That Mirror Belongs to Frank

2010-05-29T14:18:00.000-07:00

Think Twice Is What I Say

2010-04-10T16:07:00.000-07:00

My medical school holds examination review sessions. I don't agree with them but there you go. In the exam review session (which happens on the afternoon of the examination day), the students sign out their papers and a faculty member stands at the front of the room and goes through the answers one by one. I've never been said faculty member so I don't know the details of what goes on, but essentially the students know what grade they received on the examination by the end of it all (and which questions they got right and wrong).

Another thing that my medical school has is a committee of folks (faculty members) who meet with students who are in any academic difficulty. I am one of said folks. Usually the students who come to meet with us are having difficulties with grades and we offer them remedial assistance and everyone is happy at the end of the day.

These two things (the examination review session and the committee of folks) came together recently. A first year medical student was sent to visit with us after the faculty member running the examination review session caught him drinking a beer in the session. Drinking a beer! It was the final examination of the term and hence also the final examination review session so the student thought that it was entirely appropriate to bring beer to the party. Not only was the student openly drinking a beer but when the faculty member told the student that he had to discard the beer, the student defiantly stared at the faculty member as he proceeded to gulp down the remainder of the beer (which I gather was pretty much the full bottle of beer).

So what happens to a medical student who drinks a beer in a formal examination review session and then acts defiantly to a faculty member? A permanent professionalism (lack thereof) note on the student's record, that's what happens. I hope that the student really enjoyed that beer because it's going to be following him around for the duration of his four years of medical education.

MIA

2010-02-11T14:20:00.000-08:00

The move was a breeze and the new place is great. So that's good. I've become best friends with my local Home Depot store. That's been fun. I've discovered that I like being a handyman and I really enjoy being able to make my home look the way that I want it. The joys of home ownership abound.

What is not so good (baffling even) is that colleague and I had a paper rejected for publication. It took two months for the peer reviews to be returned. Well, peer review. Singular. One single peer review (what's up with that?) took two months to be returned to us.

The review itself was actually quite good, stating that the paper makes a valuable contribution to research area of awesomeness but that some points need to be addressed prior to publication (and the points were valid and easily addressed). Sounds good, right? Well, the editor of the journal rejected the paper based on that one (what we thought was positive) review. The editor commented that he hoped this would not discourage us from submitting further manuscripts to the journal in the future. Hell yeah, it will.

In any case, we're now submitting the paper to another journal. The journal is a good one but the list of instructions to authors for formatting is long and exhaustive. Silly even. And this is why I look much like this these days:

Ah, there, that feels better. I especially like when my eye ball pops out and starts swinging around my head on the optic nerve. Trust me, it feels fabulous compared to formatting the manuscript.

Two Things

2009-12-16T21:01:00.000-08:00

Two things that drive me nuts:

1. People who don't pick up their feet while walking. Rather, they shuffle along making shuffling noises. I make a point of looking at their feet in disgust but, let's face it, if you are too lazy to pick up your feet between steps then you are also too lazy to take note of disgusted looks at your feet. I want to punch you shuffling people in the face.

2. People who can't park. People: I make sure that I am parked with equal distance on either side between my car and the lines on the pavement. If I get out of my car and notice that I have parked too close to a line, I get back in my car and fix the problem. I am sick and tired of returning to my car to find a freaking mini-van parked within millimeters of my driver's side door. Not only am I left with wondering how the hell you got out of your freaking mini-van (and how you expect me to get in my car) that is parked so close to my car, but I am also left wanting to await your return to your vehicle so that I may punch you in the face.

Merry Christmas. Ho Ho Ho.

I Am A Home Owner

2009-12-12T15:59:00.000-08:00

I did it. I purchased a condo. I move in next month.

It's been a steep learning curve (there's a whole new language to learn when buying one's first property) but my friends who are already home owners have been terrific at giving me hints and advice along the way. So, in the same spirit, I will now share my experience so that if any of my bloggy friends are thinking about home ownership then perhaps I may be of some assistance.

Step 1. Go to your bank and get a mortgage pre-approval. This involves verification of your job and income and a look into your credit history and FICO score (if you don't know either then you're likely not ready to start this process because they affect your pre-approval in a huge way).

When the bank comes back with a ridiculously high number, crunch the numbers and determine how much such a mortgage will really cost you. There are mortgage calculators all over the internet. Google is your friend. I dropped $100,000 lower than the pre-approved amount to max out at 35% of my net monthly income. It's a number that I am comfortable with because I don't have any other debt. Be sure to add up not only your monthly mortgage payment but also things like condo fees (if applicable), monthly heating and insurance costs and property taxes.

Step 2. Now you know how much you can afford to spend so you can start looking with that number being the maximum home listing price. Find yourself a realtor. My realtor put me on a mailing list (with a minimum/maximum purchase price and neighbourhood-specific results) that sent me any new listings as well as updates to sold listings so that I was able to get an idea for the active/current market.

Step 3. Drive to each of your specified neighbourhoods at the peak of rush hour (both ways). Believe me, you may save yourself a lot of time by not looking in those neighbourhoods if the commute is horrific. In my case, those drives ruled out two neighbourhoods that I was considering because the commute each way approached one hour. I'm not willing to make such a long commute and so I didn't waste my time looking at properties in those two neighbourhoods and instead was able to focus on my third choice of neighbourhood (where I in fact ended up buying and where I will be an easy 10 minute commute from work).

Step 4. Start looking at properties. Your realtor will be particularly useful at this step as he or she can quickly contact the seller's realtor(s) and set up viewings. My realtor was also very knowledgeable about the area and so was able to warn me away from buildings if they had problems.

Step 5. When you find your new home, be prepared for things to move very quickly (especially if you live in a city like mine, which didn't suffer a housing slump over the past year or two ... properties move quickly in this part of the world). I viewed my new home at noon on a Thursday. I put in an offer on Thursday evening. It was countered at 10:30 in the morning on Friday. I countered that counter offer at 3:00 on Friday afternoon and the offer was accepted at 4:30 that Friday afternoon.

Step 6. It's actually not as simple as that. You need to consider what you are making the offer subject to. I made it subject to a unit/building inspection, confirmed mortgage financing from the bank and a few minor visible repairs. The seller came back and accepted those subjects on the condition that they be lifted and the sale be legally binding and finalized just one short week later. See? You've got to be prepared to move quickly. You also have to be prepared to assign a closing date (the date when you will actually be handed the keys and start paying your mortgage). The seller pushed for a closing date of December 31st, 2009. There's no way that I want to be moving over the holiday period, so I pushed back with a closing date in January 2010. The seller agreed.

Step 7. Find a building inspector. Again, Google can be your friend here or you can ask for a recommendation from a friend. I went with my friend Google and found an excellent, thorough building inspector. The building inspection went ahead on the Monday. It cost me $300 for a two-hour inspection but you can't put a price on the peace of mind of knowing that your roof isn't going to cave in any time soon. He didn't find anything major with the unit or the building but did find some minor small repairs in the unit that my realtor then added to the sale contract. The seller agreed to make those repairs at his cost prior to the closing date.

The other good part about having a building inspection done is that it allows you to spend some significant time in the property. Let's face it, you've only looked at it once so far (at the viewing). The time in the unit served to make me feel really good about the place; I enjoyed the feel of it very much. That went a long way to soothing the anxiety that naturally occurs with such a large purchase. I knew I was in the right place and that it would be a happy home.

Step 8. Confirm your financing with the bank. They will want a copy of the sale contract and other stuff like a title deed (your realtor will know what documents to ask for from the seller). The bank will also want proof that you have money for the down-payment. The payment of your down-payment will likely differ depending on where you live. In my case, I had to confirm the funds and then request a bank draft for 5% of the home value, to be delivered to my realtor in trust on the day that I lifted the subjects. Then, on the actual closing date, I will be required to deliver another bank draft for the remainder of my down payment. I didn't know about this going into the whole process, so it came as a bit of a surprise to have to write such a large cheque so early in the process.

Here's an example of how it works where I live (purchase price is hypothetical):

Purchase price: $500,000
Total down payment confirmed: $100,000
Due on the day that subjects are lifted: 5% of the purchase price = $25,000
Due on the closing day: the remainder of your confirmed down payment = $75,000
Amount of mortgage that the bank will give you: $400,000.

That last point is important because you will sign your mortgage (at which point it will be transferred to a lawyer -- no lawyers are needed in the offer to purchase; the realtors take care of those negotiations) long before your closing date, so they want to be sure that you're good to cover the entire promised down-payment. In short, the bank will give the seller $400,000 on the closing date and you need to be able to cough up the other $100,000 to give to the seller.

Step 9. Prepare to feel panicked, sick to your stomach and dizzy. You now have to make the decision to sign off on the subjects and enter into a legally binding contract of ownership. If you back out after this step then you will lose your 5% deposit and the seller can sue you. It is therefore perfectly normal to feel panicked, sick to your stomach and dizzy. Expect those feelings to last through until the day after you lift the subjects.

Step 10. Meet with your realtor to lift the subjects and sign the document that now makes the home legally yours. This happened for me exactly one week after I put in my offer to purchase (I lifted the subjects a day earlier than required by the contract).

Step 11. Find a lawyer. I took a recommendation from my banker, but you can use a friend's recommendation or Google. You may also choose to go with a notary and they usually cost a little bit less than a lawyer, but they can also be a lot more institutional than a lawyer (this advice comes from a friend who has bought two properties and once used a lawyer and once used a notary). I went with a lawyer. Expect to cough up between $1000 - $1500 in legal fees for a routine, problem-free transfer of title (and whatever else it is that lawyers do with a home purchase ... I've only spoken with my lawyer on the phone so far and I actually haven't yet gone through this step but will do so in early January).

Step 12. Go in and sign your mortgage papers. They will then be electronically transferred to your lawyer (at least they were in my case). I did this the day after lifting the subjects, so exactly one week following the accepted offer to purchase.

Step 13. Now you have some time to breathe. There's no rush to meet with the lawyer. You only have to have all of the papers signed before the closing date. I'll meet with my lawyer two weeks before my closing date in January.

And that is my home buying adventure to date. Now I'm moving on to booking a moving company and other details such as day boarding the kitty cats on the actual moving day.

I still occasionally feel panicked, sick to my stomach and dizzy but by-and-large those feelings have been replaced by excitement and anticipation of moving day.

I did it! I am a home-owner!

On Home Buying

2009-10-17T11:06:00.000-07:00

I'm certain that I could have bought a home long before now, but when I graduated I came up with the plan to first pay off all of my student loans (as in every single last penny and because that was my only debt, be completely debt free) and save a healthy down payment before applying for a mortgage. I'm happy to announce that those two things are done and done and so the home buying adventure begins.

As I begin the search I am aware of how fortunate I am in my current position:

1. My medical school provides a pretty package aimed at assisting faculty in purchasing their first home. It's meant to both attract and retain faculty members and, together with a large cash gift to put toward a down payment, offers a brokerage service for applying for a mortgage.

2. This brokerage service meant that I submitted one mortgage application. The brokerage service then hit up my credit score (so only one hit as opposed to multiple hits were I to go to banks individually) and then sent my application out to all of the major banks (together with the information that I am a tenured faculty member, which obviously decreases lending risks because I can't lose my job unless I become a serial killer or the like) and then the banks competed for my business. Sweetness.

3. As a result, I have been pre-approved for much more money than I would have ever thought and at a lower interest rate than I would have ever dreamed of. I don't see myself ever using the full pre-approved amount (because owing that much money for anything makes me want to throw up a little) but it has certainly increased the scope of the properties that I am able to seriously consider.

All of that fortune aside, I live in a very expensive city. I currently live in the downtown core of my Fabulous City and always thought that I would buy here. However, now that I have started seriously looking at listings, I may not. Sure, I can afford to buy here in the downtown core, but when I look at what I can get here versus what I can get in one of the suburbs for the same (if not less) money then I start to reconsider quite seriously. Think the same amount of money for a one bedroom shoe box (downtown) versus a two bedroom/two bath (suburbs).

Problem: I am not a suburb type of person. The thought of having to drive to get my groceries (for example) makes me want to curl up in a corner and cry. However, all is not lost as not all of the suburbs of my Fabulous City are typical suburbs. I have found one south of the city that is freaking charming. I love it. It's still a relatively easy commute to both the medical school campus and the hospital (albeit not as easy as my current commute) and it's freaking charming.

And so the search begins. I am hardly able to sit still for all of the excitement. Woo hoo! Home ownership, here I come!

My Only Wish ...

2009-10-05T21:50:00.000-07:00

... Is that drivers of cars will stop using their great mass to knock me off of my bicycle.

I get it: you are bigger and you will always win.

I wish that you would get: I may be smaller, but I still had the right of way in every incident to date. Police charges and fines back me up on this.

I'm glad that you all have been charged and fined. I hope that you are all poor and that each and every penny of that fine will hurt you as much as you hurt me by running me over with your CAR while I am on a BICYCLE.

Fuck. I am sick and tired of the total body physical pain that follows a bike (me) versus car (asshole) incident.

(Yes. There is a history. And yes, there was another incident today.)

Apply Locally

2009-09-13T21:05:00.001-07:00

A woman received a prescription for Mycolog cream with the directions:

“Apply locally 3 times a day”.

She calls back: “I have a question about my medicine.”

Technician: “We’ll get the pharmacist.”

Pharmacist: “Hi, what’s your question?”

Woman: “I have a question about Mycolog cream. It says apply locally 3 times a day, but I’ve gotta go to Dallas. Is it ok if I use it there?”

---

That made me laugh out loud. Courtesy of a new website, Dumb Medicine.

And if you're looking for more smiles, I will direct you to this. Best. Wedding. Ever.

Travel Advisory

2009-08-29T22:08:00.000-07:00

The following was issued the day after I returned from South Africa. It was issued as part of a routine weekly travel advisory to everyone in my father's company:

South Africa:

Violent crime risks underlined by robbery of a US national near Johannesburg airport. A group of armed men on 26 August attacked and robbed a US national on the R21 highway. The target was traveling in a taxi en route to the Sun City tourist resort in North West province from OR Tambo International Airport (JNB), which serves the country's largest city Johannesburg (Gauteng province).

Comment and Analysis:

The attack serves to underline the continuing risk of violent crime, which poses a significant risk to travelers; business visitors may be targeted because of their perceived wealth. Crime rates in South Africa are high, with carjacking, armed robbery and mugging especially prevalent, and the perpetrators of such attacks often use firearms.

Incidents in which travelers are followed from airports and subsequently robbed have risen in recent months, and similar attacks have targeted people withdrawing money from banks and automated teller machines (ATMs) in cities.

No area of cities can be considered to be immune from crime; such activity, especially carjackings, may take place in residential areas and the central business district (CBD). The most common forms of criminal activity remain car and truck hijacks, muggings and break-ins at residences and business premises. In addition to Johannesburg, levels of crime are highest in the cities of Cape Town (Western Cape province) and Durban (KwaZulu-Natal province).

In a recent high-profile incident, at least three armed assailants on 25 August robbed a jewellery store in the Kenilworth Centre shopping centre (mall), in Cape Town's southern Claremont suburb; the suspects reportedly escaped in a hired car. On the same day, fleeing robbers fatally shot a security guard at a shopping centre in Gauteng province, and at least three people were killed during similar crimes near Johannesburg during August. Prior to these incidents, an Indian national shot on 2 July by armed robbers at the former's residence in Johannesburg on 7 July died of his injuries.

Although President Jacob Zuma's administration has acknowledged the magnitude of the threat posed by violent crime in the country, initiatives undertaken to tackle the problem are unlikely to bear fruit in the short term.

Travel Advice

* High rates of crime pose a significant risk to travelers in South Africa. Exercise heightened caution and stringent security measures at all times and in all areas. Accommodation and transport decisions should be made with attention to the risks posed by crime.
* When traveling by car, personnel are advised to keep car doors locked at all times and roll down windows as little as possible, avoid exiting the vehicle while leaving the engine running - for instance to remove a flyer placed on the windscreen - and avoid ostentatious displays of wealth.
* Criminals are commonly armed; in the event of being accosted do nothing to resist or antagonize assailants.
* Travelers are reminded to refer to our standing travel advice.

I knew that my personal perceptions of the increased crime threat in South Africa couldn't be too far off. It's so sad because it is such a beautiful country.

Now You Know

2009-08-14T04:52:00.000-07:00

I like watching the evening news in countries that I visit; one learns about things that go completely unreported in the international press.

So it was that I was watching the evening news on good ol' SABC3 here in South Africa when they reported that physicians in Zimbabwe are on strike, demanding an increase in their salaries.

They didn't specify what kind of physician but apparently the average salary for a Zimbabwean physician is U.S. $390 per month. I'll do the math for you: that's $4,680 per year. They are holding out for $500 per month ($6,000 annually).

Jeez.

Travel Observations

2009-08-05T09:51:00.001-07:00

1. In all of my years since leaving Cape Town and navigating the globe, I have never lived as far away from the city as I do now. The trip here (with connections and transfers) topped 40 hours. Take such travel on at your own peril and seek advice from a mental health care professional before embarking on such a journey; I do not recommend it.

2. South African Airways is still one of the best airlines out there. True, they need to update their London - Cape Town direct aircraft with on-demand personal seat video, but the service from the flight crew is (and always has been) top-notch. If you connect through J'burg on the way to Cape Town then you will get on-demand video but that stop adds time to your itinerary and if you're already topping 40 hours, well ...

3. London Heathrow Terminal 4 is a dump. I know, I know, it's a dump in transition, but at the moment it's a dump.

4. The current dump that is Heathrow Terminal 4 allowed for me to experience some things that I have never experienced before (and likely never will again): being the only person on the terminal transfer bus to 4 and then being the only person walking through the entire terminal (which was actually pretty creepy) and then -- saving the best for last --being the only person in queue (which I suppose means that there wasn't a queue at all) for passing through customs!

5. The Hilton at Heathrow 4? Meh. Hit and miss. Probably not up to Hilton standards. I only stayed for 4 hours in an extreme jet-lagged/travel exhausted state, though, so mine may not be the best review.
6. South Africa can indeed be a very frightening country to navigate. What the international press is reporting more frequently these days is true: the crime problems of the rest of the country have well and truly made it south to Cape Town.

I do not feel as safe here as I once did and I once lived here for 7 years, so I consider myself quite Cape Town savvy. Alas, there have already been times during my current travels when I have been absolutely terrified and wishing that I could click my Dorothy shoes together.

Let's Go Already!

2009-07-15T17:47:00.000-07:00

I have me some of these:

Which I shall soon take with me on one of these:

To get me here:

Yays for me!

A Great Month for Letters

2009-06-29T11:40:00.000-07:00

Obviously that last letter from the President of the university was sweet, but the joy this month did not end there.

-------------------------
Additional Letter #1:

Dear Dr. K.,

Congratulations on receiving tenure and promotion. This is in recognition of your academic achievements and reflects well on your Department and our Faculty. I wish you every success in your future endeavors, and will follow your career with interest.

Yours Sincerely,
The Dean of Medicine

Additional Letter #2:

Dear First Last Name,

Re: Your Student Loan No. 2-78657y

This is to confirm the above referenced loan has been paid in full. We wish you every success in all of your future endeavors.

Yours Sincerely,
The Official Student Loans People
-------------------------

It all makes me want to skip off into the tenured, student loan-free sunset, where I shall live happily ever after.

Dr. Tenured

2009-06-16T14:34:00.000-07:00

From the President of the University:

"It gives me great pleasure to inform you that you have been granted tenure and promotion ... We regard such appointments as extremely valuable and important and I congratulate you most warmly on this achievement ..."

Tenure? Bah!

2009-06-11T22:41:00.000-07:00

In theory there are 20 days left.

Deadline for my tenure application submission: September 1, 2008
Deadline for a decision on said tenure application: July 1, 2009.

It's a good thing that my colleagues who also submitted on September 1, 2008 have not heard anything. Otherwise I'd be chopping my head off with tooth picks. Because, really, that would be less painful at this point.

I am officially beyond sick and tired of waiting for this decision.

Administrative Academia

2009-05-24T12:40:00.000-07:00

I think that I have recently mentioned that I've been sucked into the vortex that is the administrative side of running a medical school. I don't know how that happened (or why), but it did and, for the most part, I am intrigued enough by the other side of the coin to keep at it for a while. I don't think that I like it enough to give up teaching (I'm still doing as much of that as I ever did) and take it on full-time (= Deany Deans, Associate Deans and Assistant Deans) but for now it keeps me busy in my spare time.

One of the tasks that I have taken on is being the Ultimate Granter of Grades. What this means is that if a student fails an examination, the paper is handed to me to try to squeeze half marks out of it, all in the hope of pulling that student's grade up to the magical 60% pass mark. I don't particularly wish to get into the debate about whether this is wrong or right to begin with -- the Deans decided that it should be hard to fail medical school, not me -- but I do wish to point out that sometimes finding half marks is like drawing blood from a rock and it's not a fun or enviable task at all. In addition, much to my dismay, I have discovered just how hard it is to fail medical school these days.

A recent example: a question asked the student to identify a certain aspect of a pathology of the prostate gland. How am I to find half marks when the student starts off by identifying the tissue as a resting mammary gland? The answer is that I can't. However, it is then my job to defend myself to the Promotions Committee (composed almost entirely of the aforementioned Deany types) and explain very precisely why it is that I cannot pass that medical student.

If that defense process isn't enough to set my head spinning in frustration, more often than not the Promotions Committee decides that asking the student to re-sit the examination isn't fair being the darling already has summer plans that are taking them to Timbuktu or the like. The solution? The failing medical student is asked to write a Reflection & Remediation Essay (I'm not making this up) detailing why they think that they failed the exam, what they will do in the future to improve their academic standing and (here's the kicker) what the faculty should be doing differently to assist them in their remediation.

On that latter point, I'll leave you with a gem from a recent Reflection & Remediation Essay: "The faculty should set up a morning wake-up service for students who request it, because I know that I am not alone in the fact that my grades are negatively impacted by my inability to wake up in time for early morning classes/clinical skills sessions".

No wonder students have the mantra of: the only more difficult than getting into medical school is failing medical school.

I shake my head and walk away.

8 months & 8 days Later

2009-05-08T23:12:00.000-07:00

A tenure decision? You'd think!

Alas, no. Not yet. Not for me, not for my tenure cohort colleagues.

8 months and 8 days later. Not a word.

Good grief, we all could have conceived and delivered viable children in the time this decision has this far taken.

It's beyond ridiculous.

Excuse me while I step into the back alley and scream with frustration.

Interesting

2009-04-29T11:20:00.000-07:00

It may be time for North Americans to follow the British in their 2007 ban on white lab coats in the health care setting.

Researchers at Virginia Commonwealth University in Richmond used pigskin as an in vitro model to demonstrate that large inoculums of methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci (VRE), and pan-resistant Acinetobacter (PRA) bacteria could be transferred from a white cotton lab coat to pigskin 1 minute, 5 minutes, and 30 minutes after inoculation.

“Previous research has indicated that you could isolate organisms from materials such as hospital curtains, neckties, and lab coats, but we wanted to find out if you could take the inoculum from the cloth of a lab coat, transfer it to skin, and isolate the inoculum from the skin,” Dawn L. Butler said in an interview during a poster session at the annual meeting of the Society for Healthcare Epidemiology of America. “We did.”

Ms. Butler, a second-year medical student at the university, and her associates diluted MRSA, VRE, and PRA and inoculated them onto swatches of one clean, cotton medical lab coat. Next, they rubbed sanitized pieces of pigskin across the inoculated swatches, and a touch prep of the pigskin onto selective media was performed to determine if the inoculated organism could be isolated from the pigskin.

These steps were performed for each of the three study isolates at 1 minute, 5 minutes, and 30 minutes. Selective media were used to prevent growth of contaminants, followed by incubation of the cloth swatches for 24 hours in thioglycolate broth to verify the viability of organisms.

All of the swatches had grown organisms on respective selective media at 24 hours, confirming organism viability on the cotton lab coat.

“Everybody criticizes the British for banning white lab coats in the health care setting, saying that nobody’s ever shown that lab coats can transmit an infection,” Dr. Michael Edmond, chair of the division of infectious diseases at VCU, said at the meeting. “This shows that it’s biologically plausible, because in the laboratory we did transmit the organism from the coat to the skin.”

In a related poster, 141 physicians from nine VCU departments were surveyed about their attitudes regarding white lab coats. Most of the respondents (90%) were aged 29-39 years. Slightly more than half were men (52%) and the majority were medical residents (42%), followed by interns (35%), attending physicians (17%), and fellows (6%), reported Dr. J. Daniel Markley Jr., a second-year internal medicine resident at the university.

Previous studies have shown that nosocomial pathogens can persist on fabric for months, but when the survey participants were asked how long a microbe can survive on fabric, 2% said hours, 49% said days, 28% said weeks, 18% said months, and 3% said years.

In addition, 90% of respondents reported wearing their white coats daily or most days of the week, yet 62% said that they wait 2 weeks or longer to launder them.

Nearly half of respondents (49%) believed that patient perception of physicians would be adversely affected if white coats were discontinued, yet 74% believed that banning white coats could have a significant effect on hospital-acquired infection.

Dr. Markley also reported that 87% of male physicians would stop wearing ties if recommended, 42% of respondents would stop wearing a watch, yet only 48% would comply with a “bare below the elbow” policy. They wouldn’t want to wear a lab coat with short sleeves “because they don’t want to be viewed as a dentist,” Dr. Markley said.

Source.

While Waiting For The Tenure Decision ...

2009-04-12T21:01:00.000-07:00

... Let's have a kitty cat update with a long-ish story cut short.

As you know, I lost beloved kitty with much heart-break and, two months later, adopted two new kitties (siblings).

In the first month post-adoption, these two new kitties hated everyone. They hated me and they hated each other. There was a great deal of hissing at each other and scratching me. I was patient because I knew that they had been bounced between three homes in one month. They didn't yet know that they were now in their forever home.

When the "I hate you (my human) and I hate my sibling" behaviour continued into the second month, I became a little concerned.

By month three they had stopped hissing at each other and stopped scratching me.

By month four they were actively seeking me out (greeting me at the door when I came home and leaping at the opportunity to join me in bed with purrs as I read a book) and giving each other licks and sniffing each others' bums.

Now, month five, we are one very happy family. There are purrs all around. Kisses on the head between them are now a common sight.

They are in their forever home and they know it. And they fill me with delight on a daily basis.

Wow, I Had an Opinion on this International News Story

2009-04-08T21:51:00.000-07:00

Until I read this.

" ... the father of the baby that will not die ... "

I cannot imagine a more horrible string of words to type.

My thoughts are very much with both families.

She Got Me

2009-04-03T22:17:00.000-07:00

The morning of April 1st, 2009.

I am with a small group of 4th year medical students. We are discussing teratogens.

Medical student: "Last night I read a 2008 review study that conclusively demonstrated that in one of every 943 pregnancies, the maternal use of Listerine mouthwash during pregnancy resulted in an underdeveloped ovary in the female fetus."

Me: "Really?!" <-- note the question mark and the exclamation mark (I was instantly puzzled and curious).

My mind immediately started racing: what on earth could Listerine contain that would cause such specific numbers in research studies of birth defects?

The medical student let me mentally explore this line of questioning for a good 30 seconds before exclaiming "April Fools!".

She got me.

Full marks.

Conversations with Med Students

2009-03-13T23:08:00.000-07:00

Some of them astound me.

Dr. K.: "We are meeting today to discuss the fact that you are consistently late. This is unacceptable behaviour from a medical student at this level of training. What would you like to say in your defense?"

Student: "Yep, this has been a problem since I was in high school. I remember my high school principal calling me in many time to discuss this same thing."

*long pause*

Dr. K:. "And?''

Student: "And what?"

Dr. K.: *trying to hide a visible sigh*

Dr. K.: "Let's move on: what are you doing to try to improve upon the fact that you are consistently late?"

Student: "That's a great question. If you have any ideas I'd love to hear them".

At this point I want to shoot myself in the head. It would be less painful.

Tenure Anxiety

2009-02-27T18:42:00.000-08:00

As my tenure & promotion application drags into its 7th month, my anxiety level is rising. I don't have any particular valid reason for feeling this way -- it's not like any of my colleagues in the same tenure & promotion cohort have heard anything either -- but I do. I've started wanting to throw little (large?) temper tantrums because it simply doesn't feel fair that the university can leave me (us) in such limbo for over half a year.

I was discussing it with one of my (equally anxious tenure applicant) colleagues this week and she raised a valid point: she wondered whether there was any other job on the planet in which your employer can hire you, not give you a single performance review for 5 years and then feel it is justified to review the past 5 years of your performance in one fell swoop. Then, if they don't like what you've done/are doing, let you go with no (reasonable -- you'd have to hire a lawyer and fight it out for years) chance for improvement or rebuttal.

Just *Poof!* , thanks for your time, now please clear out your office and don't come back. And, really, let's face it: no other university will likely touch you with a ten foot pole if you've been denied tenure (at least in medicine; I can't speak for other disciplines). Good times. No wonder anxiety levels are high.

So I'm spending a lot of time taking deep breaths, trying not to throw visible temper tantrums and just generally reassuring myself that no news is good news and that my application is a strong one that, to the best of my knowledge, has not hit any speed bumps in its long journey.

Then I read this. Awesome. I hadn't even thought of that.

25 Things

2009-01-30T18:09:00.000-08:00

A while ago the lovely Jennifer Hawke tagged me for 25 things. The rules are: once you've been tagged, you are supposed to write a note with 25 random things, facts, habit or goals about you. At the end, choose 25 people to be tagged.

I'm going to break the rules because I'm just too lazy to tag 25 people, but because the lovely Jennifer was the one to tag me I will play along. If you would like to be tagged then go ahead and consider yourself tagged.

1. I recently heard that the average person moves homes four times in their life. This fact (if true) makes me a complete freak. I have lived in four countries in seven cities and have moved actual homes ... err ... thirty-three times.

2. The worst years of my life were spent in Baltimore, Maryland. I was lured by the Johns Hopkins name after graduating but was absolutely horrified to find myself living and working in downtown Baltimore. The city frightened me to death and Hopkins was not at all what it's cut out to be. When I left Baltimore it was the one and only time in my life that I bought a one-way plane ticket. I wept with relief as the plane's tires left the tarmac and I realised that I would never again have to set foot onto the streets of Baltimore.

3. I have ridden the Cape Argus Pick 'n' Pay Cycle Tour (109 kms & the largest individually timed bike tour in the world, with ~35,000 riders of all ages and skills) six times. Five of those rides were as a competitive cyclist and my best time ever was 3:04. It killed me to miss the fabled sub-3:00 time by 4.01 measly minutes but that 3:04 time is still something that I'm pretty proud of. Looking at me now you'd never guess that I used to be able to do that.

4. This global economic crisis couldn't have come at a better time in my life if I had planned it. The interest rate on my student loans has plummeted over the past few months (which already puts me two months ahead of my original -- "original revision" per #5 -- end-payments-date later this year) and housing prices are tumbling (which means that my original plan to buy at the end of this year is looking new and improved in terms of what I can afford).

5. Two years ago I put myself on a cash-only basis. This means that I give myself an allowance in cash every Friday and it must last until the following Friday. If I run out of cash, I stop buying until Friday. If I want to purchase something large then I save up the required cash in my savings account, buy on my credit card to get my airline miles and then pay the credit card bill in full from my savings account at the end of the month. I cannot begin to explain what a difference this has made in my financial well-being (see #4 -- this cash-only plan freed up many, many dollars that I had been spending without thinking (either on debit or credit) that in turn have shortened my student loan repayments by years).

6. I cannot stand ground beef. There's something about the consistency that makes me imagine an entire cow being shoved into one end of a large meat grinder and coming out on the other end as the stuff that is on my plate. Gross.

7. I once attended the post-mortem of a horse. If you've never seen one then you will be as surprised as I was to learn that it takes two people to pull the ribs apart to gain access to the internal cavities. Not only does it require two people but it requires two people with their feet on the horse's body, pulling in opposite directions with all of their might. You may not be surprised to imagine what kind of noise this makes if you think about how large horses' ribs are. I hit the ground in a dead faint and have not felt the need to attend a horse's post-mortem since.

8. Speaking of such fun, I have also assisted in blood collections from very large pigs. Apparently the best place to obtain large blood samples from a pig is from behind their eyes (the story goes that the blood pressure is highest at that point). The pigs knew exactly what we were up to as we approached in our space suits (the pigs were housed in a sterile research environment, hence the pre-entry sterilizing shower and space suits) and buried their snouts under their food trays. After looping a metal pole thingy around their necks to pull their heads out, I was horrified (horrified) by the almost human screams that pigs can very loudly emit as blood is being drawn from behind their eyes. This time I did not hit the ground in a dead faint but, in keeping with #7, I have not felt the need to draw pig's blood from behind their eyes since.

9. I have met one blogger on my blog reading list in real life. *waves* We shared an all-too short breakfast together but we have become great friends and I'm so glad that s/he (Ha! need to keep the rest of you guessing!) is now part of my life. I have no doubt that we will remain friends until one of us drops dead (hopefully many, many years from now).

10. I still sometimes marvel at the fact that a formal degree in education is required for teachers who wish to teach at the kindergarten to high school level but that any old idiot with a Ph.D. or M.D. (or both) can stroll into a medical school and teach our future physicians. I sometimes wonder if I should stop marvelling at that fact and become more appalled with it.

11. My favourite organ is the kidney. The counter-current multiplication system? Bring it! Scanning electron micrographs of its interior surface? Oooooh! Aaaah!

12. My least favourite organ is the GI tract. I think this dislike was first realised when I had to learn the histology of the entire GI tract. Good grief, how many times can an epithelium change? Don't get me wrong: I certainly appreciate the complexity of the GI tract and all that it can do, but the details just about brought me to tears.

13. I made the switch to Mac when ol' Bill Gates introduced Vista. Enough is enough.

14. I wish that Lance Armstrong would just stay retired already. I hope he gets clobbered in this year's Tour de France.

15. Although I have witnessed many medical students' tears, I have only been directly responsible for one student's tears. And even then it wasn't really my fault (I was simply enforcing rules), so I don't feel bad about it at all.

16. If a young physician is taking my Pap smear then I always ask them mid-procedure whether they feel that they are adequately sampling the transitional zone. Hey, I'm getting older and it's moving and I want to be sure that they know what they are doing. The answer is invariably "yes" so perhaps I should just shut up.

17. I once told (quite loudly) a parent on a plane that if they didn't make an effort to stop their child from crying then I would and it wouldn't be pretty. In my defense, I had already been in transit for 20 hours and was 6 hours into a 12 hour flight. I was exhausted and I snapped after the child had been crying for an hour and the parent had made no attempt (none!) to comfort/quiet the child. Following my words, the parent scooped up the child and started walking down the aisle (surprise, surprise, the child stopped crying) and the rest of the passengers in my immediate vicinity applauded me. Despite the applause, I have exercised more constraint since that incident.

18. I have seen -- and killed -- *flying* cock roaches. Enough said. Ugh.

19. I cannot stand when people say or write anywayS. It grates on each and every nerve in my body because it is Not. A. Word. The sooner that people realise this the sooner that I can stop feeling like I am sharing the planet with morons.

20. Mushroom egg foo young. I have died and gone to heaven.

21. The custodians in my University work building have taken it upon themselves to label which floor of the building each large, communal recycling bin belongs to. I don't blame them at all for that -- it's a good thing to ensure that the bins stay where they are supposed to be. However, I was walking through the first floor of my building this week and I noticed that all of the bins on that first floor are now labeled "FAST floor". I laughed and I laughed. I wonder if people who question the custodians about the rightful floor of these bins will be told to "go axe yur mudda".

22. There are sections of my hospital that I venture into only once per year (to teach medical students subject X). In one of those sections of the hospital is a coffee shop. I *heart* that it's been a year and the coffee dude still takes my travel coffee mug from me and asks "the usual?" (and gets "the usual" spot-on).

23. I started bike riding on a mountain bike. I then suffered a horrible accident that required surgery and bone grafts. Clever me, I stopped mountain biking and took up road riding (and later road racing). As a result, I have been hit by a car three times. As a result, I have suffered three serious concussions (even with a helmet). The worst of them left me able to literally stare at a wall for hours on end without becoming bored. I swear to you that I could feel my brain moving against my cranial vault if I moved an inch. I wouldn't recommend serious concussions to anyone. You should avoid them.

24. It drives me positively ape-shit batty crazy to see anyone riding a bicycle without a helmet. Seeing someone riding a bicycle, weaving in and out of traffic, without a helmet on the road sends me into a blind ape-shit batty crazy state. I have been known to pull over (both when driving and when riding my bicycle) to give the dumb-asses a lecture or two about the seriousness of head injuries.

25. I am still trying to decide whether problem-based learning (PBL) has a place in the medical school curriculum. If one is in a good PBL group then it works and has value. But such good (great?) PBL groups require so many seemingly cosmic factors to align that they are indeed rare. Perhaps (for the majority) PBL is not worth the time and energy?

Has It Been A Month?

2009-01-22T22:00:00.000-08:00

I've been slack in posting because I have, over the past month, been sucked into the administrative side of academia.

A month might not seem like a long time but believe me when I tell you that a months involvement in medical school administration can teach one a life full of lessons. I wouldn't have believed it myself before experiencing it, so take my word on this.

In the past month I have learned:

how to defend myself and my students without being defensive. This is huge.
how to defend medical students who need defense without defensiveness.
how to stop defending medical students whose only defense is defensiveness.
when to admit that a medical student should just fail. Full. Stop.

Over the past month I have been part of ending three medical students' careers. I've been a little busy.

Year in Review Meme

2008-12-30T11:53:00.000-08:00

I've been seeing this (in various forms) around the internet and it struck me as a fun thing to do. This one was stolen from Reassigned Time (who received tenure this year in a record-breaking amount of time -- seriously, is it just my University that takes forever and a day with tenure and promotion decisions?):

1. What did you do in 2008 that you’d never done before?

Applied for tenure and promotion.
Held my dying kitty as he was put to sleep.
Gave an oral presentation to a room full of hundreds of experts at a conference.
Visited the Northern Cascades in Washington State.
Published peer-reviewed papers in a new (to me) field.
Made the switch from PC to Mac.

2. Did you keep your new year’s resolutions, and will you make more for next year?

I didn't make any new year's resolutions and don't plan to make any this year.

3. Did anyone close to you give birth?

Yes! One beautiful baby girl.

4. Did anyone close to you die?

Beloved kitty. No humans.

5. What countries did you visit?

2008 was unusual for me; I did very little traveling.

6. What would you like to have in 2009 that you lacked in 2008?

I would like to renew my passion for teaching. The whole tenure and promotion application process (and subsequent waiting) has left me feeling flat and uninspired. Apparently this is perfectly normal, but understanding its normalcy doesn't do anything for my lack of enthusiasm these days. I have been constantly startled that my student evaluations have come back as strong as ever over the past term, because each time that I've finished any teaching session I've walked away feeling like I failed them all with my blah-ness.

7. What dates from 2008 will remain etched upon your memory, and why?

September 1st, the day that I submitted my tenure & promotion application.
September 20th, the day beloved kitty lost his fight against his CV illnesses.
November 4th, the day that Obama won the election and gave his moving speech.
November 22nd, the day that two new sweet little (terrorist) kitties came into my life.

8. What was your biggest achievement of the year?

Everything tenure-related. Also the paying down of my student loan debt. It will all be gone in less than another year and then it's on to home ownership. I cannot wait.

9. What was your biggest failure?

I can't think of any particular concrete failures.

10. Did you suffer illness or injury?

No.

11. What was the best thing you bought?

I hate to think of them as "property" but I suppose that since I paid an adoption fee, I have to say my two new kitties.

12. Whose behavior merited celebration?

All of my awesome friends (real and virtual), family and neighbours who really helped pull me through beloved kitty's death. The outpouring of support, empathy and sympathy was overwhelming and will not soon be forgotten.

13. Whose behavior made you appalled and depressed?

In the political world: Sarah Palin.
In my personal world: A colleague. But colleague's behaviour is an on-going problem, not new to 2008 but certainly persistent through it.

14. Where did most of your money go?

I became really aggressive about paying off my student loan, so the answer would be to the student loan people.

15. What did you get really, really, really excited about?

Hm. I can't say that anything got me three reallys excited. I will have to work on that in 2009.

16. What song will always remind you of 2008?

"All Summer Long" by Kid Rock. I wish that he would get over himself and release it to iTunes because I would buy that one song in a second but am generally not a fan, so I won't buy the entire album for that one song.

17. Compared to this time last year, are you:a) happier or sadder? b) thinner or fatter? c) richer or poorer?

a) the same b) the same c) richer.

18. What do you wish you’d done more of?

Taken long bicycle rides. 2008 was a year of short rides -- I really miss those 4+ hours long bicycle rides.

19. What do you wish you’d done less of?

I can't think of anything.

20. How will you be spending Christmas?

Christmas was a quiet affair with the highlight being a group of loved ones around a table over-flowing with yummy food.

21. Did you fall in love in 2008?

Did I fall in love? Well, no. But I've got lots of love, both coming in and going out.

22. How many one-night stands?

Zero.

23. What was your favorite TV program?

Don't laugh: The Sarah Connor Chronicles. I've always enjoyed the Terminator movies so I quickly became an addict of the television show.

24. Do you hate anyone now that you didn’t hate this time last year?

Nope.

25. What was the best book you read?

There was no single best one but many fantastic ones.

26. What was your greatest musical discovery?

Musical discovery? Huh?

27. What did you want and get?

A plane ticket to visit Cape Town, South Africa in 2009. It's been far too many years since I visited all of my friends there so I took the plunge and forked out thousands of dollars for the ridiculously high priced ticket.

28. What did you want and not get?

Not much; I've been pretty lucky. I suppose the only outstanding thing is a publication that was submitted in September and there still has not been a peep from the editors. It's been listed as "under peer review" for four months and I really wish that someone would get off of their butt and either accept it or reject it already.

29. What was your favorite film of this year?

I'm not much of a movie goer, but I did recently rent WallE and was surprisingly delighted by it.

30. What did you do on your birthday, and how old were you?

I turned 25 (ha ha) and spent my birthday at the lovely Sun Mountain Lodge, hiking mountain slopes covered with flowers -- it all made me feel like I was Heidi skipping through the Swiss Alps. It was wonderful.

31. What one thing would have made your year immeasurably more satisfying?

I've had a pretty satisfying year. Maybe more travel and (as mentioned above) some longer bike rides.

32. How would you describe your personal fashion concept in 2008?

Fashion?

33. What kept you sane?

I have not for a moment doubted my sanity in 2008.

34. Which celebrity/public figure did you fancy the most?

Obama.

35. What political issue stirred you the most?

The election.

36. Who did you miss?

I can't think of anyone that I miss because I keep in regular contact with the people who are important to me, no matter how far apart in the world we are.

37. Who was the best new person you met?

I've met a few new friends in 2008 and each has been as terrific as the next.

38. Tell us a valuable life lesson you learned in 2008.

I didn't learn any one particular lesson but more a series of small ones that I think come naturally with becoming older and (hopefully) wiser: patience with my own limitations and the limitations of others, a deeper acceptance for individuals' behaviours and a much deeper appreciation for the people in my life.

39. Quote a song lyric that sums up your year.

Nothing in particular comes to mind.

And A Happy New Year!

2008-12-24T11:37:00.001-08:00

Office Location

2008-12-16T22:14:00.000-08:00

My University office space has recently been relocated.

Where to?

Well, I'm most unhappy to answer: directly across from a single-user washroom. Very little separates my desk from the toilet that is used, by my best estimate, once every 60 seconds during the average work day.

I now sit in my office (even with the door closed) and listen to people farting, urinating and defecating. Believe me, people are noisy with their ablutions.

It leaves me with two questions:

1. Do the people who designed this building live in their parent's basement and have no clue about basic working conditions? Who the fuck designs office space directly across from a bathroom?

2. Should I be worried about tenure? Are they asking me to leave through this re-location? Because, believe me, this office space full of farting, urinating and defecating noises will do it.

Kitty Cats Update

2008-12-06T20:22:00.000-08:00

They have been here for two weeks and they are settling in nicely. I've had many cuddles and purrs with both of them. One of them has started greeting me at the front door when I come home and the other one has started telling me many stories (I label these chirping/meowing sessions as "the daily abuse & neglect report" because, as you know, they both must have many things to complain about here).

They are beautiful and wonderful. I am enjoying getting to know each of their personalities.

Incredible Service

2008-12-05T20:04:00.000-08:00

My University work computer died today. Just died. Full stop. No warning. I was left staring at a blue screen of death, pondering what this meant for the many files that I had apparently just lost (not to mention the many as-yet unanswered emails from anxious pre-exam medical students).

I put in my first ever call to the Faculty's Medicine Information Technology (MedIT) hot line. Within 5 (5!) minutes a friendly MedIT dude was knocking on my office door. Within another 5 minutes my computer was in pieces and MedIT dude had my hard drive in his hands (he even gave me a brief tour of the innards of a computer -- I had never seen them before).

Within an hour all of my files were returned to me on an external hard drive, a loaner laptop was sitting on my desk and a new desktop computer had been ordered because they "don't want to mess around trying to fix a computer that's breaking down because you need a reliable machine".

Wow.

Thanks, MedIT. You rock.

Call Me Flabbergasted

2008-11-29T22:20:00.000-08:00

For every student that I teach I receive a short (student-written) biography from the Office of Student Affairs. This is relevant because I know from their biographies that both students in the following story grew up in my current city. A fully developed, first-world, informed city.

This past week I was involved in teaching a small group of medical students. It doesn't matter what year these medical students are in, because I would be equally shocked regardless.

We were discussing viral entry into the human body. I raised HIV as an example.

Student #1: "Excuse me, but what is HIV?"

I blinked. I stared. I waited for the student to tell me that he was joking.

When it became clear that he wasn't joking, I explained.

Student #2: "So, are you telling us that HIV is related to AIDS?"

I blinked three times. Four times. Five times. I stared for a very long time.

Give it to me straight: I've been Punk'd.

Right?

God help us all if we are admitting students to medicine who haven't even heard of HIV/AIDS.

Tenure Application Update

2008-11-28T22:08:00.001-08:00

I am very fortunate to have a Department Head who keeps me up-to-date on the status of my tenure & promotion application.

I know that my colleagues in different departments within the Faculty of Medicine who submitted their applications as I did on September 1st have heard absolutely nothing since submission.

My Department Head does not give me details, but simply lets me know of each step that my application successfully passes through. I am very grateful for such updates.

Today I was informed that the external reviews of my application came back. Thumbs up, no questions asked.

Now? Onward and upward to the Faculty of Medicine's Tenure & Promotion Committee. My Department Head informs me that this is the longest stage of the entire process simply because of timing. It's the holiday season. I should expect that nothing more will happen until mid-to-late January or even into February.

I am, quite unexpectedly, alright with waiting.

My Contribution to the Global Economic Crisis

2008-11-25T21:03:00.001-08:00

I'm pulling out of my short-term investment (but not my long-term equities).

Screw this mess.

It has always (since inception of my contributions to this particular investment) been my intention to cash out of these funds in ~November 2009. I have a plan for the money.

But now? I'm not going to continue to lose money in the next year. For the next 12 months my contributions will be going to a savings account. As pathetic as the interest may be in a savings account, it sure will beat the losses that I have seen in the past few months. And, I must add, the continued losses that I predict over the next 12 months.

Ta da! I'm pulling out.

Meow!

2008-11-23T18:04:00.001-08:00

I now have two new kitty cats and I would love to share pictures but one is hiding under the couch and the other is camped out in her carrier. Shame, the poor little souls have been bounced between three homes (their original home, the foster home and now my home) in the past four weeks. I'd be hiding under the couch as well!

Adopting New Kitty Cats

2008-11-21T21:46:00.000-08:00

All that I have to say is this: no bloody wonder there are so many homeless animals in my city.

I am frustrated beyond belief.

It is, apparently, impossible to have an easy pet adoption in my city.

Listen To Your Heart

2008-11-14T21:38:00.001-08:00

When kitty died (was put to sleep) my immediate neighbours (and many other people -- bless you all) brought me flowers. We exchanged hugs and tears and I knew that they understood.

Two weeks later, when neighbours' dog died (was to put to sleep) from doggy MS, I took them flowers. We exchanged hugs and tears and they knew that I understood.

That was 8/6 weeks ago.

One week ago, neighbours began to tell me that they were adopting a new dog. I expressed delight to them but within myself I questioned how they could possibly think of such a thing so soon.

Today, as I was pulling up in my car, I saw them with their new dog. My heart soared. I have never felt anything quite like it. My heart soared to see my neighbours frolicking with a new dog.

I leaped out of my car to greet the new addition to the neighbourhood and was quickly told by my neighbours to avoid new dog's collar because his previous owners used to grab him by the collar and beat his face repeatedly.

My heart broke instantly at the thought but soared again in the next moment. This little doggy, so poorly treated until now, will have a fabulous, spoiled rest of his life with my neighbours. I have not a moment of doubt about that. Thank goodness that my neighbours had it in them to give love to another doggy so soon after the loss of their last doggy.

My heart soared.

It's time. It's time for me to bring home another kitty who needs (and deserves) endless love and Greenies and skritchy-skratchies and furry-purries.

Thank you, neighbours. You've made me really listen to my heart. You've made me understand that we can still love our lost pets while making room for new pets who so very much need love here and now.

[yeah, i know, medical blog? pffftht.]

I Am Planning a Visit to Here

2008-11-08T17:45:00.000-08:00

Cape Town, South Africa. My old stomping grounds.

You may all now proceed to express your insane jealousy.

Obama!

2008-11-06T21:11:00.000-08:00

Yes we can! Hurrah!

Still.

I have not talked about politics here before, but I have to state how disappointed I am with the general population of California re: prop 8.

Shame on you. You suck.

(I am not homosexual. You people simply suck at recognizing equal rights.)

Nice Try

2008-10-24T12:33:00.000-07:00

A New Brunswick judge has dismissed the appeal of an anti-abortionist who refuses to file income tax returns in protest of government-funded abortions.

David Little, 62, formerly of Fredericton but now living on Prince Edward Island, was convicted last year for failing to file tax returns for the years 2000, 2001 and 2002.

He says because some of his tax dollars go to fund abortions, it constitutes a violation of his freedom of religion.

Mr. Little is a Roman Catholic, and says he will never file his tax returns and never pay $3,000 in fines imposed by the court for the Income Tax Act violations.

Judge Hugh McLellan of the Court of Queen's Bench says while Mr. Little made an interesting religious and political argument, he didn't make a valid legal argument.

Outside the court, Mr. Little said he would continue to fight his case all the way to the Supreme Court of Canada if necessary. [Source.]

-------

As Rick C. from Calgary, Canada comments: Wouldn't we all like to withhold taxes for things we don't want publicly funded?

Do I Know You?

2008-10-22T10:58:00.000-07:00

As I get older and the average age of medical students remains constant, the obvious result is that the age gap between me and the students that I teach is widening. I am now approaching being twice as old as the typical first-year medical student. (Egad, how did that happen?)

I am now (as much as I hate to admit it) of a different generation. I am now teaching medical students who belong to the so-called Millenia Generation.

I knew that they were coming and so I've kept up with the "studies" (I've not yet seen an actual scientific study about this generation, so the "studies" that I have seen have been media reports and/or personal opinion columns).

The "studies" have not painted this generation in a favourable light. This generation is described as feeling self-absorbed, entitled and expecting a flattening of social hierarchy.

Well, I teach medical students. I don't ever expect that they could possibly become (as a whole) more self-absorbed or more full of self-entitlement than they already are/ever have been. That's just the nature of the beast (don't get your knickers in a knot because you know it's true).

Hence the first two criticisms of the Millenia Generation don't apply to medical students. However:

I also don't expect a flattening of the social hierarchy. Especially from self-absorbed, self-entitled medical students, who will undoubtedly expect society to call them "Doctor" when they graduate.

Yet I experienced it this week.

This week I had a first year medical student stroll up to me, say "heeeyaaa, FirstName" and present me with his palm expecting a high-five. As if we were long lost friends greeting each other at a barbecue after a few beers.

Do I know you?

I didn't know this student from a hole in the ground. I assume that he's been in my lectures that have been delivered to the hundreds of first-year medical students, during which I presented myself as Dr. LastName.

I am so hopeful that this one student is simply a dumb-ass who doesn't "get it" (and indications are that that is the case: I have not yet experienced another student this year who does such a thing) and that this isn't the beginning of what I may see if the reported Millenia Generations' expectation of "flattening the social hierarchy" comes to light.

I don't care what generation you are from. It is never appropriate to greet your medical school faculty with a high-five gesture and the use of the first name.

It's called professional respect or, if you don't have respect, at the very least it's professional courtesy.

Let's break this down:

1. It is NEVER appropriate to expect your faculty to greet you with a high-five.

2. Unless a faculty member invites you to use their first name, it is NEVER appropriate to do so. Not ever. Not ever for a single second ever. Not EVER.*

My response when the student greeted me with a "heeeyaaa, FirstName" and presented me with his palm expecting a high-five? I reached out my hand for a hand shake, told him that I didn't believe that we had met and said "pleased to meet you, I'm Dr. LastName".

Little does that student know how closely he is now circling on my (and my colleagues') radar screen. Medicine is a small world.

------
*I have (informally) surveyed the rest of the faculty members at my medical school. I did not hear otherwise from a single faculty member, regardless of their age.

A Weekend Away

2008-10-15T21:30:00.000-07:00

The time since beloved kitty's death has been filled with my obligations to the rest of the world.

Two days after kitty died I had to give six hours of my life to teaching medical students. Can you spell difficult? My schedule has not changed since then.

I now, almost four weeks later, finally have time for myself.

Now? I am booking a weekend away. Just me in a remote place with a beach cabin on a coast somewhere, where I will watch the early winter waves crash on the shore and shiver under my blanket as I do so.

Me. Time.

Three Weeks Later

2008-10-12T22:04:00.000-07:00

Has it already been three weeks?

Has it only been three weeks?

A friend said it best in an email:

"It's not supposed to be easy. If the death of a beloved pet ever becomes no big deal, I'll know there's something terribly wrong with my heart and that I should never have a cat again. The measure of our grief is the measure of our love. It's the price we pay. Much as it hurts, I think I would rather suffer through it than to miss out on the joy of my cats."

Well said. Especially the last sentence.

I miss you, my crazy, quirky buddy. I miss you so very much.

This Week

2008-10-03T19:07:00.000-07:00

This week I was informed that my tenure and promotion application sailed through step (committee) #1 of its long journey. So that's good.

2008-09-20T11:54:00.000-07:00

Early this morning, kitty suffered from a complete saddle thrombus together with a clot to his brain. We rushed him to the emergency vet clinic where he was given aggressive pain medication and we were able to spend some time with him before they put him to sleep in my arms. He went peacefully.

Heart broken? Yeah. Doesn't even begin to describe it.

Kitty Update

2008-09-19T18:34:00.000-07:00

Thank you so much for the supportive and caring comments in response to kitty's latest illness. Kitty and I both appreciated them and they made us both feel better.

Kitty is stable. Still hobbling around with partially paralyzed hind legs, but he's already adapting and finding ways to work around his new disability. His jumping/leaping days are over for now but I am hopeful that he will make another (third) full recovery from a clot. He's my little super hero.

Kitty: you are doing great! Keep it up, my buddy.

Dear Beloved Kitty,

2008-09-16T20:37:00.000-07:00

I am sorry that -- only two short months out of your surgery and cancer diagnosis -- you have suffered another clot.

Third one, buddy. I hope you don't remember the previous two like I do.

I am sorry that this clot has been a particularly nasty one that has left you partially paralyzed (but thankfully pain free as far as we can tell) in both of your hind limbs.

I am sorry that it is now so confusing for you when you try to walk. Keep trying, buddy. I'm here to catch you if you fall.

Most of all, I am sorry that this clot happened on the morning of your 17th birthday. It was rotten timing, wasn't it my little buddy?

I am beyond sorry that you spent your 17th birthday at the veterinary hospital but I am so glad that the evening of your 17th birthday was spent back at home, with your favourite treats and purrs and cuddles.

Biggest hugs,
Your ever-loving human.

P.S. More than anything else, this is all about you and your quality of life. I hope that you trust me enough to know that I won't keep you here for me. I won't keep you here for a second beyond your life becoming unbearable for you. The minute your enjoyment stops, I will let you go. It will break my heart, but I will let you go.

A Temporary Cure for Grumpiness

2008-09-12T22:28:00.000-07:00

An unexpected $6,000 honorarium added to my most recent pay cheque.

It seems that someone appreciates me. I shall need to find out who.

In the meantime:

How I wish that I could be irresponsible and blow it all on whatever I want. Alas, it will all be sunk into my new and improved fuck-you-and-the-horse-that-you-rode-in-on anti-interest student loan repayment plan.

Still, this honorarium is awesome.

Whoever you are? Thank you. You have no idea how much I needed this mental boost.

Well timed.

T&P Application Fallout

2008-09-06T21:25:00.000-07:00

It's only one week (or so -- who knows anymore) into the new academic year and I am exhausted.

As in, my eyes are burning to sleep while awake exhausted.

As in, my head hits the pillow and I am out for the count exhausted.

As in, the alarm clock sounds and it takes me a full minute to figure out who I am, why the alarm is going off and what day it is exhausted.

There are damn good reasons for the summer academic break.

Take that summer academic break away and you have me: exhausted.

I thought that maybe it was just me blaming my crankiness on a summer lost due to the tenure & promotion ordeal.

Until I stated, quite flatly, to a colleague (who also just submitted his tenure & promo app) that this year's first year medical class seems super-excited.

His response?

"Yeah"

pause

"But I don't care."

Yep, neither do I.

This, dear medical students, is why you have apathetic teachers. I'm beginning to understand the whole cranky professor thing.

RBOC

2008-08-29T20:09:00.000-07:00

My tenure & promotion application went in last week. The entire process was much more of a draining, politically-motivated and seemingly endless ordeal than I ever saw coming.

Now we (well, I) wait while the application makes its way through endless committee and President and Senate approvals.

The whole process left me down-right grumpy.

I'm over that now. I have the second-year medical class to thank for that. Welcome back! I've missed you guys.

The (first-year) medical class of 2012 seems different somehow. It leaves me wondering whether they are actually different or whether being post-tenure application is causing me to perceive them differently. After-all, I feel ... stronger. I've done everything that I can do to earn tenure and so now I can do what works the best. Yeah, that sounds weird. I know. I'm still figuring out this post-tenure application thing. My mind she is scrambled.

My mind sometimes needs to remind itself that this is just the tenure application. Things can still go downhill rapidly from here.

The only "back to school" downside that I have experienced is the need to once again wear socks. My toes are screaming out for their now-lost summer freedom.

Oh, and being awake at 5:00 a.m. for a 7:00 a.m. meeting. That sucks as much as socks.

Dragonfly asked how kitty is doing. Thanks for asking! Kitty is a trooper and has recovered 100% from his surgery. He's so, so, so happy to have the nasty tumour off of his chest and is back to being his normal neurotic self. And yay! He's been using the litter box consistently since his surgery. Looking back, I wish that I had paid more attention to him peeing on me/anywhere else. The vet put it down to senility and I accepted that. I now know that kitty was trying to tell me how wrong his something wrong was. The next time that he pees on me, he may rest assured that I will pay much closer attention.

Speaking of, kitty's 17th birthday is coming up. 17! We will be celebrating that in every possible way. After-all, survival through: two clots, a heart condition/uncontrolled hypertension that should have killed him years ago and now the recovery from surgical removal of a cancerous tumour. Yet still he purrs, bends his body to receive the best possible skritchy-skratchies and loves his Greenies. Quality of life. It's all worth celebrating.

I have a friend who's 18-month old child recently underwent a liver transplant due to alpha 1 anti-trypsin deficiency. Until now this inherited illness has existed for me only in text books. It's difficult. I wish that she didn't need to ask the questions that she is now asking. I wish that I had better (more hopeful) answers for her, particularly after seeing her (and her husband's) Pi phenotype.

Student loans are a bitch. This topic has become bothersome enough for me over the past few years that it likely deserves its own post. So, that's to come. In the meantime, I've become so pissed off at the entire process that I've upped my repayments to $2000/month. The bad news is that it will still take me a year to repay in full. The good news is that it won't take me another 6 years and phenomenal interest payments to repay in full, as would be the case if I stuck to minimum payments. Current students? Think carefully about each and every $1000 that you borrow. Believe me, it adds up quickly when it comes time for repayment/facing the interest on your loans.

Now you will have to pardon me. I have gin and I have tonic. They are currently demanding that they be mixed.

Facebook = Me Reading Your Thoughts. Literally.

2008-08-15T22:51:00.000-07:00

I wonder whether the incoming medical class is aware that their recently created Facebook group is really and truly in the public domain.

I am led to believe that they must be oblivious to this fact.

I can't think of any other reason to account for some of the damaging information that they are currently sharing with me through their Facebook group.

P.S. To the Facebook medical class of 2012 at my University: it's anyway. Not anywayS. I'm warning you now about my complete, total and never-ending lack of tolerance for the latter and similar ignorance.

Busy Non-Blogging Tenure Application Bee

2008-08-07T21:26:00.001-07:00

T minus 22 days until my tenure and promotion application must be submitted.

Fark! Really? Already it's that time in my academic career?

There are days when I think that putting the tenure and promotion application together is taking more time and effort than all of the combined time and effort put into the years upon years that got me to this point.

I have been preparing my application for the past two months (with the pressure picking up exponentially over the last month).

For the past two months I have alternated between:

being excited,
sticking my tongue out at the computer screen at random intervals and
sighing very heavily.

Lather, rinse and repeat.

These past two months will be known from this point forward as The Great & Mighty Summer of '08 That Flashed Before My Eyes ... and will either make me or break me as an academic.

Equality

2008-07-15T19:12:00.001-07:00

I can't remember where I found it, but I recently read a report that compared academic salaries across the United States over the past year. The report was broken down into various categories and across a wide range of ranks (everything from sessional lecturers to full professors) and one of the categories was gender. I don't know why, but it genuinely stunned me to see that, regardless of the rank, women are still being paid less than men. For example, a female associate professor earns, on average, approximately $10,000 less than her male counterpart. This was a trend regardless of discipline.

I am fortunate (Fortunate? How absurd that I should pick that word.) in that my medical school pays men and women the same amount of money and the only variations in salary are due to rank; after-all it does make sense that a tenured full professor earns significantly more than a non-tenured assistant professor.

Hence you can imagine my surprise when my University recently announced that they will be increasing the salaries of all of the women faculty. It seems that they looked at the trend of all female faculty in all departments and faculties and concluded that the female faculty are being paid significantly less than the male faculty. Rather than selectively raising the salaries of those women who are being paid less than their male counterparts in equivalent ranks, the University is making a sweeping statement and increasing the salaries of all female faculty.

I find this grossly unfair and insulting. Not long from now I will be paid more than my male counterparts in equivalent rank in the Faculty of Medicine. In fact, it is likely that my salary will be increased to the point where I will be paid more than some of the male faculty members who are in higher ranks than I am. And the sole reason will be that I am a girrrl. I'll be very surprised if the male faculty don't cry foul and I won't blame them at all if they do. This is not the way to promote equality.

A Good Kind of Cancer?

2008-07-11T14:32:00.000-07:00

Is that possible? In kitty's case, I think it may be ... the best possible worst outcome, so to speak. Today the pathologist finished assessing all of the lesions that were removed from kitty and has refined his diagnosis to Bowen's Disease. All of the tumours are still squamous cell carcinomas (which genuinely stunned me because some of the growths that were removed looked more like warts than tumours) but they are the best kind of squamous cell carcinomas.

For those not medically inclined, Bowen's Disease is characterised by numerous in situ carcinomas. The in situ part of that last sentence is the best part because it means that these tumours are typically not invasive; the chance of these tumours becoming invasive sits at less than 5% and the risk of metastases is even lower. Those are pretty awesome odds. The odds of recurrence, however, are high.

Yet all hope is not lost. There is a topical drug, called Aldara, that is an immune system activator. It basically revs up the immune system and attacks the underlying causes of Bowen's Disease. It's expensive. Really expensive. But at the end of the day, I'll have to find a way to budget it in because I can't imagine not giving kitty every chance to beat this.

Kitty and I are feeling much better and much more hopeful about his cancer than we were at the beginning of the week. Of all of the bad news we could have received, this is pretty good bad news.

Heartbreak In The Diagnosis

2008-07-09T16:09:00.000-07:00

Kitty's pathology report came in: squamous cell carcinoma. I don't know what else to say.

Letters

2008-07-08T16:38:00.000-07:00

I frequently receive requests from students for letters of recommendation. The requests are for everything from scholarships and bursaries to summer jobs to residency applications. Writing a letter of recommendation for a student is, on the whole, a remarkably pleasant task. After-all, these are medical students; they are (generally speaking) a bright, dedicated and hard-working group of people and singing their praises is a simple and fun thing to do.

That said, I'll share with you that there is a right way and wrong way for a student to make such a request. Here are two examples of requests that I have received in the last few weeks:

1. Student A emailed me and began her email by stating that she hoped I was having a great summer (I am, thank you). That's a nice start, don't you think? Even if she really doesn't care one way or the other. Next came the request for a letter of recommendation for a scholarship. Following that, a detailed explanation of why she was asking for a letter from me in particular, what the scholarship was all about, why she felt that she was deserving of the scholarship (with specific examples) and a nice linky link to a website where I could get further information and submit my letter of recommendation. She did all of this with a two-week window to the deadline for submissions.

2. Student B sent me an email with no information beyond: Hey Dr. K., will you please write me a letter of recommendation. Oh, and it's due tomorrow so you will need to hand-deliver it to Unit #101 on You've Got To Be Kidding Me Street.

I'll leave you to decide which student received a glowing letter of recommendation and which student's email quickly landed in my trash folder.

Five Days Post-Op

2008-07-04T19:59:00.000-07:00

I have a lot to say about this whole operating on an elderly cat thing (the vast majority of which is positive) and think that I will bore you all with a post about it soon. Why? Because I've done a tremendous amount of Googling over the past two weeks and didn't find one single (as in, all information in one place) source that sums up everything. I'd like to know that if someone finds themselves in our/kitty's position in the future that I can be of some help by providing our story of a major operation on an elderly cat.

In the meantime: kitty has been an absolute star this week. He's repeatedly reminded me of what a gentle and precious soul he is, which of course has brought me to tears more than once (but mostly in a happy way).

His incision (which extends the entire length of his abdomen) is healing well. There have been no signs of infection and he's leaving the suture alone. He's also beginning to demonstrate the improvements that we had so hoped this surgery would result in. We are still waiting for the histopath report but I am more hopeful than ever that the results will be negative.

And, best of all, he moved his bowels today for the first time since Sunday. A good stinky shit has never made me so happy.

Kitty Is Home

2008-07-01T11:13:00.000-07:00

Looking like Frankenstein with his sutures but gobbling up his food and purring.

I am $800 poorer. Worth every penny.

---
One day later ...

Greatest post-operative challenge: preventing kitty from licking, biting or scratching his sutures while attempts at putting an e-collar around his neck stresses kitty so much that he ends up dry heaving with his little pink tongue hanging out. I have become an attentive 24-hour nurse but I am feeling like a very bad and helpless kitty mummy.

Tough Decision

2008-06-28T22:33:00.000-07:00

Update #1: All food has been removed, 12 hours prior to surgery. I feel awful for doing this. My little buddy is going to be hungry and confused by the missing food bowl.

Update #2: We had a cuddle before going to the vet this morning. My vet is awesome. Parting words were: "if you want an update at any time, even 10 minutes from now, simply call".

Update #3: This is how awesome my vet is: vet just called to run through everything prior to starting the surgery and ended the call with "don't worry, I'll take good care of him. I love him". Aww, so do I. *sniff*

Update #4: Just finishing up with the dental cleaning (which they were also doing while he was under general). His vitals have been great throughout the surgery and they will call me again when he's awake and alert.

Update #5: Kitty is awake and quietly recovering. He can come home this evening. Yay!

Update #6: :( Kitty can't come home tonight. He seems to be in pain at his incision site and so needs to stay at the hospital to receive adequate pain medication. While I am grateful that the vet is erring on the side of caution (I would hate for kitty to be in pain), I am going to really miss my little buddy tonight.

Update #7: I visited kitty for an hour at the vet hospital. He was beyond thrilled to see me and spent the hour with his head buried in my arm, purring up a storm. The pain meds are obviously doing their thing and I feel much better about how he is doing. He's in the care of some awesomely wonderful people.

Update #8: The night nurse called to confirm that kitty has been offered food but is not eating (24+ hours without food, poor buddy). Kitty is resting comfortably. Night nurse is not worried; little does she know how much worry she relieved me of with a simple phone call.

Update #9: Little buddy still hasn't had anything to eat but the nurse is trying to feed him by hand. He's still on his pain meds and seems comfortable. Now waiting for vet to tell me whether I can bring him home this morning. Fingers and toes crossed.

-----
Weighing pros and cons. It's been a difficult week in the Dr. K. household.

At the end of it all, elderly beloved kitty will undergo surgery on Monday morning, despite his CV- and age-related anesthetic risks.

Careful attention has been paid to whether this surgery is for us or for beloved kitty. We conclude that it has enormous potential to improve beloved kitty's life. Whether he has six months or 4 years left, we think that this surgery will improve each and every minute.

We think it's for the best.

We are hoping that we are right.

(How I wish that kitty could talk.)

Please think happy anesthesia and recovery thoughts on Monday morning. I already know that I am going to be a wreck waiting for surgery updates from the vet, so any well wishes will be beyond welcomed.

Think

2008-06-17T22:00:00.000-07:00

One pre-tenure opinion that I will openly voice is this: I am sick and tired of the current generation of medical students whining and moaning about their education.

I know that you, Gen Y, are different from my generation but there are still basic principles about medical education that I will take to my grave. Over my dead body, so to speak:

1. How do you, a first-year medical student, know what is relevant? Please stop whining in your pre-clinical years that you can't see the relevance. Granted, we will teach you some things that aren't directly relevant but ... Because you are supposed to be the cream of the crop then perhaps you may start to appreciate that we are teaching you learning for the sake of learning. Believe me, it will serve you well in the future.

2. I am amazed that a Professor can stand in front of you and teach you something about the human body and you respond by wondering how it will apply to your as-yet-undetermined specialty. Aren't you, as a junior medical student, simply fascinated by the human body? As in, every aspect of it? You aren't? Really? Then why, may I ask, are you studying the human body in preparation for your future career?

3. Yes, I know that your generation lives life through YouTube and the like. That doesn't mean that you have any special privileges in disrespecting the people who have donated their bodies to your education. It is WRONG for you to record their remains in any manner at all. Full stop.

4. You are a medical student. If you are a medical student for the right reasons then you will be learning (not memorizing(!)) for the benefit of your future patients. Stop asking me if "this will be on the exam". It will be "on the exam" for the rest of your professional career. Grow up and understand this simple fact.

In short, you may all take a lesson from Jennifer's latest post. And if her latest post isn't enough then feel free to go back and read her archives. She's not striving for perfection -- because I think that she knows it impossible -- but she's the kind of physician that I want at the other end of the stethoscope that examines me now and in my final moments.

Sometimes

2008-06-15T21:24:00.000-07:00

Today, in the middle of cutting UPC stickers off of a cardboard box or two (there is $319 in mail-in rebates at stake; and yes, I first tried peeling the stickers off), I stabbed my thumb with a pair of nail scissors.

I don't do anything half-assed. When I say that I stabbed my thumb, I mean that I stabbed my thumb.

Copious amounts of blood immediately appeared, dripping down my hand and on my carpet.

I cursed, grabbed a kleenex and applied pressure.

I then waited, with my thumb above my heart, for my clotting cascade to kick in. And as I waited I wondered how long it would take for my fibroblasts to become nice and plump as they should in wound healing.

Sometimes I wish that I could stab my thumb with a pair of nail scissors and be done with it. Really, I don't need to be thinking about clotting cascades and fibroblasts.

How Are You People Managing?

2008-06-05T23:11:00.000-07:00

I fill my car, on average, once per month. I manage this through a combination of a comparatively very short commute (15-20 minutes) and cycling to work.

The last time that I filled up it cost me $10 less than it cost me today.

A $10 increase in one month.

I don't know how those of you who fill up weekly (if not more than that) are coping.

But really, if you are an American, who else do you have to blame?

Troubling

2008-06-03T19:24:00.000-07:00

I am very pro-choice but this troubles me enormously.

"This is particularly troubling since universities are places where basic freedoms are expected to be particularly upheld and valued."

Indeed.

Get. Out. Of. My. Head.

2008-06-01T11:15:00.001-07:00

Friends who have friends who are cat lovers should not forward information such as this to their friends who are cat lovers. It's stuck in my brain, swirling around in the portion of my cortex that stores information that I wish that I didn't know.

It seems that on February 14th, 2005, a certain asshole named John Ronald Hughes was drunk at his girlfriend's house when he sat on the couch and the couch collapsed. This is not what makes John Ronald Hughes an asshole. What makes John Ronald Hughes an asshole is what happened next.

It seems that his girlfriend's cat was under the couch when it collapsed. The collapse seriously injured the cat and the cat was gasping for air.

The asshole woke up his girlfriend to let her know what had happened. Sara Kons, the assistant asshole in this story, told him that the vet was out of town and that he should break the cat's neck to put it out of its misery.

The assistant asshole then went back to sleep. I'll repeat that: she has just recommended that her cat's neck be broken and she then goes back to sleep. WTF?

It seems that her peaceful slumber was disturbed moments later by the sound of the microwave door. The assistant asshole went downstairs and found asshole number one holding the cat outside of the microwave oven. Asshole had put the cat in the microwave with a weighted strap on top of it, closed the microwave door and turned it on for approximately 54 seconds.

The cat, still breathing, was convulsing and making a scream-like sound.

Asshole number one then threw the cat at the assistant asshole, who missed it and described the event as "the cat hitting the ground in front of me, gasping a few times while it was still convulsing, and died".

Asshole number one was initially acquitted of an animal-cruelty charge (!) until the hero of this story, one Mr. Justice F.W. Cole, overturned that ruling in an appeal heard earlier this year.

This whole story sends me into a rage. But what angers me the most is that the asshole is now facing a maximum penalty of six months in jail OR a fine of up to $2000. A slap on the wrist for such awful torture of an already injured and defenceless creature.

That's not justice.

Today

2008-05-29T20:39:00.000-07:00

Today, after I recorded the last medical student examination score that I am responsible for this year, I pushed back from my desk and, while spinning around in my chair, threw my head back with hands in the air and declared very loudly that another successful academic year is donedonedone. Everyone passed. Yay!

To the first years: congratulations for excelling in the first year of your medical career.

To the second years: aw, you guys rock. Thanks for the teaching award nomination this year.

To the third years: I know, you're still at it. Hang in there, you are all making me so proud.

To the fourth years: I can't believe that you are "leaving the nest". Wasn't it just yesterday that .... ? I wish each of you every success in your residency.

I have the best job in the world.

Alli

2008-05-26T22:24:00.000-07:00

Given the fact that Alli is in super-advertisement-mode, I googled.

Then I explored the site.

It speaks of "treatment effects". Not "side effects". "Treatment effects".

Here's a piece of advice, from the Alli site, on how to deal with one of the "treatment effects":

You may feel an urgent need to go to the bathroom. Until you have a sense of any treatment effects, it's probably a smart idea to wear dark pants, and bring a change of clothes with you to work.

I am still laughing. Out loud. Repeatedly.

Really? This is better than a sensible diet and exercise?

Really?

In other words: you will shit in your pants. Take precautions.

How is this any different than when the potato chips industry tried this with the same "treatment effects"?

Good God, people, are you really this stupid? If so, I no longer wish to share this planet with you.

Kitteh

2008-05-24T21:52:00.000-07:00

He's had his claws clipped once a week for all of his life.

He's put up with it because it's always been mid-cuddle and there has always been a treat after. He used to purr throughout the weekly ritual.

These days?

It means dragging 17-year-old beloved kitty out from under the bed (literally). Clipping happens now only once a month because it's all the torture I can imagine. I still do it because I worry about his claws growing into his pads. But once a month is all that I can take.

He hisses at me. He bites me. He pees on me. I have to physically restrain him. All during one nail clipping.

Other than that, he still purrs whenever he sees me. That's enough to continue the love.

You've Come A Long Way, Baby

2008-05-22T20:08:00.000-07:00

Today I dissected a clitoris from a cadaver.

Tomorrow I will have the clitoris sliced into many sections, fixed and stained and I will then add them to the histology/pathology slide collection for medical students to learn from.

I've had enough of the gender bias of histology/pathology slides of penises and prostates and the like.

The time has come for equality. Penises and clitorises for all!

I Fell Off The Face Of The Planet

2008-05-19T13:13:00.000-07:00

Not really, but I have certainly been neglecting this blog. Sometimes real life gets in the way.

I recently went hiking in the Northern Cascades in Washington state. It was my first time in Washington state, let alone the Cascades and I really enjoyed myself. The scenery was stunning ... everything from Spring wild flowers growing on mountain slopes to enough snow on a Pass to close it for three days (due to avalanches) the day after we passed over it. We thought ourselves very lucky to have made it over the day before because reaching that Pass to find it closed would have put a halt to all of our subsequent holiday plans.

I also recently went to San Diego, yet another first. There I was baffled by numerous people stopping me on the street demanding to know what time it was. They didn't ask "excuse me, do you have the time?" but rather strolled up to me and simply stated "what time is it". Does this mean something other than simply wanting to know the time? It struck me as very odd.

In between San Diego and the Northern Cascades I suffered through a wicked cold that lasted for four weeks. I very rarely get sick and so it was a revelation to me to discover how important smell and taste is in motivating one to eat food. I am now making up for four weeks of disinterest with much interest in such things as McDonald's Egg McMuffins. This, obviously, needs to stop.

I also recently met a bloggy friend in real life, the third first in this post. I can't tell you which bloggy friend because that would go a long way to giving up my anonymity but suffice to say that she is as lovely in real life and it was a pleasure to meet her. I look forward to spending more time with her in real life in the future; in the meantime we have discovered a shared addiction and so are amusing ourselves with endless email Scrabble.

I have finished all of my teaching for the year and recently published two research articles and that means that I have also done all that I can in my quest for tenure. This is a really odd feeling; there is nothing more that I can do (good or bad) for my tenure application and it's left me wondering where the years have gone. I am feeling fairly confident that I will be successful but I am not cocky enough to consider it a done deal. My tenure application is due on September 1st and then I shall wait and wait for it to pass through the numerous committees and on to the University President for final approval (or not).

I have also turned another year older. Whatever.

Perspective

2008-05-03T20:51:00.000-07:00

Fat Cyclist (and his wife Susan) will surely welcome your words of support.

Go and leave a comment for them. Please.

It's served to remind me how precious every day should be.

Illness Abounds

2008-04-15T21:46:00.000-07:00

I am coughing up both lungs (I blame conference germs) and beloved kitty threw his second clot last night at 3:00 a.m.

Kitty is again knuckling his paw and seems very confused that this loss of limb function is happening again.

Poor little guy.

I would happily cough up a third lung to avoid having kitty go through this again.

I'm here with you, buddy. I am here with you.

Looking for Inspiration?

2008-04-12T16:37:00.000-07:00

Home Again

2008-04-11T21:30:00.000-07:00

My favourite picture from my trip:

The conference was also good.

Blast Off

2008-04-03T14:53:00.000-07:00

I am off to combine conference attendance with being a tourist in a wonderfully
sunny and warm city.

Hooray!

A Quick Comment for Medical Students

2008-03-26T22:13:00.000-07:00

Don't consistently turn up late for small group sessions. Just. Don't. There is nothing that will have you on my radar screen (with blinking lights and sirens indicating a crash landing) more quickly. You counting ceiling tiles for the duration of the session will be less likely to catch my attention than showing up late.

Call me a hard-ass, I don't care. Quite simply: you are now in a professional program. You are training to be a physician. Research demonstrates that your performance in medical school indicates what kind of physician you will become.

You are expected to be in place A at time B. If that means being in place A 30 minutes before time B because of bus schedules (etc) then you need to plan accordingly. Because consistently being in place A 30 minutes after time B because of bus schedules (etc) is simply unacceptable.

You are now in training that will equip you to care for me and my loved ones in the years to come.

I will not hesitate to fail you now if I don't want you doing either in the future.

So Beside Myself

2008-03-25T21:32:00.000-07:00

You all know how much I love beloved kitty. I love, love, love him and then I love him some more.

But. How much more should I tolerate him peeing on me? He jumps up on the bed and pees on me. Night after night. At 1:00 a.m. At 3:00 a.m. At 6:00 a.m. And every time in between.

It doesn't matter what the time, I still have to jump up and change sheets and spray everything.

I am beyond exhausted.

Never-mind the exhaustion for now.

It's costing me hundreds upon hundreds of dollars on sheets and pillow cases and vet bills and is currently looking at costing me thousands upon thousands on duvets/covers, vet bills and, most economically important, ruined mattresses.

Kitty is 16 years old and senile. He is costing me thousands of dollars. Yet he still purrs whenever he lays eyes on me. And I cherish each and every last purr.

This is a really, really horrible place to be.

Because I have reached the point of thinking of putting him down, despite the purrs and despite knowing how completely empty my life will be without him being senile and peeing all over me.

Today at 30,000 Feet

2008-03-18T21:53:00.000-07:00

Long-term readers of my (mostly deleted) blog will know that few things give me greater pleasure than taking pictures such as this.

Today I was able to do it twice.

Yippee! I love flying! Twice in one day? You've got me!

The rush of the jet engines, the hurry-hurry down the runway and then, blast-off!!

(Don't forget to count to ten before fully enjoying the blast-off.)

Long-term readers? Yes, I know, I am still working on standing steady in the path of a landing jumbo. I will share pictures once I accomplish that.

Best Student Eval Comment Evah

2008-03-10T22:12:00.000-07:00

"The professor makes it too hard for the average student to get an A in his class."

Silence

2008-03-09T22:48:00.000-07:00

It really is golden.

The reason that I haven't been blogging? I am too busy being deliriously happy.

I find myself smiling at things that used to drive me to anger.

It's taken me six years of being where I am to realize -- and fully appreciate -- that I am where I was meant to be.

I am where I was meant to be. After all of the struggles, sadness and frustration. I am where I was meant to be.

Isn't it funny to reach the point of knowing that the things that you once thought you couldn't live without are now the things that you know that you couldn't possibly live a lifetime with?

I am at the starting line of the rest of my life. As ready as I've ever been.

6 Truths

2008-02-24T13:56:00.000-08:00

You cannot touch all of your teeth with your tongue.
All idiots, after reading the first truth, try it.
The first truth is a lie.
You’re smiling now, because you’re an idiot.
You soon will forward this to another idiot.
There’s still a stupid smile on your face.

Thanks to Trauma Queen for the laugh.

Diamond Shreddies

2008-02-11T22:15:00.001-08:00

I fell for it. Hook, line and sinker. I've even complained to colleagues that "I don't get it ... aren't Shreddies diamonds merely squares on their sides?" Colleagues (PhDs and/or MDs) nodded their heads in agreement and were equally baffled. We joked that they could now charge $1 more per box and that the idiots buying it would proclaim that it tastes better.

Apparently it takes little more than being a regular YouTube user (rather than an idiot PhD/MD) to know that it was a joke.

It was a joke. Right?

Student Loans

2008-01-28T21:21:00.000-08:00

I (like many in the field) graduated with student loans. In fact, I graduated with two student loans: one massive and one very large.

I have been paying them back rather aggressively (I am a big believer in suffering in the here and now in order to avoid the tens of thousands in interest that I would pay if I took advantage of the maximum loan terms and paid only the minimum payments) but have to admit that I haven't been giving much attention to the balances. After-all, it hasn't really mattered because I have been paying the maximum that I can and the balances will be what they will be regardless of whether I am tracking them or not.

Hence you can imagine my delight today when I received notification that the very large loan is now paid in full.

Woot!

I did a happy dance.

There's very little that is worse than being saddled with student loans but there is also very little better than the feeling of paying one of them in full.

The remaining massive loan? Today's news prompted me to check the balance and forecast complete repayment. 2010. In the year 2010 I will be student loan free. Ah! Today I can taste how wonderful that is going to be.

All Alone and Drowning

2008-01-21T22:51:00.000-08:00

T-1 days until the manuscript revisions are due. Co-author #1 has decided to take holiday this week (gosh, I really hope that you are having the time of your life) and co-author #2, who has essentially been useless since day one and will never again be included on one of my publications, is now in a large eastern U.S. city doing goodness knows what.

Meanwhile I am drowning in linear regressions and ANOVAs and Welch tests, trying to prove to the reviewers that we (all three of us who are listed as authors, two of which are currently letting me drown) know what we are talking about.

Have I mentioned recently how little I know (or care) about such statistical details?

I plan to drink quite heavily once these revisions have been submitted. Believe me, I have earned the hang-over.

Our Future Leaders

2008-01-20T11:40:00.001-08:00

A recent survey of British teachers by the Association of Teachers and Lecturers found that 58% had encountered plagiarism among students in their late teens.

How blatant was it? The pupils didn't even bother to remove the advertisements from the articles copied and pasted from the Internet.

Rocks & Deadlines

2008-01-14T23:05:00.000-08:00

The not-so-minor minor revisions to my publication(s) continue. Today my co-author refuted (with very good cause) one of my rebuttals to a reviewer's valid comment. Damn, damn, damn!

We require additional data.

So my co-author emailed a person of ultimate authority at our medical school, requesting the additional data. The response came back to us six hours later: we regret to inform you that we cannot release such information because it may impact on our student selection/admission process were it to be released into the public domain; it is confidential information made available only to the Deans of the medical school.

Alas, I am not a Dean. No information for me. (Reminds me of the No Soup For You! Seinfeld episode.)

The not-so-minor minor revisions are due in eight days and they regret to inform us that they cannot release the data required for successfully addressing a reviewer's valid comment. Damn, damn, damn!

Rock? Meet hard place. Hard place? Please provide us with a solution. And please do so quickly because I also need to deliver a lecture on Friday (for which I am horribly unprepared due to your rocky hard place) and update my CV by the same day in order to apply for a merit salary increase this year. Baie dankie.

P.S. For the love of everything that is good would someone please teach me how to use my iPod?? I have no idea how to do anything with it and simply keep pushing buttons until it does what I want it to do.

Now For The 11th Day ...

2008-01-11T21:51:00.000-08:00

My hospital has a wonderful restaurant that serves nothing but salad. It's a take-out restaurant and its only feature is a salad bar that offers fresh everything that is green and orange and red and good for you. It's expensive (around $9 by weight for a decent sized salad) but worth every penny. For years now it's been my treat to myself each and every Friday that I have been at the hospital.

Today was no different. Friday. I had finished teaching and was ready to drive to the University campus to continue work on my not-so-minor minor manuscript revisions. I paid the $9 for my yummy salad treat, hopped in the car, and drove to the University.

More often than not I eat my lunch at my desk while working. It's a bad habit, I know (as in: I should get out for lunch more often), but that's just the way it goes. Hence it came to be that I was eating my $9 salad while working on manuscript revisions. This meant that I was paying very little attention to what I was picking up with my fork.

Life was grand. My revisions were almost done, I was sitting in my kick-ass new office chair and I was munching on my salad. Munch, munch, munch .... crunch! What the .... ??! The texture felt wrong. Nothing that I had selected from the salad bar should have been that hard.

I fished around in my mouth for the offending piece of salad. I found it, pulled it out of my mouth and looked at it. With each millisecond that passed my horror grew. Between my finger and my thumb I was holding approximately 2 cms of a thickened, yellowish toe nail. When I turned it over to verify what my eyes were telling my brain, I saw that it came complete with sparkly grey nail polish.

I have to admit: I threw up in my mouth just a little bit.

Thus, on the 11th day of 2008, at approximately 12:42 p.m., my yummy $9 Friday salad treat became my $9 Friday disgust-o-fest.

A toe nail! With sparkly grey nail polish! In my salad! In my mouth! Gah!

A Fabulous 10th Day of 2008

2008-01-10T20:37:00.000-08:00

Ask and you shall receive. The discussion was short, sweet and to the point and a raise is on its way to my pay cheques.

I also ran into an ex-medical student at the hospital today. I haven't seen her in over a year. I first met her in the first week of her first year in medical school; she's now PGY-1 and having the time of her life. She had time for lunch so we had a fabulous, fabulous time catching up. It is such a pleasure to be able to drop the "student-teacher" relationship and an absolute honour to now call this remarkable woman a friend.

Tonight I am richer in more ways than one.

9 Days of 2008

2008-01-09T19:05:00.000-08:00

1. I am swamped under two manuscript revisions. This is good news because it means that two of my research articles have been accepted for publication, both pending nothing more than minor revisions. This is bad news because I have oh so much other work to get through as well and so the minor part of minor revisions is not feeling so minor.

2. I think I have solved the kitty poop-all-over-the-place and pee-on-Dr.-K problem. The solution appears to be a second litter box, located strategically at the foot of the bed. Kitty appears to adore his newest litter box and has abandoned his other one (although it is still there and is as clean as his new one). Of course this means that kitty wakes me up in the middle of the night while peeing and/or pooping in his new litter box. This is very unpleasant but much more pleasant than kitty waking me in the middle of the night while peeing on me/the bed.

3. I think I may have bed bugs. Think. Yuck! I followed a "find out if you have bed bugs" flow chart that I found online and that told me that I do not have bed bugs. Which of course makes a whole lot of sense because where on earth would they have come from?? But if these darn bites on my body aren't bed bug bites then I am baffled.

4. I am asking for a raise tomorrow. Wish me luck.

5. The next time that I am driving downtown on a dark and rainy morning and a pedestrian -- dressed all in black -- darts out into the road in front of me against their signal then I won't bother slamming on the brakes. Colour me cranky, but I am sick and tired of such adrenaline rushes before my first cup of coff-ay.

6. I seem to be suffering from insomnia lately. This may be a contributing factor to point #5.

7. Today I chatted with one of my favourite first-year medical students. She is very excited about everything and simply bursting with energy for what she is currently learning. I smiled sadly as I listened to her because she does not yet know that she failed her last examination. Results will be made available to her next week. Sigh.

8. Next week I have an appointment with a fourth-year medical student who wants to drop out, quit medicine forever and yet has no idea what else he wants to do with his life. Sigh.

9. I have started to assemble my tenure and promotion dossier, which will be submitted this year. I am already drowning in paper work. This may be a contributing factor to points #1, #4, #5 and #6.

9 down. 356 to go.

I Couldn't Say It Any Better

2008-01-01T11:21:00.001-08:00

Here's wishing peace on earth.

Cheers to 2008

2007-12-30T10:45:00.001-08:00

"An optimist stays up until midnight to see the new year in. A pessimist stays up to make sure the old year leaves."
(- Bill Vaughan)

Whichever one you may be, I wish you nothing but the very best for 2008. Happy new year!

B.O.R.E.D.

2007-12-20T22:19:00.000-08:00

I've now had two days off from academia and I am officially bored.

Students: while I very much hope that you enjoy your break, I am already looking forward to your return because of the intellectual challenge(s) that you present to me on a daily basis.

Thank you for those challenges. Happy New Year!

Bloody Amusing

2007-12-16T10:52:00.000-08:00

On Friday I was in my office when my secretary knocked on my door and presented me with a package, delivered by campus mail. I opened the package and found a glass slide, along with a note from my hematopathologist colleague and friend:

"Here's a bone marrow smear that I thought you would enjoy. Merry Christmas!"

Best. Present. Ever.

[Why? Because not only do I get a kick out of a particularly good bone marrow preparation but I also use bone marrow smears in some of my teaching.]

Kitty Update

2007-12-08T21:57:00.000-08:00

We are waiting for the results of blood and urine analyses.

All reflexes checked out a-okay. This makes me very happy.

Kitty is currently curled up beside the warm box (heater) and is very happy to be back home after 4 hours at the vet hospital today.

Sunday night update:

Blood and urine all normal except for - very unexpectedly! - a slightly elevated blood glucose and traces of glucose in his urine. Just. Didn't. See. That. One. Coming. No signs or symptoms of diabetes at all. In fact, he has gained weight (0.5 lbs) since his last trip to the vet ~ 2 months ago. It makes no sense. Next: we are waiting for a serum fructosamine level for clarification.

Final update:

Fructosamine was normal -- no diabetes, thank goodness. Vet is calling kitty an enigma. That's fine with me as long as he's a healthy enigma.

Exam QuestionsQuestionsQuestions

2007-12-07T20:11:00.000-08:00

If Dr. A delivers a lecture on subject x and Dr. B follows that with a second lecture on matters related to subject x, then why does one Dr. K receive pre-exam email questions about both lectures on subject x?

(I'm happy to help by providing answers, but I am more than a little bit puzzled by this.)

Beloved Kitty

2007-12-06T12:18:00.000-08:00

Readers may remember that over a year ago my beloved 15 year-old kitty suffered from a rather bizarre blood clot that left him knuckling and unable to use the distal portion of one his rear legs. Readers may also remember that he made an unexpected but remarkable recovery and, approximately 8 months following the clot, he was back to normal.

That's not to say that the time since then has been smooth sailing. Since then he has been diagnosed with heart disease and hypertension. Medication and medication. He developed a lump on his leg that concerned his vet very much until it just fell off. No kidding. One day there, the next day gone. Bizarre. He next developed a similar lump on his chest that grew and grew and now appears to have stopped growing but bleeds ever so slightly, leaving a quarter-size blood stain if kitty lies in one place for a period of time (thank goodness for Nature's Miracle!). More medication in the hope that it was infection or inflammation. No such luck.

Now, new problems have started. About two weeks ago he stopped using his litter box for defecation. He just poops at will, all over the house. Now this obviously is not all that desirable but when you love your furry little guy as much as I do, you simply cope with it -- and watch where you are stepping. Nothing had changed in his environment, so I chalked it up to old age and figured that someday I'll probably reach the same stage and won't I be thankful that someone will pick up after me without making a big deal out of it?

Last night things got to the point where they can no longer go without medical attention. Beloved kitty jumped into my lap the moment that I sat down (completely normal behaviour) and proceeded to purr and kneed his paws into me (again, completely normal behaviour). Without missing a beat he next proceeded to urinate all over me (thank goodness for Nature's Miracle!). It happened again at bed time -- the joys of changing sheets and cleaning up urine (thank goodness for Nature's Miracle!) at 11:30 at night simply cannot be expressed with the written word alone.

The poor little guy seems to have lost control of his body's functions.

This morning I called the best veterinarian on the planet and he agrees that this is really odd. He asked whether beloved kitty even appeared aware that he was urinating and the answer was "nope, he went right on purring". This, combined with the inappropriate defecation, makes a UTI quite unlikely. The best veterinarian on the planet thinks that beloved kitty is suffering a nervous system problem and wants me to bring kitty in for a system check.

Hence it will come to be on Saturday morning that beloved kitty will be taken to the vet to have things poked up his anus to check for sphincter tone, will have his bladder expressed manually and likely will be zapped with some x-rays.

The poor little guy.

I've told him many times that he must live forever but apparently he is ignoring me, one medical problem at a time.

It's really all quite heart breaking.

Priceless Part II

2007-11-28T10:44:00.000-08:00

A lottery scratchcard has been withdrawn from sale by Camelot - because players couldn't understand it.

The Cool Cash game - launched on Monday - was taken out of shops yesterday after some players failed to grasp whether or not they had won.

To qualify for a prize, users had to scratch away a window to reveal a temperature lower than the figure displayed on each card. As the game had a winter theme, the temperature was usually below freezing.

But the concept of comparing negative numbers proved too difficult for some Camelot received dozens of complaints on the first day from players who could not understand how, for example, -5 is higher than -6.

Tina Farrell, from Levenshulme, called Camelot after failing to win with several cards.

The 23-year-old, who said she had left school without a maths GCSE, said: "On one of my cards it said I had to find temperatures lower than -8. The numbers I uncovered were -6 and -7 so I thought I had won, and so did the woman in the shop. But when she scanned the card the machine said I hadn't.

"I phoned Camelot and they fobbed me off with some story that -6 is higher - not lower - than -8 but I'm not having it.

"I think Camelot are giving people the wrong impression - the card doesn't say to look for a colder or warmer temperature, it says to look for a higher or lower number. Six is a lower number than 8. Imagine how many people have been misled."

A Camelot spokeswoman said the game was withdrawn after reports that some players had not understood the concept.

[Source.]

Priceless

2007-11-27T20:11:00.000-08:00

From an on-line customer review of a restaurant that we are interested in visiting:

"My friend and my fork were dirty. One of them had residue on it."

And (same person):

"I expected chicken in my dinner but there was no chicken in my dinner. I asked the waiter and he said that the chicken went out. I was upset because the chicken went out before I ordered and nobody told me that the chicken went out."

I really, really, really wish that I could make this stuff up.

You Can't Win 'Em All

2007-11-24T13:09:00.000-08:00

As faithful readers are aware, I am in my pre-tenure year. This means that I am busy assembling documentation to prove to my medical school that they cannot possibly live without me, that I am likely on my way to winning multiple Nobel Prizes (even if they may be Ig Nobels) and that the University should not hesitate to give me a permanent, lifetime place on pay roll.

Part of all of the documentation is teaching evaluations -- both peer reviews and student reviews. Student reviews are not new to me; I have requested them for every class that I have taught during my time here. What is relatively new is my reaction(s) to students' teaching evaluations.

In my earlier teaching days, negative comments used to devastate me. I would manage to overlook all of the positive comments and focus only on the negative. This, obviously, is not sustainable if one wishes to remain within the general population rather than on the psychiatric ward of the local hospital. So I have learned to look at the big picture and to use that to determine whether I am teaching effectively or not.

Taking the good with the bad and looking at the big picture, student evaluations have been a valuable resource for learning what I am doing "right" and for learning how to improve my teaching. There have certainly been comments that I have ignored over the years, but most of the students' suggestions for improvement have caused me to pause and consider the value of the comments and how I can make use of the comments to improve the teaching and learning process.

As such, my student evaluations have improved over the years and I am told by the evaluations unit that I now consistently score at the top of all student evaluations that they process for faculty within the medical school. I am good at the teaching aspects of my job and students appreciate me. It took me many years to get to the point of being able to type/say such a statement and really believe it. It's a happy place to be.

Yet, no matter how I try, I simply can't win them all. Here's proof from a lecture evaluation that I received this past week. In the "comment on the strengths of the lecture" section, I can extract student comments such as these:

a very passionate and clear communicator
a great prof ... very approachable
her passion for and understanding of <subject x> is clear
the lectures are clear, limits confusion and gives students confidence in her
she is an excellent lecturer
extremely approachable with a great sense of humour
genuinely enthusiastic about the material
she makes it easy to learn
very enthusiastic and her interest in the subject matter was very clear
enthusiastic and clear
very skilled and interesting speaker
relaxing tone of voice
clear and articulate speaker
efficient and engaging speaker
in my opinion, one of the best lecturers I've had so far in medicine
she has passion about her students' learning

You get the idea.

In the "suggest how the lecture may be improved" section, one student wrote:

I found the lecture dry and lacking in enthusiasm. Not a good presenter.

*sigh*

As I said: you simply cannot win them all. So my advice to more junior faculty is: take a deep breath and remember to look at the big picture. Otherwise you'll simply drive yourself batty.

Lazy Sunday Lunch Bliss

2007-11-18T14:24:00.000-08:00

Anniversary: Dying In Your Next Moment

2007-11-11T22:38:00.000-08:00

I wrote this post a year ago. I think it's important to remember -- especially today -- all those that we have loved and lost, regardless of how we lost them. Rest in peace, friend. You are still missed two years on.

-----------

It's close to the one year anniversary of the death of a friend who lost a struggle against mother nature and drowned.

I've been thinking of my friend's final moments a lot and I believe that I have some understanding of it all.

Have any of you ever thought you were about to die in your next moment on earth? What went through your mind?

My experience was being caught in a rip current off of the coast of Africa. We had been enjoying a day at the beach and decided to go for a swim in the Indian Ocean.

We floated on our backs, staring at the African sky above us and feeling not a care in the world.

M, who was floating beside me, said something to me and I righted myself in the water to reply. I instantly knew that we were in trouble. Not only had we drifted far from the shore, but there was a giant wave preparing to crash over our heads.

I went under as the wave hit and then felt myself being pulled by a strong current. But I surfaced, gasping for air, and saw two things that scared me even further: M was now much further from me than he had been and there was a second wave preparing to crash over my head. Again, I went under and again I felt the current pulling me. I fought the current and tried to swim back to shore (big mistake - I now know to swim parallel to the shore, not toward it, when caught in a rip current) and I knew that I was in a situation that I didn't have the slightest idea how to cope with.

This time when I surfaced, M was much closer to me. I vividly recall looking at him with what I am sure was panic and saying "oh, M, I need help". The look in his eyes changed instantly as I think he became immediately aware that I was not kidding.

Another wave crashed over my head and forced me under the water. I was struggling to get enough air in the moments between waves and I was beginning to panic. I realised that I was being pulled further from the shore.

The next time that I surfaced, M was somehow right there beside me. He was speaking to me, trying to calm me down. It wasn't working. The next wave crashed over both of us and we went under the water together.

I remember opening my eyes and seeing M in front of me and he was holding onto my hand. Tightly. But for reasons that I still don't understand, I was being pulled further out and he wasn't. We struggled to hold on to each other's hands and we kept very direct eye contact for the entire time that we were under the water.

And then my hand slipped from his and I was being rushed away from him. I felt a complete loss of hope combined with an overwhelming rush of love for M and the life that we had together. It was literally all slipping out of our hands. The thought that went through my mind? "No! This isn't fair! Why am I going to die and he gets to live?"

I'll let you make of that thought what you like because I am still now, so many years later, trying to understand it myself. I feel immensely guilty for thinking it.

The series of events that followed are a blurr for me. I gave up. I remember M and his friend S coming to my rescue together. S is a trained life guard and knew enough to get me moving parallel to the shore to escape the rip current. I say moving because I was a panicked person preparing to die at this point, so swimming was not on my radar screen.

The next really clear memory that I have is finding myself magically back on the beach, on my hands and knees, gasping for air.

I looked up and saw M. He smiled at me with a twinkle in his eye and said "wow, that was a close call". And I actually laughed. We then calmly packed up our things and headed to the local pub for a stiff drink.

M and I never spoke of it again and I never loved him the same again. Because it became a previously unrealised impassioned love. I frequently think of that change when I recall the eye contact that we maintained and the physical contact that we lost in the midst of the rip current.

I was lucky in every way. My friend died alone in the ocean in the middle of the storm. I have no doubt that she knew that she was going to die; it just became a question of when. We know that she fought for a few hours (horrible details omitted). We don't know when the when became a reality for her.

It haunts me that she died alone. She didn't have a chance to speak with or make eye contact with the one(s) that she loved and, when she finally gave up, there was no one there to get her to the beach and onward for a good stiff drink.

Nobody should die alone. Under any circumstance. But to die alone with panic and fear and an overwhelming loss of hope ... well, it simply is too much to continue to think about.

Rest in peace, friend. You are missed.

To Ponder

2007-11-11T14:57:00.000-08:00

If two Professors -- who are co-directors of a major medical school course -- fly on the same airplanes to and from a conference, then is that the academic equivalent of the President and Vice-President taking the same flight?