Caregiving Compassion Coping with Loss Emotions Empathy Friendship Happiness Love Purpose Relationships Wisdom

Celebrate Your Best Friends!

Great friends are rare and precious gifts.

Dr. Pooh & Tigger

They enrich your life in subtle, significant and irreversible ways. They listen with interest . . .  and understand. They give honest feedback when you need it (even if you don’t ask). They can brighten your day with a not so random act of thoughtfulness.

You are never alone.

They are with you at every point of the journey. They encourage you in the struggle uphill. They shine a light when you are lost. They pick you up when you fall, and they celebrate your victories great and small.

They see right through you, and they know who you really are. They know everything about you . . . but they love you anyway.

We all need emotional first aid kits – or care packages – for the times in our lives when we feel discouraged, overwhelmed, alone or just blue. We can pack them with (1) our favourite songs – the tunes that always give us a lift and the words we can’t keep from singing out loud, (2) inspiring words – from the great women and men of history that help us transcend our circumstances, (3) spiritual wisdom – that gives us a grander perspective and an appreciation of this present moment, (4) your favourite movies – that engage your imagination, inspire you or just make you laugh, and (5) an encouraging letter – from you, a friend or someone else who believes in you . . . and what you believe in.

But the most essential parts of every virtual care package are your life lines – great friends.

One such person is my friend, Vanessa, who shared with me a little book from her own care package, The Blue Day Book – A Lesson in Cheering Yourself Up by Bradley Trevor Greive.

If you’re having a blue day, read this book today. If you’re not, why not celebrate your best friends? Let them know they make a difference!


Caregiving Compassion Friendship Love Parenting patient-doctor relationship Relationships

Appreciating Your Life

Soon after their births, my first thoughts on holding each of my children: “Thank you for this precious life.”

It remains at the core of my thoughts, grounding and shaping my actions, as a father, a husband, a friend and a physician. In the living of life and in the practice of medicine, I have witnessed and experienced the fragility of health and life, the fleeting nature of its blessings, pain and suffering. Knowing that we are mortal, each of our lives is all the more precious.

In caring for patients, I share the joys and tragedies of every patient’s life. I am privileged to participate in the births of newborns, to be the first to hold them and give thanks. I share in my patients’ lessons in life and witness their growth through challenge and adversity.

I marvel at the capacity of the body to heal itself, and I am inspired by the resilience of the human spirit.

Each life is a precious gift, and I remember this with my encounter with every patient. To be engaged in the care of their health is a privilege and responsibility.

But we each share a responsibility for one another as if we were one great family. It is a duty easily forgotten.

Most of us approach each day as if we will live forever. It is preferable to living in fear. I have counselled patients who were so consumed with the anxiety of losing loved ones that they failed to appreciate the time they had together. When their loved ones were gone, they realized how much more they had lost.

Some dads don’t take the time to enjoy family time when their children are young. They soon discover that toddlers too quickly become teens and adults, and that time has been lost forever.

We each have a capacity to harm one another. Fortunately, most of our daily sins are of omission and neglect. We take the people in our lives for granted – not only family and friends but also the people we meet each day. We do not seize every opportunity to be helpful and to give what is most needed. We fail to connect.

Your life is a rare and unique gift . . . but not one to keep for yourself. Don’t waste your life, talents and time on the trivial. Don’t get lost on the wrong paths – the fast lane of materialism, the slow, meandering road of mindlessness, or the lonely highway of narcissism and self-interest.

We are meant to travel together. We are dependent on others and they upon us. We are carried and we carry others. We can inspire and be inspired. We are better together, and together we can travel deeper and farther, discovering places in the world and in ourselves that would otherwise remain unknown.

Before you rise in the morning, consider a prayer of appreciation: “Thank you for this precious life.”

Caregiving Compassion Forgiveness Grace Growth Love Parenting Relationships

How Is Love Manifest In Your Life?

I recall in my youth – at our neighbourhood United Church, there was a point during each Sunday service when the minister would ask the congregation to share how God had acted in our lives during the week.

Like the open mike of today, various members – young and old – would speak up. A kid might say that he found a quarter on the street. Another would talk about the puppy his parents brought home.

Grownups would talk about a loved one who had been sick – and through the wonder of prayer – had now recovered. People were essentially sharing the positive events of the week.

Not a bad practice I thought – to recognize the good in your life . . . and to voice appreciation for it. I’m all for optimism and seeing the cup not only half full but overflowing.

But I also wondered how people felt about God when things were not going well.Was God responsible for the positive things for them but not the negative? Did they still recognize and appreciate His presence?

How I think about God has changed as I have with age. Having witnessed the drama of relationships, the unpredictability of health, tragedy undeserved, birth and death, I recognized that our limited minds are incapable of truly understanding God.

But I do believe that the best in our lives – and in ourselves – is God manifest through love – the caring of good parents, the understanding and acceptance of friends, the affection and commitment of partners, and the kindness of strangers.

Love is manifest in our lives in countless ways every day – in generosity, forgiveness and compassion.

We live in a beautiful world. There are wonders all around us. Yet the most palpable manifestation of God in our lives is the love we accept and give to one another.

So the question of the week is: How is love manifest in your life?

Awareness Caregiving Empathy Growth Parenting Positive Change Positive Potential Relationships stress management Workplace Health

Good Stress, Bad Stress. What Kind of Stress Do You Cause?

Hans Selye distinguished good stress (eustress) from bad stress (distress).

Sometimes it’s not easy to tell the difference.

You may dream of a stress-free life, but such a life could be boring . . . or empty.

Being a parent has been one of the biggest adventures of my life but it has never been stress-free. Parents are charged with a tremendous responsibility – the physical and emotional well-being of a baby, a toddler, a growing child and eventually a maturing adolescent.

There are special challenges and rewards with each child and at every stage of their growth. And as a child grows, so do we.

We also become a stress – mostly positive but at times negative – in the lives of our children. We set boundaries for behaviour, and we set standards and goals. Without these, they may not internalize appropriate values and achieve their positive potential.

Our words – and how we deliver them – can be a source of stress. Our children need our feedback at every stage. That feedback can help them to continuously improve and grow.

Too often, poorly chosen words can cause distress. Unhelpful criticism – that which does not improve our performance and that which attacks rather than assists – arises through thoughtlessness or our own darker motivations.

We can get into a pattern of reflexively blurting out hurtful and harmful remarks that harms both our relationship and the children we have been charged to nurture.

We are all interconnected – dependent on one another in great and small ways. We can harm or help others in our actions and in our words – what we do and what we fail to do, what we say and how we say it.

In the workplace, at school, in the field and at home, what type of stress do you cause others? What is your effect – positive and negative – on your partner, children, employees, coworkers and others you influence in your daily life?

Being more mindful of this, what would you do differently?

Caregiving Easter Grace Letting Go Love Relationships

What Easter Means to Me: The Cycles of Life & Love

April to me is a bittersweet month. We celebrate my sister’s birthday, yet it is also the month 9 years ago that our mother died unexpectedly.

In grief, we are drained of the joy in life. We may feel empty and isolated, disconnected from the rest of the world. Much of what had once engaged or enraged us suddenly becomes meaningless.

That profound sense of loss is certainly the tone of Good Friday. So why is this day deemed “good”?

Mythologist, Joseph Campbell pointed out the double meaning of Christ’s atonement for our sins. In that word, he sees “at one”-ment. This is the recognition that we share identity with one another, with nature and with the divine.

As mortal creatures with human bodies, we are born, we grow, we live and we die. We are part of the cycle of life and death.

We are also part of a more profound spiritual and emotional dynamic – the cycle of love. Recognizing this lifted me from the depths of my own grief. When I looked into the beautiful faces of my own children, I realized that I saw them with the same love with which my mother loved us. In spite of our imperfections, we were loved. She saw the best in us even when we could not see it, and through love, she brought out the best in us.

That love – unconditional and undeserved – is a gift of grace. It transcends our individual needs, egos and self-interests. It transcends cultures. It transcends our own lives.

This Easter, we find ourselves within the cycle of love as my dear father-in-law is supported in palliative care. All members of our extended family have been graced with his kindness and love, and all participate in supporting him with love at the end of life.

Caregiving Compassion Medical Ethics Meditation

The Power of Your Words . . . to Harm or to Heal

As a child, you may have said, “Sticks and stones may break my bones, but words can never hurt me.” If you did, it was most likely in response to a personal attack of insults, lies or slurs.

And as you were defiantly saying this, part of you was already hurting.

Words can have great power. Though they may be carelessly said with a moment of thought, their impact can endure.  While broken bones may heal in 6 weeks, a broken spirit can suffer a lifetime.

Though physicians, teachers and others whose work requires a respect for the trust and dependence of those they care for, the responsibility of parents is even greater. They too must seek first to do no harm in their daily duty of raising, protecting and caring for their children.

Our words can do great good, but they can also betray another’s trust in us, exploit their vulnerabilities and break their spirits.

Consider today the power of your speech, and choose your words carefully. Let them convey the best from your heart. Use them to to connect, support, encourage and inspire. Let them bring forth the best from others.


Caregiving Compassion Coping with Loss Forgiveness Grace Growth Positive Potential Purpose Relationships

Weaving Together the Tapestry of Our Lives

If your life was a straight line – beginning on the day of your birth and ending with your last day on earth and if it were nothing more than the inevitable aging of your body from infancy through childhood and adolescence with the progressive decline throughout adulthood to senescence, then your future would seem bleak and your efforts meaningless.

If you define yourself by your looks, your accomplishments, your possessions and your work, all is futile – for your youth will fade, your accomplishments will be forgotten, your possessions lost, and you yourself retired.

The randomness of illness and accident stymies our best plans. The challenges of chronic and acute disease can seem overwhelming.

But you are more than your body, and your life is more than a single thread on a straight line.

Your life crosses the lives of many others and most significantly it is intimately entwined with the lives of the special few: your deepest friends and your family. Together we weave a tapestry, and it can tell our life stories with the richness of many perspectives.

We define ourselves through our relationships, and in our relationships, there continues to be the potential for further growth at every age. A long-married couple can still grow together as they give, forgive and grow deeper in love. Aging or disabled parents can be supported and cared for by the adult children they once nurtured.

Being the caregiver – a child, a spouse or friend – of an aging or disabled adult is one of life’s greatest challenges. It requires mutual grace: the acceptance of care and the evolution of your changing roles, the acknowledgment of conflicting emotions, and the resolve of continued caring.

Being the caregivers for aging parents who are no longer at their physical, emotional or cognitive best can be more challenging than parenting our own children. We have to see the whole person in our arms – like the infants we once rocked to sleep.

We have to see the present in the context of our loved one’s entire life, and our new relationship within the backdrop of our relationship over a lifetime – the tapestry we weave together.

This Friday, October 21st at 7 pm, I will be giving a free presentation at the Norman Rothstein Theatre at 950 West 41st Avenue (at Oak Street) in Vancouver. My topic, “The Positive Potential of Caregiving: Surviving, Thriving and Finding Meaning” is part of the Tapestry Foundation for Health Care’s Dialogue on Aging Public Presentation Series. For more information contact or by phone 604-877-8335.

Caregiving Growth Positive Potential Relationships

Keys to Staying Young #5: Life Begins at Forty, So Start Counting Backwards

This week, I’m posting a tip each day on staying young and healthy.

#5 Life Begins at Forty If you were born before 1962, start counting your birthdays backwards each year. You might even begin looking forward to your birthdays again. “30” will be the new 50.

When we were in our 20s, my friend, Stan and I put together a list of things we hoped to accomplish by age 30. I’m looking forward to my next “30” and a second try at some of those things that I still want to do.

This moving backwards is not far off the reality of aging. All of us who work in geriatrics see the grand reversals over time. Adult children become the caregivers of aging or disabled parents; they tuck them in at night, look after their financial affairs, accompany them for all medical appointments, speak as their advocates, look after the meals and the household, and sometimes must feed and change them.

Keep flossing and brushing so that you will have more teeth when you are five again, and if you are lucky enough to be one again, let’s hope that you won’t need diapers and spoonfeeding.

Next: Calculate Your Realage

This Friday, October 21st at 7 pm, as part of the Tapestry Foundation for Health Care’s Dialogue on Aging Public Presentation Series, I will be speaking on “The Positive Potential of Caregiving: Surviving, Thriving & Finding Meaning” at the Norman Rothstein Theatre 950 West 41st Avenue (at Oak Street) in Vancouver.

Caring for a loved one is a special challenge. I will present a caregiver’s guide to healthcare: the challenges of caregiving, care of the caregiver, seeing the whole person and finding meaning as we weave together the tapestry of our lives. You can register for this free presentation online or by phone 604-877-8335.

For more on healthy living and positive change, listen to my Positive Potential Medicine podcast at wgrnradio.


Caregiving Medical Ethics Your Goals

The Caregiver’s Guide to Healthcare

As a caregiver, you may take on the role of an advocate for your family member. You should keep in mind one of the foundational principles of western medical ethics: autonomy – respect the values and wishes of the patient.

Sometimes what we want for our family members is in conflict with what they want for themselves. Physicians choose to respect the wishes of the capable and competent patient. When patients are no longer able to make their own decisions, we still strive to respect their values – what they would have chosen for themselves under these circumstances.

Communicating with Doctors

The List The patient’s list of problems is loved and hated by my medical colleagues. I find the list is a problematic if the patient has a list but hides it or chooses to bring out one problem at a time so that after we have gone through the history, physical examination, and discussion about diagnosis, investigation and treatment of one, another is brought up that we work through, then another and another.

The list is best shared up front when booking the appointment so that enough time may be allotted in the schedule. What is covered in a single office visit or consultation should be negotiated at the beginning of the visit, so that sufficient time is spent on a problem rather than rushing to cover things in a limited time. Mistakes are more likely to happen in the latter case when a physician doesn’t have time to think through a problem.

The Doctor’s Orders As doctors, we are notorious for giving complicated instructions to our patients and not writing it down. When we do write it down, like a prescription, you might not be able to read it.

If I ask a patient to do more than two things, such as reducing the dose of one medication and starting a new one, I will write (or print) my instructions and review them with my patient. Never leave the doctor’s office without being clear on these instructions.

A Word About Compliance In the past, patients who didn’t follow through on the doctor’s orders were labeled as “noncompliant.” This literally means not bending to or following the direction of the physician. In this day and age with educated and empowered patients, it sounds ridiculous.

If I ask a patient to do something and he comes back not having quit smoking, taken his medication or started exercise, I don’t label him as noncompliant. I would recognize that the goals I set weren’t really the patients or I didn’t give him the support he needed to achieve those goals.

Just like the agenda for the appointment is a negotiation. The course of action after the visit is a collaboration. The goals really belong to patients if they are they ones who will be carrying them out in their real and complicated lives.

As a physician, I give information, advice and options. Once a patient chooses the course aligned with their goals and values, I can help anticipating challenges and arranging appropriate support and follow-up.

What You Should Know About Every Medication  To make an informed choice about starting a medication, a patient needs to know: (1) the indications – what is it for? (i.e. to treat high blood pressure, reduce cholesterol, control the heart rate, lower blood sugar); (2) what are the alternatives? (i.e. other medications, no medications, lifestyle changes); (3) what are the common risks or side effects; (4) what are the most serious side effects?.

If you are acting as an advocate or your family member is not capable of making an informed medical decision, you should ensure that you have the answers to these questions for each medication prescribed.

Surviving the Hospital Stay

Being in a hospital can be a depersonalizing experience. We take away your street clothes, make you wear gowns that don’t keep anyone warm, make your wear a wrist band, and write all about you in charts that you can’t see.

You can be given medications to take that are unlabeled and given tests without the informed consent you would expect at the doctor’s office, but the same rules apply. For every intervention and investigation, the patient or the proxy decision maker should know (1) the indication, (2) the common risks, (3) the serious risks, and (4) the relative risks of the alternatives.

In the hospital, you may be treated by a variety of healthcare providers, but for every patient, there is one attending or most responsible physician. As a patient or advocate, you need to know who that is. That name will usually be on your wristband. This is the physician who should be able to answer all your questions about medical status and treatment plans.

This is part of my presentation this evening at the Paetzold Health Education Centre, Jim Pattison Pavilion in Vancouver General Hospital (Thursday, May 12th at 7 p.m.) as part of A Celebration for Family Caregivers. The event is sponsored by the United Way, the Alzheimer Society of British Columbia, the Parkinson Society British Columbia, Vancouver Coastal Health, and the Stroke Recovery Association of British Columbia. To RSVP for free but limited seating call 604-877-4650 or email