What’s Going On: February 2018

“The universe is made of stories, not of atoms.”
– Muriel Rukeyser, “The Speed of Darkness” (1968)

Welcome to winter! And it’s a real one this year….I noticed this on the screen of my car driving into work the other morning.

Yes, I know anyone in Winnipeg reading this will think we are a bunch of Toronto wimps and wussies… but it’s cold!!! At least we haven’t called in the army this year to dig us out. Oh, and if you think Wiarton Willie (or Punxsutawney Phil for our US readers) has any influence on the weather systems, I have some prime Florida real estate you should invest in. We just have to wait it out! (Okay, as I’m reviewing this it’s now 10 degrees but it was cold!!!)

Speaking of Groundhog Day, on February 2nd, 2018, this year we celebrated all that is good in the division with our 34th Annual Resident Research Day and had the remarkable honour of hosting Dr. Andrea Pusic, MD, MHS, FACS, FRCSC as our Hoyle Campbell Visiting Professor.

As a Canadian (we are very proud of that fact), Dr. Pusic is no stranger to the Toronto division as she has worked with several of our faculty members and has been an invited speaker at our Professor’s Rounds. Andrea is currently transitioning from her position at Memorial Sloan-Kettering Cancer Center in New York to assume the role of Chief of Plastic Surgery at the Brigham and Women’s Hospital, Harvard University in Boston and we were very grateful that she was so generous with her time and expertise.

The Hoyle Campbell Lecture was entitled “Patient-reported outcomes in Plastic Surgery: Guiding clinical care and assessment of quality, value and comparative effectiveness.” This is a great story and a remarkable example of a quantum shift in our specialty. Andrea has inspired a generation in her PRO work and set the bar at an exemplary level. All that and such a great role model, too!


Dr. Pusic with Tomas Saun and Kevin Zuo


Dr. Pusic is now an official member of Team Toronto!


The last word…

Thirty-four years is a long time to be doing anything these days. I do not think that any of the residents presenting this year were even born in 1985 when the Hoyle Campbell Visiting Professorship was initiated. As a lark, I looked back on popular culture at that time. Big hair and excessively large shoulder pads were all in fashion. Ronald Regan was starting his second term in the White House and people had stopped talking about having an actor as the leader of the free world (ha, if only they knew!). Whitney Houston had just released her first album and Live Aid was launched to help the world’s starving in Africa. The wreck of the Titanic had been discovered off the coast of Newfoundland and Back to the Future was about to make a star of Michael J. Fox. And what was even more interesting was seeing what was being published in PRS by the UofT division in 1985. Check it out below. The fascinating aspect is that every single one of these publications is relevant in 2018.

Fast forward to what our division residents published in 2017! Wow – pretty impressive contributions to the world of Plastic and Reconstructive Surgery.

This year’s event was well attended with over 100 faculty and community partners in the audience. The quality of this year’s research day rivaled that of any national or international meeting. Talks covered the gamut of basic science, epidemiology, clinical outcomes, patient-reported outcomes, education and health economics ranging in scope from morphometric analysis of the anatomy of the inferior rectus muscle in orbital floor trauma to future predictions of a shortage of burn care providers in Canada and aesthetic core competencies in residency training. Everyone aced it!

Congratulations to this year’s research award winners Dr. Joseph Catapano (Best Basic Science Award: Corneal neurotization prevents corneal ulceration and scarring in a rat model of neurotrophic keratopathy. Supervisor: Dr. Greg Borschel) and Dr. Natalia Ziolkowski (Best Clinical Paper Award: SCAR-Q: An Early Look at the Psychometric Performance Based on Data Collected in New Zealand. Supervisor: Dr. Joel Fish).


Thanks to Allergan – Medical, Canada for supporting the Best Basic Science Paper being presented to Dr. Joseph Catapano by George Saltzberg and Dr. Greg Borschel


Thanks to Mentor (Johnson and Johnson) for supporting the Best Clinical Paper being presented to Dr. Natalia Ziolkowski by Rommel Gajadhar and Dr. Greg Borschel

One of the regular highlights of the Annual Resident Research Day is to hear from the recipient of the Young Investigator Award which is a cash award given to a faculty member in their first 5 years of practice to help support their research efforts. The winner of this year’s award was Dr. Heather Baltzer (The Hand Unit, Toronto Western Hospital) who gave a superb lecture “Biomarkers and Big Data”.

This day would not be possible without the strong and sustained support of our industry partners and I would like to thank them for spending the day with us.

Thanks to Dr. Greg Borschel, Division Research Director for instilling a strong sense of enthusiasm and engagement in our remarkable group of resident presenters. And thanks to Kathy Pavlovic for coordinating and organizing the event. Oh, and a tip of the hat to Hoyle Campbell… his insights and vision in investing in our division have paid dividends and I am very grateful that he established the Tau Omicron Fund that supports this event. He was a visionary and we are fortunate to be able to benefit from his generosity.

Congratulations!

It has been a good week for Dr. Karen Wong Riff (The Hospital for Sick Children). Karen successfully defended her PhD thesis and is now one of 8 division staff at UofT who can call themselves Doctor Doctor (Howard Clarke, Karen Cross, Anne O’Neill, Melinda Musgrave, Stefan Hofer, Marc Jeschke, and Siba Haykal in case you were wondering). As many of you are aware, Patient Reported Outcomes (PRO) are an important metric that we can use to assess outcomes of treatment according to what is valuable to the patient. Working with Dr. Anne Klassen (McMaster University), Karen has developed the Cleft-Q as a PRO to measure the results of care for cleft patients. This is a significant achievement and is taking the world of cleft care by storm as one of the biggest advances in years. Her thesis is entitled “Cleft-Q: Development of a patient-reported outcome measure to provide clinically meaningful outcomes in patients with cleft lip and/or palate”. Karen’s initiative is being rolled out across the globe and has the momentum to make a significant impact on cleft care. Congratulations Karen!

Congratulations also to Dr. Greg Borschel (The Hospital for Sick Children) who was a recipient in the latest CIHR competition as co-PI with Dr. Doug Cheyne for a 5-year grant valued at $673,200 entitled “Non-invasive imaging of sensorimotor plasticity following cranial nerve repair”. The objective of this study is to determine the way the brain changes in response to operations for facial palsy, primarily relying on MEG / fMRI. This is a terrific achievement in this highly competitive grant climate.

And now… something good in the news for a change!


Check out Dr. Greg Borschel in the background in this story of Kaito and his journey through SickKids

https://www.thestar.com/news/gta/2017/12/26/miracle-on-university-avenue-thrives-six-years-later.html


Department Chair Dr. Jim Rutka is featured in this story of Nazar, a 9 year old boy from the Ukraine with severe orbital NF-1 who became a Herbie patient at SickKids, thanks to Jim’s global outreach efforts in the Ukraine.

http://toronto.citynews.ca/video/2017/12/28/herbie-fund-2017-part-4-nazar-motovylo/


Our own Dr. Siba Haykal (UHN) is featured as a notable alumna in this piece from the University of Ottawa in which she discusses the impact of a global outreach mission she took with Dr. Oleh Antonyshyn through Operation Rainbow Canada.

https://www.uottawa.ca/tabaret/en/content/reconstructing-bodies-rebuilding-lives

In case you missed this…

http://www.womenscollegehospital.ca/news-and-events/Connect-2017/Fashion-designer-David-Dixon-teams-up-with-WCH-surgeon-and-artist-Dr.-John-Semple

https://www.youtube.com/watch?v=RldiO8-8mK8

This was a terrific piece that celebrates an extraordinary collaboration between fashion designer David Dixon and Women’s College Hospital surgeon and artist Dr. John Semple to create an exquisite scarf paying tribute to the strength and courage of women facing cancer.

The great escape…

Each year there is a triumvirate of meetings (American Society of Reconstructive Microsurgery, American Society for Peripheral Nerve and the American Association for Surgery of the Hand) that are always held in a warm and sunny place and I keep intending to join, if for no other reason, than to escape the snow and ice. This past January, Phoenix was the destination and the UofT division was very well represented!


From left to right, Tomas Saun (Res), Kevin Zuo (Res), Mélissa Roy (Res), Herb von Schroeder (staff). Sandy Deo (former hand fellow), Greg Borschel (staff), Matthew Murphy (Hand fellow), Steve McCabe (staff, Chief of Hand Program)


Congratulations to PGY-3 Kalila Steen and her co-authors Victoria Hayward, Christine Novak, Dimitri Anastakis, and Steve McCabe! Kalila was the recipient of the Best Resident Paper at the AAHS meeting for her presentation “Long-term effects of radiation therapy for benign conditions of the hand”.

Congratulations also to Dr. Herb von Schroeder (The Hand Unit, TWH) who was inducted as a Board Committee member of the AAHS this year.

Just some of the presentations at the meeting…

K Zuo, HP von Schroeder, P Binhammer. Outcomes of combined tenolysis and proximal interphalangeal joint capsulotomy. AAHS January 10-13, 2018 Phoenix AZ (presentation)

M Roy, K Okrainec, C B Novak, H P von Schroeder, D R Urbach, S J McCabe. Health literacy in patients with Dupuytren’s: A cross-sectional study. AAHS January 10-13, 2018 Phoenix AZ (poster)

M Roy, K Okrainec, C B Novak, H P von Schroeder, D R Urbach, S J McCabe. Decisional conflict in patients with Dupuytren’s: A cross-sectional study. AAHS January 10-13, 2018 Phoenix AZ (poster)

CB Novak, L Mak, M Chang. Evaluation of written and video education tools following mallet finger injury. AAHS January 10-13, 2018 Phoenix AZ (poster)


Life is cooler with shades… Melissa Roy, Tomas Saun and Kevin Zuo tease a poor defenseless red pepper using the latest 3D microscope


Kathryn Isaac (TO alumna now in Winnipeg doing micro fellowship) with Kevin Zuo, Tomas Saun, Melissa Roy and Joseph Catapano


Congratulations to Tessa Gordon, ASPN President, who gave the presidential address this year at the ASPN.

And there was some down time as well…

SickKids fellows Nelson Low and Leahthan Domeshek exploring the Sonoran Desert environs around Phoenix

Hot off the press…

Check out this paper from Jamil, Frank and co-authors looking at an issue which is near and dear to all of us. Despite a low response rate of 26%, it was really insightful to see that 78% of us experience work-related musculoskeletal symptomatology. It was also interesting to see that female surgeons were at higher risk as were those surgeons with smaller hands (instrument mismatch) and also being Canadian and that we acclimatize ourselves to the work-place instead of the other way around. Those of you who are serious golfers wouldn’t dream of playing with off-the-shelf clubs. Custom-fitting is a necessary part of the game these days. Yet as surgeons, we are expected to do our best work under often uncomfortable and challenging ergonomic situations. Check out the full manuscript and sign up for the next Pilates class.

Out and about… (Ooot and aboot)

Jamil and his friends…


Drs. Sherrell Aston and Dan Baker with Jamil at the Cutting Edge symposium


Drs. Frank Lista and Jamil Ahmad attempt to get on the shoulders of a giant, Dr. Foad Nahai


Frank and Jamil in Huntington Beach


Jamil was at ASPS IM Chicago on a Rhinoplasty Performance Measures Work Group with Plastic Surgery, Facial Plastic Surgery and Oral Maxillofacial Plastic Surgery.


Drs. Dan Baker, Rod Rohrich and Jamil


Dr. Jamil Ahmad as Visiting Professor in New Haven CT at Yale University. This restaurant is in the famous Skull and Bones Club and hosts a remarkable alumni on its wall including Presidents George H. Bush and George W. Bush.

I was recently a Visiting Professor to UC San Diego which was a lovely albeit brief escape in the middle of January. I had the pleasure of doing some anatomic dissections with the residents in remarkable facility called “The Center for the Future of Surgery” – I loved the name! (as if there was any doubt about its future!).


Dr. Chris Forrest and the UCSD resident contingent


UCSD Chief Dr. Amanda Gosman just to the right of Dr. Chris Forrest


This is why the residents in San Diego walk around with a smile on their face… being close to the ocean is such a luxury

New arrivals!


Congratulations to former SickKids fellow Mr. Adel Fattah and his partner Melissa who welcomed Emerson Kate into the world at 9lbs 1oz on January 27th, 2018. Adel is a Consultant Plastic Surgeon at Alder Hey Children’s Hospital in Liverpool.


Adel on the right with former co-fellow Dr. David Keychoyan (Denver) at Zukerfest 2016 with Ron Zuker

And now, for something completely different…

TO’s very own Drake did something cool recently with his release of the latest song “God’s Plan” – the video starts off with a statement “The budget for this video was $996,631.90. We gave it all away. Don’t tell the label.”, and then Drake proceeds to give away almost a million dollars to people in Miami who are in need… Check it out… what a great guy… such a Canadian thing to do…

https://www.youtube.com/watch?v=xpVfcZ0ZcFM

“Three things in human life are important. The first is to be kind. The second is to be kind. And the third is to be kind.”
– Henry James

Ok, that’s it for now. As always, please send me your news or anything you think may be of interest.

All the best,

signature-chris

Christopher R. Forrest, MD, MSc, FRCSC, FACS
Chair, Division of Plastic and Reconstructive Surgery
Chief, Division of Plastic and Reconstructive Surgery
Medical Director, HSC Centre for Craniofacial Care and Research
Department of Surgery, Faculty of Medicine
University of Toronto