Gary Beemer

Rapid access to the Stroke Prevention Clinic

The day after Gary Beemer’s appointment at the Stroke Prevention Clinic, he was planning to board a plane to Northwest Territories with his wife. They were looking forward to an active vacation of hiking, cycling and kayaking.

Warning signs

Rewind a few months earlier when Gary’s symptoms began. His blood pressure became really high. He experienced tingling in his hand and couldn’t type on his keyboard at work. He started to lose vision in his left eye. And, after a bike ride with friends, he began slurring his words. When Gary visited his family doctor, he was referred to the Stroke Prevention Clinic at Hamilton General Hospital. His appointment was scheduled for two days later, where an ultrasound revealed one of the 57-year-old’s arteries was virtually plugged.

Time is critical

There are two carotid arteries in the neck that supply blood to the brain – one on the right side and one on the left side. Gary was experiencing stroke-like symptoms because the artery on the right side of his neck was not allowing the blood to flow. “You could tell the whole place went into a panic zone when they saw the results of my ultrasound,” says Gary. After an ultrasound determines the carotid artery is the cause of the problem, there are two treatments available: medicine or surgery. “Gary’s case was very severe so we decided to pursue surgery,” says Dr. Kelvin Ng, General Internal Medicine and Stroke Physician at Hamilton Health Sciences. Needless to say, Gary’s vacation was cancelled and surgery was scheduled for the next day to correct the artery.

“Our fast-tracked Stroke Prevention Clinic model is quite unique in the country.”

Rapid access

The Stroke Prevention Clinic provides rapid access to experts, diagnostic tests, and treatments for minor, non-disabling strokes and Transient Ischemic Attacks (TIAs), also called “warning strokes” which was what Gary was experiencing. The clinic sees over 2,000 new patients each year, aiming to have them at their appointment within 24-48 hours of referral. Referrals are made through family doctors, specialists or the emergency department. “Time is critical. Ideally, we aim to get the ball rolling with all the investigations the same day and often give our patients results the same day. Our fast-tracked Stroke Prevention Clinic model is quite unique in the country,” says Dr. Ng. Patients with a blockage in the carotid artery are at a very high risk of stroke. Without treatment, Gary’s risk of a life-changing, disabling stroke was nearly 30%. Now, his risk of a stroke is less than 5% a year.

A tough year

“Gary was fortunate that he did not have permanent disability from a major stroke and did not require stroke rehabilitation for his transient symptoms,” says Dr. Ng. Most patients can expect to recover from this surgery within two weeks. What would have been a standard recovery for Gary become even harder. Just a week after surgery, his father-in-law passed away from cancer. A week after that, Gary’s own father passed away. After suffering two great losses and going through a tough year with his own health, Gary recovered well. He and his wife are finally taking that vacation to the Northwest Territories, almost a year to the date of his clinic appointment.

Time is of the essence when you suspect signs of stroke. Use the FAST criteria to determine if you or someone you know requires care as soon as possible:

F – FACE – Is it drooping?
A – ARMS – Can you raise them?
S – SPEECH – Is it slurred or jumbled?
T- TIME – Time to call 9-1-1 right away

Trans Pride Flag

Trans Inclusive initiative launches at Hamilton Health Sciences

Hamilton Health Sciences (HHS) has officially launched its Trans Inclusive Service and Care Initiative (TISC), just in time for Pride Month. The initiative is a collection of policies, tools, and projects to make HHS a more gender-inclusive organization.

“The TISC addresses gaps in services and support for trans and gender-diverse staff and patients,” says Michele Leroux Interim VP of Human Resources. “It outlines the rights and responsibilities of all individuals at HHS to provide a truly inclusive environment.”

New all-gender washrooms

One of the most visible outcomes of the initiative is the new, designated all-gender washrooms that have been created at each HHS site. In addition, trans-affirming signage is being installed in all washrooms in the coming months. It reinforces the right of people who are transgender to use any washroom.

HHS President and CEO, Rob MacIsaac, cuts a ribbon on the new all gender washroom at McMaster University Medical Centre

The initiative also includes tools and supports for employees who are transitioning, along with guidelines for inclusive language and actions to better support gender diverse patients and families.

“I’ve seen some great progress to accommodate all genders”

“As health care professionals, it’s important for us to educate not just ourselves but our patients and families about gender diversity,” says Caden Craig, a social worker in the child and youth mental health program at McMaster Children’s Hospital.

Guided by the community

Caden consulted on the initiative along with other HHS clinicians, and members of the Hamilton Trans Health Coalition and Rainbow Health Ontario. He brought an important perspective as both a staff member and trans man.

“Since starting at HHS in 2016, I’ve seen some great progress to accommodate all genders,” says Caden. “This is challenging, but important work, and I’m proud to be involved. There is a strong commitment here to make everyone feel safe.”

The TISC is an evolving project and will continue to develop with input from HHS staff and the community.

“As Hamilton’s largest employer, we have a responsibility to take a leadership role in this work,” says Michele. “We owe it to our people, patients, and families.”

a black and white up close photo of a sad young girl

The lasting impacts of youth sexual assault

Sexual assault is far more common than most people suspect. Sexual assault is any form of unwanted sexual contact that is forced upon someone without their consent. It’s most common among youth 24 and under but can happen at any age.

Research shows that:

  • 18 percent of girls and 3 percent of boys say that by age 17 they have been victims of a sexual assault or abuse at the hands of another adolescent
  • 54% of girls under 21 experience sexual abuse; 22% of these female victims reported 2 or more incidents
  • Children and youth under 18 years of age are at greatest risk of being sexually assaulted by someone they know
  • 95% of child sexual abuse cases go unreported

Sexual assault can have harmful long-term effects – physically, emotionally and mentally – especially on the developing minds of children and youth. Some of these impacts include depression, anxiety, self-harm, relationship difficulties, eating disorders, poor self-esteem, prostitution, and drug and alcohol abuse.

It’s important to reduce the stigma around sexual assault. This will encourage more survivors to seek the help they need. Maddie, a patient at Hamilton Health Sciences’ Sexual Assault/Domestic Violence (SA/DV) Care Centre, was brave enough to share her story with us.

Maddie’s Sexual Assault Story

It happened four years ago when Maddie was in grade 12. She was desperate for friends at the time, wanting so badly to be liked and accepted. Her perpetrator took advantage of that. It started innocently enough with an invitation for a coffee date. He took her to a parking lot instead. That’s where it happened – he raped her.

“I had a really hard time talking about it to anyone after it happened. I blamed myself more than anyone else,” Maddie says.

Maddie did end up telling a friend, who encouraged her to take action. The day after the sexual assault, she went to her guidance counsellor at school. From there she went to the hospital to get the help that she needed.

The process involved an initial emergency visit to Juravinski Hospital and Cancer Centre where Maddie was medically assessed by a specially trained nurse.

“Everything was really private and confidential, and I felt like all of my feelings and decisions were well respected,” she says.

Afterward, she was connected with a nurse for medical follow-up, and was offered a number of services including counselling.

“The counselling service has been really beneficial to my recovery”

“The counselling service has been really beneficial to my recovery. I felt so alone through my experience and I really needed someone to be there for me, to guide me and to validate what I had been through. A lot of the work we did together was about letting go of the shame and guilt, and realizing that it wasn’t my fault,” Maddie says.

Two years later, she ended up taking a break from counselling to focus on school. Unfortunately, during that time she experienced a number of other sexual assaults. She realized then that her work wasn’t finished and she needed to continue with counselling.

Different types of trauma therapy helped her navigate the whole experience and the effects it had on her. Some of the routine practices she used included mindfulness, meditation, and positive self-talk.

“Eventually, repeating phrases to myself like, ‘you are worthy’, started to feel second nature and I really started to believe them,” she says. “It helped me feel liberated, to let go of the experience, and feel whole again.”

“I wouldn’t be here if it wasn’t for these services”

Now, she feels strongly about the help that she received as a youth going through such a traumatic experience.

“I wouldn’t be here if it wasn’t for these services, truly. I’ve been able to pick up all of the pieces and feel more confident and secure in myself. I feel like it’s all going to be okay, that despite any future challenges, I will ultimately prevail and come out stronger on the other end.”

Maddie’s Message to Sexual Assault Survivors

“I’d like to encourage sexual assault victims to seek out the help you need and hold on to hope. You can find a reason to move forward and get the help you need. There are people out there who care and who can make a difference if you let them in,” she says.

Although it was hard for her to open up and admit what had happened, it led her on a journey of recovery and growth. She gained strength, clarity and perspective through support networks and the resources available in our community.

“Don’t judge or blame yourself, practice self-compassion and self-love, and know that it’s okay to be where you are. You’re going to make lemonade out of these lemons.”

Getting Help

The Sexual Assault/Domestic Violence (SA/DV) Care Centre at Hamilton Health Sciences provides compassionate, confidential health care for children, adolescents, women, transgender persons, and men who have experienced sexual assault and/or domestic violence. The team strives to provide care with sensitivity and privacy.

If you have experienced sexual assault or domestic violence, visit one of the following locations and ask for the sexual assault nurse examiner:

For adults 18+:

  • Juravinski Hospital & Cancer Centre emergency department
  • Hamilton General Hospital emergency department

For children and youth 17 and under:

  • McMaster Children’s Hospital emergency department

Doctors mentoring doctors to create a healthier community

West Niagara is not immune to the ongoing opioid crisis affecting communities across North America.

An innovative model of care at West Lincoln Memorial Hospital (WLMH) hopes to expand the treatment options available for this major health issue.

One of the hospital’s biggest strengths is its primary care model, which facilitates an environment for doctors at the site to learn from each other. The aim is to provide more treatment options to at-risk patients.

Dr. Mat Noble-Wohlgemut helps lead this initiative under a new mentorship model at the site.

“We came up with this model so we can collectively find treatment solutions for patients who are at risk,” says Dr. Noble-Wohlgemut, interim site medical director at WLMH. “Doctors talk about the challenges they encounter when patients present with certain symptoms in the emergency department.

“When we saw there was a gap with what we’re seeing and what we could prescribe, we took action to fix that.”

“We came up with this model so we can collectively find treatment solutions for patients who are at risk.”

The program will start in the emergency department at WLMH and may spread to the local family practice teams over time.

Teach a person to fish

How does a mentorship model work, exactly?

Doctors at WLMH developed a grassroots solution to teach each other how to care for patients presenting challenging illnesses, both in the emergency department and in their offices.

Still in its early stages, the ultimate vision is a model that includes education for the primary care provider and access to support from a specialist.

Mental health team support

Dr. Roselyn Wilson arrived at WLMH in November. She is a psychiatrist with the mental health team and has a special interest in concurrent disorders—people who experience both mental illness and a substance abuse disorder.

When she heard about the problem doctors were trying to solve, she offered to help.

“Part of our aim is to increase community capacity for treating addiction,” says Dr. Wilson. “We support doctors and staff by getting at-risk patients connected either with our team or other support in the community.”

Dr. Wilson and her colleague Sharlene MacLennan, a registered social worker, regularly engage with doctors at the hospital and in the community about people with high addiction and mental health needs.

“Part of our aim is to increase community capacity for treating addiction.”

They meet with WLMH doctors to support them in providing the most appropriate treatment to emergency patients with addiction-related concerns while they’re in the hospital.

“In these early days, I will consult with Dr. Wilson on the best way to care for at-risk patients,” says Dr. Noble-Wohlgemut. “As I develop my skill set in this area, I can then pass that onto my colleagues and so on and so forth.”

He is confident the hospital’s emergency department will build the foundation for community doctors to provide care within their offices. This will better address the needs of those who are at risk as a result.

Population health in West Niagara

Patients at the highest risk sometimes have difficulty accessing certain services. Though doctors at WLMH can refer people to specialists with ease, the challenge for some could simply be just getting to their appointment.

Having care closer to home will further support patients to start—and continue—treatment.

“Though we’re a smaller community, we’re no less at-risk than larger populations that suffer from the opioid crisis,” says Cindy MacDonald, Director, Community Programs at WLMH.

Dr. Noble-Wohlgemut says the mentorship model will create a healthier West Niagara.

“The community recognized and defined the issue, and now the community is co-creating the program that is going to meet the needs identified.

“Patients will ultimately have increased access to treatment options.”

Strategy in Action story contest graphicThis story was selected as a winner in our Strategy in Action contest, which asks teams across Hamilton Health Sciences to share how they are putting our strategy into practice.

This initiative supports Population Health, one of four strategic directions identified in Hamilton Health Sciences’ Strategic Plan. Population Health is about creating a healthier community. It takes into account the factors that determine a person’s well-being and guides our work with health and social service providers to support people who are most at risk of disease or preventable hospital stays.

Chase sits in his hospital bed. He is holding a tablet. He is showing what’s on the tablet to child life specialist, Courtney Knight.

Cancer can’t sideline Chase

Chase from Cambridge was an active nine-year-old who was passionate about hitting home runs and scoring goals. Then he found himself unable to participate in sports because of a life-altering diagnosis.

“My son was diagnosed with cancer,” says Chase’s mother, Jaymie. “As a parent, it was the most difficult news I’d ever received.”

Chase’s cancer journey began with a persistent fever and weight loss. On the recommendation of their pediatrician, Jaymie took him to the Emergency Department at McMaster Children’s Hospital (MCH).

Testing led to a diagnosis of leukemia, a potentially fatal cancer of the blood and bone marrow. Chase began a regimen of intense chemotherapy to control the growth of cancer cells.

Chase sits on a chair holding a tablet with a chemotherapy pump to his right. To his left is child life specialist, Courtney Knight. Both smile and pose for a photo.
Chase with Child Life Specialist Courtney Knight. Both photos in this article are courtesy of Carole & Roy Timm Photography.

Staying strong

“The treatment made Chase feel very sick, but we understood that chemotherapy was necessary if we were to beat the leukemia,” recalls Jaymie.

After trying different types of chemotherapy, the care team found the right combination of medications that worked well for Chase.

“We are looking forward to the end of his therapy, when we can say that he is cancer-free.”

“One of the most difficult things for Chase is being sidelined from the sports he loves. He’s had to miss a lot of baseball and soccer because of the cancer, which makes him feel left out.”

Toward tomorrow

Chase’s prognosis is very positive and he is doing well in his treatment. Despite the challenges he has faced, he is more determined than ever to beat the cancer.

“We are looking forward to the end of his therapy, when we can say that he is cancer-free,” says Jaymie. “There is definitely a light at the end of the tunnel.”

As he continues to regain strength, Chase looks forward to spending more time outdoors, enjoying the sports he loves. He is grateful for the outstanding care he received at MCH, which has become like a second home to him.

“The doctors and the staff are wonderful,” says Jaymie. “We’re so lucky to have this amazing Hospital in the region to help us when we need it most.”

Lucas on the swings at the playground after recovery from surgery

Working together to save kids’ lives, kilometres apart

When three-year-old Lucas Waring woke up feeling sick earlier this year, his mom Nikki thought it was the flu. However, it quickly progressed to a swollen tummy and erratic breathing. Nikki knew something was very wrong and took him to the closest hospital, Niagara Health’s Welland Site.

His x-rays showed that his abdomen was filling with air and pressing on other organs. It was getting bigger by the second and his health was rapidly deteriorating. Soon, the pressure would cut off his blood supply and stop his heart.

The Niagara Health emergency team knew he would need to be transferred to Hamilton Health Sciences’ McMaster Children’s Hospital (MCH) to determine the cause of air build up, but first they had to save his life. They connected to MCH’s pediatric emergency team using the newly launched tele-resuscitation system to get immediate help.

Working as one team

The tele-resuscitation system—the first of its kind in Ontario—uses video conferencing-like technology from industry partners, Ontario Telemedicine Network. High-definition cameras are set up in the resuscitation room at each Niagara Health hospital. When the emergency team at MCH logs into the system they get a bird’s-eye view of the patient and room. The MCH team can control the view, as well as speak and listen to the team at Niagara Health. This allows the MCH team to remotely coach the Niagara Health team through advanced techniques to stabilize patients as quickly as possible.

McMaster Children's Hospital doctor using the tele-resuscitation system

“We’re focused on reaching beyond our walls to provide the best care possible to our most critically ill patients. This includes drownings, car accidents, poisonings, and acute asthma attacks,” says Dr. Chris Sulowski, deputy chief of pediatric emergency medicine at MCH and tele-resuscitation lead. “With this system, we can give advice as if we’re standing there ourselves.”

“It’s rare for an emergency doctor at a non-children’s hospital to see a child in Lucas’ condition.”

Unbeknownst to Nikki, Lucas was the first live case using the tele-resuscitation system.

“Everything was happening so quickly,” says Nikki. “I didn’t think anything of it when I saw the doctors were talking to a different set of doctors on a TV screen. Everyone was calm and knew what to do so I didn’t even realize how life-threatening his condition was.”

Once the system was up and running the MCH team instructed the Niagara Health team to stick a needle in Lucas’ abdomen to let the air out. They saw an instant improvement in Lucas as air gushed out the needle and the pressure in his belly decreased. Colour came back to his skin. They began to prep him for transport. Though they had relived the pressure, air was still filling Lucas’ abdomen so the needle had to stay in place until he was at MCH.

“It’s rare for an emergency doctor at a non-children’s hospital to see a child in Lucas’ condition,” says Dr. Madan Roy, deputy chief of pediatrics at MCH and chief of pediatrics at Niagara Health. “The ability for the Niagara Health and MCH teams to work together as if they were in the same room saved his life.”

At smaller community hospitals, complex children’s emergency cases are far less common, but the closest emergency department is the best place to go for immediate medical attention.

“It allows our teams to work collaboratively and more efficiently when time is of the essence.”

“The physical distance between McMaster Children’s Hospital and our hospitals can be a challenge in life-threatening situations,” says Dr. Rafi Setrak, chief of emergency medicine at Niagara Health. “The tele-resuscitation system eliminates that challenge. It allows our teams to work collaboratively and more efficiently when time is of the essence.”

Since these situations are not overly common, the teams anticipate using it once or twice a month at most. But it has already proven its value.

Lucas’ recovery

When Lucas arrived at MCH, the team knew his situation well and he was in surgery within the hour. It turned out his intestines had twisted, cutting off blood supply and causing a portion of his stomach to rupture. The air that regularly travels through the stomach was flowing out the hole into his abdomen. The team at MCH untwisted his intestines and removed the damaged portion of his stomach.

“A couple days after Lucas’ surgery Dr. Roy came to check on him,” says Nikki. “That’s when I learned it was the first time they’d used the live video system. I was not only surprised, since it seemed like they’d used it many times before, but extremely grateful because they were able to save Lucas’ life.”

Lucas playing at the playground now that he's recovered

Lucas’ scare hasn’t left him with any long-term consequences. His stomach is slightly smaller, but it hasn’t changed his eating habits and he’s back to being an outgoing, healthy three year old.

The team behind the tele-resuscitation project at MCH is looking to extend the system’s reach to other community hospitals within the region it serves so even more children can benefit from this technology, and the specialized expertise of its pediatric emergency team.

Young woman visiting mental health professional. Girl feeling depressed, unhappy and hopeless, needs assistance.

New mental health project launches in West Niagara

The West Niagara Mental Health (WNMH) team at Hamilton Health Sciences (HHS) is launching a research project to help healthcare providers support youth and young adults with mental health issues.

The goal of the project is to enable an evidence-based community approach to youth depression and anxiety disorders. The project will give practitioners, who already serve this population, a flexible and known treatment approach to address mental health challenges that youth may be experiencing.

The research project provides training to participating organizations in an evidence-based treatment for depression and anxiety using Cognitive Behavioral Therapy (CBT). Part of the project also provides treatment plans, further training, and resources through an innovative software called WILLOW, developed by Evidence-Based Practice Institute. WILLOW provides video instruction, handouts, and depression/anxiety measurement tools as well as self-management/self-treatment tools for those receiving treatment.

“it has proven success with giving community providers the tools they and their patients need”

“We decided to use the WILLOW platform because it has proven success with giving community providers the tools they and their patients need,” says Christopher Conley, senior clinical specialist at HHS’ West Niagara Mental Health and principal investigator on the project. “We wanted to ensure that it would be effective and simple for multiple different community providers to follow the treatment plans. Plus, the patient interaction element in WILLOW is a great way to empower patients to be involved in their treatment.”

The project gained traction when GBF Community Services committed to provide funding. Since GBF Community Services assists members of the West Niagara community to meet their basic needs, they see first-hand the impact of mental health issues. Both GBF Community Services and WNMH recognized the need for an effective approach to mental health services for the 13 to 25 age group.

“The idea of supporting a mental health project in our community received a unanimous vote from our Board of Directors so we spent many months looking for the most efficient conduit to success,” says Stacy Elia, executive director, GBF Community Services, who worked collaboratively with GBF Community Services mental health chair, Tom Beach. “When we began discussing this research project with West Niagara Mental Health and the LHIN (Local Health Integration Network), it fit so clearly with our core principles that we knew we found the best way to make a difference in our community.”

ensuring the project can continue to grow to best suit the needs of the community

The funding supports the development and evaluation of the project. Data will be collected over the course of a year to evaluate the implementation process for the participating community providers. The project team can then determine if adjustments are needed. This will ensure the project can continue to grow to best suit the needs of the community.

There are currently 10 organizations participating in the project, including Niagara Region Public Health, Gillian’s Place, Grimsby Life Centre, Pathstones and multiple medical practices. Currently, training is complete and they are ready to begin implementing the program with patients.

Dr. Harriette Van Spall, Explorer, cardiologist at Hamilton Health Sciences

Helping those with heart failure live long healthy lives

Carol has been an avid clogger for the past 20 years. What’s clogging, you ask? It’s a folk dance similar to tap dancing. Carol is part of a clogging group that travels all over the United States for workshops and conventions. Clogging is about more than exercise and socializing for Carol. It’s part of who she is.

In the fall of 2017 Carol started to notice an unsteadiness in her legs. Despite using her asthma inhalers, she also had a cough that wouldn’t go away. Both issues were starting to affect her life, including her clogging.

“My legs would get wobbly when I was clogging, so I’d sit down and take a break. Then when I stood up they’d be wobbly again and it would take me a minute to reorient myself. I just couldn’t keep up anymore,” she recalls.

As advised by her family doctor, Carol went to the emergency department at Hamilton Health Sciences’ Juravinski Hospital and Cancer Centre. She was in heart failure.

Heart failure is one of the most common causes of hospitalization in older adults.

Heart failure occurs when damage to the heart makes it too weak or stiff to work properly. Common causes include heart attacks, high blood pressure and other conditions that affect the heart. When someone is in heart failure, their heart must work much harder to pump blood through the body.

Carol is not alone. There are about 600,000 Canadians living with heart failure. It’s one of the most common causes of hospitalization in older adults. For about a month after they leave the hospital, these patients have a higher risk of their symptoms becoming worse. One in four patients return to the hospital during this period.

A Hamilton doctor is on a mission to change this.

Exploring heart failure services

Dr. Harriette Van Spall, a cardiologist at Hamilton Health Sciences and researcher at Population Health Research Institute, is exploring how improving services for heart failure patients can benefit their health. She recently led the Patient-centered Care Transitions in Heart Failure (PACT-HF) clinical trial, which investigated how education and access to resources following hospital discharge can help patients like Carol avoid another hospital admission.

Her prior research shows certain services, like regular nurse visits and multidisciplinary clinics, can reduce readmissions in heart failure patients. These services require collaboration among multiple health care settings and professionals, which makes them difficult to implement. The PACT-HF study brought everyone together to set patients up for success.

“Heart failure requires lifelong management,” says Dr. Van Spall. “Supporting these patients when they’re most vulnerable is a key way to ensuring they’re well equipped to manage their condition. And, if managed with appropriate services, they can live long healthy lives.”

“we need to ensure that all Canadians have access to heart failure care regardless of geography”

The goal of the study was to determine if the services would reduce emergency department visits, hospital readmissions, or death. While the results showed no impact on these outcomes, the services had a significant impact on the patient’s quality of life. They felt more prepared for their recovery process and ongoing management once they were home.

“Dr. Van Spall understood how important it was to me to return to clogging. Now, I’m thrilled to be back to clogging three times a week,” says Carol.

“The results indicate that there is merit to providing transitional care services as they improve quality of life. We just need to find which services will also impact readmissions and death,” says Dr. Van Spall.

“Importantly, we need to ensure that all Canadians have access to heart failure care regardless of geography. Access to specialized treatment centers, use of proven-effective medications, and outcomes depend to a large extent on where patients live. We are now developing and testing digital health technologies that will allow us to provide care in remote and rural regions, so that all patients can access optimal treatment. With new technologies that bring specialized services and treatments to where people need them, we will continue to explore how best to tackle the epidemic of heart failure.”

Dr. Van Spall with some of her research team
Dr. Van Spall and her research team

Click here for more stories of our explorations.


Research at Hamilton Health Sciences is conducted in partnership with McMaster University.

Erasing mental health stigma with The Working Mind

For people struggling with mental health, confiding in others can often be as difficult as battling their illness. This is partly because of the stigma attached to mental illness – the stereotypes that make people vulnerable to prejudice and discrimination. Due to stigma, many people suffer in silence.

“We know that our people are at a higher risk of mental health problems than any other occupational group,” says Lisa Gilmour, manager of health, safety and wellness initiatives at HHS.

She points to research by the Mental Health Commission of Canada (MHCC) that shows healthcare workers are 1.5 times more likely to be off work due to illness or disability than people in other sectors. Chronic stress and burnout are common, and many health workers report a range of conditions related to workplace stress including depression, anxiety, and substance misuse.

Helping colleagues build resilience

To promote mental health, and reduce the stigma of mental illness in our workplace, HHS launched an evidence-based education training program at the Juravinski Hospital and Cancer Centre last November called The Working Mind (TWM). The program was developed by the MHCC and is open to all employees and physicians.

People in a classroom listening to a presentation.

In a small classroom setting, participants gain a broad understanding of mental health and wellness, and ways to build resilience. They learn how to recognize changes in their own mental health and that of others. Through exercises and discussions, they also examine the impact of stigma and discrimination in the workplace, learn how to support colleagues with mental health problems, and use skills to improve their coping and resiliency.

“The goal is to create an environment where mental health is actively promoted, stigma is reduced, and people feel encouraged to seek support when they need it,” says Michelle Cassidy, a healthy workplace coordinator.

“We want to reduce any negativity faced by our colleagues with mental health challenges by encouraging everyone to discuss these issues and help our colleagues seek the support they need.”

Positive results

Results to date show that 97 percent of participants felt they could use the information they learned on the job and in other aspects of their life. Ninety-two percent said that they felt TWM training was important to their role at HHS.

“It was very well done,” said one leader participant. “The material was straightforward, clearly presented, and the inclusion of various tools I think will help everyone in the organization learn from and benefit from the program.”

An employee participant said, “I wasn’t sure what to expect from the session, but what I got blew me away. This education thoughtfully and honestly modelled the purpose of the program itself.”

Watch our video with President and Chief Executive Officer, Rob MacIsaac, to learn more about HHS’ commitment to supporting our people and mental health. For information, and to sign up for a session of TWM, visit The Working Mind on the Hub.

portrait of Michele Cardoso

The thing about cancer is…it brings out the best in people

By Michele Cardoso

A letter to my patients

The thing about cancer is …it brings out all the best in people: resilience, courage, hopefulness, compassion, and kindness. It strengthens true friendships and community. When people ask me what I do, I get these pitying looks and they say, “wow that must be depressing” or “how do you do that?” Yes, we have difficult days but truly we see the very best aspects of humanity in the patients we treat.

Coming into Juravinski Cancer Centre (JCC) for the first time is like entering another world, even for a new health care provider. I have never forgotten the overwhelming feeling of shock I felt when I began working here years ago. I was realizing how many people are affected by cancer and how little it is understood by the outside world – those who haven’t experienced it. Yes, treating cancer is challenging. It this is certainly not a job I can leave without a second thought at 5 p.m. but I think that is the same for all staff here. We don’t just care, we care deeply, and we wouldn’t be able to give compassion if it was something we could switch off.

Working in the radiation therapy department, we have the privilege of forging relationships with patients who come daily, sometimes for several weeks of treatment. We share the journey with our patients and in doing so, bear witness to the emotional experience of cancer and do our best to offer support. I’ve always felt very connected to what the patients are going through, to the point that now I can predict some aspects and help patients navigate better than I could years ago. I’ve seen patients reeling from the slap of the new diagnosis, listening to their own inner dialogue as the team explains the how’s and why’s of next steps. I’ve seen patients dealing with side effects of surgery and chemotherapy. Then it sort of slows down during radiation therapy. Perhaps because radiation therapy is so repetitive, and because with modern treatment approaches we can minimize its side effects, this is a time where emotions patients were unable to process earlier in their treatment begin to surface. This is why for us, the relationship with each patient is so important. It allows us to support the patients so much better. The entire JCC team rallies around our patients.

There is no correct way to deal with a diagnosis

I want patients to know that there is more support available within our treatment teams and in the supportive care department. There is no correct way to deal with a diagnosis and it is not easy. I tell patients they don’t have to be positive all the time and it’s okay to feel the way they are feeling. It’s also their time when they can lean on others a little. It’s okay to need help.

The other thing that may get forgotten sometimes is that cancer is rarely a patient’s only challenge. I met a person recently that was in tears during treatment. It was easy to think that the patient was overwhelmed with what was going on with the diagnosis itself. When we stopped to talk, I learned that the patient was dealing with a child with health issues and partner with a mental illness who wasn’t coping with her diagnosis. As we talked through these issues, I was amazed by the patient’s strength and focus on family. I could see this person needed the space to talk about their own feelings. It was rewarding to be able to validate those feelings and help connect this patient with the supportive care department to continue to work through this. I think this person left that day feeling a little lighter. Don’t we all need to feel heard?

I’ve also observed that until there is a cancer diagnosis many people don’t listen to their bodies. Following the diagnosis, there is greater connection and attention to the body that can occasionally lead to anxious thoughts, but can and should really be empowering. I teach a class on lymphedema, a kind of swelling caused by damage to lymph nodes that sometimes occurs with cancer treatment. I always start by suggesting that patients use the knowledge gained from the session as power and not invite the side effects in. I see a person after cancer treatment as being slightly more evolved with respect to listening to their bodies. I want them to know we will not diminish their concerns as being hyper-vigilant but instead, we will validate and engage them in understanding more.

Cancer and cancer treatment can come with many challenges, but its legacy does not have to be negative. I have seen many patients go through a de-cluttering process, no longer sweating the small stuff, as they see what truly matters in life. We celebrate the last day of treatment and though it might seem non-scientific or hokey, I encourage patients to leave “it” here and walk out the door free. Life may look different after cancer treatment but it can still be beautiful. Cancer does make the beauty of the human spirit more apparent and the strength of faith, character, and hope comes shining through.


Michele Cardoso is a clinical specialist radiation therapist at Juravinski Cancer Centre. 

a portrait of Dr. Brian Egier

End of life room honours beloved doctor

Dr. Brian Egier spent almost his entire career in the intensive care unit at Hamilton General Hospital. He also died there.

When he began his work as an anesthesiologist, the idea of a good death didn’t exist in the same way it does today. But he listened carefully to what his patients wanted. He asked about their desire for advanced measures like CPR and breathing support if their heart were to stop. If they said no, he helped communicate those wishes to their family, so everyone understood the patient’s desires.

“Nobody did it like he did,” says his wife. “He would work very hard to get everyone on board for the patient to have a good death.”

The doctor becomes the patient

Dr. Egier became sick himself about ten years ago. He had been feeling under the weather for a while, and as he prepared for an overnight shift on call, his wife Ro worried how he would fare. But he was devoted to his patients and colleagues. He was too weak to drive, so Ro drove him in. During that shift, his symptoms started to get worse.

“He got to die in his own ICU”

He ended up in the emergency department. He was in septic shock—his body was shutting down. Scans revealed a giant tumour growing on his bowel.

“It snowballed from there,” recalls Ro. “He never did return to work after that.”

Dr. Egier lived with cancer for several years. In the fall of 2017, he was admitted to the ICU at HGH, where he had spent so much of his working life.

“He got to die in his own ICU with all his best people around him,” says Ro. “His hospital family was awesome. I can’t thank them enough.”

Honouring his passion for a good death

Dr. Cindy Hamielec, Dr. Egier’s friend and colleague in the ICU, organized a fundraising effort in his honour.

“He was always there for people to talk to,” she says. “He was a role model for so many of us, and we wanted to recognize him.”

The group has donated more than $15,000 to a special fund at that was established with Hamilton General Hospital Foundation in Dr. Egier’s name to benefit ICU patients. A portion of the funds were used by the ICU’s End of Life Committee to furnish a second ‘end of life room’ for patients and families. The room is decorated with calming features, like decals of trees and birds on the walls, and artwork of outdoor scenes. It includes a couch for family members to sit or sleep on. It’s intended to feel less like a hospital room so patients can have the best death possible.

a hospital room with blue walls and calming decor

“Families tell us how peaceful and home-like it feels,” says Edita Hajdini, part of the ICU’s End of Life Committee. “They like the fact that the unit has taken time to think about their needs.”

When patients are nearing end of life in the ICU, they can be moved to the room if it is available. In addition to giving the family more space to be together, the room is a reminder to staff and other visitors that someone is in their final hours. It helps to create a sense of calm on the busy unit.

Dr. Egier’s family feels it is the perfect way to honour a man who cared so deeply for his patients.

“It was important to him to help people die with dignity,” says Ro. “Through this room he continues to do that.”


Donations can still be made in Dr. Egier’s name to support ICU patient care at


A new born baby is weighed on a scale

Up Close: Labour and Delivery

A birth has so many firsts: first breath, first touch, first kiss and cry. Even for doctors and nurses who deliver tens of thousands of babies in their careers, each one can be as unique as the babies who are born.

It’s one of the few situations in healthcare where two patients are being seen to but there is one you cannot see. Our staff are prepared for any quick change of plan in an instant by always staying a few steps ahead and anticipating what is about to unfold.

In this Up Close photo series, you get to have a look at some of the possibilities during child birth at McMaster University Medical Centre. Hopefully it’s a first look for you!

Here’s a short video tour of our labour and delivery department at McMaster University Medical Centre.

If you enjoyed this photo set, have a look at other collections in the Up Close series:

Cogeneration Plant

Biomedical Technology

Open Heart Surgery

Prosthetics and Orthotics in Motion

Trauma Team Response