 While
working in northern Alberta during the oilfield construction
boom, Jay Wortman learned some important life lessons.
"The first time I worked on a sewer job," he recalls,
"the foreman said, 'You only need to know two things to
build a sewer: shit runs downhill, and payday's on Friday."
Dr Wortman, who hails from a tiny
northern Alberta hamlet called Fort Vermilion, has done
a lot since then, from running Vancouver's first AIDS
centre to directing BC's First Nations and Inuit Health
Branch. But those earthy life lessons from his first
career have stayed with him.
"I like to cut through the bull,
find a simple solution and do it," he says. For instance,
when he discovered two years ago that he had type II
diabetes, his inner Mr Fixit kicked in. "The metabolic
defect you have is that your blood sugar's too high,"
he explains. "So, what's the first thing you do when
your bathtub's overflowing? You turn off the tap. That's
what I learned from my construction days — problems
don't have to be that complicated." In this case, turning
off the tap meant the doctor, who is of Métis
descent, completely banned any foods that might affect
his blood sugar — in other words, he returned to
a more traditional aboriginal-style diet. "Other people
have had thousands of years to become accustomed to
a diet that is higher in refined carbohydrates," he
points out. "Aboriginal people haven't." His health
improved dramatically.
His wife, an IT expert whom he
met when she was setting up a computer system at Health
Canada, pointed out that his new regime was a lot like
the Atkins diet. "Then it occurred to me — maybe
this is the solution to the diabetes problem in aboriginal
communities. Maybe the Atkins diet is the modern equivalent
of a traditional aboriginal diet." He was so impressed
by the results in his own life that he started spreading
the word.
"I put a lot of extra effort into
this when there's no discernible reward," he says. "I
guess it's my avocation as a physician, that I still
have the instinct to heal people, even though I'm working
in an administrative role."
MATURE,
BUT RADICAL
He certainly didn't start out in medicine with administration
in mind. At the age of 31 he followed the lead of some
admired friends and went to medical school at the University
of Victoria. ("I was tired of knocking mud off my boots,"
he says.) Surgery appealed to him: the camaraderie in
the OR reminded him of a construction site, and a lot
of the tools were the same — "just cleaner and
shinier," he jokes. But he opted instead for the family
medicine program. "I was old," he says, laughing. "I
couldn't take that kind of punishment."
Then fate, or rather a miserly
provincial government, intervened. "The [BC] government
was trying to cut costs," he recalls, "and they saw
doctors as the gateway to the system, so they thought
if they could reduce the number of doctors, they could
cut down on people's access to the medical system. So
they stopped giving billing numbers out the year I graduated
from residency."
He could have gone to another province,
but he decided to stay and fight. With a group of fellow
graduates, he formed a "little guerilla group" of doctors.
"We called ourselves 'Physicians for Medicare,' which
really irritated everybody," he chuckles. "We raised
awareness about the agenda behind the government's decision
— that it wasn't just about privileged young kids
not able to make a big income, it was about access to
the system. And I think we actually had an influence
on the court's decision."
REDNECK
TO CRUSADER
Meanwhile, he took on session work at the BC Centre
for Disease Control, in the HIV clinic. The busy, demanding
atmosphere appealed to him, and he wound up working
full time as Associate Director for STD control.
It was a stretch, at first. "From
my background, working in construction in Alberta, I
was a bit of a redneck — openly gay people weren't
something you saw in that environment. So this was an
adjustment. It opened my eyes. It occurred to me that
there was a lot of fear and hysteria about AIDS because
of homophobia."
One day, he came across the obituary
of a San Francisco journalist who'd broadcast an AIDS
diary. Shortly afterwards, a friend from Physicians
for Medicare, Dr Peter Jepson-Young, confided to Dr
Wortman that he had AIDS, was going blind, and would
have to give up medicine. Dr Wortman recalled the San
Francisco radio diary, and suggested they do something
similar. The result was The Dr Peter Diaries,
which ran on CBC for two years, until Dr Jepson-Young's
death; a one-hour special made from the footage got
distribution in the US, and was nominated for an Academy
Award.
"When Peter died, the goodwill
he'd generated was huge," he recalls. At Dr Jepson-Young's
request, Dr Wortman headed the Dr Peter AIDS Foundation,
which in turn established Vancouver's first AIDS care
centre.
CLOSING
THE GAP
From there, Dr Wortman put his longterm interest in
aboriginal health issues to work, developing Canada's
first HIV program targeting aboriginal communities for
the provincial government, then moved to the federal
government to develop a similar program nationwide.
His M�tis background helped. "I found early in my medical
training that aboriginal people often had difficulty
interfacing with the medical system," he says, "and
I found that when they knew about my aboriginal heritage,
the communication gap closed."
He's been working in aboriginal
health ever since. He travels a lot in his work, opening
health centres in aboriginal communities. "I'm lucky,
in that I get to attend a lot of community celebrations,"
he says. "It's a wonderful part of my job." Whenever
he can, he takes his four-year-old son with him. He
also spends a fair amount of time in Ottawa, as a senior
member of his branch, and now, with his interest in
diabetes, he's added speaking engagements to his roster.
"I've followed a particular path
in arriving here," he says. "There's been an alignment
of coincidental events where I find I'm in a position
where I can push for something that I believe is important,
and I don't see anybody else around who's in that position.
Really, if I don't do it, I don't think it'll get done."
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