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Those who know Quebec Liberal leader Philippe Couillard, a 56-year-old neurosurgeon, say he is a man of commanding intellect, trained to fix brains and stay cool under pressure.Ryan Remiorz/The Canadian Press

Philippe Couillard has repeated like a mantra that he wants this Quebec election campaign to rise above muck-throwing. But the Liberal Leader had better prepare his coveralls – or better still, a biohazard suit – if he wants to survive it.

With nine days left before the vote, Mr. Couillard's lead in the polls is starting to look as fragile as late-spring ice on a Quebec river. He heads into the campaign's home stretch vulnerable on key issues – ethics, identity and the protection of French – after a shaky performance in the toxic acrimony of Thursday's leaders' debate.

Erudite and intellectual, Mr. Couillard can look uncomfortable in the trenches of political combat. He is more in the mould of a Cartesian Pierre Trudeau than a scrapper like Jean Chrétien or Jean Charest.

His nickname when he was health minister, Bear, comes from his physique and shambling gait – not his killer instincts.

Those who know Mr. Couillard, a 56-year-old neurosurgeon, say he is a man of commanding intellect, trained to fix brains and stay cool under pressure. Voters will decide whether calm reassurance is the right antidote to the tumultuous and divisive minority government of Pauline Marois's Parti Québécois.

"I never saw him get angry," said Dr. Yves Lamontagne, who as former head of the Quebec College of Physicians dealt with Mr. Couillard in office. "He is like Dr. Welby" – the avuncular 1970s TV doctor.

Some say Mr. Couillard appears cool to the point of detachment, a trait that could be a byproduct of his training, Dr. Lamontagne said. "Neurosurgeons play inside brains. Their training is long. It's not easy and it's very meticulous. You need to be a bit transcendent … so rational that it can leave an impression of arrogance. But he's not arrogant."

Mr. Couillard spent years working as a neurosurgeon before being recruited to run for the Liberals in 2003. Colleagues describe him as a quick study with broad interests, sprinkling conversations with references to Greek philosophy, French literature, Second World War battles or the cultural traditions of Egypt. Jean-Pierre Chicoine, Mr. Couillard's boss at the University of Sherbrooke hospital, recalls he would use Latin in e-mails and once quoted Roman statesman Cato the Elder on the destruction of Carthage to describe the need to resolve a problem at the hospital.

"He was cultivated and followed his files closely, but always with good humour," Mr. Chicoine said this week.

Mr. Couillard's stint as head of surgery at the hospital, which preceded his run for public office, may have piqued his interest in politics. "He got a taste for administrative work and was good at it. He was very good at analysis and asked the right questions. It was really remarkable," Mr. Chicoine said.

Mr. Couillard's five-year term as Quebec health minister ended with good reviews, not an easy task for one of the most difficult portfolios in cabinet. He reduced waiting times for joint-replacement surgery and other procedures, streamlined bloated union accreditations and left government more popular than the premier, Mr. Charest.

He's probably best remembered for insisting on building the French-language super-hospital in downtown Montreal rather than in Outremont, a position that led him to defy Mr. Charest – and win. As minister, he could be exacting but willing to changing his mind. "He made compromises, but you needed to be prepared and your arguments had to be ready," recalled one of his close advisers, Jean-Pierre Dion.//

Still, it's Mr. Couillard's work in the private sector, not government, that has trailed him in the campaign.

He's weathered relentless questions over his association with Arthur Porter, the onetime whiz who headed the McGill University Health Centre and now stands accused of fraud. The two men sat on the federal Security Intelligence Review Committee at the same time and set up a consulting firm together, though the company was dissolved before carrying out any business.

Mr. Couillard has also had to explain the cash he stashed away in an offshore tax shelter while working as a neurosurgeon in Saudi Arabia in the early '90s. Mr. Couillard left Quebec for the conservative kingdom in 1992 with his first wife and three children (he has since remarried). He co-founded and ran a neurosurgery department, set up by the state oil company Aramco, in Dhahran.

While the tax shelter has grabbed headlines – even though what Mr. Couillard did was both legal and a common practice among Canadians overseas – the time in Saudi Arabia may have had other lasting effects. A profile in the newsmagazine L'Actualité said that while in Saudi Arabia, Mr. Couillard befriended a Jordanian colleague, learned Arabic and read up on Islam and the Koran. He let his beard grow, sparking rumours he'd converted to Islam. He didn't.

As Liberal Leader, Mr. Couillard has shown a worldly outlook, preaching inclusion and openness to other cultures, and defending minorities in the debate over the PQ's charter of secular values, which would bar hijab-wearing Muslim women from working in the Quebec public service.

During the debate over the contentious issue this year, when his party's opposition to the charter appeared to be wavering, Mr. Couillard requested a meeting with members of Montreal's Jewish community. He told them that while he did not compare the experience to that of victims who suffered in the Holocaust, members of his mother's family in Europe had died in the war as members of the Resistance.

(Mr. Couillard's father was a Montreal university professor and his mother was born in France, giving Mr. Couillard dual citizenship).

His sensitivities to war and service contributed to at least one memorable incident in which he publicly lost his cool. In 2007, several PQ legislators, including then-health critic Bernard Drainville, refused to stand in the National Assembly to applaud a group of soldiers from CFB Valcartier in the gallery who were bound for Afghanistan. An incensed Mr. Couillard called their behaviour "pathetic" and said he was "scandalized." One of Mr. Couillard's sons is in the Armed Forces, and as a government minister he attended several funerals for service members killed in combat in Afghanistan.

He has a little over a week to convince Quebeckers he should lead the province after April 7. In the Thursday debate, the die-hard federalist wore a pale blue tie and Quebec flag pin in his lapel to try to subtly bolster his Quebec nationalist cred, which took a beating. He faced a pile-on from opponents when he praised bilingualism and endorsed English for workers on shop floors. He also presented his party's vision for economic growth and struggled to defend his record on integrity. As the punches kept flying, however, he sometimes appeared flustered and destabilized as he tried to stay above the fray.

"I could answer mud with mud, but this is not the way I like to do politics," he said after the debate. Like it or not, the mud is finding him. The question is whether it will stick.

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