Honoured Faculty, Very-soon-to-be Colleagues, Families

and Guests

Good Evening
As some of you know I have two jobs, one here at Sackler
in Medical Education and one in Toronto where I work as a
hospital physician. I returned yesterday from Toronto and
had a lovely 11 hour flight to think of what I would say to
you tonight. What eloquent and well-chosen words would
I emit that would make a powerful and eternally-
remembered impact on your lives and medical career?
During my week in Toronto I polled my team members,
physicians who trained in various places all over the
world: Sri lanka, Roumania, Dominica, India, China and
yes even Canada. I asked them what they remember of
the speeches they heard during their medical school
graduation ceremonies. Now some of them are as old as
I am and most are quite a bit closer to your ages.
However for all of them the answer was a resounding
nothing.
Now thats not too surprising to a person like me who
spends her medical education career trying to practically
outlaw frontal lectures and create more meaningful ways
of learning. And so I decided to give you a case and let
you surmise what the message I want to leave you with
tonight is. After all the CBLs youve done over the past
years, this should be a piece of cake, EH?
Three days ago I admitted an 18 year man to the
Cardiology ward. The man was a student from India who
had been in Canada for one year. This young man
worked 12 hour shifts in a factory and went to night
school. He had just finished his final exams and had been
particularly overworked and underslept a situation Im
sure most of you can understand.
On the morning in question he had gone to work at 7am
and at about 0830 his co-workers saw him collapse. He
started to convulse. The co-workers brought over the
AED (debrillator) and put the paddles on. The
automatic message said shock, so they pushed the
button. Paramedics arrived and brought him to hospital
where we did ECGs, CTs, MRI, EEGs, lab tests, and
cardiac monitoring and we found: here it is IRAT
question #1
A. An exotic brain infection known only to a small area
in India
B. An exotic tumor known only in those who spend time
in Mississauga, Canada
C. A non- exotic drug intoxication known to many
overworked and underslept students
D.NOTHING
Having found nothing we proceeded to monitor his heart
and prepare to send him off to the big fancy hospital
downtown where they would check the more
sophisticated electrical connections in his heart. But after
all the AED is only a machine and the cardiologist and I
chitchatted about the odds that this was simply a mistake
on the machines part. After all the patient was a young
perfectly healthy 18 year old man.

A little later that day the Paramedic Supervisor from the

team that had attended the young man personally came
to the ward and brought us the print-out that he had just
taken from that perhaps wayward AED machine. It
showed a life-threatening heart rhythm that would have
killed that young man in seconds if he had not been
shocked. We shipped him off immediately to the great
fancy hospital downtown for further intervention that
would continue to save his life should this happen again
in the future.
IRAT QUESTION #2
I felt:
A. Relieved
B. Sorry to have the patient go as he was the only one
on my list who was less than 90 years old
C. Worried thinking we dont have an AED in the
building at Sackler
D.EXCITED
I was EXCITED. I was excited that technology had saved
a young mans life. I was excited that this young man
most likely would live a full and normal life. I was
EXCITED that I was part of the profession that could
manage all of this.
And that is the message I want to leave you with tonight.
One of the many marks of a good physician is to stay
EXCITED in the sometimes mundane, repetitive and
stressful events that mark our day. Stay EXCITED about
your patients, your research, your colleagues and your
family. Find something new to become excited about
especially something outside of medicine like a sport or a
hobby to keep you balanced.
And if you lose that excitement, take the steps to make it
happen again for you!
Good luck in all of your exciting endeavors
Oh and P.S. DISPUTES TO THE IRAT WILL BE OPEN
ON MOODLE until SATURDAY AT MIDNIGHT