Dr. Robin McLeod developed ground-breaking new methods to improve colorectal surgery through clinical trials, which she said were landmark studies that impacted how doctors did surgery, mainly in inflammatory bowel disease.MCpl Anis Assari/Supplied
Dr. Robin McLeod, who has been called an icon of Canadian surgery, conducted clinical and health systems research and advocated for using scientific data to guide healthcare decisions. Her approach helped improve patient outcomes following colorectal surgery and other procedures.
Among other things, her advocacy led to post-operative patients being encouraged to get up and move around right away, which was found to speed up recovery time. Previously patients were encouraged to stay in bed.
“Dr. McLeod was one of the first surgeons who believed in evidence-based medicine. She lived that mission,” says Dr. Carl Brown, who did his colorectal surgery training under her.
“The history of surgery was dictated by the loudest voice in the room, and choices were based on opinion and anecdotal evidence,” says Dr. Brown, who chose to train in Toronto because of Dr. McLeod’s reputation as a surgeon and teacher.
Few women of her era in medicine went into surgery, but Dr. McLeod took it further with subspecialty training in the United States and also completed a master’s in clinical epidemiology.
Dr. McLeod, who served as president of both the Canadian Association of General Surgeons and the American Surgical Association, died on Feb. 6 of complications related to Alzheimer’s disease. She was 72.
She discovered ways to improve colorectal surgery through clinical trials. Dr. Brown says many of these were landmark studies that impacted how doctors did surgery, mainly in inflammatory bowel disease.
Dr. McLeod was also remarkably skillful at persuading fellow physicians to put evidence into practice.
In 2006, she helped put together a team from across all the U of T-affiliated hospitals to implement Best Practices in General Surgery, a set of evidence-based guidelines. This quality-improvement project brought in a range of changes: pre-operative patients were advised to exercise and quit smoking; surgeons were encouraged to keep patients warmer and avoid additional catheters and tubes; and post-operative patients were instructed to eat and be active right away to aid in their recovery.
The savings and health-care benefits were huge: Patients ended up spending one less day in hospital after colorectal surgery, plus they had better outcomes overall. As a result, the program was rolled out across the academic hospitals in Ontario. Most hospitals in the province now follow these practices for all surgeries.
In the 1990s, Dr. McLeod also helped found Evidence Based Reviews in Surgery, a journal study group for surgeons across North America. “Without her, it never would have existed,” Dr. Brown says. In its early iteration, Dr. McLeod would mail out packages of journal articles on general and colorectal surgery, along with an expert’s commentary on the articles. Now, the journal club is all digital and includes a webinar.
“Her contributions to surgical science are well known internationally,” says Marcus Burnstein, a colorectal surgeon at St. Michael’s Hospital and frequent research collaborator who lauds her skills as a surgeon. “She was attentive to the details. She was as focused at the beginning of a procedure as she was at the end.”
She earned many awards, including her appointment as an officer of the Order of Canada in 2019 for having a “profound influence on medical practice and knowledge translation in surgical education and care.”
Dr. McLeod approached her personal life with the same level of conviction and care as she did her work, Dr. Burnstein says. “She was as excellent in every other element of her life as she was in science and clinical care. She was an amazing friend, mother and wife, and just a tremendous human being in every sense.”
Robin Susan McLeod was born on Aug. 24, 1951, in Spruce Grove, Alta., to Doug and Frances (who went by Nan) McLeod. She excelled in school in Spruce Grove and then Edmonton, where the family moved when she was in Grade 10. She did a bachelor of science degree at the University of Alberta. Meanwhile, her uncle, Dr. Trevor Sandy, a general surgeon in Vancouver, began encouraging her.
“He really believed in my mom and told her she was perfect for surgery. He told her she was really smart and was a big supporter of her,” says Stephanie Fauquier, Dr. McLeod’s younger daughter.
She was accepted to medicine at the university, completing her degree in 1975. “At that time, no female went into surgery,” Dr. McLeod said in a Canadian Journal of Surgery podcast in 2020.
She did her general surgery residency at U of T. In August 1978, she went on a blind date with University of Waterloo urban planning PhD student John Fauquier. Almost immediately, they mutually agreed they would get married. “They would have dates at the library. They were two peas in a pod,” Ms. Fauquier says of her parents’ studious courtship.
They married in 1981 in Edmonton. However, Dr. McLeod had recently suffered a needle injury during surgery and contracted Hepatitis B. She somehow pulled herself together for the wedding day and the tennis tournament the couple ran the next day. Then she slept for days, her husband, John Fauquier, recalls.
Dr. McLeod decided she wanted to specialize further in colorectal surgery, because it required thinking on the ground and was an evolving field. “There were a lot of problems you could solve,” Ms. Fauquier says, which appealed to Dr. McLeod.
For his part, Mr. Fauquier knew his partner was smart and hard-working, but had no idea she would have a high-profile career. While doing a colorectal fellowship at the prestigious Cleveland Clinic, she told him she had spoken to the team there about staying on afterwards to do more training. They offered her a staff position during the conversation.
“This was the Cleveland Clinic. They hadn’t expanded in 10 years. I suddenly realized, this is big,” Mr. Fauquier says.
The couple returned to Toronto and Dr. McLeod took a position at U of T and Toronto General Hospital in 1986.
They had two daughters, Claire and Stephanie. Dr. McLeod performed surgery two days a week, ran clinical trials and wrote papers. She entertained often, kept up her tennis game, went on canoe trips and prioritized time with her daughters.
“She was very busy, so she was all about quality, not quantity. Every interaction with us, she gave us her full attention,” Stephanie says. In December, she and her daughters would bake dozens of cookies that Dr. McLeod would give away as gifts to people across the hospital. They would sing and dance to All I Want for Christmas is You while they worked.
Dr. McLeod loved to cook for others; she had a deal with Mr. Fauquier that she would do all the cooking and he would do all the talking. “My mom would have a full day in the OR and then she’d come home and would make dinner for 30 people.”
Mr. Fauquier agrees his wife had an unusual ability to get things done. “She was very focused, very efficient, very goal-directed,” he says. “Her life was very much devoted to her medicine and her research. She’d stay up late writing book chapters; she seemed to have untold sources of energy all her life.”
While Stephanie always assumed her mother would live and work for much longer – being the kind of person never to retire – she admired her mother for making the most of every moment in her career and at home. That included showing up to watch Stephanie in triathlons, as part of a cross-country fundraiser she did for Alzheimer’s, even when Dr. McLeod’s health was failing. “When I look at her and the quality of her life, she did it all. And then some.”
In addition to her husband and daughters, Dr. McLeod leaves her sister, Peggy Ziegler; son-in-law, Patrick Purdy; infant grandson, Felix; and extended family members.
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Editor’s note: A previous version of this article incorrectly stated that Dr. Robin McLeod worked at Toronto Western Hospital. She worked at Toronto General Hospital. This version has been updated.