In the 2000 film O Brother, Where Art Thou?, the late bluegrass musician Ralph Stanley covered an old Appalachian folk song, Oh, Death. His Grammy-winning version included this haunting passage:
“Won’t you spare me over ’til another year?”
This is how our society generally treats casual references to the inevitable passage from this mortal coil. Death is part of the cycle of life. Unsurprisingly, most people would prefer to broach this difficult subject as little as possible.
These conversations are still important. Balancing a seriously ill patient’s personality and expectations with the daunting reality of their situation and ability to process next steps can be painful and emotional. It can also be eye-opening, calming and reassuring to patients and doctors.
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And that brings us to Dr. Sammy Winemaker.
The Hamilton-based palliative care physician has started to lead a “revolution” of sorts for her discipline. Part of this is through her hard work and fierce dedication to her patients. The other component is an intriguing podcast she started in 2020 with Dr. Hsien Seow, a health-care researcher at McMaster University.
The good doctor and I went to school together in Toronto. We lost contact for more than two decades but she found me on Instagram earlier this year. It’s been a pleasure reconnecting and learning more about her thoughtful approach to palliative care.
“I was inspired to go into medicine by my father,” she wrote in an email. “He was a beloved paediatrician for over 50 years. Some of my favourite memories were of when he would suit me up with a white lab coat, sleeves rolled up, stethoscope around my neck, tongue depressors in my pocket, and let me do rounds with him. He was a master at practising both the art and science of medicine. I dreamt of following in his footsteps my entire life.”
Winemaker was drawn to palliative care “because it treats the whole person and their family, just like my father’s medical practice. I practise in people’s homes and make home visits. Working in the community requires a high degree of artful presence, not just to understand the medical aspects of the disease, but the interplay between the social context of how the patient lives, their values, and the emotions and stress of the family.”
Winemaker’s approach to her patients has a wonderfully old-school feel. It’s remarkably different than most I’ve come across.
“Every day, I am challenged and amazed by how resilient people can be when faced with difficult situations. When other doctors say, ‘there’s nothing more we can do for you,’ we say, ‘let’s see what we can do.’” Hence, palliative care is a “type of approach that never runs dry, because it’s a synonym for good care along the entire illness storyline, from diagnosis until the end.”
Equally interesting is the podcast she co-hosts with Seow, The Waiting Room Revolution.
After being “privy to thousands of stories from patients and families facing serious illness” for decades, they found that “too many people were travelling through their illness with very little understanding of the big-picture and long-view of their condition.”
Moreover, many patients and families “were being unintentionally harmed by health-care providers that were uncomfortable discussing the truths and reality of their condition, favouring toxic positivity … this resulted in people coming to the end of an illness often feeling overwhelmed, scared, and in the dark about what to expect.”
So, they devised “7 skills to a better illness experience” to help patients navigate their health-care journeys more effectively and confidently. The podcast is built along those lines. Winemaker described it as an “‘insider’s guide’ to a better illness experience for all citizens who are experiencing or caring for a person with a serious illness.”
The hope is it will be “part of our bigger movement to provide public facing information that will position patients and families in the know instead of in the dark when they are facing a serious illness.”
Winemaker and Seow have interviewed doctors, nurses, caregivers and others for the podcast, now in its third season. The discussions are lively, intelligent and illuminating. The stories can be quite personal and heart-wrenching. Nevertheless, you’ll come out of each episode armed with more knowledge and understanding than you came in with.
“Palliative care is not about giving up hope, but rather is about walking two roads: hoping for the best and planning for the rest,” Winemaker wrote.
For all the criticisms I and others have had about Canadian health care, there clearly needs to be a shift in attitudinal thinking. The Waiting Room Revolution has started planting those important seeds. Additional elements are still required to help them grow, including a more realistic approach to how we view matters related to life and death.
Winemaker’s progress with this benevolent medical revolution will be fascinating to watch. She’s not only on the right track, she’s also the right person to lead it.
In time, maybe Oh, Death and Oh, Life will be one and the same.
Michael Taube, a Troy Media syndicated columnist and Washington Times contributor, was a speechwriter for former prime minister Stephen Harper. He holds a master’s degree in comparative politics from the London School of Economics. For interview requests, click here.
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