Just For Canadian Doctors Winter 2017

winter 2017

DOCTORS life + leisure

on ICE in the

high arctic go DEEP in

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Just for C

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DOCTORS life + leisure

contents

winter 2017

winter 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 Chris Pengilly Dr. Kellen Silverthorn Barb Sligl Roberta Staley

Cover photo Barb Sligl Senior Account Executive Monique Nguyen

31 16

Account Executive Wing-Yee Kwong Production Manager Ninh Hoang CE Development Adam Flint

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FEATURES

16 Wild at heart in Belize, from the jungle to the reef 31 Into the north and out of the Northwest Passage

clockwise from top left: Barb Sligl; janet gyenes; B. Sligl

Just For Canadian Doctors is published 4 times a year by Jamieson-Quinn Holdings Ltd. dba In Print Publications and distributed to Canadian physicians. 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

COLUMNS

DEPARTMENTS

8 photo prescription

5 winter mix 21 CME calendar 37 sudoku 38 parting shot

Antarctica beckons

11 pay it forward Mercy Ships in Madagascar

12 the thirsty doctor

Ilulissat, Greenland

What to sample in the new year

14 motoring The bespoke Porsche

www.justforcanadiandoctors.com

28 doctor on a soapbox

Printed in Canada.

want to reach us? check out our website!

Working with pharmacists

cover photo A massive iceberg, as seen from one of the Ocean Endeavour‘s zodiacs in Ilulissat Icefjord, a UNESCO World Heritage Site and must-stop on Adventure Canada’s Arctic expedition starting in Nunavut (page 31).

Winter 2017 Just For Canadian doctors

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Separation? Accident?

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CONFLICT RESOLUTION with OPTIMAL SOLUTIONS 4

Just For Canadian doctors Winter 2017

solution from page 37

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

Puzzle by websudoku.com

Marital Mediation Collaborative Divorce Elder Mediation Parenting Coordination Expert Negotiation

winter wonder

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

Puzzle by websudoku.com

ce. Snow. Sleet. Wind. Waves. Swells.

A heady brew of Mother Nature’s power is on full display in the High Arctic.

Here, you can have a taste of winter— year-round. These elemental forces are humbling and bewitching, and remind us to “tremble with joy,” as Arctic explorer Knud Rasmussen wrote.

The isolated land of the Arctic has many stories to tell, from bygone colonialday explorers of the British Admiralty to modern-day Inuit forging a life on the very edge of civilization. And after a few days aboard the Ocean Endeavour with Adventure Canada, everything seems to shift, expand, deepen…from Nunavut to Greenland, the journey through the Northwest Passage is like bearing witness to the planet’s history (page 31).

Another soul-searching trip can be found thousands of kilometres away, far from the Arctic Circle and near the Equator. Belize is becoming a hotspot for adventure seekers, from jungle to beach.

The back-to-nature experience with Island Expeditions—camping on the fringes of untouched cayes, hiking and snorkelling amidst strange creatures, kayaking in the great blue beyond of another ocean—is about discovering yet another side of Mother Nature (page 16).

There’s a north-south, hot-cold, dark-light dichotomy in all things. And in this issue prefacing the winter season, we showcase both, whether qiviut (the softer-than-cashmere fibre of the Arctic’s musk ox; page 6) or the circular perfection of the Great Blue Hole (page 5). We meet Aurora borealis, that glowing lady of the north (page 6) and then sample margaritas in the desert heat of Phoenix (page 21). We travel from the Southern Hemisphere in Antarctica (page 8) to the UNESCO World Heritage Site of Ilulissat Icefjord on the northwest coast of Greenland (page 38).

As per a quote our photography expert shares from Mark Twain: “…throw off the bowlines. Explore. Dream. Discover.” Yes. We do it with gusto in this issue. Enjoy.

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

what/when/where > winter

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

mix

into the blue

you e could b

here!

GO

DEEP

GREAT BLUE HOLE I ISTOCK

n the 1970s French scientist and explorer Jacques-Yves Cousteau “blew a piece of the crater out of the Blue Hole using dynamite,” says Bill, a park ranger from the Belize Audubon Society. These ominous words float in my head as I nervously fiddle with my snorkel and fins. I’m mentally preparing myself to plunge into the 125-metre-deep sinkhole at Lighthouse Reef, a coral atoll 70 kilometres offshore from mainland Belize. As the story goes, Cousteau wanted to create an opening for his research vessel, Calypso, to enter

this 300-metre-wide natural swimming pool so he could explore its cavernous chambers.

“Keep left,” says Rodney. He’s one of the guides leading our group on a snorkel of the inner perimeter of the perfectly circular sinkhole. “It’s going to take us about 45 minutes.” In overhead images I’d seen of this natural phenomenon it looks like the eye of a mythical beast: a dark pupil ringed in turquoise with hundreds of mottled patch reefs forming a limitless body of blues. Some legends say sea monsters

haunt the hole’s depths, but I’m afraid of real creatures like the stingrays and blacktip sharks that make their homes here. Minutes ago I wondered if our boat had stalled, not realizing we’d arrived: the hole’s rim is hidden under a vast expanse of daunting dark water.

Rodney dives down and points out colossal tube corals, along with strange black-and-white tiger tail sea cucumbers that shrink away when playfully prodded. It’s a glorious underwater garden with purple and gold coral seafans swaying to a soundless tune.

An artist’s palette of painted fish flit alongside as I swim clockwise around this massive roundabout. They take shortcuts among the coral branches, darting into the light and shadows as brilliant flashes of electric blue and neon yellow. I see a shape moving to my right in the eerie abyss. Twin wraithlike creatures—eagles rays—glide by before being swallowed up by the darkness. It’s then that I get a vivid sense of the mythology surrounding this sweet spot suspended in the sea. Haunting, indeed. —Janet Gyenes

if you go Take an excursion from Island Expedition’s Lighthouse Reef basecamp. islandexpeditions.com read more See story on Belize, page 16.

Winter 2017 Just For Canadian doctors

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mix

winter

high arctic

fashion

light show

[greenland]

Kangerlussuaq Fjord, near the Arctic Circle at ~66°5’N 52°5’W

treip th

T

Welcome to the ice age

light fantastic L

read more

See story on the Arctic, page 31.

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Just For Canadian doctors Winter 2017

ong strands unfurling in atmospheric waves or limbs looming across the sky. Aurora borealis may be a bit of a tease, but this siren of mythic proportions puts on a show of oohs and aahs. Her name literally means “northern lights” and, made up of charged particles from solar activity drawn to earth’s magnetic field lines, she’s at her most flirtatious in the High Arctic.

Expeditions north of 66º (like Adventure Canada’s Out of the Northwest Passage voyage; see page 31), offer the best chances of seeing the Northern Lights. And if it’s winter (when nights are dark and long), isolated (with little light pollution, as in Kangerlussuaq Fjord in northwest Greenland; left), the skies are clear (winter in the northern auroral zone tends to have less cloud cover) and you’re near the Arctic Circle (roughly the latitude of 66ºN), then you may be graced with a sighting.

But Aurora is fickle. She’s ending a decade-long cycle of high activity and ready for some rest, fading and shying away (following the ebbs and flows of an 11-year solar cycle) and settling into a more dormant phase. Catch her while you can. —Barb Sligl

bottom: barb sligl

northern exposure

W

inter is coming. Extreme weather holds an icy grip on remote northern reaches. Temperatures are bone-chilling, winds unrelenting, and the scenery so spectacularly sinister it takes your breath away. Here, only the strongest survive—like the musk ox, which inspired Qiviut & Co.’s ultra-luxury flagship jacket.

Like its muse, this limited-edition unisex jacket is rare (each one comes with a certificate of authenticity) and thrives in barren landscapes where few dare to wander, thanks to a downy under-fibre called qiviut. Long used by denizens of the frozen north, this rugged natural fibre is actually softer than cashmere and eight times warmer than wool. And like the musk ox, qiviut is scarce. Globally, less than 5,000 kg of the raw fibre is harvested each year from the animals when they shed each spring. Qiviut & Co. launched its innovative outerwear after observing artisans in Alaska using this fibre over two decades.

These pioneering jackets are hard-working and stylish shapeshifters. Thermolite Pro™ synthetic and 100% Canadian qiviut work in tandem to deliver high-performance insulation, while a waterproof outer-shell keeps shrouds of mist and lashings of rain at bay. A detachable collar, hood and baffle offer versatility, whatever the weather.

Winter is here. But there’s no need to rush in from the cold.

From $1,900. Qiviut & Co., qiviutandco.com —Janet Gyenes

sexy selections

winter

Style or substance? There’s no need to compromise with this year-round wish list Written + produced by Janet Gyenes

gift

guide

1

mix

1 Farm Fresh Chef Walt’s newest cookbook, Araxi: Roots to Shoots, Farm Fresh Recipes, serves up inspired recipes such as Roasted Beets with Chickpea Caponata and Nasturtium Pesto. $37.95, Barbara-Jo’s Books to Cooks, bookstocooks.com

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2 star struck We’re dazzled by these sublime sparklers. Wear the Tiffany Victoria® mixed-cluster earrings, in platinum with diamonds, at any occasion. $21,700, Tiffany & Co.®, tiffany.ca 3 artful essence Cire Trudon’s slim scented matches are conversation pieces in delightfully decked packages, like Ottoman (shown). $15, Saks Fifth Avenue, saksfifthavenue.com

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editor’s

pick

4 Cool shades Idaho-based Proof believes in giving back. Funds from the purchase of each pair of glasses, like these Goodson Eco shades in Jade, have helped build eye clinics in India. From $135, iwantproof.com

indulgent offerings

Haute Holiday

5 understated elegance With its simple styling, perforated plaque and snow-white shade, the Hermès Evelyne bag is, hands-down, our winter crush. $3,520, Hermès Canada, canada-en.hermes.com 6 Chic cuffs With their clean lines, scale and nod to architectural styling, these Hermès cufflinks exude gravitas and prove that sophistication is always on trend. $1,015, Hermès Canada, canada-en.hermes.com 7 good grooming Vancouver-based Barber & Co. has nipped all excuses for angry skin and unruly scruff with products such as its smooch-worthy Shave Oil and Beard Balm. Grab a Beard Bundle or Shave Bundle this season. Individual products from $20, unionofbarbers.com

9 6

8 GREAT Gadget No app is as good-looking or functional as this walnut multitool from Proof. Use it for tackling partytime tasks like uncorking wine and slicing cheeses. From $20, iwantproof.com 9 takeaway tin Inspired by the Toronto ‘hood, The Beaches 6 oz soy travel candle lets you transport the heady aroma of orange blossom, jasmine and bergamot on your travels. $20, vancouvercandleco.com

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10 skin smart Banish dry skin this season with Skoah’s extra-special Holiday Body Kream packed with good-for-you ingredients like shea butter, ivy extract, sea kelp algae and more. Bonus: it’s infused with brown sugar and vanilla! Available November 12, $38/8 oz, skoah.com

Winter 2017 Just For Canadian doctors

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

Framing the Antarctic

In the land of ice and penguins, a great shot just needs preparation

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

add drama + danger

The inhospitable Antarctic is a once-in-alifetime adventure; try to capture its danger and drama in your shots. In Neko Harbour, I photographed our ship amid pack ice (f11 and 1/125 second) as well as during the rough crossing of the infamous Drake Passage (left) as waves broke over the ship’s bow (f16 and 1/30 second).

Just For Canadian doctors Winter 2017

if you go

Take a tour with AdventureSmith Explorations. adventuresmithexplorations.com

nder the fading afternoon sun, we pulled our zodiac up to the small dock at Port Lockroy, an old British Antarctic research station turned museum. I wandered through the various rooms taking shots of pantry shelves stacked with old food cans, the old galley and warming room with ancient looking skis and ice ax mounted on the wall. When I entered the radio room I spotted the view from the old wooden window and knew I had the signature shot of my adventure.

Using a tripod and wide-angle zoom I selected an aperture of f11 so I could include the entire window in the frame, but render its wooden pane dividers slightly out of focus so they wouldn’t distract from the main view. Outside, a group of gentoo penguins gathered around the flagpole flying the British flag and in the background stood a dark shed with a bright orange door. I composed the shot using the window dividers as individual frames for each element in the scene and waited for wind and penguins to cooperate. Lucky for me they did.

The harsh, white environment and unpredictability of the Antarctic creates many photographic challenges, so patience and preparation are key for getting good images.

You never know when a shooting situation will present itself, so having different lenses mounted on different camera bodies and presetting controls could mean the difference between getting the shot—or not.

As we motored through Gerlache Strait our naturalist guide mentioned that humpback whales frequent the area. Leaving nothing to chance, I affixed medium and long telephoto zoom lenses to two of my camera bodies and preset shutter speeds to 1/800 second to account for ship vibrations and movements as well as camera shake. We had just sat down for lunch when the words “humpback whales” blasted over the ship’s PA system. We all raced for the lower deck.

As we jostled for position along the rail the captain cut his motors waiting for the whales to surface again. Thankfully my choice of a medium telephoto lens (24mm to 70mm) paid off when the whales surfaced about 10 metres from the boat. As the others hastily swapped long telephotos for shorter

michael defreitas

U

destination photography

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

DESTINATION LEARNING.

The US and Canadian Academy of Pathology invites you to become a better pathologist while enjoying these world class destinations.

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2017 2

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antarctic window

frame it

Use the mullions of a window and other props, or even ice formations, to frame your photography—and add another dimension to scenery.

ones I fired away. I managed to get off about 20 shots before the whales disappeared into the depths.

Some never got a shot.

One of the main difficulties in the Antarctic is trying to avoid the ever-present white backgrounds making it tough to get frontal portraits of the birds.

10

The gentoo penguin colony in Neko Cove provided lots of opportunities to photograph parents and chicks, but few angles to separate them from the whitish rocks and snowy background. After taking a few blah shots near the beach I noticed a few birds on a low hill 200 metres away. On the hilltop I took a position below and slightly to the side of one penguin family so I could shoot up into the blue sky and create balance between their white and black feathers.

I used f11 and a 200mm telephoto lens to blur the background a bit and keep some distance between the birds and me. I wanted them to interact with each other rather than gawk at me. Finally, after 20 minutes of lying on cold rocks, I captured some tender

Just For Canadian doctors Winter 2017

interactions during their feeding time.

Bright sunny days are rare and fleeting in the Antarctic—another reason to have cameras ready at all times. Camera meters typically correct for neutral gray, rendering snowy scenes dirty or darkish especially in brilliant sunshine. Presetting your camera’s exposure compensation to +1 will help whiten the snow and bring out a bit more detail in the shadows.

It’s also a good idea to utilize props to help augment the general monotone nature of Antarctic scenes. Think ahead about how to use the red survival parkas worn by crew and passengers, the red zodiacs or structures around the boat as frames or leading lines.

My prop preparation paid off as we motored through the Lemaire Channel and got a fiveminute window of sun. Just enough time to dash to the bow and fire off a few shots before the clouds engulfed us. Two days earlier I had scouted a large oval iron cleat at the bow that I now used as a frame for my wide-angle lens.

The Antarctic is one of the last frontiers.

Plan for the unexpected. Take extra equipment and backups for everything. And, of course, expect to be wowed.

michael defreitas

photo prescription [continued]

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.

Have mercy

A civilian hospital ship brings medical care to African nations in dire need of pediatric surgeons

courtesy of Dr. Sherif Emil

I

t was a grim but necessary protocol: gather the hospital board together to decide whether to operate on someone who would, in all likelihood, die without medical intervention.

The patient whose fate hung in the balance was Polly, a four-month-old Malagasy girl, who despite having a one-kilogram sacrococcygeal teratoma—a rare congenital tumour—growing from her coccyx, was thriving. Pediatric surgeon Dr. Sherif Emil of McGill University’s Montreal Children’s Hospital was championing surgical removal. The little girl—despite the immense growth—was a fighter, argued Emil, who was on a two-week surgical mission aboard the Africa Mercy, a 152-metre-long floating hospital docked at the port city of Toamasina on the eastern coastline of the island nation of Madagascar. Her condition and weight were “remarkable. So I advocated very hard that we should proceed with surgery, because she had proven her desire to survive,” says Emil, professor of pediatric surgery at McGill and director of the Division of Pediatric General and Thoracic Surgery at Montreal Children’s.

Polly’s operation was debated among staff aboard the Africa Mercy because, despite its state-of-the-art medical facilities, the hospital couldn’t risk surgery that would leave a patient disabled. In Africa, where medical care is, for many, nonexistent, this would impose a harsh burden upon the patient and her family. In Polly’s case, removal of the sacrococcygeal teratoma, which was attached close to the bladder and rectum, could damage these organs, leaving her with a permanent disability such as a neurogenic bladder requiring life-long catherization. An operation would only proceed based upon a risk assessment that leaned heavily towards a positive outcome.

As it turned out, Polly got her operation.

“We did it because we knew it was completely curable with surgery,” says Emil, who began undertaking medical missions to various regions of Africa following completion of his surgical residency in the late 1990s.

(Realizing how invaluable his time in Africa was as a young doctor, Emil has created a surgical fellow exchange program between

Montreal Children’s and Kijabe Hospital in Nairobi, Kenya that allows physicians to work and train in each other’s country.)

Africa Mercy is the world’s largest civilian hospital ship and is operated and funded by the NGO Mercy Ships. The group has brought medical care to the poor since 1978, sailing and docking floating hospitals at port cities around the globe. To date, more than 2.42 million people have received care. “There’s absolutely no model like it in the world of global health or global surgery,” Emil says.

Emil, who leaves this January for his second mission aboard Africa Mercy, currently docked in Benin, operated on Polly last February. The removal of the infant’s tumour may have been the most dramatic and difficult surgery he undertook during his stay, however, he also completed 45 operations on 30 patients, a quarter of which were “major cases.”

Many were hernias, which normally take about 20 minutes in a Western hospital but were often complex and challenging in Madagascar, due largely to neglect. Emil often dealt with massive hernias created by chronically incarcerated bowel or difficult recurrent hernias due to prior inadequate repair.

Delays in medical care are common in Madagascar, especially for children. There are only four pediatric surgeons for a nation of 25 million, in comparison to 65 in Canada.

Universal healthcare is nonexistent, meaning that the 80% of Malagasies who live in extreme poverty rarely, if ever, receive proper medical attention. In order to ensure that everyone in the country who needs care is aware the ship is in port, nurses send out a blanket text message on cellular networks to clinics, hospitals and even ombiasis (witch

doctors), calling for patients to come for free dental or surgical care. “Despite the poverty and lack of resources, it seems like everybody has a cell phone,” says Emil.

Medical teams then fan out throughout the country—the fourth largest island nation in the world—meeting and assessing potential patients.

Mercy Ships has been Dr. Sherif to Madagascar three times Emil, who works on the world’s largest civilian hospital ship

on 10-month-long surgical sojourns, fulfilling a need that has “risen to the top as a public health issue,” Emil says. Access to surgeries has been ignored for decades; “there was a feeling that surgery was a luxury.” However, access to good surgical care is vital to a nation’s welfare. “Most of these surgical problems are completely disabling. You really change people’s lives around in a major way.”

The vast sea of need in Africa can be overwhelming, admits Emil. “You look at it as, ‘I didn’t even scratch the surface.’” However, a doctor can’t take on a continent’s burden.

“We’re not going to fix Africa. We’re not going to fix the economies. We’re not going to fix the corruption. But we can at least change the lives of a few thousand people and their families.”

Winter 2017 Just For Canadian doctors

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

Adventurous imbibing

TH E FR EN CH NE GR ON I

MAKE

SUPERIOR SIPPING 0.75 oz French bitter aperitif, preferably Amer Picon orange zest

Build ingredients in a rocks glass. Add cubed ice and stir. Garnish with orange zest.

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Champagne Cocktail Kit This compact kit lets you elevate your in-flight experience by transforming sparkling wine into a quaffable champagne cocktail. $30, Amazon Brew Loops 2017 In autumn Kamloops BC celebrates all things beer and bikes at this three-day festival. brewloopsfest.ca

French Negroni Recipe courtesy Grey Goose® 1 oz Grey Goose L’Orange 1 oz Noilly Prat® Rouge Vermouth

Just For Canadian doctors Winter 2017

It describes the soil and climate in which grapes are grown. But what about that other essential element? Water. Scottish company Uisge Source has taken terroir back to its historic roots. It’s reviving an old tradition in which whisky distillers gave small bottles of their source water to customers for dosing drams to open up the spirit’s aroma and flavours yet preserve the whisky’s character.

Uisge Source sells 100 ml bottles of water from three Scotch distilleries in the Highland, Speyside and Islay regions.

Champagne producer Moët & Chandon has also taken a look inward at its long history and quite literally raided its cellars to produce MCIII, an ultra-premium cuvée made of multiple vintages.

This spring I was one of the first people in Canada to sample MCIII. Vintages ranging from 1993 to 2003 have been chosen to represent the wine’s “three tiers” or essential aging elements: metal (stainless steel vats), wood (oak casks) and glass (bottles).

Still wine vintages compose the first and second tiers, while the third tier is a marriage of grand vintage champagnes from five to 10 years old. All three tiers of wines are blended together and aged for an average of 10 years, plus one year post-disgorgement.

Complexity doesn’t even begin to describe this unique production process.

And while MCIII is pleasing to my palate, it’s aficionados of the bubbly who will truly appreciate the nuances of this superb champagne. If you can get your hands on a bottle (it will set you back about $650), pop the cork and raise a glass.

It’s an ideal way to toast a year of adventurous imbibing.

BUY

Canadian distillers are also putting their stamp on spirits—with winning results. For instance, Odd Society Spirits doesn’t use wine barrels for its Barrel-Aged Vermouth but rather charred bourbon barrels.

The vermouth is yet to be released to the public (at time of writing), but it’s already snagged a Double Gold medal and Best Vermouth award at the 2016 New York World Wine and Spirits Competition. The Vancouver-based distillery puts masses of botanicals into the mix, including bark foraged from local arbutus and cherry trees.

Another BC distillery is getting into the spirit of using local ingredients and earning gold for its efforts. Queensborough Gin, made by Central City Brewers + Distillers, took home gold in the gin category at the 2016 San Diego Spirits Competition. Spruce tips foraged from Vancouver Island and mountain juniper berries from the province’s interior region give this classic London Dry gin its citrus notes and floral nose.

The booming craft beer industry has long been known for taking detours from convention. Like Brew Loops, a celebration of the beer and bike culture (responsible biking, of course) in Kamloops, BC. This year’s event, which I participated in, introduced a pub crawl and block party—on bikes.

Along with 100 other riders, I cycled and sipped my way from riverfront Pioneer Park to Red Collar and Noble Pig breweries and finished at the block party across the river, anchored by Red Beard. The café specializes in craft brews from BC and beyond. It’s a refreshing way to get a taste of a city’s local flavour along with a little of exercise.

Terroir is another topic that constantly comes up, typically in the context of wine.

GO

M

ystery and history, science and alchemy, evolution and revolution.

The world of beverages is both complex and compelling. I’ve fallen down many rabbit holes expanding my knowledge of all things quaffable from amaro to Zwack.

This summer I strolled along the French Riviera with a Grey Goose Le Fizz Royale cocktail in hand. In a boulangerie bedecked in the apropos French blue, I sampled a slice of sourdough bread from the baker himself.

It seemed like a strange pairing with my effervescent aperitif crafted from vodka, St. Germain Elderflower Liqueur and a splash of soda.

And while this European reverie wasn’t exactly real (it was the Grey Goose Boulangerie Bleue event held in Vancouver), what I learned was revelatory.

At first flush I failed to make the French connection between vodka and bread. But I realized that the faux wheat fields at the event weren’t just for photo ops. This French vodka, after all, is made from winter wheat, not potatoes. In fact, Grey Goose purchases wheat from a trio of French farming cooperatives that’s the same high-quality grade used for baking bread. Vive la différence!

Another unexpected French twist was one of the event’s signature cocktails: the Negroni. Of course, the Negroni is not just the quintessential Italian cocktail, it’s also made with gin, not vodka.

Surprisingly, the Grey Goose L’Orange vodka’s bittersweet and oily essence of citrus (almost half a kilo of fruit goes into each bottle) stands up to the sweet vermouth.

The verdict: the French might be beating the Italians at their own game. Shake up your own (recipe below) and say à votre santé.

far LEFT: BARB SLIGL; BOTTOM RIGHT: Mary Putnam

Producers are staging a spirit revolution, and changing how—and what—we drink

OpenRoad honda Burnaby 6984 Kingsway, Burnaby, B.C. V5E 1E6 (5 minutes East of Metrotown)

Tel: 604-525-4667 OpenRoad honda Burnaby OpenRoadHonda.ca OpenRoad honda Burnaby 6984 Kingsway, Burnaby, B.C. V5E 1E6 6984 Kingsway, Burnaby, B.C. V5E 1E6 (5 minutes East of Metrotown) (5 minutes East of Metrotown)

Tel: 604-525-4667 Tel: 604-525-4667 OpenRoadHonda.ca OpenRoadHonda.ca

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.

Porsche refresh

S

ix years ago I was one of a handful of journalists who showed up for the 20-minute press launch of Singer Vehicle Design. As I recall, minimal signage.

No appies, nor libations, nor high-heeled models in formal wear. Just an aging exrocker passionate about his old Porsche 911, expensively modified to look even older (the car, not the rocker). I shook my head…but, as it turns out, for the wrong reasons.

I made the mistake of judging Singer Vehicle Design’s prospects based on my perspective. The >$600,000 USD average price for one of their “restored, re-imagined, reborn” treatments of a customer’s old Porsche 911 resulted in exquisite, bespoke creations. But, as a Porsche 911 owner and fanatic myself, I just couldn’t see a market at half that price.

too. Thirty million USD!! And Singer Vehicle Design has 75 more paid deposits waiting in the wings. Seems like front-man Dickinson could start planning his second retirement… or at least a Reunion Tour of his old band Catherine Wheel.

I feel like a cold-hearted skeptic. I was wrong six years ago. As penance, I’ll tell you now what a more prophetic scribe would have then about Singer Vehicle Design.

A Singer Vehicle Design customer needs to provide a “donor car.” The particular car needed is a Type 964, which is 20–25 years old. These are air-cooled, rear-engined Porsche 911s of 1989–1994 vintage. The client and Dickinson’s team then agree on which of a very long list of appearance and oily-bits specification options they will pull together for the re-birth. Each project car is then stripped to a bare shell and Hot car! refurbished— arguably better than new. Many body panels are replaced with carbon fibre. In particular, the re-imagined cars sport the look of the smallbumper 1964–73 Porsche 911.

Which is ironic. Because in 1974–1984 there was an industry The thing is, there are seven billion morphing the 1973 and earlier Porsche 911 in people and counting on this planet. Rob the other direction, changing small-bumper Dickinson (the ex-”Singer”) only had to find cars to look more modern as later big-bumeight to 10 similarly minded earthlings per per cars. I know because I did this to a 1972 year…with bottomless wealth. I ran the math. Porsche 911.

Dickinson needed to connect and contract At the time, my car needed body work with just 0.00000014% of the planet’s popula- anyway, so I went for it largely because tion each year. And Singer Vehicle Design has. as a new-to-911 driver, I had experienced And the world is a better place for all of us. the infamous drop-throttle-oversteer cum In fact Dickinson / Singer Vehicle Design dropkicking-into-ditch, a trait 911s prior to the now has celebrity status in the ethereal Type 964 had a propensity for. (Some called Porsche world. Jay Leno fawns. Jerry Seinfeld this character, while the more jaded said, too, I’ll bet. Fifty re-imagined Porsche 911s “engineering trying to overcome physics.”) have already been delivered. I ran that math Singer Vehicle Design clients can relax on

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Just For Canadian doctors Winter 2017

that front, as the oily bits of their new ride are comprehensively restored to Type 964 specification or better. Depending on options, the brakes, suspension and engine are also far more advanced and higher performing than a 1973 vintage or even 1993 vintage. Of course, the casual bystander can’t see any of these upgrades curbside.

What the astute bystander can see in Singer Vehicle Design’s re-born creations are subtle bespoke exterior and interior visual cues. Some of these borrow inspiration from the factory race-special Porsche 911s of the small-bumper era (911R, 911 S/T, 911 RS, 911 RSR). Other cues are musical, or from Catherine Wheel iconography. Others cues are just different, like two louvers on the Singer Vehicle Design Targa bar versus the three on the Porsche factory-minted item.

And the planet’s 0.00000014% are lapping this up. In addition to US customers, Singer Vehicle Design has sold in Canada, Mexico, France, Switzerland, the UK, Russia, Dubai, Bahrain, Hong Kong, Taiwan, Korea and Indonesia. The company reports that buyers in the emerging markets are often Gen X or even Millennial, rather than the early-and-mid Baby Boomers who actually grooved to the small-bumper 911s as teenagers.

The loyalty of these owners to Singer Vehicle Design is impressive. There’s no showroom, demo unit or even a show car. All of those roles are played by existing SingerVehicle-Design-creation owners.

But it’s not quite like the inauspicious launch of six years ago. Singer Vehicle Design now gets invited to starring roles at the most prestigious auto-enthusiast events— Goodwood and the Quail Gathering to name just a couple. Many event attendees can recite the Singer Vehicle Design story verbatim.

Unlike my prediction, fans flock. Wallets flap.

Kool-Aid line forms to the left.

You have to love the Dickinson storyline, though. “Follow your passion and great things will transpire.” The world could use more feel-good stories. I’ll pause and reflect the next time I’m tempted to shake my head at someone else’s dream.

singer vehicle design

Restored, re-imagined, reborn for the 0.00000014%

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The Premier Board Review Course in Neonatal-Perinatal Medicine

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Join us at Specialty Review, the most intensive and comprehensive review course of its kind in the country, designed to strengthen your pathophysiology knowledge and problem-solving skills in the field of neonatal medicine.

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NEO: The Conference for Neonatology addresses cutting edge, yet practical The conference aspects of newborn medicine. for neonatology Educational sessions are conducted by many of the foremost experts, who address neonatal-perinatal topics for which they have become renowned.

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Jungle zipline, Bocawina Rainforest Resort opposite Jetty, Glover’s Reef Research Station

travel the world

the

wild

Exploring Belize’s untamed jungles and coral reefs story

+ photography by Janet Gyenes

travel the world

A

n army marches before me, hefty green bundles on their backs. Streaming like a river, they cut a swath through the jungle on this sticky, moonless night. These nocturnal creatures—soldiers, workers and hitch-hikers—are leaf-cutter ants, called wee wees in Belizean Kriol dialect.

They’re delivering leaf fragments that dwarf their size to the queen, says Blasio, the local guide leading us on a night hike in Mayflower Bocawina National Park.

Located in southern Belize, Central America’s smallest and most sparsely populated country, the park is also home to Bocawina Rainforest Resort. The off-the-grid lodge existed long before the 7,100-acre national park was established in 2001. Our group is staying in the resort’s thatched cabanas tonight, the first day of our 10-day Double Atoll Adventure with BC–based outfitter, Island Expeditions. Tomorrow we’ll continue our off-the-grid excursion

hairy legs. As we walk, Blasio explains how the jewels glinting in the grass are the eyes of wolf spiders. Marc, one of our group, starts wildly slapping his shins. Fire ants.

This isn’t the picture of Belize I’d imagined. It’s better. Like an authentic adventure camp for adults where you can practically swing from vines in the jungle—or a zipline, like I did this afternoon—with wild abandon.

Luxury lives in Belize’s idyllic islands, or cayes, too. Leonardo DiCaprio has Blackadore Caye; Francis Ford Coppola, Coral Caye.

But could these famous filmmakers conjure a paradise as pristine as infamous 17th-century pirate John Glover’s remote retreat? We’ve arrived at Southwest Caye—part of Glover’s namesake 210-squarekilometre coral necklace flung 45 kilometres offshore—and our basecamp for the next two days.

The camp almost looks like a film set: a dozen tents are staggered across a stretch of blinding-white sand amid ruffled palms. My tent is a dollhouse with twin beds, a wooden table and a kerosene lantern that looks like a throwback to Glover’s time. But

Kayaking to a shipwreck, Lighthouse Reef opposite Miss Annette, camp cook at Glover’s Reef

by boat, first travelling 56 kilometres across the Caribbean Sea to Glover’s Reef and later, to Lighthouse Reef where we’ll snorkel the Great Blue Hole, put on the map by French explorer Jacques-Yves Cousteau. Both remote coral atolls are in the Belize Barrier Reef, a UNESCO World Heritage Site and the second-largest reef system in the world.

Here on the Antelope Trail, night has descended like a heavy curtain. Rubber trees, palm fronds and underbrush are woven so tightly even pinpricks of starlight don’t penetrate the jungle canopy. We’re on the lookout for wild cats: jaguar, puma, ocelot, jaguarondi and margay. Like detectives on stakeout and armed with headlamps, we spy on nocturnal birds camouflaged in the grass. A kinkajou stares at us from the high branches of a rubber tree, its eyes beacons in the black. We check in on a scorpion with a mob of babies on her back. Blasio pokes a stick into a sandy hole to coax out its occupant: a tarantula. “Nobody’s home,” he says. Then we spot a bright-white golf ball—its egg sac—and the spider’s

18

Just For Canadian doctors Winter 2017

the pirate probably didn’t feast on meals like shrimp in coconut sauce, cooked by Miss Annette and served up in the communal lodge, one of the camp’s few permanent structures.

The next morning the sun rises like a shot. Blasting heat is tempered by breezes that nudge forward the double kayak I’m paddling with Gerlinda (a German woman who’s also travelling alone) into the big blue before us. Our guides, Mike and Budge, are leading our group on a 90-minute paddle to Glover’s Reef Research Station, through hundreds of patch reefs harbouring some 500 species of fish. We soon spot a purple plasticky object and Mike warns us that what appears to be a half-deflated buoy is a Portuguese man-of-war. The prospect of getting my paddle entangled in its stinging tentacles that average 10 metres in length reminds me of how the distinction between who’s predator or prey can come down to a chance encounter.

Arms spent, we make our last push past mangroves to Middle Caye amid a scene of brown pelicans dive-bombing for fish. There’s

travel the world

if you go

For more info on exploring Belize’s jungles and reefs, go to travelbelize.org. For excursions through Island Expeditions go to islandexpeditions.com.

go deeper

Guide Budge, Glover’s Reef Research Station above left Tents, Southwest Caye basecamp, Lighthouse Reef above right Resident hermit crab below left Sunset, Halfmoon Caye below right Guide Jazz (left) and a conch fisherman near the Great Blue Hole

Read more about Belize and get a peek inside the famed Great Blue Hole on page 5.

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Just For Canadian doctors Winter 2017

little life at the research station today, just some lizards and hermit crabs. We tie up our kayaks near a weathered wooden jetty and slip on our snorkel gear. In minutes I’m immersed in an alien-looking underwater theatre of neon-yellow brain coral and plum-tinged coral fans waving in the waters.

Mike pops his head out of the sea to shout out the names of the fish, like monstrous Nassau groupers, stripy sergeant majors, and stoplight parrotfish.

“Stingray!” I spot the sand-cloaked diamond shape and its half-metrelong tail. The stingray captures water under its flat body and transforms itself into a magic carpet that does a quick disappearing act as we watch in wonder.

After about 45 minutes of underwater exploration it’s time for lunch. I swim toward the jetty and come eye-to-eye with a sliver of silver. Barracuda. The metre-long fish is suspended in the shadows, razor teeth protruding from its hinged jaw. I retreat backwards and make my way to the jetty ladder.

Mike and Budge prep a lunch of Johnny cakes with tuna salad, plus watermelon and cookies, to fuel us for our shortcut back to Southwest Caye. We outfit our kayaks with sails and let the wind fast forward us across the channel back to camp.

Two days later, we’re onshore at our final outpost, Lighthouse Reef, a deadringer for Glover’s, but bigger and wilder.

Everything here is in constant motion.

Saltwater sprays our tents facing the churning sea, rangy palms gyrate in the gusts and black frigate birds fly overhead like kites. Jack Wilde, the camp naturalist, gives our group a quick orientation: we’re sharing the island with members of the Belize Audubon Society, a colony of 3,000 red-footed boobies nesting in the native ziricote trees and hundreds of hermit crabs scrabbling about.

I spend the next four days dining on a pirate’s bounty of adventure: hand-line fishing with a piece of conch on a hook, ogling massive nurse sharks lying in repose and kayaking two-metre swells to explore a rusty ship heaped on the reef.

And under the grin of a crescent moon and the Big Dipper scooping up a million twinkling stars, I slip a flashlight onto my wrist, walk into the sea and plunge my face into Belize’s deep, dark beyond.

phoenix / calgary / napa / glasgow / singapore … | c a l e n d a r

cMe

A n intern ation a l guide to continuing medica l Education

winte r 2017 + beyond

1

phoenix

2

3 4

7

5

6

phoenix has plenty of Arizona’s desert heat but it has also sparked a spicy and vibrant art and culinary scene…with some sweet spots to rejuvenate (CME events in Phoenix + beyond are highlighted in blue.)

Barb Sligl

A

fter my Lotus Blossoming Chakra massage, I discover that some of my seven chakras aren’t quite as aligned as they should be. Apparently I need to meditate more. I try to remedy this immediately by walking the labyrinth at The Boulders Resort & Spa. 1 Round and round I shuffle, the scent of sage wafting over me, the sun warming my face, the dry desert wind softly fluttering my robe. I think it’s working.

Or it could just be this place, the huge rocks the resort is named for, the tall saguaro cacti, the amber and rusty hues of the baked landscape. The next morning I rise early in my adobe-style casita at The Boulders (theboulders.com) and venture into the desert for a run as the sun is just starting to spread its heat. I feel my chakras realigning…

The Sonoran desert may seem harsh but it teems with beauty. Closer to Phoenix (The Boulders is in Scottsdale, just outside Arizona’s capital and largest city), I walk through the Desert Botanical Garden (one of only a few botanical gardens accredited by the American Association of Museums; dbg.org) and then hike nearby Camelback Mountain to marvel at the range of colour this arid land

sprouts, like the magenta spikes of a barrel cactus 2 .

The southwest vibe continues at The Camby (thecamby.com), one of Phoenix’s newest hotels (a major refurb and rebrand on the site of an old Rat Pack bar and former Ritz property). Inspired by the surrounding desert (its name is a play on that iconic Camelback peak), the swish hotel is infused with the five Cs of Arizona—cattle, copper, citrus, climate, cotton—including lamps the shape of cow skulls and grapefruits, turquoise and copper accents, luxe pima-cotton sheets and local art 3 .

And there’s art everywhere. In the Musical Instrument Museum (MIM; mim.org), a sophisticated conference/meeting site as well as repository of some 15,000 musical instruments from around the world, art is in the form of objects like a horse jawbone from Mexico that rattles when its teeth are scraped or struck with a nail. In downtown Phoenix, Roosevelt Row or RoRo (rooseveltrow.org) is a wild display of commissioned street art that’s as vibrant as some of those desert blooms. The revitalized ’hood is home to artist studios, galleries, boutiques, co-ops, small-stage theatres, coffee shops, restaurants and even a craft

brewery and gastropub, Angel’s Trumpet Ale House 4 (angelstrumpetalehouse.com). Every first Friday night of the month, thousands of people gather in revitalized RoRo for the First Friday Art Walk.

At the nearby Phoenix Public Market Café (phxpublicmarket.com), art comes in the form of local food, from coffee roasted in nearby Tempe (try the Desert Dawn: oj and a splash of lemon topped with cold brew coffee) to “Eat the Rainbow,” a combo of farmers’ market veggies (and cool t-shirt 5 ), or the Arroz & Frijoles bowl, a healthy, heaping, hipster take on southwestern fare. More foodie inspiration is found uptown at The Yard, at the graffiti-art-clad Barrio Urbano (barriourbanophx.com). It’s an urban take on traditional Mexican cuisine by Chef Silvana Salcido Esparza 6 , a four-time James Beard Award nominee, where craft cocktails 7 and killer tacos come together in an atmosphere that’s part gritty barrio and part art gallery. And it’s yet another way of finding that desert zen. — Barb Sligl For more info on Phoenix, go to visitphoenix.com, for nearby Scottsdale, check out experiencescottsdale.com, and for Arizona, visit visitarizona.com.

Winter 2017 Just For Canadian doctors

21

Medicine

Gastroenterology

Endocrinology

Emergency Medicine

Diabetes

Cardiology

Anesthesia

Aesthetic

c Mcmee cwhen alendar where

22

topic

sponsor

contact

website jabmauisymposium.com

Feb 12-16

Maui Hawaii

39th Annual John A Boswick, MD Burn & Wound Care Symposium

JAB Symposium

info@jabmauisymposium. com

Aug 26-27

Boston Massachusetts

Management Of Facial Trauma Course

AO North America

800-769-1391

aona.org

May 14-20

Southern Portugal

Controversies In Perioperative Medicine

North York General Hospital Department of Anesthesiology

800-801-6147 See Ad Page 25

cyclecme.com

Jul 06-07

Baltimore Maryland

Practical Emergency Airway Management

Center for Emergency Medical Education

800-651-2363

ceme.org

Nov 13-17

Kauai Hawaii

2017 California Society Of Anesthesiologists (CSA) Fall Anesthesia Conference

California Society of Anesthesiologists

916-290-5830

csahq.org

Feb 02-05

Steamboat Springs Colorado

2017 Annual Vascular & Endovascular Surgery Society Winter Meeting

Administrare, Inc.

978-927-7800

vesurgery.org

Feb 11-12

Tampa Bay Florida

Progress In Perinatal Cardiology, Detection And Management Of Fetal Congenital Heart Disease

Pediatrix Medical Group

See Website See Ad Page 15

PeriCardiConference.com

Apr 29May 02

Philadelphia Pennsylvania

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

American Society Of Echocardiograph

919-861-5574

asecho.org

Mar 08-12

Barcelona Spain

9th International DIP Symposium On Diabetes, Hypertension, Metabolic Syndrome & Pregnancy

ComtecMed

011-972-3-5666166

comtecmed. com

Jul 31Aug 07

Alice Springs Australia

Australia’s Red Centre 2017 Medical Conference

Unconventional Conventions

1800-633-131 See Ad Page 10

uncon-conv. com

Feb 05-12

South America Cruise

Emergency Medicine: Clinical Topics, Personal Development, And Leadership Skills

Continuing Education, Inc./University at Sea

800-422-0711

continuingeducation.net

Feb 09-21

Baja and Sea of Obstetrics, Emergency Medicine And More Cortez Cruise Ship: Azamara Quest

Sea Courses Cruises

888-647-7327 See Ad Page 22

seacourses. com

Dec 14-17

Miami Beach Florida

Topics In Emergency Medicine

Northwest Seminars

800-222-6927

northwestseminars.com

Feb 23Mar 07

Bali to Singapore Cruise

Endocrinology, Geriatrics, Psychiatry, And Palliative Care Ship: Crystal Symphony

Sea Courses Cruises

888-647-7327 See Ad Page 22

seacourses. com

Mar 02-05

Cannes France

7th International Conference On Fixed Combination Therapy In Cardiovascular Disease, Hypertension, Diabetes, Dyslipidemia & The Cardio-Metabolic Syndrome

Paragon Group

011-41-22-5330948

2017.fixedcombination.com

Mar 15

Manchester England

3rd Manchester Dysphagia/Transnasal Course

Manchester Royal Infirmary

011-44-776533-5891

phonosurgerycourse.com

May 18-20

Mallorca Spain

1st International Congress Of MicroImmunotherapy

MeGeMIT

katharina. krueger@ megemit.org

icomi2017.org

Aug 25-27

St. Louis Missouri

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

American College of Gastroenterology

301-263-9000

gi.org

Just For Canadian doctors Winter 2017

Medicine

Internal Medicine

Hepatology

Geriatrics

General & Family

cme

calendar

cMe

when

where

topic

sponsor

contact

website

Jan 20

Banff Alberta

Common Fractures And Dislocations Course

University of Calgary

403-220-8786

cumming.ucalgary.ca

Jan 23

London England

Delivering & Developing Your Service: Leadership & Leadership Models

Royal College of Psychiatrists

011-44-203701-2615

rcpsych.ac.uk

Jan 27

Calgary Alberta

Prevention And Longevity Conference: Evidence Based Medicine For You And Your Patients

Prevention and Longevity

403-909-9095

preventionandlongevity.ca

Mar 10-17

Runaway Bay Jamaica

Dermatology & Family Medicine Resort: Grand Bahia Principe Jamaica - Family All-Inclusive

Sea Courses Cruises

888-647-7327

seacourses. com

Mar 24Apr 08

Argentina, Patagonia Cruise Chile

Update On Family Medicine Including Visits To Local Hospitals In Buenos Aires And Santiago

Doctors-On-Tour

855-362-8687

doctorsontour. ca

Apr 24May 01

Netherlands & Belguim: Tulip Time River Cruise

Medical And Public Health Issues / Roundtrip Amsterdam On AMA Waterways

Professional Education Society

877-737-7005 See Ad Page 40

pestravel.com

Jun 15-24

Cuba & Guatamala

Cuba & Guatemala 2017 Medical Conference

Unconventional Conventions

1800-633-131 See Ad Page 10

uncon-conv. com

Aug 25Sep 06

London to Lisbon Cruise

Medical Symposium At Sea / Western Europe Cruise On The All-Inclusive Crystal Symphony With Three Days In Bordeaux

Professional Education Society

877-737-7005

pestravel.com

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 40

pestravel.com

Nov 06-10

Napa California

2017 Update In Advanced Imaging

UC Davis Health System

916-734-5390

ucdmc.ucdavis. edu

Jan 14-15

Miami Beach Florida

15th Annual Mild Cognitive Impairment Symposium, Special Topic Workshop & Alzheimer’s Public Forum

World Events Forum

224-938-9523

mcisymposium. org

Nov 02-04

Toronto Ontario

9th Canadian Conference On Dementia

University Health Network

416-597-3422

canadianconferenceondementia.com

Jan 25-27

Glasgow Scotland

31st Annual British Society Of Paediatric Gastroenterology, Hepatology & Nutrition Meeting

British Society Of Paediatric Gastroenterology, Hepatology & Nutrition

carla@bspghan. org.uk

bspghan.org.uk

Mar 12-19

Eastern Caribbean Cruise

Gastroenterology & Hepatology Update 2017 Ship: Holland America - New Amsterdam

Sea Courses Cruises

888-647-7327

seacourses. com

Feb 03-05

Orlando Florida

2017 Rehabilitation Medicine Update In Orlando

Mayo Clinic

507-293-1876

mayo.edu

Feb 25

Victoria British Columbia

2017 Internal Medicine Update

Nova Clinical Services

250-658-6056

novaclinical.com

Mar 20-26

Las Vegas Nevada

23rd Annual Pharmacology For Advanced Practice Clinicians

Contemporary Forums

800-377-7707

contemporaryforums.com

Join Us as SPR Celebrates Its 60TH Anniversary!

THE SOCIETY FOR PEDIATRIC RADIOLOGY

2017 Annual Meeting and Categorical Course “Children’s Imaging: Creating Change, Celebrating Success”

May 16 – 20, 2017 The Westin Bayshore, Vancouver Vancouver, British Columbia, Canada

Winter 2017 Just For Canadian Doctors

23

Pathology

Oncology & Palliative Care

Obstetrics & Gynecology

Neurology

Mental Health

Infectious & Chronic Diseases

c Mcmee cwhen alendar where

topic

sponsor

contact

website

mdBriefcase Inc.

416-488-5500

mdbriefcase. com/influenza

Ongoing

Online Expires Feb 27

Influenza Knowledge Transfer Series: Clinical Challenges In Protecting Children Under 2 Years Of Age From Influenza

Apr 10-12

Washington DC

Influenza & Respiratory Vaccine Conference

Terrapinn

011-44-207092-1191

terrapinn.com

Apr 24-26

Bethesda Maryland

2017 Annual Conference On Vaccine Research

National Foundation for Infectious Diseases

301-656-0003

nfid.org

Mar 27-29

Maui Hawaii

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

CBT Canada

877-466-8228 See Ad Page 20

cbt.ca

Aug 03-12

Japanese Cruise (Princess Cruises)

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

CBT Canada

877-466-8228

cbt.ca

Nov 23-25

Scottsdale Arizona

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

CBT Canada

877-466-8228 See Ad Page 20

cbt.ca

Dec 16-23

Disney Caribbean Cruise

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

CBT Canada

877-466-8228

cbt.ca

Feb 24-26

Miami Florida

1st Pan American Parkinson’s Disease & Movement Disorders Congress

International Parkinson & Movement Disorder Society

414-276-2145

pascongress2017.org

Nov 04-11

Tahiti and the Society Islands Cruise

Topics In Neurology For Primary Care Providers

Continuing Education, Inc./University at Sea

800-422-0711 See Ad Page 39

continuingeducation.net

Dec 09-10, 2016

Phoenix Arizona

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

American Association of Gynecologic Laparoscopists

714-503-6200

aagl.org/phoenix2016

May 17

Toronto Ontario

25th Annual New Developments In Prenatal Diagnosis And Medical Genetics

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

416-586-4800

mountsinai. on.ca/cme

May 18-19

Brussels Belgium

2017 Obstetric Anaesthesia

Obstetric Anaesthetists’ Association

011-44-207631-8882

oaa-anaes.ac.uk

Oct 13-14

Singapore Singapore

2017 Australasian Gynaecological Endoscopy & Surgery Society Focus Meeting

YRD Event Management

011-61-7-33682422

ages.com.au

Dec 15-16

New York New York

23rd Annual Conference On Challenges In Gynecology

Symposia Medicus

800-327-3161

symposiamedicus.org

Ongoing

Online

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

American Medical Association

800-621-8335

ama-assn.org

Jan 19-21

San Francisco California

2017 Gastrointestinal Cancers Symposium

American Society of Clinical Oncology

571-483-1300

gicasym.org

Jan 14-16

Charleston South Carolina

Diagnostic Cytopathology

US & Canadian Academy of Pathology

706-733-7550

uscap.org/CMECAL

Mar 04-10

San Antonio Texas

USCAP Annual Meeting – All Specialties

US & Canadian Academy of Pathology

706-733-7550 See Ad Page 9

uscap.org/CMECAL

US & Canadian Academy of Pathology

706-733-7550 See Ad Page 9

uscap.org/CMECAL

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Just For Canadian doctors Winter 2017

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11th International Symposium On Pediatric Pain

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5th Annual Essentials In Primary Care Winter Medical Conference

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2017 Annual Spetzler-Rhoton Neurosurgery Course: Microneurosurgery Of The Anterior Skull Base

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Meeting The Challenge Of Primary Care

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11th Annual Primary Care Spring Conference: Session 1 And 2 March 27-31 or April 3-7

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Cycling, hiking and CME

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Power to pharmacists

An expanded role for pharmacists is much needed…and should be welcome

I

‘m disappointed to note that the Doctors of BC (legally operating as the British Columbia Medical Association) summarily rejected the provincial College of Pharmacists’ Certified Pharmacist Prescriber Initiative discussion paper. This carefully drafted document suggests that the already well-trained pharmacist (bachelor degree, Board Exam and internship program) undergo further education and ongoing annual CME in order to treat and/or monitor a specified list of “minor complaints” and chronic diseases.

Increased roles for pharmacists up for discussion include: • Initiating prescriptions for any Schedule 1 drug • Adapting and monitoring any

28

Schedule 1 drug • Injecting medications or vaccines • Ordering and interpreting laboratory tests Practically this could result in a certified qualified pharmacist: • Initiating almost any medication • Initiating medications in collaboration with a health delivery group • Diagnosing and prescribing for “minor complaints,” such as cold sores, allergic rhinitis, GERD, oral candidiasis, xerophthalmia, contact dermatitis, cystitis…

• Initiating and running smoking cessation programs • Delivering emergency care (for example, using an Epipen)

Just For Canadian doctors Winter 2017

• Changing prescriptions to less expensive equivalent alternatives • Monitoring chronic diseases such as hypertension, COPD and diabetes • Refilling prescriptions in the short-term • Injecting medication such as vitamin B12 and methotrexate • Injecting vaccines including influenza and travel vaccines • Monitoring anticoagulation with Warfarin The reservations expressed by the Doctors of BC concern the lack of inter-professional collaboration, continuity of care and diagnostic competence of the certified pharmacist.

These would all be valid points if we lived in a perfect world. At the moment,

doctor on a soapbox [continued]

Canadian Pharmacists Association, Pharmacists’ Scope of Practice in Canada (July 2016)

Pharmacists' Scope of Practice in Canada Scope of Practice 1

Province/Territory BC

Prescriptive Authority (Schedule 1 Drugs) 1 Initiate 2

Independently, for any Schedule 1 drug In a collaborative practice setting/agreement

AB

SK

MB

ON

QC

NB

NS

PEI

NL

NWT

YT

NU

5

5

5

For minor ailments/conditions For smoking/tobacco cessation

5

5

5

5

5

In an emergency Independently, for any Schedule 1 drug 4 Independently, in a collaborative practice 4 Adapt 3/ Manage

larger

5

5

5

5

Make therapeutic substitution Change drug dosage, formulation, regimen, etc.

Renew/extend prescription for continuity of care

Injection Authority (SC or IM) 1,5

7

Any drug or vaccine

7

Vaccines 6 Travel vaccines 6 Influenza vaccine Labs

Order and interpret lab tests

Techs

Regulated pharmacy technicians

8

across Canada, there is a significant shortage of primary care physicians. This shortage is being addressed but it will be several years before it’s corrected.

I have always got on well with Is it pharmacists and, time to give on an informal pharmacists a basis, much of the care with several role pharmacies could in healthbe described as care? “collaborative.” I have found no problem with the limited responsibilities pharmacists currently have in British Columbia (make equivalent substitutions, refill prescriptions and modify dosages). Notification of any prescription change is always sent to the family physician’s office as well as being entered into Pharmanet. Until health delivery teams, real or virtual, are created there is a need for the pharmacist to fill the gap.

Comments concerning fragmentation of care are a moot point. Care is already unforgivably scattered: continued on page 36

9

8

10

1. Scope of activities, regulations, training requirements and/or limitations differ between jurisdictions. Please refer to the pharmacy regulatory authorities for details.

2. Initiate new prescription drug therapy, not including drugs covered under the Controlled Drugs and Substances Act. 3. Alter another prescriber's original/existing/current prescription for drug therapy.

4. Pharmacists independently manage Schedule 1 drug therapy under their own authority, unrestricted by existing/initial prescription(s), drug type, condition, etc.

5. Applies only to pharmacists with additional training, certification and/or authorisation through their regulatory authority.

6. Authority to inject may not be inclusive of all vaccines in this category. Please refer to the jurisdictional regulations.

7. For education/demonstration purposes only.

8. Ordering by community pharmacists pending health system regulations and/or infrastructure for pharmacist requisitions to labs.

9. Authority is limited to ordering lab tests.

10. Pharmacy technician registration available through the regulatory authority (no official licensing).

Implemented in jurisdiction Pending legislation, regulation or policy for implementation Not implemented

© Canadian Pharmacists Association July 2016

emp lo yment

FAMILY MEDICINE & SPECIALIST PHYSICANS

Exciting opportunities are available in the Saskatoon Health Region for Generalist and Specialist Physicians. Opportunities include Physical Medicine and Rehabilitation, Family Medicine practices in Urban and Rural settings and various Medicine specialties, Emergency and Pediatrics, including Pediatric Gastroenterology. Please see our website for a complete list of available opportunities: www.saskatoonhealthregion.ca/joinourteam/Pages/ Physician-Opportunities.aspx

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Photo courtesy Marikay Falby

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Just For Canadian doctors Winter 2017

For Family Physicians interested in a challenging opportunity and settling in an area where they can enjoy an exceptional quality of life, Northeastern Saskatchewan offers vibrant, rural communities with superior access to a wide range of recreational activities all year long.

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travel at home

Into the north and out of the Northwest Passage

Storms, swells, snow and ice (topped with polar bears) are all part of this epic voyage story + photography by Barb Sligl

Iceberg at sunset, 250 km north of the Arctic Circle in Ilulissat Icefjord in Greenland, a UNESCO World Heritage Site

travel at home

High Arctic sunset, like a Rothko painting

Touring Ilulissat Icefjord by zodiac

Polar bear on ice floe in Prince Regent Inlet, Nunavut

Caswell Tower, Devon Island, Nunavut

The graves at Beechey Island

Remains of a musk ox at Anderson Bay, Nunavut

travel at home

S

Long-abandoned RCMP building at Dundas Harbour on Devon Island, Nunavut above Navigation tools on the Ocean Endeavour’s bridge below Inuk girl in Arctic Bay, Nunavut

omewhere above the Arctic Circle, I see a fata morgana. Low-lying, barren islands—like so many sperm whales with their broad, sloping foreheads—float above the horizon in Coronation Gulf. As if I’m a long-lost sea captain of yore, it’s a glimpse of what’s called a superior mirage.

In 1818, on his search for the long-sought Northwest Passage, captain John Ross’s route was barred by an insurmountable range he called Croker’s Mountains. Yet there was no such thing. A year later, another explorer sailed right through the same spot in Lancaster Sound, as did doomed Franklin in 1845 and then the first man to make it through the Northwest Passage in 1906, Roald Amundsen. Today, this storied route is often still blocked—by sea ice. It’s what makes it one of the last untouched places on earth.

I’m on Adventure Canada’s Out of the Northwest Passage voyage, and after my fata morgana sighting, I continue to see fantastical things over the next 16 days of this historicyet-still-novel voyage. From a strip of pink on the horizon that hovers between inky sea and dark swathe of clouds like a Rothko painting to storms and swells, snow and ice—all with the seductive whisper of peril. Like in those bygone days, our progress is at the mercy of Mother Nature, but as another intrepid explorer of this land, Knud Rasmussen, wrote: In life, as / On the water, let / The arch of the sky / And the mightiness of storms / Encompass you. / Tremble with joy!

It’s hard not to tremble at the Arctic’s vast beauty laid out in such starkness. The Ocean Endeavour bobs like a bath toy amidst primordial elements, stuck at sea for days. We bypass Gjoa Haven, unable to land where Amundsen found sanctuary, and lurch over the wrecks of Franklin’s sunken ships, the second of which, the Terror, was discovered just days before we embarked on this expedition. The most passionate of passengers rise at 3 am to walk the decks, some with an honorary whiskey in hand, to look out upon the unforgiving Arctic waters that swallowed Franklin’s ships.

Aboard the Ocean Endeavour, despite cancelled landings, there’s precious little downtime. Lectures, like “Ice: the Shifting Constant,” are interspersed with films and readings (Margaret Atwood has graced many Adventure Canada voyages, while this expedition’s author is the award-winning Michael Crummey) as well as interactive workshops or tasting Inuit “country food” like muktuk (whale blubber, which on this voyage is a sampling of narwhal).

It’s like being in school. The Adventure Canada crew is made up of biologists, botanists, historians, archaeologists, geologists, ornithologists…I learn Inuit words (from silarluk, “bad weather,” to aliana, “it’s fun”) and listen to serious discussions on the Truth and Reconciliation Commission and climate change. It’s sobering. An Inuit throat-singing demo, deep and resonant, brings tears to my eyes.

But the gravitas is offset by aliana. Each recap, briefing and “good morning” announcement has a heaping dose of inspirational words. One of the Adventure Canada crew, Stefan Kindberg, a veteran expedition leader hailing from Sweden (who must have Viking blood coursing through his veins) tells us to make this trip what we will—be it history chasing, wildlife viewing or finding quiet to “sit on a rock and wait for your soul to catch up.”

The wildlife viewing’s apex is Ursus maritimus, when someone spots a sea bear on an ice floe off the starboard side of the ship. One of the crew’s naturalists, George Sirk, compares the polar bear’s colouring to vanilla ice cream. And this dollop of cream against stark-white ice and obsidian-like water seems just as soft, almost gentle, as he meanders to-and-fro on his floe. A young male of about 800 pounds, he’s robust and unperturbed by the Ocean Endeavour, which the captain has managed to still to a halt at dawn so most of the bleary-eyed get a chance to bundle up and grab binoculars and long lenses.

Watching the bear in the context of this harsh land only underscores the futility of trying to tame such a place. Franklin, Ross, even Amundsen…foolish. I think of a line in North with Franklin: The Lost Journals of James Fitzjames, a fictionalized account of the ill-fated trip that I’ve borrowed from the onboard library: “Perhaps there are places where no man is meant to go.” And yet this expedition follows in their footsteps. We’re another group of interlopers. Place after place—the abandoned Hudson Bay Company’s outpost at Fort Ross on Somerset Island, the long-gone RCMP station at Dundas Harbour on Devon Island, the haunting graves of Franklin’s men at Beechey Island—is a blemish left behind by those who didn’t belong. Only the Inuit have lived here in concert with the bear, for thousands of years and still now in hardscrabble Arctic Bay, our only stop at a Winter 2017 Just For Canadian doctors

33

travel at home

if you go

Canadian community in

Adventure Canada is one of a few the High Arctic. operators offering expeditions in the And then, just as I’ve become Canadian High Arctic and beyond. There is a attached to the moodiness of four-week window in which ice-strengthened the Canadian Arctic, we cross ships like the 198-passenger Ocean Endeavour can Baffin Bay for Grønland— sail through the Northwest Passage. Next year, and its big, bright icebergs.

Adventure Canada has two such expeditions, The first ones I spot are as Into the Northwest Passage, sailing west from Greenland to Nunavut (August 22 to magical as the bear. Living September 7, 2017), followed by Out of the things—shifting, shedding, Northwest Passage, travelling back disappearing—the crenellated east (September 7 to 23, 2017). monoliths of ice are beautiful to adventurecanada.com

behold. In Karrat Fjord we pass a limitless variety of giant shards, all calved off glaciers stretching out from Greenland’s massive ice cap. I snap photo after photo but it’s pointless, for each berg is a wholly new wonder, like trying to capture a snowflake. After not being able to land due to thick fog hanging between ice-bedazzled sea and towering mountains (for Greenland is like a lacy fringe of jagged peaks wrapped around its icy core), the ship turns around to continue south.

We circumnavigate a city-block-sized iceberg and the scenery gets more and more dramatic. The culmination is in Ilulissat at the mouth of a 56-km ice fjord into which icebergs calve from the most productive glacier in the northern hemisphere—some bergs the height of the Empire State Building and size of Prince Edward Island. “Ilulissat” means icebergs in Greenlandic, and this UNESCO World Heritage Site, which produces enough ice in one day to provide New York City with drinking water for an entire year, is a frozen wonderland.

Ironically, we end our expedition where most of those polar explorers started in search of the Northwest Passage. It’s a surreal bit of backward reel, starting from the jeweltoned tundra and whale-like rock formations of western Nunavut, through the rocky archipelago of islands named for erstwhile men and their brethren (Prince of Wales, King William, Somerset and even Boothia, named for Booth’s Gin, the sponsor of Ross’s long-ago voyage) to the cliffs of Devon and Baffin Islands and then, on the other side of Baffin Bay and Davis Strait, the jagged coastline of Grønland and its fairytale-like icebergs.

In Ilulissat I look for a tupilak, a totemic carving of avenging creatures once used by shamans. Small, fitting in the palm of my hand and made of caribou antler, this piece of Inuit art is both exotic and somehow utterly familiar.

I think of a passenger’s comment overheard on the top deck shortly after the Greenland coast first came into sight: “This is the most savage land I’ve ever seen.” Yes, savage. And katjaarnaqtuq. “It’s beautiful.” A savage beauty that few witness. Once witnessed, much like this mercurial land itself, something shifts inside. I grasp my tupilak and wait for my soul to catch up.

travel at home

this page, clockwise from top

Colourful houses of Upernavik, Greenland; Ocean Endeavour, moored off Beechey Island in Nunavut; a Greenlandic Inuk woman in traditional dress; Arctic fox tracks on an uninhabited beach on Greenland’s northwest coast. opposite, clockwise from top The last Hudson’s Bay Company outpost at Fort Ross in Nunavut; a tupilak; icebergs and mountains near the mouth of Karrat Fjord, Greenland; one of Adventure Canada’s young Inuk mentees, Taya Tootoo

doctor on a soapbox [continued]

Clinical competence will always be a concern—be it doctors or pharmacists. In my understanding, the extra training will be in depth and include an examination at the end. And an extensive number of algorithms, including red flags, will

Ninety percent of patients who’ve used these services in Alberta say they would use the service again—especially if they did not have a family doctor or could not get an appointment within a reasonable time.

Several other provinces are not far behind, and I wonder when this table will

Until health delivery teams, real or virtual, are created there is a need for the pharmacist to fill the gap

service

be available to the pharmacists. Maybe I am being naïve in thinking that pharmacists will recognize their limitations.

The table on page 29 shows the wide diversity of pharmacists’ services across Canada. Alberta is leading the way and has not encountered any significant problems.

have all green ticks. I do have some reservations about the very top line if it really means “any schedule 1 drug,” and clearly other provinces do as well.

I feel that expanding the service of pharmacists is a pragmatic and needed change in healthcare delivery. This change underlines the need for collaborative groups, virtual or real.

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the “well baby care” and immunization program is conducted

by Public Health, routine PAP tests and “well woman” examinations are done by The Woman’s Clinic, contraceptive management is dealt with by The Sexual Health Clinic and innumerable minor problems are dealt with at walk-in clinics.

It would be safer to have communication between all these diverse bodies—but, alas, there is not.

A motivated and well-trained pharmacist could deal expeditiously with many patient concerns after hours and on weekends. This would take some pressure off the walk-in clinics as well as allowing primary-care physicians to get a reasonable amount of time away from the office.

continued from page 29

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E-mail: _________________________________________________________ Tel: ____________________________ Fax: ____________________________ sudoku Contest Rules:

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 604-681-0456. Entries must be received by February 24, 2017. 3. Prize: $50 VISA 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 affliates are not eligible to participate.

Winter 2017 Just For Canadian doctors

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pa r t i n g s h o t

wish you were here on the west coast of Greenland, 250 km north of the Arctic Circle, you can stand at the edge of the Ilulissat Icefjord.

This UNESCO World Heritage Site is the only spot (other than Antarctica; see page 8) where you can watch a massive ice sheet, glacial ice-stream and calved icebergs empty—in real-time, hi-def drama—into a fjord. See story on the Arctic, page 31.

n St o r y o pa g e 3 1

behind the scene

Greenland’s ILULISSAT ICEFJORD is huge (40,240 hectares huge). This is where Sermeq Kujalleq, one of the fastest and most active glaciers in the world, stretches from the Greenland ice cap into the sea, calving icebergs into Disko Bay and then Davis Strait, Baffin Bay and beyond. To stand at the edge of this river of ice, as it gurgles, crackles and shimmers, is like spying on a living thing. Or dying. It’s the last bit of the Northern Hemisphere’s continental ice sheets from the Quaternary Ice Age. The oldest ice here dates back 250,000 years, a Pandora’s Box of knowledge about climate change. —B.Sligl

38

Just For Canadian doctors Winter 2017

barb sligl

For more information - Call 800-422-0711 or visit www.ContinuingEducation.NET

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Featured Destinations Primary Care and Women’s Health: Key Topics and Topics in Neurology for Primary Care Physicians Core Strategies 14 AMA PRA Category 1 Credit(s)™ 14 AMA PRA Category 1 Credit(s)™ 14 Contact Hours 14 Contact Hours 7-Night Tahiti and the Society Islands from Papeete 10-Night French Riviera, Barcelona to Venice ms Paul Gauguin Celebrity Constellation September 18 - 28, 2017 November 04 - 11, 2017

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Course Fees may vary based on number of hours offered.

Please visit our web site for current fees and cancellation policies.

Selected Cruises listed here. See a complete Program Listing at www.ContinuingEducation.NET Accreditation: Continuing Education, Inc is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

Designation: Continuing Education, Inc. designates these live educational activities for a maximum of 14-21 AMA PRA Category 1 credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

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

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Roundtrip Amsterdam Bruges, Antwerp, Tulips & Windmills

Medical, Dental & Public Health Issues CME/CE Seminar April 24 - May 1, 2017

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Exploring the European Healthcare Model London to Lisbon with Honfleur, St. Malo, & 3 days in Bordeaux

August 25 - September 6, 2017

India’s Golden Triangle & the Sacred Ganges Medical/Dental Health and Well Being Updates 5 - nights Oberoi Hotels and 7 - night Uniworld River Cruise

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Tahiti & the Society Islands on Paul Gauguin

Treatment Considerations in Isolated Communities FREE air from Los Angeles Ι 5-star all-inclusive luxury small ship November 4 – 11, 2017

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May 12 - June 1, 2018

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British Isles Cruise on Crystal Serenity

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Medical & Dental Healthcare Updates for 2018 London | Dublin | Belfast | Dundee Maiden Call | Edinburgh | Amsterdam

Portugal & Douro River Cruise on Ama Waterways

Current Medical/Dental Health Issues Lisbon | Porto | Salamanca | Vineyards & Port Tasting | Dramatic Landscapes

September 8 - 18, 2018

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