Palliative care physician Bernard Lapointe on the inspiration the International Congress of Palliative Care brings to palliative care practitioners
“I think this congress, which reaffirms the deep values of palliative care, serves as a wonderful showcase for what this form of care can offer our society.”
By Devon Phillips. Bernard Lapointe wears quite a collection of hats. In addition to his roles as Director of Palliative Care McGill and Chief of the Palliative Care Division at the Jewish General Hospital, he is also the Chair for the 21st International Congress on Palliative Care. Bernard believes that this congress is an exceptional opportunity for practitioners around the world to truly connect, learn, and receive the inspiration they need to continue their work. I met with Bernard in his office on the palliative care unit of the Jewish General Hospital in Montréal, Québec.
Q: Tell me about the history of the International Congress on Palliative Care and the role of McGill University.
A: The International Congress on Palliative Care and Palliative Care McGill are intimately connected. McGill believed in palliative care from the beginning, as witnessed by the opening of one of the first palliative care units in North America at the Royal Victoria Hospital. The transmission of knowledge is key to the evolution of palliative care and it’s no surprise to me that the original team at the Royal Victoria in 1976, shortly after having inaugurated the new palliative care unit and opening the first service, organized the first international congress. There we had in attendance many palliative care pioneers including Dame Cicely Saunders, Elizabeth Kubler-Ross, Balfour Mount and others.
McGill was the garden which grew whole person care, physicianship and innovative approaches to medicine. The congress very much reflects these values and I believe that it is still one of the major contributions that McGill offers to the field of palliative care.
Q: What are the goals of the congress?
A: The congress has grown as the field has grown, and it has provided people with knowledge transmission: How can we do what we are doing and what we are challenged to do? Why do we do what we do? How can we improve? What are our sources of inspiration?
The congress allows people to be refreshed and inspired, and to go back home with a renewed sense of commitment to the care they deliver. So beyond the transmission of clinical data and quality courses on how to deliver palliative care, with more and more groups from all over the world wanting to share their experiences, I think the congress serves as a setting where we can be inspired because we all acknowledge that the work we do is very challenging moment-to-moment and can also be very exhausting.
Q: It’s amazing when you think how this congress has been taking place over 40 years, and yet there is always more to offer, more to learn and share. How many countries are represented?
A: There are always between 50 to 60 countries represented by caregivers and presenters with many people who come back edition after edition. And that’s an important characteristic ̶ usually medical congresses are a prompt to travel and visit a new city. I don’t know of any international congress like this that has taken place in the same city for 40 years. This shows how serious people are about attending this congress. They may increase their stay in Montreal by one or two days to visit and explore the area, but I truly believe people are coming back to this congress because of the reputation it has, the opportunity to learn, to be inspired, and to share with others.
Q: Do we have a lot to learn from our colleagues from other countries?
A: We have so much to learn from other countries. I am amazed for instance about how some countries tackle a problem differently than we would in Canada. I am always amazed at the resourcefulness and inventiveness of people who work without the benefit of all the resources we have, such as financial, staffing, and other resources. There is a group from India who will be discussing homecare delivered by volunteers only. This is one example, but there are dozens and dozens of incredible examples. In this congress, we will be talking about palliative care in refugee camps, on the street, in prisons, during the Ebola virus crisis; we will learn from the people who just went through these experiences. I am afraid to say that because we have been so busy minding our own business, we are not sufficiently aware of what others are doing. The congress gives us the opportunity to broaden our scope and our reach.
Q: What message does the International Congress on Palliative Care transmit to the community?
A: This is an incredible opportunity to present a very positive image of palliative care. These are troubled times for palliative care in this country, and particularly in this province. For the last few years with the debate around medical aid in dying and euthanasia, it’s been a struggle to maintain a positive image of palliative care. I think this congress, which reaffirms the deep values of palliative care, serves as a wonderful showcase for what this form of care can offer our society. This is why I am so excited about the congress.
Q: So much communication is virtual. As Chair, why have you chosen to keep the Congress meeting live?
A: Very often people ask me, “Why is there a need to have a live congress given the web and other technology?” The reality is that the congress is not virtual, and that’s why we need it. Virtual meetings are not the same as sitting down and having a tea or coffee with someone you just met while reading a poster. I think there’s a lot to be learned through web-based opportunities, but in palliative care, we value relationships and I think we need a physical presence.
One of the characteristics of the Montreal congress is that it is not one of those humongous congresses where you have four, five, six thousand people and where you get lost in the crowd. We try to stay within 1400 or 1500 people, maybe a little more this year, to ensure that everyone has the chance to network, mingle, and connect with one another.
I definitely see the congress continuing to flourish as a live meeting in the future.
Q: I wanted to ask you about the interface of medicine and politics. Can this be a positive relationship, and one which you have perhaps harnessed in your own career?
A: If you want things to happen in society, you need to be aware that things do not take place spontaneously. You need to establish support for your initiative and then galvanize that support towards reachable goals. Then you have to find champions who will carry these ideas and objectives to fruition. To do this, you need to develop an ongoing relationship with those champions built on trust and collaboration.
I have served very much as a leader in the Québec palliative care environment. For many years, I was the President of L’Association québécoise de soins palliatifs (AQSP), and at the national level, I served for many years as the President of the Canadian Hospice Palliative Care Association (CHPCA) and on the board of the Canadian Society of Palliative Care Physicians and so on. I have learned that you need to nurture the relationship with the doers, the politicians, and the people who are in charge, the administrators, and those who work in the government ministries. Every so often these people really want to help and they need our guidance finding the best way to do it. We all bring different gifts. I hope this is one that I have brought to palliative care over the years.
Q: I heard through the grapevine that you were a tour guide when you went through medical school. Has that skill set helped you with the congress?
A: That’s funny! You know I come from one of the oldest families in Montreal. My ancestors accompanied Jeanne Mance and Marguerite Bourgeois and Pierre De Maisonneuve in the first settlement of this area. I have a map at home dated from 1649 showing my ancestor’s land. My family has always been here, and I have always been attached to Montreal.
While I was studying medicine at Université de Montréal there was a course given to become a licensed tourist guide so I thought, “What a neat way of earning money in the summer.” I worked as a guide during the 1976 Olympics and for several years after that and it was so much fun! I met a lot of interesting people and learned a lot about the city. Montreal history is very rich and what strikes me as surprising is that most people don’t know about its history. I wrote a little piece for the Congress website called “My Montreal”. How many people know that Montreal was an American city for a brief period of time in 1775? When I tell people that, they look at me and say, “Are you sure?”
Q: Looking to the future, do you have any special projects in mind?
A: Because we are so involved with the daily care and needs of dying people, and we face incredible challenges daily, we have forgotten to cherish and nurture our commitments with our community of origin. I am always fearful of services that develop like houses on stilts, meaning they don’t have deep roots within the community.
At a recent congress, we heard from St. Christopher’s Hospice and its incredible program of renewal and investment within the community, called, “Compassionate Communities”, or, “Compassionate Cities.” We will be talking about this at the congress and it will be one of the key themes over the next few years that will benefit us all: How can we best make sure that quality end-of-life care is not the sole responsibility of a small group of caregivers? This is a societal objective and it needs to be supported by the entire community. I think that there is a lot that can be done to help people who are dying, to help their families, to help the recently bereaved, to support one another, and to think about what to do when you reach that stage in your own life. This is a very important page we need to open and start writing.
Q: Apart from the congress and your medical career, I understand you have other passions. If you were not in the hospital or at a committee meeting, where would we likely find you?
A: Possibly walking somewhere in town with my camera. I love photography! We all need a way of expressing creativity when we do this work, and my creativity has been expressed through photography. So you could find me at the botanical gardens, the mountain, or even downtown. Sometimes I find downtown fascinating, especially early in the morning or late afternoon. There is always something that attracts my eye. It could be something strange, or funny, or just beautiful. For me there is nothing more beautiful than a big snowstorm in Montreal.