Dr. Alfred Wells Farmer’s academic professional life could be divided into three eras. First, from 1942 to 1945, he was Chief Surgical Consultant to the Royal Canadian Air Force. Next, he was Surgeon-in-Chief to The Hospital for Sick Children, from 1956 to 1966. Last, he was Surgeon-in-Chief and Consultant to Sunnybrook Hospital, from 1966 to 1976. When he died on July 31, 2002, he was 98 years old. Dr. Farmer was affectionately known as “Farm” or, occasionally, “Alfie” or “Al” by his many friends and senior associates.
Farm was born in Florida, one of seven children, of British parents. His father graduated from Cambridge University as a lawyer but never practiced law. According to Dr. Farmer and his wife, he was an unusual man. Rarely home, he spent a great deal of time researching citrus farms in Africa, South America, Cuba, and Florida; during later trips, he taught fruit farming. He was a stern man who had wanderlust. Dr. Farmer’s mother was from a well-to-do family. She was a schoolteacher in Britain, spoke both French and German, and was an artist. Apparently, one or two family letters have been found that show concern about the marriage. Nevertheless, there were seven children, born quite close together, including Dr. Farmer, in Florida, where his father had acquired a fruit farm of mostly orange trees. Dr. Farmer had wonderful memories of life in Florida, including watching alligators in the farm pond catch chickens by the mouthful. He never forgot the smell of oranges in the sand. “Having an orange grove in Florida in those days was a measure of success,” he said. “The well-to-do from Boston took the train to Florida to spend their holidays in their orange groves.”
His father, ever conscious of social status and education, decided to move the family to a farm on the outskirts of Boston. They made the very difficult trip by horse and wagon with six children. At that time, Dr. Farmer was the youngest and a twin. His twin brother died shortly after birth. This move was not successful, as his father did not want his children to have a Boston accent. The family moved to England next, by which time all the children were in school. After a few years, his father decided he wanted a peach farm, saw a place on the map known as the Niagara Peninsula, and moved his family to a peach farm on the outskirts of St. Catharines, Ontario.
Dr. Farmer had three brothers. Arthur went into the British military and was badly wounded at Gallipoli. Richard joined the U.S. Marines, became fatally ill with a parasite, and later died in the United States. Robert developed tuberculosis at about 15 years of age and died. Farm had three sisters, all of whom were very good to him. Aileen was a secretary for a major law firm; Molly looked after her mother, the house, and family and became a champion golfer; and Freda worked for the Bank of Commerce.
Farm was very successful in high school. He was a medalist and passed all possible subjects in grade 13, eighteen in all, excelling in math and sciences. A choirboy, he maintained his fine tenor voice throughout his lifetime. One of his daughters said that he liked to sing with the family when driving to the farm on the weekends. He frequently sang hymns, and later recalled singing the songs of today as a choirboy. He rowed in the 8’s and 4’s for his school on the Henley course at nearby Port Dalhousie. He was a quarterback on his school’s football team, a position he continued to play on into medical school at the intramural and varsity levels. For his successes, he earned his university’s block T. One could say that he quarterbacked all the way through his academic professional life.
Dr. Farmer had successful summer jobs in medium to heavy industry. One summer he served as a tallyman during the excavation of the Welland Canal, recording the number of wagonloads removed daily. When he was too young for university, he took a job as an office boy with Alcan. He is said to have reorganized the whole office during those 2 years. Once he recalled an incident that happened when he was sent to pick strawberries at the Laura Secord Family farm. After he ate so many strawberries that he became sick, he moved over to the asparagus patch, emptied his stomach, and returned to the berry patch to pick and eat more. He had a strong desire to enter the business world, but his mother very much wanted a doctor in the family; to her wishes he succumbed, keeping his business interests as one of his successful hobbies throughout his life.
In talking about business, he told of a somewhat related experience. He had cared for a Newfoundland politician’s son who had been severely burned. After discharging the boy from a long hospital stay, Dr. Farmer made out the bill for $2000 and had his secretary mail it to the family. In due course, a representative from the medical insurance company responsible for government employees’ health care appeared at Dr. Farmer’s office and thanked him for keeping the bill so reasonable. He then handed over an envelope, shook hands, and left. When Dr. Farmer’s secretary opened the envelope, she found a check for $20,000! Of course, it was returned post haste.
Farm was elected to the Alpha Omega Alpha fraternity before graduating with a bachelor’s degree in medicine from the University of Toronto in 1927 and completing his doctorate in medicine in 1928. There followed 5 years of graduate training starting at Toronto General Hospital and The Hospital for Sick Children. The last year of training was arranged by Dr. W. E. Gallie, then Surgeon-in-Chief of Toronto General Hospital and later the Dean of the Faculty of Medicine of the University of Toronto. Dr. Gallie saw the need for surgeons trained in reconstructive surgery and made arrangements for two young general surgeons, Dr. Farmer and Dr. Stuart Gordon, to train in England under Dr. Harold Gillies (later Sir Harold Gillies). Dr. Farmer did not always agree with Dr. Gillies’s teachings and left to study at several centers on the continent. In 1932, he was appointed to the active staff at The Hospital for Sick Children and the teaching staff of the University of Toronto. In 1939, the Royal College of Physicians and Surgeons of Canada certified him in three specialties, plastic surgery, orthopedic surgery, and general surgery.
From 1942 to 1945, Dr. Farmer served in the Royal Canadian Air Force as Chief Surgical Consultant responsible for the organization and direction of surgical services. He was awarded the rank of Group Captain. He was also responsible for the creation of specialty services within the Army, Navy, Air Force (Royal Canadian Air Force), and Department of Veterans Affairs. This led to the concept of the joint service use of specialists within the Canadian military. In 1943, in preparation for the event of large-scale casualties, with the Department of Veterans Affairs and the Royal Canadian Air Force he formed a Plastic Surgery Unit at Christie Street Hospital in Toronto. For his work he became, in 1945, a Member of the British Empire, received the Coronation Medal, and was appointed Queen’s Honorary Surgeon for a period of 2 years (QHS).
Dr. Farmer was postwar Chairman of the Medical Advisory Committee to the Royal Canadian Air Force until the three services were combined. After that, he was their orthopedic and plastic surgery consultant. He organized the panel on burns and wounds for the Defense Research Board of Canada. For part of this time, he was a member of the advisory board on burns for the Shriners of America, which was responsible for the centralization and focusing of burn treatment in major burn centers in North America.
In 1956, he was appointed Surgeon-in-Chief at The Hospital for Sick Children and remained in that position until 1966. His first contribution in that position was to reorganize the Department of Surgery into seven divisions: general surgery, orthopedic surgery, neurology, urology, cardiac surgery, plastic surgery, and research. Next he formed an outpatient surgery facility, the first in Canada, greatly decreasing the length of patients’ hospital stays. During this time and before, he served as Chairman of the Medical Advisory Committee of the Ontario Society for Crippled Children, which later became the Easter Seal Society.
Dr. Farmer was a visionary. He could see what needed to be done and how to go about doing it. He was a rapid decision maker. If a treatment or procedure was not working quite right, he was quick to recognize the defect and correct it. He had an inquiring mind, which led to surgical innovation. He was a stimulator and a facilitator, always with kindness, which was sometimes submerged by his outgoing manner and tough exterior.
In 1966, Dr. Farmer was invited by the University of Toronto to set up the Department of Surgery and its divisions in its new acquisition, Sunnybrook Hospital (now the Sunnybrook and Women’s College Health Sciences Center).
In 1978, the Canadian Society of Plastic Surgeons established the A. W. Farmer Lectureship. Since then, 24 lectures have been given, each by a leading-edge plastic and reconstructive surgeon.
Dr. Farmer was a dexterous and imaginative clinical plastic and reconstructive surgeon and made a number of original contributions. In the case of patients with avulsion injuries, he pioneered transferring bone from one leg to the other in such a way that the bone being transferred never lost its blood supply, and he added greatly to our concept of the treatment of children’s birth deformities. As Chief Surgeon, he had the ability to supply the ideal conditions for superlative work, to stimulate those working under him, and then to hope they would produce. His teaching ability developed many capable plastic surgeons who became teachers of the generation that followed.
Dr. Farmer was a founder of both American and Canadian plastic surgery. He was a founding member of the American Board of Plastic Surgery, Inc., the certifying body for American plastic surgeons, and of the American Society for Surgery of the Hand. He was a very early member of the American Association of Plastic Surgery, the oldest organized body of plastic surgeons in the world. He was also a founding member of the Canadian Society of Plastic Surgeons. Many consider him to be the father of Canadian hand surgery, now a sophisticated subspecialty. His experiments with cellophane as an interposition substance led to improvements in tendon surgery, and his concepts of pedicle flaps and free skin grafts greatly improved the reconstruction of the burned and severely traumatized hand. His research findings and clinical improvements have been reported in 64 peer-reviewed publications and resulted in his award of the Order of Canada (C.M.).
Dr. Farmer was predeceased by his wife. Together they developed their beautifully landscaped farm and Ontario Heritage home at Blue Mountain in the Collingwood region of Ontario. They were very proud of their two daughters, four grandchildren, and seven great-grandchildren. Dr. Farmer retired around 1981, a kind and thoughtful father and doctor, and a great surgeon, teacher, and administrator.