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The Current Transcript for April 24, 2017

Host: Anna Maria Tremonti

STORIES FROM THIS EPISODE

Listen to the full episode

Prologue

[Music: Theme]

SOUNDCLIP

We saw what happened in England. We saw what happened in the US. With fear overcame reason and I hope today we show that we can still be proud of being French and that we can rise above fear.

ANNA MARIA TREMONTI: If they do harbour fears, French voters made it clear yesterday they are not afraid of change—catapulting two presidential candidates into an early May runoff in which neither one represents a traditional French political party. Far-right populist Marine Le Pen is now pitted against political novice Emmanuel Macron. The eventual winner will affect the future of France, the fate of the EU and relationships with other Western nations. In half an hour we're sorting through the messages voters are sending. Also today, when health care starts to resemble Groundhog Day—

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We think we can cure what ills our system by just throwing more medical bodies at it. You know Einstein had an expression for that. He said doing the same thing over and over and expecting different results—that's his definition of insanity.

AMT: Journalist Andre Picard has been documenting, tracking, chronicling and critically considering Canadian health care for three decades for the Globe and Mail. In his latest book, he looks at everything from drug policy to mental health and he says Canadians who want better health care need to make more noise. Hear him in an hour. And for a long time, she was in the headlines for all the good stuff.

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Well, they say you can't have it all, but Sheryl Sandberg comes awfully close. At 43, Sandberg is the highly respected chief operating officer of Facebook. She is also happily married with two young children.

AMT: Two years ago, Sheryl Sandberg's world collapsed with a devastating personal loss. Now she is sharing what she's learned through her grief as a wife and mother, but also as someone responsible for workers who also go through their own life-changing traumas. We are starting with her. I'm Anna Maria Tremonti. This is The Current.

How grief can lead to joy: Facebook's Sheryl Sandberg explains Option B

Guests: Sheryl Sandberg

SOUNDCLIP

Sheryl is my most trusted adviser, the person who helps me with everything I do in my job. It's like having the smartest person in Silicon Valley also working at your company, but she just happens to be my wife. I think people who have careers that are very divergent, sometimes it's like you know you want to share with your partner like hey, here's what's going on with me, but they don't necessarily understand it that well. And it's really nice that not only can we discuss these things, but we can help the other person.

AMT: Well, that was Dave Goldberg speaking with 60 Minutes in 2013 about his wife, Sheryl Sandberg, Facebook's chief operating officer. At the time, he was CEO of Survey Monkey and the two were known as one of Silicon Valley's power couples. But that came to an end in an instant. Dave Goldberg died suddenly on a vacation the couple took to Mexico in 2015 and without warning, the woman who wrote about how she and her husband leaned on each other in her bestselling book, Lean In, was forced to stand on her own as a parent to two young children. In her new book, Option B: Facing Adversity. Building Resilience and Finding Joy, Sheryl Sandberg is now sharing what she's learned about grief, bereavement and growth. When I spoke to her, she was at Facebook in Menlo Park California. Here is that conversation.

AMT: Hello.

SHERYL SANDBERG: Hi. Thank you so much. And thank you for that clip. It is really beautiful for me to hear that.

AMT: It's such a beautiful tribute to you. It reminds us that yours is a love story along with everything else.

SHERYL SANDBERG: Yeah. And a beautiful tribute to him. It is a love story. It is a love story in many ways.

AMT: Your husband was well-known as a business leader. But tell us about Dave the man, the dad.

SHERYL SANDBERG: Dave was my rock. Dave was always calm. I'm not always calm. So when I would get upset about something or pack for a trip two weeks in advance because I was excited, you know Dave was always the calm one. Dave was brilliant, a great business person. He showed me the Internet for the very first time. Long before we dated when we were friends, he encouraged me to take the job offer at Google. He was unbelievably generous. To this day, I meet people that I do not know and have not heard of who won't just say, “Oh, I knew your husband.” They'll say, “He changed my life and here's how. Here's the piece of advice he gave me. Here's the way he helped me start my company.” He was a great father. He had so much joy watching our kids. He loved to read as a child. He loved to read with them. He was incredible. And one of the things that I love about having written Option B is I think it keeps him alive because if he were alive, he would be doing so much good. So if this book in his memory can do some good, it's all about you know who Dave was.

AMT: What do you remember about the day he died?

SHERYL SANDBERG: You know there are these days in our lives that we don't forget. We were on a trip for our friend Phil's 50th birthday with a small group of adults, couples. We were in Mexico and you know it started as a normal day. We all had breakfast together. We went on a little hike. And I'll never forget this because looking back on it you know having no idea that was actually his last day, you know we did what couples do on the hike. He walked with Phil and the boys. I walked with Marnie, Phil's wife and the girls. And then later that day, he went to the gym and hours later I found him. And as anyone who's ever been through anything like this will tell you, you feel in those early days and weeks and months that you're not going to survive an hour, let alone a day, let alone a week. I felt like I was in a void, like you know the world was closing in on me and pressing in my lungs so I couldn't breathe. And the grief is still there. I mean I still think about that day and I miss him for myself and my children every day but years later, the void is gone and one of the reasons that I wrote Option B is that in the early days, people told me I would not feel this way forever and I did not believe them. The grief was so overwhelming and all-consuming that I just thought it would always be there. And years later while the sadness lingers, it's not what it was then and I want so much for other people to know that.

AMT: You made the point early on as you were struggling that one of your greatest fears was really about your children and how they would react to the death of their father, how they would be affected.

SHERYL SANDBERG: No, absolutely. You know my daughter was seven and my son was 10. And I flew home to sit down and tell them they would never see their father again. And my biggest fear was that in that same instant that Dave had the cardiac arrhythmia that killed him, we would have in that same instant wiped out my children's happiness. And I had no idea how to handle this. I had no experience. I had never thought about this happening. And so I turned to my friend Adam Grant who's a psychologist and just said what do I do? How do we get my kids through this? How do I get myself through this? And what he said is that we don't have a fixed amount of resilience. Resilience is like a muscle. We can build it. And he said the sadness will never completely go away—and of course it hasn't—but there were steps I could take. And this book Option B is us sharing what we learned from people who have studied resilience for a very long time and also from these stories of incredible people who have faced all kinds of hardship from rape and sexual assault, to incarceration to losing jobs, to losing children. To the everyday challenges people face, there are ways we can build resilience in ourselves and each other.

AMT: And tell us what Option B is.

SHERYL SANDBERG: Few weeks after Dave died, I was talking to Phil about this father-son activity that Dave had signed up for with our son and we came up with a plan for someone to fill up with Dave so my son could still go. And then I looked at Phil and I said but I want Dave. I want Dave to go. And he put his arm around me and he said option A is not available, so let's just kicked the “mmm” out of option B. And it was a very powerful moment because he didn't say you’re going to kick option B. He said we. Let's just do it together. And what I've realized over the months and years is that we all lived some form of option B. No one's life is perfect. Sometimes we've had the big traumas and the most credible hardship. Sometimes it is the everyday challenges. But we have to meet those challenges. When the worst happens, how do we make option B the very best it can be?

AMT: Well, I want to take you through some of the things that you did to get to the place you are now. As you point out, you did write this with Adam Grant, a psychology professor, a friend of yours. Help us understand what happened between those darkest of times and now, that has allowed you not only to keep breathing but to move forward with your family.

SHERYL SANDBERG: Probably the most important thing that happened is that I found gratitude. And it is so ironic to go through the worst tragedy of your life or a truly horrible experience and wind up more grateful. But it is possible. And when it happens, as sad as I still am, in many ways it gives your life more meaning. One day Adam said to me you should think about how things could be worse. I looked to him like he was crazy. I’m like things could be worse? I just lost my husband. Suddenly my kids lost their father. What could be worse? And he looked at me and said Dave could have had that cardiac arrhythmia driving your children. Oh my God, I could have lost all three of them in that second. Never occurred to me. And I would have thought when you're in the depths of grief and you're trying to feel better, you should think about good things, not think about negative things. But counter intuitively, that thought—which is the most negative of all possible thoughts—made me feel so much better because it gave me gratitude for what I now have. My mom talked about this as walking without pain. You know she walked normally most of her life and then as she approached her mid-sixties, her hip disintegrated and every step she took was painful. And then she got her hip replaced and she said for the first time she appreciated walking without pain and on the good days and even just the normal days, I feel that way. A few months ago my cousin Laura turned 50 and I called her that morning—her birthday’s on Valentine's Day—and I said happy birthday Laura. And then I said and in case you woke up this morning with that “Oh my god, I'm turning 50” thing we all had and I used to have, I'm here to tell you that you are so lucky to turn 50. Because this is the year that Dave won't. He won't turn 50 ever. And there's really only two choices. We either grow older or we don't. I never roll my eyes at getting older and a birthday anymore because I know how precious every birthday is. If I could go back and share that with Dave, live life with my 11 years of being married to Dave Goldberg with that sense of gratitude and appreciation, I would give anything to do that but I can't. So what I can do is try to help other people and myself live that gratitude that they have for everything good in their lives.

AMT: You talk about the gratitude but you also talk about being kind to yourself in a moment of grief and letting yourself grieve, letting your kids grieve. You quote a rabbi who told you to lean in to the suck.

SHERYL SANDBERG: Yeah. Yes, my rabbi told me to “lean into the suck” which is not what I meant when I said lean in, but it was very good advice because when I just accepted that the grief was going to come, I thought it less and it actually passed faster. My kids and I wrote family rules very early on the first week and the first one was respect our feelings. And I told this to my kids. It was just harder to tell myself. There are going to be times you want to cry and it might happen at very inconvenient moments like in the middle of class. There are times you're going to feel okay and feel happy. Let yourself laugh. Don't ever feel bad about that. Daddy would want you to laugh. There are times when you're going to feel jealous of other kids or even of me because I still have a father and you don't. Accepting our feelings rather than fighting them is such a big part of this and then understanding permanence—those feelings are not forever. Even in the totally horrible grief moments, we know that that moment can pass. And if we respect it and lean into it and take the cry break we need, we know that moment can pass.

AMT: Many people have a hard time knowing what to say to those who are grieving. What did people say to you that was painful even if they meant well?

SHERYL SANDBERG: This is one of the major things I learned going through tragedy myself, is really how badly I handled other people's tragedy before. I think the most important thing we can do for people facing hardship is acknowledge it and we don't. All kinds of hardship ushers in the world's biggest elephant into every room. You want to silence a room? Get diagnosed with cancer. No one knows what to say. Have a relative who goes to prison. Lose a job. Have a child who dies. People are just silent. And the problem with that silence is it doesn't acknowledge pain. I used to think that if someone was going through something hard and I brought it up, I was reminding them. So I didn't do it. I waited for them to bring it up. Losing Dave taught me how ludicrous that was. You can't remind me I lost Dave. I know I lost Dave every minute of every day. But acknowledging, saying to someone “I know you're suffering, I'm here to talk if you want to,” you know, not sugarcoating. When I had friends—and I've had many friends who've been diagnosed with cancer as many of us have—I used to say I know you're going to be okay. Well, now I know that little voice inside their head is probably saying what do you mean you know I'm going to be okay? You don't know I'm going to be okay. So now I say, “I know you don't know if you're going to be okay and I don't either, but you're not going to go through this alone. I will be there with you.” The power of we. Don't say you're going to get through this. Say we're going to get through this. And the other thing is it's incredibly powerful—rather than offering to do anything, to do something specific. I used to say to people is there anything I can do? And I meant it well but it kind of shifts the burden to the person who you're trying to help. They've got to think about what to ask for. And having been on that side, it's hard to ask for something. Well, can you help me skip Father's Day? Can you bring dinner over for me and my kids? Like it's just hard to make a specific request. My friend Dan Levy lost a child unfortunately and he and his amazing wife were at the hospital with their child for many months. And one of his friends texted and said what do you not want on a burger? Another friend texted and said I'm in the lobby of the hotel for a hug for the next hour, if you come down or not. Do something rather than offer to do anything. It really helps people feel like they're not alone.

AMT: You mentioned something else as well because people would ask you how you are. And it made all the difference if they said how are you today, to acknowledge that you were—it was a process, one foot in front of the other.

SHERYL SANDBERG: Yeah. When Dave died, it wasn't just the overwhelming grief. What happened over that first weeks and then months was just incredible isolation. The grief therapist I talked to advised me to get my kids back to school quickly and I probably didn't do it as fast as they advised, but ten days later I got my kids back to school, back into their routine so I went back to work during the hours they were at school. And you know I always had very easy friendly relationships with the people I work with. Facebook, no one has an office. I sit out in the open floor with Mark and everyone else. But people weren't really talking to me. And when I would drop my kids or pick my kids up from school, same thing from their parents and teachers. I think everyone was so afraid to say the wrong thing, they weren't saying anything. And so 30 days after Dave died—it's the Jewish period of mourning called sheloshim—it’s the period of mourning for a spouse. I wrote a post on Facebook really to the people I was interacting with every day saying you know say, “How are you today?” Because that communicates I know you are suffering. I know every day is hard to get through. I mean I wasn't even sure I was going to post it. I went to bed the night before thinking there's no way I'm sharing this. It's too personal. And I woke up the next morning in such a dark place, I thought well, might as well post it, can't get worse, might get better. And it really helped because it kicked a lot of elephants out of a lot of rooms. A friend from work told me she had been driving by my house almost every day but afraid to come in and she started coming in and strangers from all around the world posted and shared their stories. A mother posted from the NICU. She had just lost one of two twins and she said she was looking for the courage and the strength to give that surviving twin a wonderful life. And people responded to her and other people talked about their option B. And all of a sudden, I didn't feel alone. I still lost Dave. I still have the grief but I didn't have the isolation.

AMT: Well, let me ask you a little bit more about work because you talk about how grief affected your self-confidence at work. It was hard to be there.

SHERYL SANDBERG: Yeah. It's also counterintuitive, right? I mean I wrote Lean In. I had thought about self-confidence a lot for women. I was very open about the times I suffered and doubted myself professionally and then built up my own self-confidence. And I mean I had thought about grief and I knew about the stages everyone talks about so I wasn't surprised by the anger. I wasn't surprised by the sadness. But the fact that losing Dave really just destroyed my self-confidence and all other areas was something I was completely not prepared for. But of course it did, right? I was a parent. It's hard enough to be a parent. Anyone knows that. And then I was on my own with two grieving children. How could I parent without Dave in this situation? At work I would try to get through a meeting without crying but a lot of the meetings I cried. I would kind of cover up or have to leave the room. So how could I do my job well? And what I realized is that—and Mark is the one who showed me this, Mark Zuckerberg, our founder and my boss—he didn't just say take the time off you want which he did and I'm grateful he did that and so glad Facebook has good policies on these things, but he did something else which is he rebuilt my confidence. So the first night when I went home I called him and I said okay, today I came into work and I fell asleep in a meeting. I said a couple of really dumb things. I rambled in one meeting and he said lots of other people have fallen asleep. Those mistakes weren't that big. And you know you said two really important things today and here's what they were. He built me up.

AMT: Well, you have said there needs to be a rethink on sick leave and bereavement leave in corporate and public policy given what you yourself have gone through. What would you like to see in wider American society on that front?

SHERYL SANDBERG: Well, I mean it's interesting to talk about this with you because Canada has such better policies than the United States. We are one of the only countries without paid family leave and so our public policy in the United States needs to change and get much closer to what other countries have. On the corporate level, companies need to know that when we support our employees they support us and we build the kind of workplaces that really increase people's productivity over the long run. Facebook offered before really good bereavement leave—10 days for an immediate family member, five days for an extended family member. But after we lost Dave and I went through this, I worked with the team and we doubled it. I think companies need to do a better job taking care of their employees and recognizing how important that is.

AMT: And you are very up front about your own financial advantages. But what did you find out about the financial effects of a death of a spouse or partner for the average American?

SHERYL SANDBERG: Oh, it's huge. And I thought about this a lot. I mean I can't imagine going through what I went through and also being worried about paying a healthcare bill. Again, something that is so much better in Canada than United States for most people, or the single mother that wakes up every day and has to worry about losing her job if she stays home to take care of a sick child. Those are choices we should not force anyone to make. Becoming a widow pushes a lot of women into poverty and if you look in the United States, 37 per cent—37 per cent of single mothers—live in poverty, 40 per cent if you're black or Latina. That's unacceptable. Our children, our families deserve more support and poverty increases the rate of hardship. More hardship happens, more violence, more health problems, more things to recover from. But it also makes it harder to recover. And we owe people the safety net they deserve—a living wage, good family leave policies where people get paid to take the time off they need and the support from our companies and our communities.

AMT: You know as I was reading your book, I did catch the subtext of your desire for a kinder gentler nation.

SHERYL SANDBERG: Absolutely. We build resilience in ourselves and our communities and people need the resources to do that. We owe them all better. We need to do better.

AMT: We have to take a short break. You are listening to my conversation with Sheryl Sandberg, Facebook's chief operating officer. Her new book is Option B: Facing Adversity, Building Resilience and Finding Joy. It's about living through grief, the grief of losing her husband, Dave Goldberg. The CBC News is next and then we will continue this conversation and talk about rediscovering happiness. Stay with us. I'm Anna Maria Tremonti. This is The Current on CBC Radio One.

AMT: Hello. I'm Anna Maria Tremonti and you're listening to The Current.

[Music: Theme]

AMT: Still to come, the Globe and Mail's health columnist Andre Picard will join me in half an hour to talk about matters of life and death, public health issues in Canada. We will hear his reflections on our health care through 30 years of reporting. Before that, there is already a shift in French politics after the first round of presidential voting leaves the mainstream parties chewing dust. We'll talk about that. But first, picking up on my conversation with Facebook's chief operating officer Sheryl Sandberg.

[Music: Sting]

AMT: Well, if you're just joining us, we're finishing up my conversation with Sheryl Sandberg. She has written Option B: Facing Adversity, Building Resilience and Finding Joy. Before the news, we talked about her husband Dave Goldberg's sudden death in 2015 and how she and her children have coped with their grief. If you missed that part of our conversation, you can find it and listen on our website, www.cbc.ca/thecurrent or on our CBC Radio app or download the podcast. Now before we left off, Ms. Sandberg was talking about the financial consequences that the death of a partner can have on a family, especially for those less financially fortunate than her. Here is the rest of that conversation.

AMT: In the midst of all of that, individual families and individuals face the kinds of traumas and tragedies that you have written about. You're very cognizant that you live a rarified life on the one hand, but there's something very universal about what you experienced and there are some things that money and success could not protect you from.

SHERYL SANDBERG: That's right. I mean there are hardships that people face that we can avoid. We can educate our children better. We can give people equal opportunity. We can make sure that when people get out of jail they can get jobs. There's so much we can do. But there are hardships and death and loss that are not avoidable. There are natural disasters and there is death the way Dave faced for medical reasons and there are accidents that happen no matter what we do. And then the question is what then? How do we support each other? How do we build our resilience? How do we make sure that we give permission to people not just to recover but actually to find joy? And that's another really important part of this book. What I realized was that it wasn't just getting back to being okay and going through the days. It was giving myself permission to feel happy and I couldn't do that because I thought if I felt happy even for a minute, I was somehow betraying Dave. How could I feel joy if he had died? And my brother-in-law Rob did an incredible thing for me. He called me months in, you know tears in his voice. You could hear him choking up and he said Sheryl, all Dave ever wanted was for you and your children to be happy. Do not take that away from him in death. You have to let yourself be happy. And so I started trying to do things that made me happy. I realized that for the first four months after Dave died, I didn't do anything remotely fun because it reminded me of Dave. I didn't play Scrabble because I played with Dave. I didn't watch TV because that was something I did with Dave. I didn't leave my house and go anywhere even if a close friend invited me because I was afraid I would break down. But with Rob's encouragement, my kids and I started taking things back. We started playing Settlers of Catan again as a family. We took it back. We started cheering for the Warriors and the Vikings—Dave’s teams— and we started letting joy come back into our lives and I realized that after hardship, I needed help. I needed someone to give me permission to say you’re allowed to try to find happiness and even humour and even love.

AMT: Well, I have to ask you then because there are so many social norms that come into play after death and judgments of others. Can we talk about dating? Because you talk about dating.

SHERYL SANDBERG: Yeah, I want to talk about dating because one of the hardest things I think after death of a spouse particularly is grief and the loss and then the guilt. And it’s not just guilt about dating. It’s guilt about laughing. How can I laugh? How could I feel okay? You know four months after Dave died, I went to a bar mitzvah and a high school friend pulled me onto the floor and we danced to a song I liked in high school and then I just literally burst into tears publicly on the dance floor and he had to kind of usher me outside to the balcony. And I realized that I felt happy for one minute four months after Dave died—just one minute of joy just dancing to a high school song. I was kind of transported back and then I felt so guilty. And I think that we have to fight the guilt and we have to help people fight that guilt. I never wanted to date again. I found the person I wanted to spend my life with but I don't have that option. And so my brother-in-law and my mother-in-law gave me not just permission but encouragement to date but too many people do not get that, particularly women.

AMT: There’s a real gender divide.

SHERYL SANDBERG: Oh, it is. I mean we judge women for dating in a way we don’t judge men and that’s part of the reason women date less frequently and less quickly. And this is not a judgment. Everyone has to decide if they want to date when they want a date but we need to give them that permission and encouragement. The last thing that a man or a woman needs after losing a spouse and trying to find happiness is judgment because they didn't choose this. And I also write a lot in Option B about humour. Humour is really important. There is a reason people make jokes at funerals. There is a reason we try to laugh even about the most horrible things in our lives because in that second, in that instant of the joke, we take control and we snatch back joy. And I'm hoping that Option B helps people not just build resilience but rediscover joy in all aspects of their lives. And it's not going to be joy every minute. I still miss Dave. I still have sadness in my life I didn't have before. But when I can feel joy, when someone tells a joke when I can laugh, boy do I appreciate that moment in a way I never did before.

AMT: And when it comes to your children and the fears you had for them when he died, what have you let go of?

SHERYL SANDBERG: My kids are doing great. They still miss their dad and we still have our sad moments. But I am so proud of them. I would not wish their perspective on anyone, any child, let alone my own. But they have it and it makes them strong. My son's basketball team lost the playoffs a few weeks ago and all the other little boys were pretty upset. And I looked at my son, I said are you okay? And he rolled his eyes. He goes Mom, this is sixth grade basketball. I'm fine. No one died today. Again, I wouldn't wish that perspective on him or anyone else. But he is strong and the things that would have upset him two years ago really roll right off his back because he has perspective in a way that gives meaning and depth to his life along with the sadness.

AMT: And he has growth which is something else you talk about—the ability to grow through a traumatic event.

SHERYL SANDBERG: Yes. Psychologists talk about it as post-traumatic growth. With the sadness of trauma, we also grow. We can have deeper meaning, deeper gratitude, deeper relationships. I also really believe in pre-traumatic growth, that people can grow without the trauma and that's part of what I hope Option B will do for people. My friend Katie was very close to Dave and is one of my best friends, started writing letters after Dave died to all her friends on their birthdays—long letters telling them how much they meant to her. And then a friend of hers started writing letters to her friends. That friend didn't know Dave has experienced no hardship but that friend showed pre-traumatic growth. She took the lessons Katie learned of deepening her relationships after a loss and applying it to hers. And so I hope Option B can help people find the gratitude for life, the appreciation, the meaning, the relationships even before the trauma and maybe without the trauma.

AMT: Sheryl Sandberg, I'm very sorry for what you had to go through. But I want to thank you for sharing what you learned about grief with us.

SHERYL SANDBERG: Well, thank you for having me and I particularly thank you for starting with that clip of Dave. That meant everything to me.

AMT: Thank you very much.

SHERYL SANDBERG: Thank you.

AMT: Sheryl Sandberg, chief operating officer at Facebook, the author of Option B: Facing Adversity, Building Resilience and Finding Joy. She is also the author of Lean In: Women, Work and the Will to Lead. She spoke to me from Menlo Park, California. If you can relate to her experience of grieving the death of a loved one, let us know. What was your option B? How did you find resilience and even joy after grief? Are you having a hard time doing that? Tweet us @thecurrentCBC, post on this story on our Facebook page, e-mail us by clicking on the contact link at www.cbc.ca/thecurrent. And again if you tuned in part way through our conversation, take the time to listen to the whole thing on our website, our podcast or on the CBC Radio app.

[Music: Bridge]

'Fresh face' Macron and Le Pen head to 2nd round of French presidential election

Guests: Ben Barnier

AMT: You are listening to The Current on CBC Radio One and Sirius XM. I’m Anna Maria Tremonti.

SOUNDCLIP

[Through translator] Over the last few months and today, I heard about doubt, about rage, about fear from the people of France, but that strong desire to change things also. And that’s what led France to move away from responsibility—the two big parties that have been governing France over the last 30 years.

[Sound: Applause]

AMT: The independent candidate who hopes to become France's next president, Emmanuel Macron, speaking yesterday. Voters in France went to the polls Sunday to begin choosing a new president and they made one thing clear—change is on the way. Candidates representing France's two major political parties were given the boot in the first round of national voting which took place amidst high tensions and tight security because of last week's gun attack on the Champs-Élysées that left a police officer dead. Mr. Macron, a newcomer to politics and a centrist and far-right National Front leader Marine Le Pen received the most votes from a seemingly divided electorate. They will go head to head in a runoff vote two weeks from now, May 7th. The stakes for France and Europe are high. Ben Barnier is a reporter with the French broadcaster France Info and he has been covering this campaign and we reached him in Paris today. Hello.

BEN BARNIER: Hello, Anna Maria. How are you?

AMT: Well, I'm really curious to know what you know, so walk us through the outcome of yesterday's vote. How close were these two in the final count?

BEN BARNIER: Well, it's interesting because Marine Le Pen, the far-right candidate was hoping to come first in this election, in this first round of the presidential election. And even though she's now going to be in the runoff, it's a bit of a disappointment to her and people on her side. And this is I think the fact that she is going to be part of the runoff of this presidential election is the main story. Even though it was expected and the opinion polls had predicted it, it's still the main fact after this first round of the presidential election.

AMT: This is the first time she gets to the runoff because she has run before.

BEN BARNIER: Absolutely. The second time she is running for president and this time around, she is making it to the second round. You have to bear in mind that 15 years ago, her father Jean-Marie Le Pen had made it to the second run of the presidential elections against Jacques Chirac, the centre-right candidate and that time around—so that was back in 2002—it came as a huge surprise. No one had seen it coming. We knew that the National Front, the far right party had a strong political force in this country in France. But no one expected Jean-Marie Le Pen to make it to the second round. This time around it's a completely different story. Marine Le Pen has led a very strong campaign appealing to all kinds of people and I've been on the campaign trail for months now talking to young people, older people, students, farmers and hearing a lot of people determined to vote Marine Le Pen for president.

AMT: So are you surprised she didn't get more of the vote?

BEN BARNIER: I am surprised to be honest with you and I'm also surprised about the fact that Emmanuel Macron made it to the second round of this presidential election because we know very little about Emmanuel Macron. First and foremost, it's hard for me to tell what to say whether he is centre-right centre-left. It's not really easy and even when you ask him, he wouldn't tell you. He’d say I don't define myself as a left or right wing or centre-right or centre-left. I'm just different. I'm just new. And even though he was finance minister under Francois Hollande, it’s just a bit difficult to see what he stands for. He doesn't really have a turf. He doesn't have connection to local community. So I am surprised that Emmanuel Macron is going to be in this runoff.

AMT: Okay. So Ben, when you look at the breakdown of the votes, where was he strong and where was she strong?

BEN BARNIER: She is stronger with people that feel left out by Europe first and foremost and that's also what I gathered from talking to so many people. Farmers were some of them, but also many of the blue collar—people who are working in factories or trying to look for a job at a factory—and many of those people used to vote for the far left parties, the communist party or other parties. Now many of those people are voting for Marine Le Pen because they feel like they’ve tried all the other options and Marine Le Pen appears as being the only option that could work for them. As for people voting for Emmanuel Macron, my sense and what I get from the results is that a lot of young people were satisfied with his campaign, were seeing a new fresh face, something new. I mean the man, Emmanuel Macron, is not even 40. He’s extremely young. If he were to be elected, he’d be the youngest president in French history.

AMT: And he just created this party because he abandoned the traditional parties, right? So he created this new party but he is absolutely new to politics, this kind of politics.

BEN BARNIER: Exactly. And you’d think so many people turned to join his party because you're looking pretty much at a political startup with many options, many seats to be filled because before several months ago, he didn't have any party. He just had some kind of a movement. We were not even sure he was going to run for president. So you're seeing a lot of newcomers who want to be part of what's going to come next for France and are applying for those jobs, applying for all those positions that could be filled if Emmanuel Macron gets elected president.

AMT: And now I want to pick up on something you said about the far left, that the people who voted far left in the past went to the far right candidate Le Pen. It's interesting. I was just reading that the far-left candidate Jean-Luc Melenchon, he has pointedly refused to back Mr. Macron. What's the significance of that then?

BEN BARNIER: From what I gathered, from what I'm hearing, a lot of people are shocked by the fact that Jean-Luc Melenchon did not call on his supporters to vote for Emmanuel Macron. Because there is a sense—even though Marine Le Pen has led a strong campaign and she is appealing to a lot of people—there is a sense among many other people in France that Marine Le Pen’s proposal is undemocratic. It does not fit with French values. So a lot of people,even though we've known all along that Jean-Luc Melenchon has a strong character. He’s very charismatic but he's got a bit of a French attitude. People thought that in the end even though he would lose, he would say okay, now we have to vote for Emmanuel Macron. That’s the reasonable decision to make. But no. And I think the main reason why Jean-Luc Melenchon is not calling on his supporters to vote for Emmanuel Macron, the centre candidate, is that they don't agree on economics. And Jean-Luc Melenchon feels very strongly about the current French economy. He thinks that we should change the way we're dealing with Europe. We should change the way we are dealing with big companies. And he feels like Emmanuel Macron stands for capitalism which is not what Jean-Luc Melenchon wanted for France.

AMT: So he's more of the status quo when it comes to that side of things, even though he's abandoned the traditional parties. The other thing I wanted to ask you about: we know the electorate is divided, but is there a geographical divide that you saw with this vote?

BEN BARNIER: Well, it's hard to say because sometimes what I know for sure, that in the suburbs of Paris for instance, the banlieue, with a lot of communities, some of them Muslim communities but also communities from other countries, Melenchon came really strong and for sure Marine Le Pen did not come strong in those areas. And traditionally the south of France had been a struggle for Marine Le Pen, the northern part of France as well. But then it depends on how you look at things and when you look at small towns and small villages, it was very surprising. In the south of France, many people did not vote for Marine Le Pen. What we know as well is that in the northern part of France which is a bit of the equivalents of the Rust Belt in the US with former factories and mines closed many decades ago, this is a stronghold for Marine Le Pen and when you talk to people there, they feel a bit like the farmers. They feel like they have no other options. They have tried the Socialist Party. They’ve tried the centre-right party and the only option left with them is the far-right party of Marine Le Pen, Front national, National Front.

AMT: Okay. So you got people who are disenchanted with traditional parties, people who feel left out, people who feel there's no other option. And I'm talking to a man who's not only covering the French election. You were actually covering the US election for your news organization as well. Do you see any similarities in France to what happened in the United States?

BEN BARNIER: We have to wait and see. I mean if Marine Le Pen gets elected president, then for sure because when I was in the US, no one expected Donald Trump to win the election. And in this case again, a lot of people are saying okay, we have to watch it closely. We now have a far-right candidate in the second round of the election. But most people think okay, this is fine, this is fine enough. Macron’s going to be the next president. He might not be the best candidate but at least he's not xenophobic. He's not a threat to French values. But we have to see what happens. I spoke to several people who were supporting Francois Fillon, the centre-right candidate and they told me when I was interviewing them, I will never vote for Macron. That will not happen. I would rather vote for Marine Le Pen than for Emmanuel Macron. If there are many people like that like those people, then Marine Le Pen could win. We have to also bear in mind I think as well as journalists not to be biased because I think a lot of us journalists, we don't like Marine Le Pen's idea. We feel threatened by her ideas and I think it's our responsibility as well at least to talk to people who support Marine Le Pen and try and hear their outrage and understand why they want to support Marine Le Pen. Some of them might be xenophobic, some of them might be racist, but others might have genuine concerns about how things are being run and why they are being left out.

AMT: So what will you be watching for over the next two weeks in this lead up to the runoff on May 7^th?

BEN BARNIER: We're looking mostly at demonstrations. We know that the French, we have a tradition of taking it to the streets with those banners and chanting and all of that. And we were going to cover those demonstrations maybe day in day out. We have one demonstration coming up tonight in Paris and other towns of France and those demonstrations are being held by organizations that defend several communities. Some of them are anarchists. Some of them are leftists. It depends. But we are seeing grassroots movements saying we have to take it to the streets. Even though there's been a vote, we don't agree with Marine Le Pen being part of this, being in the second round of this election. And I’m also seeing people who are very unhappy with having Macron who’s as you said, appears as a candidate for the status quo.

AMT: Okay. We’ll be watching as well then. Ben, thanks a lot for your time today.

BEN BARNIER: Well, thank you, Anna Maria.

AMT: Ben Barnier, reporter with a French broadcaster, France Info. We reached him in Paris. I just want to share some feedback from last week. We have a couple of minutes. We did a story on medical misdiagnosis and we spoke with Megan Shalley whose five-year-old son Sam died after an ER nurse told her he had croup. She took them home. She was confident she could treat it herself. But he didn't have croup. He had pneumonia and soon he was not breathing.

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Sam was—his lips were turning blue. The other two kids were there with me and I just loaded them all in the car and I drove him there as fast as I could. I'm very sure that he died in the car. My two kids ran in behind me when he was in my arms. When I finally got him into the hospital, when I got him into the hospital, they couldn’t resuscitate him. I think they tried for about 45 minutes and still even then, they thought it was croup.

AMT: A lot of you were moved by Megan Shalley’s story. It struck a chord with many of you. Heather Avery wrote on Facebook and this is what she said: "Our daughter was misdiagnosed. We were told kids under two couldn't get strep throat. She ended up with strep and a blocked airway from an infection on top of strep. I always think about what could have happened if my nursing friend hadn't said go straight to another health centre in Halifax. They admitted us right away and spent hours ensuring the correct diagnosis. I only kick myself for not going there first. A simple test would have proved she had strep." Deanna Overland had a different experience. She writes: "When my son was a baby toddler, he repeatedly got croup. The first time I went to the hospital I was told 'never think it is just croup. Any time a child's breathing is compromised it should be taken seriously.' I was always so grateful for that advice." Jennifer Johne emailed: "I went through a series of problems with an ER doctor, a specialist, and then being misdiagnosed by my optometrist. I lost the vision in one eye. The thing is, I was bang on with my diagnosis but that was completely useless when facing the medical system. Now, medical professionals are better and my new optometrist basically saved me when I had a recent medical emergency. I now have the vocabulary to deal with medical staff who know nothing about eyes, or if they do know, I can give them the information they need. But something is wrong when you have to know as much a doctor to get appropriate treatment. Isn't that their job?” If you have thoughts about medical misdiagnosis or anything else on the program, we want to hear about what you're thinking. Find us on Facebook, find us on Twitter @thecurrentCBC or send us an email by clicking on contact at www.cbc.ca/thecurrent. And stay with us because we're going to stay with medicine in Canada and medical issues in Canada. In our next half hour, long-time health columnist Andre Picard of the Globe and Mail tackles the biggest problems plaguing Canada's health care system. And he nods to the successes as well. André Picard waiting in the wings when we return. I'm Anna Maria Tremonti. This is The Current on CBC Radio One, Sirius XM, online on www.cbc.ca/thecurrent, on a podcast and on your radio app.

Canadians too accepting of mediocre health care, says André Picard

Guests: André Picard

AMT: Hello. I'm Anna Maria Tremonti and you're listening to The Current.

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VOICE 1: This is an historic day for our country.

VOICE 2: With the pressure of a court deadline looming, the federal government has put forward a plan to change the way some Canadians will die. There is the question of how.

VOICE 3: British Columbia is marking a grim anniversary. It has been one year since BC declared a public health emergency as a wave of powerful opioids swept through the province.

VOICE 4: People on the remote First Nation of Attawapiskat say the spate of suicide attempts started last October with the death of a 13-year-old girl. They say since then, dozens of the community’s 1,800 people have attempted suicide, culminating in 11 attempts in one night last week.

AMT: Well, from medically assisted death to the opioid crisis, to the suicide epidemic among Indigenous young people, the health of Canadians often makes headlines and few people have witnessed and written as much about health issues in Canada as André Picard. He is the Globe and Mail's health columnist and his new book is called Matters of Life and Death: Public Health Issues in Canada. Andre Picard joins me in our Toronto studio. Hello and welcome.

ANDRE PICARD: Hi.

AMT: You've just marked your 30th anniversary with the Globe. How did you come to specialize in health?

ANDRE PICARD: Well, you know I just stumbled into it, as many journalists stumble into their specialties. I started at the time when AIDS was just getting into the mainstream media, into the headlines. And funny story is that the health reporter at the Globe at the time was not interested in AIDS at all because we had a very rigid way of writing about health back then. Things were published in medical journals, we talked to the medical experts and that's how stories were written. And I still remember to this day her saying you know well, why would we talk to patients? What do they know? And my job was you know I started as a summer student—go cover these demos and I covered a lot of AIDS demos, got to know people in the AIDS community and thankfully for me, the Globe was generous enough to let me keep covering it. And AIDS is one of the stories I've literally covered for more than 30 years.

AMT: And when you started covering that, you had a very important moment with one patient. Tell us what happened.

ANDRE PICARD: Well, that was one of the moments that marked my career for me as I went into—someone called, as people do with their new stories into the newsroom. And this was a fellow who was in St. Michael's Hospital who was ill. He was a gay man, an openly gay man, which was unusual at the time and they’d put a big sign over his bed—this big pink sign saying warning, danger, contamination. Because he was a gay man, it was assumed everyone at the time had AIDS. In fact, he was in there for a fairly banal bladder infection. It had nothing to do with AIDS. But they wouldn't bring food into his room. The trays were at the door. They wouldn't change his bed sheets. And I went in and you know I introduced myself and I shook his hand and this guy burst out crying. And I was kind of wow, what have I done? And he said nobody's touched me for three days. He's been in the hospital and they wouldn't touch him. And it just speaks a lot to the stigma at the time and to me it was a really important lesson that what matters in health care is you know taking care of people. It's not the disease you have to take care of. It's the person, to show them respect, et cetera, and that's what he didn't get.

AMT: That's really been emblematic of your whole time covering this issue then.

ANDRE PICARD: Yeah. That's sort of been a recurring theme. AIDS has always been there in the background for me. But I think AIDS is important medically, politically, socially, and it changed journalism really profoundly. We don't cover health care the way we do. We don't cover drugs the way we used to and this is all because of AIDS activists. They didn't stand back and accept the cards they were dealt. They fought back and they changed the system quite profoundly.

AMT: After so many years writing about health, how do you rate Canada's health care system as a whole right now?

ANDRE PICARD: You know I always say we deliver excellent health care but not because of the system but in spite of the system. So we have great medicine in Canada. All our problems to me are engineering problems and administrative problems and we don't often make that distinction. We think we can cure what ills our system by just throwing more medical bodies at it. And you know Einstein had an expression for that, right? He said doing the same thing over and over and expecting different results— that's his definition of insanity. And that's what we've been doing in getting the health care for 40, 50 years.

AMT: You say we're essentially a land of pilot projects.

ANDRE PICARD: Well, that's a line, a famous line from Monique Bégin who says “Canada is a land of pilot projects” and it's true. And to me that's the biggest frustration as a health reporter. I know that we've resolved every single problem in our health system at least 10 times on a small scale. And our biggest problem, I think our biggest single problem is not scaling up our successes. So when people ask me to describe Medicare in a pithy way, I always describe it as Canada is islands of excellence in a sea of mediocrity, is what we have in our health system.

AMT: And so give me an example of some of the experiments that work that don't stick.

ANDRE PICARD: Well, there's a thousand and one of them. A couple of examples: I remember going to New Brunswick—a pilot project, everything's a pilot project. Pharmacists would go into the homes of elderly people, they'd look in their medicine cabinets and they’d essentially clean them out. They'd find all the contrary indications, all the things that were making them sick—expired drugs—clean them out. Wow. These people magically felt better because they were not taking all these drugs they didn't need. They were actually taking the drugs they needed on the right time. Very simple project, cost nothing. Funding ran out. They didn't do it. There's no reason we shouldn't do that for every single senior who on average have about 12 medications. Another example is in some parts of the country, paramedics go to the homes of elderly people. So paramedics spend a lot of time sitting around doing nothing, right, waiting for a call. So they fill their time by going to visit elderly people—how are you doing—to prevent them because they know they're going to be going back to the emergency room if there's no follow up. So those are the little examples. And again, there's many, many of them.

AMT: So when we look at why there aren't wholesale changes to the system when one thing works and it doesn't stick, does the average person have a role in that?

ANDRE PICARD: I think Canadians largely are too accepting of the mediocrity in our system. You know we've embraced a lot of mythology about Medicare and the biggest one is well, Medicare is free, so I guess we have to take what we get. So we'll sit in an emergency room for eight hours and we'll grumble about it but we'll say well, at least we don't have to pay like they do in the US. And what people forget is that doesn't exist anywhere else in the world. So in my travels, one of the things I like to do is I drop into hospitals and whatnot when I travel around the world and I was in Spain in the summer and I dropped into an emergency room and I asked them what's your wait time? And the triage nurse looked at me with this puzzled look and she said wait time? It's an emergency. Why would anyone wait? And I thought well, that sounds so eminently sensible. And that's the way it should be, right? One of the most interesting pilot projects I ever came across was an emergency room that just took out the chairs. They said we shouldn't have people waiting. Why should we have chairs in the emergency? I think we have to have more of that kind of thinking that we just don't accept these things that we see as normal.

AMT: Why didn't they have wait times in Spain?

ANDRE PICARD: Well, because they have sufficient resources, the system is more organized. You know the reason people are waiting in emergency very rarely has anything to do with the emergency. It has to do with the fact that there's no input into the hospital because the beds are full. The beds are full because there's a lack of home care. There's a lack of home care because there’s not enough long-term care. People go to emergency by default because they can't see their doctor within 24 hours. We have one of the worst rates of access in the world in Canada. In fact we have the single worst rate of being able to see a doctor promptly. So all these things make for a clogging of the emergency room that people need emergency care get it and they get it promptly, but there's all these other people there who shouldn't be there.

AMT: I love that you go to hospital emergency rooms on your vacation.

ANDRE PICARD: Yeah, it makes me sound a bit like a loser but there you go.

AMT: No, you’re a guy who really cares about what you do. I think it's wonderful. So where should we start making change? What can be tackled and tackled first?

ANDRE PICARD: Well, I think let's start by doing what we're already doing well and doing it more broadly. So take all these little projects and share them. You know one of the fundamental problems is we don't have a system. We have 14 different systems in the country. They don't really talk to each other. They don't learn from each other. One of the things I'm shocked about because I'm lucky enough to travel around the country a lot is people will say to me, they'll pitch me with these—oh, we've got this great new pilot project—we've got paramedics going into homes of seniors starting next year. And I say jeez, I wrote about that in Nova Scotia. It must have been 1980 something. And they go oh really? So it's the knowledge is out there but it's not being shared. I think that's a big one. I think we have to decide on priorities. We do a lot of firefighting in Canada. Lots of things are happening. They get into the newspaper headlines so we try and you know plug that dike or put out that fire and we don't try and fix the system more generally. So I think if we had priorities. To me the big priority would be fixing primary care. I think that's where it all begins and ends. People should be able to be treated promptly. They should be able to get preventive care and then they might not need a lot of those other services or at least we could delay their need for those services.

AMT: Now do we do that?

ANDRE PICARD: Well, we say that that's a priority and our system is haunted by its history, I think. So Medicare was created in 1950s and sixties at a time when we had a young healthy population. So we created a system for them. We had doctors who got paid per act, fee for service and then we had hospitals where you would go to have a baby or you would go to die. That’s what our system was created for and we still have that model and we don't have the same demographics. We have the reality today is when you go into the health care system, it's usually with a chronic illness and you don't ever come out. You just kind of weave your way throughout it for the rest of your life. So what that means is you need to be attached to—I think every Canadian should have a medical home that coordinates all their care. That could be a GP, it could be a nurse practitioner, it could be a clinic. And I'm not inventing this stuff. This is what exists in the rest of the developed world. But you're always attached to that medical home and they guide you through. In Canada, again I always stress we get good care. But once you move within the system, you tend to fall through the cracks all the bad things happen in transitions in Canada and it's because no one is there to coordinate the transitions.

AMT: And of course when things start ratcheting up in a need for health care, as well you've got navigating the system with you. You're kind of on your own.

ANDRE PICARD: Exactly and you know there's been stories recently about how people are now starting to hire professional and private navigators to help them out but that shouldn't be the case. That should be an integral part of delivering healthcare. We know that in Canada today if you don't have someone there by your side championing you, you're going to be in big trouble in the health system. You're going to get lost and you're going to get forgotten and that's really tragic because that tends to be elderly people, confused people, scared people. And they need really simple stuff. They need information. They need hand-holding. They need comfort. And that doesn't cost a lot of money but it just has to be made a priority.

AMT: And you know it depends on where you live too. You've really looked at Indigenous health care too. What are the concerns that you have? What are the issues that really need to be addressed in Indigenous health care?

ANDRE PICARD: Well, I think we should judge a country and a health system by how the most worse off people are treated and the worse off people in Canada are without question, people in remote Indigenous communities and we treat them terribly on every single level. So to me the big issue there is the social determinants of health. It sounds like a bureaucratic academic term but it's what really matters to people's health. It's their income, it's having housing, it's having an education, it's having a sense of belonging, cultural identity and these are all the things that we've destroyed in Indigenous communities. We've made them sick and I think we have an obligation—a moral obligation and a legal obligation—to help them get better. So that's my view on Indigenous health.

AMT: What do you see that has changed since you first started reporting on the state of Indigenous health care in Canada?

ANDRE PICARD: Well, I think there has been a lot of improvement. I think the biggest change is we're talking about it which is great. The other thing is I've learned over time is it's not a hopeless situation by any stretch of the imagination. There's a lot of really healthy Indigenous communities. I was just in Saskatchewan not too long ago—fabulously healthy communities, great community clinics, really engaged, speak their culture and language. And again it's an issue of scaling and sharing that. And I think one of the things that I take the greatest comfort in is I'm seeing that. I'm seeing that nation to nation talks with Indigenous groups sharing their best practices between provinces,between territories, et cetera. So I think again we have to focus on the worst of the worst and we hear about them in the news all the time, Attawapiskat, et cetera. And those are real problems but they're not typical. A lot of communities are doing well and we have to figure out why and learn from them.

AMT: I want to talk more about the social determinants of health. How seriously is the connection between social issues and health being taken now?

ANDRE PICARD: Well again, that's been a big change. We have, in Canada especially, we have a health minister, a federal health minister Jane Philpott, who really knows this issue inside out. And that again is refreshing. She speaks very eloquently about the limitations of medicine despite being a doctor. The importance of social belonging, the importance of income, the importance of education and housing and those things matter a thousand times more than medicine. Medicine is fixing things after they're broken. The social determinants is trying to keep people healthy, keep them from being broken. So I often talk about money. Money is the single most powerful drug we have in the world and it's really poorly prescribed. Some people have way too much of it and a lot of people have way too little of it. And you know we don't talk about things again because they sound dull and boring. But one of the most important things we can do to make people healthy is to make proper use of our health system to redistribute income properly, to use the taxation system to do things like that which again a lot of countries do much better than we do in Canada.

AMT: I want to talk a little bit more about money as a drug and let's talk drugs. Because we had some sound from the opioid crisis and of course we've seen other crises. We see what this is doing. What is it, 2,000 deaths last year to opioid overdoses. How far do you think the government needs to go in doing this? What's missing?

ANDRE PICARD: Well, I think what's missing is again you know I've been around a long time and this is just the latest crisis so it's opioids now. It was heroin before. It was crack babies before that, et cetera, et cetera. I think we have to step back and say what's not working? Well, what's not working is this war on drugs mentality, this notion that we can jail people into good health and we can’y do it. I have a libertarian streak in me about a half a mile wide and one of those things is I am a great believer in decriminalization of drugs and even legalization of many drugs because I think the evidence shows that where it's been done, you don't see increased use. What you see is less damage and less harm from drugs. We spend a lot more of our energy in Canada persecuting drug users than we do helping drug users. Right? And that's just an inefficient use of resources if nothing else, never mind the moral side of it. So I think if we take away a lot of this baggage about policing and jailing people who use drugs and treat them as—most people use drugs responsibly, let's face it. Whether it's alcohol or heroin, a lot of people use drugs responsibly. The vast majority, some have problems and those who have problems often have a sickness and we should treat it as such. And we should not jail them. You know I often use the analogy: if having breast cancer made you rob banks—say it had some side effect like that—do you think we’d build all these prisons to put women with breast cancer in prison? Of course not. We would treat the illness. And there actually are drugs. There are drugs for Parkinson's that cause you to gamble. Do we send those people to jail? Of course not. We treat them and we feel sympathy for them.

AMT: And then we work on the drugs. Yeah.

ANDRE PICARD: Yeah. Exactly. So you know I think we just have to change our attitudes about drug users.

AMT: And you make the point about criminalization of those who are addicted which brings me to the other issue that you also talk about, which is the criminalization of the mentally ill, that still in this country we don't really understand how to see a lot of mental illness as a health issue.

ANDRE PICARD: Well, one of the big tragedies in a wealthy country like Canada is that I don't know, 30 per cent of our prisons, maybe 40 per cent of our prisons are people who are pretty severely mentally ill. They're not getting care. They're getting worse in many circumstances. Who's most likely to end up in solitary confinement? Someone who is mentally ill who doesn't follow the rules. They get dramatically worse there. I think solitary confinement is torture. I don't think it should be allowed in any circumstances.

AMT: Well, in fact it's been labelled torture now, like officially right.

ANDRE PICARD: Absolutely.

AMT: Physically by the officials.

ANDRE PICARD: And especially when it's someone who's ill, their behaviour is not going to change. Again, why do we punish people for being sick I think is one of the recurring themes that I write about in my columns and I think it's unconscionable.

AMT: We just saw the suicide of a man with depression, with mental illness, which raises the whole question of medical assistance in dying and where all of that fits in. All of these things meshed together at some point.

ANDRE PICARD: Well, they do. They all have an ethical aspect. They all have a practical aspect. They all challenge us to think differently. That's what I like to write about. So the case of Adam Maier Clayton got a lot of attention of late. He was a young man with intractable mental illness who chose to kill himself because he couldn't get medically assisted death—a case that makes us profoundly uncomfortable and it should. But those are really the ones that challenge our beliefs and what we really believe in. So what I liked writing about that, why I liked writing about that is because it did challenge me to say, jeez, why is a 27-year-old killing himself? That just shouldn't happen. But do I really believe in what I believe in? Do I believe that people who can make rational decisions can make that choice to die? And I do, so even though it makes me uncomfortable, I have to defend that position. And in Canada we've kind of accepted death assisted death—ah well, he's 85, he's got cancer. It's okay. He’s going to be dead next week anyhow. But that's not what the law is and that's not what the theory is. The theory is if you don't have the will to live, if you are in intractable pain, you should be able to end that suffering. And again, it's these tough things. Another example with the mental health issue is one of the ones I've gotten the most hate mail about in my whole career is the case of Vince Li, the so-called Greyhound Bus Killer. So a man who's sick with schizophrenia goes on a bus and he decapitates and cannibalizes someone. And I write no, he shouldn't go to jail. He should go to the hospital and he should get better and when he gets better, he should be released which is what happened. That outrages people. You know we often think about mental health because it's invisible, you can't see it. Maybe they're faking, they're just using you.

AMT: We can will it away.

ANDRE PICARD: I don't know how many people told me Vince Li is just faking. That guy didn't fake it. He was gravely ill. Should there be conditions on his release? Perhaps, but let's talk about it in that way. Should there be conditions on anyone who's sick? Let's have the larger discussion rather than make it on a horrific case. But again, one of those ones that really challenges you: how do you defend this guy? It seems indefensible but I think if we have principles, if we have beliefs, then we have to stand up for them.

AMT: You know listening to you, you realize all roads lead to healthcare, don’t they?

ANDRE PICARD: And hell, yes. Those are very similar spellings, right?

AMT: Yeah. I’m wondering how many times—if you can even count—but I'm curious to know how you've grown not only as a journalist but as a person in covering these issues because as soon as we start talking about an issue as a journalist, you start to go deep. You start to find the concrete examples in the general, the very particular things in the general and the universal. And you're challenged by the way you think, like you have to think about how you think. And then you have to write. So what's that been like for you, that growth?

ANDRE PICARD: I have a great job. It's a fascinating job. I learn stuff every day. I think what I've learned over the years is to become pragmatic. You know we're all judgmental right, about everything we do every day. Look at that guy, what a bum on the street. Then I go jeez, I wrote about someone like that who used to own a corporation and he became an alcoholic and then he was jailed. Why was he jailed? I wonder what this guy's story is. And I think that's what doing this over the years makes you do. You think twice and you think differently about people. And if we could all do that, I think we'd have a healthier, much more generous, thoughtful society. You know before you say something insulting about Vince Li or the guy on the street or whatever, just sit for a moment and say imagine if that was my mom or my dad, would I have the same judgment? And I guess that's what writing about people like this over many, many years has forced me to do.

AMT: What scares you about health care in Canada?

ANDRE PICARD: I think to me that we continue to embrace the mythology of Medicare. Medicare is an insurance program. You know when people say oh, Medicare is what defines us as Canadians. That frightens me because I said I don't want to be defined by an insurance program. I want it to work just like you know the LLBO works. You can get your liquor when you need it. You should be able to get your health care when you need it. We have to look at it I think—it's almost heresy to say it—but in a more businesslike fashion and I'm not talking about profit making, I'm just talking about more rationally. What do we expect? When do we expect it? How are we going to pay for it? A lot of this nitty gritty stuff, we wrap up in this romantic “Oh, Tommy Douglas was a wonderful man.” Yes, he was a wonderful man. But the health system he created was wonderful in the 1960s. It's not wonderful today.

AMT: Well, you point out—we pay more in private health care than any developed country other than the US.

ANDRE PICARD: Yes. More than 30 per cent of our health care in Canada is paid privately.

AMT: So we don’t even notice that this money's coming out of our wallets.

ANDRE PICARD: Well, I think we know it but we're not sure why.

AMT: And we don't think we have the right to say we want something else.

ANDRE PICARD: Yeah because we think the important stuff is free. You know the doctors are free, the hospitals are free. That's true everywhere in the world except the only difference with Canada and all the European countries—where I think we should compare ourselves to because the US is an outlier—the difference is that they cover stuff much more broadly with the public system. So if you go to a country like France, your dental care is going to be covered, your long term care, your home care to about 80 per cent of everything, but you're going to pay supplements. You're going to have private insurance for about 20 per cent of everything including your doctor, including your hospital. And in Canada, we think oh my god, that would be the end of Medicare as we know it if we had any private element. But is it better to have 100 per cent hospital care covered and only 50 per cent of drugs and 30 per cent of home care or is it better to have 70 or 80 percent of everything covered? And to me if you look at the needs of the people, if you look at the demographics, the latter makes much more sense. We should cover virtually everything with public money and we should supplement it with private insurance or out of pocket, however we wish to do it. But we should have the discussion and have it rationally rather than say oh, this is the end of the world as we know it. You know I'm not a huge advocate of private care. I'm not an advocate for for-profit care but I'm an advocate of more rational use and distribution of the health care money that we have. Spend it smarter.

AMT: And that's why you try to prompt that discussion in your columns.

ANDRE PICARD: Yeah. And it doesn't make me a lot of fans.

AMT: Well, thank you for your work. Thank you for all of your work.

ANDRE PICARD: Well, thank you. Thank you for the interesting conversation.

AMT: Andre Picard, health columnist for the Globe and Mail. His new book is called Matters of Life and Death: Public Health Issues in Canada. That is our program for today. Stay with Radio One for q with host Tom Power. And a reminder you can listen live in any time zone, make playlists for later and catch up on all our stories with the free CBC Radio app. Tomorrow I'll be speaking with Don MacPherson. He is the executive director of the Canadian Drug Policy Coalition. He's been pushing for radical change in drug policy since the nineties when he started working in Vancouver's Downtown East Side. He is a disruptor for his ground-breaking work to change thinking about addiction, but he is watching the current opioid crisis knowing much more change is needed. Hear his ideas tomorrow. We're going to leave you today with a little bit of Don MacPherson. This is him speaking with his typical passion back in 2010. I'm Anna Maria Tremonti. Thanks for listening to The Current.

SOUNDCLIP

Restoring Vancouver's dignity is the name of my talk and it came to me as a title for this brief talk as I reflected on my involvement as a municipal official. My complicity, my powerlessness, ignorance, helplessness, anger, frustration, deceit and yes, the small victories in trying to change when I came to believe in senseless and dangerous policies that may injure, kill and cause a great deal of pain to members of our communities, their families and our society. These policies are the current policies governing illegal drugs in this country. Einstein's definition of insanity is exactly what we have been doing with our drug policies in Canada and it's precisely why over 2,000 people have died in Vancouver alone over the past 17 years of mostly preventable overdose deaths. And countless others have contracted HIV, Hep-C and other serious medical issues related to drug use.

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April 24, 2017 full episode transcript

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