Memories of Dr. Gordon Cumming

Dr. Gordon Cumming has died at the age of 91.

For many medical directors, the name brings instant recognition. Gordon was a legendary figure in the specialty of insurance medicine. He was a Past-President of the Canadian Life Insurance Medical Officers’ Association (CLIMOA), and a long-time member of the American Academy of Insurance Medicine (AAIM) which honored him with its Distinguished Physician Award in 2001.

I will remember Gordon as a larger than life personality. He was so many things all wrapped up in one person: a world renowned exercise physiologist, a pioneer in sports medicine, a consummate pediatric cardiologist, an expert in insurance medicine, a leader by example and, by respect, an advocate, a wonderful family man and a once in a lifetime colleague you’ll never forget.

Gordon grew up in Winnipeg. After graduating from high school, Gordon obtained his initial postsecondary education at one of top Canada’s military colleges, Royal Roads Military College. Many of the talents and abilities that Gordon later applied to develop his distinguished career and guide his private life were apparent during his years at medical school at the University of Manitoba Medical College where he was gold medalist each year and recipient of the prize for highest overall scholastic, sports and leadership achievements.

Subsequent specialty training included a Cardiology Fellowship at the Cleveland Clinic during which his first wife, Patricia died, leaving Gordon with sole responsibility for their young children. Gordon had shared that information with me and it would result in a remarkable coincidence. In 1992, the AAIM annual meeting was held in Boston and the social program included a dinner at the John F. Kennedy Presidential Library and Museum. I had invited a cardiology colleague and his wife from nearby Framingham to join us. During our dinner conversation, my colleague mentioned that he knew one other Canadian cardiologist who had been one of his fellow trainees during his cardiology training at the Cleveland Clinic. He also remembered that his fellow trainee’s wife had died leaving this Canadian friend with several children to look after. I then told my friend that I had a surprise for him: your fellow trainee is sitting at the table behind us! That was Gordon!

I first became aware of Gordon in 1975. He had written a critical letter to the Editor of the Canadian Medical Association Journal that had recently published an article entitled A current view of Canadian cardiorespiratory fitness. The article received a lot of comment in the press because it had concluded that the average 60-year-old Swede was more physical fit than the average 30-year-old Canadian. I was director of the exercise laboratory at the Montreal General Hospital at the time and had been invited to write an accompanying editorial for the article. Gordon’s scathing critique of the methodology of the original article prompted me to check him out. My detective work disclosed that Gordon’s comments were those of a world-class expert in exercise physiology and testing.

Exercise physiology and physical fitness were an important part of Gordon’s life. He was one of the first advocates of the importance of exercise in the pediatric clinical setting. He was one of the first people to study exercise capacity in healthy children and those with congenital heart disease. His children benefited from Gordon’s exercise interest, each having to undergo exercise testing and regular encouragement to exercise regularly and participate in sports.

Coinciding with this interest, Gordon became a pioneer in sports medicine in Canada serving as a team physician for the Winnipeg Blue Bombers professional football team and as medical consultant for the Manitoba Marathon. In 1976, he served as team physician for the Canadian Olympic Team for the Winter Olympics in Innsbruck, Austria. Gordon was also involved in the Manitoba speed skating scene, serving as the long-time president of the Manitoba Speed Skating Association from 1969-81.

Gordon was inducted into the Manitoba Sports Hall of Fame in 2015. His acceptance speech (available via YouTube) is classic Gordon Cumming, self-deprecating, complaining about his daughters’ censoring of his remarks and generous thanks to those who helped along the way, especially his family.

I remember first meeting Gordon shortly after I became an insurance company medical director in 1988. Gordon had entered the insurance medicine community in 1981 when he joined The Great-West Life Assurance Company as Vice-President and Chief Medical Director, a position he would hold for the next 29 years. This was a time when many companies sought cardiologists for leadership positions because of their approach to risk assessment, and because heart disease was the leading cause of mortality.

Gordon brought unique skills to the position. He had clinical and administrative experience as Head, Section of Cardiology, Children’s Hospital of Winnipeg for 23 years. He was highly sought after as speaker for medical meetings as a result of his research and publications on exercise physiology.

Gordon’s approach to insurance medicine was old school. In many ways, he is one of the last of a breed. He continued to keep his hand in clinical medicine as a part-time pediatric cardiologist retiring at the age of 87. This allowed him to follow many of his patients from birth into adulthood. It also gave him enormous credibility when dealing with insurance-related complaints from clinicians.

In addition to making the transition to an insurance-based approach to risk assessment and disability claim adjudication, he also acquired in depth understanding of actuarial medicine’s mortality methodology and the business side of insurance. As a result, he understood the challenges faced by medical directors and underwriters working in the trenches and tried to address them in his presentations and publications. This approach is beautifully illustrated in Gordon’s chapter on Congenital Heart Disease in the Fifth Edition of Brackenridge’s Medical Selection of Life Risks textbook and in two of his classic articles in the Journal of Insurance Medicine where detailed literature reviews of specific congenital heart lesions are accompanied by numerous mortality tables and curves:

·      Cumming GR. Congenital heart disease mortality 20 to 30 years after surgery. J Insur Med 1994,26 (2):181-200.

·      Cumming GR. Heart disease manifesting in adults starting in childhood. J Insur Med 1995; 27(2):75-80.

Gordon’s sense of humour was legendary.

Introducing me as a speaker at a medical meeting in Regina, he once described me as someone who worships at the alter of Einthoven (the Dutch physician who invented the electrocardiogram). On another occasion at the 1995 ICLAM/AAIM meeting in Washington, Gordon ran into one of his former medical students who had premature gray hair. Gordon feigned shock and exclaimed that since his former students now had gray hair, it was time for him to retire!

For many years, Gordon and I would give individual lectures and then share the Acquired and Congenital Heart Disease Workshop at AAIM’s Board of Insurance Medicine’s Triennial meetings. There I observed what a great teacher and raconteur Gordon was. He would first warm up each group with some light banter. Then we would launch into our individual case-studies. I soon became the straight man setting up Gordon’s stand-up comedy teaching approach.

Gordon’s broad and in depth clinical knowledge of congenital heart disease allowed him to make his points by vivid examples from his practice. For example, to illustrate that an applicant with surgical correction of a Tetralogy of Fallot was unlikely to be a standard life insurance risk, Gordon told the story of such a patient who after surgery failed to appear for regular follow-up assessments. The applicant had become a jumbo truck rodeo competitor and died suddenly while standing on top of his monster truck and raising his fist in the air after winning an event. Who could not remember Tetralogy of Fallot’s post-surgery risk after that example?

Sitting through 8-10 workshops per meeting, we would know each other’s presentations so well, we could give each other’s presentations from memory. This occasionally had a downside for me. As a much sought after speaker at insurance medicine and congenital heart meetings, Gordon’s many responsibilities and busy schedule would occasionally conflict. On those occasions, he would volunteer me to take his place.

Gordon’s sense of humour was combined with a mischievous sense of fun. When he was president of CLIMOA, his idea for the closing dinner was to have a murder mystery dinner which was a big hit with the attendees.

We have lost one of the giants of insurance medicine.

Insurance medicine is a broad discipline; its scientific basis is the study of morbidity and mortality. Its practice requires experience in clinical medicine. Its domain or environment is the business world. Its responsibilities are to the individual who applies for insurance, to the company who employs its services, to the insurance industry and to society at large. One of the defining characteristics of a medical specialty such as insurance medicine is the existence of a unique body of knowledge and skills. Gordon has played a major role advancing this body of knowledge to benefit those served by the specialty. We all benefited from his teaching, guidance and support.

Ross MacKenzie

Dr. Ross MacKenzie, FRCP(C), FACC, FAAIM​

Memories of Dr. Pierre Auger

Dr. Pierre Auger of Levis, Quebec, and Honorary CLIMOA Life Member Dr. Gord Cumming of Winnipeg, both pioneering cardiologists, have recently passed away after a lifetime of service to  their cardiac patients and  their communities,  and very distinguished careers in the Insurance field.

On April 27, 2020, surrounded his loved ones, at the Littoral Palliative Care Home (MSP du  Littoral), Dr. Pierre Auger  passed away peacefully, in sweetness and serenity,  at the age of 82 years.

He was the son of the late Thérèse Dionne and the late Dr.Sylvain Auger.  He leaves to mourn his wife Lise Carrier, his daughter Renée Auger (Jean Cormier) and his adored grandchildren Camille Vermette (Maxime Choinière), Maude Vermette and Guillaume Vermette (Anne-Marie Beaudet) as well as Catherine Cormier and Louis-Charles Cormier; his brothers and sisters: Marie Auger (Dr Jean Émond), the late Louise Auger (the late Henry Beaudry), Jacques Auger (Luce Nadeau), the late Michel Auger (Renée Lachance), Claire Auger (Jean Poudrier), Suzanne Auger (Dr Guy L’espérance) and Sylvie Auger (the late Rodrigue Ferguson); his sister-in-law: Gabrielle Carrier (Pierre-Paul Gingras); his god-daughters: Suzanne Auger, Marie-Andrée Beaudry, Marie-Claude Émond and Annik L’Espérance; his nephews, nieces, cousins, friends and colleagues, as well as Louise Gingras, intimate friend of the family.

The family would like to thank all of the staff at the MSP du Littoral for their care and compassion and incomparable human warmth, which allowed his final moments to be serene.

As a pioneer in cardiology at the Hôtel-Dieu de Lévis, Pierre established the first coronary unit, was department head of the cardiology service, and was involved in the HDL Foundation.  He was as well president of the Québec Association of Cardiologists and Medical Director at Desjardins Sécurité Financière.  Pierre was an inspiration and a model for numerous colleagues up until his retirement in 2015.  He was passionate about medicine,and dedicated and attentive to his patients.  Pierre was also a lover of life, a loyal friend and especially a generous and exceptional family man.  His gentleness, his good humour and his joy for life have left an indelible mark in the heart of everyone who had the good fortune to encounter him.  Pierre, we will always miss you but your memory will remain with us forever.

Your condolences may be expressed by a gift to the Maison de soins palliative du Littoral

Given the exceptional circumstances of the pandemic, a private funeral was held on May 10, 2020.

En francais :

Le 27 avril 2020, entouré de l’amour des siens à la Maison de soins palliatifs du Littoral, s’est éteint paisiblement dans la douceur et la sérénité, à l’âge de 82 ans, le Dr Pierre Auger. Il était le fils de feu Thérèse Dionne et de feu Dr Sylvain Auger. Il laisse dans le deuil son épouse Lise Carrier, sa fille Renée Auger (Jean Cormier) et ses petits-enfants adorés Camille Vermette (Maxime Choinière), Maude Vermette et Guillaume Vermette (Anne-Marie Beaudet) ainsi que Catherine Cormier et Louis-Charles Cormier; ses frères et soeurs : Marie Auger (Dr Jean Émond), feu Louise Auger (feu Henry Beaudry), Jacques Auger (Luce Nadeau), feu Michel Auger (Renée Lachance), Claire Auger (Jean Poudrier), Suzanne Auger (Dr Guy L’espérance) et Sylvie Auger (feu Rodrigue Ferguson); sa belle-soeur : Gabrielle Carrier (Pierre-Paul Gingras); ses filleules : Suzanne Auger, Marie-Andrée Beaudry, Marie-Claude Émond et Annik L’Espérance; ses neveux, nièces, cousins, cousines, amis et collègues ainsi que Louise Gingras, amie intime de la famille.

La famille tient à remercier tout le personnel de la MSP du Littoral pour toute la bonté, la compassion et la chaleur humaine incomparable qui auront permis de rendre sereins ses derniers moments.

Pionnier en cardiologie à l’Hôtel-Dieu de Lévis, il a mis sur pied la première unité coronarienne, a été chef du service de cardiologie et s’est impliqué auprès de la fondation de l’HDL. Il a aussi été président de l’Association des Cardiologues du Québec et directeur médical de Desjardins Sécurité Financière. Pierre a été une inspiration et un modèle pour de nombreux collègues jusqu’à sa retraite en 2015. Il était passionné par la médecine, dévoué et à l’écoute de ses patients. Pierre était aussi amoureux de la vie, un fidèle ami et surtout un homme de famille généreux et exceptionnel. Sa gentillesse, sa bonne humeur et sa joie de vivre ont laissé une marque indélébile dans le coeur de chacun qui a eu le bonheur de le côtoyer. Pierre, tu nous manques déjà mais ton souvenir restera gravé en nous à jamais!

Vos témoignages de sympathies peuvent se traduire par un don à la Maison de soins palliatifs du Littoral