In 1988, I had the opportunity to visit Ontario and Quebec Provinces in Canada, to visit palliative care services there whilst presenting some research I’d been involved with at my local Cancer Centre. In the UK in 1988, almost all palliative care was provided by independent hospices, often with community outreach but rarely with any access into hospitals. In Canada, almost the opposite was true: there were well established if small palliative care teams in many hospitals, but access in the community was unusual and there was only one freestanding hospice, Maison Michel Sarrazin in Quebec City. I visited The Royal Victoria Hospital in Montreal, home of the first pallative care inpatient unit in Canada (yes, Winnipeg friends, I know you’re in friendly dispute about who got there first), and spent time at hospitals in Ottawa and Hamilton, Ontario.
Wind forward 35 years. I was invited back to Canada to speak at Palliative Care Academic Rounds in Ottawa and to give a public lecture for Palliative Care McGill in Montreal. Both invitations were a great honour, and more invitations followed once the word was out. It turned into a five week lecture tour, and I was treated like an honoured guest. In fact, there were too many invitations to accept – until one of them included an offer of travel expenses. So it came to pass that this year I have had the joy of visiting Canada twice, meeting old friends and making new ones, and I’ve had the most wonderful time.
In June I enjoyed a visit to Guelph, Waterloo and Toronto.
At the University of Waterloo I enjoyed the hospitality of Conrad Grebel College, a Mennonite foundation. I was especially impressed by the magnificent stained glass windows in the college chapel, all based on the wonders of nature.
I presented a workshop on Listening Skills and a keynote lecture about reclaiming the wisdom of ‘ordinary dying’ at the 10th International Conference on Spirituality and Ageing. There were delegates and speakers of all faiths and none from around the world. The atmosphere was a wonderful collaboration of kindness.
Hospice Waterloo has been a great supporter of my work for a long time, and I’ve met staff and volunteers online for discussion and training sessions. My trip provided a chance to visit them at last, and to admire their beautiful new in-patient building and its beautiful grounds. It was a delight to meet these dedicated folk in real life and to spend a wonderful day meeting their ACP Ambassadors, their volunteers and palliative care staff from around the Kitchener-Waterloo-Guelph area.
This was also an unexpected and poignant opportunity to make a last visit to a dear friend, now very frail and in the last weeks of her life. We were both delighted to see each other for a final conversation. And a cup of tea, of course.
My friend would later be cared for by Hospice Waterloo, with devotion and kindness.
In September, I began my five week cross-Canada trip. Beginning in Montreal, where I was a guest of the McGill Council on Palliative Care, I went on to visit Ottawa, Hamilton, Grand Bend and Thunder Bay in Ontario; enjoyed a relaxing weekend with friends at their cottage near Lake Muskoka; on to Winnipeg, where I was the guest of Cancer Care Manitoba; then Vancouver, where I spent a more relaxed week with a dear friend now living in BC (although we still managed to sneak some work in); and finally to Banff and Canmore, Alberta, as the guest of the Palliative Care Society of the Bow Valley, Alberta.
This trip was a mixture of academic, teaching and public events. Giving a public lecture for the McGill Council in Montreal was a great honour. I enjoyed meeting medical students, nursing students and colleagues in palliative care and in other medical and surgical disciplines across Canada, and meeting long-time followers as well as new readers and people who were just curious about an evening talking about ‘Tender Conversations’ at public events in Winnipeg (thanks, McNally Robinson Bookstore and the generous enthusiasm of Dr Harvey Chochinov), Vancouver (Thanks, Kay Meeke Centre, Vancouver Coastal Health, and Nurse Specialist Ali Conner) and Canmore’s Palliative Care Association of the Bow Valley. The 2023 Northwestern Ontario Palliative Care Conference, October 3 – 5, was hosted by Lakehead University and I was able to meet long-admired colleagues as well as familiar collaborators there.
And what of the differences now between palliative care provision in Canada and the UK? It’s fascinating to see that, just as the UK has gone on to develop palliative care services in hospitals, enabling provision of palliative care expertise across NHS settings as well as better NHS funding for our independent hospices, so the gaps in community provision in Canada have been closed by a growth in community palliative care services and a large workforce of family medicine doctors who have taken additional training in palliative medicine.
