Dr. Shazma Mithani, MD, FRCPC

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Dr. Shazma Mithani, MD, FRCPC I am an Emergency Doctor in Edmonton, Alberta at one of the busiest inner city emergency departments

08/19/2026

E-scooters may look like toys, but the injuries we’re seeing in kids tell a very different story.

New Canadian data should make parents take notice.

In a 2025 Canadian Paediatric Surveillance Program (CPSP) survey, pediatricians reported 57 cases of severe injury related to e-scooters and e-bikes in children under 18.

Of those:
• 10 children died
• 12 were admitted to an ICU
• 26 had prolonged hospitalizations
• About one-third required surgery
• Head injuries were the most common injury reported

And an important clarification: these numbers include both e-scooters and e-bikes, so we cannot say that 10 children died specifically from e-scooters.

But the broader evidence around e-scooters is concerning. These devices can accelerate quickly, reach significant speeds, and put kids in situations where a fall or collision can result in serious trauma.

I’m also not arguing that kids should never take risks.

Risky play is important. Independence is important. Active transportation is important.

But there are ways for kids to take risks that build confidence, coordination and independence without putting them on a motorized device capable of travelling upwards of 30 km/h.

The Canadian Paediatric Society currently recommends that children under 16 not use e-scooters or e-bikes, or ride on them as passengers.

For me, this isn’t about eliminating risk from childhood. It’s about choosing developmentally appropriate risk and recognizing that an e-scooter is a motorized vehicle, not a toy.

Do you let your kids ride e-scooters? Have these numbers changed how you think about them?

Source: Canadian Paediatric Society / Canadian Paediatric Surveillance Program, 2025 survey on severe injuries associated with e-scooters and e-bikes.

08/11/2026

One of the most important things we learn in medicine isn’t what to think, it’s HOW to think.

Working through a diagnosis teaches you to recognize when something doesn’t quite fit. When the obvious answer might be wrong. When you need to dig deeper, reconsider your assumptions or ask for help.

That critical thinking can literally change the outcome for a patient. This is why I keep wondering about AI and the next generation of learners.

If AI can instantly give you the differential diagnosis, summarize the evidence and suggest the next step, what happens if you never fully develop the reasoning skills that would have gotten you there yourself?

Now, don’t get me wrong…AI has enormous potential in medicine, and I don’t think avoiding it is the answer. I use it daily.

BUT, I do think we need to make sure we’re using it to augment critical thinking, not replace it.

At the end of the day, knowing the answer is one thing, but knowing when the answer doesn’t make sense is an entirely different skill.

In medicine, that distinction really matters.

08/06/2026

Most people apply WAY too little sunscreen, which increases the risk of sun damage and sunburns. Here are a few important things to keep in mind:

The Shot Glass Rule - 1 full ounce (about 1 shot glass, or 2 tablespoons) covers your whole body

The Teaspoon Rule - roughly 1 teaspoon per body area: face + neck, each arm, each leg (front and back), chest, back

Be sure to use Broad spectrum, SPF 30 or higher, water resistant sunscreen. It must say UVA AND UVB protection.

Apply 15 minutes before going outside. Reapply every 2 hours, and always after swimming or sweating.

Add a wide-brimmed hat (3-inch brim, not a baseball cap), UPF 30+ clothing, UV-blocking sunglasses, and shade between 10am–4pm.

A few important differences for kids:
- Under 6 months: NO sunscreen as your main strategy. Keep babies in the shade, use covered strollers, and dress them in lightweight long sleeves, long pants, and a wide-brimmed hat. A small amount of sunscreen on the face and hands only is okay if shade isn’t possible.

a Over 6 months: Choose a MINERAL sunscreen (zinc oxide or titanium dioxide) because it’s gentler on sensitive skin than chemical filters. Still SPF 30+, broad spectrum, water resistant.

- Skip the sprays when you can since they go on unevenly and kids end up with missed spots and burns. If a spray is all you have, spray until the skin glistens, then rub it in.

- Rash guards and swim shirts are your best friend because it means way less sunscreen to apply and reapply.

- Don’t forget ears, tops of feet, the back of the neck, and lips (SPF 30 lip balm).

07/31/2026

Is a full body scan the smartest way to catch cancer early?

Whole body MRI screening is being sold as peace of mind for healthy adults. Though many may confuse this for a modern upgrade to cancer screening, it’s actually a test with almost no evidence behind it for people without symptoms or risk factors.

In recent screening data, the vast majority of scans turned up a finding of some kind, but very few of those findings were cancer. The rest led to more imaging, more biopsies and more anxiety over things that may never have caused harm. Canada’s radiologists have said plainly that until there is real evidence this improves outcomes, they do not endorse it for average risk adults.

Instead, focus on the screening tests that are actually proven to save lives (but are far less glamorous):
- Mammography for breast cancer
- Colonoscopy or FIT testing for colorectal cancer
- Pap or HPV testing for cervical cancer
- Low dose CT for lung cancer in eligible current or former smokers

These are the cancer screening tests with decades of outcome data behind them.

Whole body MRIs are used in a very small subset of the population that carry genetic mutations or hereditary syndromes that put them at meaningfully higher risk. For these groups, specialized imaging protocols may be appropriate under a specialist’s guidance.

Thankfully, evidence based screening does not need to be expensive or exotic to work. It needs to be targeted, consistent, and grounded in data.

So, I would save your money until the data is more convincing and the benefit clearly outweighs the harm.

What happens when the same group of doctors is asked the same question four times over five years, and gives the same an...
07/28/2026

What happens when the same group of doctors is asked the same question four times over five years, and gives the same answer every time.

A new CMAJ study followed a cohort of Canadian emergency physicians from the start of the pandemic through January 2025. The findings: burnout has not moved since the height of COVID. 65 percent of respondents are scoring high on emotional exhaustion, depersonalization, or both. Almost half have cut their clinical hours just to stay in the job. One in ten have left the specialty entirely.

The study’s own thematic analysis identified five interconnected causes: a broken health care system, unrealistic societal expectations, insurmountable workplace challenges, physician distress and wanting to leave emergency medicine. The quotes in this carousel are pulled directly from physicians’ survey responses under each of those themes, not from summary language. Doctors describing a system that hands emergency departments the failures of everywhere else, then asks them to absorb it without the resources to do so. Patients who no longer have anywhere else to go. Colleagues quietly accepting that the job, as it currently exists, may not be sustainable.

The study’s own thematic analysis identified five interconnected causes: a broken health care system, unrealistic societal expectations, insurmountable workplace challenges, physician distress and wanting to leave emergency medicine. The quotes in this carousel are pulled directly from physicians’ survey responses under each of those themes, not from summary language. Doctors describing a system that hands emergency departments the failures of everywhere else, then asks them to absorb it without the resources to do so. Patients who no longer have anywhere else to go. Colleagues quietly accepting that the job, as it currently exists, may not be sustainable.

The study’s own thematic analysis identified five interconnected causes: a broken health care system, unrealistic societal expectations, insurmountable workplace challenges, physician distress and wanting to leave emergency medicine. The quotes in this carousel are pulled directly from physicians’ survey responses under each of those t

07/21/2026

Most rashes can wait for an appointment, but this is one that shouldn’t.

A painful, blistering rash on the tip of your nose can be a warning sign that shingles is affecting the nerve that also supplies your eye. This is called Hutchinson’s sign, and it increases the risk of eye involvement, which can lead to permanent vision impairment if not recognized and treated promptly.

Thankfully, early treatment is effective. Antiviral medication works best when started within the first 72 hours of the rash appearing, and if your eye is involved, you’ll likely need urgent assessment by an ophthalmologist.

One important point: Hutchinson’s sign is a warning sign, not a guarantee. Some people with shingles on the tip of the nose never develop eye complications, while others can have serious eye involvement without a rash on the nose. That’s why any shingles rash on the forehead, around the eye, or on the nose, especially if accompanied by eye pain, redness, light sensitivity, or changes in vision, should be assessed urgently.

Shingles is preventable. Vaccination significantly reduces the risk of developing shingles and its complications and is recommended for many older adults and others at increased risk.

Photo credit: HealthJade.net (used for educational purposes).

Share this with someone who should know that not all rashes are created equal.

This post is for educational purposes only and is not a substitute for medical advice. If you’re concerned you may have shingles involving your face or eye, seek medical assessment promptly.

07/17/2026

Canadian Summers mean both sunscreen AND bug spray together. Turns out, the order AND the type of bug spray matter.

Here’s the deal:
1. Apply sunscreen FIRST, wait 15–30 min, then bug spray on top

2. DEET (the most common repellent) reduces your sunscreen’s SPF by about a THIRD

3. Picaridin/Icaridin works just as well as DEET but does NOT reduce your sunscreen’s protection, making it the better choice when you’re layering both

4. If you do use DEET, reapply sunscreen more often and add UPF clothing or a hat

5. Skip combo sunscreen + bug spray products. They don’t work well because sunscreen and repellent have different reapplication schedules

TL;DR: Sunscreen first. Bug spray second. Pick picaridin when you can.

Save this for your next hike, beach day, or backyard hangout and follow for more practical tips to keep your entire family safe & healthy.

What does it feel like to live through the climate crisis, not just read about it?This week gave a clear answer. Wildfir...
07/16/2026

What does it feel like to live through the climate crisis, not just read about it?

This week gave a clear answer. Wildfire smoke turned the sky orange over Ontario and the Northeast United States, pushing air quality to some of the worst in the world. At the same time, parts of Western Canada are closing in on all time summer rainfall records, with streets flooding and cars stranded in water.

Though many may confuse this for two unrelated weather stories, it’s actually the same crisis showing up in different forms depending on where you live. Rising temperatures are expanding the range of mosquito and tick-borne illness. Milder winters are increasing fungal infections. Deforestation is pushing human populations closer to wildlife and raising the risk of zoonotic disease. Flooding contaminates drinking water. Displacement crowds people into close quarters where disease spreads more easily.

On the other hand, these health impacts are not evenly distributed. People with asthma, older adults, pregnant people, and outdoor workers carry a disproportionate share of the risk from both smoke and flooding.

Of course, this is only the health picture we understand so far. The full scope of the climate crisis is still unfolding.

Sources: Health Canada, Public Health Ontario, Alberta Health Services

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