Dr. A. Maxwell House was so much more than a talented, knowledgeable doctor with a likable bedside manner. He could negotiate. He could problem solve. He could organize and build virtual global bridges (and actual wharves).
An activist, progressive and forward-thinking doctor, he never stopped coming up with new ideas. And he didn't just dream them up – he put them into action. Over the course of his long career, he concerned himself with areas as diverse as the body's biological pathways to the South Pole and even outer space.
Dr. House was Newfoundland's first neurologist, helped start the medical school at Memorial University of Newfoundland, was a telemedicine pioneer whose work literally circled the globe, and served as the province's 10th lieutenant-governor.
"As a neurologist he had a technical mind," said James Rourke, dean of medicine at Memorial. "But he also had the vision. He was years ahead, even of the technical people. He could put the pieces together and put the people together and get it done, and then evaluate it to see if it had worked.
"Many people have ideas and many people can drive a project and many people can fundraise, but he could do it all."
Dr. House died Oct. 17 at the age of 87, leaving Mary, his wife of 61 years, three children and five grandchildren.
His influence was most felt in the area of telemedicine. In the mid-1970s, Dr. House started Memorial's telemedicine/telehealth program, which now links 65 locations across the province. Internationally known as an expert in the field, Dr. House travelled around the world presenting research and consulting.
"Max did as much as any individual to make telemedicine happen," said Edward Roberts, a former politician and lieutenant-governor. "Because of him we were the pioneers in Canada, and maybe in a larger context."
Dr. House served as Newfoundland's lieutenant-governor from 1997 to 2002. "He was a wonderful lieutenant-governor, personal and a thoroughgoing gentleman," Mr. Roberts said.
Arthur Maxwell House was born in Glovertown, Nfld., on Aug. 10, 1926, the seventh son of Arthur J., a successful businessman with interests from a lumber mill to a hotel, and Ellen Jane Blackwood; he also had one sister. He went to the one-room school in Glovertown, but left at 15 to work at his father's mill.
He soon decided to go back to school. He wrote his exams, passed and went on to study at Memorial University College in 1943. He then pursued a medical degree at Dalhousie University. There he met Mary (Christie), and they married when he graduated in 1952.
The couple moved to his first posting in Baie Verte, Nfld. There were no roads so when their first child, Rosemary, was born, Mrs. House was flown by Bowater's seaplane (aka The Stork) to Corner Brook. Sons Christopher and Peter followed.
The family moved to St. John's, where Dr. House began a specialization in psychiatry. But after a year or two he became interested in neurology, the diseases of the nervous system and the physiology of the human mind. The Houses moved to Montreal for three years as he studied at the Montreal Neurological Institute, where Dr. Francis McNaughton became a friend and mentor. In 1965, they moved to London, England, so he could complete six months of postgrad work at the National Hospital with Baron Walter Russell Brain, author of the standard text Diseases of the Nervous System.
Once his training was completed in 1959, Dr. House returned to practise in St. John's, where he was the province's first and sole neurologist until 1966.
This pattern of leaving one comfortable path to trailblaze in another remained a constant in his life, as did his concern for other people's welfare.
One example of his insight and foresight was helping to found the Medical Income Protection Society, a mutual fund among doctors that generated a death benefit; it was later merged with the Canadian Medical Association self-insurance plan.
Among Dr. House's appointments was chief of staff at the General Hospital for eight years. But the Memorial University medical school may have been the love of his professional life. He was one of the people instrumental in the establishment of the school in the late 1960s. This took years of planning and a touch of diplomacy, as some in the provincial medical community initially opposed it.
Dr. House was in his 50s when he left private practice as Newfoundland's senior neurologist. He spent 30 years at the medical school in positions including director of continuing medical education, associate dean of clinical affairs, associate dean of professional affairs and professor of neurology.
His own practice had made him sensitive to the long distances many patients had to travel to see a specialist, and the misery this could cause to someone suffering from an illness such as cancer. But "the challenge of designing medical services for a small population scattered amongst numerous isolated settlements dispersed over a rugged land mass with poor transportation links, a harsh climate and varying communications facilities is enormous," he wrote in the Newfoundland Medical Association Newsletter.
He had an answer though. The telemedicine/telehealth program he started at Memorial in the mid-1970s has been described as a paradigm shift in patient care. Among other challenges, it needed to overcome some physicians' skepticism and patients' wariness by demonstrating that it was a network of people, not just technology.
It succeeded, delivering care – even highly specialized care – to patients far from their doctor's office.
At first it ran through analog telephone lines, then video hookups. Even as the equipment improved, Dr. House was looking ahead – and up: Canada's Hermes satellite, launched in 1976, included a module from the Memorial medical school, as did its successor Anik B.
The province-wide system now links 65 locations, including offshore drill ships and the Hibernia platform, and provides more than 1,000 consultations a month. Initiatives have included teleoncology, telenuclear medicine, obstetrical ultrasound and child telepsychiatry. Distance health education included programs for diabetic patients and parents of deaf children. One teleconference project, in 1982, connected all 16 medical schools in Canada. Surveys and technical trials reached as far as the British Antarctic.
Dr. House became internationally known for his expertise, travelling all over the world, from New Delhi to Oslo. He presented research in more than 35 countries and networked and consulted in many others. "He was very highly regarded on an international stage," Dr. Rourke said. "His work put Newfoundland and Labrador on the national and international forefront."
Dr. House retired from full-time university faculty status in 1993.
"He was someone you could tell was good to everyone he met," said Dr. Rourke. "And he continued to make a difference long after his retirement. To have that active a mind at that age is quite dramatic."
Dr. House received several awards during his career, including the Canadian Medical Association's Medal of Service in 1997. That same year – the 500th anniversary of Cabot's discovery of Newfoundland – he became lieutenant-governor. His tenure placed a special focus on literacy and childhood poverty.
He was appointed a Member of the Order of Canada in 1990, and in 2005 was appointed an Officer.
After his term as lieutenant-governor, instead of retiring, he requalified as a neurologist and returned to Memorial University as an honorary research professor. He remained, until his death, a curious and engaged person. He'd recently bought an iPhone to explore text messaging, and he was still reading EEGs (tests that detect electrical activity in the brain) – he'd read well over 100,000 – a few days before he died.
Dr. House loved his summer home in Glovertown, where his annual rebuilding of the "recalcitrant" wharf – his construction from design sketches to shifting rocks and trees with a bulldozer being to no avail as the ice took it year after year – was family lore. Perhaps his only indulgence was sports cars; he had owned, among others, an MGB, Sunbeam Tiger and Alfa Romeo.
Elegant, quick-witted and kind, Dr. House possessed an encyclopedic depth of knowledge on many topics, not just his own field. "He made a huge number of contributions in a huge number of ways," Mr. Roberts said.
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