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Dear Editor,The world is a curiously small place. Theresidents should be aware that manyyears into the future they might come todepend on each other.

Last year while inHonduras related tosome work that isbeing done by ourdistrict of Rotary In-ternational, I had a

chance encounter. While walking into theHospital Escuela in the capital city of Hon-duras, my Rotary host suddenly veered offto speak to a gentleman in a white coatwho was also on his way in. My hostshowed the Honduran doctor my card andthe two of us eyed each other for a fewmoments. The gentleman asked, "You'reTully Chambers aren't you?" It was CarlosMedina who had been a junior surgeryresident on 9-West when I had been thesame on 9-East. It had been thirty-threeyears since I had seen Carlos. He hadchanged, slightly. After completing a JARyear in surgery, he finished his training inObstetrics and Gynecology. Currently he isworking hard on Honduras problem of ma-ternal mortality. He teaches at Hospital Es-cuela and was the first minister of theenvironment in Honduras. While it was apleasure to meet him again, he was alsoable to get on a telephone and solve aproblem that had occurred with my meet-ing with the Minister of Health.

? Lettersto The Editor

As for myself, I am a surgeon with Merit-CareHealth System (www.meritcare.com)that is headquartered in Fargo, NorthDakota. My work focuses on surgical on-cology, trauma, gastro-intestinal andminimally invasive surgery. I am based inWahpeton, North Dakota, the headwatersof the Red River, some forty miles southof Fargo. Many days I give thanks for theexcellent, comprehensive, principlefounded training I received both atQueen's University and McGill.

Robert Tully Chambers, M.D.,Wahpeton, North Dakota

Dear Editor,Thank you for your note regarding thedonation to The Square Knot. I found theSquare Knot very interesting and it is cer-tainly nice to have information regardingthe Department of Surgery at McGill.

On a personal note, I am in private prac-tice with four other colon and rectal sur-geons. I practice only colon and rectalsurgery. I am involved in academicsurgery on several levels. I am an Asso-ciate Clinical Professor of Surgery at theUniversity of Connecticut. Additionally, Ihad the Fellowship Program in Colon andRectal Surgery at St. Francis Hospital andMedical Center. We are on our 15th col-orectal surgery fellow and our graduatesare dispersed throughout the UnitedStates and Canada.

I am also involved in teaching medicalstudents and teaching general surgery toour general surgery residents. I see Car-los Barba, MD, who is Head of the Inten-sive Care Unit at St. Francis Hospital, on aregular basis.

My family is well. My wife, Patricia, whotaught nursing at McGill, continues toteach here in Connecticut. I have a 13year old daughter. I have been renovat-ing a colonial house in Vermont and con-tinue to be active with skiing.

I hope that this note finds you well. I raninto Henry Shibata's nephew, David, re-cently at a conference in San Diego. Iasked him if he had any relatives in Mon-treal and he, of course, let me know thatHenry Shibata was his uncle.

David A. Cherry,M.D.,Bloomfield, Connecticut

Dear Editor,Recently, I saw Bill Wilson, M.D. at Or-thopaedic Hospital. I knew that he was inthe Los Angeles area and through him,learned that you were the editor of TheSquare Knot. Unfortunately, I was not

THE SQUARE""z~2

aware of this alumni publication evenwhen I was at RVHCentennial, where I hadlast met you. Looking through the Sum-mer 2001 issue, there are many personswho I vividly recall and were very kind tome during my medical school and surgicaltraining days. There are other names, es-pecially news of my teachers who havepassed on. I was also glad to see the or-thopaedists - Fassier and Hamdy, whojoined the Shriners from Ste. Justine, arevery active in the research programs.

Specifically, in the 2001 issue, I was veryglad to see McGill Chief Jonathan Meakins,David Lin and Tony Dobell honored withthe Order of Canada. David was especiallyfriendly and helpful to the interns and res-idents of RVH. Unfortunately, I have losttouch with him. Dr. Dobell had been my2ed year surgical mentor for an electiveperiod. I had hoped to see them bothwhen I was in Montreal, but they had leftthe Centennial reception before I got thereand did not come back for other activities.I am also glad to read about the achieve-ments of Henry Shibata, Dr.Cruessand toknow of the academic activities of PeterMcLean and my classmate, Alan Turnbull. Iwas very sad to learn of the deaths of Drs.Tabah, Cooper Stacey who taught us frac-tures in 2ed year medical school, Paul Ottonand John Gutelius and especially John Fish,who spent some time with us at Ranchoduring his postgraduate training.

I can only guess that residents - Chughtaiand Seely are the 2ed generation when theirfathers were RVHhousestaff in the early 60's.

I hope to come to Montreal for my 40thclass reunion. It is unbelievable that Ihave been in Southern California for 30years. Most of my current activities arein the area of my special interest - sur-gical treatment of neuromuscular disor-ders and the rest of my time is spent inadministration, teaching and traveling. Irecently wrote the history of our institu-tion as one of the leading ~

(please see Letters, pg. 20)

Cedars Breast Clinic

of the MUHC

THE SQUARE..z!:l

3

SOME REFLECTIONSAFTER THE TRAGICEVENTS OF SEPTEMBER 1fHAfter the terrorist catastrophes in New York and Washington,

in addition to the sorrow and grief, there are some worries

about the future. When contemplating what

lies ahead of us, there is a certain resolve to

press on and perhaps modify our behaviour.

What are the implications for us Surgeons? In

addition to the personal and social considerations, we must

address if and whether we should modify our academic and

clinical roles. It seems unfortunately likely that there

will be further such terrorist activities. Without being

accused of pessimism, we should certainly plan for

such. How do we do this? It seems timely for hospi-

tals to review their Standing Orders for Safety and

Mass Disasters (both internal and external). At the

MUHC, this involves a review of the emergency codes

as well as avalanche and the like. We must be able

to prepare for the phenomenon of Convergence when

many patients as well as firemen, police along with

health workers meet in the Emergency Departments.

A call usually goes out for blood donors which taxes

the emergency services as well as the blood banks.

emergency physicians as well as Surgeons had to do triage on

the scene "Ground Zero': There was a great need for facilities

to take care of burn patients. We will have to take crash

courses in the handling of patients with anthrax, smallpox and

those who have been intoxicated by nerve gases such as sarin.

Editorial

The most positive aspect of all these considerations is that, in

the past, when called upon, our hospital communities have

risen to the occasion in the most efficient manner. We have

had experiences in Montreal during Civil Disorders, when our

hospitals have been able to take care of great numbers of

casualties in a personal and professional manner.

Let us hope that we do not have to experience any of these.•

Both in Washington and New York, we are told that

"Hi there, I'm Chief Surgeon TomBerkowia. I'll be taking care of yourlittle op. Today,on scalpels isJennifer Webb. Looking after swabs is

Nurse Jimmy Peters. Vital signs are ... "

AFTER YEARS OF PLANNING,the new Cedars Breast Clinic

will become a reality in No-

vember 2001. The Cedars

Breast Center of the RoyalVic-

toria Hospital (RVH) and the Montreal General Hospital Breast

Clinic will physically be in one place at the RVH site of the

MUHC. This new clinic which is a referral center for the

Provinicial Quebec Screening Program will provide a"one stop"

care for the patient. A woman with breast pathology will see

a breast surgeon, have mammography, ultrasound and a

biopsy if indicated, all in the same place and on the same visit.

It will not only contain state-of-the-art technological equip-

ment, but also an up-to-date pathology laboratory for on-the-

spot diagnostic procedures. The clinic will be completely

computerized so that information can be available for clinical

and research purposes. Facilities for teaching purposes are be-

ing developed and the latest teaching equipment will be

housed within its confines. This new clinic will create a milieu

where a group of experts will be able to work together in the

same geographical area, providing better and faster services

to our patients. These experts will also work with our recently

developed breast cancer research and network group. Such in-

teraction between basic and clinical scientists will create a

center of excellence where research and teaching will become

easier, and will lead to new discoveries in the fight against

breast cancer.

The total cost for this new clinic with the equipment is esti-

mated to be 3 million dollars, all being supported through the

generosity of many individuals and organizations such as the

Cedars Cancer Institute, the RVH and the MGH Foundations.

As in almost all enterprises, this new clinic is a result of team

work. Many other individuals and organizations have con-

tributed, and although we cannot name them all, we recog-

nize that this new clinic would not have been possible

without them .•

Antoine Loutfi, M.D. - David Fleiszer,M.D.Co-Directors

Chairman's Message- By Jonathan L.Meakins, M.D., D.Se., F.R.C.S.C., F.A.C.S.

1:,past summer, my wife, Dr. Jacqueline McClaranand I spent three months in Oxford. She was attached to the

Nuffield Department of Medicineand was hosted by Professor JohnBell, and I was in the Nuffield De-partment of Surgery hosted by Pro-fessor Sir Peter Morris. Interestingly,we had anticipated that we would

be taking holidays either in England or on thecontinent, but found that the change of environ-ment was sufficiently stimulating and the worksufficiently rewarding that we ended up stayingpretty close to our home in Oxford and travellingvery little. The change from long hours in inter-minable meetings with not' as many resolutionsas one might wish and some apparently insolv-able problems were replaced by activities in thelibrary, long discussions around issues of evi-dence based surgical practice, the examinationprocess for Oxford medical students, principlessurrounding the development and introduction

of innovative techniques and procedures, and the discussionsaround the rules of evidence as they relate to surgical practicewas sufficiently rewarding. The time passed as if we were ina summer camp.

Thoughts on a

Mini-Sabbatical

Dr.Jonathan L. Meakins

We both took a course on the teaching of Evidence BasedMedicine - a week-long program which was highly interactiveand very useful. The transition from a professor and teacherto that of student was an interesting one. It took a little get-ting used to, but fitted in very well with the general ambianceof Oxford where extended discussion around innovative ideasis both welcome and possible.

The opportunity to observe and participate in the examina-tion process of final medical students was a fascinating expe-rience. The examination system incorporates a written essay,a written exam and an extended clinical oral. The organiza-tional structure of this process led to much discussion abouthow to adapt the Oxford view of examination with that uti-lized in the majority of other UK medical schools as well asmedical schools around the world. I was requested to write areport as an external observer of the processand that together

THE SQUARE""z~4

with the post-examination discussions and critique may welllead some evolution of the evaluation process of final yearmedical students.

A second report was requested by the hospital regarding pa-tient flow and the organization of clinical services which wasa useful exercise in which to participate and crystalizethoughts that have been developed here at McGill.

The major area of investigation was in the application of evi-dence based surgical practice principles to the methods bywhich we should evaluate new procedures and new tech-niques. The Center for Evidence-Based Medicine is very muchinvolved in this exercise as is the Institute for Health Servicesboth of which are participating in publication activities wheredifferent paradigms for evaluation of surgical procedures arebeing developed. The present construct for the rules of evi-dence do not apply well to many components of surgical prac-tice where randomized control trials are frequently notpossible. At any rate, this component of my time in Oxfordwas sufficiently productive that we never quite got around totaking a holiday. In addition, Dr.McClaran's involvement in dis-charge planning processes at the John Radcliff led to severalreports on her part presented both at the John Radcliff Hos-pital and to the Regional Board as well as upcoming papers.

All and all, it was an extremely productive time and useful forus to have had dinner together every evening and to partici-pate in the academic, intellectual and recreational life of an-other great university .•

. .·······

Progress in

the MUHC

New Hospital

On Septem ber 21 ",Health Minister RemiTrudel announced thecreation of the McGillUniversity Health Centre'sDevelopment Corporation

which will oversee the hospital's design and construction."What was once an idea became a project and now the pro-ject is beginning to materialize" said Mr. Trudel at a press con-ference at the hospital's site at the Glen Railway Yards. Thisnew MUHC Development Corporation will have 9 directorswho will be in charge of planning and completing the hospi-tal complex. It is now estimated that the cost will be around800 million dollars and officials hope that the hospital will bebuilt around 2006 .•

EOM

are registered in the sixty-one residency programs of varying

lengths within the McGill teaching hospitals; a little more than

half of them can be found on the MUHC sites.

"We educate the next generation of surgeons in

the principles of surgery as well as helping them

to acquire the operative skills required for the

21st century'; explains Dr. Liane Feldman, As-sistant Professor of Surgery, who supervises residents and fel-

lows on the G-surgery service at the MGH. "Residents are a

critical component of our mission at the MUHC

Ferri(continued from pg.l)

Residencies begin after medical school and are typically

(though they vary) between two years for Family Medicine

and, on average, five years for specialities (R1-R5). After cer-

tification examinations, some residents go on to do further

specialization, called a fellowship.

A resident's day is long - about 7 a.m. to 6 p.m. - and geared

toward their speciality, in Ferri's case,surgery. The focus is al-

ways on the patient. Throughout the day the resident con-

ducts examinations, discusses cases during clinical teaching

rounds, files necessary paperwork, supervises juniors or ob-

serves seniors, all with an eye to providing the best patient

care. In between, he or she will grab a manual, stuff photo-

copied journal articles into a lab coat or rush off for a quick

literature search on the computer to learn more about specific

conditions. Residents are closely supervised each step of the

way by senior doctors in each area.

The McGill approach is one that has residents learn through

doing. Dr. Anne-Marie Maclellan, Associate Dean, Post-

graduate Medical Education and Professional Affairs, McGill

University, explains. "We make an effort to expose our stu-

dents to a wide variety of medical approaches and expertise.

We emphasize bedside teaching, which requires residents to

apply their knowledge, think problems through critically, and

develop their confidence and decision-making skills':

Most residents take five years to rotate through all the differ-

ent areas, however, some, like Ferri, devote additional time to

research activities. "When all MUHC sites are together at the

Glen, it will be easier to co-ordinate my investigative work'; he

says,"since the laboratory is on the RVH site, but the clinical

research side occurs at the MGH. Now I actually have to taxi

blood samples from one place to another':

Although blackboard teaching only accounts for 20 per cent

of the learning, it is the piece that investigates the 'why' of ill-

ness, that marries the science to the art of medicine. State-

of-the-art amphitheatres as well as 'hands-on' facilities are

THE SQUARE..z~

5

planned for the Glen; surgical skills labs and virtual classrooms

complete with cutting edge audio-visual and computer aids

where students can practice their operating techniques are

examples. So are conference rooms and computer worksta-

tions which are expected to be near the library. The residents'

lounge and lockers will be upgraded and closer to patient ar-

eas. More computerization of lab info and patient charts will

also allow them to work more efficiently.

"Currently, didactic teaching sessions for General Surgery take

place each week, alternating between the Vic and the Gen-

eral'; comments Ferri. "The distance makes attendance that

much harder':

"When all the MUHC staff is under one roof at the Glen';

Maclellan adds, "it will centralize a critical mass of senior

doctors which is particularly important in the mentoring

process with residents. It will also make it easier for people

to consult, present cases and generally be more available to

one another, which in turn, will produce a more stimulating

environment':

Finally, the fact that this interaction will be taking place within

a brand new facility is seen as a hugely competitive feature

when vying for the best and brightest medical recruits and

absolutely necessary to retain residents like Ferri. "I came here

twelve years ago and I've been offered positions out of

province at each step of my training'; he sums up, "but this is

a terrific place to live and work and as long as the MUHCstays

on course with this project I plan to remain': •

Editor's Note: lorenzo Ferri, MD is about to finish six years

of medical residency at McGill.

Reprinted by kind permission of Sharon Bishin, M.A.

MUHC Communications

...........................................................

If doctors drew cartoons ...

TMUHC Trauma Program continues to evolve and

develop. We are pleased to announce the hiring of CathlynRobinson as Trauma Clinical Nurse Specialist at the M.G.H. in

June. Cathlyn comeswith extensive expe-rience via Edmontonand has already

made a tremendous contribution in this important role. Shejoins Caterina Staltari, Trauma Program Manager, as our sec-ond recruit to the program through nursing. We further con-vey our congratulations and very best wishes to both of theseoutstanding individuals on recent weddings!

Trauma Program News

...............................................................................................................................

Dr. Guy L. Clifton, Chief of Neurosurgery, Houston, Texas, hasbeen selected as 7th Annual H. Rocke Robertson Visiting Pro-

fessor on January 23-24, 2002. Dr.Clifton is internationally rec-ognized for major contributions to current understanding of headinjury and is presently spearheading a large multicentre clinicaltrial examining the merits of hypothermia in the managementof traumatic brain injury. Residents are encouraged to submitpresentations for the paper competition (deadline for submis-

sion December 21st). First prize will be $1,000 towards the costof a course or scientific conference and all participants will receivea one-year membership in the Trauma Association of Canada(TAC)with subscription to the Journal of Trauma.

Another invited speaker later this year will be Dr. Roger Saa-dia, formerly of South Africa and currently Head of the TraumaProgram at the University of Manitoba Health Sciences Centrein Winnipeg. Dr. Saadia will be the JC Dickison Memorial

Lecturer on December 6th when he will present at SurgicalGrand Rounds and deliver the keynote address at McGill's an-

TeleSurgery

in France

McGILL SURGICAL ALUMNUS,DR. MICHEL GAGNER OPERATES IN FRANCEUSING TELESURGERYOn September 7'h, working in front of a computer-ized control panel and a television screen at Man-

hattan's Mount Sinai Hospital, Dr. Michel Gagner, 41, a pioneer ofrobotic surgery and now Head of Laparoscopic Surgery along withhis French colleague, Dr.Jacques Marescaux performed a cholecys-tectomy. The procedure lasted around one hour as they manipu-lated robotic arms for this surgery on a woman at the Louis PasteurUniversite of Strasbourg. There were no complications and the pa-tient made a full recovery, and was discharged two days later.

THE SQUARE..z~6

nual "Practical Course in EmergencyMedicine'; December 6-7, 2001. Histopic will be Pitfalls in Trauma Care.

Congratulations to McGill surgeonswith recent trauma-related publica-tions: Dr. Karen Johnston (J Am ColiSurg, June 2002) and Dr. Talat Chugh-tai (J Trauma, June 2002). Kudos alsoto Dr. Jose Pascual for advancing intoa Ph.D. program in ExperimentalSurgery under Dr. N.V. Christou for

research evaluating the immunomodulatory impact of resus-citation fluids in hemorrhagic shock and sepsis. Further con-gratulations to surgical-scientist award recipient Dr. Kosar

Khwaja who will join this research group to complete Mas-ter's work evaluating the effect of volume therapy on immunemechanisms in a clinical trauma population. A warm welcomeis also extended to Dr. Changiz Cholipour, a trauma surgeonfrom Tabriz, Iran, who is completing a 9-month observershipwithin the Trauma Program and is currently completing workon performance evaluation during trauma resuscitation.

Dr. David Evans

Some things on the horizon: McGill surgeons have initiated theestablishment of the Canadian Trauma Trials Group

through TAC. This will be a unique multi-institutional collab-orative focused on the conduct of well-structured clinical tri-als in trauma across the country. The CTTG will hold itsinaugural meeting in Toronto in October.

Finally, congratulations and thanks to Dr. David Fleiszer whostepped down earlier this year as President of the Trauma Associ-ation of Canada. He is recognized for his dedication to this im-portant organization and we wish him well in future undertakings.He is succeeded by Dr.J. Kortbeek of Calgary,Alberta .•

The team also included computer software specialists as well asMr. Steve Butner, a computer engineering Professor at the Uni-versity of California at Santa Barbara.

In Strasbourg, a surgeon made the four initial incisions and in-troduced carbon dioxide into the abdomen. Subsequently, the re-mainder of the operation was done by telesurgery.

Dr. Michel Gagner graduated from the McGill Postgraduate Train-ing Program in General Surgery in 1987-1988, and subsequentlywent to start his career at the University of Montreal. Two yearsago, Michel was the first Steinberg-Bernstein Visiting Professor atMcGill in Minimally Invasive Surgery. •

EoM

·

········

··

······

By W.O.S.Thomas, M.O., FRCSC •CMPAPresident, 1996-2001 :

··..•..••......................................................................•

F.MTHE (MPA ON ITS 100"ANNIVERSARYSome types of cases were repeatedcauses of complaints and legal actions to

the distress of the As-sociation, for example:Troublesome

Cases • the misuseof,or fail-ure to use or read, X-rays as judges tended

to consider misuse as malpractice;• careless surgical incidents such as for-

eign objects left in patients, operatingon the wrong patient or the wrongbody part;

• varicose vein surgery where thefemoral artery was confused with thesaphenous vein, which happened soregularly the Association wasprompted to advise this should be con-sidered major surgery;

• transference and fantasies of psychi-atric patients;

• informed consent issuesfor plastic sur-

geons who were shown by the Courtsto have a higher duty than the aver-age surgeon to explain possible resultsto patients;

• equipment such as new apparatus forX-ray treatment for eczema and non-standard anesthetic machines, usingunfamiliar equipment as well as faultyreadouts from ECGmachines;

• loss of teeth during anesthetic;• acupuncture treatment;• tourniquets, elastic adhesive dressings,

broken surgical needles, anti-tetanicserum, intramuscular injections, trans-fusion reactions;

• paralysis following spinal anesthesia,pressure sores, falls from examinationor operating room tables, intravenousinjections and catheters;

• intravenous promazine hydrochloride,intravenous pyelography, barium ene-mas, angiograms, triamcinolene ace-tonide, improper committals, warmingblankets and failed sterilizationsurgery .•

"Now have this prescription filled and take as directed. Then two nights after the firstfull moon, procure the left hind leg of a he-frog and a root of Sf. John's-wort ... "

- The New Yorker

THE SQUARE,..z~7

Try ThisMENSA TestYou have to work out what the lettersmean. In item NO.1 for example, theanswer is "24 Hours in a Day':According to MENSA, if you get 23 ofthese, you are a "genius':Only 2 MENSA members achieved fullmarks. See how well you do.

1. 24 H in aD2. 26 L ofthe A3. 7DoftheW4. 7W of the W5. 125 ofthe Z6. 66 B ofthe B7. 52CinaP(WJs)8. 13 5 in the USF9. 18HonaGC10. 39 B ofthe 0 T11.5TonaF12. 90 D in a R A13. 3 B M (5 HT R)14. 32 is the Tin D Fat which W F15. 15PinaRT16. 3 W on aT17. 11 P in a F(S)T18. 12MinaY19. 13=UFS20. 8T on a 021. 29 D in F in a L Y22. 27 B in the NT23. 365 D in a Y24. 13 Lin a B D25. 52 W in a Y26. 9 L of a C27. 60 M in a H28. 23 Pof C in the H B29. 645 on a CB30. 1000 Y in a M31. 15MonaDMC

(Answers on page 75)

PLEASE HELP US TO FIND THESECANADIAN ALUMNI SURGEONSDr. Z. ArekatDr. R. Bend-JabalDr. RichardBerkowitzDr. Peter 1.CapelloDr.AlcideChapdelaine

DR.Wayne E.CollinsDr. E.D.CranshawDr. D. DefornoDr. C. MascottDr. Joyce TarbetDr.William WallaceWatson

.......................................................................: The Montreal Children's Hospital

~-News: By H. Bruce Williams, M.D.: Surgion-in-Chief····

...............................................................................................................................

DR. MIGUEL N. BURNIERDr. Burnier attended the 1st Forum of Ocular Health in Brazilfrom May 28-June 2,2001. At this meeting, he was presentedthe "Brazilian Council of Ophthalmology Medal" from theBrazilian Council of Ophthalmology.

DR. PAOLO (AMPISIOn behalf of his co-authors (Drs. R. Hamdy, D. Lauzier, M.Amako and M.L. Lessard), Dr.Campisi presented a paper onTheExpression of Bone Morphogenetic Proteins (BMPs) During

Distraction Osteogenesis of the Mandible at the 46th AnnualMeeting of the Plastic Surgery Research Council held in Mil-waukee, Wisconsin in June.

Dr.Campisi was awarded First Prize for the Best Research Pro-ject,2001 Award Program for Excellence in Resident Research,co-sponsored by the Canadian Society for Clinical Investigation(CSCI)and the Canadian Institutes of Health Research (CIHR),Montreal, Quebec.

Dr.Campisi was also awarded First Prize for the Best Basic Sci-ence Research, 2001 Poliquin-Xomed Resident Research Com-

Visiting Professors

Division of Pediatric Urology

DR. RICARDO GONZALEZ,Chief, Division of Pediatric Urology - University of Miami - Mi-ami, Florida., Chief, Division of Pediatric Urology - Universityof Miami - Miami, Florida, recently visited, lecturing at McGillUrology Grand Rounds on Management of Ectopic Ureteroce-

les. He also participated in a full day of surgical activities,which included demonstration of upper pole heminephrec-tomy, bilateral lower pole nephroureterectomies, and place-ment of artificial urinary sphincter. In addition, he had casereview and discussions with the McGill Urology Residents andpresented a talk to the Montreal Children's Hospital Nephrol-ogists on Evaluation & Management of Urinary Tract Prior to

Renal Transplantation.

THE SQUARE...z:5:8

petition at the Canadian Society of Otolaryngology in Vancou-ver, British Columbia.

DR. MARK MARTINDr.Martin has won the following prizes during his second yearof training in the Faculty of Dentistry:

The D.P.Mowry Prize for Highest Standing in Second Year

The Dr. I.K. Lowry Prize for Highest Overall Standing in theManagement of Diseases/Dysfunction of the Orofacial Com-plex Course

The K.1. Melville Prize for Highest Overall Standing in TheHealthy Patient Course

The D.W.Bushell Prize for Highest Overall Standing in the Dis-eases/Dysfunction of the Orofacial Complex Course

DR. TED TEWFIKDr. Tewfik was named to the Faculty Honour List for Educa-tional Excellence in recognition of his outstanding contribu-tions to teaching in the Faculty of Medicine .•

DR. JORGE DEMARIA,Director of Pediatric Urology, Hamilton Health Sciences Corp.-McMaster Site, Hamilton, Ontario visited our Division on June4th and 5th, 2001. Dr. DeMaria lectured on Management of

Non-palpable Testicle, as well as observed our facility and ex-changed ideas about patient care.

DR. HELlO BUSON,Chief of Pediatric Urology, Hospital de Base Do Distrito Federal- Brasilia - Brazil. During his Professorship in our Divisionfrom March 26th - 30th, 2001, Dr.Buson lectured at McGill Urol-ogy Grand Rounds on An Alternative for Bladder Augmenta-

tion, and in addition demonstrated surgical techniques forseromuscular bladder augmentation and hypospadias, as wellas a major reconstructive surgery case of incontinence forbladder exstrophy. •

NEWS FROMTHEDIVISIONOFPEDIATRICGENERAL SURGERYDr. L.T. Nguyen has been President of the Vietnamese Cana-dian Federation of Canada and President of the Montreal Viet-

namese Community for the past 5 years. Heis currently serving his third term as Presi-dent of these Organizations. Dr. Nguyentakes great pride in helping the Vietnamese

community. His mission and that of these Organizations isone and the same; "To help immigrants adjust to their newcommunity and environment, assist with their professionaldevelopment, develop and preserve the culture of origin, toensure that senior citizens within the Vietnamese communityare not forgotten and to look after the people in need':Dr.Nguyen has been the Editor-in-Chief of a bi-monthly trilin-gual (Vietnamese, French, and English) magazine QUCrC GIA(The National) for six years now. This magazine is distributednot only in Montreal and Canada but worldwide.

MCH News

On a different note, the staff, residents and secretaries of theDivision of General Surgery would like to extend their bestwishes for a speedy recovery to Dr.Nguyen's and Mrs. Nguyen'srelatives who suffered a grave accident. Our thoughts andprayers are with them.

Due to the tragic events of September 11th, the 33'd AnnualMeeting of the Canadian Association of Pediatric Surgeons(CAPS),scheduled for September 13-16,2001 (Winnipeg, Man-itoba) had to be cancelled. All air travel was halted; the deci-sion was an inevitable one. However, a resolve developed, thatCAPSwould quietly continue with its mission to "advance thecause of quality surgical care of infants and children through aprogram of continuing education of its members and otherhealth care providers': Power Point presentations and a digitalphoto of the presenter were sent via e-mail and the audio por-tions of the presentations were recorded through high qualityphone digital recordings. These three components weremerged through a highly sophisticated system and it wasagreed to broadcast the presentations over the CAPS web( www.caps.ca ) where a restricted CAPSaudience could choseto view the slides only or the complete talk. Through this un-dertaking, the CAPSmeeting would not be completely lost, andwould be available to CAPSmembers all over the world. A prioragreement had been reached with the Journal of PediatricSurgery to allow articles and pictures to be published and notconsider the web broadcast a copyright infringement.

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Several of our residents would have presented at the 33,d An-nual CAPSmeeting this year, but it would not be. Instead theytook part in the web broadcasting of their presentations. Itwould be a different type of presentation, but just as interest-ing and informative. Their research efforts and case studieswould still be published. Dr. Saundra Kay's abstract A GiantFetal Cervical Teratoma Managed by Prenatal CystAspiration andthe EXITProcedure was accepted. Authors: S, Kay, S. Khalife,

H. Flageole, S. Emil, E. Goujard, L. Cartier, L. Beaumier,

J-M. Laberge. Dr. Andreana Butter's abstract Fetal TrachealOcclusion to Treat Lung Hypoplasia Associated with CongenitalDiaphragmatic Hernia: Role of Exogenous Surfactant at Birth inthe Ovine Model was accepted. Authors: A. Butter,

H. Flageole, I. Bratu, L. Kovacs, D. Faucher, J-M. Laberge.

Dr. Moishe Liberman's abstract A lO-year Experience withPyriform Sinus Anomalies was accepted. Authors: M. Liber-man, S. Kay, S. Emil, H. Flageole, LT. Nguyen, J-M.

Laberge. Saundra, Andreana and Moishe all worked very hardto ensure that the web broadcasting of these abstracts wouldbe a successful one.

Congratulations to Dr. Andreana Butter who has success-fully completed her Master's.

Dr. Jean-Martin Laberge is President-elect of the Interna-tional Fetal Medicine and Surgery Society and will be hostingthe 2002 IFMSSmeeting at Manoir Richelieu, Charlevoix, Que-bec. Dr. Helene Flageole will be heading the IFMSS 2002Program Committee.

Dr. Laberge presented at the 2001 IFMSS Meeting in SouthAfrica - October 1st - 5th. Topics of his presentations, includedin the Scientific Session of the Meeting, were Fetal TrachealOcclusion to Treat Lung Hypoplasia Associated with Congeni-tal Diaphragmatic Hernia: A Role of Exogenous Surfactant atBirth in the Ovine Model and Percutaneous Needle Aspirationto Treat Large Simple Neonatal Ovarian Cysts: 15 It Safe? Later,at the Business Meeting, Dr. Laberge presented an expose topromote the next IFMSS Meeting, which will be held Sep-tember 1st - September 4th, 2002. •

..........................................................Creation of an MUHC Dept.

of Family Medicine

On the 25th of May, the MUHC Board approved the creation of aDepartment of Family Medicine. Dr. David Culver, Chairman ofthe Board, emphasized the importance of this department for thecontinuity of care to patients in the community and in improvingcommunication with our referring family physicians.•

EOM

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Welcome Dinnerfor New R-I's

Tfirst Annual General Su~ery R-l Welcome Din-

ner took place at Le Club Restaurant on September 13'h. In-

troductions of all chiefs and R-ls was conducted by the

Program Director, Dr. Sarkis Meterissian, who revealed fas-

cinating and unheard of information on the new recruits. In-

credible stories of the existential meaning of waitressing,

pottery making and liking trucks were some of the amazing

details revealed.

P.S.: Taken from McGill General Surgery website, thanks toDr. Jose Pascual and residents.

Drs.Barry Stein, Peter Metrakos, Mrs. Janice Hazarian, Drs. Lori Medeiros, Marvin Wexler, Marc Zerey

Drs.Lorenzo Ferri, Marvin Wexler and Roger Tabah

10

Drs. Denis Klassen, Melina Vassiliou, Liane Feldman, Gerry Fried,Jean Tchervenkov

~Drs. Harvey Sigman, Roger Tabah, Sender Liberman, Mohamed Nagi,

Nancy Morin, Sarah Hagarty

Drs. Nina Ordas, lona Bratu, Hatem Sembawa, Prosanto Chaudhury,David Evans, Yasmine Jabr

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Drs. Vadim Sherman, Jose Pascual, Shannon Fraser, David Fleiszer, Tarek Razek,Shahriar Shahrokhi

Drs. Shahriar Shahrokhi, Melina Vassiliou

Drs. Caroline Rochon and Sarkis Meterissian, Program Director

DJeff Bark"" gave a pa-per at the meeting in Quebec City on theCanadian Forum of Surgery where he pre-

sented the Quebec

O II Plan in the sympo-KUD S.. sium on AlternatePayment Plans forAcademic and Com-

munity Surgeons from September 6th - 9th•He also presented a paper entitled De-compression of Malignant Biliary Obstruc-tion: A Prospective Trial Examining Qualityof Life. His co-workers on this paper areN.S. Abraham, G. Friedman,K. Menon, S. Mehta, G. Cortas, and hisbrother, A.N. Barkun.

Dr. Paul Belliveau in Kingston has beenappointed as Secretary/Treasureron the Ex-ecutive of the Canadian Association of Uni-versity Surgeons (CA.U.S.). As a member ofCAUS,Paul also chaired a symposium on theTraining of a CanadianSurgeon at the meet-ing on September 6th in QuebecCity.

Dr. Ray Chiu was an Invited Lecturer onStem Cell Transplant for Cardiac Injury atthe International Society of Heart Re-search Congress in Winnipeg on July 10th,and a member of the Advisory Panel forthe National Institutes of Health of theUnited States on the "Cardiac Assist toRecovery" project. He also served on theGrant Review Committee for the Ameri-can NIH, in the section for "Surgery andTissue Engineering" on October 1st _2nd•He also advised the Medical ScienceCommittee of the National Health Re-search Institute in Taiwan. On October5th, he was an Invited Faculty at the Con-troversies in Adult Cardiac Surgery Sym-posium of the Cedars-Sinai Hospital inLos Angeles. He co-chaired a session onCell Therapies for Myocardial Reconstruc-tion during the American Heart Associa-tion meeting in Anaheim, California onNovember 13'h. Dr. Chiu will be the An-

Dr. Olga Huk-Papanas-tasiou was the recipi-ent of the Carroll LaurinAward granted by theCanadian OrthopaedicFoundation at the re-cent Canadian Or-thopaedic AssociationMeeting in London, On-tario in June. The title of

Dr.Olga Huk-Papanastasiou her research was Im-munohistochemical Lo-

calization of Apoptosis-related Proteins inInterface Membranes from Aseptically LooseTotal Hip Arthoplasty. She also contributeda chapter What Patient-Related FactorsContribute to Implant Wear? in a book en-titled Implant Wear in Total Joint Replace-ment 2001. This work is by the AmericanAcademy of Orthopaedic Surgeons (Rose-mont, IL, 2001, Goodman and Wright, Eds.pp.13-19).

nual Visiting Professor to the CardiacSurgery Division of the University ofToronto on November 29th -30th, 2001.

Dr. John Duff of London, Ontario is theSecretary/Treasurer of the James IV Asso-ciation of Surgeons Executive.

Dr. David Evans presented a paper at themeeting in Quebec City of the CanadianAssociation of General Surgeons on La-paroscopy in the Trauma Patient. The fol-lowing Saturday, he attended asymposium on the Current Surgical Man-agement where he presented a paper onSepsis-Evolving Concepts.

Dr. Gerald Fried presented a paper duringa sympsoium at the meeting of the Cana-dian Association of General Surgeons inQuebec City on September 6th where hespoke about The Difficult Cholecystectomy.Gerry also chaired, at the same meeting, acourse on Laparoscopy and En-doscopy. Dr. Joe Mamazza,now of Toronto, was also part ofthis course.

Dr. Gabriela Ghitulescu at asymposium of video sessionsduring the CAGS meeting inQuebec City on September 8th

presented Laparoscopic Gastro-jejunostomy for Gastric OutletObstruction. Later on duringthe same meeting, she pre-sented a paper entitled A Model for Eval-uation of Laparoscopic Skills: Is ThereCorrelation to the Level of Training? Herco-workers on this paper are Drs. A.M.Derossis, Liane Feldman, D. Stan-bridge, Harvey Sigman, and G.M.Fried of the Centre for Minimally InvasiveSurgery McGill.

Dr. Philip H. Gordon of the JGHwas hon-ored by having the annual Colorectal Lec-tureship of the Canadian Society of Colonand Rectal Surgeons named after him.Philip was also appointed reviewer for theArchives of Physiology and Biochemistry.

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He and his co-workers have 6 publicationsso far this year and in addition, he hasbeen a Visiting Professor in May at theWestern Pennsylvania Hospital in Pitts-burgh where he talked about The Geneticsof Heritable Colon and Rectal Carcinoma.On the same date, he was a Guest Lecturerat the Pittsburgh Society of Colon andRectal Surgeons where he talked aboutTheManagement of Patients with PerianalCrohn's Disease. In mid May, he was a Vis-iting Professor at the Washington HospitalCenter. Phil was an Invited Participant atthe Canadian Society of Colon and RectalSurgeons Postgraduate Course: Controver-sies in Colorectal Disease in Quebec City atthe Canadian Surgery Forum on Septem-ber 6th - 9th• On one occasion, he spokeabout Colorectal Carcinoma Screening -Who, When, How and How Often? On thesecond occasion, he talked about TheCaseagainst Total Mesorectal Excision for Carci-noma of the Rectum.

Dr. James Lacey and his wife Kelly are theproud parents of a baby boy, AndreasPanayotis. James also opened a new pri-vate office in Barrie, Ontario. ~

~ Dr. Antoine Loutfi of the RVHwas present at a symposium at the Cana-dian Surgical Forum in Quebec City on Sep-tember 7th where he gave an addressentitled Can I Actually Function There? Thiswas at a symposium about Preparing Your-self for a Short-term Surgical Assignmentin the Developing World.

Dr. Joao Luiz Pippi Salle, Director of Pedi-atric Urology of the Montreal Children's Hos-pital, was awarded "Best PosterPresentation" - Pediatric Section at the Cana-dian Urological Association Annual meetingheld at the Toronto Hilton, Toronto, Ontario,June 24th - 28th, 2001, for his presentationentitled Minimizing Meatal Stenosis Follow-

ing the SnodgrassProcedure. In addition, incollaboration with Dr. Pippi Salle, Ms. LilyChin-Peuckert, Urology nurse, was pre-sented an award for "Best Podium Presenta-tion" - Pediatric Section at the CanadianUrological Association meeting with her pre-sentation entitled An Effective Method of

Treating Children with Dysfunctional Voiding

Using a Non-invasive Biofeedback Program.

Dr. Pippi Salle was invited to Casablanca -Morocco recently, for a Visiting Professorshipat CasablancaChildren's Hospital. In addi-tion, a meeting was held to discussthe pos-sibility of a "Moroccan Exchange Program"between the Division of McGill Urology andCasablanca Children's Hospital where Urol-ogy and Nephrology physicians would par-ticipate in the development of PediatricUrolonephrology and help to initiate a pedi-atric renal transplantation program. Dr.PippiSalle has also been invited to Hospital Fe-nando da Fonseca, Lisboa - Portugal for avisiting Professorship in the fall 2001.

Drs. J.L. Meakins and David Mulder areDirectors on the Executive of the James IVAssociation of Surgeons. On Saturday,September 8th at the Canadian SurgeryForum in Quebec City, Dr. Mulder chairedthe F.G. Pearson Lecture on ThoracicSurgery entitled Thoracic Trauma.

Dr. Sarkis Meterissian has been named asChairman of the ResearchCommittee of the

Canadian Society of Surgical Oncologists. Atthe meeting of the Canadian Surgery Forumin Quebec City, Sarkis chaired a symposiumon the New Developments in the Treatmentof Colorectal Cancer.

Dr. Peter Metrakos gave four talks atthe Canadian Surgery Forum in Septem-ber 2001. On Friday the 7th, he was invitedto speak to the Canadian Surgical BiologyClub on a subject of Endothelial Activation

to Xenogeneic Stimuli. He then spoke tothe Canadian Association of General Sur-geons about Pancreas Alone and Pancreas

after Kidney Transplantation. On Septem-ber 8th, Peter gave a talk to the CanadianSOciety of Colon and Rectal Surgeons en-titled What5 New in the Treatment of

Liver Metastases; followed by a talk to theQuebec Association of General surgeonsentitled A Case of Nonresectable Colorec-

tal Liver Metastases.

Dr. Dan Poenaru, who graduated fromthe McGill Postgraduate Training Programin General Surgery in 1991 and who isnow at Queen's in Kingston, gave a paperon medical education at the annual con-ference of the Royal College from Sep-tember 20th - nod in Ottawa. Along withhis co-worker, Dr. D. Delva, the title of hiswork was One-on-one Teaching Using

Performance- based Coaching.

Dr. Christo Tchervenkov was a co-mod-erator at the International Summit onNomenclature for Congenital Heart Dis-ease at the 3'd World Congress of PediatricCardiology and Cardiac Surgery held inToronto on May 27th, 2001.

Dr. Jean Techervenkov, who is the Surgi-cal Director ofTransplantation at the MUHC,is organizing the 6th annual dinner of theLiver Transplant Fund of the Royal VictoriaHospital/MUHC at Montreal's famousrestaurant Milos. Mr. Serge Savard, formerManager of Les Canadiens, will be theGuest of Honor. Mr. Ted Blackman, SportsDirector of Team 990 radio station, andtransplant recipient, is to be the emcee. The

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!:l13

dinner is scheduled for November 18th.

Dr. Carol Ann Vasilevsky of the JGH hasbeen elected as President of the CanadianAssociation of Colon and Rectal Surgeons(CSCRS). In addition, she is a Guest Editorof the Clinics in Colon and Rectal Surgery,vol. 14:3:2001. At the meeting on Sep-tember 6th in Quebec City of the CanadianSurgery Forum, Carol Ann presided a post-doctoral course on Controversies in Col-orectal Diseases.

AchievementsResidentsand Fellows

DAbdulaziz AI-Khaldi

and his wife Eman are the proud parentsof a baby girl, Razan, born on August 19that the Royal Victoria Hospital, weighing3.2 kilos. A baby sister for Fatima. Azizhad a busy research year, he presented apaper entitled Therapeutic Angiogenesis:

The Use of Autologous Bone Marrow Stro-

mal Cells at the Canadian CardiovascularCongress in Halifax, Nova Scotia on Octo-ber nOd. In November, he presented a pa-per at the American Heart AssociationScientific Sessions 2001 in Anaheim, Cali-fornia on VEGF-Dependent Angiogenic Re-

sponse Induced by Ex- Vivo Cultured

Marrow Stromal Cells. Aziz will also pre-sent another paper at the Annual Meet-ing of the Society of Thoracic Surgery inFort Lauderdale, Florida on Therapeutic

Angiogenesis Using Autologous Bone

Marrow Stromal Cells: Improved Blood

Flow in a Chronic Limb Ischemia Model.

Congratulations to Dr. Hilal AI-Sabti

and his wife, Kamila, on the birth oftheir first child, a daughter born on July10th in Oman. Baby Reem weighed in a3.15 kilos. ~

~ Dr. R.H.I. Andtbacka, R-IV inGeneral Surgery, won the CAGSBasic Sci-ence Award for the year 2001 for a paperwhich was presented at the meeting ofCAGSon September 8th in Quebec City.Along with co-workers Drs. F. Halwani,M. Edwardes, J. McGlade, M. Park andS.H. Meterissian, the manuscript is en-titled A Novel Marker of Tumor Progres-sion at Breast Cancer.

Dr. A. Behzadi along with Dr. DavidEvans of the MGH gave a paper at themeeting of the Canadian Association ofGeneral Surgeons in Quebec City on Sep-tember 7th entitled Strict Adherence to theDamage ControlSurgery Criteria SignificantlyIncreasesthe Likelihood of Survival.

Dr. Bindu Bittira, during her academicresearch year as a R-III cardiac residentin Dr. Ray Chiu and Dr. DominiqueShum- Tim's laboratory, was the recipi-ent of the First Prize for the TerrenceDonnelly Competition, competing withother cardiac surgery residents through-out Canada. Her paper entitled ThePathophysiological Role of Marrow Stro-mal Cells in Myocardial Infarction hasbeen selected as one of the five finaliststo compete for the 2001 Vivian ThomasYoung Investigator Award during theAmerican Heart Association meeting inAnaheim, California on November 13'h.Another paper on Preprogramming Mar-row Stromal Stem Cells for MyocardialTransplantation has been accepted forpresentation at the Society of ThoracicSurgeons meeting in January 2002.

The lead article in the November 2001 issue of the Journal of the American Col-lege of Surgeons is by Dr. Anna M.Derossis and her co-workers from theBreast Service of the Departments ofSurgery and Nuclear Medicine of theMemorial Sloan-Kettering Cancer Centerin New York. It is entitled A TrendAnaly-sis of the Relative Value of Blue Dye andIsotope Localization in 2000 ConsecutiveCases of Sentinel Node Biopsy for Breast

Cancer. The article favors radio-isotopemapping of the SLN.

In September, Dr. Antonio Di Carlo didan oral presentation at the VI Congress ofthe International Xenotransplantation As-sociation in Chicago entitled ComplementInactivation or Depletion of a-gal XNADoes Not Abrogate the Transcription ofEarly Growth Response Factor-I (EGR-l)in a Model of Pig-to-Human Liver Xeno-transplantation. The co-authors areA. Joseph Tector, Miguel Tan, ShuqingLiu, Michel Awwad, Carl Soderland, Pe-ter Metrakos and Jean Techervenkov.

Dr. Shannon Fraser, R-III in GeneralSurgery, addressed a symposium on theTraining of a Canadian Surgeon at theCanadian Surgery Forum in Quebec City inSeptember. The title of her presentationwas The Perspective of the Surgeon inTraining: Impact of Call Schedules.

Dr. Kashif Irshad, R-IV in GeneralSurgery, presented a paper along with Dr.L.S. Feldman, T. Chughtai, V. Chu, andJ.-E. Morin at the meeting of the Cana-dian Surgery Forum in Quebec City fromSeptember 6th - 9th• The title of his pre-sentation was Causesof Increased Lengthof Stay on a General Thoracic Surgery Ser-vice: A Prospective Observational Study.

Dr. Moishe Liberman, R-II in GeneralSurgery, was given Second Place Honorsin Clinical Investigation as the AmericanCollege of Surgeons Committee onTrauma announced its winners for the2001 Residents'Trauma Papers Competi-tion at its annual meeting March 8th_ 10thin Tampa, Florida. Second place prizewas $500.00. His winning paper ad-dressed the issue of Multi-Centre Cana-dian Study of Pre-Hospital Trauma Care.

Dr. Nancy Morin was scheduled to givean oral presentation at the VII Interna-tional Small Bowel Transplant Symposiumin Stockholm on September 15th entitledCompetitive PCR Quantification of Mi-

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crochimerism in a Sex-mismatchedPorcine Model of Small Bowel Transplan-tation. The catastrophe in New York pre-vented the researchers from attending.

Dr. Nina Ordas along with her co-work-ers Drs. J. Pintos, and Sarkis Meteriss-ian of the RVH presented a paper at theCAGSmeeting on September 8th in Que-bec City entitled Value of Follow-up inPatients with High Risk Melanomas. Shealso married Dr. John Davis in October.

Dr. Jose Pascual, R-IV in General SurgeryResearch, was married on the 4th of Au-gust,2001. His bride, DominiqueCharette, is a member of the Dietetics De-partment at the JGH.

Dr. Andrew J.E. Seely has been workingon a very interesting educational projectfor the past two years. Along with his co-workers, Drs. Marc Pelletier, JudityTrudel and Linda Snell, he has publishedhis original article in the recent Annals ofthe Royal College. The title is CanSurgicalResidents Improve Teaching and Learningwhen Supplied with Teaching Tools andSkills? A Randomized Controlled Trial.

Dr. Michael Tan presented an abstract atthe International Xenotransplant Associa-tion Meeting in Chicago in October 2001entitled Glucocorticoids do not AbrogateActivation in Response to Islets in an InVitro Dog-to-Pig Model of Xenoislet Trans-plantation. He has a manuscript pub-lished in Transplantation -Pseudoaneurysm of the Superior Mesen-teric Artery After Pancreas TransplantationTreated by Endovascular Stentint. A sec-0nd manuscript published in Liver Trans-plantation is entitled Successful OutcomeFollowing Transplantation of a Donor Liverwith Focal Nodular Hyperplasia.

Dr. George Tzimas started research atthe laboratories of the Transplant Hepato-biliary Group on July 1st, 2001. StartingJuly 1st, 2002, he will be the TransplantHepatobiliary Fellow. ~

(continued on pg. 22)

Visiting Professor

FOURTH ANTHONY R.C. DOBELL ANNUAL VISITING PRO-FESSOR OF CONGENITAL CARDIAC SURGERY- October 7st, 2007

Dr. Thomas L. Spray, Chief and Alice Langdon

Warner Endowed Professor of Pediatric Cardio-

thoracic Surgery, The Children's Hospital of

Philadelphia, was the A.R.C. Dobell Visiting Pro-

fessor for 2001. The academic day began with

Surgical Grand Rounds at the Montreal Children's

Hospital, where Dr. Spray talked on Current Sta-

tus of Pediatric Heart, Heart-Lung and Lung

Transplantation. Presentations by residents and

staff took place during the morning session fol-

Dr.ThomasL. Spray lowing by a luncheon. Later that day at McGill

University CVT Grand Rounds at the MCH, Dr.

Spray spoke on The Evolution of the Surgical Treatment for Hy-

poplastic Left Heart Syndrome.

The day's events were capped off with a banquet in honor of

Dr. Spray at the Mount Stephen Club.•

EKL

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15

Welcome AboardDr. Christian Sirois joined the Division of Thoracic

Surgery as an Assistant Professor of Surgery in July 200l.Dr. Sirois is a Laval graduate completing his General Sur-

gical training at Laval and a Thoracic Surgical Fellowship

at the University of Toronto. He

then did a two year Cardiotho-

racic Fellowship at the University

of Illinois at Chicago.•

Dr.Christian Sirois

...............................................................................................................................

In the spring of 1999, as part of the ag~ement thatmade Montreal and Hiroshima sister cities, the Faculty of

Medicine at McGill University and the School of Medicine at

Hiroshima University signed an

agreement to exchange medical

students and researchers. This

program is coordinated by

Dr. H. R. Shibata, who is an alumnus of both universities.

Dr. Seiji Okimasa

So far six medical students from Hiroshima University have

come to serve as externs in our program, while one McGill

medical student, Timur Kouliev, went to Hiroshima this

summer to do an elective in Hematology research.

Also, as part of this exchange program, Dr. Seiji Okimasa, a

junior staff member of the Second Department of Surgery at

Hiroshima University, is spending a year as a clinical research

fellow in the Thoracic Surgery Program at McGill. This was all

made possible through the kind efforts of Dr. David Mulder,Director of the Division of Thoracic Surgery, and Dr. PatrickErgina, Director of the Training Program. •

Creation of New McGill

Div. of Thoracic Surgery

T.McGill Division ofThoracic Surgery has be<ometotally autonomous effective July lSI, 2001, and will function

as a combined program with two sites at the Montreal Gen-

eral Hospital and at the Jewish General Hospital. The pre-ex-

isting relationships in Cardiothoracic Surgical Education and

the Teaching Program will continue. A plan is being prepared

for an application for approval by the Royal College for a Fel-

lowship Program in Thoracic Surgery.

EKL

Thanks to These Alumni for Recent

Very Generous Contributions

Dr. Francis Coughlin, Dr. Peter M. Feldman

Dr. Alan G.Thompson

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THE SQUARE

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17~ University Surgical Clinic2000-2001

~I

THE SQUARE..z~GENERAL SURGERY ACADEMIC HALF DAY SEPTEMBER - DECEMBER 2001

Teaching sessions will be held from 1:00-2:30 p.m., followed by M & Ms 2:30 - 4:00 p.m.Sessions will alternate between the RVH (Archibald Amphitheatre, Sl 0) and MGH (Osler Amphitheatre, D6).

RVH September S Journal Club: Esophagus Drs. Sirois/FerriMGH September 12 Guest Lecture: Reoperative Antirefiux Surgery: Dr. Lee Swanstrom

When and How/ Presentations (1-S P.M.)RVH September 19 SRP: Esophagus/Duod/Stomach Drs. Owen/CharleboisMGH September 26 Cine Clinic: Gastrectomy Drs. Meterissian/Morin/HagartyRVH October 3 SRP: Upper GI Bleed Drs. Razek/BratuMGH October 10 Lecture: Gastric Neoplasms Dr. MeterissianRVH October 17 Journal Club: Biliary Calculous Disease Drs. Barkun/Khan/FaizerMGH October 24 Cine Clinic: Hepatic Resection TBA/ AI-KabriRVH October 31 SRP: Hepatobiliary Pancreas Dr. G. CarlsonMGH November 7 Lecture: Hepatic Neoplasms Dr. MetrakosRVH November 14 Journal Club: Pancreatitis Drs. Rosenberg/MedeirosMGH November 21 Cine Clinic: Whipple Procedure Dr. BarkunRVH November 28 SRP: Melanoma/Sarcoma Dr. MeterissianMGH December S Lecture: Hernia Dr. MeakinsRVH December 12 Journal Club: Melanoma/Sarcoma Drs. Loutfi/Hagarty

ATTENDANCE IS MANDATORY FOR RESIDENTS

PRACTICE ORALS - GENERAL SURGERY SENIOR TEACHINGWednesdays 4:00-6:00 p.m.

Sessions will alternate between the RVH (SICU Conference Room CS.13a) and the MGH (L-9 Conference Room)

Place Date Topic Staff ResidentsRVH October 3 Esophagus Dr. Meakins Drs. Faizer/AI-JabriMGH October 10 Stomach PUD Dr. D. Owens Drs. Hagarty/BratuRVH October 17 Melanoma Dr. A. Loutfi Drs. Tan/MorinMGH October 24 Pancreatitis Dr. L. Rosenberg Drs. Kamal/FerriRVH October 31 Pancreatic/Biliary Neoplasms Dr. P. Metrakos Drs. Ordas/KhanMGH November 7 Hepatic Mass Dr. J. Tchervenkov Drs.Otaky/MedeirosRVH November 14 Gallstones Dr. J. Barkun Drs.lrshad/CharleboisMGH November 21 Sarcoma Dr. S. Meterissian Drs. AI-Hendal/ AI- JabriRVH November 28 Retroperitoneal Mass Dr. S. Meterissian Drs. Andtbacka/Bratu

18

T.Mcgill Surgical Alumni participated well in themeeting of the American College of Surgeons from October 7thto 12th in New Orleans, Louisiana.

McGill at the 87thClinical Congressin New Orleans

Dr. Nicolas V. Christou chairedthe Postgraduate Course on Surgi-cal Infection and Antibiotics. Hepresented a paper entitled Estab-lished Antibiotics: What Works andWhat Doesn't. Dr. Andrew J.E.

Seely spoke about Role of Host Defense Factors in the Suc-cessfu~ Resolution of Surgical Infections and Dr. David C.Evans talked about Infections Outside the Abdomen - Hospi-tal-Acquired Pneumonia, Line Infections, and Others. A paneldiscussion followed John C. Marshall's paper on Modulationof the Systemic Inflammatory Response.

In the Surgical Forum in the section on Surgical Oncology,Dr. Robert H.1. Andtbacka along with his co-workers,Drs. Fawaz Halwani, Michael Edwardes, Jane McGlade,Morag Park and Sarkis Meterissian presented a paper en-titled p66Shc - A Novel Protein Associated with HER2Expressionin Breast Cancer.

In the Surgical Forum in the section on Transplantation,Dr. Antonio DiCarlo, along with Drs. Joseph Tector,

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Miguel Tan, Shuqing Liu, Carl Soderland, Peter Me-trakos and Jean I.Techervenkov addressed the audience inthe Ernest Morial Convention Center on the topic of Comple-ment Inactivation Does Not Attenuate Endothelial Cell Activa-tion in Pig-to-Human Liver Xenotransplantation.

McGill was honored by the fact that it was Dr. Jean-MartinLaberge of the MCH who presented the update on PediatricSurgery at the section entitled What's New in Surgery?

Dr.John C. Marshall, now at the Toronto General Hospital, wasone of the presenters of a paper entitled Preconditioning withHypertonic Saline Prevents Ischemic-Reperfusion-Induced HepaticJun-kinase Activation. This was at the section on Critical (GeneRegulation) in the Surgical Forum. John was very busy since healso presented two other papers. One was during a seminar onFrontiers in Resuscitation in which he talked about Endpoints inResuscitation. The other was during the Postgraduate CourseonPerioperative Careof the Anemic Patient where he spoke aboutTransfusion Trigger: When to Transfuse?

October 11

Cancelled for ACSmeeting

Dr. Richard Novick, now at the University of Western Ontario,presented a paper in the Surgical Forum during the session onCardiothoracic Surgery entitled Heme Oxygenase Protects inLung Ischemia-Reperfusion Injury.

Dr. Carol-Ann Vasilevsky was the Moderator of the seminaron Anorectal Disease: What's New? during the PostgraduateCourse on Colon and Rectal Surgery .•

October 18

Nonoperative management of solidorgan trauma (Dr. T. Razek)

November 1

Intestinal failure(Dr. Carlson - James IV Traveller)November 8Stem cell research (Dr. L. Rosenberg)November 15

Infection control in the OR (Dr. V. Looand others) - to be confirmed

November 22

Cardiac regeneration (Dr. K. Lachapelle)November 29

Ambulatory anesthesia (Dr. F.Chung)December 6Trauma Visiting Professor (Dr. R.Saadia)December 13

Preventing recurrent Crohns disease afterresection (Dr. G.Wild)December 20-January 3

Cancelled for Christmas

Ed's Note: Dr. Liane Feldman

is the organizer of these Rounds

SURGICAL GRAND ROUNDS - THE MONTREAL GENERAL HOSPITALSir william Osler Amphitheatre - Thursday 07:30 - 08:45

October 25

Transplant Visiting Professor(Dr. C. Miller)

September 6Cancelled for CAGSmeetingSeptember 13

MIS Visiting Professor: Introduction ofnew technology in surgery(Dr. L. Swanstrom)September 20

Case records of the MGH: a woman withabdominal pain after ERCP(T-Service)September 27

Update on critical care and managementof surgical sepsis (Dr. N. Christou)October 4Acute pain management (Dr. B. Ready)

Letters teaching institutions in asymposium on History ofOrthopaedics in NorthAmerica, published in Clin-

ical Orthopaedics & Related Research.John D.Hsu,M.D.,Downey, California

Editor's Note: John Hsu recently pub-lished an interesting article in Clinical Or-thopaedics and Related Research (May2000) on the Rancho Los Amigos MedicalCenter - A Unique Orthopaedic Resourceand Teaching Institution in Downey, CA -just outside of los Angeles.

(continued from pg.2)

Dear Editor,I enjoy reading The Square Knot, but asColin Moseley said in the last edition "thenumber of familiar names is declining':Please give all my best wishes to NelsonMitchell, Peter Mclean, Henry Shibata, DickCruessand Lloyd Maclean if still practicing.All best wishes to yourself and your family.

I retired about five years ago, and am ingood health so far. I was sad to hear thatJohn Gutelius died at a fairly young age.

Brian McKenna,Saskatoon, Sask.

Dear Editor,Ever so good to hear from you. In answerto your wondering about my "course andspeed'; I think my heading is directly to-wards a continuation of a countrylifestyle in this small rather laid-back vil-lage of Gagetown; and so, it is steady asshe goes - economical speed.

You would feel right at home here withthe heavy artillary of CFB Gagetownbanging away in the background, andshaking things up a bit from time totime. My wall pictures are askew most ofthe time. The Base cuts in very close tothe village in several places.

My water craft have been downsized

from sail (which you will remember) tocanoe - which you must admit is a con-siderable change. However, there is lotsof enjoyment in canoeing around themany waterways this countryside has.

My commendation to you Ed for thesplendid job you are doing for TheSquareKnot! It keeps one very much in touchwith what is going on up there.

John R.Moore, M.D., (Ex.Surg. Cdr.)Gagetown, New Brunswick

Dear Editor,Re: The Gold Fish in the I. V. Bottle CaperI suppose that if the story of fish in theI.V. bottle had been anything less thanthe successthat it was, there would be noone claiming culpability. I've heard thestory so often with so many claimantsand variations that I got to thinking thatmaybe it wasn't me that bought the fishand put them in the bottle. Or perhapsthere were other fishy incidents of whichI'm not aware. The story recounted byGauld and Hinchey is essentially correct.I was finishing internship and remem-bered a similar joke having been playedon a patient in the "Doctor in the House"series. I had my next year's appointmenton hand so felt secure enough in goingdown to Woolworth's on St. Catherines inthe Spring of 1961 to buy three goldfish.I felt a little silly going in there with thewhite intern's outfit on. I took the lateJohn Stubbs who was my senior into myconfidence to see just how observant FNGreally was. There were a few others in-volved and perhaps Bill Gauld was one ofthem. I poured out the i.v. bottle con-tents knowing these were not saltwaterfish, shook the tap water vigorously inthe bottle to oxygenate it and thenpushed the fish through the neck of thebottle. The rest of the story if more or lesscorrect except that it was in the am-phitheatre and it was all the patientcould do to not burst out laughing whenFNG did his usual bedside examination.

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I would hate to have my only contribu-tion to medical lore as being the fish-monger who put the fish in the bottle,but for the record it was me.

P.S.:Have just graduated from the NovaScotia School of Art and Design with aBFAthis spring.

David A. Murphy, M.D.,Halifax, Nova Scotia

Dear Editor,I always enjoy The Square Knot. A num-ber of memories were rekindled when Iread Dr.Maclean's recent pronouncementthat "surgery for obesity has become analmost respectable pastime!" Itprompted me to write a little piece thatI hope you will consider for publication inThe Square Knot.

I was interested to read that lloydMaclean has now concluded, "surgery forobesity has become an almost respectablepastime!" Before entering into neuro-surgery at the Montreal Neurologicallnsti-tute, I spent two years in the McGillGeneral Surgery Training Program. This in-cluded, in 1986, sixteen unforgettableweeks on Red Service at the Vic with Dr.Maclean, known affectionately as L.D..

It would not be truthful to saythat I changedprograms becauseof my experience on RedService ... I had long harbored neurosurgi-cal ambitions. But I do recall that it was un-pleasant, difficult work taking care of thosehuge lOWest patients after they had un-dergone gastroplasties and related proce-dures. L.D.,however, was usually fun to bearound. His enthusiasm, though misguided(I thought), was always infectious, and hecertainly had one of the sharpest intellectsthat I have encountered during my surgicalcareer. When I told him of my plan to be-come a neurosurgeon, he said in his usualslow, deliberate and sardonic way, "Well ...(very long pause) it's your life': I guesshe re-membered neurosurgery from the pre-CTera with horrendous imaging, ~

20

~ terrible workloads and depressingresults - a most unrespectable specialty hemust have thought!

He now seems to concede that surgeryfor obesity hasn't always been re-spectable either. But it sure did teach mehow to take care of sick people, most es-pecially large ones. Wound infections andother post-op fever dilemmas, along withproblems with deep venous thrombosiswere rampant on the service. As the in-tern it was my job to deal with thissteady stream of complications. I also re-member going to the ORand seeing theproblems with positioning and exposure.

I never thought it would be very helpful tomy practice. I didn't encounter too manyproblems through the rest of my clinicaltraining, nor when I moved to Winnipegand started practice. While a lot of neuro-surgery involves the head, we also have toexpose the spine from the front and back,and routinely open the peritoneal cavityfor ventriculoperitoneal shunts. Obesitycan be a problem in these situations.

It was only on moving to Jackson, Missis-sippi that I really came to appreciate thelessons learned with L.D. Obesity is ram-pant in this part of the world. The resi-dents jokingly refer to patient weight interms of "Mississippi units': one unit beingequal to a patient's ideal body weight. Two"unit" patients are very common, and wesee many 2.5 even 3 "unit" individuals.

Surgery on anybody who weighs morethan 200 kg is no laughing matter. Butwhen I see one of these individuals mov-ing slowly to my examining room or lyingon the gurney in the Emergency Depart-ment' I often think of L.D.and smile inside.My experience with him taught me thebasicsof surgical care of the obese patient.And it all comes back when I imbrue myscalpel to the hilt in the greasy bulk of abig fat tummy or neck.

Ian B. Ross,M.D.,

Jackson, Mississippi

Dear Editor,

I enjoy reading The Square Knot verymuch as it keeps me in touch with thegoings-on at McGill Department ofSurgery. I am in private plastic surgerypractice with a colleague in Banff, Al-berta. Always happy to hear from Alumniif they are in the area.

TomSinclair, M.D.

Canmore, Alberta, July 200 7

Dear Editor,

In March, the McGill University HealthCentre, Royal Victoria site was presentedwith a major challenge. The discovery ofAspergillus in the main operating blockled to a decision to close this area andto undertake an extensive renovation ofthe facility.

At the same time, to meet the needs of ourpatients we arranged to transfer surgeryto five different sites. Many surgeonsmoved to the MGH,MNH, C7 and the Cys-toscopy suite in order to provide accesstosurgical care, and countless others felt theimpact of the situation in their everydayworking lives. Despite the difficulties, theentire staff pulled together and focused onour patients. Though initially our levels ofsurgical activity dropped significantly,within a short period of time they had in-creased to the point where we were doing75% to 80% of our regular volume. Ser-vices such asTransplant were able to func-tion at normal levels.

We have opened our new surgical suiteand we think that all the members ofthe staff will be pleased with the im-provements made to this importantarea. In a short period of time, extensiverenovations to the facility were com-pleted. The ventilation system and themedical gas system were upgraded.Windows were replaced and floor, ceilingand wall surfaces changed. As well, anew storage system for supplies andnew equipment have been purchased.Bringing this project in on schedule has

THE SQUARE...z!:I21

also demanded a tremendous effort byeveryone.

We would like everyone to know that werecognize the exceptional commitmentand energy that surgeons have demon-strated during the past four months. Weshall never be able to thank everyone in-dividually, but we would like the Depart-ment of Surgery to know that weappreciate its efforts. It is because ofhard work and willingness to pitch in thatwe have been able to deal with this situ-ation. We hope that you will pass on ourbest wishes and gratitude to all membersof the staff.

Jean E.Morin, M.D., Associate Chief

RVH Dept. of Surgery

CelineDoray, Associate Director of Nursing

Surgical Services-MUHC

Steven Backman, M.D., Director, Anesthesia RVH

Dear Editor,I am always happy to receive The Square

Knot, but the last issue filled me withdeep sorrow, as I read the news of thedeath of John Gutelius. He was a truegentleman and scholar, a friend and anexcellent teacher. I always remember himwith deep respect and admiration. Ithank God to have been one of the for-tunate to have had John as Senior andChief Resident, and have trained underhim. My memories are happy ones.

After many, too many, years of being theDean of Health Science at one of the topMedical School in the Dominican Repub-lic, I have returned to full time privatepractice, which I enjoy very much. Theskills taught at the Royal Victoria werenever forgotten.

Thank you for your good work and for keep-ing us informed about the "well remem-bered" McGill Department of Surgery. •

Humberto Sangiovanni, M.D.

Santo Domingo, Dominican Republic

~ He received his medical degree from Athens andthen trained in General Surgery at Brown University fol-lowed by a one year Fellowship in Transplantation in Mi-ami. He, at present, is Board eligible, has passed his writtenexams and will be doing his oral exams for Board Certifica-tion in the United States in the near future. He will beworking in the Transplant Hepatobiliary Laboratory on TheRole of Cytokines, Adhesion Molecules and Pro-protein Con-vertases Play on Liver Metastases. •

.........................................................................................·

········

(from pg.14l

GENERALPRACTICITIONERS % DIFF.1996 1997 1998 1999 2000 (96-00)

NFLD 101 103 103 103 106 4.8

P.E.1. 73 69 73 74 75 4.1

N.S. 99 99 101 101 101 2.2

N.B. 88 87 90 91 90 2.1

QUE. 104 103 105 105 106 2.2

ONT. 89 86 86 85 85 (4.2)

MAN. 87 88 89 91 92 6.0

SASK. 86 85 87 92 91 6.1

ALB. 85 83 86 88 86 1.0

B.C. 106 105 106 105 106 0.8

YUKON 125 135 125 114 116 (6.9)

N.W.T. 73 77 69 84 69

NUN. 37 21

CANADA 95 93 94 94 (0.3)94

Source:Southam Medical Services - Canadian Instituteof Health Information Service

EOMGeorgeTzimas,M.D.

SPECIALISTS1996 1997 1998 1999 2000

% DIFF.(96-00)

NFLD 64 66 67 68 66 2.8

P.E.1. 52 51 55 56 52 0.9

N.S. 88 90 94 97 100 14.1

N.B. 61 62 63 63 63 2.8

QUE. 105 106 106 106 108 2.2

ONT. 92 92 93 94 95 3.3

MAN. 86 89 88 88 89 3.0

SASK. 58 59 62 61 62 6.9

ALB. 74 74 77 79 80 7.8

B.C. 86 86 87 88 88 3.2

YUKON 22 22 19 20 20 (8.8)

N.W.T. 18 21 22 43 43

NUN. 4 4

CANADA 90 90 91 92 93 3.7

Source: Southam Medical Services - Canadian Instituteof Health Information Service

........................................................................................SHAPIRO, Or. MaynardIt is with deep sorry that we announce the death of plasticsurgeon Dr.Shapiroon September 15that the age of 66 years.Well known in Montreal, Maynard graduated from the Uni-versity of British Columbia in 1960 and qualified as a plas-

tic surgeon in 1967. He did part of his training at McGill. He had a genuine interest in hispatients who were devoted to him. He leaves to mourn his wife Beverly (Wolfe) and his sonRobert. Dr.Shapiro was on the staff of the Jewish General Hospital. •

THE SQUAREi:!:l

Answers to theMENSA Test(from page 7)

1. 24 Hours in a Day2. 26 Letters of the Alphabet3. 7 Days of the Week4. 7 Wonders of the World5. 12 Signs of the Zodiac6. 66 Books of the Bible7. 52 Cards in a Pack (Without Jokers)8. 13 Stripes in the United States Flag9. 18 Holes on a Golf Course10. 39 Books of the Old Testament11. 5 Toes on a Foot12. 90 Degrees in a Right Angle13. 3 Blind Mice (See How They Run)14. 32 is the Temperature in Degrees

Fahrenheit at which Water Freezes15. 15 Players in a Rugby Team16. 3 Wheels on a Tricycle17. 11 Players in a Football (Soccer)

Team18. 12 Months in a Year19. 13 is Unlucky For Some20. 8 Tentacles on a Octopus21. 29 Days in February in a Leap Year22. 27 Books in the New Testament23. 365 Days in a Year24. 13 Loaves in a Baker's Dozen25. 52 Weeks in a Year26. 9 Lives of a Cat27. 60 Minutes in a Hour28. 23 Pairs of Chromosomes in the

Human Body29. 64 Squares on a Chess Board30. 1000 Years in a Millennium31. 15 Men on a Dead Man's Chest

····...............................................................................................................................

New ChangesJanice Hazarian is the Administrative Co-or-dinator for the Orthopedic Residency Pro-gram and is at the MGH for the time being.

Lucie Francoeur is the Administrative Co-ordinator for the Core Surgery ResidencyProgram and Undergraduate EducationProgram.

Rita Piccioni is the Administrative Co-ordi-nator taking care of the General SurgeryResidency Program and administration forthe Division of General Surgery.

22

THE SQUARE=-=zo....~

E.D. Monaghan, M.D.Editor

Emma LisiAssistant Editor

Marie M. CimonCopy Editor

The Audio VisualDepartment ofThe MontrealGeneral HospitalDesign & Layout

We can't do itwithout you !

McGILL SURGERYALUMNI& FRIENDS

Les Servicesgraphiques, P.R.Printing

All photographscourtesy of TheMcGillSurgery Department

Write to us ! Send usyour news ! Contributions of $50.00 are appreciatedin ensuring the continued publicationof "The Square Knot" and supporting McGillSurgery Alumni activities. Pleasemakecheque payable to the McGill Departmentof Surgery and forward to Maria Bikas,McGill Surgery Alumni & Friends,The Montreal General Hospital,1650 CedarAvenue, Room: D6-136,Montreal (Quebec) CanadaH3G1A4Telephone: (514) 937-6011,ext.:2028Fax: (514) 934-8418.

We want to hear from our readers!If you have any information you want published inTHE SQUAREKNOT, comments about our newsletter

or suggestions, we want to hear from you!Send submissions to:

E.D. Monaghan, M.D .• Editor' THE SQUAREKNOT· The Royal Victoria Hospital687 Pine Ave. w., Room: 510.26, Montreal (Quebec) Canada H3A 1A1

CALL US at: (514) 842-1231, local 5546 FAX US at: (514) 843-1503E-MAIL USat:mbikas@is.mgh.mcgill.ca

emma.lisi@staff.mcgill.caedmond.monaghan@muhc.mcgill.ca

MOVING?If you change your address, or if you knowsomeone who would like to receive thisnewsletter, please drop us a line.

Sponsors of the McGillDepartment of Surgery

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