OUR SURGICAL HERITAGE

Dr Anthony Dobell, Legendary McGill Trailblazer: May 7, 1927, to June 17, 2015 David S. Mulder, MD Montreal General Hospital, Montreal, Quebec, Canada

Anthony R. C. Dobell died on June 17, 2015, at the age of 88. Dobell was the first Canadian president of the Society of Thoracic Surgeons. He was a pioneer in the development of pediatric and adult cardiac surgery at McGill University. He was inspired by Dr John Gibbon during his residency training at Jefferson Medical College in Philadelphia. He

developed a McGill-based residency in Cardiothoracic Surgery and always took pride in the legacy of more than 40 residents scattered throughout North America. (Ann Thorac Surg 2015;100:2408–10) Ó 2015 by The Society of Thoracic Surgeons

MISCELLANEOUS

T

ony Dobell (Fig 1) was born in Montreal on May 12, 1927, at the Royal Victoria Hospital, the hospital he later served as a cardiac surgeon. Tony’s father was born in Quebec City, had his early education at a boarding school in England, received a law degree from McGill University, and practiced in Montreal. Tony’s mother was also a Montrealer and an artist by vocation. Tony’s preliminary education was at Selwyn House School in Montreal. The sudden death of his father in 1941, when Tony was 12, resulted in his transfer to Bishop’s College School, a boys’ boarding school in Lennoxville, Quebec, where he completed his high school education. He graduated at the top of his class and excelled at all sports, particularly hockey and football. He earned a science degree from McGill University in 1949 before entering medical school, and received his MD CM from McGill in 1951. His all-around contributions to the university were recognized by his appointment to the Scarlet Key Society (1945–1947), which he served as president in 1946. He also sat on the Students’ Athletic Council. Dr Dobell was proud to have been goaltender for the McGill Redmen hockey team, both as an undergraduate in science and also during his time in medical school. Tony, in his modest way, always downplayed his level of play, but reliable sources tell me he could have played in the National Hockey League if he had wished to pursue this route. He was also a valued member of the McGill intermediate rugby team. This varsity athletic experience explains his lifelong participation in tennis and in alpine skiing at Mont Tremblant, and his critical assessment of both university and professional teams in Montreal. I believe it also developed in his mind the important role of a comprehensive team approach for successful cardiac surgery. While an undergraduate science student in the summer of 1945, he was working as a lifeguard at a Laurentian resort and met an elderly judge from Philadelphia [1].

Address correspondence to Dr Mulder, Montreal General Hospital, 1650 Cedar Ave, Rm L9-512, Montreal, QC H3G 1A4, Canada; e-mail: david. [email protected].

Ó 2015 by The Society of Thoracic Surgeons Published by Elsevier

Fig 1. Dr Anthony R. C. Dobell.

The judge offered to help with Tony’s medical education and introduced him to an individual he had helped through medical school and was now a surgeon in Philadelphia. This opened the door for a visit to, and enrollment in, Jefferson Medical College, where he met Dr John Gibbon, Gross Professor in Surgery. On completion of medical school, he did the customary rotating internship at the Montreal General Hospital. His second 3-month rotation was at the King Edward 0003-4975/$36.00 http://dx.doi.org/10.1016/j.athoracsur.2015.08.038

Ann Thorac Surg 2015;100:2408–10

OUR SURGICAL HERITAGE MULDER DR ANTHONY DOBELL

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Fig 2. Dr Anthony R. C. Dobell with Dr Christo Tchervenkov, inaugural recipient of the Dobell Chair in Pediatric Surgery.

Victoria Hospitals with this goal in mind. The response was cool, and he was given an appointment in the McGill Department of Surgery as a teaching fellow [1]. He began doing research using a series of primitive heart-lung machines to carry out intracardiac surgery in the Donner Building laboratories. He had the good fortune to meet Dr David Murphy, Sr, who was performing closed pediatric cardiac procedures with Dr Gordon Karn. They agreed to teach Dr Dobell the conventional closed pediatric cardiac surgical procedures of the day. Tony agreed to help them move to intracardiac surgery at the Montreal Children’s Hospital. The Children’s Hospital team began open heart procedures on animals in 1957 [1]. The dramatic results from two Minnesota centers (headed by C. W. Lillehei in Minneapolis and John Kirklin in Rochester) led the team to visit both centers. The initial animal operations used the De Wall apparatus. Simultaneously, the team began using hypothermic cardiac arrest for simple procedures such as atrial septal defect closures and opening a stenotic pulmonary valve. The initial results with open procedures were discouraging, and the program ceased. A further visit to Rochester resulted in a switch to the Gibbon’s pump oxygenator and later to a screen oxygenator. The original operations were all done with the use of right atrial or ventricular incisions on a beating heart. Aortic crossclamping and potassium cardioplegia soon followed. By 1959, Dr Dobell was working with Arthur Vineberg at the Royal Victoria Hospital on adult cardiac procedures using a commercially available Gibbon’s heart-lung apparatus. With the encouragement of H. Rocke Robertson, Dr

MISCELLANEOUS

Hospital in Bermuda. He was stimulated to a surgical career by working with a superb surgeon, Dr Mark Kaufman [1]. This prompted a letter to Dr John Gibbon, whom he had met earlier as a medical student, and led to a 4-year residency in general and thoracic surgery (1952– 1956). His second year was spent in the research laboratory, where he was assigned to Dr Gibbon’s effort to develop a heart-lung apparatus, supported by engineers from I.B.M. In May 1953, Dr Dobell was in the operating room when Dr Gibbon closed an atrial septal defect in a 16-year-old girl [2]. This was the first successful open heart procedure in which a pump oxygenator was used, and Tony provided the nighttime care of this patient, including 2-hourly “resuscitative rounds.” Tony developed a special relationship with Dr Gibbon that went far beyond surgical education. Early in the residency, he was invited to Dr Peter Herbut’s home along with Dr Gibbon and three major departmental directors, who were all McGill graduates and welcomed him to Jefferson, offering advice and support. Dr Gibbon met with Dr Dobell at subsequent surgical meetings and continued a friendly tennis rivalry [3]. Tony summed up his Philadelphia experience by noting that John Gibbon was a teacher and enhanced his surgical knowledge, John Templeton taught him surgical technique, and George Willauer showed him humanism in surgery. Tony Dobell made it clear that his major thoracic surgical exposure was in pulmonary and esophageal resection, but very little in cardiac surgery! Tony returned to McGill in 1956 determined to further the scope of intracardiac surgery at McGill. He approached both the Montreal General and the Royal

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Dobell and Dr Harry Scott began open cardiac surgery at the Montreal General Hospital. General thoracic surgery was done at the Montreal Chest Hospital by Dr Dag Munro. Open cardiac procedures progressed rapidly at the three McGill units. New recruits opened up the field of direct coronary artery bypass and valve procedures. Dr Dobell led a team at the Royal Victoria Hospital to a successful heart transplantation on November 3, 1968. This program was encouraged by the then Chair of Surgery, Dr L. D. McLean. It continues today as one of Canada’s outstanding cardiac transplantation units. Dr Dobell’s administrative skills and his team-building leadership were vital in the move from a hospital-based residency to a McGill University program that used all the resources at the three adult hospitals and the Montreal Children’s Hospital. He did this as Surgeon-in-Chief at the Children’s Hospital and Director of the McGill Division of Cardiovascular and Thoracic Surgery (1974– 1992). Simultaneously, he was Chair of the Specialty Committee of the Royal College of Physicians and Surgeons of Canada. He developed national standards for the specialty and achieved recognition for Canadian programs with the American Board of Thoracic Surgeons. One of the keys to the McGill-based residency was the concept of the Stikeman Visiting Professorship, which was inaugurated in 1968 by Dr Dag Munro and Dr Tony Dobell after the death of a patient with malignant mesothelioma. This has allowed an annual visiting professor from anywhere in the world to visit McGill, endowed by the Stikeman family. The visitor’s specialty rotates on a 3year cycle between Pediatric and Adult Cardiac Surgery followed by Thoracic Surgery. Dr Dobell expanded the annual professorship to invite all alumni of the program to return for this annual event. In his own words, “it is the glue that holds the division together!” Even though Dr Dobell retired in 1995, he remained the conscience and backbone of the division until his death. His trailblazing efforts for cardiac surgery have been widely recognized. He received Canada’s highest civilian honor, the Order of Canada, in 1996. He served in leadership positions in all cardiothoracic organizations in Canada but was proudest of his presidency of The Society of Thoracic Surgeons in 1982. The title of his presidential address was “The Human Touch” [4], which was

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characteristic of his own personal approach to his role as a cardiac surgeon. The McGill University Faculty of Medicine and the Montreal’s Children’s Hospital established the Anthony Dobell Chair in Pediatric Surgery in 2012 to recognize his monumental contributions to both pediatric and adult cardiovascular thoracic surgery. The first recipient of this chair is Dr Christo Tchervenkov (Fig 2), the current Director of Cardiac Surgery at the Montreal Children’s Hospital. An important aspect of Dr Dobell’s McGill legacy is the impact he had on the careers of all of his residents. Dr Dobell was blessed with a unique ability to express himself clearly and succinctly. He attributed some of this to Dr Gibbon, whom Tony described as having “a remarkable ability with the English language spoken and written” [3]. His discussion of current residency work hours as related to his own perception of his residency schedule at Jefferson involved a Wordsworth quote: “Bliss was it in that dawn to be alive, but to be young was very heaven” [2]. Tony and his wife Cynthia, who died in 2006, brought up four children—Karen, Curzon, Julie, and Sarah—all of whom enjoyed an active life with family weekends in Muskoka, Ontario. Julie is an anesthesiologist in Utah. The family enjoyed competitive skiing, sailing, and tennis. Tony participated well into his 80s. He is survived by his second wife, Marion Doheny. Dr Dobell concluded his presidential address to The Society of Thoracic Surgeons with his definition of surgery: “It is the care of one human being by another; a relationship involving to some extent technology, science, art, and business; a relationship involving invasion and manipulation on one individual’s body by another; a relationship requiring the human touch” [4].

References 1. Dobell ARC. Early Cardiac Surgery at McGill: Reminiscences. Square Knot, Winter Edition, 2012. 2. Stoney William in the Annette and Irwin Biomedical Library at Vanderbilt University Medical Center. http://www.mc. vanderbilt.edu/diglib/cardiac_surgery/dobell.html. 3. Dobell ARC. John H. Gibbon, Jr., Part II: personal reminiscences. Ann Thorac Surg 1982;34:342–4. 4. Dobell ARC. The human touch. Ann Thorac Surg 1982;34:1–5.

Dr Anthony Dobell, Legendary McGill Trailblazer: May 7, 1927, to June 17, 2015.

Anthony R. C. Dobell died on June 17, 2015, at the age of 88. Dobell was the first Canadian president of the Society of Thoracic Surgeons. He was a pi...
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