A day in the life of Alberta's chief medical officer is not for the faint of heart.
Since the arrival of COVID-19, Deena Hinshaw has been rising at 5 a.m. to prepare for her hectic day, spending a few minutes with her two elementary-aged kids "if she can" before heading off to work around 7.
Then it's back-to-back meetings all day, receiving updates on the spread of the coronavirus and weighing new health measures to "flatten the curve" in the province.
If she has a few minutes to spare, she catches up on email while her team pulls together everything she needs for the daily 3:30 press briefing.
When she's done with the media, her "second shift" begins.
"That's when I actually sit down and do the policy work, reviewing the documents and guidelines, making sure that I am thinking through the implications of (health measures) we're about to propose," she said.
"I get home somewhere between eight and nine at night and sometimes see my kids before they go to bed.
"I often tell them, 'I couldn't do this without you guys being patient with me,' and when I do get to see them, they give me hugs."
While Hinshaw is leading the charge for Alberta Health, putting in at least one 12-hour day on weekends, she considers herself lucky to have support on the home front.
"My husband is working from home, so he has taken on household chores and the kids, and my mother, who lives with us part-time, has also been an amazing support through all of this."
Guiding Alberta through the COVID-19 pandemic is exhausting-there's no getting around that. But Hinshaw is also acutely aware of the significance of the moment. Although she could never have seen it coming, she spent years preparing for just this scenario.
"Like most people who go into medicine, it's with a hope to make a difference," she said.
Life as a celebrity
What the quiet and thoughtful public health expert never bargained for is the intense, daily media spotlight, along with the celebrity status that was never supposed to be part of the job.
Hinshaw has been widely commended for her calm and measured delivery in press briefings, her solid command of the pandemic response and genuine expressions of empathy for those suffering from the disease.
T-shirts and outfits she's worn have sold out, including the Point Grey Periodic Table dress she wore to her March 17 briefing. A caricature of her posted on Twitter by Edmonton artist Laurel Hawkswell went viral.
On April 17, the 30-foot long plesiosaur cast that hangs in the U of A's Centennial Centre for Interdisciplinary Science was christened "Dr. Deeno Hinshaw" after a contest to name the ancient marine animal.
"It's certainly not something that I expected to be dealing with," she said. "I'm just doing my job to the best of my ability, making sure I'm giving people the best information so they can make the best decisions.
"I'm grateful that what I have to offer is resonating with people, and I always tell my team they should feel part of any kudos given to me.
"But what's most important right now is the response to the virus. It's why I haven't been doing many of these interviews. My time is scarce and I need to focus it on where it makes the most difference."
She only agreed to speak with Folio because of her deep roots at the U of A, she said, where she earned three degrees and is a clinical professor in the Faculty of Medicine & Dentistry.
The early years
Hinshaw was raised in the central Alberta town of Sylvan Lake in a third-generation farming family that values a strong work ethic and connection to community, where people "act with integrity and do their part," she said.
"My upbringing was, in many ways, privileged. I had a good education, a really stable upbringing and relatively large extended family who helped me keep my feet on the ground.
"I'm mindful that not everyone comes from that same perspective-just because I have a particular view on something, it doesn't make it the only view. That's been a real touchstone for me as I've taken on this job-feeling the responsibility to care for all Albertans no matter what background they have, no matter where they come from."
She credits the U of A's Augustana Campus in Camrose-formerly Augustana College-with giving her a broad liberal arts education along with her major in chemistry and biology.
"It really was a fantastic experience, very formative," she said. "I had the opportunity to take courses in religion, drama, music and sports, and was on their cross-country ski team.
"I made great friends, mentors and teachers who really emphasized well-roundedness and being a whole person. I saw my education as a way of observing the larger population."
Augustana was also where she started thinking about ways to keep that larger population healthy.
"As a young person, I was interested in health care in general, and thinking about prevention, alternative medicines and wellness training … that's what I was always really passionate about."
Medical training, population perspective
She completed her bachelor of science degree in 1997, then entered the U of A's medical school, where she eventually opted for a residency in family and community medicine in the early 2000s, combined with a master of public health, which she completed in 2008.
"Deena showed a real maturity in sharing her expertise with patients that enabled good decision-making," said Mike Donoff, the family medicine professor who supervised her residency.
"Good decisions are especially important when questions present unclear evidence for their resolution."
Careful, thoughtful decision-making was already a "visible aspect" of Hinshaw's natural leadership ability, said Donoff, a quality she would apply to whole populations later in her career.
It was while training in medical school that Hinshaw discovered her true calling.
"I found there was this whole specialty dedicated to public health and prevention, and I've never looked back," she said.
"I just remember her as a very thoughtful, measured person," said professor emeritus and former dean of public health Lory Laing, who taught Hinshaw in both medical school and the School of Public Health.
"Deena always had a commitment to public health," she said. "She got the fact that you can make more of an impact on the health of people if you take a population perspective."
In her master's program, Hinshaw learned basic skills in biostatistics, epidemiology and determinants of health.
"With this work you're sort of mentally prepared to work quietly in the shadows, and that's OK, that's appealing," said Laing. "You do this for reasons other than fame and fortune.
"She was analytical, always very articulate, but also had that soft-spoken gentleness. What you see now is exactly what she was like as a student-she didn't change as she acquired more education or experience."
Soft spot for geriatric care
As part of her training, Hinshaw also took on a diploma in care of the elderly in 2009, choosing to spend her six-month residency at WestView Health Centre in Stony Plain-a prescient move given the impact of COVID-19 on seniors.
"She was always calm, collected and very quiet," said Jasneet Parmar, the geriatric-care specialist in the U of A's Department of Family Medicine who supervised Hinshaw during her residency.
"You never got the feeling it was about her. I was curious, because elderly care is not an area that is oversubscribed; it's not like you're going to get a lot of attention or money."
According to the Canadian Medical Association Journal, geriatric care is a rare choice for medical trainees, which has resulted in a shortage of medical care for the elderly, a major concern as the population ages.
"She told me it was a gap in her training, and that she'd like to somehow find a way to integrate it into her career," said Parmar. "There aren't many students who stand out like that, but she definitely did-enough so that I followed her career a bit. She had a genuine concern for her patients."
Hinshaw said working in geriatrics gave her a perspective other areas of medicine rarely do, one emphasizing relationships.
"I always really enjoyed that part of it-talking to them, to family members, sometimes friends and other care providers. Geriatric care is like a puzzle-you put together the different pieces to make that whole picture that will help you understand ways to provide better support and diagnoses," she said.
After completing her residency, she worked as a medical officer of health in the Central Zone of Alberta Health Services from January 2010 to July 2017, and as medical officer of health lead for public health surveillance and infrastructure with Alberta Health Services during the last three years.
Valued mentor
In addition to her government appointments, Hinshaw has been a clinical professor with the U of A's Division of Preventive Medicine since 2011, mentoring residents in the same program from which she graduated.
"She is well liked by everyone-friendly, courteous and reliable," said division chair Sebastian Straube. "We recognize that she already has arguably more than a full-time job, and we're pleased to have her as clinical faculty. I'm grateful for the contribution she makes."
Hinshaw relishes her role as teacher, she said, especially since it forces her to constantly re-evaluate assumptions.
"Residents and students ask challenging questions that give me an opportunity to reflect on my work and why I do things the way I do.
"It gives me a chance to step back a bit and spend time looking at an issue from different perspectives, taking it apart and then putting it back together in a way that makes sense to those listening.
"It is also important to me to be honest, to share things I've learned through making mistakes in my career so that hopefully I can help others avoid those same mistakes."
"Good leadership"
Transparency and honesty as Alberta's chief medical officer of health have been paramount to Hinshaw since she was appointed to the position in January 2019, she said.
It can be tough, especially when questions and criticism arise over issues such as whether the outbreak at the Cargill meat packing plant-resulting in more than 900 COVID-19 cases at last count-could have been headed off earlier.
"I think it is important to always stay open to feedback and to learn from every experience," she said. "I strive to make the best decisions and recommendations that I can with all the information available at the time of the decision, but sometimes information changes and decisions and approaches need to be re-evaluated.
"If I'm wrong about something or if I make a mistake, I apologize and seek to make amends, as I did just today (May 1) when it became clear that long-term care visitor restriction changes I announced earlier this week had not had enough consultation or notification."
Hinshaw admits the very public role unexpectedly thrust upon her since the WHO declared the outbreak a pandemic on March 12 has been trying-a considerable sacrifice for her family as well as herself.
"I tell my family often that just because I can't be with them physically doesn't mean that I don't care about them, and my job as a mom is just as important as my job as the chief medical officer."
For her former teachers and mentors, her quiet competence is hardly surprising. They may not have seen this pandemic coming, but they always knew she had what it takes to confront any public health emergency, and they watch her daily briefings with pride.
"In a crisis, we look for leadership," said Laing. "Deena is calm, articulate, caring, empathetic and honest with people about why choices were made-that's just really good leadership."
As for the warm public response and outpouring of support, complete with all manner of celebrity memorabilia?
"I think that's awesome," said Laing. "I'm gonna buy a T-shirt or two."