THE MEDICAL EMPIRE IN THE QUEBEC BUSH

Chicoutimi's leading industry is an astonishing hospital that telecasts surgery in color and adds buildings as fast as many big-city hospitals add beds—an unlikely empire built by an iron-willed nun almost nobody knows

Cathie Breslin July 2 1960

THE MEDICAL EMPIRE IN THE QUEBEC BUSH

Chicoutimi's leading industry is an astonishing hospital that telecasts surgery in color and adds buildings as fast as many big-city hospitals add beds—an unlikely empire built by an iron-willed nun almost nobody knows

Cathie Breslin July 2 1960

THE MEDICAL EMPIRE IN THE QUEBEC BUSH

Chicoutimi's leading industry is an astonishing hospital that telecasts surgery in color and adds buildings as fast as many big-city hospitals add beds—an unlikely empire built by an iron-willed nun almost nobody knows

Cathie Breslin

DEEP IN IHE HEART of the Saguenay River country, 110 miles north of Quebec City, a former sailors' home has grown into one of the biggest, richest and most progressive medical centres in Canada. Whether Chicoutimi needs it or not. the town's Hôtel-Dieu St-Vallier Hospital is a medical empire rivaling and often surpassing the general hospitals of Canada's largest cities. Hotel-Dieu s proliferating possessions include:

• a $250,000 closed - circuit I V system for transmitting operations in color.

• an eight-hundred-seat theatre, which, between medical conferences, holds fashion shows, community concerts and touring plays.

• a main building with eleven wings added since 1902.

• two branch hospitals in nearby towns.

• a 2.550-acre farm — the region's largest — that supplies the hospital with vegetables and sells large surpluses as well.

• a fifteen-room suite for the chief surgeon, including six fully equipped examination rooms and a "relaxing room." with shower and sun lamp, tor his secretaries. Among the suite's furnishings and accessories are an eight-foot combination stereoand-short-wave console, a short-wave transmitter for sending messages to the chief surgeon's hunting lodge, autographed photos of chief surgeon

THE MEDICAL EMPIRE IN THE QUEBEC BUSH continued

Gerard Gagnon’s famous patients (including Clare Booth Luce), a brandy decanter for queasy patients, and a cooler full of champagne.

One of the most amazing things about HôtelDieu is the woman who has spent the past nineteen years making it grow. She is a five-foot, fiftyseven-year-old cloistered nun called Sister MarieJoseph, whose wispy voice and reluctant smile mask a determination to keep her empire under whiplash control.

Officially, she’s hospital bursar. Unofficially, she's much more. "You can't buy so much as a pin without a requisition from her." sighs one physician. "Not one of the nine hundred employees is hired or fired without seeing her. and she fixes every salary. She busies herself with everything. She's up every morning at five with the rest of the nuns, and she's always working at her desk past nine at night.”

You're "in" in Chicoutimi if Sister MarieJoseph admits you to her office. A few chosen favorites can boast of open access, while some doctors have waited up to seven months for an appointment with her.

”1 could get to see the Pope more easily." complains one doctor.

At one time or another, most of the region’s leading citizens have been summoned to the parlor outside her office. "No matter who he is, he’s scared the first time he meets her,” says a Chicoutimi contractor. Her stalf doctors think of her as a combination of Maurice Richard. Charles de Gaulle and a General Motors president.

No one can explain why Sister Marie-Joseph keeps her hospital in a perpetual state ot expansion.

"Here we are a little country of our own, proud and independent.” says Jean-Gérard Lamontagne, editor of Le Progrès du Saguenay. "Her aim has been to make this one of the biggest, the best, the most modern hospitals in Canada. The Saguenay people think this is no more than they deserve.”

But a Montreal doctor takes a far less charitable view. "You beware of those people," he says. “They multiply and multiply. They’d add the city's hotel beds to make their hospital bigger." (To be in line with the national average. Chicoutimi, with thirty thousand residents, would need only 168 hospital beds. Hôtel-Dieu has nine hundred.)

There are those in Chicoutimi who think Sister Marie-Joseph started her building program partly to avoid being promoted to a job outside the hospital. When she was moved up from accountant to bursar in 1941. it seemed likely that her next job would be as bursar-general for the Order oí St. Augustine throughout Quebec. “She began constructing wildly so that no one else could possibly finish the job in Chicoutimi.” one doctor claims.

Soon the diminutive nun became a symbol of the Saguenay people, who backed her to the hilt, despite the suspicion that their hospital care was going to be more than adequate. (One dissenting voice, Le Régional, a tabloid weekly, launched a series of exposé articles —then stopped them abru ptly.)

Today Hôtel-Dieu is run just the way Sister Marie-Joseph thinks it ought to be — with the best of equipment and with strictest attention to her own ideas and regulations. The parking lot provides electrical heating outlets for sixty cars. A pneumatic system shuffies messages and specimens between the hospital’s thirty-eight departments. A moustachioed gendarme stands guarding the main door, the elevator man adds to this formal atmosphere CONTINUED ON PAGE 44

The medical empire in the Quebec bush continued from page 17

Duplessis once called Sister Marie-Joseph “Quebec’s best businessman”

by dressing in spats, and the laboratory staff holds brief but regular prayers instead of coffee breaks.

It's no secret that Sister Marie-Joseph has her favorites among the doctors of Chicoutimi. Nineteen doctors, including most chiefs of staff, rent office space in the hospital, and she has room for twenty-one more. But at least two. Dr. Georges Tremblay and Dr. Paul-Eugene Blais, aren't allowed to place patients there. Blais, a specialist in skin ailments and venereal disease, refused the hospital's suggestion that he go on salary there.

"Of course it’s a financial sacrifice to be out of the hospital,” he admits. "But if Quebec passes the law on hospital insurance, Hôtel-Dieu will be forced to admit all doctors licensed to practise in the province.”

On the other hand one of her favorites, Chief Surgeon Gagnon, claims he has a standing invitation to Sister MarieJoscph's office. It's a believable claim, since Gagnon has been a key man in the hospital ever since 1951, when Sister Marie-Joseph went to the U. S. to lure him back to his native Chicoutimi. Her motive was simple. To get Hôtel-Dieu classified as an A-1 hospital, she needed — among other things — a good surgery department under a highly competent man. She was so persuasive that Gagnon, though well established by then, gave up his plans to marry a New York model who couldn’t adjust to the idea of living in northern Quebec.

One way Sister Marie-Joseph gets — and holds — first-rate doctors is to make sure they're never lacking in up-to-date equipment.

“If we need a new instrument — or anything else," says one of her surgeons, Dr. Jean Simard, “we just have to demonstrate that it's really useful, and we have it. There's never a question of money.”

How does she manage it? “It's a mystery," Simard admits. But there’s no doubt in anyone's mind that it is Sister Marie-Joseph, and no one else, who docs the managing.

Mother Marie-du-Saint-Esprit is hospital superior; and. theoretically, all major decisions are voted by a council of seven nuns.

"But.” says Gagnon, “when we have a problem we never see the superior about it. We know Sister Marie - Joseph runs the whole show.”

"She's a giant of finance,” says Lamontagne, the editor of Le Progrès. He also describes her as "modest, humble, pious, always putting others before herself.” It's true that she seldom appears at hospital ceremonies, and her name is not in the Canadian Hospital Directory's personnel listings for any of the three hospitals she runs. (As branches of HotelDieu. Sister Marie-Joseph has built a 250-bed hospital at nearby Jonquière and another, with seventy-five beds, at Dolbeau.)

Nor does she, apparently, bury herself in paper work. "You never see her w'ith a pen or pencil in her hand,” says cardiac surgeon Emile Bertho. But no detail seems to be too small to escape her attention or her recollection. Once, when a medical - equipment salesman went through his jovial line of patter, she fixed him with a cold eye and said: “You

saw me five years ago, you told me the same stories then — and your price was half as high.”

The late Maurice Duplessis once explained part of the mystery of Sister Marie-Joseph when he remarked to a newspaper editor: “The best businessman in the province of Quebec — that's Sister Marie-Joseph.” The friendship between the little nun and the powerful Quebec premier was founded on a mutual respect for talent. But it was never hindered by the fact that Paul Gagnon, the brotherin-law of her chief surgeon, was an independent federal MP for Chicoutimi. Dr. Gagnon was given the unlisted number to a private telephone answered by "Maurice id.” On several of Duplessis' visits to Chicoutimi he stayed at the hospital rather than local hotels. On her periodic pilgrimages to Quebec City to give thanks for provincial grants, Sister Marie-Joseph was one of the few nuns ever admitted to Duplessis’ inner office.

Months before he died, Duplessis accorded Sister Marie-Joseph a typical gesture of friendship: he sent her a cheque for a hundred thousand dollars. It had been a donation to Duplessis from a Montreal businessman who asked that it be used wherever it was needed most. It couldn't have come at a better time, for Sister Marie-Joseph was going into the television business.

The story of how color television came to Chicoutimi must be unique in medical annals. In October 1958 Sister MarieJoseph asked her bishop's permission to travel, then bundled a medical and administrative team off on a 1,600-mile trip to investigate possible innovations for the Hôtel-Dieu St-Vallier.

Among the U. S. medical centres they visited was the Walter Reed Hospital in Washington. Sister Marie - Joseph's fascination with the color TV system there overcame any reluctance she might have

had about spending a quarter of a million dollars. It would be especially useful, she decided, for teaching surgery to her two hundred student nurses and thirty junior interns. The fact that such large university medical centres as McGill had rejected color TV as an extravagance didn’t impress her.

"You can see the blood, the muscles and organs better in color,” she explained. "In black and white it is not at all the same.”

Several months later a 125-pound camera was mounted over a Hôtel-Dieu operating table, with remote controls in a basement room eight floors below. Operations could be transmitted to four twenty-one-inch screens or to a projection unit. (Black-and-white films and programs could also be beamed to five hundred TV sets throughout the hospital.)

Soon after that, delegates to the Canadian Medical Association’s provincial conference were on hand to see an operation transmitted over the CBC's French network. (Viewers across the province, of course, saw the operation only in black and white; for, technically, the CBC hasn’t yet caught up with Chicoutimi.)

Eight years earlier, with TV in mind. Sister Marie-Joseph had three of her eighteen operating rooms built in an ultra-modern design devised in Switzerland but never used there. When the Swiss hospital went broke, she explains, “we bought the plans and improved them." Each room has a domed ceiling studded with lights, and observation windows slashed directly above the operating table.

Chicoutimi citizens cheerfully admit to a weakness for extravagance. “People here seem to be broadminded, audacious,” grins Gagnon. “We have to progress. We're not afraid of having a big debt — we'll find a way to gel rid of it.”

The exact size of that debt remains one of Sister Marie-Joseph's many secrets, along with other financial details. Her public reports never include a dollar sign. In the Canadian Hospital Directory, which lists the budgets of almost every hospital in the country, she confesses to annual expenditures of $314,640 for Dolbeau and $ 1, 130.000 for Jonquière but doesn't reveal what she spends for Hôtel-Dieu. Presumably its budget would be several times the size of Jonquière's.

Hôtel-Dieu’s expenditures often arouse medical people elsewhere to a disgust verging on fury. “It's an awful thing to spend money like that," says the administrator of one small Quebec hospital. “It s one of the five biggest hospitals in the province, but their proportion of charity cases is only twenty-one percent — down with the lowest two fifths of hospitals.”

Such criticism has no apparent effect on Sister Marie-Joseph. When she’s busy with an expansion project (which is almost always) her sixteen-hour day includes an hour or two supervising construction.

“She understands every detail of building. architecture and engineering — the first time you explain them," says contractor Xavier Nerón, who has had four million dollars’ worth of Hôtel - Dieu contracts since 1952.

An examination of her early life doesn't do much to explain Sister Marie-

Joseph's tremendous grasp of the widely varied details with which she concerns herself at Hôtel-Dieu.

She started off Imelda Dallaire, the shy. sharp-witted daughter of William Dallaire. a farm - machinery salesman. She was a pretty, dark-haired girl who “never ran around much with boys," according to a childhood friend. She also had a golden voice. Once, when she was singing with some young people on a Saguenay riverboat, a fellow passenger offered to make a New York opera star of her. Imelda had other ideas. She graduated at the top of her convent class and served her business apprenticeship in a bank (where she is remembered by a fellow teller as “the dumbest one in the office''). She worked for a time in an uncle's insurance office and then, at twenty, disappeared into the convent. I bree sisters the youngest of them

now thirty-five — followed her into the Hôtel-Dieu cloister.

“But Imelda surprised us all when she entered,” one of them recalled recently. “She was a worldly one —■ loved theatre, luxury, life.”

Sister Marie-Joseph has come up with a great many surprises since then.

But is she reaching the point now where Hôtel-Dieu is likely to stand as a half-empty monument to her fervor for expansion?

Not according to medical director Marcel Lapointe. “We always have a waiting list of patients.” (Bed occupancy is 89.7 percent — higher than average but not exceptional.)

Where do the patients come from, in a town of thirty thousand? Nearby Arvida, where the Aluminum Company of Canada employs six thousand, provides much of the hospital's business.

But not many patients come from other parts of the surrounding countryside, since within fifty miles there are five other hospitals with a total of 725 beds, not counting a 330-bed tuberculosis sanatorium. A few patients come much greater distances. Premature twin babies were flown in by helicopter from Abitibi (although Montreal was closer), and a goitre case came from Detroit for an operation by Gagnon.

“The rest must be local people in hospital for ingrown toenails or ankle sprains,” a big-city doctor says dryly.

Meanwhile, Sister Marie-Joseph builds on. “We would like to add a department of neurology — the only specialized department we lack — and perhaps, in a few years, a little research centre,” she says.

And even among her severest critics, there's little doubt that she will. +