What is he saying (Part II)???

Whenever you go to a new location you can expect that things are going to be different (see part I of what is he saying???). For instance, when you go to France you expect that things will be in French. Likewise, in China you expect Chinese, Korea , well Korean of course. So when you arrive in Canada you should expect to hear some Canadian.

Wait, I thought the Canadians spoke English and French?
You are in fact correct.
Then what is Canadian?
That is the version of English they speak.

Today I pay tribute to some noteworthy differences that I have picked up over the last month and a half. Some are in the way in which folks pronounce things, others in the adjectives and adverbs used to highlight the conversation. So, let’s go through my most recent examples of differences from our common language.

The first example comes from Nancy and her interaction with a car salesman. We have recently purchased a happy yellow Chevrolet Aveo and we enjoy it when it runs (and when it does not it goes back to the salesman to have it looked at and fixed….a completely separate post). It was during one of her visits to the dealer to pick up the car (again) that they got to talking about the color. She calls it happy yellow. This led to a conversation as follows (deckle rhymes with freckle).

Salesman: You ought to get a deckle for that car
Nancy: A what?
Salesman: A deckle of a nice yellow smiley face, there is a guy down the road who makes em, eh.
Nancy: Confused look on her face
Salesman: See he made all those deckles for my other cars, eh.
Nancy: Light bulb comes on and she realizes he
means Decal. Hmmm………

The second example comes from several patients I have heard over the last week. You see we have had a bit of stomach flu in our community (a gift from the return of the school year). So I have seen several people with the same basic complaints.

Doc: Hello Mr Whomever, what is going on today that brings you in?
Patient: I been sqwamish, terrible sqawmish.
Doc: I see (Puzzeled look on my face masking as concern)….Tell me a bit more about it.
Patient: I been wake up terrible sqwamish, can’t hear tell of eating, make me terrible sqwamish.
Doc: Have you been throwing up?
Patient: Only when the sqwamish gets terrible.

After several encounters I began to understand that sqwamish meant squeamish. It is an unusual way to describe nausea, but I guess it works. It certainly gets the point across once you understand what they are saying.

The last bit comes from differences in the way we describe the same things (taken from the medical setting).

Terrible = As an adjective such as a Terrible smart, Terrible big, Terrible pretty, Terrible sick, or Terrible tasty. In some parts of the country they would substitute the word wicked. In Texas you might hear the word powerful in place of terrible.

Getting a Needle = an injection of some kind
Freeze it up = Numb an area for something like a stitch or an excision
Prick, as in “ I had to prick her three times to get that IV started”. I am used to hearing the word stick in place of prick.

I will continue to listen for more curisities form the north.

Well for all of you that are sweating away in Texas, you will wish that you were here. The weather is glorious, and the fall colors are beyond anything I have seen . The leaves have an electric almost fluorescent color to them as they turn brilliant yellow, red and purple. Here is a link to the science behind the changing of the leaves. I only hope that Kyle does not blow them all away prior to getting some photos of them for everyone. For now head over the flickr site (click on the slideshow on the right) to see some new photos we posted form a trip last month to the north shore of the island.

When do you serve lunch?

For anyone who has travelled around the United States, it is not uncommon to have the mid-day meal referred to by a variety of different names. Most folks in the southern states refer to the midday meal as either lunch or dinner. What is the difference?


Well both meals occur at the noon hour, so how could you tell one from the other?

I have always been a bit confused about this difference in terminology and so I went to that bastion of knowledge, the Merriam Webster dictionary (on line version).

Lunch
Etymology: probably short for luncheon
Date: 1812
1: a
usually light meal ; especially : one taken in the middle of the day

Dinner
Etymology: Middle English diner, from Anglo-French disner,
diner meal, from disner to dine
Date: 13th century
1 a: the principal
meal of the day b: a formal feast or banquet

Supper
Etymology:
Middle English soper, from Anglo-French super, from super to
sup

Date: 13th century
1 a: the evening
meal especially when dinner is taken at midday b: a social affair featuring a
supper ; especially : an evening social especially for raising funds
2:
the food served as a supper 3: a light meal served late in the evening

Well that seems to clear things up nicely now doesn’t it.

So if you drop by the clinic and catch me in the middle of the day eating a sandwich at my desk, then you have stopped by for lunch. However, if you find me at home on the weekend and we are having grilled chicken and oven vegetables then it is likely that you have come for dinner. Clearly when you come by in the evening we are having supper no matter the form or content of the meal.

This all seems perfectly clear until I went to the local Masonic lodge meeting. Lodge get’s started at 8 pm, and afterward they have a small light meal. During the meeting we talked about an upcoming event that was to take place in the evening in two weeks. We were going to have a speaker and everyone was talking about the timing of the lunch break. I must admit I was confused about the timing of the events. It was clear to me I had misunderstood when things were going to be taking place, and I was a bit sad since I clearly could attend since it would take place around lunch. It was all very confusing to me since everyone was clearly referring to an evening meeting (the lodge will open at 7:30 pm and the speaker will start at 8:15 and we will break for lunch at 8:45).

My confusion deepened when at the end of the lodge meeting they asked me to stay for some lunch. Understand the time was 9:30 pm, and I had already had supper with Nancy earlier that day, and lunch had consisted of a sandwich and some havarti cheese in the clinic around noontime. I stayed because my curiosity was high, and in very short order small sandwiches appeared as did small cookies and cakes and everyone sat down and had a social gathering over this meal with tea and coffee.

As I left that night, I figured that this was just one of the crazy local things. They referred to the morning meal as breakfast, everyone seemed to refer to the midday meal as dinner, and the evening as supper. This makes obvious the idea that the cafeteria served a hot dinner at noon (i.e. something freshly cooked and warm such as seven layer dinner), and a cold supper at 5 pm(i.e. soup, salad, wraps and such). Lunch must be when you have sandwiches. However, I have come to find out from very reliable sources that lunch has no real time and instead refers to the meal that occurs after an evening of socialization.

It does not refer to a light meal as Mr Webster implies, rather on the island it refers to the meal that happens after supper. These meals may be simple such as that of the lodge, or they may be very elaborate happenings. In fact, in the winter when folks seem to socialize more (since the weather does not permit much outside activity) people will gather for cards or some other function. Often a lunch will follow before everyone goes home. When the group convenes next, the hostess will serve something completely different, and often a bit more elaborate than the previous week. By the end of winter these lunches can take on the scope of a rather grand buffet and everyone is leaving the party feeling very full and very happy.

So there you have it, the fourth meal of the day, the meal before bedtime, or the meal when at work. Lunch it is more interesting than you could possibly imagine. Learn more about lunch, supper, and dinner at Wikipedia. You can also see the entire meal series at Wikipedia.

Seven layer what?

I have heard of seven layer cake, seven layer dip, and even seven layer salads. What I have never heard of is seven layer dinner. That’s right, seven layer dinner.

Why do I mention this?

Well, yesterday evening when I was on call at the hospital, I wandered down to the cafeteria for a little something extra to go along with my homemade sandwich. I was hoping for a little soup or something along those lines. As usual I inquired about the offerings for the evening and was told that they had barley soup, homemade pizza, and seven layer dinner. I guess my face did not hide my complete and utter ignorance, because the ladies in the kitchen all chuckled at the queer face I must have been making.

Seven layer dinner?

Yes I had heard them correctly, it was in fact seven layer dinner. What pray tell is seven layer dinner you ask? Well let me tell you friends it is nothing like seven layer cake. The seven layers of the dinner refer to the layers of ingredients with which you line the casserole dish. In the case of our hospital, the kitchen had chosen the fresh veggies that are currently available throughout the countryside at any of the many roadside stands. It begins with potato halves, then green beans followed by bell peppers, corn, peas, macaroni noodles, tomatoes, and ground beef. When it is dished up it looks a lot like any other casserole you have ever seen. Since I had never heard of such a thing, I immediately went to Google to find out more about this culinary invention, and I found several different versions of the same basic process. Like any good recipe it is easily modified, and so I found the following options for the dinners.
1 c. rice

1 c. whole kernel corn

1/2 (5 oz.) can tomato sauce

Salt and pepper

1/4 c. chopped onion

1/4 c. chopped green peppers

1/2 (5 oz.) can tomato sauce

3/4 to 1 lb. ground beef, partially cooked

4 to 6 strips of bacon on top

1 1/2 lbs. hamburger

1 c. green beans, drained

1 c. kernel corn, drained

1 c. sweet peas, drained

6 servings of instant mashed potatoes

1 c. spaghetti sauce

Salt & pepper

2 c. sliced potatoes

1 c. sliced carrots

1 c. chopped onion

1 lb. hamburger - browned

Salt and pepper to taste

1/3 c. raw rice

1 c. chopped celery

1/2 c. chopped green pepper

1 qt. tomatoes

1/2 cup uncooked long-grain white rice
3 potatoes, sliced
1 onion, sliced into rings
2 carrots, cut into 1 inch pieces
1 (15 ounce) can green peas, with liquid
1 (10.75 ounce) can condensed tomato soup
1 (10.75 ounce) can water
1 pound pork sausage, sliced and browned
salt and pepper to taste

As you can see, there are many options for the seven layers of deliciousness that could have come you way in the cafeteria, but I having a sandwich already opted for the barley soup in a cup.

While on the subject, I should make it very clear that life in a small town hospital is infinitely more fun than you would possibly expect. For instance, the cafeteria is run by the same ladies who have been there for ages, and all the meals are made from scratch using as much local produce, meat etc as possible. The meals, while different from the fare of Texas, are none the less satisfying and very good. The next nice thing is that in very short order you know absolutely everyone in the place, and there are no longer any strangers. You see these folks whenever you are out and about in town, and when you are out for a walk on the trail. Each and every one of them is ready and willing to help you with anything in which you might be interested.

As an example, I am very interested in getting some wool sweaters made prior to the arrival of winter. The woolen mill where we had gone came across two sweaters that they thought might fit me, and so when Nancy ran into the manager in the grocery, she mentioned this to her. She had put them back and was preparing to call me at the clinic to let me know that she had them and I should come try them on. During their conversation, they realized that with my schedule I would not be by the mill for some time, so they gave the sweaters to Nancy to bring to me for fitting. Understand that these are fantastic sweaters that are probably worth $300 or more in the states, and they just handed them over and said give them a try. We did in fact try them on and I am keeping one of them, a pullover that is very nice. We have looked at some other places for sweaters, but they are all marked up far too much for my taste, so I put the word out that I would be interested in “commissioning” some sweaters from any of the knitters in town. I have several names which I will be going through this week to see who has the time and inclination to knit some sweaters for me this year. I can assure you they will be very warm, very pretty and a whole lot less than the ones in the store.

Very soon I will post some photos of the hospital on the blog so you can get a better feel for my life north of the 40th parallel.

What is he saying????

Well I have officially completed the first 36 hours of gainful employment for the Beechwood Community Clinic. As luck would have it, I began my time as a Canadian doctor in the Emergency Room. It was not too bad, a pretty forgiving 24 hours all things considered. The role of the emergency room in Canada is very much the same as it is in the United States in that it serves as the catch all for anyone who does not have a personal family physician (called orphans in Canada) or those who cannot get in to see their personal physician. The patient complaints were not all that dissimilar to those seen in any urgent care setting: coughs, colds, gastrointestinal problems, as well as the odd trauma. In addition to these general difficulties you also see the expected cardiac difficulties etc that come along with an Emergency Room.

The two biggest differences that I noted were the social admissions and the difficulty with language. Let’s begin with the social admissions. Since the health system is socialized, this includes the nursing homes. So, when a patient comes to the hospital and needs to go to a nursing home and the nursing homes are full, then they stay in the hospital until there is a bed available. It is probably not the best use of resources, but it does fulfill the needs of the patients and upholds the social contract. It will be interesting to watch this over the next several years.
The second difference that I noted was the difficulty I had with the dialect as well as the colloquialisms. The dialect was very interesting for me and on a couple of occasions I had to grab one of the nurses to help me decipher what the patient was trying to say. It was especially difficult for me as the evening wore on, and my fatigue increased. Add to this the use of different phrases to explain things and it made for a very interesting evening. My favorite saying form the evening was from a patient in response to the question describe your pain…..’it’s like water running down my legs’. Now I have no idea what that means, but it is certainly descriptive. I am just glad the response was not along the lines of ‘ the way water smells when you make butter’. The nurse translator was not very helpful in figuring this phrase out, and so we had to come at the question form several different angles.

My first day in clinic was very enjoyable as well, and it was much like any other clinic in many respects. What made it more enjoyable was the small town feeling of the clinic. It is a familiar feeling for me, and reminds me very much of my time as Dugway Army Proving Ground. One of the best treats of the day was the presence of a coffee break that happened around 10:30 am. Since there is no scheduled time for tea or coffee, one of the nursing staff brews a pot of coffee and steeps a pot of tea and brings all of it to the doctor’s work station for everyone to enjoy. It was a very pleasant treat in the middle of the morning.

All in all it was a very enjoyable start to my Canadian medical system. In the next several days we will talk about the other big differences and the challenges that I can see myself facing as time progresses. In short, standard international units (http://jama.ama-assn.org/misc/auinst_si.dtl) in place of conventional units as well as different medications. More to come.