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Business Events Toronto has all of the tools and resources you need for success. As your partner, we provide complimentary expert advice and professional guidance on the following: • Reviewing and analyzing Conference Hosting Guidelines • Crafting strategic response in conjunction with the local chair and committee • Creating a conference budget (if required) • Customized bid book production PUBLISHER • Coordinated site inspections Linda Quattrin 04 • Complimentary Attendance Marketing Program • Providing information on Canada Customs and Immigration The Great • PR and Media Relations EDITOR-IN-CHIEF Heidi Singer Unknowns We share your passion for success and we will work with you to ensure Medical mysteries that your conference exceeds every expectation. ART DIRECTION + DESIGN keep us up at night. Raj Grainger For expert advice, please contact: ALICE AU CONTRIBUTORS Director of Sales, International Congress 14 Susan Bélanger Business Events Toronto Erin Howe The Secret Dir: 416-203-3819 Barbara Kamienski M: 647-242-9935 Science of John Lorinc [email protected] Beth McAuley World War II Liam Mitchell To join The Leaders Circle, please email: 28 Medical researchers at Carolyn Morris KATHY NICOLAY U of T were engaged in Julia Soudat The Genome Leaders Circle Manager a number of top-secret [email protected] Stephen Strauss Redux projects. The story of one Erich Weidenhammer that saved many lives. BusinessEventsToronto.com For 30 years, reporter Stephen Strauss has — waited for a genomic revolution that lived up to PUBLISHED BY its promise. Is it CRISPR? University of Toronto Faculty of Medicine 6 Queen’s Park Crescent West Suite 306, Toronto, ON M5S 3H2 18 Phone: 416-978-7752 Mystery Facebook: U of T Medicine Devices Twitter: @UofTMedicine Instagram: @UofTMedicine 24 What are these curious YouTube: UofTMed Mystery of medical artifacts? Help the Faulty us identify them! [email protected] Heart Valve The University of Toronto respects your privacy. We do not rent, trade or sell our mailing lists. It took a pathologist to pick out the dangerous pattern. —

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2 1 Dial M for Medicine

“The world is full of obvious things which nobody by any chance ever More Mysteries observes.” Can’t get Are you a mystery or a history buff? We have a challenge for you! Go online — Sherlock Holmes in Sir Arthur Conan Doyle’s enough? to help us determine the function of our The Hound of the Baskervilles. antique medical instruments. Share Good. your answers with us on twitter or instagram (@uoftmedicine) or email them What makes for a really good mystery? It isn’t just A mystery is rarely solved by There’s to [email protected]. an interesting question or sparring with a particularly revealing what’s unknown. It’s Guesses will be posted online. Can’t wait evil villain. A good mystery is born from the tension the careful re-evaluation of what’s more to get started? Flip to page 18. that builds as our hero pursues the truth, often right in front of us that makes against the odds. the truth self-evident. What I online! Secrets of WW II see when I look at the Faculty In many ways, that’s what happens every day in of Medicine is a community Military history fans will love reading the Faculty of Medicine. Our students and faculty committed to uncovering facts — about U of T Professor Wilbur Franks don’t just struggle with novel questions but pursue and by doing so, finding solutions and his anti-gravity suit (page 14). Check evidence through research and rigorous examination. to some of the most complex out even more archival photos online They see their fair share of villains, sometimes in the problems in science and medicine. of Franks and the invention that saved form of devious pathogens, but more often revealed And that, to anyone who observes many pilots’ lives during World War II. by a dog that doesn’t bark, like from an Arthur Conan us, is obvious. Doyle tale. Physicians and medical researchers are A Moving Tribute frequently confronted by mysteries that demand not just strong clinical and scientific skills but also a Globe and Mail reporter Ian Brown, the gumshoe determination to uncover the facts. We are father of a special-needs child, brought both Sherlock and Dr. Watson. the house down with his tribute to Denis Daneman, the departing Chair of This issue of UofTMed delves into the realm of Paediatrics, at a recent SickKids event. mysteries to find the inherent drama that rests Read what he said. behind questions and examine how we persevere Trevor Young to reveal the answers. The process is sometimes MD, PGME (Psychiatry) ’88, MSc ’89, PhD ’95 The British Connection frustrating and at other times exhilarating, but it’s Dean, Faculty of Medicine never dull. Vice-Provost, Relations with Health Care Institutions Do you know the mystery of the three paintings by Sir Frederick Banting? Read new details about Miss Nancy Archer, the works’ original owner, and go online to see → uoft.me/medmag all three paintings. 3 What makes for a great medical mystery? Seven faculty members share the unsolved cases that keep By Heidi Singer them up at night — and some of the great questions still unanswered in medicine. Where Cancer Doesn’t Tread

‌hy do our muscles almost never get Penney Gilbert cancer?‌ This disease is ‌infamous is an Assistant for‌ becoming very invasive, travel- Professor at ling‌ everywhere in the body — but the Institute for Resisting skeletal ‌ muscle is never the place it Biomaterials Wgoes. It’s just this really interesting observation that and Biomedical Our Genetic people have made, and we don’t have an explanation Engineering. for it. As far as I can tell, nobody has dug down and fig- Destiny ured out why, and there might be some important information to use in the fight against cancer. For example, there could be unique proteins in muscle that prevent here are kids with autism who can cite Stephen Scherer tumour cells from wanting to put down roots in this every name, address and number in a (MSc ’91, PhD ’95) type of tissue. Or it could be something fairly simple — phone book but have trouble tying their is Professor of muscle is always moving, so maybe it’s difficult for shoes. Sometimes I wonder which is the Molecular Genetics cancer cells to enter this tissue. bigger medical mystery — their amazing and Director, Tmemories and motor deficiencies, or everybody else’s McLaughlin Centre; memory deficiencies but adeptness at other, perhaps Senior Scientist, simpler things? The Hospital for Sick Children. Studying the genetics of autism brings up a very fun- damental mystery: Why do some people who have massive genetic irregularities never develop autism (or other disorders), but their children do? This mysterious ability that some people have to resist their genetic destiny is utterly fascinating. Scientists all over the world are now combing through the genomes of healthy people, looking for those rare ones. These miraculous genomes have learned to resist adversity, so maybe they’ll show us the way. Genetic “resiliency” is perhaps the biggest diagnostic mystery of 21st-cen-

tury science — and potentially the key to solving our LONDON LIBRARY, WELLCOME most complex medical questions. THOMAS FISHER RARE BOOK LIBRARY BOOK RARE FISHER THOMAS

6 Solving a 50-Year- Old Mystery

few‌‌ years ago, my lab discovered a cru- Richard Hegele cial‌ receptor for respiratory syncytial (MD ’84, PGME ’89) virus‌ (RSV), which frequently causes the is Vice Dean of ‌common cold and serious lung infec- Research and ‌ tions like pneumonia. Researchers had Innovation and The Mystery Aknown about this virus since the ’50s, but we hadn’t a Professor in made much progress on a treatment because nobody the Department of the Aging, had identified the molecule that allows the virus to bind of Laboratory to the cell. We looked at our quest as a mystery that Medicine and Failing Brain needed solving — and I believe that mindset helped us. Pathobiology.

First we determined the virus sticks to protein, not sugars or lipids. But which one? The cell surface con- ging,‌ failing brains are normal enough — Graham tains thousands of proteins so, we had to narrow it anyone‌ who lives a long time will probably Collingridge is down. We separated cell surface proteins on a gel and feel‌ this decline. Of course dementia is far Professor and got a common “hit” for all the cell types and RSV strains ‌more tragic than “normal” memory loss, Chair of the we tested. We identified the protein we thought was ‌ but why should we lose any part of the Department of responsible for these hits, and after a series of experi- Athoughts and memories that make us human? I don’t Physiology. ments using different techniques, we established the think it’s a given that our brains should wear out like evidence that this unusual molecule was indeed an RSV other parts of our bodies. Why should the aging pro- receptor. The answer wasn’t intuitive, but came from a cess wipe out our very identities? great deal of trial and error — gumshoe detective work that solved a 50-year-old mystery. We’ve never solved this mystery, and as a result the medical landscape is littered with failed drugs to treat The main lessons were to keep an open mind, expect dementia. But recently, we have started to take a step the unexpected and understand your tools. Basic sci- back to understand the molecular basis of learning entists don’t always see their investigations as mys- and memory. There have been great strides recently teries to solve, but I think it helps to look at it this way in this area. Now the challenge is to understand why because in any good mystery the culprit is never the and how these processes go wrong in conditions like one you suspect at first. Alzheimer’s — and then develop treatments to alleviate and perhaps even cure these awful diseases. THOMAS FISHER RARE BOOK LIBRARY BOOK RARE FISHER THOMAS

8 9 That heartbeat was like a gift Why Do Children from God. Get Cancer?

Gino Somers s a‌ medical student, I used to think cancer was (PGME ’04) is an a‌ disease of old people: your cells get old Associate ‌and don’t divide as well and the DNA gets Professor in the ‌ jumbled. But why do children get cancer? Department ‌ On an emotional level it’s totally unfair; Under Pressure of Laboratory Ahowever, there are lessons here that can be applied Medicine and to many cancers. In children, there’s a fine balance Pathobiology, between normal development and cancer. For exam- 64-year-old‌ woman was carried into the emergency room one Brian Goldman and the ple, some childhood cancers are caused by two chro- night screaming from abdominal pain. To my surprise, her (MD ’80, PGME ’82) Division Head mosomes breaking and rejoining out of order, result- ‌ belly was soft, ruling out most of the obvious causes. Her is an emergency of Pathology at ing in two normal genes being pushed together. These ‌ adult daughter was worried sick, and pushing hard for action. room physician SickKids. genes are essential for normal development, but putting ‌ I felt the pressure to get it right. Blood tests showed ele- at Mt. Sinai them next to one another, “out of order” on the chro- Avated lactate, which meant somewhere in her body wasn’t getting oxygen. Hospital, mosome, is enough to push a very controlled process I could order a CT scan, but radiologists always say if you don’t know what Assistant (normal development) to an uncontrolled one (cancer). you’re looking for, you won’t find it with a scan. Just when I’m trying to Professor of figure out my next move, she flips into atrial fibrillation. That’s when I Family and We still don’t understand what’s causing those chro- smile — now I know she’s got a blood clot leading to an ischemic bowel. Community mosomes to break in the first place. Researchers are Medicine and studying this question, and we’re hoping that genomic I put her on blood thinners and send her off to the CT scan. Now that I host of the CBC sequencing and high-powered bioinformatics will help know what I’m looking for, the scan confirms the diagnosis: it shows sev- Radio show us solve this mystery. eral feet of bowel that are deprived of oxygen and swelling up, causing White Coat, intense pain. An interventional radiologist takes the clot out. Black Art.

The things that ER physicians see are common occurrences. We solve mysteries mostly through pattern recognition. The first unusual pattern I saw in this case was pain out of proportion. But it wasn’t until her heartbeat went irregular that I thought of a blood clot in the vessels of her intestines. That heartbeat was like a gift from God: it made me realize there was tur- bulence in the blood stream.

Detectives solve mysteries. But I don’t imagine them becoming emotionally burdened by anxiety from their cases like doctors do with their patients. What if that woman had been close to death and I hadn’t had much time to figure out the problem? Clinicians are never dealing with a sterile medical mystery. Panic and logical thinking never go well together. THOMAS FISHER RARE BOOK LIBRARY BOOK RARE FISHER THOMAS

10 11 The Deep Sea of Possibility

he world’s oceans hold medical mysteries Andy Fraser overlooked since the beginning of time — I is a Professor think they hide life forms that could be the at the Donnelly next frontier in understanding and curing Centre for disease. Cellular and T Biomolecular The vast majority of this planet’s biological molecules, Research and up to 95 per cent, haven’t been studied well, because the Department we don’t know how to grow them in a lab. But they of Molecular have all kinds of interesting biological activities. For Genetics. example, there’s a single-cell organism that puts out a telescopic spike ten times longer than its body — a whole new life form. Scientists are only now starting to pull these fascinating creatures out of the sea, and they’re finding that any crazy thing you can dream up, some species does it. For example, some don’t make DNA transcripts — instead, they stitch together bits of RNA to form the proteins that control our genetic destiny. Who knows how this can be used for gene editing?

Over a billion years, evolution has figured out every way imaginable to play around with biological molecules. To fix what’s wrong in our genes, we need to uncover the mysteries that are already in front of us, or hiding under water. THOMAS FISHER RARE BOOK LIBRARY BOOK RARE FISHER THOMAS

12 When the pressure hit, Franks thought the suit would cut him in two.

Deep within a mysterious North Toronto building, Faculty of Medicine researchers developed So what exactly does an anti-gravity suit protect the world’s first the body from? When someone is sitting at ground anti-gravity suit. level, not moving, the earth’s gravitational field exerts what’s called a 1-g force, equivalent to the weight of that person. But when the same individual is being whipped around on a tight curve on a roller coaster, for exam- By John Lorinc n August 1941, moviegoers flocked to the latest ple, inertia causes their body and blood to move along Hollywood war flick calledDive Bomber, which the original trajectory, resulting in a sudden increase hit theatres months before the bombing of Pearl in centrifugal force. Harbor. The film tells the tale of two men — a Scientists say that when this increased pressure is Harvard-educated doctor and a seasoned pilot — double the g-force of a resting body, the individuals’ Isearching for solutions to the altitude sickness and weight at that moment is effectively doubled. At a blackouts that afflicted pilots on dangerous missions. high g-force, the weight of blood may be several times The unlikely pair defied the skeptics and experimented higher than at rest. The heart, in turn, strains to pump with a “pneumatic belt” meant to keep blood flowing the blood around the body, especially out of the lower to the brain. The film, audiences were told, was dedi- extremities and into the brain. Under this g-force strain, cated to the cause of “aviation medicine.” an individual experiences reduced vision, temporary Toronto audiences likely had no idea that the story blindness and finally loss of consciousness — a con- was an almost eerily accurate retelling of the pioneer- dition known as static hypoxia. ing, super-secret aviation medicine experiments car- According to a 2004 article in the Journal of Aviation/ The ried out by University of Toronto researchers at a Royal Aerospace Education and Research, the increasingly Canadian Air Force facility on Avenue Road north of powerful fighter planes that were being developed Eglinton. during the interwar period seemed to be causing more The facility was located on the grounds of the former accidents with pilots blacking out at the controls of air- Eglinton Hunt Club, which the RCAF bought for $50,000 craft that were flying higher and faster than ever before. Secret to run its training programs. Inside, Professor Wilbur In the late 1930s, with the war in Europe looming, Franks (BA ’24, MB ’28), a U of T cancer researcher working Banting realized that aviation medicine could play a for Sir Frederick Banting (MB ’16, MD ’22), used a human strategic role in a conflict that would see increased centrifuge to test the anti-gravity suit he’d designed use of bombers and fighter planes. His interest wasn’t for air force pilots prone to blacking out from intense incidental: Banting had served as an army surgeon in Science g-force pressure created by tight turns and nose dives. World War I and remained an officer in the reserves The suit, which he personally tested at Camp Borden after the armistice of November 11, 1918. west of Barrie, Ontario, and later at the Farnborough Working with the RCAF, Banting moved to create an Airfield in England, was the first of its kind and estab- aviation medicine research team at U of T and tapped lished Franks as a pivotal figure in the history of avi- Franks, whom he’d met through a mutual friend of of World ation medicine. But its development exacted a heavy Charles Best (BA ’21, MA ’22, MD ’25). At the time, Franks toll: Banting, one half of the team credited with the was doing cancer research, which involved the use of discovery of insulin, was killed in a crash in early 1941 a centrifuge for samples. He had noticed that glass in Newfoundland while heading to England to test test tubes tended to shatter in the device. But when he Franks’ invention. packed the tubes in water, they were fine.

War II PHOTOGRAPHY MARSHALL JACK / ARCHIVES TORONTO OF UNIVERSITY 15 Franks and Banting were both fearless, and seized with a sense of mission. COULD BACTERIA HOLD THE SECRET TO CONQUERING DISEASE? Seconded to Banting’s project, Franks began thinking now completing a doctorate on the history of aero- about the significance of this modification of a testing space medicine, says the centrifuge looked like a giant technique, and realized the water around the tube cre- stand mixer, with an air-tight gondola that could hold ated sufficient hydrostatic pressure against the tube to one person. The gondola’s temperature, air pressure counter the centrifugal force. Perhaps, he thought, the and orientation could be altered, with internal sen- same principle would apply to human tissue. sors monitoring performance. (There are photos of After experimenting with mice at the Banting Franks himself in the centrifuge, which was in oper- Institute, Franks in 1939 began developing a rudimen- ation until 1987.) tary version of an anti-gravity suit, which was lined with Franks reckoned it was possible to scale down the suit, fluid-filled pockets and designed to fit snugly around so the coverage was limited mainly to the legs and but- a pilot’s legs and torso. To fund the research, Banting tocks. Bimm says Franks made numerous versions of the had approached an eccentric construction magnate suit, up to “Mark 7.” “They refined it many, many times.” named Harry F. McLean for a $5,000 grant. McLean, U of T historian Michael Bliss (BA ’62, MA ’66, PhD ’72), in an aviation buff who once set out on a round-the-globe his biography of Banting, described him and Franks as flying mission with his personal nurse, was known for “tinkerers.” “They tried things,” Allen says. “Sometimes Bacteria that survive the assault of a virus slice wandering around in public, giving away large sums it worked, and sometimes it didn’t.” out and store scraps of its genetic material in their of cash or cheques. Following Banting’s tragic death in February 1941, own DNA. When the virus returns, the bacteria Early in 1940, according to “The Remotest of Franks finished developing the suit sufficiently, such read that material as instructions to eviscerate the Mistresses,” Peter Allen’s 1983 biographical essay on that the Royal Air Force was prepared to use it in combat. attacker’s genome. Franks, the researcher took a bespoke version of his But the Allies regarded the discovery as so significant invention to Camp Borden and went up with a RCAF that they didn’t want to fly sorties over Europe, for fear The recent discovery of this bacterial immune pilot. Allen, a commercial flyer and accountant who of losing a plane operated by a pilot wearing the “Franks system, known as CRISPR-Cas9, was a master first met Franks in the mid-1970s, writes that Franks Flying Suit.” If the Germans captured the flyer, the RAF class in gene editing taught by nature itself, and had never even flown before, “much less endured high thought they could reverse engineer it. it sparked a revolution in cell biology. G aerobatic maneouvers.” But he and Banting were Instead, RAF pilots wearing Franks’ invention were both fearless, and seized with a sense of mission (they sent to North Africa to provide air support for US Some of the Faculty of Medicine’s brightest minds had enlisted after Canada declared war and were given General Dwight Eisenhower’s invasion of Algeria in are now deploying this powerful system to suppress officer ranks). “It was their mentality,” Allen said in a 1942. The results, Bimm says, were mixed:“They found cancer cells, reverse muscular dystrophy and destroy recent interview. “They just did stuff that was risky.” it difficult to move around.” US researchers took over. deadly microbes. And they’re just getting started. “In the airplane, I was sitting down,” Franks told But senior American aviation medicine experts later Allen. “[W]hen the pressure hit, I thought [the suit] told Franks his pioneering work was critical in the was going to cut me in two.” Wing Commander D’Arcy refinement of the technology. The work in Toronto, To support the Faculty of Medicine’s development Greig, an ace Royal Air Force pilot, also tested the suit moreover, paved the way for the Canadian military’s of CRISPR-Cas9 and other cutting-edge treatments, during secret flights at Malton in early June 1940. He sustained investment in aviation research at CFB please make a donation today. came to similar conclusions. Allen quotes Greig’s report Downsview, which continues to this day. “That traces in his 1983 essay: “The suit in its present form is not a right back to the decision to make this a competency 416-946-3111 practical proposition.” in Canada,” says Bimm. donate.utoronto.ca/medicine Interestingly, German scientists as early as 1931 had The military didn’t declassify information about the boundless.utoronto.ca/divisions/faculty-of-medicine/ arrived at a the same impasse with their own version Franks Flying Suit until the 1950s, and Franks himself of an anti-gravity suit for pilots. They opted to discon- remained a low-key medical researcher until the 1970s, tinue their research program. when, Peter Allen heard him lecture at U of T about the Realizing that they needed to refine the invention, invention. He decided to make it his mission to ensure Banting and Franks persuaded the RCAF to partner that Franks was duly recognized for an achievement with U of T and Victory Aircraft (later Avro) and build that has reverberated through the post-war history of a human centrifuge at the Hunt Club facility in 1941. military flight. “Franks was a very understated man,” Jordan Bimm, a PhD candidate at York University Allen reflects. “He just thought he was doing his job.” 16 17 Purpose Unknown

Help Us Solve the

SNAPSHOTS Mystery of These Medical Devices

Curated by Erich Weidenhammer Photo by Jacklyn Atlas

A rich trove of curious medical devices is being stored in a back room of Sidney Smith Hall on St. George Street. Most were found in obscure corners and basements of Toronto research labs and hospitals, or passed on by collectors. Historian Erich Weidenhammer (PhD ’14) and a small but passionate group of medical history buffs from various Toronto institutions shepherd the growing collection at the Institute for the History and Philosophy of Science and Technology. One day, they hope to turn it into a museum of medical instruments. Highlights from the collection are on display until spring 2017 on the third floor of Victoria College.

Each of the objects was once a mystery to identify — or still is. Tweet your guesses to @uoftmedicine or email us at [email protected]

See page 27 for clues. 18 Dancing the By Erin Howe in Dark

With no explanation for her symptoms, Rachel became a mystery to her doctors — one of the ‘medically unexplained.’

‘The symptoms are real’

When faced with enigmatic illnesses that appear to have no clear biological explanation, doctors may describe the unexplained, using expressions like “psy- chosomatic complaints,” “functional” or “non-organic symptoms.” But Claire De Souza (BSc ’93, MD ’97, PGME ’02), an Assistant Professor in the Department of Psychiatry, says such language can be confusing for patients and their families because the terms are not diagnostic, and they can’t be looked up and better understood. “Framing an illness as a medical mystery isn’t satis- Tests and doctors’ visits gave no insight into Rachel’s fying for young people or their families,” says De Souza, chronic pain, muscle spasms and neurological symp- who is also a Staff Psychiatrist and the Medical Director toms. The 16-year-old had been a healthy, vibrant ballet of the Consultation-Liaison Psychiatry Program at The dancer. The first signs of trouble came after Rachel fell Hospital for Sick Children (SickKids). “As healthcare and hit her back during an audition for a professional providers, we need to convey to this population that dance school a few hours from her home in central we believe what they tell us and that we know they’re Ontario. not faking an illness or looking for attention. Their “Afterward, I started to have paralysis in my legs,” symptoms are real and have had significant impacts, Rachel recalls. “The longer I was sick, the worse I felt. and we can help.” But it seemed like most of the doctors just kept saying, As Rachel and her mother’s search for answers con- ATLAS JACKLYN ‘I don’t know.’” tinued, they began to feel the stigma and hopelessness Medical tests came back negative, revealing no clues. that can accompany a medically unexplained illness. Specialists, chiropractor, osteopath and physiothera- “There was one specialist who said, ‘This is not my pist couldn’t help. Nothing brought Rachel closer to a department,’” recalls Rachel’s mother. “He had my diagnosis or lasting relief. daughter stand on her paralyzed leg and fall repeat- “As time passed, it was scary,” says Rachel’s mother, edly. We asked him for a referral and with his arms Debbie. “As parents, we depend on the medical system crossed, he said, ‘Nope, that’s not my job — I would and when the specialists couldn’t figure it out, we see a neurologist or a psychologist.’ But he wouldn’t thought somebody should have been able to.” recommend anyone.” 20 Like De Souza, Antonio Pignatiello (MD ’87, PGME ’93), an Associate Professor in the Department of Psychiatry, is working to change the way medical professionals see children and youth with medical and mental health conditions. In his role as Director of the Medical Psychiatry Alliance’s Child and Youth Health and Family Services, Pignatiello is helping build a collaborative care model. The idea is to better equip physicians across specialties like emergency medicine and family medicine to treat CAMPAIGN UPDATE physical and mental illnesses — including medically unexplained symptoms — simultaneously. At SickKids, these efforts include a somatic symptom consultation group to allow caregivers from various disciplines to share their expertise with each other. Teens and parents are also making suggestions for improvement. “We want to provide better, quicker access to the most appropriate service in the most appropriate place at the most appropriate time,” says Pignatiello. “Ultimately, we want people to be able to feel that no door is the As time wrong door for accessing the care they need.” ‌here’s an art and a science to the study of anatomy, but for passed, it Nearly a year after she fell ill, Rachel’s symptoms ‌many medical students today, dissection is becoming a lost Anatomy was scary. grew worse. She had less control over her arms, slurred ‌experience. Not so at U of T, where a major overhaul to the old We thought speech and a loss of vision. Again, her family took her ‌basement Anatomy Laboratories will ensure real-life dissection in the 21st someone to their community hospital, where she was admitted. ‌continues its important role in medical education. should have Within a few days, the doctor overseeing Rachel’s T Century been able to case called the family together with a potential diag- Set to begin this fall, the renovation will be the first since the 1960s. Gone figure it out. nosis: conversion disorder, a psychological condition will be the harsh fluorescent lights and 70s-era TV screens tucked into the that causes neurological symptoms. corners. The new lab will feature 16 of the latest dissection tables, each Rachel’s doctor had seen a case of conversion dis- with a computer screen. Each table will have a second level, doubling the order before, which had left another young patient capacity for dissections, and allowing the labs to be used by more stu- confined to a wheelchair for years. He wanted to help dents. And there will be easier access to professionally dissected sam- Rachel do better. In collaboration with De Souza and ples for comparison. When answers remain elusive, De Souza advocates a team of local healthcare providers, Rachel was able for a new way of approaching the patient assessment: to recover at her community hospital. Debbie credits “The best way to learn anatomy is through dissection,” says Professor the biopsychosocial model. Using this framework, bio- the combination of help from De Souza, a physiother- Cindi Morshead (BSc ’86, PhD ’94), Chair of the Division of Anatomy. “I lec- logical factors like infections or injuries, psychological apist and the family doctor with helping Rachel make ture about the brain, but the best way to really understand its anatomy is factors like perfectionism or a traumatic experience, and a quick recovery. when you see it up close and learn about the relationship between struc- social factors like academic challenges, difficult peer tures. I can show you a brachial plexus, but when I’m dissecting it, I have relationships and family circumstances are all taken From hope to recovery to take out muscle and bone. I learn how everything relates together. I see into consideration to understand a person’s symptoms. an extra layer of complexity.” Rendering of the future lab. “There’s still a tendency to think of assessing dis- After her diagnosis, Rachel’s doctor told her she tressing and impairing symptoms using a biomedical would make progress quickly. Before she left the hos- Many medical schools now offer only professionally dissected body parts approach,” says De Souza. “When the tests don’t reveal pital, the teen took her first steps. or even 3D digital models, says Morshead. But some medical students anything, these young people are moved through to psy- “It was pretty awesome to start walking without the say they chose U of T in part because of its hands-on dissection program. chiatry, creating a bit of a mind-body split. But children parallel walking bars,” remembers Rachel. “I hadn’t and teenagers can’t be divided that way.” been able to walk in eight months. Even before that, “Students often mention that these cadavers are their first patients,” she To learn more about supporting There’s a growing recognition that medical mys- my leg would spasm or give out. So I was really happy says. “There’s a lot of empathy to be learned from someone who gave them the campaign for the anatomy teries can flourish in the gap between treating the to start walking again.” the gift of learning. It’s quite profound and I think they always realize that.” laboratory, please contact: mind and the body. A recent SickKids survey showed Today, Rachel says she feels “100 per cent better” a widespread desire by physicians to do better at help- and is dancing once more. To underscore the importance of its dissection program, U of T has agreed CARMEN SEBERT ing young people with both physical symptoms and With greater integration between specialties, De to match all donor funds for the new labs. The increased capacity comes Senior Development Officer mental health issues. And a town hall meeting at the Souza and Pignatiello hope to create more happy end- at a crucial time. Curriculum changes starting in the fall will require lab Faculty of Medicine hospital aimed at bridging the gap drew attendance ings for people whose mysterious illnesses might oth- access outside of normal teaching hours, as students integrate anatomy 416.978.7915

from nearly every department. erwise be considered “medically unexplained.” (RENDERING) KAREN NGUYEN learning throughout their medical education, rather than in one block. [email protected] 23 24 Butany Photos by JacklynPhotos Atlas T of piecing together what happened and observing patterns. andobserving whathappened together of piecing own brandofdrama:thesleuth work withits sis. Butitcomes Itinvolvesaction. careful analy examination andmeasured place in theaftermath ofthe takes —pathology procedures andintricate tight timelines —withhighstakes, specialty six monthsafter they’d implanted. been valves same three, than fourmore ofthese comeout—allless a and over thenextfewweeks thecardiovascular pathologist, replaced. ing to be ades valves mechanical dec shouldtypically last high-quality valve. anormal,fully to functional would be appear glance, At tointended prevent this first infection. bacterial coating ofmetallic silver cuff, to applied the sewing which was outwasstand alayer oftitanium,palladiumandanouter into place. The only thing that made model this particular allowing to the stitch surgeon the valve of the ring, the edge to preventclose backflow. still hadthesyntheticfabricalong It it firmed was anew ovascular Christopher Feindel surgeon as itshowed itover metalwithinthering.Hetook to cardi the device, he to thevalve. reacting heart of thehost After P Unlike surgery, whichisaninherently dramaticmedical “I’m sure not yet,” Butany replied. It was the summer of 1998, why“So do you think itFeindel failed?” Today’s asked. through and hadthetwoIt still to pivots letblood that open rofessor in the Department ofPathology, intheDepartment rofessor saw two, another — thisonehadn’t even need madeitsixmonthsbefore tissue along the outside of the ring, which is a sign whichisasign ofthering, alongtheoutside tissue container.specimen He Jagdish Butanypathologist itfrom the plucked ent from when thecardiovascular regular model valvehe mechanical heart didn’t any look differ realized itwas he’d amodel realized before, never seen design. AND THE MYSTERY OF THE MYSTERY THE AND Malfunctioning Professor Butany Professor Heart Valve noticed a greyishnoticed white ( PGME ’85 PGME seeing anX-rayseeing of ) , whocon By Carolyn Morris ------In some cases, an infection suchasrheumatic fever —rare in aninfection cases, In some ofthevalve inwhichtwo cusps defect together.heart are fused into failure. get troubletually dueto heart acongenital Others and even on the heart causing strain deposits, and phosphate valvethe aortic willhave withcalcium thickandstiff become valve. aprosthetic to insert operation Often, inolderpatients, gery removed of tissue fromformalin andpieces patients’ hearts. withpinklidshousing containers his workload —specimen “gauze”in acontainermarked nextto abluebasketholding hisaudio recorder nestled athislabbench, tic cuttingboard ruler.measure themwithaplastic Heworks onawhite plas valve inplace over leaflets abrown towel paper so hecan to smallmetalforceps holdthehumanheart-Butany uses apathology In *** were quickly. failingso Now Butany wanted to figure silver-coated outwhyvalves these abnormalities). andcardiac structural diseases muscle (heart healthy could drop playing teenager dead and otherwise sports or how a young types), it to clump (incompatible blood cause mysteries, fromwould suchaswhytwo people mixingblood have medical dramas—pathologists countless explained TV by CSI-type —assensationalized cases in“who-done-it” clues among theliving. finding In addition to forensic pathologists prevent andpotentially ofdeath fate thesame mine thecause to deter ofautopsies, —orinthecase treatment decisions to guide samples orblood organs,tissues labtests, biopsies, It’s sur Butany’s after heart to makeafinaldiagnosis job detectives, investigating are likescientific Pathologists — by examining the natural valves removed during the laboratory atTorontolaboratory Hospital, General

25 - - - - Purpose Unknown

*** Canada but still an issue in developing countries — can crip- “Any one of us might not notice the trend,” says Feindel. “You ple the valves of the heart. Butany recognizes the signs of these might see one valve come out, then not see it for a year. Jagdish conditions, and describes them in meticulous detail. But he’s was getting them from different surgeons, though, and started especially intrigued whenever he comes across a mechanical to notice something was wrong. He started to see a pattern.” valve among his specimens. As the numbers of silver-coated valves removed early con- “Many pathologists wouldn’t pay much attention to these,” tinued to climb, Butany began campaigning to get the manu- he says, “but I have a special interest.” facturer and public regulatory authorities to pay attention. The An understatement. cardiac surgeons he worked with regularly at the University Butany is one of only seven or eight internationally Health Network stopped using them. renowned experts in the pathology of prosthetic heart valves. “Normally in science you would look at a series of cases Outside his office at Toronto General Hospital hang four before making a big decision,” says Feindel, who stopped using framed photos of his mechanical valve collection, arranged this model of valve after taking just one out too soon. “But if artistically by his students. Inside, among certificates, awards, something dramatic happens, and there are other choices — conference nametags and microscopes, he keeps a Ziploc bag other good options — you would just move on. It’s the power containing a historical evolution of prosthetic valves — ball- of an anecdotal case.” in-cage models from the 1960s, valves with a single tilting disc The examples soon piled up and grew into hard data. In the and various adaptations of the gold-standard bi-leaflet device. fall of 1999, the UK’s Medical Device Agency issued an advice So when he began coming across the silver-coated valves notice warning against the valve, based on Butany’s findings 1. Electrostatic Generator? 2. Paper Cutter? 4. Micromanipulator back in the summer of 1998, he paid special attention. When as well as the concerns of a surgeon in Wales. Regulators in patients are neglecting their blood thinner, blood clots can Australia and New Zealand followed suit soon after. And finally, Continued This is a very strange-looking This is interesting. It could be for A micromanipulator is an form on the leaflets and hinges, preventing them from clos- in January 2000, a multicentre clinical trial led by the manu- from page 19. 19th-century instrument — trimming paper to size for use in a instrument for manipulating ing completely. This is something Butany sees quite often, facturer was stopped early after a significantly higher propor- completely inscrutable to me. kymograph or EEG. I have no idea microscopic objects — but it wasn’t the case with these valves. Instead, the leaflets tion of the silver-coated valves leaked and had to be removed There’s something resembling how it was used. I’ve never seen something like a dissecting seemed to have good mobility. It was along the outside edge early. The manufacturer pulled the valve from the market — a clock mechanism at the anything quite like it. microscope, but for much of the valve, where the heart tissue connects to the sewing after 36,000 had been sold worldwide. In Canada, the ensuing front. It has electrical leads, smaller objects. The technology ring, that he found clotting or greyish white tissue from host lawsuits were settled in 2014. and also what looks like the 3. Polio tool? first appeared in the mid-19th response. He speculated that the silver — known to have anti- At Toronto General Hospital, Butany’s collection of explanted stem of a thermometer or century. The micromanipulator’s bacterial properties, but also to be toxic to cells in certain con- silver-coated valves ended up climbing to 19. Since the pros- barometer emerging from the Our best guess so far is that essential feature is a very ditions — was perhaps causing toxicity in the heart muscle theses that “survive” the first year seem to have a similar per- top. It was acquired from a this is polio-related because it precise mechanism. This one and that blood was leaking around the outside of the ring. formance as other valves — he’s not sure why certain patients collection run by a local group appears to measure lung capacity. is based on screws and levers. The damage he found, known as a paravalvular leak, could react to the valves while others do not — Butany believes the of physicians, who listed it It was built in the early 20th This is a rare treasure, and I’ve potentially happen with any prosthetic valve, although these worst is over. as an “electrical generator.” century. There’s a long history done a lot of research on it. It were particularly large leaks. But the biggest indication of a Just like the keen observation and steady perseverance Since people became able of studying respiratory diseases was purchased for the School problem was the sheer number of these Butany began seeing. involved in detective work, Butany’s role as a pathologist was to work with electricity in the and developing vaccines here at of Hygiene shortly after it “I went to talk to the surgeons, to ask what was going on,” key in solving the complex case of the malfunctioning valve. 18th century, they have used U of T, so this makes sense. It’s opened in 1927. It’s a versatile he recalls. “They said, ‘Nothing. I took one out — what’s the While surgeons were busy with the multiple challenges of their electrical generators in all sorts laid out like a kymograph: long instrument, but this one was problem?’” work, Butany was carefully putting together the pieces. of healing schemes. This seems with a central spindle. But it also certainly used to gather “But in the last five years you never took one of these out “I was the first person to say, ‘Hey, there’s something wrong old for an instrument used in has these strange gauges on it individual bacteria for growing a month after the surgery. And at the same time several of with this,’” he says. “It was a terrible experience. But at least Toronto. It may have been an that suggest that its users were single-cell cultures. your colleagues have taken one out too,” Butany remembers the surgeons I work with took it seriously. And it was great to antique that a doctor picked up reading information in real time.

saying. “Too many of these are coming out — and too soon.” be validated and great to have the valve taken off the market.” SNAPSHOTS in Europe. It’s a strange object. 26 27 ‘Might I remind you, Mr. Strauss, that you may have CRISPR, but we certainly have you.’

By Stephen Strauss

Stephen Strauss, former longtime Globe and Mail science writer, has seen many supposedly game- changing breakthroughs come and go. Now, with the gene-editing Photos by Jacklyn Atlas technology CRISPR, Strauss wonders Illustrations by Luke Pauw if he’s finally found the real deal.

28 29 to see a truly scientific return to the debate about improving people through genetic manipulation.

The doubter relented and The Globe eventually printed a piece on genetics as “the eye of biology’s hurricane.”

And then wariness set in. Just two years later, I was already writing a piece about how the great Toronto genetic breakthrough of the 1980s, the discovery of the cystic fibrosis (CF) gene, had turned from the promise of a quick cure into a genetic swampland. The more geneticists looked at the genes, the more they came to realize that people who had CF often had individualized genetic differences. Former U of T Genetics Professor Lap-Chee Tsui, one of the original discoverers of the CF gene, told me it was now more accurate to talk about “cystic fibroses” and not “cystic fibrosis.” Then we realized that individualized genetic differences were found in most diseases and conditions — particularly in cancer. What I got instead was a deep and almost unbridled and his team determine that about 1,600 of them excitement. were important for the proliferation of cancer cells But assuredly it was going to get better, I kept and could be targeted in future anti-cancer drug telling myself. Surely after the human genome was Compared to previous genetic manipulating development. completely sequenced, my 1989 hymn to genomics technologies, CRISPR “is like going from using a was going to be sung worldwide. Some scientists Model T to a Lamborghini to do the same thing,” But what was almost equally amazing as the finding had predicted that by 2010 we’d have routine says Alan Davidson (BSc ’83, PhD ’91), a Professor of itself was how easy and inexpensive it was to run the his is a story about CRISPR, the gene genetic tests and the beginnings of gene therapy, Molecular Genetics who studies CRISPR in bacteria, experiments. editing technology that promises to help and that genetic medicine would be part of every as well as viruses’ ability to circumvent its actions. solve the ancient mysteries of the human family doctor’s arsenal. By 2020, many thought, “It’s like a microwave instead of a campfire. CRISPR “Before CRISPR, editing the human genome was genome and finally put an end to disease. gene-based designer drugs would be available is not so much a eureka moment as a eureka challenging. It was slow and cumbersome,” Moffat But, if I may, it’s also a story about a for conditions like diabetes, Alzheimer’s disease, technology.” said. “And CRISPR is so cheap. Depending on what you Tyounger and far more optimistic Stephen Strauss — hypertension and many other disorders. are trying to do, creating a clone cell and edited clone the science reporter who once passionately argued Cohn, who is using the technique to look at muscular can cost less than $100.” with a skeptical editor at The Globe and Mail about What had occurred was a “genomic bubble.” dystrophy, went further: “CRISPR is the most the promise inherent in our genes. Mutations — deletions, duplications and other DNA important technology that I have encountered in my In the past, using other genetic manipulation changes — were found in ever-increasing numbers scientific career thus far.” technologies, the price of doing that would have been It was 1989. Tiananmen Square and the fall of the and we didn’t know what they meant. “One of the upwards of $5,000. It could have taken a graduate Berlin Wall dominated the headlines. The Globe was most common findings we have is what is called Why are genetic scientists, who themselves have student his or her entire thesis to try to figure out what looking for pieces on the most important scientific a ‘variant of unknown significance,’” Ronald Cohn, had to live through the genomic bubble’s era of one gene mutation did, as opposed to the year or so developments of the decade, and I kept saying to the an Associate Professor of Molecular Genetics and disappointment, so excited about CRISPR? that Moffat took to look at 18,000 genes. doubter that we had, had, had to include an article SickKids researcher, would sagely tell me. on the genetics revolution. We had, had, had to talk CRISPR allows them to address two quite different As well, since CRISPR could remove damaged genes about the tsunami of change that polymerase chain And then came CRISPR, the much-hyped gene issues. They can use the gene strands, which and put healthy genes back, it also carried the almost reaction, a gene duplication technology, had begun editing tool discovered in 2012 and now the subject bacteria harness to attack invasive viruses, to instantaneous possibility of clinical application. unleashing and undoubtedly would continue to of a pitched intellectual property battle between quickly and cheaply cut or mute genes or gene Indeed Cohn has just published a paper showing unleash in ever greater waves. heavy scientific hitters in the US. I was prepared for sequences that might be related to a disease or that he could use CRISPR to remove a duplicate gene circumspection when I interviewed U of T Medicine condition. Do that and you could determine what associated with a type of muscular dystrophy found in I argued it was obvious from what had already researchers about CRISPR. I expected to be action a specific gene or gene mutation gives rise a boy in England — and in so doing potentially have a transpired that in short order we were going to cautioned about the disappointments of the past. to — without traditional methods that are slower and cure for that strain of the disease. see diseases like cystic fibrosis cured by genetic In my mind, as I sat in lab-side offices often full of more costly. manipulation; we were going to see world hunger photos of kids in hockey uniforms, I thought they too “CRISPR is a search tool,” Professor Yvonne Bombard, eradicated by genetic modification in agriculture; we would want to avoid what I had taken to calling the Consider a December 2015 paper by Jason Moffat Assistant Porfessor at the Dalla Lana School of Public were going to hear a genetic explanation for exactly Tsunami of Genetic Over-Enthusiasm. (PhD ’02), a Donnelly Centre investigator. His lab used Health, remarked to me, “but given its ability to target, how and why we humans and chimpanzees were CRISPR to turn off each of the 18,000 or so genes edit and modify genes of interest in that search intrinsically different, and we were probably going And I was wrong. in a cancer cell, one by one. That helped Moffat process, CRISPR is itself really the detective.”

30 31 I couldn’t recall any development I had reported on “Reconciliation The in the past where I felt as much absolute excitement will take from scientists in the field. Accidental some time.” Then I corrected myself — there was one. (Political)‌ So concludes the summary Tourist Cold fusion was going to create an energy revolution preface of the 2015 final report that would eliminate the use of fossil fuels. And then I of the Truth and Reconciliation recalled the day I was sitting in an American Physical Commission of Canada. With Society meeting in Baltimore, hearing scientist after its 94 explicit “calls to action,” By Carolyn Morris Nominate scientist present research data showing how they the TRC has prompted many With files from Alan Christie had tried to recreate cold fusion in their labs and organizations — including Outstanding failed. the University of Toronto — She was one of the few women After losing the provincial race to re-evaluate their relationship in her medical school class, in 1995, Bennett won in the Alumni I remember at the time not just thinking — with Canada’s Indigenous graduating from U of T in 1974. federal riding of St. Paul’s in but absolutely whole-body feeling — that cold communities. President Meric And one of very few female downtown Toronto in 1997, and fusion wasn’t real. Its proof was a scientific Gertler and Provost Cheryl hockey players. As Minister of has been re-elected six times Leadership, innovation and impact. U of T error; its notoriety was a Tsunami of Physics Regehr (MSW ’80, PhD ’96) have Indigenous and Northern Affairs, since. As chair of the Liberal Medicine alumni are making a difference Over-Enthusiasm. struck a steering committee she’s become one of the most women’s caucus, she supported in Canada and across the globe. to help coordinate U of T’s prominent political leaders in a national action plan to address But after my conversations with the geneticists, response. The committee Canada. Carolyn Bennett (MD ’74) violence against women and Nominate a Faculty of Medicine CRISPR seems on a path precisely opposite to cold includes U of T Medicine’s didn’t set out to be a politician; she helped create a Women in graduate for one of the Dean’s Alumni fusion’s eventual deflation. Instead of new research Professor Lisa Richardson just started fighting for things she House program seeking to elect continually saying it doesn’t work or was flawed, (PGME ’0T5, ’0T8), Co-Lead believed in. And for people whose more women to the House of Awards. For more information please ALUMNI PROFILE BENNETT — CAROLYN visit uoft.me/deanalumawards the scientists are telling me CRISPR does work and of Indigenous Health voices too often go unheard. Commons. works amazingly well. Rather than being the 21st Education. An interim report century’s cold fusion, CRISPR is perhaps the true eye is expected by July 1, with “My voice became clear in the In 2000, she wrote a book called of biology’s hurricane. final recommendations due by fight to save Women’s College Kill or Cure about Canada’s December 31. Hospital,” she says. In 1989, she healthcare system. She argued In the past, these scientists said, they had often successfully opposed a merger for more health prevention stumbled upon solutions like Inspector Clouseau. The TRC’s final report included and helped preserve the unique — “more health and less CRISPR was turning them into Sherlock Holmes, specific references pertaining to nature of the hospital’s services, healthcare.” And she’s spoken “trying to recreate what the criminal did and then medical training. This includes which focuses on patients to medical students across reverse it,” according to Moffat. “The investigation — recognition of the value of becoming full partners in their the country about keeping that is what drives us to do science — the finding of Aboriginal healing practices, as care. She also saw it as a fight to Canadians physically, mentally, the unknown, the trying to figure out what is going on, well as increased training in keep social determinants of health emotionally and spiritually well. that is what pushes most of us.” Aboriginal health and cultural front and centre. “Fighting for that Not just patching them up. competency. The Faculty of hospital was the beginning of my As I listened to them, I felt my decades-old cloud Medicine’s Undergraduate political career.” Soon after becoming minister of wariness and skepticism about the promise Medicine Education (UME) last fall, Bennett announced a Share Your of genetics begin to lift. It felt like I was back program has accepted these But she didn’t know it yet. federal inquiry into the estimated at The Globe, back with a new doubting editor, recommendations and is When the Ontario Liberal Party 1,181 murdered and missing Wisdom hymning to him or her about a 2016 world where working to implement them. approached Bennett — then a Indigenous women and girls. genetic knowledge was going to use CRISPR to make faculty member in the U of T’s She’s starting by listening to the medicine and agriculture and evolutionary biology In its formal response to the Department of Family and families of victims. Along with our partners, the and human society itself different. TRC report, UME said it “accepts Community Medicine — to run in Medical Alumni Association and the challenge to do what it the 1995 provincial election, she “They have been pushing for over the Department of Radiation And I inwardly smiled and said to myself: takes to move forward and explained that she didn’t know a decade for a national public Oncology, we invite alumni to Maybe I was right in 1989, but was just too early develop practitioners with anything about politics. inquiry,” she says, “not just to seek share their Words of Wisdom to know it. the skills and tools allowing justice for the victims but for us with our students and trainees. them to participate in a way up “I was told what I’d done with the to put concrete things in place to the mountain in a new era of hospital was political,” she says. stop this tragedy from happening To learn more, please visit reconciliation.” “I have always called myself an to other families.” uoft.me/fomwisdom Image credits. accidental political tourist, just Berlin Wall photo: iStock. To read UME’s complete fighting for something I believe in Fighting for meaningful change Death of Sherlock Holmes courtesy of the Toronto Public Library. response, visit — in particular fighting for people has been the hallmark of Carolyn

Stephen Strauss c. 1989 courtesy of The Globe and Mail. SANDLER TOM uoft.me/UME-TRC. who don’t have their own voices.” Bennett’s political career.

32 33 NEWS Ground- Meet U of T Medicine’s “We’re situated in Breaking New Chief Diversity Officer one of the world’s Research The challenge in front of Lisa Robinson most multicultural and News- (MD ’91, PGME ’92) is a familiar one. cities. We need Making “When I graduated from U of T in 1991, to look more like there were two Black students in my Faculty class — and I was one of them. It’s 25 the community years later and the numbers are the we serve.” same,” says Robinson, the Faculty of By Julia Soudat Medicine’s first Chief Diversity Officer. Dean Trevor Young announced the And the Brain position in January 2016 to provide Visit our website Prize Goes to ... focused leadership for change. for the latest Medicine news! Professor Graham Collingridge, have enhanced the understanding “The Faculty of Medicine needs to perennially low representation of that you can actually improve quality uoft.me/medmag Chair of the Department of of memory: how memories are better reflect Toronto, the most diverse students and faculty from Black and and diversity at the same time,” Physiology, was among three formed, retained and lost. These place on the planet,” says Dean Young. Indigenous communities — among other Robinson says. recipients of the prestigious discoveries are crucial to treating “Dr. Robinson has the skills, the drive and groups. Robinson is gathering data that Brain Prize for his research into diseases such as Alzheimer’s and the evidence to break down barriers and will help her and others in the Faculty University of Toronto has committed the mechanisms of memory. have already contributed to the help move the needle for young people understand what influences students, to continuously collect race-based Collingridge’s research focuses development of a medication that from all backgrounds.” where students are being drawn from data from its students, a move that will Cancer- on long-term potentiation (LTP), slows down the progression of the and identify the best strategies for help improve the information available, Fighting a cellular mechanism that supports disease. The prize was awarded by Robinson adds this role to her inclusion from across North America. although the Faculty of Medicine has Dream the life-long plasticity of the brain. the Grete Lundbeck European Brain responsibilities as Division Head of some related data. Te a m His research and discoveries Research Foundation in Denmark. Nephrology at SickKids and as a Senior “There is often an opinion expressed Scientist at its research institute. It’s that you have to sacrifice quality in order “We’re situated in one of the world’s A cancer “Dream Team” led by probably no surprise that the clinician- to ensure diversity. But that’s just not most multicultural cities. We need to U of T researchers is taking on She’s an scientist is taking a research-based true and numerous studies — especially look more like the community we serve,” the stem cells that drive tumour Open Book approach to her work tackling the from the United States — have shown Robinson says. growth in brain cancer. With $11.7 million of funding by Stand Up To University of Toronto scientist Rachel Harding is one of the first known Cancer Canada, the team aims to medical researchers to share her lab notes in real time. In February, Collaborating to Fight Common Computing for Medicine develop new treatments to prolong Harding began uploading all of her raw notes to her blog, LabScribbles, Cause of Kidney Disease the lives of those living with the in an effort to collaborate more closely with other scientists and U of T is bridging the gap between medicine and technology brain cancers glioblastoma and accelerate research into Huntington’s disease. A team of U of T scientists teamed up to work on with a new course for MD students called Computing for posterior fossa ependymoma. preventing, slowing, stopping and maybe even reversing Medicine. Developed in partnership with the Department Although extensive research into Huntington’s disease has been going kidney scarring caused by diabetes. This type of scarring of Computer Science, this interdisciplinary course equips “Our knowledge is at a turning on for decades, the mechanisms behind the neurodegenerative disorder can lead to organ failure, which requires dialysis or a students with the coding and programming skills needed to point, with important new remain somewhat of a mystery. While it is known that a mutation in the transplant. The work is part of a partnership called the succeed in the tech-centric future. discoveries in recent years about huntingtin gene leads to cognitive and physical decline, “the encoded Centre for Advanced Therapeutics in Diabetic Kidney the mutations behind cancer,” protein is very large — significantly larger than most other proteins Disease (CAT-DKD), funded by a grant from the Banting “You have physicians who understand what they need, but says Peter Dirks (PhD ’97, PGME ’97), in the cell — and difficult to isolate and study,” explains Harding, a and Best Diabetes Centre. not how the technology works or how to harness it,” explains the Neurosurgery and Molecular post-doctoral fellow with the U of T-affiliated Structural Genomics Professor Marcus Law (BSc ’96, MD ’00, PGME ’02, MEd ’13), Genetics Professor who leads the Consortium. The team is working on measuring which genes the body Director of Preclerkship Renewal & Academic Innovation project. “We’ve also learned a lot activates when scarring in the kidneys begins. “Once we in the Department of Undergraduate Medical Education. about the cell types that drive Harding hopes to leverage the powers of teamwork by opening her know what pathways are involved in activating the body’s “On the other side, you have programmers and developers tumour growth. That should allow notebook to scientists and patients alike. “This is what research is really scarring response, we’re well on our way to understanding who understand the technology, but not how it can be us to identify precise drugs to shut like,” she says. “It’s not so much about big breakthroughs and polished how to block it,” says U of T’s Richard Gilbert, a Professor applied in clinical settings. Combining these two streams of down these cancers.” results, but about incrementally getting closer to an answer.” in the Department of Medicine. knowledge should unleash a river of opportunity.”

34 35 OLD SCHOOL

Saint-Irénée, March 1931.

addressed to a Miss Nancy Archer. friend and artistic mentor A.Y. Jackson of Three English Roses Miss Archer, WPC? The They bore the signature of F. G. Banting. the Group of Seven. Official verdict: Yes! After the mystery was publicized in Most details of Nancy’s life remain Mysterious The discovery was well timed. Canada’s Other mysteries remained. Who were the a front-page Globe and Mail story, unknown. Yet according to one oldest biomedical research agency, previous owners? Above all, who was a woman in England identified Nancy tantalizing piece of family history, Miss founded in 1925 to commemorate Nancy Archer? as her grandfather’s great-aunt. She she went on to spend many years the discovery of insulin and support had sailed to Canada in 1928 along with the London Metropolitan Archer promising new investigators, was The foundation’s new Executive Director with her mother and younger sister Police, known to crime drama fans refreshing its mission in preparation Ramona Rea took up the case. Three Betty to visit a third sister, Marjorie, worldwide as “The Met.” Women for its 90th anniversary. Yet there were years of dead ends ensued. Then finally, then married to a Herbert Brown and began entering the force during many mysteries to resolve before the success! A single reference in the city living in Winnipeg. The family, including World War I, and full-fledged By Susan Bélanger foundation could claim this prize. directory identified Nancy Archer as Marjorie’s two sons, returned to the “Women Police Constables” were Banting’s maid in 1931. The famous UK during the 1930s. The paintings introduced in 1923. Perhaps Miss few years ago, the Banting Research Were the paintings authentic? scientist was well known for giving passed from Nancy, who never Archer went on to join their ranks? Foundation received an unusual The evidence was good: style, dates, his artwork away freely as gifts of married, to Betty. When she died, package from an unknown source: subjects all fit with Banting’s known appreciation. This was where the trail a distant relative sent the works to To view photos of all three Banting three small paintings, two of them works and his painting expeditions with ended in July 2015. the Banting Foundation. paintings, visit: uoft.me/medmag

36 37 Missing Out on Events Alumni News & Activities?

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