How ER medicine has changed and where it's going - Dr. Eric Grafstein [SUJY #001]

Should Doctors Let Personal Beliefs Influence Patient Care? Dr. Margaret Cottle [SUJY #005]

What happens when two physicians approach medicine from very different ethical frameworks? In this episode, I sit down with Margaret Cottle, a palliative care physician, author, speaker, and prominent voice in the Christian medical community. Dr. Cottle has spent more than 20 years caring for patients with terminal illness in Vancouver, BC, and is a clinical instructor at UBC Medical School. She serves as Vice President of the Euthanasia Prevention Coalition and is involved with the Christian Advocacy Society of Greater Vancouver. Together with her husband, she also helps host gatherings for the Christian Medical and Dental Association of Canada community in Vancouver. Dr. Cottle is a vocal advocate for pro-life medicine and has been an outspoken critic of Medical Assistance in Dying (MAID) in Canada. While many of her views are rooted in her Christian faith, our conversation explores how those beliefs intersect with modern medical practice and some of the most controversial healthcare issues facing society today. As an emergency physician, my own approach is grounded in patient-centered care, respect for patient autonomy, and the recognition that people bring different values, beliefs, and life experiences into medical decision-making. This discussion examines where those perspectives align, where they diverge, and how physicians can navigate ethical disagreements while still caring for patients with compassion and respect. Topics discussed include: • Medical Assistance in Dying (MAID) • Abortion and reproductive healthcare • Contraception • Patient autonomy and informed consent • The role of personal values and faith in healthcare • Palliative care and end-of-life decision making • What patient-centered care means in practice Whether you agree with Dr. Cottle, disagree with her, or fall somewhere in between, I hope this conversation encourages thoughtful discussion about some of the most challenging ethical questions in medicine. What are your thoughts? Where should the balance lie between patient autonomy, physician conscience, and ethical responsibility? Let me know in the comments below.

From Heroin Addiction to Saving Lives in Vancouver’s Downtown Eastside [SUJY #004]

In this episode of the Stably Unstable Podcast, I sit down with Dale, a former heroin addict who survived addiction, rebuilt his life through recovery, and now works on the front lines of Vancouver’s Downtown Eastside helping people struggling with addiction, homelessness, and mental illness. We explore Dale’s personal journey into addiction, what opioid addiction actually feels like, the turning point that ultimately led him toward sobriety, and the most impactful interventions that helped him break free from addiction. We also have an honest conversation about the realities of the Downtown Eastside — one of the most heavily impacted neighborhoods in North America when it comes to addiction, overdose deaths, homelessness, and mental health challenges. Chapters: 00:48 - Dale’s Origin Story 06:03 - When addiction took over 09:25 - The appeal of opioids 12:02 - The cycle of addiction 15:35 - Dale’s experience with Fentanyl 16:55 - How Fentanyl feels different from Heroin 17:30 - Dale’s experience with overdose 19:11 - What’s it feel like to wake up in the hospital? 20:50 - Impact of harm reduction after overdose 24:14 - What is it like to go into withdrawal? 26:30 - Dale’s housing situation during addiction 27:43 - The bio-psycho-social model of addiction 29:37 - How addiction impacted relationships 34:17 - Dale’s path to recovery 37:05 - Detox centers and which resources were helpful vs not 39:00 - Advice for anyone going trying to break free from addiction 42:07 - 12 step programs 43:22 - Opioid Agonist Therapy (Suboxone / Methadone) 51:07 - Temptation to relapse 53:55 - Different substances for different issues 58:34 - Alcohol and cannabis as gateway substances Whether you agree or disagree with current approaches to addiction and harm reduction, I hope this interview encourages deeper understanding and empathy for people who are often overlooked or stigmatized. Trigger Warning: This episode contains discussions surrounding addiction, overdose, homelessness, trauma, violence, and mental illness.

Cosmetic Doctor reveals ALL her Secrets [SUJY #003]

In this vlog interview, I walk through Vancouver, BC with Dr. Jiyeh Joo, an aesthetic and cosmetic physician from Toronto, Canada, and ask her everything you’ve probably wondered about skincare, anti-aging, and the truth behind beauty trends. We break down what actually works (and what’s a waste of money), from daily skincare routines to procedures like Botox — and even where the line is between self-improvement and going too far. ------ Chapters: 00:42 [https://www.youtube.com/watch?v=J6I9r2TEQCg&t=42s] Introduction 03:00 [https://www.youtube.com/watch?v=J6I9r2TEQCg&t=180s] Eczema 07:38 [https://www.youtube.com/watch?v=J6I9r2TEQCg&t=458s] Basic Skin Care Routines 09:12 [https://www.youtube.com/watch?v=J6I9r2TEQCg&t=552s] What is K-Beauty? 10:24 [https://www.youtube.com/watch?v=J6I9r2TEQCg&t=624s] Skin Types based on oil production 11:51 [https://www.youtube.com/watch?v=J6I9r2TEQCg&t=711s] Skin differences between ethnicities 12:42 [https://www.youtube.com/watch?v=J6I9r2TEQCg&t=762s] Skin types based on melanin production (Fitzpatrick classification) 15:32 [https://www.youtube.com/watch?v=J6I9r2TEQCg&t=932s] Men vs Women – Skin care routines 16:04 [https://www.youtube.com/watch?v=J6I9r2TEQCg&t=964s] Where you should save and spend your money – Skin care products 19:30 [https://www.youtube.com/watch?v=J6I9r2TEQCg&t=1170s] Night-time cleansing hacks 20:39 [https://www.youtube.com/watch?v=J6I9r2TEQCg&t=1239s] BOTOX – everything you need to know about it 24:39 [https://www.youtube.com/watch?v=J6I9r2TEQCg&t=1479s] Melasma – what is it and how do we treat it? 26:01 [https://www.youtube.com/watch?v=J6I9r2TEQCg&t=1561s] Aging – How does our skin change and how can we slow down this process? 28:00 [https://www.youtube.com/watch?v=J6I9r2TEQCg&t=1680s] Current skin care trends – Trash or Truth? 28:13 [https://www.youtube.com/watch?v=J6I9r2TEQCg&t=1693s] Looksmaxxing 29:19 [https://www.youtube.com/watch?v=J6I9r2TEQCg&t=1759s] Red-light therapy 30:41 [https://www.youtube.com/watch?v=J6I9r2TEQCg&t=1841s] CO2 Lasers 31:10 [https://www.youtube.com/watch?v=J6I9r2TEQCg&t=1870s] Sunscreen – the cheapest and most effective product for skin care 32:15 [https://www.youtube.com/watch?v=J6I9r2TEQCg&t=1935s] Cosmetic ethics – Where is the line between optimization and body dysmorphia? 36:29 [https://www.youtube.com/watch?v=J6I9r2TEQCg&t=2189s] Emergency vs Cosmetic medicine 38:00 [https://www.youtube.com/watch?v=J6I9r2TEQCg&t=2280s] How to know if a cosmetic doctor is good or bad at their craft? ------ Dr. Jiyeh Joo is a Toronto-based aesthetic physician specializing in K-beauty and cosmetic dermatology. She shares evidence-based skincare advice, anti-aging strategies, and insights on treatments like Botox and fillers—helping you achieve healthy, natural-looking skin with confidence. Instagram: @withdr.jiyeh @rejooclinic  ------ Post-production: Ben Jones

These ER Doctors left the USA for Canada - Dr. Bischof and Dr. Derek [SUJY #002]

In Episode 2 of Stably Unstable, I sit down with two American emergency physicians, Dr. Johanna Bischof and Dr. Derek, who made one of the biggest decisions of their lives — leaving the USA to move their families to Canada and practice emergency medicine here. This isn’t a political debate. It’s a raw, honest conversation about medicine, money, safety, family, burnout, and what it actually feels like to practice on both sides of the border. We talk about: 🔹 The realities of practicing Emergency Medicine in the USA and Canada 🔹 Treating patients who can’t afford care 🔹 The emotional toll of insurance barriers and massive medical bills 🔹 Gun violence in the ER — and whether you normalize it over time 🔹 When they first started contemplating leaving America 🔹 The risks of uprooting their careers and families 🔹 The licensing process to practice in Canada 🔹 The political climate and how it showed up inside the emergency department And then we get into the practical questions: 🇨🇦 What is Canadian “socialized medicine” actually like to practice in? 💰 Financial tradeoffs — do they feel richer or poorer? 🏥 Does the average middle-class patient receive better care in the U.S. or Canada? 👨‍👩‍👧‍👦 How family planning and safety factored into the move ❗ What Canada was genuinely worse at than they expected 🔄 Would they ever go back? If you’ve ever wondered what it’s like to practice medicine in another system… Or if you’re simply curious about how healthcare really works beyond the headlines — this conversation is for you.

How ER medicine has changed and where it's going - Dr. Eric Grafstein [SUJY #001]

Dr. Eric Grafstein is an emergency physician, health system leader, and one of my longtime professional mentors. His work has profoundly shaped how emergency care is delivered—both for patients and for the clinicians working inside the system. He has been practicing medicine for over 40 years and has held some of the most influential leadership roles in emergency medicine in British Columbia, including serving as the Regional Head of Emergency Medicine, overseeing 13 emergency departments across the province. In this conversation, we dive into some of the most pressing issues facing emergency medicine and healthcare today, including: -Burnout among healthcare workers -Substance use and moral distress in medicine -Emergency department wait times and system strain -Public trust in healthcare—and how we begin to rebuild it This is an honest, thoughtful, and systems-level conversation about what’s breaking, what still works, and what needs to change if we want a sustainable future for emergency medicine and healthcare as a whole. Whether you’re a healthcare worker or someone who’s ever needed an emergency department, this episode offers rare insight into how the system really works—from the inside.