Dr. Marc Ruel, chair of minimally invasive cardiac research in the Division of Cardiac Surgery at the University of Ottawa Heart Institute, on March 28 in Ottawa. After weeks of careful consideration, he walked back his job acceptance on March 4, the same day tariffs on Canadian imports went into effect.Dave Chan/The Globe and Mail
One of Canada’s renowned heart surgeons was on the cusp of moving to San Francisco for a new job at the end of this month: He had hired movers and was about to make an offer on a new home, his work visa and California medical licence were on the way and he had already said some goodbyes.
But in the weeks leading up to Marc Ruel taking on his new role at the University of California San Francisco Medical Center (UCSF), he changed his mind. The political tension between the United States and Canada had grown too intense.
In an interview with The Globe and Mail on Friday, Dr. Ruel said President Donald Trump’s threats of widespread tariffs and making Canada the 51st state were a “tipping point” for him. After weeks of careful consideration, he walked back his job acceptance on March 4, the same day across-the-board tariffs on Canadian imports went into effect. (They were paused days later, but other levies have been implemented, announced and threatened since.)
“Having had leadership roles in cardiovascular care in Canada and globally, I felt that it was the representation and the symbolism that was important. It was more than just my own person,” he said. “I wanted to do what’s best for Canada.”
Canadians, in ways small and large, have come together in patriotic unity to fight back against Mr. Trump’s tariffs and push to annex Canada. Ottawa has put forward retaliatory tariffs while citizens have cancelled trips south of the border and swapped American products for Canadian ones. Boos are still echoing inside sports stadiums when the U.S. national anthem plays.
Meanwhile, “elbows up,” a hockey-term that means to defend yourself, has become a rallying cry across the country. Dr. Ruel said it himself when describing how he came to his decision to stay in Canada.
Dr. Ruel is a veteran cardiac surgeon at the University of Ottawa Heart Institute and past president of the Canadian Cardiovascular Society. He is world-renowned for having pioneered a minimally invasive way of performing heart bypass surgery through a small incision between the ribs, rather than by splitting the breastbone.
He said UCSF checked a lot of his boxes when he was offered the job as chief of the division of adult cardiothoracic surgery last fall: It was a not-for-profit medical institution that was a “research and innovation powerhouse” and he was looking forward to sharing his expertise, like somewhat of a Canadian medical ambassador.
Dr. Ruel said the UCSF team was “absolutely amazing” and worked tirelessly to ensure his transition would be smooth. But, as Mr. Trump’s attacks on Canada escalated, so too did his concerns about moving south. He said it came down to his conscience and patriotism.
“When it directly affects Canada and our sovereignty and our identity, that changes everything,” said Dr. Ruel. “I can’t go to a jurisdiction that belittles our country.”
Julie Ann Sosa, chair of the department of surgery at UCSF, in a December newsletter, said Dr. Ruel was offered the role after a global search.
“Dr. Ruel is one of the world’s most highly regarded cardiac surgeons, and his leadership will undoubtedly elevate our division to new heights across all our missions,” said Dr. Sosa.
She did not respond to a request for comment on Friday about Dr. Ruel’s decision. The university declined to comment.
California media has reported that UCSF staff were notified of Dr. Ruel’s decision not to take the position on March 4. The internal letter, signed by Dr. Sosa and physician Joshua Adler, noted that a “tremendous effort” had been made to prepare for Dr. Ruel’s arrival but they respected his decision. The surgeons did not weigh in on the political climate.
Dr. Ruel said he stands by his decision but is disappointed it played out this way.
“Globalization is important. We all build on each other,” he said. “What’s unfortunate right now is that we’re putting up barriers that restrict not only economical trade, but also the exchange of knowledge for the betterment of mankind. That is quite sad. I hope we move away from that.”
Until then, Dr. Ruel said he is happy to continue his work at the University of Ottawa Heart Institute. He added that his colleagues and leadership have been supportive beyond his “wildest expectations” since announcing that he would be staying in Ottawa.
“It was a ‘welcome home’ moment and I think everyone understood the reasons why I was doing this,” he said. “Things changed and it’s time to continue to rally, to brace together, elbows up, and continue the great work that we’re doing.”
