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In his earlier days, Paul Winston was an accomplished dancer who performed with the National Ballet of Canada and Opera Atelier. He is now the medical director for rehabilitation medicine at Island Health in Victoria.

CHAD HIPOLITO/The Globe and Mail

Life After: This is part of a series of stories about personal transformation

It was the final, tragic scene of Romeo and Juliet and the on-stage chaos was emotionally charged. To the agonizing strains of Prokofiev, friends and colleagues were dancing to their stage deaths – but Paul Winston, as Benvolio, was alive and crying real tears. This was his last dance – his final performance for the National Ballet of Canada after a six-year career with the company and eight years at the National Ballet School before that. It was the end of his dance career – or so he thought. He was 24.

"It was just the most emotional way to leave the stage," he says, his voice breaking. "It was terrifying, absolutely terrifying."

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He was going to university – he knew that much. But he had already taken his first steps toward career number two – vocation number two, really. The catalyst was a cycling accident the previous year that had left him unable to move his arm weeks before what was to be a career high: a chance to perform at the Kennedy Center in Washington.

"That whole experience of literally having a body part taken away really just got me to feel very vulnerable and I started exploring that, reading a lot of books about neurology," he recalls. From author Oliver Sacks he learned how the brain stops believing that the injured body part can ever behave normally again – "and that really hit home for me." He could not see how his atrophied arm, which would not lift, would allow him to partner or move well again.

He would study sciences, go to medical school and ultimately become a physiatrist – a doctor who works on the physical, neurological and functional aspects of illness and injury.

The dancer-turned-doctor has not just been fortunate enough to successfully perform un grand jeté from one career he loved to another – but also to land, twice, on a dream job.

Paul Winston didn't begin dancing until he was 10, and showed promise. It was on the suggestion of his older cousin that he tried out for the National Ballet School. He was accepted: Although he had no experience, he was flexible and co-ordinated. He entered the school in Grade Five. He wanted to be a National Ballet dancer when he grew up.

"If you train at the National … that's your dream; there's nothing else. And when I was a kid growing up, it was that. That was your NHL and nothing else."

It came true. A month after he finished school, he was hired by the company. While he knew he wasn't on track to become principal ("I was not the most talented, but they said I was a hard worker and I was ready"), he was having the time of his life. A trip to Ottawa meant meeting the prime minister; there was travel around the world, a salary, applause.

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But five years in, he was cycling to rehearsal on stage at the Betty Oliphant Theatre in Toronto when his thin 10-speed wheels slipped in the streetcar track and he went over and dislocated his shoulder. "I didn't know what happened but I realized I could barely walk," he says. "I actually now know that I had complete atrophy in the deltoid muscle from axillary nerve damage because that's my field. But I couldn't move my arm after they relocated it."

He was told by an orthopedic surgeon that he would need to wear a sling for six weeks, followed by four months of rehab. But that Washington trip was only six weeks away.

"And this was such a dream," he says of the opportunity – a rare one during the 1990s recession. "But I couldn't make the arm move; it would not go, because the nerve damage was so bad. And I just spent the next six weeks [with my] arm in a sling, going to class trying to do everything. And then six weeks later I was at the Kennedy Center."

At the end of the performance, he and the other male dancers had to stand at the side of the stage with their arms over their heads for about 90 seconds – which he found excruciating. "I pushed through it," he says, recalling how his fellow dancers were silently encouraging him. "They were like, 'Come on, you can do it, you can do it.' I just saw my arm shaking and coming down. I had no strength just to hold my arm up, but I thought I'm just going to do it."

A few months later, after one of the best performances of his career, there was another key moment on his path to medicine – this time involving the real Oliphant, co-founder of the National Ballet School. Aware of his academic proclivities, she had often asked him: "Are you sure you want to dance? Don't you want to become a psychiatrist? … After you dance, what are you going to do?"

But on this particular night, Ms. Oliphant's remarks really cut through. "She said, 'Oh, the dance looks great; you look great. But how's your brain? Are you not bored yet?'" he recalls. "And I just felt a wave going over me … and I realized at that point, yes, I had been doing my dream for six years and I was really happy with it, but I could not see myself continuing to grow."

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He signed up for summer school, earned his Grade 13 credits (needed at the time in Ontario) along with prerequisites such as Grade 11 physics and chemistry. He applied to the University of Toronto, and got in. He had a plan for his life pivot.

"I started telling people very naively … I'll become a doctor," he says. "I literally did not know that this was so daunting."

An a-ha moment

As it turns out, Romeo and Juliet was not his last dance. He continued to perform, part-time, with Opera Atelier while studying for his bachelor of science at U of T – often prepping for exams backstage at the Royal Alex and Elgin theatres. "I can study or do anything in the loudest noise," he says. "I was in the backroom of the opera, Don Giovanni, studying chemistry. So I really learned to filter out noise quickly."

He was a committed student and the discipline he learned at the ballet had him wondering about fellow students who came to class unprepared – having not done the reading, for example.

"People wouldn't put up their hands, they wouldn't speak. The fact that they had no interest, I found that really [shocking] because I was trained to work hard all the time. I couldn't not work hard," he explains. "You are not going to give up the career of your dreams to be mediocre. You're not going to not put 100 per cent into it."

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He was getting help from the Dancer Transition Resource Centre – both financial (grants) and moral support. The DTRC connected him with dancers who had moved on to medicine and were able to give him advice and encouragement.

After three years of undergrad, he got into med school at the University of Western Ontario, where the workload was "soul destroying," he says. "You're exhausted all the time, you're always [feeling] self-doubt, questioning every mark. But that I was prepared for. That part was easy. The sheer brute force work is easy for me because of the dance background."

And he found med school to be a relief after the competitiveness and huge anonymous lecture halls of his undergrad. "It was a very alien experience to me, going from trying to [achieve] perfection with guidance [at ballet school] to having … no one to help you."

But at Western, in med school, he found himself among 100 people who all looked out for each other. "It was very much like being at the ballet school because it was a family there with the same purpose."

His dance background – and in particular his experience with his injury – would inform his choice of specialty. In his first year of med school, in a small group dealing with problem-based learning, he was exposed to a wide range of patients during a visit to a spinal cord hospital. This was his a-ha moment. He knew he wanted to work in rehabilitation, and physiatry, with its holistic and team-based approach, was the right specialty for him.

"We're really problem solvers," he says. "If orthopedic surgeons are carpenters, we're probably the cabinet makers."

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'Career of my dreams'

Our conversation is taking place over a sushi lunch in Vancouver. Dr. Winston has flown in for the day (to assess a patient) from Victoria, where he is medical director for rehabilitation medicine at Island Health (he's also clinical associate professor at the University of British Columbia). His patients include people who have undergone spinal cord or brain injuries, stroke, neurologic injuries and diseases, joint and sport injuries as well as amputations. Each patient is a puzzle he sets out to solve – often with assistance from his dance background.

Knowing as much as he does about movement, he uses visual clues to try to figure out why someone is not getting better. "I spend a lot of time squatting in front of the patient, watching them move … which I know is a different approach than a lot of my colleagues do; they listen more," he says. "I just watch a lot. I say, 'Do you know you do this when you walk? Do you know your pelvis is collapsing? Or why can't you move your neck that way?' … That's the gift that I have gotten from dance which I wouldn't have gotten elsewhere."

His background has also taught him that a patient gets to chronic pain for a reason. He applies that approach as he tries to figure out how to help patients in desperate situations – chronic pain that may be threatening their livelihoods, their marriages, their mental health. "That's where I go back to my ballet training and the medical school training, and say, 'Well, what are we gonna do?'"

Another thing he has learned from his dance background is to deal with problems one by one. "Because the worst teachers were the ones who tore a strip off you and made you cry because they wanted you to fix everything in one day. The good teachers would work on your arm for the week and then they would work on your leg. … The good teachers taught you how to break everything down into bite-sized chunks."

And there are some more peripheral things he learned from dance that have become staples of his practice.

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Dr. Winston remembers an advertisement from his dance years, back at the O'Keefe Centre (now the Sony Centre for the Performing Arts) that he thinks about often when trying to help frustrated patients in difficult circumstances. It was an ad for a piano manufacturer featuring an empty grand piano and text to the effect: "They always told me it would take 10 years to play the piano so I just never bothered. Unfortunately that was 10 years ago."

That ad stayed with him, and he uses it now with his patients. "What I try to tell people is: Time is going to pass. So if you're at home with a bad injury, why not work on everything you've always wanted to do?"

He also shares with his patients something he learned at the DTRC and what he calls the single best piece of advice he has ever received: Don't be a malcontent. "If you're feeling depressed, undervalued, get out. Go somewhere else."

He was able to change his life dramatically. They can, too.

He's 44 now – and some of his friends from ballet are just retiring from dance. He's still in touch with many of them. Dr. Winston cuts a rug only occasionally these days – at weddings and even more rarely at clubs. He exercises regularly: snowboards, runs, swims, rides his bike. He still travels a lot. This fall he plans to start a rehab clinic for dancers in Vancouver. He misses being on the stage, the live music, the physical freedom of that life. But he left at the right time and he believes medicine is the better profession for him. Still, his methods have been so influenced by the dancing that it's hard to imagine him as one without the other.

"The nicest thing is I [was able to leave dance] with no regrets," Dr. Winston says. "I followed my dream [and] I got the career of my dreams."

And he has performed an encore that has helped so many others dance – or walk or work or enjoy life – once again.

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