Tuesday 30 October 2018

The Old Quack Reminisces. Pt.3

     He stopped and thought for a while before proceeding.  After all, when you are an Octogenarian surely you are entitled to settle into obscurity?   He and a colleague once felt inspired to write a book that they thought was significant, but when he had sent it to an old friend from  the long past in the old country for a preliminary review the reply said, "unless you are prepared to strip yourself naked to the world , body and soul you can't write a real book.  Your manuscript is an account of all you are prepared to make public and that's okay, but it is not enough!"   He knew that was true..  Nowadays,his scribbles were mainly to entertain himself and to leave a trail, if anyone cared..  

     Mac Chase picked him up at precisely 9 am. as promised.   As he climbed into the car, Mac said,       " You know I forgot to take you out to pick up a few groceries when I dropped you off yesterday,  I hope you got by okay.."
    "Oh yes, no problem." he lied.
     It was about a fifteen minute drive to the Canadian Imperial Bank of Commerce on 11th Avenue in Regina.  It was directly across the street from the Medical Arts Clinic in Regina.  They parked the car and walked into the bank.
     " We have an appointment to see Jack," said Mac.
     They were shown into the  manager's office, which looked to Stan like a Hollywood "executive office".
     "Hi Jack" Mac said, "Stan just arrived from the old country yesterday.  He's on the clinic payroll as of the first of last month.  He has no money, so he'll need something to live on, a car, an apartment and some cash."
   "Stan, this is Jack Ink, the bank manager!"  
     Jack Ink, yes, that really was the manager's name.  In retrospect, maybe it was that name that turned Stan into a lifelong Fountain Pen and Ink aficionado!
     After shaking hands and settling Stan across from his desk Jack said, "Stan, how much do you think you will need?".
     Stan thought for a moment.  In London, England, when he needed to borrow twenty pounds (about $60 in those days), for a kerosene oil heater, the bank manager frowned at him and said, "You're just a newly graduated man, we'll have to have some security for a loan of this amount.  Do you have any life insurance?"
     "Yes, I  have one thousand pounds of life insurance. (3000$) "
     "Well, you'll have to turn it over to us until the debt is paid off."
      His baby daughter was turning blue-ish on those cold London nights and he thought he had detected a slight mitral systolic murmur when he  listened to her heart, so he was prepared to hand over his life insurance and anything else he owned.   He still thought that was the crucial moment when he decided he really didn't want to spend his life in England.  Perhaps that was good, because, shortly after he had settled in Canada, he had a letter from the practice he had worked in, in London England, asking him to come back and be  partner in the practice.  He had no doubts when  he  refused the offer.
      "Er, I really don't know," Stan said.
     Jack thought for a moment. "How about $5000?"
     Stan felt the room starting to swim a little.  Five thousand dollars!  How could he handle  loan  like that?   He almost fell off the chair.
    "Five thousand dollars," he stammered,"I don't think......"
     Jack Ink cut him off.  Don't worry, if you don't think  that's enough we can increase it to whatever you need to get started.."
     "Thanks, thanks very much," was all he could say.  It would have been too complicated to say more.
      They left the Canadian Imperial Bank of Commerce, an institution that Stan dealt with for the rest of his life.  Just shows what a Bank Manager can do!!
     "Now that you have a bank account, we have to get you a car, "said Mac, as they climbed into the car and took off for Regina Motor Products. He bought a used huge Chevrolet Biscayne, no power steering or brakes (He didn't know of such things) without even a radio.  Even now he recalled listening to reports of the Kennedy assassination on a tiny portable radio that slid around his dash!
    The next day he started work.


Wednesday 24 October 2018

The Old Quack Reminisces. Pt 2.

It's just about twenty years since the old quack moved to Ontario after thirty five years in Saskatchewan. He had come to Regina from the old country in January 1963, arriving at four in the morning at the CPR station with a wife, a little girl and forty dollars Canadian. They were supposed to be able to sleep in the Regina sleeper until eight in the morning when they were to be picked up by the manager of the Medical Arts Clinic where he was to work. It was so cold that they were unable to uncouple the Regina sleeper so they were evicted into the huge empty CP station that was totally deserted. It was four a.m. and still four hours until they were going to be picked up by the clinic manager.
"I'm hungry, daddy" the little girl said..
He looked around the huge Hall. Nothing. Absolutely nothing. Not even a bloody dispensing machine. He walked over to the door and looked across South Railway St. Everything looked white and frosty. He could almost hear the cold. Across the street, which in more temperate weather conditions served as "Hooker Row" he could see a neon light. A little restaurant, perhaps? He pulled open the heavy door and stepped outside to get a better look. The cold air hit him like a sledge hammer! He'd never felt anything like it before. Still, there it was! A dancing florescent light advertising a restaurant.
"There's a little restaurant right across the road, let's make a dash for it," he said. wrapping the little girl inside his coat and taking his wife's hand. He wished them across the road to what turned out to be the ubiquitous little Chinese convenience store restaurant that exists everywhere in Canada.
"Come in, warm up,. You just got off the train? Where you come from?"
I told him we had just arrived in Saskatchewan from England.
"Welcome to Canada," said the little old Chinese gentleman.
His wife came over and hugged our daughter. "Little girl must be hungry." And without further ado brought a bowl of cereal. "She can start with this then we'll see what she wants to eat.".
They danced around us, fed us well and didn't want to give us a bill. Of course I insisted. I've always loved Chinese people ever since.

About 8 am, Mac Chase, the clinic manager picked us up. He was horrified that we had been there for several hours.
"Why didn't you phone me?" He asked.
"I wouldn't phone anyone at 4am."
He bundled us into his car to drive us to the house the clinic had rented from someone who has gone South for the winter. The drive along Albert Street in Regina was spectacular. The leafless trees that bridged that regal Street were encrusted with jewel like bracelets that were magnificent. He drove us to a nice house on Angus Crescent, that still looked nice when I drove by when I visited my sister a couple of years ago.
"I'll pick you up in the morning," Mac Chase said when he dropped us off. "Have you any money?'
"Oh yes," I said, "about forty dollars".
"Well, we'll have to do something about that," he said, "Our first stop will be at the bank, then we'll have to get you a car and see about setting you up with an account so you can buy some furniture when you find an apartment."
As he walked out the door he said, "Pick you up about 9 am."
All of a sudden everything was quiet. The baby was asleep. Irene was unpacking her hand baggage. The rest of their baggage would arrive in a couple of days. Stan opened the fridge to check on the supplies for the next day or so. There we precious few.
"Hey, I have to go and get some basic provisions," he said. "We need some stuff to carry us over until we can do a proper grocery shop tomorrow. Right now the only things in the fridge are some bread, milk, butter and some Old Port cigarillos! There has to be some sort of convenience store I can walk to and pick up some essentials. I'll be back soon."
He put on his coat, scarf and gloves and walked out into the brilliant white sunlight. The sun glistened on the snow and the cold was so refreshing after the overheated house that he felt invigorated. But not for long,. He walked around Angus Crescent and onto College Avenue looking out for any sort of convenience store but saw nothing. He kept walking and was starting to feel a little cold now. He'd never experienced anything quite like this before and in addition, his ears were starting to hurt. He stepped up the pace. His ears were getting so painful that he was actually considering knocking at the door of one of the houses and asking if he could phone for a taxi,, but if he did that sort of thing his forty dollars wasn't going to last long. Then, saved! Right on the corner he saw a little convenience store. The Chinese woman behind the counter greeted him with, "You look so cold, better warm up!"
Saved by the Chinese twice in a twenty four hour period, he thought gratefully.
Soon after he staggered back into the house with his groceries he noticed some sensation returning to his ears. Two minutes later he was writhing in agony as his frozen ears thawed out. For years after his ears remained excessively sensitive to the cold. When the pain settled a little he took one of the Old Port cigarillos from the fridge and wished he had a rum and coke to sip on while he smoked it.
At precisely nine in the morning Mac Chase picked him up.
After the usual greetings Mac said, "Okay Stan, first thing we have to do is get you some money. We're going to the bank!".

Monday 15 October 2018

Physician dissatisfaction and CMA incompetence.

The results of the biennial 2018 Survey of America’s Physicians, intended to “take the pulse” of doctors in the U.S., were recently released and tallied from responses of 8,774 physicians (along with 2,472 written comments). And the findings leave much to be desired.

Here are some of their findings: 
  • 80% of physicians are working at full capacity or are overextended
  • 62% are pessimistic about the future of medicine
  • 55% describe their morale as somewhat/very negative, while 78% report sometimes/often or always experiencing burnout
  • 23% of their time is spent on non-clinical paperwork (meaning unrelated to patient care)
  • 49% would not recommend medicine as a career to their children

    Depressing as the above may be I have no doubt that physician morale in Canada is much worse and declining rapidly.

  News release from Concerned Ontario Doctors 

The Canadian Medical Association Abruptly Resigned 
from the World Medical Association

Why is Canada Alone?
October 10, 2018, (Toronto, ON) - On October 6, 2018, the Canadian Medical Association (CMA) abruptly left the World Medical Association (WMA) Meeting being held in Iceland and resigned from the WMA. 

In 1946, Canada was one of only ten counties to establish an Organizing Committee of international medical doctors, then founded the World Medical Association in 1947 with 29 countries. The World Medical Association developed the modernized Hippocratic Oath with the Declaration of Geneva in 1948 after the World War II atrocities and has since had the highest standard of International Code of Medical Ethics. Now in 2018, the WMA includes 114 countries and represents more than 10-Million physicians globally. Just days ago, the CMA abruptly resigned Canada from the WMA following absolutely no consultation with Canada’s physicians.

The CMA is claiming that their sudden resignation from the WMA is about an “ethical” stand on “plagiarism”. But there is far more to this than meets the eye and this will impact all Canadians. 
     The CMA had been founded in 1867 (about 100 days after confederation) as a non-profit organization of physicians for physicians. However, the CMA’s resignation comes after nearly two years of physician membership resignations nationally from the voluntary organization as the CMA has increasingly acted against the best interests of Canada’s patients and frontline doctors. More recently, the CMA encouraged the legal loss of physicians’ conscience rights, unilaterally removed physicians from the CMA's mission and vision statements, secretly sold physicians’ MD Management financial firm (founded in 1957 by physicians for physicians and their families) to Scotia Bank for $2.6-Billion with absolutely zero consultation with CMA Council or CMA Membership, and is soon to implement an unethical Code of “Ethics”.

On October 4, 2018, while at the WMA Meeting in Iceland, the CMA and the Dutch Medical Association (KNMG) had planned to put forth a motion for the WMA to be neutral on (i.e. not condemn) all physician assisted suicide and euthanasia of patients (i.e. unrestricted). The CMA and KNMG had withdrawn their motion due to lack of international support.

    The CMA claimed it was withdrawing and walked out  because of because of a speech plagiarism by the newly elected chair of the organization - the speech  had been written  by a professional speech writer, the chair-elect admitted and apologized.  I think the CMA walked out because it was criticized for the disastrous job it has done in protecting the ethics of physicians in exercising their conscience, in refusing to be  party to killing and perhaps refusing to become part of the 'drug  pushing' community.  (When the president of the CMA cautioned regarding the dangers of wide spread marijuana use, she was forced to walk back her very real concerns!)
     The $2.6 billion  sale of MD Management to Scotia Bank without consultation with the membership is appalling and surely requires further investigation.

Monday 1 October 2018

Knee. Gimme a knee!

   As I sat waiting for my bagel and cream cheese in Williams Coffee Pub,on Saturday morning, I found myself inadvertently drifting into my role as honorary medical consultant to the London (Ontario) Pen Club.  It's a role I quite enjoy, because like Marcus Welby, I have a manageable patient population to look after, (about a dozen) unlike the days when I actually had to make a living practicing medicine.  Although few of the members of our club are actually as mature as myself, most of them are old enough to have an impressive list of maladies that they appreciate discussing with an old-fashioned curmudgeon of an ex-physician.  Since this is once again my vocation, as once it was and not the way I make a living, I am free to express my convictions and views, without deference to the political correctness, that has distorted medical practice beyond recognition, as it does in so many other walks of life. Today's topic was  triggered by the story a friend told me regarding the distress his son was suffering as a result of knee  pain that is increasingly disabling him.  He is an otherwise healthy guy who has been told he will need knee surgery but not yet.  As working becomes a growing problem he wonders if he is going to be suffering for another couple of years before he goes back to the Orthopedic specialist to be put on the list to wait  an additional couple of years before his knee is replaced.   
   It is difficult to comment, because of insufficient information, but the above expectation is realistic if patient does or shortly will need surgery.   If it was me and my job depended on it, I would  seek a second consultation outside of the public system.   I'd probably go to the Cambie Clinic in Vancouver.
   The most recent damage to health care occurred in the Province of British Columbia, which is proposing to enforce prohibitions against private medical care, despite a long running constitutional challenge to the legal claim.  The provincial government is planning to close down all private clinics while the B.C. Supreme Court hearing is still proceeding.  This would close down approximately sixty clinics and close down the service to tens of thousands of patients per year.  The sort of private care that the government is prohibiting is already legally available to some, such as RCMP members, tourists, Workers Compensation cases and Federal prisoners.  The lawyer for the Clinics pointed out that adult patients are often waiting weeks and months beyond the maximal acceptable waiting time.
   "We say it is a punitive action taken by the government for no health care reason but to inflict harm on the private clinics during the course of this trial into the constitutionality on the prohibitions to access to private health care," he added.
  Simply put this is applying punitive measures to the administration of health care for purely political reasons.

   The Cambie Surgery Centre was opened in 1996 by a group of nationally and internationally renowned doctors and independent investors.  Dr.Brian Day, its founder is a British- trained Orthopedic Surgeon, who  wanted to build a facility where top  notch surgeons could perform surgery on their patients in an environment that offered the latest technology in a setting that emphasized exceptional patient care.  The clinic does indeed have an exceptional reputation and attracts patients from around the world.  The Worker's Compensation Board was one of the  first supporters of the Clinic, because patients were treated within weeks instead of the unreasonably lengthy waits of the public system.  This saved time, suffering and money by reducing recovery time and disability.  The CSC is one of the most technologically advanced surgical centres in Canada and has more operating theatre capacity than most hospitals in Canada.
   Unfortunately, much of the  Canadian public fails to realize just how rapidly our heath care system is failing.   Thriving private clinics emphasize the gross mismanagement of health care by the government and its armies of well paid, well pensioned administridiots.  
    No wonder they want to shut it down!