The Sir Mortimer B. Davis Jewish General Hospital 9780773553071

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The Sir Mortimer B. Davis

jew ish gener al hospital

The Sir Mortimer B. Davis

Jewish General Hospital fr ank my ron gu t t man and

alexander w r ig ht

Published for the Jewish General Hospital Foundation by McGill-Queen’s University Press Montreal & Kingston • London • Chicago

The publication of this book was made possible through the generous support of Senator E. Leo Kolber, a past president of the hospital, whose steadfast support and nurturing has enabled the hospital to flourish and prosper and become the leading medical institution it is today. © Jewish General Hospital 2018 isbn 978-0-7735-5306-4 (cloth) isbn 978-0-7735-5307-1 (epdf) Legal deposit first quarter 2018 Bibliothèque nationale du Québec Printed in Canada on acid-free paper

We acknowledge the support of the Canada Council for the Arts, which last year invested $153 million to bring the arts to Canadians throughout the country. Nous remercions le Conseil des arts du Canada de son soutien. L’an dernier, le Conseil a investi 153 millions de dollars pour mettre de l’art dans la vie des Canadiennes et des Canadiens de tout le pays.

Library and Archives Canada Cataloguing in Publication Guttman, Frank Myron, author The Sir Mortimer B. Davis Jewish General Hospital / Frank Myron Guttman and Alexander Wright.

Published for the Jewish General Hospital Foundation. Includes bibliographical references. Issued in print and electronic formats. isbn 978-0-7735-5306-4 (hardcover). –isbn 978-0-7735-5307-1 (epdf) 1. Sir Mortimer B. Davis Jewish General Hospital – History. 2. Jewish hospitals – Québec (Province) – Montréal – History. 3. Hospitals – Québec (Province) – Montréal – History. I. Wright, Alexander, author II. Sir Mortimer B. Davis Jewish General Hospital Foundation III. Title. IV. Title: Jewish General Hospital. ra983.m62s572 2018

362.1109714'28

c2017-906984-5 c2017-906985-3

To my wife Dr Herta Hofmann Guttman

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con ten ts

Foreword by Lawrence Rosenberg • ix Acknowledgments • xi Abbreviations • xiii Introduction • 3 Chapter 1

Jewish Hospitals • 7 Chapter 2

Jews and Medicine • 14 Chapter 3

Sir Mortimer Barnett Davis (1866–1928) • 38 Chapter 4

Montreal and the Jewish Community • 44 Chapter 5

The Dream • 63 Chapter 6

Fundraising • 78

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contents Chapter 7

Construction • 96 Chapter 8

An Ornament to Its City • 108 Chapter 9

The Depression and the War Years • 116 Chapter 10

Expansion and Specialization • 131 Chapter 11

Education and Research • 146 Chapter 12

The Jewish General Hospital and the Community • 162 Chapter 13

Influential Men • 174 Chapter 14

The Last Thirty Years • 189 Chapter 15

Departmental Reports since 1984 • 203 Chapter 16

Outstanding People at the SMBDJGH • 290 Conclusion • 311 Notes • 315

chap ter one

foreword Lawrence Rosenberg

The Jewish General Hospital is a very special place. What makes it exceptional are the people who work there. People from all religions, ethnicities, and walks of life who endeavour daily to embody the dream of the original founders to create a health-care organization embedded with Jewish values, which would provide care for all – and so it has been throughout the eighty-three years of its existence. The hospital was conceived in another era, one in which Jewish doctors in Montreal could not find jobs due to prevailing prejudice, and Jewish patients could not be cared for in an environment that was sensitive to their unique cultural and religious needs. The hospital was the idea of a group of visionary leaders in what was, and continues to be, among the most extraordinary Jewish communities in North America. It is a community whose religious and cultural identification is arguably stronger, deeper, and more resilient than most, and that continues to resist the ever-encroaching influence of today’s so-called progressivism with its philosophy of pluralistic relativism. It is the community that gave birth to a host of creative minds that went on to national and international acclaim in fields as diverse as music, literature, medicine, and law, whose emissaries included the likes of Mordecai Richler, Leonard Cohen, Irwin Cotler, Irving Layton, A.M. Klein, and Mark Wainberg. The story of the Jewish General Hospital is the story of Montreal’s Jewish community. Margaret Mead once said: “Never doubt that a small group of thoughtful, committed citizens can change the world. Indeed, it is the only thing that ever has.” Thus, despite the pressing circumstances of the times, the hospital was founded with the belief that the community had both a responsibility to the past and a commitment to the future. This notion is still deeply engrained in the community today.

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lawrence rosenberg

One might well ask: what is the basis for this deeply held conviction? In fact, it can be traced to Moses. Rabbi Jonathan Sacks comments that Moses tells us, in the final days of his life, that one can achieve immortality by being part of a covenant – a covenant with eternity itself, in other words, a covenant with God. When a life is lived within a covenantal framework, something extraordinary happens. Your parents and grandparents live on in you. You live on in your children and grandchildren. That is what Moses meant when he said, “It is not with you alone that I am making this covenant and oath, but with whoever stands with us here today … as well as those not with us here today” (Deut. 29:13–14). Rabbi Sacks goes on to say that when we renew the covenant, when we dedicate our lives to the faith and way of life of our ancestors, they become immortal in us, as we become immortal in our children. This is the source of the inspiration and resolve that motivated the building of the Jewish General Hospital, and it is the embodiment of this spirit that has continued ever since. Viktor Frankl, the psychotherapist who survived Auschwitz, emphasized that our lives are determined not by what happens to us but by how we respond to what happens to us. Within every community, there are trials and tribulations. How a group responds in the moment says much about the type of community it is and the values it professes. The Jewish community of Montreal has always looked upon problems as signposts to a better future – a “descent that leads to an ascent,” as the Lubavitcher Rebbe was wont to say. Durable and resilient communities have a clear sense of what their ideals are, and they are not derailed by the forces of change. This book, in essence, is not only the story of a great medical institution, the Jewish General Hospital, it is also the story of a great Jewish community. Lawrence Rosenberg, MD, CM, MSc, PhD, MEng, FRCSC, FACS, FCAHS President & CEO Jewish General Hospital, and Integrated Health & Social Services University Network for West-Central Montreal Professor of Surgery & Medicine, McGill University

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ack n ow l e d g m en ts

I am deeply indebted to the Jewish General Hospital, where I trained from 1959 to 1964 in General Surgery (except for the year 1961–62 at Hadassah Hospital, Jerusalem). I joined the staff a year later (1965) after specializing in paediatric surgery at Sainte-Justine Hospital. I eventually became assistant professor at McGill and associate professor (research) at the University of Montreal. I remained on staff for both hospitals until 1981, when I became chief of general paediatric surgery at the Montreal Children’s Hospital. I remained there until retirement in 1996. I believe that I was the first Jewish full professor of general surgery at McGill. I wish to thank Alexander Wright for having provided me with his insightful fiftieth anniversary history of the hospital. I am extremely grateful for the invaluable collaboration of Rod MacLeod. In addition, I would like to thank Henry Mietkiewicz and Linda Lei for their help. The department chiefs of the various services have earned my gratitude. I want especially to thank Dr Lawrence Rosenberg for his encouragement throughout this process, and the JGH Foundation for its support.

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a bbrev i at i on s

Av. Zar. AYAOP BCRA BK CECCNU CFT CFTP CHUS CIUSSS CRCEO CTU Deut. Ecclus. ESMO Ex. Ezek. FRQS Gen. Git. HFLA Ḥul. ISoN JGH JGH AR

Avodah Zara McGill Adolescent and Young Adult Oncology Program The Bloomfield Centre for Research in Aging bekhorot Comité d’experts du centre de coordination nationale des urgencies Couple and Family Therapy Couple and Family Therapy Program Centre hospitalier universitaire de Sherbrooke le Centre intégré universitaire de santé et de services Centre de recherche clinique et evaluative en oncologie Clinical Teaching Units Deuteronomy Ecclesiasticus European Society for Medical Oncology Exodus Ezekiel Fonds de recherche du Québec – Santé Genesis Gittin Hebrew Free Loan Association Ḥullin McGill Ingram School of Nursing Jewish General Hospital Jewish General Hospital annual report

xiv Ket. LDI Lev. MCETC MCTRC MJHI MPBC MRC MUHC NICU Num. OIIQ OTSTCFQ Pes. PMR Prov. Q-CROC RAMQ REC REO RVH Sanh. Shab. SMBDJGH Ta’an. Tosef. Yev. YMHBS

abbreviations Ketubot Lady Davis Institute for Medical Research Leviticus Montreal Centre for Experimental Therapeutics in Cancer McGill Centre for Translational Research in Cancer Montreal Joint Hospital Institute Molecular Pathology and Bacteriology Centre McGill Reproductive Centre McGill University Health Centre Neonatal Intensive Care Unit Numbers Ordre des infirmières et des infirmiers du Québec Professional Order of Social Workers and Couple and Family Therapists of Quebec Pesher Department of Physical Medicine and Rehabilitation Proverbs Consortium de recherche en oncologie clinique du Québec Régie de l’assurance maladie du Québec Research Ethics Committee Research Ethics Office Royal Victoria Hospital Sanhedrin Shabbat Sir Mortimer B Davis Jewish General Hospital Joshua Genesis Leviticus Young Men’s Hebrew Benevolent Society

The Sir Mortimer B. Davis

jew ish gener al hospital

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i n t ro du c t i on

In 1984, the Jewish General Hospital celebrated its fiftieth anniversity with the publication of a history called Our Tribute Everlasting, written by Alexander Wright. I have taken the liberty of modifying that text, adding several chapters on Jewish hospitals throughout the world, Jews and medicine, Sir Mortimer B. Davis, Allan Bronfman, Sam Cohen, the executive directors after 1984, and of course the enormous expansion and progress of the hospital’s past eightyfour years. The aim of this book is to map the development of the Jewish General Hospital from its inception in 1934 as a small community hospital to the major component of the McGill University medical school that it is today. The hospital began as a 230-bed general hospital. Today it is a 637-bed university hospital, committed to service, teaching, research, and innovation. The credit for this success has to be given to the drive of the Jewish community of Montreal, which has succeeded in amassing the funds necessary for the perennial collections and major efforts throughout these eighty-four years. Immediately after each addition, plans began for further expansion. As of September 2015, the hospital had 697 attending doctors, most of whom hold teaching appointments at McGill’s medical faculty; some are the heads of university departments, representing more than forty medical and surgical specialties. Three hundred residents, as well as 636 rotating residents, pass through the hospital annually, with total staff at 5,142, including 1,636 nurses. Between 1 April 2014 and 31 March 2018, 23,969 patients were admitted, about 84,100 emergency visits were made, and 3,742 babies were delivered, making the JGH the busiest emergency department in the province. Surgeons operate on about 11,263 patients every year. There are more than 1,000 volunteers, the largest such “army” of volunteers in a Canadian healthcare institution.

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However, the hospital has been the victim of its great success. Its provincewide popularity and its reputation for efficiency in the emergency department has resulted in an extra burden on the staff. In 2015–16, it reported almost 85,000 visits to the emergency, more visits than the Royal Victoria Hospital and the Montreal General Hospital combined (76,500). Daily visits to the emergency department at the JGH are double that of the next busiest hospital in Montreal. And yet, the unfair method of remunerating hospitals and global budget cuts has resulted in a decrease in service. “The government does not realize that people are not stupid. They go to the internet, and they find out where the best place to be served is,” said Alan Maislin, chairman of the West-Central Montreal Integrated Health and Social Services University Network. The JGH is thus punished for its reputation and efficiency. As a testament to its reputation, witness that a former premier of Quebec (Jacques Parizeau) and a former prime minister of Canada (Jean Chrétien) chose to be treated there. Since its inception in 1969, the JGH’s Lady Davis Institute for Medical Research (LDI) has been an integral part of the hospital, and has helped to strengthen the JGH’s academic links and status vis-à-vis McGill University. This is important because extensive clinical investigation and laboratory research are essential, leading to improved diagnoses, earlier detection of disease, and more effective forms of treatment. The JGH carries out approximately 22 per cent of the training for McGill’s Faculty of Medicine, while the LDI consistently receives one of the highest rankings from the Fonds de recherche du Québec – Santé (FRQS). Researchers at the LDI are awarded approximately $40 million in research grants from external sources each year. This places the LDI at or near the top of the list in funding per researcher in Quebec’s hospital-affiliated research institutions. To support the hospital’s growth, fundraising is ongoing. No sooner does one campaign end than the next one begins. On 24 January 2016, the hospital celebrated a historic day: the opening of Pavilion K, a state-of-the-art facility with over 200 beds, most in private rooms. In addition, two multidisciplinary surgical floors and two medical clinical teaching units moved to the new facility from their previous sites. Two integrated practice units were also created. One unit incorporated neuroscience (neurology and neurosurgery), the other cardiac disease (cardiology and cardiac surgery). Pavilion K also houses the intensive care unit, the cardiac care unit, the neonatal intensive care unit, the medical day hospital, the family birthing centre, and seventeen new state-of-the-art operating rooms. The operating room block has

Expansion of the Jewish General Hospital, 1934–2016. JGH Audio-Visual Services Department. Building Expansion 1934 – B: The JGH, a community hospital. 1950 – A: Originally the JGH School of Nursing and, after 1977, external clinics as well as the Health Sciences Library, outpatient clinics, ambulatory care, and family psychiatry. 1954 – C: Intensive Care Units, Radiology, Emergency and Laboratories. 1968 – D: Diagnostic Radiology, Emergency, Laboratories, Intensive Care. 1969 – I: Institute for Community and Family Psychiatry. 1969 – F: The Lady Davis Research Institute. Four floors added in 1992. 1990 – G: A renewed Emergency, revised operating rooms for neuro-surgery and recovery room. 1990 – E: Ambulatory Services. 2005 – H: Land and buildings bought from Les Soeurs de Sainte-Croix; it now houses the Herzl Family Practice Unit. 2006 – E: Eight more floors added to E wing; Oncology Research (2) and Clinical Oncology (2). 2010 – M: The Centre for Child Development and Mental Health. 2014 – K: Phase 1 (new emergency, underground parking). 2016 – K: Phases 2 & 3 (wards, operating rooms, Intensive Care, medical offices, surgical suites, Coronary Care, Neonatal Intensive Care).

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an enormous sterile core. Each operating room is fully equipped with minimally invasive surgery capability and wireless technology. A large hybrid cardiovascular theatre will be used for complex endovascular cases. Two of the operating rooms will be used for robotic surgery. The services now using the robots are gyne-oncology, urology, cardiology, hepatobiliary, and otolaryngology.

chap ter one

j ew i s h h o s p i ta l s

Since the Enlightenment, Jewish hospitals have been established all over the world to respond to two problems. The first was the need to allow kosher food to be served to Jews, the majority of whom were observant in the nineteenth and twentieth centuries. The second was the inability of Jewish doctors to obtain postgraduate training and then staff appointments in established hospitals, an expression of anti-Semitism. From the early nineteenth century on, Jewish hospitals were founded in every major city in the western world. In all the major cities of the USA and Canada there appeared the Mount Sinais, Albert Einsteins, Cedars of Lebanon, Beth Israels, Mount Zions, and the Barnes-Jewish, Maimonides, Montifiore, Long Island Jewish, or just plain Jewish Hospital. Jewish hospitals were established in the late-nineteenth and early twentieth centuries in twenty-four American cities. All these hospitals were founded to resolve the two stated problems, with each accentuated more or less. Indeed, the rise of anti-Semitism in France in the nineteenth century was followed closely by the French-Canadian population here in Quebec. Louis Veulliot, a prominent French monarchist and anti-Semitic journalist, followed the preaching of Edouard Drumont, whose Le testament d’un antisémite and La France Juive1 were extremely popular in France, and in Quebec. The alleged liaison between the perfidious Jews and freemasonry was supplied by Paul CopinAlbancelli in Le drame maçonnique: La conjuration juive contre le monde Chrétien.2 This was a precursor of the forged Russian secret police book “Protocols of Zion,” reporting on a supposed Jewish plot to take over the world. The French political scene of the nineteenth and twentieth centuries influenced Quebec politics, not only the liberals – the Third Republic liberal Francophiles – but also Quebec’s Ultramontanes. French monarchists also exerted a powerful influence on Quebec rhetoric. The Quebec City newspaper, La Vérité,

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and later, in the 1890s, Marie-Amedée Denault’s La Croix (Montreal), followed the doctrines of La Croix (Paris).3 Founded in 1883, for “Catholics who need to know,” La Croix became one of the most important dailies in France.4 The historian Jean-Denis Bredin estimates the circulation of “la bonne presse” (Catholic, ultramontane, monarchist) in France in the 1890s to have been about 1,000,000, including 170,000 copies of La Croix in its rural editions, as well as La Libre Parole, edited by Edouard Drumont. By contrast, the circulation of the pro-Dreyfus liberal press in France was about 40,000. This has its parallel in Quebec, where, according to historian Robert Rumilly, near the end of the nineteenth century there were thirty-one conservative newspapers as opposed to seven liberal ones.5 In 1889, La Croix added new elements to its program of Catholic militancy. According to historian Phyllis Senese, this was a trend “that went beyond its preoccupation with its devotion to nationalism to embrace anti-Semitism.”6 La Croix declared: “We want no more thieves, no more atheists, no more persecutors, no more freemasons, no more Jews, no more Prussians, no more foreigners to govern France. (We want) nothing but honest men. Nothing but Catholics. Nothing but the French.”7 Its xenophobia was clearly not restricted to Jews. But it was explicit. In Quebec, Jules-Paul Tardivel, editor of the newspaper La Vérité espoused the ultramontane cause, serving as a sounding board in Quebec City for the views of Bishop Louis Laflèche.8 He regularly attacked Laval University with charges of Freemasonry, and, borrowing from his idol Louis Veuillot, he found the dark hand of the Grand Orient – the Freemasons – not only in the schools of law and medicine, but also in the very household of the archbishop.9 The year 1905 was the period of the infamous pogroms in Russia, with widespread massacres of Jews. The Kishinev massacre occasioned worldwide condemnation of the Russian government’s involvement, including by Canadian religious and political leaders. Sir Wilfrid Laurier condemned this religious persecution in ringing tones from the steps of Parliament in Ottawa while participating in a demonstration of support for the victims. However, once again, “Petit Poucet” of Le Travailleur gave his view of what should be: I would do everything possible to keep away from our beloved country the most fearsome of all the plagues, the plague of the people, the Jewry. I would not commit the inconceivable foolishness of persisting to receive with open arms … a despicable race … which constantly seeks to stifle the real civilization, to annihilate Christianity, to undermine the nations, which brings to the forefront the indelible character of his horrific crime, and who, deicide throughout the ages, strives everywhere to destroy the divine religion

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founded by Him whom his hatred has nailed to the Cross of Calvary. (italics by the author).10 At the time, there was widespread anti-Semitism, especially among the nationalist-Catholic population of Quebec, as well as among Quebec’s English/ Scottish population.11 Yet Télesphore-Damien Bouchard, a true liberal journalist-politician from Saint-Hyacinthe, bravely expressed the views of the common people, who, in most towns in Quebec, respected the travelling Jewish peddlers and dealt with them on a personal level as human beings, inviting them in to stay the night and then accepting them as established shopkeepers.12 Bouchard’s response was not long in coming. In 1905, these were strong and courageous words, defending the Jews, and suggesting that French-Canadians would do well to follow their example of hard work, prudence, and pursuit of knowledge. Decidedly, Petit Poucet must not have shuddered at reading the horrors which the savage Russians of his kind committed in the ranks of the Jews by massacring men, women, elders and children because they were presumed the cursed race. Petit Poucet must have jumped indignantly upon learning that Mr. Wilfrid Laurier, one of our grand French Canadian men, had delivered a speech at an assembly convened for the purpose of helping the unfortunate victims of these atrocities. … This hatred towards the Jews whose heart is filled, to what then can it be attributed if not to the blindest prejudices? Are the Jews of today responsible for a crime committed by a certain number of their compatriots (sic) nineteen hundred years ago? Petit Poucet, heal yourself before seeking to heal others. Learn that hatred towards the Jews is due to one of the most unjust prejudices, and, above all, to learn that among the Jews there are men who are very honest as there are also scoundrels among the French Canadians. All people are constituted in the same way: all have their pantheons and prisons. There are a large number of French Canadians who would not waste their time if they studied and tried to imitate the spirit of economy of a certain class of Jews, their sobriety and their spirit of work. If some of them become wealthy, it is because they save the few cents they earn painfully instead of drinking them at the local inn; many French Canadians would also become rich if they followed their example.13 Unfortunately, T.-D. Bouchard’s view was rare among the intellectual circles of Quebec.

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Montreal in the nineteenth and early twentieth centuries saw many antiSemitic incidents. Students at the University of Montreal rioted in the streets of Montreal in 1895, protesting Sarah Bernhardt’s appearance on the stage, throwing rotten eggs at her. Bernhardt appeared thirty times in Canada between 1880 and 1917 and was opposed by the Church every time on the basis that she was a “Jewish whore” and of loose moral character.14 Worldwide anti-Semitism became even more evident in the late nineteenth century with the Dreyfus Affair, which divided France, and then with the rise of Nazi Germany in the twentieth century. The tragic course of the MS St Louis in 1939 was a striking example. Many ports and countries (including the USA and Canada) refused to allow the Jewish refugees to disembark. They were forced to return to Germany where many perished in the death camps. This global indifference to the plight of the Jews encouraged Hitler. “No Dogs or Jews Allowed” signs could be found on Quebec and Ontario hotels and beaches in the 1920s and ’30s. Across Canada, Jews were regularly restricted from access to universities, jobs, and housing, and hate groups like the Ku Klux Klan had members in most provinces. In Quebec, leading nationalist politicians, religious leaders, and intellectuals, consumed by the “Jewish problem” actively stirred up race hatred. The St Jean Baptiste Society campaigned against Jewish immigration, imploring Prime Minister R.B. Bennett in 1933 to refuse German Jews entry into Canada. Boycotts of Jewish shops were organized. Le Devoir, supporting Hitler, repeated the malicious myth of a Jewish media conspiracy in a 16 May 1933 article: “When Hitler attacks the Jew, he attacks the most formidable power of deceit in the world … the Jews not only control the newspapers in all the important cities in the world, but also many press agencies.’” In Canada, the Christie Pits riot in Toronto was a manifestation of this phenomenon. Many factors led to this event, but its root cause was anti-Semitism, seen in the Swastika clubs and parades, the resentment of “foreigners” in Toronto, and the rise of Hitler and the Nazis in Germany. The riot broke out on 16 August 1933 after a baseball game between two local clubs: Harbord Playground, predominantly Jewish, with some Italians, and St Peter’s, a baseball team sponsored by St Peter’s Catholic Church a few blocks away. Quebec saw the rise of Adrien Arcand and his Nazi movement in the 1930s, and the Plage Laval riot. On 24 July 1943, a gang of anti-Semitic French-Canadians armed with brass knuckles and broken bottles, led by the mayor’s son, invaded a

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Plage Laval beach. This beach was a big draw for Jewish Montrealers during the hot summer months. An amateur ex-pugilist, Moe Hershcovitch, lost the sight of one eye. Pierre Anctil, the French-Canadian historian of Yiddish Quebec, has stated that anti-Semitism has never resulted in physical injury in Quebec but this clearly was not true at Plage Laval.15 Officially McGill had an open policy, but in practice there was a quota, which was not acknowledged publicly. In his history of McGill University, Stanley Frost acknowledges its existence. In the early post-war [WWI] years, the number of students registering their religious affiliation as Jewish rose to 25% in the faculty of Arts, 15% in Medicine and 40% in Law … Measures were taken towards the end of the 1920s and through the 1930s to control the influx of Jewish students. The means employed in Medicine and Law was the institution of a roughand-ready quota system, and in the Faculty of Arts it was the regulation requiring Jewish students to satisfy higher matriculation standards … During the war period … these restrictive practices were ended and were not reinstituted.16 Dean Frost is not quite correct. The limitation on Faculty of Arts students lasted until about 1946 and in medicine until 1956. The marked differential employed in the 1930s was severe: at junior matriculation, the normal aggregate required (for admission to the Faculty of Arts and Science) was 600. For Jews, it was 750. None of these administrative practices appears to have had formal faculty or senate sanction. McGill was not alone in this. Many Jewish applicants were from the United States (because) Columbia and Harvard had similar policies.17 Indeed, as the historian Eunice Pollack points out, anti-Semitism was rampant in all American universities.18 (While I was in the School of Medicine in Geneva from 1952–57, there were about 180 Americans registered. Over 90 per cent were Jewish – an expression of the same policies as at McGill and throughout the USA.) Contradicting Frost’s affirmation that there these policies stopped toward the end of the Second World War, the Faculty of Medicine had a numerus clausus up to 1956. Four to seven students per year were admitted to Medicine from 1900 to 1923. In 1923, twenty-six Jews out of a total of seventy-two students were admitted.

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No doubt this remarkable number frightened the establishment since by 1927 the number had dropped to seventeen. From then on until the late 1950s, there were no more than seven or eight per class. Dr Isadore Rosenfeld reports that he was subjected to an interview with the neurologist Dr John Kershman before his acceptance into McGill Medicine in 1947. McGill had chosen a Jewish doctor to select the Jewish candidates for admission! Dr Kershman was humiliated by this task and later resigned.19 It should be noted that in the recent past the Faculty of Medicine has had four successive Jewish deans: Drs Sam Freedman, Abe Fuchs, Richard Levin, and now David Eidelman. The University of Montreal was no better. It self-selected students by requiring Thomist philosophy as a prerequiste, a subject that was not part of the education of the graduates of the Protestant school system. Forced by provincial regulations that did not allow non-Catholic students into the Catholic system, the Jews were deemed Protestants and could only proceed to education in English Protestant schools, as did French Protestants. Later in the 1930s, other anti-Semitic groups arose: the secret nationalist ultramontane anti-Semitic movement, the Order of Jacques Cartier, which promoted the “Achtez chez-nous” battlecry, aimed principally at small Jewish shop owners, and in the 1940s, the Bloc populaire Party. This is how Conrad Black described it: “The cause (the Bloc) attracted the adherence of disciples as different as the prolific Abbé Groulx and that ancient monk of backward opinions, Michel Chartrand … Groulx counseled Chartrand to discuss the project with André Laurendeau and Paul Gouin. The usual groups were interested in the project, the Saint-Jean-Baptiste Society of Montreal, the Association of Students of the University of Montreal, the Canadian Association of Catholic Youth and the Junior Chamber of Commerce of Montreal.”20 And again we have the question of the anti-Semitism in the French newspaper of the intellectual class, Le Devoir. The anonymous Le Devoir columnist (or columnists) writing under the pseudonym Le grincheux (“grumpy”) was clearly anti-Semitic. This daily column was most probably the work of Gérard Filion, the editor-in-chief, and several of his fellow journalists, composed as they sat at their lunch. Esther Delisle’s book on Le Devoir cites this column many times for its anti-Semitic content.21 The need for a Jewish hospital became apparent again in 1934. Anti-Semitism was the cause of a strike by all the interns and residents of the University of

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Montreal Hospital in June 1934. Dr Sam Rabinovitch, a graduate of the University of Montreal, with the highest marks in his class, was accepted for internship by the Notre Dame Hospital in June 1934. All the interns and resident staff of the hospitals of the University of Montreal walked out (the Hotel Dieu, Notre Dame, Sacre Coeur, and Sainte-Justine). To their credit, the board of the hospital supported Dr Rabinovitch’s appointment. (The only newspaper to support the strike was Le Devoir.) After four days, Dr Rabinovitch sent in his resignation, stating that he did not want to be the cause of the public not receiving medical attention. In view of the serious and dangerous conditions to which the patients of the Notre-Dame and other hospitals have been exposed because of the refusal of a number of the interns to take orders from their superiors, and [because of] the embarrassment of the various boards of Notre-Dame and other hospitals, I feel it my duty as a physician to tender my resignation as intern to your hospital. … I bemoan the fact that so many French-Canadian physicians, namely [new] graduates, should have ignored the first duty of their oath which they have so recently taken, and am glad of the fact that my resignation will make possible the immediate care that is so badly needed by those poor unfortunates who are today patients in the hospitals affected by the controversy. Dr Rabinovitch took his subsequent medical training in the USA in internal medicine (in a Catholic hospital in St Louis!) and returned to practise in Montreal until his mid-nineties. He died in 2010 at the age of 101.22 Thus, from the medical point of view, a Jewish hospital was definitely a necessity in Montreal, as it was for all Jewish hospitals worldwide, because of the need to address the anti-Semitic atmosphere. It was also necessary to establish a nursing school to train Jewish nurses, who were also not welcome in the established hospitals.

chap ter t wo

j ews a n d m e d i c i n e

Jews have had a great influence on the progress of medicine from biblical times until the modern era. In the Hebrew bible, medicine and religion were closely connected.1 The Jewish religion was very concerned with public health. Biblical medicine is distinctive in its codes for social hygiene, which are remarkable not only for their period but even by present-day standards. Prophylaxis and hygiene became religious dogmas intended for the welfare and preservation of the nation. Of the 613 commandments (mitzvot), 213 are of a medical nature. Jews’ awareness of good prophylactic medicine is astonishing, and includes frequent washing of hands, in the morning and before meals; prevention of epidemics; menstrual hygiene; suppression of prostitution and venereal diseases; care of the skin; rules of sexual behaviour; strict dietary and sanitary regulations; regular exercise; isolation and quarantine of disease; the observance of a day of rest, the Sabbath. These and other provisions inhibited the spread of many of the diseases prevalent in neighbouring countries. Jews were instructed to not eat meat from a diseased animal, or one that had died a natural death. The Jews were aware that contagious diseases are spread by direct contact as well as by clothing and household utensils. They compiled a series of sanitary regulations to prevent the spread of epidemics or infectious maladies, including precautionary or temporary isolation, quarantine, burning or scalding of infected garments and utensils, thorough scrubbing and smoking out houses suspected of infection, and scrupulous inspection and purification of the diseased person after recovery (Lev. 13–14). People who come into contact with a corpse or carrion, or who were suffering from purulent discharges from any part of their body, were also required to thoroughly clean themselves and their belongings before being allowed back into the community (Num. 19:7–16; Lev. 15:2–13).

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The clothes, weapons, and utensils of soldiers returning from a battle had to be thoroughly cleansed and disinfected to prevent the spread of diseases possibly picked up during contact with the enemy (Num. 31:20, 22–4). The peril of infectious bowel diseases spreading through excrement was also recognized. The Bible instructs how to keep the area clean (Deut. 23:13–14). Many diseases are mentioned in the Bible: tuberculosis (Lev. 26:16), leishmaniasis (Deut. 28:27), jaundice (Deut. 28:22), pemphigus (Ex. 9:9), gonorrhea (Lev. 15), lumbago (Ezek. 21:11), epilepsy (Num. 24:4), and osteomyelitis (Prov. 14:30). Cataracts were recognized among the ancient Hebrews: “Now the eyes of Israel (Jacob) were dim for age so that he could not see” (Gen. 48:10). Since the reference is to dimness rather than blindness it indicates that the illness was a cataract (Deut. 28:27). Leprosy was known, and a rigid quarantine was imposed on lepers. A bubonic plague described in Samuel 5 mentions rodents, known to be carriers of the disease. Healing was in the hands of God and the role of doctors was that of helpers or instruments of God. There are numerous references to physicians and men of healing throughout the Bible. It is always implied, however, that although man may administer treatment, it is God who heals: “I am the Lord that healeth thee” (Ex. 15:26). However, the Talmud does not regard calling upon a physician for medical aid as a failure to rely upon God to restore health: “Whoever is in pain, let him go to the physician” (BK 46b). The profession of physician – as an instrument of God – was held in high esteem: “Honor the physician before need of him. He also hath God apportioned .… The skill of a physician shall lift up his head; and he shall stand before nobles” (Ecclus. 38). The Talmud enumerated ten things that must be in a city where a scholar lives, and these include a physician and a surgeon. Among the Jews, medicine and religion have always been associated, as witnessed by the long line of rabbi-physicians that began in the Talmudic period and continued until comparatively recently. Because teaching or studying the word of God for reward was not considered ethical, medicine was often chosen as a means of livelihood for rabbis. They also made their living working part-time as blacksmiths, tailors, wine-tasters, and in agriculture. The agricultural workers taught in the winter. However, medicine was one of the few dignified occupations by which rabbis could earn their living. In early times, Jews contributed to medicine both by transmitting medical knowledge through their translations and by creating new medical concepts. It

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was through the medieval Jewish physician-translators that the medical knowledge of the East and much of ancient Greek medical lore was preserved and transmitted to the West. Biblical therapeutics consisted of washing; the use of oils, balsams, and bandages for wounds and bone fractures; bathing in therapeutic waters (II Kings 5:10), especially in the case of skin diseases; sun rays, and medicated drinks. Among medicines mentioned by name are myrrh, sweet cinnamon, cassia, galbanum, niter, and the mandrake (dudaʾim), which was considered to possess aphrodisiac properties. The modern method of mouth-to-mouth artificial respiration was also known, as testified by the accounts of Elijah and Elisha (I Kings 17:22; II Kings 4:34–35). Jewish physicians were instructed to serve the poor. If, in spite of every care, a licensed physician injured a patient or caused his death, he was not – as among many other peoples – held responsible (Sanh. 84b). Jewish doctors had an excellent reputation and practised throughout the civilized world. At the same time, numerous restrictions against Jewish doctors were already being promulgated by Christian bishops and emperors. However, they themselves often chose Jewish doctors when they were sick. There are numerous examples of noted Jewish doctors, from biblical times to the recent past, tending to kings, nobles, popes, or bishops. Rabbi Ishmael describes diphtheria as an epidemic disease that causes painful death through strangulation. The pathology of hemophilia as a lack of viscosity in the blood preventing coagulation is described, and the circumcision of an infant in a hemophilic family was forbidden. It was also recognized that the female is the transmitter of this disease (Yev. 64a; Ḥul. 47b). A large number of lung, liver, kidney, and stomach diseases were described as being caused by worms (Ḥul. 48a; Shab. 109b; Git. 70a). Lack of fluids was thought to lead to digestive disturbances (Shab. 41a). It was recognized that fear accelerates the pulse and raises the heart rate (Sanh. 100b), that falling from a great height may cause fatal internal injury (Ḥul. 42a), that injury to the spinal cord causes paralysis (Ḥul. 51a), and that “restraint” of the gall” causes jaundice. The medicines mentioned in the Talmud include powders, medicated drinks, juices, balsams, bandages, compresses, and incense. Meat and eggs were considered to be the most nourishing foods (Ber. 44b); fried food or food containing fat was regarded as difficult to digest (57b). The eating of vegetables throughout the year and the drinking of fresh water at every meal was recommended (ibid., 57b; 40a). Baths and mineral waters were regarded as general strengthening tonics and as therapeutics for certain skin diseases (Shab. 40a; 109a; Ket. 77b). Herbs

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were used for constipation and purges were recommended in serious cases, except for pregnant women (Pes. 42b). The use of opium as an analgesic and hypnotic drug was known, and warning was given against overdosing (TJ, Av. Zar. 2:2, 40d). Anything useful for healing purposes was permitted at any time, even on the Sabbath (Ḥul. 77b). Surgeons operated in special halls – “battei shayish.” “Sleeping drugs” – sammei de-shinta – were used as anesthetics. From descriptions of operations we learn of trepanning, amputations, and removal of the spleen (cf. Sanh. 21b; ul. 57a; Git. 56a). A Caesarean was also performed, but it is not clear whether the operation was done on a living or on an already dead body. In general, the life of the mother had priority and therefore the killing of a fetus during a difficult birth was allowed (Tosef., Yev. 9:4). Wound edges were cut in order to ensure complete and clean healing (Ḥul. 54a). Surgeons wore special operation aprons (Kelim 26:5). The main contribution of Talmudic medicine lies not so much in the treatment of illness but rather in the prevention of disease and the care of community health. The hygienic measures advocated were practical as well as religious and ethical. A principle that recurs a number of times is that “bodily cleanliness leads to spiritual cleanliness” (Av. Zar. 20b; TJ, Shab. 1:3, 3b). Hygienic regulations applied to, among other things, town planning, climatic conditions, social community life, family life, and care of the body. Mention is made of a disinfectant composed of seven ingredients used for cleansing infected clothing (Zev. 95a). Towns were required to have a physician and a bathhouse. Clothing had to be changed before eating. Mar Samuel declared that diseases may be carried by caravans from land to land (Ta’an. 21b). Members of a family with a sick person among them were to be avoided. Digging wells in the neighbourhood of cemeteries or refuse dumps was forbidden (Tosef., BB 1:10). It was forbidden to drink uncovered water for fear of snake venom (Av. Zar. 30a). Food had to be fresh and served in clean dishes. Kissing on the mouth was discouraged, and kissing only on the back of the hand was recommended in order to prevent contagion. During epidemics, the population was advised to avoid crowding in narrow alleyways because of the danger of contagion in the air. For body care, the Talmud recommends physical exercises, massage, sunlight, employment, and above all cleanliness. Mar Samuel states: “The washing of hands and feet in the morning is more effective than any remedy in the world” (Shab. 108b). Excesses of any kind were regarded as harmful. The Talmud also concerned itself with the health of future generations and forbade marriage to epileptics or the mentally retarded (Yev. 64b; 112b). Surprisingly, Talmudic pathology had very little influence on medieval medicine, not even on such outstanding physicians as Maimonides and

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Isaac Israeli, who were certainly well versed in the Talmud. The medical authority of Galen was so pre-eminent that all other medical theories and practice were regarded as banalities or even heresy. Scholars warned against the indiscriminate use of Talmudic remedies because they were not equally effective in all countries and at all times. Nonetheless, in the light of modern knowledge, the hygienic laws and regulations of the Talmud, as well as many of its anatomical and pathological findings, appear to have enduring validity. From the fourth century CE onward there were innumerable regulations, papal bulls, and royal ordinances in Christendom forbidding Jewish physicians to practise among non-Jews, to hold official positions, and, later on, to study at universities. The fact that Jewish physicians continued in their profession and even held high positions at the courts of the very authorities who preached against them, despite these threats and restrictions, attests to the esteem with which their medical skill was regarded. In this respect the Muslims were much more tolerant: although persecutions of Jews erupted from time to time in Muslim territories, physicians were not singled out, and consulting them was not forbidden. Greek medicine was taught, and was strongly influenced by Hebrew, Babylonian, Persian, and Indian traditions. This becomes apparent from the medical work left by Asaph b. Berechiah, called Asaph ha-Rofe or Asaph Judaeus, who lived about the sixth century CE somewhere in the Middle East. Together with Johanan b. Zavda, Judah ha-Yarḥoni, and other Jewish scholars, Asaph ha-Rofe founded a medical school. His work, the oldest known medical book written in Hebrew, encompasses all the then-known wisdom of Greek, Babylonian, Egyptian, and Persian medicine, as well as something of Indian medicine. His medical technique is based on old Hebrew traditions. No Islamic influence is apparent, which points to the fact that the book was composed before the seventh century. Most of the remedies mentioned were known in the Middle East generally. The oldest known Hebrew translation of the Aphorisms of Hippocrates, as well as chapters of Dioscorides and Galen, are also to be found in it. The book contains a “physician’s oath,” modelled on Hippocrates but far surpassing it in ethical content. (A major hospital in Israel today is named Asaph ha-Rofe Hospital.) Following the Arab conquest of the Middle East, North Africa, and Spain, Jewish communities and centres of learning started to flourish at Faiyum in Egypt, Kairouan in Tunisia, and Cordova in Spain. Studies often included ethics, philosophy, sciences, and medicine. Students acquired experience in medicine by assisting practising physicians. About a hundred years after the Arab conquest of the Middle East, the name of the Jewish physician Māsarjuwayh of Basra is men-

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A Jewish physician in traditional costume. N. de Nicolay, Les quatre premiers livres des navigations et pérégrinations orientales (Lyons, 1568), 105. Wellcome Library, London, no. 21582i.

tioned as the first of a long list of men who translated a great number of Greek and Syrian works into Arabic. One of the most outstanding medical personalities of the period was Isaac Judaeus (Isaac Israeli). He is believed to have been the first medical author in Arabic whose works were brought to Europe, and his books on fever, diet, uroscopy, and the ethical conduct of physicians were regarded as classics for several hundred years. It was said of him that he “lived a hundred years, was unmarried, shunned riches, and wrote important books more precious than silver or gold” (Saʿid b. Ahmad, tenth-century Arab scholar.) From the ninth to the twelfth century there was a medical study centre in Salerno in southern Italy associated with the name of the distinguished Jewish physician Shabbetai Donnolo, of Oria, Calabria. His most famous medical work, Sefer ha-Yakar, lists 120 different remedies and their composition. Greek

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medicine is often referred to and Hebrew terms such as those used by Asaph haRofe are frequently found in it. References to other Jewish physicians practising in Salerno and to Hebrew as a language of instruction are to be found in various records of the time. The most important Jewish physician-philosopher of the period was Maimonides. Born in Córdoba, he fled with his family to North Africa and soon attained a worldwide reputation as a religious legislator, philosopher, and physician. In 1170 he became personal physician to the family of Sultan Saladin of Egypt and continued to serve them until his death. Maimonides wrote ten medical works, of which the most important ones were Pirkei Moshe (“Aphorisms of Moshe”) and Regimen Sanitatis. Maimonides’ whole concept of medicine is based on the conviction that a healthy body is the prerequisite for a healthy soul. This enabled man to develop his intellectual and moral capabilities and lead him toward the knowledge of God and thus to a more ethical life. Maimonides regarded healing as the art of repairing both the defects of the body and the turmoil of the mind. A physician must therefore have not only the technical knowledge of his profession, but also the intuition and skill to understand the patient’s personality and environment. Maimonides divided medicine into three main fields: preventive medicine – (the care of the healthy); the curing of the sick; and the care and treatment of the convalescent, including the aged. Though leaning heavily on the medical teachings of the ancient Greeks, Maimonides warns against blind belief in so-called authorities and upheld the value of clear thought and experiments. His medical observations, diagnoses, and the methods of healing mentioned in his works on asthma, poisons, his medical responsa, and commentaries on the Aphorisms of Hippocrates contained ideas that were innovative in their day, many of which are still valid. For example, there is a description of diabetes mellitus in his writings. Maimonides wrote his medical books in Arabic: most of them were soon translated into Hebrew and Latin. At the end of the twelfth and the beginning of the thirteenth century, Jewish centres of learning were established in southern France – in Avignon, Lunel, Montpellier, Béziers, and Carcassonne. For a period of two to three hundred years, papal bulls and Synod decrees alternated in forbidding and then allowing Jewish physicians to practise their profession. Even so, the medical school of Montpellier owed its foundation largely to Jewish scholars. The Jewish influence is demonstrated by the number of portraits of Jews that were included in the marble plaques commemorating the early masters of the university. Various records mention “private” schools in which Hebrew law, science, and medicine

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Moshe ben Maimon, Maimonides also known as Rambam. Statue by Amadeo Ruiz Olmos, Córdoba. Photo: Yair Haklai.

were taught for a stipulated fee. During the fifteenth and sixteenth centuries, when certain universities were closed to Jews, Hebrew translations of Arabic and Greek medical works were made specifically for Jewish medical students. There was also a Jewish school of medicine in Lunel, France. One of its graduates, Jean Astruc, of Spanish-Jewish descent, was later professor of medicine there and subsequently physician to Louis XV. The Saporta family, of Converso descent, has a prominent place in the history of Montpellier during the sixteenth century. Louis (I) Saporta came from Lerida, was appointed city physician in Marseilles in 1490, and from 1506 to 1529 served as professor at Montpellier University. His son Louis (II) studied medicine there,

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Jean Astruc. Portrait by Ambroise Tardieu for the bust in the Paris School of Medicine. Wellcome Library, London, no. L0003093.

and his grandson Antoine became, successively, royal professor, dean, and chancellor of the university (1560). His great-grandson Jean became professor in 1577 and vice chancellor in 1603. The family then immigrated to the French colonies of America. The Sanchez family, already well known in Portugal and Spain, was represented by Francisco Sanchez (1562–1632), who was appointed professor of medicine and philosophy at Montpellier and later at Toulouse, and published many medical treatises. Benvenutus Grapheus, from Jerusalem, one of the most famous eye doctors of the Middle Ages, lived in the twelfth century. He taught and practised in Southern Europe and probably also in Salerno. His observations of and recommended cures for eye diseases prevalent in Southern Europe and other Mediterranean countries are extraordinarily accurate, and his works, which were translated into many European languages, were the most popular textbooks of the period on ophthalmology. Jewish women were also practising physicians at this time. Among them was Sarah La Migresse, who lived and practised in Paris toward the end of the thirteenth century. A record has been found in Marseilles of an agreement

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signed in 1326 between Sara de Saint Gilles, widow of Abraham, and Salvet de Bourgneuf, whereby the former undertook to teach the latter “Artem medicine et physice,” and to clothe and care for him for a period of seven months. In return, Salvet agreed to turn over to his teacher all his fees as physician during that period. This document is the earliest and best-known example of this type of teacher-student contract. Sarah of Wuerzburg received a license from Archbishop Johann II in 1419 in Bavaria and developed a lucrative medical practice. Rebekah Zerlin of Frankfurt (c. 1430) became famous as an oculist. For the most part, however, women were limited to helping other women, in obstetrics and gynecology. During most of the thirteenth and fourteenth centuries Jewish physicians in Catholic Spain enjoyed the protection and support of the reigning monarchs. The list of prominent physicians of that period is a long one. Toward the end of the fifteenth century, however, the Inquisition was established and life became much harder for Jews. Numerous Italian Jewish physicians were also rabbis and leaders of their communities, especially in Rome, Ferrara, Mantua, and Genoa. The Italian universities, notably those of Padua and Perugia, were among the few that allowed Jews to enter the medical faculties at a time when most other European universities were closed to them. The Jewish communities of Italy were also enriched by the influx of Jewish and Converso scholars and physicians fleeing the Inquisition. At various periods Jews acted as personal physicians to popes, cardinals, bishops, and dukes. It has been suggested that the popularity of Jewish physicians in Italy, in spite of the innumerable restrictions, the bitter attacks, and the calumnies, was due to the superstitious belief of Italian Christians in the “magic” arts of the Jews. At the end of the fifteenth century the Jews were expelled from Spain and Portugal. Many were forced converts and some continued to practise in Spain and Portugal until the eighteenth century, despite their precarious position in those countries, where they were under constant threat of persecution. The Conversos and their descendants were leaders and pioneers in medicine in Europe and Asia for several centuries, from the Renaissance until modern times. The sixteenth century was a time of immense exploration, discovery, and progress. During this period – the beginning of the medical renaissance – many distinguished Jewish physicians, fleeing the Iberian Peninsula, won a worldwide reputation in other lands. Saladino Ferro d’Ascoli (fifteenth–sixteenth century) was acknowledged as the leading pharmacist of his time, and his work on pharmacology was the

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Roderigo Lopez, after an engraving by E. Hulsius. Wellcome Library, London, no. 13930i.

basic textbook for all pharmacists until the eighteenth century. Bonet de Lattes (d. 1515), a native of Provence, became physician to Popes Alexander VI and Leo X. He also served as judge of the highest Italian court of appeal and rabbi to the Jewish community of Rome. Philotheus Eliajus Montalto (d. 1616), who fled to Italy from the Portuguese Inquisition, wrote Archipathologia, which dealt with diseases of the nervous system and mental disturbances; it was widely used in his time and often referred to by later medical writers. Benjamin Mussafia distinguished himself as physician, philologist, scholar, and rabbi. He served as personal physician to the Danish king Christian IV. One of the most outstanding personalities of the time was Rabbi Jacob Ẓahalon, born in Rome and later physician in Ferrara. In his book Oẓar ha-Ḥayyim he described contemporary hygienic measures as well as the 1656 bubonic plague in Rome. He used numerous new Hebrew medical terms and redefined the moral obligations of the Jewish physician to his profession. Joseph Solomon Delmedigo studied medicine in Padua and was a pupil of Galileo. He settled in Poland and became personal physician to Prince Radziwill. David de Pomis (1525–1593) of Spoleto became physician to Pope Pius IV.

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Roderigo Lopez was an internist and anatomist who fled the Inquisition in 1559 and became physician to Queen Elizabeth I of England. In 1594 he was accused of plotting to poison Elizabeth and sentenced to death. The family of de Castro produced many distinguished physicians. The most famous was Roderigo de Castro (c. 1550–1627), author of a gynecological work, Universa Muliebrium Medicina, and physician to the king of Denmark and various German dukes and princes. His son Benedict de Castro (b. 1597) started practising in Hamburg and later became physician to the queen of Sweden. He was the author of Apologia, a medico-historical work that described the achievements of Jewish doctors and defended them against anti-Semitic charges. Orobio de Castro fled the Inquisition and settled in Amsterdam, where he became a famous physician and leader of the Jewish community. Jacob de Castro Sarmento (1692–1762), was born in Portugal, settled in England, and was admitted as a fellow of the Royal Society in 1730. His work Agua de Inglaterra reveals a profound knowledge of the therapeutic properties of quinine. In the eighteenth century, Jacob Rodrigues Pereira was a pioneer in the education of deaf-mutes, inventing a sign language for the deaf and dumb. Born in Spain, of Converso parents, he escaped the Inquisition, settled in Bordeaux, and embraced Judaism. The fate of Antonio Ribeira Sanchez illustrates how far-reaching was the influence of Jewish physicians at that period. A Portuguese Converso, he fled the Inquisition to Holland at the beginning of the eighteenth century and became the pupil of the famous Dutch physician, Boerhaven. In 1740 he went to Russia as personal physician to the Czarinas Elizabeth and Catherine II. He introduced soblimat (a mercury compound) into the therapy of syphilis. A large number of Jewish physicians also settled in Turkey, where private citizens, as well as sultans, viziers, and pashas, valued their skill and medical knowledge and their high standard of ethics. In the fifteenth century, Joseph Hamon, a Granada physician, went, at an advanced age, to Constantinople, where he became court physician. Converso physicians were also among the pioneers in East India. Foremost among them was Garcia de Orta, born in Portugal. In 1534 he went to India where he studied and collected eastern plants and drugs. His Colloquios dos simples Drogas e cosas medicinas de India, which appeared in 1563 in the form of dialogues, is not only the first but also the most important contribution on this subject to the European medicine of that time. In the northern countries – Germany, Poland, and Russia – there were Jewish physicians of note generally from the middle of the seventeenth century onward, many of them refugees from the countries of the Inquisition. However, as early as the eleventh century a medical book had been written in Hebrew by R. Saadiah

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Portrait of Tobias Cohn (Tobias b. Moses Cohn of Metz). Ma’aseh Tobiyah (Venice, 1708), Frontispiece. Wellcome Library no.18306537.

of Worms, and gradually, the universities of the German states opened their doors to Jews. Tobias b. Moses Cohn of Metz was unable to obtain his degree and therefore went to Padua to receive his MD. He became physician to five successive sultans in Constantinople. His Ma’aseh Tuviyyah is almost an encyclopedia and includes medicine, sciences, philosophy, and part of a dictionary. From the beginning of the eighteenth century the number of practising Jewish physicians in Germany, Czechoslovakia, England, and Poland increased. When Joseph II of Austria proclaimed the Act of Tolerance in 1782, and when, shortly thereafter, the French Revolution brought emancipation to Jews throughout Western Europe in its wake, the gates of European medical schools were thrown open to Jewish students. The importance of the contribution made by Jewish doctors to subsequent medical progress is enormous. The quality and quantity of this contribution is reflected in the rosters of Nobel laureates and winners of other awards,2 dictionaries of eponymic syndromes and diseases, and lists of medical authors and investigators.

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The geographic distribution of Jews practising medicine in the nineteenth century reflected the incongruity between the size of Jewish communities and the number of medical practitioners and scientists. Because of restrictions practised by Russian medical schools, the youth of the world’s largest Jewish community went abroad to pursue their medical studies. Even when Jewish physicians successfully overcame the main restrictions and hardships, they were rarely permitted to participate fully in university-centred medical activities. In Austria and Germany, this involvement did not, however, come about suddenly. Although the gates of the universities were open for admission, the inner doors to academic recognition remained partially closed during the first half of the century. The best a Jew could hope for was to become a privat docent or a “titular” professor. And even after the struggle for academic recognition had been won, Jews were not welcome in “establishment”-controlled specialties, such as surgery. Microscopy was also pursued by investigators who were exclusively devoted to basic science. These contributions increased during the latter part of the century when bacteriology and the allied science of immunology became integral parts of medicine. Jews became conspicuous in the discovery of bacteria and the development of immunologic methods for diagnosing and preventing bacterial infection. At the same time, Jews were also contributing to clinical medicine; in cardiology; kidney diseases, psychotherapy, pediatrics, hematology, nutrition and infectious diseases, congenital syphilis, rickets, otolaryngology, ophthalmology, obstetrics and gynecology, X-ray therapy, surgery, and urology. A notable humanist was the ophthalmologist Ludwik Zamenhof, who created a proposed international language, Esperanto, whose intention was to unite the world in peace by eliminating misunderstanding between peoples. In America, where the Jewish community was small and medical science was not yet advanced, Jewish contributions to medicine were modest, and were often related as much to organization, administration, and the foundation of hospitals as to scientific pursuits. The ophthalmic surgeon Isaac Hays was the editor of the influential American Journal of Medical Sciences (1827) and one of the founders of the American Medical Association. Jacob da Silva Solis-Cohen, a pioneer in otolaryngology who performed the first laryngectomy for laryngeal cancer (1867), was the acknowledged “father” of organized instruction in his specialty. Another “father”– that of American pediatrics – Abraham Jacobi, was the founder of the American Pediatric Society, and in his later years (1910), the president of

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Dr Ludwik Zamenhof. The Congressional Book of the 4th World Esperanto Congress in Dresden, 1908.

the American Medical Association. Jewish doctors were also active in establishing and staffing Jewish hospitals, which provided training for Jewish interns and residents. In time, these hospitals became important research centres affiliated with medical schools that absorbed many Jewish students. World War I, the Russian Revolution, and the Balfour Declaration had demographic and political consequences that profoundly influenced Jewish participation in medicine. Many Russian Jews moved to large university centres, where they had previously been forbidden to live. As a result of this movement and of the new policy of open university admissions, the number of Jewish doctors greatly increased. In the Soviet Union, unofficial admission quotas reappeared during the later years of Stalin’s rule. The countries of Western Europe, other than Germany and Austria, had long-settled Jewish communities whose numbers were increased by refugees from Russia at the beginning of the twentieth century and from Nazi persecution in the 1930s. Jewish doctors are well represented in clinical practice and in academic centres there. Their contributions to medicine and medical science in the United Kingdom are well recognized,

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Abraham Jacobi. Portrait of Abraham Jacobi, “The Life of A. Jacobi,” Medical Life, May 1928, vol. 35, no. 5, Frontispiece. Wellcome Library, London, no. L0023794.

and French scientists made important contributions to the formative stages of molecular biology. Medicine has undergone profound changes since the start of the twentieth century. Advances in medical science have gradually transformed clinical practice from a largely pragmatic skill based on anecdotal experience into a discipline underwritten by verified laboratory and clinical observations. The increasing pace of scientific discovery continues to offer therapeutic possibilities of unprecedented complexity and expense. Medical teaching has changed from learning by apprenticeship to learning from individual teachers with varying degrees of skill and knowledge to organized instruction in universities with courses and teachers with appropriate academic credentials. Before the 1950s, patients were rarely given explanations for their illnesses and treatment. Patients now have ready access to medical knowledge and expect to be involved in decisions about their clinical management. They also have increasing expectations of the standards of medical care. Changes in attitude and technical advances have made ethics an integral part of clinical practice. In general, an overview of the Jewish

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contributions to medicine in modern times must consider advances in scientific knowledge, the application of this knowledge to clinical practice, medical education, the organization of medical practice, and the proper education and participation of patients. Early on in the twentieth century, infections were the major causes of human morbidity and mortality. Jews were prominent in the increased understanding of immunity and natural resistance to infection. The links between cell biology and cancer research are prime examples of their contributions of basic research to medicine, for instance, the formation of new blood vessels (angiogenesis) is essential for tumour growth and metastasis. Jewish scientists have made outstanding contributions to understanding the molecular basis and clinical manifestations of disordered immunity. The high prevalence rate of many metabolic diseases in Jewish populations makes this an area of especial Jewish interest. Diabetes mellitus, now recognized as occurring in two main forms, is a compelling example. The fields of cardiovascular, pulmonary, and renal diseases have many pioneering Jewish contributors. Arthur Master introduced the concept of coronary insufficiency and the “Master Step Test” for its detection. Louis Katz elucidated the principles of cardiovascular hemodynamics, metabolism, and electro-physiology. Oskar Mirowski invented the automatic implantable cardio defibrillator (AICD) which transformed the management of life-threatening cardiac arrhythmias. In 1934, Harry Goldblatt (McGill MD) demonstrated the mechanism of secondary hypertension caused by renal vascular disease. At the turn of the twentieth century, Max Einhorn and Samuel Weiss (1885– ?) were among the first clinicians to develop gastroenterology as a medical specialty. In 1931 Burrill Crohn described the inflammatory bowel disease named after him. (The paper by Crohn, Ginzberg, and Oppenheimer, listed in alphabetical order, resulted in the disease being named after him, but the initial discovery was most likely due to Ginzberg, the radiologist.) Progress in clinical neurology is largely dependent on increased understanding of brain structure and function. Jewish scientists have participated in this problem from the early days of Joseph Erlanger’s research on nerve conduction to Richard Axel’s dissection of the pathways relevant to olfactory function. Israel Wechsler compiled one of the first systematic textbooks on clinical neurology (1927) which became a standard work. American Jewish radiologists have enriched every branch of their specialty. Gustav Bucky (1880–1963) invented the X-ray diaphragm that bears his name today. Bucky showed in 1913 that a grid can be used to block scattered X-rays.

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Isadore Schwaner Ravdin in India, September 1945. From the Collections of the University of Pennsylvania Archives, UARC20020802005.

The grid is composed of alternating strips of an X-ray-absorbent material (such as lead) and an X-ray transparent material (such as plastic, fibre, or aluminum). Advances in pharmacological knowledge and drug design, testing, and production have transformed the management of virtually every acute and chronic disease. In addition to the development of anti-microbial agents, Jewish scientists and clinicians have made so many contributions in this area that selected examples must suffice. Isadore Schwaner Ravdin was the son and grandson of doctors. On his return from training in Europe in 1928 to the University of Pennsylvania he was made Professor of Surgical Research, and in 1935 the Harrison Professor of Surgery. His chief contributions were the introduction of intravenous feeding to overcome malnutrition in surgical patients and in anti-cancer chemotherapy. In the Second World War, he served in the eastern theatre and ultimately became the first Jewish major-general in the Medical Corps Army Reserve. After the war he was appointed John Rhea Barton Professor and chairman of the Department of

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Surgery in Philadelphia, retiring in 1959 because he wanted to make way for a younger man, and he became vice-president for Medical Affairs. Ravdin was awarded many honours, including the presidency of the American Surgical Association in 1958, the American Cancer Society in 1963, and the American College of Surgeons in 1960, having been chairman of its board of regents from 1954 to 1960. In 1956 he was awarded the Honorary Fellowship of the Royal College of Surgeons of England. Gertrude Elion developed the immunosuppressive drug azathioprine, the first anti-viral drug acyclovir, and allopurinol, used to treat gout. Gregory Goodwin Pincus and Carl Djerassi developed the first successful female oral contraceptive drugs. The innovative achievements of Robert S. Langer are a pertinent example. Langer is a pioneer of many new technologies, including controlled release and transdermal delivery systems, which allow the administration of drugs or extraction of analysates from the body through the skin without needles or other invasive methods. Langer worked with Judah Folkman at Boston Children’s Hospital to isolate the first angiogenesis inhibitor, a macromolecule, to block the spread of blood vessels in tumours. Langer’s idea was to encapsulate the angiogenesis inhibitor in a noninflammatory synthetic polymer wafer that could be implanted in the tumour and control the release of the inhibitor. This discovery is considered to lay the foundation for much of today’s drug delivery technology. He also worked with Henry Brem of the Johns Hopkins University Medical School on a drug-delivery system for the treatment of brain cancer, to deliver chemotherapy directly to a tumour site. Langer is also regarded as the founder of tissue engineering in regenerative medicine. He and researchers in his lab have made advances in tissue engineering, such as the creation of engineered blood vessels and vascularized engineered muscle tissue. Bioengineered synthetic polymers provide a scaffolding on which new skin, muscle, bone, and entire organs can be grown. With such a substrate in place, victims of serious accidents or birth defects could more easily grow missing tissue. Jewish scientists have also made key contributions to anti-HIV treatment. They include Jerome Horwitz, who synthesized the first drug that inhibits the viral enzyme reverse transcriptase, and Irving Sigal, who first showed the efficacy of drugs that inhibit viral proteases. Mark Wainberg of the Lady Davis Institute was a prime contributor to the field of understanding HIV and its therapy. Jewish pathologists made important contributions at the stage when pathology was developing from an observational skill into one demanding more widely-based scientific insight and knowledge. The efforts of Hans Popper and

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Abraham Flexner. Photographer unknown. Shelby White and Leon Levy Archives Center, Institute for Advanced Study, Princeton, NJ, USA.

Fenton Schaffner clarified the pathology of liver disease. Paul Klemperer’s imaginative interpretation of the damage inflicted by “connective tissue diseases” laid the basis for what are now known as multi-system autoimmune diseases. Jews have played a prominent part in the interrelated fields of medical education and publication in the US. Abraham Flexner is still remembered for his “Flexner Report” (1906), which charted the subsequent course of all medical education in the United States. Since the Second World War, a steadily increasing number of Jews have joined the teaching staffs of medical schools. Many have also contributed to teaching, as textbook authors and by editing medical journals. The well-known medical editor, Morris Fishbein, edited the Journal of the American Medical Association and played a leading role in shaping American health-care policies. Alexander Gutman (1902–1973) edited the American Journal of Medicine and Alfred Soffer (1922– ) was editor of Chest. Subsequently there has been an at least commensurate increase in the numbers of Jewish medical scientists and teachers needed to meet the enormous demand for journals, books, and education at all levels. Despite poor economic conditions, Jews in pre-Hitler Poland maintained forty

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hospitals, where many of the country’s 3,500 Jewish doctors provided services. Poverty, backward technology, and a hostile academic environment prevented Jewish scientists from attaining the achievements reached by their colleagues in Western Europe. Still, their contributions were far from negligible. Edward Platau, the doyen of Polish neurologists, researched meningitis and brain tumours. Adolf Beck investigated nerve physiology and Henry K. Higier explored the autonomic nervous system. Samuel Goldflam studied reflexes and the diseases myasthenia gravis and periodic paralysis. Zygmunt Bychowski investigated traumatic epilepsy and multiple sclerosis. Anastaszy Landau was prominent in metabolic research, Stanislaus Klein in hematology, Seweryn Sterling in social medicine, and Gerszon Lewin in tuberculosis. Aron Solowiesczyk, who was killed during the Warsaw Ghetto uprising, was prominent in surgical research. The scientific potential of Jewish doctors in Poland was not destined to develop. During the German occupation, Jewish doctors devoted their energies to caring for people doomed to starvation, torture, and death. Many distinguished themselves by acts of dedication and heroism. Over 2,800 were killed. The tragic events in Poland were paralleled by similar developments in other German-occupied territories. Jewish emigration from Europe to the US increased sharply yet again in the 1930s with the rise of the Nazi Party, though not as much as was needed. Physicians who found refuge in America arrived at a propitious time. The 1930s and 1940s marked the beginning of the current golden age of scientific medicine, ushered in by the discovery of antibiotics, cortisone, advances in molecular biology, and medical technology. With the decline of traditional European centres, the United States became the new world centre of scientific and medical activity. Jewish immigrants joined the country’s extraordinarily creative universities and institutes. Rid of any vestiges of intolerance and receptive to new talent, the country’s medical establishment and public welcomed the newcomers. Jewish hospitals, such as Mount Sinai in New York and Michael Reese and Mount Sinai in Chicago, as well as non-Jewish hospitals, research foundations, and universities absorbed many of them into the mainstream of medical progress. By the 1980s, Jewish physicians in the United States greatly outnumbered those in other countries. In the State of New York alone, there were 7,500 practising Jewish doctors compared with 5,500 in Israel and 3,000 in France. Overall, 9 per cent of US physicians were Jewish, compared with 3 per cent in the general population. More than 17,000 of the approximately 27,000 US Jewish physicians in private practice lived in the densely populated states of New York, California, Illinois, Pennsylvania, New Jersey, and Massachusetts. Of these,

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approximately 4,700 were general practitioners, 6,500 specialists in general medicine and its branches, 3,000 in surgery, 2,900 in obstetrics and gynecology, 1,000 in ophthalmology, 800 in radiology, 650 in dermatology, and 600 in otolaryngology. However, the distribution among medical specialties was uneven. Whereas only 5 per cent of doctors in occupational medicine were Jewish, Jewish doctors comprised 20 per cent of general physicians and more than 30 per cent of psychiatrists. This predominance is likely to have persisted but is difficult to quantify and compare with earlier periods. Increasing specialization has marked the virtual demise of the “general internist” and the current Jewish population is less homogeneous compared with the initial immigrant Jewish population. However, the Jewish contribution to US and thereby to medicine worldwide should not be assessed simply in terms of the numbers of practising physicians but should also take account of Jewish contributions to medical science and education. At the beginning of the twentieth century, infectious diseases were rampant in Palestine. Clinics established by European Jewish communities provided medical care for the Jewish population of Jerusalem. These clinics became hospitals that expanded to meet the needs of a modern city, notably Bikkur Ḥolim, established in 1843, and Sha’arei Ẓedek, established in 1902. The first Jewish physician in Palestine, Simon Fraenkel, was sent to Jerusalem in 1843 by Moses Montefiore. Menahem Stein was the first Jewish doctor in Jaffa (1882), Hillel Joffe the first in Haifa (1890), and Bathsheba Yunis (1880–1947) the first in Tel Aviv. Leib Pashkovsky was the first surgeon to settle in Palestine (1906). In 1912, the year that a medical association was founded in Tel Aviv, there were thirty-five Jewish doctors in the country, the majority specially trained in ophthalmology, dermatology, and parasitology to cope with the country’s most prevalent diseases. Prominent among the early specialists were the ophthalmologist Arye Feigenbaum, the dermatologist Aryeh Dostrovsky (d. 1975), and the bacteriologist, and founder of the Pasteur Institute in Jerusalem (1913), Israel J. Kligler. Although public health remained a major preoccupation, increased control of malaria, rabies, trachoma, and other infectious diseases allowed more scope for other specialties to develop. In Israel, the first research priority was the control of infectious diseases. Saul Adler, a world authority on parasitology and tropical medicine, directed research on amebiasis, leishmaniasis, and relapsing fever. Zvi Saliternik was responsible for the elimination of malaria and the parasitic disease schistosomiasis. Studies related to genetic disorders prevalent in various Israeli populations were studied extensively.

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Dr Alton Goldbloom, 1916. McCord Museum, II-212096.

Chaim Sheba, surgeon-general of the Israeli army, oversaw the rise in medical standards. Bernhard and Hermann Zondek continued their endocrinologic research, interrupted by the European upheaval, and Moshe Rachmilewitz, professor of medicine at Hadassah Hospital Medical School, carried out much-cited studies of foliate and vitamin B12 deficiency and metabolism. Bracha Ramot organized a modern hematological service at the Tel Hashomer (Sheba) Hospital and undertook a systematic program of investigation of the prevalence and management of inherited disorders of hemoglobin synthesis. Andre de Vries was a distinguished physician and hematologist at the Beilinson (Rabin) Hospital. Karl Braun initiated research programs in cardiology and Lipman Halpern in neurology. Under the leadership of Bruno Lunenfeld, the Tel Hashomer (Sheba) Hospital became a world centre in research and treatment for female infertility. In the same institute, Baruch Padeh had laid the foundations for clinical genetics in the country. David Erlick in Haifa improved techniques of renal transplantation. Isaac Michaelson developed ophthalmological services at Hadassah

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Hospital and used his expertise to treat patients with trachoma and other sightthreatening diseases in Africa. Michaelson was thereby among the first to initiate Israel’s continuing medical collaboration with disadvantaged countries. He was also among the first clinical scientists to realize the importance of angiogenesis (new blood vessel formation) in retinal disease. An international medal and a series of conferences have been named in his memory. Rami Rahamimoff ’s work on nerve transmission in health and disease is also universally respected. The advances in basic immunology made by Michael Sela and Ruth Arnon at the Weizmann Institute have been adapted to many promising strategies for treating multiple sclerosis and autoimmune diseases. Michel Revel’s research on the antiviral interferon system also has important clinical implications. Jewish doctors and medical scientists in Canada also benefited from the opportunities available in the US to improve the provision of medical services and education. Their numbers included the pediatrician Alton Goldbloom, and Arthur Vineberg, who pioneered techniques for improving blood circulation to diseased heart muscle (revascularization).

chap ter thre e

s i r m ort i m er ba r n et t dav i s (1866–1928) “Every man of means owes a duty to his fellow-men. Every Jew owes a duty to his fellow-Jew.” (Davis, 1919)

This was the motto of Mortimer Barnett Davis, preceding Melinda and Bill Gates by many years. He was born in Montreal on 5 February 1866 to Samuel Davis and Minnie Falk Davis, Jewish immigrants in Montreal. His father had settled there around 1861 and had soon made his mark as one of the largest cigar manufacturers in the metropolis. Davis graduated from the High School of Montreal and then joined his elder brothers Eugene Harmon and Maurice Edward in the family’s cigar business, S. Davis and Sons. In 1888, S. Davis and Sons purchased another Montreal firm, D. Ritchie and Company In 1895, the American Tobacco Company, which controlled about 90 per cent of the American market, purchased D. Ritchie and Company and the American Cigarette Company, another Montreal cigarette manufacturer. The Davis family became a minor partner of the Duke family, with 25 per cent of the 10,000 shares issued by the new corporation. Shortly afterwards, Mortimer Barnett Davis was named president of the American Tobacco Company of Canada. Under Davis’s direction, this company established a virtual monopoly on tobacco, buying up firms that made a wide range of tobacco products and extending its geographical base beyond the confines of Montreal. At that time, with its subsidiaries, it controlled 80 per cent of the Canadian cigarette market and 60 per cent of the market in chewing tobacco, pipe tobacco, and snuff. Its imposing factory in the Saint-Henri district of Montreal, which was also the head office, was built in 1907.

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Sir Mortimer Barnett Davis. McCord Museum, II-116589

In 1902, The British-American Tobacco Company Limited then purchased the American Tobacco Company of Canada, which became the Imperial Tobacco Company of Canada Limited. Mortimer Barnett Davis was its first president. The financial power of the empire over which he presided earned him the title of “Tobacco King,” which he shared with his great rival, Sir William Christopher Macdonald. Davis was also the driving force behind the consolidation of the Canadian cigar industry, which had been severely shaken by the First World War and by increasing competition from cigarettes. In 1916 he had bought out the family firm (then in the hands of his brothers Maurice Edward and Melvin Henry), and became the principal shareholder and president of the reorganized company,

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known as S. Davis and Sons Limited. To restore its finances and reduce the costs of cigar production, Davis turned to subcontracting, signing numerous contracts in 1919 with small cigar manufacturers in Montreal. He also moved part of his production to Port Hope, Ontario. Such a strategy was clearly designed to reduce fixed costs, but also undoubtedly to bypass the powerful trade union of cigar makers. In 1920, Davis coordinated the formation of the General Cigar Company, which would merge his company and his major rivals into a large cigar trust, absorbing the Brener Company Limited of Farnham and the Vallens Company Limited of London, Ontario. Davis persuaded the shareholders of Imperial Tobacco to buy up a majority of the shares of General Cigar in July 1921, remaining at the head of Imperial Tobacco until 1926, when he was succeeded by a long-time business associate, David Patterson. Well known for his administrative and financial skills, Davis was also invited to sit on the board of directors of the Union Bank of Canada from 1906 to 1910 and the Royal Bank of Canada from 1916 to 1928. Around 1917 he was a director of the National Car Company in Hamilton and, in 1928, a director of the Crown Trust Company, the United States Rubber Company, and its Canadian subsidiary, the Canadian Consolidated Rubber Company. He was also a member of the Montreal Board of Trade and the Montreal Stock Exchange

pers ona l l i fe On 12 June 1898, in San Francisco, Davis married Henriette Marie Meyer, daughter of Charles Meyer, a banker and philanthropist. Their only son, Mortimer Davis, Junior, died in 1940. Unfortunately, this son was mentally handicapped. Another child died at birth. In 1924, Davis divorced Lady Henriette in order to marry (eventually) Eleanor Curran. Because of her less than desirable social origins, he arranged a fictitious marriage of Miss Curran to an Italian Count Moroni, so that immediately after the Moroni divorce he coud marry the Countess Moroni, on 22 March 1928 in Cannes, France. The Countess died in 1963. In a letter to William Lyon Mackenzie King in 1916, Montreal lawyer Samuel William Jacobs described Davis as “the leading Jew in Canada.” In 1916, he was knighted by King George V, becoming the first Canadian-born Jew to receive such an honour. He was a member of Temple Emanu-El, which his father had helped to establish. He was a key force in building the Mount Sinai Sanatarium, in Préfontaine. He undertook the entire responsibility of financing the cost of the

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YMHA athletic institution on Mount Royal Avenue and Jeanne Mance Street in 1926. He undoubtedly would have been a major contributor to the Jewish General Hospital had he not died before the 1929 campaign. Like most of the upper class of his generation, Davis adopted a way of life in keeping with his great personal wealth. He took up residence in the Golden Square Mile of Montreal, as his father had done. He built an immense and luxurious residence in the neoclassical style, which was finished in 1907 (situated at the southeast corner of Peel Street and Pine Avenue – now known as Purvis Hall, of McGill University). There Davis and his wife hosted fashionable receptions and numerous balls. He associated with the Duke of Connaught, the governor general of Canada, and belonged to the most exclusive private clubs. Horticulture was one of his great passions and he took part in the activities and exhibitions of the Montreal Horticultural Society and Fruit Growers’ Association of the Province of Quebec. While his wife collected works of art, Davis acquired a full stable of racehorses. He also owned an imposing country home, Belvoir, in Sainte-Agathe-des-Monts. During the last years of his life he spent more and more time at Les Glaïeuls, his villa in Cannes, where he died in 1928. Lady Davis was also an active philanthropist, and was made an officer of the Légion d’honneur and Commander of the British Empire. She died in 1963, leaving the following tributes to honour her: the Lady Davis Institute for Medical Research of the Sir M.B. Davis Jewish General Hospital, the Lady Davis Fellowship, the Lady Davis Mechanical & Aeronautical Engineering Centre, a seven-storey low-rise building of the Technion in Haifa, and the Lady Davis Building, which is the main building of the National Library of Israel, in Jerusalem. In November 1919, in the Canadian Jewish Chronicle, Davis summed up the principles guiding his philanthropic activities: “Every man of means owes a duty to his fellow-men. Every Jew owes a duty to his fellow-Jew.” His generosity extended to a variety of causes and institutions in the province of Quebec and the rest of Canada. Especially affected by the fate of his co-religionists, he was one of the most important philanthropists in the history of the Canadian Jewish community, holding leadership positions in a number of associations and chairing fundraising campaigns. He was interested mainly in charities promoting public welfare and health in Montreal: the Baron de Hirsch Institute and the Hebrew Benevolent Society of Montreal, of which he was a benefactor and the president in 1908 and 1910; the Mount Sinai Sanatorium in Sainte-Agathe-des-Monts, of which he was a principal sponsor; and the Young Men’s Hebrew Association, to which he donated $420,000 in 1926, the entire cost of the construction of a community and sports centre. The centre opened on Mount Royal Avenue, near Park

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Avenue, shortly after his death. He gave particular support to efforts at improving social services and their financing. When the Federation of Jewish Philanthropies of Montreal was established in 1916, he was named honorary president. Davis also supported Canada-wide and international charities and these activities brought him into contact with the leaders of the Jewish communities in France and Great Britain. From 1907 to 1913 he was president of the Canadian committee of the Jewish Colonization Association. In 1915, he helped organize the Canadian Jewish Committee for the Relief of War Sufferers, which sought to help the Jews of Russia. He served as honorary chairman of the campaign and contributed $19,000 to it. His activities in the political and cultural fields were more modest and less frequent. For a few years he was vice-president of Temple Emanu-El. He made a donation to McGill University to finance a course in Hebraic religious and literary studies in the Faculty of Arts, and he supported the Montreal Jewish press and Jewish education. For a short time, he was honorary president of the Federation of Zionist Societies of Canada, which was formed in 1899. He died suddenly, of a heart attack, at the age of 62. On 12 April 1928, thousands of people came out to watch the funeral procession from his residence on Pine Avenue to the Temple Emanu-El-Beth Shalom in Westmount. He is buried in the Temple’s cemetery on Mount Royal. Sir Mortimer Barnett Davis is remembered as a competent and determined man who was bold and energetic, but also as a fighter who brooked no opposition. At the time of his death, his personal fortune was estimated to be at least $50 million. His will provided for numerous bequests to relatives and friends, as well as a sum of $400,000 to be divided among four Montreal institutions: the Montreal General Hospital, the Notre-Dame Hospital, the Federation of Jewish Philanthropies, and the Young Men’s Hebrew Association. His principal heirs, however, were his son and his widow, who shared the income from his estate. The will stipulated that at the end of fifty years the capital should be paid to Davis’s children and their offspring. By 1978 his few descendants had long since died, his son in 1940 and his adopted son during the Second World War. Davis had, however, anticipated this: the will provided that his fortune should then be used for philanthropic purposes and that three-quarters of it should go to finance a hospital in Montreal. He wanted the hospital to bear his name and serve the needs of all the people in the city, but be run by a board of directors of which the majority would be Jewish. Unfortunately, he died before the major campaigns to raise money for the initial building began. That is why his name is not prominent among the original donors. In 1978, long after he died, $10 million from his

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estate was finally donated to the existing Jewish General Hospital by his executors. (The estate had mysteriously dwindled in those fifty years!) It was renamed the Sir Mortimer B. Davis Jewish General Hospital. The late Dr Robert Levine, a retired surgeon of the hospital, recounts the story of Sir Mortimer’s initial interest in a Jewish hospital. In 1924 (Levine was six years old at the time), Sir Mortimer’s son was diagnosed as suffering from an ischiorectal abscess by Dr Joseph Kaufman. Dr Kaufman was Sir Mortimer’s personal physician and one of the first Royal Victoria Jewish staff appointments. Since surgery was required, Dr Edgar Levine (Dr Robert Levine’s father), a surgeon at the RVH, carried out the incision and drainage in the improvised operating room in Sir Mortimer’s home, because the son had raised such a fuss about having to go to the hospital. Immediately after the surgery, Sir Mortimer convened a meeting in his study and told the assembled guests that he wanted to help build a Jewish hospital in Montreal.

chap ter four

m on t re a l a n d t h e j ew i s h com mu n i t y

Montreal in the 1920s was a sharply divided city, both socially and culturally:1 the wealthy were divided from the poor, the Jewish uptowner from the eastender, the anglophone from the francophone, the immigrant from the nativeborn, and the Gentile from the Jew. From its origins in 1929, the Jewish General Hospital would contribute substantially to bridging these differences and to promoting greater harmony for the benefit of all. Both Montreal’s population and that of the Jewish community within it had been growing rapidly for some time. Census figures reveal that the number of people living in Montreal, after more than doubling since the turn of the century, increased from 618,506 in 1921 to 818,577 ten years later. Since much of this increase resulted from immigration, a great deal of which was Jewish, Jews quickly rose to prominence as the third largest ethnic group in Montreal. After a gradual growth in the old, but small, Jewish community to some 8,100 persons in 1901, by 1921 its numbers had soared to 51,287, despite immigration being interrupted during the war years. Thus, in 1921 Jews accounted for a full 7 per cent of Montreal’s population. In 1930, Yiddish was the third most spoken language in Montreal. The city grew in other ways during the first decades of the twentieth century and began to assume aspects of its present appearance. Industry, already the heart of Montreal’s economy, continued to expand once the postwar recession was over. This trend was particularly visible in traditional industrial sectors – clothing, textiles, tobacco, and iron and steel products – as well as in some newer sectors, such as electrical appliances and oil products. Finance, while employing fewer people, played a major role in Montreal’s economy; the head offices of several banks, including Canada’s two largest (the Bank of Montreal and the Royal Bank), could be found on St James Street. Montreal also served as a centre of

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transportation. Canadian National Railway and the Canadian Pacific Railway were controlled from Montreal, and the city housed much of their subsidiary industries. Montreal’s port facilities, more prominent then than now, bustled with activity, and the city claimed to be the most important grain port in the world. Passenger liners figured prominently too; for example, on 19 August 1920, forty-six ocean liners were recorded to be in port.2 With this economic expansion came a host of building projects and public works which would give Montreal a number of its more familiar landmarks. The port facilities continued to undergo improvements and growth on a large scale, especially in the East, while not far away the Imperial Oil Company’s refinery was joined by those of British-American and McColl-Frontenac, now Texaco. The year 1925 saw the beginnings of construction work on the Jacques Cartier Bridge, Montreal’s second link with the South Shore, which opened on 24 May 1930, and reflected the increasing importance of automobiles as a means of transportation. This tendency was encouraged by rapid improvements in the city’s and province’s roads, as asphalt, gravel, and macadam replaced dirt and mud. Such changes did not occur overnight, though. In 1922, the Montreal Daily Star observed of Montreal’s streets that “to drive over them in an automobile or hack is positive torture, to cross even the most frequented is to risk limb and possible life by tripping over deep ruts and gaping holes.”3 Other landmarks to appear in these years were Saint Joseph’s Oratory, begun in 1924, and the Montreal Forum, which opened on 29 November 1924 to a record-breaking crowd of 9,000 spectators, who witnessed the Canadiens trounce the Toronto Saint Patricks by seven to one. Construction of the University of Montreal on Mount Royal began in 1928. While these developments were symptomatic of a generally booming economy and increasing wealth among the better-off groups in society, Montreal’s working people – and this included the great majority of the city’s Jewish immigrant population – were still suffering from extensive poverty. Improvements in working and living conditions came slowly. Unemployment, and especially underemployment, often seasonal, as well as pitifully low wages, particularly among the unskilled and the semi-skilled, combined to make poverty a common fact of life in Montreal. In 1926, the Department of Labour estimated that the required annual income for an average family was $1,590, most of which was taken up by the bare essentials of food, clothing, and shelter. The same year, the Family Welfare Association estimated that $1,101.76 was an absolute minimum for a family with three children. This did not include such “non-essentials” as

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health care, household utensils, savings, insurance, or entertainment. Even during the boom years of 1928–29, however, the average male wage-earner (including white-collar workers) received only some $1,321 annually, while, on the average, unskilled and semi-skilled workers earned only $836 and $1,000, respectively. Female workers were paid even less. This meant that more than one family wage-earner was very often a dire necessity. Younger children were sometimes left at home without care during the day and older children often found themselves working long hours so that the family could make ends meet. Even so, about 47 per cent of Montreal family incomes (based on full employment!) fell well below the $1,590 poverty line, with an additional 25 per cent just above it.4 Conditions would further deteriorate with the onset of the Great Depression in the winter of 1929–30. Poverty, along with a rapidly expanding population, brought a host of problems with which existing facilities could only partly cope. Quebec’s social aid system was antiquated and care for the needy was left entirely to denominational institutions. While Catholics and Protestants each had sizeable, although still sorrowfully insufficient, charity systems, needy Jews looked primarily to the Baron de Hirsch Institute, the principal Jewish charity organization in Montreal. The Public Charities Act, passed in 1921, provided only limited monetary support for existing institutions and did not change the structure of the system. Housing problems followed from poverty and an expanding population. This situation was aggravated by both a dearth of building regulations and a failure to enforce the few that did exist. Severe crowding, poor lighting (especially “dark rooms” with no windows at all), lack of air circulation, deep basement dwellings, and highly unsanitary toilet facilities were some of the more common hazards. Together they contributed greatly to undermining health in the city. Education also came under considerable pressure during these years, mainly as a result of the growing immigrant population. Much of this pressure, especially in the Protestant schools, arose on account of the great number of Jews who arrived in Montreal during the first two decades of the century. By 1915, 43 per cent of the Protestant School Board’s 22,606 pupils were Jewish. Despite the eighteen new schools erected since 1905, when enrolment had been half as high, officials still found it necessary to erect temporary classrooms.5 Current health problems – notably tuberculosis, but also a wide variety of other diseases – could be largely associated with poverty and poor living conditions. While the wealthy were less prone to suffer from some of these illnesses, and in any case were better able to afford the cost of a private physician, providing adequate health care for the many who could barely feed, clothe, and shelter

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themselves was a monumental task for which society was ill-prepared. Implementing effective preventive medicine posed a further problem. In the first decades of the twentieth century, however, health was one area where substantial gains, although far from adequate, would be made. Much of the reason for the inadequacy of health services in this era was the small role played by government, both in relieving the basic social ills at the root of so much of the general situation and in solving some of the more strictly health-oriented problems. Municipal health services had existed in Montreal since 1865, but for many years these had been insufficiently funded and had been concerned almost exclusively with sanitation. Both the municipal and provincial governments were slow to adapt to developments in the “germ theory” of disease, and while provincial acts passed in 1886, 1901, and 1906 authorized municipal boards of health to take preventive action, it was not made obligatory, nor were funds supplied. Despite over 2,500 deaths in Montreal from the smallpox epidemic of 1885–86, it was not until the epidemic of 1903 that compulsory vaccination was effectively instituted. In 1895, the mayor of Montreal, the enlightened Honoré Beaugrand, tried to get the population vaccinated, but faced great resistance from French-Canadians, resulting in many more deaths among them, especially children. It was only in 1918 that smallpox was successfully banished from the city. The mortality rate from diphtheria actually rose in Montreal during the first decades of the century, unlike other cities, where such deaths declined. No campaign for mass immunization against diphtheria took place until 1926 and this was undertaken by the Montreal Tuberculosis and General Health League, not by the Health Department. A neglect of health issues by government was also reflected in its spending patterns. A Survey of Public Health Activities in 1928 revealed that the Montreal Health Department spent an average of 38 cents per capita in the previous year, a paltry figure compared with the average of 78 cents per person disbursed by the health departments of twelve comparable American cities. Altogether, including subsidies and payments for services to private agencies by both municipal and provincial governments, $1.81 per capita, or a total of $1,271,164.63, was spent on health work in Montreal, with $782,377.99 of this being spent on “bed-side nursing and hospitalization of communicable diseases and tuberculosis.”6 The Survey noted that, according to the Public Charities Act of 1921, the municipality and the province would each furnish one-third of the cost of operating hospitals, sanatoria, and other institutions, but concluded that “in Montreal, private agencies are forced to bear a much larger share of the burden than they should have to carry, due to the meagre funds allowed the Department of Health for its

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work. The Municipality and the Province do give subsidies to some of the private agencies but the amounts given and the basis of giving are not satisfactory.”7 The survey further suggested that the failure of the Act to include home nursing services placed an unnecessary additional demand on the already scarce supply of hospital beds. The slowness of government in acting and its limited response were deadly. The ravages of smallpox and diphtheria aside, infant mortality, tuberculosis, and typhoid caused particular worry. By 1927, the number of babies dying before the age of twelve months had declined to about 113 per thousand, down from the period before 1911 when about one-third of babies born died within a year. Much of this improvement followed from improvements in the production, distribution, and storage of milk, including the spread of pasteurization. By 1926, when rules concerning the latter began to be enforced, 94 per cent of milk was already being pasteurized. Even then, however, unsanitary milk was traced as the cause of the typhoid epidemic of 1927, which killed 533 individuals. The infant mortality rate of 113 per thousand reached in 1927 was not a statistic of which to be proud and compared very poorly with the infant mortality rates of both Toronto and New York. Even in 1934, Mme. Telesphore-Damien Bouchard of Saint-Hyacinthe died of typhoid disease from contaminated milk. Much work was obviously still needed to lower the number of infant deaths in Montreal, about one-third of which were caused by diarrhea and enteritis (inflammation of the small intestine).8 Tuberculosis provided the other major health concern of this period, with much of the interest raised and action taken having been stimulated by the Montreal Anti-Tuberculosis and General Health League, which acted as a lobby group and central organization. One of the League’s directors was Michael Hirsch, a cigar manufacturer and former president of the Mount Sinai Sanatorium. He represented the Federation of Jewish Philanthropies and would subsequently play an important role in the establishment of the Jewish General Hospital. While efforts had already decreased the tuberculosis mortality rate from over 200 deaths per 100,000 inhabitants before 1919 to about 120 deaths per 100,000 people in 1927, much work remained to be done and Montreal still compared badly with other cities. Continued poverty encouraged the spread of this disease and public facilities for its treatment were woefully lacking. According to the Health Survey of 1928, while there had been at least 886 deaths caused by tuberculosis in the previous year, with a further seven to eight thousand active cases at the time of the report, only 713 hospital and sanatorium beds were available for tuberculosis patients. At least 350 more beds were immediately required for Public Char-

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ities Act tuberculosis patients alone. Meanwhile, the sixteen public health nurses engaged in tuberculosis field work in 1927 had been reduced to thirteen in May of 1928. Later in the year their numbers would be further depleted when the impecunious Montreal Anti-Tuberculosis and General Health League’s discontinued its services.9 Clearly, health services in Montreal during the 1920s were under great strain. To relieve this would require vast resources, the supply of which depended on sacrifices by the city’s inhabitants. Soon, the Jewish community in Montreal would come forth to furnish much of the vitally necessary help. By the late 1920s, the Jewish inhabitants of Montreal formed a quickly maturing community within the city’s larger society. The Jewish population had grown substantially during the previous decades and, although by no means homogenous, it was rapidly developing a sense of community, an identity apart, and was giving birth to a series of institutions to serve its own particular religious and social needs. Before the twentieth century, Jewish Montrealers were concentrated in what is now downtown, in the area just north of Old Montreal and, to a lesser extent, to the west. Social and economic divisions between them increased with the passage of time, however, encouraged by the city’s continued growth and industrialization, as well as by the different situations facing recent immigrants and those whose migration was well in the past. From this emerged two very distinct sectors of the Jewish community. In the western part of the metropolis – Westmount, Notre-Dame-de-Grâce, and upper Outremont – lived the wealthier Jews, including community leaders such as the Bronfmans and Lyon Cohen. This group consisted largely of those who had either been born in Canada or had immigrated from the United States or Great Britain. Most of them came to Montreal for its economic opportunities rather than to escape the pogroms and persecution facing so many of their fellow Jews. Others had come from continental Europe, but generally these had been in Canada for quite some time. The Westmount and Notre-Dame-de-Grâce Jews numbered 4,079, according to the 1931 census. They were often viewed by the mass of poorer Jews as trying to emulate the non-Jewish population and as the owners of factories employing the poorer Jews. This earned Jewish Westmounters the unsavoury label of “assimilationist,” attributed to them by the Kanadar Adler, Canada’s first Yiddish newspaper. In contrast to the west-enders, the great majority of Montreal Jews lived east of Mount Royal, in a world of immigrants, working-class housing, and small shops. Canadian Jews who had neither arrived wealthy nor become upwardly

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mobile, the “green” immigrants who had come more recently, moved north with the growth of the city, from the downtown area of original settlement to a district outlined by Sherbrooke Street on the south, Mount Royal Avenue on the north, Esplanade Avenue and Bleury Street in the west, and Saint-Denis Street in the east. Starting about 1911, the Jewish population gradually spread northwards as far as Van Horne Avenue, into an area bounded by Henri-Julien Avenue in the east and Hutchison Street in the west. In the 1920s, this same movement had also begun to enter Outremont, which contained 6,783 Jewish inhabitants by 1931. Many of the poorer Jews were relatively recent immigrants. They had arrived mainly from Eastern Europe, especially Russia, Poland, Austria-Hungry (before 1914), and Romania (after the First World War) fleeing pogroms and other oppressive forms of discrimination. For instance, Samuel Goldbloom, the father of Dr Alton Goldbloom, had been forced to leave Lithuania at the age of seventeen to escape poverty, residential and occupational restrictions, and service in the czar’s hated army, where it was impossible to observe Jewish rituals. These immigrants, who spoke Yiddish and the languages inherited from their various countries of origin, brought little with them but their families, their traditions, a very few personal possessions, and perhaps knowledge of some kin or fellow villager who had crossed the Atlantic in earlier days. As recent immigrants, short of money, they were generally absorbed into the lower echelons of the work force, often in textiles or clothing, which were concentrated in the heart of Jewish Montreal. Others adopted peddling as a livelihood, and, as with most immigrant groups, those with a little capital frequently opened small shops. The lack of jobs in the general society drives immigrant groups to set up self-employment possibilities even today. The only housing many of these Jews could afford was the crowded, insalubrious kind typical of working-class Montreal at the time, which contributed so much to the city’s health problems. Dr Alton Goldbloom, whose three siblings died there as infants, recalled the small apartment where he spent his first five years as “a small flat with running water – cold only – and no bath or toilet. Lighting was by kerosene lamps. A latrine in the back yard smelt to high heaven; there were flies, manure and dirt.”10 Of course, such extreme poverty was not everyone’s lot, and some east-end families even attained a degree of prosperity. Clearly, though, the condition of many Jews cried out for improvement. Health services, both preventive and curative, would form an essential part of this much needed amelioration.

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As Montreal’s Jewish community grew in size, so did its institutional requirements. In response to this, by the late 1920s an extensive network of establishments had been formed to look after Jewish religious, educational, charity, leisure, and health needs. The Jewish General Hospital would form part of this institutional development. Religious institutions developed first. Canada’s original congregation, the Congregation of Spanish and Portuguese Jews, or “Shearith Israel,” was founded in Montreal as early as 1768 by Jews who had entered Canada with the British army at the time of the Conquest. This tenacious Sephardic congregation, which built a permanent synagogue in 1777 and received its first rabbi the following year, put down strong roots and has thrived to the present day. First on Chenneville Street and later on Stanley Street, the Shearith Israel Synagogue is now located on Saint Kevin Street, not far from the Jewish General Hospital. Montreal’s (and Canada’s) second synagogue appeared in the middle of the nineteenth century, by which time enough Ashkenazi Jews had come to Montreal to justify the formation of a congregation of their own. In 1846 they obtained a charter as the Congregation of English, German, and Polish Jews, and in 1858 they built their first permanent synagogue on Saint Constant Street. When the congregation moved to larger accommodations on McGill College Avenue some twenty-eight years later, its members decided to give a new name to their synagogue and settled upon “Shaar Hashomayim.” In 1922, this rapidly growing congregation moved to a yet bigger location, this time in the heart of Westmount, where an immense synagogue had been built at the astronomical cost of over half a million dollars. On occasion, as many as 2,000 members of the Shaar Hashomayim congregation, then the largest in Canada, would worship together. By 1926, at least thirty-three more synagogues had been established in Montreal. While the great majority of these were orthodox, Reform Judaism had already penetrated Jewish Montreal, primarily in the form of the Congregation Temple Emanu-El, which was founded in 1882 and which was also located in Westmount. In contrast to the west-end synagogues, however, most congregations had to make do with dingier, ill-equipped, and ill-financed quarters located in the older and more easterly part of Jewish Montreal. Some of these did not even have a permanent building or room for worshipping, due, not to a lack of generosity, but to a lack of means. The willingness of all sectors of the Jewish population to donate what they could to worthy causes, even if no more than nickels and dimes, had already been demonstrated, and would soon be shown again in the campaign to establish a Jewish hospital in Montreal.

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Connected with the growing number of synagogues and of Jewish immigrants in Montreal, several forms of specifically Jewish educational institutions had been founded by the late 1920s. Ever since the foundation of the first Montreal synagogue in the eighteenth century, some instruction in Judaism and Hebrew had been offered to Jewish children, and in 1846 the Reverend Doctor Abraham de Sola of Shearith Israel opened a day school to provide education in other subjects as well. The Baron de Hirsch Institute operated a comprehensive day school for poor children, including education in English subsidized by the city’s Protestant Board of School Commissioners. In 1907 the subsidy was withdrawn and the Jewish pupils were accommodated in the city’s Protestant schools. The Baron de Hirsch Institute continued to offer daily courses in Hebrew and religion, as well as a night school for adults and a Sabbath school. Religious training in Montreal was often gained through the medium of the synagogue, which served as both Beth Hatefillah (House of Prayer) and Beth Hamidrash (House of Study). By the 1920s, however, the greater part of education in Hebrew language and literature, Jewish history, folklore, and religion was received at a cheder (room school), from one of the numerous melamdim (itinerant private teachers) – who, according to the principal of the Folks’ Schule, “provided the Jewish children with a smattering of nothing”11 – or from one of the more substantial independent Jewish schools. Of the latter, the Talmud Torahs attracted the most pupils. The first Talmud Torah in Montreal was founded in the late 1890s and began to teach Hebrew language, literature, history, and especially religion. By 1917, this Talmud Torah, officially called the Montreal Hebrew Free School, had been joined by four others, together forming the United Talmud Torahs of Montreal, with 800 pupils in all. In 1924 they had eight branches, with some 1,250 pupils, as well as a yeshiva (advanced school) with fifty-seven children enrolled. Students of the Talmud Torah, like those of the other independent Jewish Schools, would attend one and a half to two hours per day, five days a week. The Talmud Torahs, whose focus was on religion, received the strong support of synagogues.12 The other important independent Jewish schools were all of a more left-wing bent and located in the less opulent part of Jewish Montreal. The Jewish People’s School, or Folks’ Schule, was founded in 1914 by local members of the PoaleZion, a world socialist-Zionist party. It taught culture, history, political economy, Hebrew, and Yiddish, and emphasized both the importance of building a Jewish homeland in Palestine and the mildly socialist outlook of the school’s founders. Religion, while taught, was given a secondary place, and thus the Folks’ Schule did not receive the support of synagogues. By 1924 it had 500 pupils in its two

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branches and had begun to give high-school-level courses. Politically more radical were the three branches of the Peretz Schulen. Founded in 1912 and serving some 350 pupils, these schools taught Yiddish, only a little Hebrew, and tended to emphasize socialism more and Zionism a bit less than the Folks’ Schule. Another type of school, established in 1927, was also more radical. These Workmen’s Circle Schools, or Arbeiter Ring, educated about 200 pupils, and taught Yiddish, history, biographies, and “social knowledge.”13 Apart from synagogues and schools, which were the most widespread Jewish institutions in Montreal, social and cultural organizations had also been established by and for all levels of society. Members of the economic elite could retreat to the plush luxury of the Montefiore Club on Guy Street to spend their leisure hours. This organization, founded in 1880 as a social and dramatic club, devoted some of its activities to philanthropic purposes, although its main function remained one of providing pleasure and relaxation for its wealthy members. Men with less money might join the Young Men’s Hebrew Association, which began its services in 1910. The YMHA building on Mount Royal Avenue owed its construction to Sir Mortimer B. Davis, whose trust funds later helped in the tremendous subsequent growth of the JGH. During the 1920s the YMHA offered its members (about 1,000 in 1926) a range of sports facilities and activities, as well as an orchestra, and had recently also branched into dramatic societies, choral work, chess, checkers, and billiards. It soon offered an even wider choice of leisure pursuits. Women and girls could turn to the Young Women’s Hebrew Association, on Clark Street, which in 1926 boasted a growing membership of 550. This organization provided purely social activities, such as dances, concerts, tobogganing parties, and summer camping, as well as more serious courses in languages, occupational skills, and homemaking. It also organized the first Jewish troop of Girl Guides in 1919. Recreation for the whole family might be obtained through Neighbourhood House, a Jewish agency established in the northern part of the city in 1926, which enrolled almost 1,000 children within its first month of operation. Other social and cultural activities were organized by the Jewish Public Library (founded in 1914), the Yiddish Theatre Group, national fraternal organizations, schools, and religious, and labour groups. Another form of institution that was growing in importance during the 1920s was that intended to promote the interests of Jews in general and to favour the creation of a Jewish homeland in Palestine. In 1898 Jews formed Canada’s first Zionist society (named the “Agudath Zion of Montreal”), although organized Zionist activities had taken place since at least 1887. The most important body in Montreal in this matter was the Canadian Jewish Congress, which coalesced

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in 1919 when Lyon Cohen, Hirsch Wolofsky, and others managed to unite the two principal Zionist blocs, the Canadian Jewish Alliance and the Canadian Zionist Federation, which had hitherto been at odds with one another. Montreal’s Zionists could also work through groups such as the Zionist Organization of Canada and its sister body, the Hadassah (the Women’s Zionist Organization of America), the Jewish Colonization Association, the Poale Zion, and the Workmen’s Circle. Linked with the Zionist movement and reflecting the development of the Jewish community in Montreal was the growth of a Jewish press. Despite a number of failed attempts, several newspapers became successful. The principal newspapers of Montreal Jewry during the 1920s were the Canadian Jewish Chronicle and the Yiddish Kanadar Adler (or Jewish Daily Eagle). The former initially appeared as The Jewish Times in 1897, when Lyon Cohen and S.W. Jacobs founded this biweekly to give Canadian Jews a mouthpiece and to counter the antiSemitism expressed in local papers as a result of the infamous Dreyfus case. Perhaps because its first editor, Carol Ryan, was a Gentile (although sympathetic to the Jewish community) and because its founders were wealthy west-enders, The Jewish Times mainly served the interests of the assimilation-prone uptowners, with more interest in social events than in ways to improve the hard lives faced by the poorer Jews of Montreal. In 1907, the Polish-born Zionist Hirsch Wolofsky founded the Kanadar Adler to strengthen Yiddish communication and culture in Montreal and to promote Zionism. This newspaper, which quickly became a daily publication, used unrestrained and emotional language to appeal to its largely east-end readership and remained highly critical of its anglophile competitor. In 1914 Wolofsky bought out The Jewish Times. Although he kept English as its language of expression, he renamed it the Canadian Jewish Chronicle and altered its orientation to reflect that of the Kanadar Adler. Jewish social aid institutions had also developed extensively by the late 1920s. The relatively recent arrival of much of the Jewish community and the fact that more would be arriving, often as refugees, meant that establishing an effective social aid system was particularly vital. Since 1917, the coordination of such a system was done through the Federation of Jewish Philanthropies of Montreal, which had its offices in the Baron de Hirsch Institute. However, while this organization was responsible for coordinating Jewish philanthropic societies and raising and distributing funds, the task of giving the aid itself was left up to the member societies. The oldest of these was the Baron de Hirsch Institute, which had been founded in 1863 as the Young Men’s Hebrew Benevolent Society. (Montreal’s first Jewish

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charitable organization had been the Hebrew Philanthropic Society, established in 1848.) For many years, the Young Men’s Hebrew Benevolent Society (YMHBS), with help from the Jewish Immigrant Aid Society, looked after most of the Jewish community’s charitable needs, particularly those of the immigrants. In the 1880s, when Russian pogroms brought large numbers of penniless Jews to Montreal, the Society came under particular pressure and survived financially only through the generosity of the great Jewish philanthropist, Baron de Hirsch, whose assistance reached needy Jews in many countries over many years. This support, which would continue even after the death of the baron and baroness, permitted the YMHBS, now renamed the Baron de Hirsch Institute, to move to larger quarters on Bleury Street, where it was able to diversify and improve its services. When Jewish Immigrant Aid Services were reorganized in 1927, the Baron de Hirsch Institute accepted responsibility for all Jewish immigrant relief. As well as providing resources for those who would otherwise starve, by 1929 the Baron de Hirsch Institute offered its school, a library, and reading room, a book club, a cemetery at Sault-au-Recollet, an employment bureau, some recreational facilities, a legal aid department, and offices for the Federation of Jewish Philanthropies. Other charitable organizations belonging to the Federation included the Ladies’ Hebrew Benevolent Society, founded in 1877 to provide clothing, coal, and cash, as well as friendly visits to poor women and children; the Hebrew Ladies’ Sewing Society, which made garments for the needy; the Montreal Hebrew Orphans’ Home; the Montreal Hebrew Old People’s and Sheltering Home; the Ladies’ Jewish Endeavour Sewing School; the Young Women’s Hebrew Association; the Hebrew Ladies’ Aid Society; the Friendly League of Jewish Women; the Mount Sinai Sanatorium; and the Herzl Dispensary. Outside of the Federation, charitable aid was also given by the Grace Aguilar Chapter of the Imperial Order of the Daughters of the Empire, founded in 1916 by various committees of the Montreal Council of Jewish Women, and from 1911 by the Hebrew Free Loan Association (HFLA). This society, modelled after the Gemilath Chasadim associations of Europe, offered loans in sums ranging from $5.00 to $200.00 (raised to $500.00 in 1935) without any interest or other charges. Up to 1924, 12,067 loans had been made, amounting to $677,578.73, with losses amounting to only $700.00. By the end of the Great Depression, almost two million more dollars would be loaned. The HFLA celebrated its 100th anniversary in 2011.14 By 2014 it had loaned over $125,000,000 to over 97,000 borrowers. Loans might also be acquired from one of the loan syndicates that had arisen out of the east-end Jews’ spirit of cooperative self-reliance. These syndicates, of which there were about fifty during the 1920s, with a membership of some 8,000 persons, had been

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formed by small businessmen and members of the working class who were able to put some of their earnings aside. Loan syndicates would become of great importance in raising money to establish the Jewish General Hospital. Also of great importance in the institutional development of the Jewish community of Montreal were the various services and organizations established in response to the community’s urgent health needs. These took the form of both private cooperative efforts and public charitable organizations. The former, called sick benefit societies, numbered about fifty and also contributed very substantially to the initial fundraising for the Jewish General Hospital. Montreal’s sick benefit societies, the first of which was founded in 1892, served a double purpose. On the one hand, the meetings of members gave an opportunity for family members, immigrants from the same region or fellow employees, to convene to discuss their shared problems and to recall the years before leaving their land of origin. On the other hand, and more important, membership in a sick benefit society gave Jewish workers and recent immigrants a degree of security in a time before the socialization of health services. In exchange for annual dues (usually about three dollars for a single person or five dollars for a family), a member would receive sick benefits and medical care from a society doctor in case of illness, or cemetery rights in the event of death. While this system was evidently advantageous to the members, society doctors were not as well off. The Jewish doctors (usually recent graduates) who were forced into this position, received a meagre income for their efforts, and even less status – in fact, the lowest in the profession. Often, if the sick member or his family could afford it, the visit of a society doctor would be followed by consulting with a more prestigious practitioner. The hiring system contributed further to the lowly position of society doctors and encouraged dissension within the ranks of the profession. As Dr Mordecai Etziony has commented: Candidacy of a doctor “running for election” in any one Society was a degrading experience. It was a matter of “pull” with members. Agitation and even fights occurred at the election meetings. There were actually instances of competing doctors being lined up on the platform and the merits or demerits of each candidate presented. “Lectures” on health matters, and, incidentally, ability to exhibit “know-how” were factors which some time prior to the election became prime considerations for one’s eligibility. As a result of these conditions the Jewish physicians, generally speaking, were thought of as a “necessary evil” and not being worthy of much more than minimal consideration.15

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Naturally, as soon as a society doctor had developed enough of a private clientele, or found some other chance, he would leave the society practice to raise his status and to increase his opportunities for a more substantial revenue. The Jewish public and charitable health services available during the 1920s were provided mainly by the Herzl Dispensary, the Mount Sinai Sanatorium, the Hebrew Consumptive Aid Society, and the Hebrew Maternity Hospital. The first Jewish charitable health service in Montreal began when the Baron de Hirsch Institute obtained a new charter in 1900 and extended the range of its relief activities. A medical department was established and a doctor engaged to visit and treat poor Jewish patients in their homes as well as to provide some care for the ill who were still ambulatory. The first physician hired was Dr David Alexander Hart, the great-grandson of Aaron Hart, who settled in Trois-Rivières in 1760 and established the oldest Jewish family in Canada. Dr Hart was succeeded by a French doctor, who became so popular and familiar with his patients that they would often mistakenly begin to converse with him in Yiddish.16 After a decade, this service proved to be quite insufficient for the needs of the rising Jewish population, and ended in 1912 when the Herzl Dispensary began to operate a proper clinic. The Baron de Hirsch Institute assisted in the establishment of the Herzl Dispensary and the Mount Sinai Sanatorium and would maintain connections with these newer Jewish medical facilities through the medium of the Federation of Jewish Philanthropies. The Herzl Dispensary, named after Theodor Herzl, the “Father of Zionism,” originated in a meeting of doctors, community leaders, and other interested citizens and organizations, held on 1 January 1912. Those present agreed upon the necessity of working toward establishing Canada’s first Jewish clinic. This project received particularly strong and active support from Dr Simon Sperber, a physician with a position at McGill University; Dr David Tannenbaum; Dr N. Schacher, soon to be assistant accoucheur of the Hebrew Maternity Hospital; and Dr Samuel Ortenberg, as well as Mrs Taube Kaplan, Mrs Adler, Mrs Rost, Mrs Bloomberg, and Messrs I. Goldberg, B. Steinhouse, and L. Goldman. Sufficient funds having been raised, the “Herzl Hospital and Dispensary” first opened its doors to the indigent sick on 2 June 1912, in a small rented building on St Dominique Street, just off Prince Arthur Street. The great demand upon its services required a move to more adequate quarters: first, in May 1914, when a larger building was acquired on the corner of Saint Urbain Street and Milton Street; later, to Jeanne Mance Street, just north of Mont-Royal Avenue, and, much later, to the Côte-des-Neiges area, when the Jewish population shifted westwards. By the mid-1920s, the Herzl Dispensary, which offered services in

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Yiddish, consisted of twenty Jewish physicians and treated an average of about 1,000 patients per month. It included Medicine (all branches); Eye, Ear and Nose; Nervous Diseases; Skin Diseases; and X-ray Departments, as well as a dental service and a pediatric clinic, begun, respectively, in 1922 and 1932. The dispensary also handled cases of tuberculosis before they were admitted to the Mount Sinai Sanatorium and surveyed their recovery upon discharge. In 2012, Herzel celebrated its 100th birthday. Once the Jewish General Hospital had opened and began to look after the treatment needs of the Jewish community, the Herzl Dispensary turned its focus toward preventive medicine. Vaccination was promoted on a large scale. Herzl’s nurses would visit babies born at the Jewish General Hospital and advise their mothers. It also offered a referral service and put much emphasis on re-educating the community in health matters. In 1956 the Herzl Dispensary launched an adult well-being clinic, which remained open weeknights to permit daytime workers and housewives to attend. Eventually, family planning and psychological work for schools were included, as well as services to golden-age groups, summer camps, and Jewish day schools. In May 1974, the Herzl Health Centre, as it was then called, merged its activities with the Family Medicine Department of the Jewish General Hospital, where its unique tradition of caring continues to aid Montrealers of all persuasions and ages. The renamed Herzl Family Practice Centre at the JGH received the Community Service Award of the Allied Jewish Community Services the following year. The next Jewish health facility to open was the Mount Sinai Sanatorium for tuberculosis patients, “situated on one of the loftiest and most beautiful spots in Sainte-Agathe,” about 60 miles north of Montreal.17 The hospital was founded in 1909 in St Agathe des Monts, by members of the Jewish community who recognized a need for a tuberculosis sanatorium. This kosher institution, named according to the tradition that the first Jewish hospital in any community be called “Mount Sinai,” was built on 160 acres of land provided by the Jewish Colonization Association. A host of subscriptions was raised by Rabbi Herman Abramowitz of the Shaar Hashomayim Congregation and large donations arrived from wealthy benefactors, including Jacob A. Jacobs, A.M. Vineberg, Mark Workman, and Sir Mortimer B. Davis. When the sanatorium opened it consisted only of a converted farmhouse and contained but twelve beds. Soon, however, a spacious new edifice was erected with a capacity for forty-eight patients, and care was extended to include cases of advanced tuberculosis as well as the incipient cases for which the sanatorium had originally been intended. A few children were admitted, although facilities

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The Herzl Dispensary, Jeanne Mance Street. Jewish General Hospital Archives, 1x11_9_9_2.

did not really exist for their specific needs. By 1926, the Mount Sinai Sanatorium could proudly claim that: No paying case has ever been allowed in the Sanatorium, which was intended solely for those of the poor (both Jewish and non-Jewish) who could not afford any payment whatever, and in this way a real service to the community has been performed as these unfortunate people have not only been removed from the city where they were a menace to those with whom they spent their daily lives, but they have been in so many cases fitted to take once more their places among their fellows, armed with a new lease on life.18

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As well as its curative function, the Mount Sinai Sanatorium took an active interest in prevention and to that end published a monthly bulletin in English and Yiddish, with articles on tuberculosis and hygiene. It also instituted a follow-up policy, in conjunction with the Herzl Dispensary, to see that discharged patients had suitable occupations and surroundings to prevent a recurrence of the disease. The threat of tuberculosis had diminished greatly by the 1950s, and Mount Sinai became an intermediate care facility specializing in chronic obstructive pulmonary diseases such as emphysema, bronchitis, asthma, and other respiratory illnesses. Mount Sinai subsequently moved to Montreal in 1990 to be closer to the population it served, with 107 beds, an out-patient department, and a wide range of diagnostic and treatment services. It contains modern laboratory facilities, operates important occupational and physical therapy programs, and participates actively in community awareness projects such as the annual Health and Tobacco Educational Week. The Hebrew Consumptive Aid Association, founded in Montreal in 1906 to provide material relief to victims of tuberculosis and their dependents, worked in cooperation with the Mount Sinai Sanatorium in its first years. During the 1920s, this organization, which received support from both Jews and Gentiles, gave aid to about 200 consumptives each year. The other major Jewish medical service offered in Montreal before the opening of the Jewish General Hospital was the Hebrew Maternity Hospital. This institution appeared as a result of the dreams and the indefatigable work of Mrs Taube Kaplan, a poor woman who lived on Cadieux Street (now de Bullion Street), who supplemented her husband’s meagre income by teaching Hebrew and religion to boys. Mrs Kaplan, affectionately known to the community as either the “Greene Rebitzin” or the “Greene Yiddene,” chose for her life’s mission the creation and extension of hospital facilities for Montreal Jewry and probably contributed more than any other individual, at least in terms of effort, to the fulfillment of that dream. Having begun her work as one of the principal fundraisers in the campaign to establish the Herzl Dispensary, and having gained recognition for her great contribution to that endeavour, the “Greene Rebitzin” soon formed a new and more ambitious plan. She was aware of the plight of Jewish patients in Gentile hospitals, where kosher food was unavailable or had to be brought in from outside, as well as of the language barrier faced by many recent Jewish immigrants. She also knew the sorry state of obstetrics at the time, particularly for poor Jewish mothers and their babies. Prenatal care, where not absent entirely, was minimal. Doctors were called in to the home only during labour, and complications were serious, numerous, and urgent. Eclampsia,

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Mrs Taube Kaplan, the “Greene Rebitzin.” Jewish General Hospital Archives, PF7_9_1_1a.

abruptus placentus, placenta praevia, hemorrhages, and complications from tuberculosis and cardiac diseases occurred frequently, not to mention the danger of diseases to the newborn infant in the days and weeks following birth. With this in mind, and largely unaware of all that it would require, Mrs Kaplan embarked on a personal campaign to establish a maternity hospital for Jewish and other women. From that moment, she began to raise money, as she would for many years, by going from house to house, especially in the east end, where many were as poor as she was, collecting pennies, nickels, dimes, and quarters from anyone who had anything to spare. Eventually, after years of tramping through the streets by day and by night, in winter and in summer, she raised $7,000, enough to make the first payment on a house a few blocks further north of her own humble home on Cadieux Street. With the help of donors and fellow fundraisers, primarily Mrs M. Goldberg, Mrs M. Meltzer, Mrs R. Kositsky, and Dr N. Sperber, the Hebrew Maternity Hospital of Montreal was finally incorporated on 5 March 1915 and opened on 19 November 1916. The new hospital suffered from a chronic shortage of room and for some time lacked adequate funds. After starting with fourteen public beds and a private room, in 1919 the hospital corporation bought the adjoining building and expanded the institution’s capacity by eight beds. This was still not enough to meet the demands upon its services, however, and its directors did not give up the hope of further expanding or building a larger edifice on new grounds. In 1919,

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the Maternity Hospital succeeded in raising $57,829.25 in subscriptions for this purpose, although that sum was not enough to carry out the project.19 The state of the facilities in the Hebrew Maternity Hospital also left something to be desired, and when the Montreal Board of Health raised its standards on the occasion of the influenza epidemic of 1918, the hospital found itself forced to close for almost three months. Nevertheless, it had an excellent medical staff, including Drs M. Lauterman, J.R. Goodall, Dunstan Gray, M. Wiseman, S. Eidlow, N. Schacher, N. Freedman, J. Budyk, I.B. Hirschberg, and D. Tannenbaum, and these men achieved excellent medical results. Maternal mortality was absent and morbidity (the condition of being diseased) was kept to a level respectable enough for any similar hospital.20 By the mid-1920s, the hospital was treating an average of about 400 patients (including both women and infants) every year. It also opened a clinic service for pre- and post-natal care and advice and initiated long-term research to find a vaccine against tuberculosis.21 In December 1920, the directors of the hospital arranged for the creation of a Women’s Auxiliary, which had a membership of about 850 within six years. These generous women took upon themselves the responsibility for several aspects of the hospital’s operation, including: the investigation of dietary and sanitary conditions, the supply of linen and utensils, purchasing clothing for women and baby patients, donations, treats for patients, and the investigation of cases to determine whether to admit them free or on a partial payment arrangement. One might have expected to find the indefatigable “Greene Rebitzin” carrying on her work at the head of this Ladies’ Auxiliary, or perhaps even as a member of the Hebrew Maternity Hospital’s board of directors. However, she was resolutely focusing her tireless efforts on a new project, this time much larger in scope than any in which she had previously participated: the creation of a spacious general hospital, run by and largely for her fellow Jews.

chap ter five

t h e d re a m

The founding of the Jewish General Hospital was truly a community effort. The resources required for this important link in the institutional development of Montreal’s Jewish community were pooled by Jews of all backgrounds and socioeconomic levels. Painstaking efforts on the part of some, the gift of a few hours of spare time on the part of others, and a willingness by all to donate to a more than worthy cause, permitted the establishment of this life-saving monument to Jewish generosity. The credit for the initial impetus, however, must be attributed to a much smaller group of far-seeing and public-minded individuals who, when they became aware of the growing need for hospital facilities, recognized this as a call to action. The first apparent attempt to found a Jewish-run general hospital in Montreal was by Dr Hyman Lightstone, the honorary physician of the Baron de Hirsch Institute, and Dr Norman Viner. In 1907 these two young doctors attempted to raise enough money to establish a hospital so that greater opportunities might be available to Jewish practitioners. Although well meaning, they simply did not have the resources or time to carry out their aims effectively. In 1959, Dr Viner recalled how: Each of us with a little notebook in his hand, began to canvas our wealthier compatriots, requesting the hoped for donors to sign for $1,000 and $2,000 towards the erection of a hospital and correspondingly, $100 or $200 towards the annual maintenance. I wish I had those two little notebooks today as a footnote to our communal history. In any case, we met with some pleasant receptions and, for the era, a fair number of contributions. Of the number who signed, I regret to say I now only remember three, namely,

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sir mortimer b. davis jewish general hospital the late Mark Workman, Hiram Levy and Jack Jacobs … However, Lightstone and myself found this a very time-consuming effort. We had our budding practices, hospital duties and the necessity for making a living to consider. Though our attempts received fair recognition they did not build up fast enough in contributions to build a hospital, so that after a few months we reluctantly dropped the venture. But I never forgot the purpose.1

Mrs Taube Kaplan and her supporters were the next to endeavour to establish a Jewish general hospital. Not long after the Hebrew Maternity Hospital had opened, the “Greene Rebitzin” resumed her door to door canvassing, this time using a rubber stamp reading “Neta Israel Hospital (The Plant of Israel Hospital), organized 12 February 1917.”2 Despite the fact that Mrs Kaplan’s methods and lack of connections in the west end meant that her fundraising was a slow laborious process, in the long run her efforts paid off. Helped by the Jewish tradition that anyone who asks for help must not be turned away empty-handed, by the middle of the 1920s the pennies, nickels, dimes, and quarters she had collected amounted to over $7,000. She offered this to the leaders of the more organized undertaking being formed by the Hebrew Maternity Hospital and the Montreal Clinical Society, an association of the Jewish doctors of Montreal. Her work did not end there, though; with her followers, she continued to contribute money and equipment under the name of the Sir Herbert Samuel Society, named after the British High Commissioner, whom she viewed as the first Jewish “president” of the Holy Land. The “Greene Rebitzin,” who was an old woman by the time the Jewish General Hospital actually opened, would later demonstrate the selflessness of her motives by turning down an offer from Allan Bronfman, president of the hospital, to have one of its wards named after her. Instead, she suggested that the ward bear the name of Sir Herbert Samuel, after whom she had previously wished the entire hospital to be named. Mrs Kaplan entered the Montreal Hebrew Old People’s and Sheltering Home on 22 November 1938, and died there on 2 August 1940, a great loss to the entire community. The staff and directors of the Herzl Dispensary also favoured the establishment of a Jewish-run hospital from an early date and hoped to form the nucleus of this dreamed-of institution, whose need was increasingly visible. The annual report of the Herzl Dispensary for the year 1919 put the matter bluntly: “We are compelled to turn away many cases as they are really hospital cases. When we recommend these cases to hospitals in most instances they are not admitted because of the lack of room. Our doctors feel this stress so keenly that we are left open to one question only. Is it not time for our Montreal Jewry to come for-

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ward and establish a JEWISH HOSPITAL?”3 The Herzl Dispensary, eventually absorbed by the Jewish General Hospital, played only a minor role in the events leading to the foundation of the hospital. Its staff would contribute more as individuals and through other organizations, such as the Montreal Clinical Society. Of more importance in the movement for the establishment of the Jewish General Hospital were those associated with the Hebrew Maternity Hospital. Its directors had favoured expansion for some time, due to their institution’s acute lack of space, and in 1920 they purchased a lot on Esplanade Avenue. Plans and specifications for the construction of an enlarged maternity hospital were drawn up and a call for tenders issued. These would not be opened when the moment came, however, because by that time a number of Jewish doctors had lobbied the hospital’s directors to consider the possibility of cooperating with other organizations to construct a hospital on an even grander scale. The directors suspended the Esplanade Avenue project and before long sold the lot in question to the Montreal Hebrew Old People’s and Sheltering Home to erect its new building. Two other immediate attempts to relieve the growing pressure on the Hebrew Maternity Hospital’s facilities were initiated, without success. On one of these occasions, the hospital submitted an offer to purchase the Montreal Maternity Hospital. The proposal arrived two hours too late. The directors later requested a permit to build in Outremont, only to have the municipal authorities turn them down. While some of those connected with the Hebrew Maternity Hospital, such as C.B. Fainer, continued for a time to propound above all the need for a larger Jewish maternity hospital, others quickly became convinced that the construction of a general hospital that would include facilities for maternity cases would provide the best solution to many of the Jewish community’s health problems. A committee was established to consider this question and, after much debate, it concluded that the most advantageous course, for themselves and for others, would be to apply for a new charter as both a general and maternity hospital. To further discuss this and to begin the process of drumming up support for the project, in early January 1925 one of the directors, Rabbi Max J. Merritt of the Temple Emanu-El congregation, drew up a letter addressed to the Montreal Clinical Society, asking for a conference between representatives of both organizations. The Montreal Clinical Society was founded in 1923 by Drs Nathan Freedman and Samuel Ortenberg. Its several purposes were inserted in the Society’s constitution at its first meeting, held in the Herzl Dispensary. As one of their aims, members chose “to increase the medical knowledge of members by means of

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meetings to be held at stated intervals, at which will be presented Lectures, Papers, and Communications with Discussions germane to them.”4 They placed particular importance on the educational role, due to the need to raise the status of Jewish doctors in Montreal and to facilitate their access to Montreal hospitals, not to mention the Medico-Chirurgical Society. This object would be carried out effectively with the help of local and international guest lecturers. The members of the Clinical Society also intended to improve the unsatisfactory relationship between the sick benefit societies and their doctors, a situation highly injurious to the physicians and the medical profession in general. The Clinical Society’s thirty or so members (out of a total of about fifty Jewish doctors in Montreal) took this up at the third general meeting, and appointed a committee to deal with the matter. The committee soon drew up a set of rules that would have fixed the hours of duty in the doctor’s office and the patient’s home, established an annual stipend of $1,200, and formed a body of three impartial members to supervise the application of the rules and to make all medical appointments to the sick benefit societies. The doctors on the committee approved the proposed regulations, with the exception of one member who refused to consent to the set annual fee. On account of that one dissenting voice, the committee felt obliged to abandon the whole plan. While for a time discord prevented the problems facing the society doctors from being resolved, eventually the sick benefit societies would themselves voluntarily come to a more satisfactory arrangement. The aims of the Clinical Society also included stimulating medical research, aiding in all attempts to improve the health and longevity of the community, promoting the maintenance of ethics in the practice of medicine, and keeping harmony between doctors. Last, but certainly not of the least importance to the members of the Clinical Society, their organization pledged itself “to encourage all practical efforts towards the erection of a Jewish General Hospital.”5 The association began to consider the question of establishing a new Jewish hospital from May 1924. Starting at this period, when plans for building a hospital took up much of the business portion of each meeting, the group’s attendance rose dramatically; it would never again have problems raising a quorum. Interest in the prospect of founding the new hospital appeared to be high. At a meeting of the Clinical Society on 10 September 1924, Dr Viner, the veteran of the unsuccessful campaign of 1907 and the first president of the Society, mentioned in a summary of its activities and accomplishments that he believed the immediate prospect of building a hospital was hopeless. He did not see this as a reason for inaction, however, and agreed with others present that a program

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to educate the community about the need for a hospital would be a good preliminary step and one that could be acted upon right away. The evident consensus on this point resulted in the appointment of an ad hoc committee of five members to begin the ground work. Those chosen were Dr Abram Bercovitch, a Montreal-born gynaecologist who had been educated in Montreal, New York, Baltimore, Chicago, London, Edinburgh, Paris, and Vienna, and had recently arrived from Winnipeg; Dr S. Eidlow, assistant accoucheur (a male midwife) at the Hebrew Maternity Hospital; Dr Max Rabinovitch, the first vice-president of the Montreal Clinical Society; Dr A. Bernard Illievitz, a prominent Jewish physician who held positions at the Montreal General and the Montreal Baby and Foundling Hospitals, the Herzl Dispensary, and McGill University, not to mention his place on the Medical Board of the Mount Sinai Sanatorium; and finally, Dr Samuel Ortenberg, one of the Clinical Society’s founders and head of the Medical Board of the Mount Sinai Sanatorium. This committee, composed entirely of enthusiastic advocates for the establishment of a general hospital, quickly exceeded the bounds of its original limited mandate. Communications were initiated with the analogous committee of the Hebrew Maternity Hospital. And to show that the Clinical Society meant to contribute more than words, on 26 November 1924, twelve members together pledged $4,100. By 10 December, a total of $14,000 had been subscribed.6 Momentum was building. The conference that had been requested by the directors of the Hebrew Maternity Hospital took place early in 1925. The five doctors appointed by the Clinical Society to investigate the possibility of constructing a general hospital represented that organization, while the Hebrew Maternity Hospital sent six nonmedical men. These were: C.B. Fainer, the vice-president and treasurer of that hospital; J.A. Budyk, its first secretary and honorary solicitor; S. Duskes; Solomon Z. Fels, for a while the hospital’s vice-president; Rabbi Max J. Merritt; and J.B. Miller, president of the Maternity Hospital, director of the Mount Sinai Sanatorium and vice-president of the Hebrew Consumptive Aid Society. Dr S. Eidlow, who went on behalf of the Clinical Society, belonged to both organizations. No immediate concrete actions resulted from this meeting, although the Hebrew Maternity Hospital persisted in its efforts to have the government amend its charter. That was granted on 3 April 1925. The gathering did, however, initiate a series of discussions on the hospital issue and stimulated attempts to form a more concerted and cooperative movement. Hirsch Wolofsky picked up the baton and undertook the promotion of the idea of a Jewish general hospital in his two newspapers, the Kanader Adler and the Canadian Jewish Chronicle.

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Community interest spread quickly and the original vision began to look more and more within the realm of the possible. In August 1925 a large meeting of concerned citizens, including members of the Montreal Clinical Society, agreed on the need to build a new general and maternity hospital, under Jewish control and staffed mainly by Jews, but open to all ethnic and religious groups. The mooted hospital, to be realized in conjunction with the committee of the Hebrew Maternity Hospital, was projected to cost roughly $500,000 and was expected to contain 150 beds, figures that remained in use by the pro-hospital forces during the next two years. In another meeting, held at the home of Dr Norman Viner, members of the Clinical Society did their best to win the support of some of the wealthy and influential Westmount Jews. While opposition arose among some of those whose means would have morally obliged them to donate more, a number of philanthropists were nevertheless successfully attracted to the cause. This group of benefactors included the likes of Peter Bercovitch, a Liberal member of the provincial legislature and the brother of Dr Abram Bercovitch (himself an ardent supporter of the hospital project); Allan and Samuel Bronfman, the young and rising liquor manufacturers whose immense importance to the hospital will later become evident; Lyon Cohen, the industrial magnate whose philanthropy extended to many quarters; Maxwell Goldstein, a lawyer who had co-founded the Temple Emanu-El Congregation, had held the positions of president (1917–20) and then honorary president of the Federation of Jewish Philanthropies, and had worked strenuously for equal school rights for Jewish children; Michael Hirsch, a prominent cigar manufacturer until his retirement in 1921, president and then honorary president of the Federation of Jewish Philanthropies, president of the Montefiore Club, past president of the Mount Sinai Sanatorium, and Director of the Anti-Tuberculosis and General Health League; Jacob A. Jacobs, a businessman who headed the campaigns to found and fund the Mount Sinai Sanatorium and the Hebrew Orphans’ Home; and, finally, Samuel W. Jacobs, a lawyer, member of Parliament since 1917, past president of the Baron de Hirsch Institute (1912–14), and life governor of the Mount Sinai Sanatorium, the Young Men’s Hebrew Association, the Hebrew Free Loan Society, and the Montreal General Hospital. These men, admirably suited to the task, would form the core of the hospital’s uptown promoters. In the meantime, Hirsch Wolofsky continued to make use of his editorials to remind the Jewish community of its need for and moral obligation to establish a hospital, Mrs Kaplan kept on canvassing from house to house in the east end of the city, and the situation of the overcrowded and underequipped Hebrew

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Maternity Hospital deteriorated further. Max Wiseman began to use his oratorical skills to harangue assemblies of the loan syndicates and sick benefit societies, pointing out the obvious and challenging them to set a generous example for their well-to-do co-religionists in the western part of the city. Just as important, the ideas and arguments about the foundation of another hospital passed from person to person as Jewish Montrealers gradually absorbed and ruminated over the plan, hesitating before turning the hospital from dream into reality. On 31 January 1927, a meeting of representatives of both the uptown and downtown sections of the Jewish community took place in the board room of the Baron de Hirsch Institute, including members of both the Clinical Society and the Hebrew Maternity Hospital. After some discussion of the proposal to construct a Jewish hospital, those present were informed about an offer by Edgar Berliner, the local head of RCA Victor, to pay for a study of the hospital’s feasibility and desired qualities. The assembled people welcomed the proposition and appointed a committee, with the power to increase its numbers, to undertake the survey. The committee consisted of eight members and was chaired by Samuel W. Jacobs. The other members included Allan Bronfman, then a director of the Hebrew Maternity Hospital; Horace Cohen, a son of Lyon Cohen; Nathan Gordon, a rabbi turned lawyer and president of the Temple Emanu-EI; Joseph Levinson Sr, a businessman in the clothing trade; David Kirsch, second vice-president of the Federation of Jewish Philanthropies; Louis Salomon, a director of both the Baron de Hirsch Institute and the Hebrew Maternity Hospital; and Marcus M. Sperber, a lawyer committed to Zionism who held prominent positions in the Baron de Hirsch Institute, the Federation of Jewish Philanthropies, the Immigrant Aid Society, the YMHA, the Jewish Educational Committee, and several other organizations. Despite an initial limit of three months imposed on the activities of the investigating committee, its members collected information from a number of sources for the entire year, examining annual reports of various local and outof-town hospitals, benevolent society statistics published by the provincial government, and correspondence from American hospital authorities in New York, Brooklyn, Boston, Baltimore, Cleveland, and St Louis. They also interviewed the superintendents of several Montreal hospitals, various architects with experience in the construction of hospitals, and a number of prominent Jewish and non-Jewish physicians. By 10 May the committee was sufficiently prepared for an encounter with the public, so it could acquire a sense of the community’s attitude toward erecting a Jewish general hospital. This gathering, held in the Baron de Hirsch Institute, had been advertised in the Kanader Adler, the

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Canadian Jewish Chronicle, and the Canadian Jewish Review, as well as by special notices sent to the heads of some sixty local Jewish organizations. About 100 people attended, including a large contingent from the east end, several prohospital doctors, and representatives of a number of Sick Benefit Societies, who promised financial support and their full cooperation. While not all present were convinced of the necessity of building a hospital, particularly some of those who feared the extent of the costs it might involve, the majority of those present very clearly endorsed the project.7 Following the open meeting on 10 May, the Hospital Investigation Committee drew up an initial report which contained much of what would be in the later communication. This, however, was not presented to the public and in the meantime the committee continued its enquiries. By 9 January 1928, a final and more complete report had been drawn up. The committee’s last report was brief (sixteen pages) but exhaustive and proved to be of vital importance in the events that led to the foundation of the Jewish General Hospital. It divided its observations into three main headings: whether or not Montreal Jews had an obligation to provide hospital facilities, the desirability of such a hospital, and finally the feasibility of the project. On the question of obligation, the report did not equivocate. During 1926, 1,892 Jewish patients had been cared for in the general hospitals of Montreal, almost all of them in the Montreal General and Royal Victoria Hospitals. Given the average hospital stay of 14 days, this meant that Jews continuously occupied around 130.5 beds in the city’s general hospitals, or about 8 per cent of the total available. Meanwhile, according to the Dominion census of 1921, Jews made up 7 per cent of the total population of Montreal. The report also showed that Montreal’s hospitals contained 1,715 beds for general work and 353 beds for maternity cases, a total of 2,068 beds. Only sixteen of these were occupied by Jews, all in the Hebrew Maternity Hospital. Further, “of paramount importance in the consideration of this matter is the fact that there is at present a recognized shortage of about 2,000 beds.” The committee concluded that: not taking into consideration the bed shortage above referred to, the obligation of the Jewish community of Montreal in the matter of hospitalization based upon their proportion of the population, which … is 7% of the total, would be to provide 129 beds for general alone or 155 beds for general and maternity cases. Even this number, in the case of general hospitals, is less than the number actually used by Jews in 1926, and whilst

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definite figures of maternity beds used by Jewish patients are not available, it is well known that the Jewish percentage is greater than in the case of general hospital beds used by Jewish patients.8 While the report recognized that some Jewish patients would continue to go to other hospitals, it also pointed out that many non-Jewish patients would use the Jewish hospital, as had happened in Jewish hospitals in the United States. The report considered the desirability of the proposed hospital at greater length, noting that building a sizeable new maternity hospital would require a large financial outlay but would not provide the status or the level of service possible with a multi-purpose hospital. The committee believed that the additional expense involved in the building of both a general and maternity hospital would achieve much more in proportion to the cost. The expense of maintaining a combined hospital would also be proportionally smaller than for two separate facilities. Another important argument in favour of the proposed hospital was the necessity of providing patients with a Jewish environment: Many of the Jewish patients can speak little or no English, and, even if they do speak the language, the customs and habits of the non-Jews are strange to them. In a word, they do not feel at home, there is a sense of being among strangers. This results in timidity that may be injurious to the patient, or it may cause an irritability that may retard his convalescence. From the Jewish doctors of the city, many of whom have had years of experience, come reports of innumerable instances of discomfort to patients and retarded convalescence by reason of strange environment and inability to obtain kosher food prepared in the manner to which they have been accustomed. It is generally conceded that a modern hospital, with a majority of Jewish doctors and nurses, with the serving of kosher food, and with a general Jewish atmosphere would react to the benefit of Jewish patients.9 The report noted that of the six American Jewish hospitals studied closely by the committee, four maintained kosher kitchens and another was preparing to do so. The establishment of a Jewish hospital was also perceived as a way to favour the advancement of Jewish doctors and nurses. On the one hand, local instruction in nursing simply did not exist for Jews, with the exception of elementary

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training for a few young women at the Hebrew Maternity Hospital. All other Jewish nurses had to be instructed or brought in from elsewhere. The development of a Jewish general hospital could only help remedy this situation. On the other hand, while Jewish doctors could receive training in Montreal, and indeed many did (despite McGill’s abhorrent quota policy and an almost total absence from the francophone system), few opportunities at Montreal’s hospitals were open to them. Of the anglophone institutions, the Montreal General and the Royal Victoria Hospitals were considered to be “closed”: they excluded Jewish doctors from practising in them. The extremely rare exceptions, such as Drs David Ballon and Jacob Rosenbaum, who were attached to the Royal Victoria, and Dr Illievitz, at the Montreal General Hospital, do not disprove the rule. If anything, their scarcity demonstrates the difficulty of getting appointments in those hospitals. The large number of Jews who were life governors of the Montreal General Hospital does not appear to have significantly improved the situation.10 Some of the much smaller hospitals, such as the Homeopathic Hospital on McGill College Avenue, Saint Mary’s Hospital on Dorchester Street, the Western Hospital, and the Women’s Hospital (now the Herbert Reddy Memorial Hospital) were “open” to Jewish doctors, the latter even having a Jew, Dr Abram Bercovitch, as surgeon-in-chief and chairman of its medical board. The small size of these institutions, however, limited their capacity for research and clinical practice for more than a very few doctors. The report therefore considered that a general hospital run by, and primarily for, Jews would provide enough clinical work to accommodate many physicians who would otherwise be lost to the community. The final factor in the desirability of building the hospital that received attention from the committee was the effect it would have on Jewish status in the community. In contrast to some who feared that the establishment of a Jewish hospital would result in the exclusion of Jews from Montreal’s Gentile hospitals, communications with the superintendents of other hospitals assured the members of the committee that this would certainly not be the case. Efforts to relieve the shortage of beds would receive full cooperation and could only improve the status of Jews in the community. Comparing what had occurred in other cities confirmed this opinion. The remainder of the report dealt with several aspects of the feasibility of building the proposed hospital. First, it established three cost estimates. These suggested that a topnotch hospital of 150 beds would require an expenditure of about $500,000 (including an allowance for a deficit in the first year), a hospital

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of 125 beds would cost $457,500, and a 100-bed institution could be set up for $405,000. The 150-bed hospital, which the committee favoured on account of the community’s needs and moral obligations, could be paid for partly by a grant from the government, which would amount to an estimated $1,000 per bed, or $150,000, and partly by the assets of the Hebrew Maternity Hospital – some $40,000 – which had been promised for the construction of a new hospital. The rest, $315,000, would have to be raised by public subscriptions, possibly supplemented by a loan or mortgage.11 The report then turned to the question of annual maintenance. Using estimates based on the experience of local hospitals, the committee determined the appropriate annual deficits that would result from having 35 per cent, 40 per cent, 45 per cent, or 50 per cent public beds, in hospitals of 100, 125, and 150 beds. For the purposes of this computation, a rate of $4.00 per bed per day was adopted, or about $4.70 per patient per day. (The cost per patient per day for the Montreal General Hospital in 1926 was $4.46.) Given that 40 per cent would be public beds, the amount that local experts believed would best meet the community’s needs and that hence received the approval of the committee, a hospital of 150 beds would involve an annual deficit of $45,000. Smaller hospitals of 125 and 100 beds would run at an estimated deficit of $39,000 and $30,000, respectively, per year.12 Any deficit would have to be paid for through such sources as annual subscriptions, donations, governors’ fees, bequests and endowments, and sums that might be raised by a ladies’ auxiliary. The report further suggested that some of this money could be saved by merging the Herzl Dispensary into a department of the new hospital. As for staffing, the committee found that enough local Jewish doctors were available to supply physicians for almost all medical posts that would become available, with only two or three exceptions. Any positions not immediately filled by local Jews could be easily staffed by Jews from elsewhere or by local non-Jews. The report had little to say about non-medical staff, apart from a suggestion that the principle of sectional representation be followed in the adopted scheme of management and lay administration. The report did not mention any concern about the hiring of an adequate nursing staff. Finally, comparative information was given on hospitals supported by Jewish communities in four American cities. St Louis contained a new Jewish hospital with 300 beds, serving a Jewish community of only 40,000 persons. Cleveland, with 87,000 Jews, supported a Jewish hospital with 268 beds; and Boston, a city of some 100,000 Jews, was the home of a newly-constructed Jewish hospital with

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200 beds. The last city considered, Baltimore, had a Jewish hospital with 185 beds, serving a Jewish community of about 64,000 people. From these figures, it appeared that Montreal’s Jewish population could, if willing, relatively easily support the recommended hospital of 150 beds. The committee ended its report with three basic conclusions. First, it did not consider the question of desirability to be in any doubt; the Jewish community of Montreal could only gain by having its own hospital. Second, the committee believed that “a Jewish hospital can be well and properly staffed and administered, and within a reasonable time can develop such efficiency as will cause it to rank favourably with other existing Canadian hospitals, becoming a valuable community asset and a source of pride to the Jewish population.”13 Third, the committee members thought the hospital was financially feasible, but only if it received strong support from the whole Jewish community. On that score, however, they felt relatively confident. As mentioned in the earlier draft of the report: “If there is any lesson to be drawn from the ten years’ experience of Montreal’s Federation of Jewish Philanthropies, it is that the community will increase its contribution to meet the need. It is surely not assuming too much to state that when the great need of the Jewish hospital, together with the fact that we have been leaving the burden of caring for our sick to the Goyim, is laid before the Jewish public, the response will be gratifying.”14 Clearly, the report of the Investigation Committee enthusiastically favoured establishing a Jewish general and maternity hospital. One might have expected the report to give an immediate boost to the efforts to achieve that aim. Unfortunately, important blocks stood in the way. For a start, it took more than a year before the already completed report would be presented to the public. Opposition to the hospital idea was still strong in some circles, and this turned out to include both Edgar Berliner, who had paid for the hospital investigation, and his brother. The Berliners and other Jews who opposed the hospital pointed to the findings of an expert on hospital administration who had been engaged to look over the situation. This “authority” suggested that the situation was not yet ripe and that the best thing to do would be to make arrangements with the Royal Victoria Hospital to obtain a single ward for Jewish patients. Recalling this, Dr Nathan Friedman exclaimed, “Did you ever hear such a foolish thing?”15 According to Dr Max Wiseman, an old current of “prejudice, compromise, and uncertainty,” particularly prevalent among the wealthier section of the Jewish population, was blocking the hospital project. These “old, conservative, diehard leaders of the community” could not reconcile themselves to the ability of Montreal’s Jews to take upon themselves a large project, especially to the fact that

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“the East Side has passed the stage of early immigrants, that they have matured, that they are becoming commercially and spiritually stable and that they have leaders in their own right.”16 The same attitude would emerge later in a meeting on the hospital issue held in the Montefiore Club, when a prominent moneyed citizen blurted out that “East of Bleury all are beggars, who take but don’t give!” In response to this, one of the “beggars” interjected: “If not you, then the people and the Clinical Society will go it alone!”17 Reacting to their declining influence, the conservative uptowners who still opposed the hospital adopted a policy of procrastination. Luckily this tactic proved too weak to deal with the growing momentum of the more community-minded movement then underway. While failure to present the report did slow the pro-hospital forces, by no means did it stop them. At this point the east-end section of the Jewish community showed itself to be of great importance. Hirsch Wolofsky continued to promote the hospital idea through the press, while others, led by Dr Max Wiseman, endeavoured to drum up support in the loan syndicates and sick benefit societies. The latter effort met with considerable support; by early 1929, after two years of canvassing, about 10,000 individuals from these societies had each pledged to contribute $12.00 annually for three years for the purpose of erecting and maintaining a hospital. Grassroot support was broadening rapidly.18 At the same time, the situation of the Hebrew Maternity Hospital went from serious to critical. Something had to be done, and the building of a larger general and maternity hospital still appeared to provide the best solution. But things were moving too slowly. Therefore, on 15 November 1928, at a joint meeting of the Executive Committee and the Medical Board of the Hebrew Maternity Hospital, those present decided to force the issue by closing down their institution. They also unanimously passed a resolution that provided: That a special committee, then appointed, shall have authority to cooperate with or if necessary give legal transfer of all assets in its possession belonging to the Hebrew Maternity Hospital, to any organization which in their opinion is competent to carry out its aim, viz: that there should be established in this city a Jewish General and Maternity Hospital. It shall, however, be necessary that such organization or committee be capable of showing that it has $100,000 in cash or its equivalent. Should no organization or committee be capable of showing that it has $100,000 in cash or its equivalent within four months, then this committee shall have the authority to cooperate with and or if necessary hand over the assets entrusted to it to any organization or committee possessing $50,000 or its equivalent

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sir mortimer b. davis jewish general hospital which will undertake to erect a Hebrew Maternity Hospital, or failing this the Special Committee is hereby authorized to take such steps as it may deem necessary or advisable to establish a Hebrew Maternity Hospital.19

Following this, the special committee20 was established, and, as had previously been done for similar reasons by the Beth Israel Hospital of Newark, New Jersey, and the Beth Israel Hospital of Boston, the Hebrew Maternity Hospital closed its doors. This happened in early January 1929. Needy patients were henceforth looked after by another committee, which despatched an investigator to visit the home of each future mother referred to it. If truly poor, then she was sent to a hospital (assuming an available bed could be found) and the costs were assumed by the special committee.21 Despite impassioned editorials and letters in the Canadian Jewish Chronicle,22 deteriorating conditions for impoverished Jewish mothers, and a growing need for hospital facilities of all kinds, the four-month deadline passed without any organization coming forth to accept the $40,000. Still, the committee of the Hebrew Maternity Hospital did not abandon hopes of the pro-hospital forces coalescing enough to raise the obligatory $100,000 and therefore kept its offer open. This is hardly surprising, considering some of the Maternity Hospital members’ active support for and even leading roles in the campaign for the general hospital. It is even less surprising on account of the formation in 1928 of a “Provisional Campaign Committee for a Jewish General and Maternity Hospital,” by a group of principally east-end citizens. This organization, intending to initiate a genuine and massive campaign, chose Dr Max Wiseman as its president, Alderman Joseph Schubert as its vice-president, Dr Abram Bercovitch as its treasurer, and N. Rombach as its secretary. Not long after a speech by a leading New York doctor (Emanuel Lipman) had inspired many of Montreal’s leading Jewish citizens, the executive of the Provisional Campaign Committee decided to make its big move. It called a meeting for 5 May 1929 and sent invitations to Jewish organizations in all sections of the community, most notably synagogues, sick benefit societies, loan syndicates, the Clinical Society, and the Sir Herbert Samuel Society. When the day came, representatives from most of those organizations attended, as well as a great number of others, some on behalf of institutions and others as concerned individuals. Dr Wiseman, one of those who convened the gathering, recalled this “fateful day” some twenty-two years later: “The hall of the Baron de Hirsch Institute was packed by an eager and restless crowd … Mr. Allan Bronfman opened the meeting amidst tremendous applause. A very heated debate followed, with arguments

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pro and con. But we had surprises that we knew would convince the cynics, the prejudiced and the diehards.”23 Dr Wiseman himself delivered the main “surprise.” With an estimated initial requirement of $500,000, he was able to announce firm offers of $100,000 from the loan syndicates, $35,000 from the Hebrew Maternity Hospital, $20,000 from the Clinical Society, and $10,000 from the Sir Herbert Samuel Society. Peter Bercovitch then assured the assembled people that they could probably count on the provincial government, of which he was a member, to give the hospital $200,000 to start with, and more in a year or two if necessary. This left a balance of about $135,000 to be raised by public subscription, a reasonable amount as long as the community pulled together.24 Dr Wiseman’s tactic triumphed brilliantly. The hesitant found themselves swept along in the tide of optimism, and a resolution of acceptance of these offers was passed unanimously. “I shall never forget that scene. Pent-up emotions were let loose. People who never met before shook hands. Women cried. East met West. It seemed that the unnatural demarcation of a barrier separating a people into east and west had been completely wiped out.”25 The most important step had thus finally been taken. The Jews of Montreal had boldly endorsed the hospital project and had pledged to carry it through. Now, the noble idea that had captured the imagination of those who cared most for the community could be transformed from theory into bricks and concrete. But first, money had to be raised.

chap ter six

fundraising

Raising money for the Jewish hospital thus became the next objective. To accomplish this would require cooperation from the press, solid organization and leadership, and massive popular support. Backing from the newspapers occurred without prompting and would continue from the beginning of the campaign to its very end. While the Jewish press naturally devoted the most attention to the future hospital, the larger local newspapers also responded to the cause. They reported all major meetings and provided the campaign leaders with a medium to directly communicate with the general public. Favourable editorials complemented the reporting, frequently in the Jewish papers, but also in the Gentile press, demonstrating an appreciation by one section of the population of this attempt by another to help remedy the whole city’s tragic shortage of hospital beds. Organization of the fund-raising campaign began immediately. Those present at the meeting of 5 May appointed a committee to lead them and headed the list of members with the names of Allan Bronfman, the man who had contributed the most toward raising interest in the hospital project among the uptown Jews, and Dr Wiseman, who had done so much in the east end. The other members of this large body were: Dr D.H. Ballon, Dr Abram Bercovitch, MLA Peter Bercovitch, MP S.W. Jacobs, MLA Joseph Cohen, Abram M. Vineberg, Al Lesser, Henry Weinfield, Samuel Bronfman, Elijah Silverstone, Harry Bronfman, Marco Leon, Joseph Levinson Sr, Barney Aaron, David Kirsch, Clarence Michaels, Samuel Hart, Dr J. Kaufman, Barney Rubin, S. Leopold, Issachar Greenberg, Louis Wolfe, L. Solomon, C.B. Fainer, F.A. Darwin, J.A. Jacobs, Louis Salomon, Alderman Joseph Schubert, Hirsch Wolofsky, J. Schaffran, J. Gilletz, Harry Gordon, P. Glickman, Isaac Cohen, T. Glickman, Marcus M. Sperber, Leon Crestohl, Harry Batshaw, 1. Lande, J.A. Budyk, H.M. Caiserman,

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Editorial Cartoon, 1929. Jewish General Hospital Archives, 1_1_9_1_8.

N. Rombach, Jack Lewis, Dr Sol Vineberg, Dr Samuel Ortenberg, Dr E.A. Greenspon, Dr S. Eidlow, Dr M. Ratner, S. Boulkind, A. Fleming, Mrs C.J. Gross, Mrs M.Wineroope, Mrs M. Leon, Mrs C.B. Fainer, Mr. Leon Cheifetz, and Mrs Sara Gordon Bernstein. This campaign committee, intended to represent as many organizations and sections of the community as possible, was given the power to add to its number as necessary to fulfill that function.1 Shortly after the gathering of 5 May 1929, Allan Bronfman, as head of the Federation of Jewish Philanthropies and a leading member of the Campaign Committee, called a meeting for 27 May. This assembly was meant to be more strictly representational than the last, giving the loan syndicates and sick benefit societies an opportunity to properly elect and instruct representatives, as well as to begin organizing for the campaign. It was also at this meeting that the report of the Special Hospital Investigation Committee would be presented to the general public for the first time.

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When the assembly convened at 8:15 p.m. in the Baron de Hirsch Institute, about seventy-five delegates were on hand. These included: Dr Max Wiseman, Alderman Joseph Schubert, N. Rombach, M. Herman, and M. Rabinovitch on behalf of the loan syndicates; S.H. Reubens, S. Lerner, K Goldstein, H. Nadler, and S. Shatz for the sick benefit societies; and Drs Max Wiseman, Abram Bercovitch, A.O. Freedman, Samuel Ortenberg, and S. Eidlow, on behalf of the Montreal Clinical Society. Apart from these delegates, there were also the other members of the campaign committee and a great many citizens who responded to the open invitation to all who wished to participate in the hospital plans. Again, a spirit of jubilation reigned, boosted by the presentation of both the hospital report and an address by a visiting Jewish editor from Boston, where a Jewish hospital drive had recently met with great success. During this meeting, Alderman Schubert moved, and H.M. Caiserman seconded a motion to give Allan Bronfman the power to appoint a committee of seven people to map out plans for the upcoming campaign. Those present unanimously approved the motion. Allan Bronfman then requested, and was granted the assistance of, Peter Bercovitch, Henry Weinfeld, and Alderman Schubert, in choosing the personnel for this committee.2 By 27 June, Allan Bronfman had appointed twelve men, not seven, to form the executive of the Campaign Committee, and with them had prepared a tentative plan of action. That day the members of the General Campaign Committee unanimously chose Bronfman as general campaign chairman and convenor of all committees. The other people on the executive were announced as: Michael Hirsch, Michael Morris, Morris Ginsberg, Sam Bronfman, H.M. Ripstein, A.H. Jassby, Abram M. Vineberg, Isaac Silverstone, Alderman Schubert, Louis Salomon, and David Kirsch. After a motion by Alderman Schubert, three more members were added to better represent the sick benefit societies, the loan syndicates, and the Hebrew Maternity Hospital. These were Dr Max Wiseman on behalf of the first, H. Reubens for the second, and C.B. Fainer on behalf of the Maternity Hospital. Ernest G.F. Vaz, executive director of the Federation of Jewish Philanthropies, acted as the committee’s secretary. Other bodies established included a medical committee, consisting of Drs Max Wiseman, Abram Bercovitch, A.O. Freedman, Samuel Ortenberg, and S. Eidlow, and a “cooperative committee,” whose members were MLA Peter Bercovitch, MLA Joseph Cohen, MP Samuel W. Jacobs, and Alderman Louis Rubinstein.3 As for the campaign, which now was tentatively scheduled to start on 22 September, the new executive recommended that it be waged on a door-to-door basis at both homes and offices. Workers would collect one-third of a given

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pledge on its signing and the rest in four semi-annual payments. The goal of the campaign would be $600,000. The executive committee would direct the canvassing and collection of funds and would supervise the construction of the general hospital, and would only abandon its functions upon the completion of the hospital. Finally, to run the campaign effectively, thirteen subordinate committees would be established, each with particular duties. There would be a special names committee, a medical committee, a workmen’s committee, a luncheon committee, a site and building committee, and committees to cover the loan syndicates, sick benefits societies, fraternal organizations, women’s organizations, outside communities, publicity, speakers, and the naming of the hospital. Before appointing people to these bodies, Allan Bronfman found his attention drawn to another important concern. While young, energetic, and recognized as the leading figure among the uptown promoters of the hospital, and with the complete confidence of the other campaign organizers, his family had only lately arrived in Montreal. He was concerned that his own extensive experience in philanthropic work, both in Winnipeg and in Montreal, would not prove sufficient to gain the confidence of some of the more reticent potential donors. He therefore felt that the addition of another leader, one with older ties in the community and yet capable of directing a large endeavour of immense importance to Montreal Jewry, would add considerably to the potential of the upcoming campaign. On 4 July, at a meeting of the campaign executive, Allan Bronfman announced that Michael Hirsch had agreed to work with him as joint chairman of the Campaign Committee. Hirsch was an admirable choice. As a founder and past president of the Federation of Jewish Philanthropies, president of the Montefiore Club for over a quarter of a century, past president of the Mount Sinai Sanatorium, and director of the Anti-Tuberculosis and General Health League, the former cigar industrialist easily fulfilled the requirements. Appointments to the various committees took place in July. The Building and Site Committee and the Publicity Committee were completed first. The former, whose critical function was to choose a location for the future hospital and to supervise its construction, was to be headed by Abram Moses Vineberg, a 53-year-old financier with an active past in the Federation of Jewish Philanthropies, the Baron de Hirsch Institute, the Montreal Hebrew Orphans’ Home, and the Shaar Hashomayim Congregation. The other members of this body included Drs David H. Ballon, Abram Bercovitch, and Max Wiseman, and Messrs Simon Kirsch, Marcus J. Hirsch, Harry Bronfman, Harry Gordon, Robert A. Darwin, Louis Salomon, C.B. Fainer, Herbert Vineberg, Al Lesser, and Morris Ginsberg. Later, Dr Alton Goldbloom

Above and opposite Executives of the Campaign Committee, 1929. Canadian Jewish Chronicle (Montreal, September 20, 1929). Jewish General Hospital Archives, 1_1_9_1_13 and 1_1_9_1_14.

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and Felix Leopold joined this group. Samuel Bronfman accepted the position of chairman of the Publicity Committee and under him would work Arthur Levin, Joe Asch, A.H. Asch, A.H. Jassby, newspaperman Hirsch Wolofsky, Isaac Silverstone, Dr Max Wiseman, I. Rabinovitch (the current managing editor of the Kanadar Adler), Max Finestone, Leon Levinson, Mrs Sara Gordon Bernstein, and eventually D.F. Benson, A.C. Her, and Rex Vickers.4 Gradually the joint chairmen filled the remaining committees. The names of these appointees, whose efforts would contribute so much, were recorded in the Golden Book of the Jewish General Hospital’s first campaign. The largest committee, the Special Names Committee, was put under the direction of A.H. Jassby, a pro-hospital activist from the beginning, a trustee of the Temple Emanu-El, and the past chairman of the Executive Committee of the Federation of Jewish Philanthropies. Under him were almost 140 men, including many of the community’s leading figures: men such as the Bercovitchs, the Bronfmans, F.A. Darwin, M.M. Sperber, and Dr Wiseman worked with people whose importance to the campaign only now began to be felt; men like J.A. Dobrofsky, A.L. Gittleson, and Michael Margolick, important businessmen in the garment industry; and Captain William Sebag-Montefiore, the president of Shearith Israel Synagogue and grandnephew of Sir Moses Montefiore, the great Jewish philanthropist and statesman. The smallest committee established was for outside communities, consisting of only two members, David Kirsch and Barney Rubin. Also small were the Loan Syndicates Committee and the Sick Benefit Societies Committee, the former being composed of M. Herman, M. Rabinovitch, N. Rombach, Alderman Schubert, and Dr Wiseman, the latter including L. Dacks, E. Goldstein, Saul Lerner, H. Nadler, R. Reubins, J. Stern, and Abraham Zatz. A small luncheon committee, led by Horace Cohen, was formed to provide nourishment and encouragement for the campaign workers. A.Z. Cohen, the brother of Lyon Cohen and for some time the president of the Baron de Hirsch Institute, headed the thirty-two-member speakers’ committee. Committees for fraternal organizations, women’s organizations and workmen were ultimately not created, but the executive did set up a transportation committee, staffed by Stanley Vineberg (Chairman), Allan Bronfman Jr, and Lawrence Samit; a dental committee, including five leading Jewish dentists; a legal committee, headed by Henry Weinfield; and a treasurer’s committee, under the chairmanship of Joseph Levinson Sr. Finally, the medical committee was expanded and put under the direction of Dr David Ballon. Its other members were Drs Max Wiseman (secretary), Abram Bercovitch, S. Eidlow, A.O. Freedman, E.A.

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Greenspon, L.B. Hirschberg, D.L. Mendel, L.J. Notkin, S. Ortenberg, Harold Segall, D. Tannenbaum, and Norman Viner. On 22 July, Allan Bronfman and Michael Hirsch announced the campaign’s basic strategy. Rather than organizing the drive along trade divisions, as was then usually done by the Federation of Jewish Philanthropies, the executive of the hospital campaign organization opted for a system of geographic zones complemented by the Special Names Committee for particularly promising prospective benefactors. According to this system, Montreal and its environs were carefully mapped out, from the St Lawrence River to the railway tracks, and from Rosemount to the Town of Saint Pierre. The area was divided into twenty-five districts, each of which was put in the charge of a zone chairman who, with six captains, would direct the local campaign workers and report to one of the district control chairmen, who were in turn subordinate to the two control chairmen (David Kirsch and Clarence Michaels) and to the joint campaign chairmen. The capable men chosen as district control chairmen were: H.M. Caiserman, Isacchar Greenberg, Simon Hopmeyer, Michael Morris, Morris Ginsberg, Hyman E. Herschorn, L.P. Levee, Lazarus Philips, and R. Ross Vineberg. The list of zone chairmen was also distinguished: A. Kellnor (Zone 1), B. Brodie (Zone 2), L.M. Fingard (Zone 3), David Shapiro (Zone 4), Ernest Markus (Zone 5), S.G. Bendon (Zone 6), J. Albert, Joseph Vineberg, Harry Bazar and Dr N. Schacher (Zone 7), Julius Rost (Zone 8), Michael Deskin (Zone 9), Frank S. Lauria and Louis Sendel (Zone 10), J. Cohen (Zone 11), L Stober (Zone 12), Harry Spector (Zone 13), L. Stober (Zone 14), A. Goldwater and Max Miller (Zone 15), William Singer (Zone 18), M. Goldenberg (Zone 20), Ben Yaphe, and M. Schneiderman (Zone 21), M. Rudolph and J. Schafran (Zone 22), Maurice Hartt and M.B. Signer (Zone 24), and Max Seigler (Zone 25). Zones 16, 17, 19, and 23 were to be canvassed by the Women’s Division, which would be organized into chapters and institutional units, so that women belonging to, for example, the Ladies’ Auxiliary of the Hebrew Maternity Hospital or the Spanish and Portuguese Sisterhood could work together. They were all under the direction of Zone Chairman Mrs R. Kaufman. H.L. Sourkes and Issie Singerman also worked briefly as zone chairmen.5 On the same day, 22 July, it was announced that Huntly Drummond and his associates had offered to the campaign organization the free use of a large suite on the second floor of the Drummond Building. This office building, still standing today, sits on St Catherine Street West. The executive gratefully accepted this act of generosity, and before long rooms 218–21 of the Drummond Building bustled with the activity of eager campaigners, including forty full-time clerical workers.6

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By mid-August, more detailed organizational plans had been drawn up. Volunteers had prepared a list of 12,000 prospects and had transferred these names onto cards for distribution to zone chairmen. Yellow cards were reserved for “special names,” but workers were expected to canvas every prospect within their assigned area, card or no card, with the proviso that men would not cover residences unless they had a card, and women would leave unlisted businesses to the male workers. In this manner, the campaign organization hoped to reach every Jew in Montreal, including the estimated hundreds whose names had not found their way onto one of the campaign cards. To achieve this ambitious goal, the leaders of the campaign estimated that they would require an army of 1,500 people.7 Support from many quarters, both before and during the campaign, would be an essential ingredient if the fundraising were to be a success. Fortunately, this would not pose a great problem. The fact that aid did come from a wide variety of sources helped to make the Jewish General Hospital into a symbol of community cooperation even before it was built. Industrialists worked harmoniously beside wage-labourers, and Reform Jews beside the Orthodox, each putting aside their differences to accomplish this goal of such importance to Jews of all backgrounds. On 9 August, the Canadian Jewish Chronicle announced that: Montreal Jewry’s oldest and most exclusive social club, whose lofty halls have hitherto resounded only to footsteps of favoured individuals who entered by virtue of membership, will next Monday evening be the scene of a unique dinner, when club members and “outsiders” will mingle amid an atmosphere of camaraderie and good cheer under the aegis of a communal cause which cements all sections of our communal body for a common good. The joint Hospital Campaign Chairmen will on that evening be hosts to the members of the Campaign executive, to government representatives, and to the presidents and delegates of the Loan Syndicates of the city on whose registers may be found thousands of those members of local Jewry who for want of a better term have been designated as “downtown” Jews. The role played by the Loan Syndicates in the initiation of the Jewish Hospital movement cannot be minimized and it is the intention of the Hospital executive to allow these bodies their full share in this significant and historic endeavour of Montreal Jewry. West, North and East alike will be completely organized to take up their share of the task and their representatives will be kept au courant of every step

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in the progress of the Campaign and their interest and suggestions for the good of the drive will receive a warm welcome. With the Hospital project new standards of communal activity will come into being and new blood will be infused into community efforts. The comparatively small group which in the past has carried the main burden of welfare work into Montreal will be augmented through every possible effort, by workers from all sections of our growing metropolis. Assistance, both from organizations and individuals, arrived early and snowballed with the campaign’s approach, set for the week of 22–30 September. As early as 12 July, the campaign organization had received assurances of support not only from the loan syndicates and sick benefit societies, but also from the Independent Order of B’nai B’rith, the Zionist Order Habonim, the Young Men’s Hebrew Association, the Men of Shaar Hashomayim Synagogue, the Temple Emanu-El Brotherhood, the Sons of Israel, and many other institutions. The loan syndicates continued to stand actively behind the hospital campaign organization and began to turn their promises into material contributions. The secretary of the Commercial Loan Syndicate, which had pledged to supply one dollar per member annually and fifty workers for the campaign, stepped forward during the meeting of 22 July to offer the joint chairmen a cheque for $500 as part of the syndicate’s pledge. This dramatic move provided the first payment made to the hospital campaign. The 12 August gathering at the Montefiore Club allowed the loan syndicates another opportunity to demonstrate their support. At that meeting it was announced that the loan syndicates together had already pledged about $100,000 and it was hoped that the first payments on this amount would be received before the opening of the campaign. Amounts already given included $650 from the Central Commercial Loan Syndicate, $1,060 from the Hebrew Loan Syndicate, and $200 from the National Loan Syndicate. That evening further payments were made by the United Commercial Loan Syndicate, the Kiener Loan Syndicate, the Mile End Loan Syndicate, the Pinsker Loan Syndicate, the Pioneer Loan Syndicate, and the Hebrew Working Men’s Loan Syndicate. Pledges and payments were given by other loan syndicates in the following days, including the Workmen’s Circle Loan, the Imperial Loan, the United Loan, the King George Loan, and the Progressive Loan Syndicates.8 The sick benefit societies also lived up to their words. On 20 August, the King Edward Benefit Association announced a pledge of $1500, to be made in three equal annual payments. A meeting held for the sick benefit societies and loan

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syndicates a week later resulted in substantial pledges and first payments from the Hebrew Sick Benefit Society (a pledge of $3,600), the Ishitzer Sick Benefit Society, the Russian Polish Sick Benefit Society, and the King George Sick Benefit Society. Pledges and payments would continue to arrive during the campaign. With the help of S.W. Jacobs, Peter Bercovitch, Joseph Cohen, Louis Rubinstein, and Joseph Schubert, the Jewish politicians who had associated themselves with the hospital project, the approaching campaign had attracted the attention of some of the province’s leading non-Jewish political figures. On 22 August, Montreal’s colourful mayor, Camillien Houde, addressed a letter to Allan Bronfman and Michael Hirsch, in which he gave his “hearty endorsation” to the attempt by the Jewish community to build a hospital: “One of the most urgent needs of our city at the present time, is additional hospital capacity, and your decision to keep the hospital, when built, entirely free from all racial, religious and sectarian distinctions, shows the true Montreal spirit of mutual race tolerance and inter-racial amity. You have my fullest endorsation.”9 The next day, L.A. Taschereau, the premier of Quebec, wrote an equally favourable letter to the two joint campaign chairmen: “There is a very urgent need for such a hospital, and I know of no more worthy cause in which private citizens may engage at the present time. While our Provincial Government is doing everything in its power to alleviate suffering among the indigent people, it is evident that all needs cannot be met without the active cooperation of individuals. I therefore hope that your timely appeal will find a prompt and generous response from our Jewish citizens who have already to their credit so many noble undertakings in social work and hospitalization.”10 Athanase David, the Provincial Secretary, expressed similar sentiments in a public letter of his own.11 Letters of support also arrived from some of the city’s leading medical authorities, including Colonel Herbert Molson, the president of the Montreal General Hospital; Dr S. Boucher, director of the Municipal Department of Health; Dr H.L. Reddy, the superintendent and obstetrician-in-chief of the Women’s General Hospital; Sir M.W. Gray; and Dr A.K. Haywood, superintendent of the Montreal General Hospital. Each of these communications emphasized the grave lack of 2000 hospital beds and the great service being done for the community by the city’s Jewish residents.12 Dr Haywood’s letter dramatically illustrated the effects of the existing hospital shortage on the running of the Montreal General Hospital, and hence the great need for the beds that would be provided by the new Jewish general and maternity hospital:

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Last month was the busiest month in the history of the General Hospital … This summer … conditions have been so bad that we have had to refuse to send out ambulances for serious accident cases or people dangerously ill simply because we had not a bed vacant. We are criticized for this, but we cannot accept people when there are no beds … A hospital running at 75 per cent capacity, in hospital parlance, is said to be full; at 80 percent it is crowded and over that it is said to be in an emergency state. Last year the Montreal General Hospital was operated at 94 percent of its capacity all year round.13 While the campaign’s organizational structure was being established and support from government leaders cultivated, the campaign leaders devoted much of their time to developing a solid base of popular support. Apart from public generosity, the most important ingredient for a successful campaign would lie in a strong, devoted army of campaign workers. To raise this army, the campaign chairmen and zone chairmen worked diligently. Rallies and dinners were held every few days, either in honour of those who had already volunteered or aimed at members of a specific group of potential campaign workers, such as women’s or occupational organizations. These paid off admirably, both in terms of volunteers and pledges. An afternoon tea at the Mount Royal Hotel, given for nineteen women’s organizations on 27 August, resulted in the creation of the campaign’s Women’s Division. A meeting held in the more spartan environment of the campaign headquarters led to strong union support from locals 116, 167, 209, and 277 of the Amalgamated Clothing Workers of America, including a plan for members to give the proceeds of four hours’ overtime work to the future hospital.14 Apart from those with organizational affiliations, many people were also attracted as individuals. By the middle of August, nearly 500 men had volunteered, as well as about 70 women. At the end of August, only about three weeks before the opening of the campaign, some 350 more men had offered their services, but officials announced that yet another 350 male workers and an additional 600 women would be required to make the campaign a success. In the early days of September, the numbers of male workers swelled to 1,000 and by the 13th, about 1,400 had stepped forward. Women volunteers arrived more slowly, but by 20 September, just before the commencement of the campaign, some 750 of them had decided to actively participate in this great community project. By that date, 1,500 men had volunteered.

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The willingness with which these people offered their services paid tribute both to themselves and to the Jewish community of Montreal as a whole. Their importance to the campaign is undeniable. Allan Bronfman recognized this and insisted that it was the workers, not the captains and chairmen, who did the real hard work. The executives too had worked extremely hard, “but we are second in importance when it comes to furnishing the wherewithal to build the hospital. It is on the workers that we must rely ultimately.”15 The weeks spent in raising popular support for the hospital campaign led to some touching situations. On one occasion, a self-conscious Jewish boy about fifteen years old arrived at the campaign headquarters in the Drummond Building and requested to see “the manager.” A member of the executive committee took the youngster aside, thinking he had brought some kind of message, and asked him the purpose of his visit. The executive member felt his heart strings pulled when the boy answered that he wanted to help in the campaign, as his sister, when desperately ill and ordered by her doctor to enter a hospital, could not do so because no beds were available. The boy was put to work. Another time, a man from North Bay, who had been in a Montreal hospital for two months, walked into the campaign office and emptied his pockets. All he possessed was six dollars. He nevertheless donated all of it to the campaign and promised that more would be forthcoming after he returned to North Bay.16 These are only two examples of the many people who devoted their time or money to the hospital campaign, but they illustrate well the importance that people placed on the building of Montreal Jewry’s new hospital. The last three weeks saw some final details added to the campaign plans. For one, the executive decided to adopt a slogan; it settled upon: “Your Tribute Everlasting.” Everyone in the Jewish community would be given an opportunity to contribute to the foundation of the new hospital, and this would be their individual and communal “tribute everlasting.” For those who wished to honour themselves or others, a memorial plan was worked out whereby the names of donors of $500 or more would be inscribed on bronze tablets and those who gave $100 or more would be given a “tribute certificate.” All workers and contributors would be named in a “Golden Book” that would provide a lasting record of everyone who helped in this great task. Another plan was devised for children. Certificates were printed for them in the shape of bricks and when they gave money to the campaign they would be presented with a corresponding number of “bricks,” obtained for one dollar each. Of course relatives could purchase these “bricks” for children unable to give by themselves, hence identifying even the youngest with this noble endeavour. Another late development included

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the formation of a “flying squad,” consisting of a fleet of fifty cars for the use of zone chairmen and women workers, enabling them to cover more territory. In addition to this, the Deluxe Cab Company offered the use of thirty of their taxicabs and the Montreal Amateur Athletic Association agreed to provide free parking space for campaign workers. By 18 September 1929, the campaign organization was prepared and gearing up for the next week’s hard work. That evening, A.H. Jassby chaired a large dinner meeting in an atmosphere of optimism and euphoria for the executive and members of the Special Names Committee. A number of substantial pledges were announced and when Michael Hirsch suggested that they raise their objective from $600,000 to $1,000,000, the gathering agreed without hesitation. Hirsch then declared that the campaign leaders now hoped to build a hospital of 205 beds rather than the originally planned 150. Jassby’s words on this occasion underlined the seriousness and importance of the upcoming campaign: “This campaign marks the realization of our dreams. It must be successful if we wish to retain pride in our communal work. Brick and stones are the outward and visible evidence of human efforts; this hospital will be our effort and it must be such that posterity will be proud of its ancestry.”17 The actual fundraising began in a burst of activity on the morning of 23 September 1929. It had been preceded by moving editorials in the English and Jewish press and Saturday the 21st had been declared “Hospital Sabbath” by the Vaad Harabonim. Rabbis and invited orators spoke in virtually every synagogue, emphasizing the importance of the hospital project and pleading with Jews in all parts of the city to give generously, at least money, if not time and effort. On the 22nd, the following day, at eight o’clock in the evening, the campaign was officially opened by a massive rally held in the ballroom of the Mount Royal Hotel. Allan Bronfman, Michael Hirsch, Canon A.P. Shatford, Rabbi Harry Stern, and others delivered rousing speeches that fanned the enthusiasm of the 3,000 men and women present. Thus, on the 23rd, when canvassers took to the streets, and executives, captains, stenographers, and other workers busied themselves in the Drummond Building, they each approached their respective tasks with an attitude of hopefulness and a sense of the significance of their actions. After midnight, when the returns for the first day were counted, the pledges received amounted to about $194,000, roughly what had been expected.18 The following day’s results proved to be less gratifying, although the executives did not yet see cause for alarm. Still, they did decide to issue a circular emphasizing the need for a “desperate” effort if the goal of one million dollars was to be reached. At the campaign luncheon given the next day in the Mount Royal Hotel, Michael Hirsch

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and Allan Bronfman announced that the pledges received by the second day totalled $415,000, largely due to a subscription of $100,000 from Elijah, Isaac, Flora, and Anna Silverstone.19 Though spirits did not flag, the third day’s receipts also fell below the amount targeted; consequently, the leaders at headquarters expressed some disappointment. Thursday, the fourth day of the campaign, fortunately ended on a more optimistic note and that evening’s tabulation showed a marked improvement over the previous two days. In the meantime, arrangements for the final rally neared completion and delegations were sent to Sherbrooke and Quebec City to

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22 September 1929 – opening of the Hospital Campaign with a mass rally at the Mt Royal Hotel. Jewish General Hospital Archives, 1_1_9_1_9_200dpi.

help organize and encourage Jewish campaign workers there. David Kirsch and Marcus Sperber, who had already gone to Sherbrooke, sent back an encouraging report, while Bernard Rubin and Sam Ogulnik transmitted similarly optimistic communications from Quebec City. On Friday the 27th, a young boy walked into the campaign headquarters with a small parcel. A worker saw the lad and brought him to the chairmen’s office. Once opened, the parcel revealed a large bag of pennies and a note that read: “This miser’s bag was made and filled with coppers of several years’ savings by a little girl who, sorry to say, has passed away. These coppers were cherished by the

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family, but they can now be used for buying bricks for the children’s ward in the Jewish General Hospital.”20 By the end of that evening, the amounts pledged added up to $739,253. Michael Hirsch announced this figure the next day at the workers’ luncheon and made known a generous donation of $75,000 by the Bronfman family. The sixth day brought the executives some concern and late that night the joint campaign chairmen sent out a last minute message urging that “the objective is in sight only if every man and woman engaged in the campaign will do his or her utmost to canvass every card before Monday afternoon.” By the end of the penultimate day, however, the campaign leaders, while unable to forecast the final amount subscribed, were reasonably certain of reaching their objective.21 On the last day, Monday the 30th, the campaign workers made their final appeals and then brought their complete returns to the Drummond Building headquarters at the end of the afternoon. All were invited to a dinner in the ballroom of the Mount Royal Hotel later that day. Over 1,500 people paid $2.00 a plate to attend that last and greatest rally, and even before any hints were given as to the total amount subscribed, the massive crowd was bursting with enthusiasm. Dinner began at eight, with Michael and Estelle Hirsch, Allan Bronfman, Premier Taschereau, Alderman T. Holland (in place of Mayor Houde), Sir Henry Gray (former surgeon-in-chief of the Royal Victoria Hospital), Peter and Florence Bercovitch, Samuel and Amy Jacobs, and Joseph and Ada Cohen sitting at the head table. But still no announcements were made. It was only after the meal that anything was said. Allan Bronfman began the speeches by reminding all present that they were meeting to celebrate the greatest achievement in the history of Montreal Jewry. Michael Hirsch followed, and in introducing Premier Taschereau expressed his thoughts on the history of the hospital movement: “We are seven percent of the population of this city. There is a shortage of 2,000 hospital beds per day and therefore we felt that we should contribute our percentages, but we added a little for good measure and we are going to build a hospital of 200 beds. Jewry has shown, in this campaign, that it is united and our people, assembled on this gala occasion, may feel proud of their efforts.22 Premier Taschereau followed with an announcement that in gratitude for the work done to establish the new hospital, the provincial government had engaged itself to contribute $300,000, as well as the usual two dollars per bed per day. Following the premier, Allan Bronfman again spoke, thanking the politician and emphasizing that, as “sickness knows no distinctions … the doors of

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our hospital will be open to those of all races and creeds.” He then announced, finally, to the sound of a great tumult of cheers, that the campaign had not only reached its objective of a million dollars, but had passed it by well over $500,000. The Jewish people themselves had contributed $1,238,017.98. To this could be added the government grant, as well as $31,121 in unsolicited and miscellaneous subscriptions.23 A need had arisen and together the Jewish community of Montreal had generously and successfully responded to the challenge.

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The campaign organization had raised a sufficient number of pledges. However, there remained a great deal of work to be done before the Jewish hospital could open its doors, including transforming pledges into payments, finding suitable land, constructing and equipping the hospital, and hiring an able and competent staff. Before those tasks could be undertaken, it was necessary to establish the postcampaign hospital leadership. Fortunately, much of this had been looked after by the end of the campaign. On 9 August 1929, Allan Bronfman, Michael Hirsch, and Ernest G.F. Vaz had petitioned the provincial government for a charter so that the Jewish Hospital Campaign Committee could legally hold property. The government granted this charter on 5 September 1929, making the hospital committee a corporation. On 25 September, after the legal formalities were completed, the “Jewish Hospital Campaign Committee Inc.” held its first official general meeting. Elections took place and resulted in the appointment of the following men as directors: Allan Bronfman, Michael Hirsch, Ernest G.F. Vaz, Samuel Bronfman, Charles B. Fainer, Morris Ginsberg, Robert Hirsch, Abraham H. Jassby, David Kirsch, Joseph Levinson Sr, Michael Morris, Harry Reubins, Hyman M. Ripstein, Alderman Joseph Schubert, Isaac Silverstone, Louis Solomon, Abraham Moses Vineberg, and Dr Max Wiseman. The directors held their first meeting on 7 October and then chose Allan Bronfman as president of the board. Other officers appointed included: Michael Hirsch (chairman of the board of directors), Samuel Bronfman (vice-president), Joseph Levinson Sr (treasurer), Robert Hirsch (secretary), and Ernest Vaz (executive secretary). The directors made two further decisions at that meeting. First, they would rent an office (Room 205) in the Drummond Building. Second, they would invest the

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$350,000 in cash they had received during the campaign by depositing it with local trust companies at an interest rate of 6 per cent.1 While not in themselves of monumental importance, the first decisions taken by the corporation must have seemed very significant to the men involved. Just a few months earlier the Jewish community had still been trying to make up its mind as to whether or not a Jewish General Hospital was even feasible. Now things were getting done. Electing leaders was a relatively easy matter. Collecting pledges proved to be far more difficult. The fundraising campaign had taken place when business fortunes appeared to be flourishing, when middle- and upper-income groups were thriving, and when stock market fever was reaching new heights. Industrial stocks had risen from a base unit level of 100 in 1926 to 237.3 in December 1928 and to as high as 315.8 in September 1929.2 In fact, the campaign had taken place at the very end of the “Roaring Twenties.” Early in October, however, immediately following the immense effort put forth by the Jewish community, the stock market began to slide. Thus began the Crash of 1929, one of the most serious business crises in history. Thursday, 24 October, the worst day of the stock market decline, saw widespread panic. Companies began to fold and employees were thrown out of work. Close on the heels of the Crash, but only partly caused by it, followed the Great Depression. Many of the wealthy were humbled and millions of other people became jobless as economic activity slowed considerably. Montreal, not immune to the prevailing winds of disaster, suffered like other areas. Building activity declined by 50 per cent during the first six months of 1930 and other indices showed a similar trend.3 The economic crisis would continue, in a more or less acute condition, until ended, nearly a decade later, by the Second World War. Meanwhile, Montreal’s welfare institutions, insufficient in the 1920s, now coped miserably with the crisis at hand, and, in almost all circumstances, money became extremely tight. Thus, collecting the pledges made in September 1929 would be a difficult matter. Some donors paid promptly, as asked, but for many others such an expense was simply an impossibility, at least for the time being. Samuel Cohen, the hospital’s first superintendent, recalls: “Unfortunately the 1929 campaign was held just before the Crash, so on a lot of the pledges that were … being paid over a period of four years, they’d make the first payment and then the Crash came and many of them went bankrupt. But I must say that over the years that I’ve been associated with the hospital, many of those pledges were paid twenty, twentyfive, thirty years later. We never wrote off a pledge and many people have paid

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voluntarily. We never sued anybody and pledges were paid.”4 While late pledge payments were infinitely better than no payments, this tendency, through no fault of the tardy settlers-of-accounts, inevitably slowed the process of constructing and preparing the hospital. Institutional pledges also caused much concern. Fortunately, the provincial government, the largest donor, wasted no time in making good on Premier Taschereau’s promise. On 22 October 1930, the provincial cabinet passed an order-in-council granting $300,000 to the Jewish Hospital Campaign Committee. More good news followed in early November when a letter arrived notifying the directors that the City of Montreal (which had not formally pledged anything during the campaign) intended to include in its budget for 1931 a $50,000 donation to the hospital. The committee’s directors jumped at the opportunity and signed an agreement with the city on 24 November. This contract included a provision that the hospital be completed within two years, although delays caused by the Depression later necessitated an extension of this deadline.5 Getting the loan syndicates to pay the $82,200 they had pledged turned out to be more difficult. The Kanader Adler knew of this problem and, while it did not lay all the blame on the loan syndicates, it decided to use its influence to urge the payment of these debts. On 11 May 1931, the Kanader Adler asked its readership: What is happening to the Jewish Hospital? Why don’t they build? The Jewish General Committee should advise the Jewish community just what the reason is for delay in building the Hospital. If the reason is shortage of funds, if subscribers do not pay their pledges, then it should be known … We understand that they have not received further monies from the Loan Syndicates in the last couple of years and these Societies have deducted the $1.00 Hospital Tax from all these accounts … It is not more than right that every Syndicate should turn in the money collected to the Hospital Campaign without delay. Six days later, the same newspaper triumphantly announced that its comments had brought some results. Some of the syndicates had already taken steps to pay their pledges, and one, the Commercial Loan Syndicate, had presented a cheque for $665 to the Hospital Committee. That day, a meeting of representatives of the Hospital Committee and officers of thirty loan syndicates resulted in a commitment to make good their pledges of one dollar per member per year, some immediately and others as soon as possible. Further, “we are given to understand

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the Hospital Committee are making plans for a quiet campaign to collect the pledges and to start building immediately.”6 The Depression, however, remained too devastating for this effort to achieve the desired results and money problems continued to haunt the Hospital Committee until 1934. On 10 June 1931, a delegation led by Allan Bronfman went to City Hall to ask the city’s executive committee for an additional grant of $250,000. The municipality, also financially hard-pressed on account of the Depression, postponed its decision and later turned down the request. Still, while financial problems slowed down hospital construction, the work did not stop and eventually the Jewish Hospital Campaign Committee’s account books showed some signs of improvement. The Canadian Jewish Star insisted that, while attracting pledges was easier than getting them settled (due to the economic crisis), that was no reason for the hospital to remain incomplete. The Canadian Jewish Star also reminded readers of the old Jewish proverb that says: “If God helps with fish, he will also help with pepper.”7 Indeed, after another, but less quiet, collection campaign in early 1934, the Hospital Committee’s finances recovered fully and in October of that year the hospital opened, belatedly, but completely debt-free. Before construction of the hospital could begin, the hospital leaders first had to settle upon a location. This became the concern of the site and building committee very soon after the initial fundraising and by early December they had come to a decision. At a directors’ meeting on 12 December, Dr Wiseman reported that the site and building committee had recommended the purchase of an estate known as the Légaré Property, situated on the southwest corner of Côte-des-Neiges Road and the projected Côte Sainte-Catherine Road (which did not yet extend beyond Côte-des-Neiges). This plot, located within the city limits, but still among farms, measured 325 feet by 2016 feet, and would cost 23 cents per square foot, about $150,696 in all. However, along with the majority’s recommendations came a dissenting letter from Dr Simon Kirsch, who suggested that the land on the northwest corner of the same roads be bought instead. This consisted of two properties, one belonging to Noah and Louis Timmins and the estate of the late Gaspard Deserres, and the other to the Lacombe family. Together these would make up almost twice the area of the committee’s favoured plot and would cost only an estimated $6,072 more. This location had an additional advantage because of its southern exposure, the importance of which had been stressed by a New York expert on hospital construction, Dr S.S. Goldwater.8

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In late December 1929, after the directors had had a chance to visit the two sites and to ponder their relative merits, they opted for Dr Kirsch’s recommendation. Settling with the Timminses and the Lacombes proved to be an easy matter. The hospital authorities immediately took an option on the land and made the final purchase in June 1930. Surprisingly, the city council turned out to be the main obstacle. A number of citizens in the Côte-des-Neiges area, concerned about the possible effects of a hospital in their neighbourhood, began to circulate petitions against the hospital and convinced the alderman of the Mount Royal ward to support their cause. When the alderman took this grievance to City Hall, he was told that zoning regulations could not prevent a hospital in that area from being built as long as its entrance faced Côte-des-Neiges Road. The Executive Committee of the City Council did, however, immediately draft a building amendment to close the ward to hospitals, and planned to have this bylaw passed on 13 February. The Hospital Committee, aware of this attempt to thwart its plans, quickly applied for a permit to build. The municipal authorities refused – illegally. In reaction, the Jewish Hospital Campaign Committee engaged the legal services of the Jewish lawyers Henry Weinfield (chairman of the Hospital’s Legal Committee) and Marcus M. Sperber. With a petition outlining the great need for hospital beds and the immense effort of the Jewish community to help remedy this, they applied for a writ of mandamus (a court order to override the city council). When Sperber and Weinfield presented this writ to the Practice Division of the Superior Court on the morning of 5 February, the Court judged in favour of the hospital committee. Defeated, the municipal government announced through its attorney, Guillaume St Pierre, that it would issue the permit as requested. Thus, the way was open to begin construction of the hospital.9 Despite rumours to the contrary, no plans were drawn up nor architects appointed until the end of July 1930, although previously much consultation had taken place with the internationally known consultant, Dr Goldwater. The architect finally chosen was J. Cecil McDougall, a specialist in hospitals who had done work for the Montreal General Hospital and who had already been associated with Dr Goldwater. Another architect, C.D. Goodman, the designer of the Mount Sinai Sanatorium, would assist MacDougall in the planning. The services of the engineering firm of McDougall and Friedman were engaged for consultation on mechanical equipment for systems such as ventilation, plumbing, heating, and electricity. On Thursday, 9 July 1931, at a meeting for subscribers held in the building of the Young Men’s Hebrew Association, Allan Bronfman and Abram M. Vineberg,

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the chairman of the Site and Building Committee, announced that the Hospital Committee, after one year of making adjustments, had finally approved the fifth blueprint of the hospital. They reported that the hospital’s construction would cost an estimated $1,775,000, that the awarding of contracts would soon take place, and that the hospital complex would cover about 32 acres. They also insisted that the contractors make the maximum use of local labour and materials to help the region’s unemployed. After reminding the assembled subscribers and representatives of the press that access would be easy by means of streetcar, bus, and auto, Allan Bronfman further announced: The final plans provide for a hospital of 200 beds, divided as follows: 150 adults, 20 children and 30 basinettes, comprising all essential departments of a modern general and maternity hospital. The building programme embraces the building, equipment and furnishing of the hospital proper, erection of a power house adjacent to the main building, development of terrain fronting, and the providing of a capital amount sufficient to take care of the deficit between income and expenditure for the first two years of operation. Subsequently, the erection of and furnishing of a nurses’ home is contemplated.10 On 17 July 1931, when the hospital committee’s finances were strong enough, Allan Bronfman announced the awarding of the two chief contracts. The contract for the building proper went to J. Gilletz and Company for the sum of $441,750, while the plumbing, heating, and ventilation contract was awarded to J. Becker of Villeneuve Street for $150,500. Mr Bronfman said that work on the grounds would begin shortly, in fact “just as soon as we possibly can.”11

“And in breaking the earth on which this great hospital is to be erected, I express my sincere hope that, with God’s blessing, it may long fulfill the errand of mercy for which it is destined!” With these words, Lord Bessborough, the governor general of Canada, placed a foot (with a grey spat) on his spade so that it would dig deep, plunged it into the soil, and turned the first sod, as well as several more, in a ceremony beginning the hospital’s construction. The day of celebration, 3 August 1931, had begun with suitable pomp: a sumptuous luncheon that included suprême de volaille sous cloche, peche melba, and other delicacies, held in the governor general’s

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honour at the Montefiore Club. Afterwards, Lord Bessborough and a selected entourage visited the Hebrew Educational Institute on Saint Joseph Boulevard, the Hebrew Old People’s and Sheltering Home, and the Young Men’s Hebrew Association, before driving to the hospital site, where a crowd of over 1,000 people and a band awaited them. A platform had been erected and hundreds of subscribers sat on benches. The front row included such figures as: Aldermen Weldon, Bray, and Seigler, representing the mayor and the municipality; Lt.-Col. Herbert Molson; Dr Griffiths of the Homeopathic Hospital; Edgar Berliner; Hyman Herschorn; and Rabbi Herman Abramowitz.12 Rabbi Abramowitz delivered the invocation and was followed by several other speakers. Afterwards, the governor general, along with Allan Bronfman, Michael Hirsch, A.M. Vineberg, and Rabbi Abramowitz, left the reception platform for the ground-breaking ceremony. The rabbi began to repeat the traditional prayer in both Hebrew and English: “Blessed art thou, O Lord our God, King of the Universe, who has kept us in life and preserved us and brought us to this point in time.” Mr Vineberg handed a spade to Lord Bessborough, who delivered his short speech, and, to the cheers of the crowd and to the tune of “The Maple Leaf Forever,” the governor general sank his implement into the earth. Work on the hospital had officially begun! In the excitement of the moment, several of the prominent citizens nearby each insisted on shovelling some dirt, “but none of them equalled the amount lifted in each thrust by His Excellency.” Michael Hirsch ended the ceremony by thanking the governor general and by giving him a replica of the spade he had used. Another major step had been taken toward the completion of the Jewish community’s “tribute everlasting.”13 With the construction officially under way, and given the gradually improving financial situation of the Jewish Hospital Campaign Committee, completion of the hospital was simply a matter of time. One thing that had not yet been considered at length, though, was a name for the hospital. This was finally dealt with at a meeting of the members of the Hospital Committee on 6 October 1931. That evening, C.B. Fainer moved and Dr Max Wiseman seconded a resolution that they name the new institution the “Jewish General Hospital.” Those present unanimously adopted this straightforward and unpretentious appellation. (Sir Mortimer B. Davis had died in 1928 and his trust funds only became available much later.) At the same meeting, on the urging of Michael Hirsch and Samuel Bronfman, the Committee decided to begin proceedings to obtain a charter for the hospital. However, Michael Hirsch found that it was too late to apply to the provincial legislature during that session. This did not prove to be a serious inconvenience.

His Excellency, the Governor-General, Lord Bessborough, PC, GCMG, turns the first sod at the ground-breaking ceremonies of the Jewish General Hospital at Côte-desNeiges and Côte-Ste-Catherine Road on the afternoon of 3 August 1931. Jewish General Hospital Archives, 1_1_1_4_100dpi and 1_1_14_2_200dpi.

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With the help of Peter Bercovitch and Joseph Cohen, still members of the Legislature, a bill of incorporation was presented to the Private Bills Committee of the Legislative Assembly, and on 15 March 1933, the Jewish General Hospital acquired its charter. The first general meeting of the members and incorporators of the Jewish General Hospital (as opposed to the Jewish Hospital Campaign Committee) took place on 10 January 1934, at which time its first officers were also elected. This election took place none too soon. As early as 25 November 1932, even before the charter had been acquired, Hirsch Wolofsky began to call for an immediate election of future leaders for the hospital: “Who will be the future governors of the hospital? There are two good reasons for holding the election of officers. Firstly, because the so-called “downtown” section of the community – who responded so enthusiastically and sympathetically to the campaign for funds – should be represented on the new executive.14 When elections to the Board of Administration finally occurred in 1934, most of the positions went to uptowners, although Jews from the east end did receive some representation. Not surprisingly, Allan Bronfman was elected president, while Michael Hirsch became first vice-president, Abram M. Vineberg became second vice-president, and J. Levinson Sr and Robert Hirsch received the respective positions of honorary treasurer and honorary secretary. The other members of the Board of Administration elected at that time were Samuel Bronfman, C.B. Fainer, David Kirsch, Michael Morris, H. Reubins, H.M. Ripstein, Louis Salomon, Alderman Joseph Schubert, I. Silverstone, and Dr Max Wiseman. Meanwhile, construction of the hospital continued apace. On 16 November 1931, the Site and Building Committee reported that “the building has now progressed to the completion of practically all concrete work, the roof slab having been poured during the past week. The bricking and stone are being placed on the main building and extension. The power house is practically finished and ready for the installation of boilers and the heating plant. Most of the sub-contracts have been let and the balance are under consideration at the present time.”15 The contractors completed the exterior of the main building in March 1932. In December, the Site and Building Committee announced that its architects and engineers had inspected the edifice and that the time had arrived to take it over from the general contractor and electrician. The job had even been completed at a saving of $15,000. In recompense for this, and as partial compensation for losses sustained by J. Gilletz and Co., the Hospital Committee rewarded

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the firm with a bonus of $5,000.16 All that remained to be done was to equip and staff the hospital. The vital task of equipping the Jewish General Hospital took considerably longer than expected, partly due to delays caused by the Hospital Committee’s financial restrictions (it had decided to purchase equipment with funds on hand only), and partly because of day to day problems encountered in choosing, ordering, transporting, and installing the many items required. To assist in this task, the Hospital Committee engaged the services of an American expert. Louis Cooper Levy, originally a newspaper reporter, but now a hospital administrator, had been superintendent of the Mount Zion Hospital of San Francisco for five years and of the Jewish Hospital of Cincinnati for ten years. After coming to Montreal in May 1932, he busied himself selecting medical equipment and surveyed every future department, specifying the amount of linen, beds, and furnishings to be bought. He also helped the Hospital Committee decide upon the organization and administration of the future hospital and wrote a series of articles in the Canadian Jewish Review. These articles described the progress of the work and some of the hospital’s features, and generally fanned the community’s enthusiasm for the project.17 Working with Louis C. Levy were several committees, each with particular responsibilities, including the site and building committee, a furnishings committee, and committees on kitchenware, linen, blankets and draperies, surgical and medical equipment, and dental equipment. The site and building committee, most of whose work had already been completed by the time equipment became the principal concern, was chaired by Abraham Moses Vineberg, vicechaired by Harry Bronfman, and also included S. Blumethal, N.L. Engel, Harry Rother, and Louis Salomon. The furnishings committee consisted of Sidney Levitt (chairman), Jacob Albert, and Edward Salomon. Barney Rubin led the linen, blankets, and draperies committee, which had only one other member, Mortimer Silverstein. The kitchenware committee held a particularly important role in equipping the hospital, due to the desire, from the very beginning, to adhere completely to Jewish dietary laws. The members of this group, Isadore Freedman (in the chair), S.P. Myers, and John L. Sabbath, a leading jeweller, had to choose two sets of cutlery, silverware, dishes, and tea-towels, as well as glassware and other culinary equipment sufficient for five different services. They were also responsible for devising a system whereby the dietary laws could be effectively obeyed and confusion avoided. In the end, they ordered dishes with red lines for meat dishes

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and with blue lines for dairy dishes, cutlery either grooved (for meat) or plain (for dairy products), utensils marked with an “M” or an “F,” and dish towels with red borders for meat dishes and blue borders for dairy dishes. They also purchased dishwashing machines, one for each set of kitchenware. Dr David H. Ballon led the all-important committee on surgical and medical equipment and in this task received the able assistance of Drs Abram Bercovitch, Alton Goldbloom, and Max Wiseman, all of whom had played leading parts in the early hospital movement. The group responsible for purchasing dental instruments and equipment, required in both dental surgery and the dental department of the Out-Patient Service, comprised the following dentists: Dr S.H. Feldman, Dr Hyman H. Pearson, Dr Jacob Rubin, and Dr A.S. Solomon. The final element necessary to bring the hospital to life was a competent staff, suitable to the needs of a Jewish medical institution. The first position to fill, and the key figure in any hospital, was that of superintendent. Despite Louis C. Levy, who had completed his tasks and left the province in December 1932, applying for the job, the person ultimately chosen by the directors of the hospital committee was Samuel Cohen, the thirty-three-year-old assistant director of the Beth Israel Hospital of New York, who had visited Montreal and the hospital committee in September 1933. When Mr Cohen took up his duties on 1 November of that year, he found himself in charge of the hospital’s final preparations. The hospital directors, conscious of his great expertise and of their own lack of knowledge in hospital affairs, gave him their full confidence. When Mr Cohen asked Michael Hirsch whether he had any specific instructions regarding the operation of the hospital, Mr Hirsch put his arm around the much younger man and said, “My boy, I am a cigar manufacturer. I know all about cigar manufacturing. I know nothing about hospitals. That’s what we want you here for.”18 With such an open mandate, Samuel Cohen began his work with a strong sense of confidence. What followed was a busy year of furnishing, equipping, staffing, and organizing the hospital. The first hirings of physicians did not take place until June 1934, when six distinguished doctors agreed to head the major departments. Medicine was put under Dr Joseph Kauffmann, an assistant professor of medicine at McGill and physician at the Royal Victoria Hospital. Surgery would be the responsibility of Dr Edward Archibald, the surgeon-in-chief of the Royal Victoria Hospital, while pediatrics would be looked after by Dr Alton Goldbloom, a physician at the Children’s Memorial Hospital and the Foundling Hospital. Dr A.O. Freedman accepted the position as chief of the Oto-Laryngology Department. At that time he held a similar position in the Women’s General

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Hospital and at the Herzl Dispensary, besides doing work in the Montreal General Hospital and at the Mount Sinai Sanatorium. Dr Jacob Rosenbaum, who also practised at the Royal Victoria Hospital, the Herzl Dispensary, and other institutions, besides teaching at McGill University, would head the Department of Ophthalmology, while Dr James R. Goodall, a professor and practising physician at various Montreal institutions, agreed to lead the Gynecology and Obstetrics Department. Under him, the senior physician-accoucheur would be the ever-present Dr Max Wiseman. After the appointment of a neuropsychiatrist, a pathologist, and a radiologist, the heads of departments held a series of conferences on the question of further hirings. At a board meeting on 11 September, they made known the names of all those who had been selected for staff appointments at the hospital. The Jewish General Hospital’s first doctors numbered seventy-two, sixty-four of whom had graduated from McGill University. Of the remaining eight, three had attended the University of Montreal and the others came from various American and European universities. The original nine interns, including three residents, would assume their duties on 13 October.19 Amy Mendels, a native of Lanark, Ontario, a graduate of the Ottawa Ladies’ College, and more lately connected with Mount Sinai Hospital of New York, became director of nurses. She would add her seventeen years of experience to the expertise of thirteen other nurses, eight of whom were accommodated in a small red house on the site of the hospital’s present west wing. Samuel Cohen, who also directed the hiring of the small army of support personnel, necessary for the successful operation of every hospital, recalled this period: “We tried to get as many Jewish staff as we could. Most of the people were untrained. We had to train them in their particular tasks. We had staff on for about two weeks, or ten days to two weeks, before we opened the doors. And then we opened the doors.”20

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Monday, 8 October 1934. The opening day of the Jewish General Hospital had finally arrived. Just as at the turning of the first sod, this event, which marked the culmination of so much effort and generosity, occurred in an atmosphere of dignified but enthusiastic ceremony. Two days earlier, “Jewish General Hospital Sabbath” had been celebrated in all the city’s synagogues by the reading of “In the beginning” (Genesis 1:1), as well as by prayers and sermons of thanksgiving. On Sunday, the Board of Administration held an open reception for all subscribers. Monday’s celebrations, dampened only by the absence of Allan Bronfman, who had taken ill while in New York, began at a luncheon in the Montefiore Club. Governor General Lord Bessborough, once again the most honoured guest, was presented with a silver trowel for laying the last stone, while Premier Taschereau, unable to attend, had sent Athanase David, the Provincial Secretary, in his place. By the beginning of the luncheon, however, David had not yet arrived, and when the time came to present him with the golden key for opening the hospital, there remained no choice but to give it to Peter Bercovitch, the most senior member of the Legislature of Quebec present. In the afternoon, everyone headed to the new hospital at the corner of Côte-Sainte-Catherine and Côte-des-Neiges Roads, where a dense, multilingual crowd of spectators, both Jewish and Gentile, awaited the formal opening of the Jewish General Hospital. The ceremony began with Rabbi Herman Abramovitz delivering the invocation, followed by a psalm and then prayers by the Rabbis Harry Stern and Hirsch Cohen. Next, Harry Bronfman stepped forward and delivered the brief welcoming address that his brother Allan was to have used to receive Lord Bessborough. The Governor General replied, first by

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praising Allan Bronfman for all he had done in realizing the project, then by emphasizing his own personal interest in the hospital, and finally by rejoicing in the great contribution to Montreal’s health services that the Jewish community had just provided: They have been hard years, for the world, for Canada, for the City of Montreal. Yet, through all the anxieties and difficulties of that period, the work which we inaugurated that summer day (August 3, 1931) has gone steadily forward. Obstacles have loomed up and problems have arisen, but between them your board of administration and your Site and Building Committee and the builders themselves have overcome the obstacles and solved the problems. Today, an ornament to its city, a notable addition to that city’s social services, the Jewish General Hospital stands up fully equipped and fully staffed. It is more than that too. It is a monument to that spirit of charity towards your fellow men which has always been the characteristic of Jewry throughout the world. I hope that this may be the beginning of a long and fruitful chapter in the history of that never-ending struggle which men of all races and all creeds are called upon to wage against sickness and suffering throughout the world.”1 All Jews hearing this brief speech had ample reason to be proud. A ticklish situation then arose, but one that resulted in laughs for all. Michael Hirsch stood up to announce that although he had already given the golden key to Peter Bercovitch, Athanase David, its rightful holder, had just arrived: So, between our friend Bercovitch and our good friend David they will have to reach some solution to the difficulty. I must either address the man with the key or the man without the key. Now where do I stand? It is a constitutional question. We may have to carry it to the foot of the throne. Mr. Bercovitch! Bring that key over here. If we can get something away from a member of the Bar who is also an MLA, without administering an anaesthetic, I think we’re pretty good.2 Peter Bercovitch thereupon surrendered the golden key to the Provincial Secretary, and Michael Hirsch proceeded with his introduction of the cabinet

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member. Athanase David responded with a short address, flattering both to the Jewish community in general and to Michael Hirsch in particular. Mayor Camilien Houde, who had been introduced by Abram M. Vineberg, ended the speeches: If there is one lesson more than any other which we have to learn from the Jewish Community in Montreal, it is that of solidarity and community effort. Down through the ages the Jewish people, for the most part in hardship and in bitterness of spirit, have survived as a race because they have known how to help those of their fellow-nationals who have been in trouble, in poverty and in illness. Montreal is facing problems of great moment. The calls on us are endless. The destitute have never stood more in need of help. For your initiative in financing and erecting this magnificent hospital all Montreal must be grateful to YOU.3 Lord Bessborough then used his silver trowel to place the final stone of the main building, and unveiled a bronze plaque, which reads as follows: A TRIBUTE EVERLASTING His Excellency The Earl of Bessborough, P.C., G.C.M.G. Governor General of Canada Who on August Third Nineteen Hundred and Thirty-one Turned the first sod Completed the Building of this the JEWISH GENERAL HOSPITAL By inserting in place the last stone on the Eighth Day of October Nineteen Hundred and Thirty-four Tishri 29 – 5695 To end the ceremony, Athanase David officially unlocked and opened the hospital doors, followed by anthems and the inspection of the building by all guests. The Jewish General Hospital had become a reality.

The Jewish General Hospital as it stood in 1934. Jewish General Hospital Archives, 1_1_1_4_21.

Large sunrooms were located on both ends of the original building of the Jewish General Hospital, 1930s. Jewish General Hospital Archives, 1_1_1_4_22.

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The hospital visited by subscribers and other guests on 8 October was a model of modernity in health care. Its semi-rural environment, free from the hurlyburly of downtown Montreal, provided one of the institution’s principal advantages and was a source of great pride: “Situated in a ‘splendid isolation’ of one million square feet of land, owned by the hospital, unobstructed sunshine, uncontaminated air and a splendid view is guaranteed for generations to come …. The front entrance [permits] a view of Brother Andre’s Shrine, while the solariums and windows on the rear of the building are exposed to a wide expanse of undeveloped land towards the Laurentian Mountains.”4 Taking advantage of its spacious site, the hospital had begun to cultivate a small farm, that in future would supply patients with most of their fruit and vegetable requirements. A powerhouse dominated the auxiliary buildings and contained three 175-horsepower boilers; together these produced steam for heating, laundry equipment, dishwashing machines, the sterilizing system, and other needs. The powerhouse also contained two 5,000-gallon oil tanks and an emergency generator in case of power failure. Fumes from the boilers escaped through a 130-foot chimney. The main building, whose bed capacity had been increased to 226 by the time of completion, was shaped like a “T,” with the horizontal bar lying parallel to the newly completed extension of Côte-Sainte-Catherine Road. The main block measured roughly 235 feet by 45 feet, except where space was added for the impressive front entrance (ornamented with stone imported from France), while the rear wing had a length of 75 feet and a width of 50 feet. Constructed of reinforced concrete and embellished with brick and limestone, the building was made to be fireproof, with terracotta partitions and metal door and window frames. It contained acoustic plaster ceilings and soundproof floors and walls, and had been painted in light blue, buff, and French grey. Also, a very up-to-date signalling system had been installed and observers marvelled at the fact that it could be used to page individual doctors and nurses in almost any part of the hospital. Other features of the hospital included the kitchens, solariums, and state-ofthe-art operating rooms. The two main kitchens, divided to ensure complete adherence to Jewish dietary laws, were located on the ground floor of the rear wing, while subsidiary kitchens, equipped with “steam plates, electrical refrigeration, electrical stoves and all other appliances essential to the modern kitchen,” had been installed on each of the upper floors of the hospital.5 The hospital’s extensive solariums offered patients a cheery atmosphere and a maximum exposure to the healing rays of the sun. Large sunrooms accommodating fifteen to twenty patients were located at both ends of each floor of the

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main block and all had been amply supplied with comfortable chairs, sofas, and chaises longues. A large solarium covered with vita-glass had been built on the roof, and unenclosed sundecks, capable of accommodating up to fifty patients, on the roof of the main building and above the extension, had been built for the out-patient department. The hospital contained five modern operating theatres, each supplied with the latest in operating tables. One of these, a mechanized, adjustable table for use in fracture cases, permitted X-ray observation without removal to another room and was the first of its kind in Canada. Largely on its account, experts determined the Jewish General Hospital’s X-ray room to be the most extensive such unit in Eastern Canada. The hospital authorities had also purchased a moveable X-ray machine which allowed patients to be X-rayed in their beds. The large basement provided quarters for workshops, storage rooms, the mortuary suite, and, in the leg of the “T,” extensive laundry facilities. Above this, on the ground floor, were the main kitchens, dining rooms, ambulance entrance, supply rooms, and space for the needs of staff. The main floor housed the large entrance hall, administration offices, lecture rooms, waiting rooms for patients and their friends, and, at the extreme east end of the main building, the OutPatient Department. This latter department included a large space for services in otolaryngology as well as clinics for dentistry, ophthalmology, gynecology, urology, pediatrics, cardiology, dermatology, and several other branches of medicine. Higher up, the second floor contained the children’s wards and most of the public wards. The children’s sleeping quarters consisted of three wards of six cribs each, one room with four cribs, and two private rooms. The youngsters were also provided with recreational facilities and suitably sized furniture for their solarium. The system adopted for the public wards was modern and a far cry from the large rooms of thirty to forty patients common in most hospitals at the time. Instead, the Jewish General Hospital’s public wards contained only four beds each, and were divided by nurses’ stations, with glass panels for observation. Smaller soundproof rooms for noisy or delirious patients were located off the nurses’ stations. This system permitted a more restful environment and the division of the critically ill from those in better condition. As noted by the Montreal Daily Star on 6 October 1934, “in the general policy of the hospital, a democratic principle stands out in the fact that the furniture for public patients, the solariums, and the quality and method of serving food, will be the same as for private patients.”6 The hospital’s third floor was mainly devoted to semi-private rooms of two beds each, although some of this floor would soon be converted to additional

Card issued to the first Outdoor Department patient, 20 October 1934. Jewish General Hospital Archives, 1_1_1_3_12_96dpi.

First admission to Jewish General Hospital, 15 October 1934. Jewish General Hospital Archives, 1_1_1_3_10_96dpi.

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public ward space. The third floor also housed the five operating theatres, as well as space for sterilizing, anaesthesia, and nurses’ work. These were located in the rear wing of the building. Private patients, along with some semi-private patients, received their care on the fourth floor, which also comprised quarters for residents, interns, and several other doctors. Finally, the entire fifth floor was the location of the promised maternity ward. This accommodated public, semi-private, and private patients and included forty-one bassinets for newborn infants, special new devices for bathing and controlling room temperature, and provision for isolation in complicated cases. The Jewish General Hospital had thus not only opened, but promised to provide its patients with a maximum of facilities and care. Before these services could be dispensed, however, patients had to start coming to the hospital. The first one arrived for admission on 15 October, one week after the hospital’s official opening. Beginning slowly, this trickle of patients soon became a flood. Samuel Cohen recalls: “Patients don’t walk in. Patients are referred by doctors. The doctors were aware that the hospital was open and patients came in. There were obstetrics and babies were born. Emergency procedures were performed and gradually picked up. We opened one floor, then another floor, and we found out before long that the hospital was getting small.”7

chap ter nine

t h e depre s s i on a n d t h e wa r ye a rs

The years 1934 to 1945 saw the Jewish General Hospital traverse financial problems caused by the Great Depression, shortages due to the Second World War, and an increasing lack of space. Nevertheless, the administrative and medical staff succeeded in maintaining an excellent service record and in introducing a number of substantial improvements to the institution’s facilities. The birth of the Jewish General took place in the depths of the Depression; this had a profound impact on the institution’s first years of operation. Not only had the initial pledges, made before the financial crisis, become extremely difficult to collect, but also further efforts to raise money were severely hampered. Concurrently, the costs of running the hospital shot upward. The primary reason for this great increase in cost was the poverty of much of the hospital’s clientele. With rampant unemployment and widespread penury among the population of Montreal, the number of people who could afford either a private doctor or the expenses of hospitalization dropped substantially below the already low percentage who could do so during the 1920s. A poor patient arriving at the hospital was first examined by the social service director to determine whether he or she was indeed sufficiently impecunious as to be incapable of paying fees. If this was the case, the sufferer was admitted to one of the public wards. Such hospitalizations were subsidized according to provisions in the Quebec Public Charities Act, but almost one-third of the cost was still left to the hospital to absorb. (Actually, only patients in the private wards paid the full cost of their care.) Thus, when great numbers of poverty-stricken people of all faiths began to seek admittance to the hospital’s public wards, the financial situation of the hospital appeared bleak. From the very beginning, everyone could see that the greatest demand would be for public beds. By 21 February 1935, 535 patients had been admitted to the

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public wards, as opposed to 281 to the semi-private wards and 102 to the private rooms.1 This tendency only increased. The Jewish General Hospital’s Annual Report for 1936 paints a distressing picture. Samuel Cohen reported that of the 3,827 patients cared for that year, only 8 per cent paid for private facilities and 20 per cent for semi-private rooms. A full 72 per cent were admitted to the public wards. Allan Bronfman, the president, insisted that: “It is a matter of great pride to be able to say again that no patient was ever refused treatment because he was too poor to pay for it. I need hardly add that the application of this policy was not limited to those of our own faith.”2 Still, he found it disturbing that admittance to public beds could not always be promptly carried out. A long waiting list remained, even though the number of public beds had been increased from 82 to over 120, mainly at the expense of space on the third floor, which had been intended for semi-private patients. The same problem plagued the hospital in 1937, when over half of its care was devoted to patients hospitalized under the Quebec Public Charities Act. More than half of those who received treatment at the Out-Patient Department (which then usually meant people who could not afford the cost of a private physician) proved unable to pay even the nominal fee asked for by the hospital. This continued through 1938 and 1939. In his report for the latter year, Samuel Cohen noted that the 31,316 visits to the Out-Patient Department had greatly contributed to the hospital’s deficit, as the average cost to the hospital per visit was $1 and the average revenue per visit amounted to only 12 cents. At the same time, the public wards were constantly full, accounting for 2,326 patients and 39,383 patient-days, compared with 1,636 patients (16,322 patient-days) in the semi-private wards and 439 patients (5,248 patient-days) in the private wards. The number of admissions to the private, semi-private, and public wards was only normalized after the Second World War had begun. From a ratio of 547 private and 1,813 semi-private to 2,319 public patients in 1940, the situation evolved to that of 1945, when 1,128 patients were admitted on a private basis, compared with 2,621 semiprivate patients and 1,492 public patients.3 Added to the positive results of patients being able to pay a greater percentage of the cost of their hospitalization was a decision by the provincial government to pay hospitals $3 per day for the care of each indigent patient provided for under the Quebec Public Charities Act. This decision, taken in 1942, raised the amount from $2, which had been set in 1922. This was none too soon, for the cost of medical care had been rising quickly. After a period of relative stability, the average cost to the hospital per patient-day (based on charging all operating costs to in-patients) had shot up from $4.64 in 1939 to $5.66 in 1942.4 At the same

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time, the municipal government dragged its feet by continuing to use an unrealistically narrow definition of indigence for the purpose of granting aid. Three years after the Great Depression was well and truly over, Samuel Cohen still found this as persistent as ever: “It is true that many persons formerly unemployed have found gainful occupation. There still remains, however, a large group whose earnings, while adequate for maintenance under normal conditions, are nevertheless insufficient to meet any part of the cost of illness. A distinction between ordinary and medical indigency must be made and special provision for the latter group should form an essential part of any welfare programme.”5 As the public welfare system would not cover people in the latter category who were unable to pay their medical bills, the Jewish General was obliged to absorb these costs itself. A solution to the problem of “medical indigency” would arrive partly with the spread of Blue Cross Plans (very new at that time), and still more satisfactorily with the eventual institution of socialized medicine. Coinciding with the lessened ability of patients to pay for their hospitalization, the Depression also reduced the amount of money that could be raised from the Jewish community to compensate for the hospital’s inevitable operating deficit. The first annual maintenance campaign took place in 1936. Ernest Vaz directed it, with the assistance of a large executive committee. This effort, scheduled to take place between 10 May and 18 May, was similar to the original campaign in that it was directed only at the Jewish community and involved dividing the city into zones, each one the responsibility of a zone chairman. Committees were established to look after “special names,” publicity, speakers, employees’ collections, and sick benefit societies. Despite the novel use of radio, however, the Depression precluded any chance of success. By the evening of 15 May, only 64 per cent of the modest goal of $50,000 had been raised. On 18 May, the objective had still not been attained, but, on account of the late arrival of many pledges, the campaign executive decided to extend the fundraising for a few days. But even that was not enough. The pledges still fell short by about $3,000, and after campaign expenses were deducted, added up to only $44,759.87.6 The next three annual maintenance campaigns met with similar fates. The campaign of 1937 had to be extended when it was found to be almost $20,000 short of its $60,000 objective on the closing date. Even then, after deducting expenses, the hospital raised only $45,064. The campaign of 1938 also fell considerably short of its goal, resulting in only slightly more income than the year before. When the annual maintenance campaign of 1939 did little better, the result was a financial crisis. Allan Bronfman revealed in the annual report for

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that year that the Jewish General was burdened with a debt of $100,000. The lending bank insisted that the debt be reduced and refused to extend the hospital’s overdraft. At the same time, the projected budget for 1940 involved an operating deficit of $75,000, due solely to the increasing cost of supplies. Faced with this dilemma, the board of administration decided to neglect the pressing need for expansion and the necessity of eliminating part of the debt, which they left for better times, and chose to concentrate on balancing their budget by means of strict management and a vigorous maintenance campaign. They also managed to acquire an interim loan of $12,000 from the Sun Life Assurance Company and the federal government. Fortunately, this time the maintenance campaign succeeded and the net amount raised, along with other donations, governors’ fees, and income from investments, totalled $75,175.82, $1,365.50 more than the year’s actual operating deficit.7 In 1941 a more permanent solution to the problem of raising money for the annual maintenance fund came about with the launching of the Combined Jewish Appeal (also under the presidency of Allan Bronfman) by the Federation of Jewish Philanthropies. Thus, despite a large operating deficit of $93,988.65, the hospital ended that year with a debt increase of only $3,193.42. The year 1942 ended with a surplus of $1,111.70. The Jewish community of Montreal could be proud of bringing its hospital to the point where it could expect annual subscriptions to cover the operating deficit; now the Jewish General could start working to reduce its accumulated debt.8 Although the war brought increased prosperity to the city’s population and reduced the financial pressures on medical facilities, it nevertheless entailed difficulties of its own: shortages of supplies and staffing. Wartime supply shortages caused relatively little worry to the hospital administration and, with the help of goods provided by the Women’s Auxiliary, problems of this nature did not substantially diminish the excellent quality of care offered to patients. National priorities did, however, necessitate postponing the installation of a blood and plasma bank, the money for which had been raised by the Women’s Auxiliary. Also, during 1942–43, the Jewish General Hospital found itself ordered by the Fuel Oil Controller to convert its boilers to coal, a less efficient combustible for the purpose. The hospital’s small fruit and vegetable farm assisted greatly in ensuring that certain foodstuffs were provided at a reasonable rate. It supplied plentiful fresh produce for the summer, as well as a surplus sufficient to enable the home canning of thousands of cans of fruit and vegetables for the rest of the year. This is

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how the cost per meal for raw food had been kept below 10 cents during the Depression. The savings continued after the war broke out, especially in light of the increasing rate of inflation. Samuel Cohen felt further reason to be proud of the hospital’s farming activities, for, “in these days of Victory Gardens, our farm project becomes not only a measure of economy, but a distinct contribution to our war effort by increasing food production.”9 Staff shortages during the war years caused a more serious threat to the effective operation of the hospital. While of minimal influence in 1939, by the second year of hostilities, the lack of personnel had become more severe: “War conditions have created many problems in the staffing of all departments. The inability of hospitals to compete with the higher salaries paid by industrial and commercial establishments has resulted in the loss of many employees. It is a tribute to the loyalty and sincerity of our Department Heads, that this situation was not permitted to interfere with the efficiency and the smooth operation of all services. This accomplishment meant much hard work and close supervision on their parts.”10 The situation deteriorated further in 1941 and 1942. Staff shortages due to enlistments in the armed forces, higher wages in other fields of work, and increased hospital use, now extended to doctors, nurses, and all other kinds of skilled and unskilled help, especially in the Dietary Department.11 Fortunately, some of the jobs requiring less training could be performed by publicly minded volunteers. However, this did not provide a permanent solution and could do little when extensive training and skill were required. By 1943, the lack of staff had become so acute that officials at the Jewish General Hospital, like those at other hospitals, found themselves forced to restrict admissions because the staff could not adequately look after a larger number of patients. To reduce patient-days by 4,000, from 63,026 in 1942 to 59,080, the medical staff began to refer only those in urgent need of hospitalization who could not be cared for in their homes. Patients were also discharged earlier than usual and were asked to return home for convalescence whenever possible. Faced with this strain on the human resources of the Jewish General Hospital, the remaining nurses put forth a heroic effort. Samuel Cohen, fully aware of their plight, publicly noted that “the nursing situation is particularly acute and was in the main responsible for the necessity to restrict admissions to the Hospital. That we were able to give such excellent nursing care to so large a number of patients is a tribute to the loyalty of those members of the nursing staff who remained and assumed their added responsibilities with the selfless devotion

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and humanitarianism so characteristic of their profession. We owe to all of them a debt of sincere gratitude.”12 Mr Cohen summed up that year as one of “activity, anxiety and at times disappointment,” in which, however, “we have met with reasonable success. The inability to make our services available to all who seek them is our greatest concern. The complete solution to this problem must await the day of victory, when the difficulties created by a dreadful War may be dispelled and we may once again devote our full energies to the problems of peace and reconstruction. God speed the day!”13 The staff shortage continued into 1944 and was now also particularly evident among the interns and in the Social Services Department, whose director, Etta Goldman, had obtained a commission in the Canadian army. As a result, the hospital further cut back admissions and reduced the number of treatment days that year to 57,301. That they could avoid further restrictions was largely due to the selfless volunteer work of members of the Women’s Auxiliary. That organization managed to provide seventy-five volunteers for work on the wards each week, six workers for the cafeteria, twenty women to help preserve and can fruit and vegetables during the summer, thirty-five substitutes for ward duty, and another fifteen volunteers who served intermittently.14 Fortunately, by the time Allan Bronfman was writing his president’s report for 1944, the Allies had won in the European theatre and would soon triumph in the Far East. Thus, although staff shortages existed during 1945, all could look forward to a return to normalcy when the troops came home during the latter part of 1945 and 1946. In reviewing the war years, the Jewish General Hospital could be proud of its contribution to the triumph over fascism and the perpetrators of the Holocaust. Over fifty of the hospital’s interns, as well as more senior doctors, numerous nurses, and other staff, had served in the armed forces. Moreover, “the provision of adequate medical care for the producers of the materials of war, thereby maintaining morale on the Home Front, is an additional contribution to the war effort, the value of which must not be underestimated.”15 The Women’s Auxiliary, normally concerned solely with aiding the hospital’s staff and patients, had in this case diverted some of its energies to assist directly helping the war effort. These activities included: providing V Bundles, surgical dressings, and utility bags for air raid victims; entertaining troops; addressing ration cards; and various other services. Thus, together with their assistance in the medical field, these women also produced a fine record of devotion to the defence of their country and to the cause of humanitarianism.

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Despite the financial and staffing problems which the Jewish General Hospital faced during the Great Depression and the Second World War, it nevertheless managed to achieve a number of significant accomplishments. The management of the hospital underwent an important modification in December 1936 with the election of the first board of trustees. This body, chosen by the members of the board of administration from among the hospital’s voting membership, would act as an advisory council to the board of administration, deciding on expenses, accepting yearly budgets, and controlling real property and endowment funds. The members of the first board of trustees were: Harry Bronfman, Robert Hirsch, Lyon Cohen, S.W. Jacobs, Hirsch Wolofsky, Henry Weinfeld, J. Kaufman, Elijah Silverstone, S.B. Rubin, Arthur Simon, Samuel Hart, and Sam Pesner.16 The Jewish General Hospital also benefited at this time from the institution of regular meetings between Samuel Cohen and the medical staff, at which the superintendent and the doctors discussed administrative matters of mutual interest, and from the drafting of a comprehensive set of regulations governing the medical functions of the hospital. The Medical Board, under the chairmanship of Dr Alton Goldbloom, drew up this set of rules in 1941. A more important development was the founding of the Women’s Auxiliary in January 1936. This organization, designed to assist the staff and patients of the Jewish General Hospital with both moral support and material aid, began a lengthy history of providing these vital elements. Under the presidency of Annie Goldbloom, the wife of Dr Alton Goldbloom and previously the president of the Women’s Auxiliary of the Hebrew Maternity Hospital, it spent most of its first year organizing and raising money. In addition to these time-consuming activities, however, the Auxiliary’s members gave gifts to hospitalized children at Chanukah and saved the institution at least $5,000 by purchasing additional equipment and linen, as well as medicine for poor patients. The committees established by the Auxiliary in 1936 concerned themselves with membership, a Life-Saving Fund, linen, surgical dressings, the transportation of poor patients (this car committee only lasted one year, until it was restored between 1946 and 1952) and volunteers for answering telephones. The membership committee, led by Mrs M.J. Raff from 1936 to 1948, met with immediate success. As early as 5 March 1936, upon the completion of the Women’s Auxiliary’s charter membership drive, 1,850 volunteers had joined; by the end of the year, 154 more women had chosen to take part in this meritorious organization. In 1945 the membership of the Women’s Auxiliary had grown to 2,577 senior members and 25 out-of-town associates, with dues amounting to $7,781.17

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An early iron lung in the Jewish General Hospital. Jewish General Hospital Archives, 1_9_2_2_8.

Lucy Bronfman, the wife of Allan Bronfman, chaired the Life-Saving Fund Committee and, as Annie Goldbloom and Mrs M.J. Raff had done, she kept her position until 1948. This committee fulfilled the important role of providing the hospital’s underprivileged sick with every available means to contribute to their recovery and comfort. Such succour involved paying for blood transfusions, special nurses, insulin, antibiotics, oxygen, vitamins, sulfa drugs, and other medicines, as well as footing the bills for some new equipment, which the Jewish General would not otherwise have been able to afford. For example, in 1938, the Life-Saving Fund spent a total of $1,211.50, on, among other things, the purchase of an iron lung and an oxygen tent. In 1941, these women made an outlay of $2,890.95 for new X-ray equipment and radium, $1,932.52 for drugs, special nurses, blood, oxygen, and an emergency taxi service, $759.32 for a new electric food conveyor, and $707.53 for new dispensary bottles and the replacement of small instruments. By 1944 the increasing number of patronesses and donations gave the Life-Saving Fund Committee a budget of $8,850.00, which amply provided for nurses. In addition, it provided for drugs, blood, oxygen, and the salary

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of a social worker in the tumour clinic; it also allowed for a handsome donation toward a recently established laboratory building fund.18 The Linen Purchasing Committee, under Mrs A.M. Wener and Mrs J. Greenberg (until 1942), took care of supplying the Jewish General Hospital with curtains, hangings, blankets, sheets, towels, pillow cases, and uniforms. In its first three years, this committee was responsible for a volunteer group that sewed about 10,000 articles of clothing, a task that was later taken over by paid hospital employees. The committee continued to buy linens, however, and it was largely due to its work that wartime linen shortages did not seriously affect the hospital. Also very active was the Surgical Dressings Committee, whose function was to make bandages. Its contribution is manifest in the vast number of surgical dressings produced by its members each year: 295,920 in 1938; 356,782 in 1939; and 443,247 in 1940. In 1944 and 1945 these volunteers made 287,642 and 153,681 dressings respectively.19 Six other volunteer groups were established by the Women’s Auxiliary of the Jewish General Hospital before the end of the Second World War. Two of these began in 1937. The Bottle and Jar Committee operated until 1945 under the chairmanship of Mrs Pearl Hirsch (1937–40) and Mrs M.I. Gordon (1940–45). Its members collected used bottles and jars from private citizens, and, by selling them to Brown’s Bottle Exchange, managed to collect a total of $4,192 during their seven years of service. They used this money to purchase new dispensary medicine bottles and operating room equipment. The second committee concerned itself with the Children’s Nursery Fund. Using the slogan, “No child is too young or too old to be a member of the Children’s Nursery Fund,” these women raised money by selling $1 memberships to children (or to parents on their children’s behalf) and used the proceeds to improve service in the maternity and children’s wards. The Children’s Nursery Fund helped to pay the cost of medicine for poor infants, layettes, some day-to-day expenses, Chanukah gifts, and a few larger items, such as a resuscitator in 1941. With steadily increasing revenue, this fund would be able to provide even more in the postwar period.20 The year 1938 saw the creation of a Layette Committee, under the leadership of Mrs J. Klein. This service, originally paid for by the Women’s Auxiliary regular fund and then by the Children’s Nursery Fund, operated under the direction of the Hospital Social Service Department. It provided all needy mothers in the maternity ward with a layette, each of which consisted of two dozen diapers, three gowns, two sweaters, two bonnets, two pairs of booties, and two blankets.

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The original nursery. Jewish General Hospital Archives, 1_1_1_4_26_200dpi.

During the first twenty-three years of this committee’s work, it gave out a total of 900 layettes.21 During the war years, the Women’s Auxiliary founded two groups that would greatly help to relieve the staff shortage. The Women’s Auxiliary Juniors, organized in December 1941, aimed at increasing the involvement of young women between the ages of sixteen and twenty-six. Their activities included visitor control in the public wards, volunteer help for the ward nurses, assistance on the hospital’s farm, rolling bandages, and participating in courses offered by the St John’s Ambulance and Canadian Red Cross Societies. In 1943, the Women’s Auxiliary Juniors also assumed responsibility for subsidizing and helping to staff the medical library. The group disbanded in 1947, by which time the staff shortage had ended. The Volunteer Service, intended for women of more diverse ages, lasted from 1942 until 1948, although it was reestablished in 1956. Its members assisted nurses in wards, served meals, helped with canning and preserving, and collected visitors’ cards. The last group set up by the Women’s Auxiliary prior to 1945 was the Medical Library Committee. The Jewish General Hospital, with the help of donations

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Operating room nurses, 1935. Jewish General Hospital Archives, 1x4_9x9_1_1.

from its medical staff, had established a medical library soon after opening, but for several years it remained inadequate because of insufficient funds and staffing. In 1941 the Auxiliary founded this new committee which henceforth (for a while with material support from the Juniors) solicited donations for the library, supplied volunteer librarians, and annually voted $250 for maintenance. The Medical Library Committee continued to provide these much needed services until 1957, when the hospital hired its own librarians. After that, however, these women continued to grant an annual amount for purchasing books. The extensive assistance given to the Jewish General Hospital by its Women’s Auxiliary helped that institution to achieve the medical record that would lay the foundations of its reputation for excellence, a record built by both the quantity and quality of the service it offered. By the time the Jewish General Hospital had been operating for ten years, its staff had cared for over 45,000 in-patients (including over 5,000 non-Jews) and had received about 275,000 visits to the Out-Patient Department. Further, in its

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function as a maternity hospital, the “Jewish,” as it became popularly known, had eased the arrival of more than 8,000 infants into the world. For a hospital of 226 beds, this level of service involved a continuous bustle of activity. In 1945, for example, 3,742 operations were performed (1,875 using anaesthesia), 1,011 babies were born, and X-rays were employed on 12,156 occasions: 8,193 times for radiographs, 1,314 times for fluoroscopic examinations, and 2,649 times for treatment. The laboratories were also busy, conducting 13,545 biochemical, bacteriological, and serological (blood serum) examinations. In addition, they performed 78 autopsies, took 1,994 electrocardiographs and 872 basal metabolic rates, and analyzed 1,650 surgical specimens.22 The staff and administrators of the Jewish General Hospital were particularly proud of the services they offered in the maternity ward and to cancer patients. Despite the large number of babies born in the hospital between 1934 and 1945, only four mothers died, one of the lowest maternal mortality rates in the whole of North America at the time.23 Thanks to money supplied by the Women’s Auxiliary, the care of infants improved in 1939 when the nurseries were rebuilt and a system was installed to control the temperature and humidity in that part of the hospital. This, and further changes, enabled the hospital to provide “unsurpassed accommodation for the newborn and to introduce the most scientific and advanced facilities for the care of infants. Our experience with the behaviour and comfort of the infants has exceeded the expectations of all concerned.”24 The Jewish General Hospital’s emphasis on the treatment of cancer was evident from the beginning, when it equipped itself with extensive X-ray facilities and hired a pathologist (Dr Seecos) with many years of experience in cancer research. The hospital progressed a step further in December 1935, when it obtained a modern, powerful, deep X-ray apparatus exclusively for treating cancer. This machine, small for the time, and soundless, nevertheless produced 218,000 volts. To relax patients undergoing treatment from it, the new device was housed in a room decorated to resemble “a cheerful boudoir, with a comfortable couch, reading lamps, etc.”25 Great confidence was placed in this machine, and two years later Samuel Cohen reported that “the increased number of cases undergoing deep X-ray treatment kept the apparatus constantly in use and we are pleased that this most modern weapon in the treatment of cancer and other tumours was made available to such large numbers.”26 In 1935, the hospital’s medical board established one of the city’s first “tumour clinics,” a group of specialists from various departments studied every case suspected of cancer or other tumour and together attempted to establish the diagnosis and most effective form of treatment. The Tumour Clinic, under the

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Early X-ray equipment in the Jewish General Hospital. Jewish General Hospital Archives, 1x12_9_2_5.

leadership of Dr H.C. BaIlon, was soon recognized by the American College of Surgeons and for several years remained one of the very few approved cancer clinics in Canada. In 1945, the Department of Obstetrics and Gynecology established a sub-department of vaginal cytology in the hope that this would lead to early diagnosis of certain types of cancer. The Women’s Auxiliary could take the credit for sponsoring that, as well as for a series of lectures on cancer by speakers with international stature in medicine. The Jewish General Hospital’s fine medical record and distinguished staff quickly gave it an excellent reputation. Even during its first year of operation, the “Jewish,” after inspection, was approved and commended by the American College of Surgeons and the American Hospital Association and was given permission by the Canadian and American Medical Associations to train interns. In 1939 McGill University extended the honour by selecting the Jewish General Hospital as one of five hospitals in Montreal where its graduates could perform

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their year of internship. “We are particularly proud,” Allan Bronfman remarked, “after only five years of operation, to have received this endorsement of our scientific standards, from one of America’s great universities. Such recognition will stimulate us to strive for even greater accomplishment in the field of scientific medicine and hospitalization.”27 The hospital’s growing reputation was also reflected in honours bestowed upon various members of its staff. For example, in 1939, McGill University appointed Dr Alton Goldbloom as an assistant professor of pediatrics, Dr George Strean was elected to fellowship in the American College of Surgeons, and Dr Baruch Silverman became a Fellow in the American Psychiatric Association. Five years later, Dr Goldbloom received further recognition by being chosen as physician-in-chief of the Children’s Memorial Hospital and as acting chairman of the Department of Pediatrics at McGill. (These new duties resulted in his resignation in 1946 as Chief of Pediatrics at the Jewish General Hospital, although his wife, Annie Goldbloom, continued to head the Women’s Auxiliary.) McGill University honoured other doctors at the Jewish General Hospital in 1941, by appointing Dr George Strean as lecturer in obstetrics and gynecology and Dr M.A. Simon as demonstrator in pathology. It should be mentioned that these appointments were few compared with the number of chiefs of the other McGill hospitals at the time. Thus, by the end of the Second World War, the Jewish General Hospital had not only established itself as a hospital pledged to high standards of medical care, but had acquired a solid reputation and had received official recognition for its excellence. Apart from the Jewish General Hospital’s research and educational role (which will be discussed in chapter 11, the institution’s other major accomplishment in its first years of operation was in establishing a splendid rapport with the public and especially with the Jewish community. Developing this relationship with the public was not always easy, however. All the staff had to put in long hours and yet maintain a large degree of patience and flexibility. This was the case, for example, in dealings with patients who, especially in the earlier years, always wanted their doctor to call in a consultant, afraid that the first physician might not be sufficiently qualified or observant.28 Another problem encountered in the hospital’s relations with the public was that some of the patients and visitors felt so at home there that they would not obey the rules as they would have at another hospital. For instance, Dr Ezra Lozinski observed people striking matches on the wall to light their cigarettes.29 Once Samuel Cohen stopped a woman going up the stairwell after visiting hours had ended. Upon being asked her destination, she responded that she was going

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to see her husband. “Well, you can’t go to see him now because it’s after visiting hours and you have to follow the rules, which are, after all, for the benefit of the patient,” Mr Cohen replied. The unauthorized visitor was indignant. “Rules? If I want rules, I’ll go to the Royal Victoria!”30 This woman was only one late visitor among many. Some even insisted on staying overnight with their sick relatives, a sensible notion now finally being recognized. The hospital staff also encountered problems with people who brought in food for patients, which was strictly against the rules. Often this was done by traditional Jews who suspected that the meals served in the Jewish General Hospital were not truly kosher. (In fact, the food served was fully certified, then, as it is today. This policy has never been seriously questioned.) Non-Jews, on the other hand, who might have been expected to be less concerned about respecting the Jewish dietary laws, were generally sensitive to the religious needs of the majority, not wishing to offend those upholding kashruth. The responses to attempts by patients and visitors to bring in food from the outside varied. Samuel Cohen, a Jew with a rather strict background (his father was a rabbi) and responsible for upholding the hospital regulations, insisted on rigid adherence to the rules. Some doctors, however, considering it a more personal question, averted their eyes when they saw visitors carrying food.31 Relations with the public were not always so problematic. The hospital staff established their good rapport with the community through consultation, cooperation, and service, not confrontation. In fact, dealings with the public brought situations of warmth and amusement. For example, Dr Ezra Lozinski recalled one occasion when an intern was taking an older patient’s personal history. To start, the intern asked the elderly man his age. The gentleman refused to divulge this information and soon the two were arguing. Finally, Dr Lozinski came by, and, curious, asked the patient why he would not tell his age. The answer was straightforward: “If I tell this young squirt how old I am, he’ll just say, ‘The hell with it!’”32 From 1934 to 1945, the Jewish General Hospital went through a period of both trial and accomplishment. By the end of the Second World War, the young institution and its staff had achieved high standards of medical care, a certain degree of renown, and a harmonious relationship with the larger community, both Jewish and non-Jewish. However, the hospital had become too small. The society in which it functioned had changed and it now faced a greater demand upon its bed-space and a pressing need to create new facilities.

ch ap ter ten

ex pa n s i on a n d s pe c i a l i zat i on

From the time of its second building campaign in 1945, the Jewish General Hospital has had to expand to meet the needs of the growing and changing community it serves. In fact, the need to expand arose soon after the opening of the hospital. As in his 1936 report, Allan Bronfman warned of its impending needs. To meet the requirements of a modern, effective hospital, he felt, would necessitate the construction and equipping of an adequate medical library, better facilities for research, rooms for clinical and micro-photography for the continuing education of the staff, a nurses’ home, and a training school for nurses. The latter would help to prevent shortages of nurses and would provide greater opportunities for young Jewish women thinking of becoming nurses. In the report for 1938, both the president and superintendent emphasized the need for expansion. In particular, they emphasized the necessity of establishing a nurses’ home and a comprehensive medical library, and expanding the X-ray department, the public wards, the Out-Patient Department, and the laboratory facilities. About the latter, Samuel Cohen noted that “work is carried out [there] under such difficulty as to make expanded laboratory facilities our first and most urgent need.”1 However, while the demand for growth was there, the money to carry it out was not. According to Allan Bronfman: “There can be no question of our need for more space, and if I am not recommending immediate expansion, it is not now economically opportune for launching such a program. I feel confident, however, that when there is a clearing of the economic horizon, our community will give full support to the growing needs of our institution.”2 In 1939, the board of administration ascertained approximate costs for the three most immediate requirements of the hospital: increased laboratory space ($50,000), fifty additional ward beds ($75,000), and a nurses’ residence ($150,000). That year’s financial crisis and the war caused the postponement of

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all expansion projects. Late in 1943, when the Jewish General’s financial situation had considerably improved and the need for growth had increased all the more, the board of administrators undertook a study to determine precisely what the hospital then required. Based on this survey’s results, the board drew up longterm plans, including a nurses’ residence capable of accommodating 150 nurses, a nurses’ training school, a lecture theatre for the training school and hospital staff, expanded facilities for the pathological laboratories, increased space for X-raying, more operating and case rooms, and 100 additional beds. Before this project was presented at a special meeting of the hospital’s governors on 18 December 1944, however, the board decided to restudy the problems more conservatively; in the end they opted for a project involving only sixty extra beds, no lecture theatre, and an expenditure of about $765,000 instead of $1,300,000. Of the total, $465,000 would be employed to build and equip the nurses’ training school and residence. When Bronfman presented this plan to the governors, late in 1944, they unanimously approved it and enthusiastically authorized the board to raise the necessary funds.3 Thus, on 8 February 1945, even before the war had ended, officials launched the second building campaign for the Jewish General Hospital. The campaign organization benefited from the leadership of co-chairmen Allan Bronfman and A.H. Jassby, both of whom had held prominent positions in the first campaign and in the subsequent board. Samuel Cohen and Fred Goldstein served respectively as campaign director and campaign secretary. In short, this effort in fundraising, again directed solely at the Jewish community, was a clear success. Many subscribed, adding their names to the second volume of the hospital’s Golden Book; together they offered over $1,000,000. Bronfman summed up the campaign and its results: This campaign has now passed into the history of our communal achievement, there to take its proud place alongside that other great and memorable hospital campaign of 1929, which made possible the creation of our hospital. The same unity of purpose, generosity and even self-sacrifice which distinguished our first campaign, were again nobly manifested in this effort, which remains for all those who were privileged to be associated with it, as an inspiring and gratifying memory. The greater hospital which will result from the generous efforts of our people will continue to serve all, regardless of race or creed, and will represent our further contribution to the health and welfare of our City.4

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The unexpectedly positive results of the Jewish General Hospital’s second building campaign again led its administrators and governors to expand the scope of their ambitions for the hospital’s growth. By 1948, the governors had adopted a $3,000,000 general extension scheme, to be executed in stages, and had approved the architectural plans. This project involved the eventual addition of at least 100 beds, new laboratories, more X-ray and operating rooms, and additions to the kitchens, dining rooms, and Out-Patient Department. First, though, the hospital would be augmented by the construction of an addition onto the eastern wing. Included in this nine-storey section would be new living quarters for twenty-five interns and a nurses’ residence capable of accommodating 125 nurses in single rooms, with classrooms and laboratories for training, and a 430-seat lecture hall. The administrators accorded priority to this part of the extension project because of the chronic shortage of nursing staff felt by the hospital. The Jewish General Hospital would transform itself from the only large hospital in Montreal without a school of nursing into the operator of the only Canadian nurses’ training school under Jewish auspices. Commenting on the projected nurses’ training school and residence, for which the contracts were let in mid-September 1948, Samuel Cohen observed: Giving student nurses rooms to themselves is in itself a great innovation, but in these days of competition for our nursing staff we must assure them decent working and living conditions. We feel that the new school, which will be nonsectarian, will afford an added educational opportunity to a great many girls. But primarily it will allow Jewish girls the chance to be trained in Canada. In the past there has been a great exit of Jewish girls from this country to American hospitals because the existing training schools in Canada were not accepting them.5 The contractors completed the new wing in 1950, and the following year the Jewish General Hospital School of Nursing, open to applicants of all races and creeds, accepted its first group of student nurses. On 18 June of that year, the annual general meeting of the governors of the Jewish General Hospital took place in the auditorium of the nurses’ residence. Even before construction of the nurses’ residence and training school had been completed, work had begun on the next part of the expansion project. In 1949, the hospital waged a third building campaign. The success of this fundraising venture, as well as increasing demands upon the hospital’s services,

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convinced the governors and administrators of the necessity to increase the expenditure on the total expansion project to $5,500,000. On 6 August 1952, after, once again, plans had been drawn up and contracts let, workers broke the ground, beginning the construction of yet another new wing, this time mainly devoted to increasing the number of beds. To raise the rest of the money needed to complete the building program, a fourth campaign was scheduled to take place from 27 April to 11 May 1953. Once again, Jassby and Bronfman, now each with well over twenty years of service to the Jewish General Hospital, served as joint campaign chairmen, with Samuel Cohen and Frederick Goldstein as campaign director and campaign secretary. Other leading figures in the campaign organization were Philip Garfinkle, Julius J. Block, Samuel Bronfman, Rex Vickers, and Mac Shoub. Men in business and government who lent their names to the campaign in an honorary capacity included: Camilien Houde, Hon. Paul Martin (the federal Minister of Health), Hon. Dr J.H.A. Paquette (the provincial Minister of Health), Gordon R. Ball, John Bassett, Hon. Harry Batshaw, Hon. F. Philippe Brais, Samuel Bronfman, Michael Hirsch, Sol Kellert, and James Muir. As may be observed from this list of names, for the first time in the history of the hospital, funds would be sought from the entire community, not simply from Jews. The campaign, extended until 25 May, was met by many with a warm and generous response. Including support that had been promised by the federal, provincial, and municipal governments, the campaign proved a success; the $5,500,000 expansion project would become a reality. Thus, the construction and equipping of the new additions to the hospital, as well as a number of renovations, pressed on. By the beginning of October 1954, the work had been completed. Dedication ceremonies for the hospital’s new extensions took place at 2:30 in the afternoon of Sunday 10 October 1954, almost exactly twenty years after the Jewish General’s official opening. At these ceremonies, held outside in fine weather, Health Minister Paquette announced a pledge by his government to furnish the Jewish General Hospital with a grant of $300,000. The municipality had already agreed to give half of the amount supplied by the provincial government. Paul Martin, the federal Minister of Health, also attended and reminded those present of the contribution that the federal government had given to Quebec hospitals since the beginning of the national health program six years before.6 The two new extensions with which the ministers of health were so eager to associate themselves constituted a major addition to the hospital’s facilities. The smaller of them lengthened the northern wing, or the base of the original “T.” Most important, this five-floor annex included new operating theatres with more space and up-to-date equipment. A reporter, evidently impressed, described

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some of their features: “The rooms are all equipped with air conditioning, are painted a light green to avoid reflection, and feature balconies to facilitate television reception. Oxygen tanks have been installed in the operating rooms and in each of the new rooms. In addition, a linked microphone system makes it possible for a doctor’s observations and remarks during a surgical procedure to be transmitted to a central point and recorded onto audio tape.”7 The other extension was far larger. This new wing, attached to the western end of the hospital, would eventually add 170 beds to the Jewish General, making the total number of beds just short of 400. “Each of the rooms in the north and west wings are equipped with an intercom system,” the same reporter continued, “permitting the nurses on the floor to be in constant contact with patients. The light switches are silent, and every bed can be raised and lowered by means of a device whose motor is also completely silent.”8 These wards again contained a maximum of four beds, each one with a private bathroom and enough space for the personal effects of patients, conveniences that were considered more generous than usual. The sixth floor of this wing would now become the nursery. Also occupying a floor in this section of the hospital would be the X-ray department, which had previously become scattered in several rooms throughout the hospital, and four large laboratories specially equipped for work with animals. The west wing’s first floor would now be the site of the spacious Social Service Department. Next to it would be the Out-Patient Department, with its emergency rooms, examination rooms, surgery room, pharmacy, and other facilities. The third and final part of the Jewish General Hospital’s general extension project was to consist mainly of renovations to the old hospital areas. For this, and to complete the seventh and eighth floors in the west wing, a fifth building campaign was held in 1958, with an objective of $3,000,000. Campaign officials estimated that $500,000 of this could be raised from corporate donors in Montreal, while the various levels of government would contribute $1,000,000, the rest being left to the Jewish community to supply. All sectors achieved their goals and, on 10 June of that year, Philip Garfinkle, then president of the hospital, announced that the campaign would reach its objective. The seventh and eighth floors of the west wing opened early in 1960. However, demand for the hospital’s services continued to grow; no sooner had the latest additions been completed than further extensions began to appear necessary. In March 1963, Garfinkle announced that another building expansion campaign, this time for $5,500,000, would be held from 16 May to 3 June of that year. Plans for a new northwest wing had almost been completed and included

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a further 229 beds (bringing the hospital’s total capacity to 626), new and enlarged emergency and out-patient areas, additional operating rooms, and more space for radiological, laboratory, and ancillary services. Mr Garfinkle felt certain that “the Jewish General Hospital’s dedication to a three-fold objective – patient care, scientific research and education – will be advanced greatly by the expansion programme.”9 The campaign chairmen, this time Allan Bronfman (by then the hospital’s honorary chairman) and Garfinkle, made their appeal again to both the Jewish community and the city’s corporations. About $2,000,000 of the $5,500,000 would be raised through a joint federal-provincial construction program. Although completion of the new wing had originally been scheduled for 1965, the construction did not actually begin until 29 September of that year, when Julius J. Block, the hospital’s president, turned the first sod. He used the same silver-plated shovel employed by Allan Bronfman in 1931. As had happened on previous occasions, ambitions and costs had risen considerably during the interval between deciding to expand and the start of construction. Officials now estimated that the new wing, which would add 250 instead of 229 beds to the hospital’s capacity, as well as extensive renovations, would cost about $12,500,000. This figure included a recently completed addition to the nurses’ residence. The Jewish General Hospital would finance these projects with $4,950,000 in pledged building funds, a federal construction grant of $1,300,000 and the proceeds from a $6,500,000 bond issue, the principal and interest on which would be paid for by government over a period of twenty-five years.10 Completion of the new section of the hospital took place in June 1968. The move into the northwest wing, however, had begun over a year earlier. On 15 April 1967, hospital workers finished relocating the emergency department from its old site to its new quarters in the recent addition, where it was accessible from Côte-Saint-Catherine Road. The new emergency facilities included eight examining rooms instead of three; three operating theatres rather than one; a recovery room with eight beds, whereas there had formerly been only three; an entrance for two ambulances instead of one; special facilities for ambulatory surgical cases; and new equipment for poison and resuscitation cases. For the first time, the emergency department would now contain X-ray equipment. Besides these features, this department also comprised an air-conditioned visitors’ room, an office for follow-up care by nurses, and dressing and preoperative examining rooms. Other facilities moved at that time included the physical medicine gymnasium, the maintenance shop, the medical out-patients’ department, personnel

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offices, the pharmacy, and the Auxiliary coffee shop and canteen, which was now returned to its original site. This expansion and renovation program also involved the completion of a new Department of Neurosurgery; three new intensive care units with the latest electronic EEG, ECG, and other monitoring equipment; and increases in the numbers of operating theatres, from six to thirteen, and recovery beds, from eleven to twenty-two. One of the new operating rooms, for cardio-thoracic surgery, would now be equipped with closed-circuit television outlets leading to a new amphitheatre. The Dorothy and Julius Block amphitheatre, named after the hospital’s late president and his wife, both tragically killed in an accident, seats 225 and is supplied with 35 mm and 16 mm projectors, a pit for microscopic projections, simultaneous translation facilities, and other audio-visual aids. The renovation aspects of this expansion program were also of great importance and consisted primarily of the installation of new heating, airconditioning, ventilation, mechanical, and electrical equipment. The renovations required over half of the funds that had been collected for the general project, or about $6,500,000. Some of the features of this renovation were a much larger diesel generating plant for emergency power, three new boilers, an air-conditioning system, which would cover 55 per cent of the building, rather than the previous 5 per cent, and a distilled-water system connected to all of the hospital’s laboratories. The Jewish General Hospital’s major building program prior to the 1980s began to take shape in 1966, in the middle of the previous expansion project. On 20 June of that year, at the annual general meeting of the hospital, Sam Steinberg, the president, announced two large donations. The first, a grant of $1,000,000, was made by Messrs Bernard and Louis Bloomfield, one the president and the other a director of the Eldee Foundation, established by Lady Henriette, the widow of Sir Mortimer B. Davis. They donated this money to establish the Lady Davis Institute for Medical Research. The other grant, of $750,000, was supplied by an anonymous private donor to found the Institute of Community and Family Psychiatry. The Jewish General Hospital’s Department of Psychiatry had already achieved a reputation as one of the continent’s most outstanding treatment and training centres in the field and the new institute promised to enhance this reputation. These donations were supplemented by money provided by the Federal Health Resources Fund: $2,306,490 to help build and equip the Lady Davis Institute and $1,300,651 to construct quarters for the Institute of Community and Family Psychiatry. The building of the Institute for Community and

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Family Psychiatry, located at the extreme west end of the hospital, was completed in June 1969. This allowed the Institute to expand its program, which already included a study of the families of concentration camp survivors; a suicide prevention centre; and work on suicide, adolescents, and drugs. The Lady Davis Institute for Medical Research was officially founded toward the end of 1966, but building did not begin until after sod-turning ceremonies on 16 April 1969. Construction progressed quickly thereafter and ended shortly after the completion of the Institute for Community and Family Psychiatry.11 The Lady Davis Institute would henceforth be located in a four-storey building containing laboratories, operating rooms for experimental surgery, animal quarters, conference rooms, a library, administrative offices, and all the other facilities necessary for the functioning of a sophisticated medical research institution. The Lady Davis Institute, placed under the direction of Dr Norman Kalant, formerly associate director of the Department of Medicine, is situated on Côte-Sainte-Catherine Road and is connected to the west wing of the hospital by a tunnel and covered walkway. When it was built, the Institute’s research was concerned mainly with clinical problems, including cardiovascular disease, metabolic disease, gastric and biliary malfunction, and renal disease.12 After the completion of the Lady Davis Institute, the Jewish General Hospital did not carry out any major expansion projects for over two decades. Despite uncertain financial conditions, however, it underwent important renovations in many parts of the hospital. Vital to the maintenance of the high standards of patient care that the hospital has vowed to continue, by 1970 such changes brought the number of beds up to 700 and cribs up to 60. (Subsequent budgetary restrictions, however, reduced the number of beds to 590.) One recent example of internal improvement took place in 1977, when funds from the Allan Bronfman 80th Birthday Fund and the federal government allowed the renovation of four floors of the east wing, now renamed the Allan and Lucy Bronfman Family Pavilion. This work included the building of a far better medical library than the hospital had previously possessed. By the early 1970s, the Jewish General Hospital had not only grown with the community and advances in medical science, it had also achieved full acceptance and a substantial degree of leadership in its spheres of activity. The Jewish community of Montreal, and to a lesser extent all Montrealers, could take pride in the stature and recognition acquired by the hospital, although ultimately this reflected most upon those who had directly supported it in its brief but remarkable history.

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Table 10.1 Jewish General Hospital Statistics from 1935 to 1975

Admissions Patient-days Out-patient visits Operations Births

1935 3,649 45,390 19,000 2,184 633

1945 5,241 61,359 26,378 3,742 1.011

1955 7,539 70,362 68,405 7,534 1,498

1965 12,9919 148,936 72,834 10,956 1,854

1975 18,996 195,030 194,482 12,878 2,341

Source: Annual Reports.

In the early 1980s, however, the facilities of the Jewish General Hospital no longer sufficed to ensure the continuation of that top-quality care, given in a Jewish environment, which the hospital had offered thus far. Once again, expansion had become necessary. The growth of the Jewish General Hospital since 1945 has been reflected in far more than the number of buildings and beds it contains; expansion may also be seen in statistics about the care given to patients and in the diversity of services offered. The statistics on admissions and operations are impressive and clearly reveal how the Jewish General Hospital’s value to the community has increased, especially since the Second World War (see Table 10.1). Other comparisons may also be made. The number of medical examinations using X-rays or the laboratories grew dramatically. In 1935, 6,094 X-ray examinations were conducted, whereas 18,247 were done in 1952 and 96,146 in 1973. Hospital staff employed the laboratory facilities for diagnostic purposes on a total of 10,116 occasions in 1935; see Table 10.2 for the main laboratory activities for 1973.13 The number of physicians dispensing care had also risen, from 72 in 1934, to over 250 in 1959, and to 387 in 1973. In 1967, the entire staff numbered 1,512, 17 per cent of whom were medical attending staff and 27 per cent of whom were nurses. The growth of the hospital since the Second World War is also reflected in the expanding array of specialized services. While these are many, fulfilling a multitude of roles, space restrictions here permit the description of only a few representative programs. In the years immediately following the Second World War, when the Jewish General Hospital was traversing its first period of building expansion, it also

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Table 10.2 Laboratory activities in 1973 Biochemical – units Bacteriological – units Blood Transfusion – units Cytological – units Haemotological – units Surgical examinations Electrocardiographs Electroencephalographs Electroshock therapy

3,616,286 3,579,448 773,235 358,864 2,810,926 8,322 25,928 2,052 635

Source: Annual Report, 1973.

increased the number of specialized services it offered. One of the first took the form of a sterility clinic, to coordinate the skills of obstetricians and other specialists and thus to provide the best possible treatment and guidance for couples unable to conceive. The Jewish General Hospital’s sterility clinic, among the earliest on the continent, was organized by Dr George Strean, head of the Department of Obstetrics, and by Dr Max Ratner, head of the Department of Urology. The rest of the clinic’s staff initially included an endocrinologist, a pathologist, a social worker, internists, and trained technicians. By the end of 1947, representatives of the young clinic proudly claimed that its results had been “very encouraging.”14 During the course of the following year, the hospital was faced with an extraordinary challenge, although not one that necessitated the opening of a particular program. In 1948, many thousands of refugees arrived in Canada from the Displaced Persons camps of Europe, having previously survived the concentration camps. Understandably, a large proportion of these men, women, and children required medical attention. The Jewish General took a leading role in rendering that care to the new arrivals and this contributed substantially to the increased volume of in-patients and visits to the Out-Patient Department.15 While the number of services offered by the hospital continued to grow throughout the 1950s and early 1960s, the next twenty years saw a great proliferation of specialized types of care. For example, in June 1966 the Jewish General set up an Infectious Disease Service under the direction of Dr Jack Mendelson,

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a young doctor who had studied at McGill, the Jewish General Hospital, the Strong Memorial Hospital of Rochester, and Harvard. The Infectious Disease Service was founded to conduct research as well as to assist in the proper selection, use, and non-use of antibiotics. After only a year of operation, Dr Mendelson, also the chief microbiologist of the Department of Laboratories, could remark that “there is no question that the Service is needed. Available to all hospital departments at all times, the demand for it is tremendous.”16 Two years after the opening of the Infectious Disease Service, the Jewish General Hospital demonstrated its maturity by creating a Department of Neurosurgery, on the third floor of the new northwest wing. This department, under the leadership of Dr Harold J. Rosen and Jacqueline Doucet, RN, would be responsible for any cases in which the nervous system required surgical treatment. The most common such cases are congenital injuries and malformations of the brain and spinal cord, injuries to the head and spine, abnormalities of intracranial blood vessels, such as aneurysms, peripheral nerve lesions, and intractable pain, such as that caused by recurrent cancers.17 In 1973, the Department of Neurosurgery joined with the Sub-Department of Neurology (previously part of the Department of Medicine) to form the Department of Neurological Sciences so that diagnosis and treatment of neurological cases would be better coordinated and their instructional potential enhanced. Dr Rosen, neurosurgeon-in-chief, and Dr I. Libman, neurologist-in-chief, were appointed as the department’s first co-directors. In January 1969, the Jewish General Hospital inaugurated its Department of Physical Medicine and Rehabilitation (PMR). This department, whose purpose is to rehabilitate patients through therapy to achieve their maximum potential for normal living, physically, psychologically, vocationally, and socially, has three sub-sections. One of these, physiotherapy, has existed since 1936, when Elsie Martinsen, a Norwegian physiotherapist, was put in charge, a position she would hold for over three decades. With the opening of the new department in the basement of the northwest wing, physiotherapy received about 50 per cent more space. The other two subsections of PMR were occupational therapy and recreational therapy, much of the latter done by volunteers. Other examples of specialized services developed in the past two decades may be found in the field of cancer research and treatment. For instance, in the fall of 1971 a “Reach to Recovery” support program was instituted for mastectomy patients, largely as a result of initiatives taken by Mrs Ellen Cohen, earlier a mastectomy patient herself. Modelled on American examples, the “Reach to

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Recovery” program has been operated by female volunteers who themselves have gone through the traumatic experience of having one or both breasts removed. The Jewish General Hospital was the first hospital to introduce “Reach to Recovery” to Montreal. Another cancer service that the Jewish General introduced to the region was a colposcopy clinic. This unit, part of the Department of Obstetrics and Gynecology, is aimed at the early detection of cervical cancer and the early treatment of pre-malignant lesions. In contrast to older methods, the colposcopy clinic permits more effective, less costly, and less time-consuming diagnosis and treatment. In 1979, cancer treatment and research at the Jewish General Hospital received a further boost when an oncology centre under the direction of Dr Richard Margolese was established. The clinical research program of the Centre was given two main goals: first, to improve the results of treatment for cancer patients by modifying programs known to be effective, and second, to evaluate new treatments for cancer patients. The Centre’s primary purpose, however, was the care of patients, dispensed on an outpatient basis, with each patient assigned to a team of specialists, including a physician, a nurse, and a social worker.18 Another specialized service appearing at the Jewish General Hospital in these years was the Social Disease Clinic, which was opened on the ground floor on 14 February 1972. This clinic offers diagnosis, treatment, and follow-up care to patients, most of whom suffer from either gonorrhea, syphilis, herpes virus infection, trichomoniasis, candida, mycoplasma, or chancroid. The Social Disease Clinic was staffed on a full-time basis by a nurse, who did most of the educational work (especially concerning contraceptives), and by three physicians specializing in microbiology. Together they made the clinic unique in Montreal. The foundation of this service, a response to the marked increase in venereal disease observed at the time, came about largely through the efforts of the late Dr H.L. Nutik, the director of Ambulatory Services, and Dr Isaac Tannenbaum, the head of the Department of General Practice. In December 1975, the Jewish General Hospital benefited from the addition of a new fifteen-bed intensive care unit. After several years of planning, to incorporate the best qualities of intensive-care units around the world, the ICU was built at a cost of $700,000. It was paid for by a large donation from the Allan Bronfman family and by special grants from the federal government. The Women’s Auxiliary supplied funds for the electronic equipment, including respirators and a control bank of electrocardiogram monitors. The ICU permits a concentration of equipment used in immediate treatment and resuscitation, and provides 24-hour surveillance, an immediately available staff of doctors and

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nurses, and special rooms for patients requiring isolation and for families wishing to be near sick relatives. When it opened, this intensive care unit was among the most advanced in North America.19 Further specialized services have been offered by the Department of Psychiatry, which was founded in 1951. Through its Institute of Community and Family Psychiatry, this Department was responsible for such programs as a Sexual Dysfunction Treatment Centre and a Job Experience Program. The former, established in September 1973 and staffed by a multidisciplinary team of psychologists, social workers, gynecologists, urologists, and nurses, helped couples and individuals to overcome difficulties in the sexual aspects of their lives. The Job Experience Program was designed to give psychiatric patients an opportunity to engage in volunteer work in the hospital, thus building up their self-esteem and confidence, before re-entering the rough and tumble of the job market. The Department of Psychiatry also offered care through its Adult External Services, including a Youth Service, geared to serving the specific needs of the young, which was created in 1973. Another specialized service developed at this time was the Neonatal Intensive Care Unit for high-risk babies before and shortly after birth. In the early 1960s, when about 1,600 babies were being born annually at the Jewish General Hospital, only one intensive care room was equipped to handle newborns, and that included only six cribs. In 1964, the number of cribs was increased to twelve and a chart room, X-ray machines, and a nursing mothers’ area were added. Three years later, the hospital hired two part-time neonatologists (pediatricians with at least two extra years of special training in physiopathy and the care of newborns), thus recognizing the increased specialization involved in the field of neonatology. Until then, only pediatricians administered medical care to all high-risk newborn babies. At about the same time, a generous yearly grant from the Maurice Pollack Foundation to help support the costs of the nursery resulted in the naming of that unit after Mr Pollack. However, by 1968–69 the nursery for premature infants had become seriously overcrowded. The years 1972 and 1973 saw important developments in the neonatal service. In late 1971 the provincial government passed Bill 65 concerning the operation of the province’s hospitals. One of the provisions of this act required consolidating obstetrical and neonatal care in a limited number of hospitals, including the Jewish General, increasing the pressure of numbers. In response to this, as well as to the recognized need for specialization to provide an optimum service, the hospital opened a neonatal intensive-care unit in 1972. Dr Apostolos Papageorgiou, the unit’s first full-time neonatologist, was put in charge. (He

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would hold that position until 2015.) To cope with the increased demand on the hospital’s neonatal services, work was begun on a larger thirty-bed neonatal intensive-care nursery, paid for by government funds and a further grant from the Maurice Pollack Foundation. The results achieved by this unit have been phenomenal. For example, in 1972, 20.9 babies per 1,000 were stillborn or died within the first week of birth at the Jewish General. By 1976, this rate had dropped to 7.5 per 1,000, and two years later the rate had plummeted to 4.7 per 1,000. This fell well below the provincial government’s goal of reducing perinatal mortality in the province to 12 per 1,000, set in 1980, and compared very favourably with the 1976 rate of 13.1 per 1,000 in Quebec and over 16 per 1,000 in Canada as a whole. This data applies to babies weighing over 1,000 grams at birth. For those weighing between 501 and 1,000 grams, the rate of neonatal mortality in the Jewish General Hospital was 385 per 1,000 live births, compared to 843 per 1,000 live births in all of Quebec. This is especially remarkable in that this province had the lowest perinatal and neonatal mortality rates in North America. Since then, under the continuing leadership of Dr Papageorgiou, and with the full support of Dr Sydney Pedvis, the head of Pediatrics, the record-breaking neonatal unit has continued to provide a superlative level of service and has been the site of virtual miracles, such as the survival of Simone Joyette in 1978, the first documented case of a baby surviving, despite being born less than twentyfour weeks after conception. At birth Simone weighed only 600 grams.20 While the number of specialized services at the Jewish General Hospital has grown greatly since the Second World War, there has also been a countercurrent. One example is the Department of General Practice, created in 1966 and put under the responsibility of Dr Milton Snarch. This department, initially staffed by thirty-seven doctors, making it the hospital’s second largest, was formed with the purpose of increasing the role of general practitioners. Another exception to the tendency toward growth in specialized services involved the closing of the Department of Pediatrics. After Bill 65 instituted the centralization of certain medical services, the government decided that pediatrics should be concentrated in the Montreal Children’s and St Justine hospitals. Thus, in 1973, the Jewish General closed its fifty-two-bed children’s department and devoted the space to other purposes. Henceforth, the Jewish General Hospital would provide full services only for the newborn and for youths aged fourteen and over, but would continue to look after other children through its out-patient clinics and emergency services. Children requiring admission to hospital would be transferred to one of the two hospitals specializing in pediatrics.

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Part of the kitchen crew. Jewish General Hospital Archives, 84-2493.

However, the Jewish General would arrange the supply of kosher food for Jewish children in the other hospitals, thus permitting those youngsters to obey the laws of their religion, despite the change in hospitals. On the whole, it is clear that following the tribulations of the Depression and the Second World War, the Jewish General Hospital entered a period of growth and specialization, responding as best it could to the community’s needs. It is hoped that it will continue to meet the specific requirements of that community. This will depend on the social awareness and the generosity of Jews and other communities throughout the city.

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The functions of a hospital extend far beyond the care of those arriving at its doors seeking medical aid. Other activities bring the hospital into a closer relationship with the medical and general communities at large. In this respect, the Jewish General Hospital is no exception. Foremost among its links with the medical community are its research and teaching functions. Education has always held a prominent place at the Jewish General Hospital, and has focused on the training and continuing education of physicians. In fact, ever since it opened, the hospital has offered an intern–resident program. The first group of interns to receive instruction at the Jewish General Hospital took up their duties on 14 October 1934. Together they numbered nine, including one resident attached to each of the Departments of Medicine, Surgery, and Gynecology and Obstetrics. The intern training program received approval later that year from the Canadian and American Medical Associations, although it took the better part of a decade before the resident training program, developed by Dr Harry Ballon, was accredited. In 1938 the “Jewish” broke new ground by becoming the site of the first postgraduate course in cardiology offered in Canada, taught by Dr Harold Segal. (This eminent pioneering cardiologist was kept in a minor position at the Montreal General Hospital and McGill for many years.) The following year, another important step in the hospital’s pedagogical history was taken when McGill University selected the Jewish General Hospital as one of five local institutions where the university’s medical graduates could take their required year of internship. By 1945 the Jewish General was able to claim that almost 100 young physicians had received their first training as interns and residents there. It initiated its first paid postgraduate program in 1948.

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The beginning of another type of educational activity took place at the Jewish General Hospital in 1939, when it cooperated with the Mount Sinai Sanatorium by making its facilities available for the latter’s summer school in tuberculosis. International authorities on tuberculosis were present to convey their knowledge of that disease and were heard by practising physicians from across Canada and the United States.1 In 1945, the Jewish General Hospital agreed to cooperate with McGill University in a rehabilitation program of courses for medical officers returned from the war. To be conducted by members of the hospital’s staff under the general supervision of McGill’s Faculty of Medicine, these refresher courses catered to the needs of many medical officers whose training had been interrupted by the Second World War. The hospital was further able to expand its teaching role in 1954, when the Royal College of Physicians and Surgeons of Canada approved it for the advanced training of residents in medicine, surgery, gynecology and obstetrics, urology, pathology, and diagnostic and therapeutic radiology. Three years later the College of Physicians and Surgeons of Canada increased the size and scope of the intern–resident training program. By 1959, the Jewish General Hospital had good reason to be proud of its educational role. More than forty young men and women were being appointed annually as interns or residents, and 342 had already received training there. The quality of these young physicians is evident from the fact that by 1959 three of them had become heads of departments in the Jewish General Hospital, not to mention those graduates appointed to other positions of importance, both in the “Jewish” and elsewhere. On 6 June 1960, at the hospital’s 26th Annual General Meeting, executive director Samuel Cohen commented on the institution’s pedagogical function: It is sometimes erroneously assumed that only hospitals affiliated with a university for undergraduate teaching of medical students are ‘teaching hospitals.’ Every good progressive hospital is a teaching hospital. Brief reference to our own activities in this area will illustrate this point. We have a house staff of thirty-four interns and residents for whom we maintain an organized program of education and teaching. Our Department of Psychiatry was formally recognized by McGill University and now is part of the university’s graduate teaching program in this specialty.

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There are six fellows who are pursuing graduate studies and a number are working towards a Ph.D. or Master’s degree. The entire medical staff participates in daily conferences, rounds, symposia and seminars as part of their continuing education. We are the only Englishspeaking hospital in Quebec which conducts a recognized course for laboratory technicians. We have an approved course for training X-ray technicians. Our Social Service Department serves as a teaching facility for the McGill School of Social Services. The Physical Therapy Department receives student observers from the University of Montreal School of Physical Therapy and provides summer internships for graduate and undergraduate physiotherapists … There is, of course, the School of Nursing with its full faculty and teaching organization. The Jewish General Hospital is indeed a teaching hospital and because teaching encourages and compels perfection of practice, the patient – the real reason for the Hospital’s existence – benefits from these activities.2 The teaching role of the hospital was further recognized and strengthened in 1967 by the creation of the position of director of postgraduate medical education. Dr Michael A. Gold accepted this post and within a year was also given the position of medical director. In 1969–70, Dr Gold was responsible for instituting a new system of clinical teaching units then being promoted by the Royal College of Physicians and Surgeons of the Province of Quebec. These clinical teaching units, established for each and every department in the hospital, consisted of a full-time head, several residents and interns, and six or seven specialists, often including an allergist, a cardiologist, and a gastroenterologist. Henceforth, residents and interns would experience team thinking and team work on a regular basis, an important development because of the rapid expansion of medical knowledge and the resulting need for specialization. Previously, the only part of the hospital that functioned as a clinical teaching unit had been the public ward; elsewhere, private doctors supervised the care of their patients by themselves or with selected consultations only, and taught residents and interns only sporadically and briefly. Now, while the private doctors retained supervision of their own cases, all patients would receive the comprehensive care provided by the clinical teaching units. The following years saw further developments in the education of physicians at the Jewish General Hospital. In 1970, full affiliation with McGill was granted to the Jewish General by the university’s Faculty of Medicine, with the proviso

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The Herzl Family Practice Centre of the Jewish General Hospital was an integral unit of the McGill Teaching Program for Family Practitioners. The photo was taken at the Côte-des-Neiges entrance of the Jewish General Hospital 1978–79. Jewish General Hospital Archives, Herzl_Photos_0013.

that a faculty accreditation committee be permitted visits to ensure continued adherence to the university’s high standards. This affiliation concerned the hospital’s departments of anaesthesia, diagnostic radiology, general surgery, internal medicine, nuclear medicine, neurology, obstetrics and gynecology, ophthalmology, orthopedic surgery, pathology, pediatrics, psychiatry, therapeutic radiology, and urology. Also, for the first time, McGill undergraduates were now assigned to the Jewish General Hospital for instruction. In June 1972, when the Department of Family Medicine (previously called the Department of General Practice) opened the Family Practice Centre, it also began a two-year residency training program. At the time, similar programs were being offered by only two other Montreal hospitals. Dr D. Tannenbaum, chief of the department, commented on the goals of the course: “[I]n this program, candidates are being trained to see and treat patients within the context of family and community rather than strictly as a disease. That is, they are being trained to be person-oriented rather than disease-oriented.”3 Apart from workshops, seminars, weekly rounds, regular meetings with physicians and the assumption of responsibility for any number of family cases, each resident would

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Dr Henry Neider, a resident, examines Deborah under the supervision of Dr Michael Malus at the Herzl Family Practice Centre, 1983. Jewish General Hospital Archives, 1x11_9_1_1.

spend from one to four months in each of the Emergency, Medicine, Psychiatry, Pediatrics, Surgery, and Obstetrics and Gynecology Departments, as well as at the Maimonides Hospital and Home for the Aged and/or the Jewish Convalescent Hospital. In October 1973, an agreement was reached with McGill University to make the Jewish General Hospital’s Family Practice Program an integral unit of the McGill Teaching Program for Family Practitioners.4 The pedagogical aspect of the Family Practice Unit, formally established as such in 1972, would gain additional importance in 1974 when the Herzl Health Centre was integrated into the Jewish General Hospital, thus forming the Herzl Family Practice Centre (today known as the Goldman Herzl Family Practice Centre). During that same year, the Joint Emergency Services of McGill Hospitals asked the Jewish General Hospital to accept trainees for a two-year program then being developed to train emergentology physicians. However, while educating physicians has been the cornerstone of the Jewish General Hospital’s teaching activities, the education of nurses and other health professionals has not been neglected. As mentioned earlier, only after the Second

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Some students from the first class of the School of Nursing at the Jewish General Hospital, 1951. Jewish General Hospital Archives, 1x4_9x7_1_1.

World War had ended was the Jewish General Hospital able to help relieve the shortage of nurses and the lack of opportunities for young Jewish women wishing to become nurses. Construction of the Nurses’ Residence and Training School, the first in Canada to be operated under Jewish auspices, began on 6 October 1948 and opened in 1951.

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The School of Nursing’s three-year program of study was designed to instill in each student “an appreciation of the importance of conserving her own health, of preventing disease, and of caring for the patient as an individual in the Hospital, home, and in the community.”5 The subjects studied included a vast array of fields: anatomy and physiology, microbiology, chemistry, psychology, the history of nursing, professional adjustments, ethics, nursing arts, operative aseptic technique, nutrition, foods and cooking, diet therapy, sociology, an introduction to medical science, medical nursing, dermatology, surgical nursing, physiotherapy, pharmacology and therapeutics, obstetrical nursing, the nursing of children, communicable disease nursing, and various aspects of public health. Like the rest of the Jewish General Hospital, the School of Nursing was completely nonsectarian. It fell under the supervision of Evelyn Kessler, director of nursing. The first group of fourteen nurses graduated in 1954: Zelda Soloway, Helen Altow, Natalie Kushner, Kathleen Brown, Lucy Agulnick, Shirley Silbert, Shirley Travitsky, Faye Ryback, Ruth Freedman, Ada Stearns, Lillian Wiseman, Dorothy Hager, Beatrice Weiss, and Marilyn R. Teitlebaum. As the number of graduates grew with every passing year, it did not take long for them to form an alumni association, in February 1958. The Jewish General Hospital’s Nurse Alumnae Association chose Miss Kessler as its first honorary president and held its first “homecoming event” on 2, 3, and 4 October 1964.6 In January 1966, student nurses from the Jewish General Hospital began a special course involving four weeks of training at the Maimonides Hospital and Home for the Aged. This nursing educational program, under the guidance of Joan Gilchrist, then the hospital’s director of nursing, broke new ground in the history of nursing education in Canada, working with aged residents who were neither sick nor bedridden. The purpose was to expose the student nurses to patients other than those with long-term illnesses, and thus to make them familiar with the more subtle social, psychological, and support needs of the elderly. The affiliation of the Jewish General Hospital with the Maimonides Hospital and Home for the Aged was modelled after a similar arrangement set up by Cornell University and the New York Hospital. These innovations proved to be short-lived, however, at least as far as the Jewish General Hospital was concerned. During the mid-1960s, the provincial government and the Association of Nurses of the Province of Quebec, mainly on the initiative of the latter, worked out a new educational system. Under this arrangement, which still exists, nurses would be educated at one of the newly established CEGEPs or at both CEGEP and university, depending on the degree

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Miss Margaret Masters demonstrating part of a resuscitation procedure to new nurses in orientation program, 1966. Jewish General Hospital Archives, 1x4_9x4_2_2.

desired (RN or BScN). Henceforth, hospitals would only be used for the clinical aspects of a nurse’s training. This system was intended to produce a better quality of nursing care; students would be able to cover a wider range of subjects and would be more exposed to other disciplines, either directly or through contact with other students. The School of Nursing of the Jewish General Hospital admitted its last group of first-year students in 1969, graduating in 1972. Starting in 1970, all those entering a nursing program would do so either in a CEGEP or at a university. McGill University had in fact been offering potential nurses a special BSc degree since 1957. Speaking at the last nurses’ graduation ceremony on 15 June 1972, Dr André Aisenstadt, then president of the Jewish General Hospital, reminded listeners: While the necessity to write ‘finis’ to this chapter in the history of our hospital saddens us, we nevertheless derive satisfaction from some of our accomplishments. The teaching experiences brought higher standards of

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patient care to our hospital and helped alleviate the desperate shortage of professional nurses. Furthermore, we are greatly pleased that, under the new system of nursing education, our hospital will serve as a facility for providing field work and practical experience for students in the CEGEPS. Our continued participation in the educational process is assured.7 In a different vein, Dr Aisenstadt expressed his deep appreciation for the many contributions to the School of Nursing made by the Women’s Auxiliary and by Sam Hershorn, “whose keen interest in the students’ welfare and generous support of many programs added to the school’s prestige and status.” He also paid tribute to some of those who added the most to the development of quality nursing care and education in the hospital, in particular to Amy Mendels Shaer (the first director of nursing), Evelyn Kessler, Norena Mackenzie, Joan Gilchrist, Mary Barrett, and Gwynneth Allen.8 The Jewish General Hospital has also participated in the education of other types of health workers. Almost from its inception in 1935, when it had a staff of only two trained case workers, the Department of Social Services provided clinical experience for students in social work. As early as 1937, the Montreal School of Social Work, an affiliate of McGill University, designated the Jewish General Hospital’s Department of Social Services as a centre for field instruction for its students. The training of social workers did not, however, become a large part of the department’s activities until the 1960s, by which time its functions had become more modern, involving participation with the departments of Psychiatry, Obstetrics and Gynecology, Geriatrics, Pediatrics, Medicine, Surgery and Emergency. By the 1970s, the Department of Social Work was providing practical experience for students from a number of institutions, including the McGill School of Social Work, the University of Montreal, Carleton’s School of Social Work, and Dawson College. One of the features of the Jewish General Hospital as a source of learning for social workers has been a family-therapy training course, which they could take alongside residents in psychiatry, nurses, and, before long, members of the psychiatry departments of other hospitals and social agencies. This course, officially begun in 1966 under the joint auspices of the departments of psychiatry of the Jewish General Hospital and McGill University, was initiated by Dr Nathan B. Epstein, psychiatrist-in-chief, who brought the concept of family therapy with him from New York in 1960. Dr Henry Kravitz, the next psychiatrist-in-chief, further expanded the well-recognized course, directed by Drs Isaac Rebner, Herta Guttman, Ron Feldman, Lilian Spector, and now Sharon Bond.

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Another form of educational program begun at the hospital involved the training of surgical aides. Begun in 1974, this course aimed at relieving the shortage of nurses in the operating room. Under the guidance of Isabel Adams, the surgical coordinator, it ran for six months, with the provision that the students stay on with the hospital for at least another eighteen months. After finishing the course, graduates were prepared to scrub for a variety of cases, including plastic surgery, gynecology, and urology. The first class consisted of six students. The Department of Dentistry, one of the largest in the province since its merger with the Herzl Health Centre’s Dental Department, has also offered educational opportunities, again in conjunction with McGill University. By 1975, this accredited postgraduate program to train dental residents was being taught by forty-two attending staff members, about half of whom were McGill instructors. The five residents enrolled that year received instruction in periodontics, endodontics, orthodontics, crown and bridge work, oral surgery, operative work, oral diagnosis, pedodontics and prosthetics. The Jewish General Hospital has also provided training for those wishing to enter hospital life in roles such as physical therapists, laboratory technicians, and X-ray technicians.

Along with teaching, research has also held an important position among the functions performed at the Jewish General Hospital. As noted in 1968 by Dr W.R. Slatkoff, the second of the hospital’s six executive directors thus far, “Good research and good teaching programs attract the best doctors to the hospital and the result is better patient care. Patient care appreciates in an atmosphere of good teaching and research. We recognized this very early and because of it, our Board of Administration has continuously fostered the improvement of our teaching and research programs.”9 Although research received a boost with the establishment of the Lady Davis Institute, research and experiment have always been a feature of the Jewish General Hospital. The following are but a few examples. In 1946, Drs J.C. Portnuff and Morton Korenberg, both of the Jewish General Hospital, experimented with an early form of artificial kidney in an attempt to save a woman’s life, the first time that such a procedure had been attempted in Canada.10 The “Jewish” was also one of the first hospitals in Canada to establish a radioisotope laboratory for the use of radioactive isotopes in research, as well as in the treatment and diagnosis of disease.

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In 1954, the medical achievements of the Jewish General Hospital led to a flattering editorial in the Montreal Gazette. Included in these accomplishments were the introduction of the use of radioactive gold in the treatment of certain types of cancers and dramatic pioneering heart operations performed by Dr Arthur Vineberg.11 In 1955, the Department of Obstetrics and Gynecology, under Dr George J. Strean, became interested in applying new techniques to research on the transmission of poliomyelitis antibodies from a pregnant woman to her unborn child. A team consisting of Dr Strean, Dr Morrie Gelfand (subsequently the chief of the department), and Dr Joseph Sternberg, professor of physiology and nuclear medicine at the University of Montreal, vaccinated pregnant women with the Salk polio vaccine. They found that the vaccine was transmitted through the placenta to the fetus and thus the baby was protected by the injections given to the mother. This led to studies in the placental transmission of other elements, such as lipids. By 1965, these researchers had become the nucleus of an international project, centred in the Jewish General Hospital, but with cooperation (primarily for the collection of sample placentas taken at delivery) from institutions in Greece, Hawaii, Hong Kong, India, Israel, Japan, and Korea. By then, the project was investigating the transfer of radioactive contaminants to the fetus, and its effects. Five years later, Drs Jack Mendelson and Ronald Kapusta received the annual prize of the Society of Obstetrics and Gynecology of Canada for research on the reasons for the serious effects suffered by a fetus when the mother is infected by a virus early in pregnancy. In 1965 and during the following year, a research team at the Jewish General Hospital conducted experiments using counterpulsation, a technique for mechanically supporting circulation in cases of myocardial ischemia. The team, headed by Dr Jacob Rosenweig, pioneered counterpulsation work and was the first group to apply the technique to chronic heart cases in dogs. Working alongside Dr Rosenweig were Dr Nathan Sheiner, Dr Abe Mayman, and two resident fellows in surgery, Dr Carlos Borroneo and Dr Shekher Chatterjee. While that was going on, Dr Morton A. Kapusta of the Jewish General Hospital was undertaking studies on the causes of rheumatism. Specifically, Dr Kapusta was interested in alterations in the body’s defence mechanism, the system by which noxious germs and chemicals are repelled. On 1 July 1966, Dr Kapusta became director of Rheumatism Research, responsible for studies that were supported to a great extent by funds from the Canadian Arthritis and Rheumatism Society.

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Another program, headed by Drs James Naiman and Henry Kravitz of the Department of Psychiatry, aimed at switching heroin addicts to one of two stillexperimental drugs. The first, methadone, relieves the desire for heroin, and the other, cyclozocine, cuts down the effect of heroin on the brain. The project tested and compared both of these treatments and, before the year had ended, began to release patients off heroin. Dr Kravitz pointed out “this is the first specialized facility for the treatment of heroin addicts in the province, so our project is providing a needed clinical service as well as doing research.”12 Work on diabetes was an important area of research at the Jewish General Hospital in 1968. On 1 March of that year, Dr Douglas Wilansky, assistant physician, presented a paper at the New York Academy of Sciences, describing the findings of a project he had initiated seven years before. With the help of Inge Hahn, the nurse in charge of the diagnostic unit, and Drs Gina Schochat and Jacques Kessler, Dr Wilansky studied about 3,000 apparently healthy relatives of diabetics. Together they discovered that it is possible to predict which relatives of diabetics are likely to contact the disease in the next five years and that the onset of the disease in potential diabetics could be delayed or even prevented. They also found that the short-term administration of phenformin (DBI), a bloodsugar-lowering agent, greatly reduces the incidence of diabetes in three years. The year 1968 also witnessed the fruition of Dr Jacob Rosenweig’s research on the use of counterpulsation treatment. On 4 January, Dr Rosenweig and his now larger team performed a three-hour operation which saved the life of a 47-yearold sales executive. The remarkable thing about the operation was that it was “the first time in medical history that a human being dying of an acute heart attack had been successfully resuscitated with an external computer-controlled, artificial heart-assistant pump.”13 The pump, considerably more sophisticated than that used in earlier days, had been donated to the hospital at a cost of $15,000 by St George’s Lodge, Montreal, in the spring of 1966. These are but a few of the examples of research carried on at the Jewish General Hospital before the construction of the Lady Davis Institute in 1969. Since the opening of the Institute, the pace of research at the “Jewish” has increased still further, contributing considerably to the betterment of the human condition. In a brochure published in 1976, its director, Dr Norman Kalant, outlined the importance and goals of the Lady Davis Institute: It has long been recognized that a well-based program of research is an essential element in the development of a centre which seeks to provide the

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highest quality of medical care. The establishment of the Lady Davis Institute therefore came at a most auspicious time in the history of the Jewish General Hospital, for it presented the opportunity to develop such a research program in parallel with the growing academic involvement of the Hospital’s clinical departments. With this opportunity came a challenge – to determine the problem areas on which to focus our research efforts, and to recruit the professional staff necessary to achieve our goals. We selected for study those health problems which are of greatest concern to the community served by the Jewish General Hospital – cancer, diabetes, hereditary diseases, to name a few, and we have been fortunate in attracting to our staff a group of medical scientists who are experts in their individual fields of research. The approaches and the techniques vary widely, but the goals are identical: to increase our understanding of disease through scientific inquiry, so that the toll of suffering and death can be alleviated.14 The facilities provided by the Lady Davis Institute have been used by two groups of researchers. A core of full-time investigators whose primary function has been research has formed one of these groups. The other consists of physicians affiliated primarily with a clinical department of the hospital, but who, on account of their deep interest in their specialties, have undertaken research on a part-time basis. The following are some of the Institute’s research projects, past and present. In the early 1970s, Dr Robert Nelson Jr and other scientists explored the role that “complement” plays in inflammation, transplant rejection, allergy, aging, and tumour growth. This was funded largely by a grant of $175,000 from the John A. Hartford Foundation. Dr Nelson left the Institute shortly after this work. Another line of research no longer being carried on at the Lady Davis Institute was on diabetes, by Dr Arthur Kahlenberg. Sugar metabolism is controlled by cell receptors recognizing sugar molecules and sugar molecules being transported across the cell membrane into the cell. Recent evidence had indicated that a possible cause of diabetes could be a failure in that mechanism of recognition and transport. Dr Kahlenberg chose to pursue this by identifying and characterizing the component of the cell membrane involved in the recognition and transport of the sugar. He found this to be a protein forming a channel by which the sugar enters the cell. Many of the other research projects under way during the mid-1970s are still in existence, although somewhat transformed with the passage of time. One such

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project was led by Dr Herbert Schulman until his death in 2006. Dr Schulman’s training had been mainly in microbiology. In 1975, he was experimenting with the growth of soybeans to contribute to solving one of the world’s greatest problems: protein malnutrition. This led him to search out high-protein leguminous plants in the Arctic that could be adapted to a more southerly climate, with the goal of transforming such a plant into one that could be used as a commercially viable crop. Dr Schulman also worked to develop a treatment for iron overload, a condition that frequent recipients of blood transfusions sometimes develop in which the excess iron from the transfused blood builds up in parts of the body, such as the liver, kidneys, pancreas, and heart, interfering with their function. The Lady Davis Institute was also the site of Dr Naomi Fitch’s studies on the families of children born with congenital anomalies. Dr Fitch was trying to clarify the role of heredity and the mode of transmission from one generation to the next. She successfully identified new syndromes or patterns of abnormalities, showed how they are inherited, and demonstrated the specific defects produced by a genetic abnormality. Dr James F. Perdue researched the phenomenon of cell replication, important in understanding cancer. A fundamental characteristic of cancerous tissue is the rapid, uncontrolled rate of cell replication, and Dr Perdue was trying to identify the defect in the mechanisms of growth control in cancer cells. Specifically, he was looking at changes in nutrient receptors on the external surface of cells and found that cancerous reverted to fetal-type receptors. The exact significance of this is now being determined. Other studies on cancer have been conducted by Drs Mark Wainberg, Lawrence Kleiman, and G. Shyamala. Dr Wainberg looked at the immunological characteristics of the cancer cell. It is becoming increasingly clear that some cancers may be due to viruses and it is known that infection with one virus may reduce the body’s defences against other viruses. The role of immuno-suppression in cancer was the main concern of Dr Mark Wainberg, who also played a leading role in the discovery of the AIDS vaccine. Dr Kleiman, on the other hand, has, until recently, looked into the problem of cancer by taking a genetic approach. As part of the process by which cells become malignant, changes occur in the expression of the cells’ genetic makeup; this is reflected in the nature of the proteins being synthesized. Dr Kleiman studied the mechanism of these changes in cell function in relation to cancer. Today, he is looking less at the cause of cancer and has turned more directly to questions about the control of genetic expression. Dr Shyamala researched the role of molecules called “hormone receptors” in the development of breast cancer.

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Female sex hormones play a vital regulatory part in the functioning of breast tissue, and in order for the hormones to exert their influence, tissues must contain effective hormone receptors. Dr Shyamala examined the sequence of events that occurs once a hormone becomes bound to receptors, in an attempt to discover why cancerous cells no longer respond to the hormone, and how to overcome this failure to respond. Other research at the Lady Davis Institute on hereditary factors in diabetes was carried out by Dr Ralph Germinario (who died in 2005). It had been known for many years that diabetes was a hereditary disorder. Scientists, however, had not yet been able to determine the nature of the basic abnormality that is genetically transmitted. While patients who develop diabetes in mid-life usually have an adequate supply of insulin, the body cells appear unable to respond to it by increasing their use of sugar. Dr Germinario was studying the possibility that this unresponsiveness is due to the inherited abnormality. Dr Norman Kalant, the director of the Lady Davis Institute from 1969 to 1991, was also working on diabetes. His research included efforts to understand and find a treatment for vascular disease among diabetics, who have a propensity to suffer from arteriosclerosis and related renal problems. He also pursued the question of why cells in diabetes patients who develop the illness relatively late in life cease to respond to the insulin produced by their body. To do this he studied the behaviour of isolated liver cells in tissue culture. If scientists find an answer to this question they will be able to develop a more effective treatment involving something other than additional doses of insulin, which the body, theoretically, already has in sufficient quantities. A few of the other research projects undertaken at the Lady Davis Institute include a study by Dr N. Sheiner, the head of surgery from 1976 to 1992, on the use of segments of vein to replace sections of damaged artery and the effects of long-term storage on these vein segments; a project by Dr C. Cote to determine the exact consequences of blood deprivation to the mitochondrion, the “powerhouse” of a cell; research by Dr Michael Laughrea on the process of aging, conducted on the level of individual cells; very successful work by a team under Dr Papageorgiou on the use of betamethasone, a steroid drug, to prevent respiratory distress syndrome in premature babies; a study by Dr H. Sigman on the factors controlling the healing of stomach ulcers; and an attempt by Dr R. Fogel to determine the factors controlling the ability of the intestinal tract to absorb or secrete waste, an important factor in conditions associated with diarrhea. Dr Frank Guttman becane director of surgical research in 1978–81. He continued his studies in cryobiology, supported by the MRC (Medical Research Council), and

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directed Neil Segal in his PhD thesis, obtained from McGill in 1980, “Preservation Studies: Rabbit Kidney Studies In Vitro.” In more recent years, the Lady Davis Institute has increased its research on the process of aging as part of the hospital’s continuing commitment to respond to the changing needs of the population it serves. Since 1978, education and research at the Lady Davis Institute has also received a boost from the distribution of the estate of Lady Davis’s husband, Sir Mortimer B. Davis. In his will, Sir Mortimer had ordered that 75 per cent of his estate be used to build a non-sectarian hospital that would bear his name and that would have a governing body consisting of a majority of members of the Jewish faith. He also provided that his estate not be distributed for fifty years, to ensure that his wife retain the income from it during her lifetime. The result was that by 1978 the $10,000,000 in question no longer sufficed to build a hospital; inflation and more sophisticated medical care meant that by then it took about $40,000,000 just to operate the Jewish General Hospital for a year. The estate trustees, aware of this, but still wishing to uphold the spirit of Sir Mortimer B. Davis’s last testament, therefore entered into negotiations with officials of the Jewish General and reached an agreement whereby the hospital would change its name in return for receiving the $10,000,000. In early May 1978, the 5,000 members of the hospital’s corporation voted to change the name of their institution to the “Sir Mortimer B. Davis – Jewish General Hospital.”15 Soon afterwards, the hospital’s charter was amended accordingly and the inherited funds were handed over to provide money for aspects of the hospital’s operation that are not automatically paid for by the provincial government, particularly research and teaching.

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Connections with the larger community have always been an important aspect of life at the Jewish General Hospital. Apart from patient care and fundraising, for the building campaigns, these links have mainly taken the form of work by publicly minded individuals, institutional ties, and relations with government, who manage fundraising in many ways. Until 1969, when the JGH Foundation came into being, these services were largely supplied by the Women’s Auxiliary, whose helpful and devoted activities prior to the end of the Second World War have already been discussed (see chapter 9). Since then, the Auxiliary has continued to gain in stature and to provide its life-giving resources and services. The more recent activities of the Auxiliary may be divided into three basic categories: raising money, supplying the hospital and its patients with contributions of money and equipment, and direct volunteer work. The Auxiliary of the Jewish General Hospital has raised funds in several ways. The oldest of these sources is membership dues. At the end of 1936, 204 were enrolled in the Women’s Auxiliary. By 1961, it had more than 4,000 members, and then as many as 11,000, before slipping to roughly 8,000 members by the early 1980s. Most of the other forms of raising money, apart from interest income and outright donations (usually to the Life-Saving Fund, the Tribute Fund, or the Chai Lifeline Fund, have involved greater participation on the part of volunteers. For many years, the most successful of these was the hospital’s coffee shop, which was founded by the Women’s Auxiliary in 1952. In 1982, it raised $120,000. In 1990, it was renovated and rebranded as the “Café de l’Atrium.” In 1999, the Auxiliary opened a second coffee shop (known as The Link) and outsourced a third to Second Cup. The Auxiliary has also raised funds by running the hospital’s gift shop since 1952, and by operating an outlet shop (or next-to-new store) since

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Gift Shop operated by the Auxiliary. Jewish General Hospital Archives, 2_9x4_5x1_1.

1957. The 1990s saw the appearance of a stand for selling second-hand books (which eventually became mobile, to better serve patients), and a newsstand, outsourced to Maison de la Presse.1 The gift shop was renamed the Mildred Lande Gift Boutique and Collectibles, named for one of the Auxiliary’s most dedicated volunteers, who died in 2011.2 The Flower Corner was merged with the gift shop in 2008.3 With the money it has collected, the Auxiliary has provided comfort and lifegiving resources for patients, and funds for researchers. This is all the more important because, even after medicare was implemented, the hospital has had to find non-governmental sources of money to pay for significant operating costs, notably for teaching and research, and to purchase some of the equipment needed to maintain high, updated standards of care. Direct grants to educational programs and departments of the hospital have made up an important proportion of the Auxiliary’s spending. In later years, the special projects of the Auxiliary have become more sophisticated. One example of this is the hospital’s appointment of an ombudsman or “patient relations representative,” on the suggestion of the Women’s Auxiliary, and largely at its expense. This post, created in 1973, was the first of that type in

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Volunteers in library, 1963. Jewish General Hospital Archives, MobileLibrary_Auxiliary.

Canada. Peggy Lahaie, who was appointed to the position, described her purpose as “to humanize the patient’s hospitalization period. I act as the patient’s friend from his time of admission until his time of discharge.”4 In September 1981, volunteer Sheila Kussner spearheaded the Hope & Cope Project, a program designed to provide a psychological support system for cancer patients and their families. Initially run entirely by the Auxiliary, the project was staffed by two full-time social workers and a number of trained volunteers, many of whom were former cancer patients or their relatives. Within a few years, Hope & Cope was considered “one of the best and most innovative programs of its kind in the country.”5 By 1987, thanks to the “incredible fund raising efforts of its devoted and unflagging chairman,” Sheila Kussner, the program had become self-supporting. Today it is a thriving organization, affiliated with the Hospital and the JGH Foundation.6 The 1980s also saw the Auxiliary establish its Vial of Life program to provide rescue services with information on home accident victims, by encouraging people to put relevant medical information in a vial and to deposit it in the safest location in their house: the refrigerator. The Auxiliary introduced this concept

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to Montreal, where it has spread extensively. Another project was establishing a team, paid for by the Auxiliary, that offered coordination and support for stroke victims and their families. Given the importance of providing kosher food, a program with special significance for the Jewish General Hospital was the Meals on Wheels program. By the early 1980s, more than 100 kosher meals a week were being distributed throughout the community, allowing many elderly people to continue to live in their own homes instead of having to be institutionalized.7 This number would decline from over 5,000 meals a year in 1983 to 3,274 in 1992. It stabilized at around 3,500 for the next decade, and was only discontinued in 2013. The Reach to Recovery program for mastectomy patients was another temporary but significant achievement of the 1980s. The Hospital Opportunities Program for Students (HOPS) was started in 1974 in partnership with the local school board to expose young prospective medical practitioners to the working environment of the hospital. “For six weeks in the fall and again in the winter 115 students spend a half day in the hospital observing and working in different labs, clinics and wards. The experiences give them a broad outlook on hospital life and work and are of great benefit in helping decide their futures.”8 For most of the 1980s the program was so popular that many applicants had to be turned away, but by the early ’90s the number admitted had declined to eighty; by the end of the decade only around fifty were participating, a number that has remained constant up to the present day. No doubt the decline in participation had more to do with increasing regulation within the school system than it did with the hospital’s willingness. Until recently, the hospital also held an extensive series of conferences and lectures on health matters, often oriented toward self-help, organized by the Auxiliary. This practice of bringing the hospital to the people fit into a strong tradition developed at the Jewish General, whereby medical experts keep the public informed of developments in the field of health sciences through the medium of an extensive program of speakers. The growing sophistication and usefulness of the Auxiliary has been reflected in its institutional affiliations. The board of administration realized that a closer relationship between the hospital and its auxiliary would be beneficial to both, and thus ruled that the latter’s president would henceforth serve as a member of the JGH Foundation. Shortly afterwards, the Women’s Auxiliary was invited to appoint a representative to the hospital’s Nursing Committee as well. The maturing of the Women’s Auxiliary, which has been associated with such figures as Princess Alice, Madame Pauline Vanier, and the Hon. Vincent Massey, was also accompanied by connections with sister organizations at provincial,

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national, and international levels. It became a founding member of the Quebec Association of Hospital Auxiliaries, and, along with that organization, became part of the corresponding national group established soon afterwards. Within a decade, the Women’s Auxiliary of the Jewish General Hospital further extended its influence by affiliating with the American Association of Hospital Auxiliaries. In 1979, an important change took place within the Women’s Auxiliary that gave it great new potential for development, when men were permitted, and encouraged, to join and to participate in the work of the “Auxiliary,” as it is now known. Within the first year, five male life members were recruited. In 1982, out of twenty-five new life members, nine were men.9 Direct volunteer work for the hospital has been a major concern, but not a monopoly, of the Auxiliary. During the labour-scarce war years, the Women’s Auxiliary formed its Volunteer Service, made up of women prepared to do menial tasks to free nurses for their more specialized jobs. In 1948, with the labour shortage at an end, the Women’s Auxiliary terminated this service, although the spirit of helpfulness continued through the regular activities of the Auxiliary. Seven years later, the administration of the hospital, to stretch its limited budget and to increase community concern in the hospital’s affairs, decided to bring back a system of volunteers. The Auxiliary didn’t operate this Department of Volunteer Services, but it maintained close connections by means of subsidies, a coordinating committee, and the fact that a very large proportion of those offering their time and effort were also members of the Auxiliary. The Department of Volunteer Services, many members of which receive some form of training before beginning their work, have performed duties far too numerous to mention, in many different departments, such as cardiology, dermatology, metabolism, obstetrics and gynecology, pediatrics, playroom pediatrics, recreation psychiatry, sterility and surgery, as well as in the dental, fracture, eye, pulmonary, and records departments, the out-patient emergency clinic, and the admitting office. During the Department’s first ten years, its volunteers donated more than 500,000 hours of work.10 The community involvement of the Jewish General Hospital has also taken the form of links with other institutions, notably hospitals and other health organizations. In part, this has taken the form of service-oriented arrangements, such as that shared by the Jewish General Hospital and the Jewish Convalescent Hospital in 1969. This cooperative program, under the direction of Dr David Halperin, chief of the Ear, Nose and Throat Department and director of Audiology at the Jewish General Hospital, would provide speech therapy at the Convalescent Hospital. Such a program had already been initiated with the Maimonides

A participant in the Hospital Opportunities Program for Students (HOPS) visits a patient, c. 1989. Jewish General Hospital Archives, 1_9_5_2_10.

Teenage volunteer comforts pediatric patient, 1963. Jewish General Hospital Archives, 2_9x6_7x2_2.

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Hospital and Home for the Aged (now the Donald Berman Maimonides Geriatric Centre). Another example of cooperation may be found in the help given to set up a supervised shelter for the elderly, early in 1977. The Jewish General referred the first residents and provided them with medical care and the benefits of its Social Services Department. A decade earlier, the Jewish General Hospital had participated with four other hospitals (the Montreal General, the Queen Elizabeth, the Royal Victoria, and St Mary’s hospitals) and the Victorian Order of Nurses in establishing a Home Care Program. This community service provided medical nursing care, physical and occupational therapy, homemaking services, X-rays, and medicine, to people in their homes. The Jewish General Hospital has also maintained strong links through the medium of medical and hospital associations. It has always maintained a firm connection to the Montreal Clinical Society, and from 1945, when it was first invited, the hospital has participated in activities conducted by the Montreal Medico-Chirurgical Society. The Jewish General Hospital also played an active role in the Quebec Hospital Association, a non-sectarian group including sixty hospitals, or about 25 per cent of the province’s hospital beds. In 1965, Samuel Cohen, still executive director of the Jewish General, was elected president of the QHA. Under his leadership, a merger was negotiated with the Association of Catholic Hospitals of Quebec, a larger body with ninety-two hospital members. The result was a new organization, the Association of Hospitals of the Province of Quebec, involving about 92 per cent of the province’s hospital beds. Samuel Cohen was elected as one of the new organization’s vice-presidents.11 On a more local level, the Jewish General Hospital was invited to become a member of the Montreal Joint Hospital Institute (MJHI) in 1973. The board of directors accepted and joined the Institute on 1 January 1974. The purpose of the MJHI, whose other members are hospitals, such as the Royal Victoria Hospital, the Montreal General Hospital, the Montreal Children’s Hospital, and the Montreal Neurological Hospital, as well as McGill University, is to provide common services, such as group laundry, engineering, safety programs, purchasing, and in-service education. Members of the MJHI are also, ipso facto, members of the McGill Teaching Hospital Council, established to discuss matters concerning teaching and teaching programs. The Jewish General Hospital has also maintained links with community social welfare institutions. As mentioned earlier, the hospital and its leaders participated in the formation and successful operation of the Combined Jewish Appeal from its origins in 1941. Allan Bronfman, then president of the Jewish General, also served as chairman of the Appeal’s first campaign.

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In 1965, at the 31st Annual General Meeting of the Jewish General Hospital, President J. Julius Block announced that the Board of Administrators had approved a proposal to become a constituent member of the Allied Jewish Community Services, which was then being formed. This marked an important step not only in the history of the Jewish General Hospital, but also in that of the Jewish community of Montreal, because for the first time all of the city’s Jewish community services, both welfare and social, would be coordinated by a single, central body. In 1971, the Jewish General Hospital and fifteen other constituent members of the AJCS joined to establish the Jewish Community Foundation of Greater Montreal. This organization, established under a federal charter, would raise a large endowment and legacy fund to initiate new projects in the fields of health, social welfare, and Jewish culture, and to finance special community programs unable to get sufficient funds from the Combined Jewish Appeal. Another aspect of the Jewish General Hospital’s link with the larger community, and one that must not be underemphasized, has been its relationship to government, particularly on the provincial level. While the political climate in general and legislation such as that concerning language (Bill 101) have affected the staff, administration, and functioning of the Jewish General Hospital, of more direct importance in terms of the type and quality of care offered has been the influence of government on the hospital’s funding and organization. Government money has helped to pay for expenses encountered by the Jewish General Hospital ever since its initial fundraising campaign in 1929. However, both the form and volume of this financial aid has changed significantly. For many years, government money was available only for specific projects such as building expansion or setting up new units, and through payments for the care of “public” – i.e., poor – patients, which has already been discussed. Government funding took a new turn in 1961, when, as one of the more important events of the Quiet Revolution, the Lesage administration instituted Quebec’s first comprehensive system of medical insurance. This program not only relieved individuals of tremendous financial concerns, it also greatly assisted hospitals in paying to maintain basic minimal services. Still, the hospital was left with other important operating costs, particularly research and teaching, as is still the case, as well as the salaries of full-time doctors, certain out-patient services such as dialysis and the social disease clinic, and a number of other expenses. The Jewish General Hospital, like other institutions, would have to pay for these services primarily by raising private contributions. Despite the welcome innovation of medicare, there are many operating costs the system does not cover. This has meant that, in addition to the general

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increase in the expense of medical care, in many years the hospital has had to face large deficits and sometimes embark on programs of severe restraint. The Ministry of Social Affairs (now the Ministry of Health and Social Services) made year-end settlements to reduce hospital debt loads. A direct result of the termination of that source of revenue in 1974 was the drastic closing of 100 beds on 1 May 1977, a step the Jewish General was forced to take in the face of an accumulated deficit of $4,600,000.12 Later that year, twenty-seven of those beds were reopened to accommodate short-term patients requiring stays of twenty-four to seventy-two hours. Continued financial pressures, particularly a “plan de redressement” imposed by the government in 1980 to greatly reduce spending in all the province’s hospitals, have prevented the reopening of the rest. The hospital now contains 590 beds, down from its maximum of 700 during the late 1960s and early 1970s. The present situation of economic restraint and government cutbacks, despite growing health needs, ensures that the Jewish General Hospital has not seen the last of its financial worries. The provincial government has also had great influence on the hospital through its control of the institution’s charter. In 1971, inspired by the Castonguay Report, the government decided to increase its role in the running of health institutions and to render their structures more uniform and attuned to the desires of the community at large. In the form of Bill 65 (chapter 48), which went into effect on 1 January 1973, this move affected the hospital in several ways. On the one hand, as with all other hospitals in the province, Bill 65 reorganized the administrative structure. Previously there was only the Jewish General Hospital Corporation, governed by its board of directors. Now there are three distinct bodies, each administered by its own board. The original Hospital Corporation continues to exist, but its functions have been severely circumscribed. It no longer has anything to do with patient care and the delivery of health services, but it does still own the land and buildings and governs the use of these assets in cooperation with the Hospital Centre. The board of the corporation, chosen from its membership, is elected as before. The second body is the Jewish General Hospital Centre, the hospital’s official new name as far as patient care and the delivery of health services are concerned. The Hospital Centre’s board of directors is responsible for all patient-related and medical affairs and is answerable to the government for expenses involved in running the hospital. Intended to represent a broad spectrum of interests, it initially (1973) consisted of the following positions and their holders: two members elected by previous users of the hospital’s health services (Mr Michael Green-

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blatt, QC, and Mr Myer Pollock); two members appointed by the LieutenantGovernor in Council to represent the socio-economic groups served by the hospital (Dr Katherine Berdnikoff and Mr Bernard Lande); four people elected by the members of the Jewish General Hospital Corporation (Dr Andre Aisenstadt, Mr Peter Bronfman, Mr Bernard J. Finestone, and Mr Arthur Pascal); one person designated by the Professional Advisory Council (Dr Norman Kalant); one member elected by the Council of Physicians and Dentists (Dr Henry Kravitz); one member elected by the non-professional staff (Mr Archie Deskin); one person appointed to represent McGill University (Dr R.F.P. Cronin); and, finally, the executive director of the hospital (Dr William R. Slatkoff), although in an advisory capacity only. Later amendments changed the content of the board of directors, reducing the number of representatives of the Hospital Corporation from four to three, removing the user category and adding members to represent nursing homes, social service centres, and volunteer workers. At first, the fact that the composition of the board could theoretically permit a non-Jewish majority caused unease among some of those associated with the hospital.13 Fortunately, the government’s understanding attitude and a general wish to keep the “Jewish” predominantly Jewish has avoided that undesirable occurrence. The Jewish General Hospital Medical Research Foundation, the third administrative body resulting from Bill 65, was created in 1969 with the object of encouraging and managing funds donated for research, teaching, and development. These funds are necessary to develop standards above those provided for by government. However, initially the province was reluctant to permit the purchase of new equipment and facilities, because the Foundation’s operating costs would to some extent become a charge on the public purse. The government eventually became more flexible, so it could take better advantage of private funding to cover capital expenditures. The JGHMRF became the Medical Research Institution in 1978 and in 1988 the JGH Foundation. As part of its aim to rationalize the dispensing of health care in the province, Bill 65 also had a large effect on the types of services offered by the Jewish General Hospital, above all the closing of the School of Nursing in 1972 and the Department of Pediatrics in 1973, and the great increase in the duties of the Department of Obstetrics and Gynecology. The practical result of this was an agreement signed between the Jewish General Hospital and the Jewish Family Services Social Service Centre on 31 December 1974. Workers in the hospital’s Department of Social Service would continue to perform their functions, but they would now also be responsible to the Jewish Family Services Social Service

Chanukah party in the pediatric ward of the Jewish General Hospital. Jewish General Hospital Archives, 1_9_7_1_1_200dpi.

Passover Seder Service, 14 April 1966. Jewish General Hospital Archives, 1_9_7_2_1.

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Centre and would be officially “contracted” from that organization. Early in 1975, Christine Wohl, director of the Department of Social Service, pointed out the advantages of the new arrangement: Before Bill 65 (Chapter 48), the Department of Social Service worked in the Hospital without any organizational links or direct channels of communication to governmental planning bodies, when it came time to identify needed resources for families. It meant some frustration in working with patients and families when facilities to meet their needs were not available. Now, with the contract we have recently signed, there will be a greater coordination of activities, a pooling of resources and a direct link with governmental planning bodies. Our Department remains decentralized, working here in the Hospital setting, so that we can still work closely with full healthy teams (doctors, nurses, physiotherapists and occupational therapists) as well as participate on planning bodies on how to improve the delivery of health care.14 Other institutions that came to a similar arrangement with the Jewish Family Services Social Service Centre include the Jewish Convalescent Hospital, the Jewish Hospital of Hope, the Maimonides, and the Jewish Family Services Agency. The Jewish General Hospital’s links with both the Jewish population of Montreal and the community in general have always been strong. If the hospital is to continue to provide a level of care so in accordance with the aspirations and needs of the particular group it serves, this relationship, ever a priority among the Jewish General’s leaders, must continue to be nurtured as it has been in the past.

chap ter thirte en

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No history of the Jewish General Hospital would be complete without special mention of the lives and accomplishments of two of the people who most influenced the hospital’s character and philosophy: Allan Bronfman and Samuel Cohen.

a l l a n bron f m a n Allan Bronfman, whose long and benevolent association with the Jewish General Hospital was marked by both philanthropy and administrative service, was born on 21 December 1895, in Brandon, Manitoba. An exceptional student, he entered the University of Manitoba at the age of fifteen and acquired degrees in arts and law. He practised law until 1924, and then moved to Montreal to join his brothers Sam, Abe, and Harry in the distillery and wine business. Allan Bronfman’s long career of dedicated service to the welfare of society began as early as 1921, while still in Manitoba. That year, at the age of twenty-six, he was elected president of the Jewish Orphanage and Children’s Society of Western Canada, which his father had helped to found in 1918. After coming to Montreal, Mr Bronfman’s charitable activities increased and he soon became a recognized community leader. He quickly rose to prominence in the Hebrew Maternity Hospital, the movement to found the Jewish General Hospital, and the Federation of Jewish Philanthropies, even becoming president of the latter. His work did not end there, though. During the Second World War, he served in the Royal Canadian Artillery Reserve and directed fundraising campaigns for the Combined Jewish Appeal and the war effort. Later, his humanitarian interests led him to become involved in a myriad of charitable, educational, and

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Allan Bronfman. Jewish General Hospital Archives, 1_9_1_1_4.

health-related groups and institutions. He also played an important role in a number of organizations to promote the State of Israel and the Hebrew University of Jerusalem. Being involved in such a vast number of causes, it is a wonder that Allan Bronfman had any time left for the affairs of the Jewish General Hospital. But he made sure of that, for his benevolent interest in the welfare and development of the institution that he had helped so much to found never waned. In fact, along with Samuel Cohen, he contributed enormously to establishing the hospital on a firm foundation and to forming a tradition of top-quality hospitalization in a Jewish environment. Under his presidency, the Jewish General became one of the foremost hospitals of the province and introduced many innovations in health care and surgical procedures. With its president’s initiative and encouragement, it undertook and placed a high priority on original and unique medical research. To get the true spirit of his leadership, it is perhaps apt to turn to the recollections of the person most closely associated with him in his role as president of the hospital, Samuel Cohen:

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It is difficult to describe the intensity of his leadership. There were so many details reaching out in a multitude of directions … We first met in 1934. What immediately impressed me about him was his thoughtfulness and at the same time his methodical approach to all problems. And you must understand that there were many! He knew that it really takes so little to make people happy, and, as you can imagine, there were so many people to satisfy … from the person who was Jewish and worked on the Campaign, to the woman who thought her medical student son should be appointed to the Hospital staff. He managed to handle all of them. At one time I thought that Allan Bronfman’s weakest point was his accessibility. Almost anyone who wanted to, could make an appointment with him. He found the time for all of them. But over the years, as we worked together, I began to understand that this “accessibility” represented a major strength within his personality. He was truly not a leader of causes, but a leader of people.1 For many years, Allan Bronfman would usually spend the weekdays in New York, coming back to Montreal for the weekends. Then he would invite Samuel Cohen to his residence on Belvedere Road to discuss the affairs of the Jewish General. “He would sit there with a pile of papers, periodicals and letters before him,” Cohen recalled. “It was his “hospital pile. And there were other piles to deal with as well, representing other institutional interests: the Hebrew University pile, the Combined Jewish Appeal, and so forth. But while we were together, the hospital was his only concern.” With Allan Bronfman, community leadership and diplomatic skills went hand in hand. There’s no question about it. He was the person who opened so many doors for us. His contacts throughout the community were as vast as they were significant. He could talk to the corporate heads of the community – the presidents of the Bank of Montreal, The Royal Bank, Sun Life, Canadian Pacific and others. At the same time, he was a welcome figure at Sick Benefit Society meetings. He had a great facility for levelling things off when problems would cause polarization within the community. You could always count on him for a coolheaded approach to the thorniest of situations. He was a diplomat in every sense of the word.

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Allan Bronfman and Samuel Cohen, those two most influential people in the history of the Jewish General Hospital, complemented their many years of close cooperation with a hearty, durable friendship. Again, the words of Samuel Cohen: We worked together for over two decades. Over the years our working relationship was close and harmonious. Ours was a warm friendship brought on by virtually thousands of hours of working together on behalf of the Hospital. There was always so much to discuss … I remember once I was confronted with a personal decision, a very attractive offer back in my home town, New York. After discussing the pros and cons of the invitation, he simply stated: “Mr Cohen, I can offer you anything … but I cannot bring New York to Montreal.” I have never had any regrets at not having accepted the offer, for I know that in working with a man of Allan Bronfman’s magnitude, we created something that is meaningful and lasting. Mr Bronfman passed away in 1980.

s a mu e l co h en A certain amount has already been said about Samuel Cohen, the American who, in 1933 at the age of thirty-three, came from New York to fill the position of superintendent of the Jewish General Hospital. Mr Cohen brought with him an attitude embracing Jewish values, a strong discontent with mediocrity, and full knowledge of the importance of the new hospital to both Jewish patients and Jewish medical practitioners in Montreal. Admirably suited to the task, he was able to take a leading role in shaping the hospital from before it opened until even after his retirement in 1968. From the very beginning, he sought to promote perfection in all aspects of the hospital’s operation. In spite of the fact that we were locked into the Depression and that money was very, very difficult to get, I set down certain objectives. Foremost among these was the pursuit of excellence. Perhaps we did not always achieve it, but we always pursued it. It is a destination; you never get there, but you always aim for it.

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Samuel Cohen. Jewish General Hospital Archives, Samuel Cohen.

A good example of Samuel Cohen’s insistence on excellence may be found in his attitude concerning the hospital’s initial laboratory, which he did not find to be of suitable quality for a modern Jewish hospital. I looked at the laboratory. It was nothing more than just a simple chemistry lab, guided by the biochemist of the Montreal General Hospital, something that would be fitting for a small community hospital which would farm out most of its work and would only do the essential things in the hospital. I persuaded the Board that our medical staff would have to have more than that if the hospital was going to develop. They needed the assistance of a full-time pathologist and laboratories where they could do their own work. The earlier concept was that the tissues would be sent to an outside laboratory which would send back reports. Not good enough! The doctors would not have the opportunity to consult or discuss. They’d just get a paper report, which is not sufficient for the qualified kind of staff that we had. The Board agreed and we engaged a fulltime pathologist (Dr David

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Seecos). The same way of thinking prevailed with respect to radiology. We established a basic scientific approach and this was the beginning of the quality of hospital that we now have. Samuel Cohen’s emphasis on quality and the conscientious manner in which he fulfilled his functions were also reflected in the long hours he and those under his direction worked. In the early years I spent day and night at the hospital, because there was always something that called for an on-the-spot decision. For the first twenty years I worked without an assistant. I was there all the time and I remember how a member of the Board would come home from the movies and would stop at the switchboard, which was in the main lobby at the time, and would say to the operator: “Mr Cohen here?” She’d say, “No, he’s gone home,” and he’d ask, “Is he coming back?” This was already midnight! I look back and I feel ashamed of how we took advantage of people. They worked ten, twelve, fourteen hours a day. We had a loyal staff. We had people who remained with us for many, many years. We had a good rapport. Still, despite the intensity of the effort required to perform his job well and the complaints of a few who seemed to consider the temperature of the soup served more important than the quality of medical care, Mr Cohen’s efforts proved to be rewarding. In part, this came from public recognition of his contributions and abilities, such as when he was elected a member of the American College of Hospital Administrators in 1939. Above all, however, he had the satisfaction of knowing that the Jewish General Hospital was rapidly advancing toward that degree of perfection that he so ardently desired. We managed and we managed well. We always had to keep in mind that it was this same spirit of perseverance that built the hospital in the first place …. To me it was a very satisfying experience. You know, when you look back, you like to feel that you have left something of yourself, and that’s why, although I had many offers to go back to the United States, I decided against it. I felt that I had not really completed what I had started out to do. This choice paid off in terms of job satisfaction …. The hospital has achieved ever objective that it could possibly achieve [and] has really made a distinct contribution to the Jewish people. It’s recognized not only locally;

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it’s recognized in professional circles throughout North America and has attained a status which I think is a source of great satisfaction to anybody who has had anything to do with it. The full effect of Samuel Cohen’s association with the Jewish General Hospital, an association that continues even at the time of writing this book, cannot be summarized within the space of a few pages, or even a few chapters. However, the biography of Samuel Cohen and the history of the Jewish General Hospital are so closely intertwined that to talk of one is to talk of the other. The greatest monument to the work of Mr Cohen is that lifegiving, modern institution at the corner of Côte-Sainte-Catherine and Côte-des-Neiges Roads.

l ater exe c u t ive d i re c tors William R. Slatkoff (1968–75) As medical and social progress leaped ahead in the late 1960s and early ’70s, it was Dr William R. Slatkoff who played a key role in ensuring that the Jewish General Hospital kept pace with the times. During his tenure, the hospital introduced a wide array of essential services and programs. Dr Slatkoff was at the helm when, in 1969 alone, the JGH inaugurated the Lady Davis Institute for Medical Research, opened the Institute for Community and Family Psychiatry, established the JGH Foundation, and was granted teaching affiliation with McGill University. Dr Slatkoff, a native Montrealer, earned degrees in arts and medicine from McGill University and began to practise at the Montreal General Hospital in 1934. During the Second World War, he became assistant superintendent (Medical) at the Montreal General and held that position until 1950, when he accepted an invitation to work at New York’s Maimonides Hospital. Three years later, Allan Bronfman, the founding president of the JGH, sought to enhance the stature of the hospital by creating the position of medical director. He convinced Dr Slatkoff to fill the post. In this capacity, Dr Slatkoff was responsible for coordinating the hospital’s medical affairs (including the activities of interns and residents), appointing staff, arranging for the continuing education of attending staff, and generally supervising the departments. In 1968, he succeeded Samuel S. Cohen as executive director. After his retirement in 1975, Dr Slatkoff continued to serve the hospital in an advisory capacity.

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William R Slatkoff. JGH AudioVisual Services Department.

He also remained active in such organizations as the Canadian Human Rights Foundation and the Senior Citizens’ Forum.

Archie Deskin (1975–91) Dramatic growth and expansion, enduring hallmarks of the Jewish General Hospital, continued under Archie Deskin’s guidance throughout his term as executive director. Among the most significant developments during his term were the launch of the Neonatal Intensive Care Unit, the creation of the Division of Geriatric Medicine, the establishment of Hope & Cope, the opening of Pavilion E, and the inauguration of the Bloomfield Centre for Research in Aging. In addition, he was of key importance in helping the JGH to overcome major budgetary difficulties in the 1970s to emerge stronger than ever. Born in Montreal, Mr Deskin received his BA in 1957 from Sir George Williams University and his MA in Hospital Administration in 1960 from the University of Montreal’s Institut supérieur d’administration hospitalière. He was appointed

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Archie Deskin. JGH AudioVisual Services Department.

assistant executive director of the Montreal Hebrew Old People’s Home in 1953 and was promoted to executive director in 1957. Two years later, while completing a university field placement for his master’s degree, Mr Deskin was asked to joined the Jewish General Hospital as administrative resident. After his residency ended, he remained at the JGH and was appointed assistant director. Mr Deskin went on to become associate executive director in 1971 and executive director in 1975, serving in that capacity for sixteen years.

Henri Elbaz (1992–2008) Although the ongoing growth and improvement of patient services has always been integral to the character of the Jewish General Hospital, they were especially apparent during Henri Elbaz’s tenure as executive director. To some extent, this occurred because the hospital was – and continues to be – involved in developing great expertise in many medical fields, including oncology, neonatology, geriatrics, obstetrics/gynecology, and emergency medicine.

Henri Elbaz. JGH Audio-Visual Services Department.

The library committee: Arlene Greenberg, Bram Gelfand, Aaron Rauch, Senator Leo Kolber, Henri Elbaz. Jewish General Hospital Archives, 1x3x2_9_3_4.

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Pavilion H, an acquisition from Les Sœurs de Sainte-Croix, next door, 2009. Jewish General Hospital Archives, 1_1_6_10_2.

As a result, the volume of patients has risen sharply, thereby making evergreater demands on staff, equipment, and facilities. Furthermore, the JGH is located in a neighbourhood that is home to immigrants from a diverse array of national, cultural, and religious backgrounds. Mr Elbaz worked especially closely with staff, the board of directors, benefactors, and the government to ensure that the hospital would be able to grow to meet these challenges. During the 1990s, Mr Elbaz oversaw the launch of the JGH-based McGill Head and Neck Surgery and Oncology Program; the full renovation and modernization of the Emergency Department; and the opening of Quebec’s first specially designated and fully equipped operating room for minimally invasive surgery. The largest and most significant construction project during his era was the 2005 addition of eight new floors atop Cummings Pavilion E, home to the new Segal Cancer Centre, funded by the ministry ($5 million), the JGH Foundation ($58 million), and the Alvin Segal Family Foundation ($20 million). The Divisions of Nuclear Medicine and Radiation Oncology acquired a PET/CT scanner and began construction in 2007 to significantly expand Radiation Oncology. Elbaz’s most momentous achievement was the purchase in 2005 of the neighbouring convent of Les Soeurs de Sainte-Croix, which is now known as Pavilion H.

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Sister Annette Legault, the late Arnold Isaacson, notary, Executive Director Henri Elbaz, and Sister Thérèse Lefrançois. Jewish General Hospital Archives, PavH_AV.

Existing buildings were extensively renovated to provide the JGH with space for the Cardiovascular Prevention Centre, an expanded Herzl Family Practice Centre, and a hemodialysis centre. Plans are also being considered to use the land for construction of new facilities for many hospital departments. Before joining the JGH, Mr Elbaz earned an MA in business administration and became director of research, statistics and public relations at the Montreal Stock Exchange. He also taught corporate planning and management policy at the University of Montreal’s École des hautes études commerciales. Upon joining the Jewish General Hospital, Mr Elbaz became director of administrative services and, in 1992, was appointed executive director. In 2002, his professional peers named him manager of the year in health-care delivery – the first time the CEO of a hospital had been chosen to receive this honour. Mr Elbaz has also served on several commissions of the Regional Health Council, as well as the Association of Canadian Teaching Hospitals.

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Hartley S. Stern. JGH Audio-Visual Services Department.

Hartley S. Stern (2008–13) Dr Hartley Stern was executive director of the Jewish General Hospital and professor of surgery at McGill University from 2008 to 2013. Previously he was vice president of The Ottawa Hospital Regional Cancer Centre and, the provincial head of Surgical Oncology with Cancer Care Ontario. Originally from Toronto, Dr Stern completed his undergraduate medical education and surgical training at the University of Toronto, followed by a research training fellowship at the London Hospital Medical College in London, England. He moved his practice to Ottawa in June 1994, to undertake the new roles of chief of surgery at the Ottawa Civic Hospital, and subsequently The Ottawa Hospital (amalgamated in 1998) and, as chairman of the Department of Surgery at the University of Ottawa. In August 2000, Dr Stern began a new challenge as the CEO of the Ottawa Regional Cancer Centre, which in January 2004 became a large integrated program in the Ottawa Hospital of the full spectrum of cancer services, research, and education.

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Dr Stern’s clinical focus is colorectal cancer, and he intends to continue, in a limited fashion, to teach students and perform surgery. He also holds an appointment as professor of surgery at McGill University. In addition, Dr Stern had the opportunity to work with and preside over the Canadian Oncology Society, the Canadian Society of Surgical Oncology, and the Integration Group of the Canadian Strategy for Cancer Control as it developed into a National Council. He now sits on the Strategic Advisory Committee of the National Cancer Institute of Canada. Dr Stern has assumed new duties in Ottawa as executive director and chief executive officer of the Canadian Medical Protective Association.

Lawrence Rosenberg (2013–) Dr Lawrence Rosenberg was appointed executive director of the Jewish General Hospital in November 2013. He was appointed president and CEO of the Integrated Health & Social Services Services University Network for West-Central Montreal in 2015, which includes the JGH. Dr Rosenberg is professor of surgery and medicine at McGill University. He has extensive experience as a clinician-scientist, educator, and consultant in the area of islet cell regeneration (in the pancreas), value-based care, and integrated health-care systems. Since joining the JGH in 2007 as chief of surgical services, Dr Rosenberg has been instrumental in the development of many innovative partnerships and programs to improve the quality of surgical care. In particular, he introduced the National Surgical Quality Improvement Program (NSQIP) of the American College of Surgeons to the hospital, a first in Quebec. He also played an important role in helping to create the Canadian Collaborative of NSQIP. In addition, he laid the foundation of the hospital’s robotic surgery program, which has gone on to national and international acclaim. Transformational Change, introduced under his leadership in 2011, has inspired staff to develop projects that significantly increase operational efficiency and reduce waste hospital-wide, thereby saving funds that can be used for patient care. In 2015, Dr Rosenberg actively supported the introduction of Bill 10, which introduced a major transformation of health-care and social services in Quebec. This led to regrouping the Jewish General Hospital with nine other institutions in west-central Montreal into a new organization known as the CIUSSS CentreOuest (Centre intégré universitaire de santé et de services sociaux). The objectives

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of Bill 10 were to improve access, to establish a continuum of care based on trajectories of care, and to better control costs. As the only acute care hospital in the CIUSSS, the JGH has taken a leadership role in this new network that has begun to make significant contributions to population health management within its territory and beyond. Dr Rosenberg played an important role in helping to draft amendments to the original bill to protect the historical traditions and cultures of the Jewish institutions that joined to form the new network. In January 2016, Dr Rosenberg oversaw the opening of the hospital’s latest redevelopment project, Pavilion K. Dr Rosenberg received his medical degree from McGill, where he completed specialty training in general surgery. He holds a master of science degree and a doctorate in experimental surgery from McGill and he completed post-doctoral studies and a surgical fellowship in transplantation at the University of Michigan. He also received a master of engineering degree from the University of Waterloo, concentrating on systems and innovation. Dr Rosenberg served as director of the Multi-Organ Transplant Program at the Montreal General Hospital, inaugurating McGill’s Pancreas Transplant Program and leading the team that performed the first successful adult liver transplant at McGill. He was also the associate chair (Research) for the McGill Department of Surgery. Dr Rosenberg is the only Canadian ever to have received the prestigious American Surgical Association Foundation Fellowship.

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In 1984, the Jewish General Hospital needed expansion. A study done from 1981– 83 showed that the hospital immediately required over 130,000 additional square feet of and also needed to renovate 100,645 square feet. Increased activity in the previous fifteen years, notably in the Emergency, Out-Patient, and Psychiatric Emergency Departments; the Departments of Oncology, Hemodialysis, Neonatology, Cardiology, and Radiology; and the Diagnostic and Ambulatory Services, had made this growth indispensable. Some of these departments were particularly short of space; the capacity to provide top-quality treatment had become hampered and on occasion severely compromised. As an example of the need, Dr Apostolos Papageorgiou’s Department of Neonatology, which had accomplished so much in previous years, had less than one-third of the required surface area for each baby in intensive care. The department’s success in keeping babies alive resulted in an increase in the number of high-risk references from other hospitals, and hence in a situation in which, according to Dr Papageorigiou, “at times we have as many as 50 newborn infants in the nursery designed to handle no more than 20 babies comfortably.”1 Since 1980, the Department of Nuclear Medicine, responsible for bone, brain, and heart scans used in diagnosis, doubled the number of examinations it performed. It desperately lacked space and possessed no appropriate treatment room, waiting room, or resident teaching room. In the words of Dr Gerald Stern, the head of the department: “It had long been apparent that the resources had been woefully inadequate to meet growing requirements. As a result, the waiting periods for examinations became intolerably long, resulting in delays in diagnostic and therapeutic services.”2 Similar situations were evident in the Departments of Psychiatry, Emergency, and Hemodialysis. The latter, which had only been in operation for a decade,

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had only a quarter of the space it needed for patient care and the storage of equipment, and had kept up with demands only by accepting overcrowded conditions, converting waiting rooms and corridors to other purposes, and having a dedicated and experienced staff. More space was necessary not only for decent conditions for the patients and staff, but also to implement a self-care program to teach patients to monitor their own treatment, thereby lowering the cost of their care. The circumstances of the Psychiatric Emergency Service were best described by its director, Dr Jon Ellman: Psychiatric emergencies may be quite traumatic. Symptoms may include agitation, disruptive, psychotic or dangerous behaviour. Obviously this group should not be treated next to heart attack victims. Therefore, there is a need in the emergency area itself for several appropriately equipped sound-proof rooms, which budget restraints have so far precluded. At present our waiting area, interview rooms and holding area consist of tiny, hot, windowless, converted cubicles or hard benches and, increasingly, stretchers in the hall. The Psychiatric Holding Area is a six-bed four-day stay unit with a nearly 100-percent occupancy rate. The cubicles were formerly used for obstetrical out-patient examinations. The need to move this windowless facility is urgent.3 In response to this crisis of overcrowding, the hospital’s board of directors drew up an expansion campaign involving the renovation of 100,645 square feet and the construction of two new six-storey wings. One of them, located just west of the main entrance, provided 64,125 square feet. This southwest wing became the site for the highest priority patient-related services, because of its proximity to the most acute in-patient services, and contained intensive coronary care, hemodialysis, ambulatory surgery, oncology, neonatology, neurophysiology, pathology, radiotherapy, a pharmacy, the employee health centre, the emergency psychiatric holding area, and a coffee shop. The other new wing, situated on Légaré Street, just north of the Lady Davis Institute and adjoining the existing northwest wing, involved an expansion of 66,705 square feet. It housed consolidated ambulatory care facilities, including the full-time physicians’ offices, as well as family medicine, laboratories, cardiology, opthalmology, the outpatient clinic, and the medical archives. The enlargement was part of the Jewish General Hospital’s continuing commitment to principles established by its founders in 1929. First among these is a pledge to keep the hospital attuned to the needs of the Jewish community of

Leonard Ellen, Peter Bronfman, Herbert E. Siblin, Leo Goldfarb, Gerald Bronfman, Guy Chevrette, the then Minister of Health and Social Services, and Dr William Slatkoff. Jewish General Hospital Archives, 1_1_9_7_1.

Jean-Marie Mallet, Director of Human Resources; Betty Rozovsky, Director of Public Relations; Henri Hazan, Budget-Control Officer; Barbra Gold, Director of Auxiliary Services; Henri Elbaz, Associate Executive Director Administration; Anton Torunian, Director of Finance, Archie Deskin, Executive Director; Dr Paul Heilpern, Associate Executive Director Professional Services; Diana Teitelbaum, Administrative Assistant; Joe Kleinman, Director of Hospital Services; Mary Marrett, Associate Executive Director Nursing. JGH Audio-Visual Services Department.

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Montreal and the province. The hospital intends to place more emphasis on geriatrics in the near future by hiring a greater number of specialists in this field and increasing its clinical and research activities for the aged. At present (2015), about 20.4 per cent of Jews in Montreal are over the age of 65, compared with roughly 13.5 per cent of the general population.4 These numbers are expected to increase in the years to come. The next guiding principle is the commitment to non-sectarianism. The Jewish General Hospital, while maintaining its Jewish environment, will continue to provide health services to those of any race, creed, or language, with an emphasis on functional bilingualism for all the staff. Finally, the Jewish General Hospital has every intention of preserving its focus on excellence, not only in the field of patient care, but also in terms of research and education. This is where the expansion project comes in. With it, the Jewish General Hospital does not plan to provide additional services or to accommodate a larger number of hospitalized patients; rather, it is intended to improve the quality of service and to reduce the extent of overcrowding for the same number of patients as are receiving in-patient care at present. In this way, patients will receive optimal diagnosis and treatment, in an environment conducive to maintaining their dignity and self-respect. Also, the hospital staff will benefit from much improved working conditions. To achieve these improvements in the hospital’s facilities cost a great deal of money; the estimate called for $25 million. Without it, nothing could have been done and the institution that the Jewish community did so much to acquire and that has been a source of such intense pride would decline. With the intervention of Senator E. Leo Kolber, the provincial government provided $5 million. On 21 December 1983, Social Affairs Minister Pierre-Marc Johnson addressed the following words to the hospital’s board of administration: I would like to express my appreciation for this initiative which demonstrates how much attention you have given to the quality of service delivered to the population. Knowing how scrupulously you have adhered to your budget, knowing the crucial role the hospital plays within the community, and knowing that this support will contribute to the maintenance and improvement of your property and equipment, I take great pleasure in informing you that, in conformity with C.T. 145,384 of 5 July 1983, the Minister of Social Affairs has pledged a financial contribution equivalent to 25 per cent of the total cost up to a maximum of $5,000,000, payable upon completion of the project.5

The Lady Davis Research Building with four new floors. Jewish General Hospital Archives, 1_1_6_4_6.

For this $5 million, the Jewish General Hospital has expressed its gratefulness. The remaining $20 million was raised from private sources, including an estimated $16 million from members of the Jewish community. Subscriptions were sought and an official public campaign was held from 1 May to 15 May 1984. To collect this sum, however, was not easy. In recent years, while non-Jews have fully recognized the ethnic quality of the hospital, some members of the Jewish community have come to feel that “the hospital is not ours anymore.” Executive Director Archie Deskin objected vehemently to this view: “The truth is that the hospital is no less ‘ours’ today than it was 50 years ago, notwithstanding the government’s increasing intervention in its daily operation, a universal feature of hospital life even in the United States where ‘free enterprise’ in the health delivery system thrives. One should not confuse our government’s insistence on ‘good corporate citizenship’ in the attainment of its financial objectives with any attempt to ‘take over hospitals.’ This is simply not the case, and, in my humble opinion, will never be the case.”6 In fact, the Jewishness of the hospital will in future largely depend on how much support it receives from the Jewish community in endeavours such as this. Maintaining specifically Jewish services, such as Kashruth, costs money, and to ensure their continuation and quality, Jews must live up to their responsibilities

Mayor Jean Drapeau (right) and Herbert Siblin, President. Mayor Drapeau was an honoured guest at a reception on 5 March 1984 to inaugurate the Hospital’s 50th Anniversary celebration. Jewish General Hospital Audio Visual Department, 1_1_10_8_1.

Stephen Vineberg, Stephen Cummings, Maxwell Cummings, and Morton Brownstein. Jewish General Hospital Archives, 1_1_6_7x9_3_200dpi.

Cummings Wing of the Segal Cancer Centre on Légaré Street after the addition of 8 floors with a link to the Lady Davis Institute for Medical Research, 2004. Jewish General Hospital Archives, 1_1_6_9_7.

and provide the necessary material aid. If it does not receive this support, the Jewish General Hospital will become a hospital like any other, without the particular comfort and service that it offers to Jewish patients and no longer the source of pride for those of Jewish background. After over eight decades of vital assistance to members of all religious and ethnic groups, the role of the Jewish General Hospital is as important as ever. In 1984, the hospital made the following statement: “Our hospital’s future lies in the hands of people who should have no less interest in its mission than its founders of 50 years ago. In striving for excellence, we continue to count on our community for support and, so long as this support is forthcoming, the community can be assured that the hospital is ours and always will be.”7 The expansion of the hospital has been nothing short of sensational. In 1990, the hospital built Cummings Pavilion E for outpatient clinics. In 1991, construction began on the four new storeys of the LDI (Lady David Institute), and the new facilities were inaugurated in May 1992. In 2005, the ministry announced another $5 million in support so that, in 2006, eight more floors were added to Cummings Pavilion E to create the Segal Cancer Centre. In 2010, the Centre for

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Henri Elbaz, Leonard Ellen, Unknown person, Herbert Siblin, Unknown person, Stephen Vineberg, Leo Goldfarb, and Brahm Gelfand. Standing by himself at the far right is Steven Cummings. Taken during the construction of Pavilion E, the Cummings pavilion. Jewish General Hospital Archives, 1_1_6_7x9_4.

Child Development and Mental Health Pavillion was opened in a separate building just west of the Institute of Community and Family Psychiatry. In 2014, Pavilion K was opened, launching the new Emergency Department and new parking facilities. New operating rooms, patient floors, and expanded facilities for intensive care, neonatal intensive care, coronary care, and the Family Birthing Centre opened in 2016. Funds were pledged in 2004 in the amount of $23.9 million for further construction. The signing ceremony to acquire the property north of the hospital took place in February 2005. The purchase was the initiative of hospital president Jonathan Wener and the Foundation provided an $11 million loan. Part of this building, the convent of Les Soeurs de Sainte-Croix, was renovated immediately and went into use in mid-summer as a hemodialysis clinic in what became known as Pavilion H. More services were added over the next several years, most notably the Cardiovascular Prevention Centre, the Goldman Herzl Family Practice Centre, and the Department of Obstetrics and Gynecology, all funded

New Centre for Child Development and Mental Health at 4335 Côte-Ste-Catherine, 2010. The Ruth and Saul Kaplan Pavilion. Jewish General Hospital Audio Visual Department, 09-1611Juin2010_01.

by the JGH Foundation. In 2004, the Foundation began a $200 million campaign, chaired by Morton Brownstein and Edward Wiltzer. In 2010, the Centre for Child Development and Mental Health opened in the Ruth and Saul Kaplan Pavilion, west of the Institute for Community and Family Psychiatry. That same year, the JGH Foundation launched a $250 million campaign, chaired by Harvey Levenson, Christine Marchildon, and Bernard Stotland. A transformative change in medical care commenced with the opening of the hospital’s Critical Care Pavilion K. This facility, the result of a combined effort by the government and the Hospital, together with its Foundation, was designed to improve access to life-saving treatments, reduce wait times, and continue to strive for the highest level of patient care. The opening was phased, with the underground parking garage and the new Emergency Department opened in February 2014. The Emergency facility is the largest and most advanced in Canada, accounting for approximately 80,000 square feet.

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A global view, 2016. Jewish General Hospital Archives, 07-1362(28jui09)#10.

The following additional services in Pavilion K became available in January 2016: sixteen operating rooms (including those equipped for minimally invasive and robotic procedures); a medical/surgical intensive care floor; a neonatal intensive care floor; and a cardiology/cardiac surgery floor with cardiac intensive care unit, step-down unit, and private patient rooms. Pavilion K also has an eleven-storey tower featuring private medical/surgical patient rooms, including a combined neurology/neurosurgery floor, and a unit suitable for managing pandemics. This expansion was largely funded by the JGH Foundation, which, between 1969 and 2001 raised some $100 million, and since 2002 another $500 million. This has provided essential funds for extensive research recruitment, facility renovations, and new construction – notably the Segal Cancer Centre, for which it raised $58 million.

Waiting room, new Emergency Department. Jewish General Hospital Archives, 11-1076-024.

The new Pulmonary Oncology waiting room in Pavilion E, 10th floor. Jewish General Hospital Audio Visual Services Department, 12-1209AttenteBrojde_03b.

Operating room, K building. JGH Audio-Visual Services Department.

Segal Cancer Centre. Jewish General Hospital Audio Visual Department, 12-1209Dermato_12.

The new OR. JGH Audio-Visual Services Department.

K Building during construction. Jewish General Hospital Archives, 3580_AV180dpi.

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depa rt m en t of a n e st h e s i a Dr Simcha Kleiman In 1984, the Department of Anesthesia consisted of nine members with varying credentials and levels of training. By 2014, the Department had more than doubled in size to twenty members, all with Royal College of Physicians of Canada-accredited residency training, and fourteen with advanced fellowships in anesthetic subspecialties, including critical care, pain, regional anesthesia, cardiac anesthesia, and obstetrical anesthesia. As befits a hospital that made an aggressive turn from a community-level hospital to an academic teaching hospital, the Department of Anesthesia has become an integral part of McGill teaching programs. From a department with no formal involvement in teaching, the department now receives approximately forty McGill medical students per year, as well as a full complement of residents, and a clinical fellow in cardiac anesthesia. Several department members have written textbook chapters, and conducted and published original research. Dr Ruth Covert, a program director for the McGill Department of Anesthesia residency program, was a member of our hospital department, while the present McGill undergraduate program director for anesthesia, Dr Giuseppe Fuda, is a member of our department. As well as all these academic achievements, the department is recognized for its clinical excellence, as well as its contributions to administrative activities in the hospital.

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t h e au x il i a ry j g h Presidents Rachelle Douek 1983–85 Jackie Veinish* 1985–87 Rosalie Gordon 1987–89 Lucy Wolkove 1989–91 Rona Miller 1991–93 Marilyn Golfman 1993–95 Nancy Cooperberg and Sheilah Greenberg 1995–97 Dale Boidman 1997–99 Nan Lassner 1998–99 Elaine Paperman Woolner and Evelyn Uditsky* 1999–2001 Iselott Gasman and Sharon Spiegel 2001–03 Hela Boro and Eileen Fleischer 2003–05 Dorothy Rotholz and Judy Shaicovitch 2005–07 Rona Green 2007–09 Phyllis Karper and Linny Blauer 2009–11 Fran Yagod and Merle Klam 2011–13 LinnyBlauer and Phyllis Karper 2013–15 Reisa Lerner and Beatrice Lewis 2015–17 *deceased “It’s All About People … It’s All About Caring … Educating … Fundraising.” In 1984, the leadership of the Auxiliary was lauded for the community work it had accomplished as an integral part of the hospital and for its acknowledgements of several individuals for their outstanding volunteer contributions. The late Mildred Lande, our past president, received the coveted Eleanor Roosevelt Centennial Award, and, in 2006, the JGH’s Distinguished Service Award. Our past president, Phyllis Waxman, was given the title of Chevalier of the National Order of Quebec in 1988 for her outstanding community work. In 1997, she was also awarded the Samuel Bronfman Medal in recognition of service and leadership in the Jewish community. The Rita Finestone Award from the Association of Hospital Auxiliaries in the Province of Quebec was given to the Auxiliary in recognition of its educational seminar “Cancer Answers” in 1990. In 1991, the Auxiliary was awarded the Rita Finestone Award by AHAPQ (Association of Hospital Auxiliaries of the Province of Quebec) again for its Chronic Spinal Pain Support Group. In 1995, the late Jackie Veinish, past president, was named

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Woman of the Year by the Montreal Council of Women, and we still have a representative who sits on this council. In 1999, the Auxiliary’s Urgence Presence project of having specially trained volunteers working exclusively in the ER to help with patient flow, was the recipient of the Canadian Auxiliaries Recognition of Excellence (CARE) Award. In 1984, the Auxiliary raised $491,951.00 in donations from several businesses, fundraisers, and projects: the Outlet Shop, the Coffee Shop, the Flower Shop, the Forget-Me-Not Gift Shop, the Look Ahead Show, the Fur Follies, the Bridge Luncheon, the Mobile Library Cart, kosher Meals-on-Wheels, and Brith catering. The Auxiliary also funded the Psycho-Geriatric Recreation Program for outpatients and participated in the hospital’s fiftieth Anniversary Ball. At this time, seed monies were also provided for the Stroke Team and Hope & Cope, the Auxiliary also provided the emergency room with plastic bags for patients’ belongings, up until 2011 and funding for equipment at the Nuclear Medicine Department. The new Chai Fund (in support of children with serious illnesses) brought in monies by encouraging new parents to inscribe their newborns’ name on a certificate to be sent to the child. In 1985, $535,165.00 was raised for the hospital from our ongoing businesses and in 1986 the fiftieth Anniversary Luncheon greatly benefited the ICU and other departments by helping to purchase equipment. In 1987, $608,598.00 raised helped with nursing bursaries and equipment purchasing – new revenues at this time were from Infant Photography, Bedside Beauty Service, and the Infant Car Seat Rental Service. In 1988–89, $943,686.00 was dispersed. Hope & Cope has now become a JGH project, taking leave of its many years of funding under the Auxiliary. A computerized system for ICU was our fundraiser beneficiary. In 1990, funds totalling $695,962.00 and the opening of the newly renovated Café de l’Atrium brought in increased revenues. The participation of the Auxiliary in the JGH Bal des Pavillons celebrated the openings of the Peter & Edward Bronfman Pavilion, the Cummings Family Pavilion, and the Shirley and Leo Goldfarb Centre for Radiation Oncology. In 1991–92, the Auxiliary raised $1,029,019.00, and in 1993, $492,218.00, and participated in the first JGH Golf Classic. It also provided infant and maternity services, layettes for needy mothers, and the Baby Safe Car Seat Rentals, and bought ventilators for ICU and Doppler ultrasounds. In 1994–95, it raised $815,571.00, which helped to purchase fluoroscopy equipment for the radiology department, ultrasounds for the neurology department, and a nuclear medicine processor. In 1996, the Auxiliary celebrated its sixtieth anniversary with a gala and luncheon attended by Roméo LeBlanc, governor general of Canada; funds raised that year

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Leo and Shirley Goldfarb launch the Centre for Radiation Oncology. Jewish General Hospital Archives, 1_1_6_7x9_1.

were $422,058.00. In 1997–99, it raised $1,057,000.00, which was allocated for buying fetal monitors, an ultrasound scanner, an intra-aortic balloon pump, and hemodialysis machines. In 2000–01, the Auxiliary raised $1,277,689.00 which went toward renovating the entrance to the Physiotherapy Department and the waiting room for the Family Birthing Centre, projects that kept the Auxiliary’s input visible. Its partnership with Philips Lifeline, a personal help responder service, began to benefit the Geriatric Department. The Auxiliary began providing the public with infant and child CPR classes. In 2002–03, it raised $1,584,245.00, providing birthing beds and mobile X-ray machines. The Auxiliary celebrated its sixty-fifth anniversary with the start of a new service – the Helping Heart Pillow Project, providing heart-shaped pillows for post-cardiac surgery patients to alleviate pain during recovery. In 2004, the newly published Panache cookbook raised $868,329.00, the proceeds of which went to establish the ER Learning Centre. In 2005, the Auxiliary raised $714,337.00 and launched three new projects: CARE Cart, providing cheer and companionship to patients; Humour Cart, providing comedy videos to patients during their hospital stay; and the funding of Dr Clown, therapeutic artists to relieve stress during hospi-

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Every August, from 2005 to 2015, dozens of teams and thousands of people spent a weekend walking through the streets of Montreal in the Foundation’s Weekend to End Breast Cancer (later known as the Pharmaprix Weekend to End Women’s Cancers), in support of cancer diagnosis, treatment, and research in the Segal Cancer Centre at the JGH. The grand total raised during those eleven summers was $58 million. Jewish General Hospital Archives, WEWC13-10172_foundation_72dpi.

talization. Outsourced initiatives were becoming the new financial wave, with Second Cup and Maison de la Presse, and, most recently, Proximal Pharmacy and Gateway Plus. The Auxiliary added the Link Snack Bar near the Test Centre and funded the ER Family Room. In 2006, it raised $912,488.00 and the seventieth anniversary of the Auxiliary was acknowledged with a gala, honouring all past presidents and benefiting the Ob/Gyn Department. In 2007, the Auxiliary raised $682,905.00 and funded the Montreal Jewish Hereditary Disease Fund, helping to educate and screen the community. In 2008–09, $1,198,257.00 was dispersed to launch the very successful Menus for the Mind Series, offering thought-provoking films and lectures, and to buy a digital radiology system and a pituitary endoscope. The year 2009 was also the start of the annual holiday boutique sale, offering staff and the public a place to shop and support the hospital just before Christmas/Chanukah. The Auxiliary approved a $100,000 endowment fund for an academic enrichment award for the Department of Medicine. In 2010, with $815,525.00 raised, the Mildred Lande Gift Boutique was opened in the main lobby, and, in conjunction with the Health

Every July since 2009, thousands of cyclists have made the tough but rewarding trek from Montreal to Quebec City in the Foundation’s Enbridge Ride to Conquer Cancer. The event supports cancer-related activities in the Segal Cancer Centre at the JGH, as well as other hospitals in Quebec. As of 2016, the event had brought in a total of $45 million. Jewish General Hospital Archives, RTCC_1_Foundation.

Science Library, the Auxiliary started the Books-in-Motion Cart, providing books and magazines to patients. Funding for the Centre for Child Development and Mental Health as well as a teaching and simulator centre were the priority. In 2011, the Auxiliary’s seventy-fifth anniversary launch of the highly successful and well-attended annual Florida Snowbird Lunch and Lecture event raised $1,093,659.00. In 2012, the Auxiliary raised $1,031,993.00 and started a new business – Breast Pump Rentals – which added increased revenues to help purchase a C-Arm for the neurology department and fund the Herzl Centre’s Teen Health Unit. In 2013, a major fundraiser, a theatre evening, helped to raise $994,013.00. This supported the Memory Clinic, the Skin Cancer Centre, the Cardiology Department, and a specialized microscope for the Pathology Department, which were all on the equipment funding list. In 2014, following the celebration of World Prematurity Day, the Auxiliary launched its $500,000 Tiny Miracle Fund campaign to purchase vital life-sustaining equipment for the new NICU (Neonatal Intensive Care Unit) at Pavilion K. The Auxiliary partnered with the JGH Foundation in the Mind-Strong Fitness Event, which raised $1.3 million for the Department of Psychiatry’s Youth Mental Health Services.

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The foundation also funded a PET (positron emission tomography) scanning machine for nuclear medicine, through the initiative of Aaron Fish, Manya Stendel, and Morty Fruchter. A new addition to the main lobby is the Collectibles Arts and Antiquities Shop, which sells donated treasures and turns them into money for the hospital. The amazing total contribution the Auxiliary has raised for the various departments, services, and laboratories from 1984 to 2016 is $19,042,717.00! This is a tribute to the energy and devotion of the JGH Auxiliary. The co-presidents for the 2015–17 term, Reisa Lerner and Beatrice Lewis, along with the director, Nancy Rubin, continue to enforce and update the Auxiliary’s mission statement, proudly developed eighty years ago – “providing essential funds to improve the quality of care at the JGH, providing the special, extra touches needed by patients while in the hospital and to educate and inform the general community.”

depa rt m en t of den t i st ry Dr Mel Schwartz The developers of the Jewish General Hospital in 1934 were farsighted in establishing a dental division in the new hospital. They understood the need for dental care not only for hospitalized patients, but for the indigent underprivileged people in the neighbourhood and in our community. The dental division initially functioned under the Department of Surgery and was staffed totally by volunteers; clinics were held three half-days a week. The clinic was devoted to the treatment of dental emergencies, mainly tooth extraction and minor dental alveolar surgery. In 1971, Dr Mervyn Gornitsky was appointed chief of the Division of Dentistry, which was recognized as a department by 1973. In 1975, a major metamorphosis occurred when the Department of Dentistry combined with the Herzl Health Centre to form the Herzl Family Practice Centre. The department moved to its current location in Pavilion A and recruited two geographic full-time dentists, Drs Bernard Slimovitch and Sidney Silver. It affiliated with the Faculty of Dentistry of McGill University and progressively expanded its dental residency program to seven residents. By 1984, the department and its educational component had evolved radically. McGill University Dental School undergraduates rotated through the department. All of the senior class students spent one week of their clinical training at

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the hospital. The addition of a dental hygiene residency training program under the auspices of the John Abbott College School of Dental Hygiene added a new dimension to our department’s preventive care program. This well-respected residency training program in dental hygiene was the only one of its kind in Canada when it was introduced. Dr Gornitsky began to provide dental care for physically and mentally disabled patients under general anesthesia in the operating room, a service that started under the direction of Dr Slimovitch. Patients who are not able to be treated in a traditional setting are referred by community-based dentists and physicians, as well as the Miriam Home and other similar institutions. Dr Gornitsky also plays an important role in the prevention of oral complications for patients receiving radiotherapy for head and neck cancer, a clinical program that has grown significantly over the past ten years. The outreach program for geriatric patients included the Veteran’s Hospital in Ste Anne de Bellevue, Maimonides, Father Dowd, and various long-term care institutions in and around the environs of Montreal. Our staff, including the hygienists, visited these institutions to see patients on a regular basis. We treat HIV-seropositive and AIDS patients for their dental diseases in our high-risk area. We are recognized in Quebec for our dental treatment of AIDS patients, and the hospital receives a large annual grant from the Quebec government. We developed an entente with Ohio State University’s Faculty of Dentistry to allow two senior dental students to spend two weeks in the Dental Department assisting in the OR and attending to patients. In 1992, we recruited Dr Eli Raviv, an Israeli-trained prosthodontist, to our full-time staff to fill a void in prosthetic teaching. The department also became involved in postgraduate teaching. Two students graduated with PhDs, one from McGill in 1992 and one from the University of Montreal in 1993. In 2014, two students graduated with MSc degrees from McGill and two others are currently enrolled in graduate programs. The research activity in the Dental Department began in 1986. Since then it has received twenty-one grants. Members of the Dental Department have published fifty-nine articles in refereed journals, on topics as varied as scleroderma, xerostomia, periodontal disease, AIDs, salivary biomarkers, temporomandibular disorders, pre-eclampsia, hemophilia, and Alzheimer’s disease. Accreditation surveys by the Quebec Order of Dentists and Commission on Dental Accreditation of Canada have resulted in very positive reports and we routinely receive approval for the maximum term of five years for both the residency and dental programs.

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Dr Mervyn Gornitsky retired as chief of the department in 2000 and was replaced by Dr Mel Schwartz. Dr Gornitsky retired from his hospital-based oral surgical practice in 2006, at which time he was appointed director of research for the department. Dr Ana Velly, an epidemiologist, has joined our research staff. In 2007, Dr Allan Lisbona joined the department and was appointed chief of the Division of Oral and Maxillofacial Surgery. He was appointed director of the residency program in 2013. Dr Melanie Menassa, a prosthodontist, was added to our staff in 2013. Dental staff now consists of forty-four dentists, including specialists from all branches of dentistry except orthodontics. The majority of our staff are community-based dentists who volunteer to supervise the clinical activity of dental residents and contribute to the teaching program.

depa rt m en t of d i ag n o st i c m e d i c i n e Dr Elizabeth MacNamara The Department of Diagnostic Medicine was brought into being in 1998, when the six laboratory departments of hematology, immunology, medical biochemistry, medical microbiology, test centre, and transfusion medicine were fused under the directorship of Dr Elizabeth MacNamara. This new collaborative approach allowed the laboratories to become leaders in efficiency, excellence and a shared vision in patient-centred care. Dr MacNamara remains director of the Department of Diagnostic Medicine. The laboratories were located in different places in 1984. At that time, Dr Reuben Schucher was head of the biochemistry laboratory; Dr Arthur Cooperberg, head of hematology; Dr Peter Small was head of immunology; Dr Stephen Caplan, head of transfusion services; and Dr Jack Mendelson was head of microbiology. They ran the laboratories separately, which was the state-of-the-art practice in those days. Following the amalgamation of the laboratories, Dr Stephen Caplan became director of the Division of Hematology and Transfusion Medicine. Dr Caplan was replaced last year by Dr Hans Knecht, who became director of the Division of Hematology. Dr Mark Miller, was head of the Division of Microbiology until he was replaced two years ago by Dr Andre Dascal. With the modernization of equipment and automation, many of the routine laboratory tests were centralized into a single core laboratory, on large, multifunctioning instruments. This allowed tests to be available 24 hours per day,

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Table 15.1 1998

2014

39,400

218,000

1998

2014

Laboratory Division’s number of tests per year Biochemistry 900,000 Hematology 430,000 Microbiology 35,000

5,147,000 701,000 389,500

Test Centre Number of patients per year

7 days per week, 365 days per year, leading to a significant improvement in patient care. No record remains of the numbers of tests done in 1984 in each of these sections; however, since 1998, all tests have been increasing exponentially as have the number of patients coming to our Test Centre. The laboratory is a reference laboratory receiving samples from all over Quebec. This year it is an active participant in forty-nine research studies. In recent years, molecular techniques have changed the functioning of the laboratory in many ways, including the identification of bacteria through the use of DNA methods. Personalized medicine is expanding into genomics and proteomics. The hospital laboratory is at the forefront of these changes. Dr Elizabeth MacNamara headed the McGill Medical Biochemistry residency program for twenty years. During this period, the program became the largest in Canada. Dr Shaun Eintracht served as the McGill representative on the Promotions Committee for seven years. The Department of Diagnostic Medicine has, in the last ten years, expanded its role in research and now has significant research funding in clinical trials, proteomics, and infectious diseases. The research grants to all members of the Department of Diagnostic Medicine total over $8 million. Between 1984 and 2014, there were dramatic changes within in all aspects of the Department of Diagnostic Medicine. It faced many challenges, but it has been the source of much innovation, resulting in one of the most efficient laboratories in the country.

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em ergen c y depa rt m en t Dr Marc Afilalo The Emergency Department (ED) is part of the residency program of the Royal College of Physicians and Surgeons of Canada for the emergency medicine specialty, and the third-year special competence in emergency medicine from the Canadian College of Family Physicians. We also train residents from family medicine, surgery and medicine and offer electives to many national and international house staff. Dr Marc Afilalo was appointed director of the Emergency Department in 1986 and remains at the head of the department to this day. When Dr Afilalo started, the ED counted eight doctors as part of its staff, three per weekday and two covering on weekends. The department was able to see about fifty patients per day (no staff at night.) There are now seven clinical researchers, three academic research staff, four industry research staff, and six collabrative researchers. The department has produced 185 publications. In 1990, Dr Afilalo founded the Emergency Department’s research division of the Jewish General Hospital. As pioneers in emergency medicine research in Canada, the research division became a prominent leader in this domain. Our mission has been to evaluate and improve delivery of health services, thereby improving the quality and continuity of care for the ED population. To meet this goal, an infrastructure of three research associates, a full-time statistician, and a full-time PhD researcher was hired. In addition, partnerships with other health-care networks, policymakers, and investigators were established in order to produce grant-scale research. Our program has put us at the forefront as a dynamic research centre with multiple funding, academic expertise, and a philosophy (structure) for promoting the training of new researchers. In 1995, the Jewish General Hospital was approached to participate in a “twinning” project with Morocco. The ED director was chosen to represent the JGH and McGill University as an expert consultant on emergency medicine. This experience was extremely successful and the director was awarded the award of merit in emergency medicine commitment. The following year, two médecins coordonnateurs (coordinating physicians) were hired by the hospital to help with the flow and the admission process. This important hospital-wide teamwork has led to greater efficiency and contributed to the overall excellent functioning of the emergency department, despite the increasing number of patients.

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After two years of planning and detailed analysis, a new ED opened its doors in 1997. This new ED counted a twenty-five-stretcher capacity for the Red unit and an eight-bed capacity in the Blue unit with four resuscitation beds. Innovative concepts included a family room dedicated to patients’ families that allowed for privacy during difficult times while tending to their sick relative. An information desk was also installed in the waiting room to answer queries from patients and their relatives. An onsite pharmacist was also added. The recruitment of three new doctors brought the team total to seventeen members. In 1998, the Emergency Department’s director founded a research network (Réseau de recherche en urgence du Québec) to facilitate and promote emergency medicine multicentre research across Quebec. This infrastructure allowed members to consult with senior researchers within the structure, as well as recruit young researchers interested in pursuing emergency medicine research as a career. The number of patients seen by the department each day rose to 150 by 1999. In that year, the College des médecins du Québec duly recognized emergency medicine as a specialty in Quebec,the last province in Canada to recognize emergency medicine as a specialty. This historic event enabled emergency medicine to advance through promoting research, improving teaching and training, and producing highly skilled physicians in emergency medicine that contribute to the development of the discipline and improve the quality of care. The hospital also put together a steering committee to prioritize issues and solutions involving overcrowding in the Emergency Department, as well as a services utilization committee mandated to study the bed resources available in the hospital. A volunteer program was founded and became an integral part of the functioning of the ED. This award-winning program, “Urgence Présence,” consists of sixty highly trained volunteers who offer support and comfort, and provide information to the patients and their families. They have become an integral part of the operations within the Emergency Department and the staff is very proud of their work. Within three years, the number of volunteers had risen to 100. These volunteers actively participated on important committees such as CQI (Continuous Quality Improvement) committee and operations committee. The group is diversified, multicultural, and intergenerational. A training manual for volunteers was developed to assure consistent training. A new project, “Waiting Room,” was implemented in an effort to humanize the waiting area for families and patients. In 2000, the Minister of Health named Dr Afilalo president of the Comité d’experts du centre de coordination nationale des urgences (CECCNU), a com-

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mittee mandated to resolve the ever-present problem of crowding in our emergency departments across the province. At the ministry level, as president of the CECCNU, Dr Afilalo continues his groundbreaking work to resolve emergency department crowding issues and improving emergency department functioning across the province of Quebec. Dr Afilalo also co-authored the Guide de gestion de l’unité d’urgence, a publication used by EDs across Quebec that provides the health-care system with norms and guidelines to deal with and resolve difficulties faced by emergency departments in Quebec. Two new doctors were recruited, bringing the count to nineteen. At the dawn of the new millennium, the ED was seeing about 163 patients per day. The ED pharmacy department began to meet new challenges in 2003: not only did it provide valuable assistance to our staff and ED patients, it actively participated in one of our research projects. Our social service team also played an important role in our ED and was added to permanent ED staff. Its presence in helping patients with social assistance such as home care and community integration has been exemplary. Similarly, the diligent work of our discharge planner and geriatric nurse have been felt in their support of our elderly patients by providing and ensuring appropriate follow-up care. For the first time, in 2003, evidence-based-medicine, a McMaster Universitybased teaching innovation, was brought to the teaching methodology at the JGH and to Quebec. This unique concept gave participants the necessary tools to integrate the best research evidence with clinical expertise and patient values. The ED research division continued to make important contributions in the area of health-care service research, and successfully obtained support for three projects from various peer review granting agencies. One project, “L’impact d’un coordonnateur des congés au département d’urgence sur le succès du congé des patients âgés,” was awarded a two-year grant of $456,499. A second project, “The Impact of a Standardized Communication System (SCS) Between Emergency Department and the Primary Care Network: Effects on Continuity and Quality of Care,” was awarded a grant of $570,930 for three years. The third project, “Clientèle, fonctionnement du département d’urgence et intégration du réseau dans la problématique des urgences: Analyses et études d’impact,” received $1,480,200 for five years. By this time, four new doctors had been recruited, bringing our team to twenty-two members, with the ED seeing approximately 170 patients per day. In 2005, proceeds raised from the Panache cookbook, an Auxiliary-funded project, made it possible to create a state-of-the-art ED learning centre, a conference centre with the latest electronic and audio-visual equipment. An

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integrated webcast centre has allowed for videoconferences that have enabled us to do our teaching on a large scale and at the same time to exchange with academic groups around the world. As a first step, our July lecture series was archived and integrated for our webcast. Two new recruits were hired, but for the first time two members of the team left the group, keeping the total at twentytwo members, with the ED seeing about 183 patients per day. The Red unit’s Section C was opened and finalized in 2007, with four new isolation beds and nineteen more stretchers. The following year, the ED radiology room was converted into a digital radiology room. A new way of teaching, using simulation tools and equipment, was introduced, involving a state-of-the-art simulation room whose advanced technology has proved to be a greatly efficient method of teaching our residents and staff alike. In 2008, Dr Stephen Rosenthal received the Alain Cloutier Award of the Quebec Medical Association for his leadership in promoting innovative technology projects for electronic record-keeping, digital dictation, and mobile speech recognition. Dr Eddy Lang received the Alberta Heritage Foundation Medical Research Visiting Lecture Award, as well as the McGill Faculty Honour’s List for Educational Excellence. In 2009, Emergency Ultrasound (EDE – emergency department echo) became an integral part of emergency medicine at the JGH ED and is now part of the standard of care. Thirteen attending staff were ultrasound-certified; a dedicated emergency ultrasound rotation is now part of the teaching curriculum. The goal has been to provide intensive, one-on-one training by several ED staff with the final objective of a Canadian Emergency Ultrasound Society certification. Four new MD recruits were hired in 2010, although two members of the team left the group. The following year, three recruits were hired, a fourth was added in 2013, six more in 2014, and two in 2015, bringing our team to thirty-six members. Among these staff members are a specialist in EM (emergency medicine) from the Royal College. Half have a CCFP (EM) (College of Family Physicians of Canada – Emergency Medicine) certification. At present, there are eleven physicians working per weekday, with two physicians on call. Seven physicians work each day on weekends, with two on call. The approximately 189 patients seen every day in 2010 rose to 207 in 2013 and to 231 in 2014. The concept of the RAZ unit (rapid assessment zone) was brought to Quebec for the first time by the ED team in 2011. It was an innovative method of seeing and treating patients on the spot in a minimal amount of time on Lazyboy-type chairs. The RAZ consists of five such chairs and two exam rooms. The Emer-

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gency Department received an A+ from Accreditation Canada in 2012 for having met the Canadian Standards of Health Care. The Emergency Department research division continues to evolve with its mission to evaluate and improve the delivery of health services thereby improving the quality and continuity of care for our patients. In 2013, the JGH ED adopted the LEAN concept. This innovative method is used by the multidisciplinary team to improve patient outcomes: improved quality, better access, shorter waiting times, and better service. These patient benefits come from a joint focus on improving the work life for medical and hospital staff, improving processes to prevent systemic errors, reducing stress levels, and reducing waste so that hospital staff can spend more time on and focus more on patient care. The ED research division was extremely successful in obtaining funds from peer agencies and industry in 2013. D-dimer testing, tailored to clinical pre-test probability, to minimize initial and follow-up ultrasound testing in suspected deep vein thrombosis, was awarded a grant of $742,083 for three years and six months. An additional project involving D-dimer testing, tailored to clinical pretest probability to reduce use of CT (computed tomography) angiography in suspected pulmonary embolism, was awarded a grant of $981,033 for four years. In 2015, the research division launched six funded projects; ED functioning, crowding, patient safety, and knowledge translation are the main areas of focus. We were also successful in publishing twenty-five articles and presenting new findings at four national and international meetings. The new Pavilion K ED opened on 16 February 2014. This epic move to the new building was undertaken while we remained open to see new patients. Within thirty minutes of the first patient out of the ED, we were settled and in full operation to see new patients. After two years of planning, Dr Unger’s vision of “form follows function” resulted in a new state-of-the-art ED divided in three stretcher areas counted fifty-two stretchers, an ambulatory area, a RAZ unit consisting of twenty La-Z-Boy chairs, and four treatment rooms. In 2015, the McGill Emergency Ultrasound (EDE) director became JGH EDbased and now runs four rotations per academic year, with two residents in each rotation. There are also currently twenty-five ED attending MDs who are ultrasound-certified. In addition, a research project has recently been submitted on the use of point-of-care ultrasound in acute infectious mononucleosis in the ED. Important aspects of our JGH ED functioning include: an integral physician practice plan, a cohesive “family” environment with an 87 per cent retention rate among MDs after fifteen years, strong collaboration with nursing at all

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levels, an active co-management, an active CEO who is very involved at all levels, and strong collaboration with other departments and hospital management. Despite the high volume and the acute conditions of our clientele, the ED has managed to maintain the best performance among the university teaching hospitals in Montreal.

genet i c s : m cg i l l cen t re for hu m a n gen et i c s Dr Leonard Pinsky The Centre for Human Genetics was created in 1979. The choice of an integrative “Centre” rather than a classic independent department was based on the concept that the discipline of genetics should be integrated into all sectors of human biology and medicine: clinical, teaching, and research. The first director of the Centre for Human Genetics was Dr Leonard Pinsky (who later became the first chair of the Department of Human Genetics). The objectives of the Centre were 1 to provide a corporate address/image for human/medical genetics on the greater university campus (including its teaching hospitals); 2 to promote the relevance of genetics to the categorical disciplines of biomedicine and the recruitment of human/medical geneticists to their respective departments; 3 to foster research, partly by creating a forum for interaction of supervisors and graduate students who work in various locales; 4 to coordinate genetic health-care activities among the hospitals concerned, and to represent that coordination externally; 5 to conduct the MSc program in genetic counselling; and 6 to participate in the teaching of human and medical genetics at all levels – from baccalaureate undergraduate to medical postgraduate. The Division of Genetics at the Jewish General Hospital, under the direction of Leonard Pinsky, MD, reopened in 1986. On the recommendation of the Centre’s Standing Committee: Genetic Health-Care Services, this division has been responsible for prenatal genetic counselling at the Jewish General Hospital. Currently, the JGH has assumed a major role in the area of hereditary cancer.

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Dr Leonard Pinsky continued his “studies in the broad area of congenital anomalies, or birth defects. His experimental work is concerned with the role of the male hormone in normal development and the mechanisms of hormone action at the cellular level. He has shown that the normal action may break down at several points leading to total or partial failure of the tissues to respond to testosterone and to develop normally.” Dr Pinsky received an award from the Medical Research Council so he could spend a sabbatical leave at Queen’s University “developing cloning technology applicable to his experimental work.”1 Pinksy’s “many contributions to basic and clinical genetics have led to improved diagnosis, treatment and prevention of inherited diseases in children.”2 Human genetics is identified as one of the six areas of strength in research at the JGH, along with AIDS, clinical epidemiology, aging, molecular oncology, and thyroid disease and diabetes.3 Dr Pinsky (the Lady Davis Institute’s first staff investigator) retired in 1999.4

depa rt m en t of m e d i c a l gen et i c s Dr David Rosenblatt In 1984, medical genetics was still a division of the Department of Pediatrics, with Dr Leonard Pinsky as the head. Clinical activities were focused on the pediatric population with various genetic disorders and prenatal diagnosis. Dr Pinsky was also the head of the Centre for Human Genetics at McGill University, which was an umbrella for all academic activities in human genetics at McGill. When a university division of medical genetics was created at McGill, within the university’s Department of Medicine, medical genetics at the Jewish General Hospital became a division within the Department of Medicine. In the mid1990s, human genetics became a free-standing department at McGill with Dr Pinsky as the founding chairperson. After the retirement of Dr Pinsky, Dr David Rosenblatt became chair of the Department of Human Genetics at McGill and also became head of the department at the Jewish General Hospital. By that time, the role of medical genetics at the hospital was focused in two main areas: cancer genetics and prenatal diagnosis. Dr Steven Narod, Dr William Foulkes, and Dr Marc Tischkowitz all played major roles in the evolution of cancer genetics at the JGH. Over time, most patients were seen in the Cancer Prevention Unit, underscoring the close

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ties of this clinical service with the hospital’s Department of Oncology. Today, the Hereditary Cancer Program at McGill, under the leadership of Dr Foulkes, is one of the best in Canada and among the best in the world. Prenatal diagnosis is an important clinical service at the JGH, because the hospital is a referral centre for high-risk obstetrics. Dr Pinsky played a major role in this service and after his retirement, Dr Rosenblatt and Dr Valerie Desilets continued this function. After Dr Desilets left the hospital, Dr Rosenblatt supervised this service. The year 2005 was a seminal year in the evolution of medical genetics, as evidenced from the following material from the 2005–06 annual report: The most important change over the last year is that Medical Genetics at the JGH has now been established as a department in its own right. This designation makes the JGH the first hospital in the McGill system to establish its own Department of Medical Genetics. There have also been a major expansion in personnel; Dr Marc Tischkowitz, a medical geneticist trained in the United Kingdom, joined the Department in September 2005 and he is the first full-time medical geneticist at the Jewish General Hospital since the departure of Dr Leonard Pinsky. Maria Lalous, genetic counsellor, also joined the department in August 2005 and has taken over the prenatal diagnosis work from Jennifer Fitzpatrick who now works fulltime as director of the McGill MSc program in genetic counselling. Razia Chanda also joined in August to take over the administrative work from Sabrina Notte who is now administrator to the McGill Cancer Genetics Program. The major clinical focus of the Department of Medical Genetics at the Jewish General Hospital continues to be in the areas of Hereditary Cancer and Prenatal Diagnosis. Nora Wong and Sonya Zaor are full-time counsellors, primarily responsible for cancer genetics. Marc Tischkowitz trained in both medical oncology and clinical genetics and his main clinical and research interest is hereditary cancer predisposition. Dr William Foulkes also continues to play a major role in clinical and research aspects of hereditary cancer predisposition at the JGH. Maria Lalous works fulltime in prenatal diagnosis – this post was previously a part-time post and the expansion of the post has brought additional capacity for seeing prenatal diagnosis cases and provides greater flexibility for patients in booking their appointments. The department has undergone a major refurbishment and now has a dedicated counselling room, primarily used for prenatal diagnosis cases.

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Much of the departmental work continues to take place in the Cancer Prevention Centre which has been incorporated into the new Segal Cancer Centre and provides state-of-the-art facilities for managing individuals and families with a hereditary predisposition to cancer. This new space has also improved integration of the cancer genetics service with other oncology services. The Program in Cancer Genetics, shared between the Departments of Oncology and Human Genetics is now well established (www.mcgill.ca/cancer genetics/). This program is led by Dr William Foulkes. Although there have been changes since 2005, particularly the departures of Dr Marc Tisckowitz and Sabrina Notte, Maria Lalous, Nora Wong, Sonya Zaor, and Razia Chanda remain important members of the department. In the past few years there has been an attempt to centralize the budget of the department under a single cost centre and to stabilize the structure so that there are two genetic counsellors for prenatal diagnosis, three for hereditary cancer, and one administrator for each service. The Department of Medical Genetics plays a major teaching role as a site for trainees in the MSc program in genetic counselling at McGill. It is also a site for the training of residents in medical genetics. Medical genetics is a rapidly growing discipline. Within the hospital, the department works closely with the Departments of Medicine, Surgery, Obstetrics, and Oncology.

t h e l a dy dav i s i n st i tu te The Lady Davis Institute (LDI) is the research arm of Montreal’s Jewish General Hospital, a teaching hospital of McGill University. Taking full advantage of its affiliations, the LDI has earned an international reputation for excellent science and translation from research to the clinic and to populations. Since its founding in 1969, the mission of the LDI has been to undertake health research of the highest quality that will bring important benefits to the health and well-being of patients in Quebec, Canada, and around the world. The research outcomes include the generation of new knowledge in basic and clinical science, psychosocial research, and epidemiology, as well as improvements in the delivery of health care. Altogether, about 200,000 square feet of space on the JGH campus is devoted to research, not including some clinical research space such as physicians’

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offices. Major fields of inquiry include cancer, hemovascular diseases, epidemiology, diseases of aging, HIV/AIDS, and psychosocial science. Important discoveries made at the LDI have contributed to the health and well-being of patients in Quebec, Canada, and around the world since its founding in 1969. A grant of $1,000,000, was made by Messrs Bernard and Louis Bloomfield, the president and the director of the Eldee Foundation, established by Lady Henriette, the widow of Sir Mortimer B. Davis. They donated this money to establish the Lady Davis Institute for Medical Research. Since then, the LDI has evolved tremendously under the leadership of a number of distinguished directors, among them former dean of medecine and vice-principal academic at McGill in the early ’90s, Dr Samuel O. Freedman. During Dr Freedman’s tenure, the LDI faculty grew in number and in scientific depth as it recruited very highquality scientists. Funding from competitive sources also grew, as did the Centre’s core funding from the Fonds de recherche du Québec – Santé, as a result of “outstanding” performances on quadrennial reviews. During Dr Freedman’s leadership, four more floors were built on top of the existing structure, expanding capacity and opportunities for recruitment. In 2000, Mark Wainberg became director of the LDI. He was succeeded in 2009 by Roderick McInnes, formerly director of the Institute of Human Genetics of the Canadian Institutes for Health Research, and a senior scientist at the Toronto Hospital for Sick Kids. He moved to the LDI as the Alva Chair in Human Genetics at McGill University, succeeding Charles Scriver, and as a Canada Research Chair Tier 1 in neurogenetics. He is also professor in both the Departments of Human Genetics and Biochemistry, with his McGill laboratory based at the LDI. Currently the LDI has more than 135 full-time investigators, about 40 per cent bench researchers, with the remainder clinical. Professor McInnes has shepherded a tremendous evolution in the LDI, both in structure and in function. An administrative structure was enhanced to more fully engage faculty, students, and trainees, and ensures a rigorous and collaborative environment. As a result, major funding, and the number of publications in the highest impact journals, has risen dramatically.

Investigators, Trainees, and Research Staff The LDI currently has 117 regular (50 per cent or more research time) principal investigators (PIs), 68 of whom are lab-based while the other 49 do clinical epidemiological and psychosocial research. In addition, there are 127 associate in-

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vestigators, largely clinicians with considerably less than 50 per cent research time. All LDI investigators hold academic appointments at McGill. In addition to PIs, the LDI’s high-quality personnel comprise more than 400 research staff, including lab and animal technicians, research associates, clinical research nurses, and administrative employees. The LDI is also strongly committed to providing first-class research training. Presently there are 202 graduate students (almost exclusively from McGill), as well as 54 post-doctoral fellows. The Research Axes of the LDI (and the number of PIs in each as of 2016) are as follows: • Aging: focuses on cognitive neurosciences and Alzheimer’s disease, molecular and cellular biology of aging, and biological and clinical studies of aging bones (12 PIs,15 associate investigators); • Cancer: emphasizes molecular oncology, cancer prevention, cancer genetics, biomarkers in cancer therapy, new cancer therapies, translational physics and radiobiology, psychosocial oncology, and evaluative research (35 PIs, 54 associate investigators); • Epidemiology: applies sophisticated biostatistical analyses to the causes, diagnosis, treatment, and prognosis of disease, along with assessing the risks and benefits of medications (26 PIs, 28 associate investigators); • Hemovascular disease: includes hypertension and vascular disease, coronary heart disease, atherosclerosis, stroke, and venous thrombosis (15 PIs, 16 associate Investigators; • HIV/AIDS: research includes studies on host factors, innate immunity, epidemiology, drug resistance, and advancing the search for novel therapeutics (8 PIs, 3 associate investigators); • Psychosocial aspects of disease: includes investigations of psychological, social, and cultural factors associated with physical and mental illness, the largely neglected issue of family and caregiver responses, cultural psychiatry, and risk factors for the development of psychiatric disorders (21 PIs, and 8 associate investigators).

Research Leadership of the LDI The Director The role of the director is to create and sustain an optimal culture and environment for LDI researchers, trainees, and staff that will make it possible for all to achieve their maximum potential in the ever-evolving and increasingly

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competitive world of health research. The director shares responsibility for this complex task with the deputy director, the six Axis heads, and the six research associate directors (RADs). The Deputy Director The role of the deputy director is to participate, with the director, in all major decisions involving the LDI. He or she also frequently represents the LDI at local, national, or international meetings. The Six Axis Heads The six Axis heads are responsible for academic and research leadership within their respective axes, including oversight of regular activities such as seminar programs, mentoring faculty, and working with the director and the associate directors to maintain the high quality of the LDI. The director holds four meetings each year with the Axis heads. Six Research Associate Directors (RADs) There are six research heads, one each for faculty: training of graduate students and post-doctoral fellows; infrastructure and core facilities; space; clinical research; and the clinical research unit. Operational Decision-making The RADs meet with the director, the chief operating officer (who is also the chief financial officer), and the LDI grants coordinator about once every two months. Most decisions affecting the routine operations and administration of the LDI are made by the director, the COO/CFO, and the RADs, but in instances where the issue has significant implications for the investigators, the Axis heads also participate in making the final decision. Communication with PIs The director meets one-on-one with many PIs each year, particularly those PIs whose annual review or six-year review suggests that they may be facing difficulties. Further meetings are frequently requested by the PI. The size of the LDI and the diverse nature of its faculty make an annual general assembly of PIs impossible. However, the director holds occasional town halls with each Axis to discuss complex issues, if needed. Other communications are sent by email, and also through the Axis heads.

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Evolution of the LDI 2010–15 The major changes at the LDI over the past four years include: 1 The appointment of Dr Gerald Batist as deputy director; 2 Hiring sixteen new PIs, who have contributed enormously to the continuous rejuvenation of the LDI’s culture and research: five molecular oncologists, one computational biologist, two stem cell researchers, and another eight new PIs who have enriched epidemiology and several clinical research programs. All have their own external funding and most have salary awards. 3 Greatly enhancing the training program for students and post-doctoral fellows, under the leadership of Dr Lorraine Chalifour, Research Associate Director for Training. 4 Adding to the core facilities a consultation service for bioinformatics and statistics, as well as a NanoString nCounter Analysis System for high throughput gene expression analysis. 5 Creation of the Molecular Pathology Centre to support two major initiatives: (a) Personalized medicine, including the Quebec-Clinical Research Organization in Cancer’s (Q-CROC) Fonds de partenariat pour un Québec innovant et en santé (FPQIS, Quebec Partnership Fund for Innovation and Health) funded project; and (b) the federal National Centre of Excellence in Personalized Medicine. These personalized medicine initiatives are examples of the strong integration of clinical and research activities at the LDI, since they seamlessly link molecular pathology clinical diagnostics, through state-of-theart and highly innovative molecular profiling of tumours, with clinical research. 6 Creation of the Ludmer Centre for Neuroinformatics & Mental Health, with a $4.5-million gift from the Ludmer Foundation, for a multidisciplinary research platform uniting researchers at the Montreal Neurological Institute, the Douglas Mental Health University Institute, and the LDI-JGH. 7 Development of a strategic plan for clinical research, and initiating clinical pilot project grants, one of which recently led to Dr Marie Hudson coauthoring a Nature article. 8 Making the LDI a much better employer by implementing structured job titles and salary scales; improving benefits, including the Quebec Government and Public Employees Retirement Plan; implementing a zero tolerance policy for abuse; and creating a staff council, which works with management on policies and decisions affecting staff. 9 Appointment of the LDI International Scientific Advisory Board.

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The total research budget of the LDI from 2010 to 2014 was $188 million, an increase of $48 million vs. 2006–09. Altogether, LDI researchers received $106 million from 683 peer-reviewed grants awarded by provincial, national, and international agencies. Of the 117 PIs at the LDI, 86 per cent held peer-reviewed funding over the past four years. In addition, pharma-supported clinical research, some of which is PI-initiated and peer-reviewed, totalled $22.6 million, from 289 contracts or awards to 77 PIs. Research infrastructure purchases supported by the Canada Foundation for Innovation and the Quebec Ministry of Health and Social Services totalled $2.2 million. In addition to grants, LDI PIs received 52 salary awards, including 35 from the Quebec Health Research Fund (Fonds de recherche du Québec – Santé (FRQS), 8 Canada Research Chairs, 7 Canadian Institutes of Health Research Investigator Awards and 2 from other agencies, adding $1.4 million to the 2013–14 budget. The operating budget of the LDI ($15.6 million/year) was funded by both internal and external sources.

Honours and Awards The value of the research being conducted at the LDI is reflected in the twentyseven national and international honours conferred upon LDI investigators from 2010 to 2014. These include: • Dr Jonathan Afilalo – Royal College Gold Medal in 2012; • Dr Gerald Batist – the Pfizer-FRQS Prix d’innovation in 2009, fellowship in the Canadian Academy of Health Sciences in 2012; • Dr Lorraine Chalifour – John J. Day Award of Excellence from the Heart and Stroke Foundation of Quebec in 2013; • Dr Howard Chertkow – Irma M. Parhad Award for Excellence for outstanding contribution in cognitive disease research and treatment from the Consortium of Canadian Centres for Clinical Cognitive Research in 2007; • Dr Mark Eisenberg – Fellow Distinction from the American Heart Association in 2007; • Dr William Foulkes – O. Harold Warwick Prize from the Canadian Cancer Society for his contributions to research on cancer genetics in 2014; • Dr John Hoffer – Khush Jeejeebhoy Award for Best Application of Clinical Nutrition Research Findings to Clinical Practice from the Canadian Nutrition Society in 2010;

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• Dr Laurence Kirmayer – Lifetime Achievement Award from the Society for the Study of Psychiatry and Culture in 2010; • Dr Andréa LeBlanc – Doctorat Honoris Causa in Sciences from the University of Moncton in 2009; • Dr Carmen Loiselle – Prix Florence in recognition of excellence in nursing research from the Ordre des infirmières et infirmiers du Québec in 2012; • Dr Roderick McInnes – Order of Canada in 2009; president of the American Society of Human Genetics in 2010; Hunter Award, Department of Genetics, Children’s Hospital of Eastern Ontario in 2010; Champion of Genetics, The Canadian Gene Cure Foundation in 2011; the Queen Elizabeth II Diamond Jubilee Medal in 2013; • Dr Fackson Mwale – the 2011 Canadian Orthopaedic Research Society Founders’ Medal; • Dr Michael Pollak – O. Harold Warwick Prize from the Canadian Cancer Society for contributions to research on cancer control in 2013; • Dr Ernesto Schiffrin – Order of Canada in 2010; the Björn Folkow Award of the European Society of Hypertension in 2010; the Excellence Award in Hypertension Research of the American Heart Association in 2011; the American Society of Hypertension Distinguished Scientist Award and the Canadian Cardiovascular Society Research Achievement Award in 2013; the Queen Elizabeth II Diamond Jubilee Medal in 2013; currently president of the International Society of Hypertension and of Hypertension Canada; • Dr Samy Suissa – Best paper published in Pharmacoepidemiology and Drug Safety in 2009; Gold Medal from Thorax for research on adult lung disease in 2013; • Dr Brett Thombs – The American College of Rheumatology Research and Education Foundation Health Professionals Investigator Award in 2009; the Canadian Psychological Association President’s New Researcher Award in 2009 and its Early Career Award in 2010; 2014 Principal’s Award for the Outstanding Emergent Researcher at McGill; • Dr Mark Wainberg – Officer of the Order of Canada in 2001; the Canadian Medical Association Medal of Honour in 2009; the Prix du Quebec/Prix Wilder Penfield in 2010; elected a Fellow of American Association for the Advancement of Science (AAAS) in 2011; Killam Prize for Health Sciences in 2012, Canada’s top research award; the CIHR-CMAJ (Canadian Institutes of Health Research – Canadian Medical Association Journal) Top Canadian Achievements in Health Research Award in 2013; the Queen Elizabeth II Diamond Jubilee Medal in 2013; John G. FitzGerald Award

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from the Canadian Association for Clinical Microbiology and Infectious Diseases in 2014.

The Physical Research Facility The researchers of the LDI work in four buildings that are relatively close to one another. The approximately 200,000 square feet of research space on the JGH campus does not include the considerable space used for clinical research, such as the offices of physicians and their clinical research employees. The laboratories of the LDI were originally limited to Pavilion F (128,000 square feet on eight floors), built in 1969, but capacity was increased greatly in 1992 when the JGH Foundation contributed $12 million to add four additional storeys. Capacity was further increased when three lab floors of the Segal Cancer Centre were completed in 2005 (currently 57,000 square feet), to which Pavilion F is connected through two bridges. Laboratory space is allocated by the research associate director for space in consultation with the PIs concerned and the director of the LDI. All space “belongs” to the LDI, and is allocated to PIs according to their current needs for trainees and staff. The space allocated to each PI is subject to revision on an annual basis. The Clinical Epidemiology Axis occupies the fourth floor of the Herzl Family Medicine Clinic (Pavilion H) (13,500 square feet). Most psychosocial research is conducted in the Institute of Community and Family Psychiatry (6,900 square feet) and in the new Centre for Child Development and Mental Health (600 square feet). At the JGH, 1,400 square feet are dedicated to the Centre for Nursing Research.

LDI-led Collaborations at the National, Provincial, and University Level Many LDI investigators occupy leadership roles in important provincial, national, and international research initiatives, as illustrated by the examples below. These research programs enhance research at the LDI by introducing the broader Canadian research community to LDI researchers, thereby facilitating collaborations and increasing awareness of LDI and Quebec research at the national and international level.

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Pan-Canadian Research or International Research Programs Led by LDI Researchers • The LDI is the headquarters for the Canadian Consortium on Neurodegeneration in Aging (CCNA), a $34 million, five-year national initiative created in 2014, and led by Dr Chertkow, head of the Aging Axis of the LDI. The CCNA establishes the LDI as the fulcrum for neurodegenerative disease research in Canada. This CIHR- and FRQS-funded partnership brings together twenty research teams from across Canada to examine how to delay the onset of dementia and related illnesses, to prevent these illnesses from occurring, and to improve quality of life both for those living with neurodegeneration and for their caregivers. • Since 2011, the LDI has been the headquarters for the Canadian Network for Observational Drug Effect Studies (CNODES). Led by Dr Samy Suissa, the head of the Epidemiology Axis, CNODES is a $17.5 million national initiative to evaluate post-market drug side effects and to ensure the safety of medication. • Dr Gerald Batist is the scientific director of the National Centre of Excellence – PreThera Research, established in 2014 with over $30 million in public and private funding. Its purpose is to significantly improve the cancer drug development ecosystem, to increase treatment options for patients, and to reduce the cost burden to the health system by establishing an extensive database of tumour biopsies in order to profile biomarkers in a broad variety of cancer patients. • Dr Christoph Borchers leads an LDI partnership with the University of Victoria – Genome BC Proteomics Centre, which has created the first panCanadian proteomics program. This initiative, supported by the Genomic Innovation Network of Genome Canada, takes novel technologies for protein identification and quantitative proteomics developed at the University of Victoria and applies them to clinically testable hypotheses for biomarker discovery and validation at the Segal Cancer Centre’s Molecular Pathology Centre and, ultimately, to therapeutic evaluation at the Clinical Research Unit. • Dr Susan Kahn leads the Centre of Excellence in Thrombosis and Anticoagulation Care (CETAC), with support from the JGH Foundation and $1 million from Sanofi Canada over three years. CETAC consolidates international leadership in patient care, teaching, and research in this critical field. • Dr Kahn is also the chair of the Clinical Outcomes Committee of the $10 million ATTRACT (Acute venous thrombosis: thrombus removal with adjunctive

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catheter-directed thrombolysis) Trial of the National Heart, Lung, and Blood Institute (NHLBI) of the National Institutes of Health. • Dr Mark Wainberg was a member of the World Health Organization Committee on HIV Drug Resistance. In 2014, Dr Wainberg served on the board of scientific counsellors of the National Cancer Institute of the National Institutes of Health. • Dr Andrew Mouland is one of nine PIs on CanCURE (Canadian HIV Cure Enterprise), a collaboration of leading Canadian researchers who are seeking new approaches to cure HIV-1 infection. CanCURE is supported by the CIHR (Canadian Institute of Health Research), the Canadian Foundation for AIDS Research, and the International AIDS Society. Quebec Research Programs Led by LDI Researchers • The Segal Cancer Centre, led by Dr Gerald Batist, is a co-founder of the Quebec-Clinical Research Organization in Cancer (Q-CROC), a province-wide consortium that aims to position Quebec at the national and international forefront of personalized medicine in cancer so that patients can access the most current therapies. • In 2012, Q-CROC became the clinical driver behind a $21.1 million public-private investment in a Personalized Medicine Partnership for Cancer (PMPC), whose mission is to take predictive biomarkers from discovery to clinical validation and to commercial and clinical deployment using state-of-the-art genomic, proteomic, bioinformatic, and information technology platforms. Later competitions resulted in major provincial ($9.5 million) and federal ($15 million) funding in Quebec (FPQIS, $9.5 million) to further expand these networks. The result is international leadership for Quebec in this domain of research, and major R&D investments and partnerships for Quebec science. • Dr Batist is a member of the North American Directorate, Worldwide Innovative Networking Consortium in Personalized Cancer Medicine. • Dr Wilson Miller is the clinical director of McGill’s Rossy Cancer Network. • Dr Brett Thombs is the Director of the Scleroderma Patient-centred Intervention Network (SPIN), an international collaboration to develop accessible interventions to reduce disability and improve quality of life for those with scleroderma. • Dr Andréa LeBlanc is co-director of the Quebec Consortium for the Early Identification of Alzheimer’s disease (Consortium pour l’identification précoce de la maladie d’Alzheimer – Quebec, CIMA-Q), which is supported by the PfizerFRQS Innovation Fund. CIMA-Q will create a central database of clinical, cog-

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nitive, neuroimaging, and biological measurements and materials that researchers will study to determine the early markers of Alzheimer’s disease, as well as clinical studies that will regularly assess patients for early signs of Alzheimer’s, and looking at their lifestyle in an effort to determine factors that may predispose them to, or protect them from, the disease. • Dr Mark Wainberg was co-director of the Réseau SIDA (syndrome d’immunodéficience acquise) of the FRQS. All researchers in the HIV/AIDS Axis are members. • The LDI is home to the McGill AIDS Centre, led by Dr Mark Wainberg until his death in 2017, which coordinates, facilitates, and promotes teaching, research, and treatment activities at McGill University and its affiliated teaching hospitals that relate to HIV infection and AIDS. Other Leadership Roles of LDI Researchers • Dr John Antoniou was president of the Canadian Orthopaedic Research Society from 2012–14. • Dr Robin Cohen has helped develop palliative care research in Canada by leading the CIHR/NCIC (National Cancer Institute of Canada) Strategic Training Initiative in Palliative Care, the CIHR New Emerging Team in Family Caregiving in Palliative and End-of-Life Care, and the NCIC Sociobehavioural Cancer Research Network Palliative Care Team. • Dr William Foulkes is one of two Canadians on the scientific advisory board of the US Komen Foundation and has served as the chair of the NIH’s Breast Cancer Information Core, the main repository for BRCA1 mutations. • Dr Carmen Loiselle was the Quebec representative on the pan-Canadian task force, Fostering Cancer Survivorship Research in Canada, which reported in 2010. • Dr McInnes was the 2010 president of the American Society of Human Genetics. He is presently a member of the boards of the Burroughs-Wellcome Fund USA, the Canadian Foundation for Innovation, and the Canadian Stem Cell Network Centre of Excellence. He is a member of the Sequencing Advisory Panel of the National Human Genome Research Institute (NHGRI) of the National Institutes of Health of the USA. In addition he is chair of the Principal Investigator Evaluation Committee of the Institute for Research in Cancer and Immunology (IRIC) at the University of Montreal, and a member of the Scientific Advisory Panel (SAP) of the Institut de recherche cliniques de Montréal, also aligned with the University of Montreal. He is also a member of the Scientific Advisory Board of the Child and Family Research Institute of the University of British Columbia. He is a member of the Scientific Advisory

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Boards of Research to Prevent Blindness (USA), the Foundation Fighting Blindness (USA), and the Macula Vision Research Foundation (USA). • Dr Ernesto Schiffrin is president of Hypertension Canada and immediate past president of the International Society of Hypertension. • Dr Alan Spatz is a member of the board of the International Melanoma Research Society. • Dr Samy Suissa serves on the external advisory board of PROTECT (pharmacoepidemiological research on outcomes of therapeutics), the drug safety consortium formed by the European Innovative Medicines Initiative (IMI).

re l at i on s h i p w i t h m cg i l l u n ivers i t y, t h e j ew i s h gen er a l h o s p i ta l , a n d t h e j g h fo u n dat i on The LDI is a significant component of the JGH’s role as an academic and research hospital and an essential part of McGill’s medical and health sciences teaching programs.

McGill University The JGH is a major teaching hospital of McGill University. Every PI has a McGill faculty appointment. LDI PIs must follow university rules pertaining to promotion and the securing of a tenure appointment at the university. At present, because of a near-freeze on tenure-track slots in the medical school, the majority of newly appointed PIs are placed in non-tenure-track positions, but if their research career proceeds well, their chances of obtaining tenure are reasonable, and an advantage to the LDI because PIs with McGill tenure receive 50 per cent of their salary from the university. Non-tenure-track PIs at the LDI have access to important university programs such as Canada Research Chairs and Canadian Foundation for Innovation (CFI) start-up grants. McGill University is a major and active partner in the development of the LDI, contributing nearly $4 million annually to its budget. Of that, $2.3 million covers the salaries of investigators, with another $1 million to support academic chairs held by LDI researchers. McGill also provides assistance with applications for grants (from the CFI, National Institutes of Health, the Quebec Ministry of Economic Development, Innovation, and Export, Genome Quebec, etc.), with the review of pharmaceutical contracts negotiated via the University, and with

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negotiations about intellectual property, studentships, etc. The LDI is strongly committed to providing first-class research training and presently there are 202 graduate students (almost exclusively from McGill) as well as fifty-four postdoctoral fellows representing eighteen McGill departments at the Institute. Many PIs hold significant positions in departments and divisions at the university. For example, Dr Schiffrin is vice-chair (research) in the Department of Medicine; Dr Batist was the chair of the Department of Oncology at McGill for almost two terms (2001–11) and is the Minda de Gunzburg Professor of Oncology; Dr Foulkes is the director of the Program in Cancer Genetics in the Department of Human Genetics; Dr Pollak is director of Cancer Prevention in the Department of Oncology and holds the Alexander Goldfarb Chair in Oncology; Dr McInnes is the Alva Chair in Human Genetics. Dr Kirmayer is director of the Social and Transcultural Psychiatry Division of the Department of Psychiatry. Dr Howard Bergman is chair of the Department of Family Practice. Dr Margaret Purden is a leader in the area of interprofessional education in the McGill schools of medicine, nursing, and occupational and physical therapy. Dr Carmen Loiselle holds the Christine and Herschel Victor / Hope & Cope Chair in Psychosocial Oncology. Dr Zeev Rosberger is director of the McGill Psychosocial Oncology Program in the Department of Oncology. LDI researchers currently hold seven Canada Research Chairs, including: Dr Susan Kahn (Tier 1) in venous thromboembolism; Dr Roderick McInnes (Tier 1) in neurogenetics; Dr Ernesto Schiffrin (Tier 1) in vascular and hypertension research; Dr Alan Spatz (Tier 1) in molecular pathology; Dr Stephanie Lehoux (Tier 2) in cardiovascular physiology; Dr Amir Raz (Tier 2) in cognitive neuroscience of attention; and Dr Vahab Soleimani (Tier 2) in stem cells. Moreover, a number of LDI researchers are James McGill Professors, senior scholars who are recognized for their outstanding research. These include Drs Foulkes, Kirmayer, LeBlanc, Miller, Richard, Suissa, and the late Mark Wainberg. A comparable honour is to be named a McGill William Dawson Scholar, an award currently held by Drs Brett Thombs and Brent Richards. Dr Schiffrin is chair of the McGill Clinician Investigator Program, a Royal College-accredited clinical research training program for residents. Dr Mark Blostein is the director of the program, which provides formalized postgraduate education to fulfill clinical specialty/subspecialty training requirements for the career development of clinician/investigators. Drs Mark Lipman and Ernesto Schiffrin founded a McGill Fellowship in Vascular and Renal Medicine.

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The LDI is home to the McGill AIDS Centre, formerly under the directorship of Dr Wainberg. The LDI is also home to the McGill Centre for Translational Research in Cancer. The Segal Cancer Centre is among the partners who, in 2013, established the Rossy Cancer Network to integrate cancer care across the McGill system. Dr Gerald Batist is the scientific director and Dr Wilson Miller is clinical director. The goal of the network is to deliver improved outcomes in cancer survival, mortality, and patient satisfaction.

Jewish General Hospital The Clinical Research Unit (CRU) in the Cancer Axis is the only one of its kind in Quebec equipped to conduct first-in-man and early-phase clinical trials with extensive pharmacokinetic and pharmacodynamic (biomarker) objectives. It is one of five designated sites of the Canadian NCIC-CIHR early-phase trial training program, and is extremely active in global trials of many targeted agents, alone and in combination, based on mutational analysis of tumour biopsies. The Dubrovsky Molecular Pathology Centre, a 12,000-square-foot facility that opened in 2013, contains a biobank for genetic analysis of tumours to advance the development of personalized therapies for patients. It is therefore a critical diagnostic facility for patients being treated for cancer at the JGH. It also serves an essential research function for biobanking tumour samples, which permits the analysis of molecular changes occurring within tumours over time. To support the JGH’s mission to care for the “whole person” in oncology, LDI researchers have initiated unique psychosocial programs to improve the patient experience, from prevention and genetic screening to palliation and end of life. The HIV/AIDS Clinic, led by clinicians at the JGH, currently follows approximately 500 patients infected by HIV, who represent a key source of clinical data for the virological studies that are conducted in the laboratories of the LDI. Much of this work is in the context of the Quebec HIV Genotyping Program under the auspices of the Quebec Public Health Institute (Institut national de santé publique du Québec). The work is an important source of diagnostic services to clinicians in determining which HIV drugs to prescribe to their patients. The JGH/McGill University Memory Clinic, co-founded by Drs Howard Chertkow and Howard Bergman, is a multidisciplinary research clinic that is an important

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source of patient subjects for the study of neurodegenerative disease. The clinic sees between 350 and 450 patients per year. The Centre for Excellence in Thrombosis and Anticoagulation Care (CETAC), led by Dr Susan Kahn, provides leadership and guidance to other institutions and agencies in Quebec to support initiatives in thrombosis treatment, prevention, and research. The Research Ethics Committee ensures that all medical research involving humans at the JGH is both scientifically and ethically sound, and complies with the various regulations outlined by the governmental and other agencies responsible for overseeing these activities. Its primary consideration is protecting the rights, safety, and well-being of patients and to determine the balance between risks and benefits for participants in research projects.

The JGH Foundation The interface between the LDI and the JGH Foundation is also characterized by good will and enthusiastic support. Since 2010, the JGH Foundation has provided critical financial support to the LDI, contributing a total of nearly $28 million to research and operations. This includes almost $14 million to the LDI operating budget for investigator salaries and the core facilities. The Foundation also commits almost $750,000 for the first three years to establish each new principal investigator at the LDI. This total includes salary, $100,000 per year for two years of operating funds, and then a third year if needed, and $150,000 for equipment. This support has kick-started the careers of, for example, Drs Nathalie Johnson (cancer), Marc Fabian (cancer), Celia Greenwood (biostatistics), Michael Witcher (cancer), Simon Bergman (epidemiology), Ivan Topisirovic (cancer), Claudia Kleinman (computational biology), Isabelle Vedel (epidemiology), and Brent Richards (epidemiology). In 2010, an Innovation Fund was established to promote novel discoveries in research, to be used at the discretion of the director and the CFO/COO. This fund is partially supported by the allocation of 10 per cent of all unencumbered donations to the JGH Foundation. More than $2.6 million of this fund has been used over the past four years to provide seed money to support: 1 pilot projects that could then form the basis of a major grant application, 2 the work of new PIs,

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3 the LDI’s Clinical Research Pilot Project to help clinical investigators launch new projects, 4 matching funds where required by granting agencies, and 5 bridge funding for PIs who have missed a grant. The Foundation’s Annual Gala in 2013 was dedicated to supporting research at the LDI. Thanks to the generosity of donors and supporters, it raised nearly $600,000 (net). Donor-targeted research projects. The Foundation has also invested $4.5 million over the past four years to support donor-targeted specific research projects, including the following: • funds for Alzheimer’s research, • Dr Mark Basik’s molecular profiling project (in collaboration with Genome Quebec), • the opening of the Ludmer Centre, • Dr Mark Trifiro’s research on developing a new insulin pump for diabetics, • the establishment of the Dubrovsky Molecular Pathology Centre, • Dr Will Foulkes’ genetic research, • research into novel surgical techniques, and others. Another $2.3 million was donated specifically to support oncology research, such as translational efforts to bring lab bench discoveries to the clinic. Donor support has been particularly instrumental to the JGH / McGill University Memory Clinic. Since 2011, $1 million has been contributed for its operations. The Clinic is essential to the clinical research of the Aging Axis, and has solidified the LDI’s reputation as one of the leading institutions for investigations into cognitive impairment and Alzheimer’s disease, resulting in its being selected as headquarters for the CCNA. In addition, $1.2 million was provided by the Foundation to create the Peter Brojde Lung Cancer Centre at the Segal Cancer Centre. The centre draws on evidence-based practices of western and traditional Chinese medicine, and other complementary therapies. This blend of approaches offers a holistic and personalized approach to meet the needs of patients and their families. The Centre’s program of basic and clinic research expects to improve outcomes for all patients with lung cancer.

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Distinctive features of the LDI At least three major features distinguish the LDI, to some degree, from many other research centres in Canada, although, of course, the LDI is not necessarily unique with respect to any one of these characteristics. 1 The breadth of LDI research. An important characteristic of the LDI is the scope of its research, extending from laboratory to translational to clinical, population, and health services research. This breadth reflects, first, the fact that the LDI is the research arm of an academic general hospital that practises evidence-based medicine. Second, the range of studies reflects the history of the institution, i.e., the types of research that have been fostered over the years by research leaders. Rather than diluting focus and quality, the breadth of research creates a fertile multidisciplinary research environment in which ideas and researchers have the opportunity to cross disciplinary boundaries and to move from labs to clinics and populations. There are the four classes of investigators at the LDI. Class 1 comprises lab-based scientists who identify and characterize basic biological mechanisms. Internationally recognized PIs in this group include, for example, Drs Stéphane Richard (signalling, molecular oncology), Prem Ponka (iron biochemistry and metabolism), Chen Liang (molecular biology of HIV), Ivan Topisirovic (mRNA translation), Marc Fabian (mRNA translation), and Antonis Koromilas (molecular oncology). Class 2 comprises lab-based scientists whose focus is on disease mechanisms, an area of investigation that provides increasingly shorter bridges between biology and the clinic. Highly regarded investigators in this group include the late Dr Mark Wainberg, a world leader in HIV research (HIV drug resistance), and Drs Ernesto Schiffrin (a prominent hypertension researcher), Andréa LeBlanc (molecular pathogenesis of Alzheimer disease), Josie Ursini-Siegel (breast cancer pathogenesis), and Will Foulkes (inherited cancers). Class 3 comprises the clinical investigators who examine disease processes at the level of the patient, develop treatments, and identify strategies to prevent disease. Widely recognized LDI researchers in this group include Drs Susan Kahn (venous thrombosis), Howard Chertkow (memory loss in Alzheimer disease), Alexander Thiel (non-invasive brain stimulation in post-stroke rehabilitation of motor function), and Phyllis Zelkowitz (parental adjustment to the birth of a premature infant).

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Class 4 comprises epidemiologists. Highly respected members of this class include Drs Samy Suissa (pharmacoepidemiology), Mark Eisenberg (prevention and treatment of cardiovascular disease), Celia Greenwood (statistical tools and bioinformatics), and Brent Richards (genetic epidemiology). 2 Extensive translational research. One of the most distinctive features of the LDI is its substantial translational research programs. These programs highlight the LDI’s leadership in translational research in Quebec and in Canada, and are described in the report of each research axis. 3 The LDI as a provincial and national leader of research programs. As detailed above, many LDI investigators have been placed in leadership roles in important provincial and national research initiatives.

Current Overall Strengths of the LDI Eight strengths of the LDI stand out: 1 The greatest asset of the LDI is its principal investigators. Their merits have been alluded to above and are documented more fully elsewhere in this report. 2 The investigators at the LDI are fortunate that their academic association is with McGill, one of the best research universities in Canada. 3 The JGH and JGH Foundation. The LDI would not be, and could not remain one of the leading research institutes in Canada without the strong past and present support and engagement of the leaders of the Jewish General Hospital, the JGH Foundation, and their respective boards. 4 The LDI has been fortunate to assemble an outstanding international scientific advisory board (ISAB), which first met in March 2014. Chaired by Alan Bernstein PhD, president, Canadian Institute for Advanced Research, it is perhaps the most distinguished SAB in Canada. It meets annually to provide highlevel guidance to the director on the research programs and strategies of the LDI. 5 The internal grant review and the mentoring programs. See details in the following section. 6 Annual and six-year reviews. The annual review is a brief assessment by the PI him/herself and the Axis head, evaluating funding, productivity, trainees, and other contributions. This review allows the Axis head and director to identify

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PIs who may be heading toward career difficulties, and who may need interventions to revitalize their careers. The six-year review is a reappointment review, conducted by a committee of six non-LDI researchers, to recommend a six-year reappointment, a three year reappointment (suggesting that the PI needs to show improvement), or a termination of the LDI appointment in one year. At the suggestion of the ISAB, a three-year review will now be conducted regularly on all PIs. These processes allow the LDI to be sure that its investigators continue to be productive and successful or, if they are not, to look at alternative careers or retirement. 7 A tremendous spirit of collegiality has been brought to the LDI by the sixteen new PIs hired over the past four years, a spirit that permeates the entire institution. These new PIs are highly collaborative and keen to work with others, try new approaches, run good training programs, and succeed. 8 The new focus on stem cell research. Stem cell research has begun to transform many areas of basic biological research, and its potential for cell replacement therapy for diseased organs in our aging population is enormous. This area will be the major one for growth in the next five years, since stem cell research can enrich all of our basic research areas. Two stem cell researchers have recently joined the faculty. Drs Colin Crist and Vahab Soleimani are both muscle stem cell researchers who interact extensively with the other molecular researchers.

depa rt m en t of m e d i c i n e Dr Ernesto Schiffrin Since 1984, the Department of Medicine has been headed by four physicians-inchief: Dr Harold Frank (1978–90), Dr Elliot Alpert (1990–96), Dr Barry Posner, CM (1996–2002), and Dr Ernesto L. Schiffrin, CM, since January 2006 til the present. Between 2002 and 2005, there were two interim chiefs, Drs Howard Bergman (2002–03) and Dr Rubin Becker (2003–05). The physician-in-chief, or the associate physician-in-chief (Dr Mark Lipman since 2006), not only lead the department, but are heavily involved in the leadership of the JGH, as well as their own research, teaching, and patient care. Their involvement in administrating the institution includes work to ensure a smooth flow of patients from the Emergency Department to the wards; effective discharging of admitted patients; as

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well as ensuring the quality and safety of the care provided within the Department and the hospital.This contributes to ensuring teaching excellence and nurturing the research activities within the institution. In 1984, there were eighty-four members in the Department, sixty-four fulltime staff and twenty honorary members. By 2014, the Department had grown to 109 full-time staff, sixteen tenured MDs, and seven associate staff members, and eighty-three part-time staff. Members also included nineteen PhDs, of whom ten were tenured. Members of the Department in 1984 were part of eleven divisions: internal medicine, allergy and immunology, cardiology, dermatology, endocrinology and metabolism, gastroenterology, hematology, infectious diseases, nephrology, pulmonary diseases, and rheumatology. By 1996, the divisions of medical genetics, geriatric medicine, and medical biochemistry had been created, and hematology had become hematology-oncology. In 2011, clinical epidemiology became a division of the Department, raising the number to fifteen divisions in the Department of Medicine. The Department of Medicine is responsible for consultations in the Emergency Department (ten to twenty per day), in the nonmedical wards, and in outpatient clinics. Its members are attending physicians for approximately 250 beds of the hospital. Between ten and twenty-five patients are admitted daily, mostly from the Emergency Department, to beds under the care of members of the Department of Medicine. During all these years the Department of Medicine was a preferred and highly appreciated site for teaching medicine to medical students and residents from McGill University in internal medicine and its subspecialties. By 2014, for many years there had been five McGill University Department of Medicine Clinical Teaching Units (CTU) staffed by an attending physician and a full complement of medical students, and junior and senior residents. There are three internal medicine CTUs (including a short-stay unit located in part in the Emergency Department), one CTU in geriatrics, and one CTU in coronary care, in cardiology. An internal medicine undergraduate program and a graduate (resident) program site director organize and supervise the medical students and residents. For many years, Dr Michael Gold was the director of the undergraduate program, highly regarded for his clinical and educational acumen. Later, Dr BethAnn Cummings and, more recently, Dr Nathalie Saad, have taken on this duty. The residency program has been managed locally for many years by Dr Rubin Becker, followed by Dr Michelle Elizov and more recently by Dr Ruxandra Bunea.

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The Department of Medicine has played a highly important role in basic, clinical, health services, and epidemiology and population research carried out at the JGH and the Lady Davis Institute. By 1984, numerous important publications were already issuing from the membership of the Department in highimpact scientific journals. The number of peer-reviewed scientific publications has grown from 60 in 1984 to 391 in 2014. As well, by 2014 the Department of Medicine was receiving more than $21 million in funding from external granting agencies, including the CIHR (71 per cent of the hospital’s grant money), and nearly $4 million from industrial contracts (86 per cent of the hospital’s industry contract money). Since 2007, the Department has also introduced a clinical research award program that provides non-tenured physician members of the Department protected time for clinical research, to stimulate clinical research. This program has been highly successful, offering approximately ten awards annually, and has resulted in numerous publications. For example, in April 2014, the Research Advisory Committee reviewed applications based on the quality of projects, the role and productivity of the applicant, and the likelihood of publication in a peer-reviewed scientific journal, and awarded five new applicants, renewed twelve previous applicants (seven renewals and five extra-year grants). The support has increased from an original budget of $30,000 in 2007 to $184,000 in 2014. From July 2014 to June 2015, eight clinician-scientists held prestigious career awards, fellowship awards, or research chairs from various granting agencies, totalling $531,265. Three physician-scientists, including the current physician-in-chief, hold Tier 1 Canada Research Chairs (CRC), and others hold Tier 2 CRCs, FRQS (Fonds de recherchs Santé Québec) chercheurs-boursiers, or CIHR Young Investigator Awards. Members of the Department have received numerous national and international awards, including the Order of Canada, and have held or now hold duties as presidents of their specialty society provincially, nationally, and internationally. Members of the department have also held or hold currently positions as editors of major international scientific journals. Thus, from 1984 to 2014, the Department of Medicine at the JGH has grown dramatically. This has had a great impact on health-care delivery, medical education, and research locally, provincially, nationally, and internationally. Its impact has also been felt at McGill University, in whose activities members of the Department carry out different administrative and educational activities, including that of vice-chair for research of the McGill Department of Medicine by the current physician-in-chief.

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depa rt m en t of n eu ro s c i en ce s Neurology Dr Jeffrey Minuk A neurology consultation service came into existence shortly after the official opening of the Jewish General Hospital in 1934. Consultations were carried out by neurologists who had their primary appointments at the Montreal Neurological Institute. Early consulting neurologists included Dr Norman Viner and Dr John Kershman. The latter also started a regular neurology outpatient clinic in the hospital in 1939. In 1949, Dr Reuben Rabinovitch was appointed as senior neurologist to the Jewish General Hospital. After Dr Rabinovitch’s untimely death in 1965, Dr Irving Heller was appointed as senior neurologist, and Dr Israel Libman, who had joined the Jewish General Hospital in 1962, was appointed neurologist-in-chief. Dr Libman would hold the position of neurologist-in-chief for more than thirty years. Dr Libman led the call to create a separate Department of Neurological Sciences at the JGH and in 1973 he split the Division of Neurology from the Department of Medicine. In collaboration with Dr Harold Rosen, neurosurgeon, the Department of Neurological Sciences (later renamed the Department of Neurosciences) was created. During Dr Libman’s tenure as chief and owing to his outstanding clinical teaching skills, which were recognized by McGill University, the JGH was chosen, in 1970, as a neurology training site for McGill residents. Over the years, Dr Libman was able to attract and support a productive group of clinicians and clinician-scientists to the JGH. Dr Joseph Carlton was one of Dr Libman’s early recruits. Dr Calvin Melmed joined the JGH in 1984 and would serve as chief of the Department of Neurosciences from 1996–2009. Other JGH neurologists recruited by Dr Libman include Dr Howard Chertkow, Dr Hyman Schipper, and Dr Ronald Schondorf. During his tenure as department chief, Dr Melmed recruited neurologists Dr Fraser Moore and Dr Alexander Thiel, and neurosurgeon Dr Jeff Golan. Dr Jeffrey Minuk joined the JGH as a full-time member in 1995 and would become chief of the Department of Neurosciences in 2007. During his tenure, Dr Minuk recruited neurologists Dr Michael Sidel, Dr Robert Altman, and Dr Chenjie Xia, and neurosurgeon Dr Salvatore DiMaio. The JGH Department of Neurosciences, Division of Neurology, has blossomed to eleven full-time neurologists. At the JGH in 1939, there were 847 neu-

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rology outpatient visits and 44 neurology admissions. In 2016, there were more than 6,000 neurology outpatient visits, over 2,000 in-patient consultations and more than 250 stroke admissions. We have established subspecialty clinical expertise in movement disorders, multiple sclerosis, stroke, cognitive disorders/ dementia, and disorders of the autonomic nervous system. The Department of Neurosciences, Division of Neurology has established a neurodoppler laboratory for the non-invasive imaging of the cervical and intracranial vasculature. This complements our established clinical electrophysiology laboratory (electroencephalography and electromyography). Under the guidance of Drs Libman, Melmed, and Minuk, the department has gone on to develop a strong basic science and clinical research component in the areas of neurodegeneration, dementia, stroke, neuroplasticity, autonomic nervous system disorders, and behavioural neurology. Drs Chertkow, Schipper, and Thiel have each achieved the rank of full professor with the McGill Department of Neurology and Neurosurgery. Through its strategic recruitment and planning and with its ongoing commitment to excellent clinical care, clinical teaching, and research, the Department of Neurosciences is expected to remain among the most prominent and productive departments in the JGH.

Neurosurgery Dr Jeff Golan The Division of Neurosurgery was founded by Dr Harold Rosen in 1969. Dr Rosen was a student of Dr Wilder Penfield, one of the greatest figures in modern neurosurgery, and of Dr William Cone. Dr Golan was recruited by Dr Israel Libman who officially founded the Department of Neurosciences at the Jewish General Hospital in 1973. The addition of Drs Chong and Ravvin formed a three-surgeon service, which managed a busy general neurosurgery practice for almost a decade. In 1981, Dr Steven Brem was recruited as the new chief of the Division of Neurosurgery. He had a specific interest in neuro-oncology, including skull base surgery, and was widely recognized for his contributions in the scientific community. Although there was some flux in the ’80s, including a period during which there were four active neurosurgeons – Drs Brem, Rosen, Arbit, and Colahan – the neurosurgery team was academically focused with active research

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involvement and fellowship training. Eventually, these surgeons moved on to other successful careers. Dr Gerard Mohr was recruited to lead the Division of Neurosurgery in 1989. Dr Mohr was internationally recognized for his training, research accomplishments, and surgical expertise in cerebral vascular surgery, acoustic neuromas, and pituitary tumours. He became a professor of neurosurgery at McGill University and has had several fellows and students over the years. A few neurosurgeons have briefly joined the JGH over the ensuing period, including Dr Eric Marmor. Dr Mohr was the driving force and maintained an active neurosurgical presence at the JGH for over twenty years. He remains the honorary chief of the division and continues to be involved in academics and some clinical activities. Dr Jeff Golan joined the JGH in 2009 and is the current chief of the Division of Neurosurgery. He was one of the first surgeons in Quebec to practise minimally invasive spinal surgery and has been an active member of the McGill University Neuro-Ortho Spine Team. He was joined by Dr Salvatore Di Maio in 2011, an expert in skull base surgery. Dr Di Maio quickly developed a strong collaboration with several members of the ENT (ear, nose and throat) Division. The current clinical volume of the Division of Neurosurgery includes over 400 surgeries and 3,500 outpatient visits annually. Research interests include the development of new surgical tools and implementation of quality of life and outcomes studies. The JGH is one of the main training sites for neurosurgery and spine surgery for residents and fellows at McGill University. More recruits will soon complete the current generation of neurosurgeons at the JGH. In 2014, the Divisions of Neurosurgery and Neurology were combined onto the same clinical nursing floor. This clinical unit also includes physiotherapists, occupational therapists, and specialized nursing care for strokes and neurological deficits. The Unit represents the hard work and vision of the original founders of the Department of Neurosciences and will continue to provide the community with world-class neurosurgical care. Neurosurgery has been an important clinical service at the JGH since its foundation nearly fifty years ago. The community support and unique academic setting as well as its surgeons’ pursuit and implementation of clinical innovation will ensure an important contribution toward the overall success of the JGH for many years to come.

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Centre for Neurotranslational Research A “first for Quebec” – directed by Dr Hyman Schipper: The goal is “to speed up the process of developing new, more effective diagnostic tools and treatments for patients suffering from Alzheimer’s disease and other neurological conditions such as Parkinson’s Disease, strokes, multiple sclerosis, and brain tumours,” as well as to “create an academic environment for training new generations of graduate students and researchers interested in practicing ‘bench to bedside’ medicine.”5

depa rt men t of n u rs i n g Johanne Boileau, N, MSc Nursing Director and Valerie Frunchak, N, MSc (A) Associate Director of Nursing The Department of Nursing has played a progressive and vital role in the delivery of safe quality nursing care to patients and their families since the opening of the Jewish General Hospital in 1934. Key to this success has been the transformational leadership provided by the directors of nursing. The Department has been led by several visionary nurse executives who maintained strong clinical and academic links within the McGill School of Nursing, now the Ingram School of Nursing. Leaders of the Department since 1975: Mary Barrett, N, MSc A (1975–86), Marilyn Monk, N, MSc A (1987–95), Mona Kravitz, N, MSc A (1996–2006), Lynne McVey, N, MSc A (2006–12), Johanne Boileau, N, MSc (2012–present). The hallmark of each of these exceptional nurse-leaders has been a commitment to safe quality nursing that emerges from an academically based professional practice model of care. Over the past thirty years the nursing directorate has sculpted an organization with strong talented leaders, teachers, and clinicians, who advocate and support nursing staff and patient–family-centred care, secure nurse participation at all relevant decision-making tables, and ensure the nursing mission, values, vision, and strategic plans are congruent with clinical care needs as well as larger corporate objectives. Moving from a top-down hierarchical management structure to a decentralized, participatory profession practice model has created a work environment where the nurse clinician has responsibility and authority for patient and family care and works as an active and autonomous member of the interdisciplinary

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team. As a result of introducing many innovative practices, the Department of Nursing has and retains a very highly educated workforce of over 1,300 nurses, and is sought as an employer of choice by nurses and new graduates from across Montreal and the province. Key to the Department’s evolution has been a commitment to nursing continuing education, career development, and advancement. With great foresight, the alumnae of the JGH School of Nursing (1951–73) launched an annual nursing conference – Faye Fox Educational Day in 1977, in honour of an esteemed colleague. This landmark conference continues to be one of the longest-standing nursing conferences established by a hospital in Montreal. With a constant recruitment of nationally and internationally renowned experts in nursing as keynote speakers, annual attendance exceeds 200 per year, drawing nurses from across Quebec, Canada, and the United States of America. Strong educational programs include bursaries for the Canadian Nurses’ Association Specialty Certification (over 150 specialty certified nurses to date); scholarship programs supporting Masters and Doctoral level studies, created through association with the JGH Foundation and the Toronto Dominion Bank, over eighty-seven recipients to date; ongoing and excellent relationships with the United Healthcare Professionals local representatives also facilitate nurse continuing education through financial support for baccalaureate studies, attendance at professional conferences, in-house workshops, and a variety of specialty trainings. Dr Laurie Gottlieb, professor, Flora Madeline Shaw Chair in Nursing, and former director of the McGill School of Nursing and associate dean of the Faculty of Medicine (1995–2000) was appointed the inaugural chair, nurse-scholarin-residence, in 2009. With Dr Gottlieb’s leadership, a series of symposia addressing pressing issues in nursing and quality care were launched. Nursing experts from across Quebec and Canada have participated as keynote speakers at these symposia. Dr Gottlieb’s expertise as a teacher, researcher, and leader in nursing has been at the root of many creative endeavours in the Department. Her current work, focusing on the development of strengths-based-nursing as an approach to practice, leadership, management, and education, has been piloted with nurse pivots in oncology with success. As a nurse leader and knowledge broker, Dr Gottlieb’s contribution to departmental innovation is extensive. The Department of Nursing took an active role in contributing to clinical, health service, and population health research. In 1981, Linda Edgar, N, MSc, assistant professor, McGill School of Nursing, was the first nurse researcher hired by the hospital working with oncology patients and their families. She focused

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her program of research on coping interventions for newly diagnosed patients. In 1989 the Centre for Nursing Research was established, with Linda Edgar becoming the first director of nursing research. Dr Anita Gagnon, associate professor at the McGill Ingram School of Nursing (ISoN), joined the Centre in 1992, becoming scientific director. Dr Gagnon’s program of research focused on migration and refugee health. By the mid-2000, four nurse scientists comprised the Centre and were developing extensive programs of research. Dr Margaret Purden, associate professor, ISoN, director of the Office of Interprofessional Education in the Faculty of Medicine, joined the Centre as scientific director (1999–present). Dr Purden’s research has focused on long-term adjustment in patients and their families, illustrating the challenges of chronic illness and the need for skilled inter-professional teams to intervene. Dr Carmen Loiselle, associate professor, ISoN, Inaugural Christine and Herschel Victor Chair in Psychosocial Oncology, joined the Centre in 2000, and has developed a research program focused on examining the role of timely psychosocial oncology interventions in meeting individual’s multidimensional needs. Dr Nancy Feeley, associate professor, ISoN, joined the Centre in 2002, focusing her program of research on the needs of mothers of pre-term infants, and the development of PTSD (post-traumatic stress disorder) in the same population. Dr Celine Gelinas, associate professor, ISoN, joined the Centre in 2007. Her field of study concerns the management of pain in the critically ill adult. The accomplishments of this team of nurse scientists include over 161 peer-reviewed publications, and over 576 invited and peer-reviewed presentations. The total operating and infrastructure grants exceed $27,000,000, and the total value of FRQS Career Scientists Awards is more than $1,737,000. Twenty department members currently hold adjunct faculty appointments at the ISoN and are active participants in the undergraduate and graduate programs through their committee participation, teaching, and supervision. In an important commitment to clinical teaching, the Department receives over 700 nursing students for clinical placements and supervision, from the doctoral, masters, baccalaureate, and diploma programs of McGill University, and John Abbott, Dawson, and Vanier Colleges. All nurse clinicians contribute to student learning and development and play a critical role in teaching and mentoring new nursing professionals. In 2007, the McGill Nursing Collaborative was established through a partnership between McGill University, the McGill University Health Centre, the

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Jewish General Hospital and its Foundation, and the Newton Foundation. With a total base funding of $9 million, the McGill Nursing Collaborative for Education and Innovation in Patient and Family-Centred Care was launched. The goal was to enhance nursing research and nurse-led trans-disciplinary research, to develop nursing leaders with skills in nursing education, to promote and facilitate research-informed nursing practice that meets patient and family health needs, and to sustain and advance the management structures that will support the essentials of academic nursing leadership. Much work has been done to initiate meaningful projects specific to JGH Department of Nursing needs, as well as sharing of projects across the network. Many members of the Department have received honours and awards for their contributions to the profession of nursing. Among some of the highest accolades are those awarded by the Order of Nurses of Quebec. Twelve members of the Nursing Department have been recognized: 2004 – Dr Celine Gelinas, Prix Relève; 2009 – Dr Laurie Gottlieb, Order of Merit; 2009 – Louise De Bellefeuille, BScN, Excellence in Health Promotion; Lynne McVey, MSc (A), Excellence in Leadership; 2011 – Rosemary Short, BN, Excellence in Care; 2012 – Esther Dajczman, MSc, Excellence in Prevention of Illness; 2012 – Dr Carmen Loiselle, Excellence in Nursing Research. Recognized by the Regional Order (Montreal-Laval) of the OIIQ (Ordre des infirmières et infirmiers du Québec) were: 2005 – Melanie Bérubé, MSc, Prix Relève; 2006 – Mona Kravitz, MScA, Prix Jeanne Mance, notably the first recipient of this prestigious award; 2011– Valerie Pelletier, MSc, Prix Jeanne Mance; 2011– Lyne St-Louis, MSc, Prix Mentorat; 2011– Jodi Tuck, MScA, Prix Relève; 2013 Valerie Vandal, BScN, MPA, Prix Jeanne Mance. In addition, Lynne McVey, former director of Nursing was the recipient of the YWCA Woman of Distinction Award, 2013. The Nursing Department was awarded the Employer Recognition Award by the Canadian Nurses’ Association for its extensive support of nurses who participate in the CNA (Canadian Nurses Association) Specialty Certification Programs. The Department of Nursing has evolved from 1984 to 2016 as it meets the everchanging and complex needs of the patients and families it serves. Seen as a leading and innovative nursing department able to meet the demanding challenges in the current health-care system, JGH nurses will continue to provide excellence and leadership in clinical care, teaching and learning, research, and scholarly activities. The department is proud to continue to partner with physicians, the interdisciplinary team, associates at the Ingram School of Nursing, and other

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community collaborators to sustain the delivery of high-quality, cutting-edge programs of care for which the Jewish General Hospital is renowned.

depa rt m en t of ob stet r i c s a n d g y n e co l o g y Gynecological Oncology Dr Walter H. Gotlieb Dr Gotlieb was recruited at the JGH in 2003 to initiate and develop a division of gynecologic oncology. Over the last decade, the division has grown and now has three full-time North American fellowship-trained gynecologic oncologists who perform over 250 surgeries and close to 3,400 chemotherapy treatments per year. The division has developed and has been a pioneer in robotic surgery for women cancers, obtaining local, regional, national, and worldwide acclaim for the JGH. We have lectured and proctored robotic surgery at many occasions around the world. The department has authored 140 publications on general oncological subjects and is internationally known as a leading centre for robotic surgery (eighty conferences and lectures, ten live demonstrations and proctoring , twenty-three publications and three book chapters). The academic appointments are Dr Gotlieb, professor of obstetrics-gynecology and oncology, McGill University, director of surgical oncology and of gynecologic oncology; Dr Lau, director of the Royal College Fellowship, assistant professor of obstetrics-gynecology and oncology, McGill University; and Dr Salvador, assistant professor of obstetrics-gynecology and oncology, McGill University.

on co l o g y Dr Gerald Batist In the ’70s, Dr Richard Margolese methodically developed a formal Department of Oncology at the hospital, that was to become the model for the university, for Quebec and beyond. Beginning with a focus in breast surgery, where he was rapidly becoming an international leader in innovative clinical research, he

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recruited as needed to fulfill both the clinical mission and the academic goals. He was the first JGH faculty member to occupy an endowed university chair, the Herbert Black Chair in Surgical Oncology. Margolese added dedicated oncologists Laurence Panasci and Michael Pollak, who not only took care of the patients, and participated in the ever-more complex clinical protocols, but who also established their respective research laboratories. Margolese supported them both with protected time and help with initial funding, until they had established their credibility as clinician-scientists with independent peer-funding. The nursing department offered strong support, and the ever-growing cohort of oncology nurses, led by Antoinette Ehrler, created new models of primary care nursing that ensured continuity of care and multidisciplinary approaches to patient support. The Organization Hope & Cope, founded by the energetic and visionary Sheila Kussner, added another layer of patient support, as groups of trained volunteers became a sensitive and receptive non-professional part of the medical environment in which cancer patients were cared for. Radiation Oncology was a bit slower to take shape on site, due to largely political resistance at both the university and at the ministry. Persistence paid off, and in the early ’90s a small unit was established with the collaboration of Caroline Freeman, director of radiation at the time. Initially, Julio Guerra became the local chief. In the early ’90s, Margolese and Sam Freedman, then director of the Lady Davis Research Institute, recruited Gerald Batist, who had been at the Montreal General. Batist established the McGill Centre for Translational Research in Cancer, based at the Jewish General Hospital, which was formally recognized by the Faculty of Medicine and the university senate. Not long after that, Wilson Miller, a trainee from the Memorial Sloan-Kettering Cancer Center was recruited to set up his lab and his clinical research activities. All of this activity brought patients, research funds, and some measure of notoriety to the hospital, and stimulated cancer care activities in other domains. Harvey Kreisman developed a unique model in pulmonology, where the lung cancer doctors themselves acquired medical oncology skills. Working with radiation oncology, a strong program of clinical research in lung cancer emerged. This approach has continued and remains unique; it actually accelerates diagnosis and treatment by skipping the step of a pulmonologist’s referral to oncology. Kreisman and his successor David Small, developed a model multidisciplinary tumour board, at which specialists from all domains discussed all of the cases each week, which was studied by others, like Cancer Care Ontario, before building their own system of tumour boards. This was visionary, as decades later this approach is viewed as a necessary component of “best care.”

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Drs Arthur Rosenberg and Steve Caplan were also very active in building the heme-oncology program. In parallel with an excellent clinical program, they linked with the emerging field of molecular diagnostics and a strong clinical research program. The arrival of Jacques Galipeau added a strong laboratory research component that led the way for additional depth in the program. Martin Gyger, a major innovator in stem cell transplantation, who had helped build the strong program at Maisonneuve-Rosemont Hospital a decade earlier, came to the division and added this essential component. During the same period, Phil Gordon was building a magnificent team of colorectal surgeons, whose expertise in complex pelvic surgery earned significant recognition. Gordon wrote the definitive surgical textbook on colorectal surgery and is responsible for surgical innovations that changed practice. The integration of radiation and systemic therapy was informal and would only develop later. Martin Black built a very powerful and highly skilled head and neck surgical program, with a strong emphasis on cancer. Almost from the start radiation was involved, and Khalil Sultanem has become a reference radiation oncologist, practising state-of-the-art techniques, for this domain. In the mid-90s as well, Walter Gotlieb was recruited to the JGH, notwithstanding resistance from the Faculty of Medicine and the then chair of Ob-Gyn, and went on to recruit Suzie Lau and others into one of the strongest multidisciplinary teams in the country, with one of the largest robotic experiences internationally, as well as a laboratory research activity. Petr Kavan moved from the RVH (Royal Victoria Hospital) to join the medical oncology team in the mid-1990s, and he not only established one of the only adolescent and young adult oncology programs in Canada, but was also an integrating force in the emerging GI oncology program at the JGH. The establishment of tumour boards and practice guidelines that included multidisciplinary approaches to upper and lower GI cancers moved this program forward rapidly. The eventual recruitment of Té Vuong, a world-renowned innovator in the application of radiation therapy techniques to rectal cancer, as head of radiation oncology, added to the depth of the cancer care model, as well as to the research dimension of this program. A further component came with Tsafir Vanounou, an energetic and creative hepatobiliary-pancreatic surgeon, who brought skill, vision, and entrepreneurship. For a long time, urology had been controlled centrally at the university, and despite the clear focus on cancer at the JGH, there was resistance to the development of uro-oncology at the JGH. Regardless, the director, Jacques Corcos, set in motion a uro-cancer program that included Maurice Anidjar part-time

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from the RVH. Ultimately, the resistance was overcome and the next leader was Franck Bladou, who has internationally recognized expertise in uro-cancer, including robotics. Bladou was eventually named to the McGill Herbert Black Chair in Surgical Oncology. Other important programs also developed in relative isolation. For example, Zeev Rozberger has established himself as a clinical and research authority in psychosocial oncology, and had recruited some colleagues and financial resources. With this emerging strength in cancer care and research, at the JGH Strategic Planning exercise in the mid-1990s cancer was designated as a high priority area for the JGH. In 2000, an application to the Canadian Foundation for Innovation, led by Gerald Batist, generated the millions needed to build two research floors dedicated to cancer research, with a particular focus on translational research. The vision of a comprehensive cancer centre was realized when the CEO, Henri Elbaz, proposed building several clinical floors contiguous to these labs, all placed on top of the outpatient Pavillion E. With the generous contribution of multiple millions of dollars by businessman Alvin Segal, the deed was set in motion, and in 2006, with the presence of the Minister of Health, Philippe Couillard, the Segal Cancer Centre was inaugurated. Patients’ voices were heard in the process, expressed by means of a patient committee, and the ideas were incorporated into the physical and functional planning of the Centre. The SCC (Segal Cancer Centre) is recognized worldwide as one of the most dynamic translational cancer research environments in North America, combining excellent clinical service and training with basic and clinical research. A core facility and activity in the Centre is the clinical research unit, led by Wilson Miller, which is an acknowledged leader in early-phase clinical trials of novel molecules of a whole rage of classes. These activities have allowed us to secure significant operational funding, and attract major biopharmaceutical and biotechnology investments into Quebec. An initial $5.6 million in funding provided operational support. Subsequently, Q-CROC-led trials and studies have attracted funding from numerous peer-reviewed agencies and industry. Over $66 million has been secured toward biopsy-driven clinical trials and personalized medicine for tumour resistance. In general, SCC investigators average more than $10 million funding per year, and have received more than twenty-three prestigious salary awards from McGill, CIHR, FRQ-S, and the NCIC. Fundraisers have contributed more than $15 million in additional support over the past ten years. The SCC has identified proteomics as an area of strategic importance

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for personalized medicine, and in 2014, together with McGill, recruited Dr Christoph Borchers to be the incumbent Segal Chair in Molecular Oncology. By now Dr Batist was the McGill Chair of Oncology, and he assumed the role of Segal Cancer Centre director. His co-director was Lynne McVeigh, the JGH director of nursing, and together they developed a model of partnership and interdisciplinary co-management. This began a period of physical integration of the various programs into common space, using common tools for communication and meetings. Integrating the various multidisciplinary teams was a challenge that was engaged with enthusiasm and appreciation for the power of the emerging synergy. During these years, and after, JGH professionals were making important gains in the Faculty of Medicine at McGill; Gerard Batist was chair of the Department of Oncology; Laurence Panasci was director of Medical Oncology; Walter Gotlieb of Surgical Oncology; Khalil Sultanem led the Radiation Oncology Training Program; Zeev Rozberger was director of the McGill Psychosocial Oncology Program; William Foulkes, the McGill Cancer Genetics Program; Thomas Jagoe, director of the McGill Cancer Nutritional and Rehabilitation Program; and Petr Kavan, Director of the McGill Adolescent and Young Adult Oncology Program (AYAOP). In addition, many were appointed to McGill-endowed chairs: • Gerald Batist: Minda de Gunzburg Professor of Oncology (2001– ); • Franck Bladou: Herbert Black Proffesor of Surgical Oncology (until 2014, Richard Margolese); • Michael Pollak: Steinberg Family Professor of Medical Oncology; • Wilson Miller: James McGill Professor; • Carmen Loiselle: Victor Hershel-Hope & Cope Professor of Psychosocial Oncology; • Alan Spatz: Canada Research Chair in Molecular Pathology; and • Christoph Borchers: Segal Chair in Molecular Oncology. The Segal Cancer Centre has flourished and is now a major hub for Quebecwide networks in translational cancer research, including the Consortium de recherche en oncologie clinique du Québec (Q-CROC), which Gerald Batist cofounded. Q-CROC links more than fifteen Quebec hospitals and research facilities, and focuses on serial biopsies of metastatic cancers to define molecular signatures of therapeutic resistance. In 2014, we co-led a successful application to the Canadian National Centres of Excellence (NCE) programs, and were

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awarded $15 million (matching, total $35 million) to establish Exactis Innovations, an NCE in personalized medicine. In addition, the SCC houses a highimpact clinical research unit, with innovative global programs, which is one of only five designated NCIC-CIHR early-phase trial training program sites. The Molecular Pathology Centre, led by Alan Spatz, Canada Research Chair in Molecular Pathology and chair of pathology at the hospital, is a CLIA-certified (Clincal Laboratory Improvement Amendments) environment that includes a molecular diagnostics lab which has become a focal point in Canada for highquality molecular diagnostic tests linked to specific treatments. Working closely with the Lady Davis Institute director Rod McKinnes is an extremely strong group of rising-star fundamental scientists, who are rapidly integrating into the Segal environment, rich with strong clinical-laboratory interactions. The Segal Centre at the JGH has created a wide range of care models, ranging from the AYAOP to the only geriatric oncology program recognized by the Quebec Cancer Program. Besides direct patient care, the Centre is focusing on programs in quality outcomes and process improvement, with ongoing patient satisfaction surveys, intended to ensure the best possible patient-centred care.

Cancer Research Dr Gerald Batist Gertrude and Charles Clark Cancer Research Fund established; income will provide a studentship for fellowship for training in cancer research.” The first of these was awarded in September 1985.6

Cancer Research Group • Dr Richard Margolese (chief of the Department of Oncology) was awarded a Terry Fox Development grant from the National Cancer Institute of Canada, so the JGH Dept of Oncology can “establish a research team of four scientists with a particular interest in the chemotherapy of cancer and the prevention of cancer spread” to be located on the new fifth& sixth floors of the Lady Davis Institute. This will give JGH “one of the strongest oncology research and teaching groups in the province.”7 • Dr John Hiscott became director of Molecular Oncology Group in 1991. Molecular oncology is identified as one of the six areas of strength in research at the

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JGH, along with AIDS, clinical epidemiology, human genetics, aging, and thyroid disease and diabetes.8 The Terry Fox grant awarded to Dr Margolese (1990) enabled JGH to recruit “outstanding investigators in cancer research from various centres around the world” to work in the group headed by Dr Hiscott.9 The Canadian Foundation for Innovation awards $740,000 to four young investigators, three of them (Clément Couture, Antonis Koromilas, Rongtaun Lin) working in the Molecular Oncology Group.10 Dr Volker Blank from Germany joins Molecular Oncology Group.11 Dr Koromilas is “examining a protein known as p53, which, if present at elevated levels, helps to prevent the development of cancer. The goal is to keep these levels high enough to interfere in the cancer development process.”12 Dr John Hiscott, recipient of this year’s JGH Award of Excellence in Research, was the key organizer of a major international conference in Montreal on interferon and cytokine research. Interferons and cytokines are proteins that are closely involved in the development and functioning of the body’s immune system.13 Dr John Hiscott and his research team have developed a novel “combination” therapy that kills cancer cells while preserving healthy cells. The strategy, published in Proceedings of the National Academy of Sciences (September 2008), involves using an experimental virotherapy strategy in combination with a novel cancer drug to specifically target and destroy cancer cells.14

Cancer Prevention Research Unit • Established 1998 under Dr Michael N. Pollak.15 • In 1997, Dr Pollak “achieved international recognition for his discovery, in collaboration with colleagues at Harvard, that elevated levels of a hormone called insulin growth factor-I in adults is a predictor of risk for breast or prostate cancer in later life.16 • Dr Pollak received a grant of $3M from the National Cancer Institute of Canada “for the establishment of a network of excellence in the Canadian Beast Cancer Initiative. The network will be investigating the utility of hormonal factors in assessing the population at risk for breast, prostate and colon cancers.”17 • Dr Jacques Galipeau and Dr Gerald Batist achieved recognition for “the initiation of studies in cell and gene therapy for cancer and other diseases.”18 • As the current director of the McGill Centre for Translational Research in Cancer, Dr Batist “is well placed to ensure better links between McGill and its

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teaching hospitals, especially in this new era of inter-institutional funding from various government agencies.”19

Montreal Centre for Experimental Therapeutics in Cancer • Established at the JGH with $7.5 million infrastructure grant from the Canadian Foundation for Innovation and a $2.7 million operating grant from the Quebec Ministry of Science, Research and Technology. Centre “groups together scientific investigators from all of Quebec’s major universities, representing a major leap forward in the battle against cancer.” Directed by Dr Gerald Batist.20

Cell Processing Centre • Established in partnership with IDM, a biotechnology company based in France, “this facility will allow our hospital to provide cancer patients in Montreal with cutting-edge cell and gene therapy. These treatments, previously only available in major centres in the U.S., represent the best hope for patients for whom conventional therapy has failed. Directed by Dr Jacques Galipeau.21

Stem Cell Investigation • “The federal government is providing substantial funding for a research effort led by the JGH’s Dr Jacques Galipeau into the use of adult stem cells as repair material for damaged hearts, lungs and blood vessels. At a news conference on March 31, 2005, at the Lady Davis Institute for Medical Research, Justice Minister Irwin Cotler pledged $5.3 million a year to support the Stem Cell Network, an Ottawa-based team of scientists, clinicians and engineers from hospitals and universities across Canada. Among the Network’s initiatives is Dr Galipeau’s project, as well as a study into the use of stem cells in pulmonary hypertension, with Dr David Langeben, the JGH’s Chief of Cardiology, acting as lead clinical investigator.”22

McGill Centre for Translational Research in Cancer • The Centre was established 1997 under the directorship of Dr Gerald Batist. • The great challenge faced by the oncology research community is in the translation of laboratory and clinical research data into clinical outcomes of benefit in the assessment, treatment, and prevention of cancer. The McGill

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Centre for Translational Research in Cancer (MCTRC) was established in 1996, thanks to a generous endowment gift from the Goldfarb Family Foundation and the Alexander Family Foundation. Subsequent significant support included an endowment gift from the Montreal Breast Cancer Foundation. A 1997 article in the McGill Reporter outlines the origins of the McGill Centre for Translational Research in Cancer.23 • Based at the Sir Mortimer B. Davis Jewish General Hospital/Lady Davis Institute, the Centre provides the infrastructure to bring the investigators involved in translational research together to generate novel approaches to cancer treatment and adds a key element to the coordination of cancer researchers by providing a structured focus for these activities. At its inception, the Centre included members from the McGill Departments of Anatomy and Cell Biology, Biology, Medicine (Hematology and Experimental Medicine), Microbiology and Immunology, Oncology (Clinical Research, Basic Cancer Research, Pharmacokinetics), Pathology, Pediatrics, and Pharmacology and Therapeutics. It has now become a multi-institutional organization that reaches throughout McGill and beyond, including basic and clinical researchers from five universities and ten hospital-based or independent research institutes throughout Quebec. In 2000, it was repositioned as the Montreal Centre for Experimental Therapeutics in Cancer (MCETC) in the context of an application to the Canada Foundation for Innovation. • That same year, MCTRC/MCETC linked with the Centre de recherche clinique et evaluative en oncologie (CRCEO), based at the Centre de recherche of Hôtel Dieu du Quebec, to form the Axe Thérapeutique du Réseau de la recherche sur le Cancer du FRQS. Both partners have completed construction of their respective facilities. The Segal Cancer Centre opened in 2006, and integrates the laboratories and clinical research unit of MCTRC/MCETC within a comprehensive cancer care centre: https://www.mcgill.ca/translationalresearch- cancer/.

Ribavarin A common anti-viral drug, ribavirin, helped in treating cancer patients, according to a Canada-wide trial whose clinical portion was led by hematologist Dr Sarit Assouline and Dr Wilson Miller, director of the Shirley and Max Konigsberg Clinical Research Unit. The study, in Blood (May 2009), showed that ribavirin suppresses a gene that, when overly active, can lead to cancer. Treated patients experienced no adverse side effects.24

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sir mortimer b. davis jewish general hospital Researching Cancer’s Psychosocial Effects

The psychological trauma felt by cancer patients and their families, a field that was once overlooked, has evolved to the point where it merits its own research position at McGill University: the Christine and Herschel Victor – Hope & Cope Chair in Psychosocial Oncology. The Chair, whose creation was announced in October 2008 at the JGH Hope & Cope Wellness Centre, will focus not on death, but on life during and after cancer. It is the first research chair of its kind in Quebec, and one of only three in Canada.25 The Cancer Research Axis, led by Dr Gerald Batist, who is simultaneously director of the Segal Cancer Centre and deputy director of the LDI, is housed at both centres of the JGH. Research activities include both fundamental labbased and clinical investigations, with particular emphasis on molecular oncology, cancer prevention, cancer genetics, biomarkers in cancer therapy, new cancer therapies, translational physics and radiobiology, psychosocial oncology, and evaluative research. The Axis represents the single largest area of research at the LDI. With one of the largest groups of clinician-scientists in Quebec, the Axis strives to better understand the biological make-up of, and treatment implications for, a broad range of cancers. At the Segal Cancer Centre, synergy between the lab and the clinic enables progress on important translational efforts to provide patients with the most promising novel therapies. As co-founder of the Quebec-Clinical Research Organization in Cancer (QCROC), Dr Batist has helped to establish links between investigators at the LDI, the SCC, McGill University, and with provincial, national, and international colleagues. Embracing a multidimensional approach to cancer research has brought about more extensive collaborations and resulted in new insights on how to treat the disease. The Cancer Axis also has a very active and growing program in evaluative research. This includes international leadership in robotic surgery of various types of cancers. Axis members play key roles in a new health services research program at the LDI, funded by the FRQS, and in the recently established Rossy Cancer Network’s program of outcome evaluation and integration of cancer care. Dr Léon van Kempen established a new research laboratory at the LDI in 2010, after being recruited from Radboud University Nijmegen Medical Centre in the Netherlands, where he was assistant professor and chair of the Young Investiga-

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tors Network of the European Organization for Research and Treatment of Cancer, the principal clinical research organization in Europe. Dr van Kempen is addressing the role of the X chromosome during the progression of cancer. In particular, he is trying to identify the underlying mechanism that results in women with melanoma experiencing far better outcomes than men. His hypothesis is that something inherent in the tumour makes it less aggressive in women. This may involve a gene dosage effect, since women have duplicates of genes on the X chromosome, while men have only a single copy. The “X Chromosome and Cancer” lab of Dr Van Kempen and Dr Alan Spatz (JGH chief of Pathology) has demonstrated that losses on the active X chromosomes were more frequent in females who died from melanoma than in those who had good clinical outcomes. They have also identified a gene that strongly correlates with melanoma survival. Thus, if female melanoma patients have lost this gene, their prognosis is as poor as for male patients, in whom the gene is less prevalent. So promising is this innovative research that Dr Van Kempen and Dr Spatz have received a prestigious award from the Melanoma Research Alliance for further investigations. “We concentrate exclusively on X-linked genes that might explain the biology underlying the gender difference in melanoma,” Van Kempen explains. “This is used as a benchmark because of our familiarity with its make-up. What we discover in melanoma could well be extrapolated to other cancers where this same gender effect is observed.”26 Dr Ivan Topisirovic, who came to the LDI in February 2011 from the Goodman Cancer Centre at McGill University, is examining the molecular mechanisms in the abnormal proliferation and growth of cancer cells. This is a fundamental, yet still unexplained, characteristic of malignancy. Dr Topisirovic is particularly interested in the regulation of gene expression at the level where the genetic code is carried by messenger RNA (mRNA) and directs the production of proteins from amino acids. He is also focusing on changes in cellular energetics that favour the development of cancer. Discovering how these processes contribute to the aberrant proliferation and growth of malignant cells may reveal methods by which these cells can be effectively targeted and eliminated. “I am addressing the question of how a cell transforms from normal to malignant,” he explains. “Its basic imperative is to survive by expressing the right genes at the right time. If we can interfere with the expression of genes that lead to abnormal proliferation, we can treat cancer more efficiently and apply this knowledge to cancer prevention.”27

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sir mortimer b. davis jewish general hospital Segal Cancer Centre’s Tenth Birthday

Since its launch, the Segal Cancer Centre at the JGH has evolved into a focal point of the Lady Davis Institute, where cancer research is the single largest discipline. The Centre has become so crucial to diagnosis, treatment, counselling, and research into cancer in Montreal and Quebec that, somewhat surprisingly, it celebrated only its tenth anniversary in 2016–17. Fundamental laboratory work is complemented by the translation of research into clinical applications, as well as innovative psychosocial inquiries into the well-being patients and caregivers. The Centre’s dynamic research environment has contributed to significant advances in the search for the underlying biology behind a wide range of cancers, along with improved methods of treatment. In particular, growing emphasis is being placed on personalized medicine, in which treatment is customized for each patient. This is achieved by identifying specific genetic mutations (known as biomarkers) and using this genetic “fingerprint” to develop the treatments that are likeliest to work for that person. The JGH’s Molecular Pathology Centre, currently in development, will enable researchers to build a more extensive database of biomarkers and further contribute to developing novel therapies.28

Double Honours for Dr Gerald Batist: New Avenues of Discovery The year was a memorable one for Dr Gerald Batist, director of the Segal Cancer Centre, due to his election as a Fellow of the Canadian Academy of Health Sciences and his appointment as deputy director of the Lady Davis Institute at the JGH. The Academy cited him for having “led on many fronts that improved cancer therapy, including the study of cellular detoxification in therapeutic resistance to anti-cancer treatment, and pre-clinical and early-phase clinical trials of novel therapeutics.” The appointment recognizes Dr Batist’s remarkable success in guiding the Segal Cancer Centre to becoming one of the major cancer research institutes in Canada. Dr Batist is also the Minda de Gunzberg Professor of Oncology at McGill University, and co-founder of the Quebec-Clinical Research Organization in Cancer, a province-wide network for translational and clinical research in oncology. In addition to making significant contributions to the development of new cancer treatments, Dr Batist leads a highly successful laboratory and clinical research program, while maintaining an active clinical oncology practice.29

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depa rt m en t of oto l a ry n go l o g y Head and Neck Surgery Dr Michael P. Hier In 1984, the Department had only one geographic full-time physician, Dr Martin Black, then chief of the Department. At that time, we also had part-time physicians, Dr Saul Frenkiel, Dr Melvin Schloss, and Isaac Fried. The Department of Otolaryngology began to develop as an important teaching component for the McGill University Resident program, with increasing resident participation and research. We began recruiting other supra-specialized otolaryngologists. We recruited Dr Michael P. Hier to the Head and Neck Oncology program and Dr Jamie Rappaport to lead the Otology/Neuro-Otology service. Dr Bernard Segal also joined the department improving the department’s research capacity. During this phase of evolution, two other head and neck surgeons joined our department: Dr Richard Payne, to lead our Thyroid Cancer Centre, and Dr Alex Mlynarek, with his expertise in microvascular reconstruction for the head and neck. Our staff was increased with part-time faculty, strengthening our rhino-sinus and skull service with Dr Marc Tewfik. Additional part-time physicians include Dr Véronique-Isabelle Forest, who specializes in head and neck surgery and Dr John Manoukian, who has expertise in airway reconstruction. Dr John Young, leading the laryngology, voice, and dysphasia subspecialty joined and reinforced the team. In addition, Dr Jack Rothstein and Dr Joseph Gauze continue as parttime members. After years of dedicated service, Dr Isaac Fried retired in 2012. This department at the Jewish General Hospital has also seen two of its physicians hold chairman positions at McGill University’s Department of Otolaryngology-Head and Neck Surgery, Dr Melvin Schloss from 1990 to 2002, and Dr Saul Frenkiel from 2002 to the present. After almost twenty years as chief, Dr Saul Frenkiel replaced Dr Martin Black as chief in 1992. Then in 2011, Dr Michael P. Hier became chief. Most recently, Dr Hier launched the head and neck robotics program. The department has dramatically evolved and grown in all phases of supra-specialization. The teaching, administrative, and academic output of this department has been exemplary and remains a major teaching centre of excellence for otolaryngology-head and neck surgery at McGill for residents, fellows, and medical students and other allied health professionals.

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This department has trained research and clinical fellows from all over the world, including Israel, India, Saudi Arabia, the United States, Switzerland, and New Zealand. Our staff has twelve members.

pa l l i at ive c a re Dr Bernard Lapointe Between 1982 and 1992, funds from the Shirley Berest Fund allowed a clinical nurse consultant in palliative care to be recruited and the early development of a consultation service. Dr Arthur Rosenberg was responsible for that fund and Barbara Anderson was hired as the clinical nurse consultant in palliative care. In 1986, the Shirley Berest Fund also supported a position for a nurse researcher / education day, which Barbara Anderson was appointed to. Francine Venne then took over as clinical nurse consultant in palliative care. Recognizing the value and necessity of the palliative care clinical nurse consultant role, the Jewish General Hospital Nursing Department converted this into a hospital position in 1992, and began to support it financially. A “Comité aviseur” was created in 1986 to develop a palliative care approach. The following year, Dr Michael Dworkind began to do consults in palliative care on a part-time basis. The palliative care consultation service began to develop at this time, with more part-time physicians starting to see patients. Eight palliative care beds were opened in 1993 on 4 Main (covered by Dr Harvey Chang) which also had Neuro-Family beds. These palliative care beds were under the Division of General Internal Medicine and were transferred from 2NE. Psychiatrist Dr Henry Olders began to do consults for the oncology and palliative care services in 1993, as did psychologist Sylvain Neron in 1995. In that year, Francine Venne and Barbara Henderson developed a one-day course, “Grief, Loss, Death, and Dying, on End-of-Life Care” for nurses throughout the hospital. A director of Palliative Care Services was hired in 1995, thanks to the creation of the Gertrude Vineberg Fund; Dr Michael Dworkind was appointed the medical director of Palliative Care Services. By 1997, six to ten beds were reserved on 4 Main for palliative care, and Elizabeth Blair was the head nurse of this unit. The final report of the task force on palliative care (a hospital working group) in 1997 concluded that the long-term goal should be the establishment of a com-

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bined, academically strong Palliative Care program integrating services at the Jewish General Hospital, and that a full-time medical director be recruited by McGill to head this program. Dr Bernard Lapointe was recruited by McGill University and joined the Division of Palliative Care as its medical director in September 2000. Dr Dworkind was appointed chief of the Supportive Care Team within the Division of Palliative Care. Dr Lapointe established an outpatient clinic in oncology for pain and symptom control, allowing palliative care to be integrated earlier in the oncology population. In December 2000, Bessy Bitzas was appointed head nurse of the Palliative Care Unit. Music and art therapy, funded through a genourous donation, were introduced to the Palliative Care Unit in 2000. Another generous donation, by Marjorie and Gerald Bronfman, allowed for the creation of the seventeen-bed unit on 4 Main and the enhancement of the Palliative Care program. The seventeenbed unit was first renovated with the support of Hope & Cope. The unit was completely renovated and modernized in 2009, thanks to a generous donation from Larry and Cookie Rossy. In 2001, Noami Kogan and Vivian Myron were appointed as designated social workers for palliative care; Vivian Myron still holds this position. Dr Robin Cohen, the director of Palliative Care Research at McGill, relocated from the MUHC (McGill University Health Centre) to the JGH in 2003. Marie-Laurence Fortin was appointed the first clinical nurse specialist in palliative care at the Jewish General Hospital in 2008. The following year, Dr Bernard Lapointe was appointed as the Eric Flanders Chair in Palliative Care Medicine in the Department of Oncology at McGill, replacing the founding chair, Dr Balfour Mount. Dr Lapointe also became the new director of the McGill Division of Palliative Care, replacing Dr Anna Towers. Since 2002, members of the Palliative Care Division and the larger JGH community have been participating in monthly Palliative Care Ongoing Learning Rounds. Each year, the Division of Supportive / Palliative Care cares for about 800 new patients, most of whom are seen in ambulatory clinics. Currently the Division holds integrated clinics in hemato and medical oncology, gyne-oncology, pulmonary oncology, radio-oncology and in cardiology. In 2006, the highly effective integration of oncology and palliative care services was recognized by the European Society for Medical Oncology (ESMO), resulting in the JGH being accredited as an ESMO Designated Centre of Integrated Oncology and Palliative Care, the first institution in North America to achieve this designation. This ESMO accreditation has been renewed ever since.

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A two-day course on symptom management in palliative care was developed in 2010 by Kim Sadler, resource nurse on 4 Main, in collaboration with MarieLaurence Fortin and Heather Hall. This course is offered twice a year to nurses throughout the hospital and aims at integrating the palliative care approach in acute-care settings. In 2015, the palliative care organizational model at the Jewish General Hospital was cited by the Quebec Ministry of Health and Social Services as an example of good practice. This document, Soins palliatifs et de fin de vie en centres hospitaliers recension de pratiques, can be found at http://extranet.santemonteregie.qc.ca/depot/document/3665/Pratiques_Hosp.pdf. The Palliative Care Division is grateful for all the support it receives from its dozens of volunteers, donors, and the invaluable support from Hope & Cope. We are particularly proud of the superb team of professionals, including nurses, physicians, our fantastic orderlies, housekeeping agents, social worker, psychologist, physiotherapist, volunteer coordinator, music therapist, and art therapy intern, rabbi and Catholic priest, nutrition counsellor, and administrative assistants.

pat h o l o g y depa rt m en t Dr Marie-Laure Brisson (with help from Dr Lesley Alpert and Dr Alan Spatz) As one of the largest acute-care hospitals in the province, some 80,000 specimens are processed per year for surgical, molecular and cytology services, in particular serving the hospital’s cancer mission. Technological innovation has catapulted this science into a new era in diagnostic medicine. The JGH, with its modern, new state-of-the-art facility, already takes full advantage of these advances for the benefit of patients throughout Quebec. Pathology is the scientific study of the nature of disease: its causes, mechanisms, development, and consequences. The JGH Department of Pathology conducts vital diagnostic evaluations of all tissues removed from patients, from gross examination to molecular studies, playing a pivotal role in establishing accurate diagnoses and appropriate treatment plans. JGH pathologists work in close collaboration with all clinicians and are important members of the medical team caring for patients. It has been demonstrated that about 60 per cent of medical decisions taken in hospital are based on pathology results.

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Five pathologists-in-chief have headed the Department of Pathology since the doors opened at the Jewish General Hospital in October 1934: • • • • •

Morris A. Simon MD (1937–June 1969) Sèan Moore MB (July 1969–March 1971) R.C. Lachance MD (1972–85) Marie-Laure Brisson MD (1986–2008) Alan Spatz MD (2008–present).

Each chief has developed the department in response to changing political and clinical needs while supporting the strategic goals of the hospital. The first role of the Department of Pathology at the JGH has consistently been to provide the best possible diagnostic services to the physicians to support their care of patients. In addition, Dr Simon established a strong tradition of providing clinical teaching to medical and surgical staff on a case-to-case basis, drawing often on post-mortem analyses. From these early efforts evolved the well-attended Tuesday pathology hospital-wide rounds, wherein a post-mortem case was presented in a “Cabot case-like” format on a weekly basis (until 1995) as postmortem rates diminished on a monthly basis (until 2002). During Dr Moore’s short tenure, the number of pathologists doubled from three to six to support the increasing case load as well as the development of new diagnostic techniques such as immunofluorescence and electron microscopy. Additional staffing also allowed for active participation in undergraduate teaching at McGill, mostly in small group sessions taking place either at the JGH or at the Lyman Duff building. Teaching activities at both undergraduate and postgraduate levels expanded under Dr Claude Lachance’s leadership. The connections with McGill University continued to strengthen as residents from pathology as well as residents from other departments rotated in pathology at the JGH, efforts that contributed to the eventual naming of the JGH as a fully-affiliated McGill teaching hospital in 1979. To a much lesser extent, Dr Lachance was involved in undergraduate teaching activities at the University of Montreal. Also pertinent was his personal involvement in provincial and national associations and his support of other members interested in doing so. In 1984, Dr Sèan Moore came back to McGill University as pathology chair following Dr John Richardson who served at McGill from 1976 to 1984. The year 1984 was also the beginning of a revisited teaching curriculum. Much like the previous curriculum, this one was clinically based and delivered in a mixed format of full class lectures and small group sessions, using clinically

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relevant case studies. This approach had gained popularity and was now extended to ten months over first and second year medical school, covering general and systemic pathology. Autopsy attendance with student case presentations added clinical relevance to the study of disease, and although time-consuming, these presentations were rewarding to both students and faculty alike. Furthermore, we had the students again in their fourth year when they had elective choices in “return to basics,” an intense four week period offered in specific disciplines of their choice. In 1984, Dr Lachance recruited a research-oriented experimental pathologist, Dr Richard Buel. Dr Buel is interested in the endocrine control of neoplasia, more specifically as it relates to breast cancer. In the fall of 1985, Dr Lachance resigned to accept the position of “coroner-enchef adjoint” for the Province of Quebec. In the first weeks of 1986, Marie-Laure Brisson was named pathologist-in-chief. The challenges were multiple. For the first time, we had several postgraduate fellows and a clear increase in outside clinical consultations. As the number of residents entry in specialty was more and more restricted in Quebec it became apparent that we had to increase our efficiency and function as much as possible, independent of the presence or absence of pathology residents in rotation. This was achieved by recruiting and training candidates to function as pathology assistants, such assistants being more commonly available in other provinces and in the United States. At the same time, to support the McGill University undergraduate teaching program, the department accepted a second group of thirteen to fifteen students for weekly in-hospital teaching sessions (three hours each), from September to March. This is still the case today. Additional space was under construction but for pathology the space issue would get worse before it got better. Since space was not available, we often had to travel to the Lyman Duff building on the McGill campus for our teaching sessions. Obviously, recruitment and space issues were priorities. In 1987, two key personnel were recruited. We were successful in filling Dr Lachance’s position by attracting Dr Michel Trudel, who was completing a second year of fellowship in hemato-onco-pathology, with a year of molecular pathology. He joined our group in the early days of 1987 and subsequently developed the Warren Perzow Molecular Diagnostic Laboratory with hematooncologist Dr Wilson Miller; this lab was the precursor to the molecular biology laboratory, which has been relocated multiple times, most recently in 2013 to the Segal Cancer Centre. In the second part of 1987, we were fortunate to recruit

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Dr Esther Lamoureux, a renowned teacher, from CHUS (Centre hospitalier universitaire de Sherbrooke). Although much involved in renal and skin disorders, Dr Lamoureux accepted the challenge to fill the gap left by Dr Lachance in GI pathology and started at the JGH in July of 1988. In addition to the chief, the staff included (in order of hiring): Dr Herbert Srolovitz, Dr Alex Ferenczy, Dr Louise Rochon, Dr Louis Bégin, Dr Michel Trudel, and Dr Esther Lamoureux. This means that for the first time since the early days of the JGH, in particular since 1970, when it was demonstrated that to contribute to academic life the staffing had to increase from three to six full-time staff members, we were seven. In addition, we benefited from in-house part-time consultants in areas such as neuropathology, a contribution of Dr Luis Oliva (1979–85) and Dr Françoise Robert (1985–94). Of course, statistics demonstrate that the overall volume of cases had tripled since 1970. In December 1989, we moved into the Bronfman building (G wing). Consolidating our activities in one location was welcome and helpful. Computerization at this time simplified tracking various laboratory activities, facilitated preparing reports, and enabled reporting to be standardized and synoptic. In 1990, we were fortunate to have the opportunity to hire Dr Lesley Alpert, who came to Canada when her husband was recruited to the JGH: so then we were eight. Dr Alpert’s expertise was in cytopathology and she was also experienced in breast and gastrointestinal pathology. With the opening of the Bronfman Pavilion G came the shift to day surgery, which added significant volume and pressure for results to be available to the surgeons for future treatment options. Not only was volume increasing but cases such as breast biopsies performed to identify micro-calcifications were often increasingly complex. The advent of immuno-histochemistry added valuable information (such as expression of hormone receptors), needed for treatment and research protocols. With the new space available, it was possible to add automated laboratory equipment thanks to the administration and several donations from Hope & Cope, members of the boards, as well as prominent and generous members of the community, and, more recently, by the Walk to End Breast Cancer. This equipment includes slide stainers, cover-slippers, immuno-histochemistry platforms, and a digital electron-microscope and more recently, fluorescent in situ hybridization (FISH) assessment technology for the expression of Her2-Neu. A full armamentarium added progressively to the basic technique of haemotoxylin and Eosin (H&E) and histochemical “special stains,” which helped reduce the need for more support personnel in a time of constant budgetary constraints.

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In addition to the commitment of each and every one of the pathology medical staff, we were fortunate in the dedication and expertise of our administrative assistant, Mr Edouard Depestre and all his staff. To be able to depend on high-quality reliable techniques day after day is remarkable. To benefit from the commitment and care of secretaries and technicians from the most senior to the most junior is precious. And to this can be added the energy and devotion of volunteers coming on demand to file slides or retrieve them, providing services of inestimable value. There is a constant fight to do more with less. Pathology rounds (generally referred as Tuesday Rounds), inherited from Dr Morris Simon, were still held weekly. They presented autopsy findings but at times were used as a platform to demonstrate how the advent of new technologies could contribute to reach more precise diagnoses. These conferences were maintained until 1995 but, given the declining autopsy rate, they became incorporated in the Monday medical rounds schedule on a monthly basis from 1995 until 2003 when they were reduced to once a year, targeting broad topics. In spite of the difficulties encountered, the Pathology Department maintained and recognized its pledge for excellence in clinical care and teaching. It is in the research arena that progress was more difficult to attain. Dr Alex Ferenczy had a particular status from the beginning, between his contribution to the Department of Pathology and Gynecology, but by and large those successful in publishing, such as Dr Louis Begin, were doing it on their own time. In 1983, Dr Ferenczy was named full professor of pathology and obstetrics and gynecology at McGill University. In the summer of 1986, Dr Buel resigned for family reasons. Some dedicated research time was promised to Dr Trudel upon hiring but the setting up of the molecular lab and the increasing workload in hematopathology were difficult to reconcile with this goal. In 1994, Steffen Albrecht’s recruitment included lab space in the LDI and initial funding to pursue his research efforts on hepatoblastoma in collaboration with Professor T. Pietsch’s group, at the Institute for Neuropathology, University Clinics, Bonn. Unfortunately, research grants were reduced; his demand was well-received but not funded and the lab was closed the following year. He stayed on staff taking charge of neuropathology cases and consultations received from various institutions. He joined the CUSM/ MCH in 2009. Additional recruitment was difficult to achieve due to the small number of candidates and the severe overall shortage of pathologists in Quebec. In 1993, a departmental retreat was held to establish priorities and identify ways

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to accomplish the triple goals of the department. Given the increasing importance of knowledge acquisition and the effect of precise pathologic diagnoses for appropriate therapy, the decision was taken to reorganize our service commitments in a subspecialty mode. Although this was adopted in large American academic institutions (such as the Massachusetts General), this was a challenge for a relatively small team. Indeed, one has to consider the need for replacement during absence and vacation as well as ways to adapt to changes of orientation the hospital or government policy might impose. In the long term, it can also present issues for on-call schedules. So each member had a primary specialty and one or two secondary roles in parallel to be able to cover when needed. It was naively assumed that by concentrating our efforts in specific areas we could gain increased efficiency. As it turned out, there was indeed a small benefit in sign-out time, but there was a greater benefit in diagnostic accuracy, which translated into improved interdepartmental understanding, communication, and respect. Following the decision to practice in subspecialty, interdepartmental conferences as well as specialty tumour boards, were regularly attended by pathologists. This in turn, promoted several collaborative research projects and publications. To support this mode of practice and to maintain practical knowledge on progresses in each specialty, we were fortunate to acquire a multi-headed microscope (ten heads), which was used on a regular basis for departmental conferences and teaching of staffs, students, and residents. Another impact of subspecialty practice was seen on resident teaching. Indeed, Dr Lamoureux had been the JGH representative on the pathology residency committee since 1994–95. She became program director in 1999. She was on the nucleus committee of the specialty committee of the Royal College and on the specialty committee for Region 5. For two consecutive years, she received the McGill University Residency Teaching Award, and also received the award of best teacher from the division of gastroenterology. The program review she presented to the Royal College in 2002 was based on the vision that “a one to one” approach (mentorship) would make better use of limited manpower. This was innovative, well-received, and was soon adopted by others across Canada. Dr Esther Lamoureux was McGill University program director until 2005. All residents presenting for their boards in that period were successful. Esther’s passionate involvement in supporting residents’ needs never failed. In 1999, the pathology remuneration scheme was modified to offer an alternative to the prevalent fee for service one, the mixed mode of remuneration, which had several advantages for pathologists in remote areas as well as for

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university-based departments. Although teaching medical students was not considered in the RAMQ (Régie de l’assurance maladie du Québec) remunerated activities and teaching residents, included administrative functions, such as program director. Also, this mode was adapted to the complexity of cases rather than being volume-based. The counterpart was the increasing difficulty in recruitment and the need to recruit across the border when remuneration was clearly not competitive. It is at that time that Dr Louis Begin, an important and productive member of our team, left after twenty years of devoted service, to take a leadership position in a large hospital affiliated with the University of Montreal. Finally, although it benefited the group as a whole, it was of no help to share the workload equitably between members of the pool. This was a source of recurrent frustrations. In the mid-1990s, Quebec induced physician retirement by offering retirement packages. This accentuated the severe shortage of manpower rapidly affecting the traditional stability of pathology professional services. Our group was indirectly affected but took advantage of the new rules to recruit outside the province because these rules did recognize the teaching and research needs in university departments. However, the obligation to take and pass the French exam remained a major deterrent for several of our recruits. The opening of the Segal Cancer Centre in 2005–06 was associated with a moderate increase in volume of cancer cases but an important increase in their complexity. The advent of targeted therapy was exciting but again added pressure for results of specific tests such as hormone receptors and Her-2Neu. Dr Brisson led the department forward in many areas, starting with strategic recruitment guided by new developments as well as orientation provided by the hospital-wide strategic planning. Dr Brisson recruited Dr M. Trudel to develop immuno-histochemistry and molecular pathology, which allowed the Warren Perzow Molecular Biology Laboratory to be set up in 1987. The legacy of these efforts was developed into the Molecular Pathology Laboratory (2006) expanded under the later leadership of Dr Yury Monczak and Dr George Chong and the mentorship of Dr T. Haliotis and Dr Alan Spatz, as he became the new pathologist-in-chief in 2008. The molecular laboratory was moved to the Segal Cancer Centre building in 2013. Dr Leon Von Kempen was recruited by Dr Spatz to direct the Centre. The additional space allowed stateof-the art equipment to be bought and a remarkable expansion of testing possibilities applied for characterizing hematologic malignancies, solid tumours,

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and infections, progressively enabling the era of personalized medicine and targeted therapies. Dr Alan Spatz was named full professor of the departments of pathology and oncology at McGill in 2008, in good time to orchestrate the widespread expansion and renovation of the Department, which was to start in 2014. The difficulty in recruitment, in addition to the implementation of yet another remuneration schedule, were real challenges for all. Nevertheless, by the end of 2014, the number of clinical staff was double that of 1984: from six to twelve. JGH Pathology became a magnet to attract and retain scientists and pathologists of worldwide calibre in Quebec. A popular choice with residents, the JGH Department of Pathology is a full partner in McGill University’s residency program, with department members teaching many students at both the undergraduate and graduate levels. It is also involved in numerous interdepartmental conferences. Members of the Department of Pathology are often invited to give lectures and organize courses at international and national conferences. They conduct basic and applied research, with many of their projects involving collaboration with other hospital departments. Some areas of investigation include the biology of cancer and hematological malignancies. The creation of the Molecular Pathology Centre, which has become the Molecular Pathology and Bacteriology Centre (MPBC), has allowed unique synergies to be created with the surgical pathology unit which is more focused on the non-genetic aspects of pathology diagnoses. This, along with the new clinical research unit located on the same floor as the MPBC, creates a unique opportunity to reinforce the personalized medicine program at the JGH and the comprehensive centre for personalized medicine in cancer.

depa rt m en t of pe d i at r i c s Neonatology Dr Apostolos Papageorgiou Although the pediatric wards were closed by governnent decree in 1972, the neonataology unit has remained one of the outstanding Quebec and Canadian centres of excellence. Both neonatal and perinatal mortality (which includes neonatal deaths and stillborn infants) improved substantially over the years,

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with rates ranging from 4 and 6 per 1,000 deliveries. For the Jewish General Hospital, the record of perinatal mortality is an extremely low rate of 2.2 per 1,000 deliveries. Major contributions to overall improvements include the introduction of new technologies, allowing us to continuously monitor all vital signs of the newborn infant. These include continuously monitoring oxygenation, PCO2, cardiac tracing, blood pressure, and respirations. The introduction of new respirators adapted to newborn infants, which include high-frequency oscillatory ventilation (HFOV) also played a major role. More recent developments are the use of nitric oxide (NO) for the treatment of pulmonary hypertension and cooling for asphyxiated newborns over thirty-four weeks of gestation. Extracorporeal membrane oxygenation (ECMO) still remains a last resource to treat complex cardiac patients or those unresponsive to other therapies. Another significant contribution has been the introduction of parenteral alimentation from day one of life, as well as oral nutrition, particularly of breast milk, soon after birth. The latest statistics for the JGH regarding the outcome of extremely low birthweight infants are as follows: 23 wks ga – 46 per cent; 24 wks ga – 60 per cent; 25 wks ga – 79 per cent; 26 wks ga – 88 per cent; 27 wks ga – 95 per cent. (Note: “ga” = gestational age.) The smallest baby to survive in our unit, a Quebec record, is 375 grams, born in 2013 and doing very well. We have several babies surviving who were under 500 grams at birth. The JGH Perinatal Centre has been assigned by the government as a referral centre for high-risk pregnancies. This means that the JGH is one of three centres for perinatal care in Montreal, along with Ste Justine and the Montreal Children’s Hospital, a recognition by the province of the JGH’s neonatology service.

depa rt m en t of p s ych i at ry Dr Michael Bond Research The number of researchers, grants, publications, and students trained has grown a great deal. At present, four of our researchers hold salary awards, some for over $500,000 over four to five years. Our researchers hold grants of about $15 million and publish about 125 to 150 peer-reviewed articles per year along with two books

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and twenty-seven book chapters. Our staff are editors and are on the editorial boards of many journals. About fifty students train in the research section. Dr Phyllis Zelkowitz , our research director, initiated the JGH psychiatry research day, which has been thriving for the past ten years. The Douglas Utting Research Fellowship has been active for about seventeen years, and the Douglas Utting Prize and Lecture for a dozen years. It has now evolved into the Robert Utting and Leonard Ellen Memorial Lecture, which was initiated last year with Clara Hughes as keynote speaker.

Clinical There has been a thrust toward developing specialty clinics – first-episode psychosis program, couple and family therapy program and clinic, perinatal mental health clinic, cultural consultation clinic, personality disorders clinic, youth service, and continuing care clinic. A major change for child psychiatry has been the establishment of the Centre for Child Development and Mental Health in a beautiful new purpose-driven building, consolidating the school program and all child services. On the one hand, the recovery model, which is very patient-driven, is an organizing force in our department. On the other hand, the increasing number of “judicial” patients has led to court orders being integrated into the care of many patients with severe and persistent mental disorders. Research led by our staff has shown better outcomes for these patients. Increasing links with the Centre de santé et de services sociaux has been developing with more psychiatric consultation from our department and interchange with both Centres local de services communautaires s and Groupes médecins familials.

Education Several of our staff are recurrent winners of awards for educational excellence. Many students (medical students, residents and fellows, psycholgy interns, students in occupational therapy, nursing, social work, and family therapy) compete to be able to train in our department. The new Masters of Science Applied degree in Family Therapy at the McGill School of Social Work is a partnership with the JGH and is directed by Dr Sharon Bond, who also heads the Couple and Family Therapy Clinic. There is an active continuing education program for our whole department.

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Since 1984, the chiefs have been Dr Henry Kravitz, Dr Philip Beck, Dr Michael Bond, and, since 1 September 2014, Dr Karl Looper.

cou p l e a n d fa m i ly t h er a p y p o st - g r a duate cert i f i c ate pro g r a m Dr Sharon Bond Origins In 1960, Nathan B. Epstein introduced family therapy in Montreal and developed the first training program in Canada, through the Department of Psychiatry, at the Jewish General Hospital. The Department of Psychiatry has been a leading North American centre for family therapy practice, training, and research for over forty years. Many of the early pioneers conducted their family therapy research through the Department: Dr Nathan Epstein, Dr Herta Guttman, Dr Leo Chagoya, Dr V. Rakoff, and Dr J. Sigal developed the Family Category Schema, one of the early family process research measures. Dr Epstein had wide influence on the field, having trained such notables as Nathan Ackerman (founder of the well-known Ackerman Institute) and William Pinsof (founder of the Family Institute at Northwestern University, Chicago who expanded Epstein’s established problem-centred approach). Dr Isaac Rebner was the first director of Family Therapy, one of the earliest programs in Canada. Dr Leo Chagoya followed and then in the ’70s, Dr Herta Guttman directed the program. With the collaboration of Rosylyn Spector-Posner, Dr Guttman developed a reliable system of coding family interaction. At present there are three training programs and one clinic facility operating under the auspices of the Jewish General Hospital, Department of Psychiatry.

Post-Graduate Certificate Program The Couple and Family Therapy Training Program at the Jewish General Hospital continues this tradition, integrating research into couple and family therapy, shifting from its early theoretical focus on psychodynamic, interpersonal, communication theory to a largely systemic integrative program with a

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focus on research-informed practice. The need for the Couple and Family Therapy Program originated from the lack of sufficient or cohesive university training programs in couple and family therapy. Until the launch of McGill’s newly developed MSc (Applied) in Couple and Family Therapy in fall 2014, universities in Quebec that provide professional training (psychology, social service, and psychiatry) do not offer full cohesive programs in couple and family therapy. Students have access to a very limited number of courses in this field. As a result, graduates of these university’s programs enter their work settings insufficiently prepared to deal with the difficult and complex family issues that they will encounter. Therefore, postgraduate mental health professionals who are interested in doing couple and family therapy have been left to their own devices to further their training. Furthermore, few community centres have the resources to provide supervision or training in systemic therapies and they have welcomed the availability of our programs to help fill this gap. The Jewish General has a long interdisciplinary tradition with faculty across multiple disciplines, including such fields as social work, social and transcultural psychiatry, psychology, and counselling psychology all focused on developing the profession of couple and family therapy. Key family therapy leaders at the Jewish General are: Bernadette Laroche, Shirley Braverman, Janet Sutherland, Sherrie Poplack, Sharon Bond, and Diana Shannon, to name a few trained generations of clinicians on the application of systemic methods. Two previous directors (Dr Ronald Feldman and Dr Liliane Spector) have both continued to serve as supervisors in the program. Psychiatrist Feldman and psychologist Spector are noted for their commitment to developing live supervisory methods, the use of the reflecting team, the family sculpting, and strategic intervention, which distinguish them in the field. Most of the faculty at the Couple and Family Therapy Program have university appointments in psychiatry, social work, and psychology and are established family therapy supervisors who have long trained the larger Quebec community. The Couple and Family Therapy Program (CFTP) offers mental health and health professionals (among them social workers, psychologists, nurses, counsellors, and physicians) practical and theoretical training in family and couple therapy. The program is available in two tracks – an English-language track or a French-language track. The program cycles every two years, alternating between English and French cohorts entering the program. This system allows for the possibility of students entering into the second year of the existing cohort to follow a “catch up” program (that is, they join the cohort from the previous year and take additional classes to cover the first year coursework).The Post-Graduate

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Certificate Program is accredited by the American Association for Marriage and Family Therapy and has been since 1991. Graduates are eligible to obtain their permit of reserved title as a “couple and family therapist” through the Professional Order of Social Workers and Couple and Family Therapists of Quebec (OTSTCFQ). The program features a treatment facility for couples and families in distress that serves as a training site for students in the program. The training site at the Institute of Community and Family Psychiatry provides audio-visual support through the availability of one-way mirrors, a newly renovated studio enabling clinicians-in-training to record their ongoing clinical sessions, and an expert audio-visual consultant. Students of the program are introduced to the latest training, research, and practice material in the field.The objectives of the Couple and Family Therapy Program are to provide experience and to increase the competence of mental health professionals working with families and couples. It is preferable, although no longer mandatory, for candidates to be working in the public sector – private practitioners are also eligible.

Program Completion The program includes three years of theoretical and practicum supervision curriculum, followed by continued supervision for year four and five of their training to complete 500 clinical hours of supervised clinical practice. The curriculum adheres to a modular approach to pedagogy with four learning modules, which organize the curriculum. The learning modules are: Theoretical Foundations of Family Therapy, Assessment and Treatment in Marital and Family Therapy, Human Development and Family Studies, and Professional Identity and Ethics, which align with the first four areas of the AAMFT (American Association for Marriage and Family Therapy) Education Guidelines (Theoretical Knowledge, Clinical Knowledge, Individual Development and Family Relations, Professional Identity and Ethics). The fifth area – Research – is woven throughout the curriculum and culminates in a final paper. Individual courses fall under one of the four modules described above. The curriculum includes coursework on the basic concepts and methods of couple and family therapy for a total of eight full-year courses (360 hours). Students are also required to have completed four equivalence courses (180 hours) through affiliated university programs. This totals 540 hours of instruction given over a period of three years. The course structure for our program follows a developmental pathway beginning with foundational knowledge and progressing to more advanced level instruction.

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Course seminars follow a two-hour format whereby each seminar is taught by a faculty member/lecturer with specific expertise in this area. The program director, Sharon Bond, PhD, actively oversees all elements of the program. The program also has three coordinators: Sherrie Poplack, MSW, Janet Sutherland, MSW, and Guylaine Séguin, PhD. The program director and the coordinators meet every two weeks. In addition to having teaching and supervisory responsibilities, the coordinators oversee the theoretical coursework and exams. Staff meetings that include all supervisors occur every two months. The Couple and Family Therapy program first received COAMFTE (Commission on Accreditation for Marital and Family Therapy Education) accreditation in 1991. The most recent accreditation was completed and approved in 2005. The Department of Psychiatry has been a leading North American centre for family therapy practice, training, and research for forty years. The philosophy of the JGH Department of Psychiatry, which includes the hospital’s Division of Psychology, is to treat each patient as an individual living within a larger social system that includes both family and community. Many services and treatments are available based on bio-psychosocial, family, and cultural models. This mission is directly aligned with the mission of the CFTP to provide excellent advanced training and supervision in couple and family therapy to mental health professionals, particularly those working in the public sector, and prepare professionals to work effectively with a culturally and linguistically diverse population with varied mental health needs. The Division of Psychology at the Jewish General Hospital is part of the McGill Psychology Internship Consortium, which is an American Psychological Association (APA)–accredited internship site. The Couple and Family Therapy Program’s curriculum, and teaching and learning outcomes, are aligned with the standards of the Professional Order of Social Workers and Couple and Family Therapists of Quebec (OPTSTCFQ). These standards are closely based on the educational standards set forth by the COAMFTE. In response to new legislation tabled in the Quebec legislature in 2006 governing the practice of psychotherapy and the use of the reserved title of “psychotherapist” in Quebec, the Couple and Family Therapy Program did a major review and revision of its curriculum. McGill University offers a master’s program in couple and family therapy (CFT) in the School of Social Work, in collaboration with the Department of Psychiatry at the Sir Mortimer B. Davis Jewish General Hospital. The proposed master’s program will offer specialized training in couple and family therapy to human service professionals who wish to advance their expertise in couple and family treatment, and who wish to qualify for certification as couple and family

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therapists in Quebec. This program will build on the tradition of interdisciplinary training in family therapy with student recruitment from a multidisciplinary background, including social work, counselling psychology, clinical psychology, nursing, and medicine. A Couple and Family Therapy Fellowship is also offered for one year. The Couple and Family Section research projects include Couple Attunement and its Impact on Parent Perceptions in Families with Maternal Depression, An Exploration of Attachment Security and Therapeutic Alliance in Couple and Family Therapy and Children and Global Adversity: A Rights-Based Approach.

Research Current Projects and Grants: 5 Papers in peer-reviewed journals: 13 (Overlap with Bond and Jazdar)

Psychosocial Research • Ms Linda Edgar of Nursing and Dr Jean-Claude Lasry of Psychiatry researching “mechanisms by which cancer patients cope with their disease … focussing particularly on the quality of life after different types of surgery and the role of the nurse in implementing a rehabilitation program.”30 • Dr Christopher Perry from Harvard has recently become a member of the JGH staff as director of Research for the Institute of Community and Family Psychiatry. Interests are: “psychosocial aspects of illness … the psychological impact of major illnesses, such as cancer, on patients and their families.”31 • Dr Phyllis Zelkowitz was appointed director of research at the Institute of Community and Family Psychiatry, where “investigators … explore the social, cultural, and environmental factors that affect mental health, as well as taking a strong interest in the psychosocial aspects of serious medical illness.”32 • Dr Zelkowitz, appointed director of Psychiatry Research 2004, “examined the psycho-social aspects of disease in a family context … to determine how family relationships in these circumstances can contribute to or limit the type of stress that can lead to mental illness.”33

Research Comes to Life To give medical research greater practical relevance, a hospital study on heart attacks became the subject of a documentary film, excerpts of which were shown

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at a JGH news conference in September 2004. The idea of using a movie to transform research into an educational tool was the initiative of Dr Danielle Groleau, a medical anthropologist and public health doctor at the JGH’s Institute for Community and Family Psychiatry.34 JGH clinical psychologist Dr David Dunkley found that harshly self-critical people are likelier to experience depression over a period of four years. As reported in Comprehensive Psychiatry (July–August 2009), these individuals are more apt to have troubled relationships, difficulty in daily functioning, and less satisfaction with life during those four years.35 Researchers within the Psychosocial Axis are trained in psychiatry, psychology, nursing, anthropology, public health, and cognitive neuroscience. They bring wide-ranging expertise to the study of the psychosocial elements of physical and mental illness and conduct important critical evaluations on how health research is conducted. The Axis concentrates on three distinct themes: 1 Cultural Psychiatry Located in the heart of Montreal’s most ethnically and culturally diverse neighbourhood, the Psychiatry Department of the Jewish General Hospital is world-renowned for its work on how culture influences symptom expression, help-seeking behaviour, adherence to treatment, and response to health communications, with regard to both mental disorders (such as depression and anxiety) and chronic illness (such as cardiovascular disease and cancer). There is a particular emphasis on studies of vulnerable populations, such as Aboriginal groups, immigrants, and refugees in the interest of informing health policy and reducing disparities in access. A recent initiative involves developing and implementing an innovative culturally-based, family-centred mental health promotion program for Aboriginal youth living in rural and remote communities across Canada. 2 Psychosocial Factors in Disease Among patients contending with serious illnesses, such as cancer, cardiovascular disease, rheumatoid arthritis, scleroderma, and sleep disorders, psychological distress is associated with increased morbidity and greater use of health care services, and attendant increases in health care costs. As a result, the development and evaluation of screening and treatment programs for such diseases are important areas of research. For example, research in psychosocial oncology addresses coping, communication, and risk information transmission to improve health outcomes and quality of life for cancer patients and their families. We are also innovators in the development and evaluation of

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accessible evidence-based psychosocial interventions to reduce distress and disability and to enhance quality of life in medical patients. Our research advances knowledge by investigating not only the behavioural, psychological, and physiological factors associated with pain and/or disability in patients, but also the largely neglected issue of family and caregiver responses. Women’s health issues are another important focus of research, including studies of mental health problems during pregnancy and postpartum, screening for gynecological cancers, and sociocultural factors associated with decisions about breastfeeding. 3 Etiology and Treatment of Mental Disorders This theme focuses research on the biological and psychosocial risk factors for developing psychiatric disorders in adults and children. Psychotherapy research looks at patient characteristics as well as aspects of the treatment process that are associated with outcomes in patients with recurrent depression. Research in cognitive neuroscience investigates the role of placebo effects in psychiatric treatment and the use of attention training to treat Tourette’s syndrome and attention deficit hyperactivity disorder.

ch i l d p s ych i at ry Dr Jaswant Guzder Since 1984, the Jewish General Department of Child Psychiatry has been led by Dr Martin Solomon, and since 2004, by Dr Jaswant Guzder, with four full-time staff approved by the ministry allotted to our department. The Child Department was established in 1967 under Dr Ron Feldman, who formally retired in 2015. We have continued to work in complementarity as a key member of the McGill Division of Child Psychiatry, along with the Douglas Institute and the Montreal Children’s Hospital, partnering in clinical, academic, and research activities. We continue to provide the largest non- sectorized childhood disorders day and afterschool hospital programs (fifty-six children at any time) in the McGill Division serving all CSSS (Centres de santé et de services sociaux) centres on and off the Island of Montreal. We also provide services for over 250 families a year whose children present with complex comorbidities. Our day hospitals focus on family-based milieu treatment for children age five to twelve at risk, with a collobarative care model linked with schools and community re-

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sources. The English Montreal School Board provides special educators for our multidisciplinary teams. From 1984 to 2010, the Department was located in four geographical areas with limited space for its programs. With growing demands for service and the generous contributions of the Kaplan family, Arnold Steinberg family, and the Goldman family, we opened the Saul and Ruth Kaplan Pavilion, establishing the Centre for Child Development and Mental Health in September 2010. This lovely building was the first eco-hospital building in Quebec and a significant publicprivate partnership, reflecting the generosity of the community to meet the needs of high-risk children and families. From 1984 to 2015, our department has continued to develop teaching and training excellence for medical students and residents in psychiatry. We host students from a range of disciplines in training, including masters students from the McGill School of Nursing, McGill and Concordia education faculties, Masters of Social Work applied master’s program, Concordia creative arts programs, McGill and Concordia PhD students in psychology, and McGill occupational therapists and speech therapy interns. We also train psycho-educators from UQAM (Université du Québec à Montréal) and numerous CEGEPs (Collège d’enseignement général et professionnel) as well as offering numerous observerships for various disciplines. The child department is unique in the McGill and Quebec hospital system as it has continued to develop family-based programs with a strong link to family therapy training at the Jewish General Couple and Family Therapy Clinic, currently headed by Dr Sharon Bond. The Child Psychiatry Department has developed the first Canadian Fellowship Program for a family therapy resident trainee started in 2013 under Dr Guzder and co-directed by Dr Bond. Our research section has been successful in publishing numerous peer-reviewed articles and obtaining grants. Our researchers have collaborated on seminal studies of childhood borderline personality risk and treatment, family therapy treatment, development of shared care models, access to services, transitional care of high-risk children into community, Aboriginal youth health, immigrant and refugee mental health, innovations in use of technology for attention treatment, attachment risk in young children, and global health projects in the Caribbean and Asia. Our active research initiatives have involved Dr Phyliss Zelowitz, Dr Joel Paris, Dr Jaswant Guzder, Dr Ashley Wazana, Dr Amir Raz, Dr Laurence Kirmayer, Dr Cecile Rousseau, Dr Toby Measham, Dr Luci Nadeau, Dr Miriam Denov, Dr Sharon Bond, and numerous PhD and masters

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students. For more than ten years, the Sam Solomon Trust and Bell Canada have been key funders for developing our transitional team that links schools and CSSS services with our day-hospital populations. Global Health initiatives include collaborations on Teasdale-Corti grants for the study of war and conflict regions and the Grand Challenges Grant for the “Dream a World” Jamaican highrisk study. The Child Psychiatry Department has been an active collaborator for teaching and training. It also founded the Jewish General Cultural Consultation Service in 1999 with the Division of Social and Cultural Psychiatry under Dr Laurence Kirmayer. Our staff have continued to be trainers, researchers, and clinicians developing this model of care and contributing to a book on this model of cultural consultation. In past years, our staff has been honoured with awards for community service, the Queen’s Diamond Jubilee Award, an award for promotion of health equity and diversity, and research excellence Dr Guzder is professor, McGill Faculty of Medicine, Department of Psychiatry, associate: McGill Faculty of Social Work, head of Child Psychiatry, Jewish General Hospital, director of Childhood Disorders Day Hospital, senior consultant, JGH Cultural Consultation Service, and director of the Fellowship Program in Family Therapy. We continue to offer active continuing medical education, and active involvement in McGill and departmental teaching to promote excellence of care in both the university network as well as with our community partners and school boards. In addition, our staff are active in the Quebec and Canadian child psychiatry arenas and in international academic activities promoting child mental health. By December 2015, we were in the process of undergoing a restructuring of child mental health services under the new strategic Quebec government plan.

depa rt m en t of gen er a l su rgery Drs Harvey Sigman and Shannon Fraser One of the outstanding achievements of the JGH was its pioneer participation in the movement to minimally invasive surgery and the direction away from radical mastectomy toward lumpectomy. Drs Harvey Sigman and Jacques Garzon led the former, and Dr Richard Margolese the latter.

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Harvey Sigman was chief of general surgery from 1989 to 2008. He was promoted to full professor in 1995 and emeritus professor in 2009. He acted as assistant dean of undergraduate medical education from 1993 to 1997. During his tenure he concentrated on developing a close relationship with the McGill Department of Surgery for the purposes of resident training, and he particularly aimed at complete integration into the undergraduate surgical teaching program. In 1990, with the collaboration of Dr Jacob Garzon, Dr Sigman introduced a laparoscopic cholecystectomy program, which was one of the first in Canada. In addition, the Jewish General Hospital worked closely with the other McGill hospitals, resulting in a large number of presentations in Canada and internationally. Our goal was to apply this new technology so that this operation could be carried out by our surgeons in a safe and prudent manner. The department provided a number of academic courses for surgeons across Canada and the northeastern United States. Further courses were then organized for advanced laparoscopic surgery,for the first time in collaboration with representatives from the University of Montreal. Dr Richard Margolese was a trailblazer when he participated in Dr Bernard Fisher’s initial studies confirming that lumpectomy was superior to the disfiguring mastectomy in treating breast cancer. He played a major role in involving the JGH in many clinical trials which transformed breast surgery here and in the United States. He also held a named professorship. In 2004, Dr Shannon Fraser joined the staff as a specialist in MIS (minimally invasive surgery). She became interim chief of general surgery in 2009, and permanent chief in 2010. Dr Fraser initiated the use of robotics in general surgery. Dr Lawrence Rosenberg became a member of the Division of General Surgery as a pancreatic surgeon in 2007 when he was appointed chief of surgical services at the hospital. In 2013, he became the director general of the JGH. In 2015, Dr Rosenberg was named by the Minister of Health as president and CEO of the Integrated Health & Social Services University Network for West-Central Montreal. In 2008, minimally invasive surgeon Dr Simon Bergman joined the staff. He became McGill medical director of Education for Surgery 2013 and received a FRQS Chercheur-boursier grant in 2014. In 2009, minimally invasive surgical oncology (hepatobiliary) surgeon Dr Tsafrir Vanounou joined the staff. He started the MIS hepatobiliary surgery program and performed the first robotic Whipple operation in Canada. In 2009, the JGH joined NSQIP (the National

Dr Shanon Fraser, chief of general surgery visiting a patient. Jewish General Hospital Audio Visual Department, 09-2045_04.

OR Checklist, a JGH early initiative. Jewish General Hospital Audio Visual Department, 10-1131#1_AV_150dpi.

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Surgical Quality Improvement Program), with more than 600 participating hospitals, mostly in the United States, which benchmarks and ranks for complications. A quality evaluation program started at the JGH, the first such site in Quebec. In 2012, surgical oncologist Dr Jean-François Boileau joined the staff. The Division of General Surgery participated in an augmented robust clinical trials program in breast cancer. He then became the McGill Surgical Oncology Fellowship program director. In 2013, Dr Carol-Ann Vasilevsky became chief of colorectal surgery, replacing Dr Philip Gordon. Dr Marylise Boutros joined the colorectal subdivision. She came to the strong colorectal program with expertise in the trans-anal 0MIS approach to rectal tumours, expertise in MIS colorectal surgery, and outcomes research. Dr Jean-Sebastian Pelletier joined the staff with expertise as a MIS surgical oncologist (hepatobiliary) in 2015.

ort h ope d i c su rgery Dr David Zukor The JGH Department of Orthopedic Surgery has been headed since 1984 by two orthopedic surgeons in chief, Dr Alexander Hadjipavlou (1975–90), and Dr David Zukor, from December 1991 to the present. Dr Pierre Dupuis was acting chief following Dr Hadjipavlou’s departure, until Dr Zukor’s arrival. The Department of Orthopedic Surgery has evolved considerably in the last thirty years. Traditionally the practice was along the lines of a community hospital with very limited resident involvement (though there was a research component initiated by Dr Hadjipavlou that continued until his departure). This pattern continued until 1991 when Dr Zukor (trained at McGill with fellowships in Toronto) was recruited from the Royal Victoria Hospital as chief. Soon after, McGill University orthopedic residents began regular rotations at the JGH and it became integrated as one of the clinical teaching units of the McGill orthopedic program. Around that time, the clinical and academic mission of the Department began to evolve as well. It was recognized that with so many subspecialties within orthopedic surgery it would be impossible to maintain a good and high level of service unless activities were streamlined. As the evolution progressed, hip and knee arthroplasty became the primary activity within the department. Another sphere of activity, foot and ankle surgery, was started along

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with the recruitment of Dr Ruth Chaytor in 1997 (trained at Dalhousie with fellowship training in Pittsburgh and at the University of Montreal) and later, Dr Monika Volesky in 2005 (trained at McGill with fellowships in New York-HSS (Hospital for Special Surgery) and Ottawa). Spine surgery initially increased significantly, especially with the arrival of Dr Max Aebi from Switzerland. Dr Aebi was the chairman of the division of orthopedic surgery at McGill University and worked primarily at the Royal Victoria Hospital but part-time at the Jewish General. He eventually recruited Dr Dante Marchesi, a spine surgeon from Switzerland, who became full-time staff at the Jewish General. Between Drs Aebi, Marchesi, and Dupuis, there was a strong spine presence at the JGH. In order to bolster hip and knee arthroplasty, which at that time was being performed primarily by Dr David Zukor and Dr Leonard Rosen (recruited in 1982 after training in Ottawa followed by a Hand Fellowship in Detroit), Dr Olga Huk was recruited in 1994. She had trained at the University of Montreal, has an MSc, completed fellowship training at the Hospital for Special Surgery in New York, and had a strong interest in basic science). One of the reasons she was recruited was to allow a basic science research lab in arthroplasty at the Lady Davis Institute to be initiated, which occurred shortly afterwards. This program, both clinically and especially in terms of the research activity, was enhanced by the recruitment of Dr John Antoniou, who had trained at McGill (including a PhD) and completed multiple fellowships in both lower-extremity arthroplasty and shoulder. Subsequently, basic and clinical research underwent significant growth. In fact, currently the Department of Orthopedic Surgery at the Jewish General Hospital is one of the most active units of any surgical division or department at McGill University in research output, both basic and, especially, clinical. Eventually Drs Aebi, Marchesi, and Dupuis departed and the volume of spine surgery decreased significantly. Currently, there is a part-time spine surgeon, Dr Peter Jarzem. However, the Department of Neurosurgery at the Jewish General has become very spine-focused and therefore patients at the JGH are still able to access good spine care. In 2012, Dr Stephane Bergeron, who had trained in the McGill orthopedic program, followed by fellowships in sports medicine in Alabama, and trauma at Harvard, was recruited. His main interests and passions are trauma and teaching. Dr Bergeron has won the “resident teacher of the year award” from the McGill orthopedic program for the last two years. He completed an MPH at Harvard and joined the already active JGH orthopedic research program.

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Currently there are seven full-time members, including Dr John Antoniou, Dr Stephane Bergeron, Dr Ruth Chaytor (recently appointed chief of surgery of the JGH), Dr Olga Huk, Dr Leonard Rosen, Dr Monika Volesky, and Dr David Zukor. Additionally, Dr Peter Jarzem continues working in spine surgery here on a part-time basis (because his main appointment is at the Montreal General Hospital). The current scope of activities includes: hip and knee arthroplasty with four surgeons essentially dedicating their practices full-time to this (Dr Antoniou, Dr Huk, Dr Rosen, and Dr Zukor). The volume of arthroplasty remains one of the highest in Quebec. Foot and ankle surgery (Dr Chaytor and Dr Volesky) is also a busy sphere of activity dealing with many complex issues staff, but especially by Dr Bergeron, who also works part-time at Lasalle Hospital. The JGH is one of the only departments in Quebec (and possibly in Canada) to have two Fellowship-trained foot and ankle surgeons. A full spectrum of foot and ankle care (including care/surgery of very complex cases) is provided, with one of the unique features being total ankle arthroplasty. Fellowship training was initiated in 2012. Since 2007, the Department has been providing 24 /7 day coverage to Lasalle Hospital for orthopedic care of their patients. This arrangement has benefited not only the Department of Orthopedic Surgery but the whole Department of Surgery of the JGH. After making this arrangement, outpatient operating time at Laslle became available to all divisions and departments of Surgery within the JGH. The JGH Department of Orthopedic Surgery has become a recognized leader in hip and knee arthroplasty with a national and international reputation. This is based on • a high volume of activities (approximately 600–700 joint replacements per year). • a very significant research program with numerous presentations and publications on an ongoing basis. Strong resident training and since 2006 Fellowship training of arthroplasty surgeons from around the world. While most of the volume of surgery includes primary hip and knee arthroplasty, a significant number of revision operations are also done as well as complex primary cases. A very unique component is the diabetic foot clinic started in 1997 and run by Dr Chaytor (now in conjunction with the Department of Family Medicine),

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which has garnered an outstanding reputation and is now being studied and will be used as the model of care for these patients by the Ministry of Health of Quebec. The Department continues to provide a significant level of service in this very busy hospital. The emergency room at the JGH has become one of the busiest (if not the busiest) in Quebec and has a very significant volume of level 2 trauma. We care for between 300–400 patients with fractured hips alone in our department per year, in addition to a whole variety of traumatic conditions. The research program has evolved significantly and now includes a wellstaffed basic science lab at the LDI under the directorship of Dr John Antoniou and Dr Fackson Mwale. A significant number of master’s and doctoral students and others participate in research activities there. There is also a very strong clinical component of research headed primarily, but not exclusively, by Dr John Antoniou with a consistently increasing number of presentations at national and international readings and publications in peer review journals. The Department of Orthopedics has been a leader in surgery at the JGH, having been the first department to create care pathways, to use pre-printed orders, and to initiate same-day admissions for surgical treatment. The in-patient orthopedic nursing unit on 8 West has been noted to provide excellent care and to a certain extent is a model for other nursing units. The extremely busy, understaffed and somewhat cramped orthopedic outpatient clinic tries to keep up with an incredibly high level of demand for its services and it is hoped that the imminent move to Pavillon K will allow the physical plant to expand as space within the existing hospital becomes available. From 1984 until the present, the Department of Orthopedic Surgery at the JGH has seen significant development and growth. We have become recognized nationally and internationally for excellence in arthroplasty and foot and ankle care and for our research output. We are well-regarded and this is evidenced especially by the requests by students both locally and internationally as well as residents and fellows to train at the JGH. As we are about to embark on yet another venture – the move to Pavilion K – we are hopeful that this will allow us to continue to grow and develop . For the past fifteen years, we have built up a network of national and international collaborators to help in our research mission. Our research activities have attracted an increasing number of students from different countries to pursue MSc and PhD studies while the international recognition of our clinical work has attracted fellows from Europe and the Middle East to our arthroplasty fellowship program. For the last five years, we have supervised and co-supervised

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more than fifty surgical fellows and orthopedic residents, and more than twentyfive undergraduate students. Since 2000, our research team has attracted over thirty peer-reviewed grants and industry-related clinical studies (over $5,550,000). We have also published and co-authored over 140 original articles in peer-reviewed journals, including the Journal of Bone and Joint Surgery, Journal of Arthroplasty, JAMA Surgery, Hip International, Journal of Orthopedic Research, Arthritis Research and Therapy, Biomaterials, and Arthritis & Rheumatism. In the last five years, we presented over 250 abstracts at national and international meetings and our team presented our work in more than eighty international conferences, workshop symposiums, and courses in the United States, Japan, Israel, England, Australia, New Zealand, Brazil, Italy, Greece, Belgium, and China.

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d r ger a l d bat i st Dr Batist was born in Montreal and attended Herzliah High School. He went to Columbia University in New York City, and then returned for medical school at McGill University. This was followed by post-doctoral training in New York, Boston and finally at the National Cancer Institute in Washington. He trained in medical oncology and molecular pharmacology. In 1986 he returned to Montreal to build his research program and clinical practice. During that first year though, he devoted almost half his time to Soviet Refuseniks suffering from cancer, and worked for their release and treatment. Dr Batist is best known to us as the director of the Segal Cancer Centre at the Jewish General Hospital, which was built after he led a successful grant proposal to the Canadian Foundation for Innovation. At the core of “the Segal” is the McGill Centre for Translational Research in Cancer, which Dr Batist established to stimulate rapid translation of new discoveries in the research laboratory into clinical benefits for patients. Until 2011, Dr Batist was chairman of Oncology at McGill, where he nurtured the development of a number of multidisciplinary programs that have been highly innovative and among the first of their kind in Canada. He leads a highly successful laboratory and clinical research program, with over 200 scientific publications and a number of book chapters relating to his research interests, and has been honoured by his scientific colleagues on several occasions. Dr Batist is a network-builder, having helped establish the World Innovation Network, a Paris-based group of over thirty-five major cancer centres from four different continents, all working on personalized medicine in cancer. He has built a similar consortium in Quebec. In 2014 he raised more than $35 million and

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Gerald Batist. JGH Audio-Visual Services Department.

William Foulkes. JGH Audio-Visual Services Department.

was awarded a grant from Ottawa that established the National Centre of Excellence in Personalized Medicine. In 2016 Dr Batist joined the JGH with the Montreal Ecole Polytechnique to win a Canada First Award worth $35 million, in order to bring a game-changing new anti-cancer approach to cancer treatment to the clinic. He is also very active in patient advocacy groups. In 2016, Dr Batist was awarded both the Ordre National du Québec and the Order of Canada.

d r w i l l i a m fo u l ke s Dr Will Foulkes is director of the Program in Cancer Genetics, based at McGill University in the Departments of Oncology and Human Genetics. He is also head of the Cancer Genetics Laboratory at the Lady Davis Institute for Medical Research. He is a James McGill Professor of Medicine, Human Genetics and Oncology at McGill University, and holds a FRSQ Chercheur national award. His work has focused on inherited susceptibility to cancer, mainly of the breast and colorectum. He is a clinician, who has been in charge of clinical cancer genetics at all McGill-affiliated hospitals since 1996.

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He is best known for his work on the clinico-pathological features of hereditary breast cancer, for his discovery of a founder mutation in MSH2 in the Ashkenazim, and for his identification of a founder mutation in the breast cancer susceptibility gene PALB2. He has also collaborated extensively with researchers around the world to better understand the genetics of breast, colorectal, prostate, pancreatic, and ovarian cancer. He has been the scientific organizer of the Montreal-based biennial Hereditary Breast and Ovarian Cancer conference since its inception in 2005. At the last conference, over 400 attended the three-day meeting. Dr Foulkes’s lab works on several aspects of inherited susceptibility to cancer, often generating data from individuals and families who present at his clinic. He is particularly interested in following up single families with unusual phenotypes. He is currently working on susceptibility to breast, colon, and ovarian neoplasms.

d r ph i l i p gord on Dr Gordon is the founding president of the Canadian Society of Colon and Rectal Surgeons, past president of both the American Society of Colon and Rectal Surgeons and of the American Board of Colon and Rectal Surgeons, and former director and senior surgeon, Division of Colon and Rectal Surgery, Sir Mortimer B. Davis Jewish General Hospital. He is vice-chairman, Department of Surgery, Sir Mortimer B. Davis Jewish General Hospital; professor, Departments of Surgery and Oncology, McGill University; and director, Section of Colorectal Surgery, McGill University. He is the author of seven textbooks, including the gold-standard textbook Principles and Practice of Surgery for the Colon, Rectum and Anus and is on the editorial board of sixteen peer-reviewed medical journals. Dr Gordon was named to the McGill Faculty Honour List for Educational Excellence. He was recently honoured by the Jewish General Hospital for his “devotion and dedication to the advancement of colorectal surgery, locally, nationally and internationally.” The Annual Colorectal Lectureship of the Canadian Society of Colon and Rectal Surgeons has been named in his honour.

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Philip Gordon. JGH Audio-Visual Services Department.

Susan Kahn. JGH Audio-Visual Services Department.

d r su s a n ka h n In recognition of the seriousness and prevalence of venous thromboembolism (VTE), the Canadian Institutes of Health Research (CIHR), the Fonds de recherche Québec – Santé (FRQS), and a consortium of public and private funders, including the Lady Davis Institute (LDI) at the Jewish General Hospital (JGH) and McGill University, and the Ottawa Hospital and the University of Ottawa, have invested $5.2 million over five years to establish the Canadian Venous Thromboembolism (VTE)) Clinical Trials and Outcomes Research Network (to be known as CanVECTOR). Dr Susan Kahn and Dr Marc Rodger are co-principal investigators and directors of the project, the first of its kind in the world. Dr Kahn is a senior investigator at the LDI and head of the Centre of Excellence in Thrombosis and Anticoagulation Care (CETAC) at the JGH. Dr Marc Rodger is a senior scientist and head of the Thrombosis Program at the Ottawa Hospital and chair in Venous Thrombosis at the University of Ottawa. CanVECTOR’s objectives include reducing VTE occurrence, improving VTE diagnosis and therapeutic management, improving the safety of anticoagulant

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delivery, and enhancing the quality of life of those affected by VTE, both in Canada and globally. “VTE is the second most common cardiovascular disorder after heart attack,” points out Dr Kahn, a professor of medicine at McGill and Tier 1 Canada Research Chair. “Pulmonary embolism, a blood clot to the heart or lungs – the most serious form of VTE – is the third leading cause of cardiovascular death. Ten per cent of patients who suffer pulmonary embolism will die rapidly prior to diagnosis, which highlights the importance of preventing VTE. Moreover, VTE imposes life-long burdens on many patients because it frequently becomes chronic, including recurrent episodes of VTE, the post-thrombotic syndrome (PTS), and chronic thromboembolic pulmonary hypertension.” The cost to treat a single case of acute VTE is more than $10,000. The estimated total burden of VTE and its complications in Canada is at least $600 million per year, not including such indirect costs as loss of productivity, which affects patients, families, and society in general. Such data underscores the value of the investment being made into the CanVECTOR Network. “As prevalent as VTE is, there are important gaps in our knowledge that only focused research can hope to fill,” added Dr Rodger. “We have yet to identify causal factors for first and recurrent VTE. We observe inconsistent use of proven measures to prevent VTE, as well as limited community expertise in diagnosing and managing VTE and its complications, and limited knowledge of VTE among the general public. There is an urgent need to improve therapeutic options. While anticoagulant drugs have proven to be effective, they are associated with severe adverse effects – namely, life-threatening bleeding. Moreover, the demands they impose on patients include injections, frequent laboratory monitoring, and lifestyle and diet modifications. New oral anticoagulants have recently been developed, but their long-term effectiveness and safety have yet to be determined.” The project includes sixty-one investigators based at universities spread across nine provinces. Among the participants are clinician-scientists, basic researchers, nurses, health economists, methodologists, as well as patient partners. It is rather innovative to include patients when designing research questions, but crucial as they have unique insight into the aspects of disease that are of most concern to their particular circumstance. “We are determined to focus on questions that can be translated into clinical practice so that our research will have a direct impact on public health,” said Dr Kahn.

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World Thrombosis Day, 13 October, is an event that increases global awareness of thrombosis as an urgent and growing health problem. The chair of the Steering Committee for World Thrombosis Day, Dr Gary Raskob, dean of the College of Public Health at the University of Oklahoma, said, “CanVECTOR will make major contributions to reducing premature death from VTE. This visionary partnership exemplifies the spirit of the World Thrombosis Day movement by bringing together public and private partners, government agencies and private funders, universities and health systems, health professionals and patients, all working toward the common goal of reducing the burden of disease from thrombosis and improving global health.” Dr Kahn was awarded a seven-year CIHR Foundation grant in 2015, and has published more than 200 papers in the field of thromboembolism. In 2016, she was elected to a fellowship in the Canadian Academy of Health Sciences (CAHS), considered one of the highest honours for members of the Canadian health sciences community. Also in 2016, she was awarded the Canadian Society of Internal Medicine (CSIM) Dr David Sackett Senior Investigator Award. This award recognizes excellence in research by a senior Canadian general internist, and is intended to increase awareness of high-quality research by general internists in Canada and to foster such research.

d r l au ren ce k i r m ayer Laurence J. Kirmayer, MD, FRCPC, FCAHS is James McGill professor and director, Division of Social and Transcultural Psychiatry, Department of Psychiatry, McGill University. He is editor-in-chief of Transcultural Psychiatry, and director of the Culture and Mental Health Research Unit at the Institute of Community and Family Psychiatry, Jewish General Hospital in Montreal, where he conducts research on cultural responsive mental health services for immigrants and refugees, the mental health of Indigenous peoples, and the anthropology of psychiatry. He also founded and directs the Network for Aboriginal Mental Health Research. His past research includes studies on cultural consultation, pathways and barriers to mental health care for immigrants and refugees, somatization in primary care, cultural concepts of mental health and illness in Inuit communities, risk and protective factors for suicide among Inuit youth, and resilience among Indigenous peoples. Current projects include: mental health promotion for Indigenous youth; the integration of ethnography and neuroscience

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Laurence Kirmayer. JGH AudioVisual Services Department.

Sheila Kussner. JGH Audio-Visual Services Department.

in global mental health; and models of mental health services for multicultural societies. He has co-edited the following: Understanding Trauma: Integrating Biological, Clinical, and Cultural Perspectives (Cambridge University Press), and Healing Traditions: The Mental Health of Aboriginal Peoples in Canada (University of British Columbia Press); Cultural Consultation: Encountering the Other in Mental Health Care (Springer); the DSM-5 Handbook for the Cultural Formulation Interview (APPI): and Re-Visioning Psychiatry: Cultural Phenomenology, Critical Neuroscience and Global Mental Health (Cambridge). He is a Fellow of the Canadian Academy of Health Sciences. He founded and directs the annual Summer Program and Advanced Study Institute in Cultural Psychiatry at McGill.

s h ei l a k u s s n er The news that shattered Sheila Kussner’s idyllic childhood came at the age of fourteen, as she relaxed with her mother, Sophie Golden, in the back seat of the family car on a drive through the countryside near Montreal in 1946.

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“Mummy and I have something to tell you,” said her father Jack, his eyes fixed on the road ahead. From the tone of his voice, Sheila knew: The results of the biopsy on her left knee had come in and a diagnosis had been made. It was cancer, her mother said, and the only way to save her life was to amputate her left leg above the knee. “You have a choice,” Mrs Golden continued. “Either you have your leg amputated and we have a daughter, or you’re going to die and we don’t have a daughter.” Stunned and angry, Sheila felt her mother’s words hit her like bullets. “The doctors are stupid!” she cried. “I don’t believe you!” Silently, Mrs Golden reached into her purse and withdrew telegrams from six of the world’s top bone specialists, all of whom had confirmed the diagnosis. “Think about it,” Mr Golden said gently. “We have only one daughter. Even with only one leg, there’s a lot of life left in you and a lot you can do.” A lot is exactly what Sheila accomplished as the eventual founder of Hope & Cope at the Jewish General Hospital. Sheila had the surgery that not only saved her life, but changed it profoundly. Several times a year, she was contacted by doctors who were familiar with her case, and they asked her to visit young cancer patients facing the terrifying prospect of amputation. With empathy and compassion born of her experiences, Sheila reached out to those young patients, providing them with what Hope & Cope offers now – encouragement and advice. It was a potent formula that also later helped to save the life of her husband, Marvyn Kussner. In addition, she assembled a team of dedicated professionals to help make Hope & Cope an international pioneer in psychosocial assistance during treatment and recovery from cancer. She became the driving force behind the JGH Hope & Cope Wellness Centre (also known as Lou’s House), which opened in 2007. And she helped establish the Christine and Herschel Victor Hope & Cope Research Chair in Psychosocial Oncology at McGill University. Hope & Cope has been instrumental in sparking a revolution in attitudes and approach by championing the notion that emotional, psychological, and spiritual needs must assume greater importance, as patients forge intimate bonds with volunteers. Sheila also foresaw the importance of a multidisciplinary, teambased approach to care, with the patient as the central focus. As well, she was an early advocate of the “speak up” philosophy, in which patients are encouraged to express themselves when they believe that some aspect of their treatment is not being handled properly. Not only did Sheila voice her own concerns about weaknesses in the system of cancer care, she took the initiative to fill the gaps by founding Hope & Cope, thereby lightening the burdens

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of thousands of patients and their loved ones. She was also instrumental in securing major support from Majorie Bronfman to create the JGH’s first dedicated unit for palliative care. In acknowledgement of her accomplishments, Sheila has received wide recognition, including being named an Officer of the Order of Canada, an Officer of the Order of Quebec, and Governor Emerita of McGill University, which also awarded her an LLD degree (honoris causa). In 1995, the Jewish General Hospital presented her with its highest honour, the Distinguished Service Award. In November 2010, she received an honorary doctorate from the Faculty of Nursing at the University of Montreal, attesting to her broad influence in health care. Decades later, Sheila credited her parents for providing her with the model of patience, compassion, courage, and determination upon which Hope & Cope is based. “They were absolutely wonderful,” she said, “because they refused to let me believe I was inferior. This was a remarkable attitude for the time, because in the 1940s people were uncomfortable even mentioning the word ‘cancer,’ let alone talking about it. I still remember how some of the kids at school wouldn’t share a sandwich or a drink with me because they were afraid they’d catch the disease.” Despite these obstacles, Sheila’s parents encouraged her to live a full life and to attend summer camp, where she became a counsellor and met Marvyn Kussner. “My being an amputee didn’t have the slightest effect on the way he felt about me,” Sheila recalled. “In fact, he was very adamant about it. I really don’t think many couples have such a strong relationship.” Sheila went on to McGill University, where she earned a BA in 1953. She and Marvyn got married and had two daughters, and through the years, Sheila became active in community organizations, where she served in key positions. But fate intervened once again in 1974, when Marvyn, at the age of forty-four, was diagnosed with a serious form of lymphoma. Determined to find out more about this disease, Sheila was able to turn up only a single outdated book stating that a patient with this particular cancer could expect to live no more than three years. “I was sure there had to be an easier way to deal with cancer than what we went through,” Sheila explained. “And I really wondered what was happening to people who lacked the financial means or the family support that I was fortunate enough to have.” Convinced of the need for and viability of a resource centre staffed by trained volunteers who themselves had gone through the cancer experience, Sheila began contacting medical professionals. Initially, her idea met with skepticism from doctors, who feared the volunteers would stray beyond their mandate. However, she found a receptive audience at the Jewish General Hospital when Archie De-

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skin, who was then executive director, suggested she contact the JGH Auxiliary. Phyllis Waxman, president of the Auxiliary at the time, embraced the idea and in 1981, JGH Hope & Cope was born. In 1989, Hope & Cope was recognized as such an important adjunct to the care provided by the JGH’s oncology department that it became an independent organization. It has since evolved into a model for cancer centres and hospitals throughout the world. “When we started, I never imagined our work would extend into palliative care or that we would open our own Wellness Centre,” said Sheila, who has served as chairman since the beginning. “But the sad fact is, cancer seems to be more prevalent than ever, and there’s a growing need for what we do.” When she stepped down in 2012 after thirty-one years as the founding Chair of Hope & Cope, Sheila graciously accepted congratulations on a job well done – but not before getting the last word. In a tone as characteristically dynamic as it was self-deprecating, she told well-wishers, “Let’s call it a job partly done. There’s still more to do. “What all this has taught me is the importance of listening – really listening – when someone with cancer has something to tell you. Only then can you offer the right programs and services to meet their needs, which is what Hope & Cope has always done.” Despite having devoted an extraordinary amount of time to Hope & Cope, Sheila said she has no regrets about her commitment to what she calls her “amazing journey. The rewards have more than outweighed the sacrifices, and I’m proud of where Hope & Cope is today. In fact, I believe I was put on this earth so that Hope & Cope could be what it is and what it will still become.”

d r dav i d l a n g l e b en Dr David Langleben, who joined the medical staff of the Jewish General Hospital in 1986, has been chief of the Division of Cardiology since 1997. Under his leadership, the division has become a major referral centre, known for its expertise in an entire spectrum of cardiac care. Dr Langleben is an associate professor in the McGill University Faculty of Medicine, and a project director at the Hospital’s Lady Davis Institute for Medical Research. Dr Langleben’s area of expertise is pulmonary hypertension. He founded the first pulmonary hypertension clinic in Canada, which has evolved into the internationally recognized Centre for Pulmonary Vascular Disease. His research

David Langleben. JGH Audio-Visual Services Department.

Richard Margolese. JGH Audio-Visual Services Department.

interests include the development of new medications for pulmonary hypertension; lung vascular metabolism; the behaviour and function of lung vascular cells; vascular cell biology; and the epidemiology of pulmonary hypertension.

d r r i ch a rd m a rgo l e s e Dr Richard Margolese is the Herbert Black Chair in Surgical Oncology and professor in the Departments of Surgery and Oncology at McGill University.

Research Interests Dr Margolese is involved in clinical trials of promising new anti-cancer therapies and clinical trials in breast cancer surgery, adjuvant therapy in breast cancer, and breast cancer prevention. Dr Margolese has been involved in clinical research studies in breast cancer. He and his colleagues have shown that radical breast surgery can be replaced by breast-conserving surgery, and that adding chemotherapy and hormone therapies such as tamoxifen can improve long-term outcomes by diminishing the re-

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currence rate. In one of these trials comparing tamoxifen after surgery to surgery alone, they showed that not only was the cure rate improved but that new cancers in the opposite breast were diminished. This led to the idea of prevention and, indeed, two prevention trials have successfully shown that approximately half of the cancers can be prevented in selective women with high-risk profiles. These trials continue and Dr Margolese continues his involvement in modern clinical trials.

ro der i ck r. m c i n n e s , c m , m d , ph d , f rs c Dr McInnes is the director of the Lady Davis Institute of the Jewish General Hospital, Alva Chair in Human Genetics, Canada Research Chair in Neurogenetics, and Professor of Human Genetics and of Biochemistry at McGill University. Until 2009, he was a University Professor of the University of Toronto. He was previously the head of the Program in Developmental Biology at the Research Institute of the Hospital for Sick Children, an International Research Scholar of the Howard Hughes Medical Institute, and, from 2000 to 2010, the inaugural scientific director of the Institute of Genetics of the Canadian Institutes of Health Research. He has made important contributions to the understanding of the molecular basis of retinal and eye development, and to the identification of genes and processes associated with inherited retinal degenerations. Recently, he and his collaborators discovered a novel pair of synaptic accessory proteins that modulate the activity of ion channels in the nervous system. He is one of three coauthors of the 5th, 6th, 7th, and 8th editions of Thompson and Thompson’s Genetics in Medicine. Among other honours, Dr McInnes is a Fellow of the Royal Society of Canada and the Canadian Academy of Health Sciences. He was appointed to the Order of Ontario in 2008, and became a member of the Order of Canada in 2009. In 2010, Dr McInnes was the president of the American Society of Human Genetics.

d r m ax pa l ayew Dr Max Palayew was chief of the JGH Department of Radiology from 1971 to 1992. At McGill University, Dr Palayew was professor of radiology and chairman

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Roderick R. McInnes. JGH AudioVisual Services Department.

Max Palayew. JGH Audio-Visual Services Department.

of the Department of Radiology from 1978 to 1987. In 2009, he was named professor emeritus. Dr Palayew received his medical degree from the University of Montpellier in France and trained in radiology at the JGH, the Beth Israel Hospital in Boston, and the Cincinnati General Hospital. He was a member of numerous professional associations and served as national president of the Canadian Association of Radiologists, and as administrator of the Board of the Professional Corporation of Quebec Physicians. Dr Palayew was also a visiting professor at universities throughout North America, Europe and Asia. He received numerous honours, including the Albert Jutras Award from the FrancoCanadian Radiology Society “in recognition for an outstanding career and exceptional contributions to radiology.” Dr Paleyew died in 2015. In a statement to staff, Dr Mark Levental, JGH chief of radiology, described Dr Palayew as “a dynamic individual who loved every aspect of radiology and was an outstanding teacher who influenced generations of young radiologists. His friendly and charismatic personality will forever live in our hearts. It was a great honor and privilege to have been his student, resident and colleague.”

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d r l e ona rd p i n s k y The Centre for Human Genetics was created in 1979. The choice of an integrative “Centre” rather than a classical independent department was based on the concept that the discipline of genetics should be integrated into all sectors of human biology and medicine: clinical, teaching, and research. The first director of the Centre for Human Genetics was Dr Leonard Pinsky (who later became the first chair of the Department of Human Genetics). The objectives of the Centre are 1 to provide a corporate address/image for human/medical genetics on the greater university campus (including its teaching hospitals); 2 to promote the relevance of genetics to the categorical disciplines of biomedicine and the recruitment of human/medical geneticists to their respective departments; 3 to foster research, partly by creating a forum for supervisors to interact with graduate students who work in various locales; 4 to coordinate genetic health-care activities among the hospitals concerned, and to represent that coordination externally; 5 to conduct the MSc program in genetic counselling; and 6 to participate in the teaching of human and medical genetics at all levels – from baccalaureate undergraduate to medical postgraduate.

d r l aw ren ce ro s en b erg As a medical student, Dr Lawrence Rosenberg’s goal was to become a surgeon. Along the way, his interests shifted and today he is one of the leading researchers on pancreatic endocrine failure. As a result, he started a PhD on pancreatic betacell differentiation in the hamster, during which he made a serendipitous discovery that would shape the remainder of his career: “We were able to re-grow insulin-producing cells in laboratory animals,” he explains. This fundamental breakthrough was the springboard for all his subsequent – and ongoing – research in the field. Within the next five years, it could lead to the first novel therapy of type 1 diabetes since the discovery of insulin. After post-doctoral training at the University of Michigan, where he learned transplant surgery, Dr Rosenberg accepted a permanent position in the Department of Surgery at McGill University in 1987. In 1988 he developed the

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Leonard Pinsky. JGH Audio-Visual Services Department.

Lawrence Rosenberg. JGH AudioVisual Services Department.

pancreatic transplant program, and also performed the first successful liver transplant at McGill. He is now a professor in the departments of Medicine and Surgery in the McGill Faculty of Medicine and was the director of the Division of Surgical Research at McGill University from 1997–2009. The quality of Dr Rosenberg’s work has earned him many honours, including the Nesbitt McMaster Award for Excellence in Medicine and Surgery from 1997 to 2001, the FRSQ Senior Clinician-Scientist Award from 1997 to 2001, and the FRSQ National Researcher Award from 2001 to 2006. He is also the author of a bibliography of over 200 references, over 100 of which are papers published in peer-reviewed publications. Given its potential impact, Dr Rosenberg’s research into diabetes treatments has received a significant amount of private funding, and has led to several patents. Dr Rosenberg has become an internationally renowned medical administrator; in addition to being the executive director of the SMBDJGH, on 1 April 2015 he became the president-director general of the Centre intégré universitaire de santé et de services sociaux (CIUSSS) du Centre-Ouest-de-l’Île-de-Montréal. This new health-care region in west-central Montreal came into existence on 1 April when Quebec’s public health-care system was reorganized.

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The institutions in this CIUSSS are the Jewish General Hospital, the Donald Berman Maimonides Geriatric Centre, Mount Sinai Hospital, Miriam Home and Services, the Jewish Eldercare Centre, the Constance-Lethbridge Rehabilitation Centre, the Cavendish Health and Social Services Centre (CSSS), the de la Montagne Health and Social Services Centre (CSSS), and MAB-MacKay Rehabilitation Centre (MMRC).

d r dav i d ro s en bl at t A Canadian medical geneticist and pediatrician, Dr Rosenblatt is professor in the Departments of Human Genetics, Medicine, Pediatrics, and Biology at McGill University in Montreal, Quebec, where he was the chairman of the Department of Human Genetics from 2001–13. He is known for his contributions to the field of inborn errors of foliate and vitamin B12 metabolism. Rosenblatt received a bachelor of science from McGill University in 1968 and an MD, CM from the Faculty of Medicine at McGill University in 1970. After completing an internship in pediatrics at the Montreal Children’s Hospital (1970– 71), he pursued postgraduate training in medical genetics and foliate metabolism at the Massachusetts General Hospital under the supervision of Dr John Littlefield and Dr Richard Erbe (1971–73), and in biology at the Massachusetts Institute of Technology under Malcolm Gefter (1973–74), finishing with a residency in pediatric medicine at the Boston Children’s Hospital (1974–75). Rosenblatt was first appointed in the Department of Paediatrics at McGill in 1975, and was the chairman of the Department of Human Genetics from 2001– 13. He holds the Dodd Q. Chu and Family Chair in Medical Genetics. He is actively involved in research and patient care, as well as graduate and medical student teaching. He has acted as supervisor and mentor to more than thirty-five graduate students and post-doctoral fellows, and has authored over 200 publications in peer-reviewed journals. In 1995 he was made a Correspondant étranger of the Académie nationale de médecine (France), and in 2005, he was elected as a Fellow of the Canadian Academy of Health Sciences. In 2013 he was named a Champion of Genetics by the Canadian Gene Cure Foundation. He has served as president of the Society for Inherited Metabolic Disorders, the Canadian Society for Clinical Investigation, and the Association of Medical Geneticists of Quebec.

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er n e sto l . s ch i f f r i n Dr Ernesto L. Schiffrin (MD Buenos Aires ’69, PhD in experimental medicine, McGill University ’80) is physician-in-chief, Department of Medicine, at the Jewish General Hospital; Canada Research Chair in Hypertension and Vascular Research, Lady Davis Institute for Medical Research; and professor and vice-chair (Research), Department of Medicine, McGill University. Dr Schiffrin also directs the Cardiovascular Prevention Centre at the hospital, where he carries out his clinical research. Dr Schiffrin was previously professor of medicine at the University of Montreal (until December 2005), director of the Multidisciplinary Research Group in Hypertension of the Medical Research Council of Canada (later Canadian Institutes of Health Research) and the Hypertension Clinic at the Clinical Research Institute of Montreal (IRCM), and staff member in the Division of Internal Medicine, Hôtel-Dieu Hospital. Dr Schiffrin has served on committees of the Canadian Heart Foundation and Medical Research Council of Canada (MRC). He was a member (1987–89), then chair, of the Cardiovascular B grants committee of the MRC (1989–92). In June 2008, Dr Schiffrin co-chaired the Working Group on Target Organ Damage in Hypertension for the National Heart, Lung, and Blood Institute (NHLBI), which prepared goals for the NIH to launch RFAs in the field of hypertension, and which have been posted on the NHLBI website. Dr Schiffrin has been the associate editor of the American Heart Association (AHA) journal Hypertension since August 2003. Dr Schiffrin was elected as a Fellow of the Royal Society of Canada in 2006. He is the recipient of the 2007 Irvine Page-Alva Bradley Lifetime Achievement Award of the High Blood Pressure Research Council of the American Heart Association and the 2010 Bjorn Folkow Award of the European Society of Hypertension. The governor general of Canada appointed Dr Schiffrin a Member of the Order of Canada in 2010 for his important contributions to the study of hypertension, notably through his research on the mechanisms underlying high blood pressure, as well as for his leadership roles in scientific committees and societies. Dr Schiffrin has received the 2011 Excellence Award for Research in Hypertension of the American Heart Association. The citation of the award reads: “For his pioneering translational work leading to discovery of mechanisms involved in the remodeling of small resistance arteries in experimental and human hypertension. His ground-breaking research demonstrated that antihypertensive therapy electively causes regression of vascular remodeling in hypertensive patients. His seminal studies on an-

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David Rosenblatt. JGH Audio-Visual Services Department.

Harvey Sigman. JGH Audio-Visual Services Department.

giotensin II, aldosterone, and endothelin have elucidated the importance of these hormones in the vascular biology of hypertension.” Dr Schiffrin was named the 2013 American Society of Hypertension (ASH) Distinguished Scientist and received the Robert Tigerstedt Award in May 2013 in San Francisco, CA, for his outstanding achievements in the field of hypertension and his contribution to both endocrinology and circulation. In October 2013, the Canadian Cardiovascular Society (CCS) awarded Dr Schiffrin the 2013 CCS Research Achievement Award, one of the Society’s most prestigious honours, for his contribution to Canadian cardiovascular health and care and invited him to present on his research at its annual meeting in Montreal. On 19 October 2013, Dr Schiffrin was elected president of Hypertension Canada.

d r h a rvey s i g m a n , m s c Dr Sigman is a surgeon at the Sir Mortimer B. Davis Jewish General Hospital and emeritus professor of surgery, in the Department of Surgery at McGill University.

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Dr Sigman is a general surgeon and also does laproscopic surgery. Dr Sigman graduated from McGill University Faculty of Medicine in 1957. He trained in general surgery in the McGill Diploma Course, which included a registrarship at the Postgraduate Medical School, Hammersmith Hospital, London, England. He served as Dr L.D. Maclean’s first chief resident in 1962 at the Royal Victoria Hospital. He began his surgical career at the Jewish General Hospital and he became chief of the Division of General Surgery (1989–2008). Education has always been Dr Sigman’s priority and over the years he has served as director of Surgical Education at the Jewish General Hospital (1969– 2002), where he integrated the training of surgical students into the unversity program. He was assistant dean, medical education and student affairs, McGill University, (1993–97); chair of the Curriculum Committee of the Association for Surgical Education, (1995–97); co-chair of McGill University Institutional Review Board, (2000–). Dr Sigman, with Dr Jacques Garzon, introduced laparoscopic surgery to the Division of General Surgery at the Jewish General Hospital in 1990. He played an important role in creating a coordinated university program to develop teaching and research in this new field. The SMBDJGH was thus one of the first Canadian centres to introduce laparoscopic surgery. He became a sexual harassment officer at McGill University in 1998, and was coordinator of the Sexual Harassment Office (2001–06). He received the McGill University Department of Surgery Residents’ Award for Excellence in Teaching in 1992. He was named to the Faculty Honour List for Educational Excellence in its inaugural year (1998). He is a recipient of the Queen’s Silver Jubilee Medal. The Harvey H. Sigman Lecture in Surgical Education, recognizing Dr Sigman’s lifelong commitment to education, was established to enhance the Surgical Education Program at the Sir Mortimer B. Davis Jewish General Hospital and McGill University.

m a r k wa i n b erg Dr Wainberg’s lab conducted cutting-edge research on differences among various HIV subtypes in their ability to develop drug resistance and the deeper mechanistic bases of these differences. This is important as HIV variability is widespread. Fewer than 10 per cent of all new infections worldwide can be

Outstanding People

Ernesto L. Schiffrin. JGH AudioVisual Services Department.

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Mark Wainberg. JGH Audio-Visual Services Department.

attributed to subtype B viruses, which remain the predominant type in North America. Based in large part on Dr Wainberg’s data, the World Health Organization recently removed one of the most popular anti-HIV drugs in the world from the recommended list, because it was found to promote the rapid onset of drug resistance. Dr Wainberg’s laboratory also studied the use of anti-retroviral drugs to prevent the transmission of HIV, while exploring whether drug resistance and the creation of drug-resistant viruses might be a negative consequence of this preventive approach. Until his premature death in April 2017, Dr Mark A. Wainberg was head of AIDS research at the Lady Davis Institute for Medical Research (LDI), director of the McGill University AIDS Centre located at the LDI, and professor of medicine and of microbiology and immunology at McGill University in Montreal. He was an internationally recognized scientist in the field of HIV/ AIDS, who served as president of the International AIDS Society between 1998 and 2000 with responsibilities that included organizating the 13th International Congress on AIDS in Durban, South Africa in 2000. Dr Wainberg was proud of the role that he played in choosing South Africa as a venue for this congress, which had an important effect on the issue of access to anti-HIV drugs in developing countries.

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Dr Wainberg was well known for his initial identification of 3TC as an antiviral drug, in collaboration with BioChem Pharma Inc, in 1989, as well as for multiple contributions to the field of HIV drug resistance. His laboratory continues to work in the fields of drug resistance and drug development. Dr Wainberg also turned his attention to novel concepts in the prevention of HIV infection in developing countries, such as vaginal microbicides and pre-exposure prophylaxis. He was co-chair of the Sixteenth International AIDS Conference that took place in Toronto in 2006. Dr Wainberg was a member of numerous international advisory committees in the field of AIDS. Among other distinctions, he was a Fellow of the Royal Society of Canada, an Officer of the Order of Canada, an officer of the Ordre National du Quebec, an honorary fellow of the Royal College of Physicians and Surgeons of Canada, and a Chevalier in the Legion d’Honneur of France.

ch ap ter one

con clu s i on

In this account of the life of the Sir Mortimer B. Davis Jewish General Hospital, I have stressed the history of Jewish hospitals throughout the world. For dietary reasons and because of the western world’s growing anti-Semitism in the nineteenth and twentieth centuries, Jewish hospitals were founded all over the world. I have presented a history of the close association of medicine and the Jews. It is remarkable how closely associated the Jewish religion is with prophylactic medicine. So many of the religious laws are related to hygiene, laws on the preparation of food, on hand washing, etc. Included is a biography of Sir Mortimer Barnett Davis, who, years after his death, became an important benefactor of the hospital, as well as his wife, Lady Henriette Davis. Allan Bronfman was an important initial force getting the hospital constructed. I have added a chapter on the importance of the executive directors, especially Mr Samuel Cohen (1934–68), who was responsible for setting up the hospital, getting it going, and operating it for its first thirty-four years. Following this, I have modified some of the text of Alexander Wright, written on the fiftieth anniversary of the hospital. It tells the story of the initial efforts to provide medical and, especially, obstetrical help to the increasing Jewish population of Montreal during the early twentieth century. Then came the realization that what was really needed was a general hospital that would provide both medical and obstetrical services. I have described the progress over the past thirty-two years, a period that has truly advanced the hospital as a major player in the McGill medical health network. Many of the department chiefs have been or are currently heads of their university departments. The Lady Davis Research Institute has become a leading research centre in Canada. Much of the outstanding progress in the treatment and eradication of HIV has come from the LDI.

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I have asked the heads of various departments to outline the progress of the past thirty-two years. And finally I have added a chapter on the many really outstanding individuals who have contributed so much to world knowledge of medicine. The progress of a Jewish hospital from a small community hospital into a major player in the local university medical school has been repeated all over North America: Toronto, New York, Boston, St Louis, Los Angeles, etc., for example, the Jewish Hospital of Manhattan. Mount Sinai Hospital is a case in point. From its humble origins in 1852 as the Jews’ Hospital in Lower Manhattan, Mount Sinai Hospital was already a leader in patient care by 1904, when it changed its name and moved to its present Upper East Side location on Fifth Avenue adjacent to Central Park. Recently, this old and venerable institution merged with one of the nation’s youngest medical schools, the Icahn School of Medicine, founded in 1963. The Mount Sinai Health System is today one of the largest in the world. Dr Arthur Masters of the “Masters two-step” test established its cardiology program, now one of the oldest and most distinguished in the country. One of the most pressing problems facing Quebec hospitals is the method of funding, which is based on a global budget that reflects widespread health needs calculated over a long period of time, instead of reflecting the volume of actual work accomplished during the year by each hospital. In this way, hospitals that are very busy are penalized. If the hospitals were remunerated based on activity and performance, then the Jewish General Hospital would greatly benefit because it is one of the busiest hospitals in the city, and in Quebec. From 2015 to 2016, it reported almost 85,000 visits to emergency, more than the emergency visits to the Royal Victoria Hospital and the Montreal General Hospital combined (76,500), McGill’s other large teaching hospitals. Daily visits to the emergency department at the JGH are double that of the next busiest hospital in Montreal. The Ministry of Health said that it has been studying this problem for some years but has yet to find a satisfactory answer. In the meantime, the ongoing budget cuts continue to make the delivery of high-quality health-care a challenge in this province. Until this method of remuneration is changed, I am afraid that medical care will continue to deteriorate. The problem in Quebec hospitals of crowded emergency rooms because of patients having no hospital beds has been happening since I began my internship in 1959! Even then, almost sixty years ago, the need for convalescent beds was hindering the discharge of hospitalized patients, thus blocking the emergency room.

Conclusion

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JGH does not have a president in the same way that it once did. That is because, under the new CIUSSS structure, it’s the board of directors of the CIUSSS that makes policy for the JGH and for every other facility within our group of institutions. The CIUSSS board of directors, led by Alan Maislin, the president of the board, has assumed most of the responsibilities that used to be under the jurisdiction of the JGH board of directors. Under this new structure, the JGH does have a new body, known as the advisory board, whose recommendations still carry considerable weight. This body is responsible for protecting the traditional mission and culture of the hospital, and, in particular, in ensuring the ongoing connection between hospital, its research institute (the Lady Davis Institute) and its foundation within the new reality of the CIUSSS. Its mandate, in other words, is to ensure the survival and continuity of the special character of the JGH. In addition, the JGH board of governors continues to exist with a renewed mandate as defined in Bill 10. Though the board of governors does not set policy for the JGH, its duties include helping to decide how and where to spend the funds that are raised by the foundation. The president of the board of governors is Howard Dermer, who was president of the JGH Foundation until October 2016.

ch ap ter one

n ote s

1 2

3 4 5 6

7

8

ch a p ter on e Eduard Drumont, La France Juive (Paris: Librairie Marpon et Flammarion, 1886). Paul Copin-Albancelli, Le drame maçonnique; la conjuration juive contre le monde Chrétien (Paris/Lyons: E. Vitte and La Renaissance française, 1908). Copin-Albancelli was Charles Maurras’ collaborator in the Action française movement, and a royalist, a boulangist, and anti-Dreyfusard. Marie-Amedée Denault first worked at La Minerve and then at La Croix (Montréal). Cited in Copin-Albancelli. Jean-Denis Bredin, The Affair: The Case of Alfred Dreyfus (Paris: George Brazillier, 1986), 281. Robert Rumilly. Histoire de la Province de Québec (Montreal: Editions Bernard Valiquette, 1940), 2: 139. Phyllis M. Senese, “La Croix de Montréal (1893–95): A Link to the French Radical Right,” (Canadian Catholic Historical Association, Historical Studies, 1986), 81–95. Senese demonstrates the close relationship between the French and Quebec publications, emphasizing their narrow Catholic views and their anti-Semitism. “[Nous ne voulons] plus de voleurs, plus d’athées, plus de persécuteurs, plus de franc-maçons, plus de Juifs, plus de prussiens, plus d’étrangers pour gouverner la France. [Nous ne voulons] rien d’autre que des hommes honnêtes. Rien d’autre que des catholiques. Rien d’autre que des Français.” La Croix, 90. Pierre Savard, “Jules-Paul Tardivel,” Dictionary of Canadian Biography (Toronto: University of Toronto Press, 1994) XIII, 1009–112.

316

notes to pages 8–9

9 Mason Wade, The French Canadians, 1760–1945 (New York: MacMillan, 1955), 375. As a demonstration of Tardivel’s influence, Alphonse Desjardins, the founder of the popular “caisse” banks, an Ultramontane conservative, chose Tardivel to be his daughter’s godfather. 10 “Je mettrais tout en oeuvre pour éloigner de notre cher pays le plus redoutable de tous les fléaux, la plaie des peuples, la Juiverie. Je ne commettrais pas l’inconcevable sottise de persister à recevoir à bras ouverts … une race méprisable … qui cherche sans cesse à étouffer la vraie civilisation, à anéantir le christianisme, à miner les nations, qui porte au front l’indélébile caractère de son crime horrible, et qui, déicide à travers les âges, s’efforce partout de détruire la religion divine fondée par Celui que sa haine a cloué sur la croix du calvaire.” Télesphore-Damien Bouchard, Mémoires (Montreal: Beauchemin, 1960), 2: 113. 11 See Jacques Langlais and David Rome, Juifs et Québécois français, 200 ans d’histoire commune (Montreal: Fides,1986); Victor Teboul, Mythe et images du Juif au Québec Essai d’analyse critique (Montréal: Éditions de la Grave, 1977); Naïm Kattan, ed., “Juifs et Canadiens” in Deuxième cahier du cercle juif de langue française (Montreal: Éditions du Jour, 1967); Michael Gary Brown, Jew or Juif? Jews, French-Canadian and Anglo Canadians 1759–1914 (Philadelphia: Jewish Publication Society, 1987); Arthur Daniel Hart, The Jew in Canada: A Complete Record of Canadian Jewry from the Days of the French Régime to the Present Time (Toronto-Montreal: Jewish Publications, 1926); Benjamin G. Sack, Canadian Jews Early in This Century (Montreal: National Archives, Canadian Jewish Congress, 1975). 12 Frank Guttman, Le diable de Saint-Hyacinthe, Telesphore-Damien Bouchard (Montreal: Les presses Hurtubise, 2013). 13 “Décidément, Petit Poucet n’a pas dû frémir à la lecture des horreurs que les sauvages russes de son espèce viennent de commettre dans les rangs des Juifs en massacrant des hommes, des femmes, des vieillards et des enfants parce qu’ils étaient de la prétendue race maudite. Petit Poucet a dû bondir d’indignation en apprenant que Monsieur Wilfrid Laurier, un de nos grands hommes canadiens-français, avait prononcé un discours dans une assemblée convoquée dans le but de venir en aide aux malheureuses victimes de ces atrocités. […] Cette haine des Juifs dont son cœur est remplie, à quoi donc peut-on l’attribuer si ce n’est aux préjugés les plus aveugles? Est-ce que les Juifs d’aujourd’hui sont responsables d’un crime commis par un certain nombre de leurs compatriotes (sic) il y a dix-neuf cents ans ? … Petit

notes to pages 10–14

14 15 16 17 18 19 20 21

22

317

Poucet, guéris-toi avant de vouloir guérir les autres. Apprends que la haine des Juifs est due chez toi à un des préjugés les plus injustes, et surtout apprends que parmi les Juifs il y a des hommes fort honnêtes comme il y a aussi de la canaille chez les Canadiens-français. Tous les peuples sont constitués de la même façon: tous ont leurs panthéons et leurs prisons. Il y un grand nombre de Canadiens français qui ne perdraient pas leur temps s’ils étudiaient et s’ils tâchaient d’imiter l’esprit d’économie d’une certain classe de Juifs, leur sobriété et leur esprit de travail. Si certains d’entre eux s’enrichissent, c’est qu’ils économisent les quelques sous qu’ils gagnent péniblement au lieu de les boire à l’auberge du coin ; de nombreux Canadiens français deviendraient également riches s’ils suivaient leur exemple.” L’Union, 26 December 1905; cited in Bouchard, Mémoires, 2: 101–2. Ramon Hathorn, “Sarah Bernhardt and the Bishops,” Canadian Catholic Historical Association, Historical Studies 53, 1986: 97–120.” Personal communication with Pierre Anctil. Stanley B. Frost, McGill University: For the Advancement of Learning, Volume 2 (Montreal & Kingston: McGill-Queen’s University Press, 1984), 2: 128. Ibid., 137. Eunice G. Pollock, Antisemitism on the Campus, Past & Present (Boston: Academic Studies Press, 2011), vii–xxiv. Isadore Rosenfeld, Doctor of the Heart: My Life in Medicine (New Rochelle, NY: Mary Ann Liebert Inc, 2010), 20–1. Conrad Black, Duplessis (Montreal: Les éditions de l’homme, 1977), 2: 409. Note that I used the French version of this biography. Esther Delisle, Le Traître et le Juif: Lionel Groulx, Le Devoir et le délire du nationalisme d’extrême droite dans la province du Québec 1929–39 (Montreal: L’Étincelle Éditeur, 1992). It is remarkable that Delisle has been blocked from an academic post in Canadian history for the past twenty-six years. Peter Wilton, “Historical Notes,” Days of Shame: Montreal, 1934 (CMAJ, 2003, 169).

ch a p ter t wo 1 The sources for this chapter are: www.jewishvirtuallibrary.org/; Ronald H. Isaacs, Judaism, Medicine and Healing, (Northvale, NJ, and Jerusalem: Jason Aronson, Inc, 1998). Michael Nevins, The Jewish Doctor (Northvale, NJ, and Jerusalem: Jason Aronson, Inc., 1984); Frank Heynick, Jews and Medicine, An Epic Saga (Hoboken, NJ: KTAV Publishing House, 2002); John M. Efron,

318

notes to pages 26–52

Medicine and the German Jews: A History (New Haven and London: Yale University Press, 2001). Fred Rosner, Biomedical Ethics and Jewish Law (Hoboken, NJ: KTAV Publishing House, 2001); Hagit Matras, “Jewish Folk Medicine in the 19th and 20th Centuries, in Jews and Medicine: Religion, Culture, Science (Philadelphia, Jeruasalem: The Jewish Publication Society, 1995); Harry Friedenwald, The Jews and Medicine (New Haven and London: KTAV Publishing House, 1967); David M. Feldman, Health and Medicine in the Jewish Tradition (New York: Crossroad, 1986). 2 Jewish Nobel Prize winners: Chemistry – 36 (21 per cent of all winners); Medicine & Physiology – 56 (27 per cent of all winners); Physics – 51 (26 per cent). Prizes: Kyoto Prize – Jews 25 per cent; US National Medal of Science – Jews 38 per cent; Grande médaille de L’Académie des sciences de la France – Jews 50 per cent; British Royal Society Foreign Members – Jews 27 per cent. chap ter fo u r 1 Much of the material for the next few chapters comes from Alexander Wright, Our Everlasting Tribute, 50th Anniversary, Sir Mortimer B Davis Jewish General Hospital, 1934–1984 (Montreal: Jewish General Hospital, 1984). It has been modified and expanded by the author. 2 Kathleen Jenkins, Montreal: Island City of the St. Lawrence (New York: Doubleday, 1966), 485. 3 Quoted in ibid., 468. 4 Terry Copp, The Anatomy of Poverty: The Condition of the Working Class in Montreal, 1897–1929 (Toronto: McClelland & Stewart, 1974), 31–2, 39–43. 5 Ibid., 67. 6 Montreal Health Survey Committee, Survey of Public Health Activities (Montreal, 1928), Montreal Municipal Archives, CA M001 XCD00-P4902, 7–12. 7 Ibid., 25. 8 Copp, Anatomy of Poverty, 93–100; Montreal Health Survey Committee, 79–83. 9 Montreal Health Survey Committee, Survey of Public Health Activities, 62–7. 10 Alton Goldbloom, Small Patients: The Autobiography of a Children’s Doctor (Philadelphia & New York: J.B. Lippincott, 1959), 17. 11 S. Wiseman, “The History of the Jewish People’s Schools of Montreal,” in Hart, The Jew in Canada (Toronto: Now and Then Books, 2010), 15.

notes to pages 52–72

319

12 Judith Seidel, The Development and Social Adjustment of the Jewish Community in Montreal (McGill University, MA thesis, 1939), 148. 13 Ibid., 153. The United Talmud Torahs of Montreal, the Jewish People’s Schools, and the Peretz Schools still provide education for young Jews. 14 Frank Guttman, “The Hebrew Free Loan Association of Montreal,” Canadian Jewish Studies 12, 45–72, 2004. 15 M.B. Etziony, History of the Montreal Clinical Society (Montreal, 1963), 14. 16 Canadian Jewish Chronicle, 5 October 1934. 17 Hart, The Jew in Canada, 211. 18 Ibid. 19 Hebrew Maternity Hospital of the City of Montreal, Annual Report, 1919. 20 JGH Archives, Dr Max Wiseman, paper delivered at staff meeting of the Jewish General Hospital, 15 April 1951, 3. 21 Montreal Health Survey Committee, 69, 75.

1 2

3 4 5 6 7

8 9 10

ch a p ter f ive Norman Viner, “About the Conception and Birth Pangs of the Montreal Jewish General Hospital,” Canadian Jewish Review, 28 August 1959, 10. Her descendants subsequently donated this stamp to the archives of the Montreal Clinical Society. Etziony, History of the Montreal Clinical Society, 27. Quoted in Your Community News, 6 November 1967. Etziony, History of the Montreal Clinical Society, 20–1. Ibid. JGH Archives, Dr Harold N. Segall, President’s Address, First Annual Dinner Meeting of the Montreal Clinical Society, May 1938. JGH Archives, Report of the Special Hospital Investigation Committee, 9 January 1928, 13–14 and Dr H.C. Ballon, “History,” 25th Anniversary Jewish General Hospital Banquet Program, 1. JGH Archives, Report of the Special Hospital Investigation Committee, 3. Ibid., 5. Some of these were: Rabbi Herman Abramowitz, Lyon and Rachel Cohen, R.A. Darwin, A.L. Gittleson, Maxwell Goldstein, Samuel Hart, Michael Hirsch, S.W. Jacobs, Al. Lesser, A.A. Levin, M.L. Morris, George Rabinovitch, A. Rudolph, A. Sommer, Harris Vineberg, S. Wener, and Mark Workman.

320 11 12 13 14 15 16 17 18 19 20

21 22 23 24 25

1 2 3 4 5 6 7 8 9 10 11 12

notes to pages 73–88 JGH Archives, Report of the Special Hospital Investigation Committee, 9. Ibid., 10–12. Ibid., 15. Ibid., 1927, 4. Dr Nathan Freedman and Dr Harold Segal, Interviews (transcripts undated). JGH Archives, Speech delivered at staff meeting of Jewish General Hospital, 5 April 1951. Etziony, History of the Montreal Clinical Society, 30. JGH Archives, Dr Max Wiseman, 4. Canadian Jewish Chronicle, 8 March 1929. The committee consisted of Lyon Cohen, Allan Bronfman, Harry Gordon, R.A. Darwin, C.B. Fainer, Dr Max Wiseman, Dr Eidlow, Hirsch Wolofsky, A. Rudolph, D. Duskes, T. Glickman, I. Lande, J.A. Budyk, Mrs C.J. Gross, Mrs A. Wener, Mrs C.B. Fainer, and Mrs M. Leon. Canadian Jewish Chronicle, 8 March 1929. See especially letter by Harry Gordon in Canadian Jewish Chronicle, 5 April 1929. JGH Archives, Dr Max Wiseman, 6. Canadian Jewish Chronicle, 10 May 1929. JGH Archives, Dr Max Wiseman, 7. chap ter s i x Canadian Jewish Chronicle, 10 May 1929. Ibid., 17, 24, and 31 May 1929. Ibid., 28 June and 5 July 1929. Ibid., 19 July 1929; JGH Archives, “Because of You! Success or Failure,” Campaign pamphlet, 1929, n.p. Ibid., 26 July 1929; JHA Archives, “Because of You!” Canadian Jewish Chronicle, 26 July 26 and 30 August 1929. Ibid., 9 August 1929. Ibid., 16 July, 16 August, and 6 September 1929. Montreal Gazette, 29 August 1929. Montreal Daily Star, 28 August 1929. Montreal Gazette, 31 August 1929; Montreal Daily Star, 31 August 1929. “New Hospital will Relieve Crowded Conditions,” Canadian Jewish Review, 13 September 1929; Montreal Gazette, 9 and 10 September 1929; Montreal Daily Star, 6 and 12 September 1929.

notes to pages 89–105 13 14 15 16 17 18 19 20 21 22 23

321

Montreal Daily Star, 6 September 1929. Canadian Jewish Chronicle, 30 August and 6 September 1929. Montreal Gazette, 20 August 1929. Montreal Daily Star, 14 August 1929; Montreal Gazette, 20 August 1929. Montreal Herald, 19 September 1929. Canadian Jewish Chronicle, 27 September 1929; Montreal Gazette, 23 and 25 September 1929. Ibid., 27 September 1929; ibid., 25 September 1929. Campaigner’s Review, 30 September 1929 (only issue). Montreal Daily Star, 30 September 1929. Ibid., 1 October 1929. Montreal Daily Star, 1 October 1929; Montreal Gazette, 1 and 2 October 1929; La Presse, 1 October 1929.

ch a p ter s even 1 Jewish Hospital Campaign Committee (JHCC), Minutes, First General Meeting of Members, 25 September 1929; JHCC Minutes, First General Meeting of Directors, 17 October 1929. 2 Jenkins, 473. 3 Ibid., 473–4. 4 Interview, 11 December 1979. 5 JHCC Minutes, Annual Meeting of Members, 10 November 1930; JHCC Minutes, Meetings of Directors, 24 January, 23 February, 27 March 1934. 6 Kanadar Adler, 17 May 1931. 7 Canadian Jewish Star, 8 January 1932. 8 JHCC Minutes, meeting of directors, 11 December 1929. 9 Montreal Gazette, 6 February 1930; Montreal Daily Star, 8 February 1930. 10 Montreal Gazette, July 1931; Canadian Jewish Review, 17 July 1931. 11 Montreal Gazette, 17 July 1931; JHCC Minutes, Meeting of Directors, 16 July 1931. The electrical contract for $34,850 was awarded to the Sterling Electric Company in mid-August 1931. 12 Montreal Herald, 4 August 1931; Montreal Daily Star, 4 August 1931. 13 Montreal Herald, 4 August 1931; Montreal Daily Star, 4 August 1931; Montreal Gazette, 4 August 1931. 14 Canadian Jewish Chronicle, 25 November 1932. 15 JHCC Minutes, Meeting of Directors, 16 November 1931. 16 Ibid., 22 December 1932, 26 March 1933. 17 Ibid., 19 August 1932 and 14 October 1932.

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notes to pages 106–22

18 Samuel Cohen, Interview, 11 December 1979. 19 JGH Archives, Harold C. Ballon, “History,” Years of Achievement 1934–1959. 25th Anniversary Pamphlet (Montreal, 1959), n.p. 20 Interview, 11 December 1979.

1 2 3 4 5 6 7

1 2 3 4 5 6 7 8 9 10 11

12 13 14 15 16

chap ter ei g h t Montreal Daily Star, 9 October 1934. Ibid. Ibid. Ibid., 6 October 1934. Ibid. Ibid. Interview, 11 December 1979. chap ter n i n e JGH, Minutes, Annual General Meeting, 28 February 1935. JGH, Annual Report (AR), 1936, 17. Ibid., 1937–42, 1945. Ibid., 1936–42. JGH, Annual Report (AR), 1941 (Superintendent’s Report, presented 15 June 1942), 12. Canadian Jewish Review, 15 and 17 May 1936; JGH, AR, 1936, p. 24. Canadian Jewish Chronicle, 21 May 1937; JGH, AR, 1937–40; JGH Minutes, Annual General Meeting, 29 May 1939. JGH, AR, 1941, 8 and 1942, 8. Ibid., 1943, 10; Ibid., 1936–41, 1943–45. Ibid., 1940, 23. Some of the members of the hospital’s medical staff who had joined the armed forces by 1942 included: Dr M. Aronovitch, H.L. Bacal, M.W. Bloomberg, W. Cohen, R. Gottlieb, H.A. Hershon, M. Kaufman, A.W. Lapin, B. Levine, I. Lowenstein, Max Ratner, I.C. Rubin, C. Tauer, and A.M. Vineberg. AR, 1942, 2. Ibid., 1943, 16. Ibid., 17. Ibid., 1944, 16 and 20–1. Ibid., 16 and 20–1. Ibid., 1943, 11.

notes to pages 122–35

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17 JGH, AR, 1945, 19; JGH Archives, Women’s Auxiliary of the JGH, Memoirs of Mercy, 25th Anniversary Booklet (Montreal, 1961), 20. 18 JGH, AR, 1938, 24; 1941, 16; 1944, 20. Memoirs of Mercy, 25–7. 19 JGH, AR, 1938–45. 20 JGH, AR, 1941, 17: Memoirs of Mercy, 28–9. 21 Memoirs of Mercy, 30. 22 JGH, Building Expansion Campaign Booklet, 1945, 5; JGH, AR, 1945, 15. 23 JGH, Building Expansion Campaign Booklet, 1945, 5. 24 JGH, AR, 1939, 21. (Samuel Cohen) 25 Canadian Jewish Chronicle, 13 December 1935. 26 JGH, AR, 1937, 20 27 Ibid., 1939, 12. 28 Dr Harry Ballon, Interview, c. 1979 (transcript undated). 29 Dr Ezra Lozinski, Interview, c. 1979 (transcript undated). 30 Samuel Cohen, Interview, 11 December 1979. 31 Samuel Cohen, Interview; Interviews with Dr Harold Segal, Dr Joseph Levitt and Dr Nathan Friedman, c. 1979 (transcripts undated). 32 Interview, c. 1979 (transcript undated). ch a p ter ten 1 JGH, AR, 1938, 20. 2 Ibid., 10. 3 JGH, AR, 1943, 12 and 1944, 9; JGH, Minutes, Special General Meeting, 18 December 1944. 4 JGH, AR, 1944, 9. 5 Montreal Gazette, 16 September 1948. Also see Montreal Daily Star, 15 September 1948. 6 Montreal Herald, 12 October 1954. 7 “Les salles sont toutes munies de climatisation d’air, sont peintes en un vert tendre empechant toute reverberation et comptent un balcon prevoyant l’installation d’equipement de television. Des bouches d’oxygene ont ete installees dans les salles operatoires et dans chacune des nouvelles chambres. De plus, un systeme de microphones relie directement avec une salle d’enregistrement permettra au medecin operant de transmettre constamment, au cours d’une intervention chirurgicale, ses observations et remarques qui s’inscriront automatiquement sur ruban sonore.” La Presse, 5 October 1954.

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notes to pages 135–54

8 “Chacune des chambres des ailes du nord et de l’ouest sont munies d’un systeme d’intercommunication permettant aux infirmieres de l’etage d’etre en contact constant avec les patients. Les interrupteurs des lumieres electriques sont silencieux et chaque lit peut s’elever ou s’abaisser a l’aide d’un dispositif et d’un moteur silencieux. » La Presse, 5 October 1954. 9 Montreal Gazette, 26 March 1963. 10 Montreal Gazette, 30 September 1965; Montreal Daily Star, 30 September 1965; JGH News, October–November 1965 and April–May 1968; JGH, Minutes, Special General Meeting, 15 March 1967. 11 JGH News, August 1966 and April-May 1968; Montreal Daily Star, 17 April 1968; Montreal Gazette, 17 April and 6 December 1968; Interview, Samuel Cohen, 11 December 1979. 12 Montreal Gazette, 17 April and 6 December 1968; JGH, AR, 1967, 52–3. 13 JGH, AR; JGH Minutes, Annual General Meeting, 10 May 1973; JGH News, August 1967. 14 Montreal Standard, 27 December 1947. 15 JGH, AR, 1948, 8 (President’s Report). 16 JGH News, October 1967. 17 Ibid., Summer 1969. 18 Ibid., Winter 1979. 19 The Suburban, 3 December 1975. 20 Montreal Daily Star, 24 January 1967, 18 May 1978; JGH News, Spring 1977 and Spring 1979. In 1982, the perinatal mortality rate for infants born at the Jewish General Hospital and weighing over 1,000 grams at birth was 2.2 per 1,000 deliveries. The “potentially preventable” neonatal mortality rate for the Jewish General Hospital in 1982 was 0.4 per 1,000 live births. JGH, AR, 1982–83, 11.

1 2 3 4 5 6 7 8

chap ter e l even JGH, AR, 1939, 12. JGH, Minutes, Annual General Meeting, 6 June 1960. JGH News, Spring 1973. JGH Minutes, Meeting of Board of Directors, 2 October 1973. Jewish General Hospital, School of Nursing, (Montreal, 1950). Prospectus. Montreal Star, 23 September 1964. JGH News, Fall 1972. Ibid.

notes to pages 155–92 9 10 11 12 13 14

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JGH News, August–September 1968. La Patrie, 12 December 1946. Montreal Gazette, 9 October 1954. Montreal Star, 24 November 1966. Ibid., 24 February 1968. The Lady Davis Institute for Medical Research of the Jewish General Hospital, Montreal / L’Institut Lady Davis de Recherches Medicales du Centre Hospitalier Jewish General Hospital, Montreal (Montreal: Jewish General Hospital, 1976), 4. 15 Montreal Star, 6 May 1978.

1 2 3 4 5 6 7 8 9 10 11 12 13 14

ch a p ter t we lve JGH, AR, 1999–2000, 18. Ibid., 2010–11. Ibid., 2008–09. The Canadian Jewish News, 21 September 1973; Montreal Daily Star, 3 November 1972. JGH, The Auxiliary, Annual Report, 1985–86, 10. Ibid., 1986–87, 11. http://hopeandcope.ca/about-us/history. JGH, AR, 1983–84, 14. Ibid. JGH, AR, 1979, 45 and 1982, 8. Canadian Jewish Chronicle, 29 October 1965. Montreal Gazette, 26 January 1966; Montreal Daily Star, 26 January 1966. JGH News, April 1977. Canadian Jewish News, 18 May 1973. JGH News, Winter 1975. ch a p ter t h i rte en Samuel Cohen, Interview, 11 December 1979. All other quotations in this chapter are also from this source.

1 2 3 4

ch a p ter fo u rte en JGH News, Autumn 1983. Ibid. Ibid. Voluntary 2011 National Household Survey, the short one.

326

notes to pages 192–256

5 “Je desire vous faire part de mon appreciation d’une telle initiative qui demontre tout l’interet que vous portez it la qualite des services rendus it la population. Compte tenu de votre excellente performance budgetaire, compte tenu de la vocation de votre centre hospitalier dans la communaute, compte tenu egalement que cette souscription contribuera it assurer le maintien et l’amelioration du pare immobilier et des equipements, j’ai le plaisir de vous informer qu’ en conformite avec Ie C.T. 145,384 du 5 juillet 1983, le ministere des affaires sociales vous assure d’un engagement de fonds equivalent it 25 per cent du total souscrit jusqu’it concurrence d’un maximum de 5,000,000$, lequel sera verse lors du parachevement du projet.” The percentage of non-Jewish patients in the hospital increased substantially over the years, from 8 per cent in 1936, to 33 per cent in 1959, to 49 per cent in 1973, and to about 75 per cent in 1984 – by which time the professional staff was about 50 per cent Jewish. 7 JGH, written statement, 15 February 1984.

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20

chap ter f i f te en JGH Annual Report, 1985–86. Ibid., 1990–91. Ibid., 1991–92. Ibid., 1998–99. Ibid., 2001–02. Ibid., 1985–86. Ibid., 1990–91. Ibid., 1991–92. Ibid., 1992–93. Ibid., 1999–2000. Ibid. Ibid., 2004–05. Ibid., 2007–08. Ibid., 2008–09. Ibid., 1998–99. Ibid., 1997–98. Ibid., 1999–2000. Ibid. Ibid., 2000–01. Ibid., 2001–02.

notes to pages 256–79

327

21 Ibid. 22 Ibid., 2004v05. 23 MCTRC McGill Reporter, 1997. http://www.mcgill.ca/translational-researchcancer/files/translational-research-cancer/mcgillreporter1997.pdf. 24 JGH Annual Report, 2008–09. 25 Ibid., 2008–09. 26 Ibid., 2010–11. 27 Ibid. 28 Ibid., 2011–12. 29 Ibid. 30 Ibid., 1985–86. 31 Ibid., 1992–93. 32 Ibid., 2003–04. 33 Ibid., 2004–05. 34 Ibid. 35 Ibid., 2008–09.