2006: Year in Review

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<IMG src="/images/14229-13631/sunset2.jpg”><IMG src="/images/14229-13631/cntower1.jpg”>
Top: looking west from my balconey towards Queen’s park and the University of Toronto.
Bottom Left: It has just rained, so you see the sunlight reflecting off of pools of water on the roof of a school.
Bottom Right: If I lean out over the rail of my balconey and look south, I have a good view of the CN tower.

A lot happened in 2006.  I finished my Ph.D. (finally), moved from Vancouver to Toronto, and started medical school.  I even took up motorcycling and have made plans to travel the world on a motorbike.

Medical school has been more of a challenge than I imagined.  I find it hard to sustain my focus for weeks on end as a lot of my classmates seem quite happy to do.  I guess a lot of them have been studying non-stop ever since high school and feel like something is wrong if they’re not constantly on top of their studies.  I’m amazed at how many people in my class have photographic memories to go along with their prodigious work ethic. 

I work hard before exams, but most of the time I pursue other interests.  I read books that have nothing do to with medicine.  I surf the net. I go to the pub and hang out with friends.  I run.  I go mountain bike riding.  I ride my motorbike just for the fun of it.  Even during exams, I purposefully order food from places that are a nice ten minute motorbike ride away just so I can take a break from studying.
 
It is tough trying to explain to my family why I ride a motorbike.  My mom in particular thinks that it is suicidal.  But my Dad admitted to me that if he hadn’t had problems with his eyes since the age of 17, he would have been riding a motorcycle his entire life.  The thought of me riding a motorbike in Toronto scares my mom.  But the thought of me crossing Africa by motorbike scares her even more.  I remind her that when she was young she traveled the world with her girlfriend until they ran out of money and had to take jobs.  Still, mothers worry.  Why would I choose to put myself at risk?  If I disappeared, she’d never know what happened to me.  What if I was in an accident or shot by bandits?

When I reflect on all the major changes that have taken place in my life in 2006, I realize that I trace almost all of their origins back to the period in the spring of 2005 when I succumbed to a mysterious illness that left me unable to move and in the worst pain I’ve ever felt.  I was incapacitated for over a month.  The pain hit me suddenly – I was analyzing data in the lab when I was struck by the worst headache of my life.  It also felt like a pitch fork had been jammed into the back of my neck. 

I went home to get some rest.  I assumed that I would get better – I always had in the past.  But after two days and two sleepless nights of excruciating pain that was getting progressively worse instead of better, I went to the student health centre.  Normally it would have been an easy ten minute walk across campus.  But just getting there took a monumental effort.  Several times I had to stop and lie down in the ground. 

When I got to the health centre, I realized that I had taken my health for granted to the extent that I hadn’t even bothered to get a Care Card when I moved to BC.  I was without health coverage.  Still, I was in pain and the $50 seemed a small price to pay if I could get some relief or even some kind of an answer as to what was wrong.  I had blood work done, and was given Tylenol 3 and gravol.  The painkillers did nothing.  The lab results came back and the doctor ruled out an infection.  It wasn’t meningitis.  I suppose that was good news.  The doctor told me to come back if things did not improve in the next couple of days.  Getting back to St. John’s College from the student health centre took me over an hour.  At times I crawled because standing was so painful.  Even with the gravol, I vomited into some bushes and collapsed on the ground.  Several times I considered calling campus security just to get a ride home.  No!  I could make it goddammit.  It wasn’t far.

“Are you alright?  Do you need help?” A friendly stranger asked when I was lying face down on the grass on main mall. 

“I’m just resting, thanks” I lied.

Later, I remember lying in my bed in my room at St. John’s College.  I hadn’t eaten in three days because when I stood up, the pain and nausea were so bad that I thought I’d pass out.  I couldn’t even make my way down to the dinning hall to eat.  Even if I could, I could not keep food down.  Yet I knew I had to eat.  I ordered delivery from Swiss Chalet.  But the effort of going down to meet the delivery guy in the foyer took all my energy and made me too nauseous to eat anything. 

I did not want to ask my friends for help.  I’m not entirely sure why.  Maybe I didn’t want anyone to see me in such a weakened state.  Maybe I didn’t want to burden them with bringing me food.  What was next?  Would I need help getting to the bathroom?  I certainly would never want to involve my friends with something like that.  I did not know what was wrong or how much worse I would get. 

I was grateful for the help I’d already received from my friends.  Earlier, Frank had driven me to Vancouver General Hospital.  He called his wife, a Neurologist, and she came to the waiting room to give me a neurological exam.  I had no neurological signs.  I guess that was good news.  Dr. Cayabyab discussed my case with the resident on duty, and I felt I was in good hands. 

Mark Ozog had called me earlier and found out I was on my way to the hospital.  He immediately dropped his plans (which included a female friend’s birthday party I believe) and came to VGH to hang out with me.  It was nice to have someone to joke around with.  I was worried about what could be wrong with me.  Was it the start of a neurodegenerative disease like multiple sclerosis or amyotrophic lateral sclerosis?  Had I suffered a stroke?  Did I have a tumour?  Why wasn’t I getting better?

I was hooked up to an IV line, and the neurology resident pushed one migraine drug after another.  There was no effect whatsoever.  I was exhausted after having been in emergency for over 8 hours, and finally decided to go home.  Mark drove me.

I could do nothing but lie in bed, flat on my back, for days.  I could not even watch TV because it made me nauseous.  At some point my parents called.  They knew something wasn’t right.  When the story came out, my Dad decided to fly out to Vancouver to help me.  He slept in a cot in my room, fed me, and took me to VGH for a second (and final time) where we would spend thirteen hours.  CT scans of my head with contrast were initially a concern to the Neurologist, who sent me back for more scans of my neck.  It turns out that what initially looked like a cause for concern is actually normal in 5% of the population.  As a medical student, I’d like to look at these scans someday so that I can understand what the concern was and what it is about my cerebral vasculature that makes me different from 95% of the population.

For the next several weeks, I was confined to my bed.  I lost 25 pounds.  I am glad that my mom did not see me in such a state.  The complete inactivity I endured was a sharp juxtaposition to my normal active lifestyle.  I missed golfi
ng, snowboarding, running, cycling, playing street hockey, and hanging out with friends.  My newfound solitude, although extremely frustrating, gave me an opportunity to think about my life in a way that had hitherto eluded me.  Unable to read or even watch TV, I was trapped in my body alone with my thoughts.   

I thought about a lot of things.  What did I want to do with my life?  After days of constant pain with no sign of improvement, my thoughts turned dark.  Was I going to recover?  If I did not recover, could I ever enjoy life again?  If I were to leave this planet, would I be satisfied?  I thought of all the things that I still wanted to do.  I wasn’t ready to leave.  I decided I wanted to become a medical doctor.

Slowly I started to improve.  I remember going for my first walk in weeks, and feeling so elated.  Now I am completely recovered.  I may never know what happened to me.  One possibility is that I had a dural tear that resulted from a snowboarding injury.  My cerebrospinal fluid would leak out and this would result in severe pain, pain that could be somewhat diminished by lying down flat.  Indeed, other patients that have been diagnosed with a tear in their duras have reported similar symptoms as those I experienced.  But although a torn dura is a reasonable explanation, this is just a guess to satisfy the need for an answer.  One thing I’ve learned as a scientist is to accept uncertainty because there is often no clear answer.

What I do know is that life is precious and way too short.  You might think that after having experienced what it’s like to be immobilized, I would avoid activities that could put at risk of returning to such a state.  Why would I ride a snowboard or a motorcycle after such a lesson?  The reality is that my experience has had the opposite effect.  I know what it is like to lie in bed, completely incapacitated, and think of all the things I haven’t done.  We are all going to die, but how many of us truly live?  When you contemplate the end, it’s not the things that you did in your life that you regret; it’s the things you didn’t.

My biggest fear is not death.  What do I fear?  I fear being trapped inside my body in constant pain with no end in sight.  But my biggest fear of all is opportunity lost.  I want to experience as much as I can in this life.

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