Inside the winter 2010 issue Anesthesia Calls pg 4 & 5 People in the Crowd pg 8 Photobook: Manitobans at CAS pg 10 A publication of the Department of Remembering Those We’ve Lost pg 11 Anesthesia & Perioperative Medicine

A Tribute to Dr. Douglas B.Craig by Diane R. Biehl and John G Wade

In September 2010, we said farewell to one would receive the necessary background to prepare of the founding members of the University of them for the Royal College specialty examinations. Manitoba Department of Anesthesia. Dr. Doug Doug was also the first anesthesia program director Craig was instrumental in creating and developing our to develop career counseling for residents. Each resident university department. It is a pleasure was interviewed twice a year to ensure that they were to chronicle at least some of his doing well in the program but also to help them plan for contributions here. their future careers. Particularly with the contacts at San In 1967-68 Doug was a resident Francisco, John and Doug were able to arrange additional in Anesthesia in the University of training in subspecialty areas for many residents. California Department of Anesthesia at In 1972-73, The Royal College established Anesthesia San Francisco. During this time he met as a “stand alone” specialty. Doug was actively involved John Wade and Joe Lee. He returned to in developing the first written examinations for Anesthesia McGill in 68 to complete his anesthesia and also served as an oral examiner for several years. As training and his Masters in Experimental the Royal College mandated that all anesthesia training Medicine. He received his Royal College must be the responsibility of the University, Doug was Certificate in Anesthesia in 1970. John responsible for integrating all the training at the various Wade as the new Anesthesia Department hospitals within the one university program. Head at the University of Manitoba was Because of Doug’s progressive and well- organized successful in recruiting Doug to Manitoba training program which put residency education first, in 1971 to become the Program Director he was able to attract several residents from other of the Department. programs. Examples include Rick Palahniuk, Ed Pavlin, Dr. Douglas B. Craig on the When Doug took over the residency training and Alison Froese. These individuals went on to have occasion of his retirement from program he, with the backing of John Wade, made careers in Anesthesia which involved teaching, research the University of Manitoba Department of Anesthesia some dramatic changes to the program. First of all, they and administration as well as excellent clinical expertise. decided that every Wednesday morning the department Doug was also cognizant of the looming barrier of would hold academic rounds from 0745-0845. This the “oral” examination in Anesthesia. In the early 1970s included the whole department as well as residents. This pass rates were sometimes only 50% of the residents meant of course that the surgical slate on Wednesdays taking the examination! Doug decided that this wasn’t Dr. Doug Craig was delayed for one hour. The Department of Surgery going to be the case at Manitoba. He instituted the was instrumental was initially unhappy with this decision, but within a “practice oral” for all senior residents. It was a grueling few years both Surgery and Obstetrics and Gynecology process, but once you completed the “Doug Craig in creating were holding their rounds Wednesday morning too. finishing school” the real oral exams were a piece of and developing Secondly, Doug thought that the residents needed to cake. Manitoba was the envy of other programs and in spend time presenting topics to each other to augment fact several programs sent residents to Manitoba for our university their practical training in the OR. This was scheduled special training and oral exam practice. department. for Wednesday morning from 0900 to 1200 hours. This In addition to establishing an excellent residency allowed the residents time for learning in the daytime- education program at Manitoba, Doug also served on an unheard of proposition before then! Doug developed the Royal College Accreditation Survey Teams from a series of topics to be discussed over a two year time 1986-1990 to assess other programs across the country. period so that residents at both junior and senior levels continued on page 3 A Word from the Department Head and Medical Director A Tribute to Dr. Douglas B.Craig

continued from cover With the new academic year now in full swing, the Department Anesthesia, Health Sciences. It was important to create these new The four year specialty program was not Doug’s only interest. He Doug served on numerous committees with the is fully engaged in many important activities at the University. positions as the clinical scheduling has become increasingly complex initiated the one year program for anesthesia training for Family Medicine University and the Health Sciences Centre. He served as Of utmost importance is the upcoming accreditation of the Medical School at both the tertiary care sites, with increased integration of faculty residents. This program was first directed by Dr. Don Reimer and is still going Senior Vice-President, Medical of the Health Sciences by the Committee on Accreditation of Canadian Medical Schools (CACMS) within community sites. The Associate Heads will have, amongst other strong today. Centre from 1988-90. and the Liaison Committee on Medical Education (LCME, the American responsibilities, primary responsibility for scheduling activities and work Education on a national level was also important to Doug. He was Doug became the Head of the Department of accreditation body). Many constituents have been working hard to make closely with Trevor in assuring this. actively involved in the establishment of refresher courses at the Canadian Anesthesia for the University and the Health Sciences this happen, and Dr Christodoulou has been one of the cornerstones of the The Annual Resident Research Symposium was held at Bergmann’s Anesthesiologists’ Society (CAS) annual meetings. He served on the scientific Centre from 1990-2000. He shepherded the Department University’s efforts, and the Department is indeed grateful to him for this. It is on Lombard on November 9th. Our Visiting Professor and judge was affairs committee from 1980-88 and the research advisory committee from through the tumultuous times of the establishment of through these types of efforts (that many of you are increasingly engaged in) Dr. Alan Merry from New Zealand. He is an international luminary in 1987-92. He was one of the founding members of ACUDA and served the Winnipeg Regional Health Authority and all that that that at our profile as a “serious player” within the University continues to grow. the world of anesthesiology. I would like to thank all faculty, staff, and as the vice-president from 1991-92 and the President in 92-94. Doug’s entailed for the Department. While it was not an easy As part of the accreditation process, the medical students have students for attending this important function. Many residents, faculty contributions to the Society were officially recognized in 1993 when he time, Doug’s integrity, honesty and sense of fair play completed an extensive survey of their medical school experience. This and support staff worked hard on their research projects, and it meant was awarded the CAS gold medal for meritorious service. were always evident to the Department and the WRHA. has included an evaluation of all rotations, including the Anesthesiology a lot to them to have had a large audience supporting them. Within the CAS Doug also made another extremely important In 2001 Doug became a member of the Manitoba rotation. In general, the rotation has been well-received and relatively There are many other exciting opportunities and developments contribution. He became the Editor of the CAS journal from 1983-88. Doug Medical College Foundation and was president of the highly evaluated, but as with all of these, there are some opportunities in the Department that are beyond the space accorded to me in revamped the look and structure of the journal so that it became a much more Board from 2003-2009. During this time he still was for improvement. Our educational office is working with all concerned to this newsletter. If any faculty member is wanting to become more prominent journal in the world of anesthesia. He also was actively engaged actively involved in clinical anesthesia and participated address any weaknesses that were identified. involved with University of WRHA leadership/administrative/research/ with the International Anesthesia Research Society and was a member of the in many of the departmental activities. CACMS and LCME conducted a Mock Survey this past year. There educational activities, we would be delighted to assist you and create Board of Trustees from 1978 to 1996. He was the Chairman of this board from Doug Craig was a founding member of the were many deficiencies identified, but few were really surprises. Many of these opportunities. Please follow the ongoing events 1991-94 and a member of the editorial board for the Journal of Anesthesia University of Manitoba Department of Anesthesia the fixes have already been instituted and the School is confident that the by logging onto the Department webpage at and Analgesia from 1977-82. It was this latter experience that made him such and many of the established structures within the true accreditation in April 2011 will be successful. One of the important umanitoba.ca/faculties/medicine/anesthesia/. a great candidate to be the editor of the Canadian Journal. current department were initiated by Doug. The educational standards that had to be addressed in all Departments is an The APC updates While Doug was an excellent editor of the research submissions to the Department owes much to his insight, enthusiasm and improved student evaluation-feedback, as well as improved evaluation of are posted there and are a great source Journal, he had previously been involved actively in anesthesia research organizational skills. We will always be grateful for what Faculty by students (and residents). In this regard, we have been working of information. both at McGill and also with the Respiratory Section of Internal Medicine he has done for us and we wish him the best for the with the APMSS to electronically identify student-faculty interactions and Thank you all for your at Manitoba. His interest and publications ranged from airway closure in future when he returns to Montreal and also to McGill. require a student to complete the faculty evaluation prior to receiving many contributions. the lungs to patient follow-up after anesthesia and the establishment of We are sure they are thrilled to finally get him back! the rotation evaluation. This confidential evaluation of faculty’s teaching standards for anesthetic machines. He has 53 original articles to his credit efforts will enable the faculty to receive aggregate feedback every 6-12 plus several letters and book reviews. months (depending on the number of student-faculty interactions). Similarly, a faculty-wide initiative (led by the Dean’s office and Dr. Roberts Thiopental will still be on back order until mid 2011 from the Department of Internal Medicine) is underway to establish a Dr. Eric Jacobsohn Anesthesia Equipment and Drug/ by Hospira. Site Medical Directors have been given the uniform research productivity evaluation methodology. It is likely that will Department Head, be introduced faculty-wide within the few months. Similar charges have Medical Director Supply and Acquisitions Report pertinent details, as well as instructions regarding the been given to address clinical and administrative efforts, and in this regard by Dr. Trevor Lee ordering of etomidate via the Health Special Anesthesia Program Committee (APC) established a small working group Access program. Please contact me directly should you consisting of Dr. Laurence Brownell, Dr. Dean Bell and Dr. Amir Esmail to The WRHA Anesthesia Equipment and Drug Program has require more information regarding this process. work on this matter. Good progress is being made on this front as well. been engaged in the following initiatives this summer: The upcoming winter is sure to be a busy time for the Our University of Manitoba and WRHA Anesthesia administrative WRHA Anesthesia Equipment and Drug program. There structure has undergone significant change in the last several months. Acquisition and deployment of the Smith’s syringe pumps has been are a number of disposables and pharmaceutical contracts We are delighted that Dr. Trevor Lee has assumed the position of Associate 1 completed. Please provide me with feedback regarding the drug library. under review that will be in contract renewal soon. Please Head Clinical Operations, and Dr. Stephen Kowalski has assumed the ensure that your site representatives on the Anesthesia position of Associate Head Research and Academic Activities. I am confident Custom syringe labels: Please contact Bruce Anderson regarding ordering Logistics working group provide your feedback to the that both Stephen and Trevor will make important contributions in these 2 details for the syringe labels. Replacing the entire OR site inventory with committee. domains. I am also pleased to announce that Dr. Shawn Young has assumed the new labels seems to be the preferred method of implementation. Thank you very much for your continued involvement the position of Associate Head St. Boniface Hospital Anesthesia, and that and enthusiasm for the Equipment and Drug Program. Dr. Prakashen Govender has assumed the position of Associate Head of 3 Ongoing involvement in the many disposables contracts and initiatives.

A publication of the Department of Anesthesia & Perioperative Medicine winter 2010 issue page 3 Anesthesia Anesthesia Calls: A View Dr. Bob Friesen: Where are They Now? Annual Resident Research Symposium Calls: Hiking from the Other “UP” the hill In 1982, after completing my anesthesia One is constantly reminded of the prairies. Congratulations to all award nominees and award recipients. Side of the Hill residency at the U of Manitoba, I started Many of my colleagues at work, as well as some November 9, 2010 my career at St Boniface General Hospital. of our close friends, are former Winnipegers. During my time in Winnipeg, I was also the SBGH Priorities shift with the arrival of grandchildren. Waiel Al-Moustadi – PGY5 Completed Research St. Boniface Hospital, Department of Department of Anesthesia Chair for some 11 years. We now have four; making for frequent commutes There are few Specialists in Anesthesia has a policy of voluntary 2005 was an eventful year for me. After 23 to Brandon and Calgary. the region that struggle with Kristin McCrea – PGY4 Research in Progress call reduction based on age (half call years at SBGH, my wife Penny and I sensed that it While the observation that; “it rains a lot the frequency and acuity of call at 55 years, no call at 60 years). This was time for a change. The challenge was to find in ” may be true of the North Shore , that we do in Anesthesia. On any has become a contentious issue in a stimulating practice that provided a balance for my experience in White Rock has been just the Ian McIntyre – Ben Shell Research Award for Research Excellence in Anesthesia given night there are at least 17 the Region. There are the reasons family and leisure time. This we found in White opposite. There is much to do, all less than one Anesthesiologists on call in the I feel that this policy should continue Rock B.C. Peace Arch Hospital is a 160 bed acute hour from our home. My present passions include region. Depending on the number Steven Booth – Douglas B. Craig Resident of the Year and be allowed in other institutions. care community health facility located 40 minutes hiking, skiing, freshwater fishing and boating. of Anesthesiologists on staff, call The physical toll that call takes south of Vancouver. The hospital offers a wide With the more leisure time that this new frequency can become burdensome. becomes more evident with age, range of surgical services, from care for a very position affords, retirement plans, such as a firm Chinnipalayam Rajamohan – St. Boniface Anesthesia Teacher of the Year More recently, the acuity of call has especially with respect to recovery prominent geriatric population to a maternity service “drop the tools” date have faded. I very much enjoy nominees: Tamara Miller, Barry Bradley, Raymond Deutscher, Johann Strumpher increased dramatically, especially time. Call reductions potentially of approximately 800 deliveries per annum. There the practice of for sites that are part of an Acute allows senior anesthetists to reap are also opportunities to work in private practice anesthesia and Care Surgical Service (ACSS). Call Prakashen Govender – Health Sciences Centre Anesthesia Teacher of the Year a health benefit and may prolong surgical clinics. We have 8 anesthesiologists on staff. so, my health reduction policies based on age nominees: Tim Dickson, Ron Cappellani, Howard Intrater, Stephen Kowalski their careers. I have served as departmental chair since 2006. The permitting, would mean that much of this work Anesthesia is an egalitarian hospital fosters a sense of community, loyalty and am likely to would be carried out by the more specialty. Aside from those individuals excellence in patient care, not dissimilar to SBGH. continue. You Fahd Al-Gurashi – Community Anesthesia Teacher of the Year junior members of our departments who have limitations on the type I have long had an interest in OR function and will however nominees: Sanjay Aragola, Don Paetkau, Ryan Pauls (in a stage of their lives where they of call that they do, we all do the design. My present position and more predictable frequently find a are raising young families). This high same work. There are no benefits of work load have allowed me to continue to pursue “Gone Fishing” frequency, high acuity call scenario Leena Patel – Pediatric Anesthesia Teacher of the Year seniority. Call reduction becomes a this interest. sign up. not only challenges our busy family nominees: Karthik Sabapathi, Sreekrishna Raghavendran, Jo Swartz means of acknowledging those that lives but can lead to physician have come before. It also gives them burn out. something to look forward to. Tom Mutter – YK Poon Anesthesia Teacher for Excellence in Teaching The Anesthesia community is a by Dr. Craig Haberman For many senior anesthesiologists, Anesthesia Residency Program nominees: Patricia Mykytiuk, Sanjay Sareen, Trevor Lee large one, and has made remarkable who may be financially secure, the gains recently in improving the added call income is unnecessary. integration between sites. Sites are Congratulations to all PGY5 and PGY4 residents on their Jenifer Ballen “Vascular Surgery” – Best Academic Day Presentation Faced with a choice of continuing now less vulnerable to changes in presentations and posters at the Research Symposium. Special nominees: Tamara Miller “Intraoperative Crisis Management” call or retirement they may choose the surgical program (most notably thanks to all the resident research mentors. Thank you to Ian McIntyre Jim Enns “Valvular Heart Disease” the latter. This would deprive the when they drop an ACSS program for his enormous efforts as Chief Resident as he completed his term on Howard Intrater “Chronic Pain” departments of both manpower and on your doorstep). We are now in a December 31. Ryan Brinkman has agreed to continue his responsibilities as their most experienced individuals. position to better match individuals Co-Chief Resident while assuming the role of Chief Resident on January 1, In conclusion, an age based with sites based on preferred case 2011. The Education Committee Members feel it is in the best interest of call reduction can potentially benefit mix as well as the frequency and the Program that Ryan continue in both roles as the training program roles the individual involved and the acuity of call. Unfortunately, this will out and trials a new call system in January 2011. It is that time of year again when we also prepare for anesthesia community as a whole. not change the absolute number of the CaRMS. Faculty will shortly be receiving the request for volunteers to assist with the CaRMS interview people on call on a given night… Dr. Raymond Deutscher process. I would encourage you to get involved in having a part in the selection of our future residents! I that would require something Department of Anesthesia would like to welcome Mehdi Sefidgar to the residency program. Mehdi transferred into Anesthesia from much more dramatic. St. Boniface Hospital Physical Med Rehab joining the PGY2 Anesthesia resident cohort.

Dr. Shawn Young, Editor

A publication of the Department of Anesthesia & Perioperative Medicine winter 2010 issue page 5 A Warm Thanks to Winnipeg! by Dr. Doug Craig The Role for Night Float in Anesthesia

My children Shauna, Rob and Lea join me in expressing I want to repeat a point I made in my comments at Please let me know when you will be in Montreal. With the advent of pre and post call days related to our sincere thanks for the wonderful retirement event in the event. Winnipeg really was a great place to live, work, I am definitely not ‘up to speed’ yet on everything 16 hour call it is noticeable that we lose a significant September! We extend special thanks to the team of organizers who complete schooling and to play – for my whole family. essential here, but I am making progress! number of elective clinical slates. This has been noted did such a great job! John Wade’s invitation in 1969 for me to move there from I hope to hear from many of you – my email recently at the Royal College level. Most residents will do at least When I considered Eric Jacobsohn’s proposals for an event to Montreal led to a fulfilling career that I could not have address is: [email protected] 17 months of adult anesthesia in our PGY 2-5 years of residency. recognize my 40 years in Winnipeg, my decision was to limit it to imagined in advance and a wonderful family life. I thank Because we cover two sites with a relatively small number of something ‘small’ and ‘informal’. If I had defined ‘small’ in advance it all my colleagues in the Anesthesia Department and Picture 1: Dr. Lorraine Stanko, Dr. Craig, residents (24-26 per year) most people end up doing 7 calls per Dr. Judy Littleford would have been far short of the actual! I would never have imagined elsewhere in Winnipeg, as well as all our family friends month. While there is no doubt that on-call cases are important to Picture 2: Ian McIntyre, Chief Resident presenting that so many people from so many constituencies would want to be part who helped make the 40 years so positive. thinking on ones feet, elective cases, especially earlier in residency, Dr. Craig with crystal etching to recognize the Moving from Winnipeg to Montreal has been an of the celebration. I thank each of them! I really appreciated both the set establishment of the Douglas B. Craig Resident of are important for developing approaches to anesthetics as well. of ‘formal’ presentations and the many direct comments, both from those adventure! I now feel settled in my apartment and the Year Award for the Department of Anesthesia When a 2nd year resident does 7 call they have the potential to at the event and in written form. I have many good memories! have jumped through multiple bureaucratic hoops to Picture 3: Dr. Tom Mutter, Dr. Craig, Dr. Sanjay Sareen do only 8 elective slates in one month. With no pre call day they would likely be doing 12 elective The video presentation (thank you Lorraine!) was a total surprise get my Quebec health card, car registration, driver’s Picture 4: Leah, Nurse L & D and Dr. Craig slates (this takes into account the academic full day in PGY 2). This also creates serious challenges to me, although it became clear that my children had a hidden part in licence and a local parking permit. Each of these has Picture 5: Dr. Craig and Dr. Eric Jacobsohn to evaluating residents. It would be unrealistic to expect a junior resident to be able to manage a supplying some of the material! As you would expect, I found much of a ‘story’ that belongs elsewhere! Since September, Picture 6: Lea Craig Moore, Rob Craig, Shauna Craig ruptured AAA at 3 am when they haven’t had the opportunity to do one electively. the content a very touching reminder of my personal life, not only while in I have travelled to Nova Scotia and Saskatchewan Picture 7: Karen, Women’s PAC, Karen, Women’s RR, With these considerations we have elected to trial a night float system in the last 6 months of Winnipeg but earlier (the No Smoking photo was from Pietermaritzburg, to visit my family, including Tatum Christine Moore Leah, Nurse L & D and Dr. Lisa Avery this academic year. We will have one resident doing call for up to 7 days straight from 1900-0700. South Africa – I was 10 – and secretly smoking!). The photos of my time in who was born on We will have a resident covering from 1530-1900 most nights. On weekends the residents will do the Department, both recent and remote, will serve as ongoing reminders October 31st. shifts from 0700-1900. This is a format similar to schools in the U.S. It is possible that we will tweak for me of all the good years in Winnipeg. The video has been run this based on feedback from the residents over the next 6 months. This has the potential to gain 4-5 on the family computers in Wolfville NS, Saskatoon and Montreal – elective slates per month for residents. Over the the course of our residency this could equate to 2-3 leading to many questions from my grandchildren! extra months of anesthesia exposure. If you have any questions or feedback please let myself or Dr. Haberman know.

Ryan Brinkman, Chief Resident

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Congratulating Linda Boiteau on her graduation as an Opthamalmic Sedation Practitioner in Anesthesia at the Misericordia Health Centre.

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A publication of the Department of Anesthesia & Perioperative Medicine winter 2010 issue page 7 People in the Crowd

Congratulations to the graduating PGY5’s who Congratulations to Rick Singh on completion of his Congratulations to Prakashen Govender on Birth Announcements commenced fellowships in July, August and September: Cardiac Anesthesia Fellowship. Rick has commenced his his appointment as Associate Site Manager, HSC Adult Aaron MacInnes , Pain; Marshall Tenenbein, practice at St. Boniface Hospital. Anesthesia and to Shawn Young on his appointment Jenifer Ballen and her husband Marshall Pitz Simulation; Harleena Gulati, Thoracic Fellowship as Associate Site Manager, St. Boniface Hospital. on the arrival of their first child, Alexa Elyn born on in New York; Dean Swedlo, Critical Care Fellowship Congratulations and best wishes to Brian Kuo on July 26. in Calgary; Kelvin Williamson, Trauma Fellowship his Faculty of Medicine appointment as Coordinator, Effective November 15, 2010 Patricia Mykytiuk Brian Kuo in Washington. Continuing Professional Development Program for assumed the position of Fellowship Director for Pain. Sherry Gard and her husband Jason welcomed Family-Practice Anesthesia. Thank you to Ian Sutton for his years of service to their 4th son Graham Robert on June 21. Congratulations to Judy Littleford on completion In this role, Brian will work with the Office of the Fellowship. of her Palliative Medicine Fellowship in Ottawa. Judy has Continuing Medical Education, the Family-Physician Waiel Al-Moustadi and his wife Saleha who returned to Winnipeg and has accepted the position of Anesthesia Program and the Department of Anesthesia Chris Christodoulou has been appointed by the welcomed a son, Ahmed on August 19. Course Coordinator, Information Literacy and Biomedical of the Faculty of Medicine, University of Manitoba Dean of Medicine as the Director of UGME Curriculum Informatics for the Faculty of Medicine. and the Office of Rural and Northern Health to Development for the Faculty of Medicine. Steven Booth and his wife Jeri welcomed their collaboratively develop a Continuing Professional first child a son, Kalen born on July 2, 2010. Mark Acala Thanks to Frank Ewert for his 5 years service as Development Program for FP/GP-Anesthesia. The Welcome to Alex Pandian and his wife Sowmya Chair of Anesthesia Standards Committee; welcome proposed program would serve to provide for the Narasimhan on their recent move to Winnipeg from Ian McIntyre and his wife Nina welcomed their Every so often it is to Jim Enns as the incoming Chair of Anesthesia ongoing CPD needs of the FP/GPA community through England. Alex will be practicing at Health Sciences second child a daughter, Isla on November 18, 2010. nice to stop and recognize Standards Committee. individual physician-requested programs and working Centre and Sowmya has accepted a faculty position in the professional and with the FP/GPA community, rural RHAs and CPSM to Endocrinology. Ainsley Espenell and her husband Norm personal achievements Welcome to Stephen Kowalski as Associate Head, assess the CPD needs, and develop formal programs. welcomed their third child and second son, Rylen on in our Department. Research and Academic Affairs and Trevor Lee as Welcome to Mark Acala who will be working on December 6, 2010. Here are just a few... Associate Head, Clinical Affairs. Alan Mutch has stepped down as Vice-Chair, data entry for Pediatric Anesthesia. Research and Academic Affairs. Many thanks to Al for Sean Jardine and his wife Caroline welcomed a Kim Armitt Congratulations to Rob Brown on being offered his remarkable service in establishing the Department Welcome to Kim Armitt who joins Anesthesia as daughter, Indianna Lilly on November 4, 2010. (and accepting) the position of Honorary Senior Stick of of Anesthesia Research Office and for spearheading the Executive Assistant to Reid McMurchy, Bruce Anderson, the MMSA for the 2010-2011 academic year. enterprise in so many ways. and Laura-Lee Bouchard. If you have information that you wish to The Honorary Senior Stick of the MMSA is a share with members of the department and faculty member of the University of Manitoba elected by Best wishes to Gerry Lefevre on his retirement from Welcome to Pravitta Osman who joined the Pain alumni, please forward to Laura-Lee Bouchard the MMSA Executive. The Honorary Senior Stick provides practice at St. Boniface Hospital and the WRHA. Clinic, HSC as a secretary in May 2010. at [email protected] guidance, support and an appreciation of the broader contexts within healthcare and education. Best wishes to Archie Benoit has he steps down as Welcome to Wayne Nates as he commences a one Medical Director of Pre-Hab Medicine. year followship in Cardiac Anesthesia. Gerry Lefevre

News from Pain The Canadian STOP-PAIN project – Part 1: Who are the patients The Canadian STOP-PAIN project – Part 2: What is the cost of Every issue, we will be listing all upcoming Management on the waitlists of multidisciplinary pain treatment facilities? pain for patients on waitlists of multidisciplinary pain treatment facilities? publications and lectures involving our staff. Manon Choinie`re, PhD; Dominique Dion, MD; Philip Peng, MBBS; Robert Denise N. Guerriere, PhD; Manon Choinie`re, PhD; Dominique Dion, MD; If you would like to submit your publications by Dr. Howard Intrater, Medical Manager, Pain Clinic, HSC Banner, MD; Pamela M. Barton, MD; Aline Boulanger, MD; Alexander J. Clark, Philip Peng, MBBS; Emma Stafford-Coyte, BSc; Brandon Zagorski, PhD; or let your fellow members of the Department MD; Allan S. Gordon, MD; Denise N. Guerriere, PhD; Marie-Claude Guertin, Robert Banner, MD; Pamela M. Barton, MD; Aline Boulanger, MD; Alexander know when you have been invited to lecture The National Opioid Use Guideline PhD; Howard M. Intrater, MD; Sandra M. Lefort, PhD; Mary E. Lynch, MD; J. Clark, MD; Allan S. Gordon, MD; Marie-Claude Guertin, PhD; Howard M. please email us at [email protected] so Group (NOUGG) is developing Dwight E. Moulin, MD; May Ong-Lam, MD; Me´lanie Racine, PhD(c); Saifee Intrater, MD; Sandra M. Lefort, PhD; Mary E. Lynch, MD; Dwight E. Moulin, we can print it in a future issue of Gasline. implementation strategies for the Rashiq, MB; Yoram Shir, MD; Paul Taenzer, PhD; Mark Ware, MBBS MD; May Ong-Lam, MD; Me´lanie Racine, PhD(c); Saifee Rashiq, MB; Yoram national guideline for the safe and Shir, MD; Paul Taenzer, PhD; Mark Ware, MBBS Can J Anesth/J Can Anesth (2010) 57:539–548 effective use of opioid analgesics. DOI 10.1007/s12630-010-9305-5 Can J Anesth/J Can Anesth (2010) 57:549–558 These two articles were published in DOI 10.1007/s12630-010-9306-4 CJA in the June 2010 edition:

A publication of the Department of Anesthesia & Perioperative Medicine winter 2010 issue page 9 Photobook: Manitobans at CAS – June 2010 Remembering Those We’ve Lost by Diane Biehl

The inaugural alumni function was held at CAS on Saturday, June 26 at the Maureen Cumming R.N. B.Sc.1944-2010 Fairmont Hotel in Montreal. This event will continue to be held annually at CAS. We encourage all current faculty, residents, staff and all alumni to attend. Further Maureen Cumming passed away suddenly on August 20, After the closure of the sheep laboratory in 1984, Maureen information regarding the 2011 alumni function will be announced shortly. 2010 at the Victoria Hospital in Winnipeg. She had retired transferred to the Health Sciences Hospital Department of Anesthesia from the Department of Anesthesia at HSC in 2007. but continued to be involved in many of the outcome studies. She Maureen was born and raised participated in studies in both HSC and St. Boniface Hospital and in Morden, Manitoba and graduated assisted many anesthesiologists and residents in their research projects. from the Winnipeg General Hospital Maureen always came to the early morning obstetrical anesthesia rounds School of Nursing in 1965. She held at the Women’s Centre and was a faithful attendee at weekly talk worked in the operating room of the rounds and kept the minutes of these sessions. She also participated WGH after graduating and rose to in the WRHA audit process for the all the Anesthesia Departments in become head nurse in the Section of Winnipeg when this was first established in 2002. Vascular Surgery. Following this she Besides her research work, Maureen was noted for her culinary transferred to the Recovery Room skills. She organized parties at Christmas and was famous for her and nursed there for approximately appetizers and other dishes at the Department parties and events. three years. During her time working She also had a catering business for her friends and their families. 2 at WGH she also obtained her She loved to cook and her collection of cook books would rival many Bachelor of Science degree. famous chefs. In 1975 she came to work in the Department of Anesthesia with In 2006, Maureen underwent a total knee replacement because 1 Dr. John Wade and Dr. Richard Palahniuk in the animal laboratory in of severe arthritis as a result of a car accident which occurred in 1965 3 the Medical College. Maureen was the scrub nurse for the operations shortly after she graduated from nursing. This accident, in which she on the pregnant ewe which was the animal model for experiments was the sole survivor and lost three of her friends, occurred when in obstetrical anesthesia. In addition to running the “OR” Maureen they were traveling in England. The accident was a defining and tragic helped with the various experiments and the analysis of data. Besides occurrence in Maureen’s life. The aftermath plagued her for years and 6 Drs. Wade and Palahniuk, she worked with Drs. Arnold Tweed, Bill Ong likely was indirectly responsible for her untimely death. and George Gregory plus many anesthesia residents and obstetrical Maureen touched many lives during her career in the Department research fellows on many studies. As John Wade said “Maureen was of Anesthesia at the university and at HSC. We remember her the glue that held the lab together”. Residents and fellows from out of enthusiasm, her dedication and her kindness to patients, co-workers town were always welcomed to the lab by Maureen who was always and friends. Along with her brother, Bob, his wife Susan and Maureen’s ready to help newcomers settle in to Winnipeg. She often had them two nieces, we will miss her greatly. over to her apartment and was always available to help people adjust to living in a new city. In between “sheep seasons”, Maureen helped with other research

5 projects and soon became the follow-up nurse for tracking patient outcomes in the OR. The Department of Anesthesia at the now HSC Maureen was the glue that institution began using computerized OR records and Maureen was held the lab together... she the research nurse who visited patients and reported back to the Picture 1: Laura-Lee Bouchard and Dr. Jamit Dhaliwal, PGY5 Picture 2: Dr. Ayoub Dangor, Dr. Jean Wong, Brenda Lougheed, Department and individual anesthesiologists about patient problems was always ready to help Dr. Stephen Kowalski and complications. These early studies eventually resulted in multi- newcomers settle in to Picture 3: Dr. Harleena Gulati and her husband Dr. Kenny Kumar centered tracking of OR complications in other hospitals besides Picture 4: Jon Mutch, Dr. Alan Mutch, Dr. Greg Klar, PGY3 HSC. In another study on operations during pregnancy, Maureen Winnipeg... and was always 4 Picture 5: Mrs. Barb Mutch, Dr. Jim Beckstead, Mrs. Barbara Duke and Moyra Perry travelled to communities throughout the province available to help people Picture 6: Dr. Trevor Lee and Dr. Eric Jacobsohn to look at newborn records in community hospitals to correlate data obtained from the Manitoba Health Services computer. This large study adjust to living in a new city demonstrated that emergency anesthetics during pregnancy had no specific effects on newborns at birth.

A publication of the Department of Anesthesia & Perioperative Medicine winter 2010 issue page 11 Upcoming events in 2011

January 28 and 29: Anesthesia CaRMS interviews held in the Anesthesia The Back Page Article Administrative Offices in Harry Medovy House

January 28: Faculty and Residents welcome to the CaRMS Applicants. Faculty and Residents Malignant Hyperthermia and Cholinesterase requiring further information should contact Deficiency Registries of Manitoba Cindy Marykuca at [email protected] February 8: Journal Club presented The Malignant Hyperthermia and Serum by Greg Klar and Riley Senft; staff mentor: Dr. Heather McDonald. Room AE226, Cholinesterase Registries are administered by Anesthesia Boardroom, Harry Medovy House, the Section of Pediatric Anesthesia. The Registries 4:30 p.m. Please RSVP to Cindy Marykuca at were established to keep a record of patients and family [email protected] members at risk of MH and cholinesterase deficiency. February 23: Visiting Professor – Dr. Jean Over the years the Registries have become an important Wong, Assistant Professor, Department of source of information for physicians and patients. Anesthesia, Toronto Western Hospital. Dr. Douglas Craig started the Serum Cholinesterase Registry in the early 1970s; Dr. Suzanne Ullyot is the March 7: CaRMS Match Day. current Medical Director. There are 4500 records in this March 31 – April 3: International database. Of these, 235 patients have no normal gene, Course on Pain Management (ICPM 2011). ie, they are AA, SS, AS, or a more rare variant. 1123 www.icpm.net/ patients are heterozygous with one normal gene and one abnormal one. April 7 and 8: Royal College Written Examinations, Winnipeg, Manitoba Dr. Peter Duncan started the MH Registry in 1982. It currently contains 1500 records. Of these, 185 are index cases which initiated an investigation, and April 12: Journal Club presented by the rest are family members. 385 biopsy results are on file, about half of which are Christine Pickering and David Hold; staff positive. Dr. Leena Patel is the current Medical Director. In addition to managing the mentor: Dr. Chris Christodoulou. Room AE226, Anesthesia Boardroom, Harry Medovy House, MH Program, she runs a consultation clinic once a month where patients and families 4:30 p.m. Please RSVP to Cindy Marykuca at of suspected cases are investigated and counseled. [email protected] Joanne McGorman in the pediatric anesthesia office is the Administrator for both Registries. She receives approximately 30-40 calls a month from Anesthesiologists, April 30 – May 4: 33rd Annual Society of Pre-Admit Clinic Nurses, Physicians, Surgeons, Dentists and patients or family members. Cardiovascular Anesthesiologists Meeting, Savannah, Georgia. www.scahq.org/sca3/ Most questions from physicians and nurses pertain to whether a patient is in either events/2011/annual/ registry and if they are susceptible. Patients and families call to obtain information on MH or cholinesterase deficiency and how they can be tested. May 21 – 24: IARS Annual Meeting, Both Registries currently exist largely in paper form occupying two banks Vancouver . www.iars.org/ congress/ of filing cabinets in Dr. Reimer’s office. Steps are under way to modernize the registries with the intent June 15 – 18: Royal College Oral that any anesthesiologist within the Region will Examinations, Ottawa, be able to access the databases from a hospital June 22: In-House Oral Examinations computer terminal. A basic computerized database (PGY1 to PGY4) already exists, but at present is only accessible to anesthesiologists at Children’s hospital. June 24 – 28: CAS Annual Meeting, Toronto, As part of the upgrade process, new medical directors Ontario. www.cas.ca/English/Upcoming will be needed soon to transition into these roles. June 25: U of M Anesthesia Alumni Interested anesthesiologists should contact Reception, Toronto, Ontario. Further Joanne or Dr. Reimer at 787- 2560. information will be circulated.

Submitted by, Joanne McGorman Edititor-in-Chief: Shawn Young Administrative Assistant, Pediatric Anesthesia Co-Editor: Mr. Bruce Anderson

published quarterly and posted on our University website at www.umanitoba.ca/faculties/medicine/anesthesia/ Suggestions, comments and story ideas are always welcome. Please forward them to Laura-Lee Bouchard at [email protected]