Renowned epidemiologist Robert Remis’ HIV/AIDS work was ‘life-saving’

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Robert Remis loved to talk, to discuss, to debate, to pontificate. At conferences, he was always the first to the mic, with a biting comment or probing question, and at restaurants or the family dinner table, he would always be the last to leave, never wanting the conversation to end.

What he liked to talk about was any hot-button issue, political or scientific. But, more than anything else, he liked to discuss his passion, HIV-AIDS, whether he was at work, at home or socializing.

"Certainly I could rival any 12-year-old in the world with my knowledge of HIV and the various ways it could be transmitted," his son, Samuel Lapalme-Remis, now a neurology resident, said with a laugh.

As a renowned epidemiologist, the senior Dr. Remis helped shape our understanding of how the human immunodeficiency virus was transmitted, and influence policies that helped slow the spread of the deadly disease.

He came to this role serendipitously, as always driven by curiosity and a challenge.

Dr. Remis, who died of bladder cancer last month, was born in Winnipeg on Nov. 17, 1946, to a prominent, well-to-do Jewish family.

He was a bit of a boy genius, the kind who breezed through school and garnered all the academic awards and science fair prizes.

His love of science prompted him to study physics at the University of Manitoba but, increasingly intrigued by the heady political and social changes of the 1960s, he felt stifled and restless.

Dr. Remis left the U of M after only two years and headed off to McGill University in Montreal to spread his wings. His family strongly disapproved of his hippie lifestyle and cut him off financially.

"He struggled to get through school because he was dirt poor," his son said. But, by hook and by crook, Dr. Remis managed to backpack around Europe, and graduate with degrees in physics and mathematics, as well complete medical school, graduating from McGill in 1972.

For the next decade, he was a peripatetic physician; along with spouse, Mireille Lapalme, a nurse, he worked in a number of First Nations and Inuit communities across Northern Canada, and internationally in places as diverse as India, Burundi and the Comoro Islands. The couple separated when Samuel, their only child, was still young.

In the early 1980s, Dr. Remis settled down a bit, working as a family physician around Montreal, but soon became restless. He completed a master's of public health degree at Harvard and then went to work as a "disease detective" at the U.S. Centers for Disease Control in Atlanta.

There, he played a central role in what is now a textbook case, a 1982 outbreak of food poisoning linked to a McDonald's restaurant in Oregon; the incident is well known because it was the first outbreak of E. coli 0157:H7.

Dr. Remis returned to Montreal, where he served in a number of positions with the regional public health agency, and is credited with building the province's public-health infrastructure.

But he never lost the travel bug, setting out regularly on adventures, often with his son. And the only thing he loved as much as travel was food, fancying himself a gourmet.

Dr. Remis investigated many of the early cases of AIDS in Canada, in particular among children and hemophiliacs, grim milestones that first arose in Montreal.

He took a profound interest in HIV-AIDS epidemiology, in particular understanding all the ways the disease could be transmitted, and how transmission of the virus could be prevented, particularly between mother and child.

In 1996, he was wooed to the University of Toronto and, working with the provincial government and community groups, was able to implement some groundbreaking programs, the most notable of which was universal screening of pregnant women, a policy that has eliminated mother-to-child transmission of HIV in Ontario, and has been adopted by a number of countries around the world.

"This work, this life-saving work, is one of Robert's legacies," said Liviana Calzavara, a long-time colleague at the Dalla Lana School of Public Health at U of T. "But he was never someone who sought personal glory, so not enough people know about his contributions." Dr. Remis also produced detailed epidemiological reports to help track the HIV-AIDS epidemic and, again, this approach was widely copied.

Dr. Calzavara said Dr. Remis was also unusual because, in addition to doing research and academic work, he worked closely with community groups to help them use his data to change policy.

Wangari Tharao, of the African and Caribbean Council on HIV/AIDS, said this work was crucial. "He was a great advocate. He was passionate at a time when passion was needed," she said.

Ms. Tharao said Dr. Remis ruffled a lot of feathers because "He didn't sugarcoat anything. The only thing that was important to him was the truth." In particular, he angered many in the HIV-AIDS community with his belief that some people who infect others with the virus should face criminal charges. (The most common position is that criminalization is counterproductive as it will discourage people from being tested and treated.)

Dr. Remis was diagnosed with bladder cancer in 2008. Colleagues recall that he was upset at missing the International AIDS Conference in Mexico City and called from his hospital room (where he was recovering from surgery) to be updated on the latest research.

His recovery went remarkably well and he embarked on new projects, such as research on the spread of HIV-AIDS among sex workers in China.

Dr. Remis was on the verge of being declared "cured" (five years cancer-free), when he suffered a recurrence last year. His health deteriorated quickly.

"Watching him slowly fade away over the last year was almost intolerable," his son, Dr. Lapalme-Remis, said. "But I think that the illness brought us closer together."

Dr. Remis was sapped of his telltale energy but, on days when he was feeling better, he continued to work on research papers.

In August, between hospital admissions, he felt a bit better and, in a burst of creativity, finished a couple of research papers that are now awaiting publication.

Dr. Calzavara said she visited Dr. Remis in hospital just two weeks before his death on Sept. 25, in Toronto. "I know I overstayed my welcome, but he wouldn't stop talking," she said.

In addition to his son, Dr. Remis leaves his long-time partner, Marilynne Dunbar; his brother, David; and his sister, Debby.

He was 67.

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