Loneliness (AAMFT Conference 2023) USA

 

22% of Adults report feeling lonely and isolated most if not all the time.  47% of people report having no meaningful relationship in their lives.

Challenges and Barriers

Money -  17 % of adults declared bankruptcy or lost their home as a result of heath care costs.

33 % stopped therapy soley because of cost.  38% of adults or family member did not seek health care because of cost.  Insurance pays 14% less while making billions.  350 individuals looking for therapy for every one mental health clinician.  Where do we go from here?  How Marriage and Family Therapists shape the future.  The kids are not ok and neither are the adults.  Mental health disorders have been on the rise since 2020.  

Mood Disorders -  21% of adults have a mental health condition.  Second leading cause of deaths for children 10-14 years of age is suicide.  31% are adults between 18-25.  One of eight emergency room visits are mental health related.  Loneliness is a global health crises.  

Loneliness, loss of connections and its impact on Mental Health -  39% more are getting some type of MH  in 2022 vs. 2019.  Innovative new way to take therapy to the people.  Relationships matter.   Intergenerational trauma and the impact of parental/family of origin has made its way to mainstream.  Harvard “happiness” study makes another resurgence to the popular media.  Tuning inward, tending to the healers.  Prioritizing our wellness as a model of sustainable care.  52% of therapists reported feeling burnout this year.  Self care is not enough.  Cultivating self - compassion - mindful awareness, self kindness, common humanity.  Shortage of professionals - financial challenges with payers- a challenge and often inequitable road and licensure.

-inadequate support systems for clinicians and students (for professors).  Systemic oppression and bio permeates all our professional layers.  Health disparities show up in every aspect of treatment.   How do you cover for something that never ends?  Representation doesn’t exist for most.  Things are changing.  Therapy speech is everywhere.  Mental Health disorders and relationships are being openly discussed by celebrities and the general public; social media.  

We need more professionals.  There will be graduating MFT’s but will not practice because they are already burnt out.

     When I decided to retire in December 2025 it was after asking the College Regulator questions and having different people answering differently.  Needless to say I was frustrated.  The college decided to provide tests, to all every five years on top of all the required extra education.  With all the intensive education we have had,  I began to lose respect for the College (Moral Injury).  Even though I believe that the public needs to be protected, that alone should be their job.  They imposed more work upon themselves therefore requiring more people thus some not really knowing what they were doing from my perspective.  They were also insulting and condescending inspecting files and when handwritten calling it chicken writing or something to that effect and letting us all know that.  I found that disrespectful to the therapists out there.  Days before I retired I was informed at a group event that the college stated no one retires from psychotherapy.  So, when I decided to retire, I was informed that retirement is not acknowledged and won’t be in the future or words to that effect and that my title would be that I resigned.  Really?  My advice from mentors in the past was to stay under the radar and why which I won’t share.  Now I have the time to study the Toronto Housing Market to make the right decision of when to sell without worrying about accommodating clients or the high cost of Registration, Insurance and courses.  That is all for now.  I shall continue to provide my notes to you until I am all done and then just focus on Writing Corner.  This weekend I will be selling my books at Motive in Toronto and will provide you with at least one more blog about that event.  I do hope that if you are in Toronto you will visit me.  Take care fo now.  Always feel free to ask a question.

Time is flying - thoughts of the week

 I just want to wish you a great weekend and be careful if you fly.  I don't and should be safe on our railroads.  Of course now that there has been an investigation at the airport perhaps those in power will listen to experts in the field - Police.   This is the same place where the gold went missing.  What are the hiring practices and why when they are flagged are they allowed to be employed?  Who hires these criminals and what are their connections/qualifications?   I also have seen absurd results from people not qualified trying to ascertain if people are guilty or not enough to bring to trial.  Well, that is why we have a democtratic society where we can vote people in and out.  If some feel they are too imprtant to explain themselves, there may be an adjustment period to find someone more responsible.  I am curious if people who have been victimized and are innocent are going to sue.  Money talks.

     I am amazed at how quickly time flies.  I am still slowly updating and de-cluttering and upgrading.  Well not really upgrading.  I am getting there.  What I don't need, is going to the front of my lawn for others to take.   I am thinking about erecting a sign on my lawn about my books.   I can but there are so many rules about that and again there are security concerns.  I have ordered business cards for my books which if I get in time will be handing out at Motive.  I love summer and during the writer's conference, I mentioned to someone that maybe I should consider going South for the winters.  I mentioned I love Disney World.  The writer gasped, "They're all replublicans in Florida."  My response was that I didn't really care about the politics,  I just wanted sun and Disney.  She replied that they had crocodiles.  Now that I am concerned about.  Well, for now I shall stay put.  There is a lot of excitement in my city.  My neighbourhood has become a tad more quiet with the construction.   I have debated placing the house back on the market but I am losing the debate.  It is still a poor market for sellers.   Buyers if you don't buy now you will miss that chance.  People want a house but don't want to pay high prices.  Sellers sell when they have to.  Do I have to?  Nada, but I would like to.  Bring me an offer or disappear is what I kindly tell the vultures.  So,  I want to plant some flowers, trim some trees, go to the gym.  Oh yes the gym.  I was there the other day and an older man approached me when I was on the bicycle.   His wife (I think she is) told me not to be afraid, that he was sick.  I noticed he had a heavy weight in one hand hanging firmly.  Don't be afraid?  I have to admit I kept a close eye on him, especially when he went behind me.  I could just see it.  "Toronto woman died after being attacked by forceful blunt injury to her head with a gym training weight.  The woman was cycling and trying to read the Centurians when another gym member cautiously approached her and raised the weight, slamming and forcing her head open.  There was no one else in the city gym at the time aside from his devoted wife.  Silva Redigonda was known for her charm in the community and enjoyed writing books for fun.  She shall be missed.  The assailant has not been charged due to mental related health issues.  His wife is devestated."

That's all for now world.  Good talk.  We shall start with psychology notes next week.  June is a busy month, but I always have time for you.

     

Corruption or Incompetence at Transport Canada - You choose

 

Writer's Corner

 

     I am on my backyard deck listening to the sounds of my city.  There is the roar of construction by the City and by contractors rebuilding houses to fit multiple units.  I think back to my cruise and the peacefulness of nature.  It is no wonder that it has been difficult to concentrate with writing.  I hear the warning sounds of vehicles moving backwards and nature has been blocked out.  I hear no birds.  Last night I had the same agent as last year try to come to my backyard but my beautiful friend began barking and off he went.   This time he left two cards with the same message.   I have important news from him.   I sent him an email this morning and spoke of trespassing and unethical behaviour the real estate board may be interested in and he has backed off.  It’s unfortunate that at times we have to threaten the law and regulators to keep what used to be a profession honest.  I still mourn the loss of my two paintings which disappeared with the staging.  

      Even though I haven’t done much writing, I renewed my gym registration where I pedal and read at the same time.  I debated joining another club to swim, but I don’t want to deal with parking.

     I have been doing a lot of thinking about the book I am writing at leisure and all I have to do.  You know what?  I don’t have to do anything on a schedule.   I can think all I want.  Since the conference and listening to everyone and attending webinars etc…..I have an image of half man and half computer spitting out volumes of books.  There are so many tips on how to write, but I know how to write.   I don’t know business except for all the cons out there and there are many.  I had one person claiming to be a policeman reach out on facebook saying he wanted to be friends.   Normally unless I meet the person, I reject them as friends.  Most are people I have worked with around the world.  But, this particular person claimed to be a police officer and writer and I suspect he is neither.  I told him I would check him out first.  He asked how I would do that and so strike, he is not police.   He sent me a chapter of his book which he was selling on Amazon and there is no way this person could write what he sent me.  He was selling a book, I am sure  completely generated by IA.  He never reached out to me again because he knew that I knew exactly what he is.  There are too many books out there now being sold and it is not by the person claiming to be an author.  At the conference a lot was about selling your books and maximizing your profits.   I am not good at that because I have always been in the service of others.  I am slow in that department because my focus is on writing stories.  There are about 6000 new books published each day and some are just awful.  I was thinking about my own writing and found myself telling someone that when I write it is like someone cooking who has done so for years.   I know the basics as I have been writing since I was a child.  You know what I mean all that stuff about nouns, verbs, structure, plot etc…..My passion for literature was a hobby an escape from the seriousness of other courses.  I loved creating stories and creative writing.  So,  I explained myself as similar to a home cook who knows what ingredients to use and sprinkle without the use of a cook book, one who uses a dash of this and an experimental test of that and manages a delicious dish.  This is what I do.  I use all of me to create a story which I may alter at any point or go into another direction or add a new character and there, I have my own master dish.   How do I get it out there?  I’ll let you know.

Theology Notes continues

 The Davidic Covenant (Interculteration of Sinai Desert > City

1. Rise and Fall of Saul (Islam 8-15)  
2. Rise of David (Johnathon) (16-23)
3. Jerusalem and David Covenant (Johnathon 25, 6-7) 

     Incalteration -  God of Moses and God of Sinai Covenant - semi nomadic life.  Covenant is one that is moveable.  It is on the move.  You cannot pin this down on God.  Whole institution of food gathering.  Is the God of the desert, who can intervene in history?  Is this God also the God of creation, this God who lead us out of Egypt, who helped us survive the desert, also the God of civilization.  Our God is also one who brings us into tension.  My last week’s question:  How can God demand life of sin?  To appreciate it, see how it can be used in other text- Principal.  Never read a text simply on its own.  Read other texts.  We can look at the text in the political view but it can be read in another.

to be continued with  In the Shadow of your Wings.

    

My Vacation - Trying to get there

 Well, I finally took my long necessary holiday.  So, this too shall be part of my blog.  It was expensive for a four night cruise including train fair (business) at $4000.00 from Toronto, or was it?  I thought that the taxi to and from the cruise was included but no it wasn’t and that was infuriating.  In Toronto people really try to please you and that did not happen, not even under the threat that I would not recommend the trip, nor take it ever again.  So here goes - my relaxing trip.

I had ordered the taxi from Beck (Beck is a long standing taxi company in Toronto and they are managed well by a woman married to a fire fighter.  That is all I take in Toronto and I recommend them).  The trip from my home to the station cost about $25.00 and I added a tip.  Once I boarded the train, I was on my own with the suitcase which I may refer as my brief case.  It is a Walmart, Air Canada special which usually suits me fine when I go anywhere by car.  However,  when I packed,  I had to be careful since it filled up fairly fast.  I only had room for one jacket, one set of spring clothes and the rest of the trip for hot weather.  My carry on cotton gym bag which I bought in Kenya, carried a thick Stephen King book which I never opened.  I left Toronto as it was going to warm up and entered Kingston knowing there would be a cool down.  My suitcase was too small to keep it where I usually do - in the luggage compartment.  I was informed by the female worker, that I had to keep it in the overhead compartment which for some reason, I couldn’t lift that high.  The female worker informed the passengers that they could not place the suitcases overhead for us because imagine their backs at the end of the day.  Well, my solution would be to make more baggage compartments - this is first class?  However, when I asked the male Via worker, there was no hesitation.  Thank you.  

     I don’t drink because of the sugar in it and my pharmacist taking a hissy fit if I do.  All I had was about three spoon full of wine at Christmas and that was enough to have him take a flip.  All free on the train and at meal times on the cruise, so they are making a deal on me.  The food was fine on the train.  I had a delightful elderly man from Montreal sitting beside me.  His mission to Toronto is top secret but I did find out that it was three times a year.  He was well dressed and looked like a professor, but in my experience professors love to talk.  He did not.  I focused on my coffee and the scenery and before I knew it, I was in Kingston (my shortest trip ever by VIA rail).  Now I had a new problem.  The elderly man’s tray had not been cleared and I was trying to leave the train.  He was taking his time, while I remarked that I did not want to end up in Montreal.  People were now boarding the train and when I finally manoeuvred around him (I had the window seat and I also had my seat changed for some reason) - no big deal.  I asked a tall handsome man if he could take my suitcase down for fear of dropping it on the elderly man’s head.  He provided a wonderful smile which lit up his face as well as mine, and gallantly performed the task for me.  At this point there were many people coming through and they suggested I go the other direction.  Since I had no choice, I did so to find out that there was no way out.  I returned when it cleared and looked at the VIA workers.  When I saw panic in their eyes,  I felt doomed.  I was going to Montreal and would miss my cruise.  They began talking on the walkie talkie while the female employee told me how sorry she was.  The male on the walkie talkie explained to her that I had been blocked from exiting.   To be continued.....

The Violence Project - notes continues

The reason  shooters leak information is because they want an intervention.

Insiders -  Physical security alone is not enough.

*****In crises - know the signs; crises intervention.  Suicidal:  Suicidal prevention, not punishment.  Leakage :  Reporting systems, relationships.  People get fired and come back to shoot as well as school suspensions.

Off ramp -  Resources of promoting on how to promote safety with one another.

FIRE ARMS:  The elephant in the room.  Second Constitution.  80% of shooters were getting them from family, home, friends and gifts.   If security/storage of firearms, then the shootings could have been prevented.  In the USA, there are 50,000 deaths a year.  A small portion are the shooters.

Violence is scripted in our (US) culture.  Mass shooters, study other mass shooters.  They get radicalized on line.  There is opportunity.

One who was bullied said, “I was almost a school shooter.  When you literally have nothing to lose, you can do anything and that thought is absolutely terrifying.”  One school mate invited him to his house and gave him pie.  No longer did he want to kill his classmates.

 

Question:  Why more prevalent in USA than other countries?  Longing for connection (Depths of despair), suicidal, alcohol/drugs.  The major contributor is able to get fire arms, but not only.

25% of shooters have a hallucination or delusion.  People with no power, wanting power.  There was a recent study of the military (US) 1/4 of mass shooters, 50 out of 200 have a military background and about 15 out of 50 had proficiency in marksman.  Must not stigmatize.  Transition of military to civilian life is a very difficulty transition.  In many cases, one is discharged from service because of mental illness or other problems.  There is a lack of resources for mental health care and not enough beds.  They need someone to check on them.  In one case, a caretaker who connected with a student prevented a shooting.  Even though they have a duty to report - key is what is going on afterwards.  Concluded.

     When we here in Toronto had a massive summer shooting downtown, I remember at a later conference that this particular shooter had problems with women, since they were not attracted to him.  The hospital here in Toronto received notes from the USA hospital where they had many patients who had died or were injured.  This meant so much for us in Toronto.  It is important that we recognize how this impacts everyone and how everyone involved needs support.  We need to support each other as neighbours during these tragedies.   

The Violence Project (notes)

When attending this conference there was a tragic shooting in Maine.  There was 16 seconds of silence for 16 killed.

     The speaker was from the Faculty of Michigan University.  The school is still traumatized.  The shooter had no connection to the university.  It was a random act of violence.  Today he also had an email from a student at the time.  He is still having PTSD.

     How to stop a Mass Shooting Epidemic,  A book cronicles -    The Violence Project.  How to stop a Mass Shooting Epidemic by Jillian Peterson, PH.D. and James Densley, PhD

theviolenceproject.org

     Jillian used to work on death row.  They wrote to prisoners and some wrote back, wanting to know their life before the shootings.   Also interviewed were people who knew the shooters, first responders etc... Mass shootings today are more violent and frequent than any other time in history, nearly six times every year.  

     Who are the Mass shooters?  Average age is mid thirties.  Clusters in age in 20's and 40's are transitional points in life.  Crisis point is pivital.  Certain locations tend to age.

Race and Ethnicity 

     White men are majority.  White men are under representative,  black over representative.  Work shooters - usually people of colour.  Latin communities - very close to families, which is why not as many shooters.

1.  Shooters are insiders - 30% work shooters.  

     Insiders - make it easier to prevent.  We can identify the warning signs.

2.  Shooters are in crisis - Total 80%  (oopsie)

Families of Shooters:

1.  abusive, neglectful - a lot of childhood trauma.  Often parents have their own MI issues.

2.  Parents knew something was wrong but didn't know how to help or connect son to resources.  Shame-afterwards.

3.  Parents know something is wrong and son is in crisis and then actually buy a gun as a gift.  Thus a court case of having responsibility.

Shooters are actively suicidal.  31% prior to attack,  40% during attack; 59% died at scene.

To reporter, "I hate MOndays."  To commissioner - wanted to be shot dead by police - tried suicide attempt but failed.

One sister reported that her brother went from what's wrong with me to blaming others.

School -  pick someone from school.

blame religion.

*****Key Point of intervention - 50% leaked their plans ahead of time.  25% studied others, left legacy token.  Usually a criminal charge and usually a felony.  Usually charged, even children.

     I am going to continue this next week.  I want to finish this before moving to another topic.  I am also going to take some R+R by spending time in the sun which just came back slowly and reading a Stephen King book.  I shall talk more next week.  In the meantime, balance your life with work and fun etc....Try a new hobby, spend time in nature, sing and dance and try something new.  Good talk.

Recommending this little Middle Eastern eatery www.orfuswrapgrill.com

https://maps.app.goo.gl/xPBet6ekwHMF2cMy6 

Theology notes continues

      Berit Covenant -  Dominant -  Relationship between God and Humanity.

Gifts/Tasks -  The weight of the Sinai Desert (I was there for six months which is detailed in my book: For Love of Country - Military Policewoman) is the task.  Sometimes you need to rest.  Even God did it (on the 7th day).  There is always an interplay of gift and task.  

Descendants and Land -  two big issues.  This is a way people are blessed.

Already in Genealogy - Sarah is barren.  

     How is the one reject, treated by God?  A whole theme here.  Why is one chosen?  You are not chosen for yourself.  You are chosen for others.  This theme is worth noticing.  There are not too many women who speak to God.  Sarah does.

Abraham promised third blessing.  Abrahamics promise is not only

for Israel but for all humanity.  These promises, are they not basic for survival?  There is a fear that if a tribe is not strong enough, it can be taken over.  A deep longing and value.  Wells are important.  That is where men find wives and Jesus speaks.  What is land if it is not a source for others (and other things as well).  Abraham is the descendants of three fathers - Kslam, Jews and Christians.

Sarah is barren.  Land is barren.  All they have is the promise.  God comes to Abraham in a dream - “Do not be afraid.  Your rewards will be very great.”  Abraham objects.  Noah was given a task to build an ark.

“Your ancestors shall be aliens in a land for 400 years.  As for yourself - this is the deep sleep or darkness…”  On that day, the Lord made a covenant, a berit.  Jeremiah 34.  Notice ritual.  Covenant usually had a ritual of what would if not.

Assignment:  God appears to Hagar two times to return to Sarah, “and  be obedient to her.

Meetings/Stepping down/ First Author event sales of the year - Motive

I just attended a meeting for retired Federal Employees. They are looking for volunteers, new members and those interested in advocating. I have now officially stepped down from all volunteer positions. I shall be enjoying life, writing and of course having fun as a priority. I have a full packed schedule regardless. My next book signing and selling my own books will be held from 11:00 to 1700 hrs (5pm). Saturday and Sunday 6 and 7 of Jun 26, with the Crime Writers of Canada. This will be hosted by Motive at Victoria University (on Uof T campus), 73 Crescent Park, Toronto.

Remember I always make myself available to sign/sell at bookstores and anywhere else.

If you are free come and visit me at table 9. I will be sharing with fellow writers. You are sure to meet many interesting people.

 

To Anonymous regarding Pedophiles

I had to remove your comments because first you did not identify yourself and second I would be liable if your accusations against this Psychiatrist is false.  I looked the person up with the Physicians and Surgeons and there is no complaint and the person is active.  You may contact the Physicans and Surgeons and file a complaint.   You may also report to the Police.  I believe that the Person is in Ontario.   I welcome comments but there are also laws against false accusations and there is a judicial process in place.  A person is considered innocent until proven guilty.  If you have a complaint please direct them to the proper authorities. 

Writer's Corner

 

     I was looking at some notes regarding a Sister’s in Crime webinar and realized I can barely read my writing.  Of course, it would be better if I typed, but memory is more reliable when we write.  Did you know that?  It has better retention.   I have returned to my writing but realize, I think, more than I write.  I’ll tell you more about how I do things another time.  Now back to the webinar.  The Host was sharing an experience.  Her rule of thumb is wait for 24 hours after an agent sends her a request.  She gave an example of yelling at the screen after receiving comments.  Later,  after reading it again, she realized she wasn’t being criticized but being asked for clarification.  I understand that.  When we receive feed back, we react by emotions.  After we wait, as the Host suggested, we have diffused the emotion and may react more analytically.  Of course,  I got a review so bad for Ominous my favourite that I am saving it.  I shall post it in the future and analyze it.  The reviewer (sole) never signed her name.  I consider that being a coward.  There was nothing concrete which I could have used.  Not only did she bash me but also my Editor who has been teaching writers for 30 years.  Yet, after that review, I stopped writing for some time, and listen to me out there.  Don’t let reviews get you down.  Take what is positive and recognize the rhetoric.  So, I too as the Host, would recommend that you wait for 24 hours before responding.  I have been asked to review books and have declined.  I know and recognize the heart and soul that goes into a book when written with passion.  I don’t want to say anything at all that would hurt a writer who has taken the time - to write.  I have had writers ask me for an opinion and usually it is about changes recommended by others.  One writer told me he had beta readers all tell him to remove one specific area which meant a lot to him.  I reminded him that it was his story.  If it meant so much to him why listen to a small group?    We can never please all the people and that is something to be remembered.  It can be difficult in what to decide and whom to listen to.   Find your network who you can trust to be honest and kind.  The Host continued that “Patience is a virtue and a reality.”  I’m not all that good with patience.  As many of you know by now when I go to confession - no patience is my staple sin.

     The Host continued with Roads to Publishing:  “Who am I as a writer?”  This particular host had 72 rejections from Agents.  She is now doing quite well.  She said she received rejections hundreds of time.  She said you require patience, determination and focus.  It is important to continue to write.

     What am I doing now?  Well,  today is a nice warm day at about 20.  I want to take advantage of every beautiful day because quite frankly it has been cold with overcast and I forgot what the sun looked like.  I still have my heat on, but the windows are open.  I am packing my bulky winter clothing away for the season.  I don’t think I shall be moving to Niagara this summer since the market is still at its lowest.  That’s ok.  I have squirrels and a bunny rabbit in my backyard as well as birds galore.  Unfortunately, there is also a Hawk wanting my fat little creatures.  After Victoria Day I want to start beautifying my planters, cut my rose bushes etc…I want to eat out side and enjoy every bit of sunshine.  For now, take care and enjoy life as you balance work and fun.  What do you think?  

   

Suicide: Continuing with Imagery helps………

 

Woman performed empty chair and read letter to husband.

Considerations:  Comfort and Safety Plan  

Foster and be present to client.  Office is a safe place.   “I’m here for you.  I will listen to you.  I will stand beside you.”

Cognitive Disorder:  Family/Friend support.  When to call in.  Risk factors and include in safety plan.  If believe burden to family, lack of purpose -  may feel  unable to move forward. Feels worthless.  Are you thinking of suicide?  Cannot determine.  Keep close eye on elderly.  They really question, “What is my purpose?  What do I do now?” (when lose partners).  “When do I call for support?  When call 911?  

“You don’t have to have answers.  You’re not alone.  I will work with you.”  

Most suicide people do not write a suicide note. When they do write one, please understand that they are at the lowest point.  Don’t take in every word.  Don’t read into it.

Difference of losing a child vs adults.  Death in general is a wound that never truly heals.  Don’t get stuck there.  Maybe you are watching a movie and pain comes right to the surface and you go into a rabbit hole.  “I should have done this (or that?”

Shame  - when standing at the grave of a child, it doesn’t have to be overwhelming then but it is always there.   A problem for clinicians is that we think we have failed.  There is a limit to what we can do.  We only have control over ourselves.  The speaker continued that he lost five patients to Suicide:  Continuing with Imagery helps……… patients who died by suicide.  They will be with him for the rest of his life.  Concluded

   

Theology notes continues

Psalm 22 (is my favourite and I recite it each day Mon to Fri)  innocent.  After Priestly writers, new writing comes - Wisdom literature.  If not, what replaces Covenant?  What is new in the new Convenent of Christ?  Is something new?  Yes.  Babylonic . Priestly writers offer hope and rework moments, creation with Noah and Abraham.

What values trying to put forward: 

Abrahamic Arch:

Genesis 12:  Call/challenge,  Promises, First speech of God to Abraham (land, descendants, and blessing of all people).   Leave and go to unkown land.  I will show you (task). Either accept challenge, wish, tripple promise. 

PROMISE -  (How do I know?)  Promise of land and promise of descendants (a gift).  The centre of the Berit Covenant is the promise (gift).  Abraham didn’t ask for it, it is purely a gift.  Double promise.

Genesis 22:  Call, Challenge, Promise - tripple promise.

to be continued.

 

Book Events - This summer events I have been invited to . I am so thankful.

 I just received an email from the Crime Writers of Canada that I will be able to attend and share a table at the Motive festival, at Victoria College, set at the University of Toronto,  from 1100 to 5pm, both Saturday and Sunday, 6 & 7 of June 26.  I really miss the University students and their enthusiasm.  Of course I have accepted. 

I have also been invited and of course I accepted, to a Writers Conference at the Coptic Centre in Mississauga,  Saturday 29 Jun 26,  to sell my books.   This time the event is closed to the public.  

I have also signed up again for Word on The Street, scheduled both Saturday and Sunday, 1100 to 6pm on Saturday 26 September 27 and 10:00 to 5pm, Sunday, 27 September 26.  The Word on the Street will be at the same place as last year across from TIFF and the theatre.  Lots of parking (which I love).  This year I will be sharing a table with another Author.  I had fun last year sharing a table and it is more cost effective.

     I do hope you come and say hi.  If you don't have any of my books, the cheapest is Hey Guy Buy Me.  

I am selling it for 5.00.   It has cartoons.

     I have also been nominated to receive a Quilt of Valour, for my Military Police Service.   I am extremely excited about that.  Of course I accepted.  Now it is just about when and where.  What an honour this is for me!  

      Good talk

        

        

      

Surgery - Cut and pasted because they don't have a share button for blogs. Also on my facebook and linkedin page

 When something goes wrong on a plane, investigators turn to the black box. Now, a similar tool is being tested in operating rooms – where researchers review synchronized video, audio and physiological data to gain a better understanding of what happens during surgery.  

Patricia Trbovich, an associate professor at the Institute of Health Policy, Management and Evaluation at the Dalla Lana School of Public Health, is using this “OR black box” not just to analyze failures, but to study what goes right. Her research shows that outcomes often hinge on small, overlooked details – how a surgical team communicates, where equipment is placed or how an operating room is laid out. 

The system captures video and audio from the operating room, patient vital signs and even the heart rates – and heart-rate variability – of clinicians, recorded through wearable devices. Originally developed by Dr. Teodor Grantcharov to improve surgical training and patient safety, the OR black box now allows researchers like Trbovich to examine how subtle factors – from team dynamics to the space around the operating table – influence how an operation unfolds. 

More than two million surgeries are performed in Canada each year. Yet national data doesn’t fully capture the challenges in operating rooms. Researchers have noted that surgical patients account for the highest rates of safety incidents among hospitalized patients, but many priorities identified by health-care experts – including outcomes that matter most to patients – are not well captured in existing data. 

That’s where black box research can help. By reviewing 195 surgeries across hospitals in Toronto and Palo Alto, California, Trbovich and her colleagues are identifying patterns that traditional reporting systems overlook. She emphasizes: poor surgical outcomes are not necessarily due to failure by clinicians. They are often rooted in system design.

“Our black box data reveals again and again that it’s not a lack of skill,” she says, “but rather a lack of design leading to most of the errors we see. I notice practitioners’ resilience – their ability to make small adjustments when the unexpected happens – much more than practitioner error.” 

MOST POPULAR

Understanding Repetitive Behaviours in Autism

The Story Behind Ozempic

A New Way to Protect Your Teeth

Professor Patricia Trbovich worked with hospitals to condense their surgical checklists (1) and improve their visibility in the operating room. All illustrations by Chris Philpott

Microphones (2) capture operating room audio while cameras (3) record the procedure.

Wearables (4) track clinicians’ heart rates – and stress levels – during surgery.

Names on surgical caps (5) promote clearer communication, less hierarchy. Combined data, gathered by the black box (6), reveal how subtle factors affect surgical outcomes.

ABOUT THE AUTHOR

Bonnie O'Sullivan

Senior Communications Strategist, Dalla Lana School of Public Health 

HUMAN FACTORS 

Rather than focusing solely on human mistakes, Trbovich asks broader questions: How was the operating room designed? Was someone interrupted at a critical moment? Was the equipment where it should have been? This approach – known as human factors – examines how people interact with their environment. 

Trbovich, the Badeau Family Research Chair in Patient Safety and Quality Improvement at North York General Hospital, has identified distractions, unclear communications and missing or poorly designed equipment as key safety concerns. Different members of the surgical team need to focus at different points in a procedure, she says. When colleagues understand those moments, they can avoid unnecessary disruptions and protect each other’s concentration.

Just as important are the often invisible adjustments teams make to prevent problems from escalating. A lead surgeon may switch roles with a surgical trainee. A nurse may anticipate the need for an extra instrument. The team may call in an expert to advise. These actions rarely appear in incident reports, but they are essential to keep patients safe. “Success often leaves no trace,” Trbovich says. “We’re trying to make those invisible moments visible.”

CHANGING OUTCOMES  

As Trbovich’s team studies OR black box data, they are developing ideas for operating room improvements. Some fixes are straightforward. For instance, hospitals often add items to the World Health Organization’s surgical safety checklist. Over time, some checklists become so long and densely printed that they are difficult to read from the operating table. Trbovich worked with hospitals to condense their lists and improve their visibility. 

Her team is also studying how to strengthen psychological safety in operating rooms. Rather than focusing only on individual behaviour, they are testing cultural changes such as adding names to surgical caps, offering opportunities for confidential feedback and creating structured pauses during surgery for team input – small adjustments that make speaking up easier and more routine.

Looking ahead, Trbovich is leading a project to develop predictive tools that could flag safety threats as surgeries proceed. The goal is to use AI to analyze black box data and provide timely alerts to clinical teams. The system is being designed with clinicians to ensure it augments – rather than replaces – human judgment. It is also being tested to minimize unnecessary warnings and avoid “alert fatigue,” says Trbovich.

Whether the solution involves redesigning a checklist or developing AI-driven insights, the principle is the same: better systems support better care. Trbovich compares it to Formula 1 racing. “F1 drivers aren’t superhuman,” she says. “They’re fast because every part of the system – the car, the track, the data – is engineered around performance.” Likewise, in the operating room, success depends on more than individual expertise. It depends on an environment designed to help skilled teams do their best work – even when the unexpected happens.