Eulogy of a “GOOD MAN – My Dad


Eulogy of a “GOOD MAN” – My Dad

AMEDEO MAIDA

November 1, 1929 – October 13, 2015

 

Who can tell me what Amedeo means in Latin?

Translated, it means “He who loves God”.

Although my dad did not have a middle name, if he had been given a Latin one it would have been “Amefamilia”, because he had a deep and unwavering love for his family. However, my dad had a love for everyone he came to know. He loved his relatives, friends, neighbours, “compari”, and god children unconditionally. My dad also deeply loved CANADA, and had allegiance ONLY to Canada-a fact that was validated when he elected to waive his option for dual citizenship.

Furthermore, to have known him was to love him.

What is a good man?

Is it someone who makes himself rich?

Is it someone who hits home runs?

Is it someone who wins an Oscar?

My definition of a good man is encapsulated in 2 simple words: AMEDEO MAIDA

My dad was born in 1929 in Cosenza, Italy. He was the youngest of 4 kids born to Antonietta & Francesco. My grandfather Francesco lived and worked in New York City for more than 20 years prior to Amedeo’s birth. During that period, Amedeo’s 3 siblings were raised with affluence, privilege, and access to higher education. In early 1929, Francesco Maida no longer “LOVED NEW YORK” and decided it was time to return to his family in Cosenza. With the wealth he had accumulated he was able to purchase vast property holdings in the Cosenza region. Nine months later, 2 events coincided: my dad was born and the height of the great depression occurred. My grandfather was instantly rendered penniless, and was literally forced to trade buildings for sacks of flour and large acreages of land for pieces of cheese to keep his family alive. As a result, my dad lacked proper nutrition and was not able to attend the fancy schools that his much older siblings attended. As a child under 10 years of age, he would venture alone into the mountains of Cosenza to forage for chestnuts, wild mushrooms, and firewood to help his family survive. If anyone has ever been to the mountains of Calabria, you will understand how treacherous they are with deep groves of Chestnut and Walnut trees that are infested with the vicious cinghiale (wild boar) and voracious wolves (lupi della sila). Then WW II erupted and this plunged the Cosenza region into deeper poverty.

Just after the end of WWII, Amedeo’s childhood of deprivation, hardship, and sacrifice changed when he met the love of his life, Rosa. My mom was 12 and my dad was 17. After a long and highly regulated courtship, they married in January 1952. Shortly thereafter, my dad boarded the Ocean Liner Vulcania in Naples, together with his friend and future compare, Domenic Sisca, and headed for Halifax where he disembarked at Pier 21. After a long train ride that went through Montreal, he disembarked at Union Station in Toronto. There, he met his uncle, Angelo Maida who had gracefully sponsored his immigration to Canada. My dad boarded with relatives in Hamilton while desperately trying to earn some money to have his wife and newborn daughter fly to Canada. It was not an easy time for my dad. He experienced extreme prejudice, discrimination, and humiliation, even though he was a NON-VISIBLE minority. Regrettably, in those days, Canada was not so friendly to immigrants, especially if their surnames ended with a vowel and their speech carried an accent. He worked night and day as a labourer, and had a stint at the Ford Plant in Oakville.

A testament on how committed he was to his parents was that from day one in Canada, he sent a significant part of his wages back to Italy in order to keep his mom and dad afloat for the rest of their lives!!!!!

In 1954, my dad, mom and sister Amelia moved to Toronto. My dad became a Barber and worked in the first ever barbershop within the newly opened TTC subway at the Yonge-Bloor station, owned by a wonderful gentleman named Peter Colapinto. My dad had a very elite clientele that included actors, (Robert Goulet, to name one), business leaders, and high level politicians. My dad idolized Mr. Colapinto and would always speak about his 3 sons who all became medical icons at the University of Toronto. It was through hearing about the Colapinto family that I derived inspiration for my eventual medical career. As fate would have it, Mr. Colapinto’s grandson would be in the same graduating class as I.

After my birth in 1957, our family moved from 750 Crawford Street in Toronto to 1402 Wilson Avenue in North York, where just a few blocks away from the new Humber River Hospital, my dad would soon open his own new men’s Barber shop. My younger sister, Antonette, was born ten years later.

When I reflect on my dad’s life on this earth, many descriptive terms come to my mind that exemplify his wonderful character:

Integrity                                                               diligent                                                                 courage

Sincerity                                                               selfless/unselfish                                             loyal/faithful

Righteous                                                            Ethical                                                                   Moral

My dad was also a brilliant mind. I shudder to think what he might of become had he had the good fortune of having a higher education. He was brilliant at Mathematics and had a better knowledge of politics and the financial markets that I will ever have.

In my recollection, I never heard my dad say a disparaging comment about someone else, nor use profanity, nor use GODS name in vain.

Another characteristic that my dad possessed was having a great sense of humour. One example, was that he would refer to some of the oppressive and prejudiced Anglo Saxons that he encountered through his life as “Chamberlains”. He could have called them much more poignant, if not blatantly profane things, but chose the soft and subtle mocking term “Chamberlain”. I must confess that I’ve only come to understand the humour of this moniker after reading the history books. Can anyone understand the root of this humour??? Well, Neville Chamberlain was British PM before WW II. He was probably the most ineffective and inept world leader on record. Thus, to call a person a “Chamberlain” was a sarcastic euphemism for a “dumb wit”.

My dad was always a minimalist, non-materialistic, and contented with the simplest of pleasures:

  • He did not crave fine dining-stale bread, a homegrown tomato, homemade sausage, and a glass of homemade wine (made from his own grape pergola) satisfied him.
  • He did not covet a designer shirt- a no name brand from Sears, on sale, was just fine.
  • He did not desire an expensive European car- a used domestic car would be OK.
  • He did not dream of a personal vacation-he preferred that his family realize those dreams.

My dad never complained about anything. He never bemoaned the fact that his much older siblings had better childhoods than him. He never complained that he lacked a support system when he arrived alone in Canada. He never complained about having to take care of his sick wife.

Through most of his adult life, my dad was always a very sick and suffering man. Yet, every morning he would tell me during our daily telephone call that “he was fine and he “Can’t complain”. Despite this, he remained until his death, my mother’s doting companion and main caregiver as my mother had a long list of chronic health problems. At age 47 he suffered one of the most devastating Strokes that I’ve ever seen in my career. Yet within a year, he made a remarkable recovery. Unfortunately, this led him to lose his once prosperous barbershop and led him to work as a caretaker at the local school board until his retirement.

At age 64, he suffered the most catastrophic set of complications in the history of St. Michaels Hospital when all 3 of his cardiac angioplasties collapsed. When I kissed my dad goodbye that evening, he was essentially dead and having a salvage bypass. He spent the next 3 months on a respirator and again returned to full function.

So if any of you out there doubt the existence of miracles, you have our permission to quote my dad’s experiences. And remember, those miracles were created by GOD, not by DOCTORS.

However, another reason for my dad far exceeding all survival predictions was the birth of his youngest grandchild, William. When my sister and newborn William moved in with my mom and dad, my dad, for young William, essentially became the father he never had. In hindsight, the father role that my dad willingly accepted for William, gave him a rejuvenation and a renewed sense of meaning and purpose in life.

In summary, MY DAD was a not only a good man but a truly GREAT MAN, but given that he was extremely modest and humble, he would prefer the label a GOOD MAN. My dad has set the bar extremely high for the male members of our family and beyond. Personally, I must sincerely confess, that I would be satisfied if I could achieve but 10% of the “goodness” that my dad exemplified before I die.

On behalf of the entire and extended MAIDA family, I wish to sincerely thank all you for helping us celebrate the life of a very good man — AMEDEO MAIDA

 

 

 

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“TRICK or TREAT”


As Halloween looms, I’m reflecting, metaphorically, on what occurs in healthcare everyday, particulary as it relates to the management of patients with advanced illness. With over 50% of our healthcare expenditures occuring in the last few months of patients’s lives, one must wonder about the care-effectiveness and cost-effectiveness of much of the pedantic active/aggressive medical micromanagement (AAMM) that is rendered in this clinical context. One must also wonder if it is being delivered as a result of truly “patient-centered” care or simply expediently driven by a “doctor-centered” approach. Let’s face it, it is much easier to micromanage irrevelant minutia instead of having a fulsome and often exhausting discussion with patients and families that includes details around natural history of disease, prognosis, and evidence base. Research has demonstrated that when appropriate counseling is delivered, patients with advanced illness tend to choose conservative palliative management (CPM) over burdensome, expensive, and futile late-stage AAMM. Therefore, when the latter is administered to patients, are they being “Treated” or “Tricked” ?

Posted in Bioethics, Distributive Justice, Palliative Medicine, Promoting PCC & PE | Leave a comment

DON’T Euthanate – PALLIATE !!!


It is no wonder so many terminally ill patients are begging for euthanasia. The vast majority of terminally ill patients are seldom offered a “purely palliative approach” (comfort measures only).  Instead, patients are being paternalistically forced to adopt futile medical micromanagement until their last breath. Where is the patient-centeredness in this equation? While dying patients are getting their hemoglobins, serum potassiums, and serum rhubarbs treated, there is negligible regard for the suffering they are experiencing. Available research shows NO survival benefit in continuing Active/Aggressive Medical Micromanagement (AAMM) over a purely palliative approach in late stage patients (PPS<50%). All the “fluffing and buffing” of such patients is not in the best interest of the patient, families or the health care system. Unfortunately, most physicians find it easier to simply continue with futile “fluffing and buffing” instead of having  fulsome discussions about natural history of disease, prognosis, and effectiveness/efficacy and burden of those AAMM treatments. It behooves physicians to thoroughly discuss these foundational issues with patients in order to allow them to choose the direction/philosophy of care that is consistent with their own preferences, values, beliefs, and wishes. Available research shows that if such patients are given a choice, the majority would choose a purely palliative approach (comfort measures only), while withholding continued AAMM. Such a truly patient-centered approach will lead to fewer requests for euthanasia.

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Read our newest publication in BMC Medical Education


http://www.biomedcentral.com/1472-6920/14/93

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Read our most recent publication in MEDICAL TEACHER


Restoring prognosis as a core competency in medical practice

V Maida, PM Cheon – Medical Teacher, 2014

http://informahealthcare.com/doi/pdf/10.3109/0142159X.2013.875620

Posted in Bioethics, Distributive Justice, Palliative Medicine, Promoting PCC & PE, Wound Management | Leave a comment

The DEMON in the DEEMING


A cliche excessively used by physicians relates to “DEEMING patients palliative”. To “deem” is to consider, hold an opinion, believe, think or regard. A classic example of medical paternalism occurs when physicians “deem” a particular patient as being “palliative”. This expression is not only vague, confounding, and euphemistic, but is also the antithesis of a truly patient-centered approach to healthcare. A more precise statement would begin with expressions about the terminal/incurable nature of a given disease, its natural history, prognosis, and the lack of response to disease modulating therapies. When patients are given this information in an understandable, gentle, and sensitive fashion they are the ones who must decide whether they wish to proceed with potentially life-prolonging treatments (AAMM) for the balance of their lives, or elect for a completely palliative approach (CPM) that focuses on maximizing comfort, dignity, quality of life, and quality of death. Thus, the patient must “DEEM” themselves palliative NOT the physician. Physicians must strive to clarify the language they use when dealing with terminally ill patients. Finally, the term “Palliative” should NOT be used as an adjective to describe a patient, rather, only as an adjective to describe the philosophy (goals, ideology) of care.

 

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Palliative Chemotherapy-An Oxymoron


Advanced cancer patients worldwide are offered chemotherapy and radiotherapy under the guise and pretense that it is “palliative”. The majority of patients have virtually no idea what they are getting themselves into. The term “palliative” remains one of the most misused and confounding words in the English language. Most of the time it is used in a euphemistic manner in order to avoid using the unmitigated/unequivocal and more honest statement-“You are incurable and thus terminally ill”.

Where is the evidence that Palliative Chemotherapy actually improves pain and symptom management. Only optimal palliative pain and symptom management (opioids, adjuvants, etc) has been shown to lessen the multitude of symptoms from advanced cancer. More often than not, systemic chemotherapies create more distress through CINV, painful neuropathies, skin disorders, hematologic complications, etc. The only example in the medical literature of truly “palliative chemotherapy” is electrochemotherapy used on malignant wounds. A couple of systematic reviews show that this technique actually reduces pain, exudates, and odours resulting from such wounds.

In summary, let’s avoid using the arcane and oxymoronic expression “Palliative Chemotherapy” and replace it with “Non-curative/potentially life-prolonging chemotherapy”.

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