Member of Excellence

Members of Excellence a humble doctor

Motivated by the desire to help others, Dr Purssell knew he wanted to be a doctor at a young age, pursuing Emergency Medicine followed by Toxicology in order to better treat patients, and advocate for serious change

An Arbutus Club member of 39 years, Dr Purssell is an Emergency Physician at VGH, a Professor at UBC with the Department of Emergency Medicine, and the Medical Lead of BC Drug and Poison Information Centre. "Being able to help people and understand what I needed to know in order to do that is how I became interested in pursuing medicine,"explained Purssell. After completing his Medical Degree at UBC, Dr Purssell completed his fellowship training in Emergency Medicine at McGill University, followed by a Toxicology Fellowship with the American College of Medical Toxicology. Training in toxicology, the treatment of poisoning and drug overdose, naturally followed emergency medicine. Dr Purssell said it was a simple decision, "because drug use is a common issue, there are many people who have overdoses for a variety of reasons. With a greater understanding of the mechanisms of how the drugs are causing toxicity, there is a greater understanding of what sort of treatment needs to be provided." Since first stepping foot into the ER Purssell said, "I recognized that every patient in the Emergency Department is having a difficult time, some are having the most difficult time they will ever have in their life," Purssell considers it a privilege to help.

From 1987 to 1993 Dr Purssell co-founded and was a Director at the Royal College Residency in Emergency Medicine at UBC. He later became the Head of the Division of Emergency Medicine in the Department of Surgery, taking a central role in the creation of the UBC Department of Emergency Medicine, officially formed in 2008. In addition to his achievements in medicine at UBC, Dr Purssell played a major role in supporting Mandatory Alcohol Screening, more commonly known as random breath testing by police. "It started off by looking at situations when patients would be involved in terrible car crashes and end up in the Emergency

To be able to help out in these situations is something I still find very rewarding.

Members of Excellence

Department. We wondered whether or not the drivers were being charged with impaired driving. This initial interest resulted in a 10 year long study accessing medical databases to determine that only 11% of intoxicated drivers were actually being charged with impaired driving after a crash. Although doctors had blood samples from these patients in order to manage their medical treatment, most of these patients were not facing charges. Subsequent research proved that without legal consequences, these drivers frequently engaged in impaired driving, despite seriously injuring themselves and others. "It was a terrible situation for everyone concerned," Dr Purssell explained. "The study was published and actually received a lot of media attention," recalls Dr Purssell. "I thought something might actually happen, but it didn't at that stage." However, Dr Purssell didn't stop there. He chose to take advice from colleagues who said, "As an individual you don't really have much chance of changing the way things happen, but when you work together with important associations, you can." Dr Purssell got involved with the BC Medical Association (now called Doctors of BC) and he worked on the Emergency Services Committee, eventually becoming the Chair. One of the committee's responsibilities was to come up with resolutions to support important issues intersecting public health and emergency medicine.

"I had no idea how to go about lobbying for change. The combination of working with the Medical Association and Mother's Against Drunk Driving (MADD Canada) meant we had the ability to approach and influence government. And, eventually laws were passed provincially and federally to make significant change," Purssell explained. Dr Purssell's ability to garner positive change did not go unnoticed. He was awarded the Queen Elizabeth II Diamond Jubilee Medal in 2012 and an Award of Recognition from the Doctors of BC in 2019. But, don't expect him to want to talk much about either of these awards. He humbly noted, "It's nice to have this recognition that the work is important, indicating acknowledgment from others that the work did make a difference." In October 2021, Dr Purssell and his team published a UBC Study on Prescription Opioid Treatment for non-cancer pain and the subsequent initiation of Injection Drug Use (IDU). "With injection drug use, we have such toxic drugs now. People are dying, about 6 per day in BC, a true public health emergency." explained Purssell. He continued to explain the concern about shifting from a prescription opioid, to using drugs in the illicit drug supply. "Although there was information that was mostly based on surveys, there wasn't information based on administrative data," he recalled. Uniquely positioned to access multiple databases, including long-term, detailed prescription data, Dr Purssell with the help of experts was able to divide individuals without a history of substance use, who were treated with prescription opioid for pain, into four groups. The "chronic group", those who were treated with opioids needing to take them most days for up to, or exceeding, 2 years proved to be at highest risk for IDU. "If you take opioids everyday, you will become tolerant to the effects, a larger dosage is required to have the same effect, and stopping will result in unpleasant withdrawal symptoms." Dr Purssell expalined how the study concluded that the focus needs to be on providing more support to the chronic group. "Every attempt needs to be made to make sure these individuals will not transition to IDU. Specially considering the catastrophic outcome of the drug supply that is around now. Every patient's journey is unique, and this really highlights the importance of shared decision making that puts the needs and well-being of the patient first," Purssell concluded. Dr Purssell believes we need to improve access to multidisciplinary pain management, providing patients with more resources. Multidisciplinary approaches to treat pain include access to non-invasive interventions like exercise therapy, rehabilitation, cognitive therapy, and also more invasive approaches, like using nerve blocks. "We can't continue to have people dying, it needs to change." Dr Purssell encourages us all to advocate by asking our own health care professionals about pain management. Continuing to support many people with the important work he does, what helps Dr Purssell persevere with such passion is enjoying the outdoors with friends and family. Dr Purssell became a member of The Arbutus Club in 1983 after he married his wife Lori (née Hay), whose parents were Founding Members. With three children, the Purssell family accessed the Club often, and Lori continues to use it regularly. "My wife has done courageous work as a nurse in the ICU at VGH, " Dr Purssell pointed out when talking about his family. Although he took a hiatus during COVID-19, Dr Purssell looks forward to spending time in the Club's Fitness Centre. "I think it's wonderful, very well set up. During normal times I'm there at least three times a week. The trainers are absolutely terrific, getting people on a good program and doing the right things to keep them fit and healthy, while avoiding injury." Acknowledging that COVID-19 has been difficult for everyone, Purssell shared his final thoughts,"There are an awful lot of front line workers who have been working very hard through a very difficult time." Not surprisingly, Dr Purssell expresses his appreciation and respect for the dedication of his colleagues. ♦