I awoke to the sound of screeching tires, a crash and car alarms. I ran to my window and saw a car abutted against a house facing my apartment complex. Rushing outside into the blackness of night, I offered to help in any way I could.
Four people were injured, some seriously. They were taken to the local clinic — a small, modest building where I would be working for the next month. The only people there to attend to the injured were a nurse and two others who, like me, were medical students. I also went to the clinic. Greeting me with a smile, the nurse said, simply, “Welcome to Mistissini!”
It was my first day in Mistissini, a remote Cree community in north-central Quebec. The area is surrounded by natural beauty; ancient trees extend in all directions on the horizon. The air is clean and revitalizing, with a hint of pine. The beauty of the community stands in stark contrast to the many ugly problems faced by its citizens.
I was not expecting to encounter such a wide breadth of community issues: alcohol and drug abuse, physical and sexual abuse, obesity, teenage pregnancies, a low high school graduation rate. Nearly every family in this community is afflicted in some way. I was a world away, I realized, from the world I was familiar with.
Two weeks later, back at the clinic, I interviewed a young mother who brought two of her children to her appointment. Her daughter, with her big inquisitive eyes, was fascinated by the clinic’s utilities. She played with my stethoscope, placing it on the chest of her younger brother. When she heard his drumming heartbeat, her eyes radiated with enthusiasm.
Pondering on this moment, it’s hard for me to imagine where this eager, enthusiastic and curious young girl will be 15 years down the road. Perhaps she will become a health care worker. Or maybe she will have already been pulled into the vicious cycle of alcohol and drug abuse. Maybe she will already be a mother who, like so many others in her community, failed to finish high school. I hope my encouragement to pursue daring dreams made a difference, though I may never know if it did.
Though the people of Mistissini face many problems, there is a strong network of health care professionals dedicated to addressing those problems. Physicians, nurse practitioners, social workers, nutritionists — all working together, all passionate about improving the health and psychosocial issues in the community. This group of health care workers is driven to make a difference, establishing stability and continuity of care for their patients through a variety of means: rendezvous appointments, drop-in clinics, even home visits.
I felt immersed in the historical tradition of family medicine, a practice tailored to the patient with a personal and comprehensive level of care. It was humbling to see the importance and significance of the roles of family physicians in rural communities, their responsibilities ranging from prenatal health to palliative care. The health care professionals I worked with in Mistissini provided the comprehensive, patient-centred care that had been emphasized in my medical curriculum.
During my stay, I tried to help patients in many ways. I informed one patient how to manage diabetes and hypertension. I counselled another who had attempted suicide numerous times. I spoke about the importance of contraception and about other topics, some not related to health care, such as dreams and goals and having the will, determination and courage to pursue them. As I think back on my time in Mistissini, I can only hope I made a difference.
The day I left, as I flew over northern Quebec, I again noticed the beauty of the landscape. The autumn leaves, spread across the horizon, reflected the colours of the changing seasons. High in the air, all I could feel was a sense of peace and tranquility.
I also felt touched by a community that welcomed me with smiles and open arms. I left Mistissini with an appreciation of its social and medical problems and an understanding of the meaning and importance of family and community — thanks to the people of a small Cree community who truly seem to live in a world far removed from the one I knew.