Don Henry, my first great teacher, has given me a lifetime of unconditional support and love, and opened my eyes to any number of intellectual and artistic worlds.
Maurice Mierau has worked with me to teach narrative medicine to doctors and has treated me like a serious writer from the very beginning of our friendship. Marina Rountree-James has been a sounding board for ideas and an incredibly intuitive beta-reader on perennially short notice.
I am also indebted to Heather Gibson, the incomparable executive producer of NAC Presents, and her team at the National Arts Centre, for bringing the Insights: Arts, Medicine, Life series to the stage. (Thanks for giving me the microphone, it’s mine now.) Émilie Lacharité and Dr. Kirsten Patrick at the Canadian Medical Association Journal were the driving forces behind my work under the “Med Life with Dr. Horton” banner, including the “Dear Dr. Horton” column, a place where I eventually found my real voice. I’m so grateful to my friends and colleagues at the Canadian Medical Association and its subsidiary Joule for inviting me to join their crusade to improve physician health and the lives of all Canadians. I am proud to be part of their circle.
My friend and department head, Eberhard Renner, supported my taking an academic leave to finish this book, and more importantly, he has been a source of solidarity and shared values when it comes to the importance of the non-traditional work I am doing and the relationship between medicine and the arts. Several of my clinical colleagues and friends—Drs. Pam Orr, Len Minuk, Al (and Teresa) Bras, James Johnston, Martha Ainslie, Fred Aoki, Brian Schmidt, Don Houston, Sally Longstaffe, James Paul, Wendy Hooper, Debrah Wirtzfeld, Ken Van Ameyde, Joel Nkosi and Al Buchel—have been buddies in bad times, served as inspiration and created the circumstances for healing and laughter. Some have cared for me during tough times, and others have cared for members of my family with unbelievable skill and compassion, making all the difference.
My friends in allied health—all the helping professions—have enriched my life on every level. Many a difficult day has been made bearable by the kindness of my ward clerk friends, or laughter, debriefing and tears with my beloved nurse friends. Vanessa, Marcy, Egi, Eric, Diana, Blessing, Lisa, Lulu, Judy and too many others to name always managed to make the world brighter, no matter how hard the times. If one good thing has come from COVID-19, it is the sudden awakening in society to how much these people do for so many, and the grace and love with which they do it.
Many, many students have given my work as a teacher meaning and purpose, and I’ve learned from them too. I don’t have to name them. They know who they are. Thank you.
My dear friend Grant Mitchell has passionately supported my artistic efforts on all fronts and given steadfast support and key advice during challenging personal times. John Myers, another friend and kindred spirit, has provided me with brilliant and deeply generous counsel.
Jim McLaren has been an irreplaceable champion and friend. Dawn MacDonald has been a key catalyst. My friend and producer Eitan Cornfield has been a source of inspiration and special friendship to me for twenty years. We’re not done yet. Like so many doctors and health care providers, Alan Alda and his portrayal of Benjamin “Hawkeye” Pierce on M*A*S*H had a profound influence on the best parts of my clinical identity. I have benefitted from his immense kindness, as well as the important work being led by his team at the Alda Centre.
Many of my relationships from Chapin Mill have been sources of sustenance, strength and learning. Greg Collins and Jodie Katz will always be a part of my life; I am so grateful for their love, wisdom, laughter, friendship and openness to being themselves in this story. I am especially grateful to my teaching partner, Rick Szuster, for profound friendship and hijinks. Trish Luc was an important early mentor. I’m also indebted to Jonathan Starke, for his beautiful poem and the concept of working differently with things, and to so many others who have become part of my Chapin Mill family. The activities and teaching sessions described in this retreat are part of the Mindful Practice® program, created and developed by Drs. Ron Epstein and Mick Krasner while working at the University of Rochester. For more information about the Mindful Practice® program, please visit www.urmc.rochester.edu/family-medicine/mindful-practice.aspx.
I am filled with the deepest gratitude for my patients and their families. There are many, but in particular I want to acknowledge those whose surviving families have allowed me to share their true stories in these pages: Mike Yurkiw (Tom Yurkiw), Stan Bradley (Christine and Aidan Bradley), and Maureen and David, who will always have a special place in my heart.
So many other patients and families have changed my life by allowing me to care for them—too many to ever name. I will never forget you.
Thank you to The Arnold P. Gold Foundation and Dr. Richard Levin for honouring my work, championing me as a medical educator and leading the crusade for compassion in medical education and practice.
Thank you to my parents, who modelled unconditional love, unfathomable resilience, and even M*A*S*H-like humour in the worst of times, who did everything they could for all of us despite horrendous circumstances. If my compassion is exceptional, it is because of their example. It is impossible to do justice to the endless sacrifices they made for us, and how hard they worked to create the best opportunities they could for each of us to have a good life.
Thank you to my sister Heather, my friend and confidante, second mother to our children. I am so grateful for her.
Thank you to the many people who showed our family unforgettable compassion over the years—Wendy’s devoted health-care aides, Iris Anderson, Dr. Michael Stambrook, Debbie Clevett, Dr. Liesel Moeller and Dr. Carine Minders. Also, Tommy Hunter and others.
To my loving husband, Eric, a devoted father to our sons, who has so often allowed my work to come ahead of his, including and especially my writing, and has made its success a priority: Thank you, dear.
And thanks to my three incredible boys, who have given my life purpose and healing, who have even done what they could to help me make time to write, who have made it possible for me to have a good life, because a good life means love.
About the Author
JILLIAN HORTON, M.D., is an award-winning medical educator, writer and musician. She trained in internal medicine at the University of Toronto. For sixteen years, she has cared for thousands of patients in an inner-city hospital and mentored hundreds of students as an undergraduate associate dean. Named a leading medical educator by the Arnold P. Gold Foundation and the Association of Faculties of Medicine of Canada, she was the 2020 winner of the prestigious AFMC–Gold Humanism Award.
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Praise for We Are All Perfectly Fine
“Her writing is brilliant. And the story of her burnout as a medical doctor is just heartbreaking enough to keep you longing for the resolution you know is coming. Maybe the best thing about this book is that Jillian Horton allows you to grow as she grows, while saving you the pain of the struggle. But you will grow.” —ALAN ALDA
“It’s not the most expected memoir experience to feel like you’re in the grip of an action thriller, especially one that centres around an often-silent meditation retreat. It’s that silence, ultimately—for our turbulent, cynical, funny narrator—that gives her and us the heart to keep going, no matter what’s coming next.” —CATHRIN BRADBURY, author of The Bright Side
“Profound and compassionate. . . . Offers deep reflections on the private suffering of the healing professions. A must-read.” —DR. RONALD EPSTEIN, author of Attending: Medicine, Mindfulness, and Humanity
“A bold and inspiring account of great suffering and great healing. All of us can find an ally here, wise, dedicated and kind.” —SAMUEL SHEM, M.D., author of The House of God and Man’s 4th Best Hospital
“A bright, new voice—often very funny. Weaves a brief retreat and a life into a concerto about being a modern doctor. Doctors and patients of every age will want to read it word for word.” �
�RICHARD I. LEVIN, M.D., CEO of the Arnold P. Gold Foundation
“We Are All Perfectly Fine is an ode to the healing of healers. The author’s fierce love for humanity and life shines brilliantly throughout. . . . This is a book I didn’t want to put down.” —DARREL J. McLEOD, author of Mamaskatch: A Cree Coming of Age
Copyright
We Are All Perfectly Fine
Copyright © 2021 by Jillian Horton.
All rights reserved under International and Pan-American Copyright Conventions. By payment of the required fees, you have been granted the nonexclusive, nontransferable right to access and read the text of this e-book on-screen. No part of this text may be reproduced, transmitted, downloaded, decompiled, reverse-engineered, or stored in or introduced into any information storage and retrieval system, in any form or by any means, whether electronic or mechanical, now known or hereafter invented, without the express written permission of HarperCollins e-books.
Published by HarperCollins Publishers Ltd
As a memoir, this work describes how the author has experienced her life as a physician. Individual stories of patients, students and certain others are representative rather than real, except those told with permission. Composites have been used. See the Author’s Note.
“Start Close In” from David Whyte: Essentials (2020) and River Flow: New and Selected Poems (2012), © 2007 by David Whyte; “Enough” from Where Many Rivers Meet, © 1990 by David Whyte. Both poems used by permission of Many Rivers Press. All rights reserved. www.davidwhyte.com
FIRST EDITION
Epub Edition FEBRUARY 2021 Epub ISBN: 978-1-4434-6165-8
Version 01162021
Print ISBN: 978-1-4434-6163-4
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Library and Archives Canada Cataloguing in Publication
Title: We are all perfectly fine : a memoir of love, medicine and healing / Jillian Horton, M.D.
Names: Horton, Jillian, 1974- author.
Identifiers: Canadiana (print) 20200386689 | Canadiana (ebook) 20200386840 ISBN 9781443461634 (hardcover) | ISBN 9781443461641 (softcover) | ISBN 9781443461658 (ebook)
Subjects: LCSH: Horton, Jillian, 1974- | LCSH: Physicians—Canada—Biography. | LCSH: Physicians—Psychology. | LCSH: Burn out (Psychology) | LCSH: Job stress. | LCGFT: Autobiographies.
Classification: LCC R464.H67 A3 2021 | DDC 610.92—dc23
LSC/H987654321
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* I later learned that the poem was by David Whyte: “Start Close In,” in David Whyte: Essentials and River Flow: New and Selected Poems (Washington: Many Rivers Press, 2020 and 2012).
* The “invisible” moonwalking bear video (titled “Awareness Test”) was created in 2008 for Transport for London (TfL) as part of a safety campaign, “Look Out for Cyclists.” Developed by advertising agency WCRS, it was shown in U.K. cinemas for a week before being released on social media and going viral.
† Results of the “gorilla in the lung” study were reported in 2013 by researchers Trafton Drew and Jeremy Wolfe, and based in part on 1999 studies by Christopher Chabris and Daniel Simon, whose Invisible Gorilla test is still among the best-known demonstrations of “inattentional blindness.”
* In recent years, some descriptions of the experiment and its conclusions have come under fire, but nobody questions that Dr. Maslach was the one who put a stop to the stupidity.
* Saki Santorelli, Heal Thy Self: Lessons on Mindfulness in Medicine (New York: Bell Tower, 2000).
* Mary Oliver, “Wild Geese,” in Dream Work (New York: Grove/Atlantic, 1986).
* David Whyte, “Enough,” in Where Many Rivers Meet (Washington: Many Rivers Press, 1990).
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