Making it over the finish line: Short cuts to a fulfilled life

Dr Jack Holland Dr Jack Holland There comes a time in your life when you find yourself drawn to the obituaries in the daily paper. There is no defined age at which this transformation begins. It just gradually creeps up on you, like age itself. (I just thought about this—why are the death notices always positioned after the sports section in the newspapers?). I had a look at today’s entries. Nobody I know has passed on this week. This is good. As always, I paused over a few of the lives-lived of complete strangers, and marvelled at the accomplishments of this man or this woman, and at the heartfelt emptiness expressed by those left behind by their departure. There is often a uniquely Canadian flavour to their respective stories. Humble beginnings, perhaps as a new immigrant, sacrifice, hard work, building a career, making a difference, leaving a footprint. It is amazing how a few paragraphs are able to capture the essence of who someone really was as a person and who remains as a memory. What is all this got to do with the ‘advice to my younger colleagues’ assignment? The truth is that I have been putting this task off for more than a year. I have struggled to convince myself that I have something meaningful to say that has not already been said. Several first drafts have hit the wastepaper basket. I have procrastinated unflinchingly—until today. Inspired by the stories of strangers and from the benefit of a career shaped by so many exceptional people, I hesitatingly offer some personal reflections on successes and disappointments encountered over the past 45 years. These thoughts are anchored around several key headings. In his celebrated 1976 book entitled ‘The Solid Gold Stethoscope’, Edgar Berman poked fun (or did he?) at career choices made by physicians. He stated “the Proctologist concerns himself primarily with one square inch of real estate”. The chapter on neurosurgeons was entitled ‘the Lord High Executioners’. In his chapter on paediatrics (ominously, the final chapter) he claimed, “the pediatrician is someone who can’t decide what he really wants to do with his life”. Interpret this as you may, but I think that there is general agreement that we did not choose a path in paediatrics for fame or fortune (or to pay off student or family debt). I believe that paediatrics as a career selects out those who are fundamentally interested in the welfare of children and adolescents. That said, my entire experience is limited to that of a full-time position in a large tertiary care centre. There are individuals with stellar careers in front-line community child and adolescent health, better able to offer career advice. Talk to Dr. Robin Williams or to Dr. Andrew Lynk or Dr. David Wong among others. Regardless of who we are and where we are situated, career development should be characterized from the beginning by mutual respect and interdependence for everyone within child and adolescent health, and by a common sense of purpose, both in our personal and professional lives. Wouldn’t it be great if your obituary said, “Above all, she/he was a great humanitarian”? ‘Building up the CV’ may well be the most important focus of your career, especially during the early years. This is commendable and should be applauded. Go for it. You will probably make a difference to peoples’ lives. Typically, your colleagues are those around you on the research team or like-minded individuals that you meet at academic society meetings. In this environment, it is relatively easy to separate yourself off from the rest of the world and perhaps (gasp), even your own family. So take stock. Consider organizing your life in such a way that your career goal is a ‘win-win’ for all concerned. In today’s world, research translation on a large scale may require recognition of the importance of policy development in effecting meaningful population-wide change. Early in the game, consider embracing organizations that have political clout or who may be able to open the door to Government ears. The Canadian Paediatric Society, among others, comes to mind. Take some time off for yourself. Do not neglect your family in your quest for academic recognition. They should be you first priority. Regardless of your particular strengths (clinical care, research, administration, education), it is highly likely that you entered paediatrics because you had a fundamental interest in making the world a better place for children and youth. Never lose sight of this, no matter which direction your career takes you. Your patient and his/her parent should always leave your clinic feeling that they have been listened to, and that they have received the very best that you have got, every single time. Be kind. Be patient. Be on time. Do not debase ‘Patient Centred Care’ to a meaningless mantra or simply to the realm of a time and motion study. Wouldn’t it be great if your obituary said, “Above all, her patients loved her”? Mentorship is an admittedly predictable addition to the list of success factors in career development. It seems obvious, yet the degree to which mentorship is applied is extremely variable. The relationship can be formal or informal, by mutual agreement or by central assignment. It may be long term or limited in time or scope. In my opinion, the starting point should be the acceptance of the principle that mentorship is a good thing. It should be introduced early in the learning process, before the train goes off the tracks and well before the ‘point of no return’ is reached. To be successful, the relationship should be based on a structured written agenda that incorporates specific career goals derived from mutual agreement. Mentorship assigned as a perceived punitive response to a career stumble is usually (but not always) doomed to failure. Incompatibility in the relationship should lead to early divorce and reassignment. Here is where I get a little personal and perhaps where I risk losing some objectivity. You be the judge. For a 10-year period, I was appointed as the Chair/Chief of Paediatrics at a major university in Ontario. I had no leadership role prior to this, but nonetheless embraced the opportunity that this appointment represented. These thoughts are aimed at those who may be considering a leadership position of this nature. Here is a short overview of the lessons to be learned from the process: Finances: Canadian Universities (unlike most of the prominent US Universities) are publically owned and are dependent on Government funding. Provincial/Federal fortunes seem to work on cycles of approximately 10 years (10 years of expansion, 10 years of contraction). The 10-year cycle at any given time affects the ability of the Chair/Institution to effect meaningful change. This would include potential changes to the status of clinical services and recruitment to paediatric subspecialty positions. Centralization of resources for child health: There are some competitive disadvantages when services for children are part of a larger adult medical services complex, particularly in intensive and emergency care. The cultural mindset of the institution and of the population base in this model is surprisingly different from that experienced with a stand-alone children’s hospital. Importance of general paediatrics: The importance of the practicing community paediatrician to the clinical and educational agenda of the institution cannot be overemphasized. Building a good advisory team: Nothing more to say here. It is self-evident. Listening well: Being a Department Chair/Chief requires the ability to listen and to be empathetic to peoples’ problems—both professional and personal. Dealing with difficult individuals is also a part of the job. It is important to be consistent. Going the extra mile: Nothing gave me more pleasure than the awards and honours achieved by individual faculty members. Although these were earned as a result of sustained excellence on their part, as Chair/Chief I felt that it was my responsibly to support their respective nominations by providing the strongest letters possible. This was time and effort well spent. These are some of my thoughts derived from the past 45 years or so of being ‘on the job’. It has been a joy and a privilege. I hope that this advice is of some value. Jack Holland was born in Ireland and attended medical school at Queen’s University in Belfast. In 1972, after completion of certification in Internal Medicine, he decided to emigrate to Canada to pursue both a new life and a new career direction, entering the paediatric training programs in Kingston and at the Hospital for Sick Children in Toronto. After 2 years as a Research Fellow in endocrinology at the University of California San Francisco, he returned to SickKids in 1977 as a member of the full-time staff. In January 1991, he accepted the position as Chair and Chief of the Department of Pediatrics at McMaster University, remaining in Hamilton until his retirement from active clinical practice in 2010. An interest in research ethics that began in Hamilton, led to his appointment as Chair of the Ontario Cancer Research Ethics Board (OCREB) and Chair of the Oncology REB at the University Health Network in Toronto until ‘final’ retirement was declared in December 2018. Highlights along this career path included Presidency of the Canadian Paediatric Society (CPS), Chair of the CPS Foundation, and active involvement in various CPS committees over many years. Absolute highlights in life are topped by the early years at Queen’s University in Belfast where Jack had the unbelievably good fortune to meet Joan McNally (PhD). After 50 years together, the joy in their children Joanna, Michael, and Claire is extended further through their grandchildren, Katie Alan and Paul of Nova Scotia and James, Ian, Alex, and Calum of Toronto.

Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.