WINTER 2012 by Just For Canadian Doctors

winter 2012

DOCTORS life + leisure

win a dinner in

vancouver or calgary see inside!

hot kauai cool quĂŠbec + gift ideas + take it to

telluride + better manage glucose health + taste the wonder of WHISKY Publications Mail Agreement #41073506

inside: Continuing medical Education Calendar where will you meet?

denver

/ i n s ta n b u l / g e n e va / p e r t h /

lake louise

J u stfor C

DOCTORS life + leisure

contents

winter 2012

winter 2012 Editor and Art Director Barb Sligl Editorial Assistant Adam Flint Contributors Dr. Dara Behroozi Dr. Holly Fong Janet Gyenes Tim Johnson Dr. Chris Pengilly Dr. Neil Pollock Manfred Purtzki Dr. Kelly Silverthorn Corey Van’t Haaff Cover photo B. Sligl Senior Account Executive Monique Mori

Account Executive Lily Yu

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Just For Canadian Doctors is published 4 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.

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FEATURES

15 hot in Hawaii 30 Québec cool

In Poipu on the south shores of Kauai Cold comfort in Canada’s oldest city

COLUMNS

DEPARTMENTS

10 motoring

5 winter mix

Investing in historic cars

21 CME calendar

12 doctor on a soapbox Who decides on assisted suicide?

36 classifieds

13 techworks Monitoring glucose health

37 sudoku

20 the wealthy doctor

27 employment opportunities

38 small talk

The Disability Tax Credit

with Dr. Garry Henderson

34 the thirsty doctor

Whisky wonder

www.justforcanadiandoctors.com

35 the hungry doctor

Printed in Canada.

miss an issue? check out our website!

Festive flavour in lamb chops

cover photo: Jump in to all that the Garden Isle of Kauai has to offer from the southern base of Poipu. Story on page 15.

Sales by disclosure statement only. E&OE. Delta Realty Services Ltd. 604-678-9239. Now selling from $1.3 m. A Georgia Properties Partnership project. The Private Residences at Hotel Georgia is not owned, developed or sold by Rosewood Hotels & Resorts or any of its affiliates. Neither Rosewood Hotels & Resorts nor any of its affiliates assume any responsibility or liability in connection with the project. Georgia Properties Partnership uses Rosewood Hotels & Resorts’ marks pursuant to a license agreement with Rosewood Hotels & Resorts, L.L.C. This is not an offer to sell, nor a solicitation of an offer to buy, to residents of any state or province in which restrictions and other legal requirements have not been fulfilled.

winter 2012 Just For Canadian Doctors

from the editor

what/when/where > winter

mix

clockwise from top

Scenes from Québec City: Old-school-meets-luxury décor at the Hôtel-Musée Premières Nations in Wendake, just 15 minutes from downtown; savoury First Nations’ inspired stew; and souvenir kitsch that tells it all.

Fairmont Le Château Montebello Montebello

anywhere else. Bundle up for un bon fête! Another destination that delivers in the winter—or anytime of year—is Telluride, Colorado (page 5). With wild west roots and a farm-to-fork, oxygen-swilling foodie resurgence, this ski haven mixes artsy with adrenaline. Or, still stateside, discover Colorado’s capital, Denver, from microbrews to museums (page 21). And, before escaping completely, check out some goodies to gift or perhaps take with you on that next adventure… Congratulations to the big winner of our Cayman Islands contest, Dr. Susan Beairsto from Calgary, AB. Enjoy! Next up for grabs is a gourmet dinner in Vancouver or Calgary. Go to page 37 for contest details and to enter. Good luck!

b. Sligl

t’s beginning to look a lot like winter… with the white stuff and festive flavour and a desire to get away from it all! Where better to escape from the hoopla and the cold than Hawaii. Make that Kauai. And, actually, make it the peaceful playground of Poipu on the Garden Isle’s southern shores (page 15). Here you’ll find plenty of aloha spirit and adventure—from snorkelling with monk seals in the Pacific to channelling Johnny Depp (à la Pirates of the Caribbean) and swinging into a lush freshwater lagoon. If kicking back in Kauai is too hot for you, the place to embrace winter on Canadian turf is Québec City (page 30). Here it’s all about revelling in the chill—and its beauty. Snow-crusted branches and icicle-laced old-world architecture is unlike

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getaway Telluride Tourism Board/Brett Schreckengost

get fresh

mountain high

o hell you ride!” was the ominous send-off given to prospectors who dared to adventure into the San Juan Mountains surrounding Telluride in search of gold and silver. And that legend is just one compelling explanation for how the village tucked into the southwest corner of Colorado got its name in its boom days, when the Tomboy, Smuggler-Union and Sheridan mines yielded

From rowdy mining town to festival central and year-round adventure playground precious metals and ores, and such wealth tempted rapscallions like Butch Cassidy, who pulled off his first bank heist here in 1889, making off with $24,580. You also might expect to hear that familiar farewell today, when getting ready to ski down The Plunge, a black diamond run that descends a staggering 3,140 vertical feet down from Mountain Village into Telluride. The two towns, located at

elevations of 9,500 feet and 8,750 feet above sea level, respectively, are connected by North America’s only free gondola that serves as public transport, whisking people (and pooches) on a 12-minute ride between the European-style alpine village and the National Historic Landmark District, where Victorian buildings and clapboard houses give Telluride an aura of Dickens meets L’Amour. >>

winter 2012 Just For Canadian Doctors

mix

winter getaway

Colorado bound

mountain high

FOR THE GOURMET Good things can come in small—and sustainable—packages, such as Northern Divine’s Ocean Wise white sturgeon caviar, raised on a land-based farm on B.C.’s Sunshine Coast. Savour these salty black pearls with a shot of ice-cold vodka (neat, please) or a flute of brut bubbles. From $99/30-g tin; Northern Divine

>> When a trio of enterprising men harnessed the power of Bridal Veil Falls, Telluride

became the first place in the world to have electric streetlights, earning the village a new nickname—City of Lights—long before Paris purloined the romantic epithet. But if you thumb through the pages of the Telluride Daily Planet today, it quickly becomes obvious why this famed ski resort has also made its mark as Festival Capital of the Southwest. There are more than 30 year-round events celebrating everything from hot-air balloons and history to film, photography, and “brews and blues.”

alpine adrenaline 6

3. Adrenaline junkies can run whitewater rapids, bike alpine trails, and bomb down the new hair-raising Palmyra Peak. 4. History buffs can stroll to Telluride’s landmarks such as the San Miguel County Courthouse, Finn Town and the Butch Cassidy robbery site. 5. Farm-to-table cuisine—with a Rocky Mountain flair—rules the roost in M’s Restaurant ensconced in the elegant environs of Hotel Madeline Telluride in Mountain Village. Ingredients such as cheese from Jumpin’ Goat Dairy, and pan-fried Rocky Mountain trout (above left) are guaranteed to shift your taste buds into high gear. 6. End the eve with a nightcap of a different flavour at Bubble Lounge & O2 Bar (top right). Co-owner Greg Anderson says visitors flying in from sea-level locales combat Telluride’s high altitude by inhaling oxygen infused with aromatic oils like lemongrass and lavender. Or sip on a hoppy Colorado microbrew while listening to live acts, such as bluegrass band Turkey Creek Ramblers. —Janet Gyenes IF YOU GO For moreabout TellurideandMountainVillage: visittelluride.com. Fly intoTellurideRegional Airport, NorthAmerica’s highest commercial airport: tellurideairport.com. Or takethescenic530-kmdrive fromDenver (seepage21for moreonDenver) or 765kmfromPhoenix. Makeyour baseat theNewSheridan Hotel: newsheridan.com. Soak inyour personal hot tubat theColumbia Hotel, meresteps fromthegondola: columbiatelluride.com. Devour a Black Diamondor Bunny Hill truffleat TellurideTruffle: telluridetruffle.com. Just For Canadian Doctors winter 2012

FOR THE WANDERER Trust us: wellies can be considered regal as evidenced by the pair of Royal Warrants (a thumb’s up from the Her Majesty the Queen and His Royal Highness The Duke of Edinburgh) granted to Hunter Boot Ltd. thanks to its enduring comfort and quality. Stay dry and stylish when walking the dog, mucking about in the garden, or braving the mud at Glastonbury in these sartorial standouts: Original Gloss Tall in Cranberry. $150; hunter-boot.com

winter FOR THE DANDy Help turn a tired chore into a time-honoured ritual with a bespoke shaving set from The Copper Hat in Victoria. Wet-shaving products include items like razors and super-soft badger bristle brushes fitted with handmade wooden handles, ideal for every manabout-town. Brushes from $60, shave sets from $99; thecopperhat.ca

Countdown to the holidays + beyond

FOR THE SENSUALIST Not all gifts are meant to last, but there’s nothing fleeting about the sensuous experience of biting into a salted caramel crafted by Toronto’s SOMA Chocolatemaker. The hit of fleur de sel amplifies the richness of the dark chocolate, which yields to chewy, buttery caramel. Other confections are laced with exotic ingredients such as oil of Douglas fir, Aleppo pepper and aged balsamic vinegar. somachocolate.com

FOR THE FASHIONISTA Give a double dose of arm candy with Tiffany & Co.’s reversible leather tote, which shifts from day to evening with ease. Supersoft suede transforms to metallic leather for an armload of elegance whatever the occasion. The tote comes in delectable hues including Pesto and Light Walnut (shown) evocative of Italy where it’s made. $480-$720; Tiffany & Co.

mix

Trite but true: it’s better to give than to receive. gift So earn some goodwill with a thoughtful gift for everyone on your list—year-round. Here’s help with our fave finds from little luxuries and practical purchases to the downright decadent. — J.G.

FOR THE CONNOISSEUR Give a taste of Canada’s terroir by bestowing a bottle of North America’s first single-malt whisky, produced by Cape Breton’s Glenora Distillery. Our pick: Glen Breton Rare, a gold-medal winner (95 points) at Chicago’s 2011 International Review of Spirits. Ten years resting in American oak barrels yields a whiff of orange and spice on the nose, maple and cherry on the palate, and a long lingering finish of apple and ginger. $79.99/750 ml; glenoradistillery.com

get in the spirit

farleftandtop: JanetGyenes; bottomright: TellurideTourismBoard/BrettSchreckengost

1. Rise and shine (Telluride boasts 300 sunny days a year), waking up in a luxurious suite at the historic New Sheridan Hotel, an institution since 1895, and devouring a hearty breakfast of Belgian waffles or lobster omelette adorned with créme fraîche in the Parlor. 2. Get schooled—whatever the season. Take a one-day course in anything from cooking to ceramics at the Ah Haa School for the Arts located in the former Rio Grande Southern Railway Depot building. If wilderness survival or military training is more your speed, the San Juan Outdoor School is happy to oblige, with lessons on how to build a shelter and start fire sans matches.

gift it

FOR THE URBAN ADVENTURIST. Proffer a constant companion with Tomo (Japanese for “friend”), the new square-corned pocket knife from Victorinox Swiss Army, designed by Kazuma Yamaguchi. It sports five functions, including a blade, scissors and a nail file, and comes swaddled in a 100-per-cent-recycled pulp package. Choose from seven shades including pink, mint green and classic Victorinox red. $25; swissarmy.com Abacus winter 2012 Just For Canadian Doctors

mix

winter

wet set

the cayman islands

awesome aquatic adventures

Most Caribbean islands are able to deliver on a promise of sun and sand, and that’s definitely true in the Cayman Islands—the charms of worldfamous Seven Mile Beach are many, between the warm aquamarine waters and the line of palm trees that just seems to go on and on (and on). But very few offer visitors up close and personal encounters like those found on Grand Cayman. Take, for example, Stingray City. Reachable by catamaran, this sandbar out in the middle of Grand Cayman’s North Sound offers the opportunity to rub your elbows with the fins of dozens of South Atlantic Stingrays— the curious creatures swim right up to visitors, bumping into them in search of food, and you can even pose with one of these gray monsters by extending your arms and crouching in the water. And that’s not all. You can snorkel or dive at the USS Kittiwake, a World War II rescue ship that now forms a ghostly presence at the of the sea just get- bottom offshore, or you can away SCUBA at one of the 175 dive sites that have made Grand Cayman a renowned destination amongst divers around the world. Or, if you prefer to be on the water rather than in it, charter a deep-sea fishing boat and skim along the wall that separates the North Sound’s 60-foot waters from the 2,000-foot deeps beyond, a favourite feeding ground for barracudas (and bigger). —Tim Johnson caymanislands.ky

feast fest

caribbean

winter break – a cookout in the

requently referred to as the “Culinary Capital of the Caribbean,” the Cayman Islands offer exceptional variety and unsurpassed ambiance with more than 150 restaurants to choose from to please even the most discriminating gourmand. But what really gets foodies fired up is its annual culinary event, Cayman Cookout, hosted by acclaimed Chef Eric Ripert (above), creator of the award winning Le Bernardin in NYC. This weekend of fine wine and food, now in its fourth year, is a welcome getaway for those eager to escape the cold Canadian winter and get a taste of the good life. Set on the sugar-white sand beaches of the luxurious Ritz-Carlton, Grand Cayman, the event welcomes the world’s finest chefs and savviest sommeliers, giving attendees the rare chance to rub shoulders with their culinary heroes. Last year, Ripert hosted Toronto superstar-chef Susur Lee to his hotly anticipated four-day epicurean fest. This

Just For Canadian Doctors winter 2012

year, the venerable chef went west—inviting Paul Rogalski of Calgary’s celebrated restaurant, Rouge, named one of the “World’s Top 100 Restaurants for 2010” by the prestigious S. Pellegrino awards. A strong proponent of sustainable food practices and the state of the oceans, Rogalski will cook alongside culinary all stars like José Andrés, April Bloomfield, François Payard, Laurent Gras, Richard Blais and others. The eternally witty Anthony Bourdain is also set to appear again, a big draw for fans of his popular show, No Reservations. Sommeliers Andrea Robinson, Aldo Sohm and Ray Isle and Food & Wine’s Dana Cowin are also part of the talented line-up. A peek at the schedule reveals a wide range of tastings, demonstrations and excursions, including a tell-all session of “kitchen secrets” with Ripert and Bourdain, a behind-the-scenes luncheon at Ripert’s AAA Five Diamond award-winning Blue restaurant at the Ritz-Carlton, a Barefoot

BBQ with José Andrés and others on the grill, a grandfinale Gala Dinner prepared by all of the participating chefs and much more. Rogalski, who once lived in Grand Cayman, is participating in a black box event and promising to bring his signature Canadian flavours to Cookout. Cayman Cookout kicks off Cayman Culinary Month, during which the destination’s cuisine is recognized and celebrated. Taking place between midJanuary to mid-February, visitors participate in special food and wine events around Grand Cayman. Caviar tastings, a private yacht cruise, slow food Cayman-style and the popular lionfish hunt—an event designed to remove the invasive creature from Cayman waters while also giving foodies a chance to experience this tasty fish—are just a sample of what’s on offer. The 4th Annual Cayman Cookout takes place January 12 – 15, 2012. Visit caymanislands.ky/cayman_ cookout for more information.

univadis.ca Over 24,000 Canadian physicians already registered! Access the most advanced 3D anatomy, get up-to-date medical news, view the electronic version of the CPS, online medical textbooks… and much more. All with no subscription fee. What are you waiting for? Go to www.univadis.ca

univadis® is a registered trademark of Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc. Used under license. CDN-UNV-5005608-JA

motoring

D r . k e l ly s i l v e r t h o r n Dr. Kelly Silverthorn is a radiologist and Just For Canadian Doctors’ automotive writer.

better than gold Investing in historic cars instead of the usual precious metals, stocks, art and wine…

n my early days of Class of ’83, one of our age 50-something clinicians and I discovered we were co-sufferers of tifosi (Ferrari fever). Yes, misery loves company. Yet, I couldn’t understand his then-recent purchase of a 1960 Ferrari 250 California Spyder SWB. After all, I mused, that same $60K would buy a new then-top-of-theline Ferrari 512BB. It is only some 30 years later that I understand why his choice turned out so much financially better than would have mine. You see, that 1960 V-12 Ferrari is worth $7 million today, and the 1980 V-12 Ferrari is worth just $150K. Why the 250 California outpaced virtually every other possible investment, while the 512BB fell behind even inflation is explained in Dietrich Hatlapa’s 340 page book published mid-2011 entitled Better than Gold—Investing in Historic Cars. Hatlapa’s empirical research and conclusions are particularly compelling. I couldn’t put the book down. Collector cars are compared and contrasted to gold (and stocks, classic art and wine of pedigree) as competing investment classes. For example, the mined gold supply increases daily, while collector cars of provenance are a known and finite supply. Gold’s primary price-driver is fear. Collector cars prices are driven by passion and greed. Being an investment banker by profession, Hatlapa would happily trade some of this passion within the collector car “marketplace” for more order and transparency. This trade-off may never be fully realized, but Hatlapa’s insights provide the reader with invaluable information to negotiate the more arcane nuances of collector car investing. Foremost, Hatlapa argues that the best strategy to invest in collector cars is to stay with pristine examples of “investment grade” models. All series-produced new cars depreciate. A select few models eventually find a floor to their depreciation and then gleefully appreciate to many multiples of their original cost. Common threads to those models that emerge as investment grade are limited production (certainly < 1000 units, and usually far less, see table) and relevance to racing success of international importance in-

period. Other frequent contributors include: technical innovations, aesthetics, charisma, character, build quality or materials and brand pedigree. The author’s team, the Historic Auto Group International (HAGI), identified the 100 Investment Grade models with the largest market capitalization when all surviving examples are combined. These 100 models currently trade individually between $150,000 and $7,500,000 for expertly restored examples. Worldwide this represents ~47,000 surviving cars, with a market capitalization potential of ~$20 billion. Roughly 10% of these cars change ownership annually among ~10,000 market players (mostly wealthy individuals). The HAGI Top Monthly Index is a carefully selected subgroup of 100 models backtested to 1980 to validate its representative price tracking of the entire basket. At present the HAGI team also publishes monthly price subindices of collectable Ferrari (HAGI F), Porsche (HAGI P), and non Ferrari- nor Porsche (HAGI ex F & P). So how has capital appreciation of investment grade collector cars (HAGI Top) at 12.6% average annually fared against other investment classes? In the 30 years between 1980 and end of 2009 gold was actually a weak sister at just 2.2% annualized returns. Cars also beat stocks, the S&P 500 returning 11.3%. Cars beat classic art, bonds and real estate, but lagged behind collectable wine. Among the HAGI subindices “Rocking the Casbah” was Ferrari at 15.0% annualized, while Porsche lagged at 10.4%. (My moresenior colleague’s 1960 Ferrari California Spyder pulled 16.2%). Of course, we all know the mantra that historical returns do not necessarily predict future performance of that asset. Nevertheless, Hatlapa’s contention is that the outlook for investment grade collector cars looks sound when evaluating the fundamentals. Oh, to have the brain of an investment banker… Since the various market meltdowns of 2008 – 09 and 2011 investors are understandably drawn to tangible assets they can touch, feel, and lock away. Such “global” assets are immune to individual currency

Just For Canadian Doctors winter 2012

fluctuations, and are not correlated with the stock market. Collector cars tick all of these boxes, plus importantly, the investment grade supply is finite. Collector car growth as an asset class has formed a virtuous feedback growth loop with collector car events. The Federation Internationale Vehicules Anciens (FIVA) estimate 265,000 collector-car events occur each year. The best known events—Goodwood, Monterey and Philip Island—grow from strength to strength. You can race, tour or show virtually non-stop. With enough wealth you can “live the lifestyle,” as they say. Global wealth is well correlated with the various investment markets in collectables. As millionaires have become too numerous to count, the demographers and investment bankers now track billionaires as a surrogate measure for global wealth. In 1980 there were only 11 billionaires (and oh-so-lonely at the top.) By 2009, this count had steadily shot upwards, billionaires increasing more than a hundred-fold to number >1200 and counting. The world’s individuals are getting wealthier (and less lonely!). I’ll climb out on a limb to speculate that none of the JFCD readers are billionaires. But many will be actual or aspiring multimillionaires. Does Better than Gold harbour any epiphanies for such individuals? Yes! For example, I have dozens of investments in stocks, bonds, and the like. I rarely know what precisely I hold or why I have it. Owning these investments does not instill one scintilla of passion within me. In contrast, the cars on the HAGI Top Index are wired to my very soul. Each intertwines art, desire, pleasure and passion. Better than Gold argues convincingly that I can diversify my investments, protect myself from currency fluctuations, increase my returns, and enhance my lifestyle by owning well-chosen collector cars. With collectable investments I must confess to my Classmates of ’83 that I have been both a slow learner and a late adapter. As penance, I now need to be that 50-something mentor to the Class of ’13 atoning for the errors of my previous ways. Who knew owning an achingly beautiful classic Ferrari could be so rational and altruistic?

“

techworks C o r e y V a n ’ t H a a f f

d o c t o r o n a s o a p b o x D r . c h r i s p e n g i l ly Dr. Chris Pengilly is Just For Canadian Doctors’ current affairs columnist. Please send your comments to him via his website at drpeng.ca.

Corey Van’t Haaff owns Cohiba Communications. She is Just for Canadian Doctors’ technology columnist.

who makes our laws?

less pain more gain

Assisted suicide is far too important an issue to be decided by the Courts

MyGlucoHealth: A new glucose meter on the market

am writing from the other side (for most readers) of the Rocky Mountains where again the issue of assisted suicide is surfacing, and is being dealt with by the Courts while it is being shunned by our elected politicians. This is not new. I have just finished reading Agatha Christie’s Sad Cypress which was written in 1940. The main character was an older woman who had had a stroke and was begging her physician to assist her to die. He, of course, had to explain that he could not. It is now 71 years further on and nothing has changed. In the 1970s medical advances began to make significant impacts on the length of life, but not always on the quality of life, in the face of chronic illness. It was a series of Court challenges, rather than an act of Parliament, which eventually entrenched the right of a patient to refuse treatment. This has become so ‘mainstream’ that it is hard to believe

that it was ever needing to be challenged. In 1968 Parliament did pass The Criminal Law Amendment Act which decriminalized abortion while putting so many restrictions in the way that abortions were often unobtainable. This untidy and unsatisfactory statute remained on the books until in 1988 when the Supreme Court of Canada ruled that the existing law was unconstitutional and struck it down, opening the door to abortion on demand. In the early 1990s the issue of assisted suicide was raised by Sue Rodriguez, of Victoria, BC, who was suffering from ALS. She challenged the Criminal Code of Canada in the Supreme Court of Canada. In 1993 the Court decided by a slim majority of 5 to 4 to uphold the Criminal Code leaving assisted suicide a criminal offense punishable by up to 14 years incarceration. The next year she did end her intolerable life with the help of an

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Just For Canadian Doctors winter 2012

unidentified local physician. It was a following year when one of my patients, a retired physician with widespread prostate cancer, planned his own death. He held a family party and then went to bed where he took a lethal overdose of medications. I was aware of his plans, which I condoned but did not assist. I did, however, spend a couple of very uncomfortable hours being interrogated in a police interview room, but that is as far as it went. It was an unpleasant and harrowing experience. The issue has now raised its head again in BC. The Farewell Foundation recently lost a challenge of this section of the criminal code in the BC Supreme Court. This was on a technical rather than a moral ground. The BC Civil Liberties Association is launching a similar, but more legally sophisticated, challenge in November of this year. Whether you are in favour or against the issue, it is far too important to be decided by the Courts. These decisions should be made by democratically elected politicians. Wars have been fought to protect our democratic way of life. These politicians can be lobbied, persuaded and reasoned with to enact laws which reflect the moral realities. The courts interpret to the letter rather than the spirit of the law. The legal system is immune to the will of the people which, in the case of assisted suicide, is 70% in favour of legalization. If the elected officials do not listen and behave reasonably they can be voted out of office. I suggest that the magnificent but expensive Parliament Building in Ottawa could be mothballed rather than the proposed expensive renovations undertaken, and the business be transferred along Wellington Street to the Supreme Court Building. OK—a hyperbolic suggestion but Parliament should be more effective. I would like to see physicians across Canada take a leading role in this issue; if a poll conducted by the Canadian Medical Association indicates that a reasonable majority of physicians are in favour of assisted suicide, it is our duty to go to our elected parliamentary members urging them to wrest this vital issue from the Courts, and to pass enabling legislation such as exists in Oregon, Switzerland, Belgium and the Netherlands. PS—at the time of this essay going to press the Supreme Court has frustrated the PM’s attempt to close Vancouver’s safe injection site. Right decision but wrong authority.

or diabetics, monitoring blood glucose is a pain. First, it can hurt. Second, there’s a lot of work involved in notating glucose levels and communicating them to the physician or family members, as the case may be. Enter Entra Health Systems and the MyGlucoHealth meter, which had one simple aim: to produce the best glucose meter on the market, and then add wireless. “We refer to MyGlucoHealth as a system as it has the meter, the strips and also a mobile application and the online portals,” says Richard Strobridge, CEO. Typically, a diabetic would test their blood glucose before or after a meal and at bedtime. After getting a reading and deciding, like Goldilocks, if it’s too low, too high or just right, the patient jots down the numbers on a paper log and takes three months of data to the physician for him or her to make sense of what happened. “There was a lack of communication and feedback to the patients,” says Strobridge. He figured if he improved the process and added communication capabilities; it could make life easier for both the doctor and the patient. “It can mean readings are automatically sent to electronic health records, and a text or email alert could go out to the patient or their care team,” he says. “The alert would go out if a test was too high or low or too much time had passed between tests.” Here’s the thing—if you have a diabetic child at school, or an elderly parent who might be forgetful, you can get scheduled reports without having to phone and ask. “It’s not obtrusive,” he says. Strobridge’s own sister-in-law lost her sight as a complication of diabetes and now his wife gets regular messages when her sister’s readings are uploaded. “She’s in Alberta, we’re in San Diego; the communication capabilities make it easier for everyone to keep track.” More than just the communications superiority, Strobridge wanted to build a

better mousetrap. He thought a meter that used a smaller blood sample (0.3 microlitres) combined with a faster three-second test time would do the trick. “Patients don’t have to poke their fingers as deeply. They’re more likely to do it if there’s less pain…and it’s acceptable to test on an alternate site like the forearm or hand.” “Other meters, very good meters, may do some of these things, but none have all these features,” says Strobridge. The company’s three founders came from healthcare backgrounds. Strobridge’s expertise was in surgical telecom at a time when laparoscopic surgery was gaining momentum. “This company wanted to be more patient-facing; our last company, the patients were all asleep,” he says. “We were

Cell phones will be the healthcare delivery device of the future and physicians will still be the deliverer looking for the next big thing. Chronic disease—as we learned more, we thought there’s got to be a better way to keep people engaged in their care and to communicate with their caregivers.” After trying to build a cell phone that could double as a meter and finding cell phone technology was advancing at too rapid a pace to keep up with, they decided to add a Bluetooth chip to a separate blood glucose meter that would transmit information to cell phones then directly onto the Web. “Patients have the MyGlucoHealth application on their phones. They press a button on the meter and phone and all the data is transmitted to our database.” The patients themselves decide, in conjunction with their care team, what readings, either high or low, should cause alerts, and then decide themselves who gets those alerts and when. “Patients can also log in securely and see charting in a variety of ways. They can email those charts to anyone and can sort by date

range,” says Strobridge. “We’re also the only meter system that can keep track of how many test strips are used and can alert the patient when they are low.” Physicians benefit. If the patient is engaged and likes the system, they’ll use it. Data Doctors can make the office visit more efficient by going online and downloading the data in advance of the visit. Because data is transmitted in real time, physicians (or other care team members) can respond to a patient when intervention is required. The system can even help in geographically remote locations where it is impractical to see the patient personally. MyGlucoHealth is a high-level mobile health platform that provides biometric telemetry via a cell phone. Strobridge is a big believer in cell technology for the delivery of healthcare. “Everyone carries the telemedicine device of the future. Cell phones will be the healthcare delivery device of the future and physicians,” he says, “will still be the deliverer.”

winter 2012 Just For Canadian Doctors

Poipu

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to Water Valley, where long-time ranchers mix with transplanted city folk who prefer the lifestyle in the foothills of the Rockies. Here you might have to wait for a cowherd to pass through town at the four-way stop. And at the long-running Water Valley Saloon, you can see one of the original Calgary Stampede signs alongside local ranchers’ brands burned into the wood-panelled walls. Don’t order Alberta’s own brew Big Rock on draft, “Only city people drink that!” says the bartender; locals prefer Bud or Bud Light. Everyone, however, likes the bison burger. And sated, post burger and beer (I went with the Big Rock Grasshopper; the city won that draw), we stock up on some high-quality, old-school leather goods (from gorgeous dry-milled leather and solid-brass If you prefer your travel bags to iPad sleeves; see page x)snowboarding at Derry & Wallis andTrading Company. Owner Jodi Wallis is one ofskiing those to Calgary transplants be at your who loves living amongst people who’ve same own had pace,the with no address lift their entire lives. She’s also, of all things, a yoga teacherand here, lines, no crowds and says that downward dog jives with cowboy great snow culture all day, just withfine. guides “Cowboys are moreMountain connected to theprofessional earth.” Powder Heliskiing andof Catskiing whose prime we objective And to feel more that connection ourselves finally is Whistler, BC your backcountry safety head to Cowboy College at Rafter 6 Ranch near Canmore, west 1-877-PWDR-FIX while making surecowboy you www.pmheli.com of Highway 22. This place has been run by an authentic have the best day ever, clan, the Cowley family since xxxx. Stan Cowley was a bareback Powder Mountain Heliskiing and Catskiing is your horse-riding champion in in Whistler. the Stampede his daughter has powder destination Fromand snowcats, you’ll have reigned as Stampede an amazing day of Princess. 6-12 runs in alpine bowls and fantastic The Cowleys sponsor you’ll their crew rodeos, likemiles Rob of glades. From still helicopters, have in 1,000 square Johnson, one Range of the head who’s also on the proascircuit the Coast filled wranglers with unbelievable powder runs far andas a member of the Horse Association. Tough guy. the eye can see, Wild waiting for Racing you, your friends and family. He shows us how to throw a lasso (it’s all in the flick of the wrist), and we just about wrangle ourselves a little wooden dummy calf…does that count?

travel the world

The Napali Coast on the uninhabited west side of Kauai is only accessible by foot or boat. Here, it’s seen from aboard a catamaran tour with Holo Holo Charters.

Destination Hotspots ad x1 The Westin Grand, Vancouver, offers allsuite luxury in boutique style. Our prime location at the crossroads of trendy 433 Robson St., Vancouver, BC V6B 6L9 Yaletown and Robson streets 1-800-937-8461 puts you close to the city’s www.westingrandvancouver.com best dining, shopping, and entertainment. Rejuvenate with a few laps in the outdoor heated lap pool or a workout in the WestinWORKOUT® Gym with dazzling city views. Floor-to-ceiling windows in our suites offer wonderful views of the city and our signature Heavenly Bed® and deep soaker tubs encourage complete relaxation. Enjoy a meal at Hidden Tasting Bar & Social Lounge serving tapas style dishes and creative libations.

There’s a spiritual resonance on Kauai…and the search to tap into it starts on the southern shores of Poipu, the perfect base from which to discover the many wonders of this Garden Isle >> story + photography by Barb Sligl winter 2012 Just For Canadian Doctors

travel the world

travel the world The hot-pink lehua blossom.

veryone in Kauai thinks they live near a vortex. A spiritual vortex, or passage, to some mystical core. One local says it’s in Waimea, another in Kalahoa. But, really, they concede, it can be anywhere, here on Kauai, wherever you happen to be. I’m in Poipu. And it feels like it might just be here. Poipu is on the sheltered, sunny southern shores of Kauai, a laid-back community with an ancient rhythm (locals and native Hawaiians like Auntie Stella and Ron Ilda keep it alive) that underlies the swish resorts and cliffside golf courses (it’s become one of the most developed parts of the island). This may be a resort community, but it still has small-town aloha. You can catch a surf lesson with local kahunas who radiate that aloha spirit or strike up a conversation with Ron Ilda, the caretaker of a lovely little park, featuring the centuries-old ruins of a long-gone native settlement. The Royal Order of Kaumualii park is sacred, the site of lava tubes used for burials and an altar (people

On Shipwreck Beach—and the Grand Hyatt’s backyard— another local, Mana, fishes in the traditional way, flinging a hand-knotted net into the waves. He’s catching fish for his auntie’s funeral. And he’s happy to demonstrate his skill for curious tourists. Ha, or soul, and hookipa, the spirit of welcome, are part of the Hawaiian culture and manifest in the ubiquitous lei given to visitors. And locals share this ha everyday. What Poipu really has is plenty of pilialoha, friendship and togetherness. And a connection to the great outdoors, whether through the stories of Auntie Stella or by direct immersion—in the beaches, the waters, the jungle, the canyon—through sport (take your pick: see sidebar on page 32) and the vivid flora of the Garden Isle. You feel closer to mother nature here—vortex or not—an outdoor connection that’s tangible on this island. At the Grand Hyatt in Poipu, you can star gaze (with a local guru of sorts who’s a beloved chef and amateur astrologer). Seeing Saturn through a high-powered telescope under Poipu’s pristine sky is surreal—it’s almost cartoon-like with its perfect little globe and telltale ring. It looks fake. But in Poipu the otherworldly The view from a Parrish seems within reach. Collection beachside Also out-of-this-world is Allerton bungalow on Poipu’s Gardens, an 80-acre property with southern shores. 200-foot-high Moreton Bay fig trees (their giant roots are seen as the playground of raptors in Jurrassic Park). Robert Allerton brought the seedlings from Australia in beer cans to become part of his diverse plant collection from just about every corner of the world. His goal when he bought this garden (he called it Lawa`i Kai; kai means “near the sea”) in 1938 was to create a tropical garden of Eden, showcasing (and saving) the biodiversity of the planet. He called it his “living painting,” and its flamboyance has been a Hollywood backdrop (Gilligan’s Island was filmed here on the bay, as well as Tattoo yelling “the plane, the plane” for Fantasy Island) and a sanctuary (Jackie Kennedy escaped here for a month after JFK died). Alongside the thousands of plant species (and 120 varieties of breadfruit alone) that thrive in these gardens in still leave offerings of shells) and old village. Just down the road the cushy climate around Poipu, is, again, that ha. Because, here, you’ll hear a formidable grrrrr, hissss. The growly hiss is the relentless it’s the spirit that really flourishes. That could be with a lomi lomi Pacific beating against the lava rock of the island, finding its way massage in an open-air, thatched-roof hale (mini bungalow) at through another lava tube. the Grand Hyatt’s Anara Spa. Think traditional Hawaiian healing or Auntie Stella tells the story of these bursts. They’re the tears of lokahi—unity, harmony, balance. a legendary half man, half moo or lizard, who swam from Niihau, an It’s a counterbalance for a morning of surfing (your masseuse island 75 miles farther west, and came onto land here on the south is likely a hardcore surfer and will happily share the best breaks) shores of Kauai. Now he’s stuck in the rock trying to push himself and sets you up for the languid pace of beach sitting and wave out, gushing salty sprays of tears called Spouting Horn. watching or star gazing and plumeria-scent inhaling. It’s all part of Places and stories like this (and multiple variations) are found Poipu’s south-shore experience. Just go with the flow. throughout the Koloa Heritage Trail that runs along the edges of When I’m trying to decide what to do with my last day on the resorts. They’re glimmers of a place that’s in touch with its spirits, island, I ask a local in Poipu what she recommends. Her advice? Just past and present. get in the car and see where it takes you…because, really, in any Full moon over Knidos direction you’ll find beauty and hookipa.

Just For Canadian Doctors winter 2012

Kauai’s signature red dirt en route to Waimea Canyon.

Local and native Hawaiian, Auntie Stella, tells tales along the Koloa Heritage Trail. above Walking through vine-choked jungle inland en route to a zip line. left A towering stand of golden bamboo at Allerton Gardens.

winter 2012 Just For Canadian Doctors

travel the world

Local fisherman using traditional techniques on Shipwreck Beach.

WHAT TO PACK IN FROM POIPU SWING like Jack Sparrow and Indy on a rope swing. Paddle into and then hike through lush jungle in Kauai’s interior. You’ll see (and test out!) the swings from the first Indiana Jones movie and the latest Pirates of Caribbean (um, Johnny Depp swung into that pool!). You can also see the broadleaf plant, the hau bush, that natives used to make rope (the same plant Tom Hanks used in Castaway). Outfitters Kauai; outfitterskauai.com PADDLE What’s SUP? You, on a paddleboard, that is. The sport of stand-up paddleboarding is, as local guide, Mitch, says, “super easy” to learn. You’ll languidly paddle up Hulaeia River by Alekoko fish pond, an ancient example of aquaculture (the first form of fish farming, dating back to 800 AD) developed by the Hawaiians, where little fish swam through a small opening with high tide but then big fish couldn’t swim back out of. Outfitters Kauai; outfitterskauai.com

SAIL Take to the sea to glimpse Niihau, or the Forbidden Island, as it’s also called. Here a community of native Hawaiians lives in isolation, only speaking in native tongue. Protected from outside influence, this is as close as you’ll get to the island, sailing past on a 65-foot power catamaran with Holo Holo Charters, the only tour operator with Niihau on its itinerary. Holo Holo Charters; holoholokauaiboattours.com

Giant Moreton Bay fig trees in Allerton Gardens.

Aboard the Holo Holo Charters catamaran. right Local woman making leis—the Hawaiian symbol of welcome or aloha—at a Poipu market. Each lei is made of more than 65 hand-strung orchid or plumeria (frangipani) blossoms.

if you go

SNORKEL Make like a monk seal in the balmy waters around Poipu. You may even come face to face with one of these huge whiskered creatures, found only here on the Hawaiian islands. If you take the tour with Holo Holo Charters (above), you’ll get to snorkel in open waters alongside an uninhabited island off the Napali Coast. Holo Holo Charters; holoholokauaiboattours.com

where to stay > GrandHyatt Kauai Resort & Spa Spa, dine, swimandsit back—all part of the GrandHyatt experience. Set on ruggedShipwreck Beach, where you’ll also findthe start of the stunningcliffside Mahaulepu Heritage Trail between the churningPacificandthe resort’s serene golf course. kauai.hyatt.com > KoaKeaHotel One of the original low-key hotels in Poipu, this buildingwas completely revampedafter Hurricane Aniki. Now, the boutique hotel has a modern, fresh vibe, andsome fervent regulars, includinga Vancouver cardiologist whocomes every winter for a month todecompress. koakea.com > The ParrishCollection Kauai Make like a local andstay in a condoor beachside bungalow—fromcomfy toserious swank (Harrison Ford cozieduptoCalista Flockhart at one of the collection’s beachside properties). parrishkauai.com

Just For Canadian Doctors winter 2012

SURF Of course, when in Hawaii, you must hop on a surfboard. And in Poipu, Kauai Surf School will teach you how. Poipu has sheltered, sandy beaches and easy breaks, perfect for beginners. Kauai Surf School; kauaisurfschool.com and Nukumoi Surf Co.; nukumoi.com HIKE into the Waimea Canyon, Kauai’s version of the Grand Canyon. Or tramp along Kauai’s signature red-dirt trails through jungle past the ohaia’ia or mountain apple tree, java plums and “doorbell” vines (if you pull on one, the branch it’s connected to will fall and you’ll hear bells all day), the “shy” hila hila plant (it shrinks away from touch) and Africa tulip trees (their fallen big orange blossoms decorate the gooey mud path, along with crushed kuikui nuts). Outfitters Kauai; outfitterskauai.com

ZIP Traipse through the tangle of lush jungle inland to a lagoon that boasts a mini zip line into the cooling waters. Yeehaw! On the way you might glimpse a shot of hot pink in the lehua blossom (from the ohaia’ia tree); pick it and legend says it’ll stop the rain. Outfitters Kauai; outfitterskauai.com

Waimea Canyon.

t he w e a lt hy doctor manf r ed pu r tz ki, c .a.

denver / istanbul / geneva / perth / lake louise … | c a l e n d a r

Manfred Purtzki is the principal of Purtzki & Associates Chartered Accountants. You can reach him at manfred@purtzki.com.

winte r 2012 + beyond

There’s a way to lessen the tax burden for families with disabled children

Just For Canadian Doctors winter 2012

The Frederic C. Hamilton Building at Denver Art Museum emulates the peaks of the nearby Rocky Mountains.

The Denver State Capitol marks the city’s “Mile High” nickname. right Duffy’s Cherry Cricket in Cherry Creek North has been honoured with Denver’s “Top of the Town” award 19 times!

is ordinarily only available to children under the age of 16 at the beginning of the year is extended to children under the age of 18. Additionally, instead of receiving a tax credit of $500 per child, the annual ceiling is raised

Many parents are not aware that their children may qualify for the Disability Tax Credit to $1,000 provided that a minimum of $100 is paid on registration or membership fees. The Children’s Arts Tax Credit is available in 2011. This tax credit will be for programs that promote artistic, cultural, recreational or developmental activities. Similar to the children’s fitness tax credit a child under 18 years that is eligible for the disability tax credit will receive a tax credit based on the $1,000 of eligible expenses. The Registered Disability Savings Plan (RDSP). Basically this plan allows parents to make the non-deductible contributions to the RDSP during the infirm child’s lifetime until the child attains the age of 59. There are no annual contribution limits but the overall lifetime contribution limit is $200,000. The government will match the parents’ contribution to the plan with a Canada disability savings grant based upon the parents’ income and other limits up to a maximum of $70,000 for the child’s lifetime. Regardless of the parents’ contribution but dependent upon the income of the disabled, the government will pay a Canada disability savings bond into the plan of up to $1,000 per year up to a maximum of $20,000. When the funds are withdrawn, there is no tax on the contributions made by the parent however the grant, bond and the investment income earned in the plan will be taxable to the child. If you think that your child may be eligible for the many tax benefits, I recommend you review the eligibility criteria and complete the application form T2201.

Handmade leather Liberty Boots are a splurge-worthy item from Cry Baby Ranch.

Custom “kitchen” cocktails are a specialty at Green Russell.

Its wild west ways may have been tamed, but Denver’s golden legacies live on (CME events in Denver are highlighted in blue.)

B Clockwise from top left: Steve Crecelius; janet gyenes (4)

BC. These tax credits can be transferred to the parent. In addition to the disability tax credit, there also is the Disability Support Deduction, which is available in respect of services or products provided to children going to school. Eligible expenses include tutoring services that are supplemental to the primary education of a child with a learning disability or impairment of mental functions. A medical practitioner must certify that these services are necessary. If the child has a severe learning disability, the cost of the device or software designed to enable reading print, or similar costs for note takers, reading services, and voice recognition software. The Disability Support Deduction can be claimed only against the income earned by the child in the year; it is not a tax credit which can be transferred to the supporting parent. Where the child care deduction is available, you can deduct up to maximum of $10,000 in child care expenses for a disabled child, whereas the ordinary deduction for non-disabled children is $7,000 for children up to the age of 6 and $7,000 from the ages 7 to 16. The medical expenses of all children under 18 can be claimed on the parents’ tax return as a medical expense tax credit. Parents may claim expenses for children over the age of 18 subject to a dependent income calculation that sets a ceiling of $10,000 of the child’s expenses. This $10,000 limit has been eliminated starting in 2012. There are many expenses which can only be claimed by disabled individuals, for instance the costs incurred to adapt a vehicle. The incremental costs incurred of buying a home that is more suitable to a disabled person can also be claimed as a medical expense. The Family Caregiver Tax Credit is proposed in the 2011 budget. Beginning in 2012, a $2,000 tax credit will be available to be claimed by parents of dependents with a mental or physical infirmity. The Children’s Fitness amount. If the child has a disability, then this tax credit that

denver

A n in ter n ation a l guide to con tinuing Medica l Education

tax benefits any parents are not aware that their children may qualify for the Disability Tax Credit (DTC). To qualify for the DTC, the child’s ability to perform the basic activity of daily living must be markedly restricted. While one limiting disability may not cause a marked restriction by itself, the cumulative effect of multiple impairments can cause a marked restriction of one’s basic activity of daily living. Basic activity of daily living means mental functions for everyday life, including memory, problem-solving, goal setting and judgment, speaking so as to be understood in a quiet setting, etc. The total tax credit available for the child under the age of 18 is $11,623 in 2011, which translates to about $2,300 in cash savings in

cme

roncos, Nuggets, and Rockies? Sports have put Denver—Colorado’s capital city—on the map for many, and there’s an impressive number of pro teams to cheer on (Denver Broncos have sold out every game for more than 20 years). But these names don’t just christen sports teams, they hint at the 1859 boom when miners and cowboys, like William F. “Buffalo Bill” Cody, came to stake their claims in the mountains surrounding Denver during the Pikes Peak Gold Rush. The rush of wealth steadily turned this boomtown located on the high rolling plains into a cosmopolitan city, where stately mansions and theatres held court alongside gambling halls and saloons. Today, saddling up means taking advantage of the city’s new B-Cycle bike-sharing program to explore Denver’s colourful collection of neighbourhoods. Like LoDo (Lower Downtown), where the spirit of the Wild West holds strong, its Victorian buildings now occupied by establishments like Denver’s first brewpub, Wynkoop Brewing Company, famed for the small batches

of suds brewed here (try Patty’s Chile Beer, spiced with Anaheim and ancho peppers). Eighty different beers are brewed daily in Denver, helping earn the Mile High City a new nickname: The Napa Valley of Beer. Nearby Larimer Square is a nighttime hotspot and historic hub where speakeasies operated during Prohibition. Duck into the Kettle Arcade—look for the painted ceiling depicting old west icons like Annie Oakley—and if the lantern is on, head down the stairs, through the pie shop and into Green Russell, a modern speakeasy. Ask the barkeep to concoct a custom cocktail with locally distilled Leopold’s Gin, or Absinthe Verte. Denver’s many legacies extend to the the snap-front Western shirt, pioneered at Rockmount Ranch Wear by proprietor “Papa” Jack Weil, who lived until the cowboyproud age of 107. The distinctive shirts with the signature sawtooth pocket designs have been worn by legions of celebs and have appeared in Hollywood blockbusters like Brokeback Mountain. Architectural icons and edifices figure prominently too. Like I.M. Pei, who designed

downtown Denver’s backbone, the mile-long 16th Street pedestrian mall, where vibrantly painted pianos invite passersby to stop and bang out a tune before strolling to the State Capitol. Stand on the 13th step of the stairs leading up to the granite edifice, and you’ll be 5,280 feet—one mile—above sea level, and closer to its glittering dome, plated in (what else?) 24-karat gold. New legacies are being formed in the Golden Triangle Museum District. The brand-new Clyfford Still Museum exhibits 2,400 works by the late artist, which have been sealed off from the public since his death in 1980. Denver Art Museum will host Yves Saint Laurent: The Retrospective in 2012, a stunning showcase of the fashion icon’s career. And the new History Colorado Center will open its doors in 2012 to reveal an experiential tour of the state’s splendour, from the first ski-jump at Steamboat Springs to Silverton’s hard-rock mines. —Janet Gyenes For more information on Denver, call 800-2-DENVER or visit Denver’s official Web site at VISITDENVER.com.

winter 2012 Just For Canadian Doctors

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Jan 26-29

Paris France

International Master Course On Aging Skin (IMCAS) Annual Meeting 2012

IMCAS

011-33-1-40738282

Jan 28-29

Vancouver British Columbia

Introductory Course To Botox And Cosmetic Fillers

The Physician Skincare and Training Centre

Feb 25

Vancouver British Columbia

Advanced Techniques In Botox and Cosmetic Fillers

May 03-06

Chicago Illinois

Feb 18

calendar

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where

topic

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website

imcas.com

Jan 12-14

Singapore Singapore

Asia PCR Singapore Live 2012

Europa Organisation

011-33-5-34452645

singlivecourse. com

877-754-6782 See Ad Page 25

ptcenter.org

Aug 10-22

Russian Waterways Cruise

Current Concepts In Medicine Cardiology, Rheumatology, Oncology, Dermatology

Sea Courses Cruises

888-647-7327 See Ad Page 24

seacourses. com

The Physician Skincare and Training Centre

877-754-6782 See Ad Page 25

ptcenter.org

Head & Heart Conference

CBT Canada and University of Ottawa

877-466-8228

cbt.ca

2012 Mohs College Annual Meeting

American College of Mohs Surgery

800-500-7224

mohscollege. org

Tampa Florida

Integrative Medicine Patient Conference

Moffitt Cancer Center

813-745-4988

moffitt.org

Mar 12-14

Baltimore Maryland

2012 Symposium On Human Factors And Ergonomics In Health Care

Human Factors and Ergonomics Society

310-394-1811

hfes.org

Mar 14-18

Antalya Turkey

9th Mediterranean Meeting On Hypertension And Atherosclerosis

SLS Tourism Congress Organization Services

011-90-212347-6500

medhyp.org

May 03-06

Toronto Ontario

Contemporary Acupuncture Integration In Today’s Health Care

McMaster University

silla@mcmaster. ca

university-cme. ca

Sep 12-15

Sedona Arizona

13th Annual Conference On Integrative Medicine In Women’s Health

Symposia Medicus

800-327-3161

symposiamedicus.org

Jan 23-27

Maui Hawaii

2012 CSA Winter Hawaiian Seminar

California Society of Anesthesiologists

800-345-3691

csahq.org

Feb 23-26

Whistler British Columbia

Whistler Anesthesiology Summit

Department of Anesthesiology, University of BC

604-875-5987

Apr 13-15

Kansas City Missouri

62nd Annual Postgraduate Symposium On Anesthesiology

KU Medical Center

913-588-4487

continuinged. ku.edu

Apr 20-22

Las Vegas Nevada

Difficult Airway Course: Anesthesia

The Difficult Airway Course

866-924-7929

wam-airway. treefrog.ephibian.net

Jun 16-22

Chicago Illinois

Anesthesiology Review Course 2012 – Chicago

Dannemiller

800-328-2308

dannemiller.com

Jan 17-22

Keystone Colorado

Chromatin Dynamics

Keystone Symposia

800-253-0685

keystonesymposia.org

Mar 18-23

Vancouver British Columbia

NF-kappaB Signaling And Biology: From Bench To Bedside

Keystone Symposia

800-253-0685

keystonesymposia.org

May 17

London England

Biomarker Discovery: Driving Technologies

Euroscicon

enquiries@ euroscicon.com

regonline.co.uk

Jun 05-10

Rhodes Greece

2nd International Conference On Molecular Recognition

Aegean Conferences

610-527-7630

aegeanconferences.org

Vacation CME CANADA supratentorial medicine

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Aug 13-24

Eastern Mediterranean Cruise

Oct 03-06

Big Island Hawaii

Primary Care Cardiology

UC Davis Health System

916-734-5390 See Ad Page 26

ucdavis.edu

May 08-12 2013

Denver Colorado

Heart Rhythm 2013 34th Annual Scientific Sessions

Heart Rhythm Society

202-464-3400

hrsonline.org

Jan 06-07

Edinburgh Scotland

International Conference On Drug Therapy In TB Infection

Africa Health Research Organization

011-44-793984-8586

eventsbot.com

Mar 02-03

Saskatoon Saskatchewan

9th Annual Peter & Anna Zbeetnoff Memorial Drug Therapy Decision Making Conference

University of Saskatchewan

306-966-7795

university-cme. ca

May 16-20

St. Petersburg Florida

17th Annual International “Stress & Behavior” Neuroscience & Biopsychiatry Conference

International Stress and Behavior Society

240-899-7571

stressandbehavior.com

Sep 02-04

Taipei Taiwan

ISPOR 5th Asia-Pacific Conference (International Society For Pharmacoeconomics & Outcomes Research)

ISPOR

609-219-0773

ispor.org

Jan 17-21

San Juan Puerto Rico

11th Annual Caribbean Dermatology Symposium

Caribbean Dermatology Symposium

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w i n t e r

w o n d e r land

La belle vacance: The snowy season brings forth Québec City’s many charms story

jewel of culture and refinement set amidst a wild wonderland of natural attractions, Québec City brings together the best of both worlds. Any time is a good

Tim Johnson photography Barb Sligl

opposite page, from left Hearty comfort food at La Traite restaurant in Wendake. > Snowshoes, integral to Québec culture, are even found inside NotreDame-de-Lorette. > The exterior of the lovely little 1730 church, Notre-Dame-de-Lorette, blends into the winterscape of Wendake. this page, from top left Ice-cold cocktails at the Hôtel de Glace. > Souvenir hoodie in Vieux-Québec or Old Québec. > Inside the Hôtel de Glace. > Décor at the Hôtel-Musée Premières Nations. > The Hôtel de Glace. > Ice-clad branches in Vieux-Québec. > Home-smoked fish sampler at La Traite restaurant in Hôtel-Musée Premières Nations in Wendake. > A room at the Hôtel-Musée Premières Nations, complete with a local beaver-fur pillow, handmade by members of the Huron-Wendat Nation. page 32 The Hôtel de Glace. page 33, clockwise from top left The iconic Le Château Frontenac dominates Québec City’s skyline. > On Rue Sous-le-Fort in the Quartier du Petit Champlain in Basse-Ville or Lower Town of VieuxQuébec. > Classic tourtière meat pie. > The bar at the Hôtel de Glace.

time to visit North America’s oldest walled city, but when winter arrives—its gently falling snow cloaking Upper and Lower Town’s trees and rooftops and cobblestone lanes in a fresh layer of shimmering white, with lovely little fires crackling in cafés and restaurants all over the city—there’s little doubt that Québec is the most beautiful place in the whole of La Belle Province. So pack your warm jacket and woolies and head to French Canada for a winter vacation you won’t soon forget.

Just For Canadian Doctors winter 2012

Hôtel de Glace For a truly authentic experience, spend some time at the only hotel in North America made almost entirely of ice and snow. Constructed each December and destroyed in the spring, this hotel’s 36 rooms and suites are as ephemeral as they are dramatic. Visitors can spend time in the bar and sip their beverages out of unique glass tumblers, or simply take a stroll about the ice sculptures that rise out of the snowy floors and walls. At night, LEDs embedded

in the ice bathe the place in vivid colours, and the brave can opt to stay over, sleeping on beds of ice which are covered in animal fur and professionalgrade, subzero sleeping bags. As the interior of the hotel maintains a steady temperature of five below, guests are given strict instructions on how to properly prepare for bed: no cotton is allowed (as that fabric holds humidity), and a precise step-by-step process must be followed in order to sleep comfortably (and avoid

winter 2012 Just For Canadian Doctors

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best washed down with a pint of Kwe, Wendake’s own cornbased beer (which is itself based on the traditional “three sisters” of indigenous Canada—corn, beans and squash).

A day at the museum

stepping on the snowy floor in bare feet). But it’s not all hardcore—after an evening in the bar, most guests head to the hotel’s hot tubs before hitting the hay (or ice, as it were).

Wendake Just outside of Québec City, the Huron community of Wendake offers a number of authentic First Nations experiences. Many activities operate out of the Hôtel-Musée Premières Nations, where guestrooms combine design elements from

if you go For information on Québec City go to quebecregion.com. For Wendake and the Hôtel-Musée Premières Nations visit tourismewendake.com and hotelpremieresnations.ca. The Hôtel de Glace is open January 6 to March 25 in 2012: hoteldeglacecanada.com. And the Carnaval de Québec takes place January 27 to February 12, 2012: carnaval.qc.ca

traditional Huron culture with modern conveniences (picture a room with both beaver furs and a flat-screen television), and an impressive, attached museum presents the history and background of the Wendat people as well as contemporary artwork from within the community and beyond. In the winter, the Hôtel-Musée offers guided snowshoe trips along the Akiawenrahk River, with commentary on time-honoured methods of hunting and gathering food during the cold months. After an invigorating walk in the woods and perhaps a visit to the picturesque Notre-Dame-de-Lorette Church (a national architectural and historic site that dates all the way back to 1730), settle in for a hardy meal at La Traite Restaurant. Here, Chef Martin Gagné integrates elements of the Wendake hunting, gathering and fishing into his gourmet menu, which includes things like dried deer with Chicou tai blackberry liqueur, a dish that’s

Just For Canadian Doctors winter 2012

While many of Québec’s winter pleasures are found outside, the city is also home to many fine museums which are, of course, open year round. There’s Musée du Fort, a tiny little place just across from the Château Frontenac that presents Québec’s history—from its founding to its capture by General Wolfe and the British on the Plains of Abraham during the Seven Years War—in quirky fashion, with miniatures and models and flashing lights and simulated smoke. For something a little bit more highbrow, check out the city’s excellent Musée National des BeauxArts, which houses more than 35,000 works dating back to the 17th century, and includes the world’s largest collection of Québec art. The building is, in itself, worth a visit, integrating a number of structures, including the former Québec City prison, where a few of the cells have been preserved to show visitors what prison life was like more than 100 years ago. And in Lower Town, the Musée de la Civilisation is an ultra-modern museum, placing an emphasis on hands-on and multimedia experiences in both their temporary and permanent exhibits. The latter focuses on Québeckers’ relationship with the land (Territoires), various perspectives on Québec’s history (Le Temps des Québécois) and the history and culture of the province’s native peoples (Nous Les Premieres Nations).

More than poutine Although it’s perhaps true that Québec’s most famous

culinary export features a delicious (and heart-stopping) mixture of cheese curds, gravy and French fries, Québec City is definitely one of Canada’s greatest destinations for foodies. Fine dining can be found at places like Laurie Raphael and L’Astral (which sits atop the Loews Le Concorde Hotel and provides perhaps the best view anywhere in town), while those seeking the kind of meal a loving Québecois Maman might make, head to the Buffet de L’Antiquaire, which is not in fact a buffet but rather an authentic diner, right down to the mismatched vinyl stools. And Québec is one of the few places in Canada where you can experience the cheesy, mouthwatering wonders of raclette, which can be found at La Petite Coin, a cozy spot on a quiet side street that feels a bit like a Parisian brasserie. And if you’ve just gotta have that poutine, there’s no shortage of places to get it in Québec. Chez Ashton is a good choice: despite its complete lack of ambience and fast-food feel, the gravy here is hot, the fries are hand-cut, and the curds squeak, the three essential elements in Canada’s most lethal and—beloved— dish.

Come for Carnival Québec City showcases the very best of winter during the famous, annual Carnaval de Québec, one of the world’s largest festivals of its kind. The much-loved Bonhomme de Neige makes appearances all over town, parts of the city are transformed into galleries of ice sculptures and playgrounds for zip-lining and shooting down hills in inner-tubes and rafts, and the people of the city—along with visitors from around the world—knock back some Caribou (a mixture of red wine, some whisky and maple syrup) and party from morning ‘til night.

the thirsty doctor dr. Dara behroozi

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

Dr. Dara Behroozi writes humour. In this issue he muses on whisky. After hours, he imbibes single-malt and plays soccer (although not at the same time).

Dr. Holly Fong is a practising speech-language pathologist with three young children who is always trying, adapting and creating dishes.

jewelled dish

the water of life

Why whisky—single malt, that is—evokes poetic musings and passion

Add some pomegranate polish to your plate

would have to come elsewhere. Eventually children came and domestic duties intervened and our Cardhu drinking days ended. Then Cardhu got so popular that the owners started to blend it to keep up with demand and I fell out of love. Only recently did I try it again, and thankfully the purity of the single malt has been restored and we’ve reconciled. Then there are the peaty single malts such as Talisker, Lagavulin and Laphroag. What is peat? It’s the anaerobic, acidic decaying of vegetation that forms in the wet windy highlands of Scotland. It’s on the way to becoming a fossil fuel, coal. I did my GP attachment in the Shetland Isles, which is one huge island of peat. Windswept and barren, with dark-brown peaty lakes where the water indeed tastes acidic and a bit like chewing on a cigarette. Does that sound appetizing? I didn’t think so; I stayed clear of the peaty malts until I sat down one evening with an old Scottish doctor 35 years my senior and we sipped the three I mentioned. It was a revelation. What was unpleasant in the water added complexity and a subtle burnt taste to the whisky. I had found new friends. Single malt, of course, brings out the philosopher in us all. In fact I would be very surprised if you didn’t sit down with some good friends (they don’t have to start out being that good) and a few single malts later, you’ll be discussing the deeper meaning of life, not in a strident manner, but in more of a whimsical and fatalistic way. So it was that I asked my Scottish colleague, after a bottle had been consumed, what advice he could give me based on his many years of life experience. He thought about it for a while and said, “Drink your best whisky at the beginning of the night, when you can still taste it.” Only

Just For Canadian Doctors winter 2012

later did it strike me how deep his statement was. Yes indeed. Imbibe while you still can. Do not keep the best for later, enjoy it now. But if just thinking “peaty” makes you regurg and think of taking a PPI, then may I suggest you start with a Dalmore, Balvenie or Dalwhinnie. They are all light to medium with no hint of peat. Then try a Bowmore, which will move you gradually towards the more pungent malts. And attend a whisky tasting event. My next group of friends came from Ireland. Oddly enough it was a South African who introduced me. He had had an Irish girlfriend who only drank Irish single malts, a challenge to find in most Canadian bars and pubs a decade ago, but a lot easier now. She moved on in time, but left him with a deep appreciation of the genre. He in turn brought them to my attention: Bushmills, a very fine 16-year-old triple cask, Tullamore, smooth like Cardhu and even a peaty one, Coonemare. And as I recall all these fine friends, I’m reminded of my late father-in-law, a single-malt aficionado, who would call his host, ahead of dinner, and tell them which single malts he drank. If they didn’t have them, he would gladly bring over a bottle. Once, someone tried to fool him by pouring him a blended whisky—he took one sip and poured it into the nearest plant saying that was all it was fit for. He was given a beautiful boxed Macallan, aged 25 years in sherry casks, which had been bottled in 1958 (and at its steep price, it could be exchanged for many dozens of bottles of lesser brews). I had seen the bottle many times, and we discussed what it would taste like, but somehow we never got round to drinking it. It was always being kept for that very special occasion. Of course many special occasions came and went and the bottle sat there un-opened. When he passed away and the whole family was at the wake I decided to pull out the bottle and open it. We toasted him with what he had denied himself all those years, and yes it was very fine. Drink your best whisky first.

right-red pomegranate seeds are not only good for you (full of antioxidants and vitamins) but the jewel-like seeds add a festive touch to meals. The crunchy, juicy seeds have a sweet and slightly citrusy flavour which can be used in savoury or dessert dishes. To extract the seeds, slice the fruit into quarters and bend the rind backwards to let the seeds tumble out. Avoid retaining any white membranes as these are rather tannic. The seeds can be eaten raw or you can extract juice from the seeds but why bother when it is readily available. The dark juice can make a tasty glaze for spicerubbed lamb chops. Add some crispy potato cakes and a stir fry of asparagus with peas to make a delicious holiday supper. To enhance the spice and fruit of the glazed lamb, try the 2008 Hyland Shiraz by Penley Estates. This is a well-balanced, medium-bodied Shiraz with a rich, darkpurple colour and a bouquet of blackberry with a hint of pepper and oak. On the palate, there are ripe blackberry flavours with a smoky, chocolate undertone, soft tannins and a dry lingering finish.

Lamb chops with Pomegranate Glaze, Potato Cakes and Asparagus Stir fry (serves 4) lamp chops

2 racks of lamb, 8 ribs each, cut into 8 double chops 1 tbsp ground black pepper 1 tbsp ground allspice ¼ tsp ground cinnamon 1 ½ tbsp kosher salt 1 tbsp plus 1 tsp olive oil 1/2 cup red wine 1 clove of garlic, smashed 3 cups pomegranate juice ¼ cup sugar pomegranate seeds for garnish

dr. holly fong

hisky comes from the Gaelic words for “water of life,” of course, what else could it mean? And single malts are the finest, most pure form—the thoroughbreds of the whiskys. Each one has its own character and personality, like people really, to be encountered, savoured and then liked, loved or hated, as the case may be. To be a single malt means that only malted barley has been used, which is a wonder in itself, that such a humble grain can be converted into such a complex nectar. It must be made in one distillery and aged for at least three years in oak barrels. Of course, most are aged much longer: 10 years, 16 years, even 21 years. Now I have nothing against blends, some are very good and balanced, but for the real connoisseur it would be like drinking blended supermarket coffee instead of pure Arabica from Costa Rica. There are single malts in many countries (including Canada; see page 7) and I have made merry with many of them, but I will talk only of the Scottish and the Irish. Single malts for me have been like friendships. I often remember the first taste and the story that went with it, the appreciation and the wondering why you hung out with the first one for so long to the exclusion of others, and then eventually, years later, tasting the eschewed one again and remembering what it was that you saw in them the first time. Cardhu was my first love. I was working in a large medical clinic in Campbell River, BC, and the office manager kept a secret stash of fine spirits for Friday nights when the doctors and nurses would gather to sup and sip and hear each other’s battle stories. Soon doctors from other clinics, friends and spouses would come for the weekly ritual. In amongst the bottles, I discovered Cardhu, a smooth and silky single malt and I was immediately hooked. In due course I managed to convert those who were not yet believers and by nights’ end the garbage would be full of the oddly shaped bottles. In fact, in a cost-cutting meeting of the clinic doctors, our manager brought up the hundreds of dollars a month spent on the brew and suggested we change to a cheaper blended whisky. We all shook our heads, cuts

potato cakes

1 large russet potato (12 oz), peeled and coarsely grated 2 tbsp heavy cream salt and pepper to season 1 tbsp chopped chives olive oil to coat baking sheet asparagus stir-fry

1 tbsp extra virgin olive oil 1 small shallot, coarsely diced 1 cup frozen shelled green

Preparetheglazebycombiningthe pomegranatejuiceandsugar inalarge saucepan. Cookover mediumheat until themixturehas reducedbyhalf, approximately40minutes. Remove fromheat andcool for 20minutes. Combinepepper, allspice, cinnamon, salt. Rubdrymarinademix intolambchops andset asidefor 20– 30minutes. Preheat theovento425F. Placea largebakingsheet intheoventoheat. Put gratedpotatoes inalargeteatowel

soybeans or edamame 1 lb slender asparagus, tough ends broken off and discarded ¾ tsp salt 8 oz package of sugar snap peas 1 tbsp finely chopped parsley 1 tbsp finely chopped chives Fresh ground pepper

andsqueezeout as muchwater as possible. Placepotatoes inamediumsizebowl. Addcream, salt, pepper and chives, mixingwell. Adjust seasoningto taste. Removebakingsheet fromoven andgenerouslyoil. Spoonpotatoes into 6small pancakes onthesheet. Tamp flat andbake15minutes. Reduceoven temperatureto400F. Flipandbake15 minutes longer, until cookedthrough, crisp-edged, andgolden. Keepwarmon aservingplatter. Inalargeheavyskillet, heat 1

tablespoonof oil until shimmeringover mediumhighheat. Reduceheat to medium, addshallots andstir frequently for aminutetosoften. Addsnappeas andstir fryfor about 30seconds. Add½ tspsalt andstir. Addasparagus andstir fryfor about 2minutes. Addremaining salt andthefrozensoybeans andstir for another minute. Turnoff heat, stir in herbs andpepper. Inalargeheavyskillet, heat 1 tablespoonof oliveoil until shimmering over highheat. Addthechops but do

not crowdtoallowthemeat tobrown. Frychops for 4– 5minutes per side. Removefrompantoaplate. Deglaze panwithredwine, 7tablespoons of pomegranateglazeandthesmashed garlic. Cookfor aminutetocombine flavours. Discardgarlic. Toserve, place2chops onaplate withapotatocakeandsomeof the stir-friedvegetables. Spoonsomeof thesauceover thechops. Sprinklesome pomegranateseeds over themeat to garnish.

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Golf figures prominently in this transplanted Scotsman’s life (whose celebrity crush is fellow Scot Sean Connery)—if he wasn’t a doctor, he’d be a golf pro. He also knows how to relax—in the bath with the apropos single malt. And he might add another guilty pleasure, a bag of Miss Vickie’s salt and vinegar chips. A doctor with good taste! My name: Dr. Garry Henderson I live and practise in: Kitsilano Medical Clinic and Mission Memorial Emergency Room in BC My training: MB ChB DRCOG MRCGP, all UK Why I was drawn to medicine: As a young man I wanted to be a doctor to save lives and relieve suffering and I knew the money would be decent and I could play some golf

A favourite place that I keep returning to: Maui, Hawaii My dream vacation: Golf trip to Scotland and Ireland with my golf-challenged buddies If I could travel to any time, I’d go to: Next week to get the winning lottery numbers, then come back to present time and pick them!! My favourite book: Catch-22

My last trip: Princeville, Kauai

My favourite movie: The Quiet Man with John Wayne vs Trainspotting (slightly different movies)

The most exotic place I’ve travelled: The island of Capri

My must-see TV show: Top Gear

The best souvenir I’ve brought back from a trip: Limited edition coffee mug from the original Starbucks in Seattle

My favourite CD/album or song: Dark Side of the Moon (fave album) Day in the Life by The Beatles (fave song)

My first job: Gents Tailors duties involved taking insideleg measurements. Important to choose correct side!

My guilty pleasure is: Miss Vickie’s salt and vinegar chips

The gadget or gear I could not do without: My iPod

My favourite sport to watch: Golf

My favourite room at home: My bedroom

My celebrity crush: Sean Connery

My car: Honda Accord Crosstour (Aston Martin is on order pending above lottery win)

I’d want this item with me if stranded on a desert island: A helicopter My secret to relaxing and relieving tension: Warm bath and a single malt

My last splurge: Booking a helicopter trip from Nice airport to Monte Carlo!!

A talent I wish I had: Ability to fly a helicopter (see above)

My closet has too many: Trousers

My scariest moment: When I had my heart attack

A big challenge I’ve faced: Moving from Scotland to Canada

My medicine cabinet is always stocked with: ASA Crestor and Coversyl (heart attack survivor)

One thing I’d change about myself: Be less of a perfectionist!

clockwise from top left

March 17, 2012 ENT: A Comprehensive Review for Primary Care and Emergency Care Providers 7-Night Eastern Caribbean from Miami, Florida Celebrity Cruises' Eclipse

My fondest memory: Playing golf at St. Andrews

My fridge is always stocked with: Grolsch lager

Dr. Garry Henderson’s favourite book, the classic Catch-22; The doctor in Kauai at Spouting Horn; his favourite album, Pink Floyd’s The Dark Side of the Moon; and on a cruise with his wife.

March 11, 2012 Infectious Disease Review 21 AMA PRA Category 1 Credit(s)™ 21 Contact Hours , AAFP Applied for 15-Night South American from Valparaiso, Chile Celebrity Cruises' Infinity

My favourite sport as exercise: Golf

My last purchase: iPod Nano for my wife

Most-frequented store: iTunes store

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The word that best describes me: Fun I’m inspired by: My wife (she told me to say that)

May 11, 2012 Rheumatology and Orthopaedics 10-Night Western Europe from Civitavecchia (Rome), Italy Holland America's ms Eurodam

My biggest ego boost: No comment My biggest ego blow: Not ever having an ego boost

May 12, 2012 Pain Management and Neurology 9-Night British Isles from Oslo, Norway Royal Caribbean's Vision of the Seas

I’m happiest when: I’m golfing

June 14, 2012 Primary Care Update: Cardiac Health, Metabolic Syndrome, Obesity and Related Disorders 10-Night Baltic Sea from Copenhagen, Denmark Holland America's ms Eurodam

My greatest fear: Fear itself My motto: Don’t let the bastards grind you down A cause that’s close to my heart: Heart attack research Something I haven’t done yet that’s on my must-do list: Make a must-do list If I wasn’t a doctor I’d be: A golf pro

Just For Canadian Doctors

winter 2012

courtesy dr. garry henderson

s m a l l ta l k

doctors share their picks, pans, pleasures and fears

Selected Cruises Complete Program Listing at www.ContinuingEducation.NET Accreditation: Continuing Education, Inc. is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. Designation: Continuing Education, Inc. designates these live educational activities for a maximum of 14-21 AMA PRA Category 1 credits™. Physicians should only claim credit commensurate with the extent of their participation in the activity. Continuing Education, Inc. is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation.

March 13, 2012 Neurology and Pain Management 14 AMA PRA Category 1 credits™ 14 Contact Hours , AAFP Applied for 14-Night Australia and New Zealand from Sydney Holland America's ms Volendam

July 10, 2012 Emergency Medicine Review 12-Night Western & Eastern Mediterranean from Barcelona, Spain Celebrity Cruises’Solstice July 14, 2012 Dermatology for the PCP 10-Night Baltic Sea from Copenhagen Holland America's ms Eurodam July 21, 2012 Primary Care: Mental Health Issues with a Focus on Drugs and Behavior 7-Night Eastern Mediterranean from Venice, Italy Royal Caribbean's Splendour of the Seas July 23, 2012 Autism, ADHD, and other Pediatric Behavior Disorders 11-Night Eastern Mediterranean from Rome, Italy Celebrity Cruises' Equinox

Jew e A s ia C ls of September 2, 2012 Infectious Disease ruis 7-Night China, Japan and Korea from Shanghai, China e Ask about extending your cruise or visit to Asia Royal Caribbean's Voyager of the Seas

September 20, 2012 Preventive Medicine 12-Night Western & Eastern Mediterranean from Barcelona, Spain Celebrity Cruises’ Solstice

Ask about our Guest Travels Free Program We can plan or joint sponsor/accredit your next meeting Call 800-422-0711 or visit www.ContinuingEducation.NET Our in-house travel division can handle your personal travel needs? Course Fees for all 14 hour courses MD/DO/PhD/DDS/DMD—US$695 RN/NP/PA—US$450 Florida Seller of Travel Reg. #14337

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