2.40 Should le Ministre wish to confirm my statement in regard to the irrelevance of MRI to my injury he may wish to consult with any of the following: Claude Lepage, Marc-Étienne Rousseau, Lindsay B. Lewis, and Alan C. Evans. All are associated with the Montreal Neurological Institute (MNI), McGill University, Montreal, Canada. All are co-authors of a recent paper published in Science 21, June 2013, Vol. 340 no. 6139 pp 1472-1475. Any one of these individuals will be able to attest to the fact that the form of MRI utilized by Dr. X is incapable of resolving any neurologic structure of less that 1 mm in dimension and that axonal injury is well below this 1 mm threshold and typically requires resolution in the 20 to 30 micron range. The diagnostic imagery ordered by Dr X is ten orders of magnitude below the required resolution threshold.
2.41 To phrase this so that it may be made abundantly clear to the members of the Collège des médecins du Québec who appear to lack knowledge of contemporary medical science, the MRI ordered by Dr. X is incapable of resolving axonal injury of the type likely suffered by me on March 6th 2011. By failing to understand this fact Dr. X, and the Collège des médecins du Québec are jointly in breech of Clause 15 of the Collège des médecins du Québec, Code of Ethics of Physicians which states: “A physician must, as far as he is able, contribute to the development of the profession by sharing his knowledge and experience, notably with his colleagues, with residents and medical students, and by his participation in activities, courses, and periods of continuing training and evaluation.” [O.C. 1213-2002, s. 15.]
2.42 Both Dr. X, and the Collège des médecins du Québec, are also jointly in breech of Clause 44 of the Collège des médecins du Québec, Code of Ethics of Physicians which states: “A physician must practise his profession in accordance with the highest possible current medical standards; to this end, he must, in particular, develop, perfect and keep his knowledge and skills up to date.” [O.C. 1213-2002, s. 44.]
2.43 The etiology of my injury is succinctly described in paragraphs 2.1 through to paragraph 2.8 of Exhibit A, the initial submission to the Collège des médecins du Québec(see End Note # 3).
2.45 I was unaware of this limitation on MRI diagnostic imagery until I was informed of this fact during an April 10th 2013 assessment conducted by Dr. T. Taylor BA(Kin), MSc, M.D., CCFP. I did not want to believe what Dr. Taylor communicated to me as I was certain that the big machine, big money, big science testing ordered by Dr. X would identify my injuries and permit accurate diagnosis. When I returned home I commenced an Internet search and discovered that Dr. Taylor’s unwelcome news is accepted medical science well known to all persons who practice in this field.
2.46 That this knowledge is not known by Dr. X is evidence that he is in contravention of Clause 47 of the Collège des médecins du Québec, Code of Ethics of Physicians which states: “A physician must avoid omissions, procedures or acts which are unsuitable or contrary to the current information in medical science.” [O.C. 1213-2002, s. 47.]
2.47 I note to le ministre that it is the responsibility of the médecin to ensure that he remains current in medical science. It is not the responsibility of the patient to be forced to educate either the médecin, or the Collège des médecins du Québec, on these issues.
2.48 As le ministre has been trained as a physician it is likely that he is familiar with the principle of “Diagnosis by Exclusion” (per exclusionem). This is the way most diagnostics are performed.
2.49 In the opinion of Dr X there is no neurological explanation for my “alleged” constellations of symptoms. In rendering this opinion Dr X has ruled out Heerfordt’s syndrome, Schwannoma, Neurosarcoidosis, Bell’s palsy, Diabetic neuropathy, Löfgren syndrome, Systemic lupus erythematosus, Sarcoidosis, ALS, Neurological fatigue, brain tumour, ischemic and hemorrhagic stroke. The only neurologic condition that Dr X is unable to rule out is the one that is not open to detection by the para-clinical testing that he employed namely DAI.
2.50 If it may please le ministre to examine the images in Exhibit E he will find no “alleged” symptoms. Le ministre will instead encounter a set of three signs that Dr X has chosen to completely ignore in his trivialization and dismissal of my injury.
2.51 The top of the frame contains images of pustules and lesions that commenced after the accident. I at first believed these to be burns resulting from contact with a cast iron fry pan. Dr Hulley has identified these as being due to a salicyte sensitivity and I believe her diagnosis to be correct. When I remove salicytic elements from my diet the lesions and pustules go into remission. Re-introduce salicylates, even inadvertently, and the lesions and pustules immediately return (provocative challenge).
2.52 Since le minstre has access to my health records he will be able to confirm that in my 12 year residency in Québec I have not sought or obtained any medical services until subsequent to March 06th 2011 at which time I commenced to be a burden on the system.
2.53 If I had experienced salicylate sensitivity at any time prior to March 6th 2011 I would have sought medical attention for this condition. I did not seek any such medical attention. Salicylate sensitivity is understood to be associated with brain trauma (I note as well that I exhibited signs of acidosis in the months immediately following March 6th 2011. These signs are now in remission. I further note that acidosis is the result of hydrogen ion perfusion and that the suspect cause of my constellation of signs and symptoms is DAI. DAI is a form of chemical trauma [as opposed to the more common mechanical trauma] and is associated with violent rotational accelerations and decelerations of the brain mass. As salicylate sensitivity manifests due to changes in brain and body chemistry it is reasonable to associate its onset with DAI which acts to introduce changes in brain and body chemistry). The pustules and lesions are a sign completely disregarded by Dr X in his diagnosis of “no neurological explanation for the extent of the alleged symptoms.”
2.54 The lower half of the frame presents another sign disregarded by Dr X. On the left of the frame you will observe a portion of a photographic security access card created by an HP Canada security officer. This security access card was created in late October 2010 preparatory to our team’s relocation to a new HP facility in Kanata on, or around, the first of November 2010.
2.55 On the right of the frame you will observe an image created by an agent of the gouvernment of Québec. Since my driver’s licence is valid from June 26 2012, and since an estimated 30 or more days are required for document processing, license card creation and lamination, and mailing to my residence, I estimate that this image was taken on a date prior to May 26 2012, i.e. within two months of the date of the accident. I suggest to le ministre that this photographic evidence does not demonstrate one of Dr X’s “alleged symptoms.” Rather, it is a conclusive evidence of a sign, that sign being significant atrophy of facial features subsequent to the accident. The fact of this second sign remains unexplained and unaddressed by Dr X’s dismissive diagnosis.
2.56 The third sign is immediately before you but I suspect le minsitre has overlooked it completely so let me make it obvious. The third sign is the document you have under review before you.
2.57 I have never written a document of this type or quality before the accident. When I worked for Lavalin I engaged in document production. Before that, in the oil industry, I wrote many analytic papers. But these were dull and plodding efforts, blasé and neutral in the extreme. They were functional bureaucratic arguments devoted primarily to marine safety, engineering, environmental, and human factors issues. Both these occupations are 27 years in my past. In the IT industry no one writes memos or reports; writing is slow and expensive. Instead we have on-line conferences which span countries and continents. Prior to the accident I have never written anything of this nature, or calibre. I have no means to account for this new ability which only became manifest subsequent to the accident.
2.58 In this document I am making confident legal and medical argument. I am making manifest and utilizing various aspects of symbolic and Boolean logic, elements I have not dealt with since university. I now have a peculiar facility with all aspects of my prior studies in a way that is highly uncommon for me and likely extremely unusual for a citizen 61 years of age.
2.59 I assert that this increased ability to write complex documents is evidence of savant syndrome. Onset of this syndrome is associated with brain injury.(On my blog www.facticity.ca you may find other examples including writing that includes what I find to be extremely creative flourishes. At no time in the past have I been engaged in this form of creative writing.)
2.60 It is my belief that a review of this document, and the attached items of evidence, by any individual, with any degree of medical training, will result in the challenge and questioning of Dr X’s perfunctory and dismissive diagnostic opinion. It is therefore asserted that Dr X is in violation of Clause 4 of the Collège des médecins du Québec, Code of Ethics of Physicians which states: “A physician must practice his profession in a manner which respects the life, dignity and liberty of the individual.” [O.C. 1213-2002, s. 4.] This failure on the part of Dr X represents a further violation of Clause 3 of the Collège des médecins du Québec, Code of Ethics of Physicians which states: “A physician’s paramount duty is to protect and promote the health and well-being of the persons he attends to, both individually and collectively.”
2.61 All of these matters that I have placed before le ministre today have also been cavalierly dismissed by the Collège des médecins du Québec.
2.62 It is left to the judgement of le ministre to determine if this perfunctory dismissal by a body charged with the regulation of the practice of medicine in the jurisdiction of Québec serves to respect and protect the health interests of the citizens of Québec.