Spring – when a young man’s fancy turns to…

Growing up in Regina – the only major city in the country that’s not on a coastline or riverbank – you miss out on the Canadian springtime ritual: flooding. All that winter snow has to go somewhere, right? (Vancouver and Victoria don’t count – you just get the once-a-century tsunami instead. It balances out, I guess.) In Fredericton, it’s business as usual.

Of course since the city’s been around for over 250 years they’ve managed to come up with a reasonable solution: don’t build anything important within 6,5m of the bank. But when the sky is clear and the temperature’s a balmy 20-degrees and your fancy turns to a long-awaited run or ride along the river valley, you do kind of wish they could come up with a way to keep the trails open.

It’s not just the water that puts the trails out of commission, at least for a little while – you also get a flotsam (or is it jetsam?) (Edit: I guess it’s neither) bunch of junk that washes up and gets in the way. Driftwood and such – at least, nothing in the news of anything more “exciting” ever washing up on the banks of the Saint John. That is a good thing.

These two obviously have their springtime in Fredericton down pat:

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Washed out trails didn’t stop the first Critical Mass of the year starting up though.

I always wanted to check one of these out. Basically, you get a bunch of people on bikes together, and you go around on the street. You don’t really go anywhere in particular – that’s part of how it’s supposed to work, no organisation, no set route – it’s just to be on the road, safety in numbers together, alongside cars and trucks and such, asserting the common privilege (not a right, of course) of operating a vehicle, motorised or otherwise.

The clichéd confrontation – angry driver: “You’re blocking traffic!” Angry cyclist: “I am traffic!” I don’t know if that actually happens. When I was in Victoria and Vancouver I never saw any Critical Mass events; I guess since biking is already a part of everyday life and traffic there there’s no need to state the obvious. The same way how the rest of the world wouldn’t need them either – you’d never hear of cyclists needing to assert their existence in, say, Amsterdam, or Beijing.

According to Wikipedia, sometimes there are conflicts involving Critical Mass – apparently enough to warrant an entire article, “Conflicts involving Critical Mass”. Like all conflicts generally, this happens when people become immature and decide to flout the law – drivers fail to yield or drive unsafely around the bikes, or cyclists ignore the rules of the road and actively obstruct traffic.

I wasn’t sure how Fredericton Critical Mass usually behaves, so I wanted to hang back and see what everyone else does before actually joining in. If it was just going to be some kind of perverse “revenge” against drivers and an excuse to piss them off, count me out. Everyone looked pretty nice though; and, the majority of people had helmets too, so they seemed like a reasonable bunch.

It was supposed to start up at around 5.30 or so, but when 5.45 came around and I was getting restless and hungry, I went for dinner instead and just lazed around the park. Enjoy it while it lasts – who knows, by this time tomorrow it’ll be flooded over.

You drive what you are, part two

Dad has started biking to work – about time! Being nice and Prairie flat, Regina should be an obvious place for bike commuting. The City only just started putting together a commuting cycling system a year ago, but the streets are simple and wide enough that bike routes are really more to remind people about bikes on the road, than actually providing infrastructure that makes cycling faster or easier (like bike-controlled traffic lights and left-turn lanes, for example).

He still has to take Mum to work in the morning sometimes, so the car gets out about half the time. Which is probably “optimal”, between the bike and the car – you’re still paying for the car insurance and maintenance after all, and you do have to run the car every so often to keep the lines clean and pistons lubricated (or whatever it is that needs to be clean and lubricated, I don’t know) so you kind of feel compelled to use it at least a little.

He rides a Gary Fisher Tiburon, an aluminium 21-speed hybrid, complete with front shocks and suspension seatpost. It’s a different ride from my Kona Smoke – his 700c wheels are a bit bigger, so it seems a little faster, and with the suspension the ride is a little “cushier”. Maybe it’s just my posture, but I think his seat position is a bit more relaxed and upright, perfect for surveying the traffic around. His saddle is a Bontrager “Suburbia” – how appropriate!

Riding my bike over the same path, ruts are definitely more jarring though I still find my steel frame and 26″ wheels smoother over flat pavement. I’m bent a bit further forward – from where I’m sitting, I need to consciously sit straight up to get the same street view as on the Tiburon, though for getting over hills, it feels more natural to be a bit forward. I guess I’m still tuned for my Victoria commute. Style-wise his Tiburon has the fancy racing waves and stripes beating my plain matte black frame, but I actually like the simplicity better. Whatever floats my boat, I guess.

My brother, however, will have none of this cycling nonsense – not when he just got his new baby, an Acura CSX

I didn’t get a chance to try it, though I did get to drool over its futuristic sweeping lines, bling-bling LED display and navigation screen, and the cute yet useful factory-equipped Acura first aid kit in the trunk. You can get a sense of our different personalities by what we drive; “you drive what you are”, after all. My Rabbit – “doesn’t look like much” – vs his CSX – “it exudes quality and luxury… it has a lot of class”. I guess that pretty much says it. Technically my 2.5L 150hp 170ftlb beats his 2.0L 155hp 139ftlb, but, as he says, “Well, I’m going to drive out now and see my girlfriend. What are you doing?”

Touché.

Fleeting memories

I kept putting off writing about Trauma Surgery and am regretting it. I’m looking back at the 300-odd photos I took over the two months (1 | 2 | 3) and of course there’s only a handful really trauma-related – above, that’s it. Nothing to do about it though, I suppose: shooting (with pictures) away at shooting (with bullets) patients rolling through the doors would’ve made for great images but not so much for actually learning what to do (not to mention staying on the attending surgeon’s good books).

If you look at the pictures you’d get the impression it was all an 8-week vacation: living 16 floors up the Downtown Vancouver skyline (haven’t spend this much time in elevators before) -

- eating out pretty much every night (hey, there’s Singaporean restaurants!) -

- and hiking (Lynn Peak, and the Grouse Grind (if the Grouse Grind – 800m straight up, nothing to see along the way except the buttocks of the Grinder in front of you – can be called “hiking”)) every non-at work, -on-call or -post-call day (we were a big team spreading out the call, so surprisingly there were a few – hey, I thought I was in Surgery!) -

Managed to get a few emails on topic (between patients whilst on-call) though amidst the frenzy… so my Sent Mail box has a better memory than me:

To BML: Trauma in Vancouver… it’s just like those trauma shows on TV, except with Canadian accents, less gunshots (up until 2 weeks ago anyway) and more ATV rollovers and logging injuries. You can break down the trauma patient population into three groups: the stupid, the ignorant, and the unlucky. Kind of harsh words, but apt. The stupid bring things upon themselves: get into fights, drag race, drive (whether car, motorcycle, ATV or bike) whilst intoxicated… actually getting intoxicated in and of itself is enough, you’re just asking to get beat up or walk off a bridge or cliff or somesuch.

The ignorant also bring things upon themselves, but unlike the stupid, it’s usually by doing things that, in other circumstances, probably would seem reasonable to do. Cycling, for example – I do it every day, and love it. Cycling jumps off of mountain tops, however – about every week the Whistler bike park (just north of Vancouver) produces a new teenage quadriplegic. Depending on how high their back’s broken they end up on a ventilator (because the nerves that tell their diaphragm to contract and relax so they breathe don’t work), or just (“just”) in a wheelchair because they can’t use their arms and legs anymore.

Then there’s the unlucky. Mostly random, non-intoxicated pedestrians or cyclists who get hit by cars. It’s where most of our business comes from, car vs pedestrian collisions, and I think it’s the same everywhere in North America, though you don’t see it as much on those trauma TV shows. Partly because it’s not as exciting as getting shot; and partly to do with the car-can-do-no-wrong attitude most North Americans share.

It’s those ones though that make me stop and think more. Sometimes I say I live vicariously through my patients, because they do things I never would do, like crack cocaine or cliff diving or running from the police. But the ones that get hurt/sick from the mundane everyday – the same mundane everyday that /I/ do – give me pause. My 2nd week on there was a 30-something lady hit as she was crossing the street… as it turned out, leafing through her backpack for contact info, a biology researcher with speaking notes on how to get National Research Council funding for projects… probably a very same talk I once gave in undergrad to my labmates.

She ended up dying in the Trauma Bay, though we went so far as a thoracotomy: cutting open her chest to do cardiac massage (like CPR, except you get your hands right on the heart to pump it). It was just so… senseless how it happened. Like, for the stupid or the ignorant (eg the drunken boxers, or the reckless mountain bikers), it makes total sense why they get themselves killed. But the unlucky… I don’t think there’s a more appropriate word than “senseless” to describe it.

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To JP: That thoracotomy… after all that, only to later get it drummed in that not only was it totally unindicated (useful in penetrating trauma only, not in blunt – for some reason being able to directly compress the heart, cross-clamp the descending aorta, clear out blood flooding around the heart and directly controlling bleeding doesn’t matter as much with blunt injury), but the risk of biohazard exposure (eg spraying blood, cutting yourself on bone fragments) usually exceeds the success rate of the procedure in the first place.

That’s one plus of being back in an academic centre though – no shortage of expert staff with easy-to-remember pearls like that. And though Victoria’s great for getting hands-on since there’s not as much “competition” from other learners, you definitely have to be pro-active to get it… whereas in formalised teaching centres (eg Vancouver) the staff make a point to pull you in, like they’re always thinking, “teaching case”. Like this thoracotomy – the feeling of a dying heart, in your hands, in agonal contractions… wow.

Physically, it feels like a soft, regular ripple… like sticking your hand into a pool of still water, and you relax, you can feel your own pulse softly in your palm. (At least, I do, when I’m doing dishes.) Or if you put your hands together, palm to palm, it’s the same feeling. The faint pulsing going through to your fingers. There you go, you don’t have to get your hands wet. Emotionally, when you’re cupping the heart in your hands, and the TTL finally goes, “It’s been twenty minutes of asystole… any objections to calling it? Called at 17.43. Thanks everyone”… actually it’s less of a surprise, you know how weak and far gone it was by then.

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Not all cases went as dramatic as that… that was kind of an outlier on so many levels. No warning at all: paramedics just rolled in off the street doing chest compressions and went straight to the Trauma Bay. “Gee,” noticed the Emerg doc, “that might need a doctor”. And they jumped right in: none of the usual sober second thought (“Don’t just do something, stand there and think!” and “The first pulse you check in a code or trauma is your own”). And, the patient didn’t make it.

The vast majority of trauma patients do in fact live on to tell the tale. Over two months and dozens of patients, there were maybe only 5 or 6 deaths. The lady above; a 35-foot attempted suicide, that didn’t become an actual suicide until after three damage control surgeries and a month in ICU; a 7-storey second-time attempted suicide – lost her right arm and leg the first time, hit by a train – finally done in by a plugged airway; a pedestrian struck by an out-of-control car running the sidewalk. I’m sure there was at least another, can’t remember.

A few might not be able to act out the story, ie are left paraplegic; some can’t even recount it with gesticulations and hand movements for emphasis, ie quadriplegic; and fewer still will be left only yes/no blinking about it – but yes, most do survive to tell the tale, and graduate out of the ward. Actually a big chunk don’t even need the ward at all – give them a once-over in Emerg, find nothing to worry about, and off they go. Proof that helmets and seatbelts and airbags work: the only thing highway-speed crash survivors complain about is a few minutes wait in Emerg. And having to buy a new car or bike, but that’s about it.

You get to live vicariously through your patients. Or rather, you choose to live only vicariously through your patients, because after seeing the outcomes, some things are out – for you, and if you have kids, them too. No mountain biking (it leaves you quadriplegic). No ATVing (you rollover and get crushed). No 3am drunken bike riding (you crash and tear up your face, plus you need a new bike). No trying drugs for the first time (you get into fights and get stabbed, you get robbed, your parents or even your kids will beat you, or you lose your keys and try – try – to climb a wall to your 5th-floor apartment, or you just plain overdose). No fighting the police (they have backup, you don’t). No jaywalking (you die). No joining gangs (you get shot). No sticking your head out at the bus stop to see if the bus is coming (side mirrors vs face – face always loses). No roofwork when its raining and you’re 80 and you leave your rake and garden shears pointey side up on the ground below (you can figure it out).

Some people you get to meet, however briefly: a pathologist from Sri Lanka trying mountain climbing for the first time; random fair-weather and first-time motorcyclists and dirt bikers; an animator at the Emily Carr Institute of Art and Design (he did the Globe and Mail advert with the morphing words, did you see?); random loggers; a Japanese exchange student living in an apartment too high up and too far away from family and friends for her own good; random teenage novice mountain bikers; a low-level drug dealer whose business plan included an expansion into some other dealer’s Downtown Eastside hotel (not a good plan); random gang members and their girlfriends; a mine surveyor working in Guyana who got robbed and stabbed while away; lots of elderly Chinese pedestrians struck by cars (your interview is limited to pointing at different parts and asking if there’s pain: tong?); a teenager left by his “friends” drunk and alone and asleep on the T-Can (though they did do a good job relieving their guilt by visiting him every day and doing up his room real nice with photos and “Get Well Soon We Love You” notes after he got run over twice – twice! – on the highway).

And police constables. Vancouver City, or RCMP if the patient’s from across the Lions Gate or Oak St bridges, or east of Boundary Rd. (East of the yellow lane marking line on Boundary Rd – Vancouver’s off the hook, it becomes Burnaby RCMP’s problem.) Uniformed or “undercover”, they’ve all got the same stiff Kevlar vests under their shirts and sidearm strapped to their waists; if they’re on guard duty outside your shooting survivor patient, they’ll also have their 150 round/minute submachine gun beside the laptop they’re watching DVDs on to pass the time. Police detectives wear the stereotypical suit and tie (no lapel badge though), and come in within 5 minutes of your shooting patient getting their breathing tube out of their mouth and able to whisper.

Some quotes:

MG, on having to do rectal exams on every Trauma: “The perineum is a mysterious area.”

JL, on seeing that patient run over twice on the highway: “The buttocks were not normal – normal buttocks have cheeks and a cracks. He just had mess.”

BC, on the late-night on-call vending machine diet: “It’s so easy to gain weight in scrubs and not notice it. Then you try to put on your jeans and – oh.”

MG, on scrub sizes: “Scrubs are always oversized. Dr H [who is very thin] wearing double-XLs, all baggy – he looks like Snoop Dog.”

Me, on one of the Afghanistan-bound civilian internist staff rotating with us for some pre-deployment trauma experience, and doing 1-in-1 call the whole weekend, then going back to his home hospital to do ICU call the week straight: Maybe Dr F’s excited about doing all this call again, like reliving his residency experience back in time. The same way I think I’d like to relive high school sometimes.

Two nurses:

Nurse 1: “Hey, can you open up the narcotics cupboard?”

Nurse 2: “I don’t know, I don’t know who you are, I’m going to get fired for this. But ok.”

Nurse 1: “Well, you never liked this job anyway.”

Nurse 2: “Yeah, but I can’t get my severance if I’m fired for cause.”

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To JP: Vancouver’s a great place though. It has that random artsiness that I missed that you only find in bigger cities. It’s kind of like how before farmers and the agriculture industry existed, everyone had to grow their own food and tend their own fields to survive, so no one had time to do anything else. But in big cities, the basics of survival are spread out over lots of people, so that everyone has a chance to spend time on something less survival-essential, like art and whimsy. Such that art and whimsy becomes such an important part of life, that it too becomes survival-essential, and that’s what makes Vancouver great. Does that make sense?

Random artsiness like: whiteboard doodles in the ICU -

- actually putting an RFP for a City logo design (! Definitely something public competition brings out the best… otherwise you end up with stuff like this) -

- à propos street names (this is near the Cancer Centre) –

- building details -

- Celtic sea chanties -

- pedestrian warnings: look both ways! -

- two repertory cinemas (at least two I still have memberships for from earlier on) -

- gargoyles! At least in function, anyway -

- manhole cover inscriptions -

- washroom chalkboards -

- sidewalk impressions -

- street furniture and decor -

- banners! No neighbourhood is complete without them -

Love these photo-quality Richmond ones:

- random signs -

That one makes sense when you see the actual cows:

- and the usual galleries. There’s the big ones (the Vag, etc) that get right out to the street, you can’t miss them -

- but the little community ones are treasured finds too -

These were designed as like blankets for rocks and stones:

This was an anti-war series:

Knitted cells on a biology textbook – why weren’t our books in 504-261a Dynamic Histology this creative? Probably because we didn’t have textbooks. (Dr Morales did do amazing diagrammes on the chalkboard (! They still used them back then, in the late 20th century at McGill) though. I wish I had photos of those. But then again digital cameras would’ve still been the domain of the military or secret agents. Or Ed.)

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And then of course there’s biking – you know you’re in for a treat when the City makes it so easy for you. Even Toronto is jealous, so that’s gotta count for something. There’s maps -

- bike shoppes with free oil and air (the first oiling I’d got all year – shame on me, I know) -

- paths everywhere, even on highways and bridges, from city to country and back -

You can even ride to the airport, but you’ll get weird looks when you walk in with your bike, even weirder when you ask for a bike rack (there are none), and even more weirder when you ring the bell trying to wiggle through the summertime terminal crowds:

If you use any random pole outside it’s ok though, the crossing guard will even watch it for you:

- and of course the weather just makes you want to ride on and on and on – and take pictures of you and your faithful steed -

It sucked when I got my lights stolen and again when I got my pump stolen too… but Mum and Dad got me a pair of new 9-LED headlights. Two of them, double-barreled, blowing the darkness away:

I passed this guy at Granville Island, and thought this was so Vancouver – bike and kayak, together at last!

(Enough bike porn: there’s better stuff at copenhagengirlsonbikes. I just spent an hour of my irreplaceable work-free weekend there – I think that is the closest I’ve gotten to ogling porn on the internet.)

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Anyway, memo to self – write more often. Instead of cobbling together half-assed whirlwinds like this that don’t do memory justice.

I stand on-call for thee

Dammit! Why couldn’t I have been on-call last Wednesday-Thursday?

Baby-boom blip takes VGH staff by surprise
Sandra McCulloch
Times Colonist

The maternity ward at Victoria General Hospital saw a boost in babies this week, with 17 newborns arriving between Wednesday and Thursday mornings.

The usual number of births over that period is about eight.

“It was a blip,” said Suzanne Germain, spokeswoman for the Vancouver Island Health Authority.

The baby boom has prompted considerable speculation among health-care providers at the busy hospital, the place where most babies on the south Island are born.

“The staff in labour and delivery out there have been talking about it and counting back nine months and there’s nothing specific they can put their fingers on,” Germain said with a laugh.

No power outage. No NHL strike. New Year’s Eve had long passed when these babies were conceived.

“The nurses were absolutely incredible, but they were running off their feet,” said Kira Lavoie, who gave birth to daughter Bridget at 2:53 a.m. Thursday.

“The nurses were saying they hadn’t had a break, they hadn’t had dinner, they hadn’t had anything. They were going literally from one delivery to the next.

“Mine turned into a caesarean and one doctor came running out of the other room and said, ‘OK we can see the head line on the one I’m delivering next door — I’ll be right with you.’”

New mothers waited for rooms to come open and staff dashed around to make space.

“All the [moms] with private rooms ended up having roommates,” Lavoie said.

The ward was indeed packed, confirmed Germain.

“There are 28 beds on the ward and we had a census of 39 [patients] that day,” she said.

“We do have these blips, and staff are experienced at how to roll them through. It was interesting and caused a bit of excitement and chitter-chatter as to what might be the reason.”

Those mothers who could be discharged were sent home and things are now returning to relative normal.

Lavoie has her own theory for the arrival of so many babies en masse Wednesday to Thursday: “It was a full moon.

I actually really like being on-call. I guess most people try to get out of it as much as they can – just look at the back of the CMAJ in the “physicians wanted” classified ads. “No call!” or “Call only twice a year” they go out of the way to say. But me, I actually love it. I think it’s the being-on-alert, heightened sense of awareness that comes with carrying the pager on your waist, ready to run when the moment comes. It’s like carrying a time-bomb, but there’s no countdown on it, you have no idea when it’s going to go. (BTW – real time-bombs don’t have countdown displays on them, of course.)

You can sort of be sure it’ll go off though, for example, when you’re 1) taking a break, 2) having a snack, 3) finally talking to the cute med student you’ve been crushing on since the start of the rotation, 4) in the middle of another delivery, 5) just seconds in bed about to steal a few winks; and so on. It’s like there’s a gyroscope in the pager that can tell when you’re stopped or sitting or lying down… so the key is to keep moving. And I guess that’s what I like about being on-call: always moving.

It’s like having a sleepover in the hospital: you’re in your jammies (ie scrubs), in your cozy little call-room, sharing the lounge with fellow on-callers, and maybe even the aforementioned cute med student you’re crushing on. I never really had any sleepovers when I was a kid, so here’s my chance. Maybe that’s also part of why the novelty of being on-call hasn’t worn off for me yet.

This is what I look like on-call:

Green scrub top and bottom, small – if there’s still any left on the rack. Victoria doesn’t have scrub dispenser machines like Kingston yet (actually I don’t know if those machines exist anywhere other than Kingston… haven’t seen them anywhere else) so scrub supply is hit-or-miss depending on who did or didn’t return them from the shift before. A white coat on top – full-length, earned after four years in the hip-length short clerk coat of med school. I love the feeling of it hitting behind my knees, that feeling that “you have arrived”. Plus a pair of perforated holey-soles clogs on my feet. Nice and airy – crucial for a comfy and odour-free call shift. Not so good for surgery or messy deliveries though.

In the left pocket, a Sanford Guide to Antimicrobial Therapy. You can barely see where the “Courtesy of Bayer” sticker used to be, but I peeled it off. But I don’t mind carrying a flashlight with a Regina Qu’Appelle Health Region label on the side. I used to have two of these, but I gave one to BML back in S’hai last summer whilst scrambling for a parting token souvenir. A pack of generic Shoppers Drug Mart breath strips too – crucial for on-call toothbrush-free nights around that cute med student. A VIHA photo ID/passcard – actually usually pinned to my scrub top, so that when I take the white coat off to do a delivery I’m still wearing something suitably authoritative. Plus it means I won’t walk out of the call room without a card to get back in.

In the right pocket, almost perfectly balancing the weight in the left, a set of Advanced Cardiac Life Support cheat cards – haven’t had to pull them out and use them yet, but just in case. A photocopy of the Sick Kids Resuscitation Card for paediatric codes blue (“code pink”, they say in Ontario) – this one I have had to use, because I never remember paediatric drug dosages or defibrillation settings. And just for Obstetrics, a gestational age wheel. Usually you can only ever find these with drug brands on them, but score! – this one’s a more benign promo, for A Study About Breech Babies and early cephalic version, out of U of T.

I usually would carry a green Tarascon Internal Medicine & Critical Care Pocketbook, and red Tarascon Primary Care Pocketbook (it’s now green), or my Oxford Handbook of Clinical Medicine too, but they haven’t really been all that necessary on Obstetrics and Gynaecology. They’ll all probably make a comeback when I start Surgery in mid-February.

Palm Tungsten E and Sanford uniball Micro pen in the front pocket. The Palm’s two years old now, from the Meds ‘06 mass order SC engineered back in the good old days. It came with a hard metal case, but that made it too bulky to carry around, so I took it out. If you’re not going to carry the thing with you because of size, then what’s the point of having it? So scratched up as it is sans-case, it’s been a useful dayplanner and quick reference. Moreso the dayplanner than quick reference actually – haven’t updated ePocrates in a year (it doesn’t let you open it if it’s too old; for “patient safety”, it says), and it’s still quicker to leaf through a paper Harrison’s or Tarascon than the e-version.

Stethoscope over the shoulders – a Littmann Cardiology III. Dr David Littmann was a cardiologist who wrote a paper about the “ideal” perfect stethoscope back in 1961 in JAMA: “open chestpiece for the the appreciation of low-pitched sounds, a closed chestpiece with a stiff plastic diaphragm to filter out low-pitched sounds, firm tubing with a single lumen bore, the shortest practical overall length, a spring with precise tension to hold the ear tubes apart, and light and convienent to carry and use”. Instead of the open and closed chestpieces though, mine has a tunable diaphragm in adult- and paeds-sizes. Works all right, though I do have my eye on this all-black “Master Cardiology”. It only has an adult-sized end, but it’s all black! Like a ninja.

Speaking of ninjas… I’m back to biking to work! I say “speaking of ninjas” and “biking” in the same sentence, because in a roundabout way this has to do with ninjas, since my bike and my rain gear is all black, like a ninja. Including my matte black Bell Metropolis bike helmet, replacing my Kingston Police-issue Giro Transit that was white and not at all ninja-like. Wearing my helmet and charging through the rain, all in black, feels like taking on the world – like a ninja!

Biking to work is key, because $25 parking tickets really suck. Especially when it happens early in the year, when you’re mind’s still stuck on writing “2006″ on everything, and so when you’re using those scratch permits, you accidentally scratch off “06″ instead of “07″, and they give you a ticket because of it.

I wrote them a letter saying sorry and explaining the mistake, and I sent them the next permit I used, so they could see the sequential serial number at the top and believe that I didn’t just save an ‘06 card from last year to reuse on the same date in ‘07. (Really, who’d do that?!) Haven’t heard back if it’s all good yet, but if not, if I keep biking at least they won’t be able to clamp/boot/tow my car on the hospital parking lot.

And the less I drive, the better – my first, and hopefully last, ding on my Rabbit: passenger side bottom edge, clipped a foot-high curb on a too-sharp right I pulled, coming fresh out of a car wash of all places… My poor poor bruised Rabbit… I am so, so sorry. I hope my parents don’t find out… my Dad’ll kill me. Even though it’s my own car!

The price is right

Three free things today:

1) The entire day, for one: not on call, and I’ve already covered a good spread of Obstetrics clinics, so I don’t feel too guilty about not making it out to the assessment clinics this morning. Slept in ’til 8-ish, went for a long run, actually got a little short of breath having fallen out of routine since last month’s snow “storms”, but I think my legs and knees and lungs are starting to remember how they’re supposed to work.

On top of the usual military gray T-shirt and shorts set, threw on my white Canada wordmark shirt from Canada Day ‘03 for extra warmth in the 5-degree mist. More of an off-white three years later actually… but seeing myself reflected in the storefront windows, running with the government logo on my chest – just like the people on the Olympic team! Makes me feel like I’m playing athlete. “Playing” being the key word, what with my slow and awkward form, but anyway.

2) A muffin, at the Blue Carrot Cafe, a little mum-and-pop run place in Bastion Square. (I love that name, “Bastion”. So imperially Victorian.) They were about to close up after lunch, so it was going to be a day-old anyway. Blueberry, yummy. And totally undid any healthy benefit from this morning’s run, but worth it.

3) A set of bike reflectors, from Fort St Cycle. I was looking for some old-style spoke-mounted round wheel reflectors to put on my bike to give it a little retro flair (like this 1962 3-speed Raleigh), to go with the matte-black frame and mud-flapped fenders. “We can’t actually sell you aftermarket reflectors, but here’s a set that was going in the garbage anyway.” Not what I was looking for, just a set of brand-new ones that I guess someone didn’t want installed on their new ride, but they were so nice digging into the back room to find them, I couldn’t say no. Any of you guys want some reflectors?

I did manage to find a single amber one for the forward wheel at the Bicyclitis on Bay St by the Jubilee Hospital, though came up blank for a red one for the aft. I choose to think of it as half-full than half-empty. Will wait for the whole set before putting it together; with the two blinkies on the handlebar and the 5-LED headlight pointing front I think I’m still good for night commuting in the meanwhile. But as you can see below, those regular wheel reflectors don’t do much.