Doctor’s zeal to protect children was his undoing

MONTREAL • Dr. Alain Sirard’s devotion to protecting children brought him face-to-face with humanity’s worst side.

His patients were the broken — too young to speak of the abuse inflicted upon them, too young to appreciate their lives had been saved. A 12-day-old baby girl sexually abused by her father. A three-month-old baby boy left brain-damaged after repeated beatings by his father. An infant regularly choked unconscious so the parents could consume drugs in peace.

“He was motivated by his desire to save children,” said retired pediatrician Gilles Fortin, who worked with Sirard at Montreal’s Sainte-Justine Hospital.

But Sirard’s zeal to protect the vulnerable was ultimately his undoing. Over the past three years, Sirard’s work came under scrutiny after some parents complained to the media that he had reported them to child welfare services for suspected abuse. They said what Sirard had diagnosed as abuse was actually the result of an accident or a rare medical condition, and they had expert opinion to support their claims.

The provincial College of Physicians, the provincial human rights commission and the hospital’s internal disciplinary body all investigated complaints against Sirard, and it seemed as if the cloud over his head would never clear. After learning in November that Sainte-Justine had suspended his privileges for a month, Sirard, 58, took his own life inside the hospital on Dec. 6.

As his funeral unfolds in Montreal today, Sirard’s children, peers, family members and some of his patients say he was unfairly singled out. They fear other children will suffer as a result.

The three-month-old boy had been treated like a punching bag for much of his short life, but when he was admitted to Sainte-Justine in 2007, only his 19-year-old father knew that. Tests revealed three skull fractures, four broken ribs and a brain injury, as well as bruises on his forearm.

A Quebec Court decision, which prohibits publication of any information identifying the child, describes how Sirard expressed his disbelief when the father tried to explain away the injuries. Eventually the father agreed to tell the doctor “what really happened.” Using a doll, he showed how he would repeatedly slap the child’s head, twist his ear, bite his neck and choke him to the point where he required mouth-to-mouth resuscitation. Sirard later told the court there would be lasting effects from the brain injury. He called it “one of the most violent and most upsetting cases” he had encountered.

The father was sentenced to 54 months in prison for aggravated assault. In a recent interview, the child’s grandmother — her daughter is the mother — credited Sirard with saving her grandson’s life. “Without Dr. Sirard, the child would have remained in the family and probably would have suffered other abuse and could have died from it,” she said.

Court records show that over the past 15 years, Sirard was a frequent expert witness, providing evidence in more than 60 reported child-welfare and criminal cases. But lately, his name had become associated with a handful of cases where the diagnosis of abuse was cast in doubt.

In November 2013, the Radio-Canada program Enquête broadcast an hourlong investigation of Sainte-Justine’s socio-legal clinic, where Sirard worked. The clinic’s specialists are summoned when suspicious injuries turn up in the emergency room. The hospital did not allow Sirard to be interviewed, so instead the show relied on file footage of him walking down a courthouse corridor, played in slow motion that made him appear sinister.

The show featured five couples who had been referred to child welfare for suspected abuse. They described the nightmare of having their babies removed from them, sometimes for days, sometimes for months. In some cases, they had obtained second medical opinions confirming their stories that their children had not been abused. In others, they had plausible explanations for the injuries.

Understandably, they were angry with a pediatrician who suspected they might be responsible for harming their child. Two of the parents interviewed launched an online petition labelling Sirard “a potentially dangerous man” and calling for his suspension. A week after the show aired, Sirard suffered minor injuries when he was stabbed while out for a walk. The attacker was never identified.

Following the Enquête broadcast, the human rights commission decided to investigate whether children’s rights were being trampled at Sainte-Justine. It studied 13 contentious cases handled by the hospital’s pediatricians and concluded that, in all of them, the physicians were justified in reporting the matter to child welfare. There were “reasonable grounds to believe” the patient had been abused, and under Quebec law doctors are obliged to report to the youth protection director any case where they believe a child is in danger.

Fortin, who opened the Sainte-Justine socio-legal clinic in 1989, and worked there for 20 years, said that as a result of the media attention, parents coming to Sainte-Justine would refuse to allow their child to be seen by Sirard. “He felt shoved aside,” Fortin said. “He was unable to repair his reputation.”

Fortin acknowledged that Sirard could be “aggressive” in his approach to parents whom he suspected of abuse. But that went with the territory. Sometimes, Fortin said, because of an oversight by a physician or child-welfare official, abuse is missed and an injured child is sent home, only to return later in worse shape. “When you have made a mistake, you don’t want to make another mistake,” he said.

Sirard always acted in good faith, Fortin said, but he may at times have crossed the line between being a physician and an investigator.

With Sirard’s death, the College of Physicians has closed its investigation into him, and the details remain confidential. The administration at Sainte-Justine will not discuss the disciplinary action taken against Sirard, but a spokeswoman said it was not the result of any medical error. In a suicide note obtained by La Presse, Sirard said his privileges had been removed for one month and the hospital board had issued an apology to parents who had complained about him. In the letter, Sirard lashed out at the hospital, the families who filed complaints, the College of Physicians and social workers with the youth-protection department. He said he was a victim of “institutional intimidation,” the newspaper reported.

Radio-Canada has stood behind its report on Sainte-Justine. The hospital’s heads of pediatrics, emergency and radiology filed a complaint against the public broadcaster after the program aired, alleging sensationalism and impartiality. The ombudsman at the time, Pierre Tourangeau, rejected the complaint in 2014, ruling that the report was in the public interest and respected Radio-Canada’s journalistic standards.

The parents interviewed for the report have said little since Sirard’s death. One of the mothers interviewed, Geneviève Berthiaume, declined comment when contacted by the National Post, saying only that she felt badly for Sirard’s four children.

Sirard’s death notice requested donations to a foundation that aims “to clear Dr. Sirard’s name, to denounce and respond to institutional and media harassment.” The pediatrician’s oldest son, Olivier Sirard, who is involved in setting up the foundation, said his father had to be strong to do the kind of work he did. “He was able to keep on going, even if he saw the worst atrocities,” he said. “That was his strength of character.” But the media scrutiny and disciplinary procedures proved too much.

“He was so devoted to his work, which in the end was removed from him,” Olivier, 26, said. “He had no dignity left. He couldn’t continue any longer.”

TO DENOUNCE AND RESPOND TO ... MEDIA HARASSMENT.

Dr. Alain Sirard