Dr. Rakesh Patel

Most of my professional —and probably personal life —has just been making it up as I go along.

Dr. Rakesh Patel

Division of critical care

Rakesh Patel doesn’t care about formal titles — he cares about people. Working with, and influencing people in the pursuit of social justice, creating equitable access and most importantly, doing the ’right thing’. He’s passionate about learners and is most proud of his role as Program Director, having coached 44 residents through the Department’s Adult Critical Care Medicine post-graduate residency program.

MONEY TO ME means I can travel with my niece and nephews to weird and cool places and provide them with a university education, then they are on their own! I don’t have any kids, so my brother’s kids are my surrogate experiences. They live 3500 miles away in Oregon. I’ve missed seeing them grow up — except through Facetime every Saturday or Sunday. And so, my great joy in life is travelling and eating with them whenever possible because that’s what I like to do. Travel is also a form of education —it’s not being afraid of the unknown, meeting people who don’t look like you and experiencing places outside of your comfort zone.

OUTSIDERS by S.E. Hinton had a lasting impression on me. It described kids like me, high school age, growing up on the poorer side of town. It opened my eyes to possibility, creating your own opportunities, remaining a decent human being and fostered my love of reading.

I KNOW IT SOUNDS CORNY, but I still love the characters, lines, music and sappiness of “Casablanca”. Best movie line of all time is Rick to Ilsa: “Sure, I remember Paris, the Germans wore grey, you wore blue…” It was one of the best movies ever made!

I WENT TO MED SCHOOL at age 31. I was not one of these kids who grew up wanting to be a doctor, I just wanted to fly jumbo jets. But my high school counsellor said, “you’re too short to fly a plane”, and I was crushed.

ONE THING I SHARE with my sibling is a love of Liverpool FC and the English premiership. I probably wouldn’t have been a physician-teacher if I was good enough to be a holding midfielder for England’s national football team.

INITIALLY I DID a Pharmacy degree with a doctor of Pharmacy because when you get sick you get a pill and that pill makes you better. I was curious about what happened in the body; what was the pill’s magic that made my headache go away or my fever go away — it just seemed pretty cool.

I WENT TO DETROIT to work in an ICU because at that time clinical pharmacology — from a pharmacist’s point of view — was still quite a fledgling endeavour and Henry Ford Hospital was leading-edge. And I also wanted to live close to the inner city, to experience what life was like in that part of the States. And there was crime and oppression, it was poor, there was lack of opportunity — all of that. I learned so much working there; from a social, political and medical aspect. I’d do it again in a heart beat!

AT 31 I asked myself ’is this what I want to be doing when I’m 45?’ and the answer was no. I knew I had to do something else or I was going to be bored out of my tree. McMaster had a shorter three-year med program and I thought, ’hey if I do medicine for three years it probably won’t hurt me; I may not like it but I could probably do other stuff with it like work for a drug company recreating the magic’. I kid you not, that’s literally why I went into med school.

I GOT INTO THIS HEATED debate about reverse racism in Detroit with the community panel during my med school interview; where successful Black Americans were looked down upon by Black Americans who were not successful. They were called “Oreos.” I remember going back to Detroit thinking I had done okay, that the interview was kind of fun, if I get in meh, if I don’t, whatever. I had no idea that this interview was supposed to be the hardest med school interview you’ll ever go through so I wasn’t nervous, I was just myself. And I got in.

THE HISTORICAL FIGURE I most identify with is Robert F. Kennedy. He sought to change things, he did the hard things and did things differently because it was the right thing to do.

I WAS A JUNIOR FACULTY when I took over as Program Director. At the time, there was a resident who was struggling and making serious errors in judgement but for 18 months nobody said anything and probably thought that it was somebody else’s problem — until it got to me. So, I built a case and essentially had to fire him because he was just incompetent. There was tremendous resistance from the physicians who said, “how can you possibly do this to this guy, he’s only got six more months?”, but it was unethical to allow somebody like that to call themselves an Intensivist. I just did the logical thing. Either you have the courage or you don’t. It was one of the hardest things I’ve ever had to do.

MY MOST PASSIONATE PURSUIT is with learners but my advocacy on behalf of the role of clinician teachers has been the most important. I don’t want to be considered a clinician educator or clinician teacher or clinician researcher. Why can’t I do all of that? That ’slotting’ into a category — I just abhor it. Why can’t I be recognized for all the stuff that I do rather than what I do in a particular slot? I do a lot of things that can’t be counted but that doesn’t mean they don’t count. Not everybody understands that.

I THINK PEOPLE see me as honourable and someone they can trust implicitly.

DR. GWYNNE JONES had a significant influence on my career. The man is a giant and he allowed me to stand on his shoulders and learn about the Art of Medicine — the stuff only a master teacher/physician can teach. He is my Yoda!

THE BEST ADVICE I was ever given was ’don’t be dependent upon anyone’.

MY DEFINITION of smart is knowing how to survive in the real world and not the gilded world of ivory-tower academia.

THERE WAS A QUOTE in a book I read once by a guy named Lee Iacocca. He was fired from Ford Motor Company and then he went to Chrysler and turned it around. In his book he said, “All we have around here is people, and if you can’t get along with people, you can’t help me”. And that’s true, I think it’s all about how you interact with people. With leadership, it comes down to people skills.

WHO ELSE BUT Al Pacino would portray me in a movie about my life.

PLAYING THE SAXOPHONE like Clarence Clemmons [part of Bruce Springsteen and the E Street Band] is the talent I’d most like to have that I currently don’t possess. I love that instrument’s sound — it’s a bedrock of the blues, jazz and their baby, rock n roll.

FEAR IS when I have to tell children that one of their parents is going to die in the ICU today and I cannot change that [I’ve had to do that about 5 times now]. Or when I have a leg cramp while swimming and I am in the middle of the damn lake! Or I am caught in an elevator, alone, with a Catholic Priest.

MOST OUT OF OFFICES are endlessly boring and I’d like to think I have a really good sense of humour and I’m not afraid to be out there. I got a reply to one of them once from the Head of the Committee to Evaluate Drugs who said, “hey, I totally get where you’re coming from, I love them but you’ve got to remember that you’re in the public eye and I would advise you not to do this anymore.” And I said, “thank you for your advice, I’ll take it under advisement but I’m not changing”. Sometimes I draft them ’off the cuff’ but sometimes I spend a bit more time crafting, and the crafting tends to be because I can’t swear. I feel pressure now, that’s the monster I’ve created. Some place in my inner consciousness I probably want to be a writer. It’s a nice outlet to combine humour and writing and mix the politics of the day, if you will.

GEORGE CARLIN — comic genius — always makes me laugh.

I’M INCAPABLE of killing somebody or eating seafood. I literally mean I’m incapable of killing somebody, no matter how angry I could be at them. And, I just can’t stand the taste of seafood. I just don’t get it!

LAST SATURDAY, I was paddle boarding at Lac Ste. Marie, then I started reading Cutting for Stone with a 21-year-old Highland Park whisky in my right hand, on the deck. It was total bliss.

THIS MORNING, I made a cup of Chai and had some delicious homemade Gujarati snacks while nursing a horrible man-cold that I picked up somewhere at Lac Ste. Marie. My bliss was short-lived!

MY GREATEST extravagance is whisky. I grew up in England and could not stand the taste of beer. When I tasted whiskey I just fell in love. And then it progressed to single malt because I could afford it! I did a golf and whiskey tour of Scotland in 2012 with my former colleague Mike Tierney. We golfed at St. Andrews and a bunch of other famous places and rented an old fishing house right on the Bay amongst the fisherman in a town called Pittenweem. Every night we’d find a bar and I would taste a different whiskey. Heaven by amber nectar!

THE TECHNICAL ADVANCE I most anticipate is that patients will return to wanting the human interaction despite all the noise about technology. Tech cannot hold your hand, look you in the eye and comfort you like a human being.

ONE THING I NEVER leave the house without is my cell phone — it really does have all that I need and I resisted getting one until 4 years ago!

MY IDEAL HOLIDAY is visiting far off places in the wilderness. I’m just back from the Galapagos islands — aka the real Jurassic park. My favourite city is Hong Kong. It never closes or sleeps, it’s so alive, has such brilliant food, it’s inexpensive and there is so much to do.

MY GREATEST PERSONAL achievement is that I used the opportunity my factory worker folks gave me to get an education — that was their most important gift.

MY GREATEST REGRET is not marrying Sylvia Di Sisto in Grade 13 — oh what a fool I was! I’ve tried to Google her [laughs] but I’m sure she’s married now as a typical Italian young lady would be and I don’t know what her last name is anymore. We first met in grade 7. She was refreshing because she was totally into sports. She knew stuff about sports that no guy knew, like college basketball — and this was in the days before internet. She just blew me away.

ONE PRESENT I will always be happy to receive is a homemade chocolate chip cookie.

IF I’VE LEARNED ANY TRUTHS in life, it’s this: remain curious, remain humble and care about what you do; whatever it is, it will help you do the right thing.

I HAVE NO idea what’s next for me. Most of my professional and probably personal life has just been making it up as I go along. I’m not a good five or ten-year planner. If tomorrow somebody said, “hey you could be X” and it sounded cool, I might take it on but it would always depend on what the job is, not what the title is. And it wouldn’t mean that I would stop working as a physician because I’m not ready to give that part up. I’ve just taken on a position with the committee to evaluate drugs at the Ministry of Health which helps the Ontario government decide which drugs to pay for from a formulary perspective. And I’ve taken on the same position at a national level.

RIGHT NOW, I’m in a ’maintain my health’ and’ desperately trying to make medicine only a part of my life (not all of my life)’ phase. As I’m in my early 50s, I’m kind of thinking, ’okay, been there done that, now what?’. I’m trying to create some space to do something else. Subconsciously I probably work in 20 year cycles.

I STILL THINK at some point I’ll take flying lessons… just to prove to myself that I probably could fly a jumbo jet!

Dr. Eugene Leung

You can only learn to do better if you learn from your mistakes.

Dr. Eugene Leung

Head, Division of Nuclear Medicine

Dr. Eugene Leung loves what he does and is enthusiastically committed to the rapidly evolving field of functional imaging and ’Theranostics’ — today’s buzz word to describe targeted imaging and therapy that captures real-time physiologic process from the inside out. His loyalty to this somewhat misunderstood ’black-box’ specialty is evident by his drive to educate the masses on the dynamics of Nuclear Medicine, and in doing so, protect it from being absorbed by other disciplines.

I CHOSE MY SUBSPECIALTY because it exemplifies the “art” and grayscale of medicine.

I KNOW IT SOUNDS CORNY, but Bugles are one of my favourite snacks. They’re salty and I’m a salt monster. I was also trying to make a joke: ’corny’ because Bugles are made of corn. People have told me I have very opaque humour.

THERE’S NO GOOD WAY to compensate for a missing sense. I don’t know which one I’d be able to live without. I’ve actually asked myself that more than a few times. My livelihood is built on seeing things so I’d probably pick hearing… I guess… but at the same time I had a brief fling with being a musician so that’s a hard one to answer. You really do need all your senses to fully appreciate life.

NUCLEAR MEDICINE is a discipline that’s not so well known. And when things are not quite as well understood opinions get developed and perceptions are formed that may or may not be correct. I have to deal with that on an everyday basis.

BEING NAMED HEAD of Nuclear Medicine came earlier than I thought but it gives me the tools to push the division forward.

IN SOME PLACES in the world, in the United States for instance, Nuclear Medicine is being absorbed rapidly into other disciplines. Canada is a lot like Europe — the specialty is still very protected. I want to a) maintain that and b) build upon it. My loyalty to the discipline is what drives me.

MY PRINCIPLE FAULT is procrastination and epic loose ends.

MY GREATEST REGRET is not delivering the yellow rose to my wife before meeting her. It’s a segue into a story of how I met her. I’ve been very quiet and passive my entire life, so a university crush on someone you don’t know is basically just looking at someone across the room. At some point, I decided to get a flower to give to her on Valentine’s Day, but thought it was kind of corny and I never did it — the flower just sat there and wilted in the fridge. Finally, I decided to go and say hi and introduce myself and eventually told her about the flower. She said, “you should have just given it to me back then! ”

THERE’S NO SUCH THING as luck. Luck is something that results from karma. According to Buddhist teaching — by the way I’m a Buddhist — nothing happens by chance.

ONE RULE OF PARENTING: it will be a thankless job. Diem and I don’t have children, that’s a very conscious decision we made. My sister moved into town last year and I was very happy to have my nieces closer so we are no stranger to seeing children being raised. We understand that they will never have an appreciation for their parents until basically they move out. It’s an observation I’ve made and experienced because I don’t think I ever thanked my own parents.

WHEN I WAKE UP in the morning I hit the snooze button.

MY STRESS-REDUCING TRICK is listening to frisson-inducing music (pronounced free-zon). Certain classical pieces that I grew up learning and playing give me goosebumps like The Planets by Gustav Holst. He was a great composer and made a series of works that are named after the planets and Greek astrology. They were the prototypes for a lot of the movie music and things we hear in the theatres. That grand swelling soundtrack music, that’s the kind of stuff I like.

I LIKE RED ANYTHING. My hair is always red and some other colour. I started dying it just shortly after I got married. You hear of shy people doing these things to express themselves… and that may have applied to me. Everything I do in life, whether it’s the expression of how I look or the stuff that I buy, I always try and find that something extra to be special or distinctive.

ONE OF MY PET PEEVES in life are people who just follow along with the crowd because it’s the popular thing to do. I always make a point of going with the alternative if it makes sense for me. That’s why I use a Blackberry. It also doesn’t hurt that they’re Canadian… and have keyboards. I can’t type without a keyboard.

WHAT I DISLIKE most about my appearance is the cowlick in between haircuts.

I TOOK ON QUALITY ROLES for a lot of reasons. In medicine, it’s not just about knowing your stuff and planning best practices but you also need some way to circle back to see if what you’re doing is effective and to have checks and balances to learn from the process and fix it if necessary. That process is what interests me because I’m the type of person who always wants to improve.

BEST MOVIE LINE of all time: “The greatest teacher, failure is” because a) it’s from Star Wars and I love Star Wars, and b) the quote is from YODA, the most awesome Jedi Master ever. I guess it circles back to the whole quality thing. You can only learn to do better if you learn from your mistakes. It’s just another way of saying that in a very Yoda way.

I USED TO PLAY PIANO when i was younger and a lot of that skill is just rote repetition. There’s a lot that you can learn from repetition but what really brings you one step up in ability is as each process repeats, you actually learn from what went wrong in the previous iteration.

THE BEST WAY to get things moving is gravity.

I THINK you do your best when you see the lightbulb ’ah-ha’ moment on a learner’s face. I like to teach and for me teaching has always been a given. As part of an academic institution it’s an expectation that you’re supposed to do it but you need to do it willingly. If you’re just doing it because you’re told, you’re not going to succeed or get your point across. I actually want to make sure that any trainees that come through our program get the full experience they should.

LAST SATURDAY, I was recovering from a full driving racetrack day. Some people like to get their speed fix at a ski hill. I like to take my car to the Calabogie track. It’s a full-on workout unless you’re just putzing around. To learn from every iteration of going around the course, and to do it as smoothly as possible, you have to pay full mental attention. The G-forces that are involved in trying to hold the car where it needs to go are quite a lot and after an entire day you’ve gotten a full workout.

MY FIRST SPORTS CAR was a Mazda RX8. It was a very different car, a misunderstood car that people have very different opinions of…are you seeing a pattern? It’s not powered by a normal engine; it’s built with a Wankel rotary engine. The only moving part is a triangular disc that spins around. I loved that car, it was a very different experience. It’s a light nimble sports car but not very powerful. At the track, all the Porches would blow by me in the straightaways.

WHEN THAT POOR CAR had to go — I say that because I’m very loyal to things that I like —I got the dream car I’ve always wanted. It’s an Acura NSX. Its ethos is that you can drive it to work or go to get groceries but still be capable of the performance of other supercars like Ferraris which can be difficult to maintain. Diem and I are very cognizant of the fact that it was the only one in Ottawa… so we cannot drive like bad citizens.

 

WHEN I REALLY WANT SOMETHING, I obsess and research endlessly. I build water cooled computers for fun. There’s an art to putting a computer together: a lot of customization, planning the cooling loop and seeing how it looks. So, choosing all the right parts and making sure they work well sounds kind of superficial but that takes a lot of time and research.

I’D EAT MELT-IN-YOUR-MOUTH pork belly all the time if it wasn’t for my health. I don’t understand how people stick to bland diets and refuse to try new foods.

MY FAVOURITE activity outside of the hospital is playing video games; the immersive first-person story-driven type. They still involve shooting things but you also spend a lot of time building the characters and getting to know the environment. Mass Effect is one of these big science fiction soap opera epic types that I like. My wife doesn’t play these types of games but she really enjoys sitting there watching the story. Each of the characters that I’ve built and become fond of, she knows them all by name too.

ONE PRESENT I will always be happy to receive is LEGO. I still have all the LEGO that I’ve ever been given — giant bins of it. As a kid, I was always proud of the stuff that I built because of all the time planning and putting it together. I wouldn’t stop the iterations until I was happy with the final product.

I GREW UP in the bedroom community of New Market. My mother was a cartographer; my father was a high school geography teacher. My Dad was actually the only one out of eight generations who was not a doctor. He decided in his own way to do his own thing and I appreciated that about him. If he had also been a physician I’m not sure I would have sought it out as much.

MY PARENTS are very big on tradition and respecting culture, which I don’t have a problem with. But, a big part of that has an element of doing what you’re told and going with the grain. As I’ve matured, I’ve realized that that type of thinking bothers me. While I was raised that way, I would not choose to label myself as a conformist now. It irks me — that type of thinking.

MY MOM TAUGHT ME to recite the multiplication table in Chinese.

MY GREATEST professional achievement is gaining the respect of my peers.

MUSICAL IMPROVISATION is the talent I’d most like to have that I currently don’t possess; I’ve always admired the creativity and spontaneity of expression that was the next step beyond technical competence I could never achieve.

BABY DUCKLINGS always make me laugh.

IF I HAD TO write my autobiography using only 6 words it would be: “Never pet burning animals in fall”. You know how at the end of every school year everyone goes around signing each other’s year books? Well, someone wrote that in mine. It was just the most random, stupid sentence that to this day I still have no idea what it means, but I keep thinking about it. There’s always a thread that connects everything but when there isn’t a thread – like this — then I wonder… okay, was there never meant to be a thread or is it that I just haven’t looked hard enough?

I’M PARTICULARLY PROUD of our M&M rounds. We didn’t have them at one point. So I’m very happy that when these rounds occur that not only do all the staff physicians come but also the trainees and administrative staff, technologists and managers. And they all contribute, they’re all part of the conversation. That part I’m proud of because that’s the kind of division I want – to ensure everyone feels that they have a say. 

I HOPE MY LEGACY will be that I was instrumental in turning Nuclear Medicine back into its own.

Dr. Lisa Mielniczuk

If You Really Love It, You Can Do It All.

Dr. Lisa Mielniczuk

Division of Cardiology

The grand-daughter of polish World War II survivors, Lisa Mielniczuk absorbed at an early age that nothing comes easy in life and to value hard work. She would study to become a Cardiologist with advanced training in Heart Failure and Transplantation, co-found and direct numerous innovative clinical programs and build from scratch a unique clinical and translation research program to evaluate mechanisms and novel treatments of pulmonary hypertension and right HF. With over 65 peer-reviewed publications, a University Research Chair, numerous Provincial and National consultancy positions and invitations to speak at countless international venues, she is considered one of the Departments young female superstars.

I THINK those that are very successful are those that have learned the importance of perseverance and tenacity.

AM I REGIMENTED and organized? Yes, absolutely, very much so. The first thing I think about in the morning is what needs to get done— both personally and professionally. When I get to work every morning, I write what I need to accomplish that day on sticky pads. Even on the weekends I write myself a list. I’m the type of person who will put something on that list that I’ve already done, just to cross it off —because that feels good to me.

PEOPLE HAVE JOKED that I use the word phenomenal a lot, that I’m over enthusiastic about things.

THIS SUMMER I took my kids up to the Yukon with some other family members, rented an RV— it was absolutely phenomenal (1). We went camping in Whitehorse and Alaska and I was completely unplugged for the first time — for about a week! It was stressful at first but felt good after about the second day.

APPRECIATING THE BEAUTY of nature and being outside is a shared family trait.

I DON’T LIKE IT when people say, “That is not my problem”. Complaints are normal, they’re what move us forward as a program, but it’s that discontent matched with ’but I don’t want to take part in building a solution’ that I find frustrating. Those that are unhappy would have the most valuable input because that’s exactly where we’d get the most delta in terms of things that need to change.

THE BEST WAY to get things moving is to move them yourself.

I’D EAT homemade bread and aged cheese all the time if it wasn’t for my health.

EVERYTHING tastes better when you’re camping.

MY GREATEST GUILTY PLEASURE TV show is the Walking Dead. At first, I thought it was the worst show ever and then I got hooked. It’s a phenomenal (2) story about human survival under the most perilous conditions; how do we stay together, how do we keep our humanity in the face of everything that is tearing humanity apart both literally and theoretically — that’s the part of the story I love. By no means would I suggest that I am attracted to the gore, it’s horrible but sadly you can desensitize to it after about the first four or five episodes.

MY FAVOURITE MEAL is turkey dinner, everything from the preparation to the dessert— it is such a wonderful meal to share with family and friends.

MY MOST PRIZED childhood possession was my Playmobile ambulance. My parents bought it for me when I was about six or seven and I loved it. It had a little stretcher, paramedics, a patient with a cast that came on and off; it even had little intravenous bottles and plastic tubing. From that I built a hospital using a little bookshelf in my room. That was probably my earliest interest in healthcare. Although at that age I don’t remember saying I wanted to be a doctor.

I GREW UP in downtown Toronto. My father was an early IT specialist; my mother was a salesclerk at the Bay. I was raised to be a strong and confident person. My parents taught me the importance of resilience and self-reliance. I come from very humble beginnings. My fathers a phenomenal (3) man; he himself had very humble beginnings. His parents are Polish and were displaced in the Second World War by the Germans into a work camp. My father’s upbringings were one of self-reliance, resilience, working hard to get to where you need to be and he instilled that in us. This idea that nothing comes for free, that you must work very hard— these are important traits that I’m trying to teach my children. And then when you are successful, be grateful and give back, make sure you share that with others.

I’M PROUD OF MY BROTHER for always following his passion. When we were growing up, I always had my nose in the books and he would do what needed to get done to get through, but still always had a very good sense of balance. He loves sailing, he co-owns a boat, he’s very physically active and fit and always takes time to take care of himself and to do the things that he likes to do. I probably could learn from him. I tend to switch the needle from work and Cardiologist to Mother. One of my character flaws is that I don’t have a lot of middle ground. My brother is very good at finding that middle ground.

I TOOK A JOB in high school as a receptionist at a health clinic in my neighbourhood. I was so curious, had so many questions, and one of the physicians there taught me things about medicine and about the world of being a physician. There have been people in my life who have been incredibly influential. She was one of them. Her patients adored her — the feedback I used to get at the front desk about this woman was phenomenal (4). She changed their lives and I thought, I want to be like her.

MY MOM taught me to believe in myself.

I ALWAYS WANTED to have children. I played with dolls as a child, babysat as soon as I was old enough; I was a caregiver the whole way. Where I grew up, there was a group home for developmentally handicapped kids right down the street from my house. I started volunteering there when I was ten and would go every day after school and on weekends. These kids —who were essentially my age — were severely physically disabled, non-verbal, wheel chair bound, needed to be fed and needed lots of care. The group home parents there were people who also influenced me greatly.

I WOULD NEVER DO WELL in any environment that was based purely on making a profit.

SPEAKING MULTIPLE LANGUAGES is the talent I’d most like to have that I currently don’t possess. Sadly, I’m unilingual; even after being in Ottawa for 10 years, my kids know more French than me. I’m fascinated with people who can speak multiple languages. It’s on my bucket list to become more of a polyglot but I don’t know if it’s too late for me.

WHAT I REALLY LIKED about heart failure and transplantation was the relationships that you developed with the patients. You are with them at some of the most critical and life-changing points in their life and that’s a real honour in my mind. And the complexity involved in those decision-making processes is very intense and I found it very enjoyable and very rewarding. These patients will be under your care for the rest of their lives. You really have an opportunity to get to know folks very well and be involved in their care at a very deep and intimate level. And I was absolutely drawn to that.

I’VE ALWAYS BEEN INTERESTED in research. Going to the literature to find the answer and then not finding the answer is exciting to me. I spend my day dealing with patients at the bedside on a one-to-one level but I also have this great opportunity to hopefully influence the care at a population, or a system level with research.

I’VE HAD THIS GREAT OPPORTUNITY to participate as part of Provincial and National groups and that’s really where the rubber hits the road — where you’re actually around the table with incredible geniuses and phenomenal leaders trying to figure out how best to serve a group of people at a population level.

WITH RESEARCH, the ratio of investment of time for dividend reward is very skewed. And when you are a clinician researcher, you have to be prepared to accept that a lot of that gets done after hours. If you don’t love it, don’t do it, because research is all encompassing. And you have to be all in to do it well. If not, you won’t be happy.

I SEE THE POSITIVES when the system takes care of the patients in the right way and I unfortunately see the downside, the limitations, whatever they may be; constraints on resources, lack of therapies, lack of transitional care, whatever those constraints are I see them and I see how they influence patients. For me, being able to affect change in a positive way in any of those areas, that’s my biggest driver.

I ALWAYS TELL PEOPLE that I am the luckiest person in the world because I love my job; I love coming to work but I also love being home. I’m happy wherever I am but by far and away, my greatest accomplishment is raising my three children. If nothing else, creating three little people that I hope will make this world a better place — to me that is the number one important or impactful thing that I will ever do in my life.

BEING IN MY POSITION I get an opportunity to respond to people who ask, “Is it possible to have it all?”, especially women coming up through medicine. They feel — especially as they train in Cardiology — that they almost have to choose. Am I going to have a family, am I going to be academic, should I go into private practice and I like that I have the opportunity to say, “If you really love it, you can do it all”. You have to depend on some of these crazy things like ’Nannies On Call’, and have good support around you but you absolutely can. I think academic medicine affords that, perhaps even more than private practice. Because you get the beauty of patient care and if you love research, leadership, administration, teaching, whatever it is — you get to do it all!

Dr. Kevin Burns

You go through lot of phases in life. Right now, I’m well past my best-before date.

Dr. Kevin Burns

Division of Nephrology

Dr. Kevin Burns is one of Canada’s most influential kidney researchers, but not just for his impressive grant and publication stats and the impact his research has had on care but for the passion and commitment he invested to establish and develop KRESCENT, a national training program designed to attract and sustain kidney researchers in Canada. Kevin shares what he learned from a life dedicated to medicine including the unexpected tragic death of a sibling, a life altering pep talk from a supportive father and a recent and surprising medical diagnosis.

MY PRINCIPLE FAULT is a lack of patience. Recently one of my lab people ordered reagent and it didn’t come in so the experiment didn’t get done. At the lab meeting they said “oh, don’t worry it’s coming in next week”, and I said, “next week? That’s way too long! Pick up the phone and tell them you need it yesterday”. I have very little patience for accepting the norm, just figure out a way to get it done. To the point that sometimes people around me will say “wow, that guy doesn’t understand, he really needs to relax.”

IN HIGH SCHOOL, I was very good at mathematics and terrible at dating girls. I was terrified to talk to anyone from the opposite sex– absolutely terrified! It was only in university that I even started speaking to girls.

WHEN I WAS SIXTEEN OR SEVENTEEN I wanted to be a biologist or an artist. I used to like drawing and painting and had a bit of talent. Teachers in high school encouraged me to pursue art but my father would say “you know it’s pretty tough out there to be an artist so maybe you should stick with science, you’re good at it”. And there was no question that I was good cat it. I loved analytical stuff anyway so I kind of gave the art up. I bought some paints a few years ago and painted a few things but then stopped – just for lack of time. Maybe one day…

I KNOW IT SOUNDS CORNY, but my wife Francine is my best friend.

MY GREATEST REGRET is not having 10 kids. I have three sons: two stepsons and my son William, who’s now 16. I was an older Dad and loved the experience of having a young baby and all the stuff you needed to do in those early years. And then as he got older I enjoyed bringing him to the arena for hockey and an opportunity to socialize with other people — it really broadened my horizons. Before fatherhood, I had the blinders on by research and medicine. Up until that point I was a self-centered narcissist. Then you have a child and suddenly the world is not yours anymore, it’s somebody else’s. Being completely responsible for somebody else is very healthy, so… the more kids the better.

I KNEW I WAS GOING TO BECOME a physician when I opened the acceptance letter from med. school. All bets were off until then. And actually, I almost dropped out my third year. Even though I was really book smart, as soon as we got into the hospital setting and convert knowledge to practice — I couldn’t handle it. I could analyze things; I just couldn’t deal with all the pressures of the hospital environment. So, I came home one evening and called my dad and said, “listen, I don’t think this is for me, I’m just finding it too hard. I think I should go into engineering. Tomorrow I’m going to dropout”. I was living in downtown Montreal at the time, going to McGill and he was living in Laval, which is about a 45-minute drive, and the next thing you know he’s knocking on my door. I remember it like it was yesterday — he was very kind and supportive and said “let me help you, what is it that you’re having trouble with? Let’s go through your patients”. He had no knowledge of medicine but could put things in perspective. He helped me get organized and figure out some simple things that I could do to get through the day. He told me “you can do this”. That talk prevented me from making a knee-jerk decision that would have been big mistake.

I’M INCAPABLE OF sitting still. I was always fidgety and had little ticks as a child. People in my family would point out that I kept touching my chair a lot…my nose, things that I didn’t notice. I’ve had those all my life. My leg jumps when I’m sitting so I don’t like sitting for a long time. Francine especially doesn’t like it. When we’re out she’s always telling me to stop moving.

I HAVE A RULE IN LIFE: Promise nothing, deliver everything.

MY STRESS reducing trick is running/exercise.

 

I GREW UP in Chomedey, Laval. My father was an electronics salesman. My mother was a secretary and taught me to be myself and be satisfied with that. I was raised to be independent due to the dynamics in my family. I was the second child. A lot of attention was devoted to my older brother even though he was very outgoing. He had some issues we could see early in life, started having depressions as a teenager and was diagnosed as bipolar. So, a lot of the energy in the house surrounded him. I took care of myself so my parents never had to worry about me.

I WAS VERY CLOSE to my brother, he was quite successful, very, very smart and funny. He was also studying to be a doctor. Sadly, with only three months left before completing med school, he committed suicide. Up until that time in my life I had never been exposed to personal tragedy. It obviously had a huge impact on me as it would on anybody in any family. It took me a good decade to really recover and get my life in order. I went through some bad years and had to get therapy. It was devastating. On a positive note, I have much more empathy now for people with mental illness. Too often I’ve seen situations where others don’t have that kind of empathy. I’m totally healed. Our family can, and still talk about it, and it’s something I carry every day —you never forget, it’s always there.

I THINK PEOPLE SEE ME as aloof or intimidating. People have told me that actually. So, when you hear it enough you think, ‘well, it’s probably true’. Perhaps it’s because I’m quiet and have a serious demeanour and I can sometimes speak forcefully about things in meetings or even one on one. But I’m disappointed to hear that, so that’s why I’m softening with time. Intimidation to me means that someone is fearful of responding or saying something because of the way you are. And that’s not something I would encourage at all.

AT NIH IN BETHESDA, MARYLAND there was scientist by the name of Mo Burg who discovered how-to perfuse kidney tubules —he was a giant in the field and the nicest man I ever met. I spent a day with him and was so impressed that I knew I wanted to work with him. But I was also scheduled to visit the Vanderbilt University Medical Center in Nashville and it was also great. So, I went to one of my mentors for advice and he says to me, “you know, Dr. Burg is getting a little bit up in years. What if you get down there and he suddenly says he’s retiring and then you’ll be stuck with nobody?” So, I went to Nashville. And then every single annual meeting of the American Society of Nephrology I went to I would see Dr. Burg — no kidding. Even now! He obviously didn’t retire then and he must be in his late 80s now. And believe it or not he’s still doing research.

I SPENT MOST OF MY CAREER studying the renin angiotensin system in the kidney. But most recent work I’m doing is a complete 180 from that. I’ve always been interested in acute kidney injury, where patients suddenly lose kidney function for a variety of reasons such as infections, post operatively, blood loss — the kidneys just shut down. Up to 50% of patients in the ICU have this in various grades but if you have the severe form of what we call acute kidney injury or AKI, there’s a very high mortality rate — about 50%. There are absolutely no treatments despite 50 years of research; either to prevent it or to enhance the recovery of kidneys which have the capacity to regenerate once they’ve been injured.

SEVERAL YEARS AGO, there was literature starting to come out which asked the question ‘do stem cells help kidneys regenerate?’ So, I linked up with David Allen in Hematology who was isolating core blood and core blood cells at the time and we began to collaborate, along with Dylan Burger at the Kidney Research Centre. Fast forward past some initial failures to today and our current success. My lab is discovering the therapeutic properties of small extracellular vesicles (exosomes) derived from human cord blood endothelial colony-forming cells. To date, we’ve already shown that injecting specific microRNA, (miR-486-5p) isolated from these exosomes into the mice can repair the kidneys. Now I’m working with a PhD scientist at uOttawa who’s interested in nanomedicine to create particles called nanoparticles that we think might be used to package this microRNA to deliver and target the kidneys in larger animals — that’s the next step.

I’M VERY HOPEFUL, it’s the most exciting thing I’ve done in my career in research. Every time I go into the lab I’m blown away by what we’re finding. Usually with research it’s very incremental and iterative but our data has been off the charts right from the beginning. I’ve always been very skeptical; you learn to be as a scientist. Always thinking that this can’t be true, let’s do it again. But this time I’m very excited. But, because I’m getting in the late stages of my career I know that we’ve got to move this quick. I’m hopeful that my recent 5-year grant and the research it supports will someday lead directly to novel treatment strategies for AKI in humans.

YOU DON’T KNOW what people are really like until you have a few beers with them.

SLEEP is life’s greatest luxury. Last Saturday, I slept in until about 9:00 a.m., then fixed my ride-on mower. I watched a YouTube video to guide me through the repair otherwise there’s no way I would have known what to do. Francine can tell you stories about me screwing up small renovation projects. I love that stuff but I’m terrible at it and I’m in awe of people who come by it naturally.

I DO MY BEST THINKING in the early morning, alone when I’m in my office with no calls or emails. I get up around 5:30 a.m. and get to work early. It’s probably the best time of day for me to think and when I tend to write.

MY MOST MARKED CHARACTERISTIC besides shyness is a good sense of humour. Humour for me is one of the things I love most about living. Comedy, humour and having a sense of humour will get you through anything. That’s my raison d’être. Francine says I tend to be funny when I’m in front of an audience, that it comes kind of naturally even though I dislike public speaking. I think it’s a good ice breaker for me.

FEAR is when your 16-year-old son starts driving.

WORDS I SHOULD USE MORE OFTEN are ’thank you’. It’s something I sometimes neglect to say to acknowledge people who have done good or nice things. I’ve got to be more appreciative of what people do. It’s a weakness. It’s a problem. I’m working on it.

I AM MOTIVATED by stories of great leaders. To compete in life, you’ve got to believe in your abilities and then to become good at anything you should practice, practice, practice. When I really want something, I am relentless.

FLORENCE OR BARCELONA are my favourite cities because I love the ambience, art and romance.

I ALWAYS WANTED an electric guitar. If after I died I could choose to come back as something, it would be a rock star because I love rock music, in fact I’m trying to learn how to play guitar. Ever since I was a teenager I’ve been going to rock concerts and it always seemed to be the dream life — the music and the performance. Not the drugs.

WATCHING HOCKEY is the perfect outlet for me. I’m a Sens super-fan. But my favourite activity outside of the hospital is playing golf. The afternoon of my dreams would include a golf game, then a cruise on the Gatineau river.

MY GREATEST PROFESSIONAL ACHIEVEMENT is establishing a national kidney research training program (KRESCENT) designed to attract people into this field. It was a tremendous amount of work but I enjoyed it because I had this idea that it was going to be good for the future of Nephrology in Canada. Almost 70 trainees have graduated, many of whom are top notch researchers. It’s become a model for other research training programs in Canada.

IT HAS BEEN extremely gratifying and humbling to see all those young people succeed.

WHY DID I STEP DOWN from KRESCENT? Last summer I was diagnosed with an illness; I have Chronic Lymphocytic Leukemia (CLL). It was out of the blue and showed up with blood work. So, after speaking with Francine I knew I had to make some changes in my life and gave up several administrative roles. I’m not shy to talk about it but I don’t want sympathy. Other people have much more serious issues that they’re dealing with. But even before I found out about CLL I was thinking that it was time to transition out, I’ve been doing this for fourteen years, somebody else should be doing it now. I’m really concentrating on my lab, that’s my main focus right now.

BEST MOVIE LINE of all time is “I’ll make him an offer he can’t refuse.” I like all the Godfather movies and Goodfellas because they’re kind of seedy and dark and tough — things I like. I’d like to be like some of those people in someway…well, maybe not quite.

IF I HAD TO WRITE my autobiography using less than six words it would be ’His friends called him Heavy Kevy’. It was a nickname I had in high school because I was always pensive. Heavy meaning ’lighten up’! I was always worrying about something, like an exam that was coming up.

WHO KNOWS WHAT’S NEXT. I’m just trying to live every day and I hope to continue working for five more years— that will bring me to age 65. And that’s the length of my research grant. I want to concentrate on that and see it to completion.

Dr. Alison Dugan

There’s no such thing as being too old to run through the sprinkler.

Dr. Alison Dugan

Division of general internal medicine

Dr. Alison Dugan has a long and passionate history with medical education. Her philosophy about teaching has developed over the years through a variety of educational exposures like revising the entire Undergrad Medicine curriculum, running the International Medical Graduate Program, developing feedback workshops and guiding small groups of learners through her CBL teaching. Today she is putting a big emphasis on a part of the curriculum that she feels is vital, but not always acknowledged or evaluated, and that is the importance of communication.

I CHOSE Internal Medicine as my subspecialty because I liked all of it so well and really didn’t have to memorize the coagulation cascade.

WHEN I WAS SIXTEEN or seventeen I wanted to be an astronaut.

I PROBABLY WOULDN’T have been a physician if it had required 2nd year university physics.

LAST SATURDAY, I went for walk around downtown Boston before going to school for a week. I went to do the Harvard intensive internal Medicine Review Course because sometimes I think, ’am I on top of all this stuff?’. You work from seven in the morning until seven at night for eight days in a row. So, I arrived a day early and snuck in a bit of down time before the craziness started.

I DID AN ENGLISH lit degree before I went to medical school. I knew I wanted to study medicine but while I was sitting there in life sciences I thought, I don’t really want to study this. So, I changed and did Victorian literature…restoration literature… Chaucer… Shakespeare. Typically, we teach our medical students in the science track and don’t necessarily get them to think so much about the humanities. Reading books makes you understand things about people. I think we may be missing something there.

HISTORICALLY, medicine’s curriculum has been heavily weighted to facts with not so much focus on communication and emotions. People are emotional and they care about feeling connected.

GOOD COMMUNICATION is such an important part of what we do in so many jobs and yet we don’t really acknowledge that it’s important…or talk to people about how to do it well —especially in groups. Yet when I look at my colleagues and residents on the wards who do it well, it’s just such an obvious asset — to be able to listen to other people, to recognize when they have an emotional response to something and to be sympathetic.

MY IDEA OF MISERY is being stuck on parliament Hill during a celebration.

MY GREATEST JOY in life is a canoe trip with my kids.

MY PRINCIPLE FAULT is my irrepressible desire to question authority, and challenging doing things just because of “rules”, when sometimes the rules are just wrong.

YOU DON’T KNOW what people are really like until you see them tired and hungry.

THE BEST ADVICE I was ever given was listen more, talk less.

IF I COULD ONLY pack 3 things in my suitcases to travel to an unknown destination, they would-be a Kobo reader with unlimited battery power, my mouth guard and a light sabre.

CHRISTCHURCH, NEW ZEALAND is my favourite city in the world. I spent 2 years working there. It was a great job, I had great friends, tons of adventures and the most beautiful country right out my front door. It was just a wonderful place to live but it was on the other side of the world and my family was all here. It was not a simple decision… we, my ex-husband and I, spent evenings making pros and cons lists for both places to determine whether we would come back or not. Jeff Turnbull was Head of our Department at the time and I can say quite frankly that he was one of the strong reasons for me coming back.

RIGHT FROM THE MOMENT I arrived in Ottawa I was involved in medical education — when Alan Karovitch and I took over as co-chairs of the Medicine Clerkship. We basically revised the entire curriculum, including the exam, and introduced the initial version of Problem Assisted Learning Sessions (PALs). Back when we were training, Alan and I would round and do physical exams daily, but our medical students didn’t always get that same opportunity so we also introduced physical exam teaching which, as far as I was concerned, was extremely important.

IT WAS ALSO important to teach the students about the role physio, occ health and social work played so we started sessions called ’Who Else Are on the Team’ to help them understand and navigate the barriers to a person being able to get home. Medical students are eager learners. If you teach them right they can learn to be doctors who really understand that it’s not just about the 17 causes of heart failure. It’s also about the wife who, when she gets home must pick up medications, which might be difficult if she can’t leave the house because the patient has other issues. That’s where I started in medical education. I did that job for 10 to 15 years.

I REALLY LIKE working with the medical students because of their enthusiasm — that combination of happiness they have when they get into medical school and the fact that they are very open and respectful and you feel like they are waiting on every word you say. I see this all the time as part of the CBL teaching I do.

I WAS IN A MEDICAL SCHOOL with 85 students and got 8 hours of lectures a day. As part of CBL, my guys sit in groups of eight and discuss how to solve a problem. This format allows the students to be more fluent, and consider scenarios like ’what if this was a different gender or age?’ In fact, it was the students who said, “when we do it the same way all the time we don’t really feel like we’re really getting our chops”. In this setting they each have to contribute to the conversation but not take too much air time and squeeze other people out.

 

I WAS ALSO responsible for running the International Medical Graduate Program for 7 or 8 years and was involved with the group in Toronto that reviewed the results of the screening exam and the Objective Structured Clinical Examination (OSCE) and then there would be a match. Three to eight people would be deployed to Ottawa and I’d develop curriculum specifically designed to meet their needs in order for them to transition into applying for residency here in Canada.

MY SENSE of humour is never disrespectful. I use humour a lot in my teaching because medicine is a very heavy duty topic and it helps take the edge off how difficult it can be. I think it’s a way to bond the team and make it through a long day.

MAYBE I’M WRONG, but I think the world would work much better if instead of trying to find jobs that earned the most money, we tried to find a job that made us REALLY want to get out of bed in the morning and validated uses people.

I DON’T UNDERSTAND how people would rather watch a sport than play one.

WORDS OR PHRASES I should use more often are: Don’t make me wave my wooden spoon at you!

I DON’T LIKE IT when people say, ’what are you having?’ at a restaurant. Are you asking me that so you can decide what you’re having? It’s a funny question, I don’t know why people ask that.

I AM MOTIVATED by chocolate in most forms.

I HAVE A RULE in life: leave room for dessert.

AS YOU GET OLDER, you get more comfortable looking silly while having fun, rather than looking good and having no fun.

I THINK you do your best when you like yourself.

THE THREE GREATEST WORDS in the English language are: honesty, kindness and empathy…or supercalifragilisticexpialidocious, onomatopoeia and slither.

CLEAN SHEETS (especially flannel) are one of life’s greatest luxuries.

THE AFTERNOON of my dreams would include a bike ride, a swim and a nap!

ONE PRESENT I will always be happy to receive is a new book I haven’t read or wool for knitting… but there isn’t room on my bookshelves or in my closets for any more of either.

MY FATHER was a Physics student and later a University Professor and my mother was a California dreamer — born in California and raised in San Diego. She studied social work and had a very strong sense of what she thought was the right thing to do. We lived in Boston when my Dad was getting his PhD and my parents had five kids before he got a real job in Canada as a professor — talk about stressful. My Mom had never seen snow. I was eight. 

I’VE BEEN SHAPED by growing up with four siblings and not much money, and lots of tasks to do.

WHAT I GOT from my father was an understanding of the importance of civility and good manners.

MY GREATEST professional achievement was convincing my colleagues to recruit Alan Karovitch! I think he’s a Mensch: he’s honest, ethical, smart… he’s just a superstar. I have a huge amount of respect for him. He’s just a really excellent role model. There was a point in a conversation when it could have gone either way and I’m like, “you cannot let this guy go.” He absolutely should be here, he’s like a rock star.

I DON’T FEEL super comfortable blowing my own horn but what I’ll say is that what patients tell me almost all the time when I give them an explanation about something is “nobody‘s ever explained it like that before, and I really appreciate you taking the time and helping me to understand it”. I think that when patients understand, they can manage much better. I would say my biggest educational accomplishment is conveying that to the residents that come and work with me on an ongoing basis.

I ALWAYS wanted a horse. All four girls in my family are horse crazy. As kids, all our games were imaginary where we’d scoop up the leaves in the fall and make stables, then we’d pretend to sleep in the trees while the horses were sleeping.

I’D LIKE TO BE transported into the movie avatar because like I said, I wanted to be an astronaut. Touching the plants that would disappear and riding the winged creatures would be so cool. And the message of respect for the environment and for other living creatures — I thought there were a lot of really nice themes in that movie.

CHARLTON HESTON would portray me in movie about my life. You’ve got to watch the ten Commandments or Ben Hur and then you’ll understand. I’m kidding of course.

IF I HAD TO WRITE my autobiography using only 6 words it would be “MUM and doctor, best jobs ever!”. My Dad and I were out walking —probably 10 years ago or so — and he asked something having to do with my life and I replied, ’you do know that having and bringing my kids up has been the most amazing thing I’ve ever done’. And he was completely shocked because he thought I would be most proud of my career in medicine. I feel so lucky to have had the opportunity to raise my kids and have job like being a doctor.