Fall / Winter 2017

A Chance to Make a Difference Why billionaire Jim Pattison chose St. Paul’s for a record- setting $75-million gift

FALL/WINTER 2017

VOLUME 15, NUMBER 2

EDITOR INSIDE Michael McCullough CONTRIBUTING EDITORs Sarah Burgess, Edel Burke, Sara Turcotte 10 jim pattison: difference Creative DIRECTOR maker Rick Thibert Entrepreneurial legend Jim Pattison expands on the Contributing Writers thinking behind his unprecedented $75-million gift, Helena Bryan, Edel Burke, Joseph Dubé, Melissa Edwards, Stephen Forgacs, the financial cornerstone of St. Paul’s redevelopment. Michelle Hopkins, Allan MacDonald, By stephen forgacs Jessica Werb Contributing Photographers/ 14 Two lives to save Illustrators Jesse Savage, Jay Shaw, Brian Smith/ The dramatic story of how a multidisciplinary team Providence Health Care Media Services, at St. Paul’s responded when a pregnant woman from Jeff Topham Vancouver Island went into cardiac arrest. CONTINUE READING ONLINE By Joseph dubé Check out our recently updated website at helpstpauls.com. Browse 16 well equipped to care through older editions of Promise The Cullen family has supported various Providence magazine, and read the latest news Health Care sites going on four decades, with a special and events from the Foundation! emphasis on equipment, both high-tech and low. By melissa edwards 230, 4321 Still Creek Drive FROM THE TEAM Burnaby, British Columbia, V5C 6S7 10 604-299-7311 Fax: 604-299-9188 18 research in the real world an individual to a health facility in BC, of patients in palliative care (and their Celebrating its 40th birthday this year, the Centre for chairman, ceo St. Paul’s initiative to move and build families) by hitting just the right note. Heart Lung Innovation has grown into a global centre for Every Gift Peter Legge, O.B.C., LL.D. (Hon) COVER: Jim Pattison at the cardio-pulmonary discovery in a uniquely clinical setting. anew in the False Creek Flats had to Lest we forget St. Paul’s role PResident downtown Vancouver headquarters check virtually all the boxes. responding to medical emergencies, Samantha Legge, MBA By helena bryan of the Jim Pattison Group. Enormous as it is, Pattison’s donation “Two Lives to Save” (p. 14) recounts Senior Vice-President of Integration Photographed by Jeff Topham Matters Brad Liski 21 soothing with song is just the beginning of the effort the incredible story of how a team Director of Production Music therapy has become an integral part of palliative irstly, we are so grateful for the required to truly transform medical care including an obstetrician and a heart Kim McLane care at PHC. We tag along with resident tunesmiths incredible response to our last in BC as we envision. Fortunately, we are surgeon worked together to save a Director of Circulation F Lucy Thomas and Leah Rosling. Promise cover story on the BC Centre blessed with a host of other donors, like Vancouver Island woman and the baby Tracy McRitchie PRODUCTION manager By michelle hopkins on Substance Use (BCCSU), our most the Cullen family profiled on p. 16. she was carrying after the mother Kristina Borys popular issue to date. Since our The Cullens have been behind multiple went into cardiac arrest this past IMAGING technicians interview with the team at the BCCSU, gifts across all Providence Health April. Today, both are alive and well Mandy Lau, Bernhard Holzmann they have released new provincial Care (PHC) sites, including Holy Family thanks to the world-class care “The question we ask ourselves is, guidelines for operating supervised Hospital, St. Vincent’s Brock Fahrni and provided at St. Paul’s. We welcome your comments ‘Will it make a difference?’ That’s all. consumption services and have St. Paul’s. Their long history of support Efforts like these encapsulate the on Promise magazine. Please write to us c/o launched a new training program for and that of many, many others has opportunity to make a difference that St. Paul’s Foundation, That’s the question I always ask. opioid treatment prescribers. They helped make PHC a leader in exceptional Pattison, in his interview with Promise, 178 –1081 Burrard St, Vancouver, BC, V6Z 1Y6. Will this make a difference?” continue to work to transform policy care and innovation. identifies as his No. 1 reason for giving. Website: www.helpstpauls.com Phone: 604-682-8206 — Jim Pattison, page 10 and care in BC. You can get a glimpse of this With the development of the new Promise magazine is published twice What’s abundantly clear from our exceptional work from the stories in site imminent, that chance to make a a year by Canada Wide Media Limited for conversation with Jim Pattison on this issue of Promise. Our Breakthroughs difference has never been greater. St. Paul’s Foundation. No part of this magazine may be reproduced without written permission page 10 is the connection between story on p. 8 offers an update on 16 of the publisher. Send change-of-address 2 FROM THE TEAM 8 R esearch successfully making money in one’s how St. Paul’s is pioneering the use of notices and covers of undeliverable Every gift matters. BREAKTHROUGHS career and putting it to good and lasting methodologies developed to combat copies to: Promise, c/o By Kathryn Young and How techniques developed Get the latest news from use. It’s not simply that you have to HIV/AIDS to contain Hepatitis C. Our St. Paul’s Foundation, dick Vollet to contain HIV/AIDS are now St. Paul’s Foundation: know how to get it to give it away; feature on the Centre for Heart Lung 178 –1081 Burrard St., Vancouver, BC, V6Z 1Y6. being used to tackle Hep C. Pattison, indisputably the greatest Innovation (p. 18) showcases some of For subscription enquiries, call 604-682-8206. 4 FRONTLINES By michelle hopkins @helpstpauls ISSN: 1703-6151. Canadian Publications Mail St. Paul’s joins forces with Dick Vollet kathryn Young entrepreneur in British Columbia’s the world-leading research being done in Product Sales Agreement No. 40065475. Tapestry Foundation; Feast of 23 Q&A facebook.com/helpstpauls President and Board Chair, St. Paul’s history, sheds light on the thinking that a clinical setting. And on p. 21 we meet Fortune 2018; Lights of Hope; Meet Dr. Gil Kimel and Sarah CEO, St. Paul’s Foundation; Partner, went into his unprecedented $75-million two of the trained music therapists at Simulation in the ER; Morning Cobb, RN, of PHC’s Palliative @helpstpauls Foundation, and Boyden Vancouver Report podcasts let medical Care Department. gift to St. Paul’s announced earlier this PHC who spend time across multiple the St. Paul’s students relive the rounds. By jessica werb www.helpstpauls.com year. To warrant the largest ever gift by sites, helping alleviate the suffering Foundation Team

2 Promise | Fall/winter 2017 Brian Smith/PHC Media Services fall/wintER 2017 | Promise 3 >> Questions? To find out more about our unified foundation, or how you can support residential care, please contact Diana Li, FRONTLINES Director, Seniors and Residential Care at 604-806-8625 or visit helpstpauls.com. Supporting More Patients and Residents

arlier this year, St. Paul’s his year’s Lights of Hope recognized for their support with Donors to Lights of Hope support EFoundation announced it had n Holy Family Hospital T fundraising campaign is extra stars on the display. the work of St. Paul’s Hospital, Holy joined forces with Tapestry Foundation n Mount Saint Joseph Hospital special. We’re spreading the cheer By giving to Lights of Hope, Family Hospital, Mount Saint Joseph to streamline fundraising activities and n St Michael’s Centre across Providence Health Care sites, you enable St. Paul’s Foundation Hospital, St. Michael’s Centre, St. further support patient and resident n St. Vincent’s: Brock Fahrni and celebrating the Lights of Hope to meet the greatest needs of our Vincent’s: Brock Fahrni, St. Vincent’s: care at Providence Health Care sites. n St. Vincent’s: Honoria Conway- 20th anniversary. caregivers, patients, residents, and Honoria Conway-Heather, St. Vincent’s: The unified Foundation now supports Heather Since 1998, Lights of Hope has their loved ones. Langara, and Youville Residence. patients and residents of Providence n St. Vincent’s: Langara equipment needs, research and raised more than $31 million, providing Health Care throughout the health-care n Youville Residence teaching. As always, donors will much needed funding to purchase continuum, from neonatal to palliative. continue to be able to designate their equipment, support world-class Donate today at St. Paul’s Foundation is continuing its Funds raised by St. Paul’s donations and choose what hospital, research and teaching and enhance support of St. Paul’s Hospital, along Foundation support enhanced patient residence or department they would patient care. Hundreds of donors are lightsofhope.com with the following sites: and resident care, capital projects, like their gift to support.

1998 2016 2018 Feast of Fortune Save the date! Saturday, February 3, 2018 JW Marriott Parq Vancouver

t. Paul’s Foundation is proud to Your support of the S present the 11th Annual Feast of Fortune. This signature fundraising gala 11th Annual supports compassionate, inspired care Feast through the purchase of vital medical equipment. Over the past 10 years, this of Fortune spectacular event has raised nearly $5 will help to purchase 2017 Lights of Hope million and has been host to a growing urgently needed equipment 20 hank you to our corporate sold-out crowd. Event highlights include for the Providence Breast and individual donors, St. the highly anticipated live auction, Save the Date! T Centre at Mount Saint Lights of Hope Celebration Night Years Paul’s staff and volunteers for an amazing food creations and spectacular incredible 20 years of supporting the live performances. Joseph Hospital. Thursday, November 16, 2017 of hospital’s greatest needs. Each year, From 6:00 – 8:00pm Lighting more than 150 dedicated volunteers St. Paul’s Hospital, help build the display using donated For tickets or sponsorship opportunities, please visit Burrard St., Vancouver up the materials, including over 10 kilometres helpstpauls.com/feast-of-fortune Lights will remain lit from of holiday lights. November 16, 2017, through Community to January 8, 2018.

4 Promise | Fall/winter 2017 Brian Smith/PHC Media Services Fall/winter 2017 | Promise 5 Teaching and Training St. Paul’s i “Morning

Learnings from complex report” medical cases to be shared broadly with medical community to Produce Podcasts

A cardiac surgeon (Dr. Anson Cheung, left), emergency physicians, profusionists, respiratory therapists, e try to take the anxiety out nurses, fellows and assistants take “W of learning,” says Dr. Barry part in an ECPR simulation session in Kassen, director of the clinical teaching St. Paul’s Teck Emergency Centre. unit at St. Paul’s and acting division head of community internal medicine at UBC, when he speaks of the hospital simulation program like the one she circulated through an external device, rounds he oversees at St. Paul’s, known First-in-Canada: leads today been in existence at that an ECMO machine (extracorporeal as the Morning Report. time. “I had been off for nine months membrane oxygenation), that continues Medical students simply observe, and it was still fairly early in my career. to pump and oxygenate the blood while and everyone else – the residents and Simulations would have been a great physicians work to pinpoint the cause of other senior trainees – participate at way to help me brush up on my skills the cardiac arrest – and get the patient’s their own level of training. This creates ECPR and return to work in a more measured heart started again. a collegial, supportive climate for way,” says MacLeod. MacLeod says there may be up discussion. There is, in Kassen’s words, simulation Today, MacLeod’s leadership in the to 14 people involved in the ECMO “no angst and lots of learning.” field of emergency simulation, along stage of ECPR. “It’s kind of like a “And with our residents,” says Program with support from colleagues who pit crew in auto racing. There are Kassen, “you see, in the moment, Dr. Barry Kassen, director of the clinical teaching unit at St. Paul’s (centre left), with the core Morning Report podcast group, surrounded by medical students, residents and Bi-weekly simulations help share her view that simulations are an profusionists, emergency physicians, how they think. For the physicians in other senior trainees who participate in the learning program. emergency teams keep their ECPR invaluable educational resource, sees a respiratory therapist, nurses, a attendance, this is invaluable.” skills in top shape St. Paul’s assuming an influential role. cardiac surgeon, fellows, assistants. A major achievement has been a first- Everyone has a role to play, time is of KNOWLEDGE SHARE by the chief medical resident and the problem. “Medicine is like r. Jeanne MacLeod, an emergency in-Canada ECPR simulation program. the essence, and we are working in a The idea to record the Morning Reports focuses on a challenging case. storytelling,” he says. “It’s not about Dphysician and director of very confined space.” as podcast episodes came from the Participants are tasked with reasoning statistics or numbers; they just support simulation for the St. Paul’s emergency ECPR SIMULATION MacLeod and her colleagues are richness of the knowledge being through the case, asking questions the story. So a patient’s history being department, gained insights into the PROGRAM already looking forward to the new gathered, and the fact that it was not and making recommendations. reported is not me asking lots of value of simulation exercises thanks to The 30-minute ECPR simulation St. Paul’s site and having a designated readily available to many beyond those Confidential patient information is questions. It’s me listening to a story. her brother-in-law, a pilot, who informed program sessions run twice a month space for simulations – not just for who attend. removed, and the recorded Morning Sometimes the story doesn’t make her that in commercial aviation, when in St. Paul’s Teck Emergency Centre, emergency, but for maternity, ICU Each podcast episode, typically Report episode can be shared with sense, but that doesn’t mean a pilot takes off a certain amount of allowing health care workers to train and other areas. 30-45 minutes in length, is presented the medical community. it’s wrong. So sifting through the time, simulation exercises are a must. together in a safe environment. Kassen equates the Morning Report parts of the story, trying to make Otherwise, you don’t fly. ECPR (extracorporeal cardio- podcasts with the telling of stories, sense of it, listening instead of Following maternity leave, MacLeod pulmonary resuscitation) is a process in Give now to support programs like this at helpstpauls.com/donation and says that if you don’t hear the interrupting – that’s what we’re felt she would have benefited had a which a cardiac arrest patient’s blood is story, there’s no way you can solve trying to teach.”

6 Promise | Fall/winter 2017 Brian Smith/PHC Media Services brian smith/PHC Media Services Fall/winter 2017 | Promise 7 Research

Breakthroughs prospective longitudinal cohort study of patients who have successfully cleared HCV, and Ti’s goal is to enroll 730 patients from the Greater Vancouver Hope for area who will be followed for the next four years. “There’s some research out there Hep C Patients around reinfection, but most of it has been conducted over short periods of Researchers apply lessons learned from HIV/AIDS time and is very clinical. It’s important to combat this more common – and curable – viral disease to capture data on whether individuals have accessed or engaged in harm By Jessica Werb photograph BY Jeff Topham reduction, addiction treatment, or social services, and how these might protect against reinfection,” says Ti. Dr. Lianping Ti, Research epatitis C virus (HCV) is often Elimination strategy for HCV, applying the “We know little about what the rates Scientist with the BC-CfE, Hcalled a “silent killer,” and for good Treatment as Prevention® model that of reinfection are among different pictured outside the Hope to reason: it can go unnoticed for years— was pioneered at the BC-CfE, which has groups in the province, and we need Health clinic in the Downtown Eastside — the front line office even decades—before it makes itself helped dramatically curb the spread of a better understanding of how to for the Per-SVR study. known. By the time symptoms emerge, HIV in the province and around the globe. minimize reinfection risk among serious liver damage has often already marginalized populations such as occurred. And at least 44 per cent of POTENTIAL FOR people who inject drugs, people who infected individuals in Canada don’t even REINFECTION engage in sex work, and men who know they have it. However, there is one big difference have sex with men. The question An estimated 80,000 British between treatment for HIV and the HCV really is, ‘What more can we do?’ Columbians are infected with this cure: the potential for reinfection. “For We know harm reduction is effective, blood-borne virus, the majority of them sustained HIV, antiretroviral therapy but what else can we do to help baby boomers likely exposed through provides life-long treatment for people, prevent people from contracting blood transfusions or unsafe medical and an undetectable viral load,” explains HCV again?” practices. It sounds like bad news, but there is plenty to be hopeful about. Today, there is a cure for HCV: direct- “I’m optimistic about the current landscape surrounding acting antiviral therapy, or DAA therapy, the scale-up of HCV treatment and care in the province. which comes in the form of a once-a-day pill taken for as few as eight weeks. If we have policies in place around improving testing Until recently, the cost of this therapy uptake, and addressing some of the social and structural (around $1,000 per pill) kept it out of barriers that marginalized populations face on a daily basis, the hands of all except those who could afford it; only those with more advanced I think we can get to a HCV-free future.” –Dr. Lianping Ti liver disease were able to obtain MSP coverage for treatment. However, in February, the pan- Dr. Lianping Ti, Research Scientist, Answering that question is Canadian Pharmaceutical Alliance, a Epidemiology and Population Health, critical to halting the spread of HCV, coalition of provincial health insurers, BC-CfE at St. Paul’s. “With the new and to replicating the successes seen negotiated new prices with several DAA medications for HCV treatment, with the HIV Treatment as Prevention pharmaceutical companies, opening you can be cured 95 per cent of the model. As Ti notes: “Once we have a the door for widespread treatment time. However, once cured, there is better sense of how much we need across the country. Come 2018, the no immunity.” to scale up harm reduction and other province of BC has committed to Understanding the risks of reinfection support services in the province to treating all those diagnosed with chronic is a critical part of any effort to curb prevent reinfection, then we can HCV, regardless of the stage of their HCV infection, which is why Ti is effectively apply that model to HCV.” disease. In a bid to stem the tide of leading a study to examine factors that new infections, researchers at the BC affect HCV reinfection among at-risk Dr. Ti’s research relies on the support Centre for Excellence in HIV/AIDS (BC- populations. Per-SVR (PrEseRvation of donors like you. Give now at CfE) are working on a Targeted Disease of Sustained Virologic Response) is a donate.helpstpauls.com/BC-CfE

8 Promise | Fall/winter 2017 Fall/winter 2017 | Promise 9 Difference maker

BC billionaire Jim Pattison elaborates on the reasons behind his unprecedented

$75-million gift to St. Paul’s Billionaire philanthropist Jim Pattison and Maureen Chant (seated), his longtime assistant, who was instrumental in making By Stephen Forgacs the gift to St. Paul’s happen, photographed Photograph by Jeff Topham at the Jim Pattison Group’s downtown Vancouver headquarters.

im Pattison is keen to recognize others for their role in his decision, announced in March, to give $75 million to support the construction of the new St. Paul’s Hospital. Dressed in a light purple suit jacket and matching tie, Pattison obliges a photogra- pher and stands for a photograph with his assistant of 54 years, Maureen Chant, whom he credits with encouraging him to make the gift, which at the time was the largest ever to a Canadian hospital. When he sits down to talk, he’s warm, friendly and attentive, and very much to the point. J The importance of giving back is something he was taught by his parents as a child, and the decision to support St. Paul’s was, he says, quite simple. He mentions that as a child the Sisters at St. Paul’s cared for him when he had his appendix out, that his mother was well looked after there, and that St. Paul’s

10 Promise | Fall/winter 2017 Fall/winter 2017 | Promise 11 Jim Pattison greets This early example set by his parents Dr. Robert H. Lee, clearly influenced Pattison’s values and businessman and long-standing philanthropy. And it may philanthropist, at explain why he prefers to see credit the media conference announcing Pattison’s for the legacy he’s creating for British landmark gift to Columbians assigned to the people who St. Paul’s. shaped his values and influenced his decisions, particularly his parents and, suggest another factor is the potential in the case of the St. Paul’s gift, his long- to deliver benefits to the populations time assistant, Maureen. of Saskatchewan, where he was born The Difference “Maureen was very supportive, and where he spent his teenage The move to the Jim Pattison Medical my daughter Cindy was, the whole summers working on his uncle’s farm, Centre on an 18.4-acre site on board was,” he says, referring to the and to British Columbia, where he grew Vancouver’s False Creek Flats gives If a lot of people Jim Pattison Foundation Board. up and launched his business career. St. Paul’s the opportunity to create a Maureen took a lead role in managing The benefits to British Columbians health innovation hub that will attract give a little it still adds the logistics of the St. Paul’s gift, says will be many, says Vollet. “Building global health-care innovators, spur did a great job of caring for visitors nity that we are ready to transform up to a lot. And it’s Pattison. She has also been work- on St. Paul’s expertise in research, economic development, create a vibrant to Expo 86, which he led as president health care in the province.” ing closely with Pattison’s daughter, teaching and innovation, we will deliver community and support a healthy city. and CEO. But ultimately the decision The message is getting through. not the amount; it’s Cindy, to ensure proper stewardship of health care that will set a new global This is a once-in-a-lifetime opportunity. to support a charity hinges on the Since Pattison’s gift was announced, Pattison’s philanthropic endeavours. standard. It will become easier for our answer to one question. both St. Paul’s Foundation and participating that’s “Maureen, and now Cindy, spent patients to navigate the hospital and BUILDINGS “The question we ask ourselves is, Pattison himself have received a con- important. I think a lot hundreds and hundreds of hours dealing the system. And where possible we’ll be • acute care building (main hospital), ‘Will it make a difference?’ That’s all. siderable amount of correspondence with people to give money away over the taking care into the community, which 11 storeys That’s the question that I always ask. from people praising the donation. of people who give years,” Pattison says. “It’s not easy. Over is particularly important when it comes • ambulatory and specialty clinics Will this make a difference?” Even with Pattison’s gift, St. Paul’s time we get thousands of requests.” to reaching people who are marginalized • research building(s) The Jim Pattison Medical Centre, Foundation still has a lot of money to smaller gifts in many The Jim Pattison Group, the business through illness or economics, and often • commercial space for health care both. The patient journey will be greatly where the new St. Paul’s will be located, raise in order to contribute its share ways give more than empire that Pattison has built since technology, biomedical and life will make an immense difference, says to the massive project. Success will acquiring his first car dealership in eased, bringing care to our patients, sciences businesses wherever and whenever they need it.” Dr. Jeff Pike, Physician Lead, Clinical depend on the participation of thou- we have. Because 1961, today has 545 locations world- • health-related residence/hotel Planning, St. Paul’s Redevelopment. sands of British Columbians, participa- wide and interests in everything from Ultimately Pattison’s exceptional and retail space “The opportunity to build a completely tion that Pattison says is essential, no sometimes it’s a outdoor advertising and radio stations gift will benefit all Canadians. It will new health campus in BC, particu- matter the size of the contribution. to grocery stores and forest products. help both clinical-care programs and ON-SITE SERVICES larly in an urban environment, will “If a lot of people give a little it still sacrifice for them Many of these businesses engage in medical research thrive at St. Paul’s • emergency care not happen again in our lifetimes,” he adds up to a lot. And it’s not the amount; charitable giving, often via the Jim and, as in the past, discoveries and personally to do it. • primary care says. “This is our chance for a major it’s participating that’s important,” he Pattison Foundation. innovations that originated at St. • acute care step forward around the needs of our says. “I think a lot of people who give As the owner of Canada’s second- Paul’s will continue to have a local, • spiritual and All Nations reflection patients—together as citizens, as smaller gifts in many ways give more largest privately held company, with national and global impact. space care providers, as government and than we have. Because sometimes it’s a His mother and father quickly became revenues of $9.6 billion in 2016, Pattison Despite the far-reaching implications • ambulatory and specialty clinics health-care leaders, as educators. sacrifice for them personally to do it.” involved in the community and took has the ability to make a real difference of his generosity, Pattison still sees • diagnostics and imaging We all share a deep responsibility to The importance of this sacrifice, of young Jimmy along with them to through philanthropy and in the past the whole business of giving as pretty • seniors care deliver on this opportunity for BC, giving even when you have little to give, volunteer at a gospel mission at 40 year he’s made his largest gifts. In March straightforward. “My job is to make • healthy aging programs and Mr. Pattison has demonstrated was made clear to Pattison at a very East Hastings Street. He continued he made the gift to St. Paul’s and in the money, and theirs,” he says, • doctors’ offices the strength of his commitment to our young age. “It started with tithing,” he to volunteer there, alongside his May he made another large gift, of $50 referring to his foundation’s board, • pathology/lab medicine shared vision through his gift.” says, referring to the practice of giving father, for 20 years. million, to the new Children’s Hospital of “is to deal with the different options Pattison’s gift will also help St. a percentage of earnings to the church. “My father never made any Saskatchewan (which will be renamed and alternatives.” R&D AND EDUCATION PROGRAMS Paul’s Foundation meet the challenge “I can remember when I would get an serious money, but we always shared Jim Pattison Children’s Hospital). of building the new hospital, says Dick allowance. It was 50 cents. My dad would what we had,” he says. “We didn’t own The likelihood that these gifts For more information on the new • in-hospital Vollet, CEO of St. Paul’s Foundation. say, ‘Now Jimmy, make sure you put five a house, but at Christmas my dad will make a difference is clearly St. Paul’s, please visit thenewstpauls.com. • lab-based “Having someone like Jim Pattison cents in the collection plate.’ And I did.” would always bring home people who Pattison’s top criterion in choosing To support St. Paul’s Foundation, • commercial partner research put his name behind the new St. Paul’s Pattison moved to Vancouver were less well off than we were, and causes to support. His recent donations please make a donation at • medical education sends a clear message to the commu- from Saskatchewan when he was six. we didn’t have a lot.” – to St. Paul’s and Saskatchewan – helpstpauls.com/donation

12 Promise | Fall/winter 2017 Jay Shaw Sketch courtesy of IBI Group Inc. Fall/winter 2017 | Promise 13 Two Lives to

“There’s a respect and trust that’s developed among the different teams and that is the key.”

Teamwork Savehelped to save he business of bringing babies into the world a pregnant is inherently unpredict- mother and able. No one knows this better than the vastly baby after Texperienced obstetricians at St. Paul’s mom went into Pictured in the St. Paul’s critical care unit, where maternity ward who deal with the most Dr. Elisabet Joa (left), an obstetrician, performed complex and high-risk pregnancies. cardiac arrest the emergency caesarean section on Forrest, and Dr. But occasionally even they are tested Antoinette Van den Brekel, a pediatrician, stabilized by a delivery of rare complexity. By Joseph Dubé baby Jaxon, who was born two months premature. On April 1, Brittany Forrest, a 26-year-old expectant mother, seven months pregnant, had been airlifted to window to save the baby, doctors made continue to enjoy good health. St. Paul’s after she’d experienced heart “If Brittany the decision to perform an emergency “We’re doing good. We’re both back failure at her hometown hospital in wasn’t at St. caesarian section on the spot, outside to normal. Jaxon is three months old. Courtenay, BC. the operating room, using equipment He’s healthy and weighs around eight “I just felt really sick for almost a Paul’s, she they had already set up on a cart outside pounds,” says Forrest. “I go to the heart month straight. The doctors kept telling Forrest’s room as a precautionary clinic at St. Paul’s once a month for a me it was pregnancy symptoms,” says wouldn’t have measure. check-up, but everything seems good Forrest. “One night I felt really ill and I survived. I In mere minutes Joa delivered a so far. I’d really like to thank everyone went to the emergency ward. I guess I three-pound, 11-ounce baby boy who at the hospital for giving me a collapsed there. They took a scan of my can say that was quickly resuscitated by the await- second chance.” heart and saw that it was surrounded ing pediatrics team. Cardiac surgeons “If Brittany wasn’t at St. Paul’s, she in fluid and they immediately flew with absolute rushed Forrest to the operating room, wouldn’t have survived. I can say that me to St. Paul’s.” certainty.” where they put her on an ECMO bypass with absolute certainty,” says Joa. Forrest was stabilized at St.Paul’s machine, which did the work of her “We are constantly dealing with very by the cardiology team but she — Dr. Elisabet Joa, heart, giving it time to rest and recover. complex, high-risk patients, and so Brittany Forrest with her boys: babyJaxon, remained very ill with her diagnosis obstetrician at St. Paul’s Kailen (left) and Aidan in Courtenay, BC. Born two months premature, the we’ve learned to function together in uncertain. The teams at St. Paul’s are tiny infant was stabilized and then a very unique way. There’s a respect familiar with working together and transferred to BC Children’s Hospital, and trust that’s developed among the preparing for care of both mother and was in the hospital and that she was Then at around 3 o’clock on the but as soon as we hit the ward we real- and Forrest spent the next several different teams and that is the key. baby in acute situations, but this case quite ill, and that at some point, poten- morning of April 12, things took a ized that indeed her heart had stopped weeks healing at St. Paul’s. The team It’s such a critical thing when you’re was the most extreme. The teams tially as a worst-case scenario, we turn for the worse. Forrest went into and they were trying to resuscitate her was able to determine the diagnosis dealing with high-stake cases in needed to prepare for an urgent, would have to do a delivery very quick- cardiac arrest. with CPR,” says Joa. “Once the heart after a biopsy on Forrest’s heart. the middle of the night.” extremely high-risk delivery, knowing ly,” says Dr. Elisabet Joa, obstetrician Joa, who was on call at the hospital, has stopped you’re not getting blood to Once treatment was started, she that the lives of both baby and mother at St. Paul’s. “So thankfully we planned heard her pager go off. It was a Code the placenta, so essentially the baby responded quickly and eventually Give now to support women hung in the balance. for that, and I think that made all Blue emanating from Forrest’s ward. is not getting oxygen.” both mother and child returned back and babies at St. Paul’s at “All of us were aware that Brittany the difference.” “We all ran down hoping it wasn’t her, Presented with an ever-narrowing home to Courtenay, where they donate.helpstpauls.com/maternity

14 Promise | Fall/winter 2017 Jesse Savage (above), Jeff Topham (opposite right) Fall/winter 2017 | Promise 15 lives of resident seniors. with the Cullen family,” adds Below Right: Dr. Marc Romney, Medical “When you see something that can Dr. Martin Trotter, Department well Leader, Medical Microbiology and really help somebody – even a blanket Head of Pathology and Laboratory Virology at St. Paul’s demonstrating warmer – it may be small, but it makes Medicine at PHC. “They’ve helped to Mark Cullen how the VIRTUO™ instrument’s robotics improve work flow a big difference,” says Barbara. Close improve our workflow, our accuracy by employing a motion-activated loading to her own heart is “the lab,” officially and efficiency, and our ability to make Equipped system for blood culture bottles. called the Pathology and Laboratory diagnoses faster for patients. We take Medicine department. “I think of it as pride in that, and we’re so thankful the foundation of the hospital,” she to the Cullens for helping make t first glance, there seems says. “With better equipment they that happen.” To Care little in common between can have accurate diagnoses quickly, To date, the Cullens have donated a serene garden for for doctors to determine the right more than 200 pieces of equipment, For three decades, the Cullen family seniors at St. Vincent’s: treatment for their patients. This along with significant funding for other BrockA Fahrni residence, a fibre-optic leads to better patient care, which projects. Currently, and alongside his has been quietly helping improve almost every salivary endoscope at Holy Family is our overall objective.” role as a founding member of St. Paul’s aspect of the patient and resident experience across Hospital, or a blood gas analyzer in “The Cullens have touched all of Governors Council, Mark continues Providence Health Care sites the St. Paul’s pathology lab. But these gifts, along with many others donated By Melissa Edwards by the Cullen family over their 30-year relationship with St. Paul’s and former Photography by Jeff Topham Tapestry foundations, do share a fun- damental connection: they have all made a profound impact on the real, day-to-day experience of patients and residents across every Providence Health Care (PHC) site. “We’ve become, in a small way, partners with St. Paul’s,” says Mark Cullen, whose long friendship with the organization began in 1988, when the late Terry Heenan, then a client of Mark’s at RBC Dominion Securities and chair of the hospital’s board, recommended he join the board too. Mark’s wife, Barbara, soon began volunteering as well, helping to develop a new patient relations program. Today the couple, along with their daughter, Lesley, meet regularly our lives and supported every corner to volunteer as a member of the with hospital and foundation staff to of our lab,” says Janice Bittante, PHC Residential and Community Care uncover areas of greatest need. (Their manager of laboratory operations Services Society, which helps oversee son, John, lives in Toronto but takes for St. Paul’s. The 2014 gift of an the upcoming development of advanced part when he can.) “It’s something we innovative mass spectrometer, for new sites for seniors and patients with ABOVE: Barbara and Mark Cullen, with their look forward to,” says Barbara. “It’s a example, reduced the time it takes to dementia at the St. Vincent’s location. daughter Leslie Jackson, pictured at St. Paul’s very collaborative process.” While the identify the bacteria in patients with “The relationship we have with the Microbiology Laboratory, beside the blood culture Cullens have funded major research infections from up to 48 hours to less team at Providence has developed over analyzer (BACT/ALERT® VIRTUO™) that they and infrastructure projects, their than five minutes. The recent donation so long, and it just keeps getting better,” funded. The instrument automates blood cultures focus is on donating equipment, from of a SealSafe system improved the says Mark. “We have so much respect and allows for the rapid detection of pathogens (e.g., bacteria) in patients with sepsis. TOP high-tech to low, that immediately way the pathology team processes for what they do.” RIGHT: Reginald Naidu, Histology Technologist, improves the comfort and treatment tissue samples, and new “Cellavision” “Once you start giving, it’s such uses equipment funded by the Cullen family at of patients and residents. For example, digital microscope software has a joyful thing that you want to keep St. Paul’s laboratory to cut blocks of tissue into a project to renovate the tub facili- propelled the lab’s ability to quickly doing more,” says Barbara. “It’s all ribbons and float them onto water to make slides. ties in all of PHC’s residential care diagnose conditions like leukemia about the care of patients and residents, The slides are then stained and viewed under the microscope by a pathologist to help sites may not have been exciting, says or anemia. and the more people you can help, diagnose disease. Mark, but it made a real impact on the “Our team feels very connected the better you feel.”

16 Promise | Fall/winter 2017 Fall/winter 2017 | Promise 17 Research in the real world

For 40 years, the Centre for Heart Lung Innovation has been finding answers to some of Meet the four distinguished directors who have cardiopulmonary medicine’s most pressing each helped grow the Centre for Heart Lung questions — all within the setting of Innovation into the world-leading research centre that it is today. Pictured from left, Dr. Bruce a busy urban hospital McManus (former director, 2006-2012); Dr. Jim Hogg (co-founder and former director, 1977-1999); Dr. Keith Walley (director, 2013-present); and Dr. Peter Paré (co-founder and former director, By Helena Bryan 2000-2005). Dr. Jim Hogg and Dr. Peter Paré preparing Paré, Lisa Baile and Hogg came to Dr. Bruce McManus and his research team, pictured Read more about the shapers of the HLI at Photography by Brian Smith samples in the Pulmonary Research St. Paul’s to start the Pulmonary at St. Paul’s in 1996. helpstpauls.com/promise_HLI Laboratory. Research Laboratory in 1977.

hen the Pulmonary Bench-to-bedside decades, co-founders Dr. James Hogg 39 countries on six continents. families and develop new and more ing quality of life for these patients, yet Research Laboratory research and Dr. Peter Paré actively supported “Our commitment to sharing effective ways to diagnose and treat current diagnostic tools lack accuracy. opened at St. Paul’s One of the things that make HLI related investigation. And today, it’s not knowledge has resulted in this well- the disease. DeMarco wants to change that, creating Hospital in 1977 – special is that it’s a basic science lab uncommon to find a mathematician, a spring of brilliant young people who Dr. Janice Leung is looking at why effective, accessible tools, based on bio- Wwith one trainee and two principal housed in a busy urban hospital. That pathologist, a surgeon and a basic sci- end up doing amazing things in our own people with HIV end up with chronic markers in the cerebrospinal fluid. investigators on board – who could interaction between basic science and a entist joining forces to attack otherwise communities and in distant places,” lung diseases more often and at younger Early-career investigators like have known that it would become a clinical setting is unique, says Dr. Keith intractable cardiopulmonary problems.” says principal investigator, and former ages than the general population. Her these represent the future of HLI, and world-class research powerhouse for Walley, intensive care physician and HLI director, Dr. Bruce McManus. aim is to develop targeted treatment of heart, lung and critical care research, understanding and eliminating heart, current HLI director: “Typically, scien- Inspiring a future Dr. Liam Brunham and his team, and prevention strategies for one of says McManus: “They are changing the lung and critical care disease. tists don’t interact with patients to the generation for one, are studying early-onset ath- BC’s most vulnerable populations. world – and that’s really something

But that’s what happened. Now in extent that we do. Everything we do is Senior investigators are also dedicated erosclerotic heart disease, a condition At the heart of Dr. Mari DeMarco’s to celebrate.” (40-year timeline next page) t its 40th year, the Centre for Heart Lung related to solving patient problems.” to nurturing the next generation of tracking in families that can lead to research is the growing number of Innovation (HLI), as it’s known today, HLI is also truly multidisciplinary, scientists. In the past decade alone, they heart attacks in very young men and Canadians who will develop Alzheimer’s Give now to support the Centre has plenty to celebrate. says Walley. “Even though this was a have hosted more than 600 graduate women. The goal is to identify genetic disease or other forms of dementia. for Heart Lung Innovation at pulmonary research lab for the first two students and postdoctoral fellows from and environmental risk factors in Early diagnosis is critical for improv- donate.helpstpauls.com/HLI

18 Promise | Fall/Winter 2017 (Credit for Archival images) HLI Fall/winter 2017 | Promise 19 40 years of Leading Research

LUNG 1996: Revealed that the arteries of failed human Early 1980s: Created the lung tissue heart transplants with vasculopathy (a special form biobank, a collection of biological samples that of plaque) are extraordinarily lipid (fat) rich. This have been preserved and annotated with clinical discovery shifted treatment towards intensive lipid and demographic information. The biobank is lowering therapy for all heart transplant patients. now one of the largest in the world with more 1999: Began an intense journey to unravel the than 120,000 specimens. signals in host cells that alter to either protect the 1986: Developed novel techniques to assess cell or promote viral infection. This duel between lung emphysema, cystic fibrosis and airway the host and the virus determines whether the Music therapist remodeling using Computed Tomography (CT). heart muscle ultimately fails during an infection. Lucy Thomas This research revolutionized how we diagnose New therapies target these signaling networks. and follow patients with these diseases. 2014: Showed that the common form of 2002: First demonstrated the role hardening (and thickening) of the arteries of ambient air pollution in initiating and (which causes heart attacks and strokes) contributing to atherosclerosis, the hardening depends on excessive numbers of muscle cells of the arteries. Exposure to air pollution is in the arterial walls, not so much excessive white now generally accepted as a risk factor blood cells, as long believed. This paradigm for heart attacks and strokes. shift in our understanding of atherosclerosis (plaque development) opened up a new 2013: Research revealed why certain target to prevent and treat this leading people are susceptible to asthma and COPD cause of death worldwide. (chronic obstructive pulmonary disease) and of a song, one that has been a part of why certain patients who smoke or have cystic Sepsis a family’s past, it retrieves great fibrosis progress rapidly and others do not. Soothing with This research contributed to the development 1990: Demonstrated that bicarbonate memories and evokes smiles for of new therapies and drugs to slow the administration does not improve blood flow everyone, while transporting patients progression of COPD and asthma. in critically ill patients with severe acidosis to another place and time,” explains (overproduction of acid). This contributed 2017: Found a way, in collaboration with Leah Rosling, music therapist and the PROOF Centre, to test for Western red cedar to a major change in guidelines, including the asthma, the most common form of occupational ACLS (advanced cardiac life support) guidelines, professional practice leader for music asthma in BC (affecting around five per cent so that bicarbonate administration is no longer therapy at Providence Health of forest and construction workers exposed to advised as a first line therapy of severe acidosis. song Care (PHC). sawdust), using a blood-based biomarker. This 1993: Demonstrated that using drugs to increase How music therapy is contributing to palliative care Thomas, Rosling and the several could be an easy and inexpensive alternative to the cardiac output in patients with severe infections other music therapists at PHC visit current invasive, multi-day testing procedure. is ineffective, leading to the abandonment of this By Michelle Hopkins strategy by intensive care physicians worldwide. patients and residents weekly, with photography by jeff topham guitars strapped to their backs and Heart 2008: Demonstrated that vasopressin infusion 1993: Received the heart and blood to increase blood pressure in patients with severe a combination of violins, percussion vessel biobank, a unique educational, research infections and shock works as well as, or better instruments and songbooks in their and diagnostic resource. The biobank has than, the standard therapy to increase blood arms. Not restricted to the palliative been the basis of hundreds of peer-reviewed pressure. The new treatment improved kidney aren Magill remembers feel uplifted and have this beautiful care wing at St. Paul’s, music thera- observations on human disease, and a focus function and increased survival in subsets on for education of many basic science and patients with severe infection. This led to a New watching her mother’s face look on her face. Peaceful, really,” says pists can be referred to patients and clinical trainees. The biobank now holds over England Journal of Medicine publication and the radiate joy when music Magill. “The music took her away from residents at all PHC sites. 100,000 individual specimens. adoption of vasopressin into the international therapist Lucy Thomas her pain momentarily.” “Music therapy is effective across ‘Surviving Sepsis’ campaign guidelines. 1992-93: Demonstrated a widely-held belief playedK one of her 79-year-old mom’s Music therapy is not new; in fact, so many different areas. Through the that early injury to the heart muscle following a 2014: Discovered that reduced function favourite songs by country singer it has been used for years across Palliative Outreach Consult Team, I viral infection was due to auto-immune response of the gene PCSK9 can help the liver clear Trace Adkins. North America to provide a variety spend time with patients throughout to be untrue. This turned the focus of research to itself of cholesterol and toxic bacterial fat how the virus itself disrupts cell stability, and molecules, resulting in improved outcomes “Mom loved music and she and of touchstones – social, physical, St. Paul’s Hospital. The music therapy has opened the door for anti-viral and immune- of severe infections. This has led to interest dad would often dance together,” says emotional, spiritual and psychological team also spends time at the PHC boosting therapies in such acutely ill patients. in clinical trials of PCSK9 inhibitors. Magill. “So, when Lucy would play the – for patients in end-of-life care. residential care homes and mental guitar and sing to mom, she would “Quite often during the singing health units,” says Thomas.

20 Promise | Fall/WintER 2017 Fall/winter 2017 | Promise 21 Q&A by Michelle Hopkins Dr. Gil Kimel, Physician Program Director – Palliative Services, PHC There is a lot of research to show Sarah Cobb, Clinical Nurse Leader, that during medical Palliative Care, procedures, music St. Paul’s therapy can be very Music therapist Lucy Thomas (above right), pictured with Karen Magill in the palliative care effective in pain loved one’s prognosis, care plan and what patient lounge at St. Paul’s. Before Karen’s their options are, such as home care versus mom, Willi, passed away of stomach cancer, management. Lucy and Willi worked on a Musical Life Review, hospice. We reassure families that our goal putting together a collection of Willi’s favourite is to make their loved one feel comfortable songs, with voice recordings of her sharing r. Gil Kimel leads a team of and feel better through symptom stories with Lucy. Karen helped complete the Dphysicians and nurses who, management. CD (pictured) after her mom’s passing. “It’s a like him, are dedicated to helping Cobb: It might mean dispelling the myth cherished collection of songs that represent a lifetime of my mom’s memories,” says Karen. always in their control. That’s very those in their care manage their that PC is just end-of-life care, when it empowering in a time when they pain and symptoms. Sarah Cobb might be months of managing pain have little choice left.” is a clinical nurse leader who is and other symptoms. passionate about helping those Music therapy’s singing, instrument playing and music A powerful component at end-of-life and their families. What types of challenges do many benefits therapy relaxation techniques, paired of holistic healing families face? There is a body of evidence that with verbal counselling, to enhance the At the end of Willi Magill’s life, What qualities should palliative Cobb: Common challenges, understandably, are loss suggests music therapy can contribute quality of life for terminally ill patients, her daughter Karen was grateful for care (PC) providers possess? and anticipatory grief. Additionally, they are trying to to palliative care in a host of ways. residents and their families. the pleasure music therapy brought Kimel: Some people believe that PC navigate our health care system. Our team can guide It helps alleviate isolation, loneliness “There is a lot of research to show to her mother as she lay dying of physicians just comfort patients when and support them through their journey of loss with and boredom. It can help patients and that during medical procedures, music stomach cancer. “My last memory they are dying, but PC is an evidence- resources and services available to them. residents deal with emotional issues, therapy can be very effective in pain of my mom was of Lucy playing her based medicine subspecialty where we such as depression, anxiety, fear, frus- management,” says Thomas. “Many guitar to mom’s breathing pattern,” treat patients that have symptoms. The Why did you gravitate to palliative care? tration and anger, as well as physical of my patients have told me how she recalls. “It was so soothing to qualities PC physicians should possess Kimel: During my training, I found it very difficult to pain and shortness of breath. powerful it can be.” Rosling agrees and watch mom’s breathing become include excellent understanding of pain see patients with serious illnesses in pain or suffering, “It can also support them spiritually,” adds: “The music helps them relax less laboured.” and symptom management and outstanding and so I became interested in learning about palliative adds Thomas. and they become less agitated when Music therapy doesn’t end there. communication skills with patients, medicine to improve patients’ quality of life. It’s very Thomas and Rosling are among the music’s playing.” Rosling says it can also benefit family families and team members. meaningful work for me. I also find it rewarding to build a growing number of music thera- As music therapists, both are members. “Music therapy has a way Cobb: Nurses in PC are driven by holistic strong connections with patients and families. pists accredited by the Canadian trained in how to read body language of bringing family members together patient care; you focus on all aspects of a Cobb: I worked for many years in a department Association for Music Therapy. Both and emotions and to respond to to express their love, loss and grief in patient’s life. Nurses tend to be very caring, where I saw many people die without the benefit of graduated from university with four- those cues. a container that holds so much beau- compassionate and good communicators. PC. This made me want to learn how to provide good year degrees in music therapy, along “We usually approach a patient or ty,” says Rosling. “A skilled music end-of-life care. There’s comfort from a well-managed with a six-month clinical internship. resident and get to know who they are, therapist can bring people together How do you help families prepare for their end of life, first and foremost for the patient but for Using music as a primary tool in where they are from and what genre in a tender, moving way.” loved one’s going into palliative care? family and caregivers as well. palliative care, they employ methods of music they love,” explains Thomas, Kimel: We allow for plenty of time for such as songwriting, storytelling, guid- noting that there is no limit to the Give now to support programs like this questions and discussion around the Give now to support palliative care at ed imagery and music, lyric analysis, time they spend with a patient. “It is at helpstpauls.com/donation care plan. Families want to know their donate.helpstpauls.com/palliative_care

22 Promise | Fall/winter 2017 brian smith/PHC Media Services Fall/Winter 2017 | Promise 23 Give the greatest gift of all. Give to St. Paul’s Foundation. lightsofhope.com/donate

A story of hope By the age of 26, George’s lung function deteriorated to the point that a double lung transplant was the only option.

“I spent 200 days at St. Paul’s waiting for a transplant, and the compassionate care I received helped save my life. I became a spiritual care practitioner, and now I am part of the incredible team at Providence Health Care.

Your gift gives hope to tens of thousands of patients, like me. Thank you.” Read more stories of hope at lightsofhope.com/stories PM 40065475 PM