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fall 2017

DOCTORS life + leisure

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Just for C

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DOCTORS life + leisure

contents

fall 2017

fall 2017

Publisher Linh T. Huynh

Editor Barb Sligl

Art Direction BSS Creative

Contributing Editor Janet Gyenes

Editorial Assistant Adam Flint

Contributors Cover photo

Michael DeFreitas Janet Gyenes Dr. Chris Pengilly Manfred Purtzki Dr. Kellen Silverthorn Barb Sligl Roberta Staley Rich Warren Barb Sligl

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Senior Account Executive Monique Nguyen Account Executives Janice Frome Wing-Yee Kwong

Production Manager Ninh Hoang CE Development Adam Flint

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clockwise, from top left: Janet Gyenes; barb sligl; Janet Gyenes

Just For Canadian Doctors is published four times a year by Jamieson-Quinn Holdings Ltd. dba In Print Publications and distributed to Canadian doctors. Publication of advertisements and any opinions expressed do not constitute endorsement or assumption of liability for any claims made. The contents of this magazine are protected by copyright. None of the contents of the magazine may be reproduced without the written permission of In Print Publications.

FEATURES

15 Go west and deep into China’s mountainous fringes 28 Find peace in the bustling heart of Québec City COLUMNS

DEPARTMENTS

8 the thirsty doctor

5 Fall mix 21 CME calendar 37 sudoku 38 small talk

A different kind of terroir

10 motoring Going hybrid

12 pay it forward Finding resilience upon working with MSF to improve women’s healthcare

Dr. Heather Gottlieb

14 photo prescription

In Print Publications 200 – 896 Cambie Street Vancouver, BC V6B 2P6 Canada

The beauty of Bermuda

34 the wealthy doctor

www.justforcanadiandoctors.com

Printed in Canada.

36 doctor on a soapbox want to reach us? check out our website!

Tips for tackling the new tax laws [Un]incorporation is looming

cover photo At the Jade Temple in Shanghai, China, where old and new meet (page 21). After exploring urban contrasts, go far west to Sichuan (page 15).

Fall 2017 Just For Canadian doctors

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from the editor

Back to school

In the mountains of Sichuan and the Tibetan Autonomous Prefecture, profound connections are made (page 15).

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Any ideas, comments or questions? Reach us at feedback@InPrintPublications.com.

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Just For Canadian doctors Fall 2017

janet gyenes

deep into

sudoku 1 easier solution 2 8 1 3 5 7 4 9 6 3 4 9 6 2 8 5 1 7 6 5 7 1 9 4 8 2 3 4 7 6 5 1 9 2 3 8 1 2 5 4 8 3 6 7 9 8 9 3 2 7 6 1 5 4 7 1 8 9 4 2 3 6 5 9 6 2 8 3 5 7 4 1 5 3 4 7 6 1 9 8 2

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solution from Summer 2017 contest

china solution from page 37

e all have preconceived notions of destinations. It’s easy to assume things about unfamiliar people and places. Much of the joy in travel is about serendipitous discovery, finding out that something’s not as expected. Yes, we can still learn something new and be surprised. In the far reaches of China, on the Tibetan plateau and amidst the mountains of the Sichuan region, surreal lakes are explained with fantastical stories and ornate temples hang above steep valleys. Jagged peaks puncture the skyline instead of spiky skyscrapers and the air is crisp and clear, allowing unreal colours to shimmer unfiltered (page 15). Simply put, China may not be what you think. Nor is Luther in Germany. There’s much more to the legendary figure who challenged Christianity 500 years ago with his revolutionary take on religion. Whether you’re interested in Lutheranism or just good beer, this monk’s old stomping grounds are worth discovering (page 5). Similarly, the Augustinian nuns who established Canada’s first hospital in Québec City have much to share (these were no timid nuns). Their monastère is now open to the public as a fascinating museum and hotel/retreat, where you can practise yoga and meditation or simply set up base in the heart of this country’s oldest city (page 28). Learn something new in this issue and the next time you travel and set foot on distant shores. Travel is life-long schooling.

sudoku 2 harder solution 6 9 7 4 3 1 8 5 2 8 4 1 7 5 2 3 6 9 3 2 5 6 9 8 7 1 4 7 3 2 1 4 5 9 8 6 1 8 4 9 6 3 5 2 7 5 6 9 2 8 7 4 3 1 2 1 3 5 7 4 6 9 8 4 5 6 8 2 9 1 7 3 9 7 8 3 1 6 2 4 5

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what/when/where > Fall

style | food | drink | festivals | places | getaways | gear…

500 years

Long live

A tour of this monk’s old stomping grounds reveals the man who founded Lutheranism— and enjoyed good beer

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his October 31 marks the 500th anniversary of the day Martin Luther nailed his 95 theses to the church door in Wittenberg, Germany, an action that’s now seen as the start of the Reformation. No matter your faith, that’s a pretty big historical deal. Nevertheless, you may well think—as I did—that Martin Luther isn’t all that interesting. But since he lived and worked in towns in eastern Germany that remain picture-perfect and seemingly unspoiled by time, you may well decide, as I did, that a trip to Germany is warranted this year. Think of it as Reformation tourism, while enjoying a dark beer in the famed Auersbach Keller in Leipzig or a Thuringian bratwurst in Eisleben, the town where Luther was born. Start in Erfurt, the town where Luther became a monk, just to wander through its astounding city centre, marvelling at the architecture of one of the most intact medieval and Renaissance cities in Europe. Not far away is one of those amazing German hilltop castles, Wartburg Castle, high above >>

Germany calling

Luther

mix

barb sligl

castle hideaway

Lutherstube, Luther’s room, in Wartburg Castle, where he lived for two years to avoid persecution and translated the New Testament.

Fall 2017 Just For Canadian doctors

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mix

greenhouse

Fall

fantastic

getaway

forest

You could be forgiven for feeling like Alice when you enter Botanist in Vancouver’s sample Fairmont Pacific Rim hotel. This new wonderland is composed of a restaurant, terrace garden, champagne lounge and a bar and cocktail lab, all surrounded by a profusion of plants (more than 50 species), like lush vines twisting up trellises and greenery from BC’s backyard. As its name suggests, Botanist embraces the bountiful Pacific Northwest in its cuisine and cocktails. On a recent visit, head bartender David Wolowidnyk, who dreamed up the cocktail menu with creative beverage director Grant Sceney, took me far down the rabbit hole, telling me the tale of three culinary-driven beverages crafted in the Cocktail Lab (a first for Vancouver) and served exclusively in the bar. “Gin is my favourite kind of vodka,” he quips, revealing the base spirit for the Pretty Bird, a coral-coloured cocktail served in a bird-shaped borosilicate glass that’s perched in a tangled nest. Clarified strawberries (they’re spun in the lab’s centrifuge) lend colour and sweetness to the cocktail, while dill seeds add spice. Ocean, a gin-based cocktail infused with sea buckthorn and blue algae is served in a Dali-esque glass bowl flowing over a piece of driftwood. Named for local spot Deep Cove, it’s a striking shade of blue. Curious and compelling describe my favourite cocktail crafted in the lab: Candy Cap Magic. Made with rye infused with the rare local candy cap mushroom, it’s presented inside a lantern, nestled into a bed of moss. Dry ice, made on demand in the lab, creates a wreath of mist in this fantastical forest diorama (see photo on page 8). botanistrestaurant.com —Janet Gyenes

Wartburg Castle left The famous church door in Wittenberg below left St. Mary, the first Lutheran church, in Torgau below right Thuringian Schwarzbier or black beer

travel back in time

>> the charming town of Eisenach. It’s where Luther hid out after the pope declared anyone could kill him without punishment. In Torgau, a town associated with Luther’s wife and where the first Protestant church is located, you’ll also find the oldest toy store in Germany. In Wittenberg, where Luther spent the bulk of his career, stand on the threshold of that famous church door. And then stop at the restaurant/bar, now called Zum Schwarzen Baer, where Luther left a substantial unpaid bar tab when he died. Along the way, you may begin to see Luther in a new light—as I did. It’s hard not to feel a touch of connection with him when you see the very tomb he laid atop in the shape of a cross the night before his ordination, the whale’s vertebra he used for a footstool while he translated the New Testament into German, the pulpit where he preached 3,000 sermons. You can see all those things in Erfurt, Wartburg Castle and Wittenberg—all within about 150 kilometres of one another.

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And you’ll discover another side of Luther, a lively and playful character who initially wanted to reform the church and make it more accessible to the people, not start a new church altogether; a music lover and composer who inspired Bach; a devoted father and doting husband; a gregarious partier; and a learned scholar whom people trekked across Europe to hear at a time when a day’s journey was some 30 kilometres. Stand in front of his monk’s cowl at the Luther House in Wittenberg and you may be able to visualize the man who once wore it. Even across five centuries, it’s still possible to get a vivid sense of a complex man who, quite by accident, changed history. Lutheran or not, proselyte or atheist, history buff or beer devotee, go to Germany this fall, or in any of the ensuing years during what the Germans are calling the Luther Decade. You’ll end up becoming quite intrigued if you go For more about Lutherby Martin Luther— related celebrations, just as I did. events and destinations, —Rich Warren go to visit-luther.com and for more on Germany: germany.travel

Just For Canadian doctors Fall 2017

Far left, clockwise from top left: ©WittenbergKultur e.V./Tourist-Information Lutherstadt Wittenberg; barb sligl (2); Wolfgang Sens; bottom right: courtesy of Fairmont Pacific Rim

sip +


flower power

Fall

botanical bliss

mix

Harness some flower power with these fresh finds Written + produced by Janet Gyenes

editor’s

pick

Bare essentials There’s a powerful purity in Tiffany & Co.’s collections. Its new artisanal fragrance is no different, distilled down to the 180-year-old company’s trifecta of basics: bare skin, a scent, a touch of jewelry and one iconic colour. Master perfumer Daniela Andrier has captured the spirit of Tiffany’s legacy in this floral musk fragrance, using essences such as iris (inspired by an iconic Tiffany garnet-and-Montana sapphire brooch—grand prize-winner at the Paris Exposition in 1900), the embodiment of femininity and sophistication, complemented by base notes of sensual patchouli. The bottle itself is a sparkling showpiece; the facets at the base of the glass flacon were inspired by the cushion-shaped brilliant cut 82-facet 128.54-carat rare yellow Tiffany diamond. 50 ml eau de toilette, $120; Holt Renfrew, holtrenfrew.com

scent two

a boun of bloo ty ms

scent of a woman

Peacetime perfume Noble rose, patchouli, vetiver. Bliss in a bottle. Until you know where these aromatic ingredients come from: Afghanistan, Rwanda, Haiti. Barb Stegemann, founder of Halifax-based The 7 Virtues, was inspired to support these war-scarred nations (as well as the Middle East) by sourcing fair-market essential oils for her perfumes support farmers in their peacetime scent torebuilding For instance, the company one pays $8,000efforts. US for a litre of neroli (orange blossom oil) that’s used in its Afghanistan Orange Blossom perfume. It’s incentive to farmers to stop growing poppies that go into the heroin trade. Various fragrances, from $70; The 7 Virtues, the7virtues.com

Femininity unfurled “I wanted a green fragrance, a courageous scent that transports you to a vast garden filled with many flowers and plants, a bouquet of abundance,” says Alessandro Michele, describing his inspiration for Gucci Bloom, his debut perfume for women. The Italian scent fashion designer and Gucci creative director compares the three garden to a beautiful woman: wild, colourful and diverse. Michele worked with master perfumer Alberto Morillas who blended the scent from tuberose and jasmine (jasmine-bud extract also gives the fragrance its green essence) plus an inimitable flower from South India, Rangoon Creeper, which is making its first foray into perfumery with wild abandon. 30 ml eau de parfum, $90.00; Sephora, sephora.ca

Fall 2017 Just For Canadian doctors

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the thirsty doctor janet gyenes Janet Gyenes is a magazine writer and editor who likes to dally in spirits, especially when discovering something like corenwyn jenever (a gin-like Dutch spirit)—straight or in cocktails like the “bramble.” Have a boozy idea or question? Send it to feedback@inprintpublications.com

Local infusion

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he cloak of conifers in the Pacific astringent sloes to flavour gin, it’s an example Northwest’s untamed forest was my of elevating an ingredient that’s amply availchildhood playground. Those woods able and would otherwise be ignored. offered up curiosities like plate-sized funCall it “regional quirkiness,” to borrow a guses growing on the side of a mossy tree phrase used by a writer describing how, until or edible treats: a motherlode of sweet-tart 2006 Campari used to get its vivid red colour huckleberries that I picked by the ice-cream from a natural pigment called carmine, also bucketful. The dark-blue salal berries that known as crushed cochineal beetles. He hang in orderly rows between the shrub’s was writing about connoisseurs’ quests for waxy green leaves tasted mealy to me, but liberating long-forgotten vintage spirits from both of these foraged their dusty crawlspaces and how these timeforest gems have less tipples simply taste different than their become supportmodern-day versions thanks to their ing—if not star— locavore ingredients, many of which ingredients in cease to exist. of the forest…is stirred “Regional quirks” might be comup in the Candy Cap parable to the term terroir that’s used Magic cocktail from the almost exclusively in the wine world. Botanist (also see Soil, climate, terrain—they add up to a deep sense of place you can taste page 6) in the finished product. And it’s these regional characteristics that define what gets to be called Champagne or port, for instance, and protected by law. Ingredients, of course, play a part in the fiercely protectionist spirits industry: consider Scotch, tequila and bourbon. Distilling is about history and authenticity, but also differentiation, especially in today’s saturated marketplaces. All are driving forces behind TazaRay, the world’s first spirit distilled from sunflower seeds, at Dalton Moonshine Distillery located in the Appalachian Mountains in northsmall-batch spirits. Using foraged or hyperwest Georgia. The Butler family business local ingredients during distilling seems to wasn’t always legal, but it was borne out of be part trend and part throwback. survival. “There were mouths to feed, and For instance, when I first sampled Limited you could make a whole lot more money Gin, made by Bohemian Spirits in Kimberley, making moonshine than selling corn or jelly,” BC, the distiller told me he was a forester in is how Raymond Butler Sr. puts it. TazaRay is a previous life. To me, that amply explained a portmanteau of the Native American word why he was using wild botanicals such “Taza” that translates to “warrior and chief” as fir tips, cottonwood and my beloved (homage to Butler’s roots) and “ray” in reverhuckleberries, among others. He was botence to the spirit of the sun. The 74-year-old tling the essence of the forest. To wit: “All master distiller continues his family’s East hand-harvested in the Rocky Mountains, in Tennessee tradition of making moonshine, our backyard,” according to the manifesto now in Georgia, sticking to the family’s old on Bohemian’s website. Odd Society Spirits methods but changing up the ingredients. in Vancouver, BC similarly bottles a bit of the “We changed the recipe a little bit,” says woods (in limited-edition batches) using the Chuck Butler, Raymond’s son, describing salal berries I shunned as a kid in its West how his father always used malted sunCoast take on sloe gin. Like the Brits who use flower seeds as the primary grain in his

TERROIR

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moonshine, along with malted wheat. For TazaRay, the wheat was replaced with corn (some malted and some milled but no more than 35% in total), creating an original and gluten-free spirit. “The flavour the sunflower seeds gives is a nutty finish real similar to a peanut,” says Chuck. “We age this unique product in used whiskey barrels to make a mild smoky flavour.” Another offering is TazaRay Red, which is aged in used red-wine barrels “to give a darkred colour a mild berry taste and a strong nutty finish,” says Chuck. Both products are bottled at 90-proof. Lucky Bastard Distillery in Saskatoon, SK, hasn’t been around for multiple generations like Dalton Moonshine Distillery, but prairie pride and local flavour underpin the microdistillery’s spirits, especially the Saskatoon berry liquor. The province’s capital city, after all, was named for the anglicized Cree word misâskwatômina that means “the fruit of the tree of many branches,” according to the Saskatooon Berry Institute. Farther east, Montreal-based Cirka Distillery’s spirits are an expression of “ici,” the French word for here. Precisely Québec’s terroir—water, grains and botanicals—embodied in the distillery’s two spirits: Vodka Terroir and Gin Sauvage. Vodka Terroir is distilled from 100% nonGMO corn grown in Québec and the “wild” in Gin Sauvage comes from more than 30 botanicals that infuse the spirit, found in Québec’s boréal forest. Bartenders, too, are getting in on the action. They’re not necessarily distilling spirits but infusing them with locally foraged ingredients. David Wolowidnyk, head bartender at Botanist in Vancouver’s Fairmont Pacific Rim hotel (see page 6) infuses rye with the candy cap mushroom for one of the bar’s signature cocktails. For me, it was a savoury sip of the West Coast woods. And upon reflection, perhaps a taste of my childhood terroir. Trend or throwback? It’s worth sampling the wilder side of distilling, whether savouring Saskatoon berry moonshine in the Canadian prairies or sipping sunflower liqueur in the Appalachian Mountains in northwest Georgia.

fairmont pacific rim

A taste of terroir is making its way into small-batch spirits


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motoring

D r . k e l l e n s i lv e r t h o r n Dr. Kellen Silverthorn is Just For Canadian Doctors’ automotive writer. He tries to keep one convertible and/or one track-day car in the family fleet.

Powered up

A

nyone with a passion for motoring must take an active interest in the electrification of our collective fleet. By nature I’m not an early adapter, nor a tech geek. Nor could I envision living with the range limitations of a fully electric vehicle (EV). However, as the newer plug-in hybrids gain in effective electric range I’m curious if that technology might fit my lifestyle. As a fortuitous coincidence the new Chrysler Pacifica Hybrid is re-invigorating the minivan segment. A cherry-red Pacifica Hybrid arrived for a one-week stay at the Silverthorn household. My only instruction was “the cord is in the

the new standard?

back.” Indeed the cord plugged easily into my home 110V wall plug and then into the Pacifica itself. A fully depleted Pacific Hybrid battery pack is 100% recharged to 56 km of range after 14 hours of 110V charging, or just two hours on 220 volts. I’m inherently too lazy to bundle the cord with me to seek out public re-charging stations on my travels. After all, a key plug-in hybrid feature is zero range anxiety. The Pacifica’s dinosaurjuice-fed V6 internal combustion engine kicks in once the 56 km of stored-wall-juice energy is spent. We live a 10-to-12-minute drive from our “to-do list” commercial district (groceries, gym, bank, take-out food). A return trip to this district depletes 24% of the Pacifica’s charge. Farther in the same direction is 2017 Chrysler Pacifica Hybrid

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Just For Canadian doctors Fall 2017

downtown, usually a 20-to-25-minute drive from home. A return trip downtown spends 50% of a fully stored charge. The airport and big-box stores are 30 to 35 minutes away with faster speed limits. A Costco return trip just drains the last ampere from a full charge upon my return. Thus, with a little pre-planning, the plug-in Pacifica meets all of our local metropolitan needs off an overnight recharge on 110V wall juice. So the Pacifica Hybrid can perform the utilitarian role required of our household…but how pleasant of a tool was our platinum-trim model to use? It drove quite reasonably for its intended mission. Its sight lines are great. It has an entire suite of modern safety and convenience features. Fit and finish aren’t Lexus-like, but they aren’t bad either. A sampling of standard “platinum” features includes navigation, leather seats (both heated and cooled), multiple DVD players with headphones, a serious Sirius radio and active noise cancellation. The latter auditory features are nice to have. Once the 56 km of wall juice is exhausted the “Electronically Variable Transmission” means the V6 gasengine noise and the vehicle’s speed profiles are not in cosmic harmony. The Pacifica’s badass stereo drowns that disharmony out nicely, which I fittingly figured out while the Sirius Classic Vinyl station belted out The Low Spark of HighHeeled Boys by Traffic. If needed, the Pacifica can swallow far more people and gear than a comparable priced SUV. The Pacifica will ride better too, despite hauling around 600 pounds of 12 KV battery. At present, no Pacifica of any kind is available with all-wheel-drive. The minivan stigma and the AWD non-availability may give some car shoppers pause but before holding onto those thoughts, let’s talk capital and operating costs. The price premium of the plug-inhybrid Pacifica over a similarly equipped dino-juice-only Pacifica is hard to determine given differences in standard equipment.

For argument’s sake I’ll posit that the hybrid driveline capital cost is $2,000 more, though I suspect it’s far less. I’m paying $1.25 per litre for dino juice and $1.70 per 12 KW for wall juice. I’d spend $1,750 less on juice per year with the Pacifica Hybrid over the dino-juice-only Pacifica at our 15,000 km per year usage—assuming 90% of our driving is metropolitan on 110V wall juice. The cost/price scenario gets far more complex (and attractive) depending on where in Canada you live. The Pacifica’s hybrid design qualifies for the same substantial taxpayer-funded green purchase/lease rebates as a full EV in the three provinces with rebate programs: $14,000 in Ontario, $8,000 in Québec and $5,000 in British Columbia. If you live in one of these three provincial jurisdictions your fellow provincial taxpayers are going to subsidize your capital costs for this vehicle handsomely to then save you even more operating-juice dollars! Present and future carbon taxes will also fall less heavily on plug-in-hybrid drivers. What’s not to like? Alas, no cash contribution from Justin’s feds to green vehicle buyers just yet. Interestingly, The Donald has not yet cancelled the generous federal rebates to green car buyers in the United States. Have you noticed the giddy happiness of electrified car owners? I now understand it after my Pacifica Hybrid experience. Good ol’ cognitive dissonance is no doubt at play, “I made this alternative choice, so it must be good, because I am no fool.” Another is the “pre-paying effect.” We’ll enjoy each day of our St. Bart’s vacation far more if we paid for it all six months prior, than if we paid as we consumed each flight leg, each night’s hotel stay, each beach towel, each meal. The EV or plug-in hybrid is the prepaid version of the St. Bart’s vacation. But that’s not all. My own personal halo actually looked ever-greener as the week with the Pacifica Hybrid unfolded. Saving the planet is always laudable. Saving greenbacks while saving the planet is a no-brainer. Still not sold? Last perk: How much would it be worth to you for HOV lane access 24/7/365 and free use of toll highways? I’m just sayin’ the latest in plug-in hybrids are ponder-worthy.

FCA/Fiat Chrysler Automobiles

The Pacifica Hybrid packs a lot of perks into its minivan profile


pay i t f o r w a r d

r o b e r ta s ta l e y Roberta Staley is an award-winning magazine writer and the editor of the Canadian Chemical News, published by the Chemical Institute of Canada. She is also a magazine writing instructor at Douglas College and a graduate student at Simon Fraser University.

Birthing hope

F

or women in the developing world, birth can be as deadly as war, with obstetrical medicine sometimes paralleling the emergency interventions undertaken by military physicians on the front lines of battle. Dr. Heather Gottlieb of Nelson, BC, is an obstetrician-gynecologist who was often confronted with life-and-death emergencies this past spring during a six-week mission to Jahun General Hospital in northern Nigeria, with its Médecins Sans Frontières Dr. Heather (MSF)-run maternity Gottlieb (second from right) during a MSF mission (for more on Dr. Gottlieb, see page 38)

and vesico-vaginal fistula (VVF) units. Gottlieb’s main responsibilities at Jahun Hospital, where 800 babies per month were born, included vacuum deliveries, helping complicated breech births and undertaking surgeries like cesarean sections. Gottlieb would also monitor the pregnancies of women who had undergone fistula repair, scheduling a c-section near their due date to preserve the integrity of the vaginal surgery. Fistulas occur in women who endure a long, difficult birth that damages the vaginal wall, resulting in leaking feces or urine, a malodorous condition often resulting in excommunication from the community. The women who live in this region of Nigeria are Hausa, one of Africa’s largest

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ethnic groups. Birth control is forbidden and women will bear 10, 11 or 12 babies in a lifetime—with only a handful of children surviving into adulthood. Such fecundity breaks down the reproductive system: blood ceases to clot properly, uterine distention causes placental abruption, which kills the fetus, while the exhausted uterus loses the ability to contract, leading to hemorrhage and death. In such situations an emergency hysterectomy is often needed. “You can’t stop the bleeding and have to take extreme measures to save the woman. You rarely ever see this in Canada,” says Gottlieb, who performed six emergency hysterectomies on patients during her stay. “I didn’t lose a patient on the table.” Exacerbating these dire situations is the cultural obligation to seek permission from the husband before medical interventions can be performed. “Overworked” nurses have to try to find the husband, or track down another male family member who can sign off on the life-saving procedure. “The woman has no say in her care and that’s challenging to wrap your head around,” Gottlieb says. Pragmatism must prevail. “You are in their land and you have to abide by their rules.” The autocratic control of women by men, as well as other cultural traditions and malnutrition, means that pregnancy for Nigerian women can be deadly. According to the World Health Organization, the 2015 maternal death rate in Nigeria was 814 out of 100,000. In comparison, Canada had seven deaths per 100,000 pregnancies in 2015. Causes of maternal death at the MSF hospital, says Gottlieb, included eclampsia, renal failure, sepsis, pulmonary edema, hemorrhagic shock, severe anemia, heart failure, ruptured uterus, pulmonary embolism and stroke.

The Hausa culture has other puzzling traditions whose origins—lost in the passage of time—contribute to the shocking death rate. Traditionally following birth, women are fed a high-salt diet for 40 days. They are also kept wrapped in blankets—despite temperatures that reach 40°C. This leads to peripartum cardiomyopathy, a rare type of heart failure associated with pregnancy. One in 100 Hausa women experience peripartum cardiomyopathy; in other parts of the world the rate is one in 4,000, Gottlieb says. As part of her stay, Gottlieb participated in MSF village-outreach sessions to communicate how such tragedies can be prevented. They must first establish contact with the elder males. If the men are interested and give permission, the MSF group can then discuss prevention with the elder women, then the birth attendants and lastly the pregnant women themselves. “It’s a process to infiltrate the community in a culturally sensitive way. You can’t go in and say, ‘What you’ve been doing this whole time is wrong and you are killing your women.’ That just closes the door. It’s a delicate balance.” Nigeria was Gottlieb’s second mission with MSF. Previously, she had journeyed to Peshawar, Pakistan, to work in an MSF obstetrical hospital. Here, women and babies also suffered enormously, due largely to the widespread abuse of oxytocin at private birthing clinics, where the drug is administered to hasten delivery, causing infant death and uterine ruptures. Being on the frontlines of the neverending women’s war: pregnancy, birth and the chronic, ubiquitous negligence and ignorance surrounding it, has instilled in Gottlieb a steeliness that readies her for daily life-and-death emergencies. “I have this resilience and confidence in me to deal with challenges and adapt and overcome— rather than fearing what might walk in the door every day.” Gottlieb is also inspired by the strength of her Nigerian patients. “I saw so many women on the verge of death walk out of the clinic. Their bodies can be pushed, I think, because they have a really strong spirit. Going through that journey with them and sharing that experience—it’s very humbling.”

courtesy of Dr. heather Gottlieb

And drawing resilience from the frontlines of a never-ending women’s war


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p h o t o p r e s c r i p t i o n m i c h a e l d e f r e i ta s Michael DeFreitas is an award-winning photographer who’s been published in a wide variety of travel publications. With his initials, MD, he’s been nicknamed “doc,” making his photography prescriptions apropos.

Bermuda beckons

As Mark Twain wrote in his diary, “You go to heaven if you want, I’ll stay in Bermuda”

destination photography

From beach to 17thcentury ruins, capture the Caribbean charm of the island of Bermuda

go fish

Bermuda’s connection with the Gulf Stream makes it a fisherman’s dream. As an avid fisherman, I always try to wet a line when travelling. Fishing action shots work best when you capture the excitement on the face of someone hooked into a fish. Shoot from below the angler with the rod pointing to a top corner of the frame to accentuate the action. I use a wide-angle zoom with a shutter speed of 1/500 second to get a sharp image.

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if you go

For more info on Bermuda: gotobermuda.com

michael defreitas

S

culpted by ocean currents and wind, Bermuda pops up from the Atlantic Ocean about a thousand kilometres off the coast of North Carolina. Lying well within North America’s temperate latitudes, Bermuda exudes all the characteristics of a Caribbean tropical paradise with its warm and shallow emerald waters, exquisite beaches and an African and British colonial history dating back to the early 1600s. On my first morning I hiked down to Horseshoe Bay Beach and set up my tripod and camera about 30 minutes before sunrise. Shooting directly into the sun tends to underexpose foregrounds, so I positioned the sun at the edge of my frame and overexposed (+1 stop on my exposure compensation). I used a fairly fast speed of 1/125 to almost freeze the wave as it rolled over the flat beach, allowing just a little movement. Then I walked to the other end of the beach and composed a shot of someone’s footprints heading into the sun. The footprints formed a leading line directing the viewer’s attention into the image. I returned later in the late afternoon and shot the beach from the high cliff on the south side of the bay with the sun behind me. Most people think that the fishhookshaped country is only one island, when in fact it’s an archipelago of about 180 islands. Twenty causeways and bridges connect the eight largest islands that form Bermuda proper, so as you travel around the country you’re actually moving from island to island, each with its own distinct characteristics that I tried to incorporate in my images. Fort Saint Catherine, a UNESCO World Heritage Site, perched on the northernmost point of St. George’s Island, affords an opportunity to incorporate the island’s history with the tropical topography. A mid-morning shot provides good light on the fort, the beautiful beach below and surrounding turquoise waters. Earlier or later in the day would provide better light on the fort and beach, but render the beautiful water dull. After capturing your exterior shots, go inside the fort for a wonderful museum documenting the country’s history. The country’s National Museum and Royal Naval Dockyards, continued on page 32


travel the world

Spirit of Sichu an Deep in southwest China, within the region of Sichuan and atop the Tibetan plateau is a secluded and enigmatic land. Engage, connect and navigate selfie sticks amidst much beauty‌ + photography by Janet Gyenes

story


travel the world

16

Just For Canadian dentists September/October 2017


travel the world

G

lancing nervously to my right, I see the muscular shoulders of the mountains leaning against the milky-green Minjiang River in Sichuan province in southwest China. If the massive yak I’m reluctantly sitting astride decides he’s had enough, he could launch me over the railing with little more than a shrug. Aside from that, I could almost pretend I was in the Canadian Rockies range overlooking one of its glacier-fed rivers. I remind myself that this stoic beast is not some mechanical bull I’m trying to ride in a country bar. So I smile at his wrangler, who’s holding my iPhone, spreading my arms wide open as if to say, “You win.” I had tried to persuade the thin man wearing a cowboy-like hat to pose beside the animal, but he wouldn’t budge—until I agreed to get into the saddle. “He’s a show yak!” one of my travelling companions declares. She’s right. The animal’s white coat is immaculately combed. Red pompons adorn his thick horns and his saddle is swathed with silky fabric. He’s not unlike a giant stuffie you win at the fair. Indeed, yaks are prized pack animals here in the remote reaches of the Aba Tibetan and Qiang autonomous prefecture. This encounter is one of many eye-opening stops on a bus ride that started in Chengdu, Sichuan’s capital, and travelled north on Highway 213, tracing the Minjiang River, a thin thread pinched between the Minshan and Longmen mountain ranges. I’m part of a group of North Americans headed to Jiuzhaigou Valley National Park, then driving through a 4,000-metre mountain pass to reach Huanglong National Park. These are just two of the country’s 52 UNESCO World Heritage Sites. Only Italy has more with 53, but it shares many sites with other countries. I can quickly rattle off many of Italy’s natural and manmade wonders. China’s? I can barely think of any besides The Great Wall, much less pronounce their names or pin them to a map. China is often characterized by superlatives and broad brushstrokes, but it’s impossible to define the DNA of a country of 1.38 billion people, spread across a region just slightly smaller than Canada, solely by its opaque political system and modern megalopolises that are pincushions of skyscrapers shrouded in smoggy skies. As Confucius said, “Real knowledge is to know the extent of one’s ignorance.” My consciousness-raising began on the outskirts of Chengdu, just before I met the yak, when our guide Thea Yang pointed out the Dujiangyan Irrigation System, which supplies water to the Chengdu plains. The World Heritage Site was constructed in the 3rd-century BC and is the only surviving no-dam irrigation system on the planet. Yang also points out previous page Huanglong Ancient Temple, Huanglong National Park. top row from left Panda Lake, Tibetan village, woman in traditional

Tibetan attire at Five-Colour Pond; all Jiuzhaigou Valley National Park. bottom row from left Fish in Panda Lake, Jiuzhaigou Valley National Park; Yak and Minjiang River, Highway 213; Tibetan prayer flags. Fall 2017 Just For Canadian doctors

17


travel the world


travel the world

a giant statue of Li Bing, the system’s engineer and designer. Nearby is Fulong Temple named for Li’s feat in “suppressing” an evil dragon to free the area from floods and harness the Minjiang River, a tributary of the Yangtze, Asia’s longest river. We’re not far from Wenchuan county, the epicentre of the devastating 8.0-magnitude earthquake that left 87,000 people dead or missing in 2008. Passengers on the bus drift to sleep, but I can’t rip my gaze from my window on this world. Every blink reveals another rapid-fire snapshot that lasts an instant before being subsumed by the next. In the villages, white homes have wooden fretwork surrounding their windows, garlanded with bright-red chili peppers. It’s an Instagram-worthy shot that, with the right filter, could easily be one of southern Spain’s pueblos blancos or white towns. Then there are Tibetan prayer flags strung in their unwavering order of five colours—blue, white, red, green, yellow—fluttering perpetually and sending spiritual vibrations to the heavens. Distant stone watchtowers and tombs are ominous relics of ancient times. I spot a woman embroidering. Another is braiding her long black hair. Men shovel and smooth concrete. Chicken strut and peck dangerously close to traffic. We pass restaurants with monstrous decals of chickens, yaks and whiskered fish beckoning (or terrifying) from their dusty windows. At another roadside stop I buy a bag of dried yellow cherries with sticky stems intact and watch vendors tend to eggs steeping in tea-like liquid, corn cobs bubbling in hot water and lumpy yams roasting on a metal grill. Near Qiang we stop for lunch and feast on local vegetables—peppers, mushrooms, cabbage—roasted in clay pots and swimming in soups, chicken seasoned with lip-numbing Sichuan peppercorns, plus delicious jerky-like yak. We continue northward to Jiuzhaigou Valley, if you go named for the nine stockaded Tibetan villages To learn more about in the area and famed for its old-growth Huanglong National Park, forests, ribbon lakes and glacial valleys that Jiuzhaigou Valley National Park soar to 4,752 metres in the southern Minshan or Sichuan’s other scenic spots, Mountains. Here, we board another big bus go to the Sichuan Tourism website: tsichuan.com to explore the 720-square-kilometre park. This sister-park with Yosemite, Yellowstone and Olympic National Parks in the US is home to reclusive giant pandas, a goat-antelope called the Sichuan takin and 140 species of birds. It’s late October and the leaves have begun their chameleonic change from jade to ochre and rust. I walk the wooden boardwalk that traces the 320-metre-wide arcs of Nuorilang Waterfall, mesmerized by its water droplets, evanescent prisms reflecting beams of light. (At the time of writing, a 7.0 magnitude earthquake rocked Jiuzhaigou county, killing 24 people and affecting natural sites in the region like Nuorilang.) Elevated walkways traverse a number of Jiuzhaigou’s lakes, which bear fanciful names such as Crouching Dragon, Panda and Tiger, among others, and have a fantastical backstory:

Selfies in front of Five-Colour Ponds and Huanglong Ancient Temple, Huanglong National Park; Panda Lake, Nuorilang Waterfall; Jiuzhaigou Valley National Park. bottom row from left Huanglong Ancient temple (2), Huanglong National Park; Tibetan village, Jiuzhaigou Valley National Park. top row from left

Fall 2017 Just For Canadian doctors

19


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Just For Canadian doctors Fall 2017

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COLLEGE OF FAMILY PHYSICIANS OF CANADA

a boy gave a mirror made of wind to goddess Semo. It slipped from her fingers, smashing into 114 pieces, creating the valley’s looking-glass lakes. Five-Colour Pond is a shapeshifter. Bending at various angles, I try to spot its ombré blues, greens and its most elusive shade: purple. I snatch a glimpse of the violet, but like trying to grasp a fistful of smoke, it vanishes into thin air. Visitors snap selfies. A goddess-like Tibetan woman wearing traditional attire patiently poses for me. Then they all disappear down the boardwalk and for a few seconds I have the surreal site all to myself. The next day we head back south to explore Huanglong National Park, a 650-kilometre valley. Its terraced travertine ponds are smudges of turquoise, green and yellow, creating the appearance of a huang long or “yellow dragon” ambling through the virgin forest. Discovering this mythical landscape starts with a vertical journey by cablecar. It reels us toward the valley’s precipitous peaks, many mantled in snow, including 5,588-metre Mount Xuebaoding (“Snowy Treasure Peak”), which wears its white coat year-round. From the top, everyone must travel on foot via a boardwalk that traverses the slopes, skirting panoramas of carved valleys, steaming hot springs, misty cascades, limestone formations and three Buddhist temples that date back to the Ming Dynasty. I join the pilgrimage of people decked in puffy down coats trudging along and find myself in the centre of a selfie with a group of giggling girls. The air is rarefied this high up and some visitors take refuge inside oxygen bars along the way. Everyone seems blissful, if not breathless, swallowed up by the spellbinding beauty. I step inside the Huanglong Ancient Temple and a teenaged girl asks me to take her photo as she holds skinny sticks of incense. I oblige and we exchange WeChat details (China’s version of messaging service WhatsApp) on our iPhones. We’ve made a connection through nature, spirituality and technology. It’s a few more shades of Sichuan, shaped by the forces of nature, both absolute and esoteric. A land of dragons, Tibetan goddesses, teenagers snapping selfies and roadside show yaks, perhaps best encapsulated by more wise words from Confucius: “Wherever you go, go with all your heart.”


shanghai / london / auckland / portland / toronto … | c a l e n d a r

cMe

A n intern ation a l guide to c ontinuing medical Education

fall 2017 + beyond

shanghai

At the Jade Temple

Graffiti at M50

East Nanjing Road

Prayer beads

Roof lines of the Jade Temple juxtaposed with modern Shanghai

Old Shanghai Teahouse

The Bund

Solitude in Shanghai: Find flickers of tranquility in China’s largest city (CME events in Shanghai + beyond are highlighted in blue.)

janet gyenes

T

he low morning sun hides behind the buildings huddled up to East Nanjing Road in Shanghai’s Huangpu district. A few blocks from the Bund, thousands flock to this pedestrian stroll to shop at its 600 trendy boutiques, businesses and Qing Dynasty-era department stores. But for now, it’s still slumbering. The massive façade of an Apple store hasn’t yet transformed into a glass birdcage for a captive audience. Instead, it’s the backdrop for a cadre of women dancing in formation. Like delicate birds, they flap their arms, snapping open and shut broad yellow-and-red fans that seem like plumage extending from their fingertips. This scene is a not-so-rare respite from the cacophony of China’s largest city. Once flooded with trade in tea, silk and opium, more than 4,000 years of history has shaped this port city on the East China Sea. So too has the Huangpu River (a tributary of the Yangtze), carving this metropolis of 24 million people into two distinctive areas on its east and west banks.

seek out the temple’s namesake 1.9-metre buddha; Pudong (its name translates to “east bank”) lives up to its Instagram persona, its skyline spiked with high- photography is prohibited, adding to the solitude. altitude skyscrapers such as the spaceship-like Oriental To explore the modern, artful side of Shanghai, Pearl TV Tower (its third sphere is actually called Space take a one-kilometre walk from the temple to the M50 creative park, tracing tea-stained Suzhou Creek. Capsule) and the 101-storey Shanghai World Financial Formerly the Xinhe Cotton Mill, the revamped industrial Center, a neo-futurist building that looks like a colossal space with graffitied walls is now a warren of ultra-cool bottle opener. Puxi, or “west bank,” is framed by the Bund, a one-kilometre-long riverside promenade lined artists’ studios, galleries and cafes. Chat with artisans with heritage buildings, including the 1929 art as you snap up their fashionable handmade leather goods, jewellery and ceramics. After deco Fairmont Peace Hotel. [more] With its mega-tall towers and throngs, drinking in new Shanghai, head to Old Check out Town, a cataclysm of cutting-edge and Shanghai often draws comparison to New meet-inYork City. Or Paris, thanks to the trove of ancient where smoggy silhouettes of towers shanghai.net villas and wutong (plane) trees lining the rise behind the winged eaves of wooden structures. Elbow past the crowds and climb streets in the former French Concession. But the staircase to the Old Shanghai Teahouse, a this is not the US or Europe. Chinese culture and 1930s throwback with the aura of an antiques shop. quiet can be found in Shanghai’s spiritual spots such as the Jade Buddha Temple in the Jing’An district. Here, peek Settle in, sip tea (or beer) and devour juicy dumplings in inside the halls where worshippers kneeling on colourful this second-floor enclave while listening to the chirp of cushions murmur prayers to gilded deities. Be sure to live music being performed. — Janet Gyenes Fall 2017 Just For Canadian doctors

21


c M e calendar

Diabetes

Cardiology

Anesthesia

Aesthetic Medicine

cme

MORE CME Full-access CME calendar and destinations at justforcanadiandoctors.com/cme/

when

where

topic

sponsor

contact

website

Oct 21-22

Vancouver British Columbia

Botox And Dermal Filler Training

The Physician Skincare and Training Center

877-754-6782

ptcenter.org

Oct 24-28

Shanghai China

6th Dermatologic & Aesthetic Surgery International League (DASIL) World Congress

Dermatologic & Aesthetic Surgery International League

847-577-6543

thedasil.org

Nov 24-25

Toronto Ontario

14th Annual Canadian Association Of Aesthetic Medicine Conference

Canadian Association Of Aesthetic Medicine

604-988-0450

caam.ca

Oct 07-13

Scottsdale Arizona

2017 Scottsdale Anesthesia

Holiday Seminars

970-923-9650

holidaysemi nars.com

Oct 17-29

Shanghai China

Clinical Concerns In Anesthesia Asia Cruise

Northwest Anesthesia Seminars

800-222-6927

nwas.com

Nov 13-17

Kauai Hawaii

2017 California Society Of Anesthesiologists (CSA) Fall Anesthesia Conference

California Society of Anesthesiologists

916-290-5830

csahq.org

Jan 24-27 2018

Grand Cayman Cayman Islands

2018 Anesthesia Camp, Grand Cayman

destinationCME

773-417-0075

destination cme.com

Oct 01-04

Birmingham England

2017 Heart Rhythm Congress (HRC)

Heart Rhythm Congress

011-44-178986-7523

heartrhythm congress.com

Oct 19-21

Dubai UAE

8th Emirates Cardiac Society Conference

DiaEdu Management Consultants

011-971-4-4532975

ecs-acc.com

Nov 07-10

La Jolla California

28th Annual Cardiovascular Interventions

Promedica International CME

60-720-2263

cvinterven tions.com

Dec 03-05

Tel Aviv Israel

2017 International Conference For Innovations In Cardiovascular Systems

Paragon Group

011-972-3-5767704

icimeeting.com

Feb 19-23 2018

Cancun Mexico

Cardiology At Cancun: Topics In Clinical Cardiology

Mayo Clinic

800-283-6296

go.evvnt. com/150830-0

Nov 01-04

Edmonton Alberta

20th Annual Professional Conference And Annual Meetings (Diabetes Canada And CSEM)

Diabetes Canada

800-226-8464

diabetes.ca

Dec 04-08

Abu Dhabi UAE

2017 World Diabetes Congress

International Diabetes Federation

011-32-2-5431631

idf.org

Mar 09-11 2018

Pune India

2nd International Diabetes Summit

Chellaram Diabetes Institute

91-20-66839767

cdidiabetes summit.org

Mar 15-17 2018

Shanghai China

2nd Asia Pacific Symposium On Diabetes, Hypertension, Metabolic Syndrome & Pregnancy (DIPAP Greater China 2018)

ComtecMed

972-3-5666166

go.evvnt. com/120522-0

Sep 30Oct 03 2018

Tokyo Japan

18th International Society For Pediatric & Adolescent Diabetes Science School For Physicians

K.I.T. Group GmbH

011-49-302460-3210

ispad.org

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Just For Canadian doctors Fall 2017


MORE CME Full-access CME calendar and destinations at justforcanadiandoctors.com/cme/

General & Family Medicine

Gastroenterology

Endocrinology

Emergency Medicine

cme

calendar

cMe

when

where

topic

sponsor

contact

website

Nov 06-08

St. Petersburg Florida

Introduction To Abdominal And Primary Care Ultrasound

Gulfcoast Ultrasound Institute

727-363-4500

gcus.com

Dec 03-08

Maui Hawaii

38th Annual Current Concepts In Emergency Care Conference

Emergencies in Medicine

248-463-0115

emergen ciesinmedi cine.com

Feb 09-10 2018

Miami Florida

2018 Mass Gathering Medicine Summit

American Academy of Event Medicine

info@mass gatheringmedi cine.org

massgather ingmedicine.org

Oct 30-31

Bangkok Thailand

15th International Conference On Obesity Medicine

Conferenceseries

650-889-4686

obesitymedi cine.confer enceseries.com

Nov 01

London England

Challenges In Managing Diabetic Foot Disease

Royal Society of Medicine

44-20-72903859

rsm.ac.uk

Jan 12-13 2018

Abu Dhabi UAE

2018 European Society Of Endocrinology Clinical Update

Imperial College London Diabetes Centre

971-3-746-4848

icldc.ae

Oct 19-20

Rome Italy

Multidisciplinary Acute Abdomen Workshop

European Society of Gastrointestinal & Abdominal Radiology Office

11-43-1-5358927

esgar.org

Nov 01-04

Las Vegas Nevada

2017 North American Society For Pediatric Gastroenterology, Hepatology & Nutrition Postgraduate Course & Annual Meeting

North American Society For Pediatric Gastroenterology, Hepatology & Nutrition

215-641-9800

naspghan.org

Nov 29

London England

2017 Annual Update In Paediatric Gastroenterology

Institute of Child Health

44-20-79052699

a-p-g.org

Apr 28 2018

New York New York

3rd Annual School Of Gastrointestinal Oncology

Physicians’ Education Resource

609-378-3701

gotoper.com

Oct 09-13

Napa California

2017 Practical Imaging Update

UC Davis Health System

916-734-5390

ucdmc.ucda vis.edu

Oct 12-14

Brighton England

2017 Brighton Sleep: British Sleep Society (BSS) Biennial Scientific Meeting

British Sleep Society

011-44-154344-2156

sleepsociety. org.uk

Oct 19-31

India: Delhi, Agra, Jaipur and Ganges River Cruise

Dental & Medical Health And Well-Being Updates / 5-Night Oberoi Hotels & 7-Night Uniworld River Cruise

Professional Education Society

877-737-7005

pestravel.com

Oct 25-28

Auckland New Zealand

2017 Sleep DownUnder

Australasian Sleep Association

011-61-2-99201968

sleep.org.au

Feb 19-22 2018

Grand Cayman Cayman Islands

2018 Advanced Imaging In The Islands

Duke Radiology

919-684-7228

duke.edu

Apr 16-19 2018

Honolulu Hawaii

15th Hawai’i International Summit On Preventing, Assessing & Treating Trauma Across The Lifespan

Institute on Violence, Abuse & Trauma

858-527-1860

ivatcenters.org

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Coming November 2017

10:33:5023 Fall 2017 Just For Canadian30.08.2017 doctors


c M e calendar

Mental Health

Infectious & Chronic Diseases

Internal Medicine

Hepatology

Geriatrics

cme

MORE CME Full-access CME calendar and destinations at justforcanadiandoctors.com/cme/

when

where

topic

sponsor

contact

website

Nov 02-03

Dubai UAE

2017 MENA Geriatrics Summit

MCI Middle East

71-4-311-6300

geriatricssum mit.org

Nov 02-04

Toronto Ontario

9th Canadian Conference On Dementia

University Health Network

416-597-3422

canadiancon ferenceonde mentia.com

Dec 14-16

Las Vegas Nevada

25th Annual World Congress Of American Academy Of Anti-Aging Medicine

American Academy of Anti-Aging Medicine

888-997-0112

a4m.com

Jan 25-27 2018

Toronto Ontario

2018 Better Breathing

The Lung Association Ontario

416-864-9911

betterbreath ing.ca

Dec 07-08

Madrid Spain

13th International Conference On Clinical Gastroenterology & Hepatology

Pulsus Meetings

702-508-5200

gastroenter ologysociety.org

Dec 13

Strasbourg France

Hands-on Flexible Endoscopy For Surgeons Advanced Course

Institut de Recherche Contre les Cancers de l’Appareil Digestif

011-33-3-88119090

ircad.fr

Jan 25-26 2018

Edinburgh Scotland

22nd Advanced Gastroenterology And Hepatology Course

Royal College of Physicians of Edinburgh

44-13-12473634

rcpe.ac.uk

Oct 24-27

Montreal Quebec

2017 Congrès Annuel de Médecine des Médecins Francophones du Canada

Médecins Francophones du Canada

800-387-2228

formation. medecinsfran cophones.ca

Nov 02-05

Palm Beach Aruba

Internal Medicine For Primary Care: Cardio/Endo/ Gastro/Gyn

Medical Education Resources

800-421-3756

mer.org

Nov 14-16

Brussels Belgium

2017 Echocardiography For Hemodynamic Monitoring

Erasme Hospital

011-32-2-5553631

intensive.org

Dec 15-16

Brussels Belgium

2017 Annual Congress Of Belgian Society Of Internal Medicine

Belgian Society of Internal Medicine

32-4-7687-4297

bsim.wildapri cot.org

Expiry Jan 30 2018

Online

Adult Immunization In Primary Care - Influenza, Meningococcal And Food And Water Borne Travel Illnesses Update

mdBriefCase

416-488-5500

goo.gl/M8Fe5A

Nov 02-04

Madrid Spain

Antibiotic Therapy In Practice

European Society of Clinical Microbiology & Infectious Diseases

thomas.greif@ escmid.org

escmid.org

Nov 07-21

Italy and Spain Cruise

2017 Chronic Disease Management Update - Italy & Spain Cruise

CMEatSEA

888-523-3732

cmeatsea.org

Oct 25-29

Chicago Illinois

68th Annual Society For Clinical & Experimental Hypnosis (SCEH) Workshops & Scientific Program

Society for Clinical & Experimental Hypnosis

617-744-9857

sceh.us

Nov 23-25

Scottsdale Arizona

Medical CBT For Depression (And Happiness): Ten-Minute Techniques For Real Doctors

CBT Canada

877-466-8228 See Ad Page 20

cbt.ca

Dec 16-23

Disney Caribbean Cruise

Medical CBT For Depression (And Happiness): Ten-Minute Techniques For Real Doctors

CBT Canada

877-466-8228 See Ad Page 20

cbt.ca

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24

Just For Canadian doctors Fall 2017


MORE CME Full-access CME calendar and destinations at justforcanadiandoctors.com/cme/

Pain Management

Oncology & Palliative Care

Obstetrics & Gynecology

Neurology

Mental Health

cme

calendar

cMe

when

where

topic

sponsor

contact

website

Mar 12-14 2018

Whistler British Columbia

Medical CBT For Stress And Anxiety: Ten-Minute Techniques For Real Doctors

CBT Canada

877-466-8228

cbt.ca

Mar 19-21 2018

Maui Hawaii

Medical CBT For Stress And Anxiety: Ten-Minute Techniques For Real Doctors

CBT Canada

877-466-8228

cbt.ca

May 26-30 2018

Rome Italy

16th World Association For Infant Mental Health World Congress

Worldwide Congresses & Events

011-39-6-328121

waimh.org

Oct 09-11

Portland Oregon

11th American Society Of Functional Neuroradiology Annual Meeting

American Society Of Functional Neuroradiology

630-574-0220

asfnr.org

Nov 04-11

Tahiti and the Society Islands Cruise

Topics In Neurology For Primary Care Providers

Continuing Education, Inc./University at Sea

800-422-0711

continuingedu cation.net

Feb 04-06 2018

Whistler British Columbia

10th Canadian Neuromodulation Society Annual Meeting

Canadian Neuromodulation Society

418-649-5844

neuromodula tion.ca

Oct 13-14

Singapore Singapore

2017 Australasian Gynaecological Endoscopy & Surgery Society Focus Meeting

YRD Event Management

011-61-7-33682422

ages.com.au

Oct 25-26

New York New York

2017 ART World Congress

CME Congresses

011-972-52253-0370

artworldcon gress.com

Dec 15-16

New York New York

23rd Annual Conference On Challenges In Gynecology

Symposia Medicus

800-327-3161

symposiamedi cus.org

Jan 20Feb 01 2018

Australia and New Zealand Cruise

Topics In Women’s Health And Healthcare Communication

Continuing Education, Inc./University at Sea

800-422-0711 See Ad Page 39

continuingedu cation.net

Feb 23-25 2018

Toronto Ontario

21 Annual Women’s Imaging Advances In Gynaecologic Imaging And First Trimester Ultrasound

University of Toronto

416-586-4800

mountsinai. on.ca

Nov 08-10

Alexandria Virginia

Disrupting Cancer: The Role Of Personalized Nutrition

American College of Nutrition

conf@ameri cancollegeof nutrition.org

americanco llegeofnutri tion.org

Nov 30Dec 01

Rome Italy

5th GEC-ESTRO (European Society For Radiotherapy And Oncology) Workshop

European Society For Radiotherapy And Oncology

011-32-2-7759340

estro.org

Feb 17-23 2018

Barbados

General Practitioners & Dermatology Symposium On Skin Cancer

CME Travel

877-377-2211

cmetravel.com

Nov 18

Chicago Illinois

Headache Update 2017

Diamond Headache Clinic

312-867-9104 See Ad Page 27

dhc-fdn.org

Feb 16-19 2018

Carlsbad California

The 31st Annual Practicing Physician’s Approach To The Difficult Headache Patient

Diamond Headache Clinic

312-867-9104 See Ad Page 27

dhc-fdn.org

Fall 2017 Just For Canadian doctors

25


c M e calendar

Wilderness and Travel Medicine

Respiratory/ Pulmonary

Radiology

Psychiatry/ Psychology

Primary Care

Pediatrics

Pathology

cme

when

where

Nov 22-24

MORE CME Full-access CME calendar and destinations at justforcanadiandoctors.com/cme/

topic

sponsor

contact

website

Linz Austria

Diagnostic Breast Pathology

Vincent Academy of Pathology

43-732-76774921

pathsoc.org

Jan 16-18 2018

Rodney Bay St. Lucia

5th Caribbean Biomedical Research Days

International Stress & Behavior Society

240-899-9571

stressandbe haviour.com

Oct 25-28

Grand Cayman Cayman Islands

33rd Annual Fall Conference On Pediatric Emergencies

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Level 3 Safeguarding: FGM In Children Overcoming The Challenges Faced By Healthcare Professionals

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March 26 2018

Palm Coast Florida

12th Annual Primary Care Spring Conference Session I

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6th Annual Essentials In Primary Care Winter Conference

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6th Annual Primary Care Winter CME Conference

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3rd Annual Clinical Issues In Primary Care Conference

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Psych Congress Regionals Orlando

Psych Congress Regionals

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Vancouver British Columbia

Canadian Conference On Physician Leadership “Dialogue: A Tool To Lead Action”

Canadian Society of Physician Leaders

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2017 National Diagnostic Imaging Symposium

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36th Annual Head To Toe Imaging Conference

New York University Department of Radiology

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Japanese Explorer Cruise

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2017 Inca Trail / Machu Picchu / Amazon Rain Forest Conference On Wilderness & Travel Medicine

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radiology


travel at home

Retreat redux Old is new in story

+ photography

by

Barb Sligl

Inside the courtyard of the Séminaire de Québec, just steps away from Le Monastère des Augustines, another of Quebéc City’s (and Canada’s) founding Catholic institutions (and home to the long-standing Université Laval). The sundial at the top right corner of the door is inscribed with the Latin text, Dies nostri quasi umbra: Our life on earth is short and fleeting.

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Just For Canadian doctors Fall 2017


travel at home

In 1639, a group of women came to New France to found Canada’s first hospital in Québec city. Now they’re welcoming you to stay at Le Monastère des Augustines…

le monastère

Fall 2017 Just For Canadian doctors

29


travel at home

L

eaves rustle, birds twitter, a Québec flag flutters in the wind. I’m atop ancient fortifications, older than the Citadelle of Québec, in the Parc du Cavalier-du-Moulin. Tucked away amidst the quiet streets behind Château Frontenac and in the Citadelle’s shadow, this pocket park (dating to 1663) is quite hidden by a veil of trees. I have it almost to myself, the only other occupant a young man seated against one of the leafy trees. He smiles, says bonjour and continues sipping his wine. How French. I wonder if any of the Augustines stood here. I found out about this little-known hideaway in the guest-room literature at Le Monastère des Augustines, where I’m staying while in Québec City. It’s just one gem I’ve discovered thanks to the centuries-old monastery-turned-retreat, founded even before this park. It began as the first hôtel-dieu (the French name for hospitals established by nursing orders of nuns) in what was then New France, funded by a French duchess and founded by three young nuns from Dieppe. They arrived in 1639, less than three decades after Champlain

himself in 1608—voyageurs, explorers and adventurers just as he was. Their efforts fostered 12 monastery hospitals and 2,000 nuns over the centuries. Today there are just eight sisters left from this particular monastère. Their average age is 84 yet they chirp “Bonjour!” to guests and happily welcome them into what’s still their home. Don’t think staid. Despite the mission of this completely refurbished hotel/retreat (a multi-million-dollar update) to keep the Augustines’ tradition alive, it’s surprisingly modern. “Contemporary” rooms have ensuite bathrooms, while more-traditional cell-style rooms share bathrooms (there are 65 guest rooms in total). It’s a form of sustainable and cultural tourism that gives guests a historical and enriching experience that’s far beyond the standard hotel. I attend one of the vespers held in the once-segregated section of the adjoined church (an L-shape with separate wings for the nuns and the public during mass in the days of cloistered life) and get tingles hearing their sweet-and-pure voices, a stark contrast to their wrinkled faces. I think of the inscription “Prier comme un ange” that I noticed earlier: “…after years of practise she prays as naturally as she breathes. Silently or aloud. From awakening to bedtime. In the cloister and in the hospital. Prayer slakes her thirst for the absolute. Prayer makes her heart rejoice.”

30

Just For Canadian doctors Fall 2017

I silently thank the sisters for sharing this. And all of this surrounding me. With almost 400 years of history, Le Monastère des Augustines is a treasure, a living museum. I meander through the exhibit of some 1,000 objects from the 40,000 artifacts in the Augustinians’ 12 monastery hospitals: the trunk of the fondatrices, the three women who crossed the Atlantic to found this place in 1639; a surgical instrument set from circa 1730, used to extract musket balls from soldiers wounded during the Battle of the Plains of Abraham; an anesthesia mask from the mid-19th century; a prayer book decorated with embroidery; the 21-piece habit of the sisters that has not changed since the 6th century. Down one hall is a wooden statue, Notre-Dame de la Victoire, painted in vivid red, blue and gold; Jesus, of course, is found in another, as are various other embellished or unadorned figures. “Everything that looks old in the monastère actually is,” says Marie-Eve Perron, marketing director of the monastery. I come across a replica of a nun’s room, stark yet lovely. In each of these humble cells is a rack with a curved, custom peg upon which a sister’s veil could hang crease-free. Black-and-white photos throughout also make me smile, like “Novice et postulantes au jardin” from 1945, in which the nuns sport wide grins in the courtyard garden. left The view of Lower I’m almost reluctant to venture Town from the Clergy outside the sanctuary of the Battery. opposite, top row convent again, but Vieux-Québec, from left Display of crucithe oldest part of the city, is just fixes and cannonballs in the vault of Le Monastère steps away. I stroll past Château des Augustines; Québec Frontenac, Dufferin Terrace and City’s oldest house in Vieuxthat secret park (shhh), and then Québec; an Augustine walks continue up 310 steps to the in the garden. opposite, middle Citadelle and Plains of Abraham— row from left The leafy view peaceful and eerie as an undevelfrom Parc du Cavalier-duoped monument of that epic 1759 Moulin; under the arches of battle between French and English. the monastère’s courtyard; a replica of an Augustine’s This is where Canada began. And room. opposite, bottom row as its first city, Québec is like a from left Looking into the dragonfly in amber…caught in courtyard of the Séminaire another time, a beautiful oddity de Québec; Château because this 409-year-old city still Frontenac; bust of King stands between the Old World Louis XIV in Place Royale. and the New World. In the Lower Town, I stop in front of a bust (by the famous Italian sculptor Bernini) of King Louis XIV in Place Royale square—it was his predecessor, Louis XIII, who deployed those three sisters long ago to start the continent’s first hospital. My head spins. It’s all still so audacious. As I walk along the Clergy Battery, atop the city’s ramparts, past Côte de la Montagne (once a path used by natives long before any European set foot here), I see little girls in checked uniforms playing amongst the cannons. They’re from the Ursuline school (another enduring relic, started by another group of nuns who travelled across the Atlantic aboard the same ship as the Augustines in 1639). I edge along the high wall with a bird’s-eye view of the Lower Town and St. Lawrence River far below. It’s as if I’m walking back in time, through a diorama of steep metal roofs glinting in the sun, their vertical lines of tiles laid in the traditional French “baguette” style. As I continue past the Séminaire de Québec, I remember its sundial marked with the Latin phrase, Dies nostri quasi umbra: Our life on earth is short and fleeting. Words that seem to echo in this old city. Back at the monastère it’s lunchtime and, here, that means mindful eating. “Slow cooking” (no microwave on site) with local ingredients. Some dishes are even inspired by the archives, including the most ancient cookbook in Canada. I remember the handwritten


travel at home


travel at home “Sucre à la Crême au Chocolat” recipe I saw in the museum (these nuns knew the value of indulgence too). There’s also tisane du monastère and digestive et tonnifiante à déguster made of ginger, lemon, fennel, thyme and maple syrup. And organic Québec products like honey wine, Vidal wine from Domaines des Salamandres and bière blonde biologique from microbrasserie La Barberie. Everything is connected to the centuries-long traditions and wisdom of the sisters. Breakfast is eaten in silence, a ritual that evolved out of the need for balance prior to long days in the frenzy of the hospital, tending patients. “The best state of equilibrium is a mix of action and contemplation,” is how Perron explains the Augustines’ ethos. So the sisters take their meals in silence. I venture to do the same at breakfast the next day. It’s an exercise of hyperawareness without the usual distractions: smartphones, newspapers, idle chit-chat, TVs. It’s revelatory. But, while silence at breakfast is expected to be adhered to, the rest of what the monastère offers is optional. You’re encouraged to leave your cell phone with reception (another exercise in confronting withdrawal). There are yoga and meditation classes, craft workshops and holistic-health sessions. “We propose experiences and our clients decide for themselves,” says Perron. I partake in the early morning “Awake” series, during which “breathing, movement and meditation rouse the body and help you get in touch with your very essence.” Propped atop one of the monastery’s meditation cushions, I inhale the signature “1639” essential-oil blend of cardamom, cedar and citrus that’s inspired by the nuns’ long-time use of aromatherapy (for its beneficial effects in the hospital). It’s anything but woo-woo. After three mornings of this, I actually feel refreshed (again, revelatory for a non-morning person). There’s also a “Creation” workshop on mandalas, drawing, colouring and scrapbooking. Anything you create becomes a gift for a hos-

if you go

pital patient at the connected Hôtel-Dieu de Québec. A midday “Vitality” program For more on Le Monastère might include yoga or a guided “energy des Augustines and its offerwalk.” More yoga—qi gong, vinyasa ings go to monastere.ca. For flow, yin—takes place in the latemore on Québec City and afternoon “Healing” session, and the Québec: quebecregion.com and quebecoriginal. evening “Inspiration” series showcases com/en. films, book discussions or some other talk promoting inner calm, peace and serenity. During a yoga session in the whitewashed stone vault (dating back to 1644, one of the oldest in Canada), it’s as if I’m enveloped by layer upon layer of time and spirit. So much has happened, so many have been here before me. I glance at a display of cherubic angels and crucifixes next to pitted cannonballs (relics from the Battle of the Plains of Abraham that crashed through these walls). The juxtapositions are surreal—spiritual yet secular, old yet new, traditional yet contemporary, horror and healing. But somehow it all melds seamlessly in this forward-thinking, modern-day retreat. And it reflects the core purpose of the Augustines: balance, wellbeing and inner peace. One morning I find a spot in the courtyard and watch a group silently trace the square path, walking under contemporary arches (12 arches for 12 monastery hospitals) that contrast the ancient stonework. Some are barefoot, some have their eyes closed, some seem to be mouthing a mantra. I close my own eyes and settle into a form of meditation, letting myself absorb a little of the magic of this place—so old yet so invigorating. I tell myself that I can practise these rituals, continue these lessons upon my return home. And I do buy the 1639 essential-oil blend and a meditation cushion at the gift shop. But my most treasured takeaway might be something one of the yoga instructors said about breath being the bridge between body and soul. Much like this place.

on Ireland Island at the southernmost tip of the country is the main tourist area. The district around the

continued from page 14

cruise-ship terminal with its shops housed in the old ruins of the dockyard provides lots of photographic opportunities including old red English telephone boxes/booths. I used the juxtaposition of the boxes with a modern cruise ship and the 17th-century ruins to help link the island’s past and pres-

32

Just For Canadian doctors Fall 2017

ent. A wide-depth-of-field aperture of f22 rendered both foreground and background in sharp focus. Other points of interest in the Dockyard area: the clock tower, the interior of the old hall with its massive walls and the Maritime Museum at the Commissioner’s House with exhibits outlining the New World’s slave trade history. On the rise overlooking St. George stand the stark remains of the unfinished St. Peter’s Church, dating from 1874. The ribs of the outer walls offer many good image possibilities. I used shadows, arches and windows to highlight certain aspects of the Gothic architecture (see page 14, bottom left). Most of the country is just above sea level but there are a few spots like Town Hill (the island’s highest point at 76 metres) and Gibb’s Hill that offer some spectacular panoramas of the southern islands. When shooting panoramas, I try to incorporate various local aspects like the pastel-coloured houses with stepped concrete roofs and the many offshore islets and coves.

A number of local fish and produce markets are scattered throughout the island. They seem to pop up anywhere and most vendors are friendly. Still, I find an initial chat about their fish or produce helps to relax them so you can take pics (and, whenever possible, I always try to buy something that they’re selling). Use a medium wide-angle lens and get close to include the fish or vegetables and the vendor to make the image more interesting. Also, get detail shots. Most of Bermuda’s outdoor activities revolve around the sea. The warm Gulf Stream nourishes the world’s northernmost coral reefs around the islands, most of which are only a few fin kicks from shore. When shooting down on snorkellers, take your shot when they are moving or animated to avoid the “floating dead body” look. But if you have a small underwater camera like a GoPro, it’s always best to shoot them from below and try to include some of the reef structure. From reef to fort, there’s no limit to the iconic Caribbean shots this group of islands offers.

michael defreitas

photo prescription [continued]


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What now?

Dealing with the loss of incorporation benefits

T

he only thing that Bill and his family-practice colleagues seem to talk about lately is the impact of the tax proposals on their finances. Losing the benefits of splitting income with his spouse and daughters in university will cost Bill about $50,000 in lost tax savings. He would need to generate an extra $100,000 of billings to make up for this tax loss, which is an impossible proposition since he is already working six days a week. The tax proposals will, without a doubt, create havoc in Bill’s personal financial planning. As a result, Bill and his wife, Jennifer, are facing some tough choices. Cutting $50,000 out of their budget will be painful and tightening up on their personal living expenses will not be sufficient. The annual education bill of $30,000 for their daughters’ university will need to be pared down and that shortfall perhaps financed with student loans or a line of credit on the house. Bill’s accountant recommends that he maximize the income splitting for his family trust before the new rules become law in 2018. He calculated that doubling the amount of dividends for 2017 would give him one more year of income-splitting benefits that could save him about $20,000 of taxes. He also suggested that Bill add his brother,

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Just For Canadian doctors Fall 2017

Minimize

the impact of these new tax proposals, before they become the law

who has little income, to the trust to maximize the income splitting for 2017. Below are some tax-planning tips that you, like Bill, may consider in light of the upcoming tax proposal: 1 Maximize the income-splitting benefits this year. Even though you prepay personal tax for one year, the savings can be substantial. With the tax proposals, you can continue to make payments to family members, but it must be equivalent to the fair market of services rendered. In other words, the payment must be equal to what you would pay to a neutral third party. 2 Discuss with your accountant steps to preserve your lifetime capital gains exemption if you expect to sell your practice or practice real estate at a gain in the future. The maximum exemption for each shareholder is $836,000 for 2017 and applies to the sale of shares of a medical corporation. 3 As best as you can, keep up the monthly savings you make currently to build up your retirement nest egg. Cut expenses, not savings! 4 Don’t wind up your medical corporation, the first reaction of many doctors to the new tax proposals. Your practice income in the corporation is still being taxed at the low small business tax rate of about 15%, depending on the province in which your practice is located. This means that you have $85 out of $100 of revenues to invest. The government has not figured out how to tax the investment in the corporation, but the legislation will likely be pretty complex. You can bet that a lot of income-tax specialists will study the fine print closely to scout for new strategies to lower the tax for their clients. This is a good time to put a Medical CPA on your financial team. A CPA with many medical clients reviews the tax laws purely through the medical-profession lens in an effort to search for loopholes in the tax legislation. And, like the Colonel who never divulged his chicken recipe, Medical CPAs, along with other tax specialists, will keep exciting tax-saving ideas to themselves and their customers.


d o c t o r o n a s o a p b o x d r . c h r i s p e n g i l ly Dr. Chris Pengilly is Just For Canadian Doctors’ current affairs columnist. Please send your comments to him via his website at drpeng.ca.

[Un]incorporation

Is there life after incorporation for doctors who have long relied on its tax advantages?

Q

classified ad s

uietly buried within the last Federal Budget was a proposal to discontinue the ability of small businesses to incorporate to gain some tax advantage. This was introduced just prior to the summer recess and objections need to be submitted by mid-September. It seems that it’s mostly family physicians who are making the loudest protest, at least in the press. Why is this? I really do not know. Without wishing to sound too put on, I do think that family physicians are sub-optimally compensated for the work that they do. To lose this last tax advantage may be just enough to push some out of family practice. I think it is unlikely that it will get through this time around, insomuch as this will also affect accountants, lawyers, dentists as well as a raft of other health disciplines. I have no faith that the family physicians will prevail upon the government successfully, but I do have some trust in lawyers and accountants making a very powerful lobby. It is unlikely that the proposal will be withdrawn completely but I think it will be watered-down. Even a watered-down version will not be welcome for family physicians. Maybe it is time to have a complete rethink. I have long felt that physicians have paid dearly for the ideology that we are an independent self-employed profession. Are we really? I have my doubts when we are not able to set our own fees, and especially when I just got off the phone having spent several minutes talking to some clerk, after

36

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going through a maze of pressing this number and that number, in order to get Pharmacare to pay for an ARB for a patient with significant renal impairment. Even though this medication was recommended by a nephrologist, I had to go cap-in-hand to the bureaucracy. Would the world stop rotating on its axis if family physicians were to be government employees? There would be a loss of a certain amount of independence, but there would be gains of paid holiday, maternity leave, sick time and, most of all, a pension. There would also be a loss of the need to negotiate leases, hire and fire employees, as well as the hundred other duties of running a small business—none of which is taught at medical school. The change will be fundamental and I think it would be welcome by the government. In order to accommodate this change, some hard bargaining would have to be undertaken, not the least of which is to negotiate a reasonable pension as other government employees have. Offices must be provided with adequate staff, including nurses, stenographers, pharmacists, welltrained medical office assistants, midwives and physician assistants. Or, put another way, patients could receive good team-based medical care, in keeping with the burden of increasing chronic diseases and complex patient care. I am uncertain if this would be appropriate for specialists as well. Many specialties do

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Just For Canadian doctors Fall 2017

time basis or as associates, with the intentions of being partners in the long run. Our clinic is located in North Delta, BC, since 1983. We are equipped with EMR and paper charts. All the options are available for convenience. We have a full time family practice and a walk in clinic on one side.

not lend themselves readily to team-based healthcare delivery. An exception that comes to mind is paediatrics, and maybe even dermatology. I can see many practical difficulties with this, especially for physicians who are in their 50s and 60s, too late to contribute to a pension. But, in deference to the younger physicians, it might be a relief not to have to worry about sophisticated financial manipulations in an attempt to save for a pension—which then has the potential to take a real beating in the market as in 2008. I am sure that many physicians will regard these words as heresy. Certainly, there is no way I would have written such a piece 20 years ago, but when change is inevitable it is not possible to stop it, it only may be possible to modify it. I think many physicians, especially younger ones, consider the loss of incorporation catastrophic. I incorporated very late in my career. I came to Canada from the UK in 1975 with a $2,000 interest-free loan. I now have no debts and own a house that is worth about seven digits, along with an RRSP for the same amount. I saw both my children through private school and through university without student loans. We have lived comfortably and taken the odd foreign holiday and cruise. Working under Medicare and without incorporation for the most part has served me well. Although the proposed budget change will be a blow, it will not to be catastrophic.

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37


work with msf

For OBGYN specialists like Dr. Gottlieb who are interested in working abroad with MSF, go to msf.ca/en/obstetriciansgynecologists

dr. heather gottlieb crisscrosses the globe from Alaska (where she found a most-memorable restaurant) to Nigeria during a stint in Africa for Médecins Sans Frontières/Doctors Without Borders (read her story on working abroad with MSF, page 12). Off-call, you’ll find her cycle touring or backcountry skiing (on a new set of sweet DPS Wailers) because, as per her motto, this doctor definitely bushwhacks her own path. My name: Heather Gottlieb

vated my passion for travel.

I live and practise in: Nelson, British Columbia

Best meal anywhere: Anything after a day of cycle touring, hiking or skiing

My training: Undergraduate degree in biology from McGill, Medicine degree from McGill; Residency in OBGYN, University of Calgary

Memorable restaurant: Pilot Light, a fish restaurant in the small coastal Alaskan town of Haines

Why I was drawn to medicine: I love people, working with my hands, being an advocate and I simply can’t sit still. Obstetrics and gynecology was a perfect fit for me.

A “wow” hotel/ resort I’d happily stay at again: Emerald Lake Lodge

My last trip: Cycle touring in Alaska and the Yukon

Can’t believe I’ve never been to: The Himalayas

Most exotic place I’ve travelled to: Ethiopia

A favourite place that I keep returning to: The Kootenays

Don’t need to go to: The North Pole Dream vacation: Somewhere with scenic mountain vistas, quaint towns and quiet winding

Best souvenir I’ve brought back from a trip: A silver ring I bought over a decade ago in Cusco, Peru. I’ve below A few faves: worn it everyday Emerald Lake Lodge since—a rein Yoho National Park, minder of the the film La grande trip that cultiséduction, DPS Wailer skis, Patagonia hoody and the book Americanah

38

Just For Canadian doctors Fall 2017

riding roads for endless cycling… And delicious food to satisfy the appetite I will have worked up! I always travel with: A spork Favourite city: Ljubljana, Slovenia Favourite book: Americanah by Chimamanda Ngozi Adichie Favourite film: La grande séduction (Seducing Doctor Lewis in English) Must-see TV: Call The Midwife Favourite band: Arcade Fire

My first job: Figure skating instructor

My fridge is always stocked with: Kombucha

The word that best describes me: Adventurous

Gadget or gear I could not do without: Patagonia Nano Air Hoody

My guilty pleasure: Netflix while cooking and baking

I’m inspired by: The resilience of my patients

I’d describe my home as: Cozy and personal My car: 2005 Subaru Legacy Last splurge: Backcountry ski set up: DPS Wailers with Dynafit bindings

My go-to exercise/sport: Running Favourite spectator sport: “Football” in a European stadium

Most-frequented store: MEC

My secret to relaxing: Being creative on the pottery wheel

I have too many: Scarves, I collect them from around the world

A talent I wish I had: The ability to sing and play guitar around a campfire

Dr. Gottlieb in Peshawar, Pakistan, on another MSF mission

My motto: Why take the road less travelled by when you can bushwhack your own path A cause that is close to my heart: Women’s reproductive rights (see page 12 for more on this and Dr. Gottlieb’s work with MSF) On my mustdo list: Learn Arabic Dr. Heather Gottlieb during a MSF mission in Nigeria

top photos courtesy of Dr. heather gottlieb; bottom left photo: Canadian Rocky Mountain Resorts

s m a l l ta l k

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Outstanding value for your time and resources Combine live, accredited CME and personal renewal time with family & friends Featured Destinations

Women’s Health & Healthcare Communications 21 AMA PRA Category 1 Credit(s)™ 21 Contact Hours 12-Night Australia and New Zealand from Sydney Holland America’s ms Noordam January 20 - February 1, 2018

Topics in Critical Care and Pulmonary Medicine 14 AMA PRA Category 1 Credit(s)™ 14 Contact Hours 11-Night Japanese Explorer from Tokyo, Japan Celebrity Cruises’ Celebrity Millennium April 15 - 26, 2018

January 10, 2018 Oral Dermatology and Pathology 14 AMA PRA Category 1 Credit(s)™ 14 Contact Hours 7-Night Mexican Riviera from San Diego Holland America’s ms Oosterdam

August 4, 2018 Allergy and Immunology for PCPs 14 AMA PRA Category 1 Credit(s)™ 14 Contact Hours 7-Night Hawaii Islands from Honolulu, Oahu Norwegian Cruise Line’s Pride of America

March 11, 2018 Preventive Medicine & Preventive Cardiology 20 AMA PRA Category 1 Credit(s)™ 20 Contact Hours 10-Night Panama Canal from Fort Lauderdale Holland America’s ms Zuiderdam

September 30, 2018 Primary Care and Women’s Health 20 AMA PRA Category 1 Credit(s)™ 20 Contact Hours 14-Night Holy Land & Ancient Kingdoms from Rome Holland America’s ms Prinsendam

April 11, 2018 Topics in Internal Medicine: 2018 Update 18 AMA PRA Category 1 Credit(s)™ 18 Contact Hours 10-Night Mediterranean Mosaic from Rome Holland America’s ms Koningsdam

October 1, 2018 Dermatology 14 AMA PRA Category 1 Credit(s)™ 14 Contact Hours 11-Night Mediterranean from Rome Celebrity Cruises’ Celebrity Reflection

May 28, 2018 Internal Medicine: Cardiology 16 AMA PRA Category 1 Credit(s)™ 16 Contact Hours 10-Night Iceland and Ireland from Dublin Celebrity Cruises’ Celebrity Eclipse

November 4, 2018 Topics in Primary Care & Gastroenterology 14 AMA PRA Category 1 Credit(s)™ 14 Contact Hours 7-Night Southern Caribbean from San Juan, Puerto Rico Royal Caribbean’s Freedom of the Seas

June 17, 2018 Family Medicine and Sleep Medicine 12 AMA PRA Category 1 Credit(s)™ 12 Contact Hours 7-Night Western Mediterranean from Barcelona Royal Caribbean’s Symphony of the Seas

December 1, 2018 Topics in Family Medicine: 2018 Update 14 AMA PRA Category 1 Credit(s)™ 14 Contact Hours 7-Night Hawaiian Islands from Honolulu, Oahu Norwegian Cruise Line’s Pride of America

July 14, 2018 Pediatrics 14 AMA PRA Category 1 Credit(s)™ 14 Contact Hours 7-Night Western Mediterranean Rome to Barcelona Celebrity Cruises’ Celebrity Constellation

Selected Cruises listed here. See a complete Program Listing at www.ContinuingEducation.NET Accreditation: Continuing Education, Inc is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. Designation: Continuing Education, Inc. designates these live educational activities for a maximum of 14-21 AMA PRA Category 1 credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Course Fees may vary based on number of hours offered. Please visit our web site for current fees and cancellation policies.

Ask about our Guest Travels Free Program We can manage or joint provide/accredit your next association or group meeting Call 800-422-0711 or 727-526-1571 or visit www.ContinuingEducation.NET Florida Seller of Travel Reg. #14337


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