“That Was Weird”: Reflections on Myth-Busting

Canadian Nurses Association Biennial Conference

Dr. David Butler-Jones

MD, MHSc, LLD, CCFP, FRCPC, FACPMTuesday, June 17, 2014

Winnipeg, MB

Reflections on Myth-Busting

• Whither the Pandemic?

• Myth-busting part 1: strokes, brain health and a personal story

• Myth-busting part 2: professional myths and practical postulates

• Leadership

“Success requires the ability to go from failure to failure and not lose your enthusiasm” Winston Churchill

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Public Health Agency of Canada | Agence de la santé publique du Canada 2

2001-2014: How Far Have We Come?Key Public Health Events in Canada since 2003

2001-2014: How Far Have We Come?The Public Health Network

Consists of:

• Public Health Network Council

• Council of Chief Medical Officers of Health

• 3 F/P/T Steering Committees

• Task Groups

• Talent Pool of Expertise

Myth-Busting?: Or Why Lifelong Learning and Continuing Education is Important

• What we were taught with certainty: eg-DNA, Immunity, Brain Health

• Brain Health in the 21st century- still stuck in the 70s?

• Have you ever:

– Experienced a stroke?

– Met two people with exactly the same symptoms, signs and recovery?

• Infinite brains, infinitely complex – so why reductionist view of limitations and possibilities post-stroke?

• Distinctions between major or minor stroke – crudely inadequate

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A very public stroke

• “That was weird”

• From 100mph to 5.

• No such thing as a minor stroke

• Neglect, memory, processing, locked files, balance and strength

• Complexity

• Recovery, coping and support – It takes a village…

• Training for the Olympics

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Myths in the Health Sector?BJs - Postulates

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• Everything happens for a reason

• Avoid False dichotomies (public-private, clinical-PH, domestic-international, policy-practice)

• Focus = Healthiest Population per Resources

• Health Has Inherent Worth, However Achieved

• Greatest Health Improvements came from Outside of Health Services-but what we do matters

• Prevention is Not Last Resort of Failed Treatment

• Prevention/Health Promotionis not a Panacea - Both Benefits and Liabilities

• We’re not in a cult…

• Expertise? It’s Easy To Do…Poorly

• Spectrum = Promote-Prevent-Treat-Care

Social Determinism

vs.

Health Imperialism

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AdvocateWhat should be done at policy,

legislative level?

CheerleadEncouraging

and not getting in the

way

MitigatePicking up

some of the pieces, so it isn’t worse

EnableWhat we do directly to change the

determinants

PartnerWho can we work with, to do it better together?

Strengthening Connections

Tackling the Big Problems

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Success Factors and Considerations

Partner

Advocate

Cheerlead

Enable

Mitigate

• It’s all connected

• Integration and Intersectoral Approaches

• Space for Deliberation

• Learning

• Openness and Courage to Address Bigger Issues

• What expertise do we not need?

• Respect

• Make it Practical

• Rule of three

• Have something to offer

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Even when we’re on the right track,

if we’re not moving,We’ll get run over.

Mark Twain

Public Health Agency of Canada | Agence de la santé publique du Canada 11