Author: Guest Blogger
COVID-19: Advice from previous crisis management experience
By Brent D Wolfrom MD CCFP
The following was distributed to the physicians in the Queen’s Department of Family Medicine earlier this week and has since found its way to a broader audience. Please feel free to distribute it you think it will be helpful. The context is based on my experiences as a Medical Officer in the Canadian Armed Forces, in particular lessons learned during a couple of tours to Afghanistan:
As we head into this pandemic I thought I would share a few thoughts based on my past experiences with crisis planning and management in prolonged stressful environments involving complex systems and little control. These are completely subjective lessons that helped me cope in prolonged stressful experiences and they may not relate to you. That said, I would have really valued receiving a variant of this email 12-13 years ago.
- This event is unlike anything we have lived through before and we all expect it to be drawn out, especially if social distancing does what we hope it will. It is likely that at some point we will all transition from an acute to chronic crisis mentality. This can be a difficult transition because it can feel like defeat. It’s not. It’s us getting better at beating COVID-19.
- Plan now for wellness and stick to your plan rigidly, however, also set expectations at a realistic level.
- Find supports who will talk about non-COVID, or ideally non-medical, related topics and stay in touch daily, even if just by text or email.
- There will be long and dark days ahead and people will all cope differently. A small word of encouragement or appreciation from a colleague will make all the difference.
- Support each other. If you have the time or capacity to help someone just do it.
- Communication. Communicate with those who need the information and minimize with those who don’t. Be deliberate about your email distributions and who you include on the To vs CC lines. Information overload is going to happen and we need to be deliberate about protecting each other.
- Brushup/readup now on the skills you consider outside, but proximal to, your normal scope. We don’t know where we will be needed in the coming weeks.
- Remind yourself daily that you are trained to deal with this situation, even if that means lying to yourself a little bit.
- Grief doesn’t equal failure. Bad outcomes don’t equal failure. Say those two phrases daily.
- There will be many changes and constraints over the coming weeks-months. Sports, clubs, social events, etc that used to recharge you will not be available. Try to find a replacement for each joyful activity you lose.
As a discipline we have just come out of a few recent years of public assaults, difficulty and infighting. Now we are the face of our nation’s defense against this threat. How times change quickly!
Watching our department, and specifically the physician group, come together over this pending crisis has been so encouraging. I truly believe we have a fantastic group and we have a great team supporting us. We will be even stronger and better at the end of all of this.
Dr. Wolfrom is a family physician, former Course Director for our Year 1 Family Medicine course, and currently Postgraduate Program Director for family medicine at Queen’s University. He was previously a full time Medical Officer in the Canadian Armed Forces.
A version of this post was shared earlier on the CMAJ blog.
Exceptional Healer Awards nominations now open
New award this year for allied health professionals
Nominations are now open for the fourth iteration of the Exceptional Healer Awards at Kingston Health Sciences Centre (KHSC). The deadline to submit nominations is Tuesday, December 31, 2019.
The award provides patients, families, staff and health care learners an excellent chance to celebrate health care professionals at KHSC who excel in providing patient- and family-centred care. Launched in 2017 recognizing outstanding physicians, the award was extended in 2019 to include a separate award to recognize nurses at KHSC. For this fourth iteration, a third category has been added for other allied health care professionals.
The award now honours doctors, nurses, and allied health professionals from KHSC’s two hostpial sites who are innovative in their approaches to patient care and who demonstrate exceptional bedside manner, which includes being approachable, empathetic, collaborative and respectful.
Patients, families, staff and health care learners can nominate a health care professional as long as he or she has provided care at the KHSC in the last two years.
Here are the nomination details, as posted on the KHSC site:
If a health care professional at Kingston Health Sciences Centre (KHSC) has provided you with excellent patient- and family-centred care, now is your chance to nominate that person for an Exceptional Healer Award.
KHSC is encouraging patients to nominate doctors, nurses and allied health professionals (e.g., physiotherapists, occupational therapists, psychologists, social workers, dietitians) across our Hotel Dieu Hospital and Kingston General Hospital sites who are innovative in their approaches to patient care and who demonstrate an exceptional bedside manner, which includes being approachable, empathetic, collaborative and respectful.
Who can nominate?
Patients and family members can nominate a KHSC health care professional who has provided care to them in the last two years. KHSC staff can nominate colleagues on a patient care team.
Who is eligible?
Physician nominees will have a current appointment at KHSC and will have been credentialed at KHSC for at least the past two years. Other health care professional nominees must be KHSC staff members.
What are the criteria?
The nominee creates an excellent patient care experience over and above the norm by exhibiting some or all of the following behaviours:
• Demonstrates compassion as a skillful clinician by displaying personal qualities such as approachability, flexibility and empathy.
• Uses novel or innovative methods in attempting to deliver compassionate care.
• Demonstrates a pattern of listening to and respecting patient and family perspectives and choices.
• Exhibits a value of integrating patients and families into the clinical care model to ensure they are equal, informed participants in their health care.
• Honours the uniqueness of patients and families by incorporating their knowledge, values, beliefs and cultural backgrounds into the planning and delivery of care.
What is required for the
The nominator must complete a brief nomination form that includes yes-no questions and a short explanation of the candidate’s special qualifications for the award based on the criteria listed above.
Nomination forms are now available online. The deadline to submit nominations is Tuesday, December 31, 2019.
If you have questions about the award or nomination form, please contact the KHSC Leadership & Talent Development Department at 613-544-6666, ext. 8108.
Exceptional Healer Award Past Winners
Dr. Richard Henry – Anesthesiology & Chronic Pain Clinic
Dr. Tom Gonder – Ophthalmology & Retina Specialist
Dr. Shawna Johnston – Obstetrics & Gynaecology
Dr. Maria Velez, Obstetrics & Gynaecology
Nurse Tracey Froess – Cancer Centre
This post was created with information supplied by Susan Bedell, including a KHSC blog post by Anne Rutherford
Students enthusiastically endorsed Dr. James Makokis as inaugural M. Nancy Tatham & Donna Henderson Lecturer
Public Lecture on Decolonizing Medicine is October 23 at 5 p.m.
Creating an inclusive space for transgender and Two-spirit people in medicine will be the focus of the inaugural Dr. M. Nancy Tatham & Donna Henderson Lectureship October 23 at the Queen’s School of Medicine Britton Smith Lecture Theatre (Room 132 at 15 Arch Street), at 5 p.m.
Dr. James Makokis, a Two-spirit Cree Family physician (and recent winner of the Amazing Race Canada with his partner Anthony Johnson) is the first Dr. M. Nancy Tatham & Donna Henderson Lecturer. The lectureship is organized by the School of Medicine’s Undergraduate Diversity Panel.
The students of the medical school class of 2022 who participate in the Diversity Panel enthusiastically put forward Dr. Makokis to be the first speaker for this lectureship. The students felt that inviting Dr. Makokis to speak would promote important conversations about equity, diversity and inclusion in medicine. They see this as an opportunity to learn from the experience and work of Dr. Makokis as it relates to indigenous and LGBTQ+ communities, intersectionality, and making medicine a safe space for all patients.
The students who are organizing and supporting this talk are doing so in order to promote safe, equitable care for all patient populations. It is known that diversity is an important factor in medicine, as different patient populations have different experiences and viewpoints. The goal of providing excellent compassionate care for all in medicine, can be hindered by biases and lack of awareness, and events such as this increase awareness and bring to light our biases.
The diversity panel and the generous donors promoting this event see this as a chance for students, faculty, and members of the community to come together and learn, to take a step toward making the practice of medicine more inclusive. Dr. Mala Joneja, Director of Diversity and Equity for the School of Medicine invites everyone to attend and be a part of this step forward. She invites everyone, students and faculty in the Faculty of Health Sciences to come and simply listen and understand. Events such as these are important for members of marginalized groups but also for those who wish to be allies. An ally is someone who, though not a member of an underrepresented group, takes action to support that group. She emphasized that all physicians can be allies to underrepresented and marginalized communities and attending the upcoming lecture is a great first step towards allyship.
Dr. Makokis holds a Bachelor of Science in Nutrition and Food Sciences, a Master of Health Science in Community Nutrition and a Doctorate in Medicine. He also received certification from the Aboriginal Family Medicine Training Program. He is a leader and well-known expert within the Indigenous, LGBTQ2 and medical community.
Dr. Makokis has maintained his cultural beliefs and spiritual practices in all areas of his life. His strong connections to preventative health, spirituality, and Two-spirit perspective has helped him save lives within the LGBTQ2 and First Nation communities. He also leads one of North America’s most progressive and successful transgender focused medical practices.
The Dr. M. Nancy Tatham & Donna Henderson Lectureship was established in 2018 through a donation from Dr. Tatham and Ms. Henderson to support bringing speakers to campus on issues related to diversity and inclusion, specifically in areas related to LGBTQ+ topics, Indigenous issues, and other areas of diversity relevant to the practice of medicine. Although the primary intended audience is medical students, everyone is very welcome to attend.
Cervical Cancer Awareness Week: Fourth annual Pap Party event will take place October 21-24th
By Hayley Hill (Meds 2021), Zoe Hutchison (Meds 2021), Eva Bruketa (Meds 2022)
A unique partnership between Queen’s University Department of Obstetrics and Gynecology program and the South East Regional Cancer program out of the Cancer Centre of Southeastern Ontario (CCSEO) is helping to minimize barriers and ensure adequate access for all individuals with a cervix to receive cancer screening. Known as Pap Party, this collaboration offers free pap smear clinics across Southeastern Ontario for any individual with a cervix who may not have access to a primary care provider.
The most recent Cancer System Quality Index notes that only 63.6% of screen-eligible individuals in the South East region are up to date with their cervical cancer screening. As a result of the Pap Party campaign, in 2018 four clinic dates were held and 92 individuals received a pap smear. The highest number of individuals screened since the initiation of the Pap Party in 2015!
This year, the fourth annual Pap Party event will take place October 21-24th, during Cervical Cancer Awareness week. Any person with a cervix aged 21-70 who has not had a pap smear in the last three years is welcome. To increase accessibility to cervical cancer screening, individuals without primary care physicians, with or without a valid health card are encouraged to attend the Pap Party events.
The clinics are run by a team of medical students, and residents and physicians from the Obstetrics and Gynecology Department at HSCH in collaboration with the Federation of Medical Women of Canada (FMWC). The first Pap Party in 2015 took place in Kingston and has since grown to offer clinics in Bancroft, Napanee, and Tyendinaga as well.
The 2019 Pap Party schedule is below:
- Monday October 21 5:30pm – 7:30pm: HPEPH Bancroft
- Tuesday October 22 5:30pm – 7:30pm: Community Well Being Centre, Tyendinaga, Mohawk Territory
- Wednesday October 23 5:30pm – 7:30pm: Kingston Health Sciences Centre, (KGH site) Kingston
- Thursday October 24 5:30pm – 7:30pm: Kingston Community Health Center, Napanee
Anyone interested in attending a Pap Party is encouraged to book an appointment by contacting Rachel at 1.800.567.5722 extension 7809 or CancerCareSE@KingstonHSC.ca
To further expand Pap Party and combat declining cervical cancer screening rates, we have also reached out to primary care clinics in the Kingston area encouraging them to host their own pap smear clinics during Cervical Cancer Awareness Week. They will also be encouraged to offer the HPV Vaccine. Clinics that register with the FMWC receive a kit that includes a tip sheet, colour poster, news release template, and patient education brochures. To register your clinic and contribute to reducing cervical cancer rates, please visit https://fmwc.ca/events/pap-campaign/.
The FMWC website also has more information for individuals and will help them find a registered clinic nearby.
Thank you taking the time to learn about the Pap Party initiative. Please feel free to contact us if you would like any additional information and please spread information about the Pap Party event to any individuals you feel may benefit from this initiative in your life! We would be grateful and thrilled!
Celebrating teaching and learning
This week the School of Medicine joins the other schools in the Faculty of Health Science for a Teaching & Learning Celebration featuring guest speaker Dr. Nicole Harder.
Dr. Harder, Assistant Professor, College of Nursing, and the Mindermar Professor in Human Simulation, Rady Faculty of Health Sciences at the University of Manitoba, will present the Susman Family Lecture on October 3 at 4 p.m. at the Britton Smith Lecture Theatre (Room 132) at the School of Medicine.
Dr. Harder’s position is an interdisciplinary one which includes simulation-based education and research for the Colleges of Dentistry, Medicine, Rehabilitation Sciences, Nursing, and Pharmacy. Her current work is creating, implementing, and studying the use of a psychologically safe debriefing framework following expected and unexpected patient death in simulation and clinical experiences with health care students and practitioners.
For the Susman Family Lecture on Thursday, Dr. Harder’s topic is “Safety for all: Interprofessional simulation and non-technical competency development.
According to the Canadian Institute for Health Information, in Canada, medical errors contribute in upwards of 23,750 deaths per year, one million added days in hospital, and approximately $750 million in extra health spending. While various strategies and technologies have been implemented to reduce these errors, they have demonstrated inconsistent improvements or even reductions in patient safety. In contrast, simulation-based learning has demonstrated effectiveness in improving safety competencies. In this presentation, Dr. Nicole Harder will discuss the role of interprofessional simulation in patient safety, and argue that a significant shift is needed to ensure that students and healthcare practitioners are afforded the opportunities to engage meaningfully in interprofessional simulation activities that will allow them to grow and develop the skills required for today’s healthcare practitioners.
Following Dr. Harder’s presentation, teaching innovators from medicine, rehabilitation, and nursing will also share presentations:
School of Medicine – Using Wikipedia as a platform for teaching EBM, presented by Dr. Heather Murray
School of Rehabilitation – Innovation in Teaching a Research course to a Large Class with Diverse Backgrounds, presented by Dr. Setareh Ghahari and Dr. Mohammad Auais
School of Nursing -From competence to capability in the clinical setting, presented by Ms. Jennie McNichols
Friday morning, Dr. Harder will lead Health Sciences Education Rounds ( 8 – 9 a.m.) in Room 104, Richardson Laboratories. Her Friday presentation will explore “Using simulation as a pedagogy: Who’s who in the (sim) zoo?” Video-streaming is available at Providence Care Hospital: PCH D2.069 Videoconference Rm A. Anyone unable to attend Education Rounds at either Richard Labs or Providence Care Hospital may listen remotely by joining this ZOOM call at the appropriate time: https://zoom.us/j/165499888
Simulation as a teaching and learning pedagogy is not new. What is new is the availability of technology and the changing landscape of the education learning environment. While the term active learning activities are frequently discussed among educators as a means to bring learning to life, there is nothing more active that a simulation based experience. From students to faculty, to researchers and administrators, we all have different roles in developing and implementing simulation. This session will discuss the various roles that we all have in developing and implementing simulation as an active learning strategy, and provide the audience with some suggestions on how to make the most of their time with students.
Registration for each event is appreciated but not required.
Thursday: Susman Family Lecture and FHS innovators: https://healthsci.queensu.ca/faculty-staff/cpd/programs/tlc2019
Friday: Health Science Education Rounds: https://healthsci.queensu.ca/faculty-staff/cpd/programs/hsernicoleharder
Be a Mentor, Be Inspired by a Mentor
By Dr. Klodiana Kolomitro
Queen’s Faculty of Health Sciences’ educators already inspire each other on a daily basis. The Office of Professional Development and Educational Scholarship (OPDES) is excited to launch a formal Faculty Mentorship Network to help nurture this culture of guiding and supporting colleagues.
The Mentorship Network’s purpose is to serve as a reciprocal process for sharing experiences and fostering a trusting environment for career guidance and psychosocial support. Engaged participation in the program will advance the educational development of both Mentees and Mentors.
What is the time commitment? 7 to 10 hours per year
Mentors will participate in an in-person pedagogical café in November, where the Director of Education Development will provide an overview of the program as well as share resources on effective mentorship. Also in November, Mentees will participate in their first educational webinar with a focussed topic to help guide their Mentee-Mentor discussions. Following the initial sessions, mentors and mentees are encouraged to schedule meetings on a monthly basis. Each Mentee-Mentor relationship should be driven by the Mentee and will vary based on the specific needs and strengths of the individuals. The program will wrap-up with a celebration dinner in May. We hope you will consider this opportunity to offer scholarly generosity and nurture collegial engagement.
How can you participate? APPLY online before September30:
OPDES will do their best to match all interested applicants, but cannot guarantee that every Mentor and Mentee will be matched in this first cohort.
For more information on the Faculty Mentorship Network: visit https://healthsci.queensu.ca/mentor or contact:
Klodiana Kolomitro, PhD
Director, Education Development
Office of Professional Development & Educational Scholarship
613-533-6000 x. 77899 | firstname.lastname@example.org
8th Annual Medical Student Research Showcase
By Drs. Heather Murray & Melanie Walker
This year the School of Medicine is proud to invite you to the 8th annual Medical Student Research Showcase on Wednesday September 18.
This event celebrates the research achievements of our undergraduate medical students, with both posters and an oral plenary session featuring research performed by students while they have been enrolled in medical school. All students who received summer studentship research funding through the School of Medicine in 2019 will be presenting their work, as well as many other research initiatives. The posters will be displayed in the David Walker atrium of the School of Medicine building from 8 am until 5 pm, with the students standing at their posters answering questions between 10:30 and noon.
The oral plenary features the top research projects selected by a panel of faculty judges, and will run in room 132A from noon until 1:30 pm on September 18, immediately following the poster session Q&A.
This year’s faculty judges included:
- Dr. Sheela Abraham
- Dr. Nazanin Alavi
- Dr. Anne Ellis
- Dr. Jennifer Flemming
- Dr. Laura Gaudet
- Dr. Faiza Khurshid
- Dr. Diane Lougheed
- Dr. David Maslove
- Dr. Lois Mulligan
- Dr. Chris Nicol
- Dr. Stephen Pang
- Dr. Michael Rauh
- Dr. Damian Redfearn
- Dr. Claudio Soares
- Dr. Sonal Varma
- Dr. Maria Velez
We are very grateful to these faculty members for evaluating our oral plenary applicants this year.
The three students who have been selected for the oral plenary session, and the titles of their research presentations and faculty supervisor names are listed below. Each of these three students will receive The Albert Clark Award for Medical Student Research Excellence.
Alison Michels – von Willebrand factor regulates deep vein thrombosis in a mouse model of diet-induced obesity
Katrina Sajewycz – Multidisciplinary Ambulatory Management of Malignant Bowel Obstruction: A Qualitative Study of Gynecologic Cancer Patients’ Experiences and Perceptions
Mehras Motamed – Inhibiting Pyruvate Kinase Muscle Isoform 2 with Shikonin Regresses Supra-coronary Aortic Banding induced Group 2 Pulmonary Hypertension
Please set aside some time to attend the Medical Student Research Showcase on September 18th. The students will appreciate your interest and support, and you will be amazed at what they have been able to achieve.
History of Medicine Tour of NYC
By Adam Gabara and Kelly Salman
The bus started to move, leaving the School of Medicine and commencing our long excursion to New York City. With an upcoming Mechanisms of Disease test, stress levels were high, but the excitement of the trip overrode most of those worrisome feelings. After all, this was the annual History of Medicine trip to a city that some of us, including myself, will be seeing for the first time.
Driving over the Jersey bridge, seeing Manhattan in all of its concrete jungle glory, all I could think about was all the historical events that took place within this massive cityscape. It may have been my public health background coming out, but I imagined the immigrants arriving at Ellis Island to be screened and processed, infectious disease spreading rampant through the crowded streets and apartments, and rats carrying disease to food establishments. Nonetheless, this trip was going to provide a great learning opportunity not possible in the lecture halls back in Kingston.
Even though we arrived late at night, we all split up to explore the city. Some went to celebrate a classmate’s birthday, while others explored the famous Times Square, and enjoyed a late-night meal before heading back to the hotel. For some, it may be easy to forget the history engrained in a city as modern and metropolitan as NYC. Times Square has been a central hub for many decades and known for major landmarks such as the Broadway Theatre, and we tried to see as much as we could in the short time we had.
The next morning, after a nice breakfast at a small Lime stone café and a trek through Central park, the whole group rejoined at the docks to make our way around the Statue of Liberty and towards Ellis Island Immigrant Hospital. While on Ellis Island, we were able to explore the National Immigration Museum and learn of the courageous, and sometimes tragic, stories of immigrants from all over the world coming to America to start a better life.
Our guided tour of the abandoned immigration hospital was actually an enlightening reminder of how far medicine has come. It also demonstrated how differently physicians approached immigrant health back then, keeping them segregated from the populace of New York on the basis of more than just symptoms of severe illness. Many of these immigrants came from countries in Europe, such as England, Ireland, and Germany, among others. This immigration hospital has been utilized for expectant mothers to give birth, for mental health screening, and for the treatment and quarantining of infectious diseases. The mental health screening, we learned, was based on what would now be considered archaic classifications of mental illness (idiocy, imbecile, moron, and feeble-minded). Immigrants were screened with math questions, and assessed further for behaviour and more questioning.
Saturday night was a huge bonding experience between the first and second years, as many of us attended an improv comedy act. We were able to mingle at the nearby bar, with special attention from the owner/bar tender, and to unwind after such a busy day. After the comedy, we all regrouped at a fancy top floor cocktail lounge overlooking Times Square. From here, we were able to take in the city and reflect not only on the history we learned so far, but the relationships being formed this weekend, and how important it is to take wellness break. Something we often forget in our busy lives with constant assignments, tests, research, and extra-curriculars (I was worrying about landing all the movements and vocals to Living on a Prayer for the QMed A Capella group).
The next day, we were able to see both the Museum of the City of New York and the New York Academy of Medicine. The museum, coincidentally, was displaying their main exhibit titled Germ City, a huge public health historical piece. This exhibit covered the history of various outbreaks in the city of New York and taught some of the basic science behind infectious diseases and their spread. At the academy, we were taken through a picturesque journey through various illustrated medical teaching texts including topics such as dermatology and obstetrics. It was surreal, looking at guides that medical learners would have been using many centuries ago to visualize pathologies and procedures that we ourselves will be learning on our laptops and medical texts in the year(s) to come.
And just like that, our journey was ending. We made our way back to the hotel for the long trek back home. This experience gave me much to think about, from all the medical tragedies and triumphs that occurred here, to seeing the profound impact medicine has had over hundreds of years, and how various modalities for medical instruction have changed over time. I will always think fondly of my first experience in New York, and I am reminded how lucky we are as medical students to have these opportunities to enhance our medical journey. Even on the ride back, whilst studying for the MOD midterm amongst my studious or sleeping colleagues, I realized we need to enjoy journey of medical schooland little things along the way. Like the unique experience of sitting next to a classical piano in a McDonald’s- now that’s something that will stick with me forever.
Climate Change: What is our role?
By Sasha Létourneau with Gabe Lam and the Environmental Advocacy in Medicine group
“When the health effects of tobacco became known, the CMA quickly changed its investments. In times of climate change, health organizations around the world are divesting in fossil fuels.” – Courtney Howard, Emergency Medicine physician and President of the Canadian Association of Physicians for the Environment
We (Canadians) are addicted to fossil fuels. There. I said it. Isn’t admitting it supposed to be the first step? Much like a smoker with a 20 pack-year history, humans stand on the brink of irreversible damage to that which sustains us, having to make the choice as to whether to quit or continue down a destructive path.
When I first started medical school, I took a history from a man who had been diagnosed with lung cancer after a 50 pack-year history of smoking. I was quite astonished when he admitted he had been shocked by the diagnosis. How is that possible? I thought, thinking back on all the anti-smoking ads I’d grown up with in school, and the terrifying pictures of black lungs and rotted teeth I’d seen on cigarette packages strewn on the sidewalk. How did he somehow ignore all the signs around him? These are questions I hope my children never have to ask my generation about climate change.
Continuing down the fossil fuel-burning track we are on today is easy in that the ramifications of our actions are not yet apparent in most of our everyday lives. Despite the fact that CO2 levels have risen far beyond where they have ever been in the past 400,000 years,1 we are only just starting to experience the effects of climate change. And much like COPD or lung cancer, the threats of climate change most likely to impact Canadians seem just far enough away that they are still only a hazy blur. Yet, like a smoker who is only just starting to experience the first signs of shortness of breath, we too have reached a tipping point and we need to act as soon as possible.
Studies have shown that among the top most important reasons Canadians begin the extremely difficult process of smoking cessation is their concern for their personal health.2,3 If health care professionals so adamantly advocate for smoking cessation to prevent our patients from its long-term health consequences, should we not, for the same reason, also advocate for cessation of fossil fuel dependency? And how do we convince a society (and, quite frankly ourselves) that this issue needs to be addressed now?
We’ve seen a number of recent examples that climate change is starting to threaten human health, including climate-related natural disasters like cyclone Idai which claimed hundreds of lives in Mozambique in March 2019. Touching a bit closer to home, the extreme temperatures of the Quebec heat wave in the summer of 2018 took the lives of more than 90 Canadians. And even closer to Kingston, many of us have watched with horror the footage of the recent flooding in the Ottawa River that has displaced hundreds of Canadians from their homes. I, personally, might even decry the number of lectures Queen’s Medicine students endure on Lyme disease as a direct result of climate change facilitating the spread of this tick-borne infectious disease.4
But most of us fossil-fuel “addicts” are already convinced that we need to begin to transition away from our weighty reliance on fossil fuels. So now comes the hardest part – beginning the process of actually quitting. The Intergovernmental Panel on Climate Change (IPCC) released a report in 2018 telling us that, in order to ensure global temperatures remain below 1.5˚C above pre-industrial levels, we need to significantly curb our fossil fuel use by the year 2030 and achieve net-zero carbon emissions by 2050. Why is this 1.5˚C cap so important? While 1.5˚C is still higher than current temperatures, keeping global temperatures at or below this level is humans’ best chance of mitigating further catastrophic events, including land loss from rising ocean levels, extreme heat waves, drought, increased ocean acidity and both land and ocean biodiversity loss. These climate events will inevitably threaten human health, food security, water security, job security, economic growth and physical safety from war and climate disasters.5
Unfortunately, (as far as I know) there is no magical solution and no promise that this transition will be immediate or smooth. And, like a smoker trying to quit, it is probably not realistic for us to quit cold turkey – we still are years away from being in any way independent of fossil fuels. We also need to ensure we enact a just transition for our fellow Canadians currently working in the fossil fuels industry. But if we never start the transition, if we never grasp hold of the “greatest global health opportunity of the 21st century” – tackling climate change – we will never know if we could have succeeded.6
If you’ve reached this point in the article, you may be wondering: what can I, a lowly Queen’s student/faculty/alumnus, contribute to the struggle against climate change? What can one single Canadian do? Luckily, the answer is: a lot! In this article, I’ll present you with a few ways you can start to engage as a climate advocate.
One avenue that our medical student group, Environmental Advocacy in Medicine, has undertaken is working with the Queen’s Backing Action on Climate Change (QBACC) group to ask that Queen’s divest from fossil fuel companies. We are joining them to ask that Queen’s:
- Freeze fossil fuel investment immediately
- Fully divest the Queen’s Endowment and Investment funds by 2025
QBACC needs support from students, faculty and alumni. A mass divestment movement can stigmatize and delegitimize fossil fuel use and the profiting corporations in the court of public opinion, a strategy that has also been crucial in combating smoking culture and destabilizing tobacco companies. The list of organizations calling for divestment is long and growing with new players being added every day, including commitments from the Canadian Medical Association, McGill University, Oxford University, the RockFeller Brothers Fund, the British Medical Association, New York City’s pension fund, the country of Ireland and many more. This movement on Queen’s campus has been growing since the first formal request for divestment of Queen’s funds from fossil fuels was rejected by the Board of Trustees in 2014. A diverse basis of support that includes a broad community of current and future health professionals will be imperative when QBACC approaches the Board of Trustees at their annual meeting in 2020.
If this cause speaks to you, ways you can support it are:
1. Becoming informed about divestment by reading a bit more about their campaign here: https://drive.google.com/drive/folders/17PDgVGUXaLyefEp_IwzD4JZ2OANh0qsh?usp=sharing
2. Signing and/or personalizing a letter to the Board of Trustees stating your support of the divestment campaign at Queen’s University (here: https://drive.google.com/open?id=1wDYfBT5h005XyudA-ac32fSIEU_Y6QUc)
3. Signing QBACC’s support forms:
- For faculty: https://www.qbacc.org/divestment-petition
- For alumni: https://docs.google.com/forms/d/1onGYQBJAiDpPK0r7TbLqf1V0lj_sAWSCEYS_TkQdeMI/viewform?edit_requested=true
If that’s not enough for you or you are still not sure about divestment, here are some other ways you can choose a cause, join an advocacy group and work to have your voice heard:
1. Become informed about climate change by:
- signing up for the Canadian Association of Physicians for the Environment newsletter here, or
- reading CAPE’s Climate Change Toolkit for Health Professionals here.
2. Or, better yet, join CAPE’s team (if you are a physician) here.
3. Support the Queen’s Environmental Advocacy in Medicine effort to increase climate change education in the curriculum by including information on climate change in your teaching material (contact us for more information at: email@example.com)
4. Talk to your fellow students and colleagues about their thoughts on climate change!
We are that patient with the 20-pack-year history leaving the doctor’s office, having been told the risks of letting the status quo take its course. We stand at the edge of a frightening precipice in human history, where our actions (or inaction) today will determine the world our children and grandchildren get to live in. But like that patient, we are fortunate. We know the importance of taking action and we have a timeline during which to do so. It is now up to us whether we seize the “greatest global health opportunity of the 21st century.”6
1. NASA. (2019, May 3). Graphic: The Relentless Rise Of Carbon Dioxide. Climate Change: Vital Signs Of the Planet. Retrieved from: https://climate.nasa.gov/climate_resources/24/graphic-the-relentless-rise-of-carbon-dioxide/
2. Wellman, R. J., O’Loughlin, J., O’Loughlin, E. K., Dugas, E. N., Montreuil, A., & Dutczak, H. (2018). Reasons for quitting smoking in young adult cigarette smokers. Addictive Behaviors, 77, 28-33. doi:10.1016/j.addbeh.2017.09.010
3. Kasza, K. A., Hyland, A. J., Borland, R., McNeill, A., Fong, G. T., Carpenter, M. J., . . . Cummings, K. M. (2017). Cross-country comparison of smokers’ reasons for thinking about quitting over time: Findings from the international tobacco control four country survey (ITC-4C), 2002–2015. Tobacco Control, 26(6), 641-648. doi:10.1136/tobaccocontrol-2016-053299
4. Brownstein, J. S., Holford, T. R., & Fish, D. (2005). Effect of Climate Change on Lyme Disease Risk in North America. EcoHealth, 2(1), 38–46. doi:10.1007/s10393-004-0139-x
6. Watts, N., MA, Adger, W. N., Prof, Agnolucci, P., PhD, Blackstock, J., PhD, Byass, P., Prof, Cai, W., PhD, . . . Stockholm Resilience Centre. (2015). Health and climate change: Policy responses to protect public health.Lancet, the, 386(10006), 1861-1914. doi:10.1016/S0140-6736(15)60854-6
1. Link to “Investing in a Sustainable Future” document prepared by QBACC: https://drive.google.com/drive/folders/17PDgVGUXaLyefEp_IwzD4JZ2OANh0qsh?usp=sharing
2. Link to letter of support faculty/alumni can edit and send to QBACC: https://drive.google.com/open?id=1wDYfBT5h005XyudA-ac32fSIEU_Y6QUc
3. QBACC faculty support form: https://www.qbacc.org/divestment-petition
4. QBACC alumni support form: https://docs.google.com/forms/d/1onGYQBJAiDpPK0r7TbLqf1V0lj_sAWSCEYS_TkQdeMI/viewform?edit_requested=true
5. Sign-up for CAPE newsletter: https://cape.ca/media/blog/
6. Link to Climate Change Toolkit for Health Professionals: https://cape.ca/campaigns/climate-health-policy/climate-change-toolkit-for-health-professionals/
7. Sign-up for CAPE membership: https://cape.ca/become-a-member/
If you are a Queen’s UGME student who would like to submit a column for consideration as a guest blog, email me at firstname.lastname@example.org
I have no time…
By Adrian Baranchuk MD FACC FRCPC FCCS
Division of Cardiology, Kingston Health Science Center, Queen’s University
“A man who dares to waste one hour of time has not discovered the value of life.” ~ Charles Darwin, The Life & Letters of Charles Darwin
“I have no time.”
I have heard this sentence on several occasions.
I have heard this from my co-workers, staff, fellows, residents, nurses, and managers. I have heard this from friends – who used to spend long hours chatting, laughing and playing music – but now, they have no time.
I have heard this from close family members who have exclaimed, “I have no time.”
Finally, I have heard this sentence – the same four words – said by myself. It has become part of the dialectic armamentarium that I use upon invitations – “I have no time.”
Time has become a valuable commodity.
As academicians, our job descriptions specify the “time” allocated to different roles: (i) “time” for clinical work, (ii) “time” for teaching, (iii) “time” for research. We call the latter “protected time.” The notion that our time is “protected” is comforting. We are protected. Our “time” is protected.
The structure of our life is built around time; it accepts different metrics, depending the cultural background, the level of education, and the earnings and savings.
It is “time” for you to move to your own house.
It is “time” for you to further your career.
It is “time” for you to get married and start a family.
It is “time” for you to retire.
Although time can provide structure and discipline, it has become a regulator of our abilities to do something during our life.
Inadvertently, or not, we also use time to structure the life of others, such as family members, employees, or trainees. The ability to guide – or manipulate – someone by regulating the time they spend under one’s supervision is more powerful than any other form of intervention, such as encouragement, motivation, salary, or recognition. Nothing compares to the impact that “time” regulation has over our actions, either voluntary or mandatory.
In that sense, we self-allocate “time” to activities that we perceive as meaningful or enjoyable, such as going to the gym, conversing with partners, reading a book, et cetera. Violating this principle is a trigger for anxiety and frustration. The feeling of guilt that we experience when doing something that we perceive is in place of another timely activity – despite being part of human emotions – is a source of discontent.
There is not a generalized approach to using “time” wisely – it is individualized. We go through life, with more or less success, defying our own chronometer to do some of the things that we have dreamt, and we allocate the “time” that we speculate we have to reach those goals.
Few years ago, I found myself overwhelmed with work. My mentor called from the other side of the Atlantic and I responded without much enthusiasm. The wise man of only 83 years of age recognized my exhaustion and told me, “You sound too busy…you are doing too many things at the same time…you should slow down.” Rather than taking the advice with sincerity and consider reducing my workload, it agitated me. I replied, “What do you want me to do? I have no time.”
I said “I have no time” to my 83-year-old mentor who has, from a statistical point of view, much less time than me to accomplish his dreams.
There was a period of silence on the phone line. Some say that more than 23 s of silence between two individuals is the most tolerable duration before one of the two individuals breaks the moment with a comment; after about 10 to 12 s, I said “are you there?” He replied, “I was wondering whether you have time to think?” I have not forgotten this phrase since it was spoken many years ago.
When did I lose my capacity for contemplation? When did I sacrifice my ability to enjoy doing nothing? The “dolce far niente” (“sweet doing nothing”) that the Italians have immortalized. Albert Einstein said, “Time is an illusion.” Does the perceived lack of time represent the absence of illusions? How do we regain, in this world of immediacies, the ambition of living in a world of illusions? How relevant, for the creative process of enjoying your life (and be productive) is to have illusions?
While Mahatma Gandhi taught us that “there is more to life than simply increasing its speed;” Benjamin Franklin has counteroffered that “lost time is never found again.”
If we live in this world with a constant perception of not having “time,” how are we going to construct memories that at some point may be our only companion in life? Are we losing the ability to contemplate? Does this affect our ability to relate to our patients if we have no time to connect with them?
One of my other mentors – after consultation with a patient in the hospital ward – once asked me what book the patient was reading. “I have no clue” was my immediate answer, all the while skeptical about how this would relate to patient care. I did not understand at the time that our ability to contemplate and have holistic views will aid us as physicians to relate to the patient, which is a skill that is of immense value.
Where do ideas come from? How do we connect an idea with the creative process and the systematic work flow to move it into action? How does an idea move forward into realization?
Apparently, “time” is the key that regulates this process. Time is the precious commodity that we all want to attain – despite where we live and work, and how our family is structured – and we are all “offered” the same total amount every day.
So far, we have not been able to create “time.” We have not succeeded in having 25 h in a day. We have to resolve the enigma of how to distribute our efforts and energy throughout the same amount of minutes and seconds in a day. A strict 24 h per day.
I would like to teach my students to use their time wisely so as to enjoy their life and balance their ambitions. I want my students to be happy, and help them evolve not only as great scientists but also happy and content individuals. I want my students to have time to contemplate and think freely as such that time is not a factor that regulates their decisions.
I only wrote this piece today because I had convinced myself that I had no time before.
I propose to the readers to exercise the search of finding time for what they really want to do with their lives. Perhaps allowing a few minutes a day to do what they did not find “time” to do lately.
Because the “time” that we think we do not have, is out there. It is a matter of learning how to grasp it and to make it ours.
It is time to do it.
To Sohaib Haseeb for editing the first draft. To Gustavo Bonzon for his translation into Spanish.
Creative Commons Image from: https://www.deviantart.com/mariana-a/art/She-saw-the-time-passing-by-new-350524188