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Spotlight
feature:
MANITOBAS
Father
of Nephrology
Dr. A.E. THOMSON
Did
you ever wonder how doctors become doctors? Sometimes its
a chosen destiny, sometimes its just fate with a little
guidance from others. Dr. Ashley (Ash) Emeritus Thomson reflects
back when he was contemplating his education. He aimed at
studying Mathematics, but ended up studying Biology with French
as a minor. Mathematics was not available, and it simply was
not part of his path to becoming a doctor, although he did
not know it was his destiny at the time. Biology was his ticket
to furthering his education to becoming a nephrologistkidney
specialist.
Dr. Thomson
has earned the reputation as being Manitobas Father
of Nephrology. He pioneered the treatment and technology
of hemodialysisa method of mechanically filtering and
cleansing the blood of patients suffering from short-term
kidney failure due to shock from trauma, blood loss or infection.
These patients were expected to recover from their kidney
failure, but the trick was to sustain them during that recovery
time. Dr. Thomson was called in to oversee the situation and
that is where it all started. Since then, long-term dialysis,
home/self-care dialysisespecially for northern Manitoba,
and transplantation became possible.
Ash was
born in Regina, Saskatchewan in 1921. His mother had a science
degree and his father, a WWII veteran, was farming, and at
the same time, acting as a Field Supervisor for the Soldier
Settlement Board, settling British veterans into farming in
Canada. This became the Veterans Land Act after WWll. Ash
spent five years on their farm near Sintaluta (Cree for red
fox) and attended grade school in Wolselely and then Assiniboia,
Saskatchewan.
Ashs
father fought in the famous Passchendaele and Vimy Ridge battles
and saw the devastation of WWI. A year before WWII erupted,
he advised his son to get as much education as possible before
enlisting. Ash attended Regina College for a year and passed
with Biology under his belt. At the end of that term, a supervisor
of the college suggested Ash enter the pre-med course in Saskatoon.
So, while Ash became a pre-med student at the University of
Saskatchewan, he watched several of his former classmates
become soldiers.
After
four years in pre-med here, Ash went to the University of
Manitoba to complete his final two years of medicine to obtain
his MD.
After
his first year there, he ranked 20th in his class. He tied
for first in his second year, taking the lead and graduating
at the top of his class in 1945. He did post graduate surgery
and later, research in vascular surgery.
He studied
how different arms affected blood pressure readings. He didnt
have the specialized equipment to carry out his research,
so he went to Philadelphia to learn about an intravascular
pressure recording machine. Upon returning, with the help
of a local machinist and an electrical engineer, he built
his own blood pressure monitor. This study earned Dr. Thomson
his Medical Degree.
In 1948,
he obtained a National Research Council grant, tenable in
New York or overseas. He chose Manchester, England, where
a new medical contingent consisted of ex-WWll medical people
who had served in the war. They were involved in a study of
the role of sodium in the human responses to fighting in the
tropics and the adaptations to changes in environmental temperature.
He studied the effects of salt depletion and kidney function
in those suffering from heat-related illnesses. These studies
were reported to the British Research Council in London and
it garnered interest from health professionals from all over
the world.
After
returning to Winnipeg, a couple years later, he began work
in the U of M Department of Physiology, based in the Health
Sciences Centre, teaching salt, water and renal function to
med-students.
At this
time, both major hospitalsSt. Boniface and Health Sciences
Centrewere just setting up intensive care centres. Patients
not responding to initial therapy were frequently sent to
Dr. Thomson, as he had the reputation as being that
guy in physiology who does salt, water and kidneys.
They felt if anybody could help these patients, he could.
Dr. Thomson
was then hired to set up an Investigation Unit at Deer Lodge
Centre for the Dept. of Veteran Affairs to treat mainly ICU
patients with acute kidney (renal) failure. People with renal
failure generally can survive for about a week on a high carbohydrate
and fat diet with no protein or salt. With this moose
milk concoction, the body didnt generate as many
toxic bi-products and with the lack of salt, the body didnt
retain as much fluid.
Dr. Thomson
knew there needed to be a better solution. He was aware of
a Dutch researcher who successfully treated patients with
a room-size dialysis machine. They were already dialyzing
in Montreal and the U.S., he says. The technology of
dialysis was not new. It had been extensively studied in 1850,
but was never tested on humans until the early forties. He
decided to build one of his own. In 1954, with the help of
a technician, they fashioned together some spare partsa
chrome-plated sterilizer, some copper tubing, a couple of
washing machine motors and a cellophane membraneand
constructed Manitobas first ever dialysis machine. Positive
results were immediate. Today, dialyzers are much smaller
and with modern surgical proceduresartificial shunts
and joining arteries to veins for needle access to blood supplydialysis
opened up to people with long-term or permanent renal failure.
Before, blood vessels could not handle the prolonged use of
needles. People generally dialyze three days a week and two
large needles are inserted each time, causing scarring.
According
to various sources, the first kidney transplant in the U.S.
was performed in 1950. Anti-rejection medication (immunosuppressants)
was not developed yet, so it was unsuccessful. In 1954, an
attempt with identical twins was
successful as immunosuppressants were not required. This medication
wasnt introduced until 1964. Dr. Thomson organized a
team including a tissue-type (blood match) specialist, Hildegarde
Jaggi from Switzerland, a good surgeon, Alan Downs of Winnipeg,
and other specialists, and they performed their first kidney
transplant in 1969 at HSC with reasonable success. The success
rate is 95-99% today, as technology and medicine continually
improve. There are roughly 50 kidney transplants performed
in Manitoba each year.
Dr. Thomson
dedicated most of his career life helping to improve the lives
of those suffering with kidney failure. As an educator and
mentor, he proved to be valuable to medical students and graduate
doctors, as well. He retired in 1984 but remains active, keeping
up on the latest medical technologies and treatments. He makes
regular rounds at the hospitals with his long-time friend
and first dialysis patient from 35 years ago, Joe Kollar,
on a voluntary basis. He likes to confer with doctors and
staff who, often, still press him for advice.
Anyone
who knows Dr. Thomson will tell you he cared about his patients
as human beings, not just as medical challenges. He
was very technically minded, yet he was compassionate and
would listen to your ideas and even those of his patients,
attests Pat Hill, a dietician who worked with Dr. Thomson
since 1963. His staff would walk through fire for him,
she adds.
Joe Kollar
remembers his early days of dialyzing 35 years ago under the
direction of Dr. Thomson. He would bring exercise bicycles
for the patients at the dialysis unit. And, he would organize
picnics and Christmas parties for patients and their
families, with the help of Pat Hill and other staff members,
Joe fondly recalls. Dr. Thomson fought for, and was instrumental
in setting up, home self-care dialysis for his patients. Joe
was one of the first to take advantage of this and he is forever
grateful, as it allowed him to have much more
control of his life.
Ash managed
a healthy balance with work and family, raising five daughterstwo
of which are adopted, and two sons with his wife, Muriel.
They had married in 1956. Murial had a degree in Arts and
Science. She was very artistic and many of her creations permanently
decorate the family home, although she has since passed away.
Ash was good with his hands and used them to build small wooden
toys for boys. He also built small sailboats that would hold
three or four people.
He obtained the plans from Great Britain and it was said the
boats could withstand the waters of the English Channel. The
family often went to their cottage in the Kenora area to sail
them, and to go canoeing. Ash had also played some hockey
during university and later golfed with colleagues.
Ash joined
an organization called People to People International (PTPI).
It was founded by Dwight Eisenhower after his term as U.S.
President. The purpose of PTPI is to enhance international
understanding and friendship through educational, cultural
and humanitarian activities involving the exchange of ideas
and experiences directly among peoples of different countries
and diverse cultures. Lawyers, doctors and other professionals
joined and shared their professional experiences. In return,
they got to travel and make new friends worldwide. On Ashs
time off work, he and Muriel would travel to places like Beijing,
China, Europe, South Africa, and Moscow, on these one to two-month
excursions. Once, they were on their way to visit the famous
Tiananmen Square, but were turned away. It wasnt until
months later that they learned it was because of the infamous
riot in 1989.
Thank
you, Dr. Thomson, on behalf of all the people you have helped
in Manitoba and around the world. You have impacted so many
lives. n
(Read
more in the Sept. 21/09
issue of Senior Scope)
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William J. Thomas
I
Am Not Aging.
Im Accumulating Longevity Status
Its
around this time of year, with everything dyingflowers,
leaves, even the weedsthat I start to feel old. But
I cant. Im not allowed to. Im a Baby Boomer.
We are not aging. We are gaining life-enhancing longevity
status.
Now that
we dispensed with phrases like old age homes,
nursing havens and lodges for the elderly,
were about to come up with a new and more euphemistic
name for such
institutionsMaturity Spas. Huh? Sounds great
doesnt it? Makes you want to strap an outboard motor
on the walker so you can get there faster! Those places heavy
on recreation will be called Carpet Bowlaramas
So I turned
sixty-two and like all Baby Boomers Im fighting age
as vigorously as we once fought authority. When the government
gives us death with dignity laws and makes hemlock
available over the counter, only then will the boomers go
gently into that dark night.
So Im
denying my age as best I can. Id sooner starve than
dine at an early bird special. Id rather
pay six bucks for a bucket of popcorn rather than ask for
the senior citizens discount on a movie ticket. And
dont get me started on coupons.
But there
comes a time when all willful deniers are forced to cut bait
or fish and let me be very clear. I will not accept a 20%
off Live Minnows Special for senior citizens or order
the Early Bird Fish Fry if I have to produce my Social Insurance
Number.
My seminal
moment came at a typical greasy spoon diner where I stopped
for a bowl of soup at lunch. Like the best of the booth eateries,
this was decked out in checkered table tops and tacky humour.
Over the
clock, of course: Our clock can never be stolen. Our
employees are always watching it. And above the kitchen
door: Eat here and diet home.
So I have
my bowl of soup, beef barley, which I ordered with extra crackers
and it was very good. At the cash register, as Im paying
my bill, I ask for a bottle of water and two oatmeal cookies
to go.
The waitress
is young, bored and obviously laboring in a place well below
her station in life. Im sure shes an actress waiting
tables but what shes really waiting for is the big break.
Like some
day Lorne Michaels will walk into this joint because somebody
in New York told him about the liver and onions that are to
die for and Rita here will don a red wig and throw herself
straight into Lucille Balls Vitameatavegamin routine.
In the meantime, shell pass her time picking up a paycheck
by cracking gum and jokes at the same time.
Thatll
be $6.25, sir.
I used
to enjoy being called a sir but ever since I turned
60, I resent it. I was sure she was being sarcastic. Oh yeah,
she said sir but she meant old sport.
From my
money clip, I peeled off a five dollar bill. From the same
pocket I fished out a loonie. Six dollars. No more. I was
twenty-five cents short.
I looked
at the little cup of pennies next to the cash register. Take
A Penny. Leave A Penny. I wondered what the waitress
would do if I took twenty-five pennies and left the rest as
a tip.
I
thought I had enough money, I said. I usually
only have soup.
Yeah,
but theres the water and cookies, she said, holding
up the bag. Not to mention the extra crackers.
Okay,
why dont I leave the water and . . . .
I
already rang it in, she said, now tapping her foot to
the rhythm of her snapping gum.
Maybe
the next time I . . . .
Maybe
you want the Senior Citizens Discount. Its twenty
percent off.
Then she
hit a couple buttons on the cash register and said: That
would make it $5.95. You got enough for that.
I wondered
if she was being nice, offering me a discount to get me out
of my cash shortage problem or she just pegged me at sixty
years of age.
I had
change in the car but did I really want to walk all the way
across the parking lot and back for a lousy quarter?
Yes,
that discount thing will work, I said, putting down
the five and the loonie and reaching for the bag with the
bottle of water and two cookies.
She pulled
the bag back, just out of my reach. Ill need some
I.D., she said.
Now it
was personal.
I couldnt
say I had no identification, shed seen all my credit
cards when I opened my money clip.
Ah,
okay. Drivers license do?
She took
the license and loud enough for everybody in the joint to
hear she said: October 18, 1946.
She popped
the till and tossed a nickel on the counter, next to which
she place my takeout bag.
Just
as I thought, she said.
I snapped.
So you knew all along I was a senior citizen.
No,
Libra, she said. Forgetful.
I grabbed
my bag just as she said: Would you like to join our
Early Bird Eaters Club? They get all kinds of discounts.
Thats
when I also grabbed the nickel.
And left.
As a Baby
Boom age denier, Id been outed by a spiked-hair, twenty-something
waitress with enough rings and studs to rig up a clothesline.
Unless
I stay out of diners with wise-ass waitresses, tomorrow will
be the first day of the rest of my strife.
_______________________________________
William Thomas is the author of nine books of humour including
Margaret and Me about his wee Irish mother. www.williamthomas.ca
(Read
more in the Sept. 21/09
issue of Senior Scope)
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