#canadian physician

[allthecanadianpolitics]

The B.C. Ministry of Health says a proposed bylaw change by the body that regulates doctors could allow physician assistants to work in provincial emergency rooms.

The ministry says the College of Physicians and Surgeons of B.C. has moved to make the change, which would require physician assistants to register with the college and work in hospital emergency rooms under doctor supervision.

A physician assistant is a medical professional that works under the supervisor of a physician. While they do not possess a medical degree, they are educated through a two-year graduate program under the same medical model used to train doctors.

Health Minister Adrian Dix says the ministry and the college have worked together to make the change, which will give patients better access to services while supporting other health-care workers.

Full article

Tagging: @politicsofcanada

[mitigatingchaos]

It Could Never Happen Here . . .

. . .  or could it? My mom, 86, and some of her friends just got a letter from the federal government (Canada) encouraging them to take their offer of free assisted suicide. . . . Here is the re-blog of the  original blog. A little searching uncovered this public service announcement brought to you by the caring, Canadian government. I think I better start paying closer attention to what is…

[scottsmdselect]

MD Select Trusted Resource Saskatchewan Physician Directory

MD Select compiles verified information about healthcare providers in the Saskatchewan Physician Directory. Their directory gives you an enormous head start when developing your strategies to sell to medical professionals. Rely on their accurate listings to connect with the right physician for your healthcare needs. Get in touch with them today.

[fishsticksart]

Hung Liu, Dr. Norman Bethune, 2000, oil on canvas

[supersoftly]

There's a huge push back against any privatized healthcare as well, but the other unaddressed problem is that we're also hemorrhaging all the doctors and nurses we train here who either go back home, go somewhere else where they earn what they're actually worth or just quit due to over exhaustion. Not only has our healthcare system become completely overwhelmed with the dying excess of our aging boomer population, but we're severely understaffed since our socialized healthcare actively caps wages in order to function.

Our healthcare is designed to be a generalized wide-net triage system, meaning if you have some unique illness that doesn't appear to "require" immediate attention, it's likely you won't be prioritized to be treated if treated at all. My friend's mom who got Lyme disease years back for example was basically told they're not covered after something like 6 months because the Canadian healthcare system at the time did not consider Lyme disease as treatable. My own family had breathing issues that the system basically gave up on due to a misdiagnosis only to finally find relief due to a random encounter with a nurse who identified the problem from experience. The entire time you're waiting for the system to catch up to finally getting around to helping you, you're suffering and shit out of luck for any other relief. Unfortunately for too many Canadians, the time spent waiting for healthcare ends in fucking death, whether it's being on an endless waitlist, waiting for treatment or even a diagnosis, or just because of ER overcrowding which has only gotten considerably worse since COVID. The American healthcare system isn't without its flaws, but please examine critically what is happening in my country and that waiting for hours or even days in the ER department only to be turned away is a worthless system of care.

It's absolutely wild to me anyone would compare our generously taxpayer funded overglorified meat grinder to any alternative to life, I'd rather take on a fuck ton of debt and live than be told I'm worth more dead than alive according to my government. No body of state should get to determine the set future or the worth of Canadians in need of healthcare, I don't think that is a radical statement.

[mostlysignssomeportents]

How to have cancer

THIS WEEKEND (November 8-10), I'll be in TUCSON, AZ: I'm the GUEST OF HONOR at the TUSCON SCIENCE FICTION CONVENTION.

I've got cancer but it's probably (almost certainly, really) okay. Within a very short period I will no longer have cancer (at least for now). This is the best kind of cancer to have – the kind that is caught early and treated easily – but I've learned a few things on the way that I want to share with you.

Last spring, my wife put her arm around my waist and said, "Hey, what's this on your rib?" She's a lot more observant than I am, and honestly, when was the last time you palpated your back over your left floating rib? Sure enough, there was a lump there, a kind of squishy, fatty raised thing, half a centimeter wide and about four centimeters long.

I'm a 53 year old man with a family history of cancer. My father was diagnosed with lymphatic cancer at 55. So I called my doctor and asked for an appointment to have the lump checked over.

I'm signed up with Southern California Kaiser Permanente, which is as close as you come to the Canadian medicare system I grew up under and the NHS system I lived under for more than a decade. Broadly speaking, I really like KP. Its app – while terrible – isn't as terrible as the other apps, and they've taken very good care of me for both routine things like vaccinations and checkups, and serious stuff, like a double hip replacement.

Around the time of The Lump, I'd been assigned a new primary care physician – my old one retired – and so this was my first appointment with her. I used the KP app to book it, and I was offered appointments six weeks in the future. My new doc was busy! I booked the first slot.

This was my first mistake. I didn't need to wait to see my PCP to get my lump checked over. There was really only two things that my doc was gonna do, either prod it and say, "This is an extremely common whatchamacallit and you don't need to worry" or "You should go get this scanned by a radiologist." I didn't need a specific doctor to do this. I could have ridden my bike down to the KP-affiliated Urgent Care at our local Target store and gotten an immediate referral to radiology.

Six weeks go by, and my doc kind of rolls the weird lump between her fingers and says, "You'd better go see a radiologist." I called the Kaiser appointment line and booked it that day, and a couple weeks later I had a scan.

The next day, the app notified me that radiology report was available in my electronic heath record. It's mostly technical jargon ("Echogenic areas within mass suggest fatty component but atypical for a lipoma") but certain phrases leapt out at me: "malignant masses cannot be excluded. Follow up advised."

That I understood. I immediately left my doctor a note saying that I needed a biopsy referral and set back to wait. Two days went by. I left her a voice message. Another two days went by. I sent another email. Nothing, then a weekend, then more nothing.

I called Kaiser and asked to be switched to another Primary Care Physician. It was a totally painless and quick procedure and within an hour my new doc's intake staff had reviewed my chart, called me up, and referred me for a biopsy.

This was my second mistake. When my doctor didn't get back to me within a day, I should have called up KP and raised hell, demanding an immediate surgical referral.

What I did do was call Kaiser Member Services and file a grievance. I made it very clear that when I visited my doctor, I had been very happy with the care I received, but that she and her staff were clearly totally overloaded and needed some kind of administrative intervention so that their patients didn't end up in limbo.

This is a privilege. I'm a native English speaker, and although I was worried about a serious illness, I didn't have any serious symptoms. I had the ability and the stamina to force action in the system, and my doing so meant that other patients, not so well situated as I was, would not be stuck where I had been, with fewer resources to get un-stuck.

The surgeon who did the biopsy was great. He removed my mass. It was a gross lump of yellowy-red gunk in formaldehyde. He even let me photograph it before it went to pathology (warning, gross):

https://www.flickr.com/photos/doctorow/54038418981/

They told me that the pathology would take 2-5 days. I reloaded the "test results" tab in the KP website religiously after 48 hours. Nothing was updated. After five days, I called the surgical department (I had been given a direct number to reach them in case of postsurgical infections, and made a careful note of it).

It turned out that the pathology report had been in hand for three days at that point, but it was "preliminary" pending some DNA testing. Still, it was enough that the surgeon referred me to an oncologist.

This was my third mistake: I should have called after 48 hours and asked whether the pathology report was in hand, and if not, whether they could check with pathology. However, I did something very right this time: I got a phone number to reach the specialist directly, rather than going through the Kaiser main number.

My oncologist appointment was very reassuring. The oncologist explained the kind of cancer I had ("follicular lymphoma"), the initial prognosis (very positive, though it was weird that it manifested on my rib, so far from a lymph node) and what needed to happen next (a CT/PET scan). He also walked me through the best, worst and medium-cases for treatment, based on different scan outcomes. This was really good, as it helped me think through how I would manage upcoming events – book tours, a book deadline, work travel, our family Christmas vacation plans – based on these possibilities.

The oncologist gave me a number for Kaiser Nuclear Medicine. I called them from the parking lot before leaving the Kaiser hospital and left a message for the scheduler to call me back. Then I drove home.

This was my fourth mistake. The Kaiser hospital in LA is the main hub for Kaiser Southern California, and the Nuclear Medicine department was right there. I could have walked over and made an appointment in person.

Instead, I left messages daily for the next five days, waited a weekend, then called up my oncologist's staff and asked them to intervene. I also called Kaiser Member Services and filed an "urgent grievance" (just what it sounds like) and followed up by filing a complaint with the California Patient Advocate:

https://www.dmhc.ca.gov/

In both the complaint and the grievance, I made sure to note that the outgoing message at Nuclear Medicine scheduling was giving out false information (it said, "Sorry, all lines are busy," even at 2am!). Again, I was really careful to say that the action I was hoping for was both a prompt appointment for me (my oncologist had been very insistent upon this) but also that this was a very broken system that would be letting down every patient, not me, and it should be fixed.

Within a couple hours, I had a call back from KP grievances department, and an hour after that, I had an appointment for my scan. Unfortunately, that was three weeks away (so much for my oncologist's "immediate" order).

I had the scan last week, on Hallowe'en. It was really cool. The gadget was awesome, and the rad-techs were really experienced and glad to geek out with me about the way the scanner and the radioactive glucose they infused in me interacted. They even let me take pictures of the scan visualizations:

https://www.flickr.com/photos/doctorow/54108481109/

The radiology report was incredibly efficient. Within a matter of hours, I was poring over it. I had an appointment to see the doc on November 5, but I had been reading up on the scans and I was pretty sure the news was good ("No enlarged or FDG avid lymph nodes are noted within the neck, chest, abdomen, or pelvis. No findings of FDG avid splenic or bone marrow involvement").

There was just one area of concern: "Moderate FDG uptake associated with a round 1.3 cm left inguinal lymph node." The radiologist advised the oncologist to "consider correlation with tissue sampling."

Today was my oncology appointment. For entirely separate reasons, I was unable to travel to the hospital today: I wrenched my back over the weekend and yesterday morning, it was so bad that I couldn't even scratch my nose without triggering unbearable spams. After spending all day yesterday in the ER (after being lifted out of my house on a stretcher), getting MRIs and pain meds, I'm much better off, though still unable to get out of bed for more than a few minutes at a time.

So this morning at 8:30 sharp, I started calling the oncology department and appointment services to get that appointment changed over to a virtual visit. While I spent an hour trying various non-working phone numbers and unsuccessfully trying to get Kaiser appointment services to reach my oncologist, I tried to message him through the KP app. It turns out that because he is a visiting fellow and not staff, this wasn't possible.

I eventually got through to the oncology department and had the appointment switched over. The oncology nurse told me that they've been trying for months to get KP to fix the bug where fellows can't be messaged by patients. So as soon as I got off the phone with her, I called member services and filed another grievance. Why bother, if I'd gotten what I needed? Same logic as before: if you have the stamina and skills to demand a fix to a broken system, you have a duty to use them.

I got off the phone with my oncologist about an hour ago. It went fine. I'm going to get a needle biopsy on that one suss node. If it comes back positive, I'll get a few very local, very low-powered radiation therapy interventions, whose worst side effect will be "a mild sunburn over a very small area." If it's negative, we're done, but I'll get quarterly CT/PET scans to be on the safe side.

Before I got off the phone, I made sure to get the name of the department where the needle biopsy would be performed and a phone number. The order for the biopsy just posted to my health record, and now I'm redialing the department to book in that appointment (I'm not waiting around for them to call me).

While I redial, a few more lessons from my experience. First, who do you tell? I told my wife and my parents, because I didn't want to go through a multi-week period of serious anxiety all on my own. Here, too, I made a mistake: I neglected to ask them not to tell anyone else. The word spread a little before I put a lid on things. I wanted to keep the circle of people who knew this was going on small, until I knew what was what. There's no point in worrying other people, of course, and my own worry wasn't going to be helped by having to repeat, "Well, it looks pretty good, but we won't know until I've had a scan/my appointment/etc."

Next, how to manage the process: this is a complex, multi-stage process. It began with a physician appointment, then a radiologist, then a pathology report, then surgery, then another pathology report, then an oncologist, then a scan, then another radiologist, and finally, the oncologist again.

That's a lot of path-dependent, interdepartmental stuff, with a lot of ways that things can fall off the rails (when my dad had cancer at my age, there was a big gap in care when one hospital lost a fax from another hospital department and my folks assumed that if they hadn't heard back, everything was fine).

So I have been making extensive use of a suspense file, where I record what I'm waiting for, who is supposed to provide it, and when it is due. Though I had several places where my care continuity crumbled some, there would have been far more if I hadn't done this:

https://pluralistic.net/2024/10/26/one-weird-trick/#todo

The title of this piece is "how to have cancer," but what it really boils down to is, "things I learned from my own cancer." As I've noted, I'm playing this one on the easiest setting: I have no symptoms, I speak and write English fluently, I am computer literate and reasonably capable of parsing medical/technical jargon. I have excellent insurance.

If any of these advantages hadn't been there, things would have been a lot harder. I'd have needed these lessons even more.

To recap them:

See a frontline care worker as soon as possible: don't wait for an appointment with a specific MD. Practically any health worker can prod a lump and refer you for further testing;

Get a direct phone number for every specialist you are referred to (add this to your phone book); call them immediately after the referral to get scheduled (better yet, walk over to their offices and schedule the appointment in person);

Get a timeframe as to when your results are due and when you can expect to get a follow-up; call the direct number as soon as the due-date comes (use calendar reminders for this);

If you can't get a call back, an appointment, or a test result in a reasonable amount of time (use a suspense file to track this), lodge a formal complaint with your insurer/facility, and consider filing with the state regulator;

Think hard about who you're going to tell, and when, and talk over your own wishes about who they can tell, and when.

As you might imagine, I've spent some time talking to my parents today as these welcome results have come in. My mother is (mostly) retired now, and she's doing a lot of volunteer work on end-of-life care. She recommends a book called Hope for the Best, Plan for the Rest: 7 Keys for Navigating a Life-Changing Diagnosis:

https://pagetwo.com/book/hope-for-the-best-plan-for-the-rest/

I haven't read it, but it looks like it's got excellent advice, especially for people who lack the self-advocacy capabilities and circumstances I'm privileged with. According to my mom, who uses it in workshops, there's a lot of emphasis on the role that families and friends can play in helping someone whose physical, mental and/or emotional health are compromised.

So, that's it. I've got cancer. No cancer is good. This cancer is better than most. I am almost certainly fine. Every medical professional I've dealt with, and all the administrative support staff at Kaiser, have been excellent. Even the doc who dropped the ball on my biopsy was really good to deal with – she was just clearly drowning in work. The problems I had are with the system, not the people. I'm profoundly grateful to all of them for the help they gave me, the interest and compassion they showed, and the clarity and respect they demonstrated in my dealings with them.

I'm also very grateful to my wife, my parents, and my boss at EFF, all of whom got the news early and demonstrated patience, love, and support that helped in my own dark hours over the past couple of months.

I hope you're well. But you know, everyone gets something, eventually. When you find yourself mired in a broken system full of good people, work the system – for yourself and for the people who come behind you. Take records. Make calls.

Look after yourself.

If you'd like an essay-formatted version of this post to read or share, here's a link to it on pluralistic.net, my surveillance-free, ad-free, tracker-free blog:

https://pluralistic.net/2024/11/05/carcinoma-angels/#squeaky-nail

[halorvic]

December 30, 2024

Arijit Chakravarty: “Learn to live with it,” for other diseases doesn’t mean the same thing as we have applied to COVID. When we say we must learn to live with leprosy, we don’t mean let’s make sure everybody has leprosy. When we say we must learn to live with malaria, we don’t mean let’s make sure everyone gets malaria as often as possible, let’s keep mosquitoes lurking in our tanks outside our house. No one says you must learn to live with tuberculosis. Let’s let it spread as much as possible and see how that goes. No, we suppress those diseases every step along the way. We suppress dengue. We suppress tuberculosis. This whole idea that learning to live with the disease means permitting and encouraging its rampant spread and rapid evolution is just so many levels of stupidity that I don’t have a word for it.

Benjamin Mateus: I’d like to know your thoughts on Trump and RFK Jr., his choice for secretary of health? RFK Jr. has been at the head of vaccine disinformation and anti-public health policies. They are calling for ending any cooperation with the World Health Organization. These will have immense consequences for public health globally. These are political questions, but often I hear scientists do not want to engage in political questions and feel uncomfortable about it. Can we avoid the political implications?

AC: Look, it’s not that I don’t want to get political. It’s that if I was going to get political, I don’t know who to hold up as an example. There’s not a government in the world that has handled this correctly. There’s not a party in this world that’s handled it correctly. It’s all different flavors of stupid. Pick your poison. The Democrats went out of their way to normalize mass infection. They went out of their way to lie about the vaccines and say, “If you’re vaccinated, the pandemic was over.” That was completely unnecessary. It was completely at odds with science. Then you have Trump in the first Trump administration saying, “Why don’t you drink some bleach?” It would be a comedy if the consequences weren’t so grave. Frankly, wherever you go it’s like this. You look at Canada’s Bonnie Henry (Canadian epidemiologist and physician) in British Columbia. On day one she insisted that the kids wouldn’t get infected. Then she went and published a paper, put her own name on it, bragging about how herd immunity has been achieved because 90 percent of Canadian kids have been infected. In the UK you had the hearings on the public health response by the UK government. They noted that the government failed to act quickly. There was no clear policy approach, and they even abandoned contact tracing in mid-March of 2020. They even said that masks don’t help stop the spread and the virus wasn’t airborne. It’s a disgrace. Politicians worldwide have decided that they can brazen out their way through this. And the reason for this is they’ve been advised by a certain set of scientists, a relatively small number of scientists, who have essentially sold out. There are tens of thousands of papers, if not hundreds of thousands of papers, on the risks of COVID. You could literally find thousands of scientists who would be willing to go up in front of the House of Representatives and testify that getting COVID repeatedly is bad for you. Where are those scientists? Nobody’s listening to them. They’re listening to the scientists who whisper in their ears and say that everything will be okay. Ryan Gregory and I wrote a Substack blog post a while back called Calm Mongering where we talk about this—that people have weaponized the logic of science in the service of propaganda by saying, “that’s just a hypothesis.” As soon as you bring up a risk, these “experts” shut down the conversation about the risk by saying we’re not sure that’ll happen. But in fact, that’s an inversion of the precautionary principle. And it’s a lot of the tactics that were used by the merchants of doubt during the tobacco era. The merchants of doubt were a subset of a very small number of corrupt, well-connected and well-funded scientists who went out of their way to make public statements that were at odds with the body of literature that was coming out on lung cancer and tobacco. And we are seeing the exact same thing again. Big tobacco sponsored a bunch of corrupt scientists to create a counter-narrative to reality. This time around, who’s playing the role of big tobacco? It’s the politicians and governments. But the exact same thing is playing out. That nexus between this group of corrupt scientists and politicians who are actively funding their work is a global phenomenon. Unfortunately, I hate to say this, but it’s going to take reality breaking through to solve this. They’ve been very effective at convincing people that this is not a problem you need to worry about.

[lovecla]

TAKE YOUR PAIN AWAY | quinn hughes.

00.1. the first time you saw quinn hughes.

➴ chapter warnings: mentions of shitty family.

➴ word count: 1.08k

💌 from me to you: this has been sitting on my drafts for days because i wasn’t brave enough to post it. but this story is very important to me and i promised myself i’d stop doubting what i write and just go for it. i hope with all my heart u guys like this ♡

౨ৎ

2013, SEPTEMBER.

THE first time you saw Quinn Hughes you were eleven years old.

Your family had just bought the house next to his, a beautiful four bedroom house with lots of space and a beautiful backyard— the perfect house for a family of four.

It was a week after you all settled in, your Dad as a Sports Medicine Physician working for a Hockey Canadian team, the Toronto Maple Leafs— the whole reason why you moved in the first place— your Mom as a Editor-in-Chief for the Fashion magazine, one of Canada's leading fashion publications, featuring content related to fashion, beauty, culture, and modeling and your brother, Peter, in High School as a freshman.

You were sitting on your porch, while you waited for Peter to be back so you could convince him to play football with you. He always said no, but you didn't give up. A few minutes later, Peter got out of your neighbor’s house, alongside another boy, who was slightly shorter than Peter.

You watched as they both walked towards your house, talking about something you couldn’t hear. You remember being so enamored with the sight of the boy that you couldn’t stop fidgeting your hands.

They stopped right in front of you, and while Peter was ready to ignore you and move on with his day— he’d been doing that more and more since he started High School— the other boy stopped and looked right at you.

“You didn’t tell me you have a sister.” The boy said, looking at your brother for a second before turning back at you.

“Oh, yeah,” Peter shrugged. “That’s Madison. She’s ten.”

“I’m eleven,” you corrected, voice soft and quiet.

“Whatever,” he scoffed, grabbing his keys so he could open the front door.

“Can you play with me now?” You asked, getting up from your seat, finally noticing how tall this other boy was. “I have the ball with me already.” You pointed at the ball that sat on the same couch you were also sitting not a minute ago.

“No, Madison. I’m with Quinn now.” Peter said, pointing at the boy beside him, who was now frowning at your brother.

Quinn. That’s a funny name, you remember thinking.

“We can play with her, I don’t mind—” the boy, Quinn, said, already reaching for the ball.

“Nah, bro. She’s annoying as hell. Once you pick that ball up, you won’t be able to let it go for like, three hours.” Peter replied, already opening the door.

You felt yourself tearing up and even though you hated crying in front of your brother, you couldn’t help it. Growing up, he was your best friend. Your hero even, when your parents decided that arguing during dinner, in front of their children, was a nice thing to do and he would make funny faces at you across the table just so you could laugh. When he pretended to yell at the monster under your bed or when he let you paint his nails with your pink nail polish.

But somewhere between turning fifteen and entering High School, he changed. And you hated every inch of this new Peter Carter.

He entered the house, shouting something, probably announcing to your mom that he was home. And you stood there, looking at your hands.

“Next time, I’ll play with you, okay?” Quinn, who was still standing in front of you, hesitated, looking as devastated as ever.

You felt embarrassed and you got out of there as fast as you could, running back inside and nestling yourself between your covers and plushies.

౨ৎ

YOU didn’t think Quinn had meant what he had said the other day, so you were surprised to see that he showed up the next morning, when both of your parents were at work and Peter was asleep in his bedroom upstairs.

“Hey,” he greeted you, stepping on your backyard patio and looking around. “Nice place you got here. We can play for a long time without risking throwing the ball in Mrs. Wright window.”

You giggled, remembering Mrs. Wright's funny wig.

“I’m Quinn Hughes.” He introduced himself after a while.

“I know that,” you whispered, watching as he laughed. “How old are you?”

“I’m thirteen, but I turn fourteen on October 14th,” he said. “You’re eleven, right?”

“Yes. My birthday was in February. I got this ball,” you raised the ball you were holding so he could see it better. It had your name on it. “And I also got new clothes for my plushies.”

“That sounds nice,” he nodded. “I’ll probably get a new stick on my birthday.”

“Why would you need a stick?” You asked, not sure what he could do with a stick. A tree’s stick. At least that’s what you thought a stick was.

Maybe he wants to put it on his fireplace.

“I play Hockey,” he answered and you still didn’t understand. The only thing you knew about Hockey was that it was the reason you and your family moved to Toronto. So it probably wasn’t a good thing. “And I need a new one.”

“Well, if it makes you happy, then I guess it’s fine,” you shrugged, poking your ball. “But that will probably be boring. You should ask for something cooler.”

He laughed again, sitting on the grass beside you. “I’ll think about that. Thank you for your advice.”

You puffed your chest a little, happy to feel useful for once.

That morning, you and Quinn didn’t end up playing; instead, you talked for hours, with you both asking each other questions about literally everything. From what’s your favorite color to what you wanna be when you grow up.

You could feel your heart racing in your chest every time you stared into his blue eyes that sometimes morphed into a light green shade, but you didn’t understand why. Quinn was being nice, he was treating you just like Peter did before you moved to Toronto and it felt so, so nice.

“Will I see you tomorrow?” You asked, right before he left for lunch at his house.

“I think so.” He smiled, quickly patting you on the head. He gave you a short wave before moving back to his home.

And you just stood there, counting the seconds so that maybe tomorrow would come faster, and you’d finally have a friend again.

[girlactionfigure]

“I feel I no longer belong in 🇨🇦 and may need to flee.”

A new survey from the Jewish Medical Association of Ontario reveals a devastating rise in antisemitism targeting Jewish doctors and healthcare workers. The data is shocking, and the consequences could be catastrophic.

🧵:

2/ Since October 7, antisemitism in healthcare settings has skyrocketed:

•29% of Jewish medical professionals report it in their communities.

•39% in hospitals.

•43% in academic settings.

Before October 7, only 1% reported severe antisemitism. 

3/ The survey found 31% of Jewish doctors in Ontario are considering leaving the country.

Doctors are being forced out by a hostile environment where their Jewish identity makes them targets.

This isn’t just a Jewish issue—it’s a healthcare crisis. 

4/ The survey of over 1,000 Jewish healthcare professionals across Canada reveals staggering numbers:

•73% of Jewish doctors in Ontario report antisemitism in academic spaces.

•60% in hospitals.

•Over 80% face antisemitism at work overall. 

5/ The most common sources of antisemitism?

•Organizational policies (57%)

•Organizational communications (55%)

•Colleagues (53%)

This isn’t random—it’s systemic, embedded in the very institutions meant to support them. 

6/ Doctors shared heartbreaking stories:

“I fear my colleagues’ reaction to my name and identity. I feel I can no longer admit who I am.”

Another said:

“I feel I no longer belong in Canada.”

This is the daily reality for Jewish healthcare professionals. 

7/ Dr. Ayelet Kuper, Chair of the Jewish Medical Association of Ontario, warned:

“This is a crisis for all people in Ontario, not just Jewish doctors. If we don’t address this, we risk losing a generation of physicians, educators, and researchers.” 

8/ Even unions are failing Jewish healthcare workers. One occupational therapist said:

“Union members attend protests condoning terrorism, chanting dangerous slogans, and making my workplace unsafe.”

The environment for Jewish professionals is hostile and dangerous. 

9/ As Dr. Sam Silver said:

“I work with students navigating a hostile environment where their identity as Jews makes them targets of hate. This cannot continue.”

Antisemitism is pushing doctors out of Ontario, and the healthcare system will pay the price. 

10/ The survey is clear: antisemitism in healthcare impacts patient care, erodes workplace integrity, and threatens the entire system.

Jewish doctors are being targeted, but the consequences will affect every Canadian.

11/ This is a crisis that cannot be ignored. We must demand accountability from institutions, protect Jewish healthcare workers, and fight antisemitism at every level.

Antisemitism has no place in Canada—or anywhere. 

Full story:

Jewish doctors consider fleeing Canada amid rising rates of antisemitism in their profession

'Union members have been attending protests that condone terrorism, and I’ve witnessed colleagues showing up to these protests with union flags, chanting dangerous slogans'

LINK

Antisemitism in Canadian med schools, hospitals skyrocketed after Oct. 7 attacks: JMAO

In a survey conducted by the Jewish Medical Association of Ontario, 80% of Jewish physicians said they face antisemitism at work

LINK

@Joe_Roberts01

[buttacake80]

Any additions to your NHL player trump supporter list? I'm from Germany I'm very worried about ppl in the US, I can't imagine what it must feel like watching him get elected again😖

I doubt we will see any players out themselves now.

But, I suspect most American players voted for Trump. We are a lot greedier than Canadians who are used to paying higher taxes to fund their social programs. [Leon's in Canada.]

Trump's new tax plan guarantees a cut for those making over $350,000. These greedy ass millionaires voted for a fascist so they could pocket even more of their millions. And, he won that young, white male demographic overwhelmingly.

A lot of them followed Joe Rogan, Theo, etc. whose podcasts helped shift that demographic right.

So I suspect Auston Matthews & the Tkachuks voted for him. The Tkachuks had supported him in his first term, and I can't imagine them deviating from that. I just think Auston is greedy.

I think JT Miller is a supporter living in Vancouver. I think some of that toxicity spilled into the room, and I believe tension increased AFTER the election. The Swedes & Finns were afraid of a Trump presidency despite their own countries shifting right.

Note the intensifying rumors about sending Miller to the Rangers. The Rangers team owner donated to Trump's campaign. I suspect that owners' loyalties is part of the reason Mika & others seem so depressed. I think Trouba, who was the team's union rep & is married to a physician who I suspect is a pediatric neurologist, isn't a Trumper.

The Hughes are my wild card. I'm genuinely unsure there. They're rich kids, but they are also Jewish. American Jews were the second highest demographic to support Harris after Black Americans. About 80% of Jews.

Then there is Evander Coon who don't even go here. Coon is Canadian. His baby mama is an American, so he's probably on his way to becoming a citizen. Hence why he supported this candidate with his financially & morally bankrupt ass.

There are some players who hold those ultra right viewpoints. The racism & bigotry. Those are gonna be harder to find. But, the Canadian Staals fit into that group. I thought Matt Duchene did, too, but I am less sure now. He might have existed in that space but matured out of it. T.J. Oshie falls into this category. He is definitely a dude who comes off as anti-LGBTQ.

Note how the DC Capitals are leading in the standings. Suddenly, Ovechkin is scoring again.

And then, there are the Russians.

American hockey fans seem oblivious to Canadian hockey fans' reaction to Musk's salute. Sadly, that demographic of Americans has shifted to denying the Holocaust. Antisemitism has been on a steady increase since Trump's last term. They think it's fine to ignore the fascist. That's politics. This is sport.

But that's not how humans work. And there are HUNDREDS more non American players in this league than there are Americans. I believe that American players will have to go on the record and distance themselves from Trump. Tkachuk & Matthews are at the top of that list since they are Americans who are Captains of Canadian teams. [Something tells me that Jack Eichel might regret his vote. I think he's greedy & conservative, but I don't read him as a fascist.]

I expect we'll see friction for the remainder of the season.

[whencyclopedia]

Chief Joseph (Eastman's Biography)

Chief Joseph (Heinmot Tooyalakekt, l. 1840-1904) was the leader of the Wallowa band of the Nez Perce Native American nation, who, in 1877, resisted forced relocation from his ancestral lands in the Wallowa Valley of northeastern Oregon and led his people on a 1,170-mile (1,900 km) flight toward Canada in hopes of asylum with Sitting Bull (l. c. 1837-1890).

The flight of the Nez Perce under Chief Joseph, a running battle in which he defeated US forces in every engagement, is known as the Nez Perce War, and newspaper accounts of the day, often hostile to Native American efforts to preserve their lands, were remarkably sympathetic to Chief Joseph's cause. When he and his people were a mere 40 miles (64 km) from the Canadian border, they were surprised by a US cavalry attack and forced to surrender.

Although the treaty between the Nez Pearce and the US government stipulated their relocation to a reservation in Idaho, briefly holding them in Montana Territory, they were instead quickly sent to Fort Leavenworth, Kansas, and held as prisoners of war before being shipped to Indian Territory (present-day Oklahoma), and finally to the Colville Indian Reservation in the state of Washington.

Chief Joseph spent the rest of his life appealing to US officials for the return of the lands of the Nez Perce in the Wallowa Valley, but his requests were denied. He is said to have died of a broken heart on the reservation in Washington on 21 September 1904.

In 1968 the US Post Office issued a stamp in his honor and memorial statues of Chief Joseph have been raised in many of the western states of the USA, but the lands of the Nez Perce have never been returned to them and there has never been any official acknowledgment of the outright theft of those lands by Euro-Americans.

Flight of the Nez Perce and Key Battle Sites of 1877

United States Department of Agriculture-Forest Service (Public Domain)

Text

The following account is taken from the 1939 edition of Indian Heroes and Great Chieftains (1916) by the Sioux physician and author Charles A. Eastman (also known as Ohiyesa, l. 1858-1939), republished in 2016. Eastman interviewed Chief Joseph in 1897 and prepared the following, which, as he said, was authenticated by General Nelson A. Miles, one of his former adversaries. The following has been edited for space, but the full account is below in the External Links section.

The Nez Perce tribe of Indians, like other tribes too large to be united under one chief, was composed of several bands, each distinct in sovereignty. It was a loose confederacy. Joseph and his people occupied the Imnaha or Grande Ronde valley in Oregon, which was considered perhaps the finest land in that part of the country.

When the last treaty was entered into by some of the bands of the Nez Perce, Joseph's band was at Lapwai, Idaho, and had nothing to do with the agreement. The elder chief in dying had counseled his son, then not more than twenty-two or twenty-three years of age, never to part with their home, assuring him that he had signed no papers. These peaceful non-treaty Indians did not even know what land had been ceded until the agent read them the government order to leave. Of course, they refused. You and I would have done the same.

When the agent failed to move them, he and the would-be settlers called upon the army to force them to be good, namely, without a murmur to leave their pleasant inheritance in the hands of a crowd of greedy grafters. General O. O. Howard, the Christian soldier, was sent to do the work.

He had a long council with Joseph and his leading men, telling them they must obey the order or be driven out by force. We may be sure that he presented this hard alternative reluctantly. Joseph was a mere youth without experience in war or public affairs. He had been well brought up in obedience to parental wisdom and with his brother Ollicut had attended Missionary Spaulding's school where they had listened to the story of Christ and his religion of brotherhood. He now replied in his simple way that neither he nor his father had ever made any treaty disposing of their country, that no other band of the Nez Perces was authorized to speak for them, and it would seem a mighty injustice and unkindness to dispossess a friendly band.

General Howard told them in effect that they had no rights, no voice in the matter: they had only to obey. Although some of the lesser chiefs counseled revolt then and there, Joseph maintained his self-control, seeking to calm his people, and still groping for a peaceful settlement of their difficulties. He finally asked for thirty days' time in which to find and dispose of their stock, and this was granted.

Joseph steadfastly held his immediate followers to their promise, but the land-grabbers were impatient, and did everything in their power to bring about an immediate crisis so as to hasten the eviction of the Indians. Depredations were committed, and finally the Indians, or some of them, retaliated, which was just what their enemies had been looking for. There might be a score of white men murdered among themselves on the frontier and no outsider would ever hear about it, but if one were injured by an Indian— "Down with the bloodthirsty savages!" was the cry.

Joseph told me himself that during all of those thirty days a tremendous pressure was brought upon him by his own people to resist the government order. "The worst of it was," said he, "that everything they said was true; besides"—he paused for a moment— "it seemed very soon for me to forget my father's dying words, 'Do not give up our home!'" Knowing as I do just what this would mean to an Indian, I felt for him deeply.

Among the opposition leaders were Too-hul-hul-sote, White Bird, and Looking Glass, all of them strong men and respected by the Indians; while on the other side were men built up by emissaries of the government for their own purposes and advertised as "great friendly chiefs." As a rule, such men are unworthy, and this is so well known to the Indians that it makes them distrustful of the government's sincerity at the start. Moreover, while Indians unqualifiedly say what they mean, the whites have a hundred ways of saying what they do not mean.

…the whites were unduly impatient to clear the coveted valley, and by their insolence they aggravated to the danger point an already strained situation. The murder of an Indian was the climax and this happened in the absence of the young chief. He returned to find the leaders determined to die fighting. The nature of the country was in their favor and at least they could give the army a chase, but how long they could hold out they did not know. Even Joseph's younger brother Ollicut was won over. There was nothing for him to do but fight; and then and there began the peaceful Joseph's career as a general of unsurpassed strategy in conducting one of the most masterly retreats in history.

Chief Joseph and Family c. 1880

F. M. Sargent (Public Domain)

This is not my judgment, but the unbiased opinion of men whose knowledge and experience fit them to render it. Bear in mind that these people were not scalp hunters like the Sioux, Cheyenne, and Utes, but peaceful hunters and fishermen. The first council of war was a strange business to Joseph. He had only this to say to his people:

"I have tried to save you from suffering and sorrow. Resistance means all of that. We are few. They are many. You can see all we have at a glance. They have food and ammunition in abundance. We must suffer great hardship and loss." After this speech, he quietly began his plans for the defense.

The main plan of campaign was to engineer a successful retreat into Montana and there form a junction with the hostile Sioux and Cheyenne under Sitting Bull…

It was decided that the main rear guard should meet General Howard's command in White Bird Canyon, and every detail was planned in advance, yet left flexible according to Indian custom, giving each leader freedom to act according to circumstances. Perhaps no better ambush was ever planned than the one Chief Joseph set for the shrewd and experienced General Howard. He expected to be hotly pursued, but he calculated that the pursuing force would consist of not more than two hundred and fifty soldiers. He prepared false trails to mislead them into thinking that he was about to cross or had crossed the Salmon River, which he had no thought of doing at that time. Some of the tents were pitched in plain sight, while the women and children were hidden on the inaccessible ridges, and the men concealed in the canyon ready to fire upon the soldiers with deadly effect with scarcely any danger to themselves. They could even roll rocks upon them.

In a very few minutes the troops had learned a lesson. The soldiers showed some fight, but a large body of frontiersmen who accompanied them were soon in disorder. The warriors chased them nearly ten miles, securing rifles and much ammunition, and killing and wounding many.

The Nez Perces next crossed the river, made a detour, and recrossed it at another point, then took their way eastward. All this was by way of delaying pursuit…

Chief Joseph US Postage Stamp

National Postal Museum (CC BY-NC-ND)

Meanwhile General Howard had sent a dispatch to Colonel Gibbons, with orders to head Joseph off, which he undertook to do at the Montana end of the Lolo Trail. The wily commander had no knowledge of this move, but he was not to be surprised. He was too brainy for his pursuers, whom he constantly outwitted, and only gave battle when he was ready. There at the Big Hole Pass he met Colonel Gibbons' fresh troops and pressed them close.

He sent a party under his brother Ollicut to harass Gibbons' rear and rout the pack mules, thus throwing him on the defensive and causing him to send for help, while Joseph continued his masterly retreat toward the Yellowstone Park, then a wilderness. However, this was but little advantage to him, since he must necessarily leave a broad trail, and the army was augmenting its columns day by day with celebrated scouts, both white and Indian. The two commands came together, and although General Howard says their horses were by this time worn out, and by inference the men as well, they persisted on the trail of a party encumbered by women and children, the old, sick, and wounded.

It was decided to send a detachment of cavalry under Bacon, to Tash Pass, the gateway of the National Park, which Joseph would have to pass, with orders to detain him there until the rest could come up with them. Here is what General Howard says of the affair. "Bacon got into position soon enough, but he did not have the heart to fight the Indians on account of their number." Meanwhile another incident had occurred. Right under the eyes of the chosen scouts and vigilant sentinels, Joseph's warriors fired upon the army camp at night and ran off their mules. He went straight on toward the park, where Lieutenant Bacon let him get by and pass through the narrow gateway without firing a shot…

However, this succession of defeats did not discourage General Howard, who kept on with as many of his men as were able to carry a gun, meanwhile sending dispatches to all the frontier posts with orders to intercept Joseph if possible. Sturgis tried to stop him as the Indians entered the Park, but they did not meet until he was about to come out, when there was another fight, with Joseph again victorious. General Howard came upon the battlefield soon afterward and saw that the Indians were off again, and from here he sent fresh messages to General Miles, asking for reinforcements.

Joseph had now turned northeastward toward the Upper Missouri. He told me that when he got into that part of the country he knew he was very near the Canadian line and could not be far from Sitting Bull, with whom he desired to form an alliance. He also believed that he had cleared all the forts. Therefore, he went more slowly and tried to give his people some rest. Some of their best men had been killed or wounded in battle, and the wounded were a great burden to him; nevertheless, they were carried and tended patiently all during this wonderful flight. Not one was ever left behind.

Statue of Young Chief Joseph

Visitor7 (CC BY-SA)

It is the general belief that Indians are cruel and revengeful, and surely these people had reason to hate the race who had driven them from their homes if any people ever had. Yet it is a fact that when Joseph met visitors and travelers in the park, some of whom were women, he allowed them to pass unharmed, and in at least one instance let them have horses.

He told me that he gave strict orders to his men not to kill any women or children. He wished to meet his adversaries according to their own standards of warfare, but he afterward learned that in spite of professions of humanity, white soldiers have not seldom been known to kill women and children indiscriminately…

The Bittersweet valley, which they had now entered, was full of game, and the Indians hunted for food, while resting their worn-out ponies. One morning they had a council to which Joseph rode over bareback, as they had camped in two divisions a little apart. His fifteen-year-old daughter went with him. They discussed sending runners to Sitting Bull to ascertain his exact whereabouts and whether it would be agreeable to him to join forces with the Nez Perces. In the midst of the council, a force of United States cavalry charged down the hill between the two camps. This once Joseph was surprised. He had seen no trace of the soldiers and had somewhat relaxed his vigilance.

He told his little daughter to stay where she was, and himself cut right through the cavalry and rode up to his own teepee, where his wife met him at the door with his rifle, crying: "Here is your gun, husband!" The warriors quickly gathered and pressed the soldiers so hard that they had to withdraw. Meanwhile one set of the people fled while Joseph's own band entrenched themselves in a very favorable position from which they could not easily be dislodged.

General Miles had received and acted on General Howard's message, and he now sent one of his officers with some Indian scouts into Joseph's camp to negotiate with the chief. Meantime Howard and Sturgis came up with the encampment, and Howard had with him two friendly Nez Perce scouts who were directed to talk to Joseph in his own language. He decided that there was nothing to do but surrender…

Even now, he was not actually conquered. He was well entrenched; his people were willing to die fighting; but the army of the United States offered peace and he agreed, as he said, out of pity for his suffering people. Some of his warriors still refused to surrender and slipped out of the camp at night and through the lines. Joseph had, as he told me, between three and four hundred fighting men in the beginning, which means over one thousand persons, and of these several hundred surrendered with him.

His own story of the conditions he made was prepared by himself with my help in 1897, when he came to Washington to present his grievances. I sat up with him nearly all of one night; and I may add here that we took the document to General Miles who was then stationed in Washington, before presenting it to the Department. The General said that every word of it was true.

In the first place, his people were to be kept at Fort Keogh, Montana, over the winter and then returned to their reservation. Instead, they were taken to Fort Leavenworth, Kansas, and placed between a lagoon and the Missouri River, where the sanitary conditions made havoc with them. Those who did not die were then taken to the Indian Territory, where the health situation was even worse.

Joseph appealed to the government again and again, and at last by the help of Bishops Whipple and Hare he was moved to the Colville reservation in Washington. Here the land was very poor, unlike their own fertile valley. General Miles said to the chief that he had recommended and urged that their agreement be kept, but the politicians and the people who occupied the Indians' land declared they were afraid if he returned, he would break out again and murder innocent white settlers! What irony!

The great Chief Joseph died broken-spirited and broken-hearted. He did not hate the whites, for there was nothing small about him, and when he laid down his weapons he would not fight on with his mind. But he was profoundly disappointed in the claims of a Christian civilization. I call him great because he was simple and honest.

Without education or special training, he demonstrated his ability to lead and to fight when justice demanded. He outgeneraled the best and most experienced commanders in the army of the United States, although their troops were well provisioned, well-armed, and above all unencumbered. He was great, finally, because he never boasted of his remarkable feat. I am proud of him because he was a true American.

Continue reading...

[allthecanadianpolitics]

Dr. Mohamed Soliman doesn’t have any connection to people in Gaza – what he does have is empathy and a desire to help. “I’ve been waiting for some way to help. Any chance I can help, I am willing to help,” said Soliman from his dental clinic in northwest Calgary.  “When this came up I said if you get approval to go, I’m more than happy to go and help those kids from dying. I understand the risk.” Soliman responded to a call to action by a Calgary family physician who wants to organize a Canadian health convoy to Gaza. “As a physician activist, the only thing I can do is to be there and provide health care,” said Dr. Mukarram Zaidi, chair of Think for Actions, a Calgary-based national non-profit think tank, focused on the professional development of youth. Zaidi has written to federal politicians requesting that Canadian authorities allow him and other health-care professionals access to the medical supplies they need to offer help.

Continue Reading.

Tagging: @politicsofcanada @abpoli

[martiandmichelle]

Here's little Kaatje holding my left tit out for others to play with. I love when someone holds my tit like this while others play with it - even better is one person holding one tit like this an another person holding the other the same way. But more on this below.

It's official: I'm keeping the extra pounds on and will even let my weight go as high as 175 pounds. Roxy quickly polled the people working here their of opinion of my body at either 165 pounds or 135, showing them photos. With the significantly bigger boobs at 165 I was surprised that 90% of the guys want me at the heavier weight. But even the ladies came in at 80% for the bigger size. I spent some time with Shannan, our site physician, yesterday and she gave me a clean bill of health for 167 pounds, with one exception: my blood sugar and A1C have crept up to prediabetic range. She gave me a blood sugar monitor and told me if I began to consistently go over 125 blood sugar (fasting) then it's time to lose the weight. Gail has designed a special diet for me to help me gain weight in a healthy manner and I'll have to keep up with my walks and exercises.

I'm determined to hit that Z cup!!!!!!!!!!!

Now back to the position above. The drive back Sunday to our house and Mountain Media was scary or I would have slept the 90 minutes we drove. Kaatje doesn't pay much attention to speed limits! Anyway, we got home safely and, me having been up all Saturday night/Sunday morning enjoying my tits, I was ready for a long nap, but a surprise waiting me when I walked into my bedroom suite in the house: all four of our new porn studs were there waiting for me! Each wore a tuxedo and held a dozen roses! I was stunned. They all looked very handsome and here I was in jeans, a jacket, and a sweater underneath which the bottom fourth of my boobs hung out. I didn't have much makeup on and my hair, though washed that morning, was a mess.

But the guys were soon on me and I forgot everything else. There were kisses with hands going up my sweater. Soon the jacket and sweater were on the floor and the jeans and undies weren't far behind. I was nude: they were fully clothed. Then two of them got in the position Kaatje held in the photo above; the other two began enjoying my tits and nipples. I couldn't see a thing but the backs of the two guys hold my two girls. The shortest guy was 5'11." I felt small - all of me except my boobs which felt gigantic.

The guys were thrilled with my newly grown boobs at my increased weight. They had interviewed back in August and I had put on 3 extra cup sizes with my weight. They would play and suck on them and talk about them as if it were just my tits and them in the room.

There was no video in the room, but audio was broadcast across the studio complex and into the main house. I think everyone listened in even as the four of them enjoyed my tits from 12:30 in the afternoon when I arrived until dark. Then the fucking began. As a wrote in an earlier post, our board of directors insisted all new male stars be at least 11" long - so these four guys were: two Americans (one white, one black); one Canadian; and one guy from New Zealand of all places!

It was 1:00 am when they left me, thoroughly exhausted. I finally got my sleep.

[macgyvermedical]

Do you know how our understanding and treatment of diabetes has changed through history?

Oooh good question, anon!

As you may guess, diabetes mellitus is not new.

We've known about it since at least the Ebers Papyrus (1550 BCE) when the disease and a treatment was first described. This treatment was: "a liquid extract of bones, grain, grit, wheat, green lead and earth." I did not look these up, but I would guess they did not do a whole lot for the treatment of diabetes.

Later during the 6th century BCE it was first given a name when it was described by Hindu physician Sushruta as madhumeh or "honey urine."

Honey urine is a very apt descriptor for diabetes. In any type, one of the most measurable symptoms is that the person urinates a lot, and the urine tastes sweet (or, if one didn't feel like tasting, that it ferments, or that it attracts ants). This was also the first test for diabetes.

The reason for the sweetness of the urine (as well as a lot of other general info about diabetes) is spelled out more clearly in my "Don't Be That Guy Who Wrote Hansel and Gretel: Witch Hunters" post.

A Greek physician Apolonius of Memphis named it Diabetes, meaning "to siphon" (referring to the large amount of urine lost).

Roman physician Aretaeus later made the first precise description of diabetes. This included the classic symptoms of incessant thirst, copious urination, and constant hunger leading to emaciation and death. He also notes that if deprived of water, the patient will continue to urinate until they become so dehydrated that they die.

The term "Mellitus" was not added until the 1600s by an English physician Thomas Willis. This was again due to the sweetness of the expressed urine. Willis prescribed a diet of "slimy vegetables, rice, and white starch. He also suggested a milk drink which was distilled with cypress tops and egg whites, two powders (a mixture of gum arabic and gum dragant), rhubarb and cinnamon". Supposedly his patients improved if they kept to this diet, though few managed it long term. I honestly don't know how it would have worked, even temporarily.

A major breakthrough came in 1889 when it was discovered that if you removed the pancreas from a dog, the dog would become diabetic (particularly, that it would urinate large quantities of sweet urine). Up until this point it was thought that diabetes stemmed from the kidneys and bladder, or perhaps the lungs. This was the first time it had been shown experimentally that the pancreas was the problem.

Speaking of this, this was also part of a series of experiments where an English physician named Merkowski implanted a small amount of pancreas in the pancreas-less dog's fat, which reversed the diabetes temporarily. This proved that the pancreas was making something that helped regulate blood (and thus urine) sugar.

What this was wasn't figured out until 1921, when Canadian scientists Banting and Best (with help from McLeod and Collip) isolated something they called insletin (after the islets of langerhans, where the substance was being produced). It's important to note that all of these scientists hated each other so much they almost refused a Nobel Prize over it. Later, Collip would refine the substance and McLeod would rename it insulin.

Prior to insulin existing there was basically 1 vaguely useful treatment for diabetes. Unfortunately, that was starvation. So you could either die a slow and painful death by diabetes or you could die a slightly less slow but still painful death due to eating about 500 calories per day. Either way, diabetes was fatal, usually within a couple of years of diagnosis.

By 1923, the first commercial insulin product, Iletin, had been developed. Iletin was a U10 insulin (10 units per 1 milliliter- less potent than today's U100 and U500 insulins) and was made from pork pancreases. It took nearly a ton of pork pancreas to make 1oz of insulin. Fortunately, as a byproduct of the meat industry, pancreases were readily available.

Now, you might be thinking- no one has mentioned type 1 or type 2 yet in this entire post!

Well, you would be right, because diabetes wouldn't be split into 2 forms (insulin-dependent and non-insulin dependent) until 1979, and wouldn't be classified as types 1 and 2 until 1995. That's right- some of you were alive when there was only one kind of diabetes out there.

Now, there's more about the types in the Hansel and Gretel post, but essentially type 1 diabetes occurs when the pancreas itself stops producing insulin, usually in childhood. When this happens, the body stops being able to use sugar (insulin, a hormone, acts as a "key" to let sugar into cells for use). Without replacing that insulin, the person dies because their cells starve.

Type 2 diabetes occurs when the pancreas still produces insulin, but the cells stop responding to it correctly. This causes high sugar levels in the blood, which causes longer-term complications (infections, ulcers, blindness, neuropathy, heart and kidney disease, hyperosmolar syndrome, etc..) which eventually lead to death.

We started discovering oral drugs that worked on what would later become type 2 in the 1950s. Particularly those that worked by increasing the insulin output of the pancreas, but only when the pancreas was still producing some insulin.

Predicting which diabetics would benefit from oral therapies was challenging, but it was recognized that when the onset of diabetes was slow and came on in adulthood, the oral agents would work, while if it came on suddenly in childhood, the oral agents wouldn't. Terms like "adult onset" and "maturity onset" were common:

(Side note: if you have ever read Alas, Babylon (1955) there is a diabetic character who by today's standards clearly has type 1 diabetes, but wants to switch to the "new oral pill" (called "orinase" in the book, though they are likely referring to diabinese pictured above).)

From 1923 into the 1980s, insulin was given once or twice per day, and not particularly titrated to blood sugar. This was probably just because we didn't have a great way to measure blood sugar in real time. Pre-1970s, there was no way to test blood sugar outside of a lab setting.

Urine testing was common starting in the 1940s, but was cumbersome as it required a flame for heating the urine. By the 1950s, a test had been developed that didn't require a flame, but was still not practical for home use. In the 1960s, paper strips were developed that changed color for different amounts of sugar in the urine. The problem with this was that the strips couldn't change color until there was sugar in the urine- a blood sugar level of over 200 by today's measurements. Low blood sugar readings were impossible at this time, and had to be treated based on symptoms.

In the 1970s, blood sugar could finally be measured by putting a drop of blood on a test strip, wiping it off, and matching the color of the test strip to a chart. While less cumbersome than urine tests, this was still something that would generally only be done at a doctor's office.

In 1983, the first home blood glucometer is developed. Finally, it was practical to take one's sugar multiple times per day, and it becomes possible to experiment with "sliding scale" insulin injections that keep tighter control of blood sugar. By the late 90s, continuous glucose monitors became available- though unlike today's CGMs that allow readings in real time on a smartphone or monitor, these had to be downloaded to a computer at regular intervals.

The 1980s were the first decade where insulin pumps become widely available. The very first pump was large and had to be carried in a backpack, but it represented a huge step forward in glucose control, as it more closely mimicked the function of a working pancreas than once-daily injections.

For the next 30 or so years you really had to work to qualify for an insulin pump, but recently it's been found that pumps greatly improve compliance with blood glucose control whether or not the person had good compliance before getting the pumps, and insurance has gotten better about covering them (though CGMs are still a pain to get insurance to cover).

The 1980s was also the decade that recombinant human insulin (insulin made by genetically modified bacteria) was first used. Up until that point the only insulins were pork and beef insulins, which some people had allergic reactions to. Recombinant insulin was closer to regular human insulin than beef or pork, and represented a big change in how insulin was made.

Today for people who take insulin to manage their diabetes, insulin is usually given as a single injection of a long-acting basal insulin, coupled with smaller doses of ultra-short-acting insulins with meals or snacks. This is the closest we've gotten to mimicking the way a pancreas would work in the wild, and keeps very tight control of blood sugar. This can be done by fingerstick blood sugar tests and individual injections of insulin, or it can be done with a CGM and pump- it just depends on the resources available to the person and their personal preference.

[straight-from-gaza]

"One of the founders of Hamas was 8 years old when he watched his uncle and 200 other boys and men massacred by the Israeli army." Holocaust survivor and Hungarian-Canadian physician, Dr Gabor Mate, speaks about Abdel Aziz al-Rantisi, one of Hamas founders. Today marks the 20th anniversary of Al Rantisi's assassination by Israel.

(Source: QUDS news network)

[enddaysengine]

Alberta's Transphobic Government

I try really really hard to keep this blog about RPGs and writing. I really do. But when someone comes for my students, fists gets thrown.

We've seen the rise of transphobic legislation in various US states, as well as in Saskatchwan and New Brunswick. Now Alberta has joined the party. Despite the premier pointing out that there are trans youth in her extended family (I don't know how close the relation is, but somewhere in her close family) and swearing to not marginalize trans youth in the last election.

And ohhhh boy oh boy, my home province is once again aiming to hit the bottom of the barrel

Here's the tl;dr (quoted from the article):

Top and bottom surgeries will be banned for minors aged 17 and under. Doctors say bottom surgeries aren't performed on youth and top surgeries are rare.

Puberty blockers and hormone therapies for gender affirmation will not be permitted for children aged 15 and under.

Youths aged 16 and 17 will be permitted to start hormone therapies for gender affirmation "as long as they are deemed mature enough" and have parental, physician and psychologist approval.

Parental notification and consent will be required for a school to alter the name or pronouns of any child under age 15. Students who are 16 or 17 won't need permission but schools will need to let their parents know first.

Parents will have to "opt-in" their children every time a teacher plans to teach about gender identity, sexual orientation or sexuality. Alberta law currently requires parental notification and gives them the option to opt students out.

All third-party teaching materials on gender identity, sexual orientation or sexuality will need to be approved in advance by the education ministry.

Transgender women will be banned from competing in women's sports leagues. Smith said the government will work with leagues to set up coed or gender-neutral divisions for sports.

This goes well beyond what SK and NB have passed. It violates the Canadian Charter of Rights and Freedoms, but Smith doesn't care and will likely use the Notwithstanding Clause to bypass it. Parents, medical professionals, and educators have all reacted with justified outrage. It is clear to those of us who care about youth that these policies will kill.

There is flattly no way in hell I will be deadnaming my students. For a government that says they want to remove red tape and bureaucracy, making parents opt-in to every single lesson involving anything other than heteronormativity sure seems like trying to use red tap to make teaching anything other than their ideology impossible.

What can you do to help?

If you are in Alberta, raise holy hell. Call your MLA, show up at the protests, add your voice to the chorus screaming that we don't want this.

If you are in Canada, there are also demonstrations in support of trans youth going on across the country. Let your MP know as well.

If you aren't from Canada, solidarity and visibility help! We've all seen how this shit has gone down in Florida and elsewhere. We need to stand together to stop this tide.

If you have business ties to Alberta and are able to divist them, please let the Alberta government know you are planning to do so if these proposals become law

Donate to 2SLGBTQ+ organizations in Alberta.

This is not the content I want to go viral from me... but if I have to choose one, make it this one. Please help us proect our kids.