White Coat, Black Art

Prescribed reading: How a book club helps health-care workers 'understand why we do what we do'

Since 2017, emergency staff at the William Osler Health System have been meeting regularly at Brampton Civic Hospital's auditorium to discuss book selections. Hospital staff say the book club helps them reconnect with their purpose and their patients.

'Whatever helps us in a positive way affects patient care,' says emergency nurse

Some reading recommendations from Osler ED Book Club's Dr. Phil Vayalumkal, Dr. Jeff Handler and Dr. Prashant Phalpher 1:48

Inside a Brampton, Ont., hospital, a group of health-care workers struggle to discuss aging and end-of-life care decisions.

At the heart of the discussion is American surgeon Atul Gawande's personal journey navigating his father's end-of-life care, which he chronicles in Being Mortal — one of the books the Osler Emergency Department Book Club has reviewed.

"We're somehow expected to have these difficult discussions with patients and in challenging scenarios," emergency physician Dr. Prashant Phalpher told White Coat, Black Art.

"Yet even just amongst ourselves in a book club, in the most non-threatening environment ... it was difficult just to have that discussion."

White Coat, Black Art's Brian Goldman with some members of the committee that started the book club. From left to right: Dr. Jeff Handler, Dr. Brian Goldman, Dr. Prashant Phalpher, Christina Ferguson, Alina Lobianco and Dr. Phil Vayalumkal. (Jeff Goodes/CBC)

Since 2017, emergency staff at the William Osler Health System — a network of hospitals in Ontario's Brampton and Etobicoke areas — have been meeting regularly at Brampton Civic Hospital's auditorium to discuss the selected book, enjoy catered snacks and mingle with other colleagues. They've had as many as 65 people come.

Phalpher says they encourage people to drop by even if they've only read the cover or summary. 

"I think that this is a way to get people excited or interested. And I feel like a lot of our colleagues will often read the book after the book club because they've heard so much about it and they've heard the discussions."

The informal discussions can carry on during their shifts and in the hallways, says Phalpher, and that "generates a lot of great ideas and ... enthusiasm."

'Team-building' opportunity 

Dr. Jeff Handler, who is among those who started the book club, says the meet-up provides an opportunity to bring together staff from various hospitals to share experiences and "understand why we do what we do for patient care."

"I believe that the major effect of this is to engage so many staff. We work often in silos. We work in very stressful environments," he said.

Emergency nurse Alina Lobianco considers the book club "a team-building" opportunity.

"In the private sector, they did quite a bit to engage their staff and it really benefits them in so many ways that you can't really measure," she said.

I know if I'm happy then my patients are happy.- Alina Lobianco

"However, we don't always have those opportunities. And so we created our own, which it is enlightening, really."

For Lobianco, it's a way to connect with her patients and her colleagues.

"Whatever helps us in a positive way affects patient care," she said.

"I know if I'm happy then my patients are happy."

State of health care and 'moral injury'

Emergency physician Dr. Phil Vayalumkal points to deteriorating conditions in hospitals across the country that can be demoralizing.

When medical staff are put in the position where they see a difference between "how we should be caring for patients" and the realities of their working environment, it creates this "moral injury," he argues. 

"And the question that arises is, 'Why are we doing this in the first place?'" 

That question is "often answered" through the discussions that develop from the book club, Vayalumkal says, "because we remember those first principles of our profession: that is to provide care with compassion, altruism, service, sacrifice."

These themes are brought up through the various books discussed in the club, he adds, which includes Dr. Herbert Ho Ping Kong's The Art of Medicine, and The Culture Code by Daniel Coyle. 

Vayalumkal says bringing literature back into his profession "helps us in medicine."

"Bringing the art — just artistic endeavors, from literature, music, whatever it may be — helps us develop a creativity that allows us to tap into new ideas, new approaches in what we do."

Written by Ruby Buiza. Produced by Jeff Goodes.


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