The History of Sunnybrook Hospital: Battle to Greatness

By Francesca Grosso

Heritage Toronto Book Award — Shortlisted, Non-Fiction Book

The story of Sunnybrook is one of perseverance by many dogged pioneers, rebelling and innovating to keep the organization alive.

The story of Sunnybrook Health Sciences Centre is one of battle and rebellion in the pursuit of excellence. With the perseverance of many innovators, Sunnybrook endured many battles, forging new directions and becoming stronger and greater.

The History of Sunnybrook Hospital: Battle to Greatness brings to life this tumultuous history: as a veteran’s hospital, born of the passionate battles launched by angry citizens to build better hospitals for our Second World War veterans; as a community and teaching hospital, rebelling and innovating to stay alive; and, finally, as a full-fledged academic health sciences centre, struggling to maintain its identity and focus.

In The History of Sunnybrook Hospital, you will find the stories of pioneers, rebels, and leaders, and the pivotal events and innovations that have shaped Sunnybrook’s character and legacy.

• Language: English
• Publisher: Dundurn
• Release date: Nov 29, 2014
• ISBN: 9781459729940

Francesca Grosso

Francesca Grosso is principal at Grosso McCarthy, a health care strategy firm. On the board of Patients Canada, she has also helped establish a number of other health-focused organizations. A co-author of Navigating Canada’s Health Care: A User Guide to the Canadian Health Care System, Francesca lives in Toronto.

Book preview

To honour the dead and to care for the sick and the injured, Sunnybrook Hospital stands as a living memorial to the men and women of the Armed Forces of Canada.

—Inscription on Sunnybrook Cenotaph

This book is dedicated to the Sunnybrook community: the patients, especially Canada’s war veterans in whose name the hospital was founded; the many families whose loved ones have been touched by care at Sunnybrook; the pioneers whose efforts have made Sunnybrook an internationally recognized patient care, teaching, and research hospital; and to all the staff and volunteers, past and present, whose daily work continues to honour the profound heritage that is Sunnybrook Health Sciences Centre.

Table of Contents

Preface

Foreword

Section 1

Chapter 1

Chapter 2

Chapter 3

Chapter 4

Chapter 5

Chapter 6

Chapter 7

Patient Story: Hugh McKeown

Patient Story: John Flegg

Notes

Image Section 1

Section 2

Chapter 8

Chapter 9

Chapter 10

Chapter 11

Chapter 12

Chapter 13

Patient Story: Alfred Joseph Casson

Patient Story: Kathy Cox (Sutton)

Notes

Image Section

Section 3

Chapter 14

Chapter 15

Chapter 16

Chapter 17

Chapter 18

Patient Story: Heather Oldford

Patient Story: Candace Allman

Notes

42ImageSection3

Hospital Leaders

Chairs of the Board of Directors

Members of Trustees 1960

Members of Trustees 1970

Members of Trustees 1980

Members of Trustees 1990

Board of Directors

Foundation Chairs

Sunnybrook Foundation Board of Directors

Department Chiefs

Acknowledgements

Bibliography

Preface

The story of Sunnybrook is a story of battle and rebellion in the pursuit of excellence. With each battle endured, Sunnybrook Hospital forged new directions, becoming stronger and greater, often exceeding goals and beating significant odds. The perseverance of many dogged innovators in the face of these challenges enabled Sunnybrook to morph into the dynamic academic health sciences centre it is today.

Presented in three sections, this book takes the reader through the three iterations of Sunnybrook’s development: a veteran’s hospital, born of World War II and of the passionate battles launched by angry citizens to build better hospitals for our returning veterans; a newly named community and teaching hospital, fighting for its very existence, rebelling and innovating to stay alive; finally, a full-fledged academic health sciences centre, struggling to maintain its identity and focus amidst government directed mergers and new diseases.

A great many figures have played a part in the story of what we now call Sunnybrook Health Sciences Centre. This book tells their stories — the stories of pioneers, rebels, and leaders — and the stories of the pivotal events and innovations that have shaped Sunnybrook’s character and legacy.

Foreword

My life changed irrevocably at 11:15 p.m. on September 23, 1983. I was finishing my first closing shift at the convenience store where I worked part-time when three individuals wearing ski masks burst in. Before any of them even spoke, one opened fire.

I was eighteen, previously healthy, and I had no reason to know that Sunnybrook Hospital was Canada’s pre-eminent trauma centre. But there I was in their emergency department in the early morning hours — some forty kilometres from the place where a .38 calibre bullet had torn through my spine from the right side of my neck, lodging in my left shoulder. The bone fragments from my shattered spine were pressing on my spinal cord, causing the most damage in the location where the breathing nerves transmit the messages that control the diaphragm. Although I was able to breathe on my own initially, I very soon required mechanical assistance.

After the shooting, I was first taken to the closest major health care institution, the Mississauga Hospital. However, it was quickly determined that they were not equipped to deal with an injury of the magnitude of mine, so I was transferred by ambulance to Sunnybrook. On call that night was the renowned neurosurgeon Dr. Charles Tator. Tator operated on me, delicately removing bone fragments from the cord and fusing my spine together with a piece of bone from my right hip. This would be one of multiple surgeries performed by Dr. Tator, a key participant in the trauma unit’s establishment.

Once operated on, I was moved to the Surgical Intensive Care Unit, where every patient was on a ventilator and hooked up to a myriad of other machines. This unit would be home for me for three long months. It was a crowded place, with teams of doctors, residents, students, and a host of other specially trained individuals (including pharmacists, clergy, and social workers) in abundance, all focused on many of the hospital’s most complicated cases. Despite all of the dedicated care provided by so many talented individuals, it is an indication of just how serious the injuries were of those in the unit that the fatality rate for patients was 25 percent.

As I remember, it also was a loud place, with every patient hooked up to multiple monitors and machines. Alarms rang regularly. Lights would be dimmed later in the evening and staff would make an effort to quiet the atmosphere, but there was no blocking the continual activity, with portable X-ray machines being whisked alongside beds, daily visits by physiotherapists to keep chests clear of infection, and blood work and other tests being performed at regular intervals.

Apart from the hospital crews, family members were obvious regulars, visiting patients in our less-than-private quarters. While each of us had curtains that provided a modicum of physical privacy, there was no hiding what was happening for anyone.

I came to appreciate how great the clinical expertise at Sunnybrook really is as time passed. In particular, the nurses stood out to me as one of the most outstanding groups. In the trauma unit, each patient was provided with a team of two dedicated nurses, who took turns caring for the patient, working in twelve-hour shifts. Each had extra critical-care training and was a highly skilled individual; many had years of experience in intensive care.

Because of my severe paralysis, my entire body required constant care, including bowel, bladder, and skin care. Prevention of complications, like pneumonia, was of paramount importance. Cases like mine require a real a team effort. Fortunately, I was in good hands.

It was a team approach, always, says Annette McCallum, one of my favourite nurses at the time, now a radiologist, and still a friend. There was always help and supervision around, she told me later. The ability to have one nurse per patient was huge [benefit].

My roommates were survivors of trauma and others recovering from major surgery. There were children whose parents were trying to wake them from comas. There were people who had attempted suicide, only to survive as disfigured, disabled, or both. The turnover rate on this unit was high, and the only long-term patients were those with high spinal cord injuries like me.

One of the other patients with spinal cord injuries was a young man who occupied one of the isolation rooms. He was a teenager who had been hit by a police car while crossing a highway. His paralysis was even greater than mine; he had no chance of ever weaning himself off the respirator, and he lived in the unit for an extended period of time before eventually moving to a chronic care hospital. Life had changed forever for both of us. But, unlike me, my unit-mate sadly died as a young man.

Finally, as I began to stabilize, I was moved into the other isolation room. Basic care remained highly specialized and of paramount importance, but the nurses also administered a fair amount of TLC. That might mean talking long into a sleepless night, being a comforting presence while I sobbed uncontrollably, providing compassionate care. There was such kindness.

One afternoon, the plastic tube inserted in the hole in my neck, to which the respirator was attached, needed to be changed. I was terrified, convinced it was going to be a painful experience, affecting one of the few parts of my body where I could still feel. I had my nurse, the head nurse on duty, the anesthetist, Dr. Gil Faclier, who had cared for me through many of my operations with Dr. Tator, and another of the unit’s doctors surrounding my bed. I’m sure they spent at least twenty minutes waiting, giving me the time to gather the courage I needed, without showing any impatience. When the procedure turned out to be painless and easy, they didn’t make me feel foolish.

Sunnybrook is unique and innovative. However, it isn’t special just because of its clinical excellence. It is special because of all the emotional, spiritual, and physical supports that it provides, supports that must be part of a trauma unit precisely because the many people who enter its doors are in the process of undergoing a life-altering experience.

Thirty years after my unfortunately necessary, but serendipitous, meeting with Dr. Charles Tator, we remain good friends. Without his surgical skill and the expert care I received afterward, my breathing or phrenic nerves would never have returned to normal functioning. I am pleased to say I took my first breath on my own one month after the shooting. It took me another month to get my diaphragm back into shape and to wean myself off the respirator. I can’t imagine how different these thirty years would be had I been unable to breathe on my own.

I recently asked Tator if Sunnybrook saved my life. Unquestionably that was the case, he answered. Other hospitals were simply not equipped. I will be forever grateful to Sunnybrook for all the efforts of its staff and its leadership to develop a trauma unit that saved my life. It has become a model for other institutions across the country and beyond.

Barbara Turnbull

Life Reporter, Toronto Star

February 2014

SECTION ONE

Birth in Battle: 1942–1966

Chapter One

Marian Lorenz was only seven years old in 1944 when her mother received a telegram one morning at the breakfast table. Her dad, Frederick Harry Newman, had joined the Royal Canadian Navy in Esquimalt, British Columbia, early in the war. He was immediately sent to the Atlantic coast, where he participated in convoy duty for the duration of the war. The telegram was the impersonal communiqué of choice used to inform families of servicemen about everything from leave of duty to sickness to the solemn declaration that something had gone terribly wrong and they would not be returning home. Marian watched as her mother and grandparents opened with trembling hands the telegram that could have changed all of their lives forever. As the telegram was read, relief passed through the room. Harry was very much alive and well. The telegram’s purpose was to inform the family that he had been given a period of shore leave. Marian’s mother left immediately to meet her husband and share some time before he would be called back to war.

The families of forty-two thousand other soldiers were not so fortunate. As Jean-François Born recounts in his detailed memoir on the Westlake Brothers of Toronto (for whom Westlake Memorial Park is named), The Second World War had been characterized as The Good War, or the The Good Fight, or the last just war, but these characterizations trivialize the hardships it caused.[1] The story of the three Westlake boys was as tragic as it was iconic. While there were other families to lose three sons, this story captured profound loss and tragedy in a special way. The brothers had lost their parents in the 1930s and had grown to be very close as a result. George joined the North Nova Scotia Highlanders and was the first of the brothers to die in battle, on June 7, 1944, only one day after the Normandy D-Day landings. His two brothers, Albert and Tommy, both members of the Queen’s Own Rifles, did not know of his passing when, four days later, they were also killed by Col. Kurt Meyer’s Nazi Panzer Division. One hundred other Canadian soldiers died in the same Normandy wheat field. The brothers died in each others’ arms while manning the same submachine gun.

Although heavily involved in the war effort from its beginning in 1939, Canadians reacted with horror when, a few years later, a war that had started remotely began to come home to the country’s shores. There were sightings of German U-boats making their way into the Gulf of St. Lawrence — some sailing as far as Quebec City. It was also feared that Japanese soldiers would begin invading British Columbia, using the Aleutian Islands as a point from which to launch. As a result, families were evacuated from some cities along the West Coast. Marian, her mother, and her brother were among those evacuated from Vancouver Island to settle in Toronto with Marian’s maternal grandparents.

The horrors of war continued for nearly seven long years. Then, on Monday, May 7, 1945, after 2,076 days and fifty-five million deaths, World War II was finally over. The cost of war had been exorbitant. Canada had spent more than $16 billion on the war efforts, which included supplies and outfitting, raw materials, ammunition, medical care, and other war benefits required to maintain the casualties and their families. By 1945, the country faced a $2.7 billion deficit — about twenty-three times what it had been only five years earlier.

The human cost was equally high: Canada had enlisted more than half of its two million men between the ages of eighteen and forty-five and about fifty thousand of its women — forty-two thousand never returned and another fifty-four thousand were wounded or injured. For many of those servicemen who were lucky enough to have survived the war, the pain and suffering caused by their wounds would carry on for decades after the guns had ceased to fire.

In addition to those who returned home with broken bodies and fractured minds, there were also those who came back with special physical horrors, in the form of severe disfigurements caused by burning bombers and German land mines. Casualties of these types of attacks, mostly airmen, would find hope in the treatments available at the Queen Victoria burn hospital in Surrey, England. These patients, who described themselves as fried and mashed airmen, were absolutely hideous to behold. Some had had their faces blown off; others had burns that had consumed their noses and eyes. Most of Canada’s disfigured casualties did not want to return home until everything the Surrey burn hospital could accomplish had been exhausted. For these airmen, the prospect of returning home to the stares or screams of loved ones was just too much to bear.[2]

Subjected to the most experimental of techniques to remedy their horrific disfigurements, these men called themselves the Guinea Pig Club. Sir Archibald McIndoe, along with his Canadian assistant, Wing Commander Ross Tilley, began treating these burns and disfigurements at the Queen Victoria Hospital using innovative techniques.

Dr. Tilley, a doctor’s son, was from Bowmanville, Ontario. One of very few plastic surgeons in Canada, he joined the Forces in 1939. In England, at the Queen Victoria Hospital, Tilley worked on all parts of the burned body, but he specialized in restoring badly burned hands that were so mangled that they would have been amputated anywhere else. Restorative measures for burn victims involved not one but many iterative surgeries that would slowly reconstruct, little by little, the nose, or the skin of the hands. As the war dragged on, with more air bombing-runs, the number of burn victims increased. The number of Canadian burn victims also increased and Tilley helped plan a wing of the hospital to deal specifically with Canadians.

Dr. Tilley returned to Canada in 1945, bringing with him these pioneering techniques to the veterans’ Christie Street Hospital in Toronto. He was also among the first group of doctors to work in the newly created Sunnybrook Hospital. There he continued to care for and operate on his Guinea Pigs. For his outstanding leadership, Dr. Tilley received both the Order of the British Empire and, in 1982, the Order of Canada. As fate would have it, the well-known Tilley Burn Unit that he established later at the Wellesley Hospital moved to Sunnybrook in 1998, as the result of a series of hospital mergers in Ontario.

Today, the Ross Tilley Burn Centre is the largest in Canada and complements the world-renowned trauma unit at Sunnybrook Health Sciences Centre. It is located, as journalist Tanya Talaga described in a moving piece on burn victims, at the end of an abandoned hallway on the seventh floor.

During a typical year, the centre treats approximately 135 patients. Nearly three-quarters of burn victims are men; the average age of a patient is forty-three. Each patient has a story about how they ended up at the Tilley, but, statistically, 56 percent of patients are burned by fire, 21.5 percent by scalds, 11.5 percent suffer electrical burns. Only about 2 percent are contact burns caused by lightning, friction or hot tar. [3]

One need only visit the Ross Tilley Burn Centre to feel the spirit of Ross Tilley and the painstaking mastery of his work. A portrait of Tilley hangs in the foyer of the Centre, just beside the doors that lead to the fourteen-bed unit where some of Canada’s most severely burned patients lie isolated in separate rooms. These burn victims are among the most difficult medical casualties, and require multiple treatments and surgeries. Their injuries are often life-threatening and those entering a burn unit know that they will never be the same again.

In order to deal with the casualties of World War I, Prime Minister Robert Borden created a special Military Hospital Commission tasked with setting up military hospitals in Canada. The commission set about buying up all types of buildings to repurpose them as hospitals. These were quick builds, in which quantity not quality was the main focus.

The old National Cash Register Company factory on Christie Street near Dupont Avenue was purchased and quickly converted into a military hospital. Many historians report that site was absolutely unsuitable for a health-care facility under any circumstances. The factory was often filled with coal smoke from the railway engines using the busy CPR tracks that ran next to the building. The trains also caused it to shake terribly with each coming train. It lacked the functionality of a hospital because it wasn’t built to be one. But, World War I had produced many more casualties than had been projected and the need for hospital beds was immense.

The capacity of the Christie Street building was also limited and could not handle large volumes of patients. The conversion from factory to healing facility took much more time than expected and it was not ready until after the World War I had ended. Finally, in 1919 the makeshift facility was completed and named the Toronto Dominion Military Orthopedic Hospital — a name that would change in 1936 to the Christie Street Hospital. While physical conditions were never good, the staff at Christie Street included a number of prominent medical leaders. Dr. Tilley for one would return here for a brief time to operate on his Guinea Pigs.

Only a few decades later, World War II broke out, forcing the Canadian government to increase the number of veterans’ hospitals from about eight in 1939 to over thirty by 1946, in order to accommodate more than seventeen thousand additional casualties. The problems began during the latter part of 1942, when as a consequence of heavy fighting in Europe, wounded veterans began pouring into Canada at an exceptional pace. By 1942, Christie Street Hospital had become completely outdated and overcrowded. The air quality was horrible and the roof leaked. Interviews of World War II veterans provide good accounts of the conditions:

They fed us, they changed the bed, they gave us enemas. That was about our life … listening to our radios, that was our life. There was nothing else.… We had the old wooden (wheelchairs), which you couldn’t fold up. There was only one.

— Jack Higman, paraplegic, World War II[4]

It [Christie Street] was a factory. There were twenty-five of us on the ward.… I was there from January to April 1943.… I was in there with a bunch of old WWI guys who had been there since 1918. It was pretty awful! … I was on my way into this operation and [an official] wanted me to sign my discharge. I said, To hell with you! My feeling was that you have to fix me up before you bounce me out. That is what they were doing in that early stage.

— John Gartshore, wounded in Dieppe[5]

Physicians working at Christie Street were no more enthusiastic about its conditions than their patients. One physician, Dr. Herbert Bruce, who was also an MP, complained before the House of Commons that the trains were so loud he couldn’t hear his patients’ heartbeats.[6] Fred Woodcock, who lost his sight during the Dieppe raid in 1942 and had spent more than a year as a prisoner of war in Germany, recalled his experiences at Christie Street Hospital:

Christie Street is where I was operated on the first time.… I remember lying on the top floor … they were going to put a new roof on, and there was just open boards up there and the dirt falling on us.… That’s when the ladies in Toronto got up in arms and they built Sunnybrook.… They were disgusted at the set-up we had.[7]

The ladies to whom Woodcock referred were a citizen’s group called the Toronto Women’s Committee. They lobbied hard for the creation of a new veterans’ hospital for the Toronto district. The membership included some of Toronto’s most important women, not the least of whom was Lady Eaton.

Highly prominent and public-spirited, Lady Eaton was a woman who got things done. She was a veritable force to be reckoned with when she set her compass on a worthy cause, and she was heavily involved in local charities. The wife of Sir John Craig Eaton, president of Eaton’s Department Store, she was an active member of its board and had overseen the launch of the stores’ restaurants. As far as most Canadians were concerned, she (and most other members of the Eaton family) could do no wrong. Throughout these years, the Eaton brand of department stores was very strong. As its signature promise, its products were guaranteed or your money back.

Lady Eaton’s husband, John, had been knighted for having outfitted an entire machine gun battery in World War I on his own dime — a government responsibility that it most likely could not afford. The Eatons also donated a wing to the Toronto General Hospital, called the Eaton Wing, and in 1919, the Sir John and Lady Eaton professorship in medicine was created and held by the University of Toronto’s chair of the Faculty of Medicine. These were the good deeds that the Eatons were known for and which made them model citizens.

As most other citizens, Lady Eaton had been gripped with wartime news stories and had a strong sense of patriotic duty to join the war efforts in any way she could. Eaton herself had been a nurse and had allowed her summer residence in King City, Eaton Hall, to be used as a military hospital for Canadian soldiers during the war. Replacing the old Christie Street Hospital became her campaign and she was joined by other prominent women, including Dr. Minerva Reid, Judge Margaret Hyndman, and Mrs. Constance. They marched and petitioned in support of a new Toronto military hospital for wounded veterans. Dr. Reid stood outside of Pantages Theatre demanding signatures and even wrote an open letter to the prime minister demanding action on a new hospital for Toronto’s veterans: the building is old, cockroach-infested and rat-ridden, and sick and wounded men are suffering there needlessly.[8]

The campaign was not limited to these powerful women of purpose. The local newspapers and dailies wrote extensively about the abominable conditions of Christie Street and how inadequate it was in treating those who had risked their lives on foreign shores. The public noise grew with open letters to the editor from prominent citizens. The Department of Pensions and National Health (DPNH), responsible for building and running the veterans’ hospitals, was now being referred to as the Department of Pain and No Help.[9]

Now the department was being severely criticized by other ministries within its own government. Specifically, James Ralston, minister of national defence, publicly criticized his colleague, Minister Ian Mackenzie of the DPNH, over his policies for the sorry state at Canada’s veterans’ hospitals and for the delays in bringing new ones into existence quickly.

These criticisms, however valid, were at least partially fuelled by a turf war that had broken out between the two ministries. While the DPNH ran the veterans’ hospitals, the Department of National Defence (DND) ran hospitals for active military members. Neither accepted encroachment from the other ministry, and senior bureaucrats from both ministries defended their turf at all costs.

It is reported that, at first, Ian Mackenzie took his department’s side and defended its stewardship of the veterans’ hospitals. That is, until it became apparent that staff was more interested in protecting its hospitals from encroachment by the competing DND than actually improving the medical services it provided to the veterans. Finally, Mackenzie became critical of his own staff. In a response to his own deputy minister, Dr. Robert Wodehouse, he wrote: The important question is — have we enough beds? It does not matter whether it is a Defence responsibility or DPNH but it is vital that enough beds are ready or in sight.[10]

Mackenzie agreed to meet with the ladies on his visit to Toronto in 1942. As Dr. Karl E. Hollis, Sunnybrook’s first superintendent, describes in his letters, the minister was not desirous of being with any great number of ladies (and therefore) intimated his willingness to receive a committee of three in his suite at the Royal York Hotel rather than at the city council chambers, which would have accommodated many more, as had been originally proposed. In anticipation of the meeting, the walls of the city council chambers had been decorated with many pictures of the deplorable conditions of the wards at the Christie Street Hospital. Hollis continues, by some superhuman feat on the part of the ladies, these pictures were transferred from the city chambers … and posted in the private suite of the minister. It was likely that by the time the meeting took place, Mackenzie was already somewhat inclined to support the building of Sunnybrook.

In 1942, Mackenzie, while still minister of DPNH, gave the nod for a new hospital in the Toronto district. As Toronto was a major urban centre, enlistments from the area had been high, and therefore the proportion of wounded returning to the area was also high. Mackenzie decided that building a major hospital in Toronto was the right thing to do. It wouldn’t hurt politically either.

In 1944, the federal government moved to create a number of initiatives aimed at re-establishing veterans back into civilian life. This movement was really an attempt to finally make veterans’ needs a priority of government. It included the establishment of a Veterans’ Charter and comprehensive legislation that set out services for veterans and benefits plans. The legislation also abolished the Department of Pensions and National Health. Two new departments were created — the Department of National Health and Welfare — eventually Health Canada — and the Department of Veterans’ Affairs (DVA). It was the DVA that now had responsibility for the creation and running of new veterans’ hospitals. Ian Mackenzie would become the first Minister of the DVA in 1944. Mackenzie’s associate deputy minister at DPNH was appointed Mackenzie’s deputy at DVA. He was a strong voice and an ardent supporter of veterans.

One would never consider just how many battles were fought to compel or, perhaps, shame the federal government into creating new veterans’ hospitals. Certainly, this would not be evident when reading the official literature issued by the Government of Canada on the day Sunnybrook was opened. The large-sized, pale-blue brochure offers to history a very different version of events, one in which Sunnybrook Hospital and other such hospitals are presented as the result of sound and far-sighted government thinking. This could not have been further from the truth. And so, as a result of the battle abroad and the effectiveness of the battle fought by Lady Eaton and so many others, Sunnybrook had been conceived.

Chapter Two

The road to building Sunnybrook Hospital was described by the Department of Veterans’ Affairs second minister, Milton Gregg, as one of blood sweat and tears. [11] Materials and labour were in short supply during the war years and there was no apparent suitable site in downtown Toronto for a modern hospital. Not wanting to repeat the same mistake as with Christie Street Hospital, Gregg explained that a modern hospital, calls for a structure that has beauty of design … and rural surroundings (that) can have a beneficial effect upon morale. [12]

Selecting a location was tricky. From a practical point of view, the expanse of a rural setting would allow for adequate space for the infrastructures of a state-of-the-art facility. At the same time, the Toronto hospital could not be too far from the downtown centre, or