As he prepares to step down to make way for Governor-elect Glenn Youngkin, who will be sworn in on Saturday, Ralph Northam reflected on his four years at the helm of Virginia’s government—what got him into politics, where that journey has taken him, and his hopes for the future.

The governor spoke last week with the Gazette-Journal via telephone interview.

Northam grew up on a small farm in Onancock on Virginia’s Eastern Shore, and he said that, whenever he could, he would go fishing and crabbing on the Chesapeake Bay. He never had any political ambitions—certainly never dreamed of being governor—but over time, as he watched the demise of the bay, he realized he couldn’t just sit back and do nothing. In addition, as a doctor, he became frustrated with insurance issues surrounding health care, and those frustrations helped firm his resolve.

After talking with his wife, Pam, Northam decided to run for office, and in 2007 was elected to represent the 6th District in the Virginia...