About a decade ago, while working as a columnist for the National Post, I developed something of a dark niche — writing about mass-casualty attacks. They are worth studying, both to hopefully avoid future tragedies and to understand how people and systems work during crises. But, eventually, I just had to stop.
I could tell you that it was taking an emotional toll, and it was. I could tell you that I gave up out of frustration, particularly after the Sandy Hook massacre in Connecticut, and that would also be true. But, as I noted in a Post column at the time, another factor in my decision to largely “retire” from such writing was something I’d noticed. The survivor and witness accounts of terror or mass-shooting attacks were, in a process that was fascinating but awful to watch, starting to homogenize. There had been so damned many that we had, in a perverse bit of cultural osmosis, come up with something of a standardized way to respond.
It took me a while to notice and had probably been happening for a while before I saw it. But once I saw it, I couldn’t see anything else. A reporter from some local outlet or another would race to the scene of a tragedy, and some witness or survivor would agree to go on camera and then deliver a calm, even-paced description of all that they’d seen, even using the kind of lingo they’d picked up from watching the coverage of previous incidents. You’d have teenagers who’d been running for their lives only minutes earlier calmly relating that “a lockdown” had been called due to “an active shooter” and that “first responders” had arrived to move them to a “secure location.”
We’ve learned the lines passively, via coverage of earlier tragedies, and so many have delivered them with calm and poise when it happened to one day be their turn.
I would forgive a TVO Today reader for wondering where the hell I’m going with this. Thanks for sticking with me so far. Let me make the next point succinctly: I think something similar is happening in Canada when we talk about health care. Other things, too, but especially health care.
I told my readers here a few weeks ago that I was planning to take a close look at the health-care system in Ontario. I’ve done this periodically across the years, both before and during the pandemic, and I’m hearing a lot of disquieting things about a system in crisis. My work on this has been delayed a bit by both a busy news cycle and a difficulty getting people to go on the record (more specifically, to say the same things on the record that they’ll tell me off the record). And this is where that comparison to what’s happening in the United States comes to mind.
I quipped with my colleague Jen Gerson recently that there seems to be something in the Canadian character that is often portrayed as a positive but increasingly strikes me as a negative. Canadians are seen as polite, right? And who could argue against politeness? But what is often perceived by people as politeness is, I think, more simply conflict avoidance. Awkward topics are best not mentioned. If they absolutely must be discussed, we tend to talk around them in polite euphemisms, with a heaping helping of understatement on the side.
I joked with Jen that my efforts to take a close look at the health-care system have gone something like this. Off the record, a health-care-system participant will tell me, “Matt, it’s a disaster. It’s a [expletive deleted] catastrophe. Things have never been worse, we’re doomed, and I think I’m going to quit and take up subsistence farming somewhere north of Timmins because life as we know it is going to collapse into a dystopian hellscape in which the living will envy the dead.” And then, when I try to get a quote from them on the record, they tell me something like this: “Well, the system certainly has some challenges.”
I’m exaggerating a bit for comic effect, but not as much as I wish I were.
I am a realist. Not everyone desires being a centre of media attention. Others have obligations to health-care institutions or organizations and don’t need the hassle of being the focus of complaints to their bosses after some particularly spicy quote hits the media. Navigating this kind of thing is just part of my job.
But what is really striking to me in this moment is the disparity between what health-care-sector participants are willing to say off the record and what they’re comfortable saying on the record. And I think, perhaps because health care has been an issue in this country for so long, we might be running into that same kind of cultural-osmosis problem I referred to above. An entire generation of health-care-sector participants and experts has grown up reading newspapers and magazines, watching TV news, listening to radio reports that discuss a health-care system in crisis — but in fairly calm and measured language. I think there is a widely shared belief among many people who have important things to say that there is only one proper, polite, and dignified way to say it.
I get this. I have my own very Canadian moments of trying to avoid conflict and confrontation, and I certainly love a good understatement. But there are times when only strong language will do.
Canadians have long been proud of our model of health-care delivery. An increasing number of physicians and other experts are telling me that our system is failing. Failing, full stop. But they want to say so only in a way that won’t collide with another thing Canadians are proud of: sounding like we’re reading a bread recipe into the Parliamentary record while a CBC documentary crew records the event for posterity. That’s just how too many of us talk.
We may have to pick between a collapsed health-care system and a bit of blunt talk, friends. I’m not sure we can get away without choosing one or the other. So to anyone out there with a story to tell, I beg you to remember this: manners are nice, but a functional health-care system when you, your family, or your patients need it is better. And we might need to start making some decisions accordingly.
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