Tag: Musings

First Impressions: Family Medicine

I’m 2 weeks into my rural family medicine rotation, and I am loving it so far.

For those of you unaware, family medicine is something in Canada that is similar but different than a general practitioner in most countries.  Like a GP, they are the doctor that you will see for your check-ups, and at walk-in clinics.  Unlike a GP, they have a large focus on prevention and are considered a ‘specialty’ as they do undergo additional training after obtaining their MD.

To explain it as simply as possible, Family Doctors specialize in illness prevention, harm reduction, and the therapeutic relationship.  They get to know their patients, they form an ongoing doctor-patient relationship with their patients, and they use this relationship to either prevent their patients from getting sick (lifestyle advice, smoking cessation, etc), or to reduce the harm that might result from their patients getting sick (screening for disease early, or treating illness before patients become sick enough for the emergency room).

I love this aspect of family medicine.  I love talking and forming that trust with people.  I love learning about their lives and their context.  I love being able to help them figure out ways to stay healthy or get healthy.

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So what are my problems so far?  Well, #1 would be that I am realizing how much I don’t know.  And that sucks.  Family Medicine is extremely broad in scope.  It has “99 core topics”, ranging from abdominal pain to stroke to depression.  To put it simply, there is a lot to know.  You have to know a little bit of everything to be a good family doctor.  And as this is my first rotation, I basically know a little bit of nothing.  Or so it feels.

So I spend a lot of my time realizing how much I don’t know, looking up my knowledge gaps, then realizing that I still don’t know enough, rinse and repeat.  That is my life right now.  So it sucks but I feel like I’m constantly pushing and learning.

The other thing I’m struggling with is time management.  Of course, I’ve been told that as a student, that is totally normal.  They don’t care how long I take, as long as I get all the information.  I understand this, but still… I wish I wasn’t quite as slow as I was.

And then there’s the situations that I just can’t help with.  The complex social situations that you know is contributing to people’s health struggles, but simply seem to fall outside the scope of a family doctor.  Things like poverty, racism, and cruelty.  I can offer support, but how can I go about changing things like the structural poverty that many face?  It’s extremely frustrating and sad.  Obviously moreso for the person dealing with it, but unfortunately I can’t close my heart to things like that.  It’s tiring and draining and so hard.

So, that is my first impression of Family Medicine.  Definitely something to love, definitely something that I’m interested in doing.  In a few weeks, I’ll post an update, since I have some exciting novel encounters coming up including shifts at the Emergency Room, TransHealth Clinic, and Addiction Clinic.

 

Until next,

TWS

 

 

Winnipeg, We Need to Talk About Racism

Hi all,

 

I’m the Wandering Scott, and I’m from Winnipeg, the most racist city in Canada according to Maclean’s (1). Winnipeg, we need to talk.

 

Problems with treating racism like it’s a competition aside, I found that the article did have a lot of truth to it in terms of problems that do plague Winnipeg. I was surprised, then, by the visceral and hostile response of many Winnipegers, including the radio host linked below (2).

 

I have lived in Winnipeg for the past 7-8 years (has it really been that long?), and in that time I have witnessed racially motivated hate and micro aggressions on a consistent basis. I have witnessed the disadvantage that many people face and the advantage that others enjoy. I know that I’m not alone in this either. As far as I know, it’s a well-known and documented truth that Winnipeg has always struggled with racism. Why then, when the article from Maclean’s came out, did so many Winnipeggers react the way they did and say that it couldn’t possibly be true? Where did that response come from?

 

In order to try and understand this, I took a step back. I think a key to understanding this topic is in clearly identifying the terms (something that is so often overlooked when talking about topics such as this). Let’s begin with prejudice. Prejudice is quite simply the act of making a judgment before all of the requisite facts are known. Bigotry is basically prejudice, but prejudice that cannot be challenged with facts. A bigot has pre-conceived notions about other people based on features such as race, sexuality, gender, etc etc etc, that they are unwilling to change even when their perspectives are clearly shown to be flawed or untrue. In addition, a bigot will usually hate those that they are bigoted against, or take actions against them.

 

Racism is having prejudices against, or treating somebody differently, based on what you perceive to be their race to be. (I say perceive for 2 reasons. First, treatment differs based on what race the racist thinks you belong to, not what race you identify with. Race and ethnicity are far more than the physical features the racist sees. Second, race is a loosely identified term to begin with. Genetically, all humans are quite similar to begin with, and are impossible to separate neatly into groups. Social separations are by their very nature not distinct. Hence, treatment or prejudice varies on the perception of the racist rather than truth. But I digress.)

 

So racism. There are two major types of racism, and I think this is where a lot of people get confused. You can have personal racism, or you can have systematic racism (well you generally have both but you get my point). Personal racism is a person who is a racial bigot. They are intolerant of others based on their race. Systematic racism, however, is something else entirely. Systematic racism is a system that creates advantage or disadvantage based upon racial prejudice. It can be found in company policies, social norms, government policies, and many other places. It is the insidious hostile undertones that make people feel unwelcome, unwanted, or worthless. Ranging from what we, as a community, consider to be acceptable humor, to top level discriminatory policies by the Government of Canada, systematic racism is everywhere and it is damaging.

 

So, why did some Winnipeggers react the way they did to the Macleans article? Why did Wheeler denounce the article, and stand firm that Winnipeg wasn’t a racist city? It’ s because they read ‘racist city’ to mean ‘filled with racist bigots’, when instead the article was saying that Winnipeg has a huge, gigantic systematic racism problem.

 

Among the ‘flaws’ that Wheeler pointed out was the fact that aboriginal on aboriginal violence can’t be a racism problem. This is true from a personal racism definition. However, let’s look at it from the systematic racism perspective, shall we?

 

Manitoba is a province that was founded in violence. Almost immediately after its creation, treaties were broken, lands were taken, uprisings flared. No words can ever express the true damage wrought by the horrors of the residential schools. From the beginning of this land as a province of Canada to modern times, the Metis and First Nations have encountered hardships and injustices. Our government has not been kind nor fair. No other province has a history quite as violent and broken as Manitoba.

 

These injustices and hardships are not just historical. Systematic racism still rears its ugly head in both discussion and outcomes. In modern Winnipeg, many will talk about the North Side as the dangerous part of the city. The part of the city that you don’t go to alone or at night. Although never said directly, it is always implied that it is this way because it is the Aboriginal part of the city. Far more importantly than that (and something that a lot of people like to overlook when trying to figure out why violence is so much higher there), it is also the part of the city with the least jobs, the worst housing, and even the worst infrastructure. This part of the city has been left to suffer, and its inhabitants have been put at a disadvantage. This is systematic racism. This is why Winnipeg has a racism problem. Aboriginal on aboriginal violence is not due to racism if you only consider racism from the narrow view that racism is actions personally taken by white bigots. It most definitely is due to racism, however, if you look at the disadvantage that led to the higher crime rates caused by the systematic racism to begin with.

 

To finish off this reflection, I think it’s important that we talk about the next steps. The first step is to admit that yes, Winnipeg does have a racism problem. Hopefully this article has made that clear to everybody who was doubting it or decrying it. Next, as a community, Winnipeg MUST demand work towards change. We, as a people, must commit ourselves to ridding our city of this systematic racism. We must try to eliminate the inherent disadvantage that many Winnipeggers face.   If we refuse to do this, if we refuse to try and change our system… well, then Winnipeg might as well be filled with racist bigots, because refusing to change the system would make us just as bad.

 

Until next,

 

TWS

 

1: http://www.macleans.ca/news/canada/welcome-to-winnipeg-where-canadas-racism-problem-is-at-its-worst/

 

2: http://www.92citifm.ca/2015/01/25/wheeler-vs-macleans-magazine/

 

 

On Nouns and Adjectives

Words and expressions are incredibly important and powerful, especially with regard to how we describe and treat each other. Today, I wanted to talk to you all about nouns and adjectives. Please permit a brief trip back to elementary school: a noun is a word that is something while an adjective is a word that describes something. An adjective cannot exist without a noun to describe. These terms apply to all things, not just things relating to humans. An apple is a noun, and red is an adjective.   I would argue, however, that these terms take on significant meaning when used to describe ourselves and those around us. By forgetting the difference between nouns and adjectives, we allow ourselves to cause divisions and forget the humanity of those whom we perceive to be different.

 

The first step that we must take is to decide, with regards to us what is the noun and what are the adjectives. What defines us, and what describes us. Upon reflection, I will say that in my eyes, ‘human’ is the noun. Human is always the noun. We are all human and we are always human. The adjectives, then, must be everything else that can be used to describe a human. That list is extensive, and includes but is not limited to skin colour, language, country of origin, citizenship, gender, career, religion, wealth, etc. Now, I know this point can carry controversies. There are groups that have been subjugated to years of belittlement and misrepresentation that empower themselves through defining their group as a noun instead of an adjective, and I would never try to disenfranchise those groups from doing that. Instead, I will say that my point is simple: no matter how else you describe yourselves, human is always the central noun, for that is where we all begin and where we all end.

AdjectivesandNouns

 

 

As we all begin and end as human, it is the thing that unites us. It is the common thread of every human living on this planet. When we begin to use adjectives to define ourselves instead of nouns, we begin to ignore that common humanity. We divide ourselves and we rob ourselves of that similarity. We also begin to disenfranchise each other by ignoring our shared humanity and instead focusing on the differences that exist. Think for a moment on how those marginalized in our population are often described Do you ever hear the word human when they’re being described, or do you instead hear them referred to only by something that describes them?   We are so much more willing to overlook or ignore another’s suffering when we don’t think of them as the same as us.

 

Maybe we should all take the time when we are writing or talking to say that common noun. To remind ourselves that no matter how different they might seem from us, that the people we’re talking about are still human, just like us. We are, all of us, so much more the same than different.

 

Until Next Time,

 

The Wandering Scott