Just as he does every morning, Julio Montaner awoke one April day in 1993 to his clock radio blaring the 7 a.m. news. The top story: a European study that cast doubt on the widespread North American practice of prescribing the drug AZT to people infected with HIV.
But before the Vancouver-based AIDS researcher even had a chance to sit up, his seven-year-old daughter, Michaela, ran into his room, jumped onto his bed and gave him a hug.
"She was worried. She said to me, 'Dad! Dad! AZT's not working. What are we going to do about it?' " recalled Dr. Montaner, director of the B.C. Centre for Excellence in HIV/AIDS at St. Paul's Hospital, in his thick Argentine accent.
He chuckles about it now, but the 50-year-old, who will begin his term as president-elect of the International AIDS Society at the end of the society's conference in Toronto Aug. 13-18, acknowledges he still lives and breathes for the battle against the global epidemic. And that means, so does his family.
Julio Montaner, director of the B.C. Centre for Excellence in HIV/AIDS, in Vancouver (John Lehmann/The Globe and Mail)
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"My passion sort of spills over at home because I live it on a full-time basis."
But the passion didn't always flow in that way. Becoming recognized as one of the world's leading authorities in developing new treatments for HIV-AIDS was never something Dr. Montaner -- or those who knew him -- thought he would ever be capable of.
Rugby and partying were the pastimes of choice for the young man, who was born and raised in Buenos Aires. During a good year, he would just barely pass at school. The eldest of seven children, he lived in the shadow of his distinguished father, who was Argentina's leading tuberculosis physician.
"I remember him telling me, 'I'm not sure you should go into medicine. First of all, I'm not sure you're going to make it, and second, you will be a total embarrassment.' "
Despite all that, Dr. Montaner knew at age 5 that he wanted to be a doctor just like his father, even joining him on rounds in a hospital TB ward. But he wanted to do it on his own.
He did just enough to qualify for the city's two medical schools after high school, but by then, his father had been made dean of one of them. The son went to the other one.
"Lo and behold, the day I started medical school, I completely switched gears. All the passion that I had for rugby and clubs was totally diverted into doing what I wanted to do, which was medicine."
On his first exam of the year, he scored a nine out of 10. His father was impressed, joking that he should have gotten 10. Dr. Montaner started spending weekends, spring breaks and summers working with his father who, by then, was president of Argentina's medical association.
Then came a fateful decision. Seeking to address problems in his country's social infrastructure, Dr. Montaner knew he ultimately wanted to work in Argentina, but felt the need to move away from his father's influence and make a name for himself. That opportunity arose when Jim Hogg, then director of UBC-St. Paul's Pulmonary Research Laboratory, spoke at a medical conference that Dr. Montaner was attending in Uruguay.
"I remember he came up to me after and asked me some questions in broken English, but I was just so taken aback by how intelligent and bright he was," said Dr. Hogg, now professor emeritus of pathology and laboratory medicine at the University of British Columbia.
He offered the young medical student a fellowship at Vancouver's St. Paul's Hospital, a teaching hospital affiliated with UBC. Dr. Montaner was in British Columbia by the summer of 1981. He's been there ever since.
Dr. Montaner became St. Paul's chief resident in 1984 and took the position of director of AIDS research in 1985. Under his leadership, the B.C. Centre for Excellence in HIV/AIDS has developed into a key provincial resource. Major scientific breakthroughs include the centre's high-profile involvement in the mid-1990s discovery of a drug cocktail called highly active anti-retroviral therapy (HAART), which reduces the amount of virus in a patient's bloodstream to undetectable levels.
"Now that the B.C. centre is soundly established . . . and with a strong sense of direction, I think it would be to everybody's advantage that I try to help bring this [dedication] to the international level," Dr. Montaner said. He is to assume presidency of the IAS in 2008.
Mark Wainberg, co-host of this year's International AIDS Conference and former IAS president, counts Dr. Montaner as a close friend he has known for more than 20 years, and regards him as one of the world's key opinion leaders.
"When I visited Argentina, a number of people said if he had stayed in Argentina, it would have taken him a longer time to be recognized because he would have been seen by some as working under the shadow of his father," Dr. Wainberg said.
"But I don't know if I buy that. I think Julio would have been successful anywhere in the world and we're certainly privileged and fortunate that he chose Canada."
Dr. Montaner hopes that, as AIDS society president, he can move international political leaders from talking about AIDS to actually doing something about it. One of his mentors, John Ruedy, is sure he will be able to.
"He's very much a man of the world. He has maintained strong international connections, so he certainly has a broad understanding and sympathy for the world issues in AIDS," said Dr. Ruedy, who used to head the department of medicine at St. Paul's..
It's a tall order, but Dr. Montaner says he's up to the task. That means for the time being, his wife, Dorothee, will have to continue to put up with discussions about new challenges in the world of AIDS while out to dinner with her husband. And his youngest daughter, Gabriela, will have to convince her best friend that when her family talks about HIV-AIDS at the dinner table, it's not "yucky stuff."
"AIDS is a challenge of tremendous magnitude," Dr. Montaner said. "I look at some of the things we have been able to accomplish and the lives that we have been able to touch with our research, and it would be so selfish not to proceed in this way, going all out.
"I can't imagine it otherwise."
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