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Profile: Dr. Jane Philpott

In conversation with Canada’s new health minister t was just an idea, a mere notion, and a crazy one at that. Maybe I I should run for public office. No, she thought. Why would I do that? She was already so busy, with four chil- dren and a demanding job. Besides, the career she had, as a family doctor and medical educator, was the one she’d always wanted. It married her interest in science with her desire to help others, to serve her community. Still, she wondered. What if politics could be a tool for doing even more? As she advanced in her medical career, she realized how difficult it was for a practising physician to address issues

that profoundly influence health but Courtesy of Jane Philpott can’t be fixed within hospital walls. Dr. Jane Philpott: family physician, medical educator, global health advocate and, as of Perhaps, as a politician, she could influ- November 2015, Canada’s federal minister of health. ence health care at a higher level, fix big-picture problems, address the sys- On May 3, 2011, Philpott joined the number of reasons. Perhaps they were temic drivers of health and wellness. Liberal Party of Canada. In the second depressed or having marital issues. Early on the morning of Nov. 9, week of September 2013, she emailed Some had just lost a loved one. Others 2010, over coffee at The National Club her colleagues at Markham–Stouffville were sick, or having money problems in Toronto, Dr. Jane Philpott mentioned Hospital to announce that she would or just in need of conversation. In Cam- her crazy idea to someone who knew soon be stepping down as chief of the bridge, Ontario, like anywhere else, quite a bit about politics. Philpott was family medicine department to seek troubled souls were not in short supply. there for “Hot Talks,” an event associ- nomination for candidacy in the next Her father never complained, no ated with Give a Day to World AIDS, a federal election. On Apr. 9, 2014, she matter how early or how late the phone charity she founded in 2004 to raise got herself nominated as the Liberal rang. He never begrudged a request, no money to fight HIV/AIDS in Africa. candidate for the Ontario riding of matter how big or how small. Often, he The guest speaker was Paul Martin, for- Markham–Stouffville. On Oct. 19, would stop whatever he was doing and mer prime minister of Canada. And he 2015, she got herself elected to Parlia- slip out to visit the people who called, didn’t think Philpott’s idea was so crazy. ment, and her party formed the govern- perhaps meeting them at their homes, Sure, he warned her, there would be ment. Two weeks later, on Nov. 4 — or in a hospital or at his church. It was a lot of “ifs”. But if she took the deci- five years after her chat with Paul the same selflessness Philpott saw in sion seriously, and if she could get her- Martin, almost to the day — Philpott her mother, a schoolteacher, who also self nominated as a candidate in her was sworn in as Canada’s federal min- preached the joy of serving others. riding, and if she could get herself ister of health. “I was raised on that value,” she elected to Parliament in a federal elec- “In four years, I would like Canadi- says. “If you have many opportunities tion, and if someday her party formed ans to be able to say that, as minister of in life, and you are born in a great the government, and if she was given a health, I helped improve their lives,” country, and you get a great education, position of influence in that govern- says Philpott. “That’s the big picture.” then your responsibility is to use what ment, she could accomplish so much you have to serve others.” good that it would be worth all the The joy of service This was one reason Philpott would effort and sacrifice. The phone in the tiny kitchen rang later choose to study medicine. She could “Lo and behold, here I am today,” often, day and night. Most times, Phil- have satisfied her love of science in says Philpott, laughing. “Some of those pott recalls, it was for her father. He another field, such as engineering, an steps I didn’t think would happen so was a Presbyterian minister, and people option she considered. But becoming a quickly.” in their town would call him for any doctor, she ultimately decided, would

100 CMAJ, February 2, 2016, 188(2) ©2016 8872147 Canada Inc. or its licensors News give her the most opportunities to come into their car with Emily and their other doctors warned Philpott and her hus- into direct contact with people, to address daughter, eight-month-old Bethany. band to be prepared for the worst. At real needs, to make a real difference. Emily needed injectable penicillin imme- Emily’s funeral, the next day, they still And there were few places in the diately; unfortunately, the hospital was didn’t know if Bethany would survive. world with more dire health needs than two hours away. Less than half way into But, slowly, her health improved. A Niger Republic, the West African pediatrician from Boston had been country where Philpott would visiting the hospital and helped set spend much of her early career. In up a pediatric intensive care unit. 1989, after training in London, Bethany was given intravenous Ottawa and Toronto, Philpott penicillin. Eventually, she was moved to Niger. In the past, she strong enough to travel to Canada had completed short electives in to get the care she needed to fully other developing nations, includ- recover. ing Kenya and Haiti. “The very first day after Emily “There are a lot of sobering died, I wanted to leave the country realities you face when you work and never come back, but very, with people who, often, are des- very quickly we realized that was perately poor,” says Philpott. not what we wanted to do,” says “These are people who have faced Philpott. “In a way, it would have incredible hardships, incredible been like her dying was for noth- health challenges, and would ing, if we didn’t use that experi- come to us with disease conditions ence to help inform us and to do that were almost unimaginable.” more than we had before to help Philpott found rural Niger to be other families.” an amazing place to work, live and After returning to Niger, Phil- raise a family. At first, she practised pott eventually moved from acute in acute care, seeing hundreds of care into health education. During patients a day. She learned so much, her last three years in the country, she says, not only about medicine, she worked on a project to train but also about the people of Niger. health workers in rural areas, “It shaped me forever,” says finding people who, despite lack- Philpott. ing in literacy skills, were capable Sadly, however, Niger also and eager to learn how to help became the place where Philpott Courtesy of Jane Philpott their communities. and her family experienced a devas- Celebrating her election night win. “We taught them basic public tating personal tragedy, on Mar. 11, health measures and basic treat- 1991. The worst day of her life. their journey, Emily had a seizure and ments,” says Philpott. “That was a very stopped breathing. As they tried to revive satisfying period of time. I got to really Overcoming tragedy her, Philpott noticed there was some- understand what peoples’ lives were As her two-year-old daughter’s body was thing wrong with Bethany. A purple like, travelling in a four-by-four to lowered into the stony ground outside rash. She was also infected. remote villages on a daily basis.” Galmi village, in a wooden box built by a By the time they reached the hospi- After three years of working in the vil- hospital carpenter, Dr. Jane Philpott tal, Bethany’s condition had worsened. lages, Philpott and her husband decided it prayed. If I have to return to this cemetery Her kidneys had already failed. The was time to move back to Canada. They tomorrow and bury another daughter, I don’t think I can bear it. Just two days earlier, on a quiet Timeline of Dr. Jane Philpott’s education and career Sunday afternoon, her gentle-natured 1980–84 — medical school, University of Western Ontario daughter Emily had been jumping and 1984–86 — residency in family medicine, University of Ottawa/Ottawa Civic Hospital splashing in a swimming pool. On Monday morning, however, Emily 1986–87 — tropical medicine fellowship, University of Toronto awoke with a fever and vomiting. By 2012 — master of public health, University of Toronto early afternoon, purple spots began 1989–1998 — general medicine and village health worker training, Niger Republic, Africa appearing on her skin, and Philpott’s heart sank. Her daughter, she was hor- 1998–2015 — family physician, Markham–Stouffville, Ontario rified to realize, had meningococcemia, 2008–2014 — chief of family medicine, Markham–Stouffville Hospital a rapidly fatal bacterial infection. 2015–present — federal minister of health Philpott and her husband, Pep, got

©2016 8872147 Canada Inc. or its licensors CMAJ, February 2, 2016, 188(2) 101 News had two more children by then — both boys, Jacob and David — and finding proper schooling was proving difficult. So in 1998, the family settled in the Ontario town of Stouffville, where Phil- pott would practise family medicine for more than 15 years (and have another daughter, Lydia). She would go on to lead a family health team, complete a master of public health, run a hospital family medicine department, start an HIV/AIDS charity, open a family medicine teaching unit in Markham and help a university in Ethiopia develop the country’s first fam- ily medicine training program. “There were multiple influences that were helping me to understand health care from a bigger picture,” says Phil- Courtesy of Jane Philpott pott. “How it fits into political influences. Jacob Philpott (23, flight attendant), Bethany Philpott (25, medical student), Pep Philpott How it fits into education. And also how (55, radio journalist), Dr. Jane Philpott (55, federal minister of health), Lydia Philpott (15, you can deliver really great primary care high school student) and David Philpott (21, engineering student). and keep your costs under control.” An incredible opportunity firmed she had indeed won, only then did ada. After the election, Philpott under- She didn’t want to celebrate prema- Dr. Jane Philpott allow herself to fully went a vetting process, so she knew she turely. Yes, the numbers coming in were enjoy the moment. She was heading to was at least being considered for cabi- positive, overwhelmingly so. But she Ottawa as a member of Parliament. net. As for which position, she had no waited until late in the evening, just to be “It was an incredible feeling,” says idea, not until she was led into an office sure. When the television networks con- Philpott. “I went over to my team’s in Ottawa and, during a “pleasant and party, across the street from the cam- lovely conversation” with Prime Min- Excerpts from Dr. Jane Philpott’s paign office, and walking into that ster Justin Trudeau, was asked to serve personal blog room surrounded by friends and family as the minister of health. On public life — “As for me, I want and volunteers was one of the happiest “It was an overwhelming moment,” my interaction in the public square to moments I can remember.” says Philpott. “I felt so incredibly hon- be marked by tolerance and respect Not everything about politics, how- oured to be asked to do this, and humbled for others.” ever, is as pleasant as a victory party. that he and his team felt I could do it.” On describing health conditions in Early in her foray into public life, Phil- She acknowledges it is a “daunting third-world countries — “It is a grave pott discovered one major difference task” to lead the ministry of health, and responsibility to attempt to describe between being a physician and being a that she has much to learn, but Philpott the circumstances and needs of another place in a way that is accurate, politician: adversaries. All of her life, is looking forward to working with her respectful and unencumbered by self- until that point, she had received noth- team to improve health care for Canadi- promotion.” ing but praise when embarking on a ans. She is excited to begin negotiations On public service leaders — “I want new initiative for the public good. As a on a new health accord, and to rebuild- intelligent, ethical and compassionate politician, she realized, that would ing relationships with provinces and ter- people to take up the key roles in change. There would always be opposi- ritories that have deteriorated because every political party of this country.” tion. There would always be people, “we have lacked federal leadership on On cuts to refugee health care — many thousands of people, who would health care in the last decade.” Other “Cuts to refugee health care are want her and her political party to fail. specific goals include improving home wrong from a public health “That’s a very daunting perspective, care, addressing gaps in mental health perspective, an economic perspective which I had to overcome,” says Philpott. services and making pharmaceuticals and a moral perspective. … A civilized society must protect its “You are leaving work that is satisfying more accessible and affordable. most vulnerable citizens, wherever and well-remunerated and going into an “It’s an incredible opportunity,” their origin.” environment where people won’t neces- says Philpott. “All of those conversa- On running for office — “For me, a sarily respect you and won’t be happy tions I’ve had in recent years about seat in the House of Commons is not with some of the decisions you make.” how to do better for Canadians — I’m a target, it’s a tool. It’s the tool that It helps, of course, when you have now able to put those ideas to work.” you and I will use to make this family and friends to lend support. And — Roger Collier, CMAJ community better — to make this country better.” it helps even more when one of those supporters is the prime minister of Can- CMAJ 2016. DOI:10.1503/cmaj.109-5214

102 CMAJ, February 2, 2016, 188(2) ©2016 8872147 Canada Inc. or its licensors