“I tried to kill you this week.”
That opening line, from one of the refugee patients at Vancouver’s Bridge Clinic, startled family doctor Martina Scholtens, especially since the man, who had fled from Iraq, was smiling as he said it. When Dr. Scholtens asked him to explain, he pointed at the telephone, and said, “I tried to kill you twice this week, but nobody answered.” A lightbulb went off for Dr. Scholtens. “You tried to call me this week!”
“We had a good laugh about that,” Dr. Scholtens says, speaking about one of the many patients she saw working at Bridge Clinic from 2005 to 2015, sometimes with attendant translation hiccups. Around 80% of patients would require a translator, but they were often keen to practice their English, she says, and she often became an important part of patients’ lives, evidenced by her award-winning story, ‘The birthday party’, about doctor-patient boundaries.
Now in her third year of the Public Health & Preventive Medicine program and the first year of the Master of Public Health program, her work at the clinic remains a career highlight, Dr. Scholtens says – “Patients and colleagues, we laughed way more than people would expect.” She started working at the clinic after a stint in well-heeled Kitsilano.
“[Public health], it’s about the bigger picture.”
Dr. Martina Scholtens
Many of the patients were the “worried well,” and she realized she could do more with her skills at Bridge Clinic, to which she had been introduced during residency while tagging along with a preceptor.
The work was complex and challenging, with many of the patients having fled some form of persecution, and she preferred the team-based model with sessional rates accommodating longer appointments.A project borne from her time at Bridge Clinic, begun when on maternity leave for the last of four children, last year received provincial funding. Refugeehealth.ca serves as a hub of resources for clinicians caring for refugees, including directories of language-specific practitioners, translated handouts for patients, and health insurance details, and now serves as the provincial hub for healthcare related resources for Syrian refugees, Dr. Scholtens says.
“If you need to find a Farsi speaking dentist in Coquitlam, you could.”
Dr. Martina Scholtens
She decided to focus on public health after cuts to refugee insurance by the federal government showed her the benefits of working at a population level to implement change, rather than finding fixes for patients one by one. And as she was already performing population health-type work, only the academic background and formal training were missing. Health care cannot be 100% delivered one on one, she says – someone needs to look at the system, and population, as a whole.
The residents in the public health program at SPPH are her tribe, Dr. Scholtens says, and the academic half days where they all get together make Fridays her favourite day of the week.
“Every single resident made a point of coming up to me and introducing themselves on the first academic half day.”
Dr. Martina Scholtens
Her move into public health is the logical next step for her family medicine practice, Dr. Scholtens says, and she hopes to do a mix of clinical and non-clinical public health work in the future.
As for the near future, she has a creative non-fiction book coming out next fall about an Iraqi family’s first 18 months in Canada from the perspective of a family physician. Apparently, a public health perspective is the top contender for the next novel. “I started collecting ideas from my first week in the program.”
“You can’t learn about Typhoid Mary and not see the literary possibilities.”
Dr. Martina Scholtens