Category Archives: en route…

Guest blogger: RETIREMENT/30/65/GRAD

Standard

Editor (Sara)’s note: For the first time in saratreetravels history, we are proud to welcome a guest blogger to our travel universe – my (tied-for-) favourite travel partner and mother, Mary!!

20180614_133632

What a year!

Sara and I talked about doing a major trip, but her idea and mine of a major trip were two different things. When she asked me where I would like to go, I stretched it to my biggest dreams I could imagine of what I could do in my lifetime. I suggested wild things like a train trip across Canada, or sitting on the beach in Hawaii (which by the way was slowly being covered by lava). I stretched even farther to the Alaskan cruise up the West side of our fair country.

Imagine my amazement when I received the email from Sara who must have chuckled at my ‘amazing dreams’. My dreams were so small. She sent me an agenda that saw us flying to Rome. “Now” she said “what would you like to see now?”

Editor’s note: Small?! Absolutely not how I would describe my mom’s dreams… her life has been my inspiration to dream big!

Now my vision was set farther. Europe was never in my thoughts for a trip I could ever do in my lifetime. Now I had the ticket, just had to come up with an agenda. Sara asked me, “NOW what do you want to see?” I threw out things that I had dreamed of, again, never expecting to see them happen: The Coliseum, the Vatican, Pompeii, Venice, maybe a side trip to Ukraine to see dad’s family again.

Sara took my ideas under advisement, and came up with an agenda of almost three weeks. I got my boat cruise (not the Alaskan Cruise, but on the Danube which I had planned with a friend who had passed away before we could see it). I got my train trip (two actually), I walked the Coliseum (oh yes, it was at the end of our street in view of our hostel) and the Vatican. I walked Pompeii and marvelled at the amazing lost city. I took a gondola on the canals of Venice and visited the lace museum in Burano. We experienced the amazing city of Vienna and the Matyas heritage in Budapest including public baths and the Matyas church and castle.

Wait, what’s that we spy from our front door? Could it be… ??!!

Exploring the ancient mysteries of Pompei

Aboard a gondola for a canal-eye view of Venezia

El Museo del Merletto (The Burano Lace School & Museum)

Stadtpark Vienna City Park

Beautiful Budapest

As a grand finale, we took a train to Lviv, Ukraine and then drove to Lanchyn where I was able to once again see my dad’s village, walk the roads that he walked, sit for dinner with his family.



What an adventure! I am so grateful to have had this chance to see all I did. Kudos to Sara who planned all this in spite of writing exams and doing those things required to complete her MD. Challenge should have been her middle name because she most certainly meets the challenge. However her middle name is even better: Hope. Without the Hope, we don’t have energy for future plans. And so I say “Thanks for the memories.” It was an awesome experience of a lifetime!

20180604_210934-1

Advertisements

Whatsapp? A Tale Of Two Sleeper Cars

Standard

June 05, 2018
Euro Night Schlafwagen Sleeper Car, somewhere between Venice and Vienna.

[06-05, 10:55 PM] Sara M.: Oh man oh man oh man, my love!!!!!! I am currently on the Schlafwagen – yes, you read that awesome German right – the night train to Vienna! I don’t have wifi but I am actually SO PUMPED I just had to Whatsapp you anyways and it’ll send when it sends …. this sleeper coach is freaking FANTASTIC! My mom and I are totally balling out here! Slippers, a teeny tiny sink, a crazy rope swing to keep me in my ludicrously high top bunk as the train rocks, free sparkling wine (it was on our bed and my mom being a …

[06-05, 10:55 PM] Sara M.: HOLD THE PHONE. THIS BROADCAST INTERRUPTED TO INFORM YOU THAT MY MOM JUST DISCOVERED THERE’S A SHOWER IN OUR CAR. A SHOWER. I JUST SHOWERED ON THE TRAIN. No wonders of Europe can ever – EVER – compare with that.

[06-05, 10:55 PM] Sara M.: (Continuing on with our saga)

[06-05, 10:56 PM] Sara M.: … shameless uke and asking the porter (who btw, came to ask our BREAKFAST ORDERS), “Is the wine complimentary??” And him replying, “But of course. We just want you to enjoy your evening.”

[06-05, 10:57 PM] Sara M.: Holy crap. This is what happens when josh and not sara books the overnight train 😛

[06-05, 10:57 PM] Sara M.: (I said that to my mom and she replied, “I like josh.”)

June 06, 2018
Meanwhile, back at the ranch…

[06-06, 2:17 PM] Joshua: Hahahahaha WOW this was an epic text-barrage to wake up to!

[06-06, 2:18 PM] Joshua: Lol I’d forgotten that I had bought that ticket! Well, you’re welcome, you’re welcome (said in my Maui voice, of course)

P1200186

June 09-10, 2018
Polrail… Sleeper car? Maybe. Definitely not Car 431 (since that was on our ticket and that would thus make too much sense). Somewhere between Budapest and Záhony.

[06-09, 11:19 PM] Sara M.: I don’t know if 2 sleeper cars could be more different than Polrail vs. The Schlafwagen.

P1200547

[06-09, 11:20 PM] Sara M.: To begin, Lviv wasn’t listed as a destination on any of the trains, and there were literally zero train employees anywhere in the station to ask. A cleaning lady told me this was the right train, but our car # was not to be found (we were car 431, and the train only had up to 405). So I’m running up and down the train and finally just heave mom and the suitcases onto a car and find some seat numbers that kind of match ours. There’s only one other lady seated in the whole car and we have a very confusing conversation in English / Hungarian, during which she just repeated “Chop? Chop!” And I repeated “Seats 11 and 15!!!”

P1200553

[06-09, 11:24 PM] Sara M.: My mom saves the day at this point by discovering lady is Ukrainian , so they immediately start chatting in Ukrainian about grandchildren, which is adorable, whilst I try to puzzle out where the heck we may be off to. FINALLY an employee comes along! I show her our tickets and she goes huffily, “Sleeper car. Dat way.” I’m trying to gesture and figure out where we’re going, when she snaps, “Or stay here, up to you, I don’t care!!”

She then descends on our lovely new friend and informs her, “Your ticket second class. Out. ”

Our lady obviously can’t understand English, so employee raises her voice and goes, “Idiot. Second class! Two!! Dva!” Then she turns back to us, “Sleeper car! Go!!”

[06-09, 11:28 PM] Sara M.: Ay yi. We go through what looks like an engine room and so I had assumed was off limits but nope, apparently just the way to first-class (Obviously. Maybe I am also an idiot). We find our berth. We’re so amazed and relieved there are actual beds (and not the non-reclining chairs we had thought were our “Sleeper car” seats!)

Suddenly, this balding unshaven man in dirty jeans and a beer t-shirt comes out and gets in our room, and is gesturing at the beds and grabbing at our sheets, and waving his finger at us. Both mom and I are both thinking the same thing, namely, “Holy #@$% is this guy sharing our berth????!”

I’m telling him that we have tickets and saying the berth number over and over again, and he then grabs our tickets and says, “I take these, give back in Lviv.”

[06-09, 11:30 PM] Sara M.: Wtf um, NO. So I try to grab them back and he’s getting all pissy and finally yells, “Yura!!!!!”

And Yura, this kindly older gentleman dressed in – imagine that! – a train uniform with an ID badge, comes in, and says yes, we’re in the right place and he’ll take our tickets now and give them back in Lviv. And then he brings Mom coffee in a beautiful silver salvar and leaves.

[06-09, 11:32 PM] Sara M.: Mom and I just couldn’t stop laughing and calling yelling man every bad Ukrainian name we could think of (“Snot-nosed whiney idiot flower pot!!” …it loses something in the translation). Who the heck WAS he???

[06-09, 11:32 PM] Sara M.: Needless to say, there was no breakfast menu or sparkling wine, so good thing we still had a bottle of prosecco from the Schlafwagen — we definitely needed it!!!

[06-09, 11:33 PM] Sara M.: Just spent a lovely few hours sitting and knitting with mom, and now it’s almost bedtime. When I wake up … I’ll be in my country!!!!

20180609_201705

[06-10, 12:44 AM] Sara M.: Oh jeepers. Woken up by literal banging on the door at midnight — welcome to Ukraine! Border guards on-board to examine everyone’s passports!

[06-10, 1:25 AM] Sara M.: Dear goodness. Ever since crossing the border, the train has been grinding deafeningly. It actually sounds like it doesn’t fit the tracks. Eff. Looks like there will be no sleeping in this sleeper car 😑😢😩

[06-10, 1:46 AM] Sara M.: Psych! That was actually just the Hungarian exit crossing! NOW it’s Ukraine entry time! 😣 Bwahahahaha Mom definitely found her Ukrainian sassy vibe and when there was more banging on the door, she yelled, “Що ти хочеш!?? Що ви робите?!!!?” (“What!!? What do you want???!”) in Ukrainian. Safely hiding in my top bunk, pretending I didn’t understand anything, I let her deal with the border guards!

[06-10, 1:47 AM] Sara M.: Got my passport stamps!!! Ay yi, onward ho?

[06-10, 3:05 AM] Sara M.: Update – 3AM and still no ho.

[06-10, 7:15 AM] Sara M.: Aha. So apparently a giant crane came sometime after 3AM and fixed something on our train before we could start moving again.

Even the toilet paper knows we’re in Ukraine. It is literally a roll of crepe paper streamers, the colour of every good Slavic birthday party: grey.
20180610_084326

First glimpse of the Motherland!!
P1200556

[06-10, 9:14 PM] Sara M.: Still more hiccups upon arrival, where seminary people [random family contact in the Ukrainian Baptist community who were graciously allowing us to stay with them during our time in Lviv] were supposed to meet us but no one was at the station and we were kind of peeved and there was no Internet and no phone number to get ahold of them… but we ended up talking to a lovely cabbie who informed us there was the UKRAINA RUN marathon today (but of course!) And so no cab could even get through to the seminary. We were about to brave public transit but stopped for some breakfast first and GOT PEROGIES and suddenly we weren’t peeved at all anymore 😊😊😊😄😄😄

[06-10, 9:15 PM] Sara M.: And then perogy place had wifi and we got the mobile # for the seminary guy who was apparently wandering the station looking for us! He (and everyone at the seminary) are so exceptionally lovely and our rooms are freaking ginormous! Except we each have our own and it’s actually really sad to be separated down the hallway!

June 10, 2018
And again, back at the ranch…

[06-10, 5:56 PM] Joshua: Wowwwwww you basically just composed a complete blog entry just through these whatsapps! That sounds absolutely crazy! Glad you guys look happy (in a just-teetering-on-insane kind of way 😝)

20180610_101942

Shant-outings*

Standard

*Thanks to Joshua for the oh-so-punny title

As mentioned previously, Shantou is tucked into the coastline of the South China Sea, making it the perfect jumping off point for day trips to the numerous surrounding islands. On our first weekend in China, myself and the other Canadian exchange students took the ferry for 1 yuan (~20 cents) across the Shantou Harbour and landed on the idyllic shores of Queshi island. We were greeted by a woman expertly dissecting pineapples with a machete and neatly skewering the slices onto long skewers. An entire pineapple for 7¥ ($1.5) seemed a reasonable price to pay for a snack as we walked along the island’s meandering paths.

View of Queshi from the Shantou side of the sea

P1180118


Our goal was the pagoda we had seen every morning we walked along our side of the harbour. On our way up the mountain, we explored a series of naturally formed granite caverns with such enchanting names as “Rainbow Lying Cave,” “Happy Fate Cave,” “God’s Shoe,” “The Platform for Watching Sight of Flame Mount,” and “Three-Tier Cave Toilet” (on second thought, maybe that last one was 2 separate stops…)

View of Shantou from the Queshi side of the sea! 

Terrifyingly steep steps into the caves!

Lovely lunchtime stop
P1180192

Giant Buddha (only after an entire photo sesh with G.B. did we realise we had been sitting in front of a sign that read, in Chinese, that pictures cost 2¥ each… and consequently a terrifying encounter with the giant security guard ensued)

After eating lunch in the pagoda at the mountain peak and paying our respects to giant Buddha back down on the ground, we headed back to the ferry. Before we had even landed back on mainland, we were already receiving WeChats from our host students, inviting us out for an evening of quintessential Chinese cultural fun: KTV.

KTV (aka karaoke) is more than just a past time in China… it’s practically an art form. Whole streets are lined with massive KTV buildings, each hosting a multitude of private rooms where groups can order food & drinks and custom-create a karaoke setlist of K-Pop and the newest Swifty singles. At KTV, the most stoic and shy of students suddenly comes into their own and discovers their latent pop stardom, belting out sexy ballads with no restraint or reserve whatsoever!

Post-KTV, we were up bright and early to board the bus taking us to a village about 2 hours from Shantou. Interestingly enough for a self-declared Communist country, healthcare is not publicly funded in China, and therefore many citizens cannot afford basic medications or even a simple doctor’s visit. Thanks to Guangdong-born Hong Kong billionaire philanthropist, the Li Ka-Shing foundation has instituted numerous charitable works to address health inequities across the country, including the one we were participating in that morning – Medical Aid for the Poor (MAP). Once a month, MAP physicians set up free clinics in villages near Shantou, providing free medications, blood pressure readings, and specialist consults. They also provide home visits for any rural citizens unable to transport themselves to the clinic.

My lunch at MAP won the honour of being the most interesting food I have ever eaten to date: I was so proud of myself initially for trying what I was convinced was liver, since I had never had that before. But when I checked in with my Chinese friend, she blithely corrected me: “Oh no, those are blood clots. Maybe pig? Probably dog.”

P1180275

Home visits & tour of the village temple

Since we were spending so much time in “small town” China (remember that Shantou’s population is a mere 5 million), we thought we should grab the chance to see big city China at its most iconic: Hong Kong.

P1180510

For being so close to Shantou, it was a headache and a half to actually make our way to HKSAR. A chartered car, a bullet train, a subway, a walk through two sets of customs, and another subway later, we were finally in our Hong Kong home for the weekend – an itty bitty hostel room on the 14th floor. The rule was that some part of each person had to be touching their bunk at all times, otherwise there was not enough space for us all in the room!

Hong Kong had some noteworthy features: milk tea, pork floss toast, the mind-blowing bus ride up to Victoria Peak (call me small town, but I have never seen buildings rising up higher than the surrounding mountains!!), and the hilarious experience of finding our way up to the “Highest Bar in the World” and negotiating with the hostesses and fellow patrons for rented pants so our male compatriots could actually enter the bar (because apparently, while shorts are incredibly offensive and inappropriate, ankle-skimming polyester gems passed around to 3 different gentleman in 1 hour are far, far more acceptable). However, in general, I do not feel the need to go back to HKSAR. I feel so privileged to have spent the majority of my time in “small town” China that actually felt unique, and not simply like a crowded version of any forgettable kitschy American town.

Buildings, buildings everywhere…

The day after arriving back in Shantou from HKSAR, we were again packed into a bus, this time to trek several hours to Nan’ao island, where we spent a lazy day hiking up to yet more pagodas, watching our bus driver carve roast chicken with his bare hands, and getting yelled at by locals for daring to swim in the ocean (apparently, that’s just not done).

All in all, our Shant”outings” made an already memorable exchange even more extraordinary. And after three weeks of this, I still had a week of true holidays left…
(To be continued!)

20180317_013353

Barefoot to White Coat

Standard

Having returned from my three months of out-of-province electives, I settled back into the swing of things at home… at least for the next two months 😉 I was at home just long enough to do some CaRMS interviews for my upcoming residency specialty training, complete my final undergraduate OSCE (a lengthy clinical exam with actors pretending to be patients suffering from a variety of weird and wonderful ailments), and spend an incredible month working with the Program of Assertive Community Treatment (aka PACT), a service provided at home to individuals with severe and persistent mental illness, helping them stay out of hospital and maintain their independence in the community.

March 1 was Match Day, the day where medical students all across the country are informed which specialty program they have been accepted into; or in other words, the day we find out what type of medicine we will be practicing for the rest of our careers. I was beyond thrilled to match to my first choice of Family Medicine – Northern-Remote stream, a specialized Family Med program designed to address inequities in access and quality of healthcare for Canadians living in rural and remote areas, particularly those of Indigenous descent. While every Family Med program across Canada offers excellent medical training, I was drawn to the Northern-Remote stream for its unique decolonizing vision and immense scope of practice. And now, as of July 1, I will be a member of its team!!

“Plan B” theme party on Match Day Eve – Joshua and I showed up as WWOOFers, to nobody’s surprise!

Match Day!!

Even after some epic Match Day celebrations, the adventures were not over! Two days after the Match, I boarded a plane along with three other med students, and two days after that, we landed in Shantou, China, a “small town” of only 5 million people in the Guangdong province, nestled on the coast of the South China Sea.

Our apartment complex and view from my window

Seven minute walk from my apartment to the harbour!

The four of us had the immense privilege of being chosen to participate in an international medical exchange with one of our sister universities. Every day for three weeks, we toured two different hospital wards, ranging from Neonatology to Hepatobiliary to Orthopedic surgery. An English-speaking physician was assigned to us on each ward and would accompany us on bedside rounds of their patients.

The brain tumour research hospital… appropriately shaped.

Shantou “Hospital #1”

Bedside rounds & teaching


There were a number of striking differences in the Shantou hospital wards compared to our Canadian wards, but the most notable by far was the organization of care. In North America, family physicians (known in the past as “GPs”) are the first stop for the vast majority of patients. Sore throats, earaches, slipped discs, period problems, prostate problems, depression, pregnancy… most health concerns can be treated directly by a family doc, but if need be, the patient is then referred to the appropriate specialist for more unusual and complicated health conditions.

This type of healthcare organization, aka with a “primary care” focus, is rare in China, and the vast majority of individuals in China bypass primary care physicians and attempt to access specialists directly for all healthcare concerns. In other words, if you have a headache, you try to see a neurologist. A cough and sore throat? You hope to somehow snag an appointment with a respirologist. Partly this is due to cost: with China’s three-tiered system, individuals are required to pay for most services out of pocket, so patients do not want to risk having to pay a family physician and subsequently pay another fee to a specialist. Furthermore, there is a strong historical component that has cultivated a sense of mistrust towards the idea of primary care.

Several decades ago, the concept of “primary care” referred to farmers in rural areas who received a mere 3 months of training by urban medical professionals, in an attempt to address healthcare access issues for the enormous rural Chinese population (which represented 80% of the total Chinese population during the 1970s and 1980s). While these “barefoot doctors,” as they came to be known, provided some relief to the healthcare crisis, their training and medical expertise was understandably unequal to that provided in tertiary care centres staffed by fully trained physicians. The barefoot doctor system eventually collapsed under economic policies introduced during the Cultural Revolution.

Family Medicine was only introduced as an official specialty in Chinese medical schools in 1999. In 2009, new health reforms were put in place in response to rising public frustrations over difficulties in accessing professional medical care, as well as the steep prices associated with healthcare. The Chinese government instituted a goal of training 300 000 family physicians by 2020; even this impressive number, however, would still only provide 0.2 family doctors for every 1000 citizens (in comparison, consider that there are 1.17 family docs per 1000 Canadians – ~6x more than in China – and that is still woefully inadequate!!)

Some may think that China’s approach to healthcare is actually more effective; after all, cutting out the middle step of a family physician should likely result in faster and better service, right? On the contrary. Since 2009, primary care use in China has decreased, while visits to hospitals and specialist services have increased significantly. And sadly, death from all causes, money spent on healthcare, and inequity between rural and urban health measures have also increased in China. Multiple studies have shown that regular primary care improves health outcomes and reduces time spent in hospital. But unfortunately, in China, people with multiple different health concerns tend to use specialist and hospitalist care over regularly seeing a family physician. Moreover, people with lower incomes tend to have poorer access to primary care services, and therefore are at a higher risk for poorer health outcomes in general.

The partnership between our university and Shantou has been an exciting adjunct in addressing the primary care gap in China. While in Shantou, Canadian Family Medicine faculty and residents were very involved in giving lectures to and leading discussion groups with Shantou medical students and residents.

It was fascinating to discuss both the differences in clinical approaches between China and Canada, but also realize just how many similarities existed between our sites. As one preceptor stated, “We are all just trying to provide the best care possible to our patients.”

Truer North

Standard

Nunavut.

The word evokes such longing and mystery, perhaps in part because I actually remember the announcement of its creation as a territory (also perhaps because that memory occurred while I was sitting in a junior high science class, a location that also evokes feelings of longing [but to leave] and mystery [but of acids and bases, which I still don’t fully understand]). While both the sara and the tree authors of this blog are titillated by the thought of any travel, the far North of Canada holds an especially strong fascination for each of us.

Which is why, when an inspiring physician mentor asked me rather out of the blue if I’d be interested an elective in Rankin Inlet, I couldn’t stammer out my acceptance fast enough. It turns out that she was offering an elective that did not quite exist yet: While the site took pre-clerks for summer early exposures and resident physicians for part of their Family Med specialty training, Rankin had never before been a part of the electives list for Med 4 students. Like so many other decisions I made this fall, trying to apply for an elective we were creating on the spot made my elective application process exceptionally interesting!

Hiccups (like finding out only a few weeks ago that one apparently needs a special educational permit to practice in Nunavut which normally takes months to procure… but I got that bad boy with days to spare, thankyouverymuch!) and weather advisories (apparently the day of my flight here was one of the few days this month they didn’t have a blizzard!) aside, it has actually been a remarkably smooth transition to this, my last out-of-province elective of these crazy 3 months away. After a rapid-fire but perfect 36 hours home in Winnipeg (huge thanks to Tree and our lovely roommates Scott & Laura for making that happen 🙂 ), I repacked my bags, traded my spring jacket for my new long down parka, and climbed aboard a tiny plane for a bumpy ride north.

Serendipitously (although the more remote you wander, the more frequently serendipity seems to become the norm), my host’s son and an indeterminate amount of cousins were on the same flight from WInnipeg as me, so I was welcomed at the airport by a bevy of friends and relatives who all seemed to pile into the car with us for the drive home. After a late night supper of delicious homemade ribs (my host apologized that they had just run out of caribou meat, but assured me her dad is going hunting this weekend!), I crawled into bed and had already drifted off by 10PM… when suddenly at 10:30 a crashing knock at my door sent me bolting upright. “Sara!! We’re sorry to wake you, but there are bears at the dump!!”

My host had seen her friends posting on Facebook pictures of a momma polar bear and cub meandering through the town, a rare sight in this town that is normally too far inland for bears to venture. We hopped into her truck and tore along the rimy roads to the dump, where we were greeted by the lights of 20 other trucks already sitting for the show. (Un?)fortunately, the wildlife rangers had chased the bears from town by the time we arrived, so we had to content ourselves with the ominous beauty of a massive harvest half moon, and the thrill of trying to back the truck down a narrow ice ridge lined by looming piles of snow and trash.

ᖁᔭᓐᓇᒦᒃ / qujannamiik / quana / ma’na (just starting to learn the difference between Inuktitut dialects!) for the first memorable day of many…

Caring For & About

Standard

Rewind one month ago to my final week of Med 3, a week that naturally included me hosting a family party, two band practices, a live radio interview, a final call shift, an NBME, an out-of-town house guest, and an album release.

Celebrating Annie’s 60th, with love

Heathen Eve’s radio debut on UMFM’s “Made You A Mixtape”! http://www.umfm.com/programming/shows/episode/43586/

Album Release!! “Reconcilable Differences” now available on Spotify, iTunes, Google Play, Bandcamp, and local music stores near you 😀 https://heatheneve.bandcamp.com/releases


12 hours after our show ended, I hastily shoved some clinic clothes and my stethoscope into a backpack and climbed onto a plane to Sudbury for my first Med 4 elective – a three-week placement in Addictions Medicine. My weeks were spent in a vast variety of community services aimed at helping patients recognize and manage their substance use disorders (SUD). One of the clinics I worked in specialized in “opioid replacement therapy,” which some people may recognize by names like “methadone,” “MMT,” or “Suboxone.” This is a treatment option for people with opiate use disorders (morphine, hydromorphone, Percs, Oxy, etc.) that provides a carefully-prescribed amount of medication (either Methadone or Buprenorphine/Naloxone) that acts in a similar way to opioids in people’s systems, helping them to safely reduce the amount of opioids they need to take and avoid crippling withdrawal symptoms and/or overdose. Harm reduction houses are another valuable service in the Addictions field, where individuals at risk for or experiencing homelessness are offered assistance in securing housing, while also addressing alcohol use disorder through harm reduction strategies such as monitored alcohol administration. Residential treatment programs are a major component of Addictions, ranging from abstinence-based programs (where clients cannot use any substances for a period of time before entering treatment) to harm-reduction programs (where clients are able to be actively using substances while seeking treatment, and efforts are made to minimize the risks associated with using), to anywhere on the spectrum between the two.

Residential treatment programs such as Benbowopka aim to address SUD by helping clients re-establish balance in their mental, physical, emotional and spiritual health

In particular, I spent several days working with Monarch Recovery Services, an “Addiction Centre of Excellence” that offers treatment programs spanning individuals who are managing active withdrawal, who are acknowledging their SUD for the very first time, who have been living in a recovery home for a year, who have started work again and require some help with housing, who have an SUD and discover they are pregnant, who have five kiddos and are struggling with an SUD, who have been abstinent for 10 years and continue to come to Aftercare for support with their SUD.

Getting familiar with Sudbury’s core downtown areas

I know for some this is a hard topic to read about, hear about, or even think about. I know addictions and substance use have not, historically, been topics that have been treated with the greatest grace. But the fact of the matter is that addiction is a chronic health condition. The Canadian Society of Addiction Medicine (CSAM) defines addiction as “a primary, chronic disease of brain reward, motivation, memory, and related circuitry. Dysfunction in these circuits leads to characteristic biological, psychological, social, and spiritual manifestations.” But with that definition comes hope: As a recognized medical entity, addiction is now recognized as “a preventable and treatable disease, helping to shed the stigma of misunderstanding that has long plagued it.” In other words, addicts are not necessarily “bad” or scary people. They are people with a serious health condition that, like any health condition, requires a balance of external support and personal action in order to prevent (ideally!), recognize, and manage it. More often than not, addiction co-occurs with trauma, since “addictive behaviours [are] a way of coping with emotional pain, a way of self-soothing that is not appropriate.”

An individual I spoke with eloquently summarized all of the above: “I know I have an addiction. But the question is – why do I have it?” A crucial component of recovery from an SUD is learning healthy life skills and effective coping mechanisms to replace the destructive dependance on substances as a means to attempt to handle challenges. But, as stated by Dr. David Marsh, a NOSM Addictions Specialist, “A drug user is never going to come to treatment if they die of an overdose.” In other words, while modalities like wet shelters or opioid replacement therapy do not address the underlying why? of an addiction, evidence shows without a doubt that they reduce the number of overdose deaths (see page 21), thus allowing patients the chance to stabilize to a point where they can enter further treatment to address the root causes of their addiction.

As someone who is both a professional in the medical looking to help clients with addictions, as well as an individual who is personally affected by people with addictions, this has been a difficult topic to approach. It has been challenging to recognize that I feel able to offer a very different type of support to clients who are struggling with addictions compared to those I know personally who are struggling. Does this make me a hypocrite? Am I callous towards those I claim to love?

But I have come to recognize that “caring about” and “caring for” are two very different things, and are fulfilled by different people occupying very different roles in the client’s life. Unconditional love is the role of a family member or friend. It proclaims, “I see you as a human being worthy of love, and I care ABOUT you.” But unconditionally loving someone does not mean you can or should care FOR them.

Caring for someone’s withdrawal symptoms, assessing the need for counselling through past trauma, helping them recognize and address a dearth of essential life skills – these are needed roles for professionals such as physicians, social workers, therapists. Caring for someone with a SUD requires a certain level of neutrality and distance. As the healthcare professional, I am not living with the individual struggling with an SUD or affected personally by their finances/relationships/housing/behaviours. Therefore, I am able to advocate for that individual 100% without compromising my own health or safety – as is often the case with family members or partners involved.

In the last several decades, we have made amazing advances in our understanding of and ability to manage chronic diseases like diabetes and arthritis. Let us open the door to understanding the world of addictions in order to start breaking down barriers to effective care.

Taking time for personal wellness with Thanksgiving swims at favourite park #1

Golden afternoon walks through favourite park #2



Adios for now, Sudbury. Next stop, Toronto!

First Impressions 

Standard

We arrived in Cuba after a seemingly impossibly short flight… well, an impossibly short flight preceded by a classic Josh and Sara route involving a 16 hour road trip with our roommates to the Traverse City Film Festival, a Real Madrid vs. Chelsea football match in Ann Arbor, Michigan, some intense archery and cake auctions and Gravitron shenanigans with Josh’s siblings at the Alma County Fair, and a quick road trip to Toronto with my wonderful mother in law.

Pasties in the Yoopee
P1150191

Josh and his mom… alias the Pres-B-Rapperz (please, please ask Josh for a repeat performance!)
P1150197

¡Hola Cuba!
image

With our only direct flight option being to fly into Varadero, our plan was to arrive there at 1:30PM and get out of there as fast as possible. As previously mentioned, there are a lot of opinions surrounding Cuba, and we were no exception. We had placed Varadero firmly into the category of tourist kitsch, brimming with resorts, overpriced key chains, and restaurants proudly advertising English-speaking servers. However, the vagaries of buying Cuban bus tickets online meant that the only bus that would bring us directly to Santiago de Cuba had us spending the next nine hours in Kitschityville Horror.

Resigned to our fate, we found a friendly Swiss guy to share a cab to the bus station from the airport (he was actually on his way to visit a friend in Vancouver, but as a flight with a 12 hour layover in Cuba was the same price, he had decided to hang out in Cuba for the day), found a guarda-equipaje for our bags (in other words, for $2CUC, we stood them behind the chair of friendly cleaning lady in the bus station), and then we ventured onto the streets of Varadero…

image

…And two blocks behind the bus station, found the most glorious white sand beach, sprinkled with only a few sunbathing bodies and a generous serving of reggaeton. Up the street from the water was a neighbourhood dotted with restaurants, where we received our inauguration to Cuba’s frustratingly charming habit of handing you a hefty menu while rapidly reciting the few choices that are actually available. (Side note: My favourite game while dining is now witnessing Josh’s unfailing optimism/denial* as he asks about a different dish that the waiter didn’t mention but perhaps may still be available, and then watching both the waiter’s and Josh’s faces fall into bemusement as the available menu options are repeated.)

Our unexpected welcome to Varadero
image

Our resolve to consume only bottled water products lasted exactly how long it took us to realize that all cocktails contained ice cubes. So far, so good! 😉
image

Ron de 3 años y Añejo de 7 años. 0.70 cents and $1.20 respectively
image

While “No hay!” (We don’t have it!) is indeed ubiquitous in Cuban restaurants, the promises of apathetic service and bland food simply do not deliver. Avocados, spiced tomatoes, tender beef, fresh seafood, tropical fruit, and of course, the classic (and classically named) rice-and-bean dish “Cristianos y Moros” — literally Christians and Muslims — are served in huge quantities by generally smiling waitstaff

So what have we gathered so far? That some sections of Varadero are undeniably kitschy and removed from Cuban reality, while others are definitely not. That some food and certain sabores are lacking in Cuban restaurants, while others are most definitely not. And that some Cubans work in jobs they are not suited for and could care less about, while others (…following me yet?) definitely do not.

When there is a single and controversial political ideal that unites a country, it can be tempting to assign all responsibility for the small faults and annoyances in a country to that ideal. But with excruciating honesty, we admit that in our own country there is merchandise that is occasionally unavailable (I worked at Blockbuster on Friday nights, I saw the madness that ensued when we were out of Little Man!) and service that is occasionally the absolute worst (anyone else remember the terrifying Sub Zero lady?)

Yes, la Revolución has caused some difficulties, as further days of travel and future blog posts will uncover. But in our first few hours in Cuba, we happily discovered that first impressions can make a big impression on unfounded opinions.

image

*Editor’s note: While Sara has indeed derived much entertainment from my interaction with waitstaff, optimism/denial are not entirely accurate. Example 1: when you order pizza on the side of the road and the guy asks “cheese?”, it is not unreasonable to ask “oh, what else is there?” If he had simply said “cheese” — full stop — I would have accepted that that was the singular option and that, for some reason, he felt the need to state that. Example 2: when the waitress takes your order for pork, then asks if you want rice with a side of pork, I can not be alone in thinking that clarification is needed, amiright??**

**(Turns out no clarification was needed. I was, in fact, being offered pork with a side of rice and pork.)