Human Remains is ready for pre-order, and I love the Medical Post

1. Human Remains, the fifth Hope Sze crime novel, is available for preorder online, including on .com .uk/Kobo/iTunes/Nook/Google Play (all links here), and will debut on April 25th (DNA Day). Yay!

2. Now I have time to talk about other good stuff, like the fact that the Medical Post chose my article as one of the best of the year.

Dr. Yuan-Innes reflects on a old Welsh myth of the sin eaters that Margaret Atwood writes about in one of her short stories. “We study to the point of exhaustion and work inhumane hours for the privilege of seeing the worst of human nature,” Dr. Yuan-Innes writes. While she had gotten into medical school believing doctors were heroes, the revelation in Atwood’s story gave her pause: doctors are sin eaters in their own way, often shunned and depraved as a result of their work.
Shunned and depraved, c’est moi. If you want to read the full article, it’s here.
All the articles are gated (you have to make an account with an e-mail and password), but it means that the people who read them care. I love reading the comments and seeing what people have to say.

I wrote my first Medical Post article in 2009, “The Doogie Howser Dilemma,” when patients said I looked too young to be a doctor. It sounds like a compliment, but I could tell some patients were actively uncomfortable. They wanted me to look more, um, seasoned. Fortunately, time has mostly taken care of that one, although I did laugh recently when a patient said, “This appendix scar is 22 years old. I think it’s older than you.”
I wrote about that, too, in my mini-article that was part of a cover story on Misconceptions in Medicine (“What do you feel are some of the biggest misconceptions (or myths) that exist about being a doctor?”). I wrote back, “I’m not an old, white man who plays golf.”

Since then, I’ve raged about the Ontario government cutting physician pay and blaming doctors for their mismanaged care. I made a video called YMCA doctors, with the help of Dr. Christine Suess, Dr. Renee Givari, Dr. Tim Heeley-Ray, Dr. Akram Akbar, Dr. Diane Poilly, a beloved civilian, and three videographers, including Jeff Dorn and Dominic Gauthier—and the Medical Post and helped me spread the word.

Yep, that’s our Christmas tree in March. Rock on.

I’ve written about travelling to South Africa, including dissecting an impala and manually inflating its lungs with my breath. This article also appears in my book, The Knowledgeable Lion.
I’ve talked about how to balance motherhood and medicine, including my guilt over not diagnosing my own daughter’s hearing difficulty until she was old enough to turn up the TV and yell back at us, “Whaaaaaaat? I can’t HEAR you!”
The Medical Post has helped connect me with other doctors, including Dr. Shawn Whatley, who’s organizing the NonclinicalMD’s conference where I’ll be speaking in May. Hats off to Julie Connolly, a physician-author herself, who participated in my YMCA doctors video on health care cuts and tells tales from the single mother-doctor trenches—here’s her latest, which makes me flinch. The log of poop on the floor would’ve been the last straw for me. Julie makes the fact that we still have our Christmas tree up seem absolutely normal and unimportant. (My son, Max, said, “Leave it up ’til next year!” My daughter, Anastasia, said, “Let’s decorate it for Easter. When I told RN Mary B, she grabbed my hands and said, “God love ’em. Those are well-adjusted kids.”)
I feel so much gratitude toward The Medical Post. They’ve been an independent newspaper for over 50 years, reaching 20,000 subscribers, and providing a strong voice and current information for medical professionals.
On a personal level, the Medical Post was one of the first newspapers to publish my columns. In Cornwall and on my sojourns at CHEO or the Montfort, I met doctors who recognized me from my newspaper writing. Anna, a nurse at Glengarry, loved my article, “Are Women Ruining Medicine?”  She said, “I tried to photocopy it, but the paper was too big.” (That article also appears in Fifty Shades of Grey’s Anatomy.)

E-book, print, and audio!

Writing-wise, working with the Medical Post has been a professional boon. A collection of my columns, The Most Unfeeling Doctor in the World and Other True Tales From the Emergency Room, was my bestseller on Amazon. Last year, the 62nd Canadian Business Media Awards nominated my work for Best Regularly Featured Department or Column.
Thank you, Medical Post. We need independent, thoughtful, fact-based journalism more than ever.

Signing off from Mont Tremblant

Are Women Ruining Medicine?

One famous surgeon at my alma mater used to accept only white, male, right-handed physicians to his residency program. By the time I was a med student in 2000, the surgeons laughed about it because the program boasted one brown-skinned man, one Asian woman, one Caucasian woman, and a left-handed attending doctor.

When I was in residency, one of the surgeons used to pull me aside to chat about the quota system they’d used to restrict the number of Jewish medical students when he was a lad.

Nowadays, female medical students make up over 50 percent of the Canadian and American medical school classes and have done so since the early millennium.

Which doesn’t mean that people bemoan the “good old days,” exactly, but it’s getting there. The irony is, some of the most virulent comments are from other women.

First, Dr. Karen Sibert wrote an opinion piece for the New York Times called “Don’t Quit This Day Job” in 2011. I first heard her on NPR radio, lecturing women not to take maternity leave or work part-time. She’d managed a full-time academic practice as an anaesthesiologist and a mother of four, so she instructed all women to follow in her footsteps.

I feel like this sometimes. Image courtesy of Pixabay

I feel like this sometimes. Image courtesy of Nemo on Pixabay

Apparently women in full-time practice work, on average, 4.5 hours less per week than men in full-time practice, and are more likely to take parental leave.

However, if you look at the statistics from Dartmouth College, a survey of more than 100,000 individuals, the mean number of work hours has declined for all physicians by 7.2 percent from 1996 to 2008. Physicians now work an average of 51 hours per week instead of 55 hours per week. A blogger commented that the reduced hours are not just from women, but from (mostly older, male) M.D.’s who can’t afford to retire, so they work part-time.

Of course, Dr. Siebert correctly pointed that we face a doctor shortage in the face of an aging population. But we need to look beyond blaming women for this. In the mid-1990s, the Ontario government cut medical student spots in an effort to control health care costs. Now they’re belatedly increasing the numbers, but we need doctors now, not in ten years. I highly doubt it was all-female politicians who made that policy decision.

Dr. Siebert also said that more women chose primary care and that there was a shortage of primary care doctors, so women had better get back into the trenches instead of working part-time.

Unlike Dr. Siebert, I actually trained in family medicine, but I don’t practice it. Neither do most of my colleagues. Why? Because I didn’t like it. Primary care is relatively poor pay for hard work and little prestige.  If you want more primary care doctors, you’d better change the working conditions and remuneration. But it’s much easier to blame the women entering this beleaguered specialty, and yell at them to work more hours.

Other journalist and bloggers title their articles “Should women be doctors?” and “Are women ruining medicine?” They tell me I took that medical school spot away from a man, so I’d better work like a man.


For the past decade, the research on gender differences in medical students often conclude that women are better communicators. They also note that the physicians who end up being treated for addiction or have their licenses revoked for abusing patients are almost always men. Anecdotally, some of the laziest, most incompetent, money-grubbing doctors I’ve encountered are men.

Does this mean that men are ruining medicine and that men should not be doctors?

Of course not. Some of the smartest, hardest-working, kindest doctors also possess testicles. As Stephen Jay Gould pointed out, there is more variation within populations than between populations. It’s just much more fun to scapegoat somebody else.

I freely admit that I am everything Dr. Siebert warned you about. I am a female physician who has taken maternity leave and who works part-time. I am also Asian, so I am that long ago-surgeon’s worst nightmare.

Do you think I “took away” that medical school education from a man? Newsflash. For the first time in the Western world, women are achieving higher grades, scoring higher on standardized testing, and earning more than half the coveted spots in medical school, compared to men.

I reiterate. We are not stealing spots from the men. We have earned the right to be here. Still, people are blaming women for the state of medical care.

Before you start burning me in effigy, know that I work up to 14 hours in a row in the emergency room so that I can treat the drunks, the drug addicts, the cancer patients and the babies who rush in at 4 a.m. on a Saturday night. You need me.

What’s really ruining medicine? I’d argue it’s the fact that we’re trying to take care of an aging population with chronic diseases, demanding fast access to expensive technology and care, in the face of shrinking resources. That’s your enemy.

The last thing we need is doctors pointing fingers at each other. We need every last doctor on the front line in this fight. And if you want more doctors working more hours, a carrot always better than a stick.

In Canada, in 2013, we are not yet talking about quotas restricting women or forced contracts mandating a certain numbers of hours worked per week. Or even, heaven forbid, forced sterilization for women physicians. But I want to put my two cents in before the rhetoric blows that far.

So. Are women ruining medicine?


Are women changing medicine?


Just like society is changing. Just like the world is changing.

As philosopher Alan Watts wrote, “The only way to make sense out of change is to plunge into it, move with it, and join the dance.”

This is the most downer essay in the book. The rest are about medicine and, er, the naughty bits.

This article was first published in the Medical Post and now appears in Fifty Shades of Grey’s Anatomy, an autobiographical collection of true life medical humour (and horror) stories, for $3.99 digital/$9.99 print. Find it on the platform of your choice here.

Better yet, come to the Fifty Shades of Grey’s Anatomy party at the Williamstown Library on April 1st at 10:30 a.m.! Wear grey.

A small group of committed citizens: CFUW Cornwall

Never doubt that a small group of thoughtful, committed citizens can change the world. Indeed, it is the only thing that ever has.~often attributed to Margaret Mead

Last June, I opened my Cornwall mail file, which is usually full of unsigned charts, but this time, it held a card. Was it from a happy patient?

No! It was from Hilary Blackburn of CFUW, the Canadian Federation for University Women, asking me to speak at Casa Paulo on January 27th, 2015. Thrilling!

CFUW funds scholarships. Green Party candidate Elaine Kennedy spearheads their work on environmental legislation (I wanted to do the one for bees. Melissa means honey bee in Greek. Plus, we would starve without pollinators). Kendra Smith, Coordinator for the Agapè Centre, organized the local Coldest Night of the Year, a fundraiser for “hungry, hurting and homeless” Canadians.

Anyone who works in Cornwall’s health care knows the challenges: scarce family doctors, high smoking rate (including people who already have COPD, lung cancer and/or asthmatic children), unemployment, teen pregnancy, low breastfeeding rate, and so on. Anecdotally, I can tell you that nearly every mom I see in the emerg is young, and when I started working here over a decade ago, zero of them breastfed. I don’t mean a handful. I mean zero. But in the past few years, I’d estimate the breastfeeding rate at 10 or 20 percent, which is a vital improvement.

So you can imagine how good it felt to witness this group of committed citizens working for change.

Of course, I couldn’t relax, because I had to present. I sat with my laptop in my lap, waiting for them to call on me, but it turned out I was supposed to talk after the meeting. “That way, you can enjoy the food,” said Jennifer Adams, one of my hosts.

The food was delicious. I had the salmon, which was just right, and the al dente vegetables particularly impressed me, because often vegetables seem like an afterthought. But at continuing medical education dinners (“drug dinners”), they present during meals, so the doctors can listen while eating and then bolt.

“Okay. I just hope nobody leaves,” I said, glancing around the room of happy, laughing women.

“Oh, no. We have extra guests here who came specifically to see you. They’re not leaving,” said Sally, the president, who was wearing a cool red jacket and gave me a hug.

They did stay. They applauded. They did the wave. They bought my books. And it just occurred to me that a few of them might be able to make it to my Fifty Shades of Grey’s Anatomy launch on April 1st at 10:30, at the Williamstown Library.

But they might be too busy saving the world. Please, keep saving the world. Cheers.

No society has ever yet been able to handle the temptations of technology to mastery, to waste, to exuberance, to exploration and exploitation. We have to learn to cherish this earth and cherish it as something that’s fragile, that’s only one, it’s all we have.~Margaret Mead

Killer openers: the first seven paragraphs of Stockholm Syndrome

Birth smells.

I’m not saying it stinks–well, to some people, it does. I remember the classmate who finished our med school OB/gyn rotation without ever delivering an infant. He delivered half of the head, and then the look on his face was so horrid that the obstetrician delivered the rest of baby.

My name’s Hope Sze. I’m a female resident doctor in Montreal, and whether I like it or not, I’ve become a detective too, during my copious free time.

I’ve got a stronger stomach than that classmate, but when I stepped into the delivery room, it only smelled like sweat and a little blood. The odours would grow stronger once the amniotic fluid broke and the afterbirth emerged, but for now, I didn’t hold my breath.

My eyes adjusted to the darkness. They’d turned the lights off, except a small fluorescent light. The baby’s heartbeat chugged along on the fetal monitor. Whump, whump, whump at 162 beats per minute.

Most of obstetrics is nice and normal, except the occasional C-section. They screen out congenital abnormalities at St. Joseph’s, our small community hospital. “This is the only happy area of the hospital!” an obstetrician told me, on my first day. “Everybody’s smiling!”

The black woman in the bed wasn’t smiling. She was sweating. Which made sense. “That’s why they call it labour,” the nurse will say, while the woman recovers from the latest contraction. That’s normal too. So I was pretty surprised when my obstetrics rotation transformed into a bone-chilling bloodbath.


stockholm syndrome pregnant

So Rob Cornell asked me to post the first seven paragraphs of my work in progress. For me, that’s Stockholm Syndrome, now available for preorder at Kobo and Smashwords!

You may notice two different covers because my naked cover got censored. More on that later.

If you want to start with the first Hope Sze novel, Code Blues, it’s now available for free until March 16th exclusively at Vuze

I’m experimenting with posting chapters on Wattpad and WriteOn, so you can get the first five chapters there. I don’t know if I’ll post the whole book, even though posting a partial can be seen as a dick move. On the other hand, giving away my book permanently could be a stupid move. What do you think?

Fifty Shades of Grey’s Anatomy will make its official debut at the Williamstown Library on April first at 10:30 a.m. That’s right, my latest book is an April Fools joke. Come laugh!

This is the most downer essay in the book. The rest are about medicine and, er, the naughty bits.

If you preordered, I might distribute the books tomorrow, if I have enough juice after my night shift. Pay me tonight and I’ll drop the books at the emerg on my way home to sleep, so you can spend your March Break reading about penile fractures, scrotal lacerations, and other yuk yucks.

Hot off the press: Fifty Shades of Grey’s Anatomy

Ask and ye shall receive: now you can relish the wit and physique of Fifty Shades of Grey’s Anatomy by holding a paper copy in your exquisitely hot hands.

This is the most downer essay in the book. The rest are about medicine and, er, the naughty bits.

Love that pelvis.

I know, I know. I should have timed this with the movie release and/or Valentine’s Day.

However, I’m basically in the ER for the next eight days (including tonight!), so let me know if you’d like a signed copy for a mere $10.

And, because I love you, here’s a free excerpt.



Image by WaltiGoehner on Pixabay


The first time I saw a patient’s breasts, I was supposed to practice my history-taking skills on a woman who’d recently had a heart attack. No physical exam required. I stepped up to her curtained bed and called, “Hello…”

The woman drew back the curtain. She had no top on, a washcloth in her hand, and a stainless steel bowl on the table in front of her. “I was in the middle of washing.”

“Oh. I’m sorry. I could come back. My name is Melissa Yuan, I’m a medical student, I was just going to take a history–”

“That’s okay. I don’t mind if you don’t mind.”

“Oh. Okay.” I figured this was something I should get used to, as a to-be doctor. I sat down and started asking her questions and taking notes. We had a checklist to follow, so it wasn’t too hard, and I got used to her uncovered breasts. “Do you have any past medical history?”

“No.” She shrugged. “Except that I had malaria three times.”

Even I knew that was unusual. I deviated from my form. “Why?”

“I lived in Africa for twenty years.”

“Okay.” No wonder she didn’t mind washing in front of me.

Sarah, the cardiology fellow who was supervising us, came up and joined me. Afterward, she told me that she was surprised to find the patient naked, and patients didn’t usually wash themselves in front of a doctor. “Okay,” I said. Basically, I was agreeable for just about everything. If she’d told me I should’ve conducted the interview while calling questions from the other side of the curtain, I would have said, Okay.

Now I’ve seen more than a few pairs. I should have a few funny stories, but I had to ponder for a while. You’d think boobs were naturally super droll. (Hey, I accidentally wrote drool. That, too.)

One of the nurses said that the old guys in chronic care were always drooling over hers, or at least grabbing for them and making lots of comments. She learned to wear a T-shirt under her scrubs so she could lean over to help them without causing a riot.

“It’s not fair that some of us are so blessed and some of us are…not,” said another nurse, on lunch break.

“You don’t want to have too much. My mother had such big ones that, when she was in hospital, we needed two people to wash her, one to wash and one to help hold them up!” said the secretary.

A female orderly chimed in, “That’s a problem for small women too. Once, I was washing a lady in a nursing home, lifting them up, and she said to me, ‘Dear, it doesn’t matter how small they are, they all fall down, don’t they?’”

Everyone laughed, but my laugh was tinged with pain. Not something to look forward to.

On my plastic surgery rotations, I saw a lot of breasts. The one I remember the best was the jubilant woman just before her breast reduction who said, “Do you know what size I am? HH. I had to order my bras specially from the United States. Well, no more. My only regret is that I didn’t do this sooner!”

By Pixabay's OpenClips

Image by Pixabay’s OpenClips

On the flip side, I saw some breast augmentations, which are pretty simple, surgery-wise: slide those balloons in, make sure they’re in the right place, check them from all angles, and stitch ’em up. A nurse at the foot of the gurney commented about one of them, “They’re too big!”

The surgeon shrugged. “She picked the size.”

“They’re ridiculous! She looks like [insert name of a famous cartoon rodent with prominent ears]!”

We giggled, but the implants stayed.

Personally, elective augmentations (a.k.a. boob jobs) weren’t my favourite, because I’d rather save lives than cater to the beauty myth, but lots of the surgeons love aesthetic patients. They pay, they’re generally in great shape, they want to leave immediately, and they take care of themselves afterward. And actually, after a decade in the emerg, that does sound appealing.

I preferred the microsurgical breast reconstructions after mastectomies. Before my first week on plastic surgery, I’d never heard of flaps, but it made sense to use transform patient’s own muscle into replacement breast tissue. We’d either use the latissimus dorsi muscle or the transverse rectus abdominus. Now it’s kind of weird to think that, when you’re working on your abs and core muscles, you may actually be forming your future breasts.

Back in the emergency room, the male staff are always concerned about patients charging them with harassment, but once in a while, patients apparently invite it. One of our male nurses charged away from an acute care bed after a female patient pulled off her gown to reveal her naked chest, breathing, “Want to do. My. Electrocardiogram?”

“No, thanks!” he called, disappearing on the other side of the curtain.

Breasts. Sometimes droll. Sometimes drool. Sometimes monsterish.

Sounds about right.

Links to all forms here:

Paperback available on and Createspace, and coming soon to local stores, or hit me up at the emerg. Cheers!