In the Garden of Hope & Ingenuity

Rehab pioneer Dr. Geoff Fernie’s innovative path from making Pink Floyd, Cream and other rock stars look good, to doing good for millions of people with disabilities.

Dr. Geoff Fernie explains how FallsLab enables researchers to find new ways to prevent falls. UHN Toronto. Youtube Jun 13, 2014

Stephen Trumper, Abilities Magazine October 27, 2011

Spinning around most people with disabilities are circles of support. The circle closest to your heart, of course, is composed of family. Next come friends, then your circle of job or school colleagues. Moving outward, there is the circle of professionals—doctors, nurses, therapists, specialists, etc.— who help you in some way, people you interact with and whose names you know.

The next circle is also made up of people who assist you: the designers, inventors and developers of liberation-technology products such as wheelchairs, apps, crutches, canes, scooters, raised toilet seats and ceiling lifts. These people are unknown to you but, if you’re like me, every so often you silently thank them and wonder who they are, what their lives are like and just how they came to think of, create and develop this particular wondrous thing that makes lives easier. And better.

How to prevent the elderly from falling, how to keep them driving longer, how to make it practical for them to stay in their homes as long as possible — all these problems are on the radar of Geoff Fernie and the Toronto Rehabilitation Institute.

One of the leading lights in this circle is someone I’ve come to think of as the Rock Star of Rehab: Dr. Geoff Fernie. Long before I met him this past summer, I had been regularly, silently thanking the person who had created the device that smoothly, effectively lifts me into or out of my wheelchair each morning and evening. Fernie, I would soon learn, along with his team, created this device—the first battery-powered, portable ceiling lift, the SturdyLift. He also developed the first raised toilet seat, balance pole and more.

Now, as vice-president of research at the Toronto Rehabilitation Institute (TRI), he is deeply involved in finding new ways to implement the TRI vision “to revolutionize rehabilitation and maximize life”—doing so, says Fernie, “every day through quality and innovative clinical care and groundbreaking research.”

And who better to help make revolutionary advances possible than a man who, in his late teens and early 20s, discovered a thing or two about lighting the way.

TRI, at first glance, does not look like a place in which any kind of revolution could be happening. Located down the street from the grandiosity of Queen’s Park and surrounded by several of Toronto’s muscular, big-name hospitals—Sick Kids, Toronto General, Mt. Sinai—TRI, by comparison, looks positively anemic from the outside.

Inside, the lobby also reflects the pallor of a building that appears to have seen better days, as do the 12th-floor offices, where I’m to interview Fernie. Has nothing here changed since the 1950s?

This is what I’m wondering as Fernie, dressed casually and looking more aging roadie than scientist, enters the boardroom for our interview. I start by telling him of my fascination for how ideas develop and about the lives and motivation of the people who develop them.

What followed was the first of many surprises that would come that afternoon.

In an engaging English accent, Fernie cheerfully admits that he wasn’t a particularly good student back when he was an undergraduate in mechanical engineering: “I got interested in everything else [but mechanical engineering]. I used to do stage lighting for pop shows: Pink Floyd, Cream. When I was at university, I always loved theatre. But I couldn’t remember my lines, and I wasn’t a very good actor. I loved technology, so I used to do theatre lighting as a hobby. [A group of us] actually got a contract to light Top of the Pops, the biggest-ever audience show in Britain… We were the first people—we thought we were anyway—to make sound and light integrate so the light responded to the sound.”

Following the advice of his university tutor, who wanted to encourage that love of technology in perhaps a more socially useful way than creating spectacular lighting for, say, performances of “Sunshine of Your Love” or ”Lucifer Sam,” Fernie spent the summer of ’66 in the Sussex countryside at Chailey Heritage, “a very isolated school-cum-hospital for disabled kids.” It had just set up a new laboratory with a couple of technicians.

“There was Lady Hoare. She was a philanthropic lady who’d been to Russia, and she had seen powered upper limbs. And she’d gotten all excited about that technology. And she thought kids in Britain should have it. So, she’d given the money and set up this lab in the school/hospital. I was the first undergraduate. And it was brilliant. A third of my kids were about seven or eight.”

Fernie describes the setting at Chailey Heritage as “a big country estate that also had a little operating theatre. The kids lived in Florence Nightingale kind of wards. It was really anachronistic. And the nurses went around with their gowns on. And most of the parents had separated and gone off. No one ever came to see the kids. But I absolutely adored them. So, I started working with them, fitting them with prostheses.”

This was the era of the heartbreaking consequences of doctors prescribing Thalidomide to pregnant women, a drug that caused devastating birth defects and malformations. Like the polio and AIDS outbreaks that preceded and followed this era, the wave of misshapen Thalidomide kids had a huge influence in the career direction of young men and women looking for meaning and purpose in their lives.

In Fernie’s case, he saw the need to think differently about assistive devices because of his experience at Chailey Heritage: “It was all a waste of time. Technologically, it was a complete bust.”

Why? “Because the technology was so far behind the kids’ needs. They weren’t integrated with the technology. So, you’d have a kid with no arms and no legs, and you’d put all this junk on them and there’s no way they could use it,” he recalls. “So, they would stand there for the photograph… This was when the Sunday newspapers had just launched the Sunday magazines. So, there was a front-page picture of a kid with prosthetics on. And then the photographer would leave, the kid would take all the stuff off and then the kid would play, but never using the prosthesis to play with anything.

It was a waste of time in that sense, but it really turned me onto the field, and I knew that we could do some stuff with engineering but it was not going to be easy. And I adored it. They cleared the nurses out of one of their offices on one ward and that was my bedroom. And I stayed there. I got up in the middle of the night and helped them change the kids, to really be part of the environment.”

Dedicating himself to doing more and learning more about the field, Fernie went on to post-grad work in bioengineering in Scotland, where he got his PhD. Soon after, in 1973, he came to Canada, first for a job that never materialized at the Ontario Crippled Children’s Centre (since morphed into Holland Bloorview Kids Rehabilitation Hospital), then over to Toronto General, then to what is now West Park Hospital, where Fernie worked with amputees, did work in urology and helped start a school that trained people to make prosthetics and orthotics that now has several locations in the Toronto area.

Throughout, the entrepreneur in him was growing. As was the desire to use the results of his research to build products that could actually help people and then move those products into the marketplace.

Fernie points to his father and grandfather as major influences. “I’ve always been a bit of a socialist, although not in an economic sense. I actually start companies and I’m quite in favour of free enterprise,” he says. “But I really believe in supporting the underdog and I really believe in social responsibility in society. And it started because my dad was one of six brothers and one sister. His dad, my grandfather, was a railway man. They had no money. The big expense was buying shoes every year for the kids. But he was a very clever man, Granddad. He started the co-operative movement in the east of England as a way of helping move product directly from the farms so people could afford to have the product.

Then, the war broke out, and my dad volunteered and went to the air force. He never had the money or the opportunity to go to university. But all six brothers were serving in active service simultaneously in the Second World War, and all of them had a rough time. And Dad was shot down and imprisoned in Germany for a long time, very injured—and the others did as well. They came back to Britain, no formal education beyond that, no money. Dad was told to start a little bank branch and we were to be grateful for that and he wasn’t paid very much. But he became the first chair of the national union of bank employees and led the acceptance of the union and the improvement in the working conditions of the employees, way ahead in Britain to what happened in North America. He always had a profound social conscience.”

Three generations of Fernies. Three bold solutions to social problems: a new co-operative farming movement; a new union to fight for and improve worker rights; and, now, hidden away in an unassuming building on Toronto’s Hospital Row, a garden of hope and ingenuity designed to improve the lives of people with disabilities.

Several times during our discussion, Fernie would say things like “as you’ll soon see…” I am now viewing one part of his garden, on the 13th floor of the building, getting a personal tour of the kind he’s no doubt given hundreds of times in the researcher’s constant quest to raise money or get media attention to help raise money—something Fernie seems skilled at, having raised in excess of $36 million to fund his labs and other projects.

Take a look at iDAPT – Toronto Rehab’s new, one-of-a-kind rehabilitation research facility in downtown Toronto. There’s nothing else in the world like iDAPT, which means “Intelligent Design for Adaptation, Participation and Technology”. The facility houses state-of-the-art ‘living labs’, located at the hospital’s University Avenue site, and is a quantum leap forward in rehab research. Researchers around the world can now generate new knowledge, more practical technologies, and innovative treatments more quickly, accurately and in total safety to reduce accidents, illness, and, help people overcome disability. UHN Toronto. YouTube Nov 14, 2011

At first glance, it looks like any modern workplace—lots of computers, desktop monitors and the like. But it doesn’t take long for Fernie to illuminate the latest on what’s blossoming on the frontiers of rehabilitation research.

My first stop: watching a researcher working away at creating an electronic monitor that could be clipped to a shirt or lab coat to track the handwashing habits of health-care workers and prompt them when they don’t, in order to keep superbugs at bay.

Next: sketches for a new, safer lifting device for when there’s no ceiling track. With 32 abilities, RoboNurse, as it is nicknamed, is a coproduction with China-based interests and, says Fernie, “Everyone is really buzzing. We’re doing stuff that I think is going to have a huge impact and is already having a huge impact.”

Over here: a video of an air-powered, gun-like device that shoots a connection strap for a lifting sling beneath an individual, saving the caregiver from turning the individual over onto his or her side.

“Our job is to stretch things and make sure some solution arrives,” explains Fernie. From early on in his career, he “wanted to get stuff commercialized. So, we started developing products that were pretty basic things that you needed.”

“There are a couple of philosophies you’ll see as you go around here,” he adds. “The first is that I don’t value ideas. I think ideas are worth about 10¢ each. And if we wanted to sit down, you and I, for the next 15 minutes, we could come up with 15 ideas. So, we would earn $1.50.” What does matter to Fernie is that until an idea is “translated into something that you can hold, swallow, sit in or do something with, or it’s a new treatment that you can demonstrate as useful or you change a building code or a policy or something— it’s only then that it has value.”

But for a researcher hunting for financial resources to fund the search for value, labs are needed in which to measure outcomes to prove it’s money well spent. This is why Fernie is beaming as he slides open a glass door, beckons me to a walkway and indicates that I should look down.

Below is a maze of cubicles that could be a model floor plan for a new condo, but without the style and glitz. Each set of cubicles is reserved for specific research-in-a-real-life-setting purposes. Examples include (as TRI describes them):

HomeLab: “where researchers can create and test new tools to help older people and those with disabilities stay at home longer and more safely.”

CareLab: “a convenient way to study new lifting and other devices for the hospital room… and also used to continue [TRI]’s development of products to reduce the transmission of infections.”

FallsLab: “with a 2D motion platform that can make the whole lab shake, [it] can be used to safely study balance control. Sophisticated measurement systems track subjects while they are walking, standing or sitting down.”

This maze of cubicles is only part of TRI’s 65,000 square feet of new and renovated labs, workshops and other research spaces. And impressive as these labs are, they are not, as the man who once lit rock shows and one legendary TV series would say, a showstopper. That would be found in the basement and sub-basement and what seemed to be a sub-sub-basement.

Gasp! In front of me are three baby-blue pods, each about 17 feet square and 13 feet high. “Impressive” doesn’t begin to describe them or the future of rehab they represent. The overall impression is Disney meets Star Trek. Or perhaps some secret base in the North that the government has set up to protect Canada’s Arctic claims. Within these pods are “motiontracking systems, 3D streetscapes, snow and ice, tilting floors,” explains Fernie, adding that a “huge hydraulic motion simulator that each pod can sit on rolls, tilts and even has a movable ice floor.”

As with the cubicles at least a dozen floors above, these are referred to as StreetLab, StairLab and WinterLab. Here’s how TRI’s latest annual report describes them:

StreetLab: “allows study participants to move through 3D streetscapes of downtown Toronto—or anywhere else in the world. With a curved projection screen that extends onto the floor, realistic soundscape—and sensations like bumpy sidewalks or vibrations from a passing streetcar—StreetLab… allows scientists to present people with realistic scenarios while manipulating certain aspects of the environment. For instance, traffic signals, ‘intelligent’ vehicles and streams of virtual pedestrians can be adjusted to interact with the research participant. Landmarks and signage can be altered. This will allow researchers to better understand how people with head injuries and dementia, for instance, use cues to navigate at busy intersections.”

StairLab: “where scientists can conduct studies to better understand how people manage on stairs—a common place for falls. StairLab features a staircase and handrails loaded with equipment so that scientists can precisely measure how people use stairs and handrails, and develop practical solutions. In real life, people who fall on stairs don’t always know exactly what happened. But StairLab tracks every aspect of a fall.”

WinterLab: “can generate the worst of winter—subzero temperatures, snow and winds up to 30 km/hour. A real ice floor means scientists can study winter slips and falls—without exposing study participants to risks of the outside world. The simulator base can be tilted to create slopes, or moved suddenly to safely throw people off balance. And safety is paramount. Anyone taking part in a research study is strapped into a body harness connected to an overhead robot that will move with them as they go about their tasks.”

The interview and tour are over. Fernie has to rush off to a phone conference with his partners, but he takes the time to escort me back out to street level, to the roar of traffic on busy University Avenue. On my way back home, I keep thinking of his description of the kids with Thalidomide-caused malformations, with all that “junk” on them. I grew up with several Thalidomide kids who all complained of the various prostheses that rehab specialists implored—even forced— them to wear. They were heavy. Awkward. They hurt. And they did not work very well, if at all.

To most of my generation of “crippled” children, those of us who grew up in the 1950s and ’60s, rehab of just about any kind was torture, its practitioners not really to be trusted. There was lots of pain and tears back then, and a general feeling that nobody heard our cries for help. But Geoff Fernie did—and learned.