Toronto has Tirone David’s dad to thank for enhancing the city’s reputation as a leading centre for cardiac care.
Dr. David, now one of the world’s top heart surgeons, longed to be a chemist when his was younger. But his father, who was footing the bills, insisted on a medical career.
“My father was a frustrated doctor who had to abandon his schooling during the Great Depression,” says David. “I hated medical school in first year. I fainted at the sight of blood.’
David, who eventually grew to love medicine, particularly the study of the heart, is now a world-renowned surgeon and an Officer of the Order of Canada. Colleagues from all corners of the earth flock to his operating room to watch him tackle extraordinary cases.
“If you want to expand your horizons, you have to take on cases that are unusual and that other doctors don’t do,” he says. “This gives you the opportunity to develop creative solutions.”
Born in Brazil, David was trained in the United States and Canada. He joined the faculty at the University of Toronto in 1978 after exploring a number of career paths, including working alongside missionaries in equatorial Africa.
The affable surgeon exemplifies Toronto’s reputation as a top international centre for cardiac care, but he is not the first or only physician to do so.
“There is a legacy of people who have left their mark in Toronto,” he says.
Probably the most famous of these is William Mustard at the Hospital for Sick Children, who in 1961 pioneered a surgical procedure to correct transposition of the great arteries of the heart, the defect associated with blue babies.
More recently, a research team led by Dr. Richard Weisel at Toronto Hospital has won international acclaim for developing a therapy for cardiovascular disease that would use a patient’s own transplanted heart cells to replace damaged heart tissue.
Weisel was just appointed vice-chairman of the American Heart Association’s Council of Cardiac, Thoracic and Vascular Surgeons and will become chairman of the organization in 2001.
Or there is the Hospital for Sick Children’s Dr. Marlene Rabinovitch, a leader in the diagnosis and treatment of pulmonary complications in kids with congenital heart defects. She is a recipient of a $2 million endowed chair from the Heart and Stroke Foundation of Ontario.
David says this concentration of excellence can not happen anywhere, but requires a setting that encourages creativity.
““Environment is indispensable. You must have an environment that supports you and encourages you to learn new things,” says David.
Toronto provides that atmosphere by taping into charitable organizations like the Heart and Stroke Foundation, the largest funder of non-commercial cardiovascular research in Ontario Private donors who support innovative cardiac research and applications also help to enhance the limited government funding available.
Meanwhile, the University of Toronto has been instrumental in working with the Toronto Hospital to train the next generation of top physicians and ensure that the best minds in cardiac research stay here.
The academic liaison has made the cardiac division at the Toronto Hospital one of the 10 ten in North America for academic productivity, measured by the number of scientific publications and peer-reviewed presentations produced by faculty.
The latest feather in Toronto’s cap is the $25 million Peter Munk Cardiac Centre at the Toronto Hospital, which opened its doors in May 1997. The new centre features six operating rooms and a large intensive care unit. Munk, chairman of Barrack Gold Corporation., spearheaded the fundraising campaign for the centre by contributing the initial $6 million required the renovate the 35-year-old Gerrard Wing of the hospital.
He and an anonymous donor have also agreed to sponsor a 3-year program at the centre that will test the effectiveness of mechanical hearts that can keep patients alive while they wait for a donor organ or for their own hearts to heal. The artificial hearts cost about $100,000 each and can be used only once, so the support of private donors is essential to the program.
But fundraising is the last thing on David’s mind as he cuts into the heart of 19-year old patient undergoing his second open-heart surgery.
David hopes he can save the patient’s valve, which has developed an aneurysm since the last operation six years ago. Although he no longer faints at the site of blood, a lingering discomfort with excessive quantities of the vital fluid is apparent as he makes a special effort to keep the incision site clean.
Unfortunately, the teenager’s valve is stretched and torn beyond repair. David opts instead to replace the natural valve with an artificial one. He expresses his distress at having to operate on someone so young.
On the closed-circuit TV perched in the corner of the operating room, it looks as though someone has pressed the fast forward button when David starts stitching the coronary arteries to the white, corrugated valve that resembles a cross between a toilet paper roll and a slinky toy. Within a matter of moments, David rips off his surgical gloves. The operation is complete.
If the artificial valve performs as expected, the patient will be middle-aged before he returns to the operating table. And as long as Toronto continues to strive for excellence in matters of the heart, a new generation of Dr. David’s will be ready to greet him there.