Category: trauma

When a trauma case bursts through the doors at The Ottawa Hospital, it’s Dr. Jacinthe Lampron’s team taking it on. As the Trauma Medical Director and a Clinical Investigator, Dr. Lampron is constantly working on improving our trauma care — whether directly with patients or through her quality improvement research.

When every second counts, Dr. Lampron is the one counting them out as she delivers lifesaving care every day.

Keep reading to find out what drew Dr. Lampron to trauma, what she learned in Afghanistan, and what she might have been had she not pursued medicine.

Q: What were your early years like?

A: I was born in the area of Trois-Rivières in Quebec, and I was raised in Nicolet on a dairy farm. It was a lot of work, but I tried my best to help my parents. It was a bit challenging for a child or teenager because I was far from the city and extracurricular activities — I was into swimming, hiking, and rock climbing. But I also had so much space to run around and experience other things, like driving a tractor.  

In school, I enjoyed everything around science. In CEGEP, I studied biochemistry, math, physics, and biology. I loved to learn and to try and understand things or solve the equations. 

Q: What did you want to be when you grew up? 

A: When I was four, I wanted to be a florist. At the farm, we had a big vegetable garden and a big flower garden. My grandmother lived next door, and I spent a lot of time with her. We would look at flowers, and my first name — Jacinthe — is a type of flower. I suppose I became interested in flowers then.  

Q: How did you wind up pursuing medicine, and becoming a general surgeon in trauma? 

A: In terms of medicine, it was a progression. Things were going well at school and at CEGEP, and some of my friends said, “Well, why don’t we try medicine?” I didn’t know that much about it yet, but it sounded interesting, challenging, and it would help others, so I applied.

Then, as a medical student, I enjoyed all the topics. I remember thinking, “Oh man, I don’t know what I’m going to pick as a speciality!” We started clinical rotations, and my first was in general surgery. It was very exciting to really see what it was to be at the hospital, seeing patients, and looking after them. I didn’t know anything else yet, because it was my first rotation. But none of the others hit the spot. At the end of the year, general surgery was the rotation I had the most fun in.

I remember I was working with this brilliant team of aspiring, motivating residents. I’m still very fond of them all, and when I interact with them professionally, I’m still in awe.

Q: Can you tell us about your two tours in Afghanistan as a civilian physician and how it affected your approach to medicine? 

A: It felt very different. The OR was not as technologically advanced as ours here, but there was everything I needed to do surgery and help injured people. The hospital was made out of sea containers and plywood, with big cement blocks to prevent rocket attacks!

The military base was quite large, close to 10,000 people all living there, and multinational. It was so interesting to see so many different countries in the same place at once. Military personal on the base had to wear a weapon, but everyone had to wear a frag vest, a type of body armour. Every once in a while, there would be a rocket attack — an alarm would sound, you’d go to the bunker, and you’d wait for the “all clear.”

Obviously it was very tragic and dramatic, and I can’t say I was feeling joy in the middle of the war, but I was pleased by the work I was able to do. I learned that we could do surgery with not that much.

Trauma care evolves with war, so the Afghanistan conflict brought new concepts that were then translated to civilian care. For example, it changed the way we do resuscitation: we moved towards using more blood products instead of crystalloid solutions. And while the use of tourniquets has waxed and waned over the years, Afghanistan showed us it’s quite advantageous to save lives, so we’re using them more often now.

Q: What’s something interesting about trauma care? 

A: Our team lives at the pulse of the city and society. When it’s Canada Day, we’re on standby because we know a lot is happening. When it’s autumn, and everyone is putting their Christmas lights up, unfortunately, we know many people will fall. When it’s May, and motorcycles are just getting out on the road, we know we’re getting crashes. We live through the seasons and what’s happening.

Q: You worked on Brandon Peacock’s case, where he was an innocent victim of a drive-by shooting. What made that case unique?

A: It was a very intense episode of care. His injury was a penetrating trauma, and those are high-intensity, especially if there’s a blood vessel injured. When that happens, the person can bleed out within minutes. Caring for an injury like his requires a lot of resources: having blood available for transfusions, having the operating room ready, having a team available and ready to perform all the tasks needed for resuscitation. Everyone moves fast, everyone needs to know what they’re doing, and that’s how we save people. We have a system in place and a team ready to go; that’s why trauma patients do better at trauma centres.

Q: In your role as a clinical investigator at the Ottawa Hospital Research Institute, what are you currently working on?

A: I work on the quality improvement angle of trauma. We look at our performance indicators, and if we’re not performing at the level of our peers, we dissect the data and look at what we can do to try and make it better. Then we’ll do a quality improvement project and see if it improves. I also work on improving the trauma system, which means facilitating the flow of patients and processes.

Research like this means patients will receive better quality care.

Q: How does having the most technologically advanced facility make a difference to your work?

A: Trauma mostly needs a well-trained team that’s going to do all the work together. The new campus is going to allow this by providing state-of-the-art ORs, access to the best technology, and space for video-recording and simulation to train the team members. The other big thing is the new heliport: instead of crossing the street, as we currently do, they can land on the roof. This is critical, because in trauma, every second counts.

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

A: On my bicycle, running, baking, or spending time with my nine-year-old daughter.

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.

Read Travis's Story

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.

Dr. Wilkin with his children.
Dr. Wilkin mountain biking.
Dr. Wilkin snowboarding.

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.

Dr. Kirsty Boyd

The first recorded mention of plastic surgery was found in an Egyptian medical text that dates back to 1600 BCE! In it, there are instructions for fixing a broken nose. Plastic surgery has come a long way since then, but it is a great example of reconstructive surgery, which, along with cosmetic surgery, makes up the two main types of plastic surgery. While reconstructive surgery aims to repair or improve the functioning of part of a body, cosmetic surgery aims to change the appearance of a body part. Within those subcategories, there is a huge range of procedures. The Ottawa Hospital’s Plastic Surgery Program Director Dr. Kirsty Boyd knows how varied plastic surgery can be, and that’s part of what initially drew her to it. Read on to learn more about why she chose plastics, some of her most complex cases, and what she’s excited about in her field.

Q: When did you realize you wanted to become a doctor, and how did you end up as a plastic surgeon?

A: I honestly can’t remember a time when I didn’t want to be a doctor. I come from a family of physicians in all disciplines. There are stories about me rounding with my parents on the weekends, climbing right up on patients’ beds. When they moonlighted as residents, they used to sometimes take me with them, and I would colour or read at the nurses’ station. There are even photos of me picking up sponges while my parents were working — which could never happen now! But I never really knew what discipline I would practice in until the summer after my first year of medical school, when I rotated around working with friends of my parents. I spent one day in the operating room with Dr. Martin Lacey watching him operate on a combination of a cleft lip, a burn, a hand, and a breast case and decided that day that I would be a plastic surgeon.

Q: When someone hears “plastic surgery,” they might think only of cosmetic surgery. Why is plastic surgery a critical field in healthcare?

A: Cosmetic surgery is an important part of plastic surgery, but it only represents a small portion of what we actually do. We restore form and function to patients in all areas, including hands and wrists, burns, craniofacial cases, nerves, skin cancers, pediatrics, traumas, and complex wounds. We are the “surgeon’s surgeon,” and we literally operate in combined cases with every single other surgical discipline, often getting involved to solve difficult problems and rearrange and reconstruct tissue. Plastic surgeons need to know anatomy from every part of the body. We operate on every single type of tissue (bone, cartilage, nerve, muscle, skin etc.) and in every area. It isn’t infrequent for people to be surprised to hear that I am a plastic surgeon and for them to say that they didn’t realize that plastic surgeons do reconstruction too.



Q: You worked on Karen Toop’s case following a severe injury from a snow plow. What made her case so incredibly challenging?

A: I was only three weeks into my surgical practice at The Ottawa Hospital when Karen sustained her injuries. The extent of her injuries was absolutely catastrophic, and she is very lucky to be alive. Part of what made her case so challenging is that she lost so much, and we were trying to provide her with as much function as possible with very little to work with. Karen truly required a multi-disciplinary effort, and her team involved specialists from plastic surgery, orthopedic surgery, vascular surgery, physiatry, ICU, general surgery, trauma surgery, and physiotherapy. She was an example of people coming together and applying rare and complicated surgical techniques in a novel situation. It was also an opportunity for me personally to be mentored by an amazing senior colleague — especially at such an early point in my surgical career.

Read Karen’s story

Q: You also did the first nerve transfer surgery to restore upper extremity function in a spinal cord injury in Canada on patient Timothy Raglin. How does that surgery reflect the groundbreaking work happening at The Ottawa Hospital?

A: Tim approached me after reading about a surgery that had been performed by my fellowship supervisor, Dr. Susan Mackinnon, at Washington University in St. Louis, Missouri. At the time, this was a novel application of a strategy to re-wire nerves after injury — in this case, using a redundant nerve above the level of spinal cord injury to power a non-functioning nerve below the level of injury. I was very hesitant, as I had never operated on this patient population before, and the potential for downgrading function in a patient with tetraplegia — meaning they have paralysis in all four limbs below the neck — was very worrisome. Dr. Mackinnon volunteered to come to Canada to assist me with the surgery. She and her colleague came at their own expense and we completed the nerve transfers together. I feel very fortunate to have had the support of my division head and of the chief of surgery to bring this groundbreaking work to Ottawa and to have done the first surgery of its kind in Canada.

Q: What is the most exciting research happening in the field of plastic surgery right now/where is it heading?

A: Personally, I find the research in nerve surgery, both basic science and clinical, the most exciting. Clinically, indications for nerve transfers are exploding, and function is being restored to injuries that were previously not considered operable. In addition, newer techniques have allowed us to expand our procedures to operate earlier, and on more patients, to achieve excellent results. Currently nerve transfers are being performed on patients with spinal cord injuries, pinched nerves in their spines, peripheral nervous system disorders, and other nervous system conditions — and these transfers are occurring in both upper and lower extremities. At The Ottawa Hospital, Dr. Gerald Wolff and I regularly perform research and contribute to this literature and run one of the largest peripheral nerve trauma clinics in the county. From a basic science perspective, new knowledge is allowing for improved nerve recovery and better outcomes.

Q: As a plastic surgeon, why did you choose to work at The Ottawa Hospital and what is the most gratifying part of your job as a plastic surgeon at The Ottawa Hospital?

A: Ottawa provided a perfect opportunity for me. There was no one here at the time doing complex peripheral nerve reconstruction in plastic surgery. I had the opportunity to found the Peripheral Nerve Trauma Clinic with my good friend and excellent colleague, Dr. Gerald Wolff, and to truly build one of the largest and most successful nerve programs in Canada. I had the opportunity to join Canada’s newest residency training program, to help shape the program from infancy, and then ultimately to take over the position as Residency Program Director. Most importantly, I was able to work with excellent colleagues who I consider to be both mentors and friends. This has enabled me to tackle the really complex cases, like Karen’s and Tim’s, and to feel supported while doing so. The work we have done in these areas has been recognized nationally and internationally, and I feel very proud of what we have accomplished. Without doubt, the most gratifying part of my job as a plastic surgeon at The Ottawa Hospital has been to follow our patients along and see them regain function following devastating injuries.

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