A Career Full of Notable Achievements

Published: May 11th 2010
in News » Local

Dr. Robert M. Filler


SL: You mentioned that the public is one of the reasons this hasn’t fully developed in Canada. What are some of the other reasons?


RF: I think that people are concerned that those with money will get better care than those not so affluent, and the goal of our system is to provide good, equal care to everyone. I see that the two tier system could possibly work if those principles can be safe-guarded.  Then the question is, “How do you do that? How do you ensure that?” That’s not so easy. 




SL: What do you see as your greatest accomplishment? Greatest failure?


RF: Earlier in my career, I and colleagues created and implemented a practical way to provide total long term nutrition by vein (Total Parenteral Nutrition) to infants whose intestinal tracts were not working because of a potentially correctable condition. 


Prior to this innovation these children died of starvation before the abnormality could be completely corrected.  After this concept was first used by Dudrick in one child, its successful implementation in 14 critically ill infants was reported by me and my colleagues in the New England Journal of Medicine in 1969 beginning the revolution for what is now standard hospital practice for infants, children and adults who cannot use their intestinal tracts for nutrition for prolonged periods.


My other accomplishments occurred at the operating table.  I designed a procedure for children with rare abnormalities of the trachea who could not breathe because of obstruction to the air passages in their chests.  I successfully treated quite a number of infants with severe congenital abnormalities of their esophagus and/or trachea whose previous attempts at treatment failed. 


Quite frankly, my involvement in the treatment of even the everyday common-surgical problems such as appendicitis always gave me a great pleasure. To be able to take a child who was not perfect one day and make him perfect the next was always very, very gratifying. 


I don’t really recognize any true failures in my career. Dealing with many children with life-threatening surgical problems, it was not possible to save all of them. Those were very sad days for all of us.  However I always felt that I gave these children everything I had in me to solve the problem. 




SL: How have you seen surgery change since you entered the field?


RF: I would say the two biggest changes are the imaging techniques available to surgeons and the new minimally invasive technology. Imaging with MRI the CT Scans now give surgeons a much more accurate indication of a patient’s problem before surgery, or even sometimes during surgery, so you can plan the procedure properly and have a much clearer indication where the problem areas are.


Minimally invasive surgery techniques have made great strides in reducing postoperative pain from large incisions as well as reducing hospital stay. Telescopes and small instruments placed inside body cavities allow the surgeon to perform without big incisions. This is now aided by controlling the instruments by robots. Surgical training has had to adapt to these new techniques.




SL: I know you are a professor at U of T (University of Toronto).



RF: I’m actually Professor Emeritus, which designates my retirement status.  I don’t have any specific duties any more but I keep updated on University affairs and most recently have taught anatomy to first year medical students.




SL: Do you ever miss being in the hospital environment and maybe even holding a scalpel?


RF: Not really, although I loved my surgical career and would not have made any changes. Now is a new time in my life and I have found many other interests to keep me busy and productive.

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