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DOCTORS life + leisure
spring 2021 Publisher Linh T. Huynh
contents
Spring 2021
cover photo This mural by iHeart was part of the Vancouver Mural Festival’s 2020 #MakeArtWhileApart campaign, during which public art was painted over boarded-up storefronts during the first wave of the pandemic.
Editor Barb Sligl
Art Direction BSS Creative Contributors Dr. Anand Ghanekar Dr. Chris Pengilly Manfred Purtzki Dr. Kellen Silverthorn Barb Sligl Roberta Staley Catherine Tse Cover photo Gabriel Martins Senior Account Executive Monique Nguyen Account Executive Wing-Yee Kwong
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FEATURES
Four doctors who go far beyond with their selfless care
Just For Canadian Doctors is published 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.
pay it forward
8 Dr. Daniel Kalla Bringing the pandemic to the pages of his latest medical mystery
10 Dr. Bonnie Richardson Providing care to the underrepresented in the Prairies
11 Dr. Wendy Sligl
In Print Publications 716 – 938 Howe Street Vancouver, BC V6Z 1N9 Canada
Delving deep on the ICU frontline and into ID research projects
12 Dr. Stephanie Liu
www.justforcanadiandoctors.com
Making sense of the pandemic with an inspiring children’s book
Printed in Canada.
COLUMNS
DEPARTMENTS
15 soapbox
5 photo prescription
Navigating uncertainty Funded in part by the Government of Canada.
16 motoring Looking forward to the “new normal”
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cover/top photo: Gabriel Martins; Doctor photos (clockwise from top left): Michael Bednar, courtesy of Dr. richardson, Dr. liu, dr. sligl
Production Team Ninh Hoang Annie Do
By Dr. Anand Ghanekar
6 Spring mix Gratitude for those on the frontlines and giving back to those in need
award winS!
A feature story in the January/February 2020 issue of Just for Canadian Dentists (flip for this sister magazine) won GOLD (Illustrated Story) in the 2020 North American Travel Journalists Association Awards and the cover photo won SILVER.
Spring 2021 Just For Canadian doctors
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from the editor
Carrying on
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t’s been a harrowing and haunting year that’s affected almost everyone in some way, big or small. In the publishing world that’s meant halting production of a magazine that shared stories and photography about travel, near and far, and highlighted CME conferences and meetings. No travel has meant no work for those who make their living from tourism. And others have also seen their livelihoods enter a tailspin, whether those in hospitality or teachers pivoting from in-person school to online and back again. But it’s YOU, the healthcare providers who’ve been hit with the brunt of this pandemic. Doctors in the ICU and ER, already overworked, have had to stretch their mental and physical capacity to the
breaking point. I’ve witnessed my sister, Dr. Wendy Sligl, deal with the uncertainty and resulting anxiety while working everincreasing hours (that seem inhuman to this writer and editor) and then devoting even more off-call hours to research and task forces (10 that I know of, plus various leadership and admin roles that get piled onto doctors in hospitals). I’m exhausted just thinking about it. And so all of us at Just For Canadian Doctors say THANK YOU to all the selfless healthcare heroes on the frontlines. You are amazing. This issue is our salute to you. Contributing writer Roberta Staley tells four of your stories here (including my sister’s), a mere sample of what you do and a small token of our gratitude. comments/questions: feedback@InPrintPublications.com
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Just For Canadian Doctors Spring 2021
courtesy of Dr. Wendy Sligl
Dr. Wendy Sligl (page 11) has ridden the lows and highs of the pandemic, from uncertainty and anxiety during the first wave (top, in full-on PPE) to providing care in the ICU with colleagues like Critical Care RN Abed Dergham (bottom).
photo details
Spring s t y l e + s u s t e n a n c e + t o k e n s o f a p p r e c i a t i o n f o r t h o s e o n t h e f r o n t l i n e s
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Canon EOS 6D, Canon EF 24-105 f/4 L IS lens postcard from the past Dr. Anand Ghanekar, a transplant surgeon in Toronto, took this photo of the Lavaux vineyards east of Lausanne, Switzerland, in August 2018. It looks like a fairytale scene from another time and world, which it is: pre-pandemic. This storybook quality also exudes a kind of hope for better times to come with renewed travels and adventures.
photo prescription
Tripping
dr. Anand Ghanekar
Sparked by his evocative photo, we asked Dr. Anand Ghanekar, who lives and practises in Toronto: What do you miss most about this trip or travel in general? “Since the pandemic began, I miss the opportunities to explore and experience new places, particularly with my family.”
flip & flash back
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giving back
gratitude
gestu res of thanks
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For healthcare heroes from top brands and thoughtful businesses across the country Written + produced by Catherine Tse 1 hometown hero You know him as Grammy Awardwinning, Super Bowl half-time performing artist The Weeknd, but Abel Tesfaye is also just a Canadian guy who wants to help out his hometown of Scarborough during a rough year. All proceeds from sales of his popular XO face masks were donated to the Scarborough Health Network, with the artist matching every dollar raised, for a total donation of $500,000. theweeknd.com
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editor's
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photo of the weeknd: Pari Dukovic
shout out!
2 find your roots Canadian-born Roots is giving back to frontline healthcare workers through three initiatives. Its largest contribution came in the form of $500,000 in products that were repurposed as scrubs at Canadian medical facilities. Roots also repurposed their Toronto leather factory to produce non-medical, washable and reusable face masks, all designed and made in Canada by their own employees. And Roots also donated 3,000 medical-grade masks to local medical facilities. roots.com
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good cause
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4 refuel To honour the hard work and dedication of Canadian healthcare workers for their tireless work, Molson Coors Beverage
Company in Canada provided meals to 20,000 frontline healthcare workers. Collaborating with SkipTheDishes, gift-card codes were provided on International Nurses Day last year to workers at hospitals in communities from coast to coast where Molson Coors brews. Additionally, a GoFundMe page collected over $16,000 in donations from the public, which provided an additional 665 meals. molsoncoors.com 5 Take a Seat Custom furniture manufacturer, Van Gogh Designs, is revamping 26 staff rooms at Surrey Memorial Hospital. Each room is different—some units requested recliners or dining tables and chairs, while others
asked for sofas. Once completed, the donation will total approximately $170,000 in custom furniture that brings comfort and ease to healthcare workers during long hours on-call during this pandemic. vangoghdesigns.com 6 gold star To help healthcare professionals recharge and feel refreshed after long stretches of critical work, premium haircare brand Goldwell Canada donated 400 gift sets of hair products, as well as gift cards to Taz Hair Company for salon services, totalling $48,000 worth of goods and services. Recipients were healthcare staff from St. Joseph Hospital in Toronto and St. Joseph Hospital in London, ON. goldwell.com
Spring 2021 Just For Canadian doctors
good will
3 creature comforts Everybody deserves a safe and comfortable home, and IKEA Canada worked with vulnerable communities, including the homeless, refugees and children, providing new bedding, mattresses, children’s toys and food to ensure they had just that during these challenging times. So far, they’ve contributed nearly $2.3M in products and supply donations to local communities across Canada that have been particularly hit hard by COVID-19. ikea.com/ca/en
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r o b e r ta s ta l e y Roberta Staley is an author, magazine writer and filmmaker, currently working on a documentary about street nursing in Vancouver’s Downtown Eastside.
Medical mystery
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estselling author and Department Head of Emergency Medicine for St. Paul’s Hospital in Vancouver, Dr. Daniel Kalla was working on his 12th novel, Lost Immunity, well before COVID-19 began its global metastasis near the beginning of 2020. A thriller like many of Kalla’s previous novels, Lost Immunity foreshadowed not only the COVID-19 calamity awaiting Dr. Daniel Kalla’s latest novel foretells the current crisis
society, but the inexplicable outbreak of human folly that manifested in a refusal to wear masks or self-isolate, as well as reject vaccinations that would protect against the deadly coronavirus. Many of the parallels with the COVID-19 outbreak are almost eerie. Lost Immunity, which is published by Simon & Schuster Canada and will be released May 4, tells the tale of a new, very lethal outbreak of meningitis in Seattle. So virulent it can kill before antibiotics take effect, the aggressive disease takes an especially heavy toll on the young. Just six months before, the meningitis outbreak had struck Iceland. The book’s heroine, Seattle’s public health officer Lisa Dyer,
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looks to Iceland to supply her city with a vaccine that the Scandinavian nation recently developed. A mass inoculation in Seattle is initiated to prevent more kids from dying, however, the medication has severe side effects. Several recipients fall ill and one dies. Seattle’s vociferous antivaxxer lobby feels vindicated—proof that vaccines are dangerous. However, in true thriller fashion, it turns out that someone is tampering with the vaccine. “It’s never clear why they’re doing it,” Kalla says before adding, “there’s a bit of a twist.” Alongside other British Columbian healthcare professionals, Kalla, who has been treating COVID-19 patients in St. Paul’s ER since the start of the outbreak, recently received a COVID-19 vaccine, admitting it made him feel “almost emotional.” While it doesn’t mean that healthcare staff can suddenly toss their Personal Protection Equipment (PPE) in the bin, the inoculation highlights how vaccines have been one of the “greatest miracles of modern medicine,” Kalla says. There has been resistance against inoculations for centuries, beginning with the smallpox vaccine. First developed in the late 18th century, it led to the global eradication of the disease in the mid-1900s, despite intermittent pushback from the public. Kalla explores this phenomenon, ensuring that the anti-vaxxer characters he presents in the book—one is a well-educated naturopath whose son is autistic—are sympathetic rather than unsavoury fanatics. “I tried to humanize the anti-vax side, because if you just call people names and treat them like criminals, you’re not likely to convince them to re-evaluate their ways,” says Kalla, whose books have been translated into about a dozen languages. Yet, despite this light-handed approach, the message is unequivocal. The anti-vaxxer phenomenon “is a very dangerous movement that has grown over the last 20 years,” Kalla
Just For Canadian Doctors Spring 2021
says. He lays part of the blame on the continuing influence of Andrew Wakefield, who in 2010 was struck off the UK medical register for promoting fraudulent work linking autism in children with the MMR vaccine. Kalla also blames the Internet for helping nurture conspiracy theories. “I’m not counting on changing the minds of any anti-vaxxers, but it would be really wonderful if they could take a step back and realize that the science just doesn’t support their belief system.” Despite full-time ER work, Kalla churns out books almost yearly, and has another—a psychological thriller that has virtual medicine at its core—waiting in the wings for publication in May 2022. His books— other than his Second World War trilogy— are topical; being a physician in a busy emergency room keeps him connected with society’s social woes. For example, his 2020 book, The Last High, follows a doctor and detective who track down the supplier of contaminated fentanyl that has caused numerous teenagers to critically overdose. Like Lost Immunity, this book is also timely, with recently released 2020 figures showing that British Columbia’s opioid crisis caused 1,716 deaths from illicit drugs, a 74% increase from 2019. (Statistically speaking, the opioid crisis is worse than the COVID-19 contagion.) Kalla, who says that he sees at least one overdose per day while on shift at St. Paul’s, says The Last High was the most “heartfelt novel I’ve ever written.” He continues to be outspoken about the need for profound structural change to combat the crisis. “We need far more access to detox and rehab care for these patients, we need to provide safe alternative opioid aegis, be that methadone or suboxone. We need to decriminalize opioids and put the traffickers out of business.” Whether it’s global scourges or opioid addiction, Kalla perfectly captures the zeitgeist of the 21st century. Although he’s “always looking for important medical themes to tackle,” his priority is entertaining his readers and “giving them characters to care about. I want to entertain and, hopefully, educate a bit along the way.”
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continued
A long, cold winter
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n the Saskatchewan reserves where Dr. Bonnie Richardson delivers healthcare, upwards of 10 or more people—grandparents, grandkids, parents and foster children— share three or four bedrooms in a 1,000-square-foot residence. In such homes, the parents might be absent, with a single grandmother raising a half dozen kids on her own. Such physical and economic stresses are exacerbated
commands the fight to control and treat the coronavirus on a variety of fronts: acute medicine, critical care surgery, emergencies, field hospitals and setting new COVID-19 protocols, among other responsibilities. It also means that Richardson is putting in 12-hour-days (or more) seven days a week—and has been since the virus hit the province early last year. The litany of daily tasks and decision making doesn’t describe the emotional side of the job, and Richardson is deeply frustrated about being unable to deliver the same level of care to Indigenous patients as her urban patients receive. On Indigenous reserves, says Richardson, the medical care is, “unfortunately, equal to a third world country.” Before the pandemic added layers of frustration, work and challenges to her practice, Richardson and her colleague, Dr. Stuart Skinner, would travel the highways and back roads of Saskatchewan (much like the frontier doctors of long ago) to care for sick and isolated patients, as well as set up basic healthcare systems. Richardson and Skinner called the initiative the Wellness Wagon. Eventually, the program had 19 team members dealing with the epidemic of Type 2 diabetes, kidney disease, hepatitis C and HIV found on many re“Everyone’s serves. The Aboriginal populajust tired—tired of tion in Saskatchewan is about the whole thing,” 175,000 people, or 16% of a says Dr. Bonnie by the strain of COVID-19 populace of 1.18 million. The Richardson protocols. One such statistics are grim: the average woman recently called age of onset for kidney disease Richardson, who is a specialist among Saskatchewan Aboriginals in the nephrology unit at Regina’s is 56.4 years, with 33% developing the Saskatchewan Health Authority, overseecondition. Type 2 diabetes affects more ing the care of thousands of patients with than 17% of Aboriginals, a rate three times kidney disease who need dialysis. “You higher than the general population. HIV gotta help me doctor,” the woman begged infection rates are 3.5 times higher than Richardson. “I have my dialysis today but the non-Aboriginal population, at 35.8 per I’ve got seven grandkids here and they’re 100,000. And Hepatitis C is 2.4 times higher all home from school. I can’t be gone; among Aboriginals. Substance abuse, prithere’s no one here to look after them.” marily crystal meth and fentanyl, compli“That breaks your heart, you know?” cates efforts to tackle these ailments. says Richardson, who is also the defence Poverty, says Richardson, is largely chief for COVID-19 in the southern to blame. Often, reserves only have one half of the province. This means she small store serving mainly chips and pop,
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Just For Canadian Doctors Spring 2021
and people will consume two to four litres of fizzy drink a day. A diet gleaned from hunting and gathering is much healthier, and Richardson works with Aboriginal elders, blending Western medicine with traditional knowledge, to try to improve diet and thus health outcomes. There has been progress thanks to Richardson’s efforts, with health directors and nurses now stationed on many reserves. Such localized medicine is crucial as these “marginalized populations” often feel the sting of prejudice and disrespect in urban health centres and hospitals, says Richardson. It’s also difficult, when living on rural reserves that are hundreds of kilometres from urban centres, for patients to travel. This winter, temperatures in Saskatchewan plunged to -50˚C due to a polar vortex, shutting down roads. Patients couldn’t navigate the deadly cold and roads to come in for things like dialysis. Solutions are possible, like implementing home dialysis for those with kidney disease, but many reserves don’t have an appropriate water supply or clean environments for such measures. “They are poor people living in an environment without appropriate resources,” Richardson says. COVID-19 has exacerbated these problems. There have been cases where all the household members contracted the virus due to overcrowding. This has forced practitioners to provide care virtually rather than in-person, increasing the anxiety and uncertainty already gripping communities. Further adding to the burden of care in Saskatchewan is a growing backlog of patients. Last year, many patients were reluctant to visit hospitals or clinics for fear of contracting the virus. Their conditions have now progressed to a point where they are significantly sicker than if they would have received regular care, Richardson says. As much as Richardson and her colleagues maintain a brave face, the grind of COVID-19 means that “we’re all working harder. Everybody’s feeling stressed. I mean, it’s -50˚C and everyone wants a holiday. Everyone’s just tired—tired of the whole thing.”
courtesy of dr. richardson
Bringing much-needed medical care to the rural, prairie fringes of Saskatchewan
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On the frontline
This ICU/ID doctor is on the COVID-19 frontline, from the ward to research
courtesy of dr. Sligl
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ast May, Alberta became one of the earliest provinces in Canada to open up its economy following a nation-wide shutdown triggered by COVID-19. In the weeks and months that followed, provincial coronavirus rates began to soar. Soon, Alberta had the highest infection rate per capita in Canada; with a population of 4.4 million, the province had a higher number of active cases than Ontario, with 14.6 million people. Hospitalization rates also rose, with Edmonton seeing the largest number of cases in the province. It’s a time that Dr. Wendy Sligl, a critical care physician and infectious diseases specialist at University of Alberta Hospital in Edmonton, won’t soon forget. “I can remember one ICU call shift that was probably the worst shift I’ve ever worked. It was so busy with admission after admission. After 32 hours of constant work and no sleep, I was completely destroyed,” says Sligl. For more than a year now, Sligl has toiled, donning heavy and restrictive Personal Protection Equipment (PPE)— gowns, gloves, eye protection and masks—as her daily armour. Certified in both infectious diseases as well as critical care, Sligl is uniquely qualified to treat the disease. She has helped command COVID-19 defence and attack: implementing strict infection prevention and control protocols to ensure the virus didn’t infect the rest of the hospital. COVID-19 patients were placed on droplet and contact isolation in single rooms so they could be cared for safely. Where possible, all infected patients were admitted into the same section of the ICU to make it easier to look after them, but as case numbers rose, the staff opened a dedicated COVID-19 ICU. Despite the entire team’s care and vigilance, Sligl watched many patients die. “The mortality rate was very high and emotionally difficult on everyone,” says Sligl. “It’s hard to say what the worst part is—the inability, in some cases, to do anything to help. Watching a patient continue to worsen despite doing all we can do in the ICU is hard.”
Yet hundreds more survived with supportive care and experimental treatments, none of them a magic bullet. Sligl looked to research studies from around the world to help inform patient care. Although few treatments are available to treat the disease, the UK-based RECOVERY trial, with nearly 40,000 global participants, demonstrated that patients were less likely to die if they received steroids, specifically dexamethasone, which has since become standard care in COVID-19 ICU patients, says Sligl. Other treatment studies that she has contributed to include “convalescent plasma,” when plasma from the blood of a recovered COVID-19 patient is harvested. The plasma contains antibodies to COVID-19 that theoretically fight off the coronavirus. However, convalescent plasma hasn’t been found to be helpful in critically ill patients and may only provide benefit if given early in the mild stage of disease, Sligl says. Sligl is no stranger to coronaviruses or epidemics. In 2003, she encountered several cases of severe acute respiratory syndrome (SARS) while in training. In 2009, she looked after numerous pandemic H1N1 influenza patients in ICU. The deadly H1N1 contagion, however, was “dwarfed in comparison to COVID-19,” she says. (About 575,000 people worldwide died from H1N1. At deadline, 2.5 million people globally had perished from COVID-19.) “In each pandemic, the same fears were real—fear for our patients, our families and our ability to cope at a health-systems level,” says Sligl, who has had several colleagues contract COVID-19 and recover. The vaccine rollout has slightly assuaged Sligl’s worry, but she’s still very much aware “that this pandemic is far from over.” The second COVID-19 wave has been especially challenging, and during its peak a new night-time doctor was added to the ICU staff roster to help manage increased patient numbers. Sligl
continued
Dr. Wendy Sligl after getting the first dose of the COVID-19 vaccine alongside her colleague, Critical Care RN Peter Anderst
herself spends about 80 hours a week treating patients. She also undertakes research and holds numerous administrative responsibilities. As well, she has chaired the Royal Society of Canada’s Working Group on the Epidemiology of COVID-19 and serves as a member on its Task Force on COVID-19. The grind of the pandemic has led, Sligl admits, to “extreme fatigue, anxiety, and burnout, which I’ve had to learn to manage. I can’t say I’ve really done a great job, and have experienced some pretty dark times myself. I’ve tried my best to cope.” It’s been tough on her family as well. Sligl has two young but resilient kids who were used to mom working long hours pre-pandemic but have endured even more of her absence. “But they know that these additional shifts will end.” Looking back, Sligl says she’s proud of how the health care system and ICU team has managed. “It wasn’t easy and we had to overcome a lot of challenges but we supported each other, conquered fears and provided excellent care.” There’s one key lesson from COVID-19 that Sligl hopes the international community takes to heart. “We need to protect each other and care about one another. This pandemic has reminded us that we are a global community of people that is inexorably interconnected.”
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Taking a bite out of COVID-19
A family doctor writes a children’s book that faces the scary side of the pandemic
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ne-year-old George has a somewhat toothy grin for a toddler, vaguely reminiscent of a shark, says mom Dr. Stephanie Liu. And it inspired an intuitive leap when her son’s big sister Madi was upset about the changes that COVID-19 had brought into her young life. Why not write a book about COVID-19 that was directed at kids through a character created in honour of her boy’s engaging, if slightly scary, smile? The result is Georgie Shark and COVID-19, which Liu self-published last December. The book, whimsically illustrated by Jessica Binnington, addresses the concerns that four-year-old Madi was expressing. Why is the world changing?
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Why can’t I see my friends? Why can’t I see my grandparents? Why can’t I do the things I love? There’s even a page showing how masks prevent the spread of COVID-19, in a language kids can relate to, says Liu. “A shark sneezes, and you see all these cooties flying around.” The book ends with Grandma Shark sending Georgie Shark a package filled with his favourite shark cookies and some toys. The message? “Even though we’re physically apart, it’ll never stop us from loving each other and talking to one another,” Liu says from Edmonton, where she works part-time at a community family practice, specializing in pediatrics and women’s health. “If we all work together,
we’re going to get through this,” says Liu, who is Pampers’ brand rep on Instagram. Georgie Shark isn’t Liu’s first foray into children’s fiction. Two years ago, she self-published a book for daughter Madi, who loves to look at the pictures in her dad’s copy of Gray’s Anatomy (Liu is married to otolaryngologist head and neck surgeon Dr. Graeme Mulholland). Madi Monkey Learns the Body explains in simple kid’s language the parts of the body and its function, whether that be the eyes or belly button. (Madi was born in the Chinese astrological year of the monkey, hence the title.) COVID-19 resilience messages are as relevant for adults as they are for children,
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courtesy of dr. Liu
“If we all work together, we’re going to get through this,” says Dr. Liu and Liu has embraced a variety of platforms to disseminate her own experiences with the coronavirus, as well as guidance for parents. Shortly after Madi was born, Liu launched the blog, “Life of Dr. Mom,” partly in response to the growing abundance of bad parenting advice she was reading on the internet. “You see these blogs that aren’t evidence-based,” Liu says. “It’s personal opinion and sometimes it’s dangerous. People get tricked into believing that what they’re seeing online is true and it’s confusing. That’s why I wanted to create this platform.” Liu’s blog was launched after she went online to try to find help for something all new parents struggle with: babies
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Dr. Stephanie Liu with her family
waking through the night. Months of sleep deprivation from Madi’s frequent awakenings— Liu was working at an acute care medicine ward during the day— had left her exhausted. She scoured mommy blogs for advice on how to train infants to sleep and self-soothe and was met with a barrage of dire predictions about the longterm ill effects. Skeptical of the claims, Liu researched medical journals and learned that sleep training healthy infants is safe. Since then, “Life of Dr. Mom,” co-written
with clinical pharmacist Erin Manchuk, has addressed polarizing topics like breast feeding, vaccinations, napping and birth control, as well as such COVID-19-related issues as helping kids stay in touch with relatives via video chatting, and determining how much screen time is too much.
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continued
Liu’s support of her patients goes beyond blogging. Sometimes she’ll check in personally with patients she knows might be struggling with COVID-19 protocols. “One of my patients who didn’t end up having children and doesn’t have a partner—I still check up with him regularly. He said that I was the first person he had spoken to in five days. “I really worry about people and society with COVID-19,” Liu continues. “Not just people getting it and dying, but people’s mental health. Humans are social beings and it’s important to feel interconnected, to talk to each other, reach out, and be kind. That’s been a really good lesson for me.” COVID-19 has made Liu truly value the little things in life, like “having a coffee with my husband, playing on the floor with my kids, having a nice meal or walking outside when it’s sunny.” The pandemic, however, has made her worried for more than her patients. She also frets about the deep societal divide that COVID-19 has engendered. “There’s so much division; people don’t believe COVID is a real thing and don’t wear masks.” If the coronavirus is to be thwarted, society needs to “work together towards a common goal”—something that Liu is trying to nurture and encourage through her blogging and book writing. And what does George think about being the muse for his mom’s latest writing endeavour? “He just likes ripping out the pages.”
courtesy of dr. Liu
Dr. Liu’s son George—the namesake of Georgie Shark—holds the children’s book he and his sister Madi inspired mom to write, addressing kids’ questions about COVID-19
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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 ng 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.
A message that Barack Obama also contemplated:
Back again
The first (and ongoing) waves of the pandemic have been all about uncertainty fact, the public should be made aware that the current constraints, unpleasant as they are, are not for naught. So where do we go from here? Late in 2020 the light at the end of the tunnel became brighter with the introduction of vaccines. Unfortunately, that light is beginning to flicker somewhat but it will eventually break into full daylight. In the meantime, every attempt must be maintained to keep the virus count as low as possible because the fewer viruses around, the fewer the mutations. As the immunization program rolls out, who should be treated and when? There is fairly universal agreement that the frail elderly should be treated first because they require prolonged hospital stays when
acutely ill. Then, of course, it should be frontline workers in the emergency departments, ICUs and infectious diseases wards. Then the sick and well senior population. Canadian physicians have done a stellar job of bravely stepping up to the front— along with team support from nursing staff and paramedics—in dealing with these sick and infectious people. They all deserve a pat on the back. In fact, I think they all deserve a year’s holiday when this is over, but they may have to settle for just a couple weeks. After a crisis memories can be short. Barack Obama had on his desk a plaque, which he treasured, with the simple yet powerful message: HARD THINGS ARE HARD. Isn’t that so true.
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his issue of the magazine comes out after a year of silence, and what a tumultuous year it has been. In one way I have nothing to say—and in another I could fill five volumes. Several analogies have been applied to this period of history including a rollercoaster ride of chaos, anxiety and depression—with uncertainty underlying it all. That is, uncertainty about when the situation will begin to resolve, uncertainty about effective treatments and uncertainty about when the white knight is going to ride in with a vaccine. The anxiety level is not helped by the media. For example, the CBC delivers a news update every hour. I do not need to be told and retold every hour for several consecutive days that Moderna was cutting the vaccine sent to Canada by 20%. Phonein talk shows and armchair epidemiologists further fuel uncertainty and anxiety. One word that has been outstanding with relevance to the federal and provincial governments is “unprecedented.” There is no data to consult to see how this pandemic was dealt with previously. This is all virgin territory. Given the circumstances, all levels of government have tried to maintain transparency of their processes, and communicate concerns and difficulties to the public. The results may appear, to some, suboptimal but I am not going to go there. At the time of writing the biggest concern is the availability of vaccines. By the time this essay is published this may be history, and there will be yet another problem—another mutation or unprecedented change. (There’s that word again). In spite of the fairly lively anti-mask protesters and the scofflaws with regard to assemblies, Canada is not doing too badly. The latest figures I can get suggest that Canada has an incidence of the COVID-19 virus of 2%. The global incidence of COVID-19 is 13%. These figures are reassuring, but they are not relayed to the populace because it may encourage complacency and discourage compliance with public health guidelines. I think these figures are so good because people have, on the whole, been accommodating to these restrictions—in
Hard things are hard
Spring 2021 Just For Canadian doctors
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m o t o r i ng
D r . k e l l e n s i lv e r t h o r n Dr. Kellen Silverthorn is an automotive writer. He tries to keep one convertible and/or one track-day car in the family fleet.
Resurrection and renewal
K
nowing there’s another issue of this More time was liberated as my wardmagazine after a year’s pause offers robe and personal hygiene were COVID some semblance of a nod towards rationalized. Maintaining my mental normalcy. Our individual paths to the new health dictated filling the time vacated by normal will be long, with many twists and those many activities. Mostly I ramped up turns. Like many, I’m impatient for this colpassions already present (better than the lective return journey to gather speed. alternative of Netflix soma). Thinking back to those early COVID-19 I could watch professional racing on TV days of 2020, I was cluelessly optimistic on while working out in the home gym. My what public-space access sim racing rig I had fortuitously upgraded I’d lose, and how just weeks before the pandemic onset, long restrictions and the resultant racing against AI Another big would last. I or my fellow sim-racing enthusi(positive!) story that asts across the globe flirted with has come out of 2020: addictive behaviour. Norway is the first nation to The pandemic was as good ban the ICE-powered car (by a time as any to dive deeper 2025). Here, a map of Tesla into science fiction novels. EV charging stations across Thank God for Amazon, as our the country, including this local library system seemed “supercharger” in inexplicably paralyzed for Mosjøen fjord six months. (Ironically, liquor stores and cannabis retailers didn’t miss a beat.) Sudoku was another time-occupier I resurrected. After exhausting the airport also remember softcover editions I trying to train had lying around, I tranmyself against sitioned to websudoku. touching my face. com, where I could get an It didn’t work. unlimited supply of Goldilocks As the days of restric“just right” difficulty puzzles. And tion became weeks, then with copious solo time, I re-doubled my months and then whole seasons, the stone-sculpting efforts. Yes, I sculpt stone dreary reality of life with the pandemic cars (kellensilverthornsculptures.com), a praccame into focus. One’s social life on hold. tice that’s made me aware of how Non-essential travel embargoed. Nondifferent are the mindsets and compensaessential shopping blacklisted. Dine-in tion of the arts and medicine/dentistry. restaurants closed. Libraries shuttered. Serendipity added a new dimension Gyms padlocked. Hair stylists incommuto my weekly activities. Chance linkages nicado. Even non-emergent health and between my virtual racing network and dental care on furlough. my sculpting connections found me Specific to my situation as an automoworking one day per week at a local auto tive writer, my auto industry media events restoration shop. The cross-pollination of also ceased. My driving instructor gig at tools and techniques between stonethe local track faded to black. Annual racsculpted cars and full-size metal versions ing pilgrimages to Targa New Zealand and has been a revelation. south of the 49th for endurance racing The restoration shop and sculpting were deep-sixed. gigs have kept me thinking about and
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Just For Canadian Doctors Spring 2021
discussing cars. And car fans love to contemplate changes to their family fleet. In 2020, I had wanted to sell my race car but that market was understandably flat. I did sell a roadster that wasn’t getting much use either. Acura kindly rebuilt the engine in my 10-year-old daily-driver SUV. That Acura should now stay in the fleet until its 15th birthday. One of the big global auto stories of 2020 affects my family fleet. During COVID, many OECD (Organisation for Economic Co-operation and Development) nations legislated a go-forward end to internal combustion engine (ICE) powered new car sales. Norway is the earliest with its ban commencing in 2025. More than half of Norway’s car sales in 2020 were electricpowered. Many other OECD nations (and California) are in the 2030–35 year range for regulations that end ICE new car sales. In North America, electric vehicles (EV) are presently ~5% of sales, so the end of ICE sales here is farther out on the timeline. Yet it does give car fanatics pause to contemplate the ICE-powered icons they’ve never owned but still could before it’s too late. My “car of the week” fixation for several months now has been the upcoming Mark 8 2022 VW Golf GTI. That model has epitomized the “hot hatch” segment globally since its 1976 debut (yes, 45 years ago). Arguably, a new GTI would be as practical for my daily driver needs as a small SUV, yet lighter, cheaper and more fun to drive (six-speed manual transmission is standard in the immersive GTI). Ah, so many worthy ICE icons, so little time. It’s fun to dream. This past year didn’t countenance a lot of dreaming. Nevertheless, as dispiriting as the past year of COVID has been, 2020 isn’t on my personal hit parade of worst years. Still, 2020 will be easily recalled because pandemics are infrequent and they shoehorn all of us into similar shared experiences. I plan to relish (and will cherish) the approaching normalcy because of that collective challenge (profession, city, country) that’s been faced and vanquished. Now, let’s gather speed ASAP.
tesla; istock/ Beatriz Montes Duran
Besides that other big story, 2020 saw another seismic shift to the automotive industry
