COUNCIL AWARD
appointments, I have been the beneficiary of outstand-
ing role models who were wise, generous and shared their
expertise beyond my expectations.
How did you develop your interest in pediatric
rheumatology?
In my early years in pediatric training at the hospital, I
was impressed by a small group of dynamic young faculty
who had recently started a division of rheumatology. At
the time, pediatric rheumatology was a nascent subspe-
cialty in Canada, with only a few physicians with experi-
ence and formal training. I hadn’t seen a lot of patients
with these rare inflammatory diseases, but enough to see
the devastating effects on children and the awful side ef-
fects of the few available treatments. I was excited by the
opportunity to train with this group and the potential for
transformative care in the subspecialty.
You work in a relatively small subspecialty, do
you find that challenging?
Not at all. While we are indeed a small group of special-
ists who deal with challenging conditions, we are also a
collegial and collaborative group – certainly, in Canada,
we all know each other. And the collaborative nature of
the specialty has allowed for national and international
research efforts that would not have been possible in a
single centre or country. And the rewards are incredible.
We encounter children diagnosed with chronic diseases
at a very young age, so as a physician, you get to share
a journey with patients and families. You can never be
quite sure where the journey will take you, but it can be
inspirational, filled with courage, resilience and positivity.
What makes you most proud in your academic
work?
I’m most gratified by the relationships that have de-
veloped with the trainees I’ve known over the years; to
see them transition from trainees to colleagues, friends
and collaborators, and successful leaders in their own
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DIALOGUE ISSUE 1, 2019
centres. SickKids trains physicians from all over Canada
and around the world, so there is now an international
network of alumni I can call to consult on difficult cases.
Just recently, when I hit a crossroad in treating a patient,
I found myself contacting a former trainee who has
experience with a treatment approach I was considering.
To be able to say to him “I need your help’ was quite a
lovely moment.
How did you come to focus so much of your
scholarly work on systemic juvenile idiopathic
arthritis?
Juvenile arthritis has many subtypes, but SJIA is particu-
larly severe because the inflammation affects not just the
joints with aggressive arthritis, but potentially multiple
organs. I did a study on predictors of outcome in SJIA
during my fellowship and it launched my interest. When
I joined the rheumatology faculty, my mentors encour-
aged me to start an SJIA clinic. There were really no
effective treatments back then, except for steroids which
had terrible side effects. We are fortunate that research
has led to better understanding of the pathogenesis of the
disease and new treatments. Treatment has more or less
moved from steroids to new biologic agents which are
very effective. There are still frontiers to cross for those
children who don’t respond well, but for the majority of
patients, outcomes have improved dramatically.
Tell us about your family.
My wife, Rochelle, and I have been married for 36 years
– in fact we got married just four months before we left
South Africa for Canada. I was doing my internship then
and we could only take two days off for the wedding
because my vacation time was reserved for our move to
Canada. We raised two kids in Toronto, a great city for
us, and we now have five grandchildren. Unfortunately,
they don’t live close by, but frequent visits and almost
daily FaceTime go a long way to keeping us closely con-
nected.
MD