Most of my professional —and probably personal life —has just been making it up as I go along.
Dr. Rakesh Patel
Divisions of critical care & internal medicine
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!