when NOT to compliment a lady.

had my well-woman workshop today. this is where we learn how to perform a medical exam on a "healthy" woman. it's like a physical but for women. so on top of the usual things like BP check, listening to the lungs & heart, you also have a breast exam, a PAP test and a bimanual exam. so basically all the stuff i learned during my elective.

unfortunately in classic SOM (school of medicine) fashion, they managed to suck all the fun and life out of the well-woman exam. case in point, in the student preparation notes it reads:
"avoid referring to a client's breasts/vagina/cervix as beautiful/wonderful etc. this description can be interpreted as sexual in nature. a better alternative is to describe the client's vagina and cervix as healthy or normal."

healthy or normal?? how mundane.
besides, women LOVE creepy doctors that comment on the attractiveness of their private parts. no? ladies, back me up here!
;p

give me my money!

i finally got my OSAP for the school year. in case you didn't know i started in january. JANUARY! that was 6 months ago! goodness gracious. silly government.

did you know... that the provincial government of alberta provides it's students upwards of $30,000/year in student loans. compare that with OSAP which gives you a measly $8400. pft!

back on the horse.

after a week's hiatus, went running again today. went to the city and back.
it was brisk.
(i'll let you decide whether i'm referring to my running speed or the outside temperature).

5 year, 10 year, 25 year plan?

i've been sitting on this post for a few days. don't feel like i'm getting my ideas out coherently but i thought i'd just go ahead and post it.

*****
been thinking about my future quite a bit lately.
not just about what i want to specialize in or what my first car is going to be (i'm thinking something on par with a mini cooper s???). been thinking about marriage, kids, career...

well the marriage & kids part usually requires another consenting female. put that on my need-to-obtain list. the dilemma boils down to all the things that i WANT to do & all the things that i feel i NEED to do.

so what do i NEED to do?

• pay off my ever increasing debt.
  
• get married early enough to have 4 kids without the repercussions and the associated health risks with having kids at an old age.  (yes i said FOUR kids.  and yes, i will find someone agreeable to this! :p)

and my WANTs...

• Canadian Forces. i started looking into the canadian forces in an attempt to find a way into med school. then i started looking at it as a way for me to pay off my tuition in a hurry (there is a decent sized signing bonus). but the more i think about it, i think i WANT to do. for lack of a better word, i think it'd be... cool. ok, i won't lie. i think it'd be pretty cool to fire a live weapon. what can i say? i'm just a little boy at heart. plus you get to see parts of the world you'd never get to see otherwise! i'm not saying i want to be an army guy for the rest of my life. just for a few years.
  
• i also want to do something like MSF for a year or two. ideally it'd be with a organization that has no political or religious agenda.
  
• start the next phase of my life. i want my own family. my own wife, my own kids, my own dog, my own house & my own porsche sitting in the driveway.

as you can see there is no order in my wants and needs. some of the things i want can't go with some of the things i need - how am i possibly going to pay off my tuition when VOLUNTEERING for a group like MSF??? heck, some of the things of the same list aren't even compatible with each other! i don't want to be in somewhere in afghanistan when i have a family with kids!

i think this guy sums up what i'm feeling deep down. (thanks mike for the heads up). hopefully i can look back in 5,10 or even 25 years and think, yes it was worth every night-in. every stress-induced freak out. worth every single sacrifice.

don't know why i feel like my head clock is ticking louder than ever. can't you hear that? it's going TICK! TOCK! TICK!! TOCK!!
i know i'm getting WAY ahead of myself and that i just need to take things step-by-step. my dad used to tell us this all the time...

i stole this photo shamelessly & without permission from my friend julie's facebook profile pic. it translates into something along the lines of... let's be happy. and... do when you do. as in play when you're supposed to play, and work when you're supposed to work. i'm pretty sure i'm supposed to work right now.

pretty good.

just got home from watching the dark knight. i thought it was pretty good. heath was pretty crazy. probably the best movie i've seen all winter (north american summer). better than iron man, better than kung fu panda and DEFINITELY better than indy. i hear that wall-e is quite good, but that doesn't open up down under until mid-september or so!
but this movie's left a bad taste in my mouth. i feel that making this movie definitely could've pushed heath over the edge or at least contributed. i know it was an "accidental overdose", but...

Etihad!

don't worry. i didn't just swear at you in some foreign language. etihad is actually the airline that i'll be taking home in november! yay! it ONLY cost me a smidgeon over $2400. it's pretty direct, i fly brisbane to abu dhabi and then from abu dhabi to toronto.
i know what you're thinking. "i've never even heard of etihad before. and where the heck is abu dhabi???"
Abu Dhabi is actually the capital of the United Arab Emirates (UAE) and is the 2nd largest city behind Dubai. my layover is only a few hours but i've never been to the UAE so it'll be cool.
as for Etihad, it's a fairly new airline. it was founded in 2003 and is actually the national airline of the UAE. it's in direct competition with it's 'older brother' Emirates Airlines. from what i've read so far the service is quite good and flights are never delayed.

my roommates have been busting my chops for flying with Etihad. so i did a little research. according to JACDEC (Jet Airliner Crash Data Evaluation Centre), Etihad (0.00) has a better safety index than Air Canada (0.04), American Airlines (0.22), British Airways (0.03), China Airlines (1.52) or Korean Air (0.87).
For completion sake, Cathay Pacific and Qantas also have a safety index of 0.00. without going too much into detail about the math behind the safety index, simply it is the number of fatalities/terametre. a terametre is 10^12m.

so if i survived a round trip on china airlines, i should be fine on etihad. right??? right.

*****
in other news. i took my photo for trephine (which is our yearbook - only the 2nd years get a yearbook). nothing fancy, just really casual. but i think i came out looking like a huge dork. i'm sure the hair was perfect :p but i think i had this goofy little smile on my face. oh well.

*****
did you hear? the "ice...cccoooooold...beeeeeeeeer!!!" guy (his real name is wayne mcmahon but everyone calls him the ice-cold-beer-guy) from rogers centre was fired recently. all you jays fans should know who he is. apparently he sold a drink to a 22 year old mystery shopper without checking out his ID. i'm told that the policy at rogers centre is to check all ID for anyone who looks less than 30. there's now a facebook group petitioning for his job back. it's now up to 18,000 members. that's impressive.

*****
haven't been running in the last few days. partly because the weather has been lousy and partly because i've had stuff going on right around my normal jogging time - around 4 in the afternoon. but mostly because i've been a tad lazy. the last run i did was on friday to the city. that was almost 11 clicks.

it's actually a really nice run. right along the river. should probably run it again today.

gummy bears.

came home today after clinical coaching and watched some Kaplan videos while eating gummy bears.

and then i got a little bored and distracted.
>.<
ok. back to the books.

excerpts from "an imperfect offering" by james orbinski

pat had left this book for me when he came to visit. it's written by dr.orbinski, a toronto doctor who was at one point the international president of Médecins Sans Frontières. he writes about his experiences in various war-torn countries around the world - in particular rwanda. although it reads like a history textbook in some parts, there were about a dozen pages or so that i dog-eared and i just wanted to share a few of these with you here. if you get a chance, it's worth a read.

life isn't fair. (page 57)
" one day i was in a small village near Mugonero to help with a polio vaccination campaign. the clinic was in the middle of the village, and because our jeep had broken down on the way we were an hour late. babies were crying. the air was humid and heavy with the heat. still, mothers had come from all the neighbouring villages and lined up in the hundreds with their infants to get the vaccine. we'd been working for about an hour when one mother gently pushed her baby boy into my chest. he was beautiful, and so was she. she held his leg out to me. it was limp. i took the boy, and he smiled at me. he was a fat and happy baby who smelled of soap. his mother started to speak, and the nurse translated, telling me that his mother wanted me to fix his leg. she said he couldn't crawl like the other children and had been dragging the leg behind him for the last few weeks. i looked at the boy's health card as he played with my stethoscope. he had already had two doses of the vaccine. this was to be his final booster. twice his mother had bathed him in the morning and walked miles to stand all day to get him the vaccine, and twice the vaccine had failed. the problem had to be the cold chain - the vaccine had to be kept cold right up until it was used, otherwise it deteriorated. the boy started to cry, wanting to go back to his mother. "she has three daughters. he's her only son," the nurse said. i explained as gently as i could that the leg was never going to work properly. the mother stepped back from me as i spoke, holding her now happy baby to her chest. rwandans rarely cry in public. for a brief moment, tears came down her cheeks. i reached out to touch her arm. i noticed the calluses on her hands as her son wriggled to turn to face me. i felt my own soft white palms with my fingers. through the translating nurse i suggested that when the boy was older the mother could bring him to the Mugonero Hospital to see about a brace. she listened carefully, saying, "nnn, ehhh," and finally "yego" as the nurse spoke.

the nurse told me that the mother had cried because she knew her some would be a bicycle-chair boy. "but he can go to school too," i said. "no," said the nurse, "they don't have the money for both." by now the mother's few tears had dried, leaving faint white salt marks on her black face. she bowed her head to me, turned and walked away to some waiting friends. i left the line to buy a fanta, and it started to rain. the drink had been kept cold in the cooler at the roadside stand. i sat down on a big rock. the children laughed at the muzungu sitting in the rain while michael jackson's "thriller" played on a battery-powered ghetto blaster. the clinica can't keep the fucking vaccine cold, i thought, and i hoped that the rain would mask my tears. "

only humans. (page 253)
" she said that she had escaped being killed by the Interahamwe. "my mother hid me in the latrine. i saw through the hole. i watched them hit her with machetes. the men were angry and strong. i watched my mother's arm fall into my father's blood on the floor and i cried without noise in the toilet." i listened to her and watched her lips quiver as her words came at a slow, staccato tempo. i watched her brown eyes look away as tears dropped to her cheeks and i could not stop my own.

at that moment, i felt both despair and rage. despair that she knew intimately our capacity for the most extreme rational cruelty; that she was alone. animals could never do this. animals can be brutal, but only humans can be rationally cruel. we can choose anything, we can be anything, we can get used to anything, i thought. only humans can be evil. only humans can make this choice. i felt my heart pounding and i wanted a gun. i wanted to kill the men who had done this to her. i wanted to pull the trigger again and again and again. my heart was racing; i was fighting my tears, gasping for air, for freshness, for something other than this. then eli clasped my arm with his strong hands. i felt an overpowering despair for the little girl, for myself, for all of us - that we can be alone, trapped in our passions, in our reasons, in our minds, in our politics, that i and those men could be so angry and strong. "

because we can. (page 349)
" at one point during one of our meetings the minister had expressed his fascination with 'you MSF fellows and ladies. why do you do it?' he asked.
i replied immediately, 'because we can.' "

pushing my lactase enzyme limits.

now i'm not normally lactose intolerant. but i think 2¼L of milk in less than 15 minutes is definitely more milk than my gastrointestinal system can handle.

let me give you the story as to WHY i drank that much milk...
it was our friend mike's birthday so we had him and a couple of close friends over for dinner. after dinner we decided to play some poker. being poor medical students we decided not to play for money. instead we went for the positive punishment approach. you had the option of...
(a) eating pieces of cake

(b) eating teaspoons of salt
(c) drinking cups of milk (in 500ml cups)
(d) drinking cups of water (also in 500ml cups but times 2 because water is much easier to drink)
the amount depended on the order we finished in. so for example, the first place person just had to have 1 serving of a, b, c, or d. i tied for fourth (i had crap hands all game) and so i had to do 4.5 servings. i chose the milk cause eating that much salt is just disgusting, i was way too full for more cake, and 9 cups (close to 4.5L) of water was just way too much volume - remember this was just a few hours after a FULL dinner with cake and everything.


feeling alright after downing the milk.

although i don't regret my choice, i'm paying dearly for my actions of yesterday. the first couple of hours were alright. i was just REALLY full. but then the runs started. i went THREE times last night and already twice this morning (and it's only 7:30 in the morning!). good thing we splurged on the 3-ply-extra-soft TP this week.
uuuggghhhh.... this is almost as bad as a hangover.
>.<
good times though!

10k!

i broke the 10km mark this afternoon.

will probably look to find another running route though. this one is quite hilly (which i don't mind too much) but there are portions where you have to run on the road cause there is no sidewalk. THAT i didn't like too much. maybe i'll run to the city & back next time. i think that's about 10 clicks.

felt pretty good. my right shin was killing me though - what's the mechanism behind shin splints anyway??? in terms of heart rate and resp rate, was feeling alright.

*****
Edit: just googled shin splints and this is my understanding of it in a nutshell. your shins have muscles (e.g. tibialis anterior) that dorsiflex your feet (pull your toes close to your shins). now when you run, you often get your heel striking the ground quite forcefully with each stride. this triggers a chain of events. the heel strike causes a strong plantar flexion (pointing your toes). this stretches the muscles (esp. the aforementioned tibialis anterior). this stretch then causes a reactive/reflexive contraction of these muscles. this forceful & reactive contraction is what gives you the pain of shin splints.

the good thing is that like any other muscle within the body, the tibialis anterior muscle can be strengthened & shin splints will eventually go away. apparently stretching helps too.

frayed connection.

i love my macbook.
but i loved it just a little less this week. why? cause the cable on the power adaptor was frayed. :( besides being a HUGE fire hazard, it stopped working! so i couldn't recharge my laptop.

i took it into an apple-approved authorized reseller in brisbane (did you know that there aren't any APPLE stores in brisbane? as a matter of fact, the only official APPLE store is in sydney! how ridiculous is that? stella was right. australia IS a third world country! haha)
but it's all good now. they've replaced it with a brand new one - free of charge.

now i ♥ my  again.

running log.

just came home from a run.
am trying to lengthen my runs. the route that we've been doing is only about 6km. this morning, went for a 7.5km run.

thanks to ms. cinshum for this runningAHEAD site.

people to talk to.

i'm not exactly a model christian.

on the best of days i'm a believer with one foot still on the ledge of what i would like to think is "right". cause i don't think the church is right about everything. (we can discuss this on a less public forum if you'd like).
on the worst of days i'm a skeptic and a cynic.

but what i lack in faith i make up with good people around me (& 15,000 km away). we may not agree on everything but we can still have a good discussion about it. you know who you are.

gas prices are killing me!

last year i flew home during the x'mas holidays for about $2300. if you recall it wasn't the safest airline and it wasn't the most direct route (i flew brisbane to taipei, taipei to vancouver and finally vancouver to toronto). however it wasn't that bad. service was good, no major delays and no baggage lost.

but this year i thought i'd pay the extra few hundred dollars and fly home directly (e.g. Brisbane-L.A.-Toronto) to avoid the ridiculously long stopovers. i might have to rethink this option though. that direct flight is going to cost me a cool $3400. the flight route i took last year will cost me an extra $600 - so $2900 this year.

man. that's brutal. maybe i should just stay in brisbane...
thoughts???

bashing surgeons.

during my clinical coaching session today, we were running to catch an elevator and our coach stopped the closing doors by putting her hand in between them. that prompted this mini conversation inside the elevator:

coach: have you heard the one about the surgeon trying to catch the elevator?
us: no.
coach: so a surgeon is running to catch the elevator and the elevator doors start closing. so he sticks his head in between the doors.
us: why?
coach: cause he needs to protect his hands.
:D
i don't think there were any surgeons in the elevator.

mmm... smells like home.

a little tidbit about me. i love irish spring soap.
a little tidbit about australia. australia doesn't have irish spring soap.
:(

i had asked my brother to bring me a couple of those fresh-smelling green bars of soap over with him. he didn't bring a couple. he brought a whole package!

i cracked into it today. it was the best shower i've had about 6 months. ok. so maybe i'm exaggerating just a little bit and maybe even being petty. but seriously i LOVE it!

10 year moratorium.

yesterday the UQMS (UQ medical society) held an international students seminar/info night. with the increasing number of international students (mostly from canadia) they were kind enough to have some upper years and representatives from the school come and talk to us.

i found it really useful - yet slightly frustrating.
some upper years who recently wrote the USMLEs talked to us about the steps involved in arranging for the exam - which some would argue is a challenge in itself! we also got a timeline for writing the MCCEE (canadian boards) and perhaps even staying here in australia.

the frustrating part is that are there no hard & concrete answers. even the reps from the school of medicine couldn't give us straight answers. everything is fuzzy and all the information/rules are constantly changing. but from my glass-is-half-full perspective, this is what i got from the lecture. there are no guarantees with regards to internship/residency spots in australia, canada or the US. however like the adidas slogan, nothing is impossible. it may not be easy but NOTHING IS IMPOSSIBLE.

i can work with "not easy". heck, getting into med wasn't easy. and from what i've done so far, med school isn't easy. why should getting a job be. right?

*****
i've made up my mind. i'm writing the USMLEs this winter.

*****
when i first came to australia, i had full intentions of returning to canada. however, i was also open to the idea that if i really liked brisbane/australia, or opportunities unavailable in canada came up, or whatever, i would consider perhaps even staying in australia. but after friday's seminar this doesn't seem like such a great option. in australia, there is something called a "10-year moratorium" for people like me. people with a medical degree from australia (or hopefully will have one in 2010) but don't have PR status. this means that in exchange for a internship spot, they can control (to a degree) where you work for the next TEN years! in a nutshell, for 10 years after either obtaining my PR status or becoming a fully licensed physician (whatever comes last), i will be forced to work in an under-serviced region/placement. this general concept is not unusual per se. most places enforce a "return-of-service" or a "moratorium" on international graduates/non-citizens. this is done in an attempt to offset the huge demand for doctors in rural areas. what's unusual or RIDICULOUS is the length. for example, i believe the return-of-service scheme in ontario is only 4 or 5 years or so.

TEN years? i'll be in my mid-30s by that point! gosh that sounds old!!!