10-95

Back on the auxiliary police beat, after a two-week break away from the uniform. Another way auxiliary policing is kind of like medicine: you risk losing the details you study so hard if you take too long a break away. Especially on those things you need to be instant recall for, like dispatch codes. The radio crackles the first call of the night, “Respond to a 911 call, neighbours reporting a 10-95 in progress at [address]” Uh… sure. What’s a 10-95 again? Oh right – domestic disturbance.

(10-codes vary from department to department, which can make that memorisation all the harder if you start getting into shows like Cops or Law and Order and they’re using different radio protocols than here. At least if you’re in medicine and a House or ER junkie, a tumour is still a tumour and leprosy is still leprosy, whether it’s in Princeton-Plainsboro Teaching Hospital or County General or the Dr Everett Chalmers here in Fredericton.)

Guess I could’ve figured it out by the address – not the first time we’re heading out that way, and definitely not the first time for the same thing, a 10-95. I guess it’s a sort of reassuring welcome back after holidays – no matter what happens in the world, the N family will still be at it, tearing themselves apart. Not so much a “family”, but a “situation”, really. Things haven’t changed the past fortnight, I haven’t missed an episode.

“10-4″. We start making our way over, following the posted 50km/h limit, stopping at every light along the way. No blues and twos – it’s actually surprisingly rare how often we use the lights and sirens to respond to a call. If you saw us on the road, the only way you could tell we were actually going somewhere is that we’re not like heads bopping at a tennis game, scanning every licence plate and doorway as we drive – which is how patrol usually goes, trawling for anything suspicious.

It’s a tough spot, that N family. If they were my patients, their charts would be a textbook of socioeconomic challenges: single unemployed mum, measures her days in cigarettes and beer cans. Non-supportive estranged father – with an alleged history of abuse, his very absence is probably the most supportive thing he’s done. 10- and 11-year-old boys at home, both with extensive records of behavioural problems; both with features of foetal alcohol spectrum disorder and ADHD, but neither interested in or compliant with social or medical assistance.

Neighbours report screaming; not an unusual sound to come across their paper-thin duplex walls, they’re finally moving away at the end of the month, not a moment too soon. Tonight, sounds like the 10-year-old is swinging a pair of scissors at the 11-year-old, because he didn’t share his cigarette. Or is the other way around? Last time it was the elder attacking, but using the cigarette itself and lunging at his little brother’s neck.

I like to think I’ve been in medicine long enough not to be shocked about situations like this. You see the same across the country, whether it’s on the buzzing streets of Downtown Toronto, the chilling solitude of Arctic Inuvik, or the lush greenery of west coast Masset: the vast majority of disease and illness affects the segment of society that can least afford it. So it goes with crime and violence too – part of the appeal of both medicine and policing, the opportunity to try to be there for people who need it most. To bring justice.

We pull up, slide out across the iced-over driveway, and let ourselves in through the open front door. The 10-year-old is in the backyard, visible through the back door, smoking away. The 11-year-old is sitting in the living room, watching Entertainment Tonight. He nods welcome. Where’s your mum? “I dunno, what do you want?” We heard there was fighting. He nods again. “I want to watch TV, go away.”

Mum comes down. Apparently everything is “under control”, we can leave now. The 10-year-old got his cigarette, so all is well in the world again.

And that’s pretty much that. The social workers will come and do their rounds again Monday afternoon after school. Kids look healthy, well-fed and, most importantly, unbruised and unscratched. We make sure the month’s heating assistance credit and welfare cheques are still working out. We ask if mum’s found a job yet: “no”, because then she’d lose her welfare and have to find a sitter. We ask if the kids have seen the psychiatrist they’ve been planning: “no”, because there’s no transport, and even if the doctors could do anything there’s no money for meds anyway, and even if there was, the kids wouldn’t take them.

We wish the Ns the best.

And we’ll be back again next weekend.

Add it to the list, more ways policing is just like medicine: you can engage, advise and hear out your patients as best you can; try to earn their trust through a repeated, long-term supportive relationship; elicit their Feelings, Ideas about the problem, the problem’s Functional impacts, and their Expectations from you; keep your door open to them, and be at their call when they ask; offer to tap them support, try to connect them with other resources, and show them a path forward – but actually taking those steps, it’s all up to them.

Pleasant surprises happen, sometimes, and you’re on top of the world when they do, but they’re few and far between. Now I’ve only been with the police for a few weeks now, but the general trend is looking not all that different from medicine – every time you see your “regulars”, week to week or month to month, you’re more likely to be disappointed than not.

And whether you look at it through the eyes of a doctor, or an auxiliary police constable – you lose sleep over it.

You wish you could do more.

The green-eyed monster

I don’t consider myself a jealous person. I think I’m fairly set and content with how life’s going. I don’t count my blessings because I know they’re innumerable: a family, stable and secure and warm, proof that unconditional love exists. Friends in the right place at the right time, who’ve brought out the best in me. A career that makes me feel part of something greater and takes me places… Innumerable blessings.

Yet – human nature is to look around you, comparing, wondering what you might be missing out on. It’s how we learn about new things to try, skills to learn, self-improvements to make. Ultimately, it gives us our lives reasons to exist other than just to breathe and sleep and eat. But the line between healthy motivation and inspiration, and unhealthy envy and jealousy – such a sliver of a space, so easily crossed.

In a profession like medicine, or a workplace like the military, motivation and inspiration are everywhere. Both make a point of spotlighting those who are better than you. Superior doctors publish papers, win awards, develop skills that awe and inspire, and impact lives in ways that honour the practice we share. In the military, your superior colleagues move up in rank, wield command, get entrusted with tasks and deployments and earn medals and commendations.

But the risk of envy and jealousy is always there. And when a colleague you already honour and look up to, for earning a once-in-a-career disaster relief tasking, a coveted advanced specialty training place, and a Surgeon General’s commendation for being overall better than everyone, also wins the heart of the one you’ve been pining for – that’s envy, in all its disgusting selfishness.

I hate this feeling. It’s not me. It’s self-destructive. It’s a waste of time. Of the seven deadly sins, only envy is no fun at all. And worst of all, it takes away from the gratefulness I know I should be pouring my all to show to all those I care about.

Rechanneling jealousy into something constructive, worthwhile: medicine and the military both do this by not only commemorating acts that go above and beyond, but by emphasising the relationship between colleagues. Mentors to look up to, not to envy; learners not to wallow in jealousy, but with the same potential waiting to be unlocked. Awards, skills and lives saved, or rank, deployments and medals – not things to idolise, but from which to draw inspiration.

And it’s an essential process to both medicine and the military – it’s part of what keeps us going, and keeps us useful. Wars, disasters, diseases: there is, unfortunately, no finite stock of opportunities for doctors and military staff to rise to the occasion and earn those experiences they so desire. Any one of us, with effort, practice and patience, can earn the same experiences as our superiors. So we push ourselves, knowing that, in time, our chance to serve will come.

But the one friend you hoped would feel something for you the way you do for her – nothing could be in more limited supply. That’s precisely why you value her so dearly – there’s no one else like her, and there never will be.

How do you feel anything but envy towards the colleague who’s earned that prize?

Pad thai at the Blue Door

Pad thai at the Blue Door. It’s funny that the Blue Door is one of the only places in Fredericton to do Asian meals like pad thai (one of three – the others being Asia Beef Noodle, and that stand at the Boyce Farmers’ Market, as far as I know). In the rest of Canada, you generally go to a hole-in-the-wall no-name Thai restaurant to get the best examples of Asian dishes like this. Cheap and simple, no pretense, no problem taking a table by yourself and getting your fix.

But if you’re in Fredericton, the Blue Door very well may be the place you try pad thai for the first time – and the Blue Door being all upscale and urban and chic, the sort of place you might take a date you want to impress, you end up associating simple Asian dishes like pad thai with something that’s a bit over the top. When you come here from away, you see there’s couples all around, candles lit, the place is packed… you feel bad taking up a table on your own.

Well, suck it up – definitely worth it. The pad thai definitely on par with the genuine article overseas: vegetables crisp and fresh, just the right amount of ground peanut, a good noodle-to-sauce ratio, and the sauce itself not too spicy or creamy, which is usually the thing I find that non-Asian restaurants don’t get quite right in Asian dishes: the sauce. Serving size, perhaps on the smallish side, but hey, quality over quantity, right?

Service is consistently good – Our Word of Mouth is also a fan. Despite being a solo diner, I didn’t get that “you’re costing me a proper tip” vibe that you often get at places that usually gear towards nights out for couples and groups – kudos! (Fair’s fair – I usually extra-tip when on my own, unless I get that vibe.) Last time I came here for a curry, they even gave solo-me an extra box of rice for the leftovers I took takeaway.

They’ve got a deal for January and February 2010 (except Saturdays and St Valentine’s weekend): after 4pm, two entrees for 20,10$, with the purchase of two beverages – what a great deal for a date, whether it’s actually with that special someone, or just treating yourself!

Upward, not outward

From today’s Star: “Markham plan could contain sprawl, save farms”

A groundbreaking plan to freeze Markham’s expansion onto prime farmland could voluntarily take the fast-growing suburban powerhouse where no GTA municipality has dared go: upward but not outward.

Markham council is considering a radical proposal that would stop the sprawl of buildings to preserve 2,000 hectares of farmland. The plan would make Markham the only GTA municipality to voluntarily freeze its urban boundary.

Supporters say dramatic action such as the food belt proposal, along with “thoughtful” intensification along major corridors, is needed to curb growth, limit traffic congestion and create housing density that can support public transit.

It would be awesome if we could finally get some thinking like this in Fredericton. You’d think it’d be common sense here in New Brunswick – not only do we have a swath of important agricultural land ringing the city on either side of the river, we’ve also got a woodlot to preserve, aquifers to keep potable and disgusting amounts of undeveloped and under-occupied low-density space already within city limits.

Seriously, I don’t get it. Frederictoners look like they’re all over things like local-food and keeping area farms in business – the Boyce Farmers’ Market is packed every Saturday, and not just with samosa queues – but at the same time, they’re also all over their big yards and acreages too. It’s like there’s a disconnect between that love for “country living”, and curbing the sprawl that pushes the urban line further and further out.

Last year I sent in a note to the City wearing my doctor’s hat, about the medical reasons to stop sprawl; maybe it’s time for another note wearing my new volunteer police hat. Nothing new, just common sense: less sprawl means less isolation and faster response times, denser neighbourhoods means more eyes in the community and in the streets.

Well, one can dream, anyway.

They want to suck your blood!

Blood drive at the Fredericton Inn. Blood Services has been ringing up donors across Canada this past month, probably trying to cash in on the goodwill as people make New Year’s Resolutions to be more generous and giving. Looks like it worked: the place was packed, and turns out New Brunswick tops the country in blood donation rates.

It’s been a year since I had a chance to give – combination of Fredericton not having its own year-round donation centre (what’s with that?), and the downside of making trips to malaria-infested areas like the rural Philippines, you’re on the blacklist for 12 months. Luckily Switzerland isn’t endemic, and they let me through.

Despite the crowds it’s a pretty quick routine – door-to-vein-to-door in about 40 minutes. It would be even faster if they didn’t have to do that questionnaire each time – “Since 1977 were you born or have you lived in Africa… Have you had sex with a man, even once… Have you had a dura mater graft…” – and it’s even longer now that you have to bubble in the checkboxes instead of just ticking them off.

I wonder about some of the questions. Blood Services has already gotten protests about banning sexually-active gay men from donating, no exceptions – presumably from historical rates of sexually-transmitted diseases in that population. But the question, “Have you had sex with anyone whose sexual background you don’t know” – I wonder what they do if you answer “yes” to that one.

What does “sexual background” really mean anyway – number of partners, frequency of new partners, etc? Does anyone really ever know the sexual background of every person they’ve slept with – are people really honest about that? On patient histories I’m sure it’s up there with alcohol use as the most fudged stat.

(On the other hand, they could definitely streamline the questionnaire if there was a “virgin” box. Maybe even an express lane!)

Anyway, that’s 15 units of A-positive I’ve managed to give back to the system so far. I used to joke since med school, for every unit I’d order for a patient, I’d have to put one back in the bank – so take away the 100-or-so I think I’ve ordered over the years since then (and most of that from Trauma Surgery – now that was a bloody rotation)… only 85 to go!