July 1, 2020: DR. JOSEPH VAYALUMKAL
“Wherever the art of medicine is loved, there is also a love of humanity.” – Hippocrates
Latin for Agile, “Agilis” defines the everyday Executive pursuing extraordinary goals. We are privileged to share the heartwarming journey of an Extra(ordinary) Executive, Dr. Joseph Vayalumkal, BSc, MD, FRCPC, Paediatric Infectious Diseases' Specialist at the Alberta Children's Hospital in Calgary, Alberta. Dr. Vayalumkal, also a Clinical Associate Professor in the department of Paediatrics, takes us through his upbringing, his influences, his medical journey, and the core values which continue to reflect his decisions today.
Born in Toronto, Ontario, Dr. Vayalumkal, is the eldest son of parents who immigrated to Canada from Kerala, India in the early 1970’s. Raised by a large, connected family, which was led by his parents, Dr. Vayalumkal moved to Hamilton, Ontario, as a very young child and enjoyed the “single child” attention from his parents, aunt, uncle and paternal grandparents for several years until his siblings were born. His paternal grandmother became a major influence in Dr. Vayalumkal’s life. Recalling her presence in his life as “inspirational”, Dr. Vayalumkal’s grandmother helped him gain perspective; and became an example of resilience, endurance and courage. “My grandmother was the ultimate matriarch. She was one of my superheroes. I am privileged to be brought up by strong, courageous and independent women – including my mother who stressed the importance of education and displayed a no-nonsense, practical approach to life’s problems. I am also heavily influenced by my kind, hardworking and devoted father. My father was a doctor in India and upon immigrating to Canada, faced challenges before his credentials and training were eventually recognized. He recently retired after a long career as a physician in Ontario; he was my primary physician role model”.
Dr. Vayalumkal refers to his early childhood years as “foundational”; he cherishes the memories with his family and recalls being surrounded by unconditional love. “We take for granted what we have, people around us, people who love us, and people who sacrifice for us”. Through his high school years, Dr. Vayalumkal volunteered in a paediatric ward at St. Joseph’s hospital in Hamilton, gaining an appreciation for some of the challenges children face when they are hospitalized. Upon graduation, Dr. Vayalumkal pursued an undergraduate degree at McMaster University, and continued his education there to obtain his medical degree. The medical school was well known for its revolutionary and self-directed problem-based learning model, a unique approach to medical education which made McMaster world renowned since the 1960’s. Dr. Vayalumkal reflects: “I feel very lucky to have attended medical school there”.
Dr. Vayalumkal moved to Calgary in 2000 to pursue post graduate training in paediatrics. “I was always interested in the field of paediatrics”, he shares thoughtfully. “But, it’s not for everyone. Each day, seeing children suffer is not pleasant, and it’s not easy to be around children in that state, especially when they pass. The death of a child is painful as a parent and as a physician. You don’t get immune to it; you don’t get numb to it; it’s very hard to take.”
Dr. Vayalumkal shares that although moving to Calgary was a surprise decision for him, it was the connections, the collegial spirit and the great impressions that made this decision feel like the right fit. “The interviews in Calgary made a very good impression on me; it was a solid program for residency where I felt I could excel. Plus, working with good people who were established in providing a good working and learning environment was important to me”.
Wishing to specialize in a certain field versus choosing a generalist route, Dr. Vayalumkal became interested in infectious diseases, a dynamic field focused on diseases caused by viruses, bacteria, fungi and parasites. This interest began during medical school and was further developed during residency. After completing his residency in paediatrics, he completed a two-year Fellowship in Infectious Diseases. “This is an exciting field to be a part of because it’s not concentrated in one specific organ system, it encompasses the entire body”, he educates. “There are so many very interesting environmental and cultural factors that affect how infectious diseases are transmitted”.
Dr. Vayalumkal is grateful to the mentors who encouraged him to pursue infectious diseases as a specialty. Following the completion of his Fellowship, Dr. Vayalumkal and his wife, Joyce, traveled to India to work in Andhra Pradesh with a non-profit organization, supporting a local clinic and health outreach program in rural villages affected by poverty and inequality. “This became a profound experience in itself”, he remembers. “The biggest learning point and take-home message from this experience was to keep an open mind about how things are done in different parts of the world, and hold off on passing judgement based on the way things are done in your part of the world. It is very easy to go to a different province, country, or hospital and question the way they practice or live. If you place yourself in a different circumstance, people will not be doing things the way that you did things back home. We need to be open to doing things in a different way that fits with the local context. This was my most important lesson.” Dr. Vayalumkal states that it is critical for people to be aware of the phenomenon that practices may differ in different jobs, cultures or countries, and one way is not necessarily better than another. “Our way is not always the best way. There was so much learning for me from this experience. The biggest challenge for me was the difficulty in adapting to what we would consider injustices or practices we would never support; but, we need to recognize the culture and what is culturally ingrained as well. It’s important to give yourself time to adapt and help to initiate changes that may be beneficial and accepted over time”.
Dr. Vayalumkal’s adventures then took him to Ottawa, where he spent two years working as a field epidemiologist on outbreak investigations for the Public Health Agency of Canada. He returned to Calgary thereafter, settling into a full-time role in the department of paediatrics at the Alberta Children’s Hospital. We learn that infectious diseases are very common in young children. Dr. Vayalumkal and his colleagues see many different infections due to spread in daycares and schools, which are breeding grounds (especially for viruses) caused by the close interactions within their environment. “We see a lot of different viral infections in children; and we become involved as infectious diseases specialists in diseases that often mimic other conditions or become complicated in some way. It is hard to figure out sometimes, and children occasionally present with unusual findings that are not commonly or typically seen”, he shares. “We get involved in a lot of complicated bacterial infections, which can be very severe such as sepsis and septic shock”. Dr. Vayalumkal educates us on different types of bacteria that cause illnesses in children, such as strep throat bacteria, which causes many other types of different issues, not just strep throat alone. “We see a lot of common and uncommon things: fungi, parasites, and viruses; all germs that invade humans and can cause critical illnesses. This is also due to immigration pattern changes. We see a lot of tropical and travel related conditions that we didn't see as commonly twenty years ago: malaria, dengue, and some parasitic diseases are imported from other parts of the world and reflect our diverse population”.
Within the field of infectious diseases, Dr. Vayalumkal specializes in infection control and hospital epidemiology. Dr. Vayalumkal’s research focuses on infections that are acquired while a patient is admitted to hospital and preventive strategies employed to reduce these infections. Dr. Vayalumkal reminds us how pandemics are a part of human history. “It’s not if but when a pandemic is going to happen”, he says. “We never know which virus would cause a pandemic”. As COVID-19’s pandemic paralyzes countries and forces the world to embrace unprecedented quarantines, Dr. Vayalumkal shares research and information on the ease with which this disease spread among humans. He also provides insight into the due diligence and proactive planning that began in January with him and his colleagues. “The genetic code was shared quickly so that tests were already being developed across the world. We released an interim infection control plan for our hospital on January 24th (based on World Health Organization guidance) so we could start thinking about what we needed to do. Over time, more information came out, and the World Health Organization declared an official pandemic in early March. Social media and the news created a lot of fear, which added another level of complexity as our team worked to provide everyone with facts and a plan to move forward. It will be years before we have a complete understanding about this virus. The first wave may be over, but the second wave may arrive in the coming months, and we need to be prepared”.
There is still a lot of information that is being gathered, and how COVID-19 manifests in children; the after effects; and the long term effects. He continues, “Currently, we work on understanding COVID-19, and our biggest challenge is how children are affected. How contagious are children? Could they be super-spreaders? It seems unlikely, but we don’t know for certain yet. We know for sure they are not affected the same as adults. Kawasaki disease, for example, is a very specific syndrome usually seen in children aged three to six years, with higher incidence in Asian countries, but still seen all over the world”. Several weeks following COVID-19 infection, a small minority of children are exhibiting symptoms very similar to Kawasaki disease and another syndrome known as toxic shock syndrome, which leads to uncontrolled inflammation in the body. “Research is underway to further understand this phenomenon. Approximately one thousand children in Alberta had COVID-19 infections in the first wave, but none of them had severe infections, not one single child”, he shares. “Children’s symptoms were extremely mild, and most children were recovering at home. There is the acute process to be aware of, but understanding the long term effects and complications are still to be realized”.
Dr. Vayalumkal becomes pensive, and reveals the top motivator in his career and his role: “Making a difference in a family’s life; making a positive difference in the life of a child and their family is my greatest motivator. There are different problems for different families, and diverse circumstances which require empathy, patience and a calm approach. My Catholic faith is a large part of my life, and prayer life is important to me; starting my day by praying for the strength to do well for my patients”. Dr. Vayalumkal also appreciates the camaraderie of his colleagues, and the people he works with. “Helping others to be better in a collegial environment, and helping kids and families through providing information, alleviating their fears, and reassuring them is a main driver as well”. Dr. Vayalumkal chooses to focus on making a meaningful impact in the lives of others. “A lot of time, you may not know what your success has been, only others can experience this”, he highlights. “If others think back to positive experiences people have had with me, then I would say that I was successful. We all have our roles and our duties. Often times, things come up outside of those normal roles that are unexpected, and we may not realize our impact on other people’s lives by what we do”.
Dr. Vayalumkal shares a story of a high school math teacher: “Mr. Kersley would say ‘look around! Ten, twenty, thirty years from now you won’t remember what you learned in math class, but you will remember the relationships you built with the people around you’. Those relationships I cherish. This hit home for me, because with anything we do it's true that the time we spend with people and the interactions are what we really remember”. When considering impact and the individuals we meet by chance, Dr. Vayalumkal recalls operating room technician, Douglas Martin, who he met in 1999, in the locker room of the hospital surgery department, where a simple chat about basketball led to a profound core value that Dr. Vayalumkal carries with him today. “Douglas said to me, ‘there are three A’s to being a great physician: Ability, Affability, Availability’. This really resonated with me. As you go through training and meet different mentors, and experience different collegial relationships, you begin to see that these three A’s are truly evident; all important; and they really help shape you to become someone you aspire to be”.
Today, Dr. Vayalumkal tries to achieve and emulate the three A’s consistently. A work and life balance is very important to him; he pursues goals in all aspects of his life. Dr. Vayalumkal enjoys keeping things simple, and focuses on having a balanced approach. “What is the most important role I have in this world? Being a husband and a father. I am blessed to have a loving, supportive wife and three wonderful children. Fundamentally, it comes down to priority: family, faith and professional life. I want my wife, children and the rest of my family to be proud of me, and to learn from me. I would like to give my children the gift of wisdom. There are thousands of infectious diseases specialists in the world, but as a father to my children, I have a unique role. No one can replace this position”. Dr. Vayalumkal is reflective, and pays homage and respect to the past. Ancestors who have paved the path for generations today are critically important to him. “Remembering where we came from helps us clarify our future and it’s something I truly cherish. This includes the privilege of knowing the Malayalam language and the culture from which our parents and grandparents originated”.
We admire Dr. Vayalumkal’s tenacity and compassion in his commitment to clinical work; and applaud the selfless dedication toward protecting humanity from the ambiguous world of infectious diseases.
For Dr. Vayalumkal, this is not a role he has been titled; it is a title that is awarded through a role society is dependent upon for knowledge, growth and wellbeing. A role so Extra(ordinary), we are struck with reverence as Dr. Vayalumkal adjusts his mask and prepares for another unprecedented day at the hospital…waving us a gracious “thank you”, along with a hidden smile communicated through his humble eyes.
“The three A’s are truly evident; all important; and they really help shape you to become someone you aspire to be”.
Dr. Joseph Vayalumkal, BSc, MD, FRCPC
How do you measure success?
-Written by Reena Khullar Sharma, Founder & CEO