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Department of Surgery

Department of Surgery - Our history

Milestones from 1875 to Present


1875

Maggie, the first child admitted to The Hospital for Sick Children on April 3, 1875 would be considered, by today's standards, a surgical patient. She was barely 3-years old and a few days earlier had stumbled over a bucket of boiling water. She had been scalded terribly. The best medical attention available at that time consisted in large measure of good food, large doses of religious instruction and much love. If Maggie presented today, she would be reviewed by a full-time paediatric plastic surgeon, dedicated to burn care.

The Hospital's first annual report (July 1, 1876) indicated that 111 children had been treated, of which 44 were in-patients. Twenty-one of those children were "surgical". Many of the children who were admitted in the subsequent 25 years, required treatment for the ravages of infectious disease, particularly tuberculosis. They could present with spinal deformity, or "hip or knee-joint disease". Operations were undertaken, but it remains unclear in those early days just who was the operating surgeon. Subsequently, the identity of surgery began to take shape with the appointment of Dr. Clarence L. Starr as a Junior Surgeon in 1898. Tuberculosis of the bone was his specialty and as his experience expanded he was to become one of the world's leading orthopaedic surgeons and teachers.

1913

In 1913, a new development took place in the medical management of the Hospital. This was the appointment of a Physician-in-Chief and a Surgeon-in-Chief. Dr. Clarence Starr was the first Surgeon-in-Chief, and he with his second in command Dr. W. E. Gallie, completely reorganized the surgical staff of SickKids. They chose promising young men for appointments to the staff and encouraged them to do new and daring things. They developed an esprit de corps and a strong sense of team effort that was to become, and remain, a dominant characteristic of SickKids. Starr remained in his new position until 1921 when he was succeeded by Dr. Gallie.

1918

In the fall of 1918, Emily was admitted to SickKids with previously diagnosed diabetes mellitus. What neither she nor her mother knew was that Dr. Frederick G. Banting was working on a solution to Emily's problem and that he would become closely associated with her. A graduate of the University of Toronto, Banting had completed his service in the medical corps overseas, when in 1919 he joined SickKids as a surgical registrar. He came in contact with Drs. Starr and Gallie as well as Drs. Donald E. Robertson, Bruce Robertson and A.B. LeMesurier. Banting learned surgical techniques from them that were to serve him well in his work with animals, while he and Dr. Charles Best were searching for a cure for diabetes. In the fall of 1921, on Banting's thirtieth birthday, he and Best announced that they had discovered insulin. One of the first children to come to the newly established diabetic clinic at SickKids was Emily. Admitted in a precarious condition with acidosis, Emily was given insulin and immediately regained consciousness and demanded food. She subsequently was followed in the clinic with improved health and grew to a normal height.

1920s

By the late 1920s, Dr. Gallie, who had followed Starr as Surgeon-in-Chief, completed that position in 1929 when he then succeeded Starr as Professor of Surgery at the University of Toronto. In turn, Gallie was followed by Dr. D. E. “Eddie” Robertson as Surgeon-in-Chief, a position that he held until 1944. Along with Professor Alan Brown of the Department of Paediatrics, Robertson led the fight to keep SickKids as the best and most progressive on the continent. But, during his 15 years tenure and for a few years after, there were competing interests, such as the global recovery from the Great Depression. An adverse consequence of this at SickKids affected the planning and development of the new hospital. In addition, many surgeons were absent from the hospital in order to provide consultative and surgical treatments for troops involved in the Second World War. Regrettably, Robertson died in February 1944 just a few days before a key meeting of the hospital trustees, when they agreed to organize a capital campaign for purposes of construction of the new hospital on University Avenue.

Dr. A. B. LeMesurier succeeded Robertson as Surgeon-in-Chief. He was another one of the complete SickKids surgeons who had made a reputation as a surgeon of "great skill and delicacy" especially in cleft lip operations, as well as for his work in the treatment of spinal scoliosis. The move of patients from the old hospital building on College Street to two and a half blocks south to the new building, took place in February 1951. The first emergency operation in the new hospital building, on an infant with pyloric stenosis, was performed at noon on the day of the move, by Dr. Robert M. (Tim) Wansbrough. He had taken over from LeMesurier in 1950 as Surgeon-in-Chief.

1946

In the spring of 1946, Archie, a happy, healthy, blond headed 10-year old was delivering the morning newspapers in his small town near Toronto. While taking a shortcut, he was attacked by a dog who left Archie with multiple injuries to his scalp and face. The surgeon who performed staged reconstructive procedures on Archie over the next few years, was Dr. A.W. Farmer who, earlier, had left his post as Clinical Assistant in Surgery at SickKids to join the air force. When he returned to the hospital after the war, Farmer was certified as a surgeon in three disciplines – plastic, orthopaedic and general surgery. Farmer succeeded Wansbrough and brought not only his surgical skills to the new appointment but also managerial experience that he had acquired as a Medical Director at the Christie Street Veterans’ Hospital. Farmer applied the concept of military stratification to create divisions within the Department of Surgery. He selected the surgeons who were to lead those divisions – Dr. William Keith (neurosurgery), Dr. William K. Lindsay (plastic surgery), Dr. William T. Mustard (cardiovascular surgery), Dr. Robert B. Salter (orthopaedic surgery) and Dr. Stuart Thomson (general surgery). (The Division of Urology was formed later, following the arrival of Dr. Robert D. Jeffs).

The structure of six divisions within the Department of Surgery that Farmer created remains today. Such has fostered research and creative enterprise in the various surgical disciplines. Ground-breaking advances appeared for the operative correction of infants and children (known originally as the “blue babies”) with congenital heart disease, and for congenital hip dislocation, and progressive spinal scoliosis, craniofacial disorders and infants born with major brain and blood vessel malformations. The general surgeons operated upon their first set of conjoined twins in September 1966. The first kidney transplant at SickKids was carried out in January 1969. Many more have been accomplished successfully since, in addition to transplantation of other organs, such as liver, heart and lungs.

When Farmer completed his 10-year term in 1966, he was succeeded by Dr. Robert B. Salter who had established an international reputation as a paediatric orthopaedic surgeon and as a surgeon-scientist. By this time, the paediatric identity was weaving its way through the various subspecialties of surgery. Formerly, a “paediatric surgeon” was a general surgeon who, as we have seen, was very experienced and comfortable operating upon various organ systems in the child’s body. Now, the individual surgical disciplines were becoming sub-specialized, and full-time surgeons with extra training in their respective paediatric surgical specialty were joining the staffs of children’s hospitals.

1979

In February 1979, seven-month-old Herbie from Brooklyn, New York, arrived in Toronto. He was born with a rare birth defect that made it difficult for him to breathe while being fed. This consequence of his tracheomalacia resulted in his referral to Dr. Robert M. Filler, who had been recruited from Boston in 1976, to become the eighth Surgeon-in-Chief at SickKids. A paediatric general surgeon, Filler also led surgical teams that operated on additional sets of conjoined twins. After reading about Herbie’s successful treatment in local newspapers, a number of people generously donated money to cover his hospital costs. Subsequently, a major hospital foundation supporter created the Herbie Fund that sponsors children, up to 14-years-of-age from around the world, to come to SickKids for corrective surgery.

Dr. John H. Wedge became Surgeon-in-Chief in 1995. By that time he was also the Chair of the Department of Surgery at the University of Toronto, like his predecessors Drs. Starr and Gallie. By the year 2000, the character of surgery at SickKids had changed considerably. Contemporary practice involves complex, multi-discipline tertiary and quaternary patient care.

2005 to 2015

Dr. James G. Wright became Surgeon-in-Chief in 2005. In addition, Dr. Wright became Chief of Perioperative Services recognizing the value of coordination of services for children through the operative period. The department  continued and expanded the role of the surgeon-scientists who bring the discoveries from the “bench” to the child’s “bedside”, thus sustaining the surgical advances that have been associated with SickKids, since its inception. This was the era of increasing technology in the operating room with minimally invasive techniques and simulation to plan procedures, train the new generation, and enhance safety by working together as teams. SickKids is on the cusp of a new surgical era with the potential application of surgical robotics, enhanced use of imaging to carry out surgery and new modalities that may not even touch patients. 

2015 to Present

Dr. Christopher A. Caldarone was appointed interim Surgeon-in-Chief, Department of Surgery, effective January 1, 2015 and officially on January 22, 2015.

 

Robin P. Humphreys, MD, Former Head of Neurosurgery
Dr. Christopher A. Caldarone, MD, FRCSC
Surgeon-in-Chief, Department of Surgery

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