Stuart Skinner (MD) knew something was wrong three years ago, when patients started coming to him with vision loss, fever, rashes, and meningitis.

Almost every case could be traced back to untreated syphilis — a sexually transmitted infection with caseloads exploding 1,200 per cent from 2017. Saskatchewan saw this spike just as Covid-19 entered the picture.

“With the pandemic, testing dropped dramatically,” Skinner said, noting this wave of syphilis entered north-western Saskatchewan from Alberta, often travelling alongside HIV. Syphilis often spreads through sores, and can remain unnoticed for months or years on end, making early detection difficult.

“If you don’t see it, you won’t be seeking care for it."

When the infectious diseases physician and the Wellness Wheel team began treating mothers with severely ill newborns, stillbirths and birth defects, Skinner knew he had to act. Treating syphilis usually means a series of clinic and laboratory appointments, followed by intramuscular Bicillin injections, and intense contact tracing.

Instead, Skinner, Dr. Sean Rourke, Cara Spence and their teams pared that down to a one-hour stop.

They approached tribal councils and Indigenous-led health organizations, asking for help setting up mobile locations where anyone could be tested, diagnosed, and offered treatment.

Nursing teams drove vans to powwows, festivals, even pharmacies, offering quick, confidential finger-prick tests and results.

“The whole concept was to be flexible and mobile and adaptable . . . . so that we weren't the barrier,” said Skinner. “It wasn't easy for the nurses to set up and read the results or draw the blood in a less comfortable environment, but they did an amazing job.”

In Saskatchewan, a total of 1,797 people agreed to be tested, uptake Skinner calls ‘phenomenal’. Roughly three per cent were infected with HIV; 16% had syphilis.

“The majority were willing to get treated right then and there,” Skinner said.

Those teams have now visited more than 50 locations across the prairies, through a $4M national partnership called the ‘Ayaangwaamiziwin’ Centre — which translates to ‘be careful, be prepared’ in Anishinaabe. Health officials and private donors recently extended those grants for an additional year.

Skinner's colleagues keep fielding requests for the point-of-care service, which in turn has created a network of trusted Indigenous health leaders. This web, he said, could create the backbone of targeted outreach and screening for other diseases, such as diabetes or cancer.

But it only works with mutual respect, he warned.

“This isn't going to First Nations just to help them,” Skinner said. “I've learned so much from the cultural values that are built on what happens in First Nations. We have a lot to learn."

Skinner said mutual respect also means predictable paycheques — not just the odd grant.

He said health budgets need to pay for health promotion workers employed at Indigenous-run organizations and non-profits, the ones who stick around after the testing van leaves. Patients are more likely to stay in touch with familiar faces and staff, he said.

“It’s about respect, kindness, and building trust,” he said. “That is really critical.”

Yi-Chun Chen is taking a close-up look at some of the body’s hardest-working cells — the ones often processing an overabundance of modern-day food and nutrients.

“From an evolutionary point of view, our cells are not designed to deal with that,” said Dr. Chen, who joined the department of Anatomy, Physiology, and Pharmacology at the University of Saskatchewan last year as an assistant professor.

She said our bodies are pushed into churning out large amounts of insulin rapidly after snacks and meals, “which makes the beta cells work extra hard.”

Raised in Taiwan and inspired by her grandfather—a retired elementary school science teacher—Chen’s fascination with biology first led her to work as a medical laboratory technologist, then to the world of cellular research.

Using both rodent and human models, Chen is studying pancreatic beta cells: the way they process peptide hormones like insulin and how their behaviour and function is affected by an excess of nutrients.

With high-resolution imaging, she and her team are examining how both humans and mice synthesize, process, and clear peptide hormones.

“There are a lot of things we still don't know about peptide hormones, not just in the pancreas, but in the brain, in the gut,” she said. “Those are fascinating.”

Last year, Chen was the recipient of a Canadian Institutes of Health Research Research Excellence, Diversity, and Independence Early Career Transition Award. After moving from UBC to Saskatoon, Dr. Chen said feels considerable support already from her established and mid-career prairie colleagues.

“They can mentor us and guide us, and we also have a group of five or six young scientists,” she said. “I can envision myself working on many, many interesting projects with them.”

Her goal today is to identify biomarkers that could predict diabetes far earlier.

She hopes to develop biochemical assays that measure proinsulin levels to serve as an early warning system. This could enable interventions months or even years before a traditional diagnosis based on blood glucose levels.

“We want to be able to predict the development of, for example, type 1 or type 2 diabetes before they are diagnosed,” said Chen.

In the long term, Chen envisions both preventative strategies and regenerative therapies to fight diabetes. Stem cell-derived beta cells may be a future solution, she said.

“We are making really good progress in Canada, actually. We have clinical trials. We’re putting the stem cell–derived beta cells into patients with type 1 diabetes.”

She hopes this will one day reduce the need for constant insulin injections, even helping curb obesity.

“Don’t give up,” Chen said. “We are passionate and we want to work on many, many things.”

“If you like it, keep going.”

James Stempien (MD) has navigated some of the most challenging corners of emergency medicine, from the frigid isolation of Inuvik to the bustling corridors of Saskatoon’s emergency departments. His experience in low-tech outposts has shaped his approach to modern emergency care.

“When things aren’t going well you see it in the emergency department first,” Stempien said. “We’re the front door. We’re always open.”

As provincial department head of emergency medicine, Stempien sees patients on their worst days in hospitals bursting at the seams, struggling to keep pace with Saskatchewan’s growing population.

“I worked in emergency last night and we were really busy, hours behind. All the ER docs there and nurses were running our tails off,” said Stempien. “We're seeing an increase in acuity.”

Stempien said the patients he sees now come in with serious medical concerns, which cannot be written off as minor ailments.

One in five emergency patients in Saskatoon requires hospitalization. Amid frequent congestion, Stempien says some find themselves on stretchers in the hallway, even in former linen closets, waiting to move upstairs to an acute care bed.

He said while a plan to open 109 more acute care beds at Saskatoon City Hospital ‘will make a big difference’, he and his staff are concerned overcrowding jeopardizes patients in the waiting room, leading to moral injury and burnout.

Stempien is determined to free up space inside his department. He's also led numerous innovations aimed at streamlining emergency medicine, including a recent move to send patients their discharge instructions via text message.

“They can access it as many times as they want. They're not going to lose the piece of paper on the way to the parking lot,” said Stempien.

Stempien, 67, said he still loves the job, in part thanks to the team atmosphere, and also because his patients are still full of surprises.

“Many things I've seen thousands of times, but every now and then you run across something and you think, wow, I've never seen that,” he said.

“That's what makes emergency medicine interesting. And fun."