Cortlandt Mackenzie had survived a world war and medical school. But when a woman arrived at his brand-new doctor's office in Victoria asking about birth control, he was stumped.
He knew what a diaphragm was, but because contraception was never mentioned in his medical training at Queen's University, the young doctor wasn't quite sure how to go about prescribing one. Luckily, his nurse had one on hand and he was able to duck into the back office to read the instructions that came in the box.
That was the early 1950s, when it was a criminal offence to sell or advertise contraception in Canada. Birth control was not fully legalized until 1969.
But that was Cort Mackenzie, a doctor and public health officer who wanted to help his patients any way he could and was way ahead of his time when it came to reproductive choice for women.
Discussing abortion, though, was a more serious matter.
"You couldn't do much," he explained in a 1979 interview about the history of birth control in Canada. "You could give broad hints, and more or less tell people that if they went and did anything about it and got into trouble to be sure to get back to you right away.
"This was often quite a tragedy in my private practice."
Dr. Mackenzie, who died on May 16 at the age of 92, went on to champion family planning throughout his career. He was an advocate for the environment, too, long before it became fashionable. And he was a pioneer in understanding what is now called the determinants of health – the environmental, socioeconomic, nutritional and lifestyle factors that broaden the study of wellness beyond the practice of traditional medicine.
He visited and taught around the world – in places such as Russia, Cuba, Pakistan, India and Australia – and was key in getting the medical establishment to look beyond Canada.
"He had an eclectic view of the world," said John Blatherwick, retired chief medical officer for Vancouver. "The multiple factors that came down to determining a person's health is what made Cort tick."
Cortlandt John Gordon Mackenzie was born into the lap of the Toronto establishment on Sept. 6, 1920, the only child of Henry J.G. Mackenzie and Marjorie (nee Campbell). He was in the lineage of a waning fur-trading fortune amassed by a Mackenzie ancestor who had come to Canada after the Napoleonic wars, listing his occupation as "gentleman."
Marjorie was a successful stage actress in London and New York before she became a mother.
Young Cort was raised in what his son Ian describes as "gentile poverty" on Toronto's posh Old Forest Hill Road, as his parents ended up making their living by the pen. His father wrote children's books (though he was said to have not been particularly fond of children); his mother travel books and newspaper articles.
Cort attended Upper Canada College – doing "very badly" as he later put it, but "surviving."
He studied for a year, 1939, at Queen's University before serving in the war, first in the army, then as an executive officer in the navy, where he ended up as a corvette captain.
He was fond of telling how his convoy ship crossed the Atlantic equipped with wooden guns, as the real artillery was to be installed in Britain.
After the war, in 1945, he married Jean Barker, the daughter of William (Billy) Barker, who earned a Victoria Cross in the First World War, and was famous as Canada's – indeed, the British Empire's – most-decorated war hero. Son Alec was born in 1949; Ian in 1950.
After graduating from Queen's medical school in 1951, Dr. Mackenzie defied familial expectations that he would specialize and set up a private practice in Toronto, instead taking his young family to freer pastures on the West Coast.
A third son, David, was born in 1952.
"My parents ran away from Toronto society and went as far away as they could, which was British Columbia, and they became about as bohemian as you could get in the 1950s," Ian said. "They supported all sorts of liberal causes."
They left their Anglican roots behind, as well, and found a spiritual home with the more free-thinking Unitarians.
"They were quite different from other parents," Ian said. "Especially in the way they educated us. Nothing was off the table, as it were. We received much of our education around the dining table."
Conversations ranged from details of medical procedures (which most people were not used to hearing while dining), to progressive politics, to Martin Luther King's civil rights efforts, to animal welfare, to sex education.
Ian remembers the day his father brought home a thermos bucket with a pickled human brain inside because he thought it would be educational for the children. ("Better not mention this to the other kids," they were told. "They might not understand.")
In 1954, Dr. Mackenzie closed his potentially lucrative private practice in Victoria to take a lower-paying, far-flung job with the provincial ministry of health. He was stationed in Dawson Creek in the Peace River district of northeastern B.C., a true frontier.
There, he performed life-saving operations on kitchen tables, started immunization programs, treated tuberculosis and helped combat rickets in the native community by providing vitamin D and splints for children with malformed bones.
And he continued to provide contraception for the remote settlers.
"It was a very tough life for these women on those homesteads, and they wanted some help," he said in the 1979 interview. "[They] were getting tremendous numbers of children and the women were grouching that they were a problem."
So he introduced a program – "very quietly" – to provide diaphragms, condoms and contraceptive jelly and foam.
"We didn't advertise it at all," he said. "Certainly it wasn't in the annual report of the health unit."
After Dawson Creek, the family moved to Trail, B.C., where Dr. Mackenzie served as medical health officer for the West Kootenay region and for a time commuted to Nelson as well to serve the Selkirk unit.
There he got a firsthand look at the devastation caused by sulphur dioxide released by the local lead and zinc smelter. So toxic was the cloud that officials blew a whistle before release so that drying laundry could be brought inside to avoid damage. At one time, all the vegetation in the area had died. By the time the Mackenzies arrived, one plant was starting to grow back – poison ivy.
The doctor had long been a nature lover, but this experience helped intensify his desire to help fight environmental degradation. While providing medical care to the local population, he advocated strongly for pollution control, seeking to do something about a nearby chemical plant that was fouling the air.
Eventually Dr. Mackenzie became a public-health officer on Vancouver Island, based in Duncan. He completed a fellowship and became a professor of public health in 1963 at the University of British Columbia, where he was head of the Department of Health Care and Epidemiology from 1973-80.
Students found him an entertaining, engaging and approachable teacher, according to Dr. John Batherwick, who worked on a fellowship with him there. He dealt with serious topics without taking himself too seriously and maintained a welcome sense of humour.
"Cort was one of these easygoing guys who loved his life and loved his family and whatever he happened to be doing at the time."
Dr. Mackenzie was the president of the Family Planning Association of B.C., and from 1970-74 was director and vice-president of the Family Planning Federation of Canada.
He also served as chairman of the Pollution Control Board of B.C., chairman of the Royal Commission of Inquiry into the use of pesticides, and headed a task force on arsenic in Yellowknife.
In 1986, he received the R.D. Defries Award, the Canadian Health Association's highest honour.
He never rested on his laurels, continuing until the end of his life to advocate for the causes he held dear.
In 1989, as professor emeritus, he warned the government of the Northwest Territories of possible health problems with the proposed Kiggavik Uranium mine in what is now Nunavut.
As usual, he spoke his mind: "Mining and oil extraction have, so far, usually provided more problems than benefit to the local people not directly involved in the actual process," he wrote to the minister responsible at the time. "Mines do not sustain stable local populations. They enrich distant societies."
The family moved to Vancouver in 1963. Jennifer Maynard, a neighbour near the Southlands Riding Club, remembers their love of horses and the hard work they did to support the club and the local community.
"Cort was an inspiration to me and to many others for his energy, generosity, intelligence and ability to think and act beyond his own self-interest," she wrote in a remembrance.
He and Jean were also the only people besides Ms. Maynard's family who understood why she had taken in a stray baby wood duck, who lived with her in her home.
"That's because they had a banty hen named Ernestina who lived in their house, roosted on the bookshelf and made free of their kitchen," she wrote. Later the Mackenzies adopted a baby pigeon they named Brigitte, who also lived with them and accompanied them on rides at the Southlands club.
Ian remembers: "Aside from the dogs, cats, budgies and horses, there was Hansel the raccoon, who would emerge, cold and clammy, from midnight fishing, and crawl under their covers to seek warmth."
Like he said, they were quite different from the other parents.
When Dr. Mackenzie gave up polo, he took up scuba diving and founded the Marine Environment Protection Society.
In an interview posted on YouTube last year with Roy Mulder, a videographer and marine conservationist, he lamented the state of the oceans, the decline of big fish and the near extermination of the cod because of overfishing.
"Technology is the big thing that has come along and helped us destroy the planet very quickly," he said.
"It will be a long time before the last breeding pair of humans dies, but I think they're gonna have a tough time … in this century."
The interview sounds a sad note at the end of a productive and fruitful life, but Dr. Mackenzie was not one to become unduly depressed by the fact that raising awareness is often a long process.
Until the end, he maintained the philosophical view that kept him motivated to improve things even in the face of daunting challenges.
His attitude, according to Ian, was this: "One needs to soldier on anyway; otherwise, nothing is sure to happen."
Cort Mackenzie, predeceased by his wife Jean, leaves sons David, Ian and Alec, and three grandchildren.