Saturday morning.

6:45 am. Saturday Morning.

Actually woke up about two hours earlier. Just had a baby.

Instead of filing back home to sleep I decided it was a nicer moment to enjoy a McDonald's breakfast by the pier.

Afterwards I managed to spend the rest of the morning in bed with my book.

By myself again in a great big house.

Roommate moved out, landlord left town, parents visited and left, I moved all my stuff from my basement room into one of the upper-stories bedroom. I moved the desk up here as well, making it very home-like. The soft-toned walls, the nice sheets and comforter, the tight but functional space, the brighter windows and lighting. I'm amazing how conducive I am to my environment. From migrating up from basement to cozy bedroom, I feel more liberated, more inspired to work and enjoy my time here. It's starting to feel like home. It's a little quiet, being here all by myself. But I like the privacy, I like my isolation, I like my alone-time. 

I've discovered that I like to organize all my stuff in a neatly laid-out display on my corner table. It gives me a sense of tidiness in my otherwise chaotic mind. 

How did I managed to yet again pack so much stuff for my 2 months stay here? I quickly filled the closet. But then again, I have my car to transport all my stuff. I could have taken more. 

Surrounded by hills.

The light rain and on-coming thunder has washed away the ashes from the nearby forest fires. In the sky, the smoke is clearing. 

Three days into my stay here at Salmon Arm, I realized that we are surrounded by mountains. 

It's quite beautiful, actually. All around, low-profile mountains act as guardians around this quiet, private lake-side town. The bay at the edge of the Shuswap lake is quiet, and the water usually still. 

Looking out, the horizon meets more mountains, forming a doorway in the water, preserving the privacy of this intimate community, and reminds me of being in a quiet little fishing village in rural China. 

But in town, the charming, tidy downtown reminds you that you are still at the heart of civilization. The small shops that lined Lakeshore drive carries productions that actually generates an interest from the passerby. The classic movie theatre carries small-town flare with hollywood-made entertainment. Tonight, I enjoyed a quiet meal of Beef Don and Salmon Roll in a neat Japanese restaurant with Vancouver-quality dishes. 

And best of all, coming here with my car makes all the difference between feeling like stranded in a foreign place versus feeling completely at home in a new environment. The car is my sanctuary, my nest. Climbing inside, I am reminded that I am not here alone, but with the luxury of a trusted sidekick that can carry me wherever I want with ease and excitement. 

It's a comforting reminder of a home away from home. My object of familiarity when everything else is new. 

An Epic Roadtrip

"You're crazy," I was told. "It's too rushed"

Insanity. It's too much driving. 

Over 4000 Kms. 9 days. 

From mile 0 of the Alaskan Highway at Dawson Creek, to Fort Nelson, Watson Lake, hit Whitehorse, cross over to Skagway, Alaska, then double back and then down the Cassiar Highway to Smithers, then cross the Yellowhead past Prince George and hit the straight-away home down Highway 1 back to Vancouver. 

So that I can have one day of break, before I hit the 5-hour drive to Salmon Arm for my next 2 months for another rural family medicine rotation. 

Yes it's tight. But with two glorious parents who were willing to drive all the way up from Vancouver to Dawson Creek to meet me for this insane roadtrip, with our lovely little Nissan that also did the trans-Canada trip, I felt that we could do it. 

For we had always wanted to drive to Alaska. This is the best opportunity. 

I had it all figured out. On average we would drive about 6 hours a day. That's enough time left for side detours, photo stops, lunches, and a few stops to check out the scenes. It works for people like us who seldom like to stay at one spot for too long anyways. Plus we just love the open road, the leisurely freeway cruise, the soaking-in of the road-trip music and the ever passing sceneries before our eyes. All while we act silly in our car all day. 

We just love to go places, covering the more ground the better. 

It's gonna be neat. I can't wait until we hit the mountains. It's gonna be quite a journey. 

Bongy and Bernice, wish you guys were here with us. 

Learning to fly an airplane

Ever since medical school, I've always felt skeptical at how anesthesiologists like to compare their work to that of a pilot flying a commercial airliner. How arrogant, I thought. Airline pilots are much cooler people. 

Now I am starting to see the reasoning for their altered egos. 

Doing anesthesia IS very much like flying an airplane, and I think that's why it's starting to really appeal to me. You have to be very anal retentive, and quite organized and thorough in your approach. Before each case, you go through a mental checklist with your pre-op assessment to build a detailed operative plan, much like a flight plan before each takeoff. You consider all variables and options and balance all risks and benefits, all the while trying to put your freaked out patient at ease. 

Then you enter your work station, the OR. You again follow a practiced routine in checking all your monitors and equipments. Your work space is ladened with all sorts of bells and whistles, and you can be as complete as you need to be in monitoring all parameters of the patient during the operation. In certain types of cases such as ears-nose-throat surgeries, you lose access to the patient and the airway once the case begins. You are then depended on your monitoring as you "fly by instrumentation" to ensure a safe and peaceful journey to your patient in order to live up to the promise that you have given them before the case began. 

Once the case is on the way, you essentially keep an eye on the patient by a series of second-hand parameters. Everything is a surrogate, but with enough experience you build a good understanding of what is happening to the patient at each point in time with those surrogates. The respiratory rate went up, oh he must be in pain, let me give him a little more pain control. He's fighting the ventilator, oh he must he "light", let me top up his anesthetic. The goal of the exercise is to do everything preemptively. For you want to foresee what might happen and prevent it before it ever does, much like an experienced pilot foreseeing any wind turbulence and change altitude to ensure a steady and smooth journey. 

Finally, when all is said and done, you have the landing, or emergence from anesthesia. Careful planning make for a smooth landing, and proper timing of your reversal agents and stopping of anesthetic agents make for a smooth dreamy wake from surgery as if the patient had just taken an afternoon nap. When things are done beautifully, the result is a very rewarding experience for both the patient and the anesthetist. With modern medicine, it is amazing what you can do to a patient under the right anesthetic without them experiencing a frightful and painful experience such as surgery. 

Anesthesia really is quite a neat specialty. With powerful drugs and effective monitors, you can pretty much control every facets of your patient's physiology. But more rewarding, however, is that you are in the field of relieving suffering, whether that suffering is physical pain or emotional fear. From the very onset when you go and greet a patient, you are exerting your therapeutic relationship in an attempt to calm and reassure them from all the fears and worries they have of their surgery. Show a sense of confidence, and the patients will feel that they're in good hands. Toss in some humor, and they might relax a little bit more. Hold their hands, and they will feel that they are cared for. All this, before you have even given them a single drop of medicine, and they are already ready to begin. 

ATV on Crack.

Yesterday, my friend Ian, a student up here on an elective, took me Off-Roading in his 1999 Jeep YJ. I've never done off-roading before, and wasn't even sure what it would involve. All he told me before hand was, "wear some shitty clothes, because you might get muddy". In a CAR? I wondered. But good thing I listened. 

It was incredible. I had never really witnessed what a vehicle can do when you push it to the rocky limits. It really made me respect these Jeeps, and not your average SUV at that. These machines are like ATV on Crack, with roll-bars and all. The experience gave me a whole new appreciation on 4-wheel-drive (for quite often our trip depended on just two or sometimes just one wheel to keep us going). There's quite a lot of technical skills it takes to do off-roading safely. You don't just go recklessly into the woods and tear up the trail. But it was amazing. He even let me drive his jeep for a few practice trails. I've always wanted to drive a Jeep. Working the long stick of this heavy-duty machinery was just a blast. 

Ian preparing his blue beast for the trip. 

Entering into the trails. We choose trials that were meant for ATVs in the summer or snowmobiles in the winter. They are like obstacle courses, basically, with hills and poddles and mud and all. We went about 30 minutes south of Dawson Creek into the Bear Mountain and Radar Lake area. 

Me behind the wheel of his blue beast. 

The mighty Jeep tackling another muddy route. 

Ian and I scouting out this mud pile to find the best seam to take. 

More surveying the area before keeping on. 

This was probably the riskiest area. Down a steep slope and onto a bridge that was blocked, so we had to go on the side and into the stream where we almost got stuck. 

Our car richly embedded into the stream and the front bumper catching on the log. We successfully backed the car up and got enough of an angle to craw up the log and get out of trouble. 

Success!

The muddy ride. I even got mud in my HAIR at the end of the trip. That's how much mud we kicked up. 

Ian and I with our proud moments after we finished the trip. 

Dawson Creek Rodeo and Fall Fair

Every year, Dawson Creek holds an annual "Fall Fair" (even though it's in the summer), rich with Rodeos, Chuckwagon races, rides, fair games, and an abundance of cowboys and cowgirls and horses. It's quite a bit thing here, and plenty from nearby towns come by for a piece of the action. In the evening, the fireworks kick start a night of good times and the vibrant beer gardens keeps the fun rolling. It was quite a treat to be here at the right time to be a part of this crazy event.