Dr. Barry Rubin Peter Munk Cardiac Centre
Dr. Barry Rubin
Medical Director, Peter Munk Cardiac Centre.
Lying on the operating room table is a 96-year-old man — wide awake, as it happens — whose aneurysm is being fixed by Dr. Barry Rubin.
The next day, out of the hospital and like nothing happened, the patient sends a photo of himself practising his golf swing in his apartment.
This is, as they say, par for the course of the impact that Dr. Rubin has on people’s lives.
“The type of surgery I do is life- and limb-threatening. A broken blood vessel, you fix it, and there’s no feeling like it,” he explains.
Whether on an individual level, a hospital level or province-wide, it’s not an exaggeration to say that millions of people have benefited, in some form, from Dr. Rubin’s career.
While also a professor of surgery at the University of Toronto, since 2010, he has been the medical director of the Peter Munk Cardiac Centre (PMCC) at University Health Network, where breakthrough discoveries have been made in genetics, cardiac drug treatments and cardiac disease management.
The old saying goes, “You almost never see the beaver, but you always see the dam.” The doer is in the background, while the results are in the foreground. That holds true for the Innovation Fund, a groundbreaking endeavour led by Dr. Rubin at PMCC.
In a cash-strapped health system with few resources for experimentation, a committee of investors have been corralled to help fund new processes or medical devices. It’s been referred to as something of a Dragons’ Den-esque interaction, with pitches, evaluations and capital.
“Because of the donors, we can constantly try out new technologies, and be in a position to move the field forward and change the way patients are cared for,” he notes. “Businesspeople know a winner when they see it.”
According to Dr. Rubin, half of the committee are from the health care industry and half from the business world — with the input of “thousands of people to tell us what’s new and innovative.”
Thus far, some 45 projects have been funded. One of them was a non-surgical procedure to fix the main valve of the heart, called the aortic valve. Rather than making a 12-inch incision down the breastbone with a saw, an invasive procedure — “and not for everybody” — today, a needle can be placed in the groin to replace the heart valve.
“We have patients who have bicycled from Hamilton to Toronto with the heart pump stored beneath the bicycle seat. Truly inspirational, amazing stories”
Because investors stepped up with $1 million to study the effectiveness of 40 valves — at $25,000 apiece — the government of Ontario was able to recognize the success and greenlit an additional $3 million a year in funding for these valves. In other words, that initial $1-million investment resulted in a yearly government fund of three times that.
With the heart being where his heart is, Dr. Rubin also notes other “radical changes” in treating cardiac issues while working alongside the McEwen Centre for Regenerative Medicine. It is, he says, one of the leading places for stem cell therapies.
“Now, when someone has a heart attack, you can’t fix the part of the heart that died — but you can make the rest of the heart work better,” he explains. White blood cells can now be turned into stem cells to reanimate dead heart tissues. The issue takes on more importance when statistics come in: heart disease is the leading cause of death worldwide, the second in Canada after cancer.
As a member of the Health Canada scientific advisory committee on cardiovascular medical devices, he’s in a unique position to be “in the know” with all things heart-related.
“There have been so many advances in so many areas, especially in mechanical heart support — a heart pump to keep them alive. We have patients who have bicycled from Hamilton to Toronto with the heart pump stored beneath the bicycle seat. People got married when they were in the ICU on a heart pump. They went on to have families. Truly inspirational, amazing stories,” he says.
Meanwhile, as there’s an eye to the future of medical advances, Dr. Rubin is helping ensure there’s enough medical practitioners to serve us in the future. For the past decade he has served on the Provincial Academic Medicine Steering Committee, representing six thousand doctors in the 17 teaching hospitals in Ontario.
Through his lobbying, the Ministry of Health injected a quarter-billion more dollars into the system to ensure an adequate supply of doctors. A pressing need, given the swell about to occur in the province’s aging population.
Currently, there are some 30 thousand practising doctors who attended teaching hospitals in Ontario, a recent uptick of a third because of the funding, according to Dr. Rubin.
“The teaching hospitals are where the majority of the research occurs, where patients are cared for and improve their care. To be able to support that kind of activity is great.”
Notwithstanding the balancing acts of patients, doctors, funders, committees and government, or the high pressure and high stakes of life-and-death situations, for Dr. Rubin there’s a simple “why” to it all.
“You do this because you love it, because you can make a difference in patients’ lives and the lives of their families. It’s gratifying. It’s a career, not a job.”
Photo By Max Jamali