Pearls

How can I write about ‘pearls of wisdom’ for my younger colleagues, who all carry handheld machinery that instantly gives them all they need to know at the flick of their fingers? I grew up on a train in northern Ontario, which travelled between lonely outposts along the Trans-Canada railways more than 70 years ago. If you have crossed Canada by train you will know what I mean – the miles and miles of nothing but empty stretches of trees, rivers and rocks. Occasionally, the train would whistle (as trains did in those days) at a cabin with children who came out to look at the train. My father, Fred Sloman, was the first teacher hired to teach in ‘School Car No. 1’ on a lonely strip of Canada on the Canadian National Railway mainline. He was part of the Department of Education’s successful experiment with ‘school cars’ functioning in northern Ontario. Some wise educators in Toronto took a retired sleeping car 72 feet long and nine feet wide, and turned half of it into a schoolroom, and the other half into a living space for the teacher and his wife. That was where I grew up, and it was the only school I attended until I went to medical school. The school was well equipped with desks and maps, and a stove to dry out mittens, as well as textbooks, a blackboard and a teacher’s desk with a typewriter. There was no electricity. The other half of the car was the teacher’s home with a bathroom, a living/bed/dining room all in one, and a little kitchen with a stove and an ice box for which a chunk of ice was dropped off once a week by a passing train. It was quite comfortable and we never felt crowded even though my mother and father ended up with five children, a dog and a cat. Once a week, the local train would hitch on to our school car as little ‘sidings’ were built just for the school car to be parked off the mainline. After a week, we would be moved to the next place where there were new children to teach and no school. The children were mostly immigrant children from Europe, who came out to Canada with their mothers to be with their lonely fathers who kept the Trans-Canada trains running. School hours were regular – from 9 am to 4 pm – and as the children left, their parents came into the school car because they wanted to learn English to find out how to order things from Eaton’s catalogue, and to ask my mother to see their baby who was coughing and not sleeping. My parents were the only teachers, and as a teenager, Dad let me help teach the little ones. Both my dad and mom were great teachers! Once a month, a wonderful wooden box would be dropped off from the local train – a box full of library books from a generous lending library in southern Ontario. I read every book in every box, and I selected books the children or their parents would enjoy – I was the ‘librarian’, according to my Dad, so I taught children to read. Dr Elizabeth S Hillman It was a happy childhood but I was acutely aware of many problems of isolation and preventable illness and injuries. I had seen many children with treatable diseases who had died of measles, tuberculosis and injuries that could have been prevented or treated. There were no doctors or nurses, but I learned how to look after minor illnesses from my parents. They taught me the importance of taking a history examination, observing and listening. When I was 16 years old, my father asked me what I wanted to do with my life and I said, “I want to be a doctor”. This made my parents laugh because I had never seen a doctor, but I wrote examinations by mail and went south, very scared, to the University of Western Ontario (London, Ontario) as a premed student. What a shock it was! I was terrified out of my skin to be with so many people, and I had to learn a lot very quickly. I realized how much I had actually learned from my parents and the circumstances in which we lived. I decided I would like to be a doctor for children, so when I graduated and finished my internship in London, I went by train – of course – to Montreal, Quebec, to see the world. It was a magical city to me and I still love it. I met and married Don Hillman, a Montreal-born McGill University graduate whom I met during our postgraduate training in Boston, Massachusetts (USA). Don was the best husband in the whole wide world and my best friend; in seven years, we had five wonderful children in Montreal. We were happy during our years of work at the Montreal Children’s Hospital, at our cottage in Quebec, and later in Africa and beyond. All wonderful things end too soon, and after 51 years of happiness together, Don died quite suddenly in 2006. My first message to younger colleagues is simple. Nothing ever turns out as you expect, and you must enjoy every minute together as we did while we learned together and widened our vision of this strange, needy and wonderful world in which we live, where there is always more to be done and never enough time to do it all – which is why we must teach others. Another message is to go where you can learn from great teachers. We both had so many great teachers! My parents taught me enough to get into medical school, and then I studied at Great Ormond Street Hospital for Children in London, England. Next, we went to Boston (USA), where I worked with Charles Janeway and Bob Haggerty, and afterwards, with Don at McGill University and Montreal Children’s Hospital, where we learned paediatric skills from the famous Goldbloom family and Professor Alan Ross, a great teacher and dear friend. He eventually took us to Africa when he was asked to develop a paediatric department in the first medical school in Kenya, where we have continued to work as often as possible. The next message is JUST DO IT – if possible together, as a great adventure, like we did. It would have been easy to stay in Montreal forever, but we went twice to teach in Africa with our five children – one of the best experiences of our lives. We both enjoyed working together internationally so much that we went to remote places like Laos, Bhutan and Guyana, as well as Africa and other places that could make good use of child health doctors who were ready and willing to teach. It is very important to keep a close link with your home base – in our case, Canada – because our Canadian universities have much to offer and much to gain from international links; their students like to come with us to far away places because they are ever more interested and deeply involved in international health issues – now called global health. I believe I have learned more from students than students have learned from me. The most important responsibility for teachers is to take time to really LISTEN to students, find out their interests, and what they already know and don’t need to learn again – this is far more important than lecturing to them. Do any of you remember the content of the hundreds of lectures we sat through in medical school? Only a few rare people can teach effectively through lecturing, but we can all learn by discussing matters that interest us, and help students take on the responsibility of learning. We can identify student leaders who help activate other students in learning. My friend, Dr Bob Bortolussi from Dalhousie University (Halifax, Nova Scotia), says in his new Handbook for Clinician Scientists (1) that there is an urgent need for us to recognize the very best of young minds in individuals capable of integrative thinking in this era of multidisciplinarity. We need them to be the future teachers. Dr Bob Haggerty, my great teacher from Boston, taught me that teaching and learning do not take place only in the hospital, but in the communities we serve. My best and favourite teaching always took place in a patient’s home, in an institution for children with multiple disabilities or special needs, or sitting under a mango tree in Africa with students who were eager to learn. We all can learn from seeing and listening to patients and their parents/caretakers. Dr Christine Overall of Queen’s University (Kingston, Ontario) said it well: “The days of passive note-taking are over. What people need in order to learn, is to interact with other eager human beings, to be surprised and stimulated, to spur each other on to new thoughts.” Elizabeth Sloman Hillman was born in 1928 and schooled in School Car No. 1 in northern Ontario by her father, Fred Sloman. She graduated from the University of Western Ontario (London, Ontario) in 1951, did postgraduate training at McGill University (Montreal, Quebec), in London (United Kingdom) and in Boston (Massachusetts, USA) with Professor Janeway, and worked at Montreal Children’s Hospital in Montreal. She had five children and went to Africa several times as well as elsewhere around the world with Dr Don Hillman to help others learn about child health. She now lives in Quebec in the summer and Newfoundland in the winter, where she and her husband had been on the faculty at the Memorial University of Newfoundland (St John’s); Don was Chairman of Paediatrics. They both spent some years at Université d’Ottawa (Ottawa, Ontario) as volunteer faculty members, promoting global child health. Don died in 2006 and Elizabeth keeps going to places where she may still be useful.

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