Then and now: Visiting the first residential school in Canada.

Two women led us through the oldest residential school in Canada this afternoon.  One was a survivor.  People who spent part of their childhood in a residential school are known as survivors. The other had a grandfather who lived in this residential school in and around 1899.   They both generously took us - seven Canadian family medicine residents - through one of this country's darkest legacies....

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How to Be a Meritocracy: Lessons From My Father

On May 22, my father raised his glass at a dinner table filled with 22 members of his family, my husband and my in-laws and congratulated me for completing medical school. 

"This is a great accomplishment.  But for me , the reason it really matters is because it means that we - all of us - can do anything.  We are good enough and capable enough."

My father grew up the youngest boy of eight children in the west end of Toronto in the 60s.  His father was a trucker and his mother was a home-maker and door-to-door saleswoman of Fullerbrush and all sorts of other goods.  They were raised on farms in early 1900s rural Ontario and rural Manitoba, respectively.  Their lives were difficult and complicated.  My grandfather struggled with alcoholism.  My father was told all of the time that he should take the less advanced classes at school and that his family was not a very smart one.  When they built a vocational school in his neighbourhood, the teachers told he and his siblings that they should attend.  

My father ended up attending college for a few semesters.  He did well but needed to support himself so he went out west to Edmonton in his early 20s to work with his elder brother.  

My father always knew that if he was to get by, it would be through sheer grit because he didn't believe himself to be particularly smart.  So when his daughter became a doctor, it was not confirmation of his identity - it was a challenge to it.  One he happily accepted. 

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Warning: How to Get Punched in the Face by a Smoker

My cousin recently texted to let me know that she managed to quit smoking with the help of her family doctor and vareniciline (Champix).  She's in her late 20s and has a rheumatalogical condition that is made worse by smoking.  Things I did not say to her:

  • It's about time!
  • Be careful! Temptation is around every corner!
  • You've already done so much damage!
  • Why even other, this isn't doing to last.

What I did say to her:

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The 2 Things Our World Needs to Fight Obesity

There is health.  And there is weight.  We do know that certain cancers are more likely at higher weights, so we know that a high BMI may lead to a higher incidence of disease but this isn't true for all people.  Asserting such is a form of discrimination.  There are overweight healthy people who cost the health system absolutely nothing because they eat well and move a lot, and there are unhealthy people who have normal BMIs.  When we talk about obesity, we’re really talking about being sedentary, about eating chemical food-like products, about how most people use food – a tangible – to make up for deficits in intangibles, like loneliness, grief, boredom, lack of self-efficacy.  It’s not about the weight.

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Talking about drugs.

The only way to change the parameters of the choice to use is to alleviate the pressure imposed by homelessness, poverty and a lack of opportunity.  The place to start is with helping the user stabilize their life in some respects.  If they're getting prescribed heroin in steady doses at stable, regular times, they can order their day around things like hygiene, learning, eating better, reconnecting with loved ones, and planning for the future.  This is in contrast to ordering their day around stealing, selling tricks and avoiding cops.  The choice to use starts to have more consequences, because life is a bit better, and so maybe they use a little less.  And that's where remission begins.  

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