Showing posts with label mary fernando. Show all posts
Showing posts with label mary fernando. Show all posts

14 February 2021

The Pandemic: Babies and Stories


With so much time together with our lovers, many expected a pandemic baby boom, but it is looking more like a bust.

I get it.

My writing fantasy is to have stories - the ones that reveal the places we live and breathe, the dark places, the places of joy - and also the time to write them. 

I now have the time but the onslaught of stories is just too much. The edits on my book are not a boom but a bust. A total bust.

Normally, when I work I shut out the world. Ignore it. However, this is a time in history when absorbing what is going on in the world is needed.

When I sit down to write, my head swirls from the page outward. Perhaps my characters are talking on the phone - I think of all the people isolated by #COVID19 who can only talk to those they love by phone. When my characters sit for coffee, I think of all the lonely people unable to gather and the small coffee shops struggling to survive in this pandemic.

Then there are the elderly in long term care homes, isolated and at times suffering with dementia - how do they make sense of the long days when no familiar faces come? Do they forget them? Do they remember them in their dreams?

The children who once rushed up to playgrounds to do what we have forgotten to do - play with abandon with children they have just met. Now, they are masked and are asked to keep their distance. Will they play with abandon when the virus is gone or will they grow up too soon into the far more distanced adults that surround them? Hell, we are asking them to keep their distance so it would be a small wonder if they don’t.

The lovers, the ones that had planned romantic trips, weddings and parties - what happens when none of that is possible? Do they put that spontaneous side - the most romantic moments - on hold. Can they return?

And then there are those who don’t return at all.  Their families watch them disappear into the bowels of an ambulance or hospital and then can’t see them, hold them before they die. 

I’m bombarded by stories of my colleagues in the #COVID ICUs. They have so many tools to save people but now, their tools are often useless against Covid-19. Death after death. It's everything they've been trained to fight and yet they lose the battle constantly. They are tired and demoralized when one patient dies, the numerous deaths are just too much for them.

And, perhaps a few blocks from these ICUs, people are gathering without masks, perhaps in homes, to have a drink, laugh and spread this damn virus around another room.

Will all the pandemic stories raging around demanding attention finally settle when the worst of this pandemic is over? Will we have time to write them when life returns to normal?

My hope is that these stories will be written and we will take the time to pay tribute to each person we can. There have never in my lifetime been so many stories crying out to be told. There are also so many people who are now no longer with us to tell their story and we need to honour them by telling it.

I have practiced medicine. I have written. Both involve a similar process.

In medicine, the key to a diagnosis is always the story - the more fulsome the story, the more likely the diagnosis will be accurate. And after diagnosis, following the story allows us to assess the treatment and, more importantly, how the patient is doing. 

With writing, the key is always the story and the more fulsome, the more accurate. 

With the pandemic stories that will be written, I hope that that they will be about how we recover, or don’t, from this terrible time in our history. Like a medical story, we need to follow this up. 

At this point in time I have no idea how the story ends for us all.

Oh, and babies. We need to see more babies please. We need a new generation to whom we pass on our stories, because this has been a time of such important stories. But until we pass on our stories, we need the joy of a new beginning.

10 January 2021

B2020 and A2020: How 2020 has influenced what we want to read and what we will write.


As we are bombarded with news of COVID-19 deaths, the rising unemployment and the latest attack on Capital Hill - many of us wonder how this can happen and why do some people not care?

More and more we are hearing stories from the frontline, from the unemployment line, from lines at food-banks and, from homes where seniors live. We are hearing about policies that thoughtlessly harm others and we ask - didn’t they even think about these people’s lives?

After living through 2020 – and face it, 2020 might just be a prologue to the book  “The Horrors of 2021” - we will never be the same and I suspect that what we want to read is forever changed. 

Literature changes because readers change. 

When I was a child, I would often rummage through my father’s extensive library. I remember some old books, where the room would be meticulously described, from the sun dappled curtains to the chair with slightly worn arms. These descriptions would often be a page long. I remember wondering if I was simply less observant than most people or if these descriptions were simply overdone. Being a curious child, I watched my friends and family carefully. I decided that none of them spent enough time observing to be able to write a page of details and that the people in these books had a different life, were different people or the author just made up stuff. I would still read some of those books but with a stern skim over the sun dappled this, the intricate patterns of that and any other such useless info. 

There are many takes on the immense suffering we have seen in 2020, but I suspect many readers will be drawn to different writers. Just as none of us have patience for a page long descriptions as characters enter a room, I believe we will have less patience for characters who wander the world doing things, noticing things but failing to empathize with people. Let’s face it, Sherlock Holmes was delightful, but who is going to write a book today where the characters notice the hair, that came from a rare species of cat, owned by only two families in the city, coupled with a smudge of brown dust from a particular type of stone, found in the statues of lions that sit by the doorway of one of those families? Yep. No one. Most of us read it, but we don’t write like that anymore. 

I think that many readers who have lived through this year - and the worse year that is coming - will demand characters with empathy. Not sympathy, but empathy. 

The definition of empathy is: the action of understanding, being aware of, being sensitive to, and vicariously experiencing the feelings, thoughts, and experience of another of either the past or present without having the feelings, thoughts, and experience fully communicated in an objectively explicit manner.

This stands in contrast to sympathy defined as: sympathy implies sharing (or having the capacity to share) the feelings of another, while empathy tends to be used to mean imagining, or having the capacity to imagine, feelings that one does not actually have.

If 2020 has made many of us yearn for anything, it is for people who have empathy and can imagine and feel what someone else is feeling - without having to be explicitly told and without having to have felt it themselves. Why? Because we are not all 90-year-old women, living alone in a care home, unable to see anyone. We are not all a single mother, with children to feed but with no money to feed them after we lost our job. We are not all ICU doctors, struggling to cope with losing patient after patient nor are we those who have to transport body after body to refrigerated trucks. We are not any of these people but we want someone, any one, to care about these people and tell us about them. 

What about sympathy – understanding the feelings that we actually have? This feels a little self-centred and, these days more than ever, the self-centred are at best unpopular and at worst, the villains of 2020: from anti-maskers to those who care only about staying in power.

I suspect many of us, who read voraciously,  and who have lived through this time , will want books with more characters who understand and feel what others are feeling and put us in their shoes. Detective novels highlighting not merely action but also empathy might become much more popular. I suspect this is true for all types of writing, from news stories to medical writing. I suspect we might have had our fill of self-centred characters, and I also suspect that they will often be cast as villains because, goodness knows, it feels ugly now. I have found that news stories, articles and - one could argue - political choices seem to already incorporate empathy more than before this dreadful year.

One could argue that good writing has always put us in the shoes of others, immersing us in their worlds. Somewhat true - but it is about the weight one gives to certain things. Do we devote pages to describe a room when a character enters it? Not anymore. So writing may have many elements in common but weight given differs. Weighting empathy heavily would change what we read. 

This may just be my new perspective but I doubt it. However, from a personal point of view, I am eager to read the new types of articles, books and characters born from 2020. I also look forward to new ways of telling the news, writing medical articles - any type of writing that tries to reach people who have lived this terrible year and await, with some trepidation, the unveiling of 2021. 

Whatever happens with various forms of writing, I believe that there will be fundamental changes in what writers write and readers read because we will never be the same after 2020.

08 November 2020

Protect your eyes from COVID19 infection.



 There’s a saying: if you’re the smartest person in the room, you’re in the wrong room. I recently found myself in the right room—a masked, backyard get-together with close friends.

My husband mentioned he’d added a face shield to his mask in indoor public places, to protect his eyes during the second wave of COVID-19. One of our friends, Brian Foody, said that using a face shield with a mask wouldn’t protect eyes from airborne COVID-19 but goggles would.

This statement was very surprising. Public health experts have been clear, given the airborne transmission of COVID-19, that face shields and goggles protect the eyes equally.

For the public, Dr. Anthony Fauci said in an interview, “. . . you should protect all of the mucosal surfaces, so if you have goggles or an eye shield, you should use it.”

In healthcare settings, face shields are irreplaceable to protect against splatter during procedures, but face shields and goggles are recommended by public health as interchangeable eye protection.

For protection during aerosol-generating medical procedures, Canadian Public Health recommends, “eye, nose and mouth protection (mask and eye protection, or mask and face shield, or mask with attached shield) that fully covers the eyes, nose and mouth and ensures that no part of the face is exposed.”

The CDC states, “The PPE recommended when caring for a patient with suspected or confirmed COVID-19 includes the following . . . Put on eye protection (i.e., goggles or a face shield that covers the front and sides of the face) upon entry to the patient room or care area.”

If face shields don’t protect the eyes from airborne COVID-19, the definition of “adequate PPE” changes and this may save lives. A large study of healthcare workers showed that they accounted for 10% to 20% of COVID-19 infections and, even more worryingly, “even among frontline healthcare workers reporting adequate PPE, the risk for COVID-19 was increased . . ..”

Given the importance of this issue for the public and for healthcare workers, I interviewed Brian Foody, president and chief executive officer of Iogen Corporation and an MIT-educated mechanical engineer, who specializes in fluid motion.

The movement of COVID-19 infected air is at the heart of this issue.

“Imagine two people wearing face masks, one has on a face shield and the other is wearing goggles, walking into a closed room where the ambient air contains COVID-19 infected aerosols,” Foody explained. “Whose eyes are better protected? For our wearer of the face shield, with every breath, the clean air behind her face shield is ventilated and exchanged with the contaminated ambient air. Because of this ventilation, the air behind the face shield will have the same concentration of aerosols as the rest of the room within a matter of minutes. On the other hand, for our goggle wearer, the clean air behind her goggles is sealed off from the ambient air.”

The mixing of air behind a face shield is based on the basic scientific principles of fluid dynamics: if there are COVID-19 particles, they’ll be drawn into the face shield and up to the eyes.

This behaviour of aerosols is supported by a 2014 study. “Face shields can substantially reduce the short-term exposure of health care workers to large infectious aerosol particles, but smaller particles can remain airborne longer and flow around the face shield more easily to be inhaled,” it noted.

A review of the literature in March, 2020 stated that, “There is a lack of research on the effectiveness of different forms of eye protection.”

And yet, certainly the public health recommendations consider goggles and face shields as equivalent.

I am reminded of the early days when many of us recognized the pattern of airborne transmission of COVID-19 infections and advocated for masks, contradicting public health recommendations. Now the widespread use of masks is recognized as an important tool to limit COVID-19. This information on face shields is just as important: face shields protect from splatter but do not offer eye protection and public health recommendations for the public and healthcare workers must change.

Then Brian asked a crucial question: “What are the chances of getting infected through your eyes?”

To begin to find my way through this issue, I had to enter the right room, so I unabashedly called my friend, Dr. Sherif El-Defrawy, at his cottage on Thanksgiving.

Dr. Sherif El-Defrawy is an ophthalmologist who’s chair of the Department of Ophthalmology at the University of Toronto, before which he held a similar position at Queen’s University. He’s also president of the Canadian Ophthalmological Society and of the Association of Canadian University Professors of Ophthalmology.

In short, Dr. El-Defrawy knows eyes.

“If COVID-19 infects the conjunctiva of the eye, it could travel to the nose via the nasolacrimal duct and colonize the nose or throat,” he explained. “However, we would expect to see conjunctivitis. I find it highly unlikely that there would be enough COVID-19 to cause illness without seeing conjunctivitis.”

He explained that the number of COVID-19 infected patients with conjunctivitis wasn’t that large but it was unclear how many patients were checked for this. Finally, he expressed surprise that goggles were not universally recommended in healthcare settings along with face shields.

So, first things first, I’m not a fan of primate studies but there was one that answered many questions about COVID-19 infection via the eyes, so with great regret I present it here.

Three rhesus macaques were infected with COVID, two via their conjunctiva and one via intratracheal route. The conjunctival swabs were positive for the first day only, “indicating that the inoculated virus may transfer from conjunctiva to respiratory tract and other tissues . . . specific IgG antibodies against SARS-CoV-2 were detected in the rhesus macaques, indicating that the animal was indeed infected with SARS-CoV-2 [showing] that conjunctiva is a route of SARS-CoV-2 transmission.”

A literature review concluded, “The overall prevalence of ocular symptoms in patients with COVID-19 was 11.2%, which is not a common finding. Nevertheless, this reported prevalence might be an underestimation because patients with COVID-19 present with life-threatening clinical scenarios, which may preclude a detailed ocular examination or relevant history.”

Speaking of ophthalmologists, we should acknowledge with deep gratitude that it was the ophthalmologist, Li Wenliang, who was one of the first people who warned the world about the new disease we now call COVID-19. He later succumbed to the disease after contracting the virus seemingly from an asymptomatic glaucoma patient in his clinic.

So, how does eye protection play out on the ground in healthcare settings? Here I turned to information from Dr. Rick MacDonald, a community paediatrician on staff at Halton Healthcare hospitals where he takes call seeing paediatric patients and works in the NICU.

When many other physicians’ offices were largely doing virtual visits, “we decided early on that if we were going to be a useful resource for our paediatric population. . . .We needed to see patients [and] to provide this service, PPE is the most important first step without which it could not be done.”

Dr. MacDonald spent hours sourcing PPE for his office, opting for an N95 and a face shield but now also wears goggles as well. “To [keep our office open] we need full protection. No skimping, no cheating, full attention to detail. . . . Overkill is better and no government official or cloistered ID staff will convince me otherwise.”

He’s correct: protection, including eye protection, is crucial. Doctors are often in closed examining rooms, crowded emergency departments or intensive care units, with potentially large volumes of COVID-19 aerosols. So are nurses, paramedics, respiratory therapists and many others.

Certainly, we could benefit from research on the fluid dynamics of COVID19 aerosols with people wearing face shields and masks. However, we are in the second wave of this pandemic and there are a frightening number of infections in the public and healthcare workers.

I’m asking public health, in light of the basic science of fluid dynamics of aerosols, to change their recommendations:

The public should wear eye protection if they are indoors with others.

Healthcare workers working with patients that are potentially COVID-19 positive, should use face shields for splatter alone. Goggles are the only safe eye protection for aerosols.

11 October 2020

Dr. Obenson: Doctor and Detective


Dr. Ken Obenson is one of only two certified forensic pathologists practicing in New Brunswick, Canada. He holds the distinction of being  first black pathologist certified by the Royal College of Physicians and Surgeons of Canada in forensic pathology. 

Although he investigates deaths in deceased of all age groups from babies to adults, it is with the death of babies where, “I often need to apply all the detective skills that I acquired through training and experience. Infants don’t have the usual stigmata of disease or injury unlike adults who tend to have well documented disease histories - and infants can sustain injuries that may not be as obvious at autopsy as adults.”

“My role, in the case of a natural death, is to make sure that I make the best effort to find the explanation for the death so I can allay some of the fears of the family,” Dr. Obenson explains. “When an infant dies, the parents almost always blame themselves. It can be heartbreaking for the parents when we are not  able to  provide a definitive cause of death. Unlike some other practice groups, we don’t use the term SIDS because it is a diagnosis of exclusion. SIDS or not, the cause death is undetermined and this is what they (the parents) worry about. Not just for this baby, but for others they may have in the future.” 

One case he investigated was particularly illuminating. It was the death of an infant who was only a few days old. The CT, X-ray, autopsy, toxicology, microbiology and other examinations found no cause of death. Information gathered by the police, revealed that the baby was visited by its’ large extended family who had all held the baby. On a preliminary examination of slides of the markedly autolyzed tissue that he had sampled at the autopsy Dr. Obenson found evidence of viral infection (suspected to be parvovirus) in one section of liver. Knowing exactly what to look for, he reexamined the slides more closely  and found  further evidence of the infection in several other organs. 

Because he was able to determine that death was the result of a viral infection, Dr. Obenson was able to allay the parents’ fears that something congenital was responsible for their baby’s death and reassure them that their next baby would not be at risk of dying. It also allows them to make different decisions about how many people their next baby comes into contact with while vulnerable and perhaps they may even insist on hand washing and other infection precautions in the future. Very importantly, it saves them from unspoken accusations that they might have done something directly to cause their baby’s death, like smothering, etc. 

Dr. Obenson was quite satisfied with the outcome in this case, knowing that the finding of a lethal viral infection probably helped  the parents in dealing with  their loss.  This is why he insists that as per international guidelines, a  thorough post mortem examination be performed in infants, after a comprehensive death scene investigation with review of  radiologic, toxicological, histologic and microbiological findings. 

“My role, when there is a homicide of an infant, is collect evidence such that the law is able to hold whoever is responsible to account,” he explained. “I have been qualified as an expert witness in court which means that because of my training, certification and experience, I am able to  give opinion evidence as to the cause and manner of death, unlike 'eye' witnesses who can only speak to what they have seen or heard.” 

Although for most of us, the murder of an infant is unthinkable, it does happen. Dr. Obenson explains that if there is an adult unrelated to the infant living in the house, like a new boyfriend, they are statistically more likely to kill that child. However, biological parents also do kill their babies, with fathers being more likely to do so violently than mothers. Unfortunately the less violent the trauma the more difficult it can be to detect physical evidence of foul play. For example, Dr. Obenson points out, if a baby is smothered, petechial hemorrhages in the eye  that are often seen in, but not exclusive to an asphyxial death are less likely to occur in infants- which is why these death investigations can be so complex. 

Dr Obenson takes his role as an impartial witness seriously and derives no personal satisfaction from a conviction. His only responsibility is use all available evidence from death scene, to social circumstances to post mortem examination and ancillary tests to arrive at a reasonable opinion on the cause of death. 
Dr. Obenson has practiced forensic pathology in the United States, in Jamaica and for nearly 20 years in Canada. He says, “We don’t have as many suspicious child deaths in Canada, particularly homicides. My theory is that the social safety nets in Canada alleviate some of the social stresses families feel.” 

This is the best argument I have ever heard for supporting families: protecting children.

13 September 2020

Wearing Masks During COVID19: How Neuroscience Can Help Us.


Never have lives depended so much on getting a buy in from the public to wear masks. The evidence that masks protect us from COVID-19 is clear and unequivocal. In terms of scientific evidence, that is. Where it all falls apart is when emotional arguments are made against wearing masks.

Many argue that we should avoid the emotional aspect of COVID and simply concentrate on the rational arguments for mask use. 

However, this argument falls apart too, because all decisions involve emotions and we can’t keep people safe without appealing to them. Why? Because that’s how our brain works.



In the 1990s, the neuroscientist and physician Antonio Damasio wrote a groundbreaking book, Descartes’ Error: Emotion Reason and the Human Brain. Through studying people with brain lesions he demonstrated how decision making necessitates emotional input: decisions cannot be made without emotional input. 



Much research has supported these findings and this has been taken into the political arena by authors like Westen and Lakoff. The basic conversation in both these books is how all political decisions involve emotional input. 



Some may feel that decision-making that necessitates emotional input is not a good thing. They will side with Descartes and claim that purely rational decision-making exists. Like everything in the human body, from kidney to heart function, one doesn’t get to chose how organs work. The vast amount of evidence from lesion studies proves this to be the way the brain works.

I understand the concern with the idea that decisions are emotionally based - I grew up with scientists who felt emotions should never enter decisions. Emotions were seen as out of control and in need of control. 



Perhaps it would be reassuring to look at the areas of the brain that are involved in emotions - there is a complex, interconnected system that is utterly beautiful. A glance at some of the players may inspire you: these areas respond directly and indirectly to bodily and sensory inputs and coordinate, like a symphony: orbitofrontal cortex, dorsolateral prefrontal cortex, anterior temporal lobe, ventrolateral prefrontal cortex, dorsomedial prefrontal cortex, anterior mid-cingulate cortex , amygdala, anterior insula, anterior cingulate cortex, dorsomedial/dorsolateral prefrontal cortex, medial temporal lobe, retrosplenial cortex/posterior cingulate cortex and periaqueductal gray.

So, although emotions are often viewed as the basest form of human reaction, they involve complex cascades of brain activity that are crucial for synthesizing social, empathetic and protective aspects of a decision.

This impacts mask wearing because different countries have different emotional narratives to which they generally respond.

All governments are using narratives to explain the spread of COVID-19. In Canada, the narratives of the federal and provincial governments are largely in line with each other and all appeal to a sense of helping others. This narrative has high emotional salience in Canada, where helping others, working together as a country to help each other is the basis of everything from our universal healthcare system to our investment in schooling. It is a core value. Not for everyone, of course, because no country has a homogenous set of values. However, most countries do have some values that are widely shared. 

Even some of the anti-maskers in Canada protest under the banner of “Hugs not masks”. Appealing to a sense of community well-being while spreading the virus may be odd, but it encapsulates the emotional weight of community in Canada. 



South of our border, COVID-19 infections and deaths are mounting, and masks would help limit the spread of this virus. There are many factors involved in this but one factor is the conflicting messaging coming from the federal government and the states. Another factor may well be the emotional weight given to the idea of individual decisions - much of the messaging has actually been against the community well-being by arguing that individuals can’t be forced to do things by others, particularly governments. We have some of that in Canada, but not in such large numbers because the narrative in Canada is that taking care of others is valuable and putting yourself above the health of others is generally frowned upon.

I have thought long and hard about how to encourage people to wear masks south of the border. Many of my colleagues in the United States spend their days and nights caring for COVID patients and then spend their free time on twitter encouraging people to wear masks. 


When I think of appeals that have been made to Americans, this comes to mind:




Or this as a mantra for today:





So many fine and civic minded Americans have called upon Americans to follow their better angels. These appeals are emotional - heck, I’m Canadian and they move me to the core.

Some of my American friends have argued that the population of America has changed and that appealing to better angels will not work because many are driven by anger and fear. The division of people into those who are angry and scared verses those who are rationally following public health measures is a fallacy. We are all scared and we are all angry. These are difficult times and we would be completely detached from reality if our responses to this drastic situation were not intense: remember our emotional systems are nuanced, coordinated and work with reality because they are dependent on input from our senses.

Directing our fear towards its source - this virus - drives many of us to wear masks, wash our hands, keep our distance from people and allows us to stay safe. Anger? That's a great energizer for fear and enables us to fight paralysis by driving us to action. We are seeing governments and others trying to direct anger when infections increase towards those who are infected and, these days, this is often young people who are painted with the narrative that they are selfish and irresponsible. When we direct anger towards our own, it's rarely productive and always divisive. When young people have heard inaccurate information that they are largely unaffected by this virus, we should look to the source of their behaviour and perhaps correct the information they were given, using that anger to drive us, energetically, to educate them and appeal to the values of community and empathy that we have raised them with. 

History has taught us that citizens who have been complicit in terrible things can and have turned things around - think postwar Germany. Surely, we can give our young and our fellow citizens the benefit of the doubt and appeal to their better angels - to their more noble emotions such as empathy. 

One of the bright spots - maybe - is the response Canadians have seen to mask mandates and this might help in America. “An overwhelming 95 per cent of the survey respondents say they now wear a mask on public transit. In mid-July, those numbers were as low as 45 per cent.”  In cities all over Canada, we are seeing similar response to mask mandates. Not certain if this would work with our southern neighbours given the violence that has accompanied masks refusal and the lives that have been lost. But maybe this provides some hope. Along with an emotional appeal to civic duty grounded in empathy. 

I don’t know if this will work. I’m just hoping that we can all turn the rising infections around by standing on the shoulders of scientists, who explained how we make all decisions, including whether to wear masks or not: facts without emotional appeals will simply not work to help people make the right public health decisions. 

09 August 2020

Nipping it in the bud because old men cry.



In February, an elderly man was collecting recyclables in San Francisco when another man threatened him and taunted him. A video shows the elderly man crying while onlookers laugh at him. 

In March, a man yelled at an elderly man suffering from dementia in a convenience store in Vancouver. Then the elderly man was shoved by the other man, he fell and hit his head. 

Both of the elderly men attacked were of Asian descent and, in each case, the men attacking them hurled racist remarks at them. Both of these elderly and innocent men were victims of the heinous crime that’s on the rise: hate crime. 

In the United States and Canada, hate crimes are increasing  Although the number of hate crimes in Canada remain lower than in the United States, we don’t know the actual numbers in either country: hate crimes remain underreported in both countries and, because hate crimes are defined differently in various regions of each country, counting cases accurately is difficult.

Crimes of hate thrive and grow in times of intolerance and certainly we are living through difficult times. Many of the attacks against those of Asian heritage are accompanied by accusations of somehow being blamed for COVID-19 infections. 

Social media is one of the main vehicles that transports racism through society and fuels hate crimes. One tool Canada has to fight this is illustrated by the conviction of James Sears. 

In Aug 2019, the Canadian editor, James Sears, was sentenced to one year in jail for “wilful promotion of hatred against women and Jews..[the judge] lamented the fact that he couldn’t give Sears 18 months, saying the circumstances were more severe than a 1990 case where a 22-year-old self-described racist received a year in jail for antisemitic graffiti including spray painting swastikas on a Toronto synagogue.” 

Canadian hate laws do limit free expression. David Butt has an elegant discussion of this:


“Does freedom of expression as legally defined in Canada provide the right tools for expression challenges in a fragmented and largely angry 21st century social media world?
Canadian freedom of expression law, like so many things Canadian, embodies compromise… our constitution protects not only free expression, but multiculturalism and equality as well. So to read the constitution holistically, we cannot permit one protected freedom to undermine other rights and freedoms enjoying equal status."

As we all traverse this world of social media and the spread of hate based on race, religion and sexual orientation, it remains an open question whether Canada’s compromise of balancing the right to freedom of speech with other rights, will curtail hate crimes. I won’t dwell on the legal problems of enforcing the laws Canada has, the limit of those laws and the complications of all this. Why?

What I will do is join the many voices condemning hate crimes. There can be no civil society when old men are humiliated to the point of tears and then are simply laughed at, when people are spit on, beaten and humiliated simply for their race, religion or who they love. The internet has become a place to spread hate in dark corners that radiate out to infect us all. 

We can prosecute hate crimes after they happen, but we must find ways to stop the propagation of hate in the first place. Some social media platforms are trying to manage hate speech online. However, curbing hate crimes with laws or even regulations on social media may feel like a Sisyphean task and many have asked why bother because the problem is too large? Others ask why do this and curb free speech?

I ask - would we say this about any other crime? Would we say there are too many murders, so why bother trying to stop them? Would we say that trying to stop physical assault may lead us to also stop holding hands and hugging? Surely, we can distinguish racist or homophobic rants from gardening advice. Again, I'm not a lawyer and know that these issues can be very difficult. However, as a physician, I can tell you that treating head injuries in an old man thrown to the ground can also be difficult - but you would be hard pressed to find a doctor who walked away from that task. 

So, it's time we found solutions to hate crimes and the first step is to take them seriously enough to come up with solutions.

12 July 2020

Writers: Get Thee on Twitter


When I told Leigh Lundin that Twitter is a great place for writers, he balked and then told me to write that story.

When Leigh gives me marching orders, it’s always a fascinating journey.

Writers often use Twitter to promote their work. I use Twitter to hear stories because writers are addicts. All of us. We are addicted to people. We watch people in cafes, in our homes and on the streets. We listen carefully to the stories people tell us and, as readers, we read stories. Even if the article or book isn’t about people’s stories - we ferret them out anyway.


Can anyone tell stories within the restrictions of Twitter’s 280 characters? I would have once answered that it was unlikely but, after a few years on Twitter, I’m now of the opinion that the best stories are often told in 280 characters - or less.

The story of the this time is COVID-19, and what you read on Twitter is very different than the news.

In the news - online, print, TV and radio - the infection rates and deaths are presented and often experts discuss the issues. You can find these articles and even follow these experts on Twitter.

However, many of the important stories of COVID-19 aren’t in the numbers - they are stories from the frontlines. Not just the stories by doctors, nurses and other healthcare workers, but the stories of patients who find themselves fighting this virus.

There are stories of worry and outright fear, frustration and courage, advocacy and defeat.

When people write about these times, I hope these many voices find their way into those books. I understand that some people prefer the view from 30,000 feet - looking at the numbers and the spread, the policies and the politics.

For me - and I hope for many of us - the real stories are those of people. Each and every one has a world they live in, people they love and who love them. The tragedy of COVID-19 rests in these stories, whether they are healthcare workers putting their lives on the line, living away from their families to stay at the bedsides of patients or whether they are patients with  COVID-19 and are battling against it from the other side of the bed - these are the stories that matter.

A tragedy is often defined in two ways:

1. An event causing great suffering, destruction, and distress, such as a serious accident, crime, or natural catastrophe.

2. A play dealing with tragic events and having an unhappy ending, especially one concerning the downfall of the main character.

I prefer the latter definition: great suffering is only understood from the perspective of one person - the nuances, the thoughts, the feelings, the impact on others  - and life is not a play but each and every person is a main character in their own life.

Twitter has helped me understand the lives of those in the United States during COVID-19 - those who are pushing for opening up the economy and get back to work - to return to normal. Some people use the hashtag #COVIDIDIOT for these people, arguing that they are ignoring the science and putting people’s lives at risk. However, if you read their stories, you will see that these people often live on the margins, have no savings and have no way of feeding their family without working. They risk losing their homes, being evicted even from rental homes, and their fear of homelessness and hunger seems more real to them, more tangible, than a virus they can’t see. They are not idiots. They are people struggling. 

There are scientists using their graphs, their studies, trying so hard to educate us all on the dangers of this virus, the need for measures such as masks to limit its spread and save lives. They are struggling too, trying - often for the first time - to turn their academic understanding into something that everyone can grasp.

There are doctors and nurses, often posting pictures of the scars on their faces from masks, telling us how they have no more ICU beds and begging us all to stay home and wear masks.

There are politicians, giving their story of caution or throwing caution to the wind, with policies they hope will help.

This time is a complicated time. Everyone has a perspective and a story.


Part of Leigh’s marching orders were to also explain how to DO Twitter.

Every story has a main character and on Twitter, you are your main character. Whatever you try to say or do, people will figure you out - so I suggest you simply be the person on Twitter that you are in real life.

In fact, do all of Twitter the same way you do real life. If Twitter is a place you spend some time in, then follow people because you find them interesting, just like you would invite the most interesting people for dinner.

Like a dinner party, where you listen more than you speak, on Twitter, read more than you tweet. Read people’s comments, go to their profiles and read their tweets if you like what the say but also if you don’t.

If you interact with someone and like them, treat it like your own private dinner party and enjoy. If you have an interaction that is unpleasant - also treat it like your own dinner party and don’t put up with it - block or mute them and carry on. Or better yet - if you know there could be trouble because the views are so upsetting to you, then just read and learn.

So, my advice? If you are feeling you need to hear the stories of our times - go on Twitter.

14 June 2020

Please Don't Upset Racially Mixed Children


The protests in the United States has people in many countries including Canada asking, “What can I do to help end racism?” My approach has been to listen to the stories from south of our border and within our borders: this is the birthplace of the solutions we need. However, I’ve realized that these stories weren’t addressing my concerns about my children and that’s a story I want to write.

My husband is white and our son and daughter are mixed race. I would say bi-racial but that isn’t true. My parents were from Sri Lanka—my mother’s grandfather was French, somewhere in my father’s family there was someone African but we suspect other ancestors as well, including a Chinese one. My husband has roots in Ireland, Scotland and Wales.

There is absolutely no doubt that people are suffering in the United States and—to a lesser extent in Canada—from racism. I have no interest in diminishing this suffering—we should all be amplifying those stories. However, the way we discuss these stories are adversely impacting children of mixed marriages and that is where I want to focus: I want you to imagine being one of those mixed children while you read.

The research on implicit racial biases, often based on the Implicit Association Test (IAT), has provoked some people to state—with puzzling confidence—that all whites harbour implicit racist attitudes. To be clear: for my children, this is their father that we are talking about. When our children have their feet in at least two worlds, sometimes many worlds, telling them one of their parents could dislike them because of their race is not merely the height of cruelty, it is also untrue.

But the IAT, that measures beliefs and attitudes people may be unwilling or unable to report, has numerous problems. For a test to be relevant it has to be replicable—give the same result each time you take it—and valid so measuring what it purports to measure: “Greg Mitchell, a law professor at the University of Virginia (stated) the replicability of the IAT is extremely poor. If the test suggests that you have a strong implicit bias against African Americans, then ‘if you take it even an hour or so later you’ll probably get a very different score’. . . . More fundamentally, there appears to a very tenuous relationship between the IAT and behaviour. That is to say, if your colleague, Person A, does worse in the IAT than another colleague, Person B, it would be far too hasty to conclude that Person A will exhibit more discriminatory behaviour in the workplace. In so far as there is a link between the IAT and behaviour generally, it is shaky.”

If we ignore the fact that IAT is neither reliable nor valid and look at the results—even they do not show that all whites have implicit biases: 18% don’t. Since there are serious methodological questions about this test in the first place, it shouldn’t be used as a justification for saying stuff that would upset mixed race children.

Like most mixed race children, my children have a wide range of looks: they get very dark in the sun and by the end of a long Canadian winter, they look almost white. Once my son and I were grocery shopping at the end of a long winter and we encountered one of his high school classmates. My son told me that this young man asked him afterwards what race he was. My son cheerfully listed my husband’s European roots and my Asian and African ones. When he was finished his classmate said, “No wonder you’re an alpha male in our school. You’re seriously the master race.” Never before had I heard this horrible term being used in this way and it tells you a great deal about the hope I have for this new generation.

This young man—who is white—might go on and have racially mixed children. I can guarantee you that many of this generation will do the same.

For them, and for my children, I have a simple ask: don’t tell racially mixed children that one of their parents is biased against them. It’s cruel.

What my children know, to the core of their being, is that their father would lay down his life for them without a second thought. His love for them is unconditional, deep and one of the most important truths of his life.

Please don’t make generalizations that mess with the family we have created and the children whom both my husband and I love. You can’t stop the damage of racism by ignoring the reality of mixed race children. Keep them close to your heart and don’t say anything to suggest that both their parents have anything but deep, unconditional love for them.

10 May 2020

COVID19 in America versus Canada


Anger is the biggest difference between America and Canada’s response to the coronavirus pandemic.

Many people have been discussing the difference between the response to the coronavirus pandemic by the United States and Canada. “When you look at per capita cases and deaths across the course of the entire outbreak, the comparison looks even worse: the United States has over two times as many confirmed coronavirus cases as Canada and roughly twice as many deaths.”

The factors impacting coronavirus infections and deaths in the two countries are complicated and will, I’m certain, be analyzed for years.

What I find impossibly sad is the level of anger in the United States that is not directed at this virus - because we should all be furious at this virus - but at each other.

While both countries are grappling with how to open up the country and help the economy recover, the stories in the two countries couldn’t be more different. As they say, a picture is worth a thousand words. 



In America: 



In Canada:



One obvious difference is that in Canada, we are not allowed to openly carry guns. However, aside from the guns, the differences are crucial and it is in the level of anger and intimidation in the United States.

In Ontario, my home province, the Premier responded to the protests by saying: “Ontario Premier Doug Ford says he’s furious at the “bunch of yahoos” who decided to flout physical distancing measures and emergency laws to protest outside Queen’s Park Saturday afternoon, calling them “irresponsible, reckless and selfish.”

For those who don’t speak Canadian, this is a very, very angry statement by a Canadian Premier. Also - he suggested consequences: “He said he hoped Toronto police would ticket them.
Not keeping at least two metres apart from someone not in your own household currently carries a fine of $880 in Toronto.”

In the end however: “A spokesperson for the Toronto police said no arrests were made and no tickets were issued following the protest, saying the crowd was compliant and exercised good social distancing.”

In other words, fairly polite and compliant protesters. 

It is more than not carrying guns. 

The politeness of Canadians has long been a joke among Americans. Although generalizations are never universally true, there may be something to this. However, there is one picture that explains a great deal:



In the United States, people are out of work and losing their healthcare and the financial assistance given appears to be piecemeal -both federal and state assistance- and many appear to be falling through the cracks.

In Canada, our universal healthcare system means that everyone remains covered for healthcare regardless of their employment status.

The federal government has delivered a strong set of financial protections for employees, self-employed, seniors and students. For example, if you are self-employed and have lost your job, you receive $2,000 per month for 4 months. These financial safety nets during COVID19, allow people to put food on the table. The provinces have all stepped up with other financial supports for citizens. 

In short: it is far easier to be less angry about the financial impacts of COVID in Canada than in the United States. 


There is more though. In Canada, there has been coordination between all levels of government in another area: information.

Our press conferences have been focused on Medical Officers of Health (federal and provincial) giving updates on infections, looking at models and doing the crucial work of informing the public about the new knowledge of this virus. This serves to increase scientific literacy in general. For example, prior to this pandemic, some Canadians did not understand that a virus cannot live outside of a cell for long and that is the reason for physical distancing.

The news in the United States has covered the politics of this pandemic and the disagreements between levels of government and within government. This type of coverage in Canada would be rather short - because there is general agreement about the need for physical distancing and to stay at home to defeat this virus.

So the difference in the two countries could not be more striking. In the United States the coronavirus has been a magnet for political anger. In Canada there is some of that certainly, as evidenced by the protests, but they have been small because, largely, our politicians are not fuelling them.

A virus has no politics, knows no party affiliation. It simply infects and kills. The wartime analogy has been used to describe the fight against this virus but this appears to be a strange war in the US, where there is little agreement if the enemy is dangerous, how to fight it or whether to bother fighting at all.

So, while Americans are dying, they appear to be very angry with each other. I wish they would get angrier at the virus.

12 April 2020

Surviving COVID19


COVID19 is a dangerous adversary and everyone is discussing how stressful they are finding living in the age of COVID19.


There have been many excellent recommendations on how to reduce stress. Many of these recommendations have focused on stress reduction strategies like exercise.

Given my area is mental health, I would like to add to the conversations on stress by presenting a different lens.

First, let’s talk about what stress is and is not, because to tackle something one must always know what one is getting into the ring with. 

In 1936, biologist Hans Selye described a common physiological response in rats subjected to harmful factors and he named this the stress response. “The main features of the syndrome were suppression of the immune system, ulceration of the lining of the stomach and small intestine, and activation of the two … stress-response systems.”

Over the last 80 years, there has been extensive documentation of the widespread damage of stress on our body and brain.

So stress doesn’t just feel bad - it is really bad for you. Reducing stress can save your life and a sense of control is the one way cortisol and other factors provoked by stress can be reduced and the health impacts minimized.

What is crucial is that stress is not just bad things happening to you – it is bad things happening with a sense of having no control over these things.


You might be thinking: if control is crucial to managing stress, how on earth can you control a global outbreak of a virus? How can we control not only the illnesses and deaths but also the economic consequences on such a large scale. Control? It seems like a rather ludicrous word in the face of all this.

All true points. Thank you for making them.

My answer is to introduce some people whom I have known that belong to “The Greatest Generation”- those who lived through World War II. They earned their name because of their tenacity and 'can do' attitude. They did not enter the war with these attitudes but, rather, they were forged by the hardships they faced.

My father-in-law, Bill, and his twin brother were pilots in World War II. Bill’s brother died when his plane went down in Europe and he was never able to speak of him again – it was as if the grief of his loss had torn out his heart. Bill went on to get an engineering degree, marry, have children and live a life of laughter and love.

My mother-in-law, Verna, stayed home and helped in many ways the war effort. She told me stories of how they would try to get butter to make her beloved pastries, how they would save things so they could send packages to those who were fighting along with letters. The volume of letters diminished over time because many of the young men she grew up with died.


Neither of them had any ability to stop the war or save those they loved. Both were irreparably broken by the losses they sustained. Both walked into life after the war with a strong stride. They survived the war by small acts and large ones that were all acts of resistance. Bill was a man who embraced competence – taking care of his family and being the one who got things done – and Verna was loving, taking everyone under her wing. Perhaps those characteristics were their tribute to those they lost and a way to ensure that they would keep those around them safe.

Let me introduce you to Lili. She was Jewish and was sent away from her parents as a small child into hiding. She lost her parents and everyone in her family. I learned later that she had anxiety and many difficulties all her life in response to this, but what I remember about her was that she was one of the kindest people I have ever known. If the world robs you of so much through cruelty, kindness is the ultimate act of defiance.

None of them had control over global events that ended up at their door. What they did was to take control during and after in small and large ways. Ultimately, their characters are a testament to how they became known as the greatest generation, because it was not what they endured but how they endured it that defined them.

Back to COVID19. We have no control over when we will have a vaccine and this nightmare will end. However, the reality is that we have never had control over large global events and this is no different. What we do have control over is our small corner of this planet and that is where we fight. 

Much has been discussed about the courage and tenacity of my colleagues during COVID19. When I speak with them, they talk about doing what they have always done; medicine with the patient in front of them. They read voraciously about this virus, they consult others for more information, they organize their homes to have decontamination zones to keep their family safe and do many other things to manage their corner of the planet.

Many of my non-medical friends are reading and watching the news to educate themselves, they are designing new ways to get groceries safely and clean them down. They are reaching out to friends and family to inform them, check up on them and laugh with them.

When we talk about the new normal – it is the ability of each of us to have small and large acts of defiance and resistance to keep those we love safe.

We will not recover without scars. We can only hope to minimize the number we lose and comfort those who have lost people. There will be anguish: times when we wake up in the middle of the night drenched in fear. When we emerge from this - we can do so with a character forged by how we responded to COVID and how we controlled our corner of the world.

08 March 2020

Coronavirus COVID-19: The Heroes and the Culprits


Dr Mary Fernando
Mary Fernando, MD
Every time a patient goes to a doctor with a new illness, the story of chasing down the diagnosis is like a mystery novel with one difference: everyone works hard to make the story short with as little excitement as possible.

In medicine, no one wants a long, twisted plot line and the best stories are the boring ones where the culprit is found quickly.

This desire for a short, boring story line has done what nothing else has been able to: it has united the world because citizens of every country want the story of the new coronavirus, #COVID-19, to end before they get a starring role in the tale of a new epidemic.



On December 30, 2019, Dr Li, a 34-year-old ophthalmologist in Wuhan, posted on Weibo that he had seen 7 cases of a SARS-like virus and warned fellow doctors to wear protective clothing to avoid infection. This sensible and medically appropriate suggestion resulted in Dr Li being summoned to the Public Security Bureau four days later and he was made to sign a letter confirming he had made false statements. Before his death from Coronavirus on Feb 7, 2020, Dr. Li explained why he warned people initially despite the fact that he knew he might be punished for it: “I think a healthy society should not only have one kind of voice.”


Like the Chinese government who tried to put a lid on information about COVID-19, we have had many others who have tried to do the same for political and financial reasons. There’s nothing wrong with trying to protect businesses, however, there is a great deal wrong with stifling information. The only thing that protects people and saves lives is the truth: if certain activities or places are unsafe, people should know this.

Through the evolution of this disease, there have been many kinds of voices speaking out and, just like in any mystery novel, each new crises reveals a great deal about the character of those involved.

There are some people who want everyone to stay calm – as if one smidgeon of worry will muck up their world. They came out in force at the beginning of this epidemic grabbing every straw they could to dampen down concern. I’m a huge fan of calmness but not when it is coupled with misinformation such as: this is only spread by animals, only spread by people who are symptomatic, the virus doesn’t live on surfaces for days and it is no more lethal than the flu.

Not one of those statements is true and people cannot protect themselves if they don’t know the truth. 


While some grasp at anything to calm people down, others have done the opposite and developed theories to fan all sorts of flames and even to start fires on their own. One theory floated around that this new virus was developed in a lab to destabilize the world. Right on the heels of this is another, very malignant theory that this is a virus that largely infects people of Chinese origin and that they are responsible for the spread of this. This has resulted in racist attacks on people around the globe.

There is another set of characters that have been emerging and speaking loudly: those who take a great deal of reassurance if they know things and even more reassurance if they know everything. Now this person who knows everything is a purely fictional character who has never existed but this doesn’t stop some people from emulating them. If this person who believes they have all the information has a large pulpit, they can spread information that is inaccurate and possibly dangerous.


Who is the biggest, baddest, scariest culprit in the saga of #COVID-19?
 Misinformation, spread by people whose need for calm, chaos or personal brilliance blinds them to the new facts emerging about this virus daily.

Some of those new facts are reassuring, some are worrisome and not one of us knows them all because it is an evolving story. For example, there has been some evidence that gastrointestinal symptoms such as nausea and diarrhea may precede respiratory symptoms during infection with this new coronavirus– this is crucial information that could lead people to seek medical attention earlier and therefore limit spread of the disease. Since we know that people without symptoms can spread the disease – unlike with SARS – we can’t assume we haven’t been exposed because no one around us was ill. 


Just like in any mystery novel, we should remain suspicious of all the characters - any one of them could spread misinformation – often not from malice but because their character compels them to engage in certain behaviours that increase misinformation. Bottom line – the only thing that will keep you and those you care about safe is information on how to avoid getting infected with coronavirus.

The heroes of this story? The first hero was Dr. Li  because he had a simple mission: to inform those around him with whatever information he had to keep them safe.

Inspired by the heroes in this coronavirus story, I recently told my children who were traveling with me that – given the fact that this disease can be spread by people who have no symptoms and the virus can live on surfaces for days – they could stay safer if they assume their hands are infected and not touch their face and food without disinfecting them first. This simple set of instructions was the best way I could summarize this disease to the people I care about the most in this world. I also keep telling them that we are in the midst of learning about this disease so I’ll keep them updated. My children must have confidence in me because they grin every time I say this.

As of the 7th of March, 2020, the World Health Organization reported that the number of confirmed cases of COVID19 has surpassed 100K. The doubling time of this disease appears to be around 7 days but the numbers, just like this disease, are fast moving. A peek at that study along with with data used gives an idea of why we need to take a deep breath and keep learning.

09 February 2020

Another world: Writing a Mystery Book



I wrote a new book. Except it’s not new anymore. I wrote it 2 years ago. Edited. Reedited. and yes, did that multiple times. Sent it to an editor and then another. Reedited.

Now it sits in my computer and I have a problem.

It’s not the book that’s the problem: it is the mystery novel that wanted to write.

The main character was written as a rebellion against the need to have a woman detective who is either a drunk or who sleeps around because she’s deeply damaged. Because, you know, that makes her interesting. I wrote her as someone who has lived a life with troubles – because that’s what life brings - but is like the women I know and love. They may be damaged by life but are not busy damaging others in their life. Women who I’ve looked up to. Women who make me laugh. Women who force me to think.

I wrote the things I have learned from friends, patients and my own life. There’s domestic violence to racial profiling of Muslims. I tried to write it as others had lived it. I told the stories that I have heard - the ones that had made me hold my breath in fear of missing a word.

I’m on my final edit. The problem is me.

During the writing and editing, my dearest friend was ill and then died. My father was ill and then died. My mother is now ill. All this has required time and energy to help during their illness. Time to deal with the loss.

Here is the crux of the problem: when I write I do little else. I enter this world and disappear for hours on end. I live it, breathe it and reality pales in the face of the world I’ve created.

Now, my reality has jagged edges, and cuts into this world. Sawing into it until it disappears like morning mist in sunlight. When it’s gone, I can’t get it back.

My ability to concentrate - to enter other worlds - was how I’ve done everything of value. It was as natural as breathing. It’s how I studied medicine, how I spent long hours with patients and trained, it’s how I parented by disappearing in the world of my children.

All the best things in my life were dependent on not having a reality so jagged that it sawed through every thought.

So, my book and I are now on separate worlds. I have no idea how we will live on the same planet again.

Recently, I decided to research writers block, thinking there may be suggestions that help. Unfortunately I found none. Advice like ‘Find the right surroundings’ mean little to me. I can write and have written anywhere. ‘Silence your inner critic’? That’ll be a cold day in hell. I’ve met her and write anyway.

 I could go on.

Except I can’t.

With the book that is.

Here’s the next problem: I write in my head anyway. I’m always revising and thinking of the book. Except when I sit with my book. That is the worst - to write but not write. 

So, instead of my book I’m writing an article about writing my book, which is amusing but not even that coerces me enough to write.

The one thing that keeps me hoping is coffee. The night before I have a day with even one block of time, I go to sleep with visions of coffee and writing. It won’t be tomorrow because there is far too much to do.

Maybe Monday?

12 January 2020

Airbnbs, Gangs and Pimps.


My hometown of Ottawa is the capital of Canada. Most of us who live here consider it a small, friendly town disguised as a large city.

On January 8th, Ottawa had our first murder of the year. Four young people (ages 20, 19, 18 and 15) were shot inside a home and the 18 year old was killed.

On November 2019, the Ottawa City Council ‘endorsed new rules that will restrict short-term rentals on Airbnb and other similar platforms to primary residences in a bid to crack down on so-called “ghost hotels” run by absentee owners.’

These two things are related. The young men were shot in a ‘ghost’ Airbnb.

These Airbnb ‘ghost hotels’ are “…becoming havens for criminal activity.
Unlike traditional hotels that come with security video cameras, high traffic and paid security guards on the premises, ghost hotels are often cheaper to book and come with less eyes on what’s happening inside, police say. City police are finding that in instances where violence breaks out, the person booking the rental is rarely at the home and there is a degree of anonymity in the booking. Adding to the situation is that homes are often owned by people who don’t live in the neighbourhood, or are rented by property managers. Police say they find there is little allegiance to the communities in which they are situated. It’s a “perfect scenario,” says one officer.”

When I interviewed a Crown Prosecutor for an article, he had informed me that gangs in Ottawa are mobile and change locations often weekly to avoid detection. These ghost hotels are a perfect opportunity for gangs to move every few weeks with little or no scrutiny.

I only rented an Airbnb once. My family was going to an award dinner in Toronto and I was looking for a hotel near the venue. My children argued that we should get an Airbnb. My daughter is a vegan and wanted access to a kitchen. I said I wouldn’t cook. She said I wouldn’t have to but she wanted to at least have access to the means to cook and a place to put her vegan supplies, like oat milk. This went on for a bit and I gave in, which you would only understand if you’ve had the pleasure of arguing with my children.

My daughter carefully examined reviews of Airbnbs and found one that was close to the venue and had excellent reviews. When we pulled up to the place, it was a condo building in a shady area of town. Not deterred, we went in. I found I couldn’t breathe. This makes staying at a place difficult. My asthma only gets this bad when there is mold, so I went outside with my husband to get some fresh air.

The fresh air and a puffer somewhat resolved my breathing problem but presented a new one. Pulling up to the condo were a string a large cars decanting rough looking men, wearing street clothing and women in what looked like scanty clubwear.

Since I couldn’t breathe in the apartment, and I didn’t feel safe outside of the apartment, my husband booked a hotel.

I often wondered about that odd Airbnb experience, but writing this article clarified a few things: “Investigators have noticed an uptick in pimps using Airbnb rentals in recent years. That’s likely because they’re more anonymous, and it’s more challenging for police to get information about them, compared to traditional hotels and motels, said Det.-Sgt. Nunzio Tramontozzi.”

This makes sense of our unusual experience. If I wasn’t so breathless, I might have realized that the rough looking men might have been pimps. They certainly were frightening.

So, back to Airbnbs. They are a boon for many people - both the guests and those who rent them out. My children have had wonderful experiences in Europe, the United States and Australia. It is the modern version of the student hostels that were popular when I was traveling on the cheap in other countries.

It is unfortunate that Airbnbs are being used by gangs and pimps. I hope that limits on 'ghost' Airbnbs, similar to ones Ottawa is using will curbs this. 








08 December 2019

Maple Syrup Heist eh?


In Ottawa we celebrate maple syrup season by trekking out to a sugar bush, watching the maple sap being collected and indulging in large stacks of pancakes smothered in maple syrup at one of our many sugar shacks.

So, when Leigh Lundin suggested I write about the Canadian maple syrup heist, I thought ‘heist’ was a strong word for people running through the maple grove stealing buckets of sap.

It turns out that I was wrong, a heist it was: over twelve months, 3,000 tons of syrup, worth $18.7 million, was stolen. None of this was done by stealing buckets collecting sap. Worse, learning about this heist ruined all my lovely and naive sugarbush experiences and I’ll never look at another bottle of maple syrup the same way again.

The heist was possible because of three important facts that blew my preconceived notions about maple syrup out of the water.

 First, "maple syrup comes only from the red- and sugar-maple forests found in the upper right-hand corner of North America, just where you’d sign your name if this were a test." This means that Canada, particularly the province of Quebec, produces 71% of the world’s maple syrup.

Second, since 1966 the Federation of Quebec Maple Syrup Producers has instituted quotas and rules that have increased the price of maple syrup to be, in 2016, "valued at just over $1,300 a barrel, 26 times more expensive than crude"’

Third, to control the supply of maple syrup, "members of the federation—Quebec’s bulk producers are required to join—give their harvest over to FPAQ… Some of it is sold immediately; the rest is stored in the Reserve…In this way, the federation steadies supply, filling the coffers in banner years, satisfying demand in fallow."


So, maple syrup production is not a cottage industry, adorably ensconced in sugar shacks dotting our maple groves. It’s a large profitable industry controlled and managed much like the oil industry. Total value of all maple products in 2018 was $384.4 million.

To give a visual recap:


The maple grove where I thought they stole maple syrup from:






The Reserve is in Laurierville, Quebec, where they actually stole maple syrup from:





A total of $18.7 million dollars of maple syrup was stolen from the Reserve in Laurierville. The  thieves used trucks to transport barrels, siphoned off the maple syrup, and refilled the barrels with water and returned them to the facility. Later the thieves siphoned syrup directly from the barrels in the Reserve and left them empty. The stolen syrup was then sold in the United States and in New Brunswick, Canada, to distributors, many of whom were unaware it was stolen.

When the theft was discovered in 2012, the Sûreté du Québec police began an extensive investigation aided by the Royal Canadian Mounted Police (RCMP) and U.S. Customs. The police arrested two alleged ringleaders and 24 other people. A large portion of the syrup would ultimately be recovered.

However, this not the end of the story because it raises interesting questions about the Federation of Quebec Maple Syrup Producers.

One of the ring leaders was Étienne St-Pierre, a maple syrup buyer from Kedgwick, New Brunswick, who bought the stolen syrup.

"You can't prove what tree the syrup came from," St-Pierre told the jury.

“St-Pierre also admitted he had long been an opponent of the Federation of Quebec Maple Syrup Producers, and resented their control of the market.

“The Crown produced evidence suggesting St-Pierre considered the federation to be akin to the Mafia.”

Is the Federation of Quebec Maple Syrup Producers like a maple syrup mafia? It is “a powerful marketing board with almost absolute control over the provincial industry…all Quebec maple syrup must pass through the federation, which dictates how much each producer can sell, and penalizes unauthorized production and selling.”

So, not a mafia, but certainly restrictive.

Before his sentencing, this is what St. Pierre said: he’ll continue to ignore those rules. And he’ll keep buying maple syrup from Quebec’s scofflaw producers. “I will never stop. I didn’t steal nothing.”

Étienne St-Pierre was found guilty of fraud and trafficking in 2017 and sentenced to two years less a day to serve in the community, as well as a three-year probation.

10 November 2019

Phyllis


Stories from Canada and the United States are mirroring each other. In the United States, many patients have no access to doctors because they are either uninsured or underinsured. In Canada, our growing doctor shortage is leaving patients without access.

Please note that I didn’t say anything about the healthcare system, because talk like that is too impersonal; when it comes to patients, not having a doctor when you need one is very personal.

Let me introduce you to Phyllis Smallman, a feisty and funny writer, mother, grandmother and wife of over 50 years to her best friend and high school sweetheart. Phyllis was the first recipient of the Crime Writers of Canada Unhanged Arthur Ellis award and wrote, among other books, the Sheri Travis mystery series. She won multiple awards for her writing. She grew up in Southern Ontario but, at an age when most people retire, she and her husband moved to Salt Spring Island, B.C. to be closer to her children and embark on a new adventure.

In October 2017, 72-year-old Phyllis found blood in her urine. Her family doctor was concerned but couldn’t get an appointment with a specialist to do a cystoscopy before the spring of 2018. Phyllis trusted that the system would keep her safe, but her family began to worry as she developed other symptoms. Phyllis, a self-described foodie with the personality of a small energetic terrier, was too nauseous to eat and was experiencing extreme fatigue.

My point of contact to this story was through her daughter, Elle Wild, another Arthur Ellis Award-winning writer. Elle was worried and wanted her mother to be seen sooner. Elle, her brother and father spent a great deal of time trying to get Phyllis into a specialist. They called everywhere and finally found a specialist who could see her before Christmas. When the cystoscopy was done there was too much blood for a definitive diagnosis, but an infection secondary to a previously-inserted mesh was thought to be the problem. Phyllis was put on a six-week-long course of antibiotics and then put in the queue for a second cystoscopy and a CT of the kidney.  The antibiotics did not improve Phyllis’s health. Her nausea became more severe, she lost weight and became so weak that she couldn’t even walk across the room. She slept most of the day.

Through conversations with Elle, the growing anxiety of the family was palpable as Phyllis, their lively matriarch, began to disappear into long sleeps and uncharacteristic exhaustion. Phyllis’s deterioration continued day by painful day, and by February, the family had had enough. Despite Phyllis’s objections, partly because she continued to trust that she would get taken care of in our system and partly because she was too exhausted to go to appointments, the family paid for a private CT and she was diagnosed with a kidney tumour.

However, there was another queue for a specialist to do the biopsy and yet another one to see an oncologist. It was only on April 16, 2018 that Phyllis finally received a definitive oncologist report: an advanced and aggressive form of cancer that had started in her bladder and had spread to her kidneys. She was given six months to live and offered palliative chemotherapy. Her daughter, Elle, moved with her family to Salt Spring Island to spend time with Phyllis and to provide emotional support to her distraught father.

Phyllis did her best to complete the course of chemotherapy, but was only able to do half of the treatment because of fatigue, nausea and her emaciated state. Phyllis Smallman died on October 1st, 2018.

In her obituary, her family wrote: “Those who spent time with Phyllis knew her as a caring person who loved fiercely, laughed loudly, and was always a friend to anyone in need. In keeping with her dark sense of humour, her last book was ironically titled Last Call, the final Sherri Travis mystery. The night Phyllis died, Last Call won a Reader’s Favourite Book Award. Our Phyllis knew how to make a grand exit.”
Tragedy is defined as a story involving a great person destined to experience downfall or utter destruction through a conflict with some overpowering force, such as fate or an unyielding society.

The story of how Phyllis spent her final year is a tragedy. The unyielding social truth she faced was that Phyllis simply could not get access to the doctors she needed: this reality met her faith in our healthcare system and made a mockery of it. The lack of physicians left her family alone in their growing worry for Phyllis and isolated as they watched her die, without a doctor to tell them what was happening and perhaps even intervene to help.

When people say that healthcare is a human right, I agree. There is nothing as inhumane as a patient unable to get the care they need.

08 September 2019

Mental Illness Is Not a Political Football


by Mary Fernando

I have previously written about the myth that those with mental illness are dangerous. Spoiler: they are not.

What is happening now politically is very concerning. Politicians are blaming mass shootings on mental illness and – as I cited before – Dr. Michael Stone, a forensic psychiatrist at Columbia University who maintains a database of 350 mass killers going back more than a century, has found that only one in five are psychotic or delusional. This means that 4 out of 5 mass murderers are people who are clinically sane.



Why do politicians blame mass murders on the mentally ill? Many agree with Fareed Zakaria that “turning immediately to the "sickness" of the shooter and piously calling for better mental-health care is, more often than not, an attempt to divert attention from the main issue: guns.”

This may well be true but it is damaging to label those with mental illness as dangerous to society. The prevalence of mental illness is difficult to nail down but “Around 1-in-7 people globally (11-18 percent) have one or more mental or substance use disorders. Globally, this means around one billion people in 2017 experienced one.”

This means that when we think of those with mental illness we should think of our family members, our partners, our children our friends and neighbours because that’s where you will find them. Or not find them because many hide their symptoms and suffering for fear of - you know - being labeled dangerous. That’ll certainly send someone into hiding.

Worse - mental illness is being used as an insult to those with political views we disagree with.


This is my tweet from this week:






tweet

The politician my tweet was directed at is not as important as the patients this politician’s tweet was directed at: those with mental illness have become the scapegoats of politicians.

Paraphrasing MLK gave me pause. However, his writings are filled with empathy for those suffering from discrimination and I thought that it might be appropriate to use this for this very maligned minority.

What I want to address is my dream: blaming and insulting (along with the unrealistic depictions in books and on screen) presents a very unrealistic portrait of those suffering from mental illness. After a long career of treating mental illness, I can describe them with some degree of confidence. They are just like you and your family, friends and children. They have the same wonderful qualities and the same vulnerabilities, the same bad jokes and the same hilarious ones. I could go on, but you get the picture.


I feel I must say this very loud for the people at the back: mental illness is a medical diagnosis no different than that for diabetes. It requires diagnosis and treatment and both should be given with care and compassion. Just like someone with diabetes or cancer - everyone with mental illness will have their own unique personalty but not the ones that politicians try to give them.

I was pondering - ok, I was fuming - about this issue the other day and thought about the origins of medicine. Originally all disease was thought to be in some way connected with the evil doings of those who are ill. So, diabetes, cancer and depression fell into the same category: “In prehistory, people believed that pain and disease originated from evil spirits. Disease resulted when these evil spirits entered the body. Witch doctors and shamans were employed to exorcise wicked beings…”

The belief that illness is caused by evil spirits taking residence in a patient changed when modern medicine discovered the actual etiology of physical illnesses. However, some still think that there is something evil in people who have mental illness.

Today many use the term ‘mental health’ “… to reduce the stigma surrounding mental illness, and said ‘illness’ reinforced prejudices against asylum patients because it implied segregation between the sick and the well. Focusing on health countered a persistent misconception that only some people are prone to psychiatric problems.”

This terminology is a double edged sword. Focusing on what is healthy in these patients is a good thing. However, there is value in identifying an illness. To tell a patient they have a physical illness is often a relief because they finally have an explanation for the symptoms from which they are suffering. They can explain this to those close to them, and get comfort and help when the symptoms flare up. The same applies to those with mental illness. I have found patients are immensely relieved to finally have a diagnosis and treatment plan. I have seen their relief when they can speak to those they love and get support in the same way those with physical illness get to lean on those in their life. 



 I’m comfortable with the term ‘mental illness’ and also happy to use the term ‘mental health’ if people prefer. What I want is to end the stigma, to treat each patient as just that: a person with an illness that can be be diagnosed and treated. The illness doesn’t define the person. Their character defines them.