You are MARVELLOUS!

That's a phrase we used so many times in medical school, thirty-three years ago. I look back on this and realize how much the world has changed. I am not sure if medical school is as 'vicious' now as it was then. I went to McMaster Medical School in Hamilton. It was known for it's new way of thinking and learning and it's open mindedness with respect to treating the entire patient from a holistic and compassionate point of view.

Working at the bottom of the medical school totem pole was humbling to say the least. Some senior residents and specialists set great examples of professional behaviour, others, not so much. I did the obstetrics part of my residency at St. Joseph's Hospital. It was and still is a very busy place. I remember one infamous obstetrician-gynecologist in particular. He was widely feared. On one particularly busy night, several of the residents and interns were called in to watch him deliver a breech baby. Babies in breech position are now delivered by C-section unless that option is not available but back then, women were given a shot at a very risky vaginal delivery. So many things could go wrong and on this particular night, many things did. We asked the labour and delivery nurses what to expect when we entered the delivery room. In other words, how do we manage this feared MD. Their answer? "DUCK".

Sure enough, once every part of that newborn was delivered except the head which then got stuck and the dangling newborn body started to turn blue, the stress and anger in that room were palpable. All of a sudden, this guy decides to throw one of the forceps he failed to use effectively, in our direction. We did what we were told. We ducked. A scalpel blade came next. We ducked again. Four of us, standing like frozen soldiers in a dutiful row, all ducked at the same time. That, in large part, was how we were treated by many angry folks who had not learned how to handle an intensely stressful situation without becoming abusive or did not care about managing an intensely stressful situation in a professional and respectful way. Times have changed and thankfully, this type of behaviour still exists but is no longer seen as acceptable.

On the opposite end of the professionalism spectrum, I remember assisting an obstetrician-gynecologist while she was removing a uterus. I can't remember what went wrong but the patient's pelvis quickly filled with blood and her vital signs become very unstable. We all watched the surgeon. She could have screamed and yelled profanities, maybe even thrown a scalpel blade or two.... we waited. She worked swiftly to control the bleeding but she also understood that we were looking to her for leadership and control. So, she started singing. It was the late 80's and Bobby McFerrin's hit, 'Don't worry, Be Happy' was at the top of the charts. That is what she sang. I learned more about staying calm and professional in that moment than I think any other. The entire operating room relaxed and every order she gave after singing that song was responded to with precision and expertise. We all work better together as a team when we are being led well with calmness, professionalism, dignity and level-headedness.

Our medical school class was very close. We had each other's backs. It was a well loved, now retired oncologist who started this comforting, encouraging phrase which was used to shore up an abused classmate. I don't remember who she helped first but it must have been some collapsing medical student who had just had a scalpel and a profanity hurled at them. She took them aside and whispered, " You are Marvellous". It caught on very quickly and soon became standard operating procedure. Right in front of the most abusive specialist, any nearby classmates would chant those words. It bewildered and confused the abusers. It also silenced them.

I am not sure why I am telling you this story except to make sure you know how marvellous you are, what a marvellous job we have done as a province and how close we are to making COVID-19 a manageable illness. I am also very concerned about leaders in general. The big political leaders that hold positions like premiers, presidents and prime ministers. Not all of them but too many do not live up to what we need and expect in terms of professionalism, decency, respect and kindness. But you had had some great leaders in this province and nationally. Quiet, unsung, medical leaders and professionals who have given their all in the last 19 months.

I'd like to say 'thank you' to them. They have steered us to a place where hospitalizations have remained low and steady, where 87 % of vaccine eligible Ontarions have received one dose of vaccine and 82 % have received two and where our 7 day rolling average is down to 537 not 8,000 which is what the worst case scenario modelling predicted.

Well done. YOU ARE MARVELLOUS!

Kids vaccines are next. Both the Pfizer and Moderna vaccine trials in kids have shown exceptional results with just a third of the adult dose. Kids in these trials have experienced fewer short term, minor side effects. The American Food and Drug Administration is expected to approve the use of these vaccines in children under 12 in the next couple of weeks. Health Canada will likely follow shortly thereafter. Because we are naturally very protective of our children, these studies will be reviewed with great care. I will start informing you of these studies as soon as they are available for general review. In the meantime, as we head indoors, get vaccinated. Keep your families and your communities safe. Keep our new daily cases low. Keep our hospitals open for business. Give our hospitals time to recuperate from the many, many far reaching effects of this pandemic. We are not in good shape as a medical community. Holding the fractured and broken health care system on our shoulders is a daunting and exhausting task. Be patient. Be kind. Tell someone you know in the medical field that THEY are marvellous too.

Yeah.....that's a big Thanksgiving carrot. You guys have bestowed me with great 'carrot' luck.

Be well and safe out there.

Anne-Marie

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