Your Health Matters - spring 2019

 

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ROYAL COLUMBIAN HOSPITAL FOUNDATION MAGAZINE Your Health Matters SPRING/SUMMER 2019 EDITION IN THIS ISSUE + BRAIN BLEED A Nanaimo man is airlifted to Royal Columbian for a lifesaving neurosurgical procedure + NORTHERN DELIVERY Prince George family spends more than three months at Royal Columbian after pregnancy complications + FALLING INTO PLACE Immediate CPR, emergency angioplasty, and intensive care save Tsawwassen man following a cardiac arrest + A FAREWELL WITH FAMILY How patients and doctors partner to make best medical decisions during end-of-life THIS MAGAZINE BROUGHT TO YOU WITH GENEROUS SUPPORT FROM Neurosurgeon Dr. Navraj Heran

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ONE YEAR AWAY As you read this, let your imagination drift forward a year to 2020. In addition to welcoming a new decade, we will also be dramatically transforming mental health care at Royal Columbian Hospital. It will be around this time next year that we open the brand new, state-of-the-art Mental Health and Substance Use Wellness Centre. It’s incredibly exciting to think we have entered the homestretch on this project, which is intentionally designed to be a therapeutic tool to encourage recovery. Since excavation kicked off two years ago, we have watched the new centre increasingly take shape. In this issue of Your Health Matters, we take a look at how construction is coming along, while also casting our attention to the finished version that is now within reach. Royal Columbian Hospital Foundation continues to fundraise for this much-needed addition, as we work to achieve our goal of contributing $9.1 million towards mental health redevelopment. In addition, we once again share stories of people who have received exceptional care at Royal Columbian. This issue of Your Health Matters helps to highlight the crucial role our hospital plays in the province’s healthcare system. We include stories about families from Nanaimo and Prince George, communities that are far from the typical geographical boundaries of our health region. But these stories, as well as other patient experiences from places like Tsawwassen and in our home community of New Westminster, serve as a reminder of the hospital’s importance as a leading critical care centre. This is where BC fights for hope and for life. We hope you will help us fight for British Columbians in their most critical moments. Doug Eveneshen Chair, Royal Columbian Hospital Foundation 2 YOUR HEALTH MATTERS I ROYAL COLUMBIAN HOSPITAL FOUNDATION Jeff Norris President & CEO, Royal Columbian Hospital Foundation

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EDITOR Jason Howe CONTRIBUTING PHOTOGRAPHERS Tiffany Brown Cooper Simon Hayter Jerald Walliser LAYOUT & DESIGN Gary Slavin COVER DESIGN Paula Heal PUBLISHED BY New Westminster Record Royal Columbian Hospital Foundation Board of Directors Chair: Doug Eveneshen Vice Chair: Tom Corsie Treasurer: Steve Osachoff Secretary: Colin Galinski President and CEO: Jeff Norris Directors: Cameron Belsher, Dr. Sukh Brar, Frank Butzelaar, Meldy Harris, Jennifer Podmore Russell, Farid Rohani, Catherine Ruby, Dr. William Siu, Emily Taylor, Norm Taylor, Rana Vig, Fred Withers We welcome your comments on Your Health Matters magazine. Please email info@rchfoundation.com or write to us c/o Royal Columbian Hospital Foundation, 330 East Columbia Street, New Westminster, BC V3L 3W7. Established in 1978, Royal Columbian Hospital Foundation raises millions of dollars annually to purchase medical equipment, fund innovative programs, and support training and research. To donate, please visit www.rchfoundation.com or call 604-520-4438. CONTENTS VOLUME 5 • ISSUE 1 6 10 12 2 Greetings Royal Columbian Hospital Foundation Chair Doug Eveneshen and Foundation President and CEO Jeff Norris 4 Inspired giving Behind-the-scenes briefs 5 A farewell with family How patients and doctors partner to make best medical decisions during end-of-life 6 Golden hands Ablation is providing a non-surgical option for cancer patients at Royal Columbian 8 Into the homestretch Royal Columbian Hospital’s Mental Health and Substance Use Wellness Centre is increasingly taking shape as construction proceeds for a 2020 opening 10 Identifying the signs For timely stroke treatment, don’t ignore the symptoms 11 Brain bleed A Nanaimo man is airlifted to Royal Columbian for a lifesaving neurosurgical procedure 12 Northern delivery Prince George family spends more than three months at Royal Columbian Hospital after pregnancy complications 14 Falling into place How immediate CPR, an emergency angioplasty, and intensive care helped save a cardiac arrest patient 15 Under the microscope Dr. Reza Alaghehbandan heads the hospital’s lab, but his reach is international 3ROYAL COLUMBIAN HOSPITAL FOUNDATION I YOUR HEALTH MATTERS

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INSPIREDGIVING As construction of the Mental Health and Substance Use Wellness Centre moves into the homestretch, the Foundation sent a special beam to the roof during a milestone ceremony in October. The construction beam celebrates the generosity of donors, led by BMO Financial Group, that have given momentum so far to our mental health redevelopment campaign. The new centre opens in 2020. The Foundation is proud to recognize our 2018 Champions of Philanthropy. These members of Royal Columbian Hospital have distinguished themselves by demonstrating their philanthropic commitment and making important contributions in support of the Foundation’s mission. Congratulations to Dr. Margaret Blackwell, Dr. Peter Blair, Dr. Brad Halkier and Barb Sutherland. Kingston Construction and the Backman family have been longstanding generous supporters of Royal Columbian, contributing to a number of hospital departments and projects over the years. Dozens of Royal Columbian representatives participated in the creation of the Foundation’s latest promotional effort, which includes a powerful video that captures the essence of the care provided by the hospital’s exceptional team. You can find the video by visiting whereBCfights.com For the latest Royal Columbian Hospital Foundation news, follow us: 1 By subscribing to our monthly e-newsletter at www.rchfoundation.com 2 On Facebook: www.facebook.com/ RoyalColumbian 3 On Twitter: @RoyalColumbian 4 On Instagram: www.instagram.com/ royalcolumbian 4 YOUR HEALTH MATTERS I ROYAL COLUMBIAN HOSPITAL FOUNDATION

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A FAREWELL WITH FAMILY ABOVE: Dennis Wagner expressed gratitude for his care as he prepared for end-of-life. How patients and doctors partner to make best medical decisions during end-of-life Dennis Wagner knew he had pancreatic cancer. He also knew it was inoperable and would eventually claim his life. However, as he lay in bed at Royal Columbian Hospital following new complications from his cancer, the 80-yearold Coquitlam man realized, with the help of hospitalist Dr. Joelle Bradley, how advanced the disease had become. Their discussion gradually turned to end-of-life. “Dr. Bradley came and saw me and more or less laid out the cards,” Dennis said from his hospital bed, with his wife Marleine by his side, two days before he passed away. He agreed to share his story out of gratitude for the care he received. “She (Dr. Bradley) laid it out very matter of fact,” Dennis explained. “It sort of took a load off of my mind. Now I know where I am at.” With a shared understanding of his illness, she then asked him to consider what’s most important to him now. For Dr. Bradley, it’s important to understand her patients’ health priorities and goals. “I always have conversations with my patients, ‘if things were to go sideways and you weren’t recovering, do you have any guidance, anything you want me to know?’” she says. “I ask about goals. I ask about fears. I ask about what gives you strength, whether it might be spiritual faith or family.” Finding comfort In the few months since being diagnosed with cancer, Dennis had ended up twice at Royal Columbian. Dr. Shawn MacKenzie, a hepato-pancreaticobiliary surgeon, bypassed a perforated bowel, which restored Dennis’s nutrition and helped keep up his strength. Later, gastroenterologist Dr. Ken Atkinson performed an urgent procedure, using a special powder that was invented for battlefield trauma, to stop a life-threatening internal bleed after Dennis turned up in the ER in near collapse. But with his cancer having advanced to a stage where medical options were ever more limited, Dennis told Dr. Bradley what was most important was to go peacefully. “I don’t want to be in pain and suffering and prolong it,” he said. Dr. Bradley then worked out a plan with Dennis that would allow him to remain comfortable while his family travelled to his bedside from Vancouver Island, Quebec, and England to say goodbye. Dr. Bradley finds her work very meaningful. She wants all patients to know, “Should you ever be in the situation where a physician is asking you about your goals and preferences and what the end of life might look like, it’s because they deeply care. If we can courageously enter this conversation together, we can make the end-of-life phase the best it can be.” LEFT: Hospitalist Dr. Joelle Bradley. 5ROYAL COLUMBIAN HOSPITAL FOUNDATION I YOUR HEALTH MATTERS

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GOLDEN HANDS Tumour ablation is providing a non-surgical option for cancer patients at Royal Columbian Rosalia Stil became discouraged following a surprising diagnosis of liver cancer. The 76-year-old New Westminster woman focused on end-of-life and worried about leaving her husband behind. However, six years later, she has ABOVE: Interventional Radiologist Dr. Brad Halkier has been performing ablations at Royal Columbian Hospital since 2004. found renewed optimism courtesy of the specialized care at Royal Columbian Hospital. Speaking through a Russian interpreter, Rosalia remembers wanting to give up after her diagnosis. “I can’t believe that I stopped fighting, and everybody else kept going,” she recalls. After the liver cancer was found, Rosalia met a series of physicians, eventually leading her to Dr. Brad Halkier, an interventional radiologist who performs ablation therapy. Image-guided thermal ablation is a non-surgical treatment for some cancers that affect the liver, lung, kidney, bone and soft tissues. “We are extremely grateful to be one of the few centers in Canada to be doing a large range of different types of ablations,” explains Dr. Halkier, “and to have the experience to be able to think and work outside the box on occasion to treat tumours that might not otherwise get care.” For Rosalia, surgery had been ruled out because of multiple cancerous spots on her liver. In addition, she learned during testing that she had hepatitis C. However, Dr. Halkier and a multidisciplinary team still believed they could help her. Freezing or heating There are three main ablation techniques: radiofrequency and microwave ablation, which both kill tumours with heat, and cryoablation, which accomplishes its task by freezing. “Each type of ablation has its own niche,” says Dr. Halkier, who has been at Royal Columbian since 1988 and started performing ablations in 2004. “We are fortunate to have access to all three types of ablation units at Royal Columbian.” Freezing or heating energy is delivered into the tumour by advancing thin needles or probes through the skin into the cancer using guidance with CT scanning or ultrasound. It does not require surgical incisions, and almost all procedures are done as an outpatient, or occasionally with an overnight stay in the hospital. Rosalia began a series of microwave ablations as well as blood vessel procedures whereby chemotherapy drugs were injected directly into the tumours through the arteries. Close to three years later, after her fourth liver ablation and several of the blood vessel treatments, there was no visible cancer remaining. “That’s when I thought, ‘I think I am going to be okay,’” Rosalia says. Like family It was also while she was undergoing cancer treatment that Rosalia’s life transformed in another way. Ganna Tashev, one of the hospital’s X-ray technologists, was initially brought in by Dr. Halkier to help with Russian translation. Like Rosalia and her husband, Ganna had come to Canada from the Ukraine. Soon, Ganna became an 6 YOUR HEALTH MATTERS I ROYAL COLUMBIAN HOSPITAL FOUNDATION

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integral part of Rosalia’s life, helping her navigate the healthcare system and keeping a watch out for her and her husband. “God sent her,” says Rosalia. “You are family. You are a relative, basically.” “She’s basically my grandma now,” adds Ganna. Six years after her diagnosis, Rosalia continues to receive occasional treatments, and her liver is monitored by MRI. She is very grateful to Dr. Halkier and the interventional team. “He has golden hands and a very good team with him,” she says. “Dr. Halkier really understood me as a person. He would give me the medications at the right time and do everything at the right moment. The ablations were completely pain-free.” “This is the essence of why we exist - to make a difference,” says Dr. Halkier, whose ablation work has been heavily supported by donors to Royal Columbian Hospital Foundation. “Fortunately, stories like Rosalia’s are not uncommon. Our amazing team of technologists, nurses and physicians are grateful to work in an area where we touch people’s lives. Rosalia’s success and the beautiful relationship that her family has developed with Ganna fuel our passions, guide our vision, and help us know we are on the right track.” RIGHT: Rosalia Stil (middle) with X-ray tech Ganna Tashev and Eduard Stil pose inside an ablation procedure room more than five years after her first treatment by Dr. Halkier for liver cancer. 7ROYAL COLUMBIAN HOSPITAL FOUNDATION I YOUR HEALTH MATTERS

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Redevelopment feature INTO THE HOMESTRETCH Royal Columbian Hospital’s Mental Health and Substance Use Wellness Centre is increasingly taking shape as construction proceeds for a 2020 opening. Here’s a sneak peek at where the building stood as of last November. The new 75-bed Mental Health and Substance Use Wellness Centre will help treat 55 percent more inpatients and 27 percent more outpatients by 2030. There will be outdoor patios for patients, with covered portions and high glass walls. 8 YOUR HEALTH MATTERS I ROYAL COLUMBIAN HOSPITAL FOUNDATION

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The new contemporary facility is inspired by the Fraser River and will use a patient-centred design with input from our psychiatrists, clinicians, patients, and families to create an inviting, spacious, and therapeutic sanctuary where patients can feel safe, respected, and free to express their feelings. The new building will have three floors of inpatient units including 45 beds for acute mental health care, a 10-bed Psychiatric High Acuity Unit, and Fraser Health’s first Older Adult Psychiatric Unit with 20 beds. Each inpatient will have their own private bedroom, with ensuite bathroom and shower. 9ROYAL COLUMBIAN HOSPITAL FOUNDATION I YOUR HEALTH MATTERS

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Corinne Lovelace convinced her husband Trevor to go to emergency after the 51-year-old’s arm went numb while getting ready for work. Identifying the signs For timely stroke treatment, don’t ignore the symptoms Trevor Lovelace was getting ready for work when his left hand stopped functioning. His arm was numb and tingly. At first, he thought about ignoring it and carrying on to work. Thankfully his wife was there to push him to make a trip to Royal Columbian Hospital’s emergency department. Following a CT scan, the 51-yearold New Westminster resident was confirmed as having suffered a stroke. “They determined there had been a blood clot in my right carotid artery, and three shards had broken off. I had three strokes,” Trevor recalls. “Luckily it didn’t create too much damage for me.” Royal Columbian plays an integral role in stroke care in our region. It is the cornerstone of a 24/7 Acute Stroke Team designed for centralized, comprehensive support for stroke patients. Neurologist Dr. Gregory Walker says getting to a hospital like Royal Columbian quickly is important. “There are some time-based treatments,” he explains. “But also there’s good evidence that shows even just getting to a stroke centre and getting appropriate blood pressure management and fluids and a proper neurologic assessment can prevent larger strokes from happening and also help recovery happen much faster.” Treatments at Royal Columbian can include blood thinners, clot-busting drugs, or even thrombectomy, where a blood clot is physically removed from a blood vessel during a minimallyinvasive procedure that is provided at only two other hospitals in the province. Tailored treatment For Trevor, the plan was to break down the blood clot with medication and the body’s own natural anti-clotting system. In the meantime, Dr. Walker ran some tests to identify the cause. “Once we find the exact cause of the stroke, then we can tailor treatment, which gives people the most protection to prevent a risk of this happening again,” he says. Twelve years earlier, Trevor had been treated with radiation for throat cancer. Dr. Walker believes that lifesaving treatment is behind the development of Trevor’s blood clot. Trevor stayed in the hospital for a week before he returned home. Six months later, he still feels a slight numbness in his left arm. “I’m fine with that if that’s the worst that’s going to happen to me right now,” he adds. He’s also grateful he didn’t put off a trip to the ER. “I think better say something than nothing, or be a typical guy who thinks ‘I’m tough, it’s going to go away.’ I’ve seen way too many horror stories,” he says. 10 YOUR HEALTH MATTERS I ROYAL COLUMBIAN HOSPITAL FOUNDATION

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BRAIN BLEED A Nanaimo man is airlifted to Royal Columbian for a lifesaving neurosurgical procedure Martin Bisset, with wife Angie and children, was airlifted to Royal Columbian Hospital after suffering a ruptured brain aneurysm in his Nanaimo home. Angie Bisset was reading when she first heard the strange sound. She would later describe it as either a gargling or vomiting noise. When their golden retriever started barking and running back and forth from where her husband Martin was working out in their Nanaimo home, she decided to go check. What she found was terrifying. “Basically, he was stuck in the kneeling position, straining forward, making this weird roaring sound,” Angie recalls. “He was unresponsive.” A CT scan at their local hospital discovered a ruptured brain aneurysm. The 39-year-old Martin was suffering from a hemorrhagic stroke. From Nanaimo, Martin was rushed to Victoria. He was brought to the intensive care unit as plans were put in place to fly him urgently to Royal Columbian Hospital and neurosurgeon Dr. Navraj Heran. “He presented with a ruptured aneurysm where the blood leaks out of a blood vessel and spills into the space around the brain,” explains Dr. Heran, who estimates he treats about 120 cases like this each year. “It increases pressure and irritates the lining of the brain.” Coiling In Fraser Health, all these cases are treated by Dr. Heran without requiring invasive surgery to open the skull. Dr. Heran guides a catheter through a small incision in the thigh all the way up to the site of the aneurysm. He then uses small coils to fix the problem. “Basically we put those coils into the aneurysm so it congeals the blood inside the weakness,” explains Dr. Heran. Angie says the procedure took no longer than an hour, and they soon shifted their attention to Martin’s recovery. He stayed at Royal Columbian for just over two weeks, Neurosurgeon Dr. Navraj Heran. and both he and Angie have developed a strong appreciation for their care. “We had absolutely amazing nurses and therapists,” says Angie. “They were so educated and aware. When you are in a situation that is so scary and unusual, and you have these people at your back that are the best of the best but also driven to continue to learn, there’s no words that express how comforting that is.” Just over a year later, Martin continues to recover from complications including fatigue and eye movement challenges. Overall, however, he feels thankful. “I’m doing pretty good,” he says. “Somehow I came out of it…” “Relatively unscathed,” Angie adds. 11ROYAL COLUMBIAN HOSPITAL FOUNDATION I YOUR HEALTH MATTERS

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NORTHERN DELIVERY Felicity Landrey stayed for more than 100 days in Royal Columbian Hospital’s NICU after she was born prematurely. Prince George family spends more than three months at Royal Columbian Hospital after pregnancy complications As Melanie Bodhi, 24-weeks pregnant, headed to a doctor’s appointment in Prince George in the spring of 2017, she had no way of knowing the whirlwind she and her husband would soon face. Less than 24 hours later, she was at Royal Columbian Hospital, flown in from her northern BC community amid increasing concerns she would need to deliver very prematurely. “We kind of had a complicated pregnancy from the start,” says Melanie, who learned she had a bicornuate uterus, which is a condition that can cause premature labour as well as other complications. In her 23rd week, the medical team in Prince George ran tests for preeclampsia, a complication that can be life-threatening to both mother and baby. Melanie exhibited some of the telltale signs: migraine, blurred vision and protein in the urine. Still, she and husband David Landrey didn’t expect they would soon be on a flight to Royal Columbian. The two left work Friday afternoon for an appointment with their obstetrician. Their plans soon took a sudden and unexpected turn. “Mel didn’t get to go home after work to grab things or get changed out of her work clothes,” recalls David. “She just ended up in the hospital right away for monitoring, and they didn’t like what they saw.” Level 3 centre Melanie stayed overnight in the Prince George hospital before being transported to Royal Columbian. As one of the province’s four Level 3 neonatal intensive care centres, Royal Columbian is trained and equipped to care for newborns as premature as 23 weeks and weighing fewer than 400 grams. “We were really lucky, I think, to go to Royal Columbian, because the staff there were so amazing and supportive,” says Melanie, who was monitored by the hospital’s maternity unit for a week. Then, at 25 weeks and six days into the pregnancy, Felicity was delivered. She weighed 550 grams. “In the NICU, they are very open 12 YOUR HEALTH MATTERS I ROYAL COLUMBIAN HOSPITAL FOUNDATION

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about how it’s going to feel like an emotional roller coaster,” says David. “There’s going to be good news, and then there’s going to be discouraging news, and it’s going to feel like you’re taking two steps forward and one step back.” Queenie Lai, manager of the hospital’s Variety Neonatal Intensive Care Unit, says her team is very attuned to the needs of the family as well as the newborn. And they recognize that being far from home can add stress. “You have a baby in the intensive care unit, and it’s not in your own hometown,” Queenie notes. “It is a traumatic experience, and it’s very difficult.” Donors to Royal Columbian Hospital Foundation help provide some relief for families who face unexpected expenses including accommodation, food, and travel. Melanie and David say the generosity of friends and loved ones helped them stay focused on their daughter’s care. The neonatal team makes it a priority to keep parents very involved. “They explain a lot to parents,” says Queenie. “We will instruct them how to touch the baby. They can do skin- to-skin contact. Parents can take the temperature and change diapers. We encourage parents to be involved as much as possible.” Back home Felicity was at Royal Columbian for 103 days before being transferred to Prince George’s NICU for a further two and a half weeks. Her parents had some terrifying moments, including early on when Felicity became septic. She also stayed on ventilation for close to two months. But gradually, Felicity grew stronger. “The biggest step forward for me was when she moved from the incubator into a crib,” recalls David. “We could start putting her in clothes and feel like we’re more normal parents.” Back in Prince George, the family recalls fondly those who were involved in their care. “They were just incredibly supportive,” says Melanie. “Having Melanie Bodhi had pregnancy complications that caused her to be flown from Prince George to Royal Columbian Hospital to deliver her baby at just under 26 weeks pregnancy. primary nurses was unbelievable. Having a nurse that you know and who knows your baby was just amazing.” 13ROYAL COLUMBIAN HOSPITAL FOUNDATION I YOUR HEALTH MATTERS

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FALLING INTO PLACE John and Carol Harrison are back on their bikes, three and a half months after John suffered a cardiac arrest during a ride. How immediate CPR, an emergency angioplasty, and intensive care helped save a cardiac arrest patient. John Harrison was three months into his retirement when the 62-yearold and his wife Carol went out for a regular bicycle ride in Tsawwassen. As the couple approached a big hill, Carol took it slow, while John went hard and fast. As Carol pedalled up the hill, she saw that her husband, a fair distance away, was now on the ground. “I thought he was teasing me,” recalls Carol. “I called to him, and he didn’t move. So then I screamed at him, and I screamed again as I’m racing up the hill.” As she arrived, John was having a seizure. Carol, who had taken some resuscitation classes in the past, initiated CPR. Soon, a passerby, who happened to be a former firefighter, took over the work as John turned blue. He was having a cardiac arrest. “Immediate CPR is a critical way to help someone survive,” notes Royal Columbian Hospital interventional cardiologist Dr. Albert Chan. “If the brain does not receive oxygen and blood just for even a few minutes, there is a significant amount of brain tissue damage.” Firefighters and paramedics arrived, and John was intubated and defibrillated. His pulse returned, and John was brought to the local hospital for assessment. Soon he was headed with lights and sirens to Royal Columbian Hospital’s cardiac catheterization lab. Emergency angioplasty “An angiogram showed he had a very tight narrowing in the proximal segment of the left anterior descending artery,” explains Dr. Chan. “Immediately, at the time of the angiogram, we proceeded with an emergency angioplasty to open up the artery.” Dr. Chan placed two stents, and John was sent to the Intensive Care Unit to recover. He remained unconscious, and there were still questions about how much lasting damage he suffered during his cardiac arrest. Over the next couple of days, when the family wasn’t visiting in hospital, they were getting updates by phone. It was during one of those calls they heard good news. “I was on the phone with the nurse, and he’s like ‘I gotta go, he’s moving,’” recalls daughter Emily. “It was an absolute miracle,” adds Carol. “We raced here.” John’s care during his time in hospital left a strong impression on the family. “They were amazing,” says Carol. “There was no question too small for them to answer. We could be in there for as long as we wanted and talk to them until we were satisfied.” Now a couple of months later, John recognizes how fortunate he is to have survived. “They have all told me that,” he says. “I feel good, really good. I’ve lost some weight. I am eating better. I am starting cardiac rehab. Things just kind of all fell into place for me.” 14 YOUR HEALTH MATTERS I ROYAL COLUMBIAN HOSPITAL FOUNDATION

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UNDER THE MICROSCOPE As Head of Pathology & Laboratory Medicine at Royal Columbian Hospital, Dr. Reza Alaghehbandan is part of a team that is central to the care of patients. The lab plays a major role in over 80 percent of medical diagnoses, providing answers to questions that cannot be answered by speaking with the patient or from basic physical exams or radiographic images. Foundation: How extensive is the role of the hospital’s lab? RA: Our Department is the largest in the region with 300 dedicated staff, providing 4.2 million tests annually. A major part of what we do is cancer diagnosis, which is the foundation of cancer care, with over 1,500 newly diagnosed patients per year. So we play a significant role in the health and well-being of our population. Foundation: You’re an Anatomic Pathologist. What does that include? RA: Anatomic Pathology encompasses the study of tissue and cells removed from patients during a procedure to diagnose a disease and determine a treatment plan. This includes patients’ specimens coming to us directly from hospitals’ operating rooms, outpatient clinics, etc. Foundation: Outside of your role at Royal Columbian, you are involved in a number of initiatives. RA: I am a faculty member with UBC, teaching residents and medical students. I also serve on a number of provincial and national organizations and committees. I have been very privileged to engage in volunteer activities in under-resourced countries in Africa and Asia. I am an IAP (International Academy of Pathology) Ambassador, promoting pathology services in underserved areas. I also serve as an expert on cancer control at the World Health Organization for building pathology capacity in low-resource countries. Foundation: What drew you to become involved? RA: The reason is very simple. Happiness is directly connected to service, and serving others enriches one’s soul. In life, we have been given so much and being a big believer in a two-way avenue philosophy, we must share and give back too. Serving others in need is an honour and privilege that should not be taken lightly. And in fact philanthropy is the essence of Global Health, which reminds me of this by William Shakespeare: “The quality of mercy is not strain’d, It droppeth as the gentle rain from heaven Upon the place beneath: it is twice blest; It blesseth him that gives and him that takes. 15ROYAL COLUMBIAN HOSPITAL FOUNDATION I YOUR HEALTH MATTERS

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