Working the Dead Beat (25 page)

Wilson retired from the Supreme Court on January 4, 1991, at the age of sixty-seven, eight years before the mandatory retirement age of seventy-five. She cited “diminished energy” as her main reason and said she was looking forward to living a more normal domestic life. In fact she had suffered from high blood pressure for thirty years and had been plagued with arthritis and a series of other health issues. There were other reasons that weren't publicized at the time. Her great colleague Brian Dickson had retired six months earlier, and she was troubled by what she later described as the cliquish behaviour of some of her male colleagues. “People would spend long periods in each other's rooms, arguing about changes and amendments, and so on and so forth,” she told her biographer Ellen Anderson. “You might not know anything about this, of course . . . So there was never any kind of opportunity to explain why you didn't think that was a sound addition, or a sound subtraction. The first thing you knew was that a group had now formed.”

Wilson had been an assiduous judge, having signed her name to more than 160 decisions, including at least fifty rulings under the Charter, and delivered some sixty-odd major speeches. The Royal Society of Canada elected her a fellow in 1991, she was appointed a Companion of the Order of Canada the following year, and she continued to add to her collection of honorary degrees — nearly fifty in total.

She may have stepped down from the Supreme Court, but she was certainly not ready “to sip Campari on the Riviera,” as she herself ruefully admitted. She had become enmeshed in two contentious and unwieldy projects, one within the legal profession and the other without. She agreed to chair the Canadian Bar Association's Task Force on Women in the Legal Profession. The report, which was called
Touchstones
, let the legal profession know that women faced the same inequities before the bar as they did in other professions.

Many more women were graduating from law schools, but alarming numbers were leaving the profession. Conclusions about discrimination both before the bar and on the bench and recommendations that changes be made in the brutal system of billable hours to accommodate female lawyers with young children caused a furor within the profession. The stress of raising funds and staffing the commission, researching and writing the report, and then dealing with the acrimonious backlash caused Wilson considerable anguish.

Almost simultaneously with the Task Force, she accepted an appointment from Prime Minister Brian Mulroney to the Royal Commission on Aboriginal Peoples. The three-year mandate was to work with “Canada's aboriginal peoples,” conducting hearings into their grievances and their social and economic problems, and to find a way forward “so that they can control their own lives, contribute to Canadian prosperity and can share fully in it.” This was a thornier issue than any she had encountered on the bench. The Commission took five years to complete its report, years of extensive travel, gruelling hearings, eye-opening horror at the sufferings indigenous people had endured, cost overruns, internal staffing issues, and despair that much could be changed.

By the time the report was delivered, Mulroney had retired from active politics and Jean Chrétien's Liberals were in power. For many it seemed too little, too late, but Jane Stewart, the minister of Indian affairs, did offer the First Nations a statement of reconciliation — not apology — in a ceremony on Parliament Hill in January 1998. Stewart also presented an action plan amounting to $600 million over four years, much less than the $2 billion a year the commissioners had recommended.

Frustrating and depleting as it had been to wrestle the final report into submission and to withstand the fractiousness of the deliberations, Wilson found the process illuminating and reaffirming, especially in the way it nurtured the ongoing negotiations for the Nisga'a and Delgamuukw Treaties and the establishment of Nunavut. In many ways the royal commission was the culmination of her judicial activism on behalf of fairness and justice.

As the century turned, Wilson retreated more and more from public life as the fogginess of Alzheimer's disease gradually destroyed her virtuosity. With her faithful husband of sixty-one years by her side, she died at Rideau Place on-the-River in Ottawa on April 28, 2007. She was eighty-three.

 

Robert Salter

Orthopedic Surgeon

December 15, 1924 – May 10, 2010

A
S A BOY,
Robert Salter dreamed of becoming a medical missionary in China, Africa, or India, healing the sick and spreading his practical Christian faith, patient by patient and soul by soul. Instead he followed a different path to the same vocation — as a surgeon, innovator, and teacher. Instead of working as a solitary doctor in the field, he changed the nature and practice of pediatric orthopedic surgery around the world. Besides treating his own small patients at Toronto's Hospital for Sick Children, he invented surgical methods and equipment that revolutionized orthopedic surgery, travelled extensively to impart his medical know-how in more than thirty countries, and trained hundreds of doctors from abroad who came specifically to study under him so that they could take his mentoring, his procedures, and his practices home with them.

Salter grew up in an era when polio was a prevalent childhood illness. Dealing with its ravages was a major preoccupation of pediatric surgeons. Salter realized early on that the correct intervention at the appropriate moment — while a child was still growing and developing — could make a lifelong difference between permanent disability and mobility, between dependence and independence.

During a more than fifty-year career as a pediatric orthopedic surgeon, he developed a surgical procedure to fix congenital deformities of the hip. It was called the Salter innominate osteotomy for hip dysplasia (although he preferred
to call it the “no name, no fame” operation). Salter overrode centuries of medical theory that said broken limbs needed to be immobilized in rigid casts for prolonged periods; he invented a post-operative apparatus called the continuous passive motion (
CPM
) machine, which has improved post-surgery recovery for at least nine million patients. Besides the Salter-Harris classification of growth plate injuries, he wrote the authoritative orthopedic
Textbook of
Disorders and Injuries of the Musculoskeletal System
, which is used throughout the world. Salter was making revisions for the fifth edition when he died, aged eighty-five, from complications of Parkinson's disease in Toronto on May 10, 2010.

But Salter wasn't all theory and medical practice. He loved to paint with oils and had such an obsessive interest in heraldry that he designed coats of arms for most of the institutions and clubs to which he belonged, including the Hospital for Sick Children. He liked to wear a Sherlock Holmes–style deerstalker cap and a holster under his suit jacket for his pipe while he drove around town in a 1949 Allard sports car — with his foot to the floor and the top down, no matter the weather. The car was so sleek and so low-slung that he could drive under parking barriers, and he kept it up until he reluctantly pulled the key out of the ignition in the mid-1980s because spare parts had become scarce.

Famous for treating poor kids for free and for dealing with his young patients as equals, Salter always ended his consultations with the mantra “friends for life.” That included Garth Drabinsky, the disgraced impresario, who had contracted polio in 1953, when he was three years old. Drabinsky went under Salter's knife six times — “my entire childhood,” he writes in his memoir,
Closer to the Sun
. Although he hated walking into Salter's office because he knew it meant “another procedure, another operation, another summer in hell” of surgery, recovery, and physiotherapy, Drabinsky never forgot the kindly doctor who did his best to help him walk like other kids. Forty years later, Salter wrote a personal letter on Drabinsky's behalf before the former head of Livent and convicted felon came up for sentencing in August 2009. For once the good doctor couldn't perform a miracle: Drabinsky was handed a seven-year prison term.

Another of Salter's patients was Colleen Beanish, later a special-education consultant with the Ottawa Catholic School Board. Born in 1961 in Ottawa with a congenital dislocated hip, she was confined in a body cast from eighteen months until she turned three. By the time she was ten she was limping and in pain. After a failed procedure she was sent to Salter. “I trusted him completely from the first,” she said of the surgeon, who operated on her several times over the ensuing years, including a hip replacement at age thirty. “He always spoke to the child before the parents,” she said. “He explained everything, he never lied and he always held my hand while the anesthetic was taking effect.” As an adult, she gave him “credit for being able to walk unassisted,” but what she remembered more than anything was the way he always made time for her and eventually her children, so he could reassure Beanish that they had not inherited her congenital hip problems. “Friends for life” was a promise he upheld through the generations.

ROBERT BRUCE SALTER
came from Loyalist stock on both sides of his family. His father, Lewis Salter, from Chatham, New Brunswick, was manager of the Bank of Nova Scotia in Liverpool, Nova Scotia, the hometown of a young woman named Katherine Cowie. After he wooed and wed her, they moved to Stratford, Ontario, where he headed up the local
BNS
branch. There the Salters had three sons, Douglas Campbell (who died in 1993) and fraternal twins Robert Bruce and Andrew Jack, who were born on December 15, 1924.

Almost from birth, Bob Salter seemed destined to care for others, an ambition nurtured by his mother, a woman he once described as shy, loyal, kind, and “deeply religious.” Another huge influence was David Smith, the family physician. At age six Bob told his twin brother that he wanted to be a doctor, but only “if he could be as good, or better than Dr. Smith,” recalled Jack Salter. “He worshipped him.”

When the boys were nine, Jack became seriously ill with rheumatic fever; in those pre-antibiotic days the treatment was complete bedrest for a year. “Bob taught me all during the summer holidays and I wrote the exams so that when I was well and able to go back to school I could stay in the same room with him,” Jack said. “That was very important to us.”

In the mid-1930s Lewis Salter embarked on a serious career change when he quit the bank to launch an orange-juice business. The family moved to North Toronto and the three boys transferred from Romeo Public School in Stratford to Lawrence Park Collegiate. Even then Bob was interested in research. When he was sixteen, he brought home a dead monkey from the Connaught Medical Labs. “I went into the basement and there was Dr. Bob dissecting the poor little monkey, which was staring up at the ceiling,” said his brother. “I honestly believe that is how he became fascinated with bone surgery, because he ended up with the skeleton of the monkey and he could see how the various joints functioned.”

After high school, Jack went into the navy and Bob entered a six-year medical program at the University of Toronto, the first time in their lives that the twins had taken divergent paths. Bob was about five-foot-ten and of average build, but he was very strong, athletic, competitive and driven. “When he played football and hockey, if he tackled or body-checked you, you would beg to live for another day,” said his brother. “He played to win.”

During school breaks, Bob worked as a labourer and truck driver to earn his tuition, but in his last two years of medical school he combined his religious and medical vocations by spending his summers at the Grenfell Mission, an organization that had been established by medical missionary Wilfred Grenfell in the 1890s to bring medical and social services to remote communities in northern Newfoundland and Labrador. The Grenfell Mission was a testing ground for Salter's dream of becoming a missionary doctor.

Back in Toronto in 1947 for his final year at U of T, he met Robina McGee, a community health student. She had done fieldwork on a scholarship in Copper Cliff, a community near Sudbury, in northern Ontario, and was hoping to work for the Grenfell Mission, so “we united our paths,” she said, after he completed his internship year. “I didn't know whether it was a proposal or a job description he was offering me,” she joked about what turned out to be more than sixty years of marriage, community service, and the rearing of five children.

The day after their wedding on July 3, 1948, the Salters left for the Grenfell Medical Mission at St. Anthony, on the northern peninsula of Newfoundland, doing “whatever needed to be done” in what “Bob always called ‘our two-year honeymoon,'” she said. Then, with a baby on the way, revolution in China, and partition in India, the Salters agreed to put aside his dream of working in a missionary field. Instead he enrolled in postgraduate training under W. E. Gallie, the legendary surgeon and educator who radically overhauled surgical education at U of T. Gallie believed students should be exposed to a variety of disciplines before specializing and that the coveted position of chief resident should rotate so that each of them would have the experience of being “in charge” in a supervised setting before heading off into the “real” world.

Salter then spent a year as a McLaughlin Fellow in orthopedic surgery at the Royal London Hospital. That's where the trainee from Canada took on Sir Reginald Watson-Jones, the world's reigning orthopedic guru. Listening to Watson-Jones deliver his dictum that the only treatment for fractured limbs was complete, rigid, enforced, and prolonged immobilization, Salter realized intuitively that this was precisely the wrong thing to do. What's more, he said so, to the rising ire of Sir Reginald. Over the next thirty years Salter delighted in proving he was right and relating that confrontation to generations of his own graduate students.

Salter began working at Toronto's Hospital for Sick Children in 1955, when Alfred Farmer was head of surgery. At that time pediatric surgeons were generalists. But Farmer believed that doctors needed to specialize if they were going to grow in expertise, and so he insisted that all of the doctors reporting to him had to pick a specialty. William Mustard, who excelled in both cardiac and orthopedic surgery, decided to concentrate on the former, which allowed room for Salter to become chief of orthopedic surgery at Sick Kids and a professor of surgery at U of T in 1957, at the incredibly young age of thirty-two.

Forcing doctors to specialize put Sick Kids ahead of everybody else in pediatric surgery and turned the hospital into a mecca for young doctors seeking advanced training. Salter, with his combination of ingenuity, research, and clinical expertise, led the way in orthopedics. He became surgeon-in-chief in 1966 and a “university professor” at U of T in 1984, a position held by only fifteen scholars at a time. In a life filled with accolades and honours, Salter's curriculum vitae included president of the Canadian Orthopaedic Association and the Royal College of Physicians and Surgeons of Canada; fellow of the Royal Society of Canada; member of the Canadian Medical Hall of Fame; Companion of the Order of Canada; and winner of the Gairdner Award for Medical Science, the
FNG
Starr Medal of the Canadian Medical Association, and the Bristol-Myers Squibb/Zimmer Award for Distinguished Achievement in Orthopaedic Research.

He remained a practising Christian who found a comfortable balance between science and religion. “Some things in life are not measurable — faith, hope, and love — and therefore not amenable to scientific investigation,” he told the
Globe
in an interview in the mid-1980s. As for his own soul, he said he tried every day to become a better Christian. And when pressed, he admitted: “I am not a humble man. It's one of my real frailties.”

Although he stopped doing surgery at seventy, he continued to research, write, attend conferences, and see patients even after he was diagnosed with Parkinson's disease. By 2010 the disease was accelerating and he was having increasing difficulty with his balance. After a fall at home early that May, he was taken to hospital, where he died a few days later, on May 10, 2010. He was eighty-five. “I always referred to him as my pal and twin,” said his brother sadly. “There is no living person who has known and loved him as long as I have.”