Medical Alumni Association Awards

Whether the story is told by the character in an opera he’s learning or by a patient in his Toronto psychiatry practice, Dr. Avery Krisman is fascinated by what the story reveals about the person who shares it. His approach to psychotherapy grew from his interest in talking with patients to understand who they are as people, not to diagnose them into a pre-established category.

“It puts me in the position to listen to what they’re saying,” Dr. Krisman says. “Not necessarily in a conscious way, people tell me about how they view the world and how they live in the world through their stories. People are complicated so I don’t get the whole picture in the first session or sometimes even in the fiftieth, but if I listen carefully, I come to understand somebody in a way maybe they haven’t even understood themselves.”

In medical school at UBC, Avery was the student who could sing. He joined a madrigal group, took voice lessons and was sought out for skits night. His talent for music helped him fit in.

“Medical school was a mismatch for me in a lot of ways, but a few teachers caught on that I was a fish in the wrong pond,” Dr. Krisman says.

During a third-year rotation at Shaughnessy Hospital, Avery ignored a page to call the Dean’s Office thinking it couldn’t be anything good. It turned out he was chosen for an all-expenses paid trip to an important diabetes conference in Boston, attended by students who had already published papers and lined-up positions in the field.

“Dr. Dawson, a clinical faculty member in endocrinology, had put my name forward sensing I had some potential that I wasn’t really realizing yet,” he says.

Dr. Krisman discovered his potential in psychoanalytic thinking, psychotherapy and opera during his residency in Toronto, with the help of some inspiring mentors. One of them was his new singing teacher, who informed him that he had a good voice but didn’t know how to sing. Humbled and offended, Dr. Krisman put some sweat into learning to sing well, and in the past decade he has performed in over a dozen operas.

“It’s a fabulous distraction from my emotionally taxing work,” he says. “It’s good to have that sort of outlet.”

Alongside his private psychotherapy practice and his singing, Dr. Krisman also dedicates some of his time to working with the chronic population, people who are down on their luck and seen to be suffering persistently from mental difficulties. He has also taught undergraduates and residents, mostly supervising in psychotherapy. In working with the chronic population Dr. Krisman feels it is particularly important to listen for their view of the world and to try to understand them as unique individuals rather than as a series of impersonal diagnoses and labels. “I try to encourage this approach with students as well, counter to the current wave in psychiatry.”

“In my career and my life, I’m most proud of the things I’ve pursued that were hard, that I didn’t think I was going to be able to do,” Dr. Krisman says. “The last three operas I’ve done were 20^th century pieces, and if you know anything about opera, you’ll understand they’re a pain in the neck. When I’m with a patient and I think I’ve got it all figured out, I’m receptive enough to realize, wait a second, that’s wrong. Something new has come up in what they’re saying and the whole picture is changed. I never let myself settle on a rigid formula. Each person is completely different than the last person I saw. The prospect and privilege of getting to know somebody and their life is really exciting to me.”

–Written by: Anne McCulloch

A guiding principle of working with people with brain injuries is helping them find “somewhere to live, someone to love and something to do.” UBC alumna Alison McLean, BSc (OT)’89, MSc’10, aspires to help her clients achieve all three during their recovery and rehabilitation. She has witnessed how it can be incredibly challenging to live a fulfilled life when one of those aspects is missing. McLean finds personal and professional meaning in working together with clients towards their goals and seeing them become involved in activities and roles important to them in their lives.

Back in high school, the description of the Occupational Therapy (OT) degree program in the UBC course calendar immediately peaked McLean’s interest. Her interest was confirmed through volunteer work with Sunny Hill Health Centre for Children, the Disabled Skiers Association of BC and at a summer camp for teens with disabilities. She felt pursuing a degree in OT at UBC was a good fit for her because it would allow her to contribute to individuals’ physical, social and psychological well-being. OT is the practice of enabling individuals to participate in the occupations of everyday life self-care, leisure and productivity.

After graduation, McLean found work in a brain injury rehabilitation program at the George Pearson Centre, and she continues to work in brain injury rehabilitation today.  Currently with the Acquired Brain Injury Program’s Outreach Team at the GF Strong Rehab Centre, she works with individuals living in the community who may be a few months or many years post brain injury.  She has also worked in medico-legal assessment with OT Consulting/Treatment Services Ltd. since 1995. McLean joined UBC’s clinical faculty in 2001 and began teaching clinical reasoning, evidence-based practice and neurological rehabilitation with a special focus on cognitive rehabilitation.

As a clinician and instructor, McLean found it necessary to keep up-to-date with clinical research evidence. After working as a clinician for nearly two decades, she felt it was time for a new challenge and direction in her career. She wanted to boost more than just her practical skills and knowledge—she wanted to bring something new to the table. Pursuing a Master of Science degree seemed like the perfect fit. It was never a question where she would go for her Master’s. With her life firmly rooted in Vancouver and a high regard for the OT program at UBC, her choice was simple—an MSc in Rehabilitation Sciences at UBC. Her thesis focused on exploring social participation and subjective well-being for individuals attending brain injury drop-in centres.

After graduate studies, McLean found her strongest interest lay with knowledge translation—taking new research evidence and integrating it into clinical practice.  She has returned to full-time clinical practice, but has increased her involvement in research, teaching and knowledge translation projects. Currently, McLean is working with a research team at the GF Strong Rehab Centre examining the use of a number of cognitive assessments. As part of a Vancouver Coastal Health regional working group, she is also assisting clinicians to enhance best practice in the area of cognitive assessment and rehabilitation. Now a Clinical Assistant Professor, McLean continues to teach within the Department of Occupational Science and Occupational Therapy, and she has co-developed and co-instructed a two-day workshop for OTs in assessment and intervention of executive dysfunction.

McLean also spearheaded a project to develop a decision-making tool (clinical algorithm) to guide OTs in their clinical reasoning and decision-making during the process of cognitive assessment. Her goal was to develop a tool that could be used for both OT students and clinicians. Finalized in 2011, the algorithm has practical uses across client populations, from acute to long-term care. It has become the basis of an OT clinical practice guideline in Vancouver Coastal Health. The cognitive assessment algorithm has also been shared at conferences nationally and internationally. Bridging the gap between research and clinical evidence to create a tool that enhances clinical practice has enabled McLean to merge her passions in clinical work, teaching and research and give back to a profession that has given her so much over the years.

–Written by: Anne McCulloch

There was no ‘ah-ha’ moment or a single person to take credit for a life changing procedure which has saved the lives of thousands around the world, but there was one alumnus from UBC’s Faculty of Medicine who lead a team of individuals through a series of incremental steps to pioneer percutaneous heart valve replacement; a lifesaving, non-invasive procedure to replace the aortic valve in individuals who do not qualify for open heart surgery.

John Webb, born and raised in Vancouver, BC, graduated from UBC Faculty of Medicine’s MD program in 1982 and is now an interventional cardiologist at St. Paul’s Hospital.  Growing up he had a strong interest in biology and started his undergraduate life studying this field at Simon Fraser University and Capilano College. Growing up with a father who specialized in obstetrics, Webb had seen firsthand the hours and responsibility of a doctor and medicine was not his initial choice for a career. However, his interest in biology and having an impact on other people’s lives drew him to medical school. The heart became his fascination as it was a moveable part which could be held in the hand and fixed.

Webb interned for one year at the University of Toronto and then returned to Vancouver as an internal medicine resident for two years.  He was soon offered a 2 year cardiology fellowship in Toronto and then spent another two years as a Canadian Heart Foundation fellow in San Francisco at the University of California.  The sun and sand wasn’t enough to keep Webb south and he soon returned to Vancouver where he began his incredible career at St. Paul’s Hospital.

Webb and his team developed the percutaneous heart valve replacement procedure used today in 2005.  A compressed valve, made of cow tissue, is sewn to a circular mesh stent.  This stent can expand and collapse with ease and in its compact form has a diameter no larger than a few millimeters.

The stent is threaded through the femoral artery in the leg behind a small balloon on a catheter.  Once in the desired position of the aortic valve, the stent is then pulled over the balloon and is prepared for expansion.  The stent expands when salt water fills the balloon and forces the metal mesh frame open to fit snugly against the existing valve.  The balloon is then deflated and the flaps of the artificial valve begin to pump open and closed with blood flow.

This innovative method is a remarkable alternative procedure for people who are unable to undergo open heart surgery due to age or other health risks.  It is a minimally invasive procedure with successful results, shorter recovery time, and, most importantly, gives life back to those who could not have or were at very high risk with traditional surgery.

With more than 500 successful procedures having been performed at St. Paul’s Hospital, Webb and his team are now training doctors across North America, Europe and Australia.  Webb knows the importance of sharing this discovery with other medical professionals worldwide and spends much of his time travelling the globe teaching and overseeing this procedure being done.

Recently, St. Paul’s Hospital installed a new Virtual Teaching Laboratory, which allows Webb to offer real-time broadcasts and two way communication of the percutaneous heart valve replacement.  This gives him more time to continue his research quest in transcatheter management of structural and valvular disease and new device development, but still allows him to continue educating colleagues with this technique.

While Webb has made medical history developing this procedure, he is modest and believes that his greatest life’s achievement is his family.  Spending time with his family and living an active lifestyle is what is most important.  Webb met his wife, Jennifer, in high-school and later had two sons, one who now lives in Vancouver and the other who lives in Montreal.  In keeping up with his own cardiac health activity and with the support of his family, Webb hopes to complete a Grand Fondo race this summer.

Christopher Beauchamp was in his orthopaedics residency at UBC Faculty of Medicine in 1980 when Terry Fox, whose right leg was amputated after he was diagnosed with osteogenic sarcoma, was forced to end his run across Canada because the cancer had appeared in his lungs. Inspired by Fox’s story, Beauchamp and three colleagues across Canada interested in the emerging field of orthopaedic oncology formed a group to discuss cases.

Three decades later, Beauchamp has helped to train hundreds of medical students and orthopaedics residents at UBC, and helped to build the Department of Orthopaedics at the Mayo Clinic in Scottsdale, Arizona. In his clinical practice, he has treated thousands of patients and is always touched by their courage, gratitude and optimism. A smile lit up his face as he recalled a nine-year-old cancer patient who recovered from an amputation, survived numerous surgeries and is now leaving home at age 19 to spend a year in France.

“Patient care is the most rewarding aspect of my work,” Beauchamp says. “But I also believe it’s every doctor’s duty and responsibility to teach medicine to the next generation.”

Beauchamp was born in Nelson, BC, where his father settled to practice family medicine and surgery after serving in the Second World War. Young Christopher always wanted to become a doctor, and from his first year of medical school at UBC, he knew he wanted to specialize in orthopaedics. He didn’t tell anyone, though, because he didn’t want to be seen as following his older brother, Richard Beauchamp, MD’71, now a Clinical Professor in the Department of Orthopaedics based at BC Children’s Hospital.

After completing his residency in orthopaedics from 1980 to 1984, Christopher continued his UBC training with a fellowship in oncology, which opened the door to an exciting opportunity at the Mayo Clinic—a Special Fellowship in Musculoskeletal Oncology and Adult Reconstruction. He left for Rochester, Minnesota in 1985, and also completed a second fellowship in clinical and research oncology at the University of Florida, Gainesville that same year.

Beauchamp returned to UBC in 1986 to begin his medical practice at BC Children’s Hospital, the BC Cancer Agency and the Vancouver General Hospital (VGH). He consulted for the Arthritis Society and Centre and assumed leadership positions at VGH with the Bone Bank and the Section of Musculoskeletal Oncology. He also began to teach orthopaedics at UBC, first as a Clinical Instructor and later as a Clinical Assistant Professor and Clinical Associate Professor.

“When I was a medical student, I was oblivious to the fact that my clinical teachers were largely volunteering,” Beauchamp says. “I’m thankful every day for the teachers who were so patient and taught me my skills. Teaching surgery is very stressful.”

The teachers at UBC who influenced Beauchamp the most were Drs. David Hardwick, Chuck Slonecker and David Harder. Dr. Harder introduced him to Zen and the Art of Motorcycle Maintenance, a philosophical novel that explores the meaning of quality that Beauchamp believes should be required reading for all orthopaedic surgeons. He credits Dr. Harder with “teaching me how to think.” He is also thankful to all of his mentors, teachers and ultimately colleagues at Vancouver General Hospital especially Dr. Robert McGraw.

It was the culmination of these experiences that led to Beauchamp’s recruitment in 1994 to help build the Department of Orthopaedics at the Mayo Clinic in Scottsdale, Arizona, where he was Head of the Department of Orthopaedics for 10 years. Now an Associate Professor, he continues to specialize in musculoskeletal oncology, adult reconstructive orthopaedics, and bone and soft tissue sarcomas. He is investigating new advances in joint replacement for patients with massive bone loss, tumours and infected, failed joint arthroplasty, including in-house product development using metal.