Pride and learning in reverse

Learning by doing

In “What risk of death is acceptable?” (page 299)² Dr Danny Liang, a Vancouver family physician working in the emergency department (ED), relates the case of an elderly patient with atypical chest pain and uses it as a springboard to unpack the challenges of deciding when to admit a patient to hospital, and when to send them home for outpatient follow-up and investigation. He explores and reflects on the most effective way to communicate these competing risks to patients and their families, writing:

When contemplating whether to discharge a patient from the ED, our calculus of what risk of death is acceptable is a difficult dilemma. On one hand, having a higher threshold to admit a patient to the hospital has been shown to lead to much higher rates of mortality…. On the other hand, EDs and hospitals are already extremely overcrowded, leading to thousands of additional preventable deaths every year in Canada.²

Enjoy Dr Liang’s thoughtful, evidence-informed reflection. In the face of clinical uncertainty or charged clinical scenarios, a common approach is to rely on algorithms or checklists to maximize the chance of achieving desired outcomes. This is the subject of Dr Stephanie Smith’s article “CALM amid chaos: the art of being a team leader. A toolkit to cultivate strong emergency management skills” (page 317).³ CALM stands for communication, adaptive awareness, listening, and managing team dynamics. Dr Smith writes:

Effective leadership promotes clear communication, efficient assessments, and ensures the team feels supported. By embracing a calm, composed leadership style, you will build confidence and credibility, empowering your team to handle any patient, in any environment, with exceptional skill and professionalism.³

Pride stories

The second theme in this month’s issue of Canadian Family Physician is 2SLGBTQIA+ pride.

For the past 2 years, the June issue of the journal has featured articles celebrating Pride month. This year, for logistical reasons, the June issue will be research-themed and will focus on the current crisis in family medicine and how it can be addressed using research-informed solutions. As a result, we are celebrating Pride early with 3 stories contributed by members of the College of Family Physicians of Canada’s 2SLGBTQ+ Health Member Interest Group.

In “Medicine can be queer!” (page 341),⁴ Dr Ted Jablonski reflects on his experience of participating in a medical student video project exploring the “intersection of medical professionals and the queer community.”⁴

In “When the closet isn’t glass” (page 342),⁵ Dr Robin Moxley compellingly describes her own long journey in coming out as queer. Finally, we offer readers family medicine resident Dr Sara Sotirakos’s wonderful poem, “My Gender Confuses People” (page 341).⁶

While the dual themes of the May 2025 issue of Canadian Family Physician appear unconnected, they actually have much in common. Both celebrate growth and learning (professional in theme 1, personal in theme 2), while at the same time acknowledging the need for continued progress. They are about the kind of life lessons you can only gain through experience; the kind that—ultimately—make us better doctors.