Tuesday 27 April 2021

Cabbage Pt 2.

Cabbage.  Pt 2.

'Cabbage' medical jargon for Coronary Artery Bypass Surgery

When I sprung it on relatives, colleagues and friends that I was planning to have bypass surgery, the first response tended to be reassurances as to how healthy I looked, and questions as to how long I was ill. Funny, because I never considered myself ill at all. After all, all I had experienced was a bit of breathlessness and a little tightness in my chest when I exerted myself. I could swim laps indefinitely, as long as I used commonsense and didn’t try to break records. And after all, I was sixty-nine, no spring chicken in anyone’s language. How was that to be equated with illness? I was never ill a day in my life. Never missed a day of school or university or work. Ill indeed, I thought indignantly! In fact, quite honestly, I was really only proceeding with surgery prophylactically, because the genetic scales were so heavily weighted against me. Was I just going to sit around and wait for those obstructed coronaries that I had looked at on the angiogram to totally plug and kill a huge chunk of my myocardium, or even me. I was determined to get those obstructed coronaries before they got me. So I carried on going to work every day, waiting to hear from my surgeon’s office as to when I would be having my surgery. Meanwhile, I was daily fielding a litany of phone calls from relatives and other well wishers, including dutiful nephews and nieces who no doubt were responding to their parents exhortations gracefully and did their duty. I could tell they were impressed when in response to their questions I told them I was having a quintuple bypass. That was rare at the time - the only other case of a 'quintuple' that I knew of was Bill Clinton!
Thursday - the day before Surgery. After a fairly normal day at work during which the objective was to keep as busy as possible, and to keep my mind off the following days ordeal, I headed home. At least, I consoled myself, as I manipulated my Honda along the dark, wet slippery country road, against a continuous steam of giant SUVS, nothing I was going to encounter in the next few days was going to be more dangerous than this. A serious martini and a light supper followed by a sleepless night, rounded off the day.
The nineteenth of Nov 2004 - day Zero! Up at 5 am and son David picked us up at 5.30 for our morning appointment. I remember, in a gentler more civilized era when patients were admitted the night before surgery, rested, worked up, sedated and assured of a good night's sleep . In the olden days, we used to think that getting the patient as relaxed and stress free as possible had some bearing on the patient’s subsequent progress. But that was before we had a Health Care Industry. Getting the patient up at 5 am is hardly conducive to survival, let alone surgery.
At 6 am I was through the admitting area, hardly noting all those other poor souls with their problems small and great, but none I was sure, as great as mine.
A kiss goodbye; a word of encouragement from Irene and David; clothes deposited in a plastic bag and on to the OR . Although over the years, I had spent many hours in operating theatres, this one seemed so small and so crowded with people and equipment that I wondered if there was enough room for me.
The Anesthesiologist greeted me as I was wheeled in the door.
"So you're Dr. Smith?'' He smiled, effortlessly sliding the IV needle into a vein.
"Yes, that's me,” I tried to smile back and think up a clever witticism I could throw out.
The lights went out.

I opened my eyes. The anesthesiologist was gone; it was all over, and I was surprised at how little pain I had. Just like my niece had said of her anesthetic - 'light off, light on. Like flicking a switch!” She had also added that it had made her a little less fearful of dying, and as I reflected on that particular piece of philosophy, I found I was in agreement with it.
Now I had to get the damn tube out of my throat. My God, I couldn't talk! I made as much noise as I could to attract attention and look as though I was really suffering - maybe that way I could get rid of it! The Nurse leaned over me.
“Are you having a lot of pain?” she asked sympathetically.
I shook my head - no, but harrumphed and coughed as much as I could to make it quite clear I wanted this damn tube out of my throat. Maybe if I coughed enough I'd manage to propel the thing across the room.
I could hear the machine behind me, but couldn't see anything. Where was I anyway? Alive, at least, and no sign of any stroke or paralysis or anything else horrible as far as I could determine. I seemed as sharp as ever! I tried to cough up the tube. The nurse injected something into the IV tubing in my arm and I drifted into some pleasant place.

I woke up with vague pain everywhere, and a horrible nauseated feeling. The lCU nurse slouched by. “Something for the pain?” she said, pulling her drooping sweater up around her shoulders. She deftly deposited a little cardboard container with two pills in it, in my hand, and propelled them into my mouth. I swallowed them and soon dozed off again.

“Are you on these pills too?” I politely asked the woman just to the right of my shoulder. I couldn't figure out why she was wearing a pretty bonnet right there, in the ICU. I managed to twist my neck around, to get a better look at her and saw this was an electric fan somehow managing to look like a woman's face, framed in a bonnet. I gave a little chuckle to myself, as I realized what I had done- no wonder the poor old geriatrics got wingy after a few days on narcotics. I had at least one other similar encounter and resolved I’d have to cut back on the pain pills. I looked at the clock, 11.10, but was it night or morning?. I drifted off to sleep again, and had a long deep sleep. I woke up again, thought I had slept for hours, and looked at the clock. 11.20! I couldn't decide if I had slept right around the clock and it was 11.20 twelve hours later, or just ten minutes had gone by. Then I noticed people all hustling around and going somewhere! Something was wrong, I was going to watch what was going on very, very carefully It looked like some sort of a set from the movies, something funny was going on here. Everyone seemed to be leaving. My last thought before drifting off to sleep again was that they really needed to have windows in these places, or everyone would end up disoriented and crazy.

Someone woke me up and was offering me pills again.
“I think I'm going to throw up,” I said.
“Hold on a minute,” the nurse said, a large basin appearing from nowhere.
I felt horrible, retched and threw up a large amount. The relief was immediate and wonderful. I closed my eyes and drifted into a deep sleep. When I looked at the clock a long time later, it was only 11.30 pm.

I was watching the Iraqi war on the television. A bullet in the chest. Must feel something like having your chest cracked open, I thought.

“Rate the pain with a number" a nurse asked. "if 1 is very mild pain and 10 is the worst pain you’ve ever had."
What does that mean? Depends on who you are and how much pain you have experienced. Where is 10 if you’re lucky enough to never to have had much pain? I rated my current pain at 5 - a nice median number!
"There's a button attached to your IV that will give you a pre-set dose of morphine whenever you press it to relieve the pain if you need it."
"Thanks," I said. I used it about twice and it made me feel worse than the pain! At least I don't have to worry about becoming a morphine addict!

Monday 19 April 2021

Have a Heart! -Cabbageg Pt 1.

Cabbage. Pt 1.

 Have a Heart!!

Its seventeen years now since I had my coronary artery bypass surgery. Just a short time ago, a friend of mine who was booked for an angiogram and may be having a bypass procedure asked me about it and I responded as accurately as I could. I mentioned to him I had taken notes at the time and that I had later published an article about it in a medical newspaper, The Medical Post, describing the procedure. Although I have yet to locate the article, I still have my post surgical notes that I offered to share with him.
Here they are starting with the angiogra a procedure that involves passing a catheter into a groin artery and threading it right up into the coronary arteries, injecting dye and estimating the amount of blockage.

Bypass. Pt 1. The Angiogram.
I stared straight upward at the big overhead scanner, that would be photographing my coronary arteries soon. I was rationalizing the risks of the procedure and knew I took a bigger risk every time I took the freeway. Cardiac arrest, well that was easy enough to deal with, a couple of good electrical shocks and it either started up or it didn't. And if it didn't, nothing too serious, you didn't even know about it. No, I wasn't worried about that, or about a hemorrhage from the thigh artery; they can always fix that. The only thing I was really worried about, was stroking out, ending up like a close friend, a helpless prisoner in his own body. Death was a lot easier to handle. Not that I wanted to die; I still had plans and ambitions. Far more pressing than any of the above thoughts, was the itching and burning in my groins, despite the copious shaving cream and the fresh new razor I had used when following the shaving instructions. My sympathy for the poor metrosexuals, who shaved this area on a regular basis as a part of their daily ablutions had increased.
I had kissed my wife goodbye and walked toward the Cath Lab, double gowned. Modern sensibilities and sensitivities ensured that patients no longer wandered hospital corridors with 'back to front gowns', their tails hanging out for general condemnation or admiration. I'd been issued with two gowns, one opening at the front and one at the back, providing total coverage. No locker, I held my clothes in a white plastic bag, in my right hand.
The Nurse introduced herself. "I'm sorry we're running a bit late," she said. "What do you want us to call you? Dr. Smith or Stan?"
"Stan will do," I said. "And the wait is okay, I haven't anything else to do today,"
All of a sudden, a masked pirate, swung into the cath lab. At least that's what he looked like! He wore a red floral bandanna, with the collar of a bright red shirt peeping above the drab green of operating room attire. Was this really the balding middle-aged doctor, with a rather peculiar sense of humour, that I had spent a half an hour with last week? I guessed it was.
"He's got a rather peculiar sense of humour" warned the nurse whispering into my ear.
I smiled back weakly and nodded.
Don't worry," the pirate said to me, "this won't be too bad."
"Very few things in this life are as bad -or as good as they are reputed to be", I replied, the homespun philosopher as usual.
The pirate pondered for a moment, and then said, "I think that sums up life pretty accurately."
He had told me last week that the rare complications of the procedure included hemorrhage, stroke and cardiac arrest, to name the most severe. "If you hemorrhage we might have to do some surgery to stop it, if you stroke out, there's not much we can do, but if you arrest we can defibrillate you on the table," he said benignly,.
Then, he went on to tell me that I would feel a strange warm feeling, when the dye was injected into the intravenous which had been set up right at the beginning of the procedure.
"You'll feel hot and wet all over, and might even feel as though you had lost control of your bladder, but don't worry, you won't and I'll be standing right there," he said with a strange sensitivity, I didn't expect.
He injected the local anesthetic into my groin, and after a few moments I felt nothing, but the miraculous relief of the itching and burning of the razor burn.
He brandished the sleek cardiac catheter like a rapier.
"Now I just take a run at you with this!" He laughed., holding up the catheter.
The nurse bent over and she whispered reassuringly into my ear, "he's just kidding", and even though I knew it was joking, I wondered how many times I myself might have caused a frisson of anxiety in a patient, with a light word, meant to be humorous and to reassure. It surprised me that I felt nothing at all, as the catheter ran up through my femoral artery, up my aorta and into my heart.
"You can see it all there on the monitor," the male nurse said, "if you don't mind seeing that sort of thing."
I looked at the x ray of my heart beating. I saw the thin line of the catheter thread its way into my coronary artery, like a wire coat hanger being threaded into a key hole. I hoped it would leave enough room for the blood to get through.
"Take a deep breath and hold it," commanded the Pirate.
I did as I was told, until it started to hurt, I waited a few moments.
"It's starting to hurt," I said, knowing that was because he was depriving my poor myocardium of much needed blood.
"That's okay, it's supposed to. You can let it out now."he said.
The pain resolved quickly.
Okay, now I'm learning how to play this game, I thought.
As soon as I started to feel some discomfort as the next coronary artery was being threaded, I didn't wait. "It's starting to hurt". Save my myocardium.
"Okay, you can breathe out."
Ah, now I've got it mastered, I thought.
The procedure was repeated a few more times, with little discomfort and the monitor show continued. After a few more thrusts, peppered with light commentary, the show was coming to an end.
"We are just about coming to the end of this, and I'm going to be thrusting my fist into your groin, to maintain pressure to prevent bleeding." he said. "You just lie perfectly still and we will get these three big strong nurses to lift you over to the stretcher."
Two of the nurses were fairly slight young women and the other was a slight young man. They picked up the stretcher sheet corners and whooshed from the gurney on to the stretcher.
No wonder they all have back pain, I thought, knowing that many of the patients they lifted were twice or three times my weight. A fist was thrust into my groin, applying firm pressure. The impatient Pirate took control of the gurney with his other hand and wheeled it quickly out into the corridor.
A couple of words in my ear, "your right coronary is a hundred percent blocked, your left anterior descending about fifty percent blocked, and the obtuse marginal and posterolateral branch of the circumflex eighty to ninety percent. I think you are a bypass candidate." This guy didn't waste any time.
Too impatient to wait for orderlies or porter, one fist applying pressure to the puncture wound, he wheeled me straight down to the ICU. Irene was waiting outside the Cath Lab.
"Are you alright?" she asked me, we pushed on. "Are you……?" she directed her question to the pirate.
"I'm the orderly," interrupted the man with the strange sense of humour.
"He’s the doctor - with a strange sense of humour," said I, "This is Irene, my wife."
"Hello," said the Pirate, pushing right on for the ICU, where Irene wasn't allowed to follow.
"I'll see you as soon as they move you," she called out.
And there he stood with his fist pushing into my groin for the next ten minutes.
"Drink lots and wash out all that dye," he said, "and keep lying absolutely flat for the next hour or so to try not to start up any bleeding from the puncture wound. I don't even want you to raise your head, then we'll move you to the observation ward."
Every few minutes the nurse solicitously bent over me, with a glass of water and a flexible straw. I gulped greedily at first, but then started to think of the consequences of pushing the fluids too enthusiastically. I didn't want to have to empty my bladder while I was lying flat on my back, and that was going to be at least the next hour. Better to wash the dye out a little more slowly, and a little later when I could at least sit up, it might be easier.
A nurse I hadn't seen before breezed into the room.
"I'm taking you down to the recovery unit," she said, wheeling the gurney out of the cubicle it had been occupying for the last hour. She got almost out of the unit, when the Pirate swung in.
"Where are you taking him?" he barked rudely.
I wondered if I had just been saved from a hijacking.
The unfortunate nurse flushed and said, "just to the recovery room."
"No one leaves here until they have been checked by me," he commanded gruffly. "I have to make sure they are not bleeding."
He rolled the gurney back behind the curtain, pulled back the gown and looked into my groin, was satisfied and said quietly, "okay, you can go."
She rolled me to the West Wing, where I was deposited in a two bed ward, the other bed was empty. Irene awaited anxiously.
“Are you okay?”
“Yes, everything feels numb right now,” I said.
The ward nurse was cheerful and pleasant.
“You’ve got to drink lots of water," she said cheerily, "wash all that poison out of you. And I bet you're starving. What would you like to eat?"
"What's on the menu?" I hadn’t eaten since the day before.
"Sandwiches, cookies, whatever you'd like. But you have to drink lots, juices, ginger ale, cranberry juice, whatever you fancy. If you do real well, I'll let you stand out of the bed to pee." She smiled.
This was the best offer I'd had all day. I gulped down a glass of cranberry juice through the flexible straw and ate a tuna sandwich. It was a little easier to drink now that I had been promoted to sitting up a few degrees. What was it that they'd said a few degrees every hour? I was starting to want to pee. The nice nurse whisked by with the water.
"Have a nice big drink now and I'll let you stand out at the side of the bed," she said.
I thought that one over and decided it was a deal. I sucked down a big gulp of water and looked over at the side of the bed to the bedside table, where amidst the debris of sandwiches and small juice containers, I saw the new, pristine, disposable urinal. A far cry from the old stainless steel ones, which were handed out when I was a student. I flipped off the lid and tried it on for size. It seemed fine. I swung my legs over the side of the bed, barely sitting on the edge of the bed. I was lucky my weight was propped on the bed for as soon as I put some weight on the right leg, it collapsed under me. I tried to feel it; it was completely numb. Totally anesthetized! I carefully propped myself against the edge of the bed, put the urinal in place, and was all ready to pee, when the commotion behind the drape that surrounded my bed distracted and inhibited me. The nurse stuck her head through the drapes,
"You've got a new neighbor," she said,
Irene, who had stepped outside for a moment popped back in.
"Everything okay?" she asked.
"Yes," I sighed, giving up on the bottle, and swinging back into the bed.
Irene sat on a chair near the end of the bed. The New Man's wife sat on a chair at the end of his bed. They were nice friendly people; I had seen the New Man come into the intensive unit soon after me. They started talking to Irene immediately. I felt overwhelmed with a desire to sleep, so I kept eyes closed and didn't pull back the drape.
I heard them talking and Irene replying, and then I drifted to another place where I was lying on a chaise, on a beautiful sunny day dozing, before diving into David's pool to swim another twenty laps, just to show myself I could do it without any chest pain.
I woke up about half an hour later, and thought I ought to be more sociable. Just as long as the New Man or Mrs. New Man didn't discover my occupation!
"Hi," I said to Mr. and Mrs. New Man.
"Hi," said Mr. New Man, "have a nice sleep?"
"Yes, thanks," I answered. Now I really wanted to go to the bathroom.
"What do you do, Stan?" asked Mr. New Man.
No, I thought, I'm the patient, today, I can’t tell him I’m a physician.
"I work in Mount Brydges," I answered, leaving it there.
Mr. New Man left it at that.
"Is your leg numb?" I asked.
"No, never was."
"Been to the bathroom yet?"
"Yes, the nurse let me go just before you woke up."
I had a bit of feeling in my right leg now. How come Mr. New Man had already been allowed the luxury of actually navigating to the lavatory on his own two feet? Well, I was going to make my own way there. I slid out of the bed, could feel my right leg ready to buckle when I tested it for weight, found I could stabilize it with my hand, and hobbled the few paces to the bathroom. There was a convenient bar to hold on to, which made it easy. Ahhhhh, heaven!
It was easy after that. I joined in the conversation, checking for sensation in my leg at frequent intervals. After all, I didn’t want to be in here a moment longer than necessary and the nurse said I would be able to go as soon as my leg would support me sufficiently to independently walk down the corridor and back.
And Sure enough another hour made all the difference and I could indeed walk down the corridor under the watchful eye of the nurse. She whisked me into a wheelchair and out to the waiting car
"Good luck for your surgery " she called after me as I got into the car.

Part 2, the Bypass Surgery- to follow.

Tuesday 13 April 2021

Banking on Banking!


Regina, Saskatchewan. Winter 1963. Day 2.

I was waiting for Mac Chase, the business manager of the sixty doctor multiple specialty clinic, The Medical Arts Clinic where I was due to start working the following week. First I had to get to the bank to get some money. I arrived in Canada with a grand total of forty dollars, now whittled down to about ten. Mac had assured me there would be no problem, but as I sat waiting I could not avoid reflecting on my last visit to a bank when I had been practicing for a couple of years in the other London, where I was working in a general practice as a 'trainee assistant' -in a two physician practice on south side of London. It was a poorly paid job, but the doctors I was working for were decent pleasant people and they helped us to find a nice flat in a house that had been partitioned into two apartments. It was nicely if quite sparsely furnished and the owners were charming people. Tom had been a sergeant - major in the army and had that squeaky clean look that so many ex-army men had. Not a hair out of place, crisp collar, nicely knotted tie, pants pressed and shoes spit and polished so that you could see yourself in them. Their son Bill, was the manager of the local telephone exchange and when things were quiet he connected us up to Irene's sister in New York for a nice long chat, without charge. Transatlantic telephone calls were unbelievably expensive and we couldn't afford to phone very often.
Homes were heated mostly by coal fire with all the work and dirt that entails, and there was no heating in the bedrooms. After we noticed that our daughter's lips were getting a little blue on the cold winters nights we decided to buy an oil- fueled heater to warm up the room. The problem was I didn't have enough money so I decided to go to the bank for a loan. I made an appointment to see the manager to request a loan of a paltry twenty pounds (about $60 at the rate of exchange then).
I was a licensed physician at the time, albeit a new one and I was gainfully employed, albeit at an exiguous income. Nevertheless, I did not anticipate any difficulty in getting what after all, was a small loan.
I arrived at the manager's office at Lloyd's Bank and was shown in. After a rather uninterested greeting I was invited to sit down.
After establishing for himself that I was indeed a duly qualified practitioner and was gainfully employed, he got down to business.
"How much are you hoping to borrow ?" he asked in an unfriendly tone that suggested he felt the need to make it clear that this was a loan.
"Twenty pounds!" I said, knowing that this was a huge amount.
"And what's that for?" he asked in the same unfriendly tone."
"I need to buy a "Sankey Senator."
"A what?"
"A 'Sankey Senator paraffin heater,'" I repeated. "It's a sort of oil heater, I need it for my little girl's bedroom. It gets so cold in their her lips turn blue."
He looked at me disgustedly. "What sort of collateral have you got?"
"I haven't got any collateral."
"You've got a car, haven't you." he said.
"It's not my car, it belongs to the practice." I said.
"You must have some life insurance." he said caustically.
"A little."
"How much ?"
I said, ."A thousand pounds."
So if I died at age twenty-three my wife and baby would have had a whole thousand pounds.
The Bank Manager smiled. At last he had a solution.
"You just surrender the policy to us and we will hold it until the debt is paid off."
I surrendered the policy and the bastards returned it when the debt was paid off. I had got to this phase in my deliberations when the door bell rang. It was Mac.
"Let's go," he said. "We have an appointment with the manager of the Canadian Imperial Bank of Commerce in half an hour.."
Now I was going to see how a Canadian bank would treat me!

We arrived at the bank. As we walked in the door Mac was greeted by one of the tellers as though he was a long lost friend.
"You're here to see Jack?" she said. Jack was the manager. Nowhere in the British Isles would a teller be addressing the manager by his first name. Such familiarity would an anathema.
We were greeted warmly by the manager.
"Jack, this is Stan Smith , our new boy from the old country," said Mac,
"Stan this is Jack Ink, the branch manager (That was his real name!)."
Jack sat us down, asked us if we'd like a cup of coffee and said, "What can I do for you Stan?"
Mac said, "Stan is on the payroll as of the first of this month. He needs some money." That's all there was to it.
Jack smiled at me, "How much do you want, Stan?" Was he kidding me?
I smiled blandly back and tried to imagine a figure. "I don't know," I confessed.
Jack Ink pulled out his pen, took a sheet of paper and started calculating.
He scribbled for a while, then said, "How would five thousand be?"
The room started swimming and I wondered if I was going to fall off my chair. Had I heard him right? Five thousand dollars! How was I ever going to be able to pay that back?
"Er, well er, I suppose so, I said hesitantly, trying to figure out how I would ever be able to repay that vast amount.
"Don't worry, " said Jack Ink. "If that isn't sufficient just drop back in and we will increase it to whatever you need."
"Yep, that will probably do," said Mac Chase, "He has to buy a car and feed the family. The house rent is nominal - the Kings (owners) just wanted someone in the house over the winter months while they are in Florida."
Jack Ink gave me a cheque book and an account card, told me to drop in and see him anytime. It was quite a different experience than my bank experience in England.
From there, Jack drove me over to the General Motors dealership and introduced me to Doug Higgins, the most honest car salesman I have ever met. He was a tall, relaxed, well dressed guy who was never pushy and if he didn't think a car was a good buy, for whatever reason, would tell you so.
It was the days of big cars and very big cars. Gas was very cheap, forty-four cents a gallon, the same as a twenty-five pack of cigarettes. I bought a huge green eight cylinder Chevrolet Biscayne, that you could fit six people in easily, seven at a push. There was no such thing as seat-belts and the steering wheel was on the wrong side, but then they drove on the wrong side
I was ready to start work.
Next morning I got into my monstrous green Chevrolet and managed to negotiate my way to the Medical Arts Clinic, despite having to drive the monster on what to me was the wrong side of the road. The clinic was an impressive five story building on Eleventh Ave in the centre of Regina. In addition to the doctors offices and examining rooms, the clinic had its own Emergency Room that stayed open evening and weekends. It could deal with most non life threatening emergencies and by so doing it decompressed the emergency rooms in the cities two general hospitals. The clinic had its own laboratory and radiology department and the appropriate specialists to supervise them. All in all, outside of very highly specialized situations that only high population areas tended to see I was impressed that a comparatively small Prairie city could provide services of such quality. Furthermore, all essential services were covered by the Medical Care Insurance Commission (medicare).
For better or for worse, Saskatchewan was the birthplace of government insured medical care 'medicare' in North America. For a province only slightly smaller than the state of Texas, with a population of less than a million Saskatchewan punched a lot above its weight!!

Wednesday 7 April 2021

Regina - Here we come!

 Regina - here we come!

 Arrival in Regina. 1963.

Winter 1963. A cool beginning.

   The metallic clatter of the train coming to a stop awakened all three of us. At first I thought that the noise was the compartment being detached from the locomotive as we were informed would happen upon our arrival in Regina. We were then to be able to sleep on in the sleeper unit until disembarkation at eight a.m.

   There was a rat-tap-tap at the compartment door and I flicked the light switch and looked at my watch. It was four o'clock in the morning.

   "Excuse me, sir," the porter's muffled voice, apologetically,"I'm afraid we're not able to uncouple the Regina sleeper. I'm sorry but you'll have to get off. The train leaves in one hour. So you should get all your stuff together. All your accompanying baggage will be in the baggage department and you can arrange to have them delivered later".

    "But they told us we wouldn't have to get off until eight." I said.

    "Yes, but they can't uncouple the rail-car, It's frozen up and so you'll just have to get off now. You can take your time, the train doesn't leave for another hour." It was forty degrees below zero outside.

    There wasn't much more to say.

    "Okay." I turned to awaken Irene, "I guess we have to get off, so we better start moving."

     She was awake already and ready to get up.

              "I'll get Rena ready while you get washed and dressed, then you can take her while I get ready."

            Half an hour later we were sitting in the huge deserted waiting room of the rather dated magnificent Canadian Pacific Railway station in Regina, Saskatchewan. (it was later to become a Las Vegas type casino, but that was a long way away.) A few other passengers had also disembarked and seemed to have disappeared almost as soon as they had gotten off the train. Rena ran around happily, singing away to herself. Irene and I sat on the bench and looked at each other and tried to smile.

    "Well, what now?" She asked .

   The business manager of the sixty- doctor clinic I was joining was picking us up at eight o'clock, the time we were supposed to be leaving our sleeper after a good nights sleep.

    "It's an awful long wait until eight o'clock when the business manager picks us up. Especially as it looks as though we can't even get a cup of tea." The station was deserted at that hour of the night. "Maybe I should call him anyway."

 "You can't phone someone at four o'clock in the morning."

 "Okay, well why don't I just take a look out into the street and see if I can see some little all night cafĂ©. There should be something like that near a railway station," I said.

 "Okay, I'll keep Rena busy while you take a look out. I'm sure she'll be hungry soon."

   I walked across the large deserted atrium of what would be a fashionable casino a quarter of a century later. I peered out through the large glass doors onto South Railway Street. It was too cold and too late for the hookers who frequented that area earlier in the evening. Across the road I saw a small variety store restaurant with a flashing neon sign. I pushed one side of the heavy double doors open wide enough to read the sign. I gasped at the blast of cold air. The sign said "Chinese and Canadian Food". I walked back to my family.

    "At least we're not going to starve while we're waiting. There's a little restaurant right across the road from the station. It's really cold out there, but I think we can make it!" I added dramatically.

 "I must confess I'm starting to feel a little hungry myself," Irene said.

"Let's make a run for it."

    We found a locker in which we were able to store our hold-alls and after dressing Rena as warmly as we could, we made our way to the exit. I picked up Rena and wrapped her inside the big brown topcoat that had been my father's and which he gave me when I was leaving for Canada saying 'you'll need something really warm in that cold climate". We stepped out into the cold. Little did he know!

    What did we know? It was totally unlike anything we had experienced. There's a convergence of fahrenheit and centigrade at forty below zero and it was close to that. You could almost hear the cold. The occasional car that passed by left a dense white trail of water-vapor behind it. Inside the heavy brown all-wool overcoat I could feel the heat-exchange between myself and Rena. The road was a little slippery but had been sanded down so we ran across it without mishap. Our exhalations left a trail almost as dense as the car exhaust.

    "Cold daddy", Rena said from beneath the greatcoat.

     A minute later we pushed through the door of the Chinese - Canadian Restaurant and were greeted by a blast of hot air that thawed us out instantly.

    "Welcome, welcome, come in out of cold," a middle-aged Chinese man with an accent said to us". Take off your coats, it's warm in here. Chunhua will hold baby for you.

   You just come from station?"

   Chunhua took Rena and engaged her in some Chinese baby-talk before putting her down and helping her out of her warm winter over-clothes.

    "Hungry baby?" she asked.

    "Yes, hungry," Rena replied succinctly.

    "You all sit down and I bring you a nice hot drink and a glass of milk for baby. Then you look at the menu and order breakfast. What you like to drink?"

    "Tea," said Irene.

    "Coffee," I said.

 She came back with the hot drinks.

    "Where do you come from?"

    "England," I answered. We had been living in England for about three years before we came to Canada,

    "Welcome to Canada, I come from Hong Kong," Chunhua said. "Many years ago," she added.

    We ordered a basic breakfast and Chunhua and her husband, fussed over Rena and fussed over us, bringing treats for us all.

   "When are you going to be picked up?" Ken asked them.

   "Not 'til eight o'clock," I said and told him what had happened.

 Ken and Chunhua were horrified.

"That's such a long time, it's not yet six. You sit here until eight and be nice and comfortable."

    So we did and sat and sipped innumerable cups of coffee and tea. Chunhua stopped by the table frequently as things were quiet and fussed over the baby, bringing her little treats to nibble and a colouring book and crayons. The time went by quickly and before we knew it, it was a quarter to eight. As we got up to leave, Ken and Chunhua came over to warmly wish us happiness and success and waving us goodbye said, "you come back to have a cup of tea or coffee with us sometime after you have settled in."

    "Yes, we will," said I after thanking them for their hospitality and I really meant it. Of course we never did. We have loved Chinese people ever since!

    Mac Chase walked into the busy Canadian Pacific waiting room, looking for a young couple with an infant child. He was getting used to doing this. As the business manager of the Medical Arts Clinic, he was justifiably proud of the multiple specialty sixty physician clinic for which he was responsible. He regarded it as the Mayo Clinic of the north and in truth it was a remarkable achievement for a city the size of Regina. When Tommy Douglas brought Medicare into Saskatchewan, he watched in desperation as physician after physician flocked from Saskatchewan for other provinces and for the United States, to escape socialized medicine. The aggressive advertising campaign in the British Medical Journal and the Irish Journal had been successful beyond expectations and had brought a crop of mostly young, enthusiastic and competent physicians who did a remarkably good job considering the more experienced, established physicians they were hired to replace. There were other advantages as well. A new energy replaced the ennui that had accompanied the continuing political harassment and endless meetings. The immigrant doctors were much more easily satisfied, at least for the moment, than their Canadian counterparts and were used to taking call and making housecalls. The fact that we liked most of the new immigrant doctors and that their backgrounds were similar to ours, was an added bonus.

     I was just starting to get concerned when I saw among a group of people coming into the station a well dressed man who was obviously looking for someone . He walked toward looking concerned.

 "I was beginning to think you might be still asleep in the Sleeper," he said after we had gotten over the introductions. "when they told me that they couldn't disconnect the sleeper I was getting worried that you had gone on to Vancouver."

    I told him the story of how we were turned out of the sleeper at four in the morning. He was genuinely horrified.

 "For goodness sake," he said, "why didn't you phone me? I'd have been pleased to pick you up and drop you off at the house we've rented for you. The owners are in Arizona for four months, by the way, so you'll have plenty of time to find an apartment. I really feel awful that you've had to sit around here since four this morning."

 "We just couldn't wake you up at such an unearthly hour. Anyway, we found a nice little restaurant across the road, where they treated us like royalty and we had a good breakfast. They were so taken with our daughter that they made us promise that we'd visit them after we settled in and we will."

 "That's nice," said Mac. Do you have any more hand luggage?"

 "We left a couple of bags in the lockers over there." I pointed.

 They picked up their bags and Mac shepherded them out of the station to his illegally parked car which he had left just outside the doors with the engine running.

 "When it's this cold we usually leave the engine running to keep everything warm, if we're not going to be away too long," he explained. "This is the coldest snap we've had this winter. It's nearly forty below, with the wind chill factor. You didn't exactly pick the best possible time to arrive," he smiled as he ushered us out of the cold into the warm car.

  We were soon being driven out of the downtown area and along Albert Street, a fine wide tree-lined street, with the bare trees adorned with beautiful glistening diamonds of ice that reflected the early morning sun. Fine, large majestic homes lined both sides of .the street. Hardly what we expected to find in a prairie city of 120,000 in 1963.

 "It is beautiful," Irene said.

 "It's really beautiful in the summer," Mac said.

 The exhaust of the cars left dense white trails as the water droplets in the hot emissions immediately froze. We noticed the deep tracks in the snow eroded by by the cars, that made driving somewhat like running on railway lines. After another few minutes we were turning into the driveway of 29 Angus Crescent. It was a very attractive two story home,that I still like to drive by whenever I visit Regina a lifetime later.

       "Looks like no one has been shoveling the snow since the Kings have been away."

    He got out of the car, took three of the bags, held the keys between his teeth and walked up the three stairs to the door. He guided us in, "watch the ice it's pretty slippery here."

   He tried to brief us on everything. He showed us how to soften the water, (what the hell did water need softening for?) He showed how to turn the heat up, (it needed turning down. It was so hot we thought we were going to faint.)

     "I'll let you settle in and I'll pick you up in the morning. Not too early. I made a tentative appointment for you to meet with Doug Higgins, a trustworthy used car salesman -you can't function without a car in this climate! Don't worry, Doug is a second generation used car salesman who is absolutely trustworthy. Then we'll go to the bank to make sure that you have enough money to manage until your pay cheques start rolling in."

   Doug Higgins was the most honest and reliable car salesman I ever dealt with. I remained his customer for as long as he lived in the area. Mac left with, " see you in the morning. "

   "I think I'm going to faint if you don't make it cooler," Irene said.

I walked over to the thermostat.

    "Holy cow , it's eighty degrees in here. " I stretched out my hand to alter the temperature setting and quickly withdrew it as a powerful static spark flew across to my fingers. I'd never experienced this before.

   "I think there's a short circuit in this damn thing."

    In the old country where central heating was restricted to institutions, upscale hotels and the wealthy it was rarely comfortably warm in winter , unless you were sitting right in front of the fire. We sat and relaxed for a while and fed and played with Rena until her eyes grew heavy and she was ready to sleep.

    "What have we got in the way of food?" Irene asked. "Mr. Chase said he had put a few things in the fridge and that we'd see about grocery shopping tomorrow, but I think I better take a look."

    "I'm supposed to be getting a car tomorrow, but I can't believe it will go that quickly and I have to meet the bank manager to secure a loan for the car and furniture when we find an apartment. Then I have to see about getting registered to practice as soon as possible."

   Irene walked back into the shining hardwood floored living-room She looked a little concerned.

 "There's enough of the essentials for a day or two, but it's pretty sparse,"

 "Mac said there's a little grocery convenience store about five minutes from here that we could walk to when the weather gets a little warmer. Maybe I could wrap up warm and take a brisk walk and pick up some essentials," I said.

    "I don't know, it's really cold out there. Maybe we should just wait, we won't starve."

    "Don't worry, I'll just take a brisk walk and pick up what we need. Make a list."

    Irene made up the list, while I wrapped up in my heavy wool topcoat and wound my scarf around my neck. I stepped into my overshoes that I had bought in Montreal, when we had stopped for a couple of nights to meet with some of the family, who had come up from New Jersey to see us . I walked out the door into the incredible cold. At first I didn't really feel cold at all. The sensation was rather one of stinging pain and as I walked it seemed to get worse. The cars drove by, belching forth voluminous amounts of exhaust steam, momentarily obscuring everything from view. I increased my pace, until I was almost jogging, narrowly avoiding slipping on ice several times. I was starting to feel anxious until I saw the store in the distance across the road. I further accelerated my pace until I could go no faster without losing my footing on the icy sidewalk . I opened the door and was greeted by a delicious blast of hot air that almost knocked me off my feet.

 "Hi," said the young woman behind the cash register, "a pretty crisp day, eh?"

 "That it certainly is," said I, "I thought I was going to freeze to death before I reached here."

 "You walked in this weather?" she asked incredulously.

 " Ah, from just around the corner." I said. "We've just moved in and I haven't got a car yet and I had to pick up some groceries."

   I looked around the store and could see most of the things I needed from where I stood. Canned tuna and salmon and a variety of vegetables and fruits. I filled two bags with these items and some cookies and cakes, so that I had two fairly full bags on check-out. I had arrived in Canada with forty dollars and had spent six on breakfast in the Chinese Restaurant that morning, so I still had enough money left. Mac Chase was going to take me next afternoon to the bank so that I could arrange a bank loan that would tide me over and provide the wherewithal to buy a car and furnish an apartment when we found one.

   I paid for the groceries and as I was leaving the girl said to me ,

   "Where's your hat?"

   "I haven't got one," I answered.

   "How long have you been in Canada?" she asked.

   "Just a few days," I said.

   "You better put your scarf around your ears and face. It doesn't take skin long to freeze at this temperature."

   "Yes, I said, grasping that the first thing I needed was a hat with ear flaps."

    I stepped out into the petrifying cold, and it hit me like a punch in the face. I must be walking into the wind. I thought because it felt worse than when I was coming. Tiny icicles were forming at the angle between my scarf and my face and my ears were starting to sting. The two bags of groceries were getting heavier and heavier and I could feel my fingers getting colder in my gloves. The tingling sensation in my face and my ears was getting worse. My feet, despite the extra layer of insulation, were feeling cold and making it more difficult to walk faster. I could feel the scarf slipping down and exposing more of my face and my ears. My ears grew more painful, but as I turned the corner into Angus Crescent the pain miraculously vanished as the freezing cold anaesthetized them. Irene was waiting for me as I staggered in through the double doors into the warmth.

 "You look like a snowman, you poor thing, with your scarf and eyebrows all frosted up. Are you okay?"

    I had put down the bag and was peeling off my coat and jacket.

 "I'll tell you this, I'm going to buy some sort of hat with ear flaps or something. My ears were really hurting from the cold, then the pain just went away."

 "They're sure flushing now," Irene said. "They look as red as beets."

 "Yes, and they're starting to tingle a bit," I said.

 Five minutes later I was in agony as my ears thawed out, and the anesthetizing effects of the freezing was lost. It was still only noon of their first day in Regina.

    Next day at two o'clock they finished lunch and were exploring their temporary new home, when the bell rang and it was Mac Chase.

 "How are you settling in?" he asked.

   I assured him we were settling in very nicely and went on to tell him the story of my grocery shopping expedition.

    "You froze your ears. They're looking pretty frost burnt. You're going to have to be very careful because for the rest of the winter they will freeze very easily. You'd better get a hat with ear flaps. What you need most urgently is a car, otherwise you're housebound in weather like this. That's partly why I'm back here so soon. I've made an appointment with the bank manager to secure you a loan, so that you can buy a car tomorrow and have cash for whatever else you need. It's for about three o'clock and I allowed a little extra time so we could pick up some groceries. I didn't anticipate you going out walking to pick them up. I was remiss in not warning you."

   "I think there is a short circuit in the thermostat, I tried to turn it down last night and a big spark hit my finger,"

   He laughed, "That's just static electricity. You know, like when you comb your hair and it becomes charged and will pick up paper. The heat dries out the air. You just need to turn up the humidifier a bit. I guess it doesn't get that dry in the "Old Country", as Canadians and Americans referred the countries of origin from which generations of them had originated.

    "Let's go, today we've got to get you a car and introduce you to the Bank Manager!