Reflections

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Li (Danny) Liang is a second year medical student at the University of Toronto with a BEng degree and a deep interest in the intersection of urban design and health

 

Growing up in Toronto's suburbs, I slowly began to realize what was wrong with how much of the city is designed. Most of the neighborhoods outside of the downtown core are clearly designed for cars, instead of pedestrians and cyclists. Most neighborhoods in the suburbs, composed of a sea single detached houses with small oases of high-rises sprinkled in, are not very walkable nor bike-friendly. Getting from point A to point B by walking becomes a huge odyssey: it often took at least half an hour to walk to the nearest library, movie theatre, grocery store or community centre. The way the city is designed is also unfair from a social justice perspective, as most of the people living in the Toronto Community Housing apartments I lived in could not afford to drive. The overall low population density of Toronto's suburbs means that there is not enough ridership to justify building rapid transit to the clusters of high-rises in the suburbs that are drowned by single-family detached houses. ...continue reading

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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

 

In 2002 Donald Rumsfeld, then US Secretary of Defence, mused about what we know and don’t know. He suggested there are the ‘known unknowns’ – for example, we know we don’t know how life began – and the ‘unknown unknowns’ – the things we don’t even know we are ignorant about.

But he forgot one important category – the ignored knowns; the things we know but prefer to ignore. This is what Al Gore called the inconvenient truth and is the realm of the science denial industry. With the election of Donald Trump, who seems to make a habit of ignoring science, evidence and fact, we are entering an era of what Stephen Colbert called ‘truthiness’ back in 2005: ...continue reading

nichollsStuart Nicholls is a Clinical Investigator and Methodologist at the Children’s Hospital of Eastern Ontario Research Institute and Methodologist at the Ontario Child Health Support Unit (OCHSU). He recently attended the 66th Annual meeting of the American Society of Human Genetics (ASHG) in Vancouver

 

The ASHG annual meeting takes place every fall towards the end of October or in early November, as the leaves are changing from green to reds and golds. Every four years the meeting also takes place against the backdrop of the US presidential elections. In 2012, in San Francisco, when the meeting ran from the 6th to the 10th of November, I recall standing in the main hall as part of the opening ‘mixer’ event, where several thousand scientists watched a big screen projection as President Obama was re-elected to office.

This year's meeting, which ran from the 18th to the 22nd of October, took place against the backdrop of a very different election ...continue reading

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Domhnall MacAuleyDomhnall_Mac is a CMAJ Associate Editor and a professor of primary care in Northern Ireland, UK.

 

Dear Linda,

I have just read your book - or, should I say, it completely captivated me. I couldn’t put it down. What a compelling life story. When you lectured about depression at those Masterclass lectures I chaired years ago I was so impressed with your grasp of the topic, your understanding of the difficulties facing family doctors, and your overall approach to managing the condition. You had such a clear understanding and appreciation of depression and the difficulties of treating it in practice. And, you were so assured, confident, on top of your subject. I had chaired many similar sessions but yours were outstanding. There wasn’t even the slightest hint that your understanding extended so far into your personal experience. ...continue reading

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bonnie-larsonBonnie Larson is Family Physician at Calgary Urban Project Society (CUPS) Health Centre

 

Recently I called the emergency department from my outreach clinic in an urban shelter.  Near the end of the day, the nurse mentioned that one of the clients staying there, a young aboriginal woman I will call Ms. Rain, was supposed to follow up on an abnormal lab result from a few days earlier.  As I looked the patient up on the ancient clinic laptop, I thought about the promise I had made to my daughter that morning to try to be home by suppertime.   I willed the computer to load the results a little faster so I could get home to my family.

Finally, several abnormal results, including an elevated D-Dimer, appeared.  ...continue reading

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

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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.

...continue reading

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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