ITF o@ca.on.york_county.toronto.toronto_star 2005-07-04 published
Dr. Ian NAKAMURA, 44: A kind, gentle man
By Catherine
DUNPHY,
Obituary
Writer
He was a doctor with heart -- a huge heart -- and in the end
it killed him.
Dr. Ian NAKAMURA made house calls, lots of them. Every lunch
hour he would slip away from the busy Richmond Hill practice
he shared with his sister, Liane, to see his patients who were
shut-ins, or frail, or unable or even unwilling to leave their
homes.
Sometimes his workdays started at 7 a.m. -- because that's when
patients could see him -- and often they ended long past 6 p.m.
"He'd call and say he was going to be a little late. That he
was just stopping to see a patient on the way home," said his
wife Silvia, with a rueful smile.
She knew that meant he would be having a very late meal when
he finally got home. "He took care of everybody."
He lent money to a patient whose husband ran off with the car,
baby seat and all, and the cash from their bank account. Because
the parents of a child undergoing chemotherapy were worried about
him coming into contact with people with colds and viruses in
the waiting room, he went to their home. An elderly patient who
had broken her foot was surprised to find the doctor at her door
one day, bearing her pain medication.
He sat long into the night at the home of one man who was dying
of colon cancer. There was little he could do medically by then,
but he wanted to comfort the man's family. He stayed until after
2: 30 a.m., driving home in time to pick up his own family and
head to the airport for their vacation and an early flight to
Florida.
But first he phoned his sister, on a mini-vacation in Niagara-on-the-Lake
with her own family, and extracted a promise from her that she
would take over in his absence and go to the man's home to pronounce
him dead when the time came. The man had wanted to die at home
and Ian NAKAMURA was determined he would have his wish, which
he believed meant not being taken to a hospital to be pronounced
dead.
"He did that with every patient," said Liane
NAKAMURA, also a
doctor. "If someone's kid had an earache he'd call the next day.
He didn't know where to draw the line. He gave out a lot of himself
and in the end it took all his energy."
Ian NAKAMURA died May 12. He was 44 and he had forgotten how
or was unable to heal himself instead of others.
"Within our family we thought he could never say no, even when
it was bad for his health. His good-heartedness meant he had
a higher level of stress," said his oldest brother, Glenn. "But
he would tell us that it brought so much comfort to all those
families."
Ian NAKAMURA suffered a stroke in January 2004, when he awoke
one morning so dizzy he couldn't stand up. Doctors discovered
he'd been born with a hole in his heart and put him on blood
thinners to prevent further clots and strokes. He was off work
for a record five weeks, but when he returned to the office he
went back to his old ways. His wife, who worked with him in the
clinic as a laser hair-removal technician, tried to block off
some downtime for him in the appointment book.
"He would pace in the office, worrying why he didn't have any
patients to see," she said.
Always a worrier, he had been under a great deal of stress since
the previous summer when he was notified he was going to be audited
by the Medical Review Committee. According to his sister, the
red flag had been the number of house calls he made.
"He was outside the norm of house calls. He was doing one or
two a day when most doctors don't do one a month," she said.
He was so devastated when he got the audit package in May 2003
that he couldn't come into work for three or four days. These
audits are a contentious issue with the country's doctors, and
both the Ontario and Canadian medical associations are on record
as being strongly opposed to them.
"They do make you feel you are doing something wrong," Liane
said.
In her brother's case, the auditors had spent a day in the office,
poring through files and grilling him about various billing procedures.
Expecting the worst, he had remortgaged his house in Maple while
he awaited their decision.
"It was like a black cloud over his head," said Liane.
A week before
NAKAMURA died, George
SMITHERMAN,
Ontario's health
minister, got a standing ovation at the Ontario Medical Association's
annual general meeting when he announced that the government
had stayed proceedings for all audits in progress, as a result
of an independent study submitted to it April 22 by former justice
Peter CORY that concluded the physician audit system was detrimental
to the province's health services.
The patients never knew that their gifted doctor was worrying
about his own troubles.
"They all thought of Dr. Ian as their friend," said Silvia.
"And as family," said Liane.
Although Ian was 6 years older, she graduated from medical school
just one year after him. Ian had dropped out of university in
1981 to return home to care for his mother who was bedridden
with terminal cancer. "He lost a lot of time," said Glenn. "He
had to start from scratch and reapply for med school."
He graduated from the University of Alberta's medical school
in 1990, the same year he married Silvia.
He worked at a walk-in clinic and in the North York Branson hospital's
emergency ward before he went into his own practice; he used
to tell his sister he'd still be working emergency at Branson
if she hadn't set up the clinic.
"I always thought it would be the two of us working together,
just family," she said.
After five years they were each carrying a full patient load
(about 2,000 each). Every day, Ian and Silvia's children, Kristen,
13, and Alex, 10, would come to the clinic after school, along
with their cousins, Liane's children, Madison, 10, and Mackenzie,
3, all of them heading to the back where there was a television
to watch their favourite soap opera, Passions, before doing their
homework.
"They're like one family, with two fathers and two mothers,"
said Glenn.
But last December, Ian
NAKAMURA underwent non-open heart surgery
to try to close the hole. "Part of his goal in having the surgery
was to get off the blood thinners so he could play football again,"
said Liane.
A season ticket holder for the Argos back when few other people
were, he had been playing with the Fierce Rooters of the Metro
Touch Football League for 20 years with guys he'd grown up with
on Parent Ave. in Downsview.
But the procedure didn't work and
in April he was admitted to
hospital. "There was a risk of bleeding and that's what happened,"
said Liane. "It bled into his brain."
More than 1,000 people came to pay their respects to the family
600 attended the Monday morning service. Glenn told them Ian
had donated his organs to five people in Ontario, one of whom
was a 10-year-old. "A final act of love from a man whose capacity
for caring was boundless," he said.
He was the one who bought their father a new van for his 65th
birthday, bought Glenn a big-screen television for his 50th and
then decided to give the same gift to the family of their brother,
Nolan, who had died in 1999 at 45, on the day he, too, would
have been 50. But he refused to let Silvia do anything big for
his 40th birthday. He thrived on giving; receiving made him uncomfortable.
The family has set up an education trust fund for his children.
Liane's husband, Anthony
BELO, is administering it, c/o
ITF
Kristen
and Alex, at the clinic at 10815 Bathurst Street, Unit 25, Richmond
Hill, L4C 9Y2. Hundreds of his patients have contributed to it
one wrote a cheque for $5,000 -- perhaps because this was
to be the only way they could ever thank Dr. Ian
NAKAMURA for
all those house calls and extra attention.
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