July

The term “dual diagnosis” is generally used to refer to patients with substance abuse disorders as well as mental illness. However, there are others this term is used for: children and adults who have lifelong developmental disorders along with co-occurring mental illness and behavioral difficulties. 

As 40 years of medical records  are carted away, a retired physician remembers some beginnings.

Its engine roaring, the huge truck lumbered away down the lane. Now being digested in its vast belly weae the shreds of hundreds of files; the records of patients, procedures, successes, and a few failures. Gone forever in 13 minutes.

The scenario is all too familiar. It is Friday night. I am on call and asked to see 11-year-old “Jenna,” who has been brought to the emergency department by her mother because she is “out of control.” Jenna was raging at home, throwing things, destroying her room, hitting, kicking, and biting, and threatening to kill herself. This behavior has increased over the past few weeks and her mother is worried that Jenna will commit suicide or harm her little brother. 

A few years ago I wrote an editorial about my experiences at the annual ethics conference hosted by the BC College of Physicians and Surgeons here in Vancouver. As I recall, I had attended at least one previous conference prior  to deciding to write the editorial and did so because of what I felt was an extremely rewarding professional experience. 

However, I suspect I may have been a trifle over-expansive in my praise, as I was recently asked to act as a moderator for two sessions  at the most recent conference on medical bioethics. 

The recent sitting of the BC legislature resulted in numerous legislative changes that at first glance appeared to be deep incursions into the practice of medicine, presumably in response to public pressure for improved health care access. 

This legislation should come as no surprise given the prior throne speech in which promises were made to enhance the scope of practice of existing health care professionals and expand patient access and choice of health care professionals.