Dr. Estello Nap Hill was a student doctor working on the gastroenterology service at St. Paul’s Hospital this spring when a very sick patient arrived. A CT scan showed the patient needed emergency surgery because her stomach was twisted.
It was a complicated case, and Hill’s mother, veteran gastroenterology nurse Déderique (Dee) Nap, was also working in the same unit that day.
“My mom is always the first person to stay late. She (said), ‘I’m going to stick around and help the doctors figure out this case, help them do the scope for the procedure,’” Hill, 28, recalled.
“And I said, ‘I have to stay as well. When are you going to get an opportunity to have this go on and be alongside your mom?’”
That day in the intensive care unit was the first chance mother and son got to work together in health care.
“I was over her shoulder and she was working with the specialists. … This was my mom in full action, in full swing,” said Hill. “It was amazing.”
Hill, who is now doing his residency (specialty training) at several Vancouver-area hospitals, has not worked with his mother since.
But that first experience was the culmination of a three-decade journey for Nap, a single mother who raised her son in Richmond with a small budget and a big amount of pride.
“There is no feeling that even describes what that means,” Nap said of working with her son in the ICU. “There’s no words to explain that. Hopefully, I said to myself, this will rub off and I actually can see my son doing a job like this down the road.”
Shortly after the procedure, Hill graduated from the University of B.C. medical school in May and is now doing an internal medicine residency in Vancouver. He would like to become a gastroenterologist, someone who specializes in the disorders of the stomach and intestines — meaning he would practise the same type of medicine as his mom.
Training to be a new doctor and graduating from medical school during a pandemic, when there are so many extra critically sick people in the province, came with both unexpected challenges and once-in-a-lifetime opportunities.
“I got the opportunity to work in the ICU at (Royal Columbian Hospital), and to see all of the patients on ventilators. But to be able to share the fears and the uncertainties with my mom, and then to be able to have that support, was so powerful,” Hill said.
“The whole world is on fire but this same relationship, the same bond that we’ve always relied on, was super strong.”
Nap, who has been a nurse for 33 years, said this pandemic was reminiscent of being a health-care worker through the SARS epidemic in 2003, when so little was known about how the virus spread and how dangerous it was.
“At the beginning, it’s all the unknowns that make you afraid to even be in the medical system. But at the end of the day, we have patients to take care of and they’re people, just like me and you. So you have to process it in your head, that hopefully the higher ups know how to protect us from this. And then we have to just give the patient care,” Nap said.
But there were certainly days over the past 17 months that she worried.
“The idea that you go to work and you could potentially catch this deadly disease is frightening. And knowing that my son was out there in the same field, potentially getting exposed.”
During a recent conversation in a Vancouver park, Hill and Nap spoke about their COVID-19 experiences, their parallel medical careers, and how a little boy of colour from a lower-socioeconomic household overcame the stereotypical odds to become a doctor.
Hill, whose father is Black, said there were few kids who looked like him growing up in Richmond, at high school in Vancouver, or even in medical school. Today he is a representative of the Black Physicians of B.C., which provides mentorship to Black medical students, advocates improved health care for Black patients, and fights for more equity and less institutional racism in the faculty of medicine.
He often uses the hashtag #BlackMenWhiteCoats in social media posts, as part of a growing movement to let other Black boys and young men know that they aren’t alone, that they can connect with others like them.
“With posts like that, and with connecting into that community, I feel like it’s an opportunity to show people that there are definitely other people out there who are in single-mom situations, who are in places where people tell them they can’t do this or do that,” Hill said.
Working their first shift together at St. Paul’s was coming full circle for mother and son — it was the hospital where Nap gave birth to Hill in May 1993. Her arranged ride to the hospital fell through, so the nurse called a taxi when it was time for the baby to arrive.
“We were really on our own,” Hill explained.
Money was tight for the small family, who lived in a one-bedroom apartment in a rough area of town. But Nap “dug deep” to make ends meet, and never wanted to be defined as a single parent, saying it was more of a side plot in their story than the main narrative.
Nap, who was then an ICU nurse at St. Vincent’s Hospital, remembers being outraged when the principal of Hill’s elementary school told her that single-parent children “don’t amount to much,” so she encouraged her boy to pursue every dream.
“I just wanted him to believe in him. I said, ‘Hey, you can be what you want to be and do whatever you want to do,’” she said.
Hill remembers a happy childhood, painting large murals on the apartment walls and cooking meals with his mom.
“When I think of my earliest memories, it’s only positive memories. My mom created such a fantastical environment at home. I never clued into any of the hardships or any of the struggles,” he said.
He recalls being grumpy, though, when his mother put on her hospital scrubs, knowing it was time for him to stay with the babysitter while his mom went to work, sometimes doing double shifts.
“I can remember him not loving my green uniform,” Nap laughed.
When he was a boy, Hill didn’t aspire to work in health care. He wanted to play football, just like his father (whom he didn’t see very often), who played for an NFL team.
Hill played tight end for Vancouver College, which won the provincial high school championships in 2010 when he was in Grade 12, and he was a wide receiver at McGill University. But partway through university, he dropped football and pivoted to life sciences courses, with a new focus of following his mom’s footsteps into medicine.
His mother, Hill said, has taught him “the compassion of medicine” — to treat all patients with empathy.
Both Nap and Hill said the support for health-care workers at the start of the pandemic was heartwarming and encouraging.
“It inspired you to keep (going), that what you were doing was something that was really making a difference,” Hill said. “
And especially when everybody’s working from home. Being able to don the uniform, put on your scrubs and go into work, to fight the good fight.”
Public support for health care workers has waned a bit though, they both believe, likely because of fatigue over the restrictions and mask wearing. But the veteran nurse of both the SARS and COVID epidemics has a clear message for British Columbians.
“Please get vaccinated,” Nap said.
“That is for the greater good of humankind. … I think that is the only way for us to get ahead and actually get out of this.”
Hill said the other lesson learned from this pandemic is the importance of community, and helping neighbours, friends and family, especially if they live alone.
“I truly believe that the whole COVID experience has been a pretty big psychological insult to a lot of people … I think that the fear and uncertainty is something that can be incredibly damaging, if it’s not dealt with properly,” Hill said. “There are people that are going to come out of this and never be able to leave their house without being scared, are never going to be able to have social interactions.
“I relied so much on my relationship with my mom and being able to talk and being able to have her there throughout it. And I can only imagine what it would have been like to be isolated. And so I think a message that I would want to put out there is not to forget your neighbour, and not to forget the people that are kind of really struggling in silence.”
Hill and Nap will work together for a second time in a month or two, as Hill continues his residency rounds in various Vancouver-area hospitals. It is something they are both looking forward to.
As he works in the hospitals, and speaks with parents with children who look like him, Hill realizes he and his mother have moved past their disadvantaged early years, and now have important experiences to share with others.
“We’re on the other side of it now. All of the doubt, all of the hardships, all of those things that had been barriers — now you can stand on the other side and be somebody who shows people that despite where you’re coming from, despite the hardships, despite all that, there’s a way through if you persevere. There’s a way through if you commit to whatever you’re working toward.”