Along the Saint Lawrence River

This post concerns a trip we took to Canada in August, September and October of last year. Most of our time was spent in Quebec. We drove to the Fingers Lake area of upstate New York, crossed into Ontario, traveled east along the St. Lawrence River around Montreal and Quebec City and into the North Shore region of eastern Quebec. Then we crossed the Saint Lawrence estuary on a two hour ferry trip to the Gaspe Peninsula and continued around the Acadian coast of Quebec and New Brunswick. Then back into Maine and home, 5800 miles in eight weeks.

Why did we go and what did we see? I have long been interested in the Saint Lawrence; it is one of the world’s great rivers. It is the second biggest river in North America, after the Mississippi. The Saint Lawrence estuary is the largest estuary in the world. And it is the geographical, historic and cultural heartland of our wonderful neighbor Canada. The history of European settlement of Canada is mostly that of exploration and settlement along the Gulf of Saint Lawrence into the estuary, then up the river to the Great Lakes. The majority of the Canadian population lives within the Saint Lawrence watershed. And it is an area of great natural beauty. The river itself is beautiful; it flows through the Thousand Islands region between Lake Ontario and Montreal, becomes tidal around Quebec City, and then widens into a huge estuary too wide to see across. The estuary merges with the Gulf of Saint Lawrence and the North Atlantic Ocean. We saw dramatic shorelines and coastlines and expansive beaches and wetlands. We made some detours inland into beautiful mountain valleys. Outside of Montreal and Quebec City this area is quite rural and sparsely populated. Those looking for quaint villages with historical and cultural attractions should probably stick to New England. We met few international  tourists and few Canadian visitors from outside of Quebec. 

What did we learn? Primarily that Quebec, at least outside of Montreal really is French, perhaps more French than France. As expected lots of the older people speak little English. We were surprised to find that lots of the younger people struggled with English and we spent lots of time with Google Translate. It appears that the Quebec government  goes to great efforts to discourage the use of English.  Throughout the rest of Canada signs are usually bilingual, English and French. That stops abruptly when you get into Quebec; most signage is just in  French. (In France the stop signs say “STOP”; in Quebec they say “ARRET”). All our written communications from the government campgrounds were in French with no English options. Good luck with the parking meter instructions!  I suppose the rationale for this active discouragement of English is that such discouragement is necessary to preserve the French culture and language of a province surrounded by a continent of English.

English-speaking or not, the Quebecois we interacted with were without exception friendly, gracious and helpful. I got cheerful assistance from the parking meter lady after she recognized my language limitations. Here are pictures from the Saint Lawrence watershed, in downstream geographic order:

As the Saint Lawrence Estuary widens into the Gulf of Saint Lawrence the land becomes more mountainous with rugged and dramatic coastlines. We followed the coastline along the Gaspe Peninsula in Quebec, then into New Brunswick and the Bay of Fundy.

We also spent time in Montreal and Quebec City, and visited historical sites in other places. These photos are in historical chronological order:

It is hard to say much about Canada or Canadians without using the word “nice”. It is just such a nice place: calm, clean, patient, friendly, helpful. Traveling in our camper van was a pleasure. We stayed mostly in national and provincial park campgrounds. Outside of the parks it was easy to find designated sites for overnight camper parking, usually free.

We finished the Canadian portion of our travels at Campobello Island, New Brunswick. Although the island is part of Canada, it is accessed by a short bridge from Lubbock, Maine. (The US border agent confiscated our oranges, very un-Canadian). On Campobello Island we visited Roosevelt-Campobello International Park. This park preserves the summer house where Franklin Delano Roosevelt spent most of his summers as a child and young man, and where he continued to visit with his family until his growing political responsibilities and health problems intervened. In 1921, when he was 39 years old,  FDR  was vacationing on  the island and developed fever followed by a progressive paralysis that spread from his legs upward, eventually involving his facial muscles. Prior to the onset of his illness he had spoken at a Boy Scout camp. It was assumed that he had caught paralytic poliomyelitis at the camp, that is polio. He was initially cared for at the Campobello Island house, then transferred to a New York City hospital. Roosevelt gradually recovered his upper body function but was left paralyzed from the waist down. The diagnosis of polio has subsequently been questioned; it rarely affected adults over 30. It may be more likely he actually had Guillain-Barré Syndrome, but it is not possible now to know for sure.

In September of 2024 when we visited the Roosevelt home, I had not thought about polio for years. Like almost all American doctors of my age I have never seen or even heard about a case of acute polio. I did see adult patients who retained varying degrees of polio-related disability from their childhood illnesses. A few of these patients were bedridden with paralysis; the majority had localized leg weakness, some needed braces, others had barely perceptible limps.

In 1955 a public announcement was broadcast reporting that the newly-developed Salk polio vaccine was “safe, effective, and potent.“ This vaccine was enthusiastically embraced; it was reported that “Church bells rang. Loudspeakers in department stores shared the news. Factories paused production to spread the word to jubilant co-workers. Families huddled in their parlors around their radios for the latest updates. There was glee, relief, resounding joy across the country.” Widespread vaccination of children was begun the day the vaccine was licensed. Cases of acute polio plummeted and in a few years it became a rare disease in developed countries. The last case of wild strain polio in the United States was reported in 1979. The initial Salk intramuscular vaccine was mostly replaced by the oral Sabin vaccine in 1962. I think I remember getting it; we lined up at school and were in turn given a sugar cube in a small paper cup.

These days, I think about polio on a fairly regular basis.  The polio vaccine, like the other recommended vaccines in the childhood series is highly effective. But they are not completely effective; many of them reduce the severity of illness but do not completely prevent the illness. Also a few people have deficiencies in their immune systems that impair their ability to mount an effective immune response to infection, even if they have been vaccinated. Additional protection is provided for us all by herd immunity, that desired situation in which a population attains a high enough prevalence of immunity to a pathogen that the pathogen cannot find sufficient susceptible hosts to maintain its replication. That is the pathogen starves for lack of victims and subsequently dies out or is much reduced in a community. Herd immunity requires perhaps 85- 95% of a population to be immune, either through effective vaccination or through surviving prior exposure to the pathogen. Our pediatricians cannot prescribe herd immunity; that requires widespread uptake of vaccinations.

The following picture shows my grandson Joseph running down the street with his grandmother in tow. Why is he running? He does not need a reason to run, that is just what healthy two-year-olds do. His parents, and the other people that love him, have plenty of things to worry about regarding the world that he will grow up in. His suffering from or dying from polio, measles, diphtheria, rubella, tetanus, pertussis, mumps, meningococcal meningitis and hepatitis B are not, or at least should not be, among those worries.