Bad Moon Rising (Musings on being fired for having 'long haul' COVID-19)

Updated: 31 May 2021

INTRODUCTION

The idea for the blog was stimulated by news of an American clinical laboratory scientist being fired after she had been infected with COVID-19 and was recovering from 'long haul' COVID-19, even though she had worked for  the employer (Community Hospitals of Central California) for 33 years. The news item came about because she has sued the employer for wrongful dismissal.(Further Reading)

The blog's title derives from a 1969 song by Creedence Clearwater Revival.

PERSONAL ANECDOTES

First, please note that I had a minor disability (suffered from acute lower back pain attacks) when I first joined UAlberta's Medical Laboratory Science first as a lecturer and clinical instructor for the hospital's transfusion service and later became an assistant professor. Was a candidate for surgery but the Drs decided to treat it conservatively, for which I'm grateful. 

The attacks were severe and my colleagues kindly would pick me up and drive me to work. I managed with a 2-wheel folding walker, and by taking mega doses of the pain killer ibuprofen, a nonsteroidal anti-inflammatory drug (NSAID).

The university's Faculty of Medicine/Department of Laboratory Medicine and Pathology always supported me, even when I had to take extended time off. What they did was designate a hematopathologist resident to give my classes until I could return. One who helped is now in a senior position.

NOTE: If you've read this blog before you will know I'm a contrarian.

Over 36 years working as a medical laboratory technologist and educator, I've seen only two medical lab technologists who ever faced being fired. 

#1. One was when I worked at Canada's then blood supplier (Canadian Red Cross Blood Transfusion Service, also a transfusion service for the entire city) in Winnipeg. It failed. A compulsory Dr. exam was needed after you were hired, and the Dr. said a girl with deformed hands due to a medical condition could not perform her duties, as we then largely worked manually, did a lot of pipetting by hand. Staff saw she could do the work and I decided to get every lab worker to sign a petition saying she could do the work. She wasn't fired and went on to work many years for the organization, including becoming a supervisor.

#2. The second I heard about as an educator and it disturbed me. I've decided not to give many details to respect her privacy. I knew her well when she worked in a hospital transfusion service and was helping her get her ART (Advanced Registered Technologist), then offered by the CSMLS. After losing her license to practice as a med lab technologist she became a medical lab aide and to me didn't deserve her fate. I wish I had been able to help her at the time.

SUMMARY

I've read several news items about the story and also the lawsuit , which is available online. What follows is my interpretation of the basic facts of the case. Yours may be different. Most is from the lawsuit, some from news items. The Plaintiff asked for a jury trial.

1. Plaintiff began working for Defendant, Employer, on or about 1 July 1987 as Clinical Lab Scientist. She received good performance reviews and salary increases and was not subject to discipline for her job performance over the more than 30 years of her employment.

2. Plaintiff suffers from several medical conditions including diabetes, cardio-pulmonary disease and traumatic brain injury. Defendant, Employer, is aware of Plaintiff’s medical conditions.

On several occasions when Plaintiff had to take time off work due to illness, Defendant, Employer, subjected her to discipline based on her attendance.

3. In mid-April Plaintiff contracted COVID-19. Her health care provider put her on medical leave for about six weeks.

4. Plaintiff’s health care provider suggested that she request intermittent medical leave due to her continued illness combined with her underlying medical conditions. Plaintiff requested the appropriate paperwork from Defendant, Employer’s leave of absence department. However, Plaintiff’s supervisor told her “you better not” referring to Plaintiff’s request for leave. In addition to this threat from her supervisor, Plaintiff was shunned by her supervisor and coworkers.

5. Within the year last past, without excuse, justification or privilege, agents of Defendant, Employer, including but not limited to supervisor Carol Kelley, published and republished, orally and in writing to third persons, including prospective employers of Plaintiff and other persons who are not parties to this action, the false and defamatory statements about Plaintiff, stating as matters of fact that, among other things: Plaintiff violated company policies; and Plaintiff deserved to be terminated.

My comment: Wow, they spoke to prospective employers and under which circumstances? My experience in Alberta, Canada is when FOIP (Freedom of Information and Protection of Privacy) became law, prospective employers who were not listed in an applicant's application for employment, would not comment except to say the person worked there. 

6. The Causes for Action in the lawsuit, which all relate to violations of  Government Code §12940:

1) Discrimination Based on Medical Condition, Disability and/or Perceived Disability in Violation of ...

2) Failure to Accommodate Disability in Violation of ...

3) Failure to Engage in a Timely, Good Faith, Interactive Process To Determine Effective Reasonable in Violation of ...

“It shall be an unlawful employment practice . . . For an employer. . . to fail engage in timely, good faith, interactive process with the employee . . . to determine effective reasonable accommodations . . .”

Defendant, Employer, knew of Plaintiff’s medical condition and her need for accommodation which consisted of additional medical leave. Yet, Defendant, Employer, failed to accommodate Plaintiff and ignored her requests for accommodation. Defendant, Employer, refused to explore any options to accommodate Plaintiff but, instead, subjected her to unjust discipline and terminated her employment. Accommodation of Plaintiff would not have caused Defendant, Employer, any undue hardship, significant difficulty or expense.

4) Failure to Prevent Discrimination and Discrimination Based on Medical Condition, Disability and/or Perceived Disability in Violation of...

5) Retaliation for Requesting Accommodation in Violation of...

6) Retaliation for Exercising Rights Under California Family Rights Act in Violation of 2 C.C.R. §11094

7) Wrongful Termination in Violation of Public Policy

8) Defamation

Within the year last past, without excuse, justification or privilege, agents of Defendant, Employer, including but not limited to Carol Kelley, published and republished, orally and in writing to third persons, including prospective employers of Plaintiff and other persons who are not parties to this action, the false and defamatory statements about Plaintiff, stating as matters of fact that, among other things: Plaintiff violated company policies; and Plaintiff deserved to be terminated.

The statements made by Defendants and their agents were and are false and constitute defamation on their face in that they communicate to third persons as matters of fact that Plaintiff was a problematic and poorly performing employee who deserved to be terminated from her job. This constitutes defamation per se as false statements tending to injure Plaintiff in her profession.

Plaintiff asks for the following:

1. For general damages in excess of the jurisdictional minimum of this Court, according to proof;
2. For special damages according to proof;
3. For exemplary punitive damages, according to proof;
4. For interest on the amount of losses incurred in earnings, deferred compensation and other employee benefits at the prevailing rate;
5. For reinstatement to her job with Defendant, Employer;
6. For costs of suit, including reasonable attorneys’ fees; and
7.  For such other and further relief as the Court may deem just and proper.

FOR FUN

Had difficulty choosing a song for this blog but settled on the following, as I wonder how many 'long  haul' COVID-19 folks will suffer a similar fate of the med technologist in this blog. 

• Bad Moon Rising (Creedence Clearwater Revival) 

I see the bad moon a-rising / I see trouble on the way...

FURTHER READING

1. Hospital-based clinical laboratory scientist is suing her former employer after being fired due to long-haul COVID-19 illness (5 May 2021)

Stand by me (Musings on ongoing bullying in healthcare)

Stayed tuned for updates, which are sure to occur.

INTRODUCTION
The idea for the blog was stimulated by news of a celebrated, experienced UK nurse who faced being stuck off after in 2017 she saved a woman's life who was hemorrhaging after losing her baby with a blood transfusion in an ambulance. (Further Reading) But, through no fault if hers, the required prescription for a blood transfusion had not been taken onto the ambulance with the patient. The nurse claims she has been the victim of bullying by senior NHS managers after she saved the life of the woman. She was unable to return to work at the trust's insistence for ten months, and resigned after she lost a disciplinary hearing. She had to find work outside the trust and is now practising elsewhere.

She was a finalist for 2020 Florence Nightingale Nurse of the Year after raising £100,000 to buy iPads for Covid patients isolated from loved ones. Four years later the Nursing and Midwifery Council concluded the nurse undoubtedly acted in the best interests of the patient and has 'no case to answer'. In some ways this case reminds me of the Bawa-Garba case in UK where a pediatric trainee was convicted of gross negligence manslaughter. (Further Reading)

In addition to this case, harassment and bullying of medical students has been in the news in several nations for a few years. And in my province of Alberta, Canada, in 2016 a noose was hung outside a Black Dr's operating room in Grande Prairie. It was reported almost immediately to hospital administrators by startled bystanders. Yet, according to multiple doctors who wrote complaints, nothing was done to discipline the perpetrator, a white surgeon whom colleagues say still held leadership positions after the incident. (Further Reading)

The blog's title derives from a 1961 song by Ben E. King featured in the 1986 move of the same name.

PERSONAL ANECDOTES
The University of Alberta where I once taught has explicit, well defined Employment Equity and Human Rights Definitions and policies on bullying and discrimination. Yet I'm certain both still exist. The guidelines are followed by all faculties, including the Faculty of Medicine & Dentistry. (Further Reading) It covers pretty much every kind of discrimination, whether direct or indirect: any act or omission based on race, religious beliefs, colour, gender, physical disability, mental disability, marital status, age, ancestry, place of origin, family status, source of income, sexual orientation or political belief, when that act or omission results in loss of or limit on opportunities to work or to fully participate in campus life or offends the dignity of the person.

As a patient I've seen bullying by a Dr. against a trainee and at scientific conventions. As a patient the male Dr. presumably wanted the female trainee (intern or resident) to suffer abuse as a rite of passage that would toughen her up. Few likely report it as the Dr. is all powerful and they fear being judged as troublemakers that could affect their career progression.

At Canadian transfusion medicine conferences I've also witnessed bullying, again by a male Dr. (a 'biggie') against a female Dr. who had presented and was taking comments from the audience. She held her own but his comments were dismissive and abusive and it likely cost her much stress. I wondered why at the time and since and, frankly, suspect he'd not have done that to a male colleague in the same way.

As always, comments are most welcome. Would appreciate hearing about discrimination or bullying you've experienced or witnessed, You can do so by name or anonymously.

FOR FUN
Chose this song because we all need to stand by colleagues in any field when they experience bullying, discrimination, harassment of any kind. Sad to report as items in Further Reading report, the incidence of bullying in medicine remains quite high.

• Stand By Me (Ben E. King with stars and clips from the film)

FURTHER READING
Nurse who faced being struck off after she saved a woman's life with a blood transfusion has been cleared by an official inquiry (20 Apr. 2021) | Related:

Employment Tribunal of Leona Harris (18 Oct. 2019) | The complaint of unfair dismissal is not well-founded and is dismissed.

University of Alberta: Employment Equity and Human Rights Definitions

Taylor-Robinson SD, De Sousa Lopes PA, Zdravkov J, Harrison R. A. Personal perspective: is bullying still a problem in medicine? Adv Med Educ Pract. 2021 Feb 10;12:141-5. (Free full text)

Bullying in the workplace (1 Sept. 2020, CMA)  | What bullying in health care looks like, why it persists and how to eliminate it from the culture of medicine.

Medicine's bigotry and bullying problem (Oped in Canada's Macleans magazine, 8 July 2020)

Colenbrander L, Causer L, Haire B. 'If you can't make it, you're not tough enough to do medicine': a qualitative study of Sydney-based medical students' experiences of bullying and harassment in clinical settings. BMC Med Educ. 2020 Mar 24;20(1):86. (Free full text)

Australia: Culture of bullying, harassment and discrimination in medicine still widespread, survey suggests (9 Feb. 2020)

The Bawa-Garba case should usher in a fairer culture in healthcare (9 May 2019)

Simply the best (Musing on healthcare educators during COVID-19)

INTRODUCTION
I've meant to write this blog for awhile. I'm privileged to look after the mailing lists for University of Alberta's Medical Laboratory Science. As such, even though I no longer teach in the division, I get all messages to students and staff plus more. The blog will focus on medical laboratory education but I suspect it rings true for other health professionals. Had help with ideas for the blog from a former student of mine, who I won't identify at this time.

The blog's title is based on a ditty written by Holly Knight and Mike Chapman, but best known by Tina Turner's recording of it.

HOW EDUCATORS  ADAPTED DURING PANDEMIC
Where to start. I'll need to speak in generalities because it differs depending on the prevalence of COVID-19 in educators' areas. Sample list of key adaptations heath profession educators had to make:
1. Managing the chaos of ever-changing information. Suspect most people know how hard this is as regulations and policies regularly change as new evidence becomes available. Good example is the changing advice on the AstraZeneca COVID-19 vaccine as research and real world evidence become available.

2. Online learning. This was a major transition, involving putting course material online. Much harder for instructors who didn't use Powerpoints regularly, instead had in-class activities. 
Not all students enjoy online learning as much as face-to-face interaction with classmates and instructors, nor do the assignments, required pre-reading, etc. That's true for in person classes too but worse with online learning. Plus it's much easier to be distracted when text messages arrive as today's students pretty much have their cell phones on at all times.

Online learning also put much stress on university, community college, and technical institute IT departments.

3. In introductory courses, depending on when the pandemic was declared, students had a different laboratory experience than in prior years when all routine labs and a final exam were performed before entering the clinical year. Similarly, for other pre-clinical experiences such as phlebotomy visits to outpatient labs, etc.

Ultimately, some in-person introductory lab courses resumed, but required many adaptations in student labs. Examples: Fewer students in each lab space (e.g., one lab becomes two), shower curtains erected for students facing each other on the same bench, between labs sanitizing high touch areas (door knobs, bench areas, reagent bottles).

4. In the clinical year, depending on when the pandemic was declared, students were pulled from the sites until safety precautions could be put in place. This required re-scheduling.

5. Depending on how many institutions, healthcare organizations are involved, processes and procedures could differ, requiring educators to meet the needs of each.

LEARNING POINT
To me all healthcare educators deserve a loud round of applause for how they've had to adapt during the COVID-19 pandemic to constantly changing regulations and policies. In some ways I'm glad I retired decades ago as I would have found this difficult even then.

FOR FUN
Chose this song because to me healthcare educators have been simply the best during COVID-19 pandemic. To me they're heroes similar to those on the frontlines.

• Simply the best (Tina Turner, Barcelona, 1990)

As always, comments are most welcome (you can do so anonymously or by name below) and  there are some.

I will remember you (Musings on healthcare heroes during COVID-19 pandemic)

 Updated: 1 March 2021

February's blog is about healthcare workers who have been infected and died from COVID-19 worldwide, and who have made many sacrifices for us all.

INTRODUCTION
The idea for the blog was stimulated by  a series of news items posted in TraQ's Feb. newsletter (Further Reading). Also by the fact that so many healthcare professionals have put their duty to patients above the safety of themselves and their families. COVID has also highlighted invisible health professionals such as medical laboratory technologists/biomedical scientists who have shone with dedicated work to test for COVID-19 infection. Plus

Emergency Medical Services (EMS) emergency medical technicians Also those who work for low wages in long term care facilities, often immigrants who need several jobs to make a go of it, and  personal care workers. 

I could also focus on many non-healthcare heroic workers during the COVID-19 pandemic. If I've missed any, please send a comment. Examples (Some in Further Reading):

• Hospital cleaners and maintenance staff
• Daycare workers
• Teachers, teachers' aides, school janitors
• Apartment housekeeping & maintenance staff
• Meat plant workers (often immigrants) who are often housed in close contact with other workers
• Grocery and food retail workers
• Food delivery drivers
• NEW: Transit workers who transport essential workers to and from work (Thanks, Penny)

The blog's title derives from a 1995 Sarah McLachlan song.

THE EVIDENCE
Folks, there is overwhelming evidence that health professionals and many others have stepped up to the plate during the coronavirus pandemic. I do not need to belabour the point. The aim of this blog is to celebrate their contributions around the globe at great personal cost to themselves not just dying but also anxiety and depression.

• While the numbers of those dead due to COVID-19 are overwhelming, it's key to remember that each of these folks are individuals, someone's 'significant other', child, mother, father, brother, sister, aunt, uncle, cousin, friend. 
• As of 12:39 pm Central European Time, 1 March 2021, there have been 113,695,296 confirmed cases of COVID-19, including 2,526,007 deaths, reported to WHO. (Further Reading) 
• See stories of some folks who have died from COVID-19 (Further Reading). 
• Note that people of colour are more likely to get COVID-19. (Further Reading)  

I encourage you read the items in Further Reading to gain a perspective on what we owe these heroes. Also to see affected people as individuals.

As always, comments are most welcome and there are some below.

FOR FUN
Chose this song because I hope we will all remember the heroes who put their lives at risk during the COVID-19 pandemic. I certainly will, as my husband with a serious lung disease went to the Emergency Dept. by ambulance in Dec. 2020 & spent a week in hospital.

• I will remember you (by Canada's Sarah McLachlan)

FURTHER READING

• WHO Coronavirus Disease (COVID-19) Dashboard

• Remembering coronavirus victims (UK) 

• Sharing stories of people who’ve died from COVID-19 (USA)

• Why are people of color more at risk of coronavirus complications? 

• Black people 'twice as likely to catch coronavirus' (12 Nov. 2020)

• Salari N, Khazaie H, Hosseinian-Far A, et al. The prevalence of stress, anxiety and depression within front-line healthcare workers caring for COVID-19 patients: a systematic review and meta-regression. Hum Resour Health. 2020 Dec 17;18(1):100.

• Bandyopadhyay S, Baticulon RE, Kadhum M, et al. Infection and mortality of healthcare workers worldwide from COVID-19: a systematic review. BMJ Glob Health. 2020 Dec;5(12):e003097.

• Nearly 300,000 healthcare workers have been infected with Covid-19 worldwide, threatening health systems (17 Nov. 2020) | Related:
• Erdem H, Lucey DR. Healthcare worker infections and deaths due to COVID-19: A survey from 37 nations and a call for WHO to post national data on their website. Int J Infect Dis. 2021 Jan;102:239-41. Epub 2020 Oct 29.

• In memoriam: Canada's health workers who have died of COVID-19 (19 Feb. 2021)

• ICN confirms 1,500 nurses have died from COVID-19 in 44 countries and estimates that healthcare worker COVID-19 fatalities worldwide could be more than 20,000 (28 Oct. 2020)

• Canada's medical lab staff working in the shadows to help defeat COVID-19 (6 July 2020)

• Are hospital cleaners forgotten heroes in this crisis? (20 Apr. 2020)

• Canada: Alberta slaughterhouse to close temporarily amid growing COVID-19 outbreak that has claimed one life (15 Feb. 2021) | Related:
• Labour leaders want action on COVID-19 outbreaks at Alberta meat plants (29 Apr. 2020)

• USA: About 20% of grocery store workers had Covid-19, and most didn't have symptoms, study found (29 Oct. 2020)

I will remember you (Musings on a 1991 graduation speech)

Revised: 31 Jan. 2021

Folks, recently I was cleaning out a file cabinet and came across a typed copy of a speech I'd given to MLS graduates in 1991, nearly 30 years ago. Yes, I'm a lifelong packrat who now must cope with its consequences. Fortunate to have been asked to give a few graduation speeches to MLS grads decades ago. 

On the upside it made me realize that my December blog - Sweet Dreams (Musings on the benefits of a well-rounded education) - had its origins decades ago. So what I did was to scan the speech pages into my computer, convert each .jpg photo to PDF using Adobe Acrobat Pro DC, then export as Word doc so I could copy each page into this blog.

Yes, I realize that some parts of the speech won't make sense to non-MLS grads or to non-medical laboratory technologists/biomedical scientists. Yet I hope that the blog's main theme will resonate with all health professionals. See the tidbits under 'What You Learned' and 'Personal Development' below. 

SPEECH TO 1991 MLS GRADS
Thanks very much Terry [Terry the MC, was a fellow MLS instructor] for your generous introduction. I am really glad to have this time because there are a few things I still need to cover with this class.

First, I thought we would have a spot quiz. I should point out that some of the answers will only make sense to the graduates. So let's begin, then, starting with a test of your long-term memory.

SPOT QUIZ
Question #1: How many First Year MLS students does it take to change a lightbulb? Answer: Five: One to change it and four to set up Kohler illumination.

Question #2: How many Second Year students does it take to change a lightbulb? Answer: None. At least not in my class. You see, they were all asleep and the light would only have disturbed them.

Question #3: How many Third Year students does it take to change a lightbulb? Answer: The whole class. One student to change it and the rest to complain that their friends in other faculties had all summer off to do it. 

Question #4: This one is a test of your short term memory. How many Fourth Year students does it take to change a lightbulb? Answer: Again, the whole class. One to change it and the rest to complain that it should be deleted from Path 401 [Course at the time, perhaps no longer exists?] 

Before turning to the last question, could I prevail  upon John S. to come to the podium. Well, this is something you have waited a long time for. Could we have the Gingerbread Lady please. Ladies and Gentlemen - I should explain that the Gingerbread Lady, our very own Rosemarie Cunningham [hematology instructor], always brings students gingerbread men at the end of Second Year. John pulled an Oliver Twist and said, “more please’, during third year. Well, better late than never. Let’s have a hand for this cookie monster. [Rosemarie gave him a gingerbread cookie]

Question 5: And now, so the instructors won't be left out, here's the last question. How many MLS instructors does it take to change a lightbulb? Answer: Ten. One to change it and nine to evaluate whether it was done right.

AMBASSADORS

Now that the spot quiz is over there are a few things that I would  like to talk to you about  in a  more serious vein. A few weeks ago I went to the Ambassador Awards at the Convention Centre. It was attended by people from all walks of life who belonged to associations like the CSLT [now CSMLS] that can bring conventions to the city. The organizers gave out awards and asked all of us to act as ambassadors by promoting Edmonton as a convention site.

The thought occurred to me that in one way or another we all act as ambassadors. For example, when we are tourists in a foreign country, or when we interact with visitors to our city.

So I would like to talk tonight about the idea that all of you - the MLS graduates of 1991 - are going to be ambassadors for MLS whether you realize it or not. No matter what the future holds for each of you, all of the people you will meet will be gaining impressions of MLS through you, your actions, and attitudes.

Now before you say, "Good grief! I can't handle the pressure - MLSers for life" - 1 want to tell you that I have great faith in each and every one of you. As an MLS instructor I have been privileged to share a part of your life for the past three years or so. Let me explain why I think that you will be great ambassadors. In a way I feel like  mosquito in a nudist colony. I don’t know where to start.

WHAT YOU LEARNED
To begin with, there are all of the things you have learned while in MLS. And I'm not talking about the information and technical skills you have assimilated, although these are important. You have learned so much that what you have forgotten would fill a library. No, I'm talking about skills that you will find useful all your lives.

For example, you have learned how to be good listeners. Goodness knows you have had enough practice being listeners during your time here. As you begin your careers, remember the words of  a wise  person  who once said, "good listeners are not only popular everywhere, but  after a while they know something."

You have also learned how to communicate clearly, both orally and in writing. Who can ever forget their first teaching assignment? I should explain that our students give at least three presentations to classmates and instructors beginning with teaching assignments during the Third Year.

I'm sure that some of you think that teaching assignments were cruel and unusual punishment, both for the student and the audience. But, boy, do they ever pay off! The progress you made was really shown during presentation of your research projects. Your instructors and supervisors were very impressed. This will be a real plus for you in any career. I tell you this because I have seen many technologists, scientists,  and doctors who have not had the advantage that teaching assignments provide, namely to express ideas clearly and concisely.

There are many other intellectual skills you have learned, such as your grasp of the scientific method and all that entails. You have developed the ability to be skeptical about so-called established knowledge, and to be open-minded about issues. You know that it is okay to say, "Gee, I don't know, but  I will find out." You know how to learn. You will draw on these skills over and over again, especially because medical laboratory science is evolving so rapidly.

PERSONAL DEVELOPMENT
I would like to shift for awhile to some of the ways you have all grown in your personal development. Those of you who entered MLS lacking self-confidence have seen your belief in your abilities increase. Self-confidence is essential because no one will believe in you if you don't believe in yourself. I'm not talking about being over-confident and self-important, but rather about the quiet self-assurance of people who are competent and know it.

Conversely, if you came with a fair degree of self-confidence, if you were like me at 18 (and trust me, I was18 once - and thought I pretty much knew everything) - then your experiences in MLS have added  to  your growth by teaching you humility.

Your entire Third Year was an exercise in discovering your strengths and weaknesses, coming to terms with them, and  accepting both praise and criticism gracefully. It was hard to be evaluated each and every day of your hospital rotation; it was hard to accept feedback that you may or may not have felt was justified. 

But you all did it, and because of this you will have a big advantage in the workplace, as well as in life. Having a positive approach to learning will  always serve you well. You know that imperfection is only human. The important thing is that we all  try to do better. And keep in mind that misery is optional.

You have also learned what friendship means. In the years ahead, you will remember your friends very fondly. One definition of a friend is "a friend is one who dislikes the same people that you dislike." There is a lot of truth in this, but a  better way to think of friendship is to realize that  the only way to have a friend is  to be one. You have all done that during your university days.

 Thank you very much asking me to speak and for listening.

/////////////////////////////////////////////////////////////////

As always, comments are most welcome. Now that you've read the graduation speech, please see an earlier blog closely related to this one: Sweet Dreams (Musings on the benefits of a well-rounded education).

FOR FUN 
This song by Canada's Sarah McLachlan seemed right for a speech given 30 years ago. Fact is, I remember all my 'kids' (those I taught decades ago) with a great deal of affection.

• I will remember you 

Sweet Dreams (Musings on the benefits of a well-rounded education)

Updated:  1 May 2022 (Added full names to MLS grads)

No blog for a few months but wanted to write one for the end of 2020 and specifically the holiday season. December’s blog will discuss the benefits of a well-rounded medical laboratory science education. But I hope that the blog’s theme rings true for all transfusion medicine professionals.

The idea for the blog was stimulated by a message I wrote last year for an alumni reception of the MLS program I once taught in. As I couldn’t attend the Director asked me to send a greeting that she would read out. I’ve adapted it to a blog format and omitted some personal memories and the names of those MLS grads I mentioned.

NOTE: Often MLS grads from the 1990s could not find jobs due to Alberta's Conservative government cutting clinical lab funding by 40%. (See Further Reading) Many were forced to seek work in the USA and overseas. Some decided to change careers. In both cases they had the soft skills needed to succeed: love of learning, communication skills, and the ability and skills to be lifelong learners.

The blog's title derives from a song co-written by Annie Lennox and originally released by the Eurythmics in 1983.

INTRODUCTION

Greeting to all Med Lab Science grads, no matter when you graduated. The oldster has two messages for all of you. First, I must tell you a bit about myself, but only so that you will appreciate - once you hear my messages - that I know what I'm talking about. In brief, I know the international scene in medical lab science well. Some examples (I excluded several others):

• Founded a mailing list in 1994, MEDLAB-L, which became the world's largest English language mailing list for med lab professionals in all disciplines: 2400+ subscribers in 50 countries.
• Still a list manager, albeit a silent one in the background, for CLSEDUC-L, the mailing list of U.S. clin lab science educators in all disciplines. All the leading educators are members, including textbook authors.
• For decades I’ve been the webmaster for the TraQ website of the BC Provincial Blood Coordinating Office which distributes a monthly newsletter to 1000s of transfusion professionals all over the world. 

ANECDOTES 

1. In the 1990s medical laboratory technologist positions became scarce in Alberta due to severe government cutbacks. Many MLS grads went to work in the U.S. as they had written ASCP (MT) examinations when they graduated. I know from my extensive contacts there that MLS grads were highly valued and considered excellent. One reason of several was their long internship in clinical labs. The clinical rotation is shorter now, pretty much everywhere.

2. Several also worked in NZ for its national Blood Transfusion Service. To facilitate that adventure, I sent copies of the MLS curriculum to the NZ registration body. The NZBS runs blood centres and also pretransfusion testing laboratories.  

3. In the 1990s out-of-the-blue I was contacted by a company (Wyndgate Technologies, now part of Haemonetics) in Sacramento, California who made software for transfusion labs. The company had given a demonstration of their LIS software to staff in Hamilton, NZ for the New Zealand Blood Service. They were so impressed by the 5 MLS grads working there that they wanted to know if MLS had any more like that. 

Turns out two grads were game and worked for the company for many years, travelling all over the U.S. demonstrating the software for new clients. One was a NAIT graduate, who took MLS’s degree-completion program for technologists with general certification from CSMLS. 

WHERE LIFE TAKES US

In MLS you obtained 3 main skills:

1. Extensive knowledge in all MLS disciplines; 
2. Sound practical training in clinical labs;
3. Priceless so-called 'soft skills' that are transferable to many occupations, especially communication skills and the ability to be a lifelong learner.

To me it's always been the third that's most valuable because we never know where life will take us. Most MLS grads went on to long careers in clinical labs, where many became supervisors and managers. Some rose to high positions in healthcare organizations.

Other MLS grads followed different paths. Some got post-secondary Masters or PhDs and became researchers, Deans in technical institutes and universities. Several became MDs and rose to high positions in healthcare. Others became lawyers, nurses, dentists, physical therapists, investment brokers, real estate agents, sales representatives, information system specialists.

I’ll highlight but one MLS grad: Susan Wong was born in AB to immigrant parents and when she entered grade one she spoke only Chinese. She worked in her parents’ modest restaurant, as did her sisters. After working as a med lab technologist Susan became a lawyer and progressed to be a tax specialist who was the Regional Director at the Department of Justice Canada in Vancouver. Susan was appointed a judge of the Tax Court of Canada by Canada’s Governor General and now has the title Honorable as part of her name. Hope to add Susan to the grads below.

LEARNING POINTS

#1: As an MLS graduate be aware that your hard work has resulted in graduating from one of the world's top medical lab science programs. Not just top Canadian MLS program, but one of the world's finest MLS programs. As someone active on the international scene for decades, I can attest to this. 

Concrete Evidence: In 1998 MLS won a worldwide competition to put on a 5-day seminar in Saudi Arabia for the healthcare division of Saudi Aramco (Saudi Arabia's national oil company). 

#2: With an MLS degree you can become anything. You can work as a med lab technologist in Canada, the USA, and beyond or get further education in any field. 

Indeed, most of my 'kids' work as medical lab technologists in labs across Canada, not just in Alberta but literally from coast to coast to coast, including New Brunswick in the east, BC in the west, and Whitehorse, Yukon. As such they make important contributions to Canada's healthcare system. Yes, I'm incredibly proud of all my 'kids'. 

But if you want to, with an MLS BSc - and being skilled lifelong learners - you can take further education and enter any profession. The sky's the limit. You have the education to be FUTURE LEADERS in wherever life takes you. Never forget it.

SECRET TO SUCCESS

Regardless of the health profession it’s the so-called 'soft skills' that are transferable to many occupations, especially communication skills and the ability to be a lifelong learner. Not all the facts you have learned, though they are important to being a competent health practitioner.

PHOTOS OF SOME OF MY MLS 'KIDS' (Many taken by me)

• Still hope to include more MLS grads in the future.
• Liz McBride,  BSc (MLS), MLT, LQM, ASQ CQA 

• Director of Accreditation, CPSA (until retired)
• Program Manager, Laboratory Accreditation Services,CPSA  (Managed the accreditation of over 160 diagnostic medical laboratories in AB)
• Team Leader, Western Canada Diagnostic Accreditation Alliance (WCDAA)  
• Laboratory Data Centre Supervisor - Client Response Services (CRS)/Specimen Control Capital Health Authority - University of Alberta Hospital (UAH)
• Technologist I/ Technologist II, Dept. of Laboratory Medicine, UAH
•  Many volunteering experiences, including with
• Standards Council of Canada 
• Clinical & Laboratory Standards Institute 
• Member Diagnostic Laboratory Programs Advisory Committee, NAIT 
• Chair, Combined Laboratory & X-Ray Technology Program Advisory Committee, NAIT  


• Dr. Carol Ewanowich, BSc (MLS), PhD (medical microbiology) & MD (anatomic pathologist), RAH at Edmonton Pride Parade 
  
  
  
• Colleen Young, BSc (MLS),worked for CBS for years, & currently Macopharma marketing Manager in Lille, France 
  
  
  
• Brenda Moltzan, BSc (MLS),longtime medical lab technologist, University of Alberta Hospital 
• Francene Starko, BSc (MLS) longtime medical lab technologist (Dynalife)
• Liz McBride, BSc (MLS), medical lab technologist,UAH, who became Director of Accreditation at College of Physicians and Surgeons of Alberta & more.

• Sonja Chamberlin, BSc (MLS), MEd (Post-secondary Studies), clinical instructor in MLS, now Dean, School of Health and Public Safety at SAIT
• Chris Ward, BSc (MLS), MEd, now Associate Professor, Faculty of Medicine & Dentistry, Dept. Lab Med & Pathol, Division of MLS, who teaches multiple transfusion science and immunology courses, plus is involved in a multidisciplinary UAlberta course. Earlier he worked in multi-discipline 'core lab' then got my job and volunteered for CSMLS on exam panel when that was allowed.
  
  
  
• Lisa Denesiuk, BSc (MLS), ART(CSMLS), MT (ASCP) SBB, Learning management specialist at DynaLIFE Medical Labs 
  
  
  
• Judy Wong, BSc (MLS), longtime medical technologist at CBS (photo of me & Judy) Judy was one of the grads who went to work for the NZ Blood Service in the 1990s.
  
  
  
• Lisa Purdy, BSc (MLS), MSc (medical microbiology & immunolgy)
• First non-physician, non-PhD Director of MLS;
• Assistant Dean, Graduate Student Affairs, Office of Advocacy & Wellbeing at University of Alberta
  

• Anne Halpin, BSc (MLS), MT (ASCP), MSc, Trinity College, Dublin, (Community Health/Public Health), PhD candidate UAlberta (transplant immunology);

• 2018 Outstanding Technologist Award by the American Society for Histocompatibility and Immunogenetics
• UTSW Medical Center (Dallas, Tx), Senior Medical Technologist
• Current position: Laboratory Scientist II, Alberta Health Services
  
  
   

Dr. Craig Kuziemsky, BSc (MLS), Bachelor of Commerce (Management Information Systems), PhD (Health Information Science); 

• University Research Chair in Healthcare Innovation, UOttawa; 

Current position: Associate Vice-President, Research, MacEwan University

Dr. Susan Nahirniak, BSc (MLS), MD +Hematopathology certification, University of Alberta; 

• 2020 Physician of the Year for Edmonton Zone Medical Staff Association; 
• Medical Director, Transfusion Medicine at Alberta Health Services;
• Section Chief/ Divisional Director for the AHS Edmonton Zone Transfusion Medicine Service;
• Deputy Clinical Department Head for Laboratory Medicine and Pathology
• Member of the Alberta Blood Office Collaborative (ABOC)
• Canada's National Advisory Committee on Blood and Blood Products (NAC) 
• International Collaborative for Transfusion Medicine Guidelines (ICTMG).

Photo of me & Susan 

Jodi McDonald, BSc (MLS); 

Quality Control Manager, Alberta Research Council

Quality Control Analyst, KS Avicenna Inc.

Founder & President of Keystone Labs Inc. (2005-present) 

                            

• Shelly Chamaschuk, BSc (MLS), LL.B, admitted to the Alberta Bar;
• Current position: Partner at Reynolds Mirth Richards & Farmer LLP
• Volunteer and leadership experience:
• Past President, Youth Empowerment and Support Services (YESS) Board of Directors (2003 - 2012);
• Presenter, Edmonton Community Foundation;
• Lecturer, Legal Education Society of Alberta;
• Past Presenter, Metro Continuing Education, Edmonton Public Schools.
• Prior work experience:
• Regional Coordinator for Edmonton's then Capital Health Authority, Department of Laboratory Medicine;
• Worked as a medical laboratory technologist in Saudi Arabia;
• Worked with a humanitarian aid project (Osvita medical project) in Kyiv, Ukraine. 
• Photo of me and group of Canadian medical technologists in Oslo, 1996 for a world congress. Shelly is third from the right, next to my spouse. 
  
  
  
• Dr. Gordon Chan, BSc (MLS), PhD (medical biochemistry);
• Post-doc fellow, Fox Chase Cancer Center, Philadelphia, PA; 
• Research scientist, Cross Cancer Institute, Edmonton (2002-present);
• Associate professor, University of Alberta (2002-present)
• Chan laboratory website 

                                              

• Roberta Martindale, BSc (MLS), MT(ASCP), MEd (Adult education) Work history:
• Clinical Labs of Hawaii
• University of Alberta, Faculty of Medicine & Dentistry, Dept. Lab Med & Pathol, Division of MLS - MLS instructor (Clinical Chemistry)
• Current positions: Associate Professor and MLS Program Coordinator, University of Alberta, Division of MLS 
• Instructing in Histology, Foundations of Instrumentation and Laboratory Management

                                           

Darcy Fortier, BSc (MLS), MT (ASCP) Work history: 

Medical Technologist, Associated Pathologist Laboratories 

Implementation Specialist, Sunquest Information Systems

Implementation Specialist, Misys Healthcare Systems

Business Systems Advisor, Dell Services/NTT DATA Services 

Current position: Sr. Business Analyst - LIS at Verity Health System

Enterprise Application Administrator III, MultiCare Health System 

 

Stay tuned...more graduates to come.

As always comments are most welcome and there are some.

Addendum: Please see my latest blog, which is related to this one: I will remember you (Musings on a 1991 graduation speech)

FOR FUN

• Sweet dreams are made of this (Annie Lennox, Hyde Park, London: Live 8, 2005)

FURTHER READING

• Lab restructuring
• General HC restructuring under Premier Klein .html

Revolution (More musings on using artificial intelligence in transfusion medicine)

Updated: 3 Sept. 2020 (Added to Learning Point)

August's blog will discuss the issue of artificial intelligence (AI) & 'big data' in medicine and health.

The idea for the blog was stimulated by a fascinating article in The Economist of June 13-19 as part of its Technology Quarterly: 'Driverless cars illustrate the limits of today's AI.' (Further Reading)

The blog's title derives from a 1968 ditty by the Beatles written by John Lennon

LIMITATIONS OF AI

According to The Economist article, the following are some of AI's current limitations that I've chosen to highlight. Yes they relate to self-driving cars but most have broad applicability relevant to medicine:

1. Self-driving cars work similar to other applications of machine learning. Computers crunch huge piles of data to extract general rules, and in theory the more data, the better the systems perform.  

But deep-learning is statistical, linking inputs to outputs in ways specified by training data. That leaves them unable to cope with “edge cases” ­ unusual circumstances that are not common in those training data.

• You can imagine if this applies to driving cars how much it can apply to the complexities of human beings, their health, symptoms, medical needs, etc. Humans can cope with oddities much better than AI, which in some ways works with only half a brain. 

2. Google’s “Translate” often does a decent job at translating between languages. But in 2018 researchers noticed that, when asked to translate 18 repetitions of the word “dog” into a language spoken in parts of Nigeria and Benin and back into English, it came up with the following hilarious translations:

• “Doomsday Clock is at three minutes to twelve. We are experiencing characters and dramatic developments in the world, which indicate that we are increasingly approaching the end times and Jesus’ return.” 
• Fact: Google’s system doesn't understand language because concepts like verbs and nouns are alien. It's constructed using statistical rules linking strings of letters in one language with strings of letters in another and is baffled by questions a toddler would find trivial. 

3. Richard Sutton, AI researcher at the University of Alberta and DeepMind, published “The Bitter Lesson” (Further Reading) arguing that AI history shows that attempts to build human understanding into computers rarely work. The “bitter lesson” is that “the actual contents of [human] minds are tremendously, irredeemably complex…They are not what should be built in [to machines].” 

Christopher Manning of Stanford University’s AI Lab notes that biological brains learn from far richer data-sets than machines. 

4. About Big Data, which makes AI possible, see 'Big Data in Healthcare' (Further Reading). The conclusion: 'While big data provides great potential for improving healthcare delivery, it is essential that we consider the individual, social and organizational contexts of data use when implementing big data solutions.'  Personal note: 

* The lead author is one of my UAlberta Med Lab Science 'kids'. 

LEARNING POINT

AI has a long way to go before it can be safely used in self-driven cars. Despite the hype, AI has an even longer road to travel before it's as safe and reliable as human health care professionals. Feel free to disagree. 

The entire Technical Quarterly in The Economist, June 13-19, 2020 deals with AI and its limits. As its many proponents hype AI and Big Data, it's prudent to show their limitations too. Included articles:

1. Reality check: After yrs of hype,an understanding of AI's limitations is beginning to set in
2. Data - Not So Big: Data can be scarcer than you think and full of traps
3. Brain Scan | An AI for an eye: Pioneering ophthalmologist highlights the potential, and the pitfalls, of medical AI
4. Computing Hardware | Machine Learning: The cost of training machines is becoming a problem
5. Road Block: Driverless cars illustrate the limits of today's AI
6. The Future | Autumn is coming: As AI's limits become apparent, humans will add more

Note:  If you don't subscribe to The Economist, perhaps take a trial one? Or check if your hospital is affiliated with a university, college (or perhaps the public library) has it available.

As always, comments are most welcome. And there are some.

FOR FUN

I chose this song because pretty much everyone has hopped on Big Data and AI bandwagons as if they're a revolution that's going to sweep traditional medicine aside. Maybe but I suspect not for years.

• Revolution (by the Beatles)

FURTHER READING

Driverless cars illustrate the limits of today's AI - They, and many other such systems, still struggle to handle the unexpected (The Economist, June 13-19, 2020) 

Prior AI blog (30 Nov. 2019): I can see clearly now (Musings on using artificial intelligence in transfusion medicine)

The Bitter Lesson by Rich Sutton (19 Mar. 2019)

Rich Sutton, University of Alberta | Also see this bio

Kuziemsky CE, Monkman H, Petersen C, et al. Big Data in Healthcare - Defining the digital persona through user contexts from the micro to the macro. Contribution of the IMIA Organizational and Social Issues WG. Yearb Med Inform. 2014;9(1):82-9. Published 2014 Aug 15.