Month: February 2018
A Final Gift from a First Patient
Bill died last week. He was 93 and, at the end, his passing could be considered neither tragic nor unexpected. His daughter thoughtfully called my office to let me know, and that he wouldn’t be keeping his next clinic appointment.
The last few years hadn’t been easy for him, bringing increasing disability and dependency. Things hadn’t been really right since Daphne passed away about three years ago, after over 60 years of marriage.
Before that they’d always come to clinic together and supported each other through their health issues, surgeries and increasing fragility. Bill was one of those people who seemed incapable of despondency or self-pity. Always smiling, he began every appointment by asking me how I was doing, and never left without thanking me. He never refused a request to allow a learner to listen to his heart. In fact, he usually offered before being asked. Like many of his generation, he never lost that sense of gratitude for what his new country made available to him and felt a need to repay that debt.
He’d emigrated from England in the 1950s. He was an engineer and worked in various projects over the years both in Canada and Europe, finally retiring in Kingston over 30 years ago, building his “dream house” with Daphne. In retirement, he developed a large community of friends, including many neighbours (some of whom were physicians in our hospitals) who would support him as he continued to live there alone. They would often bring him into clinic appointments, or call with concerns about him.
In one of his last selfless acts, he agreed to participate in our First Patient Program. Two of our first year students, Madison Price and Michael Christie, got the opportunity to meet Bill, visit with him, accompany him to appointments, and hear about his medical history and life story. He taught them something about heart disease and its various complications, but mostly he taught them about the patient experience of living with a chronic condition, about how physicians can provide valuable care even after cure is no longer possible, about the remarkable courage and grace with which patients can face the end of life, and about how communities can come together to support those in need.
He shared personal stories with them, telling them about how he had worked on developing radar equipment for Lancaster bombers during the Second World War. He told of how his brother was a tail gunner on those aircraft, which provided Bill even more incentive to ensure the radar was effective.
He believed he had something valuable to impart to these young people and future physicians and indeed he did. In the end, his final gift was to teach them about bereavement and, particularly, how physicians and health care providers can be affected by the loss of patients they’ve cared for, come to know, and admire. He made medicine real to them by giving it a human face that, I believe, they will never forget.
With his willingness to engage these students during his final days, he provided a priceless and lasting gift, not only to these two aspiring physicians, but also to their future patients.
Anthony J. Sanfilippo, MD, FRCP(C)
Undergraduate Medical Education
“Lifestyle as Medicine” Symposium February 12
By Daniel Rusiecki and Leah Allen (Meds 2021), “Lifestyle as Medicine” Symposium co-organizers
“The doctor of the future will give no medication, but will interest his patients in the care of the human frame, diet and in the cause and prevention of disease.” ― Thomas A. Edison
However far-fetched Mr. Edison’s vision may be, the idea of the first line of treatment being the intrinsic care of the human body and what we put into it is not off the mark whatsoever. Being the new kid on the block in first-year medical school, travelling through this area of modern medicine has one questioning how much exogenous medication would be needed if our society hasn’t progressed the way it has. What if cars never existed, and everyone had to walk to their daily job? Would over 20% of our Canadian population still be classified as obese? What if our food didn’t come out of a factory, or from a fast-food restaurant drive-thru window? Would we still be dealing with a diabetes epidemic where 3.4 million of our sisters, brothers, parents, friends and neighbours are injecting themselves with insulin daily? The questions can go on and on, but they don’t answer one vital question: how do we move forward?
Practicing physicians will have approximately 2200 patient visits per year. With a career length of 35 years that’s almost 80,000 opportunities to influence the health and lives of these individuals. It’s crazy to think about how much influence one future physician can have, let alone the whole Queen’s undergraduate cohort, the residents, and affiliated physicians. If you are a future physician or practicing physician reading this post, would you rather prescribe your patient medication for their hypertension when they are 45 years old, or have the skills and knowledge to help them prevent hypertension when they are 30?
Equipping our workforce with the knowledge, skills and fearlessness to invoke a healthy lifestyle change is at the root of how we can move forward. Not only can we prolong and enhance the lives of our patients directly, but we can advocate to improve societal systems as a whole. We also have the opportunity to reduce the cost of our healthcare over the long-term due to the reduction of drug prescriptions and improvements in health of the general population.
The “Lifestyle as Medicine” symposium will be the start of a journey to better equip future or practicing physicians with the artillery necessary for these changes. The symposium will be take place Monday, February 12 from 5:30 – 7:30 p.m. in the School of Medicine Building, room 132A.
Dr. Robert Ross, a prominent researcher in the area of diabetes and related co-morbidities will speak on how cardiorespiratory fitness can be a significant vital sign for a patient’s health status. Andrea Brennan, a registered dietitian, will then take the floor to deliver key nutritional principles every physician should know, as well as shed light on current diet trends and the evidence supporting them. Dr. Chris Frank, a geriatric and palliative care physician, will then give insight on how he maintains healthy habits while being a busy physician. Finally, to get a taste of the patients perspective, Doug Dowling will speak about his passion for fitness and how the diagnosis of Crohn’s disease in his early 20s impacted him.
We hope you will join us for this thought-provoking, educational event.