Cardiology interns at Toronto General Hospital had to be prepared when they did patient rounds with Dr. E. Douglas Wigle, lest they get what was known as the “Wigle look.” Pity the poor soul who did not have blood-work results perfectly memorized, or was not able to clearly and logically present case histories without notice. No words were exchanged – Dr. Wigle simply cast his eyes toward the offending intern, managing to convey disdain, disappointment and impatience all at the same time.
“He didn’t have to get angry or shout,” said Dr. Harry Rakowski, a cardiologist who trained under Dr. Wigle in the mid-1970s and now holds a research chair named for his mentor. “He was able to say, ‘You should have known that,’ without saying a thing.”
Of medium height, with the broad shoulders of the varsity quarterback he once was and a fondness for sayings such as “gird your loins and get on with it,” Dr. Wigle, who died on July 3 of complications from a neurodegenerative disease at the age of 84, was known as a father of Canadian cardiology.
When he began his practice at Toronto General Hospital in 1960, he noticed that some of his patients had a largely unknown heart condition – hypertrophic cardiomyopathy (HCM) – where the heart muscle is excessively thick, impeding or preventing the flow of blood to the rest of the body.
While the condition can strike at any age, it is best known for affecting people under the age of 30, especially athletes who suddenly drop dead even though they seem to be in the best of shape. Often, there are no symptoms until that sudden, dramatic death.
Dr. Wigle made research into the condition a cornerstone of his life’s work, producing about 120 peer-reviewed scientific presentations and 88 manuscripts on the topic. Despite doctors who thought otherwise, he insisted that the too-thick muscle blocked blood from leaving the heart in many of the cases; through a landmark series of experiments, he was proven right and ended up making Toronto General Hospital an international centre for research, education and treatment of HCM.
“If you said the name ‘Dr. Wigle’ anywhere in the world in cardiology circles, people would know who you were talking about,” said Dr. Paul Dorian, head of cardiology at the University of Toronto. “He was one of only two or three cardiologists who put HCM on the map. There are a number of cardiologists from around the world who came to learn what he was doing and took back that knowledge to their own countries.”
Along the way, Dr. Wigle built Canada’s first all-encompassing cardiac unit. At a time when there were no echocardiograms, CT scans or magnetic resonance imaging machines to provide pictures, he taught his students to trust their ears, their touch and their instincts.
“Making a diagnosis was more challenging back then. Heart surgery was relatively new, as was heart catheterization,” said Dr. Rakowski, referring to a procedure where a long, thin tube known as a catheter is inserted into a blood vessel and threaded to the heart. “He had a commanding presence, an extensive knowledge and an outstanding bedside manner. We would watch him listening to heart sounds and murmurs, feeling pulsations in the neck and chest, all while setting patients at ease.”
A storied, sometimes feared, teacher, Dr. Wigle headed the cardiology department at Toronto General Hospital from 1972 to 1986. He insisted that his students become experts with the stethoscope despite the imaging technology that was becoming more available.
“He would have said, ‘If you don’t know how to use your eyes and your ears, you will never become a good diagnostician,” said Dr. Dorian.
During his fellowship year, Dr. Rakowski recalled several cases in which he strongly disagreed with his mentor’s conclusions, which were drawn from a physical examination.
“Doug would listen to my point of view. In the end, of course, I was never right,” Dr. Rakowski said.
But that didn’t mean Dr. Wigle, who was made an Officer of the Order of Canada in 2007, shied away from technology. Instead, he used it as an adjunct to his own senses, even making sure that Dr. Rakowski went to Stanford University to learn about echocardiography, then bringing him back to start the echo lab in Toronto.
“Before, he could only hear. Now, he could see,” Dr. Rakowski said. “Still, when he called and asked if you could please review your study, you knew he meant that he disagreed with what you had seen. The funny thing was, he was almost always right. It was the ‘echo’ that was read wrong.”
Ernest Douglas Wigle was born in Windsor, Ont., on Oct. 30, 1928, the second of Dr. Douglas Wigle, a surgeon, and Marjorie Lyon’s three children. Known as Doug, he was an A student with a perfect visual memory. He played the trumpet and excelled at any sport he tried, even basketball, despite his smaller stature.
From his parents, he learned how to “square his shoulders” and persevere. During the Depression, life may not have been easy, but the best thing to do was take a deep breath and push through it, preferably with flying colours.
He combined his studies with leisure activities in seemingly effortless fashion. His Delta Kappa Epsilon, or Deke, fraternity brothers at the University of Toronto never understood how he could play billiards at parties the night before a big exam and still ace the test the next morning. But he did, over and over again. Upon graduation in 1953, he won the gold medal as the top student in his class, then went on to seven years of specialized study in Canada, England and the United States before returning to practise in Toronto.
While a medical student, he took several months off one summer and travelled to Europe. There, major art book in hand, he visited galleries and museums, starting a lifelong appreciation. It didn’t matter if a work was French impressionist, German expressionist or postmodern – he loved it all. The first painting he saw, a portrait by Modigliani at the National Gallery, stuck with him; years later, when at the gallery with his wife, Anne, he noticed it was missing.
“Doug being Doug, he marched right over to the director’s office and asked where it was,” Mrs. Wigle recalled. “It turned out it was on loan.”
Every Christmas, the couple carefully unwrapped an ornament for their tree – a little bear – that was a gift from a patient in Northern Ontario. In an accompanying note, the patient had written that the bear reminded her of Dr. Wigle – fierce, rough and protective.
Like his father before him, who would march through the family’s cottage in the early morning calling out “swim time” so his offspring could have a dip before breakfast, Dr. Wigle often woke his three sons and two daughters with a rousing rendition on his trumpet of When the Saints Go Marching In at the cottage on Georgian Bay he helped build.
“It wasn’t like roll call,” said his youngest, Bruce Wigle. “We probably should have been out of bed anyways. It was fun.”
Dr. Wigle retired in 2010 after being diagnosed with a neurodegenerative condition that affected the frontal lobe of his brain. He leaves his wife of 25 years; his children, Doug Jr., Cam, Lindy, Jill and Bruce; their mother, Mary (Marnie) Wigle; his stepchildren Peter and Katie Little; three grandchildren and three stepgrandchildren.
Besides his propensity for exercise, tireless work ethic and infectious guffaw, Dr. Wigle was predictable in other ways. He was a “G-man” who liked his Globe and Mail in the mornings and a gin and tonic when he got home at night, usually around 8:30 p.m., after he had finished with his office, then gone down to the cardiology ward and emergency department to speak with patients’ family members.
“He would always call me around 7 p.m. and say he was wrapping up so what’s for dinner,” said Mrs. Wigle. “I wouldn’t budge because I knew it would still be at least an hour and a half before he got home. He was that dedicated to his patients.”