Palliative care specialist Dr. Balfour Mount poses in his home in Montreal, in April, 2013.Christinne Muschi/The Globe and Mail
In August, 1980, Balfour Mount’s mother, Maude, had one last request before she died. She wanted to see where she was going to be buried, not a picture, but the real thing.
And so, the son drove her and his father to the cemetery in Ottawa. They went through the gates and came to a stop at the end of the road, where he gestured to the plot, just beyond a grass-covered rise. But it still wasn’t enough.
“I want to go look,” the mother insisted. With his father waiting by the car, the two walked up the hill. At the top, they considered the mound of earth before them.
Then, the mother said, “Bal, I want to dance. I want to know that I danced on my grave.”
For Dr. Mount, once a cancer surgeon who wanted to know nothing of death as he raced to keep his patients alive, his mother’s words were proof that the path he was now carving out as a doctor who ministered to the dying was the right one. She showed him that death was not a defeat, but rather, a triumph of will and the culmination of a lifetime of experience – and he took her into his arms, waltzing round and round to a silent beat, a final act of grace.
After half a century of fighting for those who are terminally ill, Dr. Mount, known as the father of palliative care in North America, died on Sept. 25 in the very palliative care unit that was named for him in the Royal Victoria Hospital wing of Montreal’s McGill University Hospital Centre.
He was 86 years old, a man who survived a plane crash and two bouts with cancer, and sometimes it seemed like he would live forever, combining curiosity and compassion with a surgeon’s drive to succeed.
“Bal’s vision was rich,” said John Scott, who began to work with Dr. Mount when he was in his mid-20s, one of two young doctors the older surgeon tapped to create and run the first-ever palliative care unit on the continent.
Faced with a medical culture that tended to treat dying patients as if they were untouchable and to be ignored, there was lots of pushback as they struggled to make their vision a reality – pushback spurred by the fear that funding for the clinic would take away from the so-called real goal of medical care, namely, healing, and that giving patients even small amounts of morphine would turn them into addicts.
“I actually liked the pushback, that warrior mentality of fighting injustice,” Dr. Scott continued. “We were going to uncover injustice and change the very system he had been the embodiment of.”
Balfour Michael Morgan Mount was born on April 14, 1939, in Ottawa, the youngest of Harry and Maude (Henry) Mount’s three children. In his autobiography, Ten Thousand Crossroads: The Path As I Remember It (McGill-Queen’s University Press, 2020), he recalled an idyllic childhood in a white clapboard home that stood high on a property that overlooked Dow’s Lake.
His father was a surgeon, while his mother first trained as a teacher, then as a nurse. They taught their children how to be independent, kind and unafraid to ask questions. His older brother, Jim, introduced young Balfour to everything from building model airplanes from balsa wood to Frank Sinatra and alpine skiing; his sister, Alice, was his best friend and lifelong confidante.
In May 1953, just after his 14th birthday, “Bal,” as he would be known throughout his life, accompanied his father aboard a single-engine plane the older man had bought after obtaining his pilot’s licence. They were off to visit Jim, who was studying medicine at Queen’s University in Kingston. Soon after takeoff, disaster struck. The plane began to shake, as if it was coming apart, and black oil began to stream over the windshield and fuselage. When the plane crashed and cartwheeled under a Hydro power line, the boy figured this was it. Yet, everyone survived, shaken and bruised – but alive.
Although an indifferent student in high school, with an average of only 66 per cent, in 1957, he was accepted into Queens University’s pre-med program. There, he met his first wife, Faye Wakeling; they married in 1961, and she went on to become a United Church minister.
In his 20s, Dr. Mount was diagnosed with testicular cancer; after being treated in New York, he was determined to make urologic cancer surgery his specialty. He succeeded through sheer determination and the fierce will of a survivor. By the time he was 35, he was a tenured professor at McGill’s medical school, handling a burgeoning surgical practice and running a scientific research lab all at once.
Then, in January, 1973, he organized a seminar at his church that revolved around discussion of Elisabeth Kübler-Ross’s book On Death and Dying. In a way, as a cancer survivor and surgeon, he considered himself an expert, well-placed to address the issue.
“Of course, I realized during that panel that I knew nothing,” he would later say.
When it was suggested during the panel that a study be struck to determine if the problems detailed in the book – testimony from terminal patients of being cast aside by the British medical profession and left to die in pain – were occurring in Montreal, too. With a tiny grant from McGill’s faculty of medicine, he enlisted two students to interview terminally ill patients and staff at Royal Victoria, which was considered one of the most cutting edge teaching hospitals in North America.
The results would change the course of his life, for it became clear that to die at the Royal Vic was a “catastrophe,” and that staff had nary a clue about the enormity of their inadequacies. The fact was, they did not want to think about it.
Dr. Mount, pictured in April, 2013, died on Sept. 25, 2025.Christinne Muschi/The Globe and Mail
He was spurred to contact Dame Cicely Saunders, the founder of Saint Christopher’s, a British hospice described in the Kübler-Ross book. Formidable, she told Dr. Mount that if he was serious about introducing the concept to North America, he would have to come to London for a week on his own and immerse himself in the hospice’s work.
In September, 1973, he did. He returned with the idea to expand the hospice concept – private clinics that operated outside the hospital system – to hospitals themselves, starting with the Royal Vic. Just as there was a birthing unit, there should be one for dying – and he decided to call it “palliative care.”
At 62, Dr. Mount became the patient once again, this time diagnosed with deadly esophageal cancer. As he lay in the recovery room after surgery, he thought of his mother, of dancing on her grave, of the lessons learned when engaging with terminal patients and the distinct possibility of his own imminent dying.
“I thought that whatever happens, this won’t get the best of me,” he said. “I was thinking about turning the tables.”
Justin Sanders, who holds the Kappy and Eric M. Flanders Chair of Palliative Care Medicine at McGill, noted that people mistakenly associate palliative care with the end of hope.
“Yet, we know that palliative care is all about hope,” he said in a statement. “It is about hope for more time for what matters and more well-being whatever the outcome of disease-directed treatment.… Bal did so much work to help doctors and other clinicians see a world that could be different for people affected by cancer. In doing so, he changed medicine.”
Dr. Scott said his mentor was the father of palliative care, period. “The U.K. learned it from him. He took the ‘iron’ of the hospice, the ‘iron’ of Dame Cicely and ‘iron’ of his own vision and forged into something much stronger and more flexible.”
One of the most important lessons Dr. Mount instilled in his younger protégés was that it was okay, even necessary, to show vulnerability to patients. “Indeed, it was a gift. He showed us that you needed to treasure the fact that you don’t know what to say next, but that you want the best for them and that you care,” he said.
His son, James Mount, said his father was lucid and engaged until near the end. “There is the doctor that everyone knows worldwide and then, there was dad. I lost not just a friend and a dad, but a counsellor, too – someone who made the time to help see me through some of my darkest moments.”
Dr. Mount received numerous honours and accolades during his career. They include being made a member of the Order of Canada in 1985, a promotion to the rank of officer in 2003, and, in 1988, being made an officer of the National Order of Quebec.
He leaves his wife, Linda Guignion Mount; and his children, Christopher, James, Lauren and Bethany.
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