Should we make surgeons get tested for HIV, hep B and hep C?
By Julia Belluz - Thursday, July 19, 2012 - 0 Comments
When patients go into the hospital for a surgery, it’s next to a miracle they ever leave the building unscathed. It’s not that hospital administrators and health professionals don’t do their best to protect patients—they do. But with the incredible complexity of surgeries and modern hospital systems, the intricate pathways of care, there are infinite possibilities for things to go wrong.
In the media, we tend to focus on the risks related to hospital-acquired infections or the wild pre-checklist days. But there’s another danger that isn’t talked about much outside of medical circles: getting a blood-borne infection, such as HIV, hep C and hep B, from your health-care provider.
Precautions are taken at every turn to make sure diseases aren’t transmitted from doctor or nurse to patient—and vice versa. And the risk of transmission is remote. Extremely, utterly, almost infinitesimally remote. To give you a sense, according to the U.S. Centers for Disease Control, the occupational risk of infection with hep C after a needlestick injury or cut is less than two per cent. That’s somewhere between the risks related to HIV (less than one per cent) and hepatitis B (six to 30 per cent, though surgeons working today would be vaccinated for hep B).
In Canada there have been no documented cases of physicians transmitting hep C or HIV to patients since modern antiviral therapies came on the scene to treat blood-borne pathogens and doctors started implementing what’s known as “universal precautions”—or avoiding contact with patients’ bodily fluids by using gloves, gowns and masks. There has been one reported case of hep B transmission, but it occurred before antivirals and universal precautions. Worldwide, the documented number of health-care worker to patient transmissions of blood-borne infections since 1991 has been “exceedingly low.”
Yet, provincial medical regulators in Canada are targeting blood-borne pathogens in surgeons. The College of Physicians and Surgeons of Ontario just introduced a new policy that asks surgeons—and those who assist in surgery—to report if they have been tested for the blood-borne pathogens hep B, hep C, and HIV in the last year.
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When a doctor has Hep C
By Julia Belluz - Thursday, July 19, 2012 at 6:53 AM - 0 Comments
Fear of transmission from physician to patient has some regulators taking no chances
In the early 1980s, just as AIDS was emerging along with the surgical precautions that came with it, Dr. Wayne Gregory was a resident at Sunnybrook Hospital in Toronto. Back then, he says, “We were the only trauma centre in Toronto.” So he learned the art of medicine on gunshot victims and patients severely injured in car crashes. At the end of his shifts, the surgeon from Brampton, Ont., now 57, recalls, “I remember frequently coming home and changing out of my greens, and my underwear would be soaked in blood.”
Over 30 years later, in 2009, the College of Physicians and Surgeons of Ontario (CPSO) introduced a contentious practice regarding surgeons and diseases transmitted through blood. The college, like its counterparts in B.C. and Saskatchewan, started asking doctors who do exposure-prone procedures—where there is a risk of exposing a patient to a doctor’s blood, usually through a needle prick or scalpel cut—to declare whether they’ve been tested for blood-borne infections on their annual licence-renewal forms.
Gregory answered honestly: he hadn’t. In his years of opening up patients’ chests and abdominal cavities, he never got screened for HIV or hepatitis C, and only once for hep B. “You wouldn’t automatically get tested,” he says. “A lot of people get tested if they are applying for insurance. But just for screening purposes, it’s not routine among surgeons.”
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In conversation with Mike MacDonald
By Jaime Weinman - Thursday, May 31, 2012 at 11:41 AM - 0 Comments
Canadian comedy legend on life in the fast lane, his hepatitis C diagnosis, and the miracle he is praying for
Mike MacDonald has been described as a “comedy legend” and inspired a generation of Canadian stand-up comedians. He holds the record for most consecutive appearances at Just For Laughs, the Montreal comedy festival. But last year the 57-year-old was diagnosed with hepatitis C, and following a serious infection, his liver and kidneys have shut down. He posted a message on Facebook seeking a live donor with type-O negative blood for a liver transplant. Friends have created an online campaign to raise money for his medical bills and there has been an outpouring of support. It overwhelmed MacDonald, who spoke to Maclean’s from his mother’s home in Ottawa.
Q: Were you surprised by this campaign?
A: It’s been totally unreal. Like I said in my thank-you note, I feel like Jimmy Stewart in It’s a Wonderful Life. It’s been beyond my wildest dreams and I can dream with the best of them. It’s been less than a week and the response has been amazing. Thank God for Facebook. I have a bit in my act about the top three uses of the Internet: No. 3, hate-mongering, No. 2, the downloading of free music, and the top one is porno. But something like this, this is what the Internet was intended for: to help people, to pass on information, the positive things in life.
Q: Before you had to stop working, how were you doing financially?
A: Well, I was trying to work as much as possible, but for the last two or three years, for the first time in my entire career, I was starting to feel the economic crunch of the time. Especially the corporate gigs, the gigs where sometimes in one night I could make what I could make in a whole month in the clubs. They were dwindling because major corporations weren’t doing as well as they could, so they weren’t having the big celebrations and hiring the big entertainers. And then with the complications of being bipolar and manic depressive, it seemed to go downhill. So financially, we were in and out of debt, with a heavy credit-card debt. To my wife’s credit, she pulled and scratched and crawled our way out of the debt.
Q: When did you find out you had hep C?
A. My father passed away in July after a long bout with diabetes. When I went up there to Ottawa about a month before, I’d displayed some slurred speech, and I was dropping things and tripping, which is uncharacteristic for me, because I’m very physically adept in my comedy. My wife insisted that I check in with a doctor. I checked in with the family doctor in Ottawa, they did some tests, and they said “some of these numbers are a little weird.” They checked it further, I went to a specialist, and they diagnosed it as hep C. That changed everything. Now it’s this situation where I can’t work at all and I’m stuck in Ottawa.
Q: Did the doctors say how you got it?
A: The No. 1 way is intravenous drug use. Going back 25 years, I went through my bout of trying to emulate my heroes like John Belushi and Richard Pryor, getting involved with heroin addiction and cocaine and all that stuff. I got through all that and did anti-addiction documentaries for the CBC, figuring it was the least I could do. I was so lucky I got through all that and I’m still alive. The doctors said my symptoms should have shown up sooner. My friend who went through hep C, when he found out about it, he said, “This is so weird. About nine or 10 other people have popped up from that scene alone who have hep C.” It’s like a generational time period thing, almost a mini-epidemic. I read somewhere that hep C is something that anyone from the ages of 45 to 60 should be tested for, because there’s something about that era.
Q: Do you think comedians take drugs in part to emulate other comedy idols, like Belushi, who died of an overdose, and Pryor?
A: I think that was a factor. I think another thing is that you go back to the hotel by yourself, and you have the choice between picking up somebody else, getting into that debauchery, and using the booze and the drugs to subside the loneliness. It’s all self-destructive. It took me a long time, especially after the drugs, to learn how to be by myself.
Q: Is it necessary for a Canadian performer to move to L.A., or is it possible to make a career in Canada?
A: I certainly thought, when I moved there, that it was necessary. There was all that “go to Hollywood” thing in the back of my mind. In hindsight, the only reason to go to L.A. is if you want to be on an American sitcom or in an American blockbuster movie. You can make films just about anywhere. I have bad luck stories about my experiences in L.A. There was an agent who approached me and said, “I always liked you, I thought you deserved to be farther up in your career than you are.” He said, “I just got my two top clients, John Candy and Steve Martin, five years of work, and now I would like to concentrate on you.” The next night, the guy wakes up in the middle of the night, gets a glass of water from the fridge, has a heart attack and dies. I’ve got a million bad luck stories.
Q: Why did you decide to come back?
A: It just feels right. I’m a Canadian citizen. I started here, I’ll end here. I used to exaggerate a little bit with the jokes I made about Americans, but now I don’t have to exaggerate any more. They’re really crazy down there!
Q: Has anyone come to visit you?
A: One or two close friends that I’ve known since high school. But so many people want to come and see me, so many people want to talk on the phone, so many people have offered to drive me to the health food store. When we were in B.C. or Vancouver Island, there were places where you couldn’t throw a rock without hitting a health food store. But here in Ottawa, when you start looking for salt in everything, boy, you realize that the salt barons are out there laughing their asses off at the heroin and coke dealers. They run their products with impunity. They make tons more money than anybody else, their product is everywhere. At Tim Hortons the bottled water has five milligrams of salt in it.
Q: Before people started calling and donating, were you aware you had so many friends and admirers?
A: No. There have been people, especially comedians, who I’d met once or twice at Just For Laughs, and I thought there would be politeness, but I had no idea of the deep respect and concern or the outpouring of love and prayers they’d have now. It’s been a humbling experience to say the least.
Q: Have you tried over the years to encourage younger comedians?
A: Not so much, but according to the messages, apparently I have. People remind me of stuff. I would do little things, like have these seminars. I would sign up a maximum of 10 amateurs, and we’d go through their act, examine it, take it apart, and answer any questions. And by a collective think-tank kind of thing, they’d all walk out learning something. To me it was just a little thing. But according to the messages, it was such a big deal. For some of them, it started their careers. But if you’d asked me before all this happened if I had any influence, I’d have said, “I don’t know. Maybe. One or two.” It’s comforting to know that I wasn’t an asshole every second of my life, that at least I did something good. I have a tendency to remember the bad times more than the good. But it’s like one of my favourite song quotes: “Only good people wonder if they’re bad.”
Q: Is there anything you see differently about your life now?
A: Absolutely. This has been a life-changing experience. I have a responsibility, if I get the miracle ending that I’m praying for, to use that gift properly. There’s also the realization that if you touch people in a positive way, you can touch people in a negative way. Let’s say you’re in a restaurant, and the waiter comes over and says, “I’m sorry, I got your order mixed up earlier.” Instead of saying “Well, yeah, maybe next time you’ll do better,” say, “It’s okay, you came with the right order and everything’s fine now.” Maybe he’s had a bad day, and your answer could be what makes him go and be mad at somebody else, to quit his job, to take the drugs that send him into the spiral.
Q: How do you look back on your career?
A: There was a time that I wished I would have been more famous, made more money. But who knows? I could have killed myself with more money and more fame. I’ve always enjoyed the fact that I’ve been most popular in Canada. At my level of fame, people would come up to me, and say, “I loved you on Just For Laughs,” and then they’d walk away. Where I’ve been out in public with friends that are much bigger and more famous and popular than I am, like Tim Allen and Drew Carey. People come up and expect the world from them. And I’m sitting there going, “I am so glad I’m not you right now. Even though you have tons of money, and I’d love to be able to buy my wife a new house, I don’t envy this moment at all.”
Q: Will you keep doing Just For Laughs?
A: They’re arranging a special benefit for the 30th anniversary. Originally, when they asked me last month, I had to turn them down. But lately I’ve been feeling so positive with the energy, that I said that I’m really going to try to at least get down there just for the day. I’ll take the train, because I can’t fly, and try to appear at the benefit, because Montreal’s not too far from Ottawa. My wildest dreams would be to stand up on stage and just do one joke, to get a laugh, to thank the audience for being there and thank the comedians for working for free.
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Blood, sweat and fears
By Jonathon Gatehouse - Wednesday, September 21, 2011 at 6:20 AM - 1 Comment
Wrestling legend Abdullah the Butcher may cut himself, but he claims he didn’t give rival Devon Nicholson hepatitis C
His large bald head is covered with scars. The deep vertical grooves on top were self-inflicted—or at least, consensual, by the sure, drive-my-head-into-the-ring-post standards of his profession. Others testify to the passions Larry Shreve, a.k.a. Abdullah the Butcher, a.k.a. the Madman from the Sudan, a.k.a. Kuroi Jujutsushi (the Black Wizard), was able to arouse outside the squared circle. Like the pink line linking his temple to his left ear, courtesy of a folding metal chair thrown by a fan of one of his opponents. Just don’t ask to see where the little old lady once stabbed the blubbery 400-lb. behemoth with a hatpin.
In a career that has stretched 50 years, the Windsor, Ont., native became a superstar in professional wrestling, frightening crowds from Truro to Tokyo with his predictably unpredictable behaviour. Wild-eyed and gibbering in pidgin English, he’d eat paper, bite the heads off of snakes and chickens, and stab opponents with his trademark fork. But mostly Abdullah—Abby to his friends—would bleed. Copious amounts of what wrestlers call “the juice,” set free by surreptitious razor nicks to his head. By the end of a match, Shreve was almost guaranteed to be a gory mess, slick and glistening under the TV lights. So too his grappling partners. Now 70, he can’t really remember the first occasion—or even guess how many times—he cut himself for an audience. He just knows his entire career was based upon such mutilations. “I did it because I wanted to draw people. To give them a good match,” he says from his Atlanta home. “Violence: that’s what they want.”
Lately, however, blood has come to represent something else to the Butcher—an all-too-real threat to his finances and faux-sporting legacy. This past spring, just before his induction to the WWE Hall of Fame, an Ottawa wrestler alleged that he contracted hepatitis C during a 2007 match against Abdullah. Devon Nicholson, who had been building a following as another madman, “Hannibal,” claimed Shreve had cut him without permission, transmitting the disease via a razor blade he had already used on himself. In June, Nicholson filed a $6.5-million negligence suit in Ontario Superior Court, saying the illness cost him a shot at the World Wrestling Entertainment big time, and prematurely ended his career. This past week, Shreve’s Ontario lawyer filed a defence denying the claims and countering that Nicholson, who staged the bouts, not only consented to his injuries, but is himself responsible for the illness through his own negligence.



















