Can there be a more difficult diagnosis than the one for a child with cancer? It is something no one wants to hear and delivering one is no doubt one of the hardest things a doctor has to do. But Jack Hand always broke the news to patients and their families with kindness and compassion. More than that, he could do it in a manner that, at the end of the meeting, would have everyone laughing.
"We don't know how he did it," said colleague Anne Drover. Around the Janeway Children's Hospital it was known as "the Jack factor." He was so skilled at this that other doctors asked him to help them deliver such news.
If there was a secret to it, he would have shared it - he was generous. But there was no secret; it was just him.
Hand gave people hope. They knew he stood beside them, that they were a team. He would always follow through, with the good reports and the bad. He had an ability to deal with the sad stories and rejoice in the positive ones, never getting overwhelmed.
Hand could speak to anyone. He treated everyone equally and was respectful and patient with what they could take in at a particular time. That caring was what people felt. He just knew what to say. And he was witty. The kids found him funny because he was. They called him "Dr. Jack."
He would tell his patients that there was nothing more important than family. And he lived that balance. His wife, Tina (Brennan), and their three children were the centre of his universe. Even at his busiest - and for two years he was the only pediatric oncologist in Newfoundland and Labrador - he rarely missed a soccer game or a concert.
He granted the same consideration to the medical staff. At a barbecue or his twice-weekly hockey game he would have his pager and he answered every page, graciously. He never made a nurse or resident feel bad for contacting him. Everything was important. Nothing was too much trouble. He preached this and he lived it.
His medical skills and extraordinary rapport were a foundation of his approach as a physician and the direction of his career. He was vice-chair of hematology and oncology at Janeway when he died of a brain tumour on June 6 at the age of 46.
Jack Pierce Hand was born on Feb. 12, 1966, to John Hand, a salesman, and Kathleen (Lane). He was the third of two boys and two girls, and the family lived in Kilbride, Nfld., where a young Hand delivered the paper along Skanes Avenue.
Even as a high school student at Beaconsfield, Nfld., he wanted to be a doctor. It was his ambition, listed in the yearbook, although at the time he was thinking of a M*A*S*H-style "Hawkeye" figure.
But it was his residency in pediatric oncology and hematology that proved the true fit.
He loved children, and he wanted to work with them and care for them. Even as a resident he went above and beyond, visiting the homes of children who were sick, going to funerals. This was when he was working 36 hours at a stretch. But he knew he had found his calling, the place where he felt he could make the biggest impact.
He graduated from Memorial University medical school in 1990. After a residency and fellowship in B.C. he came to Janeway in 1997, and established himself in a challenging discipline.
Pediatric oncology is a rapidly changing field, with groundbreaking research all the time.
There have been leaps in improvement in statistics for survival. A generation ago, leukemia was a death sentence, but now there are much better outcomes.
"You have to stay current and up-to-date with new protocols, investigations and treatments," Drover said. "It takes intellect, it takes discipline to constantly keep up with the literature. It takes technical skills and ability."
Hand's work schedule included outpatient clinics, daily rounds, administering chemotherapy, and long-term follow-ups that could extend for 20 years. He was part of a cohesive oncology team that had weekly meetings to discuss new diagnoses and patients, relapses, and treatment.
Current clinical research was studied to determine if patients were eligible for drug trials. If so, Hand quickly got them enrolled.
He was part of national associations and represented Janeway at national meetings of Canada's 17 pediatric oncology centres. As an administrator he was a bit of an instigator of new policies and procedures, and he would press if he felt things were not moving as quickly as they should.
He also taught medical students, and his mentorship, given "Jack fashion," included the belief that there was always room for humour, especially in tough times, and there was always room for fun.
This attitude helped fuel his incredible work ethic. Hand was also a driving force behind a new Ronald McDonald house in St. John's. "When he was invited to the board, three years ago, his first question was, 'When will this house be opened?' " Gerry Beresford, board chairman, told CBC Radio.
His persistence and dedication were a constant, and Hand's loss will be keenly felt when the house opens this September.
"[Pediatric oncology] is a very special calling," Beresford said. "He had great compassion, and passion."
"I have never known a more selfless person," said Alan Doyle of Great Big Sea, who met Hand about 30 years ago when he helped organize sporting events for kids in Kilbride and up and down the Southern Shore. "He spent his days making sick kids better, and loved every minute of it."
Besides hockey - Hand was a fan of the Montreal Canadiens, proudly wearing his Habs jersey regularly - he loved golf, and played and coached softball.
In August, 2010, just two months after his mother died, Hand was diagnosed with brain-stem glioma. His first desire was to keep everything as normal as possible for his children, for as long as possible.
At the news of his death, Janeway went quiet.
His family received hundreds and hundreds of cards and condolences, which over and over again said Hand was attentive, giving, self-effacing, funny and kind. One read, "When we wanted to fight, he fought with us. When it was time to let go, he enabled us."
Above all he was known as a physician who stayed with his patients every step of the way.
Hand leaves his wife, Tina, whom he met when they were 19 studying at university. They married in 1995. He also leaves their children, Michael, Amy and Jessica.