Doctor dilemma

Danette Dooley
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With the province about to lose a key specialist, patients young and old will be without a key player on their medical team

Three-year-old Hayden Wareham has a rare lung disease and needs oxygen around the clock.

But he doesn't let the 30-foot length of oxygen tubing get in his way when he rides in his big plastic car or plays with his shiny blue and silver drum kit.

"If one of his nose prongs falls out, he gets upset and pushes it back up," says his grandmother, Renee Wareham, who sits at the kitchen table watching Hayden play with another three-year-old in the living room.

Three-year-old Hayden Wareham has a rare lung disease. - Photo by Danette Dooley/Special to The Telegram

Three-year-old Hayden Wareham has a rare lung disease and needs oxygen around the clock.

But he doesn't let the 30-foot length of oxygen tubing get in his way when he rides in his big plastic car or plays with his shiny blue and silver drum kit.

"If one of his nose prongs falls out, he gets upset and pushes it back up," says his grandmother, Renee Wareham, who sits at the kitchen table watching Hayden play with another three-year-old in the living room.

Hayden's dad, 21-year-old Matthew Wareham, is a single parent. He and Hayden live in Carbonear with Matthew's parents.

Hayden has to see the doctor every week and will soon have to travel to Sick Kids Hospital in Toronto for more tests on his tiny, deteriorating lungs.

The family is grateful that Hayden has been getting expert medical care from the same doctor - Dr. Mary Noseworthy - since he was born.

But soon, that will change.

Because Eastern Health recently denied her request for a nine-month leave of absence, which would have allowed her to accept a paid position in Calgary that offered educational opportunities, Noseworthy has tendered her resignation and is leaving the province Aug. 27 to take a job in Calgary.

Noseworthy is the province's only pediatric respirologist and the director of the provincial cystic fibrosis adult clinic.

Renee Wareham said while there are other specialists in St. John's who help care for her grandson, she's not comfortable with the thought of Hayden's treatment team having no pediatric respirologist.

"He's the same as (Noseworthy's) own child to her," she said of her grandson's physician. "She knows everything there is to know about him. ... I honestly don't know if there is anyone else out there who can fill her shoes."

And Hayden's family isn't the only one that will be sorry to see Noseworthy go.

Seven weeks ago, 36-year-old Dale Walsh underwent a double lung transplant in Toronto after a five-month wait.

In July, he'll return home to Paradise with his wife, Peggy, and their eight-year-old daughter Regan, knowing that the lung disease specialist he says saved his life on several occasions is leaving.

Walsh said it's scary for him and other transplant patients to think about the future now.

"A (cystic fibrosis) transplant patient goes through so much to get this far, and then to be stumped now on how we're going to get our treatment in Newfoundland. ... Newfoundland is a long ways from downtown Toronto," Walsh said, referring to St. Michael's Hospital, where his transplant took place.

The president of the Newfoundland and Labrador Medical Association, Liz Callahan, describes Noseworthy's departure as a great loss to the province.

"I think it's a shame we're losing somebody of her calibre ...," she said. "It's a great asset to the community to have a pediatric respirologist when there are so few of them across Canada."

Filling the position won't be easy, Callahan added.

"Physicians find it very difficult being the only specialist in a particular area. It means they have to do a lot more work, a lot more call. They get to spend less time at home with their families," she said.

Callahan said it's disappointing that Noseworthy and her employer couldn't reach an agreement that was satisfactory to them both.

She said it's important that the government and health authorities "look after our own."

"Government has to focus on making sure that we have a level playing field with other parts of Canada. We have to be competitive in order to bring these people in. ... Things have to be done to make sure people of Dr. Noseworthy's calibre stay in the province."

Eastern Health's medical director, Dr. John Guy, said if Noseworthy's request had been for a shorter period - and strictly for educational purposes - approval would likely have been granted.

Guy said while he agrees that Noseworthy would have benefit from working with other respirologists outside the province, there was no guarantee she would have returned if her request had been granted.

"During that time, we would have to make other arrangements for her patients ... but we also could not recruit because we'd be holding the position for her," he said.

Eastern Health has already begun recruiting to fill Noseworthy's position - a process Guy said could take anywhere between six months to a year.

Meanwhile, other physicians will take over Noseworthy's patients.

Guy said he empathizes with them, since they are losing a good physician they've come to trust.

"The patients will have some adjustments to make ...," he acknowledged.

"But they will get appropriate care and, over a period of time, they will be quite happy with the care."

Walsh isn't so sure.

He suspects that once Noseworthy leaves the province, some of her patients will head to Toronto for treatment.

"You can't blame them. You don't get second chances when you're dealing with this," he said.

danette@nl.rogers.com

Organizations: Sick Kids Hospital, St. Michael's Hospital, Newfoundland and Labrador Medical Association

Geographic location: Toronto, Eastern Health, Calgary Carbonear Newfoundland St. John's Canada

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