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 →
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 →
Sarah Silverberg is an R1 in OBGYN at UBC and an intern at St. Paul's Hospital.
Please let me take your history.
I know the triage nurse and the emergency physician already asked you many of these same questions. But humor me -- let me ask them too. After all, I was asked to see you by the emergency doctor who saw you. They knew I would ask you these questions, and felt it was necessary. They referred you to me, and like it or not, you’re now under my care.
I am the resident that was asked to see you. You ask me if you could see the real doctor. Unfortunately, I am the real doctor. At least, I am a doctor; one of the country’s medical institutions has granted me an MD. And while I know what you mean – that you don’t want to see the resident, and that you want to skip ahead directly to the attending – at this moment I can’t make that happen. My attending sent me down to see you because I’m the one on consult service. My staff is in the operating room, or managing the ward, or reviewing the three other consults we’ve been asked to see this evening with other residents and students. You’d be waiting a while longer if I didn’t see you.
We are challenged to embrace frailty and a disarray between mind and body when we encounter patients at the end of their life. As we seek to nurture a place of comfort and wholeness for them, we are tested to bear witness to their helplessness, to appreciate their intrinsic values not only as patients but also as people, and to preserve their dignity. Moreover, we are presented with an opportunity to appreciate the internal struggle of their loved ones as they are confronted with a disconnect between the person they have known and loved, and the patient we provide care for in times of declining health.
Penned based on the reflections of numerous families I met on the wards, this piece strives to give a voice to the struggles many encounter alongside their loved ones in the end of life.
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: