FORTIER, RENÉ (baptized George-Émile-René), physician, professor, hospital administrator, and author; b. 4 Aug. 1866 in Sainte-Marie, Lower Canada, son of Joseph-Elzéar Fortier and Marie-Louise-Joséphine Simard; m. 12 Oct. 1896, at Quebec, Alice Boucher de La Bruère, daughter of Pierre Boucher* de La Bruère, a lawyer and superintendent of public instruction, and Victorine Leclère, and they had three daughters and three sons; d. there 8 Aug. 1929.

After classical studies at the Collège de Lévis (1875-84) and the Petit Séminaire de Québec (1884-86), René Fortier took up medicine in the Université Laval at Quebec. During the year 1889-90 he enrolled at the Grand Séminaire de Québec, but he soon abandoned theology to return to his original choice. Coming from a family of physicians (with a father and grandfather in the profession), he graduated as a bachelor of medicine in 1890 and as a doctor of medicine, with honours, the following year. On 30 Sept. 1891 he would be admitted to the College of Physicians and Surgeons of the Province of Quebec. A month before, on 27 August, he had left for Paris, where he would pursue his studies for two years. The varied clinical training he received there included work in obstetrics with Pierre Budin at the Hôpital de la Charité and with Adolphe Pinard at the Baudelocque maternity hospital. He also took courses in gynaecology, hygiene, neurology, and forensic medicine. In his second year he specialized in the treatment of children, under the direction of professors who were pioneers in this field, Jacques-Joseph Grancher and Antonin Marfan. Fortier began his study of paediatrics, paediatric surgery, orthopaedics, and bacteriology at the 800-bed Hôpital des Enfants-Malades in Paris. During his time there he visited several other countries in Europe with his colleague Arthur Simard*.

On his return to Canada in September 1893, Fortier established his residence and consulting office in the Upper Town of Quebec, at the corner of Rue Sainte-Anne and Rue Sainte-Ursule. While physicians in that era limited their careers initially to general practice, Fortier began his by including obstetric care and paediatrics as well. From 1903 his office hours would be devoted exclusively to children. As soon as he arrived back he began working with the rector of the Université Laval, Mgr Joseph-Clovis-Kemner Laflamme*, and the dean of the faculty medicine, Charles-Eusèbe Lemieux, to establish a chair of paediatrics. He began teaching there in January 1894 as an associate professor; he would be appointed a full professor in 1899 and would continue in that position for the rest of his life. In 1894 future physicians were given 15 classes in the theory of paediatrics in each of their third and fourth years, although this instruction was not yet compulsory. (It would become so on 1 Jan. 1910, when the Quebec Medical Act came into force [see Albert Laurendeau*].) Paediatric instruction would be increased to about 35 hours a year in 1905, and to 45 hours in 1925. In these courses, Fortier concentrated on information relating to newborn and nursing infants and to early childhood (from birth to the age of 6 to 7 years). Although he was concerned with the general state of the child’s health, he went into detail about various ailments and their causes, including digestive complaints related to dietary deficiencies, a subject that gave him an opportunity to explain the benefits of breastfeeding. From 1898 the faculty also charged Fortier with the teaching of hygiene (120 classes a year for first- and second-year students). In 1913, in order to combat epidemics more effectively, especially smallpox, which often broke out in poor urban neighbourhoods, a course in public health would be introduced that would lead to a diploma as an expert in hygiene. Physicians who took this course would then be qualified to work in the civil service. Its 20 classes on paediatric nursing and contagious diseases would be added to Fortier’s teaching load.

The institutionalization of abandoned children provided an initial clinical setting for paediatrics, and Fortier worked as the visiting physician at the Hôtel-Dieu du Sacré-Cœur de Jésus from 1898 to 1906. Founded in 1873, this hospital was located in the working-class ward of Saint-Sauveur, in the Lower Town, and served the needs of deserted children and epileptics. Fortier found this work increasing appreciably from 1903. That year, after a number of fruitless requests, he got permission from the hospital to give clinical instruction to the students in the medical faculty. As was the custom then, in return for this permission he looked after, with no salary, the treatment and medical direction in the establishment where the classes were taught. The Dispensaire de Québec, which was in the Hôtel-Dieu, was the first place to benefit from such an agreement with Fortier. In 1907 he would open the “sick children’s department,” and he would be in charge of it until 1929. In 1905 he also became professor and visiting physician at the Crèche Saint-Vincent-de-Paul, which provided care for illegitimate infants born in the maternity ward of the Hôpital de la Miséricorde and taken in by the Sisters of the Good Shepherd. He would continue to work there for the rest of his life. From 1916 to 1920 Fortier would give practical classes on contagious diseases at the new Hôpital Civique in Quebec. This 58-bed institution on Chemin de la Canardière, founded in 1915 and funded by the city of Quebec, was established for tuberculosis patients and was administered by the Sœurs de la Charité de Québec. Students in the faculty of medicine would also be able to study at the Hôpital du Saint-Sacrement, which opened in 1927 on Chemin Sainte-Foy and would have a paediatric service introduced by Fortier.

The movement to combat infant mortality at Quebec – just as in Montreal [see Séverin Lachapelle*], Toronto, and the big American cities – had begun as the work of social reformers, women, physicians, and members of the clergy, only later being taken over by the government. In June 1915 Fortier took part in the opening of a paediatric nursing clinic at the Dispensaire de Québec. A few weeks earlier, a similar facility had opened in Saint-Sauveur ward, under the direction of Albert Jobin. The purpose of these clinics, known as the Gouttes de Lait [see Frances-Mathilde Barnard*], was to provide care and clean milk to the children of poor families. Relevant information was made available to their mothers as well. At Quebec, where contagious diseases and diarrhoea were rampant, this service proved indispensable. In 1916, 27 children in 100 died in their first year, not counting stillborn infants. Only Sorel had more dismal figures. In June 1916 Fortier became director of the medical council of the seven Gouttes de Lait at Quebec, but he soon left this post because of a disagreement about his salary with the women comprising the executive committee. The operation would be financed by the provincial government from 1924. In the new organization that resulted from this change of administration, Fortier would be appointed chief physician.

These public experiments with the care of the city’s children were pivotal and encouraged other initiatives. In 1923, at the height of his career, Fortier helped found its first hospital for sick children. In January, Irma Le Vasseur*, the first female French-speaking physician in the province, who had co-founded the Hôpital Sainte-Justine in Montreal in 1907, opened a small dispensary on Rue Grande Allée, where Fortier was the first physician and where he admitted the first child as a patient. In May the paediatrician drew up a constitution and by-laws so that the institution could be incorporated under the name of Hôpital de l’Enfant-Jésus and receive government grants. The city’s elite gave it their moral support. Three sisters from the Dominicaines de l’Enfant-Jésus, under the medical supervision of Dr Fortier and Dr Édouard Samson, an orthopaedic specialist, were put in charge of its operation. It got off to a precarious start. The hospital moved three times before finding a home in 1927 in a new building on Chemin de la Canardière. The establishment of the hospital, with its 125 beds, reflected the local citizens’ interest in child care. Providing clinical instruction to future physicians, it then included two operating rooms, a dental clinic, a laboratory, a radiology room, and a maternity ward. After Fortier’s death it would become a general hospital.

An active man who combined the practice of medicine with university teaching, Fortier also championed the interests of his profession. He was secretary of the Société Médicale de Québec from 1897, when it was founded, until 1901. In 1899 the society began publishing the Bulletin médical de Québec; Fortier was a member of the editorial committee from 1899 to 1906 and its secretary from 1911 to 1913. He published some 20 articles in it, dealing especially with poliomyelitis, the feeding of infants, and hygiene. In his articles and lectures, Fortier encouraged breastfeeding and the practice of such hygienic measures as the pasteurization of milk and the sterilization of baby’s bottles. He sometimes criticized physicians who neglected to send sick children for consultation with specialists. Finally, in the interests of public health, he urged the government to improve the quality of milk for human consumption and to increase its financial support to hospitals.

René Fortier took to his bed in February 1929, suffering from cardio-renal arteriosclerosis, and he died on 8 August. His long-time friend Arthur Simard paid tribute to him, describing him as a shy, emotional, and modest person. With his talent, his fine moral qualities, and his professional dignity, Fortier gained an enviable reputation throughout the province, where he had become “the children’s doctor.” The career of this pioneer in paediatrics provides a wealth of information about medical practice of the time. The first Quebec City physician to devote himself to paediatrics both privately and in numerous clinics, he taught this discipline at the Université Laval for more than 30 years. He stressed the importance of physicians in general hospitals and encouraged medical specialization, especially through the founding of the Hôpital de l’Enfant-Jésus, where a commemorative plaque in his honour was unveiled in 1937.

Frédéric Jean and Érica Boisvert