Just For Canadian Doctors Spring 2016 by Just For Canadian Doctors

spring 2016

DOCTORS life + leisure

Italian

reverie

wolf watch in

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inside: Continuing medical Education Calendar where will you meet? ta m pa / o t ta wa / e d i n b u r g h / n e w y o r k /

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Just for C

DOCTORS life + leisure

contents

spring 2016

spring 2016 Publisher Linh T. Huynh

Editor Barb Sligl Art Direction BSS Creative

Contributing Editor Janet Gyenes

Editorial Assistant Adam Flint

Contributors Michael DeFreitas Janet Gyenes Chris Pengilly Manfred Purtzki Dr. Kellen Silverthorn Barb Sligl Jenn Smith Nelson Roberta Staley Catherine Tse Cover photo Janet Gyenes

19 30

Senior Account Executive Monique Nguyen Account Executives Lily Yu Wing-Yee Kwong Production Manager Ninh Hoang

Circulation Fulfillment Shereen Hoang

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

FEATURES

19 atop Italy Exploring the backyard of Amalfi 30 into the wild With wolves in Saguenay-Lac-St-Jean COLUMNS

DEPARTMENTS

8 photo prescription

5 spring mix 23 CME calendar 37 sudoku 38 small talk

Capturing the magic of Malta

clockwise from top left: Janet gyenes; Barb Sligl; Janet Gyenes

Just For Canadian Doctors is published 4 times a year by Jamieson-Quinn Holdings Ltd. dba In Print Publications and distributed to Canadian physicians. Publication of advertisements and any opinions expressed do not constitute endorsement or assumption of liability for any claims made. The contents of this magazine are protected by copyright. None of the contents of the magazine may be reproduced without the written permission of In Print Publications. In Print Publications 200 – 896 Cambie Street Vancouver, BC V6B 2P6 Canada

11 pay it forward Healer without borders

12 motoring

Dr. Michele Foster

The original “green”car gets a fresh look

17 the thirsty doctor

Four ways to amp up your bar

35 the wealthy doctor

www.justforcanadiandoctors.com Printed in Canada.

want to reach us? check out our website!

Smarter estate planning

36 doctor on a soapbox

Safe(er) narcotic prescribing cover photo

Views of Atrani, southern Italy’s smallest town, with its majolicadomed church, and the impossibly blue waters off the Amalfi coast (page 19).

Spring 2016 Just For Canadian doctors

from the editor

pring is that time of year that’s a bit in limbo…it’s still chilly in many places in this part of the world but things are heating up. Especially on the Amalfi coast. Discover la dolce vita, which is found in excess on the west coast of Italy, where the sweet life is a sensory experience best sampled on foot. Take a tour of Amalfi’s backyard along a hiking network through rustic villages, lemon and orange groves, past mules with pitstops for pizza and jawdropping views (page 19). Ahhh, Italia… And while in Italy, it’s a short side trip to the storied ruins of Pompeii, recently refurbished (page 5). A longer side trip will take you to Malta, off the Spanish coast, to practise your photography skills (page 8). Back on home turf, start planning a trip to Montréal for a spring or summer shopping/spa-ing/sampling getaway (page

6). Doing the sun salutation atop Mont Royal? Mais, bien sûr! For a rather different Quebec adventure, plan the experience of a lifetime at Park Mahikan, a wolf sanctuary deep in the boreal forest of the Saguenay-Lac-StJean region. There you can meet on alpha wolf Luna (a female!) and her beta (and brother) John. This pack of grey wolves is the furry family of Frenchman Gilles Granal, who fell in love with this corner of the wilds of Quebec on a visit almost 30 years ago and never left. A wolf whisperer of sorts, his unique set-up is first and foremost about the wolves…and if you’re lucky you may get a taste of what it feels to be a part of the pack (page 30). And after getting in touch with your inner wolf, there’s blueberries, bears and beers…

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the

Amalfi coast

Janet Gyenes

la dolce vita

Italian reverie… High above Capri, lemons and limoncello in Amalfi, and medieval Atrani. Story on page 19.

A beer is definitely in order after this magazine’s recent showing at the annual North American Travel Journalist Association’s awards. Between Just for Canadian Doctors and its sister publication, Just for Canadian Dentists, our contributors won two golds, two silvers, two bronzes and were six finalists! Wow. On behalf of all our associates, partners and supporters, congratulations to regular contributors Lucas Aykroyd, Michael DeFreitas, Tim Johnson, Jenn Smith Nelson (her Saskatchewan story/photography is below) and Barb Sligl for their 2015 NATJA awards for excellence in travel writing and photography. It’s an honour that this magazine was showcased among other esteemed publications (see the full list of award winners at natja.org). Such award-winning work is what continues to make this magazine a must-read for doctors. Thank you! Any ideas, comments or questions? Reach us at feedback@InPrintPublications.com. ome travel at h

NATJA 2015 bronze award winner!

ome travel at h

prairie unplugged

escape in

wa sa sk a tc h e

e rounding, riding, cattl all offer all play, trail nelson round of foosb where horse and even a need StORy + PHOtOgRAPHy By jenn sMith lassoing, beer ent you the entertainm

For canaDian Spring 2015 Just

Just For Canadian doctors Spring 2016

Just For canaDian

2015 Doctors Spring

Doctors

what/when/where > spring

new days of

pompeii

On the southwest coast of Italy, the sun’s rays carry their heat into the afternoon over Pompeii, casting long shadows over the crumbling capitals of the basilica. They stand sentinel in front of ruins of the Temple of Venus, whose namesake goddess was supposed to protect Pompeii. Public fountains—25 at one time—are now devoid of water. Vestiges of the covered markets, once vibrant hubs in this metropolis of almost 12,000 people, are colourless and silent. But the ominous cinder cone of Mount Vesuvius still looms over the remains of the day, a constant reminder that despite its last eruption in 1944, it’s still active. — Janet Gyenes

mix

history tour

Remains of Pompeii’s Bas ilica, the oldest kn o wn basilica in th e Roman worl d

uncovering the past

janet gyenes

Pompeii Ruins Restored

Five houses adorned with lavish frescos and a surprisingly sophisticated laundry facility have been restored and reopened to the public as part of the 105-million euro Great Pompeii Project. The UNESCO World Heritage Site located 26 km south of Naples had been under threat of losing its status thanks to deteriorating conditions, including the 2010 collapse of the House of Gladiators. When Mount Vesuvius erupted in AD 79, its ashes shrouded the city of Pompeii and toxic fumes snuffed out the lives of people as they went about their daily business. But the ashes that buried Pompeii also preserved it, suspending the city in time and providing archeologists with an intimate portrait of how middle-class Romans worked, lived, played and prayed during the first century AD. Restored homes include Pompeii’s largest house, the Villa of Mysteries, with its intriguing frescoes that some believe depicts a woman being initiated into Bacchus’s mystery cult. To plan your visit go to pompeiisites.org. — J.G.

Spring 2016 Just For Canadian doctors

mix

mais oui!

spring

Make your way to the top of Mont-Royal and reach for the sky with a sun salutation.

Munch and mingle over fine fare and bubbly at La Champagnerie. Marché Bonsecours public market has been around for over 100 years.

wellness getaway in

anada’s second largest city revolving around two iconic landmarks: the mighty Saint Lawrence River and Mont-Royal, is the ideal place to relax and recharge. Eat, drink, spa and shop the photogenic streets of the super multilingual and ethnically diverse city, Montréal.

Stop in for bubbly + eats at La Champagnerie Just off of trendy Saint-Denis, this champagne bar sits across from the beautiful domed Marché Bonsecours, a market showcasing upscale clothing and jewelry. Devour delectable charcuterie, get- or boccioni fries with salad, away watermelon while you sip on a glass of bubbly such as rose, Tartlant, Brut Nature. Sabre your own bottle and add the cork to their cork wall!

Boutique shopping at its best along Quartier des spectacles.

Shop along Quartier des Spectacles and Old Montréal Meander pedestrian-friendly Saint-Paul Street before making your way over to Place Jacques-Cartier; a lively area with street performers musicians and artisans. A short walk away, Quartier des spectacles is filled with boutique shopping at quaint little pop-up trucks full of designer goods. If you visit in the summer during Le Festival Mode & Design, be sure to take in the live fashion shows featuring mainly local fashion designers and retailers. GET your wellness on Tote your mat along and hike up 234-metrehigh Mont-Royal for a yoga session (and fantastic view!) atop the city. Or consider taking to warm waters of the Saint Lawrence River for a stand up paddleboard lesson with outfitter, KSF, near the city’s famed Lachine Rapids. Home of the “bixi” bike, Montréal is an easy place to zip through the streets

Just For Canadian doctors Spring 2016

Montréal

on your own, or with a guided tour. Fitz & Follwell’s “Hoods and Hidden Gems” tour will see you through the posh tree lined neighbourhood of Outremont (Pierre Elliott Trudeau resided there), where ivy-covered townhouses and hydrangea trees litter the yards, then over to trendy, Mile-End; a neighbourhood boasting Canada’s largest concentration of artists, with it’s Soho / Greenwich village feel. Before leaving the area, refuel at two of its most popular stops: Open since 1957, Saint-Viateur’s flagship bagel shop not only make the city’s best bagels, the lined up out the door café, is also a landmark. Get your caffeine fix with a macchiato or latte at the also bustling, Olympico Café. Bliss out at Bota Bota, spa-surl’eau Some things are just better the second time around. Take in garden and city views day or night by heading to this charming refurbished ferry in

Montréal’s Old port for a day of spa-ing with three levels of water circuits. Peek through a porthole; savour lunch out on the deck, hang in a hammock, or zen out with a signature Bota Bota massage, featuring 60 minutes of fluid, choreographed movements set to music. Rest your head at Hôtel Le Germain Montréal A few kilometres away from historic Old Montréal and iconic Notre-Dame Basilica, a stay at Le Germain ensures easy access to most of the city’s most visit-worthy spots. Modern rooms with sitting areas, incredibly cozy duvets and beds, and even some suggested reading on the bedside table, make downtime and hitting the sheets a luxurious experience. — Jenn Smith Nelson if you go Get more info at tourisme-montreal.org and quebecoriginal.com.

jenn smith nelson

spring fling

Peep through Bota Bota’s portholes for views of old Montréal and the St. Lawrence River.

necessary goods

spring

mix

a little luxury

Smart indulgences come in compact packages Written + produced by Janet Gyenes

St. John sturgeon

fancy fish

Searching for a château in France? Or an abode on a private island in say, Maldives or Malaysia? Does your list of hotel tech must-haves include a spa, wine cellar or rooftop where you can watch sailboats on Istanbul’s Bosphorus sea or the throngs in Midtown Manhattan? Find it all using the new Small Luxury Hotels of the WorldTM app, which acts as chic concierge for its curated collection of 500-plus hotels in 80 countries from Antigua to Saudi Arabia. Browse galleries of images, use the “hotels near me” function when you’re on the go, book a suite—and share it all on social media. For an added touch of luxe, join The Club to create your personal profile, including your favourite type of hotel, pillow preference, and more. Free; iTunes.ca ElevateD in-flight In our minds, the perfect Old Fashioned is equal parts art and science, depending on the maker and the imbiber. But it’s best not to make grandiose requests—especially when you’re in flight. Try telling the crew that you prefer your cocktail with two dashes of aromatic bitters and extra sugar to satisfy your sweet tooth. Now you don’t have to, thanks to the Carry On Cocktail Kit. the booze, the compact drink Minus tin comes with the essentials you require—aromatic bitters, bar spoon, cane sugar and linen napkin—for making two Old Fashioneds to your liking mid-flight. Champagne Cocktail, Gin & Tonic and Moscow Mule kits are also available. Bottoms up! $26; cocktailemporium.ca

sustainable seafood

sweet sleeps

If you mention the words “steak and eggs” to Cornel Ceapa and his wife, Dorina, they’ll probably think you’re talking about sturgeon. The couple started Acadian Sturgeon and Caviar Inc. in St. John, New Brunswick, after leaving their native Romania. The briny eggs and meaty loins are harvested from wild-caught sturgeon in the Saint John River and entire fish—from “nose-toeat the tail”—is processed and sold, often to chefs. Sustainable practices mean that the sturgeon population on the East Coast is increasing. In fact, the family’s landbased aquaculture business (Cornel has a PhD in sturgeon biology), while not yet fully mature, aims to help repopulate regions where sturgeon stocks are in decline due to overfishing. So indulge, guilt free. Vodka, dry Champagne and white wine complements the buttery taste of caviar. From $60/30 grams; acadian-sturgeon.com

BE a Mix

Master

It’s all inside! JustFor ForCanadian Canadiandoctors dentists Spring 2016 Just

p h o t o p r e s c r i p t i o n m i c h a e l d e f r e i ta s Michael DeFreitas is an award-winning photographer who’s been published in a wide variety of travel publications. With his initials, MD, he’s been nicknamed “doc,” making his photography prescriptions apropos.

rock of ages

The mists of antiquity still swirl around the islands of Malta

Send photos and questions to our photography guru at feedback@ inprintpublications.com and your shot may be featured in a future issue!

destination photography

Apply your photography skills to the shooting situations of malta.

no tripod? no problem

The Catacombs of St. Paul in Rabat, Malta, don’t allow tripods on site. Bummer. Faced with very low light and no tripod, I look for a corner wall to press my camera against. Using a wide-angle zoom (14–24mm) set to 20mm, I preset the controls for f16 at 20 seconds, pre-focused in manual focus mode and turn on the 5-second self-timer feature. I hit the shutter release and press the camera against the wall until I hear the shutter release. I repeat the process with different apertures and shutter speeds.

Just For Canadian doctors Spring 2016

if you go

For more info on Malta: visitmalta. com

michael defreitas

or millennia, the azure Mediterranean has nourished a succession of civilizations prompting most historians to refer to it as the cradle of Western civilization. And smack dab in the middle of this cradle, at the crossroads between Europe, Africa and the Middle East, lie the tiny, captivating islands of Malta. Over the last 7,000 years, the Phoenicians, Romans, Knights of St. John, Normans, Turks, Spanish, French and British have all added their own spice to Malta’s eclectic cultural melting pot. No other European country offers a more diverse blend of history and culture in such a compact package. For an opening image that captures Malta and establishes “place”—something I try to do for every destination I visit—I spend my first morning shooting the capital, Valletta, at sunrise. I position myself across the bay and use a medium telephoto lens (~70mm) to pull in the skyline. A two-stop neutral density filter helps tone down the bright sky and allows me to add a bit more exposure to the silhouetted skyline. This technique renders more detail to the buildings instead of turning them into an underexposed mass (bottom, right). The resulting images resemble any typical European city sunrise, so my plan is to return for my “this is Malta” image. Luckily, the fishing boats are back at their moorings in the afternoon so I incorporate one into the foreground of my scene. I use a longer telephoto zoom lens (set at 130mm) and a fairly shallow f8 depth-of-field so the background cityscape doesn’t overpower the boat. I focus on the bobbing vessel and use a higher shutter speed (1/250 sec) to freeze its movement. Next on my image list are a series of signature images, much like the Eiffel Tower or Big Ben, which will differentiate this destination. And Malta is so special that it’s easy to find signature images. The country’s forts, cuisine, ancient architecture and people offer an array of choices, but I hone in on Malta’s old colourful buses and fishing boats (bottom left and top right). The buses come in all shapes and designs, so after taking a few full-length shots I concentrate on their front grill work. I use

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okanaganlife.com PROGRESS 2016

find the story in a destination

a medium zoom (35–70mm) and shoot from a distance to avoid the distortion typical of shooting close with a wide-angle lens (14–24mm). I set up base at the main bus terminal and position myself with the late afternoon sun over my shoulder and shoot buses leaving the station (f11 and 1/250 sec shutter speed to freeze the movement). The fishing boats require a similar approach. Most Maltese boats have the eyes of Osiris painted on their bows. The fishermen believe these eyes usher a safe return to port in foggy weather. I capture them, anchored yet gently bobbing, using a medium telephoto (24–70mm) using f11 and 1/250 sec to freeze movement. Then, in the late afternoon, I find some beached boats and highlight their bows at f16 and 1/30 sec (with a tripod). Inland, I walk the streets. Given the country’s age, many Maltese villages have narrow lanes—some so tight that cars aren’t allowed in the historic centres. I search ancient Mdina for darker streets with sunlit buildings in the background and use the edges of the cobblestone streets or buildings as leading lines to draw viewers into the scene. I set up a tripod and wait for subjects to enter the street, recording the scenes at f16 and 1/60 sec. The backlit and slightly underexposed subjects add a sense of mystery (previous page, top left). Every story needs a good ending, especially a travel photo essay. Often, I’m not sure which image will give the best closure, so I take a variety of shots and make my final selection during the editing process. My closing shot for Malta is an old man leaning on a wall, spectacles resting low on his nose and eyes slightly shaded by his felt hat (left). I use a telephoto zoom (70–200mm) set at 180mm and snap six photos at f5.6 and 1/500 sec (the higher shutter speed reduces camera shake). I also preset my exposure control to overexpose by half a stop to brighten his shaded face. It’s a fitting send off or addiju.

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michael defreitas

photo prescription [continued]

pay i t f o r w a r d

r o b e r ta s ta l e y

Roberta Staley is an award-winning magazine writer and the editor of the Canadian Chemical News, published by the Chemical Institute of Canada. She is also a magazine writing instructor at Douglas College and a graduate student at Simon Fraser University.

healer without borders A doctor gives back in Southeast Asia

courtesy of Friends Without A Border

halassemia is an inherited disorder causing severe anemia in children due to an abnormal form of hemoglobin in red blood cells. When Cheri Nijssen-Jordan of Calgary examined the young Laos boy— one of five siblings who were all stunted, pale and perpetually fatigued—thalassemia was the first thing that came into her mind. When a blood test revealed a hemoglobin level of 18—“the lowest I’ve ever seen”—the thalassemia diagnosis was confirmed. An immediate blood transfusion was needed. (A hemoglobin level of 120–130 is normal in children.) Thalassemia afflicts many kids in Laos, a Southeast Asian country squeezed between Thailand and Vietnam. Nijssen-Jordan has lived in Laos since last April following her appointment as executive director of Lao Friends Hospital for Children, a non-profit, full-service pediatric hospital that is funded by Friends Without A Border, an NGO based in the United States and Japan that provides medical care to children in the region. Nijssen-Jordan met the boy and his family following a homecare outreach trip. Tests were carried out in the hospital, located in Luang Prabang province, followed by a blood transfusion. The boy’s condition was so severe—his heart so enlarged—that he was a week away from death, Nijssen-Jordan says. His sibling, who had a hemoglobin level of only 30, also received a blood transfusion. “They went from being as white as ghosts to happy little kids running around and they’re back at school,” says Nijssen-Jordan. “For us that is a real success story.” The hospital opened in February 2015 to provide free medical care to the children of northern Laos. A former French colony, Laos endured genocide in the 20th century and continues to struggle with hunger, poverty, corruption and a lack of international investment. Hospitals exist, but parents are charged an admission fee and have to pay for medical tests, drugs and treatment. “They discharge themselves because they don’t have money to pay so that results in no treatment or inadequate treatment; it’s a terrible situation for children,” says Nijssen-Jordan, a mother of four. The Lao Friends Hospital for Children has

signed a Memorandum of Understanding in southeastern Africa during a two-year with the national government to become period helping establish a mobile outreach the pediatric ward for the Luang Prabang clinic program. To enhance her adminProvincial Hospital. As head administraistration skills, Nijssen-Jordan undertook tor, Nijssen-Jordan oversees the training of an MBA, then joined the design teams at national staff as well as Alberta Children’s Hospital and South Health the hospital’s expanCampus Calgary. Working with architects, sion. Currently the patients and parents, Nijssen-Jordan Dr. Cheri facility sees about focused on making the hospitals “as Nijssen-Jordan, 55 patients per good an experience as possible Executive Director at day, although Lao Friends Hospital that number for Children (Friends rises to 90 during Without A Border), with the rainy season, one of her young when mosquitopatients. borne dengue fever hits. The emergency department was recently opened, and Nijssen-Jordan anticipates that this will draw more patients from the far-flung areas of Luang Prabang and even other Laos provinces. An operating room and newborn unit will also be opened this year, bringing the hospital to its full capacity of 24 beds. For the severely ill, there will be single rooms for highobservation nursing. There isn’t sufficient equipment or resources to call this area an ICU, says Nijssen-Jordan, as the hospital features only basics like non-invasive ventilafor families.” Her career then took a sharp tion, X-rays and ultrasound. turn once again when she joined Doctors Undertaking challenging administrative Without Borders in Pakistan to oversee the roles is nothing new for Nijssen-Jordan, who running of a new neonatal clinic in Peshawar ran a hospital in the southern African nation province. of Lesotho for two years shortly after graduIn Laos, Nijssen-Jordan is doing more ating from the University of Saskatchewan than administration and staff training. Many College of Medicine at age 23. For Nijssennights, she is the physician on call and, Jordan, it was a chance to test her new alongside national nurses and physicians, medical skills. “I really wanted to make sure will treat myriad diseases, from Japanese that my clinical skills weren’t based upon encephalitis to pneumonia, malaria, gasbeing able to order the latest test. I wanted troenteritis, tuberculosis, fractures, HIV and to be able to diagnose patients without all of cancers that often have been treated first by those extra things.” a traditional healer, leaving the patient desFollowing this, she undertook a pediatperately ill. But the work is fascinating and rics and ER residency in Ottawa, then tackled provides the opportunity to take on new hospital administration by becoming the challenges while making a huge difference emergency director at Alberta Children’s in the life of a very sick child. “I have had Hospital in Calgary for 11 years. Nijssentremendous medical opportunities in my life Jordan also worked intermittently in Malawi and I want to give back,” she says. Spring 2016 Just For Canadian doctors

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.

Prius playbook

The paradigm-shifting hybrid car keeps getting greener + better

Wh atever col our it is, th is car is green …

harvested from both alternator current and regenerative braking forces and then battery stored. First production Prii (that’s plural for Prius) hit Japanese showrooms in 1997, with a slightly updated driveline gracing North American models first sold in 2000. Sales were initially anemic—just 123,000 units total worldwide of the Gen I over its six-year run (1997–2003). Buyers were mostly technology geeks, as it wasn’t until 2006 that Al Gore’s narration of An Inconvenient Truth unleashed the wider greenhouse gas awareness tsunami. As a basic transporta-

tion proposition, the Gen I was expensive and in many ways did not outshine its cheaper conventional-drivetrain alternatives. During the next six years (2003–2009) Gen II Prius—larger, more stylish and practical—saw Toyota’s cumulative sales grow by a factor of 10 to a total of 1.2 million units. During this period, celebrities touted their green credentials by showing up at the Academy Awards in a Prius, rather than Schwarzenegger-like Hummers. The Gen II model was still expensive given its size, performance and appointments. In the last six years of 2009– 2015, the Gen III Prius Toyota

green credentials has ebbed. The “greenest” buyer should arguably have preferred a full-electric Nissan Leaf during the Prius Gen III run—yet total worldwide sales of the Leaf over this same period were just 200,000 units. November 2015’s Paris Climate Change conference signaled the resolve of public, government and business opinion on the greenhouse gas file. That’s fortuitous timing for the release of Toyota’s Gen IV Prius (2016–2022 estimated). The Toyota model has well-established green credentials, name recognition, a quality-focused mother brand—all in a car big enough to serve a family with original 2.2 children. On both price green-mobile : (MSRP of $25,996) and range The fourth(~900 km), the Prius slays togeneration Toyota day’s full electrics (Leaf entry Prius—”the world’s most popular and price is $31,998 and its range proven hybrid is 172 km). It’s a no-brainer to automobile.” predict further multi-fold sales growth for Toyota with the Gen IV Prius model, including Canadian sales. And in the looks department, the new 2016 Prius styling merges the aerodynamic appearance of both the Generation II / Gen III Prius with the flamboyant swooping styling of the latest Toyota Corolla and Camry models. As before, the Prius fits in between these two seminal Toyota models in interior size. So, the 2016 Prius has more sizzle while losing some of its singular identity. Its driving dynamics are further evolved, though still thoroughly amassed a further three-fold increase in Toyota—capturing the ethos of affordable worldwide sales to a total of 3.9 million quality but arguably lacking in either charmunits. Toyota’s Prius hybrid has been the ing quirkiness or Tesla athleticism. bestselling car model overall in Japan the With each new Prius Generation the batlast four years running. In Canada—not tery side of the hybrid system has become so much. Since 2000, all Canadian Toyota lighter, less expensive and more powerful. Camry sales are ~5 times that of the 55,728 A roughly 10% improvement in (fossil) fuel Prii, and all Canadian Toyota Corolla sales economy has been achieved with each new almost 15 times greater than Prii. iteration. The Gen IV Toyota is a late adapter Arguably, the growth of 2009–2015 Gen of lithium-ion battery packs, largely moving III Prius sales to 3.9 million units had more to on from the nickel-metal-hydrid era. In eido with the strength of the product and the ther guise, the Prius is routinely regarded as brand, as the model’s claim to leading-edge the lowest-cost per kilometre free-range car,

Just For Canadian doctors Spring 2016

toyota canada

appy 20th Birthday to the paradigm-shifting Toyota Pruis “hybrid.” How time flies! Once mould-breaking, the Prius nameplate is now mature and solidly mainstream. Here’s what you need to know as the Generation IV model hits Canadian showrooms. Prius Concept debuted in 1995 as a working prototype, and as such has innovation as its foundation (get ready for some car-geek techno jargon). The original Prius, and every one since, combines an Atkinsoncycle gasoline / internal-combustion driveline with a parallel-path electric drive. These are good things. The electric energy is

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despite having to factor in its relatively high capital cost. No wonder the Prii are so popular with the taxi industry. As with previous generations of Prii the new Gen IV hybrid components have a 15-year/ 240,000 km warranty, while the battery pack has a 10-year / 240,000 km warranty. While actual service life was an unknown factor when the Prius was first born, real-world experience has given no cause for buyer remorse. Toyota is committed to hybrids for the how green is long haul. Their publicly stated projection the new green? for the model year 2050 is hybrids and For one, the fuel-cell cars only. No conventional fossil2016 Prius has fuel drivetrain cars and no full electrics are expected in Toyota’s future product mix. a fuel efficiency From the 30,000-foot vantage point I of 4.5L/100KM think it’s time the Prius be included in the (city/highway pantheon of paradigm-shifting affordable combined)—one cars of the last century that began with of the most fuel the Ford Model T and carried through the efficient vehicles VW Beetle and Honda Civic (with honourin Canada. able mention to the Citroën 2CV, Austin Mini and Volkswagen Rabbit / Golf). And in some future year we’ll no doubt add a full-electric and/or fuel-cell car to that rarefied list. If only to satisfy your curiosity, make the time for a test drive in the game-changing Toyota Prius hybrid. And wish the new Generation IV car a Happy 20th Birthday.

toyota canada

motoring [continued]

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the thirsty doctor janet gyenes Janet Gyenes is a magazine writer and editor who likes to dally in spirits, especially when discovering something like corenwyn jenever (a gin-like Dutch spirit)—straight or in cocktails like the “bramble.” Have a boozy idea or question? Send it to feedback@inprintpublications.com

shake it up

Four ways to inject new life into your drinking routine

here’s the after-work bevy, something to sip while BBQ-ing, a pre-prandial aperitif, weekend cocktail—so many occasions to retreat to your home bar and mix up a little magic. But when you discover a drink you like (my fave is a whiskey sour) it’s tempting to stick to your tried-and-true. Why mess with a good thing? But imagine what you might be missing if you don’t shake things up a little? For instance, I discovered my new fave tipple—the Paper Plane—by asking a bartender to make me a cocktail with bourbon. It’s a shift from my go-to. Bourbon is still the star, but bitter-sweet orange and herbal elements from the Italian liqueurs replace the sweet-sour mashup in the whiskey sour. And that Paper Plane? Now I make it at home—often (mix together 0.75 oz each bourbon, Aperol, Amaro Nonino and lemon juice in an ice-filled shaker; shake and strain into a coupe glass). Need some inspiration? Here are four ways to inject some new life into your drinking routine. 1 GET SPICY What’s better than the earthy funk of rum? Chic Choc Spiced Rum. For the uninitated, Chic Choc is a Mi’kmaq word that means “rocky mountains.” Those rocky mountains are, of course, the Chic Choc range on Quebec’s Gaspé Peninsula. That’s right—this rum is distilled in la belle province by Domaine Pinnacle. What also makes this rum interesting is that it gets its spice from six indigenous plants grown in the Chic Chocs: peppery green alder, pine forest spikenard, witherod berries, lovage root, wild angelica and sweet gale. Need more convincing to bring this

to your home bar? Last year, Chic Choc Spiced Rum won a gold medal at the International Wine and Spirits Competition in London. The brand self-describes as audacious and adventurous, so why not go out a little on a limb and sip it neat or try a Canadian-tinged version of the classic rum drink, the Dark ’N Stormy (recipe below). Or sip it neat to appreciate the subtle nuances of the spices.

five to 15 days. I’m testing this out with one stave in a 350-ml bottle of triple-distilled white whiskey. 3 Lighten up When winter releases its frigid grip, it makes sense to leave the darker spirits on the back of the bar and lighten up. Clear spirits like vodka are the chameleons of cocktails. They blend in beautifully without being in-your-face. Wyborowa Wodka, which hails from Poland, is actually distilled from pure rye grain—not potatoes—which makes it an excellent stand-in for brown grain-based spirits such as whiskey. Wybo’s refreshing Northside cocktail (recipe below) is essentially a vodka sour with mint— a lighter take on the cold-weather classic.

2 ADD AGE What’s inside those small oak barrels you often see in bars or restaurants that serve craft cocktails? It varies, but in my experience, what comes out is always a better version of what originally went in. Some bartenders age spirits in oak barrels to impart elements like vanilla and spice to the booze. Others throw in pre-batched cocktails (booze only, no juice, please!)— Manhattans, Old Fashioneds and Negronis lend themselves well to the treatment—and let them sit for up to six weeks. Here’s your chance to try it at home. Start small, with The Barrel Aged Spirits Kit from W&P Design (wandpdesign.com). It includes two charred oak-barrel staves and cheese cloth for straining your newly aged spirit. Just stick the staves into a bottle of booze and let it sit for

4 Go sour At the launch of Central City Brewers and Distillers limited-edition Sour Brown beer in Vancouver people were happily puckering up to try a sample. Sour Brown is made in the traditional Belgian style and aged for two years in Cabernet Sauvignon oak barrels and French oak foeders. “The result is a complex flavour that balances the sour notes with a melodic malty character,” says brewmaster Gary Lohin. One warning for those used to drinking session brews: at 9.2% ABV this brown ale packs a punch. Look for it in 750 ml bottles available in Western Canada and Ontario. Routine can be comforting, but the next time you’re reaching for your go-to spirit, shift gears and try out something new.

Go for spicy or sour

2 Age your own spirits

mix it up Northside 1.75 oz Wyborowa Wodka 1 oz lime juice 0.75 oz simple syrup 8 mint leaves + 1 for garnish

Dark ‘N Stormy 1.5 oz Chic Choc Spiced Rum 2 oz ginger ale 0.5 oz lemon juice 1 sprig of spruce

Pour all ingredients into a shaker; shake well. Double-strain (strainer through a tea strainer) into a prechilled cocktail or martini glass. Garnish with a mint leaf.

Fill a glass with ice cubes. Add Chic Choc Spiced Rum, ginger ale and lemon juice. Garnish with the spruce sprig.

Lighten up: Make the Northside

10â&#x20AC;&#x201C;14 September

2016

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storied

coast Finding la dolce vita through the backdoor of Italyâ&#x20AC;&#x2122;s seaside villages story + photography by janet gyenes

Boats bobbing off Capri Island in the Bay of Naples.

Spring 2016 Just For Canadian doctors

travel the world

Views of Atrani, southern Italy’s smallest town, with its majolicadomed church.

Medieval Atrani hanging above the mouth of the Valle del Dragone. above Mule by Potone’s Basilica di Sant’ Eustachio. above left Napoletana pizza in Pontone.

Just For Canadian doctors Spring 2016

ore than half a dozen—and counting. It’s the number of modes of transportation my husband and I have taken in the past 48 hours. There was the herky-jerky Circumvesuviana train from Naples with a stop in Pompeii (see page 5) en route to Sorrento, where we boarded the bright blue Sita bus that hightailed the heart-inthroat highway to Amalfi—our home base on the “divine coast.” And then catamaran to Capri, where we sardined ourselves into a piccolo rowboat while the oarsman pulled us into the otherworldly Blue Grotto before popping us out again like a cork and then decanting us onto a bigger boat. Then it was funicular–bus–chairlift. The latter hoisted us to Capri’s highest point, 589-metre Monte Solaro, while a cortège of Japanese women drifted downward, shielding themselves with parasols from the late-September sun, shouting “Hello!” as they passed us, grinning giddily. Now it was time to reset the pace with yet another form of transport—and get some terra firma under our feet. Amalfi is just one of 13 enchanting towns strewn along the Costiera Amalfitana—a World Heritage Site. Its boxy buildings cling to the cliffs like cards that were flung at the ridges and somehow stuck. All are roughly the same size, yet with infinite variety in their pastel hues, adornments and irregular angles. Twilight softens their edges into a cubist painting. It’s intoxicating. And we drink it all in. We sit in Amalfi’s pretty piazzas and sip limoncello made with Sfusato Amalfitano lemons and imagine this former maritime republic with 60,000 people (10 times today’s population) at its apogee—until November 25, 1343 when an earthquake and tsunami swept much of it into sea. We get lost in labyrinthine lanes and find trattorias where we devour scialatielli ai frutti di mare, a traditional Amalfi pasta. And we get up close to the Duomo du Sant’Andrea with its medieval bronze doors and Arab-influenced arches. Amalfi town is our living room. But it’s time to explore the backyard. We knew that mule trails crisscrossing the Dragone and Ferriere valleys would lead us to the mysterious Torre dello Ziro and the villages of Pontone and Ravello. Our guidebook warns against hiking from Amalfi to Ravello “unless you’re part mountain goat.” We don’t even have a

travel the world map. But one night in the nearby village of Atrani we spot a ceramic arrow-shaped sign on a wall: Ravello. We come back at 7:45 a.m. to follow the sign into Atrani’s maze of covered alleyways. Our lofty plan: hike to Ravello, backtrack to Pontone and take the spur to Torre dello Ziro, before dropping down through the backside of Amalfi. Blind alleys and dead-ends at wooden doors with dogs barking behind them don’t deter us. Finally, we’re rewarded with another ceramic sign—and a cloudless sky. Now the cobblestone path lures us above terraced gardens of lemon trees braced by walnut poles and alongside spent tomato bushes and ramshackle buildings. Signs of civilization, like a ceramics factory, reassure us that we’re not lost in this paradise. But then we are. “Ravello?” I ask a woman standing at a Sita stop. “Il meccanico,” she says, pointing, and I catch the Italian word for stairs. “Grazie mille!” Sure enough, at the mechanic shop we see a sign for Pontone and a portico we walk under to a stone staircase—and another ceramic sign. Now in the shade of the woods the path climbs up, up, up and then we’re confronted with an impossibly steep flight of steps. Breathless and sweating, we slog to the top and find ourselves behind a church. At its front: Ravello. It took us about 90 minutes to reach the still slumbering village draped over a promontory 360-metres above the Gulf of Salerno. We sip espresso in the piazza and take in our exquisite surroundings. Recharged, we spend the next couple of hours strolling among palaces-turnedhotels and peering into courtyards lined with orange and olive trees. We follow a ginger-coloured cat into a shady garden of pink oleander, majestic palms and the ultimate bird’s-eye view: the lush Lattari mountains and the village of Minori, a cluster of pearls cloaked in green velvet. It’s hard to rip ourselves away, but now armed with a map from the visitors’ centre, we backtrack to the mechanic shop and walk up the road to Pontone, a lively hamlet of 1,200. In 20 minutes we’re standing in buzzing Piazza San Giovanni—a balcony overlooking the valley that Amalfi’s pinched within. A crowd has just settled in for lunch, so we make a mini pilgrimage to Pontone’s Basilica di Sant’Eustachio. We pass whitewashed houses, where we hear the singsong of Italian women gossiping, amble under a stone arch and up steps crossing sun-soaked vineyards. When we

Bronze doors of Amalfi’s Duomo du Sant’Andrea. left Traditional scialatielli ai frutti di mare.

View of the Torre dello Ziro. right Amalfi’s famed lemons. above Hiking through the backside of Amalfi.

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travel the world arrive a trio of mules with metal buckets on their backs greet us solemnly. The Basilica di Sant’Eustachio, once the region’s richest church, is a roofless ruin with crumbling walls. We, too, feel shattered so we trade this slice of ancient Pontone for a napoletana pizza covered in salty anchovies, glasses of birra and our final destination, the Torre dello Ziro. Ceramic signs point us down steps—at least for awhile—and then we wander through a forest of pines. The Torre dello Ziro is one of about 30 watchtowers strung along the Sorrentine Peninsula, built for spotting Saracen pirates. Locals, I had read, believe this tower was haunted. And for good reason. In the 16th century, the Duchess of Amalfi and her children were locked inside and later, murdered. Whether truth or tall tale, the tragedy inspired literary works, including John Webster’s macabre play, The Duchess of Malfi. We chat with two Australian women we meet on the trail, nodding at their advice to “keep left.” It’s unclear whether the dizzying glimpses of Atrani spilling into the sea or our poor Italian made us veer right at the “belvedere” signpost, but I start to worry that we’re lost in this forsaken place. Finally, the curtain of pines rips open onto a stone stage, the sun a klieg light illuminating the scene below: Atrani and Amalfi and their attendant attractions— bell towers, curved beaches flecked with umbrellas and ferries taking a constant cast of people to and fro. But the Torre dello Ziro has evaded us. It’s about 50 metres below atop Monte Aureo, unaccessible from our aerie. When we retrace our steps we see the small arrow we missed and 10 minutes later we reach the apotheosis of our adventure. Staring up at the stone tower, any feelings of foreboding evaporate. Unable to go inside, we walk the centuries-old ramparts that frame modern mega yachts suspended on the azure sea and we can feel Amalfi’s magnetic pull. Sweaty, caked with dust and knees throbbing, we walk back and descend the 2,000 steps from Pontone into the backdoor of Amalfi. In our fervour to explore under our own speed, we had hiked 20 km on this gloriously impulsive For more info on hiking day. No in Amalfi’s backyard go to timetables, amalfitouristoffice.it/en and no tickets, click on the links, Seven Color just terra Paths Around Amalfi. For more firma under our feet. on the Amalfi Coast go to

if you go

amalfiscoast.com.

Just For Canadian doctors Spring 2016

TAMPA / ottawa / edinburgh / new york / alexandria … | c a l e n d a r

cMe

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spr ing 2016 + beyond

ST.PETE/CLEARWATER

Winter, the dolphin with a prosthetic tail.

TAMPA

Kayaking in Fort de Soto Park. Paddleboarding. The Dali Museum.

left

Sunset watching over the Gulf of Mexico. right Octopus at Locale Market.

St. petersburg/Clearwater is worth crossing the bridge for—world-class arts + culture,

award-winning beaches, diverse wildlife… (CE events in Tampa/St. Pete + beyond are highlighted in blue.)

L Courtesy of Visit St. Pete Clearwater and Leroy Bridges (VSPC)

ike stepping into a postcard, St. Petersburg/ Clearwater is a gem on Florida’s west coast. Nestled on a peninsula separating Tampa Bay and the Gulf of Mexico, St. Pete/Clearwater has an impressive array of attractions and activities in a compact area. TOUR Made of glass, but resembling more like molten confectionary, Dale Chihuly’s fantastical art has a permanent home at the Morean Arts Center. This shrine to Chihuly was purpose-built, blending art and architecture to best showcase large-scale pieces such as the anemone-like Ruby Red Icicle Chandelier and the Persians. moreanartscenter.org Nearby, along St. Pete’s waterfront is the unmistakable, avant-garde building that could only be home to The Dali Museum. Here you’ll find the largest collection of the surrealist’s work outside of Spain. Not to miss: The Persistence of Memory (aka: the melting clocks) and The Hallucinogenic Toreador. thedali.org

TASTE Named one of the top seafood restaurants in town (and there are a lot to choose from) by USA Today,

Sea Salt should not be missed. Chef Fabrizio Aielli has 130 different salts in his kitchen to masterfully season his innovative dishes. seasalt-stpete.com For more casual fare, Locale Market offers a beautifully curated, European-style grocery experience designed by celebrity chefs Michael Mina and Don Pintabona. Gourmet takeaway meals are available, as are epicurean grocery items for you to cook at home. localegourmetmarket.com For a visually spectacular dining experience, RumFish Grill at the Guy Harvey Outpost features a 33,500 gallon aquarium that spans an entire wall of the dining room, filled with local marine plants and animals. Cutting edge seafood is the second main attraction, where diners can choose from elevated comfort food like lobster mac’n’cheese and Gulf shrimp jambalaya to more exotic offerings like Lionfish. rumfishgrill.com DO Just across the harbour from stunning Clearwater Beach is The Clearwater Marine Aquarium, a marine rescue centre that’s home to star of “Dolphin Tale” and “Dolphin Tale 2”, Winter, who swims with a prosthetic tail. seewinter.com For wildlife in the wild, head to

Fort de Soto Park and TAMPA slip into the water Tampa knows how to entertain. aboard a kayak. Spend Whether you’re here to observe a couple of tranquil its adorable, gentle manatees hours gliding amongst or the not-so-gentle Tampa Bay the mangroves and you Buccaneers this city offers fun may be lucky enough to across the spectrum. For cigar aficionados, check out historic see stingrays, dolphins Ybor City. yborcityonline.com If and even manatees. you’ve brought the family, Busch pinellascounty.org/ Gardens, an African-themed park/05_ft_desoto. adventure park is not to be missed. htm And if you’re buschgardens.com looking for a game head For more to see/do in Tampa, over to The Shufflego to visittampabay.com. board Club, which has been enjoying a massive renaissance in recent years. On Fridays this private club opens to the public for an evening of free shuffling fun. stpeteshuffle.com — Catherine Tse Find more info on St. Pete/Clearwater at visitstpeteclearwater.com. For more on Florida: visitflorida.com.

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5th Annual Dermatologic & Aesthetic Surgery International League (DASIL) Congress

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2016 Middle East Cardiovascular Clinical Trialists Forum

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Diabetes Guidelines Update

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2016 Arab Diabetes Medical Congress

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Vancouver Island Emergency Conference/Top 5 In 5

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Jul 09-16

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Nov 21-24

Queenstown New Zealand

33rd ACEM Annual Scientific Meeting

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Aug 21-25

Leuven Belgium

28th Conference Of European Comparative Endocrinologists

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Sep 11-12

Seattle Washington

2016 Endocrine Board Review

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Oct 26-29

Ottawa Ontario

2016 CSEM/CDA Professional Conference And Annual Scientific Meetings

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Apr 01-03

Downers Grove Illinois

Pancreas Summit

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Jul 04-06

Edinburgh Scotland

2016 Association Of Coloproctology Of Great Britain & Ireland (ACPGBI) Annual Meeting

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Boston Massachusetts

Endoscopic Surgery Of The Sinuses, Eustachian Tube, And Ear

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Apr 12 and May 21

Vancouver British Columbia

“Physician In The Kitchen” Culinary Medicine Workshops

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May 01-04

Vancouver British Columbia

13th International Congress On Obesity (ICO)

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May 23-25

New York New York

NYU’s 2016 Advanced Imaging of the Musculoskeletal System With An Emphasis On Sports Injuries

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Jun 10-11

New York New York

Second Annual Advanced Robotic Urology Surgery: A Team Approach

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Challenges In Medicine: Key Healthcare Issues For 2016

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Italy & Greek Isles on Celebrity

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Aug 01-08

Australia’s Red Centre Tour

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Spring 2016 Just For Canadian doctors

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Aug 06-20

British Isles Cruise (Celebrity)

Medical CBT Tools: Ten-Minute Techniques For Real Doctors

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Sep 08-11

Copenhagen Denmark

EURETINA Congress

European Society of Retina Specialists

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Sep 10-14

Copenhagen Denmark

XXXIV Congress Of The ESCRS (Europrean Society Of Cataract & Refractive Surgeons)

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Sep 28Oct 11

Spice Islands Cruise

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Nov 27Dec 05

Prague to Vienna Danube River Cruise on Avalon

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Dec 10-17

Disney Caribbean Cruise

Medical CBT Tools: Ten-Minute Techniques For Real Doctors

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May 04

London Ontario

30th Annual Geriatric Medicine Refresher Day

Schulich School of Medicine & Dentistry

519-685-4021

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Jul 28-31

Indianapolis Indiana

Core Curriculum On Medical Direction In LongTerm Care: Part II

American Medical Directors Association

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Mar 21-25

Marco Island Florida

19th Annual Primary Care Update - Session 1

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May 02-06

Hilton Head North Carolina

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Jun 13-19

San Francisco to Vancouver Cruise

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Meningococcal Serogroup B Frequently Asked Questions

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Apr 06-08

Chicago Illinois

HIV Hepatitis Mini-Residency Series

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Dec 11-22

Southeast Asia Conference Singapore to Hong Kong

Topics In Infectious Diseases, Regenerative Medicine, And Wellness Medicine: 2016 Update

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Medical CBT For Stress And Anxiety: Ten-Minute Techniques For Real Doctors

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Disney World (Grand Floridian)

Medical CBT For Depression (And Happiness): Ten-Minute Techniques For Real Doctors

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Apr 15-21

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2016 AAN Annual Meeting

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Jun 21-24

Quebec City Quebec

5th Canadian Neurological Sciences Federation (CNSF) Congress

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Sep 24-28

San Diego California

2016 Congress Of Neurological Surgeons Annual Meeting

Congress of Neurological Surgeons

847-240-2500

cns.org

May 02-06

Sarasota Florida

Primary Care & Women’s Health: An Update & Review

American Medical Seminars, Inc.

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May 06-08

Hyderabad India

2016 Indian Society Of Ultrasound In Obstetrics & Gynecology International Symposium

Fernandez Hospital

011-98-4-8018064

insuog2016.org

Sep 15-17

Alice Springs Australia

1st Annual Internal Medicine Society Of Australia & New Zealand / Society Of Obstetric Medicine Of Australia & New Zealand Combined Scientific Meeting

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Modernizing The Code Of Medical Ethics: Chapter 5 - Ethical Issues In Caring for Patients At The End Of Life

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Apr 13

Ottawa Ontario

Advance Care Planning - A Physician’s Guide To Start The Conversation With Prostate Cancer Patients

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Apr 23-30

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Apr 22-24

Tampa Florida

Computer Aided Maxillofacial Surgery (With Human Anatomic Specimens)

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May 18-22

Chicago Illinois

2016 Combined Otolaryngology Spring Meetings

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Ottawa Ontario

2016 Canadian Ophthalmological Society (COS) Annual Meeting & Exhibition

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11th International Symposium On Pediatric Pain

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Capacity Building Internship For HIV/AIDS Orphanage (Volunteer Opportunity)

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Jun 22-25

Charlottetown Prince Edward Island

CPS 93rd Annual Conference

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Aloha Update: Pediatrics 2016

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May 16-27

Broome Australia

Indian Oceanic Medical & Legal Conference

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Las Vegas Nevada

Hospitalist & Emergency Procedures CME Course

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Mar 25Apr 08 2017

Australia and New Zealand Cruise from Auckland to Sydney

Optimizing Health For You And Your Patients: Evidence-Based Lifestyle Factors That Enhance Cardiovascular, Cognitive, Metabolic, And Hormone Function

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May 26-28

Berlin Germany

12th European Skull Base Society Congress

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Jun 12-13

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Primary Care UPDATES -St.John’s

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Oct 31Nov 04

Duck Key Florida

7th Annual Essentials In Primary Care Fall Session I

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Nov 12-16

Colorado Springs Colorado

North American Primary Care Research Group Annual Meeting

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Apr 20-21

New York New York

15th Annual Workshop On Clinical Trials In Psychopharmacology

American Society of Clinical Psychopharmacology

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May 11

Ottawa Ontario

20 Proven & Effective Thinking & Self-Regulation Strategies: For Children With Sensory Disorders, Learning Disabilities, Anxiety & ADHD

Jack Hirose & Associates Inc.

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Aug 07-21

Mediterranean Cruise

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Oct 16-19

Melbourne Australia

1st Annual Rehabilitation Medicine Society Of Australia & New Zealand Scientific Meeting

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Apr 07-09

Las Vegas Nevada

13th Radiology After Five: How To Make Night & Weekend Call A Success

Educational Symposia

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Jun 22-24

St. Petersburg Florida

IBUS Multimodality Breast Imaging Course

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York University Topic Thoracic, Breast, Neuroradiology, Emergency New Department of And MSK Imaging Radiology

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Mar 30Apr 03

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The National Conference On Wilderness And Travel Medicine

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Sep 05-16

Raja Ampat Indonesia

Raja Ampat Dive And Marine Medicine Continuing Medical Education

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For feedback, requests or to have your course featured please email cme@inprintpublications.com or submit your course via www.justforcanadiandoctors.com Having a facial difference can create barriers to opportunities and aspirations. It affects over 1.5 Million Canadians. AboutFace promotes positive mental and emotional well-being of individuals with facial differences and their families through social & peer support, information and educational programs. We work to encourage, empower and educate. YOU CAN HELP ABOUTFACE RIGHT NOW: TEXT “FACE” TO 20222 AND MAKE A $5 DONATION For more information on how you can get involved, visit www.aboutface.ca “It was the ﬁrst time in my life that I met people who had facial differences, as I did. It was also one of the few times in which I walked into a room full of strangers and did not feel even the tiniest air of judgment.” -Samantha Loucks, 23

Just For Canadian doctors Spring 2016

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If you are seeking a challenging career opportunity, please apply in confidence to either: Jackie McKee Phone: 306 655-0196 Fax: 306 655-0192 jackie.mckee@saskatoonhealthregion.ca OR Lois Spizawka Phone: 306 655-0195 Fax: 306 655-0192 lois.spizawka@saskatoonhealthregion.ca

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Spring 2016 Just For Canadian doctors

travel at home

Parc Mahikan, le domaine des loups in Saguenay-Lac-St-Jean, where wolf whisperer Gilles Granal interacts with his pack.

Just For Canadian doctors Spring 2016

call of the wild D

travel at home

It’s a Saguenay safari with wolves, musk ox and bears...oh my! story + photography by barb sligl

eep in the boreal forest of Quebec, north of Lac St. Jean and near the Mistassini River, is a grey wolf pack unlike any other. Because this one lets humans into its midst. Here, I meet alpha wolf Luna, beta wolf John, omega wolf Sick and feel the primordial tug between man and beast. But also something more. I think of Buck in Jack London’s The Call of the Wild: “He was sounding the deeps of his nature, and of the parts of his nature that were deeper than he, going back into the womb of Time.” At Parc Mahikan (fittingly, “mahikan” is the Cree word for wolf), in the Saguenay-Lac-StJean region of Quebec, being in touch with wolves, nature— life itself—is the experience. Gilles Granal, a Frenchman from Marseille, came here in 1987 for the great outdoors and never left. With his long hair, adorned with thin braids, tattooed forearms (one with a feather, the other with a wolf

pawprint), camo gear and wolf t-shirt (worn unironically), he embodies rugged. This man could have been an original coureur des bois (runner of the woods). Except that he loves animals too much to be associated with the fur trade. Now, from his base near the town of Girardville, Granal leads canoe and kayak trips (he’s a master instructor with Leave No Trace, a non-profit organization that’s dedicated to responsible outdoor recreation) and raises and runs sled dogs (any wolf whisperer must also love dogs, of course). He brought his first grey wolf here, rescued from a zoo, over 15 years ago. Lobo was soon followed by a mate, Loba, and the pair had a litter, and then another. Now there are more than 40 wolves (15 grey, 20 arctic, seven imprinted) in three sprawling one-hectare enclosures that let the grey and arctic wolf packs live almost as if in the wild. Although, with guaranteed moose meat and no predators, life’s much easier at Parc Mahikan (outside the park, there are some 5,000 arctic wolves and 55,000 grey wolves in Canada, with just 40% of a new litter of pups surviving). While his guiding business,

if you go

BE A PART OF THE WOLF PACK! Visit Parc Mahikan to observe these elusive creatures ($12). Meet the wolves with Gilles Granal ($50, a bargain for a once-in-a-lifetime experience). Spend a few nights at Parc Mahikan in this corner of the wild and stay in a Mongolian yurt, L’Atipik, an A-frame wooden cottage, L’Affut, a house on stilts, or even a prospector tent. And be ready for that early morning wakeup call. aventuraid.qc.ca EXPLORE MORE Go to saguenaylacsaintjean.ca and bonjourquebec.com for info on the region and Quebec.

Adventuraid, explores the beauty of the Saguenay-Lac-St-Jean region, the wildest experience is with les loups du nord in Parc Mahikan, this place where Granal demystifies these highly social creatures and lets you view arctic and grey wolves in a natural environment. And even meet them. Granal carefully outlines his procedure for coming into contact with the imprinted wolves. “Imprinted” simply means that these wolves have had human touch since pups, and the difference is obvious. Upon approaching their enclosure, the wolves rush to sniff, lick and poke their noses through the chainlink fence, excited to meet and greet. Granal goes in first and the wolves swarm him, jumping up to stand on their hind legs and plant kisses on his face. After greeting his furry family, he lets the rest of us inside the enclosure with strict instructions to stand against the fence and let the wolves approach us. The first brush of wolf and slap of tongue sets off an onslaught and a perma-grin on my face. Once the wolves

engage (and lick and lick and lick) Granal tells us to follow him in single file along the perimeter of the fence. After a while, he veers away from the fence and brings us to a clearing within the trees where we’re free to relax and hang out with the wolves as we—and they— please. Because, as Granal says, this experience is as much for the wolves as it is for us. I crouch down and almost get knocked over with wolf attention. It’s bliss. Soon I’m giving belly rubs and spooning these creatures that out-size me, nose to tail. Some of the wolves get bored of us and proceed to curl up for a nap nearby, while others try to nick loose pieces of clothing in a game of tug-of-war. It’s dances with wolves. And after an hour with my newfound friends, covered

Spring 2016 Just For Canadian doctors

travel at home in slobber, hair and dirt, I feel as if I’m one of the pack. That evening, I walk around the loups artiques enclosure under the stars, tracing the periphery of the arctic wolf pack’s domain, “…listening to the subdued and sleepy murmurs of the forest,” as Buck did in The Call of Wild. Sated with an overwhelming sense of connection to the wildness surrounding me, I retire in a Mongolian yurt (as if I didn’t already feel exotic enough on the edge of boreal forest amidst wolves). In the wee hours of the morning I hear the haunting call of the grey wolves, achingly close. Stumbling outside the yurt, I try to stealthily make my way to the edge of the enclosure. My heart pounding, breath heavy and frosty in the dawn chill, I still myself to listen and watch. Rustling steps draw nearer and then I see one, two, three, seven and more figures move past me. The wolves glance my way, look right at me, but continue on, caught up in their own ritual. And yet those stirring eyes seem to bore inside of me. It’s akin to a spiritual experience and I think of Buck again, “…running at the head of the pack through the pale moonlight or glimmering borealis, leaping gigantic above his fellows, his great throat a-bellow as he sings a song of the younger world, which is the song of the pack.”

Pointe-Taillon National Park on the north shore of Lac Saint-Jean.

beyond les loups

There’s plenty more to do in SaguenayLac-St-Jean, along the massive Lac-StJean and grand Fjord-du-Saguenay Véloroute des Bleuets (Blueberry Route; veloroute-bleuets.qc.ca) follows the shores of scenic Lac-St-Jean, making it a go-to (read flat!), multi-day 256-km biking route. Refuel with bleuets (the moniker for a local resident as well as the fruit), Boutefeu (Let it blow!) red ale from Microbrasserie du Lac Saint-Jean (microdulac. com) and Fromagerie Médard cheese (fromageriemedard.com).

and fall asleep to the hum of Ouiatchouan Falls (the top of which is accessible via cable car), still a major source of hydroelectric power.

Val-Jalbert (valjalbert. com) is an abandoned pulp-mill settlement (1901–27) that’s now one of the best-preserved ghost towns in Canada. Stay on-site in luxe updated accommodations

Parc Adventures Cap Jaseux (capjaseux.com) is set at the edge of the Saguenay fjord, where you can kayak, zipline, traverse cliffs on a Via Ferrata and stay in a suspended sphere or tree house.

Bleuets, the symbol of the region of SaguenayLac-St-Jean.

Mongolian yurt at Parc Mahikan.

Zoo Sauvage de SaintFélicien (zoosauvage.org) is not your typical zoo. Here, you can see boreal animals in as natural a habitat as possible (hello, mama black bear and cubs!) and even stay in an old-school prospector’s tent in the Land of the Caribou camp.

Just For Canadian doctors

The Land of the Caribou camp at Zoo Sauvage de Saint-Félicien.

Massive grizzly at Zoo Sauvage de SaintFélicien.

travel at home

Suspended sphere at Parc Adventures Cap Jaseux.

Musk ox, soaking up the last rays of sun at Zoo Sauvage de Saint-FĂŠlicien.

Ouiatchouan Falls at Val-Jalbert.

Local brew from the Microbrasserie du Lac Saint-Jean.

Kayaking in the Saguenay fjord with Parc Adventures Cap Jaseux.

Spring 2016 Just For Canadian doctors

h e a lt h + w e l l n e s s

spring reboot

e Ca th e r i n r r a B e o Rosc fe i L e h T f o s D e l i c i ou

It’s time for some wellness rehab and banishing that all-or-nothing mentality

Morning run during the wellness retreat

2 SINGLE TASK We’ve become a culture of multitasking—to our detriment. Multi-tasking is not as effective as you might think. Roscoe Barr quotes neuroscientist Daniel Levitin: “Multitasking creates a dopamineaddiction feedback loop, effectively rewarding the brain for losing focus, and for constantly searching for external stimulation.” Instead, single-task, says Roscoe Barr. The Life Delicious wellness retreat You’ll actually get more “big” things done instead of just little bits and pieces. Remove distractions that take you on unproductive tangents by using a timer (again, Pomodoro is effective) that frees you to focus on that single task. When time’s up, check your texts and email, have a coffee, read the paper, or whatever else may The Pomodoro usually distract you. Done. Technique® tomato timer

yourself some slack!), move (join her antisedentary revolution) and even eat (inch towards a more plant-based diet). It’s a far more organic approach to achieving those resolutions you try to start each year with. And Dr. Michele Foster (see page 38) credits it for carrying her through a stressful year of clerkship on the way to achieving her MD.

1 MOVE lT Obvious, yes. But Roscoe Barr’s “anti-sedentary revolution” underlines

just how inactive most of us are for long stretches (unless you’re on your feet all day pounding the linoleum in ER). So, instead of sitting for hours, promoting poor circulation, set a timer (try utilizing the Pomodoro technique, 25 minutes on, five minutes off, or whatever timing works for you) to remind yourself to move throughout the day. For a few precious minutes, walk, do jumping jacks, the plank, down dog, or anything other than sitting still. You’ll boost blood flow and recharge your focus at the same.

3 DOWNLOAD With the daily onslaught of to-do’s and what-if’s and should-have’s, it’s hard to single-task. You’re wary of forgetting all the things on your mental to-do list. So make it physical. It’s old-school and super simple. Write it down or “download,” as Roscoe Barr says. Keep a journal. Yes, it feels like high school, but putting pen to paper (or typing in the notes app of your smartphone) means you’ve addressed that mental jab (that is, got it out of your head) and can return to it later while re-focussing on the present. Your “journal”

Just For Canadian doctors Spring 2016

(whether a tried-and-true Moleskine or iPhone) can include anything and everything, from registering for an upcoming CME conference to a reminder of that CrossFit class.

4 BE GOOD ENOUGH Perhaps the most important take-away from Roscoe Barr’s wellness program is her mantra: “Banish the all-or-nothing mentality.” You can’t do it all or be 100%. Be realistic. And cut yourself some slack. “Be gentle and kind,” says Roscoe Barr, “substitute growth for guilt.” Crush the ANTs (automatic negative thoughts), that trash-talking, negative feedback loop marching around in your head. Remember that an improvement of 1% is still an improvement. Add a minute to your jog time or one leafy green to your diet. That’s better than nothing, and every extra bit is cumulative. Ten minutes of yoga is better than zero. It’s about making your goals attainable. After all, losing five pounds is doable, and then five more…rather than setting an immediate goal of 20. 5 MEDITATE It works. Just 10 minutes (or five, or whatever time you can carve out) of stillness, deep breathing and mental focus can be the difference between a tense and harried or calm and purposeful day. Roscoe Barr cites psychologist Daniel Goleman, the author of Focus: “Think of attention as a mental muscle that we can strengthen by a workout.” That workout is meditation. Don’t be discouraged if your mind wanders during those few minutes (because it will). The point of meditation is to practise redirecting your mind when you become aware that it has wandered. It’s about attention training, and this will help with all the other things already mentioned, whether single-tasking or crushing those ANTs. —B. Sligl LEARN MORE Start your wellness reboot by taking one of Catherine Roscoe Barr’s three-day weekend wellness retreats or new “Foundation” and “Expansion” one-day sessions. You’ll cover everything from starting an anti-sedentary revolution to brain hygiene. Her next weekend retreat is April 15–17. And watch for special wilderness retreats across Canada and the world. TheLifeDelicious.ca

the life delicious weekend retreat photos: aaronjbarr.com

t’s spring, when new life blooms yet most of the heartfelt resolutions you made at the start of the year have withered away. Not so fast… As the founder of The Life Delicious urban wellness retreat, Catherine Roscoe Barr says, abolish that allor-nothing philosophy. A personal trainer and life coach with a neuroscience degree, Roscoe Barr (above) offers one-on-one sessions and weekend retreats with interactive exercises that are geared to transform how you think (cut

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

plan ahead—and right Make sure your estate planning makes sense

ometimes the best-laid plans aren’t so well laid…here are five big estateplanning mistakes—and how to avoid them.

1 Not having an updated will One of the biggest mistakes in planning for your money and your heirs is not to have an estate plan at all. If you do not have an updated will, you are not alone. According to a survey by the BC Notaries, only 55% of BC residents have an up-to-date will. And another survey by the Lawyers’ Professional

people as guardian of the children and trustee is that it creates a control system. It will be tough for the guardian to waste the children’s money, if he/she has to account for the funds to a third party.

3 Falling into the joint ownership trap Probate fees only cover assets that are dealt with in the will. Any assets that are held in joint ownership, where the assets on death pass automatically to the survivor, are not subject to probate. Probate is often perceived as a simple transaction of registering a beneficiary as a joint owner of your assets. However, for tax purposes, moving an asset into joint names triggers a disposition for tax purposes. If the asset has an unrealized gain of $500,000, the transfer to joint ownership triggers a tax of 50% of that gain. In contrast, registering your intended heir as a joint owner of your principal residence, no income tax is triggered on the registration. But if the home is sold on your death, only your half of the principal residence is covered by the exemption. The other half—while it was in joint ownership—is subject to income tax on the appreciation in value.

5 estate-planning mistakes —and how to avoid them

Indemnity Co. (LawPRO) reveals that 56% of Canadian adults (56%) do not have a signed will. If you die without a will, your estate can be tied up for years with expensive administrators, with the estate assets eventually being distributed according to the laws of the province: mostly likely not the way you would have wished.

2 Naming the same person to serve as guardian and trustee If you trust your sister with raising your children, it’s natural you want her with the money to look after them. Actually, many people name one individual as both the guardian and trustee without much thought. The advantage of having separate

estate freeze shares are redeemed on death, capital gains taxes are completely avoided. The full value of the company investments will be attributed to your family members.

5 Not using the spousal trust Transferring estate assets to your children from a prior marriage—while at the same time providing an income stream to your current spouse—is an almost impossible task unless you use a spousal trust, the magic tool to accomplish this goal. The beneficiary of the trust, your current spouse, is only entitled to income and capital during her lifetime. On your spouse’s death, your estate assets will be distributed to the trustees of the trust: the children of your first marriage.

4 Not freezing your estate Your shares in your medical or investment holding company are subject to tax on death. Implementing an estate freeze is an easy procedure that does not trigger any income tax. You simply convert your shares in your company to fixed value shares at the current value of the investments of, for example, $2 million. New common shares will be issued to your family members. The estate freeze is structured so that you retain full control over your company. Any funds you withdraw from the company will be a partial redemption of the shares. If all the Spring 2016 Just For Canadian doctors

d o c t o r o n a s o a p b o x 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.

safe(r) narcotic prescribing We have a problem with the use and misuse of prescription medications

Canada has the second highest narcotic use per patient in the world

Just For Canadian doctors Spring 2016

I suggest that a one-on-one in-office nonjudgmental peer assessment and mentoring would offer useful patient-orientated problem solving. A repeat visit or two by the mentor will probably be needed as the physician acquires and uses the new skills. A physician should be able to request this sort of help with an assurance of temporary immunity from college discipline. On a broader basis both the federal and provincial governments need to be lobbied for many more drug treatment programmes, especially residential. The chronic underfunding of mental health needs also to be addressed as well as the lamentable paucity of pain treatment clinics. The cost of dealing with this situation is going to be great, but doing nothing is estimated at a cost of $8.2 billion per annum ($262 for every Canadian) not to mention the lives lost…fentanyl-related deaths, for example, have increased in BC seven-fold in two years—13 in 2012 and 90 in 2014. And that is not acceptable.

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The subject is dealt with excellently by the National Advisory Council on Prescription Drug Misuse in their paper First Do No Harm: Responding to Canada’s Prescription Drug Crisis. I have posted a link to this on my webpage at drpeng.ca. My impression of this document is that it sets a realistic goal of 10 years to satisfactorily put things right. The authors suggest that it is going to require input (both dollars and expertise) from the federal government, provinces, public health and primary care physicians. A large part of the burden, in fact, is landing on primary care practitioners. Unfortunately they are sorely lacking support. Pain clinics are already overtaxed, and the Royal College of Physicians will need to significantly increase certification of pain care specialists from its current 20 a year. Helpful instructions are available in the document Canadian Guideline for Safe and Effective Use of Opioids for Chronic Non-cancer Pain. (The link for this is also on my webpage.) This paper has a number of useful appendices. I found it realistic, readable and replete with practical advice. The difficulties of putting the situation right is adding to the emotional stress of primary care physicians. Mixed feelings will be experienced. Guilt for allowing the situation to get out of hand, the will to practice good safe medicine and the difficulty of persuading drug dependent patients that, for their safety, they will need to significantly modify their medications. I suggest that focused support groups be created to meet regularly to offer mutual support. Good ideas could be shared, difficulties ventilated and problems discussed. Divisions of Family Practice will be invaluable in coordinating these. Provincial colleges run courses offering pain management/opioid prescribing CME. These courses are excellent, practical and well attended, but have a waiting list.

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here is no denying that there is a problem with the use and misuse of prescription medications, viz. narcotics, stimulants and sedatives, principally benzodiazepines. I will deal just with the opioids here, though much that I suggest will be relevant to all. There is an abundance of literature concerning this subject but I could find little useful current statistical information. Frequent reference is made, however, to the fact that Canada has the second highest narcotic use per patient in the world. Second only to the USA. How did this situation come about? Twenty or so years ago there was a well intentioned, but sadly misguided, philosophy that too many patients were suffering untreated pain, and that narcotics were safe, available and should be used to relieve non-cancer pain. It did not take long for it to become apparent that in fact these medications, though effective, were easily prone to abuses. The lively promotion by the pharmaceutical companies must have been a factor too. In 2007, the US branch of Purdue Pharmaceuticals was fined in excess of $600 million for misbranding Oxycontin. It was actively detailed in physician’s offices across North America. The result is that there has been an escalation in the abuse of these drugs, which is like a runaway train accelerating downhill. The safe way to regain control of this train is to skillfully and carefully apply the brakes. Trying to stop it immediately will inevitably lead to derailment and disaster.

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Spring 2016 Just For Canadian doctors

Dr. michele foster is adding MD to her list of achievements this spring. Whether on hospital rounds or visiting the Temple of Queen Hatshepsut in Egypt, she stays grounded by meditating every morning (a recent practice she learned during The Life Delicious program founded by her childhood friend; see page 34). And indulges in the odd candy treat… My name: Michele Foster I live and practise in: Studied medicine at University of Calgary; starting residency in psychiatry at the University of Alberta My training: Bachelor of Music, MBA, MD (April 2016)

rotation how much it means to be able to help both the child, as well as the family. My last trip: Mexico Most exotic place I’ve travelled to: Egypt—a two-week group tour, which was exhausting but so fascinating!

to this day! A “wow” hotel I’d happily stay in again: The Rasananda in Koh Phangan, Thailand A favourite place that I keep returning to: Lake Louise—one of the most beautiful places on earth

Must-see TV show: The Mindy Project—lighthearted and ridiculously fun Gadget or gear I could not do without: My iPhone—it keeps me connected, organized, entertained and is a useful resource on the wards

Dr. Michele Foster with her husband at the top of Ha Ling Peak in Canmore, AB, last spring

I have too many: High-heeled shoes, which I never wear anymore because they are so impractical for hospital work I’d describe my home as: Small, cozy with perhaps a bit too much cat hair My guilty pleasure: Candy— although I try to maintain a healthy diet through the week, I always make sure to take a day to enjoy some treats guilt-free My go-to exercise/sport: Spin class at Spoke N Spin in Calgary—it’s a combination of spin and TRX, or suspension bands that work both upper body and core strength

At the Temple of Queen Hatshepsut in Egypt

Why I was drawn to medicine: I am passionate about the field of mental health and am hoping to specialize in child and adolescent psychiatry. I realized on my

Most frequented store: Lululemon

Memorable restaurant: L’Atelier de Joël Robuchon—my husband and I had an eight-course tasting menu with wine pairings and we still talk about it

With best friend Catherine Roscoe Barr of The Life Delicious (see page 34)

Dream vacation: I would love to go to Antarctica on an icebreaker adventure cruise Favourite city: New York

Just For Canadian doctors Spring 2016

Last splurge: As a graduation present, a wine tour through ChampagneBurgundy with my husband!

My secret to relaxing and relieving tension: Morning meditation—just five minutes every morning keeps me grounded during stressful times. This is a recent discovery, which I started during The Life Delicious Program, which combined with exercise, lots of water and healthy eating, has helped to carry me through this stressful year of clerkship. One thing I’d change about

myself: I still struggle with negative self-talk, but I recognize this is a work in progress The word that best describes me: Positive—you’d be amazed at how your perspective changes when you start keeping a gratitude journal. I have an app that reminds me to journal five things I am grateful for every day. I’m inspired by: My best friend since Junior High— Catherine Roscoe Barr; her enthusiasm and zest for life is contagious and the 12-week journey she led me through has completely changed the way I think, and live my life. I am now the healthiest I have ever been, both mentally and physically and feel I can bring my best-self forward to patients and the practice of medicine. My motto: Whether you think you can, or think you can’t, either way, you are right (Henry Ford) A cause close to my heart: Animal rescue —I have three adopted and very spoiled cats On my must-do list: Scuba dive with Manta Rays If I wasn’t a doctor, I’d be: A wedding planner

courtesy of Michele Foster

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