Taking the Real World with You

When I went to Chicago for the first time in 2012, I had just finished my first month as a senior resident in a Medical-Surgical Intensive Care Unit.  That rotation was one of the most difficult months of my entire training.  My medical knowledge and patient management skills were challenged beyond anything I had ever experienced, and I lived in constant fear that my ignorance and/or incompetence was going to kill someone.  With only three residents in the unit, we were forced to take call every third night*, such that I was making difficult patient care decisions through a haze of severe sleep deprivation. 

And then there were the patients.

Because the unit was home to the sickest patients in the hospital, death was a constant presence.  The worst night of my training happened in that unit:  over the course of a 15-hour overnight period, I admitted or ran a code on eight patients, not a single one of whom survived to the morning**.  At 8 am, one of my co-residents walked into the unit, looked at the near-empty patient list, and nonchalantly commented "Oh, looks like you had a quiet night".  In another situation her comment would've made me bawl, but I was too emotionally drained to do anything more than put my head on the desk and moan.  It was a hard month.

My ICU rotation was followed by two weeks of vacation, which I had initially planned to spend relaxing at home and visiting with friends and family.  But as I dragged myself through the too-long days of ICU, subsisting on digestive biscuits and ice cream cups that were intended for patients, I knew that I needed something better to look forward to in order to make it to the end of the rotation.  So, a few days before I was finished with ICU, while lying nearly immobile on my couch in a post-call stupor, I booked an impromptu trip to Chicago.  Leaving at 6 am on the first day of my vacation.

It was an amazing trip.  Chicago was a beautiful city filled with interesting places to visit and a seemingly unending list of great places to eat.  The weather was perfect.  I lucked out and got a great hotel room on the 22nd floor that looked directly towards the Chicago River and the Wrigley Building.  And for one week I didn't have to take orders or give orders or feel people's pulses slip away as I held my hand over their femoral arteries.  It was the perfect escape.

I had hoped that my trip to Chicago this past weekend would be just as amazing.  And I will say that it was mostly fun, lest I seem ungrateful for having the good fortune to be able to travel to such a remarkable place.  I got to show my Mom a city that I love; I got to meet Carlos from Top Chef season 11 and eat in his amazing restaurant; and I left the pressures of work behind for four days.

But.

My family is not always easy.  My Mom is going through a difficult period, still struggling to cope with the death of my father six years ago, and there was understandably a lot of time and attention devoted to what she's going through.  She also snores.  Loudly.  And unpredictably.  I spent the first night on the couch to get away from her, and the second night I severely pissed her off by making her sleep in my brother's room.  Thankfully he is so perpetually exhausted that he can sleep through anything.

And then there's my brother.  While I love him (really...I love him), he and I see the world through very different lenses***.  I am an unapologetically left-wing, environmentally minded, socialistic granola cruncher.  My brother takes ten napkins at Chipotle and throws out nine unused ones.  If we could simply agree to disagree, we would probably get along much better; however, we both think that we have all the answers to the world's problems, and we are determined to share them with each other.  So there was some conflict.  He said I was judgemental.  I may have called him an asshole.

The good thing about family is that they are always your family.  Even if you call them an asshole.

*The resident contract in my province stipulates that residents cannot take call more than once every four days, on average; however, in situations where "patient care would otherwise be compromised", that rule can be overlooked.  Hence the one-in-three call.

**I refuse to believe that this reflects on my skill as a physician in any way.  The patients were simply that sick.  Most of them didn't make it to the end of the code blue.

***Thankfully he isn't a Trump supporter.  There are some things that I cannot forgive, even when it's family.

Values

Tonight I went to a talk about climate change by Naomi Klein, a Canadian writer and activist.  Going into it, I was worried that it was going to be a depressing lecture about how the Earth is doomed, complete with photos of polar bears floating adrift on melting icebergs.

Instead, the talk was a call for transformation - from fossil fuel to renewable energy, from a profit-driven economy to a human-centred society, from isolation to community.  It was 90 minutes of a left-wing, granola crunchy vision for humanity*, and I loved it.  Her talk encompassed everything I believe about how the world should strive to operate, only articulated in a vastly more intelligent and entertaining way than I ever could.

As I listened, I was hopeful that the world might just be capable of realizing the things I believe in:  environmental sustainability, racial/gender/sexual equality, empowerment of the poor and the marginalized.  And I wondered, what is my role in this?  As a physician (and as a queer, able-bodied, white, upper class woman), how do I live out my values and contribute to the society that I want to see?  How do I move beyond earning a paycheque and paying off debt to making a lasting change in my community?

I don't quite know yet, nor do I have the energy to really delve into this question late on a Friday night, but it is definitely something to think about.  Any ideas?

*Supported by a very solid research base and understanding of economics/politics/world systems. 

A Post on Parenting by a Childless Woman

One of my good friends from medical school has three children between the ages of 7 months and 5 years.  When it came time for her to go back to residency after her first maternity leave*, she and her husband were faced with the inevitable question of who would take care of the child.  From a financial perspective, it made much more sense for him to stay home, so they decided to go against the societal norm and make him the stay-at-home parent.

Now three children into the process, it seems to be working very well for them.  My friend thrives on her work as a physician and earns enough to support the family, while her husband (mostly) enjoys being the primary caregiver.  Whenever I visit, he is the person that the children go to first, whether for food or comfort or just to whine about one of their many grievances. 

Although the arrangement is mostly good, it does come with its own set of challenges.  While there is a huge network of supports available to mothers from the beginning of pregnancy onwards (exercise classes for pregnant moms, lactation groups, mom-and-baby programs), there is very little for fathers who choose to stay home with their kids.  There's the constant judgement of women who choose not to stay home with their children.  And then there's the never ending societal narrative that says that women should be the caregivers, not men.  It's present in ads for baby products that feature only mothers, in the language we use to describe parenting (e.g. talking about fathers who "help" with the kids or who "babysit" them when the mother is away), and in the way we label restrooms for parents with kids as "Mommy and Me" restrooms.

Even though I don't have children, and probably never will, these things frustrate me to no end.  They frustrate me because they make it unnecessarily hard for fathers to stay home with their children, even when that's what works best for their families.  They frustrate me because they perpetuate the idea that a woman's role is to raise the children, regardless of whether she would prefer to be in the workforce.  And they frustrate me because they limit us to traditional gender roles, even though two X chromosomes don't automatically make a person a better parent than an X and a Y.

We have to start doing better.

*Unlike in the States, Canada has a great parental leave policy that allows the mother and/or father to take a combined total of 50 weeks of partially paid leave.

Summer Bounty

Thanks for all of the suggestions on what to do with our abundance of CSA vegetables.  Tonight we had a CSA feast - grilled zucchini and pattypan squash, roasted beets with balsamic reduction, steamed baby carrots, and a cucumber-yogurt salad (thanks for the idea NOLA!).  The vegetables were so varied and flavourful that the barbequed sirloin steak seemed like an afterthought.

Washing down the meal was a bottle of Valpolicella Ripasso that I had brought back in my suitcase from a trip to Italy in 2013.  The bottle had long been stored at the back of our liquor cabinet, waiting for a special occasion to be opened, and I worried that I might have left it too long.  Thankfully the cork came out effortlessly, and the wine inside was smooth and mellow.

It's amazing to me how good local food can be, whether it's purchased in your home community or smuggled home from a special trip.  With such foods, why on earth would anyone buy flavourless food from Walmart* that has been shipped from hundreds (or thousands) of miles away?

*I hate Walmart, but that's a post for another day.