Dr. Clem Williams is a man who practices what he preaches. His enthusiasm is tireless; he lifts weights (arms like granite); there's a twinkle in his eyes; he has a myriad of interests—from painting to boat building. And he is 70 years old.

Clem doesn't plan on retiring anytime soon. He has been a general practitioner for 40 years and in the last ten of those, has moved his focus from general to specific— that of male menopause, or andropause.

 

His interest in andropause was mainly due to an emotional scar. His father had prostate cancer and, although the resources were there to put his son through medical school, nothing was left over; he had no health coverage (back in those days most people didn't have coverage when they were self-employed) and tragically, committed suicide. Clem was the "push-up kid" — he was the oldest of three boys and there was only enough money to put one boy through school. Although he had an advantage, responsibility to his brothers came part and parcel. And this quality has stuck with Clem, most evident in his work with foreign grad students. But we'll get to that later.

 

After graduating from Queens University in 1960, Clem landed a summer job as doorman at Chateau Lake Louise, and caught the bug to "go west, young man". He took a side trip to Victoria and fell in love with the west coast. It wasn't easy leaving Ontario, having six generations of family there, and his new wife, Heather, was leaving five generations behind. But they felt opportunities to be had in the setting sun. After a senior internship at UBC, Clem's entrepreneurial spirit found a practice for sale in West Vancouver. He was told that "all the best specialists go into family medicine for five years then onto their specialty." Although Clem still believes this to be true, he is still in family practice and has only moved office in Dundarave 18 feet in all these years.

 

One of Clem's greatest achievements is his practice. In this regard, he is a physician in the truest sense, practicing both science and the art of medicine. The art — to intuitively understand what is happening— is apparent in his practice, dealing with every age group of patients and a myriad of problems they bring. Clem's interest in men's problems goes way back. In the 60s, men didn't discuss male problems and he believed that the system had neglected men, so ten years ago several of his patients got together for informal meetings in Clem's home to discuss male issues. Back then, there wasn't anywhere to go and these men felt that women were getting all the attention and their problems weren't being heard of, neither in men's magazines nor by professionals. They talked about social issues such as marital breakdowns and job loss, and depression. It's worth mentioning that these men, some now in their 80s, are all healthy patients today.

But even now, the majority of men are loathe to tell what's really on their mind. "A patient came in a few years ago with a chest cold" says Heather, "but Clem will ask what's really going on and finds out that his wife left him and he lost his job…Clem gives him a depression test (the Beck Depression Index) and finds out he is suicidal. He is placed on antidepressants and today, life goes on." Heather explains that Clem takes them through crises, "and it takes time and energy, but this is what a full-service, family practice is all about." And he even finds the time to make house calls (three in the past four days). 

 

Clem was one of the first doctors to use testosterone at a time when the world was unaware of andropause. Men age badly and die sooner than women and they are taught to hide their feelings - a dangerous trio and one that shouts out "male menopause".  But even with these obvious "symptoms", Clem wasn't taken seriously. Even today, "95 percent of doctors are cautious or too busy" Clem says. "They've never taken the time to learn or they already have enough on their plate".

 

So how does Clem have the time, even with help from his students? "What I have done is also possible because I have a unique wife" he explains. On a plane back home from vacationing in Hawaii, Clem told Heather that "I'm getting old, I can't find anything in my office…what's wrong?" So she told him outright, "You've got a lousy staff, they don't file anything and you need someone to clean up." Heather had a successful job in real estate but committed to helping him for one month. That was 15 years ago —she never left. Although they have a few disagreements, like any working relationship, "most of the time we agree on everything in the office." Amazing…

Heather also knows that having the foreign grads is "lifesaving". She explains how it started. "As an adjunct to the practice, I was running a home care service for our patients and a young Iranian nurse applied to do anything -- she didn't have her degree here. I hired her and found out her husband was a physician, working in an absolutely unrelated field…Clem talked to him, really liked him and wrote to the college of physicians and surgeons of BC to see if he could get him started." Within a few days, he was issued a temporary licence — as long as he worked in the clinic under Clem's supervision. Dr. Zamampour now works with Clem as a full associate. "It was extremely difficult to get into the system", says Dr. Zamampour. (He spent two years in the clinic and two years at the University of Calgary.) "I had a lot of opportunities to work in Calgary but I enjoyed working with Clem" he explains, "His style of medicine is different from other doctors…covering all aspects of patient problems, spending more time, more caring." Like father, like son; like teacher, like student: Dr. Zamampour kept his word— he promised his patients that he would return to the clinic. As for Clem, the "push-up kid" traits are apparent - responsibility, dedication and loyalty have paid off, and he currently has another grad training at Dalhousie in Halifax.

 

When Clem isn't overseeing his practice he is globe-trotting, having been to every world conference on andropause. This year marks the seventh. In 1977 he attended a conference on impotency and "It blew me away…the first drug companies were launching their products and talking about Viagra". At that time, not too many physicians took male menopause seriously. "There was suspicion, it was a new field" he says, "and I was uncertain too, but I solved the uncertainty by throwing myself into literature and research." This is apparent by the walls of his home library -- floor to ceiling stacked with journals and reference books. And he is a self-confessed "king of hand-outs". One drawer in his desk at the clinic reveals 40 hand-outs he routinely gives to patients.

 

Fortunately, attitudes in male menopause have changed radically since Clem began his research, and with more physicians legitimizing andropause, men's groups such as Clem's may not feel so isolated and frustrated.  This year Barcelona is hosting the fifth world congress for The International Society for the Study of the Aging Male. Clem will be better prepared this time than he was in 1998 when his presentation consisted of a "high-school type poster" profiling before and after pics of 30 men treated with testosterone. Also, he is the Canadian delegate for the British Andropause Society and in February 2005 will be presenting a paper for the Royal Society in London, England. It will be his "proudest moment".

 

Seems like a big jump from high school posters to Canadian delegate in just a few years, but serendipity played a role when Clem met Dr. Malcolm Carruthers in London. Six years ago he knocked on a few Harley Street doors with nothing but a letter of introduction in hand. The few top specialists in male medicine were too busy to see him, but a junior partner in one office suggested he "bunny round the corner to Malcolm's office". Sometimes, timing is everything. As luck would have it, Malcolm had a patient no-show, so they had a cuppa tea and right then and there, it was decided that Malcolm would become Clem's mentor.

 

Since then, Clem has learned a lot about anti-aging and has used his knowledge effectively, both for his patients and personally:  Four years ago he self-diagnosed prostate cancer. Today he is healthier than ever. Clem believes that studying and learning (and 50 push-ups a day along with weight training) keeps him at the fountain of youth. And his advice for others: "Do your own research, think for yourself, network and work with groups…basically, since the field of the G.P. is so broad, specialize in your own interest, be it dermatology or women's issues…find your own niche and speak with confidence."

 

And clearly, Dr. Clem Williams has done just that.