ONLEY o@ca.on.york_county.toronto.globe_and_mail 2008-06-03 published
Sheela BASRUR, 51: Physician
At the height of the 2003 crisis that stunned Toronto and caused
the rest of the world to stay away from Canada's largest city,
she worked three weeks straight. At one point, she said it was
like 'ripping a bandage off one wound to stop the bleeding on another'
By Gloria GALLOWAY,
Page S8
Ottawa -- Toronto's hotels were half empty, people on the streets
were wearing medical facemasks, the city's Chinatowns were ghost
towns, and there was one reassuring voice pleading for calm.
Sheela BASRUR was Toronto's medical officer of health when severe
acute respiratory syndrome arrived in her city, stealing in from
Hong Kong and unleashing its deadly force on a population taken
fully by surprise.
Suddenly, the diminutive doctor was thrust onto the national
stage. The world's health community turned a concerned eye on
Toronto. Reporters from across the country were calling to demand
answers about the deadly and previously unknown threat.
Amid the chaos, she became a trusted general in the fight against
the disease.
In the beginning, Doctor
BASRUR and her team were working in a knowledge
vacuum. "What kind of control measures, what kind of investigation
might be needed? How many contacts might there be?" she once
said describing the questions that arose in the early days of
the crisis. "We had no idea that we might be facing hundreds
of contacts even in the first weekend and 23,000 by the end of it."
With the first deaths, the apprehensions of the entire city -
and, to some extent, the rest of Canada - came to rest on her
five-foot frame. It was a weight she shouldered with remarkable
competence.
Sheela BASRUR had always wanted to be a doctor.
She was born in Toronto to Vasnath
BASRUR and his wife, Parvathi,
who had arrived from India as graduate students during the 1950s.
Vasnath was an oncologist; Parvathi was a veterinary geneticist
who managed to obtain her degrees despite growing up in a poor
family of 10 children.
When the
BASRURs moved to Guelph, an hour's drive west of Toronto,
they were conscious of being what seemed to be the only visible
minority family in the community. When Parvathi
BASRUR breezed
by in her sari, people on the street would stop and stare.
The young Sheela penned poems and essays for sheer amusement.
She was also a skilled flautist and told the Toronto Star, in
one of the many profiles that paper wrote about her over the
years, that her artistic nature led her parents to believe she
would one day be a writer or a musician.
But the biological subject matter of the
BASRURs' dinner banter
led her in a different direction. After high school, she obtained
a science degree at the University of Western Ontario in London
and then headed to the University of Toronto to study medicine.
The newly graduated Doctor
BASRUR returned to Guelph, where she
practised as a family doctor for a year. But adventure called
and, in 1985, she headed on a trip around the world.
It was in Nepal, and then in her parents' homeland of India,
that she decided to pursue a career in public health. She told
a reporter that visits to hospitals and clinics in those countries
convinced her of the importance of community medicine. In one
village, she encountered a woman with tuberculosis who could
not afford the full treatment for the disease but whose husband
needed her to be well enough to return to work on the family
farm.
When she returned home, Doctor
BASRUR sought her masters degree
in health science as a specialist in community medicine. Her
first forays into public health were adventures. She was, for
instance, the chief investigator of a massive recall of shellfish
along the Eastern seaboard.
Then she returned to Toronto and first became the medical officer
of health in East York, the smallest of the city's suburbs. Starting
in 1998, she was made head of a huge department that formed when
all of the suburbs amalgamated.
In her private life, she enjoyed classic rock 'n roll, especially
The Who. She tried her best to be a vegetarian but was not always
successful. She did yoga every day before the sun came up. And
she was a needlepoint fanatic. "I just find it very therapeutic,"
she once said.
An early marriage did not last. However, out of that she gained
a daughter, Simone, who was the love of her life and her companion
through her final difficult years.
Dr. BASRUR's early days at the Toronto Board of Health were spent
supervising the merger of the various boards and handling ordinary
local issues - children's food programs, smog alerts, and the
first posting of the results of restaurant inspections.
And then, in March, 2003, came severe acute respiratory syndrome
which was eventually determined to be a disease caused by the
coronavirus. A genus of animal virus named for their crown-like
appearance under a microscope, they are among the leading causes
of the common cold. Until the onset of severe acute respiratory
syndrome, they had been known to cause severe diseases only in
animals.
However, by April 2003, several labs had uncovered evidence of
a new coronavirus that had infected at least some patients with
severe acute respiratory syndrome. By then it had struck more
than 2,600 people and killed 103 worldwide.
Suddenly, people were dying in Toronto. It was a disaster that
had to be contained.
Like many of those on the front line, Doctor
BASRUR worked three
weeks straight after the first cases were discovered. As severe
acute respiratory syndrome spread through the city, she and her
team charted its course, trying to build firewalls between the
infected and those who were sitting vulnerable in its path.
At times, just when they thought they had stemmed its spread
in one direction, the disease would pop up somewhere else through
an unanticipated line of transmission. Mass groups of students
and factory workers were quarantined. People were told they could
not go to the funerals of loved ones. Health workers were dying
along with their severe acute respiratory syndrome patients.
At one point, she described the fight against severe acute respiratory
syndrome as "ripping a bandage off one wound to stop the bleeding
on another."
Dr. BASRUR and others were also puzzled as to why 40 per cent
of severe acute respiratory syndrome patients failed to demonstrate
evidence of being infected with the new coronavirus. What's more,
other people who did carry the virus did not have severe acute
respiratory syndrome, or severe acute respiratory syndrome symptoms.
Also troubling was the fact that the coronavirus carried only
four to 10 genes and were infamous for mutating with every replication
and for swapping genes with other viruses.
All things considered, it is not surprising that misjudgments
did occur. It took nearly a week for the members of a 500-person
religious community to be sent into quarantine after being exposed
to severe acute respiratory syndrome because health officials
did not realized the contacts had been made. Asked about the
delay, Doctor
BASRUR said: "It's a fair question… hindsight is absolutely
my best friend."
There was the odd humorous moment, like the Abbott and Costello
routine she played with Toronto Mayor Mel Lastman. As the elected
head of Canada's largest city, he was experiencing his first
encounters with such organizations as the World Health Organization
(WHO) and the Centres for Disease Control near Washington.
Upset by a press conference about a travel advisory that had
been imposed because of severe acute respiratory syndrome, he
railed against the warnings that had been announced by "this
Centres for Disease Control group, whoever they are."
"WHO," whispered Doctor
BASRUR.
"Who?" he shouted.
"That's right, WHO," said the doctor trying to control her
laughter.
But, as 44 people lost their fight to the disease, there were
many frustrating and difficult weeks. And through it all, Doctor
BASRUR
- the face of calm and reason - became one of the acknowledged
heroes.
A female co-worker remembers bumping into her one day during
the crisis as she emerged from a washroom. The co-worker told
Dr. BASRUR that she looked wonderful and the doctor responded
by saying she felt tired.
"And I said, 'Sheela, you're great. The whole city loves you
and is counting on you. And this morning on the radio I heard
the host of the morning show say that he knew it was okay to
go out because the little doctor with the glasses said it was.'"
Dr. BASRUR laughed and hugged the woman in delight and went off
to try save more lives.
Several years later, the co-worker e-mailed Doctor
BASRUR and asked
if she remembered the incident. "And she said 'yes, but I believe
he said the cute little famous doctor with the glasses."
Those who worked with her during that time say it was a huge
privilege to be part of her team. Bonnie
HENRY, who was Toronto's
associate medical officer of health, said Doctor
BASRUR's great
strength was her ability to communicate.
Months after the crisis, the two doctors were walking through
an airport together "and people would come up to her in the airport
and say 'I feel like I know you,' said Doctor
HENRY. "
She was
always very gracious. She was really touched by the fact that
people responded to the way that she was able to communicate
things."
Dr. BASRUR's tireless efforts during severe acute respiratory
syndrome made her the first choice of the Ontario government
when it went looking for a new Chief Medical Officer of Health
in January, 2004. Her mandate was to revamp the way health programs
were delivered in the province and to do whatever possible to
prevent another severe acute respiratory syndrome. She took on
such big jobs as instituting a rigorous anti-smoking policy and
a provincewide healthy-eating program.
Then, in November, 2006, a pain in her lower back that she had
been feeling for some time became excruciating. It was caused
by a tumour on her spinal cord.
Concerned that she could become a paraplegic, her surgeons removed
it immediately. But the prognosis was still not good. She had
hemangiopericytoma, a rare vascular cancer that started in her
uterus and spread throughout her body.
All at once, the doctor had become a patient. Even so, the disease
did not incapacitate her. A week after stepping down from the
job of Ontario's top doctor, she returned to the provincial parliament
to see the introduction of legislation establishing a new public-health
agency - an agency she helped create and one that has been named
after her.
The months after the diagnosis were like a gift wrapped in barbed
wire, she said. "It's like being given the most beautiful bouquet
of roses you can imagine being placed in your arms and thinking
'whoa, they've got thorns on them.' "
Dr. BASRUR said she preferred to focus on the "rose petals,"
like the fact that, after a lifetime of hard work, she had been
able to devote time to her daughter, now 17.
In April, she was awarded the Order of Ontario in her hospital
bed by Lieutenant-Governor David
ONLEY.
The next day, she rallied
and attended a fête organized in her honour by the Registered
Nurses' Association of Ontario.
Ontario Premier Dalton McGuinty told the crowd they must not
been fooled by her size. "She's tough when she needs to be -
a regular Mighty Mouse."
Ontario Health Minister George Smitherman said later that he
could not agree more. During severe acute respiratory syndrome,
"she was the one that lifted us on her shoulders, even though
she wasn't that tall. For a little person, she proved to be awfully
mighty."
In difficult times, he said, it's particularly important that
clinicians communicate in a way that is accurate, concise and
understandable. "Not everyone has that gift."
In the end, Friends say Doctor
BASRUR was accepting of the fact
that she would die at 51. "If I can help more people have a great
life," she once said, "then I'll have a great life."
Sheela BASRUR was born in Toronto on October, 17, 1956. She died
June 2, 2008, of hemangiopericytoma, a rare vascular cancer,
at Grand River Regional Cancer Centre in Kitchener, Ontario She
is survived by her daughter, Simone
KOVES, and by her parents,
Vasnath and Parvathi
BASRUR.
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