Experience & Efforts
Updated: Mar 2
EDITORIAL NOTE
The document that Dr. Waddell used to provide sworn testimony before the Weeneebayko Area Health Authority ("WAHA") is found below in the matters of WAHA MAC v Waddell. It speaks to events and opinions that occurred from February 2005 until December 2016. The official transcript of Dr. Waddell's testimony is available to any member of the public upon request to either Dr. Waddell or the WAHA.
During Dr. Waddell’s testimony neither his accomplishments nor his allegations of wrongdoing within the physician corps were challenged by the health authority's legal team.
What is written in the document and found in his given testimony speaks to the time period of February 2005 to December 2016, and should not be attributed or ascribed to any other period.
'My father, Dr. Bill Waddell, has entered into the dying phase of his life at his home in Kingston. He wants me to be here as what's at issue is not just my privileges, but the future health of you and your community members. My dad is proud that I have stood against so many to represent the interests of my Mushkegowuk patients.
26 years in general practice, 10 years in the north; I did so many things;
Hospitalist was a great experience looking after the acute and long terms care in-patients at WGH on the second floor. It is not busy with 2 – 3 admissions a day but there is a wide range of problems that I had to deal with from one end of the body to the other, that afflicted all ages, be it a fresh newborn with a fever to a well-seasoned elder whose organs were all failing. This low volume allowed me to spend time with my patients and simply listen to their stories, often in their first language, translated by a loved one. And believe it or not listening is how I made almost all of my diagnoses in my 10 years serving in the territory as your people always told me what their problem was in their own special and deeply honest way.
While hospitalist I looked at all of the x-rays that I ordered on my patients and would spend hours doing so especially if the patients had persistent symptoms and the radiologist’s report provided no answers. In doing this I discovered the diagnoses to my patients troubles that others before me had missed.
As hospitalist, I reviewed all old paper records of my patients and mined out past medical history otherwise lost in the hospital archive and data inputted it into the EMR. This markedly improved patient care. When I discharged my patients I personally gave them a copy of their EMR discharge summary before they left and wrote them in a manner that they could understand, as this messaging was important for their recovery and good health, now, not weeks or months from now. I also sent a copy to the home community along with a phone call to the charge nurse to ensure appropriate follow up was arranged.
I started my hospitalist shift between 7 or 8 AM and signed off at 11 PM for all of my hospitalist’s duty days including being in the nursing station during their 7:30 AM and PM handovers, acting as a resource person to them at this precarious transition period to ensure nothing was missed. No other doctor did this but the nursing staff sure appreciated it.
As hospitalist I was also the Baby doctor at all deliveries that happened that week. It was not burdensome as only 3 babies are delivered at WGH for any given week. 2 of these 3 came out through nature’s gateway, the other by elective C-section, the odd urgent C-section. I was fortunate to hand well over a hundred black haired, brown eyed, kicking and screaming red-faced babies to their Mom’s over my years with you. And no matter how exhausted the new Moms were that miracle of life always brought a contented smile to their face and put star-like twinkle into her eyes
At the end of every hospitalist assignment I took the incoming replacement doctor with me and introduced him or her to all of my patients on the floor that remained at week’s end. I wanted to ensure I had said my last goodbye at the same time my replacement got to say their first hello to instill peace to the sick and fallen knowing who was looking after them with certainty rather than doubt. And by the end of the doc’s first day I’d visit the floor again to ensure nothing was missed or uncertain.
I did many ER shifts over the years. It is rarely busy, less then 1 patient an hour, mostly routine family medicine stuff but an important encounter just the same. Had some urgencies, mostly broken or misplaced bones from the mishaps of the people’s recreational pursuits. The odd emergency, maybe one or two a week like asthma, stroke, heart attack, a bout of high sugar, a serious infection like pneumonia or an acute mental health crisis including suicidal thinking or suicidal actions. In the day time I often had a family resident to help me. I did coastal calls as well, providing medical advice to the nurses in your communities. When doing the coastal calls I used the Tele-health Network as much as possible to see the patients myself to ensure a certain diagnosis, or I was considering a medical evacuation. All of these coastal calls were recorded in the EMR by me as they happened in real-time, then printed up and faxed the report to the home community’s medical center, to ensure the messaging between me and my nurses.
I did the Surgical Assistant task any day that I could even on my days off as helping a skilled surgeon mend a broken body is absolutely amazing, not matter how many times I had seen it. The surgeries were all quite routine with one C section, one gallbladder, one hernia repair per week plus the odd appendectomy for good measure. The saddest surgeries that happen about once a month were the amputations, all from calluses on the bottom of a diabetic’s foot. I had at one time 13 double amputees under my care in the various communities, 3 of them missing parts of their arms as well. The last patient I pronounced dead in person in the territory had lost all 4 limbs, blind and in end-stage renal failure. These are all preventable complications from the diabetes that runs like a savage storm through your communities every day, of every week, or every month of the year without stopping, as it is not adequately followed by the doctors.
Anytime any colleague called me for help, be it in the emergency, as hospitalist, up the coast or in a local clinic I went and helped without complaint, without fail. Most of the 75 plus doctors I worked with on
staff in Department of Family Medicine are young. They appreciated having an old man like me assist or supervise them with a procedure, or Mentor and advise them on a complicated case. All new doctors were given my number to call me even when I was not in zone.
I spent a ton of my time as a Coastal Physician. When in community I started at about 7 – 8 and worked until midnight. If a nurse needed a patient to be seen I saw them each and every time. No calls ever were made to the on-call doc when I was in your community as I was your doctor for the entire time as that was my duty, my honour. This increased the quality of patient care. If a patient had to be admitted to
WGH from the community I did everything for the admission including the history, physical and ordered all tests and arranged all consults. I never left it to the other guy. I did hundreds of house calls with the community nurses to those who could not get in to see me and saw first-hand not only the health challenges my patients faced but social determinants of health such as mold, decrepit housing and horrible overcrowding. I always introduced myself and shook my patients hand at the beginning of every visit and did the same at visits end as through touch I could sense their troubles and they could sense that I was there for them, and would be there for them, as sealed through the bond of touch. I printed out my patient encounter from the EMR and gave it to my patients, like I did as the hospitalist to clearly show what was said, what I found on exam, what the diagnoses were and what the plans were to deal with them.
I was the Tele-health Physician Lead and with the help of nurses Maureen Grahlman and Kathy Faries, and the good people of Ontario Telemedicine Network brought that service to WGH, then to all of your coastal communities. It is not the great cure or panacea for all medical or surgical ailments that befall mankind but it plays a special role just the same, especially for follow-up visits by southern specialists in the comfort of your community.
I also brought Retinal Screening to region to detect the abnormal blood vessels that develop in a diabetic’s eyes so they could be sent out for laser removal before they burst, darkening my patient’s world forever.
Drs. Ahmed, Trusler, Northcott, Unger, Gabor and I organized the pick of hospital’s one and only Electronic Medical Records, Practice Solutions. Moving it up the coast to Moosonee, Fort Albany and Attawapiskat was done on my watch as Chief of Staff with the help of the computer folks, Doug Alissappi, Joy Butterfly and Virgil Nicoara and VP Client Services Ms. Rachel Cull. I used the EMR in Kashechewan immediately once the high speed internet went into your community around 2011 by simply installing the system onto my laptop, plugging into the world wide web through a remote secure server site in WGH. It was a pain as I was disconnected at least a dozen times a day but I did it without fail as putting information into a computer that everyone can access in real-time is critical. Just like hospitalist, in my down time I went through my patients’ files in my downtime and harvested out past medical, surgical and psychiatric histories and data inputted them into the EMR along with updating allergies, family history, habits, and drugs being prescribed.
Drs. Gill, Ahmed and myself also lobbied for the purchase of the Portable Ultrasounds that we have in 2009. We were supposed to have 5 but ended up with just two, one for the ER and one in Kashechewan. Great tool to have in a doc’s hand to assess for blood clots in the legs, fluid around the heart, stones in a gallbladder, where a pocket of pus is hidden deep within the body, and so much more. Most of the docs who were trained on it moved on except but for those new docs who followed I either trained them myself or came in and did the ultrasounds at their request for the patient they were looking after.
When Dr. Trusler left in 2010 there was no Coroner in the region so I volunteered for that. I took the 3-day course at the old coroner’s office in downtown Toronto on my own time and dime. They taught me what my coroner role was, to be the voice of the dead. I did not really understand at the time what that meant but the staggering rates of suicide quickly taught me what was expected as grieving relatives would come to me looking for answers now that their beautiful, young loved ones were gone forever.
At the request of late Muskegowuk Grand Chief Stan Loutitt I helped bring the Deputy Chief Coroner Dr. Bert Lauwers to Moose Factory to present the Chief Coroner’s Death Report on Youth Suicide in Pikangikum First Nation. I wanted the dead to have the chance to speak of their hurt, worry, suffering, pain, fear and heart ache through the voice of the coroner’s officer rather then having them forever choked into silenced for all of time from the noose that I cut loose from their strained and crooked necks. I hoped these unspoken words might help local leaders, crisis workers, counsellors, parents, teachers, friends and elders reduce suicide attempts and deaths in our region by improving upon the delivery mental health services and prevention initiatives.
I brought visiting consultants to your communities, orthopaedics was Dr. Graeme Taylor, a classmate of my Dad’s at Queens. Rheumatologist Dr. Henry Averns given the tremendous amount of rheumatoid arthritis in your communities, Peadiatrician Garth Smith from COPC at the Hotel Dieu Hospital to look after all of your children, or your children’s children, psychiatrists Dr. Tim Holden and Dr. Tony Carr. Dr. Robert Gabor and I also set up twice a week tele-health with Dr. Tim Holden, a psychiatrist to help us family doctors and GP’s given the large burden of mental illness we have in our region. Ultrasounds of the heart were done by Rose Norman. I was in the process of getting a gynecologist to visit all communities twice a year to better diagnose and treat virus-caused cervix disease that causes cancer in your young women but this was unfortunately postponed when I got so sick in 2013.
I was a highly sought Teacher for family medicine residents & medical students who did electives with me over the years. It was a fascinating experience as I felt the learner taught me more then I taught them.
In my time in between visits to the territory I started to work at Queen’s Department of Family Medicine in 2012 and taught the family medicine residents there. More importantly, I looked for the next generation of docs who were in a position to actually serve with us one day and worked some magic with Program Supervisors Dr. Pinky Schultz, Geoff Hodgett and Glen Brown to ensure these prospects got a better chance to do an elective with us and fall in love with the region and her patients, like I had, and eventually provide physician services for us.
I became the ACLS instructor when Drs. Ahmed and Trusler left the region. I took that weekend course at Mount Sinai on my own time and at my own expense and taught many nurses, docs, residents and medical students with the help of nurses Brian Linklater and Lana Plumton.
There is racism in this world and sadly my Mushkegowuk patients got lots of it and from places where you would least expect it, from health care workers. Anytime I heard a physician, nurse or health science learner speak about a negative stereotypes of my First Nation patients I always took measures to better inform them, as your culture must be recognized and accommodated to optimize the delivery of your health care.
During the Kashechewan water crisis I was the only doctor from WHA sent in by Chief of Staff Dr. Trusler and was one of the last medical staff to leave along with a couple of Health Canada nurses. Interesting thing about that crisis is it brought significant health improvements to that community in two ways, many new homes to relieve the horrific overcrowding and a properly staffed and equipped police force to adequately deal with the actual demand for law enforcement service.
During the Attawapiskat housing crisis I stood with Chief Theresa Spence, Grand Chief Stan Louttit & many other local community leaders along with the federal MP and provincial MPP. I was the medical expert for Mr. Angus’ video on the housing crisis, speaking about the health effects of poor housing be it increased rates of infection, the damage the mould has on your lungs and skin, the horrible mental health stress it causes, and much more. I met with Mr. Bisson in his Toronto office and was a resource person for him to prepare his address to all members in the provincial legislature.
I helped two local First Nation nurses get into the Northern Ontario School of Medicine by way of encouragement and writing them reference letters. The fact is they did all the work, Erin Pelletier – Morrison and Elaine Gagnon. They are both doctors now and will make a difference in this world not just as physicians but role models to inspire other First Nation people to achieve.
In Fort Albany, I did a drug and alcohol awareness seminar for the older kids in the school at the request of Board Director Gisele and Chairman Leo, and arranged for other doctors to repeat the talk the following year. At the same school I held a grief seminar for a very large gathering of grandkids of an elder who was passing away from cancer at the request of Mr. Loone. I participated as the doctor for health career days at Francine J. Wesley High School in Kashechewan as my field, but all health care fields, needs to be better represented with First Nation people. I did annual flu shot talks in the local radio station at the request of Priscilla Friday, the immunization nurse in Kashechewan to dispel the local myths. The facts are flu outbreaks are deadly in FN communities and the shots actually do prevent flu-related disability and death.
Ontario Disability Support Program - I applied the employment realities of the region to the applicants’ conditions and got close to a hundred patients on disability whom would not otherwise qualify.
I signed off hundreds of Special Dietary Allowances to get extra monies for the region’s patients on social services who had diabetes, high blood pressure, kidney disease, unable to breast feed, overweight, high cholesterol and other health conditions given the outrageous cost of food in the region.
When the Moosonee Health Centre had the fire shutting it down December 2012 I re-directed a doctor into your community day and night until the Emergency Measures Ontario and all the nursing and support staff of health centre got the igloo system set up in the curling rink to provide a calming influence to the nursing staff and patients until the new site was settled and operational.
I put doctors into your communities not just on weekdays but weekends in both Kashechewan and Attawapiskat in 2012 and 2013 as patients just don’t get sick Monday to Friday which was Dr. Gibson and myself.
There are nurse practitioners in our coastal communities because I brought them to us in 2012 with the help of Rachel Cull, Buffy Sutherland & Kathy Quachegan-Faries. Andrea Gaudet in Fort Albany, Becky Cambpell and Myriam Innocent in Attawapiskat. Kashechewan was the first site in a FN station where nurse practitioners were employed and I was the supervisor of Peggy Richardson. And whether I was in zone or not in zone those NPs called me and emailed me on cases that they needed help with, not my colleagues as I respected their training, expertise, judgement and heart.
I brought midwifery to the region at great resistance of my physician colleagues. The mothers in Attawapiskat wanted it. The local leaders in Attawapiskat wanted it. The Canadian Society of Obstetrics said it should be done. The Board wanted it. And given all of those voices I fought tooth and nail and I succeeded making Christine Roy, probably one of the best midwives in Canada to Attawapiskat so that babies, new life and joy, can be born into that community for all to savor, treasure and celebrate.
When I did coastal calls I answered most calls in under 5 minutes, usually immediately. I had the community nurses call me directly bypassing the hospital locating services to add speed to my response time. All x-rays, tests or specialist consults were arranged directly by me with WAHA Client Services eliminating delays with a middle person. And when needed I spoke to the patient whenever it was needed. I arranged follow up with me by coastal calls wherever possible to ensure continuity of care. All of my notes were written in real-time into the EMR and I always printed up and faxed a copy to all communities, with or without access to the EMR. Quitting time as found in the contract was 5 o’clock but if there were outstanding patient care issues I had the nurses call me after hours rather then start anew with another doc.
I became your Interim Chief of Staff in 2012 at the begging of then CEO Jim Harrold. The doctor that was supposed to take over for Dr. Cook was suddenly taken ill and was not able to do it. As the longest serving doctor I took that job as you and the hospital were so good to me. I received not a word of instruction or a moment of mentorship. In that 16 months, I saw:
1. Large turnover of senior management staff: 4 in total including CEO Mr. Jim Harrold, Chief Financial Officer Mr. Dean Wilson, VP Support Services Mr. Derrick Gourley & Director of Professional Practice Ms. Nicole Blackman. Schmidt is new. Second in command Rachel Cull out for significant periods of time for personal reasons;
2. Large turnover of other management staff: 7 in total including Diagnostic Imaging Coordinator Ms. Kendra Benham, Regional Telemedicine Coordinator Ms. Maureen Grahlman, OR Team leader Mr. Joe Cheechoo, Laboratory Manager Sean D, Human Resources Generalist Ms. Chantal Wilson and Engineering Supervisor Mr. Jean Arsenault, Early Episode Crisis lead, Mr. Victor Wabano;
3. Staggering turnover of nursing staff: Virtually all nurses have left the region within 1 to 2 years. Something is seriously wrong when this happens and it adversely affects patient care, notably in the coastal communities where most of the actual primary care is delivered by them;
4. Debt of about $10 million and deficit of $2 million: This threatened the financial stability of the hospital. Attendance issues were so bad at the Board meetings that the NE LHIN was considering seizing control of the Board until these matters were suitably remedied;
5. Significant and unexpected reduction in physician numbers: Within 1 month of taking over down 3 doctors. One was expected but 2 were not. One locum tenens on staff at the time with no new hires on the horizon;
6. Loss of the Physician Services Coordinator: PSC took all of the inner workings of that office with her and left myself, Rose Blackned and Jamie Kapashesit with the formidable task of starting all over;
7. Acute health crisis involving key lab staff that left close to 10,000 unchecked lab results over the last several months. In addition there was so many deficiencies in the operation of the hospital lab that WAHA was in danger of losing its’ lab license;
8. Egregious conduct by many staff physicians: No less then 10 docs physicians whose misconduct included fraud both above and below $5000, theft of hospital property, willful destruction of medical records, falsification medical records, incompetence, negligence, abandonment of our patients, malpractice, sexual abuse of patients, violence in the workplace, breach of hospital policies and by-laws to name a few;
9. lIlegal dismissal of longstanding doctor on staff by violating the doctor’s human rights as found in the Human Rights Code of Ontario. I flew the doctor back to MF at my expense and arranged a meeting with HR saved the doctor’s career after Schmidt and Reuben illegal dismissal;
10. Markedly reduced lab services: Our lab practices were so dangerous that we almost lost the service. Leadership of Rachel Cull and Patti Gibson coupled with the hard work of the lab staff restored the service after several months;
11. Parts of the hospital closed down: Sewage leak in the dental office from faulty plumbing from the bedpan washer. Water leak in the dialysis unit that caused the ceilings in 3 rooms in family med to collapse. Parts of the hospital shut down due to asbestos insulation;
12. Serious physical assault against a physician: that required the doc’s medical evacuation to receive medical attention to save the sight in the injured eye;
13. Three (3) female physicians sexually harassed that had to be dealt with by the NAPS as the hospital was ineffective at preserving their safety;
14. Loss of an irreplaceable ultrasound technician: Kendra Benham that markedly affected the safe operation of our surgery, obstetrics and ER services;
15. Flooding of Fort Albany hospital that resulted in the long-term care patients being moved to other facilities and many of the homes of the nursing staff significantly damaged;
16. Fire at Moosonee clinic:Fire rendered clinic inoperable and Moosonee residents care provided out of cardboard igloos in a partially heated curling rink;
17. The ORNGE helicopter crash on May 30, 2013 4 men dead, 2 of them my friends, gone forever for a medical evacuation that was never needed as the doctor on duty failed to do their job;
18. I am threatened with physical violence and death by a patient’s loved one for explaining to the him/her what happened to his/her loved one and what steps he/she had to do to seek justice including reporting the doctor to the CPSO for disciplinary actions; and
19. I am forced to seize care and control of the Chief of Family Medicine given the predecessors incompetence and corruption and did so on my time with no sacrifice in clinical duties saving the hospital $25,000 a year in stipend that did not have to be paid.
Throughout those 16 months, I was attacked in an organized and sustained way by many physician colleagues to near death while the hospital administration looked on and did nothing. In fact, I offered Mr. Schmidt $35,000 of my money as a start to rid the hospital of Dr. Barkman by legal means, a lethal cancer to WAHA. When a stranger asked to characterize those 16 months, I said 'WAHA is a multi-dimensional, dysfunctional organization to the highest degree perpetually mired in deep chaos and mayhem.' And I doubt that any person could say it any better in 20 words or less.
As to team player, you are my patient and I will always put your interest before the team. The reason why I do that is that is what doctors are supposed to do. Any doctor who tells you otherwise should not be your doctor, in fact nobody’s doctor.
As a team player, I perform excellent history, I do thorough examinations, make good diagnosis, order the proper tests, prescribe the right treatment arrange for proper follow up and I type it into a computer EMR so any colleague that follows me knows exactly what has happened.
As a team player, I do as much as I can in a day so my teammates have less to do
As a team member, I help my teammates whenever they ask. I will never cut Dr. Martens' lawn or shovel
Dr. Green’s snow but I will help them each and every time one of their patients is in need.
As a team member, I will take on any task that needs to be done by my team and did this throughout my decade of service.
Being part of a team does not mean I will sit silent while a member of my team puts a life or limb in peril, hurts a patient through neglect or kills a patient through incompetence, carelessness or irresponsibility, steals from the hospital as that is the same as stealing from the patients. If I know my team can do better to serve our patients I shall speak. If a teammate deceives my patients, I will not protect them.
As to what others have said about me. I lie to no one. I lie for no one. I follow rules, I don’t break them. I never abandoned a patient, nurse or colleague at anytime under any circumstance. NEVER. I never took money from this hospital that I had not properly earned as Drs. Green & Martens have implied. All of my actions were predictable as they were made through reason and duty.
If I make errors I take responsibility for them, which always includes a formal acknowledgement and a sincere apology. If possible, I try to right my wrong. And I use that lessons learned of my missed steps to guide my future so as not to repeat it. I have never practiced while impaired by illness or injury, as determined by a psychiatrist with expertise in the care of falling, breaking, less then whole colleagues.
I never posed a danger to any member of society including anyone who worked at the hospital in any capacity at any time, as determined by an expert. I never gave consent of any kind for Dr. Green, Dr. Martens, Mr. Schmidt and others to disclose my personal health information or personal information that they were privy to, only because of their positions as Chiefs, to people and parties who did not need-to-know.
The Board:
I was your doctor in all of your communities since February 2005. I still would be if it was not for the horrible things Drs. Green & Martens and Mr. Schmidt did to keep me away from you. The plane from Kingston flies over my house everyday Monday to Friday and I wish with all my might I was on it to once again serve. That longing has not waned in over 2 years.
You showed me much so much in our time together. Your celebration of the beginning of a new life and the remembrance of old life no ended. Your sense of family and community. Your humbleness and honesty. Your appreciation of simple things. The way you embrace Mother Earth. Your courage. The respect for all members of your society. Your sense of humour. Your resilience and strength in the face of such hardship and deprivation. Your resourcefulness. Your artistic and musical abilities. Your freedom of the confines of the watch and the calendar. Your respect you show for your elders and the lessons you take from them. Your time and energies to show me your way. Your patience and tolerance of my way. It truly was an honour and privilege for me to see this and I will be forever grateful.
I know my ancestors took your land, silenced your voice, oppressed your culture, seized your children, robbing many of their innocence. In this wake is abject poverty, massive unemployment, deplorable living conditions, endemic malnutrition, alarming suicide rates, tremendous burdens of chronic physical and mental health illnesses that steals quality from life, markedly shortened life spans and much more. When I came to the Mushkegowuk Territory and saw first-hand what I just described I knew this was my family’s time to start to give back through my service as your doctor. I know it is humble offer. I know it does not right all of the wrongs. But it’s all I had to give and I did it with all of my might, all my heart, all of my skills, one patient at a time without fail.
I deserve to be a doctor on the Medical Staff at your hospital given my qualifications, experience and dedication to the health of your people. I ask that you grant me privileges as a locum tenens in the Department of Family Medicine. I also ask for your thoughts and prayers to give me the strength I need to once again tend to your injured and fallen be it looking in a painful ear, listening to a heaving chest or palpating a nervous pulse, and the courage to lift my head from its beaten down gaze and walk amongst your people as the doctor, the person, the kind man that I always was, decent, honest, fair and kind.
And despite the huge personal cost I paid to further your cause, I have no regrets, as every person in all of your communities was worth it
Post script: During John Waddell's ten-years of service in the Mushkegowuk Territory he had no complaints of any kind in his human resources record at WAHA and its' predecessor (WHA, JBGH & WGH). To appreciate the enormity of this John worked for five (5) different CEO's that included Mr. Schmidt, four (4) different Chiefs of Staff that included Dr. Green, & nine (9) different Chiefs of Family Medicine that included Dr. Martens. In this same time period John Waddell worked with over seventy-five (75) family doctors, over fifty (50) specialists, hundreds of nurses, hundreds of medical learners, hundreds of hospital support staff and served thousands of patients.
References
1. Transcript John Maitland Waddell v WAHA December 14, 2016
2. Human Resources file of John Waddell
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