Author Archives: CMAJ

Kacper Niburski is a medical student in the Class of 2021 at McGill University. He is also the CMAJ student humanities blog editor.

 

 


murphy’s sign

yellow on the horizon

with a dark more total than

fingers moving in small steps

and smaller spaces

an ambulance is in the distance

your breathe is on my neck

what is this gall

how do you hold me

with all your living

...continue reading

1 Comment

Austin Lam is a medical student at the University of Toronto.

 

 


The importance of mental health has rightly been emphasized in recent times. The stigma surrounding mental illness ought to be dispelled. However, I wish to take a closer examination at the conceptual elephant in the room: the mind-body problem — a philosophical issue that strikes to the core of continuing disparities between how the healthcare apparatus as a whole addresses “mental” versus “physical” health conditions.

As medical historian Roy Porter pointed out in his book The Greatest Benefit to Mankind: A Medical History of Humanity (1997): “psychiatry lacks unity and remains hostage to the mind-body problem, buffeted back and forth between psychological and physical definitions of its object and its techniques.” This was a prescient remark. In 2018, the editor-in-chief of Dialogues in Clinical Neuroscience, Florence Thibaut highlighted the mind-body problem and the challenge that it poses for psychiatry: “recent advances in neuroscience make it more and more difficult to draw a precise line between neurological disorders (considered to be ‘structural brain disorders’) and psychiatric disorders (considered to be ‘functional brain disorders’).”

To begin, let’s analyze the statement — Mental health is health.  ...continue reading

This week’s edition of Dear Dr. Horton” is a general response to the many excellent questions that were submitted in response to the CMAJ call-out for the “Med Life with Dr. Horton” podcast. Find it originally here: https://cmajblogs.com/horton-podcast-carms-interviews/


Dear classes of 2019,

Ah, CaRMS…that beloved hybrid of Survivor and The Bachelor.  You want to be the last one standing, but hopefully that doesn’t mean accepting a proposal that will become your new personal definition of hell.

I’ve coached hundreds of students through the CaRMS process over the years. My approach draws on my experiences as a long-time clinical teacher,CaRMS interviewer, Associate Program Director, Associate Dean, Royal College committee member, Royal College exam coach, and my interest and expertise in communication, cognitive error and mindfulness.  One thing I’ve learned: there are wrong ways to answer questions, but there is no universally right way.

Some interviews start with a variant of that dreaded question, “Tell us about yourself.”  Too frequently, students use that precious first impression to regurgitate dry information that is already included in their CV.  That’s a sure-fire way to get lost in the crowd.

I counsel students to spend time considering how they will structure this question.  It’s always helpful to open with what I think of as an editorial statement.  “I’m so pleased to have the opportunity to be here with you today.  When I reflect on this question, I think there are three things that help give you a window into who I am as a person.  The first thing is X.  The second thing is Y.  The third thing is Z.”

How do you settle on the content of X, Y and Z?  I recommend looking for your three best positive anchors.  Perhaps you are from a small town, in which case X might be your deep sense of community.  Maybe you’re a runner, and Y is that you are a person who has a long game philosophy in life.  Maybe you’re a person who grew up in tough socioeconomic conditions, or you have spent a lot of time in volunteer roles, and Z boils down to your personal commitment to social justice.   ...continue reading

Abhishek Gupta is a medical sub-intern with CAMH, who graduated from Windsor University School of Medicine.

 

 


Hear Ye, Hear Ye

A song of mental health for all,

In dark times and vanishing grace,

Give light and cushion a fall,

Where suffering is hidden,

And discourse forbidden,

Now, to change rules unwritten,

I pray, lend your ears to listen!

 

Where actions and mood were once controlled,

Now, fits of mania, blues, highs and lows, ...continue reading

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)!

...continue reading

Welcome to this week's edition of Dear Dr. Horton. 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. Submit your questions anonymously through this form, and if your question is appropriate for the column, expect an answer within a few weeks!

Dear Dr. Horton,

I've experienced the death of patients before — but this one feels different. I can’t help but think of small things we spoke about, like their dogs and their season tickets to the theatre. How do you navigate the intersection of professionalism and mourning another human you felt connected to?

Signed,

Mourning in Secret

...continue reading

Noémie La Haye-Caty is a medical student in the Class of 2019 at McGill University

 

Katy is sleeping on the exam table. She came in looking tired, talking with a weak voice, and walking with small steps. I tried to ask a few questions, but her lack of sleep was evidently preventing her from answering.

She is here today for a follow-up appointment. She was admitted two weeks ago because she wanted to end her life.

I try to gently wake her up. “How are you doing, Katy?”

“Better.”

“Great! What’s better?”

“I was confused, before.”

“Why were you confused?”

Katy is 24 years old and has three young children. She is now a few weeks pregnant. Two of her children were recently taken by the Director of Youth Protection (DYP), while the youngest lives with Katy and Katy’s own mother. Katy tells me that the father of her kids used to be violent with her and has been in prison for the past week. ...continue reading

Danielle Penney is a medical student in the Class of 2021 at McMaster University

 

“Doctors are jerks.” It was a statement that I had always steadfastly believed to be true; a matter-of-fact statement, just like saying the sky is blue. Though I had no shortage of concrete personal examples to justify my belief, the irony was not lost on me as I stared out from behind the glass of the nursing station, ready to begin my first clinical experience as a new medical student.

I was in the child and adolescent psychiatric ward. From the nursing station, I could see the ward’s common area: the bolted-down tables and chairs, the colourful pictures adorning the walls, the patients scattered about the room—some in groups, some alone. It was a scene that was familiar, yet different. This was far from my first time in a psych ward, but it was my first time being on this side of the glass. ...continue reading

1 Comment

Curtis Sobchak is a medical student in the Class of 2019 at the University of Toronto

 

It is well-known that workplaces strive for diversity and inclusion. Studies have shown that diversity improves productivity and contributes to creativity and new ideas. In medicine, this diversity is just as important. Having physicians from under-represented and marginalized communities provides unique views on what may be best for the patient. As medical schools continue to support new initiatives, such as specialized admission pathways for African American and Indigenous students, it is clear diversity is on the agenda. However, for those who are not of the majority ethnicity, diversity may not be enough. There also needs to be representation.

This idea was at the forefront of my mind during an elective rotation. After I had mentioned my interest in Indigenous health a number of times, I was asked by my attending whether I was of Indigenous background. I understood the hesitation, of course; sometimes it can make people feel uncomfortable to ask about your background or where you are from. Nonetheless, I was happy they had asked and I responded with a firm “yes.” ...continue reading

1 Comment

Sahil Sharma is a medical student in the Class of 2020 at Western University

 

It was my first week on service for internal medicine as a third-year clerk. I had finally begun to figure out the labyrinth of charts, forms, and computer apps that went into my interactions with patients. I still had four of the eight pens I’d started with and had managed to misplace my sacred “pocket guide” only twice — so, all in all, I was off to a good start.

I was told by my senior to go see a patient who was in ICU step-down and had recently been transferred to our care. I hurriedly went to the computers and started reading up on the patient’s history.

Mr. C had a long and complicated history. He had initially presented to the hospital with signs of cholecystitis but later developed multiple complications landing him in the ICU. After a flurry of resuscitative measures and close monitoring, Mr. C was finally deemed stable enough to be transferred to the ward. ...continue reading