The Miles of Dr. Clegg

A Photo Essay byAnita Gonzalez-Cecchin

For Robin Clegg, M.D., the value of a Harvard training program can be measured in miles.

Each weekend, Clegg completes a 4,184-mile roundtrip commute from Boston to her home in Calgary, Alberta.

“I’m a Calgarian,” says Clegg, a 33-year-old physician who grew up on the dry, windy plains of the Alberta province. That’s where my husband and daughter are, so that’s where I want to be on weekends. But from Monday through Thursday, I’m a totally focused Boston doctor.”

Then pausing for effect, she adds with a quick smile, “At Harvard.”

Clegg is training for six months as a fellow at Children’s Hospital, Boston, a teaching hospital for Harvard Medical School.

Unwilling to uproot her family for the half-year period, Clegg chooses instead to fly back and forth from western Canada.

“Considering how much I hate flying, I’m really surprised I’m doing it this way,” says Clegg as she boards the first of two Air Canada jets that will fly her from Boston to

Montreal, and then, after a 90-minute layover and plane change, onto Calgary.

Her journey begins Thursday evenings at 5:00 p.m. in a 13-row Canadian Regional Jet designed to shuttle at most 50 business commuters lugging only carry-on briefcases.

Clegg, a gregarious woman with a knack for conversation, quells her unease of being 35,000 feet in the air in a small plane by chatting with the passenger next to her.

When pharmaceutical salesman Mark Hart of Montreal inquires about his fellow passenger’s job, Clegg keeps him captivated with the details of her training program.

Clegg is one of only four physician fellows training this semester in pediatric electrophysiology at Children’s Hospital, Boston. There she masters skills needed for the care of children with irregular heart rhythms. Treatment for these children often involves the implantation of heart pacemakers or defibrillators to regulate or jump start the heart’s beats, depending on the child’s needs.

Clegg’s days at the hospital begin with morning rounds, led by senior cardiologists, like Tom Johnson, M.D., who are also part of the medical school’s faculty.

“Like all our fellows here, the ones like Robin who are from other countries are extremely talented and motivated,” says Johnson.

Slightly embarrassed by the onsite interview and impromptu evaluation, Clegg softly responds, “I just try to soak up as much as I can.

Under the faculty’s supervision, the fellows review children’s medical histories, conduct their examinations, analyze test results, and propose treatment plans for their young patients.

For the sickest patients, procedures in the operating room are required.

Sometimes, Clegg’s role during these procedures is to act as a second or third, or even fifth pair of eyes on the many monitors that display a child’s blood pressure or heart rhythm as the operating physician attempts to either burn some heart tissue to stop an irregular rhythm, in a procedure called a catheter ablation, or to insert and set a pacemaker or defibrillator to settings that will keep the child’s heart beating normally.

At other times, Clegg herself is the operating physician.

“I suppose most people would think it could be a little daunting to train in front of the world’s experts. Everyone here is on fast forward. But I’m used to it,” says Clegg, who was assigned the prestigious Chief Resident position at Toronto’s Hospital for Sick Children prior to her stint in Boston.

Fitting a child with a pacemaker or defibrillator that will keep the child healthy is fulfilling, says Clegg. But the best feeling is when a child can go home from the hospital cured of their heart problem.

Such was the case recently with Mary Boshar, a demure 7-year-old girl from Andover, Massachusetts.

Mary was born with a fast heart beat condition called Wolff-Parkinson-White Syndrome, or WPW, that caused her heart to fail when she was just 10 days old.

Doctors managed to stabilized her with medication. But as Mary grew up, any common illness, including a cold or fever, would trigger her heart to beat too rapidly.

“We decided that a catheter ablation was the best option for Mary because it offered a cure,” says senior cardiologist Frank Cecchin, M.D.

In the operating room, while she was sedated, Cecchin and Clegg inserted catheters into Mary’s heart and found the extra tissue that was causing her heart to beat too quickly. The doctors then sent an electrical current through the catheter to burn that tissue area. Within 3 seconds, Mary’s heart reverted to a normal rhythm.

A day after her successful procedure, Clegg re-examines Mary. Already feeling better and expecting good news, the young girl has changed out of her hospital gown into a favorite T-shirt and leggings. Clegg determines her fit to go home.

“We don’t keep the children in the hospital longer than needed,” says Clegg. “We know how important it is for them to get back home to their family and some normalcy.”

Seeking to provide some normalcy and comfort to her own family is the goal Clegg sets for herself each weekend as she flies home to Calgary.

Coming and going, she repeats this refrain to border control officers to explain her numerous jaunts between the countries.

Clegg says some border officials listen to her odyssey’s explanation and then simply nod and smile, too busy to fully comprehend the complexities of her journey. But most officials, stunned by Clegg’s willingness to log 4,000 miles in the air each weekend, give a quick quizzical look of bewilderment before stamping her through.

Once she clears customs, Clegg has just enough time to grab a prepackaged dinner, get to her new departure gate, and, as she waits to board her second flight, phone home.

She relays flight delays to her husband and good-night wishes to her daughter.

Clegg’s voyages from Boston to Calgary International Airport usually end eight hours after they begin, putting her in Calgary at 11:00 p.m. local time, or 1:00 a.m. Boston time.

A recent journey took ten hours because of flight delays.

Walking off the plane slowly, the exhausted doctor pulls her wheeled carry-on suitcase through the nearly desolate Calgary terminal.

She spots her husband and drops into his arms for a long embrace.

Brent Clegg, a stoic 34-year-old structural engineer, who was recently promoted to vice president of his company in Calgary, and who handles his wife’s profession and the presence of a photographer with calm chagrin, meets his wife at the airport every Thursday evening without fail.

“I could take a taxi, but he wants to always meet me. And there’s something wonderful about being met by family at airports,” says Dr. Clegg.

Because of the late hour, Clegg’s daughter, Josesina, is already asleep back at their small rented town home, supervised by a live-in nanny. The mother-daughter reunion has to wait until morning.

That makes Friday mornings special,” says Dr. Clegg.

Referring to her daughter by her nickname, she adds, “Sina usually gets up first and climbs into my bed to tickle me awake.”

Then the two head downstairs to cuddle together in a parlor room dominated by children’s toys, a collapsed pop-up nylon tent, and a 56-inch video LCD screen.

After a breakfast of poached eggs and crumbled toast, mixed together for spooning out of tea cups the way Clegg’s mom used to do, Clegg and Sina return to the parlor to set plans for that day’s adventure.

Dressing like princesses is a favorite activity. While her mom tries to secure a rhinestone crown on her daughter’s fine hair, 2 ½-year-old Sina asks in animated cadences about Disney princesses, singing lions, camera lenses, and why the giraffes and the warthogs share pens at the local zoo.

“I just want to relax and listen to my daughter,” says Clegg. “I think somebody should capture her laughter on video or tape. It’s so joyful.”

By Saturdays, Clegg is recovered from her cross-continental trek and re-energized for playground romps, shopping errands, neighborhood strolls, and dinner parties at friends’ homes.

Clegg says her friends genuinely support her decision to commute to Boston from Calgary each weekend, although some wonder why she didn’t choose a fellowship closer to home, perhaps even at a Midwest or west coast American medical center.

“I can give an easy answer to that,” says Clegg.

Reminding them of her prior residency at Toronto’s pediatric hospital, widely regarded as the best Canadian pediatric facility, she says, “I’ve trained at the best teaching hospital in Canada.

Why should I settle for less than the best in America?”

Clegg says her training at Harvard will prepare her to start a new job in July as the first-ever pediatric electrophysiologist at Calgary’s new Children’s Hospital.

That job results from the city’s fast growth. Calgary, a city of about 1 million, which sits in a river valley etched by receding Ice Age glaciers and bolstered by agricultural and oil industries, has experienced a growth of 25,000 new residents each year for the past decade.

The new Calgary Children’s Hospital, designed with the input of local children to have an exterior that looks like a big Lego set, will serve all of western Canada up to Vancouver.

Clegg will care for the children with abnormal heart rhythms.

It’s that heady responsibility which motivates Clegg to repack Sunday mornings for her return trip to Boston.

But, she adds with melancholy, “On Sundays, I always sense the change in Sina’s mood.” Clegg knows her daughter is too young to understand the value of her mom’s weekly disappearance.

On a recent Sunday morning, Sina, noticing her mom’s repacked suitcase by their stairs, marched up to her bedroom to retrieve an inflatable rocking horse to guard the suitcase.

It wasn’t clear if the horse was meant to protect the suitcase or block it from leaving.

To soften the blow of separation, Clegg lifts her daughter into her arms and reminds her that she will return in just four days.

“Can you make the number four with your fingers?” she asks her daughter, helping Sina to maneuver her fingers into the right positions.

She can.

But as the family drives to Calgary’s airport, the young child’s spirit is still solemn andheart-wrenchingto share.

Four months into her commuting routine, the weekly goodbyes remain painful for Clegg too.

So her husband reassures her at curbside that the family will be back together soon.

Clegg knows that in her absence, her husband and daughter have formed a strong bond.

“They make a good team,” says Clegg as she steps away from her family and into the airport.

If anything happened to me, I know they’d be fine together.”

The first return flight, from Calgary to Montreal, is the more difficult, as Clegg sheds her final tear and shifts gears for a busy work week.

By the evening flight from Montreal to Boston, and while other passengers sleep, Clegg is reading through the numerous medical articles and book chapters required for her Harvard fellowship.

Back at Login Airport by 9:00 p.m., Clegg waits to retrieve her carry-on suitcase, at 20-inches still too large to store in the smaller plane’s overhead bins, and then catches a taxi back to her rented condominium near Children’s Hospital, Boston.

The next day, during a clinic break, Clegg text messages the response to a question posed to her.

By her calculations, she has already traveled 54,392 miles to ensure she can complete her Harvard training.

Then she adds, “just 33,472 more miles to go.”

© A.Gonzalez-Cecchin