Reflections

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Dr. Dhruvin Hirpara is a General Surgery resident at the University of Toronto

Dr. Nancy Baxter is a colorectal surgeon at St. Michael's Hospital

Dr. Fayez Quereshy  a surgical oncologist at the University Health Network.

 

Colorectal Cancer (CRC) is the second leading cause of cancer-related death amongst men, and the third leading cause of cancer-related death in women in Canada. Although screening has contributed to declining incidence in the elderly, recent epidemiological data reflect a rise in CRC among young adults. Data from the Canadian Cancer Registry suggest a steady increase in young-onset (15-49y) CRC, from 745 cases in 1969 to 1475 cases in 2010. In Ontario, the incidence of CRC has been increasing in young adults (30-49y) since 2005, from 6.17 per 100,000 to 9.08 per 100,000 for colon cancer, and 4.31 per 100,000 to 6.29 per 100,000 for rectal cancer. Evidence from other jurisdictions, including France, Australia, and the United States reflects similar trends in the rise of young-onset CRC. Why this apparent increase in CRC among younger people? We don’t yet know the cause but theories point to an interplay of several potential factors.

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Alastair McAlpine is a fellow in paediatric infectious diseases at BC Children's Hospital in Vancouver

 

People sometimes ask me, "What’s the difference between medicine in Vancouver and medicine in Cape Town?" The answer is, quite simply, Everything.

But let’s rewind a bit. In July of this year, I flew the 20 or so hours it takes to get from South Africa to Vancouver. I arrived in the city by myself with 2 suitcases, knowing hardly a soul, and feeling completely overwhelmed. A few months earlier, I had been accepted into a 2 year paediatric (even the spelling is different) infectious diseases program at BC Children’s Hospital. Before coming I had filled out endless paperwork, done a million online courses ...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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Kevin Lam is a third-year medical student at McMaster University

Lawrence Loh is Associate Medical Officer of Health at Peel Region, Ontario, and Adjunct Professor at the University of Toronto Dalla Lana School of Public Health

 

Suburbs, and later exurbs, became central to the Canadian lifestyle during the automobile boom in the 1960s and 1970s. Cars were sold as the future and urban planners created suburban neighbourhoods that quickly became the primary venue where people lived and learned. Suburbs were touted to be cleaner and safer spaces, far away from “derelict” urban cores, where people went only to go to work. From this idyllic image, suburban built environments have since developed various distinct characteristics, typically defined by "commercial strips, low density, separated land uses, automobile dominance, and a minimum of public open space."

Having reshaped many cities in North America, the suburban model has gone global. Around the world, the suburban forms of major cities such as Mississauga (Toronto), Surrey (Vancouver), Limert Park (Los Angeles), Footscray (Melbourne), and Prospect Park South (New York) share these similar characteristics. But it’s becoming clear that suburban living doesn’t necessarily promote wellbeing. In fact, urban sprawl is not healthy. ...continue reading →

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Denis Daneman is Professor and Chair Emeritus in the Department of Paediatrics at the University of Toronto, and Paediatrician-in-Chief Emeritus at the Hospital for Sick Children in Toronto

 

Here’s a strong recommendation for all paediatricians and paediatricians-in-training: if you are going to read only one book in 2018, seriously consider Ghost Boy: The miraculous escape of a misdiagnosed boy trapped inside his own body, the autobiography of Martin Pistorius, co-written with Megan Lloyd Davies. The book was given to me by a colleague aware of my bibliophilia, my South African roots and my advocacy for child health: “Read this!” she said, simply and forcefully. I obeyed, picking it up a couple of days later. I could not put it down until I’d read it cover to cover.

The story is pretty simple: a 12 year old, previously well boy in South Africa, develops an undiagnosed neurological illness, which leaves him mute and quadriplegic ...continue reading →

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Kirsten Patrick is Deputy Editor at CMAJ

 

A week ago, André Picard published a column in the Globe and Mail entitled “How many people actually suffer from mental illness?” and later he tweeted his thanks to readers for making that column the publication’s most-read story of the day. The column may have been well-read - it certainly sparked controversy on social media - but it wasn't because Picard had anything very profound to say. In fact the piece was based on an epidemiological faux pas, which is why I called it a nothingburger.

Commenting on the findings of a poll commissioned by Sun Life Financial Canada, which found that 49% of Canadians have “experienced a mental health issue” at some point in their lives, ...continue reading →

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Jessica Dunkley is a PGY-4 in dermatology at UBC. She completed her family medicine residency at the University of Alberta

 

Every year, Match Day for CaRMS brings back heart wrenching memories for me.  It is a terrifying day for medical students who do not match to residency.  For many years medical students have placed all of their eggs in one basket - to get that one spot in residency.  Their entire lives of dreaming to become a doctor depend on that day. I matched to a competitive specialty only to be told that my disability – hearing loss - would not be supported in residency because it was different from medical school.  ...continue reading →

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Mark Soth is a mid-career academic intensivist in Ontario, Canada. He blogs as the Loonie Doctor about physicians' personal finance

 

We really have come a long way as a society in that "the talk" is not so much of a big thing anymore. We speak more openly about sex - the benefits, the pitfalls, and the repercussions both within our families and in our public institutions. It is no longer a major taboo. That was not always the case.

Historically, the taboo of sex has contributed to much misery. For example, when syphilis ran rampant around the world in the 16th century, many were denied care because it was considered “the wages of sin”. Of course, they treated syphilis with mercury back then, so that may have been worse. The advent of penicillin as an effective cure for syphilis in the 1940s was revolutionary, but it still did not eradicate the disease. With penicillin, education, and condoms - syphilis is much less common now, except on internal medicine exams.

Did all that talk about sex make you uncomfortable? Probably not. In fact, some medical nerds are probably chomping at the bit to correct me on some fact about syphilis.

"Let's talk about money." ...continue reading →

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Natasha Sarah Crowcroft is Chief of Applied Immunization Research at Public Health Ontario and a Professor at the University of Toronto in Laboratory Medicine and Pathobiology and the Dalla Lana School of Public Health. Her work aims to maximize the public health benefits of immunization.

 

It is good to celebrate anniversaries of major achievements in public health. The bicentenary anniversary of the publication of Dr. Edward Jenner’s paper on vaccination against smallpox, published in 1796, was celebrated on the cover of the 1996 edition of the United Kingdom’s (UK)’s immunization guide, marking one of the greatest achievements of humankind. Recently however we reached the anniversary of a publication that we might all rather forget.  Twenty years ago in February 1998, two years after the celebration of Jenner’s legacy, The Lancet medical journal published a paper describing a small case series of “ileal-lymphoid-nodular hyperplasia, non-specific colitis and pervasive developmental disorder in children”. The story has been described ...continue reading →

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Magbule Doko is a family physician in Windsor, Ontario, and an adjunct professor at The University of Western Ontario

 

 

Our decision, firm and dedicated
To become doctors: a noble profession
Long years of heads in our books
Clinical years of emotional turmoil
Oh yes you did not know
Their stories touched us, imprinted on our minds
We wept ...continue reading →