Thus, the month of January comes to an end. Has anyone gotten started on their New Year's resolutions yet? I still haven't picked any resolutions yet.

The past weekend on call was relatively exciting. There were a number of cardiac arrests and unstable patient events that happened on Sunday. While normally junior residents are not required to respond, Marko (another one of the junior residents) and I ran to all of them to take part in the resuscitations. I have only five more months to go until I have to start running resuscitations. I figure the more I take part in these, even in the slightest role, I can learn something, or get better at something.

One of the cardiac arrests involved a four hundred pound patient with more previous heart attacks than I have fingers and toes. It took an anesthesia resident to intubate (place a breathing tube) the patient. Two of the senior residents tried to start central lines at the same time, but were unable to after multiple attempts because there was no way to landmark where insert finder needles. One resident held the patient's body fat out of the while attempts at centrals lines were made. The nurses had to practically climb on the patient to do chest compressions. We weren't even sure if the chest compressions where doing anything given the sheer size of the patient.

I ended up being the guy yelling "clear" and shocking the patient because I could actually reach him without touching my body to the patient's. Of course, with each shock, the patient's heavy arms would fly up and smack me. The first time it happened, I was certain the current had hit me too. Then I quickly realized that if that had happened that I wouldn't still be awake.

Eventually an anesthesia resident managed to a hard-earned central line into the patient's neck. Heather (our simply amazing chief resident) led the resuscitation and did everything possible we could do. In the end, I think there were three junior residents, four senior residents, a respiratory therapist, and an army of nurses all doing something in a very small room. It got to be very hot, and amplified the smell that inherently comes with a four hundred pound person. Poor Marko got sprayed with blood, a nurse nearly got hurt when she fell off the bed while doing chest compressions, and of course, everyone smelt awful from all the activity and crowding.

We were unable to revive the patient. Death had already been knocking at this patient's door for a very long time, and Death finally got his answer.

Photos / Prague Czech Replublic - go to section

- 15 New Photos

Happy New Year to everyone. Tomorrow (January 29) is the first day in the Chinese year, the year of the dog. I get to spend tomorrow working at the hospital. On the bright side, I hope it will bring comfort to one Chinese patient I have on my service when I do my rounds in the morning. It will be the year 4702 by the Chinese calendar.

Tonight, we had a pseudo-Chinese year dinner with some of my friends. Only my roommate and I were Chinese, and we ate at a Japanese restaurant. The restaurant was run by Chinese people, so technically it was Chinese restaurant.

The rest of my family is all in Hong Kong right now, so I feel a little lonely here all alone in Canada. I think next year I will have to try to take a couple of weeks off to go back to Hong Kong. The next Chinese New Year is on February 18, 2007 though, so it will make it a little harder to get a full two weeks off for vacation.

Ervin redesigned his site, thought there are supposedly still some minor changes to come. Go check it out.

Woof. I should go to sleep now.

Photos / London England - go to section

- 14 New Photos

Well, the week has gone by rather uneventfully so far. The ward has been relatively busy, but the new medical students on the rotation have been keen and hard working, so that kept my work load relatively light. I am on call at the hospital tomorrow night and Sunday night. The senior residents that are on Friday and Sunday are stellar, so if things start to spiral out of control, I know there will be good back up. I have gotten to do quite a few procedures on this rotation, from emergency central lines in unstable patients, to draining fluid from the bellies of patients with liver disease. I must say, I quite like working with my hands again.

Anyway, this is just a quick post. I hope everyone has a good weekend.

Well, the weekend is now over and so begins another week at work. Yet, this new week is going to be four weeks at work with no weekends. I will be going on vacation at the end of February. Everyone else on my team is also taking a week off sometime during February. So of course the call schedule has me on for three weekends in a row, which will effectively make me work every day for four weeks straight. I tried to go and get it changed, but apparently there's no alternative. Oddly enough, I'm actually looking foward to the challenge.

I completed another chunk of the site redesign earlier today, and I'm reasonably satisfied with it. It's not pretty, but it's better than the way it looked before. The forum is also officially dead until I find a good solution to the problem. As luck would have it, the new php forum that I wanted to install so badly costs $160USD, which is a pretty penny to say the least.

Reading my posts below, I think I really need to lay back on the cynicism, or at the very least stop posting when I am tired and or post call. I hope everyone has a great week.

Alex, I expect you to update with something funny this week as opposed to making me wait an entire month, and I also expect you to put a link on your website to my site. Geez.

Photos / Pumpkin Carving - go to section

- 33 New Photos

Links - go to section

- 2 New Links - SigneMusic and Aaron's Photos 4

Entire bags of chips eaten this month: 2

I have been using the same layout for five years (for updates), and it is about time to change things around a little. Unfortunately, by changing the format of this main page, it may or may not destabilize the rest of the site. So watch your step when navigating about today.

Cascading style-sheets are so useful, epsecially when combined with php. I used to use them (style sheets) sporadically on the site, but now I'm trying to use them as much as possible.

One of the great mysteries about being on the general medicine wards is that despite the long hours, it feels like that nothing ever gets done. I think one of the problems is that so much time is spent sitting around thinking and discussing with a massive team about how to manage each and every patient. This process is great when a patient's condition is a mystery, but other days the procedure is a phenomenal exercise in dragging one's feet. I think I somewhat hate myself on when on general medicine because I feel so inefficient.

I recently had a patient, who weighed nearly four hundred pounds, bed ridden for years, and lived to the age of seventy-five because of the wonders of modern medicine. I ended up managing a number of failing organs, anti-biotic resistant infections, pain everywhere, and narcotic dependence, among other issues. The only problem is that all these issues existed years before being admitted to the hospital and a mild viral infection tipped this patient over the edge. To fix all of her problems would take nothing short of Jesus Himself laying hands on the patient. Even trying to talk to the patient was so depressing because he/she was always moaning in pain. We never actively shorten anyone's life, but at times like these I wonder why we are required to prolong suffering by delaying the death of someone heavily debilitated who would otherwise have died of long ago.

I ate an entire bag of chips today.

I hope everyone had a great 2005. The New Year is already a week old and before we all know it, it will be 2007.

The terms resident and house-staff have been all to true thus far on my current rotation. I am on the general medicine service, which is probably the busiest rotation in internal medicine outside of the critical care rotations. With each day of frustration in trying to find long term care for ill patients and spending inordinate hours rounding on people, there has been always something great to learn about. Whether it be drawing out liters of fluid from the belly of a patient with alcoholic cirrhosis or learning some new medical management nugget of wisdom, there is always something to discover.

There is something new in my life. It is big, ugly, high maintenance, makes squeaky noises, and weighs a ton. No, it is not a new girlfriend. I bought a bike to ride to and from work when it gets warmer. It is a pretty decent budget bike, but the thought of it potentially being stolen still bothers me.

In other news, I am still single. Yeah, I am about as unsurprised as the rest of you. One would think that the hospital would be great place to meet women. Female doctors who are still single because men are afraid of them, various allied health professionals like physiotherapists, pharmacists, and social workers, and let us not forget, nurses. Especially nurses, one would think that with disproportionate number of women and homosexual males to heterosexual males in that profession, that there would be masses of single nurses. It seems as though most of the single nurses though have already been through a marriage or two or three, and have kids. As for female doctors, dating colleagues, like in any other profession, is like trying to put your hand into a nice big candy bowl: selection, quality, and easy access. The only problem is that the candy bowl turns into a vat of acid, filled with acid-spitting hornets that also shoot lasers if you screw up.