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MUSAto four weeks in hospital, with two to threeweek breaks outside. 10Generally, acromiothoracic flaps wereutilized for deep unilateral burns, but incases where adequate free grafts could beproduced, patients were treated in thisway entirely. 8 During his tenure at QueenVictoria hospital, Tilley would replacecountless noses, reform a multitude of earsand eyelids, and re-establish facial featuresfor hundreds of men; all of this with theobjective of giving his patients the chanceto return to a normal state of existence. ButTilley’s operative virtuosity was not all heoffered his patients….A Scalpel, A Guinea Pig, And ATender Hand: Tilley’s ApproachTo The Patient RelationshipBy 1944, the Canadian wing at QueenVictoria Hospital opened, and Tilley waspromoted to the rank of Group Captain.In June of the same year, Tilley foundhimself standing in front of King GeorgeVI at Buckingham Palace with the Order ofthe British Empire being bestowed uponhim. 1 This prestigious award was fittingrecognition of Tilley’s success in Britain;along with the work of McIndoe and thehospital staff, they had become “the mostformidable and effective response to burninjuries, anywhere in the world.” 4The work at Queen Victoria hospital was sogroundbreaking that it brought one patientto remark in jest, “we’re nothing but abunch of damn guinea pigs!” Subsequently,the Guinea Pig Club was formed in 1941,by a group of airmen who had sufferedburn injuries in the war and were treatedat the Queen Victoria Hospital. Consistingof nearly 650 members of a dozen differentnationalities, the club was one of the firstsupport groups in medical history. 17 TheFigure 5. Tilley poses for a photo symbolizing thecare he gave to his real patients, the Guinea Pigs.camaraderie and sense of belonging fosteredby the club has been acknowledged bymany historians as instrumental in thetherapeutic success ultimately achievedat East Grinstead. 4 The Guinea Pig Clubhelped shield patients from suffering theirdisfigurement in isolation, and gave itsmembers the strength to venture out intothe world, and walk the streets wearing theirwounds as testaments of their sacrifice. Tilleyserved as president of the Canadian branchof the Guinea Pig Club, and continued tooperate on over two hundred of its membersfor the next forty years (Figure 5). 3Tilley dedicated a tremendous amount ofpersonal attention to the emotional andpsychological condition of his patients. Afteroperating all day and into the evening, Tilleywould rest briefly in his living quarters onlyto make his way back to the hospital at 23:00h to check how his patients were faringafter their surgeries. 4 In a medical landscapedominated by rampant paternalism,Tilley was a trailblazing pioneer of patientempowerment who went to great lengthsto educate his patients about every aspectof their care, every nuance of their surgeries,and the intricate details of what they couldexpect during recovery. 18 Where manysurgeons of the day saw their involvementin patient care beginning and ending in theoperating room, Tilley was a fierce proponentof the importance of a patient’s psychologicalwellbeing in their overall rehabilitation. In hiscare of the Guinea Pigs, Tilley transcendedthe customary duties of a physician and roseto become a shining light that illuminated acomprehensive path to recovery. 18For decades after the war, Guinea Pigsfrom across the world would come togetherfor an annual celebration where one oftheir toasts was always to the care theyreceived from Tilley. Out of gratitude forTilley’s commitment to them, the GuineaPig Club funded a bronze bust of theirbeloved physician, which was installed inthe Canadian wing of the Queen VictoriaHospital. The sculpture commemorates theman whose tender hand pulled them fromthe furnace, and allowed them to transcendwhat had once been thought of as a fateworse than death. 2No Sign Of Slowing Down:Tilley’s Life After The WarUpon his return from Britain in 1945, Tilleybecame a consulting physician at ChristieStreet Hospital and Toronto WellesleyHospital. For several years between 1949-1965, Tilley also spent three days everymonth in Kingston where he worked as astaff physician at the Hotel Dieu, KingstonGeneral, and Kingston Military Hospitals. 2As one of only ten other plastic surgeonspracticing in Canada after the war ended,Tilley was extremely busy laying theframework for the future of his specialty.His colleagues viewed Tilley as a physiciancapable of breaking new ground. In July of1942, he led the first all-Canadian plasticsurgery operation, and a few years later asan assistant professor at Queens University,he became the first to offer formal accreditedcourses in the specialty. 2 Tilley also inventedseveral surgical instruments, such as aningenious hand splint, and was the first to19, 20design the tube pedicle flap.Tilley was one of the twelve foundingfathers of the Canadian Society of PlasticSurgeons in 1947. At its second annualmeeting on June 2, 1948, the society’smembers empowered Tilley to draft a feeschedule for the operations performed mostcommonly by plastic surgeons. 20 Appointedvice-president in 1953, and then presidentin 1954, Tilley’s leadership of The CanadianSociety of Plastic Surgeons helped establishthe profession in Canada and paved the wayfor the exponential growth and prosperity itwould experience in subsequent years. 20As his specialty flourished across thecountry, Tilley continued to infuse hisdiscipline with respect and integrity ashe campaigned for years to develop burntreatment facilities in Ontario. In 1984, hisvision came to fruition and the Ross TilleyBurn Centre opened at Wellesley Hospital. 21Only three years after becoming the firstplastic surgeon to be appointed a memberof the Order of Canada, Tilley also assumedthe role of Founder and Director of the first19, 21adult burn centre in Canada.Even after retiring from practice at Wellesleyand Sunnybrook hospitals in 1981,Tilley continue to be recognized for hisoutstanding career. An elementary school inhis hometown of Bowmanville was namedin his honour, and he was inducted intoCanada’s Aviation Hall of Fame in 2006. 1,3After dedicating much of his 84 years of lifeto his patients, Albert Ross Tilley passedaway on April 19, 1988. 21CONCLUSIONThe distinguished and illustrious careerof Albert Ross Tilley exemplifies many ofthe qualities sought after by physicianstoday. As a surgeon, he is rememberedfor his meticulous technical skill, soundjudgment, and tireless work ethic. He wasa leader, innovator, and educator whoseefforts sculpted an immature specialty intoa refined profession. As a man, Tilley’s virtueand character stood beyond reproach, and34University of Alberta Health Sciences Journal • April 2012 • Volume 7 • Issue 1
he was acknowledged with Canada andBritain’s highest honours.The most valuable lesson that Tilley’s legacyoffers this generation of medical studentsand physicians, can be gleaned from hisfirst encounters at East Grinstead. Standingat the bedside of his patient and assessingthe medicines he had at his disposal, Tilleyshook his head and resolved to do better;he refused to surrender to the limitationsdictated by existing medical practice.Tilley tossed aside the contemporaneoustreatment of coagulation therapy, the meritsof which were being espoused by expertsin the field. With a steadfast convictionthat his patients deserved a higher levelof treatment, Tilley worked tirelessly withMcIndoe and hospital staff to producea revolutionary regimen that ultimatelysaved the hands, faces, and livelihoods ofhundreds of men. Tilley’s actions at QueenVictoria Hospital serve as a reminderto modern day practitioners of theirresponsibility to address deficient aspectsof patient care, and to innovate, whennecessary, in order to provide patients withthe best possible medicine.Acknowledgments: I would like to thankDr. Gordon Wilkes of the University ofAlberta, and Dr. Steven Morris of DalhousieUniversity for their generous guidance in theproduction of this article.References:1. Albert Ross Tilley. Alberta: Canada’sAviation Hall of Fame; c2011 [cited 2011Jun 10]. Available from http://www.cahf.ca/members/T_members.php#A.%20Ross%20Tilley2. Gray C. Profile of A. Ross Tilley. Can MedAssoc J. 1983;129:154.3. Wilton P. WW II “guinea pigs” playedcrucial role in refining plastic surgery inCanada. CMAJ. 1998;159(9):1158-9.4. Mayhew ER. The Reconstruction ofWarriors: Archibald McIndoe, the RoyalAir Force, and the Guinea Pig Club. 1st ed.London: Greenhill Books; 2004.5. Downing T, Johnston A. The SpitfireLegend. History Today. 2000; 50(9):19-25.6. Keegan J. The Second World War. 1st ed.New York: Penguin Books; 1989.7. Bailey G. The Narrow Margin of Criticality:The Question of the Supply of 100-OctaneFuel in the Battle of Britain. EnglishHistorical Review. 2008;123(501):395-411.8. Jackson DM. Burns: McIndoe’scontribution and subsequent advances.Annals of the Royal College of Surgeons ofEngland. 1979;61:335-40.9. McIndoe AH. Total reconstruction of theburned face. Br J Plast Surg. 1983;36:410-20.10. Geomelas M, Ghods M, Ring A, OttomannC. “The Maestro”: A Pioneering PlasticSurgeon—Sir Archibald McIndoe and HisInnovating Work on Patients With BurnInjury During World War II. J Burn CareRes. 2011;32(3):363-68.11. Alger EM. On Cutaneous Burns. MedicalRecord. 1898;53(22):766-68.12. Mitchiner PH. Treatment of burns andscalds with special reference to the use oftannic acid. The Lancet. 1933;233-39.13. Gordon RM. Treatment of burns by tannicacid. The Lancet. 1928;336-37.14. Hunter JB, Gillies H, McIndoe AH, HudsonRV, Colebrook L, Kilner TP. Treatment ofBurns. The Lancet. 1940;621-622.15. McIndoe AH. The Misuse of Tannic Acid.The Lancet. 1940;627-28.16. McIndoe AH. Burns of the Hands andFace. The Lancet. 1940;655.17. Andrew DR. The Guinea Pig Club. AviatSpace Environ Med. 1994;65(5):428-33.18. Feasby WR. The Official History ofthe Canadian Medical Services, 1939-1945. Department of National Defense,Directorate of History and Heritage.1956;363-366.19. Cheng H. Firsts in Canadian Plasticand Reconstructive Surgery. Universityof Toronto, Division of Plastic andReconstructive Surgery website. 2010[cited 2011 Jun 1]. Available from http://www.uoftplasticsurgery.ca/main.php?p=1154&s=120. Douglas LG. History of the CanadianSociety of Plastic Surgeons. 1st ed. Quebec:Canadian Society of Plastic Surgeons; 1983.21. Taylor JR. Canadian Society of PlasticSurgeons: Tribute to our founders. Can JPlast Surg. 1997;5(1):22-32.MUSAThe House of God still worth a read for today’s medical traineesAlby Richard, BScMedical Student (2013), Faculty of Medicine, University of Calgary, Calgary, Canada,PhD Candidate (Neuroscience), Montreal Neurological Institute, McGill University, Montreal, CanadaCorrespondence to Alby Richard: Email: alby.richard@mcgill.caTHE HOUSE OF GODBy Samuel ShemNew York, NY, Dell, 2003 (first published:New York, NY, Richard Marek, 1978).ISBN 978-0385337380Medical training has changed a great dealover the past thirty years, along with theway medicine is practiced in general. Thisis interesting to consider in the contextof the American medical system, whichhas the dubious honor of boasting themost sophisticated yet unevenly accessiblemedical system. In light of this, it is perhapsnot surprising that at some point alongthe way voices of dissent would emerge,even from within the ranks of the medicalestablishment itself.Samuel Shem’s (the pen name of Dr.Stephen Bergman) House of God wasfirst published in 1978, as a semiautobiographicalaccount of Dr. Roy Basch’sinternship year in the eponymous hospital.With the ripples of the civil rights movementstill being felt, and the Watergate scandalshowcasing the moral ambiguity of thenation’s highest offices, Shem’s honestand at times disturbing portrayal of oneof America’s most prestigious teachinghospitals was a timely contribution to thechanging social and political landscape.Now, over three decades later, even asophomore medical student on the brinkof entering clerkship may be struck by Dr.Bergman’s candid observations concerningthe challenges of medical education. Thisbook offers a compelling caricature of someUniversity of Alberta Health Sciences Journal • April 2012 • Volume 7 • Issue 1 35
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Page 25 and 26: References1. Brett-MacLean PJ, Cave
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Page 39 and 40: Thank youThe UAHSJ wishes to thank

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