ah, it's good to be home...

so, i've recovered from that previously described zany week, enjoyed the tail end of my rotation in Marathon, returned to TBay, settled back in comfortably at home with Ruth and Mocha, and started my next 8 week fam med stint.

What i'm enjoying most about being back -

1. company and comforts of home - that speaks for itself, really.

2. that darn cat - i did miss his entertaining antics and affectionate ways

3. access to our well-equipped and well-stocked kitchen, and the farmer's market and bulk food store selections for affordable and exciting ingredient options - we're stocked up on interesting grains and spices and nuts and squash and 'Thunder Oak' cheese (about 20 variations of Gouda - who would've thought?). Today we supped on a fabulous curry concoction from 'The Enchanted Broccolli Forest' - appreciating a delicious use for the old potatoes in the cupboard and a bunch of slightly freezer-burnt peas. Spices are like good accessories, turning an assortment of otherwise boring basics into a meal with panache for the palate.

4. more fun social opportunities! last night i went to a costume party as 'Nelvana of the Northen Lights' (i didn't make that up... google her!). I had a good time, met some interesting people and enjoyed catching up with some of the 'ultimate' crowd who i hadn't seen since the summer.
'Nelvana' (me) 'Ghost of Steve Irwin' (Andrew) 'Cabbage Patch Doll' (Sarah) 'the Sea' (Lisa) Unfortunately my superhero sidekick was on call for internal medicine, so the Superman suit is awaiting its rightful call into action soon - Ruth and i are having a soup supper and costume party on Tuesday...

tension headaches and other frustrations

it's not that bad, really... no, actually, IT IS! it's just frustrating b/c i'm feeling frazzled b/c call (although good shifts for learning and some fun patients) has been busy and challenging enough to disrupt my sleeping patterns and i have a lot of projects and presentations that are 'due' in the next couple of weeks which are consuming my 'at home' time and therefore i'm not getting enough active outside time and i'm getting stir-crazy!

these are the goings-on since i returned to Marathon:

Wed- basically a waste of a day with videoconferenced academic sessions fraught with technical glitches. The morning presentation was mostly inaudible and what i could hear wasn't anything new or particularly valuable - ironically the presentation about communication was poorly communicated... I'm sure the woman is better at the patients bedside than she is at teaching a large group including 4 videoconferenced sites (one of which was me) - at least i sure hope so!
I wrote AK a long letter tho, so it wasn't all for naught... too bad it took me almost a week to actually get it into the mail... that night i picked up some groceries, fixed a simple supper and then worked on my critical appraisal session preparations until late, frustrated by difficulty finding and then accessing the necessary resources. gr.

Thurs - full long day in the clinic, mostly interesting patients and some good learning, still tiring by the end! when i finished up, i went to Kris & Christine's for the evening, and appreciated a fun low-key evening hanging out with Christine and baby Maggie, and with Kris when he got home from work. I worked for awhile on my chart audit project before bed that night, and it was fairly late again before i realized it.

Fri - on call - busy day between the clinic and a few patients in emerg, with a couple of particularly challenging/frustrating cases that took a toll on my energy level. i appreciated a couple of hours 'off' in the evening and worked on my critical appraisal stuff again, then had just gotten into bed at 11:30 when i was called in about a couple of patients, one of whom i admitted, so it was around 2 when i got home to bed again.

Sat - handover took a couple of hours in the am, and when i got home i had a shower and read for a little while before working on critical appraisal stuff again.

In the afternoon, I finally got out for some fresh air and sunshine - joining K&C and Maggie for a hike - we went to Sturdy Cove, which was a pleasant, easy walk (although the path featured many HUGE puddles that added an element of adventure as we plotted out alternate routes around them). We saw a bunch of grouse along the way (not the brightest birds, we were within a couple of feet of them before then scuttled off the path into the bush), and quite a few fresh bear tracks down near the water (not to worry, we were jingling all the way with the bear bell to announce our presence). The cove is a lovely destination, and it was fun to muse with K&C about where they would put a house, windmill, etc. if it was their patch of homeland. On the way back to town, we stopped in at a shop that sells wood pellet stoves, as K&C are considering options to improve the efficiency of heating their new home, which at present just has electric baseboard heating. The place also sells all manner of 'gifts' (mostly over-priced kitsch - well, not my style, anyway), and was a bit too much after just a couple of minutes! It reminded me a bit of hearing Michele describe the flower shop in Iqaluit (which i managed to avoid during my stint up there) that the nurses there used to rave about, mostly b/c it was one of so few available 'shopping options' in town.

The evening was stretched and consumed by working on the critical appraisal stuff, and i'm really frustrated b/c i can't make heads or tails of the statistical analyses the authors use in the results section, which makes it pretty hard for me to evaluate the results and apply the tools i know to determine the relative risk reductions, event rates, etc and the strength of the confidence intervals. it's more challenging b/c although it is definitely a 'therapy' study (my assigned topic) i happened to choose an article that uses methodology and end-points for which the usual RRR,CER,EER, etc aren't readily applicable - and i don't have my stats texts to help me make sense of them. other than this 'critical' aspect, i am prepared for the session, and i think it'll generate some good discussion. i emailed the tutor and a librarian asking for some assistance with resources i can access online, so hopefully they'll get back to me soon!
I couldn't sleep very well that night, and when i finally did, the morning arrived far too quickly!

Sunday i was on call again - starting with heaps of inpatient rounds at 9:30 and then a few ER patients, i had a couple of hours off in the late afternoon which i used for a short nap, and then made muffins and cut up a veggie salad and a fruit salad for supper and meals today. I was called back for a couple of ER patients, and enjoyed using my sewing skills for a chin laceration. Details for a few inpatients kept me there longer, but i was home at around 11:30 to read for a bit, and sleep. the Lord knows as well as i that i really missed a day of Sabbath rest!

Today was supposed to by my 'day off' - but following up on issues from on call yesterday (x-rays and a discharge) took awhile this morning. My chart audit presentation is this Wednesday (as i found out last Thursday night). The required charts for my chart audit project are finally available (there weren't enough initially, so i had to expand the parameters of my search and it took awhile to get them pulled), as many of them as there will be for this project, anyway - so i then spent the whole rest of the day doing my chart audit project (with not much time to spare, i'll be giving my presentation by videoconference).

I've also basically been tethered to a telephone line, b/c i have been waiting ALL DAY for a specialist in TBay to call me back to discuss an important but not urgently life-threatening situation with one of the patients i say on call over the w/e. They requested a call-back number where i could be reached at his convenience, and i made a bit of a nuisance of myself calling back 3 times over the course of the day when i had to relocate for various reasons - hopefully i don't end up with him as a preceptor at some point! Welcome to the tribulations of being a 'periphery doc'. Hopefully i'll have better luck in getting some advice from the one who takes over for him tomorrow morning.

I've had a headache all day, and i know i'm well-hydrated and have kicked my vacation-associated caffeine habit, so i think this one is from a combo of fatigue and stress. Getting the chart audit research and presentation completed takes a load off tho, and i shall soon make my way to bed to help combat the other factor!

Tomorrow morning i'll be at the clinic, and have my final evaluation for this rotation in the early afternoon. I expect that finishing up all of my paperwork there will fill the rest of the afternoon, but then i'm having dinner with Barb & Ray and Pete & Laurie and their adorable combined collection of an infant and two toddlers. fun times ahead there, no doubt!

captured moments from the w/e at Glenmount

Down by the bay, Colpoys Bay...

Evidently, Collyer thought that
blueberries, maple syrup and buckwheat pancakes were a
great way to start the day
there weren't many apples, but it was a lovely day for rambling in the meadows
Sawyer went up after the higher crop
team effort to prepare and press the apples into cider,
sadly, most of it ended up watering and fertilizing the lawn
but what we did get to taste was delicious!
yikes!
Carrie decided a haircut was desperately needed
She let Dawn and i go at it with the scissors...
work - in - progress
um, well, some of it is shorter, anyway!

stuffing

noun - 1) savoury concoction of cubed day-old bread, onion, peppers, raisins, apples and seasonings and turkey juices, baked either inside or alongside the bird and served as an accompaniment, often on such a festive occasion as Thanksgiving dinner 2) fluffy substance, either natural or synthetic, used to fill pillows, blankets, sleeping bags, jackets, etc either as insulation or cushioning.

verb - 'to stuff': the act of adding more of a particular substance than that usually contained by a particular vessel.

eg.

Glenmount for Thanksgiving weekend was stuffed with 13 people, increasing to 21 at the table for dinner saturday evening. Present were Mom, Dad, Me, Jack, Carrie, Dawn & Edward, Sawyer, Collyer, Brian & Laura, Leah, and Sanjay. This was Sanjay’s inaugural visit, he is a friend from Jack’s program, (recently arrived in Canada to continue his studies), but we expect to see him here again, hopefully with his wife the next time. We were joined at various points throughout the w/e by Jim & Val, Fred, Hazel, Jordan, Kent, Carolyn, Mark & Tanya and Heidi.

All occupants were stuffed with nutritious and delicious meals including familiar favourites such as spinach salad with maple-pear dressing and toasted pecans, mushroom pie, homemade swedish rye bread (limpa), turkey, stuffing and cranberry salad with a symphony of sumptuous garden-fresh vegetables, honey pumpkin pie, dutch apple pie... We also tried out some new ones, which are destined to please our palates again in the future - these included curried pumpkin soup, figgy apples, and a pumpkin cheesecake with bourbon-laced whipping cream.

The days were packed with recreation and fellowship - hiking and picking apples (there were not many readily accessible so we used some creative harvesting tactics, and they were small - a low year for wild apple yields, it seems - good thing Carrie picked up a couple of bags from the Meaford orchards on her way home) at mountain lake (where there is no mountain and a very small, shallow lake, but lots of lovely meadowland and a riot of seasonally coloured mixed forest in which to tromp around), pressing apples into cider in the backyard (5 gallons of which poured out of the bucket onto the grass in a tragic turn of events when someone stood up suddenly and the table top shifted into its other ‘bench-like’ configuration as the weight distribution changed - that was a sad, sad state of affairs), walking down by the bay at sunrise, visiting a local potter’s shop in the successful search for a thank-you gift, running old familiar routes nearby, playing in the yard and gardens, worshiping at church, enjoying scenic backroads on the drive home, hiking and spelunking at Bruce’s Caves, taking turns to talk with Jody on the phone, reading, napping, and engaging in activities related to the preparation, sharing, and cleaning up after meals lingered over and enjoyed.

All in all, the weekend and the house and the inhabitants were all stuffed to the point of being pleasantly filled without being crammed, and I am so grateful for this time together with family, and with friends who feel like family. The abundant blessings are gracious gifts from God, meant to be enjoyed and shared, and with gratitude, we endeavour to do so day by day.

for the beauty...

puffball bounty
mom amidst the milkweed and pines
milkweed pod liberation
dancing fluff

une vacance!

I'm on vacation, just starting a week at glenmount.

i anticipate reacquainting myself with the marvels of autumn in old familiar spaces as i hike, cycle and run nearby and elsewhere on the Peninsula. This afternoon mom and i went rambling about on top of the escarpment and through 'our' planted forest - we gathered dainty dried weeds for one vase, and an armful of some wild micro-daisy variant of the mum family for another, a handful of brilliantly coloured oak and maple leaves, and topped off our found-harvest with puffball mushrooms to peel, dice and freeze for later nourishment and enjoyment in the form of velvet soup and savoury mushroom pie. we wondered if deer have been bedding down in the long grass. we delighted in the vigorous growth of the trees. we marvelled at the abundance of milkweed and the beauty of it's seedbearing silken tufts being liberated from the split pods and dancing en plein air.
...for the beauty of the earth, we praise you, Lord...

i expect to savour more delicious home-cooked meals featuring garden produce and the local harvest. On the weekend, i feasted among friends in London. Local features included homegrown pears and maple syrup in a salad, 'volunteer' acorn squash that grew out of dirt spread from Tim and Ericka's compost pile - halved and baked with that same family-sugared-off maple syrup, and ON apples grated into waffle batter and tossed into fruit salad. This evening, Mom, Dad and i enjoyed garden fresh beans and Canadian quinoa (from NorQuin in SK) with hearty and flavourful vegan Egyptian stew. i gathered a huge bowl of cherry tomatoes this afternoon, and noticed the abundance of ripening peppers, and the carrotts, beets and potatoes ready for the digging at any time.
... for abundant provision and the ability to participate in cultivating nourishing food,
we give thanks...

i do have some work to accomplish, so i've set up some home-office space here and the list of tasks is incrementally shortening, although some major ones should be written on in huge font - to remind me of their largess, and to increase the satisfaction in crossing out when that right is finally earned!
... for calling, intelligence, and capability - for your glory and your unfolding purposes...

i look forward to more reading - for work (research and critical appraisal preps)
and for induling other interests...
Here's the list of books I currently have on the go:
'Napoleon's Buttons: 17 Molecules that changed history',
'GRUB: ideas for urban organic kitchens' (Anna Lappe and Bryant Terry)
'57 Words that Change the World: A Journey through the Lord's Prayer' (Darrell R Johnson),
'Mudhouse Sabbath' (Lauren Winner)
...with gratitude for opportunities to learn from the past, marvel in your creation's complexity, live purposefully in the present, hope for a better future, and have faith in Your kingdom coming fully for forever...

and to spending more time with
friends -
on the weekend in London i savoured time to visit with Ericka & Tim, Kelly, Kent, Brent, Quang, Agnes, Fred & Hazel. tomorrow i'm meeting up with Carolyn for the evening, and Wednesday night is reserved for Corinna. there will be familiar faces and new ones too as others join in to fill the house for Thanksgiving weekend here.
and family -
i enjoy being in the company of my parents, lingering over meals and working away at various projects in and around glenmount as we talk on matters of greater and lesser significance. this weekend it will be wonderful to spend time with Jack and Carrie, and to chat with Jody on the phone all together and by turns. Our cousins and their boys from Ancaster will be here for the weekend too, welcome additions to the household anytime!
... with thanks for creating relational humanity, and for placing me within this family and these ever-evolving circles of community...

and now, for sleep...

roaming dooshima: uprooted and replanted

... coming to you now from the heart of
'the true north strong and free',
i am tucked in along the shoreline of Superior,
feeling incredibly blessed and thankful
for this life i am given by God
and the opportunity provided to be me!

this new blog will accompany me throughout my northern odyssey, which is scheduled to continue for at least the next two years as i journey through a family medicine residency based in Thunder Bay.

the foreword is that thus far in 2006,

i travelled from coast to coast over a couple of weeks for residency interviews in Jan and Feb, enjoying rich fellowship with friends along the way and enduring the rigors of CDN winter (snowbound days and associated complications in TBay and Halifax added to the adventure).

winter turned to spring as i ranked programs (with much inner turmoil and fervent prayerful consideration throughout the process), matched to Thunder Bay, enjoyed the last few months of med school, and buckled down to prepare for my licensing exam in early May


after the exam and graduation, Carrie and i loaded up my fabulous voiture (Mazda 3 Sport in Copper Red Mica, in case you are wondering) and set out to roam about on the East Coast of our beloved homeland.

:In Ottawa,
we visited RJ, Michele, their boys and Kodak, as well as Caro, Ma'n Pa Doyle, and Plato

:We stopped near Truro to deliver an orchid and some grandkid art to our cousins' mother-in-law (and had a great cup of tea and some birthday cake, and a fabulous storied tour of their 200+? year old home)

: We continued on and stayed for several days with our amazing aunt in Charlottetown, and were delighted by the opportunity to meet up with an old friend of mine from TWU who married into a potato and tulip empire over there and is busy with a growing family. We also did some cycling (it seems we found the hilliest roads for our 100km touring route!) and a lot of strolling during our stay on the island.

: on to Nova Scotia, where my friend Alex from BC flew in and joined us for a week. We journeyed on around Cape Breton at a leisurely pace, until the start of the Cabot Trail Relay (we were part of a cobbled-together-at-the-last-minute team with a lot of spunk and enthusiasm, and varying degrees of speed and stamina. Once the relay started, our pace increased considerably and further sightseeing happened while we were driving from one start/finish area to the next, cheering for our teammates, or surveying the landscape on our respective legs of the run. We did respectably well as a team, and sure had a lot of fun in the process!

: then it was time to move on to 'the rock' - we took an overnight ferry to Port-au-Basques, and Alex stayed with us as far as Deer Lake, and then Carrie and I continued as far as Trinity, Elliston and Bonavista before turning around an making our way back (the long ferry from the other end of the big island wasn't yet running for the season). We toured about, enjoyed local lore and libations and fare, we hiked and cycled, we drove and looked and photographed, we talked and laughed and learned.

: by the end of our stay in NFLD, we were nearing the end of our allotted 20 days of available time for roaming, so we drove and drove and drove with just a few stops along the way for walks, fueling up (us and the car), and a good night's sleep before the final stretch across ON to London and then on to Wiarton, where we rested (briefly, before the next adventure).


Several of my med school friends got married, and i was able to join in the wedding festivities for Elaine & Fabian, and for Loretta and Jag. it was also great to spend time with med school friends again, but bittersweet as many of them i won't see often anymore as our paths diverge.

then it was time to pack up and leave 'the forest city', and make the move to Thunder Bay. I'm living with my friend Ruth (also from UWO Meds '06 and now in the same program as me here), in a spacious half-a-house we're renting here, so we also shared a UHaul. Hi-yi-yi - that was a FULL 26' of truck! many thanks to Mom, Jody, Jim, and Ruth's parents for helping us so much with the move - and also to Jim for driving the truck for us - and for Val and my Dad lending their moral support in absentia and sending their prayers along with us! Ruth's parents and my mom stayed for several days, helping us unload and move in to our new home.
and a home sweet home it is at that...

We had a week to settle in, and then a week of orientation activities before we started working full time, which facilitated a smooth transition into residency. We have a fun, eclectic and supportive group of fellow residents (in our own year, and in the group ahead of us), and i'm enjoying these new friendships.

I started off with 8 weeks of internal medicine as my first rotation, and it was very busy and challenging - a valuable and good experience overall, but certainly tiring at times! it's taken some getting used to, this whole actually being a doctor part, more in terms of getting used to the title than anything else - although the increased paperwork, dues, fees, etc are worth noting as well. being paid to work is great, although between loan interest, rent, various insurances and fees, utilities, food and gas... there's not much left for 'incidentals' at the end of the month, and certainly not much remains for trying to make a dent in the debtload! anyway... i try to remind myself to seek first the kingdom and trust that these things shall be added as the need arises!

i enjoyed a couple of trips back to SW ON over the summer, for Ang and Bryan's wedding in July (and associated WHSS 'flawless girls and friends' reunion), and for a week of vacation in Hamilton and at Glenmount before J left for her southern odyssey in Chile. It was such a blessing to fellowship among family and friends, and catch up on some much-needed rest!

Currently i am doing a family med rotation in Marathon, about 3 h East of TBay along the shoreline of Superior. I was here for a month during my 3rd year of med school, and it's great to be back. I was delighted when one of my first patients was a 15-month old that i had delivered during my last rotation here! It was very reassuring to realize that i do love family medicine in a small-town setting (there was a L-O-N-G interval between making my program decision and actually being in the midst of what i chose). It is generally a good thing to figure out that you love doing whatever it is that you signed up for...

anyway - you are now more or less updated on the recent roamings. more of the little thoughts will follow.

peace & joy,
dooshima