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On mentors: Honouring the legacy of a palliative care specialist

I came to Windsor in 2006. I moved to Windsor with my girlfriend that summer after finishing medical school and residency in London, Ont.

I came to Windsor to begin my career. Having graduated as a doctor of medicine, it was time to put out my shingle and begin to pay back the money I borrowed to become a doctor of medicine.  And maybe help a few patients along the way.

I had done a one-month rotation at the Hospice of Windsor in September 2005. As a resident, I was required to do some of my rotations outside London and when I looked at the options, Windsor appealed to me. Not because it offered a palliative care rotation but because:

  • The Michigan Wolverines had four home games at the Big House;
  • The Wings and Leafs would have a pre-season game at Joe Louis Arena;
  • Detroit Tigers tickets were cheap and plentiful;
  • My friend Mark had an empty room at his house and a pool;
  • (We don’t talk about the Lions but Aiden Hutchinson gives me hope ….)

My decision had little to do with palliative care. I didn’t learn a lot about palliative care during my time in London since Western did not and still does not have a palliative care program. As such, I honestly didn’t really know much about hospice palliative care but frankly, how hard could it be?

When I arrived in Windsor for my rotation, I was greeted by Charmaine Jones and the staff at the Hospice of Windsor. It was a fun rotation, in spite of (or because of?) the nature of the work we did.

I can still remember my first day. I remember that our first home visit had to be cancelled because the patient had died the night before and that our second visit took place in the patient’s backyard, drinking lemonade.

When my rotation was done, Jones asked if I had any interest in palliative medicine. I said “sure” which is code for “I really have no idea what I want to do with my life.”

So, when it came time to start my career, I convinced my girlfriend (now my wife) that we should try Windsor. She would get her Bachelor of Education at the University of Windsor while I would work at “that Hospice place” for a year until we could figure out where we really wanted to settle and put down roots.

The first five years of a doctor’s career (the “First Five”) are tough. Leaving the security of a residency program and entering private practice can be daunting, intimidating and downright scary. As the only full-time physician at the Hospice of Windsor, the days were long, the work hard and often lonely.

But it was mentors who guided and helped me through the rough patches. And I can think of no better topic to raise during this year’s National Hospice Palliative Care Week. I cannot underscore enough the importance of mentors. I have had many throughout my career.

It starts with Sol Stern, who was my family doctor growing up in Oakville. He wrote one of my reference letters and encouraged me to consider a career in medicine.

I wouldn’t be here writing this to you if it were not for Bertha Garcia, a pathologist at that school in London who conducted my entrance interview and recommended me for admission despite the fact that I was high as a kite on cough syrup during said interview. Her advice over my six years in medical school and residency was always timely and nuanced, especially when I failed to match in the first round of CaRMS.

Next would be Blair Pierce, a family physician at St. Joseph’s Family Medicine Centre where I did my family medicine residency. He taught me the importance of home visits and the nature of vulnerable populations.

Then it would be Jones, who planted the seeds for what is now a 16-year career in palliative medicine. And Jim Gall, who reminded me of “who is the one dying here.”

Ciaran Sheehan was a palliative care specialist long before we knew enough to call them specialists.

But if I had to single out just one of these mentors, it would be Ciaran Bernard Sheehan.

Sheehan came to Windsor-Essex in 1979, four years before I was even born. He started a family practice in Essex and cared for patients in long-term care homes. He started Windsor’s first palliative care unit at the Grace Hospital, which eventually moved to the hospital on Prince Road (trust me, it’s just easier to call it that).

He made sure I kept my medical licence but allowed me to golf with him at least once a year (it’s a little known fact that the College of Physicians and Surgeons of Ontario requires all physicians to golf at least once a year to maintain their licence). Sheehan was an infuriatingly good golfer. Nothing fancy, nothing flashy. Each drive straight off the tees, each putt either within inches of the hole or in. He even taught me a thing or two about palliative care.

I walked away from palliative medicine in 2008, just two years after I started. It was Ciaran who encouraged me to give it a second chance.

You can draw a straight line between the arrival of Sheehan in Windsor-Essex in 1979 and the robust palliative care program we now enjoy that stretches from Tilbury to Amherstburg, from Kingsville to the Detroit River. A program that spans three acute care hospitals, two hospices, a palliative care unit, many long-term care homes and a community palliative medicine program that is the envy of our province. His fingerprints can be seen on each of our 12 palliative care physicians and countless nurses. Like a coaching tree in football, almost all things palliative in our area can be traced back to one man, the grandfather of palliative care in Windsor-Essex.

It is with a mix of sadness and gratitude that we acknowledge his passing.

Gone but not forgotten.

Ciaran Sheehan was a palliative care specialist long before we knew enough to call them specialists.

One of the best ways I know to honour his legacy would be the acknowledgement, once and for all, that the work he did matters.

This would mean each and every single medical school in Ontario would have a division or department of Palliative Medicine to ensure that every single doctor who graduates in Ontario will have the necessary skills, basic competencies and clinical acumen to care for patients facing a life-threatening illness and those who would benefit from a palliative approach to care. A touchstone that would unite palliative medicine specialists from across the health system and campus, serving as a major hub of palliative expertise. It would not only allow clinicians to provide thorough care for patients and families, but also train new specialists and meet the need for increased research on how best to reduce the burden of chronic illness and deliver high quality palliative care.

I’m looking at you Western.

Everyone wonders why I wear a University of Michigan lanyard instead of a Western one. I have one from Western. It hangs on the back of my office door.

I wear the one from Michigan because a) they have a decent football team and b) like all world class medical schools, they recognize the specialty of Palliative Medicine.

Ouch. Hurts, doesn’t it?

Your shot Western. Are you going to hit the fairway or keep slicing it into the rough?

 

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Authors

Darren Cargill

Contributor

Dr. Darren Cargill is a fellow of the College of Family Physicians of Canada, the Royal College of Physicians of Canada, and American Association of Hospice Palliative Medicine. He is the past medical director for the Hospice of Windsor and Essex County and lead physician for its community-based Palliative Medicine Program. He is one of only two certified hospice medical directors in Canada and has his designation as a certified Canadian physician executive.  He received HPCO’s Larry Librach award in 2017 for excellence in leadership and advancing palliative care through mentorship.

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