QMR Issue 17.1 | UNTITLED

[untitled]

17.1

CONTENTS Letter From The Editors by Omar I. Hajjaj & Jaryd Te

Introduction

3

Haudenosaunee Welcome by Dr. Jamaica Cass

Introduction

5

Medical Beadwork by Dr. Jamaica Cass

Beadwork

6

Room 208 by Emma Monti

Reflection

7

Poetry

9

Digital art

10

Poetry

11

Poetry and reflection

13

Untitled by Sarvesh Ramlochun

Painting

15

Voices Reclaimed by Anonymous

Poem

17

Painting

18

Poetry

19

Path of the Matriarch by Priyanjli Sharma

Painting

21

Unit 731, Harbin China by The History of Medicine Interest Group

Interview

23

Reflection no. 4 by Anonymous

Poetry

27

Wildflowers by Simoon Moshi

Mixed-media collage

28

Masters of Air by David Vaz

Poetry

29

Black Bar by Anonymous

Poetry

31

Unknown by Grace Ayoo

Painting

32

Poetry

33

Sculpture

35

Poetry and essay

37

Gazelles by Precious Adekoya

Line art

38

Session Ten, Breakthrough by Sarvesh Ramlochun

Painting

39

The Perfect Advocate by Anonymous

Reflection

41

Advocacy in Action by Dr. Eva Purkey & Mudia Iyayi

Interview

43

Poetry

47

Always See Me by Anonymous Diastolic Connections by Jaryd Te The Bridge by Ryan Truong Other (Please Specify) by Kimberly Mitchell

The Show Must Go On by Prashanth Rajasekar To OB by Helen Lin

Debridement by Simryn Atwal Sunbird by Marisa Cressatti The cry of a ghazalle by Omar I. Hajjaj

i resist by Anonymous

1

Speak Out by Nikoo Aghaei

Painting

49

Unworthy by Sabra Salim

Poetry

51

Painting

52

Women in Resistance by Yvonne Tan

Portraits and essays

53

Two Shoes on the 25th by Imran Syed

Mixed-media collage

59

Reflection

61

Digital recording

63

Hope in the Dark Redux by Tony Hu

Reflection

65

Dr. Gisella Perl by Alex Pipchuk

Reflection

67

Spring by Cheryl Jiayi Xing

Digital art

69

Healthcare and Human Rights by Jasmine Dhatt & Jose Navarro

Reflection

71

Photography

72

Painting

73

Reflection

75

Fortune Cookie by Anonymous

Line art

76

Rolling through the grass by Sarvesh Ramlochun

Painting

77

Poetry

78

Reflection

79

Line art

80

Illustration

81

The sourest lemons that life has to offer by Yalinie Kulandaivelu

Essay

82

stupid questions by Benjamin Larocque

Poetry

83

Photography

85

References

Index

87

Acknowledgements

Index

88

Our Team

Credits

89

Contributors

Credits

90

Hands of Liberation by Grace Ayoo

Medical Podcasts and Resistance by Pallavi Dutta Advocacy in Our Twenties by Pallavi Dutta

Hanging up the stethoscope by Frank Chen United in Grief by Sarvesh Ramlochun Illuminate by Anonymous

A poem for change by Benjamin Divito Still Alice by Zier Zhou Brain by Precious Adekoya Did you hear about the rose? by Michele Zaman

QMR Issue 17.1 Launch Party

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LETTER FROM To our vocation and community, The Queen’s Medical Review (QMR) is an entirely student-run magazine that highlights our profession’s contributions to the arts, humanities, and languages. Within each edition, writers, artists, and editorial staff explore the intersection of medicine and culture. Since 2008, QMR has published 16 editions and 37 issues. We welcome you to the 17th edition of the Queen’s Medical Review, Untitled.

Untitled is a celebration of the emotional vulnerability and artistic expression that cannot be distilled down into a single word. It is a time capsule of student and physician advocacy, resilience, resistance, and reflection. For this issue, we encouraged contributors to reflect on times when they’ve felt complacent or silenced in a clinical, academic, or real-world environment. We listened as our contributors shared poignant perspectives on self-worth, oppression and adversity, struggles of power, and inadequate leadership.

When our team began this journey in September, we had selected a different title for this edition, Resistance in Medicine. Resistance is a term inextricably linked to the Queer liberation movement, Black Lives Matter, and Indigeneity. To these groups and many others, resistance inspires artwork and is foundational to identify, language, and culture.

Sometime after our team announced the title, we received an email. We heard that the term resistance may be unfamiliar to some, and its definition misconstrued. What followed suit were conversations with staff administration, student advocacy groups, community members, and our classmates.

We did not want hesitation around to the term resistance to deter or repress the artwork.

Our goal with this edition was to create a safe space that would amplify all voices.

However, after discussions about how the term resistance means so much to many of our classmates, it also did not feel appropriate to retitle the issue. By barring the word resistance and retitling the issue, we would be complicit in setting a dangerous precedent in terms of what perspectives matter in this school. Similarly, we were concerned that we may be perpetuating an already bleak history of institutional discrimination. We made the decision to drop the title and proceed without a new title. This became the first untitled edition of the Queen’s Medical Review.

Importantly, the contributors to Untitled were not bound by the limits of a single-word title. This edition, and the story behind the title, inspired many for different reasons. We received a record number of submissions this edition and garnered new perspectives

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THE EDITORS on inclusivity, exclusion, community, and censorship. Within these pages are historical articles about physician activists, poetry on advocacy and discrimination, and breathtaking artwork on identity.

This edition has transformed into an amalgamation of all the formative experiences and sharp perspectives of the next generation of healthcare leaders. Together, we enter a profession tarnished by red tape, stereotypes and a history of neglect and abuse. We also enter a profession capable of systems-level health improvement and profound individual connection. As you read through, reflect on the forms of physician advocacy, resilience, resistance, and reflection. How will you facilitate positive change in our shared vocation?

We hope you approach every piece with empathy and curiosity.

With sincere gratitude,

Jaryd Te

Editor-in-Chief, Design

Omar I. Hajjaj

Editor-in-Chief, Content

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WELCOME

Shé:kon! It is my pleasure and honour to welcome you to this edition of the Queen’s Medical Review. My name is Jamaica Cass, and I am a proud member of the Mohawks of the Bay of Quinte, Turtle Clan. My Haudenosaunee relations are the Maracles, and many of my family still call Tyendinaga home. I am so grateful to live, work and play on the traditional lands of the Haudenosauneesometimes known to settlers as the Six Nations of the Iroquois Confederacy, but also home to our Anishinaabe brothers and sisters, and many other First Nations, Metis and Inuit folks over time. The Peace we all share together is governed by the Dish With One Spoon Treaty — we take only what we need, ensuring sustainability for our children and their children. The spoon has no sharp edges — we aim not to harm each other, but to enter into respectful discussions when conflict arises.

It is common, when you enter an Indigenous community, to introduce yourself not only with your name, but by claiming your relations and describing your connection to the lands. This practice is often referred to as ‘positionality’.

Indigenous Peoples deeply value how who you see in yourself and your connection to your roots, both in the physical world and spiritually, influences how to relate to all things — people, animals, the earth, work, spirituality, and wellbeing.

This differs from a Land Acknowledgement, given by a non-Indigenous person, typically used to honour the Indigenous Peoples who cared for the land for thousands of years, and acknowledge that they agree to abide by our Treaties as uninvited inhabitants.

A Haudenosaunee elder once shared with me that the Ancestors felt that this area that we call home had something a little extra. This special place, now called Kingston, was a place that the Haudenosaunee and Anishinaabe, two groups who were often at odds with each other, would meet peaceably. What a wonderful location for a place of higher learning, respect, and meeting of the minds.

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From time immemorial, Indigenous Peoples have had a deep, meaningful connection to art. Our art isn’t just an expression of our creativity — it is our culture, our history and, especially since colonization, a way of healing. Art IS medicine. Certainly, my own art has been, at different times, many of these things.

I create traditional Indigenous beadwork, often with a medical theme. Some examples are shown here.

Sometimes I create art because I feel inspired, or I would like to present someone with a gift. It has also been a way to connect with my culture and feel closer to my ancestors, manage some of the anxiety and worry that thirteen and a half years of university created, as well as five years of residency balanced with two babies.

I was invited by the leaders of the Queen’s Medical Review, in the spirit of reconciliation, to share some of this knowledge with you. Indigenous art is diverse! It comes in many forms-storytelling, painting, beadwork, songs, dance, drumming, clothing and fashion, carving, leather and hidework, metalwork and many others! Each form comes with its own history, traditions and techniques that vary by community based on what has been passed down. My own work is a mix of traditional beading, leather, caribou hair and porcupine quill work incorporating contemporary materials like faceted beads, crystals and adhesives that come together as 2D scenery, jewelry or clothing with either traditional Indigenous or modern medical and anatomy themes. I am influenced and inspired by my Mohawk heritage and my passion for science and medicine.

I hope you enjoy the diverse works presented in this issue and invite you, in the spirit of true reconciliation, to enjoy some Indigenous art by purchasing original artwork from an Indigenous artist, buying a book written by an Indigenous writer, or attending a Powwow or other open ceremony to see some traditional dancing and drumming. Be brave!

Nia:wen

Dr. Jamaica Cass, MD PhD CCFP DABOM

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I

n 1983, 29-year-old Ken Ramsauer was being treated for complications related to HIV/AIDS at a New York hospital. Ken was among one of the 562,000 people living with the disease at the time. As he lay in his hospital room, he overheard staff taking outside his door. They jokingly remarked:

diets and health trends, advising the public on pandemic precautions, the vaccines we should receive, and even political opinions. There is a certain level of trust that comes with having those two special letters after your name.

Doctors calling patients derogatory slurs and treating HIV-positive people with such great disrespect invited society to perpetuate these same attitudes towards individuals living with AIDS.

“I wonder how long the faggot in Room 208 is going to last.”

Ken died in May of 1983. Before his passing, he made a deliberate effort to ensure that the unspeakably horrible words of the clinicians he was treated by were etched into history.

Ken recounted the story in every interview he gave. The words now appear in Ken’s Wikipedia article.

I think we all acknowledge the incredible privilege and power that comes with this ability to have such great influence. By being admitted into medical school, we are being told that we are trusted to use our ability to advocate, influence, and contribute to the collective good of society. Effectively, this privilege means that every time we are representing our profession, we are expected to act in a way that would make our colleagues proud, and reinforce the inherent trust that society has in physicians.

How tragic it is that the hospital staff who treated Ken made the choice to, rather than act out of compassion and understanding, react with hate and bigotry. When faced with treating the heavily stigmatized and terrifyingly uncertain entity that was AIDS in 1983, they chose ignorance. They could have sat down and connected with him, human to human, with the intent of growing their knowledge of the disease and those it impacted. Ken’s story does not exist in isolation. The treatment of patients with AIDS by the medical system throughout the epidemic was nothing short of inhumane.

Despite the relative ease that I am sure the clinicians treating Ken felt when making homophobic comments, constantly maintaining this level of composure is no small burden to place on us. It can sometimes feel like an impossible task to maintain this level of professionalism under the omnipresent gaze of life in 2024.

I think about it every time I cross against the light while wearing my blue backpack, post on social media, or attend a protest for something that I am passionate about. While the thought does not cross my mind for

We would be deluding ourselves if we said that the words and actions of physicians do not hold weight in our society. Be it endorsing

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By Emma Monti, Class of 2026

long, I noticed something strange about this feeling: professionalism and advocacy rarely seem as though they can peacefully coexist in my identity as a medical student.

exist in a profession that often feels as though it has so little space for passionate and diverse perspectives.

My experience does not exist in isolation.

My experience reminds me that we are consistently told to use our education and voice to champion causes that we are passionate about, but when we do this in a way that is not palatable to the paternalistic and generally homogenous bodies that govern us, we are denounced and punished.

Much of the time, it feels like any meaningful advocacy I wish to pursue is at the risk of being classified as “unprofessional” by governing bodies, colleagues, preceptors, and society. I once carried a great number of pro2SLGBTQ+ pins on my bag, hoping that this would play a small role in creating a positive and safe space in hospitals and classrooms.

After having my bag met with increasingly long stares, heads turned around in the corridors of Kingston General Hospital, and even gazes in coffee shops on campus, I made the decision to remove the pins. I felt a sense of relief as I removed the pins, fortunate that my queerness is so easily concealable. I was unable to cope with the feeling of constant perception and the feeling like I was not using my position as a medical student in a way that would be universally approved.

Let our generation of physicians be the one that changes this. Let us be the doctors who are able to finally reconcile our identities as both passionate social changemakers and clinicians. Let us make society realize that these two aspects of our lives can peacefully coexist, making us stronger as a collective profession and allowing us to connect more deeply with our patients.

Let us never again be the clinicians whose hateful words are rightfully immortalized through Wikipedia articles, on display for future generations to see. Instead, let us be known as the generation who spoke out when we saw inhumanity and injustice and used our privilege and immense gifts as physicians to enact powerful change.

Perhaps it was all in my head — after all, I am very lucky to have never encountered explicit homophobia in my education.

But there exists a certain deeply rooted association between queerness and its inherent unprofessionalism in medicine. This feeling I have been unable to shake since beginning my career as a medical learner.

Perhaps one day, as an attending or staff with years of experience, I will feel confident enough to return the pins to my backpack.

But for now, it is easier and safer to simply

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ALWAYS SEE ME

By Anonymous

You don’t see my skin, You don’t see my hair, You don’t see my people, You don’t see my pain, You don’t see me.

But when it matters to you, You see my skin, You see my hair, You see my people, You see my pain.

Only when it matters to you.

To me, I always see my skin.

I always see my hair.

I always see my people.

I always see my pain.

I always see me.

And you should always see me.

All of me.

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“Diastolic Connections”

By Jaryd Te, Class of 2026

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THE

BRIDGE

By Ryan Truong, Class of 2026

“The Bridge” explores my journey from inner-city North End Hamilton to becoming a medical student at Queen’s University. The poem delves into the physical and metaphorical rift I experienced while completing parts of my education in the North/Central and West ends of Hamilton. “The Bridge” highlights lessons and experiences that shaped me as I navigated various stages of education, life, and social class. The poem recounts an ongoing journey of learning, giving back, and introspection that I embrace as part of my growth.

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THE BRIDGE What bridge?

THE BRIDGE (Reprised)

THE BRIDGE (Reprised IV)

The bridge creates the divide between you and I

The bridge creates a divide within my mind It stands as I stand between the sides

It stands to divide as I admire from one side On my side, I stall to cross

THE BRIDGE (Reprised V)

My rumbles and creaks

The bridge

I fumble to…

It unifies

THE BRIDGE (Reprised II)

THE BRIDGE (Reprised VI)

The bridge creates the divide between you and I

The bridge created the divide between you and I

It stands to divide as I drive

It stands to bind the two sides

As I climb, I stall to the side

I frolic between the sides

My upkeep is short

I split the divide

You, sly

THE BRIDGE (Reprised ...)

THE BRIDGE (Reprised III)

...

The bridge creates the divide between you and I It stands for escape as I ache As I crossed to one side, I met with awry I cried

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By Kimberly Mitchell, Class of 2026

Miscellaneous. None of the above. I feel bitterness in my throat as I look at the textbox I must fill in with my identity. I don’t fit.

I have been relegated to the other. Other is an abyss of grayness.

Where other less thans, like myself, hang out.

Not good enough to make the list of options, and so here we are in the fog.

Although we are here together, myself and the other others, We are further isolated by our otherness.

There is no camaraderie here. There is no fellowship here.

How did we get here?

Special populations they call us; what makes us special? They never said.

Too special to be a part of them, so here we are.

The other.

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REFLECTION T

he problem with denoting a group ‘special’ is that it relegates the group to ‘the other’, the ‘less than’. Some may say that by labeling a group ‘special’ there is an opportunity to address disparities. I say they are wrong. The systems put in place often disadvantage members of special populations more than they help.

To illustrate using an example, Indigenous people who access health insurance benefits through the federal health benefit program require pre-approval for numerous medications – even for those prescribed by a physician and available to non-indigenous people without government interference. The pre-approvals add delays to obtaining health care. This is particularly burdensome at a time when our healthcare system is already challenged to provide timely care.

It is tempting to summarize the message using the term ‘systemic racism’. This term is ghastly.

Systemic racism is a catchall phrase that attempts to describe inherent bias in the governmental and societal systems governing our world.

The issue with systemic racism as a term is that it can’t be fixed.

There can be no causal analysis

that identifies a root cause because the term is simply too abstract.

Actions are concrete. A person can take action. A team of people can achieve a group of actions that, together, will resolve a problem. Until we define the problem concretely, nothing will ever change for my people. That is the reality we face today.

In healthcare, one thing that has to change is the federal government’s insistence on setting different targets of wellness for indigenous people compared to other Canadians. In their 2023-2024 Departmental Plan, Indigenous Services Canada (ISC) reports that 37.8% of First Nations and 36.9% of Inuit people report being in excellent or very good physical health. ISC has chosen to set a goal that 44% of indigenous people will describe themselves as being in “‘excellent’ or ‘very good’ [physical] health” by March 2028 (Indigenous Services Canada, 2023). In contrast, Statistics Canada reports that 59.7% of Canadians already report they are in excellent or very good health, generally (Statistics Canada, 2023).

Are we that much less worthy of physical wellness?

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If you are reading this, you can help. Write to your Member of Parliament. Write to the Minister of Indigenous Services Canada.

Demand change.

We can start a revolution that changes the face of Canada for the better. I hope to see you at the revolution. Keeping special populations grouped into ‘the other’ will only result in more of the same. It puts the onus on the members of those populations to drive change. The irony is that we were grouped this way to drive equity initiatives and it is this labeling that is keeping us from the equity we deserve as human beings.

Resources: •

Indigenous Services Canada. (2023, March 24). Indigenous Services Canada: 2023-24 departmental plan. Retrieved December 17, 2023 from https://www.sac-isc.gc.ca/eng/1 666289629121/1666289645507

•

Statistics Canada. (2023, September 13). Top Five highlights from a new report on the health of Canadians, 2023. The Daily. Retrieved December 17, 2023 from https:// www150.statcan.gc.ca/n1/dailyquotidien/230913/dq230913b-eng. htm

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Untitled

By Sarvesh Ramlochun, Class of 2027

I hope this piece stands as an introspective exercise.

Painted in acrylic with brush and palette knife on paper, 11x14 in.

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VOICES RECLAIME

7am: another morning of a roof over my head

as I awake from a serene, uninterrupted sleep.

I hear the distant call of morning birds as

they glide across a vividly blue sky.

I feel helpless.

I turn on the bathroom light and lift the faucet handle. The water flows in a thick continuous stream, as if emerging from a

never-ending waterfall of plenty.

I feel helpless.

Minutes before I leave, I stand in front of the

mirror, staring at my reflection, crisp as ever.

I feel helpless.

I place the cool and flowy fabric over my

head, carefully managing the pleats and

swoops and pinning them in place.

I see myself in the mirror again - all of a sudden everything becomes clear. I am not

helpless.

I leave the house wearing what is ultimately

my pride, my freedom - what undoubtedly is

my voice.

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By Anonymous

“The Show Must Go On”

By Prashanth Rajasekar, Class of 2025

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By Helen Lin, Class of 2025

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“Path of the Matriarch”

By Priyanjli Sharma, Class of 2026

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731CHINA

UNIT

HARBIN,

D

uring World War II, unopposed human experimentation and biochemical militant atrocities were perpetrated by medical doctors recruited by the Japanese Army. In 1933, experimentation Unit 731 opened in Harbin, China. During its active period (1933–1945), 3000–12,000 human subjects were imprisoned in Unit 731. Facilities were staffed by approximately 3000 medical doctors and soldiers. Motivated by ideals of ethnic superiority, the Japanese government strove to rule Asia as the superior ‘Yamato Race,’ and justified experiments on who they perceived as ethnically inferior: the Chinese, Soviet, Mongolian, and Korean peoples as well as militant/civilian prisoners.

Experiments investigated the pathogenesis of frostbite, chemical agents, and over 50 types of microbes. Human subjects were alive and conscious during experiments that were performed without anesthesia. Prisoners were executed when their usefulness to the ruling regime ended. The agents of biochemical warfare that were researched in the unit were then used to disseminate disease in the civilian populations of China. Although almost eight decades have passed since the end of World War II, there has been no justice for victims of these atrocities.

Most perpetrators were not penalized in the Tokyo War Crimes Tribunal. Instead, research produced in Unit 731 was obtained by the American military in exchange for immunity.

The History of Medicine Interest Group organized a seminar for Queen’s University medical students to provide perspectives from a key researcher of this lesser-known historical atrocity.

Dr. Yang Yan-jun from Tsinghua University is a professor at the Crime Evidence Exhibition Hall of Unit 731. He has conducted Unit 731 research for many years and published several books. He has also traveled around the world for his career, including twice to Toronto where he contributed his expertise to the Asia Pacific Peace Museum in Toronto as their historical consultant. We asked Dr. Yan-jun to provide insight into his research.

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PHYSICIAN COMPLACENCY AND HUMAN EXPERIMENTATION IN WORLD WAR II Chen Chen, Bonnie Yang, Nikoo Aghaei, Natasha Savic, Nazanin Soghrati, Rachel Mckay and Omar I. Hajjaj, on behalf of the History of Medicine Interest Group

What inspired you to research human experimentation and biochemical warfare in Asia during World War II?

What has been the most surprising to you in your work?

When I was studying this history, I encountered Li Fengqin. Her father, Li Pengge, was arrested by the Japanese army for ‘anti-Japanese sentiment’ and sent to Unit 731. His story is exhibited at our museum. Li Pengge had been killed in Unit 731 before Li Fengqin was born. We invited Li Fengqin to our research meetings. Many of us, including myself, have not encountered wartime. We saw through her eyes a very cruel history unfolding into reality: an elderly person who never knew her father.

Afterwards, I brought Li Fengqin to Tokyo and Kyoto.

At first it was because of my work in Harbin Public Health. They had a Unit 731 archive centre. I archived documents, interviewed witnesses and perpetrators, and prepared academic articles. My work allowed me to interact, long-term, with the family members of Unit 731 victims. Conversations with these families made me realize that although the history occurred decades ago, the harms and impacts did not disappear with the passage of time. And thus, I went from simply completing a job to fulfilling what I felt was an academic and societal responsibility.

During World War II, staff from the Schools of Medicine in Tokyo and Kyoto comprised the core research staff in Unit 731. We met the Deans of Medicine at these schools. I believe that this meeting was a crucial step in resolving historical and societal issues. We cannot have history be history, and the present be the present. There are inextricable links between them. When a person is standing in front of you, when they talk about the effects of history on their life, that kind of impact comes as a tragic surprise. People like Li Fengqin inspire me to keep going. She is not only a testimony, but also a whole person with lived experiences. When we bring her lived experiences and trauma to the museum and academic exchanges, then her individual memories can become part of collective memory.

Secondly, I believe that every city has a history that should be preserved. Only history that is preserved in some way can tell us where we came from, what we have experienced, and what has led to our actions today. In other words, only by analyzing history and having a grasp of the present, can we have hope for our future. Those are two reasons that I’m conducting historical Unit 731 studies. The victims’ families and principles of historical preservation have become the responsibilities and mission of my research studies and academic international collaborations. These are common sentiments in all forms of research, dialogue, and exhibitions about World War II history in Asia.

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Physicians conducted multiple experiments on victims. Left: frostbite was studied by leaving victims outside and exposed for lengths of time, sometimes after being doused with water. Centre: disease transmission was studied on pregnant victims (sometimes forced). Right: victims were infected with diseasecausing agents and vivisected without anesthetic.

Our audience is from Canada. What do you hope for from the international community?

Do you believe that these historical atrocities have affected trust in physicians?

The two World Wars of the 20th century have led to very severe consequences, including many human rights atrocities and violations.

Now, twenty years after the start of the 21st century, these atrocities are in some ways repeating themselves. Our purpose should be advocating for maintaining peace. Only in the context of peace can we actively build our social order. Of course, the pitfall comes when we ignore what we think has nothing to do with us.

After the war, only about six or seven physicians were prosecuted properly. The rest of the perpetrators returned to Japan. They then taught at Kyoto University, Tokyo University, and Kyung Young University of the Arts, as renowned professors. They also became deans of medical schools, some became university presidents, or school of medicine board chairs.

They did not have to reflect or repent on their unethical human experiments. I’ve been collecting records of Unit 731 perpetrators who used unethical wartime experiments and illegal human experimentation/biochemical warfare research for post-war PhD pursuits.

When you are immersed in history, you will realize that pieces of history never wander far.

The realities and cruelties of the present are never as simple as books make it out to be. So, I always emphasize to leave the classrooms and books, and enter the museums and into society. Only from learning lessons in history and facing these cruel atrocities can we enact policy changes, institutional changes, and judiciary changes. So the ‘usefulness’ of history may not be ostensible right now. But if we put it in the context of human progress, its impact and value is rooted in humanity: a convergent characteristic.

The perpetrators from Unit 731 have passed away by now except for some young soldier aides, so there’s no direct way to hold them responsible. But as a history scholar, I have a responsibility and obligation to reveal the cruel and unjust history perpetuated by these physicians. These perpetrators used scientific methodology and medical measures to commit their crimes. We cannot say that it was not medicine to make the ethical violation disappear. From experimental planning to

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implementing experiments, obtaining results, setting experimental aims, and ultimately publishing, they were completely standardized medical science experiments.

mostly peaceful era. Trust in physicians and in the healthcare system is related to individual experiences. My own experience is that most physicians are to be trusted. However, medicine isn’t always taught in relation to history. Physicians are taught some principles of bioethics and norms and guidelines, but this is in peace times. When warfare intersects with medicine, bioethics has not been of foremost consideration. Only in peace can we have that societal order. War can create a messy world.

In such disorder, the greatest victims will be the civilian people.

What would you most like medical students to remember?

When it comes to circumstances of taking orders, our superior’s commands are not excuses to commit unethical medical acts.

Unethical commands must not be entertained, even in the context of war. Medical ethics should always define the bottom line governing the medical profession. It is a bottom line that cannot be crossed, and adherence to this bottom line should be an expectation of the medical vocation. Our actions are written in the history of humanity and must practice in a way that respects and acknowledges the course of history. No excuse for unethical practice is ever appropriate. However, physicians should not just aim for this bottom line. Physicians should aim for more; physicians should aim to improve the human condition. But if we know what that bottom line is, and we know why things happened in history, we are one step closer to fulfilling our mission as medical practitioners.

Prisoners were often captured civilians or soldiers who were ‘dangerous’ to the state and referred to as ‘maruta’, or logs.

Comprehensive ethical rules regarding war and medical care were formulated from post-war trials and international conferences (e.g., Nuremberg code and the Declaration of Helsinki). Today, many civilians live in a

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Reflection no. 4 on the duty of physicians and artists in critical points in history

By Anonymous

Artists and physicians are not so similar Though we share the power to heal, us physicians fall rote to apathy’s embrace While artists, intoxicated by earthly waves of candor and grief, find fresh inspiration in even their sober moments, an artist understands better than we do To heal the broken world is to heal from the heart.

Take Chopin, with his etudes of revolution for Poland, Whose soul remained tortured by the turmoil of Soviet occupation That his heart was entrusted to Warsaw’s cognac, as his body sought fool’s solace in Paris, he preserved his defiance in song, An eternal spring of peace and liberation.

And Darwish, armed with acts of ink and anguish and ashfall, Who bravely left his heart in the sweet groves of al-Birwa Was splintered by a cypress tree that broke. in exile, his sonnets became resistance Pillars of hope and persistence, like the pulsing currents of the Jordan river.

But artists and physicians are not so different Conversing in our secret language of brushstrokes and stitches, we find odd refuge in our work So what is required for medicine to embody art, for a physician to become an artist? in times of sturm und drang, we must prescribe an earnest symphony of saltwater and sorrow The timeless, life-saving elixir of history and heritage and the sea.

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By Simoon Moshi, Class of 2025

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Masters

By David Vaz, Class of 2026

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of air

Those other creatures can’t compare, With humans who have mastered air; Though birds fly fast in windward flight, It’s people who give air its might; We’re beacons of receptive thrill, We tend to speech instead of quill; We talk and talk and talk some more, Through night, through day, though peace, through war; Yet talk is cheap without a bill, One needs to know their wants, their will; Or heavens be, we lose this trust, And air becomes in charge of us.

Our breath must then intensify.

We live, we love, we breathe, we die.

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“Black Bar”

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By Anonymous

“Unknown”

By Grace Ayoo, Class of 2026

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By Simryn Atwal, Class of 2026

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You are severed like a simile steepled tendon to tendon

Glutted on naked truth in the gaping maw of that open body

You swallowed your tongue clean, off the frenulum and taste gummy silence

Imprints of words, clotted into cheek fat toothsome and chewed out

Irrigate the wound putrescent and swollen with inaction Flush it with isotonic salvation, dilute the poison until it runs clear

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“Sunbird”

By Marisa Cressatti, Class of 2026 | Photographed by Frank Chen, Class of 2026

The Sunbird serves as a visual representation of overcoming adversity.

Visible cracks and the use of alternative mediums for construction highlight resilience. Upon further inspection of the chain, the Sunbird’s ‘nest’, notice the broken link − freedom.

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The cry of a Ghazalle: evocation of grief and familial preservation Essay and poem by Omar I. Hajjaj, Class of 2026 | Artwork by Precious Adekoya, Class of 2027

The ghazal is an Arabic fixed-verse poetic form originating from the conversational art of the nomadic sixth century Arabian Bedouin peoples. Translated, “ghazal” is the mortal cry of a hunted animal and is the etymologic basis for the English noun, “gazelle.” The ghazal is a sorrowed ode to one’s beloved or Beloved; its imposed strictures amplify expressions of grief and adoration for the poem’s muse.

This muse is often an absent lover, unrequited dream, or a longing for a distant homeland. It behooves the poet not to anguish in the words of the ghazal but reflect on the beauty that inspired grief.

The ghazal likely evolved from the qaṣīdas and nasīb, two fixed-verse poetic decrees of ethical maxims and nostalgic yearnings. Unlike the qaṣīdas and nasīb, the ghazal is shorter in length and demands strict adherence to poetic metre.

For the next six centuries, the orallytranslated ghazal would travel the Eastern world where it would develop these structured conventions. With thematic preservation, the ghazal spread from the Arabian Peninsula westwards into Africa and Spain and eastwards to Persia. The ghazal was also widely adopted on the Indian subcontinent where the poetic form, now written in Hindi or Urdu, would be sung atop backing instrumentals.

By the 12th century, the structural conventions of the classic ghazal had been accepted by most poets and translated in Arabic, Hebrew,

Hindi, Farsi and Urdu. Today, the ghazal is a cannon of English poetic forms.

‘The ghazal’s disconnectedness must not be mistaken for fragmentariness; that actually underscores a profound cultural connectedness. The ghazal is not an occasion for angst; it is an occasion for genuine grief.’

- Agha Shahid Ali The ghazal is a short series of semantically independent and syntactically complete couplets (shers); enjambment between couplets is discouraged. Despite their narrative and thematic independence, all couplets in a ghazal are related in metre and rhyme. In practice, writing and reciting a ghazal forces unity through commonality despite distance and dissimilarity. When read consecutively, all couplets together are greater than each individual, creating belonging and wholeness in the writer, reader, or listener. The first couplet (matla’a) creates the scheme and introduces the refrain (radif; a repeated word or phrase). A rhyme (qafiyah) may also precede the refrain. Each line of the first couplet, and the second line of all subsequent couplets end with the refrain. In addition to the rhyme and refrain, each line of the couplet follows the poet’s selected metrical pattern and syllabic count.

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The particularity of the ghazal’s strictures and rhythmic restrictions makes the scholarly task of translation between languages nearimpossible. Moreover, the intimate subject of the ghazal brings into question whether an individual’s experience of love and grief can itself be translated. Of course, there is a commonality in love and grief but a focus on this commonality undermines individual experience.

In other words, a ghazal’s bystander may sympathize with the poet and their grief, but this bystander may not understand the uniqueness and totality of the poet’s adoration and mourning. Nevertheless, the ghazal’s poet invites its audience to transiently join in their bereavement to honour and preserve the ghazal’s muse.

The final couplet of the ghazal (maktaa) optionally incorporates the poet’s signature, nom de plume, or some derivation of their name. The purpose of this inclusion is multifold. Firstly, given that early ghazals were recited and not written, including the poet’s name ensures appropriate credit is received. As the ghazal spreads in language, time, and space, the poet’s name is always associated with their artistic contribution. Moreover, the inclusion of a family name is a purposeful act to preserve the beauty and history of a bloodline despite loss.

This ghazal is dedicated to the Hajjaj family and their neighbours.

Do not fossilize beneath malachite sputum.

Ascend! Latch the sticky gooey kite of sputum.

His gangrenous knee drips drags drips when he drags and it fertilizes his Land, despite blight sputum.

Your teal bindle and troubled barefoot pilgrimage Godspeed! Begone your only devote acolyte, sputum.

Autoclaved tools and shrapnel sutures, save a boy!

Beneath surgeon’s scalpel, bring to sight his sputum.

In the absence of illness and sickness, you ache and it festers: a tearful clear and light sputum.

Outside confines of nautical jurisdictions, fish!

Fish from the interstellar pool of greenlight sputum.

Return the page, Hajjaj. They request the name and find in cultural archives, your familial plight and sputum.

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SESSION TEN, BREAKTHROUGH

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By Sarvesh Ramlochun, Class of 2027

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THE PERFECT ADVOCATE

By Anonymous

I

was once the perfect advocate, and I am ashamed of it.

I was made of truth when it all began. At the time of my early footsteps onto this path of advocacy, I was unacquainted with the name of this road and had embarked on it solely to reach a destination called “justice.” At this stage of life, I was accountable to no institution or profession: this freedom was my golden strength. My voice and advocacy knew no bounds. As I would learn years later, these attachments can become a noose around our necks.

Not yet privy to this well-kept secret, I walked into medical school a fool.

“Why medicine?” many had asked. Medicine, to me, remained an end of itself. It was also a powerful means to several worthwhile ends, including advocacy. Medicine offered an unparalleled lens, a unique platform, and sacred insight into the human condition that could be wielded to embolden the act of advocacy. While all of this, in theory, remains true, there are several myths that time has unkindly debunked for me over the course of my career as a medical student. One of these myths was that of the truthful, and just nature of medicine.

“We need advocates just like you,” I was told. So, I resumed on the path of advocating, this time as a medical student. I bore witness to the patient experience in the waiting room of the emergency department and in the crowds of the operating room. I realized that the practice of advocacy can exist without medicine, but the practice of medicine is hollow without advocacy. To truly do no harm, physicians must extend to uphold this promise not only in the clinical setting, but especially outside of it in structures and societies designed to manufacture injustice. Ablaze with the fantasy of creating true, meaningful impact, I scribbled my

name down for leadership positions with grandiose titles and promising potentials to champion change.

For some time, my visions for advocacy flourished in these roles: my peers and I learned and unlearned how to conduct ourselves as steadfast allies. We tried again and again to translate our good intentions into execution (lest we harm others with well-meaning mistakes) and educated ourselves on social justice causes that we knew little of. We upheld truth as our guiding light and clutched faithfully to the integrity of our profession.

Our medical schools were proud of us. We were the spitting images of the CanMeds competencies model: “Medical student advocates lead the way towards an equitable future, boldly communicate their perspectives and calls to action,” would be the caption decorating a picture of us on one school’s Twitter account. “Collaboration between medical students across the country embodies the very essence of professional and scholarly success,” might boast another blog post. We were invited to share our work and lend its successes to our schools’ legacies.

Our institutions were proud of us, until the day came when they weren’t.

I was brought into a room with high ceilings and ivory busts raised on plinths that lined the walls. As I walked in cradling my icy hands, I could focus only on their glazed eyes. As if they had willed it, I was suddenly aware of the isolation crushing my ribs.

There, on a table in front of me laid the terms and conditions of The Perfect Advocate, printed on crisp sheets of paper I could have sworn I had never seen before. I squinted, for what felt to me like the first time. I was seeing the fine print cluttering the pages of the contract that outlined, in lengthy detail, the permissions of my license to advocate.

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“You have transgressed,” I was sentenced, “and chosen a cause unbefitting of the perfect advocate.”

version of the tale that is told. The show must go on, of course.

It seems that I was the picture-perfect advocate only until I was a conditional one.

“The perfect advocate knows how to sit perfectly still.”

“The perfect advocate,” a voice clarified, “picks what to advocate for wisely.” My mind flooded with a memory of my father at the grocery store, knocking on the rind of a watermelon to listen to its ripeness.

The watermelon had testified in its deep, hollow voice: “I bear witness that I am worthy.” The perfect advocate picks a cause the way my father did watermelons, examining them repeatedly to find one that is ripe with profit for the picking.

I wondered for the first time if the figures of ivory in this room were once advocates themselves who stayed still too long. “You must understand,” they warned, “it is not always worthwhile to get your hands dirty.” I looked down at my hands. They were stained red with inaction. It was the colour of blood.

I began to turn and head towards the door.

“The perfect advocate knows when to make exceptions.”

“Don’t say we never warned you,” were the final words that trailed me, and it was the making of a threat. I had been ample warned indeed, but only of the true face of medicine. At the beginning, I believed medicine to be a worldview of its own, one sterile from the stereotypes, biases, and prejudices of the world it serves. Pollyannish, I revered medicine as a duty to the truth, irrespective of the cost. This was the medicine I vowed myself to, right hand on my heart. It was a mirage.

Baffled, I asked, “When is injustice not injustice?”

“When justice is not convenient,” the ivory figures replied.

When I was young, my friends and I would put on masks that veiled our entire faces, except our eyes that glimmered with mischief. We would run around and try to recognize each other, suppressing our giggles behind our disguise. I played the same game today, and recognized complacency masquerading as convenience.

Medicine, like any other collection of human beings, barters anything that sells: integrity, truth, and justice included. Advocacy is allowed onto the premises of the profession of medicine only until it decorates it; step any closer and it is held at the door. Do not come further, there will be consequences. Advocacy that makes us uncomfortable, that makes us squirm in the systems of injustice we call home, is not welcome here.

To maintain this charade, medical students mold themselves into the type of advocate that medical institutions quietly seek: the perfect advocate, who does not recognize that the spirit of advocacy is resistance. I can no longer fill this vacancy, because from what I have learned, the perfect advocate is not an advocate at all.

“The perfect advocate does not go off-script.”

“Advocacy is not a performance,” I argued. The statues shook their heads at my naivety. “Everything is a performance,” they said matter-of-factly, as if this simple fact is enshrined in our mission statement. “Those tempted to improvise are not welcome back on stage.” There was an unbearable weight on my chest. I thought I might suffocate under the weight of all the words I could not say.

It was my mistake for forgetting that words and freedoms have a commonality in that they can shift allegiances. One moment, they are your fundamental rights, the next, they are mutiny.

Whichever garners more audience applause is the

The perfect advocate is a hypocrite.

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DR. EVA PURKEY:

By Mudia Iyayi, Class of 2026

One of the cornerstones of medicine is advocacy, where physicians play a key role in supporting their patients. This is often viewed on a larger scale, such as when medical learners or physicians volunteer their time to help patients in disadvantaged regions. It is also often perceived as a political venture, where physicians defend patients’ rights through lobbying politicians and upholding healthcare law. While these population-based advocacy methods are impactful, the one-to-one advocacy that takes place in daily practice is just as crucial to the betterment of healthcare. At its core, the physician-patient relationship is truly one of advocacy, where the former advocates for the latter.

I had the opportunity to reach out to Dr. Eva Purkey who is a family physician and an assistant professor in the Department of Family Medicine and has been with Queen’s University for almost 11 years. This profile showcases one of the many ways that medical learners and physicians can become involved in advocacy, in large ways or in small ones.

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advocacy in action 1

What are your current clinical/research responsibilities/interests?

I provide full scope family medicine as well as intrapartum obstetrical care to low-risk patients. I also run a clinic for government-assisted refugees in collaboration with KEYS in which I do intakes for newcomers from all over the world, organize their medical and social care, and then after about 6-12 months, help to set them up with another family doctor.

My non-clinical roles in the Department include the leadership role of Health Equity Director, the purpose of which is to support the implementation of Department of Family Medicine’s strategic goals around health equity and social accountability. These goals influence the education, clinic, research and operation pillars of our department.

An example of a project we are working on is integrating patient advisory councils into both our clinical work at the Kingston site, and throughout all four sites of our education program.

My research work has always been focused on the social determinants of health of equity-seeking groups (though the language we use for these groups has changed over time). I have two main research programs. The first is international, focused on a 20-year partnership on the Thai Burma border with migrants from Burma who cross the border into Thailand. Eastern Burma is the site of what some call

the longest running civil war in the world. For 20 years I have been supporting community health and research capacity building in the migrant community of Mae Sot, Thailand. For the last 8 years I have done this work in partnership with Dr. Colleen Davison from Public Health Sciences. We have been fortunate enough to have students work with us on these projects as well. I find huge value in the relationships with Burmese (and Thai) colleagues built over many years, which importantly keeps me grounded in an international perspective.

My second program is local. In 2020, Dr Imaan Bayoumi and I started the I-CREAte project which is a community-based participatory research team that aims to improve health and well-being among equity seeking people here in the Kingston area. Beyond this, I have worked on many local projects related to health equity and health service utilization, including with unhoused individuals, members of the Indigenous community, and others.

This work complements my clinical work. While the relationships I have in clinic are impactful (I hope) at an individual level, this work helps me feel I may be able to have an impact on some of the bigger societal issues that affect the lives of the people I see in clinic every day.

2

Was there a moment that sparked your interest in public health and patient advocacy? If so, can you describe it?

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Like many people in my position, I think, I grew up surrounded by advocacy. My mother was an activist in the women’s movement in the 1970s and 80s, and taught women’s studies, followed by international studies. She ran the Amnesty International club at the college in which she worked and started a refugee sponsorship committee in the 90s which is still active. I grew up exposed to all of this. Also, as an anglophone in Quebec, I was often expected to represent the view of “all anglophones” in the many French spaces where I spent my time throughout high school, CEGEP, and university which helped me learn about politics and advocacy.

I was somewhat disappointed by the absence of politics or advocacy in my medical school education.

When I finished, I took a year off prior to starting residency to work in the migrant community along the Thai Burma border which I mentioned previously. This was a life changing experience for me, and helped me to reorient my priorities and my perspectives on health, healthcare, and the possibility of using my position in healthcare as a tool for equity.

After a few years in practice at the Community Health Centre, where the social determinants of health you learn about in medical school now are right in your face all the time, I felt the need to expand my work beyond the individual patient encounter. I completed a Master of Public Health at John’s Hopkins University in order to develop my

advocacy and research skills, and eventually moved to Queen’s to be able to fit this work into my “day job” rather than into after hours and weekends.

I remember specific patient encounters that moved me in this direction. One in Thailand was a small child who presented with hydrocephalus. He had presented a few times before, and the American pediatrician who was working in this unofficial migrant clinic had sent him for a shunt. The Burmese medics clearly felt that this was not an appropriate use of resources – the clinic had to pay for this care as the patient needed to be referred into the Thai system. The cost was high, and this money could have been used in other ways to improve the lives and outcomes of many patients instead of just one. Additionally, they felt, perhaps rightly, that this child was going to return to rural Burma and would not have access to the care required to maintain the shunt. The alternative, of course, was that the child would die, and the American pediatrician, trained as a specialist in one of the world’s top medical systems, could not tolerate this.

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Can you describe a time in your career where you faced resistance in an advocacy initiative you were working on (i.e. lack of funding, institutional complacency with the status quo, bureaucracy, etc)? How did you overcome it?

My medical school experience taught me to not necessarily expect the medical system to lead change from an advocacy perspective, so the fact that it often doesn’t has never been a surprise. I have definitely had experience with advocacy initiatives that failed despite everyone’s best efforts. During the COVID-19 pandemic, I learned a lot

about advocacy at the municipal government level through working to stop evictions and maintain basic quality of life for unhoused people living in Belle Park. I, and other colleagues, wrote letters to local newspapers, signed petitions, spoke at city council, came out for direct action, and spoke to the media. But ultimately the camp was dismantled.

Watching it be dismantled (which involved watching people’s tents and possessions be removed by dump trucks) was important. It reminded me of the violence which some individuals feel by the State every day. Many of us, as physicians, have not directly experienced this, but it is a common experience for many of our patients. It is a good thing, I think, for us to witness or experience this type of interaction first-hand.

I think that we need to view setbacks like this as part of the process. We need to advocate, but we also need to bear witness to suffering (which we do every day as physicians). We need to form interdisciplinary coalitions with people who share different perspectives and recognize that while we may not all agree on everything, we all have different roles to play in a given movement or towards a given objective. We also need to realize that a set back like this is part of a much longer story.

Resistance and advocacy movements have often taken years or decades to effect change. But many have.

Women and Indigenous people in Canada have the vote. Black and Jewish people are accepted into Canadian medical schools without quotas. Policy has shifted around criminalization of substance use.

Things do change. It just takes a lot of time. I think Martin Luther King Jr said “the arc of the moral universe is long, but it bends toward justice”. This is what I have to believe.

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4

In your opinion, how can physicians serve as advocates for their patients, in particular those who are disadvantaged?

I think the lowest bar, which is incumbent upon each of us every day, is to ensure that we are advocates for the individual patient in front of us. This is part of the CanMeds roles. This means not just seeking excellent medical care for our patients, but being aware of and concerned with the social determinants that may make it challenging for them to achieve their right to health, or at least to health care. We know that the healthcare system is estimated to account for somewhere between 10 and 20% of a person’s health. So if we, as physicians, are in the role of trying to help our patients achieve the best health they can, we need to support their access to the other determinants of health that can complement our medical care. This means, again, at a minimum, being aware of our patient’s financial status, their insurance, their ability to afford food, warm clothes, adequate housing, the medicine we prescribe, and the allied healthcare services we recommend. It means striving to understand how their identity (race, gender, sexual orientation, ability, language, migration status, religion, etc.) may affect their interactions with the healthcare service and with other services they need to access to be healthy. It means taking the time, even though it is super tedious, to do a good job filling out forms, writing letters, and doing the necessary advocacy to help them access these services, resources and care.

It means seeing them, and getting to know them, as the complex individuals they are.

More than that though, I think that physicians have a moral obligation to use their power and the respect

they are given, their privilege, to improve population health more broadly. Perhaps this needs to be more clear during medical school admission – while a very important role of medical schools is to train excellent medical practitioners, another should be to train good citizens, who are able to work across political lines to improve the health and lives of their communities. We can learn to leverage the power, and more importantly, as I said, the respect that comes with our profession, to broaden the health impact that we originally set out at the beginning of our careers to have.

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What advice do you have for medical trainees wanting to engage in public health and advocacy?

Develop skills. Recognize the position and power you hold (or will hold). Then think of the skills that you have or that you can develop that would be useful in advocacy.

When teaching about this, I talk about the advocacy toolkit. When you learn medical practice, you add “tools” to your toolkit – how to conduct an interview, how to do a physical exam, how to write a clear note, or provide an oral case report.

Advocacy is the same. Your tools can be things such as public speaking; research to provide the evidence that will support your public speaking peers; written communication of different forms (think letters to the editor, social media posts, and so forth); organizing skills that bring people together around events; and, uniquely, patient stories which, when used with proper confidentiality and care, can be very powerful tools for advocacy.

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Any parting words or wisdom or anything else you wanted to share?

You said that this is optional, but I think that this is the most important thing. I am going to say two things here which may sound like they are at odds with each other, but I don’t think they are.

The first, is that advocacy is political.

Whenever you make a statement or take a position, that is political.

Very little is completely politically or morally neutral. So you need to be aware of this when you speak.

The second is that because of the power and privilege we hold as physicians, we need to think about what we are going to say with great care. And I say this for many reasons. First, people are likely to listen to us. They may or may not agree, but they will likely listen, which is not the case for everyone who speaks up. Second, what you say, or do not say, reflects on you as an individual, but also on your entire profession, and by this I mean that it will affect the perceived legitimacy of other advocacy actions that you or other medical practitioners will take in the future.

Because of this, you need to think carefully about language and about position. I am the first to say that I know I have got this wrong at times – we will all make missteps, and some of them will be hurtful to others, or to your cause. When I am considering what I can and/or feel I must say, I have learned to try to reduce it to the core principles. For example, human dignity. I believe in the inherent dignity of every human being, and that this dignity should be respected and preserved, really in almost all cases. Other examples might be the right to life, or human rights more broadly, as enshrined in the Universal Declaration of Human

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rights, for instance.

The person on the other side of the table may have a position which you completely disagree with in all aspects. They may behave in ways or hold beliefs that are totally reprehensible to you. But somewhere deep down inside almost everyone there is a core of shared humanity.

And if you can reach this, most of the time you can at least have a dialogue, even if it is to, at the end of the day, agree to disagree. This process will allow you to come to the table again, in the future, if there are other issues to be advocated for.

I will say that this is something that Family Medicine in particular can perhaps train us for – we are trained to listen.

Taking the time to think through, for yourself, what your core principles are is important. If you do this, then you can learn to take moments of calm, whenever possible, before you speak, to assess many different sources of information and opinions, to listen to others, and to see whether your position can be tested against the core values in which you believe. And also importantly to ensure that what you are about to say or do does not contradict your other core values as much as possible, recognizing that there might be a hierarchy in some cases.

As I said above, we will all make mistakes. When we do, we need to approach these with humility. But we must not allow the fear of the mistake to prevent us from acting.

We have taken an oath, formally or informally, to protect and improve health. We have a moral obligation to do this outside of the hallowed walls of the academy, the clinic or the hospital, as well as within.

i resist

By Anonymous

i bite my tongue over and over i tell myself, the metallic taste is sweet

you are silent because you are wrong i resist. i cross my arms as protection i tell myself, it is safer this way

you are still because you are weak i resist. i turn my back to hide my tears i tell myself, i need to think clearly

you are solemn because you are powerless i resist. one day i will have the right words. one day i will take the right stance. one day i will step forward. but for now, for today, i will stand right here. we will share space. i will show up. my existence is resistance.

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“Speak Out”

By Nikoo Aghaei, Class of 2027

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Unworthy

By Sabra Salim, Class of 2025

You pushed me on the playground today Blood seeping from my knees, tears in my eyes, fear in my heart, I asked for your atonement But instead of mercy you showed me anger As our teacher watched, ne’er did she console Instead she told me that if I cleaned myself of my blood, I’d receive the apology I sought So I scrubbed myself pristine, until the evidence of your violence was no longer and returned to you.

I asked for your atonement.

Though cleaner, i did not please.

Instead of mercy, you showed me anger and pushed me again.

To the teacher I returned She said maybe if I wiped the tears from my face that I’d receive the apology I sought So i dried my eyes, until the display of my pain was no longer and returned to you.

I asked for your atonement.

Though less pitiful, i did not please.

Instead of mercy, you showed me anger and pushed me again.

To the teacher I returned She said maybe if I smiled, that I’d receive the apology I sought.

So i masked my fear, filled my heart with a love i did not receive and returned to you.

I asked for your atonement Though filled with a pleading kindness, i did not please Instead of mercy, you showed me anger and pushed me again.

But this time I ran to the mirror to understand what you saw For some part of this image made me undeserving of your mercy

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“Hands of Liberation”

By Grace Ayoo, Class of 2026

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WOMEN IN

RESISTANCE Portraits and essays by Yvonne Tan, Class of 2026

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Gertrude B. Elion

Gertrude B. Elion was born in New York City to Robert Elion, a Lithuanian Jewish immigrant, and Bertha Cohen, a Polish immigrant. Her father had a dental practice and provided for the family; however, after having invested heavily in the stock market, they lost the majority of their wealth in the Wall Street Crash of 1929. Fortunately, she was able to attend Hunter College tuition-free, given her good grades.

After graduating from Hunter College, jobs were scarce and the few laboratory positions available were not accessible to women. Fortunately, following the shortage of chemists during World War II, she was able to get a job in a laboratory. However, it was not a job doing research – she did analytical quality control work for a major food company. After more than a year at this job, Elion left – she felt that it was too repetitive and she was no longer learning anything.

Instead, she took a position as a research assistant to Dr. George Hitchings.

In Dr. Hitchings’ laboratory, Elion helped develop drugs to treat leukemia and prevent kidney transplant rejection. Using the innovative new method of rational drug design, she helped develop drugs that interfered with unwanted cell growth to treat leukemia, gout, malaria, and a variety of other illnesses, including AZT, azathioprine, and acyclovir. She went on to win the 1988 Nobel Prize in Physiology or Medicine for this discovery, sharing the award with George H. Hitchings and Sir James Black. In her lifetime, Elion developed 45 different patents for her drug developments and discoveries in medicine.

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Rupa Bai Furdoonji Rupa Bai Furdoonji began her studies in 1885 as one of the few women enrolled at Hyderabad Medical College. Hyderabad was the capital city of a state in the south of India during a time of British rule. It was also the city in which Surgeon Major Edward Lawrie took charge as chief surgeon of Afzalgunj Hospital as well as Hyderabad Medical College.

Not only did he allow five women to enroll in medical courses, which was unheard of at the time, but Lawrie also popularized chloroform anesthesia and made his students proficient in administering it. Since teachers at the medical school were Englishmen and their lectures were in English, only by having an Urdu translator was Furdoonji able to obtain a degree of ‘Hakeem’ – equivalent to that of a medical doctor today.

Furdoonji later worked as a hospital anaesthesiologist where she administered chloroform to her patients. In 1909, she studied physics and chemistry at the University of Edinburgh before going on to earn a doctorate at Johns Hopkins Hospital in Baltimore and retiring in 1920.

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Ruby Hirose Ruby Hirose was born as Nisei, a generation of Japanese-Americans raised with both the Japanese culture of their immigrant parents at home and the American culture of the public school system. Growing up in a predominantly white community, however, Hirose often struggled with racial identity and discrimination. Despite these challenges, Hirose worked hard to earn bachelor’s and master’s degrees in pharmacology from the University of Washington before moving to the University of Cincinnati to complete her doctorate.

Following the attack on Pearl Harbor, President Roosevelt ordered the relocation of people of Japanese ancestry living along the West Coast, which affected Hirose’s father, brother and sister.

Hirose had fortunately moved east and was living in Ohio by that time, although widespread discrimination against Japanese-Americans continued throughout the country during this period.

Hirose nevertheless continued to contribute to important biochemistry and allergy research.

She conducted research on hay fever, also known as pollen allergy, discovering ways to improve pollen extracts to treat hay fever for patients such as herself. Hirose also published a paper on the anticatarrhal, antiinflammatory, and antiseptic qualities of Hydrastis canadensis, chronicling the history of the native North American plant and its use in Indigenous communities. Hirose’s hard work ultimately made her one of the 10 women recognized by the American Chemical Society in 1940 for accomplishments in chemistry.

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Dorothy Hodgkin

Dorothy Hodgkin was born in Cairo, Egypt, where her father, John Winter Crowfoot, was working in the Egyptian Education Service. She became interested in chemistry and in crystals around the age of 10, after which she fought hard to be allowed to join boys studying chemistry at school.

During the fourth year of her undergraduate chemistry degree at Oxford, she completed a research project investigating the crystal structure of dimethyl thallium halides, a project that catalyzed her career in crystallography. After graduating, Hodgkin completed a PhD in the crystallographic investigation of steroid crystals.

It was during her PhD that Hodgkin first visited a consultant about pain in her hands. Swelling in the knuckle joints had caused her hand to become deformed, a condition for which her doctor prescribed rest. Hodgkin, however, put this off in order to finish her experiments. A few years later, an infection triggered Hodgkin’s first attack of rheumatoid arthritis. After a couple weeks at a specialist clinic, however, Hodgkin returned to the lab. Despite her hands being so affected that she could no longer use the main switch of the x-ray equipment required in her experiments, she carried on with her research undeterred.

Hodgkin was eventually awarded the 1964 Nobel Prize in Chemistry for elucidating the atomic structure of important molecules such as penicillin and insulin using X-ray crystallography. Despite her worsening arthritis, Dorothy gave her time and expertise generously and enthusiastically.

She kept up with a demanding global schedule for the rest of her life, using a wheelchair to move between conferences when walking became increasingly difficult and painful.

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Rita Levi-Montalcini Rita Levi-Montalcini was born in Turin, Italy, to a father who strongly opposed women’s education beyond finishing school – in other words, school that taught etiquette and social graces rather than scholarship and academics. However, this attitude only fueled Levi-Montalcini’s ambitions.

At 20, she realized that she did not want to conform to her father’s expectations and asked for permission to pursue a professional career.

Levi-Montalcini began her studies in neurology and psychology, however, shortly following Mussolini’s 1938 Racial Laws forbidding non-Aryans from professional or academic career pursuits, she was kicked out of school. Levi-Montalcini built a laboratory in her bedroom, fashioning scalpels from sewing needles, using an ophthalmologist’s tiny scissors, and repurposing a watchmaker’s forceps. With these tools and inspired by an article she read by embryologist Viktor Hamburger, she dissected chick embryos and studied their motor neurons under a microscope.

Levi-Montalcini was eventually able to work with Hamburger and biochemist Stanley Cohen.

They discovered that mouse tumours spurred nerve growth when implanted into chick embryos, and traced this effect to what they then named nerve-growth factor (NGF). Levi-Montalcini, along with Hamburger and Cohen, shared the Nobel Prize for Physiology or Medicine in 1986.

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“Two shoes on the 25th”

By Imran Syed, Class of 2025

“One is a gift”

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“One is just a shoe”

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Medical Podcasts: Storytelling as a form of Resistance

By Pallavi Dutta, Class of 2026

True Crime is a genre that has defined podcasting for me. I would regularly listen to episodes about cold-blooded murders, missing persons cases, cons of the century and, of course, the cults. One can never forget about the cults. I took a lot of these stories at face value and commended the individuals who told their stories for their wisdom and courage. I also applauded the producers and hosts for shedding light on important topics and for giving a voice to those who have been silenced through the stories they chose. It is only until I entered the realm of medical true crime that my perspective started to expand beyond the storytelling value of podcasts. I also started to see the stories being told on podcasts as a form of resistance and an act of courage. In this piece, I aim to explore how the podcasts “The Retrievals” and “Exposed: Cover-up at Columbia University” are redefining the frontier of resistance in medicine.

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Exposed: Cover-up at Columbia University is another true crime podcast that tells the story of women speaking up. This time, against a former OBGYN who was sexually assaulting women during examination.

When the women spoke up, they were brushed off. Not only by the clinic, but also at an institutional level, whereby the university failed to turn over key evidence during the investigation and swept the misconduct under the rug. To stand up against such a powerful institution was a form of resistance. To hold an institution accountable despite their willful ignorance and lack of transparency is a form of resistance. To refuse to uphold the status quo where mistreatment, particularly against women, continues to persist was a form of resistance. For all the women involved, to continue to tell their stories is a form of resistance. What is striking in both the podcasts is the lack of institutional responsibility. By demonstrating the utmost courage in speaking up and resisting institutional dismissal, the women challenged a patriarchal medical system that has historically disparaged women’s pain and experiences.

The Retrievals tells the story of women who came to the Yale clinic to seek fertility treatment. The women came in with a sense of hope and anticipation but left with excruciating pain. The pain that the women felt was continuously dismissed and there were no answers for months. But as the number of women experiencing pain continued to rise and a patient suspected a nurse of pocketing fentanyl, an investigation ensued. So, what was going on? As it turns out, a nurse at the clinic was switching out the fentanyl for saline water. And though, the story is more complex as it involves the vicious cycle of substance use disorder, this ultimately meant that the ‘fentanyl’ that the women were receiving for their pain was not actually being delivered to them. A federal investigation was conducted and over 200 women were found to have been impacted.

When inflicted with pain, speaking up was a form of resistance. When their experiences were dismissed, continuing to speak up was a form of resistance. And when the women chose to go public and tell their stories, that was also a form of resistance.

These two podcasts tell important stories of resistance and serve as a hopeful reminder that continuing to tell our stories can have an impact and, slowly but surely, move the needle forward.

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“Advocacy in our Twenties”

By Pallavi Dutta, Class of 2026

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“Chai in Our Twenties” is a podcast series featuring co-hosts Pallavi and Sharon, dedicated to sharing the distinctive perspectives of South Asian-Canadian women. Our platform serves as a space to discuss relatable topics that resonate with us as first-generation immigrants, and we extend it to showcase the stories of others by featuring them as guests. Throughout this series, our aim is to present unique and approachable voices, fostering a community where people can learn and grow alongside us as we explore various topics of interest.

In a recent episode, we delved into the theme of Advocacy in our 20s. Recognizing the challenges in the world, we sought to underscore the significance of advocacy and its diverse dimensions. Our conversation spanned topics such as the meaning of advocacy, women’s health, climate justice, and the questioning of institutional norms.

Emphasizing the importance of listening and utilizing our voices, we explored how advocacy can lead to actionable and longlasting changes. We invite you to enjoy this episode and explore any of our other discussions that you may find relatable.

Thank you for tuning in!

- Pallavi & Sharon -

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Hope in the Dark

REDUX

By Tony Hu, Class of 2026

“I’ve felt this way before.”

Ms. X shared with me how she wanted to return to China when her mother fell ill, to care for her. However, given Ms. X’s lack of status, leaving for China meant that Ms. X might not be allowed to re-enter Canada to see her daughter. Faced with an impossible choice, Ms. X chose to stay in Canada.

Tragically, her mother died in China without seeing Ms. X.

That’s what I thought after logging out of the Society of Graduate and Professional Students (SGPS) November 2023 Council meeting.

If you applied to the MD program at the Temerty Faculty of Medicine at the University of Toronto (U of T) for admission starting Fall 2022, you might recognize the title Hope in the Dark by Rebecca Solnit.

Before this interaction, I had worked for almost a year with the Chinese Canadian National Council Toronto Chapter, a Toronto-based non-profit organization, working to advocate for social and economic justice. I had hope that even if I did not see immediate nor momentous changes, I was making the world a better place. Yet, here was someone who could not have their situation changed. Ms. X would never see her mother again.

In Hope in the Dark, Rebecca Solnit writes, “Hope locates itself in the premises that we don’t know what will happen and that in the spaciousness of uncertainty is room to act…

It’s the belief that what we do matters even though how and when it may matter, who and what it may impact, are not things we can know beforehand.”

After this interaction, I felt guilty for having hope when others didn’t. I was upset that I expected everyone to have hope despite people living through experiences I couldn’t even begin to imagine. I was angry that the changes I was advocating for could not have come sooner for Ms. X.

For my application to U of T, I wrote in response to this quotation, reflecting on my experience encountering Ms. X. Ms. X was an undocumented frontline worker who I met as part of a project collecting frontline worker’s stories during the pandemic. The project, Our Lives Are Essential: Chinese Canadian Frontline Workers Pandemic Report, is available online. Ms. X described taking three buses to get to work every day and taking three buses to get back home. She told me she made $10 an hour, less than the legal minimum wage in Ontario. After overstaying her visa to take care of her daughter who has a chronic illness, Ms. X became undocumented. Ms. X lived in constant fear of the police, fear of getting evicted by her landlord, and fear of contracting COVID-19.

I’ve felt this way before. Before the SGPS meeting, a year or two ago. When I interviewed Ms. X. At the SGPS November 2023 Council meeting, two contentious issues arose.

The first was a recommendation from a Senate subcommittee to remove God Save the King from convocation, and, separately, to remove O Canada from convocation. SGPS Council representatives felt okay about removing God Save the King, but some representatives felt incredulous about

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removing O Canada. Why in the world would anyone want to remove O Canada from convocation?

For context: On Dominion Day (now called Canada Day), 1923, the Chinese Immigration Act was passed, banning the entry of virtually all Chinese immigrants for 24 years. In the immediate aftermath, many Chinese Canadians referred to this day as “Humiliation Day” and refused to join in its celebrations for many years. The Chinese Immigration Act, also known as the Chinese Exclusion Act, is just one example of a long history of settler colonialism and white supremacy on the land that is now called Canada, a history that endures to this day. Decades earlier, over 15 000 Chinese labourers worked on the Canadian Pacific Railway (CPR), connecting eastern Canada to western Canada. This is sometimes touted by conservatives as one of the great nation-building feats of Sir John A. MacDonald, the first Canadian prime minister.

But this rosy view obscures the reality of the abhorrent antiAsian racism faced by Chinese labourers, the corpses of over 600 Chinese labourers who died working on the CPR, and the instrumental role the CPR played in allowing settlers to dispossess Indigenous peoples—laying the foundation for the institutionalized cultural genocide committed against Indigenous peoples.

Many people, myself included, would like to see O Canada removed from convocation. Only, I felt I should not speak up.

Although I am an elected member of the five-person SGPS executive team, SGPS Council representatives collectively hold the power to remove me from my position. I was afraid that by criticizing the dominant view in that space, I would start a controversy that could cause me to lose my position.

A second issue was the SGPS’ statement on the conflict in the Middle East. Israel-Palestine has long been a contentious issue, especially in the post-secondary education sector. I was a student at the University of Toronto when the search for a new director of the law school’s International Human Rights Program (IHRP) led to considerable controversy. The IHRP hiring committee had selected Dr. Valentina Azarova, an international law practitioner who has written widely on Israel-Palestinian affairs, as the preferred candidate.

The hiring process was abruptly aborted following concerns by a sitting judge and donor over Dr. Azarova’s academic work on human rights in Israel and Palestine. The judge, identified as Justice David E. Spiro of the Tax Court of Canada and former director at the Centre for Israel and Jewish Affairs (CIJA), discussed concerns about Dr. Azarova’s published work on Israel with an Assistant Vice President at U of T. Justice Spiro himself was entrusted by a staff member of an organization at which he had been a director prior to his appointment to the bench, presumably the CIJA. The

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subject line of the email communication between Justice Spiro and the staff member is striking: “U of T pending appointment of major anti-Israel activist to important law school position.” The email goes on to request if “someone could quietly find out the current status” of the job search, hoping that “through quiet discussions, top university officials will realize that this appointment is academically unworthy, and that a public protest campaign will do major damage to the university, including in fundraising.”

Instead of respecting the confidentiality of hiring decisions, a chain of events led to the then-Dean of the law school disqualifying Dr. Azarova’s candidacy, defying the unanimous decision of the IHRP hiring committee. Vincent Wong, who has also formerly worked at the Chinese Canadian National Council Toronto Chapter, and served on the hiring committee for the new IHRP director, wrote a great piece about this row entitled What the IHRP Hiring Scandal Tells Us About Intersectional Privilege in Canadian Legal Institutions, also available online and worth a read.

In it, Wong writes, “the consequences speak for themselves: Dr. Azarova has still lost her job; I as a person of colour have lost my job in order to truthfully bring details of this incident to light; Palestinian rights and international law with respect to the Israel/Palestine situation are now demonstrably a taboo subject in the law school; and the powerful white men who are at the heart of this impropriety have thus far escaped any sort of formal accountability.”

In the SGPS’ case, the executive received feedback that the original use of “occupied Palestinian territories” in the statement was too political and too provocative. “Gaza” was more neutral, and Gaza was the language used in the final statement.

In both cases, I wanted to speak but I felt silenced. The current state of discourse on Israel and Palestine reveals the complexity involved in speaking your mind on important issues. Even when one speaks with a clear conscience, with calculated, reasoned, and thoughtful arguments, the fear of backlash and vitriol cannot be eliminated. This is why many people do not say anything. Behind the scenes, in meetings of decision-makers, censorship, complicity, and silence reign.

Yet for millions of people, silence is not an option. Lives are on the line.

Professionalism begets apathy. Doctors and doctors-to-be are inculcated with norms of acceptable behaviour and unacceptable behaviour. In the face of mounting injustice, it is easy to keep silent. It is far harder to speak with courage to challenge oppression in all its forms. Resistance in medicine is a response to a culture of complicity in medicine.

Dr. Gisella Perl: A Story of Resistance in Medicine During the Holocaust

By Alex Pipchuk, Class of 2027

W

hen we reflect on the role of doctors during the Holocaust, we most often think of human experimentation, complicity with Nazi doctrine, and other forms of medical cruelty.

Equally, however, there are also stories to be told of courage and resistance, particularly among those physicians who were held prisoner in the Nazi extermination camps.

Dr. Gisella Perl was born in 1907 to a Hungarian-Jewish family in the town of Sighetu Marmației (presentday Romania). She graduated from secondary school first in her class and became the first Jewish woman admitted to Cluj-Napoca Medical School in Kolozsvar, where she trained as a gynaecologist. After completing her training, Perl returned to her hometown to establish a successful practice and settle down with family.

When the Nazis invaded Hungary in 1944, Perl was deported to Auschwitz-Birkenau alongside ~400,000 other Hungarian Jews. She was identified as a physician and assigned to operate a hospital in ‘Block C’, which housed 32,000 female prisoners. Alongside a team of 4 other physicians and 4 nurses, Perl made use of scant resources to provide care for an “unholy medley” of diseases including typhoid, pneumonia, malaria, scarlet fever, and infectious skin conditions.

Perl soon discovered that to be pregnant in Auschwitz was a death sentence – both mother and child were sent to the crematory, perhaps after being subjected to cruel experimentation at the hands of SS officer Josef Mengele. In the face of this reality, Dr. Perl resolved to do what she could to save her expectant patients. There was no chance of successfully hiding and nurturing an infant in Auschwitz; in order to save the life of a mother, the life of a child was to be taken.

On dark nights, in the hidden corners of Auschwitz, Dr. Perl would induce labour in her patients and provide care for them during the delivery. She performed these procedures under unsanitary conditions without water or instruments, using only her fingers to rupture the amniotic membrane and produce dilations. Always the deliveries were rushed – morning roll call in Block C began at 4am, and discovery of these procedures by the camp guards would have invariably led to the death of both Dr. Perl and her patient.

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“We were given no medicines, no bandages except for a few rolls of paper bandages, no instruments.

The fever-ridden patients shivered on the bare planks without blankets; lice crawled over their bodies carrying germs from one to the other.”

- Gisella Perl, “I Was a Doctor in Auschwitz”

Aided by the formless garb worn by prisoners and widespread stomach bloating caused by undernourishment, Perl actively hid the condition of pregnant woman by bandaging their abdomen, admitting them to the hospital under false diagnoses, and positioning herself to shield their bodies with hers during roll call. She began her efforts by delivering the 9-month pregnancies, before continuing to abort pregnancies in earlier stages. If the fetus survived delivery, Perl was forced to strangle the child and hide the body amidst “a mountain of corpses waiting to be cremated”.

“No one will ever know what it meant to me to destroy these babies. After years and years of medical practice, childbirth was still to me the most beautiful, the greatest miracle of nature. I loved those newborn babies not as a doctor but as a mother and it was again and again my own child whom I killed to save the life of a woman.”

- Gisella Perl, “I Was a Doctor in Auschwitz”

Ultimately, Perl succeeded in delivering countless pregnancies without a fatal incident, saving many women from a certain death sentence. In the winter of 1945, she would be sent from Auschwitz to another forced labour camp in Hamburg, and subsequently to Bergen-Belsen. Throughout her time in these camps, Perl would continue to treat patients to the best of her ability under difficult conditions and with limited resources.

represent a limit-case of this phenomenon; no matter the situation, there are always ways in which a doctor can do a little more right by their patients. The modern practitioner may think to her story as a reminder to identify these opportunities, not only under the most difficult of circumstances but also in their everyday practice. If we can demonstrate the courage to consistently recognize and act on these chances, we may better serve our patients in some comparatively small way.

On April 15th, the day of her liberation, Perl delivered the first free-born child of BergenBelsen – a child whose life she would not have to take. She approached the first British and Canadian troops to enter the camp to ask for water and antiseptic, which she then used to preserve the life of the new mother.

“‘Listen to me’ I called to them.

‘Do not be afraid! This is only a disinfection center, nothing will happen to you here. Afterwards we’ll be put to work, we’ll all remain together, friends, sisters in our common fate. I am your doctor. I’ll stay with you, always, to take care of you, to protect you.’”

After gaining her freedom, Dr. Perl participated in the rehabilitation efforts at Bergen-Belsen before emigrating to the United States. In 1948, she would return to work as a physician in labour and delivery at Mount Sinai Hospital in New York, where she specialized in the treatment of infertility and ultimately delivered more than 3,000 babies.

- Gisella Perl, “I Was a Doctor in Auschwitz”

Even under the worst imaginable circumstances, physicians are blessed with opportunities to go above and beyond in the service of others. The actions of Gisella Perl

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“Spring”

By Cheryl Jiayi Xing, Class of 2027

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HEALTH C A R E

&

HUMAN RIGHTS

By Jasmine Dhatt & Jose Navarro, Class of 2026

H

ealthcare is inextricable from human rights. This has never been so relevant.

how can we learn how to do this better?

Now more than ever, we are aware that practicing medicine is not only a science, but an art. To wield the paintbrush that is medicine, the best artists remember that you cannot use the same colours for every picture.

We see this in class when we work through cases; the patient is placed in the context of their social setting. In the first week of medical school, we learn to take a social history. The precedent is this: we cannot treat people if we do not consider more than their disease. However, there are endless things that impact a person beyond the most frequently discussed issues. So who are the voices we don’t hear? The people we don’t consider? Are they a silent minority? Or are they simply forgotten?

Whose stories are unheard, unshared, unknown?

To tread along with someone through their deepest concerns is an advanced swimmer’s skill. You can easily drown by focusing on the wrong things at the wrong time — by simply not listening, not wondering, but assuming. The HHRC helped humanize topics; it reminded us that people with complex experiences are still people. Only they get to decide how much their experiences define them.

The topic of the 22nd Annual Health and Human Rights Conference (HHRC) was Stigmatization in Healthcare. We discussed sexual violence, Indigenous health, and abortion care, topics so complex in their own entity brought together in a room where we could merely graze the surface of their depths. These human experiences, closely tied to the health care setting, demand attention beyond the science. But

A common thread throughout the conference was a call to a perspective shift: why is it that we often focus exclusively on the trauma experienced by equity-deserving groups? So quick are we as healthcare providers to rush to aid that we forget to appreciate the resilience in our patients. If we only view marginalized groups as struggling in the margins, are we not advancing a paternalistic approach

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to medicine? We forget that our patients are also strong. We are called upon to tap into the patient’s power, courage, and resolve, first to respect their dignity but also to ensure we are swimming alongside them, not dragging them through currents they do not want to traverse.

The HHRC spread awareness about varied topics, highlighting community resources and inviting attendees to be curious and have conversations about the interconnectedness of health and human rights. While the culture of medicine is changing for the better, the HHRC affords students a place to learn about the voices that may go unheard in the formal curriculum. There are vast improvements to be made to medical education so that these perspectives are not just “for-interest only.” The HHRC is a starting place to view healthcare in the globalized sphere and discuss the commitment healthcare makes to human rights. Beyond awareness is the necessity of action. It is our hope that, with the growing body of initiatives like the HHRC in the dimension of healthcare, we become incensed to not only reflect on disparities but act on them.

~

“Hanging up the stethoscope”

By Frank Chen, Class of 2026

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“United In Grief”

By Sarvesh Ramlochun, Class of 2027

Make peace with what’s within Wash away the injustice Wipe away the tears After winter comes the spring

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Poem and artwork by Anonymous

Although seemingly insignificant, I have always kept a small piece of paper in the back of my phone case. A fortune, destined to bestow luck, wisdom, or fate.

Previous renditions have included:

“You will travel to many exotic places”, “An exciting opportunity lies ahead”, and “Your hard work will soon be rewarded.”

Despite being generic messages constructed for the masses, I have always found a personal connection to these little words of wisdom.

An illusion (… or perhaps a delusion?), where each fortune seems to fit within a context relevant to my current life or future aspirations.

I close my eyes and circle my hand around the pile. I reach down and grab the thin plastic, eager to see what lies inside. I open the packaging, place my hands on either side and carefully break the cookie.

“Even the smallest candle burns brighter in the dark.”

I eat the cookie and tuck the message into the back of my phone case, completing the ritual.

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This fortune speaks to the idea that every individual, regardless of their perceived status or influence, possesses an innate strength that can illuminate even the darkest of times. It serves as a reminder that your voice matters and that every action, no matter how small, can lead to change.

It highlights the essence of resilience and opposition in the face of oppression, censorship and adversity. It also reminds us that even when faced with the darkest moments, the smallest acts of perseverance can emanate a light that transcends the shadows of darkness.

Despite how hard the darkness tries to silence and subdue our spirit, to put out the flame, our courageous light challenges it. The small candle in the fortune parallels the enduring human spirit and reminds us to embrace the belief that our smallest efforts, our strength, and our determination can indeed burn brighter in the dark.

And so, until the time for my next ritual comes, I cherish this slip of paper and the silent pact I have made with the universe. Its meaning represents fate, wisdom or a mere illusion still unbeknownst to me. Nonetheless, it inspires me to lead each day with the steadfast belief that even the smallest spark has the power to illuminate my surrounding world.

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“Rolling through the grass, shading out the trees, looking through a glass.”

By Sarvesh Ramlochun, Class of 2027

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A POEM FOR CHANGE

By Benjamin Divito, Class of 2026

The bitter wind whips through the falling leaves, slicing up the colourful landscape with threads of icy cold.

The looming winter hangs over the gentle fall, still clinging tightly onto the life of summer growth.

What separates the warmth of fall from the cold of winter? When do the leaves begin to fall and die?

The winter chill hardens the ground and chokes the roots, stalling growth and forcing life away.

Rabbits burrow, birds fly, squirrels nest; the world hides away from the cold.

Must I lose my warmth too? When will my leaves change their colours and wither away?

Underneath the falling snow, the decaying leaves, the frozen earth, lies dormant life.

Deep roots wait through winter storms, rising into the warmth of spring to bring new life.

Let me never forget the spring.

Let my darkest moments never sever my roots.

Let the pain of past winters never lessen my warmth.

Let me change the cycle that came before me.

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Opinion by Zier Zhou, Class of 2027 | Artwork by Precious Adekoya, Class of 2027

STILL ALICE: a n u n forg et t a b l e f i l m abo ut liv i n g w it h A l z h eimer ' s

A

lzheimer’s targets the brain, yet it is one of the most heartbreaking diseases.

It does more than break down one’s physicality and cognitive capacity — it tears at the core of their identity. It also intensifies any plot. Based on Lisa Genova’s novel, Still Alice is an unforgettable film that follows one patient’s experience with Alzheimer’s disease. This year marks the movie’s 10th anniversary, which gives reason to revisit this timeless story.

familial Alzheimer’s, meaning this is only the beginning to a difficult end.

When her daughter asks what it’s like, Alice reflects on her uncomfortable experience: “I’ve always been so defined by my intellect, my language, my articulation and now sometimes I can see the words hanging in front of me and I can’t reach them, and I don’t know who I am. And I don’t know what I’m going to lose next.”

This line has always stood out to me. By connecting a less familiar experience of Alzheimer’s with the universal feeling of insecurity, it’s much easier for us to empathize with Alice.

Alice, a middle-aged woman, lives a comfortable life with her husband in New York City. She has three children who are all grown up. She takes pride in her career as a linguistics professor at Columbia. All is well until she loses her train of thought in a lecture one morning. A visit to the neurologist results in a diagnosis of early-onset

Universal values of family and career are

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further emphasized in the film, as everything Alice has worked so hard to create for her life is threatened by this disease. It’s clear she hates that her sense of independence and identity is fading away each day. As her condition deteriorates, however, she still resists its effects in different ways. Although nothing Alice does can reverse this situation, her human reactions are what makes the movie so compelling.

Feelings of shame and frustration are pervasive in the scenes that show Alzheimer’s interfering with Alice’s life. She forgets important objects such as her phone in the freezer. She cries when she cannot find the bathroom in her own house. After missing a dinner party, she even admits: “I wish I had cancer. People wear pink ribbons for you and go on long walks. I wouldn’t have to feel like a social... I can’t remember the word.”

On better days, Alice lives in the moment and enjoys holiday celebrations with her family.

To exercise her memory, she scribbles down random words on her fridge to check whether

she still remembers them minutes later. On the other hand, however, Alice is aware that one day she’ll no longer be able to answer simple questions about her own life. That’s when she’ll know she’s no longer herself.

To gain some control over her circumstances, she records a video instructing her future self to take her life once that day arrives. Again, I don’t think viewers have to be like Alice to grasp the mental and emotional pain that’s causing her to take such drastic measures.

Understandably, the gradual process of losing everything she values, including her identity, forces her to confront the question of whether to end it all.

Still Alice is a sad film, but surely worth watching. It highlights the meaningful aspects of living by showing what happens when those are gone. For Alice, she resists her Alzheimer’s by letting out her negative emotions, holding onto what her mind still can, and planning to let go once she decides it’s time. Even the title Still Alice reflects her resistance, and will to hold onto her own identity.

Despite being a work of fiction, Still Alice captures the real-life impacts of neurodegenerative decline on people, their families, and the memories that make up who they are. I’m glad this film exists to provide a fuller view of a very human story, without defining the patient by their diagnosis or confining their experience to the hospital.

As future physicians, keeping the bigger picture in mind, beyond medical details, is key to understanding patients as they tell us their own stories.

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By Michele Zaman, Class of 2025

By Michele Zaman, Class of 2025

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The sourest lemons that life has to offer

By Yalinie Kulandaivelu, Class of 2026

G

rief is a universal human experience. No one leaves this life alive, therefore none of us leave untouched by grief.

Grief happens when one loses a spouse, a parent, a child, a sibling, a friend. Grief also happens when one experiences the loss of a life dreamed of: of children that have not come and will never come. We may want to forget the grief and forget the memories, because forgetting is easier than remembering and realizing what no longer is or no longer will be.

We may also choose to put our grief aside, and not necessarily forget it, but file it away on a shelf or cupboard so we can make the space to experience new events and emotions and live our new reality. Grief may ebb and flow, you may carry it better because of the strength you have developed, but it may never get easier.

Much has been written about grief, how it changes us forever, it literally rewires the brain, changes how we make meaning in life, and effectively alters the course of our lives. However, I’d like to focus here on how we choose resistance in the face of grief. One of the ways grief can cause us such acute pain is by taking away some of our agency in life. The loss feels as if it has happened to us like a storm wreaking havoc. In the aftermath, we may choose between leaving the wreckage of the storm as it is and revisiting it as a monument to what happened. Or we may choose to clear away the wreckage and rebuild what was there, maybe slightly differently and maybe a little stronger. Or we may choose any combination of the two, building around the wreckage of the storm or using it to design our new blueprint.

When the time is right and we are ready, I’d like to think that many of us would choose to rebuild in some way, as a way of taking back some of our agency.

Taking back agency may look like a thousand different things to different people. It may be art, it may be gardening, it may be puzzles, it may be carpentry, something entirely different or something completely the same. Focusing and/or learning a new craft or art rewires the brain as well, but through a stimulus of our choosing. We need not be masters of our craft or art, and nor does the art or craft need to center or pay homage to the loss. It is simply our way of reshaping our lives after a loss. Whichever form of resistance we choose against our grief, I hope we always remember that it is not meant to take the place of who or what we lost. It may not reduce the grief and likely will not make it easier, but it might help you feel more like you. Not the same you as before the loss, but similar and more familiar. The grief will still be there, but it might look more like shadows rather than darkness engulfing your world. I hope that when you are ready, you choose your resistance in the face of grief.

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?

I

ask you that same stupid question you’ve been asked one hundred times and will be asked one hundred more You’ve rehearsed

Of course you’re sure You wouldn’t tell me if you weren’t I haven’t earned that, I realize I am someone you put off speaking to You’ve slowly laid this foundation I noticed I think I knew enough to avoid your calls I ask you what’s next Lots but not that When Months you think

stupid questions

I ask you to take things slow What’s another day Thousands too many when all you’ve known is slow

By Benjamin Larocque, Class of 2026

I ask you to be careful like I always do This time I mean it Do you know what this world– Of course you know Your friends Your family Your doctor and me I blur these roles and another Liar They ask me why you hide and so I hide I didn’t ask for this Can I handle what you’ve asked of me Of course I must I speak so you don’t have to Now it is their turn to be strong for you

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Photographed by Frank Chen, Class of 2026 & Alice Li, Class of 2027

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,

,

,

,

,

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INDEX REFERENCES: OTHER. PLEASE SPECIFY. (PAGE 14) 1. Indigenous Services Canada. (2023, March 24). Indigenous Services Canada: 2023-24 departmental plan. Retrieved December 17, 2023 from https://www.sac-isc.gc.ca/eng/1666289629121/1666289645 507 2. Statistics Canada. (2023, September 13). Top Five highlights from a new report on the health of Canadians, 2023. The Daily. Retrieved December 17, 2023 from https://www150.statcan.gc.ca/n1/daily-quotidien/230913/dq230913b-eng.htm

REFERENCES: THE CRY OF A GHAZALLE (PAGE 37) 1. Agha Shahid Ali, Call Me Ishmael Tonight: A Book of Ghazals. New York: W.W. Norton & Company Inc., 2003 2. Agha, Shahid Ali. Ravishing Disunities: Real Ghazals in English. Middletown: Wesleyan University Press, 2000.

3. Hashmi, Shadab Zeest. Ghazal Cosmopolitan: Ghazals and Essays on the Culture & Craft of the Ghazal. Jacar Press, 2017.

4. Pritchett, Frances W. “Overview of the Genre.” A Desertful of Roses: The Urdu Ghazals of Mirza Asadullah Khan “Ghalib.” Columbia University. Web. January 21, 2024.

REFERENCES: DR. GISELLA PERL (PAGES 67-68) 1. Perl G. I was a doctor in Auschwitz. Madison, CT: International Universities Press; 1948.

2. Weisz GM, Kwiet K. Managing Pregnancy in Nazi Concentration Camps: The Role of Two Jewish Doctors. Rambam Maimonides Med J. 2018 Jul 30;9(3):e0026. doi: 10.5041/ RMMJ.10347. PMID: 30089088; PMCID: PMC6115479.

3. Brozan N. Out of Death, a Zest for Life. The New York Times. Nov 15, 1982. [accessed Jan 07, 2024]. Available at: https://nyti.ms/2MSMhJ3.

4. www.auschwitz.org. (n.d.). Prisoner doctors. Prisoner doctors / Camp hospitals / History / Auschwitz-Birkenau. https://www.auschwitz.org/en/history/camp-hospitals/prisoner-doctors/ 5. Kronemeyer, A. (2015). Doctors of the Holocaust: An Examination of Both SS and Prisoner Doctors.

6. United States Holocaust Memorial Museum. (n.d.). United States holocaust memorial museum. https://encyclopedia.ushmm.org/content/en/timeline-event/holocaust/1942-1945/deportation-of-hungarian-jews

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ACKNOWLEDGEMENTS & SPECIAL THANKS Goat Ridge Farm @goatridgefarm

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OUR TEAM Editors-in-Chief

Design

Omar I. Hajjaj, 2026

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Omar I. Hajjaj, 2026

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Contributors Precious Adekoya, 2027

Dr. Eva Purkey, physician

Nikoo Aghaei, 2027

Prashanth Rajasekar, 2025

Simryn Atwal, 2026

Sarvesh Ramlochun, 2027

Grace Ayoo, 2026

Sabra Salim, 2025

Joshua Bierbrier, 2026

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Dr. Jamaica Cass, physician

Priyanjli Sharma, 2026

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Yvonne Tan, 2026

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Omar I. Hajjaj, 2026

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Tony Hu, 2026

Bonnie Yang, 2027

Mudia Iyayi, 2026

Michele Zaman, 2025

Yalinie Kulandaivelu, 2026

Zier Zhou, 2027

Benjamin Larocque, 2026

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