A Doctor for the People

    Inuk Dr. Elaine Kilabuk is taking her medical skills back to the Arctic

    Dr. Alison Dugan is one of two internists who work in Iqaluit and one of Kilabuk’s mentors. © Season Osborne

    As a little girl living in Iqaluit, Nunavut, Dr. Elaine Kilabuk knew certain days of the week were “no doctor days.” On those days, she knew no plane was coming into the community, which meant there was no way to get to a doctor.

    When she was five, her brother was carrying her across a stream. He slipped and fell and hit his head on a rock. It bled profusely, and he needed stitches. Kilabuk’s mother, Karen Kim Tyler, remembers how upset Elaine was because it was a “no doctor day,” and told her, “I’m going to be a doctor when I grow up.”

    Kilabuk doesn’t recall that as her career-defining moment, though. For her, it happened when she was 17, visiting her grandparents in Pangnirtung on eastern Baffin Island.

    Her grandmother suffered from chronic obstructive pulmonary disease, a serious illness that damages the lungs and makes it difficult to breathe. Getting her grandmother the medical care she needed was complicated. For starters, the nurse at the Pangnirtung nursing station didn’t speak Inuktitut, and her grandmother didn’t speak English.

    The nearest hospital (and the only one in Nunavut) was in Iqaluit 297 kilometres — or an hour away by aircraft. The nurse called a doctor at the hospital and arranged over the phone to have her grandmother admitted. Getting her to Iqaluit depended on the arrival of the next plane. There was no air ambulance to medivac her there.

    Elaine’s baptism in Pangnirtung – her mother Karen Tyler stands left of the minister and her grandfather Ipeelee Kilabuk and grandmother Nellie Kilabuk on the right. © Karen Tyler

    Kilabuk had lived in Florida in the U.S.. So, she was used to the southern health-care system where a seriously ill patient goes to the nearest hospital’s emergency department and is seen and treated almost immediately by a doctor and other health-care professionals.

    “That was definitely an eye-opening experience to say the least… and how different it was based on the location. That is the reason why I went into medicine,” said Kilabuk. She resolved to become a doctor and take her medical skills back to the Arctic.

    In 2010, Kilabuk was accepted into medical school at McGill University in Montreal, Quebec.

    “I wasn’t too surprised Elaine wanted to be a doctor,” said Tyler. “She, herself, recognized the injustices and would say, ‘This isn’t fair. Everything we take for granted is not available to people we care about.’ ”

    In her fourth year at medical school, Kilabuk did a month-long family medicine rotation in Iqaluit. At an infectious disease conference there, Kilabuk met Ottawa Hospital respirologist Dr. Gonzalo Alvarez who focuses on tuberculosis (TB) treatment and research.

    She said meeting Alvarez was very serendipitous, having just been matched with The Ottawa Hospital in Ontario to do her residency. The big attraction for her was doing research in the place where she planned to practice medicine — the Arctic.

    The rate of TB in Nunavut is 296 times higher than it is among non-indigenous people living in southern Canada. As part of Alvarez’s team, Kilabuk examined the various social factors that contribute to the spread of this highly contagious disease, including education and income. They put this data into a mathematical model, which showed that crowding, caused by a housing shortage in northern communities, was the single most important driver.

    The Kilabuk children sit on a qamutiq: Tanya, Jason, Nathan beside their mother Karen Tyler who holds baby Elaine. © Karen Tyler

    Kilabuk was the lead author on the study’s research paper, published in February 2019. She presented the findings at the Inuit Tapiriit Kanatami and at an international conference in Vancouver, British Columbia.

    “It has been a wonderful opportunity,” said Kilabuk. “It’s good we can have an impact and determine what the highest risk factor is for TB. It was always what can we do about that? How can we make a change? That is my hope when I’m there — I can continue doing research and working with the people on how they can make the most sustainable change.”

    “It’s an absolute joy to be able to work with Elaine and see her succeed,” said Alvarez. “Her Inuit roots combined with her medical training allow her to work in a special zone that can reach further than others can. Having the opportunity to work with her in research, and also to get her involved in teaching the next generation of medical students has been absolutely fantastic.”

    Although Kilabuk initially considered respirology, or breathing issues, she specialized in internal medicine. Internists treat adults in all aspects of medical care.

    At the moment, two internists each spend one week seeing patients in Iqaluit.

    People needing to see an internist outside those two weeks have to go to Ottawa. This means leaving their family and community; sometimes just for a follow-up appointment. Kilabuk wants to change that and be the first internist to work for longer periods of time in Iqaluit.

    Dr. Alison Dugan is one of the internists who’s been seeing patients in Iqaluit for more than 10 years. Dugan met Kilabuk when she became a resident at The Ottawa Hospital.

    “When it became clear that Elaine was going to be involved in providing care in Iqaluit in the longer term, I wanted to make sure that we collaborated to make sure she was able to develop the skills she needs to be a good doctor up there,” said Dugan.

    Kilabuk is hoping to work at the Qikiqtani General Hospital in Iqaluit. She sees what a huge benefit this would be to patients in the territory. It means more continuous follow-up and the ability to build a doctor–patient relationship. Once she is stationed in Iqaluit, she hopes to travel to the various communities in Nunavut.

    “It’s easier to bring the physician to the patient than the other way around. I think that would be better, more timely, and more efficient,” said Kilabuk. “I could see more people in the community, because people would come out.”

    “Elaine is very good with patients,” said Dugan. “She relates very well to them. She’s a very gentle, kind person, and has a personality that patients find easy to connect with.”

    Inuktitut was Kilabuk’s first language as a child, but she lost much of it living in the United States. She intends to change that when she starts her northern practice in a couple of years. Kilabuk anticipates that it will be 10 years from the time she started medical school until she finishes her training.

    “It’s hard. The trajectory is very long to become a specialist,” said Alvarez. “Elaine’s one of only a couple of Inuit who have achieved it. Even though the path is hard and still has many barriers, she is living proof that it is possible. She is a fantastic role model to other young Inuit. I hope that her becoming an internal medicine specialist will inspire many other young Inuit to become doctors because we need more Inuit doctors.”

    Alvarez said McGill University established a bursary in her honour. The Elaine Kilabuk Inuit and Indigenous Health Professions Student Award will help support the training of an Inuit student from Nunavut in medicine at McGill.

    “It’s a long haul, but it’s definitely worth it,” said Kilabuk. “It’s all about the reason why you’re going into it, though. It’s about the people you are working with, the patients you follow, the difference that you are making. I do like to think I’m making a difference in people’s lives.”

    Dugan agrees. “Elaine’s going to be a huge asset there [in Iqaluit],” said Dugan. “l think the combination of her energy and optimism, and her relative fearlessness, are all going to serve her really well in getting an outcome for the people of the North, and for herself, that is really going to be better for all of them.”

    Ultimately, with Kilabuk working in Nunavut there may be fewer “no doctor days”.

    Season Osborne is the author of In the Shadow of the Pole: An Early History of Arctic Expeditions, 1871-1912. She lives and writes in Ottawa, Ontario.

    VIASeason Osborne
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