Maybe it’s his Eastern Shore roots. The son of a judge and a nurse, Gov. Northam grew up on a small farm in Onancock. He graduated with distinction from Virginia Military Institute, and in 1984, he earned his medical degree at EVMS.

“As a student, Ralph rotated through my neurology service,” Dr. Frank remembers. “Hopefully, I triggered his interest in child neurology.”

Back then, Gov. Northam shared an apartment with fellow medical student John “Rob” Marsh, MD (MD ’83), the highly decorated military physician portrayed in the movie Black Hawk Down. Dr. Marsh, once named national Country Doctor of the Year, now splits his practice between two rural communities in Virginia’s Shenandoah Valley.

“Ralph hasn’t changed the way he operates over 40 years,” Dr. Marsh says. “He’s not going to change now that he’s in the governor’s mansion.”

But politics — let alone living in that particular residence — wasn’t part of his plan.

After graduating from EVMS, Gov. Northam served for eight years as a U.S. Army physician, completing his residency in Texas before treating soldiers injured in Desert Storm. When he returned to Hampton Roads, he co-founded a pediatric neurology practice and joined EVMS as Assistant Professor of Pediatrics.

Dr. Marsh never hesitated to refer a sick child to his former roommate, even when it was one of his own. “My daughter had a significant neurological injury when she was three months old,” he says. “Ralph made the diagnosis and developed a treatment plan.”

He also remembers another family he sent to his friend. “I had a child out here with an unusual seizure disorder, and the family was very poor. UVA couldn’t diagnose it, so I called Ralph. He said if they drove down there, he would see them. He even helped them out with gas money. He called a colleague at Johns Hopkins and convinced him to see the child, and they finally got a diagnosis. He will always do what’s right for the patient.”

Nancy Stern tells similar stories. As CEO of Eastern Shore Rural Health System, she has known Gov. Northam for nearly two decades. “For years,” Ms. Stern says, “Ralph came over here once a month to see our patients because he knew it was a such a challenge for these families to get across the bay.”

In 2007, she was surprised to learn of his run for state senate. “I kept asking him, ‘Are you sure you know what you’re doing?’ And he said, ‘I think I can make positive change.’”

Surprise was Pam Northam’s reaction, too, when her husband proposed entering politics. “Ralph had been complaining to one of his partners about what was happening with healthcare,” she says, “and the partner finally asked, ‘Why don’t you do something about it?’”

Ms. Northam remembers going for a long walk with a good friend. “I had to really think about it to get an understanding of where Ralph was coming from.”

Her husband won his state senate seat by a wide margin and was re-elected easily in 2011. In 2013, he ran for lieutenant governor and again won handily. Shifting his focus from caring for patients to caring for citizens was a natural transition, Ms. Northam says.

“It doesn't matter who you are,” she says. “It doesn’t matter what religion you are or your political background, Ralph treats everyone the same. I’ve often said that people mistake his kindness for weakness. To be kind and have so much compassion for people are what makes him strong. His medical training is a large part of that.”

It prepared him well for the world of politics, too, she says. “Working 24/7, the sleepless nights, the travel, handling crises on the run, working as a team — all of that was instilled in Ralph by medical school and the military. And it gave him a thick skin.”

As an Army officer, Gov. Northam saw first-hand the sacrifices soldiers made, Dr. Marsh says. “In Desert Storm, Ralph functioned as an adult neurologist, and he saw the veteran aspect of military service from the bad side.”

Ms. Northam points to her husband’s combination of medical and military service for another reason. “We’ve been given a very special gift of understanding how fleeting life can be,” Ms. Northam says. “Dealing with life and death on a daily basis gives you a whole different perspective.”

In 2016, Gov. Northam took a leave of absence from teaching and practicing medicine to campaign for governor. With his win, his leave continues.

But that hasn’t changed Nancy Stern’s view of him.

“Whenever I picture Ralph,” she says, “I see him in his white coat making children with challenges smile.”

Gov. Ralph Northam, MD

Ten days after the election, EVMS sat down with Virginia’s new governor (who asked us to “please, call me Ralph”) to talk about how his background as a physician will shape the way he leads the commonwealth. What follows are excerpts from that interview.