Chair's Column: Looking Back and Looking Forward: Celebrating 100 Years of Sir John and Lady Eaton’s Legacy
Professor Edward Shorter, Hannah Professor of the History of Medicine at the University of Toronto
At the beginning of the 20th century, Canadian medical students were taught to practice medicine through careful observation of patients, aided only by a few simple and usually crude laboratory tests. Professors of medicine were practicing clinicians who volunteered time from their practices to teach medical trainees. The systematic study of disease was conducted by only a handful of scientists working in a few isolated laboratories.1
The shift to medical education and study as we now know it was stimulated in North America by the Flexner Report of 1910. The report was based on a survey of medical schools throughout North America, including the University of Toronto. It criticized the virtual absence of research based on scientific methods and of full-time clinical faculty members.
Dr. Goldie also realized the need for philanthropic support to facilitate the appointment of a full-time Professor and to propel the medical school into the era of scientific medicine. He proposed the establishment of an endowed Professorship of Medicine to financially support with stipends a group of academic physicians – in other words, to provide these physicians ‘protected time’ from their busy clinical practices to teach and conduct research.
In 1918, Dr. Goldie was able to persuade two of his patients, Sir John and Lady Flora Eaton, to donate $500,000 – an amount that would be the equivalent to $6.7 million today – to create in 1919 the first endowed Chair at the University of Toronto, and the first full-time Chair in Clinical Medicine in what was then the British Empire.
With this endowment, the University appointed Dr. Duncan Graham as the first Physician-in-Chief of TGH and Chair of the Department of Medicine at the University of Toronto. Dr. Graham used the opportunities provided by the Eaton Chair to create the residency system at U of T and establish postgraduate training in medicine. He recruited ‘academic physicians’ who combined clinical skills with scientific training and experience to interpret scientific advances to students and practitioners and to conduct laboratory research.
According to Professor Edward Shorter, the Hannah Professor of the History of Medicine at U of T and author of Partnership for Excellence: Medicine at the University of Toronto and Academic Hospitals (2013), the appointment of Dr. Graham signified the critical 'turning point' in Canadian medicine: "The Eaton Chair marked the emergence of academic medicine in Canada […] and had a 'flagship' effect on the Department of Medicine at the University. The Chair […] helped attract high-profile investigators, many of whom went on to head departments of medicine at other Canadian universities."
With such a significant gift from the Eatons leading to this turning point, it’s no coincidence that a direct line can be drawn from this endowment to the discovery of insulin by Drs. Fredrick Banting and Charles Best at U of T only two years later. Following the discovery of insulin, in 1922 Dr. Graham established the first diabetes clinic at TGH. Today, our diabetes researchers rank among the top in the world.
As we look to the next 100 years of the DoM, how will we pay it forward?
Simply put, the gift from Sir John and Lady Flora Eaton in 1919 was an act of "paying it forward." Thanks to the case made by Dr. Goldie, Sir John and Lady Eaton had the foresight to understand how valuable protected time could be for physicians. Their gift paved the way for academic medicine at University of Toronto.
Over the past 100 years, under the leadership of nine Eaton Chairs, the department has thrived. Collectively, we have launched the careers of thousands of physicians who have gone on to provide extraordinary care, to train, mentor and inspire the next generation, and to bring about countless discoveries and breakthroughs that have significantly impacted healthcare locally and globally.
Dr. Gerry Scott on 14 Eaton at TGH introduced me to internal medicine. Dr. Scott was an extraordinary individual, hematologist and master clinician. I was mesmerized.
Flash forward a couple years later to senior residency on 6 Bell, also at TGH, where I was introduced to rheumatology by Drs. Arthur Bookman, Carl Laskin and Dale McCarthy. Exemplars of humanism in medicine and master clinicians, they instilled in me the desire to pursue rheumatology.
As a first-year rheumatology resident at the Wellesley Hospital (may it rest in peace!), I met the smartest person I know: Dr. Claire Bombardier. Having just established the Master of Science Program in Clinical Epidemiology at U of T, she introduced me to clinical research, about which I became passionate. I decided to pursue graduate training in clinical epidemiology, supervised by none other than Dr. Bombardier.
While many others have contributed to my journey, it was these early interactions that were the formative ones. These are the clinicians and teachers who inspired me to be who I am today, and I am very grateful.
As we launch this centennial year marking the establishment of the Eaton Chair, we invite you to tell us, who inspired you? Who were the people who introduced you to your specialty, who sparked your research interests, who taught you what really matters when we care for our patients? Who were the people who paid it forward throughout their own careers to help launch yours?
Email us at firstname.lastname@example.org to share your story. We’ll be sharing our favourite stories throughout 2019 to celebrate the 100th anniversary of the endowment from Sir John and Lady Eaton, and the tremendous legacy of the Department of Medicine.
1This Chair's Column features excerpts from Partnership for Excellence: Medicine at the University of Toronto and Academic Hospitals