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

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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).

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2 Comments

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.

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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

 

Some of the fundamental principles of our health-care system — universal access to a comprehensive range of services in a system that is publicly administered — are threatened by the court challenge being mounted by Dr. Brian Day. But there is no smoke without fire.

Back in the 1990s, I organized study tours for Swedish health-care managers interested in learning from Canada’s health-care system. In introducing them to the system, I would point out that we do not have a national health-care system, as they do in Sweden, the U.K. or many other places.

Instead, we have ...continue reading

David Cawthorpe is a Professor (Adjunct) in the Faculty of Medicine at the University of Calgary, Alberta

 

By the end of this month the 22nd International Association for Child and Adolescent Psychiatry and Allied Professions (IACAPAP) Congress will have come and gone. As this will have been its second congress hosted in Canada since 1954, it is perhaps time to take stock.

In Istanbul, in 2008, our team got its first whiff of tear gas and we won the 2016 bid; it was the beginning of an exciting journey, wherein the hope was to form a national community around this torch, a mental health Olympics for children and adolescents. Did we succeed? A good question. Regionally, we hoped to gain access for at least 1000 participants who would never otherwise have the opportunity to attend such a world class event. Did we achieve this or will this congress have been just another big business venture? The proof will, no doubt, be in the residual pudding! ...continue reading

irisIris Gorfinkel is a General Practitioner and Founder & Principal Investigator of PrimeHealth Clinical Research in Toronto, Ontario

 

I’d been attending this particular patient’s medical needs as her GP for the past five years.  Enid dressed impeccably, was a young 85 years of age and had the amenities that most elders dream about.   She had her health, financial security, education and a strong intellect.  What she was missing was companionship.

“If only I had someone to travel with,” she lamented.

Hardly 24 hours later, I was asked to see Fred who had been my patient for 7 years.  He was a robust 87 year old, financially secure, well educated, and possessed a marvelous sense of humor.  He had remained active despite having lost his partner to lung cancer the year before.

 “I miss having someone when I travel,” he told me.

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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

 

Our health care system is not the only, and not even the most important determinant of the health of the population. But it is a determinant, and thus any threat to the proper functioning of the system is a threat to health. One such threat is the court case that started this week in the BC Supreme Court, in which Dr. Brian Day and others are seeking to overturn some of the fundamental principles on which the system is based.

Day co-founded the Cambie Surgery Centre in Vancouver in 1996; in essence it's a private hospital with a number of operating rooms, offering a wide range of surgical procedures. There is nothing wrong in principle with a private hospital. Most Canadians don’t seem to realise this, but much of our care is provided through privately-owned clinics – that is what your doctor’s office is. ...continue reading

genevieve2015-msgDr Genevieve Gabb is a Senior Staff Specialist in General Medicine at the Royal Adelaide Hospital in Australia; she also works at the Veterans Heart Clinic, Repatriation General Hospital, Daw Park,  in ambulatory cardiovascular medicine.  Genevieve has an interest in drug safety, particularly in relation to medicines commonly used in the prevention and treatment of cardiovascular disease

 

We have scientific consensus that global temperatures are rising.  Despite this, debate and argument continues about whether global warming is occurring, the extent, possible causes and potential solutions to the problem.

In early January 2013, as this debate continued to rage, the Australian Bureau of Meteorology was confronted with a dilemma. Forecast temperatures were so extreme that they exceeded the colour range available for its isotherm charts.  Isotherm charts are used to indicate temperature across the continent, and have lines that join points of equal temperature.  Different colours, starting with cool blues; increasing to yellows and a deep burnt orange are used to show areas of similar temperature.  An ominous, solid black topped the scale, indicating a temperature of 50 degrees Celsius. ...continue reading

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

 

“I want to quit my chemo. I can’t take the nausea. My drug is not available and the other things just don’t work.” It was November 2010 and in front of me sat a 50 year-old widowed mother of two with uncanny, pale green eyes and stage IV cancer; she shook with nerves and defiance. Her support drug was prochlorperazine, which has been around as long as I have. “That’s impossible!” I said and picked up the phone to call her pharmacist. He sounded weary, but politely explained that there was none left in the entire city. “But,” he added, “you can prescribe XXX.” Well, although XXX is fancy, new, and expensive, it did not work for my patient. I smelled a rat.

We quickly discovered that this “shortage” was just one of many that had been increasing ...continue reading