Sometimes the moon, it'll follow you in the middle of the day.
Waiting to be found, we were just standing around,
With nothing really much to say.
- Last of the Ghetto Astronauts, The Matthew Good Band
It has gotten cold in Yellowknife. When I arrived here 11 days ago, I was surprised at how balmy it was. Though the skies were grey, the temperature was above zero, and for an Ottawa boy that's practically t-shirt weather. I went to work without my coat to avoid arriving there drenched in sweat. Now I shiver even though I bundle up.
Out on Frame Lake
A woman came into the ED today with cold exposure. Her temperature was normal, so she wasn't really hypothermic, but she had severe frostbite on the soles of her feet and both hands. Apparently well known to the staff, she and her common-law husband were homeless, but lived as vagabonds in the true sense; wandering around and between towns, pitching a tent and sleeping on the ground. She was a chronic alcoholic, with a median nerve palsy sustained from a failed suicide attempt. "She's hard on herself," said the day-shift doctor.
Her story was hardly unique. While most emergency rooms have a couple of regular alcoholics, given the size of Yellowknife, Stanton has a huge number of them.
A year or two ago, a partly aboriginal classmate of mine was involved in remaking the aboriginal health curriculum, and I asked her what she wanted the focus to be. She said "I don't want people to think of the stereotypes when they think of aboriginal health. You know, the obese, diabetic, alcoholic, suicidal aboriginal." Here in Yellowknife, I learned that those stereotypes exist for a reason.
On Tuesday I drove down to the nearby town of Rae with two physicians. Rae is almost entirely Dene. Aside from alcoholics (some of whom were recovering) I encountered my first case of child sexual abuse. It's the sort of thing they teach you about in medical school, but which you don't expect to see until you've been in practice for several years. "I diagnosed a seven-year-old up here with an STI just a month ago," said one of the physicians, himself a graduate of the class of 2004.
We left the case in the hands of the local social services, and headed off to visit the local elders' home. Even before medical school, I had been to a lot of old folk's homes, and they generally have a particular atmosphere, even a particular odour that tell you "this is a place where incontinent, demented people are sustained by purreed vegetables, Ensure, and inconsistently caring staff."
This place was different. The residents I saw were, first of all, all on relatively few medications, mostly of sound mind. All the staff spoke Dene languages, and treated the residents with a kind of respect I haven't usually seen in such a facility. Although I needed an interpreter to take all the histories, they were relatively easy patients to sort out. The food even smelled good.
I had noticed, however, on the walls of the room of one 94-year-old resident, a multiplicity of catholic icons. The words of an early Malcolm X speech came to mind "You look on the walls of any of those churches, and what do you see? White people! God white, Jesus white, Mary white, everybody white! . . . You listen to hymns like they taught my own mother; 'Wash me white as snow.' " The Dene of Rae might be responsible for some of their own problems, but somebody had taught them to hate themselves.
Back at the clinic. Social Services had talked to the mother, and put in place a "safety plan" for the abused child. The doc who had discovered the problem was beside himself. "It is obvious that she is being abused. [it was indeed obvious] I'm not making any accusations, but there's a male in the house, and mom's a known alcoholic. Even if the abuse isn't happening at home, this child doesn't need a safety plan, the child needs to be put somewhere safe!"
"Well, there are some historical issues around taking aboriginal kids away from their parents," replied the lady with Social Services.
Nobody could deny that there weren't, but the perverse result of the acknowledgement of that history was that an aboriginal kid was getting less protection than she would have had she been white.
On the drive back to Yellowknife, I got an education in "Indian and Northern Affairs" to quote the Government of Canada. "When you live up here, you realize just how unrealistic some of the stuff we tell people to do is. 'Eat more fresh fruits and vegetables.' What vegetables? An old Inuit man in my practice once told me 'My wife bought a pepper this week . . . it cost her $15.' We tell them 'Get more exercise.' Where are they supposed to do that? There are no gyms."
"Well, what were they doing before Europeans arrived?" I have a habit of asking questions that I already know the answer to, but I wanted to hear it from someone who had actually seen it with his own eyes.
"They hunted, they ate dried berries, and they were active because they had to be."
"So maybe you should tell your patient to get himself a spear."
"People like TV too much. It's a little too late to go back to that. The world has changed. They just haven't adapted well. They just haven't adapted well."
I personally don't think that the modern lifestyle is sustainable in the North, but that is something I'll hopefully write about another day.
It was dark by the time we got back into Yellowknife. Since my trip here has been phenomenally cheap, I was in the mood to have some good food. One of my companions referred me to "Taste of Saigon," supposedly the best Vietnamese food in town, and next door to "Fuego" supposedly the best desserts in town. The former was nothing to write home about (and so I won't!), but the latter delivered, and then some. The live music was also oddly memorable. My brother asked me on the phone "So if you were told that you had to practice in Yellowknife, would you be sad?" No sadder than if I were told I had to go to Calgary or Winnipeg. This town has a few things going for it.
The Maple Crème Caramel - a memorable dessert!
Out on Frame LakeA woman came into the ED today with cold exposure. Her temperature was normal, so she wasn't really hypothermic, but she had severe frostbite on the soles of her feet and both hands. Apparently well known to the staff, she and her common-law husband were homeless, but lived as vagabonds in the true sense; wandering around and between towns, pitching a tent and sleeping on the ground. She was a chronic alcoholic, with a median nerve palsy sustained from a failed suicide attempt. "She's hard on herself," said the day-shift doctor.
Her story was hardly unique. While most emergency rooms have a couple of regular alcoholics, given the size of Yellowknife, Stanton has a huge number of them.
A year or two ago, a partly aboriginal classmate of mine was involved in remaking the aboriginal health curriculum, and I asked her what she wanted the focus to be. She said "I don't want people to think of the stereotypes when they think of aboriginal health. You know, the obese, diabetic, alcoholic, suicidal aboriginal." Here in Yellowknife, I learned that those stereotypes exist for a reason.
On Tuesday I drove down to the nearby town of Rae with two physicians. Rae is almost entirely Dene. Aside from alcoholics (some of whom were recovering) I encountered my first case of child sexual abuse. It's the sort of thing they teach you about in medical school, but which you don't expect to see until you've been in practice for several years. "I diagnosed a seven-year-old up here with an STI just a month ago," said one of the physicians, himself a graduate of the class of 2004.
We left the case in the hands of the local social services, and headed off to visit the local elders' home. Even before medical school, I had been to a lot of old folk's homes, and they generally have a particular atmosphere, even a particular odour that tell you "this is a place where incontinent, demented people are sustained by purreed vegetables, Ensure, and inconsistently caring staff."
This place was different. The residents I saw were, first of all, all on relatively few medications, mostly of sound mind. All the staff spoke Dene languages, and treated the residents with a kind of respect I haven't usually seen in such a facility. Although I needed an interpreter to take all the histories, they were relatively easy patients to sort out. The food even smelled good.
I had noticed, however, on the walls of the room of one 94-year-old resident, a multiplicity of catholic icons. The words of an early Malcolm X speech came to mind "You look on the walls of any of those churches, and what do you see? White people! God white, Jesus white, Mary white, everybody white! . . . You listen to hymns like they taught my own mother; 'Wash me white as snow.' " The Dene of Rae might be responsible for some of their own problems, but somebody had taught them to hate themselves.
Back at the clinic. Social Services had talked to the mother, and put in place a "safety plan" for the abused child. The doc who had discovered the problem was beside himself. "It is obvious that she is being abused. [it was indeed obvious] I'm not making any accusations, but there's a male in the house, and mom's a known alcoholic. Even if the abuse isn't happening at home, this child doesn't need a safety plan, the child needs to be put somewhere safe!"
"Well, there are some historical issues around taking aboriginal kids away from their parents," replied the lady with Social Services.
Nobody could deny that there weren't, but the perverse result of the acknowledgement of that history was that an aboriginal kid was getting less protection than she would have had she been white.
On the drive back to Yellowknife, I got an education in "Indian and Northern Affairs" to quote the Government of Canada. "When you live up here, you realize just how unrealistic some of the stuff we tell people to do is. 'Eat more fresh fruits and vegetables.' What vegetables? An old Inuit man in my practice once told me 'My wife bought a pepper this week . . . it cost her $15.' We tell them 'Get more exercise.' Where are they supposed to do that? There are no gyms."
"Well, what were they doing before Europeans arrived?" I have a habit of asking questions that I already know the answer to, but I wanted to hear it from someone who had actually seen it with his own eyes.
"They hunted, they ate dried berries, and they were active because they had to be."
"So maybe you should tell your patient to get himself a spear."
"People like TV too much. It's a little too late to go back to that. The world has changed. They just haven't adapted well. They just haven't adapted well."
I personally don't think that the modern lifestyle is sustainable in the North, but that is something I'll hopefully write about another day.
It was dark by the time we got back into Yellowknife. Since my trip here has been phenomenally cheap, I was in the mood to have some good food. One of my companions referred me to "Taste of Saigon," supposedly the best Vietnamese food in town, and next door to "Fuego" supposedly the best desserts in town. The former was nothing to write home about (and so I won't!), but the latter delivered, and then some. The live music was also oddly memorable. My brother asked me on the phone "So if you were told that you had to practice in Yellowknife, would you be sad?" No sadder than if I were told I had to go to Calgary or Winnipeg. This town has a few things going for it.
The Maple Crème Caramel - a memorable dessert!
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