Unscripted:* in conversation with Dr. Michael Julius

Moderation is a fatal thing. Nothing succeeds like excess.
—Oscar Wilde

Nearly 20 years ago, Dr. Michael Julius moved an obscenely large Kentia palm into Room A3 30, one with fronds far too exuberant for the corner in which it was placed, and so began his tenure as vice-president, research (VPR), Sunnybrook. His time has been marked by a singularity of vision—to achieve discovery and its clinical impact through the medical marketplace—and constant unapologetic excess in pursuing that vision.

The milestones are many. The achievements abound. Fundamental discoveries that have advanced our understanding of how the body works in sickness and in health? Check. Knowledge that has changed clinical practice? Check. External funding that has near tripled? A quadrupling of staff, with similar multiplication of square footage for research? Check, check and check. In this edition of Nexus, we showcase some of this legacy, as well as the impact Julius has had not only on the Canadian health research and care systems, but, also, individually, on too many people to count (or include, regrettably, in this publication).

We start here, glass in hand, with Julius, aka MJ, talking to Stephanie Roberts about formative influences, proudest moments, super highways and two things he cannot live without.

He is not, for the record, retiring. He is relocating his expansive palm (the fourth) to another corner of the world, one yet to be revealed, though he drops clues in this interview. There is, then, tantalizingly and fittingly, no conclusion.

The suspense is terrible. I hope it will last.
—Oscar Wilde

* albeit lightly edited

Why? Why on earth did you take on the role of VPR?

Just like every job I’ve thought about, the first question I ask myself is whether there is something I could do that would have material impact in making the surrounds a better place; if not, I don’t take the job.

And so when the offer came forward, I came to Sunnybrook with the same question: what could I do? That’s when the fundamental question occurred to me: why are we doing research in a hospital, if it’s not tethered to the clinical domain of the corporation?

If we are not tethered to the clinical domain, then we are functioning as a university—discovery research engines—not a bad thing, at all—but not what I was interested in. And so, at the end of the day, I became comfortable that I could put together a vision to integrate discovery into the clinical domain. I can walk the halls of Sunnybrook and SRI and ask folks why they care that their work could have an impact on patient care and why they do what they do; almost to an individual, they reply, ‘It’s because I can.’ It’s an ethos we’ve grown over the last two decades.

You have four publications in Nature, the world’s most cited scientific journal, which accepts fewer than 8% of submissions to it. How did it feel to have to dial back your research intensity to be able to dial up your focus on being VPR?

Hugely challenging. I’ve never had an enormous lab. I’ve maxed out at 10 or 11 individuals, and these are my children. When I take on trainees, I take it extraordinarily seriously and am dedicated to bringing on the best, with a multitude of ideas. When I came on board, I was confronted with, ‘you get what you give to the position,’ and it became very, very clear to me that the distractions of the vision that I was bringing forward were basically impeding my capacity to continue my research activity with the same depth and breadth that I came to the shop with.

It was a choice. Actually, it wasn’t a choice. It was an obligatory choice—if I was going to succeed in this role. And yes, it was tough. I have to tell you, walking away from Sunnybrook, the thing that I will miss most is my ‘kitchen’—it has been my anchor.

Once an immunologist always an immunologist, irrespective of whether you have a lab?

I do not consider myself an immunologist. Immunology is a spectacular discipline, because you need to be a geneticist, you need to be a biochemist and you need to be a cell biologist in order to solve the physiological problems that are confronting us through the immune system.

I am a geneticist by training and a basic scientist by craft. I understand a little bit about the genome. I’m starting to understand a little bit about the complexity of the physiology of the immune system. These two understandings have helped me to understand that everything applies to everything. It’s convergence. One of my dearest mentors, Niels Kaj Jerne [Nobel Laureate and director of the Basel Institute of Immunology], once said to me, ‘Michael, I am not interested in stop signs. I’m interested in super highways.’ He was right—and it’s convergence that will lead us to super highways.

So, then, once a basic scientist, always a basic scientist?

I think yes. It’s the reductionist approach that you can apply to any walk of life.

When and why did you decide to become a scientist?

I did ballet for eight years of my life. I was told I wasn’t ever going to be a principal [dancer] at age 12—devastated. The good news is one of my first courses in university was genetics.

I don’t know how best to describe it to you: I just got it. You know, there’s stuff you get, and there’s stuff you get less. I got it, and I got 100% in the course. When you get 100% in a course, they pay attention to you. I know I do as an instructor [at the University of Toronto]—and these are the people who usually come and talk to you.

So I remember going to the lecturer in the genetics course, and I said, ‘I’m thinking about the Honours genetics program.’ He said, ‘Oh, really. That’s lovely. Did you bring a transcript?’ ‘I certainly did,’ I said, and I give him my transcript. He looks at my transcript [with one low mark that had pulled the average down to 65%], and goes, ‘Holy cow. How am I going to deal with this? I have to go talk to the chair.’ He came back in 10 minutes and said, ‘We’re going to give you a chance.’ So, I went into Honours genetics.

In the next year, where I could take the courses I wanted to take and not the ones I had to take, my average went to 99.9%, because I had found something that resonated. Then I went to my guidance counselor, and they said people who get marks like this go to medical school. I made application and was accepted. I did my premed summer [at City of Hope Medical Center in Duarte, California, U.S.] with Susumu Ohno [renowned geneticist and evolutionary biologist]. He wrote the book, Evolution by Gene Duplication, and I said, ‘This is what I want to do.’

At that inflection point, was that the moment you decided you wanted to be a scientist, rather than just study genetics?

Yes. This guy, when I walked into his office, said, ‘Ah, yes. I remember you. Why don’t you look at this,’ and threw me some papers. I looked at it, and it was a chapter from Evolution by Gene Duplication ahead of its publication.

I was reading Evolution by Gene Duplication while he was writing it, and I was just blown away. I didn’t realize that you could have fun in life with career choices, because it was about the work ethic: you got to get a job, you got to make money. The luckiest thing I think most true academics say is, ‘Holy Moly. I found a job where someone is actually going to pay me to do what I want to do.’ True academicians say this—and so I got into genetics.

Did you expect to have more of an impact during your time as VPR?

Oh my goodness. For clarity, when I came into Sunnybrook in 1999, 2000, my predecessor Mark Henkelman had planted a seed, and he did a brilliant job over his decade of service. He nurtured and fostered that seed. It sprouted. We had scions, but the tether to the clinical domain didn’t exist, so I appreciated what my goal was.

Am I impatient? Absolutely. Did I think it was going to go a lot more quickly? Absolutely. Recruitment of scientists took years and years. Creating the clinical receptors for those scientists that shared the same ethos and passion took years and years. At the end of the day, to be at the top of the world in at least one or two arenas of science as it impacts the health care system is material—we stand on the shoulders of giants. I am so proud of our Sunnybrook family.

Did I think I was going to do more? I was hoping I could do more. It was an 8-million ton battleship, so I’m going to induce a course correction? I was disabused of that concept probably within a couple of hours of taking on this position. It’s not complicated, but it is complex. Like everything else, it’s people. People are our most precious resource, and it was assembling this team over the last decades that enabled the successes we’ve enjoyed thus far, and I know they are material.

Is there one moment that springs to mind as your proudest?

A moment? Two moments. Three moments. The first moment was that, during the first five years of my stay here, there was the need to recruit a successor to Mark Henkelman, my predecessor, who was running the then-called imaging platform, and we landed Kullervo Hynynen in 2005.

The second moment was picking up the phone and talking to my then-chief executive, my fourth, Barry McLellan, and telling him, ‘Barry, we’ve received about 100 and X millions of dollars from the Research Hospital Fund to create the Centre for Research in Image-Guided Therapeutics.’ This is the flower, the work product, of our recruit to take over what is now called the Physical Sciences Platform of SRI.

My third moment was convincing my CEO to take a chance on building the fundamental third arm of what we need to be a full service discovery to clinical impact research institute. This is the investment into the Biological Sciences Platform and recruitment of David Andrews in 2012. Once you have the team in place, I don’t want to say the conductor is irrelevant, but it’s self-fulfilling.

Nineteen years is a long time. It’s almost as long as it took to build the Taj Mahal, at 21 years, or the Great Pyramid of Giza, at 20 years, albeit longer than Macallan 18 is matured. How do you feel looking back?

It was the blink of an eye. This was my family. I was dedicated to it from morning to night. I guess you might call me eccentric, captivated by the vision that we as a collective created, and I dedicated myself to bringing that vision to life—the blink of an eye.

So that reaches back to, did I think I was going to accomplish more? Yes, I did, but while making progress took the requisite time to build the team, I think the path for further growth will be hugely accelerated as a consequence of the machine that we have created.

It’s one thing to have a vision. It’s another for people to agree to and accept the vision, and to follow it. How do you get people to drink your Kool-Aid—without offering it with a side of Macallan 18?

Number One, Macallan 18 is always on the table. Number Two, I focus on talking to people who are smarter than I am. If I can tantalize and induce a sparkle in conjunction with a glass of M 18, they’re on board. That’s the way it’s worked.

The leadership that we have created at SRI is one of our most precious resources. My capacity to have accomplished that is because I didn’t drink my own Kool-Aid, and I knew what I had to be around to even start chipping away at this enormous vision of inventing the future of health care.

It’s not that I was starting from zero; it’s just that the changes we’ve implemented over the past 19 years—they’ve been material. We did good. The team is good. The intellect is strong. The drive for discovery overwhelms and inspires, and it is a self-fulfilling prophecy when you are dealing with people of that ilk.

Why should Mrs. Schwartz on the corner of Dundas and University care about basic research? It’s not like it’s going to change her life today—or ever, perhaps.

I’m reminded of the vision that Bones from Star Trek elicits in bringing someone who has been injured to sick bay, and picking up a wand that goes [weird but convincing trill], and the injury is fixed. I am also amazed at the rapidity at which the health care system is approaching that accomplishment.

Our capacity to achieve that vision is based on our understanding of our physiology—not our understanding of breast cancer, or prostate cancer, or hip replacements or brain tumours—but our understanding of life and its physiology at a molecular basis. Advancing our health care system depends on discovery research.

Our capacity to save ourselves depends on our capacity to fix ourselves and/or to prevent all of the devastating things that can happen to us. In medicine today, if you look at survival associated with various diseases, mortality has precipitously dropped with the onboarding of all of the new information that is coming from discovery research.

Our challenge is to compact the time it takes to move those understandings into the clinical domain. It is also to understand the distance between those working at laboratory benches and those next-generation practitioners who are being trained with yesterday’s ways of doing [medical] business. We have to re-equilibrate those systems; in other words, to create an evolving health care system, it has to go all the way back to the training not only of the next generation of scientists, but also practitioners. Right now, they are two solitudes that interact poorly.

Everyone is struggling to bring these two paths together, but again, it’s the way universities work. It’s the way they are compartmentalized. It facilitates teaching. It facilitates grading. It facilitates, ‘OK; we’re making sure we’re not letting loose people who have no idea what they are doing,’ but it does not facilitate the translation of basic discovery into the clinical domain. Hospital-based research does that.

What would you say to a young you who was just beginning his career, be that in science, in academia or as VPR?

You talk to everybody. You listen to everybody, however quickly, with a smile—because I listen quickly. You test your anchor always, and don’t stray from it. Tenacity is everything.

The capacity to deal with the solitude of a leadership position is important. You need to manage it as a positive, not a negative.

Solitude is wonderful.

For some people. For others, it could be an existential threat.

How do you test your anchor?

If you listen and are open, if you are dedicated to playing tennis with people who play tennis better than you, you will learn from them. That can induce course corrections, in your tennis game, in your thinking about what you are trying to accomplish in life—but at the end of the day if your vision is true, crystal clear and validated by people who play tennis better than you, don’t stray.

There’s the BS factor—the stuff you love doing divided by the stuff you love doing less. If that ever becomes less than 1, you’re not in the right place. You always want to be positioning yourself, as ‘Oh my. People are actually paying me for something I want to do.’

You are a single-term prime minister. What do you do?

We should only have single-term prime ministers. I would change the governing dynamics of the health care system. Everything is so thick and tainted by, ‘I have to get re-elected again.’ But, there are challenges with one-term anything, because you can’t boil the ocean.

Many people who play tennis better than me have thought this through. Indeed, we have evolving health care systems around the world that are working with efficiencies that enable, for example, hip replacements where people are complaining about three weeks as opposed to two weeks, whereas we are two years. In my opinion this system is broken.

We need to make a national health care system, notwithstanding that we do transfer payments so that the provinces take care of health care. Leadership of the health care system by the federal government is by cheque, and it impacts the governing dynamics of everything we do—even most specifically discovery to clinical impact through the medical marketplace. The Ministry of Health, Health Canada and all of the cognate regulatory bodies are siloed. The processes are fragmented.

I would bring the fragmented pieces together, under one conductor, the prime minister, dedicated to fixing the system. A national health care system should be what we are trying to achieve. It’s not rocket science. It’s happening everywhere else on the planet.

It would be liberating. The PM’s term might have to be a bit longer. If it were a six-year term, I believe that material change could be accomplished. And it’s rational thought that’s leading the goal, which is getting the best for Canadians—that’s the motivation.

What’s one thing that would surprise people about you?

[That I did] ballet. Nobody is surprised that I really enjoy Scotch. They would be surprised to know that it was a passion: a guy, ballet—how many people like that do they know? I was devastated. I wanted to spend the next 10 or 15 years dancing.

Je ne regrette rien: something you can say about your career thus far?

I really don’t have any career-dependent regrets, because I’ve never been anything other than selfless in the goals. I’m one of the luckiest people on the planet. And there is no pretense, with a little bit of hubris, that I don’t deserve it, because I work with absolute dedication from morning to night.

You don’t need to eat (much) or sleep (much). What are two things you cannot live without?

I eat one really good meal a day, and I eat it late in the day by most people’s criteria, because I don’t sleep as much as most people sleep. I’m blessed. People I can learn things from and Scotch, I cannot do without them.

I’ll ask what’s next, just so you can leave readers with a suitably enigmatic answer.

It will be private sector. It will be health care-related. I am very excited to experience a private sector set of barnacles after having experienced other barnacles over the last four decades, first in the academia arena and then in the public sector health care arena. I’m looking forward to the new rules of engagement.

Any final, parting thoughts? Anything I should have asked?

Well, you didn’t ask me to prioritize Scotch and people, and that would be a tough one, so don’t.