Doctors making a difference: Dr. Rachel Pearl

This story is part of William Osler Health System’s (Osler) Doctors Making a Difference campaign featuring Osler doctors who are going beyond to improve our community’s health.

Mani Kaur can’t say enough about Dr. Rachel Pearl, one of William Osler Health System’s (Osler) paediatric nephrologists who has, in many ways, been like an extended member of her family over the past seven years. The feeling is mutual.

The two women met for the first time in 2017, when Mani’s twin girls, Sharan and Sargun, were born prematurely at Osler’s Etobicoke General Hospital. The girls were immediately transferred to Brampton Civic Hospital’s Neonatal Intensive Care Unit (NICU) and shortly thereafter to The Hospital for Sick Children (SickKids), when it became clear that they required a more specialized level of care.

It was there that the girls were diagnosed with a rare genetic disorder involving the kidneys, Pseudohypoaldosteronism Type 1. They remained at SickKids for three months before being transferred back, close to home, to the NICU at Brampton Civic and into Dr. Pearl’s care.

“This condition causes the kidneys to hold onto too much potassium, and too much sodium is expelled through the urine, which means the girls are vulnerable to developing a serious condition called hyperkalemia, which can cause a life-threatening heart arrhythmia,” said Dr. Pearl. This disorder is a lifelong condition that requires the girls to receive extra sodium and bicarbonate supplements for management.

Both girls – now seven years of age – have a gastrostomy tube (G-tube) for delivering supplements directly to the stomach. They also take medicine to bind the potassium to the food. Although unrelated to their condition, the girls also both have mild asthma, acid reflux and hearing loss. Sargun is deaf and has a cochlear implant, while Sharan only has hearing in one ear. It’s a lot for any parent to manage, but Mani takes it all in her stride.

“She’s an amazing Mom,” said Dr. Pearl. “She keeps on going and keeps on smiling no matter what is thrown at her. She’s done such an incredible job raising her girls.”

Serving as both their nephrologist and paediatrician from the time they were born, Dr. Pearl sees the twins both in her Kidney Clinic at Peel Memorial Centre for Integrated Health and Wellness and in her office at Castlemore Pediatrics. While the visits were initially weekly when the girls were young babies, they were then every few weeks, and now – their appointments are approximately every three months.

“They have made amazing progress. When they initially came to the clinic, they used to be terrified and cry all the time, but now they’re happy to see me and talk to me. They’ve come a long way,” added Dr. Pearl.

The girls are now in grade two, and have recently enjoyed their first vacation out of the country as a family, not an easy feat considering the twins have endured multiple hospitalizations over the years. Mani credits Dr. Pearl with being her and her husband’s anchor, instilling the confidence they need as parents to help the girls thrive.

“She’s an amazing doctor and human being,” says Mani. “She’s so knowledgeable about their condition, and her words always give me strength when I need it most. She supports the girls to keep them healthy, and I always feel like we’re in good hands when we see her.”

Dr. Pearl’s Kidney Clinic at Osler is one of only a few dedicated kidney clinics for children outside of SickKids, a hospital where she also has privileges and where she is able to conduct tests like kidney biopsies or angiograms for her patients as needed.

“Being able to provide this level of care close to home means the world to families just like Mani’s, as it eliminates the need for parents to travel downtown with their children and spend up to a full day there.”

Dr. Pearl is proud of Osler’s multidisciplinary team, which consists of a dietitian, social worker, nurse practitioner, nurses, lab technicians and a supportive clinical services manager.

As the physician lead for Osler’s paediatric outpatient clinics, she’s also proud of the growing number of sub-specialty clinics Osler offers, including those for gastroenterology, rheumatology, chest and Sickle Cell – another fine example of delivering the services families need, close to home.

“Osler has excellent sub-specialists in paediatrics, so I’m particularly excited that we’ll be training medical residents and students in these fields once Toronto Metropolitan University’s new School of Medicine in Brampton opens – with Osler as its primary clinical partner,” said Dr. Pearl.

As someone who knew she wanted to be a paediatrician from the age of five, Dr. Pearl was drawn to the field of nephrology during her paediatric residency due to what she sees as a mix of art and medicine.

“There are the quantifiable numbers associated with nephrology that include things like ‘the protein is this, the sodium level is that, and the kidney function is this’, but there’s also an art to the way we manage patient conditions based on experience and intuition about the patient.”

Dr. Pearl, who has been at Osler since 2002, is so passionate about what she does that she never sees herself retiring.

“We’re providing children with care for both rare and common conditions. I often see people at the worst of times, when their child has just been diagnosed with something scary. My hope is that I can make them feel better by equipping them with accurate information, compassion and a plan based on my years of experience.”

For parents like Mani, there is no one like Dr. Pearl.

“I can’t imagine trusting anyone else with my girls’ care.”

Read about more Osler doctors making a difference.