Lots of New Impressions and Många Nya Intryck

Sometimes life makes you dive into an experience that is so new and unfamiliar that you spend days afterwards reflecting and digesting the impressions.

That happened to me this summer. And then immediately, it happened again. And it happened again. And by now, back in Gdansk, I feel like the New Experience Processing department of my brain is backed up and overloaded– and I mean that in the most positive, exciting way. One month in Sweden, two weeks in a radiology internship, six cities, lots of relatives, friends, and sightseeing… I don’t even know where to begin. I would start at the beginning, but my brain lost all sense of chronology long ago. Instead, I’ll start with whatever comes to mind first:

— When looking for a free guided tour of Stockholm, I stumbled into the midst of a huge protest at Sergels Torg against the political party Sverige Demokraterna. “Vad ska vi göra?” “KROSSA RASISMEN!” the people chanted. I won’t get into the politics here, but the translation of the chant basically involves crushing and destroying racism, with regards to this very controversial political party receiving13% of votes in the recent election.

— Ended up going on this free guided tour of Stockholm’s Old Town after the protest moved to another part of the city. One of our stops was the the site of the Stockholm Bloodbath, where Danish King Kristian II invited all the Swedish nobility for a “feast” to celebrate his recent coronation (Sweden was owned by Denmark at the time). All he actually wanted to do was behead all of them, which he did after the feast in the middle of the town square. Luckily, Gustav Vasa had chosen not to attend that dinner. Thus, Gustav Vasa was not beheaded, and in his anger at the dishonesty which killed his fellow noblemen, he went on to lead Sweden in a revolt against Kristian II. Gustav Vasa was the first king of Sweden as we know it today.

— I learned how to hit a golf ball, and now I am actually interested in pursuing golf further when the opportunity arises. Unlike other horrifying sports where people throw or kick a ball at you and you are given 3 milliseconds to decide what to do, golf gives you plenty of time to think, plan, take a deep breath, and then go. That’s a much more conducive environment for enjoyment, if you ask me!

— Went sightseeing by myself for the first time. Granted, I wasn’t truly traveling alone, as I was staying with relatives and visiting friends along the way. In Stockholm, though, I spent the daylight hours on my own and went to museums, cafes, and explored the city on my own. I do enjoy having company, but there is also a small sense of liberty when you can spend your time precisely how you want to. Sometimes you have to choose between doing something alone, or not doing it at all. It’s cool to know that I’m able to travel independently if I want or need to.

— I watched the musical “Chicago” in Swedish! I had mentally prepared myself for the possibility that this amazing musical might be a translated version in Stockholm, so I wasn’t completely shocked. When I stop and think about it, though, I somehow find it sort of amusing. I know all the lyrics to all the songs from the musical soundtrack in English, and then hearing my beloved characters singing “Cell Block Tango” and “We Both Reached for the Gun” in Swedish was both confusing and not confusing. It’s the same feeling I get when I watch my childhood cartoon characters speaking Swedish in the Christmas Eve TV special (Kalle Anka). Nonetheless, the performers in “Chicago” were extremely talented, and as usual, I wished I was up there onstage with them. A great show!

— I took a train from Stockholm to Uppsala, another one of Sweden’s largest university cities. It’s funny hearing students from Lund and Uppsala talking about each other, as they are rival universities. “This is our church. It is bigger than the one in Lund!” “Our botanical garden is nicer than the one in Lund!” And so on (I heard a similar yet opposite story during my time in Lund, I might add). Uppsala is a beautiful city and I had the privilege of being shown around by my childhood pen pal (you know, those days before email when we actually wrote letters with a pen and paper and affixed a postage stamp on an envelope). She is a graduate of Uppsala University, and proud of it!

— Jumping backwards in time, I also spent a day in Malmö where I met up with a friend I grew up with in Canada, and his girlfriend. It’s interesting to relate to the experiences of another dual-citizenship Swedish-Canadian, and what his thoughts are regarding our two countries.

— Jumping forwards in time, I flew to Gdansk for a weekend to celebrate my birthday in September. As a Canadian I still marvel at the simplicity of international travel in Europe– an hour on a cheap flight across the Baltic Sea, and I’m in a completely different country. Granted, my new house in Canada is about 5 minutes from the American border, but take a one-hour flight in any other direction and you would definitely still be in Canada!

— Went for dinner with my mom’s friend and her family. This was my first time meeting up with them alone, without my mom (and we missed my mother dearly!). It was really fun to meet up with this awesome family. My mom’s friend said something that made me think for a moment. She said that it was sort of amazing, sitting here in Stockholm with me, my mother’s daughter– because when she and my mom were teenagers, who would have expected that someday she would be having dinner with her best friend’s daughter? I look forward to the day when I, too, can meet up with my friends’ kids and treat them to a delicious dinner!

— As a relaxing and cozy finale to my whirlwind tour of Sweden, I spent a few days with my Mormor (grandmother) and B. During this time I brushed up on my hunter-gatherer skills and we “plockade svamp” in the forest, with the company of my uncle and aunt. “Mushroom picking” sounds totally weird in English. I don’t even know if anyone even picks wild mushrooms in the forests of Canada– I certainly never had. But this Swedish tradition is SO MUCH FUN! With gumboots on my feet, a large basket in my hand, and a special knife with a brush on the end, we wandered through the trees and collected enough mushrooms to cook two meals at home. Nothing tastes as good as a mouthful of “svampstuvning,” knowing that you found these mushrooms all by yourself in the mossy shade of the underbrush!

And now here we are again, Medical University of Gdansk, third year! Meeting the new first year students reminds me of where I’ve been and how much I’ve learned– academically, but also personally– in the past two years. On Monday our summer vacation ends, and my life will be engulfed by studying once again. It will take over my life, as it always does, so it’s a good thing I enjoy school so much!

Photos: In My Grandmother’s Garden / Mormors Kolonilott

Adventures in Radiology: Placed a Filter in the Inferior Vena Cava, Took Home X-Rays as a Souvenir

I’m at that stage in my medical degree where EVERYTHING I learn is SO COOL. When I start third year at the end of September I’ll be starting real clinical courses– an exciting promotion from the theoretical courses in first and second year. At the moment, though, I have limited clinical experience, so I am an eager, enthusiastic, easily-fascinated medical student, and I have no shame in showing it!

Radiology is basically like “50 Shades of Gray,” and I mean that in a literal sense. Ultrasound, MRI, X-ray, and CT scans can give you a lot of information if you are able to identify dark gray and light gray blobs. I’m impressed by the way that ultrasonography is used for procedures like thoracocentesis and nephrotomy, for a live image of where you stick a needle or place a drain. I was allowed to try using the ultrasound probe on my supervising radiologist’s thyroid (on the neck) and I identified a myeloma in an X-ray of the scapula (slightly dark patch indicating cancer in the bone marrow).

But today was far more exciting than that! Today, I actually took part in an interventional procedure in the angiography department!

My contribution was both legitimate and idiot-proof. I participated, but it was a very controlled environment with practically no room for error under my supervisor’s instruction.

The patient had deep vein thrombosis in his leg, which could be dangerous as the clot could dislodge and float from the leg through the veins and get stuck in the lungs. To prevent the acute situation of blocked lung vessels, our task was to place a filter in the inferior vena cava (one of the biggest veins in the body) so that clots from the lower body would be “captured” before reaching the lungs.

I’ll briefly go into a bit of detail in this paragraph: Notably, blood flow was still freely permitted through the filter, which is essentially permanent once placed. Only large solid particles would get stuck in the filter. It was critical, though, for the filter to be placed inferior to the renal veins. If the embolus did get caught in the filter, blood from the lower body would be redirected and find another path back to the heart without a problem. However, the renal veins must drain into the inferior vena cava; therefore, the filter had to be below the renal veins so that venous drainage of the kidney would be unaffected by an embolus.

The Polish-Swedish doctor I was following today did all the difficult/important parts. He injected local anesthetics, inserted a wire and a catheter into the femoral vein in the groin, and used the X-ray to navigate the wire to the correct part of the inferior vena cava. After some other preparation, the filter was ready to be placed.

Meanwhile, I had been wondering why I had been asked to wear the whole sterile outfit this time. During the earlier procedures, I had stood in the background with just the heavy vest to protect me from the X-rays. I wasn’t touching anything, so I didn’t need the sterile scrubs and gloves. The reason for my new outfit became clear when Dr. C pointed to the catheter said, “Now hold this with your left hand, like this.” I did. And then my right hand held the wire which was in the catheter, which I held stable as I pushed the filter out of the catheter. Then I pushed a red button, a blue button, and the filter was released!

“You have placed your first IVC filter,” Dr. C proclaimed quietly, already removing wires and preparing for the next part of the procedure.

I might add that there’s something familiar and almost comforting about hearing English spoken with a Polish accent in a hospital. Dr. C worked in the US for many years, and seeing as I know all my medical terms best in English, he and I speak English together. Perhaps it’s because my medical school in his country of origin, or perhaps he can tell how interested I am in learning about his expertise. Regardless, Dr. C has been very kind and has gone out of his way to give me lots of awesome learning opportunities. So have the other radiologists and nurses at this hospital, too– something I am greatly appreciative of.

The second part of the procedure was more complicated, so I simply observed. There was a tumour causing a hematoma in the liver, so to block the bleeding, Dr. C injected tiny beads that looked like sand to block the vessels. This deliberate embolization if the left hepatic artery would cut off the tumour’s blood supply, while the rest of the liver parenchyma would still be supplied by the hepatic portal vein.

It’s a bit of a special discovery to meet an expert who remembers what it was like to be a novice. When I thanked Dr. C afterwards for letting me participate, he smiled and shrugged with a twinkle in his eye, saying, “The first filter is fun.” He offered to let me take home images from the procedure so I could show my friends what I have accomplished.

What Am I Doing in Sweden?

This past week in Sweden has been full of new experiences. I aged backwards to fifteen again, and went to school with my cousin one day. I took a train across a bridge and through an underwater tunnel to Denmark, and spent the day in Copenhagen (the train trip takes less than an hour from Lund Central station). My uncle, aunt, cousin and I went to a driving range and I learned how to hit a golf ball. We took a day trip driving around Skåne and managed to avoid the massive flooding in other parts of southern Sweden this weekend; in lieu of floods, our Sunday consisted of picturesque fishing villages and an all-you-can-eat “fika” (yummy coffee cakes, sweet buns, and other baked goods) at Cafe Annorlunda. 

I have temporarily become part of a new family, as I was warmly accepted by my uncle, aunt, and cousins from the start. I am very grateful to be taken in as one of them during my visit here. I must say, this is a family which has a pace of lifestyle more eventful than any other I’ve experienced! Teenagers doing homework, teenagers having slumber parties, teenagers trying to avoid doing homework, walking the poodle and the spaniel, going places, meeting people, changing plans and making it all happen anyways, uncle making fun of aunt, aunt making fun of uncle, parents teasing kids, kids bugging parents, dogs eating leftovers, everyone eating candy, and so on… All at the same time! There is never a dull moment, and I love it. 

I would gladly visit Sweden for the sole purpose of these experiences, but I am a medical student, and my summer gets to be even more fun than that– I am doing a two-week radiology internship at the Lund University Hospital! I have been looking forwards to this internship for months. So far, I have had two days with neuroradiology. For the remainder of my internship I will be rotating between observing other sub-specialities, including pediatric radiology, skeletal radiology, and gastro/thorax radiology. 

My first day as a medical student in a Swedish hospital was exciting to the brink of overwhelming. In some aspects, a hospital is a hospital, and my knowledge of Polish and Canadian hospitals made the setting feel familiar– barely. Medical Swedish language really boggled my brain, even though I studied my cousin’s biology textbook beforehand to learn some Swedish names of organs. The radiology department is enormous, to the point where I got lost for 10 minutes at lunchtime just trying to find my way out of the department (although we must also acknowledge my inherent lack of sense of direction). 

We spent yesterday looking at MRIs and CT scans of brains, skulls, and spinal cords. It took me a few hours to realize that the young woman I was working* with was a radiologist. Up to that point, I wasn’t quite sure whether she was a resident, a technician, a nurse, or a doctor. It took me that long to realize she was a doctor because, like every single other person in the hospital, she introduced herself to me by first name (in my experience, doctors are often addressed Dr. _______). And almost everyone else was wearing the same white hospital clothes as her, myself included (in Poland, only doctors wear white, and medical students wear white lab coats). Also, we weren’t visiting patients; we were looking at pictures on a screen instead (please note that although I was aware radiologists typically have no patient contact, I hadn’t actually visualized what that would look like). It was during a nice long coffee break that I met some other doctors, and then met some nurses and medical secretaries as well. Only a minority of people wore name-tags with their titles on them. 

After the coffee break, I started to process that this young woman’s expertise and responsibilities could only match up with “radiologist.” I’m not really sure what else I expected her to be; it’s more like I simply wasn’t able to place her in the hospital hierarchy I’ve learned in Canada and especially Poland. Luckily I had been previously informed of the equality in Swedish hospitals. Still, though, the hospital environment as I knew it had been broken down and shifted around. Even today, I was battling to rebuild my understanding of the system of behaviour among the employees at the hospital.

Today I was at INR, which stands for Interventional Neuro Radiology. It was awesome! I got to watch two procedures close-up. INR involves entering the body’s arterial system through an artery in the groin, sending wires and catheters up through the body’s vessels to the brain, and then using X-ray images as visual guidance as you perform a procedure in the brain vasculature. Technology is really amazing in the field of radiology. When I looked at the doctor, he was standing and delicately twisting and pushing a little wire between his gloved fingers. But when I looked at the live X-ray, I saw an aneurysm in the internal carotid artery return to normal vessel size as he diverted the flow with a stent! It is astounding that this mesh cylinder (stent)  could be inserted into a bulging brain vessel (aneurysm), all the way from the groin! 

SO COOL! 

I have already learned a lot and put my rusty anatomy knowledge to good use. I’m looking forward to seeing what other sorts of new experiences this internship will bring! 

*I use the term “work” lightly, referring to my role as observer and asker-of-questions. Considering the early stages of my education, this summer is more like a job shadow experience than an internship.