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winter 2018

DOCTORS life + leisure

a tale of two

rockies reflect in

costa rica Publications Mail Agreement #41073506

inside: Continuing medical Education Calendar where will you meet? m i a m i


hokk aido


b er l i n


a r os a


o ja i



Dr. Henk van Zyl Emergency Physician Royal Inland Hospital

Average Commute Lower Mainland= 1 hour 22min Average Commute Southern Interior B.C. = 16 min

What will you do with an extra 24 hours a month? Live, work & play where others only vacation! Itâ&#x20AC;&#x2122;s better here! ... and you can afford to buy a home!


Just for C












Publisher Linh T. Huynh

Editor Barb Sligl

Art Direction BSS Creative Contributing Editor Janet Gyenes

Editorial Assistant Adam Flint Contributors Michael DeFreitas Janet Gyenes Dr. Chris Pengilly Manfred Purtzki Dr. Kellen Silverthorn Barb Sligl Jenn Smith Nelson Roberta Staley Cover photo Henry Georgi

16 29

Senior Account Executive Monique Nguyen Account Executives Janice Frome Wing-Yee Kwong

Production Manager Ninh Hoang CE Development Adam Flint

Sales, Classifieds and Advertising In Print Circulation Office 200 – 896 Cambie Street Vancouver, BC V6B 2P6 Canada Phone: 604-681-1811 Fax: 604-681-0456 Email: email@example.com

clockwise, from top left: jenn smith nelson; barb sligl; Henry Georgi

Just For Canadian Doctors is published four times a year by Jamieson-Quinn Holdings Ltd. dba In Print Publications and distributed to Canadian doctors. Publication of advertisements and any opinions expressed do not constitute endorsement or assumption of liability for any claims made. The contents of this magazine are protected by copyright. None of the contents of the magazine may be reproduced without the written permission of In Print Publications.


16 Self discovery in the wild beauty of Costa Rica 29 Two sides of mountain adventure in the Canadian Rockies COLUMNS


11 photo prescription

5 winter mix 21 CME calendar 37 sudoku 38 parting shot

The Garden Isle

13 pay it forward Providing ocular care in the developing world

On ice in Winnipeg

14 motoring Making racetrack notches

34 the wealthy doctor

In Print Publications 200 – 896 Cambie Street Vancouver, BC V6B 2P6 Canada

Get to know your IPP

36 doctor on a soapbox

www.justforcanadiandoctors.com Printed in Canada.

want to reach us? check out our website!

Navigating the sticky situation of patients with vehicle-accident claims

cover photo Skiing nirvana is found on both sides of the Canadian Rockies—like here, a powder session in one of Fernie Alpine Resort’s five bowls (page 29).

Winter 2018 Just For Canadian doctors


from the editor

Find your story


ometimes the act of travel—the escape from routine and then the immersion into unfamiliar territory— sparks something. A new story. Your story. One that may have been inside all along but only comes bubbling out when you gaze upon that beach, walk in that jungle, see that monkey or hear that tweet tweet early one misty morning. In Costa Rica, our writer travelled from a coffee plantation high in the hills to empty, pristine beaches on horseback and then into the rainforest chasing birds (page 16). There she found herself reflecting on past heartache and realized she had these feathered friends to thank for getting her where she was. A full, twittering circle. Far from the tropical heat, in the Canadian Rockies, a different story unfolds


(page 29). This is the tale of two Rockies, on the east and west sides, in Alberta and BC. Two ski towns, both still small enough (read not completely overrun by tourists) to be home to passionate locals (read great local establishments) who might rather keep these spots under the radar (sorry)… Back south, Miami has the usual and expected hot factor but we partake in a different heat…because the city is a modern-art mecca, from fab architecture (page 5) to interactive public art (page 21). So turn a page. Remember and reflect. Explore and engage. Write your own story, wherever you are, however far you go. And be generous (check out our gift guides, pages 6 – 8). Happy holidays!

Just For Canadian doctors Winter 2018

Any ideas, comments or questions? Reach us at firstname.lastname@example.org.

find your

costa rica

Jenn Smith Nelson

Bird- and monkeywatching and coffee cupping (catación) in Costa Rica (page 16).

what/when/where > winter

style | food | drink | festivals | places | getaways | gear…

night out


a r ch i

Miami musicmaker

Wh er te e ct ur

nd ic a s u t m ee m e

barb sligl

get lyrical

Palms sway and symphonic notes stir. It’s warm enough to sit upon the grass in a sleeveless shirt and watch stars pop out one by one, surrounded by like-minded Miamians and feel abuzz in South Beach while also still in a moment of serenity. // This is Soundscape Park at the New World Center, home of the New World Symphony in Miami. Both educational campus and laboratory (it’s a post-graduate orchestral academy) and striking public park and architectural space (designed by architect Frank Gehry), it’s just steps from South Beach’s sand, water and Art Deco beauty, making it one of this city’s must-visit destinations. // Inside, the lyrical lines of Gehry’s design seem to mimic the curves and swoops of musical notes, adding another layer to this already multi-faceted place. From the rooftop garden there are wow views of that renowned beach, Biscayne Bay and the Atlantic (it’s also a great spot for group receptions, parties and performances). // But the encore is back outside, under those stars during one of the so-called Wallcasts, when musical performances are screened on the pristine-white exterior of the New World Center for picnicking guests spread out on blankets and folding chairs, sipping wine and soaking up the read more See story on Miami, page 21. sound beneath the palms. And come morning, there’s a yoga session under the same trees… Winter 2018 Just For Canadian doctors nws.edu — Barb Sligl



give or get


age e n gh e t es s se n

so sensory For them…or you


1 beat it [sound]These on-ear, noise-cancelling Beats Solo 3 Wireless headphones are hardcore (as created by Dr. Dre and Jimmy Iovine) but also oh-so-pretty in Porcelain Rose. $329.95, beatsbydre.com; available at indigo.ca


2 dish out [taste] Celebrating food and culture, The Recipe Box: YVR shares 100 recipes from 50 of Vancouver’s most celebrated restaurants. The recipes cover a wide range of signature dishes from hot spots like Bauhaus (top left) and the Botanist in the Fairmont Pacific Rim (far left). Think sugar, spice and everything nice, whether ice cream, cocktails or must-try vegan treats—on recipe cards housed in a lovely ashwood or walnut box. $65; recipeboxyvr.com 3 blanket case [touch] Baby, it’s cold outside…but not with this soft-grey Klippan blanket. The Swedish company has been spinning and weaving home textiles for five generations, since 1879, and this “Trip” design by Akira Minagawa is sure to last a couple generations in your family. $329; klippan.ca

wrap it up

5 3

5 carry a tune [sound] Grab-and-go your tunes with the Wonderboom in a range of fab colours (we like this on-trend grey). $129.99, ultimateears.com


gift guide x1


4 Turn on [sound] Forget digital. The new Planar 1 turntable from UK company Rega is a sleekand-simple music-maker that’s a modern take on nostalgic LP sound—using manual mechanisms, of course. $425, rega.co.uk; available at shop.vanspecial.com

6 7


6 aroma therapy [scent] Saje’s essential oils (try the invigorating Mountain High blend) can now be used in this minimalistic Aromatime ultrasonic diffuser. Part alarm clock, part delicious-scent dispenser, it lets you set one aroma for morning, another for night. Good mornings and sweet dreams… $189.95, saje.com 7 light it up [scent] The smallbatch, hand-poured, coconut-wax candles (made in Whistler, BC) are the passion project of a former forester and tree planter. She named the company Hollow Tree 1871 after the beloved Stanley Park landmark, a Western Red Cedar that’s more than 800 years old. And this candle, Valley of a Thousand Falls, is inspired by an actual place in Mount Robson Park. Take a deep breath. Ahhh. $42, hollowtree.ca — B.S.

star gaze

T winter

black magic Explore the dark side this winter

gift guide x2


k ly r a d oe s d it

black and blue There’s plenty of black beauty to be found in a particular blue box. From show sky high to more down to earth, these Tiffany & Co. pieces are a dark delight. Shooting for the stars…if a single piece of jewelry could evoke a constellation, it’d be the Schlumberger bracelet. Its celestial-like bands of platinum-set diamonds are ringed in 18-karat gold and wrapped around a black-onyx gleam. Designed by legendary jeweler, Jean Schlumberger, whose nature-inspired creations were beloved by stars like Elizabeth Taylor, it has an astronomical beauty (and price). Tiffany & Co. Schlumberger® alternating bracelet of diamonds and onyx, $305,000 ; tiffany.ca Practical yet luxe, the black-leather men’s tote is a modern new classic with a disarmingly simple silhouette and chic T-shaped hardware. Men’s tote in black leather, large,$2,150; tiffany.ca The black-leather Diamond Point card case has a dark edge—a studded statement piece that brings just a little bit of punk to its polish. Diamond Point card case in black leather, $235; tiffany.ca — B.S.



When Apple revealed its futuristic iPhone X, the electronics giant wowed the world once again with its new A11 Bionic processor, facial recognition technology and Super Retina gear Display, which harnesses OLED technology to make those bajillion pixels ultra black or super colourful. But how to safeguard all that gorgeous glass and stainless steel that’s bound to take a beating when the super-slim phone slips from your fingers? Well, one good design trick inspired another—the complete retooling of Mujjo’s leather iPhone wallets. Now in its sixth year, the Dutch company launched a new in-mould production process, allowing the slim profile of its premium full-grain leather to protect the iPhone, not hide it. Sophisticated and thoughtful touches include Japanese microfibre lining and a simple sleeve, which allows you to stash three cards (hello, driver’s licence!). Available in Black (pictured), Tan and Grey, $60; Mujjo, mujjo.com — Janet Gyenes

night moves


top 3 images: Tiffany & Co.

HEROIC STYLE OK, so neither Wonder Woman nor Thor wear wristwatches, but Fossil’s style hefty smartwatches are superhero worthy in our books. The second-generation rose-gold-toned stainless steel Fossil Q Wanderer is as hardworking as it is stylish, connecting to your smartphone and offering functions such as a built-in fitness tracker, voice-activated Google, social media alerts and more. The black stainless steel Fossil Q Nate gets its gravitas from military-inspired analogue styling and smart features that let you keep track of your training goals, emails, sleeps and even let you control your music or snap a photo with the press of a button. Superhuman feats indeed. Fossil Q Wanderer, $365, Fossil Q Nate, $235; Indigo, indigo.ca — J.G. Winter 2018 Just For Canadian doctors




the thirsty doctor


in the spirit

For a hurrah to celebrate the end (and beginning) of the year and a last nod to Canada’s 150th, partake in these 5 bottles from distillers­—coast to coast—that are an easy (and highly sippable) gift…just put a bow on it, year round

gift guide x3

li qu i d a s s e ts

local libations 1 [PORT] Capiteux is a maderized and fortified port-style wine with mmmmm aromas of vanilla, prune, nuts and roasted coffee. Made on the bucolic Île d’Orléans in Québec (by sample a très chic team of sisters and their father, thus the name, Cassis Monna & Filles), it’s a digestif that’s perfect with strong cheeses like Stilton or dark chocolate…or a cigar. $23.75, cassismonna.com 2 [AQUAVIT] Make like a Viking with BC distillery Okanagan Spirits’ caraway-and-cumin-tinged Aquavitus. Aquavit is the new “it” spirit, used by in-the-know bartenders in innovative concoctions (try it in place of the standard gin in a Negroni). And this particular aquavit won a double-gold at the World Spirits Awards held in Denmark in 2015. As Oluf Folkersen, President of the Danish Brotherhood says, “This Canadian Aquavit is excellent. I would rate it a 9/10. A fantastic pairing for pickled herring.” Skål! $40, okanaganspirits.com 3 [VODKA] Horilka, a traditional Ukrainian honey-pepper vodka, is affectionately called “the kiss and the slap” at Lucky Bastard Distillery in Saskatoon because “it starts off nice and sweet on the palate then slaps you in the face with the warmth of those Mexican chili peppers.” It’s traditionally used to toast—a lot—during meals. Or try it in a Caesar or with OJ for a Ukrainian screwdriver. Dybosia! $35, luckybastard.ca 4 [GIN] London-dry style Parlour Gin from Eau Claire Distillery in Alberta adds some Canadiana to the traditional juniper: Saskatoon berry, as well as rosehip, coriander, lemon, orange, mint and spice. And there’s a limited-release seasonal Christmas Gin inspired by the story of the gift-bearing wise men—infused with frankincense and myrrh, of course. $48.95 and $34.95, eauclairedistillery.ca 5 [RUM] The Bluenose Black Rum by Nova Scotia’s Ironworks distillery is named for that iconic ship…and this deliciously dark and rich rum (think caramel, molasses, spices), which won the top prize at the 2014 World Rum Awards in London, is perfection in a Dark ‘n’ Stormy. Arrrrr! $42.80 ironworksdistillery.com — B.S.

sip +



Daughters and dad …the très chic team of Cassis Monna & Filles in Québec. Salut!


1 4

[meet the makers]







sk i n e r h soot

[get the goods]

Visit Silk Road Tea in Victoria (store, spa, workshops), Vancouver (store, workshops) and online at silkroadteastore.com Tea Master Daniela Cubelic, called “Canada’s Queen of Tea,” trained with Chinese and Taiwanese herbalists and imparts that wisdom master through Silk Road Tea, the company she founded 25 years ago. But she goes beyond simple brewing, pairing tea with food, mixing it into cocktails, using it in cooking, incorporating it in skincare and designing teaware. She’s even collaborated on a 100% organic and compostable tea bag (the first of its kind in North America). Cubelic also offers instore workshops to share some of that know-how (kombucha, anyone?). l i

ta c oc kx e r fi

Holiday-making and bone-chilling

primp+ weather take a toll. Beau-TEA-ful pamper

tea is a tonic for tired-out skin, an antioxidant, alkaline-boosting blend of white and green tea leaves, rooibos, calendula, lemon balm, peppermint, citrus peel, lemongrass and lavender. From $4.99 Not a steaming cup of tea, but pocket-sized essential-oil concoctions are portable hits of goodness, like “Happy,” one of five go-to roll-on remedies in the Holiday Survival Kit (in a gift-worthy handmade paper pouch) to keep that jovial vibe going. $75.96 Your face needs oil—really. “Nourishing Dew” has been a cult favourite since it’s introduction more than 20 years ago. A few drops will dew it… From $29.99



photo of Daniela Cubelic: Chung Chow; other photos: silk road tea

“Candy Cane” herbal tea is just what its name implies: fresh and minty peppermint flecked with hibiscus and Turn over a pink peppercorns. Steep this vibrant mix into a blush that’s a cheery, new [tea] leaf can’t-miss addition to wintery tipples ­by Barb Sligl like the aptly named “Rosy Cheeks”: stir ounce of tea mix one with two ounces of vodka. It’s even better garnished with a candy cane, of course. For a non-alcoholic option, mix equal parts of the brewed tea with cranberry juice and garnish with cranberries. Merry and bright, indeed. From $4.99

more tea

[toronto] lemon lily This tea emporium collaborates with tea estates and farms worldwide to bring certified organic teas to Canada. Try the line of chai and matcha teas like Chocolaty Matcha, Ceremonial Matcha and Turmeric Matcha. lemonlily.ca

Can’t decide which tea to get or gift? Get the black tea sampler kit with four mini-tins brew (or the green or herbal kit), packaged in that pretty paper pouch (made from recycled paper by a women’s co-operative). Our picks: London Fog, Berry Victoria, Mystic Rainforest, Mango Shade. $22.95

[Montréal] Camellia Sinensis A zen tea house with some 243 teas (all sourced directly from growers in Asia) that also runs two tea schools (in Montréal and Québec City) with more than 20 workshops and courses and has published award-winning books on the history, terroirs and varieties of teas. camellia-sinensis.com



What are YOU doing this February? Join us in Orlando for neonatal-perinatal continuing education or board review led by industry experts. Hyatt Regency Orlando


www.specialtyreview.com CHOOSE


FEBRUARY 20-25, 2018







The conference for neonatology


One of the Premier Meetings in Neonatal Medicine




FEBRUARY 22-25, 2018



The Premier Board Review Course in Neonatal-Perinatal Medicine

NEO: The Conference for Neonatology addresses cutting-edge, yet practical aspects of newborn medicine. Educational sessions are conducted by many of the foremost experts, who address neonatal-perinatal topics for which they have become renowned.

Specialty Review is the most intensive and comprehensive review course of its kind in the country, designed to strengthen your pathophysiology knowledge and problem-solving skills in the field of neonatal medicine.

Target audience: All neonatal-perinatal providers, including neonatologists, advanced practitioners and staff nurses.

Target audience: Neonatologists, residents, fellows and advanced practitioners.

Themes covered:


• Forging New Pathways in Neonatal Nutrition • The Future of Neonatal Medicine — Where Are

• Maternal-Fetal Medicine • General Care of the Neonate / Pharmacology/Fluids

• Controversies in Cardiology for the Neonatologist • Changing Thoughts About Neonatal Sepsis • Evolving Concepts in Neonatal Respiratory

• • • •

We Headed?


• The Pharmacology of Neonatal Neurology — Where

and Electrolytes / Birth Transition/Derm

Neonatal Gastroenterology and Nutrition Neonatal Hematology / Bilirubin / Neonatal Nephrology Neonatal Respiratory System Neonatal Cardiovascular System

Are We Today?


p h o t o p r e s c r i p t i o n m i c h a e l d e f r e i ta s Michael DeFreitas is an award-winning photographer who’s been published in a wide variety of travel publications. With his initials, MD, he’s been nicknamed “doc,” making his photography prescriptions apropos.


Kauai gets its nickname from its vast tropical rainforests and taro fields

destination photography

Practise your sunset shots (not cliché here!) in Hawaii’s Garden Isle of kauai

look up

michael defreitas


spent my first day on Kauai at Kilauea Point National Wildlife Refuge on the northern tip of the island. Besides its historic 1913 lighthouse, the point’s steep cliffs are one of the world’s prime nesting sites for the rare Laysan Albatross and the magnificent Red-tailed Tropicbird. After photographing the lighthouse, I shifted my attention to the birds coming and going to their nests. A 70–200mm lens is perfect as it allows you to zoom in as you pan the approaching birds. A shutter speed of 1/600 second allows you to freeze the bird’s fast beating wings while an aperture setting of f8 will render the entire bird in focus. Set your motor drive for a burst of five or six shots. To avoid a static looking image, I added the appearance of action/motion by framing the bird along a diagonal. I composed some shots with the bird’s wings pointing to the corners of the frame and some with its head and tail. Then I tried to get the wings on one diagonal as well as the bird’s head and tail along the other. It’s a lot harder than it looks, but my patience finally paid off with a few almost perfect double-diagonal shots. Always remember to compose with space in front of the bird to create the effect of the bird flying into the frame. Given the island’s nickname, I thought a good opening image might be the taro fields in Hanalei Valley. After shooting close ups of plants and fields on the valley floor, I moved to a higher vantage point for a panorama shot that included the island’s rugged mountains. Using f18 and my 24–70mm medium zoom I composed a number of different shots. I wasn’t happy with the clouds above the mountains so I used a nearby palm tree branch to frame the top of the image and break up some of the clouds. The branch was moving in the wind so I selected 1/250-second shutter speed to freeze it. What really separates Kauai from its siblings, besides its unique wildlife and majestic taro fields, is its unmatched natural beauty. And Kauaiians aim to keep it that way by designating almost 35% of their island to Forest and Wildlife Reserves. One of Kauai’s prized natural jewels is the Kalalau Valley in the Napali Coast State

I can’t stress enough the importance of perspective/scale in photography. Like my jeep near the Napali cliffs, I placed a woman in my rainforest shot to show the size of the trees and used the trail edge as a leading line. The leading line and the model looking up both help to draw the viewer’s eyes into the scene and up to the trees. I used a tripod and wide angle zoom set at 18mm with f5.6 and 1/30 second.

if you go

For more info on Hawaii and Kauai: gohawaii.com



Wilderness Park. There are many great viewpoints on the park’s 20-kilometre trail that snakes along the 1,300-metre-high

ridges flanking the valley. My first few shots didn’t really capture the essence of the lush valley so I looked for a foreground element to help highlight the valley’s vegetation and its deeply eroded ridges. After finding a


large fern, I used a wide-angle zoom and f18 (for a wide depth of field) to create a more interesting and informative image. Another of the island’s crown jewels, the 16-kilometre-long and 900-metre-deep Waimea Canyon, is nicknamed the Grand Canyon of the Pacific. Vantage points along Highway 550 look upon outstanding views that are best captured in late morning when the sunlight penetrates to the canyon floor. I used f16 and the Waimea River as a leading line to draw the viewer into the canyon. Where I could, I used people to help provide perspective to the scene. Next on the jewels list is the majestic Napali Coast on the island’s west coast. A few dirt roads lead to the rugged coastline from Highway 550, but I managed to get some great shots of the cliffs from the beach at Polihale State Park. You can drive along the beach to the foot of the cliffs and I used my rental jeep to add scale to the image (below). The beach is also popular


with surfers so after photographing the cliffs I turned my attention to these wave riders. I shot the windblown cliffs at f16 and 1/250 second and captured the surfers’ “rooster tails” at f8 and 1/800 second. And no trip to Kauai would be complete without a sunset. The trick is to avoid that “please not another sunset” response to the image. Insert something or someone into the image to create a bit of drama or interest (like my sunset hula girl with a tiny bit of fill flash). Making a great sunset image starts with an interesting location. On rocky Poipu Beach near a local beach bar, I found the perfect clump of coconut trees with Puuwai Island off in the background. Using a tripod and 70–200mm telephoto zoom, I composed my shot at f11 and 1/250 second (to almost freeze the swaying branches). Luckily, I didn’t have to wait long before a man wearing a hat walked out to the rocks and sat down (left). I got my shots and started packing up when I noticed someone from the beach bar lighting tiki torches near the beach. I repositioned and bingo. Just the interest I wanted.


photo prescription [continued]

pay i t f o r w a r d

r o b e r ta s ta l e y

Roberta Staley is a Vancouver-based, award-winning magazine editor and writer and documentary filmmaker.

Into the light

A Vancouver doctor helps alleviate vision impairments in the developing world

courtesy of Dr. Yin


eople from different cultures express gratitude in different ways. But the last thing Dr. Vivian Yin expected was a slap on the butt. Yin had recently undertaken successful cataract surgery on an elderly Filipino woman and was conducting a postoperative checkup at the ophthalmology clinic where the operation had been performed. The procedure transformed the septuagenarian’s world from grey shadows to colours and distinct, clear images. Delighted, the woman began slapping the derrières of clinic staff. “My initial reaction was shock; for North Americans this was highly inappropriate,” Yin recalls with a laugh. The Filipino nurses at the clinic reassured Yin: “She is just trying to tell you how happy she is. This is what grandmas do to children or grandchildren as a way of saying, ‘good job!’” Yin, an oculoplastic and orbital oncology specialist, has been to numerous countries around the globe, working to help alleviate the ophthalmological scourges predominantly found in the developing world. Recent World Health Organization statistics estimate that 36 million people around the globe are blind while another 217 million have moderate-to-severe vision impairment. About 19 million children are visually impaired. More than 80% of these impairments can be prevented or cured, with chronic eye diseases being the main causes of vision loss. The Filipino grandmother’s slap of gratitude, although startling, indicated how proper vision-care can impact an individual. “It is the reason I became a physician,” says Yin, adding that the elderly woman’s problem—cataracts— is the number-one cause of blindness worldwide. A Vancouver native, Yin is an assistant director at the University of British Columbia’s BC Centre for Epidemiologic and International Ophthalmology Centre in the Department of Ophthalmology & Visual Sciences, as well as a consultant at Vancouver General Hospital (VGH). This past fall, Yin took up a research and teaching position at Memorial Sloan Kettering Cancer Center in New York City. Yet Yin is most

passionate about the work she does as a board member with the Vancouver-based charity, Seva Canada Society. Seva, which means “selfless service” in Sanskrit, has been preventing blindness and restoring sight in the developing world for the past 35 years. Yin began working for Seva three years ago and has trained oculoplastic surgeons in Bangladesh, the Philippines, India and Nepal. Seva’s emphasis on capacity building has meant that Yin—rather than focusing solely on cataract removal surgery—is designing curriculum as well as teaching oculoplastic techniques to physicians in these developing nations. Under Yin’s direction, Seva piloted a teaching program last spring in Nepal at the country’s two tertiary medical centres: Bharatpur Eye Hospital and the Lumbini Eye Institute. Nepalese physicians undergo a four-week intensive in ophthalmology surgery under the tutelage of specialists such as Yin. Six months later, Yin and her colleagues will return to assess the Nepalese physicians’ mastery of the techniques during another four-week intensive training, possibly introducing them to one or two new techniques. The Nepalese physicians are highly enthusiastic, says Yin. “They want to start doing orbit surgery. I am holding them back—they have to show themselves proficient in other things first.” It is vital that physicians in the developing world learn complex ophthalmological surgical techniques, in addition to more common operations such as cataract removal. For example, people with hyperthyroidism can develop Grave’s orbitopathy, which is when the eyeballs protrude beyond their normal protective orbit. Nepalese with Grave’s orbitopathy simply go blind. “This is one of the surgeries they really want to learn in Nepal,” says Yin. Yin, who has a master’s degree in public health, is also working with Seva on sustainability, another key challenge for medical systems in the developing world. Less than two decades ago, both the Bharatpur and Lumbini hospitals were on the verge of bankruptcy. Seva helped both centres introduce a payment system,

Dr. Vivian Yin, an oculoplastic and orbital oncology specialist who works with Seva Canada Society

ans S eva me “selfless in service” it r k s n Sa

based upon the simple formula of pay what you can. Both hospitals have since become self-sustaining while ensuring access to poor patients. Yin was part of another innovation revolutionizing health surveys. A key part of global health is assessing the impact of foreign-aid programs, which is challenging in rural societies. Yin helped pilot the first rapid assessment of avoidable blindness (RAAB) methodology using a mobile data collection process on a smartphone app. Using clusters, rather than an entire population, researchers were able to compile accurate data about blindness rates in Nepal faster than conventional survey methods, says Yin. “We now have a new, faster tool that will allow us to change tactics or enhance programs in case things aren’t working as expected.” Yin recalls, as an introspective child, thinking, “If we’re all going to die, what is the point of living?” She decided that, whatever career path she chose, it would have to have impact, “so I could know, in my old age, that I had contributed something positive to the world.” Something a Filipino grandmother whose sight was restored by Yin would wholeheartedly agree with.




D r . k e l l e n s i lv e r t h o r n Dr. Kellen Silverthorn is Just For Canadian Doctors’ automotive writer. He tries to keep one convertible and/or one track-day car in the family fleet.

Is 30 a lot?


’ve notched the crash helmet 30 times. Figuratively that is, once for each different track raced or hot lapped. I’ve been conscious of that approaching landmark of 30 for a few years. Now that I’ve reached it, I’m curious—is 30 a lot? If you’re reading this magazine, then 30 years old is not a lot. Regardless of your age, and unless you are the character Dirk in the movie Boogie Nights, 30 different sexual partners would qualify as more than a few in most people’s books. Have I been swimming in 30 different lakes? I think so, but don’t ask me to name them (nor the partners). Played on 30 formal or semi-formal sports teams? No, not me.

mountain climbing expedition. The racing part has gotten far more accessible in recent years, although there are still far more ski hills or golf courses or mountain peaks than racetracks. Do you know where your nearest permanent road-racing circuit is? (Not the roundy-round kind). There are less than 10 across Canada, and none currently between the Okanagan and Peterborough. Insurance requirements at most racetracks mean someone organizing a full complement of corner workers and safety response personnel. If your goal is to race against other cars then a sanctioning body (similar to a College of Physicians and Surgeons) will have all kinds of requirements

hot laps

Two of 30: Daytona (left and bottom right) and Laguna Seca are checked off the list

I seem more drawn to individual or paired endeavours. (No wise cracks on that one.) Thirty “rated” mountain peaks climbed? That feat would impress me, as I’m a little bit afraid of heights, and I know many efforts are not successful in reaching the peak. Ski hills? I can think of four that I’ve visited more than 30 days each. But 30 different places? (Pause for count). Yes, I’m just over 30 across three continents, but I’ve seriously stalled on accumulating more. For many of these activities, it’s mostly a matter of just showing up. If you don’t have the equipment, you can typically rent it or swim commando or take a little blue pill. And a hundred bucks is usually tops. Racing a car around a real racing circuit is almost as logistically challenging as a


for approving racing cars, racing drivers and the administration of the race. This description of road racing makes getting to race sound daunting. Fortunately, the various Crap-can racing organizations make it all surprisingly affordable and accessible. I’ve raced Daytona and Laguna Seca and four other great tracks this way, with “cold call” postings on their on-line forums. I’ve made a lot of friends through my involvement in these semi-affordable endurance races too. I’ve raced at night. I’ve been pitstop crew for my fellow team drivers. I’ve gone sleepless for no pay, just like on-call. I’ve even won this continent’s only 36-hour race ever held. Not quite ready to find your inner Mario Andretti? Fear not, there are other options


short of a racing licence to get you on track. First, starring in Las Vegas, is the Super Car Laps concept. Pay hundreds, not thousands, and take a Ferrari, Lambo, McLaren, Aston etc. around that racetrack with an instructor riding shotgun. And Super Car Laps equivalents are now playing and/or coming soon to a number of Canadian racetrack venues. Perhaps a special gift for someone you know? (Or a certain columnist?) Less “costly” than Super Car Laps, and more conducive to becoming a better performance driver, is to take your own performance car to a DE (Driver Education) Event held at various tracks. The Porsche club or BMW club are usually involved. Club volunteers provide the instruction and supervision as you gradually build speed throughout the day. A caveat is that unless you have the right car model for this useabuse then your tires and brakes may get thrashed—penny-wise but pound-foolish. Many tracks have commercial race driving schools within their operations that will rent performance cars upon enrolment. Some even offer single-seater, open-wheel racers. This tuition is more expensive than DE enrolment, as well as Super Car Laps quickies. The upside of the commercial school is professional instruction through the day and your car expenses are a known. (Of course, if you crash in any DE commercial school car or a Super Car Laps vehicle, you’re on the hook for the repairs). So, back to “is 30 a lot?” Yes and no. Thirty isn’t a lot if you’re a seasoned pro or long-suffering amateur. If you’ve put in your 10,000 hours to mastering performance driving, then 30 tracks is a given. Even Crapcan racing will cost you more than $200 per hour of track time, so 10,000 hours is hardly for the feint of wallet. Scions or the truly gifted line up here please. For most of the rest of us, 30 race helmet notches would require a family that tolerates spending all discretionary time and money (and then some) on racing. I’ve bucked convention in getting to 30 tracks without having to do that. Mostly, I’ve been at this for 30-some years trying to add one new track a year. Boogie Nights meets middleaged motoring male.

courtesy of Blane Aarup (bottom right) and Brian Peele (left and top right)

It’s an investment to race a car around a real racing circuit…or is it?

travel the world

connecting in

Costa Rica story


+ photography by Jenn Smith Nelson

Just For Canadian dentists November/December 2017


Atop a mountain in Uviata, guests are eye level with the clouds at Kura Design Villas. below A ChestnutMandibled Toucan chows down on vegetation. opposite page, top White-headed Capuchin monkey on a beach minutes from Lapa Rios. opposite page, bottom Costa Rica’s incredible scenery as seen on a horseback ride with Rancho La Merced.


irds saved me once,” I confide to my travel partner who replies, “Sounds like there’s a story there.” Over the coming week in the tropical forests, valleys, cliffsides and seascapes of Costa Rica, amidst a cacophony of wildlife, I learned how right she was. My journey begins in Costa Rica’s highlands, in the eco-paradise of the Central Valley of San Jose. The capital city welcomes me with a warm hug of humidity to its urban jungle surrounded by hills, mountains and volcanoes that meet rain- and cloud-forests.

November/December 2017 Just For Canadian dentists




It’s late and dark when I arrive at Finca Rosa Blanca, a boutique property and organic coffee plantation. Twenty minutes from the airport, positioned 4,000 feet above sea level, it’s just far enough from the city to enjoy sprawling views of neighbouring hillsides and the valley below. Fourteen casas with private verandahs feature bespoke tile, artwork and murals, handcrafted furniture and architectural design elements like art nouveau-inspired columns, rounded archways and window frames. I explore the 40-acre plantation the next morning and learn about the property’s shade-grown organic coffee production and how it’s cultivated, harvested and processed by hand. Strolling under tree-shaded pathways, I also learn a thing or two about crossspecies interdependency. Despite the beauty of the décor and the storytelling on sustainability, I’m distracted—the landscape and wildlife compete for my attention. A group of cicadas nearly deafen me at one point, and vibrant birds, ranging from stunning red Summer Tanagers to Bluecrowned Motmots with feathers of orange, green, blue and black, constantly keep me on the lookout. My ears perk up when guide, Ulysses, explains the significant role birds play on the plantation as our group watches a tiny Rufus Capped Wren jump from plant to plant. “Wrens are one of the most important birds we have here for insect control, which help protect our trees,” he shares. The property’s 5,000 planted native trees (and 50+ species) also give back to the birds by producing shade and nitrogen, acting as a biological corridor for the 200 or so species of tropical migrants. Post tour, I put my taste buds to work with a cupping experience called catación, during which I attempt to discern what makes a good cup of joe (distinguishing and recognizing aroma, acidity, body, flavour and finish). And those who really dig coffee can request a five-course menu featuring coffee as the main ingredient (think Coffee Rubbed Beef Tenderloin). I also indulge in the Pura Vida Coffee Scrub at El Targuá Spa. Fully caffeinated, I take flight again the next morning, this time landing in Puerto Jimenez, the Osa Peninsula’s largest city along the country’s southwestern coast. My local guide promises plenty of wildlife during the 35-minute drive, including, of course, birds. Ten minutes in and two birds checked off my life list, I’m propelled to my happy place. My squeals of delight over the sighting of a Dalton Lapwing, followed by a Tropical Screech Owl, quickly reveal my fanaticism for wildlife. Continuing over small rivers and alongside teak-wood plantations, my travel companion and I ask to stop every five minutes. Our heads hang outside the windows catching the south’s warm breezes as we scour the landscape. Every minute, new birds appear. Great Kiskadees line up, littering barbed-wire fences and fields are full of egrets hitching rides atop cattle. By a stream, I see a Green Kingfisher balanced on a branch looking for lunch, while on the ground across the way is a Crested Caracara, a strikingly patterned bird of prey that sports a signature black cap and intimidating yellow talons. The guide spots a two-toed sloth tightly bundled up high in a tree, then a Cayman Alligator, some turtles, and even more if you go birds. His promise holds true.

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We pull into Lapa Rios Eco Resort and are welcomed by a congregation of high-energy Spider Monkeys who pause as they swing through the trees as if to get a good look at this new group of visitors. Known for its seclusion and pristine beaches set next to some of the country’s oldest growth forests, Lapa Rios is also recognized as a National Geographic Unique Lodge of the World. I soon find out it’s also THE lodge in Costa Rica for wildlife, especially bird lovers (with 300+ species). There’s everything from insects and lizards to marine animals and rainforest-dwelling species like monkeys, armadillos, opossums and even the very elusive pumas. And I’m warned by staff of the resort’s natural “howler” alarm clocks. I make my way down what feels like a million steps following the forest’s natural ridgeline to my bungalow on the rainforest floor (it’s actually 269—I counted between panting breaths later on the way up). Damp with sweat, I crash onto my mosquito-netted bed for a bit, and then step onto the balcony. An unobstructed view of the rainforest and Pacific meets me outside. Lush landscape is abuzz with hummingbirds flitting furiously between heaps of birds of paradise flowers. I hear monkeys in the distance and see a toucan on a branch mere metres away plucking away at vegetation. It’s difficult to pull myself away but a sunset bird tour is calling. Along the same road we came in on, our birding group observes the antics of a male Black-Throated Trogon as it passionately courts a nearby female. Being so close to so many new birds, I’m hardly able to contain my excitement. Reacting to every sound and movement, I’m like jungle paparazzi. The only problem is I’m so animated my hands shake wildly, blurring my images. “You’ve got warbler’s neck,” a woman jokes while I try to work out kinks from my strained neck. After a few dreamlike hours filled with more brilliantly hued birds like Cherry Tanagers, Scarlet Macaws and Crimson-Fronted Parakeets, we turn back. Tropical Kingbirds perched on posts remind me of Western Kingbirds back home. And my ex-husband, who introduced me to birding. In happier times, we’d take long drives along country roads in Canada’s prairies in search of bluebirds, owls and hawks. He’d help me identify ducks, which, at the time, all looked the same. Over the years, my interest in birding increased as his seemed to wane. When our marriage finally fell apart after 14 years together, I weathered the tough times outdoors, listening to and watching birds. Mesmerized, I’d sit for hours soothed by the meditative sounds of their trills and chirps. Through these small slices of solace I became part of the landscape—deeply rooted to the environment, my avian friends and myself. This daily practice connected me to something larger and allowed for healing. The birds saved me. And it’s the birds, not the howlers that wake me the next morning. Bird chatter urges me to peel open my eyes and welcome the dawn. It’s another glorious day and before starting out on the Ridge Hike, I spot a male three-toed sloth and two species of monkeys— the adorably small Squirrel Monkey and, finally, the notorious noisemakers: Howler Monkeys. Weaving through regenerating trees and carefully stepping over massive green roots, my hiking compadres and I trek between

opposite page, top row from left Beautiful design elements allow the outside world in at Finca Rosa Blanca; Collared Anteater; Namesake sushi, the Kura roll topped with crispy onions and carrots. middle row from left “Pura Vida,” a common phrase in Costa Rica, describes its natural beauty and optimistic spirit of its people; Sunset reflections in Kura’s gorgeous infinity pool overlooking the ocean; Squirrel Monkeys, one of four monkey species found within the Osa Peninsula. bottom row from left Cupping experience or catación at Finca Rosa Blanca; Staring contest with a Common Black Hawk near Lapa Rios; Sticky Chicken Strips at Kura.



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primary and secondary forests. Fivehundred-year-old trees tower above and leafcutter ants transporting leaves march purposefully below. The hike quickly turns into another bird-watching expedition, thanks to a birding couple in the group. Sensing our enthusiasm, our guide Edwin, switches gears. Soon we all work together to identify each sighting. Using a laser, he points to spots he’s scouted over his 21 years guiding. He shows us a Crested Owl, perched so high and camouflaged so well, we’d likely never spot it on our own. Later, we’re deep into the secondary forest ambling alongside walking palms with stilted root systems. In a hollowed tree hangs a group of long-nosed bats and moments later we stumble upon a Collared Anteater clumsily trying to slide down a tree trunk, slipping every few metres, attempting to get out of sight. It’s December, the tail end of the rainy season (May to November), and for a short while, light rain trickles, cooling us down. At a shallow yet steadily flowing river we remove our shoes to cross, and then follow the path to a small waterfall before heading back to the resort. Leaving the next day is hard, but the blow is softened at Kura Design Villas. A modern, luxurious six-room (adult-only) property in the small village of Uvita, it’s set atop a mountain with an infinity pool overlooking the ocean and Marino Ballena National Park. After jungle trekking, my trip ends with a couple days of posh pampering, cocktails and cuisine. I fill up on a locally inspired menu with microgreens produced onsite and freshly caught seafood like octopus, seabass and yellow-fin tuna served in various forms of ceviche, rolls, tartare and sashimi. Relaxation and reflection come next. Settled poolside, I spot a hawk fly by at eye level and break into a wide grin. Costa Rica’s birds have won me over (and all of its wildlife and landscape, from anteater to howler, coffee plantation to valley floor to cliff-side infinity pool). But, actually, the birds had me at first tweet. Then I realize it. It’s bird therapy—at home or with the 300-plus species in Costa Rica. Birds will always be there to connect with throughout travels and life to remind me how far I’ve come on my journey. But it took the Costa Rican birds to remind (and tweet) me that.














A n intern ation a l guide to c ontinuing medica l Education

winte r 2018 + beyond


“Le Corbusier” public art

“Sprache der Vögel,” Margulies Collection

Wynwood Walls Inside the de la Cruz Collection

Miami vibes on South Beach

South Beach “Fly’s Eye Dome” public art


miami modern: Where art is hot (CME events in Miami + beyond are highlighted in blue.)



h, Miami. It conjures hotness…as in beach, beach bodies and spicy Cuban fare, moves and music. And, yes, there’s all that. But there’s a hot factor in its art scene too. The city has become a modern-art mecca, which Art Basel Miami shines a bold spotlight on. The see-and-beseen party gets the glitterati out (think Leo and George and such), mingling, critiquing and buying contemporary artwork (this year it’s on December 7 – 10). But to partake in Miami’s art scene all you need to do is walk through Wynwood Arts District (wynwoodmiami. com). Edgy and all things hip, this once industrial ’hood is now home to more than 70 art galleries, performance spaces, shops, bars and restaurants. And its crown jewel is the Wynwood Walls street-art installation (thewynwoodwalls.com). Beyond those vivid walls are galleries within old warehouses, now showcasing museum-worthy private collections. Your mind may be blown at the Margulies Collection at the Warehouse (margulieswarehouse.com), housed in a 45,000-square-foot retrofitted warehouse that presents seasonal exhibitions from the vast collection of renowned art collector Martin Z. Margulies.

Sample artwork: the spread wings of a three-ton sculpture by German artist Anselm Kiefer. Sprache der Vögel, or “Language of the Birds,” refers to 20th-century French alchemist Fulcanelli’s ideas on hidden truths and the transformative nature of alchemy. Stand beneath its massive wingspan and let its meaning soak in. There’s more to ponder at the de la Cruz collection (delacruzcollection.org), in the nearby Design District (miamidesigndistrict.net). An extension of billionaire art lovers Rosa and Carlos de la Cruz’s home, it’s another massive (30,000 square feet) contemporary art space showcasing mind-boggling sculptures, paintings and installations. And it’s free to the public. Also free in the Design District is the Institute of Contemporary Art (icamiami.org), which is all about experimentation in contemporary art. A new 20,000-square-foot exhibition space and 15,000-squarefoot sculpture garden (yes, Miami likes to go big) open on December 1, 2017. Still in the Design District, meander the pedestrianfriendly maze of shops and office spaces to find various public art pieces like Neo-Futuristic architect Buckminster Fuller’s “Fly’s Eye Dome,” which is…just that. A 24-foot

Check out miamiand beaches.com

fly-eye-like sphere that’s considered a green-architecture pioneer—an interactive sculpture that the artist called the “autonomous dwelling machine.” It connects underground parking to the sky and courtyard above (part of the Palm Court shopping centre and another must-see design project composed of glazed-glass fins by architect Sou Fujimoto), where you’ll find a giant bust of Le Corbusier by French artist Xavier Veilhan. Surreal. Just south is the Pérez Art Museum Miami (pamm. org), Miami’s main art museum, which, besides the art inside, is set in a 200,000-square-foot showpiece by Pritzker Prize-winning architects Herzog & de Meuron. Its simple-and-sleek three-storey slatted canopy, hanging vertical garden and expansive deck overlook Biscayne Bay—a celebration of the city’s tropical vibe. And on the other side of Biscayne Bay is the Art Deco wonderland of South Beach, where there’s both eye and ear candy… Gape at the curvaceous shapes and pastel palettes of iconic architecture from the Rat Pack era and then have picnic in the park while listening to the New World Symphony (nws.edu) projected on the façade of yet another architectural masterpiece, this time by Frank Gehry (see page 5). It’s Miami modern. — Barb Sligl






Alternative Medicine

c Mcmee when calendar where

MORE CME Full-access CME calendar and destinations at justforcanadiandoctors.com/cme/





Feb 17-18 2018

Vancouver British Columbia

Hypnosis: The Language Of Change: Clinical Training Workshop For Health Professionals (Levels 1 & 2)

Canadian Society of Clinical Hypnosis



Mar 21-22 2018

Rotterdam Netherlands

2nd Probiotics Congress: Europe

Global Engage

laura@glo balengage.co.uk


Apr 12-14 2018

Hollywood Florida

26th Annual Spring Congress Of American Academy Of Anti-Aging Medicine (A4M)




Apr 25-28 2018

Ojai California

5th Annual Spring Conference On Integrative Medicine In Womenâ&#x20AC;&#x2122;s Health

Symposia Medicus


symposia medicus.org

Jan 24-27 2018

Grand Cayman Cayman Islands

2018 Anesthesia Camp, Grand Cayman



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Jan 26-30 2018

Winter Park Florida

Society For Education In Anesthesia 2018 Workshop On Teaching

Society for Education in Anesthesia



Jan 29Feb 02 2018

Arosa Switzerland

2nd NSpine Platinum Small Group Educational Event




Dec 17-20 2018

Miami Florida

Current Topics In Anesthesia

Northwest Seminars



Feb 19-23 2018

Cancun Mexico

new CE to beInplaced Cardiology At Cancun: Topics Clinical


Mayo Clinic


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Feb 22-25 2018

Venice Italy

5th International Conference On Prehypertension, Paragon Group Hypertension & Cardio Metabolic Syndrome


2018.prehy pertension.org

Feb 25Mar 02 2018

Atlanta Georgia

21st Annual Society Of Cardiovascular Anesthesiologists Echo Week

Society of Cardiovascular 855-658-2828 Anesthesiologists


Mar 18-20 2018

Glasgow Scotland

2018 Society For Cardiothoracic Surgery In Great Britain & Ireland Annual Meeting

Society for Cardiothoracic Surgery in Great Britain & Ireland



Mar 09-11 2018

Pune India

2nd International Diabetes Summit

Chellaram Diabetes Institute


cdidiabetes summit.org

Mar 16-18 2018

Shanghai China

2nd Asia Pacific Symposium On Diabetes, Hypertension, Metabolic Syndrome & Pregnancy (DIPAP Greater China 2018)



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Sep 30Oct 03 2018

Kanagawa (Tokyo) Japan

18th International Society For Pediatric & Adolescent Diabetes Science School For Physicians

K.I.T. Group GmbH



Dec 01-04 2018

Cape Town South Africa

18th International Congress Of Endocrinology: 53rd Annual Society For Endocrinology, Metabolism & Diabetes Of South Africa Congress

Scatterlings Conference & Events







General & Family Medicine



Emergency Medicine










Jan 08-13 2018

San Diego California

2018 National Association Of EMS Physicians Annual Meeting

National Association Of EMS Physicians



Jan 27-28 2018

Las Vegas Nevada

Hospitalist And Emergency Procedures Course

Hospital Procedures Consultants


hospitalproce dures.org

Feb 27Mar 03 2018

Beaver Creek Colorado

18th Winter Conference On Pediatric Emergencies



symposiamedi cus.org

Mar 10 2018


Ophthalmology Update For Emergency Physicians

University of British Columbia



Jan 12-13 2018

Abu Dhabi UAE

2018 European Society Of Endocrinology Clinical Update

Imperial College London Diabetes Centre



Mar 01-03 2018

Dubai UAE

8th Emirates Diabetes & Endocrine Congress (EDEC)

MCI Middle East



Mar 11-14 2018


40th Annual Meeting Of The Society For Inherited Metabolic Disorders

Society for Inherited Metabolic Disorders



Jun 13-16 2018

Berlin Germany


go.evvnt. com/166212-0

Jan 25-26 2018

Edinburgh Scotland



Apr 21 2018

EPC 2018 Team new CE to Congress INTERPLAN be placed 22nd Advanced Gastroenterology & Hepatology Royal College of 50th Jubilee Meeting Of The European Pancreatic Club


Physicians of Edinburgh

New York New York

3rd Annual School Of Gastrointestinal Oncology

Physiciansâ&#x20AC;&#x2122; Education Resource



Sep 03-06 2018


2018 FoodMicro Conference

MCI Deutschland


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Jan 21-26 2018

Hokkaido Japan

2018 Winter In Japan Integrated Health Care Conference

Amped Medical Conferences


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Feb 09-10 2018


2018 Mass Gathering Medicine Summit

American Academy of Event Medicine

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Feb 19-22 2018


2018 Advanced Imaging In The Islands

Duke Radiology



Mar 01-04 2018


2018 South Beach Symposium (Dermatology)

South Beach Symposium


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Honolulu Hawaii

15th Hawai’i International Summit On Preventing, Assessing & Treating Trauma Across The Lifespan

Institute on Violence, Abuse & Trauma



Apr 20-21 2018


Canadian Conference On Physician Leadership “Dialogue: A Tool To Lead Action”

Canadian Society of Physician Leaders

613-369-8322 physicianleaders. ca

physicianlead ers.ca

Apr 26-28 2018

Boston Massachusetts

Writing, Publishing, And Social Media For Healthcare Professionals

Global and Continuing Education, Harvard Medical School


wps.hmscme. com

Jun 07-19 2018

British Isles And French Open Cruise

Topics In Addiction Medicine, Mental Health, Obesity, And Preventive Medicine

Continuing Education, Inc./University at Sea

800-422-0711 See Ad Page 39

continuingedu cation.net

Oct 13-20 2018

Tahiti & Bora Bora

Treatment Considerations In Isolated Communities / Seminar At Sea On The Paul Gauguin

Professional Education Society

877-737-7005 See Ad Page 33


Oct 21-28 2018

Southern France River Cruise

Medical Symposium Confronting Healthcare Needs / 7-Night Uniworld River Cruise Avignon To Lyon




Nov 08-11 2018


19th Annual Fall Scientific Meeting Of Sexual Medicine Society Of North America (SMSNA)

Sexual Medicine Society of North America



Jan 20Feb 01 2019

Rio to Buenos Aires Cruise

Medical Healthcare Delivery In Challenging Environments / Brazil, Uruguay & Argentina On Regent Explorer




Dec 14-16




Jan 25-27 2018

Toronto Ontario

2018 Better Breathing

The Lung Association Ontario


betterbreath ing.ca

May 03-04 2018

Montreal Quebec

La Gériatrie

Université de Montréal



Aug 08-10 2018


14th Global Conference On Ageing

International Federation on Ageing



Jan 19-20 2018


2018 Highlights Of ASH In North America

Washington University School of Medicine in St. Louis



Mar 28-30 2018

Paris France

38e Congres de la Société Française d’Hématologie

Société Française d’Hématologie



Dec 13

Strasbourg France

Hands-on Flexible Endoscopy For Surgeons Advanced Course

Institut de Recherche Contre les Cancers de l’Appareil Digestif





22nd Advanced Gastroenterology And Hepatology Course

Royal College of Physicians of Edinburgh



Apr 16-19 2018

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Adult Immunization In Primary Care - Influenza, Meningococcal And Food And Water Borne Travel Illnesses Update




Nov 07 2018


5th International HBV Cure Workshop

Virology Education


virology-edu cation.com

Dec 15-16

Brussels Belgium

2017 Annual Congress Of Belgian Society Of Internal Medicine

Belgian Society of Internal Medicine


bsim.wildapri cot.org

Jan 06 2018

Richmond Virginia

Urological Update & More 2018

Virginia Commonwealth University Health


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Feb 02 2018

Sherbrooke Quebec

AMU - Atelier Pratique de Techniques Utilisées en Médecine d’Urgence

Université de Sherbrooke



Feb 13-17 2018


2018 Association Of Academic Physiatrists (AAP) Annual Meeting

Association of Academic Physiatrists



Mar 12-14 2018

Whistler British Columbia

Medical CBT For Stress And Anxiety: Ten-Minute Techniques For Real Doctors

CBT Canada

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Mar 19-21 2018

Maui Hawaii



May 26-30 2018

Rome Italy

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Jun 22-23 2018


14th International Regional Stress & Behavior Neuroscience & Biopsychiatry Conference (North America)

International Stress And Behavior Society


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Jul 22-29 2018

Disney Mediterranean Cruise

Medical CBT For Anxiety




Oct 07-16 2018

Japan Cruise

Medical CBT For Depression: Ten Minute Techniques For Real Doctors




Jan 18-20 2018


2018 Neurology Update And Stroke Intensive

Miller School of Medicine


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Feb 04-06 2018


10th Canadian Neuromodulation Society Annual Meeting

Canadian Neuromodulation Society


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Mar 22 2018

St. Petersburg Florida

Ultrasound Guided Vascular Access

Gulfcoast Ultrasound Institute, Inc



Mar 24 2018


MSK Spine Tools

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Internal Medicine

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Pain Management

Oncology & Palliative Care

Obstetrics & Gynecology









Topics In Women’s Health And Healthcare Communication





21st Annual Women’s Imaging. Advances In Gynaecologic Imaging And First Trimester Ultrasound

University of Toronto


mountsinai. on.ca

Feb 16-23 2018


General Practitioners & Dermatology Symposium On Skin Cancer

CME Travel



Jul 15-29 2018

British Isles Cruise

Symposia On Hospital, Palliative, Primary And Dental Care On The All-Inclusive Crystal Serenity




Aug 15-18 2018

Sydney Australia

17th World Congress On Cancers Of The Skin

The Skin Care Foundation

wccs2018@ arinex.com.au


Feb 16-18 2018


Neurology & Pain Management For Primary Care

MCE Conferences


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Feb 16-19 2018

Carlsbad California

The 31st Annual Practicing Physician’s Approach To The Difficult Headache Patient

Diamond Headache Clinic

312-867-9104 See Ad Page 28


Jul 12-15 2018

Lake Buena Vista Headache Update 2018 Florida





Orlando Florida

The Conference For Neonatology

Pediatrix Medical Group

800-243-3839 See Ad Page 10

neoconfer ence.com

Feb 20-25 2018


Specialty Review In Neonatology



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Jul 31Aug 02 2018

Austin Texas

Innovations Conference



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Feb 05-09 2018

Naples Florida

6th Annual Essentials In Primary Care Winter Conference

Continuing Education Company

800-327-4502 See Ad Page 37




6th Annual Primary Care Winter Conference




Mar 26-30 2018

Palm Coast Florida

12th Annual Primary Care Spring Conference Session I (Session II: April 02-06, 2018)




Sep 30Oct 14 2018

Holy Land & Ancient Kingdoms Cruise

Primary Care And Women’s Health Key Topics And Core Strategies






23rd Annual Conference On Challenges In Gynecology

Jan 20Feb 01 2018

Australia and New Zealand Cruise

Feb 23-25 2018

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travel at home

Looking down Red Tree run at Fernie Alpine Resort below Ice skating on the lake at Fairmont Jasper Park Lodge right High above Jasper atop Whistlers Mountain below right The view from the top of Currie Bowl at Fernie Alpine Resort

a tale of two Rockies From west (Fernie) to east (Jasper)â&#x20AC;Śthere are two sides to the Canadian Rockies to discover story by

+ photography Barb Sligl





here’s a dusting of snow over the quiet main street, the sky’s a deep, twilight blue edging into dark night and unlike anything you’d see in the city. Peaks rise high above the quaint buildings, stars start to emerge, the snow seems aglow and ski-jacketed people amble about in search of a warm spot to continue their après-ski. It’s a small-town scene in the mountains after the ski hill shuts down for the day. I’m in Fernie, tucked into the southeastern corner of BC on the west side of the Rockies. But on the other side to the north is another, similar scene. There, the mountain village is Jasper, where the sky may be darker (it’s home to one of the world’s biggest Dark Sky Preserves) and there are more tourists (it’s in a renowned national park, after all) but it’s still under-theradar as far as ski destinations go. Go-to resort towns (ahem, Whistler, Mont Tremblant, Banff’s big three) are an easy pick for getting that ski fix, but venturing farther out of the way makes for a more local vibe (and less lift lines). And I found both on opposite sides of the Rockies. Fernie’s long been known as a skier’s wet dream—deep powder, stellar steeps, five glorious bowls—but because of its location—on the west side of Crow’s Nest Pass, a three-hour drive from Calgary and more than 10 hours from Vancouver—it’s not overrun. And people actually live and work here (mining marmot basin employs a good Number of runs: 86 (30% easy, 30% percentage of the intermediate, 20% advanced, 20% expert) population). That Terrain: 678 hectares (1,675 acres) longest run: 5.6 kilometres (3.5 miles) means year-round Summit elevation: 2,612 metres (8,570 feet) establishments like a Vertical drop: 914 metres (3,000 feet) sushi joint locals happily average snowfall: 4 metres (13 feet) line up for (yes, nigiri skimarmot.com in the mountains, and Yamagoya even has a solarpowered sushi truck, Yama2Go, in warmer months) and a coffee shop that’d fit in the hippest ’hoods of any big city. I walk off the main drag into this coffee spot, The Valley Social, to find a cow skull top The view of Jasper townsite from the top of Jasper Avenue black-diamond run at Marmot Basin middle row from left Buffalo head above the fireplace in the Fairmont Jasper Park Lodge; snowshoeing in Jasper National Park bottom row from left Parks Canada photographer, Ryan Bray, in front of one of his captures of the Dark Sky Preserve; sampling local microbrew from Jasper Brewing Co.

travel at home hanging above a menu etched on planks of wood and a plaid-and-toque-wearing proprietor behind the counter, drawing espressos himself. He tells me how he started his venture with a mobile trailer, bringing good coffee to the good people of Fernie. Demand was such that he opened this bricks-and-mortar place just over a year ago, and now also hosts pop-up multicourse dinners. A few steps away, still on that softly blanketed and hushed main street, I have dinner at The Loaf, where oven-baked pizza and the Shaft are a much-loved thing (the Shaft is described as “the quintessential BC mountain town cocktail,” made of Fernie Alpine coffee, vodka, Kahlua, Number of runs: 142 (30% easy, 40% cream). Afterwards, intermediate, 30% advanced) Terrain: 1,012 hectares (2,500+ acres) I wander about in longest run: 5 kilometres (3 miles) the chill to admire Summit elevation: 2,134 metres (7,000 feet) historic turn-of-theVertical drop: 1,082 metres (3,550 feet) century buildings. average snowfall: 9 metres (30 feet) And, of course, skifernie.com before all of this was the actual skiing. If you’re into skiing, you’ve heard of Fernie (and Calgarians certainly have; here, they’re known as Calfernians). Because those five glorious bowls of white stuff are revelatory. Beneath the looming ridge of rock called the Headwall (yes, it’s skiable, but strictly for those with hardcore skills and absolutely no fear) are the “old” and “new” sides. Local ski guide and instructor Johnny (who runs the Steep and Deep program) takes me to the edge of the old side, along Snake Ridge to where out-of-bounds Fish Bowl beckons to serious powderhounds (avalanche equipment required). We ski the ridge, down Red Tree and into Cedar Bowl, before heading over to the new side and up to the very top of Fernie, where Polar Peak provides vertigoand adrenaline-inducing views and runs. After a killer ski day (in the best sense) of Johnny’s fave runs and tips (slap those skis down the moguls’ side, keep on balls of feet, stay forward!), I have a much-needed Wolf IPA (from Fernie’s own microbrewery) at legendary slope-side bar, the Griz. Named after a rockface high above that looks like Lone Wolf IPA from Fernie Brewing Co. at legendary après-ski spot, the Griz; Lost Boys Café, go-to lunch stop at the top of Timber Bowl in Fernie middle Twilight in downtown Fernie with view of the Headwall bottom row from left The Valley Social coffee house in Fernie; Steep-and-Deep instructor, Johnny, surveys his domain from the top of Currie Bowl and across from Polar Peak top row from left

travel at home said bear, it’s also known for beer-lubricated table sliding…in the nude. I forgo the table slide and instead tackle another bowl, the Knob, some 600 kilometres northeast of here, across the Continental Divide, at Marmot Basin in Jasper National Park. With the highest base elevation in Canada, Marmot is far above

Marmot Basin Snow School instructor Jezz’s office below Skiing down from Polar Peak at Fernie Alpine Resort

Jasper village, reached via a twisty 20km road that’s a bit of a trek itself (there’s a bus or cab service…really). Despite Jasper’s renown, Marmot is little-known, largely serving a local and Edmonton market. Read: no crowds. Ever. And wow skiing. My guide, Jezz (lead instructor with the ski school and Ski Instructor Training program), takes me down Elevator Chutes


(sweet tree run), Show-off (one of his faves), Milkrun (more in the trees), Grizzly Glades (another “griz,” this one a bumpy tree run)…and on and on. We never encounter anything resembling a lift line, and my quads are on fire by the end of the day. Thankfully, again, this town has lively après-ski and even better, “In Jasper you can

days, I also snowshoe, hike along a frozen waterfall, watch fireworks and practise yoga (okay, this is indoors, but part of the Lolë Wellness Weekend, one of the Jasper in January events, like those fireworks). I also try some night photography in this Dark Sky Preserve (public workshops take place during the annual Dark Sky Festival), which is documented beautifully by a resident Parks Canada photographer. My snowshoeing session is one of many free activities that Parks Canada offers, and in the hour or so I’m in the woods, I come across numerous tracks (wolf?!) and concave formations (curled-up and napping elk!) in the snow. Then I cross paths with other creatures—a young (and local!) family out on cross-country skis for their weekly loop through the forest. After my calorie-burning foray in the forest, I stop in at Jasper Brewing Co. (the first brewery in a national park) for Jasper the Bear ale (another thing named after a bear). I sample other funky spots like Coco’s Cafe to fuel-up with an apropos Groomers Breakfast and Snowdome to caffeine-up while others do their laundry (yes, it’s a laundromatcum-café and it’s wonderfully For more on what to see and weird and right). do in Jasper go to jasper.travel, There’s a ravedand for info on the Alberta side about sushi of the Rockies: travelalberta. place too, as I’ve com. For more on Fernie go to come to expect tourismfernie.com, and for of these two info on the BC side of the Rockies: hellobc.com. not-so-surprisingly sophisticated small ski towns. This one’s hidden away in the lower level of the Fairmont Jasper Park Lodge and just as hard to get into (Oka Sushi is a one-man operation with just 12 seats). But my most off-beat experience in this mountain village is The Den in the bowels of Whistler’s Inn. A can’t-miss, Jezz insists when he tells me about this “attraction.” I buy my token at the front desk (a mere $3), make my way to the basement and insert the coin into a turnstile to enter a dark diorama of forest creatures. Or more accurately, some 100 taxidermied animals—cougars, biggo to a bar and actually sit next to a local,” horned rams, eagles, elk, grizzlies—that are says Jezz. “Try do that in Banff.” Jasper prides strangely arresting, grotesque yet beautiful. I itself on this difference and its independent can’t imagine seeing anything of the kind— spirit; this a town where McDonald’s tried to so unabashedly quirky—in a larger ski-resort make a go of it and only lasted six months. town. And that’s the joy of these two But, being a national park and UNESCO sides of the Rockies, because these smallWorld Heritage Site, there are the inevitable and-sweet ski towns still make space for tourists, which also means plenty of non-ski- authenticity…with a little bit of eccentricity. ing activities—even in winter. Over a couple And a lot of great skiing.



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t h e w e a lt h y d o c t o r M a n f r e d p u r t z k i Manfred Purtzki is the principal of Purtzki & Associates Chartered Accountants. You can reach him at firstname.lastname@example.org.

Peace of mind

The resurgence of the tax-sheltered and untouchable Individual Pension Plan


ith punitive taxes on corporate investment income looming on the horizon, many doctors will seek tax shelter in the Individual Pension Plan (IPP). The IPP is a one-person pension plan which operates like a teachers’ pension plan, offering tax-sheltered growth, locked-in savings, creditor proofing and inflation adjusted benefits on payout. Here are the maximum contributions for 2017 your corporation can make in your first year of setting up the IPP. Earnings of $144,500 and service from 1991 are assumed. Age 40: $111,056; age 45: $181,471; age 50: $258,706; age 55: $343,709; age 60: $437,055; and age 62: $476,883. For individuals 40 years or older, can be a source the annual contribution to the IPP is of comfort in this higher than the RRSP contribution. chilly tax climate For instance, the maximum 2018 IPP for physicians contribution for a 55-year-old doctor is $37,666 compared to an RRSP contribution of $26,230. Additional advantages:


at your


• The company can deduct the interest on funds borrowed to make the contribution. • Actuarial, accounting and administration fees are tax deductible in the company and are not a taxable employment benefit. • If the return on your investment becomes insufficient to fund the IPP benefits, you can top up the IPP. • Upon early retirement the company can make a final contribution, called terminal funding, to increase pension benefits. • You can wait 120 days after the company year-end to make the tax-deductible contribution for the year. • IPP pension income is eligible to be split with spouse at age 50. RRIF income is not eligible for income splitting until age 65. • Ability to roll RRSP into IPP.



The IPP has some disadvantages: • Since you require the services of an actuary, the administrative expenses are higher than the RRSP. • You cannot make spousal RRSP contributions. • New RRSP room is restricted to $600 per year. • You don’t have the ability to withdraw funds prior to retirement. • You need T4 earnings of about $144,500 in order to maximize the current IPP contribution, very similar to maximizing your RRSP contributions. The actuary prepares a tri-annual valuation of IPP and if there is plan deficit in relation to the prescribed limits, then the company must make up for the shortfall. On the other hand, if your IPP has a surplus, you must reduce your contributions. The funds are locked in and must provide pension income using one of these three options: 1. IPP funds are used to purchase a life annuity, which can be joint with your spouse. 2. Since an IPP does not have to be wound up, the IPP can pay pension benefits directly. 3. IPP funds are transferred directly to an income-paying locked-in retirement plan. This is the most popular option. If the doctor dies after retirement and the IPP funds were transferred to another locked-in retirement plan, the surviving spouse can roll the full value of the plan to his or her own registered plan. The beauty of the IPP is that it gives you peace of mind in the uncertain investment climate; you know what your retirement income will be when you retire. And most importantly, the IPP gives you the comfort of knowing that the money in the IPP grows taxsheltered and untouchable to any new tax measures affecting your investment income in the corporation.



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

Responsible recoup


Pain-free recovery from car accidents must go further than a physician’s care


uch! I have just paid my auto insurance for another year, and it has gone up another $50. It is now costing me $1,320 and would be closer to $1,900 if I was not able to claim an accident-free status. There are minor variations but basically this is the same across Canada. I thought it was the same in Europe but my brother-in-law in the United Kingdom pays just $264 for a fully comprehensive policy. His son, however, pays $1,600 on account of his age and gender, which is considered a higher risk as per common underwriting practice. This cannot happen in Canada as it is considered age discrimination. I am writing specifically about BC, but it’s my understanding that automobile insurance is fundamentally the same across the country. There are minor variations, such as in Saskatchewan, which has nofault insurance. Insurance premiums would increase even more if it were not for legislation to limit alcohol-impaired driving and now distracted


and mobility versus extended invalidism

The problem is that once litigation is involved in a claim everything grinds to a halt. It takes about five years to have the claim settled, by which time the patient has become fixed in a pattern of chronic pain and invalidism. These patients come to the office with their pain diaries and a detailed list of every ache and pain that has occurred. This focus on the negative goes against physicians’ inherent practice of encouraging and rewarding rapid recovery. I sometimes wonder if I’m a bit insensitive to these patients— some patients do suffer chronic symptoms and pain—until I was rear-ended by a texting driver and sustained $6,000 worth of car damage and then my wife was also rear-ended by a large, heavy truck. We stayed active and developed negligible symptoms, and both made a rapid recovery. I think some patients are genuinely scared that they have some form of occult injury or are doomed to develop problems later on in life—anxieties that are usually fuelled by well-meaning friends or relatives who “know somebody who was involved in an accident just like yours and ended up paralyzed several years later…” It’s left to the physician to reassure the patient that permanent injury is unlikely, remote complications improbable and early mobility and activity essential—and to never, therefore, impede recovery with a cervical collar (a controversial prescription that can actually make things worse with immobilization). I would like to see the end of contingency billing. I have had several patients over the years who have begun a claim for motor vehicle injuries but later realized that it was not justifiable—yet they were unable to quit the process unless they paid a substantial fee of thousands of dollars. They were trapped. We, as doctors, can do little to change this process on the grand scale. But, one by one, we could urge our patients to agree to a settlement sooner rather than later. Most patients still listen to and heed the advice of their primary care physicians. We need to remind them that the body has a great ability to heal, encourage mobility and provide a positive message that may just save them from becoming chronic invalids.

sudoku 1 easier solution 1 9 8 2 5 6 4 3 7 4 2 7 3 1 9 8 6 5 3 5 6 8 7 4 9 2 1 5 3 9 1 4 2 7 8 6 7 4 2 6 3 8 5 1 9 8 6 1 7 9 5 2 4 3 2 7 3 9 8 1 6 5 4 9 8 4 5 6 3 1 7 2 6 1 5 4 2 7 3 9 8

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solution from Fall 2017 contest

driving. Some provinces have photo-radar enforcement but this was banned in BC several years ago as a matter of political expedience. There are other steps, major and minor, which could be taken to reduce accidents, and hence insurance costs, and would involve all levels of government and have different levels of efficacy. It would seem logical to have all cars fitted with universalheight bumpers that are impact safe up to 5 km an hour (a very minor bump at a traffic light dented my bumper and resulted in a replacement cost of about $1,000). Road lines made of a durable material that includes reflective elements would prevent them becoming virtually invisible when it rains. More roundabouts would reduce not only the number of accidents but also the severity of injuries. Such things make a difference, like the praiseworthy introduction of universal backup cameras in all vehicles by 2018. But these are small potatoes compared to the main motor (unintentional pun) behind the escalation of insurance costs. That is, the disproportionate remuneration for “pain and suffering” for relatively minor accidents. Of course, adequate compensation is reasonable and justified in the event of serious injuries but one element that precipitated me into retirement was having to write medicolegal reports concerning mostly trivial injuries. These reports take up a great deal of the physician’s time that’s much better spent in dealing with truly sick patients. The last medicolegal report I submitted was billed at $450 an hour and paid without demure. Even at that price it was not worth the time involved.

solution from page 37

It is up to the physician to reassure the patient that permanent injury is unlikely, remote complications improbable and early mobility and activity essential…

sudoku 2 harder solution 4 9 6 8 7 3 1 5 2 2 7 1 6 9 5 4 8 3 5 3 8 4 2 1 9 6 7 3 8 7 2 6 4 5 9 1 9 2 4 1 5 8 7 3 6 1 6 5 9 3 7 8 2 4 6 5 9 7 4 2 3 1 8 8 4 2 3 1 9 6 7 5 7 1 3 5 8 6 2 4 9


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sudoku 1 easier solution on page 36

9 8 4 3 1 4 2 4 9 2 3 5 4 8 6 3 5 7 2 9 9 4 8 6 5 4 7 3 9 6 3 7 2 5 3 9

sudoku 2 harder solution in next issue

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pa r t i n g s h o t

place to be

on ice

image: Camille Bianchi and Ryder Thalheimer

gs a n i r b Ice or ld w n e w l i fe . . . to

Every winter, when the Red and Assiniboine Rivers freeze at The Forks in Winnipeg, a new world appears. Atop this frozen surface, the visions of creative minds come to life in a series of fantastical warming huts set on the country’s longest public skating trail. One of the winners in this year’s competition is The Trunk, by Camille Bianchi and Ryder Thalheimer of Vancouver, BC, seen here as a rendering (the real thing will be constructed once the ice is thick enough, early in 2018). It’s an inhabitable “tree” made of layers of laminated wood that mimic growth rings. Inside this arboreal structure is an opening to the sky. “The Trunk is inspired by the quiet slowness of growth in the natural world,” say the designers. It stands tall against the flat landscape of the frozen river, a refuge from the elements and place of communion with this most Canadian of experiences. warminghuts.com For more on Winnipeg in winter: tourismwinnipeg.com —B. Sligl



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Published on Dec 12, 2017

Just For Canadian Doctors Winter 2018
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