In Focus
Profile Jean-Pierre Chanoine: taking paediatric endocrinology global Living green, healthy, and thrifty is an ethos we could probably all benefit from sticking to a little more, but for Jean-Pierre Chanoine’s patients the stakes are considerably higher. One of Chanoine’s primary interests is the prevention and management of childhood obesity, and the LiGHT programme is one of his newest weapons in the battle to turn the tide against an ever-increasing epidemic. That the fundamental philosophy of the programme seems inimical to the interests of western capitalism only serves to illustrate the scale of the task ahead, Chanoine explains with a wry laugh. “There is an antagonism between what we say and what the patient is exposed to when they get out of the door of the clinic, but we won’t be able to solve obesity by looking at just the medical point of view because it’s so engrained into the way we live.” If doing battle with the modern world sounds like serious business, Chanoine certainly doesn’t take himself too seriously, peppering our conversation with dry, deadpan humour. The immediate past President of the Canadian Pediatric Endocrine Group, Chanoine has called the Endocrinology and Diabetes Unit in British Columbia’s Children’s Hospital home for the past 13 years, and is the unit’s director. Not bad for someone who, as a child, was adamant he didn’t want to go into the family business. Growing up in Belgium, Chanoine’s father was a physician— an internist and a diabetologist in fact—and Chanoine remembers seeing him only fleetingly as he struggled with an impossible schedule. “At the time I said ‘well never, I’m never doing this stupid job because I want to have a life’”, he recalls. “But at the time in Belgium—I finished high school in 1975—the career choices were way more limited than today”. Chanoine went into medicine at the Free University of Brussels, Belgium, in the full knowledge, he says, that he would become a paediatrician. And according to Arya Sharma, Chair in Obesity Research and Management at the University of Alberta, Canada, Chanoine’s “humble, kind hearted, knowledgeable, and soft spoken” nature makes him “everything one could expect from someone who works with children”. It was at medical school that Chanoine got his first taste of what would later become his second major interest. “I spent 2 months in the Belgian Congo, back when it was called Zaire. And I really loved that; I always wanted to get into global health, but unfortunately it did not unfold until recently.” Compulsory military service intervened, and although there was an option to do social service for 2 years in a developing country, the money to fund it was impossible to come by. “I ended up in a cavern in Germany for 13 months, where I had the choice between drinking beer or writing grants. I took the second one, got a grant and was happy to www.thelancet.com/diabetes-endocrinology Vol 1 September 2013
go to another developing country: the USA”, he laughs. It was the beginning of a peripatetic phase of his life. Although he loved his time as a fellow at the University of Massachusetts, and describes his mentor Lewis Braverman as a “marvellous man”, Chanoine says he always knew that, in the long run, staying in the USA was not an option. “The culture is very different; the superficial aspects, the confessional aspects, the guns”, he says. “With a family it’s tough out there, and I like the quality of life of Europe.” Instead he returned to Belgium, and after a brief spell in what he describes as a “depressing” and sterile academic setting he turned to industry, taking up a post as Medical Director for Novo Nordisk’s Belgian operation and founding the medical department there. “It was a very interesting experience because I’d never worked in a company like that, and these guys think differently. I mean these guys would sell anything to anybody. But the concept was very interesting and actually it was a good company and I learned a lot, but I knew I didn’t want to do it forever”, he recalls. “So I was very lucky to find the position as division head for paediatric endocrinology in Vancouver, BC, Canada. I’ve been here since 1997, and they never told me how long it would be for. I never asked, and I’m still stuck here in 2013.” Perhaps stuck is the wrong word, because as global health increasingly becomes a primary focus for Chanoine, he is spending more time abroad training others. “Until 5 years ago, there were just no paediatric endocrinologists in central Africa”, he says. “Global health was directed, understandably, to the main killers like HIV, maternal health, nutrition. But there is a case for bringing training for specialty and even subspecialty care to developing countries, and diabetes is a great example. It’s not an uncommon disease, but in the past, children were dying because there was no care, and they were never even diagnosed with diabetes. Now we can diagnose them, and although the quality of care probably remains quite poor, patients are still living 20 years more than they would have been.” Together with colleagues in the Global Paediatric Endocrinology and Diabetes group, Chanoine is “absolutely superb” at coming up with “innovative ideas, sharing a vast canvas of knowledge and experience, and endless sensible enthusiasm for projects that would advance the future”, says Margaret Zacharin of the Royal Children’s Hospital in Melbourne, VIC, Australia. In May, Chanoine chairs the first symposium at the Pediatric Academic Societies meeting in Washington, DC to discuss paediatric endocrinology in lowincome settings. “Things are really coming along,” he says, “and I’m very enthusiastic about that”.
Published Online January 30, 2013 http://dx.doi.org/10.1016/ S2213-8587(13)70002-0
David Holmes e9
Profile Jean-Pierre Chanoine: taking paediatric endocrinology global Living green, healthy, and thrifty is an ethos we could probably all benefit from sticking to a little more, but for Jean-Pierre Chanoine’s patients the stakes are considerably higher. One of Chanoine’s primary interests is the prevention and management of childhood obesity, and the LiGHT programme is one of his newest weapons in the battle to turn the tide against an ever-increasing epidemic. That the fundamental philosophy of the programme seems inimical to the interests of western capitalism only serves to illustrate the scale of the task ahead, Chanoine explains with a wry laugh. “There is an antagonism between what we say and what the patient is exposed to when they get out of the door of the clinic, but we won’t be able to solve obesity by looking at just the medical point of view because it’s so engrained into the way we live.” If doing battle with the modern world sounds like serious business, Chanoine certainly doesn’t take himself too seriously, peppering our conversation with dry, deadpan humour. The immediate past President of the Canadian Pediatric Endocrine Group, Chanoine has called the Endocrinology and Diabetes Unit in British Columbia’s Children’s Hospital home for the past 13 years, and is the unit’s director. Not bad for someone who, as a child, was adamant he didn’t want to go into the family business. Growing up in Belgium, Chanoine’s father was a physician— an internist and a diabetologist in fact—and Chanoine remembers seeing him only fleetingly as he struggled with an impossible schedule. “At the time I said ‘well never, I’m never doing this stupid job because I want to have a life’”, he recalls. “But at the time in Belgium—I finished high school in 1975—the career choices were way more limited than today”. Chanoine went into medicine at the Free University of Brussels, Belgium, in the full knowledge, he says, that he would become a paediatrician. And according to Arya Sharma, Chair in Obesity Research and Management at the University of Alberta, Canada, Chanoine’s “humble, kind hearted, knowledgeable, and soft spoken” nature makes him “everything one could expect from someone who works with children”. It was at medical school that Chanoine got his first taste of what would later become his second major interest. “I spent 2 months in the Belgian Congo, back when it was called Zaire. And I really loved that; I always wanted to get into global health, but unfortunately it did not unfold until recently.” Compulsory military service intervened, and although there was an option to do social service for 2 years in a developing country, the money to fund it was impossible to come by. “I ended up in a cavern in Germany for 13 months, where I had the choice between drinking beer or writing grants. I took the second one, got a grant and was happy to www.thelancet.com/diabetes-endocrinology Vol 1 September 2013
go to another developing country: the USA”, he laughs. It was the beginning of a peripatetic phase of his life. Although he loved his time as a fellow at the University of Massachusetts, and describes his mentor Lewis Braverman as a “marvellous man”, Chanoine says he always knew that, in the long run, staying in the USA was not an option. “The culture is very different; the superficial aspects, the confessional aspects, the guns”, he says. “With a family it’s tough out there, and I like the quality of life of Europe.” Instead he returned to Belgium, and after a brief spell in what he describes as a “depressing” and sterile academic setting he turned to industry, taking up a post as Medical Director for Novo Nordisk’s Belgian operation and founding the medical department there. “It was a very interesting experience because I’d never worked in a company like that, and these guys think differently. I mean these guys would sell anything to anybody. But the concept was very interesting and actually it was a good company and I learned a lot, but I knew I didn’t want to do it forever”, he recalls. “So I was very lucky to find the position as division head for paediatric endocrinology in Vancouver, BC, Canada. I’ve been here since 1997, and they never told me how long it would be for. I never asked, and I’m still stuck here in 2013.” Perhaps stuck is the wrong word, because as global health increasingly becomes a primary focus for Chanoine, he is spending more time abroad training others. “Until 5 years ago, there were just no paediatric endocrinologists in central Africa”, he says. “Global health was directed, understandably, to the main killers like HIV, maternal health, nutrition. But there is a case for bringing training for specialty and even subspecialty care to developing countries, and diabetes is a great example. It’s not an uncommon disease, but in the past, children were dying because there was no care, and they were never even diagnosed with diabetes. Now we can diagnose them, and although the quality of care probably remains quite poor, patients are still living 20 years more than they would have been.” Together with colleagues in the Global Paediatric Endocrinology and Diabetes group, Chanoine is “absolutely superb” at coming up with “innovative ideas, sharing a vast canvas of knowledge and experience, and endless sensible enthusiasm for projects that would advance the future”, says Margaret Zacharin of the Royal Children’s Hospital in Melbourne, VIC, Australia. In May, Chanoine chairs the first symposium at the Pediatric Academic Societies meeting in Washington, DC to discuss paediatric endocrinology in lowincome settings. “Things are really coming along,” he says, “and I’m very enthusiastic about that”.
Published Online January 30, 2013 http://dx.doi.org/10.1016/ S2213-8587(13)70002-0
David Holmes e9
