Psychiatrist Ruth Kajander was a pioneer in schizophrenia treatment

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In her 80s, Ruth Kajander took two of her grandchildren to visit the Eiffel Tower. They could have taken an elevator to the top, her grandson Robin Fiedler recalled, but Dr. Kajander had no interest in taking the easy way. She climbed the stairs, keeping up with her then-teenage grandsons.

“I think part of it was wanting to prove to herself and to her younger grandkids that that’s something she was still capable of doing,” Mr. Fiedler said.

Dr. Kajander proved her mettle on that trip, as she did throughout her long, extraordinary life, which saw her graduate from medical school in post-war Germany and eventually become a trailblazer in the field of psychiatry and a member of the Order of Canada.

She died on Nov. 8 in Thunder Bay, Ont., at the age of 95. Those close to her remember her as caring but tough, with an extraordinary intellect to match her tenacity.

Born on Aug. 15, 1924, in Goettingen, Germany, Ruth Elisabeth Emelia Auguste Koeppe came from a long line of scientists and physicians. The daughter of Else (née Corman) and Hanskurt Koeppe, she and her two younger brothers grew up in an aristocratic family that lost its wealth around the Second World War. The family was uprooted repeatedly, as her father, who joined the resistance movement, kept losing his job because he was not a member of the Nazi party. He was later shot to death, while her middle brother broke away to join the Nazis.

By the time she was in her teens, she and her youngest brother and mother found themselves in Berlin as Allied forces advanced. Worried about the safety of her teenage daughter, her mother urged her to leave the city, without the family, on bicycle.

Dodging gunfire, she made the 300-kilometre journey back to her hometown of Goettingen. In 1948, she graduated from medical school at Giessen University.

A swift and tumultuous marriage to a Finnish man brought her to Finland, where again she took medical exams to obtain a licence. But shortly after giving birth to the couple’s son, Aleksei Jakovlew, she was forced to flee the marriage, leaving the infant behind. He reconnected with his mother many years later.

With Europe still hobbling after the war, she made her way to Canada, where she went through medical training anew, and specialized in psychiatry. At the time, however, Canada was an inhospitable place for a young female immigrant doctor, according to Sam Sussman, author of Dr. Ruth Kajander, A Pioneer in Canadian Psychiatry. She endured a great deal of discrimination, including from peers and superiors who were determined to “cut her down to size,” he said.

In 1953, she became the first female intern at the Oshawa General Hospital, Dr. Sussman said. There, she learned about the drug chlorpromazine (known by the brand name Largactil), which was used as a kind of preanaesthetic, given to patients before administering an anaesthetic. She noticed the drug sedated patients, but did not put them to sleep.

After her one-year internship, she got a job as a resident at the London Psychiatric Hospital, where she sought the medical superintendent’s permission to use chlorpromazine on an experimental basis, to see how it would work, Dr. Sussman said. They tried the drug on an agitated patient, for whom no other interventions seemed to have an effect.

“And that’s where the story begins,” Dr. Sussman said. “He calmed down.”

The drug was later used, not only to sedate psychiatric patients, but as a form of treatment for those with delusions, he said. Today, it is still used for various conditions, including schizophrenia.

In psychiatry, where early experimental treatments included an array of noxious substances, including opium, the use of chlorpromazine spread quickly and it became “like penicillin for the mentally ill,” Dr. Sussman said.

Although the young female doctor was the first to use the drug on psychiatric patients in Ontario, credit for this ground-breaking contribution to the field went to psychiatrist Heinz Lehmann, who, unbeknownst to her, was experimenting with the drug in Montreal around the same time.

Her use of chlorpromazine may have slightly preceded Dr. Lehmann’s, said colleague John Deadman, associate clinical professor in the department of psychiatry and behavioural neurosciences at McMaster University.

“However, because her actions did not follow the usual, what you would call ‘scientific rigmarole,' I think that’s one of the reasons why the London Psychiatric Hospital didn’t make too much of it at the time,” Dr. Deadman said. “That doesn’t take away from her achievement.”

Upon hearing that a new psychiatric facility was opening in Port Arthur, Ont. (now Thunder Bay), she took on the job of leading it, becoming the founding director of the Port Arthur Mental Health Clinic.

There, at a social function, she introduced herself to Aatto Arthur Kajander, a successful local lawyer and prominent member of the area’s large Finnish community. Mr. Kajander, who at age 40 was an eligible bachelor, had vowed to give a case of champagne to anyone who introduced him to his future wife, according to their daughter, Ann Kajander.

Long after the two married in 1957, Dr. Kajander jokingly complained that her husband owed her that case of champagne.

Dr. Kajander started a private practice out of the ground floor of the family’s home, which, Ann Kajander recalled, operated like clockwork. Meals were always served on time by a housekeeper, and were often consumed over cerebral conversations about history and politics. Official functions were also frequently held at the house, as Mr. Kajander served as honorary consul of Finland for roughly 35 years.

In 1959, the couple had their first child together, a baby boy, born with serious health problems, Ann Kajander said. Although surgery might have prolonged his life, Dr. Kajander declined, and he died days later.

While her husband was devastated, Dr. Kajander was pragmatic about the loss.

“My mom had experienced a lot more grief and tragedy," Ann Kajander said. “To her, it was just nature’s mistake, and that was it.”

A year later, Ann was born. The couple had no other children.

Because of her directness, Dr. Kajander came across as unsympathetic to some, but her family – which included three grandchildren, Arthur, Robin and Maria – also saw a soft and deeply caring side of her. Her grandson Arthur Fiedler said he has fond memories of spending hours with her, playing cribbage and rummy, reading side by side, and talking about everything from politics to feminism and sharing views on death and marriage.

Ann Kajander said her mother once darted off one Christmas Day to help a woman who was suicidal. Every subsequent Christmas, the woman sent her a large bouquet with a note, thanking her for saving her life.

Dr. Kajander was the first female president of the Ontario Psychiatric Association in 1982, and one of the first women actively involved in the Ontario Medical Association.

She was named a member of the Order of Canada in 2011 for her care of patients with psychiatric illnesses in Northern Ontario. After the death of her husband in 1998, she was named to the Order of the Lion, Knight First Class, a prestigious honour from the Finnish government.

But for her grandsons, that trip to the Eiffel Tower stands out because her approach to the arduous climb mirrored her approach to life.

“She always went for it – physically, mentally, everything,” Arthur Fiedler said. “She said, 'I’ve worked for everything I’ve gotten through all these tough times, and you don’t complain through the tough times. You just do it.”