JANUARY FEBRUARY 2009 by Just For Canadian Doctors

January/ february 2009

J u st f or C

DOCTORS life + leisure

bring on the bubbly warm up on Amelia Island disciplined investing welcome the Year of the Ox in Torontoâ&#x20AC;&#x2122;s Chinatown

mush!

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in the Yukon

tasty

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inside: Continuing Medical Education Calendar

J u st f or C

DOCTORS life + leisure

contents

january/february 2009

Editor and Art Director Barb Sligl Editorial Assistant Adam Flint

Contributors Jim Barr Dr. Dara Behroozi Dr. Susan Biali Dr. Mel Borins Dr. Peter Brindley Yvette Cardozo Judie Fein Dr. Holly Fong Dr. Marlene Hunter Dr. Lili Nasseri Dr. Chris Pengilly Dr. Neil Pollock Manfred Purtzki Paul Ross Dr. Kelly Silverthorn Corey Van’t Haaff Cover photo B. Sligl Advertising Sales Manager Ruth Findlay

Account Executive Trisha Chu

14 the foodie north 21 gone to the dogs Embrace the snow and dogs of the Yukon

Classified Sales Ninh Hoang

Sales Office Advertising In Print 710 – 938 Howe St. Vancouver, BC V6Z 1N9 Canada Phone: 604-681-1811 Fax: 604-681-0456 Email: info@AdvertisingInPrint.com

COLUMNS

DEPARTMENTS

8 doctor on a soapbox

5 January/February mix

9 aqueous humour

Associate Publisher Linh T. Huynh

Production Manager Ninh Hoang

Family physicians vs specialists

Traffic Manager Judy Huynh

Circulation Fulfillment Kim Lam

CME Development Adam Flint

Founding Publisher Denise Heaton

Just For Canadian Doctors is published 6 times a year by In Print Publications and distributed to Canadian physicians. Publication of advertisements and any opinions expressed do not constitute endorsement or assumption of liability for any claims made. The contents of this magazine are protected by copyright. None of the contents of the magazine may be reproduced without the written permission of In Print Publications.

Printed in Canada.

Appreciating a good brew

25 CME calendar 33 employment opportunities

The beauty of the bubbly

11 the food doctor

36 classifieds

37 sudoku

Beat the chill with chili

12 motoring

38 small talk

Motorsports in art

with Dr. Michael Roberts

13 tales from the trenches

Reevaluating the placebo effect

20 techworks

Brain plasticity

31 the wealthy doctor

Disciplined investing

In Print Publications 710 – 938 Howe St. Vancouver, BC V6Z 1N9 Canada www.justforcanadiandoctors.com

18 prescribing R & R

The pursuit of happiness

10 the wine doctor

clockwise from top left: yvette cardozo; b. sligl (2)

FEATURES Explore the gourmet side of Greenland

Senior Account Executive Monique Mori

14 21

miss an issue? check out our website!

cover photo:

Snow, snow, snow, and more snow. It clings to branches alongside the Yukon River, creating the starkly beautiful abstract forms of a northern winter landscape.

January/February 2009 Just For Canadian Doctors

from the editor

embrace the winter!

a gourmand’s delight (page 14). Of course, after tramping through snow or fishing the chilly waters off Greenland, that hot cocoa is in order again…Or a steaming bowl of chili (page 11). If you do need more warmth, escape to Florida’s Amelia Island, a great southern CME destination (page 5 and 25) And keep the champagne coming (a libation to be enjoyed year-round; page 10). Celebrations continue on January 26 with Lunar New Year. It’s the Year of the Ox…time to grab the proverbial bull by the horns? Yes, get out there and mush it! Barb Sligl, BA, MPub feedback@InPrintPublications.com

Thrilling International Sports, Friendly Competition and Dynamic Outdoor Adventures Team up with us for the sporting experience of a lifetime

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Sports are a way of life here in Antigua and Barbuda, so come share our passion. Watch a lively game of soccer, tennis, basketball or cricket. Or join in! Bring your school team or club for some friendly competition with our local players.

The ball’s in your court! To learn more about all our sporting possibilities, simply contact us:

For added fun, you’ll discover a huge variety of active outdoor adventures. Hike across deserted islands, glide above thick vegetation, or dive to brilliant underwater reefs. After the exhilaration, cool off at one of our 365 beaches, enjoy an icy exotic drink and savour authentic island cuisine. A topscoring vacation experience –

Just For Canadian Doctors

January/February 2009

Antigua and Barbuda Tourism Office 60 St. Clair Avenue East, Suite 601, Toronto, Ontario M4T 1N5 416-961-3085 or 1-800-547-3055 info@antigua-barbuda-ca.com www.antigua-barbuda.ca

from left: nancy mccarthy; b. Sligl

appy New Year! Over the holidays there have been plenty of chestnuts roasting over the fire, hot cocoa, and such…Now it’s time to embrace the cold! Get out there and experience the brilliance of winter. There may be no better place than the Yukon to play in the snow. The dogs will show you how it’s done (just look at Yukon dog, Sprocket, right, bounding through the snow). If you’re a dog person, you’ll love Dawson City, Yukon. And the time to go is during the famous 1,000-mile Yukon Quest dog mushing race. It’s a big party in a tiny town immersed in snow thousands of miles from anywhere else. It’s unforgettable. Try mushing yourself—in the Yukon or closer to home (we have enough snow across Canada!) to see this country’s wintery landscape via dogsled. Dr. Lili Nasseri Bundled up and hanging out in the deep snow mushed it in BC (page 22). with one of the Yukon’s resident dogs, Sprocket. Another northern Antigua_CdnDoctors_0901.qxd:Layout 1 12/13/08 6:28wonderland PM Page to 1 discover: Greenland. Isolated, beautiful, and

mix

what/when/where > january/february

amelia island

escape to a southern “plantation”

resort

b. Sligl

Amelia Island Plantation is a secluded resort nestled in a 1,300-acre idyll on the coast of northeast Florida, between the Atlantic Ocean and the Intercoastal Waterway, and amidst miles and miles of pristine beaches. This fragile barrier island, with its tidal marshes, oceanfront dunes, grassland and savannahs, is home to a protected turtle population that comes ashore to lay and bury eggs in the soft sand; tiny turtle tracks blend in with guests’ footprints and are part of a sandscape shared by seashore wildlife and beachcombing guests and surfers. For more on Amelia Island Resort, see page 25. —B. Sligl

January/February 2009 Just For Canadian Doctors

mix

january/february

food

yum

If you didn’t partake in enough chocolate indulgence over the holiday season, February 14 is yet another opportunity… to both give and receive. Three chocolatiers across Canada who dish out the best: Thomas Haas Fine Chocolates in Vancouver thomas haas.com; Soma Chocolatemaker in Toronto soma chocolate.com; Chocolaterie Bernard Callebaut in Calgary bernardcallebaut.com

powder-filled

—B.S.

education

Acontinuingmedical educationconferenceshowCME casingwildernessmedicine inasnow-filledenvironment isnowmorecrucial thanever. “Werecentlyconcludedariskassessment surveyandwhat wasfoundissurprising,” explainsJohnKelly, operationsmanager for theCanadianAvalancheAssociation. “One out of 10individualsdroppingunder aresort’s boundarylinetoget at that temptingpowder run, acceptstheriskof amajor incident or deathasaresult of their quest for freshtracks.” AccordingtotheAssociation, therehavebeen 207avalancherelatedfatalitiesinCanada between1994andtoday. Track&Trail Adventuresisanadventure travel companyamassingtop-notchfaculty

that worktogether todevelopengagingaccreditedcurriculumpairedwithalegendary adventure. Track&Trail, inassociationwithNorthern EscapeHeli-Skiingandfacultyincluding ShuswapGeneral Hospital’sChief of Staff Dr. Scott McKee, arehostingauniqueopportunity inApril 2009entitled “WildernessMedicine Updatesfor theBackcountry.” Thisfive-dayeducational adventure blendsaccreditedCMEwithheli-accessed skiingor snowboarding. “Sometimeswe’ll beaskedbypatientsif theyarehealthyenoughtogointothebackcountry, but it shouldbemorethanthat, they alsohavetobeeducated. Throughthiscourse, physicianswill learnhowtobepreparedif somethinggoeswrong: fromfieldtreatment

techniquestodealingwithhypothermiaand orthopeadicinjuries,” saidMcKee. Theselife lessonsarenot uniquetoavalanchesituations, but canalsobeappliedtoanyonewhodeals withanywinter exposuretrauma. “I amafirm believer inexperiential learning. Youcanread all thetextbooksyouwant, but inafive-day courselikethis, youcantakeawaysomuch andbebetter equippedtoimplement those lessons,” saidMcKee. JohnForrest, oneof NorthAmerica’s most accreditedavalancheexperts, Northern Escape’sGMandpresident of HeliCat Canada, will complement McKee’sandothers’ curriculumwithavalanchetrainingandworkshops. For full conferencedetailsvisit Track&Trail Adventureswebsiteat tandtadventures.com. —Jim Barr

Most peoplehavelikelyreadoneor twoof Michael Crichton’ssuspense-and-action filledtomes; hemadehimself ahouseholdnamewithbestseller-turned-boxofficehit booksandmovieslikeJurassic Park. Andif youhaven’t, thenhis recent deathmaybetheimpoetustotakeanother lookat wherehe book started: The Andromeda Strain. Writtenin1969whilehewasattending HarvardMedical School, thenovel reflectshismedical knowledge(a techno-thriller about scientistsbattlingaspace-bornekiller micro-organism).Then readCrichton’slast book, Next, inspiredbyhisoutrageat learningabout current laws governinggeneticsissuesduringa2005conferenceonGeneticsandLawat theSalk Institutefor Biological Studies. michaelcrichton.net —B.S.

Just For Canadian Doctors

January/February 2009

heli-ski photo courtesy NE Heli-Skiing

read + re-read

january/february give

mix

free rice

Want a place to share some of that New Year goodwill—while also upgrading your vocabulary? Do the ongoing quiz at FreeRice.com; each correct word yields a donation of 20 grains of rice through the UN World Food Program. A quick go can produce over 1,000 grains of rice and at least a few new words—like “fimbriate” (fringed) or “hoyden” (tomboy)—to your vocabulary. Total grains of rice donated since the site’s inception in October 2007: over 55,000,000,000. A good number to try wrapping your head around! freerice.com —B.S.

tour

discover the foodie side of Chinatown

andhistoricdevelopments. If youwant tosavour ChineseLunar NewYear, youcanpamper your palatewithafoodiewalkingtour of ChinatowninToronto. ShirleyLum, who’sthereal deal (a Chinesepersonal chef-in-training, culinaryhistorian, storyteller andtour guide) will whiskyoutoa pastryshopfor sesameballsandgoldenspongecakes; both areservedinredpaper asthat colour isusedfor offerings tokitchenandbusinessgods. She’ll teachyouabout the rituals, symbolismandsuperstitionsassociatedwiththe annual festivitiesasyouvisit freshproducemarkets, grocerystoresthat specializeindryseafood(abalone goesfor $450apound) andshopsthat sell mummified geikos, lizardsandherbsreputedtocureeverything fromabloatedbellytoabrokenheart. (That’sLum, right, holdingoneof thoselizards.) You’ll besniffing andperhapssamplingteaandhavethechancetobuy ahand-craftedteapot. BesureNOTtoeat breakfast beforeyour trek, asShirleywill treat youtoahealthy dimsummeal that includesabalancedblending of thefiveessential elements—shape, texture, colour, aromaand, of course, flavour. Throughout theyear, Lumoffersfabulous foodiewalkingtoursduringthedayandfor NewYear’seveshe outdoesherself byofferinga10-coursedinner banquet. Asyouloosenyour belt between courses, you’ll haveachancetoflipthroughahoroscopebooktofindout what your zodiacsignis andwhat theupcomingyear holdsfor you. OnFebruary9th there’salanternfestival andonJanuary 26, 31andFebruary1st you’ll gapeintothemouthof abigcat asyouwatchtheLiondance; if you offer thebeast alittlemoneyinaredenvelope, your ownprosperitywill beassured. What makesall walkingtourswiththe highlyentertaining, fast-talking, extremely knowledgeableLummemorableisthat shesharespersonal storiesabout growingupas aCBC—Canadian-bornChinese. Asachild, sheateAsianpastriesanddrankmilkwhile watchingtheFlintstones. Shewas taught never tohaveacolddrinkwithglutinousrice, that addingJohnnyWalker RedLabel tosoupenhancedthelatter’sflavour, andthat the number 3bringsgoodluck. She’ll alsoregaleyouwithChineselegendsliketheoneabout theevil couplewhoweredeepfriedastheir punishment. BecauseShirleylovessharingher ancestral language, she’ll teachyoutosay“GungHeyFatt Choy” (HappyNewYear inCantonese) or “GongXi FaCai” (thesamegreetinginMandarin). The ChineseNewYear beginsJanuary26, 2009; practiseyour greeting! —Judie Fein

year of the ox

chinatown photos: paul ross

Goodbye, Year of the Rat. Hello, Ox—ayear of steadygrowth

Regular tours(includingfood&non-alcoholicdrinks) are$43for adults, $38.50for seniorsover 65 and$27.50for childrenunder 12. TheChineseNewYear banquet is$50. TorontoWalksBikes.com January/February 2009 Just For Canadian Doctors

d o c t o r o n a s o a p b o x D r . c h r i s p e n g i l ly

Battleground? Patient referrals are pitting family physicians against specialists

n 1981 I can remember listening to “As It Happens” on the CBC Radio about a seemingly amusing little skirmish that happened on the Falkland Islands. Apparently some Argentineans had come on to the British Islands to plant a flag. Little was it realized at the time that this was going to escalate into a full-blown war between the United Kingdom and Argentina, resulting in 258 British and 649 Argentine deaths. Well, in British Columbia, what would appear to be a mild skirmish is now developing into quite the conflict. I am not sure how it began. It is concerning the relationship between consulting specialists and family physicians; particularly the role of the respective office staffs in arranging appointments. Gradually

there seems to be an increasing burden of responsibility on the referring [usually family] physician to arrange the details of the consultant appointment. The issue began with the orthopaedic surgeons, but does involve several other specialties. The response to a family physician’s request for a consultation is a directive to the family GP’s office to: •

contact the patient

•

inform the patient of the appointment date and time

•

inform the patient of the location of the specialist’s office

•

inform the patient of the consultant’s office policies

•

advise the patient that there may be at least a one-hour wait

•

arrange specified investigations prior to the consultation

•

direct the patient to confirm their appointment within a week of the appointed date.

One group of family physicians objected to this, and asked the provincial College to intervene. After “due consideration” the College has done a good job of sitting on the fence—suggesting that this matter be negotiated between the family physician and the consultant. The College did, however, clearly indicate that the arrangement for investigations should be undertaken directly by the consultant. Recently there has been an upping of the ante. One of my colleagues has had his referral refused because it did not include an x-ray. A fax was sent to him stating that the entire referral letter had been shredded, and he would have to begin the entire referral process again—this time including the x-ray. He had already included a relevant MRI which he felt would render the x-ray redundant. Clearly this situation should not continue. Have we forgotten that, though we are not a profession of Albert Schweitzers, we originally went into medicine, not only to earn a reasonable

Just For Canadian Doctors

January/February 2009

income, but also to try to help patients in their suffering? We really are very lucky in that we can offer great help and assistance to patients in their pain and/or distress. Should we allow our staff to disrupt the referral process? Are we, or our staff, destroying collegiality? Part of the consultation fee, I feel, covers the cost of contacting a patient, ensuring that they know the office policies of the consultant, and the arrangement of necessary investigations. I, as the referring physician, have great difficulty with blindly ordering investigations in order to obtain a specialist consultation. The funding of Medicare is not unlimited— caution in each and every investigation is called for. Ordering a full series of x-rays for each and every orthopaedic consultation, when the pathology is already shown on an MRI, seems wasteful at the very least. I have recently had a request from a nephrologist directing me to contact the patient for no less than 20 haematological and urological investigations as well as a renal ultrasound. Trawling for investigations is a perturbing profligacy. Failure to complete these investigations would mean that the consultation would not be arranged. What is the answer? What is the compromise? I do not know. I just suggest that we do remember that we are in this profession for the benefit of patients and not for our own glory. To do this we must remember that family physicians and specialists should be “on the same side.” There is enough stress in our jobs that we do not need to add to it by this divisive issue. Maintaining our physical and mental health is, of course, essential, but offering a reasonable service to our patients is mandatory. I would be interested in hearing how this conflict is playing out in other provinces. How is this managed in other cities? Is this unique to British Columbia? Is it unique to urban practices? Am I, as a family physician, appearing idealistic and/or unreasonable? Dr. Chris Pengilly is Just For Canadian Doctors’ current affairs columnist. Please send your comments to him at peng2004@telus.net.

aqueous humour Dr. dara behroozi

Happiness The promised land of milk and honey?

few days ago I was snowshoeing with a good friend on a favourite back-woods trail. We stopped to look around at the beautiful snow-covered landscape and remarked, as usual, how lucky we were to be able to tramp on virgin snow and breathe clear clean air. “This must be the closest one can get to pure pleasure and happiness. At least at our age,” I remarked, and we resumed our trek, starting up what we enjoyed most, a philosophical discussion with no purpose and no point, but which would be hotly argued nevertheless. We had long ago agreed that there was no “fundamental” purpose to our lives. The scriptures of the various religions we had studied had failed to move us, and the facts of evolution carried with them some inescapable and depressing truths about our “place” in the universe. So we had reconciled ourselves to the fact that we might as well try and enjoy life. Without of course causing undue harm and distress to the environment or other humans. Try is the operative word. The thing one realizes fairly quickly is that the harder you try to be happy, the more elusive it is. More than one great writer has noted that those who strive the most for happiness, by acquiring endless material goods or countless lovers, or constantly searching for something to quench the thirst of an unmet and unknown desire, are the least likely to have found the state they seek. Instead, they suggest an uncomplicated life, with simple needs, good company and a generally benign disposition to the world, fellow humans and the Universe, and lo and behold Happiness will settle upon us. Ah… were it but that simple! As the two of us discussed on that cold Saturday morning while it snowed, the truth is, that to be truly happy you would either have to be deeply spiritual or stupid as a piece of wood. Let me explain. The world is far from a benign place for many of our race who face uncertainty and challenges from the first day they step foot on the earth. That, and the countless random events of tragedy that occur around

us, requires a soul so placid and ethereal that he or she is convinced that what is around us is just a façade and the real show starts afterwards. I know a few of these people. Or, it requires people to be cocooned from the real world and not expose themselves to news and events that may intervene with their state of happiness. As Mark Twain said, happiness and sanity is an impossible combination. I know many more of these folks. When I travel in thirdworld countries I see how happy people are in the villages, despite the fact that they have so little. They live the uncomplicated simple lives we are told are the path to nirvana. They are not only lacking RRSPs and mortgages, but also a connection with the general burden of misery in the world. As newspapers, TV and the internet arrive in the villages, I have noticed that the inhabitants are not quite as cheery. They are now exposed to floods, famines, bombs blowing innocents up, wars in places they had never heard of, the uncertainty of world climate changes and economic crisis. They are also now able to envy others half a world away who drive fancy cars and live in large solid houses. They now realise how deprived and poor they really are. Truly ignorance is bliss. Since I cannot cut myself off from the world, perhaps I can train myself, like a jogger getting ready for a race, to be happier. Even the psychologists are getting on the bandwagon. Until now they would just tell us what was wrong with us, but now there is a whole new field called “positive psychology” which is geared to make you feel happier. There are many definitions, but the one I liked most was “to try and make normal life more fulfilling.” The emphasis should be on the “normal.” Obviously when we climb our big mountains, get married, have children, win a game of squash against a younger opponent etc., we are happy. It is all the time in between that is the problem. The time at work, then taking the kids to soccer, cooking, cleaning,

putting away laundry and dishes, and looking in the mirror at an older person looking back—that is the time when happiness seems most elusive. How do we make the hum-drum boring rote chores that make up 90% of our waking hours a source of wonderful fulfillment instead of a well of silent despair? That is what I sought, and so off to a class I went. I looked around; most of my fellow students were lost souls like me looking for a guru to lead them to the promised land of milk and honey. Our speakers were up-beat positive types who looked like they needed a lithium level check. We were told that we should live every day like it was our last. “What would you do TODAY, if you knew it was your last day?” The speaker looked around and his gaze fell on me. I was unprepared. I should have said something profound. Unfortunately I was so taken aback that my response came straight from my amygdale. “I would cry a lot and then get drunk on my best whiskey.” There was an uncomfortable silence and then the speaker moved on to another subject making sure never to make eye contact with me again. The lady next to me whispered in my ear. “Don’t worry I would do that too. In fact I do that almost every day now!” The rest of the information actually made a lot of sense, telling us to accept ourselves warts and all, be thankful and grateful for everything we have, smile a lot and show people love, live a healthy life, and realize that money is not the source of happiness (thankfully, given the state of my finances). Above all simplify. Nothing too revolutionary. This is the 12-step route to happiness. The other path, via spirituality, is much more arduous and less certain. In the meantime I will head off to the hills with a good friend, my snowshoes and my hipflask.

Happiness and sanity is an impossible combination

Dr. Dara Behroozi is Just For Canadian Doctors’ humour columnist. He practises medicine, plays soccer and enjoys single-malt.

January/February 2009 Just For Canadian Doctors

the wine doctor dr. neil pollock

Bubbly beauty Champagne—what other drink do you really need?

“I am tasting the stars!” —Dom Perignon, upon discovering champagne

of white) champagnes are made from 100% Chardonnay. There are three types of champagne: non-vintage or multiple-vintage champagne that’s a blend of two or more harvests; champagne made from a single vintage; and “prestige” cuvée from a single vintage with longer aging requirements. In addition to longer aging in the bottle, prestige cuvée champagne must meet other requirements. It must be made from the first pressing of the grapes, and from the best grapes of the highest-rated village. Prestige cuvée is made in a vintage year in small quantities with high demand; price is dictated largely by supply and demand. The original prestige cuvée was Moet & Chandon’s Dom Perignon, launched in 1936 with the 1921 vintage. Until then, Champagne houses produced different cuvées of varying quality, but a top-of-the-range wine produced Thetraditional méthode champenoise is usedin to the highest standards (and theproductionof champagne. After primary fermentationandbottling, a second priced accordingly) was a new alcoholicfermentationoccurs inthebottle(inducedby addingseveral grams of yeast androck sugar). AccordingtotheAppellationd’OrigineContrôléea idea. In fact, Louis Roederer had minimumof 1½years is requiredtodevelopthemost exceptional flavour. During been producing Cristal since 1876, this timethechampagnebottleis sealedwitha crowncapsimilar tothat used but this was strictly for the private onbeer bottles. consumption of the Russian After agingthebottleis manipulatedina process calledremuage (riddlingin tsar. Cristal was made publicly English), sothat thelees (residual yeast) settleintheneck of thebottle.The available with the 1945 vintage. bottles arechilled, theneck is frozenandthecapremoved. Pressureinthebottle Then came Taittinger’s Comtes de forces out theicecontainingthelees, andthebottleis quickly corkedtomaintain Champagne with the first vintage thecarbondioxide. Syrupis addedtomaintainthelevel withinthebottle. of 1952. Theamount of sugar addedafter thesecondfermentationandagingvaries and A few of my favourites would dictates thesweetness level of thechampagne. >> Brut Natural (less than3 be the medium styles of Charles grams of sugar per litre) >> Extra Brut (less than6grams of sugar per litre) Heidsieck and Pol Roger. For >> Brut (less than15grams of sugar per litre) >> Extra Secor Extra Dry (12 fuller, richer champagne I prefer to20grams of sugar per litre) >> Sec(17to35grams of sugar per litre) >> Veuve Cliquot. The more white Demi-Sec(33to50grams of sugar per litre) >> Doux (morethan50grams of grapes in the blend, the lighter sugar per litre) the style, the more red in the blend, the fuller the style. The three dominant types of grapes in Champagne is always the Champagne region are Pinot Noir, Pinot served cold; its ideal drinking Meunier and Chardonnay. Black Pinot Noir temperature is 7 to 9°C. and Pinot Meunier give the wine its length Ideally the bottle is chilled and backbone. Chardonnay gives the wine in a bucket of ice and its acidity and biscuit flavour. water before opening. Most champagnes are made from a Champagne is served in blend of Chardonnay and Pinot Noir (for a glass flute with a long example, 60% / 40%). Blanc de blanc (white agree with the good Dom, I love my champagne. You can serve it to jump-start a morning celebration (and invigorate your oj). Or treat yourself to a special lunch memorialized by an icy cold bottle of bubbly. For dinner, it helps celebrate life’s milestones with family and friends. It’s also the worldwide ambassador for ushering in the New Year. No drink has the diversity and presence of champagne. True champagne is exclusive to the Champagne region in northeastern France, 145 kilometres northeast of Paris and centred on a small range of hills rising from a chalk plain carved in two by the River Marne. Almost three quarters of the vineyards in Champagne lie in this Marne region. Wines from here have been valued for nearly a millennium, and classical sparkling Champagne since about 1700.

bubbly 101

Just For Canadian Doctors

January/February 2009

stem, tall-and-narrow bowl, thin sides and an etched bottom. Hold the flute by the stem or base as opposed to the bowl, and refrain from overzealous clinking to preserve the taste. Don’t over fill; a flute should be only two-thirds full. The classic act of shaking the bottle, popping the cork, and letting the wine spray is common in celebration. And fun—but one should open the bottle at a 45-degree angle and ease the cork out with a whisper rather than a pop. This may not change the taste, but does the volume left in the bottle… The famous quote “In victory you deserve it, in defeat you need it,” believed to be said by Napoleon, expresses the world’s attitude towards champagne; it’s been the wine of both success and consolation for the past two centuries. If you didn’t manage to punctuate your New Year’s celebration with a great bottle of champagne, create another opportunity to enjoy one. Recently, my wife and I shared a bottle of Moet & Chandon over lunch in Paris at a low-key brasserie. It was early afternoon, and after a tasty buffalo-mozzarella-and-tomato salad we washed down a beautiful salmon fillet stuffed in a large cappelletti with the wonderful champagne. It was the perfect prelude to visiting the Musée d’Orsay, where the Impressionists’ work had never seemed more alive. Send feedback to drneil@pollockclinics.com; visit his website on wine at vinovancouver.com. Dr. Neil Pollock is a member of the Wine Writers’ Circle of Canada. He practises no-scalpel, noneedle vasectomy and infant circumcision.

t h e f o o d d o c t o r d r . h o l ly f o n g

Beat the chil

With a steaming bowl of chili

Chili Con Carne with Cocoa Serves 6 2 tablespoons oil 1 large onion, diced 1 clove garlic, minced ½ teaspoon dried chili flakes ½ teaspoon ancho chili powder (if unavailable, use dried chili flakes) 1 red pepper, seeded and diced 1 teaspoon ground coriander 1 teaspoon ground cumin ¼ teaspoon ground cardamom 1½ tablespoons unsweetened cocoa powder 2 pounds of extra lean ground beef 1 can crushed tomatoes (796 ml can) ½ can tomato paste (156ml can) ¼ cup ketchup 2 cans kidney beans (540 ml each can) 2 large carrots, peeled and cut into ½-inch cubes salt grated cheddar cheese (optional)

Heat theoil ina very largeheavy-bottomedpot and fry theonionandgarlicuntil it begins tosoften. Add thechili flakes, coriander, cuminandcardamom, stirringwell. Addthepepper, thenbreak upthe groundbeef intothepanand, usinga fork, separate it as themeat browns. Addtheanchochili powder, tomatoes, ketchup, tomatopastetomakea richred sauce. Stir well. Whenthechili starts tobubble, add thecocoa andthebeans, mixingwell. Reducethe heat tolowandsimmer coveredfor 1½ hours. Stir approximately every 15 – 20 minutes, scrappingthe bottomof thepot toavoidburningthebeans. After 1 hour of cooking, addthecarrots andstir well. Ladleintobowls. Topwithcheeseif desired.

ping other than dicing an onion and smashing some cloves of garlic. Peel and slice some carrots for more vegetable content. You don’t even have to soak the beans; just open a can of red kidney beans. The versatility of chili is that you can make it as spicy as you wish. I prefer a nuanced spiciness that comes from the variety of flavours rather than mouth-burning chili pepper. In this version, chili, cumin, coriander, cardamom and cocoa blend into a rich, full-mouth flavour. The whole thing can be cooked in one large pot. The key here is to use a heavy-bottomed pot to allow browning of the meat and vegetables without burning the chili as it cooks. If your pot is thin, you need to stir the chili more often, scraping the bottom of the pot to avoid scorching the beans, which have a tendency to stick as they cook down. This recipe makes enough for six people with plenty left over for Sloppy Joes or chili dogs the next day. Serve your chili with some crusty bread or corn bread and a green salad for a relaxing, no-fuss dinner. If you’re looking for a wine, the 2005 “Le Prestige” of Château du Cèdre matches beautifully. This is a big wine from one of the great estates of the Cahors region in France. It has a deep-purple black colour typical of the region (90% Malbec and 10% Tannat). Aromas of fruity, summer berries with a hint of floral anise give way to more black fruit (blackberry, plum) followed by a hint of spice and chocolate on the palate. The wine has a velvety mouth feel with a long finish that’s peppery from ripe tannins. Overall, a well-balanced wine that enhances the flavour of the chili. Dr. Holly Fong is a practising speech-language pathologist with three young children who is always trying, adapting and creating dishes.

2003 & 2006 International Winemaker of the Year International Wine and Spirit Competition www.peterlehmannwines.com

January/February 2009 Just For Canadian Doctors 4110_CD_3rdVert_FA.indd 1

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fter a long day outdoors playing in the winter cold, there’s something very nurturing and comforting about a steaming bowl of chili. The heat drives the cold from the nasal passages, filling you with warmth that radiates throughout. A good hearty chili fills like nothing else after a chilly day outside. And it’s so easy to make. I prefer a big batch of chili over soup because it takes less time; I make it the morning before serving. There’s not much washing, cutting or chop-

10/9/08 12:20:11 PM

motoring

D r . k e l ly s i l v e r t h o r n

Dipping a toe in the art pool

e used to refer to our basement as “grenade space.” The 1960s handyman look—the accumulated random junk—justified that moniker. That basement is now a freshly renovated games room and home theatre. Art will provide the finishing touches. Surprisingly, my wife has deemed me worthy as Basement Curator

modern BC. I trade spicy inside information with the handful of Commercial Motorsport Curators (let’s call them CMCs). Mostly, I keep ending up with those same six motorsport artists whose work I already know or own as prints. I delete many more sites where the works, at least as rendered on my laptop, just don’t grab me.

(BC). After all, how much trouble could that cause? I trust she realizes my appointment as BC entails motorsport themes. Through the years I’ve collected lithographed prints of classic sports-car-racing art: LeMans, Spa, Targa Florio, and the ‘Ring (Nurburgring, ed). Each limited edition print of approximately 24” x 18” was matted, framed, and glasscovered. At about $500 a pop, I have spent roughly $4,000 to date. Yet, I’ve decided my framed prints don’t have “presence.” They are too small—too alike in size, shape, and style. So my first edict as Basement Curator is to pension off these prints. Next, I must find those motorsport artists whose works speak to me at some subconscious artist-to-curator level. These days, the internet is the logical launching pad for such quests. Google “motorsport art” and get some 347,000 site hits. Then spend a few mindnumbing evenings to follow up the first thousand or so threads. Ah, the trials of the

But, I also add to “favourites” a select few artists who stir my aesthetic soul! After my marathon sessions on the internet I have found 10 new-to-me artists of curatorial interest. I decide to focus initially on the two artists who create really large canvasses, with great flair for colour and motion. Some would call the style abstract. It is certainly very different from the nearrealism of my lithographed print collection. Of the two artists, Bill Patterson is the easier to contact, down the west coast in Simi Valley, California. I call him up, and discover a great perk of my Basement Curator post. These artists are as smitten with motorsports history as I am. Art, and passion—I envy their careers. We yack for a good hour. Bill already has a deposit on the “Laguna Trio” original I fancy. To my disappointment, that sale does complete. Fortunately my BC title has some pull. Bill has access to a high zoot printer that can make a full-size (36” x 48”) gilcee-on-canvas reproduction.

Just For Canadian Doctors

January/February 2009

Post-reproduction, we agree in that rarefied artist-to-curator way, to change one competitor, re-touch and re-sign. The original, and my modified semi-original, will be the only versions of this artwork in existence. My cost, $1,200. The second artist is Klaus Wagger, busy perfecting his craft in Austria. Fortunately, Klaus’ English is far better than mein Deutsche. His website displays dozens of his amazing large works. Again, the originals that most grab me are all sold. Several gilcee-on-canvas reproductions are marketed by affiliated galleries. I opt for “Maserati 300S – Stirling Moss,” in the original’s full-size grandeur (59” x 31”). From an unlimited series run, its $425 delivered, CMC-to-BC. So my first two acquisitions as Basement Curator succeed in breaking my previous art acquisition mold. Now I’ve got big, bold, and abstract. “Original-looking” canvas too. But like any explorer, once I’ve begun to push the boundaries of my known world, I’m intrigued with what lies further into the unknown. So I continue on my curator quest, surfing the net, pouring over the remaining 346,000 Googled “motorsport art” hits. Commissioning original works would be the logical next progression for me as BC. No doubt I’d feel tremendous pride and connection to art that I’ve been integral to its creation. I’m already distilling down a plethora of possible eras, racers, and moments to depict—even agonizing over the all-important lens placement. It’s serendipity, how this all started with a need to store junk. Then came the desire to have rooms look finished. At the time, I’m sure it seemed innocent enough for my wife to encourage me to dip a toe in the art pool. Instead, I feel like I’ve fallen overboard from the cruise ship. I’m now borderline-obsessed with motorsport paintings. Art and passion—a powerful combination. Dr. Kelly Silverthorn is a radiologist and Just For Canadian Doctors’ automotive writer.

courtesy klaus wagger

Motorsports in art stir this car aficionado’s aesthetic soul

ta l e s f r o m t h e t r e n c h e s D r . m a r l e n e h u n t e r

Magic medicine? Reevaluating the placebo effect

ometimes I wonder what “placebo” really means. It has a kind of detrimental aura around it, as if the recipient of a placebo is really just a bit of a nut and the physician/nurse/specialist has said, “Here take this, it will solve all your problems.” When I was in Kenya, I would often “prescribe” an innocuous substance—partly because we had a limited range of “real” prescription drugs—and it seemed to work just fine. In fact, sometimes the patients would come in and specifically request them. Often these magical substances were vitamins (which I thought were a good idea anyhow, as our patients did not have a lot of options regarding good eating habits or the availability of a wide range of groceries) and the patients almost invariably thought that the “medicine” was a magical cure for their problems. Seldom did they ask what the magic medicine was, or what it was supposed to do. The physician had written some words on a special piece of paper (in itself indicating something important) and they took it to the hospital pharmacy and were given the pills or liquid and, usually, told how they were supposed to take it, how often, how much and so on. The advice was received with appreciation and the patient presumed that it would be the answer to his or her problem. And, human beings being the way we are, it often was the answer, or at least a sufficiently helpful substance when used with the belief that it would do what they believed it could do. It’s the belief that is the magic, not the “medicine.” My early years in going to Cuba often replayed these situations. Here, however, the patients were perfectly aware of what was happening and that what the pharmacy had offered was not a medication in the sense that we presume it to be. I’m referring especially to the early 1990s, during which life in Cuba was difficult, to say the least. The United States refused to allow any ships that had been to Cuba to dock in

the US, no matter where they came from or were going to. No trade was allowed. Realizing this, the Cuban pharmaceutical and medical professions decided that they would explore all possibilities regarding the manufacture of helpful substances based on plants, which could, in fact, achieve relief and lead, hopefully, to recovery. It has been a remarkably successful venture and has led to a vigorous new professional opportunity. In Cuba today, “natural” medicines are frequently used and the range of medications is broad. The results appear to be very satisfying. Many people believe that they are safer than the chemically complex concoctions that are now so widely—and often, badly—used. Nasty side effects are rare, as are allergic responses. Many, if not most, Cubans, prefer to avoid taking chances, and use the natural medicines. In fact, I do not think of these products as “placebos” at all. They are natural products that can be very helpful in easing an uncomfortable situation or health problem. And they cost a lot less than most of the synthetic medications that we now take for granted as being the only road to recovery. It is astonishing to me how frequently I get a notice about a “new” wonder drug. In my days as a family doc, I often used to take the samples that the drug representative gave me, offer them to my patients, and it seemed that my patients appreciated that. However, looking back, seldom did they come out and ask for a full prescription. It seems to me that this was a kind of placebo situation, too. In my year that I spent in Kitkatla, a First Nations community on a tiny island between Prince Rupert and the Queen Charlotte Islands, the nurse visited us about every three months. I had a patient whose small child was running a terrible fever that had gone on for a couple of days and all the

usual “native” remedies had been tried. The child seemed to be too exhausted to even cry any more—just lay there whimpering. I had a small package in the dispensary of a brand new medication so, there being nothing more that I could do, I gave it to the child’s mother, warning her that I had no idea whether it would work or not. The next day I went back to their house and she met me at the door, beaming. The child’s temperature had dropped to normal within hours and she was wide awake, bright and cheerful and full of energy. The mother and grandparents almost fell on their knees in front of me, despite my attempts to explain that I really had nothing to do with this miracle. And it was a miracle at that time—one for which all physicians were very grateful. Allergic responses to drugs were virtually unknown. The risk of nasty side effects was minimal. Oh, to have those days again! Now we dispense medication with long lists of possible side effects; we spend hours explaining the possible problems to the patient, which I personally think scares them more. But then, I am still living in a simpler era in medicine. I have no qualms in accepting the miracle that may be happening—on the contrary—but I wonder if we are so caught up in the miracle that we tend to ignore the human being whom we call a “patient.” Let’s not lose sight of that simple fact.

It is the belief that is the magic, not the “medicine”

Dr. Marlene Hunter is a well-travelled physician who is now the director of the Labyrinth Victoria Centre for Dissociation.

January/February 2009 Just For Canadian Doctors

travel the world

went to Greenland planning to gnaw on whale blubber and sip seal oil. This is, after all, the land of the Inuit, of hunters in polar-bear-fur pants and raw-fish entrees. Who expected the best (and yummiest) fishing trip of my life? Greenland is one of those places, like New Zealand, with more food on the run than people. The capital, Nuuk, has 15,000 residents (and only three traffic lights). Villages of 80 inhabitants are not uncommon. Meanwhile, 30,000 musk ox wander the tundra within sight of the country’s international airport and the seas teem with shrimp and prawn and cod. Greenland, 2,700 km long, is the largest island on earth. Most of it lies above the Arctic Circle, and throughout modern history it’s had a bad reputation. This is the place so harsh, even those bully boys of the world, the Vikings, couldn’t survive. And several waves of Inuit didn’t do much better. But it’s also a land of breathtaking nature…of rolling tundra and ancient, worndown hills, midnight sun, magnificent glaciers and so much empty terrain, you can hardly believe it. And it’s about as laid back a place as you can find. Forget draconian security searches on domestic flights. You just climb aboard the airplane, like the old days, and go. Even five years ago, there was no customs station for arriving passengers at the international airport. You just got off the jet and walked in. If you wanted a stamp in your passport, you had to go to the local police station. But don’t come here expecting villages of mud huts with locals eating dinner on the floor. Most homes have satellite TV, cell phone service and internet, and there are supermarkets stocked with Danish delicacies (Greenland is, after all, part of Denmark, though with its own home rule). Dinner on our first night in Nuuk at Hotel Hans Egede was an unexpectedly gourmet affair whose centrepiece was a cube of glistening rare meat that I assumed was prime beef. But no, it was one of those 30,000 musk ox... lightly charred on the outside, fork tender on the inside, with the most incredibly rich flavour and a silky, smooth mouth feel. After dinner, I was lucky enough to run into Greenland’s queen of herbs, Anne Sofie Hardenburg. Greenland is that kind of place…stand in one spot long

enough and you will inevitably meet everybody of interest to you. She has cooked for the Danish royal family, written cookbooks and now supplies fresh herbs, which she collects and prepares herself, to select restaurants across Europe. Her favourites: juniper, which she likes on lamb; thyme, which is much stronger here than elsewhere; and angelica (in the parsley family), which she swears goes good in everything from soups to breads, fish, meat, even dessert. And then, there is roseroot, voted Sweden’s “herb of the year” in 2004…perhaps because it is also known as nature’s Viagra. The leaves are used in salads. The bark can be dried and the root is steeped to become an extract. The next night, we went to the home of Ida and Stig Winthers for an authentic Greenlandic barbecue. What this meant was the most incredibly fresh fish and meat. “I promise you,” Stig said as he put out a bowl of tiny, tender shrimp, “none of these have gained their colour by artificial means. It was all caught here, in open waters.” In too many countries, “wild” food means farm raised and government inspected. Not in Greenland. The thin, salmon-coloured slices of arctic char (a salt-water trout) had been smoked over tundra heather by hunters. You could taste the cook fires in the woody flavour. “And reindeer season has just started,” Stig added. “So we will have local reindeer, shot yesterday in back of our fjord.” I’m not sure where Stig got his reindeer recipe but it was an incredible blend of old and new. He sliced deep pockets in the haunch of meat, filled them with parsley, mushrooms and cream cheese and wrapped the whole thing with strips of bacon. The result was a salty charring on the outside that crunched as you chewed, with just a hint of the wild in its flavour. But that is the history of Greenland…one of change and adaptation. The first Inuit here arrived around 2500 BC. They lasted a few hundred years, disappeared and were replaced by several waves of new Inuit who also disappeared, as did the Vikings, who held on for 400 years before vanishing with hardly a trace. The present Inuit are descendants of the last wave of natives, known as Thule, who arrived around 900 AD. And, of course, there are also the Danes, who established their permanent foothold in the Nuuk area in 1721.

GourmeT GreenLanD the land of ice + snow offers plenty to chew on

story + photography by Yvette Cardozo 14

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January/February 2009

this page, from top Kiss a fish… aboard a fishing boat in a fjord near Sisimiut. > Author Yvette Cardozo with fresh-caught seven-pound cod. > Captain Bo Lings holds lunch, ready to be prepared and served aboard the boat. opposite page Fresh-caught cod in a plastic bucket. page 16, from top Greenland is a foodie’s delight. Lamb dinner in Sisimiut (the second-largest city). > Plate of fresh prawns, caught in a fjord near town, next to polar bears and the mythical creature tupilak, carved of narwhal tusk. > Gourmet fare: rare musk ox, beer-braised potato and shredded musk ox with herb crust.

travel the world

January/February 2009 Just For Canadian Doctors

travel the world This is not an easy land. The interior—85 percent of all Greenland—is ice. The thin band of coast is tundra, covered by low grass, full-grown willow trees that stand hardly a foot tall, and a surprising amount of desert-like sand. People here have to “make do.” The Chinese restaurant in one town we visited uses seal and whale in its Asian dishes. I couldn’t imagine this and hoped to make a visit to taste. There’s also a thriving beer industry here. My favourite, named simply Greenland Beer, is made from melted glaciers and allegedly (though I couldn’t confirm this) advertised as “older than Jesus.” Like its people, Greenland’s food stock comes and goes. The world’s biggest flounder, a 273 kg monster, was caught here in the 1970s. It was so big, the fisherman had to shoot it with his rifle and tow it into shore behind his boat like a whale. And then, flounder disappeared from Greenland’s waters. Now people fish for shrimp and prawns. Last year’s 18,000-ton harvest of cold water prawns accounted for a third of the world’s consumption. Cod, too, came and went. And now it’s back again, as we learned firsthand in Greenland’s second largest “city,” a village of 5,700 people named Sisimiut. The morning of our fishing trip, the sun came up, as it does in August, around 4 am and immediately disappeared in a soup of fog so thick, I could barely see buildings across the street from my hotel. “Not to worry,” said Captain Bo Lings. “We have GPS and radar.” And indeed, the instrumentation aboard his small boat looked like something out of science fiction. The best was the sonar that gave us 360-degree, three-dimensional, fullcolour views of the boat, the underwater shelf and nearby cliffs from any angle…above or under water. We headed for a fjord north of town looking, Bo said, for a good current. Cod like to hide behind islands in the current. Soon enough, a school of cod showed up as a feathery line of blue on the radar screen. Bo’s mate, Michael, set up the rods, each with three separate lures spaced a foot

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apart on the single line. As instructed, we released the line and let it all drop to the bottom, then cranked the reel three times and waited, jerking the rod upward every 15 seconds or so. No more than five minutes from the moment the first line hit the water, someone got a hit and reeled in a two-pound cod. Then somebody else got a hit and somebody after that. I put my line in and jigged it three times. “Oh heck, I’ve caught the bottom of the boat.” “No,” said Bo. “That’s a fish.” And indeed, it was. My rod bent over, its tip reaching for the water. This was no one-kg baby. By the time I reeled it in, I realized my catch weighed at well over three kilograms. It went like this for 90 minutes, with three people each catching 11 fish. We got 48 in all…more than enough for lunch and to feed a friend’s sled dogs in town. I was just about to reel in my line for the last time when I got a final hit. This was even stronger than the big one before. I held on, bracing the end of the rod on my hip as I reeled in whatever was at the other end. It broke the water’s surface. No, THEY broke the water’s surface. When we got it all aboard, there was a four-kg cod and his smaller two-kg brother hanging from separate lures on the single line. Cod, I have decided, are really stupid. But they sure are tasty. While Michael filleted our catch, Bo fired up a stove that amazingly shares his boat’s instrument panel. We dropped anchor in a beautiful little cove where the cold gray water was like glass. Soft round hills rose around us, covered with tufts of grass and a low scrub tinged with the first reds of autumn. The recipe was simple: a pan full of sizzling butter with a touch of salt. Nothing more to interfere with the delicate flavour of the fish. And indeed, the fish was tender but with substance, silky smooth and slightly sweet. It would have been criminal to use more than a squirt of lemon. I never did make it to the Chinese restaurant for Sichuan seal. But that’s okay. Memories of those 48 cod will do just fine, thank you.

January/February 2009

opposite page,

Late afternoon sun highlights colourful houses of Sisimiut on Greenland’s southwest coast. > Kennel owner in Sisimiut holds a sled-dog puppy. > On the ice cap of Russell Glacier near Kangerlussuaq, Greenland’s international airport. > Children playing in Sisimiut. > Greenlandic ceremonial costume, made of caribou skin, beads and embroidery. > Sled dog by a native sled at sunset. > Deserted whaling village of Kangerq in Nuuk Fjord outside the capital Nuuk, inhabited for 4,000 years until 1970 when the Danish government centralized small settlements.

from top

if you go

by boat Though youcanfly intoGreenland onyour ownandstay invarious villages, the most effortless way to seethecountry is by cruiseship. Hurtigruten GroupASA, a Norwegian company, offers sailings throughout summer that visit eventhemost remotenorthernvillages. For moreinformation: hurtigruten.com. go fish The experiencewehad fishingwas not unusual. Theboat captainsaidhe has never, ever failedto bringinat least some fish. Thehalf-day trip includinglunchruns 695DKK, approximately $151Canadianat timeof publication. For general information onGreenland: visitgreenland.com

travel the world

January/February 2009 Just For Canadian Doctors

prescribing r & R

by dr. peter brindley

To imbibing beer while touring Germany

or this particular doctor, many of life’s finest, quirkiest, and most surreal moments would have been missed but for a glass (or two, or three) of good beer. Conferences and business trips where sage words such as “well, I’ve a long day tomorrow, I should turn in” were blithely disregarded for “well, one won’t hurt” have meant many life-long friendships and the anecdotes that sustain them. While I don’t intend to use this argument during my annual academic report, beer has indeed gotten research started, conferences organized, invites accepted, and manuscripts written. Quite an achievement for four simple ingredients: water, yeast, sugar and hops. At the risk of sounding quite the “lager-lout,” I wish to give simple thanks for my alcohol dehydrogenase. For centuries, primitive sanitation meant that European drinking-water was simply unsafe. Therefore, fermentation became, quite literally, a life-saver. In contrast, in eastern cultures, safe potablewater was created through boiling and then flavouring with tealeaves. Fast forward generations and one culture has ADH; another gets red in the face at the very thought. Regardless—whether icecold pilsner in Prague; warm soupy “heavy” in Edinburgh; stout, black as coal, in Dublin; or ludicrously potent tripels in Brussels—for all my protestations that quality beer deserves it due, its ability to lubricate social muscles also warrants celebration. However, right now my focus is squarely on Germany and Austria. It’s very trendy to talk of those 100 places you must visit; those “must-dos” and “must-sees.” Even Hollywood has entered the fray with such drivel as The Bucket List (i.e. things to do before you hit the “bucket”). Regardless, I implore you to add Munich’s Oktoberfest to yours. Fabulous Wiess Biers (wheat beer rather than the typical barley), served in litre steins and supped in 400-year-old beerhalls, was the best cure for jet-lag I have ever experienced. An overnight flight in the stale cabin of a cramped jet was quickly forgotten with best friends, cold beer, and just a touch of “umpapa.” International détente was rapidly established with others from Germany, France and England. All it took was the willingness to sing silly drinking songs, and the crashing together of glasses whenever high school language skills failed. The ambience was further achieved by the rows of beautifully decorated steins in lockers built for the regulars. This was combined with gravity-defying feats by waitresses loaded with beer and bratwurst. In a world of homogenous franchises, it was rather refreshing (pun intended) to spend a little time in a place that is “cool” precisely because it isn’t trying to be. Hours later (I think) we found ourselves (goodness knows how) in bucolic beer gardens, ready for more inspired silliness. However, again, a picture is worth a thousand words: These are not your standard beer gardens. Left heavily treed in order to keep the beer cool below ground (of note, the word lager comes from the German for cold storage), these unspoiled urban rest spots invite all members of the family, and in no way resemble the cordoned-off lepercolonies of North American beer gardens. The Bavarians would no more insult you with plastic cups, fences and Neanderthal bouncers than Canadians would suggest playing hockey in a swimming pool.

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January/February 2009

and Austria The following morning began with nary a hangover (thanks in no small part to the Bavarian beer purity laws of 1516). Buoyed with advice from the previous night’s revelry, the beer halls gave way to cars, castles, and cuckoo clocks. We sped into the Bavarian Alps and lunched at mad King Ludwig’s Neuschwanstein castle. Because it seemed just too decadent not to, we then had supper in the medieval splendour of Innsbruck, Austria. With mountains on three sides, an alpine river gurgling away, and a refreshing evening chill, the food and drink pairing became a doddle. As long as the beer was cold and the food hot, the evening couldn’t fail and the conversation couldn’t help but crackle. In contrast, the following day stopped conversation dead in its tracks. A harrowing, but nonetheless deeply meaningful, tour of Dachau concentration camp left all of us speechless. I am profoundly impressed with how little Germany hides the unsavoury parts of its history. I had also, until that day, never fully empathized with the idea of drinking to take the edge off a hard day. With little shame, I’ll admit this day beer provided anodyne relief. Perspective regained, and perhaps with a touch more humility and humanity, we headed off to the remarkable, fabulous, city that is Berlin. Whether it’s to see the remnants of the Wall, the Fernsehturm communication tower (built by the east to intimidate West Berlin but resembling a giant spear of asparagus), or Checkpoint Charlie, you owe it to yourself to pencil-in this city on your bucket list. However, astute readers will notice little mention of its beer. This is deliberate. For such a wonderful destination, Berlin’s beers compare to Munich’s much as do its historic cars: Berlin gave us the Trabant (18 horsepower and a two-stroke engine!); Munich birthed the BMW. During its heyday as the capital of the German Empire, Berlin housed some of the country’s largest and most influential brewers. A century of turbulent history (now there’s an understatement) means that bland Pilsner now dominates, as it does in much of the world. There is the chance to try a Rauchbier (quite literally “smoked beer”) or as my friend called it “bacon in glass.” While unlikely to become your regular tipple, it does pair nicely with smoked meats. There is also the chance to avoid Berliner Weisse. Its sour taste means it differs from the marvelous German wheat beers mentioned earlier. It also means that it’s usually mixed with red (raspberry) or green (woodruff) syrup. It might even be served with a straw (oh, the humanity). Just don’t say you weren’t warned. If light American beers are for those that hate beer, but love to pee, then the same accusation works for Berliner Weisse. Germany and Austria offer scenic, historical and epicurean delights. Despite an extensive bucket list of my own, to quote in the words of a famous local…I’ll be back. Dr. Peter Brindley is an Intensive Care Specialist in Edmonton, AB, who has been known from time to time to enjoy a beer.

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techworks

C o r e y Va n ’ t H a a f f

Brain plasticity Making do with what you’ve got

hen Paul Bach-y-Rita’s dad suffered a significant stroke in his 60s, he was left incapacitated. Doctors said he would never be normal again. Paul’s brother took their father into his home and began the labourious process of re-training him. He started from scratch; first crawling then walking. The process of recovery took 18 months. The father ultimately died of natural causes some eight years later but not before climbing mountains in South America. This cemented Paul’s belief about brain plasticity. An autopsy of Paul’s dad showed significant damage to the brain but also showed that undamaged areas were able to compensate. Paul, who was already a full professor at Pacific Medical School (part of Stanford at that time), decided to complete a residency in rehab medicine after his father’s stroke and recovery. His ideas about the brain’s plasticity were novel then, though commonly accepted today. “Paul took from that the knowledge that the brain is quite amazing and people can be rehabilitated long after other people give up on them,” says Robert Beckman, CEO of Wicab Inc., the folks who own the exclusive license to BrainPort® technologies, invented by Dr. Bach-y-Rita and the property of the University of Wisconsin. Paul Bach-y-Rita formed the company Wicab, Inc. prior to his death in 2006. BrainPort is a device that helps train people with a balance deficit to

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maintain their balance. It uses a small chip accelerometer embedded in a device that is placed on the surface of the tongue. Usually, it is used twice a day for 20 minutes each time, and is often used for the rest of the patient’s lifetime. The accelerometer senses a change in the position of the head and converts that information into a signal on the tongue. The patient is trained to maintain the signal at the centre of the tongue. “It’s so intuitive; they learn to keep their balance by maintaining the signal. Over time, people begin to experience and retain improved balance,” says Beckman. “Patients train with their eyes closed and take vision out of the equation. They get a very accurate signal from the device and learn to coordinate with their own proprioception— how they feel balance through their leg muscles when standing.” Paul Bach-y-Rita’s basic belief was that any sense can be replaced with a substitute sensory device. In the early days of his research with tongue stimulation, one of the engineers working with Paul had become ill with a head cold. He was riding a bus and felt it spinning, though he knew no such movement occurred. He thought the key to eliminating that feeling was to find a way to send an accurate signal to his brain rather than the convoluted information that was causing his dizziness. Then he put two and two together, says Beckman.

January/February 2009

Accelerometers were very cheap and used in cars to deploy air bags based on a sudden deceleration. The tiny computer chips were able to sense gravity and motion and deploy an air bag immediately before a crash. Initially, they mounted an accelerometer on a helmet and Cheryl was their first patient. Cheryl suffered from bilateral vestibular loss. She came to Paul unemployed and unable to walk without a cane or walker. Today, after training and using BrainPort, she has a full-time job, rides a bicycle and is fully recovered. She no longer even uses her BrainPort. The BrainPort is an effective solution, helping 60-to-70 percent of the people who try it, but it doesn’t come cheap. The Health Canada-approved device costs $10,000 USD and is not covered by insurance. Patients must also receive training on how to use the device, usually with a physiotherapist, but can trial the device for a month before purchasing it. There are about 40 devices in use in Canada and the company is completing clinical trials in the US and hopes for FDA approval in 2009. Beckman says it is hard to accurately assess how many people could potentially be helped with BrainPort as no one keeps accurate tallies of people with balance problems, though he estimates 100,000 people in Canada suffer from balance issues from strokes, traumatic brain injury and peripheral vestibular disorders. “Since there’s no device or drug therapy and no treatment, there’s been no reason to tally who has the disease,” he says. “Many sufferers may be unemployed. There’s nothing else for doctors to do with them, so they fall out of the medical system. This definitely gives them a way back in.” Corey Van’t Haaff is a Vancouver-based writer and owner of Cohiba Communications. She is Just for Canadian Doctors’ technology columnist. She can be reached at medicalnews@ cohibacommunications.com and welcomes ideas for future columns.

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mush!

north of 60Ë&#x161;

Winter this far north is bold, brilliant, beautiful and, yes, bone-chilling. But the hip-deep snow, hundreds of tail-wagging sled dogs, snowsuit-clad mushers and grinning locals have a way of keeping you toasty warmâ&#x20AC;Ś story + photography by Barb Sligl

January/February 2009 Just For Canadian Doctors

mush it!

a doctor rides with the dogs The sound of howling dogs pierces the air. We’re running late, but now I know we’re on the right track. We run faster and our warm breath can be seen against the cool, crisp mountain air. My sister and her husband are visiting from Ottawa and I had thought what better way to introduce them to “the wild west” than by going on a dog-sled adventure in BC’s backcountry. I had envisioned a peaceful ride in the snow, being pulled by a few cuddly dogs on a sled, while happily enjoying some hot chocolate. Our professional guides, Jack and Cindy, welcome us with large smiles and usher us to the side of the trees, away from the dogs as they jump up and down, pulling wildly at their chains. “These are purebred Alaskan huskies. They know they’re going to go for a run and they’re excited,” states Cindy. “Who’s going to be the driver?’ asks Jack. “It’s a lot of work and you need to keep control or you’ll wipe out and hurt yourselves.” His words linger in the air. I was not banking on quite so much action or risk when I’d booked the tour. Jack shows us how to get the dogs running by a click of the tongue, how to encourage the dogs when going up hill by running along with them, and how to stop the sled by bearing down with all your weight. All whilst talking, Jack and Cindy have picked the six dogs for each sled and hooked them up. I can’t believe we’re ready to race our very own team of Alaskan huskies. My husband Jonathan is the strong one, so I nominate him to be the driver and, incidentally, do all the work while I snuggle under a blanket in the sled (above). Jonathan yells, “Mush!” and we’re off. I feel the raw strength of the dogs as they lunge forward. The powder snow flies in the air and the dogs yelp out to one another, howling as they run free. At every turn, I watch their paws sink into the glistening white snow. I feel the adrenaline rushing in my veins, and I decide that this is even better than hot chocolate. —Dr. Lili Nasseri IF YOU GO > Dr. Nasseri’s dog-sledding adventure was at Sun Peaks Resort in central BC. > sunpeaksresort.com/activities; activities@ sunpeaksresort.com MORE > See “if you go” on page 24 for where to mush in the Yukon.

Just For Canadian Doctors

nce you’ve spent any time in the winter in the Yukon, you’re entitled to some bragging rights. Especially in February, when the nights last 17 hours, the mercury can dip to –50˚C, and the Yukon Quest is in full swing. This is when you’ll bump into down-wrapped figures lumbering the snowy streets of Dawson, curls of misty breath following everyone. And add to all that human exhalation the dogs’… Dogs seem to outnumber people here (Dawson’s population is 1,889) at the halfway point of what’s called “the toughest race on the planet.” The Yukon Quest is 1,600 km (10 days, 2 hours, 37 minutes in the fastest time) through the frozen wilderness between Fairbanks, Alaska, and Whitehorse, Yukon, on the old “highways of the North”—historic winter routes followed by prospectors, adventurers, mail and supply carriers travelling between the gold fields of the Klondike and the Alaska interior. It was the only means of travel a century ago, and it’s still a huge part of the Yukon today. The start and finish of the Quest alternates between Fairbanks and Whitehorse, but the place to get immersed in the race—and the winter bravado—is Dawson. Fans travel far to witness this spectacle of dogs and their mushers braving the harsh journey. And to experience the glittering beauty of winter this far north. There’s nothing like it. It’s even better if you love dogs. (Fittingly, the Yukon Coat of Arms is surmounted by a malamute, or husky, standing on a mound of snow.) A 36-hour layover in Dawson means mushers check in, rest and fuel up, get updates on trail conditions and mingle with dog handlers, media (from all over the world), locals and groupies—all with sleepy, wind-burnt faces, and all clad in fleece and covered in dog hair. The celebrity and mushing guru here is Alaskan Lance Mackey, four-time champion of the Yukon Quest (and two-time winner of the Iditarod, and the only musher to win both 1,600-km races back-to-back). As the first to check in to Dawson, he’s also the prize winner of four ounces of gold nuggets (one of the previous year’s nuggets graces his ear as a stud). But every musher here is a star—young, old, male, female, rookies and veterans alike. Troops of followers trudge across the frozen Yukon River to the provincial campground that becomes base camp for all the dog teams. Spectators watch the teams come and go. Like the young German photographer from Munich. It’s his first time in Canada—or anywhere this cold—and he loves it. It’s not unusual to hear multi-lingual conversations on the icy river banks and snowy streets. A group of Italians ask a local volunteer about seeing Jack London’s cabin while here. It’s closed over winter, but a call is made and someone shows up to let the Italians in for an impromptu visit. Such is the Yukon hospitality. The camaraderie continues at Bombay Peggy’s, the go-to gathering place and watering hole (and former gold-rush era brothel). During Quest season you might sip on a Dog Ball Highball (just what it sounds like…) at the Night of Northern Naughtiness (a benefit to raise funds for the Dawson Humane Society). More merriment is found at The Pit, another bar and institution dating from 1901. And another festive spot: the Downtown Hotel, where mushers take advantage of a soft bed while tourists and neophytes swig the bar’s famous and kitschy Sourtoe Cocktail (complete with another kind of appendage, this one human). previous page, clockwise from top left

Snow clings to branches on the frozen banks of the Yukon River; A sled dog peers out from a kennel atop a pick-up; A snowy Dawson street; The vast Yukon as seen from the Air North flight between Whitehorse and Dawson; Ice inukshuk on the ice bridge over the Yukon River; Typical house in Dawson; Icicles cling to the beard of musher, Phil Joy, a contestant in the 2008 Yukon Quest. opposite page, clockwise from top left Caribou and bison sausage makes gourmet picnic fare along the Dempster Highway; Iconic Downtown Hotel in “downtown” Dawson, home of the Sourtoe Cocktail; Trail up to the Midnight Dome; Sled dogs arrive at Dawson checkpoint in the Yukon Quest; Pick-ups, kennels, and dog sleds are a common sight during the Quest; Sign outside the ribald Pit Bar, a local institution since 1901; Moosehide mittens handmade by local First Nation artist Eldrea Christiansen; Dawson’s go-to bike shop, run by Tim Gunter, keeps cyclists pedalling year-round; Winter along the Dempster Highway is stunning and like nowhere else—a view towards Tombstone Territorial Park.

January/February 2009

photo this page: courtesy dr. lili nasseri

travel at home

January/February 2009 Just For Canadian Doctors

travel at home Winter doesn’t stop anyone in the Yukon. Going on in Dawson at the same time as the Quest: a bonspiel tournament (a big deal and 110-year-old tradition) and a hockey tournament (competing is a group of doctors from New Hampshire). There are also the typical get-togethers of the rather cosmopolitan locals, like the regular meeting of what may be the most northerly scotch club (sampling single-malt only, of course; the group has been known to make the six-hour drive to Inuvik for a good scotch deal). So what to do? Head towards Inuvik. Not for the scotch but for the views alongside the Dempster Highway (and a reprieve from all the Dawson festivities). Driving through this barren beauty is unlike any other road trip. The white is punctuated by ribbons of turquoise overflow. At Tombstone campground the fluffy dry snow sits in big cottonballs on branches that are still auburn with fall colour. It’s the perfect spot to stop for a winter picnic Yukon style—caribou and bison sausages roasted over a fire. This is what winter adventure tastes like in the Yukon. Back in Dawson, the way to cap it all is to hike up the Midnight Dome as twilight settles, when the snow takes on every bit of fading blue and the sky is tinged every gradation of pink. This is no monochromatic landscape. Atop the Dome, the lights of Dawson, tucked between the banks of the frozen Yukon and Klondike Rivers, beckon as the one small, sweet spot of civilization within the 360˚ view of the vast North. It’s endless…but just up the winding Yukon River is another tiny twinkling light. Dogs yowl far below. It’s a musher slowly gliding into town.

if you go

Getting there Fly toWhitehorsevia Vancouver; aircanada.ca > Or fly direct fromCalgary andEdmonton; flyairnorth.com> Fly toDawsonCity via Whitehorse; flyairnorth.com Where to stay InWhitehorsecheck out: TheEdgewater Hotel; edgewaterhotelwhitehorse.com; 1-877-484-3334> TheHighCountry Inn; highcountryinn.yk.ca; 1-800-554-4471(withinCanada & US) > TheWestmark; westmarkhotels.com/whitehorsehotel; 867-393-9700 What to do Check out yukonWILD, a groupof licensedwilderness tourismoperators that offer adventures intheYukon—½-day, full-day andmulti-day activities. yukonwild.com; wtay.com Dogsledding CathersWildernessAdventures> Family-runbusiness—on the“margeof LakeLaberge” (as intheRobert Servicepoem)—offeringwilderness trips since1974. cathersadventures.com; yukon@cathersadventures.com>> Muktuk Adventures> 30+ years intheYukon, 25+ years mushing. Guest ranch, B&Bwith husky kennel tours inthesummer. muktuk.com; muktuk@northwestel.net >> Sky HighWildernessRanch> Choiceof dog-sledadventures: hourly, ½-day, full day, multi-day andfull-moonadventures. Lodgeandcabinaccommodations. muktuk. com; muktuk@northwestel.net >> UncommonJourneys> Small-groupwilderness travel; dogsleddingledby professional outdoor educators. Week-longtrips to month-longArcticexpeditions. skyhighwilderness.com; info@skyhighwilderness.com northern lights viewing NorthernTales> Aurora Borealis viewing tours, winter adventurepackages andexpeditions beyondtheArcticCircleandonthe iceroads tothecoast of theBeaufort Sea. northerntales.ca; info@northerntales.ca >> FrancesLakeWildernessLodge> Inthebelt whereit’s most likely toseenorthern lights duringclear winter nights. Full boardat Frances LakeWilderness Lodgeinyour owncosy logcabin. franceslake.ca; info@franceslake.ca >> KanoePeople> Aurora tours basedat thewest shoreof LakeLaberge, anhour drivefromWhitehorse. The nearest neighbour is over threemiles away; optimumnorthernlights andstar gazing fromthe280-degreeviewinghill. kanoepeople.com; info@kanoepeople.com

Choose your Yukon adventure u Mush your own dog team with our adventure experts. For a fresh look at a winter holiday, visit www.yukonwild.com or contact our member companies directly. dog mushing adventures: Cathers Wilderness Adventures www.cathersadventures.com Muktuk Kennels www.muktuk.com Sky High Wilderness Ranch www.skyhighwilderness.com Uncommon Journeys www.uncommonyukon.com northern lights viewing tours: Photo: www.hartmier.com/www.archbould.com

Frances Lake Wilderness Lodge www.franceslake.ca

Kanoe People Ltd. www.kanoepeople.com Northern Tales www.northerntales.ca

Just For Canadian Doctors

January/February 2009

amelia island / sydney / baltimore / ottawa …

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A n intern ation a l guide to continuing Medical Education

winte r 20 0 9 + beyond

amelia island

b. sligl; golf course photo courtesy of amelia island plantation

Escape to the wind-swept beaches of Amelia Island in Florida (CME events at Amelia Island are highlighted in blue) People at Amelia Island Plantation call it a “little sliver of paradise.” Theresort is surroundedbystateparks (includingthe Okeefeenoke Swamp) andmelds nature andluxury—live-oak forest, salt marshes, and beach dunes alongside top-notch golf courses, finediningandahigh-end, eco-consciousspa. The resort has been a pioneer in maintaining its natural resourcessince1972, whenit wasbuilt anddesignedafter Hilton Head, South Carolina. The barrier island is a wildlife refuge and travel corridor andretains 70%of theoriginal treecanopy(gaze out upontheseeminglyendless bulbous greentops of giant live oaks fromthe topfloor of the Amelia Inn). The resort diligently protects the native turtle population (you may see one or two waddleby) andits NatureCenter provides rehabfor birds, gators andsnakes, andeducationfor kidsandadultsalike. Greeninitiatives abound; the resort uses grey water onits threechampionshipgolf courses(all certifiedbyOutwardBound asnaturesanctuaries).Thespaisall green(above, left),andoffers

signatureislandtreatments—likethe”SweetIslandWrap”—as well ascrèmedelaspastuff likeVichyshowers. You’ve got plenty of ways toexploreall this: boogieboard thesurf (above, far left); kayak thewaterways andsalt marshes (top, centre); bike the winding network of trails; birdwatch via golf cart; horseback ride on the beach; beachcomb and watch for whales and porpoises (whale season is now until March, when pods float just offshore with calves); roast s’mores at a beachbonfire (a weekly year-roundfamily event); tee off at 72 championshipholes(seaside, like#6onOceanLinks, topright, or sculptedaroundtheforestofliveoaks,sabal palms,pinesandwax myrtles); swingaracquet(thetennisprogramisknownasoneof theworld’s best, andRacquet Park has hostedtennis greats like Navratilova, Evert, Sampras, Connors andAgassi oncentrecourt, hometotheBausch& LombandWTAChampionships); or tour aroundinan“islandhopper”(aglorifiedgolf cart at everyguest’s disposal). Youcanevenrent aSegway...

However you get there—Segway, bike, island hopper— besuretocatchsunriseonthebeachandthensunset atWalker’s Landing,apopularfishingspotoverlookingthesaltmarsh(above, far right). Andjust off theresort grounds is FernandinaBeach, an oldsettlement (theentireislandwasorignallysettledbypirates) that’s hometocuteshops withbeachytrinkets (above, right), as well as theoldest continuouslyrunningbar inFlorida.ThePalace Saloon, withits original mosaictilefloor, pressed-tinceilingand mahagony bar (a gift fromAdolphus Busch), has beenhopping since1878(top, left). Askfor atasteof thesignaturebrew,made right here: “Pirate’sPunch”. The myriad activities make Amelia Island Plantation a big destination for meetings and events (49,000 square feet of function space accommodates conferences of up to 1,000 guests).Butthere’ssomuchtodo,mostconferenceattendeesend upcomingback… For more on Amelia Island Plantation goto: aipfl.com; spaamelia.com — B.S.

January/February 2009 Just For Canadian Doctors

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7th Anti-Aging Medicine World Congress

EuroMediCom

011-33-1-56837-800

euromedicom. com

Vancouver British Columbia

XVII World Congress Of Aesthetic Medicine

CongressWorld Conferences Inc.

604-685-0450 See Ad Page 26

aestheticmedicine2009.com

Jul 17-19

Estes Park Colorado

Colorado Integrative Medicine Conference (cIMc 2009): Focus On Mind-Body Medicine

AlterMed Research Foundation

970-310-3030

altermedresearch.org

May 16-21

Sydney Australia

Royal Australasian College Of Physicians Congress 2009

Tour Hosts Pty Ltd

011-61-2-92650700

racpcongress. com

Jun 11-12

Baltimore Maryland

Current Concepts In Complementary & Alternative Medicine

Johns Hopkins University

410-955-2959

hopkinscme.edu

Feb 09-13

Lake Tahoe Nevada

Current Topics In Anesthesia

Baylor University and Northwest Anesthesia Seminars, Inc

509-547-7065 See Ad Page 31

nwas.com

Feb 15-20

Kauai Hawaii

Clinical Anesthesia: Perioperative

Baylor University and Northwest Anesthesia Seminars, Inc

509-547-7065 See Ad Page 31

nwas.com

Mar 15-20

Whistler British Columbia

14th Annual Update On Cardiopulmonary Bypass

Society of Cardiovascular 804-282-0084 Anesthesiologists

Apr 02-04

Seoul South Korea

2nd Annual Protein & Peptide Conference (PepCon 2009)

Emily Liu

011-86-4118479-9625

bit-pepcon.com

Apr 18-24

Honolulu Hawaii

Scientific Meeting And Exhibition Of The International Society For Magnetic Resonance

ISMRM

510-841-1899

ismrm.org

Apr 22-27

Olympic Valley California

Complex Lipids In Biology: Signaling, Compartmentalization & Disease

Keystone Symposia

800-253-0685

keystonesymposia.org

Jun 13-17

Toronto Ontario

56th Annual Meeting Of The Society Of Nuclear Medicine

Society of Nuclear Medicine

703-708-9000

sbng.nl

Cardiology

Feb 13-15

Mont Tremblant Quebec

2009 Winter Cardiac Team Meeting

Schulich School of Medicine & Dentistry

519-663-3384

lhsc.on.ca

Feb 20-22

Hong Kong China

Cardio Rhythm 2009

Hong Kong College of Cardiology

852-2294-4468

cardiorhythm. com

Feb 20-22

Vancouver British Columbia

Pharmacology - Plants and Natural Products in the Treatment of Disease

National Education Institute

Apr 22-24

London England

British Association For Psychopharmacology Masterclasses In Clinical Psychopharmacology

BAP

011-44-1223358-421

bap.org.uk

May 15-17

Limassol Cyprus

International Conference On Alzheimer’s Disease And Related Disorders

World Events Forum

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Biochemistry

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Just For Canadian Doctors

January/February 2009

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Genetics

General & Family Medicine

Endocrinology

Emergency Medicine

Dermatology

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Feb 07-13

Wailea, Maui Hawaii

33rd Hawaii Dermatology Seminar

Skin Disease Education Foundation

240-221-4401

sdefderm.com

Mar 06-12

San Francisco California

67th Annual Meeting Of The American Academy Of Dermatology

American Academy of Dermatology

847-330-0230

aad.org

Apr 10-20

Canary Islands Cruise

Family Medicine: Focus On Dermatology

Continuing Education Inc. / University at Sea

800-422-0711 See Ad Page 39

continuingeducation.net

May 06-09

Montreal Quebec

69th Annual Meeting Of The Society For Investigative Dermatology

SID

216-579-9344

sidnet.org

Feb 04-06

Ottawa Ontario

27th National Capital Conference On Emergency Medicine

Ottawa Hospital

613-761-4480

uottawa.ca

Mar 16-20

Terrace British Columbia

2009 Winter Escape Emergency Medicine Update

BCCFP

888-308-3007

tandtadventures.com

Aug 16-19

Las Vegas Nevada

Annual National Emergency Medicine Boards Review

Center for Emergency Medical Education

800-651-2363

chestnet.org

Mar 05-07

Los Cabos Nevada

Clinical Endocrinology For Primary Care Physicians

Medical Education Resources

800-421-3756

mer.org

Jun 06-14

Mediterranean Cruise

Endocrinology Update

Sea Courses Cruises

888-647-7327 See Ad Page 36

seacourses.com

Jul 10-17

Seattle Washington

Hot Topics At Sea: Multidisciplinary Management Of Hepatic, Pancreatic & Biliary Malignancies

Johns Hopkins University School of Medicine

410-955-2959

hopkinscme.edu

Feb 13-14

Vancouver British Columbia

3rd Annual Pacific Psychopharmacology Conference: Safety Issues In Psychopharmacology

BC Mental Health & Canadian Assoc. of Psychiatric Pharmacists

604-524-7509 See Ad Page 30

bcmhas.ca/ education

Feb 21-24

Amelia Island Florida

12th Conference On Osteoporosis: Diagnosis, Management & Prevention

Southern Medical Association

800-423-4992

sma.org

Mar 05-07

Marco Island Florida

Pain Medicine: A State-Of-The-Art Course In Pain Management For The Non-Pain Specialist

Mayo Clinic CME

800-323-2688

mayo.edu

Mar 15-22

Western Caribbean Cruise

Continuing Education Vacations: Diabetes

888-523-3732 See Ad Page 29

CMEatSEA.org

Jun 27Jul 05

San Jose Costa Rica

Adolescent Medicine And Young Adults: Costa Rica Adventure Tour

MCE Conferences

888-533-9031

mceconferences.com

Mar 11-15

Prague Czech Rep.

9th International Conference On Alzheimerâ&#x20AC;&#x2122;s And Parkinsonâ&#x20AC;&#x2122;s Diseases

Kenes International

011-41-22-9080488

kenes.com

Apr 21-26

Whistler British Columbia

Stem Cell Niche Interactions

Keystone Symposia

800-253-0685

keystonesymposia.org

Jul 08-11

Barcelona Spain

7th Annual Meeting Of International Society For Stem Cell Research

ISSCR

847-509-1944

isscr.org

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January/February 2009 Just For Canadian Doctors

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website

Immunology & Allergy

2nd Annual Protein & Peptide Conference

BIT Life Sciences

011-86-4118479-9609

bit-pepcon.com

Whistler British Columbia

22nd Annual Spring Meeting Of The Canadian Society For Immunology

CSI

Gill.wu@yorku. ca

csi.ucalgary.ca

Apr 24

London England

Improving Immunohistochemistry 2009

EuroSciCon

enquiries@ euroscicon.com

euroscicon.com

Mar 04-06

Ft. Myers Florida

Focus On Fungal Infections 19

Imedex

770-751-7332 See Ad Page 28

imedex.com

Mar 25-28

Hunter Valley Australia

2009 Annual Scientific Conference Of Australasian Society For Infectious Diseases

ASID

011-61-2-82040770

asid.net.au

Jul 18-25

Beijing China

BIT Life Sciencesâ&#x20AC;&#x2122; 2nd Annual World Summit Of Antivirals 2009

BIT Life Sciences

011-86-4118479-9609

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Feb 21-22

Ottawa Ontario

2009 Conference Of National Council On Ethics In Human Research

NCEHR

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Mar 16-19

Vale Colorado

Harassment (Sensitivity) Training For Health Professionals

National Education Institute

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Apr 04-11

Zermatt Switzerland

Europe Oceania Medical And Legal Conference

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May 17-20

Zefat Israel

International Conference On Bioethics Committees In Hospitals

ISAS International Seminars

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Feb 13-16

Hong Kong China

19th Conference Of The Asian Pacific Association For The Study Of The Liver

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Mar 25-29

Nashville Tennessee

2009 Spring Clinical Meetings Of National Kidney Foundation

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Jun 01-03

Birmingham England

2009 Conference Of British Renal Society

BRS

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Mar 04-07

Hurghada Egypt

34th Annual Meeting Of Egyptian Society Of Neurological Surgeons

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Apr 16-18

Edmonton Alberta

Alberta Brain Injury Conference 2009

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May 17-19

Houston Texas

Goodman Oral Board Preparation: Neurosurgery Review By Case Management

American Assoc. of Neurological Surgeons

847-378-0500

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Aug 12-15

Vancouver British Columbia

MTBI 2009: An International Conference On Mild Traumatic Brain Injury

CongressWorld Conferences Inc.

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Nov 09-21

Southeast Asia Cruise

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Just For Canadian Doctors

January/February 2009

Orthopedics

Ophthalmology

Oncology

Obstetrics Gynecology

Nutrition

cme

calendar

when

where

topic

sponsor

contact

website

Feb 01-04

New Orleans Louisiana

2009 Clinical Nutrition Week

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Apr 23-25

Kuala Lumpur Malaysia

28th American Overseas Dietetic Association Conference

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011-603-21-620566

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Apr 25-26

Toronto Ontario

Nutrition For Docs 2009: Using Nutritional Supplements In Clinical Practice, A Practical, Evidence-Based Approach – Part 1

University of Toronto

888-512-8173

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Feb 19-21

Orlando Florida

32nd Annual Advanced Ultrasound Seminar

Center for Medical Ultrasound

800-277-7654

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Apr 09-11

Kyoto Japan

Kyoto Breast Cancer Consensus Conference

KBCCC

011-81-75-7615751

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Jun 04-06

Melbourne Australia

2009 Annual Scientific Meeting Of Australian Gynaecological Endoscopy Society

AGES

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Sep 19Oct 03

Mediterranean Cruise

Continuing Education Vacations: Women’s Health

888-523-3732 See Ad Page 29

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Feb 11-15

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13th Annual International Congress On Hematologic Malignancies: Focus On Leukemias, Lymphomas & Myelomas

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Feb 20-21

Valencia Spain

11th International Symposium On Febrile Neutropenia

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Caribbean Cruise

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Mar 16-20

Vail Colorado

26th Annual Current Concepts In Ophthalmology

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May 16-19

Bali Indonesia

Asia-Pacific Academy Of Ophthalmology / American Academy Of Ophthalmology Joint Meeting

Indonesian Ophthalmologists Association

011-62-213190-7282

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Jun 20-24

Toronto Ontario

2009 Annual Meeting & Exhibition Of Canadian Ophthalmological Society

COS

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Feb 06-07

Cancun Mexico

3rd Annual Controversies In Spine Surgery

BroadWater Medical Meetings

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Apr 05-09

Osaka Japan

7th Biennial Congress Of The International Society Of Arthroscopy, Knee Surgery And Orthopaedic Sports Medicine

ISAKOS

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May 28-30

Durham North Carolina

From The Playground To The Stadium: A Comprehensive Update On Sports Injuries Of The Foot & Ankle

American Orthopaedic Foot & Ankle Society

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Jul 06-10

Padova Italy

XLVII Annual Symposium Of The Society For Clinical Electrophysiology Of Vision

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2009 Annual Meeting Of The British Pain Society

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Royal Australasian College Of Physicians Congress 2009

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Pediatrics In The Islands... Clinical Pearls 2009

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Feb 25-26

Brussels Belgium

2nd European Brain Policy Forum: A Focus On Depression And The European Society

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Vancouver British Columbia

6th Annual Forensic Psychiatry Conference: Mental Health And The Justice System Across The Lifespan

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Huntsville Hospital Rheumatology Conference

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Sydney Australia

2nd Joint Meeting Of The International Bone & Mineral Society And The Australian & New Zealand Bone And Mineral Society

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Jun 10-13

Copenhagen Denmark

European League Against Rheumatism - Annual 2009 Congress

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Clinical Anesthesia: Perioperative Care

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

Information and Registration www. bcmhas.ca/Education/RVHConferences.htm

Just For Canadian Doctors

January/February 2009

t he wealth y d oc tor m an fred pu r tz ki, c .a .

Be systemic Disciplined investing = winning results

albar, Inc., a Boston-based financial research firm, recently concluded a 20-year study that produced some surprising results. Having examined real investor returns for equity, fixed income, and asset allocation funds for the 20-year period ended December 31, 2007, they concluded that investors themselves are to blame for the disappointing performance of their mutual funds. In other words, if your mutual fund company advertised an annual investment return of 10%, and you are making less than 5%, don’t point your finger at the mutual fund company and accuse them of false advertising. According to Dalbar’s study, you, the investor, is the one who is to blame as, apparently, the investment return is far more dependent on investor behaviour than fund performance.

NW AS

Examining actual investor behaviour over the span of the study showed that the average equity fund investor earned only 4.5% annually, or an inflation-adjusted return of a mere 1.5%. Fixed-income investors did even worse, losing 1.5% per year, factoring in inflation. The company now set out to find out why the investor returns were so low compared to what the mutual fund companies advertised? They identified these two major reasons: 1 Unsuccessful timing of investing and redeeming. When the tech sector blossomed in the 1990s, investors got caught up in the hype and moved away from the protection of a diversified mutual fund and invested directly in “dot-coms.” 2 Investor holding periods, on average,

are shorter than the periods measured by mutual fund companies. Equity investors typically sell their holdings in less than four years, regardless of their ultimate investment objective of long-term growth. Obviously, investors do not have the discipline and patience to weather stock market dips. The company also compared the investment returns of an average investor to those of a systematic investor, who typically uses investment strategies such as the dollar cost averaging method. Let’s examine the following scenario. Twenty years ago, an average and a systematic investor each invested $10,000. Dr. Average earned $14,011 as of December 31, 2007, while during the same period Dr. Systematic earned $21,036 or 50% more than his average investor counterpart. >>

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t he w e a lt hy do ctor co nti nued >> The difference becomes more drastic with fixed income investments. $10,000 invested in 1988 for 20 years generated income of only $3,600 for the average fixed income fund investor, while the systematic fixed income investor earned $10,654, an increase of 196%. As you can see, systematic investing reaps great rewards, and if you are not already doing so, I recommend that you consider strategies such as dollar cost averaging. By using this technique, you will purchase an investment with a specific amount of money at specific intervals. It doesnâ&#x20AC;&#x2122;t matter whether the market is up or down, you invest the same amount of money. When the prices are down under the dollar cost averaging method, you buy more shares than when prices are high. Especially when the market is as volatile as it is now, the dollar cost averaging can provide great benefits, as the chart (right) illustrates. So, as you can see, if you invest $1,000 each month for six months into a stock which increases gradually (no volatility) from $10 â&#x20AC;&#x201C; $15, your stock value is $7,335 after six months. If the stock price fluctuates, then

No Volatility

Volatility

Month

Invested

Share Price

Shares Purchased

Share Price

Shares Purchased

$1,000

$10

100

$10

100

$1,000

$11

125

$1,000

$12

200

$1,000

$13

143

$1,000

$14

$12

$1,000

$15

Total

$6,000

Total value at month 6 you boost your stock value to $10,770. The reason for this is that you purchased more shares when the price was low. Of course, you would have made the most money had you purchased the share when it was $5. The fly in this particular ointment is that nobody has managed yet to predict the bottom of the market. I urge you to consider the dollar cost averaging method, especially when you are at least five years away from retirement and

489

718

$7,335

$10,770

your need to reduce your investment risks dramatically increases. It will not guarantee success, as you still need to find the right investment vehicle to provide you with long-term growth, but it will decrease your emotional and knee-jerk reactions to market declines, and assist you on your path to becoming a disciplined investor. Manfred Purtzki is the principal of Purtzki & Associates Chartered Accountants. You can reach him at manfred@purtzki.com.

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INTERNAL MEDICINE PEDIATRICS FAMILY PHYSICIANS Our recruitment specialist would be pleased to provide further information on any of our physician opportunities as well as incentive packages available. Maureen Webster Coordinator, Physician Recruitment Pictou County Health Authority 835 East River Road New Glasgow, NS B2H 3S6 Phone: 902 752 7600 x3490 Mobile: 902 921 0657 Fax: 902 752 6231 Email: maureen.webster@pcha.nshealth.ca

The Pictou County Health Authority offers a wide range of specialist and family practice opportunities. Located in northeastern Nova Scotia, Pictou County offers excellent professional opportunities in small town and rural settings.The Pictou County Health Authority is responsible for delivering health care services to the 48,000 residents as well as regional programs to the greater population of northeastern Nova Scotia. The Aberdeen Hospital in New Glasgow and Sutherland Harris Memorial Hospital in Pictou are just 90 minutes from Halifax and the Robert Stanfield International Airport. Moncton and Charlottetown are not much further and weâ&#x20AC;&#x2122;re minutes away from the warmest waters north of the Carolinas and some of the most beautiful beaches in Nova Scotia. The Aberdeen Hospital is a 112-bed regional facility providing a broad range of primary and secondary services through inpatient, outpatient and community-based services. Services provided include: anesthesia, cardiology, diagnostic imaging, emergency, general surgery, internal medicine, obstetrics and gynecology, ophthalmology, orthopedics, pathology, pediatrics, psychiatry and urology. Sutherland Harris Memorial Hospital plays an important role in the lives and communities it serves. It has a 12-bed restorative care unit, a 20-bed veterans unit and various outpatient and community programs and services.

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RICHMOND, BC – Efficient & well managed busy, modern Group Family Practice/Walk-In with EMR in busy shopping Plaza within a middle class area with tremendous population growth. Congenial Male/ Female Doctors looking for another Family Doctor to pick up some shifts. 70% Split. Monday-Friday 9am5pm. Shared Saturday single coverage of 10am- 4pm. Email tomedicalclinic@shaw.ca.

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VANCOUVER, BC – Busy walk-in clinic shifts available in Yaletown and the heart of Kitsilano at Khatsahlano Medical Clinic. “Best Independent Medical Clinic in Vancouver” - Georgia Straight Reader’s Poll. Contact: Dr. Chris Watt at watt1@telus.net.

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VICTORIA, BC – Walk-in clinic shifts available in the heart of lovely Cook St. Village in Victoria. Steps from the ocean, Beacon Hill Park, and Starbucks. For more informationcontact Dr. Chris Watt at watt1@telus.net. BURNABY, BC – Lougheed Medical Clinic is a wellestablished, family oriented clinic, conveniently located at the lougheedTown Centre with sky train access. We are seeking P/T or F/T physicians and specialists for full service or walk in. Our warm, spacious clinic has experiencedandfriendlystaff toassist you.Split is65/35. For further information please e-mail jenniferkube@ gmail.comor telephone Jackie 604-421-2555. GREATER TORONTO AREA, ON – My congenial family practice of 1700 rostered patients is looking for a new familydoctor as I amreadytoretire.This practiceis ideal for amedical coupleor doctor withayoungfamilyasthe office is right in your own home. Northwest of Toronto. Hospital workavailableif desired. Part of afamilyhealth team. $10K incentive. Contact me at barbara.watts@ ontariomd.ca

MISSISSAUGA, ON– Associate needed for a busy family

solution from page 37

4 7 5 2 1 8 6 9 3

building with PT, lab, x-ray, and pharmacy. 75:25 split. Email pmak@maknet.com for detailed information or telephone Patricia at 416-569-9733. RICHMONDHILL, ON– Richmond Hill After-Hours Clinic require physicians for daytime shifts 9 a.m. to5 p.m., as well as evenings and weekends. Guaranteed minimum. 70:30 split. Contact Dr. Ian Zatzman at (905) 884-7711. Fax (905) 553-5360. Email: medz@rogers.com.

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vacation properties Greece – Two houses to rent on the same property in a quiet inland village on the Greek island of Corfu. Available April-October. Details at www.kapoutsi.com or contact anaismith@shaw.ca

The Surrey Chapter of the Medical Office Assistants’ Association of BCis hosting the annual conference for MOAs in April 2009. For more info or to purchase raffle tickets for a chance to win a cruise for two, email the ConferenceCoordinator at claudiajamieson@telus.net. Reach 32,000+ Canadian physicians Complimentary classified ads to practising physicians in these categories: positions available, locums wanted, practice/ equipment for sale/rent and office space. All other classifieds:

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PARKSVILLE, BC: Golf and ski the same day on Vancouver Island! New, luxurious 2 bedroom, 2 bath SURREY, BC – Locum or associate wanted, Busy and condo at Rathtrevor Beach. Walk to the world famous well established family practice in the best location Grotto Spa. Granite kitchen with stainless appliances, of fastest growing city Surrey, Greater Vancouver, BC. flat screen TV’s. Contact Diana at 250-727-7895 or Negotiable split guaranteed minimum income. Full or galbraithd@shaw.ca. part time, locumor associate. Ideally Chinese speaking. Purchasing available. Start on any date. Contact: zhuandyu@hotmail.com. moa conference

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winner of last issue’s sudoku contest: Dr. David Buckley of St. John’s, NL

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________________________________________________________________________ E-mail: ________________________________________________________________ Tel: ______________________________ Fax: _________________________________ Sudoku Puzzle Contest Rules: 1. Entry form must be accompanied with solved puzzle. Only correctly solved puzzles will be entered into random draw. 2. Send puzzle & entry form to Just For Canadian Doctors, 710 – 938 Howe Street, Vancouver, BC, V6Z 1N9 or by fax to 604-6810456. Entries must be received by February 18, 2009. 3. Prize: Tilley Endurables High-Tech Winter Hat & Travel Accessory gift pack. Odds of winning dependent upon number of entries. Winner will be contacted by telephone and announced in the March/April 2009 issue. 4. Contest can be changed and/or cancelled without prior notice. 5. All entries become property of In Print Publications. Employees of In Print Publications and its affiliates are not eligible to participate. January/February 2009 Just For Canadian Doctors

Dr. Michael Roberts travels near and far, from the western edge of Canada to the Far East and Burma. Along his travels he’s accumulated plenty of Birkenstocks, great stories, and an appreciation for meditation and his children’s awe in seeing the world. And more inspiration comes from sources like physician-cum-author William Carlos Williams and activist and Nobel Peace Prize winner Aung San Suu Kyi of Burma (Myanmar). My name: Michael Roberts I live and practise in: Toronto My training: HBSc. BEd. MD CCFP FCFP Why I was drawn to medicine: Understanding my motivation has changed throughout my career. My last trip: Camping at Pacific Rim Park , Tofino, BC The most exotic place I’ve travelled: Pagan, Burma The best souvenir I’ve brought back from a trip: My children’s sense of awe from travel A favourite place that I keep returning to: South East Asia My ultimate dream vacation: Visiting venerated Buddhist temples, then relaxing on a beach by the Andaman Sea If I could travel to any time, I’d go to: The future, to see how my children’s lives have unfolded My favourite book: The Doctor Stories by William Carlos Williams My favourite movie: Waterwalker My must-see TV show: None, I don’t have a TV! My favourite music: Anything by Van Morrison My first job: Grade 2 teacher on a remote Indian Reserve in Northern Ontario The gadget or gear I could not do without: My meditation bench My favourite room at home: Front porch

Dr. Michael Roberts with his family in S.E. Asia; His favourite book, The Doctor Stories, is a collection of short stories by William Carlos Williams, who, as a practising physician throughout his literary career reflected a deep regard for patients’ lives and helped develop the short story form in 20thcentury American literature; Dr. Roberts’ family at another exotic destination; Cycling with his daughter in Vietnam. clockwise from top left

Just For Canadian Doctors

January/February 2009

My last purchase: Penny, our Cockapoo puppy My last splurge: Renting a cottage for a week on Hornby Island, BC Most-frequented store: Bookcity

My closet has too many: Pairs of old Birkenstocks My fridge is always stocked with: Papayas and mangoes My medicine cabinet is always stocked with: Naprosyn My guilty pleasure is: Reading travel books when I should be doing something else My favourite exercise/activity: Bicycling, canoeing, crosscountry skiing My favourite sport to watch: Tour de France I’d want this item with me if stranded on a desert island: A poetry book by Mary Oliver My secret to relaxing and relieving tension: Meditation and riding my bike to and from work A talent I wish I had: More patience My scariest moment: Being robbed while travelling in Costa Rica My fondest memory: Getting married in a rainforest in New Zealand

A big challenge I’ve faced: Neck injury 16 years ago One thing I’d change about myself: To be able to laugh more The word that best describes me: Passionate I’m inspired by: Aung San Suu Kyi My biggest ego boost: Travel articles published My biggest ego blow: Not being listened to I’m happiest when: I’m travelling with my family My greatest fear is: That I am too busy to listen to my wife and children A cause that’s close to my heart: Prevention of chronic diseases through lifestyle choices My motto is: Sit, Wait and Listen A cause close to my heart: Social Justice at home and abroad Something I haven’t done yet that’s on my must-do list: Travel to Turkey If I wasn’t a doctor I’d be: A poet

courtesy Dr. michael roberts

s m a l l ta l k

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Accreditation: Continuing Education, Inc. Is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. Designation: Continuing Education, Inc. designates these educational activities for a maximum of 14–21 AMA PRA Category 1 credits™. Physicians should only claim credit commensurate with the extent of their participation in the activity. Nursing Contact Hours: Continuing Education, Inc. is an approved provider of continuing nursing education by the Georgia Nurses Association, an accredited approver by the American Nurses Credentialing Center's Commission on Accreditation. Florida Seller of Travel Reg. #14337

Featured Exotic Destinations

April 10, 2009 Family Medicine: Focus on Dermatology 14 Category 1 CME Credits 10-Night Canary Islands Cruise Conference Royal Caribbean's Brilliance of the Seas November 9, 2009 Neurology and Pain Management Up to 21 Category 1 CME Credits 12-Day Southeast Asia Explorer Holland America's ms Volendam June 22, 2009 Neurology

14 Category 1 CME Credits 10-Night Gems of the Baltic from Copenhagen Holland America's ms Eurodam

July 2, 2009 Orthopaedics and Sports Medicine for Primary Care: Hands on examination techniques 14 Category 1 CME Credits 10-Night Baltic Sea and London Holland America's ms Eurodam

September 28, 2009 Women's Health

14 Category 1 CME Credits 10-Night Black Sea and Holy Lands Cruise Royal Caribbean's Vision of the Seas

October 17, 2009 Women's Health

14 Category 1 CME Credits 14-Night Cradle of Civilization from Athens, Greece to Rome Italy Holland America's ms Rotterdam

January 20, 2010 Dermatology for the Primary Practitioner 14 Category 1 CME Credits 14-Night New Zealand/Australia Cruise from Auckland Holland America’s ms Volendam

We can plan or joint sponsor / accredit your next meeting Call 800-422-0711 or visit www.ContinuingEducation.net Did you know our in-house travel division can handle your personal travel needs? Course Fees for all 14 hour courses MD/DO/PhD—US$695 RN/NP/PA—US$450 20 -21 hour courses are US$895