To compete in life you’ve got to take advantage of even small opportunities with tenacity.
Dr. Alaa Rostom
Division of gastroenterology
Dr. Alaa Rostom is a self-professed geek. He builds his own computers, tinkers with electronics and solders almost every day. According to this Gastroenterologist, when it comes to technology, he’s right up there in geekland. And there’s more. He flies racing drones. Yes, that’s right – racing drones, even has a bonafide drone pilot certificate! He’s serious about this stuff. The word enthusiast does not even begin to describe him. When it comes to hobbies, he takes them all to the extreme!
Alaa’s passion goes far beyond pastimes though. To compete in life, he says, you’ve got to take advantage of even small opportunities with tenacity. And take advantage he has, building the Calgary Colon Cancer Screening Centre from the ground up and returning to Ottawa to Head the Division of GI. Whether leading a national training program for practicing endoscopists or tackling the system-level coordination of endoscopy, medical and surgical services, Alaa’s determination and conviction to improve the quality of patient care across this region is undeniable.
Below, a wide-ranging discussion with Dr. Rostom about playing complicated riffs on his guitar, what it would be like to visit time zero and his love of dogs, music and photography.
When we started our program in Calgary, we were able to hire everybody ourselves and chose them on the basis of their interpersonal skills and ability to be free thinkers. What I found was that if people buy into the process and have a vested interest in its success, then motivating them isn’t hard. So, every policy and procedure was basically created by the actual front-line people. We included them in all the decision making. I think that’s the key, particularly in a work environment; valuing people for what they can do.
I’m not afraid to voice my opinions, even if they’re unpopular to people that are higher up than me. You have to be a strong advocate for what you’re trying to do.
Courage is doing the right thing even when there is no benefit to you.
I really dislike people who exercise their power over others that have no power: whether that’s in society overall or in the work environment. It really burns me when a manager/supervisor treats their staff poorly and I would probably fight against something like that.
In the last little bit, my genuine goal has just been to bring the level of care for gastrointestinal patients in Ottawa to an acceptable level for a major teaching hospital. And I think that we’ve accomplished that actually; I think we’ve filled in all the clinical care gaps. We have brought all the advanced skills and procedures available elsewhere (except liver transplant). Now we can concentrate on the academic side.
I had the opportunity to go visit the UK where they had implemented, for the first time, quality metrics to measure Endoscopists’ skills. As a result of their success, we adopted it too. If you’re measuring quality and realize that only 80% of physicians can do a full colonoscopy or can’t recognize what they see or can’t remove polyps, then you need to educate them on how to get all to obtain these minimal skills. So, we developed this national hands-on training course where participants observe one another via a video feed. This way more people can watch and learn. When it’s their turn to practice they’ve already benefited from watching previous instruction. This program started off in Calgary. Now we have a centre in almost every teaching hospital in Canada and I am invited to demonstrate this course internationally.
I’ve also been working in the region through outreach and mentorship to try and improve quality. I go to different hospitals to assist them with complex cases. I feel that helping gastroenterologists and surgeons update their skills regionally, not non benefits them, but all their patients as well and works towards ensuring patients get the same quality of care regardless of institution or region.
Right now, there’s a complete lack of coordination of our healthcare system. Regionally, this is akin to the tragedy of the commons. Each hospital hires and provides services for a narrow window of needs, but the region as a whole suffers from lack of resources in key identified areas of gastrointestinal disease medical and surgical care. For example: a hospital needs a surgeon or endoscopist, throughout the rest of the region, there are more surgeons and endoscopists than are needed regionally. So rather than collaborate and move surgeons to cover this hospital in need, the hospital just hires yet another surgeon who duplicates services that are not globally needed. I feel that without a true central regional coordinating authority, there really can be no fix for these issues since good will unfortunately only goes so far.
If I had one trip in a time-machine I would see what happened at time zero. Another geeky thing about me is my interest in quantum physics. If I hadn’t gone into medicine that might have been a very interesting field. From a philosophical, religious and scientific perspective I’m curious about that moment.
My idea of misery is stagnating. I think that personal growth and progress is really important; we all have something to learn. Early on in our careers, my wife Catherine and I felt that we had reached a certain level and that prompted our move from Ottawa to Calgary to take part in developing an the provincial and regional colorectal cancer screening programs from beginning to end. The experience was incredible for both of us. My hope is to give young GI staff opportunities like that here in Ottawa.
What I got from my father was his nose, though my mother’s is not a lot better.
I grew up in Cairo Egypt until age 6. We moved in part because of the instability in the region. My father was a TV announcer and journalist and my mother was a child psychologist. She did her training at Ohio State University and was constantly back and forth to the States. She got an offer to lead a program for developmentally delayed children so in the context of what was happening they thought, why not move. My Dad never really adopted very well to the move to Canada. Although I definitely believe my brother and I have had a better life here in Canada and I am very grateful for that, I don’t think that my parent’s lives were better. They sacrificed a lot and the instability they were concerned about never really materialized and most of their peers did quite well in Egypt.
One characteristic I share with my sibling is my bald head.
I’m most proud of my brother for our close relationship. If I need something, I know that he’s gonna be there at a moment notice. And likewise, on the opposite side. We’ve gone through a lot together as a family; my mother had polio when she was a child. My brother and I experienced a decrease in her physical ability when we were living with her and I think that brought us closer.
I knew I was going to become a physician in my early teens. I liked biological sciences and I also really like helping people. Part of it may also have been my mother’s illness. I was attuned to that and felt that it would be nice to be able to do something that was both sciences based and would help people.
You don’t know what people are really like until you stick a colonoscope up their butt. I’m joking of course. Unfortunately, in my area, simply because of how invasive the procedures are, it could be the most horrible experience of people’s lives, especially for young people. So, I try and keep things lighthearted in the endoscopy suite whenever possible. I also take the time to explain what’s going to happen and most of the time patients come out saying, “Well, that was a lot better than I thought”.
If you learn anything with age, it’s that you have a lot to learn.
I think those that are successful are those that can compartmentalize and maintain perspective. I’m not good at either of those. I’m not somebody who is able to go from one task to the next without the previous task possibly distracting me. Or not like people who, when they’re at work, do their work-related stuff, but then when they go home, they’re able to leave all that behind and be 100% focused. I find that really challenging. I am better at it now than I was, but it is still an area of personal growth for me.
One rule of parenting: be available.
I don’t understand how people can dislike dogs! I like the companionship they bring and the unconditional happiness and love. They’re always super excited to see you. I know its kind of cliché, but it’s true. I also I think it is a real privilege when your dog knows you so well and trusts you that there is this non verbal communication.
It’s important to make decisions based on facts, empathy and compassion. But it is important to be decisive.
I do my best thinking while walking alone or listening to great music. My parents always listened to music and encouraged me to play some sort of instrument. I’m definitely not a natural. I still have the red guitar I played when I was six years old. My son is a natural. He was never really interested in the technical side, whereas I’m actually way more interested in trying to get the song almost exactly as it was played – try and reproduce that great riff as perfectly as possible. He’s more on the artistic side so he wouldn’t concern himself with getting the song as it was written, but rather make it his own.
Part of my stress reducing trick is meditation. My brother works for this big law firm in Toronto and they brought in personal coaches to increase their productivity. I had heard that meditation is great; everybody sings its praises. But then when my brother, through this year long personal coaching, said it really was quite beneficial, I actually started doing it. I started with an app called Headspace. It only takes 10 minutes; I highly recommend it.
The most imaginative thing I’ve done as an adult is create a videography from wildlife drone footage. There was a short period of time between moving from Ottawa to Calgary where I wasn’t working and got back into all my old hobbies; flying remote control airplanes and photography for example. I was in the park one day and serendipitously met this group of people from all walks of life who shared my interests, so we started going out before sunrise to photograph bears and wolves – you name it. Then this new remote-control helicopter came out that had four propellers. From the moment that thing came out, we started sticking cameras on it. We were actually at the forefront of developing drones. I even tested them for a company in the US. What I’m into now are these little micro drones that you can fly around the house, inside or out, that have cameras on them. And just so you’re aware, I have a license to fly a drone through taking an online exam. It’s funny because after I passed this exam, I was telling Catherine that this is the best achievement I’ve had in so long.
The stupidest argument to have with somebody is about politics or religion.
I’m least tolerant of dishonesty in others. It’s hard to work with people if you can’t trust them, especially if they’re being overtly dishonest or untruthful. I find that very challenging.
The worst thing in the world is cruelty, or worse, indifference.
The habit I’d most like to give up is overthinking.
I’d eat rib eye steak all the time if it wasn’t for my health.
Everything tastes better when made with 35% cream. The milk in Egypt tasted quite creamy and I loved it. When I met Catherine, she introduced me to eating blueberries and cream with a little sugar. Since then, I’ve been putting cream on everything.
My favourite foods are watermelon and mango. Eating them brings back good childhood memories.
My willpower is the weakest for giving treats to our dogs.
The biggest reward I would pay to get my pet back is almost anything.
The best thing I’ve ever gotten for free is my wife.
My most prized childhood possessions were Cracker Jack 3D wildlife animal cards. I still have them. Some of them really mimicked motion. I don’t think I really liked the popcorn; it was all about collecting those cards.
The most money I’ve spent on something really stupid was a night out at the W Hotel bar in Montreal with residents. I was Program Director at that time attending a Canadian Association of Gastroenterology conference and back in 2004 the thing to do was get taken out by drug reps, So, on this particular occasion, we were having a great time and when we were about to leave the drug reps were nowhere to be seen. We ended up being stuck with the bill, it was over $12,000! Fortunately, there were a few faculty there to share in the cost, but it was still crazy.
The most valuable thing I own are my camera lenses. I got into photography pretty early; public school, I think. I don’t consider myself that artistic, I have to really work hard at it. My favorite subject matter is a nature; both landscape and animals. Without exaggeration I used to take 200 pictures a month with my group back in Calgary. Sadly, I haven’t even taken a hundred pictures in total since I’ve come back to Ottawa.
When I was sixteen or seventeen, I wanted to be fighter pilot. I probably wouldn’t have been a physician if I had perfect vision.
I chose my subspecialty because somebody’s gotta do it – haha.
Technological advancements had a significant influence on my career. I would not have imagined that technology would progress to the point of endoscopic microsurgery and removing early cancer endoscopically. The technical advance I most anticipate is effective endoscopic suturing.
Growing up, ‘cannot’ was not a word I knew. My mother taught me perseverance.
My principle fault is impatience. On a scale from one to 10, I’m a 10. I want to see results relatively quickly, whether from a personal or professional standpoint. If I set a goal, I want to see progress. I’m learning to be more patient as time goes on. If you can believe it, I’m much better now than I used to be.
The most difficult choice I was forced to make was palliation for my dad.
A turning point in my life was accepting that none of us are perfect. We can’t be everything to everyone, so we need to forgive ourselves and others. That takes work.
The greatest life-forming experience I’ve ever had was taking on my job in Calgary – it was a big move with two young kids and a new-born and not really knowing anyone out there.
The closest I’ve ever come to death was being trapped under a windsurf sail in rough water.
The most disgusting thing I’ve ever had to do was using a public bathroom in a third world country with diarrhea.
A book that has had a lasting impression on me is The Alchemist, by Paulo Coelho. Often the things we are searching for in life are right under our nose.
The one non-monetary thing I have the highest hope of obtaining in life is peace of mind.
In a Little While, by U2 is a song that is guaranteed to start my day off right.
Vin Diesel would portray me in a movie about my life because, unfortunately he’s the only actor that has any resemblance to me, but I probably wouldn’t want him to.
I feel I’m on the threshold of a new phase in my career; that I’ve basically accomplished most – I don’t want to say all – of the things professionally that I wanted to accomplish. From Program Director to leading a national organization on education to Chief Examiner for the Royal College to having some publications – not up to the Phil Wells level of publications – but nonetheless enough that I’m satisfied with it. And then I’ve been a leader at the Centre in Calgary and now working on our divisional vision here, but I have no aspirations to become Department Head or anything like that. I am grateful to be an internationally recognized and respected gastroenterologist. Administratively, getting out of the weeds and doing something regionally or provincially if it had a true possibility of change would be interesting, but I think I’d be happy to go back to doing more patient care, teaching and some more research. That would be a nice transition.