Spring 2015 (Volume 25, Number 1)
History of Rheumatology in Quebec
By Jean-Yves Lang, MD, CSPQ
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It is almost impossible to trace the origins of rheumatology in Quebec with any certainty. The most likely scenario is that a close link existed with what was happening elsewhere in Canada, especially at the Toronto General Hospital (TGH). It was at the TGH that, in the aftermath of World War I, first Dr. Almon Fletcher (1890-1965) and then Dr. Wallace Graham (1906-1962) focused their efforts on sufferers of rheumatic disorders.
According to my research, around 1936 Dr. Douglas Taylor, an internist affiliated with McGill University, joined with Dr. Fletcher to establish the Canadian Rheumatism Disease Association (CRDA); Dr. Taylor was later elected its president in 1938. We know that he was interested in arthritis thanks to one of his articles published in the Annals of Internal Medicine, detailing his radiological observations of various forms of chronic arthritis.1
Following World War II, the Canadian Arthritis and Rheumatism Society (CARS) was incorporated, likely in 1947-48. Among the names in its founding manifesto are those of two Montreal physicians who served as directors.2 One of the main objectives of CARS was to encourage fellowships to increase the number of rheumatology specialists and promote advances in arthritis treatment. Dr. Graham died prematurely in 1962, at the age of 56; the greatest wish of his successor, Dr. Metro Ogryzlo, was to establish, through CARS, rheumatic disease units (RDU) in all medical faculties in Canada.3
Armed with two years of training in arthritis in Paris and an internship in the same field in the United States, Dr. Réné Dandurand (1906-1949), of Montreal’s Hôtel-Dieu Hospital, possessed all the attributes to become one of the fathers of rheumatology in Quebec. Regretfully, this pioneer died tragically in a plane crash on October 9, 1949.
Around 1947, Francophone and Anglophone physicians came together in Montreal to create a rheumatology section within the Medico-Chirurgical Society. During one of these meetings, the idea for the Laurentian Conference of Rheumatology was born. The conference was held annually beginning in 1965, and continued for the next five years. After a brief hiatus, the conference resumed on a regular basis in 1974, thanks to the combined efforts of Dr. André Lussier and Dr. Roger Demers. Another contributor worthy of mention was Dr. de Guise Vaillancourt (1921-2000). Following graduation in medicine in 1947, he studied rheumatology in Boston and New York before returning to Montreal to take a position at Hôtel-Dieu Hospital as an internist and rheumatologist.
About the same time, Dr. Maurice Campbell (1919-2014), a general practitioner in Cap-de-la-Madeleine, opted to specialize in internal medicine and rheumatology in 1947. He began a series of internships at Hôtel-Dieu Hospital in Montreal and in 1955 returned to Trois-Rivières to practice rheumatology, a vocation he pursued to the end of his long and exemplary career.
In 1969, Dr. Lussier founded the first RDU in Quebec at the Centre Hospitalier Universitaire de Sherbrooke (CHUS), drawing on his earlier years of training in rheumatology at one of the most prestigious centres in the United States, under the guidance of Dr. J. L. Hollander.
The following year, Dr. Lussier presented a brief to the Collège des Médecins du Québec (CMQ), advocating for official recognition of rheumatology as a sub-specialty of internal medicine.4 For these and many other reasons, Dr. Lussier merits the title of Father of Quebec Rheumatology.
In 1970, all Quebec physicians with an interest and competency in rheumatology prior to the creation of the training program were granted rheumatology certification under a grandfather clause. At the CHUS,
Dr. Daniel Myhal, who had been trained in Scotland, became an associate of Dr. Lussier and helped usher in the first generation of rheumatologists. The first two rheumatology graduates in Quebec were Dr. Monique Camerlain and Dr. Henri Ménard, in 1973.
In 1975, the Université de Montréal’s RDU was inaugurated;
Dr. Guy Germain of Notre-Dame Hospital was its director, assisted by
Dr. Jacques Gascon and Dr. Alain Prat. The RDU held a special association with Montreal’s Hôtel-Dieu Hospital through Dr. Jacques Durivage, Dr. J.A. Blais, Dr. Vaillancourt and Dr. Demers, all of whom trained in rheumatology in the United States or in Europe. St-Luc Hospital participated courtesy of the involvement of Dr. Murat Kaludi and
Dr. Claude Blondin.
Around 1975, McGill University’s RDU was formally established, with
Dr. Kirk Osterland of the Royal Victoria Hospital as its director, assisted by Dr. Louis Johnson, Dr. Cooper Stacey, and Dr. Douglas Kinsella.
The RDU was also able to draw on the expertise of many other specialists, including rheumatologists Dr. John Martin, Dr. David Hawkins, and later, Dr. Hyman Tannenbaum and Dr. John Esdaile from the Montreal General Hospital, and Dr. Lyon Lapin, Dr. Morton Kapusta, and Dr. Murray Baron from the Jewish General Hospital.
In 1976, the last RDU was established in Canada at Université Laval in Quebec City. Dr. Lucien Latulippe was named its director, assisted by
Dr. Jean Rousseau and myself.
In the early 20th century, rheumatology was generally misunderstood, ignored, and not viewed as a priority by most universities in the Western world. Due to sheer ignorance, the prevalent belief was that rheumatology had nothing to offer arthritis sufferers. The result was a teaching void. Thanks in large part to the RDUs’ threefold vocation of care, research, and teaching, a new generation of highly skilled practitioners was trained.
In 1970, there were approximately 25 rheumatologists in Quebec. The majority of these were internists and physiatrists who had taken advantage of the grandfather clause prior to certification. In 2014, there are more than 100. Since the advent of biotherapies in the early 2000s,
a major step forward has been taken in the fight against arthritis. Let us hope that this continues.
References
1. Taylor GD, et al. Roentgenologic observations on various types of chronic arthritis. Ann Intern Med 1936; 1vii:979-98.
2. Graham KM. Origins and early beginnings of the Canadian Arthritis Society and the first rheumatic disease units. J Rheumatol 2000; 27:1592-8.
3. Gordon D, Smythe H. The Life and Legacy of Metro Ogryzlo. CRAJ 2007; 17(2):4-5.
4. Ménard H. In Memorium: André Lussier. CRAJ 2009; 19(3):17.
My sincere thanks to Dr. Guy Germain, Dr. Claude Blondin, Dr. Carol-Anne Yeadon, and Dr. Henri Ménard, who probed their memories and came up with names or facts that were indispensable to the writing of this article, which I hope faithfully mirrors the reality of rheumatology in Quebec.
Jean-Yves Lang, MD, CSPQ
Rheumatologist (1974-2012),
Centre hospitalier de l’Université Laval (CHUL)
Quebec, Quebec |
