Each year, the Montreal Children's Hospital welcomes dozens of fellows from abroad thanks to a mix of donor support and public grants. These physicians strive for excellence and their stories are truly inspirational. In this edition of Doc Talk, meet Dr. Amit Dotan, whose work spans three continents. Dr. Dotan, you could practice medicine in Israel, your country of origin, yet you decided to come to Canada. Why is that? My wife, an internal medicine specialist, and I wanted our family to experience a different culture. Dr. Mark Clarfield, formerly from McGill and now the dean of an international medical school of the Columbia University in Jerusalem, attached to the hospital where I worked, spoke to us about the excellent training we could get at the Children’s. We felt it was a natural fit and we were grateful to count on scholarships to help us move here. Was it difficult to find a home and everything associated with such a big move? The hard part is not the move per se. We got acquainted with Israelis in Montreal and they reserved an apartment for us after we saw pictures. It is more about finding the balance between our demanding work and our three children. In Israel, the grand parents were there to help. But here, we had to adapt our schedule. My wife and I alternated our time in the research lab because it offers more flexibility, but there have been months where we both had intense periods as physicians. Fortunately, we can count on our friends to help out. Why did you choose to specialize in hematology-oncology? I knew it was what I wanted to do on my very first day at medical school. Cancer is often a scary word. Although it is emotionally hard because you witness families who feel like their world is breaking down, it is more optimistic than what people think: most children survive. I like the fact I can bring the psychological support to the families, that my work goes beyond the medical aspect. Is it in the same spirit that you opened a clinic in a small village in Ethiopia? Yes. I was given an opportunity during my school years to work as a medical student in Addis Ababa. My wife came with me. I ended up preferring more volunteering in an orphanage for HIV positive kids. Back then, there were no specific treatments for these kids but children were still treated medically by Sister Maria who managed the place. Each week, at least one child died. When specific treatment did arrive, we implemented a system to ensure these kids took all their medication. We were treating them very intensively all the while trying to give them the emotional support every child needs, especially in an orphanage: play, do homework… When we heard some nuns were having difficulty establishing a clinic in a village called Zizencho, it really appealed to us. Ethiopians are considered poor to the western world but they have happiness and balance in their lives. I felt privileged to live among them during that time.

What type of clinic did you develop? A clinic that would continue to operate after our departure. Sustainability is very important since the closest village is located 100 kilometers hospital, accessible only by a dirt road; that is inaccessible to most people, especially in winter, and also too expensive. Thinking about the future, we have decided to offer treatment for simple things that can often be fatal here, like dehydration caused by diarrhea, for example. We taught these skills to local nurses. We made the clinic more welcoming. My aunt, who works in a school in Israel, came to spend a week in Ethiopia and created crafts with the children to decorate the clinic. We also raised funds to ensure we had enough money to meet the clinic’s needs for a long time. Managing the clinic had its share of administrative difficulties, but with determination, we made it. Is there an event that affected you most? I remember very well this four-month-old baby. With limited diagnostic tools in the village, I was able to determine that he was suffering from a severe pneumonia, with respiratory distress that was worsening every day. He needed oxygen, which we had in the village. We took the decision to send him to the orphanage in Addis Ababa, an 11-hour bus ride away. He had trouble breathing, we were not sure he was going to survive, but we had no other choice. We made half the trip with him before sending him on alone. He eventually spent three weeks in Addis Ababa where he received oxygen. He got his strength back and returned to the village. It's a drop in the ocean, but it's the kind of work we were doing there. What do you miss the most here? During quite some time, I looked for hummus and falafels as they are made in Israel. I ended up finding a place where the cook is the brother of a restaurant owner in Israel, and every time we eat there, we feel like we’re in our country! What have you learned in Montreal that you will bring back home? Workwise, I have been really impressed by the cooperation within the multidisciplinary team at the Children’s: physicians, nurses, child life, social workers, everyone works together with such respect and efficiency. Something I have also learned, but will be harder to apply, is skiing. The entire family, even our three-year-old boy, can now ski! Also, French: some of my patients have been assigned to be my teachers, like Léa-Marie, and so I learned things like: “Est-ce que tu peux parler plus lentement?”. If there is a phrase you want to learn French in order to better communicate with your patients, what would it be? Francophone families who have just been diagnosed with cancer, I would say, "It will be long and difficult, but in most cases, in the end, all will be well.”

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