Archive | March, 2013

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Witty Concerti

Posted on 25 March 2013 by Hao Li (Meds 2016)

1948…the year when the world almost lost three of 20th century’s greatest composers to the power-hungry wrath of politics. The entire Soviet Union watched as Sergei Prokofiev, Aram Khachaturian, and Dmitri Shostakovich one by one made their way to the platform and apologized to the people for producing corrupt and abominable music that contaminated the goodness of humanity. They had just been condemned by the Communist government for the “formalism” characteristic of their works. The punishment was brutal humiliation. Perhaps none was affected more profoundly than Khachaturian, who later said of the event: “Those were tragic days for me… I was clouted on the head so unjustly. My repenting speech…was insincere. I was crushed, destroyed. I seriously considered changing professions.” Continue Reading

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Wellness on the mind

Posted on 18 March 2013 by Jimmy Yan (Meds 2015)

I guess it’s just that time of the year. The latter half of our 2nd term is rising over the horizon, March Break (aka vacation time) ending, finished with St. Patrick’s Day and Easter just around the corner, the tax season deadline approaching, and the slow but inevitable lurch forward (like some sort of not giving up…school guyof clerkship, all these things have got me thinking about the whole “work life balance” and wellness.

Again.

Yes, I realize this topic enjoys as much attention in medical school as pictures of cats do on the InterWebs, but with the 1st OMSA Wellness Retreat geared up this Friday, it’s hard not to think on the subject and muse.

The concept of Wellness has developed it’s own curriculum. Through stand-alone lectures, lunch time seminars and workshops, regular emails (while writing this piece, I actually received an email regarding Wellness), and sharing of published literature on the subject, Wellbeing and learner health has become as integral to the medical school experience as anatomy. This has obviously been a great improvement upon the attitudes and culture in the past.

As a side note, an interesting piece of history can be found when examining how one of the longest standing traditional notions in medicine, the superhumanly long overnight on call shifts, was largely influenced by the work habits of a prominent physician who himself was using and addicted to cocaine throughout his whole career (it was not yet illegal at the time). While better regulation for sleep and shift scheduling have finally been implemented, through the goggles of hindsight it is fairly obvious that such a practice was inevitably unbalanced.

But with the acknowledgement that there is more focus on Wellness and Health these days, more than ever, in medical school, there should still be a caution on how the pendulum has the tendency to over swing.

The caveat  that should be mentioned is that Wellness is not simply an ends to reach, or another goal to accomplish, or another role (like the other CanMeds ones) for students to adopt and check off their mental CVs. Nor should Wellness remain focused solely on Physical and Social wellbeing. While these are necessary components to wellness, there are other equally important components that are under-appreciated.

Current Wellness Counseling theory contents that a person’s wellbeing and individual health can be conceptualized to include aspects of physical, intellectual, social, spiritual, emotional, financial, and occupational (or environmental) wellness. Each of these components can be in or out of balance, and it’s important to appreciate what could be missing in one’s lifestyle. That said, I will reiterate that it shouldn’t be about determining that components A, B, or C are depleted and by doing activities X, Y, Z, they will be more in line with the other ones, but rather realizing a lifestyle that can fulfill these aspects to your satisfaction.

I realize that this doesn’t require a total and sudden makeover (are you thinking what I’m thinking?), but is more of a mindset that one adopts over time. And, as one of the more infamous Night Owls in my class, definitely a topic I could use some more appreciation about.

Well, I got a few more days to think about this as I head to the Wellness Retreat this weekend. As overemphasized as this subject is, I still believe in it’s importance and am very excited for a weekend designated especially for learning more about it.

 

 

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The Hidden Beauty of Ugly Music

Posted on 08 March 2013 by Hao Li (Meds 2016)

Why do I love classical music so much?

When I was little my mom told me that while I was still in her womb, she played records of classical music to me. After I was born my parents encouraged me to listen to voluminous amounts of classical music. They desired to bring me up with an ear for what they perceived as “nice music”. And that is what I thought of classical music initially, “nice music”. The first classical CD that I recall ever listening to was that of Mozart’s Eine kleine Nachtmusik, I was four at the time. I also remember my experience of hearing Beethoven’s Für Elise for the first time, and how I was so deeply mesmerized by the sound of it. Though I was only five, as the timeless, ethereal melody entered into my soul I knew that I was entranced. Snared. In love.

My formal training in music began in the same year in the form of piano lessons. For the next few years, these lessons would continuously reinforce my already hardened preconceptions of classical music, that of it being “nice music”, beautiful to listen to whether you were young or old, boy or girl, good or bad... Indeed, my first pianistic ambitions were to somehow learn to play Beethoven’s Für Elise and Moonlight Sonata before I die. (I thought that girls would like me if I could play these pieces in front of them, I was very naïve at the time.) Somehow I did eventually learn to play Beethoven’s Für Elise and Moonlight Sonata, but while the girls flocked to me, I felt more musically unsatisfied than ever. By this time I had acquired enough musical knowledge to realize that classical music consisted of more than just Beethoven (not that Beethoven’s music was not profound). I needed to explore further.

Thus from the courtly formalities of Mozart and Beethoven I moved on to the tragic poetry of Chopin, to the mysterious harmonies of Debussy, to the erotic passions of Rachmaninoff. Yet, still I was not satisfied, and asked myself: why should you restrain yourself to the piano when there is an entire world of other instruments out there? I then became obsessed with orchestral music. Ultimately I was crazy enough to try and teach myself to sing opera, and met only limited success. Even that is an overstatement, for I was certain that some of my friends were so irritated by my singing that they were prepared to terminate our friendship.

Sometime during this feverish journey I opened my mind to the music of Igor Stravinsky, Arnold Schoenberg, Karlheinz Stockhausen, and other colleagues. I didn’t like them at first, so I tried to shut them out. Only later did I realize that it was too late. Once the door had been opened, it could not be locked again. I had let the monsters in, permanently, and now I had to live with them. But miraculously the creatures that terrified me the most I fell in love with. And they were horrible creatures! I often see their brutal shadows, their bloodthirsty eyes, their barred teeth, from behind which comes chilling shrills that never end. They torture me by day with these unbearable cries, and at night they return in my darkest nightmares. But somehow I cannot resist them. I continue to long for their deathly embrace, and let them rape me and slaughter me in whatever way they see fit. To me they represent the unlimited possibilities of classical music, a genre that will never see bounds. When it is beautiful, it is relaxing. But when it is ugly, it is divine! When classical music shows its other side, that when it is not “nice music”, we see all our flaws, vices, and sins stare back at us, and we fall with our faces flat against the ground in utmost shame. Ugly music is created from the darkness within us, and in that respect it is truly the light that shines into the innermost corners of our souls.

Can classical music really sound ugly? you ask. Well, yes it can. And with the coming of spring, a perfect example comes to mind. We shall compare and contrast Schumann’s Spring Symphony with Stravinsky’s ballet The Rite of Spring. One represents the epitome of classical music that everyone knows and takes delight in, and the other, a sickening, unspeakable abomination.

Robert Schumann’s (1810-1856) Symphony no. 1 “Spring” (composed 1841) was designed to be a gem of pure ecstasy. Interestingly, it was composed shortly after Schumann’s marriage, for which he fought for many bitter years, to the extent of launching litigations against his now father-in-law. Was the symphony an expression of his long-sought love? We do not have any evidence of that unfortunately, as much as we would like to speculate. But in any case, from the opening trumpet calls which proclaim the arrival of spring, we are immersed in a fresh, green world. After being greeted by a shower of butterflies and birdsongs in the first movement, we sit back while being serenaded with a soothing, pastoral idyll in the second movement. The third movement jolts us to our feet with a vigorous country dance, and in the finale, we wave our farewells to spring, knowing that it will never die, always to return.

http://www.youtube.com/watch?v=zvwCdaaidLU

 

Compare this with Igor Stravinsky’s (1882-1971) representation of spring, which is less optimistic. In fact, it is horrendous, so much that it sparked a riot at its premier. From the first note of The Rite of Spring (composed 1913), Stravinsky’s signature ballet, we find complete chaos. Brutal rhythms and outbursts abound, such as near the end of Adoration of the Earth when the village boys get into a fight. Part two, entitled The Sacrifice, is even more diabolical. We see maidens of the village dancing mystically in a circle, awaiting one of them to be chosen as the sacrifice to the god of spring, who must be appeased so that spring would not disappear forever. As the Chosen One is singled out in the center of the circle, the other girls rejoice wildly, perhaps even insultingly, at their unbelievable fortune. And finally, with a last demonic burst of strength, the Chosen One dances until she is completely spent, collapsing in death. Just how do you make sense of this madness? One must appreciate that just as spring makes all things anew, Stravinsky’s ballet reveals our most primitive instincts and behaviours, and in that it is beautiful. And can anyone replace the notes with other notes and still achieve the same effects? I say not. The notes were destined for their purpose, and in that they are beautiful. And if you are looking for a more contemporary insight into their beauty, Leonard Bernstein (composer of West Side Story) once randomly exclaimed this while rehearsing The Rite of Spring with his orchestra: “Don’t you get it? This music is all about sex!”

http://www.youtube.com/watch?v=jF1OQkHybEQ (I)

http://www.youtube.com/watch?v=iH1t0pCchxM (II)

http://www.youtube.com/watch?v=C_7ndqgwxcM (III)

 

We now return to my opening question: Why do I love classical music so much? I love classical music because when it is “nice” it sounds beautiful, and when it is “ugly” it still sounds beautiful. Classical music is like an oasis at the edge of a cliff. When I was little I lived quietly and peacefully in the middle of the oasis, never daring to venture to the edge and peer down. But when I finally did, looking into the bowels of the abyss, my mentality was changed forever, and I was enlightened. For instance, Schumann’s and Stravinsky’s contrasting portrayals of spring taught me an important lesson. Yes, spring is gorgeous; at this time of the year everything is in full bloom. But spring is more than just flowers and birds and meadows. It offers a glimpse into our very humanity, providing a view of what it means to be us.

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An interview with Dr. Dale Ziter

Posted on 05 March 2013 by Kyle Pangka (Meds 2016)

Although I was the one conducting the interview, I was nervous stepping into Dr. Ziter’s office. I became more relaxed when he immediately greeted me with a smile and shook my hand.

Dr. Dale Ziter is the academic director of the family medicine residency program in Windsor, and is involved in teaching both residents and medical students.  His sense of duty to provide total care for his patients and the pride he takes in his work came through while he answered my questions.

The purpose of these interviews is to get to know local physicians in Windsor: In other words, we want you to get a glimpse of who they are and what they do!


How does your typical day look like?

Generally I get up between 5:30 and 6:00 am, and head over to Hôtel-Dieu hospital, where I make rounds. I still have active privileges at Hôtel-Dieu as a family doctor, so I’m often most responsible physician for my patients, anywhere from the one to six on average that are in hospital.

I’ll make rounds and then I’ll head over here to the office ahead of patients to do paperwork. Forty-five minutes to an hour to get paperwork done. Instead of taking it home at night, historically I’ve always done my work in the office. Generally the patients start rolling in at about 8:30 am and I work through seeing patients from about 8:30 am till about 5:00 pm—and maybe get 15 minutes for lunch. There’s usually a resident with me or a student with me in the office.

Then I’ll do about another hour of paper work at the end of the day, and I’ll get home between 6:00 and 6:30 pm. So typically it’s about a twelve hour day.

After such a long day, how do you relieve stress?

I have a lot of coping mechanisms. One of my favourites is long walks with my wife and my dog. We usually go in the evening and on weekends for eight to ten kilometre walks and hikes. I play hockey on Monday nights and basketball on Thursday nights with a group of guys. For stress I do sports, physical activity, gardening—those types of things.

After finishing your medical education, what was it like starting out? 

It was exciting. I finished and I started off in central Ontario, I worked in cottage country in the summer and fall, doing locums for doctors who would go away and it was extremely busy. We had a little office and an eight-bed hospital and it was fun, it was very busy, I was doing a lot of things. After about six to eight months, my brother convinced me to come back home to Windsor to work, where I took up practice with him and my father. I said I would try it for two years, because I always wanted to settle in north or central Ontario. Then thirty years later I’m still here—I love it here.

Do you have a notable mentor who helped you get where you are today?

A couple of my preceptors, while I was a resident, were very influential in the way I practice, how I practice medicine, and my work ethic.

My father was probably my most valuable mentor in that he was a family doc who absolutely loved his work. He was a hard worker, but I never saw a frown on his face. He was always very interested in what he did and would always bring me with him on house calls when I was a little guy. I saw nothing but a great lifestyle from my dad, so he was probably my most influential mentor.

What would you say is the coolest thing about your work?

The coolest thing is having the privilege to have people trust you with their deepest worries and their deepest concerns, and then bringing to them the best that you have and having that relationship of trust grow over the years—being able follow my patients from birth to basically giving birth themselves now. I have patients that I took care of when they were newborns, now I’m taking care of their newborns. To me that’s very cool, that’s very exciting, to go through the years with a person and a family and have them trust you so much over the years. The job satisfaction is just huge in that situation.

What direction do you think family medicine will be taking in the future?

I think we are going to continue to have a bigger role with medicine in general. I think we are going to see, as we have seen in my career, more things done in the community, less things in the hospital, or at least shorter hospital stays and more physician influence in the community and patient’s homes, and getting things done as outpatients.

I think family medicine is going to be a huge part of developing good, strong primary care. In Canada we are lucky that we have a good primary care focus. I think it’s very cost effective and works very well for patients and families.

You’ve been the director of the family medicine training program in Windsor for many years. Can you tell us what this program means to you?

It means a lot in that we’ve taken it from virtually one resident training here to over twenty residents training here every year. There’s a certain amount of pride in seeing that it works, that the physicians in Windsor, family medicine teachers and specialist teachers, have all embraced the family medicine residents. Collectively we’re very close and communicate well.

And the patients, the patients really have taken to the residents. They love having residents involved in their care. To me it’s a matter of pride to see this thing get together so well. It’s more than just about keeping physicians in our community, it’s about teaching them the right way and giving them the good guidance. I think collectively our specialists and our GP preceptors do that and we are putting out some very good doctors.

If you could have a super power, what would it be and why?

A super power would be fun for myself, but if you would grant me one wish instead of a super power, I would use it to bring back to life my best friend of forty years who passed away last year.

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