Media Reviews

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Staying Human during Residency Training: How to Survive and Thrive after Medical School, Seventh Edition Paperback – May 11, 2024 by Allan D. Peterkin MD (Author), Derek Puddester MD (Author)

“Staying Human during Residency Training is an important reminder: that humane treatment – of oneself and fellow residents, as well as our patients – is what makes a good doctor, and that one cannot have empathy without good self-caretaking. That is a lesson we can all afford to review.” ―Sonya Rasminsky, CIR News “Peterkin has created a wonderful reference for all of us.” ―Benjamin Lemelman, MD, New Physician “This guide should be required reading for each intern beginning residency and also for each and every residency program director in North America.” ―Aliye Runyan, Medical Education Team Chair, American Medical Student Association, and Sonia Lazreg, AMSA/Committee of Interns and Residents Health Justice Fellow “An excellent resource for residents at any stage in their training.” ―The Canadian Association of Internes and Residents Editorial Reviews “This catalog of indispensable advice can help residents at all stages of training. Read it today, and pass it on!” ―Wayne M. Sotile, PhD, author of ‘Letting Go of What’s Holding You Back!’ and ‘The Resilient Physician’ “Chock-full of all kinds of information that is pertinent, if not essential, to residents, including innumerable survival tips and suggestions. Dr Peterkin offers a penetrating and far-ranging, yet humane, perspective and has not lost sight of the “person within”, in contrast to attitudes common in academic medical centres of today. This book will go a long way toward alleviating much of the worry and demoralization among contemporary residents, as well as their partners or spouses. A copy should be stuffed into the pocket of every resident physician.” ―Michael Myers, MD, author of ‘Doctors’ Marriages: A Look at Problems and Their Solutions’ and co-author, ‘The Handbook of Physician Health (AMA)’ “Addressing all the various facets of residency life, both in depth and also at a very practical level, Peterkin and Puddester present a practical guide for those about to enter or who are currently in residency. Up-to-date and relevant, this new edition covers the impact that COVID-19 may have on residency life and discusses responsible social media usage. A very solid and enjoyable book, I wish I had known about it when I entered residency!” ―Patrick W. Arthur, Clinical Psychiatrist, NYU Langone Psychiatry Associates “This is a very comprehensive overview of the many facets of life in residency. Resources are presented in a thorough, systematic way. Offering broader scope commentary on the medical system from their years of experience, Peterkin and Puddester are engaging and effective in presenting all aspects of resident life.” ―Dorothy Yu, Staff Psychiatrist, University of Calgary

Staying Human During Residency Ten Tips for Resilience with Dr. Peterkin
AMSA National

Caring for LGBTQ2S People: A Clinical Guide, Second Edition Paperback – May 31, 2022 by Allan D. Peterkin Cathy Risdon Amy Bourns (Editor), Edward Kucharski (Editor)

PRAISE FOR THE FIRST EDITION “With this clinical guide, psychiatrist Allan Peterkin and family physician Cathy Risdon have made an outstanding contribution to the global literature on gay and lesbian health. Anchored solidly in scientific literature and well supported by references, the text is remarkably practical.” ―CMAJ “The book is a welcome contribution in a field with few resources, especially for the practitioner who wants to provide the best possible care for the lesbian or gay patient.” ―JAMA SECOND EDITION This book, written by top Canadian academics and clinicians practising in LGBTQ health, is a must-read for healthcare professionals. In addition, it highlights Canadian scholarship in this area.” ―Gail Knudson, Clinical Professor, Faculty of Medicine, University of British Columbia   Amy Bourns and Edward Kucharski, community and academic leaders in health care, have marshalled a collection of treatises on caring for LGBTQ2S people. Professors, trainees, the general public, family members, and LGBTQ2S persons will find practical advice, clarification of terminology, and exhaustive discussion of the many biological catalysts and social conditions which cause ill health or impede recovery in the LGBTQ2S community. This encyclopedic volume is a keeper.” ―Philip B. Berger, OC OOnt MD, Longtime AIDS Physician, and Associate Professor, Temerty Faculty of Medicine, University of Toronto Interview with Dr. Allan Peterkin Host Jillian Horton, MD, FRCPC speaks with Allan Peterkin, MD, FRCPC about his lived experience as a gay physician and work with the LGBTQ2S community as well as his perspective on the evolution of physician health and finding happiness as healers.

Health Humanities in Postgraduate Medical Education Illustrated Edition by Allan D. Peterkin (Author), Anna Skorzewska (Author)  Format: Kindle Edition

Review of Allan D. Peterkin and Anna Skorzewska, eds.,  Health Humanities in Postgraduate Medical Education: A Handbook to the Heart of Medicine  New York: Oxford University Press, 2018 The backbone of this innovative and informative collection is comprised of eleven essays that address the spectrum of the arts and humanities and how they relate to postgraduate medical education. Most of the authors and their experiences are grounded in Canadian medical schools, but the literature they draw from is international and the lessons learned are almost universal. Two main intellectual strands underpin the collection: first, that the arts and humanities have made inroads within many undergraduate medical curricula, yet their presence at the postgraduate level is minuscule; and second, that the arts and humanities should assist doctors in becoming better on-the-ground clinicians. The editors maintain that “the health humanities incorporate ways of thinking to complement content-based knowledge and practice-based skills.” They can develop critical thinking, foster narrative competence, and enhance the “ability to see—both literally and metaphorically—and to reflect—to step back and learn from past experience so that it can be applied in the here and now.” (10) Chapters generally follow a template, with each providing a literature review, “theoretical arguments” to help convince academic administrators to make curricular space, sample lesson plans, and lists of resources for further reading. In almost all respects, Health Humanities in Postgraduate Medical Education is truly a useful handbook for instructors. Contributions reflect the breadth and range of the humanities and address topics related to textual analysis, visual imagery, and areas that span both these approaches such as theater and performance. In the first group, narrative medicine and medical history (in particular, the history of psychiatry) are addressed. In the second, cinema and film and their ability to explore subtle aspects of the clinical gaze are explored, as well as the use of the visual arts to sharpen clinicians’ ability to see better, observe more, and interpret in more robust and comprehensive ways. In the final group of chapters, theater is used not only as means to see the world as reflected in spectacle and performance, but also as a “vehicle to engage with complex stories, ethical dilemmas, ambiguity, and themes which are woven into the fabric of medical practice.” (169) Similarly, human interactions, relationships, and working as a team or ensemble cast are key to interprofessional collaborative practice, all of which can be grounded in pertinent aspects of the arts and humanities. There is also a grouping of other chapters, some of which might be expected for a book of this sort, while others are more innovative. Perhaps not surprisingly there is a chapter on bioethics in which autonomy, social justice, beneficence, and non-maleficence are addressed, but the chapter also contextualizes postgraduate medical education across the four specialties of family medicine, psychiatry, surgery, and pediatrics. The use of numerous text boxes to summarize chapter sections will be helpful to those unfamiliar with teaching bioethics, but this practice tends to be reductionist as a pedagogic technique. While chapter authors recognize the almost universal presence of ethics teaching in the undergraduate curriculum, they assert it remains “haphazard and underevaluated” (104) in postgraduate programs. More unexpected is the chapter on teaching the social sciences in medical residency. On the one hand, purist humanities scholars might find it jarring to include this sister group of diverse disciplines, but on the other hand, it is consistent with the mindset that any field that is not embraced within the clinical or biosciences is lumped together as the humanities. Based on their extensive postgraduate teaching experience at the University of Toronto, the chapter authors make the case for the value of residents grasping the tenets of the social sciences as an underpinning for a more sophisticated understanding of advocacy, professionalism, and cultural knowledge. Two chapters in this last group stood out as particularly helpful for a practical teaching guide and handbook because the focus topics are often overlooked in discussions for the inclusion of health humanities in the medical curriculum. In her chapter “Difficult Conversations: Evaluating the Medical Humanities,” Martina Kelly highlights the tension typically present between so-called “hard sciences” and “soft skills,” between measuring outcomes that are believed to be quantifiable and objective and those that are more subjective, subtle, and personal. In Kelly’s view a definitive resolution of this tension is probably not achievable, but neither should it be; there probably is no right answer in this debate. Some readers might find the futility of that conclusion frustrating, yet to truly understand how the humanities work is to grasp that the destination is less important than the journey to reach it. In another essay, the late Robert Pierre Tomas outlines potential funding avenues and marketing skills that might be deployed to get a humanities program off the ground and maintain it. Both these chapters are realistic reminders that in some medical settings the humanities can be a hard sell. As postgraduate medical education continues to change, perhaps an opportunity exists to introduce more arts and humanities into the curriculum. And, further, in a post-COVID-19 world where social distancing will probably become routine and small group learning the norm, the longstanding and effective humanities seminar mode of teaching might be able to make real inroads into the medical curriculum. Health Humanities in Postgraduate Medical Education: A Handbook to the Heart of Medicine is a seminal, encouraging, and forward-thinking guide for medical educators. J.T.H. Connor St. John’s, Newfoundland, Canada Source: https://hekint.org/2020/06/01/review-of-health-humanities-in-postgraduate-medical-education-a-handbook-to-the-heart-of-medicine/

Body & Soul: Narratives of Healing from Ars Medica Paperback – November 26, 2011 by Allison Crawford (Editor), Rex Kay (Editor), Allan Peterkin (Editor), Robin Roger (Editor), Ronald Ruskin (Editor), Aaron Orkin (Editor)

The truth lies between the lines Jack Coulehan Source: https://www.cmaj.ca/content/185/4/327 CMAJ March 05, 2013 185 (4) 327; DOI: https://doi.org/10.1503/cmaj.120382 Body & Soul: Narratives of Healing from Ars Medica. Allison Crawford, Rex Kay, Allan Peterkin, Robin Roger, Ronald Ruskin, editors, with Aaron Orkin. University of Toronto Press; 2011 In the poem “Paterson,” William Carlos Williams voices a neighbour’s reaction when he reveals that he is a poet, as well as a physician: “It must be a great/thing to have such a pastime./But you were always a strange/boy. How’s your mother?”1 To many people, the combination of medicine and poetry does seem strange, because people tend to believe that science and technology have replaced the art in medicine. After all, if the body is a machine, and the doctor a technician whose job is to fix malfunctioning parts, where does art come in? What role can poetry possibly play? Yet something is missing. As traditional components of the healer’s art, like empathy and trust, ritual and narrative, drift farther and farther away from technological practice, all is not well. Patient satisfaction declines, anxiety increases, symptoms multiply and medical costs skyrocket. Physicians feel unfulfilled and experience burnout. Patients feel alienated from, but also addicted to, the treadmill of tests and treatments. No wonder Allan Peterkin and Robin Roger in their introduction to Body & Soul pose the question, “What can patients and health practitioners do to address the growing divide between science and humanism?” This is a crucial issue in medicine today. In North America, educators and practitioners have begun to address it by developing medical curricula in self-awareness, mindfulness, reflective practice and, especially, narrative medicine. Peterkin and Roger point to the ancient art of storytelling as the key to rehumanizing health care. Several years ago, with this premise in mind, these editors created Ars Medica, a literary magazine dedicated to “adding a narrative dimension to portrayals of the universal experience of illness, treatment, and healing.” Body & Soul is an anthology of poetry, prose and visual art drawn from its first five years of publication. The collection is divided into three sections, featuring narratives of patients, family and friends, and health care practitioners. It also includes a useful index that allows readers to select stories and poems by topic, like children and parenting, or chronic illness and aging. Remarkably, for an anthology based on a fairly small body of work, Body & Soul contains excellent, highly illustrative, pieces in each section and for every topic. Perhaps “I, Michael” is the story that best illuminates the complex interaction of real and imagined worlds in a patient’s confrontation with illness. It carries the reader into the mind of a young man suffering from amyotrophic lateral sclerosis (ALS), where he identifies with Michelangelo, who could visualize a fully formed statue inside a block of marble even before he began to liberate it with his mallet and chisel. This metaphor sustains Michael, as ALS reverses the process, gradually turning his body into stone. At the same time, Michael falls in love with Sheila, his nurse, and creates an alternate world in which someday they visit the Sistine Chapel as man and wife. “The Cure of Metaphor” is another piece that gives expression to the power of metaphor in patient narratives. A patient awakes to discover that his vision has become blurry. An ophthalmologist tells him that the cause is “venous occlusion,” a blockage of the retinal veins. But the patient, “not being from the scientific side of things,” imagines “venous” to be Venus, goddess of love, and concludes that his “images were fading/Because they’d not been loved enough.” A clinician narrative, “The Texture of a Word,” demonstrates the explosive potential of a single word. A neurosurgical resident tells a patient his diagnosis, glioblastoma, a death sentence. The patient responds with devastating silence. Eventually, he murmurs, “Thank you, doctor … for everything.” This powerful moment is reminiscent of the final line of Raymond Carver’s poem, “What the Doctor Said,” in which, after being told of multiple metastatic lesions in his lung, the poet writes, “I may even have thanked him habit being so strong.”2 “Accident Room,” a thoroughly engaging story by Jay Baruch, weaves many strands of narrative into a seemingly routine emergency department encounter. Brick may, or may not, have fallen from his chair and later “mentioned” back pain. Brick, his wife, Old Doc Owens, young Doctor Diggs — each one tells a different story, but, ultimately, the truth lies in listening between their lines. Similarly, for the attentive reader, Body & Soul captures the complexity and impact of the illness experience, as illuminated through multiple narratives and images. References 1. Williams WC. Paterson. New York (NY): New Directions; 1958. p. 114. Google Scholar 2. Carver R. What the doctor said. In: A new path to the waterfall. New York (NY): Atlantic Monthly Press; 1989. p. 113. Google Scholar

Still Here: A Post-Cocktail AIDS Anthology (New Writers Series) Paperback – December 27, 2012 by Allan Peterkin (Author), Julie Hann (Author)

Understanding through therapeutic writing Lara Hazelton Source: https://www.cmaj.ca/content/179/5/453 CMAJ August 26, 2008 179 (5) 453; DOI: https://doi.org/10.1503/cmaj.081030 © 2008 Canadian Medical Association Still Here: A Post-Cocktail AIDS Anthology  Collected and edited by Allan Peterkin and Julie Hann; Life Rattle Press; 2008; 327 pp $25.00 ISBN 978-1-897161-55-5 “Psychologically, I see my personal facts the way they are, not as how I would like to see them. Admitting the truth has become a little easier.” — From the book under review. When we experience change, uncertainty or loss, the most useful response, although not always the most natural, is to try to make sense of what is happening. To do this, some turn to psychotherapy. Others write. At the Clinic for HIV-Related Concerns at Mount Sinai Hospital in Toronto, Ontario, people living with HIV may choose to do both at once. Still Here: A Post-Cocktail AIDS Anthology is a collection that arose out of the Therapeutic Writing Group facilitated by psychiatrist Allan Peterkin and occupational therapist Julie Hann. The essays, collected over 8 years, reflect the experiences of people living with HIV since the advent of the antiretroviral medication “cocktails” that have prolonged the lives of many patients. In the group, participants are encouraged to create a “competent” narrative that is comprehensible to other members when the work is read aloud. The pieces are meant to incorporate feelings as well as facts, and the authors’ own insights are an important part of the finished essay. The potential value of this approach can be appreciated from participant feedback. One commented that he “had to make something rational, organized, confront things without rambling.” Many of the benefits identified by participants would be difficult to provide using other therapeutic modalities. For example, one person reported he was “less likely to forget my stories versus forgetting what I said in therapy the week before.” Another valued the “possibility to reread then reanalyze my old thoughts.” “Now able to share my stories with my family so they can understand me better,” was another comment. The essays in the anthology are grouped under 5 themes: change, hope, severance, treatment and loss. There are often strong emotions expressed, including grief, anger and fear, although some have a lighter and even humourous touch. The writers are articulate in describing their experiences, and it is obvious that time and thought has gone into polishing the works before publication. In a brief appendix at the end of the anthology, the editors explain the process for forming an expressive writing group. Before setting up the group, Peterkin and Haan consulted with Guy Allen PhD, a professor of writing at the University of Toronto. They also reviewed the literature on narrative and therapeutic writing, including the writings of James Pennebaker and Michael White. The anthology features instructions on how to start and run a group, ranging from pointers on selecting patients to how to improve the quality of the compositions themselves. Not only is this an interesting topic, the notion of setting up an expressive writing group may be attractive to many health care professionals. While the authors do provide a list of references, it still might have been worthwhile to expand this section. As a psychiatrist who does not have any HIV-positive patients at the present time, I was engaged and challenged by this book. Reading it caused me to reflect on the experiences that are unique to patients with AIDS as well as those that are common to other medical and psychiatric illnesses. This anthology would be of particular interest to patients, family members and those who work with people with AIDS, and could be useful for teaching medical students or other learners. Ultimately, it is the authors of these stories who will find the greatest value in them, and in the process of their creation. As one writer says, “I believe in the strength, wisdom and effect of my stories. Ergo, I believe in myself.”

News from Rady Faculty of Health Sciences UM Today Network

Source: https://news.umanitoba.ca/stories-can-humanize-us/ ‘Stories can humanize us’ March 20, 2019 — When it came time to choose a career path, Dr. Allan Peterkin struggled with his decision. Should he choose medicine? Or become a writer? His father was a physician so he was fairly certain what his dad would say, but he was dead wrong. “He told me, ‘I don’t think you should be a doctor. I think you should be a poet.’” His father knew that writing was close to Peterkin’s heart – Peterkin had studied English and French literature while earning his BA at the U of M – and that he’d be miserable without it. But, as it turns out, a medical career doesn’t preclude a vibrant life as a writer. “I always think of reading and writing as the centre of my wheel and that the spokes were the various parts of medicine,” said Peterkin, who graduated with his MD and B.Sc. (Med.) in 1985 from the University of Manitoba and went on to complete residencies in family medicine and psychiatry at McGill University. “Whatever creative spark you have, think of it in a way that informs your work as a healer.” On March 12 and 13, Peterkin, professor of psychiatry and family medicine at the University of Toronto and a senior fellow at Massey College, visited the Rady Faculty of Health Sciences to offer workshops sponsored by the Alan Klass Medical Humanities Program, Department of Internal Medicine and Office of Educational and Faculty Development. Participants from all five colleges took part in lectures and hands-on writing to gain deeper insight into the intersections between the humanities and the sciences. For Peterkin, founding editor of the literary journal ARS MEDICA who has published widely on physician well-being, narrative medicine and the importance of humanities in medical education, the connection is clear. “In the work we do as clinicians and educators, there is a teller and a listener. The plot may be an illness or a disease. There is a reason the story is being told. And there may be a denouement or a resolution.” Combined, Peterkin says all these elements become a narrative – the patient and the physician are making meaning of the situation together. The better the communication, the greater the opportunity for successful care. He points out that word choice plays a vital role in our conversations with patients, too. “So often today, we talk about conquering your illness,” he said. “Cancer is a battle, a war. You have to be courageous. You have to win, to beat it.” A lot of the language comes from military culture, says Peterkin. “But the implication is that you’re going to get better – that there is something you can do, that you have control of the situation.” Unfortunately, not all diseases can be cured. “And that puts a lot of pressure on patients,” he said. Whether health-care professionals decide to pursue their own writing or not, Peterkin recommends that at the very least they should strive to become regular readers. “Why would I bother reading fine fiction,” asks Peterkin. “What does that have to do with anything?” It’s a question he’s asked a lot by busy professionals already overloaded with the business of providing care. The answer is simple, he says. “Stories can humanize us and get us to think about situations different from our own,” said Peterkin. “You’re stretching your world view – there’s evidence that shows reading literature can actually influence and increase levels of empathy, a vital skill for all of us.” ANNETTE ELVERS alumni, max rady college of medicine, rady faculty of health sciences

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