The ‘sensational’ Dr. Deborah Cook: Hamilton’ award-winning ‘Three Wishes’ creator runs on different fuel
The teenager in the black and white photo will one day become Dr. Deborah Cook: a world-renowned ICU physician who colleagues call things like sensational and extraordinary; an award-winning trailblazer in treating patients and easing the way toward death for those who don't make it.
Look closely at the track and field photo: can you see it? That the Dundas District high school student soaring over hurdles in the late 1970s is destined for great things, or if not, will strive mightily?
A few years later, Cook will be a McMaster University student, playing varsity tennis, with her heart set on becoming a phys-ed teacher, when she reads through a medical journal in the library. She is surprised at how much she understands, thanks to her anatomy studies.
At the dinner table, her parents stress the importance of making a difference.
Cook decides to volunteer at McMaster's hospital ER. The wheels are in motion. Next up: Mac's medical school.
Cook's parents immigrated to Canada from England after a three-year stint in India; her father John an engineer, and mother Joanna a teacher. She has a younger brother, Richard, who is a biostatistician at the University of Waterloo.
The family's home was on Governor's Road in Dundas, next to a farm with horses, and fields of fruit trees. A ravine led to her primary school, and she walked 30 minutes to her elementary and high schools at the foot of the Niagara Escarpment.
It was an idyllic situation, we spent hours outside exploring and playing," said Cook. My parents fostered conversation at the table where we could speak our minds, and they supported us following our dreams."
Cook studied internal medicine at McMaster, where Dr. Gordon Guyatt, an epidemiologist, was a mentor. And then she attended Stanford University to pursue a fellowship in critical care, and set her gaze on new hurdles to clear.
Critical care, or intensive care, is a relatively modern area of medicine, with roots in the 1950s when ventilators were first used in the ICU (intensive care unit).
Researching the needs of critically ill patients had been a blind spot in the specialty, suggests Dr. David Russell, the interim chief of staff at St. Joseph's Healthcare, who worked for years with Cook.
He said Cook was one of the first to truly investigate how the sickest patients could be more effectively treated. Toward that end, she was the first Canadian critical care specialist trained in clinical epidemiology and biostatistics.
The impact she had was to apply the clinical trials methodology to critically ill patients; this had been absent from critical care," said Russell.
Cook studied common and potentially fatal afflictions for ICU patients, including gastrointestinal bleeding, as well as clotting, and pneumonia that could arise as a complication from ventilators. She has published more than 800 peer-reviewed scholarly articles.
In that vein, she helped found the Canada Critical Care Trials Group.
That was an immense achievement," said Paul O'Byrne, dean of McMaster's Faculty of Health Sciences. It helped change the care of critically ill patients ... She is an extraordinary woman, and a leader in research recognized around the world."
It was an experience during her studies at Stanford that helped spark her interest in the ethical realm of critical care.
Twice as part of Cook's studies she travelled to South Africa to observe the ICU environment. On patient rounds she listened to the reflections of an ethicist named Ernle Young: a former Methodist minister and an anti-apartheid activist who founded Stanford's centre for biomedical ethics.
It was a formative experience," said Cook. He was a wonderful man ... I saw so much suffering, and he gave voice to the concept of a moral compass guiding practice, just as in life. That really stuck with me."
In 2013, Cook helped create the Three Wishes" program in the ICU at St. Joe's.
The atmosphere in an ICU can be sterile, dominated by beeping machines and staff shuttling in and out of rooms. It can be a cold setting for patients about to die, and their loved ones.
The initiative was simple and profound: offer the approximately 20 per cent of patients who die in critical care, and their families, closure and dignity by granting deathbed requests in the ICU.
The idea is to keep wishes simple but meaningful. Over the years at St. Joe's they have included a grandchild playing the violin, or saying farewell to a pet; everything from holding a smudging ceremony, renewing marriage vows and turning a patient's bed toward Mecca, to savouring the taste of a final spot of cappuccino or maple syrup.
The program caught on. Its principles are used in ICUs far and wide in North America. And nearly every patient treated in end-of-life care at St. Joe's experiences Three Wishes in some way.
It was the kind of thing very smart people see that others don't, when they cut through to the essence of things, and then implement it," said Russell.
Cook has won four different lifetime achievement awards, and became a member of the Order of Canada in 2014.
And this week, Deborah J. Cook was named a winner of the Canada Gairdner Wightman Award, perhaps the most prestigious national honour a physician/scientist can receive.
She is the fourth McMaster faculty member to receive the honour. The others were John Evans (1992), David Sackett (2009), and Salim Yusuf (2014).
Dr. Janet Rossant, president of the Gairdner Foundation, told the Spectator that Cook represents the best in a clinical scientist."
And she cares," said Rossant. The foundation is looking to award scientists whose research impacts health and well-being and addresses the ethical concerns involved."
The award comes with a $100,000 prize. Cook said she will reinvest the money into critical care research in Hamilton.
I was overwhelmed and humbled by it," said Cook. And it's very much a team honour; I work with a group of ICU colleagues at St. Joseph's Healthcare, and students, that make all the difference in the world."
O'Bryne described Cook as a kind person whose career has been marked by an almost obsessive drive to care for patients. Russell said her stamina is off the charts, even as she is easy to work with: I've spent 30 years watching her, and she is sensational."
Cook never had children. She also had never married - until two years ago.
It was at a Christmas Eve church service in Dundas awhile back where she exchanged glances with an old friend from medical school, Robert Sheppard. He had recently returned to live in Canada after practicing emergency medicine for many years in Texas.
The couple lives off Governor's Road, along with Cook's mother. The house is not far from the home where Cook grew up, and where her father still lives.
Cook and Sheppard delight in walking their dog Rufus, a big Saint Bernard-Poodle cross: He walks us," she joked.
As far as her attempts to mix in leisure time with her schedule treating patients, researching, and teaching, she said she is a work in progress."
There are no plans to stop doing what she does, though.
Cook still runs on different fuel, just like that Dundas Valley track star with the D" on her T-shirt.
Striving to make a difference with others is energizing," she said. That's going to take me forward. And I've always tried to take the view that hopefully your best work is just ahead of you."
Jon Wells is a feature writer at The Spectator. jwells@thespec.com"