Stephanie Choquette is a medical student in the class of 2020 at the Northern Ontario School of Medicine
Public health is most often understood as “...the science and art of preventing disease, prolonging life, and promoting health through the organized efforts of society”. Its scope is broad and encompasses both physical and mental health. We are often attuned to the ways these efforts are not meeting the needs of our patients, and to the public-health crises that continue to plague us (pun, intended). Fifty-six long-term drinking water advisories remain on public systems on First Nations Reserves in Canada as of September 3rd, 2019. Although a significant reduction from previous years, this indicates that many Indigenous Canadians still lack access to clean drinking water. In Thunder Bay, an HIV outbreak affecting predominantly the homeless population was declared in June 2019 within the context of an ongoing tuberculosis outbreak. News coverage regularly includes threats to public-health programs and funding, and concerns from within the field about changes to public-health organization and infrastructure. During my Public Health and Preventive Medicine elective at the Interior Health Authority in Kelowna, B.C., I discovered that no matter how distant that fifth-floor board room might seem from the exam table in my future, public health is changing the lives of individuals for the better every day. ...continue reading →
This dynamic executive committee will create policies and direction to foster the growth and development of our new national, health humanities organization. A lot has already been accomplished thanks to the diligent work of our colleagues, students and friends. Over 1000 people have attended our annual Creating Space conference since its inception eight years ago. We have funding for three years from Associated Medical Services, which is being used in part for start-up costs, including administrative support. The CAHH website is also operating and a conditional constitution has been posted for members’ review. ...continue reading →
Maria Powell is an Internal Medicine Resident (R1) at the University of Calgary who graduated from medical school at Memorial University of Newfoundland in 2017
Admittedly, my social histories used to consist of the same three questions: Do you smoke? Do you drink alcohol? Do you use recreational drugs? I would occasionally ask if the patient worked outside the home, or what they did for income, but the question rarely came up when reviewing consults with resident and staff physicians so I did not routinely ask about it. One thing I am sure of: I never asked whether or not the patient had a home.
During my first two years of medical school, I had lectures on the social determinants of health, and I thought I understood their importance. Yet, it was not until I did a “Health of the Homeless” elective in downtown Toronto that I truly appreciated the impact of the social determinants of health. ...continue reading →
Prasham Dave is a medical student in the Class of 2018 at the University of Ottawa
Sunken eyes my burden and a blazing smile my shield,
My patient burned under baleful fluorescence—purified en blanc.
My breaths were shallow. His shallower still.
I was haggard and he was in shambles,
I was shuffling and he was frozen,
I was ash and he was a husk. ...continue reading →
I’m tired. I’ve worked just under 17 hours today, but I can’t sleep.
Too bad. I will start at 8 am again tomorrow for another 8 to 9 hour day.
I can’t sleep because I’m thinking about my patient with the declining oxygen saturation. I worry that I may have missed something in the history, in the investigations… did the on call physician and I make the right decision?
On the first day of my Social Paediatrics elective, I accompanied a nurse on a visit to a family shelter. I entered the single room and noticed a healthy newborn girl, sleeping peacefully in an old crib. The room consisted of a bed, a table, two chairs, a fridge, and a microwave. There was no stove, no kitchen sink. Clothes, toiletries, dishes and bottles were strewn everywhere. The floor was dirty and there was graffiti on the wall. One of the parents was present, but the other was out looking for work. It was my first time in a shelter, and I was stunned that a family with a newborn was living in such conditions.
The 20th International Epidemiology Association World Congress being held in Anchorage, Alaska, this week is focusing on global epidemiology in a changing environment, and particularly, delegates are discussing and learning about the epidemiological effects of climate change. While much research being presented in concurrent sessions and posters is the usual mix of national and regional epidemiology (infectious diseases, nutritional diseases, cancer…), and epidemiological methods research (always interesting to a journal editor), the ‘circumpolar perspective’ is the subject of many sessions. What is happening in the world’s frozen regions as a result of climate change?
It may or may not surprise you to hear that people who live in areas that are frozen year-round aren’t high-fiving each other about the mean increase in temperature of 3°C. They aren’t throwing off their traditional fur clothing in celebration. This is because communities are being destroyed by warming in polar regions. ...continue reading →
I’ve come back to competitive swimming in the last couple of years, as a Master. Although I enjoyed a youth spent in the water, I can't fully identify with the T-shirt slogan I've seen this week, “I used to be faster; now I’m a Master!” I didn't find myself motivated to set competition goals when I was 14, sadly. Having had a pretty good 2013/14 training season I am about as fast as I was when I last competed as a teen. Last week I had the opportunity to compete in the 15th FINA World Masters Swimming Champs in Montreal, Canada, which someone told me is the largest aquatic event to be held in the Americas, ever.
While some things do not change – e.g. familiar anxiety, with its negative consequences – aches and pains are more worrisome than they were 25 years ago, ‘recovery’ is slower, and, since improving as you age is pretty unlikely, my main (and realistic) aim is to slow the rate of decline rather than to ride a trajectory of gradual improvement.
That said, this week, I’ve seen some truly inspiring swims, and also some nigh-unbelievable race times achieved by swimmers who are a lot older than me. The oldest participant in the 3km open water event was an incredible 87. The oldest participant in the pool swimming division was a 97 year old lady who had traveled from New Zealand! She looked 75. There were women in the 90+ category in all the swimming events INCLUDING the 400m individual medley and the 200m butterfly (in which one aged 90 set a new world record of 8min 52sec ....I couldn’t swim 200m fly NOW so the thought of swimming fly for nearly nine minutes at the age of 90 boggles the mind!). There were two 95-year-old men and there were men in the 90+ categories in most events. A lovely 87 year old man from my club competed and won a pair of silver medals. There were some pretty old participants in the diving category too. Scary to watch.
Looking at the results I can dream that if I work really hard at slowing the decline (to a rate of zero…okay who am I kidding?) I could, for example, swim the 200m individual medley in my current time at this meet in 20 years time – and medal!
Clearly these inspiring seniors are a healthy lot, enjoying the benefits of partaking in regular aerobic and strength-building exercise over many years. Yet it seemed to me that there are benefits of competitive/club exercise, aside from direct cardiovascular health related ones, when you are growing older. If you are introverted like me, being in a sports club helps you to connect with people in a less-stressful way than regular socializing. I see the power of the swim club in the way that the older members of my own swim club care for and encourage each other. I’ve seen it at the Masters Champs. Most people are not there to win, or to medal. Most are team mates who have made a journey half way around the world together. They have fun with each other and support each other, cheer each other on, say ‘Good job!’ even if a swimmer comes in way off their PB. At other, more accessible, events I have seen swimmers in the over-80-&-90 years age categories that are in wheelchairs on poolside, who can still swim a race and may hope to set a new record.
On the last weekend of #FINAMasters2014, we shared Parc Jean Drapeau with festival-goers attending the Heavy Montreal event. It made for an interesting contrast. Hundreds of lean, older, healthy, lightly clad athletes drinking fruit smoothies, alongside thousands of heavy metal fans wearing heavy jackets in the hot sun, arriving on Harleys, drinking mainly copious alcohol and filling the air with tobacco and marijuana smoke. Populations drawn from different demographics.
That got me thinking about the older competitive swimmer demographic, or at least the crowd that managed to get themselves to the World Champs. We’re looking at a privileged bunch – that much is clear. They have enough money to travel a long way to compete. They have enough leisure to put in hours and hours of training; many can afford to hire personal trainers to help them with land training as well as pay fees that come with Masters swim club membership (registration with a Masters club was a requirement for entry). Some could afford to bring their spouses and kids along too. I noticed that the only competitors who came from Africa were from South Africa and Egypt. The majority came from Canada (‘home country’) and the United States, with large contingents from wealthier European countries, Japan and Australia. South American countries were quite well represented. I didn’t see a single black person competing (although I’m not saying I saw every competitor), which seemed odd.
So when admiring the obviously superior health and wellbeing of Masters Swimmers, it is prudent to remember what’s known about the associations between socio-economic advantage, good health and longevity. I’m still in awe of the 80+ and 90+ year old swimmers who came to compete at Worlds this year. They are an inspiration. I hope to be a 90-year-old competitor myself someday. That’s a good intention to have. “If you can’t beat ‘em outlive ‘em,” they say 😉 Yet I recognize that alongside all effort of training hard and eating healthily, the long term health of my body depends on other factors, too, like my income, many childhood advantages, education, genetic factors, and luck. I’d like to develop another intention, too – to encourage people who don’t think swimming is ‘for them’ to try it. Hopefully, by the time I’m competing in the 80+ age groups, Masters swimming will represent a broader demographic.