Interview with: Dr. Milena Forte

Learn more about Dr. Forte & her debut anthology: Full Circle, A Collection of Family Medicine Birth Stories

Interview by: Megan Park

Dr. Milena Forte is a staff physician at the Mount Sinai Academic Family Health Team where she has practiced Family Medicine including full-scope maternity care for over 20 years. Dr. Forte has authored several articles, two book chapters and is the creator and lead editor of the recently published anthology entitled: Full Circle, A Collection of Family Medicine Birth Stories.

Q: Could you please share with the readers a little bit about yourself and who you are?

I am a first generation Canadian, born to Italian immigrants with a very strong sense of my Italian heritage (I am not sure if some of my passion for the arts comes from that). I have been a family doctor in Toronto for over 20 years at Mount Sinai, practicing full- scope family medicine, including maternity care. I have patients from newborn to geriatric patients, and I have always been passionate about women’s health in both my clinical practice and academic work. I’m happily married with two teens and two chickens!

Q: What was your inspiration to first mix maternity care into your family medicine practice?

From a young age, I knew I wanted to do something in the realm of women’s health. I was interested in women’s studies and thinking about empowerment from that perspective. I was also interested in pregnancy and birth. Despite having a full- scope practice, my passion has always been centered around women’s health, partly from my own experiences and partly from my undergraduate studies, where I studied sociology along with health sciences. Also, given the disproportionate representation of women in our healthcare system, naturally, any family practice has a lot of women’s health embedded in it. Pregnancy care in particular captivates me because of the medical, hands- on, relational, sociological, and psychological dimensions of it.

Q: How did you discover your interest and passion for writing and storytelling?

I have always loved various forms of art and communication, including visual arts, photography, and music. For writing, I engaged in fiction, short stories, and poetry before medical training. Through medical training, I was honing other skills so this was on the backburner. My professional writing has primarily centred around patient charting, scientific journals, and commentaries. However, my interest in narrative and storytelling led me to create this anthology, bridging my medical and personal experiences. They say write what you know, so this is something I have experienced both as a physician and a mom, over the past two decades.

Q: When did you begin publishing narratives and stories?

I wrote a short story about the first birth I participated in after giving birth myself—that was published back in 2008. Then I published a story, preceding Full Circle by a couple of years. The narrative, titled Dawn and Dusk, recounts a 24-hour day when I happened to deliver two patients—one at dawn and one at dusk—with quite different circumstances surrounding their births. It really struck me and I felt the need to write about it. I encouraged a student of mine to write about one of these stories from a different perspective—and that account appears in the book.

Q: How did the idea for “Full Circle” come about?

The inspiration for the book was to have a place where we could tell patient stories, but also to highlight the role of family doctors in these stories. Many people do not know that family doctors deliver babies, and we do it in a unique way because we are already embedded in the patients’ stories, from cradle to grave. The stories in the book came together very organically, painting a picture of not only the different aspects of birth, but also illustrating how family doctors are interwoven in patient stories and the impact that patients have on us.

Q: How did you gather family doctors from across Canada to share their stories with maternity care and birth?

Through a grant by the College of Family Physicians, we were able advertise it through their platforms and social media to all family doctors in Canada, coast-to-coast. We asked for stories, poems, photographs, but we received mostly poems and stories. We wanted to create the themes of the book based on the submissions, and we were really grateful that the stories naturally aligned to the chapter themes, showcasing different aspects of care.

Q: Why did you find it important that it was the family doctor sharing these stories?

The inspiration was multi-layered. Unless you live in a community where it is the norm that your family physician provides a lot of the low-risk obstetrical care, people are often surprised that in most places, babies are also delivered by family doctors. We aimed this toward a non-medical audience, so we wanted to share relatable stories showing that family doctors are involved in birth. We wanted to share the core values of what it means to be in family medicine, and a big part of that is continuity of care. There are stories of doctors that have delivered a baby, cared for that patient into adulthood, and are now delivering that “baby’s” baby. The opportunity for that to happen is really unique to family medicine; we wanted to give a voice to that.

Q: What do you hope that readers take away while reading these stories?

I hope readers can relate to the stories, find surprising elements, and gain an appreciation for the diversity of birth experiences. It was so fun for me to hear from a non-Canadian reader, who said it was really cool to see how birth is perceived in different cultures. I think we take it for granted the diverse communities that we live in; for instance, there are stories in the book about Jewish, Southeast Asian, and Indigenous communities. Additionally, I really hope it gives readers an appreciation of how much family doctors are invested in patient’s personal stories, and the impact that they have on us.

Q: Do you have a favourite story from the collection?

While I love all the stories, two favourites are Sitting in the Light by Kristina Powles and In Stillness, Thanks by Sarah Gower. Sitting in the Light provides the less-glamorous, graphic, and intimate descriptions of post- birth moments.

For the second piece, In Stillness, Thanks, I think I cried the first, second, and third time reading it, because it was such a poignant account of processing loss. These two are my favourites, but each story resonates with a unique aspect of care that I can personally relate to.

Q: Any plans for future publications?

I am always writing something these days, but for this book, my co-editor Nisha Arora and I are discussing a second edition of Full Circle to include more voices and diverse stories. I am also excited about a project led by Katie Lee, exploring narratives around first births from both the perspective of parents and medical students, and how this can be a transformative experience.

Q: To end off the interview, how does your creative passion help you become a better physician?

Ultimately, for me, what is at the core of medicine is relationships. The arts are also very much about relationships and how you communicate certain values; I do not see art and medicine as so separate! Everyone has stories within them, and interviewing and building relationships with patients is a form of art in itself.