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Film Review: The Fugitive Doctor in ‘River’

30 Jun, 16 | by cquigley


‘River’, Canada, Laos, 2015, directed by Jamie M. Dagg


Released on DVD and digital download on 18th July 2016

Reviewed by Dr Khalid Ali

Doctors and crimes of professional misconduct have been the focus of films such as ‘Coma, USA, 1978’, and ‘Shutter Island, USA, 2010’, while  doctors volunteering in NGOs in troubled zones were the subject of films such as ‘Sleeping sickness Germany, 2011’ and more recently ‘The last face, USA 2016’.

‘River’, a new Canadian film, combines the two themes in its storyline; John Lake ‘Rossif Sutherland’ is an American volunteer doctor in Laos who accidentally kills an Australian citizen in a drunken rage. In his attempt to flee the crime scene, John goes through a harrowing journey across the Mekong River. He tries to get the support of his fellow doctors in the NGO; one of them, Dr Stephanie (Sara Botsford) faces the moral dilemma of whether she should be a whistle-blower and report him to the authorities or should help him escape, while another doctor Douangmany (Douangmany Soliphanh) takes advantage of John’s desperation and uses him as a drug-mule. The loopholes in the legal system between Thailand and Laos give John an opportunity to escape prison. Struggling with his professional role as a doctor who should be saving lives, but an infallible human being at the same time, John approaches the American Embassy in Vientiane for help.

Public interest in doctors’ criminal offences fuelled the media exposure of extreme cases such as the notorious Harold Shipman, and the recent news of Dr Pramela Ganji who was convicted by New Orleans jury in a 34.4 million fraud scheme (1).

The film raises serious questions about the ability of the legal system to exercise ‘equity and fairness’ when operating in a foreign environment such as Laos that is not accountable to regulations set by Western professional bodies. The requirements set by the General Medical Council (GMC) and the British Medical Association (BMA) in England are clear in mandating a ‘code of conduct and practice’ that a doctor should declare a criminal conviction (2, 3).

In addition to its exploration of accountability and violations in healthcare professionals, the film works extremely well as a gripping action thriller winning the best film award at the Academy of Canadian Cinema and Television. Rossif reprises the role of a doctor in turmoil following in his father Donald Sutherland’s footsteps who played a doctor in the cult comedy MASH (USA, 1970).

‘Whistleblowing’ is another thought-provoking theme the film raises; Rodulson argues that reading and appreciating Homer’s the Iliad can support medical students’ understanding of ethical dilemmas (4). ‘River’ achieves a similar feat by portraying a challenging ethical and moral situation where a doctor is ‘trying to do the right thing’.


  1., accessed Wednesday 29th June 2016.
  2., accessed Wednesday 29th June 2016.
  3., accessed Wednesday 29th June 2016.
  4. Rodulson V, Marshall R, Bleakley A. Whistleblowing in medicine and in Homer’s Iliad. Med Humanities 2015; 41: 95- 101.


Dr Khalid Ali, Screening room editor

Address for correspondence:

First impressions only happen once

7 Jun, 16 | by cquigley


Fergus Shanahan


Eyes smiling, face beaming, the porter rose from his stool to greet arrivals at the cancer centre, each nervously hesitant, staying close to a supporting loved one. With the confidence of a man who enjoyed being good at his job, he paused for those needing directions, reassured us that we were in the right place for our appointment, and then boomed: “Welcome everyone, and good luck to you all today.”

Good start. After that, we didn’t mind inconveniences like waiting for the single working elevator and felt better about whatever unknowns were ahead. The moment was still fresh when we got to the sixth floor. There, we faced a receptionist unable to switch her gaze from a computer to address us. Detached with jaded eyes fixed elsewhere, her outstretched arm dispatched us to an adjacent touch screen to register. We obeyed but the system insisted on a five-digit address code. Bad enough to be labelled ‘international’ as code for not having acceptable insurance, but not having a zip code was a new stigma. Before we could explain, Miss No-Eye-Contact was on the phone staring at some distant point behind us, then back to her screen with a facial expression that said: “Can’t you see! I’m busy.” Bristling a little, I blurted out my son’s details to demand attention. Without the slightest shift in posture, she confirmed our existence in the system with a few flicks of her keyboard. Progress. Then she left us with the unsettling comment: “Hmm, that’s interesting…take a seat and wait while I check with Accounts.” This is not what patients want to hear as they contemplate the prospect of major surgery. No one wants to be that kind of interesting.

Joe shot a warning glance at me “Dad…don’t be rude with this lady. Don’t lose it!”

Lose it! After 8 months of continual worry and stress trying to steer my son through the complexities and decision-making of a young man’s cancer treatment, I was determined not to ‘lose it’. We were overseas in a different healthcare system for a high stakes operation. They were now in charge and I would just have to play it their way. After all, I wasn’t the patient. I was supposed to be the support. So I stayed quiet. Then, the silence was broken, delightfully so, it seemed to me, when an old woman behind us flatly refused to have anything to do with self-registration. Dismissing the technology with an impatient wave of her hand, she snapped at no one in particular in a brash accent: “I’m not gonna do it, I can’t be bothered with that.”

Miss No-Eye-Contact receptionist had met her match.

While waiting, I imagined myself telling anyone seeking my opinion that professional staff within medical offices and hospitals should heed the little things that comfort patients. I would tell them that little things are important. Staff should know that routine for them is crisis for the patient. I would remind them that there is only one opportunity to make a first impression. First impressions are made up of little things. Little things can make a big impression. If the front office experience is poor, anxiety increases and confidence in the rest of the enterprise becomes more doubtful. In other words, if the dentist’s receptionist is a barracuda, don’t expect much pain relief when you get to the back office.

Then, we heard our name called out and we were on our way into the back office.

The interview with the surgeon was probably over within minutes but it seemed much longer. He began with a firm handshake. Then, sitting beside us not across a table, he spoke confidently in clear, crisp, explanatory sentences. These, he must have repeated on hundreds of previous occasions but it didn’t seem that way. He anticipated our questions and acknowledged our sense of urgency.

In the end, the professionalism of the porter that morning and his memorable welcome was the bellwether for what followed. The surgeon’s skill and experienced team determined what was to be a favourable outcome. But something else made a difference and a lasting impression. To borrow from the poet Maya Angelou:  “…people will forget what you said, people will forget what you did, but people will never forget how you made them feel.”


Fergus Shanahan, MD, DSc

Professor and Chair,

Department of Medicine,

Director, APC Microbiome Institute

University College Cork,

National University of Ireland

Tel +353-(0)21-4901226  also cell phone 086 280 4881

FAX +353-(0)21-4345300



Ayesha Ahmad: Review of ‘Doing Clinical Ethics’ by Dr Daniel Sokol

4 Dec, 11 | by Ayesha Ahmad

Since Hippocrates in early 5 B.C., Medicine has carried an ‘angel on its shoulder’; a reflexive gaze on the skill, and phenomenologies of healing between the doctor and his patient. Ethics is a code, a practice, and a guide amid the terrain of the hands that tend to the body using instruments of medicine’s enterprise. Referring to the Oath:

I will preserve the purity of my life and my arts’.

Daniel Sokol, Honorary Senior Lecturer at Imperial College, London and recently qualified barrister, undertook the challenge of fitting ‘ethics’ into our contemporary medical practice; whereby Medicine is confronted by a body unprecedented in relation to the ways in which we can perceive, examine, intervene, create, and prolong the existence of our bodies; our lives.


Medicine Unboxed 2011: Medicine and Values, Cheltenham UK 15 October 2011

5 Apr, 11 | by Deborah Kirklin

Good medicine is more than a set of technical decisions and interventions involving drugs, operations or tests. It demands more of the practitioner – professionalism, empathetic care, moral consideration, insight, an understanding of human suffering and necessarily, wisdom. These attributes are not always prioritised in selecting for or training healthcare professionals, and there is little time or attention given to their authentic development within busy working environments. Further, there is a widening hiatus of trust, understanding and expectation between medicine and society around what constitutes good medicine. This pressingly requires real engagement around medicine’s role and society’s values. A purely scientific answer will never prove sufficient here.

Medicine Unboxed is a unique project and conference programme that engages both the public and front-line NHS staff with a view of medicine that is infused and elaborated by the humanities. Contributors include artists, writers, the clergy, poets, philosophers, lawyers, linguists, musicians, theatre, ethicists, academics and doctors. The results are thought-provoking, inspiring, sometimes funny and often

Our theme this year is Medicine and Values.

We think of medicine as simply fact-based, efficient and scientifically robust. These arbiters can become the measures of good medicine. However, medicine is infused with judgments of value – individually for doctors and patients but also in medical science, for society, for policy-makers and health economists. Ethics, law and religion inform duties and rights in medicine, through principles and values. The values that define good medicine are not always apparent or agreed upon and there remains the potential for tension between them.

We’d like to invite you to come along to Medicine Unboxed 2011 and join us in uncovering the values that pertain to medical care and debating the ambivalences around the arbiters of good medicine. Our speakers this year include the Rev. John Bell, John Carey, Lionel Shriver, Jo Shapcott, Ray Tallis, Paul Bailey, Michael
Arditti and Havi Carel.

Come to the debate – be inspired.

Sam Guglani, Consultant Clinical Oncologist.

Off Sick; Narratives of Illness Past and Present

31 Mar, 11 | by Deborah Kirklin

Scholars from the universities of Glamorgan and Cardiff are currently breaking new ground in the Medical Humanities with the Off Sick project, writes Dr Richard Marsden. This research initiative, led by Dr Martin Willis and Dr Keir Waddington, puts a new twist on the well-known concept of the ‘illness narrative’. It focuses not on the people who actually suffer from illness, but instead on those who support and care for them. In this vein the project team is currently gathering stories from carers across the South Wales area. more…

Oncologist Sam Guglani wonders what medical care really means

30 Mar, 11 | by Deborah Kirklin

Care infuses medicine. Well, the word ‘care’ infuses the language of medicine – Healthcare, Intensive Care, Palliative Care, Standard care, Standard of care, Best supportive care, Care Quality Commission. But what actually is medical care? more…

“Newspeak (PART TWO): British Art Now is doubleplusgood!” by Dr Jane R Moore

6 Feb, 11 | by Deborah Kirklin

SAATCHI GALLERY 27th October 2010 – 17th April 2011

A few weeks ago I visited the new exhibition at the Saatchi Gallery with my group of 4th year King’s College Medical Students. Visits to galleries, museums and art installations are an integral part of the ‘The Good Doctor’ Special Study Module but I hadn’t included the Saatchi Gallery before.  Modern conceptual art is challenging and I was uncertain how this visit would help in our exploration of medical matters. I need not have worried; our visit was enjoyable, reassuringly accessible and it was easy to make links to the theme of goodness in contemporary medical practice.

Newspeak Two on display in the large bright rooms at the Saatchi Gallery, King’s Road, London continues the showcase of contemporary British Art started in June 2010 with Newspeak One.  All the original exhibits, including the widely advertised Pink Cher by Scott King, have been replaced and the new collection opened at the end of October.  Charles Saatchi’s Sensation! exhibition (Royal Academy 1997) had – sensationally –  brought late 20th century British Art to public notice. This was the outing of Damian Hirst’s shark, Tracey Emin’s unmade bed, Mark Quinn’s blood sculptures, Chris Ofili’s ingenious uses of elephant dung and the Chapman Brothers doing what they do best – shocking us into a reaction.  So what would we make of Newspeak? more…

’21st Century Medicine, Aristotle And The Church’ by Dr. Andrew R. J. Tillyard

23 Nov, 10 | by Deborah Kirklin

I recently attended the funeral of the local parish priest and this led me to consider many of the similarities between what I do in medicine and the role of the ‘Parish Priest’ as well as the ‘misrepresentation’ of 21st medicine. I work in intensive care, a setting of immense emotional stress for patients and relatives, and not infrequently for staff as well. Intensive care can appear more like the cockpit of an aeroplane – full of machines that bleep and flash as they keep patients alive. This, however, can belie the true meaning of what we do. There is an evolving mis-interpretation of what medicine is: that good medicine in the 21st century is skill based technical wizardry, where ‘good’ doctors are people, who can diagnose, treat and cure using magnetic resonance imaging (MRI’s), gene therapy, or laser guided scalpels and the like.


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