Meet Our Team
Q&A with Dr. Natasha Datoo
Dr. Natasha Datoo is a volunteer with Two Worlds Cancer Collaboration and our Sunflower Children’s Network. Dr. Datoo is a pediatric hematologist-oncologist and palliative care specialist. She works at both BC Children’s Hospital and Canuck Place Children’s Hospice in Vancouver, Canada.
Photo: Chuck Russell/Two Worlds Cancer
How did you get into health care?
Ever since I was little I've always wanted to be a doctor. It sounds totally cliche, but I always really wanted to do something to give back and help people. I didn't really have a plan B. So I’m glad it worked out.
My mom's a nurse, so I kind of knew what health care was like and I've always loved kids. I think they're a lot more fun to hang out with than grown-ups most of the time. They're honest. They're resilient. They're just able to be who they are, and it's pretty fun. So that very quickly led to pediatrics.
I was just struck by the philosophy of palliative care – how incredible the team is at Canuck Place. It’s intense work. As intense as acute hospital care, which I think a lot of people don’t realize.
When you have a really sick patient and you're trying your very hardest to make their pain better, you're still aiming to help a child. You are able to have amazing relationships with these families, who let you into their lives often at the hardest times. If their child's dying, or when the child dies, you get to be part of this sacred space. It’s an honor to be part of that.
How did you come to split your time between Canuck Place Children’s Hospice and BC Children’s Hospital?
I kind of just fell in love with Canuck Place the second I walked in. I really just connected with the philosophy of care, the people and the children. I moved here from Ontario in 2015 to do my oncology fellowship. All of the oncology trainees rotate through Canuck Place to get a month exposure to pediatric palliative care.
Now, I split my time as one of the doctors at Canuck Place and also at BC Children's Hospital. I'm one of the pediatric hematologist oncologists at BC Children's. I work with families and children who have cancer diagnoses, neuro-oncology diagnoses, as well as hematology diagnoses.
There's definitely overlap. It's helpful for me to meet them as an oncologist, because if I’m taking care of them with that hat on and if they have a disease that we can't cure I also meet them as Canuck Place.
A palliative care team carries a lot of meaning to families. I like to think it's helpful for families to see someone they know, someone who knows their child and their story already and can explain why the palliative care team can help support them. I've been told by families it is comforting to see a familiar face when you're meeting a new team.
How long have you been with TWCC? And why our organization?
I got involved when I started my fellowship at Canuck Place in 2019. Camara van Breemen and Dr. Peter Louie, who also volunteer with TWCC, got me involved. And I haven't looked back.
I grew up volunteering and it's just something I've always done –organizations like Canadian Blood Services and the Aga Khan Foundation. Global health and volunteering keeps us humble and more open-minded. It reminds us that the world is bigger than just North America.
I really did fall in love with the philosophy of Two Worlds Cancer Collaboration. It's pretty unique. I think one of the amazing things about it is that, although we're growing, it's a small organization where you really do know the people.
Everyone has a common goal. The goals are grassroots. You can physically see the impact. I appreciate that there's all these people with amazing skills who come together just for the purpose of supporting different people around the world in palliative care.
When I first started, the team had just started talking about having a pediatric-focused group –now the Sunflower Children’s Network (SCN). I was really excited when they asked me to be part of it.
Dr. Megan Mean Doherty [our SCN director] also got me involved with Médecins Sans Frontières. So I also volunteer with MSF now doing virtual consults for them.
How has your role evolved with the Sunflower Children’s Network?
I’m mainly focussed on Nepal. My role has been to bridge the gap between the two worlds of oncology and palliative care in the pediatric world.
We were able to introduce procedural sedation at Bhaktapur Cancer Hospital (BCH) last time we were there in 2022. We were able to support the team in using sedation which really improves a child’s comfort and reduces fear around procedures. I applied and was approved for a micro-grant for us to be able to pay for the sedation so parents don't have to. In Nepal, parents have to pay for their child’s treatment and often they can’t afford it.
If you think about a $1,000, it may not sound like a lot of money to us, but [a small grant from BC Children’s Hospital] means we’ll be able to support procedural sedation for kids at BCH for at least a couple of years.
Can you give me some impressions of what struck you when you arrived in Hyderabad and Kathmandu?
I hadn't been to either place before. I’d heard so much about the Hyderabad group just because they're so established in palliative care and involved in everything we do at TWCC. One of the things that struck me right away is the speed at which everything happens. They just get things done which is incredible.
We're all busy, but the number of patients the Hyderabad team cares for and supports is unreal. You just can't complain when you're there. They give as much attention to their patients as we do in Canada but for probably eight times more patients.
Traffic is crazy in India – the traffic and the noise – all the honking which makes it India. I’m taken to the Kumudini Devi Hospice and Mandara Hospice for Children not that far away from the hospital [in central Hyderabad] and it's quiet and green. I was really in awe of what they've built with the two hospice. It's incredible – not just the building and the people – there's a home and a beautiful sense of peace there.
Nepal was very different. It's quiet, very quiet. It was a stark contrast.
What I was really struck about was the care at the two pediatric hospitals. One of them, Kanti Children’s Hospital, is the only pediatric hospital in the country and then Bhakatpur Cancer Hospital which has a small pediatric ward.
The standard of care is incredible at BCH. The training for their nurses is amazing, and I was really struck actually by the care that families and children get.
One of the other things I fell in love with was the demeanor of the people and the way they live. They’re very spiritual. It aligns very well with the palliative approach to care.
Do you think there’s a shift in thinking about palliative care?
It's fascinating to me because I think it's a global shift. In the past, palliative care teams rarely got involved until the very end when a child was dying. Now, we are integrated early on in a child and family’s journey a lot more often. We’ve seen this in Canada, in the last decade, and we’re seeing the taboo around palliative care change. I think it's the generational shift actually.
There are so many things in North America that we do to keep kids alive. When I was in India, we did a home visit with this boy who has cerebral palsy. He's thin, but he doesn't have secretions. He doesn't have skin breakdown. He doesn't have constipation.
All the kids with CP I see in Canada have all those problems. I honestly think part of that is what we feed our kids. Here we put G-tubes in and we feed them artificially. And who knows if they want that, or if they're comfortable.
In India his Mom would blend the same food that the rest of the family would eat. She would give him this throughout the day and he would just eat normally and regulate himself.
He didn't have the problems that we often create. So I know there are things that we do that I don't know that they're actually the right or best thing. This is just an observation – reflecting on the differences in care.
Is there a young patient that has stayed with you from your visit?
One of the kids with cancer that we went to do a home visit for in Hyderabad – a teenage girl who had a brain tumor. She was pretty much bedridden, but able to get up once in a while. Her cousin was getting married that weekend and they’re very close.
One of the things that I was struck by was the parents of kids who are dying, or who know their kids are going to die, are the same universally. The things her Mom said, the worries she had, the pain she had. It was exactly the same as a Mom in Canada.
We were just able to have this beautiful conversation about her worries and her fears. And [the team] was able to make some adjustments to her daughter’s pain medications. She apparently had an amazing weekend at the wedding. I thought, ‘Yeah, this is why we do this.’
That’s palliative care – just being present. It’s so translatable and universal. It matters to families, to children, just to have someone there with them and feeling with them.
What have you learned from our partners, or from your experiences in India and Nepal, that that you bring back to your own practice?
One of the things that I love is how much I learn from my international colleagues whenever I teach with them virtually or visit in person. You don't go to someone else's home, or place of work, or country and try and teach them what you know, because it may be completely irrelevant.
I think one of the things that I took back from Nepal was to be more calm. They don't question why did this happen? I think that it's partly that so many people are spiritual, whether or not they're religious.
One of the things I took away from Hyderabad was to speak up. There’s always the joke about us Canadians that we don't say what we need to say. And I think that's so true. There, they just say it in this gentle, professional, appropriate way but they say what they're thinking and if it's different from someone else that's fine. Often it leads to better care and a joint understanding.
I took two very different things away from each place, but I think I learned so much about communication and interacting with others.
A big part of what TWCC supports is mentorship. Did you have mentors as you started out?
I think that's a huge piece of why I've been able to get to where I am today. One of my big mentors in oncology when I first came here was Dr. Caron Strahlendorf. She's our division head in pediatric oncology at BC Children's Hospital.
I always appreciated how she interacted with families and her approach to care. She's been a huge part of my journey and supporting me through this. I'm the only oncologist who works in two places. And she's been pivotal in encouraging and supporting that.
And one of my other big mentors has been Camara, for sure. I joke that my fellowship at Canuck Place was following her around for a year. Camara somehow always has the right words, especially when interacting with families in hard times.
In what’s still a pretty male-dominated field, it's definitely been amazing having these strong female mentors. It’s given me the opportunity to get where I am and navigate what I wanted to do with support behind me.
The other person is Dr. Peter Louie. Peter's been a huge, huge advocate of me. He worked really hard to develop a year’s fellowship specifically for me [at Canuck Place]. I am so grateful to him and he continues to support me in work and life.
How do you cope with the emotional intensity of the demands of your work?
I’ve thought a lot about that in the last year. It was a hard year. For many, many reasons. I was on call a lot. I had my dad going through radiation [therapy]. I had a very close friend’s child who was very, very sick. It was actually probably the first year of my short career so far that I thought, ‘This feels like a lot right now.’
I’ve learnt to be kinder to myself. If I've been working for three weeks straight over the weekends and I don't want to do anything on a Saturday that's okay.
I think being outside is really helpful for me, even if it's just a walk. I find that that's something I need to do. I think that debriefing and reflecting that's a huge, huge part of how we do this work. Debriefing with people who get it is huge and actually to be friends with them is such a privilege. And rare I imagine.
Volunteering with TWCC has been a reset. Going to India and Nepal – It's fascinating. It’s crazy busy. It's not relaxing, but it's it just rejuvenates you. Being able to offer my time and energy to something that I believe in has been big for me and having that support of the TWCC team most definitely helps.
Is there anything else that you'd like to share?
You see colleagues in India and Nepal and all the barriers that they have to breakthrough and all the amazing work that they've accomplished.
I think the stigma of palliative care is still very much alive. There's a lot of people who go into medicine to fix things – oncologists, surgeons, cardiologists. It's really hard to tell a family that you can't fix their child’s cancer.
But at the same time I have seen when you can't fix the cancer there's still so many things you can do to help and improve a child and family’s life. Judging doesn't help and we all want to help our patients. So it's just figuring out how do we do that together.