The black bag has been replaced by a backpack, but the kind of medical assistance Dr. Chris Lund offers his patients is relatively new today too, so why not an up-to-date carrier of his equipment?
Lund does things a little differently than many of his peers, and he pooh-poohs the idea that what he does is extraordinary. For example, a large part of his medical practice is making house calls, but despite most people believing that form of medicine has gone the way of the buggy whip, Lund says there are numerous doctors he knows of in Wellington County who will visit patients in their homes.
Lund’s wife, Dianne Wallace, is from Guelph, and the couple lived in Australia for a year when their three children Ethan, Hannah and Sam Wallace-Lund were ages 2, 4 and 6 respectively. Lund said his wife always wanted to return to the area of her birth, so in 2000 they moved to the Fergus area and he became a general practitioner in Mount Forest for six years.
Lund earned his medical degree in the US and has been a general practitioner for 22 years. Wallace, who works in infection control at Grand River Hospital in Kitchener, learned the importance of home care treating her mother, who died in 2003.
Lund said it was around that time, “I became aware there was a need for general practitioners to do work in palliative care.”
Palliative care generally means working with those who are dying or very seriously ill, and it is a relatively new (again) field of medical care. Lund said there was some work done in that area in the 1920s, but by the 1940s, “palliative care disappeared. Doctors lost sight of looking after people who were dying because their focus was on keeping them alive.”
He said the idea of “Do Not Resuscitate” was very new in the 1970s and 1980s, and “people would look at you funny” when that idea was expressed in company.
But, Lund said, “By the 1990s, the idea of modern medicine was to treat people with high technology,” and the idea of care for the dying began to be considered once again. The thesis was to provide people with “comfort care. It emerged as a discipline on its own.”
And Lund, who took up the cause in 2006, has emerged as one of the best regarded practitioners of such care in the province. He is one of five people who recently received a Human Touch award from Cancer Care Ontario, recognizing his compassion for patients throughout their cancer journey. Oddly, that award, about five years old now, was first presented about the time he was beginning his new practice.
He still spends about 25 per cent of his time working in emergency at Louise Marshall Hospital in Mount Forest. The rest of the week he is in his blue Honda, with his blue backpack, bringing a hospital setting to people’s homes. His patients are referred from another general practitioner or specialist, and those referrals come from the Grand River Cancer Centre. Others are from Mississauga, Hamilton or Princess Margaret Hospital in Toronto.
Lund said the patients have to be within driving distance for him, and that includes just outside the northern borders of Wellington County, Waterloo Region and parts of Grey County.
His practice, from the car to the patient’s home, entails a fair bit of work.
“My time’s best spent in bringing medicine and specific medical interventions” to the home, he said. “Some things associated with the hospital now can be done at the bedside in the home … tubes, pumps, things like that.”
He noted such services are “largely unavailable outside the hospital setting.”
Lund, though, takes little credit for himself, and stated several times he has plenty of medical help.
“I am absolutely part of a team,” he said, citing nurses, case managers, social workers, physiotherapists, occupational therapists and spiritual care workers.
“There is many layers of care – even overlap,” he said.
It is the mention of “spiritual care workers” that seems to set Lund apart. He seems to understand instinctively that people’s state of mind is important in their treatment.
The people who nominated him for the award cited him for that special brand of service and caring.
Registered nurse Shelley Lillie, supportive and palliative nurse Sandra Howatt and registered nurse Diane Hanlon wrote in their joint nomination, “Chris is very aware of the nuances of the large rural communities and has adapted his practice accordingly, dependent on individual situations. Chris continues to be a strong advocate for patient-centred care for those that live in rural Wellington. One of the many examples of Chris’ advocacy is about a patient who resides in North Wellington, but was scheduled to travel a great distance to Grand River Hospital in Kitchener for blood work.
“Chris recognized the burden this placed on the patient and family and made the necessary arrangements for the lab work to be completed locally. His willingness to ensure patient-centred care for this patient highlights one of the many ways his daily practice decreases stress and improves the well being of so many patients and families on this very difficult cancer journey.”
They also stated, “Patients benefit greatly from Chris’ ability to provide seamless care, from time of diagnosis, through the treatment phase, and transitioning through their journey, whether it is at the local hospital, at home or into a hospice setting. He collaborates well with the visiting nurses to ensure that the team feels supported with necessary tools and guidance to provide optimal care for our patients.”
They added, “The team appreciates his approachability in that he is almost always available via cell phone, email or text messaging, which has definitely improved collaboration and continuity of care. His continued empathy and support to the family and health care team inspires us to look towards him as one of our most valued role models in this very demanding yet rewarding work. His leadership encourages team members to model his approach and reinforces the benefits of teamwork.”
They also noted another aspect of Lund’s career.
“As an Associate Clinical Professor at McMaster University, he has welcomed the opportunity to mentor medical students in community care, and we have enclosed a letter of support in that regard.”
Howett said there was no difficulties finding support for that nomination; “We got a lot of letters from different people in the community.”
She said the description for Lund was “gentle, kind, considerate, compassionate – there were lots of them.”
While Lund insists most of his work is replicating the hospital in a home, he provides some extras for his patients that are unlikely to occur in a hospital setting. One woman he recently visited told him she had not been outdoors in several years because of her illness. They completed his visit with her in his car – driving the back roads and seeing the scenery, while they talked about her medical and other needs.
He has also helped elderly people who have a difficult time coping with modern technology. Patients who are forced to lie in bed all day can become bored and even despondent. He said in some cases they simply cannot program such things as their DVD players, because they are unaware the players must be on channel 3. He has helped several set up their home entertainment systems to make life just a little nicer.
Lund said patients almost always do best when they have great family support and he noted, “It’s often actually easier on families to have a loved one at home than a hospital where they feel they have to be at the bedside at all hours.”
Lund said one of the most common questions he gets is how he handles working with people who are dying. Actually, he said, some patients he sees for only a few days and others he has had for years.
He and Wallace admit, though, that they do not quite have the travel bug out of their system yet, and they say spending only one year in Australia might have been a mistake. They agree that maybe two or three years might have been a better stay – and there is a chance some day they might return with some of their three children.
But for now, Lund hits the pavement many times a week, bringing hospital care and his own brand of caring to patients who need his help.
