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The AIH transcript for December 20, 2024

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PETER ARMSTRONG: Hello, Peter Armstrong, sitting in for Nil Köksal.

CHRIS HOWDEN: Good evening, I'm Talia Schlanger, sitting in for Chris Howden. This is As It Happens.

[theme]

TS: Tonight:

PA: Foot the billing. A B.C. city hopes to attract more family doctors by promising to handle the paperwork and let the doctors focus on patients.

TS: Power struggle. Iran is in the midst of a widespread energy emergency -- despite being rich in natural gas and crude oil. Our guest tells us what the frequent outages mean for its people and how the country got there.

PA: In harm's way. A national survey aims to uncover the true extent of violence against paramedics in Canada as calls grow to better protect those who protect us.

TS: It's beginning to sound a lot like Christmas. Tonight, our annual holiday reading will take us to Cape Breton, where a young boy realizes Christmas isn't about Santa Claus after all.

PA: We'll hear Chris Howden's reading of Alastair McLeod's 1977 short story To Everything There Is A Season ahead of tomorrow's annual presentation of The Shepherd.

TS: And... high watermarks. A researcher tells us what he learned from digging into the New Zealand tradition of Manu jumping about the best way to really, really make a splash.

TS: As It Happens, the Monday edition. Radio that always strives to be the wetter person.

Part 1: City Employee Doctors

City Employee Doctors

Guest: Doug Kobayashi

TS: It's no secret that being a family doctor can be gruelling. In addition to caring for patients, the job often includes mountains of paperwork and other after-hours administration. Of course, many Canadians would tell you finding a family doctor is a full-time job as well. The City of Colwood on Vancouver Island has taken note. And now, they're trying out a first-in-Canada approach by opening a clinic where the city, as opposed to the doctors, will take on those duties. Doug Kobayashi is the Mayor of Colwood. That's where we reached him.

PA: Mayor Kobayashi, how dire is the need for family doctors in Colwood right now?

DOUG KOBAYASHI: It was extremely dire, i.e. we have a population of almost 23,000 people. And we simply did not have one family doctor attached to the city.

PA: Wow.

DK: So with the eight doctors that we're going to hire, that's 10,000 citizens that will now have a family doctor.

PA: So that'll still not even get you halfway through the problem.

DK: Yeah, but some already have an attachment, but they're, they're with doctors from outside the, our own city.

PA: Right.

DK: They're in different municipalities, yes.

PA: The first doctor to join your new clinic, Dr. Cassandra Stiller-Moldovan, spoke with our colleagues at CBC Radio's On The Island last week. Let's just play our listeners a bit of what she had to say.

SOUNDCLIP

CASSANDRA STILLER-MOLDOVAN: You know, as family physicians, we have two full-time jobs. We have the job of taking care of our patient roster but also the job of running a small business. So having, for instance, a two-year-old and my partner here at home, when I come home at the end of the day, I'll put my daughter to bed, we'll have dinner together. But then I need to still do all the administrative aspects.

PA: So, with that response in mind, I wonder if you can just tell us how you see things being different under your program?

DK: That's exactly what we're trying to cure. You know, the doctors are spending too much time, you know, running the business and, and the administration side rather than what their focus should be, which is, you know, health care of, of the people. So, you know, the whole idea with our particular model is they don't have to worry about that anymore. They can come in in the morning and they leave that night and for all eight hours or whatever many hours they spend in the office, all they're doing is focusing on people's health care.

PA: And so, who will be doing all that business administration stuff you talk about?

DK: The city. And that's exactly what this model is all about. If we can deliver this whole model with the same sort of, sort of numbers, but, you know, offer them something more like a, like a pension and benefits, we said that that's an advantage of our particular model.

PA: And just to be abundantly clear here, the city runs it. But who pays for that administrative work that's going to be done for the clinic and for the doctor?

DK: Okay. So, back in 2022, the province did one great thing. Not only did they change the fee structure for the doctors to make it very competitive to, you know, the rest of Canada, they also came up with this model called the LFP -- the longitudinal family physician payment plan. And so, this allows us to do what we're doing right now. So, they're, they're basically assigning their paycheck. And there's an overhead element in that. They're assigning it to the clinic, which is the city. And we're, we're doing the billing. And then we're paying the doctors, you know, a salary.

PA: What has the response to this been like?

DK: Outstanding. [joyous laughter] It's way better than we could, we imagined. We thought it was going to be good. It's been better than we anticipated. In fact, I'll tell you one thing we did is we went to the Family Physician Forum in Vancouver, which was held in the first week in November, and we put a Colwood booth up. And we sort of said, here, here's our new model. What do you think? And we, the response was overwhelming. We had over 100, I think was 115 people that signed up with an expression of interest.

PA: Oh wow.

DK: But the other big key of this right now is that since this has gone national and has gone across the province, our phones have not stopped ringing here. And, and the number of emails, even extra, extra doctors that have shown an expression of interest in this is, it's just, it's just overwhelming, actually.

PA: It sounds like a no-brainer, though. Why have -- [DK laughs with joy] Why hasn't everybody done this?

DK: I don't know. [PA chuckles] You know, I was talking with another mayor of a much bigger city than ours. And the mayor had indicated that, you know, this is something that they thought of about six or seven years ago. The big difference was, was, I think, you know, was in 2022 when I was telling you they changed the fee structure and they came up with this LFP model. That's what changed it. But no one was watching, you know, keeping their eye on the ball. It, like you said, it's, it's common sense. I'm a professional engineer by background, and I'm going, wow, I just can't believe no one ever tried to implement something like this.

PA: Is there some young lawyer or bureaucrat in your office who figured this out that is going to have a statue to them in your town one of these days?

DK: [laughter]No. You know what? There's an old saying. If it is to be, it's up to me. Well, this is a case of if it is to be, it's up to we. And this is me just gathering the, you know, getting the council behind me 100 per cent, unanimous. Getting the city staff behind this, getting the citizens, getting the doctors. And, you know, it's been unbelievable the support we've got. So, that's, that's basically the story behind this.

PA: Is there a risk? Is there a downside to this that somebody flagged to say whether it's liability or something else?

DK: You know, not really. At first, I must admit, they didn't like the ideas of doctors being, you know, having pensions, you know?

PA: Right. [chuckle]

DK: You know, and, you know, the benefits. But, you know, yet if you work in a hospital, you get that. Where are we losing all our family doctors to? They're going to hospitals. So, you know, we, we've got to have a level playing field.

PA: Okay. So, you want to hire eight doctors in total. So seven more. Where do you, like when you scale out and think about this, where do you hope this, this initiative goes ultimately?

DK: Well, I'd love to see this across B.C. And if this works, I'd be more than happy to export this. We've learned a lot of lessons, and it's been a process because people were uncomfortable with this because there's no precedent for it. You know, especially on the legal side, you know, our own municipal lawyers went woah! Well, jeez, we don't have a precedent. And there was a reluctance. You know, everyone, just the fear of the unknown and the risk. But no one has really pushed back and said, you're not doing this. This does not meet, you know, the Canada Health Act or anything. We know we're all within those boundaries.

PA: Well, it'll be fascinating to watch as your recruitment continues. Thanks a lot for speaking with us today. And I'm sure we'll speak about this again in the future.

DK: Thank you very much, Peter.

TS: Doug Kobayashi is the Mayor of Colwood, B.C. We reached him in Colwood, B.C.

[folk]

Reading: ‘To Everything There Is A Season’

TS: 'Tis the season to load yourself into a plane, train or automobile and make a journey armed with presents for loved ones -- who are sitting at home awaiting your arrival. Just like the 11-year-old narrator of tonight's reading. Alistair MacLeod's 1977 short story To Everything There Is A Season takes us to Cape Breton, where a young boy is anxiously waiting for his older brother to return home from Ontario for the holidays. And as he waits, he contemplates what it means to grow up. Tonight, we bring you As It Happens host Chris Howden's reading of that story. This is To Everything There Is A Season.

Reading:

CHRIS HOWDEN: I am speaking here of a time when I was eleven and lived with my family on our small farm on the west coast of Cape Breton. My family had been there for a long, long time and so it seemed had I. And much of that time seems like the proverbial yesterday. Yet when I speak on this Christmas 1977, I am not sure how much I speak with the voice of that time or how much in the voice of what I have since become. And I am not sure how many liberties I may be taking with the boy I think I was. For Christmas is a time of both past and present and often the two are imperfectly blended. As we step into its nowness we often look behind.

We have been waiting now, it seems, forever. Actually, it has been most intense since Halloween when the first snow fell upon us as we moved like muffled mummers upon darkened country roads. The large flakes were soft and new then and almost generous and the earth to which they fell was still warm and as yet unfrozen. They fell in silence into the puddles and into the sea where they disappeared at the moment of contact. They disappeared, too, upon touching the heated redness of our necks and hands or the faces of those who did not wear masks. We carried our pillowcases from house to house, knocking on doors to become silhouettes in the light thrown out from kitchens (white pillowcases held out by whitened forms). The snow fell between us and the doors and was transformed in shimmering golden beams. When we turned to leave, it fell upon our footprints and as the night wore on obliterated them and all the records of our movements. In the morning everything was soft and still and November had come upon us. My brother Kenneth, who is two and a half, is unsure of his last Christmas. It is Halloween that looms largest in his memory as an exceptional time of being up late in magic darkness and falling snow. “Who are you going to dress up as at Christmas?” he asks. “I think I’ll be a snowman.” All of us laugh at him and tell him Santa Claus will find him if he is good and that he need not dress up at all. We go about our appointed tasks waiting for it to happen. I am troubled myself about the nature of Santa Claus and I am trying to hang on to him in any way that I can. It is true that at my age I no longer really believe in him yet I have hoped in all his possibilities as fiercely as I can; much in the same way, I think, that the drowning man waves desperately to the lights of the passing ship on the high sea’s darkness. For without him, as without the man’s ship, it seems our fragile lives would be so much more desperate. My mother has been fairly tolerant of my attempted perpetuation. Perhaps because she has encountered it before. Once I overheard her speaking about my sister Anne to one of her neighbours. “I thought Anne would believe forever,” she said. “I practically had to tell her.” I have somehow always wished I had not heard her say that as I seek sanctuary and reinforcement even in an ignorance, I know I dare not trust. Kenneth, however, believes with an unadulterated fervour, and so do Bruce and Barry who are six-year-old twins. Beyond me there is Anne who is thirteen and Mary who is fifteen, both of whom seem to be leaving childhood at an alarming rate. My mother has told us that she was already married when she was seventeen, which is only two years older than Mary is now. That too seems strange to contemplate and perhaps childhood is shorter for some than it is for others. I think of this sometimes in the evenings when we have finished our chores and the supper dishes have been cleared away and we are supposed to be doing our homework. I glance sideways at my mother, who is always knitting or mending, and at my father who mostly sits by the stove coughing quietly with his handkerchief at his mouth. He has “not been well” for two years and has difficulty breathing whenever he moves at more than the slowest pace. He is most sympathetic of all concerning my extended hopes and says we should hang on to the good things in our lives as long as we are able. As I look at him out of the corner of my eye, it does not seem that he has many of them left. He is old, we think, at forty-two. Yet Christmas, in spite of all the doubts of our different ages, is a fine and splendid time, and now as we pass the mid-point of December our expectations are heightened by the increasing coldness that has settled down upon us. The ocean is flat and calm and along the coast, in the scooped-out coves, has turned to an icy slush. The brook that flows past our house is almost totally frozen and there is only a small channel of rushing water that flows openly at its very centre. When we let the cattle out to drink, we chop holes with the axe at the brook’s edge so that they can drink without venturing onto the ice. The sheep move in and out of their lean-to shelter restlessly stamping their feet or huddling together in tightly packed groups. A conspiracy of wool against the cold. The hens perch high on their roosts with their feathers fluffed out about them, hardly feeling it worthwhile to descend to the floor for their few scant kernels of grain. The pig, who has little time before his butchering, squeals his displeasure to the cold and with his snout tosses his wooden trough high in the icy air. The splendid young horse paws the planking of his stall and gnaws the wooden cribwork of his manger. We have put a protective barricade of spruce boughs about our kitchen door and banked our house with additional boughs and billows of eel grass. Still, the pail of water we leave standing in the porch is solid in the morning and has to be broken with the hammer. The clothes my mother hangs on the line are frozen almost instantly and sway and creak from their suspending clothespins like sections of dismantled robots: the stiff-legged rasping trousers and the shirts and sweaters with unyielding arms outstretched. In the morning we race from our so frigid upstairs bedrooms to finish dressing around the kitchen stove. We would extend our coldness half a continent away to the Great Lakes of Ontario so that it might hasten the Christmas coming of my oldest brother, Neil. He is nineteen and employed on the “lake boats,” the long flat carriers of grain and iron ore whose season ends any day after December 10, depending on the ice conditions. We wish it to be cold, cold on the Great Lakes of Ontario, so that he may come home to us as soon as possible. Already his cartons have arrived. They come from different places: Cobourg, Toronto, St. Catharines, Welland, Windsor, Sarnia, Sault Ste. Marie. Places that we, with the exception of my father, have never been. We locate them excitedly on the map, tracing their outlines with eager fingers. The cartons bear the lettering of Canada Steamship Lines and are bound with rope knotted intricately in the fashion of sailors. My mother says they contain his clothes and we are not allowed to open them. For us it is impossible to know the time or manner of his coming. If the lakes freeze early, he may come by train because it is cheaper. If the lakes stay open until December 20, he will have to fly because his time will be more precious than his money. He will hitchhike the last sixty or hundred miles from either station or airport. On our part, we can do nothing but listen with straining ears to radio reports of distant ice formations. His coming seems to depend on so many factors which are out there far beyond us and over which we lack control. The days go by in fevered slowness until finally on the morning of December 23 the strange car rolls into the yard. My mother touches her hand to her lips and whispers “Thank God.” My father gets up unsteadily from his chair to look through the window. Their longed-for son and our golden older brother is here at last. He is here with his reddish hair and beard and we can hear his hearty laugh. He will be happy and strong and confident for us all. There are three other young men with him who look much the same as he. They too are from the boats and are trying to get home to Newfoundland. They must still drive a hundred miles to reach the ferry at North Sydney. The car seems very old. They purchased it in Thorold for two hundred dollars because they were too late to make any reservations, and they have driven steadily since they began. In northern New Brunswick their windshield wipers failed but instead of stopping they tied lengths of cord to the wipers’ arms and passed them through the front window vents. Since that time, in whatever precipitation, one of them has pulled the cords back and forth to make the wipers function. This information falls tiredly but excitedly from their lips and we greedily gather it in. My father pours them drinks of rum and my mother takes out her mincemeat and the fruitcakes she has been carefully hoarding. We lean on the furniture or look from the safety of sheltered doorways. We would like to hug our brother but are too shy with strangers present. In the kitchen’s warmth, the young men begin to nod and doze, their heads dropping suddenly to their chests. They nudge each other with their feet in an attempt to keep awake. They will not stay and rest because they have come so far and tomorrow is Christmas Eve and stretches of mountains and water still lie between them and those they love. After they leave, we pounce on our brother physically and verbally. He laughs and shouts and lifts us over his head and swings us in his muscular arms. Yet in spite of his happiness he seems surprised at the appearance of his father whom he has not seen since March. My father merely smiles at him while my mother bites her lip. Now that he is here there is a great flurry of activity. We have left everything we could until the time he might be with us. Eagerly I show him the fir tree on the hill which I have been watching for months and marvel at how easily he fells it and carries it down the hill. We fall over one another in the excitement of decoration. He promises that on Christmas Eve he will take us to church in the sleigh behind the splendid horse that until his coming we are all afraid to handle. And on the afternoon of Christmas Eve he shoes the horse, lifting each hoof and rasping it fine and hammering the cherry-red horseshoes into shape upon the anvil. Later he drops them hissingly into the steaming tub of water. My father sits beside him on an overturned pail and tells him what to do. Sometimes we argue with our father, but our brother does everything he says. That night, bundled in hay and voluminous coats, and with heated stones at our feet, we start upon our journey. Our parents and Kenneth remain at home but all the rest of us go. Before we leave, we feed the cattle and sheep and even the pig all that they can possibly eat so that they will be contented on Christmas Eve. Our parents’ wave to us from the doorway. We go four miles across the mountain road. It is a primitive logging trail and there will be no cars or other vehicles upon it. At first the horse is wild with excitement and lack of exercise and my brother has to stand at the front of the sleigh and lean backwards on the reins. Later he settles down to a trot and still later to a walk as the mountain rises before him. We sing all the Christmas songs we know and watch for rabbits and foxes scudding across the open patches of snow and listen to the drumming of partridge wings. We are never cold. When we descend to the country church, we tie the horse in a grove of trees where he will be sheltered and not frightened by the many cars. We put a blanket over him and give him oats. At the church door the neighbours shake hands with my brother. “Hello, Neil,” they say. “How is your father?” “Oh,” he says, just “Oh.” The church is very beautiful at night with its festooned branches and glowing candles and the booming, joyous sounds that come from the choir loft. We go through the service as if we are mesmerized. On the way home, although the stones have cooled, we remain happy and warm. We listen to the creak of leather harness and the hiss of runners on the snow and begin to think of the potentiality of presents. When we are about a mile from home the horse senses his destination and breaks into a trot and then a confident lope. My brother lets him go and we move across the winter landscape like figures freed from a Christmas card. The snow from the horse’s hooves falls about our heads like the whiteness of the stars. After we have stabled the horse we talk with our parents and eat the meal our mother has prepared. And then I am sleepy and it is time for the younger children to be in bed. But tonight, my father says to me, “We would like you to stay up with us a while,” and so I stay quietly with the older members of the family. When all is silent upstairs Neil brings in the cartons that contain his “clothes” and begins to open them. He unties the intricate knots quickly, their whorls falling away before his agile fingers. The boxes are filled with gifts neatly wrapped and bearing tags. The ones for my younger brothers say “from Santa Claus” but mine are not among them anymore, as I know with certainty they will never be again. Yet I am not so much surprised as touched by a pang of loss at being here on the adult side of the world. It is as if I have suddenly moved into another room and heard a door click lastingly behind me. I am jabbed by my own small wound. But then I look at those before me. I look at my parents drawn together before the Christmas tree. My mother has her hand upon my father’s shoulder and he is holding his ever present handkerchief. I look at my sisters who have crossed this threshold ahead of me and now each day journey farther from the lives they knew as girls. I look at my magic older brother who has come to us this Christmas from half a continent away, bringing everything he has and is. All of them are captured in the tableau of their care. “Every man moves on,” says my father quietly, and I think he speaks of Santa Claus, “but there is no need to grieve. He leaves good things behind.”

Reading:

TS: You heard Chris Howden reading To Everything There Is A Season by Alistair MacLeod.

[chillhop house tour music]

Part 2: Iran Power Outages, Paramedic Abuse Survey, Biggest Splash Science

Iran Power Outages

Guest: Elnaz Ali Karami

TS: In Iran, the currency is in freefall, the autumn harvest is down by 30 per cent, and government workers are being told to go home. These are all problems tied in one way or another to the country's

unprecedented energy crisis. Though it has one of the world's biggest supplies of natural gas, decades of sanctions and failing infrastructure, combined with reported Israeli strikes targeting pipelines, are forcing some difficult decisions. Choices that include whether to send gas to heat people's homes ... or to the power plants that generate electricity. Elnaz Ali Karami is an Iranian researcher in neuroscience at McGill whose parents are in Tehran. We reached her in Montreal.

PA: Elnaz, what are you hearing from your family about these outages?

ELNAZ ALI KARAMI: Well, I hear that they're happening every day, usually. And they last around like two hours. And it can be like any time of day. But recently, there is a chart on a website that they can check the time, but it's been published like a day before.

PA: And pretty widespread, not just across the country, but right through Tehran, yeah?

EAK: Yes. Yes. It's, it's in mostly in everywhere in the country and in the different districts of Tehran, like different neighborhoods, yes.

PA: You were, if I've got this right, a dentist in Iran before coming to Canada.

EAK: Yeah.

PA: These kinds of power outages, you know, we hear about them. They're frequent enough. Were they ever like this? And how did they impact your work?

EAK: Well, it's usually, the power outage was usually more common during the summer.

PA: Right.

EAK: Back when I was still living in Tehran six years ago. But luckily, I didn't personally experience it while I was on the work. It was either when I was finished, or I was planning to start to work.

PA: Right.

EAK: So we would just cancel out all my reservations and just, yeah, there's not much you can do because you need the light, you need the suction, you need the equipments. There's not much you can do independently to the power, even if you have a torch that your assistant is willing to hold it for you. There's not much to do. You just have to pass.

PA: Yeah, and I mean people get pretty adept at dealing with this, at sort of adjusting and waiting and figuring out how to manage through it. I wonder what your former colleagues that are back in Iran are telling you about how or whether things are different this time around?

EAK: Well, there's not much different. Emergency power access usually helps out to get yourself out of the very outrageous situation. But these charts, actually, have been helping them out that's being published. Even though it's like an hour before, you can still call your patients and reschedule them. But one way or another, you're losing some profit. You're, you're losing anyways.

PA: To put this in a context, Iran is, you know, an energy superpower. Huge supplies of natural gas, crude oil, much like Canada. And imagining something like this happening here, I think, has people wondering what on earth is happening. Why do you think this is happening now?

EAK: Well, officially, what we're hearing and that sort of makes sense is that, well, the natural gas is not, not what is limited there. Because, you know, we have the hugest, one of the biggest resources in the in the area. The problem is the shortage of the natural gas in the power plants does not fall to the capacity that should be able to cover. The infrastructure is, is old, It's, it's worn out. And it hasn't been renovated or updated or upgraded. Why that has happened, well, sanctions.

PA: Right.

EAK: And economical crises, one after one that gets bigger and bigger, which means like there is no resources for renovation and upgrades. And well, of course, the human resources, especially in the governmental organizations, is not based on the talent or qualification. And, well, most of our good scientists and engineers are living abroad right now. So, this is what has officially has been said. There is the outage. And the outage is due to the lack of natural gas in the power plants.

PA: You know, though, history tells us that, that, you know, people will put up with a lot. And as I say, you get pretty adept at adjusting. But if you're losing power every day and you're not able to do what you want, that wears thin pretty fast. Do people, do you hear that, that people feel the government needs to hold some responsibility of what it needs to prioritize in getting this fixed?

EAK: Well, yes. So, when you hear people speaking, you hear all these things, these frustrations and, you know, speaking out. But the thing is that people are too busy passing every day by, like surviving every day, and trying to make it day by day. And that's also quite a lot of work. If you, if you're asking me that why they are not being too bold about it, like they're not protesting in some way, the society, the people, the generations that I'm in touch with are exhausted and, and worn out, and depressed. It feels like after Woman Love Freedom, which was a big protest and pro-life protest. So, you have lost a lot that you're lethargically grieving still. And protesting doesn't really make much of sense to them because they've lost a lot instead of gaining much. And because you know that the world is just watching and doing nothing for you. It's just like, you know, a lethargic grief that is passing that they don't really have much a reason to go out and make a bold move. But the frustration is out there. They are frustrated.

PA: There's a member of Iran's Chamber of Commerce Energy Committee who told The New York Times that Iran's government is, quote, scrambling to manage the crisis and contain the damage. Because, he said, and this is the quote here, this is like a powder keg that can explode and create unrest across the country. I get what you're saying about the exhaustion of activists and what they've been through. But do you agree with that sense that this is something that could build into a new wave?

EAK: Absolutely. This has happened before. And every time something like that has been provoking people. Six years ago, five years ago, this was due to an increase to gas price. And, yes, this can be that. And I can see it that, yes, people are frustrated. They don't see it. But at some point, you're passing the threshold that you're not giving any reason for people to remain quiet.

PA: Indeed. Well, listen, it's a hugely important story and we're really grateful to get your insight on this today. So thank you so much.

EAK: Thank you for hearing me.

TS: Elnaz Ali Karami was in Montreal.

[ambient]

Paramedic Abuse Survey

Guest: Marc-André Périard

TS: Paramedics are trained to save lives. But on many shifts, they end up fearing for their own. Stories of verbal, physical, and even sexual abuse are common among many who do the job. And now, the Paramedic Chiefs of Canada are trying to put those stories together and come up with a better picture of what their frontline workers are up against. Marc-André Périard is the vice-president of the Paramedic Chiefs of Canada and a working paramedic for Prescott and Russell United Counties outside of Ottawa. That's where we reached him.

PA: Marc-André, what kind of stories are you hearing from paramedics about the abuse they face on the job?

MARC-ANDRÉ PÉRIARD: We're hearing all kinds of stories, actually, Peter. This is a daily occurrence that paramedics face. And this includes physical, verbal violence, bullying, threats and even goes to sexual assault and sexual harassment. And this is from multiple facets, whether it be patients, family and friends, bystanders and even, unfortunately, colleagues.

PA: It's so widespread and so common. Have you encountered this kind of stuff yourself?

MAP: So, I've been in the world of paramedicine for over 35 years. I haven't been a frontline paramedic for over 15 years. But, unfortunately, when I was a frontline paramedic, it was something that was almost a daily occurrence. Whether, whether it be physical attacks, people spitting on you, pushing you, even attacked with weapons is something that, that, unfortunately, occurs too regularly.

PA: The details in this survey are shocking. What goes through your head as a veteran of the business when you hear some of the worst examples of what your colleagues have been going through?

MAP: Well, you know what? And I say this, you know, with all due respect, it's nice to hear the stories finally. Because for the longest time, this was underreported. This was not something that paramedics would report. They were afraid of, you know, reprisal, maybe because they weren't getting support from their supervisory or their coworkers. Fear of blame. There was also, you know, belief that this was just part of the job and, and that there was a sign of weakness if you were to report violence. So the fact that we're hearing these stories now is in a way positive because now we're bringing this, this topic to light and we're hopefully going to bring some change and make it safer for our paramedics.

PA: Part of the problem is that there isn't some kind of a standardized national complaint system for paramedics or very much data documenting on the abuse in the first place. What do you hope we learn from having gone through this and learn from, from the survey?

MAP: Hopefully, we'll be able to do many things. First of all, understand the physical and psychological consequences of the violence that paramedics face on a daily basis. Be able to identify what kind of training is currently being implemented, and the perceived efficacy of that training, and how can we improve that and, obviously, advocate for change. We want to influence policy and create awareness on the issue of violence within, you know, the paramedic community and in public in general. The public needs to know that this is something that's far too common and that is unacceptable.

PA: When we were talking about this story for the show, one of the questions that first came up is why is this research only happening now?

MAP: Well, that's the big question, right? So, there has been some, some local research done in certain areas, but there hasn't been a national wide study. So, the Paramedic Chiefs of Canada have been advocating for this for a while. And we were lucky enough to get the support of the DRDC and some funding to, to do that. Obviously, I agree with you. This should have been done a long time ago, but we are there now and taking steps in the right direction to, to, to rectify this and make this the working conditions of our paramedics much more safe.

PA: I wonder, logistically, almost mechanically, what do you think it would take to create a proper national framework for documenting these kinds of incidents more routinely?

MAP: Well, I think just a standard process right across the country, a standard process, a quick process and a process that will identify and help rectify the situation quickly. If we can standardize something that everybody across the country uses the same tool and also feeds a database, I think that will be so important to making the right choices, the right changes and the right steps into building a safer environment for our paramedics. Now, that being said, there are some things that can be done right now, not just on the reporting side. One of the biggest things that is right in front of government right now is Bill C-321. You know, that's a bill that would change the criminal code and increase penalties towards, you know, violence towards frontline workers. That's, you know, being hung up in Senate right now. Hopefully, that will go through. That would be the first great step to show, you know, the government to show that our frontline workers are people that we care for. We often forget we need to take care of the people that take care of us in our times of need. And this would be a great first step.

PA: A lot of people say it would be a great first step, but that Bill C-321 doesn't go on to address a lot of the underlying societal issues, lack of mental health, addiction, income support. What's your take on what else needs to be done to augment that?

MAP: Yeah, so for sure, Bill C-321 is the first step, right? We know that if Bill C-321 passes, the violence has still occurred. So that's where we want to, you know, address that situation. But we also want to curb those, those incidents. So, the study, obviously, hopefully, this will identify some of the underlying factors and help us invest and advocate for investing into those, you know, societal issues that might contribute to violence. But there's also a lot of other, you know, contributing factors just internally where paramedics are taking this as part of their job. And, and we are seeing the shift where we're, we're not accepting this as as part of our daily routine. And we need to be in a position where we can make sure we're protecting ourselves and our first responders at all times.

PA: You know, no one wants to call a paramedic. It's usually a pretty bad day when you guys show up. But I think everybody needs to know that they're being taken care of, that they're supported. What is the one thing you'd like just regular Canadians across the country to understand about the realities of working as a paramedic?

MAP: You know what? These men and women, over 40,000 of them in our country, dedicate themselves every day, right? To provide compassionate care to people in their most vulnerable time of need. And even though the nature of their work will put them in a position or an environment where it might be dangerous or chaotic, the public needs to be patient with our frontline workers. Understand that, you know, these are people that have a family to go home to. And, and understanding that even though it's a stressful, difficult situation that they are living in the moment, that these people are here to help them. Our paramedics are incredible people, right? They're the people that take care of us. But on the other hand, we need to make sure that we're taking care of them, too.

PA: Well said. Marc-André, I really appreciate your time for this. Thank you.

MAP: Hey, Peter, any time.

PA: Take good care.

MAP: Okay. Have a good evening.

TS: Marc-André Périard is the vice-president of the Paramedic Chiefs of Canada. He was just outside Ottawa.

[chillhop house tour music]

Biggest Splash Science

Guest: Pankaj Rohilla

TS: There are countless ways to enter a body of water. You've got the swan dive, the cannonball, the cringeworthy belly flop. But in New Zealand, one technique rules them all: the Manu. The jump get its name from the Maori for bird, and is famous for the giant splashes it produces. And if you're really good, you might end up at an event like this one:

SOUNDCLIP

[an announcer speaks quickly and excitedly, counting down to a Manu]

TS: Everybody! Some live commentary from the Manu Championships in New Zealand earlier this year. Far away at the Georgia Institute of Technology, researchers wanted to know exactly how to master the Manu. So they went to the lab and got to work. Pankaj Rohilla is a postdoctoral researcher at Georgia Tech's Bhamla Lab and an author of the resulting study. We reached him in Atlanta.

PA: Pankaj, this certainly is a dramatic jump that makes a big splash. What made you and your colleagues want to analyze this so-called Manu so closely?

PANKAJ ROHILLA: So, you know, Olympics are going on this year. And in that case, they dive into water in such a way that they don't create a splash. And in New Zealand, there is this recreational sport which is called Manu jumping. Maori people do that a lot. So, the idea is to create the largest splash. And then in our lab we thought that we should study this. Like how exactly to create a large splash. We studied YouTube videos of people doing Manu jumping where they create the largest splashes. And then we recreated that in our lab using 3D-printed human mimics that also included a robot which was created by a co-first-author of the study.

PA: You're getting all this mostly from you say these YouTube videos. Can you just describe, like to somebody like me who sort of jumps off the side of the pool and sort of goes one foot in first, what am I doing wrong? What do they do right that, that creates such a splash here?

PR: Yeah. I mean, I think you might be aware of cannonball, where you like jump in water forming a sphere, holding your legs.

PA: Yeah.

PR: It's just, you don't hold your legs. In this case, you just enter like a V. And the angle of a V is like 45 degrees. If you land like, you know, vertically, you will get a jet, but not like a huge splash.

PA: And just like when you talk about huge splash, how big are we talking about here?

PR: So that can go up to like 15 metres.

PA: Fifteen metres?!

PR: Yeah. So like right now, Manu Jumping Championships are going on in New Zealand. And I think somebody created like a, like a live record of 13 metres. And I think that that person jumped from a height of five metres. But, you know, you can jump from different heights. You know, the, the whole trick is in the how you enter the water and what you do under the water.

PA: Right. And so, you go through kind of butt-first in a V-shape, and then you just kind of, I've been watching these videos. I can't quite figure it out. Do they just kind of flail out?

PR: Yeah. So it's like a roll back and kick motion. You know, just like because you are in a V-shape. Now, you like straighten your body, but your head goes down, your legs go up. So is that kind of just straightening out your body inside water. And that has, that has to be quick. If you delay it too much, you know, you won't get the proper large splash.

PA: Yeah, the timing seems to be the trick to this. Now, you mentioned in your first answer there you didn't just look at these YouTube videos. You created sort of "Manu Bot" that you guys made. How did you even use it in the lab?

PR: So the Manu Bot essentially it's just like a wedge. But now, we can control the opening like exactly when this V-wedge will open and become straight like a road. So that's what exactly humans do. And we tried to control the timing of it related to when it enters the water, for example. And it opens up after point-one seconds or point-two seconds or point-two seconds. So we tried wearing that time and we we figured out that there's an optimal timing when we open it inside water it will create the largest splash.

PA: So in following this on YouTube, I've discovered that the Manu technique is pretty well-established. People seem to know. I guess what we didn't know is why it works so well. And is it, is the timing of that thrust? The air bubble it creates? What has your research taught us about why this works so well?

PR: I think the angle was very important. Like I think people do the V angle, but they did not know that why this V angle is so important and what is the optimal angle. And the second most important thing we find out was the optimal timing. Like what time exactly you should open it, open your body to, to create a large splash. So these two main points are the, you know, the key takeaways from our study. And we do that, we did that systematically using high-speed imaging. So we captured these videos at 2,000 frames per second, and we analyzed the whole thing frame by frame, and we analyzed the kinematics of the splash and the body itself. So that's how we got these conclusions.

PA: You know, if you were to have a video of me and my friends on a dock in the summer, you'd see us all trying this. I guess one of the things that always comes up in groups of people is the different shapes and sizes of me and my friend's body really impacts how high the, the, the splash goes. How, how important is that? Or is it really just technique that it doesn't matter the shape of the body going into the water?

PR: So the technique is very, very important. But what we did not capture in the study is the body weight because that is also important, like how much mass your, you know, will impact the water. That will dictate the kinematic energy and that can affect the cavity size as well as a splash size.

PA: I'm going to make an assumption here that one can't really do this much research and spend this much time in study without being quite personally interested in the subject matter itself. Now that you know a little bit more about it, have you already given it a try? Is it something you're going to?

PR: I would love to try that. [chuckling] I think we'll need permission from the, from, from our university to do this in the diving pool because there are some safety regulations and all that. But, of course, yeah, I would love to try that at some point.

PA: Well, listen, I personally appreciate this as you've given me, as I say, the inside track with my friends on the dock this summer. So, I'm very grateful, and it's just fascinating research. Thanks a lot for this.

PR: You're most welcome. Thank you.

TS: Pankaj Rohilla is a post-doctoral researcher at the Georgia Institute of Technology and the co-author of a new study into Manu jumping. We reached him in Atlanta.

The AIH Transcript For December 23, 2024

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