Thursday, June 16, 2011

Dr. Herb Fitterman, ophthalmologist (1932-2011)

Dr. Herb Fitterman is believed to have performed the first lens implant operation in Canada.

By Tom Hawthorn
Special to The Globe and Mail
June 15, 2011

Dr. Herb Fitterman offered hope to those whose failing eyesight made their future as cloudy as their vision.

The Vancouver ophthalmologist was a trailblazing eye surgeon who, in 1968, performed what is believed to have been the first lens implant operation in Canada.

The procedure, now standard, was controversial at the time. Dr. Fitterman and the medical establishment did not see eye-to-eye on the efficacy of what many regarded as an unorthodox, perhaps even dangerous, surgery.

Dr. Fitterman, who has died, aged 78, continued practicing until his death, precipitated by a fall while on vacation.

His patients included cross-eyed children and elders with cataracts, all of whom would find comfort for their affliction from a doctor known for wearing a lab coat and wooden clogs. A jar of candy provided rewards for well-behaved children, not to mention for a physician with a sweet tooth.

A stubborn advocacy on behalf of patients earned him their devotion.

After lens implants became an accepted treatment, he initiated a letter-writing campaign to the health minister in Victoria to protest a long waiting list.

A cache of thank-you cards was found by his family after his death. One of the letters included black-and-white photographic portraits of a grateful patient as a girl and as a middle-aged woman. “I was eight years old when I first came to see you and I will never forget putting on glasses for the first time and seeing individual leaves on tress,” she wrote. “And now I need reading glasses!”

Herbert Norton Fitterman was born in Saskatoon, Sask., on Nov. 28, 1932 to Betty (née Blank) and Harry Edward Fitterman, a retail clothier. His paternal grandfather, Morris Fitterman, was a veteran of the Russo-Japanese War who immigrated to Winnipeg from London in 1910. He ran a fur shop. His materal grandfather, Shmelik Chaykin, had worked in Rothschild-owned vineyards before emigrating to Canada, where family lore has an immigration official refusing to accept the unfamiliar surname, telling them to complete a form by filling in the blank. The Chaykins became the Blanks.

The call to medicine came to him as a youth, though he was undecided as to become an eye surgeon or a brain surgeon. The former speciality was chosen as he figured fewer patients would die and he would contribute to the joy of providing sight.

He enrolled in a program of pre-medicine at the University of Manitoba in 1948, not long after the school’s unofficial policy of maintaining quotas based on “ethnic origin” were exposed. The policy was designed to restrict the admission of Jews, especially to the medical school.

The student was in the middle of his med school studies when his mother died suddenly in 1954. That same year, his restaurateur uncle, Oscar Blank, the well-known proprietor of Vancouver’s popular Oscar’s, died when his Trans-Canada Air Lines plane collided with an air force trainer in the skies above Moose Jaw, Sask. The accident killed 37.

While interning at Vancouver General Hospital, he was introduced by a cousin to Shirley Veiner, a second-year education student at the University of British Columbia and the daughter of the mayor of Medicine Hat. The couple married on June 30, 1957, before leaving on a California honeymoon. Dr. Fitterman graduated the following year.

It would not be long before his eagerness to try new techniques was noticed by peers and reporters. Inspired by a report in a Japanese medical journal, Dr. Fitterman conducted a trial with eight glaucoma patients, four of whom he treated with anthranilic acids. Those patients reported a decrease in the amount of pressure on the eyeball, as well as an easing of other symptoms of the eye disease. He reported his findings in a brief to the Canadian Ophthalmological Society during their annual meeting in 1959.

Almost a decade later, he anticipated opposition to his plans to perform an implant surgery, fearing rejection on the grounds the proposal was a “quirky procedure.” Instead, he found, to his delight, a supportive management at St. Paul’s Hospital in Vancouver. After consulting with Dr. Cornelius Binkhorst, the Dutch ophthalmologist who had made important contributions to the development of the interocular lens, and obtaining a supply from Germany, he performed the surgery on an American patient in February, 1968.

Not all were supportive. Forty years later, he wrote that “there was much antagonism from many colleagues,” some of whom “thought this was going to be the worst thing in the world.”

“It was immensely controversial,” said Dr. Ilan Hofmann, of Montreal, a friend and colleague. “The establishment considered it almost a heretical procedure. They felt it was dangerous, and against the patient’s best interests.”

Dr. Fitterman persevered, Dr. Hofmann said, challenging the orthodoxy of the times.

The operation on that first patient lasted hours, the instruments used unwieldy, almost primitive by today’s refined standards. Still, it was a success, and a harbinger of the future for those suffering from cataracts.

The surgeon spearheaded the creation of the hospital’s eye clinic, while cataract patients from around the world would seek a spot in the operating theatre. In time, Dr. Fitterman would head the ophthalmology departments at both St. Paul’s and the Vancouver Children’s Hospital.

He used to fly to small northern towns in British Columbia to treat First Nations children who might otherwise have gone without specialist care.

He was on holiday in Palm Springs, Calif., when a fall broke his pelvis and ruptured an artery. A pre-existing blood disorder made it difficult to stem internal bleeding. He returned to Vancouver by air ambulance, dying a few hours after arrival at St. Paul’s Hospital.

Dr. Fitterman, who died on April 22, leaves Shirley (nee Veiner), his wife of 53 years; a son; two daughters; and, two grandchildren.