3 Comments

is a writer and special needs advocate.

 

In just one year, my son, Jacob, was put on Bi-Pap in the PICU on four separate occasions. Only a respiratory therapist was allowed to put the device on him or make adjustments when he was in the hospital. On the first occasion, he was not allowed on any other hospital unit while dependent on Bi-Pap. On subsequent occasions, he could transfer to the General Pediatrics unit as long as his Bi-Pap needs remained stable but, should his Bi-Pap needs increase, he would be transferred back to the PICU. ...continue reading

 Sarah Silverberg is an R1 in OBGYN at UBC and an intern at St. Paul's Hospital.

 

 


Please let me take your history.

I know the triage nurse and the emergency physician already asked you many of these same questions. But humor me -- let me ask them too. After all, I was asked to see you by the emergency doctor who saw you. They knew I would ask you these questions, and felt it was necessary. They referred you to me, and like it or not, you’re now under my care.

I am the resident that was asked to see you. You ask me if you could see the real doctor. Unfortunately, I am the real doctor. At least, I am a doctor; one of the country’s medical institutions has granted me an MD. And while I know what you mean – that you don’t want to see the resident, and that you want to skip ahead directly to the attending – at this moment I can’t make that happen. My attending sent me down to see you because I’m the one on consult service. My staff is in the operating room, or managing the ward, or reviewing the three other consults we’ve been asked to see this evening with other residents and students. You’d be waiting a while longer if I didn’t see you.

...continue reading

 Ashleigh Frayne is a Family Medicine (R1) at the University of British Columbia.”

 

 


The pavement darkens as the chill of the night settles

Stretched across the lap of the day, a shadow cat

Moving swiftly down the street, between pools of light

Cast by warm windows, freeing the damp of evening

To reach long fingers down my spine, the sigh of today.

I rub my eyes, crusted with the dread of tomorrow.

...continue reading

1 Comment

 is an Internal Medicine Resident (R1) at the University of Toronto. Check back the last Thursday of each month for a new featured piece as part of his series (Doc Talks: Reflections to Reality)!

 


We are challenged to embrace frailty and a disarray between mind and body when we encounter patients at the end of their life. As we seek to nurture a place of comfort and wholeness for them, we are tested to bear witness to their helplessness, to appreciate their intrinsic values not only as patients but also as people, and to preserve their dignity. Moreover, we are presented with an opportunity to appreciate the internal struggle of their loved ones as they are confronted with a disconnect between the person they have known and loved, and the patient we provide care for in times of declining health.

Penned based on the reflections of numerous families I met on the wards, this piece strives to give a voice to the struggles many encounter alongside their loved ones in the end of life.

*

Our voices echoing ...continue reading

1 Comment

Courtney Bercan is community health nurse at a clinic in the Downtown Eastside of Vancouver

 

Years later, I still don’t want to think about it, let alone type it out. Three children, babies practically, dead before me. Their parents, dead beside them.

It has now been two years since I was on a Doctors Without Borders search and rescue vessel in the Mediterranean and it’s been a slow path, at times, to finding healing and peace for the things I saw and experienced there. As my life settled into a predictable rhythm, the memories started coming out of the blue and with intensity. They demanded attention. Normally, in Canada, the process of finding closure for a patient’s death, while not always easy, is not usually this difficult. There are mitigating thoughts and phrases to help you along the way:

“They were elderly and had had a good life.”

“We did everything we could.”

“At least now they are out of pain.”

...continue reading

5 Comments

Sarah Tulk is a family physician in Hamilton, Ontario

 

Despite earnestly advocating for physician mental health, my own story has remained cloaked in secrecy. As a medical student, I felt far too junior to risk such a revelation. I watched as stigma, perpetuated by the hidden curriculum, kept my peers from seeking mental health care. Still, I kept my head tucked safely in the sand, and swore to break my silence in residency. However, as a resident the fear of jeopardizing job prospects maintained my mutism. I vowed to speak up when I was staff. Unfortunately, early in my staff career my advocacy efforts were smothered by fierce judgment and harsh consequences. I wholeheartedly renewed my vows with the ostrich approach and reconciled to start talking about mental health when I was protected by more seniority. I hated the secrecy and hypocrisy, but at least I was safe. Then I heard of another resident suicide. Then a medical student. Another resident. A staff physician. ...continue reading

Kacper Niburski is a medical student in the Class of 2021 at McGill University. He is also the CMAJ student humanities blog editor.

 

 


murphy’s sign

yellow on the horizon

with a dark more total than

fingers moving in small steps

and smaller spaces

an ambulance is in the distance

your breathe is on my neck

what is this gall

how do you hold me

with all your living

...continue reading

1 Comment

Austin Lam is a medical student at the University of Toronto.

 

 


The importance of mental health has rightly been emphasized in recent times. The stigma surrounding mental illness ought to be dispelled. However, I wish to take a closer examination at the conceptual elephant in the room: the mind-body problem — a philosophical issue that strikes to the core of continuing disparities between how the healthcare apparatus as a whole addresses “mental” versus “physical” health conditions.

As medical historian Roy Porter pointed out in his book (1997): “psychiatry lacks unity and remains hostage to the mind-body problem, buffeted back and forth between psychological and physical definitions of its object and its techniques.” This was a prescient remark. In 2018, the editor-in-chief of Dialogues in Clinical Neuroscience, Florence Thibaut : “recent advances in neuroscience make it more and more difficult to draw a precise line between neurological disorders (considered to be ‘structural brain disorders’) and psychiatric disorders (considered to be ‘functional brain disorders’).”

To begin, let’s analyze the statement — Mental health is health.  ...continue reading

This week’s edition of Dear Dr. Horton” is a general response to the many excellent questions that were submitted in response to the CMAJ call-out for the “Med Life with Dr. Horton” podcast. Find it originally here: http://wakiganavi.info/horton-podcast-carms-interviews/


Dear classes of 2019,

Ah, CaRMS…that beloved hybrid of Survivor and The Bachelor.  You want to be the last one standing, but hopefully that doesn’t mean accepting a proposal that will become your new personal definition of hell.

I’ve coached hundreds of students through the CaRMS process over the years. My approach draws on my experiences as a long-time clinical teacher,CaRMS interviewer, Associate Program Director, Associate Dean, Royal College committee member, Royal College exam coach, and my interest and expertise in communication, cognitive error and mindfulness.  One thing I’ve learned: there are wrong ways to answer questions, but there is no universally right way.

Some interviews start with a variant of that dreaded question, “Tell us about yourself.”  Too frequently, students use that precious first impression to regurgitate dry information that is already included in their CV.  That’s a sure-fire way to get lost in the crowd.

I counsel students to spend time considering how they will structure this question.  It’s always helpful to open with what I think of as an editorial statement.  “I’m so pleased to have the opportunity to be here with you today.  When I reflect on this question, I think there are three things that help give you a window into who I am as a person.  The first thing is X.  The second thing is Y.  The third thing is Z.”

How do you settle on the content of X, Y and Z?  I recommend looking for your three best positive anchors.  Perhaps you are from a small town, in which case X might be your deep sense of community.  Maybe you’re a runner, and Y is that you are a person who has a long game philosophy in life.  Maybe you’re a person who grew up in tough socioeconomic conditions, or you have spent a lot of time in volunteer roles, and Z boils down to your personal commitment to social justice.   ...continue reading

Abhishek Gupta is a medical sub-intern with CAMH, who graduated from Windsor University School of Medicine.

 

 


Hear Ye, Hear Ye

A song of mental health for all,

In dark times and vanishing grace,

Give light and cushion a fall,

Where suffering is hidden,

And discourse forbidden,

Now, to change rules unwritten,

I pray, lend your ears to listen!

 

Where actions and mood were once controlled,

Now, fits of mania, blues, highs and lows, ...continue reading