The Making of a Troublemaker UofC MD class 2023
•Download as PPTX, PDF•
0 likes•40 views
On May 7th, i had the opportunity to speak the 2023 medical class. I framed my presentation around my medical history, my lessons in healthcare as a patient, roles I played as an advocate and what i see is the difference between a good clinician and a great one
Recommended
Recommended
More Related Content
Similar to The Making of a Troublemaker UofC MD class 2023
Similar to The Making of a Troublemaker UofC MD class 2023 (20)
More from Maya Pajevic
More from Maya Pajevic (7)
Recently uploaded
Recently uploaded (20)
The Making of a Troublemaker UofC MD class 2023
- 1. The Making of A Troublemaker Lessons from a hat trick in health(care) @mayapajevic 1
- 2. 2
- 3. 3
- 4. 4
- 5. 5
- 6. 6
- 7. 7
- 8. Troublemaker ˈtrə-bəl-ˌmā-kər Noun 1. A truth-telling person who dreams of a better healthcare system, and does something about changing it. 2. A dreamer and a doer; someone who gets stuff done in order to change the healthcare system for the better. 8 A patient advisor is a volunteer position that brings the lived experience with clinical experience to improve the healthcare system on a systemic level
- 9. 9
- 10. 10
- 11. 11
- 13. GOOD ● Hears ( to respond) ● Trust is assumed ● Patient- doctor relationship ● Sympathy ● Assumes ● Patient visits are a performance ● Disease care ● One size fits all ● Listens (to understand) ● Trust is sacred and earned ● Human- human relationship ● Empathy + Compassion ● Asks ● Patient visits are authentic ● Human care ● Care that fits/ personalized care GREAT ** You are never that important… ** Titles does not impress me and either does medical jargon ** I am the expert 13
- 14. “The difference between a good doctor and a great one, is that one knows the disease, the other knows the person” - Maya Pajevic 14
- 15. Thank you Let’s chat. maya.55@hotmail.com OR Tweet me/ DM me @mayapajevic @mayapajevic 15
Editor's Notes
- Hi, my name is maya and its a pleasure to get to talk to you about what living with diabetes is like, amongst other things..
- I was a happy, healthy kid. The poster child of health, dreaming of one day representing Canada on the world stage in either downhill skiing, or ice hockey. But after a family trip in the summer of 2002, my parents noticed there was something off Being irritable, sleeping most of the day, but waking up to pee and drink water, weight loss, loss of appetite They thought it was the stomach flu, but thought it would be best to be checked out by a dr My life changed in a blink of an eye that summer and made me have a harsh intro into healthcare
- On August 17, 2002 at the age of six, I was diagnosed with DKA, underpinned by the diagnosis of t1D, a disease that was foreign to my parents and i thought in no time i would be back eating and enjoying my carefree life. I was admitted and that night my mom woke up to beeping monitors and realized that there was something off - and immediately called over the nurse to take a look. The nurse came and took one look at me and immediately called the on call dr to come take a look. The resident came 45 minutes later, took one look at my chart, and stated that I was suffering from diabetic shock and that there was nothing to worry about. Even though both my mother and nurse questioned whether it could be neurological. His condescending, dismissive, self confident and arrogant answer “ trust me, im the doctor” ended the conversation Healthcare failed me, because the morning of the 18th, everyone on the unit knew I had suffered a brain injury. I was sent for imaging and stroke specialists from foothills were called in - stating that best case scenario - i would be dependent on others for life. Wheelchair bound, unable to swallow, chew, have fine motor skills, never communicate or understand language and be cognitive impaired for life. That is if i survive the next 24-48 hours. On top of this, ICU doctors found 2 more blood clots in the mitral valve that could cause another stroke. I was on the STARS helicopter that day to Edmonton and I underwent open heart surgery August 19th to remove the blood clots.
- My mother was the first to believe that I could recover beyond anyones expectations. it was the community that rallied behind my recovery, it was my headstrong mother who advocated daily to get me the best care - asking for my medical records, researching best therapists, testing theories.. over time doctors believed in my recovery and helped and not hinger my mother find resources - and i would say that i recovered pretty well all things considered. Im a thrill seeker, risk taker, a traveler. I can downhill ski, i attend university full time, and i volunteer as a patient advisor
- Because I have every right as a patient to feel sorry for myself, to be jaded, to not want to do anything, saying that everything is hard, to point blame at the emotional and physical trauma the hc system inflicted on me, but humor is my coping strategy and my mother taught me that I have a nice story, but it what you do with what you have that defines you. So I became a patient advisor, which is a volunteer position that weanes the lived experience with clinical experience to improve the hc system, in order to change the healthcare system on a systemic level - especially around pt experience, creating a culture that is person centred and around care that fits for the patient. I didn't become a patient advisor because i wanted to buff my CV, or to get noticed, I became a patient advisor to give back to the ACH, while also making the healthcare system action oriented vs just talking, proactive rather than reactive, but to make the system kinder, cut red tape and be less traumatic for the next patient. It was during my first few years as being a pa, that i met a lifelong friend, who took me under her wing and showed me not only how to be reputable, respectful and vocal youth advisor but also a better person… We soon were labeled by a well known hc leader as the Troublemakers
- Being a troublemaker is about having a yes and mindset, its about speaking truth to power and being action oriented. Because as a canadian who is a heavy user of the healthcare system, i am not proud of our healthcare system - designed around acuity and not chronic care. Looking too much at clinical care and not enough at compassionate care. So i got my hand dirty As a ™ pa, I played a pivotal role in bringg the WMTY campaign, not by sitting in committee land, passively talking about how we would get the campaign off and running but rather emailing influential people that would enable this campaign to go ahead - which was the CEO and her executive comms team, even though some people told me to conform to the patient advisor role and to know and stay in my lane It was redesigning the pt. 1 strretgy, one of 4 strategies for ahs - through codesign workshops to ensure that people's views were collected, especially the end users and testing ideas was quick and constant From a messy and complex strategy to ones that had tangible vision and implementable ideas It was co-faciliating the first ever patient led season with the ceo chatting about the current and future state of patient engagement at the quality and safety summit within ahs. It was keynoting with my pediatric neurologist centered around patient oriented research, partnership and how to bring advisors to the planning group to enhance brain health in the youth demographic It was leading the 3d printing campaign at the ACH, where 3d printing ideas were welcomed and tested to improve the patient experience. But one of my biggest wins was getting my a1c results via email Bc when i first started on the insulin pump roughly 5 years ago, i would have to travel to Richmond road every 3 months to simply get my a1c results. And when i asked the nurse if she could tell my numbers via email or by phone, she said it was a legal issue, a policy issue, a privacy issue, a pump protocol issue, that she could use her job because of it. I didn't buy any of that. So i went on the ahs insite, ad contacted her manager. Her manager said she would love to, but that it was the systems fault, not hers. So i emailed fancois belanger and told him that i was very dissatisfied with my care and the reasons behind it. He emailed me that day and within the week he emailed me stating that it was a misunderstanding of the policy and that there was no reason on why i and others couldnt get my blood results in a convenient way. But even though to many, im seen as successful, an inspiration, to me whats reflected to me is the six year old kid,
- Because it's a privilege to learn and study about diabetes and not experience it Because Type 1 Diabetes may clinically be the same, but how people with the disease experience it can be vastly different And Even though ive developed this thick skin and would say that i am a better, stronger wiser person because of what's happened. I deal with trauma everyday - reminding me of my story everyday - the butched chest that splits my body, my weak right side, right arm that isnt functional, the limbing and the diabetes that is a peast everyday. Living with diabetes broke me internally, where I was taught how to clinically live with the disease, but not how to truly live with the disease. Where I live with this constant fear that my style of management will eventually catch up to me and where no matter how well controlled the disease may be- there are no two days that are identical.Where I feel like I am at war with my body every day trying desperately to have decent blood sugars and to cooperate. Where I could be in a live class, doing a presentation, taking an exam, chatting, working and then having to drop everything to treat a hypo or a hyper. Which feels like you are recovering from the worst hangover ever when high, heads about to explode to feeling like i haven't sleep in days, muscles lagging, slurred speech and hard to think, energy sapped when low. Living with type 1 Diabetes is far more than glycemic control and carb counting, its mentally and emotionally draining. Where I have to have a mental pep talk every time i change my pump, telling myself just how important taking insulin is and that i need it to live. And where I have to examine my beaten body to find a suitable site as giving a bolus is like getting punched in the gut. Its about having to mentally figure out how to treat a low on the fly, while on the ski hill. And always having to think 2 steps ahead to ensure im prepared for every scenario. People have told me to move on too, but its not as easy as that…. I haven't accepted the disease and i may never, Diabetes in particular is as raw as when i was first diagnosed and its never easy, i feel like that six year trapped in this body - its not a natural, normal part of my life. There is no vacation its a full time job and the only reward I get is that i get to do it all over again.
- And while dealing with diabetes is a daily grind on all fronts, dealing with the system at large is just as frustrating. Where the system is not designed around chronic care - where having to advocate for myself is a safety mechanism first, a skill second. Where navigating and ensuring everyone is on the same page is both traumatic and exhausting. And ensuring that my voice is not only acknowledge, but heard to those providing care - and if our relationship is paternalistic and an ill fit - firing them. Where navigation the system is is being blinded and spun around - where the prize isnt candy in a pinnata but rather life saving medication, an insurance win, getting supplies, letters etc. Its a default settling for me to fake a smile and say im ok, when im not. But the constant noise of being a patient is eased by providers that deeply care
- Because I don't trust healthcare, i trust ppl, and in my 18+ years being a patient, there has only been 3 doctors and 1 single experience where the art and science of medicine merged so beautifully It’s the ICU doctors who were the first to acknowledge my parents as members of the hc team back in 2002, making sure everyone in the room knew that. They undid only part of the hospital gown for the echo, preserving my dignity, stroking my hair, holding my hand, talking TO me and explaining what was happening for my parents but also to me in plain language. They spoke to me as a kid, not a diseased body cavity.. After the discovery of the blood clots in my mitral valve, they took my parents to a conference room to help them fill out the endless forms and explain in more detail what the echo showed and what that meant. Its my pediatric neurologist, after my mom fired the previous one, who introduced himself with his first name, shook hands with me, left hand with left hand, sat in the stool looking up at me and chatted with me and not my mom. He was the first to acknowledge me as Maya, not this interesting med case. Taking an genuine and sincere interest in getting to know me - what i liked, what sports i followed, what i hoped our relationship would look like - short and long term. He was my quarterback during my time at ACH and to this day we still stay in contact. Its my wrist surgeon, who from the very first apt, ensured that I was the captain, that i called the shots and that she was my assistant - ready to help whenever, listening and offering advice on best treatment options. She asked for permission to examine my arm, listened to what i hope to do with my hand, gave surgical options and asked when i would like to have surgery. She helped me speed up the process to see multiple hip surgeons and offered her advice as well. She made awake surgery less anxiety inducing and she told me what she was doing every step of the way. She calmed me down with her way of caring. Its Hanan, who a med student friend told me i should be referred to because she was just that great, and while i had my doubts,i decided to take the leap of faith. And i wish i did it sooner. Hanan is Someone who is not only a great doctor, but an even better person who deeply cares. Who is in my corner and is always on standby, ready to listen, provide advice, and always having an open heart and mind. Where I feel safe, listened to, seen as Maya and where she doesn’t lecture me or paternalize me about management.. And where I see her more than a doctor, but a friend. Hanan is someone who i don't have to pretend to be ok all the time and where i can take off my densely layered patient armour and be vulnerable. I don't love her because she knows more than the last endo. I love her because she knows me. She is a definite silver lining of diabetes These are the experiences and doctors that makes being a patient less lonely Because Anyone can treat me clinically, but its takes humility to treats me as Maya. These are my all star doctors, the definition of what a dream doctor means - ones that so many pts advocate for, but few get.. They are not heroic doctors, but rather human doctors that are heroic and while there will never be another hanan, another adam, another Carmen there are characteristics that make them great drs including
- Its about listening which is an active skill its about recognizing your privilege as a physician and yet understanding that trust is not automatic and its built over time because trust is foundational to a healthy relationship Its about seeing patients as human beings, not an intersting case- and having that humanity lens to see patients as people first. Where patients can see you as a friend and not just a md Empathy may be seen as a soft skill, but its the skill that determines whether patients trust you and how much they open up to you - Its aboy not assume what you read in a medical file is what you’ll see in person. Many people assume that my stroke was connected to the diabetes, which wasnt. My chart leads to believe that i am dependent on others and in a wheelchair - which im not. Its about asking those questions to truly understand the person. Its about Patient visits that are organic to nature, and not agenda binding. Where going through the checklist doesnt feel boxed in, but rather its a natural and normal process, where the patient speaks without interpretion. Its about providing care that is human and holistic, asking how how health is overall, and not just healthcare/disease specfic care Its about care thats customized for each patient and not having the patient conform to the system. Health goes beyond the walls of a clinic and so does caring. Because as doctors, you are never too important to get down at a patient's level and explain a diagnosis, or a treatment plan or adjust a patients pillow. And for me, titles and medical jargon doesnt impress me, its about understanding.
- But if you take anything from this presentation,let it be this… As you go through the rest of your clinical rotations, please remember that you are treating the person who has the disease, not the disease who has the person. Thank you
- Hi, my name is maya and its a pleasure to get to talk to you about what living with diabetes is like, amongst other things..