I first met Dr. Julio Montaner around 1996. He was giving a talk at the International AIDS conference in Vancouver; a few of my friends had told me it would be worth my while to attend his HIV “Up-Date”. I listened and soon realized that he was an incredible leader in the scientific fight against HIV. What I discovered over the next few years took me by surprise, a side of Dr. Montaner I had not suspected - that of a humanitarian and a doctor who cared deeply about his patients.
When I first met Dr. Montaner in his office, he was working in the old part of St. Paul’s Hospital at the end of a long, darkly lit hallway. In thinking back, I am reminded just how many patients lined that hall - many stood, others sat, and we all waited very quietly and as patiently as possible. In those days, the waiting area had a whole different feel to it. It’s hard to describe, but I felt like I was a comrade to all those who waited with me. We were in this thing together and there was an underlying sense of friendship. Then, it was not unusual to wait up to two hours to see your specialist and far more people went in with their loved one for support. There were not many women in line.
I often wonder where some of those patients are now...the ones I knew by name but didn’t see outside of the hospital. I sometimes fear the worst but hope for the best.
I'd heard he told you what he thought and didn’t pussyfoot around. I liked that about him because I felt he had far more knowledge than I did about HIV... besides I was going to see him to get cutting-edge advice, not to have my ego stroked. But as time went on I realized there was much more to him than just science and advice.
I became friendly with his secretary, Patricia and it was through her that I got to know the real Dr. Montaner - “Julio”. He would stay late, work through his lunch-hour and often see patients who had no appointment - they just turned up as emotional wrecks and he had the job of giving them the facts, a person who wouldn’t judge them. I didn’t envy him his task.
When I first went to visit him, I had chronic PTSD (Post-Traumatic Stress Disorder) and was in deep depression. While I sat there, he phoned the Psychiatric Department at St. Paul’s and he told me not to worry, I was going to be helped. That afternoon, I was seen by a psychiatrist and immediately given counselling.
On another occasion, I was taking a medication that was new to me and he said a side-effect was psychotic behaviour! Not long after, I was at the house when the phone rang and it was Julio on the other end of the line. He asked how I was doing and I told him that I was fine, in fact I was feeling far more confident and had even had the nerve to tell a few people what I really thought about them - it was a whole new me that I liked! He asked to speak to my husband and then asked to be put back to me...
“You know, maybe this drug is not for you”, he said.
Soon, Julio was examining the theory that a “drug holiday” was a possibility and he let his patients know there was an opportunity to rest from the medication. He immediately put me on a trial break from the meds, which confirmed to me that he was definitely not a blind proponent of the medication. Within no time at all, I became extremely tired and could barely keep awake. After testing my blood, I was discovered to have a lower CD4 count and a higher viral load and after three months, I was back on the meds. I believe his quick reaction actually saved my life by not allowing my body to succumb to the virus and by doing so gave me many more years to live.
In later years, I knew one patient who had decided to go to another doctor and the patient had become sick. Julio told me to tell the patient if they needed anything he would be glad to do whatever he could. It didn’t escape my attention that he didn’t take it personally when his patients changed to a different specialist and he would always be there to care for them.
Over the years, Julio and I both became very aware that I had a high intolerance towards medication and often developed an allergy. Because of this, he had to be very careful what he prescribed for me and was always watching over me, particularly in the first few weeks on a new med. I found it very soothing to know that I could contact him and he took my assessment of my own condition seriously.
Once I took matters into my own hands and went off one medication that was bothering me. I sheepishly arrived at his office within the week. He asked me how things had been going and I answered:
“well, I don’t think you are going to be thrilled at what I’ve done”
“aye-ya-yai!” he replied and, palms up, he flicked his fingers towards him in an action of “OK, give me the details...”
I gave him the news. He reminded me that it was not a brilliant idea to go off a med without seeking my doctor’s OK beforehand and that going off one could make me resistant to all the other meds I was on. I smiled and assured him it would be OK; he looked at his computer screen and set to work finding me another medication. He didn’t make me feel bad, he just got on with the business of making me well.
In the last ten or more years, I have come to know another Julio - an extremely strong advocate for people with HIV. He has not been afraid to speak out against governments and has “named names” of politicians who are hampering the struggle to end the disease.
Finally, I hope Julio will not be offended when I compare him to my doberman... doggedly determined, quick-witted, exceedingly loyal, a defender... and never truly appreciated by those he serves, very misunderstood.