Monthly Archives: September 2018

Arnav Agarwal is an Internal Medicine Resident (R1) at the University of Toronto. Check back the last Thursday of each month for a new featured piece as part of his series (Doc Talks: Reflections to Reality)!

 

"First of all," he said, "if you can learn a simple trick, Scout, you'll get along a lot better with all kinds of folks. You never really understand a person until you consider things from his point of view […] until you climb into his skin and walk around in it." — Harper Lee,To Kill a Mockingbird

This piece reflects a daughter’s internal struggle as she comes to terms with her mother’s suffering through delirium and terminal illness. Touching on the sensitive balance between seeking care and doing no harm, this piece provides an intimate perspective on the challenges many family members encounter in letting go of their loved ones during trying times of declining health, as well as on the difficulties involved in recognizing that ‘more’ is not always better — that, sometimes, less is more. ...continue reading

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Dr Margaret Rundle is a Family Physician practicing in Scarborough, Ontario

 

There is little dispute among care providers that a person’s dietary habits influence preventative and treatment outcomes. Every year, there is more research validating the role of food and therapeutic diets for chronic disease management and prevention. However, basic education around the role of nutrition and lifestyle for a long time has been a blind spot in the Canadian medical school system. ...continue reading

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Rebecca Lauwers is a medical student in the Class of 2019 at McMaster University

 

Empathy as invited, first. Still it knocks. Waits. Empathy sees the fogged glass but drags no fingertip across it. There is a grey field; can you, too, see suffering like a red coat in the distance, walking? Do not go charging. What is imposed is not empathy. Set the kettle on the stove. Stoke the fire.

Empathy as unattached. As tracking a runaway bride, who knows what it’s like to be in one moment Ready and the next hijacked by fear. Empathy as the lover who will follow anywhere... yet as fluid as the crowd that will part to allow for what must happen. Empathy as the veil acknowledging the ground it grazes, feeling out the terrain as it follows.

Empathy as seeing it all, somehow, at once. Guided by someone whose vision will narrow and widen and narrow, and — somehow — letting each momentary glimpse be the only thing it sees while watching still over shoulders, overhead. ...continue reading

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Ever wish you could ask a wise, kind, approachable Student Affairs Dean something without having to admit the question was yours? Maybe you think it’s cringe-worthy; maybe you feel like you should know the answer already; maybe you think you will be judged; maybe you’re sure you are the only medical trainee on the planet ever to have felt this way, and you need confirmation now.

Enter Dear Dr. Horton, a new feature on the CMAJ Blog. Send the anonymous questions that keep you up at night to a real former Dean of Medical Student Affairs, Dr. Jillian Horton, and get the perspective you need with no fear of judgment (rest assured, though — Student Affairs Deans in Canada are all really great people, and not only have they heard it all, but they take on these decidedly unglamorous, 24-hour call jobs because they really, really care about learners).

Submit your questions anonymously through this form, and if your question is appropriate for the column, expect an answer within a few weeks! ...continue reading

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Julian Nguyen is a medical student in the Class of 2019 at McGill University

 

Monday morning; flu season. The attending respirologist has spent the whole weekend on call battling the symptoms of influenza, likely caught from one of our many afflicted patients. Swallowing a Tamiflu pill, he tells me how—despite a hectic shift in the emergency room—he managed to complete a major grant application for his next research project. His voice is hoarse from coughing and exhaustion lies around the corner, yet his determination to carry on is unshaken. I admire his fortitude while hating myself for lacking his sense of sacrifice.

Michel Foucault, in his seminal Naissance de la clinique (The Birth of the Clinic), highlights the primordial role physicians occupy in a society predicated on science. He sees in physicians (and priests) “les héritiers naturels des deux plus visibles missions de l’Église — la consolation des âmes et l’allègement des souffrances” (the natural heirs of the two most visible missions of the Church — the consolation of souls and the lessening of suffering). Western society’s obsession with youth and health has elevated physicians beyond mere technicians to all-encompassing healers, increasing the burden placed on aspiring doctors. ...continue reading

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Austin Lam is a medical student at the University of Toronto

 

 

We often hear and use the term “patient-centred care” without having a precise definition in mind. In order to elucidate the meaning of this term, it is important to analyze the concept lying at its centre: the patient. What does it mean to be a patient? What is the core, essential definition of patient?

Some have argued for patient to be replaced with a different term. As someone who has undergone surgeries myself, I have reflected on the meaning of this word and its associated implications. My hope is that this preliminary analysis can help provide directions for future questions, emphasizing an open exploration rather than closing off areas of discussion. ...continue reading

Abhishek Gupta is a research and medical sub-intern at CAMH who graduated from the Windsor University School of Medicine

 

The controversial debate over cannabis legalization has concluded on an official level, legally placing the drug in the hands of the Canadian public. Very soon, anyone over the age of 19 will be able to walk into a store and obtain it for personal consumption.

For mental health professionals, some aspects of this decriminalization effort are appealing. Conventional marijuana is often laced with far more dangerous substances leading to highly dangerous health outcomes. Furthermore, individuals with substance abuse issues are more likely to seek professional help when the consequences of drug possession are milder. Much like needle exchange sites, this move towards legalization provides consumers with a safer alternative for addressing their cravings for cannabis. ...continue reading

Sarina Lalla is a medical student in the Class of 2020 at McMaster University

 

When McMaster medical students learn about medical conditions in a problem-based setting, we frequently use the mnemonic “DEEPICT” (Definition, Epidemiology, Etiology, Prognosis, Investigations, Clinical presentations, Treatment) to approach them. Medical schools focus on teaching students about these important aspects of diseases; with time and practice, this information can be retained and applied by students to make them better clinicians.

However, there is also value in understanding a disease through the eyes of patients. More specifically, it is critical to recognize how facing an illness and navigating the healthcare system impacts their lives. Patients are the experts on their own experiences, and the knowledge they can present in the form of stories can teach us a lot. While we learn how to interpret information in the form of bloodwork and imaging, patients present first and foremost with a story. ...continue reading

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Bader Alamri is an Internal Medicine Resident (R3) at Dalhousie University

 

Since 1978, more than 4,500 Saudi physicians and surgeons have been trained and have provided healthcare in Canada. These individuals have trained and practiced at many university hospitals across Canada over the past forty years, working within a very wide range of specialties—from general residency training to subspecialty fellowships, as well as very specific areas of research and clinical interest [1].

The Royal College of Physicians and Surgeons in Canada (RC) recently signed a Master Executive Agreement with the Saudi Commission for Health Specialties (SCFHS) to increase and improve the quality of training in Saudi Arabia, which reflects the long-standing relationship between the two parties [2]. In fact, the current SCFHS CEO is himself a Canadian-trained gastroenterologist at the University of British Columbia, and the current CEO of RC is a hematologist who established the first bone marrow transplant program in the Kingdom of Saudi Arabia. ...continue reading

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Katherine Atkinson is a PhD student at the Karolinska Institutet in the Department of Public Health Science.

Cameron Bell has a B. Eng from McGill and is the lead technical architect for the CANImmunize project.

Kumanan Wilson is a physician and senior scientist at the Ottawa Hospital, Professor of Medicine at the University of Ottawa, and lead at the Ottawa Hospital mHealth Lab

 

As they accumulate their “10,000 hours” of caring for patients or examining the health system, health care providers and researchers often come up with great ideas on how the system could be improved.  The advent of digital technologies and mobile apps has helped to tear down the barriers to introducing these newly devised solutions and created opportunities for a new breed of medical entrepreneurs.  You may want to build an app that will help you get critical information to your patients because you know this is why they are having trouble staying healthy.  Or perhaps you want to empower them to manage their own health care by tracking aspects of their health.  Or maybe you have an idea that could allow physicians to do simple diagnostic tests at the bedside using smartphones.

At the beginning of 2018, there were almost 100,000 health apps on the Apple iOS App Store and Google Play. Health and fitness apps are cited to have the highest user retention rates, engagement, and frequency of use ...continue reading