From clinician to researcher to administrator — Dr. Melissa Forgie’s career touches just about every area of healthcare as we know it. She’s treated patients, conducted practice-changing research, and now, as Vice President of Medical Education at The Ottawa Hospital, Dr. Forgie is shaping the next generation of healthcare providers.

With an M.D. from uOttawa, two specialty certifications — in internal medicine and hematology — from the Royal College of Physicians and Surgeons of Canada, a fellowship in thromboembolic diseases, and a Master of Clinical Epidemiology, Dr. Forgie has been a part of The Ottawa Hospital since 1995, when she first joined as a medical consultant, later taking on a clinical investigator role doing research into thrombosis — when blood clots block veins or arteries.

Dr. Forgie took some time to tell us about how her career has been shaped by falling in love with internal medicine, going on maternity leave, and hope for the exciting possibilities of the new campus development of The Ottawa Hospital.

Q: Can you tell us a little bit about your early years and where you grew up?

A: I was born in Washington, D.C., to a Scottish father and a British mother. My father was a military physician at the Walter Reed Military Hospital at the time I was born, and then I grew up all over the place. My formative years were in Germany, but I was a Canadian citizen by grade school. I was raised with all the Scottish traditions though — I love bagpipes, oatmeal, and wear the family tartan.

Q: How did you decide you want to pursue medicine?

“I never wanted to be anything else. From the moment I could say the word, I wanted to be a doctor.”

— Dr. Melissa Forgie

A: My grandfather was a doctor, so I’m a third generation Dr. Forgie. Some of my earliest, most vivid memories are of going on ward rounds with my father in Germany at the military hospital there. This is going to sound very nerdy, but I remember sitting in Germany with headphones on, listening to classical music and reading my father’s medical journals. His bedtime stories to me were about the parts of the eye. I’ve just always been a real sponge for anything medical.

Dr. Melissa Forgie and her father in their family tartan.

Q: Why did you choose internal medicine and hematology as your specialities?

A: For internal medicine, I was a third-year med student at the University of Ottawa, and it was back in the days when putting the student on the spot as initiation was acceptable. I remember one of the staff threw me into a room at the Civic and said, “you have two minutes to make the diagnosis.” Absolutely that would be unacceptable behaviour with a med student nowadays, but fortunately I managed to come up with the diagnosis, and the rest is history. I just really liked the challenge of no one knowing what’s going on and multisystem disease and illness, so I gravitated towards that.

Then, hematology appealed to the science nerd in me. It’s a speciality where there’s the lab and basic science happening right at the bedside. You’re looking at the molecular basis of disease in the patients.

Q: What were your first years practicing like?

A: I started off in a very heady, stimulating, awesome time back in the mid-to-late ’90s — we were literally doing practice-changing research. It was the early days of thrombosis research. I was the first thrombosis fellow in Ottawa way back in the dark ages, and now we’re the biggest thrombosis fellowship program in the world.

But there were some glass ceilings. I was the first woman in Canada with a career-funded research grant through the Medical Research Council to take a maternity leave. They had no maternity leave policy back in those days. I had to fight some pretty intense battles to get these policies in place.

They were challenging and interesting times, but lots of fun.

Tim Kluke, Dr. Melissa Forgie, and Cameron Love at The Ottawa Hospital’s President’s Dinner, held at the EY Centre Tuesday, June 13, 2023.

Q: How did you get involved in medical education?

A: I was having a lot of fun on the research track; this would have been in the mid-to-late ’90s. To be a principal investigator then, you had to be travelling all over the world, and that’s how you got your grants, by giving public presentations and attending investigator meetings.

I remember exactly when I realized I couldn’t do this anymore. I was pregnant with my second child, it was a snowstorm, I was driving from an airport to an investigator meeting, and I just thought, “I can’t do this. I’m miserable, and I’m away from my daughter.”

I thus made the difficult decision to step away from being a clinician investigator. I was already doing some teaching at that point, so I was straddling these education and administration roles, and it was a steppingstone into medical education and advocacy for learners. The rest is history as I moved up the medical education hierarchy, and my current job — Senior Vice Dean and Vice President Medical Education — is without doubt, the best job in the world. You can advocate for all learners and make change.

There’s a real link between the learning environment and patient outcomes. We joke that specialists don’t just emerge from the uterus as fully trained physicians. There’s a whole process, and we know the better the learning environment is, the better physicians they’ll be. It all boils down to my most important driving force, which is the patient.

“Clinical care looks after patients today; education is looking after patients tomorrow.”

— Dr. Melissa Forgie

Q: What makes The Ottawa Hospital stand out on the international stage?

A: I can mostly speak to my very niche areas, which are thrombosis and education.

Back when I started, I went to a course at Harvard right before my Royal College exams, and when I showed up, they said, “You’re from Ottawa, you’re one of them cowboys who treats pulmonary embolism patients as outpatients!”

Even now, when we as thrombosis specialists travel, everywhere else in the world is sort of like, “Oh my gosh, you’re from Ottawa?”

“In Ottawa, we’re heavy hitters in medical education.”

— Dr. Melissa Forgie

We are uniquely poised in Ottawa in that we have a large adult hospital, a children’s hospital, and a number of specialty hospitals. So, we have a rich learning and teaching experience, we have depth and breadth, and we have some unbelievably well-known medical education researchers.

There are so many pockets of excellence where we’re absolutely world leaders in clinical care, clinical research, and education. We’ve got it going on, but people just don’t know about it. We don’t blow our own horn; I think that’s a bit of an Ottawa thing.

Q: What will a new, state-of-the-art health and research campus to replace the aging Civic campus mean for your patients?

A: For me, what resonates is that the technology will profoundly improve patient care. From virtual reality (VR) to artificial intelligence (AI) — it’s all really inspiring.

I also love the sustainability piece, the planetary health piece. Healthcare provision is one of the most wasteful industries on the planet, and it’s where we really need to up our game. I’m hopeful that this will be a huge part of the infrastructure in terms of the capital and basic operations.

What also excites me is that this will be a leading facility that will attract and retain top talent.

Q: Where would we find you when you’re not at work?

A: I do some volunteering for disadvantaged youth and other not-for-profit board work, and I’m also a big animal rights person.  I used to have 15 pets because we would rescue animals. The list is a bit smaller now, but we still have a fair array of beasts. People joke that I should have been a vet.

I have two adult children; my daughter is a lawyer on Wall Street living the dream, and my son is an officer in the Canadian Armed Forces currently deployed for the Ukraine war effort.

My husband’s a lawyer, and I met him in Grade 4. I was the weird kid with a funny accent and funny clothes. He took me under his wing, and the rest is history. We can have three-hour conversations with one look. We live on a five-acre property out in the woods; I love to wander around my beautiful, wooded paradise with my dogs, just 20 minutes from the hospital.

Dr. Melissa Forgie snowshoeing with her dogs.
Dr. Melissa Forgie and her husband.

From Naval Officer to award-winning researcher

Meet orthopaedic surgeon Dr. Paul E. Beaulé

Dr. Paul E. Beaulé considers it a privilege to practice his art. The former Chief of Orthopaedic Surgery at The Ottawa Hospital (2015-2021) has spent his career refining and redefining this art — specializing in the preservation and replacement of hips while maximizing patient outcomes. When he’s not working directly with patients, Dr. Beaulé works as a scientist at The Ottawa Hospital, Director of Research and Innovation for the University of Ottawa Orthopedic Program, and more recently, Chief of Staff at Hawkesbury and District General Hospital.

With more than 350 papers and 200 lectures and workshops in several areas in orthopaedic research to his name, Dr. Beaulé is among the top 2% of most-cited authors in the world in the field of orthopaedics.

Despite so much on to go, Dr. Beaulé found some time to tell us more about what drives his research and why a better healthcare provider experience means better patient care.

Q: Can you tell us a little about your early years?

A: I’m originally from Quebec City. My first language is French, but my father sent us to English school, which was somewhat unusual in the ’70s, at the height of separatist movement. I always felt outside the box, outside the norm of practice, like I was challenging the status quo. That, I think, was a key foundation to some of my character or personality today.

I was also heavily involved in Sea Cadets. You define your area of interest within a larger organization — I was in band — and move up the ranks. It showed me how to follow a leader but also how to become a leader, and how to integrate with people of all walks of life. I was a musical instructor, and when you take a group of young teenagers and not only make them play an instrument but also play together and perform together, to me, it showed the importance of teamwork, collaboration, and education, which translated through my career as a researcher, educator, and leader.

Dr. Beaulé (far right) as an officer with the Sea Cadets

Q: What drew you to medicine, and specifically to orthopaedics and research?

A: I became interested in medicine early on. I like it in terms of the stability, knowing your role. We had a close family friend who was an orthopaedic surgeon, and I heard what he’d dealt with. The technical aspect of orthopaedics and giving people back their quality of life is what drew me to the speciality.

I wasn’t really aware of the level of research intensity you could achieve in orthopaedics until I went to Los Angeles in 1998 for two years of fellowship — one at University of California, Los Angeles (UCLA) and one at University of Southern California (USC). There, I discovered that musculoskeletal research, which is the core of orthopaedics, has this reach in so many other fields of science. There’s a capacity to innovate on so many fronts, in terms of how you do your procedures, what implants we use, how we influence patient recovery, and just the sheer magnitude of the disease burden — musculoskeletal diseases are the number one chronic disability in the world!

Q: Can you tell us about some of the research you do at The Ottawa Hospital?

A: My research on hip disease and biomechanics was influenced by my years in Los Angeles, where I worked with two internationally renowned hip surgeons who opened my eyes to how hip surgeries can be quite versatile. We brought together a group of multidisciplinary investigators — in medical imaging, human biomechanics, and health sciences engineering — and built out a research program to look at patient outcomes, and for which we received several Canadian Institutes of Health Research (CIHR) grants. In 2018, we were awarded the Kappa Delta Award, which is the top research award in the world for musculoskeletal research, from the American Academy of Orthopaedic Surgeons. We were only the second group in Canada to get it. The program has continuously evolved since.

We collect patient-reported outcome measures (PROMs) in one of the largest platforms in Canada covering all orthopaedic specialities. We’re pushing the envelope when it comes to assessing how we do things better.

Another aspect of my research is the quality of care in orthopaedics and overall, within medicine. It’s mainly looking at how to improve the efficiency of our processes. I’m also looking at the healthcare provider experience, which has been at the forefront of HR challenges since COVID. It’s important because when you have a good healthcare provider experience, that impacts patient experience, and we’ll have a sustainable workforce.

Getting her life back

Plagued by discomfort and pain her entire life, Amy Volume was diagnosed with juvenile rheumatoid arthritis at the age of 18 months. She turned to our orthopaedic surgical team in hopes of finding a solution to her suffering.

Q: What will the new campus development mean for your patients?

A: I think the new campus will help the patients in regard to their experience, but also the healthcare worker experience. We’ll have an improved workflow through the new layout and through the integration of technology and access to the most advanced imaging. This will all ease the patient’s journey, both mentally and physically.

A rendering of the new campus development.

Q: Where would we find you when you’re not at work?

A: The key is variety, and I squeeze in leisure where I can. The days are jampacked with work; some days I’m in Hawkesbury in the morning, have various administrative meetings, head back to Ottawa where I’ll provide clinical care, and then I’ll often have another couple meetings in the evening. If I finish early, I’ll go play a round of golf. Golf is something I enjoy tremendously. When I have work at the Civic or General campus, I’ll bike to work. The bike paths are a beautiful aspect of Ottawa: if I go to the General, I bike along the Rideau, if I go to the Civic, I bike along the canal. I’m so privileged to be able to do that.

As the most common cancer, it’s no surprise there’s a lot of awareness around breast cancer. But there might not be as much awareness around the spectacular researchers and physicians who are changing the way we diagnose and treat breast cancer every day. The Ottawa Hospital is proud to say one of the most renowned of them works right here. Dr. Jean Seely is Head of the Breast Imaging Section at the hospital and a Clinical Investigator in our Clinical Epidemiology Program. Dr. Seely’s career is built on bringing research directly into patient care to improve the outcomes and reduce the mortality of breast cancer patients through better screening and diagnosis.

Read on to find out what Sci Fi innovation and personal family moment inspired Dr. Seely to become a breast radiologist.

Q: Did you always know you wanted to be a doctor — and specifically a breast radiologist?

A: I grew up in a family of doctors, so I was interested in being a doctor since I was five. My mother was a family doctor, and my father was a kidney specialist and worked in palliative care. My grandfather was a researcher and a doctor, and he always said medicine was the best field to go into — you could travel the world, teach, research, treat patients.

I knew I wanted to go into medicine, but I didn’t know much about radiology. After I completed med school in Montreal at McGill University, I did a general internship in Vancouver and realized how much I love to diagnose with my own eyes — to make early diagnoses. I remember watching Star Trek where they would use these machines to make diagnoses, and I thought that was something I wanted to do. [Editor’s note: those machines are tricorders.]

My grandmother died of breast cancer when I was four. She was diagnosed at 40, and it metastasized at 60. She would take care of me a lot, so I was very close with her. Looking back, she was instrumental in me going into breast radiology.

Q: How has the field of breast radiology changed since you started?

A: It’s dramatic! When I was in medical school in the ’80s, it’s when the old Canadian National Breast Screening Study was just being done. Nobody was really talking about screening before that; they didn’t pay attention to the quality of the mammogram. You’d get surgery to get a lump removed, and they’d diagnose it as cancer — or not.

“Not only can AI help with risk prediction, but it can improve the accuracy of the read of mammograms by 20%.”

— Dr. Jean Seely

What we do now is a mammogram and an ultrasound. We do a biopsy to see whether you have cancer, and you only get surgery once you have a proven diagnosis of breast cancer.
We have all these tools now that allow us to see cancer before it’s felt. In the ’90s, we started using MRIs for breast cancer, which is basically the most sensitive test for breast cancer. We now use ultrasound to screen — and to guide the needle for the biopsy.

We even have AI, and we can use the imaging components, pixels that are below the threshold of our eye, to predict whether someone will get breast cancer or not. Not only can AI help with risk prediction, but it can improve the accuracy of the read of mammograms by 20%. Some people say AI will take over the radiologist’s job, but I’m not at all worried about that. We do a lot of patient-centred care. We talk to patients, do biopsies, scanning — a lot of hands-on care on with patients.

Q: You’re leading the Tomosynthesis Mammographic Imaging Screening Trial (TMIST) and recently reached 2,000 participants. Can you tell us a little more about this?

A: TMIST is a multi-centre trial, happening at hospitals around the world. We’re looking to recruit 160,000 patients, and we’re at 100,000. At The Ottawa Hospital, we have 2,000 of those patients.

It’s a randomized controlled trial, so patients go into one of two arms: one is the regular screening for breast cancer using a 2D mammogram, and the second is 3D tomosynthesis, which uses a different technology.

Tomosynthesis isn’t a true 3D image, because it doesn’t go all the way around the breast, but it’s a pseudo-3D, where using a very low radiation dose, we get a sweep of images. With 2D imaging, sometimes the compression of the breast creates an overlap of tissue that makes something look like a mass or a density of tissue hiding a cancer. The 3D technique has been shown to reduce the number abnormal recalls — where patients don’t wind up having cancer — and increase the cancer detection rate by 40%. It’s a win-win, where you have fewer abnormals that are truly normal and you have more abnormals that are truly abnormal cancers.

Some people might say, “Why are you studying it if you know it’s so much better?” But we haven’t studied it in a randomized control trial in a very large population. We’re looking to see if it reduces the rate of advanced breast cancers after eight years and if a broad range of people will benefit.

Q: What is The Ottawa Hospital doing in radiology and breast health that is exciting or groundbreaking?

A: What I love about The Ottawa Hospital is that there’s always been this attitude of being the best and trying for excellence — of trying things out and working together to make things happen. And it’s not always necessarily led by physicians — it’s very much a joint relationship between administrators and physicians.

I’ve been here since 2001, and when I’ve gone to meetings or elsewhere, I realize this isn’t the norm. This kind of collaborative approach for innovation and excellence is something we should be very proud of.

Specifically, we’ve implemented things like improving how we locate tumours that were found in screening. It sounds barbaric now, but we used to insert a wire in the patient’s breast on the day of their surgery, and it would be hanging out of the breast, and they’d use the wire to locate the tumour for removal. But now, instead of the wire, we use a tiny little “seed,” almost the size of a grain of rice, with a tiny amount of radiation. The surgeon uses a Geiger counter to find it. It saves money, reduces delays, and improves patient satisfaction — it really revolutionized the approach. We were the third site in Canada to implement this.

We’ve also reduced the amount of time it takes to get an MRI. We used to screen women at higher risk, or those with dense breast tissue, for 45 minutes. We shortened it to 12 minutes. There’s been a huge improvement in patient satisfaction, outcomes, and capacity. Research helped provide this benefit. We were also one of the first in Canada to do this.

Q: If someone has just been diagnosed with breast cancer, what advice would you give them or how would you respond to them?

A: The key when I talk to patients is that there is always hope.

I think the whole reason why it’s important to do this is to undo some of the fear of the diagnosis of breast cancer. One in eight women will get breast cancer. Nobody wants to deal with it, but it’s something we have to be aware of. We have these great tools and wonderful people who are committed to diagnosing and treating it. That’s my hope with this, to provide encouragement.

The Rose Ages Breast Health Centre at The Ottawa Hospital is committed to providing an exceptional level of care for our patients, approaching each case with medical excellence, practice, and compassion.

Unfortunately, there are some people where they present really late, and when they get diagnosed, it’s already spread. That’s harder for us to deal with. That’s one of the reasons I do so much research — because I’m always trying to reduce that advanced cancer rate.

The key in these cases is compassion. My father was a palliative care physician and he always said he learned the most about living through dealing with the dying.

Q: What would we find you doing when you aren’t at the hospital

A: I get a lot of inspiration from my two children and my wonderful husband and friends as well as my three siblings. You might find me in the Gatineaus riding a bike. I also love to ski — cross-country or downhill. I get a lot of benefit from doing exercise in the outdoors. I also love to read — anything with good storytelling — one day I’ll write a book.

Dr. Dar Dowlatshahi is a stroke neurologist and scientist at The Ottawa Hospital and the scientific director of the Ottawa Stroke Program.

If Dr. Dar Dowlatshahi looks familiar, maybe it’s because you’ve received care from the accomplished stroke neurologist here at The Ottawa Hospital, or maybe you’ve seen him playing a tourist in his own city, or maybe you watched Med Students back in the day — the documentary on medical students at McMaster University that featured Dr. Dar, as he’s known to patients, as one of its subjects. If he’s not familiar to you yet, get ready to meet one of the research powerhouses shaking things up at The Ottawa Hospital.

Dr. Dar grew up in Iran, lived briefly in France, and then moved to Canada in 1979 with his family. He moved around quite a bit during his youth, eventually settling in southern Ontario, which is where he earned three degrees — a Bachelor of Science, a PhD in Neuroscience, and an MD, all at McMaster in Hamilton — before completing a stroke fellowship in Calgary.

Today, Dr. Dar is a stroke neurologist and scientist at The Ottawa Hospital and the scientific director of the Ottawa Stroke Program.

Read on to learn which exciting developments in stroke neurology would have seemed like “science fiction” just two decades ago — and how Dr. Dar stays busy when he’s not working.

Q: How did you decide to pursue neurology?

A: When I started university at McMaster, I was studying the sciences, but I didn’t know exactly what I was doing and where I was going. Early in my undergrad, I took a psychology course and fell in love with the brain portion of the work. I went on to do a PhD in neuroscience, followed by med school. But even then, I had no intention of being a psychiatrist or neurologist.

I tried everything from general surgery to cardiology, but the surgeons kept telling me I should be a neurologist. It was always the one thing that was very easy for me; where I could walk into the situation and feel like I already understood it.

Q: What do you love about stroke neurology in particular?

A: What I like about neurology is the action. Often, people don’t see neurology as an action field, they see it as an intellectual field. But when you watch all those action movies, with these guys making decisions and saving lives, that really does happen in the world of stroke.

Dr. Dar Dowlatshahi is a neurologist and researcher at The Ottawa Hospital.

“With stroke, with the snap of the fingers, the brain can be gone. And you’re the person who can, during that snap of the fingers, save that brain.”

— Dr. Dar Dowlatshahi

You have to make these decisions, which can have massive implications, all within seconds. With stroke, with the snap of the fingers, the brain can be gone. And you’re the person who can, during that snap of the fingers, save that brain.

When someone has a stroke, it can change their life — and the lives of everyone around them. But there’s a system in place to bring them to the Civic Campus, the only hospital in the region that can reverse this, where a group of highly trained specialists arrive to make the decision to give you a drug or treatment that can stop the changes that are happening.

I don’t know how many of these patients realize how different the outcome could have been. But being right here in Ottawa means they’re back home the next weekend with a bit of a story to tell, but otherwise carry on as though nothing ever happened. You get to be a part of that.

Q: How has the field of stroke research and care changed since you started out?

A: It’s changed completely. When I was in my first year of med school, we did clinical work where I was in the room when a stroke happened. There was nothing that could be done at the time, but today, with that same patient, we’d have been able to reverse the stroke.

“The action that’s taken today when a person has a stroke would have been science fiction in my first year of medical school.”

— Dr. Dar Dowlatshahi

I saw the first round of breakthroughs in the first five to 10 years of my career. These were advancements in our knowledge of how to use clot-busting medications.

Then, I was part of the team here at The Ottawa Hospital who brought the next set of breakthroughs, which was thrombectomies to remove clots from the brain. It’s now standard care.

Dr. Robert Fahed navigates a catheter through a model of the circulatory system to replicate how a thrombectomy is performed.

A third round of breakthroughs came with imaging software that gave us the technology to better understand what was happening to people in the first few hours after a stroke.

The action that’s taken today when a person has a stroke would have been science fiction in my first year of medical school.

Q: As a scientist at The Ottawa Hospital, you’re working on an important trial for the treatment of a very dangerous type of stroke. Can you tell us more about that?

A: The breakthroughs I described before are all for ischemic stroke. Unfortunately, for the other major type of stroke, intracerebral hemorrhage, we’ve not had the same level of discovery and advancement in the last 20 years.

This trial, called FASTEST, is for intracerebral hemorrhage, or ICH. About 40% of people who experience an ICH will die within the first month, and of those who survive, about 80% are disabled. It’s by far the worst stroke.

The Ottawa Hospital is the national lead on this trial, which is looking at a medication that’s a clotting factor, or protein, that’s already in your blood stream, and the drug is a concentrated form of it.

When any blood vessel tears, your own clotting factors try to fix the tear. Your vessel first releases something to sort of raise a flag to say, “the trouble is here.” The factors circulating the body looking for trouble see the flags and congregate at the site and form a clot, which is essentially a plug.

In this trial, we’re trying to get these clotting factors to go into superhuman mode. It gets injected into the blood stream, it courses through your veins, it gets to the target, and then immediately starts to form a clot to stop the bleeding.

Q: What is some of the other exciting research happening here at The Ottawa Hospital?

A: In stroke alone, we’re doing work on new catheters to pull clots out of the brain, we’re working on imaging to advance our ability to find treatable patients, and we’re bringing in new scientists to develop new clot-busting medications. We’re also looking at the connection between cancer and stroke and ways to prevent stroke. When it comes to stroke research, you name it, we’ve been in that space.

Q: As a neurologist, why do you work at The Ottawa Hospital?

“We’re a medium-sized city, but we’re on par with these famous international institutions.”

— Dr. Dar Dowlatshahi

A: When I started out in 2010, The Ottawa Hospital was doing stroke research, but it had room to grow. I had advanced training and the hospital had an interest in developing programs my areas of interest — cerebral hemorrhage and acute stroke therapies. Today, there’s a strong network of academic stroke physicians across Canada, and many of us have decided to call Ottawa home. We’re rich in stroke research culture. We’re a medium-sized city, but we’re on par with these famous international institutions.

We have this modesty we don’t need to have here. This is the capital; we should be the best. I wanted to be right where the heart — or should I say brain — of the country is.

Q: What would we find you up to when you’re not at work?

A: I’ve been playing in bands since I was 16. Music was my plan A, while medicine and academia were plan B. I went into medicine, but during the pandemic, a lot of people were holed up and went back to their old hobbies and things they wished they were still doing. Some colleagues and I started a band called Phenotype ─ I drum ─ and it’s just a lot of fun. It’s the opposite of what I do during the day, no one’s life is on the line.

I also enjoy going out and about the Ottawa area with my two boys and my wife. There’s a lot of really cool stuff when you live in a capital town. Rideau River Cruises, touring the Parliament Buildings, Beaver Tails in the market — all that stuff that you would only expect tourists to do, you’ll see me there.

Making great strides in the lab or on the dance floor

Meet Dr. Lauralyn McIntyre — sepsis researcher and clinician extraordinaire

Dr. Lauralyn Mcintyre is a physician and sepsis researcher at The Ottawa Hospital.

Dr. Lauralyn McIntyre’s path to The Ottawa Hospital wasn’t necessarily a direct one — it took her all over Ontario and out west to the mountains — but she couldn’t do her groundbreaking sepsis research anywhere else, or with any other team. 

Today, Dr. McIntyre balances her role as a critical care physician working clinically in the Intensive Care Unit (ICU) and with her role researching sepsis as Senior Scientist in the Clinical Epidemiology Program. 

Keep reading to learn what Dr. McIntyre moved out west for, why she came back, and what exciting new support her research recently received. 

Q: Can you tell us a little about your background and early years?

A: My father was in sales, and so we moved around a lot. I was born in Sudbury, then we lived in Winnipeg, Montreal, and Toronto.

A big part of my early life was figure skating. Skating was sort of dominant until I was 14, when due to long term injuries, I had to stop. I also grew and became five-foot-nine, which is not so compatible with skating!

Q: Did you always know you wanted to study medicine?

A: From a very young age, I knew I wanted to do medicine. I started volunteering when I was young. At 15, I started volunteering at a spinal cord centre in downtown Toronto and did that through high school. I guess I always knew I wanted to be in some kind of helping profession. 

But I was a bit of a “free spirit” when I was younger — and maybe even now! I needed to just go live in the world for a bit first. So, after my first degree in Guelph, I diverted and went out to Whistler and taught skiing for a year and a half. Then I went back to school, I got into medical school and went to McMaster.

Q: What made you settle in Ottawa and here at The Ottawa Hospital?

A: I came to Ottawa to do my internal medicine residency, then went back to Vancouver for my critical care fellowship, and finally, came back to Ottawa for my research fellowship and to do my masters in epidemiology.

Coming back to an established critical care research environment with really successful and collaborative scientists was super important to me. The clinical environment in the hospital’s ICU is like my second family.

"The clinical environment in the hospital’s ICU is like my second family."

— Dr. Lauralyn McIntyre

Q: Can you describe your current work at The Ottawa Hospital?

A: I am an ICU physician, or intensivist, looking after critically ill patients. And the other major part of my career is research, which over the years has focused on studying resuscitation and the stabilization of patients that have very severe infections in the intensive care unit.

For the first several years of my career, I really focused on the fluids we use in the ICU — which we use every day and have been around for decades. I was trying to figure out whether one type of fluid was superior to the other, and whether they could help our acutely ill patients and those with sepsis and septic shock survive.

More recently, I’ve been focusing on the study of mesenchymal stem cells (MSCs) for the treatment of septic shock. This program of research is super collaborative, and we collaborate with an internationally recognized group of critical care investigators called the Canadian Critical Care Trials Group. It’s really inspiring to work and collaborate with so many different sepsis critical care minds in Ottawa and throughout Canada.

Q: What exactly is sepsis?

A: Sepsis is caused by an infection, a bug — be it bacteria, virus, fungi. Many of us will get these bugs, and we’ll do fine. We’ll get a cold or maybe we’ll get a mucousy cough, and we might feel like hell for a couple days, but we recover from it. Sepsis occurs through our body’s response to that infection, and it, in part, will determine the severity of that infection. If how your body responds results in the failure of one or more organs, we call that sepsis. And if the infection becomes even more severe and causes shock, we call it septic shock.  

Some of this is a result of the genes you have, your genetic makeup, which can affect how you respond to a given pathogen. Other things, like how many other chronic illnesses you have, can also affect the severity with which you respond to an infection. There’s also environment, diet and physical fitness, and other external factors that can have an impact.  

You can pick up a bug externally, through an open cut, but you can also breathe it in like we do with COVID, influenza, or RSV. There are other ways, like through the urinary tract or the digestive tract, the latter of which has millions and millions of bacteria and fungi that live there even when we are healthy. But where bugs can wreak havoc is when they get into the blood stream.

To learn more about sepsis — the stages, symptoms, and how to avoid it — check out our full sepsis health profile.

"The only way we can do research in ICU settings is to have funding to support the research team and the research engine — meaning the manufacturing of stem cells and the recruitment of patients that make the research go."

— Dr. Lauralyn McIntyre

Q: You were awarded $1.3 million from the Canadian Institutes of Health Research and $1 million from the Stem Cell Network to conduct a Phase II clinical trial of MSCs in patients with septic shock — can you describe what this funding will help with and why it’s so important?

A: The UC – CISS II trial follows on an earlier study (CISS I) that suggested mesenchymal stem cells (MSCs) are safe when treating patients with septic shock. We saw some signals to suggest these cells also affect inflammatory markers in our blood stream that are related to sepsis. MSCs might hold immense therapeutic promise for the treatment of sepsis, because in animal sepsis models they seem to balance out the immune system again. We’re studying introducing MSCs when patients are in the very early phase of sepsis, when the immune system’s cascade response is peaking, to try and blunt the severity of this immune response.

The only way we can do research in ICU settings is to have funding to support the research team and the research engine — meaning the manufacturing of stem cells and the recruitment of patients that make the research go. Having this $1.3 million from CIHR and the $1 million from the Stem Cell Network has provided us with sufficient funding to really do an awesome trial. We’re good to go. We are just so grateful that our funding agencies believe in us, and we will follow through.

Dr. Lauralyn McIntyre with Christine Caron, who is a lead patient partner in sepsis research.

Q: Christine Caron was treated for septic shock at The Ottawa Hospital in 2013, and she has since become a patient partner in your research. What makes patient partners so important to your work?

A: Working with patient partners has been illuminating in many ways, and in particular regarding post-sepsis survivorship. In critical care, especially in clinical trials, we used to just focus on improving survival — at 28 days, three and six months, maybe out to a year — which is incredibly important. But there has been much less emphasis on the quality of that survival. Sometimes, patients (and their families) feel like they’ve been abandoned by our healthcare system; they receive care in the ICU and then the hospital wards, and then after they’re discharged, they’re on their own to follow up with their health care provider in the community, if they are fortunate enough to have one.

Patient and family partners really help us understand, as researchers, what aspects of quality of life are affected by experiencing a critical illness — and which aspects are most important to people in their lives. Working with these partners really inspires me to do the most rigorous research to answer scientific questions that will have a positive impact on patients’ lives.

Q: What would we find you up to when you’re not in the clinic or lab?

A: I love being outside, in the bush, just going for hikes. You could call the forest my soul food. I love not hearing anything, just being. We have a cottage in Tenaga (near Chelsea, Quebec) where a lot of my hikes span from.

Over the last couple months, I’ve also started ballroom dancing. There’s a very similar joy that I had when I figure skated. It’s just incredible; it feels like I’m on the ice again. Dancing for me is also like a therapy, as it has helped me with my grief after the loss of my husband Christopher, who died of cancer in 2021.

Besides that, the other big thing I love to do is spending time with my family — my daughter Maia and my dog Kiko, extended family, cousins, and dear friends. There are eight McIntyre families, all my dad’s siblings, who grew up in Ottawa. Several of the siblings and then their kids (my cousins) and their kids’ kids spend the summer in Tenaga at the cottage — the McIntyre’s go back there for over 100 years. Every summer, we’re all together, and it’s the most beautiful thing.

The Ottawa Hospital is a leading academic health, research, and learning hospital proudly affiliated with the University of Ottawa.

Infusing research with care

Meet Dr. Manoj Lalu, the clinician-scientist bringing lab discoveries to patients every day

Dr. Manoj Lalu is as much a juggler as a doctor, constantly balancing his roles at The Ottawa Hospital. He’s an Associate Scientist in The Ottawa Hospital’s Clinical Epidemiology and Regenerative Medicine Programs and an anesthesiologist for the Department of Anesthesiology and Pain Medicine. But Dr. Lalu’s unique position as a clinician-scientist means not only is he balancing these roles, he’s also blending them — his research is informed by his clinical work seeing patients and vice-versa.

From looking at how we can use stem cells to treat diseases like sepsis to dealing with patients directly in the ICU and OR, Dr. Lalu is making an impact behind the scenes and beyond.

Keep reading to learn what drew Dr. Lalu to The Ottawa Hospital and how he’s turning today’s research into tomorrow’s treatments.

Q: Can you tell us a little bit about your early years?

A: I was born and raised in Edmonton, Alberta, and it’s where I spent my whole childhood.

Growing up, I was mainly into music. I did piano and classical guitar for a number of years. My first paid job was actually as a back-up singer for a Christmas record.

I was also kind of a nerd; I really liked science. I liked the concrete nature of it, although what they teach you in school is quite different than what you learn when you actually start doing research; it’s a lot less clear cut in real life. I enjoyed doing experiments, and once made it to the regional science fair. I had a very simple experiment related to a pendulum, but I couldn’t compete with all these other people, who were doing things in cell cultures and other complex things.

Q: How did you get from high school science fairs in Alberta to The Ottawa Hospital?

A: I was looking for something that was biomedical in the sciences, which drew me to a Bachelor of Science in Pharmacology at the University of Alberta. In my first actual pharmacology class, we learned about all the different classes of medication and the different pathways through which they affect the body, and I thought it was so interesting.

Following my undergrad, I did a PhD in pharmacology, studying sepsis, and then did my medical degree — all at the University of Alberta. After graduation I got married, and my wife, who is also a doctor, was ready to leave Edmonton. We came to Ottawa so I could do my residency in anesthesiology in 2008.

To learn more about sepsis — the stages, symptoms, and how to avoid it — check out our full sepsis health profile.

Q: Today, you are a clinician scientist at The Ottawa Hospital, working as an anesthesiologist in the clinic and as a scientist doing research in the lab, how do these roles complement each other?

A: There is something unique that a clinician scientist brings to research. In my job as an anesthesiologist, I interact with patients, I see what the problems are in the operating room when patients are critically ill and have things like sepsis or lung injuries. Seeing things in the real world helps us decide how to proceed in the lab.

And it goes both ways. Something I’m working on a lot is “bench-to-beside” research. We have lots of different exciting findings that we have in our laboratories. That’s the bench: working with pipettes and models and cells in culture dishes. But to actually move those exciting findings — sometimes they’re therapies, sometimes they’re ways to diagnose a disease better — into clinical care, where we could actually help patients with those findings, can be a difficult and long process.

Q: Can you tell us a little bit about The Ottawa Hospital’s BLUEPRINT Excelerator and how it relates to your work?

A: The hospital’s Excelerator is a program run by the BLUEPRINT Translational Research Group, which I co-lead, in collaboration with the Ottawa Methods Centre. The Excelerator helps bridge that gap I was describing from research discoveries to clinical trials and care. It goes back to trying to apply best principles to what we know works in the clinical world.

One thing we do quite a lot of is systematic reviews, looking at all the evidence out there for a specific therapy to better understand the risks and benefits.

We also look at the barriers patients face when participating in clinical trials, the economic evaluations of therapies, or assessing criteria to assess who might do the best in a clinical trial.

These might seem like common sense things, but they’re usually not done in a systematic way leading up to all trials. We think it’s important to take this rigorous approach, and it takes time and money to able to do this kind of work.

Q: Early on in your career at The Ottawa Hospital, you worked on Christine Caron’s septic shock case. What made her case stand out, and how does it relate to the research you’re doing today?

A: I helped take care of Christine when I was a resident doctor at The Ottawa Hospital. I remember her case so clearly because it was very unique. People who are healthy, like she was, rarely respond to an infection that severely.

The issue with sepsis right now is a lot of the treatments we use are supportive — meaning we might give the patient fluids because we need to keep their blood pressure high. But what we’re trying to do in my lab, and Dr. Lauralyn McIntyre’s group, is come up with some novel therapies to help the body heal itself when it has a condition like sepsis.

Right now, we’re running a multiple laboratory study on sepsis called the National Preclinical Sepsis Platform. We’ve done multiple centre clinical trials before — those are common — but this is the first Canadian multi-lab trial, where researchers in different labs, instead of clinics, are working together on the exact same trial.

“Sepsis took so much from me — it scarred me in so many ways. We need to advocate and educate because sepsis does not discriminate.”

– Christine Caron

Q: What keeps you working here at The Ottawa Hospital?

A: The same things that brought me here: my clinical department, and The Ottawa Hospital more broadly, have been very supportive of my research. Whenever I come up with an idea, the conversation starts with “how can we make this happen” as opposed to “here are 10 reasons this won’t work.”

I also enjoy my colleagues and patients, and we do so much here that no one else in the region does. It’s exciting to work in a clinical and research environment like this.

Q: Where would we find you when you aren’t at the hospital?

A: Spending time with my family. My wife and I met through research, she was a tech at the lab across from where I did my PhD, and she’s a family doctor here in Ottawa now. We have twin girls, and they take up most of my time now. We like to travel and snowboard.

The Ottawa Hospital is a leading academic health, research, and learning hospital proudly affiliated with the University of Ottawa.

Encyclopedias, an eclectic education, and a lot of care

Meet Dr. Paul MacPherson, the first Clinical Research Chair in Gay Men’s Health at The Ottawa Hospital and the University of Ottawa

Dr. Paul MacPherson is recentring the “care” in healthcare for gay men in Ottawa every day through his practice-changing work. As a clinician scientist at The Ottawa Hospital, Dr. MacPherson balances research and clinical work to make sure gay men receive the best care possible. Now, after two decades working in infectious diseases, with a focus on HIV and other sexually transmitted infections, Dr. MacPherson is taking gay men’s healthcare in new directions as the first Clinical Research Chair in Gay Men’s Health at The Ottawa Hospital and the University of Ottawa.

Read on to learn about Dr. MacPherson’s favourite hobby as a kid and what motivated him to go to medical school in the ’90s.

Q: Can you tell us a little about your background and early years?

A: I grew up in New Brunswick, and though I’ve lived more than half my life outside the Maritimes, I still identify strongly as a Maritimer.

Growing up, I was definitely a geek. My favourite thing to do on a Saturday morning was read the encyclopedia. I know that sounds pathetic, but I really did love reading all the biological things. I was very good in school, and the only thing I didn’t like was math.

Q: How did you decide to pursue the sciences and medicine?

A: When I started university, I enrolled in a Bachelor of Arts, taking psychology, biology, classical Greek studies, English literature, and French. I liked that one hour I was in the biology lab and the next hour I was reading ancient Greek literature.

In my second year, some people slapped me across the head and told me I needed to get some focus. They said, “there’s no jobs for people in classical Greek studies and biology!” So, I switched into a Bachelor of Science in biology. I was offered graduate positions in physics, chemistry, math, French, and biology. There was no way it was going to be math or physics, so I went to the University of California at Berkeley to do my PhD in molecular biology. There, I studied the papilloma virus and the proteins that were involved in replicating the virus.

After a post-doc in neuroscience, I started a second post-doc in HIV in Ottawa. We’re talking early ’90s, at the real peak of the AIDS crisis, and a couple things coalesced for me: I came out and accepted that I am gay, and I realized I was actually a virologist. I saw gay men all around me suffering; they were not being treated in a way that would make you feel good. There was a lot of stigma, and let’s just say it was not a very happy time.

"I wanted to roll up my sleeves and wade into the muck and help."

Dr. Paul MacPherson

I went to medical school specifically to be involved in HIV medicine and HIV care — I wanted to roll up my sleeves and wade into the muck and help. I wanted to make sure gay guys were treated appropriately and with respect — not blamed for acquiring a viral infection.

Q: How have things changed since you first started working in HIV and gay men’s health in the early ’90s?

A: Things have changed enormously, certainly from a medical perspective. When I first got involved and went to med school, HIV was something people eventually died from. We were really trying to mitigate opportunistic infections and make the passage from health to illness to death as comfortable as possible, as people progressed eventually to AIDS.

HIV treatment now is generally one pill, once a day. Now, we even have injectable medications. The legacy of horrible side effects is gone. From a medical perspective, it’s really easy. It’s effective. People with HIV really can live out a normal life. Today, most of my HIV clinics are very social, asking patients: “How’s it going? How’s your life? Where did you go for vacation?” If you’d told me in the mid-’90s it would be like this today, I’d have been overjoyed, and I’d have found it hard to believe.

So yes, things are very good from a medical perspective. But, there’s still a lot of stigma and discrimination. People living with HIV still live with a heavy burden. We still have a lot of work to do and a long way to go there. I only wish we had come as far in that arena as we have with treatment.

Q: Why did you choose to work at The Ottawa Hospital?

A: The opportunity to do basic science research, which I did for 15 years, brought me to Ottawa. As I grew personally and delivered HIV care, I became more focused on that delivery of care, and I kept seeing that lack of a holistic view. Being gay was all about HIV, either having it or avoiding it, but being gay is really about being a person. We need medicine to see us entirely — as physical, mental, sexual, and social beings. So, I gradually moved away from basic sciences into what I do now: a focus on clinical care delivery. The thing about The Ottawa Hospital is, they let me do that. When I said, “I want to do more of this,” they said, “Fine, good on you.” No one said I couldn’t, and that’s unique in employment. They let me grow personally and professionally, and that provides motivation and allows for new ideas to come forward.

Dr. Paul MacPherson

Q: What is The Ottawa Hospital currently doing for gay men’s health?

A: We’re working towards better, relevant healthcare delivery for gay guys. We’re not there yet, but we’re working towards it and committed to it.

Currently, we’re developing a guide on primary care for gay guys that can be used by healthcare providers. If we want change, we need to stimulate and support that change. The other big thing is our website — HUGO, or Health Unlimited for Guys in Ontario. We have health information for gay guys and four learning modules for care providers on HUGO.

When we created HUGO, I thought the hospital would want nothing to do with it; there’s a lot of stuff about sex in it and sexual health. I thought they were going to slam the door in my face, but they didn’t. I asked, “Who actually looked at the website? Did you see some of the words in there?” I mean, the website uses common language and vernacular. We don’t talk about sex clinically. But, when I asked if they had actually seen it, they said, “Yep, we did.” I thought, “Man, that’s impressive.”

Kudos to The Ottawa Hospital for doing this. Not everyone’s going to step up, but they did it.

Q: How did this role come about?

A: It came from a community focus group discussion where we were talking about the barriers gay guys face in healthcare. One of the community members said, “Since there’s so much work to be done, why isn’t there a research chair in this area?” Initially, I didn’t think the hospital or university would support one. But this guy brought the idea forward to the Foundation and The Ottawa Hospital’s Research Institute, and there was immediate interest.

The purpose of the chair is to take a really broad, inclusive view of gay men’s health through education, clinical programs, and research so we can address their physical, mental, social, and yes sexual, wellbeing.

A big thing to emphasize is that gay men’s health isn’t just about HIV or sexual health. We need to be seen as full individuals.

Q: What do you hope to accomplish as the Chair in Gay Men’s Health?

A: What I’m really hoping is that this is just the beginning, the groundwork, as we make healthcare more relevant for gay guys.

Mental health is a huge issue. The prevalence of depression and anxiety in gay men sits in the mid to high teens, with anxiety higher in younger guys. Our data show 25% of guys find sex stressful.

We’re also looking at seniors in the community. Alcohol use is much higher in older gay men than younger men. We’ve found about 40% of senior gay guys live alone, and 45% don’t live in the downtown core. You can see there’s a population that’s living alone, outside the core, with heavy alcohol use, that’s not connected to sexual health services. Our concern is, based on their life experience from decades ago, maybe they don’t feel welcome in medicine. We need to find these guys and make sure they know they’re welcome — and bring them into gay-informed care.

"I also hope this will serve as a model for other minority health groups facing healthcare barriers: lesbians, transgender people, refugees, street-involved people etc."

Dr. Paul MacPherson

It’ll be a two-pronged approach: education and programming, and also reaching out to the gay population to make sure they know we’re working on this.

I also hope this will serve as a model for other minority health groups facing healthcare barriers: lesbians, transgender people, refugees, street-involved people etc.

Q: What would we find you up to when you’re not in the clinic or lab?

A: Like every other person, when I’m not at work, I’m at home doing housework! But two things I really like are languages and travel. I had a goal as a kid to speak seven languages. I fell far short of that and haven’t even mastered English yet, but I still enjoy languages. I’ve been very fortunate in traveling very broadly — highlights were Bhutan and Russia — and I consider myself blessed for all the different cultures and people I’ve been able to visit. 

The Clinical Research Chair in Gay Men’s Health is funded through the generous support of the Department of Medicine and community support through The Ottawa Hospital Foundation. The Ottawa Hospital’s Research Institute and the University of Ottawa helped make the Chair a reality through the Faculty of Medicine’s Clinical Research Chair program. Read more about Dr. MacPherson and what his vital new role will mean for patients.

A childhood revelation and rethinking what you know about bones

Meet orthopaedic surgeon Dr. Geoffrey Wilkin

When you break a bone, there’s a small window of opportunity to set it up to heal properly. No one knows this better than Dr. Geoffrey Wilkin, an Orthopaedic Trauma surgeon at The Ottawa Hospital. If a patient comes in with a traumatic injury, Dr. Wilkin knows he needs to come up with a plan, and fast. A properly aligned and healed bone can mean a world of difference for a patient’s recovery and restoring function in the affected area.

After an early interest in exercise science and an undergraduate degree in kinesiology, Dr. Wilkin became fascinated by the mechanism that allows bones to heal. Read on to learn more about these mechanisms and hear about his first encounter with orthopaedics at just 12 years old.

Q: Were you always drawn to medicine, and specifically orthopaedics?

A: As I’ve reflected on my career arc, there is one thing that might have had a bigger impact than I initially thought. When I was about 12, my younger sister was hit by a car and broke her leg.

She had surgery, so she had a big cast and pins sticking out of her leg. They had home care nurses coming in that changed her dressings. I remember thinking it was fascinating.

It’s funny, I have a distinct memory of one of her first follow up visits. We were looking at the X-ray and saw there was new bone forming; the bone had already started healing. It was my first introduction to this fascinating ability of our skeleton to heal itself.

There was nobody in my family who was medical, but towards the end of high school, I had it in my head that I wanted to be a doctor. I don’t remember if there was an exact moment, but I took a course on how our bodies work and function, and it spurred me to my undergrad degree in kinesiology, the science of human movement, at McMaster University. Then, I went straight into med school at Queen’s University.

Dr. Wilkin with his spouse.

Q: As an orthopaedic surgeon why did you choose to work at The Ottawa Hospital?

A: My connection to Ottawa started early and sort of by chance. It was the summer after my second year of medical school, and my girlfriend at the time, who is now my spouse, was in law school at the University of Ottawa. We had been commuting back and forth through all those years, and I wanted to spend the summer in Ottawa to have more time with her.

I knew I wanted to get into orthopaedics at this point, so I went to the uOttawa faculty list and saw someone whose primary area of interest was orthopaedic trauma and upper extremity surgery. I thought, “That sounds kind of interesting. I’m just going to email them and see if they’ve got any research I can do as a med student.”

That someone was Dr. Steve Papp, here at The Ottawa Hospital, and he said they could find a project for me. I came up and started working with him and Dr. Allan Liew, who’s also in trauma, and we really hit it off. I just found it fascinating and learned a ton working with them. They became great mentors and certainly supported me getting into orthopaedics.

It was apparent to me at the time that the orthopaedic program here had a lot of strengths. Ottawa is big enough that we see a huge range of pathology — traumatic injuries, joint reconstruction, oncology, spinal issues, pediatric cases. For someone looking to have a well-rounded residency training, Ottawa covers all those bases. I’m grateful to now be able to contribute to the residency program that trained me.

"Trauma care is really a team sport, and a well-functioning team is critical. We have a particularly strong group of trauma specialists."

Dr. Geoffrey Wilkin

After my fellowship training in New York City, I had the opportunity to stay and work there but chose to come back to Ottawa, because I thought it would be a great fit for my career and my family. As the only trauma centre serving the National Capital region, eastern Ontario, and Nunavut, I knew there would be no shortage of challenging injuries I could help treat, and this would translate into a rewarding and fulfilling clinical practice. Also, our division had recently established a research chair in regenerative orthopaedic surgery, which I knew would provide great collaborative research opportunities to improve our treatment of challenging fracture-related issues.

But the decision to come back on staff was ultimately about the people I would get to work with. I knew we had a great group of orthopaedic surgeons I would be joining. Trauma care is really a team sport, and a well-functioning team is critical. We have a particularly strong group of trauma specialists at the Civic Campus. My early mentors are now my partners, and we always support each other. We also have excellent nursing staff, physiotherapists, imaging technologists, and other allied health professions, who are all working towards a common goal. This makes for a great work environment, and I know this translates into world-class fracture care.

Q: What is the most interesting thing you’ve learned as an orthopaedic surgeon?

A: The most interesting thing I’ve learned, and I think this speaks to a perception a lot of people have, is that bones are not an inert part of your skeleton. We have this perception that bone is this hard substance that just sits there and holds our body up, but it’s really a living, dynamic tissue. It has amazing reparative potential, and it’s one of the only tissues in the body that heals without a scar.

As trauma surgeons, we have to harness that potential, that living aspect of the bone, and respect it. Orthopaedics gets a bad rap as being just carpentry — and there is a lot of that — but it’s also gardening. You have to nurture this living tissue and try to find the right mix of getting the mechanical properties of the bone to work together with its biologic properties.

My role as a surgeon is to guide the bone to do what it knows how to do.

"You have to nurture this living tissue and try to find the right mix of getting the mechanical properties of the bone to work together with its biologic properties."

Dr. Geoffrey Wilkin

Q: You worked on Travis Vaughan’s case. What made it so unique?

A: Travis had a very severe injury to his femur due to his snowmobiling accident. In addition to a bad fracture, he also had bone loss, which poses a particularly unique surgical problem.

When Travis was referred to me, we initially thought the task was simply rebuilding the bone loss, but we also realized it wasn’t as well aligned as it could be, and we needed to address that to make sure his range of motion was maintained. He thought he was going in for a 90-minute procedure, and I had to break the news that this was probably going to be more of a five-to-six-hour procedure.

Early after people’s injuries is the best time to get it perfect. The window of opportunity to get it right is small. Anything that comes after is more difficult to deal with.

The other challenge in cases like Travis’s is that we can do this big surgery, but we don’t know whether we’ve won for months. At each follow-up visit, we’re seeing how he’s doing, we’re watching X-rays for signs of bone healing, but often on an injury like his, it’s a year or more to know if we’re in the clear.

Fortunately, he did well, and we were able to eventually declare victory on his injury.

Q: The Ottawa Hospital is currently working towards the creation of a new, state-of-the-art health and research centre to replace the aging Civic Campus. What will this new hospital mean for your patients?

A: I’m certainly excited for the New Campus Development. I’ve been involved in some of the planning for the orthopaedic clinics, where we will have new clinic space with lots of rooms to deal with the increased patient population. The demand for orthopaedic care grows every year, and we need to ensure we have the capacity to meet people’s needs.

The new campus will be a state-of-the-art trauma centre. There will be an integration of trauma services, including a roof-top helipad with an elevator that goes right to the trauma bays, the emergency department, and the operating rooms. That integration is going to be critical for patients with the most severe injuries; it saves precious minutes.

Orthopaedics is just one piece of the puzzle; multiple services need to be integrated, and the better we can put them together in one spot, the better care we can provide for patients.

"Orthopaedics is just one piece of the puzzle; multiple services need to be integrated, and the better we can put them together in one spot, the better care we can provide for patients."

Dr. Geoffrey Wilkin

Q: What would we find you doing when you aren’t at the hospital?

A: I love spending time with my family. My two young kids bring a lot of joy to my life. I’ve also really taken to mountain biking. I get out in the summer whenever I can and do fat biking in the winter, which is way more fun than I expected it to be. I also enjoy snowboarding and skiing. If I had more time, I really do like cooking, but sometimes it’s hard to find the time.

Life-altering stroke treatment and care from a “gym rat”

Meet The Ottawa Hospital’s Dr. Robert Fahed, one of only four interventional neurologists in Canada

Not all heroes wear capes — Dr. Robert Fahed plucks blood clots from the brains of stroke patients, saving lives and mitigating injury. The revolutionary process, called thrombectomy, is just a part of what Dr. Fahed brings to the fight against strokes and their disabling effects as an Interventional Neuroradiologist and Stroke Neurologist at The Ottawa Hospital, and Assistant Professor at the University of Ottawa. After training in France, Dr. Fahed was recruited by The Ottawa Hospital, and he’s become known for his practice-changing research and care for stroke patients — and others.

Read on to learn about the eyebrow-raising moment Dr. Fahed learned about thrombectomies and why he chooses to call Ottawa home.

Q: How did you wind up at The Ottawa Hospital?

A: I was born and raised in the suburbs of Paris, France. Both my parents immigrated from Syria before I was born because they wanted a better life for their kids. I’ve always felt like everything I’ve achieved was thanks to them.

I did my neurology residency in Paris, and then I did my master’s degree in Montreal, because I wanted to do research. I have family in Montreal, and I’ve always loved Canada, ever since I was a kid. Why Ottawa? It’s for three reasons: two personal, one professional.

Number one is that The Ottawa Hospital is known for its great research infrastructure and how they support researchers. Number two is that Ottawa is a peaceful, quiet, family-friendly city, and I wanted exactly that environment to raise my kids. Number three is I find it very stimulating to be constantly working in and speaking English. It stimulates my brain because it’s not my natural language. My brain is always functioning at a higher pace because of it, and I like that.

Q: Why did you choose to go into neurology?

A: My father is a neurologist, so I grew up in the field and always liked it. Seeing my father as a hero, it was always pretty clear that I wanted to become a doctor.

One of my first electives was in stroke neurology, and I saw these patients coming back from the dead, basically, after a stroke. That was an epiphany for me; it was what I wanted to do.

Then, when I was a first-year resident in France, I had already decided I wanted to be a neurologist, but the vast majority of neurologists don’t do endovascular procedures. A woman in her 50s showed up with a massive stroke, her right side was paralyzed, and she couldn’t speak.

I thought to myself, “Poor woman, she’s going to be paralyzed for the rest of her life.” Then one of my team members said, “Robert, there is something we can try. It’s experimental; it’s called thrombectomy. Bring her to that room.” I pushed her to the suite, she went in, the doors closed, and I went around to my patients. Half an hour later, I received a call that the procedure was done, and I went to pick her up. I saw a woman coming out of the room, and she was moving her right arm. She wasn’t paralyzed anymore!

I immediately though, “I don’t know what happened in that room, but I want to be the one doing it. I want to be the one bringing those people back to life.”

“I don’t know what happened in that room, but I want to be the one doing it. I want to be the one bringing those people back to life.”

— Dr. Robert Fahed
Dr. Robert Fahed_neuroradiology_The Ottawa Hospital_profile

I thought to myself, “Poor woman, she’s going to be paralyzed for the rest of her life.” Then one of my team members said, “Robert, there is something we can try. It’s experimental; it’s called thrombectomy. Bring her to that room.” I pushed her to the suite, she went in, the doors closed, and I went around to my patients. Half an hour later, I received a call that the procedure was done, and I went to pick her up. I saw a woman coming out of the room, and she was moving her right arm. She wasn’t paralyzed anymore!

“I don’t know what happened in that room, but I want to be the one doing it. I want to be the one bringing those people back to life.”

— Dr. Robert Fahed
Dr. Robert Fahed_neuroradiology_The Ottawa Hospital_profile

I immediately though, “I don’t know what happened in that room, but I want to be the one doing it. I want to be the one bringing those people back to life.”

This woman wanted to give us a gift for what we did for her. Her job was running a beauty salon, so she gave me a coupon, and she said, “This is for your …” and she couldn’t remember the name, but she pointed at my eyebrows.

I thought that was hilarious. She gave me a hug, she left, and I never saw her again. It just resonates, and every time I do a thrombectomy, I think about that woman.

Q: How would you describe your role at The Ottawa Hospital?

A: I have dual training: I’m a neurologist who deals with strokes, and I am an interventional neuroradiologist, which means I do endovascular neurology, which consists of navigating little catheters into the brain from the groin or wrist, using just a little puncture that leaves no scar. After treatment, you can’t tell you had a procedure, because the process is what we call minimally invasive.

There are only four neurologists who do interventional neurology in the whole country, and I’m one of them. It’s usually done by radiologists or neurosurgeons, but it can be done if you’re a neurologist.

Here at The Ottawa Hospital, we cultivate this multidisciplinary approach, and I think that’s the best way to offer optimal care to our patients.

I’m also a researcher. I think research is important because today’s research is tomorrow’s care. What we are studying today will be the cutting-edge, groundbreaking, disruptive treatment we can offer to our patients.

Q: How is the field of neurology changing?

A: I’m proud to be able to be part of such disruptive innovations and treatments, and I have a lot of excitement, because the future is even brighter.

Not only are we going to be better at treating stroke, but we are also going to expand the number of people we treat. We’re treating more strokes because we can go get clots that are smaller, and we can treat patients who are a bit older, and we have catheters that can navigate basically anywhere.

We’ve even started to treat other things, like tinnitus, and we might in the future help treat Parkinson’s disease, because we’re not able to implant little electrodes in the brain from inside the vessels.

The pace of evolution and improvements is exponentially higher and better every year. My job already has nothing to do with what my job was 10 years ago when I started; it’s already so different. And 10 years from now, it will again be a completely different field.

1
A major blood vessel in the brain is blocked by a blood clot, causing an acute ischemic stroke.
2
A thin catheter inserted into the groin travels through an artery until it reached the clot. A stent passes through the catheter and engages with the clot.
3
The stent is then pulled back taking the clot with it. The goal is to remove the entire clot on the first try to restore blood flow as quickly as possible, limiting damage caused by the stroke. 
4
Blood flow is restored, and brain function can often improve immediately.
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New technology and techniques like the endovascular thrombectomy changes the outcome for stroke .

Q: How is the field of neurology changing?

A: I’m proud to be able to be part of such disruptive innovations and treatments, and I have a lot of excitement, because the future is even brighter.

Not only are we going to be better at treating stroke, but we are also going to expand the number of people we treat. We’re treating more strokes because we can go get clots that are smaller, and we can treat patients who are a bit older, and we have catheters that can navigate basically anywhere.

We’ve even started to treat other things, like tinnitus, and we might in the future help treat Parkinson’s disease, because we’re not able to implant little electrodes in the brain from inside the vessels.

1
A major blood vessel in the brain is blocked by a blood clot, causing an acute ischemic stroke.
2
A thin catheter inserted into the groin travels through an artery until it reached the clot. A stent passes through the catheter and engages with the clot.
3
The stent is then pulled back taking the clot with it. The goal is to remove the entire clot on the first try to restore blood flow as quickly as possible, limiting damage caused by the stroke. 
4
Blood flow is restored, and brain function can often improve immediately.
Previous
Next

New technology and techniques like the endovascular thrombectomy changes the outcome for stroke .

The pace of evolution and improvements is exponentially higher and better every year. My job already has nothing to do with what my job was 10 years ago when I started; it’s already so different. And 10 years from now, it will again be a completely different field.

Q: What will the Campaign to Create Tomorrow mean for your work in neurology?

A: It means more beds to treat more patients in a timely manner, so it means better care. But more importantly, it means more support to do research. I think many people dichotomize research and care, they separate those two entities, which is a big mistake that The Ottawa Hospital is not making. The Ottawa Hospital is supporting trials and studies embedded within clinical care, so we can care for patients while offering them cutting-edge treatments within the context of a research study.

Dr. Fahed welcomes a new piece of technology to TOH.

In terms of research, we’re going to find neuroprotective drugs that can be administered in the ambulance to protect the brain. We’re also working on stem cell therapy to enhance rehabilitation and brain recovery following on a stroke. And we’re going to have new tools and techniques that will allow us to reopen vessels faster and better, which will translate into better outcomes for patients.

I think our performance in neuroscience research is already pretty amazing worldwide, but we’re going to go up to that next level with a new neuroscience institute. I am very hopeful that with this new space and research infrastructure, we’ll be able to do miracles.

Dr. Fahed welcomes a new piece of technology to TOH.

In terms of research, we’re going to find neuroprotective drugs that can be administered in the ambulance to protect the brain. We’re also working on stem cell therapy to enhance rehabilitation and brain recovery following on a stroke. And we’re going to have new tools and techniques that will allow us to reopen vessels faster and better, which will translate into better outcomes for patients.

I think our performance in neuroscience research is already pretty amazing worldwide, but we’re going to go up to that next level with a new neuroscience institute. I am very hopeful that with this new space and research infrastructure, we’ll be able to do miracles.

Q: Where would we find you when you’re not working with patients or in the lab?

A: That one is easy: I’m a gym rat, I love working out! I’ve been doing it ever since I was a teenager. I have dumbbells, a bench, a rowing machine. I started working out at the gym on campus, but when COVID started, I stocked up on some equipment. My colleagues all made fun of me, saying it wouldn’t be that long. Two months later, everyone was knocking on my door asking if they could use my equipment for a workout.

There is a saying in Latin, “mens sana in corpore sano,” which basically means a healthy mind, a healthy body. I’m training my brain enough with my work, but the body is very important too. We only get one, and we need to look after it. Prevention is the best medicine.

I also spend a lot of time with my family. My parents and sister are now in Gatineau. Along with my wife and my daughter, and soon my second daughter, we enjoy everything Canada has to offer. Ottawa is a magical city: it’s full of parks, you can go on a boat on Dow’s Lake in the summertime, and in the wintertime, you can do ice skating, which is completely new to me. You can go skiing, you can go to zoos, you have so many things to do. I’ve been here for three years, and I have so many things to discover. I am enjoying everything this beautiful country has to offer.

Q: Can you tell us about the world-first treatment you just completed on a tinnitus patient?

A: We recently used this endovascular procedure on a patient with pulsatile tinnitus. It’s a rare type of tinnitus in which patients have any variety of underlying vessel disorders that cause a whooshing sound in the ears. We can almost always treat this type of tinnitus endovascularly, and traditionally, we’d place a stent and put the patient on blood thinners. But for patient Chris Scharff, we used the process typically used for brain arterial aneurysms on the venous aneurysm that was causing the pulsatile tinnitus. It solved the tinnitus without the need to put the patient on blood thinners. It was the first time this treatment had ever been done in the world.

We also recently opened the Ottawa Pulsatile Clinic. While other types of tinnitus are treated by an ear, nose, and throat doctor (ENT), pulsatile tinnitus requires a different approach.

This new treatment and the clinic really highlight how The Ottawa Hospital is at the forefront of innovation.

As the Medical Director of the Amputee Program, Dr. Nancy Dudek is one of the many faces you may see if you were a patient in our Rehab Centre.

She joined our team at The Ottawa Hospital in 2004 and focuses on caring for individuals with limb amputations, limb difference, and complex bracing needs. She is the recipient of multiple awards in medicine and education.

As a prosthetics expert in amputee medicine, she leads our team helping patients who have lost limbs get back to what they love to do. Her patients appreciate the confidence she instills in them and her encouraging words; with her help, they work hard toward recovery.

We had the opportunity to have a conversation with Dr. Dudek about what she loves most about her work.

Q: When did you first realize you wanted to become a doctor, and why rehabilitation?

A: I knew I wanted to be a doctor by the time I was 12 years old. I did well in science, and I really liked helping people. As a young person, I thought the career that best fit those things was a doctor. I did not decide to go into rehabilitation medicine until I was in medical school. I had always thought I would be an orthopedic surgeon as I wanted to be able to help people with their mobility. However, I realized I did not love being in the operating room as much as a surgeon does. A classmate directed me to consider Rehabilitation Medicine given my interests. I did an elective rotation, and I’ve never looked back. It is a perfect fit for me.

Q: How has amputee rehabilitation changed since you started?

A: There has been a tremendous change in the types of prostheses available, which enables people with amputations to achieve much higher levels of function. As well, there are newer surgical and medical advances to deal with some of the challenges patients have with things like pain. These advances do create some disparity in what different patients have access to, though, as prosthetic devices are not fully funded by the provincial healthcare system. As a result, advocacy for funding is a necessary part of my work.

Q: You worked with Bushra Saeed-Khan for a decade after she was injured by an IED explosion in Afghanistan. Is it normal to work with someone for that long, and what sort of bond forms from such a long relationship?

A: Absolutely. An amputation is a permanent condition, so I get to continue to work with people on a long-term basis. This is one of my favourite parts of the job. It is wonderful to be able to know people and assist them at different phases of their life.

Q: Bushra used the CAREN system at The Ottawa Hospital. What makes the CAREN system such an important tool?

A: The CAREN system provides people with the opportunity to gain new skills such as walking up and down hills, handling rough ground, and running. It is a safe environment where a harness system prevents the person from falling and hurting themselves. This lets people really push themselves and gain confidence in their abilities, which they can then use in their day-to-day life in the “real world.”

Q: You also worked with Marcie Stevens, one of the Westboro bus crash patients. She had an incredibly positive attitude during rehab, how did that impact her recovery?

A: Her attitude is amazing. She is such a positive person and a joy to work with. I always smile when I see she’s booked for a visit with me. There is no doubt that her positive approach to handling her situation has helped her to achieve great things during her rehabilitation.

Q: What is the most gratifying part of your job as Medical Director of the Amputee Program at The Ottawa Hospital?

A: Helping people achieve their goals. As an example, there really is nothing better than having a father come back to the clinic and show me the pictures of him dancing with his daughter at her wedding. There are a lot of challenges to having an amputation, but when I see people back in clinic and doing well, there is tremendous satisfaction in that.

Q: How do donations from the community support your work at The Ottawa Hospital and how do they help patients?

A: Donations from the community are vital. The technological advances in rehabilitation care are truly remarkable and absolutely result in better outcomes for our patients. However, they come at a cost that is often not covered by provincial healthcare funding. Community support allows us to provide world-class care to patients at the Rehabilitation Centre.

Q: Why did you choose to work at The Ottawa Hospital?

A: I did my residency training at TOH and got to experience the dedication of the healthcare professionals who truly do strive to provide the best care possible for their patients. On a personal note, I benefited from an excellent mentor, Dr. Meridith Marks, who developed the Amputee Program at the Rehabilitation Centre into one that was recognized across the country as a true centre of excellence. I was grateful to be recruited to take over that role from her. My goal is to continue to earn that reputation for excellence by providing the best care possible for patients with amputations.