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Monday February 18, 2013

His new techniques in facial surgery made operations more effective, less painful

Doctor was a shy, musical youth who matured into the founder of a centre for jaw reconstruction

Special to The Globe and Mail

Colleagues describe Gerald Baker, former chief of oral and maxillofacial surgery at Mount Sinai Hospital, as "a man with golden hands," "a surgeon's surgeon" and "an outstanding teacher." He died on Jan. 21 of gastric cancer at the age of 71.

Dr. Baker's proudest achievement was the establishment of the internationally recognized Mount Sinai Hospital's Regional Centre for Temporomandibular Joint Reconstruction. The centre came into being in 1997 after Dr. Baker, along with philanthropist/entrepreneur Larry Wasser, championed the cause of a 13-year-old girl born without joints in her jaw. Despite three surgeries, she couldn't open her mouth more than a few millimetres. Eating was extremely difficult, dental work was impossible and vomiting would have been fatal, as she would have choked to death. It was only good fortune that she had never thrown up.

The cost of a metal and acrylic jaw replacement for the girl was more than $10,000 and fell outside Ontario government guidelines. Her family had no means to pay for it. After Dr. Baker went public with the story, Mr. Wasser stepped in with funding for the implant while Dr. Baker performed the gruelling new eight-to-10-hour procedure.

Dr. Baker then successfully lobbied for the Mount Sinai Centre, where subsequent procedures would be covered under OHIP. Mr. Wasser says, "I will never forget Dr. Baker's perseverance and how he gave this young girl the gift of a brighter future."

Gerald Baker and his younger brother, Michael, grew up in Toronto as the middle-class children of Saul Baker (née Bakerspigel) and Esther Bruner. Saul Baker owned a hat factory and, for a while, did well financially by making hats for soldiers. Before she became a mother, Esther worked at Kresge's (the chain of five-and-ten-cent stores that later morphed into K-Mart), where she called herself "Esralita" in order to disguise her Jewish identity. As a Jew, she would not have been hired.

With the birth of her children, Gerald on June 15, 1941, and Michael a year and a half later, Esther gave up her job, although she later trained as a special education teacher. The family purchased a house on Delaware Avenue, on Toronto's west side, for $4,000. It was a controversial move at the time because it was away from the Jewish enclave in the Kensington Market neighbourhood. Both boys were subjected to bullying by Catholic classmates, particularly around Easter. Sticking together, neither brother reported the abuse to their parents.

As a child, Gerald showed precocious musical talent. Both boys were signed up with a conservatory teacher. Gerald received an honours certificate in Grade 10 piano and several gold medals at the annual Kiwanis Music Festival. In Grade 8, the head of music at his school gave him peer papers to mark. Gerald announced his intention to become a doctor of music, but his family convinced him it wasn't practical to pursue a career in the arts. A doctor of medicine? Now that was practical.

The Baker parents had reason for concern about their sons' financial prospects because they had troubles of their own. By the mid-1950s, Saul Baker's hat factory was failing. The family sold the house and moved into a single room at the back of a hat store they opened on St. Clair Avenue in what was then midtown Toronto. It took several years before they were solvent.

By the time Gerald reached high school at Oakwood Collegiate, he was overwhelmingly shy. Since the brothers had identical voices, Gerald frequently prevailed upon Michael to impersonate him on the telephone in order to ask for a date. This shyness would persist throughout his life. His wife, Nancy, said, "He had trouble with small talk and depended on me for social plans."

Convinced that his marks weren't good enough to get into medical school, Gerald chose dentistry at the University of Toronto, where he vigorously applied himself. Too nervous to check the first-year exam results, he sent his father with strict instructions on how to read the publicly posted marks. When Saul Baker reported that his son stood first in his class, Gerald's reaction was one of incredulity. He thought his father must have misread the posting. Reluctantly, Gerald went to see for himself. His father was not mistaken and, it turned out, the marks were no fluke. Thereafter, he came first in his class every year, winning scholarships and invitations to work with professors during the summer.

After graduation in 1964, Dr. Baker completed a one-year dental internship at Michael Reese Hospital in Chicago. While there, he met Nancy Stern, a nurse. They married in April, 1966, then returned to Toronto after he completed a three-year residency in oral and maxillofacial surgery at the University of Illinois.

Three children duly arrived, Andrew in 1968, Jason in '69 and Suzanne in '73. Whenever they made requests of him, the cautious Dr. Baker would typically respond, "I'll put it on the list," thereby allowing himself time to ponder.

Nancy Baker says her husband was an ethical, straightforward "what-you-see-is-what-you-get" kind of man who could be warm and funny and who loved gadgets. Any adventurous trips the couple took later in life necessitated the purchase of a new camera.

Dr. Baker established his reputation in Canada in the 1970s, when he introduced a revolutionary technique for the removal of impacted wisdom teeth. The procedure involved inserting a small drill through tissue to grind up the impacted tooth. It could then be removed by suction. Prior to this minimally invasive approach, a patient could expect sutures, a swollen face and two weeks of liquid food. With Dr. Baker's technique, developed initially in the U.S., a patient could eat a bagel the same day.

Later in his career, Dr. Baker introduced yet another revolutionary development, this one originating in Sweden, and one that became commonplace in Canadian dentistry. He inaugurated the use of titanium implants, and trained hundreds of oral surgeons in the procedure.

After a few years of private practice, Dr. Baker began working at Mount Sinai Hospital part-time, eventually extending it to full-time 15-hour days that incorporated teaching as well as surgery.

Mira Wassef, a former resident at Mount Sinai, remembers Dr. Baker as a teacher who made time for his students despite a heavy schedule. "He always made us laugh, especially dancing away to pop songs that he played from his iPod in the speakers in his surgery."

Dr. Baker's brother, Michael, a Toronto physician, said, "You would be hard-pressed to find a dentist in Canada who wasn't a pupil, or an oral surgeon who didn't owe him part of their craft." He said it's fitting that, since 2006, a Gerald Ian Baker Scholarship in Oral Surgery Research at the University of Toronto's Faculty of Dentistry has been awarded annually to a graduate student doing research in this field.

Appointed chief of oral and maxillofacial surgery at Mount Sinai in 1980, Dr. Baker maintained this position until two months before his death. Over a 45-year career, he operated on leading politicians, captains of industry and academic leaders, people with the right connections who had done their homework in order to discover a top oral surgeon.

David Psutka, Dr. Baker's surgical partner, colleague and friend of 33 years, sums up Dr. Baker's life. "He was a wonderful surgeon, as well as a wonderful human being."

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