Ok, so summer came late this year.....at least it came (sort of)

Let me begin by apologizing to everyone I know who reads this in Texas, I know it has been hot (think 1980 hot) if not more, so you may well want to skip this post while I talk about the weather from this summer (think cool and wet).  Why am I talking about the weather?  Well, because it is a time honored tradition on the Island and it has been as unusual as ever based on the reports of my Octogenarian patients.  

Let’s begin with tradition.  If you visit our Fair Island, then one thing you must be aware of is that each conversation must contain some discussion of the currently prevailing meteorologic conditions.  Typically this is phrased in the form of a rhetorical question....

‘Getting enough snow at your place?’

‘Not to dry for you is it?’

The former question being the one you got over the winter, and the later being the question for this sumer.  You see, our winter this year was a little warmer than the previous winters which translated into massive amounts of snow.  The weather has to be warm enough for it to snow, and this year it was.  Additionally, the storms came through in a pattern that was unusual and it made for lots more snow sticking around.

The typical pattern for weather here is to have a storm, a couple of clear days then another storm.  It really does not depend on the season, it is the pattern that seems to prevail year round.  The main difference is that the season will determine the quality of the moisture delivered, not the pattern of the cycle.  In winter, this is snow, in the remainder of the year in rain.

This winter the pattern was windy day, storm day, windy day x 2 storm day, windy day x 2, storm day, windy day x 2 etc from January through mid March.  There were none of the typical clearing days after the storm, just the wind from the departing storm and then from the approaching storm.  As spring approached everyone was hoping for a change, and on schedule it occurred.  The snow turned into rain, but the pattern did not alter.

This made for a very cool, very wet spring.  The spring lobster fishermen had lower than average catches because of the stormy cold waters, and all the farmers were gritting their teeth waiting on the chance to work their fields and plant.  We got a few breaks in late May early June so that the farmers planted (as did gardeners) and then the cycle kicked back into gear and things stayed wet (and cool).  We were wearing sweaters into July as the cool temperatures persisted.  

In conversations with my patients, the weather played an important role.  Everyone was/is worried about the gardens as this is a key staple for storage for winter, and lots of folks had to plant their gardens a second time because of the weather.  Usually by mid July summer has really arrived and the temperatures are getting into the high 80’s (mid 20’s C) and low 90’s (Low 30’s C) throughout the day, but still in the 60-70 degree range at night(15-22 C).  July this year has seen our daytime temps from mid 60’s to low 80s for the daytime highs and the evening temps in the 50’s and 60’s.  This combined with regular rain and cloud cover have made summer seem down right spring like.  

So, what does all this mean in practical terms?  Well, it is after all the weather, and there is not really much that can be done.  It does mean that the growing season is a little funky, and that farmers who are making hay have had a hard time finding the perfect window to cut the hay so it can dry and be baled prior to the next rainy day (our hay farmer usually puts 10,000 bales back yearly and had only done 3,000 by mid July).  Some crops are doing well (if you land is well drained), but the warm weather garden crops (think peppers and tomatoes) are struggling.  For my part, I have a bumper crop of carrots, broccoli, radishes, lettuce, celery, onions, squash, pumpkins, and beans.  My tomato plants are large, but the tomatoes are green, and the peppers may not produce at all (time will tell).

It is as odd as the extreme heat in Texas, and the older patients are all apologizing to me about the lousy weather.  If is funny, but it is a part of life here, and always part of the conversation.  Hoping the weather is favorable where-ever you reside.

Merry Christmas Message

In our little corner of the world, Christmas morning has arrived with a little snow on the ground and a definite nip in the air. We have had a wonderful year on Prince Edward Island, and with the arrival of our second Christmas, we have come to appreciate and enjoy the warmth of our small town even more. The island has allowed us to slow the speed of our lives, given us the chance to look around, and reminded us of the joys of daily living. It has given us the chance to learn who makes our food and buy from them directly. It has given the opportunity to see the needs of others and help. It has reminded us of the spirit of community and encouraged our inclusion. It has released us from the bonds of time by asking us to sit for an hour when we drop by for a visit. In short, our little corner of the world has helped us return to the values and ideals that we believe in our core. It is our sincere hope for each of you, that this opportunity to return, refresh and re-energize comes you way, and in so doing renews the joys of your life and living.
Merry Christmas to you all….…..Gil and Nancy

Healthcare difference part II……….Rationing in the US

Anticipating the differences between the US and Canada, I focused on the rationing of healthcare. When most folks I know talk about the difference between the delivery of health care in the two nations, rationing and quality are two differences that stand tall among the potential pitfalls of a nationalized system. Rationing occurs in both systems, the prime difference is the transparency with which it occurs in each system.

Rationing in the United States
Many people are surprised to learn that rationing of healthcare resources does in fact take place within the United States, and the absence of transparency is why most American do not recognize the rationing. The rationing of healthcare in the US occurs in two forms- insured and uninsured.

Uninsured
If you are unfortunate and lack health care insurance in the United States, then by definition you ration the health care that you receive from the system. You ration your healthcare because you have no choice, it is simply too expensive to be sick, and even more expensive to purchase insurance. So like most folks when money is short, you do without things that seem to be luxuries. This means that you do not enter the healthcare complex until you have no choice, and enter the system when your health has deteriorated to such an extent that you must enter the system because you are simply too ill to do otherwise. This illness may be something seemingly innocuous such as a bad case of the flu, or something more complicated. In the end, it means a trip to the emergency room/urgent care/walk in clinic for the help. Often the choice of where to enter the system is dictated by the available cash on hand, with those who have the fewest resources shunting to the emergency department for their care. Unfortunately this means that they are entering the system at the most expensive point.

This makes little sense economically but it is one of the only ways people can be guaranteed that they will be seen and treated, and it is the Emergency Medical and Active Labor Act that makes this possible. This obliges the emergency department to make sure that the patient does not have any life threatening illnesses and that they are medically stable before sending them home. This does not mean that everyone has to be treated, but in a practical sense, everyone is. The line between diagnosis and stabilization to treatment is very small, so it makes little sense not to just finish the work. This is in part why so many people arrive for prolonged waits in the emergency departments across the US. Patients who have more discretionary spending often go to the Urgent Care or Walk In clinics to be seen for their minor ailments. These clinics are far more efficient than the Emergency Departments, but payment is expected at the time of service. In both cases, the treating provider has no obligation to care for the patient beyond their encounter, that is, they have no obligation to look after the long term chronic health care needs of the patients they treat. In essence they are rationing the care they deliver; they do not deliver the long term care.
If you need hospitalization and you lack health insurance, then this prospect is a nightmare. The EMTALA obligates the hospital to admit you to the hospital, stabilize you condition, and then look toward discharge. Hospital costs are such that even an overnight stay in the hospital may cost you over $1500 which for a family of four with two working parents earning $50,000 a year will find difficult. Additionally most folks without insurance work in jobs where there is little if any paid sick time, so there is the burden of lost income for the period of time you are hospitalized as well as any time spent recovering after you leave the hospital. In fact recent studies (prior to the economic slump) indicate that health care expenses contribute to bankruptcy in 50% of the cases and when looking at housing problems (failure to pay rent or mortgage payment), 25% are due to healthcare expenses.

The Insured
If you are one of those fortunate enough to have insurance, you are still subjected to health care rationing, but unlike the uninsured, it is often a more complex form of rationing that takes place. It is not called rationing in the usual sense; it is couched in terms such as “covered services”, “preferred provider”, “pre-existing condition”, and “denied claims”. Here is how it plays out from the perspective of a physician inside a very organized integrated health care network.

When a patient presented to be seen in the clinic everything went very well as long as I did not ask the system do more than it was prepared to accomplish. In other words, if I saw the patient, diagnosed the condition, and treated it then there was no particular problem. However, if I wanted to involve other providers, provide more than one type of service on the same day, or provide care that was outside of the usual scope the rationing began. As an example, if I a patient can to me with a mole on their skin that was concerning and I determined that the mole should come off, then proceeded to remove this mole during the same visit, it was often not paid. What this meant to the patient was inconvenience, in that I would diagnose them and have them come back on another day for the procedure that should have taken place at the same time as the initial visit. If I wanted more specific testing it often required additional paperwork to be completed in order to justify the service. Often this would involve a phone call to someone who would approve the service. These same steps were required when medications outside of the formulary were required, or when a referral to a specialist was indicated. These additional steps increased the time line for a patient to obtain the services, and each step provided an opportunity for the insurance company to decline the coverage. Often after a claim had been submitted, additional paperwork would come through that would essentially be asking if the condition being covered might have been a pre-existing condition. If you are unfortunate enough to be found to have received services for a pre-existing condition, then the claims will be denied and you will be stuck with the bill for any services that can be related to that condition, after the fact.

An additional component to the rationing of health care for the insured patient is the conditions and services covered as well as the amount of coverage for these conditions. The fact that you have insurance is not a guarantee that you will receive treatment. If you need treatment for a condition that is not covered by your plan then you are out of luck. Likewise, the type of treatment that you may be eligible to receive will depend on the terms of you plan. These terms may change without your notice, and you may be left holding the bag. Finally, if the cost of your care exceeds the threshold of the plan, then you insurance runs out and ceases to pay for any additional costs. This is in fact rationing. If you have insurance and you do not need much then you get what you want without any real trouble. If you have significant needs, then it is likely that the insurance company will ration your access until you run out of coverage or they find a link to a pre-existing condition that allows them to decline payment for the claims. If you are uninsured you really only get acute treatment and nothing more, at great cost.

In the case of the US, the rationing that occurs is done in a manner that is not transparent and is without any recourse. You cannot vote out the people who have rationed your healthcare, you cannot sue the insurance company that has decline your care, and the majority of people cannot afford to get sick. In a system where healthcare is nationalized transparency is a key element to the rationing of care…..more to come.

Comparison Shopping for your Health Care System Part 1

In the end you are still taking care of the patient

Since I have been in practice in Canada for six months I thought it might be time to reflect on the similarities and the difference s between the US and Canadian system of health care. As a reminder, I am a Family Physician. This means that I take care of whomever walks through my office door to the best of my abilities regardless of age, sex, or ability to pay. I see everything, and refer to specialists when I am out of my comfort zone, or have run out of good ideas. So a good place to begin our review would be in the typical clinic day.

The View From Texas

When I practiced in Killeen for Scott and White my day started in clinic around 8:30. I would see a patient basically every 15 minutes until 12pm, break for lunch, and start at 1pm and continue until 3:45pm. This resulted in seeing about 26 patients a day give or take (depending on how many physicals I had that day).

I usually arrived earlier in the morning to try and answer all the patient messages, look over lab results, complete forms, and answer e-mail prior to the first patient of the day. I dictated my charts as I went and that usually took 2-3 minutes per patient so I spent roughly 10-12 minutes of each visit with the patients. During that time you would try to complete all the work that needed to be done for this patient. The presence of the electronic medical record allowed me to review all the visits since the last time I had seen them as well as all the specialty visits. It also let me look and see if they were up to date on their labs, preventative care, and such. Some days the computers worked well and this did not take much time, other days they were slow and it became difficult. In general, my patients were older with my average patient being late 60s early 70s with the occasional child thrown in for variety. If a patient needed a procedure done often it happened during their visits, or was quickly scheduled for my dedicated procedure day.

The days felt very busy and I usually returned home feeling fairly worn down. I usually left the clinic in Killeen after 4:30 or 5 pm and then headed to the house. As part of my practice in Texas I did the occasional delivery usually in the wee hours of the night, and one week of every six was spent working in the hospital taking care of the hospital service. On the whole, the patients that I took care of in clinic and in the hospital were older sicker folks.

The View From Prince Edward Island

My practice in Canada is usually starts around 7 am with hospital rounds at the Alberton hospital where I see my one or two patients, then I drive to O’Leary for hospital rounds on my one or two patients. I arrive at the clinic between 8:30 and 9 am to begin my clinic day. I see a patient every 15 minutes from 9 am through 11:45 and then from 1 pm until 3:45 pm give or take I see between 23 and 25 patients a day depending on the number of work-in patients.

During the visit you work on many of the same issues as I did in Texas, catching up on preventative health care, reviewing labs and such to monitor chronic illnesses, and cajoling patients into changing their lifestyles. Since the notes are handwritten, there is no time spent dictating the chart (and thus no time spent signing off on dictation). Since it is a paper chart, there is a bit of work to keep the flow-sheet organized so that you do not have to dig through the chart each time you want to review preventative care. Because of the manner in which the clinic is arranged, it is difficult to perform procedures in the clinic, so I often send those to myself when I am going to be working the urgent care clinic. You still have the usual lab to sign off on, as well as the consults to review and such, but the paperwork that seemed to be such a large part of my practice in Killeen is not here. I do not have any pre-approval insurance forms to complete, and I cannot think of the last time that I had to complete a Pharmacy Assistant form for anyone. The patients do not seem as ill either. I have some terribly sick patients (i.e. the renal failure alcoholics with diabetes) but they are not as big a part of my practice as they were in Texas. The pharmacy does not fax forms to me for refills, they either refill the medications for one month and have the patient make an appointment to be seen, or they call me directly during the day and I give them the go ahead. This relieves all the pharmacy paperwork that I had from Texas and it was a huge chunk of my paperwork.

There are some distinct differences in the prevalence of certain medical conditions, specifically thyroid disorder, crohn’s disease, celiac disease, and cancer, but I think that these represent the effect of a small isolated population (after all there was no direct connection to the mainland until 20 years ago). I usually complete all my work by 4:30 or 5 pm and head home. I am no longer delivering babies so I do not have those night-time calls. There are two duties that I did not have in Texas that are part of my practice, the Urgent Care Clinic and the Emergency Room. On average I have one call in each location weekly. Usually they are back to back where I work the UCC one day and the ER the next. The hours for the UCC are from 8 am to 8 pm and the volume is variable. The ER is a 24 hour shift, and volume is steady but manageable. As influenza has arrived in our part of the island, the UCC and ER have become very busy places. Despite the addition of daily hospital work and the shifts in the ER and UCC I do not feel as tired as I did when I was in Texas.

Quelle est la différence?
The question in my mind is why am I less fatigued than when I was in Texas. I have been giving this a great deal of thought over the last weeks and I have come to a couple of conclusions.

First, the ever present push in Texas to see more folks all the time felt like a weight on you back. The addition of 3 patients a day meant an additional 15 people a week really seemed to increase the work load (especially when you translate that into the additional dictations, labs, and pharmacy faxes).. Where I feel like I have the time to talk to folks here, I never really felt that previously.

Second, the patients have a different level of expectation in Canada. In the US I always had the feeling that patients wanted everything done all the time whether they needed it or not. I felt like I was always counseling patients about why they did not need antibiotics, an MRI, or a CT scan. The sense of entitlement that I felt form the patients in the US was always present as was a continuing concern that someone was going to file suit for the care that you provided. I am not saying these are rational feelings, but they reflect the feelings of the day when I was practicing. As well, my conversations with my colleagues during lunch confirmed that others felt the same way. The patients here do not demand that everything be done, and if you are sending them for extra tests, they do not fret if these tests take a couple of weeks to get accomplished. With the malpractice laws in Canada, the frequency of litigation is low, and patients do not seem to view it as a lottery like chance for a big win.

Finally, paperwork here is not nearly as onerous as it was back in the Texas. I know it goes against what I initially expected from a government run system, but the amount of paperwork that flows through the clinic is not nearly as copious. This burden was one I did not really appreciate until it went away, and I do not miss it one bit.

Well that is the first view of the similarities and differences. I will post more on this subject over the course of February and try to continue to fill in the gaps so you get a good feel for what is working and not working in both systems. Stay tuned.

Merry Christmas From PEI

It’s Christmas Eve, Irving Berlin’s White Christmas is on the TV, snow is gently falling outside (making our own white Christmas), the furnace is piled high with logs, and I am putting the finishing touches on our yearly Christmas greeting. Our Christmas greetings come to you this year from the North Atlantic Island of lobster, potatoes, and ADL. ADL? ADL is the maker of the BEST milk, chocolate milk, butter, and cheese you can possibly imagine. Drinking a glass of their chocolate milk is like drinking a little slice of heaven (I just finished a glass!). Well, our greeting comes to you, as you know, from 83 Lewis Road, Union R.R. 1, Alberton, West Prince, Prince Edward Island, Canada.

We left the U.S. in August, leaving the dog days of summer in Central Texas (the day we left was 107 degrees with 100% humidity), and headed across the U.S. moving up the east coast. So, here we were, Gil and I, accompanied by 2 dogs, 1 cat, and 1 Lucy Bird, pulling our horse trailer filled with things we thought we would need until our household goods arrived, headed for Canada. Gil and I had never driven through the states lining the east coast so we were really looking forward to seeing the land. An added bonus, especially when traveling through the southern states, being in the land of really really good grits! Yummmm. The only part of the trip that truly sucked was going through Atlanta with a horse trailer, and we didn’t even go through at a rush hour time. Thank God Alli and Jesse gave us the wonderful gift of a GPS before leaving or the suck factor of Atlanta would have been significantly worse!

We stayed for a few days with Alli and Jesse in Swanzey, New Hampshire and the rest was greatly welcomed by us and the animals. We had a wonderful time with Alli and Jesse and got to spend some time watching Aaron, their 7 m/o son, being Aaron. He is a truly happy and delightful child. Even though this is their first and they have little parenting experience (7 months to be exact!), I told them they HAVE to be doing it right or he wouldn’t be so happy and well adjusted to life. He is a joy to be around. We had such a wonderful time seeing Keene (Swanzey is just a couple of blocks from there) and Walpole (where their family business is located). We brought sausage from Green’s Sausage House in Zabzkville with us and Gil made a huge pot of his gumbo. We had our usual trio of gumbo, baguette, and wine, accompanied by lots of wonderful conversation.

We crossed into Canada at the border crossing located in Houlton, Maine. We were prepared with a file box full of papers which were required to get us, the animals, and the car across the border and fully expected to spend hours going through papers and getting it all sorted. We were shocked and pleased that it was so quick and painless. Gil got his work visa and I got my Canadian papers and we were across the border in less than an hour (none of the documents we worked so long and hard to get in the U.S were asked for!). As we drove through New Brunswick headed to PEI, we looked at the scenery passing us in a different way than we looked at Canada all the times we had visited. This was our HOME now, and it makes you look at your surroundings quite differently.

The horses made it here about a week after we got here. There was a bit of difficulty getting them across the border. The transporter called me in a panic at midnight saying they weren’t going to let them across. We finally got everything worked out so the border agents understood why we were bringing them here and finally in the wee hours of the morning they made it across into Canada. When they made it to me they had a bit of a deer in the headlights look, but that is to be expected. They were on a transport from Texas to Maine for 3 full days without stopping, stayed over in Maine for 2 days, and then were on another transport for another 12 hours here.

Cowboy and Olivia have settled in and done well. I have been riding Cowboy and although it took him a bit of time to settle in and get back to where we were in Texas, he has been just awesome. In the past, when he traveled, a show was at the end, so he was in full (and I mean full with bigness and glory!) saddle seat mode. We finally got the dressage brain engaged again and he has been spectacular. I have been lunging and long lining Olivia since arriving, but haven’t ridden her yet. She has continued to be sound as can be and I have looked long and hard to find a driving trainer that I could continue lessons with and perhaps start Olivia driving. We attempted it once before with my trainer, Tom O’Carroll, in Texas, but she didn’t stay sound for it. Since then, we have had her on Naproxen, and she has stayed sound. The bad news is I can’t find a trainer. Most people on the island harness race which is, of course, not the same at all. I have, however, made a couple of friends who drive (not competitively) – carriage in the summer and sleigh in winter. So, I am going to get a bit of sleigh experience this winter. I am really excited about getting to sleigh this winter. The two horse experiences topping my list for PEI were riding on the beach and sleighing.


As most of you know, our Ophelia sustained a devastating injury on a back leg on Thanksgiving Day and the prognosis was extremely poor. It was felt by all that it would have caused her great suffering to attempt to fix it and in the end, we would have been putting off the inevitable. So, the decision was made and Gil was with her until the end. Of course, Ophelia was out of my mare, Olivia, and we were there at Dr. T’s when she was born. Alli took care of the farm while Gil and I spent every evening/night at Dr. T’s watching Olivia on the monitor, playing lots and lots of cards, until finally 3 weeks later, at 2 a.m., Ophelia was born. She would have been 3 years this January. This has been extremely difficult for both Gil and I, but especially Gil. He was bonded to her (and her to him); the way Olivia and I are bonded. It is so tragic and sad and we will miss her so much.

Gil started working on 01 September and is really enjoying small town medicine again. He sees patients at the clinic in O’Leary and also has some on-call time at the O’Leary Hospital. Of course, he has beat the “evidence-based medicine” drum since arriving and is now back to doing some teaching. He has just gotten a medical student who will be doing a one month rotation with him. Since he was a hospitalist at S&W the last 8 months or so before moving here, he wasn’t doing any teaching, so he is really enjoying having a student and teaching again.

There are lots of changes in medicine going on here though. For many reasons, they are consolidating services on the island and toward that end, they closed the ER and hospital (acute care beds) in Community Hospital O’Leary, where Gil works. Alberton’s hospital, which is 15 minutes from O’Leary (and closer to where we live), will serve as the local ER and in-patient hospital for acute care and when Gil is on call, he will work out of Alberton. All that sounds good, but we are not entirely convinced that Alberton’s ER/hospital will remain open either. It seems, what would make the most sense, is to have all ER and acute care in-patient in the 2 largest centers – Summerside and Charlottetown. Eventually the only services left in the small communities would be clinic/urgent care. These decisions and changes are very unpopular with the people of these communities, as all the individual communities want their own fully functional hospital/ER, so I imagine these changes are going to come piece-mill and slowly, but I think they are inevitable. So, this makes it difficult to know how to proceed with the horses.

Aside from helping a great deal with this kind of change, Gil is also doing here what he does everywhere he goes, seeing what needs to be changed to make patient care better and setting to work. Providence seems to have led him here for this reason, above all. There are many huge changes which are occurring here and change is something that is difficult for anyone, but it seems especially difficult for the good people of Prince County. The way they have done things in medicine for the past 50 years is being turned on its head and they are being catapulted into the 21st century of medical practice. In so many ways PEI is like the U.S. was in the 50’s and early 60’s and it is refreshing, but not in medicine. It will take probably a good 5 years to really implement these changes and have them running well. For all of you who really know Gil, that will be the time we will be ready to go on to our next adventure…

Willa and Isobel are very happy here. They love the snow, although it is s a little difficult to see Isobel dashing through it as it usually deeper than she is tall!! Lucy bird is great too. It is somewhat cold for her and we have to keep the house a bit warmer than we would otherwise and I keep an oil heater on next to her cage. She seems very happy there though. She is dangling off toys in her cage and talking smack constantly! We also brought Dory, one of our barn cats from the farm. She is now an inside cat, as she doesn’t care for the snow or the cold much!

Gil and I learned what it is to prepare for winter in a north Atlantic region. Everyone here utilizes two sources for heating – oil and wood. Oil is extremely expensive, so everyone uses it sparingly. So, we ordered our 7 cords of wood for the winter. Wood makes more of a warm/cozy heat than oil does as well. Our wood was dumped on the front lawn, 3.5 cords at a time, by the entrance to our basement and we had to get it down there and stack it. I won’t lie – it sucked. I am used to walking over to a thermostat and putting it to whatever temp I would like the house to be. Well, that really isn’t an option here. As our good fortune would have it, Alli and Jesse came for a visit for U.S. Thanksgiving and helped us with the second 3.5 cords. What a huge help that was. Gil had discovered on the first 3.5 cords that he isn’t 20 anymore!! After helping to get 7 cords down to the basement and stacked, I like the thermostat thing even more. Imagine this though – there are 70 and 80 year old men here who stack 7 cords by themselves every winter. Holy cow!

We really like it here though. The pace is MUCH slower here than in the U.S. I will say that has taken some getting used to. I tend to approach most everything with a snap, snap, snap, get it done now approach. You can forget that here. No one is in any hurry ever for anything. There is no such thing as running by someone’s house quickly to drop something off. If you go by, you have to come in for at least an hour for hot tea and conversation! Everyone here loves to talk. Even if you go into a store in search of something and have to ask for assistance, you will usually get at least 15 minutes of conversation before you get the answer. We went into a shop in Charlottetown which has woolen knitted clothing to look for a sweater for Gil – one sweater – we came out about 2 hours later! Even in the checkout line at the Farmer’s Co-op (grocery in O’Leary), a bit of conversation occurs within the check out timeframe (and if you don’t conclude it and move on, they will keep talking while folks just stand behind you and wait – and they will just stand there and wait patiently for however long and listen to your conversation!!) and it will almost always include comments about the weather. EVERYONE loves to make a comment on the weather conditions of the day. In fact, the other day I was sitting at the kitchen table working when I noticed the recycle garbage truck coming down our street and realized I hadn’t yet put out or recycle bags. So, I rushed to throw on warm clothing, grabbed the bags, and ran out to the street just in time. The garbage man, took my bags, threw them in the truck, and then proceeded to talk to me for the next 15 minutes about… the weather!!! He told me all about a horrible snow storm they got in the 1982 and how the snow was almost to the top of the telephone poles and how winters here have been really mild in comparison since… and on and on for 15 minutes. The garbage man even loves to talk! He was very pleasant and we had a very nice conversation.

I will have to say though that the folks we have become good friends with the quickest here are also people from “away”. That is was the locals call folks who move here and are not from the Island, even if you have moved from Nova Scotia. They say, oh you are from “away”! When folks say that to me, I say yep, we are from “way away”, 2400 miles, to be exact! Our good “from away” friends Pam and Jim, originally from Ontario, but have lived many, many places, are headed to Nunavut (above the 60th parallel) for the next year for Pam to work. It is only one year and they will be back, but we will miss them so much. We have had so many wonderful dinners with them and, in fact, that is where we will be on Christmas Day.

Being on PEI has been such a wonderful learning experience and we have only been here a short while. We know what it is like to stand in the midst of a blizzard, drive in one (the first snow of the season was pretty close to a blizzard and I had to drive home from the barn – 45 minutes away!), drive in a mixture of snow and then rain (slicker than poo you’d find in microbiology!) the smell of a woolen mill, the taste of exquisite ADL dairy products, the flavor of fresh (out of the ocean less than 2 hours, boiled in ocean water on the boat) lobster, and what it feels like to stack 7 cords of wood.

So, that about wraps up our year. It has been one of learning, joy, and sadness. We are still at the same e-mail addresses and you can always find what is new in our day-to-day lives by visiting Gil’s blog.

Uh…Hello….its Canada………. (spoken in a valley girl voice)

Well Nancy has finally arrived in Canada.

What? I thought she came with you?

She wrote about Halifax, how can she have just arrived?

We all have moments in life when a realization hits us smack in the forehead, a Satori moment if you will, that moment of utmost clarity when you seem to see the world around you in a very different light. Sometimes those moments are the end of a long quest of the most profound nature, at other times they arise from the simple act of looking at your shoes in a different light. Either way, they offer you the opportunity to shift your viewpoint of the world, to allow you to see the world anew. It is a moment when you look out into the world and see everything around you as if you are seeing it for the first time.

Well, Nancy reached her Canadian Satori this week in the Atlantic Superstore. She was in the store shopping for groceries for the week, and headed to the Deli counter for some sliced turkey. After carefully pursuing the options available and considering the particular taste preferences for us both, she determined that the sun roasted tomato and rosemary turkey would be the best option for the week. Decision made, she promptly moved on to the instructions for slice width and quantity. As usual she wanted it sliced as thin as possible without shaving it, and as always she asked for one half pound. She promptly moved on to thinking other thoughts and waiting on the delivery of the turkey. She snapped back to reality when she noticed the large pile of turkey that was accumulating.

Nancy: Whoa, whoa, whoa…..what are you doing?

Deli Girl: weighing the turkey.

Nancy: Yes but I asked for a half pound, and that's way to much

Deli Girl: Yeah, but I don't know what a half a pound is, I usually pile it up until I think it is enough and ask the customer if it looks good.

Nancy was enlightened, she was in Canada, the measure in Kilograms, and she had no idea how to convert from pounds to kilograms. Her world had changed. She was different and the world around her would never be the same.

We hope that you are all doing well, and that you all have a moment of Satori in your lives. We shall post our Christmas Letter in the next day for everyone.

She will be missed

She was ojnly 22 months old.

We had to put Ophelia down today due to an injury to her right hind leg. We are not sure how it happened, but it was clear that it was an injury from which she would not recover. She had bisected the superficial deep digital flexor tendon as well as the deep digital flexor tendon and incised the skin through to the periostium. After discussion with the vet, Nancy, and the barn owners it became clear that she was not likely to recover from this injury. In short, it would likely be a long hard road and she would not ever be able to be ridden or worked in any way. With this in mind we made the decision to have her put down. It was a hard decision, but it was the right decision. In the end, being a horse owner means that you often have to make the very hard decisions and do what is right by the horse.

Ophelia was a lovely horse and she has taught us all so very much over her very short life. She was the first, and I dare say the only, foal that we had from Olivia. She was the product of a breeding of Olivia and Bergamon. She had lovely movement and loved to jump, going out of her way to jump things even if they could have been walked across. She taught me to be a better person, and taught me how to put my energy and emotions in check in order to better serve the hose at hand. As horses go she was a very special horse, always full of energy and full of herself. She was a horse with a very big personality and that personality touched everyone who worked with her. She was an extraverted horse and that made her very tough in some respects. She was a constant challenge and tested the boundaries at every turn. If she was thinking something you knew it immediately since there was no filter between what she was thinking and what she was doing.

She will be missed more than words can express. Born January 16th 2005, died November 26th 2008.
Ophelia Viedo
Ophelia Photos

Oh, the weather outside is frightful......

The furnace is so delightful..

and since we really can’t go,

best take photos of the very big snow.

(sung to the tune of "Let it snow")

Day: Snow at times heavy and blowing snow ending near noon then cloudy with 60 percent chance of flurries or rain showers. Snowfall amount 10 to 20 cm. Wind northeast 40 km/h gusting to 60 becoming north 60 gusting to 90 early this morning then northwest 30 gusting to 50 this afternoon. High plus 3.
Night: Flurries. Amount 2 to 4 cm. Local blowing snow. Wind northwest 30 km/h gusting to 50 increasing to 50 gusting to 80 this evening. Low minus 6.

It was interesting to listen to the subtle change in the nomenclature used by the weather forecasters in describing the upcoming (now present) storm. As you recall (see prior post) the weather office had mentioned flurries in the forecast that resulted in a snowfall of roughly 5 cm. In the description of this storm, they substituted the word snow in place of flurries. It no longer read a 60% chance of flurries overnight. It now read snow overnight. That makes me wonder…If we got 5 cm when the forecast said flurries, how much would fall when they say ‘snow’.

The snow is definitely blowing, but I can still see the house across the street, as well as the plow that comes down the street. What I can no longer see is the individual wood stacked in the pile out in front of the house. Likewise, when the dogs go outdoors, I can no longer see Isobel (our Cavalier King Charles Spaniel) when she hits the drift coming back inside.

Since we have no place to go, we will sit and enjoy the snow. This naturally brings up the question of what do you do with your time on ‘snow days’. In order to understand the answer there are a few things that are worth remembering about how we spend our days in general. First and foremost is that we do not have access to broadcast television. That’s right, we do not have “TV” in our house. That is not to say that we do not have a television, after all, we love to watch movies and Harry Potter or Lord of the Rings is especially good on the big screen. What we lack is a connection to the broadcast television world. We do not own cable (it does not come down our road anyway), we did not purchase a Direct Way dish, and we do not have rabbit ears (that would be external television antennas to the under 30 crowd). Now I realize that the thought of being without television is an anathema to some, but it suits us well, and it frees up our time to do other things that we enjoy. Needless to say, we listen to more radio than I would wager many folks do, and we certainly read. As well, since we cannot find the kind of bread we really like we make it ourselves (roughly two loaves a week). Nancy spends many of her days at the stables so there is not a lot of time on those days for around the house sort of stuff, and that tends to get put off until the weather prevents us from going outside. As for me, since I am new to the Canadian health care system, I have a significant amount of reading to plow through as I get accustom to the different recommendations from the Canadian Preventative Task Force. So, all in all our days are far too full to be spent watching television.

As for today, the most important activity is to capture some video of the storm as well as some photos for all our friends in warm places so you can have a little bit of Canada in your lives.

Putting in the wood

Winter is coming with big nasty teeth, biting winds, and a deep frigid grip. The cost of filling our heating oil is $700 CA a tankful and it is estimated that if we were to run only oil, keep the house at a comfy 20C (68F) it would take a tank a month starting in December. So that translates to $4200 total for oil to see us through the winter from December to May. That is a heck of a lot of money, and I cannot believe that oil is not going to go up in price over the next several months.

We have thought a great deal about alternatives to the use of oil heat and forced air, and looked in to the use of a wood stove or a pellet stove on the first floor of the house. We ran into a couple of problems when with these two alternatives. First and foremost, we are renting the house, and anything we put into the house will stay when we leave. The second problem was one of cost. You see, in order to put in a wood stove it would require a chimney through the house to the roof. We cannot use the chimney that already exists since putting a wood fire above an oil furnace risks a backdraft and potential explosion (bad idea). The pellet stove would not require so much work on a chimney as it could vent right out of the wall of the house, but the cost of the pellet stove would equal the cost of the wood with chimney.

So given these costly alternatives to the oil, we decided to look into the use of the wood furnace in the basement. This has several advantages, not the least of which is that wood is much less expensive than oil. It does mean that you must work a bit harder to make the heat work, start the fire, tend the fire, tote of the ash, but the heat is more constant than the oil since the fan runs as long as the wood is burning to dissipate the heat. Oil comes on and off as the temperature fluctuates and thus it often feels cold before you have the furnace kick in again.

Well, if we want to burn wood, and that seems like the best choice, then we need to get wood. I contacted a local gentleman (Paul Smallman who is a great local Entrepreneur, more in future blogs) and he said he would get things arranged. Our neighbors, who had lived in the house until recently, told us to expect to burn seven cords of wood if we used wood exclusively, and so that is what I ordered form Mr Smallman. The cost of hardwood is more than soft wood, and to have it cut, blocked, and split runs $174/cord which translated into $1218 a darn site better than the $4K plus of oil alone.

Mr Smallman dropped 3.5 cords off several days ago, and we commenced to putting it away. Now, in order to understand what this entails, take a look at the wood pile in front of the house. Just under the window in on the house is the trap door that leads to the basement which means that the wood must be moved from point A outside to point B in the basement and the stacked. To say that the process was an undertaking would be putting it mildly. It was a royal pain in the arse. You see, you have to toss the wood down, separate it into the sizes and then stack according to size. This gives you the chance to handle each piece several times. We asked one of our friends if her sone wanted to earn some money, he did of course, and so he helped me move the wood today. He started his work in the basement, and after about 45 minutes realized that he needed a break. I took over and we worked for another 4 hours stacking the wood.

Now, before you think that it was no big deal, you must understand that our basement is not finished, and there are only one or two places where a grown man taller than 5’8” can stand upright without hitting his head. I spent most of my time in the crouch as I sorted and stacked the wood for our furnace. Believe me, as I stacked the wood the thought of a pellet stove on the first floor looked better and better. I am hoping that Mr Smallman was pulling my leg when he told me it was only half the wood, because I really do not know where we will but another 3.5 cords if we have that coming our way.

So, tonight Nancy and started talking about building a house on the island, and the first thing I mentioned was geothermal heat, pellet furnace, and no basement. Ah the lessons just keep coming.

If you are interested in where the horses are now living, check out the link to the right titled Wild Wind Stables.

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.

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.

The wool mill around the corner

It appears that some folks reading the blog have become curious if all that is taking place at the new homestead is the steady drill of painting, unpacking, sleeping and repeating. Well I can assure you that nothing could be further from the truth. In fact there has been a great deal more taking place than this simple four step cycle represents. There has been grocery shopping, the eternal quest for Fritos, trips to the barn, work with horses, setting up an office, painting, deciphering the mandatory recycle system, searching for Fritos, sleeping, unpacking, going to the hardware store, painting, and of course, sleeping.

In all seriousness, the quest to get everything important unpacked, as well as finishing the painting so that the rooms can be organized has occupied a significant amount of time. However, we are venturing forth to explore the surroundings as we make our way north and south across the island on the regular trips to the barn and clinic. Today we ran into a most amazing place which we have passed several times, but today decided needed closer inspection. It is the MacAuslands woolen mill and it has been in operation since 1870. The building itself is newer having been rebuilt after the fire in 1948, but the mill itself has been operating on this site since 1870. We have driven past it several times as it is on the way from O’Leary to the Kent Hardware (think Lowes or Home Depot). Today we popped in and took a look around (Link to flickr photos). It was fantastic. The equipment is wonderful, and the women who were working away on it moved with a sense of finesse and grace as they ran the spindles that created the yarn. We talked with the owners for about half an hour prior to taking our leave. They put me in touch with a lady who knits wool sweaters and I will be visiting her soon to get a few in my size.

This weekend we are hoping to head to the northern and western most point of the island to the town of Tignish to see a beautiful Catholic church and enjoy the sites. Also, since we now have a reliable internet connection at home I will begin uploading more photos of the travels.

In case you are curious as to the multiple mentions of Fritos, we are having great difficulty finding these chips in Canada.

Has it already been a week?

Let’s review the latest happenings.
Eight days ago we arrived in our new house having passed through customs without so much as a long glance. We spent the first night on the floor, and then slept in hotels until our mattress and other household goods arrived on Tuesday the 19th. We have been painting furiously, although it amounts to two rooms, they each required several coats of primer and two coats of pain in order to cover the colors that were there previously. We have unpacked kitchen stuff and are finally cooking instead of eating out, and the horses arrived on Wednesday the 20th and seem to have settled in to the new routine. Since we are new in town, we have established our electrical service, a new bank, received our Social Insurance Number (i.e. Social Security Number) and been treated to lobster for four separate meals.

So what is left to accomplish?
We have our internet coming to be set up in three days. Currently we are poaching the internet form our neighbors across the street that thankfully have a G-band wireless router that is unsecured, and an unobstructed view of their house. We still need to get Nancy set up with cellular service, and the hospital has been kind enough to supply me with my service (although I do not yet have my permanent number). I still need to apply for my malpractice insurance through the medical society and I have yet to receive my billing number from the government (although I am told it will be ready by Monday). There is some cleaning up from Texas that still has to happen, specifically I need to contact the state medical board and let them know that I have moved (same with the drug enforcement agency and with Medicare). That will pretty much clean up the loose ends from the states, and we will be free and clear professionally to jump into work here.

What are the differences?
Prices are higher for some things, lower for others. For example, in Texas it cost roughly $100 to fill up the Suburban if it was below a quarter tank. It costs more like $125 to accomplish the same task here. The costs for soda are marked up about the same amount, as are some other staple food items. The biggest differences that we are seeing at this point are the people. Things here move at a slower pace than they did back in Texas, and it feels like that mythical place called Mayberry RFD. People do not lock their houses, they leave their keys in the car at the store, and think nothing of letting their kids run around the neighborhood playing all day.

More people are walking or biking, especially in the small towns where it appears that everyone walks to lunch or to run their errands when they are at work. The tellers at the bank already know our names, and when we go in we do not have to have the deposit/withdrawal slip already completed, they do all of this for us while chatting about the latest news from around the town. We run into people we already have gotten to know when we go to the local store so every trip turns into a social visit.

Litter does not exist as far as I can see. There is no rubbish on the sides of the streets, no junk in people’s yards, no plastic grocery bags floating down the streets. People seem to take a great deal of pride in their yards which are al neat, tidy and full of flowers. The same holds true for the local parks and green spaces. They all look as if they have been freshly planted and mowed, and rarely do we pass the local cemeteries without seeing at least one that is being mowed and clipped. Speaking of which, every little church has its own local cemetery, if not right next door, then usually only one or two lots down. The churches themselves are an entire blog entry and once I have some photos of them I will be writing about them in depth.

Grammatical oddities……
Civic address= home address
Hydro= Electricity as in hydroelectric
You people= Ya’ll
Never hear tell of it = I haven’t every heard of it
Dairy Mart = Ice cream shop
Licensed (sign in restaurant window) = they can serve liquor
With the Works = indicated that the meal comes with brown gravy and peas
I will try to post more of these differences as they become known to me through my work as I am sure they will once I am in the clinic.
Finally, once the internet is up and running full time, I will post some photos from the house, and the surrounding area for all to see. Also, I hope to set up a web camera that will provide some real time glances out our front window so you can get a sense of what the weather is like and how the apple trees are doing. Remember we are two hours ahead of you time wise so you will want to look at the live photos before the sun sets out here.

Our stuff is here…..where are the horses

Well, the household stuff arrived today and it is a welcome sight. We were able to cook in the kitchen without having to improvise measuring devices (those little plastic sandwich containers work well in a pinch) and we no longer have the limited choices of sitting on the floor or standing in the kitchen when we have dinner. The guys who unloaded our stuff worked very quickly and got everything off the truck in about four hours. Thus far, the only damage we have found was a dent in our metal trashcan.

In other news, the painting is progressing albeit a bit slower than I would have liked. In the perfect world we would have completed two rooms prior to the arrival of the household goods, but since our world is anything but perfect, I have just finished the second coating of primer on the master bedroom. With luck, I can paint the whole thing tomorrow and we can move most of our furniture out of the other rooms and into the bedroom. That would mean we could sleep in our house, on a bed, how cool.

The arrival of the household goods is not without a hitch. The staircase that leads upstairs is a bit narrow. The house is 100 years old, it is an old New England style farm house, and the stairs are narrow. Come on, it is 100 years old, and beds were smaller then. Our bed, a queen size, was unable to successfully navigate the stairs. The mattress made it alright, but the box spring got stuck, and since we are renting, we did not feel the comfortable pushing it through. So, we have a mattress upstairs, a box-spring in the garage, and one more item on the “to do” list.

Medical News
Now that we have arrived on the island, I am beginning to get the last minute in person details finished in order to legally work, and receive compensation for that work. To bring things up to date, the process of getting a license to practice on the island was far easier and more straight-forward that things were in Texas.

The process involved completing the application for the College of Physicians and Surgeons PEI since they are the licensing authority. This was pretty straight-forward and did not require any complex actions on my part. Much to my surprise, it was relatively efficient, and not too expensive. The attitude of the College is trust but verify, so I have been granted a temporary license until all of my credentialed are verified by the Educational Commission for Foreign Medical Graduates (ECFMG) for PEI.

Again, this was pretty straightforward. I had to complete an application, send some money, and await the verification process to be completed. In less than one week I had received an e-mail from the ECFMG folks telling me that they had received my application, and that it would be reviewed and processed in three weeks. Once this is complete, I am fully licensed.
With all of that rolling along smoothly, we arrive at the last minute details that cannot be completed prior to arrival in Canada. These include things like the application for a billing number, malpractice insurance, and training on the computers at the hospital. The one thing that is currently outstanding is the acquisition of a Social Insurance Number (the Canadian equivalent of a social security number) and we are applying for these tomorrow, as well as squaring away our insurance.

Not bad for a couple of folks from Texas. Now if only our horses would arrive things would be great.

It ain't home till you strip the wallpaper and paint the rooms

C+3

Today we began the repainting process. It seems that no matter where we go, we immediately get involved in the process of repainting the house. Today was no exception, we bought paint yesterday along with all the equipment needed (brushes, paint, tape, drop cloth, rollers, pails, etc). Today we put those to use and began taping off the master bedroom as well as stripping off the wallpaper in the other bedrooms. You would think that we would have gotten quite a bit done today with the painting, but we had social obligations that came first.

Dr Dickieson and his wife wanted us to have brunch with them at the local golf club, and brunch turned the house so they could look it over and render their opinions. So, the noon brunch ended around 3:30 and we began to tape the bedroom and strip the wallpaper. However, we were not to get too much done because at 6:30 we had a dinner date with Pam and Jim at their house and by 11 pm we were back home to gather our things to go to the hotel for the night.

“Hotel for the night? I thought that you were in your house?”
Well that would be correct, we are in the house, but our household goods will not be arriving for another two days, and so we spent last evening at a hotel, and we will spend the next two nights at a different hotel.

“So that is Saturday and Sunday night in hotels, what happened Friday?”
Well Friday we arrived at the house and got things set up in the home (including the movement of the fridge etc) and then we settled in to fall asleep. The trick to the sleeping was that the only bed in the house was the dog bed. Granted it is a nice bed, but it is not a proper bed. As I mentioned yesterday Nancy had the bed and I had a yoga mat. Well everyone insisted that we could not sleep on the floor again, and so they put us up at a hotel. We had the best night of sleep that we have had in several days. Needless to say, when they offered to continue to put us up until our stuff arrived we took them up on it without question.

So, today was wonderful with a series of meals and conversations. We did not get as much taped as we would have like to do so, but we did get some “work” done. Tomorrow we get the last of the customs papers completed and fax off the last of the paperwork for the horses. Also, we will get some painting done.

A dog's life....

We are on now on C+2 (that is Canada day 2) and things are falling into place. We have some internet connectivity so it is time to catch up on everything that has happened over the last several days. When our adventure was last updated, we were in Keene New Hampshire and enjoying a brief respite from the daily grind of loading, driving, and unloading everything. The animals seemed to enjoy the break almost as much as the humans.

Thursday August 14th
We got up and drove to the last US town prior to the Canadian border so we could get an early start with the border crossing escapade being well rested. As we headed further north we came to realize that there are some very desolate places in the United States, and northern Maine is one of those places. We stopped briefly in Augusta Maine to talk with the barn where the horses will board until the Canadian Transport can pick them up for the final leg of their journey. The barn owners were exceptionally grateful, and they had some very good advice before heading further north, stock up. We took the advice and are very thankful, because northern Maine does not really have any stops for gas or anything else once you head out from Augusta. We made it to Houlton Maine and spent a nice evening getting everything together for the morning.

Friday August 15th
06:00 We get up
07:10 Everything is loaded
07:40 Breakfast on the go and entering the ramp headed north on I-95
08:20 Arrive at the border
08:30 Finish the preliminary chit chat with the border guard
08:35 Begin work on the temporary worker visa
09:15 In the car headed north on Transcanada Highway 2

They did not check any of the contents of the vehicle, nor did they check any of the pets, not even the bird. This was far easier than we had thought it would be and the answer lies in the fact that the initial work visa is a one year visa. In the eyes of the Canadian government we are simply visiting for an extended period of time.

Well, that left us ample time to drive across New Brunswick and over the 13 kilometer bridge to Prince Edward Island and allowed us to arrive on the island at 2pm. After a quick stop at the visitor center to get a free updated map, we were headed “Up West” to Alberton to check out the new house.

Home Stinky Home OR Where is my Bed?
Well the house looks exactly as it did in the photos we had seen before, but there was a strange smell in the kitchen. It smelled of old fish and mold, and good lord, it is the refrigerator. It was apparently a refrigerator that was used to store old fish and the drip tray for the condensation had a nice thick layer of mold. It was clear from its condition that it had to go, so out comes the dolly, the restraining straps attached, and the fridge is out in the garage (but not without leaving a trail of slime across the floor). It took two rounds of cleaning before the smell was exorcized form the room. Well, one piece of furniture that we will need is a new refrigerator (put that on the “to do” list for tomorrow).

As we wondered through the house it became clear to us that certain rooms were going to have to be repainted in order to match any of our furniture. Additionally since three of the rooms had been painted specifically for children, they were going to have to be repainted on general principles.
As renters, we need permission before we alter the property so before anything was unloaded from the vehicles, we spoke with the owners to make sure we could make some changes to the property. Thankfully they felt the same way about the paint scheme, and had no real attachment to the fridge, so everything is going well.

As we settled in to sleep, we got a call from the driver who will be delivering our household goods and the arrival date has moved from Sunday the 17th to Tuesday the 19th. Well that is not so bad, but we do not have anything to sleep on except the floor. Wait, we do have a large dog bed form Orvis, and since the floors are all hardwood, that thing is starting to look pretty good. However, it will only sleep one comfortably, and so it goes to Nancy while I get the thin yoga mat. It was a pretty good night, we were both so tired we did not notice any difference between these beds and anything else we could have had, and we woke early (the sun comes up at 5:30) and started our day.

C+2
It has not been as eventful as yesterday but we have been out to see the stables where the horses will board, and we made contact with the driver who will be bringing the horses across the border. We also had the time to get into Charlottetown to get the new washing machine and fridge. As we were out running our errands, we got a call from the folks here on the island to make sure that we had arrived alright and that everything was in order. They were a bit shocked that we had slept on the floor overnight, and so by the end of the day they had set us up with a local hotel gratis until our household stuff arrives. I guess it is a dog’s life overnight.

Well, tomorrow starts the painting……

My God this is beautiful…..

So we have arrived in Keene, Hew Hampshire to spend some time with friends (Alli, Jesse, and Aaron Lewis), and I now understand why folks from the Northeast say Texas has no trees. This place is a forest and it is overwhelmingly green. The temperature s in the sweet spot as well with highs in the upper 70s to low 80s, and evening temperatures dropping into the 60s. If I were back in Texas I would say it feels like football weather but I am told this is simply the end of summer and not yet the fall.

New Hampshire also represents a stop in the action for us for the next several days. We have heard from our driver and he will not be to PEI to deliver our household goods until the 18th so we have some time to hang out and be cool. We will be leaving for the border on the 14th so we can cross without feeling rushed.

In other news, Nancy is adapting to being without the horses, she does not seem crazy, nor does she seem to be going through withdrawal, but it is still early. She did try to wear some high heeled sandals yesterday and that was a sight. She has not really had a need for such footwear for the last several years (horses and heels do not mix) and s she had to re-learn the art of walking in heels. This was complicated in part by the presence of many small rocks in the parking lot of the restaurant which caused her no end of trouble as she tripped and wobbled her way inside. By the end of the day she was doing a bit better and could walk with a minimum of stumbling.

Finally we had had our first casualty of the trip, the loss of the martini glasses. Alli had wanted us to bring the martini set so she and Nancy could have a few drinks while we were here, and we packed the glasses in with the other stuff we were bringing to Alli’s house (stuff to make Gumbo). Anyway, at some point during a hard stop to avoid cell phone chatting situationally unaware drivers from colliding with us, some heavy things fell over on the box and crushed the glasses. Thank god the shaker is made of stainless steel or everyone would have been sad. So it is off to the store today to find a couple more glasses which we will leave with the Lewis family for our return visits.

Link to the interview with the CBC.

Arriving before Sunset is so cool.....

Today we arrived in Harrisburg Pennsylvania and did so prior to the setting of the sun. It was wonderful to be able to drive in and see everything as we did, and to get here early. We had a good drive today and saw a great part of the United States, the Blue Ridge parkway.

So, we got out this morning from Charlotte North Carolina and in very short order we were in Virginia. We headed north until we hit interstate 81 and headed north until we got to Pennsylvania. We crossed through West Virginia and Maryland to get here, but really not enough of either of these two states to take much notice. The drive through the hills of the Appalachian mountains was very beautiful and the weather obliged us with just enough cloud cover to make it pretty, but not so much as to make is dark.

This is a part of the United States that Nancy and I have never seen and so alternated roles as driver and scenery observer frequently throughout the day. It was a slice of Americana, the typical and classical farm houses, the silos, the dairy cows. It was wonderful and we are very glad to have seen all of it.

In Harrisburg, we are staying again with the La Quinta chain and since we arrived early enough we were able to head across the street to have some very yummy calzones from Salvatore’s pizzeria. They were very good and we were exceptionally hungry having eaten light today because we were focused on making good time to our destination.

Being Interviewed…….

So, to follow up on yesterday, let me go back in time to Wednesday, the 6th of August. While we were in deep east Texas the phone rang and it was Brendon Elliot form the Canadian Broadcasting System wanting to speak with me about an interview. I am still not clear how he heard about me coming to the Island (Nancy says it just indicates how size of the island), but they had contacted Herb (the doctor that I will be working with on the island) and he gave him my phone number. So we set up a time on Thursday to speak when I would have access to a land line so he could get a good recording of the interview. The gist of the interview revolved around why a doctor would move from Texas to PEI. Nancy listened to half the interview (my answers) and she said it made good sense to her and that I did a pretty good job answering his questions about how we came to choose the island and the reasons behind the move (which are outlined in my prior posts). I will be curious to see what it ends up sounding like, and when I get to the island I will ask for a copy or a link so I can post it for anyone who might be interested (or exceptionally bored).
I will say that all the education that I had in Texas through the Texas Academy of Family Physicians really paid off during the interview. I felt comfortable and I remembered to allow for small silences instead of providing the very nervous “Uhm” that I am prone to use to fill in the gaps. We shall see what it sounds like after the editing. (Listen here)

Tomorrow we are off to New Hampshire ( a short drive through mountains) and then a few days with Alli.