Dr Yvette Bonny

Interview with Dre. Yvette

By Ikram Abow-Mohamed (Second year medical student, Udem)

Where did you study? And did it go for you ? 

I was born and raised in Haiti. I studied there and obtained my medical degree from the State University.  I did 1 year and half of residency in pediatrics. I then pursed my pediatric residency at Sainte-Justine for 4 years and decided to specialize in hematology. At the time, there was not a specialization specific to pediatric hematology. Thus, I had to complete my two-year internship with adult patients at Maisonneuve-Rosemont Hospital. I really liked my experience there and there was a small department of pediatrics. Over time, the field of hematology grew, and I had many cases of pediatric hematology. I also spent a year in pathology. I also did a year of specialization in France in regard to radioactive tests and globular survival ( ?) . Finally, I continued my specialization at the Royal Victoria Hospital. All in all it took me 8-9 years to complete two specialties. During that time, I was able to apply for an immigration visa and go through the Canadian naturalization process in order to practice at the end of my training.

What motivated you to pursue such a path? How did you decide that you wanted to study  in medicine? Why did you choose to become a pediatric hematologist hematologist pediatrician?

I was initially exposed to the world medicine thanks to my paternal grandfather, who was very well known in the field. I did not get a chance to meet him, but his work inspired me. The alleviation of suffering has motivated me to pursue medicine. Even when I was a camp guide, I was in charge of the pharmacy and different types of care such as doing dressings. I love working with kids. Hence, pediatrics had always interested me. In Haiti, child mortality was very high. One child out of three would die at a very young age because of poverty, malnutrition, and common infections.  My initial intent was to go back to Haiti at the end of my residency at Sainte-Justine and work with the kids there. Unfortunately, with the political and social instability, my family told me not to come back. I then decided to pursue my specialization in hematology while obtaining the necessary documents to practice here.

The practice of pediatrics is unique. Children are honest and we can tell when a child is in pain. we know. I have worked with so many children and they are resilient despite hardships. Helping them, seeing their progress and their smiles kept me going. Contrary to what we might think, children understand and know more than we think. Let me tell you an anecdotal story. There was a 9-year-old with terminal leukemia. After I gave him the necessary transfusions, he went fishing with his father. Upon his return, he told me about the fish he caught, despite the difficulties. He said he had trouble getting the fish into the net as it kept escaping from it. He then compared his trip to his own situation. “Dr. Yvette, I think you’re doing the same thing with me.” I have come to realize how important it is to be honest with children. I told him that I was doing everything I could to try to cure him, yet the disease is very strong. I could not lose this boy’s trust. Hence, we cannot lie them, and parents have a hard time understanding that they cannot hide a child’s diagnosis. It’s all about talking to children with words they understand and only answer the questions they have at the moment, without additional information.

You performed the first bone marrow transplant on a child  in April 2, 1980. How was it ?  

A lot of research was put into it. As a team, we were ready to go through with bone marrow transplantation, at least in relation to the theoretical aspect. We even managed to get funding from the government. It was a question of putting knowledge into practice. I met my first patient unexpectedly. It was at the end of the day and I was told that there was a case with an abnormal blood formula. The patient in question barely had any platelets and she had severe anemia. However, I could not find the doctor who was in charge of her. Since the patient was not physically present at the hospital, I had to personally call her at home.  After exploring all our options, performing a bone marrow transplant was our best shot. We did compatibility tests and found that the patient’s sister was a match. However, at the time, such a transplant was not practiced here in Montreal. The patients had to go to Seattle, Boston or New York. It would have been expensive to send the mother, the donor sister and the patient to the United States. We wanted to give this patient a chance. We ended up having a big meeting with the Registry Committee to convince them. Finally, the project was approved, and the first bone marrow transplant was carried out. The first transplant took place on April 2, 1980 and it was certainly not the last. My first patient is now a nurse at Maisonneuve-Rosemont Hospital. After that, I began receiving patients from everywhere, as far the Outaouais region and New Brunswick. During my career, I have done 200 bone marrow transplants. For a long period of time, I was the only pediatric hematologist doing such a transplant in eastern Quebec. Since then, the pediatric bone marrow transplant unit has been transferred to Ste-Justine, a unit that is now very active. They will soon complete their thousandth transplant and they invited me to attend this occasion. 

Would you say that it was more difficult as a woman to do such an accomplishment? What about today ? Would it have been easier for a woman?

Yes. Things were more difficult back then. There were barely any women in hematology. When I started my career, I was the 3rd hematologist and I was the only female hematologist in Maisonneuve-Rosemont.  I was also the first hematologist with a specialization in pediatrics. I would say there are around 20 women in the field today. At the time, my colleagues trusted me and knew I had the abilities to my work. Yet when I had to deal with other professionals or if I found myself in an environment where people did not know me, it was sometimes harder. Whenever I felt like I was not being listenedd, I would engage less in such discussions. Instead, I would go back and redo my readings and come back well prepared. One of the reasons I did not want to leave Maisonneuve-Rosemont, when they were transferring the pediatric bone marrow transplant unit to Sainte Justine, is that I shared experiences with my colleagues, and I had my place there. It had become my home. I did not want to leave and start from scratch, even at the age of 60. 

Some professionals who were not part of my immediate team ( i.e. doctors,technicians)  doubted my ability sometimes. Even as an attending, I would get asked if I was able to do a bone marrow puncture because I was physically small and seemed frail. I told them that it was not a matter of force, but a matter of knowledge and skills. Some parents, including those who were sent by the great specialists of Sainte-Justine, doubted me at first. Yet, things would change as soon I was done with the transplant and thtey wanted their child to stay in my service. 

Today, women occupy important positions in medicine, and they play key roles. We could also see how dedicated and involved female students completing their clerkship or residency are in regard to their work. Previously, male doctors were trusted. Nowadays, I would even that trust has shifted towards female doctors. The approach they have towards their patient is different. From my perspective, they have more empathy and they are closer to their patient.  

You were the first black resident in Sainte Justine. Could you tell me about your experience?

To put you in context, I immigrated here and when I arrived here, I had a problem with the accent. Since I was at the beginning of my residency, I had a lot of people who were above me. My knowledge was often tested at first, but I think it was also the case for all the other residents. I had a nice relationship with the department chiefs and the nurses around me. Thus, my integration was done with ease. I did not feel sexism or racism during my residency. Sometimes, when I had to work with other teams, there were people who questioned me more than usual and there were trust issues. I could sometimes see the confusion in their facial expressions. At the time, I was one of the only black people and there were barely any women in the field. I believe the issues I had, if ever, were mostly related to the fact that I was a woman and not because I was black. There were times when I felt I was being trapped with the questions being asked, but I kept my calm. I was not arrogant or vindictive, but I trusted myself. I was able to say what I did not know, and I made sure that I did my research. Yet when I was certain of my answers, I defended my points. I have had difficult encounters with some families. I felt like I had to prove myself even more because I was black and because I was a woman. I had to find a way to build a trusting relationship with them, which was harder with patriarchal families. I was able to face such cases because I knew what I was doing, I knew where I was going, and I spoke with confidence. However, people would not expect that I would be able to impose myself to do my job.

As for children, they were very curious. Those who lived outside Montreal were not familiar with people of color. The kids would ask me about my skin color or they would say that my skin was darker than someone with a suntan. Yet I was not offended. I have an unconditional love for them. I would tell where I am from, about the variety  of skin colors and so on. 

Have you ever felt the imposter  Syndrome? How did you deal with it ?

Yes, especially at the beginning of my residency. Since I was a black, immigrant, and a woman, I felt like I had to put in as much effort as possible. I had to be the best, I had to give my 100% in all, and my interventions had to be noticeable. It was certainly not to flatter or to show that I was the best. It was really for me. I wanted to develop capacity, clinical skills and maintain a reputation. As long as I had confidence in myself and I came prepared, I was able to overcome obstacles. With such  attitude, I developed a good work ethic that I maintained until the end of my career. I have noticed that your first impression lasts. If you are someone who is curious, who comes prepared, who is able to present their cases well, people will take you more seriously and your contributions will be valued even more.

Have you ever felt that you were the spokesperson for your geder or communit ( As if your actions should be impeccable because they reflect on your gender/community ?) ? How did you manage that?

Yes, always. I do not know if I gave myself such a role or if it was given by others . I always gave my best, but I also made sure that the other members of my team were comfortable in what they did. I was often told that I was a bit like Mother Teresa. To give you an example, at the beginning of my career, if I saw a female colleague, a young doctor, a nurse or even a student doing their clerkship, I made sure to go check on them before their superiors came to see if they were ready to present their cases. I encouraged new members to participate and prepare themselves beforehand. Basically, I was helping my team, especially if they were women, ethnic minorities or students. I always tried to set an example in terms of what it is to be an implicated doctor who wants the best for her team. I wanted to create a learning environment. Times have certainly changed. At the end of my career, the tables have turned. I was mostly giving advices to men, which is something I never expected to do 

What do you think about diversity and representation in medicine today? Would you say there have been changes over time?

There is a lot more representation in medicine and I have seen the change until the end of my career, that is in 2013. When I first started, I was the only black person, which is not the case anymore. Furthermore, I no longer see this trend of really trapping people with questions.  

I encourage people from less represented communities to not hesitate when it comes to medicine. You have to stop thinking, “Oh, I would not make it. There is no one like me in this field.” As long as you have an interest and you have the capacity, you need to believe in yourself and follow your dreams. 

What advice would you give to young female medical students?

I could give four advices to future generations:

  1. Being assertive without being arrogant 
  2. Respecting others is crucial. You have to stay humble and avoid disregarding others.
  3. See patients as a whole and listen to them.
  4. Give the best of yourself