The Himalayas.

During a recent health expedition in northeast India, I had the unique opportunity to spend a month in some of India’s rural Himalayan villages.  We spent most of our time in West Bengal, but also visited Sikkim – the tiny “hidden gem” state which borders Nepal, Tibet and Bhutan.

The local people are a beautiful mix of Tibetan, Nepalese and Indian. As such, the culture is diverse and unique.  I was constantly humbled by the people and the breathtaking surroundings.  I learned a lot about tropical medicine and a lot about myself. Here are a few sights from a trip of a lifetime.

Photos by Susanne Price, 2009.

CaRMs

CaRMs (Canadian Resident Matching Service) is a process that anyone who has applied for medical residency in Canada is very familiar with. Through the CaRMs electronic application process and matching service, candidates apply for postgraduate training in their chosen specialties. Basically, candidates submit online applications, reference letters, personal letters, and any other required information to CaRMS, and then choose the schools and specialties they’d like to apply to. Candidates then wait patiently to hear from programs for invitations to interview. Once the interview period is over, which often involves travel across the country, it’s time for candidates to rank the schools and programs they want. The programs rank the candidates that they have interviewed and also submit their rank to CaRMs. Then, based on these ranks and through some magical process, the CaRMs matching system spits out where you’ll be completing residency and what you will be doing with the rest of your life. This happens on the long-awaited MATCH DAY.

For anyone preparing for CaRMs interviews in the future, I’ve listed some of the questions I was recently asked during my interviews for Family Medicine. Keep in mind that depending on the school and program, the interviewers may not have seen your application, so often they won’t know things about you unless you tell them. My interviewers at Dalhousie University had access to my personal letter only, so I had to remember aspects of my application that I thought was important to share.

Sample  CaRMs Interview Questions for FAMILY MEDICINE

Why do you want to be a family doctor?

Tell us why you’ve applied to our program, and what has brought you to this decision.

Talk about a patient that had an impact on you.

Give an example, either through personal experience or clinical experience, of empathy and what that means to you.

Give an example of how you have been creative, either in your personal life or in medicine; or tell us about an achievement that you are proud of.

Share an experience where you were a team member and you had to deal with conflict; how did you deal with it and what was the outcome?

Tell us about yourself.

What do you feel are the positive aspects of family medicine?

Give an example of a difficult patient that you have had to deal with; how did you manage and what was the outcome?

What do you feel are the negative aspects of this specialty?

Do you have any questions for us, or is there anything we haven’t covered that you would like to share about yourself or your experiences?

MATCH DAY is MARCH 9, 2009.

Good luck 2009ers!!

Photo: MUN Med Class of 2009. White Coat Ceremony 2005.

Fabulous St. John’s Wedding Vendors

In July 2007, my husband and I had our wedding in St. John’s, Newfoundland. We didn’t hire a wedding planner, and we were planning on a budget.  As such, we did A LOT of shopping around for every aspect of the wedding to find exactly what we wanted for a reasonable price. And I’m glad we did. We were extremely happy with everyone involved in making our wedding happen.

If you or someone you know is planning a wedding in St. John’s, check out my list of favorite vendors.

Fabulous St. John’s Wedding Vendors

Photography

Kim Goodyear and Jennifer Gillard were our wedding photographers, and I can’t say enough good things about them.  Our experiences with them, from the early stages of planning to the finished product, were fantastic! They encouraged a very nontraditional approach, with few posed shots and many candid ones…which was exactly what we wanted.  They were also quite flexible (not to mention super fun and budding comedians!), and made sure they captured specific shots that we asked for.  They provided a relaxed atmosphere, and were often “behind the scenes” clicking the camera and discretely capturing moments  (some moments I didn’t know about until I saw my photos!).  Kim and Jennifer are one of the reasons we had such an enjoyable and memorable day, and our photos were just perfect.

www.newfoundlandwedding.com

The Cake

Mandy Young, from St. Philip’s, NL, baked and decorated our cake.  I  met with her once in her home and described what I wanted, and she exceeded my expectations. She was very reliable and easy to work with. She arrived at the reception site and set up the cake, and I didn’t have to worry about a thing. We served the wedding cake as dessert, which turned out to be a great decision! It was beautiful and DELICIOUS!

www.mandysweddingcakes.citymax.com

The Flowers, Part I

Murray’s Garden Centre and Horticultural Services arranged our bouquets for the wedding. We were very happy with the prices, the service and the flexibility (I changed my order 3 times because I couldn’t make up my mind!). The bouquets were beautiful.

www.murraysgardens.com

The Flowers, Part II

A good option for beautiful flower arrangements that can save you money is to go with Dominion or Sobeys florists.  For our table centre pieces and for other larger arrangements for the room, we went with Sobeys.  We were very pleased with the flowers.  I’d advise that you pick a florist that you’re happy with and who’s work you’ve seen or heard of through photos or recommendation.  The flower arrangements were exactly what I was looking for, and I didn’t have to break the bank for them.

The Officiant

If you’re looking for a nontraditional and nondenominational wedding ceremony, Wendy Squires-Ennis is a good choice for Marriage Commissioner.  Working with Wendy allowed us to incorporate our own wedding vows and personal touches to the ceremony.  She was extremely well organized and arrived early at the ceremony to ensure everything and everyone was ready.  She truly helped make our day special and memorable.

www.wendysweddingworks.com

The Wedding Venue

The Fluvarium, located in Pippy Park, is a great choice for the wedding reception and/or ceremony, especially for small weddings. We had approximately 60 guests and wanted a nonreligious ceremony, so the Fluvarium was a perfect fit.  The nearby walking trails are a great way for guests to keep themselves occupied while waiting for the reception to begin.  The Fluvarium also has underwater viewing windows on the lower level which give views of Nagle’s Hill Brook; this is especially nice for the younger guests.   Of course the Fluvarium is just one choice of many for great wedding venues in St. John’s, but it worked very well for us.

www.fluvarium.ca

The Food

Taste of Class is a catering company based at the Bella Vista in St. John’s, and is one of the caterers that provides services at the Fluvarium.  We were very pleased with Dereck Collier (chef) and the Taste of Class team.  The food was amazing and the service was efficient, professional and friendly.  They were very flexible and agreed for us to serve our wedding cake for dessert.  They also added special extras to the tables such as chocolate covered strawberries.  We highly recommend Taste of Class for your wedding!

www.bellavista.ca/atasteofclass/about.htm

The Music

I first met Jack Daw and Charlie Barfoot at a function I attended in St. John’s. I was so impressed with them, that I just had to call them up and ask if they would provide the music for our wedding reception.  Jack and Charlie provided an acoustic guitar and double bass duo, and played a mix of traditional newfoundland, jazz, and classical music during our dinner.  They set the perfect atmosphere for our dinner, and my guests are still talking about how beautiful the music was.  Not only do these guys have amazing talent, they have amazing personalities as well. I’d highly recommend Charlie and Jack for weddings or any other function you’re planning.

All photos by Kim Goodyear and Jennifer Gillard, 2007.

Cyril.

My earliest memories of Cyril are from my elementary school years. Cyril lived just down the road from our house.  Every time there was a school fundraiser, Cyril’s house was one of the first places I’d go.  I’d pack up my backpack with chocolate bars and make my way down the steep and narrow road to Cyril’s small white house at the very bottom of the hill. He always bought 3 or 4 bars, which made him my favorite customer.  “I’ll give these to my grandsons”, he’d say, as he handed me $8 in exchange for the bars.  He’d proceed to ask how my parents were doing, and how my grandparents were doing.  He had very thick white hair and very tanned skin.  His face was friendly, and his voice was loud, but gentle.

Another early memory of Cyril was his garden and his apple trees.  He had several apple trees which were often the target of late night raids by some of the older kids.  They would climb up those trees and get as many apples as possible, often breaking several limbs in the process.  I didn’t give it much thought at the time when I heard kids talking about it, but now it kinda makes me sad that they didn’t respect his property.

Almost two decades later, I married Cyril’s grandson, Steve.  I soon learned that the friendly old man who lived at the bottom of the hill was much more than just that.  It didn’t take me long to start loving Cyril like my own grandfather.

I learned that Cyril had been a very hardworking man all of his life. He spent years working long hours in the woods and living in the old camps.  He had only attended one half day of school in his life, but he was very bright and very wise.  He and his wife Elizabeth had 10 children.  Cyril lost his wife very early, when she died suddenly in her late 40s.  He never remarried.  He finished raising his children on his own, and then lived by himself in his house until he was 85.  He loved to grow things and put a lot of time and effort into making his garden just right.  Apple trees, and flowers of every color and variety.  Almost every evening, he’d walk up over the garden to Steve’s parents’ house to have supper with the family.  Sometimes he’d participate in the dinner table conversation.  Other times, he’d turn down his hearing aid (I guess so he could eat in quiet!).  He’d usually sit at the table for a little while after supper was finished, then put on his hat, and make his way back down through the garden again.

What I appreciate about Cyril the most was the impact that he had on my husband.  Steve practically grew up down over the hill with his ‘Pop’, constantly by his side, absorbing every word and action.  Cyril taught Steve how to fish, how to grow things, how to make things, and countless life lessons.  He spent hours sharing stories, passing on his experiences and reflections.  It’s easy to see that Steve has held on to each and every story and lesson that his Pop shared.  Steve not only inherited his Pop’s physical features, but also his strong and silent personality, his love for the outdoors, his practical knowledge,  and his sense of self confidence.  As Steve stated, “Pop was quietly confident and as steady as the sunrise”. And I can see all of these qualities in Steve.  It’s what I love about him.

Cyril died on January 21 2009, at the age of 86, after a short battle with pneumonia and finally a stroke.  His death was quick, and his family was by his side when he took his last breath.

Since his death, I’ve been thinking a lot about life and death and the footprints we leave, or don’t leave, behind.  Cyril left his mark, and has truly made the world a better place.  I hope I can be like him, and take the time to share, love, teach and give something back.

I didn’t thank him for buying all those chocolate bars, and I didn’t tell him how much I appreciate the influence he had on Steve and on me, and will likely have on our children and our grandchildren.  But I don’t think I needed to.  He wouldn’t have wanted any thanks.  It was just who he was.

He will be deeply missed.

Donations can be made in memory of Cyril Ings to the Heart and Stroke Foundation of Newfoundland and Labrador.

Stick to the Right

New York City is a remarkable place. Recent news from the Hudson River got me thinking back to our visit there this past summer. The lights, the skyscrapers, the theatre…it’s all fantastic! One of my very favorite things to do in NYC, and in any city, is to spend an early morning or a late evening walking around, with no plans or expectations, taking in all the sights and sounds.

By far my most favorite walk in New York is the Brooklyn Bridge. This neo-gothic bridge is a work of art in itself. It has a walkway above the traffic which offers spectacular views of Manhattan’s skyline. It’s loud and it’s crowded. But if you stick to the right (cyclists on the left), and take your time to enjoy the views, it is actually quite serene.

Photos by Susanne Price and Steven Ings, 2008.

Lessons from Medicine.

During my medical school interview I remember being asked ‘what does a family doctor mean to you?’ I remember sitting there for a moment, taking a sip of water from the styrofoam cup sitting in front of me, and thinking nervously about it for a moment before answering. As part of my response, I talked about what the patient needs a family doctor to be. I remember saying that a good doctor should be an effective communicator. I thought I knew what good communication meant. But the truth is it has taken me four years of medical school, and personal experiences on the receiving end of the health care system, to really grasp what good communication is and the impact it can have on patients and their families.

I recently worked with a urologist who delivered a cancer diagnosis to a patient. The doctor walked into the room, pulled up a chair next to the patient, put his hand on the patient’s shoulder and gave the news in simple and honest terms. Even though his clinic was running late and patients were waiting outside, he took the extra 15 minutes to explain the diagnosis and answer all of the man’s questions. Each gentle word and genuine gesture seemed to lift the weight off the patient’s shoulders, piece by piece. I believe the man and his wife left the office that day well informed and with a sense of security during an uncertain and scary time.

I’ve also seen doctor-patient interactions on the opposite end of the spectrum. Doctor walked into the room, stood at the opposite end of the room from the patient who had been recently diagnosed with cancer…“Ma’am, the cancer you have puts you at very high risk of recurrence. You’re going to need surgery, and then chemotherapy and then radiation therapy…here are all the treatment options….blah blah blah blah…..here are some booklets to read…any questions?” I couldn’t fight the knot in my stomach or the tears. My family members in the room that day were silent and fearful, trying to process the news. We don’t remember half of the mumble-jumble that was said that day. Luckily, we had much better interactions over the following months. But it goes to show that choice of communication makes all the difference to a patient and their families.

Lessons to be learned? They’re basic things, most of which we’re taught in kindergarten. Whether you’re the doctor, the patient or the family member, be honest. Be kind. Take time to listen. Don’t be afraid to ask questions. Be informed. Care.

Photo by Kim Goodyear and Jennifer Gillard, 2007.

Save your Couch!

My husband and I had been considering getting a new dog for about 2 years before we finally decided to get Phoebe, a now 6.5 month old Golden Retriever. We got her at 3.5 months of age from a highly recommended breeder. She’s been much more work than we anticipated and she often tests our patience. But she’s a wonderful dog, and we are in love with her!

Like most large breed dogs, Phoebe loves to chew…A LOT! She will chew on ANYTHING!

I’m definitely not a dog expert, but I’ve had to learn pretty quickly how to deal with a dog that loves to chew. Here are some chew toys we’ve found to be very helpful and have provided hours of chewing pleasure:

1. The KONG

The Kong is one of the very best chew toys out there. You can find Kongs at most pet stores, and they come in a variety of sizes depending on your dog’s size. They are extremely durable and virtually indestructible. You can fill the center with the Kong brand treats made specially for the Kong. A cheaper and equally effective option is to fill the Kong with dog biscuits, peanut butter or cheese. It will keep your pup occupied and happy for a long time. You can gradually increase the size of the treats you use to keep the Kong a challenging game for your dog.

2. STERILIZED BONES

These are strong, hollow bones. They’re inexpensive and last forever (well, for Phoebe’s lifetime so far anyway!). Like the Kong, you can fill these bones with treats, peanut butter or cheese. Phoebe also enjoys it on its own with no added flavor. Make sure you get a bone large and strong enough so that your dog won’t break it into pieces or swallow it.

3. NYLABONES

These bones were recommended by our breeder. They come in a variety of flavors and sizes depending on the size and chew strength of your dog. Along with the Kong, these were Phoebe’s favorite chew toys for the first 4-5 months of age. She now spends most of her chew time with her Kong and sterilized bones, but she’ll still go to her crate to get her Nylabones from time to time.

Chew Toys that May or May Not be Good Options:

1. Stuffed Toys:

Stuffed toys may not be a good choice for strong chewers. Up until Phoebe was about 4 months, we bought stuffed toys for her from a local pet store. They used to last her for a week or two, but now seemingly tough stuffed toys are no match for Phoebe’s strong jaw and teeth, and are destroyed within a few minutes. Of course, if you can afford it and you’d like to give your dog a treat once in a while, a stuffed toy will offer loads of fun for a few minutes. Just be sure you take the toy from your dog before he/she starts eating the stuffing!

Stuffed toys can be a good choice for dogs who aren’t strong chewers, and for new puppies (they seem to get a sense of security from their stuffed toys). Make sure you choose toys that don’t have small parts that can be easily chewed off and swallowed.

2. Raw Hide:

Phoebe loves rawhide! However, she likes to chew the rawhide into pieces and then tries to eat it. I’ve read that if your dog likes to do this, then it is best to avoid rawhide. If your dog is the type of dog that just likes to suck or gnaw on the rawhide without destroying it, then it can be a very good choice.

A piece of advice from a new dog owner: Buy quality chew toys for your dog, even if it means buying the more expensive toys. It will keep your dog happy and will save your couch!

Recommended reading: Good Owners, Great Dogs. By Brian Kilcommons.

Finally a blogger.

My first official blog.

I’ve been wanted to start a blog for some time now, but never got around to starting one until now.

Blogs are a great way to get your thoughts out there. To write whatever you want, to whoever bothers to read; to keep a record of meaningful moments and photos, to reflect, and to just write….or so I’ve heard. These are reasons I decided to start a blog anyway. Time will tell if I actually stick with it.

And starting a blog was super easy. Of course it helps when you’re married to a computer genius. He started his own blog recently and is really enjoying it. But really, all I did was follow a few easy steps on wordpress.com, and voila! I have my very own blog! Of course, there are lots and lots of blog options out there, but I like this one because it’s easy to set up and easy to use.

Happy Blogging!

Photo by Steven Ings, 2008.