Author Archives: CMAJ

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Mark Speechley is a Professor of Epidemiology at Western University

 

The age-old debate over who should be addressed as ‘doctor’ lives again in recent letters to CMAJ. Of course, it is important not to confuse the public. Since more people get sick than get university educated, members of the public are more likely to have met a physician-doctor than a professor-doctor. As a PhD epidemiologist, ‘the population is my patient’. Consequently, when I meet my medical colleagues in the hospital, I do not expect to be addressed as ‘Doctor’, but should the whole population be in the hospital, and the crowding in the corridors be so acute that I would have the statistical power to practice my profession by expertly assembling the massed throngs of gurneys into long rows of cases and controls, or exposed and unexposed, as appropriate, I would most certainly expect to be addressed as such.  ...continue reading

Philippe Barrette is a psychotherapist, workplace facilitator and former Assistant Clinical Professor at McMaster University, Department of Psychiatry.

David Streiner is Professor Emeritus in the Department of Psychiatry and Behavioural Neurosciences, and the Department of Clinical Epidemiology and Biostatistics at McMaster University; and Professor of Psychiatry at the University of Toronto.

 

 

Halfway through, Roma, the 2018 award-winning film set in the early 1970’s, the audience is suddenly confronted with witnessing a stillbirth. The scene elicited audible gasps from some viewers in a screening we attended, when the perfectly formed, dead baby was removed from its mother’s womb.

In the film, Cleo, the nanny and domestic worker for a middle-class family living in Mexico is rushed to hospital following an emotionally draining 9 months. Cleo’s boyfriend abandoned her shortly after learning of her pregnancy, and the family have endured marital tensions and a separation.

After an initial examination the assisting physician at the birth says, “I can’t hear a heartbeat," ...continue reading

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Ally Istl is a senior General Surgery resident at Western University

 


 

The concept of Wellness in the professional medical arena has become a contemporary Gargantua that we are perpetually seeking to satisfy, but never able to sate. As other disciplines seek to make their trainees ‘Well’, wellness has also become a growing subject of exploration in surgical disciplines.

Wellness means different things to different people and formal definitions provide no clarity in the context of the medical profession: ‘the state of being in good health, especially as an actively pursued goal’ only provokes more ...continue reading

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Iris Gorfinkel is a General Practitioner, and Founder and Principal Investigator at PrimeHealth Clinical Research in Toronto, Ontario.

 

On July 10, 2018 Health Canada issued a recall of several products containing the blood pressure lowering drug, valsartan. This came in response to a disclosure from its Chinese manufacturer that the drug had been contaminated with a known carcinogen. A massive effort to contact patients to stop the affected drug lots, and to replace it with an alternative, ensued. Few clinicians had been even remotely aware that ...continue reading

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Emily Harris is the Business Manager for the Heart and Vascular Program at Unity Health Toronto – St. Michael's Hospital

 

Healthcare is a varied and multidisciplinary world. From clinical medicine to social work to data collection, expertise from many diverse specialties is required to ensure that hospitals run successfully and that patients receive the very best care.

The value of a collaborative environment in healthcare is ...continue reading

Simraaj Kaur Powar is a Family Medicine Resident at Western University Windsor Campus

Sukhbinderjit (Nikki) Powar is a Family Doctor in Mississauga

 

 

The concept of addiction,

Is it science-fact or fiction?

Sex, drugs, or alcohol,

Get involved, and you’ll lose it all.

 

Face the reality; time to confide and confess.

To get it off your chest or cause you more distress? ...continue reading

Cal Robinson is a PGY2 Pediatrics resident at McMaster University interested in how social determinants of health impact Canadian children.

 

On November 22nd, 2018, Ontario’s Progressive Conservative government unveiled their planned reforms of provincial social assistance programs, including changing the definition of disability for the Ontario Disability Support Program (ODSP). These announcements have been met with criticism from political and advocacy groups who argue that these represent further cuts to social assistance. Further policy announcements last year included a reduction of the planned 3% increase in social assistance to 1.5% and cancellation of the Ontario Basic Income Pilot, one of the largest minimum income studies ever developed. The Ontario Basic Income Pilot had already enrolled 4,000 low-income individuals across the province. These intended cuts to Ontario’s social assistance programs will have a substantial negative impact on the health of Ontarians, and will particularly threaten the physical, psychological and social wellbeing of Canadian children and their families. ...continue reading

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Marcy White is a writer and special needs advocate.

 

In just one year, my son, Jacob, was put on Bi-Pap in the PICU on four separate occasions. Only a respiratory therapist was allowed to put the device on him or make adjustments when he was in the hospital. On the first occasion, he was not allowed on any other hospital unit while dependent on Bi-Pap. On subsequent occasions, he could transfer to the General Pediatrics unit as long as his Bi-Pap needs remained stable but, should his Bi-Pap needs increase, he would be transferred back to the PICU. ...continue reading

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Courtney Bercan is community health nurse at a clinic in the Downtown Eastside of Vancouver

 

Years later, I still don’t want to think about it, let alone type it out. Three children, babies practically, dead before me. Their parents, dead beside them.

It has now been two years since I was on a Doctors Without Borders search and rescue vessel in the Mediterranean and it’s been a slow path, at times, to finding healing and peace for the things I saw and experienced there. As my life settled into a predictable rhythm, the memories started coming out of the blue and with intensity. They demanded attention. Normally, in Canada, the process of finding closure for a patient’s death, while not always easy, is not usually this difficult. There are mitigating thoughts and phrases to help you along the way:

“They were elderly and had had a good life.”

“We did everything we could.”

“At least now they are out of pain.”

...continue reading

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Sarah Tulk is a family physician in Hamilton, Ontario

 

Despite earnestly advocating for physician mental health, my own story has remained cloaked in secrecy. As a medical student, I felt far too junior to risk such a revelation. I watched as stigma, perpetuated by the hidden curriculum, kept my peers from seeking mental health care. Still, I kept my head tucked safely in the sand, and swore to break my silence in residency. However, as a resident the fear of jeopardizing job prospects maintained my mutism. I vowed to speak up when I was staff. Unfortunately, early in my staff career my advocacy efforts were smothered by fierce judgment and harsh consequences. I wholeheartedly renewed my vows with the ostrich approach and reconciled to start talking about mental health when I was protected by more seniority. I hated the secrecy and hypocrisy, but at least I was safe. Then I heard of another resident suicide. Then a medical student. Another resident. A staff physician. ...continue reading