Know Before You Go

Image this morning via DriveBC Traveller Information

In the surfing community I grew up in, we would wake up at dawn and listen to the local radio station’s “Know Before You Go” surf report to hear the latest conditions. Not much has changed! Given our extreme weather we’ve experienced, I’ve posted a series of links that I reference before heading out on the roads, mountains, water, snow, or ice. It’s important to be prepared!

Get Prepared in Severe Storms via Government of Canada
Winter Driving Tips via Canada Safety Council

One final note, practice putting on your tire chains in your driveway before attempting it on snowy, slippery roadside conditions. Here’s a short video on it.

Warm regards,


First in Canada Pilot Project: Takeaway Suboxone

“A first-of-its-kind pilot project is underway at St. Paul’s ED, in collaboration with the VCH Regional Addiction Program, providing opioid overdose patients with takeaway doses of suboxone upon discharge. Patients are given a three day supply of the opioid substitute treatment, along with instructions on how to take the medication. Patients must be in a sufficient state of withdrawal to start Suboxone. By letting patients take the dose with them, the barrier to treatment is reduced for patients uncomfortable with hospital stays.”
Learn more here at BC Emergency Medicine Network.

Amanita Phalloides

BCMJ_Vol61_No1-poison-mushroom-web-fig0.jpg“Amatoxins in Amanita phalloides, commonly known as the death cap mushroom, are responsible for 90% of the world’s mushroom-related fatalities. The most deadly amatoxin for humans is α-amanitin, a bicyclic octapeptide that irreversibly binds RNA polymerase II, thus preventing protein synthesis and causing cell death. Three recent poisoning cases in British Columbia show how the death cap can be easily mistaken for edible mushrooms such as the puffball and the paddy straw mushroom.”

More on The World’s Most Poisonous Mushroom, Amanita Phalloides, is growing in BC.
Issue: BCMJ, vol. 61 , No. 1 , January February 2019 , Pages 20-24 Clinical Articles
By:  Maxwell Moor-Smith, BSc  Raymond Li, BSc(Pharm), MSc  Omar Ahmad, MD, FRCPC

International Day of Women and Girls in Science

1*HwIGneuOGhaQv1A8EHv1NQ.png“In different environments, people can judge you by the way you look or talk, by the color of your skin, and so on, and you can’t please everyone. Therefore, I always treat my mind as a garden, and focus on the beautiful flowers in it, discarding all the negatives, because people and their opinions can get to you very easily. Sometimes, I do feel tired and exhausted, but I never reach a dead end, because I feel that if there is a will, there is a way. And you need to surround yourself with people who, even if they haven’t excelled in their own education or career, really believe in you, no matter what. It’s because you need that unconditional trust and love. And once you have a mission in life that is a light to carry you forward, you won’t even notice the obstacles and the challenges anymore.”

Dr. Hayat Sindi, Saudi Arabian medical scientist and one of the first female members of the Consultative Assembly of Saudi Arabia, on Leading the Way. More on International Day of Women and Girls in Science.

Artful Medicine

“By looking closely at works of art that portray empathy in human interaction, caregivers can discover their common humanity with patients. Caregivers can also hone observation skills that help paint a portrait of a patient as a person and not a collection of symptoms, lab tests, and scans. Through presence at the patient’s side, unmediated by technology, a caregiver can make the patient feel cared for in addition to being treated.” ~ Dr. Fred J. Schiffman

Artful Medicine: Art’s Power to Enrich Patient Care (2017) is an edX tuition-free course designed by Dr. Fred J. Schiffman at Brown University’s Warren Alpert School of Medicine. The course is archived so you can enrol at any time and complete the course at your own pace.

Faculty Development: Communities of Practice (CoPs)

“Health professions educators often feel isolated inside academic institutions, powerless to fight for the changes they believe necessary. CoPs are an efficient strategy to gather faculty members committed to teaching and learning activities while creating a safe and trusting environment.”

More on Twelve Tips for Implementing a Community of Practice for Faculty Development by Marco Antonio de Carvalho-Filho, René A. Tio, & Yvonne Steinert

Innovation in Treating Complex Gynecologic Conditions

model for women.jpeg

“The Women’s Health Institute designed three integrated practice units, one each for pelvic floor disorders, chronic pelvic pain, and vulvar disorders. We chose the IPU model because it surrounds a patient with the expertise to treat her condition and holistically meet her needs. Circling the providers around a woman in a single clinical setting also reduces inefficiencies in care coordination for the subspecialist, patient, and her family.”

Rebecca Rogers, MD, Haley Gardiner, MPH, CHES, Stephanie Nutt, MA, MPA & Amy Young, MD in An Innovative Approach to Treating Complex Gynecologic Conditions

What I love about this piece is it made me ponder what informs and structures an undergraduate or post-graduate curriculum. Maybe we need to design, build, and illustrate our curriculum in this concentric circle model to illuminate the internal and external factors and agents that impact the delivery of care and their proximity to the patient’s experience and outcome. I think taking that approach would educate the learner on the systems that influence a patient’s journey as well as help them identify where gaps or issues exist. Furthermore, the learner better understands the meaning of their role and how their care is positioned within the larger context of treating complex conditions.

Warm regards,



Integrated Practice Units

“Rather than delivering patients serially to one exam room after another, each owned by a different provider, we made the patients the owner of their own rooms, and instead, circulated the providers to the patients.”

Stacey Chang, Executive Director & Founder of the Dell Institute for Health on Nobody Wants a Waiting Room

Informed by the Integrated Practice Unit structure, Stacey Chang and his Design Institute team completely revitalized the patient and healthcare provider’s experience in their new clinics and physically eliminated the waiting room (yes, you read that correctly). Kudos to the courageous and collaborative efforts of + . #GoLonghorns #MustRead #GameChanger

Friday Link Pack

Last night I watched Alex Honnold’s Free Solo. Wow. So many pearls from this movie. What stood out for me is that we all, probably on some level, have a wall we’d like to climb. I took note of Honnold’s methods that helped him accomplish one of the greatest athletic achievements in our time. Here’s what I gathered:

  1. Surround Yourself with the Right People. A team comprised of trusted experts can offer specific and constructive feedback and provide emotional support.
  2. Practice. Practice. Practice. Prior to free soloing a route, Honnold repeatedly climbs it with ropes and a companion. He plans every move and takes meticulous notes describing everything from the feel of the granite to where he’ll place his fingers and toes.
  3. Mental Rehearsal. He visualizes the experience of climbing the wall and how he needs to move through each pitch.
  4. Attitude Towards Risk. Honnold invests his energy in what is required of him to achieve success as opposed to focusing on failure.
  5. Find a Confidence Builder. For Honnold, it was testing himself on other walls that were challenging and achievable.
  6. Work Through Your Fear. Honnold’s approach to fear is to use practice as a comfort and confidence builder.
  7. Sink Into the Experience. On game day, his attitude is to release the anxiety and fear and immerse himself in goal attainment.

Interesting to note, Honnold’s brain, specifically his amygdala, functions differently and as a result he doesn’t experience fear as most of us do.

Now, here’s what I found on my route:

Preparing for exams? Try spaced learning as a method to increase retention.
Tarana Burke’s A Movement that Empowers
A new website illuminating the Heiltsuk Nation. Húy̓at: Our Voices, Our Land
Chicago hit 50 below and Candace Payne responded.
New voices at patients’ bedsides.
Wonder how a songbird learns?
UBC’s Celebrate Storytelling in Medicine event.
Age discrimination in the workforce.
Society of Teachers of Family Medicine (STFM) conference.
If you’re working on medically and scientifically validated technologies supporting mental health, emotional wellbeing, and human thriving, check this out.
Design abilities of problem solvers.
Tuition-free Stanford course: Partnering with the Public and Patients in Medical Research
Swearing reduces physical pain (I’m not condoning it).
How to change your mind.

We may see some sunshine on Sunday! Enjoy the mountains!

Onward and upward,