46 - Deborah Cook - The compassionate and world-leading Canadian granting wishes at end of life
Release Date: 08/29/2019
Mastering Intensive Care
Thank you for listening to the ninth and final episode of the Mastering Intensive Challenges - Run Larapinta series. If you’ve listened to the series, you’ll know my friend Ed Litton and I entered a four-day stage trail running event, the Run Larapinta Stage Race, and ran, climbed, descended, scrambled and walked with 200 other enthusiastic participants along a mountainous and rugged trail in the spectacular red centre of Australia. Ed and I thought these conversations on the podcast might help others in setting and completing endurance exercise challenges, something we both prioritise in...
info_outline Mastering Intensive Challenges - Run Larapinta - Episode 8Mastering Intensive Care
This is the 8th episode of the "Mastering Intensive Challenges - Run Larapinta" series and if you’ve been listening to the previous ones, you’ll know that this episode is coming out after the four day stage race that fellow intensivist Ed Litton and I set ourselves the challenge of running many months ago. Two Intensive Care doctors, both novices at trail running, looking for something moderately hard, something we could do together, and something we could talk about on the show to hopefully inspire you and other listeners to go for a run or to set yourself your own exercise challenge....
info_outline Mastering Intensive Challenges - Run Larapinta - Episode 7Mastering Intensive Care
Fellow intensivist Ed Litton and I signed up for a big challenge 10 months ago when we registered to run in the Run Larapinta, a 4-day stage race in central Australia. We’ve both completed many endurance events, however neither of us have done any serious trail running nor have we ever run 130km in 4 days on a rocky and mountainous trail like the beautiful Larapinta trail in the Northern Territory of Australia. It’s now only a week away so Ed and I had a conversation to update each other on our recent training before answering 5 questions we thought were worth asking each other at this...
info_outline Mastering Intensive Challenges - Run Larapinta - Episode 6Mastering Intensive Care
To help Ed Litton and I get really prepared for the Run Larapinta stage race we are only a few weeks away from competing in, today we bring a seasoned ultra trail running doctor on to the podcast to share her advice. In this sixth episode of the Mastering Intensive Challenges series, we welcome Dr Cheryl Martin, who is an Emergency Medicine specialist, a podcaster and has huge experience in trail running, including ultra marathons. Cheryl’s podcast, the Mind Full Medic podcast, explores health, wellbeing, optimal performance and professional fulfilment, with a focus on doctors and...
info_outline Mastering Intensive Challenges - Run Larapinta - Episode 5Mastering Intensive Care
This is the fifth episode in the Mastering Intensive Care - Run Larapinta series. Ed Litton and I are back on opposite sides of Australia, and neither of us has had the perfect three weeks since we last chatted. There are now less than seven weeks until the event starts, so we chat about our training, then swing over to what we are each thinking about the logistical challenges we will be presented with. We hope you’ll enjoy listening to the conversation, even if you prefer the couch to your running shoes. If we can inspire you to get out for some exercise, that would be even better. Thanks...
info_outline Mastering Intensive Challenges - Run Larapinta - Episode 4Mastering Intensive Care
Here is another episode in the Mastering Intensive Care - Run Larapinta series. For this one, I travelled to Perth to meet with my Run Larapinta co-participant Ed Litton and to head out for a few runs together over a three day weekend. We also set up the microphones to update each other with our preparations and to discuss our perspectives on the social aspects of exercise, mainly endurance sport. We talked about group training, family support, and even using the social media platform Strava to share inspiration. We hope you’ll enjoy listening to the conversation, whatever exercise you...
info_outline Mastering Intensive Challenges - Run Larapinta - Episode 3Mastering Intensive Care
This is a follow on episode as Ed Litton and I continue our discussion about the Run Larapinta Stage Race we will be participating in soon. Ed and I tell each other how our running training is going. Then we talk about our general views on nutrition and sleep, especially as we lead into a multi-day endurance event. One of us has picked up a little niggle. And each of us has a different approach to what we consume during long runs. It might not be what we talk about on regular episodes of Mastering Intensive Care but we hope you’ll enjoy listening to the conversation, whether you run, walk,...
info_outline 82 - Will Bonavia - An ICU trainee’s perspective on learning, culture and wellbeingMastering Intensive Care
This episode features the wise perspectives of an Advanced Trainee in Intensive Care Medicine, Dr William Bonavia. The discussion covers: Why he chose medicine and Intensive Care His training journey and his learning strategy What makes a good ward round Learning from colleagues The principles of good communication and collaboration The value of work being fun Making mistakes Dealing with the pressures of the job His thoughts on sleep, exercise, resilience and burnout Gender inequity in training The future of his career Tips for fellow trainees Will Bonavia is an Intensive Care Trainee at...
info_outline Mastering Intensive Challenges - Run Larapinta - Episode 2Mastering Intensive Care
In this second of a different style episode, Ed Litton and I continue our discussion about the Run Larapinta Stage Race we will be embarking on in August 2023. Ed and I talk about our preparation and then tell each other why we run, and what we get out of it. Ed is a multi-sport endurance athlete whose reasons for getting out in nature are deep and truly inspiring. We hope you’ll enjoy hearing this conversation, whether you run, walk, cycle, hike, work out in the gym, or do whatever is your style of physical activity. Thanks for listening. Andrew Davies ...
info_outline 80 - Tub Worthley - A pioneering “Grand Master” of intensive careMastering Intensive Care
This episode features the memories, experiences and wisdom of Dr Lindsay ‘Tub’ Worthley, AM. The discussion covers the following: Tub’s training to become an intensivist when no specific training existed His experience at a time when Australian ICUs were in their infancy The difference between the beginning and the end of his clinical career His eventual transition to retirement His writing of textbooks, scientific papers, editorials and a memoir What he learned about humanity in the ICU Working and communicating with various team members Enthusiastic leadership and the importance of a...
info_outlineWhat do you do for your patients around their dying experience?
Do you celebrate their lives and support those left behind in grief?
Could you bring more humanity to your ICU?
Whilst you and your ICU colleagues likely act with kindness much of the time, I suspect listening to this podcast will have you wondering whether you could do better, especially when your patients are receiving end of life care.
This episode’s guest, Professor Deborah Cook, from Hamilton in Canada, is striving to do this through the 3 Wishes Project she and her colleagues initiated several years ago. They encourage specific wishes unique to their dying patients, thereby dignifying the person, giving greater voice to the family and evoking clinician compassion. In this podcast you will hear all about this profound and important work, the sort of acts of kindness that have occurred in her ICU, the way you could approach this in your ICU, the benefits to clinical staff and institutional leaders, some of the logistical challenges they’ve faced, and some thoughts on spiritual care in the ICU.
Deborah Cook is a Distinguished Professor at McMaster University in the Departments of Medicine, Clinical Epidemiology and Biostatistics. As a life long clinician-scientist, she holds the first Canada Research Chair in Intensive Care Medicine and is the Academic Chair in Critical Care Medicine at McMaster. She is a founding member and 2-term Chair of the Canadian Critical Care Trials Group. Deborah is an active practitioner in critical care medicine at St. Joseph’s Hospital where she supervises junior and senior clinical trainees. She is devoted to mentoring Masters and PhD graduate students in McMaster's Health Research Methodology Program, and junior faculty around the world, resulting in the creation of the Deborah J Cook Mentorship Award by the Canadian Critical Care Trials Group.
Deborah has published over 700 peer-review articles with an associated H index of 168. Her multi-method multi-disciplinary research interests include life support technology, prevention of ICU-acquired complications, end-of-life care, and research ethics. She has received numerous national and international awards for her practice, teaching, mentoring and research. She is a pre-eminent critical care scholar. Dr. Cook was inducted as a Fellow of the Royal Society of Canada (2009), a Fellow of the Canadian Academy of Health Sciences (2010), and received the inaugural Distinguished Lecturer Award in Critical Care Sciences from CIHR's Institute of Circulatory and Respiratory Health (2017). Her work on microbiome modification in critical illness using probiotics resulted in a prestigious Killam Fellowship in Health Sciences from the Canadian Council of the Arts (2017). Deborah received the Gold Leaf Award from CIHR for her enduring contributions to health care (2019).
For life long scientific contributions to the improvement of global intensive care and her foundational leadership in the first national ICU research network in the world, Dr. Cook was appointed an Officer of the Order of Canada (2016).
In this conversation Deborah also talks about:
- How she was drawn to intensive care from internal medicine
- How she discovered several gold mines to conduct research on
- Her belief that following your passion is the key to research success
- How humanity has fallen by the wayside as intensive care has developed
- How she was dissuaded from doing end of life research early in her career
- The growing interest in ethics and end of life care
- How she approaches ward rounds
- Dealing with our fixation on computer screens
- Being present and avoiding note-writing on ward rounds
- Her high expectations as a clinical mentor (including of herself)
- The importance of presence and engagement as the attending consultant
- The irrelevance of many of the words spoken on ward rounds
- The importance of keeping things fresh by releasing dying passions
- Her thoughts about how she cares for herself
- Which exercise and which books she prefers
- Her mindfulness practice
- Her love for family
- Some invaluable career tips
Deborah is passionate about patients receiving the very best care, about clinicians delivering this in an organised and cohesive fashion, and about researchers providing the highest quality evidence to guide this. She has been a kind friend and advisor to me over many years and I can’t think of anyone with a better mix of acumen, experience and personality as the ideal Mastering Intensive Care podcast guest.
She is a personal favourite so please enjoy listening to the wonderful Deborah Cook.
Andrew Davies
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About the Mastering Intensive Care podcast: The podcast is aimed to inspire and empower you to bring your best self to the intensive care unit, through conversations with thought-provoking guests. I hope you’ll glean insights to help you improve as a healthcare professional and as a human being so you can make a truly valuable contribution to your patient’s lives.
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Links to people, organisations and other resources mentioned:
Deborah Cook (McMaster University)
Canadian Critical Care Trials Group
PROTECT study comparing dalteparin and heparin
Publication from 3 Wishes Project
Other publications from 3 Wishes Project
Book "Essentialism – The Disciplined Pursuit of Less" (by Greg McKeown)
Mastering Intensive Care podcast - Episode 45 with Scott Weingart
2019 World Congress of Intensive Care Medicine
Mastering Intensive Care podcast
Mastering Intensive Care page on Facebook
Mastering Intensive Care at Life In The Fast Lane
Andrew Davies on Twitter: @andrewdavies66
Andrew Davies on Instagram: @andrewdavies66