In search of a name

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Today I brought my baby home.  She was quieter and gave a smoother ride than I expected.  I really enjoy the riding position.  I was sitting so high that I could see over the cars in front of me on the freeway.  She cornered better than I expected too.  The frost heave and potholes on the highway were a breeze.  She sailed easily over cracks and holes, even at 130 km/h.  On Helen, this type of road surface is downright scary.  Somewhere on the 427 I started to truly believe that this bike could take me around the world.

The Gerbing’s electric vest and gloves performed well at -9 deg. C. even at highway speeds.  My only cold-related problem was the wind around my neck.  Maybe I should have worn a balaclava.

What surprised me in a bad way was how awful the front brakes were.  Compared to Helen, stopping the KLR felt like stopping a semi.  How could the front brake be so ineffective?  It was mushy and unresponsive.  The bike is not that heavy.  Hopefully the braided brake lines and the new rotor that I plan on installing will make a difference.

Naming my new child is proving difficult.  I’ve been pondering “La Poderosa” (The Mighty) after Che Guevara’s bike, but it seems a bit unoriginal.  I think I want something Spanish sounding because her maiden voyage will be through Latin America.  Any ideas?

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Life in the ER

Shadowing a doctor is one way for medical students to get a taste of what practicing medicine is really like.  The Wightman-Berris academy at the University of Toronto has a faculty mentoring program whereby students are matched to a doctor in a discipline of their choice.  I chose emergency medicine because I thought it would be interesting.  There’s a lot of variety in what patients present with, and you never know what the next person will have.

What follows is a FICTIONAL account of what an evening shadowing an Emerg Doc might be like.  No real patient information is used.

I arrived at 9 PM.  I met my faculty mentor, who seemed to be in the process of doing 10 things at once.  A CD containing CT scans of patient had gone missing.  A neurosurgeon had been called in for a consult, but couldn’t do anything without the images on the disc.  Tempers were short.  The ER seemed to be in complete chaos.  The waiting room was full.  Every examining room was taken.  The emerg doctor was saying “Move the bar fight from the ENT room to ONE, put Chicken Bone in the ENT room, and put Cat Bite in FOUR.”

A white haired old lady was lying on a bed in the hallway next to the nurse’s station.  Every once in awhile she would suddenly start screaming “THE PAIN, THE PAIN, THE PAIN!” in an eastern European accent and then stop just as quickly.  No one paid her any attention.  I went over an asked her what was wrong.  She lifted up her gown and showed me a nasty scar running along the outside of her thigh.  It was red and swollen, and her skin was flaking off around the wound, and I smelled a foul odor.  Apparently she had broken her hip in a fall and had required surgery. 

I asked her a couple of questions about her fall and she told me her life story.  Her family had fled from Hungary and gone to Brazil at the end of WWII because of communism.  She had been living in Canada for 30 years.  Her son was “no good”.  He had taken her home and everything she had, according to her, and put her in a nursing home.  I listened for about half an hour (my mentor was still too busy for me) until the transfer team came to take her back to the nursing home.  By the end I realized that she was racist.  At one point she said that “Canada used to be a nice place 30 years ago before all the coloured people came.”  I felt a little less sorry for her, and then felt a bit ashamed.  Did it matter if she was a racist?  She was still a patient who needed help.

Soon I was following my mentor from patient to patient as he tried to keep up with the constant influx.  Most people had been waiting between 4 and 6 hours, which was apparently not that bad.  It could get much worse.

There was a schizophrenic with diabetes.  He thought the doctors were trying to poison him.  He had back pain and wanted an X-ray.  It was a tough situation because he refused to get blood work yet it was likely poor control of his blood sugar that was causing his physical symptoms.  In the end, the doctor managed to convince him to voluntarily be admitted to the psychiatric ward for the night.

Next was a girl who had landed on both knees while playing basketball.  An X-ray revealed no fracture, and she was sent home with orders to ice it and rest.  Another man had lacerations on his face from a bar fight, and needed sutures. 

Later, we examined a woman had been bitten by her friend’s cat on her hand, and now, only a few hours later, the bite was red and swollen (obviously a Pasteurella multocida infection).  She was given an X-ray to make sure there were no tooth fragments in her hand as well as antibiotics and a tetanus shot.  Her hand and forearm were put in a sling and she was sent home with instructions to come back in two days.

There was another 85 year old woman spoke no English.  Luckily a nurse was found who could speak Portuguese.  It turns out the woman thought she had a fish bone lodged in her throat.  She was also suffering from dementia.

A second old woman who didn’t speak English would repeatedly pull the IV out of her arm, getting blood all over her sheets.  She would shriek hysterically.  How do you deal with that situation?  Luckily there was one young nurse who would patiently put pressure on the old woman’s wound and then redo the IV.  She said that most nurses would have restrained this particular patient by now, but she felt that she could calm the patient down with soothing words (even if the patient could neither understand nor appreciate what the nurse was doing).  The nurse said she didn’t mind having to come back to redo the IV.  I was impressed by her compassion.  

Her shift was supposed to be over at 11:30 PM, but she was still there at midnight because it was so busy.  The doctor didn’t even notice.  But I did, and I’m glad she was working that night because I saw that despite the never ending torrent of patients washing through the ER, it was still possible to care.

Yo me llamo Tyson

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Winter has finally hit Toronto.  It’s been so cold for about the past week that I’d rather be slapped in the face than go outside.  It may not be minus 42 like Winnipeg, but minus 30 (with wind chill) is bad enough.  I wonder where all the homeless people went?  Before the cold snap, I used to see people sleeping outside all the time.  I haven’t seen a single homeless person in days.  It wouldn’t take long to die of hypothermia in this weather.

Despite the cold, thousands of students in Toronto (and across the country) staged a protest against high tuition fees today.  Their route took them past my building on Bay street before they ended up at the provincial legislature at Queen’s Park.  I’m impressed that they braved the frigid temperatures to make a statement.  I for one can feel their pain.  My tuition was almost 18,000 last year.

In other news, as you can infer from the title of this post, I have started taking Spanish.  I hope to be able to have a rudimentary conversation in Spanish before I set off for South America. 

A couple of weeks ago, I also started taking a motorcycle maintenance course taught by a mechanic at a local bike shop.  The reason I took the course is so that I’m not helpless if my KLR650 breaks down in the middle of nowhere. 
I really enjoy the classes.  There are three of us in the class, and the other two guys are firefighters who have been riding motorbikes since before I was born.  Tonight we took apart a carburetor and learned electrical system basics.  Last class I learned how to do a 40 point safety inspection.  Next week we are going to give a motorbike a tune-up. 

I can’t help but make comparisons between what I’m learning about humans by day and what I’m learning about motorbikes by night.  There are advantages to working with humans: they can tell you were it hurts, how long it’s hurt, what makes the pain worse, what makes it better, whether the pain radiates, how severe the pain is, etc.  Diagnosing a human is 80% based on getting a good medical history.  The physical exam and lab tests often only serve to support a hypothesis. 

In contrast, a motorcycle can’t tell you what’s wrong.  You rely way more on the “physical exam” and your powers of observation.  The biggest advantage of working with motorcycles is that you don’t have to make repairs with the engine running, as you do with humans.  Motorcycle repairs would be much harder if you had to hook them up to a surrogate engine (heart and lung machine) while replacing a valve or a piston, for example.  You can leave the bike in the garage until a spare part arrives, and do the replacement at your leisure (with no risk of rejection!).

There are also similarities between the parts of a motorcycle and various organ systems in humans.  The piston is obviously akin to the heart.  The oil filter is like kidney or a liver.  The circulating fluids (oil, coolant) are like blood.  The brakes are like joints, because the pads wear with age.  Eventually the pads will wear right down to the metal.  The metal grinding on metal will start eating away at the brake rotor, just as bones eat away at each other when the cartilage between them wears away in osteoarthritis.  The exhaust system is like the gastrointestinal tract.  The fairings are the skin.

I’m sure you can see the analogy.

Cuidado.

A big step closer to South America

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Yesterday I put a deposit down on not one, but two new 2007 Kawasaki KLR650’s (a red and a black).  The reason for the purchase of the second bike is that Tom has decided to buy a KLR for his 3 weeks in South America instead of renting a bike.  Since the KLR is not available in the UK, I bought it here for him.  We plan to ship the bikes to Buenos Aires by plane, and then Tom will ride with me as far as Lima, Peru, at which point he’ll ship himself and his bike back to the UK.  I will continue on by myself all the way to Canada.

Buying the bikes was a big step.  The momentum is definitely building towards the launch of this trip.  The next step is to modify the bikes to get them ready for their upcoming overland journeys through the Americas and Africa.  We plan on ordering dozens of replacement parts to improve the durability of the bikes.  Modifications will include armour (e.g. hand guards, skid plate, muffler guard, etc.), engine improvements (e.g. doohickey kit, indestructible oil filter, etc.), new seats, aluminum panniers, and a plethora of other stuff (e.g. tall windshield, centre stand, etc.). 

Tom will come to Toronto during March break so that we can work on the bikes.  I’m guess he doesn’t realize that Toronto is not exactly Miami Beach during Spring Break.  He got a deal on the airfare because nobody in their right mind would come to Toronto in March.  More than likely he’ll be riding his new KLR back from the dealership in a snowstorm.

With the purchase of the new bikes, I have to sell Helen.  This pains me, because I’ve grown to really like her.  She’s nimble and fun to ride.  Unfortunately she’s scratched and a bit beat up (see picture below).  I plan on repairing the damage to the fairings and front fender, and replacing the signal lights, mirrors, and windshield before I put her on the market.  New fairings are ridiculously expensive, so I’m going to see if i can get the old ones repaired by a plastic welder and then repainted.

To get the front fender off the bike, I had to remove the front wheel.  This job was the perfect opportunity to break in my new MasterCraft ratchet and wrench set.  The jack from my car also found a good use, propping up the front end of the bike.  I quickly ran into trouble because some of the bolts requiring a Hex wrench to turn were on so tight that they might as well have been welded.  In desperation, I put the Hex wrench through the closed end of a normal wrench to add extra leverage, but I just ended up lifting the whole bike without budging the bolt.  Finally, with my foot through the front wheel to keep the bike down and torquing on the wrench-hex wrench assembly as hard as I could, I was successful.  It was satisfying to solve the problem and see tangible results.  If medicine doesn’t work out, maybe I should train to become a motorbike mechanic instead.

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