Pavel Hamet: building the impossible

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November 6, 2017
Pavel Hamet

Charles University, Prague, 1966. On a regular basis, Pavel Hamet spent many nights in the laboratory, chasing his passion in research. As a 23-year-old medical student, Pavel Hamet devoted all his energy to his studies and published his first three scientific articles. Having had surgery for appendicitis at the age of 12 and deeply marked by the care he received and the hospital environment, Pavel had planned to become a doctor. To his surprise, he discovered a passion for research.

In the Czech Republic (the then Czechoslovakia), his future in medical research looked bleak. A competition sponsored by the International Federation of Medical Students’ Associations offered a clerkship abroad. However, Pavel didn’t speak a word of English or French. “I learned 2000 anatomy terms during my medical studies, so I figured I could teach myself French. And I won the competition. The first-place prize was Canada,” he says.

Pavel Hamet arrived in Montreal at a time when the city was buzzing in preparation for the 1967 Universal Exposition. “I saw Montreal come to life: the construction site at the Place des Arts, the Montreal Clinical Research Institute, the construction of the metro. With the backfill from the metro, they were building the Île-Notre-Dame! I told myself: I can live here, they are building an island, they are constructing a metro! When my internship was over, I returned to Prague to complete my degree and came back to Montreal in 1967, three weeks after the Expo.”  

Pavel’s mentor: Dr. Jacques Genest, a physician, a trailblazer in the world of research in Quebec, and a world-renowned scientist in the area of high blood pressure. Then director of the Montreal Clinical Research Institute (IRCM), which he founded, and director of the department of medicine at the Université de Montréal, Dr. Genest offered him a grant to work at the IRCM. He also facilitated his entry into the Ph. D. program at McGill, which he completed in 1972. At the same time, Dr. Hamet specialized in endocrinology at the Université de Montréal. “I paid for and completed the two programs of study in four years, all while working at the Institute. When you are an immigrant, you are in a hurry. Having originally lived in a communist country, I had lost one year as a labourer before going into medicine, and one year as an immigrant in Paris. I was ready to invest long hours. Delightfully, Dr. Jacques Genest’s group was permissive. A career as a clinician-researcher was well regarded, even highly encouraged.”

A man of the Hôtel-Dieu

Pavel Hamet

After a year of residency at McGilll and two years of post-doctoral training at Vanderbilt University in Nashville, Pavel Hamet returned to Montreal. At the Department of Endocrinology of Hôtel-Dieu and at the IRCM, he pursued his dual careers in medicine and research. He reformed the Hôtel-Dieu research centre and set to work building what would become the University of Montreal Hospital Research Centre (CRCHUM): “When we started the Hôtel-Dieu research centre in 1990, we were poor: we barely had $600,000 in research funds for the entire centre. Six years later, we had collected six million. The Government of Quebec offered us savings investments that allowed us to purchase equipment and recruit researchers. And we had the extraordinary and wholly incongruous support of the religious community”, Pavel Hamet recollects.

The Congregation of the Religious Hospitallers of Saint-Joseph sold them one of their buildings in the Hôtel-Dieu research centre for one dollar. “I have always been an atheist, but I have a profound admiration for this religious community, starting with Jeanne-Mance who, from the founding of Montreal, provided care to everyone, including First Nations and enemies. These women were visionaries and the extent of their accomplishments in education, medicine and advancements in science is incredible. When I would win a prize, Sister Treasurer, Sister Superior General or both would come to congratulate me. They never mentioned the prize, instead they thanked me for the work I was doing for patients! They planted the seed for this idea of public service for patients in my mind.”

Founding the CHUM Research Centre

In the mid 90’s, the University of Montreal Hospital Centre (CHUM) did not exist yet. “There were discussions around combining the three hospitals Hôtel-Dieu, Saint-Luc and Notre-Dame. The researchers liked it. Even though, they competed among themselves, there were several advantages to joining forces: the critical mass, colleagues and exchanges with people from complementary disciplines. We held our first retreat for researchers from the three hospitals, one year prior to the signing of the CHUM. At that time, we called it the CHUM Research Centre. We believed in it!”

The CHUM was created on the 1st October 1996. Dr. Pavel Hamet became the first director of the new University of Montreal Hospital Research Centre (CRCHUM). He held this position for 10 years, until 2006. The centre enjoyed the financial support of the Government of Quebec. In the early 2000’s, researchers rallied to submit requests for subsidies with the Canada Foundation for Innovation and the Quebec Ministère de la Santé. Sixty-five million dollars were granted to the teams of the CHUM Research Centre, for the purchase of equipment. This is what allowed us to become the number one institute in Canada,” confides Pavel Hamet.

As the construction project for the CHUM at 6000 Saint-Denis Street failed to materialize, there was a lack of space to house all this recently acquired cutting-edge equipment. In December 2005, three research groups moved into a three-story building in the Technopôle Angus development on Rachel Street, on the eastern side of Montreal. These new facilities are today dedicated to three research platforms: cardio-metabolic, diabetes and predictive and preventive medicine, which has allowed us to modernize the CRCHUM technology park.    

The medicines of tomorrow

From his office on the 14th floor of the new CHUM Research Centre, inaugurated in October 2013 at 900 Saint-Denis Street, Pavel Hamet has a stunning view of Montreal, his adopted city in which he has carved out a local identity for himself. Here, books and boxes filled with documents compete for space with family pictures. At 74, after an international scientific career spanning more than 50 years, might Pavel Hamet consider slowing down a bit? He gets up and – his blue eyes still shining bright – comes back with a document to explain his next project. It has to do with bringing genomic research and personalized medicine into the offices of the general practitioner in order to prevent diseases and provide personalized treatment to every patient. Nothing less. 

Head of the Genetic Medicine Department of the CHUM and the Canada Research Chair in Predictive Genomics, Pavel Hamet is laying the groundwork for the medicines of tomorrow. We are almost there. In 20 years, it will be possible to obtain the genetic profile of a patient during a routine exam. “It will change how we practice medicine in a way. It’s at least as revolutionary as were antibiotics in 1947. It will be possible to do a test in just a few minutes at the general practitioner’s office, a little bit like the way in which we prescribe a scan today and have it read by a radiologist. In fact, in the area of breast cancer, genomics has already been in play for years. Angelina Jolie is an example of personalized medicine. When at the age of 40 you have an 87% chance of developing breast cancer, proceeding with removal is the logical thing to do.”

Personalized medicine for the wealthy? “On the contrary, I think that this will change things financially. We waste at least half of our budget on drugs, often for people who do not respond or who have side effects. We are best off investing in prevention, which ends up making the process more democratic in the long run.” 

Dr. Hamet is particularly interested in the prevention and treatment of people suffering from high blood pressure and diabetes, two chronic diseases that affect 40% and 20% of the population, respectively. He is in fact continuing on the same quest. At the beginning of his career, patients suffering from diabetes had a life expectancy of 17 years after their diagnosis. Today, his patients still see him despite 50 years of living with diabetes. Over the course of the past few years, in particular with the large-scale Opti-Thera research project, he has identified sub-groups of people who possess particular physiological predispositions for these diseases, and who thus respond differently to certain molecules present in medications. The idea is to optimize personalized prevention and treatment according to one’s genetic profile.

Pavel Hamet is now working on “a project that seems within reach at my age and that we will be able to get into the hands of general practitioners within a few years”. This end-of-career project consists in developing a diagnostic test to prevent renal complications from diabetes. Diabetics develop vascular complications that impact kidney function, requiring dialysis and hemodialysis that cost $100,000 per year, per person. His greatest wish would be to be able to administer a personalized medication that would act at the source, before the kidney was even affected.  

“We know that the way we treat kidneys does not work in 30% of people. I am interested in those 30%. We are going to need new medications that work differently.” 

Epilogue 

Among Pavel Hamet’s proudest achievements, his family is at the very top. He and his wife Johanne Tremblay, his best friend and a researcher at the CHUM Research Centre in her own right, have four children and six grandchildren. “I made my home here, I carved out a local identity with a fantastic family, and that is my most significant accomplishment. My second success has been to do research and practice medicine concurrently, with equal enthusiasm and dedication. And third, I reformed the research centre at the Hôtel-Dieu and founded the CHUM Research Centre. That was pretty significant at the time.”

And what is the secret to becoming a builder? He cites Samuel Langhorne Clemens, better known as Mark Twain: “They didn’t know it was impossible, so they did it”. “You have to be naive, you have to believe. Then, you need a team to support you, and finally, you need luck.”