leaders in health: dr. shazma mithani and patient advocacy on the frontlines of emergency medicine
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dr. shazma mithani loves to stay active because it promotes overall health and gives her energy for early-morning or overnight shifts and raising her two young kids.
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when you’re working shifts under the enormous pressure of a city hospital er, taking time to reboot is as critical to the job as iv lines and resuscitation. for emergency physician and award-winning health advocate dr. shazma mithani, the good news is she lives in her hometown of edmonton, alta. – a place she can’t say enough about.
“if you don’t live in edmonton, you don’t realize what an amazing city it is. i love everything about it here. we have such a great network of people. my parents are here, my husband and his friends he grew up with are here. we love the outdoors. there’s a beautiful river valley where we go in the summer, there’s opportunities to bike, run and go hiking and camping within a stone’s throw from the city,” says mithani who is a big proponent of staying active. it promotes overall health and gives her energy for early-morning or overnight shifts and raising her two young kids.
lifestyle holds even more weight when you consider that burnout among healthcare providers has been such a public issue through the tough days of the pandemic and its aftermath. mithani is keenly aware of the importance of self-care, and depending on the day, that can involve a run with friends, playing tennis or ultimate frisbee in a summer league.
what’s consistent in emergency medicine is the unexpected. you never know what might come up at her workplaces, the royal alexandra hospital, the largest hospital in western canada that also serves northern b.c., yukon and the northwest territories, and the stollery children’s hospital for pediatric care. that level of challenge is part of what drives her passion for the job and navigating the maze of responsibility.
“there might be a very sick patient who comes in that needs to be resuscitated immediately, and they get brought straight into a resuscitation room. that may be when i’m in the middle of talking to a patient in a room. there’ll be an overhead page where i have to quickly excuse myself and get all my ppe off and then run to the other room. it’s quite unpredictable.”
for her efforts and dedication, dr. shazma mithani recently received the alan drummond advocacy award by the canadian association of emergency physicians.
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she’s seeing patients, talking to them to learn their stories, ordering bloodwork and imaging as part of her investigations to figure out why they’re there – all of which is happening simultaneously with multiple patients, in some situations where every minute counts.
“the problem-solving of emergency medicine is like nothing else. i have no idea sometimes what i’m dealing with and trying to use the investigation to get a better sense of what’s going on, whether the patient can go home or needs to be admitted. so, putting all those puzzle pieces together i find really interesting.”
as for her day-to-day, “i’m understanding what investigations i need to do, then interpreting those investigations and then talking to whoever i need to talk to, getting them admitted or arranging outpatient management for them, or reassuring them that everything looks okay.”
her journey to medical school started with being drawn to biological sciences in high school and then choosing pharmacology to pursue drug research. she spent two summers doing research in a lab while at the university of alberta, but realized she needed a role with more people interaction. medicine made sense because it offered both scientific investigation and spending time with colleagues, patients and their families. at medical school at western university in london, ont., pediatrics appealed at first, but the job-shadowing opportunities in general surgery, internal medicine and obstetrics all captured her interest.
she landed on emergency medicine because it brought all these specialties together, and went back to alberta for her residency, graduating in 2014. “we see everything in the emergency department, so it made sense because i liked everything and it was a great mix of medicine, using my hands and doing procedures. it blended everything together in a way that felt natural for me.”
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if you ask her about saving people who are victims of violence or heart disease patients, for example, she says the cases that stay and weigh on her mind are the losses, the sad ones.
she witnessed her first devastating patient death in her first year of residency, she shares on instagram: “i was rotating through internal medicine, doing a consult in the er, when one of the attendings pulled me into a resuscitation room. the patient was in their 20s and had suffered a cardiac arrest from severe asthma. i stood there, did what i was told, and witnessed an entire team do everything they could to try to save this patient. the agonizing sobs of the patient’s mother still echo in my brain today.”
there’s an emotional toll to the work that has to be acknowledged and processed.
“thankfully, i have a lot of very good friends in emerge that i often will debrief with. i have an excellent psychologist that i see when i need to. and sometimes i just cry it out when i need to as well. there are different ways to address it and cope with it.”
after a decade in the specialty, she brings not only a wealth of experience and capabilities, but an incredible warmth and caring. she works with vulnerable patient populations every day on shift and is a known advocate for access to care and health literacy. she also serves as a director on the boards of the alberta medical association and sexual assault centre of edmonton, and is an assistant clinical professor in the department of emergency medicine at the university of alberta.
“one of the pillars of being a physician is advocacy and being such an integral part of the healthcare system, especially in emergency medicine, we’re at the interface of acute care and community care. it gives us a unique view of the healthcare system on both sides. we can see where the system breaks down and how it affects our ability to help our patients. all we want to do is be able to take care of our patients and sometimes that’s not possible because of system challenges. it really pushes a lot of us to speak out and use our expertise to improve the system.”
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in her line of work, you have to build on the positives of public outreach while grappling with the distress of losing patients, like the law enforcement officer shot and killed by a civilian, the six-year-old with a blood infection so severe that putting them on a machine to pump blood and oxygen for them wasn’t enough, and the mother of three with an unexpected heart complication that left her family without a mom, she writes.
you could say, she’s the kind of person who wears her heart on her sleeve – she has a tattoo of the wavy line of a pulse rate from a hospital monitor on her lower arm. and she is adamant about having a publicly accessible healthcare system where people don’t have to pay, instead of introducing a for-pay system. “it would be heartbreaking if that happened in canada.”
dr. shazma mithani enjoying some time off with her husband.
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she’s seen firsthand how money can impact health. if people can’t afford medications, they get sicker and end up coming to hospital seriously ill, whereas if they had access to preventative medications for their blood pressure and their diabetes, for instance, they would be healthier and not resorting to acute care. “when we bring in the stress of having to think about how you’re going to pay for something, health outcomes get worse.”
every canadian needs access to a family doctor, she writes in an opinion piece. “we need a true understanding that the best patient care is care in the community, and that in part, hospitalization for preventable illness is a failure.” part of the solution to sustainable healthcare is systemic change that focuses on primary and preventive care, so that the er is no longer acting as the safety net.
she has taken her advocacy work to social media, building a following that has led to local and national media appearances. her videos range from tips to combat motion sickness and misconceptions about supplements to the shortage of family doctors and gynecologists in southern alberta that means many women don’t have any access in some cases to any prenatal care.
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for her efforts and dedication, mithani recently received the alan drummond advocacy award by the canadian association of emergency physicians. “dr. mithani has a truly impressive record of advocating for vulnerable populations, social justice and physician wellness, among many other things,” dr. alan drummond tweeted in a congratulatory note. “she also has a huge social medial presence and has used this wisely to inform the public and dispel the many myths that have emerged during the pandemic. at a time when we need physician advocates more than ever, it seems to me that dr. mithani is a great role model.”
in fact, social media has become an important tool for her as a physician to provide a credible voice to cut through all the noise. “as misinformation grows and as non-credible people are promoting non-evidence-based medicine and preying on the vulnerabilities of people, i think it’s more important than ever for more trained health professionals to get out there to provide that credible scientific evidence-based information. people need a reliable group of people to listen to and get that information from,” she says.
the takeaway she hopes to inspire through her social profile?
“the biggest thing is to be informed with credible information. one of the reasons that i started getting out there on social media is that the overall health literacy of the population is so low,” she notes. “i want people to know more about health and their bodies so that there’s empowerment that comes with information so that you can not only be informed for what you can do at home, but also be informed so that you can advocate for yourself within the system.”
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