Just For Canadian Doctors Spring 2020 by Just For Canadian Doctors

spring 2020

life + leisure

DOCTORS elephant love in kenya a new side to

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inside: Continuing medical Education Calendar where will you meet? to ro n to

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EXPOSURE TO LT-PRODUCING ENTEROTOXIGENIC E. COLI CAN HAPPEN DUKORAL® [Oral, Inactivated Cholera and ETEC Diarrhea Vaccine] is indicated for the prevention of and protection against cholera and enterotoxigenic Escherichia coli (ETEC)producing heat-labile enterotoxin (LT) (either LT alone or both LT and heat-stable enterotoxin (ST) together). Cholera: The vaccine is recommended for adults and children from 2 years of age who will be visiting areas with an ongoing or anticipated epidemic or who will be spending an extended period of time in areas in which cholera infection is a risk. ETEC-diarrhea: The vaccine is recommended for adults and children from 2 years of age who will be visiting areas posing a risk of diarrheal illness caused by LT-producing ETEC. DUKORAL® should not replace standard preventative hygiene measures. Rehydration measures must be taken in case of diarrhea. Consult the DUKORAL® Product Monograph at https://health-products.canada.ca/dpdbdpp/index-eng.jsp for contraindications, warnings, precautions, adverse reactions, interactions, dosing, and conditions of clinical use. The Product Monograph is also available through our medical information department. Call us at 1-855-356-0831.

Tell them to visit the consumer website dukoralcanada.com VALNEVA Canada Inc. 600-3535, Saint-Charles Blvd. Kirkland (Montreal), Quebec, H9H 5B9 © 2019 VALNEVA Canada Inc. All trademarks used under license.

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Just for C

DOCTORS life + leisure

contents

spring 2020

spring 2020 Publisher Linh T. Huynh

Editor Barb Sligl Art Direction BSS Creative

Contributing Editor Janet Gyenes

Editorial Assistant Adam Flint

Contributors Tim Johnson Lisa Kadane Dr. Chris Pengilly Manfred Purtzki Dr. Kellen Silverthorn Barb Sligl Roberta Staley Catherine Tse Cover photo Tallulah Photography Senior Account Executive Monique Nguyen

CE Development Adam Flint

Sales, Classifieds and Advertising In Print Circulation Office 200 – 896 Cambie Street Vancouver, BC V6B 2P6 Canada Phone: 604-681-1811 Fax: 604-681-0456 Email: info@AdvertisingInPrint.com

Just For Canadian Doctors is published four times a year by Jamieson-Quinn Holdings Ltd. dba In Print Publications and distributed to Canadian doctors. Publication of advertisements and any opinions expressed do not constitute endorsement or assumption of liability for any claims made. The contents of this magazine are protected by copyright. None of the contents of the magazine may be reproduced without the written permission of In Print Publications. In Print Publications 200 – 896 Cambie Street Vancouver, BC V6B 2P6 Canada PHOTOS: Tallulah; lisa Kadane; Tallulah

Account Executive Wing-Yee Kwong

Production Team Ninh Hoang Annie Do

15 FEATURE

15 Find big love in Kenya at an elephant sanctuary 34 (Re)discover Niagara Falls…and beyond COLUMNS

DEPARTMENTS

11 the thirsty doctor

5 spring mix 19 CME calendar 37 sudoku we’re social! 38 small talk Find + follow us on social media:

Tropical tipples

12 pay it forward Treating the disenfranchised on the city streets of Canada’s west coast History lesson

30 motoring Looking back at the automotive leaps of the past decade

www.justforcanadiandoctors.com

32 the wealthy doctor

Printed in Canada.

award winS!

Stories and photographs that appeared in this magazine and sister publication, Just For Canadian Dentists won multiple awards in the latest 2019 North American Travel Journalists Association Awards, including bronze.

Dr. Gigi Osler

26 doctor on a soapbox

facebook.com/ justforcanadiandoctors @justforcanadiandoctors #justforcanadiandoctors @JFCDoctors

Unexpected GST reassessments

cover photo The Sheldrick Wildlife Trust is a non-profit organization in Nairobi, Kenya, that rescues injured and orphaned baby elephants and rehabilitates them for return to the wild. And you can visit…see page 15.

Spring 2020 Just For Canadian doctors

from the editor

ravel can mean many things. A business trip to a far-flung destination for a CME course or medical meeting (see where to go on pages 20–24). A family visit. A spur-of-the-moment beach getaway. Or a serendipitous detour on a journey that might just be soul-stirring. Contributing writer Roberta Staley, who also shares the inspiring story of Dr. Susan Burgess (page 12), visited the Sheldrick Wildlife Trust in Kenya last year (page 15). For her, this haven for orphaned and injured elephants was a balm: “It was life changing, this overwhelming sense of love for these gorgeous, sweet creatures, who are happy to engage with humans and be petted.” Sometimes we reconnect and rediscover closer to home, where tourist

attractions like Niagara Falls (Canada’s most visited), are an opportunity for a bit of nostalgia, travelling back to a long-ago family vacation from our childhood. The falls still put on a grand show, but now there’s also fine wine and food to supplement that spray (page 34). And we love the seaside sojourn—but sometimes we want a version that’s less surfer and more swank (page 5). Think Michelin-star restaurant… Or channel your inner artiste and tour Toronto’s cultural side (page 19). If you go, be sure to snap a cool angle or selfie and share with us on Facebook (facebook.com/justfor canadiandoctors), Instagram (@justfor canadiandoctors; #justforcanadian doctors) and Twitter (@JFCDoctors).

Just For Canadian doctors Spring 2020

comments/questions: feedback@InPrintPublications.com

Tallulah

Meaningful travel

The elephants of Sheldrick Wildlife Trust (page 15)

what/when/where > spring

Dish on the multicourse tasting menu at Michelin-star restaurant Addison: caramelized cod, cruciferous, caviar and bonito butter

mix

san diego

posh on the pacific

beyond the beach taste

tour

DYLAN + JENI

If you have a penchant for the beach and luxury travel, you can experience seaside San Diego without a fish taco or surfboard in sightâ&#x20AC;Ś

Just For Canadian doctors Spring 2020

mix

spring

taste

tour

b e a c hn d o & b ey

sensory san diego

Grand Digs The tony enclave of Del Mar (30 km north of downtown) is peppered with gated communities. Here, the Fairmont Grand Del Mar (fairmont.com/san-diego) is a palatial property, accessed by a long driveway. The road winds alongside the hotel’s stunning Tom Fazio-designed 18-hole golf course before emerging to reveal the elegant Spanish Colonial, open-air courtyard and lobby. Lounge around one of the four pools, cozy up in the elegant library/games room or nosh your way through a collection of stellar cafés and restaurants. Star Ser vi ce San Diego’s very first Michelin star was awarded last year to Addison (addisondelmar.com). The food is divine, but the level of service needs equal recognition, executed by a stealthy army of elite servers who quietly glide through the room. Last June, Chef William Bradley eliminated the à la carte menu for a five- or 10-course tasting-menu-only format in the omakase tradition, where ultimate trust is given to the chef. Island Paradise Located on Mission Bay’s Vacation Island, the spa at Paradise Point (paradisepoint.com) is nestled in lush, tropical foliage that seems more South Pacific than South Cali. The services also reflect unique, island-forward options, such as a Balinese massage or treatment soak in a traditional wooden Ofuro tub. Pink Lady Located across the street from the beach (and within barking distance of the famous sea lions), La Valencia (lavalencia.com) is seaside La Jolla’s pink grand dame. This hotel might be historic, but it remains current with contemporaries like the Kardashians. Du cking Amazing Juniper and Ivy (juniperandivy.com) is a beloved farm-to-table restaurant in Little Italy. Perennial favourites include the yellowtail (on the menu since it opened) and uni (dropped off fresh daily from a local diver who harvests them at 3am), but the must-order is the whole duck—free-range, happy Pekin duck from nearby Sonoma County. You’re excused if you leave the cutlery on the table and use your fingers. Instagram can wait. A Ne w Realm In the up-and-coming neighbourhood of Convoy, Realm of 52 Remedies (52remedies.com) is an Asian-inspired speakeasy hidden behind secret doors within Common Theory Public House. Realm has quickly established itself as the place in San Diego for eclectic and beautiful cocktails that don’t shy away from unusual ingredients like dried mushrooms and salted cream cheese. And a new omakase-style cocktail tasting menu lets the bartender create bespoke cocktails based on your preferences. —Catherine Tse

San Diego’s wild side: the cliffs at Torrey Pines State Beach

Just For Canadian doctors Spring 2020

Spot prawns at Juniper & Ivy Barquette d’endive, beetroot and blackberry at Addison above right Comprador’s Fortune at Realm of 52 Remedies

if you go Dig deeper into San Diego’s high-end options: sandiego.org.

cocktail photo: ames Tran & Olivia Beall; addison photo: DYLAN + JENI

seaside sensation

Explore San Diego’s high life…from haute to high octane…

refuel x 6 bits + bites

spring

mix

snack attack

Curb pangs with powerful bites

Written + produced by Catherine Tse

1 Ready to pop A new take on an old favourite, ActivPOP is organic popcorn that’s seasoned with charcoalinfused sea salt. And not just any sea salt —this is sun-evaporated sea salt from a Molokai Island Salt Master. With the added benefits of detoxifying charcoal, the black-mottled popcorn just looks cool. And no, the charcoal doesn’t come off on your hands—no one will know you’ve been snacking. activpop.com 2 Smart cookie Sometimes, it’s just not a sugar craving that needs feeding, but a texture craving. GO Raw’s sprouted cookies are satisfyingly crispy and crunchy, tricking your brain into thinking you’re chomping down on caramelized, crystalized sugar when, in fact, you’re crunching into crisped, sprouted, healthy seeds. Sprouting encourages seed germination, which makes the seed a lot more nutritious and easier to digest. This is your new cheat, no-cheat. luckyvitamin.com

ie mm

editor's

pick

nom nom

5 Sweet tooth If you have an unhealthy relationship with sugar, you might want to adopt Smart Sweets’ motto, “Kick sugar, keep candy.” Their confectionaries look like gummies, taste like gummies, but don’t contain added anything: sugars, sugar alcohols, or artificial colours or flavours.

3 so good These granola bars have such a satisfyingly, chewy texture, you’ll be double-checking the ingredients list for mention of marshmallows or HFCS. They contain neither, but they do contain one full serving of vegetables from six different sources: spinach, broccoli, carrots, tomatoes, beets and shiitake mushrooms. You’d never know it, though. These vegan, low-sugar, high-fibre bars taste, impossibly, closer to a candy bar than a traditional granola bar. madegoodfoods.com/ca 4 Keto friendly These soft-baked bars are keto certified by the Paleo Foundation— because, you don’t always want to snack on beef jerky. These cookie-like bars contain 160 calories with a minimum of 13g of plant-based fat and only 15g of carbohydrates. Using real, organic ingredients like coconut, cinnamon and raspberries, these will help anyone on the keto diet avoid that midday energy slump. good2gosnacks.com

These candies are coloured naturally from fruits and vegetables like pumpkin, carrot and spirulina (algae), and flavoured by plant-based sweeteners and natural fruit flavours. smartsweets.ca 6 Edgy Veggie Move over kale chips, cauliflower continues its world domination, now

in the snack aisle. Yes, these are cauliflower crisps. They’re organic, non-GMO and gluten-free. Baked with real cauliflower, these earthy, crunchy snacks are enhanced with pumpkin seeds, sesame seeds and sea salt — a minimally processed chip that actually tastes like roasted cauliflower (but better, ‘cause they’re chips). hippiesnacks.com Just For Canadian doctors Spring 2020

mix

spring

tropics calling

View of Nevis Peak from the Four Seasons opposite, from top Lobby of the revamped Four Seasons Resort Nevis; iconic island dweller, the vervet monkey; snorkelling in the Caribbean blue

The two-island nation of St. Kitts & Nevis feels like a lost enclave in the Caribbean…waiting to be found

caribbean dream

getaway iconic resort

four seasons

Stay at the Four Seasons Resort Nevis, which has long been this island’s landmark property—and has undergone a multi-million dollar enhancement project, a complete revamp in haute Nevisian style inspired by local flora and fauna, including the island’s beloved ambassadors, green vervet monkeys. Strung along Pinney’s Beach, one of Nevis’ finest stretches of sand, the hotel brings together aquatic activities on a nearby reef, golf, and a spa set in lush tropical gardens. Stay in a mountain- or sea-view room, or take it up a notch and opt for a private villa, which includes dedicated ambassador service and private pools and sundecks. Plan and book here: fourseasons.com/nevis — Tim Johnson

Just For Canadian doctors Spring 2020

hot spot getaway

island hop

Exploring earthy delights, from St. Kitts to Nevis

n y ou r o w pr i v a te i s le ) (a lm ost

mix

[go luxe]

Local operator KayanJet offers the indulgent option of being met on the tarmac and whisked away in a Porsche Cayenne to a private airport lounge… stkittstourism.kn/plan/air

un-plug

four seasons

anding at Robert L. Bradshaw International Airport, I have a rather glamorous arrival. Descending steps from the 737 to the tarmac, a suited man awaits, alongside a Porsche pulled right up to the plane. He’s holding a sign with my name on it—this car, it’s for me. Climbing into the back, I’m whisked to a posh lounge, where my companion and I enjoy cool drinks (and air conditioning) while our passports are processed. Soon, we’re skimming across the blue waters of a strait, continuing from our decidedly celebrity-style entrée to this island nation. Joined by my father, I’m in St. Kitts and Nevis, two islands united into one nation and separated by a shallow, three-kilometre stretch of water known as The Narrows. Each island has its own style and pace. While the former receives the larger share of tourists, the latter feels like a place set apart, a quiet, earthy island, from the flanks of majestic Nevis Peak, a dormant volcano, to an endless collection of often-hidden, white-sand beaches. This is our home base for the next week. After our high-profile arrival in that high-powered automobile, our next vehicular adventure takes place…in a golf cart. Albeit one outfitted with big, knobby tires. Joining a few other adventurers on a 4x4 tour, we trace dirt roads deep into the interior of Nevis, finally going completely off-road, into rainforest, beneath coconut palms and emerging to aquamarine views of the Caribbean. We tour abandoned sugar mills, once the economic driver here, as well as the remnants of the 19th-century Cottle Church, where slaves and free men could worship together. We finish our trip in the right place—at the water, rolling those big tires up to Sunshine’s, Nevis’ legendary beach bar. Relinquishing the keys, we order a Killer Bee, the signature cocktail that’s a mix of rum, passion fruit juice, nutmeg and, of course, honey. The following days are full, quite literally, with local fare and cooking lessons on traditional dishes like conky and Johnny cakes (my dad taste-tests them all, approvingly). We attend the weekly pig roast at the Hermitage, a hotel built within a former plantation that dates back to 1670—including the oldest building on the island—where the current owner, an amiable man named Richie, has been spinning pork on a spit every Wednesday since he can remember. Afterwards, we snorkel in The Narrows, enjoying the warm, salty water, and then soak up the sun on a catamaran. Back on land, we continue to tour around the island, passing monkey-crossing signs (Nevis is home to a resident population of green vervet monkeys) and navigating around big herds of sheep and goats on the quiet roads, then browsing the charming shops in Charlestown, the island’s laid-back capital. We take a deep dive into history, visiting the birthplace of Alexander Hamilton and the former home of renowned British admiral, Horatio Nelson. Everywhere we go, we hear soca beats and, whenever possible, sample local rum. Too soon, we’re back on another boat, rolling across The Narrows again to the sister island of St. Kitts. We’ve both gained a few pounds, and even more stories. And the Porsche? Turns out it’s waiting for us, again, ready to drive us onto the tarmac to the 737. — Tim Johnson

spring

if you go Plan your trip to Nevis, “the authentic Caribbean,” at: nevisisland.com.

Just For Canadian doctors Spring 2020

mix

photo prescription

spring

dr. henry adamson is an anesthesiologist who lives and practises in Halifax, Nova Scotia.

photo finish

“

These photos were taken in Spring 2019 on a fly-in visit to Sable Island to the south of Nova Scotia, infamous for the number of shipwrecks and justly famous for the 500 wild horses that are year-round residents and 300,000 seals that co-exist in this unique eco-system.”

photo details

dr. henry adamson

Nikon D750, 300mm Nikkor lens with x1.4 teleconverter for the two top photos and Nikkor 20mm prime for the bottom image

Send your “wow” photo (high-resolution) to feedback@inprintpublications.com, along with a few words on the context of the photograph (including time, place, technical details and equipment/gear). We want to see what you’ve captured on your travels!

Just For Canadian Doctors Spring 2020

the thirsty doctor lisa kadane Lisa Kadane is a newspaper and magazine writer who likes to travel and partake in the destination’s preferred tipple, whether it’s rum, wine, a margarita or whisky sour. She’s been sharing her thoughts on spirits and cocktails since 2010.

Taste of the tropics

tim e fo r “lim in g"

Caribbean cocktails will take you back to island time

nside a shady rum shack on Brandons Beach in Barbados, patrons line the bar escaping the heat and quenching their thirst with local Deputy beers and icy glasses of rum punch. I take a sip of the national cocktail and enjoy the taste of dark rum, sugar and lime spiced up with Angostura bitters. It’s good. “Can you tell me your rum punch recipe?” I ask the bartender at Rascals. “We can’t say,” she says in a lilting Bajan accent paired with the hint of a smile. “It’s a secret.” Every rum shack in Barbados makes their own punch, and each also claims that theirs is the best. On a hot, lazy day, you’ll agree they’re probably right. In fact, on any given Caribbean island, a cocktail with good rum and lots of ice will give you the attitude adjustment you’re looking for, as I discover on a recent holiday. In Castries, St. Lucia, a Bounty and Coke tastes like heaven, while in Puerto Rico—the birthplace of the Piña Colada— local Bacardi white is best blended with pineapple juice, coconut cream and ice. On Antigua, self-proclaimed “drink connoisseur” Cassim Greene introduces me

to an Antigua Smile, a happy mix of white rum, crème de banana and pineapple juice that conspires to make me grin. Afterwards, the orange, lime green, turquoise and yellow painted homes and buildings that line the narrow roads of St. John’s appear even brighter. The truth about rum, says Greene, is that it helps beat the heat, and acts as a social lubricant when locals go “liming” after work (translation: hanging out at a rum shack and shooting the breeze, basically). It’s no wonder we want to bring back tropical cocktail recipes to get us through the last days of winter. Back at Rascals in Barbados, I manage to get the coveted recipe from the bartender after ordering a couple more drinks. It pretty much follows the classic rum punch rhyme: One of sour (lime), two of sweet (sugar), three of strong (rum), four of weak (water). “You just kind of play around with it,” she says. I intend to do just that when I trade powdery sand and jade waters for white snow and blue ice back in Canada.

Tropical cocktails for a taste of the Caribbean in Canada 1 Antigua Smile

1.5 oz white rum 0.75 oz crème de banana 2 oz pineapple juice Squeeze lime Pinch sugar

2 oz Mount Gay Eclipse 1 oz simple syrup 0.5 oz fresh lime juice 2-3 dashes Angostura bitters Pinch nutmeg

Garnish: Skewered cherry and pineapple wedge

Garnish: Skewered cherry

Method: Add all ingredients to a shaker and shake with ice. Strain into a cocktail glass over fresh ice. Garnish. lisa kadane

2 Rum Punch, Barbados

— Recipe courtesy Cassim Greene, Antigua

Method: Add rum, syrup and lime juice into a cocktail shaker with generous ice. Shake until thoroughly chilled. Strain into a cocktail glass over fresh ice, add bitters, nutmeg and garnish. — Recipe courtesy Rascals rum shack, Barbados

drinks to transport you

3 Piña Colada, Puerto Rico 2 oz Bacardi white 1 oz coconut cream 1 oz heavy cream 6 oz fresh pineapple juice 1/2 cup crushed ice

Garnish: Pineapple wedge and cherry Method: Add all ingredients into a blender and blend until smooth. Pour into a cocktail glass, garnish and serve. — Recipe courtesy Hilton Caribe, San Juan, Puerto Rico

Spring 2020 Just For Canadian doctors

pay i t f o r w a r d

r o b e r ta s ta l e y Roberta Staley is a Vancouver-based author, magazine editor and documentary filmmaker.

Street medicine

ive days a week, Dr. Susan Burgess, 10-kilogram backpack full of medical supplies slung over her slight shoulders, traipses—or sometimes drives—along the streets of Vancouver’s Downtown Eastside (DTES) on her rounds. Some of her patients live in single resident occupancies, or SROs, as bleak, grim and Dickensian as any Victorianera London poorhouse. Others eke out a living on the street, shiverDr. Susan

mid-1990s, when she first came to the DTES from Ontario via the Northwest Territories where she delivered healthcare in Aboriginal communities. Upon her arrival on the west coast, Burgess began working with Vancouver Native Health, a place that supported outreach care. It was an overwhelming time, with soaring rates of HIV/AIDS, syphilis, tuberculosis and hepatitis C that were exacerbated by intravenous cocaine and opioid use and a growing population of people with psychiatric illnesses, Burgess makes due to the closure of Vancouver’s her rounds in Riverview Hospital mental Vancouver’s health facility. Hope emerged Downtown in 1996 with the introduction Eastside of Highly Active Antiretroviral Therapy (HAART). But it would be the early aughts before HIV/AIDS was under some control. Burgess was part of this achievement, being the lead study physician with the BC Centre of Excellence in HIV/AIDS, researching the effects of directly observed therapy, or DOT. Burgess, a palliative care physician, is still trying to keep a lid on HIV, which she says is now increasing among younger DTES residents. She describes one patient—a homeless man in his 20s whose HIV had gone untreated for months. With the help of a social worker, the man was finally placed in a shelter—a key first step in helping street people establish some order in their lives and link with a variety of supports, such as drug treatment and HAART. Providing care to such individuals “is often difficult,” says Burgess who, despite 27 years spent pounding the paveing at night in sleeping bags, sheltering ment on rounds, plans to continue her from the rain under eaves, spending their gruelling work regimen. “Once they’re in days scraping together enough money a shelter, we connect and get them help.” to buy a bit of food or the brief mental But the reasons they’re homeless—childrespite afforded by a hit of crystal meth or hood trauma, addictions, incarceration, street fentanyl. mental illness and paranoia and psychosis The chaotic lifestyle of thousands from methamphetamine and fentanyl of marginalized DTES residents—an use—can lead to errant behaviour, resultarea referred to as Canada’s poorest ing in eviction from even the most basic postal code—often makes it imposshelter. “They get kicked out and you start sible for such patients to organize things over again and try to find them.” (Burgess like medical appointments. So Burgess also sees patients at the Downtown goes to them. She has done so since the Community Health Centre, Kílala Lelum

Just For Canadian doctors Spring 2020

Clinic and the Vancouver Coastal Health Home Hospice Palliative Care service.) Burgess’s tireless work in the DTES resulted in her being given the Canadian Society of Palliative Care Physicians (CSPCP) Humanitarian Award in 2017. She was surprised by the recognition and hopes that it raises awareness of the challenges DTES residents face. “That award was an opportunity to highlight our commonalities. Everyone is a human being and deserving of the same human rights. We’re all born; we all die. That has to be acknowledged.” It’s in between birth and death that can be so dramatically different, with some people facing their final few years, months or days in an SRO with only Burgess and an outreach nurse by their side. She has many patients with advanced HIV/AIDs—virtually all her patients are HIV positive—while co-morbidities, such as heavy addiction and psychiatric illnesses, are factors in inconsistent HAART treatment, leading to high viral loads. “It’s heartbreaking,” says Burgess. Distressing, too, is the loneliness. “The worst thing for folks is when there’s nobody. They don’t have family; Joe down the hallway, maybe he’s sort of a friend.” Despite enormous hardships, the residents of the DTES are proud, lacking self-pity. Burgess remarks that, with some patients, she will have to visit them numerous times before they agree to be looked at or treated. One patient, psychotic from drug abuse, who slept on a towel on the floor of his SRO, refused to allow Burgess into his room. After five separate “knocks on his door” from Burgess, he finally relented, which allowed her to finally initiate an HIV regimen. Eventually, after detoxing during a long stint in hospital, his psychosis diminished and the man, a gifted visual artist, now supports other HIV patients and helps train nurses and physicians. Burgess calls him “amazing.” Burgess doesn’t expect all her patients to be so successful. And that’s OK. “We’re just walking alongside these folks, whatever happens to be their path. They’re beautiful and troubled—they are my teachers. It’s a gift to be able to do this.”

Tallulah Photography

Helping those in need at home, here in Canada, on the streets of Vancouver’s inner city

Leave a Legacy of Caring for the Future

Have you considered leaving a gift to Doctors Without Borders/Médecins Sans Frontières (MSF) Canada in your will?

Over 2,000 loyal supporters like yourself have made the pledge to leave a charitable legacy to MSF. A gift in your will helps guarantee that we can respond with emergency medical relief wherever and whenever future needs occur. PHOTO: A participant hugs MSF nurse Chrissie Nasiyo during an outreach clinic conducted for a group of sex workers in Nsanje, Malawi. © Isabel Corthier/MSF

legacy@msf.ca, or visit doctorswithoutborders.ca/mylegacy For all other inquiries, please call 1-800-982-7903 or email donorrelations@toronto.msf.org

travel the world

For the love of

elephants

A sanctuary in Kenya rehabilitates injured and orphaned pachyderms story by roberta staley photography by Tallulah Spring 2020 Just For Canadian doctors

travel the world

awn is breaking, spreading golden light like butter on the green and red-dirt landscape rising on either side of the highway leading out of Nairobi, Kenya. Thanks to our early start, we have eluded the capital city’s notorious traffic snarls, arriving at the Sheldrick Wildlife Trust on Magadi Road a few hours before the tourists arrive. Pulling into the quiet, empty, packed-dirt parking lot, we encounter a small family of tusked wart hogs. Surprised by our appearance, they trit-trot past, tufted tails held vertical in alarm, eyeing us with suspicion. Sheldrick Wildlife Trust is a non-profit organization that rescues injured and orphaned animals: elephants, rhinos and the occasional giraffe, and rehabilitates them for return to the wild. Founded in 1977 as the David Sheldrick Wildlife Trust (its name until 2019) by Daphne Sheldrick, David’s widow, the trust was created to honour her husband’s anti-poaching activism and work as a warden in Tsavo National Park, southeast of Nairobi. Although Daphne, an author and conservationist, died in 2018 at age 83, her daughter Angela and other Sheldrick family members continue the legacy. The trust has opened its arms to the world, inviting tourists to visit Sheldrick every day of the year from 11 am to noon, except December 25, to watch the orphan pachyderms cavort in mud or dust baths with their caregivers, who stay with the youngsters, supporting and protecting them, just as a mother elephant would. (The charge is 500 Kenyan shillings, about CDN$9, cash only.) Sheldrick Wildlife Trust’s herd of orphaned elephants range in age from a few months to about three—all rescues from various regions of Kenya. The circumstances of their rescue have usually been dire. The trust’s anti-poaching and veterinarian crews, utilizing ground and helicopter and fixedwing plane surveillance, have freed elephants from snares that have almost severed legs or trunks. While a mature elephant can be treated in situ, an injured infant is unlikely to survive, and will be flown to the Sheldrick facility for long-term medical treatment. One such baby is Enkesha, who was rescued after a snare almost sliced her trunk off. It has healed, although the hole that was left will never close. Enkesha, however, has adapted, learning to grip her trunk muscles tight to close the gap, allowing her to suck water through her trunk. Some rescued babies have suffered gunshot wounds. Others were orphaned when their mothers were slain by poachers, who hacked off the tusks for sale to the Asian ivory market. Other elephant mothers were killed for bushmeat or by farmers to protect crops, leaving the offspring orphaned. Such human-elephant conflict is exacerbated by climate change, which is linked to prolonged periods of drought so severe that Kenya has seen high mortality rates of both wild and domestic animals in past years. Along with the company of their fellow pachyderms, and crucially the love and 24/7 attention of caregivers, who sleep with their young charges at night in the stables, most of the rescued babies survive the traumas that left them orphaned and will start to be rehabilitated into Tsavo National Park in southeastern Kenya when they are about four. Raising baby elephants isn’t easy; they have complex emotional as well as dietary needs. It took Daphne Sheldrick a decade to perfect a

Just For Canadian doctors Spring 2020

milk formula that, today, is if you go fed to the babies until they Visitors to the Sheldrick Wildlife become more independent; Trust should come on their own at the Nairobi nursery they and make arrangements with are fed every three hours, a taxi or their hotel and driver, imbibing 24 litres a day, and ensure they have the 500 Kenyan shillings for entrance. says trust spokesperson For more info: sheldrick Kirsty Smith. wildlifetrust.org. Our early arrival, to document the work at the trust, means that we are here for the 9 am feeding, which is heralded by the soft thump of heavy round feet as the babies scurry out of the Nairobi National Park forest where they’ve been nibbling vegetation. Excited rumbles greet a wheel barrel full of freshly prepared 3.5 litre milk bottles. The elephants, with varying degrees of adeptness, grab a bottle with their trunks, suckling the bottle dry in a few minutes. Some youngsters need help from their keepers, who hold the bottles up to facilitate suckling. The amount imbibed varies; those who haven’t quite mastered the art of bottle feeding, spill much of their breakfast onto the ground. After the feeding, the keepers accompany their charges back into Nairobi National Park to chew on branches and brush and dig up roots. When the tourists arrive, the babies are brought to the mud and dust baths for easy viewing. Such behaviour prevents the youngsters’ sensitive skin from sunburn, while mud baths—apart from being fun—also help keep them cool. All the babies have names that acknowledge the region of Kenya they were rescued from and head keeper Edwin Lusichi, who has been with the trust for 21 years, provides a history of each baby during the visit. Visitors are also offered the opportunity to “adopt” one of the young elephants for $50 a year. Although this money is put into general operations for the Orphans’ Project at Sheldrick, the adopter receives monthly updates about their elephant, a certificate of adoption and digital copies of Angela Sheldrick’s delicate, whimsical watercolours of the babies. Giant-eared Luggard became my adoptee. Luggard was an infant when a Sheldrick helicopter pilot on anti-poaching patrol spotted him, obviously distressed, in 2016 in Tsavo East National Park in Kenya. A veterinarian crew was mobilized and Luggard caught. Only five months old, he had been shot. A bullet had shattered the knee in his left hind leg, penetrating through into the other foot. Luggard was tranquilized and evacuated via helicopter to the Sheldrick facility for intensive care. Now a four-year-old, Luggard will always limp, delicately putting just a bit of weight on the left hind foot as he walks. When it is time to reintroduce him back to the wild, he will be moved to a special place called Umani Springs in the Kibwezi Forest, one of the trust’s three reintegration units. “This is where those elephants that have been injured will be integrated into, as it’s easier, with more water and richer forest for feeding,” says Smith. In the film Larger Than Life, actor Bill Murray said, “You know, they say an elephant never forgets. But what they don’t tell you is that you never forget an elephant.” Any visitor who comes away from viewing these engaging, sweet and good-natured babies at Sheldrick Wildlife Trust will attest to that observation. Once seen, these youngsters’ remarkable stories of survival and resilience remain forever in your memory—and your heart.

travel the world

Young elephants drink 24 litres of milk daily; Each elephant has its own individual keeper; The scar from a snare can be seen on Enkeshaâ&#x20AC;&#x2122;s trunk; Keepers protect the orphaned elephants from harm in Nairobi National Park clockwise from top left

March/April 2020 Just For Canadian dentists

2020 Education Spring Workshops: May 2-3, 2020 | Las Vegas, NV Chelation Advanced Providers - Workshop & Certification

The workshop and practicum provides in-depth training by combining the information presented in the pre-requisite webinars (Step 1) with a full course of new material. The CCT certification exam takes place on the afternoon of the second day.

Visit acam.org/CAP to learn more & register.

The Science of Longevity - Stem Cell & Peptide Therapies

The purpose of this intensive regenerative workshop is to critically review the large body of clinical work performed with respect to the use of stem/ progenitor cells and peptides in humans. Emphasis will be paid to new reviews of the science of repair, wound healing, aesthetics & longevity, cancer care, immune modulation and more!

Email info@acam.org to learn more & register.

Annual Meeting in Seattle, WA - Registration OPEN!

Upgrade Your Education

Since 1973, ACAM has educated practitioners with the mission to provide an expansive medical “toolkit”. We help you better treat patients, be more effective in treating difficult cases, and discover safe & cost-effective treatments in our signature learn-today-use-tomorrow format.

Join a Patient-Forward Community

ACAM strives to encourage strong relationships. The Collaboration Cures movement is about bringing together practitioners of all fields to provide optimal patient care. That is why, for the 5th year in a row, ACAM has joined forces with AAPMD, whose primary focus is airway health & sleep medicine. Learn what a fresh perspective can do for your practice.

Be Inspired

Find out why past attendees say they leave our meetings “with a renewed vitality for [their] practice” by attending our value-packed program in Seattle!

Learn more at acam.org/CollaborationCures2020.

Program Topics

- Neurodegeneration - Chronic Infectious Disease - Inflammatory Disorders - Cancer Care - Sleep Medicine and more!

Featured Speakers

- Daniel Amen, MD - Neil Nathan, MD - Satchidananda Panda, PhD - Gregory Smith, MD, MPH - Theoharis Theoharides, MD, PhD - Simon Yu, MD

toronto / asheville / prague / kobe / panama … | c a l e n d a r

cMe

A n int ern ation a l guide to continuing medica l Education

spr ing 2020 + beyond

toronto

[more]

Catch Hot Docs, the Canadian International Documentary Festival (the largest in North America) from April 30–May 10. hotdocs.ca For info on Toronto: seetorontonow.com

from top left: Museum of Contemporary Art; Tourism Toronto (3); Dawson Lovel, Unsplash

Tour the art—old, new and reimagined—of toronto (CME events in Toronto are in blue.)

osmopolitan allure—big city, bright lights—and culture make Toronto an art-lover’s go-to. Gaze at a Flemish Baroque painting or marvel at Indigenous street art, and see old architecture, like the 1892 Gooderham Building or Flatiron Building 1 , contrast with the sweeps and angles of modern edifices, sometimes even morphing within one structure. Like the Royal Ontario Museum, a cultural institution since 1914 with a world-class collection of 13 million artworks, cultural objects and natural history specimens—the most-visited museum in Canada. Its original Italianate/Neo-Romanesque building has been melded into the prism-like Michael Lee-Chin Crystal, a contemporary structure designed by Daniel Libeskind 2 . Walk by in wonder. rom.on.ca Another reimagined space, including a glass-and-wood façade and show-stopping spiral staircase 3 , is the Art Gallery of Ontario redesign by Canadian architect

Frank Gehry. Here, you can see a collection that includes The Massacre of The Innocents (by that Flemish master, Peter Paul Rubens), alongside the Group of Seven. And, on now is an exhibition of striking black-and-white portraits by renowned American photographer Diane Arbus. ago.ca Also revamped, the historic 1919 Tower Automotive Building in the city’s Lower Junction neighbourhood—once the tallest in Toronto and an aluminum factory that manufactured products for World War II— has become the Museum of Contemporary Art 4 . The original structure is now a stripped-bare backdrop for modern-art exhibitions like the current interactive cardboard installation by Carlos Bunga. moca.ca Yet another historic industrial site that’s been turned into gallery space is the Evergreen Brick Works. A former kiln building where bricks were made is now the TD Future Cities Centre, where immersive installations by a resident artist inspire visi-

tors to ponder urban density, public space and diversity. evergreen.ca And throughout the city there’s the mix of old and new, with colourful street art on weathered walls in alleys or below once-gritty highway passes and subway bridges. In Underpass Park, designed by landscape architects to transform one such neglected space into a public park, local artist and architect Paul Raff’s “Mirage” is displayed on the actual underpass, its 57 octagonal stainless steel surfaces reflecting new life below. Another Toronto artist, Indigenous muralist Philip Cote 5 , shares the oral traditions of storytelling in his public artwork—from a vibrant Anishinaabe woodland mural in the neighbourhood of Roncesvalles to a depiction of “All My Relations” in Allan Gardens, one of the oldest parks in Toronto. It’s a big-city mash-up of art, industry, history, high-tech and creativity in the urban heart of Toronto. — Barb Sligl

Spring 2020 Just For Canadian doctors

cme

calendar

Dermatology

Cardiology

Anesthesia

Aesthetics

cme when where

MORE CME Full-access CME calendar and destinations at justforcanadiandoctors.com/cme/

topic

sponsor

contact

website

Level 1 Online: Advanced Anatomy & Intro To Botulinum Toxin & Dermal Filler - Online & Self-Directed Course

Pacific Training Institute for Facial Aesthetics

855-681-0066 See Ad Page 20

ptifa.com

Level 2: Basic Botulinum Toxin: Aesthetic Upper Face & Pain

Pacific Training Institute for Facial Aesthetics

855-681-0066 See Ad Page 20

ptifa.com

Ongoing

Online

Multiple Dates

Vancouver British Columbia

Apr 17-18, May 15-16, Jun 26-27

Apr 23-27

Las Vegas Nevada

American Society For Aesthetic Plastic Surgery Aesthetic Symposium 2020

American Society For Aesthetic Plastic Surgery

562-799-2356

surgery.org

Jun 19-21

Bangkok Thailand

International Master Course On Aging Science Asia 2020

International Master Course On Aging Science

33-1-40-7382-82

imcas.com

May 14-18

San Francisco California

International Anesthesia Research Society

415-296-6924

meetings.iars. org

May 29-31

Seattle Washington

The Difficult Airway Course: Anesthesia

Airway Management Education Center

866-924-7929

theairwaysite. com

Jun 19-22

Halifax Nova Scotia

Canadian Anesthesiologistsâ&#x20AC;&#x2122; Society Annual Meeting

Canadian Anesthesiologistsâ&#x20AC;&#x2122; Society

416-480-0602

cas.ca

Apr 02-05

Porto Portugal

6th International Congress On Cardiac Problems In Pregnancy 2020

Paragon Group

27-0-87-4700365

cppcongress. com

Apr 24-25

Tokyo Japan

5th International Heart Conference

Advanced Heart 2020

heart congress @cardiology summit.org

heart.cme society.com

Jun 25-26

Toronto Ontario

Toronto Ottawa Heart Summit

416-340-3721

toronto ottawaheart summit.com

Jul 26-28

Whistler British Columbia

Success With Failure: Strategies For The Evaluation And Treatment Of Heart Failure

Mayo Clinic

866-246-1581

radiology education. mayo.edu

Sep 16-18

Baltimore Maryland

2nd International Cardiology Conference And Expo

iMedical

jessie@ icardiology icardiology conference.com conference.com

Oct 17-21

Chicago Illinois

CHEST 2020

American College of Chest Physicians

224-521-9800

chestmeeting. chestnet.org

Jun 24-27

Ottawa Ontario

CDA 95th Annual Conference

Canadian Dermatology Association

800-267-3376

dermatology.ca

Jul 09-12

Asheville North Carolina

Society For Pediatric Dermatology 45th Annual Meeting

The Society for Pediatric Dermatology

317-202-0224

pedsderm.net

Jul 30Aug 02

San Francisco California

Pacific Dermatologic Association 72nd Annual Meeting

Pacific Dermatologic Association

888-388-8815

pacificderm.org

International Anesthesia Research Society Annual Meeting

AUA: May 14-15 SOCCA: May 15 IARS: May 15-18

new CE to be placed

Just For Canadian doctors Spring 2020

MORE CME Full-access CME calendar and destinations at justforcanadiandoctors.com/cme/

General & Family Medicine

Gastroenterology

Emergency Medicine

Diabetes & Endocrinology

cme when where

calendar

cme

topic

sponsor

contact

website

Mar 25-29

New Orleans Louisiana

National Kidney Foundation Spring Clinical Meeting

National Kidney Foundation

855-653-2273

kidney.org

Nov 23-25

Toronto Ontario

Diabetes Educator Course

Kinghooper Diabetes Education Inc

604-998-1444

king hooper.com

Jul 19-23

Snowmass Village Colorado

The Intestinal Lipid Metabolism Conference: In Health And Disease

Federation of American Societies for Experimental Biology

301-634-7010

src.faseb.org

Aug 03-06

Boston Massachusetts

Prevention And Management Of Diabetes Complications

Harvard Medical School

617-384-8600

harvard.edu

May 27-31

Santa Fe New Mexico

Wilderness Medicine & Global Health

Center for Emergency Medical Education

971-236-8088

wildernessmedicine.com

Aug 03-05

Bay Lake Florida

How To Save A Life: IR And Surgical Management Of The Trauma Patient

University of Chicago

773-702-1056

uchicago.edu

Aug 03-12

Aquarius Reef Base Florida

Dive Medicine

World Extreme Medicine

44-0-1297300503

world extreme medicine.com

Jul 27-28

Vancouver British Columbia

International Conference On Gastroenterology And Digestive Disorders

LEXIS Conferences

32-800-75358

lexisconfer ences.com

Jul 29Aug 01

Miami Florida

International Federation For The Surgery Of Obesity And Metabolic Disorders 25th World Congress

39-0817611085

ifso2020.com

Oct 23-28

Nashville Tennessee

ACG 2020

American College of Gastroenterology

301-263-9000

acgmeetings. gi.org

Nov 05-08

Kobe Japan

Japan Digestive Disease Week 2020

Japan Digestive Disease Week

infoen@jddw.jp

jddw.jp/ english

Dec 03-05

Prague Czech Republic

Gastro 2020

World Gastroenterology Organisation and the Czech Society of Gastroenterology

420-284-001444

gastro 2020prague.org

Apr 02-05

Orlando Florida

Update CME Internal Medicine And Primary American Medical Care Forum

678-899-6444

amf-cme.org

Apr 25May 02

Nicoya Peninsula Costa Rica

Costa Rica Tropical Medicine & Wellness Retreat

Wild Med Adventures

413-813-5330

wildmed adventures.com

May 02-03

Las Vegas Nevada

The Science Of Longevity: Stem Cell & Peptide Therapies Workshop

American College for Advancement in Medicine

May 13-16

Naples Florida

5th Annual Conference On Challenges In Sexual Healthcare

Symposia Medicus

info@ symposia medicus.org

symposia medicus.org

Jun 01-02

Orlando Florida

Scholars World Healthcare Summit

Scholars Conferences

44-2035140512

scholars meetings.org

Federation new CE to for the Surgery of Obesity and Metabolic Disorders be placed International

888-995-3088

See Ad Page 18

acam.org

Spring 2020 Just For Canadian doctors

cme

calendar

Hematology

Geriatrics

General & Family Medicine

cme when where

MORE CME Full-access CME calendar and destinations at justforcanadiandoctors.com/cme/

topic

sponsor

contact

website

Jun 06

Seattle Washington

Caring For Transgender And Gender Diverse Youth

Seattle Childrenâ&#x20AC;&#x2122;s Hospital

206-987-2000

seattle childrens.org

Jun 07-21

Norwegian Fjords & the Midnight Sun

Medical Seminar At Sea & The Scandinavian Healthcare System / 14-Night Cruise Along Norwayâ&#x20AC;&#x2122;s Scenic Coast

Professional Education Society

877-737-7005

pestravel.com

Jul 19-26

Southern France River Cruise

Medical Symposium Confronting Healthcare Needs / 7-Night All-Inclusive River Cruise

Professional Education Society

Aug 12-20

Ireland Land Tour

Addictions, Fibromyalgia, Medical Cannabis & Sleep And Mood Disorders

Sea Courses

Aug 15-25

Blue Danube River Cruise Bucharest to Vienna

Topics In Critical Care

Continuing Education, Inc./University at Sea

See Ad Page 39

Sep 18-27

Ethiopia

Medical Conference Including Topics On Infections Diseases, OBGYN, Emergency Medicine And Neurology

Unconventional Conventions

Sep 24-26

Toronto Ontario

9th Fragility Fracture Network Global Congress 2020

Fragility Fracture Network

Oct 04-11

Danube River Cruise

Health & Well-Being Seminar / Begin In Munich Or Prague followed By 7-Night River Cruise

Nov 12-14

Seattle Washington

Feb 25Mar 01 2021

Antarctica & Patagonia Cruise

Medical And Dental Conference Including Topics On Respiratory And Sleep Disorders, Diabetes, Clinical Communications, Emergencies And Oral Medicine

Unconventional Conventions

May 27-30

Washington DC

Interdisciplinary Symposium On Osteoporosis 2020

National Osteoporosis Foundation

703-647-3007

inter disciplinary symposium osteoporosis.org

Jun 18-28

Scandinavia & Russia Cruise

Cardiology And Geriatrics

Continuing Education, Inc./University at Sea

866-456-9464

continuingedu cation.net

Nov 05-13

Panama Land Tour

Joint Disease And Replacement, Musculoskeletal Injections, Rehabilitation, Dementia & Geriatrics

Sea Courses

888-647-7327

seacourses. com

Apr 15-17 2021

Vancouver British Columbia

2021 Annual Scientific Meeting

Canadian Geriatrics Society

855-415-3917

canadian geriatrics.ca

Apr 02-03

La Jolla California

Acute Leukemia Forum

Global Academy for Medical Education

561-777-9426

global academy cme.com

Aug 06-09

Chantilly Virginia

ASH Meeting On Lymphoma Biology

American Society of Hematology

202-776-0544

hematology.org

877-737-7005

See Ad Page 23

888-647-7327

seacourses. com

866-456-9464

continuingedu cation.net

See Ad Page 33

1800-633-131

unconventio nal.com.au

41-0-44-80942-86

fragility fracture network.org

See Ad Page 21

Society new CE to American College be placed Collaboration Cures Annual Meeting for Advancement in

Professional Education

877-737-7005

See Ad Page 23

888-995-3088

See Ad Page 18

Medicine

pestravel.com

1800-633-131

See Ad Page 33

pestravel.com

acam.org unconventio nal.com.au

604-616-9706

planetsmileforkids.org Help us develop a comprehensive and sustainable programs for the treatment of children with Cleft Lip and Palate (CLP) and other Craniofacial Anomalies, Oral Cancer and Disabilities in Canada and Developing Countries around the Planet.

Just For Canadian doctors Spring 2020

MORE CME Full-access CME calendar and destinations at justforcanadiandoctors.com/cme/

calendar

cme

topic

sponsor

contact

website

Buenos Aires Argentina

HIV & Hepatitis In The Americas

Ashfield Healthcare Communications

44-0-1625664390

hivhep americas.org

Jun 21-25

Toronto Ontario

International Symposium On Pneumococci And Pneumococcal Diseases Conference 2020

International Symposium on Pneumococci and Pneumococcal Diseases

31-20-76305-18

isppd2020. kenes.com

Jul 30Aug 08

Best Of Italy Cruise from Venice to Rome

Infectious Diseases And Immunizations: A Comprehensive 2020 Update

Continuing Education, Inc./University at Sea

866-456-9464

continuingedu cation.net

Apr 02-04

Amelia Island Florida

Trending Topics In Internal Medicine 2020

Mayo Clinic General Internal Medicine

507-284-8781

mayo.edu

Jul 13-17

Palm Coast Florida

11th Annual Essentials In Primary Care Summer Conference

Continuing Education Company

800-327-4502

cmemeeting.org

Apr 25-29

Philadelphia Pennsylvania

American Psychiatric Association Annual Meeting 2020

American Psychiatric Association

202-559-3900

psychiatry.org

May 14-16

Barcelona Spain

27th International Symposium On Controversies In Psychiatry 2020

International Symposium on Controversies in Psychiatry

34-934-161220

controversias barcelona.org

Aug 10-11

Vancouver British Columbia

CBT For Anxiety

877-466-8228

cbt.ca

Jun 20-28

Spain & Portugal Cruise

Palliative Medicine And End Of Life Care, Including Related Topics In Neurology

Continuing Education, Inc./University at Sea

866-456-9464

continuingedu cation.net

Jul 06-10

Pittsburgh Pennsylvania

Gamma Knife Radiosurgery Course

University of Pittsburgh

412-647-3685

neurosurgery. pitt.edu

Aug 13-14

Venice Italy

International Conference And Exhibition On Biomedical Electronics And Devices

OLC International

917799901270

olc international. com

Aug 13-15

Toronto Ontario

SNO Conference On Brain Metastases

Society for NeuroOncology

713-526-0269

soc-neuro-onc. org

Jul 11

San Diego California

Scripps MD Anderson’s 2020 Oncology Update

Scripps Health

800-727-4777

scripps.org

Aug 09-12

Singapore

World Conference On Lung Cancer

The International Association for the Study of Lung Cancer

855-464-2752

iaslc.org

Oct 14-17

Ottawa Ontario

52nd Congress Of The International Society Of Paediatric Oncology

International Society of Paediatric Oncology

Nov 04-06

New York New York

38th Annual Chemotherapy Foundation Symposium: Innovative Cancer Therapy For Tomorrow

Physicians’ Education Resource

See Ad Page 37

609-378-3701

L EDUCATIO NA N IO CIETY

Norwegian Fjords on Holland America

gotoper.com

Professional Education Society — CME/CE Cruise & Travel Seminars

SIOPCongress.org

Visit our website and sign up to receive our emails to be the first to know about new CME/CE Cruise & Travel Seminars!

Southern France on Uniworld

Eastern Caribbean on Crystal

Danube River on AmaWaterways

Seychelles Islands on Crystal Yacht

info@PEStravel.com

1980

Since CR

Medical Health & Well-Being Updates October 4 – 11, 2020

Medical Symposium Confronting Healthcare Needs July 19 – 26, 2020

Medical Seminar at Sea & Scandinavian Healthcare June 7 – 21, 2020

info@sioponline.org

new CE to CBT Canada be placed

Apr 23-25

PROFE

Oncology

Neurology

Mental Health

Internal Medicine

Infectious & Chronic Diseases

cme when where

SE & RAVEL T

Medical Symposium at Sea November 21 – December 2, 2020

Hot Topics in Medical & Public Health Issues February 21 – 28, 2021

Call Toll Free 877-737-7005

www.PEStravel.com

Spring 2020 Just For Canadian doctors

a divisio

cme

calendar

Women’s Health

Radiology

Pain Management

cme when where

MORE CME Full-access CME calendar and destinations at justforcanadiandoctors.com/cme/

topic

sponsor

contact

website

Canadian Pain Society Scientific Meeting

Canadian Pain Society

416-642-6379

canadianpain society.ca

May 19-22

Calgary Alberta

Jul 16-19

Lake Buena Vista Florida (Walt Disney World)

Headache Update 2020

Diamond Headache Clinic Research & Educational Foundation & Amita Health

Jul 18-24

Newfoundland Land Tour

Practical Pain Management

Sea Courses

Oct 24-31

Iceland Land Tour

Pain Management Across The Continuum—From Prevention To Palliation: Movement, Motivation, Mindfulness, Medication

Sea Courses

Nov 21

Chicago Illinois

Update In Headache 2020

Diamond Headache Clinic Research & Educational Foundation & Amita Health

Dec 03-06

Lubbock Texas

33rd Annual Southern Region Burn Conference

Southern Medical Association

800-423-4992

sma.org

Apr 20-24

St. Petersburg Florida

Introduction To Adult Echocardiography

Gulfcoast Ultrasound Institute

727-363-4500

gcus.com

May 18-21

Houston Texas

Advanced ECG Interpretation Boot Camp

Medicus of Houston

713-931-5423

medicusof houston.com

Jun 29Jul 03

Bermuda

Abdominal, Musculoskeletal, Thoracic, Breast & Interventional Imaging

New York University Department of Radiology

212-263-3936

med.nyu.edu

Jul 13-16

Jackson Hole Wyoming

Imaging At Jackson Hole

CME Science

855-383-7116

diagnostic imaging update.com

Apr 17-19

New York New York

Survival Skills For Today’s Gynecologist Spring 2020

World Class CME

980-819-5095

worldclasscme. com

Apr 18

Toronto Ontario

Canadian Society Of Pelvic Medicine Annual Meeting

Canadian Society of Pelvic Medicine

416-586-4800

mountsinai.on.ca

May 14-16

Sonoma California

The Health Of Women Conference

University of California, Davis

events@ ucdavis.edu

health.ucdavis. edu

Aug 05-08

Paradise Island Bahamas

21st Annual Summer Conference On Women’s Health

Symposia Medicus

800-327-3161

symposia medicus.org

Oct 17-27

Sunshine in the Canaries Cruise

Women’s Health & Healthcare Communications

Continuing Education, Inc./University at Sea

866-456-9464

new CE to be placed Summer Radiology Symposium:

312-867-9104

See Ad Page 25

888-647-7327

See Ad Page 21

888-647-7327

312-867-9104

See Ad Page 25

See Ad Page 39

dhc-fdn.org seacourses. com seacourses. com

dhc-fdn.org

continuingedu cation.net

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

Just For Canadian doctors Spring 2020

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.

History lesson

Reflecting on a long career that’s seen many big and broad changes in the medical field

at your

solution from Winter 2020 contest

service

It was also this decade that saw the useful utilization of diagnostic ultrasound. This provided a relatively inexpensive, safe and mostly effective diagnostic tool. It’s used, for example, in diagnosing gallbladder pathology or, probably most prominently, as the obstetrical ultrasound—undertaken productively about two or three times even in uncomplicated pregnancies. In 1981, there was the introduction of captopril, the first ACE inhibitor. Initially indicated for the treatment of refractory hypertension, it introduced the first welltolerated antihypertensive and was also more than useful in treating congestive cardiac failure. Though it is no longer available in Canada, it did blaze the trail for ramipril and a whole bunch of other ACEs. This was shortly followed by ARBs that have proven equally useful and better tolerated. The development of PDE-5 inhibitors in 1981 has revolutionized the treatment of the distress in pulmonary hypertension, with the very useful side use for erectile dysfunctions. This was a difficult condition to treat in family practice, leading to my sense of helplessness and prescribing the useless placebo of yohimbine. In 1982 I had the first case of AIDS admitted to hospital; he was discharged with the diagnosis “viral infection NYD.” At that time this was a 100% fatal illness but now it’s another chronic disease with which to exist under medication.

Just For Canadian doctors Spring 2020

The result of these and many other changes means that physicians—all physicians—are able to offer patients many options and improved treatments. A few of these treatments will reduce the demands on the system; for example laparoscopy reduces hospital stays significantly. But this is more than offset by the needs of many patients—like the 59,000 hip replacements and 70,500 knee replacements last year in Canada. As I leave the profession it seems to be in a bit of a shambles. Wait times are becoming untenable again, and there is a chronic shortage of hospital beds and nursing home care. I am treading very carefully here because I want to avoid any misunderstanding. I am not suggesting an alternative private pay system. I am suggesting revisiting the politically unpalatable concept of a modest user fee for those that can afford it. As an example, my wife is now on a seven-to-nine-month waiting list (along with hundreds of others) to have a second knee replacement. During this time, I’ve witnessed her becoming increasingly disabled (now able to walk about 200 metres on the level). I’m fortunate to be able to pay a reasonable user fee—with no expectation of queue jumping. And I’d like to be able to do so. Can total medical care continue to be provided completely free? At the very least let us start a discussion…

sudoku 2 harder solution

8 6 2 4 9 1 5 7 3

3 9 5 2 7 6 4 8 1

1 7 4 8 3 5 6 9 2

7 2 1 6 8 3 9 5 4

5 8 6 9 4 2 3 1 7

4 3 9 5 1 7 2 6 8

2 5 3 7 6 8 1 4 9

9 1 7 3 5 4 8 2 6

6 4 8 1 2 9 7 3 5

Puzzle by websudoku.com

sudoku 1 easier solution solution from page 37

t has happened at last. I have finally terminated my provincial College licence. I orchestrated a soft landing from my original chaotic pace, but eventually had to quit taxiing along the runway and call it a day. This has inevitably made me look back over the 45 years since I first went into family practice in Canada in 1975. Looking back, the changes are great and numerous. I’ll admit that in 1969 (year of my UK graduation) I had hoped that by the time I retired from family practice I could say “oh, it’s just a cancer, take these and see me in a month…” Nevertheless, there have been many changes enabling physicians to offer hitherto unimaginable treatments as a result of unforeseen diagnostic tests and pharmacotherapies. I’m sure that many of the younger readers could not imagine practising medicine without the ready availability of the CT scan (1979), let alone the MRI (early 1980s) or even the PET scan (1995). This enhanced medical imaging, besides being a great help to oncology, also enabled (or at least facilitated) the development of effective and enduring joint replacements. The hip was first (early 1970s), then the knee (1970s through 1980s) and the successful shoulder (1985). The 1970s seem to have been a busy decade, during which the rapid development of computer chip-based microcameras was a pivotal event in the rapid introduction of laparoscopy and facilitation of flexible endoscopies.

7 4 3 8 9 6 2 1 5

5 2 1 7 4 3 8 9 6

8 6 9 2 5 1 4 3 7

9 1 4 5 3 7 6 2 8

6 5 2 4 1 8 3 7 9

3 8 7 6 2 9 1 5 4

4 3 8 1 7 5 9 6 2

1 7 6 9 8 2 5 4 3

2 9 5 3 6 4 7 8 1

Puzzle by websudoku.com

employment

opportunities

opportunities employment

Sierra Leone needs you! Sierra Leone is very, very poor. Their medical system is inadequate.

International Vision Volunteers Canada (IVVC) has recently opened a new general hospital near Makeni, Sierra Leone, West Africa. The plan is that the hospital shall be managed and administered by Sierra Leonean staff and be funded by fees for service, and be ďŹ nancially self-sustaining within a few years. It can be done, but we are not there yet. The hospital is operational, it has the basic medical equipment for forty beds, it has a keen young Sierra Leonean staff. What it needs now is technical medical equipment and instruments, and western expertise to train surgeons, doctors, and nurses towards better medical standards and techniques. In fact, we need YOU.

If you have expertise in any medical or dental specialty you can help to develop the skills of the local staff. The top eight immediate needs for help are: - Vaginal-vesical ďŹ stula - X-ray interpretation - Ultrasound interpretation - ECG/EKG interpretation

- Pregnancy management - Diabetic management - Cardiovascular management - Dentistry

The catchment area of the hospital is about 1,000,000 people. Tens of thousands of people need your help. Whether you can transfer your skills in two days, ten weeks, or even by email, Sierra Leone needs YOU! The air-conditioned accommodation is good; food is western, with African options.

If you can help us, please respond to amd@ivvc.ca

www.ivvc.ca

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motoring

D r . k e l l e n s i lv e r t h o r n Dr. Kellen Silverthorn is Just For Canadian Doctors’ automotive writer. He tries to keep one convertible and/or one track-day car in the family fleet.

Top-10 from 10

The big automotive takeaways of the last decade—from Elon to EcoBoost It’s fast and fossil-fuel free. Elon eschews the usual automotive industry domicile, dealerships and discipline. Sales of the now-aged Model S continue unabated, enjoying New-Age status symbol credibility. Competition is only arriving now. K2 STRENGTHENS AND MORPHS TO K3 (2014 +): Strides by Korean corporate siblings Hyundai/Kia/come-lately Genesis—in product, reputation, recognition—im-

[tesla]

McLAREN OFFERS ALTERNATIVE TO UNAFFORDABLE ITALIANS (2011): Many brands have tried, but McLaren actually succeeds in joining the Ferrari and Lamborghini brand echelon. I find it challenging tracking McLaren’s plethora of generally look-alike models. Nevertheless, the brand has dealerships in Montréal, Toronto and Vancouver. Calgary’s store must be imminent… TESLA AND ELON THE DISRUPTORS (2012): The expensive, svelte Tesla Model S sedan arrives in 2012 with polarizing effects.

WHEN A RANGE ROVER IS NOT POSH ENOUGH (2015): Since 1970, Range Rover has been the benchmark aspirational SUV. In 2015, Bentley pitches the Bentayga SUV far above the Range Rover’s price. (Indeed, Bentley offers a dash clock option costing more than an entire Range Rover.) It sells well. Lamborghini, Rolls Royce and Aston Martin all debut SUVs. Ferrari will be next. Hopefully, these brands don’t abandon automobiles to focus only on SUVs. CUTE UTES RULE (Q1 2019): Cars are steadily losing market share to light trucks. No longer is the Toyota Corolla/Honda Civic/Mazda 3 segment the top choice for first-time car buyers. Now, it’s the Toyota RAV4/Honda CR-V/Mazda CX5 cute utes. Canadian sales of the new RAV4 in Q1 2019 are 12,386, up 13% from Q1 2018. Meanwhile, Corolla sales are just 9,255, down 2%.

The Model S sedan sped into 2012: fast, fossil-free and a fresh New-Age status symbol

THE AFFORDABLE ITALIANS ARE COMING (2011 + 2014): Fiat returns to our shores in 2011, and then Alfa Romeo in 2014. Offerings are either cute or sporty. And we’re richer for their presence. North American brand viability remains somewhat in question, hopefully to be stabilized by the pending merger between FCA (Fiat-Chrysler) and PSA (Peugeot-Citroën).

700-hp muscle cars? Yes, and now Ford and Chevy have them too.

press. The Sonata of 2014 is key. By 2018 the siblings are claiming Car and Driver’s 10 Best Awards. Ditto Road & Track’s 2020 performance Car of the Year, the Veloster N.

TOYOTA SUPRA RETURNS, SORT OF (2019): The stylish Supra, absent since 1996, returns. Yet it’s arguably more BMW Z4 than Toyota. Scoop: via multinational joint venture, both the Supra and Z4 are Austrian-built by Magna-Steyr. Such corporate tie-ups underwrite many new sports models; witness the 2017 Subaru-Toyota BRZ/GT86, and the 2016 Mazda-Fiat MX-5/124.

F150 ESCHEWS Fe FOR Al (2015): In a shocking move, Ford morphs its family jewels (the F150 pick-up) from a steel to an aluminum body. This saves weight and thus improves fuel economy. Previously, aluminum bodies were reserved for rarified luxury and exotic cars. Ford has another key contemporaneous F150 pick-up truck innovation: EcoBoost Twin Turbo V6 engines instead of V8s. The F150 continues as the best-selling nameplate in North America.

CORVETTE FINALLY FLIPS (Q3 2019): Corvette engineers have been scheming to switch from front-engine to mid-engine since the late 1950s. With the new eighth-generation Corvette, that dream is achieved. It’s unclear, to date, if the rank and file of the greying Corvette Nation owners appreciate this “foreign car” change. Pricing will be sharp, at least initially.

HELLCATS FOR ALL (2015): We’ve all become a bit blasé about 700-horsepower rides, but in 2015 this is big news…almost illicit news, it seems. Head down to your Dodge (FCA) dealer and order up a Hellcat (supercharged Hemi) Challenger. Will the government actually go along with affordable

OK, full disclosure. Top-story billing goes to the extended steamroller that is SUV market share. Runner-up is Elon and Tesla (hey, relax, the Toyota Prius debut was in 1997). Honourable mention: the aluminum body Ford F150 pick-up truck with V6 EcoBoost. Bring on the Roaring Twenties!

Just For Canadian doctors Spring 2020

tesla

t seems like I was just writing the ’Naughties (2000–2009) review, and now here we are…another decade. And, hands down, 2010-to-present has been the more impactful decade for auto enthusiasts. I’ve chosen a vehicle that encapsulates my top-10 themes since 2010… and lost too much sleep trying to order by historical significance, so it’s a simpledoes-it, chronologic approach (after all, we accept chronologic for dental history).

RCAs and IPPs – Revisiting Tax-Advantaged Retirement Savings ROBERT DEAN, CPA, CA, CFP, TEP

or professionals, prior to 2018, typical tax planning was to incorporate, set up a family trust, save inside the company and split income with family members to manage your annual tax costs. With low tax risk, and being relatively easy to administer, it was an effective tool for longterm financial security. The federal government’s new limitations on earning investment income inside of corporations and significant restrictions on the ability to manage tax costs through income splitting turned more than 20 years of tax planning on its ear. The new rules are a part of the tax environment for the foreseeable future. What we need to do is to look at the tools we still have and determine how we make the best use of those to build a resilient plan which manages tax costs over your career and into your retirement. What is a retirement compensation arrangement (RCA)? This plan allows companies to put funds into trust to be paid to employees upon retirement. Larger companies may use an RCA to top up retirement benefits beyond those provided for by pension or other retirement benefits. RCAs can help highincome earners bridge the gap between the benefits RRSP provide and what they expect they will need in retirement. •

Four Key Advantages of RCAs Plan features are flexible

•

Contributions made to the RCA are not subject to payroll taxes and are tax-deductible.

•

Once a person retires, the access to funds is flexible. In particular, participants do not have to wait until age 65, they may take out lump sums, or income over time.

•

Like an RRSP, payments from an RCA are taxed personally when withdrawn in retirement.

Two Key Disadvantages of an RCA • Only half of the contributions to an RCA can be invested. Plan

contributions and investment income are subject to a 50 percent refundable tax. •

Neither the employer nor employee can directly control the investment assets while held in trust.

What is an individual pension plan (IPP)? An IPP is a defined benefit pension plan for one member. IPPs specifically benefit owners of incorporated companies who do not participate in an employer pension plan and who have annual earnings in excess of $120,000. Individuals should be at least 50 years of age to derive the maximum benefits from the plan. • •

Five Key Advantages of IPPs All contributions to an IPP can be invested. Contributions are tax deductible, allowing for efficient flow through of corporate savings / profit to business owner, bypassing new passive income rules and taxation.

practice 10 years ago and wishes to retire in seven years. She’s coming into the highest income earning years of her career and wants to focus the next seven years on her retirement savings. An RCA is flexible and an effective means of moving the taxation of income into the future, where taxable personal income is expected to be lower. Future marginal tax rates can provide a substantial tax advantage. By effectively doubling the invested capital over an RCA, an IPP results in the highest amount of invested assets in the shortest amount of time, growing to provide long term financial security. Which is best for Dr. Smith? If her biggest concern is the short-term cashflow gap between 57 and 65 and having funds available until her other retirement assets come to maturity, an RCA is an excellent tool to consider.

However, if Dr. Smith’s biggest concern is funding her lifestyle after age 65, then • IPPs fall under pension legislation, an IPP could provide substantial benefits. allowing you to split income in Maximizing the current tax deductions, retirement with spouse or significant maximizing the investment pool and other. deferring income taxation until after 65 are some of the ways to benefit from an IPP. • Contribution limits are higher than in RRSPs and you can top up your Finding out more contributions if the IPP does not achieve Professionals are high-income earning a 7.5 percent annual growth rate. individuals with complicated tax situations and retirement planning and have many • Assets are secured from creditors. more consideration than other individuals. Discussing your long-term plans with an Two Key Disadvantages of an IPP MNP advisor, in conjunction with your • The pension cannot be drawn upon financial and legal advisors on a regular (with limited exception) until the basis, leads to having a clear strategy and individual turns 65. Existing RRSPs peace of mind. By having a well-informed may need to be transferred into the team, we can identify opportunities like locked plan to fund past service. RCAs and IPPs or other estate and tax planning options that can help you realize • Plans are provincially regulated. your long-term financial goals. In some provinces, contributions may be mandatory regardless of Robert Dean, CPA, CA, CFP, TEP, is a the financial circumstances of the Business Advisor within MNP’s Tax Services individual or the company. Which is better: an RCA or IPP? Consider the hypothetical example of Dr. Smith. She’s 50, incorporated her

team. For more information, contact Robert at 902.835.7333 or Robert.Dean@mnp.ca.

Advertising Feature

t h e w e a lt h y d o c t o r M a n f r e d p u r t z k i Manfred Purtzki, CPA, CA, is a principal in the Vancouver office of Purtzki Johansen & Associates. He can be reached at: Manfred@purtzki.com or 604-669-7558.

Surprise attack

Don’t be stunned by large GST assessments

classifieds

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we can help. Let our 10 years of experience in Canada and our extensive knowledge of the licensure and recruitment processes work for you. View our current job postings on our website today. Website: www. physiciansforyou.com Office: (778) 475-7995 RADIOLOGISTS — Winnipeg, Manitoba Radiology Consultants of Winnipeg Medical Corporation is seeking fellowship-trained

Just For Canadian doctors Spring 2020

radiologists, certified by the Royal College of Physicians and Surgeons of Canada. Opportunities include oneweek locum tenens June to October 2020 and potential full-time roles for general and subspecialized radiologists. Radco is an established private radiology group based in Winnipeg, which owns and operates community clinics. Our radiologists are affiliated with the University of Manitoba, and

in a litigation or act as an expert witness. One exception is that if the doctor actually examines the individual, even at the request of a third party, then the courts have held that a doctor-patient relationship has been created and GST will not apply. Additional services that a doctor might provide and will trigger GST: 1

The doctor is paid to manage a medical office.

The doctor is paid an amount to be on call at a retirement home or nursing home.

The doctor is paid to give lectures.

The doctor is paid in a consulting capacity, for instance the development of a patent for a medical device.

And, be aware, if the CRA issues you a GST reassessment, that amount owing is payable—even if you file a Notice of Objection. This differs from income tax, for which the debt owing and payment can be deferred and delayed by filing a Notice of Objection. By understanding when and how GST applies to healthcare services, you can save yourself the unwelcome surprise of an unexpected tax bill.

provide professional services to several Shared Health Manitoba hospitals including the Health Sciences Centre, one of the largest tertiary care centres in Canada. Areas of practice include CT, X-ray, ultrasound, mammography, fluoroscopy, MRI, and interventional radiology. Interested radiologists please submit CV to: Margo Smith, Chief Operating Officer, Winnipeg, MB, MSmith@ radco-wpg.com.

travel PROVENCE, FRANCE — YOUR VILLA Les Geraniums, a luxury 3-bedroom, 2 ½-bath villa, is your home in the heart of Provence. Expansive terrace with pool and panoramic views. New kitchen and bathrooms. Walk to lovely market town. One hour to Aix and Nice. Come and enjoy the sun of southern France! 604522-5196. villavar@telus.net

istock

RA is reassessing healthcare profesrangement to share fees—irrespective of sionals for amounts paid for serwhether the locum or the principal is the vices that do not qualify as exempt initial recipient of the fees—CRA will not medical services. The amounts consider this to be a payment assessed, including interest for the supply of adminisand penalties, can be trative services made by well over $100,000. the principal to the And the reassesslocum. The underlyments that relate ing characteristic of to cost-sharing this arrangement arrangements is an apportionare particularly ment of the fee painful, because a for the healthcare simple restructurservice. Thus, ing of the arrangefor the purposes ment would have of the GST, the avoided the GST amounts apporliability altogether. tioned between the Here’s an example. two parties are not Doctors A locum works in subject to tax. beware…not the clinic and is Before you start reorganizallocated 100% of ing the clinic structure to avoid all medical the fees charged paying tax, please consult with services are tax to the patient. Out your CPA about setting up such a exempt of the fees received, GST-exempt arrangement. the locum pays the Similarly, cosmetic procedures principal for using that have no medical or reconstructhe clinic, the staff and tive purpose are subject to GST. You must equipment. And, in this case, the principal register if you generate $30,000 or more must remit GST on the fees received from of such taxable services over any four the locum. consecutive calendar quarters. On the other hand, when the locum Another scenario in which GST may and principal enter into a bona fide arapply is when a doctor is paid to consult

travel at home

beyond the

falls

After the spray of that famous waterfall, discover the rest of the Niagara Peninsula story + photography by Lisa kadane

clockwise from top left

Sunrise over Horseshoe Falls; Family-run Honsberger Estate Winery was originally a farm; Soaking in the vineyard views at Two Sisters; Locally caught pickerel on the menu at Vineland Estates; Boardwalk that parallels Class VI rapids along the Whitewater Walk

Just For Canadian doctors Spring 2020

travel at home

t’s just 80 metal steps from the top of the Niagara escarpment down into Niagara Glen, but it feels like a journey back in time. The lower I descend, the more the limestone cliff walls soar above me, revealing 250-million-year-old trilobite fossils imprinted into the easily eroded shale along the Cliffside Trail. I’m only seven kilometres from Niagara Falls, Canada’s most well known natural wonder visited by 12 million people annually. On this network of trails that cuts through a lush forest, however, I’m alone. The famous waterfall crashed down in this very spot some 8,000 years ago, but as the waters’ power eroded the land, the falls travelled south to their present location. In its place, a Carolinian forest of broad-leaf trees flourished thanks to the relatively warm and humid climate nurtured by the surrounding Great Lakes. I hike past tulip trees, a kind of magnolia, and 800-yearold white cedars. Moss covers everything from fallen logs to giant boulders. It feels downright Jurassic all the way to the river’s edge, where water courses down the Niagara Gorge in a tumult of rapids and eddies. It’s as though I’ve stumbled upon a secret world. I almost forget where I am until a jet boat packed with tourists whizzes up-river, snapping me back to reality. This secluded hiking spot is one of many surprises I discover on the Niagara Peninsula. In the days that follow I’ll visit quaint wineries, a top-notch theatre in a postcard-cute town, and an educational museum, all close to the area’s namesake calling card. I first visited Niagara Falls as a teenager over three decades ago, on a day trip from Toronto. My mom and I posed for the obligatory misty photo close to the brink, and rode up to the top of the Skylon Tower for a birds-eye view of both Horseshoe Falls and American Falls. Then we called it a day. I have no memory of the Coney-Island-meets-Las-Vegas vibe of adjacent Clifton Hill, where tourists meander the midway, waiting in line to play dinosaur mini golf, ride the new multi-level go-kart speedway or visit the wax museum. In the past 30 years the Canadian side has been built up. There’s a new casino, and construction is nearly complete on an adjacent entertainment centre. You can even zipline above the Niagara River toward Horseshoe Falls for a thrill. The real draw, though, is still the falls. They’re even more magnificent than my childhood memory—a ceaseless torrent that churns 7,500 bathtubs worth of water over the brink every second. They create a constant mist, a deafening roar and an eternal rainbow that shifts between the American and Canadian border. Their power is mesmerizing and it’s easy to understand why this spectacle of nature has drawn daredevils, tourists and honeymooners since the 1820s. In fact, marriage proposals are still common onboard the Hornblower Niagara Cruises boats, which ferry poncho-clad sightseers into the mist of Horseshoe Falls multiple times a day. Spring 2020 Just For Canadian doctors

travel at home

About the same time I was admiring I learn about the falls’ history of romance and derring-do in bits and bobs Niagara Falls with my mom, the first wine grapes were being planted in the as our group explores the water works region. There are now 97 VQA wineries in different ways. We do the Journey on the Niagara Peninsula, from boutique Behind the Falls to travel through tunnels operations to large estates. The same under Horseshoe Falls and feel the thundering vibrations summer climate that sustains a Carolinian forest is also ideal for as the surge of water growing wine grapes such as shakes the bedrock Riesling and Cabernet Franc, above. Along the if you go but being in Canada poses Whitewater Walk, a unique challenges. wooden boardwalk Discover Niagara’s charms at niagarafalls that parallels the “We fight nature here tourism.com and southern all the time,” confides Kelly Niagara River and Ontario’s at ontario Mason, the winemaker at its frothing Class VI travel.net. Honsberger Estate Winery rapids, interpretive while we sip the 2018 rosé at signs describe the the outdoor patio bistro. rapids, the region’s Humidity from the surrounding geology and the history lakes, combined with an early frost of the falls’ barrel riders and some years, can spell trouble for grapes. tightrope walkers. Winemakers work with the conditions by After a day or so of waterfall positioning their vines to take advantage “immersion,” I’m ready to escape the of natural airflow and by vigilantly crowds. It’s a quick drive to adorable watching the fall forecast. Niagara-on-the Lake for shopping and In addition to grapes, everything else theatre and, as a budding oenophile, I’m grows well here, from peaches and apples excited to visit nearby wine country.

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to most vegetables. In fact, Niagara has become somewhat of a foodie paradise. “One thing that’s grown with the wine is the food industry in Niagara,” confirms David Hulley over lunch at Vineland Estates Winery. “We live farm to table here.” We dine on red pepper bisque paired with sauvignon blanc, then move on to Lake Erie pickerel washed down with buttery chardonnay. For dessert, there’s light vanilla bean cheesecake served with sweet Vidal Icewine. It’s all delicious. The inspired dining and wine sipping carry on at Peller Estates and Two Sisters Vineyards in Niagara-on-the-Lake, on the southern shore of Lake Ontario. The man versus nature theme continues at the Welland Canals Centre in St. Catharines, where humans’ quest to tame the land is detailed with historic accuracy. The Great Lakes have always been a way to ship goods between Thunder Bay and the Atlantic Ocean via the St. Lawrence River, but getting into the upper lakes was difficult because of Niagara Falls. The solution was the Welland Canal, an engineering marvel completed in 1923. Its eight concrete locks rise up 99 metres in 43 kilometres (the highest canal lift west of China) and make it comparatively easy to transport natural resources east, or manufactured products west, along the inland waterway. It’s interesting to think of Niagara Falls as an obstacle to be overcome rather than a wonder to witness. On our last night in the area we watch a performance of Brigadoon at the renowned Shaw Festival Theatre in Niagara-on-the-Lake. The classic musical is a tale of adventurers who get lost in the Scottish highlands and end up travelling back in time to an enchanted town called Brigadoon, which isn’t what it seems. It’s an apt metaphor for my return to Niagara Falls, which has been its own journey back in time. I’ve learned about daredevils and romantics, winemakers and engineers, and I’ve discovered my own secret and ancient world at Niagara Glen. Though the spectacular waterfall is what draws people here, upon arrival they realize the region is so much more than a natural wonder.

diversion

sudoku

4 ways to win a $50 Amazon gift card! Follow us on either Facebook, Instagram or Twitter contest! (or all 3!), facebook.com/ OR solve justforcanadiandoctors Sudoku @justforcanadiandoctors puzzle #2. #justforcanadiandoctors @JFCDoctors Each social Contest closes May 15, 2020 media follow and is open to practising Canadian doctors. = one entry! Each sudoku puzzle has a unique solution that can be reached logically without guessing. Fill in the grid so that every row, column and 3x3 square contains the digits 1 through 9. GOOD LUCK!

sudoku 2 harder solution in next issue

sudoku 1 easier solution on page 26

$50 Amazon Gift Card winner: Dr. Chris Elzinga of Calgary, AB

APRIL 1, 2020 ABSTRACT SUBMISSION DEADLINE JULY 29, 2020 EARLY REGISTRATION SAVINGS DEADLINE

3 1 8 3 7

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52ND CONGRESS OF THE INTERNATIONAL SOCIETY OF PAEDIATRIC ONCOLOGY OTTAWA, CANADA OCTOBER 14-17, 2O2O

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3 9

2 1

4 3 6 9 7

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Spring 2020 Just For Canadian doctors

s m a l l ta l k

doctors share their picks + pleasures dr. gigi osler lives and practises as an ENT surgeon in her favourite city—Winnipeg!—where she’s also an Assistant Professor at the University of Manitoba. She served as the President of the Canadian Medical Association from 2018–19, the first female surgeon to take on the role in 151 years, and has volunteered on a medical mission with Canadians Helping Kids in Vietnam (chkv.org), a Winnipeg-based charity. She’s also trained surgeons in Africa, hiked the Camino de Santiago, and does hot yoga… We say namaste! My name: Flordeliz Gigi Osler I live in: Winnipeg, MB My training: BScMed, MD, FRCSC Why I was drawn to medicine: I knew in medical school that I wanted to be a surgeon and

psychologically challenging, and spiritually uplifting. Beautiful scenery and amazing food. A favourite place that I keep returning to: The beach. Can’t believe I’ve never been to: Fiji. Because it rhymes with Gigi.

Dream vacation: Would love to finish hiking the Camino de Santiago. Favourite city: Winnipeg! Great people, affordable living, beautiful parks, short commute to work, lots of activities for families.

Favourite book: A Fine Balance by Rohinton Mistry. Must-see TV show: Still love Game of Thrones. I’d describe my home as: Welcoming, messy, full of love.

My fridge is stocked with: Dodgy-looking leftovers of unknown origin and age. My guilty pleasure: Eating chocolate and potato chips at the same time. My go-to exercise/ sport: Hot yoga. My secret to relaxing and relieving tension: Spending time with my family. A talent I wish I had: A good singing voice. Do I have a singing voice? Yes. Is it good? No. A big challenge I’ve faced: Saying ‘no’ to things that excite me and that I am passionate about. I’m inspired by: My colleagues— hardworking Canadian doctors, medical students and residents.

was drawn to Otolaryngology-Head and Neck because of the elegance of the surgery and the variety of subspecialties. My last trip: Hiking the first part of the Camino de Santiago in northern Spain with my husband. It was physically hard (we did no real hiking before the trip),

Don’t need to go to: Mount Everest. I used to think that I could be a mountain climber but now realize that No, I Am Not A Mountain Climber. When we hiked the Camino de Santiago, the first day was spent going up the Pyrenees from France into Spain. That was hard. It was then that I realized that I Am Not A Mountain Climber.

Just For Canadian doctors Spring 2020

I always travel with: Hope, good intentions, my flat iron.

My car: Is always in need of a good interior and exterior car wash.

Best souvenir I’ve brought back from a trip: A puppy. From Saskatoon. It’s a long story…

Last purchase: Hand lotion (literally my last purchase).

My jet lag cure: I would LOVE to know a good jet lag cure—someone please share.

Last splurge: Hand lotion (it has shea butter). Most-frequented store: Amazon.

On my must-do list: I don’t really have a must-do or ‘bucket list.’ You never know when your time is up and I don’t want to have regrets about places I haven’t visited or things I haven’t done. If I wasn’t a doctor, I’d be: Working for a charity or NGO in a lowincome country.

courtesy of dr. Osler

My motto: Work hard, rest hard, and find joy in what you do.

For more information Call 866-456-9464 or visit www.ContinuingEducation.net Continuing Education, Inc. University at SeaTM

Topics in Critical Care

10-Night Blue Danube River Bucharest, Romania to Vienna, Austria Amadeus River Cruises’ Amadeus Silver II August 15 - 25, 2020

Allergy, Immunology and Infectious Diseases May 1 - 9, 2020 8-Night Spain & France Round-trip Southampton, England Celebrity Cruises‘ Celebrity Silhouette

Critical Care, Emergency Medicine, and Neurology June 5 - 15, 2020 10-Night Italy and Best of Greek Islands Round-trip Rome (Civitacecchia), Italy Celebrity Cruises’ Celebrity Edge

Family Medicine & Behavioural and Developmental Pediatrics June 13 - 20, 2020 7-Night Alaskan Explorer Round-trip Seattle, Washington Holland America Line’s Eurodam

Cardiology and Geriatrics

June 18 - 28, 2020 10-Night Scandinavia & Russia Copenhagen, Denmark to Stockholm, Sweden Royal Caribbean’s Jewel of the Seas

Current Topics in Family Medicine July 19 - 26, 2020 7-Night Norse Legends Round-trip Amsterdam, The Netherlands Holland America Line’s Nieuw Statendam

Infectious Diseases and Immunizations: A Comprehensive 2020 Update July 30 - August 8, 2020 9-Night Best Of Italy Venice, Italy to Rome (Civitavecchia), Italy Celebrity Cruises’ Celebrity Constellation

Emergency Medicine and Pediatric ENT August 8 - 16, 2020 8-Night Scandinavia and Russia Round-trip Copenhagen, Denmark Royal Caribbean’s Jewel of the Seas

Selected cruises listed here. See a complete program listing at www.ContinuingEducation.net Accreditation:

Continuing Education, Inc is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

Women’s Health & Healthcare Communications 10-Night Sunshine In The Canaries Cruise Round-trip Southampton (London), England Royal Caribbean’s Anthem of the Seas October 17 - 27, 2020

Delivering Personalized Medicine & Topics in Allergy and Immunology September 05 - 12, 2020 7-Night Greek Isles Round-trip Venice, Italy Royal Caribbean’s Rhapsody of the Seas

Updates in Diabetes, Obesity, Preventive Cardiology, and Advanced Lipidology October 27 - November 03, 2020 7-Night Classical Danube River Budapest, Hungary to Passau, Germany Amadeus River Cruises’ Amadeus Star

Family Medicine and Sports Medicine December 05 - 12, 2020 7-Night Hawaiian Islands Round-trip Honolulu, Oahu, Hawaii Norwegian Cruise Line’s Pride of America

Topics in Sports Medicine and Mental Health December 26, 2020 - January 02, 2021 7-Night Southern Caribbean Holiday Cruise Round-trip San Juan, Puerto Rico Celebrity Cruises’ Celebrity Summit

Healthcare Communications & Depression, Anxiety and Borderline Personality Disorders: Strategies for Treatment in Primary Care January 25 - February 05, 2021 11-Night Panama Canal Cruise Round-trip Tampa, Florida Celebrity Cruises’ Celebrity Constellation

Topics in Family Medicine

February 12 - 21, 2021 9-Night Australia & New Zealand Cruise from Sydney, Australia to Auckland, New Zealand Celebrity Cruises’ Celebrity Solstice

Neurology on the Nile

March 07 - 15, 2021 8-Night Egyptian Treasures Nile Cruise from Cairo, Egypt to Cairo, Egypt Sonesta MS Moon Goddess

Call 866-456-9464 or 727-526-1571 or visit www.ContinuingEducation.net Please visit our website for current fees and cancellation policies. Florida Seller of Travel Reg. #14337

Just For Canadian Doctors Spring 2020

Articles inside

doctor on a soapbox

small talk

motoring

the thirsty doctor

the wealthy doctor

pay it forward

spring mix