Hey, Residents!

Last month, we interviewed Dr. Julia Vander Heiden, who is a PGY2 in Family Medicine. We spoke with her about her rewarding experience in helping deliver a baby at Bella Bella. We had a great time chatting with Dr. Heiden, and we hope you enjoy reading about it just as much!

Thank you for this interview opportunity! Could you tell us a bit about yourself and your background?

I am a second-year Family Medicine resident with the Strathcona Program, currently living and training in beautiful Campbell River. I completed my medical degree through the UBC Southern Medical Program in Kelowna, and before medicine, I earned an MSc in Global Health at McMaster University as well as a BSc in Biology and Psychology from the University of Victoria.

Outside of medicine, I love spending time in nature and take full advantage of living on Vancouver Island through hiking, kayaking, and camping. I am also a fan of hot yoga, medical memoirs, and finding the perfect hazelnut latte. One of my more unique life experiences includes working as a bridal consultant – helping brides find their perfect wedding dress.

Professionally, I am particularly interested in women’s health, emergency medicine, and surgical assisting, and I am deeply drawn to the breadth and continuity that rural family medicine offers. Long term, my goals include practicing full-scope rural family medicine in a community I feel genuinely connected to, building a home office with enough bookshelves for my ever-growing collection, and eventually travelling to all seven continents. I am passionate about community-based, relationship-centred care and feel incredibly grateful to be training in a setting that aligns so closely with the kind of physician – and person – I hope to be.

We heard that you recently had a very stressful but rewarding experience in Bella Bella that was actually covered by CBC News. Could you tell us more about it?

During the Thanksgiving weekend, I worked a 24-hour emergency department shift that became one of the most formative experiences of my residency. Just prior to the start of my shift, I was informed that a medically complex 33+6 week pregnant patient known to me was en route with suspected rupture of membranes. She had missed her planned transfer out of the community and, given that Bella Bella does not perform local deliveries or have surgical capacity, this created a complex and high-stakes situation. Working with my preceptor, we confirmed rupture of membranes and quickly connected with the obstetrics virtual support line for guidance and transport coordination. When all transfer options were declined due to weather conditions and, later, risk of delivery during transfer, we had to prepare for a low-resource local delivery.

We used bedside ultrasound to identify a breech presentation and initiated care, organizing into “team mom” and “team baby” to review protocols with virtual pediatric support, even discussing difficult scenarios such as how to allocate resources should both mother and baby require resuscitation. As labour progressed, with no possibility of transport, we made a final request for OBGYN support, and thankfully, Dr. Don Wilson (originally from Heiltsuk territory) and his partner, an OBGYN and anesthesiologist pair, were able to be flown in by helicopter from the Comox Valley. They arrived after the patient had already begun to push, and after assessment, it was deemed that a cesarean section would be the safest option. We scoured the hospital looking for relevant equipment, surgical instruments, and medications, before turning the trauma bay into a makeshift operating room. We eventually proceeded with a cesarean section with me acting as scrub nurse. At 1:36 am, nearly 24h after rupture, the baby was delivered safely without the need for resuscitation.

We are so relieved that you were able to get the help you needed and that the baby was delivered safely! You said you see this as one of the most formative experiences of your residency. What are your biggest takeaways from it?

This experience was a powerful example of rural teamwork, adaptability, and creative problem-solving under pressure. It also highlighted the importance of clear communication, role flexibility, and mutual respect within an interprofessional team. As a resident, it was humbling to realize that I was one of the team members with the most recent obstetric and neonatal experience, and that my contributions mattered meaningfully to the outcome. The experience reinforced my commitment to collaborative, community-oriented care and the resourcefulness essential to rural family medicine.

Any final thoughts?

I was very grateful to have had this opportunity and that it led to a great outcome, but I am also keenly aware that we were fortunate in how things resolved. In rural communities, healthcare professionals tend to come and go, and it is often new faces- team members are not necessarily used to working together. We really came together to be creative and adaptive in this instance. However, even after the successful delivery, we had to monitor and provide care for both mom and baby without many of the resources that would have been available in an urban setting. The support that we received leading up to the delivery and transfer, both in-person and over the phone, was critical for the positive outcome. It is my hope that cases such as these inspire collaboration between medical colleagues, even when they are separated by a vast distance- every bit of support is incredibly appreciated and really makes a difference to those managing high acuity low frequency presentations in low resource settings.