Reminiscing on residency: Dr. Evan Lewis has been thinking outside the box on treating pediatric epilepsy from the get go

To trace a common thread through Dr. Evan Lewis’ career would reveal a fondness for the controversial. In the early 2010s, Dr. Lewis was training in Miami. After completing his medical school and residency with the University of Ottawa, he took a fellowship in clinical neurophysiology at Miami Children’s Hospital, where he saw the trials being done on cannabis’ efficacy for treating pediatric epilepsy. “I bore witness to the fact that it works,” he says. In 2014, he returned to Canada to continue his education in epilepsy as a fellow at Toronto’s Hospital for Sick Children. From there, he continued building his career in paediatric epilepsy practice and research first at the Kids Neurology Centre Toronto and then back at Sick Kids where he worked as a clinical neurophysiologist and outpatient general neurologist, where he worked for over a year. It was while working as a neurologist, diagnosing, treating and helping patients manage acute concussions at the Early Care Concussion Clinic that Dr. Lewis decided to start his own practice. He founded the Neurology Centre of Toronto in 2016, where he served as medical director from 2016 to 2024, and which gave him the time to focus on his research into psychedelic-assisted therapy for neurologic disorders. It was at that clinic that Dr. Lewis built a ketamine-assisted therapy program. “I treated over 50 patients with ketamine from 2021 to 2024,” says Dr. Lewis, whose work has helped his patients’ symptoms ease.His work has included epilepsy, concussion and brain injury, functional neurological disorder (FND), and functional seizures. He’s worked with both medical cannabis and psychedelic and ketamine assisted therapy.“I tell people psychedelics are brain network medicine—they kind of dissolve those networks,” he told Dr. Lynn Marie Morski on the Psychedelic Medicine Podcast. “If the thinking is that the FND is due to dysfunctional connection or hyperconnectivity in certain networks, what we have to do is we have to repair those networks, but first we have to take them apart and build them back up.” Part of his confidence in working with controversial therapies might come from his experience in residency. “When I first got into medicine I was really flying by the seat of my pants,” he says. Coming from a family of non-doctors—his father completed a bachelor of education—Dr. Lewis didn’t have some of the familial insights into what medicine would be like before starting residency, but whatever guidance he could not get from home, he found at his residency program in Ottawa. “It was a very small program. I was the only resident in a three-year span, so I was able to really soak it in,” says Dr. Lewis, who was able to form strong bonds with the staff doctors throughout it.To this day, a highlight of his career is the first patient he treated with ketamine assisted therapy. “They were having two to three seizures a day, and we were able to get a sustained response from her for more than a year. It’s totally rewarding to see that it works. It reaffirmed that I get this stuff, and the gruelling hours I put in. If you work really hard at something you can get to a point where it pays off,” he says. 1. What is your number one tip for residents?By the time you get to residency, you’re thinking about the shape your career is going to take. Point the direction of your career towards something that brings you meaning. I found that what brought me meaning and made me feel fulfilled in the work that I do was often the stuff that I found challenging. Often in residency, we’re burnt out and it’s so easy to choose the path of no resistance, however time passes. At one point all of us got into medicine because we enjoy being challenged, and that’s where the passion is. In order to be a good doctor, you’re going to have to challenge yourself, to keep yourself interested to remain a good doctor. 2. What is the biggest thing that residency taught you about being a doctor? Residency is just the beginning. It really is just a foundation of experience, and you’re going to draw everything from that experience. Have compassion for yourself. There’s so much more after this. That perspective will help going forward. 3. What is something you've learned further down in your career?I’ve learned that I don’t know everything. There’s a culture throughout medical school that makes us feel like we know everything, it trains us to be the knower. Once you get into the field, you realize that diseases don’t present the way they do in textbooks. Practicing medicine is a very confusing place. In my early interactions, I didn’t know how to handle not knowing. I would become frustrated with a patient because they kept on asking questions. All of that was because I was afraid to be wrong. It’s better to know this, and approach your patients from a place of humility. You’re probably afraid that you just don’t know what you’re doing. If you’re thinking about opening up a clinic, don’t even think about it without taking at least a year of a business program. I started a tutoring company when I was younger and built that up, which gave me some of that practice, but I still didn’t know enough. Banks will often easily give physicians cash, which I think is pretty irresponsible, because a lot of us don’t have that business sense, it’s simply not what we’re taught. You should take some time to learn before jumping into a decision that will have such a big impact on your life.

Reminiscing on residency: Dr. Evan Lewis has been thinking outside the box on treating pediatric epilepsy from the get go

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