The Secrets of Barista Nick

What better way to relax after a brutally long first week, than sleeping in Sunday morning and making yourself a Iced Grande Creme Brulee Latte to wake up to.

Ingredients

• 2 scoops of freshly ground dark roast espresso beans
• 1 ounce of Torani Creme Brulee flavour syrup
• 2 ounces of filtered water
  
• 2 cups of cold skim milk
• handfull of crushed ice
• (espresso machine)
• (martini shaker)
• (sexy looking mug)

Directions (followed by my expert advice)

1. Press ground espresso into handle of espresso machine (The key is to compact the espresso both hard and evenly)
2. Fill the espresso machine with 2 ounces of water and pull two shots of espresso (Use the best quality filtered water you have available)
3. Immediately after the shots are pulled, mix espresso with 1 ounce of flavour syrup (Mixing the syrup at this step ensures even flavour distribution)
4. Add 2 cups of cold skim milk to a martini shaker filled with crushed ice (Shaking in ice versus pouring over ice cubes has a number of advantages, quicker and more thorough cooling, and less dilution from the melting ice)
   
5. Add the 2 shots of flavoured espresso to the martini shaker (If you add the espresso before the milk, you would melt too much of the ice!)
   
6. Cap and shake vigorously (Until your hand is cold)
   
7. Decant your tasty beverage into a sexy mug (If shaking was vigorous enough, there will be a nice layer of foam on top, rarely seen in store bought iced lattes! As for the sexy mug, appearance/presentation is key. It just tastes better.)
   

First Week on the Wards

Look at me. Do I not look tired? That's because I had just finished my very first shift at the Royal Alex Hospital in Internal Medicine. Just as my luck would have it, I was the poor sucker who was on-call on my very first day! This means that we started the day at around 7:00am, and then I didn't get home until 4:30pm. THE NEXT DAY!!

You heard me right. I was conscious for at least 35 hours during my first day in the hospital. And while I'm complaining about working too much on my first day, I should mention that I was also on call on the Friday of the first week, bringing me to a grand total of 78.5 hours of hospital time during just my first week. Is that not double a full time job? Needless to say the time during which I wasn't in hospital I was either:

a) asleep

or

b) studying

OK now that I've got the whining and complaining out of the way, here is how it went. Actually my first week was much better than I had expected. It was definately frustrating not knowing ANYTHING, but I'm beginning to get a feel for how the hospital works. At first I didn't know who to call for what, which forms to fill out and when, where to find those forms, where to put those forms, etc etc. So my knowledge of medicine (or lack thereof!) has not really come into play yet. At this point its still just learning how to do the paperwork and how to deal with the simple things.

Here I will run through my schedule for tomorrow to give you a sense of what a day is like for me:

0745 to 0830: Morning Sign-In Rounds
- arrive with coffee in hand to get a short lecture on some random clinical subject

0830 to 0835: Prepare for Rounds
- head up to the on-call suites to print out my patient list for the day, meet my junior resident, and page my staff doctor so we can meet up

0840 to 1030: Round with Staff Doc
- go and visit every patient along side my junior and staff doc, check out what happened to them during the night, see how they are progressing, order new labs/tests and change managment if required

1030 to 1200: On My Own
- after the staff doc takes off, I am on my own usually doing paper work for our patients, arranging for Consults with other physicians on my patients, following lab values the come in throughout the day, grabbing lunch if possible

1200 to 1300: Rheumatology Teaching
- find my way down to a lecture hall in the basement to receive an hour of teaching on some random rheumatology topic with all my fellow students (rheumatoid arthritis, lupus, osteoarthritis, etc.)

1300 to 1400: Clinical Skills Teaching
- meet up with one of the senior residents along with all of my classmates, to go visit a patient and go over some clinical skills teaching (pulmonary exam, liver exam, cardiac exam, etc.)

1400 to 1800: On My Own
- again follow-up on random things ongoing with my patients, see what my junior resident is up to, if nothing to do: study, do assignments for the week

1800 to 2359: On ER Call
- consult patients in the ER who are requesting admission to General Internal Medicine, do full history/physical on the patient, write up full admission orders and admit the patient under the care of my staff doc (to become a patient I will follow throughout the next couple of weeks)

0000 to 0700: Still on ER Call
- sleep when I can, study when I can't sleep, and just hope my pager doesn't go off for another consult, in which case I would be wandering back down to the ER to admit another patient (we will probably admit 5-10 new patients throughout the night)

0745 to 0830: Morning Sign-In Rounds
- receive another short lecture on a clinical topic, except this time my eyes will barely be open, and the thought of coffee will make me sick

0835 to 1000: Round with Staff Doc (again)
- once again go through and visit all of my patients with my junior and staff doc, update their current progress, order new tests/labs, arrange for followup/placement, check new lab results as they come in, ask the nurse what happened throughout the night, etc.

1000: Go Home (hopefully)
- at this point I will not be punished for going home (after 26 hours of work) but if there are any issues ongoing with my patients, or if there are any other lectures throughout the day, I will be pressured into staying longer




So that's what my schedule is like for tomorrow! Craziness. I suppose I am coping well considering the magnitude of this change to my life. This next week will definately run smoother than the last, and hopefully that trend will continue. On top of that, this is supposed to be the greatest amount of work in any of my courses this year, so if it is all down hill from here, that's perfect for me. Should make for a relaxing year.

Year Three Begins

Year three of medicine has began. My first year in the hospitals. Just as lectures were becoming comfortable... (maybe too comfortable: sharing junk food, watching video clips on palm pilots, playing Text Twist on my palm with everybody that sat close enough to see the screen, running for coffee after the first lecture of everyday, spilling that coffee on myself almost everyday in a rush to get back to class on time, playing countless hours of Sudoku and Solitare, passing notes, beaming notes through Bluetooth/Wifi, running commentaries making fun of profs accents/mannerisms, fixing peoples Palm Pilots, sleeping, taking pictures of people sleeping, drawing on people sleeping, gossiping, throwing things at people, studying for upcoming exams, copying notes from previous lectures, finishing homework, applying for scholarships, playing Bike or Die on Zak's Palm during every single pathology lecture...

Proof that I lack human emotions

This pic was from one of the rollercoasters at the Calgary Stampede this year. A "kiddie rollercoaster" to be exact. One of the rollercoasters where you are the tallest person in line by like 3 feet.

Compare the emotions in my face (calm, cool, collected, double-guns to the camera), to that of Nicole's sitting directly to my left (pure terror). This death defying drop, the grand finale of the ride, was a grand total of 9 vertical feet. This was the one ride I could convince ALL of the girls to go on.

Fitness Craze

Lately I've found myself in a bit of a fitness craze. This is unusual for me. During school I hardly have any free time at all, and when I do I usually tell myself I should be using that free time to study. On top of that, my usual fitness routine for the summer is to go for a run every once and a while. I can usually keep that up for a week or two, but running is boring and overall completely unenjoyable for me. I have found a much more enjoyable way to burn many more calories. My new routine involves the following activities:

• Working out (8 times in the past 2 weeks)
  
• Playing Squash (5 times in the past 2 weeks)
  
• Swimming (7 times in the past 3 weeks)
  

How am I able to keep this up? I just bought myself a membership to the doctor's gym in the hospital. Not only does it have the allure of being a high-society exclusive fitness club, but it's less than 5 minutes from my place if I left now. On top of the excellent location, it is open 24 hours a day. I've been there for workouts and squash games past midnight a couple of times already, which is perfect for when I can't sleep. At this rate I should be able to undo a years worth of laziness in no time!