Art of Medicine

“Many, if not most, medical schools have recognized the value of including the humanities in the education of future doctors, art for medical education. A person who appreciates art is likely to be open-minded, curious, at ease with the unknown, able to tolerate ambiguity, and to approach artwork with a beginner’s mind – that is as if they were experiencing something for the first time. The need for this is expressed by a third year McGill medical student, Susan M Ge, who wrote, ‘Due to the technology available to look into the patient, doctors have lost the ability to see the manifestations of illness from simply observing the external appearance and demeanor of the patient. This void in the area of observation can be filled by the study of art. A piece of artwork holds both the physical and emotional back story of the people depicted in it if one knows how to look.'”13

Art of medicine, art as medicine, and art for medical education via CMEJ.

Study of Epigenetics: Reversing Skin Aging

“’Environmental and behavioural factors certainly can influence the health and vitality of our skin,’ she explains. ‘These external elements can lead to skin damage and signs of premature aging, in the form of wrinkles, dull tone and dyspigmentation, as well as the development of skin cancers. ‘Examples of positive factors include sun protection, physical activity/exercise and a balanced diet. Examples of negative factors include sleep deprivation, stress and pollution.’

More on “How the study of epigenetics could help reverse skin aging: While we know that behaviour and environment can impact skin health, experts hope epigenetics research may offer clues as to what might help repair that damage over time” via Vancouver Sun.

Welcome! CaRMS 2022

Hi & Welcome!

We’re the Abbotsford-Mission Family Practice Residency Team based out of Abbotsford and Mission, British Columbia, Canada. We’re passionate about medicine, your educational journey, and delivering the best care to our community. We know you have several choices ahead and we’re here to help you in making the right decision for your future. Learn more about our program here.

Ibe’s Black Fetus

Chidiebere Ibe’s recent illustration of a fetus has gone viral. From Nigeria, he told CBC News: ‘I’m glad that people are blessed by the work and people feel that it’s time to make great change.’ (Chidiebere Ibe)

“Ware wanted to share the illustration to say, ‘Look, we can do better — this is what it looks like to make change in the medical industrial complex.’

‘This young medical illustrator who’s training to be a neurosurgeon is doing just that. He’s interrupting the process of white supremacy and instead saying, in fact, I want to imagine Black babies being born in this world, so I’m going to draw them … It really shows the importance of representation and supporting those medical illustrators who can actually tell our stories as part of their medical work.'” 

More on llustration of Black fetus has Canadian parents, educators calling for diversity in medical resources via CBC.

Value of Children in our World

Baby’s First Caress. Artist Mary Cassatt. 1891.

“The Sandy Hook, Dayton, and El Paso mass killings have all involved children being victims of violence or losing their parents. It’s not difficult to infer the subsequent lack of gun control essentially means that the public have accepted the murder and suffering of children. This is more than social media rhetoric; children continue to be separated from their parents and/or family members at our borders, and the ongoing practice of separating children from relatives or siblings, while familial ties are validated can take weeks to months. This is not a north American phenomenon as the ongoing plight of Syrian and Libyan refugees demonstrates. As practicing pediatricians and neonatologists, we are enraged that our countries and world, accepts these events happening to children. Why is a principle of zero tolerance not applied to these tragedies, as it is in Sweden to road deaths? (https://www.york.ac.uk/news-and-events/news/2006/zero-tolerance/).

Thus, the question thus arises about the value of children in society. Two decades ago, the Institute of Medicine published a book on the impact of the environment on children, Children’s Health, the Nation’s Wealth. In it is the following sentence on how our societies value our children: ‘The social transformation of childhood in modern societies reflects a retreat from the view that parents have full and unlimited jurisdiction over their children to one, in which the welfare of children is increasingly understood as a shared social responsibility, which requires investments in education, health care, and other institutions.’ Those other institutions may be seen to be institutions engaged in research that assesses and improves child health, both for the child and for the adult the child will become.

From this sentence quoted above, it seems as though the value of our children to society has steadily risen over the past few centuries, since the rights of the child were enshrined in the United Nations convention.

But it seems now that we are in a downward spiral. That the value of children depends on whose child. That the value of children depends on their ethnicity, the wealth of their parents, their genetic makeup, and their socioeconomic level. For example, the infant mortality rate in the US is higher among Black non-Hispanic infants, Native American infants, and Hispanic infants than white non-Hispanic infants (https://www.childstats.gov/americaschildren/infant_mortality.asp).”

Read more on the Value of Children in our World via Pediatric Research.

AI & Digital Pathology

This talk is part of a limited series co-presented by SBME, BMI&AI, and BC Translational DPI.

Talk: “Artificial Intelligence and digital pathology: dealing with the annotation bottleneck”

The introduction of scanners that are capable of digitizing microscopic slides at high magnification has led to an explosion of interest in computational pathology in general and deep learning applied to whole slide images (WSIs) in particular. In my lab at Sunnybrook, we are developing AI models that can detect cancer, automatically segment regions of interest, and learn predictive and prognostic models that can be used to guide treatment decisions. In this talk I will outline some of the unique challenges of working with these extremely large WSIs and discuss some of the approaches that we have developed to overcome the problems of sparse annotations and weak, noisy labels, including self-supervision and multiple instance learning. I will also outline some of the challenges in deploying AI algorithms to the clinic.

Register for free here.

mRNA Vaccine, Covid-19, & Myocarditis

“According to the World Health Organization and cardiology societies, myocarditis is defined as an inflammatory disorder of the heart muscle that is characterized by lymphocytic and monocytic infiltrates within the myocardium, myocyte degeneration, and nonischemic necrosis (the so-called Dallas criteria).

It follows that for a truly definitive diagnosis of myocarditis occurring after vaccination, endomyocardial biopsy would need to be performed and viral myocarditis (including from Covid-19 infection) would need to be ruled out to exclude a chance occurrence of myocarditis temporally associated with the vaccine.

Most of the reported cases that occurred after vaccination had an uneventful course. The take-home messages from the two studies may be that clinically suspected myocarditis is temporally associated with the BNT162b2 mRNA vaccine but is rare, is more common in young male patients, and (with a few exceptions) is self-limiting. As acknowledged by the authors, temporal association does not imply causation, and the risk of vaccinal myocarditis is very low. The results of these two studies are valuable for doctors, patients, and the public to reduce the fear of myocarditis as a reason for excluding young people from vaccination, especially since myocarditis has also been temporally associated with Covid-19. Meanwhile, active surveillance for myocarditis should continue, and endomyocardial biopsy could be performed in severe cases to affirm the diagnosis and possibly to guide therapy, such as the use of antiviral drugs or immunosuppressive and immunomodulatory agents.”

More on Receipt of mRNA Vaccine against Covid-19 and Myocarditis via NEJM.

On the topic:
Mevorach D, Anis E, Cedar N, et al. Myocarditis after BNT162b2 mRNA vaccine against Covid-19 in Israel. N Engl J Med 2021;385:2140-2149.
Witberg G, Barda N, Hoss S, et al. Myocarditis after Covid-19 vaccination in a large health care organization. N Engl J Med 2021;385:2132-2139.
Caforio ALP, Baritussio A, Basso C, Marcolongo R. Clinically suspected and biopsy-proven myocarditis temporally associated with SARS-CoV-2 infection. Annu Rev Med 2021 September 10 (Epub ahead of print).