A Physician’s Perspective on Medical Assistance in Dying

By Andrew Appleton / June 6, 2021 /

Having recently assessed a patient for medical assistance in dying, and reflecting on the sort of conversations I have with my patients, I felt it was important to dust off this essay and get it out there. I wrote it last fall, in response to an especially meaningful encounter with a patient, at the same…

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It’s OK to Hit Pause

By Andrew Appleton / April 21, 2021 /

We have a productivity problem. I’m not referring to the economic devastation wrought by the pandemic. I’m referring to our collectively narrow view that work productivity is synonymous with individual success and well-being. This existed long before COVID-19 did. The chasm between what has been anointed “essential” versus “non-essential” work has all of us standing…

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The Worst Case: Critical Care Triage in Ontario

By Andrew Appleton / April 13, 2021 /

As the third wave continues to put more Ontarians into hospitals and ICUs, it is now conceivable that we could soon be faced with a worst-case scenario: invoking Ontario’s Critical Care Triage protocol. Everyone in Ontario needs to understand what this means. We are all one illness or accident away from being at its mercy.…

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Why lockdowns feel amoral

By Andrew Appleton / April 7, 2021 /

The government has issued another “stay-at-home order” in Ontario. In my view, it is excessive, overly restrictive, and will result in more harm than good. Today, I am mostly interested in how government imposed restrictions make us feel. When you have an immediately intense feeling about something, positive or negative, your intuition gives you an…

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Remembrance is about values

By Andrew Appleton / November 11, 2020 /

Today is Remembrance Day. We remember the sacrifices made by others to secure our freedom, a future many of them would never experience. Why would someone risk their life, not knowing what the outcome would be, to benefit another? It’s about values. We all have values, deeply held beliefs about the world and our place…

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How to test your stories

By Andrew Appleton / November 4, 2020 /

At the time of this writing, the US election of November 3rd is undecided, showing signs that an eventual result will be contested. Those of us watching (most of the world) will experience feelings about this, along with an attempted explanation for ourselves. Yet most of us will never be privy to the sort of…

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Feelings and the limits of language

By Andrew Appleton / November 3, 2020 /

How are you feeling? A simple enough question, sometimes hard to answer. If you pay close attention, you know how you feel, but describing it to someone else seems impossible. The limits of language do not allow it. Human beings love having words, or labels, for things. If we know what something is called, we…

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You must observe from the audience

By Andrew Appleton / November 1, 2020 /

We are always with ourselves, so it’s natural to view our lives from the first person perspective, as the main character. This is an egocentric position, leading us to see the world as happening to us, or for us. If we believe the narrative that we generate from this view, we become easily irritated when…

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It’s about conditioning

By Andrew Appleton / October 31, 2020 /

In every situation, whatever you are being and doing, your feeling and stories are a product of your conditioning. You were born with a set of pre-conditionings, a combination of human instinct and genetics. From then on, every experience you’ve had has slowly moulded this into the conditioning that you are running now. Often, this…

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Well-being depends on context

By Andrew Appleton / October 30, 2020 /

When asked to evaluate your well-being, your mind will naturally focus on only a few aspects of your life. It is an impossible task to assess the totality of your experiences to date, arriving at some value representing the whole. By focusing on one or a couple of things, your mind is trying to define…

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What is well-being?

By Andrew Appleton / October 29, 2020 /

We have covered that the Human Condition allows us to have experiences within consciousness, our only true possession. I have also said that everyone is going about the same project, albeit in various and frenetic ways, to improve their well-being. The trouble is, most of us don’t know what outcome we seek. Everyone has a…

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Experience is your only possession

By Andrew Appleton / October 28, 2020 /

Your only true possession is your human experience. It is the only thing that cannot be taken from you. Everything outside of you exists merely because you experience it. This experience is uniquely your own. It will never be entirely accessible to another, nor theirs to you. Understanding this simplifies matters. For to optimize well-being,…

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What is the Human Condition?

By Andrew Appleton / October 27, 2020 /

Let’s start at the beginning. To get what you want you must know what you have. Everyone, every single person, wants to improve their experience of life. We are all chasing well-being. Why? The Human Condition. The Human Condition is what makes us human, apart from the animals. It is the condition we have inherited…

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Be Unrushed.

By Andrew Appleton / May 12, 2020 /

Quite often the place we least want to be is where we currently are. This is, in part, because we are thinking about what we need to do in the future. If whatever is happening right now could just end, we could get on with things. This is a treadmill scenario, common in our default…

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Expect the Unexpected

By Andrew Appleton / May 1, 2020 /

We form expectations about all manner of things. Sometimes this is explicit, but often it’s not. Without being aware of our expectations, or testing their validity, we set ourselves up for disappointment.  The most recent example of this is the proposed timing for reopening schools and the broader economy. It’s all over the media, people…

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Why We Care

By Andrew Appleton / April 21, 2020 /

During the COVID-19 pandemic we’ve seen the meme of doctors and nurses holding signs that read, “I stayed at work for you. You stay home for us.” This refers to health care workers willingly putting themselves (and their families) at risk to perform their work under more hostile than usual circumstances. When asked why, many…

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Lessons From The Front Line

By Andrew Appleton / April 18, 2020 /

I just completed a week of attending on the acute medicine wards in the COVID-19 era. Needless to say, nearly everything about the workflow and environment was different. We are fortunate to not be inundated with cases the way many jurisdictions are, but the impact is still tremendous. Below I detail a few things I…

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Breaking bread (not bad).

By Andrew Appleton / April 15, 2020 /

An interesting observation of human behaviour during the COVID-19 pandemic is to make note of which shelves in the grocery store are empty. We’ve all heard the meme about toilet tissue. Clearly a necessity, but an odd one to hoard. What I find more intriguing are the bare shelves of flour and yeast. It would…

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Remember what is important.

By Andrew Appleton / April 13, 2020 /

Most of us are craving the return to normal life right now. The same life that we used to complain about before it all changed. This reveals an interesting phenomenon of the human experience. We quickly adapt to any context in which we find ourselves. No doubt, this has served us exceptionally well over the…

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To wait is our fate.

By Andrew Appleton / April 8, 2020 /

No one likes to wait. As we grow up, we can’t wait to drive, graduate, leave home, join the “real world”. As adults we can’t wait to build a successful career, go on vacation, get a new car, retire and be free. Nevertheless, we wait, counting down the days, ignoring today. But today is what…

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How to win the day during COVID-19 (or any day).

By Andrew Appleton / April 6, 2020 /

To understand something, you must strip it down to its raw ingredients, making sure you then understand each of them. Only then can you put them back together and assert that you know why the product of their constitution is what it is. The same applies to optimizing well-being. We need to understand the problems we have,…

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This isn’t the end of the story.

By Andrew Appleton / April 3, 2020 /

Perhaps you’re feeling overwhelmed, exhausted, seeing no end in sight. You think this shouldn’t be happening, it doesn’t make sense. You want nothing more than for things to get back to normal. In a word, you’re suffering.  We are all suffering. Some more than others. That’s what happens when life changes quickly and we don’t…

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This is it. This is what we get.

By Andrew Appleton / April 2, 2020 /

In times of struggle our minds rebel. We think things should be different and lament them not meeting our expectations. We ruminate on the past, wondering why we didn’t see this coming, or at least prepare for it. We look to the future and see nothing but a bleak horizon, with little hope. We do…

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You can’t control everything. That’s OK.

By Andrew Appleton / April 1, 2020 /

We all like to be in control. We wonder why people don’t see things our way. We feel it’s unfair when the world seems to be against us. The problem here is not someone or something else, it’s us.  The stoic philosophers, like Marcus Aurelius and Epictetus, wrote about the dichotomy of control. Essentially, they direct…

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On Being Disappointed in Oneself

By Andrew Appleton / March 13, 2020 /

We’ve all experienced disappointment in many forms. Disappointment is the feeling of displeasure when something doesn’t turn out as expected. Perhaps the most insidious form is self-disappointment. It’s insidious because it occurs within the privacy of our own minds, subject to our inner monologues, badgering us relentlessly. I find the notion of being disappointed in…

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