Ask the expert: The past and future of children’s health care with Dr. Penny, pediatric orthopedic surgeon for Island kids

Throughout the COVID-19 pandemic, Children’s Health Foundation is committed to supporting Island families. This post is part of our Ask the Expert blog series in which our CEO Veronica Carroll interviews experts across Vancouver Island and the surrounding islands on issues affecting children’s health and how families are adapting during these unprecedented times.

Veronica recently connected with pediatric orthopedic surgeon, Dr. Norgrove Penny, who shared the history of the evolvement of the Queen Alexandra Centre, the positive aspects of virtual care, and why he chooses to give back to Children’s Health Foundation.

Can you tell me about your professional background?

I’m a children’s orthopedic surgeon. I trained first in orthopedic surgery, then specialized in pediatric orthopedic surgery, with an additional interest in sports medicine. I’ve worked in the Victoria area since 1978 with one interlude when I worked in Uganda for six years, where I set up a country-wide program for children’s orthopedics and rehabilitation. That work takes up about half of my time even now.

What inspired you to get involved with Children’s Health Foundation?

I came to Victoria in 1978 as a young guy right out of my pediatric training in Boston. One of the first things I did when I arrived was looked around to figure out the landscape of children’s health in Victoria, and I came across the Queen Alexandra Centre (QA). At the time, it was known as the Solarium and had about 90 children staying there long-term.

The former CEO of QA, Gerry Fisher, the namesake of the Fisher Building, asked me to be on the medical advisory board, and together with other members of the board, we were able to provide medical advice to the Centre that helped to guide its direction, eventually leading to the establishment of the Fisher Building, Ledger House, and Anscomb House.

We had a few wonderful people working in isolation who we were able to bring together to establish more robust services at QA, including Christine Stowe, an occupational therapist, Carol Wilcox, a physiotherapist, and more. Together, we set up a seating program, cerebral palsy clinic, neuromuscular clinic, and the spina bifida clinic.

When I came back from Uganda, I stopped practicing sports medicine and solely wanted to focus on children’s health. I was asked to set up a pediatric orthopedics program across the Island, which I was very happy to do. I set up my office at QA. And while I’ve moved away from that office, we still do our combined clinics there, including the neuromuscular clinic, scoliosis clinic, and the seating program.

QA is a place close to my heart because I love kids and wanted to do something to improve children’s care on the Island. When it came to the final stages of my career with reduced time in the operating room, I wanted to give back to Children’s Health Foundation of Vancouver Island for everything they’ve done for me. When they asked me to join the board, I was very happy to do so.

I’m sure there have been many changes in the field during your practice. How would you compare the landscape of pediatric orthopedic surgery to when you first started?

It’s very different and yet somehow still the same. When I was in my training, we were still doing a significant amount of work around polio. In the past 30 years, we have learned so much about cerebral palsy; treatments are much more sophisticated and specialized.

The biggest change has been the coordinated team approach to treating kids with complex orthopedic needs. From doctors, to physiotherapists, to occupational therapists, and more, the degree to which we now work in teams has made the most significant difference in care.

The practice of pediatric orthopedics has always involved treating kids with complex needs. While we do also care for those with fractures and other injuries, at the heart of our work has been, and will continue to be, helping children with complex needs.

What are some of the most common types of physical health challenges that you help families with?

We see children with a range of challenges, from genetic conditions such as Down Syndrome to scoliosis, to cerebral palsy, to those born with clubbed feet or limb deficiency. We also treat children who have had fractures and other injuries that haven’t healed well as well as those experiencing growth issues.

How has COVID-19 impacted pediatric orthopedic surgeries?

Surgeries have been delayed. For some children, this is not a significant issue, for instance a child with cerebral palsy who needs a surgery sometime between age six to eight. If we delay it three months, it’s not a big deal. But there are other conditions that are very time sensitive. For a baby born with a dislocated hip, for example, it is crucial that we treat it within their first month of life.

Now that COVID-19 is easing, our current problem is dealing with the backlog and catching up on those who had been delayed.

How many children do you see from across Vancouver Island and the surrounding Islands per year?

Between 3,000 and 4,000.

Have you seen any positive developments come as a result of virtual care during the pandemic?

Our office was quickly running virtual appointments, and I think the big winners of this are the children. As many of my appointments are follow-ups – I tend to see children through their entire growing years every six to twelve months – parents have been able to help their kids through their maneuvers they’d previously made in my office. This has been particularly impactful for families who live in remote and rural areas of the island; we can assess if they truly need to make the long trip to Victoria in the future.

Virtual care has also streamlined the process of assessing toddlers, who are often shy and apprehensive. It can be difficult to see them walk, run, and play when they are nervous in my office; at home, they naturally move around and parents can show me through video. The pandemic has been a huge learning experience in showing us the positive aspects of virtual care.

What inspires you most in your work?

I am one of those lucky people who truly loves what they do. Kids are the best little patients and it’s incredibly rewarding to see the positive results. Pediatric orthopedic surgeons get to see the progression of a child who, without our intervention, would face significantly more difficult challenges in life. We get to see them thrive and enjoy life to the fullest.

Is there a story of a patient that comes to mind that inspires you?

While every child that comes into my office inspires me, one incredibly inspiring individual was Lisa Huus. Lisa was diagnosed with spinal-muscular atrophy, which is a severe disability that results in spinal deformities and mobility issues.

Despite these challenges, Lisa overcame every obstacle that was thrown at her and was a very bright young woman. She insisted on going to regular school and then went on to pursue a university degree when she passed away. And through the Lisa Huus Bursary for post-secondary students with physical disabilities, her life has lasting meaning.

We’ve often used your expression of children may be only 21% of the Island population, but they are 100% of our future. Building off of that statement, what message do you want to give to future donors?

Because of the many competing priorities of our health care system, including cancer, heart disease, and joint replacement, many children with complex needs are falling through the cracks. I think it’s a crime that wheelchairs, braces, and drugs are not funded by our system. We must not forget the children whose families cannot afford crucial equipment, support services, and medicine.

Together, we can participate in making the world a better place. Children truly are our future.