Only Human – Episode 7 – Veevek

Henry Goldstein: 0:00 Welcome to Only Human, a podcast from Don’t Forget the Bubbles. This is Henry Goldstein with Becky Platt, and these are the stories that reflect the diversity of our community, and the multitude of life events that come our way, that shape us as professionals, and as humans. Veevek is a migrant from Calgary, Canada now working as a paediatric emergency specialist in Brisbane, Australia. In primary school, he acquired profound hearing loss, but that hasn’t stopped him from achieving his dreams of wanting to make the world a better place one patient at a time.

Veevek: 0:31 In my formative years, I don’t have very good memories of the teachers, because I think a lot of them were afraid of what sort of trouble I would be for them. Back in those days, we used to go in alphabetical order, even if you went by first name, or last name. Being Thankey, you’re bound to be at the back of the class. And, you know, if you’re not able to hear very, very well, you suddenly have this disinterest in whatever’s going on. Some of the comments that that particular teacher had made – “Veevek is very rude and doesn’t listen to anything in the class.” And so there were all of these sorts of cases against my parents of going, you know, ‘your child is essentially a bad apple’.

There was one particular event that happened where my parents thought something’s up, something’s not quite right. And it was back in the days where you would go on Sunday drives, and you know, listen to the radio, and you didn’t really care where you’re driving, but it was just, it was the journey itself. And it was my Uncle who was driving this old Datsun. And we always listened to the radio. And this particular trip, I remember asking him and I said, ‘Oh, I can’t hear the radio‘. And I had to jump to the back of the car and put my ear on the speaker to actually hear it. And that’s when my Uncle slammed on the brakes, and he was like, ‘something’s wrong’. And so that’s kind of led to the hearing test and audiology appointments and the actual diagnosis of wow, you actually have profound sensorineural hearing loss.

That in itself was a bit of a challenge because I was probably a very feisty young child, like I don’t think I was a very passive child, to say the least. And getting fitted for hearing aids, and all of those sort of things was such an alien concept to me in terms of, ‘why do I need this, like, you know, what, how is this going to help?‘ and having an overlay of being a child that doesn’t necessarily conform, or listen to a lot of other people. I would often like throw my hearing aids out, and you know, my parents would be scolding me and I’m like, ‘I can’t hear you‘. And, you know, just refuse to put my hearing aids back in.

So the audiologist was based at the Alberta Children’s Hospital and I still remember her name. Her name was Lucy and she was lovely. She was a lovely woman who had a very soft voice. She had this smell about her that was just almost that came from, like a beauty magazine like that sort of, you know, the free perfume sample. Just very pleasant that just almost drew you in. I still remember some of the toys that were in the big sound room, essentially. And I remember having to sit on the chair in the middle, and they kind of set you up with all these sorts of headphones. And, and I still remember the script that she would have, and she would put a piece of paper in front of the microphone she would have. And she’s like, ‘Okay, Veevek, I want you to repeat after me, say the word hammer, sausage‘. And that would be the exact script. And she would dial up the frequency or dial down the frequency in terms of deciding at what level can I hear, what level can’t hear.

Those memories were kind of put away up until I started my paediatric training at the Mater when I actually had to do a community/developmental paediatric rotation. And one of the sessions was to sit in with the speech pathologist and the audiologist. And it was in one of these exact same rooms. And I just had this flood of memories going, ‘Oh, my goodness, this is this was my childhood sitting in this small room‘, and I’m on the other side of it and kind of thinking, ‘wow‘. Some things never changed in terms of the machinery, this set-up, and the script. It didn’t feel weird. It kind of felt like this was right like a full circle has come and I’ve completed that circle. It felt normal. It felt that this was the right thing. This is the right path or this is the right process that was about to happen.

Henry Goldstein: 4:27 Veevek’s force of personality is such that, despite his hearing impairment, he was determined to make it to med school.

Veevek: 4:34 We lived in a city where a lot of schools fed into each other. So, if you lived in a particular suburb, you went to that particular suburb’s main school, and then you were fed into the high school that would be in that catchment. So 7, 8, 9 were the years where I decided to really jump into academics, because my brother who’s four years older than I was, was extremely smart. And we had a lot of the same teachers. And they were the same expectation of all ‘Here’s another Thankey child coming through, you know, they’re going to be good in English and the Arts and that sort of stuff‘ which my brother was. Whereas my strong suits were more so in Maths and Science. And I really enjoyed Social Studies. English for me wasn’t very, it wasn’t my strong point. But I understood the value of it. And prior to entering high school, year nine was the year that I decided I wanted to do medicine.

So high school was all about trying to do as much as I possibly could to then get myself into a good university for medical school. So high school was all about doing all the sciences, doing all the honours programme, doing yearbooks, Social Club, Model, United Nation, debate, a part of the leadership committee, trying to try for sports, which I never did any. But it was, it was three years of trying to do as much as I possibly can to make my CV at that time, be filled with meritocracy. To be filled with, with things that actually showed merit. High school, so I really enjoyed Model United Nations – there was an avenue to learn about World Politics and International Affairs. And every year, they had a city-wide Model United Nations tournament that was held at the University. And it was a really nice association of people that I thought, ‘wow, like, these are people who are thinking about the world problem’, as opposed to what my personal issues are as a year 10 student.

And going through High School and knowing that, you know, there’s so much more to our world than just what was in Calgary or what was happening in high school was exciting. It probably left an indelible mark with regards to knowing more about the world and knowing what the world has to offer and being actively involved in trying to create social change or trying to be involved in activities that highlight how much can we do for the world. How can it be, how can it truly be a better place? And interestingly enough, in the end, there are about 12 of us that were in all of the same honours classes. And coincidentally, all 12 of us had become doctors, I don’t know if that was the beginning of where that sort of pseudo-medical fraternity started where I thought, well, here are people who are, you know, are thinking about the world or thinking about other things about from themselves.

Henry Goldstein: 7:26 As an undergrad, Veeveks experience of accessing the curriculum was quite different to that of his school days. And his progression through university was truly down to his tenacity.

Veevek: 7:36 University was. It was a community of people that wanted to be there, you know, there weren’t a lot of hecklers, or there weren’t people there that were teasing you because you had to wear hearing aids, or you had to put up your hand to ask the teacher to change your hearing aid batteries or anything like that. Hearing in that capacity at university was almost an afterthought, to be honest, like, I didn’t have any issues. I was able to sit in classrooms that would have TT technology. And so it can kind of technically Bluetooth into your hearing aids.

The only areas in which I found it difficult were in two settings. One would be social settings where there was a lot of noise, and that noise just kind of comes from all different angles, and you’re trying to almost triangulate where that noise is coming from, and try to draw your attention to that. So that’d be one. And then the other one, when I found it difficult was…so I almost did a minor in Spanish. And a lot of when you learn a language is about comprehension. So you do a lot of listening to tapes and things like that. And unfortunately, if your hearing is not as good, even for a normal person, you know, listening to an old tape that’s been played however many times before – it can become very scratchy. And I always found that a little bit difficult, and there wasn’t much more that I could do. I can you know, it’s not like I could be a little kid and put my ear on the speaker of the boombox or whatever it is being played. But yeah, those are the two areas that I probably found difficult.

But I think given the type of person that I am social situations weren’t that difficult for me. I had the courage and I also had the strength to tell people that look, ‘I’m really sorry, but I can’t hear you. Are you able to repeat that?. Or just let people know that ‘the interaction that I’m having with you could be made better if we went outside or if we sat in this room‘ or things like that. Initially, I probably thought that I shouldn’t be asking those things because that would set me apart. That would make me different. That would make me look like I have a problem, quote-unquote. But then I realised well, at the end of the day, if you’re not gonna stick up for yourself, then who is? And if you don’t ask the question, the answer will always be ‘no’. I then realised that the access issues that I thought I had weren’t necessarily from a system base. It was more so my own personal access issues that I had.

Henry Goldstein: 9:58 After graduation, a big change for Veevek was moving overseas and beginning to study medicine in Australia, where some of those previous anxieties around access came into play again.

Veevek: 10:09 My journey from undergrad to moving overseas and doing development work, I don’t think I had a lot of issues, but it was coming to Australia. And knowing that I got into medical school and the thought around ‘oh, crap, I’ve got to use a stethoscope, how am I going to do that?‘ And that’s when a lot of this sort of inner child that kind of came out because they kind of went to a place of openness. I don’t, I don’t know what I’m going to do. I don’t know, of anyone who has a profound hearing loss and had done medicine. I knew of, you know, older doctors who had grown into their deafness, if that makes any sense, or if they became deaf as they grew older, but no one who actually was profoundly deaf to med school. And I remember still asking the School of Medicine about you know, what sort of services are available, what sort of access is available? And to be honest, I didn’t get much back. And it was a lot of my own volition that I had to find a stethoscope or find things that I could then use to help my hearing. And it kind of took me back to the place of almost primary school, again, of not wanting to be the child or that person who needs to sit in the front row, because you need to be able to hear the lectures or anything like that, and trying to kind of balance that with the social life of what medical school offered in terms of – which group do you want to be a part of which social activity do you want to partake in, but then be mindful that ‘I’m here to become a doctor, I’m here to study I’m here to do all of these things and by doing so, I need to be able to use the conventional ways of learning‘.

I need to be able to listen to my instructors and listen to the professor, and the doctors and be able to communicate in that same fashion as well. Hitting med school was what I’ve always wanted to do. Every day was fantastic. I was around people that I truly had a connection with. I was doing the things that I wanted to do. These were the skill sets that I was learning to help me in my future practice. I absolutely loved it. It was probably some of the best four years of my life.

Henry Goldstein: 12:14 Veevek became an Australian citizen after 11 years. And it wasn’t until then that he found accessing support for his hearing impairment much easier. Throughout his professional career, Veevek has wrangled with self-belief and pragmatic strategies to enhance his medical practice. I mentioned to him about a time one of our colleagues mentioned his gee-whizz-bang stethoscope,

Veevek: 12:37 I think that particular stethoscope was – I think it was somewhere around almost 900, or $1,000. And technology has come so far that the prices have been reduced. But the technology back then still didn’t give me enough to listen to everything that I wish I could have heard. And I think that that probably made my imposter syndrome a little bit worse in terms of thinking, I have a hearing impairment, say, I can’t get all the clues through this stethoscope. Physically, it won’t let me hear past a certain decibel. And therefore I need to use my diagnostic acumen to actually then determine what else could be happening. What are the other signs that this patient has that could lead me to the appropriate diagnosis? And I would like to think that there has never been a case in which I had made up something if that makes sense. Like there’s always a situation to go, ‘I’m not sure about what I’ve just heard, I’m going to get someone else to listen to it‘. And once again, that is that whole thing of thinking, sometimes you might need to ask someone else for help. And that’s not a bad thing. It’s not making you any less of a physician. It is not making you any less smart than your colleague, but sometimes you just need help.

And I think a lot of, especially in trainees who are doing their physicians exams, you know, we’ve all been taught that if an examiner asks you a question, and you don’t know the answer, the answer should be ‘I don’t know‘, because you will definitely get caught out on an answer that you’ve fabricated. And once again, you know, we are dealing with the lives of our patients. And those sorts of answers to those questions are really, really important. And so if you don’t know it, you know, it’s your duty of care to say ‘I don’t know‘. And, as you said, it’s something that junior medical officers should take on board early in their training – to have that sense of humility.

Henry Goldstein: 14:33 The biggest challenge for Veevek in recent times has, of course, been managing and adapting the way he cares for patients through the COVID-19 global pandemic.

Veevek: 14:40 You know, if there was a potential COVID patient and I had to be in that room, I would have to be there as the role of a team leader like I would not be able to actually utilise my stethoscope because I would need to: A) take out my hearing aids, put my stethoscope in my ears to actually listen to the patient and then have to put my hearing aid back in. So there’s a time delay as well. And B) it’s also there’s a health risk, you know, in terms of not being able to clean instruments properly. And so I have to then weigh between the risk versus benefit of me being involved in that patient’s care.

There’s technology out there which I’m currently trying to access with regards to stethoscopes that Bluetooth directly into your hearing aids and you actually don’t need to remove your hearing aids to you that. And unfortunately, it is not an Australian product, so there are some limitations to resourcing those pieces of technology. But it is out there in terms of being able to augment the technology. In terms of being able to Bluetooth phone calls into your hearing aids, being able to Bluetooth music. And now that the scopes are another overlay of technology that could be Bluetooth into hearing aids as well.

Henry Goldstein: 15:53 Veevek has clearly come a long way from being the mischievous little boy growing up in Calgary and listening to his Uncle’s radio. The time I’ve known Veevek is personified by wisdom and kindness. When we spoke, what really struck me most was his humility and perspective about the position of a paediatric emergency practitioner with.

Veevek: 16:14 When I was in year nine, I knew that I wanted to become a doctor. But that was also the time that I knew I wanted to be a paediatrician. Then in my intern year I really thought of doing emergency medicine. In my intern year, I interned at the Gold Coast hospital. And it was a great hospital for many reasons. And one of them was the emergency department. It was just such a vibrant community of people that I’ve just found a group of people that were on point for so many different things. It really made me think I loved the spontaneity of Emergency Medicine. And I thought, how can I couple this with paediatrics.

And I’ve now realised where I had realised that the coupling of Paediatrics and Emergency Medicine isn’t always about the resus. It’s not about the trauma, It’s not about, you know, the gory things that come through. It’s about creating positive public health changes for parents. There was one child that I can remember who had come in with their umpteenth number of episodes of bronchitis. And I still remember having a chat with the parents and going, you know, both parents were smokers and looking at, you know, smoking as a risk factor. And the parents seemed to be very in that sort of pre-contemplative stage of like, ‘Now, this is not us, you know, we’ve got another child to go to daycare; and doing that‘. And then I remember, a couple of years later, I’ve seen this same child, but for a very, completely different reason. And the parents were there and they said ‘Oh, do you remember, do you remember us?‘ And I was like, ‘I’m really sorry, but I can barely remember you. But I’m not really sure where I know you from‘. And the parents are like, ‘Oh, you know, you’re the one who told us that smoking was causing our baby to have all these infections, and we actually now are non smokers‘. And that was when I thought, ‘Yes, this is exactly what I love about paediatric emergency medicine‘.

And it’s something that I try and pass on to the juniors as well, you know, you may be the only doctor that this family will see this year. And there are so many opportunities to actually create positive changes in a family. And you can use that child as a conduit to get to the parent. Because at the end of the day, the parent will do whatever they can for their child. And there is so much education that we can provide in the ED with regards to how to manage fevers, how to manage appropriate crying behaviours, and how to manage constipation. But the frame of reference that I have, and I hold quite dear to my heart, especially in the emergency department is to say that I go to work and it is a place that I love to be in. I have a smile, I’m glad to be there. I’m interacting with the people that provide me with support and hope and joy. But in saying that, even though it’s my day-to-day, for some families, the worst day of their entire life. And to have that frame of reference actually is quite grounding. It’s something that I try and impart to a lot of the juniors to say, ‘You know, we are in a profession that allows so much trust, and we need to be able to honour that trust in the family that we serve. And to know that we at least get to walk out of the doors at 6pm or midnight, or whatever time we’re due to finish. But for some families – they may not have the same number of people in their car on their way home‘. And that’s a really powerful message and a very powerful frame of reference that I have when I see patients.

Henry Goldstein: 19:36 Thanks for listening. You can find more episodes of Only Human as well as details of events, courses and articles at DontForgetTheBubbles.com .

Until next time,