Two Sides of the Story
By: Jerri Clout
Not to many families have a relationship with a neurosurgeon the way our family does with Dr. Fehlings.
My mother had her first spinal cord surgery when I was 9 years old and my little sister Meg was 7. I remember going into his office for my mothers first follow up after she had been released from the rehab hospital. Meghan and I had each made Dr. Fehlings a card, thanking him for my mothers ability to walk. I have a distinct memory of him kneeling to be eye level with us, and me handing him the card I had made. 12 years later, I was handing him my completed undergraduate thesis paper.
As a recent Neuroscience grad from University of Toronto and with Mom's 'always find the silver lining attitude', I have been doing my best to making her 3rd neurosurgery a learning experience.
During the summer before my 4th year and final year of university, I decided I wanted to do an undergraduate thesis. I remember perusing through the list of possible projects and stopping at one listed as "spinal cord injury rehabilitation, cord resiliency, stem cells, surgery and pain control". I decided that was it, the project for me. I emailed the coordinator who quickly emailed me back to say that this project was with one of the best neurosurgeons and spinal cord researchers in North America. Perhaps I had heard of him, his name was Dr. Fehlings. That my friends, is what I believe you call fate.
For 8 months I worked closely with a member of Fehlings' research team, Dr. Sukhvinder Kalsi-Ryan. She took me everywhere from the diagnostic clinics with the neuro team to working with patients pre- and post-operatively. I treasured working not only with a world-class team of neuroscients and researcher, but also gaining a female mentor who had a very successful career, a family and work-life balance as well.
It was towards the end of my time at Toronto Western that Mom's MRI came back irregular in the lumbar spine for the first time in 12 years. Memories and emotion of her first spinal cord surgery came flooding back back; Lyndhurst rehab hospital, being away from my sick mom as a young child and the 100 times we drove from North Bay to Toronto that fall. The emotions and concern quickly faded though when I thought about my past 8 months with the Fehlings' team. If I knew anything, it was that she was in good hands.
But after 8 months I knew more than that; I knew how to read and diagnose MRIs, the clinical symptoms of stenosis and how to test for it and the indicator that a patient needs surgery. I had just spent 8 months researching and writing about how clinical impairments and pain manifests as disability in a patients life after surgery. Now I was about to get a hands on lesson in it.
Going through the pre-operative, surgical and rehabilitation progress of her past two lumbar surgeries; there was always two sides on the story. The clinical side and its interpretation, which I got from Dr. Kalsi-Ryan and Dr. Fehlings and Moms side, how the clinical diagnosis manifested into how she felt and how she lived.
Then one day it clicked and the two sides of the story became one. Last week, 2 days post-operative, Dr. Fehlings came into my mothers room to chat about her progress to date. He admitted that they had been quite stumped at the temporary paralysis after her surgery, but they thought they had an answer to it. He addressed mom as he explained how the local anesthetic they injected right into the surgery site may have “leaked” out on to the nerves and caused the paralysis. I pondered the neurobiological basis for this in my mind for a few moments before Dr. Feelings caught my eye and must have read my mind. He saw the teachable moment as he turned to address me and explained the few unique circumstance in my mothers particular case that allowed this to happen.
He then went on to explained the new medication regime he was starting her on, a drug still in clinical trial, for which the foundation of the research laid down by his team at TWH (a drug that would go on to increase moms mobility over the next few days). Towards the end of the conversation, he said as soon as mom was able to it was critical that she get ‘walking, walking, walking’, then he paused and followed up with ‘but we don't need to tell you that, because you are the one that taught us that 12 years ago’.
Bam. It clicked.
In research you are taught that the answers are in the numbers, but in reality, the numbers are only the beginning of the story. The doctors learn from the patients just as much as the patients learn from the doctors. The research that is conducted in the laboratory is only valid if it can translate to improvement in patients health or the care they receive.
So as I start my career in clinical research I will hold the lessons learned from this process close. First and foremost, to always listen to each patient. Ask for their story and listen to every part, because I have a lot to learn from them. To remember that not all the answers are in the numbers and that every number is a person.
Finally, on the days I don’t want to get out of bed, I will remember 10 year old me giving Dr. Fehlings the cards my sister and I had made. I will remember how grateful I was for the man who gave my mother the ability to walk again. And as I grew older and developed a greater understanding of the situation, how grateful I have been for the research team at TWH, how grateful I am for the drug she is on now that I has improved her mobility. I will remember what a difference research makes in the lives of everyone in this country, but mostly how much of a difference it has made right at home, and remember that it is my turn to give back.
My mother had her first spinal cord surgery when I was 9 years old and my little sister Meg was 7. I remember going into his office for my mothers first follow up after she had been released from the rehab hospital. Meghan and I had each made Dr. Fehlings a card, thanking him for my mothers ability to walk. I have a distinct memory of him kneeling to be eye level with us, and me handing him the card I had made. 12 years later, I was handing him my completed undergraduate thesis paper.
As a recent Neuroscience grad from University of Toronto and with Mom's 'always find the silver lining attitude', I have been doing my best to making her 3rd neurosurgery a learning experience.
During the summer before my 4th year and final year of university, I decided I wanted to do an undergraduate thesis. I remember perusing through the list of possible projects and stopping at one listed as "spinal cord injury rehabilitation, cord resiliency, stem cells, surgery and pain control". I decided that was it, the project for me. I emailed the coordinator who quickly emailed me back to say that this project was with one of the best neurosurgeons and spinal cord researchers in North America. Perhaps I had heard of him, his name was Dr. Fehlings. That my friends, is what I believe you call fate.
For 8 months I worked closely with a member of Fehlings' research team, Dr. Sukhvinder Kalsi-Ryan. She took me everywhere from the diagnostic clinics with the neuro team to working with patients pre- and post-operatively. I treasured working not only with a world-class team of neuroscients and researcher, but also gaining a female mentor who had a very successful career, a family and work-life balance as well.
It was towards the end of my time at Toronto Western that Mom's MRI came back irregular in the lumbar spine for the first time in 12 years. Memories and emotion of her first spinal cord surgery came flooding back back; Lyndhurst rehab hospital, being away from my sick mom as a young child and the 100 times we drove from North Bay to Toronto that fall. The emotions and concern quickly faded though when I thought about my past 8 months with the Fehlings' team. If I knew anything, it was that she was in good hands.
But after 8 months I knew more than that; I knew how to read and diagnose MRIs, the clinical symptoms of stenosis and how to test for it and the indicator that a patient needs surgery. I had just spent 8 months researching and writing about how clinical impairments and pain manifests as disability in a patients life after surgery. Now I was about to get a hands on lesson in it.
Going through the pre-operative, surgical and rehabilitation progress of her past two lumbar surgeries; there was always two sides on the story. The clinical side and its interpretation, which I got from Dr. Kalsi-Ryan and Dr. Fehlings and Moms side, how the clinical diagnosis manifested into how she felt and how she lived.
Then one day it clicked and the two sides of the story became one. Last week, 2 days post-operative, Dr. Fehlings came into my mothers room to chat about her progress to date. He admitted that they had been quite stumped at the temporary paralysis after her surgery, but they thought they had an answer to it. He addressed mom as he explained how the local anesthetic they injected right into the surgery site may have “leaked” out on to the nerves and caused the paralysis. I pondered the neurobiological basis for this in my mind for a few moments before Dr. Feelings caught my eye and must have read my mind. He saw the teachable moment as he turned to address me and explained the few unique circumstance in my mothers particular case that allowed this to happen.
He then went on to explained the new medication regime he was starting her on, a drug still in clinical trial, for which the foundation of the research laid down by his team at TWH (a drug that would go on to increase moms mobility over the next few days). Towards the end of the conversation, he said as soon as mom was able to it was critical that she get ‘walking, walking, walking’, then he paused and followed up with ‘but we don't need to tell you that, because you are the one that taught us that 12 years ago’.
Bam. It clicked.
In research you are taught that the answers are in the numbers, but in reality, the numbers are only the beginning of the story. The doctors learn from the patients just as much as the patients learn from the doctors. The research that is conducted in the laboratory is only valid if it can translate to improvement in patients health or the care they receive.
So as I start my career in clinical research I will hold the lessons learned from this process close. First and foremost, to always listen to each patient. Ask for their story and listen to every part, because I have a lot to learn from them. To remember that not all the answers are in the numbers and that every number is a person.
Finally, on the days I don’t want to get out of bed, I will remember 10 year old me giving Dr. Fehlings the cards my sister and I had made. I will remember how grateful I was for the man who gave my mother the ability to walk again. And as I grew older and developed a greater understanding of the situation, how grateful I have been for the research team at TWH, how grateful I am for the drug she is on now that I has improved her mobility. I will remember what a difference research makes in the lives of everyone in this country, but mostly how much of a difference it has made right at home, and remember that it is my turn to give back.
