“With his open, honest and emotional tribute to his son Callum, Damon humbly reminds us of the fragility, inexplicable and indelible grief of parents from all walks of life, who are forever changed by the devastating premature death of a child.” Dr. Annie Huang, Staff Oncologist, Paediatric Brain Tumour Program, Hospital for Sick Children, Toronto, ON

“An insightful, moving, and personal story of loss, grief, and the familial bonds that can hold us together. As heartfelt as it is honest.” Iain Reid, Critically acclaimed Canadian Author & International Bestseller

“Damon’s story is almost impossible to put down once you start, and it is even more moving than it is gripping. I had always known that Damon was an excellent physician and educator. But, I have to admit, I didn’t realize before reading his book that he is such a powerful writer as well.” Dr. Richard Reznick, 46th President, Royal College of Physicians & Surgeons of Canada & Former Dean Faculty Health Sciences, Queen’s University

https://www.amazon.ca/

The HHC Series is a multi-disciplinary forum for practicing healthcare professionals to share lived experiences through story-telling and facilitated discussion. A diverse group of speakers are invited monthly to discuss frontline personal stories of triumph, struggle, reflection, sorrow, and joy with the participating audience via ZOOM as a means to create a community of shared vulnerability and connectivity. The series is intended to be inclusive of all practicing healthcare professionals and learners along the training continuum and will actively seek out participation from hospital, community, and regional partners.

https://healthsci.queensu.ca/opdes/faculty-development/programs/humanity-healthcare

Conversations with Jillian - Royal College of Physicians & Surgeons of Canada Humanities Series

Dr. Damon Dagnone is interviewed by acclaimed physician, writer, and wellness guru Dr. Jillian Horton. Many topics are unpacked in their conversation including grief, vulnerability, joy, motivation and personal agency.

https://www.youtube.com/watch?v=1eZt6XTkM1c

Published Vol. 11 No. 4 (2020) Canadian Medical Education Journal

Dagnone JD, Takahashi SG, Whitehead CR & Spadafora SM.

DOI: https://doi.org/10.36834/cmej.69182

Abstract

In 1996, the Royal College of Physicians & Surgeons of Canada (RCPSC) adopted the CanMEDS framework with seven key roles: medical expert, communicator, collaborator, health advocate, manager, professional, and scholar. For many years, CanMEDS has been recognized around the world for defining what patients need from their physicians. From the start, the RCPSC acknowledged that these roles should evolve over time to continue to meet patient and societal needs (updates in 2005 & 2015). We propose that an 8th role is now needed in the framework: “Doctor as Person”. Interestingly, this role was present in the foundational work through the Educating Future Physicians for Ontario (EFPO) project that the RCPSC drew upon in creating CanMEDS more than 20 years ago. Given today’s challenges of providing care in an increasingly stressed Canadian healthcare system, physicians are struggling more than ever with health and wellness, burnout, and the deterioration of the clinical environment. From the patient perspective, there is growing concern that physician-patient interactions are becoming increasingly impersonal and decreasingly patient-centered. The crack emerging in the foundation of physician identity needs to be remedied. We need to pay close attention to how we define ourselves as physicians, by better identifying the competencies required to navigate the personal and professional challenges we face. Only in so doing can we ward off the threat that exists in losing authentic human to human care interactions. Formalizing Doctor as Person as an 8th role in the CanMEDS framework will help patients and physicians create the space to have essential conversations about the humanity of medical care.

Commentary Published 20 Dec 2021 Canadian Journal of Emergency Medicine

Dagnone JD, Brooks J, Mann M, Cameron B, Gray S, Poonja Z & Lim R

doi: 10.1007/s43678-021-00253-1.

Introduction

Emergency medicine physicians are experiencing suffering like no previous time in the history of the profession. Even prior to the COVID-19 pandemic, moral injury as a consequence of long patient waits, barriers in access and hallway medicine was rampant. The state of the Canadian healthcare system has placed an enormous burden on emergency physicians, and despite frontline emergency physicians exhibiting remarkable resilience, the system has created such an unhealthy workplace that almost 85% suffer from burnout and poor physician mental health as a consequence [1]. During the COVID-19 pandemic, ED staff coined as “health care heroes” have now been subjected to hospital protests and political backlash surrounding compulsory vaccination. Many are suffering from PTSD and are poised to leave their profession at alarming rates [2].

Despite recent attention to many possible strategies advocating for physician wellness, these efforts have not translated into meaningful positive change [3]. The COVID-19 pandemic has amplified this crisis, with physicians feeling increasingly overwhelmed in what has become a multi-year global emergency [4] . …

Published Vol. 12 No. 3 (2021) Canadian Medical Education Journal

Dagnone JD, Bandiera G, Harris K

DOI: https://doi.org/10.36834/cmej.68245

Abstract

The adoption of competency-based medical education (CBME) by Canadian postgraduate training programs has created a storm of excitement and controversy. Implementing the system-wide Competency by Design (CBD) project initiated by the Royal College of Physicians & Surgeons of Canada (RCPSC), is an ambitious transformative change challenge. Not surprisingly, tensions have arisen across the country around the theoretical underpinnings of CBME and the practicalities of implementation, resulting in calls for evidence justifying its value. Assumptions have been made on both sides of the argument contributing to an atmosphere of unhealthy protection of the status quo, premature conclusions of CBME’s worth, and an oversimplification of risks and costs to participants.

We feel that a renewed effort to find a shared vision of medical education and the true value proposition of CBME is required to recreate a growth-oriented mindset. Also, the aspirational assertion of a direct link between CBME and improved patient outcomes requires deferral until further implementation and study has occurred. However, we perceive more concrete and immediate value of CBME arises from the societal contract physicians have, the connection to maintaining self-regulation, and the potential customization of training for learners.

Invited Presentations

Queen’s Health Sciences (April 2021, Oct 2020)

North York General Hospital (March 2020)

University of Toronto (Nov 2018, Nov 2019)

Sick Kids Hospital (June 2018, Nov 2019)

International Conference of Residency Education - ICRE (Oct 2018)

https://healthsci.queensu.ca/opdes/faculty-development/programs/humanity-healthcare

Globe & Mail Opinion May 14, 2020

Liao L & Dagnone JD

Over the last two months, the COVID-19 pandemic has reshaped our lives. People used to commuting through major cities, mingling among colleagues, enjoying restaurants and bars, visiting family members and travelling with relative ease have had to stay isolated at home, cooped up and glued to our screens. Video-conferencing programs have become primary modes of communication, replacing parties, gatherings, weddings and wakes. But now, as experts look at the numbers of new cases and deaths with cautious optimism, governments across Canada are beginning to lay out their plans to return to a life that’s as close to normal as possible.

But for some of us, this unprecedented moment has been compounded by a ramping-up of work that has filled us with increasing fear – and that might not change when we’re through the pandemic. Physicians and other health-care workers in particular have faced daunting obstacles: shortages of personal protective equipment (PPE), the threat of infection of a mysterious coronavirus, increased isolation from family members, and the psychic burden of knowing that numerous patients may die – or will soon.

There have been wonderful responses from our communities that have boosted morale in the short term. Restaurants have teamed up to deliver food to hospital personnel, and we have seen cheering, parades, and banners in the streets.

But the pandemic’s stresses cannot be withstood indefinitely. We need to take a long view regarding the realities and dangers of physician burnout. And we need to help our health care teams before the dam breaks.

…

https://www.theglobeandmail.com/opinion/article-we-can-all-do-our-part-to-defend-health-care-workers-against-burnout/

CMAJ July 09, 2018 190 (27) E836-E837;

J. Damon Dagnone

DOI: https://doi.org/10.1503/cmaj.180247

Twelve years ago, I completed my residency training as an emergency medicine doctor. Earlier that same year, my son died of cancer. When that happened, my world changed forever — I was broken, full of grief and barely able to hang on. As an emergency doctor preparing for independent practice, I honestly didn’t know if I would ever be able to return to such a challenging health care environment.

In the days immediately before my three-year-old son, Callum, died, he had become unrecognizable: connected to numerous machines, sedated and paralyzed into unconsciousness 24 hours a day. His body was suffering from chemotherapy-induced multiorgan failure. He had endured six months of intensive treatment, including neurosurgery, multiple crippling chemotherapy cycles and three stem cell transplant rescue procedures. My wife and I lived in the hospital with him for nearly six months, and we watched him amaze us every day, despite his intense suffering.

On the day Callum died, my wife, Trisha, phoned from his bedside in the SickKids intensive care unit saying to come urgently. When I got there, she was standing at the end of the bed silent, with tears running down her face. She was not frantic but calm, as we’d known for many days this moment was inevitable. She reached out for my hand and I grabbed it. I could see she was relieved I’d made it in time. We shared a brief moment, maybe a few seconds, and then focused on Callum and the team. The monitors that had showed no heart rhythm or pulse were now showing that both had returned. The team had stopped doing cardiopulmonary resuscitation. Callum was still alive. As tears poured out, I said to Callum quietly, “Thank you, honey. Thank you for letting Daddy make it here in time. I’m here. Mommy’s here. We’re ready, honey. We know it’s time.”

…

Encounters — An emergency physician heals his grief by helping others.

https://podcasts.apple.com/ca/podcast/encounters-emergency-physician-heals-his-grief-by-helping/id962398118?i=1000415461472

In this narrative, Dr. Damon Dagnone shares how helping others with grief can be healing. Dr. Dagnone is an emergency physician at Kingston General Hospital and Associate Professor at Queen’s University School of Medicine in Kingston, Ontario.

Canadian Medical Education Journal. 2017 Dec; 8(4): e97–e98

Dagnone JD

In this issue of CMEJ, Lester Liao presents a theoretical framework with five key components of the physician as person and advocates for additional training opportunities for the integration of more humanities training within medicine.1 Let me comment as a physician whose life and professional identity have been forever and unfathomably transformed through and by a tragic event in my life. He contends that not only is separating out our own personal life experiences not possible in the practice of medicine, but is entirely inappropriate. I agree. Authentic and personalized interactions are an essential piece in caring for patients, whereby, the interrelatedness of life experiences should be at the centre of relationship building and meaningful connection for patients and physicians. In particular, evidence2,3 that suggests depression, burnout, and declines in empathy are on the rise demand that we explore new perspectives of understanding. In this article, the physician as person is more fully recognized and core principles are put forward to change the way we approach training physicians in the humanities, which has implications for us all.

…

CMEJ Vol. 8 No. 4 (2017) / Images

JD Dagnone

DOI: https://doi.org/10.36834/cmej.43113

Eleven years ago, my wife and I lost our son Callum to cancer. He had just celebrated his 3rd birthday at Sick Kids Hospital in Toronto where he was undergoing his 3rd“rescue”stem cell transplant for his 6th and final chemotherapy cycle, following the surgical removal of a brain tumor. The image above is a plaster imprint of Callum’s untouched foot, and was created on November 11th, 2006 –just moments after he died in the Paediatric Intensive Care Unit. Its tiny proportions, detailed imprinting, and delicate craftsmanship all powerfully convey its simple message. Protected permanently in our home, it is being shared in CMEJ to help tell my personal journey as a bereaved parent, loving husband, individual human being, and Emergency Room physician. It accompanies and amplifies Lester Liao’s commentary (in this issue) on “The physician as person framework.”For my wife and me, the image of our son’s footprint represents many things. At the time of its creation, it represented a final keepsake created during a time of intense suffering. The imprint of his foot also captured one of the last remaining parts of our son that had not been affected by the ravages of cancer and struggles of his treatment–the invasive monitors, intravenous lines, tubes, and the destructive transformation of his physical appearance during the end stages of his illness.it represents for us our journeys together and alone.

…

Paul Waldie, Globe & Mail Correspondent

November 25, 2011

The donors: Damon and Trisha Dagnone

The gift: Raising $115,000 and climbing

The cause: Canadian Cancer Society

When Damon and Trisha Dagnone found out their three-year old son Callum had cancer, the news, understandably, was devastating.

Callum went through months of treatments at Toronto's Hospital for Sick Children, including chemotherapy and stem-cell transplants. The family lived in Kingston, Ont., and spent weeks travelling back and forth to Toronto, all while Dr. Dagnone was trying to complete his fourth year of medical training. Callum died on Nov. 11, 2006.

"It was pretty awful," recalled Dr. Dagnone, now an emergency room physician in Kingston. The couple, who have two other children, Thai and Mae, wanted to find some way of staying active and honouring their son's memory by supporting other families going through similar difficulties.

With the help of dozens of friends and family, the Dagnones became involved in the Cancer Relay for Life, a 12-hour relay that takes place in communities across Canada, including Kingston. They participated for the first time in 2007 and raised $20,000. "We thought, 'Wow, I guess we're not bad fund raisers,' " Dr. Dagnone recalled.

The family has been raising money through the relay ever since and have pulled in $115,000 in total so far for the Canadian Cancer Society. While the annual event is rewarding because of all the money that has been raised, the Dagnones have found it emotionally draining as well. "It's hard always talking about our son who died at the age of three," he said. "It's very difficult to be strong enough to talk about it."

They plan to take a more secondary role in the event in future, but they'll still be involved somehow. The relay has given them "a way to give back and find meaning by helping others with their cancer journeys," Dr. Dagnone said.

Waters HM, Oswald A, Constantin E, Thoma B, Dagnone JD. Physician humanism in CanMEDS 2025. Can. Med. Ed. J [Internet]. 2022 Oct. 18 [cited 2023 Feb. 20];. Available from: https://journalhosting.ucalgary.ca/index.php/cmej/article/view/75536

CMEJ 2023 In Press

Dagnone JD, Glover Takahashi S, Whitehead C, Spadafora S