It is time to wax eloquently over the past year, with respect to travel medicine and otherwise.
It has been a good year.
While my travels are no longer far flung, I have visited Cayo Coco in Cuba, Apsley and Silent Lake Provincial Park, the Rideau Canal and Ottawa, St. Johns, Newfoundland, Kingston, and Paris. I am glad that I waited sixty-six years to see Paris. It made it that much more stunning. Playing the grand piano at the Gare du Nord stands as one of the highlights of my life. I plan to return to Cuba in March with my children and grandchildren, “before the Americans get there”, as so many of my patients say.
Travel medicine has not changed that much. We have run out of destinations and diseases, with the exception of new arrivals like Zika. Vaccine shortages have become a way of life. Mefloquine or Lariam has had a resurgence of bad publicity. No destination is immune to natural disaster or terrorism. Vaccine costs in North America continue to present a barrier for many travelers. The next meeting of The International Society of Travel Medicine is next May in Barcelona. I look forward to seeing that beautiful city, renewing old acquaintances and finding out what is new.
In Ontario, pharmacists have now been granted the right to provide travel medicine advice and vaccines. Needless to say, in spite of my obvious bias or conflict of interest, I don’t feel that this is in the best interest of the traveler. More to say about that in the new year.
I am also a busy family doctor. My aging practice, along with its aging doctor, is overwhelmed with high cholesterol, diabetes, heart disease, addiction, aches and pains, leaky valves, cognitive impairment, depression and cancer. Wait times for diagnostic testing and specialist consultations are usually, though not always, longer than I and my patient would hope for. Guidelines, drug interactions, side effects, natural remedies and patient demands are part of my daily life. I am blessed to lie geographically halfway between Sunnybrook and North York General Hospital. I am also fortunate to have a caring and superb staff, who look after and care for me as much as my patients. That would be Indi, Karon, Lilliana and Dolly. Lesson for young doctors – surround yourself with excellent colleagues (or work alone like I have for the past 15 years), but more importantly, staff.
We are in constant conflict with the Ontario government, with only imposed solutions rather than negotiated settlements. Our health minister, himself a physician, seems to despise us. The future will likely bring more bureaucracy, more scrutiny and less freedom. No surprise that the thought of retirement marinates in my mind.
I have lost many people this year, as we have all. Family, friends, colleagues and patients. Christy Afuwape, my Nigerian travel nurse and treasured friend, passed away unexpectedly this year. I subscribe to The Globe and Mail. While I wouldn’t call it my favourite section, the Obituaries is where I turn to first, to learn about the accomplished and loving lives that people have led.
I feel fortunate to have a wonderful family, with children and grandchildren that make me proud, thankful and happy. My spare time, or perhaps my primary time, is filled with squash (the racquet sport), piano, sample here, (jazz), coffee (double cream and sweetener), reading and dear friends. I dislike Toronto traffic and endless passwords.
I wish you a happy and health New Year, and hope some of that pleasure comes from travel.