jjablkowski's blog

Lynn Holden, MD (UBC 1974) killed herself on 1 December 2015. She was 67 years old. Her family remembers her as a generous, kind, vibrant person, an accomplished baker, highland dancer, trumpet player, pianist, and poet.

At the time of her graduation from medical school she wrote:
    I dream I was alive
    Energy suspended
    The first rocket of a firecracker
    Ready to burst in lightening beauty of hope
    Radiant blush . . .
    I am waking up.
    My time is now.    

In medicine a gold standard is the best available diagnostic test or benchmark under reasonable conditions. So I found it ironic to learn that the toilet seat at home is becoming the gold standard for office and even hospital hygiene. The reality is that, for example, our average office desk may contain 400 times more germs per a defined unit of space than the otherwise unheralded toilet seat. On our way up to our office or hospital facility we have already deposited and picked up germs from the elevator buttons—well in excess of what we harvested in our bathroom facility.

I was searching for historical material for a Labour Day blog post when I discovered that there are walking tours in Vancouver focusing on working class life and labor history—commemorating the importance of labor unions, individuals, collective actions, and much more in Vancouver’s history. A thought struck me: how fitting it would be on Labour Day to be able to travel back in time to the 1860s and 1870s and take a walking tour in the town that was yet not even called Vancouver!

Since the early 1990s we have shaped our medical practices in various ways, such as with evidence-based medicine, translational medicine, narrative medicine, evolutionary medicine, personalized medicine, and precision medicine. Now there is an emerging subset of the personalized and precision approaches on the horizon: chronomedicine. This medical practice recognizes that there are optimal times and less than optimal or even hazardous times for certain medical interventions. 

I always thought that the primum non nocere injunction to physicians came from the fertile minds of Galen or Hippocrates, but I discovered that the elegant English version, first, do no harm, is attributed to Dr Thomas Sydenham (1624–1689), author of Observationes Medicae, a textbook of bedside practice and observations. Published in 1676, this book was used for 200 years, reminding physicians that every medical decision carries the potential for harm.