Gilles Bertrand, centre, stands behind William Cone and Wilder Penfield in the Montreal Neurological Institute in 1953.Yousuf Karsh/Supplied
When Gilles Bertrand was a young neurosurgeon in 1950s Montreal, he operated on patients with a hefty German brain atlas open on a stool beside him. It was a bit like travelling to Mars using a treasure map drawn on the back of a napkin.
These were the days before MRIs and other technologies for visualizing the infinitely complex three-pound organ in our heads. Surgeons looking to remove tumours or repair damaged blood vessels had to navigate using cruder methods.
“We were operating blind,” Dr. Bertrand told The Globe and Mail.
His generation would help change that. At the Montreal Neurological Institute, he trained under the famed Wilder Penfield, whose technique for epilepsy surgery helped map the functional areas of the brain. It was a golden age that arguably founded modern neuroscience and charted the elaborate workings of memory, pleasure and speech.
Dr. Gilles Bertrand died on Feb. 24 at the age of 101.Supplied
A consummate craftsman and healer in a hothouse of scientific visionaries, Dr. Bertrand stood out for his vast technical skill and focus on patient care, eventually becoming chief neurosurgeon at probably the world’s greatest centre for brain research. His pioneering work treating Parkinson’s disease helped earn him the Order of Canada among many other honours.
When he died on Feb. 24, at 101, so did one of the last living embodiments of neurosurgery’s heroic age, when steel nerves were as important as steel wire sutures and the brain was an “undiscovered country,” as Dr. Penfield liked to say.
Dr. Bertrand and his colleagues did as much as anyone to discover it.
Gilles Guy Pierre Bertrand had medicine in his blood. He was born in Montreal on Aug. 5, 1924, the only child of Albert and Françoise Bertrand, a microbiologist at Notre-Dame Hospital and a nurse respectively.
Soon after, the family moved to France for Albert’s studies, and when Gilles returned to Quebec at age three or four he had a Parisian accent his classmates teased him about. A knee injury from skating then left him bedridden for months and prompted his transfer from primary school to a private tutor when the nuns wouldn’t readmit him.
If a fairly isolated childhood contributed to his adult reserve, it didn’t dampen his sense of humour and love of practical jokes. At the prestigious Collège Jean-de-Brébeuf, Gilles was known for his pet squirrel, which once scampered into the cassock of a severe Jesuit professor, to the delight of his fellow students.
The young man’s smarts were never in question, nor was his ambition. He finished second in his medical class at the University of Montreal, although not finishing first “always burned him up,” his daughter, Maryse Bertrand, said.
The young doctor-in-training gravitated to neurology, a specialty that was opening thrilling new horizons of understanding about the brain. In Quebec, however, the treatment of the nervous system was held back by certain moral hangups. Still deeply influenced by the thinking of 19th-century Freud mentor Jean-Martin Charcot, who once remarked “c’est toujours la chose genitale” (it’s always the genital thing), his superiors often blamed neurological conditions on venereal disease.
“Everything was syphilis,” Dr. Bertrand recalled in a 2023 interview. “Slipped disc? Syphilis. Sciatica? Syphilis.”
The prevailing treatment was hardly more enlightened. The nuns working as nurses at Montreal’s Hôtel-Dieu hospital would induce hyperthermia in ostensibly syphilitic patients, to sweat the disease out, sliding them into coffin-like boxes with their heads sticking out and heating them up. When the poor souls complained, the sisters, in their infinite compassion, replied that it would be much hotter in Hell.
There was a beacon in the world of neurology and it happened to be in Dr. Bertrand’s backyard. Wilder Penfield was turning his institute, housed in a neo-Gothic stone building on the southern slope of Mount Royal, into the international gold standard with bold explorations of the brain’s geography. His “Montreal procedure” treated epilepsy by stimulating the cortex with an electrode to find scarring that needed to be removed, and in the process triggered involuntary physical movements, vocalization, smells and even memory fragments that revealed what certain areas of our grey matter did. It was groundbreaking.
When Dr. Bertrand applied for a surgical residency, Dr. Penfield said it would be a two-year wait, he took a detour to the Salpêtrière in Paris – Charcot’s old stomping ground – and a hospital in Toledo, Ohio, before finally going to work as a trainee at The Neuro.
It wasn’t a glamorous life. Junior residents were paid $25 a month, plus room and board, and slept in the gloomy dormitories of the Royal Victoria Hospital next door; Dr. Bertrand’s bed was in the cavity of a chimney, so he had to be careful not to bump his head getting up in the morning.
The caseload was unrelenting and grim. In winter, the institute received a steady stream of helmetless hockey players with cracked skulls; at the start of summer, they always saw a spike in children who had fallen from third-storey balconies in Montreal’s distinctive triplex apartment buildings.
William Cone.Osler Library of the History of Medicine/ McGill University.
The young Dr. Bertrand quickly came under the influence of William Cone, Dr. Penfield’s best friend and deputy, and the hospital’s overlooked workhorse. A pioneer of spinal and trauma surgery who ministered to his patients with parental care, Dr. Cone was single-minded and technically masterful. He despised lapses in care such as pressure sores and maintained one of the world’s lowest hospital infection rates for that time. To keep patients company at night he would sit by their bedside and share a cigarette, squeezing their hand if they were afraid. His resident was learning what it took to be a great surgeon.
So it was especially devastating when, on the morning of May 4, 1959, Dr. Bertrand got a call from a fellow resident that Dr. Cone had been found dead in his office. The cyanide crystals around his lips made it clear this was a suicide. Dr. Cone had suffered from periods of depression for decades but his death was a shock. In the days that followed the institute’s residents wore green in homage to Dr. Cone’s trademark green scrubs.
“He was an extraordinary man,” said Dr. Bertrand, still emotional about that period more than 60 years later.
Pioneering neurosurgeon explored the mind’s mysteries – and left behind secrets
In the vacuum left by Dr. Cone, Dr. Bertrand became his own man. He was the first French-Canadian neurosurgeon appointed to the institute’s staff, a major landmark at a time when francophones were often excluded from the upper ranks of anglophone society, and well before The Neuro became a bilingual environment.
His human warmth and technical skill made him one of the most popular surgeons on staff, “personable, gregarious, always with a smile and with a kind word for all,” said Gabriel Leonard, a retired neuropsychologist at the MNI, who marvelled at his colleague’s skill in treating Parkinson’s.
“Once I had evaluated, cognitively, one of his pre-op patients and I was invited to observe the ensuing surgery,” Dr. Leonard recalled. “The patient sat in a surgical chair with a probe inserted into just the right spot deep in his brain. Dr. Bertrand said to the awake patient, ‘I am about to make the incision,’ and just like that the horrible shaking on his left hand was rendered still. For me this was astounding to witness, for the patient, a Mr. G, it was a miracle, for Dr. Bertrand, another wonderful success in his long, pioneering career.”
Along with treating movement disorders, Dr. Bertrand became known for handling especially challenging spinal conditions, another legacy of his training under Dr. Cone.
“He got very, very tough cases,” said Richard Leblanc, a retired MNI neurosurgeon and the leading historian of the institute, who trained under Dr. Bertrand starting in the late 1970s. “These were cases that required a great deal of judgment to decide to intervene or not, and a great deal of courage.”
Decades after he first leafed through a physical brain atlas while performing surgery, he made a leap forward in neural navigation that would benefit everyone who came after him. Dr. Bertrand, along with his colleagues André Olivier and Chris Thompson, “developed a computerized brain atlas that could be matched to an individual patient’s brain using mathematical transformations, which they used in the operating room, to greater accuracy and to the patient’s benefit,” Dr. Leblanc. It was a major advance, “and probably the first instance of the use of computers in neurosurgery, if not in surgery as a whole.”
Over time, Dr. Bertrand developed a reputation as a surgeon’s surgeon, whose deft movements in the operating room and deep knowledge of neuropathology were best appreciated by fellow practitioners. His name spread as a steadily growing corps of disciples brought his techniques to hospitals across the world.
In 1972, Dr. Bertrand was appointed neurosurgeon-in-chief at the MNI, and in 1988 he was named William Cone Professor of Neurosurgery at McGill University, a chair endowed by grateful patients after his mentor’s death.
The extreme care he took in operating and his sensitivity outside the OR earned Dr. Bertrand legions of appreciative former patients as well. Prime minister Brian Mulroney was forever thankful after Dr. Bertrand extended his father-in-law’s life. Even the director of the institute, William Feindel, owed him one after Dr. Bertrand removed a troublesome lumbar disc from his spine.
Beyond the institute, Dr. Bertrand was a devoted husband to Louise Bertrand (née Lafleur), whom he met in his 20s and whose fun-loving personality complemented Gilles’s, and an affectionate father to his daughter and two sons.
“It’s true that we rarely had dinner together as a family because he would be home too late, but every weekend when he wasn’t on call, he’d be building us igloos in the snowbank, or taking us sailing on Lac des Deux Montagnes,” Maryse said.
Apart from his passions for family and sailing, Dr. Bertrand was an avid woodworker, saving his most elaborate contraptions for his grandchildren, like the desk he built for his grandson Philippe with six or seven secret compartments and a different mechanism for opening each one.
The basement workshop was his outlet when he was feeling particularly upset about losing a patient, usually a child, Maryse said.
Unlike Dr. Cone, however, who brooded over losses, Dr. Bertrand had a naturally sunny disposition and a twinkle in his eye, especially after telling a funny story. Later in life he developed a taste for single-malt Scotch, and into his final illness he looked forward to his 4 p.m. tipple. His family even smuggled whisky into the hospital as he was dying – in a bottle marked jus écossais, or Scottish juice – and he enjoyed a final dram, along with 18 oysters, before receiving medical assistance in death surrounded by his children on Feb. 24.
“At the end, he was resolute in his desire to go, kissed the three of us and did a little wave of his hand as one does when leaving on a long trip aboard one of those transatlantic ships that he had taken so many years before,” said Maryse. Another voyage to an undiscovered country.
He leaves his daughter, Maryse, and sons, François and Martin Bertrand, along with two grandchildren and a great-grandson.
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