[Photo: Thomas Lu]

The good doctor

Improving end-of-life care for people experiencing homelessness

It was a patient she encountered early on in her fourth year of medical school that reinforced for Dr. Jacqueline Carverhill (MD’19) the importance of providing good care to everyone, regardless of social status.

She sat at the bedside of a Congolese refugee who had been forcibly separated from his family. The man in his 50s was homeless and dying of advanced prostate cancer. He had lost all of his belongings -- including his cellphone -- when he was admitted to the palliative care unit in a state of delirium. So he couldn’t communicate with anyone outside the four walls of his hospital room. 

As the only member of the care team who spoke French, she translated for him. 

“But mostly, I listened,” says Carverhill, who is seven months into a two-year residency in family medicine at McMaster University in Hamilton. “As with countless other clinical interactions, it reminded me that in order to truly honour my patients’ vulnerability, I need to combine my clinical passions with broader advocacy that champions health equity as the ultimate goal.”

Carverhill’s commitment to looking out for those less fortunate started early. She grew up in a family that was “very social justice oriented,” says Carverhill. Her parents had her set aside Halloween candy she’d collected trick or treating, to share with sick children staying at Ronald McDonald House.

Carverhill can remember being about six, and rather than spending the money she’d socked away to buy herself a Beanie Baby, she contributed it to a hamper at Christmas so another child would have a toy under the tree. “I am sure that the values my parents raised me with have influenced the kind of medicine I want to practice,” says Carverhill, who last year was named Student Leader of the Year by the Saskatchewan Medical Association. 

On her radar

Palliative care, which focuses on improving quality of life and reducing suffering for people with life-threatening medical conditions, appeared on Jacqueline’s radar in first year of medical school, when she had the opportunity to shadow other physicians. She liked that it involved working with families, and focused on what the patient wanted and figuring out how to make that happen.

“Sometimes that involves thinking really creatively, or outside of the box, to provide the care that’s most patient centred.”

Carverhill’s introduction to what has subsequently become her North Star -- providing palliative care to people experiencing homelessness -- came in spring 2016, when as an organizer for the College of Medicine’s Health Innovation and Public Policy Conference, she helped land guest speaker Dr. Naheed Dosani, the founder of PEACH (Palliative Education And Care for the Homeless) an inner city, mobile palliative care clinic in downtown Toronto.

Many people without stable housing lack consistent access to care -- including palliative care. And because they don’t have a regular family doctor, they frequent the Emergency Room often. “I had never really thought of that before, in terms of that specific niche area.” After meeting Dosani and hearing him speak, Carverhill initiated a mentorship that continues to this day. 

Carverhill was so struck by PEACH’s innovative approach that she travelled to Toronto after her second year of medical school, to see the program first-hand.

Then, in fourth year, she arranged her electives so she could actually work with Dr. Dosani and the PEACH team -- and in similar programs across the country. The time she spent working with inner city mobile palliative teams in Edmonton and Calgary sealed the deal.

“It was really those weeks that I spent doing this work where I just loved every minute of it. That’s when I knew that that’s exactly what I wanted to do. I think there’s a huge need to provide this kind of care.”

Building the will and securing funding to launch an outside-of-the-box care program will require more than just passion.

Learn more about Carverhill's plan to develop a mobile palliative care clinic in Saskatoon at the Green & White.

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