Just For Canadian Doctors Spring 2015 by Just For Canadian Doctors

spring 2015

DOCTORS life + leisure

wine tour in

win

Portugal

$50 Visa Gift Card page 45

giddy-up in

Saskatchewan

+ MIX IT UP: cocktail conjuring + hot in Tetiaroa, Brando style + the Maasai School Project + photography MASTER class Publications Mail Agreement #41073506

inside: Continuing medical Education Calendar where will you meet? l i s b o n

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DoctorsMagazine_2015.pdf 1 3/6/2015 4:46:43 PM

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Just for C

DOCTORS life + leisure

spring 2015

contents

spring 2015

Editor Barb Sligl Art Direction BSS Creative

Contributing Editor Janet Gyenes

Editorial Assistant Adam Flint

Contributors Joanne Blain Michael DeFreitas Dr. Holly Fong Dr. Chris Pengilly Manfred Purtzki Dr. Kelly Silverthorn Jenn Smith Nelson Roberta Staley Cover photo B. Sligl Senior Account Executive Monique Nguyen

14 38

Account Executives Wing-Yee Kwong Lily Yu Sales, Classifieds and Advertising In Print Circulation Office 200 – 896 Cambie St. Vancouver, BC V6B 2P6 Canada Phone: 604-681-1811 Fax: 604-681-0456 Email: info@AdvertisingInPrint.com

FEATURES

14 Port of call Sample Portugal through its wine and beyond 38 Prairie escape Unplug in Saskatchewan’s cowboy country

Associate Publisher Linh T. Huynh

Production Manager Ninh Hoang

Circulation Fulfillment Shereen Hoang

CME Development Adam Flint

Founding Publisher Denise Heaton

COLUMNS

DEPARTMENTS

10 photo prescription

5 spring mix 23 CME calendar 45 sudoku 46 small talk

Combine more than one photo technique into one stellar shot

clockwise from top left: B. Sligl; Jenn smith nelson; B. Sligl

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

13 pay it forward Helping Maasai women and girls

19 the thirsty doctor

with Dr. Millan Patel

Make a memorable mix

21 the wealthy doctor Pros and cons of life insurance

30 doctor on a soapbox

cover photo

A traditional rabelo boat on the Douro River in Porto, where port has long been shipped in barrels from the Douro Valley inland. Story on page 14.

Assisted suicide

35 motoring Remember the Sonett?

www.justforcanadiandoctors.com

44 the hungry doctor

Printed in Canada.

miss an issue? check out our website!

Fresh fish fare for spring

Spring 2015 Just For Canadian doctors

from the editor How to tour wine country in Portugal: sip a porto tónico at Quinta do Bom Retiro; meet the dapper proprietor and host at Quinta do Seixo; and visit the tower of Herdade do Esporão. Story on page 14. clockwise from top

spring cleanse

serious pampering in the South Pacific. If you haven’t heard of Tetiaroa before, it’s because up until a few years ago it had been Marlon Brando’s private island retreat. Now it can be yours too. Decompress and download a new mindset beachside, and then island hop to Bora Bora and do it again (page 5). If you’ve managed to get a head start on rebooting, then perhaps you just need to take a break and indulge. For that, we suggest a tour of Portugal’s surprisingly sophisticated vinho regionals (page 14), topped off with a few days in lovely Lisbon (page 23). The Portuguese really know a thing or two about bom retiro or the “good retreat.” Here’s to everyone getting to sample some of that lifestyle—with a porto tónico in hand, of course. Cheers! feedback@InPrintPublications.com

f the new year didn’t already impel you to reboot, recharge, rethink (or any other verb with a “re” prefix), then it’s likely that spring may be an impetus for change, or at least a cleanse of sorts. You can take that literally and do an actual cleanse, and, in that case, we’ve got the tool for you—think green (as in smoothies; page 6). Our “The Thirsty Doctor” columnist also reinterprets cocktails with a healthier mix—so your drink fix gets a better-for-you boost (page 19). If your form of a cleanse is more cerebral, we suggest a digital fast. Abandon emails, internet, social media and electronic crutches, and head for the hills. The hideaway of La Reata Ranch in Saskatchewan provides a prairies recipe for spiritual release (page 38). Or get in touch with your inner royalty/ movie star and drop out of the real world for

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mix

time out in Tetiaroa to the

South Pacific

Tim McKenna

f you dream of being marooned on a tropical island without the privations that usually entails, two resorts in French Polynesia provide visitors with new accommodation options. Marlon Brando discovered Tetiaroa while filming Mutiny on the Bounty and later bought the whole island. In July 2014, a decade after the enigmatic actor’s death, a resort called The Brando opened on the island, a 20-minute flight from Faa’a

International Airport in Tahiti. With just 35 villas, each with a plunge pool and beach access, it’s an oasis for travellers who crave pampering and privacy. That all comes at a price: One-bedroom villas are priced at 3,000 euros ($4,200 Cdn) a night, which includes meals and drinks (with a few exceptions), plus one recreational activity per person and spa visit per villa per day. Double that for a twobedroom villa and triple it for a three-bedroom, and there’s no

such thing as a bargain in the off-season—the same rates are in effect year-round. Obviously, that limits the clientele to the well-heeled. But what you get for your money is an experience that’s hard to match in a setting that’s almost too stunning to be real. The white-sand beaches and turquoise waters are more or less standard fare in this part of the world, but the contemporary and spacious villas, high-end dining orchestrated by a two-

Michelin-star chef from Paris and faultless service will make you sigh with regret when you step on the plane to leave. Before you do, make sure to try the beach bar’s signature drink, the Dirty Old Bob. Named for a friend of Marlon Brando, it’s a seductively smooth blend of bourbon, pineapple juice and Tetiaroa honey, among other things. Careful, because one Dirty Old Bob tends to lead to another. thebrando.com continued on page 6 >>

Spring 2015 Just For Canadian doctors

mix

get juicy

spring

With spring here, healthy wannabes start thinking the “c” word. Cleanse. It doesn’t have to be something to cringe from. In fact, it’s never been easier to kickstart a better-for-you diet, or at least boost your existing one, now that cult-favourite Vitamix gadget has come out with the super-charged and -sleek S30. The S-Series high-performance personal blender (with both larger 1.2L and to-go 600mL containers) is a mini juicing operation in-house. Order in, take it out, make it your own. Like ginger? Add a knob to that mango smoothie (see below), or, if you’re on-trend, some acai berries. Into green tea? Add matcha. Chocolate lover? Add some! This convert’s go-to blend: cacao powder, almond milk, kale, hemp seeds, frozen blueberries and some Vega protein powder. It’s my Supergirl smoothie…and the Vitamix is my personal phone booth. $469, vitamix.ca —B. Sligl

go-to

Pool , in g l oun g son s ea Four S ora Bora B styl e

+ bora bora continued from page

FIX!

5 >>

On Bora Bora, the Four Seasons Resort, which opened in 2008, added three two-bedroom overwater bungalows with private plunge pools to its inventory in late 2014. In all, 15 of the resort’s 100 overwater suites and all seven of its beachfront villas have private pools, along with direct access to ocean waters or the resort’s man-made lagoons. getWhether or not you have your own pool, you away shouldn’t miss a visit to the coral-filled Lagoon Sanctuary. Book a snorkelling tour with resident marine biologist Oliver Martin, who is hand-grafting coral to keep the lagoon’s ecosystem thriving. If you’re lucky, he’ll show you how he has trained some of its resident puffer fish to literally eat out of his hand. It’s all about the water at the Four Seasons Bora Bora—if you tire of swimming or snorkelling, get a kayak, stand-up paddleboard or a jet ski from the resort’s activity centre. And don’t miss an offshore excursion to swim with stingrays and lemon sharks. Don’t worry, we were assured (with a sly smile) that the sharks are all vegetarians. Prices at the Four Seasons start at 91,000 Pacific francs ($1,075 Cdn) for an overwater bungalow and 269,000 Pacific francs ($3,200 Cdn) for a two-bedroom beachfront villa. fourseasons.com/borabora — Joanne Blain

health

Just For Canadian doctors Spring 2015

go green / get juicy

The Vitamix S30 comes with a book of supersimple and -healthy recipes, from hummus to beet juice. It’s as easy as tossing grapes, mango chunks, kale (yes, still the it wonderfood), basil leaves, ice and water into the to-go container. Rev the blender engine that roars like a Maserati… and then sip a Mango Basil Smoothie, our spring power drink pick.

Barbara Kraft

island idyll

master blend

travel smart

spring

gear

From left Lava, Frost, Carbon

Low-tech lover or early adopter? Our gear list offers the best of both

hightech

bionic band

mix

Written + produced by Janet Gyenes

What could be more unique than your heartbeat? Toronto tech startup, Nymi, put that thinking into action when it created its eponymous band, which you wear on your wrist to unlock devices and remember passwords. It uses secure biometric analysis to identify your electrocardiogram, so you can safely perform such mundane gear tasks as unlocking your car or house, scanning your boarding pass, accessing your computer and more, without having to constantly prove you’re you. The company has also partnered with RBC and MasterCard to pilot a payments project that could see Nymi Band wearers buying goods with a simple flick of their wrist. Available in Carbon, Lava and Frost; $149; nymi.com

lowtech

Outsmart Mother Nature

pick

sport -tech smart sidekick Who doesn’t want the jackknife of luggage? The Genius Pack Hardside Spinner lives up to its name, melding low-tech simplicity with high-style. Sure, the compact carry-on has a sleek, yet rugged exterior that keeps contents from getting crushed, plus a TSA-friendly combo lock for added insurance when you tote want to check your bag. But it’s the thoughtful touches, like a built-in packing list and smartly placed (and labelled!) pockets that make it indispensable. Digging around for charging cables or wondering which socks are clean are worries for someone else. $158, geniuspack.com Spring 2015 Just For Canadian doctors

smart styling

Admit it: Mother Nature can be harsh. Galeforce winds, unrelenting rain, sub-zero temperatures ... but Canada Goose has stayed one step ahead. Its new collection of technical gear means you can hike Machu Picchu or paddle the Tatshenshini without having to worry about what you’re wearing. Soft Shells (Trenton shown in green, $525) let you take your adventure to the next level, thanks to its new innovation—Triwear Durance SS™, a three-layer waterproof fabric that sports twoway stretch and extreme breathability—plus plenty of other editor’s comfort- and safety-enhancing features. And you won’t have to sacrifice warmth for weight when travelling with the award-winning HyBridge™ Lite Jacket that barely registers on the scale at less than half a pound. Or go for the vest (right, $325) It keeps wind and water at bay while still being breathable, and it comes in a range of colour-blocking choices so you’ll look as stellar as you feel, whether extreme adventurer or weekend warrior. canada-goose.com

mix

peak play

spring

haute

hut

ul d o c you y here! sta

get high! at the Monte Rosa Hütte…

into the high alpine Before or after your trek to Monte Rosa Hütte (make reservations at alpenonline.ch/reservation/calendar?hut_id=6&lang=en), spend some time in the picture-perfect Swiss Alps village of Zermatt. This summer, Zermatt celebrates the 150th anniversary of Edward Whymper’s epic ascent of the Matterhorn (July 13, 1865) with various events, including an open-air theatre performance, The Matterhorn Story, that reenacts that first climb (zermatt.ch/en/150/ Activities-Offers-for-2015). And because Zermatt is car-free, arrive in true Swiss fashion by train, via the national rail system SSB (swiss-pass.ch) or the Glacier Express (glacierexpress.ch), gliding through spectacular scenery. For more on Zermatt, go to zermatt.ch, and for more on Switzerland in general, myswitzerland.com.

Just For Canadian doctors Spring 2015

Christof Sonderegger

The Monte Rosa hut, run by the Swiss Alpine Club, sits at 2,883 metres far above Zermatt in Canton Valais in Switzerland. Its sweeping views include the legendary Matterhorn. Known as the “rock crystal” for its jagged aluminum architecture (reflecting light and peaks and effectively doubling the mountain scenery), this “hut” is self-sustaining and ultra energy efficient (what else did you expect from the Swiss?). But getting here isn’t easy. You must traverse the Gorner Glacier amidst the highest peaks in the Alps. Not for the faint of heart, this a serious alpine trek. Take on the challenge (with a mountain guide!) this spring with skins and skis for blow-your-mind ski touring or in the summer with ropes and carabiners for mountaineering that channels your inner Edward Whymper, the first to ascend the 4,478-metre Matterhorn in 1865, 150 years ago this July. He may have stood atop it, but the best view of this peak may be from the Monte Rosa Hütte. —B. Sligl

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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.

put it all together

Combine various photographic techniques for more impact

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

Why is this photo of the Lower Yellowstone Falls so full of impact? Besides making the trek to find this wow-factor vantage point of natural beauty, photo columnist Michael DeFreitas

also combined more than one key photographic technique.

> LEADING LINE The composition of the photo places the river on a diagonal

Just For Canadian doctors Spring 2015

line, from bottom left to top right, leading the viewer’s attention into the photo and to the focal point of the waterfall.

> RULE OF THIRDS

The spectacle of the waterfall

is carefully composed within the frame on one of the four intersections of lines that divide the photo into thirds. And to further amp up the drama, the shutter speed is

set low enough that the power and rush of the water is further emphasized with a subtle blur.

> PHOTO SPECS

Nikon D300, 120mm, f5.6, 1/125 second, ISO 200.

michael defreitas

show off all those skills!

good travel photographer is familiar with a number of techniques— panning, slow shutter speed, rule of thirds, leading lines, framing. These photographic techniques (see back issues of Just for Canadian Doctors for columns covering all of these) elevate standard snapshots into souvenir-worthy images. The next step? Don’t limit yourself to just one technique at a time. Combine two or more photographic tricks into the same shot for an even more dramatic photo. But don’t force it. Multiple-technique images work best when they look natural. Have an idea of what you want your image to convey—then look for obvious combinations. Start with two techniques and try to imagine how the combination will look before you try to compose it in your viewfinder. With a bit of practise you’ll start seeing all sorts of combinations. And after mastering various pairings you can start adding even more techniques to the mix. In Peru’s bucolic mountain villages I found plenty of photo opportunities. In Chinchero, I photographed an Inca woman weaving a decorative waistband on a small handloom. She was looking down, so I decided to zoom in and emphasize her deft hands working the loom in her lap. I placed them near the upper left third intersect, as per the rule of thirds. I then positioned the anchored end of the wool in the bottom right corner of the viewfinder so it formed a leading line to her hands. Thirds and framing are another easy combination. Earlier this year I was in Cancun to shoot a story with a tropical honeymoon theme. The art director wanted images that had a romantic tropical feel, preferably with a beach. After finding an attractive couple on a crowded beach I looked for a natural frame to help me hide the other people (a crowded beach isn’t very romantic). I framed

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29/01/2015 16:16

photo prescription [continued]

PRO TIPS for shooting in combo

> The number-one rule for combining techniques is

to think about what you want the image to convey. Combining elements for the sake of combining usually yields disappointing images.

> Once you have a concept, view your subject from

various angles to find the most natural composition. Photography is all about seeing the final image before you shoot.

> Make sure you are proficient with each technique before you try to combine it with others.

> Expect rejects. Make the delete button your friend. gear up With new DSLRs coming out each year,

buying one can be daunting. Most purchase decisions are based on brand and price. Few shoppers consider ergonomics. They should. While most new DSLRs offer similar features, they differ ergonomically. A better “fitting” camera (one that fits your hand and shooting style) that’s more comfortable will lead to better pics. For example, people with small hands should think twice about buying a heavy camera with a wide grip. It can lead to fatigue when shooting (and not-so-good pics). Similarly, those with larger hands do better with a substantial grip and slightly heavier cameras. New DSLRs can cost $700 to $3,000 so, instead of concentrating only on brand/ price and/or features, test-drive it first. Make sure it fits.

the couple using palm fronds to both isolate the couple and signal that this was a tropical destination. And I placed the couple near the bottom right third intersect for added effect. Sometimes luck plays a major role in capturing a compelling image. Last year, I stopped to shoot a group of pronghorn antelope feeding beside a New Mexico highway. When some of the animals moved towards the road, I decided to use the painted highway lines to lead the viewer to the crossing. As I shot the first antelope stepping onto the roadway, a car suddenly appeared in the top left of my viewfinder. I quickly recomposed the shot to include both the car and antelope near opposite third intersects with the highway lines leading the viewer into the scene. Fortunately, the car slowed and the antelope safely crossed, but the shot still conveys lots of drama. Combining three or more photographic elements is difficult and requires a fair bit of prep. Using a slow shutter speed, panning, leading line and thirds is one of my favourite multi-element combinations. I used it in Disneyland’s Toontown to capture action shots of families having fun. I stood near a small rollercoaster where I could use the track as a leading line. Using shutter priority, I selected a slow shutter speed (1/15 sec) to emphasize motion and practised panning along the track. As each coaster car entered my preselected section of track, I positioned it in the upper left near a third intersect and panned (trying to hold the car on the intersect). It took a dozen or so tries before capturing the desired action image of a father and son hugging. Improving your photography is an incremental process. Trying to do too much too fast usually ends in frustration. Be conscious of the various techniques, but avoid trying to construct images. Simply try “seeing” natural combinations. And don’t get discouraged if the combo doesn’t fall into place immediately—it can take years to master certain techniques. The important thing is to keep looking and shooting.

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Just For Canadian doctors Spring 2015

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.

women’s hurdles

A psychiatrist helps fulfill basic needs of young women through the Maasai School Project

Christopher Michel

ometimes the simplest things cause the biggest problems. No where is this more evident than in Kenya among the girls and young women of the Maasai people, whose lack of resources make it almost impossible to cope with menstruation outside the home. It is such a problem that it prevents girls and young teens from being able to attain an education—a pattern seen not only in Kenya but other parts of Africa and around the globe. As co-founder of the Maasai School Project, child and adolescent psychiatrist Jean Clinton of Hamilton, Ontario, is trying to improve this frustrating reality for girls who live in the Maasai Mara, a national park about four hours from Kenya’s capital of Nairobi. An associate clinical professor in child and adolescent psychiatry at McMaster University, Clinton first came to Kenya in 2012 with colleague Pippa Moss, another child psychiatrist who helped create a sanctuary for AIDS orphans in Kenya several years ago. As a child development expert, Clinton was especially interested in visiting the local school, Oloolaimutia Elementary, a 10-room structure with 685 students in kindergarten to Grade 8. Nine teachers instruct classes of up to 100 pupils. Here, says Clinton, the poverty of the Maasai people—traditional subsistence cattle herders—was clearly evident. Not only were the class sizes enormous, but basics like pencils and desks were in short supply. Youngsters also arrived at school hungry and tired from walking up to 15 kilometres to school in bare feet, Clinton says. But as challenging as these issues were, none was as bad as the problem of periods. Traditionally, menstruating girls and women use anything at their disposal to staunch the monthly flow, from torn rags to newspapers and even feathers. It is impossible to stem leakage, resulting in humiliating stains. As a result, Maasai girls will miss about four or five days a month, or at least two weeks of school per term. The repercussions were severe. When Clinton analyzed school attendance numbers, less than half a dozen girls were in Grade 8, out of a class of 28. In pre-school, which was attended by four to five-year-olds, 89 of the 144 students were girls. Part of the

reason for the dramatic drop in attendance, their own ability to generate the funds for says Clinton, was that girls were required to whatever it is that they need rather than help out at home, or were married off. The depending on us to do it,” says Clinton. number of boys at school also dropped There are myriad other needs that because they were required for cattle the MSP is tackling. This year, it funded herding. construction of a badly needed toilet for Clearly there were lots Olooaimutia Elementary. The children are of things that could be also being taught proper oral health Child done, and Clinton set and given toothbrushes and paste. and adolescent to work establishing Clinton also worries about the psychiatrist Jean objectives for the small dormitory for elementary Clinton co-founded the Maasai School boy and girl students, which Maasai School Project in Project (MSP). is under minimal supervision. Kenya, which provides basic The key priority needs to Maasai school was supporting girls, like this young those children who student, working on passed their national her math. exams to attend high school in the city of Narok, nearly two hours northeast of Maasai Mara. Because the Maasai parents are poor, the MSP, with the help of the of the Fundy Peace Foundation charity in New Brunswick, raises the $450 per student needed to cover a year’s tuition. As a result, five children— three girls and two boys—now attend the high school in Narok. There are additional challenges for these teens. One Those girls who don’t stay in the dormitory of the girls, says Clinton, “is experiencing are vulnerable to rape by young men while tremendous pressure as her family wants to walking to and from school. Ultimately, marry her off to get cows but she wants to however, a bigger dormitory is only a become a nurse.” Band-Aid solution. Educating both men The second key priority is ensuring that and women about gender rights is key to girls can attend their elementary school addressing this problem in the long-term. classes by supplying them with sanitary Currently, Clinton says, women have low pads and uniforms. Perhaps surprisingly, a status in Maasai society in comparison to year’s supply of sanitary pads, bought locally, men. But education will change that, helping as well as a uniform, costs only $45 a year, make women economic drivers not only Clinton says. A challenge is sustainability. If in their families but their nations, as well MSP funding dries up, how will the girls buy as strengthening their voices in the local sanitary pads? “How do we make sure that community and national stage. “We need to the supplies that the girls need are there for have girls staying in school.” them? Ideally we would be able to facilitate Spring 2015 Just For Canadian doctors

travel the world the

good life Here, that means lunch outside overlooking the vineyards of Herdade do Espor達o in the Alentejo region of Portugal.

Just For Canadian doctors Winter 2015

travel the world

Porto tónico, as served at Ramos Pintos’ Quinta do Bom Retiro. right Taking in the terraced Douro Valley at Quinta do Crasto.

bom retiro

taking in portugal one porto tónico at a time story + photography by barb sligl

View of the winding Douro River from Quinta do Crasto. right Sandeman’s Founders Reserve ruby vintage porto, as served at a picnic at Quinta do Seixo.

travel the world ’m at a picnic under the shade of a giant olive tree surrounded by vineyards. There are embroidered cushions and ham-spiked melon soup and arroz de frango and rows of vines stretching across the steep hillsides and to the lazy river winding far below. It’s an aquamarine ribbon against terraced schist slopes that rise from the riverbanks like a many-layered cake. An almost-neon glow draws my gaze away back to the glass I’m holding. I swirl the luminescent red libation, ice chinking and orange slice bobbing, and take another sip of the liquid manna that this landscape

granite to reach water. The result: complex wine with just as much depth. And the Douro is just one wine-growing region in Portugal. There are 14 vinho regionals, and 31 DOCs (controlled denominations of origin) within those. There are more than 250 varieties of indigenous grapes (in a country that’s about 0.01 times the size of Canada), from rather obscure varieties like Esgana Cão (Dog Strangler) and Amor-NãoMe-Deixes (Love-don’t-leave-me) to the big-name grapes of Trincadeira and Touriga Nacional, “our star,” as it’s often called, Portugal’s pin-up, much like the UNESCO designated Douro or “golden” Valley. Sipping that ruby vintage port while

Lounging poolside at Casa das Pipas at Quinta do Portal. right João Nicolau de Almeida sipping a porto tónico at Quinta do Bom Retiro. below right Bacalhau at Quinta de Lemos.

has produced. It’s a ruby vintage port of the Douro and it’s sublime. Earlier I had a porto tónico—white port with tonic water. Another revelation. Not the cloying sweet stuff you might imagine, Portugal’s eponymous drink is surprisingly sophisticated. As is its table wine. After all, the Douro wine region is one of the oldest appellations in the world, officially designated in 1756 (if it’s not from here, it’s not “port”). Perched high above the Douro River, those centuries of toil are visible, each carved terrace or ancient patamar in this dusty, dry landscape producing vines that must burrow deep into the cracks of the schist slate and

overlooking the Douro River feels set in another era, when producers were isolated within this curvilinear countryside and the river was their only conduit. They’d send barrels of port downriver on rabelo boats to Porto on the Atlantic Coast, where the big “lodges” or storehouses were located. Today, producers like Graham’s still house and age their port (in more than 2,000 pipas or oak casks, tonels and huge balseiros or oak vats) and vintage port (in bottles) here, just across the river in Vila Nova de Gaia. It’s where I had my first porto tónico, a soon-to-be nightly tipple while in Portugal, on a terrace as twilight descended upon the many-hued

Just For Canadian doctors Spring 2015

facades of the diorama-like city. But inland, towards the river’s source, is where it all begins. And while there’s a strong connection to the storied past and rural tradition, the vineyards or quintas of the Douro are part of a renaissance going on since Portugal joined the EU. Last year, Portuguese wines took three of the top-four spots in Wine Spectator’s 100-best wines (with Graham’s sister producer, Dow’s 2011 Vintage Port named number one). The world is finally discovering the wines of Portugal, and especially those of the Douro. My picnic paired with ruby vintage is in the heart of the Douro at Quinta do Seixo, the showcase vineyard of Sandeman, another legendary, seventh-generation producer, whose caped and Zorro-like Don has graced its labels since 1928. The Don is old-school cool but the winery’s history dates back to the late-18th century and a circa-1750 chapel that still stands atop a windy hilltop at the end of a serpentine road. And yet old happily meets new—modern winemaking facilities include fully automated lagares or crush tanks (no foot stomping necessary) and a design-savvy tasting room that seems to hover over the Douro. Perched there in tasting mode, I try white port (made from white grapes and chilled as an aperitivo in the becoming-ubiquitous porto tónico), ruby (fruity, aromatic blends of red grapes aged in larger casks, including LBV or late bottled vintage), tawny (richer, mellower blends aged longer in smaller casks) and vintage port (highest quality from a single harvest, aged in bottles). My favourite is a burnt-orange, cedar-tinged and caramelly 30-year-old tawny that George Sandeman, dressed as dapper as the Don himself, describes as the colour of his wedding ring, “…and I’ve been married a long time,” he says. Not far away is Ramos Pintos, another well-known name and sixth-generation winery founded in 1880. Olive trees demarcate the boundaries of Quinta do Bom Retiro (just as it sounds: a good retreat). I meet João Nicolau de Almeida, whose grandfather bought this quinta in 1919, poolside (and it’s a lovely pool that dates back to the same year, an original in the Douro and apt setting for another porto tónico). He peppers conversation with lovely descriptions; “It’s like making the sun,” he says of the Folgazão grape. He’s the one who calls Touriga Nacional a star and likens the winemaking diversity in Portugal to playing piano. Ramos Pintos itself has 83 different grapes or keys that can be compiled into scores and scores of music. Here, a lunch of bacalhau, the country’s beloved salt cod (which becomes

travel the world

Olive trees at Herdade da Malhadinha Nova in Alentejo.

Each suite at Ecorkhotel has its own whitewashed patio to take advantage of the Alentejo’s sun.

Sandeman’s Don logo oversees vineyards at Quinta do Seixo

Infinity pool— overlooking the Douro River, no less—at Quinta do Crasto. Cork tree, partially harvested, at the Ecorkhotel in Alentejo.

The 13th-century tower at Herdade do Esporão in Alentejo.

Gooey good Serra da Estrela cheese at Quinta do Bom Retiro. Cellars at Herdade do Esporão. below Port-paired fare, including almonds and olives grown at Quinta do Crasto.

Picnic scene at Quinta do Seixo.

travel the world almost as regular a part of my diet as the porto tónico), is paired with Duas Quintas Reserva white (50% of that sunny Folgazão plus Rabigato, Arinto and Viosinho) and, after a few more tastings, ends with a tawny port and orange pudding cake that almost looks too good to eat. João jokes, “When we are born we have 12% alcohol in our blood.” I think I might have some Portuguese in my own blood…. And it continues. Farther downriver and up another steep dollop of a hill is an ancient site that’s now Quinta do Crasto (“castrum” is Latin for Roman fort), a fourth-generationowned winery that, of course, makes port but now focuses on quality table wines. Here there are 48 grape varieties and the crush in the lagares is still done by foot. The white I sample while dangling my feet in the infinity pool overlooking the Douro River (designed by a renowned Portuguese architect) is affectionately dubbed “swimming pool wine”—the perfect match for this very scene. Olive oils are also produced here, “summer” and “winter” varieties. I dunk chunks of bread into both, as well as quince marmalade and creamy Serra da Estrela and Azeitão, soft sheep cheeses served in wheels with the rinds sliced off and the gooey goodness scooped out with a spoon. I cap that with a

ruby-style LBV porto, one that’s also served in First Class on Emirates Airline, no less. At Quinta do Portal (where they say the door is always open), I stay the night at Casa das Pipas (loose translation: house of the barrels in which tawny port is aged), but not before another porto tónico in the late-afternoon heat, lounging by the pool alongside rows of vines—Tinta Roriz, Touriga Franca, Moscatel, to name just three. Afterwards, at dinner, there’s more soft quiejo, cod macerated with port, octopus and chestnut ice cream. I’m still in the Douro…and this is but one vinho regional. South of here there’s the forested Dão (must stop: the sleek Quinta de Lemos where modern design and the finest Portuguese textiles are the backdrop of a newer winery) and farther southwest is Tejo (where legendary Luisitano horses and falcons enter the mix at Casal Branco winery in the flatlands along the Tejo River). Farther south still is hot Alentejo (literally “beyond the Tejo”), where gnarly cork trees dot the landscape and inspire hotels (Ecorkhotel uses cork throughout its state-of-the-art design) and the UNESCO World Heritage Site of Évora holds ancient ruins (the Roman temple of Diana in the middle of town looks like a movie set). Oh, and more wine and olive oil to taste at Herdade do

Esporão (founded in 1267, it has its own 13thcentury tower) and Herdade da Malhadinha Nova (where giant Galega olive trees stand like sentinels and rare Alentejo black pig and cattle are raised). And that still leaves 10 other vinho regionals to explore, from the north’s Vinho Verde to the south’s Algarve. Or what amounts to unlimited compilations and compositions played out on that piano of Portugal. There’s nothing to do but listen to the music and have another porto tónico.

if you go

a sipping tou r of the Dou ro & beyond

SAMPLE PORTO E DOURO Graham’s, grahamsport.com > Sandeman, sandeman.com > Ramos Pinto, ramospinto.pt > Quinta do Crasto, quintadocrasto.pt > Quinta do Portal, quintadoportal.com SAMPLE Dão Quinta de Lemos, quintadelemos.com SAMPLE TEJO Casal Branco, casalbranco.com SAMPLE ALENTEJO Herdade do Esporão, esporao.com > Herdade da Malhadinha Nova, malhadinhanova.pt STAY In the Douro, get cozy at Casa das Pipas at Quinta do Portal, quintadoportal.com; in Alentejo, go luxe at Ecorkhotel, ecorkhotel.com MORE For info on all 14 vinho regionals of Portugal: winesofportugal.info

Sampling the estategrown olives and olive oil at Herdade do Esporão. left George Sandeman in the vineyards of Sandeman’s showcase Quinta do Seixo.

Just For Canadian doctors Spring 2015

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

in the mix

Inspired by Hemingway in words + cocktails

Creating a high-quality and healthier cocktail

hat does a Nobel Prize-winning writer have in common with a bartender? Plenty, if you’re talking about Ernest Hemingway. The peripatetic novelist has been fêted, it seems, as much for his contributions to the cocktail lexicon as for his literature. Renowned for his minimalist writing style, “Papa” once said, “The greatest writers have the gifts of brevity .…” His quote could easily apply to his knack for creating and inspiring cocktails. The prolific drinker preferred his libations like his writing: strong and spare. And he spurned sugar in his cocktails, for health reasons, apparently. Though his ailments were likely a result of his over-indulgences. Regardless, lessons can be learned from Hemingway’s legacy. At La Floridita, for example, one of Hemingway’s favourite Havana watering holes, he insisted on drinking sugar-free daiquiris made just with white rum (double the usual 2 oz. pour) and fresh lime and grapefruit juices. But as the story goes, the bartender

knew the cocktail needed some sweetness to offset the citrus, so he snuck in a little maraschino liqueur. Hemingway’s departure from the traditional recipe upset its flavour balance: a ratio that bartenders often refer to in shorthand as 2:1:1. That’s two parts base spirit, one part sweet (simple syrup—see recipe) and one part sour (freshly squeezed lemon or lime juice). It’s simple—and it works. Consider some of our perennial cocktail faves, which are all versions of a “sour.” Each follows the 2:1:1 ratio closely, if not exactly (see page 20). To make a well-balanced cocktail, start with the tried-and-true formula. Then experiment to personal taste. Try cutting back on the sweetener for a more tart cocktail. Swap lime juice for lemon, grapefruit or even yuzu. Agave, maple or honey syrups can be used to add hints of caramel or floral notes. So can a shot of liqueur, such as Cointreau or the maraschino dosed in Hemingway’s daiquiri. Creativity, however, will only get you so far: quality ingredients are essential. Yet, many

of our favourite drinks, such as whiskey sours or margaritas, are made with ready-to-buy mixes. These “just-add-booze” bottles are full of high-fructose corn syrup, cellulose gum and a bunch of other unpronounceable stuff that’s probably not good for you and certainly tastes bad. The Caesar, Canada’s beloved brunch cocktail and vaunted “hair of the dog,” has similarly been tainted with a dirty laundry list of ingredients—MSG included—that comes in its de facto mixer, Mott’s Clamato. Makes us question whether this hangover cure is actually worse than the night-before poison …. Aaron Harowitz, co-founder of Vancouverbased Walter All-Natural Craft Caesar Mix, couldn’t agree more. “Like many Canadians, we think that added ingredients like MSG, high-fructose corn syrup and artificial colours simply have no place in our favourite cocktail, the Caesar.” But before Walter was launched a few years back, there was precious little alternative, other than continued on page 20 >>

essential SYRUP In a saucepan, boil together 1 cup of sugar and 1 cup of water, stirring occasion{ ingredient } SIMPLE ally until the sugar has dissolved. Cool and store in a bottle in the fridge for up to a month. Imbibe better: 1 spirit, 3 great—and healthier—cocktails 1 Cane sugar, 1 ginger + ginseng

T Our pick: Luksusowa vodka

Tomatoes, fresh horseradish + clams

MOSCOW MULE 2 oz. Luksusowa vodka 4–6 oz. Harvey & Vern’s ginger beer 1 /2 of a fresh lime

2 CAESAR 1 oz. Luksusowa vodka 4–6 oz. Walter Caesar mix 2–3 dashes Tabasco sauce lime wedge salt and pepper

Squeeze lime into a traditonal copper mug or tall glass. Drop lime in; add ice cubes and vodka. Top with ginger beer. Stir. Fill a tall glass with ice. Pour in vodka and Walter. Add Tabasco and salt and pepper to taste. Garnish with lime.

3 VODKA LIME TWIST 3 Made in Poland from potatoes since 1928

Rosemary , lime + cane sugar

2 oz. Luksusowa vodka 4–6 oz. SIP Rosemary Lime soda 1 /2 oz. fresh lime juice

Fill a tall glass with ice. Pour in lime juice and vodka. Fill with SIP soda. Stir.

Spring 2015 Just For Canadian doctors

thirsty [continued] >> continued from page 19 whipping up your own clam-tomato mix in your home blender. “We only use premium, allthe perfect natural ingredients in Walter,” pucker : 5 sours Harowitz adds. Tomatoes, that (mostly) he says, are vine-ripened, stick to the 2:1:1 ratio

sweetness in its recipe; however, each 355 ml can still includes HFCS equivalent to about 10 tsp. of sugar. Hemingway would certainly pass on a sugar-laden Cuba Libre (or opt for straight rum). But could he resist the spicy effervescence of another Caribbean cocktail—the Dark ’n Stormy— made with dark rum SPIRIT SWEET SOUR (Goslings Black Seal, if you want to be Daiquiri 2 oz. white rum 1/2 oz. simple syrup 1 oz. lime juice authentic), lime and Margarita 2 oz. tequila 1 oz. Cointreau 1 oz. lime juice ginger beer? In Ottawa, Whiskey Sour 2 oz. whiskey 1 oz. simple syrup 1 oz. lemon juice Harvey & Vern’s Olde Fashioned Soda Brown Derby 2 oz. bourbon 1/2 oz. honey 1 oz. grapefruit juice makes its ginger Sidecar 2 oz. brandy 1 oz. Cointreau 1 oz. lemon juice beer with certified pure cane sugar, real ginger, plus they add a layer of spice with horseradish is freshly grated, and real (and ginseng. sustainable) clam juice comes from the North Atlantic. Worcestershire, hot sauce and spices Grayson McDiarmid, brand manager of Harvey and Vern’s says, “The spice would lie round out the mix, which comes in spicy and somewhere between a British ginger beer non-spicy varieties. No MSG here—or gluten. and a Jamaican one,” adding that Dark ’n Another booze bedfellow, the soda Stormy cocktails enjoyed a renaissance in market, is making much-needed changes, Ottawa restaurants when the ginger beer was but shifts are slow and slight. High-fructose launched. corn syrup (HFCS) is still the go-to sweetener. “The main benefit of cane sugar is that Coca-Cola Canada recently reduced the

there is nothing artificial and no chemicals,” says McDiarmid. “Sugary drinks are by no means good for you, but in moderation, studies have shown that real sugar is better for you than artificial sweeteners.” Of course, moderation is the key here. Hemingway wasn’t known for that. Spices and herbs are also used to give SIP sodas their natural flavours. The Vancouverbased company offers three flavours— Lavender Lemon Peel, Rosemary Lime, and Coriander Orange—which have 7 grams of cane sugar in each 355 ml bottle, says Jennifer Martin, chief soda officer. “The herbs provide a unique taste and our citrus peel, which contains the better tasting citrus oils, acts like the zest or garnish bartenders add to most drinks.” And bartenders have embraced SIP’s non-traditional flavours to use in new recipes like the Gin and Lavender. Martin says the Coriander Orange is ideal for mixing with rum and a splash of guava juice. (Check out our recipe for a healthier take on the classic Vodka Collins, the Vodka Lime Twist on page 19) “SIP is really about refinement and health,” she says. “Its simplicity allows the finest spirits to shine through.” Hemingway would approve.

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t h e we althy do ctor m an fred pu r tz ki Manfred Purtzki is the principal of Purtzki & Associates Chartered Accountants. You can reach him at manfred@purtzki.com.

looking into life policy Using the life policy as a retirement vehicle—pros and cons

r. Bob, a 32-year-old family physician, is reviewing a proposal from his financial planner that promises him tax-free retirement income. The proposal is a life insurance policy that provides both a $1-million death benefit and cash value of $2.5 million, which will be paid out to him in 10 annual payments of $200,000 at age 75. The plan is that Dr. Bob’s medical corporation will purchase the policy and pay the annual premiums of $20,000 for the next 15 years. Cash value policies are expensive because the steep premiums must be paid with after tax dollars. With a corporate tax rate of 15%, the corporation uses only $23,500 of its cash flow to pay the premiums. A personally owned policy requires pretax cash of $40,000, assuming a 50% marginal tax rate. Withdrawing the cash value of the policy triggers personal tax. The cash value is only tax free on Dr. Bob’s death. To avoid personal tax on drawing funds from the policy, the insurance company will arrange for a personal line of credit with the life insurance policy as collateral. With Dr. Bob drawing $200,000 annually on this line of credit, his bank debt will be $2 million in 10 years. On his death, the corporation receives about $3 million, which will be used to pay off the bank loan with the remaining $1 million paid to his estate tax free. On the surface it looks like a slam-dunk deal. For only $300,000 of premiums Dr. Bob receives a tax-free $2-million retirement nest egg plus a $1-million death benefit. Not so simple. There are reasons why not every doctor should sign up for this type of life insurance policy.

1. Projections are too optimistic. Dr. Bob’s projection is based on an investment return of 6% over 50 years. If the actual returns are lower, it can erode the cash value quickly. Many doctors who subscribed to this plan in the past never realized the projected returns and were unable to draw any retirement income from the policy.

what to know before you commit

There are reasons why not every doctor should sign up for this type of life insurance policy

2. Early withdrawal penalty. Changing your mind is costly, especially in the early years. You build up the cash value but you cannot access it because of the substantial cash surrender charges.

DO YOU REALLY WANT TO KNOW?

CANADA’S REALiTY

3. The loan arrangement is complicated. If the company owns the policy and the company borrows the money secured by the policy, then any payments to you will be considered a taxable dividend taxed at about 40%. You basically convert a tax-free bank loan into a taxable benefit. If Dr. Bob takes out a personal line of credit secured by the corporate policy, as his planner advises, it will have the following consequences: Dr. Bob must use personal funds to pay the non-deductible interest on the loan, since the loan interest is only deductible if the loan is used for investment purposes—not to finance his lifestyle. Also, the cash value in the company increases the value of the shares, resulting in capital gains taxes on Dr. Bob’s death. continued on page 22 >>

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4. Do you really want to have a $2-million loan when you are 80 years old? If your bank loan exceeds the lending limit of, let’s say 75% of the policy’s cash surrender value, then you have the following unpalatable options available: • Repay a portion of the loan • Provide more collateral security

On the surface it looks like a slamdunk deal The insurer’s bank can call the loan and force you to surrender the policy. Before you commit yourself to a cash-value policy and writing big premium cheques, ask yourself whether you absolutely need it in terms of all the benefits the policy provides.

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lisbon / bermuda / cape cod / papau / krakow … | c a l e n d a r

cMe

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spr ing 2015 + beyond

500-year-old Belém Tower below Funicular

LISBON

The Santa Justa lift aglow at night right

Azulejos tiles

Lisbon is a treasure trove of weathered architectural details

Dancers in front of Convento Carmo

Ginginha Carmo

pure lisbon Portugal’s capital city melds its powerful past with a relaxed rhythm that’s as intimate as it is unmatched (CE events in Lisbon are highlighted in blue.)

Janet gyenes

pair of dancers are twirling on the street in Lisbon’s chic Chiado district, eyes locked and feet expertly navigating the cobblestones. Their sexy routine ends in a dramatic flourish, with the woman leaping into the man’s arms, much to the delight of passersby. Hours later, just up the hill, couples young and old practise their dance steps in front of the Convento Carmo ruins. The church’s roofless nave is open to the starry sky, a reminder of the 1755 earthquake (and tsunami) that flattened much of Europe’s westernmost capital. The clock strikes midnight. The music stops; lights are snuffed out. Dancers embrace, say their goodbyes and the crowd fades into the shadows, perhaps down the hill to Rossio Square for a shot of ginjinha (a sweet cherry liqueur) or up to the Bairro Alto’s latticework of streets for a bite at a busy tapas bar.

Lisbon is a city of neighbourhoods scattered among seven hills and pressed up against the northern banks of the Tagus River, which flows into the Atlantic. Old trams and funiculars rattle up and down the slopes, whisking Lisboetas and visitors past stately edifices—some showing centuries of patina on their crumbling facades, others adorned with colourful azulejos (tiles)— and up to miradouros (viewpoints), such as the Portas do Sol. It’s easy to lose yourself in Lisbon’s rambling streets, especially the alleys in the medieval Alfama district, where the laments of fado music reverberate among the white-washed buildings deep into the night. But soon, a familiar landmark will appear, such as the Moorish São Jorge castle that commands attention from a hilltop, the Santa Justa Lift, a Neo-Gothic iron elevator designed by one of Gustave Eiffel’s pro-

tégés, or the grand arches and arcaded buildings surrounding the riverfront Praça do Comércio, where the royal palace once stood. It’s a glorious spot to watch ferries zip by and to gape at the Ponte 25 de Abril bridge (a doppelgänger for the Golden Gate), which commemorates the city’s Carnation Revolution. Take tram 15 from the square to one of Lisbon’s most historic parishes, Belém, to visit two UNESCO sites: its boot-shaped namesake tower constructed to protect Portugal from invasion and the ornate 15th century Jerónimos Monastery where explorer Vasco da Gama is entombed. End the afternoon at the Antiga Confeitaria de Belém, birthplace of Portugal’s beloved pastel de nata, a custard tart that will fortify you for late-night dancing. — Janet Gyenes For more on Lisbon, go to visitlisboa.com. For more on Portugal, see page 14 and go to visitportugal.com.

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IBD: East Meets West

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2015 Latin & Ibero American Congress Of Paediatric Gastroenterology, Hepatology & Nutrition

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Pan Europe Pacific Medical & Legal Conference

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13th Annual UC Davis Clinical Pharmacotherapy Conference

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Apr 23-25

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Canadian Respiratory Conference

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Controversies In Internal Medicine

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Barcelona Spain

6th EuCornea Congress

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St. Petersburg Florida

16th Annual Current Concepts In Sleep

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Sep 26-30

Denarau Island Fiji

Medical Specialists’ Peer Education Conference

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New Zealand Cruise

Autism, ADHD And Developmental Disabilities Through The Lifespan- Biological And Environmental Perspectives

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Apr 11-25 2016

Asian Cruise (Diamond Princess)

Medical CBT Tools: Ten-Minute Techniques For Real Doctors

CBT Canada

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May 21

London England

2015 Osteoporosis London

MA Healthcare Limited

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Oct 16-17

Philadelphia Pennsylvania

23rd Annual Pennsylvania Society For PostAcute & Long-Term Care Medicine Symposium

Penn State Hershey

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May 07-09

Lisbon Portugal

International Conference On The Tumour Microenvironment In The Haematological Malignancies & Its Therapeutic Targeting

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Sep 18-20

Tehran Iran

Challenges In Pediatric Hematology & Oncology: 2nd International / 9th National Congress Of Iranian Society Of Pediatric Hematology & Oncology (IPHOS)

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Apr 21May 07

Eastern Caribbean Cruise

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May 07-09

Amelia Island Florida

Mayo Clinic Infectious Diseases Subspecialties Update

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May 28-30

Boston Massachusetts

HIV Update: Contemporary Issues In Management

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May 28-31

Palm Beach Florida

Eastern Allergy Conference - Update In Allergy, Asthma And Immunology

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Sep 03-04

Barcelona Spain

7th International Conference On Ocular Infections

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Apr 18-25

Washington DC

AAN Annual Meeting

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Baltimore Maryland

5th American Delirium Society (ADS) Annual Meeting

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Guilin China

21st World Congress On Controversies In Obstetrics, Gynecology & Infertility (COGI)

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Jun 14-17

Lisbon Portugal

31st European Society Of Human Reproduction & Embryology (ESHRE) Annual Meeting

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Apr 24-25

Krakow Poland

7th Clinical Oncology Update

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Beijing China

8th Annual BIT World Cancer Congress

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

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Jun 11-14

St. Petersburg Florida

3rd Annual Practical Topics In Pediatric Emergency Medicine

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Apr 19

New York New York

Pediatric Bedside Ultrasound Course

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New York New York

The Many Faces Of Pain

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Apr 20-24

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Current Clinical Pediatrics

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Seattle Washington

10th International Symposium On Pediatric Pain

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Jul 04-10

Maui Hawaii

Pediatrics In The Islands…Clinical Pearls 2015

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Jun 11-14

Sarasota Florida

39th Annual Florida Suncoast Pediatric Conference

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Sep 04-06

Barcelona Spain

3rd World Congress Of Paediatric Ophthalmology And Strabismus

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20th Annual Primary Care In Paradise

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9th Annual Primary Care Spring Conference: Session I

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Spring 2015 Just For Canadian doctors

Wilderness and Travel Medicine

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Oct 19-30

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Caribbean Cruise (Disney Fantasy)

Medical CBT For Anxiety (And Calmness: TenMinute Techniques For Real Doctors

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May 28-30

Montreal Quebec

2015 Joint Congress On Medical Imaging & Radiation Sciences

Canadian Association of Radiologists

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Jun 22-26

Cape Cod Massachusetts

NYUâ&#x20AC;&#x2122;s Summer Radiology Symposium In Cape Cod

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Aug 03-07

Bermuda

NYUâ&#x20AC;&#x2122;s Clinical Imaging Symposium In Bermuda

New York University Department of Radiology

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Apr 23-25

Toronto Ontario

Update In General Surgery

University of Toronto

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May 28-29

Lausanne Switzerland

Educational Programme on Transplant Virology

European Society of Clinical Microbiology & Infectious Diseases

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Sep 05-09

Barcelona Spain

33rd Congress Of The ESCRS

European Society of Cataract & Refractive Surgeons

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Apr 08-12

Maui Hawaii

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Apr 17-19

Toronto Ontario

The Travel Medicine Review And Update Course

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May 27-31

Santa Fe New Mexico

The National Conference On Wilderness Medicine And Travel Medicine

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Big Sky Montana

The National Conference On Wilderness

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Bariloche Argentina

Argentina Ski/Avalanche I Mountain Medicine CME Conference

Andes Mountain Guides

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Sep 21Oct 02

Papau Indonesia

Raja Ampat Liveabord Dive And Marine Medicine CME Conference

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Papau Indonesia

Carstensz Pyramid Jungle And Mountain Medicine Expedition

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Aconcagua Mendoza Argentina

Aconcagua Expedition

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magazine

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

assisted suicide

A ground-breaking Supreme Court decision changes the landscape of medicine

am writing this essay on February 6th, 2015. It’s a pivotal day in Canadian medical history, when the Supreme Court handed down a unanimous decision that competent adults with grievous and irremediable medical conditions have the right to ask a doctor to help them die. This has been a long time coming, and any reader who’s read my previous essays will certainly guess that I am pleased with this decision. A recent poll suggests that I am in company with 85% of the population who favour this option. In 1993 Sue Rodriguez, a patient with ALS, lost her second appeal to the Supreme Court for assistance in ending her life. In a 5 to 4 decision the Supreme Court chose to uphold section 241 of the Criminal Code, which makes it illegal to counsel or aid or abet a person to commit suicide. In 2012 Gloria Taylor, another patient with ALS, was granted, by Justice Lynn Smith in the BC Supreme Court, leave to seek assistance with her suicide when she felt the time was right. Unfortunately, the Federal Government, which clearly did not anticipate today’s ruling, appealed this; Parliament has now been given one year in which to draft and pass new legislation. Effectively what will happen is that the provinces, which are principally involved in the delivery of medical care, will each have to draft up new legislation compatible with this Supreme Court ruling. There seems to be some buck-passing here. This is where I think physicians should become involved in making sure that the new legislation is clear and safe. It must not end up in a debacle like the marijuana legislation. The first thing that must be emphasized is that there is a fundamental difference between euthanasia and suicide. Though I am in favour of assisted suicide I cannot support euthanasia in any form. First of all the patient must be of sound mind at the time of making the request. In a difficult case, for example, of Huntington’s disease, the patient, years ahead when in good health, should draft a request for assisted suicide for when certain clinical parameters are met. This will present a new challenge. The request for assisted suicide should involve two or even three

Call-out

medical professionals such as physicians, nurse practitioners, registered nurses or psychologists. I can also see a role where maybe a notary public or lawyer could be involved. This is an entirely new concept to Canadian medicine and should be regarded as a learning curve. It will need to be reassessed and refined as time goes on by provincial colleges, the Canadian Medical Association and the Federal Government. As with any new process it will need time to grow and evolve. This matter has been widely covered in the media, and I think there is much nervousness that the vulnerable will be slaughtered to reduce the cost of long-term care. This has not happened in other jurisdictions (the list of which is growing) and, with the prior mentioned safeguards, will not happen in Canada. Some of the skepticism concerning this process is reflective of a loss of faith and trust in physicians, and family physicians particularly. This is regrettable. It is my firm conviction after having conducted many peer reviews over the past 20 years that the overwhelming majority of family physicians are dedicated and proactive to their patients. As another issue, I think it is regrettable that this fundamental change to Canadian society is being made by non-elected judges and not by our elected Parliament. The process has cost millions of dollars that could be better spent in direct patient care, and has taken 20 years. Many people have ended up suffering in the intervening time. Not necessarily suffering in physical pain but lacking the peace of mind to know that when their medical condition has reached an intolerable state that they will be able to end it. This ruling has put control of their condition into their hands with consequent peace of mind. In fact, it is predicted that few people will actually request suicide assistance. Colleagues, we can, we must, make this legislation work to the benefit of our patients.

to medical professional colleagues

Physicians should become involved in making sure that the new legislation is clear and safe

Just For Canadian doctors Spring 2015

We now ha ve a new challenge to na vigate

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motoring

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

Dr. Kelly Silverthorn is Just For Canadian Doctors’ automotive writer. He tries to keep one convertible and/or one track-day car in the family fleet.

a Sonett by any other name

Wherefore art thou, the quirky cars of a bygone era of unrestricted design creativity?

peeding by to catch a flight, a simple sleek shape in my peripheral vision triggered a pattern recognition. Was that yellow silhouette, buried deep under all that snow, really a Saab Sonett? Even more curious was that I reflexively cared. What the f*&%? Had aging delivered me to retrospective contemplativeness already? Upon arrival at my snow-free destination I sent my car buddy Jerry an FYI text about my in-thesnow yellow silhouette sighting. I knew he wouldn’t be able to stop himself from investigating. Jerry owns a more mainstream Saab (there’s an oxymoron), the Turbo 900. And sure enough, within 24 hours I had a textful of details on the yellow Sonett’s age, equipment, condition, history and asking price. Depending on your definitions, Saab has been dead, on life support, in suspended animation or a zombie since 2010. In their twilight GM-directed years Saab products became more mainstream. However, back-in-the 50s/60s/70s Saab was definitively going its own way (when others were not), with front-wheel-drive, twostroke engines, three-cylinder engines, turbocharging, rally racing, crash survival and aeronautical inspired design. Early adapters sometimes thrive—and sometimes not. Saab never produced many cars and so the Sonett was its low-low-productionnumbers quirky sports car. Just 1,700 were produced per year over the III Series’ fiveyear life cycle (1970–74). It was tiny. Weight: just 810 kg. Length: 12.5 feet. Width: less than five feet. The body was fibreglass. The pop-up headlights mechanism was not hydraulic, vacuum nor electric—it was humanpowered. The engine was V4, a configuration more typically seen in motorcycles and outboard boat motors. During its production runs the Sonett struggled to be favourably noticed by nonSaabers. Neither its looks, nor its performance, made for bar-room bravado. In the early 1970s affordable sporty coupes were legion: Porsche 914 and Karmann Ghia, various Fiats and Alfas, Opel GT and Ford Capri, Triumph GT6 and MGB GT, Japan’s 240Z

and Toyota Celica, even Swedish rival Volvo P1800. But there’s no other V4, fibreglass or front-wheel-drive car in that list. The Sonett didn’t resonate with me then, but because of that quirkiness, it does now. It’s a bit like the Galapagos critters. Saab was following its own evolutionary path in Sweden, mostly

cut off from the rest of world’s automotive cross-fertilization. Without thoughtful custodianship Saab and the creatures of the Galapagos would most likely be lost. Saab’s path was just interesting enough that some of the relics were saved by the community of automotive enthusiasts—and arguably no Saab relic is more worthy or rare than the Sonett. I’m not alone in this belief. Jay Leno is perhaps the most famous car collector in the world, and he relishes saving the odd, not-widely-loved orphans. All sorts of automotive strangeness from the 1960s has developed rabid followings: BMW Isetta bubble cars, Honda S600s sports cars, Mini Mokes cute utes, Amphicars. At auctions, top examples of these are selling for $50,000 or more. Perhaps I’m gifted with divining the next wave of weirdness that will meet

popularity and Tinseltown prices…Saab Sonetts, AMC Pacers, Jeep Wagoneers, Alfa Romeo Montreals anyone? The pragmatist reading this will rightfully point out that dreaming about owning such oddities and actually living with them are two completely different undertakings. “My” yellow Sonett has not run in five years. Much of the interior is missing. The clutch and brake master cylinders are seized. I don’t have the space, skills, tools or patience to take on such a makeover task, Old-school let alone a full cool. The Saab restoration. Sonett exudes a That flash certain Swedish, ’70s style, whether in bright yellow or red. Here’s to preserving some of that automotive quirkiness.

of yellow against the snow in my peripheral vision left an indelible mark, its quirky Saabness now inspiring my future automotive activities. That particular Sonett may have come along too soon for me to help with its rescue, but it’s spurred me to find ways to help save other bizarre and not-yet-appreciated cars that were produced in 1960–1980. And I want to collaborate with other dedicated and passionate enthusiasts to marshal the necessary resources to execute these rescues. All that retrospective contemplativeness will be a blast. Any takers?

Spring 2015 Just For Canadian doctors

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Richmond, BC — Physician Recruitment Very busy group practice in south-east of Richmond BC (juncture of Richmond, Ladner and Tsawwassen) with easy highway access requires a physician that must be comfortable with good primary care, women’s health and EMR skills. Fast paced, friendly environment, supportive staff, 4 working days, competitive split. Seeking a long term associate to build up your practice or transitioning practitioner to relocate practice within Richmond/ Tsawwassen. www.mydoctor.ca/drsinghal For information please contact office number: 604-448-9595 or email: msinghalmd@ gmail.com Richmond, BC — Psychiatrist Recruitment Very busy group practice in south-east of Richmond BC (juncture of Richmond, Ladner and Tsawwassen) with easy highway access, requires a psychiatrist to replace psychiatrist on permanent medical leave. Plenty of patients, friendly environment, excellent support staff, flexible hours, and competitive split. Seeking a long term associate. www.mydoctor.ca/drsinghal For information please contact office number: 604-448-9595 or email: msinghalmd@gmail.com

Spring 2015 Just For Canadian doctors

travel at home

unplugged prairie escape in

saskatche wan

Just For Canadian doctors Spring 2015

travel at home

where horse play, trail riding, cattle rounding, lassoing, beer and even a round of foosball offer all the entertainment you need story + photography by jenn smith nelson

Spring 2015 Just For Canadian doctors

travel at home lip, plop. Giant raindrops fall intermittently on my car hood as I navigate prairie back roads in search of La Reata Ranch. Finally I come upon some marker posts along an electric fence, which I’m grateful isn’t live. In true prairie fashion, a melodic meadowlark atop one of the posts welcomes me as I pass through. It’s slick as I head down the sprawling ranch’s twisty dirt road. Soft hills roll down toward the lake, where on a hot day I imagine guests cooling off with a dip. Several weathered buildings dot the pastureland, the scene reminding me of a western movie set. As if on cue, the rain stops and the sun peeks through a heavily clouded sky just as I pull into the ranch. After the short drizzle, the prairies surrounding me are green and lush. Two dogs greet my car, followed by owner George Gaber, who’s outside overseeing

horses getting shoed. “Cow Boss George” is your typical allCanadian cowboy. Although I soon learn he’s actually German. His accent long gone, Gaber’s been living the Canadian dream and enjoying the laidback pace on his working ranch for almost two decades. “All it took was an overnight campout on horseback along the Swift Current Creek,” says Gaber. That outback prairie experience 19 years ago led him to change his lifestyle and look for a property in the area. “I wanted to give other western/country enthusiasts the same experience.” Tucked away in the Saskatchewan River Valley, 20 minutes from Kyle, Saskatchewan, La Reata’s expansive 5,000 acres, with river frontage on Diefenbaker Lake, includes ravines, coulees and hills. The property was just what Gaber envisioned and he purchased it on the spot. Running since 1996, La Reata, Spanish for

previous page, left

Bringing up the rear, Gus’s spotted ears perk upward as the trail thins toward Lake Diefenbaker. previous page, right, clockwise from top left George Gaber gives a lesson in lassoing. > Yuma, with his dread-like locks, up close and personal. > After a day’s work, Gaber’s horses freely roam the 5,000 acre ranch. this page, above The herd head off toward the ranch early in the morning. opposite page, clockwise from top Gaber from behind on his ATV as he rounds up his horses first thing in the morning. > Immersed in an expanse of prairie hills, Kristina enjoys her last ride and a slow-paced rhythm with horse, Bennet. > An old red A-Frame, now a cabin, stands out against prairie greens. > A new crop of calves and their cow moms, amble waterside as Lake Diefenbaker winds between a hilly divide. > Gus’s spotted muzzle. following page Done for the day, Gus roams free on the prairie.

Just For Canadian doctors Spring 2015

“the rope,” now provides all-inclusive cowboyimmersion getaways. Think downtime for those seeking connectivity with like-minded folks in an unplugged, distraction-free environment, designed to escape life’s hectic day-to-day demands. It’s late afternoon by the time I settle into my cozy western-style cabin, rustic and spacious with plaid blinds and wood beams. I freshen up (meaning I don cowboy boots and hat) and set out to survey the property. A pathway lined with black-eyed Susans leads me to a pond where hungry swallows zip back and forth feasting on buzzing insects. I sit for a few minutes and watch horses grazing in the distance. I reluctantly break my reverie and stroll over to a large red building, the cook shack, where home-cooked prairie-style dinners are served on a long communal farm table. The room is filled with chatter as I enter, and after a few minutes I meet the other guests, three European women and two fellow Canadians. From the colossal spread of cowboy cuisine I get a good waft of grilled steak— all-Canadian beef, of course—and my mouth waters. As we dig in, family style, Gaber talks about how the wide-open space of the prairies is what draws so many Europeans here, from beginner to expert riders. I make fast friends with Kristina, a German woman who works in the financial industry back home. Here, she sports head-to-toe cowgirl attire and looks as if she belongs. Her two-week visit is nearing an end, and I sense Kristina’s sadness at the thought of leaving the ranch and horse she’s grown close to. She’s clearly embraced this prairie experience wholeheartedly. And her passion for La Reata’s lifestyle is so contagious, I can barely wait for tomorrow’s ride. Early next morning, after a hearty breakfast, we check out the horses for hire. I spot a handsome blonde horse, but he’s too big for me to ride. I’m not surprised to find out his name is Hollywood. But I see past Hollywood’s showy beauty to a freckled Appaloosa named Gus. We’re a good fit and, lucky for me, Gaber tells me Gus is also a trustworthy guide for a novice rider. Before setting out, we learn how to clean the horse’s hooves, groom and saddle them. While I don’t quite fit the part of certifiable cowgirl with my floppy red linen hat from Mexico, skinny jeans, sweater and running shoes, I’m instantly comfortable atop Gus. We start out down a road that turns into a thin riverside trail. Soon after, the defined pathway disappears and I realize this isn’t an average trail ride. We’re not riding nose to tail and all I see are hills, coulees and the vast prairies.

travel at home

Spring 2015 Just For Canadian doctors

if you go

travel at home

Leave laptops at home. The point here

With all of this land to explore, Gaber says it’s nice to mix up the routes—roam free. He gives us a few Western style-riding tips and everyone eases into his and her own groove. In flashy fashion, the Norwegian rides English style, although her horse doesn’t seem as keen to adhere to the more restrictive exercises and, with a touch of good ol’ western rebelliousness, nearly bucks her off. In contrast, Kristina is completely at ease with her horse, Bennet, deep in thought and distant from the group. Meanwhile, I adjust to Gus’s rhythm. Easily excited as others gallop past, he picks up the pace every so often, breaking free from an even trot. Gradually, my gentle whoa whoas calm my equine pal and slow him to more my speed. Off in the distance we spot some cattle. Gaber, excited about the season’s new calves, asks if we want to take in an authentic cowboy activity: a wandering cow and her calf need to be herded. We all do, of course, so we cross a waterway, maneuver down a steep hill and attempt to convince the pair to change course. It becomes clear, however, after about 15 minutes, that this is harder than I first anticipated. Navigating some precipitous spots, the novice rider in me is nervous. Gus senses it too, and we fall well behind the pack.

is to take a break from day-to-day life. A few more minutes to the recent rain, a pass before I catch up to mud-laden path is Bring your cowboy duds: jeans, buckled belt, cowboy boots and hat. the group and join the our route back to the cheering as Gaber and ranch. My 1,300-pound Be ready to embrace your inner the Norwegian get the companion struggles to cowboy/girl. Learn how to care for cattle back on track. maintain his balance on your horse, take riding lessons and enjoy trail rides, or immerse yourself Job done, we break the slope, mud up to his in ranch culture and authentic cowboy in a nearby meadow knees. I hold my breath activities. Try herding cattle, lassoing, to eat our pre-packed as we press on, but Gus dummy steer roping, taking in a smalllunches. Gaber lies makes it back without a town rodeo or even branding the year’s down under a shaded muddy tumble. new offspring. tree beside a small After cleaning our Explore the rich history of nearby stream with hat over horses, we refuel and Fort Walsh, a National Historic Site of face, leading all of us then take in some Canada and one of the first settleinto a lull and nap lassoing lessons before ments of the North-West Mounted beneath the early checking out the Police, the highlands of Cypress Hills afternoon sun. saloon. Decorated or the Great Sand Hills. Guided tours can be arranged. Back on the trail, with tractor-seat stools, I’m more relaxed, old licence plates and Stay at La Reata May 18 – October 12 absorbing the calm cowboy paraphernalia, in 2015. For more: lareataranch.com. quiet and reveling in its kickback atmosphere the grassy scent of the is a welcome sight after light breeze. I notice a long day on the range. everyone else seems to be Cold beer is swigged as soaking in the last leg of the ride, too. we refuel and rehash the day. Kristina and I We spot a coyote on a hill but it quickly dominate in a frenzied foosball tournament. zips out of sight. Then simultaneously, without Afterwards, drained yet abuzz with beer, warning, the horses pick up speed as if camaraderie and fresh air, I take in the sensing home is close. Nearly five hours after star-filled sky in the hot tub, rounding out a starting out, we see the lake again. Thanks remarkable day unplugged in the prairies.

Just For Canadian doctors Spring 2015

OpenRoad honda Burnaby 6984 Kingsway, Burnaby, B.C. V5E 1E6 (5 minutes East of Metrotown)

Tel: 604-525-4667 OpenRoadHonda.ca

t h e h u n g r y d o c t o r d r . h o l ly f o n g Dr. Holly Fong is a practising speech-language pathologist with three young children who’s always trying, adapting and creating dishes.

get fishy

Put halibut on the menu this spring

Pan-seared halibut 8 oz washed and dried baby arugula and baby spinach mix 1 cup diced just ripe mango (¼inch cubes) ½ large red bell pepper, diced into 1/4-inch cubes 1 green onion, rinsed 1 tablespoon finely chopped cilantro 1 tablespoon Dijon mustard 1 cup freshly squeezed orange juice ¼ cup freshly squeezed lime juice olive oil 4 pieces of halibut (100–150g per piece) salt and freshly ground pepper

Divide the salad amongst four plates and set aside. Trim ends off green onion. Thinly slice, cutting along the diagonal. Separate white parts from green. Place green parts in a medium size bowl along with mango, red pepper, and cilantro. Mix to combine and set aside. Pat fish dry on all sides with paper towel so that it will brown when fried. Season both sides of fish with salt and pepper. Set a large non-stick pan over medium-high heat. Coat bottom of pan with a tablespoon of olive oil. When oil is shimmering but not smoking, add fish pieces so that they do not touch each other. Let cook for about three minutes before turning over so that fish develops a rich brown

crust. Turn and cook for another three minutes so that fish cooks for a total of six minutes per inch of thickness. Remove from pan, placing a piece over each plate of prepared greens. Add a tablespoon of olive oil to same non-stick pan over medium-high heat. Add white parts of green onion. Stir fry until translucent. Turn down heat to medium to avoid burning. Add Dijon mustard and citrus juices. Stir to combine and cook for another minute to thicken slightly. Turn off heat and add mango mixture, stirring to combine well. Spoon dressing over the fish and salad greens. Serve.

Ri esl i n g pl ease!

holly fong

Pair this pan-seared halibut and mango dressing with a sweetness that doesn’t overpower. Go for a well-balanced Riesling like the Forstmeister Geltz Zilliken with its floral, grapefruit, peach and honey notes.

(serves 4)

acific wild halibut is an extremely versatile meaty white fish that is not only tasty but environmentally sustainable. It can take strong marinades and be grilled, steamed, baked or fried, making it one of my family’s favourite fish. And as the cold weather starts to recede, the inherent sweetness of the fish comes out in lighter dishes that evoke the fresh start of spring. Simple does it. Panfry the fish and put it in on a bed of mildly bitter greens with a warm mango or pineapple-citrus salsa-like dressing for a healthy yet satisfying meal. For lunch, go with individual servings of 60–75g; for dinner, plan servings of 100–150g. When buying halibut, I ask the fishmonger for a whole piece that is uniform in thickness and have it divided into individual servings for easier cooking. To obtain a golden brown crust, use a large non-stick pan, big enough that the pieces of fish do not touch—otherwise it’ll be steamed not panfried. Rieslings, especially the drier ones, pair well with halibut. The 2012 Riesling from Forstmeister Geltz Zilliken has just enough sweetness to not be overpowered by the mango dressing. It’s wellbalanced with a refreshing mouth feel and long finish with floral notes, grapefruit, peaches and honey. Enjoy!

Just For Canadian doctors Spring 2015

diversion

http://www.amgguides.com/cme

sudoku Solve puzzle #2 for a chance to win a $50 VISA gift card!

Each sudoku puzzle has a unique solution that can be reached logically without guessing. Fill in the grid so that every row, column and 3x3 square contains the digits 1 through 9. GOOD LUCK!

sudoku 2 harder solution in next issue

sudoku 1 easier solution on page 22

$50 Visa Gift Card winner: Dr. Donald Farrell of Saint John, NB

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1. Entry form must be accompanied with solved puzzle. Only correctly solved puzzles entered into random draw. 2. Send puzzle + entry form to Just For Canadian Doctors, 200 â&#x20AC;&#x201C; 896 Cambie St., Vancouver, BC, V6B 2P6 or fax 604-681-0456. Entries must be received by May 22, 2015. 3. Prize: $50 VISA Gift Card. 4. Contest can be changed and/or cancelled without prior notice. 5. All entries become property of In Print Publications. 6. Employees of In Print Publications and its affiliates are not eligible to participate.

Spring 2015 Just For Canadian doctors

dr. Millan patel’s big moment? Diagnosing an ultra-rare disease…and then coming up with a treatment for it. Bravo. It’s why his near-and-dear cause is the Rare Disease Foundation. Outside of work, he hangs with elephants in Africa or ponders a dream getaway aboard a dive boat off the coast of Fiji. Otherwise, you might find him in Switzerland, a place he keeps returning to. (We like it too; see page 8.) Meanwhile, his secret to relieving stress is a good mind-bender for all of us: “…frustration only exists to teach me that my current view of reality is incorrect.” My name: Millan Patel I live and practise in: Vancouver, British Columbia

My training: MD, FRCPC (Medical Genetics) Why I was drawn to medicine:

Love the detective work of trying to diagnose among 4,000 known syndromes, and describing new ones. My last trip: East African safari The best souvenir I’ve brought back

from a trip: Coral. In my foot. Took a year to work its way out. Ouch! A favourite place that I keep returning to: Switzerland (see page 8 for why you too should go this summer)

My ultimate dream vacation: Live aboard a dive boat in Fiji

anymore. Yet another thing I learned after it was too late…

If I could travel at any time, I’d go to: Stock market trading floor one year from now. With pad and paper.

My guilty pleasure is: Dark chocolate and marzipan.

Favourite book: In Love with the Mystery by Ann Mortifee Favourite film: LOTR [editor’s note: that’s Lord of the Rings for those not well versed in Tolkien or Peter Jackson’s films]

clockwise from top left

Favourite music: 100 Years by Five for Fighting My closet has

Dr. Millan Patel; in too many: Switzerland, one of his go-to places; boating with Ties. Now known as a friend; making friends with an elephant while petri dishes, on an East Africa so patients safari.

go ewww and I don’t wear them

Favourite exercise/sports activity: Squash My secret to relaxing and relieving tension: Knowing frustration only exists to teach me my current view of reality is incorrect My fondest memory: Playing with my lovely children in the backyard My biggest ego boost: Diagnosing an ultra-rare disease and then researching a useful treatment for it A cause close to my heart: The Rare Disease Foundation

make some small talk Want to share your picks, plans + pleasures? Tell us where you’ve been and share some of your favourite places and photos. We’d love to include you on this page. Reach us at feedback@inprintpublications.com.

Just For Canadian doctors Spring 2015

courtesy of Dr. Millan Patel

s m a l l ta l k

doctors share their picks, plans + pleasures

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