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This is my story of my six‘comir days spent at the Shouldicei Th: Clinic where I had two herniaito cl operations one day apart. Thejcaugl: late Dr. Earle Shouldice per- from fected the hernia operation. shave elevating the technique to a fine vMy ' art. His son, also a doctor, is pronc carrying on the technique. and down tradition at the new 88â€"bed out.1 clinic which began operating at to go Thornhill in 1969. The team ef- Tw‘ fort of the clinic staff conveys arour confidence and efficiency, while morn maintaining a fraternity and fast: home-like atmosphere. a dri I first knew that I had 3 her- nia in August 1969 while on a bus tour of the United Kingdom. It became necessary for me to keep my right hand in my right pants pocket in order to press against the lower part of my abdomen to hold the hernia in place. This I did for two weeks. There was a mixed group of eighteen people on the bus. At first I got away with it. No one noticed..Thcn there were looks of amusement. Then when the truth was al- lowed to leak out. I received their sympathy. I secured a truss In Edinburgh. This permit- ed me to enjoy the remainder of the tour. When I returned to London. Ontario. I immediately wrote to Shouldice of Toronto. I did this because two of my friends had wonderful results from their hernia operations by Shouldice and also my doctor said “They are the experts." In my letter I told them that I was in the pro- cess of taking off ten pounds to get down from 156 to 146 stripped. They promptly an- swered my letter. sending me a diet, and also telling me to get down to 146 lbs. with my clothes on. This meant reducing another five lbs. Muscular me didn't think that my fivefoot three- inch frame. with heels, carried that much insulation. This is a much better word than fat or blubber. I was examined January 3 in Toronto at the Downtown office. A date of January 26 was es- tablished for my operation. Four more pounds had to come off. making a total 'of 14 pounds. I reported at the clinic at 7750 Bayview Avenue at 1.30 pm Sunday. The exterior of the clinic and the forty-four acres of ravine and woodlot. made me think that this was a swank country club, not a hos- pital. The carpeted foyer, loun- ges, and corridors and the beau- tiful views that I could see from the picture windows, seem to confirm this idea. However, there was no bar. 22 Just at that moment a white frocked doctor appeared. and I was weighed in before I was booked in. If you haven’t lo the required number of pounds. you are rescheduled. I made it. I was later assigned to room 220. My semi-private room had two single beds. two night tables and a desk all in dark oak, with rich brown carpet and matching bed spreads. The soft brown and gold drapes over the picture window would do credit to the Holiday Inn. This can‘t be a clinic, I kept telling myself. I met my room- mate Charles Jacobs and others of the graduating class of January 26. 1970. At 5.30 pm I went downstairs to the dining room for dinner. The room was spacious. well appointed, with a home-like atmosphere. It was made so. I think, by the round tables that seated six people. We each introduced ourselves, just like a convention. People came from all points of the US. and Canada, and from all walks of life. The age varied from four-and-one-half years, to eighty-seven. In spite of this. we had a number of things in common. First. each hustled back to our beds to examined by the doctor. We Were instructed to lie on top of the bed. A nurse pren be‘ yceded the doctor and she in- stantly removed one side of the narrow bandage, exposing the incision. This was the first time that I had a peek at the opera- ting doctor‘s artistic work. It was a thing of beauty, a very thin straight line with 17 clamps spaced along the 4" in- cision. In some ways my mid- section looked like an abstract painting. Then in hurried the doctor. and in eleven seconds flat he removed eight of the clamps. The other seven he left till the next morning. People came from all points of the US. and Canada, and from all walks of life. The age‘ varied from four-andâ€"onehalf years, to eighty-seven. In spite of this. we had a number of things ,in common. First. each of us had a hernia or a rupture. Second. each had deci'ded to have the necessary operation to correct the condition. Third. each had selected the Shouldice Clinic as the place for the re- pair to bread basket. And to- morrow was R. B. Day. of us had a hernia or a rupture. Second, each had decided to have the necessary operation to correct the condition. Third, each had selected the Shouldice Clinic as the place for the re- pair to bread basket. And to- morrow was R. B. Day. ‘ Several friends and relatives Promptly at 10 o’clock all patients assembled in one of the main lounges for exercise. This is a daily affair. The nurse turns the record player on and then you stretch your arms in all directions in time with the music. The next exercise is bend- ing sideways from the waist. of the patients joined us for the This is followed by attempting nicely served dinner. After- wards we were instructed to get into our dressing gowns and pyjamas and house slippers. This was to be our attire for the next four days. At nine o‘clock we returned to theldining room for a snack. Immediately afterwards I re- tired to my room to take care of a shave job. This was a dry shave over a wide area for the to bend forward and touch the floor. All patients that had an operation the previous day are excused from this exercise. Then all march around the cor- ridor, take long steps and swing the arms. This is to promote blood circulation. All are then dismissed. Everyone starts to talk. Some play pool. Card games are or- ganized, and checkers. Some former Stephanie Kasyn from Manitoba. They have one daughter Jeannette, who is graduating in medicine in June at the University of Toronto. He was still in his army uni- form for a week when, at age 28, he joined the Shouldice Surgery staff at the old Church Street location. He was rec- ommended to Dr. Shouldice by his commanding officer in the army. Actually. Dr. Obney had known Dr. Shouldice for about 10 years. Dr. Shouldice was his clinical teacher at the uni- versity, but then he was only one of the veteran professor’s many students. Dr. Obney next met the hos- pital's founder when Dr. Shoul- A:AA "n.- flnâ€"II:â€"~ na- OL- -â€"...u.Â¥_ The site occupied by the new Shouldjce Hospital in the To- ronto fringe community of ’l‘hornhill once belonged to three local residents. Shouldire Hospital Site Once Was Owned By Two Farmers, Butcher In 1937 three parcels of land were brought under single own- ership as the\ site for an illusv trious country estate home. The land ‘deeds show the three parcels were purchased from bachelor farmer Major Dean. butcher William Dean, and farmer Howard Jackson Ness. The purchaser was the late C. George McCull-agh, a power- ful financier who once owned both “The Toronto Globe and Mail" and "The Toronto Tele- gram" newspapers. Patient Tells Story Of 6 Hospital Days Mr. McCullagh was a well known associate of former On- tario premier and former feder- THE LIBERAL, Richmond Hill, Ontario, Thursday, May 28, 1970 weeks. gé-câ€"aâ€"rhe ibeautiffilly contented, )up of partially stupid. But I was ms. At aware of what was going on._ .ef- Twenty minutes to six came Ieys around very quickly the next hile morning. I was given no break- and fast and was forbidden to take a drink of water. I was told her- to put on this white gown so m a that it was easy to identify 1eir Forty-five minutes later the iice doctor dictated to the nurse. hey some medical terms related to er I my operation in a very noncha- )ro- lant voice, as if this was an s to everyday affair. What a let- 146 down. This was a very important an- event in my 63-year young life. These we're delightful things _A4._ 1.“..Létnn11uv nnnfanh coming operation The nurse said “I’ll be around to check the shaves, I have caught the devil too many times from the doctors. This time the shaves are going to be right. My barbering activities were pronounced excellent. Then down with some pills. Lights out. It was ten o’clock and time to go to sleep. ihbse having an bperau‘on, and to wait. At eight o'clock a young man escorted me downstairs to a cpt. l wésfigivefi two small capsules containing a yellow ppwder. Next I was escorted to the operating table. and I climbed up on the table myself. A cur- tain was raised between me and the doctors. I felt a few pricks 575‘ the area for the operation was frozen. Then I watched the electric clock go around. I cogld see a little movement on the other side of the curtain. The nurse checked my pulse at my bemple once in a while. She had soft hands. However, I realize that this was the second operation per- formed by Dr. Brown and Dr. John this day and they would in all probability perform one or two more before 1 pm. A toaal of 17 people were operated on in the five operating rooms during the morning. No opera- tions in the afternoon, I was told. With assistance, I climbed down off the operating table and made my way back to my cot. In about twenty minutes I returned to the bed in my room, with guidance. The nurse gave me some pills and juice for a chaser. After a little snooze and a sponge bath, I got up and had a walk. The nurses are very ef- ficient and considerate. At 4.30 pm I was served my dinner in bed. I found that my little night table had a tricky concealed shelf that swung around over the bed and pro- vided a table. I sat on the edge of my bed to eat my dinner. I got up and walked around and at nine o’clock went downstairs for a snack. Then after a back rub I went to sleep at ten o’clock. Somewhere between six and seven o’clock. I was given pills and juice. Then I got up, did a little exercise, went for a walk, and went downstairs at eight for a breakfast of oatmeal, bacon and two eggs, toast and coffee. The fellowship is terri- fic. Everyone is talking to everyone else. Why not. We had all been through the same ex- perience. At 8:45 we were all hustled back to our beds to be ‘examined by the doctor. When Mr. McCullagh died, the property was inherited by his family. which included his wife. two boys and a girl. h Actually, the Shouldice Sur- gery at one time was pretty well staffed with old army bud~ ' dies. In 1948 a 50-year ac- al leader of the Progress“? quaintance of Dr. Shouldice. Dri Conservative Party, George Noble Black, joined the staff Drew. . from the army. and worked in A London. Ontario natlYe. tllefhe hospital until his death in late Mr. McCullagh worked inl1965. A London. Ontario native. the late Mr. McCullagh worked in a brokerage firm and was aided in his career by the owner of Wright-Hargreaves Mines Ltd. of Toronto. The late Dr. Earle Shouldice, founder of the hospital, pur- chased the site in 1953. The mansion built by the for- mer owner was first used to provide additional hospital space for the Shouldice Surg- ery's downtown facilities. It was renovated according to the hospital’s requirements and lat- er incorporaied into the new building. talk about gas or just plain shoot the breeze. Gas plagues everyone, exercise is most help- ful. I walked two miles up and down the corridor. Eleven full laps is a mile. The men outnumber the wo- men patients about thirty to one. The women do not seem to suffer as much as the men, except when they are forced to laugh when watching Bob Hope on color T.V. My third day ended up a little different from most. It was a repeat of the first day, as I had to have the left side operated on. In my wuuyness while on the table. I very carefully in- structed the doctor that I wan- ted matching incision, so that my mid-section would be bal- anced. Two hours after the operation, I was playing pool. The fourth day I said goodby to my newly made friends who had only one operation. Two days later I left also. A doctor gave the departing group a talk lVlUSL patients Have a \‘HSLLUA feeling when leaving, as they say goodby to the doctors and nurses and friends. Three thousâ€" and and eighty-eight patients performed this ritual in 1969. I am one of the first of 1970. My neat repair jobs are guaranteed. Should they re-occur within ten years. my bread basket will be repaired for free. So now all that remain is to warm up the car that has been resting in the parking lot and drive home. Since I have returned home I have met a couple of friends who have also been to the clinic on the Operation, telling them in Toronto. We greeted each that they would be able to re- other like Brother Elks. The turn to their normal occupation ‘very soon, and that you were ;to be guided by any feelings of surgery, in fact. seems like the initiation ceremony to the Shouldice Health Club. Dr. Nicholas Obney. chief surgeon and head of the med- ical staff, has performed 18,500 hernia operations in his 2+year career at Shouldice Hospital. Dr. Obney is also president of Shouldice Hospital and chairman of the board of dir- ectors. He was the personal under- study and confidant of the hos- pital‘s founder, the late Dr. Earle Shouldice. Chief Surgeon President 24 Years With Shouldice “The hospital was built on public service. Every patient gets the same treatment," says Dr. Obney. “The basic thing is good sur- gery and good medicine, the very best we know. Then comes the human element. with the nursing staff being a major key. “The whole thing originated with Dr. Shouldice. He trained us. We are carrying on his tra- dition and passing it on,” says Chief Surgeon Obney. Dr. Obney came to Canada from Eastern Europe with his parents. He was then nine years old. He attended Charles Fraser Public School and Parkdale Collegiate in Toronto. He stood first in his class every year through high school. To be a doctor, he says. a student must be good in science and maths. The student can‘t be content with just passing. He must be determined to get to the top. because competition is so keen at medical school and in the profession. The student aiming for medicine must be one who struggles to reach as nearly as possible toward per- fection. But this isn't all, says Dr. Ob- ney. To be a doctor. the stud- ent must like people and be interested in them. He must know how to work with them. EspecialLv in surgery he must be able to inspire confidence. The Shouldice Hospital has been Dr. Obney’s life work, although in the early years he never expected it to be, The responsibility and involvement just grew and grew. he says. Dr. Obney is a graduate of Toronto University. He in- terned at Toronto General Hos- pital. During World War II he was an army medical of- ficer, leaving active service with the rank of captain. Dr. Obney is married to the former Stephanie Kasyn from Manitoba. They have one daughter Jeannette, who is graduating in medicine in June at the University of Toronto. He was still in his army uni- form for a week when, at age 28, he joined the Shouldice Surgery staff at the old Church Street location. He was rec- ommended to Dr. Shouldice by his commanding officer in the army. Dr. Obney next met the hos- pital's founder when Dr. Shoul- dice was serving as the army‘s surgical consultant. He worked in the army a year at the To- ronto Exhibition Grounds with Dr. Shouldice. When Dr. Obney joined the staff, Dr. Shouldice was then still operating and felt he needed some help. Dr. Obney started work the day after Dr. Shouldice suggested it. A second operating room was opened and Dr. Obney began doing his own operations alone in 1948, after close to two years of careful tutoring by Dr. Shouldice. But Dr. Obney con- tinued to be advised by Dr. Shouidice during difficult oper- ations. In 1948 Dr. Shouldice de cided to take a holiday in Flor- ida and the hospital faced being closed doxm while he was away. Many patients then were still pain and strain. The repair was twice as strong. as originally. The three layers of muscles were rearrange and sewn into place using stainless steel wire. No screening is used. All patients are to be examined once a year by the clinic after the first year. Your family doctor can do this and the bill can be sent to Shouldice. if it is inconvenient to visit the clinic. This is done for nine years. Most patients have a wistful“ feeling when leaving, as they say goodby to the doctors and nurses and friends. Three thous- and and eighty-eight patients performed this ritual in 1969. I am one of the first of 1970. My neat repair jobs are guaranteed. Should they re-occur within ten years, my bread basket will be repaired for free. So now all that remain is to warm up the car that has been resting in the marking lot and drive home. insisting that Dr. Shouldice had to be around when they had their operations. It was decided Dr. Obney would ask patients on the wait- ing list if they would be happy to go ahead with Dr. Shouldice's understu-dy, a doctor trained for many months in the hos- pital founder’s method. There turned out to be a lot more willing patients than ex- pected and Dr. Obney ended up having 38 operations done by himself and the staff in the first 1% weeks. The surgery then had no emergency operating r o o on lighting, and the lights went out. Dr. Obney finished up one of his first solo operations by flashlight. The surgery con- tinued in operation until after the 38 operations were done under Dr. Obney. Dr. Shouldice arrived back from holiday and was very im- pressed and pleased with Dr. Obney‘s work. After that Dr. Obney took on progressively more difficult operations. From then on he had Dr. Shouldice’s best teaching attention, support and encouragement. Dr. Obney then began taking on administrative responsibili- ties at the hospital and had complete responsibility when- ever Dr. Shouldice was away. % Dr. Obn’ey always refers to the late Dr. Shouldice as the Chief. He tells of 1958 when in Moscow. the Chief met a Russian medical professor who was going to visit Canada. The Russian professor ended up vis- iting the Shouldice Surgery, bringing with him a number of colleagues. one of whom hap- pened to be suffering from a hernia which had recurred on the same side after two opera- tions. Dr. Obney operated on him on Thursday and discharg- ed him on Saturday. “Dr. Shouldice really loved teaching and always wanted to pass his knowledge on,” says Dr. Obney. “He never agreed to have any contracts with his medical staff. None of the hos- pital’s doctors .ever had any. He always said his people would only stay if they wanted to, and no contract would ever hold them," the chief surgeon says. Dr. Frank Glascow is the In this way he was able to second most senior staff surg- determine what had gone wrong eon at the hospital. and so was able to bring about The late Dr. Shouldice had.a steady improvement in tech- done 4,000 hernia operations at nique. 'his surgery by the time he The Shouldice Hospital’s her- Estopped doing surgery in 1955, nia recurrence rate is now down Dr. Frank Glascow is the second most senior staff surg- eon at the hospital. says Dr. Obne.“ DR. NICHOLAS OBNEY We Are Happy To Be The Supplier of Fresh Produce P. T. MANNONE PRODUCE 126 ESPLANADE EAST - TORONTO 1 7750 BAYVIEW AVE., THORNHILL Shouldice Hospital FOR THE NEW prime target. He usually keeps eating well and fat replaces muscle tissue. especially in the groin. One day, confident that he's the same man he always was, he will help someone lift or push something and his weakened belly wall will split. But it‘s not only the fat and the soft who hit trouble: any man, no matter how strong. fit and muscular, can develop a lmpture. Shouldice Hospital Opens May 30123395 HOSP'ITAL'S FOUNDER Shouldice Hospital has an in: teresting history, much of it related to one man, the late Dr. Earle Shouldice. Earle Shouldice was born in 1890 on a farm in Bruce Coun- tY. Ontario. When he was eleven, the family moved to a 10,000 acre ranch in Alberta. Ranch chores interfered with his school work and at various times during his education only stubborn determination com- bined with bursts of intense study pulled him through. But the ranch work also convinced him not to do manual work all his life. When he enrolled at Toronto University, he didn't know what course to take so. at his mother’s urging, he tried the- ology for a year and also toyed with forestry. But in 1911 he settled into medicine and grad- uated five years later. Probably all men who ach- ieve prominence can recall some comment that later in- fluenced their lives. Earle Shouldice always remembered a remark by his professor of surgery, that “more opportun- ities exist in medicine now than ever before. Each new discov- ery opens up an entirely new field for research.” Shouldice’s eventual career always blended practice and research. During the 1920s the young Dr. Shouldice carried on inten- sive research into intestinal ob- struction and later also gave special attention to saline in- jections as a protection against dehydration following periton- itis; and the strengthening of sprained ankles. He lectured in anatomy at the university for} many years and also worked closely with Professor Gallie who had by then developed his ‘own technique for repairing hernias. And again the professor had a lesson for the doctor. Gallie made a point of always analyz- ing hernia operations which had failed; and this in turn stimulated Shouldice's interests in perfecting techniques and led eventually to his hospital’s elaborate follow-up procedures, In the 19305 Shouldice’s in- novating mind was teased by the possible advantages of get- ting patients on to their feet again very soon after surgery. In those days patients were ex- peeted to remain quietly in bed for days and even weeks after an operation. This forced in- ‘activity frequently led to comp-1 lications. Frequently blood clots would form in the legs and sometimes break loose, travel to the lungs and cause sudden death. Other pulmon- ary problems also often result- ed from long stays in bed. REMEMBERED DOGS Shouldice remembered that in the 19205 he had operated on dogs and found that none suf- fered ill effects from moving about normally as soon as the anaesthetic wore off. In 1932 Short Length Of Stay Makes Big Difference At Shouldice Hospital The short length of time the average patient stays is one of the things that makes the dif- ference at Shouldice Hospital. VThe average stay per hernia patient in the United States is nine days. wKt éhouldice Hospital the average patient stays only four days. The hospital does about one- sixth of the hernia operations done in Ontario and about 25% of its patients come from the United States. Of alls-the patients that come to Shouldice Hospital, about 13% are described as recurrenc- es. That is, patients that had previous operations elsewhere before coming to This specialty ‘institut-ion. l More of the US. patients are recurrences, about 16%. When the founder. Dr. Earle Sh-ouldice, started his surgery, he had a 12% recurrence. He learned by operating on some of his own recurrences and ran his own follow-up research pro- below one percent Continued from Page 21) he performed an appendectomy on a small girl and the next day noticed her jumping about happily in her bed. He ob- served that no harm resulted from this and she was shortly back at her school. In 1936 he performed four hernia opera- tions and all his patients insist- ed on getting out of bed to use the washroom. He let them do this and they all recovered well. By this stage he was convinc- ed of the advantages of early ambulation but he also knew he? would have to proceed caut- iously. A blunt, determined and sometimes tactless man. Earle Shouldice had already rubbed a number of his medi- cal colleagues the wrong way. Conservative doctors distrusted the way young Shouldice kept questioning the accepted way of doing things. He now realized that if heencouraged early ambulation and} then post-operative complica- tions arose because of deficien- cies in surgical techniques, the ambulation. not the surgery. would be blamed. To give early {ambulation a fair trial under 1the stern gaze of his detractors {he would first have to become highly expert in surgery. The decisions he was making in the late 305 would eventually estab- lish the whole direction of his life. In June 1940 he became a consulting surgeon to the Can- adian army and soon learned that many volunteers could not be accepted for service because they suffered from hernias. Canada needed soldiers but hospital space and doctors were both hard to get for such non- emergency surgery which nor- mally needed three weeks of? hospitalization. The doctor discussed this problem with Charles Rathgeb of the Canad- ian Comstock Company. Shoul- dice contributed his own serv- ices free and, as a contribution to the war effort, Rathgeb ag- reed to under-write hospital costs for the hernia patients. emergency surgery which nor- mally needed three weeks of hospitalization. The doctor discussed this problem with Charles Rathgeb of the Canad- ian Comstock Company. Shoul- dice contributed his own serv- ices free and. as a contribution to the war effort, Rathgeb ag- reed to under-write hospital costs for the hernia patients. Under this arrangement the doctor operated upon many men. At times when there was a shortage of hospital beds he would operate in the Emergen- cy Department and later in the day drive his patients to a med- ical fraternity house where the students nursed him for two or three days. Under this ar- rangement Dr. Shouldice per formed seventy operations On August 20, 1965. Earle; Shouldice died but his hospital and the techniques he develop- ed continue. His son, Bymes is now a surgeon there and staff doctors include many who have worked with the institute for ten or more years. Manag-u ing Director, Jack MacKay. joined the hospital in 1950 and Dr. Obney is now in his twenty- fifth year. Head Nurse, Caro-i line Martin, has spent twenty-3 five years at the hospital. The; new hospital will serve as a‘ memorial to Dr. Earle Shoul- dice â€" but it will not be a static memorial. In this spec- ialized branch of medicine, as in all others, techniques will continue to improve and evolve, and knowledge and experience to grow. upon men all oi whom later joined the army. The volunteers were. of course. delighted and rapidly spread the word in their home- towns. ’ Civilian patients start- ed contacting the doctor and asked him to operate upon them too. Under war condi- tions this was impossible but a nurse kept a list of all such ap- plications and by the time Dr. Shouldice left the army 200 civilian patients were awaiting him. As more and more patients} requested operations. Dr. Shoul-l dice extended facilities by buy- ing other houses nearby. and finally owned four buildings on one block. Gradually other doctors joined his hospital. In 1953 a rambling estate in ‘Thornlhill, on the northern out- lskirts of Toronto, was purch- ased and the second Shouldice hospital was established. By planning and supplying furniture and furnishings, we are proud to have participated in the progress and development of the Hospital in meeting the growing demand for its services and facilities. Congratulations EATO N'S CONTRACT SALE§ DIVISION 0-? EATON" An active sports-minded teen- ager was one of the many for- mer Shouldjce Hospital patients who wrote letters of apprecia- tion during the past year. who wrote letters'of abprecia- “Thus, if anything were ever tion during the past year. to have gone wrong. it would The Colgan. Ontario 15-year-lhave been during those years old wrote as follows: 11 have played these sports. I “I had been planning on must say my mother always writing you a letter thanking told me to be careful and not you for the wonderful hernia to strain myself. operation you performed on me But don‘t think that I’m go- when I was four. ing to strain myseli playing “Before I got a chance to write that letter, I received in the mail an envelope with two pictures of your new location. It looks very modern and i1- lustrates your area of progress in the modem world. “I am 15 now. and for nine years I have had that operation. And not once has it ever given me any trouble. Boy. I must admit I have been quite rough on it. “I played baseball all sum- mer as a catcher. I play foot- t0 the Shouldice Hospital on completion of its magnificent new addition S. Bone 8: Sons Florists Thornhill Paint Supplies Ltd. 7707 YONGE STREET THORNHILL The Shouldice Hospital ON THE OFFICIAL OPENING OF THEIR NEW EXTENSION Friend 8: Neighbor SHOULDICE HOSPITAL 7750 BAYVIEW AVE., THORNHILL THORNHILL on the Official Opening of their new extension 195 AVENUE RD., TORONTO All Sports After Surgery We Salute A Congratulations to or CANADA Lmnxi ball for our high school as half- back. I also play hockey as a defenceman and spare goalie. But don’t, think that I'm go- ing to strain myseLf playing football, hockey or baseball, no sir. “And above all that, I live and work on a 200 acre farm. Thus I have now realized that l have complete confidence in myself. “And I’m proud to say I am participating actively in every sport, without a single handi- cap. “My thanks to the wonderful staff at Shouldice Hospital, and my recommendation to you will always be extended."