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The other day I was on both ends of CME.

In the morning was our Montreal Derm Society meeting (have 6-8 per year). Since I don't like to be on the road these days, I'm getting my CME meetings close to home. I don't miss the bigger meetings. They are chaotic and with too many people (I'm not a social butterfly). There are some wonderful speakers, but we get just as good speakers to our local meetings. Mostly they're the same people; if you want to be an international level expert, part of the price is running around the world speaking at meetings. Often someone local who attended an international meeting recommends bringing in someone they'd heard speak, and we arrange to do so. Montreal being the city it is, we get people from across Canada, the US, and Europe, especially France & UK.

This time we'd brought in Richard Weller from Edinburgh. (Apparently, he has a great TED talk that you can find on line.) He was an awesome speaker. His first talk was on whether we should be so rigidly anti-UV as we are. For a Derm, that is practically apostasy. I've been known to threaten patients with death and/or rotting in hell for tanning. His point was that it might prevent skin cancer, but looking at all-cause deaths, it might lower it. UV seems to lower blood pressure, which is the number one killer disease (in terms of total years of lost life) worldwide. I'm still digesting what he had to say, so not making any changes in my recommendations at this point, but he made a powerful point.

Afterwards, we took him out to lunch. Be "we," I mean two of us from the Board of Mtl Derm. It's a matter of courtesy and protocol that if you bring someone in from another country, the least you can do is entertain them a bit, not to mention get to-and-from their hotel and such. At the beginning of the year, when we set the schedule, the Board divies up who takes out the speakers. I'm used to this from the military, where a visiting dignitary is assigned an escort officer. The other doctor (who is female) and I were teasing each other about our new sideline as Escorts, as that was a non-medicare service, and we could charge what we wanted. Anyhow, had lunch with him, then took him sight-seeing a bit before dropping him at the train station. (No silly, there's no train back to the UK, he was going to Quebec City to give a talk the next day.) Weller is a fascinating person: clinician & researcher; grew up as a Army brat; was a rower in University, mountain climber as a hobby; trained in UK, US, Germany, and Australia; voluable and knowledgable on almost any subject. A true internationalist. Even I enjoyed his company.

That night, I was on the other end of CME. McGill has various series of this. Some, like evening one I did, are principally geared to Family Doctors. Although given in a lecture hall, there are only a dozen or so physically in attendance, with most people getting it as a Webinar. I was asked almost a year ago - long enough in advance, that doing it was a commitment at a misty future date that I could put out of my mind and delude myself I wouldn't be as busy then. Wrong. But did manage to put the talks together (I did two back-to-back, both on papulosquamous disease). Parts were recycled from the medical student series that I'd already written, but I ramped up the level and focused more on practicalities. That is, I limited it to three common diseases, for each one I focused on "how do you know it's this thing and not another," and "how do you as a Family Doctor treat it." I also left lots of time for questions. The initial feedback was that it was very well received; that I geared it exactly at the right level. I really would like to see the official feedback, but at worst it's going to be good. 
24th-Mar-2017 08:02 pm - Maple & Snow
Springtime in Canada
There was a cabane à sucre at the Market today. A true cabane à sucre is in the countryside, when the maple syrup starts to run. Generally have a massively huge breakfast with pancakes and waffles and ham and bacon, all smothered with maple syrup. Old Quebecois custom, what with Quebec being the biggest maple syrup producer in the world. (For those poor, benighted folks who live in places where you've never tasted real maple syrup, we will have a moment of sympathy.) This was more a degustation of various yummies made with a touch of maple syrup: baked beans, pulled pork, chocolate, foie gras, ham, goat cheese. In the background were a couple of fiddlers. It was good to take the kids out. Although they didn't try much, they did like wandering around and looking at things (and getting underfoot). The highlight was a wonderful substance: bourbon flavored maple syrup. Basically pure Quebec maple syrup, but aged it in old Kentucky bourbon barrels (hurrah for N. Am. Free Trade!). I imagine little-to-no-alcohol. It tastes like maple syrup crossed with bourbon, a.k.a. nectar of the gods. I’m going to make pancakes tomorrow morning just to get to use it. (Very tempted to just eat by the spoonful, but would probably get cloying after a bit.)

Afterwards, the kids romped in the snow. They haven't been very big on that, or maybe we've been too tired or too big wienies to take them, but they had fun. It was the perfect, picture postcard winter weather: not very cold (barely below freezing), with big flakes of fluffy snow falling gently. Played until everyone was tired, then went in before everyone was soaked through.

Am writing this, sitting by the fire, with the children actually playing quietly. *smiles with contentment and satisfaction*
Apparently I'm not allowed to do educational activities anymore. We had our Journal Club last night. The Derm staff of my hospital meets about once/month at a restaurant to discuss patients, journal articles, meetings we've been to, and administrative matters. (Okay, and a fair amount of gossip).

When I got home, Nom reported that Hedgefund asked where I was.
Nom: "He's having dinner with his friends."
HF: "No, he's not allowed do that anymore. He's supposed to stay here with Hedgefund."
Okay, I've been told. Reading & discussing Journal of the American Academy of Dermatology is out. Reading out loud great classics of literature (like The Cat in the Hat, and Caillou et la Poupée) for the 200th time is in.

Sometimes when I'm working at home, if I ask Nom if she needs anything, and she doesn't, she'll tell me, "that's okay, go do your work." The other day, asked Hedgefund if she wanted me to read to her.
HF: "No, go do your work."
Me: "You're very bossy."
HF: "Yes."

I might be changing my views on what to say to some future boyfriend from,"touch my daughter and I'll kill you," to "good luck, son, you're gonna need it."
18th-Mar-2017 10:19 am - Illness of body, but not spirit
HHG-Throne of fruit
One of the few problems with having been born and raised in the 19th century is the occasional attack of gout, one of which I seem to suffering from right now. (The offset of actually living in the 21st century is that the naproxen is starting to kick in.) I never had a joint tapped to analyze the fluid, which is the actual sine qua non for diagnosis, but the first major attack met the classical clinical findings of podagra, and the Rheumatologist & I agreed to just treat based on clinical findings rather than sticking a needle where I didn't need one stuck. (Which IMHO is any part of my body - I prefer being on the back/non-pointy end of needles.) Had a bit of ache yesterday morning, but it went away. Today full-blown, even if not at base of great toe. Might not be gout, could be some other arthritis/arthralgia. Could just be general I'm-achy-because-I'm-old-and-falling-apart. But I'm going with gout.

On the more positive, spiritual side of things, "Happy St. Patrick's Day." (Yeah, the day was yesterday, and the parade is tomorrow, so I'm splitting the difference.) The most important part of the day (yesterday, the actual day) for me, beyond my being pseudo-Irish, is that is the anniversary (5th anniversary this year) of when I met that wonderful woman who is now my wife-and-mother-of-my-children. (Yes, Nom, for those of you not keeping track.) We'd "met" and dialoged on line for weeks before that, but as ravensron (and other lesser intellects) frequently points out, you haven't really met anyone until you've bet them IRL. Spekaing of the kids, they are adorable and all the other adjectives that doting parents say, and you're all probably tired of reading, even if entirely true in this case.

At the hospital the other day, someone was selling candy to help raise money for her son's high school something-or-other. I bought a box of chocolate mints (or minty chocolates, if you prefer). In my mind, that goes well with St. Paddy's Day. When I lived in Portsmouth NH, at one point I lived over a bakery. I was living with an exotic older woman musician, in one of the few true urban lofts in that small but lovely city. I forget the name of the bakery; it's not there now, although Ceres Bakery, my other favorite from that era, is still there. Anyhow, said bakery would do Leprechaun Brownies every year for 1-2 weeks leading up to St. P's Day. I adored them, often had one every day. After I'd moved up to Montreal, I was doing the long-distance relationship thing with the lovely lady for over a year. (That worked out as well as most long-distance relationships work. In the end, just as well, because (see 2nd paragraph) I'm now married to Nom.) I was down in Portsmouth the weekend before St. P's and decided to buy a whole tray of Leprachaun Brownies to bring back with me. I ended up scarfing down the entire tray in the course of 2 days, and then couldn't abide the taste of chocolate mint for over a decade. (No residual objection to exotic women, or even older ones, although Nom is in fact, much younger than I am.)
16th-Mar-2017 05:37 pm - Libraries
Books (Trinity College Library)
A few quotes (listed a Dictionary.com):

Your library is your paradise.
     Desiderius Erasmus

A library is a good place to go when you feel unhappy, for there, in a book, you may find encouragement and comfort. A library is a good place to go when you feel bewildered or undecided, for there, in a book, you may have your question answered.
     E.B. White

A library is the delivery room for the birth of ideas, a place where history comes to life.
     Norman Cousins

My alma mater was books, a good library.... I could spend the rest of my life reading, just satisfying my curiosity.
     Malcolm X

The library is an arena of possibility, opening both a window into the soul and a door onto the world.
     Rita Dove

When I got my library card, that was when my life began.
     Rita Mae Brown

Libraries raised me.
     Ray Bradbury

A library is not a luxury but one of the necessities of life.
Henry Ward Beecher

I was made for the library, not the classroom. The classroom was a jail of other people’s interests. The library was open, unending, free.
     Ta-Nehisi Coates

I have always imagined that paradise will be a kind of library.
     Jorge Luis Borges
15th-Mar-2017 11:28 am - Snow day
Springtime in Canada
So far this AM had 60 cm and more falling. Don't think hit as quite as bad as NE USA, but bad enough that Evil Secretary actually didn't make it in today. I told her to stay home with a nice cup of hot chocolate and a side order of guilt. Managed to get through the morning (lots of no shows), now heading up to the hospital. At least it's kinda pretty in a stark way.

20170315 Blizzard-Train

20170315 Blizzard-Train2

20170315 Blizzard-Canal & track
5th-Mar-2017 03:01 pm - Relapse is the word for the day.
Sword & Microscope 1
- Winter relapsed with a vengeance this week. Snowed (although didn’t stick) and hit below zero even on that absurd Fahrenheit scale (below -17 for who live in advanced countries). The only thing I find surprising about this is that people seem surprised. Hey people, you live in Canada, it’s only March, it’s supposed to be like this.

- People in our household being sick also relapsed. Seem to have passed it around (so far Normandie missed it). Hit me short but very sharp; I was barely functional yesterday: fevers, weak, dry cough. Wearing 4 layers of clothing indoors and at some point still needed to huddle under a blanket to be warm. *Whine, whine, whine.*

- Have a coupla talks and such to prepare, which I’ve been procrastinating on. Had trouble sleeping last night (that being sick thing), so got about half of the first one done. Actually, not really writing that one so much as compiling it from bits and pieces other talks (so I suppose that could count as a relapse also). McGill does an evening lecture series - CME mostly for family docs, but anyone interested is invited. For some silly reason I agreed to do one. When finished with that, have to do my McGill format CV (that will be the subject of another post), and then put together another talk for April (which I might actually have to write, not just compile). The April talk is for the Assoc Derm Quebec annual meeting, which is in Montreal this year, and I was asked to do a talk on Cutaneous Lymphoma. Also CME. I think I even get paid for that one.
2nd-Mar-2017 03:21 pm - Doting Daddy etc
Hedgefund seems to channeling Sheldon from Big Bang Theory. She was sitting somewhere and informed me that that was her spot, and no one else was allowed to sit there. She is also highly obsessional about things needing to be put back in the right place, or things to be done in a certain order. On the other hand, that could also be normal for toddlers, who are just learning "the way things 'sposed to be" and don't want it mixed up. Certainly not because she's my daughter (*looks innocent*)

Everyone is sick except her. I have visions of her nursing the entire family. Sometimes she does like taking care of her baby brother, Wallstreet. Today she was teaching him to read. No, she doesn't know how to read either, but that wasn't stopping her (again, certainly not my daughter there… again *looks innocent*). It was more she was showing him the pictures and teaching him individual words. *Kvells.*
28th-Feb-2017 02:29 pm - Chemistry
Sword & Microscope 1
Patient who is a grad student in sciences came in with a coffee cup with a label reading "it's all chemistry: Calcium - Iron - Iodine - Neon" (Look up the chemical symbols if you don't get it.)
27th-Feb-2017 05:30 pm - Hedgefund has discovered bubble wrap
And the joys of popping it.
That's all.
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