Thursday, June 30, 2016


I am waiting a week now into my very precious, very special vacation. A year ago my brother was diagnosed with pancreatic cancer and I made the decision that I’d ship my sailboat down to him with the plan that we’d sail together.  I wanted to have him have something to look forward too.
It wasn’t completely unselfish.  Having already sailed to Hawaii solo in winter my next sailing trip would have been to the Philippines, Hong Kong or Singapore.  But the pirates and the Muslim Jihadists made cruising anywhere in the region around Malaysia and Indochina unattractive.  Besides 25 years ago I had sailed GIRI, my 40 foot 13 ton cutter rigged steel sailboat to the Sea of Cortex with my ex wife.  The next plan had been to ship it overland to the Caribbean and come up the inside passage back to Canada.  So here I was positioning my sailboat for the trip down the east coast should I wish to continue. The fresh water sailing in the unknown islands and passages around Kingston.  Mostly it brought my brother and I closer in the project of boat shipping, costly as that was and storage at Loyalist Cove Marina.
Loyalist Cove Marina has been so helpful with the storage and with finding me a berth in the harbour.  I phoned a month or so ago and gave them the dates with the request and agreement for my boat to be restored for sailing for this week from work.  I had expected to find the boat in the water, rigged and ready to leave.  It wasn’t.  It still isn’t.  But my brother needed to begin a new chemotherapy and I accompanied him to Toronto where I met Dr. Aaron Hansen, the new researcher who has accepted Ron to this newest cancer therapy trial.   Ron was given 6-12 months untreated, 2-4 years with treatment. Ron’s past 12 months and happy to moving forward again with hope.
Each month he holds on there is greater hope for a cure as cancer, thanks to research centres like University of Toronto’s  Princess Margaret Hospital Cancer Research, and our west coast UBC cancer research teams are now focusing attention and resources on Gastroenterological Cancers.  Trials of new potentials therapies are occurring all around the world as a major push is being made to address this historic early killer.  The breakthroughs that have cured so many cancers these last few decades I”ve been in practice are now resulting in quicker and more significant advances in individual care. The miracle of scientific medicine that so quickly addressed the Ebola Virus epidemic and the terrifying HIV epidemic has been applied now to cancer and specifically Gastrointestinal Cancer.  Genetic studies that have shown us the building blocks of the human genome now show us the differentiation between cancer and non cancer cell lines.  Chemotherapies are increasingly developed with greater specificities and less side effects.  Ron’s not as optimistic as I am and his doctors are all those ‘modest’ sorts that work in cancer research, medically legally concerned, and "not making any promises’ but they know all the breakthroughs that I know. Since Ron’s first diagnosis I’ve scoured the literature, and increasingly enjoyed listening , as I commute to and from my psychosomatic and addiction psychiatric practice, to the leading symposium from around the world on cancer research, specifically Pancreatic Cancer.  It’s not just for my brother’s sake as I have several cancer patients in my practice with dozens more patients with gastrointestinal disease in addition to their psychiatric concerns.
The rigger who got the mast on Friday, said that he’d be back Monday to finish the re wiring and putting up the sails Monday. The hardware for the boom holder and the radar post are up but the mast wiring and sail rigging remains to be done.  My chemical engineer nephew, Graeme, drove in from Ontario’s Deep River nuclear power plant so we got to do a final check of all the systems on the boat, yesterday. He replaced one of the bilge pumps in record time while together then epoxied a loose stanchion while I expoxied a cockpit drain that was leaking.  The riggers said they’d be back in the afternoon so we waited about and they didn’t show.  Meanwhile my other geologist nephew, Andrew, was flying in that night from the North Pole on a Canadian military plane landing in Trenton Air Force Base.  So God didn’t intend for us to go sailing till he was able to join his brother and I on the boat.  Today, perhaps, the riggers will complete their work and we’ll be able to get the boat out while Ron is feeling good. Despite starting the new chemotherapy he had a really good day 2 and there weather has been perfect for sailing, sunny, light winds.
I’m feeling some anxiety which is disheartening because I’m going to have to fly back to Vancouver in a few days where I’ll be the object of scorn for I keep countless people waiting.  I had a 2 year waitlist to see me a couple of years ago. It had grown and most of my colleagues because of the extreme shortage of specialists have closed their practice or at very least run a year waitlist. If there’s an emergency it simply has to go to the hospital where there now, due to government waste and mismanagement, there is simply no follow through.  Duplication of services is an easily resolved problem which England addressed decades ago as a central feature of their cost saving health care system but the gloriously bloated and outrageously elite health care bureaucracy has had mangers saying, “we don’t need doctors and nurses”.  This is at variance with the whole idea of the ‘medicare system’ which has put government after government into power in Canada and is government’s principle claim to fame even as Obama Care is failing due to administrative abuse.  Canada’s health care system is now 20 to 40 times the administration of the relatively equivalent if not superior German health care system.  The percentage of doctors and nurses to patients has remains relatively constant for thirty years despite the aging practice, increasingly complex medical and psychiatric problems of the elderly and the encroachment on the health care field by the legal beaurocratic parasites which have caused perhaps 90 % of increased costs in health care to be ‘unnecessary waste’ from a strictly medical perspective.
The government is publishing the incomes of doctors so which to the ignorant looks good.  Except that income is not a ‘lifetime’ in come which by contrast shows that nurses who work full time actually make as much if not more than doctors.  Hospital administrators with often only a few years of education and a whole lot of despotism are making more than doctors in reality.  The trouble is that for 12 years I studied, and my study wasn’t ‘academic’. I was in an apprenticeship, from the second year of my training so for 10 years I did the major work of hospitals and institutional medicine.  Medicine is not like Arts PH’D programs. It’s more like trade school, with the academic demands expected by the full time job working at the bed side.  And yes, the requirement is straight A’s.  So while everyone academically wants to say their program is equal, it’s not.  I acknowledge that Colonel Hadfield’s astronaught training program was more strenuous than mine but I only slept one night in three for years and every single day of my internship and residency program I was doing 12 to eighteen hours of patient centred work.  With all the entitlement in Canada today, I hear secretaries from the military saying their jobs are as tough, ‘if not more tough’, than ‘the boys fighting on the front lines’.  We’re a ‘me’ generation so the kardasian want to be complains that her having to get her nails and hair done to look good is a terrible strain.
I have nightmares still about what I’ve seen and done.  Visiting the hospital with my brother I fought down a panic attack and was assailed by images of sliding and falling on blood coated floors in obstetrics, picking up bowels from a dehiscence, the terror of those days and years treating the AID’s dementia biters, being strangled by a patient, finding the dead on the ward, the violence and sickness and disease, the nights were the worst.  I was diagnosed with PTSD years ago.  I drank and smoked dope those first years of the AIDS epidemic, working with AIDS dementia ‘biters’ and seeing colleagues I knew personally die along with patients.  The dangerously insane wards were difficult as well as treating the prostitutes and forensic patients and working with the LBGT patients which others ‘avoided’.  That Christian service ‘calling’ kept putting me in the frontline while all around me others more reasonably chose not to take the risks.  Our Prime Minister drinks wine and smokes dope.  It’s fashionable today.  I haven’t drank or smoked anything in 19 years.  I’m thankful for International Doctors in AA for helping me remain sane and practicing medicine.  I did my addiction medicine sub specialization and continue to work with two types of practice, one I call ‘uptown’ and the other I call, “downtown’ . Some days I overhaul totally crashed Ferraris, Rolls Royces and  Cadillacs while other days I do tune ups on Ferrari’s, Rolls Royces, and Cadillacs.
I’m going to have another coffee and go to the Loyalist Cove Marina. Patience.

No comments: