Alumni Interviews: Physician without borders
You’ve led a rather peripatetic life — having lived, studied and worked on every continent (except Antarctica). How did your family wind up in Nigeria in the 1970s?
I was nine years old when I left Poland. My parents were physicians from Łódź. The country had a professional exchange program with economically developing countries, one of them being Nigeria, which was designed to flow hard currency such as US dollars into the country, while giving professionals a chance to work abroad. It was in Nigeria that I learned English; I was placed in a local school not knowing the language nine months after arrival, and I had to learn quickly to survive. We lived in Lagos for five and a half years.
What brought your family to Canada?
After traveling around Europe and North America, my parents decided that they could not go back to Poland. It was tough living in a socialist country then, and they felt that it would be a long time before there were opportunities for my sister and me, despite perestroika. They applied to several countries as economic refugees but were turned down. Canada was the ‘Mercedes Benz’ of countries for immigrants; we felt we had no chance of getting admitted. But in the end my parents applied for immigration, and they were greatly surprised and very much delighted that we were let into the country. We arrived in Toronto on June 1, 1983, with five suitcases in hand, after diverting to London from a planned route back to Warsaw through Rome, to make sure we were not being followed by any eastern bloc authorities.
It probably wasn’t easy for your parents to make that kind of move, despite having medical degrees.
My parents were brave and committed people. Our landed immigrant papers stated that while we were welcomed in Canada, and could live where we wanted, unless we settled in London, Ontario, we could not apply for government assistance for housing or income benefits or language classes. My parents decided to stay in Toronto, which meant we had to make our own way. We moved into a basement apartment with my mother’s distant uncle. My father got a job in a factory. My mother washed surgical instruments at a local hospital. I got a job as a Toronto Star delivery boy, worked first in a factory, then at a Dominion grocery store. My parents managed to redo their licenses after working for no remuneration for several years, and they were finally able to practice as general practitioners: my father at St. Joseph’s and Mississauga General Hospitals, my mother setting up a family practice in Etobicoke. We still did not have much money coming in back then, so I had I three jobs through my undergraduate studies: the first part of the week as a secretary at my mom’s office (as she could not yet afford one); the second part as a cashier at the Dominion store; and on the weekend as a ward clerk at the Toronto General Hospital, after having volunteered as a candy-striper there. By the time I got admitted to the Faculty of Medicine, my parents had saved enough money so that I could stop working. I still had to live at home and commute from Mississauga, but I could concentrate on my studies, again, all thanks to my parents.
What is the most important thing your parents taught you?
Tenacity — and to be fearless.
What made you decide on U of T?
For me, the University of Toronto was the top school for undergraduate and postgraduate studies in Canada. There was no question I wanted to enrol there. Furthermore, I wanted to be downtown, in the thick of it all. And I knew that St. George would be a great launch pad. I was not wrong.
When I entered the campus for the first time as an enrolled student, I was on top of the world. No one believed then, except my parents and my sister, that a poor immigrant boy who had just arrived in Canada three years back, would go to university. Luckily, given how hard my parents had to work, and because of my top marks in high school, I got a full scholarship to St. Michael’s College. My goal was to get into medical school, and follow in my parents’ footsteps. It wasn’t easy; those were turbulent times. I went through a period of personal and family crises.
What did it take for you to overcome these personal setbacks and get into a highly competitive med school?
Tenacity, again. I showed the admission committee that I was incredibly passionate about becoming a physician and had the determination to go through challenges and still stick to my studies and pursue my dreams.
What was the most valuable part of your undergraduate studies?
In retrospect, I am glad I did not get into medical school after two years. The extra year allowed me to mature and realize that I am tougher than I thought I was, that one can never be too sure about what the next day will bring, and that one had to prepare for the journey ahead. I also met some wonderful people who are my friends to this day. Finally, I realized that there is a lot more that one could do to contribute to society, other than becoming a physician. One could say the ‘medical school blinders’ I had on all through the first and second years were taken off, and that I grew up.
You spent almost 10 years in Emergency in the GTA, the last four as Chief of Emergency for UHN. What was the appeal? And what were the challenges?
I had always been impressed by people who are ‘jacks of all trades’, who can find their way through a challenge even when confronted by profound uncertainty. That is why full-time emergency interested me. This ability to handle anything that comes through the glass doors really appealed to me. When I was in my family medicine practice I felt old and it felt like work. When I was in the emergency, I felt like a kid in pyjamas (in the form of scrubs) playing, and I had trouble accepting that I was being paid for this great responsibility. It was great to know that I and my team in the ER could work together at all times of the day and night to save lives.
After six years of working as an emergency physician, I became the interim Chief of Emergency. My peers convinced me to take on the permanent position. The University Health Network (UHN) offered me the full-time job. I was 32. Still today I have trouble understanding why the physicians, my peers, felt compelled to do that, but I was outspoken, I had energy, and I guess they saw me as an agent of change. I will always be grateful to them for that, and to the then President of the Medical Advisory Committee who was also a great source of encouragement.
But then the dark days set in: being on call 24/7/365, having to manage 15 ambulances lined up outside the doors of the two emergency departments at 3 AM, having to deal with SARS as it hit our city — these were all tough experiences that took a heavy emotional toll. Three of my staff contracted the illness, I took care of SARS patients, was worried I would catch the virus, pass it to my parents, to my fiancé who was also studying medicine. And during 9/11, my mother called me and told me to turn on the television. When I saw the destruction of the second tower I immediately rushed down to my car, but then had to abandon it on Bay and run up to the Toronto General Hospital emergency, just before we went into lockdown, thinking we would receive casualties, and our own city would be attacked.
What lessons did you take from the experience?
All these events gave me first-hand experience in disaster preparedness and mass casualty preparedness, which led me to start revamping the Code Orange, Mass Casualty Incident Planning, protocol for my hospital. It also once again reinforced that one never knew what would happen the next day, and one had to work hard at all times to prepare emotionally, physically, socially and financially. I also realized that as an emergency physician, I could impact one person at a time, but as an administrator, by developing procedures and policies, I could impact tens of thousands of people at a time.
This was an exhilarating time. And also a time of learning. And the most wonderful thing that happened to me is that I met my future wife, Dr. Rebecca Dent, a talented and renowned medical oncologist, in the emergency department; she was rotating through the emergency as an internal medicine resident. Since then she completed her Masters in Clinical Epidemiology and Biostatistics at U of T.
You flew as a medevac doctor for a few years in places like northern Iraq and Lebanon — under some pretty hairy circumstances.
I carried out about 80 missions over five years working first for Canadian Global Air Ambulance, and then Skyservice Ambulance. I took on this work to ‘clear my head’ after working long and hard in the emergency. It was not a career, but it was a great job, and it allowed me to work two weeks on, two weeks off, and pursue other interests. I was also able to move with my wife to New York and Paris, where she did some of her training. Being on call, and getting a phone call that I needed to be ready to go within two hours to say Lima, Mumbai, Paris, Barcelona, South Africa, Colombo was exhilarating. And working with a dedicated team in the close quarters of a Lear Jet with sometimes critically ill patients further taught me the value of teamwork.
I remember flying into Mosul, Iraq, where we dropped from 20,000 feet to avoid the ground to air missiles, and where we attempted to evacuate a 27-year-old security guard who had blown off his hands and face in an very unfortunate incident with an IED (Improvised Explosive Device). We spent a day in the camp interacting with the US Medical Team, and learning how tough their practice environment was, what dangers they had to face every day, the complicated cases they had to handle. The other thing that I learned is that medical risks are all around us when we travel, and that it is not a matter if IF but of WHEN that something will happen. The idea of needing to prepare properly for a journey, whatever that journey is, was reinforced.
Your career hasn’t exactly followed a conventional path. Why Asia?
I wanted to move from the clinical side into administration. While I was Chief of Emergency, I had started to see the bigger picture and realized that by getting involved in policy development, you could positively affect the lives of many people, perhaps even entire communities. But even more than that, I wanted to give it a try in the private sector, as I had always been fascinated by new things, business and finance being one of them.
Around that time my wife was giving a series of lectures in Asia, and I joined her. I was blown away by the pace at which people walked in Hong Kong, by all the building and expansion, by the work ethic of the Asians. It was around that time that I decided I needed to get an MBA, to cope in the business world, which I earned at INSEAD’s French, UAE and Singapore campuses. At the end of my studies, I was approached by a company called International SOS, a privately-owned corporation that provides medical assistance, medical services and security services to most of the Fortune 500 companies. I interviewed in Singapore and Tokyo, the fit seemed perfect: my emergency and medevac experiences, and a company that saves lives but needs to make a profit doing so. The deal was sealed. In 2010 I moved to Singapore where the company’s headquarters were, and my wife followed in 2011, joining the National Cancer Centre as a Senior Consultant.
Tell us about life in Singapore.
I fell in love with Hong Kong when we were there. But it was clear that we were 10 years too old to live there. The pace of life was quite hectic, and it was an environment of late nights and intense socializing. When I spent time in Singapore during my MBA studies I developed a strong respect for Singapore, an ultra modern city that was clean, safe, full of nightlife and connected to all the places we wanted to visit and needed to go for our work. It seemed to be a softer version of Hong Kong. Since International SOS’s headquarters were located there it became the natural place to move to. And my wife and I have not been disappointed. The city continues to inspire us, living in it is a vibrant affair, and we use it as a hub to travel throughout Asia as well as across the continents to Europe and North America. We love it here.
What does your work with International SOS entail?
The company was founded 30 years ago by a doctor and his childhood friend who was working in finance. It now operates globally: providing medical and security assistance, as well as running a network of clinics, and providing on-site medical clinics for remote and urban sites. The big push over the last few years has been to get corporations to act in prevention. About a third of the employees are medical professionals.
I started at International SOS as a Coordinating Doctor in the assistance centre to learn what the company’s core work, namely emergency medical assistance and evacuation. When I was promoted to Regional Medical Director, Medical Services South and Southeast Asia, I spent a lot of time visiting remote sites where we were proving medical services for the energy, mining and infrastructure clients (EMI). And three years ago I was promoted to the position of Regional Medical Director, Corporate Solutions, Asia. I assist corporate clients in the IT, Financial, Automotive and Scholastic industries to define what their needs and pain-points are with respect to health and wellness and then designing customized solutions for on-site services. We focus nowadays on wellness, as the prevention mantra is sweeping into the region from North America. I work with some global players in the IT industry, and help manage their clinics in India, the Philippines and Malaysia. I spend one week a month in China where there continues to be immense growth in all the industries.
What’s it like transitioning from being a physician to working for a corporation?
Landing the job with International SOS was a life-changing event. Through my studies at INSEAD, I was convinced once and for all that the only reason we have functioning societies is because of corporations. These create value in the form of revenue, and then effective governments harvest this value in the form of taxes. These taxes then pay for roads, medical care, schools, infrastructure.
In some ways this was a loss of innocence, as in Canada as a physician I thought it was my right to make a good living, and society had an obligation to pay my salary. Working in the private sector has shown me that if I do not create value each and every day I will not have a job the next morning. I spend about 50 per cent of my time travelling to the countries in Asia meeting clients, presenting at conferences, preparing proposal, helping execute them. And this forces me to continually adjust my approach and most importantly learn.
What advice do you have for students who are considering a career in the corporate health services sector in the Asian market?
It has been a steep learning curve over the past six years since my wife and I moved to Asia. And I continue to learn each and every time I take a trip to one of the countries that I oversee. I have three pieces of advice:
First, be open to new ideas, whether they be related to business, personal interactions, forms of government. Keep your eyes open and for the first year ask a lot of questions and learn and learn and learn, while keeping as silent as possible. We might think we know it all in North America, but we do not. Some of these countries in Asia might be economically developing countries, but they certainly are well developed from a cultural and business standpoint, and have had histories much longer than Canada and the US. We can learn as much from them as they can learn from us.
Second, expect to have culture shock when you move to Asia. Even if you have lived in different places, and had been exposed to different cultures, as I have, you will not be able to bypass this. This culture shock is due not as much to the differences from one’s culture — which there are — but more so to not having the familiar reference points that we have when we grow up in North America. There will be days when you will feel off, and every fibre in your body will tell you that you need to go back to that familiar place in Canada. But persevere, be tenacious, because those feelings will pass. And one day while thanking someone in the traditional sing-song way in Thailand, or handing something over with both hands in Singapore, or touching your chest after saying hello to someone in Malaysia, you will suddenly realize that you have arrived, and now you are part of Asia, and Asia is part of you. And that is a great feeling
And finally, expose yourself to as many different experiences outside of Canada as possible, while you got through your studies. Take every opportunity to enrol in electives outside of North America, to secure internships through multinational companies. Take a position with an NGO to spend time in Asia. Only by doing this will you know whether you really are keen to leave your home and embark on a global journey. Only by doing this will you know whether you can adapt to a new culture and thrive in it. And whatever the decision is in the end, you will be incredibly enriched and better informed. And that in itself is a success.