Just For Canadian Doctors Summer 2019

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summer 2019

life + leisure

DOCTORS

on a mission in nepal

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Just for C

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DOCTORS life + leisure

contents

summer 2019

summer 2019

Publisher Linh T. Huynh

Editor Barb Sligl

Art Direction BSS Creative Contributing Editor Janet Gyenes

Editorial Assistant Adam Flint Contributors Janet Gyenes Lisa Kadane Dr. Chris Pengilly Manfred Purtzki Dr. Kellen Silverthorn Barb Sligl Roberta Staley Sarah Staples Catherine Tse Cover photo iStock Senior Account Executive Monique Nguyen

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

FEATURES

12 A trek in Nepal that’s also a philanthropic mission COLUMNS

DEPARTMENTS

9 pay it forward

5 summer mix 19 CME calendar 29 sudoku 30 small talk

A soldier on the Ebola battlefront

11 the thirsty doctor A cocktail tour

17 motoring

Dr. Jennifer Kask

Colour coding

26 the wealthy doctor

Fight investment shrinkage

28 doctor on a soapbox

There’s a tsunami of change surging across the west side of the Rockies

www.justforcanadiandoctors.com

PHOTOS: sarah staples; istock

Printed in Canada.

award winS! Stories and photographs that appeared in this magazine (and sister publication, Just for Canadian Dentists) won multiple awards in the 2018 North American Travel Journalists Association Awards, including silver.

cover photo En route to Everest Base Camp or EBC, trekking in the Himalayas of Nepal, where the writer of our cover story trekked on a charitable expedition with a healthcare crew from Ontario (page 12).

Summer 2019 Just For Canadian doctors

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from the editor Writer Sarah Staples (middle) on the trek to Everest Base Camp with high-altitude mountaineer Andrew Lock (left) and Peter Hillary, son of the legendary climber; on the trail to EBC (page 12)

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e all have different reasons for getting on a plane and flying thousands of kilometres to farflung places, and then perhaps going even farther to climb thousands of metres up a mountain. It could be an inner mission—or a more benevolent quest. Sometimes it’s the journey, the experience itself, that makes the trip. Sometimes there’s a goal to reach or achieve at the destination. Sometimes the trip is for the joy of it, the pleasure of going somewhere new or returning to a special and beloved place. Last year, writer Sarah Staples travelled with a crew of healthcare professionals from Ontario to the upper reaches of Nepal. They were on a mission to raise money for school and hospital funds, trekking along the rugged trail to Everest Base Camp.

She shares her journey and the backstory of the organized, charitable trip—a tale that stretches to that most-famous mountaineer, Sir Edmund Hillary, who made the first ascent of Mount Everest with Nepalese Sherpa and mountaineer Tenzing Norgay. It’s both an epic tour and humanitarian expedition (and one you can participate in; page 12). Similarly, Dr. Kask’s travels have included a philanthropic component (page 30). And Dr. Pegg has participated in 15 MSF missions, and still counting (page 9). In the spirit of such altruistic trips, more and more companies are offering products that have an element of “giving back” (page 7). Because we can all do some good in even small ways.

make it a mission

sarah staples

Travel for good

comments /questions : feedback@InPrintPublications.com

When & Where

Congress

@IntDiabetesFed #IDF2019

2-6 December 2019

Busan Exhibition and Convention Centre (BEXCO), Busan, Korea

2-6 December Busan

Key Dates

Korea

June - Full scientific programme online 1-31 July - Late-breaking abstract submission 31 August - Registration early rate deadline

idf2019busan.org

Why attend? Learn

160h scientific sessions 1000 e-posters 25 CME credits

Discover

8 programme streams 70 international exhibitors

General inquiries congress@idf.org T: +32 2 543 16 32

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Just For Canadian doctors Summer 2019

Connect

250 world-renowned speakers 10,000 international delegates

Programme and abstracts programme@idf.org


what/when/where > summer

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

Wild walkers

mix

getaway

on the wall

take a hike (+ camp) on the great wall at Jiankou

janet gyenes

“F

ollow the old man,” says Daniel, our group leader with the Shanghai-based Travelers Society, then doubles back on the path to corral the rest of the hikers. Now I understood why he ignored the billboard we passed in Xīzhàzi Village bearing the words, “Please help us protect the Great Wall. This section of the Great Wall is not open to the public.” >>

Summer 2019 Just For Canadian doctors

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mix

e pi c g pi n cam ip tr

summer

getaway

beyond beijing

History and adventure are just off (and on) the Great Wall of China

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previous page Scrambling up unrestored steps clockwise from top Camping atop a watchtower; roasting marsh-

mallows; setting up camp (and hammering in tent pegs with a brick from the Wall); Ming dynasty-era bricks

Ming Dynasty moments

e’re breaking the law, albeit in Beijing’s rural Huáiróu district some 100 km north of the capital’s omnipresent CCTV cameras. No one is watching. The flip side: we plan to camp overnight at Jiankou (“arrow nock” in English, an archery term), touted as the wildest and most dangerous part of the Great Wall built during the Ming dynasty (1368–1644), with steep sections ominously named Sky Stairs (a 70-to-80-degree angle) and Eagle Flies Facing Upward. In The Great Wall, author John Man describes how myth and history are tangled in the series of rammed earth, wood and stone curtains representing a 2,300year timeline that traces six dynasties defending against barbarian nomads and marks a unified China. “This Wall, this ‘it,’ is rooted in the mindset of Chinese leaders down the ages. It is an idea that gives a boundary to the Chinese sense of identity,” Man writes. “Yet there is a singularity, which allows us to speak of the Wall as one. It exists not on the ground, but in the mind.” Traversing northern China’s mountains and deserts to the sea, the Wall comprises 21,196 km—longer than once thought—according to a 2012 archeological survey undertaken by the country’s State Administration of Cultural Heritage. I had already hiked the most modern and restored part at Bādálǐng (see page 19), but that only deepened the Wall’s mythic allure; I wanted to see its unrestored watch towers, ramparts and bricks. Fifteen of us hikers, mostly expats living in Shanghai like me, follow the villager uphill through the forest and bamboo groves. After about an hour our grunts turn to jubilance as a section of Jiankou emerges. Sweaty and breathless we scramble up the steps. I’m wonderstruck at the scene before me—rows of stone zippers, their smashed teeth chewing at folds of ancient green velvet as if trying to keep the centuries from unravelling into the great beyond. My adrenaline surges as I see the precipitous path crawl alongside an avalanche of broken bricks. For the next hour or so I add my fingerprints, footsteps, sweat and some skin from a scraped kneecap to this expanse of history deconstructing itself as fragments of brick tumble down the cliffside. Finally, we arrive at a large watchtower. “Who knows how to pitch a tent?” asks Daniel. Only two hands go up, including mine. So I give an impromptu lesson, using a brick from the Wall to hammer in the tent pegs. With our camp set up, we continue to explore while chasing the setting sun. We have essentially entered the lives of the soldiers, peasants and prisoners who laboured in these serrated mountains and become part of the myth and history woven within the wild Great Wall. — Janet Gyenes

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Go (way) off grid

History Meets high-tech

janet gyenes

The China Foundation for Cultural Heritage Conservation has teamed up with Intel, whose Falcon 8+ drones and artificial intelligence (AI) data will be used to help identify sections of Jiankou in need of repair. Restoration is underway and expected to be completed by 2020.

if you go To explore the Great Wall at Jiankou and beyond visit

travelers-society.com and travelchinaguide.com/china_great_wall.

Just For Canadian doctors Summer 2019

Explore the city of Beijing on page 19 >>


good buy

summer

x5

good(s) ^

give back

These products provide philanthropy as well as style 1 Framed Oxford & Kin is a Vancouver-based brand that offers stylish, hand-crafted frames using acetate from a heritage Italian company. For each pair of glasses purchased, Oxford & Kin donates a pair plus an eye exam to someone in a developing country. “As an optometrist, I try to give back by volunteering in clinics similar to those that we support via our donations,” says founder, Dr. Harbir Sian who most recently was volunteering in Jordan this spring. Starting at $175, oxfordandkin.com

Province of Canada socks purchased, they will donate a pair to a Canadian homeless shelter. Socks starting at $14, provinceofcanada.com

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2 Roll with it Ajna Wellbeing is an indie brand with a cult following for their beautiful reversible yoga mats, made with organic jute on one side and eco-synthetic rubber on the other. They’ve partnered up with One Tree Planted, a non-profit that plants trees around the world. For every Ajna Wellbeing product sold, they will plant a tree. “Planting trees [will] help stabilize our climate, provide habitat for biodiversity and create sustainable jobs.” US$55.99, ajnawellbeing.com 3 Pretty please Cheekbone Beauty is a made-in-Canada makeup brand that is helping indigenous school kids. They donate 10% of profits from all purchases to First Nations Child and Family Caring Society of Canada, to help bridge the funding gap that exists between Indigenous and non-Indigenous schools in Canada. “There needed to be a brand that was made in Canada, never tested on animals and that gave back to the First Nations community. That brand did not exist, so I created it,” Jenn Harper, founder. Starting at $24 for lipgloss, cheekbonebeauty.ca 4 Feet first Did you know that socks are one of the most sought after items in shelters, yet are one of the least donated items? Who has socks to donate? They simply don’t last long enough and very few think to buy new socks as part of their clothing donations. To the rescue: With each pair of

Written + produced by Catherine Tse

er Su mm re ad

5 book club One of the joys of going to school is exploring the library and all the stories within. Through Indigo’s Love of Reading Foundation, funds are provided to high-needs elementary schools across Canada to help them acquire new books. Since 2004, the Foundation has provided $30 million to over 3,000 schools, inspiring more than 900,000 children. “We need all our kids to be rich and confident readers... Nothing short of that is good enough,” Heather Reisman, Chair of the Love of Reading Foundation. Pick up a book (we suggest the one below) and help support Indigo’s reading initiative. chapters.indigo.ca and loveofreading.org

pay back

packaged

mix

[read]

Washington Black, winner of the 2018 Scotiabank Giller Prize and finalist for the Man Booker, is Esi Edugyan’s novel about a field slave whose flight from a sugar plantation takes him across the world. “From the blistering cane fields of Barbados to the icy plains of the Canadian Arctic, from the mud-drowned streets of London to the eerie deserts of Morocco, Washington Black teems with all the strangeness of life.” 3

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editor's

pick

2 Summer 2019 Just For Canadian doctors

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m i x summer

photo prescription

photo

op

capture the action This photo was taken during the street parade at the Carnaval International de Victoria, part of the Kreol Festival in the Seychelles. Michael DeFreitas won Gold in the 2015 NATJA Awards for his photography and story about the Seychelles for this magazine, including this image that was on the cover of sister magazine, Just for Canadian Dentists. (“Photo Prescription�) and multi-award-winning photographer, Michael DeFreitas is putting down his professional camera and pen. We thank him for his inspiring work in these pages. And to keep the photo love going, we want to feature some of YOUR photos in the magazine. Send us a high-resolution photo with wow factor (include info on where/when/how/why/who, plus details on camera, aperture, shutter speed), and we may publish it here! feedback@inprintpublications.com

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Just For Canadian doctors Summer 2019

Michael defreitas

and send your photos! Long-time columnist


pay i t f o r w a r d

r o b e r ta s ta l e y

Roberta Staley is a Vancouver-based magazine writer, editor and documentary filmmaker.

On the Ebola battlefront

A doctor works for Médecins Sans Frontières in the Democratic Republic of Congo

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ebruary 24 and 27 of 2019 will not be easy dates for Dr. Anne-Marie Pegg— or other Médecins Sans Frontières (MSF) staff in the Democratic Republic of Congo (DRC)—to forget. Under dark of night on the 24th, unknown militia stoned and set fire to an MSF-supported medical facility in Katwa in northeastern DRC that was treating victims of an Ebola outbreak that began August 1, 2018. Patients and staff fled for their lives. The alarming event was repeated three days later when another MSF Ebola treatment centre was attacked in Butembo, a city adjacent to Katwa. MSF suspended medical care in both urban centres. The Butembo attack happened just hours after Pegg and a medical team

passed through the city. The cause of the attack is still unknown, Pegg says from Paris, her home for the past year after moving from Yellowknife to become MSF France’s clinical lead for epidemic response and

Kivu province as MSF’s emergency medical coordinator. By the first of April of this year in the Central African nation, 1,100 people had contracted the highly contagious infection

“Testing ‘skills and intellectual limits’ while working with people equally dedicated to caring for the vulnerable” vaccinations. “It was really distressing for the medical teams; it was a threat to their own security and they feared that the patients would be harmed,” says Pegg, who spent this past February and March in DRC’s North

and 683 had perished, a death rate of more than 60%, making it the second-worst Ebola outbreak in history. The worst was the 2014–2016 epidemic in West Africa, which claimed 11,310 lives.

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pay i t f o r w a r d

r o b e r ta s ta l e y

The death rate in DRC, says Pegg, might be lower than the West African contagion due to a vaccination developed by Winnipeg’s National Microbiology Lab. About 95,000 people—patients as well as national and international health care workers—have received the lab’s rVSVZEBOV vaccine, which protects against Ebola. (Data on the vaccine aren’t publicly

centres,” which MSF is using as an isolation strategy for suspected Ebola cases. Even before a diagnosis is confirmed, healthcare workers don unfamiliar and extensive protective gear while family members aren’t allowed to get close to their sick relative. Although medically sound, the strict isolation protocol and intense care regimen, combined with the high death

until he was tested. Pegg and a medical team immediately admitted the critically ill man to the special isolation ward, where he received care for Ebola as well as other possible diseases. Tests showed that the man didn’t have Ebola, so he was moved into the health centre’s ICU ward, receiving treatment for the more common diseases meningitis and malaria. (Symptoms are similar to Ebola.) Further tests cleared him of meningitis, so staff focused on malarial treatment. The young man walked out of the hospital four days later, giving Pegg a high five on the way out. Caring for the man and moving him into a more normalized hospital setting helped ease the family’s worries, removed the stigma of Ebola and gave his two brothers hope that their sibling would convalesce. It also helped quash rumours regarding care in the “Ebola centres”—that being placed in one was a death sentence. Since then, the family has “become our greatest ambassadors in the area”—living proof that an individual can be admitted with a potential diagnosis of Ebola yet emerge healthy, says Pegg. Back in Paris, following a 12-hour-day, seven-daya-week work regimen in DRC, Pegg can take time to enjoy the pleasures of the City of Lights: from morning croissants to walks in her neighbourhood of Belleville, famed for its food markets, galleries and street art. However, she remains focused on organizing initiatives that meet the vaccination needs of some of the world’s most desperate people, whether they live in the Central African Republic, South Sudan, Niger or Nigeria—places riven by war and poverty. A veteran of more than 15 MSF missions since 2008, including to Haiti and Syria, Pegg looks forward to her next trip abroad and the challenge of testing her “skills and intellectual limits” while working with people equally dedicated to caring for some of the vulnerable.

Dr. AnneMarie Pegg (above, second from left, in the Democratic Republic of Congo on International Women’s Day) is a veteran of more than 15 missions with Doctors Without Borders/ Médecins Sans Frontières (right, she’s on a mission with MSF in Syria).

available yet, so the efficacy is unclear.) Although the death rate in DRC is lower than the West African contagion, health-care workers are struggling to contain this outbreak, the country’s tenth since 1976, says Pegg. Civil unrest in the war-torn nation, as well as the ubiquity of malaria, meningitis, typhoid, cholera, diarrheal illnesses and malnutrition, conspire to increase the challenge of diagnosing and treating Ebola. Public suspicion of government institutions also feeds scepticism and mistrust of the system of viral containment in “transit

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rate, has proven so bewildering and scary to patients and their families that the ill are seeking medical help elsewhere. “So that’s why we are seeing a spread of the epidemic,” Pegg says. Pegg relates the case of a 28-year-old man, accompanied by two brothers, who was brought to an MSF facility in Lubero where she was the medical coordinator. The man, who was in a coma, was suspected to have Ebola, which couldn’t be confirmed

Just For Canadian doctors Summer 2019

courtesy of Dr. Pegg; bottom photo courtesy of MSF

“The young man walked out of the hospital four days later, giving Pegg a high five on the way out”


the thirsty doctor lisa kadane Lisa Kadane is a newspaper and magazine writer who likes to travel and partake in the destination’s preferred tipple, whether it’s rum, wine, a margarita or whisky sour. She’s been sharing her thoughts on spirits and cocktails since 2010.

A cocktail tour

Boldly go where the contents of your glass take you

r ov n i k

* Ogopogo Sour cocktail Pour all ingredients except ice, bitters and garnish into a cocktail shaker. Shake until incorporated and frothy. Add ice and shake until chilled. Double strain into a chilled coupe glass. Dot bitters over the surface of the drink in an up-anddown pattern, then use a straw to connect the dots in an Ogopogo shape. Garnish with a cherry. —Recipe excerpted from A Field Guide to Canadian Cocktails by Victoria Walsh and Scott McCallum

n

1 small egg white ¾ oz kirsch, such as Maple Leaf Spirits Canadian Kirsch ¾ oz cherry liqueur ¾ oz freshly squeezed lemon juice ¼ oz scotch ¼ oz orgeat Large handful of ice cubes 3–4 drops Bittered Sling Suius Cherry bitters or Angostura bitters 1 fresh cherry or homemade cocktail cherry for garnish

sa fa r i

cocktail PHOTO: Juan Luna; travel photos by Lisa Kadane

travelling tipple*

flavours of Chartreuse, cardamom and Bruto Americano. Sip it and imagine you’re on a boat with a fierce but mesmerizing predator. West in Whistler, where snow-toqued peaks dominate every view, bartender Lauren Mote created the Spirit of the Mountains menu for Sidecut Modern Steak + Bar at the Four Seasons Resort. The six drinks pay homage to mountains spanning the globe, from Japan’s Mount Fuji to the roof of Africa (Mount Kilimanjaro), and use exotic flavours, aromatic fragrances and even mouth-feel to encapsulate their essence in a glass. And in Vancouver, the tiki torches of the 1960s, 70s and 80s are being re-lit at H Tasting Lounge in the Westin Bayshore, as a tribute to the Trader Vic’s that occupied the space for three decades. The iconic Bayshore Inn cocktail is a medley of South Pacific flavours including rum, pineapple, falernum and coconut, while bartender Chiara Fung’s enticing “True Lies” takes tiki to a new level. Not everyone associates tropical flavours with Vancouver, but in the context of the bar’s tiki past, it works, says Fung. And chances are, travellers from afar who session these tipples on the new tiki patio will circle back to their time in Lotusland if they recreate in these recipes when back home.

b Du

Walsh so believes in this idea that she co-authored a book in which it’s the central theme. A Field Guide to Canadian Cocktails takes readers across the country one glass at a time, from Victoria to Prince Edward Island. It tells the story of made-in-Canada drinks that reflect place through history and context, food pairings, or local spirits and ingredients. In the fruit-laden Okanagan Valley, Walsh’s “Ogopogo Sour” (see recipe below) features valley cherries turned into kirsch and liqueur. It’s the taste of summer, juiced and fortified, and—if you made a point of consuming an Ogopogo Sour a day while vacationing in BC’s sunny interior—would no doubt come to represent the cherryeating days of your lakeside holiday. For Toronto, she features “The Torontonian” by Robin Goodfellow of Bar Raval, a riff on the city’s bold and bitter whisky and Fernet classic. In PEI, where fresh seafood influences drink choices, a “Sparkling Watermelon Sipper” becomes her light, thirst-quenching foil to fresh oysters. Bartenders are tapping in to this trend, too, creating entire menus whose purpose is to transport the drinker elsewhere. In Calgary, Proof’s new list evokes fictional places or worlds featured in books and movies. The Richard Parker, for example, is named after the tiger in Canadian author Yann Martel’s Life of Pi. Fittingly, it captures the bite of Lot 40 whisky with the alluring

o

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have long believed in the transportive power of cocktails. During a trip around the Adriatic Sea, my husband and I enjoyed so many Aperol spritzes that those effervescent bubbles, splashed with the bittersweet orange liqueur, became the holiday’s liquid anthem. Now, whenever I sip the ruby-hued tipple it carries me back to the canals of Venice or the walls of Dubrovnik. Likewise, I cut my safari teeth in Tanzania while sipping Sundowner G&Ts. In the years since, this simple highball—historically used as a malaria Rx—has become my prescription for helping hot summer evenings approximate the leisurely pace of a game drive. The power of spirits to induce nostalgia trips isn’t just a phenomenon for drinks from far-flung destinations. Plenty of Canadian cocktails remind me of home, too. The combination of Alberta Premium Dark Horse Rye and tea-infused Pilsner in “A Bit of Northern Hospitality,” an original cocktail from the creative bar team at Proof (sadly, no longer on the menu), will forever remind me of Calgary. Similarly, the smell and spice of Caribou—a boozy punch of red wine and grain alcohol—plunks me right back in the Québec forest at a trappers’ camp where I first tried it. “Cocktails transport you back to a place,” agrees Victoria Walsh, a writer, recipe developer and food stylist. “It’s the look and the smell and the taste.”

Summer 2019 Just For Canadian doctors

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travel the world

trekking high in A long trek to Everest Base Camp and mission to bring vital health care Suspension bridge over Dudh Koshi river above Prayer flags at EBC opposite, top Australian mountaineer Andrew Lock opposite, bottom EBC horseman


travel the world

I nepal story

+ photography by Sarah Staples

n high trekking season, 500 tourists every day step off twin-engine turboprop planes at Tenzing-Hillary Airport, in Lukla, Nepal. Its single paved runway ends in a 2,000-foot vertical drop, so from there, you’d best be headed up, not down. And most trekkers— by some estimates, 40,000 a year—are aiming for Mount Everest’s South Base Camp, or EBC: a thin line of colourful tents fixed like barnacles to a glacier at 17,598 feet of elevation. Attempt to fly directly to EBC, and you’ll be unconscious in minutes and risking high-altitude pulmonary oedema (HAPE) or cerebral oedema (HACE) within hours. The atmospheric pressure is 50% of sea level, causing an equivalent cliff-dive in blood oxygen saturation (SO2). The trek to EBC is a beautiful, spiritual experience, one of earth’s epic adventures. It’s also physically uncompromising and at times slightly terrifying. “Bistari, bistari” isn’t a quaint Sherpa saying, so much as a polite warning that at least 12 days of trekking, slowly, slowly, are essential for the body to acclimatize. Last spring, I hooked up with MSH Trek Everest: a trip to EBC by 25 staff and supporters of Markham Stouffville Hospital organized as a fundraiser for the hospital foundation. MSH’s physicians ended up diagnosing HACE in three trekkers from other expeditions who were hallucinating, vomiting, their SO2 lagging in the mid-50s. Three lives were unexpectedly saved. Our group also donated medical and school supplies, and thousands of dollars to Sherpa villages. But the greatest surprise was learning just how closely we’d been following the boot-steps of Canadian physicians, nurses, teachers and forestry experts who have gone before. There’s a little-known, extraordinary legacy of Canadian humanitarian achievement in the foothills of the world’s highest mountain. And much of it traces back to the friendship between an ex-Toronto Argonaut football player and Sir Edmund Hillary, who was the first to climb Mount Everest, on May 29, 1953.

Months after my trek, William (Zeke) O’Connor sits in the tidy living room of his retirement condo, flipping through photo albums and old slideshows. He’s helping me ‘unpack’ the history of Canadians on the trail to EBC. In one grainy photo, he’s smiling broadly, having just caught the championship-winning pass of the 1952 Grey Cup. Zeke grew up in New York’s Bronx neighbourhood, attended University of Notre Dame, played for the NFL and CFL. Retiring from pro sports, he joined Sears and rose to take charge of its outdoor gear division. That’s how he met Ed Hillary. Following his ascent of Everest, Hillary had become an international superstar. He was also a Sears brand ambassador and gear-tester, and in 1972, was sent by the retailer on a canoe trip to Québec’s La Vérendrye Wildlife Reserve. Zeke was there, too. And afterward, Sir Ed convinced his new Canadian friend to join him in Nepal the next year, repairing bridges along the trail to EBC. Hillary, through his Himalayan Trust, had fundraised to build Lukla’s airport by hand. He foresaw the inevitability of tourism—ordinary folks would want to retrace his own route to Everest, he knew, and was determined to help the region’s Summer 2019 Just For Canadian doctors

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semi-nomadic mountain tribes, originally from Tibet, reap the benefits. In Zeke’s fascinating memoir, Journey with the Sherpas, he recalls asking Hillary what token of gratitude he could offer for such a life-changing trip. “Help me help the Sherpas,” the mountaineer replied. So in 1974, Zeke founded his own charity, the Sir Edmund Hillary Foundation (SEHF), and with Hillary, hit the Rotary and Lions Club breakfast circuits across Canada. While Sir Ed led the creation of Nepal’s Sagarmatha National Park, Zeke spearheaded the replanting of more than five million trees surrounding Mount Everest. Hillary and his brother Rex built 12 schools before they met Zeke; together they built 16 more. Over the years, they also established and managed many of eastern Nepal’s first hospitals, surgical MASH units, women’s health and literacy programs, steel bridges, roads, latrines, gardens—you name it. From 1977 to 2003, the Toronto-based foundation was the largest individual donor to Hillary’s vision of communityled development. Photo after photo shows the now 93-year-old Zeke standing shoulder-to-shoulder with Sir Ed and village elders, hauling construction supplies. “Our relationship wasn’t just a friendship; Ed was more like a brother,” he explains. “The whole thing just evolved.”

Beyond Lukla, the trail ebbs and flows through pleasantly undulating hills and fertile valleys of the lower Solukhumbu District, then up stone steps chiselled into steeper and steeper mountains. In spring, the teahouses and their open-air patios are full, and you can spot mountaineering legends trekking to EBC, where they’ll wait for a break of perfect weather to make a dash for the top. Certain classic sights you tick off like rosary beads. Porters and yak trains ferrying anything from fridges to roofing up the hill. Buddhist stone mani walls draped with coloured flags that send prayers to the wind. Rhododendrons, azaleas and magnolias arcing over the trail—so old, they might even be the same giant blooms that Zeke saw, reminding him of a Shangri-La. At the convergence of the Thami and Khumbu valleys, the Namche Bridge—the best-known of a series of Swiss-made steel suspension footbridges—sways with the weight of trekkers crossing the Dudh Khosi River. These bridges used to be made of logs lashed together over gorges. Zeke, petrified, crawled across on hands and knees, he

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Just For Canadian doctors Summer 2019

recalls. It was Hillary who introduced the safer suspension design. At Namche Bazaar, an acclimatization midpoint for trekkers to EBC, we browse camping stores and delicious bakeries, then go on a day-hike to Kunde Hospital. It’s the highest 24-hour critical-care centre on earth, at 12,598 feet of elevation, and treats some 8,000 Sherpas and a few dozen tourists every year. Kunde Hospital is funded by SEHF. For decades it was staffed by husband-andwife physician teams mostly from Canada and New Zealand. At first, they slept on the operating-room floor. Now the hospital is led by chief medical director Dr. Kami Sherpa, who earned his medical degree on a Canadian-funded scholarship. At the next village, Khumjung, we visit a school hand-built by Sir Ed. It’s one of dozens that in the earthquake-prone region, Canadian donations have helped rebuild (along with the famous monastery at Tengboche).

Just as Hillary predicted, in two generations, the Sherpas have built a prosperous climbing economy. But the ‘Everest Effect,’ you might call it, doesn’t apply equally. Veer off the trail to EBC, and in the next valleys, you’ll find evidence of crushing poverty. There’s still so much to do. Zeke didn’t make it to EBC in 1973. A colleague’s altitude sickness forced everyone to turn back at nearby Gorakshep—a first twist in a journey he’d never expected to take, which has lasted nearly a lifetime. Now Sears, SEHF’s key patron for decades, is bankrupt, and its implosion threatens countless Nepalis a world away. Without Sears, SEHF will struggle to pay for projects like Kunde Hospital. “We’re still operating overseas normally, and we certainly will go on,” he explains, “but we’re out searching for a replacement patron, fast.”

Past goat-herders’ cottages of the high alpine, a pulverized mass of boulders riven with ice and clay dominates the treeless landscape, gouging its way through a highsided valley. The Khumbu Glacier is framed by Himalayan mountains, like a tongue flicking between snow-white teeth. It leads beyond the Everest Memorial site of rubble cairns paying tribute to fallen climbers. These higher reaches of the trail, where the basic ingredients of life, earth and death collide, are the loveliest by far.


travel the world hallowed crew Sir Edmund Hillary’s decades of humanitarian accomplishment reflected his belief that individuals have the power to effect lasting positive change. His can-do spirit inspired MSH Trek Everest, which was timed to the 65th anniversary of Mount Everest’s first ascent. Sir Edmund Hillary’s son, Peter Hillary, and Australian Andrew Lock, only the 18th person ever to have climbed all 14 of the world’s highest mountains (in every case but Everest, without supplemental oxygen), were guides and honoured guests.

Stupa honouring Sherpas, near Tengboche

above Arriving at EBC by the Khumbu Icefall right Yaks at EBC opposite, from top Khumjung

Secondary School, which was rebuilt with the help of Canadian donations; Hindu women at Kathmandu’s Pashupatinath temple; hiking beyond Namche Bazaar; teahouse terrace near Namche Bazaar

May/June 2019 Just For Canadian dentists

15


travel the world One afternoon before we reach Base Camp, Dr. Eileen Lougheed sits me down on a rock and advises deep breathing to calm my vagus nerve. A chaotic thumping of arrhythmia subsides. But that night, whenever I shut my eyes, I stop breathing—it’s altitude-induced sleep apnea, scary as hell. At least I’m coherent, unlike those three trekkers from the Indian expedition, who Drs. Lougheed and Roberta Hood, nurse-practitioner Stephen Ng and others from MSH Trek Everest had worked to keep alive until they could be medevacked to safer altitudes. Dr. Lougheed, suffering from a prior injury, ends her trek very nearly at EBC, then choppers the rest of the way in for a quick look. Dr. Hood makes it there, and poses for a group portrait by the helipad. That evening, she succumbs briefly to the overexertion of nights on call treating fellow trekkers, but is fine after some pure oxygen and rest. I reach EBC, too, and watch yellow-billed choughs soaring into the ‘death zone’ above 26,247 feet. They’re a reminder that humans aren’t meant to be here. This experience can take part come at a price. But, Join renowned Canadian overall, my apple pie mountaineer/filmmaker/ fresh-baked for lunch expedition leader Ben Webster on at the edge of Mount his next charitable expedition: ben@ Everest, could never canadianadventureproductions.com. taste sweeter. Donate to MSH Trek Everest: (mshf.on.ca/ featuredevents. Reach Zeke, at zoconnor. sehf@gmail.com, to find out how you can support medical and dental care for the Sherpas of eastern Nepal through the Sir Edmund Hillary Foundation.

16

Just For Canadian doctors Summer 2019

A Buddhist mani wall with prayer flags, possibly hundreds of years old top Another mani wall en route to EBC above left Peter Hillary above right Lukla


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.

Colour me crazy Trendy car colours have little staying power…

A

utomotive colour fads have come and gone for decades. These trendsetting hues arise from automotive obscurity, promulgate, and within a few years, fade back to oblivion. The current such automotive colour fad could be described as grey-white, sometimes with a hint of light brown. I’ve taken to calling this hue “Dirty Dishwater.” Usually I’m ambivalent, or even mildly positive, to the revolving door of car-colour fads. My pejorative label for the grey-white trend presumably conveys my negative opinion on this one. Most auto hues have aspirational names that would make

However, I knew it was time to share this story with JFCD readers when we unwittingly ordered my wife’s dream SUV in a variant of Dirty Dishwater. How could this happen? All manufacturers have a “Build Your Own Vehicle” section within their websites. Within said site, while equipping her dream ride, “Meaningless-Pronoun White” in the metallic paint section seemed white enough on the computer screen. However, within days, an SUV of the same brand drove by us dressed in Dirty Dishwater. We recoiled at the sight. Panic gripped us. Could Meaningless-Pronoun White be a marketing alias for Dirty Dishwater?

With a sinking feeling we made our way to the nearest dealer. The playingcard-sized colour samples in the showroom were scarcely better than the thumbnails on the computer screen. Our concern was yet further heightened. We ended up wandering the dealer’s not-yet PDI’ed (pre-delivery inspection for less car-versed folk) inventory until we found a vehicle with the no-extra-charge refrigerator-white colour we wanted. Fortunately our ordered SUV had not yet been built, and our colour preference could be changed. Salvation, then. The wisdom of aging propels us to construct take-away lessons. Regardless of the colour you’re after, do not rely on computer-screen depictions or paint swatches in the dealer’s showroom. To judge the colour you’re going to be living with for the next thousand or so days, you need to view an entire vehicle from that brand painted in the hue in question. And you need to view said vehicle outside in daylight. Of course, there is more to the topic Fads come and of car colours than go, like this purple being aware of that was first offered on the latest trend— 1970 Dodge muscle cars. and ensuring The “Plum Crazy” hue was reborn on the Dodge 2010 you actually like Challenger, seen here. the colour once it’s blown up from

from top: FCA/Fiat chrysler automobiles; BMW AG

Dod g e Th e 2010 e r in Ch a l le n g a zy ” "Plu m C r

laxative manufacturers blush—say, “Enlightened Serenity.” Or are rather on the nose, like “Plum Crazy” (seen on the Dodge Challenger, above). The Dirty Dishwater appellation won out over “Concrete Slurry” in my selfabsorbed name game. Yet, there is more to this tale than flaming out others’ aesthetic choices in car colour. Please accept my apologies if you have acquired such a trendy-hued vehicle. And you might cringe at my choice of wall art. Beauty is in the eye of the beholder, after all.

Another colour fad… BMW’s “Frozen” black matte was followed by versions in red, white and blue…as well as dark brown and grey. What’ll the next colour trend be?

Summer 2019 Just For Canadian doctors

17


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motoring

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Just For Canadian doctors Summer 2019

thumbnail size to 15 feet long and 4,500 pounds. Conventional wisdom in car colour choice is that black, silver and white are the safest choices for resale. But certain cars can wear more diverse colours, such as red for Ferrari, blue for Subaru WRX or Shelby Mustang, and British Racing Green for anything British. Importantly, if you are using a walk-away leasing plan, Dirty Dishwater or any other colour choice in the universe means no financial harm, nor foul. The value of the car at the end of the lease is pre-determined independent of the car colour. As well, you’ll be rid of the car before Dirty Dishwater is, at most, one or two fad colours out-of-date. However, after a few years, that same fadcolour car is an expensive 15-foot billboard advertising that you haven’t kept up with the fads, nor the Kardashians, nor the Joneses. When I see a fad-colour car from the past I can’t suppress mental associations with the politics, economics and popular culture of that past period. I’ve got your backstory: matte black, metal-flake cream, burnt orange, teal, aubergine and earth tone green/ brown/maroon. I can match them to Carter, Reagan, Bush, Clinton, Bush, Obama. Ditto with linkages to then-popular TV series. Dirty Dishwater will wear Trump’s epitaph, which seems somehow cosmically fitting. Here’s hoping both prove mercurial. In the used-car trade these past fad colours are charitably referred to as “period colours.” Typically such a characterization is the equivalent positive spin of “nice personality” to the blind date a friend set you up with. Most dealers will discount, or even decline, a trade-in when painted a colour they expect to be hard-to-move—including yesteryear’s colour fad. Some pundits argue a rare or past trend adds value and interest to any used car. Generally, I would argue the opposite for every example I’ve listed above. I’ll posit two exceptions: Soft pastels from Eisenhower’s era rock around the clock; Nixon-era loud jellybean colours, which are sweet when adorning muscle cars or exotic sports cars. Said jellybean colour theme has kept an underground following among specialinterest car models. Generally, the more adventurous the car model, the more latitude for ostentation in its paint-colour choice. Somehow, I don’t think Dirty Dishwater, when applied to SUVs or other Trumpian-era vehicles, is going to be a third exception to my anti-colour-fad rule.


beijing / prague / telluride / cairo / montréal … |

calendar

cMe

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

summe r 2019 + beyond

beijing

clockwise, from top left Flowers in Tian’anmen Square commemorate the founding of the People’s Republic of China on October 1, 1949; Tian’anmen

Gate, formerly the front gate of the Forbidden City; holiday crowds on the Great Wall at Bādálǐng; ornate detail from the roof of the Temple of Heaven; The Temple of Heaven looms high; skewered fried scorpion on Wangfujing Snack Street in Beijing’s Dongcheng district

big in beijing Explore China’s colossal capital of culture + cool (CME events in Beijing are in blue.)

janet gyenes

T

here’s a touch of sweetness to the fried scorpion I’m crunching on while strolling Wangfujing Snack Street in Beijing’s Dongcheng district. It’s one of the delicacies hawked in this ravenous megalopolis of 21.5 million that’s brimming with thousands more when I visit during Chinese New Year, or Spring Festival. But crowds converge here year round, many of them domestic tourists. I find fewer people and less-daunting items like tanghulu, sweet-tart candied hawthorns threaded on bamboo skewers in the lacework of lively hutongs like Dazhalan Xijie near Tian’anmen Square. Heady aromas emanate from these traditional alleyways that are steadily disappearing as this behemoth capital trains its focus on the future. Case in point: the new Beijing Daxing International Airport (designed by Zaha Hadid Architects and ADP Ingénierie) will become the world’s largest when it opens in September. Dubbed the “starfish” by Chinese

media for its sci-fi shape, it will welcome 72 million to the Imperial Vault of Heaven, an ornate three-tiered people annually, well in advance of Beijing hosting the circular structure ringed by an Echo Wall. Its hermetically 2022 Winter Olympic Games. Earlier this year, China’s sealed bricks send the sound of even a whisper to the other end of the round structure. A different kind of expanded 144-hour visa-free transit policy came into effect, making it even easier for international travellers grandeur greets me a day later when I disembark the to explore this cultural nexus that’s home to seven of train at Bādál ǐng for my first foray on the Great Wall. the country’s 53 UNESCO World Heritage sites. Located just 70 km north of the city core, in 1957 Local life, however, still plays out among the this section of the Wall was the first opened to centuries-old cypresses and lush gardens tourists and it remains the busiest and best [go] More info: surrounding the ancient architecture at preserved (see “Wild Walkers,” page 5). I travelchina.gov. the Temple of Heaven, or Tian Tan, first spend hours in awe walking this vast stone cn/en. For a trip constructed in 1420. I wander by seniors snake coiling across the scrubby winter beyond Beijing, see page 5. bent over decks of cards and dominos landscape. Although it’s slow-going being and stop to watch a group of men play a wedged shoulder to shoulder with thousands spirited ring-tossing game before visiting the who have also made the trek to explore the 273-hectare complex’s temples and sacrificial altars Ming dynasty-era towers and crenellated battlements where emperors prayed for rain and a good harvest there’s something about being in the crush that feels during the Ming and Qing dynasties. There’s a regal vibe comforting and quintessentially Beijing. — Janet Gyenes Summer 2019 Just For Canadian doctors

19


cme

calendar

Collaborative Health

Cardiology

Anesthesia

cme when where

20

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

topic

sponsor

contact

website

Sep 06-07

Bandar Seri Begawan Brunei

21st ASEAN Congress Of Anesthesiologists

Society of Anaesthesiologists Brunei Darussalam

673-2240800

aca2019 brunei.com

Nov 04-07

Sedona Arizona

Sedona Red Rock & Grand Canyon Adventure 2019 Encore Symposium

Encore Symposiums

877-3727627

escrnas.com

Feb 01-08 2020

Aspen Colorado

Aspen Anesthesia Seminar

Holiday Seminars

877-859-0550

holiday seminars.com

May 04-07 2020

New Orleans Louisiana

Anesthesia Update In The Big Easy

Cornerstone Anesthesia Conferences

281-836-0777

cornerstone anesthesia conferences. com

Jun 23-26

Orlando Florida

15th Annual Complex Cardiovascular Catheter Therapeutics: Advanced Endovascular And Coronary Intervention Global Summit (C3)

C3 Interventional Academy

773-714-0705

c3conference. net

Jul 14-19

East Rutherford New Jersey

Awesome Review Certification And Recertification Course

Awesome Review

201-905-0102

awesome review.com

Aug 31Sep 04

Paris France

European Society Of Cardiology (ESC) Congress 2019

European Society Of Cardiology

33-4-92-9476-00

escardio.org

Sep 08-11

Singapore Singapore

Computing In Cardiology (CinC)

info@cinc.org

cinc.org

Oct 24-27

MontrĂŠal QuĂŠbec

Canadian Cardiovascular Congress 2019

Canadian Cardiovascular Congress

866-3178461

cardio congress.org

Feb 5-7 2020

San Diego California

Ninth Annual Structural Heart Intervention and Imaging

Scripps Conference Services & CME

858-6526400

scripps.org

July 24-25

Rome Italy

9th International Conference On Alternative & Traditional Medicine

Pulsus Events

traditional medicine@ pulsusevents. org

traditionalalternative medicine. cmesociety. com

Aug 03-05

Selangor Malaysia

9th International Traditional And Complementary Medicine Conference

Ministry of Health Malaysia

03-2279-8100

intracom2019. moh.gov.my/ intracom/

Oct 12-16

San Diego California

2019 Academy Of Integrative Health & Medicine Annual Conference

Academy of Integrative Health & Medicine (AIHM)

858-240-9033

aihm.org

Oct 17-19

Nashville Tennessee

Updates In Collaborative Functional Medicine

American College for Advancement in Medicine & American Academy of Physiological Medicine and Dentistry

888-995-3088 See Ad Page 29

acam.org/ 2019Meeting

new CE to beConference placed Computing In Cardiology 2019

Just For Canadian doctors Summer 2019


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

Endocrinology

Emergency Medicine

Diabetes

Dermatology

cme when where

calendar

cMe

topic

sponsor

contact

website

Aug 13-16

Virginia Beach Virginia

Skin, Bones, Hearts And Private Parts

Dillehay Management Group

770-640-1022

skinbonescme. com

Aug 19-20

Tokyo Japan

19th Edition Of International Conference On Dermatology And Melanoma

EuroSciCon

800-841-6480

dermatology. euroscicon.com

Oct 03-06

Budenheim Germany

16th International Workshop On Langerhans Cells

Conventus Congressmanagement & Marketing GmbH

9-3641-3116-314

lc2019.de

Jan 11-13 2020

Moshi Kilimanjaro Tanzania

Tropical Dermatology In Tanzania - A Unique Experience At The Regional Dermatology Training Centre

American Academy of Dermatology

847-240-1280

aad.org

Oct 30Nov 02

Boston Massachusetts

ISPAD 2019 - 45th Annual Conference

International Society for Pediatric and Adolescent Diabetes

49-0-3024603-210

ispad.org

Dec 02-06

Busan Korea

IDF Congress 2019

International Diabetes Federation

congress@idf. org See Ad Page 4

idf2019busan. org

Dec 06-07

Singapore Singapore

Dermatology, Skin Care And Skin Professionals Meet 2019

Lexis Conferences

505-557-2157

lexis conferences. com/skincare

Jan 20-22 2020

Haikou China

International Symposium On Diabetes

flcevent.com

Jul 17

South Pasadena California

new CE to Advanced Cardiac Life Support (ACLS)be placed Lifesaver Education Certification Course

0086-41139417298 626-441-3406

lifesavered. com/classes/ acls

Nov 05-09

Honolulu Hawaii

16th Annual Emergency Medicine Update: Hot Topics 2019

University of California, Davis

events@ ucdavis.edu See Ad Page 18

ces.ucdavis. edu/ emhot2019

Jan 06-11 2020

San Diego California

National Association Of EMS Physicians Annual Meeting 2020

National Association of EMS Physicians

800-228-3677

naemsp.org

Jan 08-11 2020

Nassau Bahamas

Topics In Emergency Medicine

Northwest Seminars

800-222-6927

northwest seminars.com

Jul 18-20

Denver Colorado

Hormone Advanced Practice Module 2019

Institute for Functional Medicine

800-228-0622

ifm.org

Aug 31Sep 03

Kraków Małopolskie Poland

41st ESPEN Congress On Clinical Nutrition & Metabolism

MCI Suisse SA

412-2-3399580

espen congress.com

Sep 03-07

Madrid Spain

16th World Congress International Federation For The Surgery Of Obesity And Metabolic Disorders

Federation for the Surgery of Obesity

39-0817611085

ifso2019.com

Mar 25-29 2020

New Orleans Louisiana

National Kidney Foundation Spring Clinical Meeting

National Kidney Foundation

855-653-2273

kidney.org

v

v

FLC Event

Canadian Psychiatric Association Dedicated to quality care

Association des psychiatres du Canada www.cpa-apc.org

Dévouée aux soins de qualité

Summer 2019 Just For Canadian doctors

21


cme

calendar

Hepatology

Hematology

Geriatrics

General & Family Medicine

Gastroenterology

cme when where

22

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

topic

sponsor

contact

website

Jul 25-26

Cairo Egypt

World Summit Of Pediatric GI And Nutrition (WSPGIN) 2019

US Certified

202-23050739

wspgin.com

Dec 05-07

New York New York

Gastroenterology, Hepatology & Nutrition 36th Annual Conference

Columbia University Medicine

212-305-5960

columbia.edu

Nov 05-08 2020

Kobe Japan

Japan Digestive Disease Week 2020

Japan Digestive Disease Week

infoen@jddw.jp

jddw.jp/ english

Aug 02-04

Beijing China

8th Beijing International Private Health And Medical Exhibition

Zhenwei Exhibition

13-520519808

bihmexpo.com

Oct 22-29

Yachting the Rivieras: Rome to Barcelona

Exploring Medicine & The Mediterranean Healthcare Model / 7-Night Cruise On Windstar Wind Surf

Professional Education Society

877-737-7005 See Ad Page 25

pestravel.com

Oct 30Nov 02

Vancouver British Columbia

Family Medicine Forum 2019

The College of Family Physicians of Canada

800-387-6197

fmf.cfpc.ca

Nov 07-09

Prague Czech Republic

Modern Molecular-Biochemical Markers In Clinical And Experimental Medicine

European Scientific Center Biomarkers

42-077-49514-83

escbm.org

Dec 30 2019Jan 06 2020

United Arab Emirates Cruise

Family Medicine

Continuing Education, Inc./University at Sea

866-456-9464 See Ad Page 31

continuingedu cation.net

May 05-15 2020

West Coast San Diego to Vancouver

10-Night Cruise On Windstar Star Breeze

Society

877-737-7005 See Ad Page 25

pestravel.com

Jun 07-21 2020

Norwegian Fjords & the Midnight Sun

Medical Seminar At Sea & The Scandinavian Healthcare System/14-Night Cruise Along Norway’s Scenic Coast On Holland America’s Newest Ship

Professional Education Society

877-737-7005

pestravel.com

Aug 09-11

Galveston Texas

Texas Geriatrics Society And Texas Society For Post-Acute And Long-Term Care Medicine TMDA Annual Conference

Texas Geriatrics Society

See website

texasgeriatrics. org

Oct 03-05

Québec City Québec

10th Canadian Conference On Dementia

University Health Network

416-597-3422

canadian conference ondementia.com

Dec 07-10

Orlando Florida

61st American Society Of Hematology Annual Meeting & Exposition

American Society Of Hematology

202-776-0544

hematology. org

Jan 30Feb 01 2020

La Jolla California

12th Annual T-cell Lymphoma Forum

Jonathan Wood & Associates

973-290-8200

tcellforum.com

Nov 02-03

Monterey California

39th Annual Update In Gastroenterology And Hepatology For The Primary Care Provider

University of California, Davis

events@ ucdavis.edu

ces.ucdavis. edu/gastro hepa2019

Nov 08-12

Boston Massachusetts

The Liver Meeting 2019

American Association for the Study of Liver Diseases

703-299-9766

aasld.org

new CE to be placed Medical Seminar At Sea & Well-Being Updates Professional Education

Just For Canadian doctors Summer 2019


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

Oncology

Nutritional Medicine

Neurology

Mental Health

Internal Medicine

Infectious & Chronic Diseases

cme when where

calendar

cMe

topic

sponsor

contact

website

Nov 07-09

Johannesburg South Africa

8th Federation Of Infectious Diseases Societies Of Southern Africa Congress

Federation of Infectious Diseases Societies of Southern Africa

079-491-7109

fidssa.co.za

Mar 31Apr 03 2020

Orlando Florida

ASCCP 2020 Annual Scientific Meeting On Anogenital & HPV-Related Diseases

American Society of Colposcopy and Cervical Pathology

301-857-7877

asccp.org/ 2020meeting

Jul 29-30

Amsterdam Netherlands

International Conference On Cancer Science & Stem Cell Research

Medical Conferences

31728080590

medical conferences.nl

Dec 05-07

Amsterdam Netherlands

International Society For The Study Of Bladder Pain Syndrome Annual Meeting 2019

Essic International Society for the Study of BPS

39-0523338391

essicmeeting. eu

Boston University School of Medicine

617-358-5005

bucme.org

Summer Symposia For Mental Health Professionals

Jul 08-19

Cape Cod Massachusetts

Sep 05-08

Hyannis Massachusetts

Cape Cod Symposium On Addictive Disorders

C4 Recovery Foundation

800-611-5735

ccsad.com

Sep 12-14

Québec City Québec

69th Annual Conference

The Canadian Psychiatric Association

800-267-1555 See Ad Page 21

cpa-apc.org

Sep 28-29

Iqualuit Nunavut

CBT Tools & Techniques With Dr. Greg Dubord

877-466-8228

cbt.ca

Oct 21

Davis California

Provider

Davis

events@ ucdavis.edu See Ad Page 18

ces.ucdavis. edu/ neuro2019

Sep 09-12

Beijing China

World Federation Of Neurosurgical Societies Interim Meeting

World Federation Of Neurosurgical Societies

41-0-22-3624304

wfns.org

Jan 10-12 2020

Fort Lauderdale Florida

American Society For Peripheral Nerve (ASPN) Annual Meeting 2020

American Society for Peripheral Nerve

312-853-4799

peripheral nerve.org

Jul 27-30

Orlando Florida

52nd Annual Conference: Nutrition Education - Rooted In Food

Society for Nutrition Education And Behavior

800-235-6690

sneb.org

Oct 15-18

Dublin Ireland

13th European Nutrition Conference

Federation of European 353-1-400Nutrition Science and 3626 The Nutrition Society

fens2019.org

Aug 03-04

Newry Maine

Hormone-Dependent Cancers Gordon Research Seminar - Overcoming Endocrine Resistance And Metastasis In HormoneDependent Cancers

Gordon Research Conferences

401-360-1521

grc.org

Sep 21

Seattle Washington

10th Annual Comprehensive Hematology & Oncology Review Course

Seattle Cancer Care Alliance

education@ seattlecca.org

seattlecca.org

Jan 09-11 2020

Houston Texas

NRG Oncology Meeting

NRG Oncology

267-519-6630

nrgoncology. org

• Transformational Moments: How Master Clinicians Think, Talk, And Listen When Facing The Most Challenging Of Clinical Tasks • Forgiveness: Mindfulness And Compassion In Action • Clinical Psychopharmacology: Overview And Recent Advances • Challenging Clients: Creative Use Of Best Practices

new CBT CECanada to be placed Neurology Update 2019 For The Primary Care University of California,

StrongerTogether

18th Annual Pain Medicine Meeting

American Society of Regional Anesthesia and Pain Medicine Advancing the science and practice of regional anesthesia and pain medicine to improve patient outcomes through research, education, and advocacy

November 14-16, 2019 | New Orleans, LA

#ASRAFALL19

Register at www.asra.com/pain Summer 2019 Just For Canadian doctors

23


cme

calendar

Women’s Health

Radiology

Primary Care

Pediatrics

Pain Management

Orthopaedics

cme when where

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

topic

sponsor

contact

website

Jun 19-22

Montréal Québec

Canadian Orthopaedic Association Annual Meeting And International Combined Orthopaedic Research Societies (ICORS)

Canadian Orthopaedic Association

514 874-9003

2019icors.org

Oct 22-25

Berlin Germany

DKOU 2019 - German Congress Of Orthopaedics And Traumatology

Intercongress GmbH

49-61197716-0

intercongress. de

Jul 25-28

Lake Buena Vista Florida

Headache Update

Diamond Headache Clinic

312-867-9104

dhc-fdn.org

Sep 05-08

Dublin Ireland

IHC 2019: 19th Congress Of The International Headache Society

International Headache 44-1-730-71Society 5274

mci-group. com

Nov 14-16

New Orleans Louisiana

ASRA 18th Annual Pain Medicine Meeting (Novel Opioid Targets, Alcohol Use In Chronic Pain, Advances In Advanced Interventional Care, Fibromyalgia, Chronic Fatigue Syndrome, Headache, Intrathecal Therapy, Electrodiagnostics, Dedicated NP/PA Program)

American Society of Regional Anesthesia and Pain Medicine

412-471-2718 See Ad Page 23

asra.com/pain

Jul 22-23

Valencia Spain

2nd International Conference On Pediatrics And Neonatology

Colloquium

307-222-6372

colloquium online.com

Sep 05-07

Venice Italy

Global Forum On Pediatrics And Women’s Health

Genoteq Healthcare

14-693420402

pediatricconferences. com

Sep 22Oct 01

Spain, France & Italy Cruise

Primary Care 2019 Update: Type 2 Diabetes, Metabolic Syndrome And Obesity

Continuing Education, Inc./University at Sea

866-456-9464

continuingedu cation.net

Oct 14-18

Maui Hawaii

9th Annual Primary Care Fall Conference

Continuing Education Company

800-327-4502

cmemeeting. org

Oct 21-25

Charleston South Carolina

NYU’s Fall Radiology Symposium In Charleston

New York University Department of Radiology

212-263-3936 See Ad Page 24

med.nyu.edu/ courses/cme/ sc19

Dec 16-20

New York New York

NYU’s 38th Annual Morton A. Bosniak Head To Toe Imaging Conference

New York University Department of Radiology

212-263-3936 See Ad Page 24

med.nyu.edu/ courses/cme/ h2t19

Mar 16-20 2020

Telluride Colorado

18th Annual NYU Radiology Alpine Imaging Symposium

New York University Department of Radiology

212-263-3936

med.nyu.edu/ courses/cme/ ski20

Sep 21-22

Bangkok Thailand

International Conference On Healthcare, Pediatrics & Nursing Care

Confimprint Events

609-414-7807

confimprint. com

Oct 24-31

Rhine River Cruise

Current Topics In Women’s Health

Continuing Education, Inc./University at Sea

866-456-9464 See Ad Page 31

continuingedu cation.net

Jan 02-06 2020

Kohala Coast Hawaii

36th Annual Conference: Obstetrics, Gynecology, Perinatal Medicine, Neonatology, And The Law

Center for Human Genetics

617-492-7083

chginc.org

new CE to be placed

For feedback, requests or to have your course featured please email cme@inprintpublications.com or submit your course via www.justforcanadiandoctors.com

NYU Radiology CME Presents

38th Annual Head to Toe Imaging Conference December 16-20, 2019 • The New York Hilton Midtown • New York City

Earn over 40 AMA PRA Category I Credits www.med.nyu.edu/courses/cme/h2t19

24

Just For Canadian doctors Summer 2019


CIETY

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CME/CE Cruise & Travel Seminars 2019 - 2020

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The Professional Education Society invites you to join our 2019 - 2020 CME/CE Seminars for Medical, Dental, Nursing, and Allied Healthcare Professionals

Rome to Barcelona on Windstar Wind Surf

Norwegian Fjords & the Midnight Sun on Holland America

New Zealand & Australia Discovery: Custom Land Program

Taiwan, Philippines, Borneo & Indonesia on Crystal Endeavor

Panama Canal Tropical Winter Escape on Regent Splendor

Splendors of Egypt & the Nile on Uniworld S.S. Sphinx

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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, CPA, CA, is a principal in the Vancouver office of Purtzki Johansen & Associates. He can be reached at: Manfred@purtzki.com or 604-669-7558.

Honey, I shrunk the investment The incredible shrinking investment return

Y

ou are investing in the Canadian stock market, which has enjoyed a robust average annual growth of 8.5% for the last 30 years. Yet, your investments have you perplexed or, more likely, depressed, because these stock market gains are not reflected in your portfolio. What is the reason? Consider the following scenario. You invested $10,000 in 1980 in the stock market and left it there until 2018. During that period the S&P/TSX composite index generated an average annual return of 8.5%. That means your $10,000 investment grew to $222,000. But not all that money came to you. After paying your 2% annual management fee, your investment shrank from $222,000 to $109,000, a 50% drop! Income tax ate up approximately 20% as well and, taking into account the inflation rate of 2.8%, your net return on investment ended up a meagre 2.4%. After investing $10,000 for 38 years you ended up with less than $25,000 in real money (see table above). You need some strategies to boost those returns.

S&P/TSX comp. average

8.50%

$221,988

Management fees

2.00%

$(112,521)

Income before tax

6.50%

$109,467

Income tax at 20%

1.30%

$(21,893)

After-tax return

5.20%

87,574

Inflation adjustment

2.80%

$(62,948)

Real net return

2.40%

$24,626

*$10,000 invested in 1980 until 2018

only compounding at 6.5%. Over many years, that makes a huge difference. 2 Use the medical corporation or holding company as your investment vehicle. Take advantage of the low corporate tax rate by investing all surplus funds in the corporation and only draw funds for personal and living expenses. If you invest $30,000 of your before-tax income annually in the corporation for 30 years at an interest rate of 6%, the corporate investment will grow to $2 million. If you decide to invest the same income personally, then you only have $1.3 million of investments (assuming a corporate and

at your

service

1 Look for ways to reduce your management fee. Although 2% sounds harmless, in our example, it reduces your stock market gains by more than half. The reason for this is that instead of compounding at 8.5%, your money was

Investment*

26

Just For Canadian doctors Summer 2019

personal tax rate of 4 strategies 12% and 44%, respectively). to battle that There are investment additional personal taxes to shrinkage consider when drawing retirement income from the corporation, however, the tax benefit of corporate investments remains significant. 3 Borrow money to invest. If you are confident that your financial advisor is consistently producing above average returns for your portfolio, “leveraging� will give your wealth-building efforts a big boost. If you take out a 3% mortgage on your house for $500,000 and invest it for 10 years at 8%, you will gain an extra $300,000 using the bank’s money. 4 Postpone retirement. When all available strategies fail to provide you with the funds required for a decent lifestyle during retirement, you can either postpone your retirement for a few years or work part-time to earn sufficient income to pay for your living expenses. Instead of spending more time on your investments and finding ways of getting better returns, many physicians are resigning themselves to the fact that they have to work long past their retirement due date.


Creating An Emergency Plan For Your Medical Practice: Following These Steps Protects Your Practice Value If Emergency Strikes MATT WILSON & LYNNE FISHER

I

f you couldn’t be in your practice, advisors and family minimizes disruption how would that impact you, your to patients and cash flow. family, your staff or your patients? Simon’s action: Simon designates Ultimately, the successful livelihood members of his staff to take certain roles of a practising physician depends on the in case of emergency. His receptionist is consistent f low through of patients and responsible for connecting with patients and revenue. In turn, a disruption in that suppliers and one of his family members f low caused by an emergency means communicates with bankers and advisors. lost revenue. But mitigating this risk is Simon also investigates options for sourcing relatively simple, and well worth your and contracting with a locum physician, investment and time. including creation of a draft which would be available in case of emergency. To illustrate how to make an emergency plan, consider the example of Simon Smith, a practising physician. His office Every medical practice was buzzing with patients until a cycling needs to be prepared to accident abruptly took Simon away from deal with disruption or work. The lack of an emergency plan created you risk losing patients to chaos. The practice cancelled appointments another practice. Knowing and patients were frustrated. Simon was not available to sign off on payroll and your personal net worth, employees were not paid. The cancellations and how a disruption resulted in lost patients because of the would impact your family’s negative experience. These problems are avoidable. Use Simon as an example and learn about the steps of making an emergency plan. UNDERSTAND WHAT IS AT RISK

long-term wealth is an important first step.

CREATE A SIGNING AUTHORITY SYSTEM FOR EMERGENCY SITUATIONS

Every medical practice needs to be prepared to deal with disruption or you If an emergency happens and you cannot risk losing patients to another practice. sign documents, you risk missing bill Knowing your personal net worth, and how payments or payroll. To avoid this, create a a disruption would impact your family’s “two out of three” signing authority policy. long-term wealth is an important first step. Another option is creating a wellSimon’s action: Simon documents and written Power of Attorney to grant updates his personal net worth statement authority to someone trusted and allow regularly. As part of this process, he works them to make decisions on your behalf with his accountant and wealth advisor when you are unable. to understand the financial impact of an absence from the practice and to ensure Simon’s action: Simon creates a two he has the right types and amounts of out of three-signing authority policy, insurance for practice continuity and designating two other staff and/or family income replacement for his family. members as the other signers. He also meets with his lawyer to work through a BE CLEAR ABOUT YOUR detailed Power of Attorney plan. INTENTIONS FOR HANDLING UNPLANNED ABSENCES CONSIDER YOUR FAMILY’S PROTECTION AND WHAT THEY Determine who is in charge if you are NEED TO KNOW not there and what they should do. Creating a step-by-step action plan for dealing with Stress runs high in emergency situations. patients, suppliers, bankers, professional You can ease the tension by sharing your

plans and wishes with family members ahead of time, providing your family with a simple roadmap to follow. Simon’s action: Simon develops a plan in case of absence and compiles that in a folder with important documents like insurance, powers of attorney and a will. He shares this with his family, his staff and his professional advisors, as appropriate, to ensure these documents are accessible if needed. Regardless of the life stage of a practice, the simple step of putting a plan in place for ensuring continuity if you were away for a short or long term, protects your practice and your family.

Matt Wilson, CPA, CA, is a Partner and Business advisor for MNP’s Professional Services Team. Drawing on more than nine years of experience, Matt works with professionals, including doctors, dentists, lawyers, engineers and veterinarians, helping them achieve their goals throughout the lifecycle of their practice. You can reach him at 780.451.4406 or by email Matt.Wilson@ mnp.ca Lynne Fisher, is the National Team Leader of MNP’s ExitSMART™ service. Drawing on more than fifteen years of direct experience, Lynne brings her expertise to MNP’s comprehensive succession program, ExitSMART™, which offers endto-end succession planning for privately held companies. She has worked with clients in a variety of industries and brings expertise from having been a business owner, commercial banker, consultant and educator. You can reach her at 780.451.4406 or email Lynne.Fisher@mnp.ca.

Advertising Feature


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.

Change is here

At last, a tsunami of change is surging on the west side of the Rockies

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Just For Canadian doctors Summer 2019

There’s an increasing number of enthusiasm— women in the from doctors and profession— patients— for this there’s new of growth. My wife believes, family medicine and I agree, that young female family physicians are much less likely to want to appear omnipotent or become empire builders; they want to do just what they went to medical school for. This change is apparent to me in the many peer assessments I have undertaken over the past 30 years. So what is the practical change here in British Columbia? I see it as the opening of a series of “Urgent Care Centres.” Here, the physician comes to work with the help of an entire team. This team comprises a variety of paramedical personnel, including secretarial help, nursing help, on-site pharmacist and on-site mental-health nurse. The physician is paid on a sessional basis, and the fee is reasonable but not overly generous. The physician comes and works his/her shift and then is free to go home without having to worry about negotiating leases, paying staff, checking on supplies…and the list could go on and on. I think, as I am heading out to pasture, I am leaving behind a new model for family medicine that has great potential to be significantly different and, I hope, considerably better for both doctors and their patients.

new order

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

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solution from page 29

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recognise the changes in the delivery of medical care. So what are these changes? What is the government trying to address? Why now? I have seen many changes over the years in the delivery of medical care. Some of these include the increased documentation required by the medical protective associations who are ably assisted by the provincial colleges. Furthermore, there is documentary evidence required by employers, schools and insurance companies, amongst many many others. Another change is the simple demand of an increasing number of patients with a snowballing number of treatable pathologies. Many of these are age-related but not entirely. Some illnesses, not that long ago fatal, are now treatable, often requiring intense medical intervention. Physicians have long paid the price for insisting that medicine is an independent business. I argue that it is not. How can it be when the fees—and hence the income— are fixed by the government? The solution is that physicians need assistance. As a profession, we need to learn to delegate to secretarial staff and paramedical practitioners. Maintaining the “independent profession” all-inclusive fee means this is not practically affordable. With regards to “why now?” I think that this has come to fruition after being sowed long ago. Now that the provincial government has fertile ground in which to plant the seeds of a happier medical profession—due in part to careful selection of entrants to medical school, including

solution from Spring 2019 contest

I

have forgotten how many years it is that I have been writing op-eds—and in retrospect I’m surprised that I’ve delivered roughly the same message in many different ways. To be fair, things have changed over this time—some for the slightly better, some with no effect at all and some making things worse. Suddenly, however, on this bit of land on the other side of the Rockies we seem to have a provincial government that is actually making some bold, hands-on practical changes in response to the physician shortage. The change in attitude seems to be infectious; there’s enthusiasm—from doctors and patients—for this new order of family medicine. I think this is analogous to the introduction of digital photography. I remember getting my first digital camera (a whopping two megapixels) at the turnof-the-century. Digital photography could have become accessible and practical much sooner, but it was held back by large chemical photography companies. Once the logjam began to give way, the flood of digital photography has been impressive. Much the same argument could be made about the conventional car manufacturing industry, with its resistance to hydrogen cell and rechargeable zeroemission vehicles. The changeover to these vehicles is becoming irresistible, and the increased sale of alternative automobiles is now exponential. I think the logjam for our profession was provincial government parsimony, combined with my generation’s failure to

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

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diversion

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8 7

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1. Entry form must be accompanied with solved puzzle. Only correctly solved puzzles entered into random draw. 2. Send puzzle + entry form to Just For Canadian Doctors, 200 – 896 Cambie St., Vancouver, BC, V6B 2P6 or fax 604681-0456. Entries must be received by August 23, 2019. 3. Prize: $50 Amazon Gift Card. 4. Contest can be changed and/or cancelled without prior notice. 5. All entries become property of In Print Publications. 6. Employees of In Print Publications and its affiliates are not eligible to participate. 7. In Print Publications is not responsible for lost or stolen prizes.

Summer 2019 Just For Canadian doctors

29


s m a l l ta l k

doctors share their picks + pleasures dr. jennifer kask grew up fishing off the wharf of a small island where the only inhabitants were her family. That sense of adventure and love of the outdoors has stayed with her and is now shared with her children, from trekking in New Zealand or the Himalayas of Tibet to jumping off cliffs into lakes in her backyard of Vancouver Island. As per Dr. Kask’s cure for travel fatigue: “I try to ignore jet lag and get outside ASAP.” Or, as her family’s motto states: “Res non verba,” which translates from Latin to this more commonly known credo: “Actions speak larger than words.” Just do it! My name: Jennifer Kask I live, practise in: Campbell River, BC My training: MD from UBC, CCFP, FCFP Why I was drawn to medicine and/ or chose my field/ specialty: Family Practice was a good fit because I enjoyed all of

January 1, 2019. Most exotic place I’ve travelled to: Mana Island, Fiji The best souvenir I’ve brought back from a trip: I returned from a big hiking trip (with my husband)…pregnant Best meal anywhere: I grew up on a small island. Our family was

Favourite place that I keep returning to: The beautiful lakes, coastline and mountains in my “backyard” on Vancouver Island Favourite city: Sydney, Australia. When we visited with our three kids a few years ago we spent a delightful Sunday taking public

day hikes they were just too little to manage at the time. If I could travel to any time, it’d be: The west coast of Canada in the 1920–50s, travelling by ship to all the logging and fishing camps and canneries—it must have been so interesting

I’d describe my home as: Loud, and smells like teenagers and sports gear Last purchase: A newto-me mountain bike I have too many: Reusable water bottles My go-to exercise/ sport: Running

photos, from left

Dr. Kask on a medical mission in Guatemala, April 2018; a photo she took of son Gideon Loeb last summer, jumping into Cream Lake on Vancouver Island; in Tibet with Extravagant Yak Tours, earlier this year; and hiking with her then-young children on Sealy Tarns Track in Aoraki Mount Cook Park In New Zealand, an experience she hopes to repeat

My last trip: Three weeks in December and January in China and Tibet with my husband and three children. We went into Tibet with Extravagant Yak Tours—it was amazing. We were able to watch the sunrise from near the base of Mount Everest on

30

the only inhabitants and it was only accessible by boat. If we had unexpected visitors my parents would send us down the wharf to catch fish for supper. My mom would pan fry them so fresh that they didn’t even taste like fish. “Wow” hotel/resort I’d happily stay at again: Jasper Park Lodge in the winter; skating on the lake then getting warm and cozy inside

Just For Canadian doctors Summer 2019

transportation for something like a 2$ allday ticket Can’t believe I’ve never been to: Disneyland with my kids Dream vacation: Twice our family has had the chance to spend a season of life in New Zealand, where I worked as a locum. I would love to return now that the kids are teenagers and see some of the places they loved when they were much younger…and do some of the multi-

My jet-lag cure: I try to ignore jet lag and get outside ASAP First job: Working in the bindery department of a local print shop Favourite book: The Hobbit Gadget or gear I could not do without: My camera Fuji FinepixHS20 circa 2011. It has been used and abused and has been to 18 countries and countless sailing, hiking, canoeing trips.

Favourite spectator sport: Kids soccer A talent I wish I had: Diplomacy I’m inspired by: My parents; they raised us in an unconventional place and way, equipping us to be resilient and resourceful, to seek adventure, and to, above all, be kind My motto: “Res non verba” is on the family crest given in 1513 [Latin for “deeds not words”] If I wasn’t a doctor, I’d be: A high school science teacher

photos courtesy of Dr. Jennifer Kask

my rotations in medical school and could not decide on any one specialty…I was always worrying about missing out on other parts of medicine


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