Interview with Order of Canada Recipient Dr. Charles Tator, Founder of the Canadian Concussion Centre
By: Brandon Seltenrich
Although concussions and the long-lasting effects of Traumatic Brain Injuries (TBIs) have only come to light in recent years, there are some who have worked diligently on the matter–through research, tests, and studies– to garner a better understanding of how to treat patients of concussion. Order of Canada recipient and longtime innovator in the medical field Dr. Charles Tator is one of these people, and Headsup had the opportunity to interview him about his background, his contributions to science, and the accomplishments and objectives of his newest organization moving forward.
Dr. Charles Tator has family roots in Toronto that go back more than a century. He comes from a large family, and has been able to enjoy support and encouragement his whole life, something that motivated him to stay in Toronto himself to this day. He went to medical school in Toronto and has spent his career working in the medical field, giving back to the community where he was born.
"My friends from childhood and school have stayed with me over the years," said Dr. Tator, when asked what it meant to have a support system for his career in Toronto, "and have always been very strong supporters of my research, practice, and public service endeavors."
Dr. Tator's public service endeavors through the research he's conducted over the years have not gone unnoticed. In fact, they have been recognized in perhaps the highest regards possible. In 2000, Dr. Tator was awarded and invested with the Order of Canada, a Canadian national order given to individuals who make a major difference to Canada through lifelong contributions in every field.
In 2017, Dr. Tator was elevated to Officer of the Order, a promotion he called "[an] incredible thrill for [him] and [his] family".
"It is wonderful to know that your work is recognized," said Dr. Tator on receiving the Order of Canada, "In fact, this recognition has made me feel privileged to be in the position I am in and make me want to 'give back.'"
Dr. Tator has certainly "given back" over the years, and that is evident in the myriad recognition he has received.
In addition to the Order of Canada, Dr. Tator was also named to the Canadian Medical Hall of Fame in 2009, to Canada's Sports Hall of Fame in 2017, and has been recognized in many other respects, as well.
"Yes," said Dr. Tator, "it is true that I have received other awards and recognition, but, in my view, the greatest thrill was the Order of Canada."
A close second, he says, was an annual award recently created by Brain Canada, a national, charitable organization that supports innovative brain research in Canada, in honor of himself and Barbara Turnbull.
"It is very meaningful to me, because Barbara Turnbull was a great person, and an inspiration to me. Our relationship started when she was shot in the neck, and I was on call the night it happened. After the operation to remove the bullet, and when she started breathing again, we became very close friends. We worked together for about 30 years on several programs and had great success in enhancing basic research on brain and spinal cord injury and injury prevention until her recent death."
The three insignia of the Order of Canada, Dr. Tator's proudest honour
Dr. Tator's thirty-year relationship and research endeavors with Barbara Turnbull are a testament to the work he has dedicated himself to over the course of his career– treating and preventing complex injuries.
"I became involved in injury prevention because several hockey players that I looked after ended up in wheelchairs because of broken necks that happened in the game of hockey, the game I love. That experience triggered my injury prevention activities, first with Think First Canada, and then with its successor, Parachute Canada."
Founded in 1992, Think First Canada/Penser d'Abord allowed Dr. Tator to revolutionize spinal cord injury prevention, especially in sports, recreation, and treatment.
"Unfortunately, brain and spinal cord injuries are so complex that we haven't learned to 'put the pieces back together again,'" said Dr. Tator when asked about the challenge of such a complex and difficult type of injury. "[That makes] preventing these injuries so important."
Significant strides have been taken in brain and spinal cord injury prevention research in the past few decades, much to the credit of Dr. Tator and his colleagues. Dr. Tator was part of the first lab in Canada to study acute spinal cord injury from a basic science perspective, creating one of the first experimental models of spinal cord injury in lab animals.
"We did some really interesting research on why the spinal cord did not recover from injury. In the early days, about 50 years ago, we were making discoveries at a very rapid rate, and this was very exciting to me. It became obvious that a small animal model was needed, and we were very fortunate to hit upon a very good model many years ago, which we still use today."
One major necessary facet of having the ability to conduct paradigm-changing research for complex injuries is securing the needed resources: funding, assistance, policy, and more. Organizations coming together and working toward a common goal is one way to achieve successful research, and that is exactly the sentiment Think First Canada acted upon seven years ago.
In 2012, Think First Canada amalgamated with Safe Communities Canada, Safe Kids Canada, and SMARTRISK, to form Parachute Canada, a national, charitable organization.
"The amalgamation of four injury prevention charities to form one strong national charity was very important, and this merger has had the approval of industries and governments who have been the principal funders of injury prevention programs. Parachute Canada is performing great work as Canada’s national injury prevention charity, and it was my privilege to be there at the beginning moving things along."
"Preventing Injuries. Saving Lives." - The credo of Parachute Canada
Dr. Tator was instrumental in developing the mission and vision of Parachute Canada from its beginning, but has since shifted the focus of his own research to another issue in the realm of complex injuries with little prevention and treatment options: concussions.
"Concussions were neglected in research until about the year 2000 when it became apparent that many concussed people were not recovering promptly, and indeed, in some cases, were enduring lifelong suffering. It became apparent that more research was required to try to solve the many issues causing the continuing grief, and to develop treatments."
Dr. Tator has been at the forefront of groundbreaking research throughout the entirety of his career, so his interest and determination with improving the understanding, identification and treatment of TBIs makes perfect sense. To embark on his next journey, Dr. Tator founded the Canadian Concussion Centre (CCC), an organization that focuses specifically on concussions and the health effects victims suffer because of them.
One area of research the CCC has devoted significant time to is conducting studies linking one's genetics and their inherent proneness to concussions.
"There has always been some evidence that there is a genetic link between susceptibility to concussions and the lingering effects in certain families," said Dr. Tator. "However, the exact genes involved have not yet been discovered despite all the work that we, and others, have done."
The CCC continues to look for biomarkers of brain injury in the blood and cerebrospinal fluid of athletes who have had multiple concussions, and are hopeful that one day, a greater understanding of the genes involved in the susceptibility to concussion will be available.
According to Dr. Tator, these biomarkers may be proteins in the blood, spinal fluid, and changes on MRI scans, or other tests such as MEG scans or PET scans.
"The whole world of research is now on the hunt for reliable biomarkers for concussion," said Dr. Tator. "With the amount of work being done worldwide in the search for biomarkers of concussions, I am confident that there will be a reliable biomarker discovered in the next few years."
MRI scan of a human brain after concussion
Identifying biomarkers for concussion is paramount in being able to diagnose concussion, but there are more steps involved in treating each and every injury in a speedy, effective fashion.
"Biomarkers will aid in the diagnosis of concussion, but it will still be important for doctors to be trained to recognizewhen a concussion may have occurred based on clinical assessment of symptoms and signs. These are skills that we have learned to teach. Early recognitionby all health care professionals and early diagnosisby medical doctors are essential features of quality care."
As increasingly effective methods of recognizing symptoms of concussion become more widely practiced, doctors will not be the only people able to recognize a possible concussion when they see it. Coaches, parents, teammates, and even the victims of the concussion themselves should have the acuity to recognize the symptoms, as well.
While concussions are gaining more attention each day, some of the more severe consequential symptoms and diseases are still vastly understudied, and do not have much available in the form of treatment and prevention going for them. One of these diseases is the neurodegenerative disease Chronic Traumatic Encephalopathy (CTE).
CTE has come into the public spotlight in recent years due to the diagnosis of the disease in a number of former professional athletes after they were deceased. Many athletes have pledged to donate their brains to science to further aid the ongoing research of CTE since. The biggest roadblock as it stands is that CTE is only diagnosable in autopsy– that is, when victims have already passed away. With the work being done at the CCC, there is hope that, one day, it will be diagnosable and treatable in the living.
"Our centre has been very active in trying to develop biomarkers and better ways to recognize CTE in the living, and hopefully one of the strategies we are pursuing, such as PET scanning with tau seeking tracers or CSF or blood analysis for abnormal proteins will prove to be a reliable test for CTE."
CTE is not the only residual, long-lasting symptom of a TBI. In fact, a widely misunderstood aspect of concussions is that not everyone who sustains one, or more, fully recovers. People often associate aversion to light, persistent headaches, and inability to focus with symptoms of concussion, and often forget about the residual symptoms linked with them, such as anxiety, depression, and even suicidal thoughts.
Dr. Tator talks about brain injuries to children at McMurrich Junior Public School
"Post-concussion syndrome, which means that the symptoms persist for longer than the expected time of 30 days or so, occurs in about 25% of concussed people," said Dr. Tator.
"Fortunately, there is treatment available for many of the 65 or so symptoms that can occur in post-concussion syndrome. Thus, we like to make sure that people with persisting symptoms should seek help from a multidisciplinary concussion clinic that is run by a medical doctor. Important symptoms like depression, anxiety, photophobia, headaches, neck pain, etc., can be treated."
The CCC is unique in that it is the world's first program dedicated to a "four-pronged approach" to concussions: education, research, treatment, and diagnosis. To read more about the variance of research conducted by the CCC, click here and explore their site.
As the choice donation partner of Headsup, the CCC receives 15% of all proceeds from Headsup to go toward funding concussion research.
Originally, when Headsup began their search for a donation partner, they had considered Dr. Tator's previous organization, Parachute Canada. However, they wanted to pursue an organization that was dedicated specifically to a mutual cause– that cause, of course, being creating an increased research platform for concussions. The CCC turned out to be the perfect match.
"The clinicians and scientists at the Canadian Concussion Centre are honoured that we are the 'charity of choice' for Headsup," said Dr. Tator. "We have not previously had support from 'the grassroots' of this nature, and we love it!"
According to Dr. Tator, it is incredibly important to foster a passion in young individuals to be the next generation of leaders in medicine, especially in combating TBIs through treatment and prevention.
"It is so appropriate for young people to play a role in supporting research and injury prevention in the field of concussions, because so many young people sustain them. Indeed, there is some evidence that the brain continues to develop well into the twenties, and that concussion may take a greater toll during the developmental years. In addition, young people are often engaged in risk taking activities; especially in sports, work and driving, activities in which concussions frequently occur. Thus, it is really important for young people to receive messages about concussion from their own group."
Dr. Charles Tator, posing with the Headsup team
Dr. Tator praises the work that Headsup has strived to accomplish in raising awareness through its platform, and thanks them for the work that they do to help fund research at the CCC.
"Headsup gives young people the opportunity to participate. Headsup has already generated a significant amount of money for concussion research, for which the clinicians and scientists at the Canadian Concussion Centre are very grateful."
The Canadian Concussion Centre will continue its four-pronged approach of education, research, treatment, and diagnosis of concussion, while Headsup will continue its mission of creating a platform to raise concussion awareness, all the while raising significant funds that go directly to the CCC.
Dr. Tator has spent a lifetime revolutionizing and innovating treatment and prevention of complex injuries, and concussions are the next frontier. Both he and the Headsup team hope that the next generation of young individuals will follow in his footsteps.
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Image sources:
• Dr. Tator desk image from The Globe and Mail
• Order of Canada image from The Globe and Mail
• Parachute Canada image from YouTube
• MRI scan image from Centre for Brain Health
• Dr. Tator talking to kids image fromToronto Star
All other images courtesy of Headsup.