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DOCTORS
inside: Continuing MediCal eduCation CalendarPubliCations Mail agreeMent #41073506
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where wil l you meet? london / tel aviv / baltic / macau / berlin >>
+ panamera road-test
+ tango in Buenos aires
+ LonDon calling
+ eureka in arkansas
sun + spice ingrenaDahot + coLD inkootenay*win
a Kodak PlaySport Waterproof Pocket HD Camcorder! DetaiLs on page 35
+ a tilley gift pack!
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november/december 2010 JuST FOR CanaDian DOCTORS 3
16
Features
16 peak powder Heli-skiing in the mountains of interior BC
32 spice island Sampling the many flavours of Grenada
ColuMns
8 doctor on a soapbox The Justice System
10 motoring Testing the Panamera
18 techworks The Lungpacer
30 the wine doctor Viva Italia!
35 the food doctor Linger over brunch
36 the wealthy doctor Retirement wealth
noveMber/deCeMber 2010 Contents
dePartMents
5 November/December mix
12 prescribing R & R
19 CME calendar
26 employment opportunities
26 classifieds
37 sudoku
38 small talk with Dr. David May
cover photo:A hot spot for winter getaways? The Caribbean, of course. Here, snow transforms to sand on a tropical beach in the sunny Caribbean.
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DOCTORSJ u S T F O R C a n a D i a n
life + leisure
november/december 2010
editor and Art director barb Sligl
editorial Assistant Adam Flint
contributors dave Hobson dr. Holly Fong Janet may dr. chris Pengilly dr. neil Pollock manfred Purtzki Lisa richardson dr. Alex russell dr. Kelly Silverthorn corey van’t Haaff dr. monica Yuzak cover photo b. Sligl
Senior Account executive monique mori
Account executive Lily Yu
Sales, classifieds and Advertising In Print circulation office 710 – 938 Howe St. vancouver, bc v6Z 1n9 canada Phone: 604-681-1811 Fax: 604-681-0456 email: info@AdvertisingInPrint.com
Associate Publisher Linh T. Huynh
Production manager ninh Hoang
circulation Fulfillment Alison mulvey
cme development Adam Flint
Founding Publisher denise Heaton
Just For Canadian Doctors is published 6 times a year by In Print Publications and distributed to canadian physicians. Publication of advertisements and any opinions expressed do not constitute endorsement or assumption of liability for any claims made. The contents of this magazine are protected by copyright. none of the contents of the magazine may be reproduced without the written permission of In Print Publications.
In Print Publications710 – 938 Howe St. vancouver, bc v6Z 1n9 canada
www.justforcanadiandoctors.com
Printed in canada.
miss an issue? check out our website!
winter escape Late fall and early winter is here again.
In the last months of the year, things slow down. we slow down. But we
also get revved up for the holidays—visiting family or just getting away. So, where to?
Many of us will choose warmer climes if possible. Like Grenada. Just off the coast of Venezuela, it’s one of the most southern of the Caribbean isles. And it’s divine…literally, according to Columbus, who named it Concepción. from nutmeg-infused fare to waterfalls gushing into idyllic pools, it’s hard not to become captivated too (page 32).
Then there’s a food fest in the Cayman Islands (hard to beat a combo of cuisine + Caribbean) and a Spanish school in Costa Rica (page 7). Need another option? Not as warm…but warmer (and rainier) than the typical snowy Canadian winters. London’s foggy, drizzly skies still provide plenty of colour and cure for the winter blues. The cosmopolitan city’s vibrant culture, fashion, art and food scene is calling! (See page 19.)
of course, type-A personalities won’t be content to museum hop or loll on a beach or sit poolside (despite the obvious appeal). with a touch of the hardcore and a little chill factor, heli-skiing is the go-to escape once winter hits. It’s all about vertical drop and powder depth for ski and snowboard aficionados. Lucky for them, there are plenty of options on Canada’s west coast. The powder beckons…(page 16).
wherever you go, happy holidays!
See pages 12 and 14 for the fifth and sixth finalists in our R & R writing contest. Dr. Monica Yuzak shares her adventure in Buenos Aires, and Dr. Alex Russell takes you along on his backpacking trip into the wilds of BC. The winner of an All-expenSeS-pAid TRip with Quark expeditions will be drawn from the six finalists and announced at justforcanadiandoctors.com on december 15. Thank you to all those who sent in a submission. We’ll continue to publish runner-up stories in 2011. And please continue to share your own adventures with Just For Canadian Doctors’ readers, whether at home or afar. Send us your stories!
Barb Sligl, BA, MPubfeedback@InPrintPublications.com
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november/december 2010 JuST FOR CanaDian DOCTORS 5
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s t y l e | f o o d | s h o w s | f e s t i v a l s | p l a c e s | g e t a w a y s | g e a r …w h a t / w h e n / w h e r e > n o v e m b e r / d e c e m b e r m i x
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get-away
this isarkansas
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There are a few things you probably know about Arkansas—it’s the home of President Clinton and the base of Wal-Mart. But there’s plenty more to this state—from the Ozark Mountains to the crisp Arkansas Black apple (delicious). First, see the splendour of the Ozarks from Whitaker Point, Arkansas’ most-photographed spot (with good reason) 1 . Locals call it Hawksbill Crag, named so by Dr. Compton, a GP known
as the “Saviour of the Buffalo River.” He saved the river, far below this scene, from damming by campaigning to designate it a National River in the US. Not far from here is an idyllic getaway at the Buffalo Outdoor Center, where you can hole up in a luxurious log cabin (Mary Steenbur-gen’s a regular visitor) overlooking the Ozarks (buffaloriver.com). In Bentonville, visit Compton Gardens, Dr. Compton’s former home turned into a conference centre and public park (comptongardens.org). Here you can listen to mockingbirds and discover indigenous flora like the bulbous bright-green fruit of the Osage Orange tree 2 . For a taste of historic Arkansas, go to Eureka Springs in the Ozarks, where there are 2,000 jacuzzis for 2,500 people 3 . The quaint town is the site of more than 60 natural springs and has long been a place of pilgrimage for healing. The Osage Indians believed in the waters’ restorative qualities, and after a doctor brought his sick son here in the late 1800s, the town flourished (eurekasprings.org). The famed Crescent Hotel, an imposing castle of a building overlooking the town, was built as a resort in 1886 and later became a quasi cancer-treatment centre and hospital in the ’30s, run by the so-called Dr. Norman Baker—later exposed as a fraud. It’s said the now-refurbished hotel is haunted (part of its appeal), with Dr. Baker’s ill-fated patients roaming the halls…Take a ghost tour to see the former morgue, or gaze over the surrounding countryside at the seven-story Christ of the Ozarks atop a hill (the second-largest statue of Christ after Rio’s) 4 while sampling a “Rib Removal” (a beef-rib dish, of course) in Dr. Baker’s Bistro and Sky Bar (crescent-hotel.com). This is weird and wonderful Arkansas. For more info, visit arkansas.com.
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The Arch is a chic boutique hotel in London’s West End. A short walk from the Marble Arch tube stop and the northeast corner of Hyde Park, the 82-room luxury bolthole was created out of seven Georgian townhouses and two mews homes (with original sash windows) on a tranquil residential street, making you feel like part of the posh set in Marylebone. Selfridges, Oxford and Bond Streets, and the medical scene of Harley Street are all in your neighbourhood. Inside you’re amidst on-trend colours, hip patterns and sumptuous finishes—classic Brit style that’s very now. Luxe bathrooms boast black granite, rain showers, flat-screen TVs (a rugby match and bubble bath go together quite well), and Malin + Goetz amenities. Beyond your suite is HUNter 486, The Arch London’s bar and restaurant (the name refers to Marylebone’s 1950s district dialing code), where you can sample an Earlgrey MarTeani and perhaps some pan-roasted guinea fowl. A member of the Small Luxury Hotels of the World network, this hideaway off Hyde Park makes a stylish base in London. thearchlondon.com —B. Sligl For more on London and upcoming CME events there, see page 19.
stay/hotel
m i x n o v e m b e r / d e c e m b e rgi
ft it!
london ca
lling
sweet scent
sweet scent soy candles burn better and longer. And they’re more eco too. But all that is secondary to the evocative scents. Our pick: the divine smelling Portuguese
Olive Blossom, like a blooming orchard at home. kobocandles.com under cOver
Award season has unleashed some provocative must-reads. shortlisted for the Man Booker Prize, there’s Peter
carey’s Parrot and Olivier, set in 19th-century America and inspired by the life of Alexis de tocqueville. The Tiger, by vancouverite John vaillant, tells the true story of a man-eating tiger on the prowl near a remote village in russia’s Far east. And, out in paper-back this January is The Imperfectionists, a debut novel with a lot of buzz (Brad Pitt optioned the film rights) that follows the lives behind an international english-language
newspaper in rome. ran-domhouse.ca dish it cool thermo cups with hot tattoos. Pick a pair: Faith & hope or Love & Luck. menu.as gAd-get geAr set your iPhone apart with an eco case made out of wood. sleek and sustainable. accessorygeeks.com. —B.S.
under coverthe goods
gift
dish it
Goodies for the holiday season—to give and get. Tis the season!
gadget gear
dish it
november/december 2010 JuST FOR CanaDian DOCTORS 7
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plunge in! Immersed in in Costa Rica
Doctor
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the quite culinary
caymanislands
n o v e m b e r / d e c e m b e r
For those well travelled, the Cayman Islands is a destination long known for culinary excellence. These three idyllic islands, tucked
in the western Caribbean, have a loyal following of repeat visitors who enjoy an array of top-drawer dining options. The tiny trio of islands has over 150 dining choices, offering both locals and travellers great diversity, quality and selection.
Grand Cayman is the home to Seven Mile Beach, a seemingly endless strip of white powdery sand and impossibly blue water. As each sun-drenched day comes to a close, the scene transitions from the beach to the culinary offerings along West Bay Road, and more recently, to George Town’s Camana Bay. Restaurants and patio lounges fill with patrons seeking custom cocktails and dining options that rival South Beach, Vancouver or Toronto. What other sun destination can offer eight Wine Spectator-rated restaurants within a few miles of each other?
Those close to the food scene in Grand Cayman speak of a culinary renaissance—an urban chic movement—that is drawing international attention. Newly built Camana Bay, a town development adjacent to the capital city of George Town, has stunning modern design, upscale shops and a vibrant urban sensibility. There’s a definite vibe happening here on the patios and long bars of Abacus and Michaels Genuine Food and Drink at cocktail hour. And a quick trip over to Morgan’s Harbour takes you to casually swank Osetra Bay,
a chic waterside dining experience with flowing white linen gazebos and a hip indoor lounge. It’s uptown in a beautifully relaxed Caymanian way.
Foodies will flock here this January, when the Cayman Islands host the world’s most talented chefs at the the third annual Cayman Cookout. Venerated Chef Susur Lee, touted by Food & Wine magazine as “one of the best chefs of the millennium,” will be featured alongside Chef Eric Ripert (creator of the acclaimed restaurants, Blue and NYC’s Le Bernardin). Representing Canada, Lee was personally invited by Ripert to join what has become an unparalleled experience for gourmands and oenophiles in Grand Cayman.
Cayman Cookout, sponsored by the Cayman Islands Department of Tourism, The Ritz-Carlton, Grand Cayman and Food & Wine magazine, is a four-day feast of epicurean experiences including demonstrations, tastings and excursions, as well as personal encounters with participating world-class chefs and sommeliers. This year’s super-star line-up, hosted by Ripert, includes Lee along with culinary masters Anthony Bourdain, José Andrés, Rachel Allen, Michael Schwartz, Charlie Trotter, Food & Wine magazine’s Gail Simmons, and wine and spirits experts Ray Isle, Anthony Giglio, Denis Cakebread and Bo Barrett.
For such an idyllic Caribbean setting, the Cayman Islands clearly enjoy a secure footing in the international culinary world—and polished Canadian travellers are quickly catching on. Join the feast!
The Grand Cayman Cookout takes place January 13 – 16, 2011. Go to caymanislands.ky/cayman_cookout for more information.
foodfest
Chef Susur Lee
Osetra Bay
Abacus
sunn
y da
ysIt‘s distracting when monkeys hang from the trees over your homework. At the Intercultura campus in Samara, Costa Rica, there are many things to take your mind off studies: a surfing beach just outside the gateway, water so warm you barely feel it, yoga and salsa dancing after school. It’s a wonder that any homework gets done: but you can’t avoid learning Spanish here.
The classes are not a push over. Spanish only is spoken, and class size is six or less. This is not
the place for those wanting to hide in the back and listen. Cheating is difficult since most of the other students are from Europe and speak little English. Instructors patiently draw out the most reluc-tant speaker. They are imagina-tive communicators, so students always know, more or less, what is going on.
Ticos are friendly and patient people, and the village locals are accustomed to being interviewed by students on assignment. Students can live with a family, and
augment their learning with sto-ries told around the dinner table. (Everything is more dramatic in Spanish!) But be warned, this may not be the most comfortable choice. Some families are friend-lier than others, and all live simply, no air-conditioning, bugs in the bathroom, and bland cooking.
Intercultura’s students are part of the community and con-tribute to the local economy in sev-eral ways. Many of the instructors are from nearby, and the school itself is integrated with the village.
The school’s donations range from roof repairs to com-puters for the elementary school, and they also provide art and music programs for local kids on campus.
No question, these week-long, immersion classes are a memo-rable way to learn more Spanish. Just watch that the monkeys don’t eat your homework. —Janet May
For more information, check out interculturacostarica.com and samaralanguageschool.com
class-room
8 JuST FOR CanaDian DOCTORS november/december 2010
Iam not Saint Christopher, but I do try to pay my taxes on time, bill the medical plan honestly, and generally fit unobtrusively into society.
Recently, however, I came as close to having to go to prison as I ever want to.
I was required to appear as a witness in a civil litigation that had been going on for 10 years. I was given just 10 days notice. failure to appear, I was warned, would be viewed as “contempt of Court” punishable by incarceration.
This is a daunting power in a free society—but it does not stop there…The maintenance or the scrapping of the long-form census. The legality of brothels. The implementation of the Harmonised Sales Tax.
what do these have in common? They are all at risk of being usurped by the courts—with decisions being made by members of the judiciary
who know a great deal about the law, but, with all due respects, have no specialized knowledge of population statistics, public health or government finance.
In this new millennium, the Court system (I cannot refer to it as the Justice system) bears a resemblance to the role of organized religion in the Middle Ages. It is autonomous. Judicial decisions carry the same aura as papal infallibility. An authority figure wearing fancy dress sits front-and-centre overlooking a convoluted ceremony conducted by other members of the profession wearing similar get-ups. when the minister judge enters the church courtroom all attendees are required to stand.
I allow that a judge is a senior and knowledge-able person, but so is a proctologist. I have never seen all the staff in the operating room stand
when my colleague enters to undertake some of the most difficult types of surgical procedure I have ever witnessed in my years administering anaesthetics.
To speak against the system is still, in 2010, regarded as heresy. To my surprise and disquiet, when I casually mentioned my intention to write this essay, people expressed concern—asking me if I am not nervous to do so.
when I did appear as a witness I was ques-tioned for about two hours with attempts made to interpret my 10-year-old hospital progress note and discharge summary to say different from its clear original intent. Answers were cut off, one lawyer accused the other of “leading questions”—it had nothing to do with the real world, the real people involved, and the real pain a wrong decision causes.
There has been much criticism of the police concerning the delay in apprehending william Picton. I suggest that if the judicial system was less complex with fewer technical loopholes, the police may well have proceeded sooner.
Defenders of the current system say it protects the public against the potential tyranny of the police. It is also argued that it is better that three guilty persons go free than one be imprisoned incorrectly. In this regard the system has failed Donald Marshall Jr., David Milgaard and Guy Paul Morin amongst others.
Physicians as well as nurses, midwives and nurse practitioners, make many, and occasionally life-and-death, decisions every day. These decisions do not take days, weeks or even months. The civil case in which I was a witness was scheduled to last three days. I am sure that, with a well-motivated mediator, it could have been settled in three hours. It is analogous to taking a week to diagnose and treat an acute appendicitis—by that time the patient is either moribund or dead.
So why am I railing against a system that has been in place throughout the world for centuries? There are many reasons but the principal one is the pervasion of this archaic and negative system into the physicians’ area of practice. Medical practitioners should not be given carte blanche, with no regard to consequences of carelessness or malevolence, but we all, every day, order tests and interventions to protect against the ever-present threat of a malpractice suit. It costs the public-funded system an inestimable fortune—money much better spent on direct and appropriate patient care.
The pervasion of this archaic and negative system into the physicians’ area of practice
the justice system?
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.wordpress.com.
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10 JuST FOR CanaDian DOCTORS november/december 2010
m o t o r i n g d r . k e l ly s i lv e r t h o r n
My historically inspired benchmark: 3,300 km over five days. Such was the prescription for Mexico’s leg-
endary 1950 – 54 border-to-border car race, Le Carrera Panamericana. My conundrum is which 3,300 Canadian kilometres are best traversed on my five days with Porsche’s namesake Panamera?
My prescribed starting point is prairie-bound Calgary. Porsche’s “Sports car for four” Panamera demands testing on sporting roads. Logic dictates heading
west across the multiple mountain ranges to the Pacific shores. A huddle with Google Maps and presto…sum the non-repeat road distances of the three available routes from Calgary to Vancouver nets the requisite 3,300 km. How convenient.
I set the Panamera’s Satellite Radio on the $6,770 upgrade Burmester stereo to Classic Rock. Music, caffeine, and Hi-test Chevron will fuel the next five days. The Panamera Turbo and I creep out into the descending darkness. Its pedigree and potency are unparalleled—Porsche un-
leashing the quintessential Q-ship for its first ever four-door sedan. All-wheel drive, 500 horsepower, and Valentine one collectively ride shotgun over the proceedings.
the direct route The border-to-border Le Carrera Panamericana was sprung on an unsuspecting world in 1950. The Mexican government sought to promote awareness of the paved completion of their section of the Panamerican Highway. A legend was born (with the race resurrected in 1989). Interestingly, Trans-Canada Highway (TCH)
east-to-west wasn’t “com-pleted” until 1962, when over half its 7,700 km were still gravel!
The most-direct route Calgary to Vancouver runs 980 km. It still follows the Trans-Canada westbound through Roger’s Pass and past the Last Spike at Craigellachie as far as kamloops. Then the direct route follows the mid-1980s engineer-ing masterpiece of the Coquihalla Highway.
Both highways boast majestic scenery. However, as the main artery of commerce between the Pacific and RoC (Rest of Canada), the BC portions of the Trans-Canada are an embarrassment to our great nation (ditto through Calgary proper!). The vast majority of BC’s TCH is just two lanes with flow claudication secondary to truck-plaque and RV-thrombi. I hum Radar-love to myself, but to no avail.
best moment: T Rex belting out Bang-a-gong as the sun sets beyond snow-capped mountains two hours outside Vancouver on the serpentine, high-alpine, 110-kph-limit, six-lane Coquihalla.
best side roads to explore: yoho Valley Road (Cathedral Lodge) just east of field, BC…and skipping the Coquihalla to run the now-traffic-free vestiges of the Trans Canada from kamloops through the fraser Canyon to Hope.
the southerly route This route es-chews the Trans Canada near Lake Louise, Alberta, to run southwest through kootenay National Park on Highway 93 to Radium Hot Springs, BC. I then follow Highway 93/95 along the floor of the expansive Columbia River Valley south to Cranbrook. My route heads west on Highway 3 parallel to the Canadian-uS border, traversing multiple mountain passes and intervening valleys.
The southern route is 1,125 unique kilometres. Though the roads are two-
lane highways, the traffic density (es-pecially truck) is much lower than the
Trans-Canada. This route boasts the Salmo-Creston-Skyway, the high-est year-round pass in Canada. The tortuous Hope-Princeton Pass section is also remarkable for its tough traffic slogging if unequipped with superbike-level overtaking capabilities. The Panamera’s 569 ft-lbs of torque
shine throughout.
best moment: watching a bald eagle circle a tree-top beside glim-
mering Slocan Lake.
best side roads to explore: Skip the aforementioned Skyway and instead
take 3A, kootenay Lake ferry, 31, 31A, and 6 to visit Crawford Bay, kaslo, New Denver and Nelson. As well, consider the Coalmont-
Revving Porsche’s new engine along the west Coast’s scenic motorways
tri-partite panamera
Dr. Kelly Silverthorn is a radiologist and Just For canadian doctors’ automotive writer.
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The Porsche Panamera, “with a top speed of 188 mph, 0 – 60 mph at an eye-popping 3.5 seconds and all-wheel-drive sure-footedness,” may just be “the
fastest multi-day cross-country tool currently available,” says Dr. Silverthorn, who tested it on some of BC’s most scenic and iconic highways (below).
november/december 2010 JuST FOR CanaDian DOCTORS 11
Spoil yourself in a Grand way. Starting this November, fl y WestJet non-stop from Toronto to Grand Cayman. With convenient connections between Toronto and other Canadian cities it’s easy to experience an island vacation.
Book your fl ight or vacation package today at westjet.com or call your travel agent.
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WES111081AB_1.indd 1 10/20/10 4:48:16 PM
Tulameen Road out of Princeton (if clinically indicated).
the northerly route My familiarity with this route is the least of the three, and thus it generates my greatest anticipation. The route is the longest at 1,129 unique kilometres. I was not disappointed, save for the traffic density. Don’t these people know about the shorter routes? Nevertheless, if I could recommend only one Calgary-Vancouver route, this would be the one.
The route begins in west Vancouver, following Highway 99 through whistler, Pemberton and Lillooet. upon joining Highway 97 I head north into the Cariboo before heading east across Highway 24 to join the yellowhead (Highway 5) at Little fort. The yellowhead then delivers me to majestic Jasper. The spectacular Ice fields Highway (Highway 93) completes the return journey to Banff/Calgary.
This route is tops in scenery (ice fields). It’s tops in twistiness (whistler to Lillooet). The northern route visits all three of western Canada’s most iconic resort communities of whistler, Banff and Jasper, where the Porsche can blend easily into the automo-tive landscape.
best moment: In the early morning mists XM plays Led Zeppelin’s Stairway to Heaven
as I drive the long climb out of Clearwater into wells Gray Provincial Park to scenic Helmecken falls.
best side roads to explore: The road from Mount Currie to Darcy. Also Lillooet to Lytton on Highway 12. The above-mentioned Clearwater Valley Road to Helmcken falls.
the car So enough about the 3,300 km. what about the car? Is it any good? why has Porsche done a sedan? Isn’t it a stretch to name a sedan after a famous race?
five days of driving in any car tells you a lot about its character. The Panamera has world-class depth of dynamic abilities, es-pecially in this top-of-the-range Turbo Sport Chrono form. with a top speed of 188 mph, 0 – 60 mph at an eye-popping 3.5 seconds and all-wheel-drive sure-footedness, it may be the fastest multi-day cross-country tool currently available. No other car I have driven provides this degree of performance, stability, and comfort for two people, let alone for the full four places and stealthful character the Panamera offers.
These immense capabilities do come with compromises, and at a cost—$172,430 for our full-load yachting-Blue-on-Cream full-leather version. The Panamera range in Canada starts at $88,000 MRSP with a 300-horsepower V-6 and rear-wheel-drive.
It is impossible for Porsche to imbue a 4,500-lb sedan with the road communication de-lights of their 3,100 lbs sports cars (or 2,400 lbs if you go back to 911s of the early 1970s).
The Panamera’s styling is controversial to say the least, but good design should push the envelope and then grow on you. I now regard the car’s visual impact as menac-ing, which fits its personality perfectly. Throughout the range, though, I found lug-gage space rather limited for a four-seater.
Porsche did very well financially with its 2002 entering of the SuV market with the Cayenne. Entering the sedan market is viewed as somewhat less sacrilegious. The brand is able to effectively share factories and some components between these two platforms. To any lover of Porsche’s sports cars, or those who want a sedan with these capabilities, there really is no (sedan) substitute!
As to the propriety of Porsche naming its sedan after the iconic 3,300 km Mexican road race, I came across a little-known fact in my research. In 1950 and 1951 Le Carrera Panamericana rules stated the entered cars must seat four. So the name and the car are indeed a perfect fit. So too is the Panamera for five days of Canada’s most challenging roads.
m o t o r i n g c o n t i n u e d
*tango tranceB y D r . m o n i c a y u z a k
p r e s c r i b i n g r & r
JoSe
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eS
cont
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The winner of Just For Canadian Doctors’ contest and an All-expenSeS-pAid TRip with Quark expeditions will be announced december 15 at justforcanadiandoctors.com. Read the last two finalists’ stories here. We’ll continue to run more adventure stories by runners-up in 2011. Send your submission to feedback@inprintpublications.com.
A physician kicks up her heels in Buenos Aires
Ihave always loved to dance. My memories begin with my Polish father polka-ing me around in his arms before I could walk,
and later me dancing on his feet around the kitchen. Then, as a teen, perfecting moves with one of my younger sisters. As the eldest daughter I was often next, after my mother, to dance with dad at weddings and family parties. Such deep dance delight.
Perhaps, not surprisingly, I fell in love with my partner on a dance floor. It was a supper club, and that night we closed the place down. we have been dancing through life together ever since. Along the way we’ve explored several Ballroom and Latin dances, tackled two-step, grooved to jive and west-coast swing.
Then one day, we came upon the Argentine Tango. It was instant love. we dropped all the others and became totally committed to it. I think it was the intensity that drew us in and began our journey with this very complex dance.
The man opens his arms and invites the woman into his embrace. She fills the circle
he creates by expanding her chest, leans forward to meet him by centering her weight onto the heads of her metatarsals. They meet chest to chest, she drapes her left arm over his shoulder and rests it on his upper back while her right hand rests gently in his left. Both strive to be comfortable, relaxed, and connected to the other. The upper bodies act as one and the lower bodies dissociate. Hips rotate, legs enter each other’s space. The lead is subtle and exacting, the woman closes her eyes to better feel it. Together they move to the ever-changing tempos in the line of dance like a string of ants. The salon becomes one. It’s been called the “tango trance.”
will I ever “get” it? I learn a movement, then forget it when my focus shifts. Take lesson after lesson to master one sequence, consult you Tube over breakfast, once again dancing in the kitchen.” Patience, persistence,” I tell myself.
To learn more about tango and the culture from which it sprang, we went to the source: Buenos Aires, Argentina. would we be inspired, or would this experience dash all
hope of our mastering this dance?we chose bohemian San Telmo with
its cobbled streets and architectural jewels as our base. we found a great teacher and discovered to our delight that we were surrounded by milonga halls (tango salons). The Sunday morning Artisan Market exploding under our balcony on Defensa Street was an unexpected bonus and provided badly needed retail therapy between lessons.
we learned that Tango originated on the docks, created by Italian and Spanish immigrant portenos (people of the port),and gauchos (cowboys) from the Pampas (plaines), who were mostly working men. They danced with each other and with the women of the Bordellos. Through music and movement emotions were given expression. Tango between rival men was a macho competition; between lovers, foreplay; and for the lonely, a way to connect with the female energy they missed from back home. Mostly it was men practising with each other, whenever a musical instrument would sound. They
november/december 2010 JuST FOR CanaDian DOCTORS 13
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were looking for the best ways to please a woman, preparing for the moment when they would have a woman in their arms and a chance to make her their sweetheart.
A cauldron, this history helped explain the “intensity” of the dance. A reflection of the pains of a people in a new land.
our teacher proceeded to teach us…to walk. The fundamentals of walking are essential to all the beautiful moves that follow, and attention to fine detail turns an “okay” dancer into a tanguero. “one body, four legs,” Gustavo intones. “Relax, breathe,” I remember. It truly takes two to tango!
The culture of Buenos Aires is defined by its music and cuisine. The cafés, bars, and restaurants provide the romantic ambience for a carefully prepared recipe, served by seemingly timeless waiters. A city of daytime snackers that finally sit down to their major meal around 10 pm, when the numerous legendary eateries are full. As the parillas (grills over open fire) smoke, people in groups share huge platters of meats washed down with full-bodied malbec and much merriment.
It is only then, when the meal is finished and the food nicely settled that the milongas begin, from 1 am till dawn. I felt like I was entering a scene from a Bogart movie, men wearing white linen suits, fedoras, and spats watching from the shadows. women in sequins, flowers in their hair, dresses slit up the side. Holding a man’s gaze across a crowded room signals a “yes.” He then sashays over, confident that the woman will follow him to the floor. The two have agreed to a short-term commitment to co-create an experience. Together, focusing, listening to each other and the music. Convention prohibits idle chatter on the dance floor, and insists that a couple remain together for three songs. It IS intense. And while on the dance floor, the dance is all there is.
I was terrified and kept my eyes glued to the floor. Not willing to look for too long at anybody, should they assume I wanted to dance. one night, close to the end of our stay, I found myself caught by the eyes of a tall, dark, handsome man. I was on the floor, he was inviting me into his embrace and my body was remembering the stance, the pressure points, and he began with simple patterns till I was able to relax and breathe. By the second dance he sensed my level of experience and matched it with his lead. By the third, my eyes were closed, my mind was quiet and I was following patterns that were totally new to me, effortlessly! I was in Buenos Aires, dancing with a real live Argentinean tanguero, in a real live milonga!
Giddy with wine, fatigue, and dance, my partner and I watched the sun come up.
14 JuST FOR CanaDian DOCTORS november/december 2010
mountain cure B y D r . a L e x r u s s e L L
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Backpacking solo in the wilds can do wonders for the spirit*p r e s c r i b i n g r & r c o n t i n u e d
It was a patient who made the diagnosis. “you’ve got industrial disease,” he wrote, in an actual letter to me. He was right; I
needed wilderness, and some time alone, but where do you go when you don’t want to see anybody? Someplace primeval. It could not cost a lot, because I not only suffer industrial disease, I also suffer cheapness. only one quarter Scot, but it definitely manifests.
Mt. Robson Provincial Park is a little chunk of the Rockies within driving distance from Edmonton. All the moist pacific air gets wrung out here on the western slopes, making the trees taller, the glaciers thicker, the mountain streams more wild and tumbling. Just what the doctor ordered, but such spectacles attract other humans, and the 20 km trail to Berg Lake at the foot of Emperor face is indeed a well-travelled path. I had heard of a 66km back door route along Moose River. No bridges, no signposts, no campsite development. Travel on the route is not recommended until August, when the rivers are lower and the grizzlies fatter. It was July. with luck, I’d be the only specimen of human for miles.
Packing for a wilderness trip is almost as fun as actually going on a wilderness trip. I borrow a stove. I buy six dinners in six tin foil bags. I have soup, matches, a one-man tent, an akubra hat, and a pair of old hiking boots. I have a Swiss army knife (thank you Dagny), and bear spray, which arrives in the mail from my concerned brother. The only thing I do not have is a good sleeping pad (damn that Scots blood).
The woman in the park visitor centre gives me a brochure with a map of the route, and advises me to: a) get a real map, and b) go later in the season. Since I insist on going immediately, there is also c) report in when I get back. I appreciate this girl. Her warnings are keeping the path empty, and her eventual
permission is making me feel worthy. Maps, I decide, are for tourists. The (free) brochure looks perfectly adequate for a wilderness man like me. The entire route is free, except the campsite at Berg Lake ($10). using the special pointy tool next to the corkscrew on my knife, I prise open my wallet and extract the money, then catch a ride back up to where the highway crosses Moose River. It seems pretty far, but I am excited, and march undaunted into the woods in the vicinity of the river. After several hours of wandering through forest, I head towards the sound of water, and am relieved to find that there is in fact a track. Turns out that wandering through unmarked bush is a good way to reduce zealousness.
Later I find some mushrooms, and as I had packed a little light on the food, decide to try them in the soup. while stirring, I notice some sort of maggot, which is no doubt high in protein, and no reason for tossing out soup. It is hard to be sure if I am being judicious with my food supply, or just cheap. I guess I am still a little excited about being here, and prone to some excess in my efforts to get back to nature. It is only the first day and already I have: a) done some off-piste adventuring, b) felt quite alone, and c) eaten worms!
Rain and more rain, and I lose my way a few times. I still have the gist, but am constantly backtracking. A wrong turn and I end up crossing the river several times. uncertainty, combined with getting wet, and being alone, is stressful. I realize that I have to be more protective of my map, as the paper is quite soluble, and without it I would be lost. The only matches that survive the river swim are in my wallet, presumably protected
by its tight grip.
I climb to an alpine meadow and surprise a mother Grizzly with her two cubs. Actually have no way of telling if she was surprised, as I am running for the trees too fast for the light carrying this information to reach my retina. This day takes me past the source of the Moose, which turns out to be a small puddle. I see mountain goats in the distance, and it occurs to me that their pee will run into a different ocean than the bears’ and mine. Just before camp I startle an actual moose, and feel my journey is complete.
At Berg Lake I meet people and am happy to see them: a good sign. It takes me five minutes to find a patient, a hatless, somewhat braised young man in need of my sunscreen. This bodes well for my recovery.
Snowbird Pass, a side trip that winds up behind Berg Lake and gives views of Robson Glacier and the North face, ends in what seems like a non-descript little snow covered ridge. I persevere and am rewarded with a sudden cliff edge dropping down to the huge and silent Coleman Glacier; a last dose of solitude before the walk out.
I make excellent time getting to the parking lot, stopping briefly to visit the places I have been before with friends and family. A boulder here, a waterfall there; I miss them and wish I had been a wiser and more joyful companion. Here the task of living seems to rise up as stark and monumental as the broad shoulders of Robson. I like it that there is a climbing route to the summit, somewhere on the Emperor face, called “Infinite Patience”.
I keep my promise to the park lady, and report my return. She seems happy to see me. I tell her about the bear, and how high the river is running, and then I say something stupid, like “best $10 I ever spent.” Some things, it seems, cannot be remedied.
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16 JuST FOR CanaDian DOCTORS november/december 2010
Indulging in hot-spring bubbles and cold-smoke on a Kootenay ski trip comes hangover free. (But don’t forget the Ibuprofen.) story Lisa richardson photography dave hobson
hot+ cold therapy
t r a v e l a t h o m e
november/december 2010 JuST FOR CanaDian DOCTORS 17
as my husband approached 40, I found myself screening for the symptoms of mid-life crisis. Especially when he started to talk about buying a Porsche. It was clear I needed to do something to distinguish the moment, switch off the autopilot light, arrest a potential slide into melancholy. But champagne and cigars were
not going to cut it. we needed shock therapy.for a skier, a perfect day is as easy to define as it is difficult to attain: a mountain to oneself.
Great snow conditions. food that is so good that conversation falls off as plates are laid before you. The view of moon-rise over mountains from the steam and churn of an outdoor hot-tub.
There was only one place for it: we headed for the Powder Highway in the heart of the kootenays. The kootenay Rockies region is the birthplace of heliskiing and cat-skiing. The terrain and its legendary “blower” champagne snow conditions have attracted more than 50 cat, heliskiing, resort and backcountry lodge operations, all concentrating in a south-eastern corner of British Columbia, where the Purcell Mountains, the Selkirks, the Monashees and the Valhallas drain down into the Columbia River Valley.
unlike the mega-operators, who can cater to 120 guests at a time, Snowwater Heliskiing is one of the region’s boutique operators, a cluster of timber-frame cabins with radiant in-floor heat, wood stoves, micro-hydro and generator power that accommodates 12 guests at a time, perched at 5,200 feet on a west facing slope in the Selkirks.
owner-operator Patric Maloney is a bon vivant, the incarnation of his latest idea for a TV show: how to live like a millionaire without being one. He welcomes guests to the lodge with hot towels, champagne and the look of a man who has found his place in the world, in a king-dom he’s built by hand, that allows him to indulge his own champagne tastes, and stock the place with big-boy toys: Patron, fine wine, a personal chef, dynamite, snowmobiles, a bio-diesel fuelled snowcat (that serves as back-up for bad-weather days) and an A-star helicopter.
The A-star’s 700 horsepower jet engine is our ticket to living like a millionaire. we are free of the frenzy one feels on a powder day in a ski resort, to get to the best terrain before it’s tracked out by the masses. It’s just three of us and a guide. our legs will give out before the powder does. we ski 30 minute laps. The helicopter picks us up at the bottom like a chauffeur, turbo-boosting us up for another run so quickly the lactic acid doesn’t get a chance to disperse. After nine runs of roughly 1000 vertical feet each, my husband pronounces himself cured of his life-long powder-chase: “I could never ski again.”
It’s only temporary. The addiction surg-es, and we rally. our approach is holistic: we’re targeting midlife malaise from every angle. After all, variety is the spice of life.
Snow-lovers joke that catskiing is a poor man’s heliskiing, but it feels more like the alternative for social democrats, with less of the alpha-aggression and rush-rush-rush that can mark the heli-experience.
Catskiing is an inherently social experience, and 12 is the magic number. If you book your own cat, you can even control the chemistry. we’re lucky to slide in to a group that is so full of chemistry, they’re practically a periodic table. They call themselves the Powder Pachyderms: “we might be fat, but we still give’r,” and the jokes come fast and furious, giving laughing muscles as good a workout as the legs get.
As the beast lurches up improbable roads through a tenure that is over 21,000 acres, group members chat, joke, and pass around con-tainers of home-made sandwiches, cookies, snacks. “This doesn’t suck,” someone announces and we share out the one-bite brownies and donut holes. The tailguide, riding the bench seat, probes through the other lunch treats. “Anyone want any vegetable sticks?” There are no takers. Skiing 15,000 vertical feet of untracked snow is heart-friendly enough.
The hang-over comes the next day—a localized sensation in the thighs that insists: get me to the hotsprings. we lower ourselves into 42 degree natural mineral baths, surrendering to an age-old remedy for joint pain, muscle fatigue, high blood pressure, circulatory and diges-tive issues. whether it can cure a mid-life crisis is yet to be determined.
But if, as the deep ecologist Dolores LaChapelle claimed, the essence of life can be found in deep-snow turns, it’s better to turn forty eating pow than birthday cake.
As LaChappelle wrote in her classic Earth wisdom: “one can never be bored by powder skiing because it is a special gift of the relation-ship between earth and sky. It only comes in sufficient amounts in particular places, at certain times on this earth; it lasts only a limited amount of time before sun or wind changes it. People devote their lives to it ‘for the pleasure of being so purely played’ by gravity and snow.” Everything passes. Skiing powder makes that ephemerality a cause for celebration, rather than regret.
In the end, my husband bought the Porsche as well. But that’s a whole other story.
t r a v e l a t h o m e
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if yo
u go
snowwater’s kootenay sampler takes all the elements of your dream ski trip and super-sizes them into a seven-day package: cat, heli (with unlimited vert and back-up cat-skiing in case of no-fly weather), and resort skiing, exquisite food, funky towns to explore, and a good balance of free time, natural mineral hot springs, champagne snow. snowwater.com
Valhalla is the old Norse for “the hall of the slain,” or warrior’s heaven…luckily, skiers don’t need to wait until they die to taste the pleasures of the Selkirk’s Valhalla range. valhalla powdercats offer single day, multi-day and Powder Safari packages, as well as the group option of booking your own cat. valhallapow.com The ainsworth hot-springs attract worked-over snow-tourists and grey-haired, slow-gaited locals in equal numbers, drawn to the restorative powers of the natural hot springs and the high mineral content of the water. hotnaturally.com
nelson, bc, is a funky interior town, population 10,000, full of hip-pies, artists, green-thumbs and counterculture types. And, for some reason, great chefs. Nelson is a town worth experiencing through your belly. Oso Negro coffee and incredible baking. Grab breakfast at the Red Fish Grill for the world’s best hash browns. Stay at the Prestige Hotel on Kootenay Lake. discovernelson.com; prestigehotelsandresorts.com
18 JuST FOR CanaDian DOCTORS november/december 2010
Dr. Andy Hoffer will be the first to tell you that necessity is the mother of all invention, but that idiom never
rang truer than when his own mother fell ill.It was shortly before his planned trip
over Christmas in 2006 to his family home in uruguay (one of the top four countries in the 2010 Soccer world Cup, he says proudly) that he received word his mom had pneumonia and was rushed to intensive
care in a local hospital. The biomedical physiologist at Sfu immediately went to her bedside, where she lay connected to a mechanical ventilator.
“She was conscious but couldn’t breathe on her own, nor speak, eat or drink” he says.
He spent the next five weeks with his mom, witnessing her inability to wean herself from the machine. She had
recovered from her illness after one week, but now couldn’t breathe well enough on her own. All around them were other sick people, other stories: kids, middle-aged people, victims of trauma, sunstroke, the elderly; all struggling with varying degrees of success to get off their ventilators.
“My mother’s condition was worsening with the prolonged bed stay. I was trying to figure out why it was so difficult to wean off the ventilator,” he says, adding that physician friends advised that failure-to-wean is common, with 20 to 30% of patients becoming ventilator-dependent.
His mom worked with a respiratory therapist, training her to breathe on her own, but she would fatigue after a few hours and start to panic, so she was put back on the machine overnight. It was the same story for many patients, often kept sedated to prevent them from fighting the machine.
“I knew that the diaphragm could weaken from not being used during ventilation, but I had no idea of how
incredibly quickly it atrophies,” he says, adding that a year later, Levine published an eye-opening finding in patients who died after 18 to 69 hours of
sedation and ventilation: their diaphragm muscle fibers had atrophied to less than half of normal size. “It’s scary how fast the diaphragm muscle declines.”
“while I was trying to find a better way to help wean my mom, in visualizing the tubes and leads that were keeping her alive, I had a key insight. I came up with an idea for pacing the diaphragm that should speed up the weaning process.”
Hoffer had studied neurophysiology at Johns Hopkins, earning his PhD. He was specifically interested in the control of limb movement and developed implantable cuff sensing electrodes permanently connected to nerves. He led the development of Neurostep, a pacemaker-like device implanted in the thigh that enables people with paralysis from stroke to walk again.
Hoffer’s diaphragm pacing technology doesn’t require any surgical exposure of nerves; it is a minimally invasive, temporary procedure. Based on his experience is the use of electrical stimuli, he figured the diaphragm would benefit from electrical activation during ventilation in order to prevent or reverse disuse atrophy. He asked himself, ‘how does one put in an electrode quickly, simply, and reversibly, that can be removed after the patient recovers?’
He came up with the Lungpacer intravenous electrode, placed in the upper chest under local anesthesia. The nerves that control the diaphragm run next to large veins under the clavicle. The Lungpacer electrode “inside-out cuff” design provides mechanical stability and selectively activates the diaphragm using very low currents. Hoffer and his Sfu team have since been busy developing and testing a medical grade, disposable electrode lead.
The Lungpacer lead, connected to a bedside control unit, will produce diaphragm contractions to keep it strong. Similar in concept to a car’s block heater, the Lungpacer will keep the diaphragm warmed up and ready to work normally when the patient is ready to breathe again.
when he conceived this technology, he thought “of people like my mom, but I didn’t have any idea of how large a number of people this problem affects. The elderly are more susceptible but a lot of young people die too. Ventilator-dependent patients in ICus are the most expensive hospital in-patients, and too often they die.”
Lungpacer Medical (lungpacer.com) has completed proof of concept, safety, and stability in animal trials and recently won several awards for its innovative technology and compelling business case.
Hoffer’s mom inspired but couldn’t benefit from the Lungpacer; she died that March.
“It isn’t ready for use in people yet, but we are not far from it. By this time next year we hope to be testing it in patients.”
An intravenous electrode that offers new hope to patients on ventilators
breathe easy
Corey Van’t Haaff owns Cohiba Communications and writes about business, medicine, technology, and law, especially where two or more of these intersect.
She can be reached at corey@cohibacommunications.com.
t e c h w o r k s c o r e y v a n ’ t h a a f f
Dr. Andy Hoffer receiving the LifeSciences BC 2010 award.
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november/december 2010 JuST FOR CanaDian DOCTORS 19
fa l l 2010 + beyond
c m ean international guide to conTInuInG MedIcal educaTIon
london / tel aviv / balt ic / macau / berl in … | c a l e n d a r
Where to start? London is a monolith of a city—there’s much to see along its storied streets. It demands repeat visits. Easy to do, since it’s a
major hub for travellers flying east to Europe and beyond. Make it a stopover on your next trip or, better yet, your destination for a CME event. Then get out and explore. With over 300 museums and galleries, it’s an art lover’s mecca. Of course, shoppers be ready to pound the pavement…as well as gourmands. [stay] Make your base in the West End, at the edge of Hyde Park. In posh Marylebone, you’ll be in the vicinity of Harley Street, a long-renowned centre for healthcare. With several private hospitals and “the largest concentration of medical proficiency in the world,” it’s often referred to as Medical London—more than 1,000 doctors practise here. [harleystreetguide.co.uk] Stay a walk away, close to Marble Arch in the northeast end of Hyde Park, at The Arch 1 , a swish and sleek new hotel carved out of the area’s classic Georgian townhomes (see page 6). [thearchlondon.com] [dine] British food hasn’t had the best rep, from bangers-and-mash to fish-and-chips, but London has evolved
into a foodie’s playland. Try a twist on classic high tea at another hip-and-happening hotel at the southeast end of Hyde Park, the Metropolitan. The Afternoon De-Light 2 is a selection of sweet and savoury cupcakes, fruit scones, and no-bread sandwiches—“the quintessentially British afternoon tea with a cool touch of avant-garde, waist-friendly chic.” [metropolitan.london.como.bz] [culture / art] After fortification walk through Hyde Park, back to Marble Arch at the northeast end to Speakers’ Corner 3 . You can spend hours here on a Sunday listening or partaking in spontaneous debates on any subject—from the existence of God to foreign policy. Locals and tourist alike prop themselves up on makeshift podiums and pontificate. It’s been an oral tradition here for over 150 years; some big names that stood here in the past—Marx, Engels, Lenin…Beyond the lively, living culture found on a park or street corner, London is a museum mecca. There’s no way to take advantage of all the art on offer here, so go to at least one must-see: the Tate Modern. Housed inside a former power station in the heart of London, it’s a gorgeous reinterpretation of a building. Inside is a stunning collection of
modern art. The Turbine Hall is a venue for grand works of art created specifically for the cavernous space, like Miroslaw Balka’s monolithic installation described as a “box of darkness” and “black hole” 4 . After exploring, head up to the café for a local microbrew (the Brits know their beer) 5 and gaze over the Thames River, Millennium Footbridge and St. Paul’s Cathedral. [tate.org.uk/modern] [neighbourhood hop] Take the Millennium Footbridge across the Thames and stroll to the 61-metre-high Monument, built to commemo-rate the Great Fire of London in 1666. Up top, you’ll have views of London Bridge and the skyscrapers of The City, London’s financial district 6 . [themonument.info] Just northeast of The City explore the happening markets of Spitalfields 7 , Sunday UpMarket and Brick Lane. Shop for cool togs and nosh on fabulous, authentic ethnic food. Back in the West End, dilly-dally and shop on Oxford and Bond Streets (and score the latest Kate Moss design in Topshop), and don’t forget to window shop on Carnaby Street 8 , where London’s modern fashion scene began in the hippie heyday. —B. Sligl For more info: visitlondon.com
across the pond in london: one of the world’s great capitals (cme events in LonDon are highlighted in blue)
B. S
LIG
L
LONDON
145 3
7 6 8 2
20 JuST FOR CanaDian DOCTORS november/december 2010
new CME list from Adam
For: Just For Canadian Doctors Issue: Nov / Dec 2010 issue Fax: 604 - 681 - 0456 Attn: Advertising in Print Email: Copy sent to admaterial@advertisinginprint.com
CME CRUISES Companion cruises FREE
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introductory Course to botox and Cosmetic Fillers & advanced Techniques
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2011 annual Symposium and Congress Of The american Society Of Cataract and Refractive Surgery
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istanbulTurkey
TaRTen 2011 (Transatlantic Reproductive Technologies network)
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Grand CaymanCayman isls.
anesthesia Camp - Grand CaymanDuke university and destination Cme
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2011 Winterlude anesthesia Symposium university of Ottawa 613-761-4940ottawa-anesthe-sia.org
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Tucsonarizona
Current Topics in anesthesianorthwest anesthesia Seminars
800-222-6927 nwas.com
bioc
hem
istr
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Dec11-15
Philadelphia Pennsylvania
50th annual meeting Of american Society For Cell biology
american Society for Cell biology
301-347-9300 ascb.org
mar09-13
barcelonaSpain
10th international Conference On alzheimer’s & Parkinson’s Diseases
Kenes international011-41-22-908-0488
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Quebecmontreal
19th Scientific Meeting And Exhibition Of The international Society For magnetic Resonance in medicine
international Society For magnetic Resonance in medicine
510-841-1899 ismrm.org
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nov 30-Dec 03
Romeitaly
Xiv international Symposium On Progress in Clinical Pacing (2010)
aim Rome 011-39-06-330-531
aimgroup.eu
Dec10-12
Grand CaymanCayman isls.
Diving into Cardiac imaginguniversity of Pennsylvania School of medicine
215-662-6982 uphs.upenn.edu
Jan16-30
South americanCruise
Respirology, Cardiology, Psychiatry Sea Courses Cruises888-647-7327See ad Page 20
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Londonengland
33rd Charing Cross international Symposium: vascular & endovascular Consensus update
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november/december 2010 JuST FOR CanaDian DOCTORS 21
Learn Virtually anytime - anywhere
Connect with us 24/7. toll-Free:1-866-685-6860 www.neiconferences.com
access your Cme worldwide travel & Learn Format
7X2.5_canadian_family_physicians1 1 3/15/07 9:28:25 AM
new CME list from Adam
c a l e n d a r c m ecme when where topic sponsor contact website
Clin
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Pha
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Quebec CityQuebec
Journee Clinique De Pharmacologie u. Laval 418-656-5958 ulaval.ca
Feb03-04
Londonengland
6th international Pharmacoeconomic Conference On alzheimer’s Disease
alzheimer’s Drug Discovery Foundation
212-935-2402 alzdiscovery.org
apr08-10
napaCalifornia
Clinical Pharmacotherapy 2011: Practical information For Physicians, nurses and Pharmacists
uC Davis Health System 916-734-5390 ucdavis.edu
Der
mat
olog
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Dec06-09
ParisFrance
2011 annual Congress Of The international master Course On aging Skin
CHeCK-uP SanTÉ011-33-1-4073-8282
imcasweb.com
Dec09-12
DresdenGermany
Cosmoderm 16: international aesthetic Dermatology Congress Of european Society For Cosmetic & aesthetic Dermatology
Conventus Congressmanagement
011-49-36-413-5330
cosmo-derm2010.de
Feb04-08
new Orleans Louisiana
69th annual meeting Of The american academy Of Dermatology
american academy of Dermatology
847-330-0230 aad.org
Dia
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Feb16-19
Londonengland
The 4th international Conference On advanced Technologies & Treatments For Diabetes
Kenes international011-41-22-908-0488
kenes.com
mar04
SacramentoCalifornia
37th annual uC Davis Diabetes Symposium uC Davis Health System 916-734-5390 ucdavis.edu
mar12-19
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Diabetes management Sea Courses Cruises888-647-7327See ad Page 8
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Dec13-17
SarasotaFlorida
Primary Care: improving Your Outcomes Through Diagnosis and Treatment
Hamad medical Corporation
011-974-439-7398
qatarhealth.info
Jan13-15
bonita SpringsFlorida
2011 annual meeting Of national association Of emergency medical Services Physicians
national association of emergency medical Services Physicians
800-228-3677 naemsp.org
Jan 31-Feb 02
SilverStarbritishColumbia
beem (best evidence in emergency medicine) Course
mcmaster university 905-521-2100 beemsite.com
Feb17-19
Sydneyaustralia
austrauma 2011Royal australian College of Surgeons
011-61-3-9276-7406
austraumacon-ference.org
Feb20-23
WhistlerbritishColumbia
24th annual update in emergency medicine CePD 416-978-2719 cepdtoronto.ca
endo
crin
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Jan 29-30
GlendaleCalifornia
Two Days back On earth Wiley Protocol 805-565-7508 thewileyproto-col.com
Jan 31-Feb 04
SarasotaFlorida
Geriatrics: a Primary Care approach To The aging Population
american medical Seminars, inc.
941-388-1766 ams4cme.com
mar13-18
big islandHawaii
14th mayo Clinic endocrine Course mayo Clinic 507-284-2776 mayo.edu
Jul21-31
balticCruise
endocrinology 2011 Sea Courses Cruises888-647-7327See ad Page 8
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22 JuST FOR CanaDian DOCTORS november/december 2010
new CME list from Adam
c m ecme when where topic sponsor contact website
Gen
eral
& F
amily
m
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ine
Dec03-04
San FranciscoCalifornia
5th annual Primary Care Sports medicine: abCs Of musculoskeletal Care
university of California, San Francisco
415-476-4251 cme.ucsf.edu
Jan12-15
new Yorknew York
nei Conference Seriesnational educationinstitute
866-685-6860See ad Page 21
neiconferences.com
Jan20-21
Londonengland
6th medical update For The General Practitionerinfomed Research & Training Limited
011-44-20-8123-0021
infomedltd.co.uk
Jan23-29
Jerusalemisrael
nei Conference Seriesnational educationinstitute
866-685-6860See ad Page 21
neiconferences.com
Jan26-29
Romeitaly
2011 international Conference On Health informatics
inSTiCC351-265-100-033
insticc.org
Feb19-27
CaribbeanCruise
Hospital Clinical medicine Sea Courses Cruises888-647-7327See ad Page 20
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Primary Care Refresher Sea Courses Cruises888-647-7327See ad Page 8
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may09-19
Western mediterranean Cruise
Family medicineContinuing education,inc./university at Sea
800-422-0711See ad Page 39
continuingedu-cation.net
Gen
etic
s mar16-20
vancouverbritishColumbia
2011 american College Of medical Genetics annual Clinical Genetics meeting
aCmG meetings Department
301-718-9603 acmg.net
Oct11-15
montrealQuebec
12th international Congress Of Human Genetics.international Federation of Human Genetics
301-634-7300 ifhgs.org
Ger
iatr
ics Feb
21-27Tel avivisrael
7th annual update Symposium On Clinical neu-rology and neurophysiology
iSaS international Seminars
011-972-2-652-0574
neurophysiology-symposium.com
mar18-21
San antonioTexas
2011 annual meeting of the american association of Geriatric Psychiatry
american association of Geriatric Psychiatry
301-654-7850 aagpmeeting.org
Hem
atol
ogy
Jan21-22
vancouverbritishColumbia
Highlights Of aSHamerican Society of Hematology
202-776-0544 hematology.org
Feb10-12
Las vegasnevada
17th annual nOCR meetingnetwork of Oncology Clinicians and Researchers
See Websitenocrannu-almeeting.com
Feb19-22
San FranciscoCalifornia
Scripps Cancer Center’s 31st annual Conference: Clinical Hematology/Oncology
Scripps Conference Services
858-652-5400scrippshealth.org
imm
unol
ogy
&
alle
rgy
Jan27-29
berlinGermany
1st international Conference On Current & Future vaccination in adults
Comtecmed011-972-3-566-6166
comtecmed.com
apr08-11
Lake Louisealberta
24th annual Spring meeting Of Canadian Society For immunology
Canadian Society for immunology
See Website csi-sci.ca
apr18-20
amsterdamnetherlands
Pharma-nutrition elsevier See Websitepharma-nutri-tion.com/
c a l e n d a r
november/december 2010 JuST FOR CanaDian DOCTORS 23
new CME list from Adam
c m ecme when where topic sponsor contact website
infe
ctio
us D
isea
ses Dec
27-31SarasotaFlorida
infectious Diseases in The adult Patient: a Primary Care update
american medical Seminars, inc.
941-388-1766 ams4cme.com
Feb11-12
SacramentoCalifornia
29th annual uC Davis infectious Diseases Conference
uC Davis Health System 916-734-5390 ucdavis.edu
apr07-10
montrealQuebec
ammi Canada - CaCmiD annual Conferenceammi Canada and CaCmiD
613-260-3233 ammi.ca
inte
rnal
m
edic
ine Jun 26-
Jul 03balticCruise
internal medicineContinuing education,inc./university at Sea
800-422-0711See ad Page 39
continuingedu-cation.net
aug21-28
alaskanCruise
Chronic Diseases update 2011 CmeatSea 888-523-3732 cmeatsea.org
Lega
let
hics
Feb02-04
Rochesternew York
Frequently encountered ethical Dilemmas in The Community Practice
mayo School of Cme 507-284-2509 mayo.edu
Feb20-21
Ximer arporaindia
2nd international Conference On medical negligence and Litigation in medical Practice
indian association of medico-Legal experts
011-91-98-9109-8542
iamleconf.in
nep
hrol
ogy Feb
17-20bangkokThailand
21st Conference Of The Asian Pacific Association For The Study Of The Liver
Kenes asia011-65-6292-4706
apasl2011-bangkok.org
apr08-12
vancouverbritishColumbia
World Congress Of nephrology 2011international Society of nephrology
info@wcn2011.org
wcn2011.org
neu
rolo
gy Dec03-07
San antonioTexas
2010 american epilepsy Society’s annual meetingamerican epilepsy Society
703-960-1213 aesnet.org
Dec07-08
St. andrewsengland
endoscopic Spine Surgery aesculap academy011-49-7461-95-2001
aesculap-acade-my.com
nut
ritio
n Jan13-16
San DiegoCalifornia
8th annual natural Supplements: an evidence-based update
Scripps Conference Services
858-652-5400scrippshealth.org
apr14
bolognaitaly
international academy On nutrition and aginguniversity of new mexico School
505-272-3942 unm.edu
Onc
olog
y &
Palli
ativ
e C
are
Dec09-11
Chicagoillinois
2010 Chicago multidisciplinary Symposium in Thoracic Oncology
american Society for Radiation Oncology
703-502-1550 astro.org
Jan27-29
San FranciscoCalifornia
T-cell Lymphoma Forum 2011Jonathan Wood & associates
201-594-0400 tclf2011.com
Feb17-20
vancouverbritishColumbia
15th annual international Congress On Hematologic malignancies: Focus On Leukemias, Lymphomas, and myelomas
Physicians’ education Resource
888-949-0045cancerlearning.com
Oph
thal
mol
ogy
Dec09-12
macauChina
international Symposium On Ocular Pharmacology & Therapeutics
Paragon Conventions011-41-22-533-0948
isopt.net
Jan16-21
mauiHawaii
Hawaiian eye 2011vindico medical education
856-994-9400osnhawaiianeye.com
Feb03-06
ahmedabadindia
69th annual Conference Of all india Ophthalmological Society
all indian Ophthalmological Society
011-91-079-2630-3208
aioc2011.com
c a l e n d a r
24 JuST FOR CanaDian DOCTORS november/december 2010
c a l e n d a rc m e
Toll-Free: 1-866-DREAM11 • www.balmoralhall.com
Over 99% of Balmoral Hall graduates attend the university of their choice.
At Balmoral Hall School, we place a high priority on every studentʼs personal and academic development.
We are committed to developing the whole student: young women who not only succeed but also strive to make a difference.
Balmoral Hall is a day and boarding school for girls in Winnipeg, Manitoba and is an IB World School.
cme when where topic sponsor contact websitePa
in m
anag
emen
t Dec03
Calgaryalberta
Calgary Pain Conference university of Calgary 403-220-7240 ucalgary.ca
Feb 12-mar 02
africaLand & Cruise
Cardiology & Pain management update 2011 CmeatSea 888-523-3732 cmeatsea.org
Pedi
atri
cs
Dec28-30
OrlandoFlorida
Pediatric Review For Primary Care mCe Conferences 888-533-9031mceconfer-ences.com
Feb12-18
mauiHawaii
Pediatric Potpourri: State Of The art 2011Childrens Hospital Los angeles and american academy of Pediatrics
323-361-2752childrenshos-pitallamedical-group.org
Jul02-08
mauiHawaii
Pediatrics in the islands … Clinical Pearls 2011Childrens Hospital Los angeles and american academy of Pediatrics
323-361-2752childrenshos-pitallamedical-group.org
Psyc
hiat
ry
Jan16-30
valparaisoChile
Cognitive behavioural Therapy South america Cruise
CbT Canada 877-466-8228 cbt.ca
mar26-27
newport beachCalifornia
2011 medical Legal Skills Workshop; Fact based Opinions and Testimony Removing bias From medical Legal assessment
Objective assessment Solutions
See Websitemedicalexpertc-me.com/
Rad
iolo
gy
Jan10-14
TorontoOntario
CT angiography and 3D imagingLevels 1 and 2
university of Toronto 888-512-8173events.cmetoronto.ca
Feb20-23
Grand CaymanCayman isls.
advanced imaging in the islandsDuke university medical Center
919-684-2711 duke.edu
Rhe
umat
olog
y
Feb11-15
Cancunmexico
2011 Canadian Rheumatology association (CRa) Conference
Canadian Rheumatology association
905-952-0698 rheum.ca
Feb 28-mar 04
SarasotaFlorida
Rheumatology: improving Primary Care Outcomes Through Diagnosis and Treatment
american medical Seminars, inc.
941-388-1766 ams4cme.com
apr15-17
TaipeiTaiwan
1st Symposium Of The Asia Pacific League Of associations Of Rheumatology
Kenes asia011-65-6292-4706
kenes.com
Surg
ery
Jan05-07
Calgaryalberta
Spine & Peripheral nerve anatomy & Surgery university of Calgary 403-220-7240 ucalgary.ca
Feb11-12
Las vegasnevada
managing Coding & Reimbursement Challenges in neurosurgery
american association of neurological Surgeons
847-378-0500 aans.org
uro
logy
Jan27-30
ParisFrance
4th World Congress On Controversies in urology Comtecmed011-972-3-566-6166
comtecmed.com
Jun26-29
mont TremblantQuebec
66th Canadian urological association annual meeting 2011
CUA Central Office 514-395-0376 cua.org
For feedback, requests or to have your course featured please email cme@inprintpublications.comor submit your course via www.justforcanadiandoctors.com
26 JuST FOR CanaDian DOCTORS november/december 2010
RICHMOND, BC - Physicians required for very busy walk-in/family ractice clinic. 65/35 split. Please contact Richard at rishar@shaw.ca or 778 231 8911.
SIDNEY, BC - Well established family practice in office shared with one other female MD. Admitting privileges at Saanich Peninsula Hospital, no obstetrics or ER required. One in five weekend call. Great lifestyle in small seaside town near Victoria. Details at practiceinfo@shaw.ca
VICTORIA, BC - Burnside, Tillicum and Uptown Medical Clinics require a P/T or F/T GP and Walk-in doctors. Email bridger@shaw.ca.
ETOBICOKE, ON - Walk-in/family practice group of 3 clinics/8 MDs seeking MD to join in busy clinics in North Etobicoke. Attractive split. Call Yasmin 416 834-2807 or e-mail alkarim@damji.ca
KINGSTON, ON - Opportunities in a new clinic! CDK Family Medicine and Walk-in. Downtown Kingston. Start a new group, solo practice, wal-in shifts, locums. Contact Dr Chris Kozanitis (613) 329-3604 or e-mail cdkoz@bell.net.
MISSISSAUGA, ON - Part-time/fulltime family practice/walk-in available. Ability to take over a family practice and join a FHG. Many patients looking for a new family doctor. Work in a positive practice environment with support from the other MDs. Lab, pharmacy, foot clinic, optometry on site. Email doctorsearch@hotmail.com or call 416-844-8340.
OTTAWA, ON - Take over solo family practice located in large medical building adjacent to The Ottawa Hospital, Civic Campus. Member
of Family Health Group with full night and weekend coverage. Approved for EMR funding beginning end of May. Opportunity for teaching and hospital work. Telephone 613 725-1465, fax 613 725-0340 or e-mail wjw@sympatico.ca
practice for saleKITCHENER, ON - Family practice for sale. Full and equal partnership in FHO. I am retiring. Completely computerized EMR (Practice Solutions) with no paper records, no hospital work, no OB. One day/weekend in 14. Staff experienced with the system. Perfect for a new physician or one contemplating a mid-life career change. K-W is a great place to settle down. Hoping to find a good physician for the families that have put up with me for almost two generations. http://mydoctor.ca/drgeorgemiller For more information E-mail gbmiller@sympatico.ca.
vacation propertiesPUERTO VALLARTA - Need a holiday in the sun? Deluxe one bedroom beachfront condo in Puerto Vallarta, Mexico overlooking Mis-maloya Bay, sleeps 4, full kitchen, fully fur-nished, A/C, sat TV. Available monthly/weekly. 604-542-1928 or jorajames@telus.net
record storage
Medical record scanning and storage services for practices, clinics and hospitals. Ask about our FREE storage offer for closing GP practices. Contact RSRS at 1-888-563-3732 Ext. 221, www.recordsolutions.ca.
positions available positions available
fax 604-681-8149 • tel 604-681-1811 • email classified@InPrintPublications.com
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november/december 2010 JuST FOR CanaDian DOCTORS 27
Family Physician Opportunity Primary Health Care Clinic Moose Jaw, Saskatchewan
A new Primary Health Care (PHC) Clinic, Kliniek on Main, is looking for an ambitious family physician to join their team. This is a highly organized, modern, efficient office running on EMR. The main role of Kliniek on Main is to provide initial comprehensive assessments, care and follow-up to government-assisted refugees and the newcomer population in Moose Jaw. The clinic is actively involved in the Health Quality Council’s Chronic Disease Management Collaborative.
The successful physician will enjoy an excellent work/life/professional satisfaction balance in this progressive clinic that allows for collegial arrangement/cross coverage for time away. Additional obstetrics/ER special interest work is available if desired.
The community of Moose Jaw offers many cultural, entertainment and recreational activities, as well as excellent educational facilities and affordable housing in a friendly and safe environment. Visit www.fhhr.ca for more information about the Five Hills Health Region.
For further information, or to apply: Erin Kell Medical Affairs Coordinator Five Hills Health Region Phone: (306) 694-0228 Fax: (306)694-0282 ekell@fhhr.ca
Full Time ER Physician Opportunities Also Available
doctorworkandplayongeorgianbay.caImage by Diane Soward - www.artofdianesoward.com
Physician RecruitmentRecrutement de médecins
Georgian BaySOUTHERN
www.gbgh.on.ca
baie Georgienne
GEORGIAN BAYHôpital général de la
G e n e r a l H o s p i t a l
To learn more contact: David Gravelle, Physician Recruitment Officer gravelled@gbgh.on.ca 1-705-526-1300 Ext 3135
Midland/Penetanguishene, OntarioOnly 90 minutes north of Toronto.
Southern Georgian Bay
Where Doctors Practice Their Art!Where Doctors Practice Their Art!
Create a flexible career by combining a family practice with Emergency or Hospitalist positions.
Financial incentives and relocation costs provided.
Family MedicineInternal Medicine
Emergency MedicineHospitalist
Opportunities in:
em
plo
ym
en
t op
po
rtun
ities
Available immediately for aCanadian-trainedOphthalmologistinterested in an
Anterior Segment andRefractive Surgery Fellowship
For more information, please contactAnnette Stanwick, Vice-President,Medical Affairs, Gimbel Eye Centre,Calgary, Alberta, Canada at(403) 202-3318 ortoll free: (800) 661-1138 orsend a curriculum vitae via e-mail toAnnette Stanwick atastanwick@gimbel.com
UNIVERSITY-AFFILIATED FELLOWSHIP POSITION
28 JuST FOR CanaDian DOCTORS november/december 2010
em
plo
ym
en
t o
pp
ort
un
itie
s
Fort Smith Health & Social Services Authority 41 Breynat Street P.O. Box 1080 Fort Smith, NT X0E 0P0
Fort Smith Health and Social Services Authority Is seeking Family Physicians
For Locums - 1, 2 &3 year Contract & Permanent Positions
Experience the North
Fort Smith, the garden capital of the NWT, is a community of 2,500 residents located off of the mighty Slave River just one mile north of the Alberta border. This community provides a variety of social, recreational and cultural activities. Being
surrounded by a vast natural setting, it is an ideal location for outdoor enthusiasts. Here you can spend the long summer days
golfing, camping, fishing, hiking and kayaking or tending to your garden. Winter days can be filled with snowmobiling, cross-country skiing, snowshoeing, hockey, curling
and a whole lot more.
For more information contact: Mahalia Villebrun, Physician Recruiter
fshssa_exec@gov.nt.ca T: 867-872-6257 F:867-872-6291
Insertion Date Media Section Size PriceNovember Issue Just for Canadian Docs Careers 1/2 page $2200
ESTIMATE 1010-004
santé
Sud-Est
health
So
uth
Eas
tman
Family Physicians. Come for the career you imagined, and the lifestyle you couldn’t.
At SEH, you’ll experience all the benefits of rural practice – a flexible, diverse and secure career, hands on patient-focused care, plus affordable living & a more balanced, healthy, community-oriented lifestyle for you and your family.
FOR MORE INFORMATION, PLEASE CONTACT:
South Eastman Health Medical Administration Office Tel: (204) 424-5880 Email: corp@sehealth.mb.ca
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30 JuST FOR CanaDian DOCTORS november/december 2010
Have you ever found yourself frozen, hand hovering mid-air in the Italian section of your local wine store?
unsure exactly how to narrow down and choose between bottles that all claim to be classic Italian wines from the best regions?
This is the common theme I hear regard-ing Italian wines: How does one learn to navigate confidently among Italy’s best-known wines given the country’s hundreds of varietals, thousands of vineyards, and numerous wine-producing regions?
The best place to start is the ABCs of Italian wine: Amarone, the killer Bs (Barbaresco, Barolo and Brunello) and
Chianti. In this issue I’ll explain the regulatory structure behind the Italian wine alphabet (next issue I explore the regions and varietals behind these five giants of the wine world). once you learn your ABCs, choosing your next bottle of red is a walk in the vineyard!
Before we zero in on some of Italy’s most influential vino, briefly vinify your brain and consider the hierarchical organization of Italian wine. Italy produces more varieties of wine than any other country in the world and employs a complex regulatory structure to keep tabs on its legions of producers.
If you take a closer look at the top of certain bottles, you’ll notice they say Denominazione di Origine Controllata, or DoC, while others say Denominazione di Origine Controllata e Garantita, or DoCG. These labels guarantee that the contents of the bottle
conform to strict industry standards for a particular type of wine. A DoC or DoCG designation can only be used by producers that make wines according to the tradi-tional recipes of their particular region, and only certain recipes have been granted government recognition. DoCG wines are more prestigious than DoC wines because they are held up to special tasting stan-dards. Today there are 37 DoCG wines and Amarone, Barolo, Brunello, Barbaresco and Chianti all have this designation.
Ranked below DoC/DoCG wines are those in the IGT category, Indicazione Geografica Tipica. The contents of bottles
with this label can also lay claim to a specific region or, with recent changes in regulations, be a blend of one or more varietals, thus not conforming to DoC or DoCG rules. Some producers who felt confined by the rigid recipes of the DoC denomination chose to experiment with 100% varietal wines or other blends known as Super Tuscans. I explored these at length in another issue (please see the May/June issue of Just for Canadian Doctors) so will just note here that these adventurous vintners can now affix the IGT stamp to their bottles. Previously, Super Tuscans fell into the final category, VDT, Vino de Tavola, or table wines. These are the most basic Italian wines; they lay no claim aside from “made in Italy.”
understanding Italian wine requires more than an appreciation of the coveted
pink DoCG label. when you peer into the ruby-red depths of your next purchase, you should know what grapes you are about to savour, and where they originate.
There are 20 wine regions in Italy, but these are the standouts: Valpolicella in the northeast; Valle d-Aosta, Lombardy, Liguria and Piedmont in the northwest; there’s Tuscany, of course, in the centre, along with Emilia-Romagna, umbria and Latium; and in the south, there’s Molise, Campania, Calabria and Puglia. Some, like Lombardy in the northwest, are best known for their sparkling wines, while others—take Puglia in the south—were long known for mediocre
reds but have recently produced some high-quality blends. All these regions contain both DoC and DoCG zones. Sometimes these zones overlap—the most obvious example being Tuscany, which is home to multiple DoCGs. This is possible because while the main varietal may be the same, the exact blends differ according to traditional recipes.
So, where do the ABCs originate? Amarone hails from the northeast region of Valpolicella, Barolo and Barbaresco are from Piedmont in the northwest, while Brunello and Chianti are both natives of Tuscany. Before we get better acquainted with this Italian wine alphabet, pick up some DoCG wines, sit back, sip and savour…and in my next column, we’ll study our ABCs. Arrivederci until we journey to Valpolicella!
italian wine 101
t h e w i n e d o c t o r d r . n e i l p o l l o c k
Part 1: How to decipher that label—especially with more wine varieties than anywhere else
Dr. Neil Pollock is a member of the Wine Writers’ Circle of Canada; visit his website on wine at vinovancouver.com or send feedback to drneil@pollockclinics.com.
He practises no-scalpel, no-needle vasectomy and infant circumcision.
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The hills and vineyards of Piedmont—known for Barolo and Barbaresco wines. middle Harvesting grapes in Piedmont.
The monastery of Badia a Passignano, dating from 890, sits amidst the vineyards of chianti.
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32 JuST FOR CanaDian DOCTORS november/december 2010
greatThe Spice Island embraces all the senses. Inhale, imbibe, indulge, engage + explore this Caribbean wonder—from leafy callaloo to rich chocolate…
t r a v e l t h e w o r l d
B am. Ba ba ba ba ba bam. Ba bam. It’s friday night in Gouyave, a little fishing village on the north end of Grenada. Drums are beating, locals singing, children giggling…fresh seafood is sizzling on open grills. The air is still heavy with the day’s heat, and now the
steaming food from busy stalls. The scent of savoury “oil down” stew mixes with sweet local lobster.
There’s a party going on. It’s the weekly fish fry, where locals and visitors
alike can sample piles of crispy jackfish with a frosty bottle of Carib, the island’s local brew. when the bounty is this fresh and flavourful, you need to celebrate.
A tiny jewel at the southern end of the chain of Caribbean islands, Grenada is just 100 miles off of the coast of South America. Christopher Columbus was an early enchanted visitor in 1498. He named the island Concepción, a fitting name for the jungle-covered hills, gushing mountain streams and waterfalls, rugged cliffs and soft beaches that rose out of the sea when the island was created in an ancient volcanic eruption.
Today, this lush landscape is largely unspoiled. And at its edges are pockets of charming communities. The small, hilly, seaside town of St. George’s is steeped in history, from long-gone explorers to modern-era communist coups. The colonial capital has retained its french and British legacy with charming red-tile roofs, grand hilltop forts, smiling school children in uniform, a bustling open-air market, and even cars on the left-hand side of the road. And the port town’s deep, natural harbor, the Carenage (from the french word for where ship repair took place shoreside), has long lured sailors into its perfect horseshoe shape.
More towns dot the 21-mile-long and 12-mile-wide island, each with its own character, from Gouyave, with its friday fish fry, to Sauteurs on the wilder north end of the island, where the last indigenous people, the Caribs, are said to have leapt to their deaths rather than succumb to french rule.
Along the way are serpentine roads that jostle and delight at the same time with unending views of the sea, jewel-tone boats resting ashore, dripping boys carrying home a silvery catch, peeks inside humming rum shops, and walls of green fronds at the edge of dense tropical forest. All this in a drive that, from tip to tip and from placid Caribbean to churning Atlantic, takes less than a day.
Beyond this is the beach…Grenada boasts string after string of pristine sand dotted with resort sanctuaries. Stroll the beach or loll by a seaside pool on miles-long Grand Anse Beach with its posh properties or the more secluded and cliff-hugging Magazine Beach.
And taste the island—again and again. Sample fresh-caught seafood and local fare like the national dish of oil down, a savoury concoction of seafood, callaloo (a leafy green plant similar to spinach), coconut milk and spices.
or chocolate…The Grenada Chocolate company is a tiny, humble facility that processes some of the world’s finest chocolates (Lindt sources most of its chocolate here). A somewhat stronger sample of Grenada’s bounty (in terms of potency, that is) is Rivers Rum at the River Antoine Rum Distillery. This ancient distillery has been operating in Grenada since 1785. Take a guided tour from a local and marvel that the original water mill still functions as it did when Grenada was a french colony. for a non-alcoholic quencher, the island is known for flavour-packed smoothies featuring local goodies like paw paw (papaya). The best are rumoured to be at a strip mall just outside St. George’s but the Run Down at Spice Island Resort is a liquid treat—sea moss (an aprhodisiac), coconut cream, banana, nutmeg.
Nutmeg is in just about everything here. It’s such a part of island life that it adorns the country’s flag. There’s also ginger, saffron, cinnamon, clove, vanilla (and that chocolate!). A visit to one of the island’s spice processing plants reveals why Grenada is called the “Spice Island.” Then there’s bright red sorrel, leafy green callaloo, banana, mango, coconut, paw paw…The volcanic soil here grows vegetation unlike anywhere else; this land is so lush and fertile that it’s said if you put a stick in the ground it will sprout. A short trek into the Grand Étang National Park and forest Reserve reveals the bounty…
Crunch, crunch, crunch. footsteps reverberate over broken nutmeg shells that coat a trail through the moist quiet of rainforest. Starting at a plantation that grows banana, tonka bean, and cacao trees, a tight trail plunges into the Seven Sisters falls Valley, where it’s lined with big blooms of ginger and birds of paradise and towering stalks of bamboo. Mona monkeys watch from deep within the green. Lower in the valley, the air thickens and the falls roar as chocolate-like mud sucks up a last crunch. Squelch.
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stay Spice Island Beach Resort is a luxurious place to rest your head—and entire body (there’s a spa here as well, naturally). The posh resort is on miles-long, white-sand Grand Anse Beach, and a member of the Small Luxury Hotels of the World network. Here, you’re a guest of Sir Royston Hopkin, K.C.M.G. (he was knighted for his work in promoting local tourism). Stay beachside and listen to waves while in bed or opt for one of the sleek hideaways with a private plunge pool (midnight skinny dips are definitely in order). Bliss! spiceisland-beachresort.com
sample The Grenada Chocolate Company’s organic dark chocolate is amongst the finest in the world: grenada-chocolate.com
go For more info on the Grenadian islands of Grenada, Carriacou and Petite Martinique, go to: grenadagrena-dines.com
Grenadastory + photos
by Barb Sligl
t r a v e l t h e w o r l d
Grenada’s bounty at one of the island’s spice processing
factories. nutmeg is the Spice Island’s prize product, seen here with its lacy red coating of mace.
a local “Butterfly” diving one
of the Seven Sisters Falls in
Grand Étang national Forest.
Private pool in a luxury almond Suite at the Spice
Island Beach Resort.
More of the island’s bounty for breakfast at the Spice
Island Beach Resort.
View of St. George’s and the carenage from the French-colonial-era
Fort George.
cliff-hugged Magazine Beach, a local favourite.
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Recently I was reminded of how won-derfully indulgent Sunday brunch can be. The beauty of brunch at home is
that you wake up late to a leisurely breakfast/lunch—all the while in your jammies. Brunch can be simply a large hearty breakfast of eggs, bacon and pancakes or something fancier but still easy…such as crepes.
A crepe is just a batter of eggs, milk, flour and butter (make the batter overnight, and let it sit for at least two hours for light, thin crepes). yet this simple mix can be an elegant wrap for other ingredients.
Crepes made with buckwheat or whole-wheat flour have a subtle eggy, nutty flavour—a delicious foil for crispy bacon-wrapped asparagus. Choose fat asparagus shoots without white woody ends; they have a silky sweetness when broiled. Top crepes with a poached egg and serve with citrus salad.
when poaching the eggs, the water should be lightly salted and barely bubbling. use fresh eggs so the whites won’t spread out as much in the water. Let the eggs sit for three minutes so that the whites barely solidify and the yolks are still runny. If you let the yolk harden even the slightest bit, you’ll miss out on a delicious creamy sauce. The overall effect is unbeatable: fatty, sweet, salty, meaty, creamy and tangy.
A champagne or sparkling wine is a perfect accompaniment. The crackling effervescence, acidity and lower alcohol counterbalance the dish’s salty richness. The non-vintage Champalou Brut Vouray pairs beautifully. It has a delicate floral nose with a hint of honey. on the palate, it’s full of foaming mousse that tastes of stony peach with toasted almond. It ends dry with strong acidity to cut through the bacon’s fat yet isn’t rendered sour by the citrus. Bon appétit!
the food doctor dr. holly fong
bacon-wrapped asparagus crepes with citrus salad (serves 4)
Dr. Holly Fong is a practising speech-language pathologist with three young children who is always trying, adapting and creating dishes.
craving crepes
16 spears of asparagus, rinsed and patted dry
1 package of sliced baconcitrus salad2 blood oranges or
tangerines 1 pink grapefruit 1 navel orange seeds of 1 pomegranate1 tablespoon chopped
chives2 tablespoons extra virgin
olive oil 1 tablespoon sherry vinegar ½ teaspoon honey lime juice to tastepinch of saltpepper to taste
eggs4 large eggs (1 per person) crepe batter½ cup whole wheat flour½ cup white flour¼ teaspoon salt1 ½ cup whole milk, plus
more if needed2 large eggs2 tablespoons melted
unsalted butter, unsalted butter for skillet
Peel fruit; using a sharp knife, cut off both ends at the poles to expose flesh and make a flat surface to stand upright. Then cut close to the pulp, slicing off skin in strips and removing the pith. Over a medium-size bowl, cut along the inside of the membranes separating the segments to the centre of the fruit. Cut each section into the bowl, discarding the membrane. Add pomegranate seeds.
In a small bowl, whisk together olive oil, vinegar, honey, lime juice, salt and pepper. Add chopped chives. Taste, adjust seasoning and drizzle over citrus salad. Set aside.
Set oven to broil. Place a wire rack into a large cookie sheet. Trim asparagus ends and peel halfway up the spear. Twirl bacon around each spear, stretching to cover the tip. Place on prepared rack. Don’t crowd the spears to allow the bacon to crisp.
Make the crepes; whisk together salt and flours in a large bowl. Whisk eggs and milk together in another bowl. Stir egg mixture into the
flour mixture. Add butter, stirring to combine. Batter should be the consistency of heavy cream; add more milk if needed. Refrigerate batter for at least 2 hours.
Heat a 12-inch fry pan over medium heat. Coat bottom with pat of butter. Ladle 1/3-cup batter into pan, tilting to spread evenly. Cook until top of crepe is set and centre is lifted by pockets of air, about 1 – 2 minutes. Run a spatula around the edges to loosen and flip. Cook until bottom is firm and golden brown, about 1 minute. Transfer to a plate. Repeat with remaining batter, buttering pan as needed. Cover plate of crepes to keep warm.
Put the pan of wrapped asparagus on the top rack of the oven under broiler for 4 – 5 minutes per side until the bacon is crisp. Turn over. Keep warm. Meanwhile, poach eggs.
Roll 2 bacon-wrapped asparagus spears inside crepe. Repeat. Plate 2 rolls with citrus salad on the side. Top with poached egg.
Try crepes for a luxurious weekend brunch at home
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36 JuST FOR CanaDian DOCTORS november/december 2010
the wealthy doctor manfred purtzki, c.a.
Manfred Purtzki is the principal of Purtzki & Associates Chartered Accountants. You can
reach him at manfred@purtzki.com.
The majority of physicians stops worry-ing about their finances once they have accumulated a net worth of $1.5 million
(not counting the value of their principal resi-dence and household belongings). A retirement nest egg of $1.5 million at age 60 is estimated to produce an after-tax and inflation-adjusted cash flow of $6,000 each month for the rest of your life, or $72,000 annually. As a rule of thumb, it’s wise to plan for an annual retirement income of at least 50% of your pre-retirement after-tax an-nual income derived from your medical practice.
So, is your savings plan sufficient to generate that level of income? Here are some suggestions for optimizing your savings to pay for the post-career lifestyle you want:
1. Maximize after-tax practice cash flow through incorporation. unless your annual in-come is less than $100,000, you should consider setting up a medical corporation. Any income retained in the corporation is taxed at the low Small Business tax rate, which ranges from 12% in PEI to 19% in Quebec. ontario’s rate is 16%. By investing cash surplus in the corporation, rather than distributing it to the shareholder, the tax deferral benefit is about 30%—the difference between the corporate tax rate and the maxi-mum personal tax rate.
2. draw funds only to live on and not to save. To reduce personal taxes to the absolute minimum, only take funds from the corporation to pay for living expenses and house mortgage payments. There is little benefit in making an RRSP contribution from corporate funds, since the tax benefit of the RRSP deduction is reduced by the tax you pay on drawing the RRSP funds from the corporation in form of a taxable dividend or salary. for the incorporated medical practice, the Tax-free Savings Account (TfSA) makes no sense because you need to take a $7,000 dividend from the corporation and pay $2,000 of income tax, so that you have $5,000 left to contribute to the TfSA. It’s an expensive proposition! you are better off keeping the $7,000 invested in your corporation where it enjoys a much reduced tax rate.
3. Take advantage of income splitting. Paying a salary or dividend to family members in a low-tax bracket is number-one tax shelter
for physicians. The best tax savings are with children attending a post-secondary institution because you can allocate a dividend sufficient to absorb a substantial portion of their tuition and education costs. It is not unusual to allocate a $60,000-$80,000 dividend to a student without any personal taxes, producing a tax saving of about $20,000.
4. Make home mortgage repayment a priority Before you start your investment program, pay off the mortgage first. Investing in the repayment of a 4% non-deductible mortgage rate is equivalent to an investment return of 7%, which is all but impossible to achieve today in any low-risk investment, much less a zero-risk investment such as mortgage repayment. Physicians who still face a large mortgage burden in their 50s are facing a future of considerable financial pressure because the available cash surplus that should be going toward retirement funding is being used to pay off the home mortgage. This financial squeeze is often exacerbated by the need to provide financial support to children for their post secondary education.
5. Buy assets not liabilities. In our experience, the major purchases doctors have regretted include boats, recreational properties, and even condo purchases for children attending university. These purchases are often made on impulse without the consultation of a financial advisor. Generally speaking, recreational proper-ties do not support themselves, they are often under-utilized by family members, they require time and effort to maintain, and when the real estate market is soft, as it is now, the value of a recreational property drops the most. Same goes for post-study condos left vacant by kids that have moved on. Rent instead.
6. Invest conservatively. The medical corpora-tion is a safe and bountiful savings tool. It allows you to invest $87 dollars out of a $100 pre-tax practice income (assuming a 13% corporate tax rate), whereas the individual with a personal tax of 43% can only invest $57 dollars. The low corporate tax allows you to build up a sizeable portfolio without exposing your capital to the risks of the market. Many doctors in fact have done better over the past few years investing
their savings in conservative vehicles, such as GICs, rather than investing in the stock market. An effective method of savings is the “out-of-sight, out-of-mind” plan. Each month, take a por-tion, ideally 10% of your gross practice income, and automatically transfer it to a corporation savings account. Don’t be concerned about the tax you have to pay once you withdraw the funds during your retirement. you’ll be in a lower tax bracket, and can split the dividend income with your family.
Consider what your income needs are likely to be after you retire from your practice and what you need to do between now and then to make sure you will have that income avail-able to you. There are many options, but just going to the office and hoping it will take care of itself is not one of them.
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november/december 2010 JuST FOR CanaDian DOCTORS 37
solve puzzle #2 for a chance to win a tec-Wool cap and ivy cap in the take on Winter Wearing tilley pack (worth $150)
sudoku is simple enough that anyone can play, yet difficult enough that anyone can improve at it.
each sudoku puzzle has a unique solution that can be reached logically without guessing. Fill in the grid so that every row, column and 3x3 square contains the digits 1 through 9.
winner of last issue’s sudoku contest:
Dr. patricia edgar of Banff, aB
sudoku
15
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sudoku puzzle contest rules: 1. entry form must be accompanied with solved puzzle. only correctly solved puzzles will be entered into random draw. 2. Send puzzle & entry form to Just For Canadian Doctors, 710 – 938 Howe Street, Vancouver, BC, V6Z 1N9 or by fax to 604-681-0456. entries must be received by february 18, 2011. 3. prize: take on winter wearing tilley pack. odds of winning dependent upon number of entries. winner will be contacted by telephone and announced in the spring 2011 issue. 4. contest can be changed and/or cancelled without prior notice. 5. all entries become property of in print publications. employees of in print publications and its affiliates are not eligible to participate.
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wealth building tipsIs your savings plan sufficient to generate the post-retirement income you want?
38 JuST FOR CanaDian DOCTORS november/december 2010
My name: David May
I live and practise in: Powell River, BC
My training: MD, university of London; GP Anaesthesia, uBC, Vancouver; MRCGP, university of Nottingham
Why I was drawn to medicine: Medicine is an Applied Science
where I could make a difference and in family Practice I can see the continuity of life.
My last trip: Cornwall, England: A blissful coastal hiking holiday be-tween picture perfect fishing villag-es and eating at niche restaurants.
The most exotic place I’ve trav-elled: Hanoi, Vietnam: where the rules of life are completely re-writ-
ten. It was refreshing to not know what was going on.
The best souvenir I’ve brought back from a trip: $250 worth of saffron from a market in Catalonia, Spain. I was travelling with my choir and three of us beat the saffron dealer’s price down.
A favourite place that I keep
returning to: The united kingdom is where my heart is.
My ultimate dream vacation: Having time to wander European back roads finding family-run hotels. To experience those serendipitous events that are part of the ethos of those countries.
If I could travel to any time, I’d go to: Renaissance Europe: spectacular
but dangerous. or Ming Dynasty China: breathtaking and scary.
My favourite book: Captain Corelli’s Mandolin, by Louis de Bernières
My favourite movie: [several!] The Jungle Book,
Butch Cassidy and the Sundance Kid, Amélie. La Jetée, Star Wars
My first job: Gardener at the local school in London.
The gadget or gear I could not do without: Bottle opener
My favourite room at home: Bedroom
My car: Vw Golf
My last purchase: A selection of wines to serve my friends at a locavore meal.
My last splurge: 2004 Bordeaux: I am saving it for my 50th birthday.
My closet has too many: of my wife’s clothes in it.
My fridge is always stocked with: Good cheese
My medicine cabinet is always stocked with: Tylenol
My guilty pleasure is: fresh sourdough croissants and newspapers on Saturday mornings.
My favourite exercise/sports activity: Swimming
My celebrity crush: Juliette Binoche
I’d want this item with me if stranded on a desert island: A barbecue to cook the wonder-ful fish I would catch.
My secret to relaxing and relieving tension: Not bringing work home
A talent I wish I had: Ease with foreign languages
My scariest moment: failing the exam when I was a new
doctor in Canada, with a young family.
My fondest memory: The birth of my children
A big challenge I’ve faced: keeping a healthy balance between work and family.
I’m inspired by: Classical music, great food, wine and art..
My biggest ego boost: My wife thinks I am great occasionally
My biggest ego blow: The low opinion which my teenage children hold of me
I’m happiest when: I am with people who love me.
A cause close to my heart: Palliative Care and Chronic Pain: two fields where there is room for huge improvements
Something I haven’t done yet that’s on my must-do list: A walk-ing tour of Tuscany
If I wasn’t a doctor I’d be: A restaurant critic
sm
al
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al
k d o c t o r s s h a r e t h e i r p i c k s , p a n s , p l e a s u r e s a n d f e a r s
This physician loves his food, from mango in Mexico to pine mushrooms foraged at home. If he wasn’t a doctor, he’d be a restaurant critic. As his wife says: “David is a gourmand who savours traditional and new flavours in life and on the table. He just walked past me with two cucumbers he picked from his greenhouse, so I know that we will share a fresh salad tonight.” She adds, “He loves to share his passion with friends, and I am so lucky that he shares his life with me.”
Co
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ESy
DR
. DA
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MAy
from top Dr. David May skiing with his daughter Kate at Mount Washington on Vancouver Island; Escaping bulls while hiking in the Wye Valley in England; Sampling fresh mango and
coconut in Cholula, Mexico; Above the town of Monterosso in the Liguria region of Italy.
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