Doctor Thérèse Perreault was just preparing to settle into adolescence when she decided how she wanted to make her mark on the world. Even now, as a pediatrician at the Montreal Children's Hospital since 1988 and Division Head of the hospital's Neonatal Intensive Care Unit (NICU) since 2003, Doctor Perreault can't think of anything she would want to do other than practice medicine. These, and other facts about our physician of choice in this edition of Doc Talk.
Doctor Perreault, when did it become clear to you that you wanted to be a physician?
I can recall I was 12 years-old when I thought this was what I wanted. That’s a long time ago! Yes, at some point when I was in CEGEP, I had a little hesitation because I liked chemistry, but I came back to my first thought very quickly.
Did you do go into medical school with a clear idea already of the medical specialization you eventually wanted to train for?
When I did my internship, I could see very clearly that pediatrics was something that attracted me. I always thought it was fun to be around kids. It’s always straightforward with them, very genuine. For sure, I liked procedure and acute care, but also I always felt more comfortable with children. I thought about doing surgery, but I thought surgeons had a hectic life so I opted for neonatology.
Do you have a sense that working in the NICU at the Children’s has its own particular challenges and rewards?
I quickly discovered them! It certainly is heavy work, but the reward is there too. It’s very rewarding to see the kids leave the ICU and come to visit with their parents. That’s a very precious moment as well, you know, because this is when you see you really made a difference.
Do you mostly take care of premature babies at the NICU or also infants with other health issues?
Prematurity is anything less than 37 weeks, so of course we have a significant number of these cases. Half the admissions at the NICU are of premature babies. But preemies aren’t always among the most difficult cases we see, a lot depends on how premature they are. Sometimes, term babies come with numerous congenital anomalies that are quite challenging. But, understandably, for every parent, their sick child is a challenge because that’s their baby. For them, it’s always very significant.
Now that the Children’s has moved to the Glen campus, how has the proximity between the NICU and the birthing department at the Royal Vic impacted your work?
It’s been one of the most fantastic changes! It’s way better for babies and way better for families of newbowns requiring immediate attention: the baby doesn’t have to be transported by ambulance, and has access to all the pediatric and other specialists right away. It leads to better team-work with the obstetricians and this means better care for the babies. To be able to work all together is one of the major accomplishments. This is the way to go!
Is it correct to say, then, that this proximity makes the new Montreal Children’s a real Mother-Infant Centre, along the same lines as the city’s other pediatric hospital, Sainte-Justine?
Yes, but even more than that: if the mother requires intensive care, she can be cared for also on the same site. This is the major difference.
What aspect of your work do you find most challenging?
It would be to keep the highest quality of care with continuously diminishing resources. You know, having to “do more with less”. But you could probably describe me as an optimist: it’s only when we are challenged that we must find solutions. If you’re never challenged, you’ll just get comfortable and may not find solutions that can end up being for the best.
What is the most important thing you’ve learned from your patients or their families that you might not have picked up in medical school?
Families teach us a lot about coping and adapting. Sometimes, we’d like to have a crystal ball and be able to tell people what the health outcome will be, but, in all humility, I tell patients that I can be wrong. I think we can learn that from families – that we sometimes underestimate the outcome and that things can be better than we anticipated.
Can you imagine yourself doing anything other than practicing medicine?
After all these years, I would say probably not! You know, medicine has all these different aspects that you discover, like medical management, the psychology of medicine, and so on. Medicine touches everything and everything touches medicine. I guess this niche I’m in is comfortable for me.