Dr. Kirsten Johnson, M.D., MPH: Assistant Professor, Department of Family Medicine, McGill University; Director, Humanitarian Studies Initiative, McGill University; President, Humanitarian U (Part Two)

Author(s): Scott Douglas Jacobsen

Publication (Outlet/Website): In-Sight: Independent Interview-Based Journal

Publication Date (yyyy/mm/dd): 2015/02/01

ABSTRACT

Part two of two, interview with Dr. Kirsten Johnson, MD, MPH.  In it, she discusses: professional advice for young medical doctors such as the need for clear and precise reasons for entering into the medical profession, the difficulty of medicine in Canada, and humanitarian work and initiatives; example from ex-President of The University of British Columbia (UBC) Stephen Toope, broad-based admissions policies at UBC, and the importance of life experience for the medical profession; example of Dr. Sho Yano earning a PhD at 16 and MD at 21 from the University of Chicago to consider some of the previous points on life experience as important; brief commentary on some general characteristics of the Millennial generation in direct efforts; personal responsibility for societal matters, Segal Centre’s Segal Centre’s 2010 Januscz Korczak award for your work on protecting the rights of children in conflict; Richard Feynman on the Nobel Prize and responsibilities implied by awards and honors; Hippocratic Oath; more power and influence implying further responsibility; and biggest influences.

Keywords: Dr. Kirsten Johnson, Humanitarian, responsibility.

12. From a professional opinion, what advice do you have for young MDs?

In medicine, I think there are so many possibilities.  I think that anybody can have any kind of career they want within medicine.  I think that, by virtue of being an MD, that there is a tradition of leadership.  I think they should look at ways to make an impact in their practice, in the world, even if it is to direct patient care, in policy making at a bigger level.  I think MDs have a bigger responsibility to step in those kinds of roles now.  I think they should take those kinds of thing seriously.  So many field are combining with practice with family and other things too.  There are doctors still out there doing the traditional role.  I think also people are making medicine in so many more things from research to administration to positions of leadership.  I think the young doctors shouldn’t be restricted to that.  I think they should think about all of the impact they can have.

I think you have to be so clear on the reasons for entering medicine because medicine has become so many different things.  You can practice medicine and do law or business, or other things, at the same time.

People need to be clear, precise on the reasons for entering medicine.  It is such a cynical field too because it so difficult in Canada.  Our system is such an overstretched one through simple 2 and 3 year waitlists for a knee or hip surgery.

Even to see a neurologist takes a year, from the point of a professional for a young MD entering the field, your heart needs to be in the right place and you need to know what you are doing.  It is not as easy a job to do anymore.  It might not sound hopeful, but it can be hopeful.  In that, you can ‘have your cake and eat it too.’

Medicine is a great field because it allows you to do so many things, and you do not need to be confined by the traditional way of doing medicine.  You are not some doctor doing some ward rounds for 12 hours a day anymore.

For example, I travel around the world and treat patients in high-intensive care patients in planes.  I go and lecture for National Geographic as the humanitarian specialist in Africa.  I do humanitarian work.  I research and teach.  There are many ways to take the career in medicine and make it, morph it, which can make it very, very exciting.

You could be clear about going into medicine, and using that for a stepping stone, or be clear about doing surgery.  However, people should not go into medicine because of uncertainty, “I do not know.  Mom told me to do it.”  That is what worries me about accepting these young kids.

For instance, University of Calgary, when I got accepted – and I got accepted to other schools, but only 10% were accepted from in-province and the average age was 26.  We had an athlete, a philosopher, an NHL hockey star, and many other exciting things.  It brought a different bend into the way they dealt with patient care in a positive way.  It was very exciting to me.

13. I can draw some analogies there. As from fall 2012 at The University of British Columbia with President Stephen Toope, they began broad-based admissions for undergraduates, called ‘holistic’ under a different guise in various universities, looking at other aspects of the individuals applying for admission to the particular university, but this extends beyond UBC’s and does have an impact.  For example, UBC began to accept a decent amount of students otherwise previously rejected based on these standards for admissions.  In other words, they do not merely pay lip service to the idea of ‘broad-based admissions’, but provide evidence of their desire to have a more experientially diverse student body in practice.

I think this accepting people based on having a grade point average of 4.0, having 100% of everything, and being super-student, and yet they have never gone out and done anything experiential.  It is scary to me.  They can be very good scientist-doctors, but I do not know if it brings too much to our field.

14. Based on that, I think of a case out of the University of Chicago. Sho Yano, he earned a PhD at the age of 16 and MD at 21. To me, that goes to your point by providing the contrast.

Yes. Maybe, but maybe not at the same time, I do not know about his case in particular.  However, even going out and attempting to figure out your desires out in the field.  For example, being in a specialty, I do emergency medicine.  You can do it two ways.  First, one in family medicine; second, one in emergency, a specialty.

Or you can do a five-year program, even in the five-year program, students who go into here have a year to enter into something of great interest to them, though, those students have never cultivated those interests because they have never had to do it.

They have been academics their whole lives.  It totally confounds me.  How can you not be interested in something in medicine?  But you are in medicine.  It is hard to get out of it.  It is important to have other interests. (Laughs)

15. Maybe, as a safe, and mild, generalization, the millennial generation may have a tendency to look for others to do the side-work for them, even the development of individual genuine interests aside from core work such as school and work. However, it seems something more inculcated for such a long time, which, probably, provides the basis for limiting the scope of potential and considered interests.  Even one relevant example, people active in the Occupy Movement, with the caveats of understanding it, the desire and want exists, but they look to others to make the change by sitting out rather than making concrete changes.

Exactly. Exactly!

16. Although, maybe, that lies in another general characteristic of the millennial generation in their distrust of government-run systems in terms of authority. On a similar line of thought about personal responsibility to societal matters, you were awarded the Segal Centre’s 2010 Januscz Korczak award for your work on protecting the rights of children in conflict and the Award of Excellence for your work in global health by the College of Family Physicians of Canada in 2010.  What do these awards mean to you? 

There is a practical and personal meaning.  From a practical standpoint, it is important to get those kind of recognitions, and I also support other women and people in my field.  For instance, I nominate people. If I am asked to write something, I will.  For example, I have a colleague nominated for the Order of Canada.

I will spend the time to write something.  I do that because it is important to have those kinds of recognitions to move one’s career forward.  I am not talking about on the way, “I want more.  I need to get to the next level.”  I am talking about the type of recognition for important work that gets you the further funding for the same or other important research.

I really feel that the program we are doing – by training professionals in the humanitarian field impacts the services by providing – the best standard of care, and sets a standard all Canadians should be aiming for.

Actually, I was awarded the Top 40 Under 40 in Canada.  It is not even an academic one.  It is unlike the Segal one.  It is kind of the trendy award, but I was the only person in that list for the year doing non-profit, humanitarian related stuff – out of all 40.

It brings important issues to the field that people do not even think about.  So the people I met at the award ceremony discussed how much money they made!  Everybody, we had to talk for a three minute on ourselves.

In my three-minute spot, I did not talk about me, actually.  I talked about the people in my field.  The women impacted by gender-based violence.  It was about the way we trying to make an impact globally.

Other people would come up and talk about buying six Humvees, and so on.  I thought, “Oh my god, really?  You were giving me recognition for this.  Who are these people besides this?”  When they had pictures of their family, they were out in Disney and it was all consumerism.

So on one level, these awards transform the message, the important stuff we are trying to do by helping to get funding.  They help raise awareness, but people do not even know about it.

On the personal level, some people in your career, it is nice to be recognized, but it does not means too much to me.  To others, it may, but I do my work because it means a lot to me.

Therefore, I want to do it right.  It is not necessarily about becoming recognized for it.  However, it does feel nice.  It is a bit weird.  If it came with a million bucks, it would be more! (Laughs) Because then I could do more projects and programs for research that I want to do.

17. Richard Feynman had a great documentary. He talks about earning the Nobel Prize.  He sternly says, “I do not know anything about the Nobel Prize… I will not have anything to do with the Nobel Prize.  It is a pain in the. (laughs) I do not like honors… I have already got the prize.  The prize is the pleasure of finding the thing out, the kick in the discovery, the observation other people use it, those are the real things.  The honors are unreal to me.”  Following from this, what further social responsibilities do these entail?

For me, they sometimes put you in a bit of the spotlight.  I think number one is to set an example.  I think that it helps to inspire my students and other people who are thinking about going into medicine and doing some humanitarian-related work because I hope that the things I do, and invariably some of these awards providing some media attention.

People hear about them and realize what you are doing, and there is some level of social responsibility in setting an example and maintaining a standard of work – and quality of work.

As I said, the research I do is because I love advocacy.  I know you are not supposed to be doing research for advocacy purposes.  I am not doing research for that bias, but I think it is great when we have numbers that can speak for the problem, and then we can have funding and policy change for these things.  I think that the recognition enforces that there needs to be a certain standard of excellence around my work.

Also, that it allows me to do the advocacy piece to take the work that I do and spin it in that way.   This can allow me to speak for these populations that we are trying to assist.  It elevates the issue to a public forum.  I think that it is an ongoing thing.  In all of my work, and in anything you do, there is social responsibility.

I think that is one good thing about having an MD after your name.  People pay attention to what you have to say.  I do not understand the reason why, but it is kind of stupid.

18. Maybe, people, in some tacit way, take the Hippocratic Oath serious without knowing the oath formally. They see it as a good and moral thing.  Plus, those helping them with their major health problems in their lives have been medical doctors.

True, but you meet a lot of doctors today that are not morally motivated people. (Laughs)  Much money-grubbing.  I do not know if you have read this news.

For instance, the CEO of our hospital, Dr. Arthur Porter, Panama will extradite him back to Canada, except that he is saying he is some diplomat from Sierra Leone.  However, he is a fraud.  He has stolen money.  He has been a part of all these other nefarious things.

Not necessarily every doctor is motivated by the Hippocratic Oath.  It is terrible.

All of the Board of Directors in the hospital here were in on this ‘mafia’ dealing.  It is a pretty thwarted affair that has been going on here.  They have a social responsibility, but they are not at all outstanding citizens – let alone doctors.

19. They have more power and influence. By default, they have more responsibility.

Yes.

20. Whom do you consider your biggest influences? Could you recommend and seminal or important books/articles by them?

Early on, I think the Dalai Lama.  I did a lot of work in that area.  One of my personal heroes is Roméo Dallaire for sure.

He was a Canadian General, retired now.  He is the one that led the UN forces in Rwanda during the genocide.  What happened was that – I do not know if you know much about that war – the war essentially turned their back on the Hutu, the Tutsi population who was being killed by the hundreds of thousands.

Roméo Dallaire was able, when the UN pulled out, and when he was under strict instructions to pull his troops out and leave the country, in certain terms more people would die.

He had this moral conviction to stay and do the right thing.  His whole career.  All of it.  All of this respect as a top Canadian General. He was clear that he would have to be court marshalled.  He was clear that he would have to give all of this away.

To the Secretary General of the UN (Boutros Boutros-Ghali), he said, “No, I am staying.”  All of the troops left.  He was left with some Ghanaians and Pakistanis.  He managed to secure the stadium in Kigali.  He saved 1,000s of peoples’ lives who would otherwise have died.

Against all of the odds, he stayed there for the whole genocide.  He witnessed terrible things, atrocities.  He still speaks of them today.  He is really the voice, the only guy, who stayed there – besides James Orbinski, a doctor from Canada.  This man did a great good.

He came back and had terrible issues with post-traumatic stress disorder (PTSD) and mental health issues.  He still does a lot of great work.  Now, I work with him on the initiative.  He is a real hero and spokesperson for this kind of thing.

His most recent book is called Fight Like Soldiers Die Like Children.  It was a documentary in theatres too.  My other big influences were my mentors at Harvard such as Jennifer Leaning.

One of my research mentors, Peter Walker.  He basically wrote the handbook of the standards and guidelines for the field.

I feel lucky.  A lot of the people I looked up to I get to work with now.  It is pretty neat.  The humanitarian world is small enough that if you are running in it and doing stuff.  You will meet people doing lots of stuff in it.

These are the people that are really making the difference in the world, but not having the recognition for it.  Yet, they are the ones finding themselves in the middle of a war.   They are killed, or raped, and so on.  I consider them the real heroes and really influential on me.

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