When Cy Frank was a young man, he was an exceptional baseball player but suffered a devastating knee injury, a torn anterior cruciate ligament. It required him to spend six weeks in a full leg cast and surgery was recommended.
But, as a young medical student, he wondered what the evidence was for the recommended treatment and was shocked by the paucity of studies. So, in his spare time, with the help of an engineering professor, he fashioned a research project that eloquently demonstrated that neither the cast nor the surgery would be helpful.
Solving that riddle was the beginning of a 39-year career that would see Dr. Frank become one of the most respected leaders in Canadian health care, relentlessly promoting evidence-based care in his multiple, simultaneous careers as an orthopedic surgeon, scientific researcher, teacher, entrepreneur, mentor and health-system administrator.
"Cy was a visionary leader with a constant, unrelenting commitment to the greater good," said Tom Noseworthy, associate chief medical officer for clinical networks and clinical care pathways at Alberta Health Services, and a long-time colleague.
"It was his preoccupation – obsession even – to make the health system better, and he did."
Dr. Frank, president and CEO of Alberta Innovates Health Solutions (AIHS), which funds health research and promotes innovation in the health system, died in his sleep of a heart attack on March 5. He was 65.
Stephen Lougheed, president and CEO of Alberta Innovates Technology Futures, and a life-long family friend, said Dr. Frank's sudden death was a shock and the loss is incalculable.
"It's hard to put into words how important his contributions were. He worked on everything from discovery in the lab to implementation at the bedside, and he changed the system along the way. That's the kind of innovator we rarely see," Mr. Lougheed said.
Cyril Basil Frank was born on Aug. 3, 1949, and raised in Edmonton. His father was a Second World War bomber pilot who became a bush pilot, flying all over Canada's Far North.
From a young age, young Cyril enjoyed tinkering with planes and cars in his father's workshop, and he brought the same curiosity to his study of medicine and later to re-engineering the health system.
He did his undergraduate studies in his hometown, at the University of Alberta, earning a Bachelor of Science in zoology before applying to medical school. Surprisingly in retrospect, his application was rejected four times but, ever the optimist, he was undaunted.
In the interim, he earned a diploma in education and completed two years of genetics before finally gaining entry to medical school at the University of Calgary.
It was during his time in the education faculty that he met Joyce Cranmer, whom he would marry in 1977. The long-time science teacher died of cancer in 2000.
Dr. Frank completed his MD training in 1976 and, four years later, graduated with a specialty in orthopedic surgery.
"And he never did get his ACL repaired because he realized the surgery was not evidence-based," said Nigel Shrive, a professor of engineering at the University of Calgary, who helped with the initial research and collaborated on a number of projects over the years.
Dr. Frank did postgraduate studies at the University of California, San Diego, and the University of Toronto, before returning to the University of Calgary in 1984.
The first thing he did upon his return was go see Prof. Shrive to help design a study on the best treatment for a torn medial collateral ligament, one of the other main knee ligaments alongside the ACL.
"He felt that everything we do in medicine – and health care more generally – should have a basis in evidence," Prof. Shrive said.
Dr. Frank, however, did not feel that approach should apply only to clinical practice but to health-system design as well.
While his clinical research influenced how and if knee surgery is performed and how osteoarthritis is treated, he is probably best known for developing a system that dramatically reduced wait times for hip and knee replacements in Alberta, because it came when wait times were at the top of the political agenda. The secret of the project's success was getting health workers, from physiotherapists to surgeons, to co-ordinate care and, more importantly, to involve patients in the process.
Dr. Frank founded the McCaig Institute for Bone and Joint Health – funded with a generous donation from Calgary philanthropist J.R. (Bud) McCaig – and when he was unsatisfied by available surgical tools, he created a company to make them, Tenet Medical Engineering. He sold the company shortly before his death.
In 2001, when the Medical Research Council of Canada was revamped and bolstered into the Canadian Institutes of Health Research, Dr. Frank became the founding director of the CIHR Institute for Musculoskeletal Health and Arthritis, a post he held until 2007.
He also became a member of the prestigious Canadian Academy of Health Sciences, where he was chairman of a blue-ribbon committee that examined how best to measure the impact and return on investment of health research; the report they produced influenced science research funding bodies around the world.
Dr. Frank decided that he could have the greatest impact on the health system in his home province, so he took up the post of vice-president of research at Alberta Health Services and, most recently, as the CEO of AIHS.
He was also appointed to the national Advisory Panel on Healthcare Innovation, which should release its report later this year with recommendations on how the federal government can better promote and support health-care innovation.
Dr. Frank received a number of national and international awards, but invariably left them off his CV because he was modest. When he was admitted to the Order of Canada last year, he didn't tell his sons until two weeks later and, instead of wearing the prized pin on his lapel, he kept it in his pocket, worried that putting it on display would be immodest.
Andreas Laupacis, executive director of the Li Ka Shing Knowledge Institute at St. Michael's Hospital in Toronto, said it is hard to overstate Dr. Frank's efforts to reform the health system and make it more patient-centered.
"His was a life of continuous journey in pursuit of medical knowledge, health-care innovation and visionary public health policy," he said.
"We have lost much intellectually. But what hurts the most is that we have lost someone who had such passion about what he was doing, and who did it because he wanted to make the lives of patients better," Dr. Laupacis said.
While Dr. Frank worked long hours, he always made time for his family. He has two sons, Ryan, a pediatric plastic surgeon, and Tym, a resident in orthopedic surgery.
The older son, Ryan, said their father inspired them to pursue careers in medicine but, beyond that, he was a good dad. "No matter how busy he was, he made time for us, like coaching our baseball team," he said.
Ryan said his father was devastated by his wife's death and it changed him. "He underwent a transformation, and realized that there was more to life than just work," he said. "We became very close – a whole other level of friends."
Dr. Frank also purchased a cabin in the Rocky Mountains, near Kananaskis, where he loved to get away (there is no cellphone service) and take long hikes.
Still, at the age of 65, there was no talk yet of retirement, though the elder Dr. Frank did increasingly eye the vintage car he was planning to refurbish – a 1970 Chevelle 396 SS that he had purchased in his student days and hung on to all these years.
"We were looking forward to getting him back in the shop, like he did when he was young," Ryan said.
In addition to his two sons, Dr. Frank leaves his older brother, Geoff; long-time partner, Hélène Lévesque; and her two children, Lauren and Devon Plante.
A public celebration of Dr. Frank's life will be held at the University of Calgary's Jack Simpson Gymnasium on March 21 at 1 p.m.
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