Barbara Sibbald, News and Humanities editor for the Canadian Medical Association Journal, reads the CMAJ Humanities Encounters article "Cathartic narratives for chaotic thinking" (subscription required). The article is written by Dr. Richard Hovey, associate professor in the Division of Oral Health and Society with the Faculty of Dentistry at McGill University.

In the article, Dr. Hovey speaks from personal experience about life with severe chronic pain.

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Diagnostic delay of central nervous system tumours in children has serious implications for the children and their families. Dr. Ran Goldman, Pediatrician at BC Children's Hospital, Professor of Pediatrics at the University of British Columbia and Chief Medical Officer for the website medschoolforparents.com, discusses how practitioners can maintain a high index of suspicion for these rare tumours, yet not overinvestigate benign conditions.

Dr. Goldman co-authored a review article (subscription required) on pediatric central nervous system tumours published in CMAJ.

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TH - PHSPTrevor Hancock is a professor and senior scholar at the University of Victoria’s school of public health and social policy

 

In 2002 Donald Rumsfeld, then US Secretary of Defence, mused about what we know and don’t know. He suggested there are the ‘known unknowns’ – for example, we know we don’t know how life began – and the ‘unknown unknowns’ – the things we don’t even know we are ignorant about.

But he forgot one important category – the ignored knowns; the things we know but prefer to ignore. This is what Al Gore called the inconvenient truth and is the realm of the science denial industry. With the election of Donald Trump, who seems to make a habit of ignoring science, evidence and fact, we are entering an era of what Stephen Colbert called ‘truthiness’ back in 2005: ...continue reading

Barbara Sibbald, News and Humanities editor for the Canadian Medical Association Journal, reads the CMAJ Humanities Encounters article "First, do no harm" (subscription required). The article is written by Dr. Sarah Tulk, a family medicine resident at McMaster University.

In the article, Dr. Tulk reflects on the time she treated a terminally ill patient in the emergency department.

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jack_westfallJohn M (Jack) Westfall is a Professor of Family Medicine and Director of the High Plains Research Network. Dr Westfall will be speaking at the forthcoming North American Primary Care Research Group (NAPCRG) annual meeting.

 

The High Plains of eastern Colorado have been referred to as a dwindling remnant of the “worst hard time”, reminding us of a not too distant past that included the dust bowl and westward out-migration to the West Coast. Rural Colorado has become mostly a crop-circle curiosity or a time to “put your seat into the upright and locked position” for the thousands of travelers that fly over at 30,000 feet. The small town of Last Chance, Colorado sits at the junction of 2 blue highways. It is home to just 22 residents.

Last Chance once had a Dairy King and 2 gas stations, and was for many, the last chance for food and fuel before heading east into the vast open plains of eastern Colorado. ...continue reading

CSE_photoshot_KPKirsten Patrick is Deputy Editor at CMAJ. She is currently attending the North American Primary Care Research Group (NAPCRG) annual meeting in Colorado Springs, CO.

 

In the plenary session on providing primary care for refugees, one of the speakers, Kim Griswold, shared an image, now familiar to many, that is designed to help people to understand the difference between equality and equity. It demonstrates how some people start off at a relative disadvantage and need extra help to be able to achieve or access things that more advantaged people are able to experience equityeasily. This image, and similar ones, have been criticized by some social justice thinkers who point out that ...continue reading

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author-pictureJeremy Zung

University of Toronto

Class of 2016


Taut sheets as cotton fetters

In curtained cloister bare

Enshroud the shrivelled limbs

Whose fingers flex in fetal curl

'Round liquid sleep.

---

Masked messenger in priestly white,

Hath divined th'encircling doom?

My fallen airways, Medusa's veins spell

Agonies untold.

 

Lips pursed, throat tight, and orbits sunk,

You scrabble to set me free

Of serpent tubes and catheter lines

Ensnaring, strangling me.

 

But stenotic hours, austerities

Have hemmed you in too far.

I fault you not, dear Hermes, but quick--

Prescribe your closing mercy:

 

The noose which crowns your chiselled neck can't

Auscultate mute screams.

I pray: release these sesame pupils to

Spelunk Elysian dreams.

Domhnall_MacDomhnall MacAuley is a CMAJ Associate Editor and a professor of primary care in Northern Ireland, UK. He is currently attending the North American Primary Care Research Group (NAPCRG) annual meeting in Colorado Springs, CO.

 

Not many primary care doctors have an 8 billion dollar budget. Mitch Katz, who gave the opening keynote address at NAPCRG 2016, is director of the Los Angeles County Health Agency which combines the Departments of Health Service, Public Health and Mental Health into one service. He continues to see patients and described how he had become so specialised in his career in a primary care AIDs clinic in San Francisco, that he found returning to generalist practice extremely difficult. When he focused on AIDS he was on top of his topic like any specialist, but, as a generalist, he had to cope with anything from a heart attack to broken heart.

Los Angeles, until recently, had no ambulatory care ...continue reading

griswoldKim Griswold is Associate Professor of Family Medicine, Psychiatry, and Public Health and Health Professions at Jacobs School of Medicine and Biomedical Sciences in Buffalo, New York. Dr Griswold will be speaking at the forthcoming North American Primary Care Research Group (NAPCRG) annual meeting.

 

Communities in every nation are faced with providing competent, equitable and culturally appropriate services for resettling refugees. Health centric disciplines are not enough to meet the challenges presented by these newly arriving populations, nor to alleviate the disparities they face – such as isolation, limited English proficiency, differences in patients’ attitudes and health literacy levels, and a lack of cultural awareness on the part of providers.

Health inequity can be defined as: “unjust differences in health between persons of different social groups.” ...continue reading

spottieKevin Pottie is Associate Professor of Family Medicine and Epi & Community Medicine at the University of Ottawa, as well as co-Chair of the Canadian Collaboration for Immigrant and Refugee Health, and a family physician at the Immigrant Health Clinic of Ottawa, which he helped to found. Dr Pottie will be speaking at the forthcoming North American Primary Care Research Group (NAPCRG) annual meeting.

 

My residency training in Ottawa began with a wave of refugees from El Salvador and Guatemala.  Most conflict-affected refugees - Somali, Sudanese, Congolese, Karen, Bhutanese, Colombian - come quietly and settle rapidly in our communities.  And, even in instances when the media cover the arrival of large waves of refugees, such as the Vietnamese boat people or the recent Syrian war victims, the refugees themselves settle quietly in our communities.

In the early 1990s, it felt almost revolutionary to care for refugees. There were few primary care practitioners trained and ready to lead ...continue reading