September

Looking at medical school curricula over the centuries, end-of-life training is clearly a new phenomenon. From the time of the first medical schools physicians were counseled not to intervene with dying people. The Hippocratic tradition defined medicine as “to do away with the suffering of the sick, to lessen the violence of their diseases, and to refuse to treat those who are overmastered by their disease, realizing that in such cases medicine is powerless.”[1]

As physicians and members of a profession, we have a complex relationship with society. We are highly respected, are granted generous privileges and reasonable autonomy, and in return we are entrusted with the care of patients, the maintenance of standards, and the expectation that we will sustain our ranks by educating the next generation of physicians.

When fetal heart monitoring was in its infancy, everyone involved in obstetrical care was excited by the potential of this technology to improve fetal outcomes. Numerous monographs on the subject were produced and distributed; numerous tutorials were conducted to bring all clinicians quickly up to speed in the use of these wonderful machines.

The life of full-service physicians working in British Columbia’s northern and rural communities is a challenging one. They work long hours, often diagnosing patients without the help of modern technology and managing their care without immediate specialist backup. They work out of full-service offices (not episodic care centres), do house calls, manage complex and time-consuming cases, assume primary responsibility for hospitalized patients, and perform a wide variety of tasks and procedures at short notice and at all hours of the day and night.

Lymphogranuloma venereum (LGV) is a disease caused by the L1, L2, and L3 serovars of Chlamydia trachomatis; genital C. trachomatis infections are caused by serovars D through K. It is normally a disease found in the tropics and only rarely in developed countries.

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