Summer 2019 (Volume 29, Number 2)
Womb-Mates:
U of T Professors, Alumni and Twins
Jay and Ed Keystone Pay It Forward
By Edward C. Keystone, MD, FRCPC; and
Jay S. Keystone, CM, MD, MSc (CTM), FRCPC
Download PDF
Professors of Medicine Jay and Ed Keystone, both BSc ’65,
MD ’69, are esteemed clinicians, researchers, educators
and mentors — and foremost experts in their respective
fields. Jay, a travel and tropical medicine specialist at University
Health Network, is a member of the Order of Canada,
and Ed is a Master of the American College of Rheumatology.
They reflect on the people who got them to where
they are today, and what it means to pay it forward.
In 1943, we were "womb-mates" for a mere seven
months, entering this world together weighing a total
of six pounds. We later found ourselves failing in public
school. Not because we were bored, but because we were
not very bright. We are the same students who were told
by our public school principal that we would never get to
university. The same mediocre high school students who,
later, through sheer hard work, graduated at the top of our
medical school class (University of Toronto [U of T]) and
who have since enjoyed academic careers in the Faculty of
Medicine at this great university.
What is our point, you ask? Our point is this: it doesn’t
matter where you begin or even how well you begin, but
where you end up. And, recognizing the help of the people
who got you to where you are, it’s up to you to pay it forward
to those who will come next.
So, how could two mediocre students find their way into
the competitive world of medicine? We started our university
careers in commerce and finance at U of T, from which
we extracted ourselves at the beginning of second year. We
had received advice from a newly graduated physician from
the University of Michigan, our cousin, Jay Allen Keystone.
“Why don’t you go into medicine?” he asked.
“Because only students dedicated since toilet training
and Ontario Scholars go into medicine,” we answered.
His response changed our lives: “Dedication in medicine is
important when you come out, not when you go in.”
With this lesson from his experience as a new physician,
he paid it forward.
Academic institutions are not homogeneous, and neither
are the departments within them. One of the first lessons
we learned about academic medicine is that, apart
from ability, there are two ways to succeed: you can step on
or over your colleagues in your quest to reach the top, or
you can be kind and fair to those with whom you work.
Treating colleagues equally and with kindness has
been a rule that we have diligently followed throughout
our careers. This philosophy has paid us both enormous
dividends. We have been given unexpected opportunities
in leadership positions in our specialty societies and the
university. Not because we are brilliant (we are not), but
because we treat our colleagues, whether specialists or not,
with respect, and have always been very supportive and attentive
to their requests for assistance.
One notable anecdote comes to mind: When Jay received
his stem cell transplant from his “spare parts clone” brother
Ed at Princess Margaret Cancer Centre, he was visited
by several colleagues from Toronto General Hospital and,
unexpectedly but appreciatively, by a maintenance man
who learned about his illness and came to provide support.
Similarly, when he was admitted to Toronto General Hospital
repeatedly this year, senior nurse administrators with
whom he worked many years ago on the general medical
wards provided invaluable support. Treat people well, and
you will be well treated.
As medical educators, it is our job to train the next generation
to be better physicians than we were. Basically, to “train
ourselves out of a job.”
There were many wonderful educators who came before
us. At the University of Toronto, Arthur Scott,
MD ’53, taught us how to solve medical problems from first principles
utilizing basic physiology. Hugh Smythe, MD ’50, taught
rheumatologic physical examination, following which Ed now
teaches rheumatology fellows all over the world to do an expert
joint exam. Joe Marrotta, an outstanding clinical neurologist at
St. Michael’s Hospital taught us to evaluate neurological events
first anatomically and then functionally in the days before CT
and MRI were even on the horizon. His colleague Peter Kopplin,
MD ’63, the quintessential, caring and consummate internist
who, in his quiet, understated way, demonstrated the importance
of the doctor-patient relationship.
And finally, Bob Goldsmith, a tropical medicine expert
from University of California, San Francisco, encouraged his
colleagues (namely Jay) to step down from leadership positions
“sooner than later” to allow younger clinicians to take
over and make their mark. It is very important, and often difficult,
to know when it is time to step back for the next generation,
a subtler form of paying it forward.
Someone once wrote, “A good education can change anyone,
but a good teacher can change everything.” We have
tried to give the next generation the benefit of our experience
and knowledge, inspired by those outstanding clinicians
who came before us.
Our lesson to everyone reading this is to think about the
people who made an impact or provided you with mentorship,
and how you can pay it forward to others.
Dr. Jay Keystone (left) and Dr. Ed Keystone (right).
Edward C. Keystone, MD, FRCPC
Professor of Medicine,
University of Toronto
Director,
The Rebecca MacDonald Centre for Arthritis
and Autoimmune Disease
Consultant Rheumatologist,
Mount Sinai Hospital
Toronto, Ontario
Jay S. Keystone, CM, MD, MSc (CTM), FRCPC
Professor of Medicine,
University of Toronto
Director,
Toronto Medisys Travel Health Clinic
Tropical Disease Unit,
Toronto General Hospital,
Toronto, Ontario
|
