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Tomorrow’s Health Care Today
Dr. Ed Buchel: The worst feeling in the world is to say, no, I'm sorry, I can't deliver that care, or I can't deliver it in a timely fashion, or we don't have a robot, or we don't have a hybrid vascular suite. And the Foundation just enables that. It enables us to say, yes, yes, we can. Yes, we can deliver the care today. And yes, it'll be the best care that's possible.
Jonathon Lyon: When your vision is tomorrow's health care today, when your goal is to acquire the latest technology and to redevelop spaces so patients at Health Sciences Centre can have the best care possible. When your plans are ambitious and your donors care deeply, there is no time for half measures or partial solutions. There's no time for dotted lines. At the HSC Foundation, we like to draw solid lines. Solid lines between a dollar donated and a life changed. Solid lines between big ideas and extraordinary results. Solid lines between community action and better patient outcomes. We have conversations to share that will inspire and impress you.
Jonathon Lyon: Stories that shine a light on excellence in care and the passion of Manitobans. Welcome to the first episode of Solid Lines, the HSC Foundation podcast presented by the Bouchard Family Foundation. I'm your host, Jonathon Lyon, President and CEO of the HSC Foundation. And I can't think of a more fitting first guest than Dr. Ed Buchel, Provincial Surgery Specialty Lead for Shared Health, Surgery Site Director for HSC, and the architect of the HSC Foundation's generational Operation Excellence campaign. Dr. Buchel will share some insights about his pioneering work as a plastic surgeon, how new surgical technologies are changing HSC, and what we need to do to make the patient journey better. Stay tuned, and I'll be back in a minute with Dr. Ed Buchel.
Jonathon Lyon: Thank you, everyone, for being with us today on Solid Lines, the HSC Foundation podcast. I'm here with Dr. Ed Buchel, a plastic surgeon and surgery site director at HSC, amongst other professional designations he has. Thank you for joining us, Dr. Buchel.
Dr. Ed Buchel: Thank you for having me.
What Plastic Surgery Means at HSC
Jonathon Lyon: Ed, you're a plastic surgeon. Can you tell us what plastic surgery is in the context of HSC? I'm sure we're not talking about tummy tucks and nose jobs.
Dr. Ed Buchel: Yeah, no, not really. We're talking about someone losing an arm or a leg in a trauma, someone putting their head through the front windshield of a car when their face is fractured into multiple pieces. Somebody getting a breast cancer, a sarcoma of their leg, a gynecology cancer involving losing their vagina or part of their perineum, and we put them back together again. So what HSC Plastics does is repair functional deficits caused by trauma, burns and cancer resections. So it attempts very hard to return people back to their normal functioning or as near-normal functioning state when something unanticipated happens in their life.
Transforming Care Through the RR4 Plastic Surgery Clinic
Jonathon Lyon: It's amazing work that goes on. In 2023, you and I and others unveiled the renovated and repurposed RR4 Plastic Surgery Trauma Clinic at HSC. And it was funded, as you know, entirely by donors. Could you speak to the impact that that has had on the delivery of patient care for Manitobans at HSC?
Dr. Ed Buchel: So, our RR4 Clinic is our plastic surgery clinic. It sees the breadth of what I just described. So, it sees all of our patients that have had minor injuries and major injuries, minor cancers and major cancers. And what it specifically does for HSC is it takes all of those people out of the emergency room and moves them up to RR4. So we created a clinic space that not only sees postoperative patients, but it sees patients instead of them going to the emergency room. Whether they have a broken hand, a broken wrist, a broken face, a burn, a fracture, an infection or a postoperative complication, all those people would otherwise go to the emergency room.
Dr. Ed Buchel: And it might not seem like a lot of people that would have that, but it's thousands, now tens of thousands of people per year that run through the RR4 clinic. By doing that, not only are we giving people better care for a traditional postoperative course or seeing people after surgery, but we're now treating them without even going to the emergency room. So instead of you rolling up to the emergency room and waiting for hours, and many of these people coming from the core area and not having a place to go to or a phone to even call them, we can take them directly up, or they can be scheduled directly up to RR4 where they can get their tendons repaired on their hands, their fractures repaired, because we built operating rooms, procedure rooms we call them, but they are fully functional rooms that allow us to operate on people. With local anaesthetic or block anaesthetic—meaning nerve blocks where we can essentially anesthetize an entire arm or part of a leg, and repair those things without going to the emergency room, without going to the operating room. So it's great for our patients. It's great for my cancer patients to have a clean, secure, private place to undress for a post-op exam of their breast cancers, head and neck cancers, or gynaecologic cancers. But it's also amazing for populations that come from up north or our core area that can be treated immediately instead of being told, go home and we'll call you in a week, or go home and wait on our emergency list and we'll call you in 1 day, 2 days, maybe 5 days to get surgery done.
Dr. Ed Buchel: It's point-of-contact care. They come in with a problem, we facilitate the treatment of their problem immediately because of the structure that we've built.
Jonathon Lyon: Yeah, it really is incredible care that goes on there. I know when this was first presented to our foundation, goodness, that's going back 7 or 8 years ago, I think there was about 10,000 patients a year who were benefiting from care in the plastics clinic. And now I'm told that number is 20,000. And to be able to impact patient care to that level, to see the growth in patient care. And again, as you've pointed out, when patients get sick or injured, when you get sick or when you get injured, what do you want? You want to get diagnosed quickly, you want to get treated quickly, and you want to get home as quickly as possible. Can you walk us through what the sort of before and after of that looked like for a patient who had, whether it was a broken hand or a skin cancer, whatever? So before RR4 was redeveloped by donors, and I think we spent about just $2.3 million or so, it wasn't a massive capital expenditure, but it just goes to show how investing in the right areas can have a significant impact across the spectrum of healthcare. But if you could maybe walk us through like a before-after scenario with a patient because of the impact of RR4 from a time for care and those sorts of things perspective.
Dr. Ed Buchel: If I fall off my bicycle riding home today and assume RR4 doesn't exist, I would fall off, I would break my hand, break one or two fingers. I wouldn't be severely injured, but I'd break something and I would need surgical treatment. But I'd need a diagnosis first. So I'd come into the emergency room, I would wait, maybe many, many hours, and then I'd get my X-ray done. And then the plastic surgery resident would come down. And they would say, great, we'll put you on an emergency list. I would get my cast and I would go home. And then every day I would sit and wait.
Dr. Ed Buchel: I wouldn't eat in the morning. I would wait till I get a call from the operating room at Health Sciences Centre to see if I could get time on the emergency slate at Health Sciences Centre. And typically that's a low priority case. So I would be bumped every day. By stab wounds, by traumas out of a car, by brain aneurysms, by other things that were obviously much higher priority. And I would wait. And sometimes I'd wait for a week before— sometimes I'd wait for 2 weeks before I would get my fracture done. And typically I wouldn't go to work.
Dr. Ed Buchel: I wouldn't eat every day until about 4 or 5 o'clock when I'd be called. And so what happens now is if I fell off my bike in the morning, I would go to the emergency room, be triaged, and they would say, yeah, you're healthy. You're fine. You don't have a head injury. You got a hand injury. They would call up to RR4 and say, hey, how busy are you right now? And they would say, send them up. We'll deal with them. So I would come up.
Dr. Ed Buchel: We have X-ray capacity. We have surgical capacity. We have casting capacity. We have physios that come up there now. Everything would be done at that time. So the difference can be really game-changing for many of these patients with what we consider relatively minor injuries that are converted into big deals for these patients to take off 1, 2, 5, 10 days off work waiting for care.
Jonathon Lyon: So now we've gone from potentially 10 days to immediately being seen when presented to RR4.
Dr. Ed Buchel: Correct. And the emergency room has the option, if a patient comes in at 2 o'clock in the morning, they don't even call us. The emergency room is so heavily linked with RR4, and all urgent cares in our province are linked with RR4, that they know the criteria for sending people there. They know who can go there. So it's not just about plastic surgery. It's about the emergency room at HSC. But again, not just about the emergency room at HSC. This is a provincial resource.
Dr. Ed Buchel: We're a provincial service. So we provide care to many urgent cares and many hospitals in the entire province. They all know how to access RR4. They all benefit from RR4.
Advancing Autologous Breast Reconstruction
Jonathon Lyon: Dr. Buchel, your own work, I understand that you pioneered a unique technique to improve a procedure known as immediate autologous breast reconstruction. First thing, can you explain to laypeople what autologous means?
Dr. Ed Buchel: Well, you talked about tummy tucks at the start. Essentially, when a lady has breast cancer and they do a mastectomy, they take out the entire breast and I need something to reconstruct that using your own tissue. So autologous just means your own tissue. In these cases, the breast cancer and the breast are removed. Remember that the majority of people who get breast cancer do not get their entire breast removed. This is when the breast cancer is severe enough, it's recurrent, it's in multiple places. But there are a lot, there are thousands of women that get mastectomies. And so, for these women, we can offer tissue transfers from some part of their body.
Jonathon Lyon: Most people do well.
Dr. Ed Buchel: For women who want or need a tissue transfer, we try to take it from the lower part of their abdomen, essentially a tummy tuck, but it's a little bit different. We take the tummy skin and fat from the lower part of their abdomen, and we need to move it up to their breast. We shape it into a conical shape, and then we put it inside the breast. The problem is if we just cut it off and put it in the breast, it dies because it doesn't have blood flow. So we need to take the blood vessels associated with that skin and fat on the lower abdomen, dissect those blood vessels out from the center of the muscle fibers, underneath the muscle, saving all the nerves, and then down inside the pelvis. And then we clip those vessels. We put the fat and the skin from the lower abdomen with its associated blood vessels on a back table, so it's now free from your body. We close up the abdomen like a tummy tuck.
Dr. Ed Buchel: And then in the breast, when the oncologic surgeons are done, we're left with some skin on the chest and a cavity. And then we take the tissue that's now on the back table and we move it up inside the breast and we hook it up to blood vessels underneath the rib cage on top of the heart. And we take those out and we pull them through the ribs, and then we hook up the blood vessels that were on the abdomen to blood vessels that were now inside the chest. And we use a microscope for that, and it's called microsurgery. And it's a free flap because it's a flap, or tissue from your body, that's free from your body, and then we reconnect it. So, it's technical surgery. It's some of the most technical surgery that we do in surgery. It's very small.
Dr. Ed Buchel: The blood vessels are about a millimeter in size. We put a dozen stitches in a millimeter circle. We obviously can't do that without pretty significant microscopes. And it does really well for many, many women. What the advance was is not taking out all the muscles from the stomach. So, we used to take the muscles out of the abdomen because that's where the blood vessels were. So, we would cut out the 2 big muscles, the 6-pack ab muscles. We would cut out those 2 muscles and then move the muscles and the blood vessels up.
Dr. Ed Buchel: And what we are enabled to do now is to leave those muscles behind on the abdomen. So women don't have a functional loss of their abdomen. They can sit up, they can run, they can hike, they can mountain climb, they can do whatever they want afterwards. All they have is a true tummy tuck, very complex true tummy tuck, but it's still a true tummy tuck. And we move the tissue around and we find spare parts. So plastic surgery is, that's what we do. We find spare parts that are partially expendable on people to reconstruct things that we— really don't want to have a deficit in.
Bringing Microsurgical Innovation to Manitoba
Jonathon Lyon: And this is a procedure that you came upon, that you're the originator of it. And at what point in your career, because I know of course you're born and raised in Manitoba and then you went to other parts, Mayo and other places, where were you when you— and what was that moment like when you had this sort of epiphany that this was the right thing to do and that was going to just provide a better option for breast reconstruction.
Dr. Ed Buchel: Yeah. So I did my general surgery training in Manhattan, and then I moved to the Mayo Clinic in Rochester, Minnesota, sort of Mother Mayo in Rochester, Minnesota. And then I was pleasantly informed that I was going to Scottsdale, Arizona, because Mayo Clinic had created a new campus in Phoenix or Scottsdale, Arizona. And it was down there that in 2000 that I started to do reconstruction surgery, and there were no free flaps being done. There was one paper that was published at that time about this new technique, and Mayo gives you the opportunity to push boundaries, to strive for excellence. And we just decided at that point that my surgical team and I would start to figure out how this paper did this procedure. We started in about 2001, started very, very slowly, very cautiously. There is limited tolerance for major complications, especially in a Mayo Clinic model.
Dr. Ed Buchel: But they supported me very much in developing that, and traveling, and learning how to do this technique. And so gradually, by about 2003, 2004, we were doing 80 to 100 of these cases a year. Jump forward a couple years, and I'm back in Winnipeg in 2004. None of these cases were being done in Canada at that point. Very, very few were being done in the U.S., and there was one place in Europe that was just starting them. And so, we decided that we were going to start them here quietly, no fanfare. We just sat down and said, oh, we're going to do this. Luckily, I had a great surgical partner at that time, and he said, sure, let's start.
Dr. Ed Buchel: And so, we started, and gradually, we grew the program to be by far the largest autologous breast reconstruction program in Canada, and it still trains a significant amount of our academic surgeons to do this. We still get visitors coming every month today to come and look at what we're doing here because of it. And it's something Manitobans can be very proud of: most people who want breast reconstruction get breast reconstruction in our province.
Returning to Manitoba and Building a Culture of Excellence
Jonathon Lyon: It's an amazing story, frankly, about your curiosity. And again, you and I have known each other a long time. I always just find with you, people always talk in the healthcare system about it's about being patients first, but you actually live it. You breathe it and you bring that to your practice on a daily basis. So when you look back, a kid from Westwood goes to the States, works in New York City and at Mayo, and then you came back to Manitoba in 2004. When you look back now, it's been 22 years. What was your vision at the time for your practice and/or beyond? And what did you want to accomplish by coming back to Manitoba?
Dr. Ed Buchel: To be completely honest, I was coming back for a short time. I was coming back because my father was quite ill. We thought he was going to die. We weren't able to get a situation where he would come down and be with us. So we decided that all of my brothers, and I have 3 brothers, they would all move back to Winnipeg and be with my father. My father lived for more years than we thought, and my family grew up, and my kids grew up, and Winnipeg's not a bad place to live. But it's exceedingly good to work for me or for anyone when there's buy-in for the system to allow us to try and deliver more care, better care, faster care. And I had that opportunity in 2004 because the leader of the surgical program at that time, Louis Oppenheimer, who has since passed away, was a visionary.
Dr. Ed Buchel: He very much wanted to make things better for everybody in our city at Health Sciences Centre, but for our entire province. So Mayo is very much about striving for excellence. But so was Dr. Oppenheimer, and he more or less allowed me to push as hard as I want, and he just supported me in doing these things. I had a second leader at that time, his name was Perry Gray, who was heavily involved in administration. And he kind of said, hey, you were doing some admin very early on in your career at Mayo Clinic. Do you want to start doing admin here? I said, sure. And he also supported me heavily.
Dr. Ed Buchel: We then got involved in pushing forward and expanding the care, the types of care, the volume of care at Health Sciences Centre. And then throughout the years, we gradually involved philanthropy, very small at the start, almost nonexistent. And you got to remember, I came from a place where more than— 60 to 70% of everything that happens at the Mayo Clinic happens through philanthropy. The care does not fund that place. The care is the reason for that place. And then grateful patients fund the Gonda Building and the other buildings that are billion-plus dollar buildings. So I came immersed in this lack of separation between patient care and growing the ability to develop more patient care by engaging philanthropy. And I came here and I didn't find any.
Dr. Ed Buchel: And it took a while. It took us probably a decade before we finally had HSC Foundation step up to where it is now and engage. So I had my surgical practice running at that point. I had my administrative practice running at that point with support from very senior leadership. And then all of a sudden, I had support from the HSC Foundation, and it's been a snowball since then. So it just keeps on rolling down the hill, getting bigger, moving faster, and picking up more care as it goes down. So we just get more and bigger and faster as we continue to grow. But we grow, and I got to grow.
Dr. Ed Buchel: I grew in surgical leadership, as a surgeon, administratively, and then through now a significant involvement in the political system and the HSC Foundation, that it really grows in a collaborative, symbiotic way. We can't grow separate of each other.
Operation Excellence and the Patient Care Journey
Jonathon Lyon: So here we are, 20 years after your return, and you referenced, of course, innovation and that excites you. Could you perhaps speak a little bit about Operation Excellence and what we talked about RR4 at the beginning and subsequent to that, we worked on the Wilf Taillieu project. We're going to be opening a new urological centre this year, but perhaps because we really have started small and then built up to some larger, more dynamic projects, Operation Excellence, frankly, you're the author of it. If you could maybe explain to our listeners a bit about the goals behind Operation Excellence and how that drives innovation in healthcare at HSC.
Dr. Ed Buchel: So as you said, we started small. We have a plastics clinic, a couple million dollars, a Wilf Taillieu Thoracic Clinic, which is a premier thoracic centre for all of Canada. And it's $3.5, $4 million. And then we're going to a urologic centre that's now over $10 million, over $12 million. And these are stepwise advances. And then we sat back and said, we're doing great things, but let's really move the needle forward for HSC. How do we do that? And the plan was to look at the path that a patient takes from their car into the hospital, back to their car to go home. And we really needed to say, okay, I need clinic space.
Dr. Ed Buchel: Yes, we need clinic space. But I need operating room space. I need equipment in those operating rooms that are cutting edge for those patients. I need step-down units. I need recovery room spaces. I need bed bases. And then I need to get them back home in a timely fashion. There's not one part of the patient care journey that you can target that just improves that entire path.
Dr. Ed Buchel: There are multiple steps along the way. A patient needs to see somebody before surgery, during surgery and after surgery, and then we need to get them home. So we really envisioned how we would do that and what we would target at HSC. We strongly believed we need more operating room time. We strongly believed we needed the best equipment to give the best care to our patients. So we envisioned a hybrid vascular suite, which does minimally invasive surgery. We envisioned better oncologic treatment.
Dr. Ed Buchel: This gives us higher-resolution cameras, better rooms so that everything is integrated in those operating rooms, so the surgeons can deliver the best oncologic care that they can possibly do. And we envisioned having a robot, the first in Manitoba, and we are wonderfully positioned now with the advances that our robot has had for thoracics, for urology, for gynecology, to improve the care of all of those patients. That's just the start. We want more capacity, but we want the best capacity that we can possibly build. That's important for our patients, no doubt. It decreases our length of stay, no doubt. That effectively buys us more capacity in the system. More capacity buys us the bed base so I can treat more patients.
Dr. Ed Buchel: The equipment and the operating room and striving for best, striving for excellence, not average, not just to get enough done, but to do the best we possibly can allows us to keep our students, keep our residents, recruit the best attendings we possibly can, and retain the ones we have. So, we build capacity to deliver care. We deliver excellent care by buying the best equipment we possibly can, and that allows us to keep our daughters, our sons, our neighbours, and the people that are currently in this training program in our province. So, when they go to med school, they're not going to go to Ontario, they're not going to go to BC, they're going to stay in our province because we have the best and can deliver the best care.
Recruiting and Retaining Manitoba’s Medical Talent
Jonathon Lyon: I suspect that's somewhat of a personal response too, if you're comfortable sharing with our listeners a ceremony you attended last week.
Dr. Ed Buchel: Yes. My oldest daughter is a vet. She came back to the province and stayed here. My second daughter has finished med school and graduated and has agreed to do a residency in neurosurgery in the province. So, I am very proud of the neurosurgical program. We have spectacular neurosurgeons, but the Foundation has invested millions and millions of dollars in pushing spine care forward in our province. Spine surgical care was one of our big pressure points where we weren't able to deliver enough care or advanced care as much as we would like. So, we have gone from three or four spine surgeons, and now we're going to be sitting at more than nine surgeons soon in the province, but at Health Sciences Centre, we will be having more orthopaedic spine surgeons and more neurosurgical spine surgeons than we ever have. That is facilitated by recruitment and retention, which is facilitated by delivering the best care. We have cutting-edge technology for navigation and minimally invasive spine surgery, for robotic spine surgery, for imaging with CT scanners and other devices intraoperatively so we don't have to move patients or do open procedures. So we've moved the needle dramatically in neurosurgery, multiple other aspects of neurosurgery, functional neurosurgery. And I'm actually very, very pleased with the Neurosurgical Group and its evolution over the last decade, its leadership under Patrick MacDonald, and I'm super proud.
Hope for the Future of Health Care in Manitoba
Jonathon Lyon: As you should be. It's just a wonderful thing to have your daughter decide to plant her medical roots in Manitoba. And I'm very pleased for you and for Tamara, your wife, and for Angela, of course. So congratulations. We talk about and we read about on a daily basis, and certainly the healthcare system in Canada is under immense stress. What gives you hope for the future of healthcare when you look at the discussion we've had today, some of the investments that we're making, and the direction that you're having an incredible impact on, Dr. Buchel, with your leadership roles in health care in Manitoba? What gives you hope for the future?
Dr. Ed Buchel: I think in my 20 years of doing this, the biggest hope comes from when we enable people, people respond. So our caregivers respond so well to the enabling that the foundations, the sites and the province have done for them together so that we can deliver the best care. So when we look at how happy people are when we give them the capacity to say yes to patient care, the worst feeling in the world is to say, no, I'm sorry, I can't deliver that care, or I can't deliver it in a timely fashion, or we don't have a robot, or we don't have a hybrid vascular suite. When we hand over the keys to those cars, people are thrilled. Our nurses are thrilled to work in those operating rooms. Our surgeons are thrilled. Everybody is thrilled.
Dr. Ed Buchel: Our care goes up, and then the people around that patient delivering the care have a smile on their face, and they're happy to take care of people. So that's what gives me hope. I think we can enable people to give care to people. And the foundation just enables that. It enables us to say, yes, yes, we can. Yes, we can deliver the care today. And yes, it'll be the best care that's possible.
Jonathon Lyon: That's great. Well, that's certainly the mindset we have at the Foundation. It's formed on the basis of there but for the grace of God go I. No one wants to have a bad car accident or a bad cancer diagnosis, whatever it might be. When you do, you want to know that you've got the right people at our hospital, Health Sciences Centre, as an example, with the right equipment, the right facilities, and again, the right people, people like yourself and your daughter and the many other thousands of people who provide care at HSC, the nurses, the doctors, allied health professionals there for us. So we are extremely grateful to the leadership that you provide in working in collaboration with our Foundation, government and other stakeholders, to have that alignment so that we can, again, allow our friends and loved ones and neighbours to get better care sooner. So, it's really important work that you're doing, and I want to thank you again for all you do. You know, Dr. Buchel, your work is complex.
Helping People at Their Lowest Point
Jonathon Lyon: You're involved in planning, administration, budgeting, other executive responsibilities. I know how tirelessly you work for the good people of Manitoba. But what I know from you is that you see yourself as a surgeon first. Through your work, you're able to change lives, you extend lives, you save lives. What does this work mean to you?
Dr. Ed Buchel: Well, there's nothing better you can do. There's nothing better that you can do to help somebody in a low point in their life, a time where they come to you and they ask you, can you help me? Can I feel better? Can I function better? Can you take my cancer away? Can you fix my broken heart? Broken bones, there's nothing better. I can have the worst possible day and just go back into the operating room and it's my happy place. It's my zen place. I go there, it's organized, it's designed to treat the patient right in front of me. It is completely selfish at that point for me because it's about me delivering care to somebody and everybody's there to help us care for this person. If you can't feel good doing that, that's really sad.
Dr. Ed Buchel: There's nothing better you could do in your life than help somebody who comes out and asks you, can you please help me? And we're just being enabled. And the goal is that I want every surgeon to feel like I do. And every student to feel like I do so that they can say, yes, we can deliver the best care. The Foundation enables that. We want every surgeon to say yes, and every nurse to say yes, and every physiotherapist to say yes, and every other person who cares for any patient at this site to say, yes, I can deliver that care, because it's a great feeling and it's a great job.
Jonathon Lyon: Dr. Buchel, thank you very much for your time with us today. Thank you for all you do—not just the personal delivery of care. I happen to know a number of patients because they've told me that they're your patients and how grateful they are for the care you provide. And also, frankly, I'm just a Manitoban who happens to fundraise, and I know how hard you work. You have been instrumental in developing the plans we've talked about today with the plastics department, with the Wilf Taillieu Thoracic Surgery Clinic, with the Manitoba Urologic Centre, with Operation Excellence and beyond. We are, of course, looking to just continue to advance care through the acquisition of more robotics, more minimally invasive care, and an ability to provide those training spaces for those young medical graduates so that they do stay in Manitoba.
Jonathon Lyon: So, we're just grateful for you. Thank you for spending time with us today and sharing your insights on all the good work that's happening at HSC.
Dr. Ed Buchel: Thank you so much. And I'd be remiss to say that I got one more daughter that's in med school, and I'm working hard to keep her in the province. So we'll continue to move forward.
Jonathon Lyon: That's great. We'll all work together on that as well. Dr. Buchel, thanks very much.
Dr. Ed Buchel: Thank you.
Donor Support That Accelerates Progress at HSC
Jonathon Lyon: I'll be right back with some closing thoughts. Whether we're talking about the redevelopment of the RR4 Plastic Surgery Clinic, the Wilf Taillieu Thoracic Surgery Clinic and Endoscopy Unit, or the remarkable Operation Excellence campaign, donor support is essential for raising the bar and accelerating progress at HSC. I think Dr. Buchel made that very clear today. He's a proud Manitoban who only wants the best for healthcare in this province, and I know he's not alone. Thank you for listening to Solid Lines, presented by the Bouchard Family Foundation. Our guest today was Dr. Ed Buchel.
Jonathon Lyon: Solid Lines is produced by Stu Slayen. Our associate producer is Heather McNicholl-Milne. Technical production and post-production by Johan Heinrichs. Please support the HSC Foundation at hscfoundation.mb.ca and help us deliver tomorrow's healthcare today. Until next time, I'm Jonathon Lyon. Thanks for listening.
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Robotic Surgery Is Transforming Patient Care at HSC
Dr. Alon Altman: I didn't realize that 25% of cases I could do robotically that I couldn't have done before. The tech and the visualization and the equipment is just incredible. It is so much better than I had actually imagined it being. You can see the anatomy. You can see what you're dissecting. You can see everything.
Jonathon Lyon: At the HSC Foundation, we invest in leading-edge diagnostic and surgical equipment, and no recent investment has had a bigger impact than the da Vinci Xi Robotic Surgical System, Manitoba's first surgical robot. The robot was funded by donors to the Foundation's Operation Excellence campaign, and it has transformed surgical care at the Health Sciences Centre since its arrival in 2024. Hundreds of patients have been treated with the robot, and the results have been extraordinary. Patients feel less pain. They recover faster. They often go home the day after cancer surgery. Some even go home the same day. This is Solid Lines, the HSC Foundation podcast presented by the Bouchard Family Foundation.
Jonathon Lyon: I'm your host, Jonathon Lyon, President and CEO of the HSC Foundation. And today I'll be speaking with Dr. Alon Altman, an HSC surgeon who uses the surgical robot to treat many of his gynecological oncology patients. Dr. Altman will talk about his surprising initial reaction to the robot, the impacts he's seeing, and about his role as president of Doctors Manitoba. And this former British Columbian will also reveal whether he cheers for the Canucks or our beloved Jets. Stay tuned. I'll be back in a minute with Dr. Alon Altman.
Jonathon Lyon: Thank you for being with us today on Solid Lines, the HSC Foundation podcast. I'm here with Dr. Alon Altman, gynecological oncologist at HSC. Thank you for joining us, Dr. Altman.
Dr. Alon Altman: Thanks. Yeah, it's a pleasure.
Jonathon Lyon: It's great to be with you. So listen, in May 2026, I was at the dinner. It was a great evening, and you were elected president of Doctors Manitoba. Congratulations.
Dr. Alon Altman: Thank you. No, it's a big honour. It's been a fun first month and lots of places to go.
Physician Retention in Manitoba
Jonathon Lyon: Good. So tell me, when you were elected, you said the primary focus would be physician retention. Can you tell us what makes a physician stay in their job and what do we need to do in Manitoba at HSC, the provincial hospital, for example, where you practice, to be more successful in this regard?
Dr. Alon Altman: Yeah. So retention is a big part of what I wanted to highlight as president this year. There are a number of factors that keep doctors in the province. Obviously, if you're from here, you have connections here, that keeps you here. But if you're not from Manitoba, you've come here, or you've done a specialty or subspecialty, so you're really focused on a particular area, keeping people here is my goal. And so part of that is community.
Jonathon Lyon: Right.
Dr. Alon Altman: Part of that is the medicine, part of that is the technology. At Doctors Manitoba, we want to strengthen that sense of community, helping people make connections in Winnipeg and Manitoba and make this place their home. We want them practising the kind of medicine they want to practise. So the research that they want, the clinical work that they want, and part of that is the technology. And so I think with the HSC Foundation, the robot is a great example of something that the HSC Foundation and the foundation donors have brought to Winnipeg to advance technology, to help specialists and subspecialists be able to do their job to the best of their ability and allow us to keep people that would otherwise leave because they're looking for that bleeding edge, that new innovation elsewhere.
How Robotic Surgery Improves Recovery
Jonathon Lyon: Great. So, from speaking with you, I understand you had performed da Vinci surgery on roughly 80 patients. And there was a good percentage of those who would not have been eligible for surgical treatment were it not for the da Vinci. Could you just expand on that a little bit to outline for us what that means?
Dr. Alon Altman: Yeah. So prior to the da Vinci, we had 2 major ways of doing surgery, either laparotomy, which is a big cut in the belly, or laparoscopy, which is minimally invasive. But there are limitations to laparoscopy in that patients that were too big or their cancers or their surgery was too complicated, you couldn't do it. Because laparoscopy is where you're using straight sticks and the surgeon is in an awkward position and they're doing surgery as best they can with the equipment that they have. Between the three surgeons using the robot in gyne-oncology, we've now completed just over 200 cases. And when we look back, about 25% of our cases, we couldn't have done laparoscopically, which means that they would have had a big cut in their belly. Now, that big cut, that laparotomy, means that those patients are staying in hospital for 3 to 5 days. They have a higher risk of infection.
Dr. Alon Altman: They face more complications. It costs the system more money, and patients experience more pain and more problems. And so that group of patients now, instead of having to make a large incision, can have small cuts with the robot and have minimally invasive surgery. The vast majority of them go home in less than 24 hours, with significantly less pain.
Jonathon Lyon: And that's incredible. And then there are the downstream impacts: their ability to get back to life, return to work, play with their children or go to the soccer field. And infection—you referenced that as a significant issue. Obviously in Manitoba, the government understandably places a high priority on emergency department wait times. And it would be my understanding that, of course, if someone, through da Vinci surgery, can be in the hospital for less than a day versus 5 days, that that's also going to free up bed space. And there has to be a correlation between freeing up bed space and assisting with the emergency department wait times and challenges that exist, not just in Manitoba, but across our country.
Dr. Alon Altman: Yeah, absolutely. I mean, if you're freeing up a bed because a patient isn't there with a complication, let alone for a regular hospital stay of three to five days, if a patient's not readmitted with infection or complication, that bed is now available to either do a different surgery, maybe even a different group of surgeons doing it, but they have the bed that they can use, cutting down surgical wait times, or that bed is used to admit patients from emergency, clearing out the emergency room, and then decreasing the wait for patients that are coming into emergency.
From Scepticism to Belief in the da Vinci Robot
Jonathon Lyon: All good stuff. You and I recently were speaking at a foundation event and your remarks were on point and related to your cynicism, for lack of a better term, in terms of when we first brought the da Vinci to Manitoba and some reticence from you. I'm curious if you could just speak to that and then how you're finding it today. And in terms of the impact that you're seeing the da Vinci have, you talked about it a bit, but just overall what you were originally thinking and where you're at today with it.
Dr. Alon Altman: Yeah, yeah. I like that cynicism. It's true. Yeah, yeah, I can't argue with that. No, it's true. So I trained on laparoscopic and traditional laparotomy surgery. That's how I trained. And so I didn't have a robot in my fellowship, and many centres in Canada did at that time.
Dr. Alon Altman: But I was doing everything that I thought I could do laparoscopically. And if I couldn't do it, I did it with an open procedure, which I thought was good enough. I didn't realize that 25% of cases I could do robotically that I couldn't have done before. So that's one thing. The other is that the tech and the visualization and the equipment is just incredible. It is so much better than I had actually imagined it being. You can see the anatomy, you can see what you're dissecting, you can see everything, whereas you're limited with laparoscopy and laparotomy. And the funny thing is that all of my partners that now work on the robot, when we're not on the robot for a period of time, we just miss it.
Reducing Surgeon Fatigue and Wear
Dr. Alon Altman: Like, it is significantly better than the other ways of surgery that we do. Now, sometimes those are still the right ways, but if you can do it on a robot, it is much better. And the other thing that has come up a lot, and I'd heard about but didn't experience until I was on the robot, is surgeon wear and tear.
Jonathon Lyon: Mm-hmm.
Dr. Alon Altman: Surgeon fatigue. Every gynecologist that I've ever talked to has been to a physio for hip, knee, and shoulder issues because of the positioning when you're doing surgery. Since starting on the robot, I have not had those pains. And so I can sit on the robot, do a full day of surgery, and at the end of the day, I am not sore or trying to work out kinks in my shoulders and knees and hips and stuff. So in theory, and I hope this is true, you can then prolong your surgeon's utility as well.
Jonathon Lyon: Right. So you're not signing up for the lawn bowling league and wearing Velcro shoes yet? You're still good to go for a while?
Dr. Alon Altman: Not yet.
Jonathon Lyon: Excellent. Well, I'm thrilled to hear it. Again, from a Foundation perspective, we look at minimally invasive surgery from the patient perspective: shorter hospital stays, a quicker return to work and better outcomes because you can see more clearly and use the articulated arms. I'm just curious to know how that feels to have that sort of advance in technology and the impact that you're having for the patients. How many people are in the operating room with you at a time? Like, how does that make the entire team feel knowing that with these advances, how the care delivery is just improved?
Dr. Alon Altman: I mean, I think everybody's quite happy about it. It was certainly a learning curve when we first started. You know, we had to train all the nurses. We had to train our assistants. So everything felt slower, right? Because it's not something that you're used to. But within a couple of months, our times for doing it robotically and doing it laparoscopically are comparable now.
Jonathon Lyon: Right.
Dr. Alon Altman: And everybody's quite excited about being able to do these cases that we couldn't do before. Patients with a high BMI or excess weight are a challenge at the best of times, and the robot has made surgery much easier. So everybody's quite happy to say, okay, we can now do this for these people where before, we couldn't.
Expanding Access to Robotic Surgery in Manitoba
Jonathon Lyon: That's great. So you've referenced doing roughly 200 cases so far in under 2 years. Whether it's as a percentage or just overall, is there a need for more robotics?
Dr. Alon Altman: Yeah, absolutely. So we are currently in gyne-oncology getting a day and a half a week because we share this with thoracics and urology. There is somebody on the robot every single day, and there is a huge unmet need for more time. Urology could use more time. Thoracics could use more time. Gynae-oncology by itself could probably use 2.5 to 3 days a week. Not to mention all the other specialties and areas that aren't using it that could and should use it. Colorectal surgery, hepatobiliary surgery, general gynecology.
Dr. Alon Altman: And none of them have access to it at the moment because we only have one and it's full every day. So just gynecology and gyne-oncology could fill a robot for most of a week.
Jonathon Lyon: There is a demand there. We knew when we acquired the first da Vinci robot through the generosity of our donors, that it's almost like a you build it, they will come thing. From the Foundation perspective, we've had the opportunity to bring a number of donors in to see the impact of their generosity, and everyone is excited by how that is allowing Manitobans to receive better care sooner. And then all the ancillary benefits in terms of shorter hospital stays, impact on the emergency department. You pointed out back pain and shoulder pains and those sorts of things. So everyone wins with this. And we are excited to be able to work with you, both in your capacity as president of Doctors Manitoba and as a surgeon at HSC Women's to look to expand.
Research That Leads to Better Patient Care
Jonathon Lyon: And certainly, we will expand the number of robots that we have at HSC in order to meet the needs for all these Manitobans. We believe we should get to a place where every Manitoban who will benefit from robotic surgery through the da Vinci has access to it. We know the hospital is asking for this, and our board and organization are going to work tirelessly to support it. So I'm really thrilled knowing the impact of the da Vinci and seeing again those benefits. Just switching gears to a couple areas, you're also involved in research. Many of the physicians we deal with, they carry multiple hats, leadership hats, and one of them is in the area of research. If you could just walk us through the importance of research to your work and then how research translates to better care at the bedside. The Foundation also supports the hospital's research program through annual funding.
Jonathon Lyon: We just had a board meeting recently where several hundred thousand dollars were approved for that work. If you could just shed some insights into research and your work and what that looks like.
Dr. Alon Altman: Yeah. So my main research areas are clinical trials, supporting research for our learners—residents and fellows—and perioperative research, so enhanced recovery after surgery. So having support for doing research and being able to bring clinical trials and new ideas to these patients is not an extra. It is part of regular clinical practice now. As a cancer surgeon, conducting clinical trials allows me to bring drugs to patients that they wouldn't be able to access. Supporting residents and fellows in research with the HSC Foundation's help has also allowed our learners to learn how to do research in women's health and publish and make a difference nationally and internationally with what they're doing. And then the research that I've done in perioperative care and enhanced recovery has actually impacted clinical outcomes. So we've shortened our hospital stays, like our average hospital stays, from 5 to 8 days to 3 days, even on the big open laparotomies and cases, because you're looking at all the components of trying to get people better faster.
Dr. Alon Altman: So research is a huge component of what we do, what we teach and how we improve patient care.
What Is Perioperative Care?
Jonathon Lyon: Dr. Altman, you referenced perioperative care in that answer. If you could explain for my benefit and those of our listeners, what is perioperative care?
Dr. Alon Altman: Sure. Yeah. So that is the care around the time of surgery. So before surgery, we call that preoperative care. In surgery, we call that intraoperative care. After surgery is called postoperative care. Altogether, anything that is around the time of surgery, before, during, or after, is called perioperative care.
Jonathon Lyon: Learn something new every day. Thank you. Excellent stuff. Because you hit on it and you talked about it at the beginning. It's one thing to be able to provide the spaces and the tools like the da Vinci, but we need to support not just allowing people like you who moved here from BC to stay, but also those who are going through our medical school. I think there's 150 graduates now a year, which is important, but we want them to stay here. Providing them with tools like the da Vinci and supporting young researchers as they develop advances that allow people to have shorter hospital stays is critical. No one wants to be in HSC for any period of time, so anything that we can do through either the research side or supporting our physicians to allow for that is a great thing for all Manitobans. So it does circle things around for the benefit of patient care when we're able to support both research and investments in technology that allow people like you to do your best work.
Building a Medical Career and Family in Manitoba
Jonathon Lyon: So tell us, I had the good fortune of meeting your children at the Doctors Manitoba dinner, fine young, outstanding Canadians and very joyful to be celebrating you that evening. So you moved here how many years ago?
Dr. Alon Altman: I've been in Manitoba 15 years.
Jonathon Lyon: How's that going?
Dr. Alon Altman: It's great.
Jonathon Lyon: Good. Jets fan? Canucks fan?
Dr. Alon Altman: The Jets have now won over the Canucks. I mean, I was disappointed with the Canucks most of my life and continue to be. So definitely Jets fan. We have tickets with the family and then I cheer the Canucks when they're not playing the Jets.
Jonathon Lyon: Okay. Well, that's important. Glad you're Jets first. And your children all born in Winnipeg?
Dr. Alon Altman: Two were born in Winnipeg and the other one was born while I was in fellowship in Calgary.
Jonathon Lyon: Back to that, I used to— 100 years ago, I used to sort of work in politics and the catchphrase of the day was to make Manitoba the best place to live, work, invest, and raise a family. I would argue every political party would operate on those same assumptions. How has that been for you and your family, your 15 years in Manitoba? How are you enjoying it?
Dr. Alon Altman: Well, it's great. I mean, we've enjoyed it. My kids love their school. They have their close friends. We've made close friends. We're incorporated into the community. I love my group. My practice group is amazing.
Dr. Alon Altman: I love the people I work with. But this has all taken time, and this is kind of under my mandate as the president of Doctors Manitoba in that a lot of the things that I've learned, a lot of the things that have kept me here, it took time to learn. And nobody told me these things. Nobody guided me. So I want Doctors Manitoba—
Jonathon Lyon: Yeah.
Dr. Alon Altman: to actually help new physicians that come to the province figure these things out faster, figure out their communities, figure out the resources that they need, figure out the day-to-day life that they need that will then keep them here.
Jonathon Lyon: Right. Well, and that's so important. Again, at the HSC Foundation, the work we do is ultimately to allow patients to get, again, quicker diagnosis, quicker treatment, better health outcomes, shorter hospital stays. But the ancillary benefits, we want people like you to remain here and grow into leadership roles that you have. And anything that we can do through the generosity of our donors to improve that, whether it's physicians, nurses, allied health professionals, their experience in delivering healthcare at HSC, Manitoba's hospital, which underpins our healthcare system, we're all in on that. And it's been a real pleasure over the past period of time getting to know you, meet your family, and see the successes that you've been able to lead at both HSC Women's and then through your role with Doctors Manitoba. So really appreciate you taking the time today to join us on Solid Lines, the HSC Foundation podcast, and wish you every success in your great work going forward. And thank you for all you do for the benefit of Manitobans.
Jonathon Lyon: We're all so grateful for everything. Thank you.
Dr. Alon Altman: Thanks, Jon, and thanks to everybody who is supporting this and all the donors and what they've done.
Making Robotic Surgery Available to More Manitobans
Jonathon Lyon: I'll be right back with some closing thoughts. Dr. Alon Altman and other healthcare professionals throughout HSC tell me all the time that the initiatives we fund put them in a position to do their best work. And that's what our doctors, nurses, and allied health professionals want more than anything else. They want to do their best work and provide the best care possible for Manitobans. Your support makes that possible. Our first surgical robot has had a significant impact, so we are investing in more. Our next robots will increase capacity and allow more surgical specialties to take advantage of this technology.
Jonathon Lyon: With your ongoing support, we will be able to achieve our goal: Any Manitoban who can benefit from robotic surgery will have access to robotic surgery at HSC. Thank you for listening to Solid Lines, presented by the Bouchard Family Foundation. Our guest today was Dr. Alon Altman. Solid Lines is produced by Stu Slayen. Our associate producer is Heather McNicholl-Milne. Technical production and post-production by Johan Heinrichs. Please support the HSC Foundation at hscfoundation.mb.ca and help us deliver tomorrow's healthcare today.
Jonathon Lyon: Until next time, I'm Jonathon Lyon. Thanks for listening.
Dr. Alon Altman: Thanks for listening.
Episode transcript Read the full transcript
Eating Disorders, Mental Health and Recovery
Jodi Unrau: This episode includes a personal conversation about eating disorders, mental health, and recovery. Some listeners may find these topics difficult. Please listen with care and consider reaching out to someone you trust or a mental health professional if you need support.
Jodi Unrau: So I latched on to eating behaviours. I latched on to exercise because it was the only thing I could control in my life at the time. And that's the thing about an eating disorder—you may start to act in those behaviours. Not for everyone, but for me it was a slippery slope where suddenly I thought I had all the control in the world, and then within just a short amount of time, I had no control.
Jonathon Lyon: At HSC, Manitoba's hospital, we hear stories of resilience and determination every day. Stories that inspire us. Stories that remind us of the strength of the human spirit and the power of community. We're going to share one of those stories with you today on Solid Lines, the HSC Foundation podcast, presented by the Bouchard Family Foundation. I'm your host, Jonathon Lyon, President and CEO of the HSC Foundation. Almost 20 years ago, Jodi Unrau was, in her own words, at rock bottom. Her anorexia and body dysmorphia had taken their toll, and her very life hung in the balance. With the help of HSC and through her own resolve and focus, Jodi survived, thrived, and turned her attention to helping others.
Jonathon Lyon: Hers is a truly remarkable story. We'll be back in a minute with Jodi Unrau in conversation with HSC Foundation Board Chair Katie Hall Hursh.
Katie Hall Hursh: We're back with Solid Lines, the HSC Foundation podcast. I'm Katie Hall Hursh. Today, we're honoured to have Jodi Unrau with us. She is here to share her very personal journey with anorexia and body dysmorphia. And we're going to learn about how her journey led to a passion for community education and fundraising for the HSC Foundation. Jodi, thank you so much for being here.
Jodi Unrau: Thank you so much for having me.
Why Jodi Unrau Shares Her Recovery Story
Katie Hall Hursh: So, Jodi, you've had quite a journey in this space, one that no one should have to go through, but you have, and you've turned it into something so powerful and meaningful in helping others. I'd love to go right back to the very beginning and to understand why it is that you, at this point in your life, are so willing to talk about this and to share your experiences.
Jodi Unrau: For sure. I think for me personally, well, I've been in recovery also for 20 years now, so I've had a lot of change and a lot of growth in that 20 years. If you had asked me maybe 5, even 10 years ago, yes, I was an advocate, but would I be willing to do as much as I'm doing now? Perhaps not, only because I was still triggered and I was still going through my own healing journey. But I'm at a place in my life where I basically live with my eating disorder, but it is no longer in control of me. It's my voice; the behaviours aren't active. So recovery, it's not linear, but I will say with every year, it gets better and better, just like any mental illness. So where I am today is a place where I know how valuable it can be to be open, to be honest, and to share your story, and how much someone who's struggling hears that, relates to it, and just knows that they are not alone. And I think that's kind of like the heart of everything I'm doing right now is to share my story to help at least one person who might hear it and needs to hear it.
Katie Hall Hursh: And we certainly are so grateful that you're willing to do that for everyone in this province that is similarly struggling with something. Before we get into really the place that you are now, I think we need to go back and think about that person 20 years ago and really what started you down this path and where you were at that point in your life then. And if you're okay with it, maybe share a little bit about your experiences in those early days.
When Control Becomes a Trap
Jodi Unrau: Yes, for sure. So, the thing about an eating disorder is there's no exact trigger, right? There's not an exact cause. It can happen for many different reasons. For me personally, I was bombarded with a lot of change in my life. I had no control over what was going on. I was overwhelmed. I also had some past trauma I had never dealt with. With the combination of everything, I latched onto eating behaviours. I latched onto exercise because it was the only thing I could control in my life at the time.
Jodi Unrau: And that's the thing about an eating disorder. You may start to act in those behaviours, and not everyone, but for me, it was a slippery slope where suddenly I thought I had all the control in the world, and then within just a short amount of time, I had no control. My anorexia was very aggressive. It took ahold of me very fast, and it nearly did take my life. I was extremely ill. I was hospitalized many times. Due to malnourishment, my body was starting to shut down. And I had many doctors tell me, you may not see your next birthday. You might not see next month.
Jodi Unrau: Some were more compassionate, some were more focused on trying to scare me a little bit. But at the end of the day, everyone was just doing their best to support me and help me get better. But the thing is, with the eating disorder and any mental illness, unless you're ready, you're not actually going to go down any path of recovery.
Choosing to Live and Accept Help
Katie Hall Hursh: Right. So what was it then that eventually caused you to become ready to accept the help that you needed?
Jodi Unrau: There was never really one guaranteed moment. I think being ready, it was a process, right? It took time. It took like one step forward, maybe 5 back, but just like every little step was one step forward. For me, I also had an incredible support system, so that was tremendous. I had a mother who I talk about a lot, who was kind of like my rock through it all. And I would say at my very worst, my rock bottom, this is a point where I didn't want to live anymore because the pain was overwhelming. I wasn't in denial anymore, but I wasn't ready to let go because that's the thing about an eating disorder. It kind of has you trapped and you feel like there's no way out.
Jodi Unrau: Even if you want to, you're not sure if it's possible. So you just kind of stay stuck in a sense. And for me, the only way to recover wasn't actually recovery in terms of living. It was just going to bed one night and not waking up the next morning.
Katie Hall Hursh: Mm-hmm.
Jodi Unrau: That was the only way to get rid of the pain and the struggle. So it took one day where my mom happened to find me at my very worst. I call it my rock bottom. And she basically was my strongest person in the world through it all. In that moment, she broke too. And I think that's one of the things I've realized, and one thing I do now as an advocate, is to remind people that everyone struggles. It's not just the person with the eating disorder. The whole family is affected, and the whole family does struggle.
Jodi Unrau: So for me, when I realized this was tearing my mom apart, it was kind of that realization, okay, maybe I don't want to live for myself yet, but I'm going to do what I can to live for her. And then with time and with getting into treatment and therapy, I realized, wow, I actually want to live for me again.
Katie Hall Hursh: That's incredible. Thank you for sharing it. I imagine now being a mother yourself that recognition and sentiment hits even harder.
Jodi Unrau: Oh yes. Yes. Tremendously.
Finding Care Through HSC’s Eating Disorders Program
Katie Hall Hursh: Yeah. And you touch on the way that an experience in a disease, like an eating disorder, really does affect the entire family system. And certainly, you've spoken about the strength of your mom through all of this to be able to get you there. But once you actually got into the program and started to get the help, do you mind sharing what that looked like and what that patient experience looked like, now that you suddenly had an entire care team beyond your immediate circle of support working through your recovery with you.
Jodi Unrau: I think it was such a tremendous shift because the worst part, I would say, with your eating disorder is when you're out of denial, but you're on the waitlist, because there are waitlists. There's a long wait for access to care. So, at that point, you are caught in the what-ifs, not knowing what's next, and you kind of go from your very worst to suddenly in a program or treatment. Therapy is different for everyone. But for me, it was the program. And yeah, you have people who care, people who understand it, people who aren't judging you, people who are listening, people who are not just focusing on the eating behaviours, which is something that's so crucial for recovery, is not focusing on just the behaviours, but the root causes, what got you here, who you are without it. So, a lot of my focus now is thinking about your identity beyond your eating disorder, because that's the thing about an eating disorder: you lose your connection to your self-worth. So, you have to rebuild that all the way back up again. And the program truly helped me with that.
Jodi Unrau: And also, I wasn't alone. You know, as much as I don't want to know anyone else is struggling with this, being in a room full of other people who are going through exactly what I'm going through, know exactly what I'm feeling, it is helpful. Because there's stigma, there's silence, there's shame with eating disorders, and knowing that others are going through it just takes a little bit of the darkness away.
Katie Hall Hursh: Right. And I want to get into the power of community and that sense of you have others that understand exactly what you're going through. But before we do, so when you speak about the program, is it at HSC?
Jodi Unrau: Yes.
Katie Hall Hursh: Yes, it is. And so, is it inpatient? And can you maybe speak to who the care team is that's around there? What are their professions? What do they do?
Jodi Unrau: Yeah, so I was in the program in 2008, so it was a while ago. So, I know a lot of the program has changed itself, but I personally was an outpatient. I was supposed to be an inpatient, but there wasn't a bed available for me. So, I started as an outpatient. I would come Monday through Friday. It was kind of like school. I would show up in the morning, I would leave at the end of the day. And for me, luckily, my recovery started as an outpatient, and I never had to become an inpatient.
Jodi Unrau: However, some people are in more critical condition, and that's where they need to be. But yeah, it was kind of like a little family. We'd sit around a table, we would talk, we would share our feelings, we would go through some like heavy challenges. There was a lot of CBT therapy as well.
Katie Hall Hursh: Mm-hmm.
Jodi Unrau: I found that extremely helpful. There were moments of sitting together, holding hands sometimes, waiting until everyone feels better before we move on to the next thing. I would say it was very flexible, yet structured, kind of like organized chaos, but that's what you have to do in those situations. So, my personal journey was incredibly powerful and helpful. I also have to acknowledge that with any program, people have to be ready and willing to receive the support, right? You have the best supports in the world, but if someone's not ready, it may not be the right time for them, but for me, it was the right time and it was exactly what I needed.
Waiting for Access to Care
Katie Hall Hursh: And you talk about that gap between being ready and then receiving the support and the care that you need. For you, how long did you need to wait from that moment of being at your rock bottom with your mom in the bathroom to entering into the program?
Jodi Unrau: I think I was about a good 3 months at that point, and I was critical, right? So, the fact that I had to wait was pretty scary. And unfortunately, despite how critical I was, there are others just as critical as me that needed those beds that were being used at the time. So, a lot of what I do right now is supporting the HSC program in any way I can and really helping them help others, right? That access to care is huge. There's way more people struggling than anyone talks about. The waitlists are way longer now than they were when I was waiting. More support to help those who are doing their very best is what I hope for.
Katie Hall Hursh: And helping to be that bridge between those that are out in the community and the program itself in a view to trying to help scale it and to amplify the work that's being done there.
Jodi Unrau: Exactly. Yeah. And even the more people I talk to, the more people don't even know what programs we have here in our city. Oh, how many? Oh, do we have some? So, there's just not enough knowledge either. Right? People don't know where they can seek help, how they can seek help, because it's just not a conversation that we have as much as we should be.
Turning Recovery into Eating-Disorder Advocacy
Katie Hall Hursh: So, thinking now, it's been 20 years since— almost 20 years since the time you entered into that program, and you are still very much involved in this community. And in fact, you are now leading important conversations that are happening here. Tell me about what your continual commitment and your purpose in this space is. What fuels you to do the work that you are doing?
Jodi Unrau: I think one of the biggest things that fuels me is, once again, that awareness piece, right? The amount of people that don't know much about eating disorders. When I did my awareness campaign a few months ago, we went out and interviewed people, and we asked: How much do you know? Do you know this? Can you name the types of eating disorders? Some people think there's just anorexia and bulimia, but there's actually 6 different types. So, just giving people a little bit more of an insight and then seeing what people knew. Unfortunately, as I expected, not as many people knew as much as we would have hoped. So, the more we talk about these things, the more knowledge, the more support, the more people know how to react, what to say, for example, if someone's struggling. So, I think a big thing is awareness. And for my personal events, even if someone who's struggling doesn't come to the event, because often they're the ones who don't want to show up. They're the ones that are struggling in silence.
Jodi Unrau: The people that do come are reminding those that are struggling from home, hey, I'm going to this event. I'm showing up. I'm supporting. I'm a part of the positive impact. So, I think a big thing I'm trying to do is build a community of people who might not normally be in settings where eating disorders are discussed, and bring the conversation into real-life situations—not just clinical settings. For example, at the park, we're doing a fitness experience, we're doing a guided reflection, but we're also talking about eating disorders. So, I think it's just really bringing our city together, bringing community together, is supporting those who might listen, might hear from afar, and know that they are not alone and people are actually doing something about it.
Katie Hall Hursh: And that's so important. It's breaking down the stigmas, as you say, around this, that there is safety in sharing the various experiences, whether as a support, a loved one, or the person that is battling the disease themselves. Tell me more about these events and embracing your reflection and where really the genesis for that started, how long ago, and what does it look like for you going forward?
Building Awareness Through Embrace Your Reflection
Jodi Unrau: It's actually quite funny. My company started when I woke up in the middle of the night and I just decided I wanted to do something for Eating Disorder Awareness Week. This was two years ago, and I've done something every year since. And then I thought to myself, I want to take it beyond social media this year, so I'm going to do perhaps a workshop. And then in the middle of the night, I just woke up and I created a workshop. And then from there, it spiraled from one workshop to more workshops to, well, there need to be more events that aren't workshops, but are focused on fundraising and awareness. So now my company offers workshops, keynotes, community initiatives, as well as reflective coaching.
Katie Hall Hursh: Mm-hmm.
Jodi Unrau: It's a kind of mentoring based on my own experience with the eating disorder, and it's focused on positive body image, eating disorders, as well as building confidence and self-acceptance, because I think that identity piece is also very crucial.
Katie Hall Hursh: Right. That's incredible to be able to take the experience that you've had and translate it into something that really has a demonstrable impact on the way that our community shows up for one another.
Jonathon Lyon: Yes.
Katie Hall Hursh: And certainly at the Foundation, we're so grateful that you are continuing to advocate for this space and that you are not only opening up the conversation, but then raising funds, because there is power in being able to mobilize where you see a gap and being able to direct funds there so that you can try and improve access, as you say. Such a critical time between when someone recognizes that they need help and actually getting help.
Jodi Unrau: Yes.
Katie Hall Hursh: And if there's anything that can be done to shorten that time in between, then that's incredible work. So we're very grateful for everything you're doing for the community.
Support After Treatment and Early Intervention
Jodi Unrau: Yeah, I think another important thing is also that transition after treatment. Once you leave the program, you have to go back into your regular life where you're going to be exposed to triggers, right? So that's another area that I want to work on is like, how do you transition after recovery and go back into the real world? So I feel like that needs more support and also, of course, early intervention. As a former teacher, I'm seeing people struggle with body image and a lack of self-esteem at younger and younger ages. So, it's happening earlier and earlier. And as a mother too, I believe there needs to be more early intervention and prevention around this.
Katie Hall Hursh: Absolutely. Yeah, no, I think everything you're doing is just so key to the conversation that we're having here. So, thank you for that, Jodi.
Keeping a Promise to Help Others
Jodi Unrau: Thank you. I did promise myself in my early stages of recovery, if I ever got to a good place in my own healing, then I would do exactly this. And that's what I'm doing.
Katie Hall Hursh: So you're living that out.
Jodi Unrau: Yeah.
Katie Hall Hursh: I appreciate that. Keeping the promise. So again, Jodi, thank you so much for being here today and sharing not only your story, but really your mission to improve the lives of so many Manitobans. If people want to learn more, where can they find you?
Jodi Unrau: People can visit my website at embraceyourreflection.com, also through social media @JodiUnrau or @EmbraceYourReflection. I have everything there. And I have plenty more events coming up because awareness should never be limited to one day or one week. So, this is ongoing: building community connection, all centred around purpose.
Katie Hall Hursh: Wonderful. Thank you very much, Jodi. And many thanks to you, our listeners, for joining us here and listening once again to Solid Lines, the HSC Foundation podcast. We will put all the show links to Jodi's website and her social profiles in our notes. Until next time, I'm Katie Hall Hursh.
Community Connection Can Change Lives
Jonathon Lyon: Thank you, Katie and Jodi. I'll be back in a few moments with a closing thought. When I hear a story like Jodi Unrau's, not only am I reminded of the impact HSC can have on people's lives, I'm reminded that when we connect as members of a community, anything is possible. I think Jodi understands that intuitively, and through her efforts to connect with Manitobans living with eating disorders, she is changing lives. That's what we aim to do at the HSC Foundation, and your support makes that possible. We rally the community together to fund important initiatives, to invest in transformational technologies, and to enhance our facilities, all with the goal of improving care and enhancing patient experiences. Thank you for listening to Solid Lines, presented by the Bouchard Family Foundation. Our guest today was Jodi Unrau.
Jonathon Lyon: Our interviewer was Katie Hall Hursh. Solid Lines is produced by Stu Slayen. Our associate producer is Heather McNicholl-Milne. Technical production and post-production by Johan Heinrichs. Please support the HSC Foundation at hscfoundation.mb.ca and help us deliver tomorrow's healthcare today. Until next time, I'm Jonathon Lyon. Thanks for listening.
Jodi Unrau: Thank you.