Thank you for believing in me

Heather Dean “Please do me a favour. Pick up the phone this evening and call one of your teachers to say thank you. That teacher might be the special person in elementary school, high school, university, a coach or a community member who believed in your potential. Tell them how much you appreciate what they did for you. You have no idea how much your call will mean to them.” That request was made annually at the white coat ceremony in the Faculty of Medicine at the University of Manitoba by the Honourable Theresa Oswald during her years as Minister of Health for Manitoba. As a former teacher, she was speaking candidly and from the heart. Those of us sitting in the audience were touched by her commitment to acknowledging mentors. We can all name the teachers in our lives who made a difference in our journey to becoming a paediatrician. The teachers who believed in us. The teachers who invested their time in us. They provided opportunities that have made a difference in the paths we have chosen along the way. My grade 8 teacher, Mary Hinch, drilled correct spelling and grammar—skills that became so important later in my academic career. To this day, every time I start a sentence with the phrase ‘I don’t think that ....’, I stop in mid-sentence, smile and remember Mrs Hinch saying “If one doesn’t think, how on earth can you say anything more?”. My grade 9 high school English teacher suggested quietly after class one day that I read Thomas Hardy instead of Hardy Boys. Specifically, she recommended Tess of the D’Ubervilles. That was a heady task for a 13-year-old girl, but one that I have never forgotten. She pushed me gently. At Queen’s University, the women’s basketball coach, Brenda Mackie, took a risk recruiting a skinny girl (with a big heart but undeveloped basketball skills) from rural Ontario. These were my first adult experiences in the challenges of teamwork and, in later years, of leadership on the team. Drs Charlie Bird and Duncan Sinclair at Queen’s taught me memorable lessons in critical thinking in clinical medicine. Faculty members in the Department of Pediatrics provided me with my first opportunity to learn the beauty of Indigenous teachings in Moose Factory and coastal communities on James Bay. The Pediatrics Program Director at Children’s Hospital of Eastern Ontario (CHEO), Dr Peter McLean, and his office assistant, Margaret Kennedy were great sounding boards for junior residents. The same Margaret Kennedy, later at the Royal College of Physicians and Surgeons of Canada (RCPSC), instilled in me a career-long commitment to postgraduate medical education and interprofessional education. Drs Frank Sellers, Otto Teixeira and Brock MacMurray at CHEO believed in me as I tackled my first clinical research project—one of the first clinical trials of indomethacin for closure of patent ductus arteriosus in premature infants. Collecting and analyzing data by hand was a tedious task in those days, with seemingly endless pages of data and lists of numbers. I loved the excitement of interpreting data. I presented the project as an oral abstract at the CPS meeting in Halifax in June 1978 just before moving to Winnipeg to start my 4th year of paediatrics and first year of ‘unofficial’ paediatric endocrine training (not yet an official RCPSC specialty). Dr Jeremy Winter was an amazing mentor in the world of paediatric endocrinology, a specialty that had just exploded. At that time, children with type 1 diabetes were cared for by general paediatricians and most of the current paediatric endocrine conditions were poorly understood and undertreated. Dr Winter was a Canadian pioneer in establishing a provincial newborn screening program for congenital hypothyroidism (circa 1977) and congenital adrenal hyperplasia (circa 1980) in Manitoba. He was a taskmaster in writing scientific manuscripts using prolific red scribbles all over my early writing to enhance clarity. Manuscript revisions were done over and over again by hand on a typewriter. His high standards in writing made me appreciate the strict lessons in spelling and grammar that I had had many years earlier by, Mrs Hinch, and later, served me well as a journal editor. During my early exposure to paediatric endocrinology, Dr Henry Friesen, an adult endocrinologist and head of the Department of Physiology at University of Manitoba asked me to assist him with the clinical aspects of the Therapeutic Trial of Human Growth Hormone (hGH) supported by the Medical Research Council of Canada (MRC). Leading the MRC hGH trial from 1980 to 1988 was an incredible honour as it offered me the opportunity to meet and collaborate with all of the paediatric endocrinologists in Canada. It also came with the responsibility for my first national leadership role, including working with Dr Friesen, Dr Guyda (McGill), Dr Henry Dinsdale (Queen’s) and senior leaders at MRC during the Creutzfelt-Jacob crisis of 1985–6 which resulted in cessation of the use of hGH and the first national trials of biosynthetic growth hormone (GH) in use today. Dr Sonia Salisbury, the only paediatric endocrinologist in Halifax serving the children of Nova Scotia and New Brunswick, was an important early role model for me—a busy clinician working in a regional tertiary hospital and academic centre, on call 24 hours per day for a regional paediatric diabetes program, and a mother of three children. I served seven paediatric department chairs at the Winnipeg Children’s Hospital 1983 to 2015. They all treated me with respect and endorsed my involvement in various roles. In 1985, the head of the department, Dr James Haworth, suggested to the government of Manitoba that I be hired as the Pediatric Medical Advisor to the new Manitoba Diabetes Education Resource program. The Assistant Deputy Minister of Health, Dr Sharon MacDonald, had designed a provincial diabetes education program. She advised the Minister of Health that there needed to be a unique and dedicated program for children—the first ‘freestanding’ program of its kind in Canada that was staffed by a full time nurse, dietitian, social worker and administrator. We integrated care and education from the outset. That was the beginning of my clinical and academic activities in paediatric diabetes at the provincial, national and international levels. Two of the Deans of Medicine at the University of Manitoba in my senior faculty years, Drs Dean Sandham and Brian Postl gave me incredible opportunities in university leadership as an associate dean (academic) and a member of Dean’s Council, the decision making body of the Faculty. It was a steep learning curve to understand the important and complex differences between tenured basic science (nonclinical) faculty and clinical faculty. It provided me the privilege of supporting academic career development for a broad group of scientists in the Faculty of Medicine. I was also honoured to have a role in building a culture of interprofessional education across eight faculties at the University of Manitoba from 2006 to 2015. Five of those Faculties are now Colleges in the new Faculty of Health Sciences with an embedded culture of interprofessional education and collaborative shared care—a structure based on the principles of teamwork that paediatricians know well, especially in care of children with chronic disease. All of the teachers named here and many more believed in my potential, invested in me and provided incredible opportunities to build self-confidence and to achieve self mastery. They were the ‘wind in my sails’, allowing me the unspoken freedom to explore different ideas and accept new responsibilities. Their subtle mentorship came in the form of concrete activities such as membership or leadership on a committee, sharing their invitations for co-authorship of book chapters, manuscripts, research grants, and manuscript reviews or seeking my opinion on difficult matters in a genuine, respectful and nonjudgemental manner. These opportunities often came at a time in my career when I seemed to be still ‘finding my legs’. In retrospect, the result was valuable career counselling and was key to developing my academic clinician identity. When appropriate, all of us should seek an individualized approach for our students, junior colleagues, as well as the children and youth in our clinics, especially the vulnerable ones living in socially disadvantaged populations. They need us to believe in them, to take risks for them, to invest in them and to provide opportunities for them to succeed. I have noted the special teachers in my professional career. In closing, I want to acknowledge that we all have special people in our lives who taught us life lessons. My mother, who at age 35 found herself a single parent of three young girls, taught me resilience and courage. She gave me the precious gift of rose-coloured glasses. Also noteworthy, she introduced me to knitting early in life, including recognizing mistakes and knowing how to fix them and when to start over. Knitting was portable and could be integrated into my daily schedule of meetings, rounds and travel. My maternal grandmother who was my first ‘life coach’ suggested that I think about medicine as a career. My husband, who I met playing cards with the nurses and nuns at the Fort Albany nursing station and who asked me to bring him some dental equipment when we travelled up the west coast of James Bay to Attawaspiskat, has been a life partner. He has kept me grounded for the past 40 years—literally on our grain farm in rural Manitoba! Our three adult children are now teachers in middle school or university and are thrilled when a previous student calls to say thank you. Please do me a favour. Dr Dean graduated from Medicine at Queen’s University in Kingston, Ontario in 1975 and pursued paediatrics and paediatric endocrinology training in Montreal, Ottawa and Winnipeg. She was a full time academic clinician in Winnipeg for 33 years. She held many leadership positions in the Department of Pediatrics and the Faculty of Medicine at the University of Manitoba as well as numerous external agencies such as the Canadian Diabetes Association and the Royal College of Physicians and Surgeons of Canada. Her major research areas were type 2 diabetes in children, transition of adolescents with diabetes to adult care and Interprofessional Education. She retired in June 2015 as Professor Emeritus.

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