Deck Them Halls

I've usually had a very Grinch-like attitude toward Christmas, finding it hard to muster up any enthusiasm for the holiday. For as long as I can remember, Christmas has been about driving up to my grandmother's house and eating a meal of turkey and rice pudding with my tiny Canadian family, people who I already see every week.

After the meal, we settle down in the living room and unwrap presents that we actually bought ourselves before handing them over to the gift giver a couple days prior to Christmas. I always do my best to feign surprise and slap on a smile while someone snaps pictures.

But this year I decided to rediscover the Christmas spirit. I was inspired to this end after flipping my journal over to the very first entry: December 25th, 1999. I had scribbled over five pages with excited musings about all the wonderful things about Christmas; the contents of my stocking, gingerbread cookies, my new N64, etc, etc.

Yearning to feel the Christmas spirit once again, I threw myself into holiday activities. I went to two Secret Santa parties and then carolled for charity in a beautiful Victorian neighbourhood in Dundas. The families in those Dundas homes would open the door, look at us suspiciously, and then break out into smiles when they realized we wanted to sing for them. It was almost always a happy response. In return for "Silent Night" or "Jingle Bells", they would take our information pamphlets, donate money or even, in one case, serve us giant fresh pretzels from their oven.

I also decided to put the "surprise" back into gift-giving, which involved a very successful trip to Walmart. One hundred dollars and eight cents later, I had a box of dark Swiss chocolates and "Chicken Soup for the Christian Soul" for my grandmother, a set of cherry candles for my mom, a warm fleece blanket for my sister, and special collectors' DVD box-sets for my uncles. My dad normally refuses gifts, but I bought him a box of cashews anyway. I wrapped each gift nicely and included a hand written card - although they were pretty simple, they didn't fail to delight.

Unfortunately I can't say that my own presents were much of a surprise: a gift certificate to Chapters, a fat check, a sweater, socks and a $40 pen that exploded all over my hands. And yet I'm still glad that I put serious effort into injecting some spirit into the holidays. Because, in the end, Christmas is what you make of it. It could be a cold and lifeless affair, or it really could be the most wonderful time of the year... even for an ex-Grinch like me.

Our Own Worst Enemy

Medical school was supposed to be stressful and exhausting, but my experience at McMaster hasn't borne that out so far. Even though my schedule is typically packed with tutorials, clinic time and studying, I’ve always managed to find pockets of time to relax and socialize.

It helps that McMaster has taken strides to encouraging a work/life balance in its curriculum. Even the keynote speaker at this year's medical student conference, Dr. Marla Shapiro, talked extensively about her belief in self-care through the framework of her experiences with cancer.

But there are tough times on the horizon. During their residency, perhaps the toughest part of a physician's career, a resident will likely do a 28-hour shift. If you think it seems a bit unreasonable to allow an inexperienced doctor to suture cuts while being extremely sleep-deprived, then you’re not alone. The province of Quebec has capped the maximum shift rate to 16 hours, citing the fact that exhaustion chokes off cognitive and motor functions.

As far as I’ve gathered, the 28-hour shift doesn’t actually serve any true medical or educational purpose. Instead, it’s a rite of passage into the medical profession that has continued on for generations (up until recently, it was actually 36 hours instead of 28 at many hospitals). This “rite” is borne out of the traditional conception of a physician in the West as being infallible to normal human weaknesses like stress and fatigue. Before the era of House and Grey’s Anatomy, doctors were routinely portrayed as being all-knowing father figures who could handle any emergency that came their way.

Dr. Ben Casey: surgeon, hero

and manly man. A fairly typical

TV doctor in the early 1960s.

But these views have rapidly changed over the past couple of decades as evidence has shown that doctors have a relatively high rate of suicide amongst professionals. Looking at my classmates and myself, I realize that we’re just as vulnerable to burn out as anyone else, and it’s easy to see the negative effect of exhaustion on the provision of care. When we’re physically and mentally exhausted, our emotions become blunted and we’re less able to empathize with our patients. We miss the nuances and subtleties in patient communication, or we just become too tired to even care. 

At a conference I once attended, a doctor recounted a story about a particularly gruelling clinic shift. After working for 20 hours straight, he had finally fallen into a nap when a patient called in with chest pain. The doctor, who was exhausted, brushed it off as indigestion (the patient had a history of this), even though he knew there was a possibility that it was a heart attack. After waking from his nap several hours later, the doctor panicked and called up the patient, half-expecting him to be in serious trouble. 

Fortunately it was indigestion after all. Was the physician at fault for not getting up? Absolutely. But at the same time, it's also true that the medical system put him in a position where it was very easy to miss a critical diagnosis. Are our resources really stretched so thin that we can’t afford well-rested doctors?

Sadly, in this regard I think that doctors are their own worst enemy. There's still a strong attitude within the profession that we should be totally resilient to stress, that we should be able to provide care but never have to accept it ourselves. In reality, even though we made it through the gruelling admissions process of medical school, we're still vulnerable to burn out.

Ultimately, a well-rested doctor is so much more capable of communicating with patients and synthesizing information, skills that are essential to accurate diagnosis. By learning to take care of ourselves, we become better care providers. While med schools may be holding more lectures on stress management, deeper institutional reforms are needed to make a real difference. 

Sweet Surprises

Standing in the maternity ward room last week, I couldn’t help but wonder whether I’d been assigned the wrong patient. My task was to perform an abdominal exam on someone who’d just delivered her baby, and yet the woman lying in front of me had a hugely distended abdomen. There shouldn’t still be a baby in there, I thought.

She suddenly opened her eyes and wearily looked me over.

“Hi,” I said nervously, “Are you Ms. So-and-so?” She nodded. Yep, right patient. Pressing my stethoscope against her stomach, I heard all the normal bowel sounds. Wait, was that the baby kicking?

As it turned out… no, no it wasn’t. Behind me, a nurse wheeled in a small bed with a tiny newborn happily perched in its centre. The mother broke out into a tired smile. “That’s my son,” she said proudly.

Surprise! A woman’s uterus remains enlarged for days after she delivers the baby, before it eventually shrinks back to its normal size. The uterine muscle inside becomes so thick over the course of the pregnancy that it could probably mug an old lady on the street.

Day in and day out, medicine has never failed to surprise me since I started here at McMaster. Now that I’ve wrapped up my first semester or “foundation”, I can only look back at the last three months and marvel at all the weird yet wonderful things I’ve seen and done. It’s been the most intense period of my life, a rollercoaster ride through success, failure, exhaustion and jubilation with a healthy dose of surprise.

First of all, I’m really surprised about how much I’ve enjoyed working with patients. Before entering med school, I kind of assumed that I would branch off into a more research or teaching-based specialty with minimal patient contact. The thought of having to drain pus-filled abscesses, suture wounds and do prostate exams on a daily basis didn’t seem particularly appealing.

And yet I’ve come to love being in the clinic. Yes, it’s messy, stressful and endlessly frustrating, but it’s also invigorating to be in such close contact with the human experience; to share in people’s lives and stories while feeling like you’re in a position where you can actually help. The cases do tend to get repetitive, but for every one hundred episodes of diarrhea and headache, there always seems to be that one case that touches you. 

Recently, a four-year-old boy came into the clinic with a cough and fever. With a short thatch of red hair and big, expressive brown eyes, he instantly reminded me of Puss in Boots from Shrek. But unlike the feisty cat, he was polite and clearly very smart, describing his symptoms in great detail. At the end of our interview, I asked him what he wanted for Christmas.

“Ummm, I asked Santa for Cars 2 [a movie].”

“Nice… Anything else?”

“And some Hotwheels cars, and…”

“And?”

“And a Jeep,” he said earnestly. His dad laughed.  

“So I take it you like cars a lot?” I asked.

He seemed to think for a moment. “Um yeah,” he replied with a giggle, as if only suddenly realizing his obsession.

Sitting the kid up on the examination table, I listened to his breath sounds with my stethoscope and found fluid in the lungs, an early indication of pneumonia. After I presented the case to the doctor and medicines were prescribed, the boy stuck out his hand.

“Thank you, doctor,” he said.  I shook his tiny hand before his dad whisked him off.

Despite being slightly concerned that I had just contracted an infectious disease through hand-to-hand contact (don’t worry, I hit up the Purell right afterward), I felt all warm and fuzzy inside. It was deeply satisfying to think that I played a small role in making this little person get better. And one day I’ll get paid to do this? I thought.

Small group learning

But perhaps my biggest surprise has been my fellow med students. Far from being stereotypical “Type A” personalities, the people I’ve met so far are generally relaxed, friendly and have great senses of humor. I spent most of my time this semester with my tutorial group, a team of eight students who study and train together every week. No matter how stressed or tired I felt on a particular day, I always felt cheered up at tutorial. We bonded through laughter, cracking jokes in between obscenely long discussions about death and disease.

Going into the Christmas vacation, I’m looking forward to a break from all the surprises and toward more predictable activites: sleeping in every day, eating lots of fat and going shopping for presents. Then I’ll be jetting off to the Bahamas with my mom and sister for a “self-discovery” program in yoga and meditation. To be honest, I only signed up because of the beaches and warm weather … I’m not sure how much more of myself there’s left to discover. But who knows? Maybe the greatest surprises are yet to come.

A Spark of Insight

I felt slightly terrified when my supervising doctor told me that I’d have to speak with his patient and wife alone. The patient, a man in his early middle age, had come into the clinic the week before complaining of dark urine and fatigue. A CT scan confirmed that he had advanced pancreatic cancer. Whereas he had been planning a vacation with his family only a short time ago, he would now be contemplating his own death.

Knocking on the clinic room door, I felt my heart pounding out of my chest. What do I say to someone who’s just been diagnosed with a terminal illness? After greeting the patient and his wife, a woman with long brown hair and a gentle expression, I pulled out my pad of paper and plunged into a series of biomedical questions: What colour is the urine now? Do you have any nausea? When is it worst? Every time there was an awkward silence, I would quickly fill it with another question.

When the interview was nearly over, I looked up and saw the man looking despondent while his wife just stared at the floor. I had completely and utterly failed to make any connection at all. I realized that I had kept cutting him off when his answers began to veer into the emotional. Even out of the clinic, I sometimes feel guarded when talking with people I don't know well, and yet here I was expected to talk to a total stranger about his impending death.

My heart pounding, I put aside my pad, looked the man in the eye and asked, “How are you personally coping with this diagnosis?” The man started to speak but then lapsed into silence, a silence that seemed to stretch on and on as the clock ticked loudly onward. What do I do now? Did I say something wrong? I wondered. But I shoved these anxious questions aside while my stomach tied itself into knots. 

After what seemed like an endless interval, he resignedly said, “I just don’t know what to do.”

I had suddenly made a connection. The man opened up after that, explaining how frustrated he felt to be diagnosed with cancer at such a young age. He described how he envisioned the final chapters of his life; he didn't want extensive surgery or chemotherapy, but rather to just be at home with his family. Whenever he would struggle for words, his wife (now engaged with the conversation) would help him out. By the end of our interview, I felt like I had gained a much deeper understanding of his suffering. In turn, I think he appreciated that someone just listened to him. 

By putting aside my script and connecting with the patient on a personal level, I saw him as being much more than a series of symptoms. I better understood his illness in the broader context of his life, an understanding that can help shape the course of medical treatment and improve the quality of care.  As time goes on, I'm becoming better at ripping up my script in favour of the spontaneity of genuine conversation. Maybe this conversation is more awkward and uncomfortable, but it is undoubtedly a much deeper source of insight than scripted responses could ever be. 

Sweet Escape

The short, stocky man wearing the blood-spattered apron approached me with a broad smile. In his hands he held the severed head of an elk

“Yer a med student, boy. Think you can stomach this?” he said with a chuckle, lifting the head to within a foot of my nose.

I exchanged a glance with my fellow medical students. None of us expected to be touring a Mennonite slaughterhouse today. We had come to Mount Forest, a small community two hours northwest of Hamilton, to spend the day learning about rural medicine and experiencing something of the old-order Mennonite culture in the area. The Mennonites are a fervently religious Christian sect that rejects the "corrupting" influences of modern technology. They live off the land as farmers, travelling from place to place via horse and buggy. 

Aside from trying to traumatize us with the head, our Mennonite host (whose name was Melvin) was gracious and informative. He was happy to field our questions about Mennonite life. Melvin works from 4 am to the late evening every day, tending to his farm and operating his butcher shop. He spoke passionately about the "brotherhood” amongst Mennonites, who are bound together by their shared sense of destiny. After escaping religious persecution in Europe, his community migrated to North America over two hundred years ago. They have sustained their culture by homeschooling their children, instilling in them a deep sense of religious obligation. For the Mennonites, life is about hard work, duty, family and service to God.

At the same time, their community is no paradise. Melvin explained that their youth are barred from attending “real” schools because it would tempt them to join modern society. Without education, a youth has little choice but to remain within the fold. That begs the question: Are the Mennonites bound together by the strength of their faith or by a social structure that makes it impossible to leave?

My brief encounter with the Mennonite culture was just the icing on the cake of a fascinating day of training. Arriving that morning in Mount Forest, I learned three ways of popping a dislocated shoulder back into its socket, sutured a pig’s foot and put an arm cast on an eight-year old boy. We were hosted by several of the town’s doctors, who were eager to tell us more about medical practice in rural Canada.

"High" actually refers to the town's elevation. 

Over a lunch of chili and peach cobbler, I thanked them for providing such wonderful training for free.

“Oh, there’s no such thing as a free lunch,” one of the doctors said with a slight smile. “We need you to settle here once you’ve graduated from medical school.”

“Are you facing a shortage of doctors?” I wondered.  

“A lot of the docs here are getting old. Frankly, we're one heart attack away from disaster,” he said grimly. 

Although I savoured my experience in Mount Forest, I'm still not sure whether I'd ever practice in such a remote setting. While I love the outdoors, community spirit and low housing prices, I find the social conservatism of rural Canada somewhat stifling. Meanwhile, I cherish the cultural diversity and liberal attitudes of big cities like Hamilton and Toronto. 

But wherever I end up practicing, I'll have no regrets about signing up for this training day. It felt so refreshing to break free from the monotony of tests and tutorials, a brief but sweet escape into rural Canada. 

First Jab

It’s been over two months since the rosy glow of orientation week, which seems like a distant memory. Winter has begun to settle on Westdale, and my morning walk to McMaster has become much brisker as the temperature has plummeted. But more than the weather has changed. I’ve moved from being absorbed in medical books and lectures to actually being at the bedside with patients. To put it more colloquially: “Shit's gotten real.”

I’ve been assigned to shadow a family doctor in another city for the next 6 weeks. He is an incredibly efficient and organized individual, with dozens of patients shuttling in and out of his office every day. 

He explained to me that he believes in throwing in students head first – letting them learn by struggling and making mistakes. In the first appointment, a large, amiable man bounded into the office, needing his blood checked.

“Is it OK if my student takes your blood today?” asked the doctor (he collects blood samples himself). This came as a surprise to me.

“Ummm, yeah. Yeah that would be fine,” said the patient hesitantly. I could tell that the man was enthusiastic about helping a student learn but wasn’t sure if he wanted to be at the other end of the needle when said learning actually took place. But he gave consent and seated himself on the examination table.

I uncapped a fat syringe, tied a band around his upper arm and watched as a vein emerged from his skin like a green submarine. I would have to go in at just the correct angle.

The doctor sensed my hesitation. “Jab it in,” he said sternly. The patient looked mildly terrified. I’m sure he was wondering: What if he misses? I was wondering the same. As I held the needle over his arm, I looked up and saw his big blue, puppy eyes looking back. You still want to help me learn, buddy?

I forced myself to stop over thinking. I slid the syringe easily through the first layer of fat and then felt it “pop” through the vein’s wall.

“Ow!” said the patient unhappily. Oops, I had gone too far.

“Draw back,” said the doctor. “Now… put in the first collection vial.” If the needle had gone in properly, blood would flow in. If not, we’d have to take it out and try again.

I gently picked up a vial and pressed it into the syringe. Thankfully, reddish-black blood gushed in, filling the vial in seconds. The patient sighed and relaxed as I filled another four vials. I went to the backroom and centrifuged the samples as the patient and doctor chatted about politics.

Practice. Whether you’re in professional school, a trade or at McDonald’s, you have to practice and practice a skill countless times to master it. Unfortunately, every medical student has his first injection, first lumbar puncture and first surgical incision, and a (possibly) terrified patient at the other end. Sure, we may have the chance to practice on rubber arms, but no synthetic device can ever fully mimic the human form. We must eventually try our skills on a live patient, and just hope that enough patients will be willing to risk extra pain from a student’s unsteady hand in order to advance the cause of medical learning.

We spent the rest of the day encountering a vast range of health problems, and getting to explore the human stories behind them. I took blood several more times, talked to an elderly man about his feelings of loneliness and comforted a girl with enlarged tonsils. It was refreshing to be immersed in the nitty gritties of clinical practice. While endless textbooks and lectures suck out your soul, seeing patients in real life leaves you feeling alive and connected. 

Inner Beauty

I’ve never enjoyed going into the anatomy lab, and the times when I do, it's usually only out of necessity. The sight of shriveled, gray cadavers and prosected organs bathed in formaldehyde – a powerful, odorous preservative – makes my stomach uneasy. And so it was with a sense of resignation that I put on my lab coat on Wednesday and went to the lab for a dissection. I washed my hands, snapped on a pair of rubber gloves and waited with nervous apprehension for whatever specimen was about to be plunked down on our table.

The lab coordinator walked over to my group with a metal tray bearing a pair of pig’s lungs and heart, which closely resemble their human counterparts. Unlike the preserved specimens, these organs were fresh, plump with hydration and gleaming red. My instant reaction: Wow, these are beautiful!

Even though our objective was to dissect the heart, I was far more fascinated by the lungs. I detached them with a few well-aimed slices and moved them over to my side of the tray. They are so incredibly soft that they jiggle when you prod them with your finger. The trachea, our windpipe, plunges through the top and separates into two main "bronchi", which further split into countless "bronchioles" with hundreds of millions of alveoli at their tips - microscopic sacs of air that exchange gases with the blood. I tried tearing an opening in the pleura (the membrane that bounds the lungs) with my hands - but it was incredibly tough,  the product of millions of years of evolution.

Fortunately the pleura stood no chance against my medical scissors. I cut through the lower right lobe like a knife through butter, revealing tiny air passages. Squeezing on the lobe, I felt an infinite number of little “pops” under my finger pads, the sensation of the delicate alveoli collapsing.

Our lungs have their own little universe within them, an intricate mosaic of airways, nerves and air sacs that sustain our breathing for our entire lives.

Later that day, on my car's radio, I listened to Christina Aguilera sing passionately about how we are all beautiful inside.

I couldn't agree more.

The Pulse of Human Connection

Two weeks ago, our medical school class received our white coats in a fancy ceremony at the Hamilton Convention Centre. It felt intimidating to walk up on stage in front of hundreds of people while one of the faculty members helped you put on your coat – I struggled to get mine on. Because McMaster has the second largest medical class in Ontario, we had to wait for over 200 students to walk across the stage. Afterwards we all headed into the main hall for refreshments and pictures.

To be honest, I feel a little pretentious wearing this white coat. I have never made a diagnosis, taken blood or even given a shot. And so it was a welcome relief a couple days later to shadow an internal medicine specialist in the Emergency Room of a local hospital. We stayed primarily in an area for patients (mostly very sick and elderly) being assessed for admission into long-term care. During my visit, the doctor focused mainly on an elderly man suffering from a severe infection and the beginnings of dementia. I, and a fellow classmate, performed basic cardiac and respiratory exams and helped hold the man as the doctor performed a rectal exam.

Here, the painful realities of medicine – of suffering and death – contrasted sharply with the glamor of the White Coat Ceremony. The old man we saw just wanted to be home with his wife, but he recognized that his body was failing and that he needed to be in hospital. I was surprised at how cheerfully he behaved, even though he was in a lot of pain and trapped in his hospital bed 24/7. He even told us a few snippets about his time fighting in World War II.

It was chilling to think about how this man was once strong enough to fight in a war, but was now extremely vulnerable and weak. When we asked him if we could perform certain exams, he always said, “Do whatever you want to do.” Clearly, he completely trusted his healthcare providers to protect and care for him in his final lap of life. I felt a need to do every thing that I could do (which is not much as a student) to make him feel comfortable. This was not just out a sense of caring, but also because I could imagine myself lying in that hospital bed one day, aged and sick.

The next day (Friday), hundreds of medical students from across Ontario descended on the Radisson Hotel in Sudbury for the annual Ontario Medical Students Weekend. I was expecting it to be an intense two days of skills training, but it turned out to be mostly a giant frat party. By 11 pm, the hotel was full of drunk med students being intermittently yelled at by the security guards for bringing alcohol into the hallways. At 2 am, a student pulled the fire alarm as a prank, and everyone in the hotel had to evacuate. Then the alarm was pulled again.

All of us exhausted, we began skills workshops the next morning. I learned how to suture using artificial, rubberized skin followed by a session on IV injection. The conference organizers provided us with these incredible rubber arms that had their own veins and a working system of blood supply. We learned how to find a “juicy” vein and inject the needle at the proper angle.

Since returning from the thrill and exhaustion of that weekend, I’ve buried myself in studying the heart’s conduction system, the current focus of our curriculum. I even went into the lab a couple days ago and held a few prosected hearts in my hand. Not to mention spending hours learning obscure cardiac medical terminology.

But I’ve realized that all this terminology, the white coat, the ceremonies – all pale in comparison to the value of connecting with the patient. While shadowing the internist, I had checked the heart rate of the elderly man. Placing my fingers over the bottom of his wrist, I felt his warm skin and a gentle pulse. I could sense the patient looking at me, and I felt a sense of deep appreciation from him. That sense of appreciation was more real than any ceremony could ever be. 

The Drumbeat of Marriage

The day before yesterday, my aunt and uncle flew back to India. They had visited Canada for a month, staying in our guest bedroom and sharing in our daily lives. I felt uncomfortable at the prospect of this level of closeness after I found out that they had gotten their Visa to visit in early September. In the past it was always I who dropped in on their lives in Northeastern India, and when I did, it was just for brief spells of time.

Although they are nice people, I have always felt a sense of disconnection from them. We have vastly different beliefs on every facet of life imaginable – caste, marriage, religion, racial minorities, the role of women in society, gay people… I could go on. Their world view was developed in a traditional, middle-class Hindu household. Mine was forged in a liberal, interracial family living in Canada.

My father, the rebel, left that traditional Hindu lifestyle and married a Canadian woman. Although both sides of the family came to embrace the new couple, I often wondered how I would be viewed in my Indian family as a half white, Westernized young man. Would I be considered Indian? Would my grandmother still insist on arranging my marriage?

The answers to these questions have become much more clear over the past month. Little did I know, I occupy an important position within my extended family hierarchy. I am the oldest son of the oldest son of the oldest son on my father’s side. Take of that what you will, but the Hindu tradition regards this as being spiritually significant.

Even better, I apparently haven’t even let my Indian family down, despite my Westernization. Going into university, studying medicine and generally being well behaved mean that I’m a good Indian boy. But of course I’m going to fail the next and perhaps most important step: marrying an Indian girl.  

The older generations of women in Indian families comprise a highly effective marriage machine. As soon as a young man has graduated from his studies, they begin to sweep through their vast networks of friends and track down girls to marry. Once they decide on a suitable prospect, they arrange a meeting between the woman and man. If they like each other, then they will get hitched in a massive ceremony several months later. They may not even see each other until the wedding. 

Oftentimes, as with my uncle, the man leaves the responsibility of selecting his wife entirely to his mother and grandmother. His objective is to find a beautiful and hopefully docile girl from within his caste. But in turn there are factors that affect his attractiveness as a potential suitor;  first his income and caste with his height and looks as distant, secondary factors. 

Not to boast, but since getting into medical school I’ve become an ideal Indian groom. A doctor’s salary in Canada is enormous when converted to rupees (the Indian currency). My father was also of a “decent” caste, I’m tall, fair-skinned (a plus) and can speak Hindi. My dad claims, quite seriously, that my grandmother could have a long line of gorgeous Indian girls waiting to marry me, ready to serve me hand and foot for the rest of my life and have my children – two is traditional.

Personally, that sounds like a nightmare. I don’t want someone to marry me based on economic convenience, and I don't want to marry purely on looks; what about factors like a sense of humour, kindness and personal interests? Sure, on paper it may sound like a good idea to marry a random, beautiful brown girl – but what happens when you find out that you don’t get along with said hottie? What if she has a terrible temper or hates puppies?

Sadly, in my experience, many arranged marriages end up cold and lifeless but stay bound together for life because of the deep taboo against divorce in India. Faced with this prospect, young Indians turn to Bollywood films to get their fix of love relationships. It’s also becoming trendy among middle class youth to have a wild love affair with whomever they like before settling down into an arranged marriage with their family’s chosen suitor.

While we were shopping last week, my aunt suddenly asked, “So... what nationality will you marry?”

I replied, “It could be Indian, or black, white, Chinese… whoever I fall in love with.”

She smiled. “So it will be a surprise?” For a second I imagined introducing my future spouse to my Indian family. 

All I could say was, "Yes auntie. It will probably be a very big surprise."

When Life Gives You Lemons...

Hanging out with friends as an eleven-year-old, I went into the kitchen and came back with a lemon and salt shaker. After slicing it neatly it half, I showered it with salt and devoured one of the halves in a couple minutes. This particular lemon was plump, sour and delicious. 

To my surprise, both my friends looked horrified.
"Why... why would you do that?" one of them stammered. The other gave me a look that said: You're weird.

I suddenly got the awful sensation of being "different". I had assumed that eating lemons as a snack was perfectly normal; after all, my sister did it too! 

After they left, I shoved the uneaten half into a bag and shoved it in the fridge. From time to time, I would jostle by it as I reached for milk or butter. I would stare at the lemon... and it would stare right back. I wanted to douse that sucker with salt and spices and devour it. But I resisted... I didn't want to be that weird guy who ate lemons. I didn't want to be different.

And so I let the lemon, once so vibrantly yellow and bursting with juice, shrivel and brown until my mom threw it away.

As the weeks, months and years passed, I stopped eating lemons altogether. Once in a while I would get a craving and cave in, bicycling to the grocery store and later guiltily eating a lemon alone in my bedroom. At restaurants, I would sometimes try to chew on the cut-up lime they give you along with your drink. But to be honest, a lime is too sharp and bitter to be eaten raw. It really is a sad excuse for a fruit.

But soon I had a surprising experience that changed my attitude toward lemons forever. After high school, I flew to India to volunteer for a few months. Sitting in the living room of one of the locals, I was surrounded by a sea of brown faces eager to see the videshi or "foreigner". Then, to my great surprise, a young boy walked in bearing two gigantic, juicy lemons the size of soccer balls.

This picture would be perfect if it wasn't for the girl.

So this is what lemons are like in India, I thought. My host cut up one of those mammoth specimens and served me several lemon slices in a bowl, along with a packet of masala (Indian spice). I showered them with the spice and squeezed the salty-sour juice into my mouth; raw and delicious. It felt great to be alive.

Flying back to Canada, I couldn't help but ask myself: Why did I deprive myself of this pleasure for so many years? 

We change ourselves all too easily to fit in with the expectations of others, especially as kids. While it's natural to seek acceptance, sometimes those expectations don't make any sense and we end up losing a precious part of ourselves. Beyond citrus fruits, this could extend to major life decisions. It could be a boy who, despite his love and talent for painting, trades in his brushes for dumbbells because his father thinks that painting isn't manly. Or a woman who rejects friends from outside her ethnicity because of the closemindedness of her own cultural tradition. 

Fortunately, we have the ability as (young) adults to consciously be our genuine selves, but it may take a long time for us to recognize that. In my gap year, I would weightlift for at least an hour a day and down protein shakes like they were candy. Eventually I realized that I was subconsciously doing this to seek others' approval, as if there were a correlation between muscle mass and worthiness as a person.

Now I spend most of that time reading great books and writing (this blog included). Sure, I'll miss the bulging muscles (*ahem*) but living out my genuine interests has made life far more fulfilling. Whether it's choosing what you study, who you love or how you worship (or what citrus fruits you eat), basing your decisions on authentic passion rather than programmed fears opens up life in countless new ways.

Dancing on the Edges of Burnout

Note: any identifying patient details have been removed to preserve confidentiality. 

Last week I met my first patient ever. She was an elderly woman with shortness of breath and swollen legs. McMaster's medical school is famous for getting their students to see patients within the first month of classes. But in reality, at this point we know next to nothing about medicine. So I and a classmate were assigned the fairly straightforward task of taking a medical history.

The patient was sitting upright in her hospital bed being pumped with oxygen and an IV drip. We proceeded to ask questions over the next half hour, trying to build up a complete picture of the patient's medical history. I felt very out of place, shuffling through my notes while trying to figure out what to ask next. But the woman was patient and understanding. She also had a very dry sense of humour that made us laugh several times. 

It was likely her heart had become too weak to keep pumping enough blood to sustain her body. The clinical term is “congestive heart failure”. I felt sad, but the woman’s cheery mood and humour lifted my spirits. At the end, my supervisor thanked her for taking the time to speak with us.

“Oh yes, because I have a very busy schedule,” she deadpanned, alluding to the fact that she was in her hospital bed almost 24 hours a day. 

The only complication came early in the interview when the nurse changed the soiled diapers of a patient nearby. I have an extraordinarily sensitive nose and the smell hit me like a truck. Even if I was blindfolded in the morning, I could probably still sniff my way from class to class. This supersonic sense of smell can be a problem, since medicine is usually a smelly profession. But fortunately I got used to it quickly and it stopped bothering me. First test passed.

Although the clinical encounter was a high point, I feel like I've been rapidly burning out over the last two weeks. I’ve become overwhelmed with classes, extra-curricular commitments and studying. 12 hour days are becoming common place, and even once I get home there are countless more readings to do. 

Unfortunately this is very much self inflicted. I seem to have signed up for every extracurricular opportunity available - last week I registered myself for two medical conferences and a semester of hip hop classes. Facing a deluge of opportunities, it's too easy to say "Yes" to all of them.

Best show ever

When the second season of "Battlestar Galactica" arrived at the library, I knew I was doomed. Watching the riveting story of the power struggle between the Cylons and the remnants of humanity has eaten up the last bits of sleep that I enjoyed.

Fortunately the turning point came a couple nights ago, when I was watching a National Geographic documentary on the human life cycle. The narrator was talking about menopause when my eyes suddenly welled up with tears. This came out of nowhere; I was actually in a good mood. I guess our bodies start to do unpredictable things when we push them too hard. 

I dried my cheeks and reached for my sister's bottle of skin cream sitting on the desk. Smearing the cream over my face, I immediately grimaced - it was full of tiny, sharp particles. Exfoliator.

So here I was, exhausted and crying over a documentary about menopause while inadvertently exfoliating my face. I shut off the TV and went to bed.

Waking the next morning after a long rest, I felt determined to restore my sleep cycle and take better care of myself. Armed with this new determination, and with skin as smooth as a baby's bottom, I'll soon be ready to take on the world again. 

From Africa to Ancaster: A Fascinating Life

Nine candles sit on the enormous white cake at the front of the hall, their flames flickering as the chattering in the room quiets. Almost all at once, sixty voices begin to sing “Happy birthday” together. All eyes are focused on a dignified, elderly woman at one of the tables near the front; Bernice Trollope, my grandmother, or as I affectionately know her, “Nana”. They are celebrating 90 years of a remarkable life.

In 1921, Bernice was born in a tiny Norwegian settlement in South Africa. Her father, a Christian missionary, was often away on missions in Madagascar, leaving her mother to raise four children. There was no running water or electricity, and her family was so poor that they couldn’t afford shoes for her until she was five years old. But education promised a way out of these dire circumstances. Bernice hitched a ride with several other kids from her settlement on a horse-and-buggy that drove them to school every day.

Classically Norwegian, Bernice was a plump-cheeked, big-boned girl with auburn hair, ivory-skin and green eyes. She was very gentle and obedient, and her Grade 1 teacher remarked in her report card that she was “An excellent and disciplined pupil who takes herself too seriously.” Bernice fell in love with languages, becoming fluent in Norwegian, English and Afrikaans. She chose to become an English teacher.

Then, on September 4^th, 1939, the Union of South Africa declared war on Germany following Hitler’s surprise attack on Poland. The declaration of war changed the life of every South African, and my grandmother voluntarily joined the army. She was trained to operate supply vehicles and monitor radar, and was promoted to Sargeant. 

During the war, she met a young engineer named William Trollope. He was skinny and rather awkward-looking but was charming, brilliant and had a fantastic sense of humor. He courted Bernice, but on a trip to Norway after the war ended, she became engaged to a Norwegian man. For some reason, the engagement fell through and Bernice returned to South Africa. A gregarious and successful man that she had known since childhood began to court her, but she reconnected with William and accepted his marriage proposal instead. 

Bernice envisioned a life in South Africa surrounded by her vast extended family. She despised Apartheid and opposed the nationalist government, but despite this, she loved the country passionately; its lush, tropical countryside and vibrant way of life. She didn’t realize that William did not share the same attachments. Shortly after they were married, he secured a two-year position at an engineering firm in Quebec, Canada.

This came as a shock to Bernice. Quebec seemed very foreign; a French-speaking province in a distant country with a cold, snowy climate. Most important, she was deeply connected to her family, and this would mean leaving them behind. But since it was only for two years, Bernice accepted the plan.

By now she and William had two children, including my mother. The little family arrived in Sherbrooke, Quebec to a small apartment, in the dead of winter. Bernice struggled to adjust to their new life in Quebec. Her body, especially her sinuses, couldn't cope well with the extreme cold. But she didn't complain and instead adapted herself, starting a small English school for French children. 

Bernice missed her family terribly during those years, especially her mother. Their only connection was through letters. And so it came as a huge shock when my grandfather decided that they would settle in Canada permanently. He didn't see a positive future for South Africa. Bernice was devastated by the decision, but she came from a generation where the husband made the big decisions. Sadly, she couldn't even visit her family for many years because of her family responsibilities.

Meanwhile, William fell into severe clinical depression that would last for most of the next two decades. Unfortunately, this was before the time of effective treatments for major depressive disorder. When he returned from work, he would immediately go to bed and only come out his room for supper. Bernice took on the responsibility for making family decisions, caring for the children and caring for William himself.

The family moved to Ancaster, but over the next years my grandmother's workload would only increase. William suffered through three different types of cancer brought on by a lifetime of smoking. When she was not taking care of him, she was volunteering at church. Her idea of Christianity is one of a loving, encompassing faith; last year, she voted in favour of allowing gay men and women to serve as priests within the Anglican church.

My grandfather died of leukemia in 2000. His depression had finally lifted in the last years of his life, and he enjoyed a relaxed retirement in his Ancaster home. Although it was heartbreaking for my grandmother, it also marked the start of a wonderful new phase in her life. She loved to travel but had always stayed home to care for her husband. 

And so we took a family trip to South Africa, crisscrossing the country. We celebrated Nana’s 80^th birthday in the city of Pretoria and over a hundred family members and friends attended. I met the other man who had courted my grandmother all those years ago. Once she married William, he went on to marry another woman, had several kids and led a happy life in South Africa. 

I can’t imagine how different her life would have been if she had accepted his proposal. She could have stayed with her family in South Africa and avoided the decades of hardship created by my grandfather’s depression. Now, in her old age, she continues to be a nurturing influence on our tiny Canadian family; making countless pots of jams and blueberry pies, hosting family dinners and lending out her car. As a boy I would sleep over at her house every Friday, playing ridiculous word games with her while eating delicious heart-shaped waffles. She has always been a rock of stability in my life and the lives of all those close to her.  

But now as I look at my grandmother in the church, I realize how heavily time weighs upon her. Where once she was tall and strong, she is now stooped over and fragile, as if even a gentle breeze would blow her over. Although I’m sure she’s in pain from her aching hip or from the severe arthritis that wraps around her spine, she doesn’t show any trace of complaint. She never does. Instead she smiles as she greets her guests.

For her, life has always been about grace, dignity and quiet resolve.

Love in the Time of Medical School

I’ve always been a romantic. In Grade 4, my friend had an enormous crush on a blonde girl in our class named Megan. He was desperate to think of a way to woo her, but too shy to approach her directly. When he asked me what he should do, I hatched a plan to write anonymous love letters on his behalf and deposit them in Megan’s locker. My friend agreed to the plan, and a couple times a week I dictated romantic messages as he scribbled them down on dollar store stationary.

As it turned out, the plan badly backfired. Megan’s friends, upon learning of the anonymous letters, teased her relentlessly and immediately suspected my friend. Megan implored him to stop writing the letters, killing off any potential for a steamy romance.

Despite this setback, romantic feelings simmered and bubbled under my surface as the years passed. I had my first dance in Grade 6 with a cute brunette and then my first date in high school. I planned our date to be dinner at a nice Indian restaurant. A couple hours before, I bought a long-stemmed rose from the local florist, washed my car and put on my nicest shirt and pants. Pulling in front of her house, I took a deep breath and knocked on the door.

Her father answered. Shocked, I hid the rose behind my back and proceeded to talk with him for 5 minutes. Please, please don’t ask me what I’m hiding behind my back. Then you’ll know how lame I am, I thought. Once the girl finally came out and her father disappeared, I gave her the rose and she took a good whiff… I think she liked it. It was a lovely evening.

Unfortunately, once I entered university and became hyper-focused on getting into med school, my romantic life quickly fell by the wayside. I think the most romantic thing I did in undergrad was watch a rerun of The Notebook with my mom. Sadly, this trend looks to continue in medical school, as I find most of my time consumed with respiratory structures, cadavers and freaky medical disorders.

And yet I feel a constant undercurrent of desire for romantic love. It’s probably one of the most basic, primal needs one could have. Intellectually I know that I’m headed towards a nice career, and I live in a nice house with a caring family and great supports. I have many varied interests that I enjoy, like badminton and writing. I don’t want for any material goods.

But there’s something missing: the feeling of intimacy and closeness on a level much deeper than friendship. So many of our interactions on a daily basis are superficial and meaningless; the average “Hi! How are you?”

Love pierces this layer of superficiality. Two people in love know one other better than anyone else in the world; each other’s secrets, dreams and all the emotions, neuroses and vulnerabilities usually kept well hidden from the world. I believe a couple crosses the threshold of simply loving each other to falling in love when they form a powerful bond that is nearly unshakeable by any external force.

A man truly in love is the man who marries his fiancée even after she has been horribly disfigured in an accident. Or a woman who stays faithful to her husband through years of war.

The idea of establishing this deep connection with someone else seems like an incredible dream to me. One day I hope it comes true.

O-Week: It Begins!

Sunday, August 28th, 2011

I return at 4 am from a night of clubbing at Sizzle & Koi, a popular dance club in Hamilton. It's probably a bad idea to pull an all-nighter only a couple of nights before med school starts, but it's my last chance to see a couple of good friends before they take off to various parts of the world.

After four hours of restless sleep, I wake up with no hearing in my left ear. I figure that the loud, pounding music has temporarily deafened me. It's the day before school starts and I feel uneasy. I don't like being the new kid, even though everyone else is new as well. It's hard being thrown into a new environment surrounded by hundreds of people you've never met and expected to make friends, establish a routine and generally succeed.

Monday, August 29th

I file into a huge lecture hall in the McMaster School of Medicine at 8 am. Each administration member impart a few "words of wisdom". We get fitted into our new white medical coats and scrubs, the clothes you wear in the operating room. I hope that I don't have to wear scrubs too often, since seeing surgical procedures up close makes me a little queasy. The administrator implores us not to wear our scrubs while at the gym or out shopping - apparently it's happened before!

Next, our class of 207 is divided into teams and set out on a scavenger hunt. Our mission is to locate a list of places (eg: the fake goldfish bowl in Mills Library) and take funny pictures beside them. Since I know Mac so well, it's fun giving my fellow team-mates a little tour.

In the late afternoon, I collapse into bed exhausted. I'm sapped of energy and my hearing is still gone. I really didn't feel like going to the evening barbeque for the med students in the Dundas Driving Park, but the promise of free food is too much to resist. I should really see someone about my health. If only I was a doctor.

Tuesday, August 30th

The day begins with safety training and a lecture on financial management. These activities are followed by - SURPRISE - a huge bouncy-castle obstacle course! Two med students compete at a time, climbing over walls, throwing themselves down slides, and shimmying through narrow tunnels to get to the finish line. Even though I feel half-dead with whatever strange ailment is afflicting me, my competitive side kicks in and I win my match.

Wednesday, August 31st

We start with a thorough lecture on infection control. The speaker passes around a UV light that lets you see all the germs on your hands. Ew. From now on, I think to myself, I may carry around a bottle of Purell at all times. In the evening, I go with my family to "Little India" in Toronto to celebrate my dad and sister's birthdays. They happened to have both been born on August 23rd. Unfortunately, I discover that my favourite Indian snack has been banned from Canada by the government. That seems to be the fate of many imported Indian foods, which tend to be manufactured in unhygienic conditions. 

Thursday, September 1st

Medical class formal at Liuna Station, a beautiful former train station near downtown Hamilton that has been converted into a place for formal functions. It's also where my high school prom was held. I spend a lovely evening joking and laughing with my med school colleagues. Starting to make some friends.

Friday, September 2nd

Crisis. My left ear, which I've been neglecting for days, suddenly bursts during the night.The pain is so bad that I can't sleep or do anything. It feels like someone is dragging a serrated blade through the left part of my head. I finally see the doctor and she diagnoses a severe infection, prescribing a course of antibiotics. She tells me that this is one of the worst pains that the human body is capable of feeling. I somehow make it to the Niagara Wine Tour, the last event on the O Week calendar.

Since then...

Despite my ear problems, O Week was a great experience. Just like in Artsci, I found the people really interesting and friendly. I don't think there's such a thing as being a "nerd" in medical school, since every one is a nerd in some or other way. It's OK to break out into a conversation about classic novels or the merits of different voting systems without receiving a hostile stare. 

Even better, the days of cut-throat competition in medical schools are gone. The School of Medicine doesn't assign marks or rank its students, and instead students work collaboratively in groups. This fosters a trusting and non-competitive atmosphere. I appreciate that on an academic and personal level. I also feel excited to meet my first patients and begin to delve into the world of medical knowledge. In a profession where one has so many encounters - with patients, other med students, doctors - there are bound to be challenges. I plan to continue to use this blog to reflect on and share my experiences while on this incredible journey. 

A Summer of Transformation

When I'm old, I'll probably remember the summer of 2011 as a major turning point in my life. I began the month of May exhausted after 4 years of university. I had spent an obscene number of my waking moments thinking about, studying for and applying to medical school. It's a grueling process, partly because of the uncertainty of being rejected; what do you do then? Should you spend one, two, or even three more years reapplying? There's immense pressure to compete. For last year's class at McMaster, 3785 students applied and roughly 250 were sent offers of admission, with a final class size of 207.

I never thought that I'd actually make it, and I had little faith in myself as a student. I took the MCAT last summer, but for the first few days only studied a couple of hours per day. My practice test results were terrible. My thought process was: What's the point of studying hard when I won't get in anyways? Then, in early June I had a chance encounter with an old friend from high school at the movie theater, who told me that she studied for the MCAT every day from 9 to 11.

“Yeah, I do about 2 hours too,” I replied.

“No. 9 am to 11 pm,” she laughed.

That was perhaps one of the most important conversations I've had in my academic career. I was frustrated with my poor study habits already, but the conversation made me question myself deeply: why was I pursuing this goal in the first place if I was unwilling to even put in the work necessary to achieve it? I felt a sense of urgency to study. The next day I  took my large stack of review books and studied from 9 am to 7 pm. I would take a break for an hour-long nap in the afternoon followed by lunch. This routine lasted consistently for the next 3 months, with just one day missed for an outing to Wonderland. 

My stack of MCAT books.

My new attitude was to do my best, even if I failed. In the month leading up to the exam, my practice tests were still below the cutoffs. But in the last two weeks I somehow managed to synthesize and absorb the material very efficiently, and I managed to do better on the MCAT than I had ever hoped.

My new attitude of "Try your best, even though you're not going to make it" carried me through a tough final year, long applications and several multiple mini interviews (which uses live actors to challenge applicants with realistic scenarios). In January, I was sitting in my Cell Bio class when a new message came in on my phone: a rejection from Queens for an interview. I felt shaken to my core and went back home. Lying on my bed a couple hours later, I checked my messages. Another email from Queens: Oops, sorry, we accidentally sent you a rejection. No, we'd actually like to invite you for an interview.

Phew! It turned out to be a technical glitch in Queens' computer system that affected hundreds of students and possibly caused a few heart attacks. Then came May 5^th, the day when all the Ontario med schools inform applicants about whether they've been accepted or rejected. I woke up early, refreshed my Hotmail inbox and saw that I was accepted by Queens. Then Wendy Edge, admissions coordinator at McMaster, emailed me shortly thereafter with an offer of admission. I felt a deep sense of relief wash over me and a feeling that the last 4 years of work had been validated in an important way. 

I also felt like the medical profession had swept me up into its arms and planted me firmly on my life's path. I could suddenly envision the next 40 years of my life; not the details, but the general contours. I would study for three years, do my residency and then pick a specialty that suited my interests and skills. After becoming accustomed to uncertainty, this sense of clarity was a welcome change.

After giving my parents a hug, I called my Indian grandparents, who were perhaps more excited than anyone else. My grandmother had made several offerings at the Temple to her Hindu gods so that I would be admitted. Once she heard the news, she walked around her apartment complex an hour away from New Delhi and handed out sweets. I also talked with my "Dadadji" or grandfather on the phone for several minutes. He had grown up in dire poverty, and was naturally very happy.

After achieving this goal, I could finally concentrate on my personal growth more. At times I felt empty; when a certain goal occupies so much of your life, it tends to knock out everything else that is there. Now that the dream was fulfilled, it was replaced by many questions: OK, so I'm going to be a doctor. Who cares? What's the point of any of this? Is this all there is to life?

Those questions inspired me to read “Man's Search for Meaning” by Viktor Frankl, a holocaust survivor, and it's no doubt one of the most important books that I've read. It's about taking responsibility for your own happiness and actively creating meaning in life. I also planned out a summer with ample opportunity for new experiences, new friends, and plenty of self-reflection. A combination of working for the Census, traveling to Colorado and doing the Explore program in Quebec has given me a welcome chance to develop personally. I have a long, long way to go. But with med school less than two weeks away, I feel ready to tackle this new stage of my life.

New friends

A Mini Update from my iPad

Sorry for the lack of updates, Blog, but I've only had sporadic access to the Internet here in Trois Pistoles. Things are going really well here, much better than I had hoped or anticipated. In the past I haven't always felt comfortable being around other people 24/7. I like to have my space and quiet time, which is difficult in a program like this. But I've adjusted well here, and in fact have enjoyed being immersed in constant socializing. I'm also finding my sense of humor again and enjoy cracking jokes with my dinner mates every day.

Things that keep me sane: reading English books, long walks, ping pong and a nap every afternoon. I've really appreciated my Kindle (an ebook reader). There are next to no English books available in rural Quebec, but using my Kindle I can download and read new books at my leisure. Personally I prefer the feel of a real book, but considering that I couldn't haul 12 paperbacks from Hamilton, the Kindle is a great substitute.

My friends, Andrew and Ashley, just announced their engagement. Congrats to them!

And so it begins...

My long journey to the rural town of Trois Pistoles, north of Quebec City, began on Saturday morning when I hopped on a VIA train at Union Station. As I passed the rows of seats, I consciously made an effort to find a slender Asian girl to sit beside - thinking it would be my best chance to fit comfortably in my seat. As it turned out, the girl I sat beside was Angela Chung, an old friend from McMaster!

The journey was 16 hours long, but it passed quickly. I`m very content when I`m in a comfortable place with books, the Internet, and good company. Once I arrived in Trois Pistoles at 2 am, I was escorted to my host family`s house. I was shown into the basement with another guy my age named Frasier. We were given rapid instructions in French about where things were located, and I discovered that my hosts didn`t speak a word of English.

Since then, I`ve come to enjoy my new life in rural Quebec. I wake up at 7:15, head to a small dining hall and then start French classes at 8:30, which go on until 3:30 with a break for lunch. I find this the most difficult part of my time here, as learning a new language in a classroom for hours upon end can feel torturous at times. But I try to keep my mind on my goal of learning French and of course ponder all the fun activities I`ll do for the rest of the day.

My host is Conrad Hudon and his wife, who get paid to lodge students for the Explore Program. Conrad is an avid hunter, and the basement where I sleep doubles as his showroom for his many kills. I counted a total of 45 different animal heads or scalps mounted on the walls - animals like moose, deer, hares, and turkeys. Conrad kills them and has them professionally stuffed and mounted, with a little gold plate proudly announcing the date of the kill. All the furniture in the basement is made out of animals. My bedside lamp and flower pot, both very furry, are made out of the lower part of a moose`s legs. On my bookshelf is a gigantic hornet`s nest.

I find this quite gruesome, but at the same time I appreciate that I`m in a different world. Rural Quebec is far more politically and culturally conservative than Montreal or Paris. In fact, many people proudly wave Quebec`s provincial flag outside ther homes, and I have yet to see a single Canadian flag. There is a strong sense of the Quebecois identity, borne out of decades of political oppression under English Canada.

Despite the political tensions, my host family and the people here have been very welcoming. It`s no surprise, since their economy gets a huge boost from the Explore Program, which sends 250 English Canadians here to learn French every summer, with two different sessions. The rule is that you MUST speak French at all times, or else face expulsion.

I love my free time here, as I can hang out with friends from the program, read a variety of books (in English!), and bicycle through the beautiful town.

Off to the Three Pistols

Dear Blog,

I can honestly say that I haven't felt this relaxed in at least five years. I am at a strange and wonderful phase of transition in my life which will not last long. I wrapped up my Arts & Sciences degree at McMaster less than a month ago, and will be starting medical school at McMaster in late August. This "in between" period involves little pressure and few responsibilities. As a result, I've been able to shape this summer to my liking. First I worked with the Census for 1.5 months, then vacationed in Colorado with my mom, followed by a short First Aid course (required by Mac Med) that ended today.

Now I'm packing my bags for Trois Pistoles, a tiny town in rural Quebec, to complete the "Explore" program organized by the government. The stated goal is to learn French, but my personal goal is to enjoy myself and make new friends. I'm comforted by the fact that I already know my room-mate: Daniel Carens-Nedelsky.

After 5 weeks of Explore, I have a couple weeks before the grind of medical school begins. Mac is unique amongst Ontario medical schools in that it adopts an accelerated, 3 year curriculum. That means that summer vacations are shortened to only 1 week! They also try to model their education on problem based learning, so I should be meeting patients as early as September. In many ways I think that "Mac Med", as it is called, will be a lot like my Arts & Sci program; surrounded by many smart people who are passionate about different interests. Plus, Mac is based on "small group learning", similar to the Inquiry courses of Arts & Sci.

My grandmother, three uncles, parents, and sister are on their way right now to celebrate my birthday, which was on the 27th. So I better go. But I'll be back next week, writing from Trois Pistoles!