Tuesday, 18 October 2022

December 13: an Evening With Dr. Lilit Garibyan

 The Doctors’ Lounge Series, home of medical imagineering in Toronto, invites you to our final event of 2022 in collaboration with one of Harvard’s team of medical imagineers.

The Magic Wand Initiative has a decade’s worth of experience encouraging transformation of clinical observation into clinical innovation.

Dr. Lilit Garibyan is the co-Founder and Director of the Magic Wand Institute.

Please join us to explore how your clinical insights might contribute to the collective wisdom within the greater medical mind.

This December, set your imagination free.

Remembrance Day program: November 10

 Remembrance Day is a time to reflect on our military, past and present.

On the eve of that day, you are invited to spend some time reflecting on the mind of the modern soldier, as seen through the lens of a fellow physician and military officer.

What happens when medical culture meets Canadian military culture?

You are invited to find out.

Our guide for the evening will be Dr. Atif Butt.

Dr. Butt joined the Canadian Armed Forces in 2003 as a Health Care Administrator.

He then completed his medical school and Family Medicine Residency at McMaster University, through the Military Medical Training Program.

Upon graduation in 2013, he served as a Medical Officer and is currently the senior military physician, holding the rank and position of Clinical Major, at 31 Canadian Forces Health Services Centre, Borden.

He has earned several commendations including the Surgeon General Clinical Coin Awarded for Excellence and the Special Service Medal for deploying with the Disaster Assistance Response Team (DART) to Pakistan for humanitarian earthquake relief.  

He has an MBA in Health Services Management and is a Certified Health Executive.  Dr. Butt has worked on several important projects at his military clinic including implementing virtual care and improving women’s health.

Since 2013 he has been regularly working as a staff ER Physician at Stevenson Memorial Hospital in Alliston, as well as being an urgent care physician at Huronia Urgent Care Clinic in Barrie.

Please join us for the annual Doctors’ Lounge Remembrance Day event.

Sunday, 16 October 2022

A Piece of Fiction

As the discussion on MAID for mental health patients starts to pick up, a piece I wrote for and presented at the Doctors' Lounge annual storytelling event years ago- HP.

Our annual storytelling evening will hopefully be back March 2023: start your creative engines now

The voice arising from the computer console was robotic, but melodic.

“The doctor will see you now. Please proceed to room B-52. Thank you for choosing the Center for Robotic Assisted Psychiatry to meet your mental health needs.”

Joe Primum pushed his chair back from the computer, exhausted by the lengthy on-screen intake interview. Joe was already exhausted just by being alive. For Joe, everything was a major chore.

He did not need a computer to tell him he was depressed.

What he needed was a doctor to pull him out of his dilemma.

But, progress being progress, this was the procedure that the government had set up to help people such as him.

Joe seated himself in the room, and awaited salvation.

Soon, the door opened, and in walked a pleasant enough human.

“Hello, I am Dr. Golem. How can I help you? “

Joe sighed.

“Doc, I don’t have any family, but if I did, I would just be a burden to them. Instead I’m just a burden to the planet, wasting space and oxygen. Can you fix that? What did my computer analysis say?”

Dr Golem checked the computer screen.

“The report was quite clear. You are suffering from major depressive disorder. Unfortunately, the computer analysis also says that you have failed every on-label medication known to man for this condition, as well as failing ECT and TMS in the past.  The government doesn’t allow us to go off-label anymore, since the introduction of National Pharmacare. So, all that is left are a few options.  Have you considered psychotherapy?”

“My family doc talks to me. She’s young, she’s nice enough, but I don’t think she really understands what’s going on in my head,” replied Joe with a bitter edge. “What are you offering?

Dr. Golem began his pitch.

“We have a CBT program, but there is an 11.3 month waiting list for that. Unfortunately, the computer says that due to the deep shame from your history of sexual abuse as a child, you have a low chance of success with that.”

Joe countered.

“Can you offer me anything else that is appropriate for trauma survivors such as me?”

Dr Golem responded.

“Unfortunately, we only offer such services to women, and the wait list for that is 17.3 months. Would you consider transitioning?”

Joe sat in silence, and let his puzzled face look do the talking.

Dr. Golem continued.

“The computer says that if you enter the gender reassignment program, we can get you trauma counselling within 6.2 months. Offering cutting edge treatments such as this allows us to get funding as a centre of excellence.”

Joe started to get angry.

“That’s ridiculous. I’m not getting a sex change to get over what some pervert did to me decades ago. Is that all you’ve got?”

“Well,” said Golem, after checking the computer screen,” it says in your report that you stopped abusing drugs and alcohol 6 months ago. Would you consider restarting that?”

Joe rolled his eyes.

Dr. Golem didn’t miss a beat.

“We would only have a 5.7 month wait time to enter the psychotherapeutic arm of our concurrent disorders program, but you have to be actively abusing substances for at least 3 months to get in.”

“No f***ing way doc,” replied Joe. “Any other brilliant ideas?”

“Well, as a centre of excellence, we can offer you another leading edge service. It says in your report that you have had suicidal thoughts. Have you given those thoughts careful consideration?

“Yeah, that’s why I’m here. They kind of freak me out,” Joe said with a sense of shame and confusion.

“No,” Golem replied, I meant have you given careful consideration to the possibility of having us help you complete the act? The College of Physicians has made it mandatory to make sure that you are offered all therapeutic options, and this option is 100% effective in eliminating your problems. The outcome is remarkable when compared to medications, which only offer dismal remission rates.  Plus, you would be helping us out with our upcoming hospital accreditation review. By exercising that option you will help us show our assessors how effective we can be in our treatment outcomes. Don’t you want to be helpful? Isn’t that the opposite of being a burden?”

Joe had heard enough.

“Are you nuts? I’ve got enough problems. I’m leaving! I don’t need this stupid crap!”

Dr. Golem pressed the green button on his desk. Security guards immediately entered the room.

Dr. Golem put on the most reassuring face he could muster.

“Your response of being overwhelmed by the prospect of a 100% cure rate is understandable.  Fortunately, or unfortunately, depending how one sees it, I am obliged to certify you for admission to our Special Treatment Unit for Physician Induced Death. Under a form 1-1, you will be held there for 3 days to give you time to more thoroughly consider to the options that I have outlined for you.”

Joe gave it one last shot.

“Check your damn computer again. Does it have anything else to say?”

Golem replied: “Indeed it does. It says: thank you for seeking help at the Centre for Robotic Assisted Psychiatry, where excellence comes alive. At CRAP, excellence is what we do. Hope you have an excellent stay.”

Monday, 5 September 2022

MONDAY October 24 (Please Note the change of date): An Evening with Dr. Zahra Kassam

 Thanksgiving is a wonderful time of the year to reflect on what and how we eat.

What are the best food choices for a healthy life?

What should we be recommending to our patients, especially those struggling with illnesses such as cancer?

Please join us for an interactive discussion on plant-based medicine (PBM) with oncologist Dr. Zahra Kassam and Michelle Fedele RD, co- founders and co-directors of Plant-Based Canada.

We will spend the first hour looking at the evidence for reducing the burden of cancer with plant-based nutrition and, in the  second hour, we will open it up to Q&A on anything related to PBM.

Dr. Kassam is the co-editor of the recently published (September 2022) academic text Plant Based Nutrition In Clinical Practice (you can read the first chapter here), as well as co-author of Eating Plant-Based, written with her sister Dr Shireen Kassam for a general audience.

Please join us for what may turn out to be a transformative evening  for you and your patients.

PS: Recent addition to resources: a Facebook group: Plant-based doctors of Canada https://www.facebook.com/groups/533280448801276
















Wednesday, 6 July 2022

September 29: An Evening with Dr. Chase McMurren

 Over the past year in the Doctors’ Lounge, we have been examining medical culture and its subcultures.

To begin our fall series, we will take a look at cultures within the context of the clinical encounter.

With over 250 ethnicities represented in the city of  Toronto/ Tkarón:to / GichiKiiwenging , it can be difficult to appreciate the nuance & complexity of compassionately and respectfully caring for members of any of these cultural groups.

All of  these groups have their own cultures and subcultures, and as a member of the medical culture and the other cultures that may define you, you may experience the feelings of being an Outsider, especially when when the values of your patients’ cultures may clash with yours as you struggle to maintain a sense of professionalism.

What can a caring and competent clinician do to adapt?

You are invited to spend the evening before National Truth and Reconciliation Day reflecting on the concept of cultural humility, a particular way of listening to Others that may potentially enhance your clinical encounter. Our guide for the evening will be Dr. Chase McMurren.

Dr. Chase McMurren (Spirit name: Water Song Medicine Keeper) is Michif/Metis (Turtle Clan) from Lethbridge, Alberta which is located on traditional Siksikaitsitapi, Blackfoot Confederacy Territory and covered by Treaty 7. He currently lives and works in Tkarón:to | GichiKiiwenging and serves as the Indigenous Health Theme Lead in the MD Program and the Indigenous Practitioner Liaison within the Office of Indigenous Health in the Temerty Faculty of Medicine at the University of Toronto. Dr. McMurren is also the co-chair of the National Consortium for Indigenous Medical Education (NCIME) Working Group on Physician Wellness and Joy in W

Sunday, 20 February 2022

June 15: An Evening with Dr. Andrew Howlett

With the annual Father’s Day, June can be a time to reflect on fatherhood. And as we understand more about the transition into parenthood, we have learned more about this vulnerable period for the individual and the family.

 

In addition, COVID has also taken a toll on all aspects of the family, and, given our society’s often ambiguous respect for the role of fathers, any weak link in the chain that maintains a family’s mental health should concern us all.

 

Please join us in the Doctors’ Lounge as we explore “The Marvel of the Human Dad.

Our guide for the evening will be child psychiatrist Dr. Andrew Howlett of Toronto’s Fathers’ Mental Health Program.

 

The mysteries of fatherhood have a lasting influence on our lives. Whether you are a father, know/knew your father well, or never met the man, you are invited to spend an evening with colleagues and a local expert examining fatherhood from a new perspective.

MAY 26: An Evening with Dr. Jason Fung

 ShapeThe spectrum of medical treatment is vast. 

At one end are practices that we should adopt, but rigidly resist. This is known as the Semmelweis Reflex. 

At the other end of the spectrum are practices from which we should rigidly desist, but don’t. This has been called the Cifu Reflex (1,2). 

The latter is more likely to occur when we don’t have an understanding of the basis for the condition that is being treated. Cancer is such a mystery, and medical reversals both in terms of theory and treatments characterize the history of medical practice in oncology.

Sometimes an outsider can address mysteries by attempting to solve the puzzles of the unknown through fresh eyes. You are invited to look at cancer with fresh eyes.

Dr. Jason Fung, author of The Cancer Code, will guide us through insights gained about the very nature of our cells in the writing of his latest book.

Please join your colleagues in the collegial environment of the Doctors’ Lounge as we participate in one of our favourite activities: paradigm shifting. 

April 25: An Evening with Dr. Susan Fox

Rigid thinking about muscular rigidity and the other motor manifestations of Parkinson’s Disease (PD) can distort our appreciation of the significant non-motor manifestations of the condition, such as autonomic and cognitive dysfunction, sleep disturbances and pain.

Rigid thinking about the failure to prevent progressive neurodegeneration with present treatments can lead to despair for both patients and their physicians.

Rigid thinking is not welcome in the Doctors’ Lounge.

You are invited to spend an evening during Parkinson’s Awareness Month thinking differently about the future.

Think: Precision medicine. Focused ultrasound. Innovative surgeries. Manipulation of the microbiome and mitochondria. Neuroprotectants. Even vaccinations!

Think: hope.

Please join us as our distinguished guide for the evening broadens our horizons on future therapies for PD.

Dr. Susan Fox MB, ChB, MRCP(UK), PhD is Head of the Division of Neurology, University Health Network and Sinai Health Systems; holds the Krembil Family Chair of Neurology; Professor of Neurology, University of Toronto and Associate Director of the Movement Disorder Clinic, Toronto Western Hospital. Dr. Fox is Chair of the Pan-American section of the International Parkinson and Movement Disorder Society (MDS) (2021-23). She has served on committees, grant review and advisory boards for MDS, NIH, CIHR, Michael J Fox Foundation for Parkinson research and DMRF among others. Dr. Fox has over 20 years’ experience in preclinical models of Parkinson’s disease and translational studies of novel pharmacological therapies for Parkinson’s disease and other movement disorders such as dystonia. She has published over 170 peer-reviewed papers, reviews and book chapters in the field and is a regular speaker at national and international conferences.