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Legends in Urology


(15) 4 Aug 2008

Jack L. Sales, MD, FRCSC
University of Western Ontario (Retired)
London, Ontario, Canada

Dr. Gabriel Haas honors me with his request for my biography for this column in The Canadian Journal of Urology. It also humbles me because the word Legends in the title of the column means “a collection of stories about admirable people.”

I have a deep love for surgery and Urology, and I enjoy the satisfactions of a lifelong career. Each person’s path to a successful, satisfying career in Urology is a bit different, but the principles involved are remarkably similar. These are mine:

• Have a dream

• Work hard

• See setbacks as opportunities

• Derive satisfaction from your work in Urology

• Volunteer to work in organized Urology.

When I was a boy, my father, a piano teacher, wanted me to become a concert pianist. With great difficulty, I convinced him that other school activities would help me get into medicine. By age 12, I was very interested in anatomy and was dissecting chickens, mice, rats, and rabbits. Later, I learned to work long, hard hours under very trying conditions on my grandfather ’s farm, saving my earnings for expenses at a university.

Before high school graduation, I was chosen to represent Ridgetown High School at the London Free Press Leaders Club. This honor provided my first visit to London and a tour of The University of Western Ontario (UWO). The next year, I enrolled at UWO in pre-medicine with a modest two-year scholarship. It was a trying time for the Sales Family; I was the only son, and both my father and grandfather had hoped I would take over the 250 acre family farm. Eventually, I was able to persuade my father that the many hours of piano practice had given me good hands for surgery, and that the hard work on the farm had taught me how to work long, difficult hours.

The pre-medicine program at UWO was very competitive because only 30 candidates out of 120 would be selected for medical school. All of us had an interview by three professors, and I learned later that they had considered me most unlikely to succeed in medicine. Many years later, I operated on two of them. Obviously, it was my marks that got me into medical school.

In medical school, I was surrounded by smart students, but I knew I could outwork them. I had to, to have any chance for a surgery course. Tim Russert, who died in June of 2008, had a similar philosophy, “I am surrounded by smarter people, but I can outwork them,” and he rose to the top in television journalism.

During the first year of medical school, I contracted mumps during our study of the Abdominal Regional. This was a terrible setback because in those days, treatment was 3 weeks in bed to prevent orchitis. So I memorized abdominal anatomy from Gray’s Anatomy. This helped me for the rest of my life. Yes, I got the highest marks in Anatomy, but more important, I was able to pursue study in Surgery under Dr. Angus McLachlin. Through hard work, what appears to be a setback in life can provide great opportunities.

The opportunity to study under Dr. Angus McLachlin was probably the most important turning point in my life. Dr. McLachlin was a great surgeon, a great teacher, and a great man whose influence impacted all areas of my life. He stressed hard work, dedication to surgery and patients, and he demanded perfection, focus, intellectual honesty, and endurance.

For 4 years, I worked under Dr. McLachlin and with young specialists as they returned to London to build the Department of Surgery at UWO. They included Dr. Charles Drake – Neurosurgery; Dr. John C. Kennedy – Orthopedics; Dr. John Coles – Cardiovascular; Dr. Robert McFarlane – Plastic; Dr. Lloyd McAninch – Urology. All of these legends in surgery had an impact on my career, especially Dr. Lloyd McAninch.

Next came 2 years of Residency Training in Urology at the University of Toronto under Dr. David Mitchell, Dr. Carl Aberhart, Dr. Charles Robson, and Dr. William Kerr, all renowned Urologists. After Residency Training, a McLaughlin Traveling Fellowship allowed me to work with Dr. Wyland Leadbetter, Dr. Victor Marshall, Dr. William Wallace Scott, and Dr. Albert Pacquin. With such broad, long training, I returned to London feeling like a surgical robot.

For the next 38 years, I had a large practice. As an Associate Professor at UWO, I helped train about 50 young Urologists. Most appreciated and responded to my tough approach to teaching, which I had learned from the Legends in Urology and Surgery mentioned. I enjoyed teaching Percutaneous Nephrolithotripsy and Ureteroscopy, which I brought to London and made St. Joseph’s Hospital the stone centre for London and District. The Extracorporeal Lithotriptor followed.

Beyond the success of my career, I had begun to enjoy even greater satisfaction volunteering to participate in organized Urology. In 1983, I was elected Secretary of the Northeastern Section of the American Urological Association (NS-AUA). The Section was so short of funds, it was difficult to plan the annual meeting. So my thoughts turned to raising money and partnering with our industry friends to establish financial security for the organization. As President of the NS-AUA in 1988, I raised $30,000, and the annual meeting in Montreal was a scientific, financial, and social success.

Through the attendance at the Quebec Urological Association (AUQ) meeting, I met Dr. Normand Sullivan, President and premier fund-raiser for the AUQ. The next year, we decided to work as a team to raise money for the NS-AUA, not only for general use to improve the annual meeting, but also to secure funds for research and education programs. With Searle-Canada and Searle-USA, we established the Research and Education Fund. Dr. Anthony Passaretti and Dr. Datta Wagle joined our Development Committee team.

By 1998, when Dr. Alvaro Morales was President of the NS-AUA for its 50th Anniversary year, we began giving scholarships to young Urologists. Since then, 20 scholarships have been awarded to young Urologists to further their research, education, and academic careers. Dr. Wagle has taken the Research and Education Fund to a level higher than I ever dreamed possible. It is now the NS-AUA Scholarship Foundation, the only one established by a Section of the AUA. Dr. Sullivan and I each earned the NS-AUA’s Distinguished Service Award, an honor conferred upon only eight individuals from 1948–2008.

While I was Treasurer of the Canadian Urological Association (CUA), Dr. Sullivan and I raised approximately $2 million, establishing considerable security for the CUA and the Canadian Urological Association Scholarship Foundation (CUASF). This foundation was started by Dr. Kenneth MacKinnon. The CUASF has given about six scholarships most years. This has elevated the face and place of Urology in Canada for the benefit of patients and Urologists. Dr. Sullivan and I were presented with the CUA Lifetime Achievement Awards in 2003.

For 10 years, I was the Canadian consultant on the AUA Socioeconomic Committee. During that time, I encouraged the committee chair, Dr. Logan Holtgrewe, and the committee to avoid the single payer government health system we have in Canada. At the end of my term, I was elected an Honorary Member of the AUA, the highest honor I have received.

When I was President of the CUA in 1998-99, the annual meeting was in London, Ontario, for the first and only time. A highlight of the meeting for my wife Helene and all of my children, Douglas, Robert, John, Lisa, and Mark was hosting the Fun Night at Helene’s and my home, Stoneybrook, on Windermere Road.

I encourage all young Urologists to get involved in the organized Urological Societies and Associations in your area. This will help all patients and Urologists and will provide you with the greatest satisfaction of your career.

At the age of 70, I had to retire from St. Joseph’s Hospital, so I obtained a work visa for the USA, where I practiced in Texas and Georgia. I worked for the US Army at Fort Benning and learned the paperless method of record keeping. Colonel Margaret Rivera, Commander of the Martin Army and Community Hospital, presented me with a Citation stating, “Your professional attitude, dedication to duty, and expertise reflect distinct credit upon you, Martin Army and Community Hospital, and the United States Army.” So once again, what at first seemed to be a setback became a rewarding experience through hard work, an experience of which I am very proud.

In 2007, I was elected Historian of the NS-AUA. I plan to write a booklet about the 20 scholarship recipients of the NS-AUA Foundation. Also, I will investigate the feasibility of developing an NS-AUA display at the new AUA headquarters in Linthicum, Maryland.

Today, I work 2 days a week in my office in London, doing office Urology. I enjoy seeing patients and doing the outpatient procedures. My childhood dream of becoming a surgeon has been fulfilled beyond my wildest expectations; I have done small procedures for 66 years and Urology for 52 years. Beyond my expectations, my greatest satisfactions have come from my involvement and work in the NS-AUA, CUA, and AUA. To all young Urologists – get involved in organized Urology. You are needed by your patients and your colleagues. You will not regret doing so, and you will derive great satisfaction from this activity.

Jack L. Sales, M.D., FRCSC
Associate Professor (Retired)
University of Western Ontario
London Ontario, Canada

I thank Margaret Meyer, Ph.D., for helping me prepare this article.

© The Canadian Journal of Urology™; 15(4); August 2008 4142