SUMMER 2012

inside: Continuing mediCal eduCation CalendarPublications Mail agreeMent #41073506

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where will you meet? montpellier / riga / taipei / barcelona / hollywood >>

Doctors

wina VISA gift card + Cayman Islands Gift Pack!see page 29

+ new geNe test + reminisce in

MOTOR CITY+ saN dIegO suds+ study aBROad+ TRaVeL pHOTO

TIps from our pRO

luxury lodge in BC

unexpeCted

israel

Summer 2012 Just For canaDian Doctors 3

13

FeatureS

13 luxury lodge Fishing + fine food on Vancouver Island

18 holy holiday Culinary + natural pleasures in Israel

ColumnS9 techworks

It’s in the genes

10 photo prescription Face to a place

12 doctor dispatch A med student’s summer

16 the wealthy doctor Study abroad

17 doctor on a soapbox Overqualified for menial work

30 the thirsty doctor San Diego suds

31 the hungry doctor Soup’s on

32 motoring Motown muscle

Summer 2012 ContentS

dePartmentS

5 summer mix

23 CME calendar

29 sudoku

34 employment opportunities

38 small talk with MD student Alison Read

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DoctorsJ u s t F o r c a n a D i a n

life + leisure

summer 2012

editor and Art Director Barb sligl

editorial Assistant Adam Flint

Contributors Lucas Aykroyd Yvette Cardozo michael DeFreitas Dr. Holly Fong Tim Johnson Taylor Kennedy mélanie Paul-Hus Dr. Chris Pengilly Dr. Neil Pollock manfred Purtzki Alison read Dr. Kelly silverthorn Corey Van’t Haaff Cover photo micky Wiswedel

senior Account executive monique Nguyen

Account executive Wing-Yee Kwong

sales, Classifieds and Advertising In Print Circulation Office 200 – 896 Cambie st. Vancouver, BC V6B 2P6 Canada Phone: 604-681-1811 Fax: 604-681-0456 email: [email protected]

Associate Publisher Linh T. Huynh

Production manager Ninh Hoang

Circulation Fulfillment shereen Hoang

Cme Development Adam Flint

Founding Publisher Denise Heaton

Just For Canadian Doctors is published 4 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 Publications200 – 896 Cambie street Vancouver, BC V6B 2P6 Canada

www.justforcanadiandoctors.com

Printed in Canada.

miss an issue? check out our website!

cover photo: Salt crystals form on rocks on the shore of the Dead Sea. For more on the unexpected side of Israel go to pages 6 and 18.

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4 Just For canaDian Doctors Summer 2012 Summer 2012 Just For canaDian Doctors 5

summer heats up

f r o m t h e e d i t o r

For most of us summer is synonymous with the great outdoors, whether that be cycling through wineries in

France or fishing in chilly mountain streams in BC. two types of adventures that happen to be part of our summer-getaway lineup this issue…

First, escape to…BC. Central Vancouver Island, surrounded by the dense forest of century-old Strathcona park, is virtually undiscovered. which is why there happens to be a rather luxurious lodge to hole up in. not only is the fishing world-class but the lodge is a mix of high-end and down-home, making it the place to retreat this summer (page 13).

Somewhere else that’s unexpected: Israel. It’s long been a place of pilgrimage but this tourist friendly haven in the Middle East offers everything from fabulous food and wine to desert mountain biking and

surfing (page 18). Discover the unexpected Israel.

wherever you go, be sure to pack that camera. And utilize the travel photography tips from our award-winning pro. this issue he shows us how to put a face to a place. we’ve all taken photo after photo of landscapes that tend to blend into one another after awhile…to make your photos and adventures stand out, start taking photos of the local people you meet on your travels (page 10). And send us your shots!

we want to know where your travels take you this summer. let us know what you’re up to—at home and on the road— and send us your photos and questions. And keep your subscription going at justforcanadiandoctors.com. Enjoy!

[email protected]

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clockwise from top Scenes from The

Lodge at Gold River, a luxury escape into the

wilds of BC.

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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 …

It’s not everyday you meet a count. But at Château de Flaugergues you’re likely to bump into Pierre de Colbert, the 10th-generation comte who oversees this “House in the Foliage.”

It’s one of the many châteaux or “Follies” built in the Montpellier coun-tryside at the end of the 17th century as part of a new order of aristocracy. Today it’s part family home, winery, restau-rant, event venue and even museum. “We have been trying to keep the place alive,” he says.

And you can see just how by touring this slice of life in the south of France. Inside the gorgeous château is an imposing central staircase, finely wrought tapestries, ornate Louis XV fur-niture, Limoges porcelain and exquisite artwork, from engravings by Rembrandt to portraits of past occupants (including one who was beheaded). But the main charm in touring the home is hearing its history from the comte himself (his tales peppered with lovely French expressions like “Et voilà…” throughout). This comte courant is very down-to-earth.

Outside, gorgeous gardens showcase both French and English styles, from kumquats and meticulously maintained hedges to an orangerie and olive-tree alley. And, of course, the vines. Flaugergues has French wine with great value; “This is the nouveau wine style in old-world wine,” says the count. He sees a bottle of wine as a book, and Flaugergues’ Cuvée Sommelière, for instance, is “a book you can read every day.” There’s also Cuvée Foliae, Cuvée de l’Uncle Charles and Cuvée Les Comtes, of course.

Try them all at Folia, Flaugergues’ courtyard restaurant, where you can live the Follie lifestyle, at least over a lengthy lunch under the Mediterranean sun. As the comte says, rather abstractly, “Tradition means everything and nothing.” There’s no pretentiousness here, but plenty of thoughtfulness. This 10th-generation count is definitely of today. flaugergues.com —B. Sligl

the wine counta sTORIed CHâTeau + wINeRY IN THe LaNguedOC-ROussILLON RegION Of sOuTHeRN fRaNCe [for more on this region + montpellier go to page 23]

tour+taste

m i xw h a t / w h e n / w h e r e > s u m m e r

above Fettucini with Truffle at Rouge, one of Rouge Restaurant’s signature dishes. far

left The Calgary dinner took place at Rouge, where Paul Minich, Canadian Representative

for The Cayman Islands Department of Tourism, awarded contest-winner Dr.

Susan Beairsto, an all-expenses-paid trip to the Cayman Islands. near left The dinner in

Vancouver took place at the award-winning Hawksworth Restaurant. In attendance were:

Dr. Aniz Khalfan, Dr. Alexander Shearer, Dr. Iain Cleator, Dr. M.M. Cleator, Dr. Kathryn Fung,

Dr. Derek Smith, Dr. Jacquie Hurst, Dr. Karen Kruse, and Dr. Michael Woolnough.

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The Cayman Islands Department of Tourism and Just For Canadian Doctors magazine hosted two dinners at two of Canada’s hottest restaurants: Hawksworth Restaurant in Vancouver, and Rouge Restaurant in Calgary. Chef David Hawksworth and Chef Paul Rogalski attract plenty of buzz locally, nationally and beyond. And Chef Rogalski will be the next Canadian guest chef to join celeb Chef Eric Ripert for the annual Cayman Cookout. It’ll be another feast to remember, with gourmet fare served amidst sun and sand. And, while it may not have been in the Caribbean, a few lucky Just for Canadian Doctors readers feasted on fine food and wine closer to home. Next time: the Cayman Islands! We’ll ask the grand-prize winner of the all-expenses-paid trip, Dr. Susan Beairsto, about her Cayman Islands experience…


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Food is not ex-actly what you think of when you envision a trip to Israel.

But yes, you can nibble, chew and otherwise eat your way across this country, where a meal is full of fresh, organic veg-gies, fruit, fish and meat.

the echo of Middle Eastern culture touches everything whether it’s at a kibbutz, an Arab falafel shop, or an ethnic minor-ity restaurant tucked in someone’s home on a narrow, hairpin road high up some mountain.

One of your first must stops: a falafel/shish kabob place in the Arab sector of Jerusalem’s Old City or on a day trip to Bethlehem. the fresh, homemade hummus, creamy and tangy, will utterly ruin you for the store-bought junk back home. It’s served with pita bread, tender chunks of lamb and/or grilled vegetables on a skewer, and of course, falafel, the fried ground-chickpea

balls or patties.On to a Druze

dinner…the 100,000 Druze, believers in a 10th-

century Egyptian reli-gion, live in 16 villages

across Israel, usually high atop a mountain among a spiderweb of narrow roads. It’s not typical for Druze to be open to outsiders, making Amal Dabbour’s restaurant and B&B in Beit Jann quite special. the meal here is made up of small dish after dish…like eating a dozen appetizers for dinner. In fact, this is how

you order. think 14 dishes, soup and three meats for 100 shekels (about $26) apiece…semolina with onion, eggplant, hum-mus, lentils with wild (yes, Amal gathers it himself) anise.

then drive into the golan heights. Citrus trees crowd the hills, so loaded with oranges, grapefruit and lemons you can hardly see the leaves. And here’s where you discover the story of modern Israeli wine.

the problem with kosher wine is it’s boiled to pasteurize it so that Orthodox people can serve it. this pretty much destroys any taste and aroma. But 30 years ago, a handful of wineries started producing non-kosher wine and today, 300 mostly boutique wineries are scattered across northern Israel.

And the wine, well, it’s quite good…varied, light when it should be light, full bodied when it should be that.

For what may be your single finest meal of the trip go to Muscat, the meat restaurant (restaurants in Israel are either meat or dairy/fish) of hotel Mizpe hayamim in Rosh pina. the resort is part farm, part spa, part hotel. they grow organic produce on 30 acres, raise their own lambs, goats and cows, make their own cheese and soap. the goat here is so tender, it falls off the fork.

then there’s the Sea of galilee, where you can sample “peter’s fish,” farmed tilapia that’s breaded and fried whole

into a crispy, tender creation. there’s also a roadside coffee shop that sells spices from dozens of open bins, and another spice shop buried in tun-nels under the old city of Acre that’s so small, it has neither website nor email address. But owner kurdi hamudi has, among other things, 12 different kinds of curry powder.

Back in Jerusalem, there’s the wonder of Mahane yehuda Market with its meats, fish, produce, 1,200 different cheeses from one tiny hole in the wall, halvah and pastries. And, halvah, made from sesame-seed paste, survives quite nicely in your suitcase coming home.

But before leaving, top the foodie tour by cooking dinner along-side Israeli celebrity chef tali Friedman. Split into groups, you’ll either smash veal flat for carpac-cio, cut vegetables for salad, make fish balls, cook peppers or handle delicate filo pastry for a caramelized apple-filled dessert.

“I can’t believe I’m cooking in Jerusalem,” someone exclaims in wonder. And eating in Israel…a truly wonderful place to gain five pounds. — Yvette Cardozo

IF YOU GO Eat your way through Israel: Dine at Druze Restaurant, hvaya.com/art.php?ID=9, then at Hotel Mizpe Hayamim: mizpe-hayamim.com, and take a cooking tour and class with a celebrity chef, haatelie.com. And for more on Israel go to page 18 and goisrael.com.

a taste tour of Israeltour+taste

m i xget geared upIs

rael

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st travel smart

1. RubbeR made add more colour to your summer get-ups with an oversized, lightweight, water-resistant and, yes, rubber watch. Get in on the season’s hottest colours (hello yellow and bring it on purple) or create your own custom combo (be it animal print or psy-chedelic) with this fun sports accessory. you’ll be on trend on the trail, beach, lake, green... rubrwatchnation.com

2. WeaRable aRt the message tee is a way to wear what you think. and be quite literal about it. make a statement with what you wear—whether it’s showing your reverence for The Origin of the Species or The Great Gatsby. out of Print lets you celebrate these great stories through fashion. a classic summer pick, for beachwear if not a beach read, is Moby Dick…after all this tome is much easier to wear than read. outofprintclothing.com

3. WateR aid summer is synonymous with the outdoors. and when you’re out there—hiking, biking, surfing, golfing, boating—you’ll need to hydrate. Keep your cool with this sleek stainless-steel water bottle. It’s insulated so the cold stuff stays that way for 24 hours (and anything hot stays steamy for 12). BPa-free, it comes in a rainbow of colours and variety of sizes (the 25-ounce s’well holds a bottle of wine very nicely) and, best of all, 10% of sales go to Wateraid, an orga-nization that provides sustainable safe water, hygiene and sanitation to the world’s poorest communities. swellbottle.com

4. luxe luggage the telltale grooves of the iconic aluminum case from rimowa are part of a timeless German design that’s been synonymous with stylish travel since the 1930s. and it’s hotter than ever. Lightweight and strong, with 360-degree wheels and tsa-approved locks, this salsa deluxe Business multiwheel in oriental red makes a red-hot mother’s day gift—anytime of year. Get ready to roll and jet set. rimowa.de —B. Sligl

Whether you’re on the road or in the air, here’s the gear for travelling in style this summer

gear

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4

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style on the go

2

Must-try Middle

Eastern dishes: hummus +

tabouli.

Grilled tilapia from the Sea of

Galilee.Spice it

up, from curry to smoked paprika.


Doctors know that on any given evening in any ER across the country, a patient may arrive complaining

of chest pains. these doctors know that, for patients with a narrowing or blockage in their arteries, a catheter might be inserted into the heart, a balloon used to open the artery, and a stent would be placed, allowing blood to flow. And doctors know that post-procedure, two medicines are routinely prescribed: aspirin and plavix (clopidogrel).

there is one more fact that doctors know and that’s that in some patients, plavix doesn’t work sufficiently enough to regulate platelet activity. when the body produces clots or sees the stent as a foreign intruder and reacts to that, these same patients can have subsequent cardiac events, and some die.

what doctors don’t know is how to ac-curately predict which of these patients will respond normally to plavix and which are more likely to have reduced platelet activity and have an increased risk of death.

until now.Drs. Jason Roberts, chief cardiology resi-

dent and Derek So, interventional cardiologist at the university of Ottawa heart Institute, had a plan. It was relatively common knowl-edge that some patients have a genetic varia-tion that makes them less likely to activate plavix well. If doctors could identify which patients were at risk, they could prescribe a different drug.

“the importance of the genetic vari-ant was discovered a few years ago,” says Roberts. “we know that with European ancestry, 30% is the variant; as high as 50% with Asian ancestry. the chance of having another cardiac event after a stent has been placed for a heart attack is approximately 5%, during the next year. If you add the genetic variation to that, it increases risk (in the people affected) by about 50% so they have a 7.5% risk.”

there was no question the risk was unac-ceptable. the question was, can anything be done?

“we wanted to find a test to determine who had the variant so we could treat them

differently. After we put in a stent, we start drugs immediately so the stent stays open as the first 24-to-48 hours is the highest risk period for the stent blocking off. to address this, we wanted to make a genetic test that could be done quickly and, ideally, at the patient’s bedside,” he says. they also wanted something that nurses could do with little additional training.

the doctors worked with Spartan Bioscience to create the Spartan RX Cyp2C19.

“people recognized that such a fast test would be useful, but it was generally felt that the technology was not available. we approached a biotechnology company that had focused on different forms of rapid DnA test-ing for other applications. After explaining the medical issue, the company appreciated the clinical need and ultimately developed a device that was ideal for the clini-cal setting,” he says.

the test is painless. At the patient’s bedside, a nurse swabs the patient’s cheek, places the swab in a tube, and then puts the cartridge in the machine—the Spartan RX—and gets results in an hour.

the doctors put the device through its paces in a proof of concept study called the Rapid gene Study. the timing of the study was ideal.

“Over the past couple of years, two new drugs, ‘cousins’ of plavix, became available that inhibited platelet activity and had both benefits and disadvantages. the advantage was these drugs were more potent and could inhibit platelets better to help keep the stent open. Both were shown to reduce the chance of heart attack or blockages relative to plavix in clinical studies.” he says. the disadvantage was an increased risk of bleeding which dis-couraged a wholesale switch of all patients to the new drugs.

“we knew it would be great to target the subset of the population that didn’t respond well to plavix and give them a more potent

drug and leave the rest on plavix. It would likely mean better clinical outcomes in terms of both heart attacks and bleeding.”

A point-of-care genetic testing device used bedside which produces results within an hour is revolutionary.

“It’s the first time in medicine that genetic testing has been done at the clinical bedside,” says Roberts. “there was a need for speed as people could react as soon as the stent went in. the new drugs are not affected

by this genetic variant.”the randomized study involved 200

patients. twenty-three patients in each group carried the variant. there were no cardiac events with either group within the first month.

“Bedside genetic testing is a radical change that will hopefully facilitate the inte-gration of genetics into daily medical practice by making it easy to perform and hence easily accessible,” says Roberts. “presently, the Spartan device is the only test capable of point of care genetic testing.”

the device is in use worldwide: in Canada it is allowed only for research; it is awaiting FDA approval in the uSA; and it is used as an approved clinical test in Europe.

how knowledge of a genetic variant created a world-class technological device

what doctors know

t e c h w o r k s c o r e y V a n ’ t h a a f f

Corey Van’t Haaff owns Cohiba Communications. She is Just for Canadian Doctors’ technology columnist.

Dr. Derek So (left) and Dr. Jason Roberts (right), researchers in the RAPID GENE study.

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10 Just For canaDian Doctors Summer 2012

p h o t o p r e s c r i p t i o n [ c o n t i n u e d ]

Why you should take photos of people:Put a face to a place. In photography of people, the goal is to capture their smile or interesting facial expression. And don’t let the lack of a smile stop you—a solemn or pensive look can speak volumes (just be sure the subject is okay with being photographed). ABOVE A Quechua or Uros Indian woman in one of the floating Uros Islands in Lake Titicaca, Peru. Fill flash was used with the sun behind and over her left shoulder. Shot was taken late morning. RIGHT A Quechua boy holding hands with his parents in Atuncolla, Peru. After a nod of approval from his parents, the photo was taken with the sun behind and a bit of fill flash. It’s another late-morning shot.

Send your photos and questions to our

photography guru at feedback@

inprintpublications.com and your shot may be featured in a future

issue!

p h o t o p r e s c r i p t i o n m i c h a e l d e f r e i ta s

M y most memorable experience on a

recent trip to peru was not Machu picchu or the beautiful rugged mountains, but the time I spent with the amazing uru people, who live on the floating reed islands on lake titicaca. I spent two hours photographing the women in their colourful dresses and simphanas (pompoms in their braided hair). the stark contrast between the drab, monotone huts and their vibrant costumes was both philosophically and photographically compelling.

Each year, in my photography workshops and seminars, I review dozens of travel portfolios packed with hundreds of images of sweeping landscapes, wispy waterfalls, mouth-watering food and impressive ancient ruins. unfortunately, I don’t see many people shots. And that’s too bad because the single most defining characteristic of any region is its culture, and few things define culture better than people.

So why don’t we shoot more people portraits when we travel? First off, most of us are terrified of approaching a stranger and asking if we can take their picture, and second, good portraits are more technically challenging than landscapes or ruins. good people shots require a ton of patience.

the biggest hurdle in photographing people is getting them to stop moving long

put a face to a place

Michael DeFreitas is an award-winning photographer who’s been published in a wide variety of travel publications. With his initials, MD, he’s been

nicknamed “doc,” making his photography prescriptions apropos.

whether haunting or heart-warming, here’s how to put a face on a destination

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PRO TIPS on people portraits> Try to shoot subjects in open shade, in a doorway or when

the sun is low. To avoid that squinting look, never pose subjects facing the sun.

> Crop tightly and try to use a shallow depth of field (f4 or f5.6 aperture) to blur distracting backgrounds.

> Check the background for posts or poles. Posts that appear to grow out of a subject’s head or shoulder have ruined many good portraits.

> Don’t shoot down on people––it can make them look small. Shoot level or from slightly below the level of their face. This is especially important when photographing children (get down to their level).

> Ask about local customs before shooting. People in some countries believe that cameras capture their souls.

> Grab shots are okay if asking permission will spoil the moment, but be cautious, you may get your shot at the expense of upsetting someone. We travel to learn, not to upset people.

> Imagine that your viewfinder is divided into a grid of thirds (two vertical and two horizontal lines). Try to place your subject’s eyes near one of those intersections.

Ready to take it to the next level?GEAr uP Wide-angle lenses can distort faces (camel nose) and long telephotos tend to flatten faces, so invest in a medium-range zoom (70 to110mm focal lengths). Most point-and-shoots include this range and DSLR zoom lenses that include this range run from about $300 to $500.

enough for you to get a well-composed shot. Most of the people we meet in our travels are busy with their daily lives and getting them to stand still for a portrait is difficult. Further complicating our task are language barriers, superstitious beliefs, skin tones, a person’s attire and their surroundings. All issues that test our ability to get good portraits.

After 20 years of shooting in some 80 countries I have learned that most people don’t mind having their picture taken. A polite smile and a few friendly words work wonders in establishing a rapport with your subject. So instead of trying to “sneak” shots, learn a couple of local greetings then move in close to get an intimate portrait.

Images of people looking directly into the camera, if done incorrectly, can accentuate round faces and produce that deer-in-the-headlights look. A good tip is to have your subject turn her head slightly away from the camera. then, try to keep the tip of her nose within her outer cheek line.

It’s always best to photograph people in shade, but I didn’t have that luxury on a floating island devoid of trees. So I positioned my subjects with the sun at their backs and used a bit of fill flash to brighten their faces. It took a couple of tries to get the exposure right, but my guide helped with instructions and conversation to relax the women.

good travel portfolios should include a selection of traditional close-up and environmental portraits. For traditional portraits remember to shoot vertical, fill the frame and place the subject’s face off center (use the rule of thirds). Environmental portraits work best when you include enough surroundings to connect the subject with his world. too much surroundings can be distracting, though, so play around with the composition.

I try to have fun with everyone I photograph. I even let some of the uru women take my picture. Of course this produced many laughs, and nothing spices up a portrait better than a smiling face.

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d o c t o r d i s pat c h a l i s o n r e a d

G rowing up in Vancouver, I never really considered the possibility of living in a smaller centre. I was a dedicated

urbanite, frequenting Starbucks and jogging the Seawall. however, my experience in penticton for rural family practice made me think twice about my future goals.

As I sped down the freeway towards penticton, I was excited to venture into the unknown. I had arranged to stay with my

dad’s friend Dave from medical school, a family doctor that I hadn’t seen in years. he greeted me at a lovely acreage in the hills of penticton, filled with orchards and gardens. the first night we had a savory moose roast, courtesy of Dave’s hunting prowess. As we ate, he told harrowing tales of his expeditions, and the cougars and bears he had encountered along the way.

I began my first day at 8 a.m. with hospital rounds, where I met a whirlwind of patients with my preceptor. It was exciting to be thrown into the medical world and given the opportunity to apply what I had learned. Over the following weeks, I completed physicals, pAp exams, excisions and suturing. patients and staff welcomed me and wanted to know when I would be moving there to fill their shortage of

doctors. In emergency, I helped reduce a

dislocated shoulder and assessed broken bones. I listened to rapid fetal heartbeats in maternity and witnessed the excitement of expectant parents. One night, Dave called me to help with a delivery. I assisted as the baby emerged and cut the umbilical cord. It was so surreal to finally see a birth; nothing like I had imagined. On another day, I visited

a dying man and his family at the hospice as they prepared for his last breath. he died shortly after we had left. with these experiences, it became clear to me that medicine is a diverse field where you have the privilege of interacting with people at different moments in their lives.

the doctor I worked with was an excellent teacher and I was inspired by his passion for medicine. he taught me to trust my instincts in the diagnosis of patients and frequently used the analogy: “If it looks like a duck and quacks like a duck, it’s probably a duck.” After being taught numerous rare conditions in my studies, it was useful to also learn a more common differential in the office.

Outside of the clinic, I made new friends with classmates in town and we explored penticton together. we spent a beautiful hot day biking through the vineyards and wine tasting. Dave took us out on his boat to go fishing and waterskiing. we were told that the chief of surgery starts his days with waterskiing on the lake! we floated down the canal on inner tubes, raced across the lake on seadoos, and explored the farmer’s market. At the annual Elvis competition, we saw glittering hip-gyrating renditions of “Blue Suede Shoes.” I soon became enamored with the town and began to visualize myself living there.

One thing that struck me was the balance that penticton doctors maintained in their lives. In addition to working hard, many of them cycled to work, spent time with their families and planned exciting vacations. this balance is something I desire in my future practice of medicine. I was impressed by the tight-knit community, which enabled doctors to know one another and communicate easily about patients.

As I left this idyllic setting, I prayed that my car would start. I was told that the local marmots had developed an appetite for car engine wires. Earlier, I had seen them emerging from underneath my car while foraging outside their colony across the street. In addition to my medical training, I also learned to shoot a gun, fish for bass, bake a sour cherry pie, and appreciate the delicate flavors of wild game. what more could you ask for?

life’s a peach

Alison Read is a fourth-year medical student at the University of British Columbia. Here, she gives her impressions of rural medicine and the quality of life in Penticton, B.C., where she spent last summer.

As a future medical professional, she’s now considering family practice in a more rural area.

In penticton, this med student enjoys a summer of medical instruction and moose eating

One thing that struck me was the balance that penticton doctors maintained in their lives

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on the edge of vancouver island is a shangri-la for fishing enthusiasts, foodies & anyone who wants into the wild in luxury

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mental health.” And if he ever takes the beauty that surrounds him for granted, he’s reminded of it through the wide-eyed wonder of guests.

If the rest of us can’t live there, the next best thing is to visit. Again and again. those who’ve already discovered this place keep coming back for the secluded pampering and world-class fishing.

they arrive, more often than not, via heli. there’s a helicopter pad on the property (first created for the group of California investors who own this slice of paradise), right next to the man-made trout pond (where newbies like me can practice their

cast). A former nFl coach (with four Superbowl rings) is a regular here, as are Vancouver Canucks management and certain celebs. Because when you’re here, you’re cut-off—in a very good way (and there’s always wifi if you must stay connected).

And, while happily cut-off from the outside world, you can do pretty much whatever you

want. O’neill will make it happen. whether that’s heli hiking and a spa treatment or deep-sea fishing and clay shooting.

the real prize here, though, remains the fishing. the entire staff lives and breathes it, as well as the typical guest. Chef MacDonald goes

fishing on his days off, and when killoran isn’t tying flies for guests he’s tramping through the bush to find the next best fishing hole.

Back on the Elk River, where I’m still trying to mimic the smooth swing killoran tosses off without a thought, the fish are biting—in rapid fire. the elusive catch is thrilling to pursue. And addictive.

there certainly is something about learning the language of the river, finding those pauses and pools and landing a fly in just the right spot. not something you can figure out in one session. the hook is in. I need to come back.

t r a v e l a t h o m e t r a v e l a t h o m e

The water is cold and the current is strong. It swirls around my

legs and tugs at the rub-ber overalls I’m wearing. I mean waders…It’s my first time wearing the fly fishing gear, and I feel rugged and ready for anything. Donning the waders puts you in a certain frame of mind.

One that makes you think you’re one with the river. kind of.

It’s exhilarating to wade in amongst the smooth river rocks and brace myself against the rushing water. the hard part is casting. I let the line out just enough, arc back with my arm (bent

enough but not too much) and circle before releasing forward. Thunk. I lose the fly on the back swing. And more than a few times…on a log, branch or some other obstacle that seems to always get in my way but never my guide’s.

that’s because my guide is Randy killoran, who has catch records with the tyee (the legendary longtime

Vancouver Island fishing club) that put him in the big leagues. here, however, he keeps it small and simple for a neophyte like me.

patient and relaxed, he replaces the fly time after time after time. he tells stories of his other fishing adventures via

helicopter or four-wheeler into the deep wilds of Vancouver Island. And reveals some of his past clients—like george Bush Sr.

It turns out that Vancouver Island is a mecca for world-class sport fishing. And killoran has taken out some rather illustrious fishing fanatics. whether CEOs from Silicon Valley or past presidents (Bush

Sr. is quite the accom-plished fly fisherman, by the way), these clients come for the stellar sports fishing and stay for the isolated getaway.

here, in the centre of the island, there’s not much more than trees and more trees (and plenty of logging trucks).

Century-old Strathcona park is on one end and the pacific on the other. you’re really away from it all.

tucked away amidst this wilderness is the lodge at gold River. the town of gold River is a bit of a working-class way-station for the fishing and logging sets hauling saltwater catches and logs in Muchalat Inlet, but the lodge is

serious luxury. think log-cabin luxe

with antler chandeliers, impressive taxidermy and First nations art (so much of it that a Bill Reid piece is stashed away in a closet). A cougar skin near the entryway is Silex the resident dog’s trophy; she pinned the

big cat under the porch just outside…

Arriving here, I’m greeted by the big, bounding Silex (named after a fishing fly, of course) and siblings winston and Sage. the three black labs—possibly the happiest dogs ever—are a good sign of the welcome I have in store.

host kent O’neill, a longtime Vancouver Island resident, has a passion and pride for this region that’s infectious. It’s all about keeping things local, from the BC wine list to the farm-to-fork menu. Dinner that night includes pacific halibut with spotted prawns and patty-pan squash from a local farmer. Even the sorbet is made from fresh, local berries. As is the organic blueberry jam the next morning.

the locavore cuisine served here, prepared by Red Seal-trained Chef terry MacDonald, is unexpectedly high-end—from a deconstructed salad of golden and rose tomatoes and buffalo mozzarella (from nearby Comox Valley water buffalo, of course) to the halibut-and-spotted-prawn main course.

post-meal in the main lodge there’s shuffleboard and billiards and even a drum set to bang on. And the bar and O’neill are at the ready. But satisfyingly sated, there’s nothing to do but hole up in my cabin-chic room—complete with wood-burning fireplace. I sit on the back porch, listening to the gurgling river just below. the mind and body can’t help but unwind.

As O’neill puts it, this is “a great place to live in terms of personal

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the lodge at gold riVer Everything you need is taken care of, from the helicopter, should you want it, to the best-of-BC selection of wines with an island-sourced multi-course menu. thelodgeatgoldriver.ca more Find out about Vancouver Island’s central region, including the century-old Strathcona Park, at hellobc.com and env.gov.bc.ca/bcparks/explore/parkpgs/strath/.

Fly-fishing lures.

First Nations’ art.

The main lodge’s great room.

Just one example of

the impressive taxidermy at The Lodge at

Gold River.

Über fly-fishing guide Randy Killoran.

Apropos custom-made

front-door handle.

Coho salmon catch on a fishing day

with The Lodge at Gold River.

On top of the world (via a heli ride) post fishing and picnicking in BC’s spectacular scenery.

Heli hiking group.

Log-cabin luxe at the main lodge.


the wealthy doctor manfred purtzki, c.a.

Manfred Purtzki is the principal of Purtzki & Associates Chartered Accountants. You can

reach him at [email protected].

study abroadFinancing your child’s education in a foreign country

This may be the last column I will be writing because what I’m going to say is an unpalatable truth—physicians are

not working to their full potential and are not giving optimum value for the taxpayer dollar.

the causes of this are several and the result is an unproductive spiral.

One reason is that a significant propor-tion of physicians’ work and investiga-tions are more to protect the physician from a medicolegal point of view than truly for the benefit of the patient. this is a systemic flaw in the ever increasing litigious society, and over which physicians have no control.

Another reason is that physicians spend time doing tasks for which they are overqual-ified. the fee schedule for physicians which was appropriate in 1966 has now become a poor fit. the problem being that physi-cians have to do “menial tasks” in order to meet overheads in order to spend time with their more complex and demanding patient problems. this is further compounded by the fact that walk-in clinics are abounding dealing with short-term, often uncompli-cated problems i.e. the “menial tasks” in the previous sentence.

this problem has come to a head in British Columbia in an ugly and very public dispute concerning fees and conditions of on-call between anaesthetists, the Ministry of health and the provincial medical associa-tion. the government’s solution is to legislate them back to work while they urgently train and employ anaesthetic nurse practitioners. this would have been much better intro-duced by the anaesthetists themselves, and at a gentle pace rather than being imposed and parachuted in by the government.

yet another suboptimal use of physicians’ time is time spent in the business aspect of running an office. that is to say hiring and firing of staff, negotiating leases, paying utili-ties etc. I am now in a group of physicians where I no longer have to deal with this side of practice—I love it. It is a great sense of

freedom to concentrate on medicine and patient care.

Furthermore physicians are slow to adopt new technologies, not so much in patient care (as in adopting new drugs and investigation techniques), as much as in the delivery of this care. Examples of this are that

only 16% of phy-sicians exclusively use an electronic medical record, and 38% are still using entirely paper-based charts. what’s more, about 23%

of family physicians run a solo practice.An extension of the previous problem is

the physicians’ fiscal inability to employ and delegate to quality assistants. these would include stenographers, registered nurses, nurse practitioners and physician’s assistants.

Finally physicians are being impeded in trying to progress by all levels of govern-ment. the most glaring example of this is the absence of a unified patient database. It would take a bold step and some legal clarification concerning confidentiality, but would save a great deal of physician time and healthcare dollars when it is instituted. I yearn for this every time that I am on call and have to spend time gleaning informa-tion and having to make a ‘best guess.’ not pleasant for me and not always the best for the patient.

underlying all these preceding argu-ments is the physicians’ insistence on their being an independent profession, and the deep mistrust of physicians by all levels of government. Fiercely held independence has resulted in physicians having inequitable fees, few benefits and no secure pension, as well as an already overwhelming and increasing amount of paperwork and regula-tions.

Maybe physicians should reconsider the cost of this independence, and consider working with governments to provide staffed offices or clinics in which physicians can work at the level for which they are trained.

when practising in groups, primary care physicians can sub-specialise and use their skills to the maximum. For example I am surgically inept and will happily delegate my minor surgery. I can, however, give a good intrarticular injection, and I do a fair job of cognitive therapy. I am also finding it increas-ingly difficult to keep up with the treatments of diabetes, and would be happy to refer to an in-house colleague who had a particular interest in this area.

physicians will need to regain the trust of governments to have the fee schedules fundamentally rejigged to reflect the increased level of care and responsibility in this new, more productive pattern of practice.

physicians’ time is being spent doing more and more menial tasks

not giving optimum value

d o c t o r o n a s o a p b o x d r . c h r i s p e n g i l ly

Dr. Chris Pengilly is Just For Canadian Doctors’ current affairs columnist. Please send your comments to him via his website at drpeng.ca.

physicians are not working to their full potential

Lately I have been receiving inquiries from doctors looking for advice on how to finance their son or daughter’s

education outside Canada. here is such a scenario. Dr. Bob is delighted that his 18-year-old son was accepted to study medicine in the same university in Scotland he graduated from a generation ago. then, the initial euphoria gives way to the sobering question of how to finance the $40,000 a year for the next five years, including the annual tuition costs of about $20,000.

Also, his 16-year-old daughter is already expressing her wishes to follow in her brother’s footsteps and study abroad as well. Dr. Bob is turning 60 this year. he’s divorced and does not expect any contribution to the children’s education from his ex-wife. the financial advisor looking after his $1.5-million portfolio suggests that he tack on another five years of practicing medicine after his retirement target date of 65. But Dr. Bob is definitely not embracing his advisor’s suggestion to work until age 70 just to get his kids through school. his son is very much aware of his dad’s financial situation, and even suggests taking out a loan himself if his dad co-signs.

Dr. Bob agrees that the loan arrangement is the only way for his children to finance their stay in a foreign country. he considers three loan options:

1. his son takes out the bank loan with his personal guarantee.

2. his medical corporation, which owns all of his non-RRSp investments, makes a loan directly to his son.

3. he will arrange for the financing by way of the line of credit on his home, which his son will be obligated to repay in the future.

In a call to his banker Dr. Bob quickly discards the first option as the bank would charge a higher interest rate to his son than he would receive personally, even though he would guarantee the loan.

the second option is intriguing. his accountant advises him that his son would have to report as income

any loans from Medco. An advance of $40,000 would trigger tax of about $2,500, assuming a $20,000 tuition fee. the beauty of this arrangement is that, later on, when the son is a high-income earner and repays $40,000 to Medco, he can deduct in full the repayment on his tax return—yielding a potential $16,000 tax refund. not a bad result given that the son originally only paid

$2,500 of income taxes.the third option is also attractive. Dr.

Bob arranges for a line of credit on his home at a low interest rate. An expected $40,000 will be drawn each year on this line of credit. Dr. Bob suggests to his son that any income splitting benefits he would enjoy by paying dividends to him and claiming the tuition fees, he would then apply to the line of credit amount.

to illustrate, Medco pays a $80,000 dividend to the son, who transfers the funds to his dad. Dr. Bob uses these funds for his own personal use. having no income other than the dividend, the son’s tax liability is about $5,000. had Bob reported the $80,000 dividend on his tax return, the additional tax would be about $27,000. the income splitting benefit is $22,000, which pays for the son’s tuition. the tax benefit is particularly large because of the substantial tuition fee claim.

to be eligible to claim tuition fees to a university outside Canada, all of the following conditions have to be met:

1. the student has to be in full-time attendance;

2. Each course must be of at least three consecutive weeks’ duration;

3. Each course must also lead to a degree for the student of at least the bachelor level or higher;

4. the tuition fees claimed must consist of eligible fees and must have been paid. Eligible tuition fees include any portion of tuition fees paid by scholarships or

bursaries.

when you’re facing large tuition bills for your children,

consult with your chartered accountant to see how you can minimize the cost and

ideally set up a structure where the government ends up paying for your son’s or daughter’s education.

set up a structure where the government ends up paying for your son’s or daughter’s education


A beluga whale swims up to a kayak

in Hudson Bay.

Tel Aviv beach on the Mediterranean Sea.

t r a v e l t h e w o r l d

unexpected Israel

It’s a warm, breezy day in the Negev desert, and I am perched on the very precipice of the Makhtesh ramon, the largest crater in all of Israel. Safely

harnessed and buckled and in the capable hands of an experienced guide, I begin to descend the vertical limestone wall, rappelling down into this great

depression, a vast abyss caused by millions of years of erosion, 40 kilometres long and 10 kilometres at its widest. Just as I start to feel comfortable, settling into the harness, feeling the breeze, taking in a little bit of the dramatic view all around me, the peace and tranquility of the desert is shattered by the roaring

sound of fighter jets, two of them, conducting a training exercise, cutting through the air faster than the speed of sound, rumbling past my back as

I hang over the abyss. Not what I expected—but then, here in Israel, nothing quite matches my expectations. and that’s a very good thing. >>


In search of surprising culinary and natural pleasures in the Holy Land By Tim Johnson



After dropping into the Ramon (and climbing back out), I clamber onto a bike and ride it along the edge of a nearby wadi. this area, part of Avdat national park, about two hours outside of both tel Aviv and Jerusalem, supports some 120 kilometres of trails, and outdoorsy types can choose anything from day-long rambles to serious multi-day excursions into this Biblical wilderness. For me, it’s

just a brief, half-day trip, a combination bike ride along the lip of the canyon, past a griffin vulture feeding area and a group of curious Ibex, who squint suspiciously at me as I ride past, then a hike through the wadi zin, the longest valley in Israel. Down inside the wadi, I keep seeing caves, and my guide, a kind, indefatigable man from tel Aviv named yigal zevi, explains that the valley has, for thousands of years

(or even more) served as a corridor for both people and animals. Migratory birds like pelicans, flamingo and storks trace this path en route to Africa, and everyone from the tribes of Israel to Roman traders to nabateans on the Spice trail from petra to gaza have used this valley as a sort of ancient superhighway—flint, tools, and other archeological remains have been found down here. As we ascend up a

narrow path, steps carved right into the sandstone, the dark, spring-fed zin River bubbling nearby, zevi shares that these caves were inhabited some 1600 years ago by Byzantine monks. “they just wanted to spend some time here,” he explains. “they considered this to be holy ground.”

Before driving back to civilization, we make a brief stop at the grave of David Ben-gurion, a key founder and the first prime minister of the modern state of Israel, who is buried in a simple plot nearby, a short distance from the Sde Boker kibbutz, where he spent the final years of his life. we enter Jerusalem as night is falling, checking into a hotel nearby the Jaffa gate, the main entry point from the west into the Old City. looking to refill the tank after a busy day, we walk up a hill, along Jaffa Street, deeper into modern west Jerusalem. I’m surprised to see that, in what is often considered the world’s holiest city, Jaffa is a hopping hub for nightlife, home to bars, pubs, coffee houses and small, trendy restaurants. As I look upon the city’s young, stylish, well-dressed denizens strolling along or gathered in friendly groups, it’s hard to believe that this good-time place is located in the very heart of the often-troubled Middle East. we duck into one of the warmly lit restaurants near the top of the hill, a place called Canela, and settle in for a fabulous evening of Mediterranean fare and excellent Israeli wine.

After two days in the capital, browsing the busy Arab markets (which sell more varieties of olives than I thought existed, alongside spices and challah bread and dried figs and dates), exploring the slanting lanes of the Old City and sampling some of the best hummus in the world in the Muslim Quarter, we head for the coast. tel Aviv, which serves as Israel’s


>>

Vineyards at Karmei avdat in the negev. left food stand in the arab quarter of the old City in Jerusalem.

the vast Judean Desert landscape, looking east towards the Dead sea.

the Jewish Quarter of the old City in Jerusalem.

Biking in the negev.

inside a Bedouin tent in the negev.

The fishing port of Old Jaffa. top Dragot (Daraja) canyon in the Judean Desert. left sign for the Jaffa gate entrance to Jerasulem’s old City. bottom left pastry stand in Jerusalem’s arab souk.

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it’s hard to believe that this good-time place is

located in the very heart of the often-troubled Middle East


t r a v e l a t h o m e

c m ean international guide to CoNTINuING MEDICAl EDuCATIoN

montpell ier / r iga / taipei / barcelona / hollywood … | c a l e n d a r

summer 2012 + beyond

ah, the south of France. It’s a perennial favourite destination—with good reason. The weather, cuisine and lifestyle are all about la bonne vie.

But there’s one city here that doesn’t get the attention it deserves. Montpellier is 11 km from the Med and just three hours from Barcelona, Italy and Paris. And it’s smack in the middle of the Languedoc-Roussillon region that boasts seven UNESCO World Heritage sites, including the Pont du Gard. Oh, and it’s been named one of the top 45 places to go in 2012 by The New York Times.

With over 1,000 years of history, Montpellier is a feast for art-and-culture lovers. Here, you can see gorgeous mansions and courtyards from the 16th to 20th centuries, the oldest still-active university of medicine in the western world (dating to 1180), and a never-ending network of narrow medieval alleyways.

But it’s also France’s fastest growing city with a vibrant student community (it’s been a university town for centuries) and plenty of modern appeal. Watch the interplay between old and new from a café on the central Place de la Comédie (known as l’Oeuf for its oval shape).

Or walk through Place de la Canourgue, a garden haven with a view overlooking the Faculty of Medicine, and Place Jean Jaurès, a gathering spot for Montpellier’s younger crowd.

A must is the unexpected and relatively unknown Fabre Museum. The building itself is a renovated mansion and gorgeous combination of classic and contemporary architecture, and inside is one of the most important collections of art in France. This summer see “Bodies and shadows: Caravaggio, Caravaggism in Europe.” Then, back outside, there are close to 100 parks and gardens. This city does green very well—it always has. The Jardin des Plantes was created in 1593 to study medicinal plants, an offspring of the renowned medical school and the model for all such botanical gardens in France.

Of course, this being France, there’s plenty of green space to be found in surrounding wineries. AOC Languedoc wines include Minervois, Saint-Chinian, Faugères, Limoux, and on and on. Make your introduction to this region’s under-appreciated viticulture at Château de Flaugergues on the outskirts of the city. This boutique

winery is the place to sample stellar wine and local fare in a charming courtyard. Tour the historic château afterward—you may even meet the comte (see page 5).

Back in the city, hop on the tram. It’s been called Europe’s sexiest tram system, with trams flaunting whimsical designs by the likes of Christian Lacroix (think Mediterranean motifs of octopus, fish, starfish and marine monsters). The flashy new Lacroix line just opened this past April.

Make stops to see the medieval mikve, a ceremonial Jewish bath dating from the 13th-century and one of the best-preserved in Europe. And more architectural wonders await, from the 1536 St. Pierre Cathedral and 18th-century Comedie Opera House to the modern Berlioz Opera House and futuristic Pierresvives building (by architect Zaha Hadid, the only woman to have won the prestigious Pritzker prize). View it all from atop the 17th-century Triumphal Arch. And then walk some more. After all, Montpellier has one of the largest pedestrian zones in Europe. Yes, this city has it all. —B. Sligl For more info on Montpellier, go to ot-montpellier.fr/en/.

Montpellier is tucked into the lovely southern France region of languedoc-rouissillon and growing faster than any other city...it’s a French revolution! (CME events in Montpellier are highlighted in blue.)

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clockwise from top left Dessert at Château de Flaugergues; inside the historic château; café scene on the main square of Montpellier, known as L’Ouef; looking down on L’Ouef; and the medieval mikve.

Montpellier

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centre of diplomacy, home to its international embassies, is also Israel’s favourite party town, a sort of Miami on the Med. we walk the length of its seaside boardwalk, a chosen route of joggers and bikers by day and romantic hand-in-hand couples by night, then tour the ancient port of Jaffa, a picturesque, cobblestoned settlement, one of the oldest in the world, which anchors the southern end of the boardwalk. After browsing through its high-end boutiques and bustling, low-end flea market, we head for lunch at Dr. Shakshouka. A waiter brings us heaping plates of shakshouka, a Middle Eastern pan-fried casserole with spicy tomato sauce and poached eggs. turns out, it was indeed just what the doctor ordered.

while most people understand that Israel is the homeland of the Jews, the truly multinational flavour of this small country only becomes readily apparent during an in-person visit. Jewish people who had previously made their homes in countries around the world have flooded back to Israel, bringing with them the particular traditions of their former homes. In this case, the owner—the “doctor”— a rotund, extremely affable man named Bino gabso, came here from libya. he serves me himself, sidling up at an open-air table in an area of the restaurant that used to serve as a stable in Ottoman times, taking my spoon and combining the shakshouka with couscous, handing it to me to taste. As I lift the steaming food to my lips, he explains that this is a homemade recipe. “It’s how my mother used to cook in our kitchen when I was a child,” he says in hebrew, the faithful zevi translating for me. And with that bite, it all comes together: the history of the place, the sun shining down on my shoulders, the smell of the air, the rich, wonderful taste of the shakshouka. It would perhaps be too much to call this a religious experience, but this is where my own pilgrimage brought me. It’s not my homeland, but it feels like home—and that, perhaps is the biggest surprise of all.

the truly multinational

flavour of this small country

only becomes readily apparent

during an in-person visit

STAy > Dan Hotels, including the world-renowned King David Hotel, offer comfortable (and often luxurious) accommodations throughout Israel: danhotels.com SAMPlE > Canela serves up great food with its lovely ambiance: canela.rest-e.co.il Dr. Shakshouka features excellent shakshouka, and much more: drshaksuka.rest-e.co.il Go WIlD > Visit Avdat National Park: parks.org.il MorE > Discover more about what Israel offers at: goisrael.com

if you go +


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t h e h u n g r y d o c t o r d r . h o l ly f o n g

Dr. Holly Fong is a practising speech-language pathologist with three young children who is always trying, adapting and creating dishes.

soup’s onChilled summer soup makes a surprisingly delish dish

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When the weather turns hot, cold soups make refreshing meals. Soups such as gazpacho require

no cooking, making them ideal summer meals. And some cooked soups can be served warm or cold, like vichyssoise. then, there are the soups that are traditionally served warm but can also be fantastic cold. who knew?

Such is the case with a spiced mango soup recipe I got from a friend’s mother. the original recipe was spicier and served hot. But upon tasting the leftovers straight from the fridge, I knew it would be fabulous dur-ing the dog days of summer. not only was it delicious, but the actual stove cooking time

was only about 5 minutes, with 30 minutes of cooling down before transferring to the fridge. Make the soup the day before or throw together a salad and relax with a glass of chilled wine while waiting for it to cool.

Because the soup has some heat from chilies, choose a wine with a slightly lower alcohol content. Otherwise you might wish you had a cool beer instead. with the sweetness of the mango, a well-balanced dry or medium-dry german Riesling is the ideal pairing. without breaking the bank, the prinz von preussen Medium-Dry Riesling from Schloss Reinhartshausen works well with this soup or on its own as a summer

sipper. the wine has floral notes of apples and apricots, and is well-balanced with good acidity, fullness in the mouth and tastes of stone fruit with a slight min-eral edge ending in a long lemony finish. Mmm…

2 tsp chickpea flour 1/8 tsp ground

turmeric ¾ tsp ground cumin ¾ tsp ground

coriander 2 c water plus 3 tbsp

and ½ cup½ c plain 2% yogurt

(without agar, gelatin, xanthan or carrageen gum)

3 c chunks of ripe mango (6 – 7)

1 ¼ –1 ½ tsp salt ½ tsp sugar or to taste 1 small fresh red chili,

partially slit, not completely sliced

through 2 tbsp corn oil½ tsp whole brown

mustard seeds ½ tsp whole cumin

seeds 1/8 tsp whole

fenugreek seeds 1 whole dry chili10 to 15 fresh curry

leavesCrisp flatbread

optioNal garNish: 1 tbsp finely chopped

cilantro1 red bell pepper,

finely diced and ½ mango, finely diced

SPICED MANGo SouP (SeRveS 8 – 10)

Puree mango with 3 tablespoons water and set aside. > Put chickpea flour, turmeric, ground cumin and coriander in a bowl. Slowly stir in ½ cup water until no lumps are left. Whisk in yogurt, mango puree and 2 cups water. Add salt, sugar and fresh chili. Mix well. > Pour oil into a heavy, medium-size pan and set over medium-high heat. When the oil is very hot, add mustard seeds, cumin seeds, fenugreek seeds, dried chili and curry leaves. Remove from heat and stir in the mango mixture. Place over medium heat and simmer for 5 minutes, stirring. Remove from heat, cover and let sit for at least 30 minutes. > If serving hot, gently stir and reheat. Strain soup. If serving chilled, strain and cool soup in refrigerator for 1 – 2 hours. Adjust seasoning with salt and sugar to taste. Serve with some crisp flatbread and garnish with chopped cilantro and diced mango-red pepper mixture (optional).

Prinz von Preus-

sen Medium-Dry riesling from schloss reinhart-

shausen works well with this soup or on its own as a sum-

mer sipper.

t h e t h i r s t y d e n t i s t l u c a s ay k r o y d

San Diego sudstasty, edgy microbrews lure visitors to this beer mecca

G ranted, water is San Diego’s dominant liquid, from the uS navy presence to Sea world. yet California’s second-

largest city also boasts a burgeoning beer scene. More than 30 area microbreweries quench the thirst of beer lovers. Check out three of the best.

Stone Brewing Co.this aggressively gorgeous, 55,000-square-foot Escondido brewery is beer’s answer to a

SoCal theme park. March through the packed parking lot, under a curving canopy of green-ery, and into the high-ceilinged entrance hall before unleashing your taste buds. Swig the signature Arrogant Bastard Ale (7.2%) or Stone pale Ale in the 380-capacity bistro, built around a majestic rock water feature. Ready to investigate those towering stainless steel tanks beyond the interior floor-to-ceiling windows? Free 45-minute brewery tours are offered daily, guided by perky, humorous “indoctrination specialists” and culminating

with a four-beer tasting. In the gift shop, score t-shirts, glasses, and even skateboards with Stone’s gargoyle logo. Or take home the official history book, the Craft of Stone Brewing Co. ($25 uS), which features food and brewing recipes. stonebrew.com.

Green FlashFrom the Rolling Stones to Death Cab For Cutie, rock music echoes

through green Flash’s new, warehouse-style tasting room off Mira Mesa Boulevard. happily, the beer rocks too. “people who never even knew what craft beer was come in and say, ‘wow, this is amazing,’” says certi-fied cicerone Dave Adams. Craving flavourful ales? try the west Coast IpA, super-bitter with a citrus character and malt backbone. Relish a twist on Belgian tripel with le Freak (9.2%), with its huge banana nose and hints of bubble gum and spice. green Flash of-fers scheduled weekend tours and private

tours by appointment. Ask to toot the steam whistle. greenflashbrew.com

lost AbbeyBeer is a religion at this well-hidden, 2006-founded San Marcos brewery. Surreal, suds-themed paintings of the Magi and the Four horsemen overlook the bar, where patrons quaff everything from the booze-laden Belgian-style Inferno Ale to the copper-coloured Avant garde—similar to a French Saison—with its distinctive aftertaste. In the “fight between good beer and bad beer,” as lead bartender Jason Danderand puts it, lost Abbey’s crusade includes one of America’s largest barrel programs, with about 1,000 barrels. Sacred rites range from barrel-tasting nights to masquerade balls. lostabbey.com

+ more ways to beer it upCreate your own San Diego beer route, downloading a free map from the San Diego Brewers guild, which outlines public trans-portation options (sandiegobrewersguild.org). Alternatively, contact Brewery tours of San Diego and sample selected highlights over five hours while being chauffeured around (brewerytoursofsandiego.com).

want one-stop beer shopping? Savour more than 200 bottled beers and dozens of draughts at hamilton’s tavern (hamiltonstavern.com). Or meet local brewers at San Diego Beer week in november, enjoying tastings, food pairings, and book signings. the festival offers 200-plus events (sdbw.org).

Lucas Aykroyd writes about everything from adventure travel to sports (hockey is his forte) for publications ranging from the National Geographic Traveler to the IIHF. Here he delves into something that goes rather well with hockey (especially during playoff season): a good brew.

below + right The “aggressively gorgeous” Stone Brewing Co. brewery, where you can sample the signature Arrogant Bastard Ale. above right le Freak from Green Flash is a Belgian-style brew that “rocks.”

and the NaggINg winner is… Thank you to all those who submitted answers to Dr. Neil Pollock’s wine quiz in the Spring 2012 issue. We’ll announce the winners (along with those answers!) at justforcanadiandoctors.com. If you’ve proven yourself wine worthy you’ll soon be sipping a Nagging Doubt vintage from this new, boutique BC winery.

And let us know what you’d like us to cover in The Thirsty Doctor column—from pinot noir to pale ale.


and vendor booths. the whole event is free-entry, alcohol-free and family friendly. Arrive early for the best parking and viewing spots.

A few hours after my final cruise of woodward Avenue I was touring the hemi sedately around my old guelph neighbour-hood. the new-age Dodge felt as at home as the originals. I’m pleased that Motown muscle still sells. Ford Mustangs, Chevrolet Camaros and Dodge Challengers make up roughly one in 10 of the cars sold by the “Big three.” And that’s good news for the Ontario and Canadian economy, with every Challenger and Camaro assembled right here.

As my flight time home loomed, I snuck in one last bit of nostalgia by pulling up outside pam’s old house and tuning in to a Detroit FM station broadcasting a Supremes hit. Ahhh, seems like just yesterday. life was simple and mostly local to me in the late 1960s. And those products and events that best recapture for us our simpler rose-tinted memories of yore will earn our loyalty. So, as the only true franchise holders of the muscle car, I wish Motown success in appealing to future generations. the world would be a far less interesting place without them.

m o t o r i n g [ c o n t i n u e d ]

The final years of the 1960s were a coming of age for me: close friends, the break-up of the Beatles, the first

moon landing, that crush on pam. All oc-curring during two pivotal years in guelph, Ontario. little did I realize the impact that nearby Detroit had on me during those formative years.

Motor City’s muscle cars were the rides everyone I knew wanted. we were all super-envious of the older kid on our street with his new 1970 Sublime green Dodge Super Bee. Mopar’s plymouth and Dodge always boasted the coolest names and colours. no surprise then that it’s the original hemi-engine ‘Cudas and Challengers in wild period colours that are today’s most acclaimed

muscle from back in the day.So, last August I did a “rediscover my

roots” trip. I timed my journey to take in Detroit’s woodward Avenue Dream Cruise, followed by a ride up highway 401 to check out my old guelph neighbourhood. My press friends at Chrysler obliged me by providing a 2011 SRt8 hemi Challenger in “top Banana” (a vivid yellow), and six-speed manual shift. yes, Motown’s muscle cars are in a renais-sance period, and Chrysler has re-christened a new Challenger, several new hemi engines, and period colors like plum Crazy.

My Challenger’s retro-styling and wild paint scheme got lots of stares throughout my trip. the big hemi’s 425 horsepower and menacing rumble backed up those Vanishing point good looks. I was intrigued

that those eyeballing my bumblebee Dodge would then seek out eye contact with me. this eye-dance does not happen when I drive luxury cars or exotics. My theory is that muscle cars provide a comfort zone for most people to acknowledge they actually like exciting cars.

Detroit’s modern muscle cars may look, sound and accelerate like their forebearers of 40 years ago. however, today’s muscle provides relaxed highway cruising in sixth gear, acceptable ride, noise, vibration, harsh-ness, braking and even decent fuel mileage. handling, however, will not be confused with a true sports car. At 4,200 pounds and large enough to carry four in comfort, that compromise is somewhat expected.

the city of Detroit has had to make many compromises; it’s been in slow decline almost continuously since the zenith of the original muscle car era some 40 years ago. however, Motown is a city as defined by its primary industry as any major city in north America. Detroit eats, breathes and sleeps car manufacturing. Car enthusiasts abound.

So it should not come as a great surprise that the Motor City hosts the world’s largest

annual one-day car event. For the past 16 years as many as 1.5 million people have lined the 16 miles of woodward Avenue the third Saturday in August. Forty thousand classic and special-interest cars parade up and down woodward from 9 am to 9 pm. the vast majority of those 40,000 cars are muscle cars, many of which have been modi-fied for more horsepower or with louder paint.

Cruising is not the only attraction of the Motor City event. the nine communities that share the event are partners in the largest annual event in the Michigan economy. It spins off $56 million dollars to these commu-nities, more than even a Super Bowl would. Over 100 local charities also benefit. the host communities further support the event with numerous free concerts, car club displays

Motown muscleRe-connecting with my hometown via Motown

m o t o r i n g

Dr. Kelly Silverthorn is a radiologist and Just For Canadian Doctors’ automotive writer.

Sweet ride. The

“Top Banana” Challenger from

Chrysler.

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Work. Life.Balance.

Travail. Vie.Équilibre.

Practicing in New Brunswick is more than a career choice. It’s a life choice.

Come to New Brunswick. Make life happen.

L’exercice d’une profession dans le secteur de la santé au Nouveau-Brunswick s’avère plus qu’un choix de carrière, c’est un mode de vie.

Venez au Nouveau-Brunswick. Vivez pleinement.

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LIFESTYLECalgary is a growing city, approaching a population of 1,200,000 people and is located on the Bow River in Southern Alberta, Canada. This is an exciting, young and vibrant city, known for its proximity to the Rocky Mountains and world famous Banff National Park.

INCENTIVES

- ~13 shifts per month for 1.0 FTE (FTE of 0.25 to 1.0 available)- CME opportunities are encouraged and supported- partnershiped training with the Society of Critical Care Medicine (Fundamentals of Critical Care Support Course)- Crisis Resource Management training provided via high fi delity simulation (on-site)- additional support always available through function in the ICU team environment

Interested physicians should forward their CV with references, and address all inquiries to:

QUALIFICATIONSPhysicians must be eligible for Practice Permit from College of Physicians and Surgeons of Alberta, AHS Medical Staff Privileges, appropriate Canadian Medical Protective Association coverage, and ACLS certifi cation.

The Department of Critical Care Medicine is currently recruiting Clinical Associates for the Intensive Care Units at all adult sites within the Calgary Zone.

APPLY TODAY

We require clinical associates to provide service from 1700 to 0800 hours, seven days a week in the 3 multisystem ICUs of the Region and day shifts (0800-1700) in one of these ICU’s. Physicians will be integrated into the current physician healthcare team, including bedside physicians, residents and attending intensivists.

As part of a specialized multidisciplinary team, the clinical associates’ role, in addition to patient care responsibilities in the unit, will be to provide tier one responses for all ICU Outreach Team calls within the institution. These teams were created as a patient safety initiative to advance the “ICU without walls” concept. Activation of the outreach team can occur by any concerned staff member or any unit of an acute care facility. The team is expected to rapidly assess and stabilize the patient, assist with communication, educate and support staff who have activated the team and assist with transferring the patient to the ICU when necessary (25 – 30% cases).

Jeannie Shrout, Department ManagerCritical Care MedicineAlberta Health Services Room 0452 - McCaig Tower, 1403-29 St. N.W.Calgary, AB T2N [email protected]

CONSIDER CRITICAL CARE MEDICINE IN CALGARY, ALBERTA

Rural Family Practice Opportunities Saskatoon Health Region

To learn more about the opportunities available, please contact:

Jackie McKeeTel: 306-655-0196Email: [email protected]

To Apply:

Water, beach, hunting, fishing, camping, golf, and so much more…

It might surprise you to find out what our rural communities have to offer.


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Enjoy a safe, secure, rural lifestyle and community support for your family in Flagstaff County, Alberta, Canada. Daysland is 1.5 hours SE of Edmonton.

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16 acute and 10 rehab beds under the management of a well established practice: currently have 3 GPs (1 with anesthetic privileges ) and 4 visiting surgeons and 1 visiting anesthetist.

Surgery performed 3X week including laparoscopic cholecycstectomy, tubal ligation, hysterectomy, C-section, endoscopy.

Approx. 120 deliveries/year.

“Your new home away from home” will consist of working in a brand new well equipped 4 physician clinic. 24 hour emergency coverage and weekends on call are on a 4 week rotation.Moving and signing bonuses provided. Must be qualified to obtain obstetrical privileging.

Daysland Health Centre Tel: (780) 374-3746Mariann Wolbeck

[email protected]

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Daysland is 1.5 hours SE of Edmonton. an established clinic with a collaborative on-site pharmacy located in the heart of Osborne Village, recently voted as Canada’s ‘Best Neighbourhood.’

A new practice opportunity is available with the Wardlaw Medical Centre,

Exciting Medical Practice Opportunity in

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Remuneration is generous, offering a 0% split to start in order to help you establish your practice, or a guaranteed minimum income can be negotiated.

Our clinic is fully staffed with experienced professionals to ensure all of your billing and scheduling requirements are met.

Clinic space will be newly redesigned for our staff and patients needs.

There is no on call, weekends, or evenings required.

Jason Pankratz Clinic [email protected]

If you would like to be part of a growing practice, in a dynamic location, with a pleasant working environment please call or email for additional information.

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REGISTER TODAY! healthmatchbc.org

Job #H104-13300Client: HeAltH MAtCH bC

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FIND A JOB IN BC

Join the hundreds of physicians who have moved to rural british Columbia to enjoy a quality of life that is envied around the world. our physician services team will assist you with licensing and immigration, and match your skills and interests with job vacancies in the regions of your choice. Register online today!

PRACTICE mEDICINE IN bRITISH COLUmbIA Enrich your career. Enhance your quality of life.

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Medical Director Required for UKSH South WestFull TimeEmersons Green (Bristol), Devizes, Cirencester

Opportunities with a leading healthcare provider

UK Specialist Hospitals (UKSH) is a leading healthcare company contracted to deliver elective services to NHS patients. UKSH delivers high quality healthcare, excellent professional standards and outstanding clinical results as reported in the most recent Dr Foster publication.

UKSH South West operates 3 treatment centres in Bristol, Cirencester & Devizes covering a range of specialities including orthopaedic, ophthalmology, gynaecology, general surgery, dental, and urology and employing 40 consultants to support our activity.

We are inviting applications for an Medical Director post with signifi cant managerial focus. We seek an individual with demonstrable leadership qualities who will lead the consultant body through a track record of delivering clinical excellence. The successful candidate will support the Group

Medical Director in achieving local and national clinical standards whilst acting as an ambassador for UKSH in the medical community.

The post holder will undertake some clinical work but will focus on leading the medical team whilst contributing to the clinical management of UKSH South West in conjunction with the Registered Manager and senior team.

To apply for this position please email your CV to Neil Andrews, Recruitment Manager, to: [email protected]

Candidates for the above position will be subject to CRB disclosure.

We are an Equal Opportunities Employer.


My name: Alison Read

I live and practise in: Vancouver, BC

My training: BSc psychology, currently in 4th year medicine

Why I was drawn to medicine: Interest in my

father’s work as a family doctor

My last trip: new york

The most exotic place I’ve travelled: thailand

The best souvenir I’ve brought back from a trip: Shoes from Italy

A favourite place that I keep returning to: Cabin on the Sunshine Coast

My ultimate dream vacation: Europe

If I could travel to any time, I’d go to: See Michael Jackson and Motown performers in the 1970s

My favourite book:

Lord of the Rings by J. R. tolkien

My favourite movie: The Godfather

My must-see TV show: Game of Thrones

My favourite song: Michael Jackson’s “Billy Jean”

My first job: lifeguard/swim instructor

The gadget or gear I

could not do without: iphone

My favourite room at home: kitchen

My car: nonexistent at the moment!

My last purchase: Anesthesia textbooks

My last splurge: Shopping in the u.S. with my mother

Most-frequented store: winners

My closet has too many: Shoes

My fridge is always stocked with: Sandwich-making materials

My medicine cabinet is

always stocked with: Band-aids

My guilty pleasure is: Dark chocolate

My favourite exercise/sports activity: Swimming

My favourite sport to

watch: hockey

My celebrity crush: Jude law

I’d want this item with me if stranded on a desert island: Food

My secret to relaxing and relieving tension: Exercise, cooking and good wine

A talent I wish I had: good sense of direction

My scariest moment: Cliff jumping into the ocean

My fondest memory: Annual family ski trips to Sun peaks Resort

A big challenge I’ve faced: trying to decide which residency to pursue!

One thing I’d change about myself: Over-analyzing most things

The word that best describes me: Enthusiastic

I’m inspired by: physicians who are passionate about their work

My biggest ego boost: positive feedback during my hospital rotations

My biggest ego blow: Criticism from a surgeon in the OR regarding my subcuticular suturing

I’m happiest when: I achieve balance between sleep, work and extracurricular activities

My greatest fear: Failure

My motto: Strive for balance in one’s life to maintain happiness

A cause close to my heart: Volunteering as a doctor in disadvantaged countries

Something I haven’t done yet that’s on my must-do list: travel to new zealand

If I wasn’t a doctor I’d be: A lawyer

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It’s in the genes…her father’s a family doctor and now she’s following in his footsteps. This fourth-year med student spent last summer learning the ropes from another MD and family friend in Penticton. Her summer agenda while there (in between medical training): biking through vineyards, wine tasting, fishing, seadoing, tubing, and following the example of yet another local MD, the chief of surgery who starts his days by waterskiing on the lake (see her story on page 12).

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Accreditation: Continuing Education, Inc. is accredited by theAccreditation Council for Continuing Medical Education to providecontinuing medical education for physicians.Designation: Continuing Education, Inc. designates these liveeducational activities for a maximum of 14-21 AMA PRA Category 1credits™. Physicians should only claim credit commensurate with theextent of their participation in the activity.

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September 5, 2012 Internal Medicine: Cardiology10-Night Eastern Mediterranean from Rome, ItalyHolland America's ms Noordam

September 14, 2012 Orthopaedics and Sports Medicine7-Night Bermuda from Boston, MassachusettsNorwegian Cruise Line's Norwegian Dawn

September 20, 2012 Preventive Medicine12-Night Western & Eastern Mediterranean from BarcelonaCelebrity Cruises’ Solstice

October 12, 2012 Pediatrics9-Night Western European from Amsterdam, HollandCelebrity Cruises' Brand New Celebrity Reflection

October 20, 2012 Diagnostic Imaging for Primary Care:A Review of Specific Approaches to Clinical Problems

7-Night Western Mediterranean from Rome to Venice, ItalySeabourn's Quest

October 23, 2012 Infectious Disease8-Night Asian Explorer Hong Kong to SingaporeRoyal Caribbean's Legend of the Seas

Florida Seller of Travel Reg. #14337

October 12, 2012 Pediatrics14 AMA PRA Category 1 Credit(s)™ 14 Contact Hours9-Night Western European from AmsterdamCelebrity Cruises' Brand New Reflection

February 6, 2013 Emergency Medicine21 AMA PRA Category 1 Credit(s)™ 21 Contact Hours14-Night Australia/New Zealand - Sydney to AucklandHolland America's ms Oosterdam

December 29, 2012 General Medicine Review 7-Night Eastern Caribbean from Miami, Florida Celebrity Cruises' Reflection

January 26, 2013 Internal Medicine: Cardiology 7-Night Eastern Caribbean from Ft. Lauderdale, Florida Holland America's ms Eurodam

March 2, 2013 Women's Health7-Night Mexican Riviera from San Diego, California

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April 20, 2013 Pediatrics Review 7-Night Hawaiian Islands from Honolulu, Hawaii Norwegian Cruise Line's Pride of America

June 30, 2013 Primary Care: Addressing Issues of Aging Patients 9-Night Scandinavia and Russia from Copenhagen, Denmark Norwegian Cruise Line's Star

August 9, 2013 Primary Care Update: Cardiac Health, Metabolic-Syndrome, Obesity and Related Disorders 12-Night Western Mediterranean from Barcelona, Spain Celebrity Cruises' Equinox

Vancouver, British Columbia | October 10 – 13, 2012

October 10 – 13, 2012Vancouver Convention Centre – West BuildingVancouver, British Columbia, Canada

Join your colleagues to learn about, celebrate achievement regarding and share your commitment to the fi ght against diabetes and other endocrine disorders.Throughout the conference, enjoy complementary lunches, wine and cheese poster presentations and other networking opportunities.

Featured Lectures• Gastrointestinal Dysmotility in Diabetes – Michael Horowitz MBBS PhD FRACP (Adelaide, Australia)• Implications of the ORIGIN (Outcome Reduction with Initial Glargine Intervention) Trial – Hertzel Gerstein

MD MSc FRCPC (Hamilton, ON)• Treatment and Targets for Type 2 Diabetes – Stuart Ross MB CHB FRACP FRCP(C) (Calgary, AB)• Insulin Therapy: General Principles and Practical Tips – Peter Senior MBBS PhD (Edmonton, AB)• Cardiometabolic Risk: Treating Pre-Diabetes – Peter Lin MD CCFP (Toronto, ON)• The Diabetic Foot: A Practical Approach to Prevention and Management of Complications – Keith Bowering

MD FRCPC FACP (Edmonton, AB)

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Documents

SUMMER 2012