Dr. Robert Wood is smiling and characteristically blunt: "I'm getting out of the way."
That's how Dr. Wood, or Bob to his colleagues, describes his decision to step aside as Head of the Dental Oncology and Maxillofacial Prosthetics Clinic at Princess Margaret Cancer Centre at the end of the year.
"I think it's important to know when it's time to move on and give the younger staff in our group a chance to grow," he says.
After leading the department for 12 years, Dr. Wood is ready to turn over the reins, but he's not calling it retiring.
"Just knowing myself – to go full tilt and then stop is death, so there has to be a transition," he says.
The need to ease into the next move isn't surprising. Dr. Wood has spent his entire 32-year career at the Princess Margaret, starting at its original location on Sherbourne St., to its current home on University Ave.
"Bob's always had an entertaining and energetic approach," says Dr. Jonathan Irish, who has worked with Dr. Wood since 1991 in his role as a surgical oncologist specializing in head and neck cancers at the Princess Margaret.
"He has a very pragmatic approach to patient care, never says no, and always does it with a smile on his face and with great humour."
Pragmatism is a trait Dr. Wood has always embraced and it's what helped set him on the path to dentistry.
"I knew absolutely nothing about dentistry," he says. "My thinking was you could apply to dentistry after one year or you could apply to medicine after two years. I grew up poor, so I thought let's go with dentistry.
"I never believed I would get in, so I had zero stress during the interview and aptitude test. When I actually did I thought, 'well I guess I have to do this now.'"
He would go on to finish his years of dentistry at the University of Toronto and do his post graduate year in hospital dentistry at Toronto Western Hospital working with who he calls "giants of medicine," including Drs. Tirone David, Robert Jackson, Karel terBrugge, Nick Oreopolous and Morris Uldall.
"Getting to work with such top people is what made me think it would be really desirable to have a hospital career," he says. "I've been very fortunate over my entire career to work with really good physicians and surgeons."
Dr. Wood decided to pursue his interest in diagnostics and did his Masters in maxillofacial radiology – a specialty of dentistry concerned with performance and interpretation of diagnostic imaging. He would then travel to Cape Town, South Africa, for two years to complete a PhD in maxillofacial radiology at Stellenbosch University, the Afrikaans university during the time of apartheid.
When he returned to Canada, he was hired at the Princess Margaret Hospital to work in the dental clinic with a familiar face, Dr. Walter Maxymiw.
"Bob was a student of mine from 1979-81. I started the clinic in 1982 and hired him around 1986 or so when he returned from South Africa," recalls Dr. Maxymiw. "In essence, I was both his teacher-mentor and department head."
The dental oncology clinic began as a small operation with just one room and a small team at the 500 Sherbourne St. location. It has grown to a team of roughly 20 staff, with seven rooms, and a sterilization centre.
"One of the memories that sticks out most working with Bob is navigating the merger of the Princess Margaret with what would become UHN," says Dr. Maxymiw.
"We were the only department, excluding Radiation Oncology, that was not merged with a similar department at UHN. We assimilated their services and have grown significantly over the years."
Dr. Wood would take over from Dr. Maxymiw in 2006 as department head. Today, the clinic sees 1,400 new patients a year and receives 14,000 patient visits a year in a clinic not much bigger than a medium-sized dental office.
"In addition to treating patients, Bob has also always been passionate about advancing dental oncology for our patients through supporting fellowships and growing the research presence of the department," says Lisa Tinker, Nurse Manager for Malignant Hematology at the Princess Margaret and former nurse manager for the dental clinic.
Not your average visit to the dentist
While the dental clinic at the cancer centre may look like your family dentist's office, it serves a much different purpose. The team at the Dental Oncology and Maxillofacial Prosthetics Clinic offers a wide range of specialized diagnostic and therapeutic dental and facial prosthetic services for people with all types of cancer. The clinic helps:
- Prepare patients' teeth and mouth for cancer treatment by removing teeth that may cause an infection and affect treatment later on
- Treat any dental and oral side effects from cancer treatment, including emergency care when needed
- Fit and create face prosthetics (aids that replace part of the nose, ear, eye, or other parts of the face that have been removed during surgery)
When time permits, Dr. Wood and his team also provide consultations, in clinic or at the bedside, for pre-cardiac surgery patients, pre-lung and liver transplant patients, and some patients confined to the Intensive Care Units (ICU).
"People don't think very much about the teeth until they have a problem," says Dr. Irish. "But it's so critical to have a good foundation when you think about recreating a jaw or maxilla after surgery and after the removal of cancer.
"So I view the service Bob and his team provide as foundational to having a great cancer program."
Dr. Wood credits the team of dentists, dental assistants, hygienists, dental technicians and front desk staff with maintaining a high standard of care under high-pressure circumstances.
"The reality is we are caring for a greater and greater number of people who are really sick," Dr. Wood says. "Every week there's a potential disaster.
"So there are times you're in a situation that you weren't taught in dental school and you have to be able to adapt and learn on the job and that's the part I enjoy."
A new chapter
While he continues to have a strong desire to take on challenging cases and mentor students, he says he's happy to ditch the administrative duties that come with being head of the department to have more freedom and time to sink his teeth into other things.
Dr. Wood's schedule is already filling up quickly. He will work on transitioning in a new department head and institute a researcher-training module for younger staff. He's also volunteering his time to supervise the work of several graduate and PhD students, and continuing his work with the Accreditation Council.
In his personal life, he's looking forward to spending more time with his wife Joan, their daughter, and his Nova Scotia Duck Tolling Retriever, Huckleberry, "who's like a genius and who I love more than life itself."
When asked what impact he hopes he's had on the clinic, he replies with the humour and care he's known for.
"Generally everybody hates the dentist," he says. "But as a cancer patient, first you're told you have this terrible disease and then we say, 'oh by the way you also have to go see a dentist.' As if we couldn't make things miserable enough!
"But despite all that when they come to our department they usually leave with a smile on their face and feeling better than when they came in. It is a testament to the team that will take over the duties of the department.
"I have every confidence in them."