Dr. Sunil Mangal was ready to start winding down his career in emergency medicine. He had practiced from coast to coast—from PEI to Tofino—and spent over 20 years providing care at St. Paul’s Hospital. He had just discovered mountain biking and was thinking that alternating two weeks in Whistler with two weeks working in Vancouver was a good step towards retirement. He was planning to slow down: take fewer shifts, fewer nights, gradually fade out. He had a full life outside of medicine and did not understand how much his career meant to him.

That came into sharp focus in 2019 when Dr. Mangal had a massive stroke while visiting family in Phoenix. He went from being the fittest he had been since med school to being unable to tie his own shoes. That sudden change and its repercussions was the basis for a talk Dr. Mangal gave to members recently. One of the questions he asked attendees to consider: can you prepare when everything shifts?

Life, he recalled, has a way of derailing your plans. And, when bad things happen, it changes your perspective. There is gratitude, and there is grief. Dr. Mangal spent nine days in an American hospital; the bill was $250,000 USD. He was lucky; he hadn’t purchased travel insurance, but he did have a credit card that provided that. He was transferred to VGH where he received great care. When he was stable, he went to GF Strong; the teams there, he said, are stars. It was there that he began to appreciate the physical deficits of the stroke. He was determined to be the hardest working rehab patient ever; he lived and breathed rehab. But he still had physical deficits including his vision. He learned he would never be able to drive again and there were cognitive deficits too that didn’t sink in right away. He was unable to succeed at any of the executive functioning tests and he was immersed in speech pathology sessions. He seriously contemplated suicide.

During this time, Dr. Mangal discovered mindfulness. It was something that he had been skeptical about, but he found it gave him perspective. He learned that feelings are transient and how to ride out negative thoughts.

Dr. Mangal was able to cope well with the change financially. He had no debts and had maxed out his RRSPs. He also had disability insurance—$6,000 per year tax free until he turns 65. (Supplemental insurance can also be purchased.) He did not need to work, but he struggled with his identity.

Now that he could no longer practice medicine, identifying as a physician became important. It was something he wanted to hold onto. In an effort to return to work, he took several tests and assessments. Doctors of BC felt he could practice medicine provided some accommodation could be made for his vision. However, the College would not clear him to practice.

Along this journey, Dr. Mangal has learned many things that he believes would now make him a better doctor. Being a patient offers a new perspective on providing care. He also advises colleagues to live their lives to the fullest: go to that restaurant; try that new sport; take an adventurous holiday. And he recommends we strengthen social bonds, be more open to increasing resilience and mental health, and check that that we have disability insurance. Create a five-year plan, he said, and revisit it every five years. Enjoy the journey.

Feedback

Several of the people who attended the session either in person or online completed the post-event survey. Here are some of their comments about what resonated the most with them:

• Hits very close to home. Thank you for sharing this story and am still marinating all the pearls of wisdom. Much to appreciate and think about.
• Honesty, humour, relevance.
• The resilience of a human being.
• Mental health aspects.
• Gaining perspective.
• Resiliency and making reaffirming decisions about where your life is now and to not work so hard.
• Honest feelings about losing one’s career to medical challenges.
• Candid expression of feelings.