Just For Canadian Doctors Spring 2017

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spring 2017

DOCTORS life + leisure

e Morrd a w a s! win


Cuba! exploring the

yukon Publications Mail Agreement #41073506

inside: Continuing medical Education Calendar where will you meet? g r a n d cay m a n

/ m a n c h est er / n a pa / k ua l a

lu m pu r


Just for C








DOCTORS life + leisure


spring 2017

spring 2017 Publisher Linh T. Huynh

Editor Barb Sligl Art Direction BSS Creative

Contributing Editor Janet Gyenes

Editorial Assistant Adam Flint

Contributors Michael DeFreitas Janet Gyenes Sharon Matthews-Stevens Dr. Chris Pengilly Manfred Purtzki Dr. Kellen Silverthorn Barb Sligl Roberta Staley Mark Stevens Cover photo Barb Sligl Senior Account Executive Monique Nguyen Account Executives Janice Frome Wing-Yee Kwong Production Manager Ninh Hoang

CE Development Adam Flint

Sales, Classifieds and Advertising In Print Circulation Office 200 – 896 Cambie Street Vancouver, BC V6B 2P6 Canada Phone: 604-681-1811 Fax: 604-681-0456 Email: info@AdvertisingInPrint.com

Just For Canadian Doctors is published 4 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.

clockwise from top left: barb Sligl (3)

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14 Viva Cuba Explore this storied island in a new way 34 Yukon gold Discover a bounty of wild beauty COLUMNS


8 photo prescription

5 spring mix 21 CME calendar 33 sudoku 38 small talk

Capture Utah’s geological formations

11 pay it forward Humanity as driving force

12 the thirsty doctor

Dr. Scott Forsyth

A new frontier in whisky

27 motoring American muscle…car

28 the wealthy doctor

Permanent life insurance


29 doctor on a soapbox

Printed in Canada.

want to reach us? check out our website!

Pandora’s box of medicine

cover photo Circumnavigating Cuba on a cruise may just be the best way to get an overview of this relatively undiscovered country and Caribbean island (page 14).

Spring 2017 Just For Canadian doctors


from the editor



Just For Canadian doctors Spring 2017


s | ge taway


s | ge ar…

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preO lym pi



dusk in the Brazilian wetlands. right Caim abound in Amazon ans rivers.

deep int O bRazi l ons with nat ural wonders


From the Am azon to the Pantanal, Sou th America’ s biggest cou ntry burge

award wins!

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

Riding pantane horses. iro


Hyacinth macaws perch



2016 Just For can


suMMer 2016


spread far below a surreal sightseeing flight over the world’s largest non-polar icefield (page 30). Each adventure is a version of a perfect day. Much like the days captured in past stories in this magazine, from Norway to Brazil (right), that have since received multiple awards from the North American Travel Journalists Association (NATJA)—including gold in sister publication Just for Canadian Dentists. Congratulations to contributors Lucas Aykroyd, Janet Gyenes and Barb Sligl for their writing and photography awards. Here’s to the magic of those perfect days encapsulated in their words and images.


als | p lace

Using a blowgun in the rainfore st. right Sun over the rise pantana l.



hat makes the “perfect day”? Everyone’s answer will be different, but the common note is some kind of transcendent experience, whether on the beach or amidst glaciers. And this magazine is about collecting and showcasing such special days, whether they take place in the South Pacific or far north. It could be a meander down the Grand Union Canal in England (page 5), a rather idyllic trip through forgotten countryside at a purposefully slow pace. Or it might take shape as a bliss-filled day somewhere in the Caribbean, on a circumnavigation of the island nation of Cuba (page 14). On dry land, the many shades of red in Utah beckon in the early-morning light, the start of a photographer’s dream day (page 8), while the remote reaches of Yukon

| fest iv

jungle fev er

Perfect days

Winners in the 2016 NATJA Awards include Lucas Aykroyd’s “Deep into Brazil” story (bronze), Barb Sligl’s “New Mexico cowboy” photo (finalist) and “Nordic cool” feature photo essay for the summer 2016 issue (bronze).

| food | drin k




Doctors life + leisure


Into the fjord!

summer in Norway

sail aWaY God’s Island Ontario to


win $1,o00

towards any cME coURsE page 12 $50


visa Gift card page 37

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inside: Continuing mediCal eduCation Calendar where will you meet? s e at t l e / q u e e n s t o w n / c o p e n h a g e n / d o h a / o t tawa >>

what/when/where > spring

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


canal days

janet gyenes

water world England’s 220-km Grand Union Canal stretches from London to Birmingham, offering boaters a slower pace to explore, away from the madding crowds.




Explore England’s Grand union canal by narrowboat


he red logo on a Virgin train is a smear of lipstick as it rushes past, its signature V publicizing its pedigree as it catapults passengers southward to the urban chaos of London. I’m standing on an ancient stone bridge curving above England’s Grand Union Canal, which idly flows below. The train is already an afterthought when I hear the low hum of a narrowboat gliding under the bridge on this early-September morning. >>

Narrowboat on the Grand Union Canal near Weedon Bec

Spring 2017 Just For Canadian doctors




chill time

if you go

take the rural route

To learn more about England’s waterways or to hire a narrowboat, go to Canal & River Trust. canalrivertrust. org.uk


Dew drops glisten on blue-black sloes and plump rose hips that frame the grassy towpath. The faint whiff of petrol lingers in the crisp morning air as the brightly painted boat drifts into the distance of this pastoral picture. It’s as moody and romantic as a John Constable painting. Stay-aboard narrowboats are available as vacation rentals throughout England, where more than 35,000 of these so-called barges cruise the canals and rivers. Painted with traditional motifs like roses and castles, the history of narrowboats dates back to the Industrial Revolution when horses tramped the towpaths (often led by children) getaway hauling the flat-bottomed boats filled with coal. I’m travelling on Fuzzy Duck (she’s 55-feet long and just shy of seven feet wide), on which the six of us (if you count Bill and Bella, two rescue greyhounds) continue our six-day journey north on the Grand Union Canal to Foxton Locks (we set off at Bugbrooke) on the Leicester Line, with a detour down the Welford Arm, before retracing the route back. This 220-km-long


Just For Canadian doctors Spring 2017

waterway begins at the Thames in London and wriggles to Birmingham, crossing 216 locks along the way. A speedy trip on one of these slow boats would take a dozen days. We tie up at the village Weedon Bec in Daventry, Northamptonshire, and poke around in an antiques shop brimming with curiosities such as loaf-like ceramic hot water bottles that were used to “iron” chilly sheets to warm up the bed. Back on the barge, we chat with other boaters as they glide by, steaming cups of tea in hand. Soon, it’s all hands on deck at the Whilton and Buckby flight of seven double locks. Two of us grab tire-iron-like windlasses, which serve as gate keys, and jump off the back of the narrowboat with Bill and Bella. Using the windlasses, we start cranking open the paddles to let water rush into the lock. Then we push open the heavy wooden lock beams to let Fuzzy Duck inside. After, we reverse this winding-and-pushing dance that we’ll repeat six more times. The narrowboat floats uphill at an unhurried pace. It’s a timeless trick and an idyllic way to explore the England countryside. — Janet Gyenes

janet gyenes

Narrowboat on the Leicester Line near Long Buckby clockwise from below right Cranking open a lock paddle, Foxton Locks; sloes, or blackthorn fruits, used in sloe gin; narrowboat in a staircase lock, Foxton Locks; Bill, the greyhound, frolics alongside the canal

artful elements

material World




Light show

There’s more to these indulgent items than meets the eye Written + produced by Janet Gyenes

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a bag that gives back

peak oil “Designer Tom Dixon has always defied convention with his output of everyday objects that go beyond the quotidian, thanks to his clever interplay of shape, colour, material and light. His new Materialism collection is an exploration of intangibles. The Materialism Oil Candle seems to invite decor controversy as the vessel’s exterior recalls the lustre of blues, golds and purples created when a slick of oil catches the light. What could be more materialistic and perhaps polarizing than oil? Inside this iridescent cylinder (it’s deliberately mishapen) is 100% paraffin wax, deeply scented (it has 8% fragrance; industry standard is a paltry 1–3%) with essential oils such as tar, cedar and styrax. Is Dixon making a statement about the environment and oil? Only he knows for sure. From $180, The Modern Shop; themodernshop.com

shape shifters


ted ! c e p unex ent: tar elem

fashion forward There’s a rock-and-roll vibe to the hand-painted bags created by Michelle Zerillo-Sosa, owner and principal designer at Amore Bags. Emblazoned with inspirational words and phrases, the wearable art isn’t just arm candy with attitude; each of these one-of-a-kind gear bags has a back story. Originally vintage leather doctors bags’ Zerillo-Sosa has reclaimed, refurbished and redesigned these deeply personal pieces, giving each a new injection of life as a stylish staple. An impressive 30% of the proceeds benefit an organization that’s near and dear to Zerillo-Sosa’s heart: Médecins Sans Frontières (Doctors Without Borders). “I’ve always known about the incredible work of Doctors Without Borders and was inspired to tie this great organization to my bags.” From $1,588, Amore Bags; amorebags.ca



Spring 2017 Just For Canadian doctors


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.

50 shades of red

In Utah’s tapestry of landscape, parks, dinosaur digs and Native American culture

Send photos and questions to our photography guru at feedback@ inprintpublications.com and your shot may be featured in a future issue!

destination photography

Apply your photography skills to the shooting situations and scenery of utah.

the perfect petroglyph

Native Americans etched petroglyphs on protected sandstone cliff walls. Years of erosion and corrosion have weathered the glyphs making them difficult to separate from the cliff face. You’ll get the best results by shooting them at a slight angle and using a polarizing filter on your lens. I used a medium telephoto lens (set at 65mm) a circular polarizer filter and recorded the scene at f11 and 1/200 second.


Just For Canadian doctors Spring 2017

if you go

For more info on Utah: visitutah.com

michael defreitas


he cold predawn breeze forced me to wear gloves as I set up my tripod and cameras at Bryce Point overlooking the breathtaking, five-kilometre-wide amphitheatre. About 30 minutes before sunrise the northern sky turned a beautiful pinkish yellow so I started shooting with my 14–24mm wide-angle zoom, set at about 20mm, and varied my shutter speeds from 5 seconds to 1/2 second as it got lighter. Then, just as the sun peeked over the amphitheatre’s eastern ridge, I switched to an 80–200mm zoom to isolate some of Bryce Canyon National Park’s more interesting hoodoo formations. I picked side-lit formations for emphasis and dramatic effect. When a carpenter-turned-preacher led his flock of followers into Utah’s inhospitable wilderness in 1847, most people thought he was mad. But Brigham Young, and the members of the Church of Jesus Christ of Latter-day Saints saw Utah as an opportunity for spiritual freedom, solitude and peace of mind. They prevailed and built a state around those beliefs, establishing one of America’s highest concentrations of public lands, including five of the country’s top national parks. As a photographer who’s travelled the globe, Utah’s sandstone formations are the most colourful and unique I’ve seen. Decades ago, at the start of my career, I took a workshop from a local photographer who said that Utah is a great confidence builder for new photographers because the natural beauty makes it really difficult to screw up an image. To this day the state remains one of my favourite photography destinations. Given Utah’s many shades of red, it’s best to shoot early morning and late afternoon. The exception to this is shooting in the steepsided valleys common in sandstone regions. I shot Bryce’s aptly named Wall Street canyon, with its tall ponderosa pines stretching out of the narrow canyon, in the late morning (the higher sun angle lit the canyon). Using a wide-angle zoom (set at 14mm) and 1/125 second, I shot up, placing the tree trunks at the corners of my frame as leading lines to pull the viewer’s gaze into the scene. Another great morning shot is the magnificent sandstone cliffs of Capitol

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photo prescription [continued]

Reef National Park. I happened to be there during a full moon so I picked a spot well back from the cliffs to include the lunar orb in my composition. I used a 300mm zoom lens to increase the size of the moon relative to the cliffs. Had I used a wide-angled lens it would have rendered the moon tiny. I needed all my depth of field to render the moon and cliffs sharp, so I shot at f22 and 1/125 second using an electronic shutter release and tripod to avoid camera shake. Rounding off the list of great morning-image locations are Monument Valley and Canyonlands National Parks. I framed the

on at Full mo Reef Capitol Park l Nationa

buttes before sunrise and used the park’s dirt road as a leading line into the frame. I recorded the scene with a medium telephoto lens at f8 and 2 seconds with exposure compensation set for +2/3 f-stops. For Mesa Arch in Canyonlands I went with f22 and 1/125 second to create a starburst effect of the sun peeking over the east valley ridge. I composed the scene with the arch running across the top of the frame and the sun at the left. The low light sweeping across the valley floor created a moon-like landscape. Utah is a pretty dry place, but I did manage to find a small picturesque waterfall in Calf Creek Recreation Area. The water cascades over a sandstone ledge into a small pool. I asked a friend to get into the cold water and keep perfectly still while I shot the scene at 1/2 second and f18 with a medium telephoto zoom (set at 60mm). The slow shutter speed produced a wispy wedding-veil-like stream of water and my shivering friend added scale to the falls. As my old workshop instructor said, it’s pretty hard to screw up Utah images. The main challenge is trying to show the breathtaking scale of things. Images of arches look ordinary until you place someone in the composition for scale. Two cases in point are Corona Arch near Moab and the Ear Of The Wind Arch in Monument Valley. After shooting both from numerous angles they still looked blah. It wasn’t until I incorporated someone into each scene that the size of the arches delivered awe. So, if you do just one thing while shooting in Utah, find a model to place amidst the topography. And go in May or September (although Utah is a year-round destination), when daytime temps are manageable and the sun’s lower angle emphasizes those 50 shades of red.

michael defreitas

Monument Valley at sunrise


Just For Canadian doctors Spring 2017

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.

A paucity of hope

In hopeless times, one physician’s guiding force in medicine is the humanitarian aspect

courtesy of Dr. Tom Jagatic


physician treats pain, illness and injury. But when a patient has lost hope, how does a doctor treat this, perhaps most devastating, human malady? It was early 2016 and Dr. Tomislav Jagatic of Windsor, ON, was working with Médecins Sans Frontières (MSF) in a sprawling refugee camp near the village of Idomeni, Greece on the border of the Balkan nation of Macedonia. The makeshift camp had sprung up after the European Union began closing borders in early 2016 to Syrians, Afghans and Iraqis fleeing their violent homelands. Originally intended to house 1,500 refugees, by the time Jagatic arrived 15,000 people were stranded in the camp, vulnerable to cold, rain and sickness, dependent upon the flimsy protection of tents or marquees, with no end in sight to their predicament. Jagatic recalls one Iraqi mother who brought in one of her three children: a four-year-old daughter in severe respiratory distress due to a serious infection. The mother, Jagatic says, was indifferent— emotionless—crushed by the weight of never-ending hardship as well as the loss of her husband, who was killed in the civil war. “The mother had a very flat effect—she wasn’t worried—she just couldn’t react. She was burned out,” Jagatic says. Jagatic recalls another patient, a Syrian woman with four children whose husband had also perished in that nation’s civil conflict. Her home had been bombed and identity papers, like her passport, destroyed. The woman had a heart condition and was paralyzed on the left side of her body by a stroke. Without identification papers, the border guards deployed along the Greek border refused to allow her to even apply for entrance into the EU. “She came into our clinic, saying, ‘I don’t know what to do. I’m stuck here. They won’t let me go,’” Jagatic says. “She’s the only remaining parent of this family—these four children—and they’re giving her all these hassles. There was just no desire to help this woman.” Jagatic has been working with MSF since 2012, not only in refugee camps in Europe but on missions in Africa, where he has provided medical aid to the victims

of war, those suffering HIV-AIDS, as well should someone be diagnosed with the as those stricken by Ebola during the disease. epidemic that swept West Africa more than Ensuring the health of the most a year ago. Even before attending medical vulnerable and poor—of nurturing hope school, Jagatic was determined to practise as well as treating injuries and illness—is humanitarian medicine. This drive, a way to ensure the wellbeing of in fact, influenced his decision all peoples, including those The to study medicine in Croatia, fortunate enough to have World Health where tuition is about one been born in the West, Organization’s tenet quarter what it is in Canada Jagatic says. “We are that everyone has the or the United States. (Jagatic “right to health” is Dr. holds dual Canadian and Tom Jagatic’s driving Croatian citizenship.) inspiration in his “The guiding force for work for MSF. me in medicine was the humanitarian aspect. I realized that if I was to go into debt from school—since the things I am interested in don’t pay that well—then I wouldn’t be able to undertake humanitarian missions until later on in life.” Jagatic points to the World Health Organization’s tenet that everyone has the “right to health” as his driving inspiration. “It just felt natural to devote my time to trying to reinforce that declaration,” says Jagatic, who currently works in the ER department of a hospital in Zagreb, Croatia until May, when he anticipates being sent on another MSF mission. Jagatic doesn’t know where he will be sent; despairing and dying people are to be found all over the globe. He recalls one of the most desperate situations he has ever been in: West Africa, where the Ebola outbreak killed more than 11,000 people over a 21-month period, from 2014-2016. Jagatic not only treated patients but trained physicians and healthcare workers at a new Ebola treatment centre in Guinea, ground zero for the outbreak. As a result of the training and support by Western destabilizing our society by marginalizing healthcare experts like Jagatic, West African people,” says Jagatic, who is scandalized governments today are better able to deal by the apathy of the EU as well as other with another Ebola crisis, should one occur, Western nations, whose closed-door he says. policies are perpetuating the refugee Altogether, Jagatic did three tours crisis. “We are destabilizing our society by of duty in West Africa during the Ebola marginalizing people, by not providing outbreak. As a result, Public Health Canada them with the proper access to healthcare and several Canadian hospitals called upon and education. In 15 to 20 years from Jagatic to help them create guidelines now we’re going to see the results of our and protocols for the medical system here inaction, which is very sad.” Spring 2017 Just For Canadian doctors


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

A toast to Canadian whisky


the Scots first brought to Canadian shores wasn’t the sometimes-peaty whisky. “It was rum,” says de Kergommeaux. He’s sharing this piece of Canadiana with a group of guests invited to sample the Lohin McKinnon single-malt whisky at Central City’s HQ in Surrey, BC. “Scots made rum in Nova Scotia, not whisky,” he continues. “They wanted booze they could drink right away.” Molasses was easy to come by on the coast, so it was rum that flowed freely in eastern Canada. When communities started cropping up in Ontario—away from the sea—molasses fell out of favour. Wheat became the gateway grain for Canada’s first batches of whisky. But it took 200 years “before there was any successful single-malt distillery here,” says de Kergommeaux. The first was Glenora Distillery in Cape Breton, NS, which has Sweet sip been producing Canadian single-malt whisky since Single-malt whisky is 1990. A young upstart now in the repertoire of on the global scale, it’s Canadian distilleries. Case helped cement Canadian in point: Lohin McKinnon whisky’s solid rep by by Central City racking up international Brewers. awards and paving the way for younger players, like Still Waters Distillery in Concord, ON, with its single-malt and 100% rye Stalk & Barrel whiskies and Lucky Bastard Distillers in Saskatoon, SK, which recently released a small batch whisky, not to mention a number of newcomers in BC contributing to the West Coast microdistillery boom. Central City’s brief history goes back to 2003, when it was solely brewing beer. The company has won the Canadian Brewery of the Year Award twice and is known for its flagship Red Racer series of craft beers, available coast to coast. Earlier, Lohin toured us through Central City’s 68,000-square-foot operations. Standing by a trio of gleaming copper Holstein stills, Lohin explained the kinship between beer and whisky, distilling the grain-to-glass processes. “Whisky is the closest cousin to beer. All you are doing is making a beer without hops.” Aging, of course, is essential. Canadian

hisky takes time,” says Davin de Kergommeaux. “They are doing it right.” It’s high praise from the author of Canadian Whisky: The Portable Expert for Central City Brewers & Distillers’ just-launched Lohin McKinnon Single Malt Whisky (named for the awardwinning brewmaster Gary Lohin and head distiller, Stuart McKinnon). Age is a relative thing. Even the ripe age of 150, which Canada celebrates this year, is youthful compared to countries like Scotland whose history runs so deep that its national animal is, well, the unicorn. And while some might wonder about Scotland’s ties to mythical beasts, there’s no quarrel with its canniness for producing legendary spirits, especially whisky. But you might be surprised to learn that the liquid legacy


Just For Canadian doctors Spring 2017

law dictates that, to be called a whisky, the spirit must be aged in wood for a minimum of three years. In the barrel room we’re surrounded by casks bearing the stamps of madeira, Pedro Ximenez, Olorosa, Tokai, Sauternes and bourbon. Each cask imparts character to the whisky, not just from the wood but from the vestiges of what was originally inside. “Why, in Canada, would we ever think about making single-malt whisky?” asks de Kergommeaux before answering, “I’d say the Scots and Japanese have already perfected it.” He’s alluding to a dichotomy that perhaps favours patriotism over perfection, though both are purely subjective constructs. “We can do it our own way,” he says, adding, “Whisky in the US doesn’t taste like scotch.” Pride of place, particularly when it comes to ingredients, plays a big part in small-batch distilling. And it’s time for us to taste that character in four samples, each an expression of Lohin McKinnon whisky. We start by sipping the single-malt spirit now commercially available in BC and ON. Made with Canadian malted barley and BC water, it’s aged for three years in bourbon casks. Given its youth, it’s surprisingly smooth, featuring light fruit, with a little sherry in the background. The second sample is a limited-edition whisky that will be launched (only in BC) in June, in honour of Canada’s 150th. It’s about 70% rye and naturally more peppery. The single malt, with a mix of pale and chocolate malt aged in Sauternes casks gives our third sample an entirely opposite flavour: sweetness and pronounced chocolate notes. It’s a striking contrast from our final sample. Distilled in 2015, it doesn’t qualify as whisky, but it’s pleasantly peaty, and aged in bourbon casks. It brings home a bold statement de Kergommeaux made earlier: “This is not cowboy whisky. The most important thing is that the flavours are balanced. There are no sore thumbs sticking out.” The event offered an enlightening look inside Canada’s expanding portfolio of micro-distilleries. It’s not about challenging the players, whether in the UK, Asia or the US. Instead, these newcomers are distilling our country’s heritage in their own way.

central city brewers

Raise a glass to our country’s crop of small-batch distillers









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!viva Cuba!

travel the world

Looking over the rooftops of Trinidad below Street musicians in Havana opposite, top The grand old architecture and cars of Havana, by Parque Central opposite, bottom Watching the fortress of Morro Castle go by as the Celestyal Cruises ship leaves Havana

A cruise around this hot and oh-so-colourful island sails from port to port, city to beach, paladar to fort story

+ photography by Barb Sligl

travel the world Celestyal Cruises ship moored at María La Gorda below, from left Cristal cerveza at the Hotel Nacional; dancer at Tropicana cabaret club in Havana


Just For Canadian doctors Spring 2017


watch a woman in a flirty little skirt and tank top, dancing in flip-flops. She’s held tight against her partner. His hands are low on her hips and he sets a steady rhythm. He moves easily across the pavement in his slim pants and bright-red sneakers. Her skirt twirls as he spins her. I’m mesmerized. And blush when he turns and catches me staring. He grins and keeps dancing. Ah, Cuba. There’s something in the air here, in Havana on a hot afternoon in the shade under the palm trees of Parque Central. It makes me want to join the fray—the young couples, grannies, toothless men and toddlers, all enjoying the music and public dance floor surrounded by the gorgeous facades and faded glory of Old Colonial Havana. Feeling rather hot, I cool down with a daiquiri in its “birthplace” at nearby El Floridita (alongside a life-size statue of patron saint Ernest Hemingway), before meandering through the crumbling architecture, past fruit and cotton-candy vendors, kids playing soccer in the street, locals gossiping in the late-afternoon sun. I’m part of the scene, at least for a little while before passing security and re-boarding the cruise ship I came into Havana on. Starting in Montego Bay, Jamaica, the seven-day Celestyal Cruises circumnavigation of Cuba includes two days and one night in Havana, a stop in Santiago de Cuba (where Fidel Castro’s revolution began in 1953 at the Moncada Barracks), a beach day and then a tour inland to Trinidad from Cienfuegos. It’s a somewhat conflicted way to visit this stillstruggling country—to tour a port by day and then escape at night back to the shelter and comfort of a cruise ship. But with limited accommodations and amenities onshore, despite the slow shift out of hard-line communism, it’s also the easiest way to see the most of this country in a week’s time—from Havana’s gorgeous fervor to untouched strips of sand. And because there’s so much to take in on this island—seven UNESCO Cultural World Heritage Sites (including Old Havana), six UNESCO Biosphere Reserves, two UNESCO Natural World Heritage Sites, more than 300 beaches—this cruise is like a bit of a primer on the country. In Santiago de Cuba, I learn about Velázquez. As in Diego Velázquez de Cuéllar, the Spanish conquistador who came to the New World on Columbus’s second voyage. He “discovered” Santiago in 1515 and then conquered Cuba. The rather intimidating and impenetrable Castillo de San Pedro de la Roca (a UNESCO site), perched atop an outcrop overlooking the blue-blue Caribbean

Locals hanging out on the malecón in Havana right Walking in Old Havana below, clockwise from left Literature in Havana; dancers in Havana’s Parque Central; a classic Cuban “marriage” of coffee, rum and a cigar; ’50s-era car in Trinidad; the Castillo de San Pedro de la Roca in Santiago de Cuba

travel the world

travel the world

Castillo de San Pedro de la Roca, near Santiago de Cuba above left Havana street scene above right El Floridita daiquiris below left Photo of Hemingway at one of his haunts, the Hotel Ambos Mundos in Havana below right A duo plays music at a paladar

seems to embody some of that brutal history. Built as a fortress against pirates, this UNESCO World Heritage Site is where a decisive battle took place during the Spanish-American War, served as a prison (with whispers of horrendas torturas) and is now home to tourists and red-tinged crabs scuttling over its moat. As I walk along its ramparts, I hear a group of women singing inside the old ruins, their voices accompanied by the wind blowing off the sea. Because in Cuba, everything comes back to music. On any given street, musicians strum and sing, ranging from strident to sultry to solemn. At the Santa Ifigenia cemetery (where Castro’s ashes have since been interred), our cruise group watches the changing of the guard to honour José Martí, another fighter for independence and so-called Shakespeare of Cuba (and far less controversial national hero). Everywhere there’s a tropical lushness juxtaposed with cosmopolitan old-world urbanity—from this cemetery to Havana’s Parque Central. This is a poor country with a rich culture. A land of dualities. Punctuated with signs and graffiti scrawled across walls, proclaiming “Unidos con la revolución.” Here, Soviet-era Moskvitch cars coast right alongside American Chevrolet BelAir convertibles. In Havana, I ride in one of those vehicles of a bygone era. My guide, Ray, drives an original Ford Model T—from 1914. His grandfather traded a 1948 Cadillac for it 50 years ago. It’s patched and polished with whatever means available and putts along with a charming rat-ta-tat, rat-ta-tat. Driving past Parque Central again, I see a group of men in crisp white uniforms gathering to stand at attention for some military event. There’s a strange nostalgia at play with such decorum and discipline butted up against the chaos and decay surrounding it. I think of those ordinary citizens grooving (not so ordinarily) under the same palm trees, as if thumbing their nose at the rigidity on display here now. Continuing on my Model-T tour of Havana, I see old Havana (with a bustling, non-touristy Chinatown) and block after block of colourful, crumbling facades and grand architecture long past its heyday. We coast by graffiti of the ubiquitous Che Guevera and then street art of a not-so-stoic hooded and kneeling man, perhaps a reference to prisoners of Gitmo or elsewhere. At the famous Hotel Nacional bar there are photos of world leaders who presumably have been to Cuba on some sort of state visit and stayed here…Vladimir Putin, Mahmoud Ahmadinejad, Bashar al-Assad (all a bit of a gut punch), alongside the more neutral faces of Charlie Rose and Matt Dillon. I try

travel the world if you go

Year-round cruising to Cuba takes place with Celestyal Cruises from now until the end of December 2017. Weekly seven-day sailings depart every Friday from Montego Bay and every Monday from Havana. Along with three port stops, there’s a beach day at Punta Frances on the Isle of Youth. cuba.celestyalcruises.com

A local woman in Havana leans against one of the city’s many crumbling-yetcolourful walls Spring 2017 Just For Canadian doctors


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travel the world


Just For Canadian doctors Spring 2017

to cleanse some of the unpleasantness with a local cerveza and a walk along the hotel’s lovely grounds overlooking the sea. Dropped off back in the hub of Havana, my sampling of local beverages continues, this time Cuban coffee and rum, accompanied with a cigar. It’s called the perfect marriage. I have to agree, especially when sampled in the courtyard of the Palacio de la Artesania, amidst artists selling their wares and a quartet of singing women (because music follows wherever you are in Cuba). Later, at a paladar (El Zaguán, one of a growing number of privately owned and operated dining restaurants that have cropped up in recent years), there’s another live soundtrack during lunch, this time by two women strumming guitar in stilettos with heart-breaking aplomb. They’re gorgeous. And throughout my exploration-by-cruise skirting the island, I can’t help but stare at Cuban beauty—inner and outer. People unabashedly stare back. Some even ask for help. Sometimes money, but more often almost anything else. An old woman shows me a toonie and asks if I’ll take it back in exchange for pesos (CUC or Convertible Cuban Pesos, that is). One man asks if he can have the pen I’m writing my notes with. Another asks if I’ll buy some milk for his children in the store. When food rations are still a thing, money doesn’t mean as much. In Santiago I watch as people line up for guarapo (sugarcane juice). And I notice a woman in bright-green capris with a T-shirt hitched up to bare her midriff in the heat, showing off a lower-back tattoo. She’s utterly unselfconscious. But that’s Cuba. Everyone’s at ease in their skin. Communism has done nothing to tamp down the inherent sexiness of this place. People sit on stoops or the curb or lean against the ever-present ’50s-era cars parked in the streets. I could stroll along these streets indefinitely, taking everything in, observing locals, watching their interactions, peeking into open doorways and windows. I think of one of über-traveller Anthony Bourdain’s comments about some other far-flung destination, something akin to every door being a glance into another world. I feel that tenfold here. Every corner, stoop, curb, car is abuzz with life, and some tale to tell. Much like those dancers back in Havana’s central square, where young and old meet to simply move and groove, this island—despite, or in spite, of everything—brims with a bold, if disheveled, beauty. Everyone has a story—we all do—but Cubans have one with an especially deep and soulful rhythm, bumping and grinding with joy.

grand cayman / manchester / napa / kuala lumpur … | c a l e n d a r


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

spr ing 2017 + beyond

grand cayman



[check in]




Kimpton Seafire Resort + Spa, the island’s first new major resort in 10+ years. Recently opened, it’s the new go-to on Seven Mile Beach (seen here). seafireresortandspa.com

grand cayman has all the Caribbean musts—beach, snorkelling, marine life, sunsets…and enough food and drink to warrant an annual festival (CME events in Grand Cayman + beyond are highlighted in blue.)

sharon matthews-stevens


nsconced beachside, on an alabaster swath of sand 1 guarded by elegant hotels, stretching 10 km along Grand Cayman’s west coast, nuzzled by waters so clear you can see starfish on the bottom, I wonder how I’m going to fill tomorrow. Right now, entertained by a perfect sunset (one of the Caribbean’s best), I don’t feel like doing anything, though tonight it’s fine dining at Abacus at Camana Bay (camanabay.com), a modern town centre boasting boutiques and other fine dining options beside the water. Wherever I dine, I’ll be sated: many consider the Cayman Islands the Caribbean’s culinary capital. It’s also home to the annual Cayman Cookout festival with renowned host, Chef Eric Ripert (plan for next year’s 10th annual fest now; @caymancookout). Tomorrow’s first stop, I decide, will be a helping of

history. Pedro St. James (pedrostjames.ky) 2 is both a refurbished 17th-century great house and host to an interpretive centre worthy of Disney World. I’ll stroll here by the sea amid stands of banana and mahogany trees, tour the outdoor kitchen and then explore the furnished house itself. Then maybe bond with nature. Welcome to the Cayman Turtle Centre (turtle.ky)—combination wildlife sanctuary, turtle hatchery and theme park—where I’ll learn about efforts to save the sea turtle, pet these huge animals and maybe even swim with them. Or maybe 5 I’ll just cross the road and swim with the dolphins at Dolphin Discovery. Or I’ll get really close to nature—and bond with the sea. Maybe book a catamaran tour to Stingray City (stingraycitytrips.com) 3 , snorkelling with those graceful creatures—or take a

side trip to Starfish Point where I stand in water up to my waist as the stingrays wheel and soar between my legs. Then it’s time for some R and R. Make for Rum Point (rumpointclub.com) 4 . Stake out a claim in the shade near a congregation of pastel-painted picnic tables; do frosty Caybrew beers at Wreck Bar, once rated among the world’s top-50 beach bars. Go for a swim in bathtubwarm waters. After some downtime, maybe I’ll take things up a notch: the Cayman Islands are considered among the world’s best dive destinations. I’ll take a lesson in the pool at the Westin Grand Cayman (westingrandcayman. com), then out on—or in—the water. Maybe I’ll dive Babylon or Ghost Mountain. We’ll stop en route back to our hotel and be mesmerized by the beauty and might of the Caribbean at Blow Holes 5 . Then, it’s home James, for ringside seats to another spectacular sunset 6 , the perfect finish to another perfect Grand Cayman day. — Mark Stevens To discover even more activities to round out a perfect stay here, go to visitcaymanislands.ca.

Spring 2017 Just For Canadian doctors


Emergency Medicine




Aesthetic Medicine

c Mcmee when calendar where

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





Jun 17-18

Vancouver British Columbia

Botox And Dermal Filler Training

The Physician Skincare and Training Center

877-754-6782 See Ad Page 24


Aug 26-27

Boston Massachusetts

Management Of Facial Trauma Course

AO North America



Oct 21-22

Vancouver British Columbia

Botox And Dermal Filler Training

The Physician Skincare and Training Center

877-754-6782 See Ad Page 24


May 14-20

Southern Portugal

Controversies In Perioperative Medicine

North York General Hospital Department of Anesthesiology



Jul 06-07

Baltimore Maryland

Practical Emergency Airway Management

Center for Emergency Medical Education



Nov 13-17

Kauai Hawaii

2017 California Society Of Anesthesiologists (CSA) Fall Anesthesia Conference

California Society of Anesthesiologists



Jan 24-27 2018

Grand Cayman Cayman Islands

2018 Anesthesia Camp, Grand Cayman



destination cme.com

Apr 29May 02

Philadelphia Pennsylvania

18th Annual American Society Of Echocardiograph (ASC) eXAM/ReASCE Review Course

American Society Of Echocardiograph



May 05-07

Houston Texas

2017 Southwest Valve Summit

Houston Methodist Institute for Academic Medicine


houston methodist.org

May 19-20

Leiden Netherlands

2017 European Society For Vascular Surgery (ESVS) Spring Meeting: Basic & Translation Research In Vascular Surgery

ESVS Administration Office



Apr 21-23

Kuala Lumpur Malaysia

9th Diabetes Complications Conference & Grand Rounds

011-60-3-7876National Diabetes Institute (NADI) Malaysia 1676

nadidiabetes. com.my

Jun 09-13

San Diego California

77th American Diabetes Association (ADA) Scientific Sessions

American Diabetes Association



Sep 11-15

Lisbon Spain

53rd Annual European Association For The Study Of Diabetes (EASD) Meeting

EASD Headquarters



Apr 10-14

Sarasota Florida

Pediatric Emergency Medicine: An Evidence-Based Approach

American Medical Seminars


americanmed icalseminars. com

Jun 07-09

Jackson Wyoming

Advanced Airway Course Yellowstone/Tetons

Center for Emergency Medical Education



Jun 22-23

Ottawa Ontario

Emergency Department Targeted Ultrasound

Canadian Association of Emergency Physicians



Dec 14-17

Miami Beach Florida

Topics In Emergency Medicine

Northwest Seminars


northwestsemi nars.com

NYU Radiology CME Presents

36th Annual Head to Toe Imaging Conference December 18-22, 2017 • The New York Hilton Midtown • New York City

Earn over 40 AMA PRA Category I Credits www.med.nyu.edu/courses/cme/h2t17


Just For Canadian doctors Spring 2017

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


General & Family












Apr 27-28

Montreal Quebec

2017 Bureau en Gros

Université de Montréal



Jul 27-30

Boston Massachusetts

3rd World Congress On Thyroid Cancer

The Bayley Group


thyroidworld congress.com

Sep 21-22

Stockholm Sweden

Pancreas Workshop: A Multidisciplinary Imaging Approach

European Society of Gastrointestinal & Abdominal Radiology Office



May 15

Manchester England

3rd Manchester Dysphagia/Transnasal Course

Manchester Royal Infirmary


phonosurgery course.com

May 18-20

Mallorca Spain

1st International Congress Of MicroImmunotherapy


katharina. krueger@ megemit.org


Aug 25-27

St. Louis Missouri

2017 American College Of Gastroenterology (ACG) Midwest Regional Postgraduate Course

American College of Gastroenterology



Mar 16-17

Manchester England

2017 Medicine: Royal College Of Physicians Annual Conference

Royal College Of Physicians London



Apr 24May 01

Netherlands & Belguim: Tulip Time River Cruise

Medical And Public Health Issues / Roundtrip Amsterdam On AMA Waterways

Professional Education Society



May 12

London England

Red Whale GP Update Course - London

Red Whale



May 16-20

Vancouver British Columbia

SPR 2017 Annual Meeting & Categorical Course: Pediatric Radiology, Radiology, CT, PET/ MRI, Neuroradiology, Cardiovascular Imaging, Interventional Radiology, Ultrasound, Thoracic Imaging, Oncology & Nuclear Medicine, Machine Learning And More

The Society of Pediatric Radiology (SPR)



Jun 06-07

Stavanger Norway

37 ºC – Life Science Technology Conference & Exhibition

37 ºC


37degreescel sius.net

Jun 15-24

Cuba & Guatamala

Cuba & Guatemala 2017 Medical Conference

Unconventional Conventions


uncon-conv. com

Jun 24

Washington DC

Hospitalist And Emergency Procedures Course

Hospital Procedures Consultants


hospitalproce dures.org

Aug 25Sep 06

London to Lisbon Cruise with Honfleur & Bordeaux

Medical Symposium At Sea / Western Europe Cruise On The All-Inclusive Crystal Symphony

Professional Education Society

877-737-7005 See Ad Page 23


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 See Ad Page 23


Oct 31Nov 04

Napa California

2016 Update In Advanced Imaging

UC Davis Health System


ucdmc.ucda vis.edu

CME/CE Cruise & Travel Seminars

Additional 2018 CME/CE Seminars • • • • •

UPCOMING PES CME/CE SEMINARS Western Europe Cruise on Crystal Symphony

London to Lisbon with Honfleur, St. Malo & three days in Bordeaux

August 25 – September 6, 2017

India’s Golden Triangle & The Sacred Ganges 5-Night Oberoi Hotels and 7-Night Uniworld River Cruise

7-Night aboard the luxury small ship m/s Paul Gauguin Cruises

November 4 – 11, 2017

Professional Education Society: quarter page CME section-Summer-2017.indd 1


Patagonia & Chilean Fjords Cruise on Ponant

14-Day five-star expedition from Ushuaia to Valparaiso

March 7 – 20, 2018

October 19 – 31, 2017

Tahiti Cruise Bora Bora & the Society Islands

For more details contact PES

British Isles on Crystal Serenity Portugal & Douro River Cruise Crystal River Cruise Peru & Machu Picchu Iceland and Alaska!

Historical Holy Lands Cruise on All-Inclusive Regent

Dubai to Rome with Jordan, Egypt, Israel, Cyprus & Greece

May 12 – June 1, 2018




2/24/2017 3:30:00 PM

Spring 2017 Just For Canadian doctors


Mental Health

Infectious & Chronic Diseases

Internal Medicine



c Mcmee when calendar where

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





May 18-20

San Antonio Texas

2017 American Geriatrics Society (AGS) Annual Meeting

American Geriatrics Society


americangeri atrics.org

Nov 02-04

Toronto Ontario

9th Canadian Conference On Dementia

University Health Network


canadiancon ferenceonde mentia.com

May 12

Indianapolis Indiana

20th Annual Indiana University Gastroenterology/ Hepatology Update

Indiana University School of Medicine



Dec 07-08

Madrid Spain

13th International Conference On Clinical Gastroenterology & Hepatology

Pulsus Meetings


gastroenter ologysociety.org

Apr 13-15

Cancun Mexico

Neurology And Psychiatry For Primary Care

MCE Conferences


mceconfer ences.com

Apr 19-22

Washington DC

2017 Society Of General Internal Medicine (SGIM) Annual Meeting

Society Of General Internal Medicine



Jun 01-02

Quebec City Quebec

Les Petites Urgences en Cabinet

Fédération des médecins omnipraticiens du Québec



Ongoing Ends Jan 2018


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



mdbriefcase. com

Apr 10-12

Washington DC

Influenza & Respiratory Vaccine Conference




Apr 24-26

Bethesda Maryland

2017 Annual Conference On Vaccine Research

National Foundation for Infectious Diseases



Jul 10-12

Banff Alberta

Medical CBT Tools: Ten-Minute Techniques For Real Doctors

CBT Canada



Aug 18-19

Vancouver British Columbia

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

CBT Canada



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


Dec 27-29

Disney World Grand Floridian

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

CBT Canada

877-466-8228 See Ad Page 20


Jun 07-09

Strasbourg France

Microscopic & Endoscopic Approaches To The Skull Base

Institut de Recherche Contre les Cancers de l’Appareil Digestif Training Centre



Jul 24-28

Colorado Springs Colorado

14th Annual Society Of NeuroInterventional Surgery (SNIS) Meeting

Society of NeuroInterventional Surgery



Nov 04-11

Tahiti and the Society Islands Cruise

Topics In Neurology For Primary Care Providers

Continuing Education, Inc./University at Sea


continuingedu cation.net

Physician Training Center (REVISED).pdf 12/05/2015 2:13:45 PM










Just For Canadian doctors Spring 2017

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

Primary Care



Oncology & Palliative Care

Obstetrics & Gynecology










May 17

Toronto Ontario

25th Annual New Developments In Prenatal Diagnosis And Medical Genetics

University of Toronto Dept. of Obstetrics & Gynaecology & Mount Sinai Hospital


mountsinai. on.ca/cme

May 18-19

Brussels Belgium

2017 Obstetric Anaesthesia

Obstetric Anaesthetists’ Association



Oct 13-14

Singapore Singapore

2017 Australasian Gynaecological Endoscopy & Surgery Society Focus Meeting

YRD Event Management



Dec 09-10

Phoenix Arizona

Workshop On Surgical Anatomy Of The Pelvis & Procedures In Patients With Chronic Pelvic Pain

American Association of Gynecologic Laparoscopists



Dec 15-16

New York New York

23rd Annual Conference On Challenges In Gynecology

Symposia Medicus


symposiamedi cus.org

Jan 20Feb 01 2018

Australia and New Zealand Cruise

Women’s Health And Healthcare Communications

Continuing Education, Inc./University at Sea

800-422-0711 See Ad Page 39

continuingedu cation.net



Modernizing The Code Of Medical Ethics: Chapter 5 - Ethical Issues In Caring for Patients At The End Of Life

American Medical Association



Apr 21-23

Prague Czech Republic

2017 European Focus On Myeloproliferative Neoplasms & Myelodysplastic Syndromes




Jul 16-21

Halifax Nova Scotia

Diagnostic Pathology Update

US & Canadian Academy of Pathology


uscap.org/ cme-cal

Jan 16-18 2018

Rodney Bay St. Lucia

5th Caribbean Biomedical Research Days

International Stress & Behavior Society




Multiple Cities Colombia

Capacity Building Internship For HIV/AIDS Orphanage (Volunteer Opportunity)

The Humanity Exchange


thehumani tyexchange.org

Jul 06-09

Kuala Lumpur Malaysia

11th International Symposium On Pediatric Pain

My Meeting Partner by Anderes Fourdy



Aug 07-09

Austin Texas

Innovations In Neonatal Care Conference

Pediatrix Medical Group

See Website

innovation sconference. com

Oct 25-28

Grand Cayman Cayman Islands

33rd Annual Fall Conference On Pediatric Emergencies

Symposia Medicus


symposiamedi cus.org

May 15-19

Maui Hawaii

Clinical Issues In Primary Care Conference

Continuing Education Company



Jul 13-16

Lake Buena Vista Florida

Headache Update 2017

Diamond Headache Clinic

312-867-9104 See Ad Page 20


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Spring 2017 Just For Canadian doctors





Sep 18-28

Primary Care And Women’s Health: Key Topics And Core Strategies

Continuing Education, Inc./University at Sea


continuingedu cation.net

Oct 08-18

Far East Cruise Conference

Topics In Preventive Medicine And Geriatrics For PCPs

Continuing Education, Inc./University at Sea

800-422-0711 See Ad Page 39

continuingedu cation.net

Nov 18

Chicago Illinois

Update In Headache 2017

Diamond Headache Clinic

312-867-9104 See Ad Page 20


Apr 20-23

Montreal Quebec

42nd Annual Meeting Of The Society For Sex Therapy & Research (SSTAR)

The Society For Sex Therapy & Research



May 16-19

Athens Greece

2017 Association Of Psychology & Psychiatry For Adults & Children (APPAC) Annual International Conference

Association of Psychology & Psychiatry For Adults & Children



Oct 23-27

Charleston South Carolina

NYU’s Fall Radiology Symposium In Charleston

New York University Department of Radiology

212-263-3936 See Ad Page 22


Dec 18-22

New York New York

36th Annual Head To Toe Imaging Conference

New York University Department of Radiology

212-263-3936 See Ad Page 22


Feb 19-22 2018

Grand Cayman Cayman Islands

2018 Advanced Imaging In The Islands

Duke Radiology



Apr 29

Houston Texas

Non-Small Cell Lung Cancer Hands-On Summit - Houston

American College of Chest Physicians



Sep 25-27

Chicago Illinois

3rd World Summit On Pediatric Cardiology & Pulmonology

Conference Series LLT


pediatriccar diology.con ferenceseries. com

Sleep Issues

Oct 12-24

Brighton England

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

British Sleep Society


sleepsociety. org.uk

Oct 26-29

Auckland New Zealand

2017 Sleep DownUnder

Australasian Sleep Association



Jul 06-07

Cambridge Massachusetts

16th Cambridge / UCLA Course On Clinical Exercise Testing & Interpretation - A Practical Approach

Cambridge Postgraduate Medical Centre



Jul 20-23

Toronto Ontario

American Orthopaedic Society For Sports Medicine’s Annual Meeting

American Orthopaedic Society For Sports Medicine



Apr 08-12

Big Island Hawaii

2017 National Conference On Wilderness Medicine

Wilderness Medicine



Sep 03-23

Bali Indonesia

Wilderness Medicine Educational Conference: Highest Point In Oceania: Carstensz Pyramid

Andes Mountain Guides


andesmoun tainguides.com





Primary Care


French Riviera Barcelona to Venice

Sports Medicine

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

Wilderness and Travel Medicine

c Mcmee when calendar where

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Just For Canadian doctors Spring 2017


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.

The trump car Inaugurating the halcyon days anew

Ford Motor company


s your loyal scribe, I knew something had to be done. A historic political event from this past November meant I needed to upgrade my American muscle-car knowledge. Hundreds of study hours later I’m now prepared for the “Trump Effect” on car enthusiasts. By the time you read this “The Donald” will have been inaugurated as “The Pres.” His campaign tagline, “Make America Great Again,” spoke to those Americans suffering disaffection from one or more of these modern realities: globalization, open borders, technological change, shifting social values, creeping nanny state…or all of the above. We all tend to look at the good ol’ days through rose-coloured glasses. Those most threatened by change are most susceptible to retrospective distortions. Cue those with less education, conservative values, bluecollar jobs and advancing age (I include Boomers in that age description). Trump’s election has each of those demographic groups of Americans feeling empowered and newly confident. So how do these social forces transpose onto the car enthusiasts’ world? Two words: muscle cars. Most living Americans would envisage their country’s best peace-time mojo as the 1950s and ‘60s. Today’s American car enthusiasts regard the mid-50s through 1970–71 as the golden age of muscle cars, when horsepower and acceleration were king. In their minds, what forces ended the muscle car’s golden age in the early ’70s? Meddling government regulators, greedy insurance companies and those tireless greenies. These are just a few of today’s scapegoats for Trumpites. Now ponder which demographics have kept the flame burning on muscle cars since that golden age…and meet those same groups who say, “Make America Great Again.” The hourly-wage-earning white males will invigorate today’s $10,000 to $100,000 collector muscle-car market. Today’s “selfmade” men who grew up in those same neighbourhoods will bid up the thousands of >$100,000 collector muscle cars.

Would you be surprised to learn that after 9/11 there was a surge in demand and pricing for collectible American muscle cars? That was a period of fear, anger and economic uncertainty for the above demographic groups. With early 2017 promising these same groups confidence, pride, bullishness and an inflationary fiscal policy—the new valuation surge could be more dramatic. Let’s just hope the banks have learned their lesson from 2007–09 and don’t pour credit-fuel onto this fire. (OK, but one can hope). In theory, a Canadian now entering the market of golden-age muscle should also benefit from the expected short-term increase in value of the US dollar relative to most other currencies. The muscle-car collector market is a multi-billion dollar hobby/business and [mustang] every such vehicle is AND THEN… essentially valued in Ford’s version of the US currency. American muscle car, Two schools of circa 1967—and in “Playboy” pink. thought exist on what examples to collect from this market. Purchase what you like and count on the rising tide to float all boats (or in this case, all American collector cars). Or, alternately, purchase the crème de la crème. During other collector muscle-car market advances these models have always outpaced the wider market. Given that horsepower was king in the golden era, there is one marquee engine from each of the Big Three that power the upper-crust collectibles: the Mopar 426 Hemi from Chrysler, the Big Block 427 Chevy from GM and the Ford FE 427. A documented original

“born with” engine is pivotal to valuation. With hundreds, or even millions, of dollars riding on a vehicle’s provenance, fraudulent cars and representations exist. Seek professional help before pulling the trigger on a purchase. Many of us may not like what Trump’s election [mustang] represents and promises, NOW…The 2017 but we can’t change the version of Ford’s classic American muscle car.

fact that it is upon us. On some fronts my curiosity is piqued by what trends the regime change will trigger. I may even elect to go along for some parts of the ride. Now if I could just find one of the 12 original 1969 Pontiac Grand Prix SJ that were given the famous quasi-factory Royal Bobcat upgrades…

Spring 2017 Just For Canadian doctors


t h e w e a lt h y d o c t o r M a n f r e d p u r t z k i Manfred Purtzki is the principal of Purtzki & Associates Chartered Accountants. You can reach him at manfred@purtzki.com.

A hard sell

Permanent insurance as a retirement vehicle


any insurance agents will try to sell you a permanent policy as a retirement vehicle. They’ll tell you that it’s a great forced-savings vehicle that grows tax-deferred like an RRSP, with the option of receiving the funds for retirement income tax-free. Sounds good, right? The concept sounds reasonable, too: a portion of the premium is invested in a tax-sheltered investment account inside the insurance policy. Rather than withdrawing the policy’s cash value, which is subject to tax, the insurance company makes an arrangement whereby the payments to you are funded from a bank loan that is secured by the policy. No interest needs to be paid on this loan during your lifetime, and upon death the bank loan, plus accumulated inter-

est, is paid off from the insurance proceeds. The lure of receiving risk-free, tax-free retirement income is hard to resist for even the most conservative investors. Consequently some will commit themselves to many years of substantial premium payments. The problem is that many policyholders become frustrated by the slow accumulation of the premium dollars inside the investment account. For many the projected cash value of the policy never materializes. With low-investment returns in recent years and the fact that a substantial portion of the premium is used to pay for the death benefit, many policyholders end up trying to get out of this policy. This is easier said than done, considering the very stiff surrender charges, usually applied during the first 10 years.


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Just For Canadian doctors Spring 2017

When you are contemplating taking out a permanent life policy, ask yourself: Do I need (not would I like to have) permanent life insurance coverage? Like many doctors, you need lots of coverage, but usually not past the end of your medical career. There are a small number of doctors who do need the long-term coverage, to pay for capital gains taxes so that the real estate can be transferred to the children without a fire sale, for instance, or to secure long-term funding for the care of a disabled child. Most, however, do not need permanent coverage. Life insurance, like any other insurance, is there to provide cash to cover a financial loss. Insurance is not an investment per se. This may seem obvious, but many people purchase a permanent policy to gain access to its tax shelter aspects without having any need for the death benefit. If you have no real need for life insurance coverage, paying premiums into such a policy is a waste of money as a large chunk of the premiums are used to fund the mortality charges. Take the case of Elsie, a 40-year-old doctor who’s been paying a $12,000 annual premium for a two-year-old $500,000 Universal Life policy. It turns out that this $12,000 premium is actually costing her $20,000 of before-tax cash flow. For the premium Elsie’s paying now, she could purchase a term life policy at a fraction of the cost and use the remainder to help pay for a rental condo she’s considering purchasing. Elsie is joining the ranks of many doctors who’ve regretted the purchase of a permanent insurance policy. Like them, Elsie wants to get out of the policy because, after paying two years of premiums, she realizes she doesn’t actually need any of the benefits the policy offers. She doesn’t anticipate she’ll leave a sizable estate that will attract substantial income taxes on death, nor is she keen to invest her retirement dollars in an insurance policy. One problem remains: she cannot draw out the investment value from the policy because of the substantial cash-surrender charges. The solution? She’ll use this policy as a term policy, by using the accumulated locked-in cash value to pay for future terminsurance premiums.

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.

Pandora’s box

Evidence-based medicine and clinical practice guidelines

rockicon / noun project


hen I began researching this essay I came across a surprising amount of conflicting information and a wide variety of opinions on evidence-based medicine and clinical practice guidelines. It’s a subject that presents many points to consider and hash out well into the future. To some, questioning evidence-basedmedicine is considered heresy against a deep-rooted belief, in spite of its relatively brief history. In 1987, Dr. David Eddie presented an informal yet powerful publication in which he proposed that medical teaching and medical care should be less empirical—that, rather, it should be based on scientific data. In other words, medicine should be more of a science than an art. This phenomenon became mainline in 1990 when his article was published in JAMA. He proposed medical decision-making should be based upon data (a.k.a. evidence) taken from meta-analyses, randomized controlled trials and systematic reviews—in that order of strength. This evidence should then be used to create clinical practice guidelines (CPGs)—and these guidelines have two branches, one for bedside or office clinical decisions, and the other for deciding public health policies (and budgets). Since 1990 CPGs have increased exponentially. There are many sources of statistics concerning guidelines, and these vary considerably but they all reflect an exponential increase. For example, in 1980 PubMed had no guidelines, in 1990 it posted 100 and by 2012 there were 7,000. This is readily apparent by the Appraisal of Guidelines for Research and Evaluation (AGREE II)—a watch-dog think-tank supported by The Canadian Institutes of Health Research—listing 16 CPGs for neuropathic pain, 11 for hypertension, 18 for asthma, 20 for diabetes and 17 for vancomycin. Incidentally, AGREE II gave none of these a rating, based on quality/rigour, greater than 55 of a potential 100, and vancomycin came in at 20. (These figures are available at agreetrust.org.) Guidelines should be based on good, solid scientific evidence. They cannot be if approximately half of clinical trials fail to be

published, and studies with negative or non-significant results are twice as likely to be “lost.” Many CPGs are based on “expert” opinions by panels, often sponsored by pharmaceutical companies. This puts clinical practice guidelines at risk of being erroneous or, worse still, outright misleading. One example is with reference to tight glycaemic control (A1c 6.5% to 7%) in diabetes, despite the evidence of eight meta-analyses, four large clinical trials and two follow-up trials that there is no reduction in microvascular complications. A similar number of trials show comparable results with reference to macrovascular changes, and all cause mortality. In spite of this, tight glycaemic control is still advocated in 100% of CPGs. A further area of concern is the uncertainty of legal liability if CPGs are not followed. These have not been around long enough to establish case law precedent. The Canadian Medical Association, in its Handbook on Clinical Practice Guidelines, clearly states that guidelines should NOT be used as a legal resource in malpractice cases. Nonetheless the CMPA (Canadian Medical Protection Association) advises physicians to discuss with a colleague and/or specialist, and then the patient, any proposed divergence from guidelines; this must be meticulously documented including the rationale for this choice, the discussion and the patient’s express consent. Contradictory? Confusing? Yes, it is. Physicians will be navigating these uncertain waters for some time. Finally, there are the unexpected consequences of CPGs and evidence-based medicine. I have noticed in my recent peer assessments that younger physicians, when recording Pap tests, note that the speculum is passed, a specimen is taken—and that is it. I criticized them for not undertaking a bimanual examination until it was pointed out

that trials suggest that a routine bimanual pelvic examination does not uncover or affect any serious pelvic pathology. There’s a similar argument for breast examinations. The unfortunate consequence of this is that a physician who does not undertake enough normal pelvic examinations will have insufficient experience to confidently recognize an abnormal pelvic examination when this examination is clinically indicated. Furthermore, evidence is used to influence budgetary considerations. The evidence is that a Pap test examination under the age of 25 does not affect long-term cancer diagnosis or outcomes. I suggest that routine Pap tests for late teenage years and early 20s are a good opportunity to screen for sexually transmitted diseases, discuss and educate about safe sex and appropriate contraceptive options. This is not the primary purpose of the Pap test, but nonetheless one should take a broader look at the delivery of practical and useful medical care. Did Dr. Eddie open a Pandora’s box? There is certainly no closing it. I suggest that we step gingerly and use the contents carefully.

Questioning evidencebased medicine is considered heresy

Spring 2017 Just For Canadian doctors


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This opportunity is a contract position, not a fee for service, with a guaranteed annual income of $360,000. The on call ratio is currently 1:4 with hospital billings going to the physicians, RRNP eligible to max of $60,000. Accommodation in a newer three-bedroom, two bath home is included in the contract!

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Just For Canadian doctors Spring 2017

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Spring 2017 Just For Canadian doctors


travel at home

Flying over the St. Elias mountain range in Kluane National Park below left Things get lively at the annual Dawson City Music Festival below middle Terry Lee, “Toe Captain,” of the Sourtoe cocktail in Dawson City’s Downtown Bar below right On the Tatshenshini River

The blue waters of Kluane Lake right Whitehorse refers to the rapids of the Yukon River that look like wild white horses, as seen in this mural in the same-named city and capital of the territory

travel at home

High above Dawson City, atop the Midnight Dome below left Horseback riding near Whitehorse below right Robert Service’s cabin in Dawson City, where he wrote poetry like “The Spell of the Yukon”

the spell of the

yukon story

The Yukon Theatre aglow under the midnight sun in Whitehorse above “Dirty Northern Bastard” t-shirt from the Dirty Northern Public House, a popular Whitehorse watering hole


photogr aphy by

Barb Sligl


ar below me, and far beyond my line of sight, stretches the surreal, snaking strip of a snow-and-ice-choked glacier. Or what looks like an ice highway. It’s the Kaskawulsh Glacier. At some 25,000 square kilometres, its size is hard to take in, literally and figuratively. It curves around the jagged peaks of the St. Elias range in the southwestern reaches of the Yukon for more than 60 kilometres, at some points six kilometres wide where it converges from different arms—a gigantic, lacy fan dotted with blue glacial pools. I’m in a little bush plane (outfitted with skis for those occasions when the weather allows Captain Tom Bradley to actually land on the glacier) and struck dumb as we fly from the shores of oh-so-turquoise Kluane Lake into Kluane National Park towards Mt. Logan, Canada’s highest peak. I see the massif, its 5,959 metres just emerging above the clouds. As the plane soars and banks around this mountainous hinterland it’s as if I’m looking upon something undiscovered, wholly new. Often called Canada’s Himalayas, the St. Elias Mountains are some of the youngest and tallest with six peaks reaching higher than 5,000 metres. Part of the world’s largest tract of internationally protected land (made up of Kluane, Wrangell-St. Elias, Glacier Bay and Tatshenshini-Alsek parks in the US and Canada), it’s a UNESCO World Heritage Site. And all the standout stats—most seismically active inland area in North America, biggest massif on Earth, largest non-polar icefield in the world, 200-plus glaciers—reinforce an underlining feeling I’ve been having throughout the Yukon. This place is all about superlatives. In Whitehorse, the capital, I sample what might be the cheekiest cocktail in one of the best-named bars: Half in the Bag (because, yes, it’s a gin-and-St. Germain mix served in a bag with a straw) at the Dirty Northern Bastard. In this public house— wood-panelled, antler-adorned, mummifiedcat-displaying (the petrified cat resides in the adjoining Miner’s Daughter restaurant and was found during a reno of the Dirty Northern)—I hang with a happily rowdy crew of locals and sample another nowhereelse drink: the Oldest Pussy. It involves rolling Just For Canadian doctors


travel at home

if you go

dice to see what shot of FLY Icefield Discovery is the only whisky I’ll get, from Oban flightseeing company allowed to land in to J&B. Kluane National Park. icefielddiscovery.com The vibe at the Dirty RAFT Be one of the few to go down the Tat with Northern is a nice warmTatshenshini Expediting. tatshenshiniyukon. up for my next stop, com PARTY The 39th Dawson City Music Dawson City, a mere (in Festival takes place this year on July Yukon perspective) six 21–23. dcmf.com MORE Discover the land of the midnight sun: hours away. This territory is travelyukon.com a vast place. It’s pointless to try see it in one visit, although with just a few main highways connecting a stray number of communities (there are less than 34,000 people living in the entire territory), it’s simple to criss-cross from Whitehorse to Dawson City and back to Whitehorse to get to Haines Junction and Kluane National Park. In Dawson, I continue the Yukon’s odd ode to drinking at the Downtown Hotel. This is the home of the Sourtoe cocktail, which is just what it sounds like: a human toe (donated by those who’ve lost their appendages to frostbite or otherwise) in Yukon Jack liqueur (“the black sheep of Canadian liquors”). As I down the stuff—under a sign that says, “man the feck up!”—the toe must touch my lips but not pass them (swallowing the toe would cost me $2,500). Done. I join the 66,836 others who’ve been “served” before me—a number that keeps growing. On the Icefield Certificate in hand, I join locals (who Discovery flightseeing tour, Mt. scoff at the touristy toe experience) for a Logan, Canada’s rousing set of music at a surprising number highest peak, of venues—the banks of the Yukon River, a rises above 1902 church, the ballroom of a Gold Rush-era clouds in Kluane building and a tent over a mucky lawn where National Park gumboots are in order. The Dawson City Music Festival is on and things are hopping, but this tiny town of less than 1,400 residents is always ahum, which I feel acutely in the Pit, a year-round dive of the most-entertaining kind, and after stumbling out into the midnight sun. I continue my pleasant hum back in the natural beauty of the UNESCO World Heritage Site that includes Kluane National Park and Tatshenshini-Alsek Provincial Park, where I end my Yukon foray on the waters of the Tat as the Tatshenshini River is also known. It’s a wild ride, and my rafting guide, who goes by “Hot Rod,” tells me stories of nearby Million Dollar Falls, one of which claims the presence of that elusive gold nugget, still out there waiting to be found long after the great Klondike Gold Rush came and went. “I imagine all the treasure we’re floating over,” he says. And I think to myself that the real treasure surrounds us right now— from snowcapped peaks and frothy white waters to desiccated cats and toes, nuggets are hidden throughout the Yukon.


Just For Canadian doctors

Dawson City facades above Blue-tinged ice crevasses in Kluane left Captain Tom Bradley below right Gold-nugget-adorned belt buckles

Inside the Dirty Northern Bastard bar in Whitehorse left Assortment of Dawson City Music Festival footwear

s m a l l ta l k

doctors share their picks dr. scott forsyth is a family physician…and so much more. As a resident in his final years of medical school he began taking photographs of the Rockies, and has since become an award-winning photographer (named “Photographic Artist of the Year” by the Professional Photographers Of Canada), indulging his love of wild landscapes as a photographic guide with tour companies like Adventure Canada. His most recent endeavour: running as the Calgary Heritage Candidate in the House of Commons to work alongside Prime Minister Justin Trudeau. My name: Scott Forsyth I live, practise in: Calgary, AB

courtesy of Dr. scott forsyth; photo with PM: Adam Scott

My training: Science Degree B.Sc. Dalhousie University, Law Degree L.L.B. (1996) University of Calgary. Medical Degree M.D. University of Calgary (1999), Family Medicine Residency CCFP University of Alberta (2001) Why I was drawn to medicine: To learn practical skills that combine science with the art of communication. Chose family medicine because I like the diversity of being a generalist, along with the continuity of patient relationships, and finally the freedom to set my own schedule. This has enabled me to work part-time as photographic guide and instructor aboard expedition companies to remote regions such as the Canadian Arctic, Greenland, Labrador Coastline and Haida Gwaii—with Adventure Canada and Maple Leaf Adventures. My last trip: September 2016, my fifth Arctic journey with Adventure Canada. Travelled through the Northwest Passage to the high Canadian Arctic and then down the western coast of Greenland. Most exotic place I’ve travelled to: Grise Fjord, the northernmost

exotic traveller :

Dr. Scott Forsyth, a.k.a. zodiac driver and photographic tour guide, in Disko Bay, Greenland

Canadian settlement on the southern coast of Ellesmere Island The best souvenir I’ve brought back from a trip: Muskox-hair hats, scarves and headbands. Incredibly warm yet extremely light. Best meal: “Country” food prepared and offered to us along our journeys in the Canadian Arctic by generous Inuit hosts, in Gjoa Haven and Grise Fjord. Place that I keep returning to: Tofino, Vancouver Island. The raw power of the open west coast along windswept beaches with house-sized waves crashing ashore in the winter. A surfer’s paradise—and in Canada. Just need a wetsuit! Can’t believe I’ve never been to: The Yukon!

On my list… [See Yukon story on page 34.] Dream vacation: Skiing in the Rockies in winter—and an occasional medical conference in Hawaii! If I could travel anywhere, I’d go to: St. John’s Newfoundland. I love the feeling of the city, the character of the streets and the friendliness of the people—it feels strangely familiar. My jet-lag cure: Stay up…sleep on the new schedule and get lots of fresh air and exercise. I always travel with: A few emergency medicines, especially while up in the Arctic or any remote location. Also, of course, my camera! Favourite city: At the moment I’m really enjoying business trips

Dr. Forsyth (right) with PM Justin Trudeau

to Ottawa. I always like being near the centre of things, and it happens to be full of good friends.

Favourite band/album or song: George Harrison, Here Comes The Sun

Favourite book: Fatal Passage, Ken McGoogan—the truth about the Franklin Expedition and the unsung incredible Canadian Arctic European Explorer John Rae.

Gadget or gear I could not do without: My solar-powered altimeter, compass, barometer and all-in-one waterproof watch.

Favourite film: The Secret Life of Walter Mitty

Last splurge: As above

Must-see TV: Marco Polo

Last purchase: Nikon D5 Camera Most-frequented store: Vistek and The Camera Store, or MEC

Spring 2017 Just For Canadian doctors


s m a l l ta l k

doctors share their picks >

dr. scott forsyth

[continued from page 37]

award -winning photographer :

Arctic scenes, from icebergs to polar bears, photographed by Dr. Forsyth

My fridge is always stocked with: Maple syrup My guilty pleasure: Espresso and Oreo cookies Go-to exercise/sport: Walking the dog—English Cream Golden Retriever— otherwise biking, swimming Favourite spectator sport: Football Another Dr. Forsyth photo, taken in Torngat Mountains National Park, Labrador

Celebrity crush: Not any longer—I know they are all just human I’d want this with me if stranded on a desert island: Companion My secret to relaxing and relieving tension: Regular outdoor exercise, and time to create something lasting— learning an instrument A big challenge I’ve faced: Stepping up in the past year to be vice-chair of the board of directors for our Calgary West Central Primary Care Network.


Just For Canadian doctors Spring 2017

This is a large not-for-profit health corporation partnering with Alberta Health and Alberta Health Services—456 physician members serving >300,000 patients, spanning >100 medical clinics in SW Calgary. One thing I’d change about myself: Would like to be able to speak a second language with natural fluency The word that best describes me: Determined I’m inspired by: Lauren Harris, the Group of Seven painter My motto: Just say yes— then figure it out afterwards A cause close to my heart: Canadian Geographic Challenge’s mission—to make Canada better known to Canadians and abroad On my must-do list: Witness Aurora Borealis in the Yukon If I wasn’t a doctor, I’d be: A science writer and artist

Dr. scott forsyth

I have too many: Emails

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