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.