How Dr. Geoff Fernie helped turn a small rehabilitation institute into a world-leading research centre

By Glynis Racliffe

In 2003, Dr. Geoff Fernie had what he admits was a wild idea: convert a smallish hole, destined to be a parking garage, underneath University Avenue in Toronto into a massive opening that could house four large research labs. At the time, Dr. Fernie was the Director for the Centre for Studies in Aging at Sunnybrook, while the KITE Research Institute, which was then called the Toronto Rehab Research Institute, was just in its infancy.

When he proposed the concept to the leadership team at Toronto Rehab – the hole would contain four large cylindrical structures where KITE’s growing stable of scientists could conduct their research – they were skeptical.

Fortunately for Dr. Fernie, who spent 15 years as Research Director at KITE and is currently the Creaghan Family Chair in Prevention and Healthcare Technologies, it didn’t take much to convince Mark Rochon, then CEO of Toronto Rehab, that having these labs – simulators that would mimic everything from weather and driving to conditions to help researchers study accidents accurately – was a good idea.

It was then that the Toronto Rehab Research Institute, renamed KITE in 2019, started becoming the world-leading rehabilitation research institute that it is today. The centre’s evolution is also a result of strong leadership, generous funding and smart scientists and clinicians, but the institute wouldn’t be what it is today without Dr. Geoff Fernie.

We spoke with Dr. Fernie, Mark Rochon, research associate Pam Holliday and postdoctoral student-turned-scientist Dr. Alison Novak to find out how KITE – which is an acronym for Knowledge, Innovation, Talent, Everywhere – came to be.

In the beginning: Toronto Rehab is born

Mark Rochon: I started in late 1998 as CEO of Toronto Rehab, and our research efforts were quite small. There were a number of academic enterprises in post-acute care and rehabilitation, but none of them had sufficient critical mass to really push education and research alongside a clinical mandate. We needed an organization with significant clinical heft to be able to create a world-class research institute.

Before merging, Toronto Rehab was four different organizations: Hillcrest Hospital, the Queen Elizabeth Hospital, Lyndhurst Hospital and the Toronto Rehabilitation Centre. We were all post-acute organizations, none of which were large enough to offer much funding for scientists. One of the major reasons behind the amalgamation was the desire to create an organization with sufficient scale to support the development of a major academic enterprise with a focus on post-acute care.

Dr. Fernie’s path to Toronto Rehab

Geoff: I always loved making things; I loved engineering. When I was in the final summer for my first degree, my advisor sent me to a special school in the south of England in the countryside, Chailey Heritage, that provided a living environment for kids with disabilities and also was a hospital.

I was assigned to look after kids whose moms had taken the drug thalidomide (a drug pregnant women were prescribed to combat morning sickness, which was later found to impact neonatal development). They had lost typically two or four limbs, with a lot of other complications as well. They were about seven years old, and had a lot of courage.

I would get up in the middle of the night to help the nurses change beds and really lived in the thick of it. I tried to work with prostheses for these children and saw some of the operations on them, and thought, “Wow, this is what I want to do.”

I was really taken by the fact that engineering was the only way that these kids were going to get a more reasonable life, so I applied to the PhD in bioengineering program at Strathclyde University, in Scotland. At that time in the U.K., it was necessary, once you got your doctorate, to spend some time in North America, and get what was a BTA, a “Been To America” qualification. Of course, when I came to North America I never went back.

Pam Holliday: Geoff was looking for a research assistant not too long after he arrived in Toronto. He was working at Toronto Western Hospital and they had money to do some projects related to amputee management and care at West Park Hospital, nearby. I actually don’t think I ever had an interview! He was doing rounds when I met him and he kind of tested my balance by, you know, pushing me to see whether I recovered. Then he said, “Yeah that’s good. You’ll do,” and away we went. So that’s how I started working with him on balance in the amputee program, in 1975, and we’ve worked together ever since.

Geoff: The long-term patients at West Park weren’t getting much activity, and there was a lot of incontinence and a lot of falls. I thought these were under-researched areas, and we should do something about them. That’s how we ended up focusing on balance and aging. Then in 1986, I got a visit from the CEO of Sunnybrook, who asked me to help start a Centre for Studies in Aging.

At Sunnybrook, I realized that you aren’t going to solve these problems by treating people after they’ve fallen over. It’s too late. We had to prevent problems. I needed to build a laboratory that would allow me to study things like falling over in winter, pedestrians having problems on the street with traffic, elderly drivers getting into trouble, people falling down stairs or falling in bathrooms. That’s when I got the invitation to meet with Mark.

Mark: What Geoff brought to Toronto Rehab was a deep history with, and experience in, research and development work that made a real difference to patients and caregivers. He also had a vision for evolving the research enterprise at Toronto Rehab into the organization that you see today. It was great. It was one of the parts of my job that I enjoyed a lot – working with him and helping to create this extraordinary facility.

Building a state-of-the-art research facility

Mark: In 2001, I negotiated an annual $3-million grant for research purposes with the province of Ontario, and the Toronto Rehab Foundation added to that. We used that money to attract researchers to come to Toronto Rehab and investigate new treatments and technologies that might help people living with life-altering disease or injury.

Geoff: Mark was CEO of Toronto Rehab when I came on – a lovely, incredibly bright and very kind-hearted, enthusiastic guy – and without his support, none of the expansion would have been possible. His leadership was essential for modernizing TRI.

Mark: Together, we created a different focus for the research side of Toronto Rehab that not only looked at the efficacy of various treatment approaches but really asked the question of how we can make lives better for people experiencing life-altering disease, through the application of technology.

We had this idea to create a simulation laboratory as an anchor of the research efforts at TRI that would attract scientists, grad students and researchers to the facility.

Geoff: I wanted to create a motion base for a very sophisticated simulator and various environments that we could swap onto it – no one had done this before. We needed to be underground and we needed quite a high ceiling for cranes to move equipment around.

Mark: This coincided with the redevelopment of the University Avenue site of Toronto Rehab. And so, we were able to use that construction project to create a space that was purpose-built for the simulation laboratory Geoff wanted, with research spaces on the upper floors of TRI.

The importance of research

Pam: Once we opened up those labs, part of the process was building the science base, the network to use the facilities. So, setting the groundwork for people to come in and collaborate on research projects, collect data and even manage their data elsewhere.

Alison: I started at KITE as a postdoctoral research fellow, working with Geoff. I had done all my doctoral work on understanding stair ambulation and people who have had a stroke, and Geoff had a big vision for understanding and preventing stair falls.

Mark: Geoff’s fingerprints are all over what you see today at KITE. What we were able to do with him was create a different focus for the research enterprise that not only looked at the efficacy of various treatment approaches, and so forth, but really asked questions about how we can make lives better through the application of technology for people experiencing life-altering disease.

Mentoring the next generation

Alison: He started off as my postdoctoral research supervisor. And then, as I transitioned into a scientist role at KITE, Geoff was the Institute Director at the time. He informally served as my mentor, as I started out in my research career.

The biggest thing that Geoff did for me specifically was set me up for success in terms of developing my research program and aligning me with his contacts. A lot of my work is to redefine or to provide evidence to support building codes and building development, and as a mentor Geoff was exceptional at identifying where my expertise would be critical to their processes and just supporting me, as a new scientist, to get involved in those circles and in that industry.

A success story

Pam: Our research has always been not just understanding what’s going on – the biomechanics of what happens to balance, for instance – but simultaneously looking at what we can do about it. What are we going to get out of this? Are we going to change the way we do therapies? Do we have a new product? An improved way to make an artificial limb? Or can we change policies, regulations, codes, those kinds of things?

Geoff: We get feedback all the time about the results of research we’ve been conducting. We’ve changed building codes in Canada and we’re about to change more of them. We produce more publications at KITE than anywhere in the world. And not only do we write more, we actually have more impact than any other rehab research facility – the research that we do actually changes things. So I don’t think there’s a week that goes by without me feeling good about something we’ve accomplished.

Mark: Toronto Rehab is about knitting together research, education and care in a way that will improve not only what happens to individuals who come through here but the extent to which we can transfer what we’ve learned and our knowledge to other providers. Geoff’s legacy is one that’s really related to the positive outcomes people experience in their lives: helping people live their lives to the fullest following life-altering disease or illness.

Glynis Ratcliffe is a longtime journalist, who has written for the Walrus and the Globe and Mail.