ECHO Epilepsy: In My Words – George Derbyshire, MD, FRCPC, FAAP | Paediatric Neurologist

Where do you practice?

I am a general Pediatric Neurologist practicing in Thunder Bay, Ontario and of course seizures and epilepsy are a big part of my practice. I see a lot of children with developmental disabilities, I have over 200 children with autism in my practice, there’s children with attention deficit disorder, it’s a very broad field. I also evolved into managing a child and adolescent mental health unit. I’ve stepped a bit back from that now and am just an attending physician there. It’s a Form 1 secure unit where we deal with adolescents and jeuvenilles with suicide, self harm, depression. So it’s a very diverse practice and one that has kept me busy but kept me stimulated as well.

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In My Words | An ECHO Epilepsy Ontario digital series (Video | Time: 58 sec.)

Spotlighting healthcare practitioner participants of the ECHO Epilepsy Ontario technology-enabled, collaborative, CPD-accredited learning program.

Why did you join and what where were you hoping to gain from the ECHO program?

One of the challenges in being a paediatric neurology physician in Thunder Bay is you’re essentially practising in isolation. I’m often used by my colleagues for information, so I’m their resource, but I need a resource too and that’s where this program has just been excellent. I mean where else do I get to listen to Dr. Carter Snead, who in paediatric neurology circles, is world famous for his work with infantile spasms and other seizure disorders. Or someone along the lines of Dr. Elizabeth Donner, or Dr. Andrea Andrade. I mean these are top people in their field, so as a generalist in pediatric neurology I know more than the average pediatrician, but these are the elite and they’re the ones who can update me and that’s one of the values that I wanted out of this.

Here I get to sit and listen to outstanding geneticists, neuropsychologists, a psychiatrist who specializes in epilepsy disorders, I mean it’s invaluable to me being somewhat isolated here. The case presentations that are done are so good and challenging and the didactic sessions once again by people who are who are leaders in the field, that’s priceless to me.

How has ECHO impacted your practice in Thunder Bay and in serving rural communities?

The main area that’s impacted my practice with new ideas would be genetics, that was really important and valuable. There’s been such dramatic changes in genetics over the last five or ten years. When I graduated med school or even when I graduated in paediatric neurology, there were 10 to 15 identified abnormalities in chromosome genetics. Now it’s legion. The other area of impact was in polishing, crossing the “t”s and dotting the “i”s. For example, there was information about valproic acid that I wasn’t aware of that made me change a bit how I would prescribe it and when I would prescribe it, in terms of for other physicians.

The region we serve up here in Northwestern Ontario is the size of France. We have an area that’s massive so that has a lot of issues in terms of providing care continuity, especially with our winters where some of the communities are fly-in only and some are with ice roads. So here I get to sit with some leaders and authorities and learn more. So I think for the physicians up here, as I say I was a GP for four years and I would have found this so interesting and so valuable. It’s so easy to get so busy with your clinical work that you forget that there’s other things out there in the world you need to do. It’s a great form of CME. It just doesn’t, from my perspective, get better. I wish I’d done it two or three years ago.

In My Words | An ECHO Epilepsy Ontario digital series (Video  | Time: 1 min. 43 sec.)

Spotlighting healthcare practitioner participants of the ECHO Epilepsy Ontario technology-enabled, collaborative, CPD-accredited learning program.

Why did you choose to become a Paediatrician?

When I went to university my goal was to be a highschool history and english teacher. The problem was when I finished university there were no jobs. I had a job part-time through university at the Hamilton Psychiatric Hospital. There was a fascinating man there, Dr. Joe Falletta, a family physician. I tagged along with him and I’d just ask him lots of questions about what he was doing and watched him as he examined patients, and it was really interesting. One day, after about a year, he said to me, “What are your plans?” I said, “Well I want to be a teacher but it’s not going to happen”. He said, “Have you ever thought of medicine? You’re interested, you ask good questions.” He was very complementary. And he said, “Apply to Med School.” So on a whim really, I applied to med school. Low and behold I got accepted. I went to Med School at McMaster, internshipped in London, Ontario.

I worked as family doctor in a small northern town for 4 years. It was good, I enjoyed it. But the times I got most excited was when a paediatric case came in. So I went back and did my paediatric fellowship in Winnipeg. And then the times I got most excited was when a neurology case came in. So I did a second paediatric neurology fellowship in Winnipeg. So it’s kind of been a natural evolution for me.

When I moved to Thunder Bay in 1989 they had no neurologist at all, so I walked into a wonderful opportunity to develop a regional epilepsy seizure paediatric neurology program. Being the only paediatric neurology person between southern Ontario and Winnipeg has made it a very busy and active practice; very rewarding in many ways, demanding at times, but it keeps you going, and keeps you stimulated.

Why do you like being a Paediatric Neurologist?

It’s working with people. There’s a great satisfaction in making a good diagnosis. Sometimes I say to patients and parents, “You may not want me to find what I’m looking for but if I do find something and it’s treatable, then we’ll have a plan to treat it and if it’s not treatable, then we’ll have a plan about how can we support you.”

I really like explaining things to patients. Sometimes I get a little long-winded and a little verbose as you can appreciate (laughs) but I love explaining disorders. It takes a little longer but it’s really reassuring to see the light go on when they understand.

And being able to help people through difficult times is really important. That’s what I really like about it, dealing with the kids and the families.