A doctor, against all odds
By Ritva Liisa Snellman in Stockholm
A machine at a construction site has cut a bad wound into the arm of Leif Sahlin. He waits for his turn in the emergency room of a Stockholm hospital.
The doctor arrives, sits down and introduces herself. "Hello, my name is Victoria Webster. I have a congenital defect, which is why I speak like this. I hope that it doesn't bother you."
Victoria Webster has introduced herself to patients like this thousands of times before.
Just as many times she has received the same answer: "It doesn't bother me."
Leif Sahlin says the same thing.
Two or three times she has been in a hurry and forgot to explain the situation, in which case the patient has become confused, suspicious, and asked to see a different doctor.
A doctor does not nave to be perfect. It is enough for a patient to be able to have confidence in him or her. And confidence is built on small things. It begins with the attitude that a doctor has toward a patient.
"It is easier to get close to a patient when I say that I have this disability", Webster explains.
Finnish-born Victoria Webster has become something of a celebrity of her profession in Sweden and the Åland Islands since last summer, when she became Sweden's first specialist in emergency medicine.
Webster is proud of her degree, and of the fact that she graduated as a doctor 14 years ago after many obstacles and much opposition.
However, she has needed no reminders of being a victim of CP. She has been that all of the 42 years of her life.
But it is impossible to speak about Webster without mentioning her disability. It became a significant factor when she began her medical studies at the Karolinska Institute in Stockholm in 1987.
However, let us begin in the 1950s. Victoria Webster's parents Diana and Michael Webster are British. They met each other in Finland in 1954, stayed in the country, got married, and established a family.
Diana Webster taught English language and literature at the University of Helsinki, and wrote English language textbooks. Michael Webster taught English both at the University and at Helsinki's Swedish School of Economics and Business Administration.
The family's first child was scheduled to arrive in April 1965. A time for a Caesarean was already booked, but the baby decided to come on her own schedule.
It was Easter and the maternity hospital had less staff on call than usual. On Good Friday, the Webster family got a dark-haired baby girl. It was a difficult delivery and the child suffered from a lack of oxygen. The parts of the brain that control movements and muscle control were damaged.
The CP diagnosis was not made until Victoria was two years old.
Her disability was too mild for her to get physical therapy. Speech therapy was offered later, but it did not suit the stubborn little girl, who did not want to stand out among her peers.
At the age of 13, Victoria Webster changed her mind. She was on a bus, returning home from a dentist, but the driver did not let the girl who made strange movements off the bus, thinking that she had escaped from an institution.
Victoria began to go to speech therapy. She learned to regulate her breathing, and her slurred speech became easier to understand.
Victoria and her younger brother John attended the Swedish-language Rudolf Steiner School in Helsinki. The school was good, warm, and encouraging, but there were some unpleasant memories as well.
Victoria was singled out by a few pupils. Back then school bullying was not a big issue, and nobody spoke about zero tolerance. Victims just had to take the teasing that came from her not being enough like the others.
Fortunately things were different in her home playground. Victoria played with the boys, tenaciously did what others did, and learned to skate in spite of her difficulties in coordination. In ice hockey games Victoria was always made the goalie, because she was so good at falling down.
Victoria did well in school. She spoke Swedish at school, Finnish in the playground, and when the door to her home went shut behind her, the language immediately switched over to English.
"I was able to keep the different worlds apart from each other", Webster days. "I was never different at school. My mother wrote a radio play about the first nine years of my life, called So Many Everests. It was aired in many countries, and it was even translated into Finnish.
In 1979 the Websters got a detached house in Kilo, in Espoo. On the day that they moved her father died. Victoria was 14 years old at the time.
A couple of years later the family moved to England. Diana Webster wanted to allow her children to decide if they wanted to live in Finland or Britain.
The family enjoyed their time in a small town north of London. Diana had many friends and the children had people their own age to be with. However, each family member had decided, without telling the others, that Finland was where home was. After six months the family moved back to Finland and Victoria went back to her old school and the same class.
"The bullying had ended already when father had died. After that I was left in peace."
After her matriculation exams Victoria Webster applied to study medicine. She had wanted to be a doctor since she was 11 years old. The first time it did not work out, or on the second.
Webster attended training courses and went to work at a home for the elderly in the district of Haaga in order to get a feel for what kind of an attitude people under her care would take.
Another spring came and Webster applied for the University of Helsinki again and sent application papers to Sweden as well.
The fifth time around she was successful. Webster began her studies of medicine at the Karolinska Institute in Stockholom.
The adversities began already on the third day. The event was more than 20 years ago, but the incident still makes Webster angry.
She wanted to present herself to the study advisor, because it was always best to speak of herself and her own weaknesses directly. That way there would be less whispering behind her back. Sitting next to the advisor was the head of the course who said abruptly something amounting to "thank you and goodbye". The head of the course felt that patients do not want to be cared for by a disabled doctor, and that it would be better for Webster to find a place to study somewhere else.
Webster would not give up. She had noticed that while working at the home for the elderly that those being cared for do not care if the person caring for them moves awkwardly and speaks slowly. Other qualities were much more important.
Her first year of studies was rough. Webster did not really adapt to the people on her course. The reason for this came out years later, after she had graduated. During her first term a number of inquiries had been made about her. None of her fellow students had made any mention of it to her.
After the first year Webster decided to take a break of half a year. She moved back to Helsinki, took a job as a nursing assistant at Aurora Hospital, and pondered whether or not her studies were worth all the bother.
"Then I decided, damn it, I'll continue", Webster says, slamming her fist on the table so that the coffee cups jangle.
She returned, adapted well to the new group, made friends, and had the strength to resist each time that someone suggested that she give up her studies.
These suggestions came with every course that she took, whether the course was two weeks or two terms. There was always someone who came up to suggest that if she went somewhere else, a spot would open up for someone who is actually capable of working as a doctor.
Then came the first clinical course. The students went from the lecture halls to hospital wards and outpatient clinics.
It was time to learn to conduct clinical studies and to draft anamneses.
At the end of the course there was a practical exam, and a few days later a written one. Failure would mean that the student could not continue on the course.
The practical exam went well. When Webster did what she was expected to do, the examiner said that he had decided to reject Webster so that she might take a break and reconsider her choice of profession once again.
A couple of days before the written exam Webster was asked to the office of the rector, where she was told that if she passes the written exam, she cannot be forced to interrupt her studies.
"I passed. Largely because one of my friends on the course came to me every day at 8:00 o'clock and would not leave until five in the afternoon. We both read for the same exam in my flat, so I also had to focus on reading. Otherwise I certainly would not have succeeded", Webster recalls.
The summer came and the other students went to work. Webster took a bus tour of Australia. She had received an inheritance from her godfather, and wanted to go somewhere far away to think about her future - once again.
At the end of her break she managed to get a two-week trainee's position at a small Australian hospital.
I asked a doctor if he thought I was capable of clinical work. He said that there was no reason why not."
"Webster asked to have it as a written statement, and faxed the paper to the Karolinska Institute.
During the bus tour she had decided that she would finish her studies in Sweden, but would not work as a doctor there for a single day.
She would always work in Finland during the summer, first at the Meltola Hospital, and then to the Åland Islands.
Her life was getting to be in order.
In January 1994 Victoria Webster was a doctor.
It was a strange winter. There was a recession in Finland, and many young doctors fresh out of medical school were unemployed, as a result of spending cuts. It was even hard to find substitutes' positions.
Webster thought that she would return to England, where there was always work for doctors. In the midst of her preparations for the move, she was offered work in Åland - first a two-week substitute's post at an outpatient clinic, and then a steady job.
Work at the clinic was a new experience. Webster had dreamed of a career in paediatrics or internal medicine, but in Mariehamn she became interested in emergency medicine.
"I loved to be in the emergency room. I loved being on call. However, I was constantly afraid that I was enjoying myself there because people knew me at the hospital and in the city. I was not sure if I could do the same work somewhere else.
Therefore she went back to Britain again. It was the closest place where it was possible to specialise in first cure.
Two years later a colleague in Åland noticed an advertisement in a publication, in which the Södersjukhuset hospital in Stockholm looked for doctors who wanted to specialise in emergency medicine. Five years earlier a professorship was established for the purpose, a post which was taken by a Finn, Maaret Castrén.
Webster decided to set aside her boycott of Sweden, because specialisation was more important than her own feelings.
Last summer she became the first doctor in Sweden to specialise in the field.
Now the location is the Södersjukhuset in the district of Södermalm in Stockholm. The hospital is locally known as SÖS. It is where Victoria Webster works now.
On television shows set in hospitals, emergency rooms are depicted as places where blood splashes around, where ambulance crews and nurses run back and forth, and someone's heart is always stopping so that the doctors can place a defibrillator on a patient's chest.
At the SÖS things are calm, even though it is Monday, the busiest day of the week.
I also watch ER, but reality is quite different from the constant drama that takes place on the show. This is everyday work. We stitch up patients, and there are always queues."
An average 350 patients come in to the emergency room each day. There is a doctor on call for each speciality - internal medicine, orthopaedics, and surgery.
"There are 33 doctors on duty in the emergency room. Each of the specialist fields has is there on call: internal medicine, orthopaedics, and a surgical line."
"I love this work. Never can we know what will happen ten minutes from now. If I leave at the end of my shift without learning something new, I have probably made a mistake."
Leif Sahlin's wound has been patched up. Webster has made three stitches, and gives instructions for further treatment. The hand should not be put under too much stress, and no showers or swimming.
Sahlin resists. He teaches weekend swimming classes for young children. Webster remains adamant. He must not go into the water for a while because of the danger of infection. It is possible to yell at small children from the side of the pool.
The patient concedes and waits for the nurse who comes to give a tetanus shot.
"Can I remove the stitches myself?"
"Sure, if you're up to it", Webster answers and goes to see what is happening in other parts of the emergency ward.
There are still five hours left on the shift, and Webster is able to see quite a few patients.
"Hello, my name is Victoria Webster. I have a congenital disability, and that is why I talk like this. I hope it doesn't bother you."
Helsingin Sanomat / First published in print 16.3.2008
RITVA LIISA SNELLMAN / Helsingin Sanomat
ritva.liisa.snellman@hs.fi
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| 18.3.2008 - THIS WEEK |
 A doctor, against all odds |
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