Mansbridge One on One: Dr. Nadine Caron, Canada's first female Indigenous surgeon

Summary

Dr. Nadine Caron, Canada's first female Indigenous surgeon, shares her journey from basketball player to medical pioneer. She discusses the cultural divide in healthcare, advocating for culturally safe practices and addressing the systemic racism faced by Indigenous patients. Dr. Caron's experiences highlight the need for trust, respect, and understanding in the medical field, as she strives to change perceptions and improve healthcare for Indigenous communities.

Takeaways

• 👩‍⚕️ Dr. Nadine Caron is Canada's first female Indigenous surgeon, breaking barriers in the medical field.
• 🏥 Dr. Caron emphasizes the importance of cultural history and background in patient care, advocating for culturally safe healthcare practices.
• 📚 As a professor at UBC, she educates on the intersection of medicine and anthropology, aiming to change healthcare for Indigenous peoples.
• 🏆 Her journey to becoming a surgeon began with a pivotal moment during a basketball championship, where she shadowed a surgeon for the summer.
• 🩸 Dr. Caron describes the emotional challenges of her profession, particularly in building trust with patients who are scared or in pain.
• 🌐 She discusses the disparities in healthcare availability and options between metropolitan areas and Indigenous communities.
• 🌿 Dr. Caron highlights the need for healthcare providers to understand and respect the cultural backgrounds of their patients.
• 💔 She shares personal experiences and stories that reveal the systemic racism present within the healthcare system.
• 👵 A poignant moment is shared where an elderly Indigenous patient expresses relief and joy at being treated by an Indigenous doctor for the first time.
• 👨‍⚕️ Dr. Caron recounts a story of a colleague's racist comment and the subsequent apology, illustrating the potential for change and growth within the medical community.
• 👨‍👧‍👦 She discusses the impact of Canada's history with residential schools on successive generations, including her own family.

Q & A

Who is Dr. Nadine Caron?

Dr. Nadine Caron is Canada's first female Indigenous surgeon, working at a hospital in Prince George, British Columbia.

What is Dr. Caron's approach to treating Indigenous patients?

Dr. Caron emphasizes the importance of considering the patient as the expert, including their cultural history and background in their treatment.

What impact does racism have on Dr. Caron's patients?

Racism affects Dr. Caron's patients by causing distress and concern, which can lead to a lack of trust in the healthcare system and potentially hinder necessary medical care.

How did Dr. Caron become interested in a career in medicine?

Dr. Caron's interest in medicine was sparked during a visit to Jackson, Tennessee, where she shadowed a surgeon and was deeply impressed by the surgeon's calm and focused approach during an emergency operation.

What challenges does Dr. Caron face as a surgeon in Prince George?

Dr. Caron faces challenges such as the emotional difficulty of building trust with patients who are scared or in pain, and the reality that the medical options she learned in metropolitan centers may not always be feasible for her patients in Prince George.

Why is cultural competence important in healthcare according to Dr. Caron?

Cultural competence is important because it allows healthcare providers to build trust and understanding with their patients, leading to more effective treatments and better patient outcomes.

What is an example of racism Dr. Caron has witnessed within the healthcare system?

Dr. Caron recounts an incident where an elderly First Nations patient cried upon meeting her, expressing relief at seeing an Indigenous doctor for the first time in her life, highlighting the systemic lack of Indigenous representation in healthcare.

How does Dr. Caron handle patients who are not comfortable with her Indigenous background?

While Dr. Caron has not personally experienced patients refusing her care due to her Indigenous background, she chooses not to share her background with those who are not Indigenous, anticipating that it would not be viewed positively.

What was the outcome of a racist comment made by a fellow surgeon that Dr. Caron confronted?

After a fellow surgeon made a racist comment, Dr. Caron responded and later received a heartfelt apology from him years later, indicating a change in his perspective and a recognition of his past biases.

How does Dr. Caron's family history relate to her work and message?

Dr. Caron's family history, including her mother's experience as a residential school survivor and her own journey to becoming a surgeon, underscores her message about the importance of cultural understanding and the potential for positive change in Canada.

What is Dr. Caron's vision for the future, particularly for her daughter?

Dr. Caron hopes for a future where Canadians have higher expectations for themselves, no longer tolerating racism or discrimination, and where her daughter can be proud of her Indigenous heritage without facing prejudice.

Outlines

00:00

👩‍⚕️ First Female Indigenous Surgeon in Canada

Dr. Nadine Caron, Canada's first female indigenous surgeon, is highlighted in this paragraph. She is shown at work in the scrub room at a hospital in Prince George, British Columbia. Dr. Caron is described as being in high demand, both at the hospital and at medical conferences where she advocates for a change in the treatment of indigenous people. She emphasizes the importance of considering the cultural history and background of patients in their healthcare. The paragraph also shares a personal story of Dr. Caron's journey into medicine, which began with a basketball team sponsorship by Hospital Corporation of America, leading to her witnessing surgery and deciding to become a surgeon.

05:03

📚 Cultural Competence in Healthcare

This paragraph discusses the importance of cultural competence in healthcare, particularly for First Nations and Aboriginal patients in Canada. Dr. Caron points out that while guidelines exist, they are not always applicable due to the unique circumstances of indigenous communities. She stresses the need for trust, understanding, and respect in patient-physician relationships. The paragraph includes a powerful account of an elderly First Nations woman who, upon meeting Dr. Caron, expresses relief and the desire for her community to see an indigenous doctor, highlighting the impact of representation in healthcare.

10:04

🌐 Encounters with Racism in Medicine

Dr. Caron shares her experiences with racism within the healthcare system, both as a provider and as a witness. She recounts a patient's discomfort upon realizing Dr. Caron's indigenous background and her own feelings of sadness that such attitudes persist. The paragraph also includes a story of a colleague's racist comment and Dr. Caron's response, which led to a later apology and reflection on the part of the colleague. This narrative underscores the ongoing struggle with racism and the potential for growth and change within the medical community.

15:05

👨‍⚕️ Apology and Reflection in Medicine

In this paragraph, Dr. Caron recounts a significant apology from a surgeon who had previously made racist comments. The apology, which came years later, was heartfelt and indicative of a deeper understanding and change in attitude. It serves as a poignant moment of personal growth for the surgeon and a symbol of hope for broader societal change. Dr. Caron reflects on the importance of Canadians acknowledging historical wrongs and working towards reconciliation and improvement.

20:08

👨‍👩‍👧‍👦 Intergenerational Impact and Hope for the Future

The final paragraph explores the intergenerational impact of Canada's history on indigenous people, particularly through the experiences of Dr. Caron's family. Her mother was the first to graduate high school from their reserve, and Dr. Caron herself became the first female indigenous general surgeon in Canada. The paragraph discusses the challenges her daughter faces, including racism and misconceptions about her indigenous heritage. Despite these challenges, there is a sense of pride and hope for the future, with Dr. Caron's daughter embodying resilience and a strong sense of identity.

Keywords

💡Indigenous

Indigenous refers to the original inhabitants of a particular place who are often distinct culturally, linguistically, or genetically from other people who arrive or invade the area later. In the video, Dr. Nadine Caron is Canada's first female Indigenous surgeon, signifying a breakthrough for representation and diversity in the medical field. The term is crucial as it highlights the underrepresentation and challenges faced by Indigenous people in professional roles.

💡Surgeon

A surgeon is a medical professional who performs operations. Dr. Caron, as a surgeon, is in a position of trust and responsibility, requiring extensive medical knowledge and skill. The video emphasizes the significance of her role, particularly as an Indigenous surgeon, in providing culturally safe care and changing perceptions within the healthcare system.

💡Cultural Competence

Cultural competence in healthcare refers to the ability of healthcare professionals to deliver services that meet the cultural, linguistic, and social needs of diverse patients. The video discusses the importance of cultural competence, particularly in treating Indigenous patients, where historical and ongoing systemic issues require a deeper understanding and respect for their cultural backgrounds.

💡Racism

Racism is prejudice, discrimination, or antagonism directed against someone of a different race based on the belief that one's own race is superior. The video script addresses racism within the healthcare system, illustrating its impact on both patients and healthcare providers. Dr. Caron's experiences provide a personal perspective on how racism can affect patient care and trust.

💡First Nations

First Nations is a term used to describe various Aboriginal peoples in Canada who are neither Inuit nor Métis. The video script mentions First Nations patients and the unique healthcare challenges they face due to historical and cultural factors. Dr. Caron's identity as an Indigenous surgeon allows her to connect with her First Nations patients on a deeper level.

💡Cultural Safe Care

Cultural safe care is an approach to healthcare that ensures the cultural safety of patients, recognizing and respecting their cultural identity, beliefs, and values. The video emphasizes the importance of cultural safe care in creating an inclusive healthcare environment where Indigenous patients feel respected and comfortable.

💡Residential Schools

Residential schools were government-sponsored religious schools that aimed to assimilate Indigenous children into Euro-Canadian culture during the late 19th and mid-20th centuries. The video script references the lasting impact of residential schools on Indigenous communities, including the experiences of Dr. Caron's mother and the broader intergenerational trauma.

💡Truth and Reconciliation

Truth and Reconciliation refers to the process of acknowledging past wrongdoings, especially in the context of historical injustices, with the aim of promoting healing and understanding. The video mentions the Truth and Reconciliation Commission of Canada, which investigated the Indian Residential School system, as a step towards addressing past injustices and fostering a more inclusive society.

💡Representation

Representation in this context refers to the inclusion and portrayal of a particular group or individual in a particular field or role. Dr. Caron's role as Canada's first female Indigenous surgeon is highlighted as an example of representation, showing the importance of having role models from diverse backgrounds in professional fields.

💡Healthcare System

The healthcare system encompasses all organizations, people, and actions whose primary intent is to promote, restore, or maintain health. The video discusses various issues within the Canadian healthcare system, particularly concerning the treatment of Indigenous patients and the need for cultural sensitivity and understanding.

💡Stereotypes

Stereotypes are widely held but fixed and oversimplified ideas or images of particular types of people or things. The video addresses how stereotypes about Indigenous people can negatively impact their healthcare experiences and perpetuate harmful biases within the medical community.

Highlights

Introduction of Dr. Nadine Caron as Canada's first female Indigenous surgeon.

Dr. Caron's dedication to treating Indigenous patients with respect for their cultural background.

The importance of understanding patients' cultural history in medical treatment.

Dr. Caron's experience as a professor at UBC and her advocacy for cultural sensitivity in healthcare.

The story of Dr. Caron's journey to becoming a surgeon, starting with a pivotal moment in 1992.

The emotional challenge of building trust with patients who are scared and in pain.

Dr. Caron's perspective on the differences in healthcare between metropolitan centers and Prince George.

The necessity of culturally safe care in healthcare systems.

Dr. Caron's experience with racism within the healthcare system and its impact on patients.

A patient's emotional response to being treated by an Indigenous doctor for the first time.

Dr. Caron's view on the importance of cultural competency in healthcare.

The apology from a colleague who had previously made racist comments, and its significance.

Dr. Caron's thoughts on the current state of reconciliation and the actions Canadians can take.

The impact of residential schools on Dr. Caron's family and the importance of acknowledging this history.

Dr. Caron's daughter's experience with racism and her response to it.

The potential future paths for Dr. Caron's daughter and the importance of cultural pride.

Dr. Caron's call to action for Canadians to elevate their expectations and intolerance for racism.

Transcripts

[Music]

[Music]

take a look at this scene because

something special is happening

here it's the scrub room at a hospital

in Prince George British

Columbia all looks routine until you

hear about the doctor scrubbing in are

you guys ready for us to start

that's Dr Nadine Caron and she is

Canada's first female indigenous surgeon

can I have a l she's in constant demand

at the hospital by her

patients at home by her 10-year-old

daughter and at medical conferences

across the country where she's trying to

change the way we treat indigenous

people the patient is the expert

everything down to their cultural

history and their cultural background

and where they reflect from every day

she sees the impact that racism has on

her patients and on her as their doctor

Caron is also a professor at UBC she

often drops by the Museum of

anthropology we talked about something

that may make you wonder about your

country and how we as Canadians see each

other let's talk

about being a

surgeon being a doctor when did you

first realize that that's what you

wanted to do you know what it's it's one

of those things that it's the most

bizarre story but it comes down to an

actual moment in time it was back in

92 and uh SFU our basketball team was an

amazing team we were down at National

Championships and they they made it so

that all 16 teams that got to the

national championships were assigned a

corporate sponsor our corporate sponsor

was HCA or Hospital Corporation of

America and they off offered the

opportunity for us to come down to

Jackson if there was any of us

interested in the field of medicine what

were you wanting to be at that point I

was waned to be a national champion in

basketball but were you heading in a

certain direction you know I had done

kinesiology at SFU so I was studying

human physiology and human movement and

I loved it so I got on a plane and went

down to Jackson my first night there I

arrived they had this welcome barbecue

for me and a whole bunch of of

Physicians were there and administrators

and they introduced me to a physician a

surgeon that said that he would take me

on as a shadow for the summer and uh I

was there for about an hour at his house

uh for this welcome barbecue and his

pager went off and so I said you know

I'm here to follow you I'd love to come

so we're heading in this pickup truck

down these dirt roads in in Tennessee

and uh we head into the hospital and I

see the ambulance pull in just as we

pull in everything was happening in slow

motion as I saw the chaos but he seemed

so calm and all of this um we went to

the office operating room and on the way

in he was asking me questions have you

ever uh seen a lot of blood and I was

like well you know I've cut myself a

couple times he's like have you ever

seen anyone die um no have you ever been

in an operating room no the nurse has

just basically scrubbed for my hands for

me to get me into sterile gown and I

stood at the operating table and uh he

asked me if I was ready um and he

started he was so calm he he knew what

he was doing uh he was so focused by the

time we were finished it was about 1:00

in the morning and uh I was covered in

blood I was just amazed at what I had

just witnessed and I remember going into

the bathroom and there was the

oldfashioned paper towel and I was

rolling it down and I wrote my

experience down on this piece of paper

towel um and uh I it was this is when it

started off with I found it this is what

I want to do and it was just moment in

time you were hooked I was hooked what's

the most challenging the most

challenging um getting from that point

to this point I think what's hard is the

emotional part of it it's um it's having

that honor of asking questions to people

who are scared who are in pain and they

don't know you and there's this this

need to find that level of trust uh so

that you can help them but they can help

you all of a sudden it's this instant

team um and you both need to be in it

all

in want to take that and so you use it

as a pen like a pen

yeah thanks living up in Prince George

living in the north uh the demographics

are very different than my training in

the metropolitan centers I did my

education in Vancouver San Francisco

Boston um I'm in a different world I'm

in a place where the options that we see

and the options we studied from

textbooks and guidelines from National

organizations they're not always

possible for the people that you're

talking to and what do you mean by that

what I mean by that is I think as um as

um a patient and a physician

relationship or a nurse or a dentist or

a pharmacist or a midwife it's a it's a

relationship and relationships are built

on trust

and understanding and respect and I

think that I've witnessed it we fall

short when it comes to understanding and

respecting and honoring the culture of

First Nations Aboriginal patients in

Canada and it's based on a lot of it's

based on history and so sometimes it's

just the fear or the um the worry that

if you do as a first nation's individual

enter into the Health Care system at any

point whether it's for the screening or

the ultimate treatment or the followup

um are you going to run into issues with

the lack of cultural competent care

culturally Safe

[Music]

Care I'd like to Now call on Dr n Cat on

to uh give the next talk as the healthc

care provider the person with the power

the person with the degrees and the

initials after your name you're learning

from your patient you're asking the

questions because you have no idea where

the abdominal pain is you do not know

how long that headache's been there and

you don't know what surgeries they've

had in the past or what their allergies

are the patient is the

expert everything down to their cultural

history and their cultural background

and where they reflect

from it's not just the skill of the KN

for the scalpel it's not just the what

you hear with a stethoscope it's not

just being able to read the X-ray or get

a spec CT scan it's pulling that all

together so you can communicate that in

a culturally safe environment so that

anyone of any background feels

comfortable coming in to your office to

your clinic to your hospital uh and

realizing they're going to be respected

and acknowledge for what they bring to

the table one of the areas that you've

been fairly out spoken on is the issue

of racism within the Health Care system

which is a difficult discussion um and

I'm sure at times a painful one for you

a times caught in the middle on this

give me a sense of an example for

you of how you've seen racism within the

system when it comes to the patient care

that's delivered for uh First Nations

are indigenous

peoples an example a patient walks into

my office she's a First Nations lady

that's traveled the distance and I walk

in and um she I ask her what nation

she's from and she tells me and uh I

explain oh you know I'm anishnabe I'm

from the other end of Canada um and she

starts to

cry she just breaks down

crying she's I don't know in her early

80s and she says I never thought I would

ever ever see and come to talk to an

Indian

doctor eight decades she goes you got to

meet my

grandkids you got to talk to them you

got to come to my community you got to

tell them that this is possible and so

it's not there so there's that element

of it where that you just see this

relief you know sort of wash over her

face and what's it doing to you it's

amazing it's an incredible honor um it's

that's a incredible responsibility what

is the racism in that story is it simply

that this woman in her 80s had never

been in a situation before where she

was being dealt with by an indigenous

doctor yeah and that's how it started

and then we started talking and then I

started realizing that a lot of the

things that was on her sort of chart

that had been sent to me by the

referring physician there was so much

missing things that she hadn't done and

so she'd come to me for one reason and

we started talking about okay besides

all that you know have you had a

mammogram because she she wouldn't she

didn't trust going into the medical

system but I had this opportunity to

work with her to sort of say okay how

can we take advantage of this safe space

that we have right now to optimize the

things that that have sort of fallen off

the Wayside because of a level of

distress you know a level of concern um

and you certainly see that I still see

it too

much I feel it too much and I hear about

it too much have you had the opposite

example where a patient has come to

you and when that patient recognized

that you were First Nations they said

you know I'm not comfortable here yeah

you know what I'm not not that I'm aware

of you know not that I'm aware of um but

having said that um I don't share my

background with someone who's not

indigenous because I don't think they'll

care I don't think they'll find that as

a POS why you don't you don't share

because well that point yeah wouldn't be

a positive thing I don't think they'd

find that a positive thing is that a

pretty sad admission I guess it

is when you wear your white coat or

you're a physician people don't say

racist things up to right to your face

when you have initials after your name

they they kind of they can't really say

you know those stupid you know those

stupid Indians those First Nations you

know they're graduation rate they can't

even get out of high school they can't

say that kind of stuff because I'm

protected by these sort of Western

measures of

success but I hear it and I and I hear

it enough because I have this honor of

meeting on a daily basis new patients

that come through the door and share

their stories with

me

what about your colleagues what have you

seen not necessarily about you but about

the patients as you're saying in Prince

George where most of your work is a lot

of the patients are indigenous or First

Nations yeah a lot of the surgeons

obviously are

not yeah and so what do you see from

them yeah um there are a few examples

that really hit home I remember one in

particular um because it was it was a

fundamental learning experience for me

very very early on in in my training

when you're training you're in so many

different hospitals all over the country

and I was sitting in this um Lounge a

surgery lounge and uh a gentleman came

in that was obviously a surgeon that had

just finished a long case he was sweaty

and um and I know the feeling you can be

pretty drained uh and he sat down at our

table and he said you know if I never

operate on another Indian it'll be too

soon and

um it was hard because it was awkward um

it hurt I was angry like this

instantaneous like gut gut reaction to

it and um so I I would say my mom taught

me if if you ever feel that way just

count to 10 don't say anything don't do

anything um and so at the end of it I

just sort of said well you know if you

don't want to operate on the Indian and

get paid then you certainly don't want

to eat with an Indian for free and I

sort of packed up all my stuff put it on

my tray and and walked away and um I

didn't know what else to do but I needed

to get out of there and I also needed

him to hear that it wasn't all right and

that he that that it hurt and and that

it was wrong um but it was odd because

as I went on across the lounge slowly

one by one the other surgeons at the

table that I was with they packed up

their stuff and they moved away too it

was it was awkward and um eventually I

looked over and he was sitting at this

table by

himself and uh and then next operation

started I had to go get ready and the

day went on and then it wasn't until

much later about four years later after

that day um I I I was in a situation

where I was seeing him quite frequently

again and uh he came up to me and he

said you know do you have time to talk

and I said sure and and uh I I thought

he was going to talk about a a clinical

case or a referral or something and he

said um I I wanted I I wanted to

apologize and I was apologize for For

What and I was thinking could he

possibly be talking about this because I

thought to him it was just another day

and he said do you remember it and I

said I remember it I remember it and he

said um well I'm sorry and I said well

what are you what are you sorry for are

you sorry for hurting my feelings are

you sorry

like what are you sorry for and he said

well that's just it lady he said I know

that if I would have said sorry that day

you never would have accepted it because

it's bigger than that and it's I've been

thinking about it and every throughout

the years when I see a patient who's

obviously Aboriginal now I catch myself

I I think about that day I think about

that experience I think about what I

said and I realized just how wrong it

was and and my assumptions and the

biases and the stereotypes and the

racist way I thought to hear his apology

so so honest and transparent and so

genuine and and what I've said is I

think that's the apology that ainal

people in Canada are waiting

for you know there are probably

thousands of Canadians if not hundreds

hundreds of thousands of

Canadians um who would like to fulfill

what you just

said

and they probably don't know how they

can do

that you know people argue and you know

we've witnessed I've witnessed it for

longer and and seen it that exact kind

of feeling that doctor had in the

initial

conversation but I think we're living

through a time now I think think you

know

people tell me that we are where where

Canadians have realized the wrong was

done they've listened to Truth and

Reconciliation they've listened to

Murray Sinclair yeah they're not sure

what it is they're supposed to do

yeah you know what I

can it's come up it's come up been

conversations that I've had and I think

it's Having the courage to die into the

history of of what our country is made

of um and and looking at it differently

um and recognizing that that's who you

are as Canadian and be proud of

everything that's great about Canada um

and fix what's

not we're part of the mang Gand yeah you

can say it really well wolf Clan the

wolf brings the spirit of the people

together and teaches the importance of

family and community be kind to your

family always try to be thankful for

them I've witnessed firsthand how

residential schools continue to

impact the generations that

follow I my daughter is 10 I asked her

permission to tell this story thanks

Mom we were driving one day and it was

she was four and uh it was in the

springtime and so it was just a couple

months away from when she was stting

kinder Garten and I'd actually even

taken her to the school where she was

going to be going to show her you know

this is a school this is a playground

and she was pretty pumped about that and

and I'm driving her to her daycare one

day and I look in my rearview mirror and

she's sitting in the booster seat and

she's crying like tears are just

streaming down her face so I don't know

what's going on so I pull over and I'm

like Alia like what's what's going on

and we had just driven driven by this um

this development that they cut down all

the trees only one big huge house on

this development and it was just dirt

surrounded by dirt and uh there's no

siding on the house and that one of the

windows was broken so it was all boarded

up and and she said is that where I'm

going to

school I said no you're not going to

school there I showed you the school

you're going to the school with the

playground and she goes no is that where

I'm going and I

said why why would you think that and

she said when you Dro me off at school

are you going to allow to are you going

to be allowed to pick me

up are you going to be allowed to see me

and then I realized you know just

started thinking about she's heard about

my mom's experience she's overheard me

talking to my mom she's overheard the

stories on the news she's she's Canadian

it was an eye opener to me that I

couldn't shelter her from this history

and nor should I

[Music]

so right there that answer and that

answer

and

okay yes good job good job the history

of your family is

is fascinating in terms of the span of

your mother

you and now your daughter your mother

went to residential

school she graduated yeah high school

and residential school yep she was the

first on her Reserve to do that and the

next first was you yeah okay you begin

your pathway you go through high school

you go through University you lost the

basketball

count them all you become the first um

female general

surgeon in the Aboriginal in the

country now we look at your daughter as

10 yeah what's the pathway for

her H you know what

I I think we're at a Crossroads I think

that we have some uh amazing choices to

make as a country are we going to really

grab them we've got the hook in are we

going to reel them in so what's my

daughter's path she's proud she's proud

of her

background she doesn't understand why

and she has there have been incidences

already in her young life where she's

been told quite clearly it's it's not

that great to be an

Indian she's been made fun of in terms

of her background because she's proud of

it so she wears that on her sleeve um

but I love her response her response is

that she just feels sorry for those

people that don't understand how

wonderful that history is I think we

have to start elevating our level of

what we expect from ourselves as

Canadians what we're going to tolerate

and what we will no longer

tolerate well on that note uh I thank

you so much I mean obviously we've Ted

talked about a lot more than just health

care and surgery and the issues that are

everyday ones for you but a life concern

of yours is one we've we have talked

about and I uh feel richer for having

had that opportunity well thanks so much

thank

you