FAY­OLA K J FRAS­ER

Rarely do you meet some­one who, de­spite wear­ing mul­ti­ple hats, in­clud­ing CEO, doc­tor, moth­er and founder, still man­ages to make time for any­one. Meet the ef­fer­ves­cent Dr Chelsea Gar­cia, an Amer­i­can Board-Cer­ti­fied In­ter­nal Med­i­cine Physi­cian, Pal­lia­tive Med­i­cine and Hos­pice Spe­cial­ist, a mom of two, CEO of med­ical com­pa­ny LivHealth, and a “Tri­ni to de bone.”

Dr Gar­cia has been blaz­ing the trail in med­i­cine in Trinidad, pro­vid­ing at-home Pal­lia­tive Med­i­cine ser­vices for peo­ple with se­ri­ous ill­ness­es, and of­fer­ing a mul­ti­dis­ci­pli­nary treat­ment ap­proach to help her pa­tients meet their goals and achieve mile­stones. Pal­lia­tive Med­i­cine is a term that many peo­ple con­fuse with end-of-life care, but by de­f­i­n­i­tion, is “spe­cialised med­ical care for any­one with a se­ri­ous ill­ness (whether cur­able or in­cur­able) en­com­pass­ing all do­mains to en­sure the best qual­i­ty of life.”

Dr Gar­cia in­cor­po­rates pain man­age­ment, ag­gres­sive symp­tom con­trol and goals of care to “help pa­tients live their best life.”

Born and raised in Trinidad, Dr Gar­cia did not al­ways en­vi­sion her­self as a doc­tor. Grow­ing up, her “soft spot” for an­i­mals fu­elled her de­sire to be­come a vet. Even­tu­al­ly re­al­is­ing that her pen­chant for heal­ing ex­tend­ed to hu­mans, and up­on win­ning a na­tion­al open schol­ar­ship, she pur­sued med­i­cine at the Roy­al Col­lege of Sur­geons in Ire­land. Ini­tial­ly, she con­sid­ered be­com­ing an on­col­o­gist, but “it was the Pal­lia­tive and restora­tive as­pect of on­col­o­gy that was spe­cial to me.” Pal­lia­tive Med­i­cine is not a road well-trod­den, es­pe­cial­ly lo­cal­ly, but while work­ing in the ICU as a res­i­dent doc­tor in the US, Dr Gar­cia was steered to Pal­lia­tive care.

De­scrib­ing her time in the ICU, she ex­plained that in­ten­sive care of­ten fails to suf­fi­cient­ly ac­knowl­edge pa­tients’ wish­es, along with their qual­i­ty of life dur­ing sick­ness. Al­though can­cer is on­ly one of the ill­ness­es she treats, she stress­es how ear­ly re­fer­ral to Pal­lia­tive care “can re­al­ly help peo­ple turn it around.” For ex­am­ple, Pal­lia­tive Med­i­cine’s role in­cor­po­rates treat­ment of the ef­fects of chemother­a­py, such as nau­sea and vom­it­ing, so pa­tients can con­tin­ue to un­der­go treat­ment and chemo can save their lives.

In 2020, Dr Gar­cia es­tab­lished her own at-home Pal­lia­tive Med­ical com­pa­ny, LivHealth. Af­ter spend­ing ten years close­ly ex­am­in­ing in­ter­na­tion­al health­care mod­els, and adapt­ing them to be fit-for-pur­pose to our lo­cal con­text, she be­gan treat­ing pa­tients with the help of her LivHealth team. “Where do peo­ple want to be the most?” she asks. The an­swer, “home”. Be­liev­ing in the sig­nif­i­cant val­ue of de­liv­er­ing home care, it is with that sim­plic­i­ty she ex­plains the foun­da­tion­al ethos of her com­pa­ny’s care prac­tices. How­ev­er, Dr Gar­cia in­sists that al­though her prac­tice is unique in pro­vid­ing Pal­lia­tive care in the home, she is not the first to have paved the way in Pal­lia­tive Med­i­cine in T&T. She high­lights “the amaz­ing Pal­lia­tive pi­o­neers who de­vel­oped the prac­tice and con­tin­ue to col­lab­o­rate to­wards our com­mon goal,” men­tion­ing specif­i­cal­ly “the tire­less work of the Trinidad and To­ba­go Pal­lia­tive Care So­ci­ety, Liv­ing Wa­ter Mer­cy Home and Vi­ta’s House.”

Shar­ing com­mon goals with a com­mu­ni­ty con­tin­ues to give her pur­pose, and she as­serts that her ul­ti­mate goal “is to see Trinidad and To­ba­go be­come a leader in Pal­lia­tive Med­i­cine.”

The ques­tion of­ten raised to work­ing women in con­tem­po­rary so­ci­ety is, can you have it all? Dr Gar­cia doesn’t nec­es­sar­i­ly be­lieve in hav­ing it all but in let­ting your pas­sions guide you in achiev­ing the things that are im­por­tant to you. Em­pha­sis­ing the ne­ces­si­ty of in­di­vid­ual hard work, she al­so stress­es the vi­tal im­por­tance of be­ing able to lean on her com­mu­ni­ty. Aside from her hats as a doc­tor and busi­ness own­er, she is a wife and a hands-on moth­er to two young chil­dren. Both at the be­gin­ning and end of long days of see­ing pa­tients, out­ing fires and deal­ing with emer­gen­cies, she makes it a pri­or­i­ty to drop and pick up her chil­dren from school, “sim­ply be­cause my daugh­ter asked me to do it.” She doesn’t dis­count how chal­leng­ing her many hats are, and that it is in­evitable to suf­fer from “work­ing par­ent guilt”, but ded­i­cates her­self every day not on­ly to be­ing a bet­ter doc­tor but be­ing a bet­ter moth­er. “A lot of women think we should be do­ing it all, but no one per­son can do it all. Ap­ply the prin­ci­ples of en­er­gy, or­gan­i­sa­tion and ded­i­ca­tion to work and fam­i­ly, and you can have both.”

In 2022, she donned an­oth­er hat as a founder, and launched the LivHealth Char­i­ta­ble Foun­da­tion (LCF), as a re­sult of wit­ness­ing im­mea­sur­able suf­fer­ing, per­pet­u­at­ed by a lack of fi­nan­cial ac­cess to health­care. This not-for-prof­it Foun­da­tion seeks to of­fer much-need­ed at-home Pal­lia­tive care to those who can­not af­ford it and con­tin­ues to ad­vo­cate for Pal­lia­tive Med­i­cine. Dr Gar­cia sees this foun­da­tion, along with the ex­ist­ing non-prof­it Pal­lia­tive care in­sti­tu­tions, as a way for­ward for T&T in tar­get­ing in­equal­i­ty and cre­at­ing eq­ui­table ac­cess for all to health­care.

Her pas­sion can en­er­gise a room, and the ques­tion of­ten posed to Dr Gar­cia is how she con­tin­ues to keep her spark so bright amidst bear­ing wit­ness to so many sick and suf­fer­ing peo­ple. She said her pas­sion is both pa­tient and coun­try-dri­ven. She con­sid­ers her com­pa­ny as her “pas­sion project” and not with­out its var­i­ous chal­lenges of fi­nan­cial risk and vul­ner­a­bil­i­ty that she per­se­veres through dai­ly. “I find joy every day in my work,” she re­marks, “I went to med­ical school with peo­ple who suf­fered be­cause they were pushed on the path of be­ing a doc­tor.” But Dr Gar­cia’s joy is in help­ing peo­ple and in giv­ing back to her coun­try. Cred­it­ing her up­bring­ing in T&T as giv­ing her the tools, ed­u­ca­tion and re­silience that she need­ed to suc­ceed in­ter­na­tion­al­ly, she says that “Trinidad has giv­en me every­thing, there’s noth­ing like the con­fi­dence and abil­i­ty of Tri­ni peo­ple.”

Dr Chelsea Gar­cia is a woman with a mis­sion. An un­stop­pable force, ex­tend­ing her­self and her ex­tra­or­di­nary abil­i­ties to any­one in need who cross­es her path. Liv­ing in her pur­pose, she is build­ing on the work of pi­o­neers to carve a space for Pal­lia­tive Med­i­cine in Trinidad, hop­ing that Pal­lia­tive care will be­come a point of first re­fer­ral for peo­ple with se­ri­ous ill­ness­es. She is an in­spi­ra­tion to work­ing moth­ers, busi­ness­women and health­care pro­fes­sion­als. At heart, she re­mains a true Tri­ni woman, and a pa­tri­ot, stand­ing firm and fo­cused on “mak­ing an im­pact and pos­i­tive con­tri­bu­tion to the com­mu­ni­ty and so­ci­ety that raised me.”

Fay­ola K J Fras­er is a pro­fes­sion­al in the in­ter­na­tion­al de­vel­op­ment are­na. She has a BA in In­ter­na­tion­al (Mid­dle East­ern) Stud­ies and an MSc in In­ter­na­tion­al Re­la­tions & Diplo­ma­cy from the Lon­don School of Eco­nom­ics.