Dog with a Bone

Abstract

MOST PEOPLE ARE SURPRISED to learn I started out to be a laboratory chemist. In 1977, when I was working on my master’s degree in clinical chemistry at the University of Toronto in the hospital laboratory after my undergraduate training in Cooperative Applied Chemistry at the University of Waterloo in Ontario, Canada, I initiated making hospital rounds with the clinicians. Both I and the technicians in the laboratory loved knowing how our work “fit in” with the actual care of patients. In addition to loving the clinical correlations, I made the observation that, if I ever wanted to be the head of the laboratory, I needed a medical degree. My mother was furious that I went back to school when I was so close to a perfectly respectable career. After medical school at McMaster University in Ontario, Canada, I trained in internal medicine at the Wellesley and Western Hospitals (University of Toronto). Then, I trained in radiation oncology at the Princess Margaret Hospital and Toronto-Bayview Regional Cancer Center (University of Toronto). It did not take me long to realize I was more interested in managing pain and other symptoms than I was debating whether the cure rate from whole beam radiation was 89.4% or 91.3% for stage IA Hodgkin’s disease. Since there were no palliative medicine fellowships in Canada in 1987, I negotiated my own 3-year fellowship in pain and symptom management with Dr. Ian Kerr, a medical oncologist at the Toronto-Bayview Regional Cancer Center. It took me 20 years after high school before I finally found my niche and got a real job. My mother was profoundly relieved! There were two “bad deaths” during that time that influenced me. My father had advanced Parkinson’s disease and died 1 week after moving to a nursing home. He had fallen out of bed and died of acute pneumonia 12 hours after returning from the hospital where he’d been x-rayed to rule out a hip fracture. I was furious at the care he received and his sudden, unexpected death. However, my mother, having just lost her husband of 35 years said, “Frank, your father is dead. Don’t waste your time being angry at the nursing home. Put your energy into activities that will make the world a better place for the living.” When my very Pioneers in Palliative Care