Wednesday, July 30, 2008

So long and thanks for all the fish.....


Well my time at Scott and White has come to a close. On July 31st I will leave my employment at this fine institution where I have worked for 8 years. I realize that some folks look at 8 years in a place and think ‘Hey that’s a pretty good start’. I have never been one of those people. I do not know if it the youth that I spent moving every 4 years as we crossed the state form job to job, or if I just have an inherently restless streak . Either way, I cannot seem to stay in one place for an extended period of time.

Eight years seems like a long time in my mind, until I look back on what I have gotten done that I set out to accomplish during my time at Scott and White. First and foremost, I completed my Family Medicine training which was my paramount goal. Along the way toward completing that training I got to do some pretty cool things. I got a chance to learn a great deal about teaching through the Faculty Development Fellowship that I took through Waco Faculty Development Center it laid the foundation for what was to follow and without their guidance I could not have achieved all that I have as a teacher. It was through them that I challenged myself to try and become the ideal teacher that I wanted to have when I was being trained, and to their credit I got closer than I ever thought possible. During that process I made some very dear friends whom I will very much miss.

So what was it I wanted to try and change that prompted me to stay for eight years? Well, I wanted to do what I could to help make the Family Medicine residency become the best program possible. Toward that end I was able to make some incremental changes in the way we conducted morning report so that it would better serve the needs of all the participants. I also managed to change the way in which we conducted the Morbidity and Mortality report so that it provided a better teaching moment for all concerned. I was lucky enough to work with Dr Marc Via and through his example became a much better clinician through my understanding and ultimately teaching of Evidence Based Medicine, and it was this step that allowed me to really teach the things I had wanted to understand when I had been in practice in Utah all those years ago in the Army.
Along the way I had the chance to work with many wonderful and inquisitive students that challenged me to become a better teacher. I worked with residents who prompted me to continually stay on top of medical advances through their probing questions about why I chose to do any particular thing. Finally my colleagues who through their gentle rivalry spurred me to improve my medical practice. All of these things were wonderful and without them I would not be the physician that I am today. But their time has passed and the next adventure waits as I move forward to meet those new goals.

So today as I look back and give thanks for all that has been I am excited as I look forward to all that has yet to become.

Tuesday, July 29, 2008

Seven days and counting.........


No more mattress problems……..

In our last adventure we were trying to find a way to get our mattresses across the border to Canada. I could not believe that I had to fumigate the mattress and certify that it was fumigated in order to get the mattress across the border but there it was in the regulation
that makes it appear that mattress trafficking is forbidden. So as you know I called as many folks in the local area as I could to find someone who would be able to complete this task, to no avail. Well, things were getting a little more concerning, and thus began the rationalizations.

Well we have had the mattress for 10 years………
I guess we should not pack it in the first place……
We could always fake a letter………….
We could get one of those do it yourself household fumigation kits….
Maybe there is a place on the border that can do this for us…….

It was the last item that prompted a change in fortunes. In search of a solution for the problem, I fired up google and went looking for a place in Maine that might be able to fumigate a mattress. After a long hard search with great handfuls of nothing to show for it I changed my query mode and entered the following “mattress fumigation Canada” into the search box. Well that did the trick, I landed upon a site called BritishExpat and they and they had the answer
(turns out the regulation is poorly written and does not apply to folks form the US or UK).

This is a great site that provides a huge amount of information on moving to Canada. In fact they even provide a general list of what to accomplish prior to your move. Granted it is geared toward the British, it is still a very valuable resource and one that we will be combing over in the last days in the heat.

So, the mattress issue is solved and we are moving on, next stop, finalizing the route of travel and booking the hotels.

Monday, July 14, 2008

22 days left to find more new immigration rules.....

Moving your matresss

So you see, we are moving to Canada with used mattresses. That presents us with a bit of a problem. Apparently the Canadian Mattress Coalition has a fairly decent lobbyist and they have introduced and passed legislation that requires that anyone entering into Canada must certify that their mattress is clean and that it has been fumigated. In addition, the method of fumigation must be described (the official rule). Well, I did not completely believe that I needed to do this so I contacted the Border Information Services and asked them directly and they confirmed indeed that I was supposed to go through this process.

Since it was obvious that I was indeed going to have to go through this process, I began calling around to find out where I could get this done without to much trouble. So, who do you speak to about getting this sort of thing done? I began with the carpet cleaners; after all they were going to be cleaning the rest of the house when we moved. So I called and spoke with them, and sure enough they could easily clean the mattress, but as for the fumigation they were not able to help me out. Well, if maybe I could get some help from the Orkin man since they specialize in pest control. Well they let me know they could fumigate the house, but that they did not fumigate mattresses. Well that left me wondering where else I could go and so I thought about all the places that might possibly sell used mattresses and decided to call Goodwill and ask them if they could help me out. Well it turns out that they no longer take mattresses and they cannot help me out.

It seems to me that this may indeed be a conspiracy by the mattress coalition of Canada. It seems to me that we have only once choice, that is to fake it. Since a worst case scenario is that we cannot get our mattresses across the border, what do we have to lose? Having read the rules again, I have decided that there is nothing in the rules that say that I cannot do this myself; I just need to document what I did and how I did it. After all if it is not good enough then we are back at square one and purchasing a new mattress in Canada. What the heck, we have nothing to lose.


Fun new rules you did not know about…..
Just when you thought that we had everything in order to bring our car across the border. We have made sure that there are no recalls on the vehicle (as evidenced by the letter form the dealer). We have confirmed that we can make the needed modifications in order to bring the vehicle into line with the specific law regarding the vehicle immobility devices. Well it also seems like there is something new on a daily basis that we must prepare for the move. We though that we had everything prepared for bringing the vehicle across until this morning when I ran across a requirement that I must get our vehicle cleared by US Customs prior to moving it across the border. This means that we have to go to the bank and get them to sign a letter allowing us to take the vehicle across the border.

Saturday, July 5, 2008

31 days and a wake up.........



What the heck does that mean? Well, when I was in boot camp at Marine Corp Recruit Depot in San Diego that was how we kept track of the number of days we had left until we could wake up on our last morning in boot camp. There you have it then, 31 days until departure, plenty of time to get things done that need to be accomplished, yet no so much time that you would get bored by the waiting. Some folks call this time by another name…………..

The Chaos Zone

Sure enough as we close in on the last month we will be living in Texas several things have to be accomplished at once. Now I would like to tell that because of our numerous moves in the past, we were well trained for the process and that it was taking place with such ease and grace that it appeared as if it was being handled by others. However, it is about a crazy as I could imagine it to be without becoming overwhelming.

Pack, unpack, re-pack.
This is the first of the crazy issues. The moving company told us that we did not need to be obsessive about the household inventory for the move. They said that generalities would be sufficient for the border crossing into Canada. Granted this does not fit with the written account of the rules as given by the Canadian Border Information Service, but heck they had just moved another person to Canada so they should know.

Well maybe. You see, the last person they moved was a Canadian citizen headed home, and we are immigrants and that changes the rules. You see we do need an inventory, not an exhaustive Fillmoresque (see letter for further explaination) inventory worthy of the god Obsessius, but we do need to list the contents of the boxes and value the items in the boxes. Well we had not really done that good a job of describing the contents of the boxes. We had been pretty general- box 32 Kitchen stuff (heavy). What is really needed is a bit more detail- box 32 Pots, pans, skillets, bowls, and towels. To which we add a value for the customs folks so they can determine if we should be paying taxes. The end result is that we are taking the 40+ boxes apart and inventorying the contents and then repacking them. If you have enough cold beer, the process is relatively benign.

Launder your money
Getting money to Canada is proving to be an interesting thing. We certainly have the option of packing cash, but I for one am not in favor of emptying the account into a bank bag and then hauling it across the country, the border, and through hotels of dubious quality. Wiring the money has been suggested as a relatively easy alternative, but a quick look at the western union rates makes me a little reluctant to utilize this method. The option of a personal or a bank check is there, but considering the length of time it took for the Canadian checks to clear our bank, we do not really want to be waiting on this while we need access to our money. So what should we do? Nancy is going to speak with the bank about options, but here are a few we have come up with to date.

Traveler’s Checks
Sure we would spend several hours signing all the checks, but the fees are more reasonable than wire services and the money is relatively safe.
Teller: How may we help you sir?
Gil: I need $10,000 in traveler’s checks please.
Teller: faints dead out on the floor

Debit/ATM card
Believe it or not, this method works very well overseas and has been utilized in Ghana on the last trips. This prevents you from having to use a credit card, and also prevents you from carrying a load of cash. It is easier than a traveler’s check, and just about as safe. The part of the process that we have to confirm is that there are ATM outlets on the island that we can use, and that the fees associated with the card will not be to extravagant.

Bank to Bank wire transfer
This is the last resort of the better ideas. We can wire money from our bank to the new bank if we need to do this. We have put everything into place to make it possible to do this remotely after we have left the area, but it will also have some associated fees, and there is still a little lag time before the funds are clear.

All in all an interesting situation and I will let you know how it turns out.