We started this podcast on the history of medical oncology. We’ve called it The Mustard, after nitrogen mustard, the preferred chemo agent.

Dr. Neil Reaume

head, Division of medical oncology

Which TV series contained an image or reference to Superman in each episode? Dr. Neil Reaume knows the answer – it’s Seinfeld. Rule to the wise: don’t ever play TV trivia with him. He’ll smoke ya.

As the youngest of three siblings, Neil watched a lot of TV as a kid and gravitated towards doctor shows; they fascinated him. He watched every episode of M.A.S.H. and afterward, knew that he would eventually become a doctor. He remembers the first few years of that show being raw and witnessed people who were passionate about whatever medical emergency they were facing. And it wasn’t just the medicine aspect, there was a whole other layer.

As a newly appointed Division Head, responsible for dozens of medical oncologists, he is experiencing this ‘whole other layer’ firsthand. This leader is taking new approaches to address issues affecting the wellbeing of the people underneath that white coat.

EPIC sherriff and podcaster, Dr. Neil Reaume talks pineapple on pizza, banana seat bikes and why nothing comes for free.

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When I took on this job and moved into this office, I changed everything. I wanted to create an environment where people can pop by, have on the spot meetings or simply hang out and chew the fat. I’ve had some really good conversations with people in here, that’s important to me.

I think people see me as too serious. I don’t know if they’re completely wrong. I’d like to think that I’m an approachable person. As the Program Director I had residents come to me and share things that I would never have imagined. Whereas now as Division Head I’m dealing with 25 chefs, it’s a bit different; these colleagues are well established. My mom was a high school teacher and her students used to say, Mrs. McNeil, ‘you’re tough but fair’. I always thought that was a good thing to aspire to. That was certainly my approach as Program Director; I’m still figuring it out as Division Head.

I started yearly retreats for our residents where we’d bring in speakers to talk about mindfulness and other things. We’ve tried to branch out to totally non-medical topics like legal stuff and other things that stress people out.

During the first two weeks of EPIC implementation we put in 20-hour days – it was just insane. To get through it and ease the tension I tried to take a lighthearted approach. So, when they gave me the ‘EPIC super user vest’ I went out and bought a sheriff’s badge and pinned it on. It made people laugh. So, I bought more and went around deputizing people. I was really trying to be motivational even though I knew there were huge problems. In the long run we’ll fix them all and eventually be way ahead of where we were before.

We’re really lucky that our payment plan gives us opportunities for sabbaticals. I really pushed our group to take their sabbatical for their wellness. We’ve always valued collegiality so together we’ll manage covering each other’s work loads and our stress will deteriorate.

The furthest I’ve ever pushed myself physically was a triathlon. I’d like to train for a full iron man but that’s a major commitment. You pretty much have to sign a contract with your family and I’ve never been in a position where I had that much time. Maybe when my kids hit university. I don’t know, we’ll see.

I am motivated by trying new things.

I’ve got a few pet projects right now that I’ve jumped into. We started this podcast on the history of medical oncology. We’ve called it The Mustard, after nitrogen mustard, the preferred chemo agent. All the legends are retiring right now so it’s time we get a record of all this stuff.

In the clinic we’ve been interviewing cancer patients on their experiences related to travel; things like insurance costs and other practical stuff. The most common question I get starting in about September right through to March is, ‘can I go to Florida, can I book a flight’? After asking 500 patients in the waiting room over four weeks, we’ve got part of the answer and we’ll keep expanding on it. Asking questions outside of science, focused on economics are things I’ve always thought about and just never had an answer for.

My Dad lent me a book about how to run a meeting because essentially meetings are often just complaining. I’ve changed that. Now at our division meetings, if you’re going to talk, you have to have a proposal and the proposal has to be circulated a week ahead, so people have time to think about it. Now, we finish on time and there’s no complaining anymore. In this environment I’m happy to debate the issues, but you need to be prepared.

My greatest regret is not seeing Terry Fox run. When he came through Ottawa I was living in Barrhaven at the time and in hindsight, I should have gone downtown to see him. I remember clipping all the newspaper articles out and reading about Interleukin and the experimental treatment they were giving him. I was just fascinated at how a young person could have cancer – wondering what cancer actually was. It was around the time that I was going into high school. That experience probably planted a seed back then.

The thing that makes me go insane the fastest is REPLY ALL.

You know you’re in love when you can have comfortable silences.

There’s no such thing as too much education.

One rule of parenting: build trust.

Maybe I’m wrong, but I think pineapple on pizza is good.

I think those that are very successful are those that have a plan from the get-go. They’ve been very selective and probably had great mentors. I’ve had some good mentors and some who’ve offered me things that I turned down. Looking back, I’ve thought damn that was a good offer and I missed it. Malcolm Gladwell says you’ve gotta invest time and there’s no doubt about that, but it’s also about positioning yourself to get opportunities – they don’t just fall in your lap.

I do my best thinking when in the shower.

The most indulgent thing I do each day is watch tv. I can just turn my brain off and watch anything and everything. We have themed parties once every few months and one time we did tv trivia – I just smoked everybody. They never want to play tv trivia with me again.

The best ritual of my daily life is tea. I never got into coffee, I had it once and never liked it. The only time I ever drank coffee was when I went to Brazil because I couldn’t get a good cup of tea.

If I’ve learned any truths in life, it’s this: nothing comes for free – there’s always some catch. We’ve pushed for years to get a point of care unit at this hospital and now they’re ready to move forward. I’m not the most political savvy person but I’m learning that if we want it, we have to agree to put in our physical space, we’re not going to get it for free. Sometimes you just have to give and take.

 

The childhood fear I still have as an adult is heights.

The most imaginative thing I’ve done as an adult is take a 12-week cross-country camping honeymoon. My original idea was to go to Scotland to do a little hiking and to see my wife’s grandmother, who is now 107! But that was mad cow year. Btw, my life insurance is going to pay for my wife’s second wedding because men don’t live that long in my family.

In medical school I spent a summer living with a family in Malaysia and did a health project where we went around from hut to hut. Their medical record keeping was amazing. We’d walk in and they’d pull out a Ziploc bag and everything was right there. I also went to Sydney Australia and worked at King’s Cross; total sex, drugs and rock n’ roll. I was in the emergency department at St. Vincent’s for three minutes when the first heroin overdose came through the door and they had to resuscitate her. And she woke up, said thanks and off she went.

When I really want something, I need to research it to death.  That’s why I like Costco; they do all the research for you. They only offer you one kind of anything because they’ve already determined the best value for the dollar. It’s not the best one, it’s not the worst one but it’s the best bang for the buck. Which, by the way, was exactly the topic of my masters in health technology.

The best way to get rid of a dead body is by watching Breaking Bad. I’m Walter, that’s for sure. I’m totally Walter. I mean, the show was about this guy who had stage four lung cancer! He’s just the guy who’s trying to do the right thing and just bumbles his way through it.

The best thing I’ve ever gotten for free is a pair of shoes – so lame. I did a triathlon this past weekend called Xterra Tremblant that included swimming, mountain biking and trail running. It’s a bit of a niche race; there were only about 70 of us. Anyway, I won the door prize which was a free pair of shoes – no strings attached. But man, I worked hard for those shoes.

My definition of a good hotel is a full gym. I’ve always been active. My Dad was a collegiate football captain. My mom was a cheerleader and tennis player and sports were something our family did all the time.

My favourite app is The City of Ottawa Parking app. You get notifications if you’re running out of time and can renew from anywhere!

The silliest thing I own is a banana seat bike. It was great when the kids were really small cause the sissy bar wasn’t that tall, and they could get on it. As they got older, they laughed at it, so it sat gathering dust. Then the show Stranger Things came out and it became popular again. We recently took it camping and my son was a hit with all the girls.

I grew up in Nepean. My father was a church minister and writer. My mother was a high school teacher. What I got from my parents was the value of education.

 

I chose my subspecialty because no two cases are alike, it’s a constantly evolving field.

 

Growing up, poverty was not a word I knew. While we didn’t have a lot of money, we lived a comfortable suburban life.  Medicine has opened my eyes to the spectrum of lives we care for.

The closest I’ve ever come to death was sustaining a head injury while canoeing in Algonquin Park. I wasn’t even canoeing at the time. We’d just finished a portage and I was taking a picture when I turned my back and fell off a rock ledge and landed on my head. Thank goodness we had a paramedic in our group who bandaged me up because we were still a day away from getting anywhere. I bought a helmet for the following week’s canoe trip.

 

The most disgusting thing I’ve ever had to do was look after a monkey colony at the experimental farm for two summers during university. And by the way, monkey colonies are vicious, they have huge fangs. At the time, I wasn’t sure if I wanted to do med school or veterinary school. One time I was looking in a cage and saw two monkeys and three tails. A baby was coming out the wrong way of a pregnant mother. So, I got to sit in on it and help with a c-section. It was cool.

I feel I’m on the threshold of a change in career focus to policy/management. The Cancer Centre got absorbed and integrated into the hospital about eight years ago. All the standing operating procedures dissolved in that moment and we immediately fell under The Ottawa Hospital ones, which are much more generic. When I became Division Head, I walked into this office and realized that there’s nothing written down, absolutely nothing. So, whenever I ask, “What’s our policy on this?’, the answer is always, ‘we don’t have a policy. That’s our policy’.

You know you’re the old guy in the clinic when you make jokes that reference shows like M.A.S.H. or Trapper MD and the other two people in the room are like, huh?

Best movie line of all time: build it and they will come. As a Program Director trying to build a program, it was challenging to convince people to come to Ottawa; it’s not Toronto, it’s not Vancouver, but we offer something different here. We’re not the biggest, but we’re the only shop in town and cancer’s going to happen to 1.3 million people here. As a resident you’re going to see more here than you would see anywhere else. I’m using twitter and my new podcasts to continue to get the message out.

Oncologists are very Canadian in that we don’t sell ourselves very well. We have all those tv screens downstairs in the waiting area showing patients how to cook but nothing about our team or for instance, the New England Journal paper Derek Jonker published last week. I started to capture and distribute this stuff via my Friday Fast Five weekly email blast because we need to self-promote.

Matt Damon would portray me in a movie about my life. Who wouldn’t want that identity? He survived Mars by eating his own sh–, and he got saved by Tom Hanks, who I want to meet some day plus the Bourne action agent thing. It’s perfect!

If I had to write my autobiography using only 6 words, it would be: being last sometimes works out. That was my mom’s ongoing joke? I was the last guy into my med school. Someone didn’t show up on the first day, so they phoned me up and said, do you want in?’ And I said, ‘I’ll think about it’. She got so mad and since then, she’s been reminding me.  She actually wrote on my card MD LGO: Last Guy in Ontario.

I don’t read emails or try to do work stuff after seven except maybe for drafting my Friday Fast Five email because I’ve left it to the last minute.

You go through a lot of phases in life. Right now, I’m using what I’ve learned and paying it forward. I’m trying to make sure my junior people have some act of mentorship early in their career; that they aren’t left on their own and that they’re productive early on for whatever they want to do. I took on the role of Residency Program Director very early in my career and that got me off track. I would never recommend it for someone who’s not an educator – I wasn’t. I learned a lot from doing it, but that kind of sent my career away from its original path.

I’m going to measure my success after this role based on whether my group creates a momentum of their own. Right now, we have a lot of good things going on, but they seem a little disjointed. I’m hoping to bring things together. And that all the people in our group are happy and I can hand it off to someone else to do whatever they want with it, because I would have at least created an infrastructure.