National Physicians’ Day 2020 – Dr Michael Kenyon

To pay tribute to the many dedicated physicians practicing at Island Health and in honour of National Physicians’ Day, we are profiling some of the doctors leading innovations and delivering high quality service to show the human behind the profession.

Dr. Michael Kenyon is an Internal Medicine and Critical Care physician with 40 years of clinical medicine experience who practices in Nanaimo and Terrace, B.C.

  • Why did you chose medicine and your speciality/field?

“I was encouraged to go into medicine by my grandmother when I was four years old. Her father and Sir Arthur Conan Doyle trained together under Dr. Joseph Bell (the inspiration for Sherlock Holmes). I grew up with stories of great medical detective work. My great grandfather was one of the first ENT surgeons in Edinburgh. Tuberculosis caused Conan Doyle to move to Switzerland (and write in earnest) and my great-grandfather moved to the Drakensberg (South Africa) to overcome his own TB. I treated many patients for TB in my early career. When the HIV pandemic hit Africa, the resurgence of TB was a defining feature.

There are few careers where everyone works towards a common goal; in medicine it is almost always a good one. Medicine is constantly changing, evolving - I have never been bored. When you can do something that interesting, that is good for other people, it is a great thing. Getting paid to do it is just a bonus.”

  • What is most meaningful to you about your work in medicine?

“Getting to know people. One of the reasons I choose internal medicine and critical care, is you develop a level of trust that you don’t get in other areas. It drives you to do your best. You are seeing people at their best and their worst, it is really revealing. In critical care, time is short and decisions have to be good. With internal medicine, you get all the time in the world. You can spend an hour with a patient, not have to see a new one every ten minutes. I love the fast, “life or death” adrenaline side, but also love the slow side. You get to see the gem in everyone. I have learned a profound lesson from every single one of my patients. “It is as important to know the patient that has the disease as it is to know the disease the patient has” - Hippocrates. This is one of the more important things I teach.”

  • What are your professional interests and notable achievements?

“When I started working here, UBC was not producing community internists. They were training internists for big-city practice, but there was not a lot of exposure rurally, or comfort, for example in critical care components, for rural/community practice. UBC had not had a rural internist for a decade but we helped turn it around. The university has come a long way. I formed a closed, specialist ICU in Nanaimo and started immersing residents and fellows in the rural/community internal medicine model of practice with strong ICU components in Nanaimo and Terrace. I represented ICU and Community GIM at the Royal College in Ottawa to help get General Internal Medicine recognized as a specialty. Community/rural rotations and Critical Care are strong parts of the curriculum. You need to be able to “do it all” in rural communities.

I am humbled to be designated as a “Founder” of the discipline of General Internal Medicine, RCPSC (GIM – Founder)

I was honoured in 2019 to receive a UBC Clinical Faculty Award for Career Excellence in Clinical Teaching in Medicine. It has been great to see rural medicine recognized. I teach a boot camp each year for UBC Internal Medicine Fellows at the beginning of their training, with the help of Island intensivist & RT colleagues. The fellows then rotate through Nanaimo ICU and then up to Terrace and other sites for more rural exposure.

I am proud to have served Canada (three times) running the ICU on Kandahar Airfield, Afghanistan.”  

  • Who or what do you turn to for inspiration?

“Patients a lot of the time. Colleagues some of the time. It is a gift to work with nurses. They are the most wonderful humans on the planet. They always give 110%. They are amazing people and it is a privilege to work with them.”

  • Where do you go, or what do you do, to recharge your batteries?

“Fly-fishing! It is why I came to Canada. I love to go steel-heading anywhere in the Skeena River system. I have walked from the start of rivers in the mountains all the way to the ocean. You get to know the water, the environment, the plant life, the animals. It’s incredible.”

  • What is the last book or podcast you’ve enjoyed?

The Selfish Gene on Audible, and also reading Arthur and George by Julian Barnes.”

  • What experience have you most relied on during the COVID-19 pandemic? 

“I have spent quite some time working as a physician in conflicts, wars, and disasters. One of the few beneficiaries of war is medicine. Things are down to the wire and you have to do what works with minimal resources. My ICU group in Nanaimo went to Afghanistan to help run the Role 3 (Main/ISAF) ICU and resuscitation service on behalf of the Canadian Forces.  They needed ICU docs who could work flexibly in a wide range of conditions and could do most things themselves – run ventilators (and even service them), put in central lines, whatever was needed. Five of us went, usually for six weeks to three months. I went three times. What we learned, developed and taught was amazing. ICU is a team-based endeavor. We were some of the first to do damage control resuscitation on a large scale. The results were amazing. I have used that experience in planning, training and operationalising in difficult times.”

  • What is a change you’ve seen to the health system over the last few months that you are eager to see sustained?

“Definitely the start of a High Acuity Unit in Nanaimo. I would like to see the step down expansion capability sustained. It is good for the building and cohesiveness in the hospital. We need to plan for the future. Having a second intensivist on the schedule helps with morale throughout the hospital. We can do codes during the day and help our ER colleagues. We have also been doing more training with staff and working closer with the ER. It improves care when critical care staff are working throughout the hospital.

I’d also like to see the way we have come together to solve problems continue. We are creating better relationships with administration and other departments. We have been setting aside our differences and communicating regularly. The information sharing has been nice. It is keeping everyone up to speed across the island. We can pick up the phone and quickly overcome obstacles together.” 

  • What do you wish more people knew about practicing medicine?

“How strongly you can connect with people. The strength and vital nature of the doctor – patient relationship. It should be more sacrosanct than attorney – client privilege. It is constantly under threat. Good medicine cannot be enforced or legislated or ordered. It can only be modelled and transmitted through passion for it.

Growing up I spoke Zulu and learned English later, Kwangali in Namibia, Portuguese in Angola. Now I have learned Indigenous languages from the west coast. When you can speak their language and learn their ways, it is a large part of connecting with your patients.”

  • How has your work changed because of COVID-19?

“We are agile as a group; we adapt and adopt things quickly, our team in Nanaimo. We started asking early for what was needed and colleagues and administration listened to us early on. Kevin Patterson started the conversation as soon as the first cases came out in Wuhan. He wrote a prescient article for The Walrus at the end of January – I proof-read it early February. (It was only published in March!) In February, we looked into starting a plan and connected with the Victoria team in March. Within a couple of days we got going. It was beautiful to watch. Dr. Gordon Wood brought out our (H1N1) pandemic plan which we modified for COVID-19 and we started thinking about what was needed and had already defined a decent, comprehensive plan before any “official” requests/plans had even come down from above. Nursing got involved in planning and training. Dr. Omar Ahmad cohesively engaged all, Island - wide. Administration listened to clinicians and tried to help proactively where they could. We were simulation training our staff (led by Dr. McLaren) and had a workable COVID plan in place before we ever got a case. We were ready to engage the unknown. It was exciting and good to be a part of this.”