SHAW SHAPES SASK SYSTEM
Chief medical officer sees potential for positive changes
The ever-present smile on Dr. Susan Shaw's face disappears when she's asked about COVID-19 conspiracy theorists and people spreading misinformation.
She admits she's not very good at being angry, but as a leader in Saskatchewan's health-care system and the response to the pandemic, Shaw has encountered the effects of misinformation.
She also works regularly in a Saskatoon hospital, part of her position as chief medical officer with the Saskatchewan Health Authority.
She saw the effects of misinformation first hand during the pandemic in intensive care units.
“I have looked after people who deny COVID,” Shaw says. “I have looked after people who have gone to anti-mask rallies and contracted COVID. I have looked after people who have gone to super-spreader events that were purposefully created.”
Even though anger does not come easy to her, Shaw gets even angrier during an interview at a picnic table on the grounds of Royal University Hospital in Saskatoon.
She says the misinformation includes “blatant lies” and she sees a connection between COVID-19 conspiracy theorists and white nationalists.
Shaw supports people's right to express their opinions, but also points to the harm that can be caused by the spread of misinformation.
Providing care for people who have knowingly contributed to making the pandemic worse can prove difficult, she acknowledges. She pauses.
“They've received really good care,” she says. “It's so hard on our nurses and our doctors and our pharmacists and our social workers that are absolutely trying their best to help people recover.”
Shaw quickly shifts her focus to the positive, even while discussing the pandemic, which has brought some dark days for the province's 40,000 health-care workers.
Shaw says she's always had a positive, optimistic outlook. She smiles and laughs frequently and finds a way to turn negatives into positives.
She gets her energy by envisioning a brighter future and an even better health-care system after the pandemic, she says.
“I like being able to look ahead and see there's an opportunity here. Like this may feel like it sucks right now or this is really hard, but there's an opportunity here.”
The bespectacled doctor with the distinctive bob hairstyle emerged as a respected voice for the health-care community during the pandemic.
Frequently, Shaw's voice stood out as the only female one communicating Saskatchewan's pandemic response.
She was born in England and moved to Regina with her parents and younger brother when she was about 10 years old. She admits there's still a trace of her English accent.
She's still a little surprised she wound up as a doctor; she never dressed up in a white coat as a child and pretended to care for teddy bears.
“I didn't really plan out my career,” she says. “But when you were kind of thinking, `What do I want to do when I grow up?' I never imagined any of this. I never imagined being an ICU doctor. I didn't even know those positions existed.”
Shaw grew fond of sciences at school and later followed around her family physician and volunteered at Regina's General Hospital.
She felt comfortable in the hospital and enjoyed talking to people in that setting, she says.
Shaw began her post-secondary schooling at the University of Regina and was then accepted into medical school at the University of Saskatchewan in 1991. Saskatoon has been her home ever since.
“A lot of people when they enter medical school don't realize — and I sure didn't — that you actually have a series of further career decisions that you need to make once you've decided and you're successfully entered into medical school.”
Shaw spent a year of her education in clinical settings, including time in intensive care units. She found she loved the team environment, the problem solving and the excitement.
“I just fell in love with critical care, actually,” she says.
She decided to become an anesthesiologist. Many will recognize the anesthesiologist as the doctor who puts patients to sleep for surgery, but the specialty plays a much larger role in patient care.
She embraced the opportunity to engage with patients' families, she says.
“A lot of families remember the ICU team. The patients often don't, and that's, I think, probably a good thing. They don't need to remember. And if they do remember, they often have difficult memories because it's a stressful part of their life.”
As part of her education, Shaw also spent a year at the medical school at Stanford University in California. It helped her appreciate Canada and the public healthcare system here compared to the profit-driven, mainly private system in the United States, she says.
“I learned a ton,” Shaw recalls. “But mainly I learned I like Canada.”
“I got to see what's it like to be in a pretty high-prestige American medical institution that also needs to run a for-profit medical centre. So I got to see what it means to patients and families if they don't have insurance.
“That was heartbreaking to me. It was really a big wakeup call about how important the underpinning system is.”
Shaw also found the system in Saskatchewan needed change once she began practising medicine here.
She recalls a 1995 encounter with the mother of a man who had severe injuries. At the time, relatives and loved ones were told to leave the room when medical staff consulted about a patient's treatment.
Shaw, who headed up critical care, approached the mother for her opinion on her son's care, confident that the metrics gathered at the time indicated a job well done.
“She said, `I'll be honest, you suck. The times when I need to be there the most as a mother are the times when you ask me to leave.' ”
Shaw allowed the mother to sit in with the medical team the next day. That helped trigger a change at Royal University Hospital, then the former Saskatoon Health Region, and then throughout the province.
Sadly, the tenet of involving families more directly in patient care has been severely hindered by restrictions made necessary by the pandemic.
Yet Shaw sees restrictions remaining at medical facilities long after they are lifted elsewhere.
“I can tell you that there's no going back to what the healthcare system was like in February of 2020,” she says. “It's going to be a long time before anybody with shortness of breath and a fever and some fatigue isn't suspected to have COVID until proven otherwise.
“I think a lot of the health-care system has been changed for a very long time.”
When the Saskatchewan Health Authority was created four years ago by amalgamating the health regions, Shaw moved into her current leadership role.
As chief medical officer, she spends a fifth of her time as an active doctor, which helps her observe the health-care system firsthand and direct change — the same way she did a quarter century ago.
Shaw made one of the most memorable statements on the pandemic shortly after the provincial government began introducing more severe restrictions in November, including mandatory masks in indoor public spaces.
She invited people skeptical of the restrictions to trade places with her for conversations with family members of patients who were sick and dying with COVID-19.
“I assure you, that conversation is much more difficult than wearing a mask,” Shaw said at the time.
While other provinces received much of their public health information from women during the pandemic, Saskatchewan's communications mainly came from male messengers; Shaw was a notable exception.
She says she's “quite purposeful” about that role. She faced few barriers during her career because of her gender, but still feels women are underrepresented in some medical specialities and in leadership roles.
She points out more than half of people who enrol in medical school have been women for a generation.
“We have amazing female physician leaders in our province, but not as visible though,” she says. “So I do think (my voice is) important. I'm very grateful. It's so satisfying and it really makes me feel really great when friends will message me going, `My kids are talking about you. Nicely.' ”
One of the prominent male voices during the pandemic, SHA CEO Scott Livingstone, says Shaw's voice and message were “critically important” during the pandemic.
He believes Shaw is already inspiring other women to take on leadership roles in the health-care system, he says.
Her background as an intensive care physician and her ongoing work in that role helped her to communicate the message about how serious the pandemic is — and her personality helped make the delivery more effective, he adds.
“Susan doesn't talk in 15-syllable words. She talks in a way that people can understand the meaning of both what she's trying to say and what she's experienced. I think she's a very genuine and caring individual.”
Shaw also brings a wide array of knowledge, and proved to be the right person to occupy the position as the most senior physician practising medicine, according to Livingstone.
She also proved she was the right person for that role during a pandemic, he adds.
“She's not that person who runs around with her hair on fire. Not even close. She often brings a calming approach to many discussions.”
Like many people, Shaw developed a new hobby during the pandemic: bird watching. She also remains a fan of hip-hop music dating back to the Beastie Boys.
Her 18-year-old son, Evan, shares her musical tastes and makes playlists for her.
Shaw and her husband, Dean, also have a 21-year-old daughter, Rachel.
Despite lower COVID-19 case numbers and restrictions lifting, Shaw sees ongoing struggles for the health-care system.
People who delayed retirement because of the pandemic, or will retire sooner than expected, could create a staff shortage, Shaw says.
There will also be people with chronic diseases that have yet to be diagnosed as well as those whose surgeries or procedures were postponed due to the pandemic.
Despite these challenges, she sees an opportunity to rebuild the system better with the lessons learned from the pandemic.
Shaw works with Indigenous elders and knowledge keepers in her role as chief medical officer. She says she has been guided throughout the pandemic by the words of an Indigenous elder in the early days.
“This is going to teach us all something; you just have to listen,” the elder said.
“And her words resonate in me. It is. This is teaching us something about how did we get here and where are we going. I think we have a lot of ability to influence that. So that's where my optimism comes from. Not easy, though.”
Susan doesn't talk in 15-syllable words. She talks in a way that people can understand the meaning of both what she's trying to say and what she's experienced.