Why did you become a rheum-atologist? What or who influencedyou along the way to do so?It was all due to a five-year-old boynamed Arthur who I was assigned tocare for as I was nearing the end ofmy first year of pediatric residencyat the Montreal Children’s Hospital.He had systemic juvenile idiopathicarthritis (JIA) and was very sick. Wedid not have a rheumatologist onour staff and we all struggled to carefor Arthur. I decided then that I would become a pediatric rheuma-tologist and return to Montreal toprovide excellent patient care. Iwent to Vancouver to pursue my fellowship training butwas never offered a job in Montreal.

What is it about autoinflammatory disease that socaptures your interest? What changes have you seen inthe field since the beginnings of your research untilnow?When I returned from administrative “purgatory” to full-time rheumatology in 2009 I wanted to tackle a new clin-ical challenge and decided to start a clinic for patientswith autoinflammatory diseases. These disorders areespecially interesting because—in most described sofar—the biology makes clinical sense (i.e., a gene muta-tion alters the inflammatory response). For many, thereare now effective treatments which can be life-altering.Our team has been part of gene discovery for four novelautoinflammatory diseases. With the ability to do next-generation sequencing more and more diseases will bediscovered, pathways described and understood, andhopefully, treatments developed. Many old diseases—such as gout and recurrent pericarditis—are now con-sidered to have a large autoinflammatory component,and treatment for the classic autoinflammatory diseases

may be applicable to some of thesemore common diseases as well. Ialso love the clinical challenge ofbeing able to actually make a diag-nosis in patients with multi-systemdisease.

Sources close to us report that you walk to and from work and arean avid Fitbit fan. Why is it soimportant that you get all thosesteps in daily? We moved closer to the hospital andour children six years ago; my mini-mum 45 minute commute by carbecame a 15-20 minute commute.

But I live a 16-minute walk to the subway so I began trav-eling by subway and eventually was able to get rid of oneof our cars. On one sunny day I decided to walk homefrom work, and then came the idea of walking to workwhich I do daily (almost 8 kms). If I get out of work at areasonable time (rare) I also walk home, which I do moreoften in the summer. I recognize the importance of exer-cise, which I really do not like to do, but I do love walk-ing, especially with the many excellent podcasts that Ilisten to.

In 2009 you were the second Canadian to be awardedthe Distinguished Clinician Scholar Award from the American College of Rheumatology (ACR). In your opinion, why is pediatric research so oftenoverlooked? What did receiving this honour mean interms of validating your pediatric focus?Firstly, we are very few in numbers compared to our adultcolleagues. Second, we are only now really maturing as aspecialty. I think that being overlooked because we arepediatric rheumatologists is a thing of the past.Excellent work aligned with any of the academic pillars(creative, professional activity, research, teaching, and

NORTHERN (HIGH)LIGHTS

Distinguished Rheumatologist:Dr. Ronald Laxer

CRAJ 2016 • Volume 26, Number 28

education) should be—andmore recently has been—recognized, no matter whereit is coming from.

In two sentences, what happened with the Habsthis season? World’s best goalieDevastating injuryHabs season destroyed

You have been heralded asthe “driving force thatlaunched, sustained, andencouraged the growth ofthe Division of Rheumatol-ogy” at the University ofToronto. What do you thinkabout that distinction? I am very proud of theDivision but cannot takesole credit for its develop-ment. It began as part of the Division of Immunologyunder Dr. Erwin Gelfand. Dr. Len Stein had trained inpediatric rheumatology in Ann Arbor and came toToronto to do research with Erwin. I joined Len in July of1984 and Dr. Earl Silverman joined the two of us inNovember 1984. Both Len and then Erwin departed over the next few

years, allowing Earl and me to work together with Dr. AbeShore, a fully trained pediatric rheumatologist who wasalso on the SickKids hospital staff. We formed a separatedivision in 1990. Tragically, Abe died in 1991. We are nowup to 10 staff rheumatologists, all of whom (besides Earl and me) are graduates of our fellowship program,and two of whom, Dr. Rayfel Schneider and Dr. BrianFeldman, became my bosses as Division Heads. All havemade great contributions, making the SickKids programone of the best pediatric rheumatology programs in theworld.

What was your first thought when you learned thatyou would receive this award?I had an overwhelming emotional reaction, with feel-ings of both pride and humility. I felt proud of theprogress that our team had made and that our specialty

has made, and also that my efforts to help advance thefield were being recognized by my peers. This award hasbeen given to the giants of Canadian rheumatology andto be included among such an elite group is very humbling.

What is the greatest professional challenge you havefaced, and how did you address/overcome thischallenge?I spent more than six years as a hospital Vice-Presidentoverseeing a huge portfolio that included the entiremedical staff. Directing areas where I had no experience(e.g., hospital laboratories, quality, and risk-management,among others) proved to be a huge challenge. Once I wasable to recognize who in the different groups were thebest people to provide leadership, I felt that the situa-tion was under control. Recognizing talent, treating peo-ple with respect, providing strong oversight, interveningonly when required, and allowing people to do what theywere good at were some of the things that allowed me tosucceed in the job.

We hear your memory is tremendous and a frequentsource of amazement for your trainees. What has it

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Surrounded by friends and colleagues.

meant to your career to have such a precise anddetailed recollection? On the other hand, has thereever been a time when you wished you could justforget something?I have been blessed (and perhaps cursed) with having agood memory. It has allowed me to quote from articlesthat I read in the distant past and to recall what hap-pened to patients. I remember patients that I knew weshould be able to diagnose but could not, and havebrought some back many years later to confirm a sus-pected diagnosis. Are there things I would like to forget?You bet! Those years as a hospital Vice-President aresome I would like to forget about! As time goes on,though, I am forgetting more and more.

Over the course of your life, how many cities have youlived in and which was your favourite?I have lived in Montreal, Vancouver, and Toronto. Theyare all favourite cities. I grew up, went to school, andtrained in Montreal, a city with a joie de vivre like noother in Canada at that time. I got married there and our first daughter was born there. I saw the Habs win 10 Stanley Cups, attended the opening game of theMontreal Expos, and saw many events at the SummerOlympics in 1976. I did my fellowship training inVancouver which has the natural beauty of the moun-tains and the ocean. We made lifelong friends therewhom we are still close with and our second daughterwas born there. Toronto is now home, a vibrant, cultural-ly diverse city that has afforded me incredible academicopportunities and was the city where our third daughterwas born. We are staying put as we are not planning tohave any more children!

Ronald M. Laxer, MDCM, FRCPCProfessor, Departments of Pediatrics and Medicine,University of TorontoStaff Rheumatologist, The Hospital for Sick ChildrenToronto, Ontario

CRAJ 2016 • Volume 26, Number 29a

NORTHERN (HIGH)LIGHTS

From one great educator to another.

A poetic moment with Dr. Claire Bombardier, Dr. Ron Laxer, and Dr. Cory Baillie.