March 2014

The box that jump-started emergency medicine MD game apps

MEDICINE ON THE MOVE

+

CANADIAN PUBLICATIONS MAIL SALES PRODUCT AGREEMENT No. 40063504

MARCH 2014

EUROPE Medieval magic in Albi France Find amore along Italy’s Amalfi coast In Flanders Fields 100 years later England’s Atlantic links

10

ACCESS CODE: drcme

BEST Free art from Istanbul to Reykjavik

for your chance to win a $100 gift card from Atmosphere

NEW

The speed of 2 or 3 day dosing

in Actinic Keratosis is here

Picato® Gel (ingenol mebutate) is indicated for topical treatment of non-hyperkeratotic, non-hypertrophic actinic keratosis (AK) in adults.

Relevant Warnings & Precautions • Severe Local Skin Responses (LSRs) including erythema, flaking/scaling, crusting, swelling, vesiculation/pustulation, and erosion/ulceration can occur after topical application • Severe eye disorders, including periorbital edema, eyelid edema, eye edema, eye pain, and eyelid ptosis, occurred more frequently in patients treated with Picato® Gel than vehicle, and may result from spreading of application site edema • Administration of Picato® Gel is not recommended until the skin is healed from treatment with any previous medicinal product or surgical treatment • Contact with skin outside the treatment area should be avoided • Picato® Gel is for topical use only but should not be used near the eyes, on the inside of the nostrils, on the inside of the ears, or on the lips • Picato® Gel must not be ingested • Avoid the use of Picato® Gel during pregnancy • Nursing mothers should avoid physical contact between her newborn/infant and the treated area for 6 hours after application • The efficacy of Picato® Gel in the prevention of squamous cell carcinoma (SCC) associated with actinic keratosis (AK) has not been studied • Clinical data on re-treatment and treatment of more than one area is not available • Clinical data on treatment in immunocompromised patients is not available

Demonstrated efficacy Median % reduction in lesion count at day 57:1 for face and scalp - 87% (study 1) and 83% (study 2)* for trunk and extremities - 75% (study 3) and 69% (study 4)†

Complete clearance at day 57:1 for face and scalp; 47% for Picato® Gel vs. 5% for placebo gel (study 1) and 37% for Picato® Gel vs. 2% for placebo gel (study 2) (p<0.001)* for trunk and extremities; 42% for Picato® Gel vs. 5% for placebo gel (study 3) and 28% for Picato® Gel vs. 5% for placebo gel (study 4) (p<0.001)†

Once daily dosing: 3 days - face & scalp, 2 days - trunk & extremities For more information Please consult the product monograph at www.leo-pharma.ca/picato_pm for important information relating to adverse reactions, drug interactions, and dosing information which have not been discussed in this piece.

The product monograph is also available by contacting LEO Pharma Medical Information at 1-800-263-4218.

1. Picato® product monograph, January 30 2013. *Two multi-centre, double-blind, randomized, parallel-group, vehicle-controlled, clinical studies of AK patients evaluating the efficacy and safety of Picato® Gel 0.015% applied once daily on the face or scalp to a 25cm2 area of skin for 3 consecutive days in adult patients. Efficacy measurements included

®Registered trademark of LEO Pharma A/S used under license and distributed by LEO Pharma Inc., 123 Commerce Valley Dr. E., Suite 400, Thornhill, Ontario L3T 7W8

complete clearance rate and median percent reduction compared to vehicle control assessed at day 57 in Study 1 (PEP005-025) (Picato® Gel N=142, Placebo Gel N=136) and Study 2 (PEP005-016) (Picato® Gel N=135, Placebo Gel N=134) (8 weeks). †Two multi-centre, double-blind, randomized, parallel-group, vehiclecontrolled, clinical studies of AK patients evaluating the efficacy and safety of Picato® Gel 0.05% applied once daily on trunk and extremities to a 25cm2 area of skin for 2 consecutive days in adult patients. Efficacy measurements included complete clearance rate and median percent reduction compared to vehicle control assessed at day 57 in Study 3 (PEP005-028) (Picato® Gel N=100, Placebo Gel N=103) and Study 4 (PEP005-014) (Picato® Gel N=126, Placebo Gel N=129) (8 weeks).

www.leo-pharma.ca

Gone fishin’

CRISTAL TRAN / SHUTTERSTOCK.COM

There’s an article in this issue with some tasty seafood recipes: Fishing for compliments (page 59). Humans have been consuming fish since the beginning of time, but these days the subject raises questions.

The first has to do with sustainability and the article’s author, Cree LeFavour, and the editors have gone to considerable lengths to ensure that the fish and shrimp mentioned here are, indeed, sustainable. Problem is that some sources say they are, others that they’re not. If you’d like to do a little research on your own, turn to “Hooked for More?” on page 62, follow the links and come to your own conclusion.

Question number two: is Pacific-caught fish radioactive? When, in March 2011, Japan’s Fukushima nuclear power plant suffered a meltdown in three of its six reactors following an earthquake, utility officials and the government downplayed the radiation risks. That was a mistake. Since then there has been nothing but bad news.

Last fall, for example, it was revealed that one of the massive tanks full of seawater used to cool the damaged reactors was leaking. Three-hundred tons (272,152 litres) of contaminated water are pouring into the sea each day — enough to fill an Olympic-size swimming pool every eight days.

This ignited new concerns among consumers of West Coast-caught fish about radioactive levels. Also worrying is that the number of tanks which store the contaminated seawater is growing. The tanks will sit there until the day when the water can be cleaned and returned to the ocean.

With each new revelation, public alarm grows. The truth is we should not fear radiation in Pacific seafood. A recent peer-reviewed study published in the Proceedings of the National Academy of Sciences evaluated the health risks of consuming Pacific bluefin tuna (the fish most susceptible to radioactive accumulation) after the Fukushima event and found the following: a 200-gram serving of bluefin tuna contains about five percent of the radiation you would get from eating one uncontaminated banana and absorbing its naturally occurring radiation. Even at very high intakes (about 350 grams of contaminated bluefin tuna a day) for an entire year, you’d still receive only 12 percent of the radiation you’re exposed to during one cross-country flight from Halifax to Vancouver.

One other thing: huge numbers of starfish from Alaska to San Diego are “turning to goo” from a yet-to-be-explained infection. What’s that about?

It’s enough to make you wonder.

May this issue of the magazine provide some respite from these troubling questions: it’s all about holidaying in Europe.

Visit

doctorsreview.com David Elkins, Publisher delkins@parkpub.com

Like

facebook.com/doctorsreview

Follow

@doctorsreview MARCH 2014 • Doctor’s

Review

1

Your banking should be as personalized as your patient care.

Specialized banking advice for your practice.

Your expert advice helps your patients stay healthy.

TD Business Banking Specialists work with you to help keep your business just as healthy with product expertise and specialized banking advice. And because weâ&#x20AC;&#x2122;re open earlier, open later and even on Sundays,* you can get the advice you need, on your time.

Because a healthy practice deserves specialized care.

Visit tdcanadatrust.com/doctors or call 1-888-679-4808 *Individual branch hours vary. 400 branches are open Sundays. ÂŽ The TD logo and other trade-marks are the property of The Toronto-Dominion Bank.

contents MARCH 2014

EKATERINA POKROVSKY / SHUTTERSTOCK.COM

features 28

All eyes on Italy Make Sorrento your base for day trips through one of the world’s most beautiful coastlines

by Gerald Fitzpatrick

34

Field focus As WWI turns 100, we explore what Belgium’s Flanders Fields are like today

by Susan MacCallum-Whitcomb

40

Aim for the sky Golf tees and good pasties along UK’s coasts of Cornwall and Devon

by Anita Draycott

28 46

A free show 10 museums in Europe that charge absolutely nothing

by Will Coldwell

50

The Lautrec legacy Beyond Paris: at home with artist ToulouseLautrec in medieval Albi

by Jeremy Ferguson

59

Fishing for compliments Three deliciously easy seafood suppers perfect for weeknights

by Cree LeFavour

contest

Get ready for summer sports!

WIN

a $100 gift card from Atmosphere at doctorsreview.com/meetings

59

ACCESS CODE: drcme Go to page 20 for details MARCH 2014 • Doctor’s

Review

3

Where can you turn for help in preventing

* MENB? Serogroup B has become the most common invasive meningococcal disease (IMD) serogroup to affect Canadians (2007).1 Percentage of reported IMD cases by age and serogroup, Canada (2007)1,† AMONG INFANTS <1 year of age Other serogroups 20%

AMONG CHILDREN 1-4 years of age

AMONG ADOLESCENTS 15-19 years of age‡

Other serogroups 33%

B 80%

B 67%

Other serogroups 38%

B 62% ‡BEXSERO® is used in individuals 2 months through 17 years of age.

Introducing

BEXSERO

®

BEXSERO® is indicated for active immunization of individuals from 2 months through 17 years old against invasive disease caused by N. meningitidis serogroup B strains.

Refer to the page in the bottom right icon for additional safety information and for a web link to the Product Monograph discussing t $POUSBJOEJDBUJPOT JO JOEJWJEVBMT XIP BSF IZQFSTFOTJUJWF to the BEXSERO® vaccine or to any ingredient in the formulation or components of the container closure.

The first and only vaccine indicated for active immunization against invasive meningococcal disease caused by serogroup B strains.1,2,§

t 3FMFWBOU XBSOJOHT BOE QSFDBVUJPOT SFHBSEJOH temperature elevation following vaccination of infants and children (less than 2 years of age), postponement of the administration of BEXSERO ® in subjects suffering from an acute severe febrile illness, thrombocytopenia, hemophilia or any coagulation disorder that would contraindicate intramuscular injection, impaired immune responsiveness, not administering by intravascular, intravenous, subcutaneous or intradermal injection, not mixing with other vaccines in the same syringe, availability of appropriate medical treatment and supervision in

case of an anaphylactic event following administration of the vaccine, risk of apnoea in premature infants and need for respiratory monitoring, known history of hypersensitivity to latex, hypersensitivity to kanamycin, that protection against invasive meningococcal disease caused by serogroups other than serogroup B should not be assumed and that as with any vaccine, BEXSERO® may not fully protect all of those who are vaccinated. t $POEJUJPOT PG DMJOJDBM VTF BEWFSTF SFBDUJPOT ESVH interactions and dosing instructions.

*MenB: meningococcal disease caused by serogroup B. †In 2007, in infants <1 year old, 20 out of 25 reported IMD cases were caused by serogroup B, in children 1-4 years old, 18 out of 27 reported IMD cases were caused by serogroup B and in 15-19-year-olds, 18 out of 29 reported IMD cases were caused by serogroup B. §Comparative clinical significance is unknown.

References: 1. National Advisory Committee on Immunization. Update on the use of quadrivalent conjugate meningococcal vaccines. Can Commun Dis Rep. 2013; 39(ACS-1):1-40. 2. BEXSERO® Product Monograph. Novartis Pharmaceuticals Canada Inc. December 6, 2013.

Novartis Pharmaceuticals Canada Inc. Dorval, Québec H9S 1A9 www.novartis.ca T: 514.631.6775 F: 514.631.1867

BEXSERO is a registered trademark.

Product Monograph available on request.

Printed in Canada ©Novartis Pharmaceuticals Canada Inc. 2014 13BEX044E

Be informed. Be immunized.

See additional safety information on page xxxx 63

contents MARCH 2014

26

regulars 7 LETTERS Golf and ground rules

9

Toronto’s Royal Ontario Museum turns 100; Riga, Europe’s Capital of Culture; Cirque du Soleil in Mexico and who are the happiest people on earth?

by Tyson Lowrie

13

BUDGET TRAVELLER

57

ONE BOTTLE Spain’s glorious garnacha

by James Nevison

64

5 great Euro deals

by Annarosa Sabbadini

15

9

PRACTICAL TRAVELLER

PHOTO FINISH Spring time in Paris

by Dr Orest Sochaniwskyj

FOOD Why gardeners should love dandelions

by Annarosa Sabbadini

17

coming in April

GADGETS The Nest, Google and the new smart home

by David Elkins

19

BEST MD APPS Clinical games for almost every specialty

by David Elkins

21

17

France’s Évian-les-Bains: discovering the Rhône-Alpes where water springs from the rocks

•

Spain’s divine Castile and León

•

Planning a visit to Melbourne? We’ve got the city’s best walking trails

•

Follow a Saskatchewan MD and his family as they try to spot the Big Five on a South Africa safari

•

Is Canada’s hospital food killing patients?

•

The doc who invented the calorie-counting diet.

Her 100-year-old advice will still help you lose the love handles

•

The best MD apps, the hottest gadgetry, the most exciting conference cities, recipes and much more

TOP 20 The world’s best meetings happening this August.

Plus, why conference in Toronto

26

•

HISTORY OF MEDICINE The shock to the heart that jump-started emergency medicine

by Jackie Rosenhek

MARCH 2014 • Doctor’s

Review

5

Recognize and report

serious and unexpected adverse reactions Help improve the safe use of health products for your patients by reporting adverse reactions to Health Canada. Your report may contribute to the identification of previously unrecognized rare or serious adverse reactions and changes in product safety information.

There are three ways to report: • Online at www.health.gc.ca/medeffect • By calling 1-866-234-2345 • By completing an adverse reaction reporting form which you can send by postage paid mail, or fax to 1-866-678-6789

To stay informed on new health product safety information: • • • •

Advisories and Recalls MedEffect Canada RSS Feeds MedEffect e-Notice Canadian Adverse Reaction Newsletter

Visit www.health.gc.ca/medeffect

MedEffect™ Canada Together we can improve health product safety

LETTERS

EDITOR

Annarosa Sabbadini

Golf and ground rules

MANAGING EDITOR

Camille Chin

CONTRIBUTING EDITOR

Katherine Tompkins

TRAVEL EDITOR

Valmai Howe

SENIOR ART DIRECTOR

Pierre Marc Pelletier

DOCTORSREVIEW.COM WEBMASTER

CONGRATULATIONS!

Pierre Marc Pelletier

The winner of a $100 Lee Valley Tools gift card is Dr Kim Adzich, a family physician from Rimbey, AB.

PUBLISHER

David Elkins

DIRECTOR, SALES & MARKETING

Stephanie Gazo / Toronto

OFFICE MANAGER

Denise Bernier

CIRCULATION MANAGER

Claudia Masciotra

EDITORIAL BOARD

R. Bothern, MD R. O. Canning, MD M. W. Enkin, MD L. Gillies, MD M. Martin, MD C. G. Rowlands, MD C. A. Steele, MD L. Tenby, MD L. Weiner, MD

MONTREAL HEAD OFFICE

400 McGill Street, 4th Floor Montreal, QC H2Y 2G1 Tel: (514) 397-8833 Fax: (514) 397-0228 Email: editors@doctorsreview.com www.doctorsreview.com

TORONTO SALES OFFICE

553 Prestwick Oshawa, ON L1J 7P4 Tel: (905) 571-7667 Fax: (905) 571-9051

None of the contents of this publication may be reproduced, stored in a retrieval system or transmitted in any form by any means, without prior permission of the publishers. ISSN 0821-5758 Canadian Publications Mail Sales Product Agreement No. 40063504 Post-paid at St. Laurent, QC. Return undeliverable Canadian addresses to: Circulation Department, 400 McGill Street, 3rd Floor, Montreal, QC, H2Y 2G1.

Subscription rates: One year (12 issues) – $17.95 Two years (24 issues) – $27.95* One year U.S. residents – $48.00 *Quebec residents add PST.

HIT — OR MISS? I just finished the article on golf in Maui [Hawaii’s hole-in-one, January 2014, page 50], mere days after returning from two weeks there. If one wanted to read an advertisement for the three main resorts, one could go to the respective websites for some effusive and uncritical prose.

However, if one wanted an article on the relative merits of the courses on the island, this article was not it. I have travelled to Maui many times, never without my clubs, and have played nearly a thousand courses worldwide, so consider myself a decent judge. If I were to write about golf there, I would say something like this: avoid the Wailea, Kapalua and Kaanapali courses — unless you are someone who really doesn’t like money.

While good courses, they are dramatically overpriced. Equivalently good golf can be had on Maui at Kahili, Elleair and especially the Dunes at Maui Lani, where,

if you look for deals, you can play for under $70, or about a third of the fee at Kapalua’s Plantation Course.

If you’ve never played the big expensive courses, by all means play them — once.

But you’ll have just as much fun, just as much challenge at the others, and have a lot left over for another round, plus dinner.

Dr Mike Marshall Via email

TRIAL AND ERROR I was most intrigued by the article on medical cannibalism [“Bite me,” History of Medicine, January 2014, page 19]. I find it hard to swallow — pardon the pun — that physicians once advocated consumption of honeymarinated “human mummy confection” as a panacea. Today, one cannot advocate any treatment unless it has undergone rigorous, double-blind, prospective, placebo-controlled, registered trial that has been approved by an Ethical Committee of one’s institution.

Dr Muri B. Abdurrahman Via email

All prescription drug advertisements appearing in this publication have been precleared by the Pharmaceutical Advertising Advisory Board.

StiStill sufferi ll sufferingnfrom g fromGERD? GERD? Roll over to page xx.

Roll over to page xx.

MARCH 2014 • Doctor’s CHANGE #

PRODUCTION NOTES

CHANGES BY

TAK TEC 13435 Doctor Review_1.25x3.5.indd 1

APPROVAL

Review SIGNATURE

7

2013-10-23 4:06 PM

ONBREZ* BREEZHALER*

Pr

Helping to treat your symptomatic patients is all in a day’s work…

Demonstrated fast, 5-minute onset (FEV1 improvement shown 5 minutes after first dose 0.1 L; p<0.001, serial FEV1 measurement)1† Maintained round-the-clock (24-hour) bronchodilation (LS mean FEV1 (L) vs. placebo at week 12, p<0.001; time points were 5 min, 30 min, 1 hr, 2 hrs, 4 hrs, 6 hrs, 12 hrs, 16 hrs, 22 hrs, and 24 hrs)1,2†‡ Improved transition dyspnea index (LS mean TDI focal score at week 12, 1.34 vs. 0.11 for placebo, p<0.001)1,3§

ONBREZ* BREEZHALER* The only ONCE-DAILY LABA in COPD

¶

Indication & clinical use: ONBREZ* BREEZHALER* (indacaterol maleate) is a longacting ß2-agonist (LABA) indicated for long-term, once-daily, maintenance bronchodilator treatment of airflow obstruction in patients with chronic obstructive pulmonary disease (COPD), including chronic bronchitis and emphysema.

• Not indicated for the relief of acute deterioration of COPD, for asthma, or for use in patients under 18 years of age Contraindications: • Not indicated for treatment of asthma Most serious warnings and precautions: Asthma-related death: Increased risk of asthma-related death is considered a class effect with LABAs, including indacaterol maleate. ONBREZ* BREEZHALER* is not indicated for asthma.

Other relevant warnings and precautions: • Not indicated for acute episodes of bronchospasm • Increased risk of cardiovascular effects • Caution in patients with cardiovascular disorders • Caution in patients with convulsive disorders, thyrotoxicosis and patients who are unusually responsive to ß2-adrenergic agonists • Risk of hypokalemia and hyperglycemia • Paradoxical bronchospasm • Immediate hypersensitivity • Should not be used in patients with acutely deteriorating COPD • Should not be used concomitantly with other LABAs • May inhibit labour

* ONBREZ and BREEZHALER are registered trademarks.

Product Monograph available on request.

Exp: 05/2014 © Novartis Pharmaceuticals Canada Inc. 2013

References: 1. ONBREZ* BREEZHALER* Product Monograph. Novartis Pharmaceuticals Canada Inc., October 24, 2012. 2. Data on file. Novartis Pharmaceuticals Canada Inc. Study B2355.

3. Data on file. Novartis Pharmaceuticals Canada Inc. Study B2354.

For more information: Please consult the Product Monograph at www.novartis.ca/ asknovartispharma/download.htm?res=onbrez%20breezhaler_ scrip_e.pdf&resTitleId=482 for important information relating to adverse events, drug interactions, and dosing information which have not been discussed in this piece. The Product Monograph is also available by calling the Medical Information department at 1-800-363-8883.

FEV1: forced expiratory volume in 1 second; LS: least square; TDI: transition dyspnea index. † B2355: A 12-week, multicentre, randomized, double-blind, placebo-controlled, parallel-group study assessing the safety and efficacy of ONBREZ* BREEZHALER* 75 mcg once daily vs. placebo in patients with COPD (n=318). ‡ From a subset of 239 patients in B2355. FEV1 data shown is ONBREZ* BREEZHALER* vs. placebo, respectively: 5 min: 1.56 vs. 1.39; 30 min: 1.57 vs. 1.38; 1 hr: 1.56 vs. 1.38; 2 hrs: 1.56 vs. 1.37; 4 hrs: 1.51 vs. 1.35; 6 hrs: 1.48 vs. 1.33; 12 hrs: 1.43 vs. 1.29; 16 hrs: 1.39 vs. 1.24; 22 hrs: 1.44 vs. 1.27; 24 hrs: 1.48 vs. 1.34. § B2354: A 12-week, multicentre, randomized, double-blind, placebo-controlled, parallel-group study assessing the safety and efficacy of ONBREZ* BREEZHALER* 75 mcg once daily vs. placebo in patients with COPD (n=323). ¶ Comparative clinical significance has not been established.

P R AC T I C AL T R A V E L L E R by

T y s on L ow r i e

Child emperor’s ceremonial robe (chaofu).

Forbidden Toronto

BOTH IMAGES THIS PAGE © THE PALACE MUSEUM

This year the Royal Ontario Museum turns 100, and to celebrate they’re shining a light on a much older institution: the Chinese imperial court. The Forbidden City: Inside the Court of China’s Emperors exhibition is open now until September 1. It features more than 200 items from the Forbidden City (now Beijing’s Palace Museum) where China’s Ming and Qing emperors ruled from 1420 to 1912.

Highlights include a rare 15th century porcelain cup, the robe worn by six-year-old Emperor Tongzhi on the day of his inauguration in 1861, and the portraits of Emperor Yongzheng and some of his many mistresses. A significant part of the collection has never been shown outside of Beijing.

Some of the more fragile items (like the robe and painting pictured) will be removed and replaced by others starting in early June. Adults $27, kids 4 to 14 $19, includes general admission. tel: (416) 586-8000. rom.on.ca/en/forbidden-city.

Prince Yinzhen’s painting of Twelve Beauties, anonymous court painter, Qing dynasty.

MARCH 2014 • Doctor’s

Review

9

PR A CTICA L T RAVEL L ER

Cirque in Mexique

Fittingly enough, Cirque du Soleil is heading to sunny Mexico. The Montrealbased company is partnering with a resort developer, Grupo Vidanta, to build a 600-seat dinner theatre in Riviera Maya, outside Cancún, which will house a yet-to-be-announced show.

The company promises that “world-class dining and champagne will be integrated with the spectacle.” We’ve never tried pairing filet mignon and bubbly with artistic acrobatics, but you’d have to assume they go well together. It will be the Cirque’s latest residency in addition to those in Las Vegas and Orlando. Both of those cities’ shows seat around 1600, so the Cirque du Soleil and Grupo Vidanta are trying to design the theatre to give a more intimate experience. The premiere is scheduled for November 2014. Updates at cirquedusoleil.com/rivieramaya.

Culture is going north

10

Doctor’s Review • MARCH 2014

The Bremen Town Musicians statue, Riga.

TEQUIERO / SHUTTERSTOCK.COM

Riga, Latvia’s capital, and Umeå, a university town in northern Sweden, are celebrating being named Europe’s “capitals of culture” with a year absolutely packed with cultural events.

Among Riga’s 200 events include one of Europe’s biggest summer solstice celebrations, and mid-November’s Staro Riga light festival. There are also plenty of exhibitions and galleries to see at the capital’s national museums and new national library. Umeå, a six-hour train ride north of Stockholm, is the northernmost capital of culture ever.

Their year is divided into the eight seasons of the Sami people, and plays up Sweden’s hip, progressive image with the UxU crowd-funded music fest (July-August), the contemporary circus festival (August 29-September 7) and the Liet minority-language song festival (October-November), “a polyglot alternative to the Eurovision song contest.” riga2014.org; umea2014.se.

Follow the rainbow

Room to fly

HXDYL / SHUTTERSTOCK.COM

If, like me, you’re a tall person who gripes about legroom on planes, TripAdvisor’s new search features might give you one less reason to complain. The flight search engine now lists legroom for each flight and also lets you filter flights by amenities such as power outlets and televisions. You can also see luggage fees and legroom upgrade options. For many flights user-submitted seat photos are available to give you an idea of what you’re booking. Like me, you’ll probably still pick the airline with the cheapest price and complain about the seating anyway, but at least you’ll be forewarned. For the record, Porter is listed as “spacious” while WestJet and Air Canada are usually “average,” with some “spacious.”

US-based discount companies Spirit Airlines and Allegiant Air are “tight.” tripadvisor.ca/cheapflightshome.

The Istanbul Modern is celebrating its 10th anniversary this year, and the museum is trotting out all the colours of the rainbow to commemorate it. They’ve installed a massive 7.5-metre by 15-metre neon display, created by Turkish-Armenian conceptual artist Sarkis, on the outside of the building. It’s meant to represent “endless rhythm, excitement and joys of life” and is up for all for 2014. If you can get there

by May 8, you’ll also have the chance to visit Neighbours, an exhibit which brings together 35 artists from Turkey and neighbouring countries. It explores cultural transmission and the social practices that influence the region’s artistry. The emphasis is on visual art, folk culture and spectacle. Rainbow can be seen outside for free; general admission adults $9, kids under 12 free. istanbulmodern.org/en.

SINAN KOÇASLAN

MUHSIN AKGUN

The Hunter that Lied

by One Square Meter.

MARCH 2014 • Doctor’s

Review

11

P R A CTICA L TR AVEL L ER

KEVIN J SMITH / MAPLE LEAF ADVENTURES

Good cause, Great Rainforest If you have $10,000 lying about, Canadian Geographic is launching expedition cruises into BC’s Great Bear Rainforest, with the first announced trip running from June 19-27.

The cruises will be operated by Maple Leaf Adventures, which often operates Great Bear Rainforest trips of its own, and will raise funds for the Royal Canadian Geographical Society. Celebrated Canadian wildlife painter Robert Bateman is coming along for the ride, as are several Canadian Geographic staff members. There are a maximum of seven guests per ship, and a maximum of three ships will take part, leaving from Bella Bella.

The path will mostly be centered around circumnavigating Princess Royal Island, with stops including bear viewings, hot springs, a whale research station and the native villages of Hartley Bay and Klemtu. A flight from Vancouver is included. tel: (888) 599-5323; mapleleafadventures.com.

Back in 2012 these same Doctor’s Review pages told you that Denmark was the happiest country on earth, according to the UN Sustainable Development Solutions Network’s first-ever World Happiness Report. Well, the same folks who put it together crunched all the numbers again… and discovered Danes are still pretty happy, once again more so than anybody on the planet. We’re not surprised; it’s difficult to fathom how living in a land of Lego, breakfast pastries and absurdly-sized dogs wouldn’t be a surefire recipe for contentment. As with the previous study, wealthy European countries dominated the top 10. Canada dropped from fifth to sixth.

The calculations were based on criteria such as GDP, perceived corruption and personal freedom.

It does differ somewhat from the rival ecologicallybased Happy Planet Index, which puts the Danes at a more melancholy 110th, just behind Rwanda and Afghanistan. unsdsn.org/resources/publications/ world-happiness-report-2013.

12

Doctor’s Review • MARCH 2014

MIKKEL HERIBA / VISIT DENMARK

Let the gøød times røll

5

BUDGET TRAVELLER by

An n a r os a S a b b a d i n i

Euro deals!

Porto, Portugal.

Paris

Dating back to the 1600s, the Marais’s Marché des Enfants Rouges is Paris’s oldest covered market, named after red-uniformed orphans who once lived nearby. It’s an excellent stop to buy both fresh produce and prepared dishes.

You’ll have a hard time choosing among the French, Italian, Japanese, Lebanese and Libyan spreads. 39 Rue de Bretagne, 75003. The entrance is through a small iron gate.

Prague Sandemans New Europe’s popular three-hour tour of Prague offers a headful of learning on the city’s turbulent past. The tours are free — the guides work for tips only — which means they come prepared to inform and entertain. Tours start at the Old Town Square at 10:45am and 2pm, usually seven days a week. Check the website to confirm. newpraguetours.com.

Amsterdam Two ways to visit Amsterdam for less. The most obvious is to rent a MacBike (macbike.nl). The second is to stay at the two-star Chic&Basic in the Jordaan district — its 26 rooms are simple but clean and the staff is friendly. The common areas are where the chic comes in: there are nice corners to check emails or plan your day. Some of the rooms overlook To yourClaudia Masciotra the lovely Herengracht Canal but, depending on availability, you to bookReview in the higher price range for a view.

Formay have Doctor’s March 2014 Basic rates start at €95 and include a small breakfast. If you have trouble with steep stairs, request a ground-floor room.

Fax 1-855-861-0790 chicandbasic.com.

Tensing Pen in Negril, Jamaica.

The view from one of Chic&Basic’s rooms in Amsterdam.

Reykjavik Reykjavik’s three-star Hotel Bjork has 55 fully equipped rooms. The hotel makes for a good base, be it for business, sightseeing or overnighting before touring the countryside.

Parking is free. You’ll be within walking distance of the city centre and not far from the Hlemmur bus station and the Kringlan shopping mall. The hotel has a restaurant, which focuses on local, healthy ingredients. From €85, breakfast included. bjorkhotelreykjavik.com.

Budapest If you’re planning a visit to Budapest, check out the three-star Hotel Sissi: it’s central and has a beautiful garden. There are 44 rooms, all with free Wi-Fi. From €70, breakfast included. hotelsissi-budapest.com.

DISCOVER THE WORLD WITH CME CRUISES SCANDINAVIA & RUSSIA FRANCE & IBERIA PORTUGAL/CANARY IS. INDIA & S RI LANKA TAHITI & TUAMOTUS

ALASKA BERMUDA CARRIBBEAN ANTARCTICA SOUTH AMERICA

GREECE & ITALY JAPAN & CHINA FIJI & VANUATU HAWAIIAN ISLANDS DANUBE RIVER

call Sea Courses Cruises for

PROMOTIONS and PRICING

1-888-647-7327 for dates, topics, and itinerary visit

www.seacourses.com

MARCH 2014 • Doctor’s

Review

13

MAY 7-10, 2014 INTERNATIONAL CENTRE Hall 2 - 6900 Airport Rd,Toronto, ON

WORKING TOWARDS BETTER PATIENT OUTCOMES FAMILY PHYSICIANS, GENERAL PRACTITIONERS, PHARMACISTS AND NURSE PRACTITIONERS

REGISTRATION FEE

Early Bird - $95.00 + HST After April 15th- $150.00 + HST

3

1

2 Primary Care Today is the largest annual inter-professional CME/CE conference in Canada with a focus on primary care. PCT attracts over 3,700 GP/FM's, Nurse Practitioners and Pharmacists from across Canada.

2014 NEW PROGRAM

The family medicine academic program delivers three days of Mainpro-M1 CME featuring 5 keynotes and 20 concurrent sessions (25 hours).

Relevant CME

1

MAINPRO-M1

2

MAINPRO-C

Register with Promo Code

3

dr1

SYMPOSIA

15 Hours of Mainpro-M1 37 Mainpro-C Seminars Peer to Peer Collaboration Industry Sponsored Events Interactive Exhibit Hall

at www.primarycaretoday.ca

F OOD by

An n a r os a S a b b a d i n i

Why make war on dandelions when you can braise them instead?

The tastiest garden-variety dandelions come out in spring*. The younger the leaves are, the more tender and less bitter their taste. This is when they’re best in sandwiches and salads. They’re also delicious stir-fried and seasoned with sesame seeds.

Keep it up and you’ll be proudly foraging your weekend lunches. But by July, their leaves are tougher and seriously bitter. You’ll want to treat them as you would kale — chop them up and serve them sautéed with garlic, onions and olives or capers.

Like most bitter greens, they’re nutritionally packed, in this case with vitamins A, B, C and D, as well as iron, potassium and zinc. The leaves act as a diuretic — which explains why some, including Newfoundlanders, call them pissabed and the French pissenlit. You’ll need to check for interactions not just with diuretics but other meds: antacids, blood thinners, lithium or diabetes drugs. Chinese dandelion can interfere with some antibiotics.

The petals taste of honey when picked young and become bitter with age. Unopened buds are the best: try them raw or steamed. As soon as the flowers have bloomed, separate the petals to wash them and sprinkle them over salads. If you’re adventurous, make an all-yellow petal dandelion risotto, instead of the Swiss, risotto alla pissenlit, made just with the leaves.

Then there are the roots. Dig them up, cut off the stringy stuff, wash, chop, oven roast and grind the bark-like bits into a tea. Lovers of the beverage call it dandelion coffee, but that may be setting yourself up for a taste letdown. It’s dandelion tea.

Dandelion roots have been used medicinally since the 10th century for everything from liver, kidney, digestive disorders and wart issues.

Of course, none of this has ever been tested on humans. Until recently.

BRZOSTOWSKA / SHUTTERSTOCK.COM

Gardeners, eat thy enemy

After seeing that the roots killed cancerous cells of chronic monocytic myeloid leukemia (CMML) patients — leaving healthy cells alive — a research team at the Windsor Regional Cancer Centre in Ontario launched a 30-person trial, due to be completed this year. Participants are all terminally ill and haven’t responded to any other therapy.

Should this trial prove successful, and the group further its research, well, who knows… that unweeded garden you’ve come to despise may one day be a lifesaving goldmine. Then you can pat yourself on the back for being such a good gardener.

* Never eat dandelions that grow on roadsides, in parks or lawns that may have been treated with chemicals.

MARCH 2014 • Doctor’s

Review

15

gs n i t lis cme e c en e: dr r e f Con ss cod e We asked... acc

MEDICINE ON THE MOVE

Clinics, hospitals and even your office are places where stress needs to be managed.

How do you manage workplace stress?

Survey says: “I book time at the beginning of each day to catch up on miscellaneous paperwork. I am much more productive and head into a day of seeing patients feeling like I’ve already accomplished a lot.”

“I just close the door of my office, take off my shoes, unroll my yoga mat and do some yoga. As the muscles stretch, the mind gets more focused. It just takes 10 to 15 minutes, and the rest of the day seems to pass more fluidally.”

“The practice of ‘mindfulness’ has been shown to assist everyone, including physicians.

Although there are many ways to act on this, my personal favourite is to just ‘breathe consciously.’ I can do it anytime, anywhere, alone, in a crowd or with patients....”

“Make an effort to find something to laugh about, whether it’s reading funny material or sharing a good joke with colleagues.

With practice, it’ll become an activity that breaks up part of the stress spiral.”

“Have an interest outside of work and make it part of your routine. You’d be surprised how great you feel when you regularly decompress!

I go dragon boating, and every Thursday night I’m on the water, come rain or thunder; we stop in lightning!

A supportive significant other is a huge asset as well!”

“When I have the time, I find baking very relaxing and the rewards are twofold; you get to eat the yummy results, and your colleagues get a break when the treats come in the next day!”

“I close the doors to labour and delivery, and sit with a woman in my care. I listen to her story and inevitably end up smiling, thankful for the little things in life. Getting close to my patients keeps things in perspective and reminds me of the gift I have been given: the privilege of entering into someone’s life and helping them through a difficult time. That makes all the white noise dissipate.”

“I always have classical music playing in my office.

It relaxes me and my patients.”

Source: Doctor’s Review, August 2008.

Work out your stress with some new outdoor gear!

Enter to win a $100 gift card from Atmosphere.

Go to doctorsreview.com/meetings then register or use access code drcme to get to the contest ballot at the top of the page.

GA D GE T S by

D a v i d Elk i n s

Quiet, the thermostat may be listening In January, Google paid $3.2 billion for Nest. Why? The short answer is that Google wants to get its foot in the front door of the smart home — read: your home in about five years. Nest currently makes a thermostat that adjusts to living patterns and a smoke detector that’s networked with it. Google, on the other hand, makes its money from advertising products that are keyed to customer desires determined by meticulously tracking web surfing behaviour. When the acquisition was announced, Valleywag, a Silicon Valley gossip blog tweeted: “If your house is burning down you’ll now get gmail ads for fire extinguishers.”

The extra value Google perceives in Nest is its ability to collect information from a variety of devices and share it.

The thermostat, for example, “learns” to regulate temperatures in rooms according to your comings and goings. This is the early days for these devices but even now, Thermostat (pictured above) can tell Protect (left) whether you’re in the house or not, something that would be most useful to firefighters summoned by the device.

As they proliferate and grow smarter, they will build a picture of human behaviour that is able to anticipate what we want in much the same way that present shopping algorithms tap into our buying preferences.

In a more immediate example, a smart-home thermostat will soon be able to connect directly to the smart metres currently being installed by electric utilities across the country.

Working together, they will provide a great deal of information about you by tracking your precise use of electricity, which the utilities can use to better allocate electricity use across the provincial and, ultimately, the continental grid.

On the face of it such uses are a good thing: the aim is to make your life simpler and more pleasant by taking care of mundane tasks — fiddling with your thermostat to find the right balance between comfort and cost. There is, though, a price to pay in loss of privacy.

We fret today about identity theft on the web, tomorrow we may have to worry about the tales our toasters and refrigerators conspire to tell the whole wide world.

MARCH 2014 • Doctor’s

Review

17

Keynote Speakers

Samantha Nutt Mr. Mr. Ray Zahab Dr.Dr. Samantha Nutt Ray Zahab Sunday June 1 Monday June Sunday June 1 Monday June 22

Dr.Ian IanStiell Stiell Dr. Tuesday June33 Tuesday June

Dr. Dr. Mel Mel Herbert Herbert Tuesday TuesdayJune June33

June 4 4 Wednesday WednesdayJune June4 4 Wednesday Wednesday June

EARLY REGISTRATION DEADLINE: APRIL 7TH May 31 - June 4, 2014 Ottawa Convention Centre

For more information visit caep.ca/Conference

BEST MD APPS by

D a v i d Elk i n s

Clinical games that make it fun to disagree Introduced this January, the Prognosis suite consists of nine applications of clinical games. The games present a series of complex clinical cases that you’re invited to investigate, diagnose and manage. Each one takes a few minutes to complete; you’re then rated on how well you’ve done, from poor to satisfactory to excellent. This is followed by an analysis and an expert explanation that can be quite useful. There’s also an opportunity to comment on the case and to read comments posted by others.

For example, “Sparkly,” one of the cases in the Prognosis: Your Diagnosis app, is discovered to be suffering from a migraine.

By early March, 21 physicians from all over the world had commented on Sparkly’s case. Lisa K wrote: “One of the cardinal symptoms of a true migraine is unilateral pain, making this presentation more consistent with a simple headache or a pre-migraine, which may localize to one side and evolve into a classic migraine.” Juan asked: “Why not a CT scan?” Another commentator agreed: “A CT is non-invasive and relatively inexpensive. Using drugs when an infarction can cause the same symptoms is bad medicine.”

The cases are fun and, clearly, the results not always without disagreement.

You might take a few minutes to play here and there when you need a short break, and fancy a clinical challenge and an opportunity to update your skills.

Each Prognosis app includes a number of cases from about 20, in the case of cardiology, to as many as 180 found in the Prognosis: Your Diagnosis.

If you enjoy it, an invitation to your friends to play is only a click away.

Prognosis: Your Diagnosis (prognosisapp.com)

by Medical Joyworks Other game titles in the suite: Cardiology, Diabetes, Emergency Medicine, Neurology, Respiratory, Rheumatology and STDs Devices: iPhone and iPad, Android Cost: free

MARCH 2014 • Doctor’s

Review

19

!

T S TE

NE

ON C W

drcme

is the access code to search our 2500+ medical meetings

+ fill out a contest ballot Be one of the first 100 doctors to enter and you could win a $100 gift certificate from Atmosphere doctorsreview.com/meetings Find a meeting. Win a prize.

Search by destination â&#x20AC;˘ date â&#x20AC;˘ specialty

doctorsreview.com/meetings access code: drcme

the top 20 medical meetings compiled by Camille Chin

Canada Montreal, QC August 21-24 43rd Annual Scientific Meeting of the Society for Hematology and Stem Cells

August 26-30 19th World Congress of the International Federation for the Surgery of Obesity and Metabolic Disorders

St. John’s, NL August 25-28 28th Annual Scientific Meeting of the Canadian Association of Radiation Oncology

Vancouver, BC August 6-8 6th International Conference on Patientand Family-Centered Care: Partnerships for Quality and Safety

August 13-14

Around the world Barcelona, Spain August 30-September 3 European Society of Cardiology Congress 2014

For contact info on these and 2500+ more conferences, visit doctorsreview.com/meetings

TOURISM VANCOUVER / CANADIAN TOURISM COMMISSION

66th Annual Meeting of the Pacific Dermatologic Association

You can cycle the 10-kilometre paved path around Vancouver’s Stanley Park seawall or pedal beneath giant trees in the park.

Amsterdam, Brasilia, Florence, Hamburg, Honolulu, Istanbul, Madrid, Milan, Paris, Quebec City, San Diego, Seoul, Shanghai, Sydney, Toronto

Go to doctorsreview.com/meetings for a reason to visit these cities... and many more!

MARCH 2014 • Doctor’s

Review

21

Why Toronto?

by Tyson Lowrie

ROSS BRUNIGES / FLICKR.COM

It’s Toronto cadre of innovative chefs that are the talk of the town (aside from a certain mayor).

Chef Grant von Gameren’s menu at the new Bar Isabel is Spanish-influenced and full of unconventional choices. Eat a tongue sandwich, wolf down sweetbreads or try the specialty, the octopus.

Hot chef groupie

When Nova Scotian Geoff Hopgood opened Hopgoods Foodliner two years, it was named best restaurant by blogTO.com and one of the best in the country by EnRoute. This East Coast-style eatery serves everything from the Halifax donair to a bevy of seafood classics.

Edulis is the preserve of chef Michael Caballo.

The menu changes nightly, but is built around a five-course ($50) and seven-course ($70) presentation. Expect dishes like charcoal beef shoulder, duck and chestnut sausage, and mushrooms (Caballo is crazy for fungi) cropping up often, even in dessert.

Morning person

NATHAL / FLICKR.COM

Toronto is known for its plethora of brunch spots.

The mainstay Aunties and Uncles was named by blogTO.com as the best of the bunch. Prepare for a line on weekends as folks will happily wait for breakfast tacos or the pan-bagnat (wet bread).

Toronto Life hands the crown to Farmhouse Tavern. The magazine speaks highly of the duck bacon and duck eggs that have found their way onto the menu, while other mags give accolades to their eggs benedict.

Sports fan

If the thought of a heavy brunch induces a sense of professional guilt take a 10-minute 501-streetcar ride to Tealish, which, since 2005, has been the centre of all things loose leaf with over 130 kinds of tea. Stop in for a chai latte, feel good about avoiding duck bacon and pick up something for the tea lover you know.

A Toronto meeting: September 3-6 40th Annual Conference of the International Society for Pediatric and Adolescent Diabetes

For contact info on this and 2500+ more conferences, visit doctorsreview.com/meetings

22

Doctor’s Review • MARCH 2014

OTMPC

Watch a crucial game in the Blue Jays’ quest to miss the playoffs for the 21st straight year.

The last week of August will see the team host the Yankees, while beginning September 8 the Jays host the Chicago Cubs. Tickets from $17.25.

Soccer fever has hit the city with Toronto FC investing heavily this year in a trio of international stars: Michael Bradley, Jermain Defoe and Julio Cesar. Catch them September 6 against Philadelphia and take in BMO Field’s crackling atmosphere.

August will be too early to watch the Leafs, but you can still get your hockey fix. Unlike its more stodgy baseball counterpart, the Hockey Hall of Fame is wonderfully interactive and a good bet for kids.

DIRECTORY

JEFFREY CARLSON

Temps in the low 20s make early September a great time to escape to the Toronto Islands and Hanlan’s Point Beach. The extensive strip of sand has both clothing-required and optional zones, and the water at the end of summer should still be bearable. Catch the return ferry at sunset for great views.

Allan Gardens Conservatory 19 Horticultural Avenue toronto.ca/parks/prd/facilities/ complex/41 Free

DIEGO SILVESTRE

Ok, this one’s indoors, but the Allan Gardens Conservatory consists of six historic greenhouses featuring plants from around the world. Located downtown, the glass-and-castiron domed Palm House was built in 1910, and hosts 1500 square metres of greenery.

There’s plenty to do in the expansive High Park, with hiking trails, Grenadier Pond, a zoo, a swimming pool and more. It isn’t right downtown, but very easy to get to by riding the 501 streetcar.

Museumgoer

Art Gallery of Ontario 317 Dundas Street West tel: 416-979-6648 ago.net adults $19.50, kids 6 to 17 $11 Aunties and Uncles 74 Lippincott Street tel: 416-324-1375 auntiesanduncles.ca

Bar Isabel 797 College Street tel: 416-532-2222 barisabel.com Bata Shoe Museum 327 Bloor Street West tel: 416-979-7799 batashoemuseum.ca adults $14, kids 5 to 17 $5

BENSON KUA

Blue Jays (Rogers Centre) 1 Blue Jays Way tel: 416-341-1000 bluejays.com

Edulis 169 Niagara Street tel: 416-703-4222 edulisrestaurant.com Farmhouse Tavern 1627 Dupont Street tel: 416-561-9114 farmhousetavern.tumblr.com

Open-air adventurer The Royal Ontario Museum is celebrating its 100th anniversary this year. The ROM has diverse collections on just about everything from fashion to fossils to fine art. September exhibits haven’t been announced yet.

TORONTOWIDE.COM

If you’re all arted out, the Bata Shoe Museum is quirky, but gets high marks from visitors.

Its collection of colourful moccasins is a highlight.

Want to see Napoleon’s socks, Marilyn Monroe’s red heels, or (sigh) Justin Bieber’s sneakers?

Look no further!

OTMPC

Renowned architect Frank Gehry oversaw the redesign of the Art Gallery of Ontario, completed in 2008. The revamped museum has about 80,000 works of art. Beginning in August, the AGO will have a gallery dedicated to the works of Canadian painter Alex Colville, who died in 2013.

Hanlan’s Point Beach (Ferry information) 9 Queens Quay West tel: 416-397-2628 toronto.ca return trip adults $7, kids 2 to 14 $3.50 High Park 1873 Bloor Street West highparktoronto.com Hockey Hall of Fame 30 Yonge Street tel: 416-360-7765 hhof.com adults $17.50, kids 4 to 13 $11

Hopgoods Foodliner 325 Roncesvalles Avenue tel: 416-533-2723 hopgoodsfoodliner.com Royal Ontario Museum 100 Queen’s Park tel: 416-586-8000 rom.on.ca adults $16, kids 4 to 14 $13

OTMPC

Tealish 728 Queen Street West tel: 416-203-3301 tealish.com Toronto FC (BMO Field) 170 Princes Boulevard tel: 416-360-4625 torontofc.ca tickets from $27 MARCH 2014 • Doctor’s

Review

23

doctorsreview.com/meetings access code: drcme

the top 20 medical meetings Big Island, HI August 11-15

Edinburgh Castle and the Ross Fountain are two of the most recognizable landmarks in Scotland’s capital city.

11th Annual Emergency Medicine Update: Hot Topics 2014

Colorado Springs, CO August 10-13 American Society of Hematology Meeting on Lymphoma Biology

Durban, South Africa August 11-14

GODRICK / SHUTTERSTOCK.COM

21st World Congress of the International Association for Child and Adolescent Psychiatry and Allied Professions

Edinburgh, Scotland September 3-6 XV World Congress on Cancers of the Skin

Fremantle, Australia August 22-23 2014 Conference of the Australia and New Zealand Academy for Eating Disorders

Lima, Peru August 21-23

Singapore, Singapore August 7-10

6th Latin American Conference on Lung Cancer

10th Asian and Oceanian Epilepsy Congress

Lisbon, Portugal July 2-5

Sydney, Australia August 17-20

19th Europe WONCA Conference

2014 Annual Meeting of the Society for Behavioral Neuroendocrinology in conjunction with the International Congress of Neuroendocrinology

Mackinac Island, MI August 15-17 27th Annual Cardiology Update

Melbourne, Australia August 20-22 8th Annual Australia and New Zealand Endovascular Therapies Meeting

Washington, DC August 7-10 2014 Annual Convention of the American Psychological Association

SIMON HS / SHUTTERSTOCK.COM

Paradise Island, Bahamas August 6-9 16th Annual Summer Conference on Pediatrics

Singapore’s oldest Hindu temple, the Sri Mariamman, dates to 1827.

24

Doctor’s Review • MARCH 2014

Porto, Portugal September 3-6 13th Conference of the International Association for the Treatment of Sexual Offenders

For contact info on these and 2500+ more conferences, visit doctorsreview.com/meetings

Established 1983

americanseminar.com 1-855-763-2150 l wn Do

!

t in a e rm bl Fo la D ai DV Av & w CD No oad,

Any Course...

Any Time...

Anywhere.

ASI offers CE courses for medical and dental professionals.

Simply give us your travel plans. ASI will provide accredited educational materials and documentation of your dates and location.

MEDICAL SEMINARS: Adolescent Medicine•Alternative Medicine•Anesthesiology•Arthritis/Rheumatology•Cardiology•Critical Care•Clinical•Pharmacology Diabetes•Dermatology•Endocrinology•Epilepsy•Emergency Medicine•Family Practice•Geriatrics•Gastroenterology•Headache•Hospitalist Medicine Hepatology•Internal Medicine•Imaging•Infectious Disease•Multiple Sclerosis•Neurology•Neuro-Otology•Nephrology•Nutrition•Obesity•OB/GYN Oncology•Ophthalmology•Orthopedics•Otolaryngology•Pain Management•Pediatrics•Psychiatry•Psychology•Pulmonary Medicine•Sleep Medicine Sports Medicine•Surgery•Trauma•Travel Medicine •Urology•Women’s Health•Muscle & Movement Disorders ...and many more!

DENTAL SEMINARS:Nitrous Oxide Sedation•Dental Pharmacology•Infection Control•Oral Surgery•Dental Emergencies•Oral Pathology•Root Canal & Implants•Geriatric Dentistry•200 Top Rx Drugs•Dentures/Prosthodontics•Dental Infectious Diseases•Local Anesthesia ...and many more!

HIS T ORY O F MED I C I NE by

Ja cki e Rosenhek

Clear!

How a shock to the heart jump-started emergency medicine

of human life. The electrical impulse that compels the heart to beat is at once unknowable and, as it turns out, entirely replicable.

When Mary Shelley’s daring Dr Frankenstein conceived his monster, it took nothing less than the awesome power of lightning to bring a biological jumble of stolen body parts to life. At the time her book was published in 1818, electricity and in particular galvanism — the use of electrical current to contract muscle — were at the forefront of both the public’s imagination and the scientific community’s interest. Strangely, what began as romance and science fiction were fast becoming fact.

Late in the 18th century, Italian physician and philosopher Luigi Galvani (1737-98) had proved that a simple spark of electricity could make the legs of a dead frog dance with life. It was 1791, and the idea that a shock might be used to correct heart problems and even bring the dead back to life was still many decades away, but it was the birth of the study of bioelectricity and scientists soon began connecting the dots that would eventually lead to defibrillation.

In the mid 19th century, German physiologist Carl Ludwig (1816-1895) was at the forefront of cardiology, exposing the inner workings of what made the heart tick — as well as what made it stop. In his lab at Zurich University, Ludwig induced ventricular fibrillation via electrical current in the heart of a dog in 1850. The poor pooch may not have survived, but the notion that electricity and the heart were intricately, exquisitely connected did, inspiring other researchers to pick up the torch.

Researchers in the United States, Europe and Russia simultaneously came to the conclusion that a shock to heart might actually be a good thing, with far-reaching therapeutic benefits. From various labs around the world, devices specifically designed to zap cardiac muscle were emerging.

These early capacitors stored an electrical charge, which could be transmitted via a pair of paddles directly to the heart.

At the University of Geneva in 1899, Swiss researchers Jean-Louis Prévost (1838-1927) and Frederic Batelli (18671941) were experimenting with single-pulse defibrillation.

They were the first to revive animals whose hearts they’d stopped using charged capacitors. A weak current caused

26

Doctor’s Review • MARCH 2014

DITTRICK MEDICAL HISTORY CENTER, CASE WESTERN RESERVE UNIVERSITY

T

he spark of life lies not only at the core of the wonders of science, it is arguably the greatest mystery

FROM TOP: A replica of Claude Beck’s homemade AC defibrillator; its paddles were metal tablespoons attached to a transformer.

Luigi Galvani made the legs of a dead frog dance.

In the case of the defibrillator, fiction was only slightly ahead of fact. (Movie still from the 1931 film, Frankenstein.)

ventricular fibrillation, they observed, while a stronger current actually stopped fibrillation and kick-started the heart into action again. The catch, of course, was that none of this was possible without the shock being applied directly to the heart muscle. Since cardiac surgery in humans was relatively unheard of at that point, electrical defibrillation was a wonder well ahead of its time.

MODERN DR FRANKENSTEIN? Beginning in 1925, thoughtful funding by the Edison Power Company — interested in reducing the rising number of electrocution deaths in linemen who oversaw the wiring of North America in the early part of the 20th century — led to experiments conducted on victims of accidental electrocution.

The research was jointly conducted at Johns Hopkins University by engineer William Kouwenhoven (1886-1975) and several physicians, including neurologist Orthello Langworthy (1897-1996) of the School of Hygiene and Public Health.

Throughout the 1930s, the team unravelled the electrical mysteries of the heart, using shocks to induce and then reverse fibrillation in rats and dogs, effectively reviving the earlier work of Prévost and Batelli. The Hopkins team was also the first to test and prove that defibrillation was technically possible simply by shocking the outside of the chest, too.

The notion had been fairly well proven: direct electrical stimulation to a fibrillating heart can get it beating regularly once again. But what therapeutic benefit might this hold?

Animal experiments were acceptable, of course, but interference in the workings of the human heart was another story entirely. Fortunately, desperate times call for desperate measures, as one pioneering cardiologist discovered during a crisis in surgery.

Claude Beck (1894-1971), the first professor of cardiovascular surgery in the United States, had developed a keen interest in defibrillation experiments on animals during his time at the University Hospitals of Cleveland during the 1940s. While conducting surgery on a 14-year-old boy with a congenital chest defect who suddenly went into cardiac arrest, Beck attempted the standard therapy, cardiac massage, to halt fibrillation.

He administered drugs and manually pumped the boy’s heart for 45 minutes, but knew the end was near. As a lastditch effort, Beck sent for his homemade AC defibrillator — its paddles were simply metal tablespoons attached to a boxed transformer unit with a variable resistor to control the current — and successfully shocked the boy’s heart into a normal sinus rhythm once again. Dr Beck literally brought his patient back from the dead, in much the same way as the fictional Dr Frankenstein had animated his monster on that stormy fictional night.

Word of Beck’s success spread like wildfire across the country, and electric defibrillation during surgery began saving human lives almost immediately. Still, the method was crude.

It often led to heart damage and even broken ribs from having to quickly crack the patient’s chest cavity open to access the heart and apply the electrode paddles directly to its sides.

DUBIOUS DEVICES The early open-chest, alternating-current (or AC) defibrillators as they were called, were large and bulky units that needed to be plugged in to the wall, and were actually quite heavy to move around. To make matters worse, they were a little too powerful and the current was hard to control, resulting in many injuries, burns and even death. Things changed dramatically with the advent of closed-chest defibrillators, and the introduction of batter-powered devices.

In the 1950s, continued corporate funding by the power companies allowed for the development of the first closedchest defibrillator by Kouwenhoven and cardiovascular physiologist William Milnor (1920-2008). In 1954, they successfully revived a dog using their device, elevating a last-ditch surgical effort to a miracle-level cardiac cure.

Dr Beck brought his patient back from the dead, in much the same way as the fictional Dr Frankenstein had Also in 1954, Paul Zoll (1911-1999), Chief of the Cardiac Clinic at Beth Israel Hospital in Boston, proved that external defibrillation during a cardiac event was remarkably successful in treating more than just man’s best friend. By increasing the power of the electrical current, shocking a patient’s chest directly was indeed enough to restart the human heart and get a stable rhythm going. It was a watershed moment in emergency medicine, dramatically reducing the mortality rate for cardiac arrest and heart disease from that moment on.

AND CPR TOO! External defibrillation was also a precursor to the birth of CPR. In 1958, Kouwenhoven’s assistant, engineering student Guy uu CONTINUED ON PAGE 63 MARCH 2014 • Doctor’s

Review

27

All eyes on Italy Make Sorrento your base for day trips around a peninsula that looks like a painting

FRANCESCO R. IACOMINO / SHUTTERSTOCK.COM

by

Gerald Fitzpatrick

Naples Herculaneum Pompeii

GULF OF NAPLES

Ravello Sorrento

Positano

Amalfi

Capri

Paestum

MEDITERRANEAN SEA

D

own narrow streets from the Italian town of Sorrento, the tiny harbour of Marina

Grande slumbered in the late October sunshine.

Fishing dinghies that were at work before dawn netting sardines and anchovies were drawn up on the beach, their owners chatting nearby. A cruise ship lurked offshore in the shadow of Mount Vesuvius, but few passengers ever find their way here. There are no souvenir shops, just a few restaurants; none of them were busy, even though it was warm enough to lunch on the patios outside.

Marina Grande is a 15-minute walk from the centre of Sorrento, so the end of the tourist season was even more apparent there. Visitors were thinning everywhere and it was a great time to use the town as a base for touring an area rich in history and natural beauty. Pompeii and Herculaneum, the island of Capri, Naples, the Amalfi coast and the Greek temples of Paestum are all within an easy day’s reach of Sorrento. All you need to do is find a nice hotel, unpack once and stay for 10 days or so. And what’s not to like about a town with not one, but two restaurants dedicated to local diva Sophia Loren?

You’ll have to take steep staircases lined with cafés, galleries and shops to get to the beach in Positano, but it’s half the fun.

MARCH 2014 • Doctor’s

Review

29

GERALD FITZPATRICK

GERALD FITZPATRICK

The mosaics in Herculaneum’s House of Neptune and Amphitrite suggest that the owner was wealthy and cultured.

It’s impossible to truly appreciate Pompeii, caught in time by the eruption of Mount Vesuvius in 79CE (and 45-minute train ride from Sorrento), without walking its cobblestone streets: streets that still have the wheel ruts of carriages made over seven centuries before being covered in as much as 20 metres of scalding lava.

Courtyards of gracious homes still have mosaic pavements and wall paintings. Perhaps most astonishing in a city the size of Owen Sound, Ontario, however, is the spacious Forum. A plaza barred to wheeled traffic that was bounded by temples and law courts, it served as the city’s principal market.

With the fall of the Roman Empire the world would not witness such well-ordered cities for a thousand years or more.

Herculaneum, a former seaside resort, is much smaller than Pompeii, but arguably offers a better understanding of what daily life was like in Roman times. It’s also better preserved.

In one villa, for example, a sliding door of carbonised chestnut wood is almost intact. Many mural paintings have been revealed, but mosaics had a better chance of surviving. Particularly beautiful is the one of Neptune and Amphitrite in Room 10.

A guide joked that Herculaneum’s artifacts are in the museum that doesn’t exist. “A new building is ready, but there’s no money to open it,” he shrugged.

“People in other countries have a better chance of seeing our treasures than we do.”

30

Doctor’s Review • MARCH 2014

GERALD FITZPATRICK

POMPEII AND HERCULANEUM

To build his white villa in Capri, Swedish MD Axel Munthe treated foreign dignitaries in Rome.

NAPLES The most repeated comment of our Pompeii guide, pointing to an artifact, was: “Of course this isn’t the original. That’s in the National Archaeological Museum in Naples.” Reason enough to spend at least a day in the city. It’s an hour by train from Sorrento but you should keep your eyes peeled for pickpockets; they’re infamous on all of Italy’s trains.

The museum has the world’s greatest collection of artifacts from ancient Rome, and the finest finds from both Pompeii and Herculaneum. The Alexander

To truly appreciate Pompeii, walk its cobblestone streets that still have wheel ruts made seven centuries ago

Why go to busy Athens when you can have the Greek temples of Paestum almost to yourself?

Mosaic, from the House of the Faun in Pompeii, is not to be missed.

Too often Naples has been in the news for all the wrong reasons. Rife with crime and corruption, the densely populated city had become virtually ungovernable with mountains of uncollected garbage clogging the streets. Fortunately, a new mayor has been working hard to clean things up — including the garbage — but many UNESCO sites are in sad repair and the bus service recently ran out of gas. On the bright side, stations of the subway system (which Neapolitans say will never be finished) have become stunning galleries of contemporary art.

CAPRI A 20-minute fast ferry ride from Sorrento, Capri is certainly worth a day trip — more if you have the time. But it’s become the place for the rich and famous to see and be seen so prices are much higher than in Sorrento.

Ferries arrive on the island’s own Marina Grande.

From the harbour, a funicular ascends to the town of Capri and shuttle buses climb the cliffside to Anacapri.

Near the drop-off point at the Piazza Vittoria, a chairlift can take you to the highest point on the island for spectacular views over the impossibly aquamarine sea.

But you might want to take a pass on the famed Blue Grotto. The sun shining through the water casts a vivid colour of blue in the cave, but to get there you’ll likely endure a long wait — especially if a cruise ship is in — before transferring to a small rowboat so that you can squeeze into the grotto for

just a few moments. Better value is a boat trip from Marina Grande around the entire island.

More rewarding than the Grotto is San Michele, a dazzling white villa perched high above the Bay of Naples in Anacapri. It was built by Axel Munthe, a Swedish physician born in 1857. While working in southern Italy during typhoid, cholera and earthquake disasters, Munthe came across a ruined Tiberian property. With the help of a local family, and doing much of the work himself, Munthe uncovered skeletons, ancient coins and long hidden mosaics as his new home took shape. When Munthe ran low on funds, he set up a practice in Rome serving foreign dignitaries and neighbourhood families. In 1929 he published The Story of San Michele, a hugely popular memoir of his fascinating life that has been called one of the best loved books of the 20th century.

Before heading back to Sorrento, put on your dark glasses and take a seat at an outdoor table in the Piazza Umberto I back in Capri town. This fashionable plaza, known simply as the Piazzetta, is the heart of the island and sooner or later everyone goes there.

PAESTUM The Greek temples of Paestum (about 100 kilometres south of Sorrento) are ignored by many visitors and that’s a pity. However, getting there by train and then bus is time-consuming, so pick up a day bus tour in Sorrento with a guide instead.

Paestum’s peaceful rural setting is in utter contrast to pollution-ridden Athens where crowds go to see the crumbling Parthenon. In Paestum, there’s a light breeze from the sea and the only sounds are of songbirds. Other than a few lizards, we almost had the site to ourselves. It’s this quiet atmosphere that makes the place so compelling.

In the Middle Ages, a malaria epidemic drove people from Paestum. The temples were forgotten until rediscovered by a road building crew in the 18th century. Built in the 5th and 6th centuries BCE, the three Paestum temples are the finest Doric structures in existence. With heavy columns and squat capitals, the superb Temple of Poseidon appears less graceful than the Parthenon with its taller and more MARCH 2014 • Doctor’s

Review

31

FRANCESCO R. IACOMINO / SHUTTERSTOCK.COM

The gardens of the Villa Rufolo in quiet Ravello feature incomparable views of the Amalfi Coast.

Positano is a must-do trip from Sorrento, but go in late October when most of the crowds have gone.

POSZTOS / SHUTTERSTOCK.COM

Sorrentoâ&#x20AC;&#x2122;s Marina Grande has lots of dinghies and fishermen, but few souvenir shops and less tourists.

KHIRMAN VLADIMIR / SHUTTERSTOCK.COM

TEACHERS ON TOUR All of the places mentioned were visited during a 10-day, small-group, cultural tour organized by Teachersâ&#x20AC;&#x2122; Travel (tel: 800-268-7229; teacherstravel.com), a 44-year-old, Toronto-based travel agency founded by former teachers.

The tour costs $5200 per person, based on double occupancy, including air; $3900 land only. Accommodation, buffet breakfasts, dinners and day trips are included; lunches are not.

The tour uses one hotel in Sorrento for the entire stay.

The historic Hotel Tramontano (hoteltramontano.com) overlooks the beach and has views of Mount Vesuvius. Day trips are made to the surrounding area with two days free.

Steinbeck wrote: “Positano bites deep.

It is a dream place that isn’t quite real when you are there and becomes beckoningly real after you have gone” slender columns, but it’s much more complete. It’s unique in still having an internal colonnade surmounted by smaller columns to support the roof.

And if you have time for lunch, there’s nowhere better to sample the local buffalo mozzarella cheese.

The water buffalo here live a charmed life. To produce superior milk at the nearby Tenuta Vannulo Buffalo Farm they are gently massaged and relax to classical music each afternoon. I wonder what the effects of listening to Justin Bieber rather than Mozart might do to the quality of the cheese.

POSITANO AND THE AMALFI COAST In 1953 John Steinbeck wrote: “Positano bites deep.

It is a dream place that isn’t quite real when you are there and becomes beckoningly real after you have gone.”

Lucky John Steinbeck to have seen it before the Amalfi coast became one of Italy’s most popular attractions.

Regardless, it’s still a “must-do” trip from Sorrento and in late October most of the crowds have gone.

The best way to get there is by local bus, which drops passengers above the village. Forget about renting a car. It’s a hair-raising road and parking is almost impossible.

Half the fun is getting to the beach down stepped alleys and staircases lined with cafés, bars and galleries.

Shops sell ceramics, linen, handmade sandals and more things made from lemons than you can imagine.

Looking back from the beach, the pastel coloured houses climbing the cliff are crammed together in a single organic form. Steinbeck’s words still ring true.

After a leisurely cappuccino, one option is to take a small boat along the coast to Amalfi. The morning sun gleams on the cliffs and terraces of lemon groves cling to the sides of the valleys. Close to Amalfi, the guide will invariably say, “That beautiful house on the left is the former summer home of Sophia Loren and Carlo Ponti.”

Amalfi harbour is busy with ferries from Capri and Positano. A few metres inland the stunning polychrome Duomo at the top of a flight of steps overlooks the Piazza Duomo. If it’s time for lunch, restaurants along the Via Pietro Capuano will be happy to serve up marinated anchovies and sea bass sautéed with the best tomatoes you’ve ever tasted.

Just east of Amalfi is the quiet little town of Ravello, situated on a terrace high above the sea with stunning views of the coast from the gardens of the Villa Rufolo.

Among the many artists who found inspiration in Ravello, German composer Richard Wagner said that he found the garden of Klingsor in Parsifal at the Villa Rufolo.

At the end of these day trips go back to Sorrento each evening. Have an aperitivo in the Piazza Tasso.

Walk the now familiar lanes back to your hotel and maybe return to a favourite restaurant. And, on your final evening, head for the Villa Comunale for a last look over the Bay of Naples as lights twinkle below the outline of Vesuvius. All you need to make you cry is the distant strains of that song urging you to “Come Back to Sorrento.”

Oh, and did I mention that in the far distance is Pozzuoli where Sophia… I did? Sorry!

In heartburn associated with GERD,

Fight the Fire In adults 18 years and older, DEXILANT® is indicated for: • Healing of all grades of erosive esophagitis for up to 8 weeks • Maintenance of healed erosive esophagitis for up to 6 months • Treatment of heartburn associated with symptomatic non-erosive gastroesophageal reflux disease (GERD) for 4 weeks

DEXILANT® is a registered trademark of Takeda Pharmaceuticals U.S.A., Inc. and used under license by Takeda Canada Inc. ©2014 Takeda Canada Inc. ®

MARCH 2014 • Doctor’s

Review

33

ALL PHOTOS COURTESY VISIT FLANDERS UNLESS OTHERWISE NOTED

N

o poppies were blowing on that damp spring day; nor for that matter did I see crosses row on row, the original wooden markers having been replaced by stark white gravestones long ago. Even in their

absence though, it was impossible to remain unmoved in Flanders Fields (visitflanders.com). Maybe it was the unseasonable chill, maybe the residual effect of some old, collective ache. In any case, the pressure of history was palpable. Touring Belgium’s western-

34

Doctor’s Review • MARCH 2014

most corner as the centenary of World War I approached, I could feel it in my bones.

The emotional impact is not immediate since, at first glance, the pastoral countryside with grazing sheep seems like it could have been painted by Brueghel.

Field focus

Zoom in on Flanders in northern Belgium as WWI turns 100 by

Susan MacCallum-Whitcomb

The Cloth Hall used to be the city of Ieper’s main market where wool was traded; today it’s the In Flanders Field Museum.

The museum features high-tech projections and bracelets with chips that personalize each visit.

MARCH 2014 • Doctor’s

Review

35

In Passchendaele, 2300 Canadian casualties were incurred to gain a mere 1000 metres of ground in one day alone

When you look closer, however, battle scars are apparent — and not only because 150-plus military cemeteries and memorials dot the area. The land itself, still mine-pocked in parts, bears witness: farmers continue to unearth undetonated shells and human remains on a regular basis.

Moreover, road signs read like a grim chapter in history textbooks: picture Passendale (aka Passchendaele), or Passion Dale, the Valley of Suffering, which for Canadians has become synonymous with unspeakable loss; Langemark, where Germans troops added “chemical warfare” to the military lexicon by releasing 135 tonnes of chlorine gas in 1915; or Hooge, where soldiers of the British Empire first encountered the hellish “liquid fire” of flamethrowers that same year.

G .

36

Doctor’s Review • MARCH 2014

Traffic running through Menin Gate is stopped each evening for the Last Post ceremony.

14LCOCL2 / SHUTTERSTOCK.COM

round zero, of course, is Ieper (toerisme ieper.be), which rhymes with “deeper,” but is better known to most of us from our school days by its French name, Ypres. Strolling around its Grote Markt, you could again be forgiven for thinking that Ieper had been untouched.

Grand public buildings represent a compendium of architectural styles from Romanesque to Renaissance, while step-gabled residences, many converted into cafés or shops, provide an intimate counterpoint.

The overall effect is so pretty you almost expect rotund, red-faced burghers to step out of a Golden Age canvas and onto the cobbled square.

Ask locals about the buildings, however, and they’ll explain that they were originally erected between the 13th and 17th centuries — “originally” being the operative word. They were levelled by bombardments during the three battles that bear this city’s name.

Had Churchill prevailed, they would have stayed that way. Believing that “a more sacred place for the British race [did] not exist in the world,” the future prime minister suggested that “the whole of the ruins of Ypres” be preserved as a memorial in 1919.

The Flemish clearly felt otherwise; returning evacuees soon began rebuilding, faithfully recreating flattened edifices and even reopening old quarries to source matching stone.

Tellingly though, the dominant one — the Cloth Hall, which ranked among the world’s largest commercial buildings in medieval times — is devoted to the In Flanders Fields Museum (34 Grote Markt, Ieper; inflandersfields.be; adults €9, young adults 18-25 €5, kids 7-18 €4). Recently redesigned, it introduces the “War to End All Wars” by combining arresting artifacts with upto-date technology, including touch screens, video projections and microchip-equipped poppy bracelets that personalize each visitor’s experience. Temporary installations (such as one concerning medical care at the front, open now through June) are staged as well.

A

fter perusing the exhibits, get the lay of the land by climbing the Cloth Hall’s 70-metre-tall belfry for views over the entire Ypres Salient. During the Great War, holding the Salient — a bulge in the Allied line bordered on three sides by Germanheld territory — was crucial; from the tower’s vantage point, with the heights, hollows and France beyond spread before you like a giant topographic map, it’s easy to see why.

To understand the price paid, go to the burial grounds themselves, starting with Essex Farm Cemetery. Two kilometres north of Ieper, it contains the graves of 1200 Commonwealth soldiers, the youngest being 15-year-old rifleman V. J. Strudwick.

There’s an added resonance for Canadians because, directly to the left, bunkers mark the location of the Advanced Dressing Station where Guelph-born brigade surgeon Lieutenant Colonel John McCrae penned the war’s most-memorized poem in response to the death of his friend Alexis Helmer in May 1915.

The Gate honours the 54,896 Commonwealth soldiers who went missing in the Ypres Salient between 1914 and 1917.

The Memorial Museum Passchendaele 1917 features a replica of a six-metre-deep dugout in its cellars.

FIELD GUIDE Exploring the Ypres Salient independently is easy enough. Museum exhibits tend to be multilingual and English info is available at Commonwealth cemeteries and memorials.

At Tyne Cot, a visitor centre establishes the context through military paraphernalia, personal effects and flickering photos, while smaller burial sites have interpretative panels or at least a plaque.

For a sample itinerary, advice on themed-driving and cycling routes, and events being held in conjunction with the 2014-2018 Great War Centenary go to greatwarcentenary.be. To learn more about the Last Post ceremony, including how to participate by laying a wreath, go to lastpost.be.

Small group tours, readily arranged in Ieper, are an alternative. Battlefield Exploration (battlefield exploration.com), for example, offers a range of excursions among them a three-hour Canadian Experience (€30 per person).

For a customized tour, consider hiring a private guide. Those authorized by the tourist office charge €25 an hour (you can cover a lot of ground in a half day), regardless of the size of your party. My guide, Raoul Saesen (raoulsaesen@hotmail.com), can also lead you around Canadian sites across the border in France, including Vimy Ridge and the Newfoundland Memorial Park at Beaumont-Hamel.

However you proceed, the Commonwealth War Graves Commission website (cwgc.org), which has details on all Commonwealth cemeteries along with a searchable database pinpointing individual graves, is a valuable resource for Great War “pilgrims;” the Veterans Affairs Canada website (veterans.gc.ca/eng/remembrance) is another.

For more tour companies and for accommodations, visit Tourism Ieper (toerismeieper.be).

38

Doctor’s Review • MARCH 2014

There are 11,954 servicemen interred at Tyne Cot, the largest Commonwealth war cemetery in the world.

Visitors can walk through a reconstruction of German and British trenches at the Passchendaele museum.

I wept for my grandfather who served with the Royal Canadian Artillery’s 12th Siege Battery.

Badly wounded, he never made it this far Nearby Tyne Cot, the largest Commonwealth war cemetery in the world, proves that McCrae’s haunting injunction to “take up our quarrel with the foe” was heard and heeded. Allied forces captured a small pillbox-style guard station here in 1917, transforming it into a rudimentary first-aid post. (The concrete structure would later be incorporated into the towering Cross of Sacrifice at the behest of King George V). Soldiers who could not be saved inside were laid to rest around it, and their numbers quickly multiplied as the mud rose and the death toll mounted on other battlegrounds. A few kilometres away in Passchendaele, 2300 Canadian casualties were incurred to gain a mere 1000 metres of ground on October 30 alone. Over time, 11,954 WWI servicemen would be interred at the cemetery, the vast majority of them unidentified but, as their headstones attest, “Known unto God.”

T

here’s no shortage of related sites in the immediate vicinity including the 11metre-tall Brooding Soldier monument at Vancouver Corner in Saint Julien; the Hill 62 (Sanctuary Wood) Canadian Memorial at Mount Sorrel, which is approached via a maple-lined avenue dubbed Canadalaan; and the private Memorial Museum Passchendaele 1917 (5 Berten Pilstraat, Zonnebeke; passchendaele.be; adults €7.50) in Zonnebeke. Here, displays are complemented by a walk-through replica trench and a dugout that extends some six metres below ground that makes you feel claustrophobic.

Yet arguably none is as moving as Ieper’s Menin Gate Memorial: the classically-inspired triumphal arch unveiled in 1927 to honour Commonwealth soldiers who went missing in action in the Ypres Salient between July 1914 and mid-August 1917. Neither the miniature Maple Leaf flags tucked into the stonework nor the “thank you” notes left here by schoolchildren can fully prepare you for the sheer number of names — 54,896 all told — inscribed upon it.

Poignant by day, a visit to the Menin Gate can be emotionally wrenching at night. Each evening at 8pm, traffic on the road running underneath it — the same road so many soldiers traversed en route to the front — is halted for the Last Post ceremony. At the one I attended, bugles were played, wreaths were laid, a poem was read and tears were shed… mine among them.

I wept in part for my grandfather who had served with the Royal Canadian Artillery’s 12th Siege Battery.

Badly wounded just on the other side of the FrenchBelgian border, he never made it this far; nevertheless, his hushed tales of trench life (tales that were all the more powerful because they were infrequently told) seemed to encapsulate the resilience of the human spirit.

While I am not a person who is naturally drawn to that bunting-hanging, cymbal-banging brand of patriotism, I wept out of a genuine sense of national pride, too. After all, the First World War’s baptism by fire helped forge my country’s identity and earned Canada a new level of independence.

But I wept in gratitude as well for the people of Flanders who, despite having worked so long to rejuvenate the war-cratered landscape and rebuild their bombed-out landmarks (the Cloth Hall, for one, wasn’t completed until 1967), still refuse to “break faith” with those who died. Instead they have resolutely chosen to remember.

with DEXILANT.

®

warfarin, tacrolimus, and other Consult the Product Monograph at drugs for which gastric pH is important www.DEXILANT.ca/PM for important for bioavailability information on: • Conditions of clinical use, adverse • Contraindications in patients reactions, drug interactions, and dosing concomitantly treated with atazanavir • Other relevant warnings and precautions instructions regarding gastric malignancy; increased The product monograph is also available risk of osteoporosis-related fractures by calling us at 1.866.295.4636. (especially in patients >71), DEXILANT® is a registered trademark of Takeda hypomagnesemia, and gastrointestinal Pharmaceuticals U.S.A., Inc. and used under license infections; concomitant use with

by Takeda Canada Inc. methotrexate and/or its metabolites, ©2014 Takeda Canada Inc.

®

MARCH 2014 • Doctor’s

Review

39

Aim for the sky The Atlantic Links along the UK’s coasts of Cornwall and Devon should be on every golfer’s list by

Anita Draycott

Saunton’s golf course sits on Braunton Burrows, the largest sand dune system in England and a Unesco Biosphere Reserve.

Bristol

BRISTOL CHANNEL

Burnham & Berrow

Saunton CLOVELLY

Royal North Devon

ATLANTIC OCEAN

THE MUSEUM OF WITCHCRAFT

ON DEV

TINTAGEL

Exeter

St. Enodoc

Trevose

Wadebridge Plymouth

Newquay

L AL NW R CO

THE EDEN PROJECT THE LOST GARDENS OF HELIGAN

M

ENGLISH CHANNEL

ALL PHOTOS COURTESY ATLANTIC LINKS UNLESS OTHERWISE NOTED

y friend Clive Agran, a fellow golf travel writer who lives in East Sussex, prefers to put his own unique spin on things. When Clive first told me about a brilliant collection of ancient courses

scattered along the English coasts of Devon and Cornwall called the Atlantic Links (atlantic-links. co.uk), I was keen to pack my clubs. However, Clive being a fitness fanatic, undertook his Atlantic adventure by bicycling from course to course on two wheels: approximately 525 kilometres.

I don’t recommend Clive’s method of transportation, but I strongly suggest that you experience the Atlantic Links. The courses are grand, the scenery sublime and there are plenty of other temptations along the way including Devon cream teas, Cornish pasties, and some sweet villages and gardens.

All this at bargain prices with green fees almost half the cost of comparable courses in Scotland and Ireland.

Stay-and-play packages are reasonable, too. An eight-day itinerary including six rounds and fourstar hotels (with breakfast), for example, starts at £843 per person in April. Atlantic Links will book your golf and accommodations.

BURNHAM & BERROW My husband and I flew to Bristol and rented a car.

(Yes Clive, we’re wimps.) Half an hour later we pulled into Burnham & Berrow Golf Club, originally laid out by Charles Gibson in the 1890s. Herbert Fowler, the first “professional” course designer extended it to over 6000 yards in 1910 with more tinkerings by Harry Colt and Alistair Mackenzie beginning in 1913.

MARCH 2014 • Doctor’s

Review

41

ANITA DRAYCOTT

Westward Ho! is a popular family beach, but the wild sea bass in its waters attract anglers from around the UK.

Dune-lined fairways heave and ho like the sea beyond and a few marsh holes create a memorable first impression. Number 10 requires a blind drive over a hill through a couple of striped goalposts. The 18th finale is a longish sweeping dogleg to a green surrounded by four daunting bunkers.

The welcoming clubhouse served tasty toasted shrimp sandwiches and homemade tomato/basil soup. England’s former reputation for bad food is long gone; West Country cuisine, we soon discovered, is worth the trip alone.

SAUNTON

42

Doctor’s Review • MARCH 2014

Don’t miss the 13th-century chapel at St. Enodoc’s 10th green if your game needs some divine intervention.

ANITA DRAYCOTT

We could have saved time by taking the M5 to our evening destination, Saunton Sands in Devon. Instead, we took the coastal route past cute villages and patchwork fields of green and gold. Often the roads were barely wide enough for Clive’s bicycle, let alone four wheels.

We arrived at the white, art deco Saunton Sands Hotel, with commanding views of a long golden strand, in time for an alfresco dinner of lamb Provençal and strawberries topped with Devon’s decadent clotted cream.

We were booked to play the Saunton East and West courses the following day. North Americans accustomed to using carts or buggies as they’re called in the UK should take note: these courses are meant to be walked. Make sure you have comfortable shoes, and be prepared to shoulder your bag or haul a trolley up and over the dunes. You can rent battery-operated trollies at some clubs, which I highly recommend, especially if you’re tackling 36 holes a day. Mea culpa, Clive.

We played the East course, circa 1897, with members, Danny and Ann Wallace. So lofty are the dunes, it feels like each fairway is your private play-

Who cares if St. Enodoc ranked 99th? It still made Golf Digest ’s World 100 Greatest Courses in 2014.

ground. The East is no walk in the park. Eight par fours exceed 400 yards and the par threes demand pinpoint accuracy. The West is shorter and a bit easier, but still a worthy challenge.

At Saunton, as at all the other clubs, we were impressed by the warm welcome we received and the pride these folks take in their clubs’ pedigrees.

Sir Nick Faldo once remarked that Saunton East is “the finest course never to hold an Open.” I’d venture to say that most of the Atlantic Links courses are worthy of a major event, but none have the infrastructure to host upwards of 50,000 spectators per day — which is part of their charm.

The best fish and chips in North Devon is reputedly served at Squires (1 Exeter Road; squiresfishrestaurant.

co.uk) so we absolutely had to make the short, fiveminute drive to the Braunton restaurant after a round.

We’re glad we did. Chef Mike’s light crispy batter lived up to its reputation.

ROYAL NORTH DEVON Wild and windswept, Royal North Devon at Westward Ho! is England’s oldest course dating back to 1864. It was the first club in England to have the title “Royal” conferred upon it by the Prince of Wales in 1865 and became the world’s first true ladies’ golf club in 1868.

Originally laid out by Old Tom Morris, it hasn’t changed much — except the sheep are fatter. This is MARCH 2014 • Doctor’s

Review

43

Trevose is located on the rugged North Cornish coastline where towns huddle in the cliffs for protection against the sea.

JUST FOR SPORT You came to play golf, but here are a few side trips not to be missed.

The seaside village of Clovelly (clovelly.co.uk), 20 kilometres from Westward Ho!, has donkeys, but no cars, or individually-owned houses or hotels. It has been the property of only three families since the 13th century.

Steep cobblestone lanes lead down to an enchanting harbour. Enjoy Devon cream tea here, and don’t miss the short movie about Clovelly’s history and residents.

Learn all about curses and spells at The Museum of Witchcraft (The Harbour, Boscastle, Cornwall; museumofwitchcraft.com), 29 kilometres from St. Enodoc.

It houses the world’s largest collection of artifacts related to sorcery and black magic.

Neighbouring Tintagel (tintagelweb.co.uk) is reputed to be the site of King Arthur’s castle and the Knights of the Round Table. Take a hike out to the castle ruins that cling to the rugged coast.

Sir Tim Smit created his version of Utopia out of a reclaimed clay pit. The Eden Project (Bodelva, St. Austell, Cornwall; edenproject.com), 34 kilometres from Trevose, is a 14-hectare living laboratory. Huge biomes (domed ecosystems) house vegetation from the around the world.

Trek through a rainforest, discover Mediterranean vines, olives and cork.

The Lost Gardens of Heligan (Pentewan, St. Austell, Cornwall; heligan.com), which date back to the 18th century, are nearby. Once part of a 404-hectare Victorian estate, the gardens were discovered by Sir Smit in 1990 and have been restored to their former glory.

44

Doctor’s Review • MARCH 2014

Burnham & Berrow’s two courses often host amateur championships and even Brit Open qualifications.

Or, go local with an award-winning Cornish pasty from Chough Bakery (3 The Strand, Padstow, Cornwall; cornishpasty.com). Pasties began as a mealin-one for Cornish tin miners. One end housed the savoury part, usually steak, turnips and potatoes; the other, dessert. The crescent-shaped meal had a crimped pastry handle so the miners could hold it with their dirty hands and then toss the crusty edge away.

ANITA DRAYCOTT

TREVOSE Squires in Braunton reputedly serves the best fish and chips in North Devon.

common land where the livestock get lifetime memberships. Hole number one resembles a petting zoo.

You’ll have to let it rip to clear the massive Cape Bunker on number four and don’t let that pesky creek on 18 ruin your score.

Be sure to have a cuppa in the atmospheric clubhouse filled with antique golf memorabilia, mashies (or clubs) and featheries (balls).

Our last round on the Atlantic Links was at Trevose, located high on a promontory overlooking Constantine Bay. We stayed comfortably in a self-catering cottage just a pitching wedge from the first elevated tees of the Championship course.

We won’t forget the par-five fourth where the sea froths and crashes against the headland. This masterpiece, another by Harry Colt circa 1925, requires every club in your bag and the wind is a mega factor.

Trevose’s Constantine restaurant, with its sunset views and scrumptious local scallops, made the ideal grand finale. It was also a fitting place to toast “cyclopath Clive” for introducing us to this splendid collection of links, and some of the best scenery and hospitality in England.

ST. ENODOC We bade farewell to Devon and crossed into Cornwall.

In the small hamlet of Rock, where the likes of Prince Andrew come to play and party, we found St. Enodoc Golf Club, designed in the early 1900s by James Braid.

You can play 36 holes here, but if time is short, make the fabled Church course your first choice. It was recently included in Golf Digest’s inaugural ranking of the “World’s 100 Greatest Courses” proving that shorter and quirkier — it’s a par 69 and 6557 from the tips — can be sweeter.

The quality of the links and the views of the nearby town of Padstow and the Camel Estuary make for an enchanting round. The first three holes are blind with plenty of oddities and obstacles — plus lots of walkers with their dogs. I think every third person I met in Cornwall had a dog. Number six boasts the Himalaya Bunker, reputedly the highest in Europe.

Don’t miss a small detour to the 13th-century chapel tucked behind the 10th green. At this point, you might feel the need for a bit of divine intervention. The gravestone of poet laureate Sir John Betjeman, who penned beguiling verses about his beloved game of golf, is buried beside his favourite course.

We took a quick ferry over to Padstow, a harbour town nicknamed “Padstein” because British restaurateur, Rick Stein, has several eateries here.

For a splurge, book a table at Seafood Restaurant (Riverside, Padstow, Cornwall; rickstein.com/the-seafoodrestaurant.html).

The only PPI with Dual Delayed Release® technology*

In adults 18 years and older, DEXILANT® is indicated for: • Healing of all grades of erosive esophagitis for up to 8 weeks • Maintenance of healed erosive esophagitis for up to 6 months • Treatment of heartburn associated with symptomatic non-erosive gastroesophageal reflux disease (GERD) for 4 weeks For important information on contraindications, warnings, precautions,

adverse reactions, interactions, dosing, and conditions of clinical use, please consult the product monograph at www.DEXILANT.ca/PM. The product monograph is also available by calling us at 1.866.295.4636. * Comparative clinical significance has not been established.

DEXILANT® and Dual Delayed Release® are registered trademarks of Takeda Pharmaceuticals U.S.A., Inc. and used under license by Takeda Canada Inc. ©2014 Takeda Canada Inc.

MARCH 2014 • Doctor’s

Review

45

© PARIS TOURIST OFFICE/AMÉLIE DUPONT

Paris’s Musée d’Art Moderne consists of 9000 works including The Electricity Fairy mural by Raoul Dufy.

A free show 10 museums in Europe that bare it all and ask for nothing in return by

Will Coldwell

W

hen it comes to museums, Brits have got it pretty good in the UK with free entry to many major institutions. In London, for example, locals can pop into places like the National Gallery, the British Museum

or the Tate on their lunch break without making a dent in their sandwich money.

Most museums in Europe do charge an entry fee, but there are still plenty of opportunities for budget travellers to get a free culture fix. Many cities have adopted a free first Sundays scheme, giving visitors access to the permanent collections once a month, while many others offer free entry on other days.

46

Doctor’s Review • MARCH 2014

Of course, there are still museums that offer free entry to their permanent exhibits every day. Some may be small, specialised or hard to get to — like the Florence Nightingale Museum in Istanbul — but many, like the Modern Art Museum in Paris or the Berardo Collection in Lisbon, are just as grand and comprehensive as their pricier counterparts. Here are 10 free museums across the continent.

PARIS

AMSTERDAM

MUSÉE D’ART MODERNE

STADSARCHIEF

While it may not have the je ne sais quoi of the Pompidou Centre, Paris’s modern art museum boasts an enviable collection with over 9000 works illustrating all the major art movements of the 20th century. In 2010, five masterpieces by Picasso, Matisse, Braque, Modigliani and Léger were stolen in “the art heist of the century,” a haul worth over €100 million. The crime was never solved, but the remaining works, displayed in a vast 1930s building with looming pillars, are more than enough for an afternoon wander. mam.paris.fr.

Amsterdam’s Stadsarchief (or City Archives) is housed in an imposing though gritty-looking building that was originally the headquarters of an investment bank. Inside, its tiled rooms are decorated with bold, jagged graphics and patterns. The underground Amsterdam Treasures exhibition is a collection of artifacts that help tell the story of the city; they’re worth a good nose around while anxiously hoping the heavy vault doors stay open until you’re done. stadsarchief.amsterdam.nl.

DORIANN KRANSBERG

The 32 kilometres of archives at Amsterdam’s Stadsarchief includes a record of Rembrandt’s burial from 1669.

© VISITBERLIN/STEFFEN

The grounds around the Berlin Wall Memorial are preserved to give a true-to-life impression of the dead space it once occupied.

BERLIN WALL MEMORIAL While the ghost of the Berlin Wall still lingers around much of the city, this memorial and museum is a fantastic place to learn about the concrete strip that once divided the German capital. The site contains a piece of the wall, with the grounds around it preserved to give a true-to-life impression of the dead space it once occupied and where many who tried to cross were killed by border guards. The visitor centre offers films and books, while the documentation centre features a viewing platform overlooking the site and a summary of events leading up to and following the wall’s construction. berliner-mauer-gedenkstaette.de.

MARCH 2014 • Doctor’s

Review

47

LISBON BERARDO COLLECTION MUSEUM A recent — and impressive — addition to Lisbon’s list of cultural attractions, the Berardo Museum opened its collection of modern and contemporary art to the public in 2007. The museum is filled with vibrant works by all the hard-hitting pop artists such as Warhol, Pollock and Lichtenstein as well as greats such as Picasso, Bacon and Dalí. It has an unparalleled collection of advertising art: wonderful vintage posters you simply wish you could own. Regular temporary exhibitions (some requiring tickets) focus on specific artists or themes. museuberardo.pt.

COPENHAGEN

Copenhagen’s National Museum has exhibits on the Stone, Viking and Middle Ages, and a Children’s Museum, too.

WONDERFUL COPENHAGEN/TY STANGE

NATIONAL MUSEUM Charting the history of the Danes since prehistoric times, the National Museum is a proud and comprehensive collection. Particularly interesting is the Stories of Denmark exhibition, which uses thousands of everyday objects to illustrate how life has changed in the country since 1660. It’s good for families, and has a dedicated children’s museum, where the kids can try on period dress and pretend to be Vikings. natmus.dk.

If you thought the 642 snaps you have on iPhoto were impressive, the Reykjavik Museum of Photography has five million

REYKJAVIK MUSEUM OF PHOTOGRAPHY If you thought the 642 holiday snaps you have on iPhoto were impressive, brace yourself; the Reykjavik Museum of Photography has a collection of around five million photos, dating from 1870 to 2002. There are also works by contemporary Icelandic photographers and objects related to the art of photography. ljosmyndasafnreykjavikur.is.

48

Doctor’s Review • MARCH 2014

The Berardo Museum in Lisbon is filled with pieces by pop artists like Warhol as well as greats like Picasso, Dalí and Bacon.

ROME MUSEO STORICO DELLA LIBERAZIONE During the Second World War, this building in Rome’s Via Tasso was taken over by German security forces who used it as a headquarters and base from which to murder and imprison many of the city’s civilian population. Once an infamous site of terror, the building is now a museum and the rooms that were once cells for political prisoners are dedicated to the memory of those who were detained. viatasso.eu.

ISTANBUL NICE MUSÉE DES BEAUX-ARTS Housed inside the striking former mansion of a Ukrainian princess, this museum’s building is a spectacle in itself. Once past the iron gates and through the elegant gardens, you’ll find an art collection spanning realism, romanticism and symbolism, with works from Monet to Rodin displayed within its palatial rooms. After you’ve finished admiring the mansion’s gleaming marble interior, the collection of Raoul Dufy’s work is particularly worth a look. www.musee-beaux-arts-nice.org.

FLORENCE NIGHTINGALE MUSEUM This is not the most straightforward museum to visit.

You’ve got to arrange an appointment by fax at least 48 hours in advance — but it’s worth it for anyone fascinated by the Crimean War and the story of the lady with the lamp. The museum is within the Selimiye Army Barracks, built in 1799, which was the military hospital where Nightingale and her students developed the nursing techniques that saw her go down in medical history. Explore her living quarters and the room that served as an operating theatre. Adding to the experience is the fact that the guides are often young soldiers on their military service. To arrange an appointment, fax the date and time of your visit, and a photocopy of your passport to 011-90-216-553-1009/ 310-7929.

MADRID

PEDRO ALBORNOZ / MUSEO NACIONAL DEL PRADO

MUSEO DEL PRADO The Prado, one of Madrid’s most popular attractions, is simply huge, so it’s a real treat that entry is free every evening (expect long lines). There’s no need to race through the neoclassical hallways in a futile attempt to see all the sculptures, portraits and murals: instead drop in on a couple of evenings and view the rich pickings at your leisure. Highlights include The Annunciation, a lavish gold altarpiece crafted by Fra Angelico in the 15th century and Peter Paul Rubens’ The Three Graces. There are useful route suggestions for visitors pressed for time. www.museodelprado.es.

Copyright Guardian News and Media Ltd 2014.

Take your time studying sculptures like El Furor de las Águilas; the Prado is free every evening.

MARCH 2014 • Doctor’s

Review

49

CLAUDIO GIOVANNI COLOMBO / SHUTTERSTOCK.COM

The

Lautrec

legacy

The alcoholic aristocrat Toulouse-Lautrec ruled Paris’ brothels but he also called quiet Albi home by

Jeremy Ferguson

enri de Toulouse-Lautrec, born a rich man and a descendent of the Counts of Toulouse, lived, painted, whored, drank and died at age 36. Because he shares a birthday with me (and no one else of note seems to), I feel a certain gratitude. The 1.37-metre Toulouse-Lautrec — a congenital condition prevented his legs from growing as an adolescent — painted in larger brushstrokes than he could have guessed. He died a failure in 1901, the usual irony: his understated painting of a red-headed laundress sold for $22.4 million in 2005.

Today he is the most celebrated son of the beautiful medieval city of Albi in the French southwest.

Albi’s Musée Toulouse-Lautrec (Palais de la Berbie, Place Sainte-Cécile; museetoulouselautrec.net; adults €8 for

permanent collection, €10 for exhibits, kids under 14 free; closed Tuesdays in low season) unveiled in 2012 with 1000 paintings, drawings, lithographs and posters, qualifies as the largest single-artist museum in the world. Housing it is the Berbie Palace, also known as the Bishop’s Palace, a 13th-century castle overlooking the Tarn River and the majestic Pont Vieux, a 1000-year-old bridge.

The 750-room palace is a work of art in itself: its medieval rooms — one reserved for torturing heretics — vaulted arches and tiled floors are as

The formal gardens of the Berbie Palace overlook the Tarn River and offer excellent photo ops of Albi.

JEREMY FERGUSON

JEREMY FERGUSON

Le Musée Toulouse-Lautrec is the largest single-artist museum in the world.

For the flaneur, people-watching is as good as admiring the art.

When Rome’s “crusaders” asked how to distinguish Catholics from Cathars, the response was “Kill them all...” compelling as its art. A painstaking restoration turned up paintings under plaster, found floors under floors and discovered a secret passage from the bishop’s quarters to a nearby convent.

The galleries are a traipse through the life and works of the artist. His little-known early pieces, the tinkering of a young man, are at times broodingly beautiful. There are compelling portraits of Lautrec by his peers. One likeable work captures him as an amateur chef — yes, a gastrognome — toiling blissfully among the pots.

The collection concludes with Lautrec as PostImpressionist interpreting Parisian life in the fin de siècle. So the bishop’s quarters have been taken over by the brazen cancan dancers and frumpy prostitutes of Montmartre. Resurrect the bishop and he might jump through a stained-glass window.

The Lautrec heritage doesn’t extend much further.

His likeness turns up on a menu or two. The family home on Rue Henri de Toulouse-Lautrec has a simple plaque and no public access. The restaurant Le Lautrec (13/15 Rue Toulouse-Lautrec; restaurant-lelautrec.com) on the same street has a reputation for using the artist’s recipes, but this is a fib: it’s merely one of the few restaurants left in France to treat foreigners like cretins.

52

Doctor’s Review • MARCH 2014

I

n the 21st century, Albi is simply one of the loveliest cities in France. In the 13th century, it had been an episcopal city, a seat of high and tyrannical religious authority. And because it is such a superbly preserved medieval city, its core was named a UNESCO World Heritage Site in 2010.

The presiding icon is the hulking Sainte-Cécile cathedral, which looms over the city like a raging tyrannosaurus. If it were to topple over, you’d wonder if all of Albi might be crushed under it. But the bullying exterior gives way to an interior packed like a treasure box spilling over with 16th-century wall paintings, Renaissance frescoes and religious tchotchkes.

The Bishop-Inquisitor, whose name was Bernard de Castanet, erected this colossus to celebrate the vicious extermination of an estimated half-million Cathars, a runaway Christian sect that challenged Vatican doctrine and privilege in the 13th century.

When Rome’s “crusaders” asked how to distinguish Catholics from Cathars during the massacres, the response from Rome was “Kill them all. God knows his own.” And so they did.

Below the organ, the Last Judgment fresco revels in sinners undergoing a kickline of medieval grotesqueries, while a troupe of bewildered nudists appears to be wandering in the background.

JEREMY FERGUSON

A walk along the Tarn River before sunset is a must as the bridge and skyline almost change colour from ochre to pink.

Elsewhere in Albi’s downtown, the aforementioned convent with its secret passage has become the Musée de la Mode (17 rue de la Souque; museemode.com; adults €6, kids 9-14 €4; closed Mondays), a little jewel of a museum exhibiting French costume from the 17th to 20th centuries.

It comes driven by the singular passion of ownercurator Dominique Miraille. He purchased the wreck of the Covent des Annociades and spent 12 years restoring it. This would become home for the 10,000 mint costumes he’d been collecting since his 20s.

Nothing wrong with an unbendable obsession.

History, artistry and sartorial craftsmanship fuse in these threads. The flamboyant costume of the late 18th century, the time of the French Revolution, will arrest anyone who grew up on The Scarlet Pimpernel, A Tale of Two Cities, and that rollicking screen swashbuckler, Scaramouche.

Albi’s monuments are impressive, yes, but the puzzle of medieval streets that weaves around them is their equal. The flaneur, wandering without purpose, becomes happily lost among cobbled streets, narrow passages, twisting alleyways, half-timbered shops and gabled houses (a sublime movie set, only the ghosts are real).

The city’s other essential stroll takes you along the banks of the Tarn an hour before sunset. It’s

magic to the eye: Albi’s old bridge and skyline take on a hue that melts from ochre to pink, flattering even the galumphing cathedral. Lautrec should have painted it a hundred times.

T

he artist loved food and no wonder. It’s always a pleasure to eat in the French sud-ouest, which means duck every which way: foie gras of duck liver, duck breast, duck rissoles and never least, juicy, crispy-skinned duck confit preserved in crinolines of its own fat. There’s no shortage of duck in Albi.

At Le Goulu (Le Grand Hôtel d’Orléans, 1 Place Stalingrad; hotel-orleans-albi.com) “the glutton,” which has been feeding Albighensians since 1902, chef Guillaume Arguel ventures beyond tradition in a handsome room with shades of grey and beige and splashes of vibrant modern art.

Elegantly plated dishes, such as deeply smoked herring atop julienned celeriac, follow through. A signature main is a juicily roasted lamb shank rising like a Gothic steeple out of a meadow of thyme, carrot puree, oyster mushrooms and savoury baby potatoes.

Dessert of raspberry sorbet and chocolate pot de crème with butter crumble confirms the impression of a first-tier kitchen with second-tier prices.

MARCH 2014 • Doctor’s

Review

53

Bleed: 4” Trim: 3.5”

Le Parvis is one of the many Albi restos specializing in regional dishes.

54

Doctor’s Review • MARCH 2014

JEREMY FERGUSON

V

eteran travellers know France has the most beautiful countryside in the world, and Gaillac doesn’t disappoint. A distinct figure in this verdant, rolling landscape is the pigeonnier. The pigeon house has a long history in the vineyards: the birds were a delicacy on the plate and it was their poop that fertilized the soil. Some observers even claim it was responsible for the distinct flavour of the wine.

Built of stone, brick and wood and clay, the pigeon houses came in every style from farmhouse simple to chateau elaborate. The Tarn area alone has 1700 and a Circuit du Pigeonniers acts as a novel thread for tourists on the move. In some cases, pigeonniers have been converted to gîtes, cottages for rent.

Must-do day trips from Albi lead to bastides, the walled hill villages of Cordes-sur-Ciel and Puycelsi.

All cobbled streets, and half-timbered and arcaded houses, they crawl with busloads of tourists in summer (oddly, neither are mentioned in Lonely Planet’s France).

Puycelsi was founded by Benedictine monks in the 10th century. Its ramparts stood up to devastating

JEREMY FERGUSON

Reference: Goldenberg R and Punthakee Z. Canadian Diabetes Association 2013 Clinical Practice Guidelines for the Prevention and Management of Diabetes in Canada: Definition, Classification and Diagnosis of Diabetes, Prediabetes and Metabolic Syndrome. Can J Diabetes 2013;37(S1):S8-11.

Trim: 10”

There’s more to the story.

Visit SGLT2diabetes.ca

Bleed: 11”

Until recently, diabetes research has focused mainly on the role of impaired ß-cell function and insulin resistance in hyperglycemia.

Albighensians urge tourists to drink local, the product of Gaillac, the nearby wine region nowadays upgrading from plonk to wines of quality.

Exploring Gaillac, the traveller might pause at the Château de Mayragues (81140 Castelnau-de-Montmiral; chateaude-mayragues.com), a boldly biodynamic winery offering top-of-the-line labels and a medieval chateau for overnighting. The property has been a vineyard since 1609. Owner Alan Geddes spent the past 30 years restoring the chateau and he applies the same energies to his wines.

Make time for the town of Gaillac in the heart of wine country. An amble through the Abbaye SaintMichel wine museum (Place Saint-Michel; patrimoine@ ville-gaillac.fr) is worth your time and lunch at the La Table du Sommelier (34 Place du Griffoul; latabledu sommelier.com) on the square is a fine idea.

Proprietor Daniel Petrie was elected best wine waiter in France in 2004 and his restaurant is clever with the grape: every glass of wine comes tagged and labelled, and the customer can purchase the bottle at the restaurant’s in-house wine store.

Food is no afterthought: think puff pastry tartlet stuffed with fresh tomatoes and warm chèvre, baked seafood in Parmesan crumble, duck roasted in a foie gras sauce and the sort of cheese tray you only find in France (one might come here only to eat cheese).

Bleed: 4” Trim: 3.5”

sieges in the 13th and 14th centuries. Restored in the 1950s — its critics have called it “over-restored” — its walls, streets and colours evoke a medieval fairy tale.

Cordes-sur-Ciel perches on a hill 25 kilometres from Albi. Classically photographed afloat in morning mist, it’s a ghostly medieval pile. But inside its walls, its sloping main street is a gauntlet of souvenir shops, cafés and hotels. In one of the better hotels, tourists can be seen tucking into foie gras terrine under a canopy of 300-year-old wisteria.

Its principal tourist attraction is the Musée Les Arts du Sucre et du Chocolat (33 Grand Rue Raimond VII; artdusucre.fr), one of the world’s more original museums. It’s all about the oeuvre of Yves Thuriès, a famous pastry chef and chocolatier who runs 55 shops in Paris.

The building is a multi-storey sculpture garden, with entire street scenes, paintings, flowers, food, muskets, swords and a voluptuous ebony nude forged in sugar and chocolate. It recalls those miniature cities made of toothpicks and paper clips or souvenirs from Lourdes. One might give a hoot, but only because so remarkable a journey should end on a sweet note.

ACCOMMODATE YOURSELF IN ALBI Le Grand Hôtel D’Orléan (1 Place Stalingrad; tel: 011-33-5-6354-1656; hotel-orleans-albi.com), home to Le Goulu restaurant, is a 10-minute walk from the city centre. Rates are €75-132. Until December 25, pay one night (double occupancy) and receive two breakfasts and two tickets to the Musée Toulouse-Lautrec for €110.

There’s another key factor contributing to hyperglycemia in type 2 diabetes.

Get more of the story.

Visit SGLT2diabetes.ca

Twenty-five kilometres from Albi, Cordes-sur-Ciel is a well-preserved town that dates to 1222.

Reference: Mather A and Pollock C. Glucose handling by the kidney.

Kidney Int 2011;79(Suppl. 20):S1-S6

MARCH 2014 • Doctor’s

Review

55

Early Diagnosis Keeps Your Life From Unravelling.

Almost half of all Canadians affected by dementia, including Alzheimerâ&#x20AC;&#x2122;s disease, are waiting too long to be diagnosed. Yet, early diagnosis can improve the journey for the person with dementia and prepare their family and friends for what lies ahead.

The Alzheimer Society makes the disease easier to live with by providing information, support and education every step of the way. Find out more at www.earlydiagnosis.ca and see your doctor.

Thereâ&#x20AC;&#x2122;s So Much To Hold On To.

ONE BOTTL E by

James Nevison

Spain’s glorious garnacha It wasn’t meant to be more than a pitstop; a respite on the road to Spain’s world-renowned La Rioja wine region by way of the glamorous streets of Barcelona. That said, the sun was setting and a good night’s rest was in order—somewhere in the province of Zaragoza, in the autonomous community of Aragon.

A turnoff from the main autopista, a few twists and turns later, and Tarazona appeared. Suddenly the respite became a recipe for good fortune.

As often happens in travel, an uncertain itinerary led to unexpected delight. Tarazona turned out to be an amazingly picturesque Roman-era town, replete with a resplendent Town Hall, an architecturally intriguing cathedral, and a grand bullfighting arena. Not to mention walled, narrow antiquated streets.

A comfortable room in the old town was fortuitously secured, and mere yards down the street a tapas bar materialized. It was packed, ebbing with both local lore and locals seated elbow-toelbow. Calamari a la plancha, mushrooms and blood sausage soon arrived, served up alongside a glass of red. In this territory that almost exclusively equates to old vine garnacha (or grenache, if your accent prefers). Garnacha is, by far, the predominant grape in this hot, continental climate region. It comprises twothirds of the vineyards in the area, mostly grown in classic, bush vine disposition, and produces a bounty utilized in the production of rich reds and gutsy rosés.

The wine in the glass was garnacha, not unlike Bodegas Borsao Campo de Borja Garnacha 2011, which happens to be made from grapes grown just down the road from Tarazona in Borja, square in the middle of the garnacha territory. This is feel-good, comfort wine. It nicely showcases garnacha’s great berry and bramble sensibilities while amping things up by adding velvety Tempranillo and grippy Cabernet Sauvignon to the blend. But perhaps the best thing about this wine is its food-pairing versatility. Able to marry with roast chicken, roast beef, or anything braised in between, it is a willing, and able, dining companion.

Where to find it

James is an award-winning wine writer and educator based in Vancouver. The 2014 edition of his bestselling wine guide, Had a Glass: The top 100 wines under $20, is currently available through all major booksellers.

Visit www.hadaglass.com to learn more.

Bodegas Borsao Garnacha 2011 is available across Canada, priced from $12.80 – 14.99

MARCH 2014 • Doctor’s

Review

57

Fear colon cancer, not the test Colon Cancer is the number two killer of all cancers â&#x20AC;&#x201C; and it can affect anyone. But with early detection the survival rate is estimated at 90%. And it all starts with a simple self-administered test that you do in the privacy of your own home. Talk with your doctor and get the test. Not knowing is not the answer.

Darryl Sittler,

Hockey legend Lost his wife to colon cancer

Colon Cancer Canada Weâ&#x20AC;&#x2122;re behind your behind

For more information or to donate visit coloncancercanada.ca

P18541_CCC_DSittler_8.5x11_FA.indd 1

3/13/09 3:08:08 PM

Shakshuka.

Arctic char with charmoula.

Fishing for compliments

Three seafood suppers that’ll get cooks rave reviews without even having to ask recipes by

I

Cree LeFavour

photos by

Antonis Achilleos

n Fish, published by Chronicle Books, cookbook writer Cree LeFavour writes that there are as many ways to prepare seafood as there are fish in the sea. Raised on a ranch near the Salmon River in central

Idaho, she presents 54 ways in Fish via six chapters: American, European, Latin, South Asian, East Asian, and Middle Eastern and African.

She believes that good ingredients, simple methods and intuitive (and sometimes even counterintuitive) combos are all that’s needed to make fillets, shellfish and crustaceans come alive — on a plate, that is.

She also thinks that seafood is ideal for last-minute suppers because it rarely takes more than 15 minutes to cook.

Here are two recipes that’ll help “scale” back your time in the kitchen and another — a shrimp risotto — for that cold weekend when spring still feels so far away.

MARCH 2014 • Doctor’s

Review

59

ARCTIC CHAR WITH CHARMOULA Charmoula, like salsa verde and harissa, is versatile, but never dull. The alchemy relies on lemon juice, garlic, chili flakes, olive oil and herbs. It pairs magically with any protein, delivering acidity, spice and freshness. Tunisia, Morocco, Algeria — each can lay claim to the sauce.

For the charmoula ¼ c. (60 ml) fresh lemon juice grated zest of 1 lemon 1 tsp. (5 ml) chili flakes 1 tsp. (5 ml) coriander seeds, crushed 1 tsp. (5 ml) cumin seeds, crushed 1 shallot, minced

½ c. (125 ml) finely chopped fresh parsley ½ c. (125 ml) finely chopped fresh cilantro 2 garlic cloves, minced ¼ c. (60 ml) very good extra-virgin olive oil ¼ tsp. (1.25 ml) salt four 4- to 6-oz. (115- to 170-g) Arctic char fillets 1 tbsp. (15 ml) olive oil ½ tsp. (2.5 ml) salt

To make the charmoula, mix all of the ingredients together in a small serving bowl. Stir and set aside.

Preheat the broiler to high, positioning a rack as close to the heat source as possible. Line a baking sheet or large,

Yellowfin tuna with jalapeño-cumin butter.

ovenproof frying pan with foil, crimping the edges up all around to catch any liquid that will be released by the fish.

Brush the Arctic char with the olive oil, sprinkle with the ½ teaspoon (2.5 ml) salt and set it on the foil.

Cook the fish, without turning, for 6 to 12 minutes — possibly more or less, depending on its thickness and the intensity of your broiler. Check the fish by inserting a knife into the thickest part. The fish should flake apart without resistance. A thermometer inserted into the thickest part should read (135°F) 57°C. Spoon a little charmoula in the centre of each plate, place the fish on top and sprinkle with mint. Serves 4. Suggested side: roasted eggplant with pearl (Israeli) couscous.

n

FISH NOTE Wild Alaskan salmon or coho salmon are the closest alternatives to Arctic char. Truth is, the charmoula will pair up with any fish.

YELLOWFIN TUNA WITH JALAPEÑOCUMIN BUTTER ¼ c. (60 ml) peanut or vegetable oil four 6-oz. (170-g) yellowfin tuna steaks, approximately 1 in. (2.5 cm) thick 2 tsp. (10 ml) salt 2 tbsp. (30 ml) cumin seeds jalapeño-cumin butter (recipe follows) 4 lime wedges

Preheat the oven to 175°F (80°C). Use a dab of the oil to rub the tuna steaks all over and liberally salt both sides. Sprinkle one side with the cumin seeds.

Heat a large cast-iron pan over high heat. Let the pan get very hot before adding the oil. Once you do, wait for it to shimmer before you put the tuna steaks in, cumin-side up. Cook for 3 to 4 minutes and turn.

Cook the cumin-coated side of the tuna for just 1 minute. Transfer to a plate and place 1 tablespoon (15 ml) of the jalapeño-cumin butter on each portion before resting it for 3 minutes in the warming oven. Finish with a squeeze of lime. Serves 4. Suggested side: butternut goat cheese argula salad.

n

FISH NOTE Buy troll- or polecaught yellowfin tuna from Canadian or US waters. Substitute mahi mahi. Don’t ever buy bluefin — ranched or wild.

Jalapeño-cumin butter 4 tbsp. (60 g) butter, at room temperature 1 shallot, chopped 2 tbsp. (30 ml) cumin seeds, toasted and ground 1 tbsp. (15 ml) coriander seeds, toasted and ground 1 jalapeño with seeds, minced (about 3 tbsp./45 ml)

In a small bowl, mash together the butter, shallot, cumin seeds, coriander seeds and jalapeño. Set aside.

ON TOASTING Is it really necessary to toast spices? It’s important; here’s why. Spices contain oils — which is also why they go bad relatively quickly. These oils, when heated, undergo chemical changes that release their fragrance.

In addition, toasting produces that famous Maillard reaction, resulting in new, rich and intense flavours. When we heat anything to the point of browning — whether it’s farro, coffee beans, cumin, or coconut — it tastes different, and better.

Rock shrimp risotto.

ROCK SHRIMP RISOTTO Cooking risotto is tricky. The rice can’t be mushy and shapeless, nor crunchy and stiff. The risotto will cook beautifully if you stand guard at the end, as it transitions from al dente to mushy.

(It’ll do this in the time it takes to rinse the tasting spoon.) If you mess it up, relax. The sweet rock shrimp, fava beans and dairy will make it sublime anyway.

3½ c. (875 ml) chicken, shrimp or fish stock (recipe follows) 2 tbsp. (30 ml) olive oil 2 shallots, minced 1 c. (250 ml) arborio rice 1 large garlic clove, chopped grated zest and juice of 1 lemon

¹⁄₃ c. (80 ml) freshly grated ParmigianoReggiano cheese, plus more to finish the plates salt 3 tbsp. (45 g) butter 1¹⁄₃ c. (330 ml) fresh fava beans, blanched and removed from their outer casing (substitute fresh or frozen lima beans or edamame) flaky or coarse salt 1½ lb. (680 g) rock shrimp ¼ c. (60 ml) Fino sherry ½ tsp. (2.5 ml) chili flakes, lightly crushed black pepper ¼ c. (60 ml) fresh basil leaves, rolled and cut into threads

Bring the stock to a boil in a large saucepan. Transfer to a heat-proof con-

tainer and set aside. In the same saucepan over medium heat, combine the olive oil and shallots. Cook for 2 to 3 minutes or until just soft.

Add the rice and cook for another 2 to 3 minutes or until the rice is well coated and heated in the oil. Add the garlic and half the lemon zest. Cook for another 1 or 2 minutes or until the garlic is just fragrant, but not coloured.

Add 2 cups (500 ml) of stock, stir and turn the heat to medium-low. Cook, stirring frequently to prevent sticking, for 10 to 15 minutes or until the stock is mostly absorbed, before adding more stock in ½-cup (125-ml) increments.

After about 20 minutes, you’ll notice the rice has increased in volume and gained a thick, creamy consistency. It’s almost done.

MARCH 2014 • Doctor’s

Review

61

Lower the heat to slow the cooking and taste the rice. It should be smooth and creamy, with a lovely body of texture, but not hard. If it’s done, turn off the heat and stir in the remaining lemon zest, 1 tablespoon (15 ml) of the lemon juice and the Parmigiano. Taste for salt, lemon flavor and acidity, adding a pinch or two of salt or a little more lemon juice, as you like.

In a large sauté pan, melt 1 tablespoon (15 g) of the butter over high heat. Add the fava beans and cook for 2 to 3 minutes or until they’re hot and have lost their raw edge. Give them a pinch of flaky or coarse salt, transfer to a plate and set aside.

Lower the heat to medium and melt the remaining 2 tablespoons (30 g) of butter. Add the shrimp, sherry and chili flakes and cook for 3 to 5 minutes, stirring frequently, until the shrimp are just cooked. (If you’re not using rock shrimp, you’ll need to cook the shrimp longer.) Sprinkle with the leftover lemon juice, a little flaky or coarse salt and good grind of black pepper.

In shallow bowls or on dinner plates, portion out the risotto with the shrimp and beans. Finish with a scattering of basil and freshly grated Parmigiano. Serves 4.

n

FISH NOTE When it comes to shrimp, wild-caught and farmed from the US or European Union are the best choices, with wild spot prawns from Alaska and wild pink shrimp from Oregon being the best of the best. Avoid farm-raised shrimp from Asia.

HOOKED FOR MORE? There shouldn’t be anything fishy about eating seafood, but there is. One of the biggest problems with warm-water shrimp, like the rock shrimp called for in the risotto recipe, is bycatch. Small-mesh nets are dragged along the sea floor permanently damaging algae, sponges and coral.

Endangered and/or threatened sea turtles are caught and killed, too. By US federal law, otter-trawl gear must include Turtle Excluder Devices, designed to let turtles escape. All US states except Louisiana enforce this requirement.

Programs that rate the sustainability of seafood help raise consumer awareness. Here are four to help you navigate the slippery marketplace.

• Founded in London in 1997, the Marine Stewardship Council (msc.org) is a global program that sets its own standards for sustainable fishing and seafood traceability. Look for a blue MSC ecolabel on certified products.

• The Monterey Bay Aquarium Seafood Watch (seafoodwatch.org) program has distributed over 40 million pocket guides and their smartphone app has been downloaded nearly a million times.

• SeaChoice (seachoice.org) is a coalition of five Canadian conservation organizations that works closely with the Monterey Bay Aquarium. It uses a similar green, yellow and red seafood colour rating system.

• A Vancouver Aquarium initiative, Ocean Wise (oceanwise.ca) uses an ecolabel on restaurant menus and products to identify items that are good choices for keeping ocean life healthy and abundant.

The David Suzuki Foundation features a fun PDF of the Top 10 Sustainable Seafood Picks that you’ll want to print and put on your fridge. Look for it at davidsuzuki.org/what-you-can-do/eat-for-healthy-oceans. [CC]

Fish stock

If you can make chicken stock, you can make fish stock. Most fish shops will happily give you fish heads and carcasses. For the lightest, most versatile stock, ask for non-oily fish.

2 lb. (910 g) fish heads and carcasses 4 ribs celery with leaves 2 carrots, peeled 2 sprigs thyme 1 small bunch parsley 1 leek, split and rinsed 1 c. (250 ml) dry white wine (don’t use oaky chardonnay)

62

Doctor’s Review • MARCH 2014

Place the fish parts in a large stock pot, pushing them down to condense them.

Cover with cold water and then add the celery, carrots, thyme, parsley, leek and wine. Set over high heat to bring to a boil, skimming away the foam (and scum!) that rises to the surface.

Once the liquid reaches a boil, reduce the heat to produce a quiet simmer. Cook for 30 to 40 minutes and drain through a colander. Transfer to storage containers and freeze or refrigerate any stock you aren’t using right away. Makes 3 quarts (3 L).

Recipes and photos from Fish: 54 Seafood Feasts (Chronicle Books, 2013).

Indications and clinical use: BEXSERO ® is indicated for active immunization of individuals from 2 months through 17 years old against invasive disease caused by N. meningitidis serogroup B strains.

As the expression of antigens included in the vaccine is epidemiologically variable in circulating group B strains, meningococci that express them at sufficient levels are predicted to be susceptible to killing by vaccine-elicited antibodies.

Contraindications: • Hypersensitivity to the BEXSERO ® vaccine or to any ingredient in the formulation or components of the container closure.

Relevant warnings and precautions: • Temperature elevation following vaccination of infants and children (less than 2 years of age) • Administration of BEXSERO® should be postponed in subjects suffering from an acute severe febrile illness • Individuals with thrombocytopenia, hemophilia or any coagulation disorder that would contraindicate intramuscular injection • Subjects with impaired immune responsiveness • Do not inject intravascularly, intravenously, subcutaneously or intradermally

• Do not mix with other vaccines in the same syringe • Availability of appropriate medical treatment and supervision in case of an anaphylactic event following administration of the vaccine • Risk of apnoea in premature infants; need for 48-72 hours respiratory monitoring • Caution in subjects with known history of hypersensitivity to latex • Hypersensitivity to kanamycin • Protection against invasive meningococcal disease caused by serogroups other than serogroup B should not be assumed • As with any vaccine, BEXSERO® may not fully protect all of those who are vaccinated For more information: Please consult the Product Monograph at www.novar tis.ca / BexseroMonograph for important information relating to adverse reactions, drug interactions, and dosing information which have not been discussed in this piece.

The Product Monograph is also available by calling Medical Information at 1-800-363-8883.

BEXSERO is a registered trademark.

Product Monograph available on request.

Printed in Canada ©Novartis Pharmaceuticals Canada Inc. 2014 13BEX017E Novartis Pharmaceuticals Canada Inc. Dorval, Québec H9S 1A9 www.novartis.ca T: 514.631.6775 F: 514.631.1867

Be informed. Be immunized.

BEX_7386_PI_DoctorsReview E01.indd 1

14-02-25 1:52 PM

Clear! uu CONTINUED FROM PAGE 27

Knickerbocker (b. 1932), noticed that the mere act of placing the heavy paddles on the chest of the dogs they had been reviving during defibrillation experiments caused blood pressure to rise. It was the birth of CPR. They soon discovered that repeated manual chest compression worked on humans too, proving it once and for all by saving a woman in cardiac arrest in 1959. For his incredible contributions to medicine, engineer Kouwenhoven was given the first honourary Doctor of Medicine by Johns Hopkins.

In 1960, the direct-current (DC) defibrillator was introduced by cardiologist and Nobel-Prize winner Bernard Lown (b. 1921) of Harvard University, while Seattle cardiologist Karl William Edmark (1924-1994) of the University of Washington came up with a DC device as well. These lowervoltage units that no longer had to be plugged into the wall were far safer and smaller than the earlier AC versions, which damaged tissue and all-too-often jolted patients to death.

Technology greatly reduced the size of the machines during the 1960s and ’70s. Before long, portable defibrillators were everywhere. Non-physicians and even lay people could be trained in their use, making their presence ubiquitous everywhere emergency medicine was happening: ambulances, airplanes, athletic events and remote clinics. As the digital age in medicine was ushered in and computer technology elevated these once basic boxes into sophisticated machines, defibrillators have saved countless lives around the world.

AC defibrillators were a little too powerful and the current hard to control, resulting in injuries, burns and even death Once it became clear that electricity was so effective in regulating heart rate and even resuscitating patients on the brink — or even past — the point of no return, it didn’t take long for physicians and researchers to push the idea of the defibrillator even further by permanently implanting miniature versions directly inside cardiac patients’ chests.

From the cataclysmic power of lightning to the microscopic miracles that keep countless cardiac patients alive on a daily basis, the ability to control the power of electricity to cure what ails the human heart has been nothing short of revolutionary.

MARCH 2014 • Doctor’s

Review

63

P H OT O FI NI SH by

Dr Or es t S oc ha n i w s k y j

Spring time in Paris

advertisers index AMERICAN SEMINAR INSTITUTE Corporate.........................................25

Our family decided to go to Paris for March break last year. Paris is one of the most romantic, beautiful cities to visit and absolutely perfect for families. It has great pastries, food and wine, and all of the amazing museums are free for kids.

One evening we were on top of the Arc de Triomphe. Its viewing platform gives you a great perspective of the 12 streets that converge below. Everyone was taking pictures of the amazing view. I was there when my son, Matthew, took this picture of his brother, Mark, and his friend, Danielle.

I think the picture captures the physical beauty of Paris as well as that special magic that the city brings out in hearts of youth.

This moment was captured with a Canon Rebel.

CANADIAN ASSOCIATION OF EMERGENCY PHYSICIANS Corporate.........................................18 LEO PHARMA INC. Picato............................................ IFC NOVARTIS PHARMACEUTICALS CANADA INC. Corporate...........................................4 Onbrez...............................................8

MDs, submit a photo!

SEA COURSES INC. Corporate.........................................13

Please send photos (black and white only) along with a 150- to 300-word article to:

TAKEDA CANADA INC. Dexilant............................... 33, 39, 45 Tecta..................................................7

Doctor’s Review, Photo Finish, 400 McGill Street, 4th Floor, Montreal, QC H2Y 2G1.

TD BANK FINANCIAL Corporate...........................................2

If it’s printed, you’ll receive $50.

editors@doctorsreview.com

Got a colour pic you want to showcase?

Go to doctorsreview.com to Share your Photos.

64

BOEHRINGER INGELHEIM CANADA LTD. Corporate...................................54, 55 Trajenta....................................... OBC

Doctor’s Review • MARCH 2014

FAIR BALANCE INFORMATION Corporate........................................ 63

Make your travel dreams come true Go to doctorsreview.com/meetings to search 2500+ top world conferences Access code: drcme

N coveIHB TRAJ rage ENTA Limi ted bene use fit

The plumage of Ploceidae males is typically brightly coloured, usually red or yellow and black. Some species show colour variation only during the mating season.

Find out more from your Boehringer Ingelheim/Eli Lilly Alliance representative.

TRAJENTA is a trademark of Boehringer Ingelheim International GmbH. Jentaduetoâ&#x201E;˘ is a trademark used under license by Boehringer Ingelheim (Canada) Ltd.

â&#x201E;˘