1 Comment

Domhnall MacAuleyDomhnall_Mac is a CMAJ Associate Editor and a professor of primary care in Northern Ireland, UK.


Dear Linda,

I have just read your book - or, should I say, it completely captivated me. I couldn’t put it down. What a compelling life story. When you lectured about depression at those Masterclass lectures I chaired years ago I was so impressed with your grasp of the topic, your understanding of the difficulties facing family doctors, and your overall approach to managing the condition. You had such a clear understanding and appreciation of depression and the difficulties of treating it in practice. And, you were so assured, confident, on top of your subject. I had chaired many similar sessions but yours were outstanding. There wasn’t even the slightest hint that your understanding extended so far into your personal experience. ...continue reading



It’s 1:15 am as I write this.

I’m tired. I’ve worked just under 17 hours today, but I can’t sleep.

Too bad. I will start at 8 am again tomorrow for another 8 to 9 hour day.

I can’t sleep because I’m thinking about my patient with the declining oxygen saturation. I worry that I may have missed something in the history, in the investigations… did the on call physician and I make the right decision?

...continue reading

bonnie-larsonBonnie Larson is Family Physician at Calgary Urban Project Society (CUPS) Health Centre


Recently I called the emergency department from my outreach clinic in an urban shelter.  Near the end of the day, the nurse mentioned that one of the clients staying there, a young aboriginal woman I will call Ms. Rain, was supposed to follow up on an abnormal lab result from a few days earlier.  As I looked the patient up on the ancient clinic laptop, I thought about the promise I had made to my daughter that morning to try to be home by suppertime.   I willed the computer to load the results a little faster so I could get home to my family.

Finally, several abnormal results, including an elevated D-Dimer, appeared.  ...continue reading

People who smoke tobacco may be interested in quitting, reducing their smoking or neither. Physicians can offer interventions for all of these groups. In this podcast interview, Dr. Robert Reid and Dr. Andrew Pipe – experts on smoking cessation from the University of Ottawa Heart Institute’s Division of Prevention and Rehabilitation – offer practical advice to guide physicians in helping their patients. They, and co-authors, have reviewed evidence on smoking cessation initiatives in an article published in CMAJ.

Full review article (subscription required): www.cmaj.ca/lookup/doi/10.1503/cmaj.151510


...continue reading

J_DuffinJacalyn Duffin is a hematologist and historian who holds the Hannah Chair in the History of Medicine at Queen’s University


Recently, I addressed first and second year residents in the Queen’s University family medicine program, during their annual retreat at Camp Oconto, near Sharbot Lake, Ontario. Roughly every other year for some time now, I’ve been asked to talk to them about my work on drug shortages and what drives them, my website (which I mentioned in my previous blog), and the mysterious causes, harms and  frustrations of drug shortages. ...continue reading

Domhnall_MacDomhnall MacAuley is a CMAJ Associate Editor and a professor of primary care in Northern Ireland, UK.


We publishing the wrong research and funding too many of the wrong studies. This was the general message from Adrian Bauman’s keynote address - "What gets published in physical activity research and why it seldom has an influence on policy" - at the Health Advancing Physical Activity (HEPA) conference.

The talk might have been about physical activity research but the message has resonance across medicine. If we really want to change medicine we really need to understand how researchers produce evidence and how policy makers interpret, or misinterpret, what is published. There is a significant mismatch between researchers’ objectives and policy makers’ needs. And, rarely heard in a medical context, Adrian was quite sympathetic to the needs of policymakers. ...continue reading

Stuart Kinmond reads the CMAJ Humanities Encounters article "Cutting through the shame". The article is written by Stephen P. Lewis, associate professor in psychology at the University of Guelph in Guelph, Ontario. In the article, the author reflects on a period of self-injury and what he learned from it.

Article (subscription required): www.cmaj.ca/lookup/doi/10.1503/cmaj.160119

...continue reading

berghDr Rod Bergh is a general pediatrician who has practiced medicine since the early 1960s.


I have practiced Pediatrics for most of the 59 years since I graduated from Medical School and I have seen tremendous changes in our knowledge. For the past 16 years, I have restricted my practice to children with ADHD and have experienced the great satisfaction of seeing in this period about 3000 children turn their lives around.

Change is based on knowledge gained by research. However, I would like to point out an area where I believe we have ignored evidence, which has resulted in some less-than-optimal therapy for ADHD.  ...continue reading

Physicians from many specialties may care for inpatients with opioid use disorder. An acute hospital admission is an opportunity to engage with patients who have this common, chronic disorder, discuss addiction treatment and possibly affect the course of their illness. In this podcast, Dr. Joseph Donroe, Assistant Professor of Medicine at the Yale School of Medicine, discusses the best approach to specific problems that may arise when a patient with chronic opioid use disorder is hospitalized for another reason. Potential problems include withdrawal symptoms and managing acute pain.

Dr. Donroe co-authored a review article published in the CMAJ (subscription required).

...continue reading


Daniel Bierstone

Daniel Bierstone

University of Toronto

Class of 2016

On the first day of my Social Paediatrics elective, I accompanied a nurse on a visit to a family shelter. I entered the single room and noticed a healthy newborn girl, sleeping peacefully in an old crib. The room consisted of a bed, a table, two chairs, a fridge, and a microwave. There was no stove, no kitchen sink. Clothes, toiletries, dishes and bottles were strewn everywhere. The floor was dirty and there was graffiti on the wall. One of the parents was present, but the other was out looking for work. It was my first time in a shelter, and I was stunned that a family with a newborn was living in such conditions.

...continue reading