Dr John Dowe Keith

Dr John Keith, the most eminent Canadian pediatric cardiologist of his time died on February 8, 1989, aged 80 years, after a lengthy illness.

With foresight and tremendous drive he was responsible for establishing and developing one of the foremost pediatric cardiology centres in the world at the Hospital for Sick Children in Toronto, Ontario.

Born in Winnipeg, John Keith came to Toronto at age four. He attended the University of Toronto schools for his secondary education and graduated from medical school in 1932. He completed his internship in Rochester, New York, and thereafter spent five years of postgraduate study in England at the Birmingham Childrens' Hospital as resident medical officer and fellow in theumatic fever research. On his return in 1938 he was appointed to the medical staff of the Hospital for Sick Children. He was designated physician-in-charge of the cardiac department which was virtually nonexistent before his arrival. At that time heart disease in children was mainly diagnosed as rheumatic in origin and little was known about congenital heart disease. He served four years in the Royal Canadian Navy as Surgeon Lieutenant Commander during World War II and was attached to a North Atlantic convoy ship for nine months. During those years he contributed to the knowledge of the relationship of streptococcol infection to rheumatic fever and treatment with sulphonamide and salicylates of affected naval personnel.

When he returned to the Hospital for Sick Children after the war, a new era was beginning in pediatric cardiology with Dr Gross's successful surgery of patent ductus arteriosus and Dr Blalock's and Dr Taussig's shunt surgery for cyanotic congenital heart disease. From then on Dr Keith instituted and developed new diagnostic and therapeutic techniques at the hospital to help infants and children with all types of congenital heart disease. He was the first to carry out a cardiac catheterization procedure and angiography in children there. He soon teamed up with Dr William Mustard, the first pediatric catdiovascular surgeon at the Hospital for Sick Children, and became involved in the pioneering stages of almost every area of surgery for congenital heart disease.

Techniques and technology advanced together over the years and the cardiology division developed into a unit of worldwide renown for diagnosis and treatment of children with heart disease. Dr. Keith developed the largest data bank on congenital cardiac defects long before computers existed and this has been and still is a remarkable resource for patient care and research study. A key and classic textbook on ''Heart Disease in Infancy and Childhood'' co-authored by Drs Richard Rowe and Peter Vlad was first published in 1958. With this book and many other publications and monographs John Keith shared the knowledge, so carefully gathered and critically analysed, with cardiologists and pediatricians the world over. Dr. Keith was a great thinker and administrator, a realistic planner, able, when necessary, to be a skilful politician. He was instrumental in the establishment of the section of cardiology of the Ontario Medical Association which became the springboard for the establishment for the Ontario Heart Foundation in 1952. He was also a key figure in the formation of the Canadian Heart Foundation. He was honoured by the foundation with the President's Award in 1960. In 1972 he received its highest honour, the Gold Medal, the Award of Merit, During his illustrious career Dr Keith also worked on the advisory board of the International Society of Cardiology. In 1967 the Canadian Cardiovascular Society chose him for its annual lecturer and the Canadian Heart Foundation established the John Keith Lectureship which is new and important feature of the sociery's annual meeting.

Under his direction in the division of cardiology more than 100 fellows were trained and many now practice as division chiefs in pediatric cardiology in all parts of the world. One of the most eminent, the late Dr Richard Rowe, returned to Toronto as director of the division of cardiology when John Keith retired in 1973. In 1975 John Keith received the Gairdiner Foundation Award for his research in children's heart disease.

John Keith's vigour and enormous energy were particularly impressive. He walked briskly several miles every day between his home and the hospital and he generally shunned motorised transport. He was an ardent outdoorsman and loved the wilderness, and especially enjoyed canoeing, sailing and skling. He loved to build log cabins, spending much weekend time building additions to his country residence in Bolton, Ontario.

He was intensely proud of his family, his wife Mary of 50 years, his two daughters, and his son and his grandchildren. John and Mary were generous hosts and warmly welcomed friends and fellows at their homes both in the country and the city on many special occasions.

John Keith will be remembered as a renowned Canadian, a pioneer and builder both in personal endeavours and all aspects of achievement in pediatric cardiology today.

In 1987, asked what advice he would pass on to junior staff physicians based on his experience he stated: ''Never let the sailboat jibe''

Vera Rose, M.D. FRCPC
Hospital for Sick Children, Toronto, Ontario

Reproduced with permission of The Canadian Journal of Cardiology, April 1989, pp XI-XII