Dean’s lunch, June 13, 2012, to honour the MD class of ‘4T4

Edward ShorterJason A Hannah Professor in the History

of Medicine, Faculty of Medicine

On May 5, 1944, the Class of 44 graduated in Medicine.

• Big event!• What was going on in the world on May 5,

1944?

The War in Europe!

How about in the world of medicine? What was happening in 1944?Almost all the Toronto medical faculty were in the armed forces. But there were some events of importance.

In 1944 Clarence Crafoord in Stockholm, one of the international pioneers of cardiac surgery, did the first repair of a coarctation – or stricture – of the aorta.

Four years later young Toronto surgeon Bill Mustard studied with Crafoord, learning the fine points of cardiac surgery.

This marked the beginning of by-pass surgeryIn 1949 Mustard and Lawrence Chute at HSC initiated by-pass surgery – in the world – performing the procedure on an animal model. This was a historic first for Toronto.

[here Bill Mustard with Bill Bigelow]

In 1944 Arthur LeMesurier became chief of surgery at HSC.LeMesurier made important contributions, including originating a technique for the repair of cleft lip – the LeMesurier technique – that initiated a new era in the treatment of cleft lip patients.

(Here he is as he graduated in Medicine in 1910.)

In 1944 Gordon Richards, the professor of radiology, became inaugural director of the OCTRF. Richards was a pioneer of radiotherapy.

The photo is interesting because, if you take a similar photo of our senior colleagues today, they don’t look like this. They’re wearing running shoes and shorts and swearing because they’ve burned their fingers on the barbeque.

There’s been a sea change since then.

The Class of 44 was on the cusp of that change.

The class of 44 stood on the cusp of three changes, or three “pivots.”Here is the old Medical Building, erected in 1903, where the Medical Sciences Building now stands.

The first pivot: the shift of Canadian medicine and science from the UK to the US.It is hard for us to imagine today to what extent Canadian public life was once under the influence of the United Kingdom – and Canadian medicine influenced by British. Ontario had been heavily settled by Scots, and the early days of the Faculty saw a profusion of young Scottish and English physicians who had studied in Edinburgh and London.

Many of our valued colleagues today are from the UK, but Toronto medicine is no longer, in any sense, “British.”

[Here is a 1904 caricature from the student yearbook, Torontonensis, of “the young medical graduate,” unmistakably in an English top hat, cane, and spats!]

A transitional figure: Jack Laidlaw of ‘44Trained on both sides of the Atlantic.

---PhD in biochemistry in 1950 in London

---postgraduate work in endocrinology at Harvard

Other famous members of the Class were entirely turned to US medicine.Barney Berris, later chief of medicine at the Mount Sinai Hospital, trained at Minnesota and never set foot in the UK.

But there weren’t so many later academics among the ‘44 graduates who trained entirely in the UK – unlike earlier.

The second pivot for the Class of 44 was the shift from teaching to research. In London and Edinburgh, the master-apprentice model of medical education prevailed, as opposed to the American model of training young physicians for a future in research. It is striking how the early professors of medicine in Toronto – Ray Farquharson and Keith JR (“Kager”) Wightman [here] -- held to this gentlemanly model of august and learned clinicians forming the minds of a small number of elite student- acolytes.

The bellwether of the US emphasis on research: HollenbergWhen Charles Hollenberg ascended the chair of medicine at Toronto in 1970, a new model of US-origin was put in place -- one that Hollenberg had learned at Tufts University near Boston and had already incorporated in the department of medicine at McGill: the purpose of a department of medicine was to inculcate the goal of achieving world-class research; the training of clinicians came decidedly second.

[Here Hollenberg and Edward A Sellers]

The third pivot: the acceleration of research in the hospital departmentsBefore the Second World War, the main Toronto research accomplishments had been in the basic-science departments: insulin and heparin in the Department of Physiology, the anesthetic gas cyclopropane in the Department of Pharmacology.

[Here is Velyien Henderson, founder of the Department of Pharmacology, who played a role in the cyclopropane story.

With the Class of ‘44 the hospital clinical departments begin to come on line as research departments.

. . . And some of the members of the Class are players. Bill Spaulding revives the Canadian Society of Internal Medicine.

And Henry JM (“Barney”) Barnett makes major contributions to neurology

. . . At a university hospital, which happened, however, to be at the University of Western Ontario – but the principle remains the same.

So the future belonged to the hospital departments as well as the departments in the Medical Science Building

Toronto’s eight great teaching hospitals became part of an Academic Health Sciences Center that was the motor of medical progress in many discoveries.

[Here Vera Peters, at the Princess Margaret Hospital, who discovered that Hogkins’ Disease was treatable with radiation therapy.]

So the Class of ‘44 had a ringside seat . . .

. . . At a time of great change, not just in medicine in Toronto but in medicine in Canada.

But, hey, other classes had front-row seats and they had distinguished members, too. We’d love to hear from some of these people!

[Here’s a photo of the Class of ‘46. Let’s have a poll . . . ]

Thank you for your attention.