Celebrating a passionate advocate for people living on the margins of society

Inner-city family physician Jessica Kirkwood. Photo supplied.

For the past five years, Jessica Kirkwood has looked forward to attending the annual Canadian Women in Medicine (CWIM) conference with her friend Megan Lyons, now a plastic surgeon in Saskatchewan, whom she met when they were students in the University of Alberta’s MD Program. Their favourite part of the conference was the award ceremony, when they would hear about amazing women doing inspiring work. But in June 2022, Lyons headed to the podium instead of remaining in the audience with Kirkwood. “Oh,” thought Kirkwood, “she’s nominated someone — that’s great!” But when Lyons began to speak, Kirkwood burst into tears as she realized that her friend had nominated her for the Dr. Setareh Ziai Inspiring Woman Physician Award.

Kirkwood admits that much of her friend’s speech that night is a blur. It was hard for her to believe those glowing remarks were about her. But Lyons felt Kirkwood was an excellent nominee for the award, given her work within Edmonton’s inner city providing primary care to people who are houseless, experiencing extreme poverty and dealing with mental illness and substance use disorders. The award also recognized Kirkwood’s work at the Edmonton Isolation Facility during the height of the COVID-19 pandemic, and her involvement with the PEER: Patients, Experience, Evidence, Research group in the Department of Family Medicine.

Kirkwood is a family doctor who has been working at the Boyle McCauley Health Centre for the past 10 years. She acknowledges that not everyone could work with the inner-city population and their unique struggles, but her fierce passion for equality led her to this role, in which her favourite part of the work is her patients. “I love my patients!” she says. “I couldn’t imagine a population more deserving of resources and care. It really infuriates me that there are still people in our society who don’t want to reach out a hand and help someone up.”

When Kirkwood first started as a family doctor she would often have quiet times during the month when she could catch up on paperwork. But those days are gone. “Crystal meth leads to pure chaos in the clinic and in the city in general. We see a lot more injuries and medical complications of substance use. In the winter we see a lot of frostbite.”

Kirkwood has seen unintentional drug poisonings in Edmonton increase exponentially in the past 10 years. She recalls, “I remember we had 15 accidental overdoses that occurred in one day. And there are times when really strong, potent batches of fentanyl come through the streets and we’ll see multiple people accidentally overdosing at the same time.” While these situations were initially frightening, the nurses and staff are now accustomed to pausing whatever they’re doing to run outside and save a life, come back in and restock, then continue with their work. If a patient isn’t responding to Narcan or Naloxone, a doctor or nurse practitioner will go help, sometimes providing CPR and making sure emergency services are on their way.

At the beginning of the pandemic Kirkwood volunteered to work at the Edmonton Isolation Facility, which provided shelter and medical care to houseless Edmontonians with COVID-19 or COVID-like symptoms. “It was amazing. After working in the inner city for a decade, I really felt like I knew our vulnerable Edmontonians, but I got to meet so many more people that were scattered throughout the city, living quite dangerously on our streets,” Kirkwood says. “We were able to connect a lot more people with primary care and start people on opioid agonist therapy to treat opioid use disorder. That was incredibly rewarding.”

“When my patients have somewhere to sleep and live that isn’t unsafe or on the streets, their substance use can oftentimes dwindle down to absolutely nothing,” says Kirkwood. Her experience at the isolation facility demonstrated that Edmonton needs a medical shelter. Traditional shelters can sometimes fail to meet people’s needs, especially if they’re medically unwell. But when the isolation requirements for COVID-19 ended, so did the funding for the facility.

In addition to being a family doctor, Kirkwood has been an assistant professor since 2019 in the Department of Family Medicine, where she lectures on issues such as working with marginalized populations, taking an addictions history, treating youth experiencing homelessness, or breast cancer screening. “I really try to encourage our medical students to focus on shared decision-making and educating our patients to make the best decision for them,” she adds. “If a mammogram is going to be really traumatic for a patient, the evidence doesn’t show that we should be forcing people to do certain procedures.”

Kirkwood mentors a group of eight or nine students to discuss ethical topics throughout all four years of their medical training, and is looking forward to catching up with them this December after they’ve experienced working on the wards. She also teaches residents and at any given time will be faculty advisor for at least one, and enjoys being in contact with the residents doing electives through the clinic at the Boyle McCauley Health Centre.

As a member of the PEER team — a multidisciplinary group of primary care providers working through the Department of Family Medicine in collaboration with the Alberta College of Family Physicians — Kirkwood works hard to make evidence-based medicine fun and easy to understand for primary care providers and their patients. PEER produces bi-weekly, nationally distributed evidence summaries, primary care guidelines and entertaining talks and conferences. Kirkwood, who loves public speaking, was involved in developing a workshop to teach primary care providers how to treat people with opioid use disorder and what medications to use — based on the evidence — and delivering it across Alberta. Kirkwood, along with others on the PEER team, just finished writing a guideline on chronic pain.

“I love the people I work with — both at my clinic and the academic team," says Kirkwood, "I am so lucky to work with the most energetic, passionate people who love the work they do. And I love my work too; I think it's incredibly rewarding. There’s never a boring day. I couldn't imagine doing anything else.”

In addition to Kirkwood’s professional accomplishments, Lyons adds, “She is the world’s best cheerleader and is always there to hype you up when you need it. She is also the funniest person I know and an inspiring mother who strives to raise two young children with love and empathy. She is a positive influence in so many people’s lives. She inspires me every day with her empathy, dedication and knowledge. She is undoubtedly an inspiring woman physician.”