Serum Light Chain analysis only paid in Cancer units.

Monitoring patients with monoclonal light chain diseases but no M-spike on protein electrophoresis

Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test

The monoclonal gammopathies are characterized by a clonal expansion of plasma cells that secrete a monoclonal immunoglobulin (Ig). The monoclonal Ig secreted by these cells serves as a marker of the clonal proliferation, and the quantitation of monoclonal protein can be used to monitor the disease course.

The monoclonal gammopathies include multiple myeloma (MM), light chain multiple myeloma (LCMM), Waldenstrom’s macroglobulinemia (WM), nonsecretory myeloma (NSMM), smoldering multiple myeloma (SMM), monoclonal gammopathy of undetermined significance (MGUS), primary systemic amyloidosis (AL), and light chain deposition disease (LCDD).

Monoclonal proteins are typically detected by serum protein electrophoresis (SPEP) and immunofixation (IF). However, the monoclonal light chain diseases (LCMM, AL, LCDD) and NSMM often do not have serum monoclonal proteins in high enough concentration to be detected and quantitated by SPEP.

A sensitive nephelometric assay specific for kappa free light chain (FLC) that doesn’t recognize light chains bound to Ig heavy chains has recently been described. This automated, nephelometric assay is reported to be more sensitive than IF for detection of monoclonal FLC. In some patients with NSMM, AL, or LCDD the FLC assay provides a positive identification of a monoclonal serum light chain when the serum IF is negative. In addition, the quantitation of FLC has been correlated with disease activity in patients with NSMM and AL.

See Laboratory Approach to the Diagnosis of Amyloidosis and Laboratory Screening Tests for Suspected Multiple Myeloma in Special Instructions.

Reference Values Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.

KAPPA-FREE LIGHT CHAIN
0.33-1.94 mg/dL

LAMBDA-FREE LIGHT CHAIN
0.57-2.63 mg/dL

KAPPA/LAMBDA FLC RATIO
0.26-1.65

Interpretation Provides information to assist in interpretation of the test results

The specificity of this assay for detection of monoclonal light chains relies on the ratio of free kappa and lambda light chains. Once an abnormal free light chain (FLC) K/L ratio has been demonstrated and a diagnosis has been made, the quantitation of the monoclonal light chain is useful for monitoring disease activity.

Changes in FLC quantitation reflect changes in the size of the monoclonal plasma cell population. Our experience to date is limited, but changes of >25% or trending of multiple specimens are needed to conclude biological significance.

Cautions Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances

Elevated kappa and lambda free light chain (FLC) may occur due to polyclonal hypergammaglobulinemia or impaired renal clearance. A specific increase in FLC (eg, FLC K/L ratio) must be demonstrated for diagnostic purposes.

Moderate to marked lipemia may interfere with the ability to perform testing.

Supportive Data

Studies at Mayo Clinic have shown that in some patients with urine monoclonal light chains and negative serum immunofixation (IF), the free light chain (FLC) assay can identify monoclonal FLC in the serum. These studies support the increased sensitivity of the nephelometric FLC assay. In a series of patients with primary systemic amyloid treated by stem cell transplantation, the quantitation and monitoring of FLC predicted organ response (eg, disease course).

Clinical Reference Provides recommendations for further in-depth reading of a clinical nature

Drayson M, Tang LX, Drew R, et al: Serum free light chain measurements for identifying and monitoring patients with nonsecretory multiple myeloma. Blood 2001;97(9):2900-2902

UK DAILY MAIL: COST of AIDS

MOUNTING COSTS OF HIV TREATMENT

The cost of treating someone with HIV in the UK is estimated to be around £18,000 per year when they are not showing any symptoms.

This is based on the price of care as well as triple-drug antiretroviral therapy.

However, it costs £21,500 to treat patients who are showing symptoms and £41,000 for those with full-blown AIDS.

Patients who have four drugs cost the NHS between £22,775 and £48,000 per year.

The annual cost of providing HIV treatment and care in the UK could be as high as £758 million by 2013, according to a study in PLoS One. 

Read more: http://www.dailymail.co.uk/health/article-2067496/Number-people-HIV-UK-poised-hit-100-000-infections-rise-6-year.html#ixzz1f6DXIu6F

CSCH-(OD) WORKSHOPS JAN & MARCH 2012

CANADIAN SOCIETY OF CLINICAL HYPNOSIS
(ONTARIO DIVISION)

The Fundamentals of Hypnosis
a three-day Introductory workshop - January 20-21 and March 15
Medical accreditation info: 19.5 CFPC Mainpro-M1 or RCPS Section 1 credits
$675 - only $225 per day
three workshops on the Evolution of Ego State Therapy
with Claire Frederick M.D.
Part 1: History and Applications
a two day Intermediate workshop on Friday March 16 and Saturday March 17 $695
Part 2: Healing the Divided Self
a two day Advanced workshop on Friday June 8  and Saturday June 9 $695
Part 3 will be presented as part of the SCEH conference which will be held in Toronto in October 2012, co-sponsored by CSCH-OD
All workshops will be held in downtown Toronto. Student discount and CSCH / ASCH / SCEH members discounts may be available. These are non-member "early bird" rates shown above. There are eligibility requirements for each workshop. Brochures will be distributed through this mailing list as they are finalised. Registration for the Introductory workshop will open in early December.
http://www.hypnosisontario.com/

Ontario College of Family Physicians new Pres. David TANNENBAUM MD( McGill 77) FCFP

At Richmond St. HILTON HOTEL Toronto Mt. Sinai Granovsky Glusken  GP Centre David TANNENBAUM MD FCFP was acclaimed President.

Many GPs now leaving General GP and Focusing on a Specialty recognised by the Royal Colleges of Physicians & Surgeons. Mainly Acupuncture, Anaesthesia, Cosmetic medicine, Geriatrics (Nursing Homes) Hair Transplants, Musculoskeletal medicine(including joint injections & manipulation), Palliative medicine, Psychotherapy, Refraction, Rehabilitation (car accidents & WSIB), Sports Medicine, Surgical assisting.Weight loss.

Reasons:
Many specialties have lower overhead: especially psychotherapy.
Higher status: not "just a GP" Similar to UK GPwSI (GP with Special Interest).
Higher income as many services not covered by Provincial insurance with higher PRIVATE RATES.
Less medico-legal risk as TREATMENT stressed not Diagnosis.

With increase of clinical responsibility of Nurse Practitioners, the rise in Canada of Physician Assistants, and of Pharmacists in PAID Counselling, the role of GP in Ontario is declining. A worry to the College of FPs.

COFP Exec.Director & CEO is a Registered Nurse Ms Jan KASPERSKI

COCKROACH SENSITIVITY in Allergic rhinitis

Tahira Batool

*, Rozita Borici-Mazi

From

Victoria, Canada. 3-6 November 2010

Canadian Society of Allergy and Clinical Immunology Annual Scientific Meeting 2010

Background

Role of cockroach allergy in asthma has been widely studied

and the effect of environmental control on asthma

symptoms has been established. However, the role of

cockroach sensitivity remains unknown. We have

designed this study to establish role of cockroach sensitization

on allergic rhinitis.

Hypothesis

Cockroach allergy has significant role in allergic rhinitis.

Population

Allergic rhinitis patients attending allergy and clinical

immunology clinic under Dr Rozita Borici-Mazi in Kingston

General Hospital, Kingston ON.

Method

Retrospective chart review of patients evaluated for

allergic rhinitis and underwent skin prick testing.

A cohort of 250 patients was randomly selected with

inclusion criteria being symptomatic allergic rhinitis and

positive allergy skin prick testing to usual panel of allergens.

Data collection included demographics, smoking

exposure, symptom pattern, presence or absence of

non-nasal symptoms, positive skin prick testing for

cockroach and other environmental allergens such as

dust mite, cat, dog, and seasonal pollens.

Results

Allergy to seasonal allergens was found to be the most

common (n=191, 76.4%) followed by house dust mite

(n=149, 59.6%) and cat allergen (n=118, 47.2%). Cockroach

sensitization was found in 62 (25%). Among the

cockroach sensitivity group, 8 patients had monosensitization

to cockroach. All of them had perennial symptoms.

75%of these people were residents of urban areas.

Two patients who had symptoms for more than 8 years

had developed asthma.

Conclusion

Cockroach allergy is found to be one of the significant

indoor allergens in allergic rhinitis in Kingston area.

Given the relationship of Allergic Rhinitis and Asthma

development, there is need to recognize this important

allergen earlier and treat it through allergen avoidance

and/or Immunotherapy, not only to treat allergic rhinitis

symptoms but also to prevent development of allergic

asthma. Further studies to establish the correlation

between allergic rhinitis and cockroach sensitization are

needed.

Published: 4 November 2010

doi:10.1186/1710-1492-6-S2-P11

Cite this article as:

allergic rhinitis patients; is it significant? To see prevalence of cockroach

sensitivity in allergic rhinitis patients in Kingston area.

Clinical Immunology

* Correspondence: 7TB11@queensu.ca

Department of Internal Medicine, Queen

Ann Allergy. 1978 Dec;41(6):333-6.

A comparative study of prevalence of skin hypersensitivity to cockroach and house dust antigens.

Kang B, Sulit N.

Abstract

Allergy skin tests with cockroach antigen along with various common inhalant allergens were performed on 222 atopic and on 63 non-atopic subjects. The most prevalent allergen producing a positive skin test was house dust antigen with a positive response of 72%, 78% and 57% in atopic adults, atopic children and non-atopic children, respectively. The next prevalent positive skin test was to cockroach antigen with 50%, 60% and 27%, respectively, of the three groups tested. The differences between positive cockroach hypersensitivity and house dust hypersensitivity in all three groups tested were statistically significant. Next in order of prevalence of positive skin test to common inhalants were western weeds, ragweeds and cats. Incidence of cockroach hypersensitivity was 58% among asthmatic adults and 69% among asthmatic children. The results indicate that cockroach hypersensitivity is highly prevalent and that cockroach antigen is an independent agent from house dust as a cause of immediate hypersensitivity reaction.

PMID:

569451

[PubMed - indexed for MEDLINE]

Batool and Borici-Mazi: Cockroach sensitivity inAllergy, Asthma &2010 6(Suppl 2):P11.’s University, Kingston, Ontario,

POSTER PRESENTATION Open Access

WISEMAN RD, WOODIN WG, MILLER HC, MYERS MA. Insect allergy as a possible cause of inhalant sensitivity. J Allergy. 1959 May–Jun;30(3):191–197. [PubMed]

Cockroach sensitivity in allergic rhinitis patients;

is it significant? To see prevalence of cockroach

sensitivity in allergic rhinitis patients in

Kingston area

OMA COUNCIL MEETING ELECTION RESULTS

DIRECTOR elected from the General & Family practice assembly:

Georgetown GP Kiran Udaya CHERLA MD (Tor. 2001) defeated incumbent Ottawa GP Alicia DONOHUE MHSc (Tor.1983) MD (Ottawa 1985)

DIRECTOR re-elected from the Surgical assembly, Toronto Vascular Surgeon Wayne TANNER MD( 1972 Tor.) FMSQ (1980 Quebec) FRCS(C) (1984 Vasc.Surg.)

Other candidates:
1)Toronto Surgical assistant Dr Davis ESSER MD (U.Western Ont 1987)

2)Chief of Staff Scarborough Hosp Dr.Steven JACKSON MDCM (McGill 1987) FRCS(C) Surgical oncology 1994  MBA(Rotman, U.Toronto 2011)

3)Peterborough Anaesthetist Dr Renwick MANN MD (Queen's 1975) FRCP(C) 1979

BAYER point-of-care HbA1c test using capillary blood & "A1CNow+" monitor

A1CNow+^®

Fast. Easy. Accurate.

Get A1C test results now in just 5 minutes. The A1CNow+^® monitor is hand-held, portable and simple to use. Test results are lab accurate at 99%¹.

The A1CNow+^® monitor enables you to get rapid A1c test results while your patients are in your office, empowering you to make on-the-spot treatment decisions for your diabetes patients.
Using the A1CNow+^® monitor is:

Fast.

• In office testing. No waiting for lab results
• Results in just five minutes
• Hands-on procedure time is less than one minute
• Provides opportunity for immediate, face-to-face counseling

Easy.

• Simple, 3-step procedure
• CLIA waived
• Only 5 μL of blood from a fingertip is needed
• No calibration, no daily controls, no maintenance
• No refrigeration necessary if used within four months
• No capital equipment required
• Enables A1C testing in every exam room

Accurate.

• Proven lab accuracy at 99%
• NGSP certified

To learn more about purchasing A1CNow+^® for use in your practice, please contact your Bayer sales representative or call our Customer Support Line at 1-800-268-7200.

PricewaterhouseCooper The OMA Study of Income,Overhead and Hours Worked

$600,000 PwC study commissioned by OMA. published Oct. 2011. 108 pages. PwC Head Health Dept.Ms Barbara PITTS PwC CEO William McFarland B.Com(Hons.U Tor.) CA.
18 York street, Tor.,Ont. M5J 0B2

"The OMA Study of Income,Overhead and Hours Worked."

1,249 OMA members responded : 8.6%


HIGHEST DAILY NET (after overhead expenses).
#1 NUCLEAR MEDICINE $2,116
#2 RADIATION ONCOLOGY $2,085
#3 CARDIOLOGY  $2,013
#4 General THORACIC SURGERY  $1,854
#5 Diagnostic RADIOLOGY  $1,780

HIGHEST OVERHEAD/HOUR
#1 OPHTHALMOLOGY $126
#2 GASTROENTEROLOGY $110
#3 CLINICAL IMMUNOLOGY $104
#4  RESPIROLOGY $83
#5 UROLOGY $82

HIGHEST HOURS WORKED/day
#1 General THORACIC SURGERY 9.2
#2 PLASTIC SURGERY  8.8
#3 Orthopaedic SURGERY 8.7
#4 UROLOGY 8.7
#5 CARDIAC SURGERY 8.6

HIGHEST NET HOURLY INCOME
#1 RADIATION ONCOLOGY $311
#2 NUCLEAR MEDICINE $ 300
#3 COMMUNITY MEDICINE $296
#4 CARDIOLOGY $260
#5 Diagnostic RADIOLOGY $249

Dusseldorf Heinrich-Heine University Prof N.GATTERMANN MD PhD visits Canada

Thanks to NOVARTIS sponsorship,  Prof. GATTERMANN gave a series of lectures in Canada on MYELODYSPLASTIC SYNDROME (MDS) with special reference to Non-Transferrin-Bound Iron (NTBI) overload trearted by chelating agents such as deferasirox (Exjade).

Approx. 1800 Canadians are affected by MDS.

The cardiotoxic effect of  NTBI was emphasised.

Ann.Haematol.(2011) 90:1-10 (Springer)
"Iron overload in MDS-pathophysiology,diagnosis, and complications."
N.Gattermann H.H.U. Dusseldorf, Germany   E.Rachmilewitz E.Wolfson Med. Center,Holon, Israel.

Prof Gatterman studied with Late Hepatologist Dame Sheila Sherlock at the Hampstead branch of London's Royal Free Hospital and at the Boston Harvard Medical school. An idiomatically perfect English speaker..

LEGAL NEWS friom GARDINER ROBERTS

NEW CHANGES TO RHPA TO AFFECT ONTARIO’S PHYSICIANS
By Lonny J. Rosen, LL.B., C.S. and Elyse Sunshine, B.A., LL.B.*
Significant changes to the Regulated Health Professions Act, 1991 (RHPA) and its procedural
code have recently come into effect. These will dramatically affect the information about all
regulated health professionals, including physicians, that is available to the public, and will
provide health Colleges with sweeping new powers and access to more personal information
about and from their members than ever before. Some of these changes were enacted with the
passage of Bill 171 in 2007, but were not implemented until this month. Other changes were
introduced and enacted this year to enhance Colleges’ powers of investigation. This article will
summarize some of the more significant changes to the RHPA’s Procedural Code.
Enhanced Mandatory Reporting
The RHPA and its procedural code previously imposed very limited reporting obligations. These
arose only when a doctor learned in the course of his or her practice, that a patient had been
sexually abused by a health professional or when a health professional’s employment had been
terminated or suspended because of misconduct, incompetence or incapacity.
These reporting obligations remain. Now, however, operators of a facility where one or more
members practice will now be required to report to the Registrar if they believe that a member
practicing at the facility is incompetent or incapacitated - regardless of whether the operator
terminates the member’s employment or association. As “facility” is not defined in the
legislation, Colleges are likely to interpret the word broadly.
These obligations may therefore apply to any person who operates any type of practice,
including a family practice or health team. If an individual fails to report in these circumstances,
he or she faces a fine of up to $25,000.00 for a first offence and could be subjected to
professional misconduct charges (if he or she is a professional). As operators of a facility may
have difficulty determining whether a member practicing at the facility is incapacitated or
incompetent, it is important for all professionals and “facility operators” to understand the legal
meaning of “incompetence” and “incapacity” and to avail themselves of legal advice before
taking any steps in this regard.
Additionally as of June 4, 2009, all health professionals are required to file a report with their
College if they have been found guilty of any offence. This obligation will enable Colleges to
investigate members’ conduct, and to determine whether the finding raises concerns relevant to
their suitability to practice. Offences reported to Colleges should not appear on the public
register unless there is a related finding of professional misconduct.
What Was Private is now Public
While the College of Physicians and Surgeons of Ontario (CPSO) has made much of the public
register available on its website for some time, it must now include more information than ever
before. The result of every disciplinary and incapacity hearing, a synopsis of those decisions, all
cases which have been referred to the Discipline Committee for a hearing, notations of every
suspension or revocation that has been issued to a doctor and, for the first time, any finding of
professional negligence or malpractice made against them by a court must now be included on
the website. Doctors will now have to self-report any such findings to the CPSO.
Introducing the ‘Inquiries, Complaints and Reports’ Committee
Each College will see its Complaints Committee replaced by the Inquiries, Complaints and
Reports Committee (ICRC), which will receive all complaints, inquiries and reports about a
member. Previously, if a complaint dealt with issues of standards of practice, the Complaints
Committee could refer the matter to the Quality Assurance Committee for some form of
assessment and/or mediation. This referral power has been eliminated but the ICRC could
require a member to complete continuing education or remediation.
Enhanced Emergency Powers
What is potentially most distressing for doctors is that the CPSO’s ICRC now has the power to
make an interim order suspending their licence, without notice, if there are grounds to believe
that the doctor’s conduct exposes, or is likely to expose, his or her patients to harm or injury and
urgent intervention is needed. Previously, the CPSO Executive Committee had this authority,
but could not exercise its “emergency powers” without giving the member an opportunity to
comment.
The Past May Haunt You
Among other concerning changes to the RHPA is a requirement that the ICRC, when considering
a complaint or report about a member, consider all prior decisions about the member, including
decisions in which no misconduct was found and no action was taken (except for decisions
regarding a complaint that was found to be frivolous, or made in bad faith). These amendments
will be troubling for all doctors who have previously been the subject of a complaint - even
where no action was taken by the Complaints Committee - due to a concern that the ICRC may
be reluctant to dismiss a complaint simply because a doctor has been the subject of numerous or
similar allegations in the past. Further, while information about past decisions will not
necessarily be disclosed to a complainant, such information may still become available in a
review, appeal or subsequent proceeding.
Alternative Dispute Resolution
Another change to the regulatory regime is that Alternative Dispute Resolution (ADR) is now
formally available for the resolution of a complaint matter. A complaint matter may only be
referred to ADR with the consent of both the complainant and the physician, as long as it does
not involve an allegation of sexual abuse. If an ADR process results in resolution, the panel has
discretion to accept the proposed resolution, but may reject the settlement and still continue with
its investigation of the complaint! If no resolution is reached, however, then all communications
between the health professional, the complainant and any facilitator in connection with the ADR
process shall remain confidential and cannot be part used in any subsequent proceeding.
Penalties Effective Immediately
Presently, most Discipline Committee orders which suspend or revoke a doctor’s license or
impose terms, conditions or limitations on the license, will not take effect until he or she has had
the opportunity to appeal and the appeal has been decided. Colleges will now be permitted to
apply to the Court to have the decision of the Discipline Committee take effect immediately,
notwithstanding the commencement of an appeal. Additionally, if a doctor is found guilty of
certain types of sexual abuse or has his or her licence suspended or revoked on the grounds of
incapacity or incompetence, the suspension or revocation takes effect immediately, despite any
appeal.
Enhanced Powers of College Investigators
CPSO Investigations have typically involved chart reviews and witness interviews, but rarely
have investigators sought to compel the physicians under investigation to answer questions or to
carry out procedures while under investigation. When the CPSO attempted to employ these
investigative techniques in the course of recent investigations, some of the physicians being
investigated challenged the scope of the CPSO’s investigative powers. The Divisional Court
accepted the CPSO’s expansive interpretation of its investigative powers, but the Ontario Court
of Appeal agreed to hear the physicians’ appeal and did so (the decision is under reserve). In the
interim, however, rather than awaiting the Court of Appeal’s ruling, the Government of Ontario
has enacted Bill 141, further amending the Code to authorize investigators to “make reasonable
inquiries of the member who is the subject of the investigation” and to compel the member to
cooperate fully with an investigator. The Code now provides for direct observation of a member
in his or her practice, including the direct observation by inspectors of procedures (i.e. surgery).
It appears that regardless of the Court of Appeal’s determination, CPSO investigators and
inspectors will have significantly greater and more intrusive powers at their disposal.
Conclusion
While these amendments will no doubt allow for the CPSO, patients and members of the public
to learn more about Ontario’s doctors, there is no corresponding enhancement of doctors’ rights
or procedural protections. Such protections will still be available in connection with many
proceedings, but the concern remains that doctors will find themselves embroiled in more
conflicts and other proceedings as a result of the College’s enhanced investigative powers and
the increased information disclosure required by the new amendments. For these reasons, access
to advice from lawyers who specialize in representing health professionals in regulatory
proceedings will be more important than ever before.
This column is intended to convey brief, timely, but only general information and does not constitute legal
advice. Readers are encouraged to speak with legal counsel to understand how the general issues noted
above apply to their particular circumstances.
*Lonny J. Rosen (a Certified Specialist in Health Law) and Elyse Sunshine are partners in the Health
Law Group at Gardiner Roberts LLP. Please talk to Elyse or Lonny about how the changes discussed
in this article will impact your practice. Elyse can be reached at: 416.369.4343 or by e-mail
esunshine@gardiner-roberts.com. Lonny can be reached at:
416-369-4345 or by e-mail:
lrosen@gardiner-roberts.com

Ontario College Physicians & Surgeons uses Private investigators with secret cameras.

In three published discipline cases`the CPSO used secret cameras and private investigators.

SPYTECH has`details of hidden cameras.

http://www.spytech.com/

In USA some doctors are recording all patient contacts.

CAMERA DETECTOR $1000

Mini Gadgets CD-PRO Pro Camera Detector

ONTARIO: GP with FOCUSED PRACTICE a copy of UK GPwSI (GP with Special Interest)

Ontario College Phys & Surgeons (CPSO) has copied UK NHS status of "GPwSI"; above  basic GP but below a Specialist. GPwSIs often work as hospital clinic assistants to UK Consultants.

CPSO changed the phrase of "Practice Limited to...."
Now "GP with Focused Practice in..."
The "GP" must be included to le4t the public know that the doctor is NOT a Specialist. (The result of the YAZDANFAR case when a GP who did liposuction killed a patient.)

The new`law will help Specialists who trained abroad but can not or will not take the Canadian specialty exams.

It will also help GPs who want to rise above the herd by taking extra courses. It will also help provide a degree of specialised services in parts of Ontario where Specialists do not want to live.

GP Focused Practice Designation: Policy and Program Overview September 2011 Page 34 of 39 Appendix B: Royal College of Physicians and Surgeons of Canada List of Specialties and Subspecialties Adolescent Medicine

Anatomical Pathology

Anaesthesiology

Cardiac Surgery

Cardiology

Clinical Immunology and Allergy

Clinical Pharmacology

Clinician Investigator Program

Colorectal Surgery

Community Medicine

Critical Care Medicine

Dermatology

Developmental Paediatrics

Diagnostic Radiology

Emergency Medicine

Endocrinology and Metabolism

Forensic Pathology

Gastroenterology

General Pathology

General Surgery

General Surgical Oncology

Geriatric Medicine

Gynecologic Oncology

Gynecologic Reproductive Endocrinology and Infertility

Hematological Pathology

Hematology

Infectious Diseases

Internal Medicine

Maternal-Fetal Medicine

Medical Biochemistry

Medical genetics

Medical Microbiology

Medical Oncology

Neonatal-Perinatal Medicine

Nephrology

Neurology

Neuropathology

Neuroradiology

Neurosurgery

Nuclear Medicine

Obstetrics and Gynecology

Occupational medicine

Ophthalmology

Orthopedic Surgery

Otolaryngology-Head and Neck Surgery

Palliative Medicine

Pediatric Emergency Medicine

Pediatric General Surgery

INTERNATIONAL HUMANIST: OBIT.Dr.Robert A.Amiel BUCKMAN

IHEU Eulogy for Rob Buckman
Posted: 01 Nov 2011 03:25 PM PDT
When Rob Buckman – Humanist, oncologist, and TV personality – realized he was dying from an autoimmune disease, he thought it would be useful to make a film to help others learn from his death. He was right about the value of the film: Your Own Worst Enemy was a great critical success and helped countless people address a topic that is taboo and yet unavoidable. But Rob was wrong about the subject of the film: thanks to a new treatment he survived another three decades after the 1981 movie. And those three decades were filled with the love, learning and laughter that made him a hugely popular figure on both sides of the Atlantic.It was somewhere over the Atlantic that death finally caught up with Rob Buckman on October 9, 2011. He died in his sleep while flying back to Toronto after filming some health shows in London. He was 63. He is survived by his first wife, Joan van den Ende, and their two daughters, Joanna and Susie, and by his second wife, Pat Shaw, and their two sons, James and Matthew.

The attitude that led Rob to make Your Own Worst Enemy was typical of his life. He used his remarkable communication skills to share his medical expertise with the widest possible audience. But he was so much more than just an expert communicator: he laid bare his essential humanity, right down to the details of his own mortality, in order to help others find understanding and comfort. And these rare talents can be found throughout his life, intertwined in his vocations as physician, communicator and Humanist.

The 1994 Canadian Humanist of the Year, Rob was always eager to help the Humanist movement. For more than a decade, starting in 1999, he was a hands-on president of the Humanist Association of Canada. He also worked with the International Humanist and Ethical Union (IHEU) serving as Chairman of the Advisory Board for IHEU’s bio-ethics center at the United Nations. He made frequent trips from Toronto to New York City to help the bio-ethics center, speaking at the center's conferences and contributing to UN briefings.
Rob grew up in London, and then went to St John's College, Cambridge, where he graduated in medicine in 1972. At Cambridge he was a star in the famous Footlights troupe, which has featured so many of Britain's leading comedians.As a junior doctor at University College Hospital, London, he met Chris Beetles, and they teamed up as "Beetles and Buckman" Buckman" to perform live comedy and revue. Rob wrote for the long-running satirical BBC Radio 4 show Week Ending, and for a TV sitcom, Doctor On the Go, based on Richard Gordon's Doctor in the House books. In the 1980s, Rob went on to front a long-running TV medical series with Miriam Stoppard, Where There's Life.
In 1985 Rob emigrated to Canada, working as an oncologist at Sunnybrook Hospital in Toronto, before moving to Toronto’s Princess Margaret Hospital. He also became a full professor in the Department of Medicine at the University of Toronto and adjunct professor at the M. D. Anderson Cancer Center in Houston, Texas. He specialized in breast cancer and also in teaching communication skills in oncology to physicians and nurses.In Canada, Rob continue his career presenting television science-and-medicine programmes Magic or Medicine? his series on ‘alternative medicine’, won him a Gemini award (the Canadian TV Industry equivalent of an Emmy).
As well as writing a weekly column for the Toronto Globe and Mail, Rob wrote 15 books. Many of these aimed to help people deal with death and dying, including: How To Break Bad News: A Guide for Healthcare Professionals; What You Really Need To Know About Cancer: A Comprehensive Guide for Patients and their Families; Cancer is a Word, Not a Sentence: A Practical Guide to Help You Through the First Few Weeks; and I Don't Know What To Say - How To Help And Support Someone Who Is Dying. His autobiography was titled Not Dead Yet. He also wrote a national best-seller exploring his Humanist philosophy: Can We Be Good Without God? Biology, Behavior and the Need to Believe.
In Twice Around the World and Still Stupid, Rob Buckman wrote, "To me, Humanism is what you are left with if you strip away what doesn’t make sense. I was always attracted by science, and the more I learned, the more I found that many established world-philosophies (particularly among some of the organized religions) didn’t make any form of intuitive sense. Undoubtedly they bring great comfort to their believers, but I found that I was unable to sincerely believe in any divine architecture to the cosmos, or in any predetermined destiny for any race or creed or even for any individual. From my teenage years onwards, I basically came to think that we humans are a most peculiar species huddled together in a rather uneven and random way on a rather pleasant planet, and it’s up to us to do our best. I have never felt that we can look for assistance elsewhere. What we see around us is what we’ve got.
Now that might sound as if I am some sort of unemotional reductionist - a B. F. Skinner playing the role of doctor – but I know that I am not. Accepting a Humanist view of our world does not mean that you don’t feel love, anger, fright, tenderness – or even humour. A Humanist basis simply allows you to spend less of your time twisting what you see and contorting it to fit somebody else’s idea of what ought to be. Of course I could be wrong: but if I am I don’t think I shall have done all that much damage on the way – on average, Humanists don’t."--Matt Cherry, IHEU