Pat Gullane: Member of Order of Canada

Patrick Gullane

"Please join me in congratulating Professor Patrick Gullane on his appointment as a Member of the Order of Canada. Pat is Chair of the Department of Otolaryngology - Head and Neck Surgery and is cross - appointed to our department of Surgery. A friend to all who know him, Pat has had a distinguished career as a surgeon and administrator. Pat went to medical school in Galway, Ireland and then trained in Otolaryngology - Head and Neck Surgery at the University of Western Ontario. After fellowships at the University of Pittsburgh and Columbia University in New York, he returned to Canada as a faculty member at the University of Western Ontario in London. He was recruited to U of T in 1983 and has distinguished himself as a world authority in head and neck cancer, with a specific area of expertise in skull-base surgery. We are proud that Pat is cross appointed to our Department and congratulate him on his magnificent achievements." These were Richard Reznick's words as he announced Pat Gullane's recent honor.

Pat described the appointment as "so unexpected and profoundly meaningful to me as a Canadian. Though I have been fortunate to receive honors from surgical and scientific societies in the United States, England and Australia, this appointment is the most meaningful".

Q: What was the contribution to surgery and the University of Toronto that the Advisory Council was recognizing?

A: I believe they were focused on the clinical contributions to head and neck oncology and creating a learning environment to inspire young and dedicated trainees. We have been fortunate to attract outstanding residents and fellows over the past 30 years. Many of these superstars have been recruited as faculty members to the University of Toronto. Our Head and Neck fellowship is a combined program with the Department of Surgery, accredited by the Advanced Training Council of the American Head and Neck Society. It was the first program within Canada to be recognized. Over the years many international graduates have successfully completed advanced fellowship training in all aspects of head and neck oncology here and have returned to such countries as England, Ireland, the United States, Finland, Norway, Sweden, Japan. These trainees, and the numerous visiting professors who spent time with us, on returning to their countries adopted many of the philosophies that have helped to further enhance numerous academic programs in head and neck oncology internationally.

Q: What is your main legacy at the University of Toronto?

A: I feel my legacy has been the establishment of a major head and neck oncology program within the University Health Network and the University of Toronto facilitated through the generous donation of a grateful patient, Mr. Bob Wharton and his wife Gert. A combination of opportunity, vision of the institution and the University, the generosity of our donors, and finally support of the administration and dedication to the specialty of head and neck oncology helped realize my dream. This initiative was a further impetus for future donors to contribute to this subspecialty area, and in 2002 Dr. Mariano Elia, another grateful patient, donated $2.5 million to endow a Basic Sciences Chair dedicated to head and neck research.

A combination of generous donors, hospital and University focus, and finally the recruitment of outstanding faculty, many of whom had served as our fellows, resulted in the department's recognition and academic productivity that has made it one of the most attractive institutions in head and neck surgery in the world. So with this windfall I realized my dream of a very attractive academic unit that combines superior surgical care, radiation, medical oncology and research. The Divisions of Neurosurgery, Thoracic Surgery, Plastic Surgery, Pathology, Radiation and Medical Oncology, Dentistry, Prosthetics, and Microvascular Surgery all contributed significantly to this multidisciplinary program.

Q: How did all this come about?

A: Dr. Alan Hudson, then Surgeon-in-Chief was remarkably supportive of this success story. His leadership helped to integrate the Princess Margaret Hospital with the Toronto General Hospital. Alan and I developed an immediate relationship of trust. He said: "Let's make it a program integrated between Otolaryngology - Head and Neck

Surgery and the Department of Surgery with you as chief and to include all of the other players. At that time Dr. Bernard Cummings, Chief and Chair of Radiation Oncology and Dr. Robert Bell, CEO of the Princess Margaret site helped enormously to facilitate the formation of head and neck oncology. I am indebted to the Jim McCutcheon Chair at the Toronto General Hospital, then held by Alan Hudson.

This opportunity provided me a platform necessary to establish a multidisciplinary concept for head and neck oncology. I have often said: "if you can imagine it, you can achieve it; if you can dream it, you can become it". The dream came true. The great challenge and charge is to convince people in leadership positions that you are genuine in your goals and objectives to select and educate future leaders, then surround yourself with people more talented than you who generally will make you look good.

Q: What were the turning points in your career and the turning points in the development of the program?

A: In 1994 the spectacular success of the Thoracic Surgery Division with the first successful human lung transplantation lowered the profile of the other surgical programs including head and neck surgery. Then, by great fortune, I was the lucky recipient of some 8.5 million dollars that helped in the establishment of four chairs in Head and Neck Surgery and Oncology. Peter Neligan was selected as the Wharton Chair in Head and Neck Plastic and Reconstructive Surgery, Patrick Gullane as the Wharton Chair in Head and Neck Surgery, Brian O'Sullivan as the Bartley-Smith/Wharton Chair in Head and Neck Radiation Oncology and Fei- Fei Liu as the Mariano Elia Chair in Head and Neck Basic Science Research. The most important take home message here is the importance of sharing of fortune with other members of the team, and establishing close relationships with all the others. Those relationships then and even now are unprecedented.

Q: Who were your role models and mentors?

A: On completing my residency, I had the good fortune to take advanced training with some of the masters in head and neck surgery in both Pittsburgh and New York. Dr. John Conley, a magnificent Head and Neck Surgeon at Columbia University, and Dr. Sebastian Arena at the University of Pittsburgh both influenced my career greatly and I feel developed what was already in me - a passion to effect change, enhance patient care, minimize deformity and improve the quality of life of patients with head and neck malignancies. My other hero was Dr. Griff Pearson, who adopted me as a colleague, and whose advice and guidance helped enormously to enhance my career.

Q: What is next for you?

A: I have two more years as Chair of the Department of Otolaryngology - Head and Neck Surgery and as Otolaryngologist-in-Chief at the University Health Network. My goal is to help facilitate a succession plan that will help to further enhance this specialty. One of my great anxieties is that we have had it all over the past 25 years, but "if we snooze, we will lose". Incidentally, I had the best hobby I could find in life. To quote from the famous American comedian Johnny Carson on his final "Tonight Show" performance: "I am one of those lucky people in the world who found something I loved and enjoyed every moment of it". That certainly describes me in the arena of head and neck surgery.

The opportunity afforded me at the Toronto General Hospital/Princess Margaret Hospital and the University of Toronto was unprecedented. I am indebted to the support provided by Drs. David Naylor and more recently Cathy Whiteside in their role as Dean. Their untiring support and counsel helped enormously in the success of head and neck surgery within our University as did the resources provided by the University Health Network under the leadership of Alan Hudson, Tom Closson and Bob Bell. In addition, I am extremely grateful to Bryce Taylor for his unselfish support and trust, providing the resources to care for the most complex patients in head and neck oncology in Canada. I take this opportunity to thank my many associates both in surgical, radiation and medical oncology and in addition the other support services including the members of my department all whom have helped to increase the global impact of our discipline.

My hope for the future is for the continuing development of a seamless relationship with the other hospitals within the University system. Like Richard Reznick, my role was to harmonize the disparate programs. Following my chairmanship, I hope to be an ambassador for the Department of Otolaryngology - Head and Neck Surgery, the University Health Network and the University of Toronto in helping to facilitate fundraising for all of the surgical disciplines. In particular I would like to further support the establishment of endowed chairs, as I have seen their positive impact on recruitment and program growth. My fear is that the future will be costly as robotics and other expensive technology is introduced. The goal will be to enhance the profile of the University of Toronto, its affiliated hospitals and all the disciplines I have been fortunate to work with. To know the road ahead, ask those coming back.

M.M.