“What’s your dream?”

Dr. Gilles Julien likes to sculpt. He searches the raw stone for its story “without preconceived notions,” without judgment. Each figure he carves takes a completely different shape – all smooth and abstract, but each completely individual.

“I don’t have an image in my head of what the stone is going to be. I’m going to discover it – the stone will guide me.”

No two blocks of stone are the same. And at Dr. Julien’s practice, in one of Montreal’s poorest neighbourhoods, Mercier-Hochelaga-Maisonneuve, no two children are the same. Just like the stone he carves, each child Dr. Julien works with has their own story and their own path.

“I am completely guided by the child,” he says. “I discover from children things that people don’t normally see. I sense their emotions quickly, and I quickly sense their needs.”

Dr. Julien practices social paediatrics which is an approach based around the rights of the child. It’s a holistic treatment designed to treat disadvantaged and abused children.

Social paediatrics considers not only the physical treatment – of injuries and illnesses – that’s the “easy” top layer. Just as important to a child’s health, he believes, are elements such as mental welfare, family stability, closeness between child and caregiver, and community support.

His health centre is brightly painted both inside and outside, and is a hybrid of a medical office and a community centre.

In his home province of Quebec, Dr. Julien is considered a pioneer – the “father” of social pediatrics. It’s a path that started early, but wasn’t always easy.

His impulse toward social involvement is innate, but it developed through volunteer work in his small town, where he saw real poverty among children and the elderly for the first time. That work pushed him toward medicine, and, strongly, toward pediatrics.

“I really saw significant gaps.”

Through his training in emergency medicine, Dr. Julien saw firsthand a “treat ‘em and street ‘em” approach that wasn’t working. Children suffering from “social misery” – ongoing problems at home and in their communities – could only be treated at the hospital for as long as they were physically unhealthy.

“We’re told that we are going to save lives. But are we really?”

He worked in a traditional pediatric office with a small group of colleagues straight out of medical school, but he only lasted three or four years.

“I left to find a voice, much to the annoyance of my colleagues, who considered me a bit of a traitor,” he says, with a small chuckle. “I was a good doctor with a big clientele. They didn’t really understand why I was leaving.”

He left Montreal to find the type of medicine he wanted to practice, first going to the Comoro Islands, off the southeast African coast, and then to Northern Quebec, where he worked with the Inuit community. He didn’t return to Montreal for twenty-five years.

In both Africa and Northern Quebec, Dr. Julien found communities that worked with their doctors to support patient care. With the Inuit, he encouraged the community to speak as openly about sexual abuse as it did about physical injury and illness. Both experiences inspired him as he returned to Montreal in the early 1990s.

“I decided I was going to do a different type of medicine,” he says.

He didn’t have an office, but he had a bicycle and he became the travelling paediatrician, visiting his young patients in their homes, giving him a better view of the social supports.

With the help of a benefactor, who provided him with two properties across the street from each other in Mercier-Hochelaga-Maisonneuve, Dr. Julien founded the Assistance d’enfants en difficulté (Assistance for Children in Difficulty), and the Fondation du Dr Julien (Dr. Julien Foundation), to fund the health centre. He started to work directly with the community.

He now sees 3,000 children a year, and is either responsible for or oversees their direct, ongoing care. There are numerous volunteers and benefactors that support his vision and his work.

The closest to his heart is his wife who helped him see how closely related social paediatrics was to the rights of every child. Together, they work to apply the Convention on the Rights of the child to those 3,000 children he sees annually.

“It’s a medicine about proximity. That’s different. It’s exactly what was in my wildest dreams.”

Patience and persistence are absolutely vital to his work. In one case, Dr. Julien waited seven years for a patient to confide in him that she was being sexually abused. In another, he went to court for a patient as a medical expert. His testimony helped prevent the DPJ (Direction de la protection de la jeunesse) from taking away her baby.

“I was proud to be able to get real justice for someone who was extremely excluded from mainstream society.”

Dr. Julien’s somewhat bohemian approach to medicine has had its detractors. It’s only in recent years, that social pediatrics has received recognition – both from governments and from Dr. Julien’s own peers.

He’s been practicing medicine for more than 40 years, but he’s not giving it up anytime soon. “It’s the best work. I don’t want to let it go. All my colleagues already retired a long time ago. That’s not for me.”

Along with sculpture, Dr. Julien copes and finds inspiration through his patients. The children’s stories – be it a simple letter or their ongoing healing process – motivate him every day.

“The children give back to me enormously.”

Dr. Julien works to give his patients hope and a second family – though never to replace a child’s original family.

This hope comes from a combination of protection and opportunity. Defending a child, Dr. Julien believes, comes not from removing them from their current life, but from preserving and developing their existing security – family, friends, language, and schooling. He provides support to these children “like I was their father, or grandfather.”

He now has many people watching and listening to this holistic brand of social paediatrics, and it’s slowly being tried in other regions in the country, and in the US.

“We’re in the process of giving another face to medicine.”

“We work on a lot of hope.”

“Addressing the health and wellness of a child includes protecting that child by honouring their rights to identity, to speak their language, to their connection with family, to be educated in their community with their friends. It’s all about rights.”

“You have to understand people but the system judges so quickly. When you are excluded, you lose everything. We need to change that.”