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An Interview with Distinguished University Professor Gordon Guyatt, OC, FRSC (Part One)

2017-05-01

Interviewer: Scott Douglas Jacobsen

Numbering: Issue 14.A, Idea: Outliers & Outsiders (Part Ten)

Place of Publication: Langley, British Columbia, Canada

Title: In-Sight: Independent Interview-Based Journal

Web Domain: http://www.in-sightjournal.com

Individual Publication Date: May 1, 2017

Issue Publication Date: September 1, 2017

Name of Publisher: In-Sight Publishing

Frequency: Three Times Per Year

Words: 2,922

ISSN 2369-6885

Gordon Guyatt

Abstract

An Interview with Distinguished University Professor Gordon Guyatt, OC, FRSC. He discusses: his geographic, cultural, and linguistic personal and familial background; influence on development; influences and pivotal moments in major cross-sections of early life; interests in epidemiology and biostatistics; the importance of mentors for research; tasks and responsibilities as the Distinguished University Professor in the Department of Health Research Methods, Evidence and Impact at McMaster University; and what informs pedagogy.

Keywords: biostatistics, epidemiology, Gordon Guyatt, McMaster University, Mentor.

An Interview with Distinguished University Professor Gordon Guyatt, OC, FRSC (Part One)[1],[2],[3],[4]

*Footnotes in & after the interview, & citation style listing after the interview.*

*This interview has been edited for clarity and readability.*

1. Scott Douglas Jacobsen: In terms of geography, culture, and language, where does your personal and familial background reside?

Professor Gordan Guyatt: [Laughing] My dad is a Canadian of 5 or 6 generations. Our family moved to an area around Hamilton called Binbrook in the 1820s. They had a farm. The road that runs by the farm is called Guyatt road because they had the farm there. Those Guyatts were farmers, and the Guyatts in the region are descended in this region from them. My mother was a Czech Jew, who grew up in a little village in what is now the Czech Republic. Eventually, she moved to Prague.

She was at Prague when Hitler gained control of the Czech Republic. She ended up in a concentration camp with an extensive family. Everyone died in the Death Camps. Except her mother and her, they escaped to North America. She married a British soldier, who drove a tank into Belson. She was there at the end of the war. Upon arrival to Canada, they broke up. She met my dad in Canada. He came from an extremely different background. They managed to meet and stay together. They lived in Hamilton. I was born there. I grew up there. Now, I am still here.

2. Jacobsen: How did this influence development?

Guyatt: Through my mother’s background, I have a strong social conscience. I want to contribute as much as possible to society. I strongly identify with the less fortunate. It led to firm left-wing politics. I ran for the NDP 4 times, federally. I mercifully lost on each occasion. I have been active in politics. I started a group called the Medical Reform Group, which has been superseded by Canadian Doctors for Medicare.

I have a deep commitment for equitable, high-quality medical care for all Canadians without restrictions on the ability to pay. My academic career links with the political career. Even if you take the academic career alone, there are strong elements of belief in social cohesiveness and patients getting what they want rather than what doctors think patients want.

 3. Jacobsen: What about influences and pivotal moments in major cross-sections of early life including kindergarten, elementary school, junior high school, high school, undergraduate, and graduate studies?

Guyatt: [Laughing] Sadly, my memory of early life is sketchy. My mom said some things that influenced me. Her attitude: it would happen to the Jews again. However, she said, “Not to my kids.” My dad was from a strong Baptist family. His dad was a doctor, but qualified as a Baptist minister. He left ministerial work and became a doctor. He was a deacon on the Baptist church. It might have contributed to my values. My mother went to the Baptist church.

However, at some level, her heart was not there. She grew up as a Jew in Czechoslovakia. She went along with my dad’s world. Yet she was skeptical about his perspectives on the world. Baptists did not like drinking, dancing, or singing. They were puritanical. Also, my father was Right-wing. He had passionate Right-wing feelings. My negative characterization of some Right-wing folks is an upbringing of privilege, but even so, they manage to feel hard-done by.

Jacobsen: [Laughing].

Guyatt: [Laughing] I remember dad walking into the house every July for a few years, and saying, “For the rest of the year, I will be working for the government.” Because he was in the 50%+ percent tax bracket. He felt resentful. My mom said, “Well, that’s not the only way to look at the world.” I think skepticism, but some positive things from dad too. My dad is an extremely self-disciplined individual. On a 1-100, he is 99.5 on the self-discipline scale. He was model of true self-discipline. I turned out very self-disciplined.

Also, he loved the English language and precision in speech. As an academic, it helped me. Those are specific events, but streams of influence from childhood too. Then a clear  influence, when I was a resident in internal medicine, I loved the academic environment. I loved to teach. However, I had no interest in research. The chair of the department of medicine, who was a leader  in thrombosis research, Jack Hirsh, had a mission. He took bright young people and turned them into researchers.

He called me to his office. I described personal plans. He said, “Gordon, that’s fine, for now, but, in ten years, you’ll be bored. So, you should really think about research.” I knew one thing. I had zero interest in basic research. I was obedient and understood, “If the boss tells me, then I will do it.” I spent the second year of sub-specialty training in clinical epidemiology. Someone picked up: I am a bright guy. They thought, “We have this bright guy. Let’s lead them in the directions preferred by us.”

Hirsh sent me to the chair of the Department in Clinical Epidemiology, Peter Tugwell. Peter did a preliminary interview. This was not the interview for the program. He guided me, in the right direction. He said, “How much of your time in the long run do you want to be spending on research?” At the time, the real answer was zero. However, that answer would have been rude. I said, “25%.” He looked concerned and said, “Oh, well, if you say that in the interview, they won’t let you into the program.”

I went into the interview for the program. This time, I said, “50%.” I was allowed into the program. Lo and behold, I found, “This is great stuff! This is really interesting!” As I progressed through the program, I did not know, but, as it turned out, I am great at research. It is interesting. The more I went on, the more exciting it became. Then the same theme, I was directed. I continued to think, “I am a real doctor.” I wanted to be a real doctor. So I am with the Department of Medicine, not this Department of Clinical Epidemiology.

For some reason, the chair of Medicine, and the chair of Clinical Epidemiology, wanted my primary appointment in clinical epidemiology. I said, “Okay, I’m a real doctor. But if you want that as my primary appointment with these eggheads, then I’ll do it.” Quickly, in my training, I picked this up. Then I found myself in the best department in the world for this area, where I stumbled into it.  I was surrounded by brilliant people.

Those who taught me had a profound belief in collegiality and caring about one another, and mentoring junior people. Here I found myself not only doing interesting stuff, but with the world’s greatest mentors. Jack Hirsh continued to mentor me, and Dave Sackett, who was probably one of the leading lights. Those guys were mentors for me, but I had other senior folks in the department. They helped me too.

Now, I am in this spectacular environment. Now, I start writing grants and – lo and behold – the grants earn funding. I realized, “I’m surrounded by all of these smart people, and I find that I’m in the same league, and I actually talk to these people as equals and sometimes come up with ideas now.” Then over the next few years, I found, “Wow! This is exciting and great stuff, and I’m good at it.” There is the story of personal evolution.

4. Jacobsen: Two questions come from that. One has to do with epidemiology, biostatistics, and medicine. The medicine one as the natural inclination for you. The epidemiology and biostatistics, at least within research, as an unwilling participant. Any other interest in those disciplines – biostatistics, epidemiology?

Guyatt: No, as an undergraduate, I took the usual pathetic statistics course, which, as far as I can tell, could not be better designed to make people think that statistics is boring and uninteresting. It had the natural effect on me. As it turns out, another thing was peculiar about in contrast to other doctors about me. I never did science training. I never did biology or chemistry. Any of it. As it turns out, there was one medical school in the country for people without a science background: McMaster University. So I got into McMaster without a science background.

Once in the program, I was interested in physiologic reasoning. I went into internal medicine because it is the most interesting and challenging branch of medicine. Nothing specific to epidemiology or biostatistics, but an interest in an academic approach. This was the reason for the interest in an academic environment and in being an academic teacher. A major interest in an academic approach to the practice of medicine, which is clinical epidemiology. Clinical epidemiology, and making the medicine practical, became evidence-based medicine (EBM).

5. Jacobsen: In the previous responses, you talked about mentors. What is the importance of mentors for research – especially if they didn’t even know they had an interest or a talent in it?

Guyatt: Oh! Crucial, these folks directed me. I would never would have done these things myself. My colleague David Sackett wrote a book about mentorship. He talked about the importance of it, and the aspects of a good mentor. Dave died 2 years ago. The Journal of Clinical Epidemiology produced a series with one section of a recent issue was a review of Sackett’s life. He mentored me. He mentored tons of people. They were nice enough to ask me to do it.

A big aspect is Dave’s brilliance as a mentor. He influenced so many people. I am enormously lucky for the mentorship. It was crucial. If you are left alone, it is much more difficult. If you have the right mentorship environment, even somebody on the mediocre side, you can do well with the right support.

6. Jacobsen: You work as the Distinguished University Professor in the Department of Health Research Methods, Evidence and Impact.[5] What tasks and responsibilities come with these positions?

Guyatt: Basically, they let me do what I want. Fortunately, my preferred work keeps with the university’s mission. I do enough clinical work to stay competent. I teach at the undergraduate, residency, and post-graduate levels. I do a lot of research. For me, a wonderful marriage of research and teaching responsibilities. In the last decade, under research and teaching responsibilities, I supervise 5 or 6 PhDs at any point in time. I get credit for, as my major education credit, supervising the PhDs, but the PhDs are the ones doing research for us.

Again, I have been extremely fortunate in a series of ways from the beginning to the end in my academic career. Now, I work with young people. I enjoy it. I enjoy getting people connected. So I have educational responsibilities, which are teaching undergraduate, and some teaching at the graduate level. My main educational activity is supervising these senior trainees. You need research associated with it. By university standards, I am extremely productive, where it counts. Since I am productive, I feel that’s why they let me work on what I want.

7. Jacobsen: What informs pedagogy for you?

Guyatt: In terms of communicating concepts: clarity, keeping things as simple as possible, using examples of everything, using paradigmatic or extreme examples to illustrate concepts, ensuring that people really understand the idea, and then gradually introducing increased levels of sophistication. Tons of feedback for people, always trying to keep it as positive as possible, while making it clear where improvements are needed, creating a facilitative environment of learning where the people feel supported and valued. They get enough positive reinforcement to them keep them going while conveying a top priority on rigour and doing work at the highest possible level.

References

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Appendix I: Footnotes

[1] Distinguished University Professor, Health Research Methods, Evidence and Impact, McMaster University.

[2] Individual Publication Date: May 1, 2017 at www.in-sightjournal.com; Full Issue Publication Date: September 1, 2017 at https://in-sightjournal.com/insight-issues/.

[3] B.Sc., University of Toronto; M.D., General Internist, McMaster University Medical School; M.Sc., Design, Management, and Evaluation, McMaster University.

[4] Courtesy of Gordan Guyatt.

[5] McMaster University. (2016). Gordon Guyatt. Retrieved from http://fhs.mcmaster.ca/ceb/faculty_member_guyatt.htm.

Appendix II: Citation Style Listing

American Medical Association (AMA): Jacobsen S. An Interview with Distinguished University Professor Gordon Guyatt, OC, FRSC (Part One) [Online].May 2017; 14(A). Available from: http://www.in-sightjournal.com/an-interview-with-distinguished-university-professor-gordon-guyatt-oc-frsc-part-one.

American Psychological Association (APA, 6th Edition, 2010): Jacobsen, S.D. (2017, May 1). An Interview with Distinguished University Professor Gordon Guyatt, OC, FRSC (Part One). Retrieved from http://www.in-sightjournal.com/an-interview-with-distinguished-university-professor-gordon-guyatt-oc-frsc-part-one.

Brazilian National Standards (ABNT): JACOBSEN, S. An Interview with Distinguished University Professor Gordon Guyatt, OC, FRSC (Part One). In-Sight: Independent Interview-Based Journal. 14.A, May. 2017. <http://www.in-sightjournal.com/an-interview-with-distinguished-university-professor-gordon-guyatt-oc-frsc-part-one>.

Chicago/Turabian, Author-Date (16th Edition): Jacobsen, Scott. 2017. “An Interview with Distinguished University Professor Gordon Guyatt, OC, FRSC (Part One).” In-Sight: Independent Interview-Based Journal. 14.A. http://www.in-sightjournal.com/an-interview-with-distinguished-university-professor-gordon-guyatt-oc-frsc-part-one.

Chicago/Turabian, Humanities (16th Edition): Jacobsen, Scott “An Interview with Distinguished University Professor Gordon Guyatt, OC, FRSC (Part One).” In-Sight: Independent Interview-Based Journal. 14.A (May 2017). http://www.in-sightjournal.com/an-interview-with-distinguished-university-professor-gordon-guyatt-oc-frsc-part-one.

Harvard: Jacobsen, S. 2017, ‘An Interview with Distinguished University Professor Gordon Guyatt, OC, FRSC (Part One)‘, In-Sight: Independent Interview-Based Journal, vol. 14.A. Available from: <http://www.in-sightjournal.com/an-interview-with-distinguished-university-professor-gordon-guyatt-oc-frsc-part-one>.

Harvard, Australian: Jacobsen, S. 2017, ‘An Interview with Distinguished University Professor Gordon Guyatt, OC, FRSC (Part One)‘, In-Sight: Independent Interview-Based Journal, vol. 14.A., http://www.in-sightjournal.com/an-interview-with-distinguished-university-professor-gordon-guyatt-oc-frsc-part-one.

Modern Language Association (MLA, 7th Edition, 2009): Scott D. Jacobsen. “An Interview with Distinguished University Professor Gordon Guyatt, OC, FRSC (Part One).” In-Sight: Independent Interview-Based Journal 14.A (2017):May. 2017. Web. <http://www.in-sightjournal.com/an-interview-with-distinguished-university-professor-gordon-guyatt-oc-frsc-part-one>.

Vancouver/ICMJE: Jacobsen S. An Interview with Distinguished University Professor Gordon Guyatt, OC, FRSC (Part One) [Internet]. (2017, May; 14(A). Available from: http://www.in-sightjournal.com/an-interview-with-distinguished-university-professor-gordon-guyatt-oc-frsc-part-one.

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Based on a work at www.in-sightjournal.com.

Copyright

© Scott Douglas Jacobsen, and In-Sight Publishing and In-Sight: Independent Interview-Based Journal 2012-2017. Unauthorized use and/or duplication of this material without express and written permission from this site’s author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Scott Douglas Jacobsen, and In-Sight Publishing and In-Sight: Independent Interview-Based Journal with appropriate and specific direction to the original content.  All interviewees co-copyright their interview material and may disseminate for their independent purposes.

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