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