the different cultural mixes – it’s full of German Mennonites, Mexican Mennonites, and many Portuguese, Italians and Lebanese. The other thing we noticed right away was how friendly the hospital staff was! Initially we thought it was the generic ‘we welcome you’ type of friendliness, but soon we realized that it was a truly amazing set of happy healthcare workers. The best way I can describe how happy I found the hospital environment is to just let you imagine everyone, including myself, on Prozac all day.

The best part of doing an elective in a small town, as you know from rural week, is that you are exposed to a lot of hands on experiences. In Leamington, we learned how to put in IVs (at the expense of some poor patient’s veins), take histories in the ER, scrub in the OR, and listen to tons of murmurs. Furthermore, I got to watch/help with two births, as well as more paps than I can count. Which brings me to my next point – I don’t know whether to feel bad for all the things women have to go through or to just admit that women are the stronger sex. So now that I’ve distracted myself with women, I’ll move on to the next distraction. I can’t count how many times the nurses and a bunch of patients who gave me this advice – “If you want to have a happy marriage, the key is to say ‘Yes dear’”. While this was amusing to me, it often came out of nowhere in the middle of a conversation! It was just as bizarre and amusing when one of the nurses wanted to set me up with her sister – thankfully I didn’t say ‘yes dear’ to that suggestion. Before I stray back to my review of my summer electives, I’d like to point out to the guys reading this –saying “yes dear” to your lady is probably a good idea unless she asks you if her new dress makes her look fat.

My overall experience with MedQuest would be best described as priceless. It was hectic to try to balance your day at the hospital, running back home to organize the camp, make tons of phone calls to physicians, people to sponsor food, answer too many emails, find supplies for suturing, casting, create lectures, and so on. It was difficult at times to remember that I was actually on a summer break. At times we stayed up until 2 am organizing various aspects of the camp for the 30 grade 10 and 11 highschool students, and somehow we had to find the energy to wake up at 7 am to get ready for the hospital. If it wasn’t for the unbelievably friendly family we stayed with and the amazingly friendly staff at the Leamington hospital, I don’t think I would have stayed sane throughout the 6 weeks I stayed there. I was also lucky to have stayed with two great classmates, who I now know so well. However, there were some bumps, especially with the late nights planning, but Ahraaz, Marielos and I came out alive and a lot closer than when we had first started.

The best part of MedQuest was the final week when everything we had planned began to unfold. Everyday we watched our highschool students grow closer to us, learn a lot about healthcare, learn a lot of hands on procedures, and most importantly – develop the confidence to know that they can achieve their goals. After we finished a large mock disaster involving the students, fire department and the EMS, we wrapped up the week by thanking the students for making this camp a worthwhile experience for us. The students surprised us with thank you cards, hugs, tears and memories that will forever be ingrained in our memories.

Fast forward through life

I don't really like telling people that I'm in medicine. My willingness to admit that I'm in medicine is even smaller when the person I'm talking to is new to me. Why? Because people tend to make a big deal out of it. Telling people that I'm in medicine suddenly changes their view of you, and while some people do enjoy this sudden burst of respect, admiration etc. bestowed upon them, I find it fake - how can your opinion of me change so rapidly simply because of a title!? I will then hear (again) about how privileged I am. While this is true, I believe that people don't understand fully why those working in healthcare are privileged. Yes physicians will never go hungry, they'll have a nice car or house, they're respected and they have job security etc. But you can get that with other careers too without doing another 10 years of school, going $100,000 into debt, or losing a lot of sleep.

The greatest privilege in medicine for me is the impact it has on my life. I began a summer elective in rural town (population about 25,000). I spend most of my time in the emergency room (ER) and on my second day working there I realized the beauty and true privilege of being in medicine. The privilege that healthcare workers have is the opportunity to see life in fast forward! In the hospital, I would watch babies being born, I would watch children with injuries, adults with various ailments, and elderly people with all sorts of complaints and an eye for someone to listen to them. It is truly fascinating to watch an entire lifecycle in one working day. However, I have the privilege of listening to all of these patients when they are in need. This truly makes you appreciate life as a whole, especially the days when your health is strong.

Soren Kierkegaard once said "Life can only be understood backwards; but it must be lived forwards.", maybe the privilege of medicine is that we get to peak ahead.

Why stress?

The respirology exam is coming up in 5 days and I havn't reviewed a lot of my notes yet. I have a big faculty meeting in three days and I have to do two reports for that meeting. I haven't touched my assignment yet...and I'm trying to apply for summer electives. Sounds quite busy, and that's why all day I felt stressed..most of my day has already flew by! Then it hit me...we will always have one task after another, we will always have a lot of work, especially in this career. I realized that no matter what level of education we're in, we think our current workload is insane, and we look back at our previous years and laugh at our previous workloads. Who knows how much we 'stressed' in kindergarten.
So what is the solution? I figure one day I'll look back at this exam and this week and I'll laugh at the silliness of it all. So why not laugh at it now! To make things even more cheerful and simple, why not just be happy that we're alive? Life goes by too fast to get stressed and angry. Don't regret. Just live day by day and be thankful for that. Just don't forget your goals, life is boring otherwise!