Montreal, Canada (Fall 2012)
|Montreal Children’s Hospital|
Hospitals are more than bricks and mortar. The Montreal Children’s Hospital (MCH) is no exception. Like all famous hospitals, there is little about the buildings themselves that warrant acclaim. It is the accomplishments and contributions of the staff that make them respected.
Accordingly, this account focuses on some of those who have made the MCH a noteworthy institution. From the outset, the MCH has been a bilingual institution, struggling to hold its own against the larger French hospital, Hopital Ste. Justine, also in Montreal. Its birth date places it among the 10 oldest children’s hospitals in North America alongside such institutions as Children’s Hospital of Philadelphia, the Boston Children’s Hospital, and in Canada, the Hospital for Sick Children.
The idea of a hospital devoted exclusively to children was novel in 1902, when A. M. Forbes, an orthopedic surgeon, decided that one was needed primarily to serve the “crippled” children of Montreal. The result was the Children’s Memorial Hospital, intended as a memorial to Queen Victoria. Forbe’s idea was encouraged by Sir William Osler, among others, and greatly assisted by H. B. Cushing and A. D. Blackader. The original occupants were children with tuberculosis, cerebral palsy, and later, poliomyelitis. A succession of moves to other sites followed, with the move to what is now the Montreal Children’s occurring in 1956. The final move to the nearby, newly constructed McGill University Hospital Center site is scheduled for 2013.
What makes the MCH famous? As stated, it is undoubtedly the staff and what they contributed to hospital care and in particular its long record of pioneering innovations. A few of these are “firsts” only for Quebec; others apply to Canada, but many are internationally recognized achievements. This attempt to summarize some of the most important MCH contributions draws heavily on two sources: a small book written by Jesse Boyd Scriver, one of the first female pediatricians in Canada,1 and a more recent book issued to celebrate the hospital’s centenary.2
The succession of noteworthy “firsts” credited to the MCH range from technical advances (e.g., in heart surgery) to advances in patient care. Among the most important were, in chronological order: the establishment of a Social Work department in 1926; Recreational Therapy in the 1930s (later to become the Child Life Department); Speech Therapy in 1933; Child Psychiatry in 1950; the abolition of restrictive visiting hours in 1970; the Home Care program (now called Intensive Ambulatory Care) created in 1964; the first multiculturalism program in Canada in 1985; and the Palliative Care Service in 1991. Multidisciplinary teams were introduced in the 1960s, initially in the care of children with cleft lip and palate, and later for those with spina bifida. All of these were “firsts” at one level or another that involved improvements in patient care.
Alongside these is an impressive list of technological advances. These include the first Canadian congenital heart surgery in 1938; use of microvascular surgery in 1970; the living donor transplant program; the first pediatric heart, liver, and bone marrow transplants in the 1980s; and the launch of biochemical genetics, followed by the Quebec Network of Applied Genetic Medicine in 1980. In 1977, the first pediatric CT scan in Canada was performed at the MCH. Brain mapping and ultrasound technology were introduced in 1980 and magnetic resonance imaging in 1994. In 2000, the MCH delivered the first baby in Quebec using the EXIT (ex-utero intrapartum treatment) procedure, and in 2002 a mechanical heart (the Berlin Heart) was used as a bridge to transplant on the youngest North American patient.
The fame of the MCH also relates to its Research Institute (RI), established in 1966. Among the most renowned research teams at the RI was the Medical Research Council Medical Genetics Group under Charles Scriver. This group was noteworthy not only for its basic science discoveries but also for its screening programs. The Community, Developmental, and Epidemiologic Research group attracted national attention for its studies ranging from pain, crying, obesity, and small-for-gestational–age (SGA) in infancy to injury prevention. A combined metabolism-nephrology team under Keith Drummond excelled in studies of renal disease among children with diabetes. In summary, the major research strengths of the RI are in the fields of genetics, public health and preventive medicine, growth and development, and cardio-respiratory health. Other important RI research involves autism, endocrine and renal disease, infection and immunity, musculoskeletal disorders, and neuroscience.
Finally, it should be noted that the fame of the MCH also stems from its long involvement in programs in Northern Quebec, the Arctic, and abroad, including Kenya, Ethiopia, and Belarus.
1. J. B. Scriver, The Montreal Children’s Hospital: Years of Growth, (McGill-Queen’s University Press, 1979).
2. E. Hirst, et al., The Montreal Children’s Hospital: 1904–2004, (Montreal: Price Patterson Ltd., 2005).
BARRY PLESS, CM, MD, D.Sc, FRCP, FRCPCH, FCAHS, is professor emeritus of pediatrics, epidemiology, and biostatistics at McGill University, Montreal, Canada. He is editor emeritus of the journal, Injury Prevention.
Highlighted in Frontispiece Fall 2012 – Volume 4, Issue 4