Yesterday I had my first experience at getting a real good glimpse of some of the conditions of the First Nations reserves, especially in these remote settings. Yesterday morning I embarked on a two-hour boat ride with my attending physician to do a clinic at one of the smaller, even more remote villages than where I am already stationed. They only have a nursing station there full-time, and he's the only visiting physician at the moment.
Their health centre there is impressive; it looks like it was built within the last decade and is still in rather good shape. My clinic had its interesting variation - MRSA impetigo, uncontrolled diabetes, an incision + drainage, etc.... but it was the home visits that made the most lasting impression on me.
Without going into too many details, I saw some of the worst conditions of poverty that I can remember in my life time. I'd like to think I've had my fair share of exposure to seeing people live in dismal conditions given my mother is from the Philippines, and ensuring I witness the realities of living conditions there from a young age, and the summer I spent in rural Tanzania a few years ago. But some of the conditions I saw yesterday... I couldn't remember the last time I saw some situations that hopeless. One particular household, I don't think I'll ever forget. Everything from the condition of this prominent non-mobile elder who we were treating, to the condition in which he and his family lived was not something you could make up. It was a confusing feeling too. They were not a conventional obvious lack of food, clothing or basic needs like you see in those World Vision ads. This household seemed to have these necessities; but its upkeep was non-existent. Clutter was scattered everywhere from old discarded electronics to food crumbs. There was food out, which had clearly been out for weeks given that it was covered in mold. Our patient only seemed to have his home-care nurse looking after him judging by the dry urine and flaking skin around him. Earlier that week, apparently a dog had to be removed from the property due to being severe malnourished. I spent that morning on a two-hour ride on a 17-foot boat in choppy waters after eating a gigantic egg and cheese sandwich, and it was after that home visit that I felt the most ill that day.
It's not a feeling of pity I took away from the home visits. While I did feel sorrow and sadness for these families, it was more than that. I felt embarrassed that these living situations occur regularly on these First Nations reserves within our country on which we pride ourselves on our strong social infrastructure, and that while we call ourselves a "first world nation", these pockets all over the country are clearly no better than developing nations.
I can't attach blame to these feelings though, or offer insight into what I've seen. My time here is also shedding even more light to me on the layers of complexity of the relationships between the government, First Nations people and other citizens of this country. Many fractures exist. In many ways I have seen the friendliness, openness and beauty of these First Nations villages and its people, but I have also learned more about the politics, tensions, dynamics and bureaucracy that exist at many levels. Some people dedicate their lives to these aforementioned areas.
There's still so much to learn.
Showing posts with label Residency. Show all posts
Showing posts with label Residency. Show all posts
16 May 2014
12 May 2014
Remote BC
Just finishing up my first week in a super rural remote First Nations village, Bella Bella, along the pacific coast of British Columbia. It's on a small island that actually faces east towards the mainland of BC but between the two land masses is a pristine ocean channel through which fishing boats, whales, kayaks and the occasional ship traverse.
The town's most prominent guests are its ravens, crows and bald eagles. On any given day, I can count a handful of any of the above either soaring high in the air, perched on a tall post or tall tree branch or flying low above the rooftops. I've never seen this many bald eagles in my life. On Sunday, when I think some fishing boats came in, I saw at least four bald eagles circling above. They're basically the pigeons of this town. Haha.
A pleasant custom I learned on arrival is you wave or greet anyone with whom you cross on the road. It doesn't matter if you're driving a vehicle or going a walk, a friendly wave is the norm, regardless of familiarity. It adds an extra element of openness and courtesy. Anonymity is not likely around here.
The band store is where people get any sort of groceries. It's not cheap to import anything so while I was looking to maybe have a half pint of blueberries today, I'm also not keen on paying $6 for it. It hurts paying $6 for a 1 L bottle of milk too. Unfortunately, the cheapest things in the store are canned or preserved meals, candies, sodas and junk food. Good luck making an affordable salad or snacking on fresh fruits for very long. Trying to bake an apple crisp would probably set somebody back at least $20 on the apples alone.
The people here are pleasant and actively interested in who you are, which makes the transition easier. They want to know your name and where you're from. It's been a week and I've stuffed myself full from two gracious dinner invitations.
I've spent an afternoon kayaking on the calm waters, watching the soaring birds of prey look like circling specs over certain areas of forests. You gotta wonder what kind of prey they're stalking. I'd love to catch one of them in the act of swooping down to catch a mouse or fish.
On a run, looking west of the town are rolling hills of coniferous trees as far as I could see. Of course, the rolling hills meant my pace was getting destroyed on that run, haha.
I hope to check out some hiking trails this week if the weather clears up, and of course more kayaking. What I would give to see a whale while I'm on the water...
The town's most prominent guests are its ravens, crows and bald eagles. On any given day, I can count a handful of any of the above either soaring high in the air, perched on a tall post or tall tree branch or flying low above the rooftops. I've never seen this many bald eagles in my life. On Sunday, when I think some fishing boats came in, I saw at least four bald eagles circling above. They're basically the pigeons of this town. Haha.
A pleasant custom I learned on arrival is you wave or greet anyone with whom you cross on the road. It doesn't matter if you're driving a vehicle or going a walk, a friendly wave is the norm, regardless of familiarity. It adds an extra element of openness and courtesy. Anonymity is not likely around here.
The band store is where people get any sort of groceries. It's not cheap to import anything so while I was looking to maybe have a half pint of blueberries today, I'm also not keen on paying $6 for it. It hurts paying $6 for a 1 L bottle of milk too. Unfortunately, the cheapest things in the store are canned or preserved meals, candies, sodas and junk food. Good luck making an affordable salad or snacking on fresh fruits for very long. Trying to bake an apple crisp would probably set somebody back at least $20 on the apples alone.
The people here are pleasant and actively interested in who you are, which makes the transition easier. They want to know your name and where you're from. It's been a week and I've stuffed myself full from two gracious dinner invitations.
I've spent an afternoon kayaking on the calm waters, watching the soaring birds of prey look like circling specs over certain areas of forests. You gotta wonder what kind of prey they're stalking. I'd love to catch one of them in the act of swooping down to catch a mouse or fish.
On a run, looking west of the town are rolling hills of coniferous trees as far as I could see. Of course, the rolling hills meant my pace was getting destroyed on that run, haha.
I hope to check out some hiking trails this week if the weather clears up, and of course more kayaking. What I would give to see a whale while I'm on the water...
16 November 2013
Trail mix
Nothing compelling to write about today, so instead it will be a pot pourri, nay a TRAIL MIX of quick points:
Arcade Fire - We Exist
- I had a couple interviews this week for two very good programs. Two more to follow in the next two weeks. I always find it interesting the extremely friendly yet underlying tense atmosphere behind interviews especially when it is happening en masse. It's also intriguing how one portrays and sees oneself because it is a time where you're putting yourself on display, like a product to be purchased.
- I think these interviews were actually the first time I've faced the 'panel' format versus the in vogue 'MMI' more commonly seen for medical school and residency interviews. The most striking difference is it is essentially over before you know it. There's no rest time to regroup. You gotta lay it out all on the line all at once.
- I really like that music can be (in fact it should be) a shared experience. Some of my most favourite and unique artists, were from friends' recommendations. Basia Bulat is an example, from my friend Courtney who randomly went to her concert, and I've posted one of her songs below.
- I wrote 'can be a shared experience' above because it's not always shared. It can often be a rather unilateral dictation of what people should or should not like especially in the blogosphere, or what's good and what isn't. I've always maintained that songs I post here are "favourites" (i.e. subjective taste), and not something that can be objectively seen as "best".
- Speaking of favourites, Arcade Fire is out with their newest album Reflektor. I've listened to it a few times and the album as a whole isn't quite pulling me in. It's growing on me a little but, only a few isolated songs stand out to me. I posted my favourite one below.
- Another pet peeve about the blogosphere climate is only a handful give credit where it's due or cite the site (lol) when they post something "new". Comes with the pretentiousness I guess.
- I miss gourde season.
Arcade Fire - We Exist
02 November 2013
Who needs coffee when you have CCR?
Busy night? Yeah. A couple hours of interrupted sleep, on home call night no less.
How do I fix this zombie-like sensation?
How do I fix this zombie-like sensation?
- CCR - who needs coffee when you have them?
- Fresh ground coffee, just for good measure
- Avocado scrambled eggs - I made these a few months ago when I had some extra guacamole lying around and the results are MARVELOUS. The avocado add this extra creaminess in the eggs that just make it melt in your mouth. Added some cilantro, feta, cheddar and grape tomatoes today. Hallelujah!
Walt Jr. would be so proud.
08 October 2013
Sometimes life's OK, some med news, big music days
Typically I feel kind of blue when I come out of a long stretch of inactivity or inconsistency with blog posts, like I'm not imaginative, creative or committed enough to keep up with posts. After all, it's designed to be an outlet to share my thoughts, ideas and/or things I'm enjoying.
I think this is one of those times, however, when I'm not as regretful. As Modest Mouse says, "sometimes life's OK". It's been a busy past couple months with longer hours at work, applying for future endeavours, committees or commitments around work like journal club or meetings, and trying to stay active. Unfortunately, blogging isn't the only thing that takes a step back. I haven't had a long chat with my family for a couple weeks although I've shot a few emails and texts a couple times a week.
Of course, since it's been almost two months(!!) since I've posted, there's a lot to share!
First off, a rare comment about a medical matter. Over the last couple months, word has gotten out about a new decision rule to be used in emergency departments developed here in Ottawa: the Ottawa SAH (subarachnoid hemorrhage) rule. Some of the same people brought us the well-known Ottawa ankle rules, Ottawa knee rules, and CATCH pediatric CT rules, Canadian CT head rules, and Canadian C-spine rules. Some people like long walks on beaches, but these guys prefer to make RULES. Who can blame them? They make clinical decision-making for some difficult scenarios a lot more streamlined and methodical.
The unique side of things from my side is that this is the first time that I've been close to the action, so to speak. It's making some waves in local press, but it's also intriguing to see one of these rules come hot out of the oven with its results, and immediate response, critique and feedback in essentially real-time in the medical community. It is impressive that it offers 100% sensitivity, but what's even more interesting is how they're able to achieve that goal, as detailed in this blog post. You can find a more critical discussion here. It will be interesting how this unfolds in the next few months.
On to music...
The number of quality releases in 2013 continues. As previously discussed, I was a huge fan of Entertainment! and Random Access Memories which were my big two for a huge chunk of the first half of the year. In the tier below, I also listened heavily to new albums by Tegan & Sara, the National, Savages, How to Destroy Angels and Bonobo, and more.
This fall there has been another massive wave of solid albums. As solid as two-week old bread. Wait, that's not a good analogy. What's a good solid? Like a never-ending popsicle on a hot summer day.
I've been trying to simultaneously balance...
Lastly, in tribute of the end of the best ever shows on television, and from another great 2013 album...
I think this is one of those times, however, when I'm not as regretful. As Modest Mouse says, "sometimes life's OK". It's been a busy past couple months with longer hours at work, applying for future endeavours, committees or commitments around work like journal club or meetings, and trying to stay active. Unfortunately, blogging isn't the only thing that takes a step back. I haven't had a long chat with my family for a couple weeks although I've shot a few emails and texts a couple times a week.
Of course, since it's been almost two months(!!) since I've posted, there's a lot to share!
First off, a rare comment about a medical matter. Over the last couple months, word has gotten out about a new decision rule to be used in emergency departments developed here in Ottawa: the Ottawa SAH (subarachnoid hemorrhage) rule. Some of the same people brought us the well-known Ottawa ankle rules, Ottawa knee rules, and CATCH pediatric CT rules, Canadian CT head rules, and Canadian C-spine rules. Some people like long walks on beaches, but these guys prefer to make RULES. Who can blame them? They make clinical decision-making for some difficult scenarios a lot more streamlined and methodical.
The unique side of things from my side is that this is the first time that I've been close to the action, so to speak. It's making some waves in local press, but it's also intriguing to see one of these rules come hot out of the oven with its results, and immediate response, critique and feedback in essentially real-time in the medical community. It is impressive that it offers 100% sensitivity, but what's even more interesting is how they're able to achieve that goal, as detailed in this blog post. You can find a more critical discussion here. It will be interesting how this unfolds in the next few months.
On to music...
The number of quality releases in 2013 continues. As previously discussed, I was a huge fan of Entertainment! and Random Access Memories which were my big two for a huge chunk of the first half of the year. In the tier below, I also listened heavily to new albums by Tegan & Sara, the National, Savages, How to Destroy Angels and Bonobo, and more.
This fall there has been another massive wave of solid albums. As solid as two-week old bread. Wait, that's not a good analogy. What's a good solid? Like a never-ending popsicle on a hot summer day.
I've been trying to simultaneously balance...
- Haim, Days Are Gone (I was waiting for it for months and gosh it did not disappoint)
- London Grammar, If You Wait
- Lorde, Pure Heroine
- Disclosure, Settle
Lastly, in tribute of the end of the best ever shows on television, and from another great 2013 album...
11 August 2013
Mind drawing a blank
It's odd, I haven't posted much recently not due to forgetting about the blog per se, or not having much going on (quite the opposite)... I guess I'm just having trouble finding topics I really want to talk about in a longer, more united post. Maybe I'll just leave it up to a "quick hits" post today:
- I did my first ever triathlon last weekend! It was a sprint triathlon (500 m swim, 20 km bike, 5 km run) and was an interesting challenge. I remember feeling more mentally and physically exhausted after the half marathon, but this was its own challenge. My relative inexperience in the open water swim and the cycle leg showed, not to mention my transitions. Fortunately I made up a lot of ground in the run. I'll be looking to do another with a long-term goal of finishing an Olympic length triathlon by the time
I'm 30, no let's say 2014... - While "training" for the triathlon I found myself trying to challenge my times with some slightly longer run distances. Ever since I started hitting the sub-5 min per km consistently this spring, I've been pushing myself distance-wise. I'm now at the point where my all-time 8 km record I achieved in Grade 10 (2003!) of 36:45 is now within reach... my most recent run hit ~37 min, so I'm still a few seconds off. It's gonna be hard but not impossible at this stage...
- The next six months are really going to be testing my resolve and discipline as I look to go through CaRMS again. This may be the hardest I'll have to work to earn something...
- Mid August means that first "smell of fall" is on its way. What I mean by this is that there's always one morning probably 4-6 weeks before the first evidence of autumn hits where you can just smell or feel the fall air. It's kind of neat, but also kind of depressing even though I really do like fall. I don't think anyone really looks forward to summer ending.
- As much I've been trying not to, I've been binging on a lot of music this year. I partially blame Spotify, but I think there have been a lot of solid albums that have been released so far in 2013. I'll post some of my favourites soon.
31 July 2013
Helplessness
First post with some substance in a while, and it's gonna be a heavy one about work. I'll try not to divulge too much in the interest of not being too specific about the patient's case but I'll try not to be vague-city either.
I'm working with the ICU team right now so I help deal with calls from other units when their patients are in trouble. There was a guy we were called about last week who wasn't really responding to anything. At first I think the nurses just thought he was having a deep sleep but over time it became clear he wasn't responding to anything. He was generally high functioning and independent before coming to hospital for a totally unrelated issue. A young grandfather and a husband. I met his family. For the better part of an hour or two we really had no idea what was going on. He had a huge work-up done yesterday for a similar issue and nothing came back remarkable. Labs so far showed nothing either. Besides him being essentially comatose (GCS ~4), he was otherwise stable. I actually had to leave in the middle of transferring him to ICU to go to clinic in the afternoon.
Later that evening I decided to look up the CT of his head because I had an inkling he had something neurological going on. He had a massive intracranial bleed with midline shift and herniation. I was floored. I don't think I've been shocked about a test result for a patient in a long time. He had imaging the day before which was pristine and overnight for no reason he bleeds.
It made me think that despite all the training we get, the hours we put in, as much as we label ourselves "experts", when something like this happens to somebody, we're completely helpless to do anything. There was nothing that was significant in his history that could have caused it, nor could it have been prevented. In a profession where we are constantly searching for answers or remedies to ailments, mother nature pulled a fast one on us where all we could do is look and not have an answer.
I'm working with the ICU team right now so I help deal with calls from other units when their patients are in trouble. There was a guy we were called about last week who wasn't really responding to anything. At first I think the nurses just thought he was having a deep sleep but over time it became clear he wasn't responding to anything. He was generally high functioning and independent before coming to hospital for a totally unrelated issue. A young grandfather and a husband. I met his family. For the better part of an hour or two we really had no idea what was going on. He had a huge work-up done yesterday for a similar issue and nothing came back remarkable. Labs so far showed nothing either. Besides him being essentially comatose (GCS ~4), he was otherwise stable. I actually had to leave in the middle of transferring him to ICU to go to clinic in the afternoon.
Later that evening I decided to look up the CT of his head because I had an inkling he had something neurological going on. He had a massive intracranial bleed with midline shift and herniation. I was floored. I don't think I've been shocked about a test result for a patient in a long time. He had imaging the day before which was pristine and overnight for no reason he bleeds.
It made me think that despite all the training we get, the hours we put in, as much as we label ourselves "experts", when something like this happens to somebody, we're completely helpless to do anything. There was nothing that was significant in his history that could have caused it, nor could it have been prevented. In a profession where we are constantly searching for answers or remedies to ailments, mother nature pulled a fast one on us where all we could do is look and not have an answer.
01 June 2013
Saturday-at-noon music: 11 months into residency / Parov Stelar
What have I learned so far?
- As much as we made fun of the FIFE pneumonic in medical school, I find its framework has been vital for good patient care, rapport and satisfaction. Even from a medical side there have been countless times where an important piece of information was gleaned exploring this side. Go figure.
- Family medicine rulez. The people in my program are happy with their future in their profession, the flexibility and what limitless directions it can take. The job opportunities are endless, we are fostered in a positive environment and I've found it satisfying. Huzzah!
- Despite my previous point, medicine can consume you. Be careful. It will be all you think about at work, it is most of what you and your co-resident friends will discuss and it will seep deeper into your consciousness even more than in medical school. The hours are longer, the pressure is stronger.
- I started re-watching Scrubs (again). I have heard that out of all the medical shows out there it is the most accurate in its atmosphere, the conflicts and the stories. I couldn't agree more.
- In Atul Gawande's book, Better, he emphasizes the importance of asking every patient one question completely unrelated to why they are in hospital or about themselves. I saw the value in it but I am blown away by how much it improves my rapport with patients and in turn my enthusiasm to genuinely want to help them. You can see their faces light up when they see that you're not just running through the motions and show an interest in who they are. It can be anywhere from a simple "what do you do for work/fun/school?" or a follow-up question regarding a random tidbit they mention about themselves. I now actively try to do it at least once a day.
As much as I find it interesting looking back, the future is just as intriguing. I could be finished in just over a year, or more hopefully on to further training in something that will further diversify my future practice. Either way,
Whoa, this got too long! Anyways, here's my tune for the week. I stumbled upon Parov Stelar recently via Spotify (best music streaming service ever) and am really digging his jazzy-loungey-chill songs. Excuse my incoherence and lack of proper vocabulary, I'm a bit low on sleep. Just listen.
07 May 2013
Staycation + Ísjaki
When I started residency, I swore I'd make the most of my time off since we only get four weeks off each calendar year. I have written off staycations as silly, lazy and unambitious... yet, here I am on day one of it. A number of reasons have led to it today -- trying to save money, lack of coordination, and nothing really jumping out at me right now to justify a one week blitz somewhere. On top of that, the early summer-like weather Ottawa is getting right now kind of helps.
So here I am, anxiously trying to find ways to make the most of staying in town, and minimize playing Bejewelled before embarking on CTU this next block. Heh, kind of funny to be stressing about vacation.
Today's agenda: buying a portable charcoal BBQ, getting some CDs and PATIO
And now, to end the entry with a single from Sigur Ros's upcoming album. As much as I love that band, I don't think I've ever been this addicted to a single one of their songs. Best enjoyed with headphones or an excellent loud speaker :)
So here I am, anxiously trying to find ways to make the most of staying in town, and minimize playing Bejewelled before embarking on CTU this next block. Heh, kind of funny to be stressing about vacation.
Today's agenda: buying a portable charcoal BBQ, getting some CDs and PATIO
And now, to end the entry with a single from Sigur Ros's upcoming album. As much as I love that band, I don't think I've ever been this addicted to a single one of their songs. Best enjoyed with headphones or an excellent loud speaker :)
12 April 2013
Lazy Friday with its music, featuring Iron and Wine
Lazy Friday. At least partially, and as much as I can. The stage is set quite nicely for it to be lazy. It was a long day at work, I worked out yesterday making today a rest day, and there's nasty weather outside with winds, freezing rain, sleet and slush. I'm on call though, and every time that cursed pager goes off I jump, dreading a call for a consult from the emergency department.
Sipping the tea, got my loafers and wool sweater on, and I've got the coachella YouTube feed going in the background. It's kind of weird watching people sweating profusely while I'm a bit chilly wearing a sweater. What's weirder is watching Lee Scratch Perry perform live. Picture a 70-year old (wait, Wikipedia says he's 77!) Caribbean gentleman with a white beard dyed bright red, in a full red suit and baseball cap. I hope that if I live to be 77, that I'm living a rather healthy and functional life... but aiming to be singing reggae in 35 C heat at one of the world's biggest music festivals seems like it would be hard to top.
Anyways, I digress. Today I was wondering why it seems I post on every Friday. It seems like rather poor timing considering all forms of media including papers, TV, Facebook and twitter get the least amount of readership on this day of the week. Needless to say it's not on purpose. It is however the day of the week where I'm able to let out a big exhale and just let myself relax. Even though I'm on home call tonight, it's still the same.
As a result, I'm more able to unwind and enjoy listening to music. And there's a ton of it right now. I can't remember the last time I've had this many new release albums I simultaneously want to put on repeat. It's a nice problem to have. I'll be sharing more of that later, including a spring playlist for all y'all.
Posts in the near future will be about many albums that have been recent released in what is shaping up to be a massive 2013. To change it up, here's a tune from a few years ago. Probably my favourite Iron and Wine song. It's chilled, but the overlapping piano, drums, other percussions and guitar just makes me tap my feet. Love it! From his album, The Shepherd's Dog...
.
.
.
Well, there goes that pager...
Sipping the tea, got my loafers and wool sweater on, and I've got the coachella YouTube feed going in the background. It's kind of weird watching people sweating profusely while I'm a bit chilly wearing a sweater. What's weirder is watching Lee Scratch Perry perform live. Picture a 70-year old (wait, Wikipedia says he's 77!) Caribbean gentleman with a white beard dyed bright red, in a full red suit and baseball cap. I hope that if I live to be 77, that I'm living a rather healthy and functional life... but aiming to be singing reggae in 35 C heat at one of the world's biggest music festivals seems like it would be hard to top.
Anyways, I digress. Today I was wondering why it seems I post on every Friday. It seems like rather poor timing considering all forms of media including papers, TV, Facebook and twitter get the least amount of readership on this day of the week. Needless to say it's not on purpose. It is however the day of the week where I'm able to let out a big exhale and just let myself relax. Even though I'm on home call tonight, it's still the same.
As a result, I'm more able to unwind and enjoy listening to music. And there's a ton of it right now. I can't remember the last time I've had this many new release albums I simultaneously want to put on repeat. It's a nice problem to have. I'll be sharing more of that later, including a spring playlist for all y'all.
Posts in the near future will be about many albums that have been recent released in what is shaping up to be a massive 2013. To change it up, here's a tune from a few years ago. Probably my favourite Iron and Wine song. It's chilled, but the overlapping piano, drums, other percussions and guitar just makes me tap my feet. Love it! From his album, The Shepherd's Dog...
.
.
.
Well, there goes that pager...
06 April 2013
Hurry up, spring + new Bonobo
It's that funny time of year, well maybe especially this year. Mother nature teases us with the March equinox and the longer days, the sun beaming through the windows, but she's still keeping it nippy in these parts. Normally in Ottawa (apparently), the green is all around, but this year there's no denying that she's letting Old Man Winter linger a little longer.
Oh well, that's fine with me. I'm just happier with the extended daylight hours, and that I can ride my bike through the Market. Respirology is almost done, and I'd say it was probably the toughest rotation I was on so far in residency. Mental fatigue not so much due to long hours, which I can handle, but moreso from seeing tons of cases with dismal outlooks (idiopathic pulmonary fibrosis, end-stage COPD, lung cancers galore) and scratching tooth and nail to try to get some improvement or at least good follow-up for these people. It's also strange seeing Emergency from this side... I understand the political divide in the hospital a bit better now which I'd rather not delve into right now, but at the same time I really don't see much of a solution. Not many solutions + not many solutions for the politics = many frustrations.
With that, I'll try to focus on it being close to spring. Running my first race of the year tomorrow, just a 5 km to get things going. Aiming for a sub 5 min/km time.
Of course, I'll leave you with a tune today. Bonobo is out with a new album, The North Borders. He has an interesting interview up on NPR where he discusses sampling actual sounds you hear out in real life... trains, water, etc. His previous album didn't actually stick with me very much, but I like this one. It's excellent for almost any setting... chilling, reading, hosting -- a good sign it's gonna rack up some play counts with me :)
Below is "Jets", one of my favourite songs from the album.
Oh well, that's fine with me. I'm just happier with the extended daylight hours, and that I can ride my bike through the Market. Respirology is almost done, and I'd say it was probably the toughest rotation I was on so far in residency. Mental fatigue not so much due to long hours, which I can handle, but moreso from seeing tons of cases with dismal outlooks (idiopathic pulmonary fibrosis, end-stage COPD, lung cancers galore) and scratching tooth and nail to try to get some improvement or at least good follow-up for these people. It's also strange seeing Emergency from this side... I understand the political divide in the hospital a bit better now which I'd rather not delve into right now, but at the same time I really don't see much of a solution. Not many solutions + not many solutions for the politics = many frustrations.
With that, I'll try to focus on it being close to spring. Running my first race of the year tomorrow, just a 5 km to get things going. Aiming for a sub 5 min/km time.
Of course, I'll leave you with a tune today. Bonobo is out with a new album, The North Borders. He has an interesting interview up on NPR where he discusses sampling actual sounds you hear out in real life... trains, water, etc. His previous album didn't actually stick with me very much, but I like this one. It's excellent for almost any setting... chilling, reading, hosting -- a good sign it's gonna rack up some play counts with me :)
Below is "Jets", one of my favourite songs from the album.
24 March 2013
Last night
Resent.
It was not the busiest call shifts I've had, although I was running around for most of the day, well into the evening. I also got a "decent" 4 hours of sleep which isn't bad by call standards.
For some reason though, it was probably the most miserable I've been on call. It was the first time I despised my pager and wanted to hurl against a cement wall... but also had moments of brief panic if I thought I misplaced it because I couldn't afford to miss a page. I resented each page. I resented the ward calls from the nurses even though they just wanted to improve patient care. I resented each page from other hospital services. Some were appropriate, some were not -- but they were all because they wanted our help. I resented each consult from Emergency, cursing them for being soft consults even though I admitted most of them. I resented myself for forgetting a couple tasks along the way.
It was an unhealthy and unhappy 24 hours. On the bright side, it was only 24 hours and could have been longer on other services, and I don't feel this much like a storm cloud very often.
It's something for me to monitor.
It was not the busiest call shifts I've had, although I was running around for most of the day, well into the evening. I also got a "decent" 4 hours of sleep which isn't bad by call standards.
For some reason though, it was probably the most miserable I've been on call. It was the first time I despised my pager and wanted to hurl against a cement wall... but also had moments of brief panic if I thought I misplaced it because I couldn't afford to miss a page. I resented each page. I resented the ward calls from the nurses even though they just wanted to improve patient care. I resented each page from other hospital services. Some were appropriate, some were not -- but they were all because they wanted our help. I resented each consult from Emergency, cursing them for being soft consults even though I admitted most of them. I resented myself for forgetting a couple tasks along the way.
It was an unhealthy and unhappy 24 hours. On the bright side, it was only 24 hours and could have been longer on other services, and I don't feel this much like a storm cloud very often.
It's something for me to monitor.
13 March 2013
"Why do you want to be a doctor?", circa 2008
(ah, the beauty of shower thinking)
I remember this question was asked many times when I was applying for medical school in 2008. I had to explain it in essays, think of a unique way to tell my friends, and in a way reason to myself. In the end, it always came down to the patient, and being able to be there for someone in a way I couldn't in any other career.
Fortunately, someone (or some people) thought what I was saying was a good enough reason and I made it through, I'm almost a year into residency (wow). However, I'm looking back at that question and am wondering now if there's a slowly transforming mindset that is happening that is usurping the very reason why I went into medicine in the first place.
Before I start, I want to explain what happened today that triggered this train of thought. An older patient who I discharged today had a number of questions for me before she left. I was happy to answer some of them, but as time progressed I could sense myself getting more irritated at her persistence. I wanted to get back to finish the paperwork, and we were meeting to go over our patient list soon. In that instant though, I found myself wondering how I got to this point.
No matter what level of training, those of us in medicine face pressure on a daily basis. There's pressure to impress your residents or fellows senior to you, your staff, etc. You expect yourself to be able to answer all the questions they pose to you, and to do what ever task they ask you competently and mistake-free. It doesn't matter if you're told "it's ok" if you mess up, or don't know the answer, or that it's a learning environment, it gets to you. Secondly there are those smaller pressures, or annoyances that pull you in different directions. Tasks that need to get done. Did you write that progress note? Is that antibiotic dosage correct? Are you sure there's no interaction with these two meds? Is that abnormal lab value something you need to address? More items on that list.
Oh yeah, some sleep would be nice too. Are you going to get time for that on this call shift?
When you're not worried about how you're performing on a day-to-day basis, there's always a ladder to climb, or a rat race to finish. There's CaRMS in medical school, matching to the specialty you want. Evaluations, references, and elective experiences are all important. Then there's pursuing other fellowships afterwards. More references needed. Then there's securing an ideal job opportunity, or position. It's endless, and it's always in the back of your mind.
We also tailor the careers to the way we want. It's about our needs. What type of career will keep you mentally stimulated the most? What excites me the most? What lifestyle am I most comfortable with? How can I do more procedural skills? Where can I have the most autonomy?
Amidst all these arrows, sometimes the patient gets lost. Not literally. And in a way, not figuratively either. One of the biggest priorities of all is ensuring that you're not making this patient sicker or killing them. But what I think does get lost is the care.
We've all written that down in our essays. We wanted to go that extra mile for our patients. When we were just starting medical school or even before, we were resolute in believing the patient always comes first. We would all be that doctor who would sit by them longer than anyone else, be the one that really cares. Years later, am I still doing that? Am I still trying to do that? Do I even believe it's a legitimate part of my job description?
I'll be honest. There are days when I forget this conviction I had. I now think back to this lady who I was talking with today. All she had were a few questions for me. "Is it safe for me to continue exercising?" "Does arthritis affect my bones?" These aren't hard questions. I answered them... but in my mind, it wasn't so I could adequately educate her so she could better understand what illnesses she has, but so I could finish her discharge paperwork.
Remember your resolve, Josh.
I remember this question was asked many times when I was applying for medical school in 2008. I had to explain it in essays, think of a unique way to tell my friends, and in a way reason to myself. In the end, it always came down to the patient, and being able to be there for someone in a way I couldn't in any other career.
Fortunately, someone (or some people) thought what I was saying was a good enough reason and I made it through, I'm almost a year into residency (wow). However, I'm looking back at that question and am wondering now if there's a slowly transforming mindset that is happening that is usurping the very reason why I went into medicine in the first place.
Before I start, I want to explain what happened today that triggered this train of thought. An older patient who I discharged today had a number of questions for me before she left. I was happy to answer some of them, but as time progressed I could sense myself getting more irritated at her persistence. I wanted to get back to finish the paperwork, and we were meeting to go over our patient list soon. In that instant though, I found myself wondering how I got to this point.
No matter what level of training, those of us in medicine face pressure on a daily basis. There's pressure to impress your residents or fellows senior to you, your staff, etc. You expect yourself to be able to answer all the questions they pose to you, and to do what ever task they ask you competently and mistake-free. It doesn't matter if you're told "it's ok" if you mess up, or don't know the answer, or that it's a learning environment, it gets to you. Secondly there are those smaller pressures, or annoyances that pull you in different directions. Tasks that need to get done. Did you write that progress note? Is that antibiotic dosage correct? Are you sure there's no interaction with these two meds? Is that abnormal lab value something you need to address? More items on that list.
Oh yeah, some sleep would be nice too. Are you going to get time for that on this call shift?
When you're not worried about how you're performing on a day-to-day basis, there's always a ladder to climb, or a rat race to finish. There's CaRMS in medical school, matching to the specialty you want. Evaluations, references, and elective experiences are all important. Then there's pursuing other fellowships afterwards. More references needed. Then there's securing an ideal job opportunity, or position. It's endless, and it's always in the back of your mind.
We also tailor the careers to the way we want. It's about our needs. What type of career will keep you mentally stimulated the most? What excites me the most? What lifestyle am I most comfortable with? How can I do more procedural skills? Where can I have the most autonomy?
Amidst all these arrows, sometimes the patient gets lost. Not literally. And in a way, not figuratively either. One of the biggest priorities of all is ensuring that you're not making this patient sicker or killing them. But what I think does get lost is the care.
We've all written that down in our essays. We wanted to go that extra mile for our patients. When we were just starting medical school or even before, we were resolute in believing the patient always comes first. We would all be that doctor who would sit by them longer than anyone else, be the one that really cares. Years later, am I still doing that? Am I still trying to do that? Do I even believe it's a legitimate part of my job description?
I'll be honest. There are days when I forget this conviction I had. I now think back to this lady who I was talking with today. All she had were a few questions for me. "Is it safe for me to continue exercising?" "Does arthritis affect my bones?" These aren't hard questions. I answered them... but in my mind, it wasn't so I could adequately educate her so she could better understand what illnesses she has, but so I could finish her discharge paperwork.
Remember your resolve, Josh.
11 March 2013
The end of the TO chapter
It was actually pretty sad leaving Toronto in that last week. Mostly because living with Q and Court had gone so well. Not that I was expecting any problems, but it was almost being back in med school where we could casually hang out together, shoot the breeze, walk home together, and so forth. Near the end of the week I realized there was a variety of things I wanted to do when in town but never had the chance. I also struggled to understand where the time went. Sadface emoji.
The ICU elective itself was great. I felt I really hit my stride in the last couple weeks and got a decent amount of exposure (and success!) to procedures I was looking to get practice on while I was there, put myself out there a few times in management plans and juggling multiple issues in some of the more sick patients. In reality, it was an introductory exposure to critical care since I'm only a PGY-1 so I hope it sets me up for more comfort and preparedness for it next year.
Anyways, here are a couple highlights:
The ICU elective itself was great. I felt I really hit my stride in the last couple weeks and got a decent amount of exposure (and success!) to procedures I was looking to get practice on while I was there, put myself out there a few times in management plans and juggling multiple issues in some of the more sick patients. In reality, it was an introductory exposure to critical care since I'm only a PGY-1 so I hope it sets me up for more comfort and preparedness for it next year.
Anyways, here are a couple highlights:
 |
| If it looks like we're sitting around, looking at that empty chair, it's because we are. We Skype'd in James in Newfoundland who has been banished there. He seems to be enjoying it though. |
 |
| Being artsy on the drive back from a brief weekend stay in Kingston. It's too bad I don't have instagram anymore. |
 |
| Wandering around Kensington Market I came across a gem of a seafood market, Hooked. Other similar shops in the area were cheaper, but just smelled awful so I decided to take a gamble here. I think it paid off. I just had a brief conversation with one of the ladies behind the counter but I could tell she knew her stuff. I think it's incredibly responsible that they knew exactly where they get their fish, and the environment where they reside. I look forward to reading more about this industry and where I can find a similarly responsible seafood market in Ottawa. |
07 February 2013
Blink, and it's off to the center of Canada's universe
It's funny looking back to six months ago how terrified I was at the prospect of this rotation. I don't know what it is or was that caused obstetrics to give me so much anxiety. Now I face obstetrics call as almost like any other day, but with it just being a tad longer. As I increase the number of deliveries, perineal repairs and "exams" under my belt, the more it becomes something I look forward to doing. Muscle memory. Myelination. But you'll never corner me to say this type of work will be a focus of mine in the future!
The other day I delivered my first baby "independently". I use that word loosely because there is always a ton of nurses around, and an obstetrician peeked in to make sure everything was going ok, but it was the first time I didn't have the most responsible physician right over my shoulder until the placenta was on its way out and the hard part was over. She was in her third pregnancy, and this baby came out fast. I think there were... two pushes. Probably could have sneezed him out if she wanted. Anyways, it was a scary rush, like being let go on that two wheeled bike for the first time, and I felt great about it afterwards. The safety net was there of course, but it sure felt a lot farther away.
In a few days I'm off to Toronto for a month-long ICU elective. I've always had a great time in that city, but we'll see how it goes working there for a month. I'm staying with two good friends where I will be resuming my role as "Dupri", or Ted to Lily and Marshall, or the Phoebe/Joey to everybody else. It's an odd but familiar and comfortable role :-)
Don't know what to expect! Onward, ho!
The other day I delivered my first baby "independently". I use that word loosely because there is always a ton of nurses around, and an obstetrician peeked in to make sure everything was going ok, but it was the first time I didn't have the most responsible physician right over my shoulder until the placenta was on its way out and the hard part was over. She was in her third pregnancy, and this baby came out fast. I think there were... two pushes. Probably could have sneezed him out if she wanted. Anyways, it was a scary rush, like being let go on that two wheeled bike for the first time, and I felt great about it afterwards. The safety net was there of course, but it sure felt a lot farther away.
In a few days I'm off to Toronto for a month-long ICU elective. I've always had a great time in that city, but we'll see how it goes working there for a month. I'm staying with two good friends where I will be resuming my role as "Dupri", or Ted to Lily and Marshall, or the Phoebe/Joey to everybody else. It's an odd but familiar and comfortable role :-)
Don't know what to expect! Onward, ho!
28 December 2012
on christmas
4½ days... my most brief Christmas vacation ever. Such is life in residency, I suppose. I should be thankful I was a) able to go home over the break, and b) I had my time off over Christmas. Without a doubt there will be a few years in the future where I won't be so lucky.
Definitely felt too short. It was nice to see my family and many close friends, but there was no chance to have time for everyone I wanted to see. Our family is very fortunate to be able to afford to exchange gifts; I sometimes think about the contrast in emotions around Christmas if this were not the case.
One of the most unusual feelings I have in a year usually occurs around December 25th by around 10 PM. By this time, most gift exchanges, dinners, parties and masses for Christmas have all ended, and just like that the festive feeling is over. Sure, lots of relatives and family is likely still around but that sort of spirit you get with Christmas quickly zips to thinking about Boxing Day, then New Years. The Christmas songs come to a sudden halt. Nobody wears red and green anymore.
It's kind of funny because it seems every year the build-up seems to start a bit earlier. This year, it basically usurped Hallowe'en a few days before that was even done. And despite the slow rising action, its dénouement is almost non-existent.
And with that said, I see myself reflecting on 2012 and what it has brought me (oi vey, it was a lot), and also on what 2013 might have in store. Hey! I think this year I'll start my own set of predictions and see how it holds up for next year. I've never done this before. Suddenly, I'm strangely excited.
To come...
- some sort of 2012 musical wrap-up in my world
- Josh's duodenum's predictions for next year
- some vague attempt at being insightful
Definitely felt too short. It was nice to see my family and many close friends, but there was no chance to have time for everyone I wanted to see. Our family is very fortunate to be able to afford to exchange gifts; I sometimes think about the contrast in emotions around Christmas if this were not the case.
One of the most unusual feelings I have in a year usually occurs around December 25th by around 10 PM. By this time, most gift exchanges, dinners, parties and masses for Christmas have all ended, and just like that the festive feeling is over. Sure, lots of relatives and family is likely still around but that sort of spirit you get with Christmas quickly zips to thinking about Boxing Day, then New Years. The Christmas songs come to a sudden halt. Nobody wears red and green anymore.
It's kind of funny because it seems every year the build-up seems to start a bit earlier. This year, it basically usurped Hallowe'en a few days before that was even done. And despite the slow rising action, its dénouement is almost non-existent.
And with that said, I see myself reflecting on 2012 and what it has brought me (oi vey, it was a lot), and also on what 2013 might have in store. Hey! I think this year I'll start my own set of predictions and see how it holds up for next year. I've never done this before. Suddenly, I'm strangely excited.
To come...
- some sort of 2012 musical wrap-up in my world
- Josh's duodenum's predictions for next year
- some vague attempt at being insightful
26 November 2012
If a tree falls...
Time for some free-writing...
Post-call day (day off after a 24-hour or overnight shift)! I'm sitting at home after a workout and my limbs feel similar to jelly, satisfied after a relatively healthy lunch. It's 15:48, what to do? I've already caught up on Walking Dead (can't wait for the mid-season finale), drinking some fresh ground and brewed coffee. For some reason, Kid Cudi is hitting the spot at this moment. I couldn't really tell you why. If James were here, he'd insist I play "Make Her Say"... he's obsessed with that song.
I'm not really sure who reads this on a sporadic, semi-regular or a creepily regularly basis but I sometimes wonder. Obviously this is a post rich in deadwood, but lacking in conciseness. Are people frustrated reading this? Can this considered a frustrating post if nobody reads it?
Let's go with some rapid-fire thoughts:
- There is a cupcake beside me but I think I'll enjoy it after I take a shower.
- I am sad my other friends who have blogs have not kept up... it makes Google Reader a lot more boring.
- I would be willing to bet money the NHL season is lost. Not many of you would take me up on that bet because it is looking more obvious. I have been thinking this for the past month... so maybe if I said this earlier there would be a much more lively discussion. Anyways, the NHL and the players are making their bed.
- I think I steeped this second cup of coffee for too long. Whoops.
- Yesterday when I was on call for family med/obstetrics I heard about a terrible case about a newborn who is braindead. I wish I could write more about it. Sometimes medicine is brutal.
- The song I want any of you who are still reading to hear is "Ride" by Lana del Rey. She has gone through some rough patches as her fame increases (SNL, some nasty rumours) but you can't deny this is an awesome track. I feel that she maybe sings a bit too low for her range in some parts, but man she has a haunting voice.
Post-call day (day off after a 24-hour or overnight shift)! I'm sitting at home after a workout and my limbs feel similar to jelly, satisfied after a relatively healthy lunch. It's 15:48, what to do? I've already caught up on Walking Dead (can't wait for the mid-season finale), drinking some fresh ground and brewed coffee. For some reason, Kid Cudi is hitting the spot at this moment. I couldn't really tell you why. If James were here, he'd insist I play "Make Her Say"... he's obsessed with that song.
I'm not really sure who reads this on a sporadic, semi-regular or a creepily regularly basis but I sometimes wonder. Obviously this is a post rich in deadwood, but lacking in conciseness. Are people frustrated reading this? Can this considered a frustrating post if nobody reads it?
Let's go with some rapid-fire thoughts:
- There is a cupcake beside me but I think I'll enjoy it after I take a shower.
- I am sad my other friends who have blogs have not kept up... it makes Google Reader a lot more boring.
- I would be willing to bet money the NHL season is lost. Not many of you would take me up on that bet because it is looking more obvious. I have been thinking this for the past month... so maybe if I said this earlier there would be a much more lively discussion. Anyways, the NHL and the players are making their bed.
- I think I steeped this second cup of coffee for too long. Whoops.
- Yesterday when I was on call for family med/obstetrics I heard about a terrible case about a newborn who is braindead. I wish I could write more about it. Sometimes medicine is brutal.
- The song I want any of you who are still reading to hear is "Ride" by Lana del Rey. She has gone through some rough patches as her fame increases (SNL, some nasty rumours) but you can't deny this is an awesome track. I feel that she maybe sings a bit too low for her range in some parts, but man she has a haunting voice.
01 November 2012
Back to the rural
It's kind of odd being back in Hinton where I finished my rural rotation about a year and a half ago. The reason I say so is because it's like this place was frozen in time when I left, and it's almost exactly the same since I came back. Granted, it wasn't that long ago but it's still kind of a bizarre feeling. The most dramatic change I noticed was one of the doctor's hair is a bit more salt than pepper and one of the hospital's walls are a slightly darker grey colour.
It also makes me hope that it seems that I've improved in my clinical training, judgment and management skillz. I may not know prenatals like the back of my hand as I did before but I'm hoping everything else has gained at least +1 EXP.
The one new thing I have enjoyed is the teaching role I've taken with the medical students. It's something I've already noticed I enjoy doing, and it adds something unique to my day. I'm finding myself looking to incorporate that into my future career.
Each day I'm also trying to look for what I would like to do in at least my more immediate career... both major and minor factors. It's difficult to evaluate because I still give the usual "Iiiiii... dunno" shrug whenever someone asks me, but small pieces are coming in here and there. It doesn't seem that full-time rural life is in the cards... at least for now. In many ways I still like the academic life, exploring cities, and while the schizoid side of me enjoys the remoteness, being in a hub city makes travel much more accessible. These may seem like minor factors in the end, but they're something for now.
22 July 2012
Surprises and faces
I'm still a young sapling when it comes to the world of physicians, let alone residents. As a result, I expect to be challenged, tested, surprised and humbled almost every day. Yesterday was no exception.
I was doing a shift in an emergency department the other day where I came across my next patient's chart. She was middle-aged but had a number of chronic genetic conditions, and was here for a possible localized infection. Seemed simple enough. I saw her, and talked to her next of kin who was also asking for some pain killers for the patient to use in case some pain she was having previously returned. It got me sort of annoyed. I'm not sure if it was the way she had rolled her eyes or made snide comments about the wait, or the way she demanded pain medication. Maybe both. Anyways, I proceeded to remove the blankets to examine the patient, I was shocked. She was not only small in stature but looked markedly frail. There was no way she weighed more than 75 lbs. A good portion of the outline of her pelvis was visible, even moreso her ribs. You could even see the outline of her descending aorta because she had no fat and almost no muscle mass. Upon further questioning, it turns out she is also completely deaf, difficult to communicate with and bound to wheelchair. I felt a number of emotions.
I then informed my supervising doctor of the case. I should mention he's normally quite the joker and there wasn't much he didn't joke about. He entered the room, and I noticed he connected almost immediately with the caregiver. I've seen it on a number of occasions where he's able to put on the face, the tone, and even the cadence of his speech that connects with patients and their families. It's no wonder all his patients in his family clinic love him.
This story had a number of things come to mind. First, I need to expect to be surprised by patients I see, and the diseases that manifest for a long long time. There's still so much out there I haven't seen. Second, I admired my preceptor in this scenario not because he's a joker, or he's able to empathize genuinely that lets patients and families feel safe, looked after and provided for... but that he can change these faces, know when it is appropriate to use them, and be genuine and comfortable in each one.
I was doing a shift in an emergency department the other day where I came across my next patient's chart. She was middle-aged but had a number of chronic genetic conditions, and was here for a possible localized infection. Seemed simple enough. I saw her, and talked to her next of kin who was also asking for some pain killers for the patient to use in case some pain she was having previously returned. It got me sort of annoyed. I'm not sure if it was the way she had rolled her eyes or made snide comments about the wait, or the way she demanded pain medication. Maybe both. Anyways, I proceeded to remove the blankets to examine the patient, I was shocked. She was not only small in stature but looked markedly frail. There was no way she weighed more than 75 lbs. A good portion of the outline of her pelvis was visible, even moreso her ribs. You could even see the outline of her descending aorta because she had no fat and almost no muscle mass. Upon further questioning, it turns out she is also completely deaf, difficult to communicate with and bound to wheelchair. I felt a number of emotions.
I then informed my supervising doctor of the case. I should mention he's normally quite the joker and there wasn't much he didn't joke about. He entered the room, and I noticed he connected almost immediately with the caregiver. I've seen it on a number of occasions where he's able to put on the face, the tone, and even the cadence of his speech that connects with patients and their families. It's no wonder all his patients in his family clinic love him.
This story had a number of things come to mind. First, I need to expect to be surprised by patients I see, and the diseases that manifest for a long long time. There's still so much out there I haven't seen. Second, I admired my preceptor in this scenario not because he's a joker, or he's able to empathize genuinely that lets patients and families feel safe, looked after and provided for... but that he can change these faces, know when it is appropriate to use them, and be genuine and comfortable in each one.
27 June 2012
Lots of new
My old "apartment building-mate" inspired me to dust this thing off and get things going semi-regularly again. You could say he's the psyllium to my blogging constipation.
Who knows what I'll churn out? Music will be discussed of course, maybe some interior design jazz since I'm becoming more domesticated, and speaking of domestication what could scream that more than my new friends I've adopted? There's four of them and until I think of more creative names, "chocolate mint plant", "peppermint plant", "oregano plant" and "rosemary plant" would like to say hello.
The apartment is still a work-in-progress but it'll be interesting to see what the 'end' product will look like.
Orientation tomorrow!
I'll leave my loyal crowd (ha!) a fun jam so your foot can tap with purpose. You may love to hate or hate to love Carly Rae, but you can't deny that ROSTAM did a pretty clever job with this mash-up of "Call me Maybe" and "Walking on Broken Glass".
Who knows what I'll churn out? Music will be discussed of course, maybe some interior design jazz since I'm becoming more domesticated, and speaking of domestication what could scream that more than my new friends I've adopted? There's four of them and until I think of more creative names, "chocolate mint plant", "peppermint plant", "oregano plant" and "rosemary plant" would like to say hello.
The apartment is still a work-in-progress but it'll be interesting to see what the 'end' product will look like.
Orientation tomorrow!
I'll leave my loyal crowd (ha!) a fun jam so your foot can tap with purpose. You may love to hate or hate to love Carly Rae, but you can't deny that ROSTAM did a pretty clever job with this mash-up of "Call me Maybe" and "Walking on Broken Glass".
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