Just For Canadian Doctors Spring 2015
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Transcript of Just For Canadian Doctors Spring 2015
Publications Mail agreeMent #41073506
life+leisure
sp
rin
g 2
015
where will you meet? lisbon / bermuda / cape cod / papau / krakow >>
win$50 Visa Gift Card page 45
Doctors
inside: Continuing mediCal eduCation Calendar
Giddy-up insaskatchewan
wine tour in portugal
+ MiX it up: cocktail conjuring+ hot in tetiaroa, Brando style+ the Maasai school project+ photography Master class
Okanagan Valley, Vernon, British Columbia, Canada 250.275.1556 www.sparklinghill.com
make wellness a priority.
O�ering a 40,000 sq.ft. European-inspired KurSpa, luxury accommodation and a place to start your Okanagan adventures.
C
M
Y
CM
MY
CY
CMY
K
DoctorsMagazine_2015.pdf 1 3/6/2015 4:46:43 PM
Spring 2015 Just For canaDian Doctors 3
FeatureS
14 Port of call Sample Portugal through its wine and beyond
38 Prairie escape Unplug in Saskatchewan’s cowboy country
ColumnS
10 photo prescription Combine more than one photo
technique into one stellar shot
13 pay it forward Helping Maasai women and girls
19 the thirsty doctor Make a memorable mix
21 the wealthy doctor Pros and cons of life insurance
30 doctor on a soapbox Assisted suicide
35 motoring Remember the Sonett?
44 the hungry doctor Fresh fish fare for spring
Spring 2015 ContentS
departmentS
5 spring mix
23 CME calendar
45 sudoku
46 small talk with Dr. Millan Patel
Clo
Ck
wiS
E FR
oM
to
P lE
Ft: B
. Sli
gl;
JEn
n S
Mit
H n
ElSo
n; B
. Sli
gl 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.
14 38
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
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: [email protected]
Associate publisher Linh T. Huynh
production Manager ninh Hoang
Circulation Fulfillment shereen Hoang
CME Development Adam Flint
Founding publisher Denise Heaton
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 publications200 – 896 Cambie street Vancouver, BC V6B 2p6 Canada
www.justforcanadiandoctors.com
printed in Canada.
DoctorsJ u s t F o r c a n a D i a n
life + leisure
miss an issue? check out our website!
4 Just For canaDian Doctors Spring 2015
spring cleanse If 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 ac-tual 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 crutch-es, 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
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!
b. S
lig
l
f r o m t h e e d i t o r
clockwise from top 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.
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s t y l e | f o o d | s h o w s | f e s t i v a l s | p l a c e s | g e t a w a y s | g e a r …
m i xw h a t / w h e n / w h e r e > s p r i n g
to the South
pacific
If you dream of being marooned on a tropical island without the priva-tions 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 ac-tor’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 two-bedroom 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 >>Tim
mc
Ken
nA
time out in tetiaroa
6 Just For canaDian Doctors Spring 2015
*
m i x s p r i n g get juicymaster blendWith 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 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
continued from page 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.
Whether or not you have your own pool, you 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
pool
lounging,
Four Seasons
Bora Bora
style
get-away
+bora bora
island
idyll
gO greeN / geT JuICy
The Vitamix S30 comes with a book of super-simple 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.
health FIX!
go-to gadget
BARB
ARA
kRA
Ft
Spring 2015 Just For canaDian Doctors 7
travel smart m i xsm
art stylings p r i n g
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 tasks as unlocking your car or house, scanning your boarding pass, access-ing 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 buy-ing goods with a simple flick of their wrist. Available in Carbon, Lava and Frost; $149; nymi.com
gear
Low-tech lover or early adopter? Our gear list offers the best of bothWritten + produced by Janet Gyenes
Admit it: Mother Nature can be harsh. Gale-force winds, unrelenting rain, sub-zero temperatures ... but Canada Goose has stayed one step ahead. Its new collection of techni-cal 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—Tri-Durance SS™, a three-layer water-proof fabric that sports two-way stretch and extreme
breathability—plus plenty of other comfort- and safety-enhancing fea-tures. 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
wear
Outsmart mOther Nature
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 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
low-tech
gear up
biONic baNd
From left Lava, Frost, Carbon
tote
smart sidekick
high-tech
editOr’s
pick
sport -tech
8 Just For canaDian Doctors Spring 2015
CH
RiSt
oF
Son
DER
Egg
ER
m i x
You’ve worked long and hard to build your career. It only makes sense to do everything you can to ensure your continued success, both professionally and personally. The Scotia Professional® Plan is a fully customized banking package designed to help you build a strong, profitable practice while ensuring your personal finances receive the attention they deserve. Which is the kind of good feeling we’d like to spread around.
To learn more about Scotia Professional Plan, visit your nearest Scotiabank branch or visit scotiabank.com/professional today.
Scotia Professional Plan
® Registered trademarks of The Bank of Nova Scotia.
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Canadian Marketing 100 Yonge Street, 16th Floor
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We see the person behind the profession.
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Get hiGh! at the Monte rosa hütte…
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
you could
stay here!
haute
hut
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.
s p r i n g peak play
You’ve worked long and hard to build your career. It only makes sense to do everything you can to ensure your continued success, both professionally and personally. The Scotia Professional® Plan is a fully customized banking package designed to help you build a strong, profitable practice while ensuring your personal finances receive the attention they deserve. Which is the kind of good feeling we’d like to spread around.
To learn more about Scotia Professional Plan, visit your nearest Scotiabank branch or visit scotiabank.com/professional today.
Scotia Professional Plan
® Registered trademarks of The Bank of Nova Scotia.
File Name: SMBIZ_AD_Doctor_8.25x10.75_E_0215 Trim: 8.25” 10.75” Bleed: 0.125" Safety: 7” x10” Mech Res: 300dpi Colours: CMYK
Publication: Just for Cdn DoctorsMaterial Deadline: Feb. 25Insertion Dates: March 16, April 27
Canadian Marketing 100 Yonge Street, 16th Floor
Toronto, ON M5C 2W1
We see the person behind the profession.
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10 Just For canaDian Doctors Spring 2015
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
put it all together
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.
Combine various photographic techniques for more impact
MiC
HA
El D
EFRE
itA
S
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 im-pact? 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 LINEThe composition of the photo places the river on a diagonal
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 THIRDSThe 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 SPECSNikon D300, 120mm, f5.6, 1/125 second, ISO 200.
A 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 combi-nations. 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
sho
w o
ff a
ll
tho
se S
kILL
S!
3rd World Congress of Paediatric Ophthalmology
and Strabismus4–6 Septemberwww.wspos.org
The 7th International Conference on
Ocular Infections3–4 September
www.ocularinfections.com
6th EuCornea Congress
4–5 Septemberwww.eucornea.org
XXXIII Congress of the ESCRS5–9 Septemberwww.escrs.org
WSPOS
FOUR EVENTS ONE VENUEFira Gran Via, Barcelona, Spain
Barcelona2015-Group_FPA-Just-For-Canadian-Doctors.indd 1 29/01/2015 16:16
12 Just For canaDian Doctors Spring 2015
Buddhist monks are backlit by natural light as well as flash. above Shot outdoors, shadows on this Hawaiian dancer’s face are eliminated with the help of flash .
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 de-cided 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 prese-lected 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.
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 “fit-ting” camera (one that fits your hand and shooting style) that’s more comfortable will lead to better pics. For ex-ample, 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.
p h o t o p r e s c r i p t i o n [ c o n t i n u e d ]
FOR MORE INFORMATION OR RESERVATIONS, PLEASE CONTACT YOUR TRAVEL AGENT OR CALL: 855.219.8623
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Spring 2015 Just For canaDian Doctors 13
Sometimes 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, says Clinton, was that girls were required to help out at home, or were married off. the number of boys at school also dropped because they were required for cattle herding.
Clearly there were lots of things that could be done, and Clinton set to work establishing objectives for the Maasai School Project (MSP). the key priority was supporting those children who passed their national 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 of the girls, says Clinton, “is experiencing tremendous pressure as her family wants to marry her off to get cows but she wants to become a nurse.”
the second key priority is ensuring that girls can attend their elementary school classes by supplying them with sanitary pads and uniforms. Perhaps surprisingly, a year’s supply of sanitary pads, bought locally, as well as a uniform, costs only $45 a year, Clinton says. A challenge is sustainability. if MSP funding dries up, how will the girls buy sanitary pads? “How do we make sure that the supplies that the girls need are there for them? ideally we would be able to facilitate
their own ability to generate the funds for whatever it is that they need rather than depending on us to do it,” says Clinton.
there are myriad other needs that the MSP is tackling. this year, it funded construction of a badly needed toilet for
olooaimutia Elementary. the children are also being taught proper oral health
and given toothbrushes and paste. Clinton also worries about the small dormitory for elementary boy and girl students, which is under minimal supervision.
those girls who don’t stay in the dormitory are vulnerable to rape by young men while walking to and from school. Ultimately, however, a bigger dormitory is only a Band-Aid solution. Educating both men and women about gender rights is key to addressing this problem in the long-term. Currently, Clinton says, women have low status in Maasai society in comparison to men. But education will change that, helping make women economic drivers not only in their families but their nations, as well as strengthening their voices in the local community and national stage. “we need to have girls staying in school.”
women’s hurdlesA psychiatrist helps fulfill basic needs of young women through the Maasai School Project
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.
CH
RiSt
oPH
ER M
iCH
El
Child and adolescent
psychiatrist Jean Clinton co-founded the
Maasai School Project in Kenya, which provides basic
needs to Maasai school girls, like this young student, working on
her math.
14 Just For canaDian Doctors Winter 2015
t r a v e l t h e w o r l d
bom retiro
the good life Here, that means lunch outside overlooking the vineyards of Herdade
do esporão in the Alentejo region of
Portugal.
t r a v e l t h e w o r l dt r a v e l t h e w o r l d
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.
Porto tónico, as served at Ramos Pintos’ Quinta do Bom Retiro. right taking in the terraced Douro Valley at Quinta do Crasto.
16 Just For canaDian Doctors Spring 2015
t r a v e l t h e w o r l d
i ’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
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 desig-nated 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
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 region-als, 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-não-Me-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
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
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, anoth-er 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 wed-ding ring, “…and i’ve been married a long time,” he says.
not far away is Ramos Pintos, another well-known name and sixth-generation win-ery 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 set-ting 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
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.
t r a v e l t h e w o r l d
Infinity pool—overlooking the Douro River, no less—at Quinta do Crasto.
the 13th-century tower at Herdade do Esporão in Alentejo.
Sandeman’s Don logo over-sees vineyards at Quinta do Seixo
Olive trees at Herdade da
Malhadinha Nova in Alentejo.
gooey good Serra da Estrela cheese at Quinta do Bom Retiro.
Cork tree, partially harvested, at the Ecorkhotel in Alentejo.
Picnic scene at Quinta do Seixo.
Cellars at Herdade do Esporão. below Port-paired fare, including almonds and olives grown at Quinta do Crasto.
Each suite at Ecorkhotel has its own whitewashed patio to take advantage of the Alentejo’s sun.
18 Just For canaDian Doctors Spring 2015
t r a v e l t h e w o r l d
if you go +a sipping tour of the Douro & beyond SAMPLE PORTO E DOURO Graham’s, grahams- port.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
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-generation-owned 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-after-noon 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 macer-ated 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 legend-ary 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 in-spire hotels (Ecorkhotel uses cork throughout its state-of-the-art design) and the UnESCo world Heritage Site of Évora holds ancient ru-ins (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 13th-century 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.
Sampling the estate-grown olives and olive oil
at Herdade do Esporão. left george Sandeman
in the vineyards of Sandeman’s showcase
Quinta do Seixo.
Spring 2015 Just For canaDian Doctors 19
t h e t h i r s t y d o c t o r j a n e t g y e n e s
in the mixCreating a high-quality and healthier cocktail
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 [email protected]
W 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 liba-tions 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 dai-quiris 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 tradi-tional 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 experi-ment 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 mara-schino 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 actu-ally worse than the night-before poison ….
Aaron Harowitz, co-founder of Vancouver-based 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
SIMPLE SYRUP In a saucepan, boil together 1 cup of sugar and 1 cup of water, stirring occasion-ally until the sugar has dissolved. Cool and store in a bottle in the fridge for up to a month.{ }essential
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Squeeze lime into a traditonal copper mug or tall glass. Drop lime in; add ice cubes and vodka. Top with ginger beer. Stir.
1
CAESAR
1 oz. Luksusowa vodka4–6 oz. Walter Caesar mix2–3 dashes Tabasco saucelime wedgesalt and pepper
Fill a tall glass with ice. Pour in vodka and Walter. Add Tabasco and salt and pepper to taste. Garnish with lime.
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2 oz. Luksusowa vodka4–6 oz. SIP Rosemary Lime soda1 /2 oz. fresh lime juice
Fill a tall glass with ice. Pour in lime juice and vodka. Fill with SIP soda. Stir.
3
conTinueD on PAge 20 >>
inspired by hemingway
in words + cocktails
20 Just For canaDian Doctors Spring 2015
whipping up your own clam-tomato mix in your home
blender. “we only use premium, all-
natural ingredients in walter,” Harowitz adds. tomatoes, he says, are vine-ripened,
horseradish is freshly grated, and real (and sustainable) clam juice comes from the north Atlantic. worcestershire, hot sauce and spices round out the mix, which comes in spicy and non-spicy varieties. no MSg here—or gluten.
Another booze bedfellow, the soda market, is making much-needed changes, but shifts are slow and slight. High-fructose corn syrup (HFCS) is still the go-to sweetener. Coca-Cola Canada recently reduced the
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 efferves-cence of another Caribbean cocktail—the
Dark ’n Stormy—made with dark rum (goslings Black Seal, if you want to be authentic), lime and ginger beer?
in ottawa, Harvey & Vern’s olde Fashioned Soda makes its ginger beer with certified pure cane sugar,
real ginger, plus they add a layer of spice with ginseng.
grayson McDiarmid, brand manager of Harvey and Vern’s says, “the spice would lie somewhere between a British ginger beer and a Jamaican one,” adding that Dark ’n Stormy cocktails enjoyed a renaissance in ottawa restaurants when the ginger beer was launched.
“the main benefit of cane sugar is that
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 Vancouver-based 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.
SWEET
1/2 oz. simple syrup
1 oz. Cointreau
1 oz. simple syrup
1/2 oz. honey
1 oz. Cointreau
SPIRIT
2 oz. white rum
2 oz. tequila
2 oz. whiskey
2 oz. bourbon
2 oz. brandy
SOUR
1 oz. lime juice
1 oz. lime juice
1 oz. lemon juice
1 oz. grapefruit juice
1 oz. lemon juice
Daiquiri
Margarita
Whiskey Sour
Brown Derby
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>> conTinueD fRom PAge 19
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Spring 2015 Just For canaDian Doctors 21
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D 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 pre-tax 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.
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.
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.
looking into life policyUsing the life policy as a retirement vehicle—pros and cons
Manfred Purtzki is the principal of Purtzki & Associates Chartered Accountants. You can reach him at [email protected].
the wealthy doctor manfred purtzki
what to know
before you commit
there are reasons why not every doctor should sign up for this type of life insurance policy
conTinueD on PAge 22 >>
22 Just For canaDian Doctors Spring 2015
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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:
• Repayaportionoftheloan• Providemorecollateralsecurity
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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On the surface it looks like a slam- dunk deal
>> conTinueD fRom PAge 21
Spring 2015 Just For canaDian Doctors 23
spr ing 2015 + beyond
c m ean international guide to CONTINuINg MeDICAL eDuCATION
l isbon / bermuda / cape cod / papau / krakow … | c a l e n d a r
apair 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 build-ings 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 Por-tugal’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.
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.)
JAn
Et g
YEn
ES
LISBONthe 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
500-year-old Belém tower
below Funicular
24 Just For canaDian Doctors Spring 2015
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6th annual conference: integrative Medicine For Mental Health
integrative Medicine for Mental Health
913-915-5136integrativemedi-cineformental-healthconfer-ence.com
ane
sthe
sia
apr25-26
colorado springscolorado
22nd colorado society of anesthesiologists (csa) annual anesthesia symposium & Meeting
colorado society of anesthesiologists
303-770-6048 csa-online.org
May07-08
londonengland
royal college of anaesthetists (rca) cPD Days
Meetings and events, rca
011-44-20-7092-1670 rcoa.ac.uk
Jun24-27
Kiawah islands. carolina
2015 carolina refresher course: update in anesthesiology, Pain, & critical care Medicine
Mountain area Health education center
828-257-4400 sys.mahec.net
sep02-05
ljubljanaslovenia
34th annual european society of regional anaesthesia congress
Kenes international 011-41-22-908-0488 kenes.com
car
diol
ogy
May14-16
lisbonPortugal 2015 euroPrevent european society of
cardiology 011-33-4-9294-7600 escardio.org
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sevillespain 2015 Heart Failure european society of
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continuing education,inc./university at sea
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nov20-22
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15e congrès annuel de la société des sciences Vasculaires du Québec (ssVQ) ssVQ [email protected] ssvq.org
Dia
bete
s
apr15-18
berlingermany
8th international DiP symposium on Diabetes, Hypertension, Metabolic syndrome & Pregnancy
comtecMed 011-972-3-566-6166
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Jun19
londonengland Diabetes guidelines update Med guidelines 011-44-20-
3514-5870med-guidelines.co.uk
nov 30-Dec 04
Vancouverbritishcolumbia
2015 World Diabetes congress international Diabetes Federation
011-32-2-543-1631
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2015 american society of colon & rectal Surgeons (ASCRS) Annual Scientific Meeting ascrs 847-290-9184 fascrs.org
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17th World congress on gastrointestinal cancer
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Medical cbt tools: ten-Minute techniques For real Doctors cbt canada 877-466-8228 cbt.ca
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23rd annual Pennsylvania society For Post-acute & long-term care Medicine symposium
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international conference on the tumour Microenvironment in the Haematological Malignancies & its therapeutic targeting
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HiV update: contemporary issues in Management
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eastern allergy conference - update in allergy, asthma and immunology
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7th international conference on ocular infections
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5th american Delirium society (aDs) annual Meeting
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21st World congress on controversies in obstetrics, gynecology & infertility (cogi)
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Jun14-17
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31st european society of Human reproduction & embryology (esHre) annual Meeting
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3rd annual Practical topics in Pediatric emergency Medicine all children’s Hospital 727-767-8523 allkids.org
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2015 Joint congress on Medical imaging & radiation sciences
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Jun22-26
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Iam 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 be-tween euthanasia and suicide. though i am in favour of assisted suicide i cannot sup-port 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
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.
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
assisted suicideA ground-breaking Supreme Court decision changes the landscape of medicine
Dr. Chris Pengilly is Just For Canadian Doctors’ current affairs columnist. Please send your
comments to him via his website at drpeng.ca.
Call-out to medical professional colleagues
physicians should become involved in making sure that the new legislation is clear and safe
We now have a new challenge to navigate
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Spring 2015 Just For canaDian Doctors 35
m o t o r i n g d r . k e l ly s i lv 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 namewherefore art thou, the quirky cars of a bygone era of unrestricted design creativity?
Speeding 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 retrospec-tive contemplativeness already?
Upon arrival at my snow-free destination i sent my car buddy Jerry an FYi text about my in-the-snow 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, two-stroke engines, three-cylinder engines, tur-bocharging, 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-production-numbers quirky sports car. Just 1,700 were produced per year over the iii Series’ five-year 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 hy-draulic, vacuum nor electric—it was human-powered. the engine was V4, a configura-tion more typically seen in motorcycles and outboard boat motors.
During its production runs the Sonett struggled to be favourably noticed by non-Saabers. neither its looks, nor its perfor-mance, made for bar-room bravado. in the early 1970s affordable sporty coupes were legion: Porsche 914 and karmann ghia, vari-ous 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-fertiliza-tion. without thoughtful cus-todianship Saab and the creatures of the galapagos would most likely be lost. Saab’s path was just in-teresting enough that some of the relics were saved by the community of auto-motive 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 right-fully point out that dreaming about owning such oddities and actually living with them are two completely different undertak-ings. “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, let alone a full restoration.
that flash
of yellow against the snow in my peripheral vision left an indelible mark, its quirky Saab-ness 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-appreci-ated cars that were produced in 1960–1980. And i want to collaborate with other dedi-cated and passionate enthusiasts to marshal the necessary resources to execute these rescues. All that retrospective contempla-tiveness will be a blast. Any takers?
Old-school cool. The Saab Sonett exudes a
certain Swedish, ’70s style, whether in bright yellow or red. Here’s to
preserving some of that automotive
quirkiness.
36 Just For canaDian Doctors Spring 2015
Photo courtesy Marikay Falby
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38 Just For canaDian Doctors Spring 2015
saskatchewanunplugged prairie escape in
t r a v e l a t h o m e
Spring 2015 Just For canaDian Doctors 39
saskatchewan
t r a v e l a t h o m e
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
40 Just For canaDian Doctors Spring 2015
t r a v e l a t h o m e
p 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 weath-ered 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 all-
Canadian cowboy. Although i soon learn he’s actually german.
His accent long gone, gaber’s been living the Canadian dream and enjoying the laid-back 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
“the rope,” now provides all-inclusive cowboy-immersion 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 spa-cious 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 graz-ing 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.
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.
Spring 2015 Just For canaDian Doctors 41
t r a v e l a t h o m e
42 Just For canaDian Doctors Spring 2015
t r a v e l a t h o m e
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 restric-tive 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.
A few more minutes pass before i catch up to the group and join the cheering as gaber and the norwegian get the cattle back on track.
Job done, we break in a nearby meadow to eat our pre-packed lunches. gaber lies down under a shaded tree beside a small stream with hat over face, leading all of us into a lull and nap beneath the early afternoon sun.
Back on the trail, i’m more relaxed, absorbing the calm quiet and reveling in the grassy scent of the light breeze. i notice everyone else seems to be soaking in the last leg of the ride, too.
we spot a coyote on a hill but it quickly zips out of sight. then simultaneously, without warning, the horses pick up speed as if sensing home is close. nearly five hours after starting out, we see the lake again. thanks
to the recent rain, a mud-laden path is our route back to the ranch. My 1,300-pound companion struggles to maintain his balance on the slope, mud up to his knees. i hold my breath as we press on, but gus makes it back without a muddy tumble.
After cleaning our horses, we refuel and then take in some lassoing lessons before checking out the saloon. Decorated with tractor-seat stools, old licence plates and cowboy paraphernalia, its kickback atmosphere is a welcome sight after
a long day on the range. Cold beer is swigged as
we refuel and rehash the day. kristina and i dominate in a frenzied foosball tournament. Afterwards, drained yet abuzz with beer, camaraderie and fresh air, i take in the star-filled sky in the hot tub, rounding out a remarkable day unplugged in the prairies.
if you GoleaVe laptops at home. the point here is to take a break from day-to-day life. BrinG your cowboy duds: jeans, buck-
led belt, cowboy boots and hat.Be ready to embrace your inner
cowboy/girl. Learn how to care for your horse, take riding lessons and
enjoy trail rides, or immerse yourself in ranch culture and authentic cowboy activities. try herding cattle, lassoing, dummy steer roping, taking in a small-town rodeo or even branding the year’s
new offspring. eXplore the rich history of nearby
Fort Walsh, a National Historic Site of Canada and one of the first settle-ments of the North-West Mounted
Police, the highlands of Cypress Hills or the great Sand Hills. guided tours
can be arranged.stay at La Reata May 18 – October 12 in 2015. For more: lareataranch.com.
OpenRoad honda Burnaby6984 Kingsway, Burnaby, B.C. V5E 1E6(5 minutes East of Metrotown)Tel: 604-525-4667OpenRoadHonda.ca
44 Just For canaDian Doctors Spring 2015
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.
Pacific 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 indi-vidual 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 well-balanced with a refreshing mouth feel and long finish with floral notes, grapefruit, peaches and honey. Enjoy!
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.
get fishyPut halibut on the menu this spring
PAN-SeAreD HALIBuT (SerVeS 4)
8 oz washed and dried baby arugula and baby spinach mix
1 cup diced just ripe mango (¼-inch cubes)
½ large red bell pepper, diced into 1/4-inch cubes
1 green onion, rinsed1 tablespoon finely chopped
cilantro1 tablespoon Dijon mustard1 cup freshly squeezed orange juice¼ cup freshly squeezed lime juiceolive oil4 pieces of halibut (100–150g
per piece)
salt and freshly ground pepper
Ho
llY
Fon
g
riesling please!
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.
Spring 2015 Just For canaDian Doctors 45
d i v e r s i o n
sudokusolve 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!
$50 Visa gift Card winner:dr. donald Farrell of saint John, nb
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ue Sudoku Contest entry form (solve + send in sudoku!)name: __________________________________________________________address: ________________________________________________________city, province, postal code: _________________________________________e-mail: _________________________________________________________tel: ____________________________ fax: ____________________________
sudoku Contest ruLes: 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 – 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.
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46 Just For canaDian Doctors Spring 2015
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 syn-dromes, and de-scribing 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 return-ing to: Switzerland (see page 8 for why you too should go this summer)
My ultimate dream vacation: live aboard a dive boat in Fiji
If I could travel at any time, I’d go to: Stock market trad-ing floor one year from now. with pad and paper.
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]
Favourite music: 100 Years by Five
for Fighting
My closet has too many: ties. now known as petri dishes,
so patients go ewww and
i don’t wear them
anymore. Yet an-other thing i learned after it was too late…
My guilty pleasure is: Dark chocolate and marzipan.
Favourite exer-cise/sports activ-ity: Squash
My secret to relaxing and reliev-ing tension: know-ing frustration only exists to teach me my current view of reality is incorrect
My fondest memo-ry: Playing with my lovely children in the backyard
My biggest ego boost: Diagnosing an ultra-rare disease and then research-ing a useful treat-ment for it
A cause close to my heart: the Rare Disease Foundation
Co
URt
ESY
oF
DR.
Mil
lAn
PAt
El
sm
al
l t
al
k d o c t o r s s h a r e t h e i r p i c k s , p l a n s + p l e a s u r e s
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.”
clockwise from top left
Dr. Millan Patel; in Switzerland, one of his
go-to places; boating with a friend; making friends with an elephant while
on an East Africa safari.
*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 [email protected].
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