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By Dr. Heather Gooden

I was asked if I would like to write a piece for the new CWIM blog and at first it felt like I was back at school, called on when I wasn’t sure of my answer.

But the second the initial imposter syndrome faded, I was excited. How often does one have a chance to speak to their peers?

Some of you already know me but for those of you who I haven’t been lucky enough to meet, my name is Heather Gooden. I attended the University of Manitoba, graduating with my doctor of medicine in 2006, then continued on to McGill where I had the most wonderful family medicine residency program, based out of St. Mary’s Hospital just off Cote Des Neiges.

Full of dreams and plans to change the world, I spent my first three years after graduation working the full spectrum of family medicine in The Pas, Manitoba. I delivered my own patients, went to nursing stations, ran the chemotherapy remote location, and worked at least a hundred hours a week in the hospital, emergency room and clinic.

But something shifted the moment I became pregnant. I had loved almost every minute of my work, no matter how crushing or exhausting, because I felt I was making a difference, because I felt I was valued.

After discussing our goals and dreams for the future at length with my husband, a crazy-wonderful paramedic who had the best hand-over manners in the world- I realized I couldn’t sustain that pace if I also wanted to see my children grow up. It was a dramatic and difficult shift, moving with an eight year old and a 3 month old from Manitoba to Alberta, but slowly we settled in.

Far from friends, I was completely exhausted in a way I’d never been with work.

Having children was hard!

As time passed, my practice goals changed more. I began to spend more time at a supportive living facility where the residents felt like extended family. At one point, I had almost the entire building under my care. In time, the staff and residents began to feel like home to me, which makes the work so much more difficult and rewarding.

When you see the same people day after day, knowing they will continue to decline even with the best possible treatments, your mindset shifts from cure to care.

You begin to wonder not ‘how can I fix this’ and consider instead ‘how can I ensure suffering is minimal’- and even more, you learn just how little suffering is actually due to physical causes alone.

Over the years I’ve had many experiences I can’t explain, and I began writing to help me process the emotions my work leaves behind. I’ve shed more tears in the last few years than any time in my life, but the memories I have gained in exchange are pearls.

I wanted to share one story which I hope you can relate to. This particular piece is about one of my favourite patients.

When I woke up at three am on Christmas morning filled with a restlessness in my heart, I knew he had passed and I truly believe he came to say goodbye.


The Cactus

Everyday I greeted him.

“How are you today?”

And everyday, he shot back, a twinkle in his eye, knowing he was being bad.

“Not worth a God damn.”

At first, I had been concerned.

“Is there something wrong? What can I do to help?”

And just as rapidly he replied, the same every time.

“Get me the lead pill.”

I’d been horrified, but only for a week. As I grew to knew him better, I quickly discovered he was a tough talking, hymn-singing, prickly-shelled, soft-hearted bastard.

My favorite kind of person.

Sure, sometimes those who are rough around the edges hide a hard interior, but in my experience, now entering my fifth decade of living, the tougher the talk, the softer the center.

Honesty can be blunt at times, but usually, the honest ones don’t go out of their way to be hurtful.

And so I grew to love him.

Warts, and swears, and all.

I cared for both him and his delicate, calm wife for many years; watched their love shine through the wrinkles, white hair, and dementia.

I watched him grieve when she went first, likely to plead his case before the eternal judge, and we all feared he’d be right behind her.

But he surprised us all.

As if a burden had lifted, he suddenly bloomed, a cactus in the desert of supportive care.

His responsibilities settled, he was at peace,


Knowing he would see her again.

I saw him yesterday.

When he asked if I was God, I bit back my tears.

“No,” I said. “Would you like to see him? Are you scared?”

He smiled, then turned his head to the sky and sang a hymn as loudly as he could.

And I watched

As a cactus bloomed before us in his twilight hours.

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