Professor Evelyn Shapiro died in Winnipeg on November 10th at the age of 84. Evelyn was a pioneer in gerontology and home care research and policy. She was also a mentor to me. In 1973/74 I had the pleasure of completing an elective in medical school with Evelyn on home care services. Evelyn has been a life-long inspiration on my work.
Winnipeg had a very progressive geriatric and palliative care community in the early 1970s. I had been exposed to some truly innovative and inspiring programs at Deer Lodge Hospital during a summer job in 1973 between 2nd and 3rd year medicine. Dr. Jack MacDonnell was the chief physician and his wife Dr. Asa MacDonnell practiced with him. They pioneered many aspects of geriatric medicine in Winnipeg.
When Dr. Arnold Naimark was appointed Dean of medicine in 1970 at a youthful 38, he blew some much needed new wind into the school. He led a re-vamp of the curriculum towards patients and their problems rather than mind numbing memorization and rote learning. He also created one of the first Departments of Social and Preventive Medicine. Dr. David Fish a sociologist was appointed the first chair. He promptly hired Evelyn, Noralou Roos, economist John Horne, a sociologist named Angus Reid who soon became famous for his international polling firm, and many others. Eventually, the departmental faculty led the way to the creation of the world famous Manitoba Centre for Health Policy and Evaluation.
Evelyn Shapiro had been hired by the University in 1972 and I met her in 1973 on Dr. MacDonnell’s recommendation. I was immediately entranced by her sharp analytic mind and her dogged pursuit of policy. Evelyn was not your regular academic. She wanted to ensure good research was implemented into policy. As part of Dr. Naimark’s remaking of the curriculum, a 14 week elective was introduced to be taken in 3rd or 4th year. Most of my class mates wanted direct clinical experience. One of them went to the Amazon where he learned how to perform Caesarian sections and emergency abdominal surgery.
But I was always more interested in public health and policy. Evelyn was a perfect person to supervise my elective. In the lead up to the 1973 election campaign, the Schreyer Government passed legislation to cover most of the costs of nursing home care. By January 1974 there were over 700 patients waiting for care.
Evelyn wanted to know more about the people waiting for nursing homes and both of us suspected that many of them might do as well or better at home with appropriate services. I first analyzed a number of variables from the 700 people on the waiting list. I then interviewed a random sample of 70 (with their caregivers) of the 450 who were residing in the community, as opposed to residing in an institution like a hospital.
In retrospect the methods were not as strong as work done later. But, consistent with audits of wait lists for a variety of health services, I found that over 40% of people would not actually take a nursing home bed if it were offered to them that week.
I asked the people and their caregivers what home care services they were receiving and then I asked about whether they would like other home care services (from a menu). Finally, I asked if they would prefer to stay in the community if they could get these additional services. One-third of those who had indicated that they would take a nursing home bed if offered to them changed their minds and preferred to stay at home.
The project was an amazing opportunity for me to learn about research and how it affects public policy. My project was a small piece of grist for Evelyn’s creative mill. Later in 1974, Evelyn was appointed the provincial director for continuing care where she pioneered the implementation of the continent’s first universal home care program. She went on to many other senior government positions interspersed with stints at the University. But, it didn’t seem to matter whether Evelyn was working for government or the University. She was always dedicated to social justice and evidence-based policy.
Evelyn was born in Lithuania but grew up in Montreal. In Quebec, there are lots of people like Evelyn – public intellectuals who spend time in academia, government, and often in politics. They are rare in other parts of the country.
Evelyn even had a short and ultimately failing career as a candidate for municipal office. Evelyn was very active up until her death and I was so delighted that she could be present on May 13th when I was granted an honorary doctorate by the University of Manitoba at the Medical School convocation. She was part of a small and lovely dinner the night before and I will treasure the memories. (See picture below.)
You can find out more about Evelyn at the site that notes her 2000 University of Manitoba honorary doctorate: http://www.umanitoba.ca/admin/governance/senate/hdr/998.htm.