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The Current Transcript for February 22, 2017

Host: Anna Maria Tremonti

STORIES FROM THIS EPISODE

Listen to the full episode

Prologue

[Music: Theme]

SOUNDCLIP

You saw some people die in the forest so we were really scared. So we just laid down and we prayed to God because we don’t know where we are going.

ANNA MARIA TREMONTI: He's an asylum seeker from Ghana risking everything with his young family on a circuitous route into South America and then up to Mexico. The plan is to get into the US, but the goal is to reach Canada. As the US toughens its immigration policies, those desperate for a better life are looking to Canada. And many are gathering in Mexico with a plan to travel north and over the Quebec and Manitoba borders. In just a moment, Evan Dyer in Mexico meets those would-be asylum seekers. Also today—

SOUNDCLIP

Hey. I am a miracle. I mean, I don't mean that like personally I’m a miracle. I just think that like the fact that I'm still alive is a miracle.

AMT: She has incurable cancer but by sequencing its genome, her doctors found a mutation they could block with a simple drug for blood pressure. And then they watched her tumours shrink. It will not work for everyone but the trial under way at the BC Cancer Agency to sequence the genomes of individual cancers is offering new information on how cancer treatment may be evolving. Hear from the doctor leading the clinical work on this idea in half an hour. And then could this be you?

SOUNDCLIP

VOICE 1: Do you exercise or play sports?

VOICE 2: I do the elliptical 45 minutes four times a week. Thirty minutes three times a week. There is a cluster of elliptical machines at my gym. I'm planning on joining a gym near my house. Okay?

AMT: Avoiding fitness machines? Well, no wonder when you consider the treadmill. Two-hundred years old this year, it was originally designed to punish prisoners. And in the places where people live the longest, no one goes to the gym. In an hour, our season-long project, The Disruptors, re-imagines fitness. I'm Anna Maria Tremonti. This is The Current.

'Canadians will welcome you': Refugees begin long trek north via Mexico

Guests: Evan Dyer

SOUNDCLIP

I'm establishing new vetting measures to keep radical Islamic terrorists out of the United States of America. We don't want them here. We want to ensure that we are not admitting into our country the very threats are soldiers fighting overseas.

AMT: US President Donald Trump has made his plan for immigration and refugee policy very clear since he came to power, starting with his visa ban last month, followed by his directive to Homeland Security yesterday to find arrest and deport those in the country illegally, regardless of whether they have committed a serious crime. In Canada, there is a very different narrative. Prime Minister Justin Trudeau has spoken out around the world, paraphrasing the tweet he sent out when the US ban was first announced, saying, “To those fleeing persecution, terror and war, Canadians will welcome you.” Asylum seekers are acting on Mr. Trudeau's words as people who may have once sought refuge in the United States now head further north trying to cross the Canadian border at Manitoba and Quebec. In question period yesterday, NDP MP Jenny Kwan argued the Canadian government is unprepared.

SOUNDCLIP

Many refugees are crossing the border illegally, risking life and limb because they have no other options. Clearly the Conservatives have no plan. And while the Liberals sound welcoming, they have implemented absolutely zero measures to address the situation. Things will only get worse. So will this prime minister finally act? And will he suspend the unfair agreement and support border communities and help those desperate refugees?

AMT: Well, today the Associated Press is reporting that Mexico now fears deportee and refugee camps will be created along their US border. Evan Dyer has been tracing the steps of the asylum seekers who are going through Mexico on their way to Canada and he joins us from Mexico City. Hello, Evan.

EVAN DYER: Hi, Anna Maria.

AMT: Gee, things keep changing. There's so much in the news now since this Homeland Security directive. What's the perspective from where you are?

EVAN DYER: Well, I think the Mexicans would say that they have been cooperating with the United States with regards to all those non-Mexican migrants who are now the main group of people crossing the border. The biggest single group is Central Americans. There’s more of them crossing the Mexican border into the US than Mexicans. In fact, the net flow of Mexicans has been out of the US back to Mexico for several years. And in practice, Mexico’s been acting as a sort of a border policeman for the USA on its southern border. Just a couple of days ago, I saw Mexican migration authorities stopping minivans and pulling Central Americans out of them and taking them into detention. And they do that at the rate of over 10,000 a month and that is part of a program with the US. So if the US were to simply start pushing all of those Mexicans back into Mexico, I think the first question would have to be would the Mexicans accept them? I think that under the current circumstances where there's a lot of anger in Mexico against the Trump administration, that's very unlikely and that would either have to be sweetened with a great deal of money—I would think for Mexico or some other concession—or you could even see those people just ending up living in a sort of a no man's land between the two countries where the Americans simply kick them out and the Mexicans won't let them back in.

AMT: And along with people coming up from Central America then, of course you are meeting now people coming from African countries. Tell us who you're meeting.

EVAN DYER: That's right. Because this is an old route but we're seeing a lot of new kinds of people on it. So we had heard that there were African refugees using this route and specifically we heard about Somali refugees stuck in Mexico unable to travel into the US because of the ban on their country and six other countries. They wanted to use the US only as a transit country to come to Canada. We heard a lot of people saying things about Canada as their destination. Things like this.

SOUNDCLIP

We will be a success story. That's 100 per cent I’m sure, if they will give us the opportunity for the resettlement of refugees in Canada.

EVAN DYER: So that’s Abdikadir Ahmed Omar who is from Somalia—southern Somalia—Kismayo and I met him here in Mexico City where he's essentially stranded now with a group of other refugees. Right now they're in a sort of a low rent hotel but they've slept in garages and everywhere else and they’re basically trying to plan the next move.

AMT: How did he get to Mexico City from Somalia?

EVAN DYER: Well, he left, fled overland from Somalia to Kenya and then from Nairobi, Kenya’s capital, he flew to the little country of Togo in West Africa which gave him a 30-day visa but doesn't accept asylum claims. And then from there, he took a flight to Brazil which allows Somalis to enter without a visa. That's a critical point for them. From Brazil, he then made a trek across nine countries through South and Central America. It took him three months and that's a journey that many people make. Not just Abdikadir.

AMT: Hmm. That's incredible. Before you tell me more about that journey though, tell me a little bit more about him. Why did he leave Somalia in the first place?

EVAN DYER: Well, he was targeted by al-Shabaab, the jihadi group that's linked to al-Qaeda, which accused him of being an infidel because he worked as an interpreter and as sort of a fixer for foreign infidel organizations. And so his house was raided by two men who sprayed it with bullets. He escaped and he immediately went to see. He has good contacts in his country. He's somebody who's worked a lot with the government. He went to see what they could do to protect them. Let's listen to what happened.

SOUNDCLIP

And I go to the police commissioner. Alright? I report there, saying that you know people who raided my house like that and I need a certain kind of protection. And they say, my former head of security guy was being killed by Shabaab and he was having all that kind of [unintelligible]. If Shabaad want to kill you, they would kill you. And he said I'm cannot protect you. So if the government itself cannot secure themselves, they cannot secure me. So the only option for me was to leave.

EVAN DYER: So this led him to flee to Kenya and in fact Al-Shabaab is also in Kenya because of the large Somali population there.

AMT: What about his family? What's happened to them?

EVAN DYER: Most of these migrants are male because they've mostly left behind wives and children. He left behind a wife and two children because this journey, he just didn't want to expose them to the rigours of this journey. But in all of the cases, these people want to reach their target country, make a claim, get accepted and at that point, bring them back over with them and reunite the family. He is in contact with her but he doesn't tell her a lot about what's happening because he just doesn't want her to worry. He says I'm safe and he says at the end of the day, what can she do to help anyway?

AMT: So how typical is Abdikadir’s story? How many other refugees are in Mexico trying to make their way to Canada?

EVAN DYER: Well, many thousands, it's safe to say. I mean we've spoken with dozens of refugees and migrants here. We spoke with them also at the southern border coming in from Guatemala. We've met people from Somalia, Ghana, from India, from Bangladesh, from Nepal, Yemen.

AMT: And they're all heading for Canada.

EVAN DYER: Well, some of them began with Canada as their target destination but a lot of others actually were going to the more traditional destination, which is the US, but heard about the Trump ban on the way. And even if they weren't on the list of seven countries, you know they heard that refugee acceptance numbers in the US were being cut by more than 50 per cent. They heard that they were going to be more deportations and it was at that point that some of them reassessed where they wanted to go to. And at the same time of course, there's a pull factor from Canada because they're getting that message from the Canadian government that it is open to refugees—a very different message from the one from the US. So you have a mix of people who always wanted Canada and a mix of people who are just changing their minds on the road.

AMT: Well, as you pointed out, we have seen people coming up from South America and Central America crossing into Mexico to get to the US and then move. But the movement from Africa and South Asia, this is new, huh?

EVAN DYER: Mhm. It is. And in the past, migrants would have probably tried to find refuge closer to home and we saw a lot of African migrants of course crossing the Mediterranean. But that route has become increasingly dangerous, not only because of all the drownings but also because the more the boats are interdicted and turned around as well. But also because people are very afraid to cross Libya which is the point of departure and migrants are treated very poorly in Libya. Often they're kidnapped by militias and held for ransom. So people are avoiding that. The people who can afford to fly to the Americas will do so and we're typically seeing with the kind of refugees who do have the money to make that kind of a jump across the Atlantic, these are not terribly poor people in their country. They are typically middle-class and up. And the critical factor for them is that you can land in several American countries like Brazil, Ecuador, Bolivia, without a visa and so they're able to get that toehold on the American continent in a way they can't in Europe and then that allows them to do the rest overland.

AMT: Okay. Well, talk to me a little bit about that route overland. How did they get there? Where do they go?

EVAN DYER: Well, usually it starts in Brazil, although there are a few other countries as well and Abdikadir, in his case for example, he landed in Brazil—often they land in Sao Paolo—and then they travelled by foot or bus, boat in some cases, by train. Sometimes they take short flights, two domestic flights typically, and they from Brazil cross right across the continent to the Pacific side, Peru, and then they come up through Ecuador, Colombia. They cross onto Central America and come through Panama, Costa Rica, Nicaragua, Honduras, Guatemala. Finally they cross the river that separates Guatemala into Mexico. That journey typically takes them between three, five months something like that and it costs a lot of money.

AMT: Such a circuitous route. Okay. You're making the point that instead of going to Europe, they can't go through Libya. They can't get to Europe. What else is going on? Are there traffickers involved here?

EVAN DYER: Absolutely. I mean most of the money that that people pay for this journey goes to traffickers and there are traffickers in all of the countries on these routes now. Even though some of these borders are actually fairly easy to cross—you can just walk across them really—a lot of the migrants don't know that and they assume that they have to be smuggled. And so of course because they are so visible too, they are often identified by traffickers who contact them. Some of these traffickers do what you know they say they're going to do and others don't. Others are very exploitative and they cost people many thousands of dollars. We've heard of people paying between 4,000 is about a minimum for the overland journey, up to 12,000 to get here.

AMT: Well, you've got another piece of tape. Let's hear a little bit more about Abdikadir Ahmed Omar’s journey.

SOUNDCLIP

Nicaragua, there’s smugglers who will cross you across there. Then they arrange for you a boat. The boat will take you a certain distance then they will take you with the kind of close to the border of Honduras. But most of them, they are liars. They just take you to halfway. They will rob you and then they will take you to the police and the police would take you back to Costa Rica. So it’s like you know, start from zero again.

AMT: So he was robbed by the people who were smuggling him.

EVAN DYER: Yes. And that is not unusual in any human smuggling operation. But he actually considers himself lucky because he was robbed. He lost his belongings but for many people that we've met, the scam is to take them across Nicaragua, turn them over to authorities and then send them back to square one, which is the southern border of Nicaragua with Costa Rica. That way, you get them to pay the smuggling fee again. In some cases, they rob them of everything they have. They send them back to the southern border of Nicaragua and then those people have to try to get money wired from relatives all around the world to pay the fee again because they've lost everything to that robbery. And Nicaragua's in fact that one of the toughest countries for people to cross because the Sandinista government there—the socialist government of Nicaragua—is the only one on this migratory route that won't give people transit papers. And the government in Nicaragua hunts migrants and so they consider it—although it's not far from being the most dangerous country in Central America—for the migrants, it really is.

AMT: It really underlines the fact that they are really in uncharted territory. They don't know where they are. It's so perilous.

EVAN DYER: Absolutely. I mean you know Honduras, one of the countries they have to cross and El Salvador, another one. These countries have the highest murder rates in the world. They are number one and number two. So you know there's a great human danger. They also have to cross through some real natural hazards. And one of them is the Darién Gap. This is a sort of a roadless area at the southern end of the Central American [unintelligible]. So crossing from Colombia into Panama and it's jungly, it's extremely mountainous and there's about a five to seven day trek—basically depending on how fit you are—that has people report walking past dead bodies because people starve. People fall off the mountains. People drown. We met a young man and a woman from Ghana who, unlike most of these migrants, had a child with them, actually a seven-month baby and they were trekking through the Darien Gap but they couldn't keep up with the other group because of the baby. And so the smugglers abandoned them without any food, without any water. This man wanted to remain anonymous. But let's listen to what he had to say about that experience.

SOUNDCLIP

In the forest, me and my kid and my wife. We are almost 30 people. But they don't have babies so they walk fast. And me and my baby and my wife, we can’t do that. So the next three days, me and my wife, they left us. So we are behind in the forest. So we sleep at night with my wife. So when we continued our journey the next day, we saw some people dying in the forest. So we were really, really scared. So we just laid down and we prayed to God because we don't know where we are going because you can lose your life or you can win. So I hold my wife and we give our life to Christ and we say we don't know.

EVAN DYER: So that is a very typical experience in the Darien Gap. Many people pointed to the scars on their hands and legs from crossing. Actually I saw one man who showed me where he'd lost a toe crossing through there and a lot of people were scarred by their experience of passing through that area, especially the younger ones.

AMT: It sounds terrifying. Why are they looking to do all of this and then come to Canada?

EVAN DYER: Well, Justin Trudeau's message which you played there, sort of what we talked about off in the introduction, has been heard around the world and they're very aware of Justin Trudeau. All of the migrants we spoke to have heard about this. There's also another person that most of them have heard about too, who's Ahmed Hussen, and a lot of the Somalis, in particularly Africans generally but Somalis especially, are really inspired by this idea that someone who used to be a refugee, a Somali refugee like them, is now the minister of immigration. But they've all heard of what's going on in Canada and Abdikadir for example, told us that he follows Justin Trudeau. Let's listen to what he had to say about that.

SOUNDCLIP

I follow him on Twitter, Facebook, YouTube. Like when he was teaching Donald Trump that there is a good side of the refugees and he doesn't compromise the security of Canada. At the same time, they have a policy and system in place. And one of the things that he’s very proud of, like the refugees who come in Canada, are part of right now on the top ministers in Canada—Mr. Ahmed. It’s a kind of of a success story where the refugees are not bad but it can be something positive. And he is the outcome of that kind of success story of immigration in Canada or the refugee system in Canada.

AMT: That's quite incredible, huh? Follows him on Twitter, knows about, yeah. So we know there are migrants crossing the Canadian border on foot at Manitoba and Quebec. We know many are suffering from frostbite. Do they understand how difficult the journey will continue to be once they do make their way north?

EVAN DYER: You know I think they do. I mean one Somali migrant actually said to me, I've heard it can be zero degrees there and I had to say to him no, look again, it’s more like minus 30. So to some extent, most of these people have never seen snow so they don't know. But then when you put it in the context of the dangers that they've already faced, the Canadian border actually is a lesser danger to them in the sense that they're not going to be robbed. They’re not going to be killed. If they dress warm, they feel they can probably make it. Here's what another Somali man told me about that.

SOUNDCLIP

VOICE 1: I would just take the risk because I don't have any other option. I either die or survive. Those are the two options I have and I'm ready to do that for the sake of my parents and my wife.

VOICE 2: You know you can freeze to death, right?

VOICE 1: Absolutely. But what my parents do for me when I was young is greater than what I’m doing for them now.

EVAN DYER: So that was the voice of the Somalis I met here in Mexico city. Guled Abdi Omar is his name. He’s 27 years old. He's a thin Somali guy who grew up in Dadaab, you know the largest refugee camp in the world in Kenya. He spent all of his life there from age two and he learned English there from the UN, became an interpreter for the UN actually. His family is all over the world. He's the middle brother of three. His parents are back in Somalia. His eldest brother escaped Somalia, made it to Australia some years ago after a terrible journey and told him don't follow me. Whatever you do, don't repeat what I did. The youngest was killed in Somalia. He's the middle brother and he's made this journey.

AMT: How much do you think the Canadian government is responsible for the situation we're seeing then, where you are?

EVAN DYER: Well, I mean you know when we were talking earlier about Justin Trudeau's tweets, I think you have to say that it's one thing to send out that kind of a message when you have the geography of a country like Canada and it's another thing to put out that kind of a message if you are for example in Central Europe and if you're in Italy, if you're in Austria, if people from the Middle East can basically just walk to your country. I mean Canada has two borders and both of them are with the United States and that puts it in a very privileged position of being able to more or less select who comes as a refugee in most cases. A lot of countries have not had that luxury and Canadian politicians, when they put out this message, they're not just talking to a domestic audience. That message is being heard in refugee camps. It's being heard by refugees who are already on the move. And a lot of them when they hear that message are going to make a beeline for Canada. They’ll put themselves in very dangerous situations to reach Canada. And I think when we look at the situation at the border in Manitoba, in Quebec, what we're seeing is that Canada’s sort of geographical immunity is fading away. Migrants are traveling further around the world. They're using new routes and that Canada no longer has the luxury to just put out that message and think people aren't going to act on it.

AMT: Evan Dyer, thank you.

EVAN DYER: Thanks, Anna Maria.

AMT: CBC reporter Evan Dyer reporting from Mexico City. Well, let us know what you think. There’s some compelling voices there. You hear what Evan is saying about what he's learning from the plans that people have. You can tweet us. We are @thecurrentCBC. Find us on Facebook or go to our website, www.cbc.ca/thecurrent, and click on the contact link. And stay with us. The CBC News is next and then a unique clinical trial in Vancouver has some hopeful that the future of cancer treatment lies in the genome. I'm Anna Maria Tremonti. This is The Current.

Clinical trial aims to crack cancer code using genome sequencing

Guests: Dr. Janessa Laskin

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

[Music: Theme]

AMT: Still to come, if you hate the gym don't sweat it. History helps explain why time on the treadmill can feel like torture.

SOUNDCLIP

The idea of hard labour was that it should punish the prisoners’ hearts and souls. It was thought that something pointless should be done. An inventor called William Cubitt came up with his idea of the treadmill and it became something that people were sentenced to.

AMT: How the treadmill and the gym have disrupted our approach to health and fitness. That's in half an hour. But first, new Canadian research that could help crack cancer.

SOUNDCLIP

You know the whole thing for me has been a rollercoaster. I had a baby and there was so much joy. And then 10 months later, I had breast cancer and everything changed.

AMT: Zuri Scrivens, who you just heard there, is 39 years old. Six years ago, she was diagnosed with breast cancer. She had a mastectomy, underwent chemotherapy and radiation. And at first she thought the treatment was successful. It was successful at first. Less than a year later however, the cancer returned in her liver and lymph nodes. That's when Zuri Scrivens joined an experimental clinical trial, a trial called POG, which stands for Personalized Onco-Genomics. It's a trial that maps the genome of patients with incurable stage for cancer to gather information and to see if there are personal lives treatments that may help. For some people—a small number at this point—the help is extraordinary. For Zuri Scrivens, five months after entering this clinical trial and taking a drug normally used for diabetes, scans revealed she no longer showed signs of cancer.

SOUNDCLIP

It still shocks me. Even though I've had three scans over the course of two and a half years, I’m still a bit surprised.

AMT: Well, Zuri Scrivens has been called a “super responder” and not all patients have had such dramatic results. Still, initial findings were so promising that the trial has expanded from 30 patients in 2012 to more than 750 to date. POG is the subject of a documentary that airs tomorrow night on CBC Television, The Nature of Things. Dr. Janessa Laskin and her work are featured in this program. Dr. Laskin is a medical oncologist at the BC Cancer Agency. She's also the clinical leader of POG and she's in Vancouver. Hello.

JANESSA LASKIN: Good morning.

AMT: How did you hit on this idea of using genetics to treat cancer?

JANESSA LASKIN: Well, it's a long story. I had a patient back in 2009 and he had a complicated rare kind of cancer. And I was going to give him standard chemotherapy. As a medical oncologist, that's what we do. We are chemotherapy doctors. And he challenged me to use more in-depth biology to guide my treatment decisions. And he was aware of the new technology in genome sequencing and really launched that collaboration. But it took us a while to actually get this trial together for a variety of reasons, both technical and financial. It's a complicated thing to do to people.

AMT: So when we talk about personalized onco-genomics, what does it mean?

JANESSA LASKIN: Well, it's basically an in-depth probing of the set of instructions that tells a cell how to behave. So we all inherit genes from our parents and this is the DNA of the cell and they tell a cell how to behave. Your liver cell, you should do this or that. But in cancers, we know that that something's gone wrong with those set of instructions. We can understand cancers better by understanding where has this set of instructions disrupted the cell’s growth and what does that mean for the cell? And so this is where they the question comes in for each individual person: if we can look at how that set of instructions have gone wrong for that person, can we understand how to treat them better?

AMT: So when you do the genome sequence of a stage four cancer patient, are you doing the genome of the cancer or you’re doing their DNA and like the cancer? You’re doing both?

JANESSA LASKIN: Yeah. That’s a great question. When we look at a cancer cell, we need to know how it's gone wrong in comparison to the person's own normal set of instructions. And so it's not enough to compare it to a reference, some unknown genome. We need to compare it to this specific person. So yes, we do the DNA of their normal body cells that they inherited from their parents and we compare the DNA to their cancer cells and then we also look at the RNA of the cancer cells. And so that takes it a step further. The RNA is really what the cell does with that set of instructions. And so sometimes we see abnormalities in the DNA that we don't see in the RNA. And even more important is when we see abnormalities in the RNA that you don't really predict from the DNA, so the RNA itself gives us a lot more information to work with.

AMT: And what do you do with the information you gather?

JANESSA LASKIN: We put it into huge computers and there's a lot of computing power that goes with this but we subtract out the abnormalities comparing the cancer DNA to the normal DNA and then we look at what's left and we say what in here has been associated with cancer before in the literature? So it's a lot of looking into the literature. And with that set of abnormalities, we draw these cancer pathways for each individual person. So we can map out ah, this is where this person's cancer has gone wrong. This is what's driving this cancer and we correlate all of that data with the RNA as well and then with the clinical picture of the person.

AMT: Hmm. And who are the people in this clinical trial?

JANESSA LASKIN: Well, at the moment these people are both pediatric cases of incurable cancers, plus adult patients from British Columbia and we're looking at all different tumour types and really trying to characterize what metastatic cancers look like.

AMT: And how do you determine the treatment options when you have the genetic information?

JANESSA LASKIN: So we have some phenomenally smart, what we call genome analysts or bioinformaticians. And so they take the abnormalities that come out of the computer and they draw these pathways and they then match these abnormalities to the known mechanism of action from a drug database so we sort of correlate these things and then they produce a report for us and then we try to think about whether we can use that information to make treatment decisions for a person.

AMT: Okay. So you literally then start like scouring the medical knowledge to see what drugs are out there?

JANESSA LASKIN: That's exactly right. You know there are some computer programs or natural learning software processing programs that say they can read the medical literature. But I would not as an oncologist or a person, I would not trust at this point something that spit out of a computer to tell me what potentially poisonous drug to give to a patient of mine. So I really rely on the knowledge and intelligent putting together of these pathways to match that up to known literature. I think that the human element to this does add some complexity. It makes the analysis a lot longer but it also increases our confidence in the data that's produced and our willingness to try a drug on a patient.

AMT: Okay. Well, let's talk about one of the success stories. We heard about Zuri Scrivens in our introduction. What did mapping her genome tell you about her cancer?

JANESSA LASKIN: Well, Zuri’s case is a good example of what we what we look for, which is something we would call an outlier. So there was a particular protein in Zuri’s cancer that was very, very high—higher than anybody had ever mapped this kind of protein before in cancers. And when you look through the literature, it could potentially in theory be blocked by metformin, which is a diabetic drug. And so we thought we would try it. Now it is given in combination with a standard hormone treatment and that's sometimes the tricky thing about POG, is that we're often using standard treatments sometimes in combination with something a bit more experimental.

AMT: So you see that there's something that could be blocked by a diabetic drug and so she got the drug. What happened?

JANESSA LASKIN: Well, her cancer disappeared on all of our ways of imaging cancer and it stayed away now I think we're almost at five years. You know the question is could that have happened with hormones anyway? And that's always the question when you're talking about personalized medicine, what would have happened if you gave somebody standard treatment? And of course when you're talking about an individual person, we don't know. But on average, people who have metastatic cancer do not respond to hormones alone for this long. And so we think that the metformin has something to do with it. But we're not at all saying that metformin is good for everybody. That's the thing about personalized medicine is that this is the only person we've predicted—out of 550 or so—that metformin would be a good drug for. This is the tricky part when you're applying this data.

AMT: So that kind of success, it surprised you too though, when you saw the scans.

JANESSA LASKIN: Absolutely. We were delighted. And you know but it's not just about Zuri. It goes beyond Zuri or any of the other cases that you'll see in the documentary. We take that information and we're delighted that it helped this individual. But more important for us is to use POG as a catalyst to say how do we find other people like Zuri and maybe they don't have breast cancer, maybe they have a different kind of cancer. How do we use our experience with Zuri to go forward and find other people like this that we can help?

AMT: How common is the kind of success among the patients seen in the trial?

JANESSA LASKIN: Well, I would say the minority of people have had such profound responses. On the other hand, we've only been open for a few years so sometimes people are still responding. We don't know how long that will happen for. The majority of patients respond for a period of time and then their cancer grows. We are talking about aggressive metastatic cancers here. We don't hit a home run in everybody.

AMT: I want to talk about another patient and I have a clip. This is Marcy Johnson at one of her appointments with you.

SOUNDCLIP

VOICE 1: Wouldn't it be great to be one of those miracle stories? There's something out there that is going to cure me. And if there is, Janessa’s going to find it. I signed the waivers. Clinical trials, whatever she's got, make me a Janessa Laskin little guinea pig because I'm here to fight the battle.

VOICE 2: Hey Marcy. Nice to see you.

VOICE 1: Nice to see you again.

VOICE 2: That’s a huge improvement. Yeah. Yeah.

VOICE 1: Yay.

VOICE 2: Those pills are doing something.

VOICE 1: Those pills are doing something.

VOICE 2: And honestly, I don't think it gets any better than this, which is that we've done a test, we found a drug. The drug is helping you. That's pretty good.

VOICE 1: I'm sending you an invitation to my 65^th birthday party.

VOICE 2: That’s a deal

VOICE 1: 2020.

VOICE 2: Okay.

AMT: What happened with Marcy?

JANESSA LASKIN: Well, that clip was from the beginning and she did have initially tolerated the drug really well and then started to get more side effects. The cancer did respond dramatically and her pain went away and she felt a lot better. And then after a few months, it started to slowly come back and then I think it was about six months later. So it was clearly back. So we managed to interrupt this aggressive metastatic lung cancer for a period of time. I think that that period of time was successful. I wish it had been longer. I can't explain why it wasn't longer. But most cancers will become resistant to treatment even if it's good treatment.

AMT: Marcy died in October, huh?

JANESSA LASKIN: She did.

AMT: But she says there she felt that this was a worthy thing to try.

JANESSA LASKIN: I think you'll see in the documentary, even when the drugs don't actually help people, there is hope. And as an oncologist, we really try to balance giving people hope with the reality of what they're what they're dealing with and people with metastatic cancers do tend to die after a period of time. You know I don't think POG is telling people that we're going to cure them. On the other hand, people need hope and that is important.

AMT: Well, let's hear from another patient. This is Karl.

SOUNDCLIP

So they put me on a pill that was originally designed to lower blood pressure—which it did marvellously— but it did nothing for my cancer. On one level, of course I'm disappointed. You know. I wanted them to wave their magic wand and make the cancer disappear. That didn't work. You know that didn't happen. But at the same time, I'm realistic enough to realize that this is an experimental program and not everything they try is going to be successful. I just happened to be one of the ones that were not successful.

AMT: Janessa Laskin, parts of this film are hard to watch because patients are hanging on to the hope of something that may or may not work and they know that. But I wonder what that is like for you.

JANESSA LASKIN: Well, that's the life of a medical oncologist. I think that we also have hope and doing this kind of research is helpful to a lot of us to feel like things are changing, things are getting better. We are there at arguably the most desperate time in patients’ lives and we need some hope too. And I think research is how we find that.

AMT: So what happens in cases like Karl’s? The drug you thought might work actually doesn't work.

JANESSA LASKIN: Everything is a learning opportunity for us. So even the patients where we sequence them and we can't actually find something to target, we are still learning a huge amount about metastatic and advanced cancers and that is one of the main goals of POG, is to characterize complicated metastatic cancers. You know sometimes we find drugs that work, sometimes we don't. Sometimes the drugs that we postulate might work, we think might work, they don't work and we're still learning. And part of what we're understanding about cancer now is that the way we've defined cancers has been in a kind of an anatomical silo, if you will. This is a lung cancer or breast cancer. That's where it started from. But sometimes there's more biologically in common across cancer types than within cancer types. In fact, in Marcy's particular case, we found that exact same mutation in a breast cancer case and gave that person with breast cancer the same drug that Marcy had. And so we're learning about how mutations or abnormalities can be spread across different tumour types and that's really important for us in terms of repurposing drugs.

AMT: I want to talk about another patient. Jen Strack from Chilliwack was in her forties when she was diagnosed with lung cancer. What made her case so important to your research?

JANESSA LASKIN: What made Jen’s case so important was of course the fact that Jen herself responded and had an excellent quality of life for a year that I don't think she would have otherwise had. But again, Jen’s case is something that we use to catalyze future research. So the abnormality that we found in Jen's situation was two genes that were fused together that should have never been next to each other. And then we hypothesized, we had this theory that if we could block that, maybe we could slow her cancer down. And that's in fact what happened. So when we saw this exact same mutation in a patient with cancer of the gallbladder, we tried this again and it worked again for six or eight months, not forever. But we were able to use a drug in a type of cancer that we never would have tried this drug in and now our big question is how do we find these mutations in other people? How do we expand our collaborations internationally to say hey, this mutation can be targeted? Everybody should be looking for it. And that's I think one of the main strengths of POG.

AMT: What happened to Jen?

JANESSA LASKIN: Well, Jen's cancer did eventually become resistant to this blockade. It's like when you know when there's a roadblock, eventually people find their way around it. And that's the same thing that cancer does. You block one way, eventually it evades that blockade and that's what happened to Jen and it did spread into her brain. And I tried some other treatments but she died of actually complications of the cancer and an infection which is often what people with cancer die of.

AMT: But you managed to prolong it with this treatment. Her life was prolonged longer than initially thought.

JANESSA LASKIN: I think when I initially started the experimental treatment with Jen, I don't think she had very much more time and she certainly was quite symptomatic and within a few weeks of starting it, she had quite a dramatic improvement and she had a year where she felt really well and you'll see that in the film. She looks great and she was feeling well. So we gave her some time. We didn't give her enough time. We never give people enough time. But we gave her some time with quality. And if we can do that for more patients, then this is all worth it.

AMT: It's not a small thing to buy time when someone has a diagnosis of an incurable cancer though.

JANESSA LASKIN: Absolutely. Time and quality time is critical. You know this is the allure of targeted therapy. We know when we give a targeted treatment to a patient with that target and they match up together and the treatment works, we can buy people years. So Jen had another anniversary, another birthday. She got to spend time with her family. That is so worth it.

AMT: And so ultimately, what do you hope comes out of your trial?

JANESSA LASKIN: Well, we have two main goals. One important goal is the characterization of metastatic cancers. So if you think about what we're doing—we're sequencing the DNA of cells—it's an amazing technological feat. I mean it was only about 17 years ago that the first human genome was sequenced and arguably it cost a billion dollars and took 10 years and was a very complicated process and now we can do it in a couple of weeks. This is a phenomenal accomplishment. And there are about 16,000 cancers that have been sequenced in the world and those are mostly primary cancers, sort of surgically resected, untreated small cancers. And so the information from those primary cancers is important. But we know that that metastatic cancers are different. They're more aggressive. There's something different about them. And so we're cataloguing and trying to characterize metastatic cancers. And so we now have the largest collection of sequenced metastatic cancers—it’s about 500 or so—and we can see that there are significant differences when we compare primary untreated cancers to these more complicated metastatic cancers. So the dream is we have characterized, let's say 100,000 metastatic cancers, what would that tell us about drug development? How would we re-characterize all cancers? That would revolutionize our approach to cancer. So it's an ambitious goal to think about 100,000 cancers but we've got to start somewhere. So this is one of the main goals of POG, is to look at metastatic cancers.

AMT: And would this lead to wider scale genetic testing of cancer patients?

JANESSA LASKIN: It's part of routine standard of care in most countries that cancer patients will get a biopsy and some number of targeted gene tests will be done to match them up to known therapies. So we already do that as part of standard of care, but POG takes that considerably further in a much more experimental realm. So I don't think POG will be integrated as the new standard test. POG is more of an innovation discovery program but we can use the information to feed standard of care.

AMT: Okay. And so that the number of cases that you have, all the data you're collecting now, you're getting to the point where you have more than most institutions looking at this anywhere in the world then.

JANESSA LASKIN: Absolutely. We have a resource under the BC Cancer Agency called the Genome Sciences Centre and this is under the direction of Dr. Marco Marra. He's my co-lead in this project and their mandate is to sequence cancers and there's really not another centre in the world that has their expertise or their capacity. So we are making use of this phenomenal resource here in our backyard in Vancouver and we do have the largest collection of metastatic fully sequenced cancers.

AMT: You know I'm really struck by the fact that you got on this path because of one patient who, like you discussed this and then you do the genome sequencing of that cancer and it turns into all of this.

JANESSA LASKIN: Well, isn't it the Dalai Lama who said if you don't think one person can change the world, then spend the night with a mosquito? [laughs] I think that you know one person can challenge the way that you think and this particular case coincided with a technological advance that made this thinking possible.

AMT: But it's so extraordinary and it makes me want to say who are you? Like you're doing this incredible work. But what was it that drove you into medical oncology?

JANESSA LASKIN: Medical ecology is an incredibly interesting field. There's so much complexity. And you're able to interact with people at such a critical time in their lives. And I think even if you don't have a good treatment for them, you can help guide or usher them through this difficult journey in a way that positively affects their lives. And I think that's a very powerful thing and a very privileged position to be in. I think that it's an incredibly rewarding job and it is very challenging. I think you see people day to day that are struggling for their lives. And I think as Zuri said, it even makes all of us feel like things are a little brighter in the world.

AMT: In the film, you say that you hope to make cancer a chronic disease with tolerable treatment.

JANESSA LASKIN: That is what I hope.

AMT: That would really be something, huh?

JANESSA LASKIN: Well, if you look at examples from targeted treatments that are already in practice, we know that we can do that and I think that's about buying quality time. Of course I want to say that we're going to cure cancer, but I don't imagine that that will happen in my lifetime or my career. I would love to be wrong about that. But I also have to balance that realism and I think that hoping that we can make this a tolerable chronic disease like so many other chronic diseases that we can't cure—diabetes, high blood pressure, heart disease. Those are not diseases we can cure but arguably patients can live with them and I think that that's a valuable goal.

AMT: It's really interesting to be able to see the kind of work you do. You are one of our unsung heroes. Thank you so much for talking to me and for your work.

JANESSA LASKIN: Thank you very much. Really I think it's our patients that are our unsung heroes. They make this project possible. They make this work possible and you can see their altruism shining through in their desire and hope to help not just themselves, but everybody.

AMT: Janessa Laskin, thank you.

JANESSA LASKIN: Thank you.

AMT: Dr. Janessa Laskin, medical oncologist at the BC Cancer Agency and clinical leader of the Personalized Onco-Genomics clinical trial known as POG. She's in Vancouver. You can watch this documentary tonight. It's called “Cracking Cancer” tomorrow night, 8.p.m, all time zones on CBC Televisions's The Nature of Things. It's fascinating. Read more, get more information about the clinical trial at www.cbc.ca/thecurrent. And just to let you know, this season as we hold our public forums across the country exploring various issues related to missing and murdered Indigenous women in Canada, we are holding another one, our fourth event tonight in Toronto, and the discussion will focus on children and youth. This is part of our virtual reality documentary, The Highway of Tears, which is also shown at this forum and then we use that to jump off and have a bigger discussion. This one focuses on children and youth. The forum sold out. We will broadcast it next Wednesday and then it'll be online as well. In the meantime, you can join us online today for a Facebook Live conversation with two of my guests from tonight. Jody Porter, reporter with CBC Thunder Bay and Rebecca Benson, member of the two-spirit community. If you have questions for them, join us at three o’clock Eastern: www.facebook.com/thecurrent. And stay with us. We are talking about the gym. The treadmill used to be a torture device. What a surprise.

Hate the gym? History explains why the treadmill can feel like torture

Guests: Vybarr Cregan-Reid, Eric Chaline, Dan Buettner

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

[Music: The Disruptors theme]

AMT: This season on The Current, we're looking at disruptors—people, objects, ideas that have changed how we look at the world. And today we are at the gym.

SOUNDCLIP

[Sound: Treadmill]

VOICE 1: Just warming up right now. I’m starting with 3.0 and then I go every two minute, up and up until I hit 12.

VOICE 2: Kilometres an hour?

VOICE 1: Yeah. Yes.

VOICE 2: That’s fast.

VOICE 1: It is. I do three times a week. I love it.

VOICE 3: I’m blowing up steam. I was up early. Drove my kid to basketball practice. Made my other kid’s lunch. I tend to be a solo runner mostly, so this works for me. I just lock it and go and I’ll feel so much better during the day having done this.

VOICE 4: I’m working on the couch to 5K program. So trying to work up to running for 30 minutes.

VOICE 2: Is the treadmill your thing or do you run outside normally or?

VOICE 4: Not when it's negative 11. This is where it goes on. Yeah. It does feel awful.

VOICE 2: You don't love it?

VOICE 4: No. No. It’s the other parts I love. Stopping. I love stopping.

[Sound: Treadmill]

AMT: Okay. Can you relate? Treadmill enthusiasts bright and early at the downtown Toronto YMCA. Although enthusiasts may be the wrong word for some of them—perhaps sufferer is more apt. This year the treadmill celebrates its 200th anniversary. It's become a mainstay of the modern gym but the treadmill’s origins are downright torturous. As part of our project The Disruptors, we're looking at how the treadmill and the gym have disrupted how we look at health and fitness and we'll start this exploration with Vybarr Cregan-Reid. He teaches English at the University of Kent. More to the point, he's the author of Footnotes: How Running Makes Us Human. And he joins us from London. Hello.

VYBARR CREGAN-REID: Hello, Anna Maria.

AMT: Well, we just heard that woman there not enjoying her treadmill time. She may be on to something though. What was the original purpose of the treadmill 200 years ago?

VYBARR CREGAN-REID: In the UK in the late 18th century, there was lots of penal reform and it was felt that many of the crimes that were given the death penalty should be given something short of the death penalty. And the idea of hard labour was invented. The idea of hard labour was that it should punish the prisoners’ hearts and souls. It wasn't that they would be given labour to do that was fruitful or restorative. It was thought that something pointless should be done. An inventor called William Cubitt came up with his idea of the treadwheel, which we know today as the treadmill. And it became something that people were sentenced to.

AMT: That explains a lot. What did it look like?

VYBARR CREGAN-REID: Initially it started off as a sort of huge cylinder, like a water wheel that the men—because it was men—would all walk on together, a bit like a giant cylindrical Stairmaster. The wheels beneath them so that they are effectively on a floor is in motion but with small steps on it. By the time that Oscar Wilde was infamously imprisoned in 1895, prisoners then would walk the treadmill for about up to five to six hours a day. It was really serious punishment. And instead of being able to talk to one another, they were put into a sort of separated booths so that they had no sensory stimulation of any kind. It was terrifying.

AMT: So it really was hard physical labour. It was punishment. That is staggering.

VYBARR CREGAN-REID: Yeah, it is.

AMT: And so how does it evolve? Because at some point child labour comes into this.

VYBARR CREGAN-REID: It was a beginning of a movement that was recognizing that people were beginning to become more sedentary. And there was a patent called the gymnastican, which was basically a sort of cross-trainer that could be given to students or men of leisure who weren't getting appropriate amounts of exercise and they would climb inside this machine and then they would work the machine with their feet. But the gymnastican also had a huge wheel with a handle on the side and the patent explains that the reason for this is that [chuckles]—it's not funny—a child could be employed to work the wheel if the gentleman didn't want to have to go you know make the efforts of working the machine himself.

AMT: Wow. As you went through this history, what were you thinking?

VYBARR CREGAN-REID: Well, it was wondrous really. The gymnastican was not a commercial success. Only with electricity does it become workable. But the gymnastican, when you see the picture of it, whenever I show it at a talk or something, everybody in the room just breaks into laughter. It looks so ridiculous. But it's a lovely moment where we can see the beginnings of ourselves really in this history. It’s something that starts with the beginning of the industrial revolution, this recognition that modes of labour are changing so drastically that we now have to find other ways of moving our bodies.

AMT: So it goes from punishment perspiring because you're under punishment to perspiring for pleasure. When does the treadmill take on what we see today in our gyms?

VYBARR CREGAN-REID: The treadmill sort of disappears in the early 20th century and is forgotten about for a generation and then a cardiologist at the University of Washington in the 1950s wants to assess the fitness levels of his heart patients. He puts a treadmill together that looks a lot more like the treadmill that we would know today. And then it's not until the jogging revolution of the sixties and seventies that it becomes a sort of consumer commodity. And now I think the business is worth around $15 billion.

AMT: But this is not the treadmill that you would like to see, the treadmill of the future. What would you like to see?

VYBARR CREGAN-REID: Anything that gets people moving and exercising is great and there are things that people like about the mechanical treadmill now, like the fact that they can just punch in a number like 30 minutes into a treadmill or a speed. They have outsourced their responsibility for their exercise to the machine. But one of the things that's perfect about running is it stimulates us on so many levels that we're not aware of. But once you start stripping away the experience of an outdoor run in a green space and putting it onto a rubber belt in a gym, it might seem like you're doing the same thing, but actually lots of the things that you would have been doing have been lost in the translation. So the things that might create empathy between yourself and other people or yourself and a place, the things that might decrease stress, the things that might make you a better friend or a partner or a spouse or in preview or exam results or even make you less likely to commit a crime, these things are all lost on the treadmill. Our senses get stimulated in so many ways that they have very subtle effects on our psychology that aren’t always very easy to trace.

AMT: So you're saying we're not out in nature.

VYBARR CREGAN-REID: Basically, yeah. We're not out in nature and we're missing out on a great deal by being so. So to get back to your original question of what needs to be on the treadmill, basically the answer is more of nature. So things like treadmills with big screens that will allow us to feel like we're running in natural spaces. We need treadmills that are silent so that we can listen to nature sounds as well.

AMT: And where would the nature sounds come from?

VYBARR CREGAN-REID: Speakers or headphones. God, this is going to be a very complicated machine because it has to release smells as well.

AMT: Oh, okay. But that is your optimum treadmill, one that releases smells and sounds.

VYBARR CREGAN-REID: That would get as close to the outdoor running experience as possible. And the effects on the runner would be almost the same.

AMT: So I have to ask, if that's what it should incorporate, why don't we just run outside?

VYBARR CREGAN-REID: That's a very good question, isn't it? You know I'm obviously a very committed outdoor runner myself and I like this idea of the perfect treadmill that has bits of grass growing out of it. Hopefully it might encourage runners to see a little bit more of what it is that they're losing when they translate the runs from analog to digital.

AMT: What do you think of those people, like some of the people we heard earlier, who just love running on a treadmill?

VYBARR CREGAN-REID: I'd love to maybe sneak a few more of the benefits of outdoor running into their treadmill experience. But you know to hear people speaking so positively about any form of exercise, I think that's just great.

AMT: It's come a long way in 200 years.

VYBARR CREGAN-REID: Indeed, it has. It's got a long way to go as well.

AMT: Okay. Well, Vybarr Cregan-Reid, thank you for your time. Thank you for having me on. Vybarr Cregan-Reid teaches English at the University of Kent. He is the author of Footnotes: How Running Makes Us Human. He's in London, England.

SOUNDCLIP

[Sound: Treadmill]

VOICE 1: Do you like the treadmill?

VOICE 2: Don't like it as much but it's nice to see everyone come in and you know the activity in the place. It’s very stationary. I can listen to a podcast. I can zone out. It's great.

AMT: Well, these days it is standard protocol for indoor runners to get into the zone. Ear buds in, screen on, heartbeat measured and eyes straight ahead. But the gym was not always like this. For that matter, the gym wasn't always just about exercise and health. For more on that, I'm joined by Eric Chaline. He is the author of The Temple of Perfection: A History of the Gym and he's also in London, England. Hello.

ERIC CHALINE: Hi.

AMT: What would we have seen if we'd walked into one of the very earliest of gyms back in ancient Greece?

ERIC CHALINE: What you would have seen is something completely different from a modern gym. You would have been in a large open air space set in parklands. Everybody trained naked and then they would be very little actual equipment because what was practiced were the six Olympic sports.

AMT: Everybody trained naked. They were all men.

ERIC CHALINE: They were all men, of course. Yeah.

AMT: And it wasn't solely a place to train for sport. It became more like a school and even military training, did it not?

ERIC CHALINE: The social functions of the classical gym much greater than that of the modern gym, certainly. It was also the only thing that the ancient Greeks had as a primary school or secondary school and even a university. For example, Plato taught at the Academy gym on the outskirts of Athens.

AMT: Let's skip ahead many, many centuries. What do the Napoleonic wars have to do with the emergence of the gym in Prussia?

ERIC CHALINE: The first modern institution devoted to physical exercise re-appears in 1811, in Prussia and it started by a Prussian teacher who wanted to build the German race up after Prussia's defeat by Napoleon, who were considered the major military power in Europe. So his take on exercise was to restore Prussia to its ancient virility which had been taken away by civilization, industrialization. After the mid-century, states started to realize that if they wanted fit soldiers and stronger workers, exercise was a good way of attaining that.

AMT: How does the advent of photography play into the changing image of fitness and then the gym?

ERIC CHALINE: Some of the first people who use it are strong men. One of the most famous at the time is a German called Eugen Sandow and he is the first recognizably modern fitness entrepreneur. He starts a chain of gyms. He has a fitness mail order business for all kinds of home equipment and he uses photography of his own rather extraordinary physique to promote his fitness enterprise. And the middle classes realized that they needed to start to do exercise to regain some kind of health and also attractiveness, I think, was a very important aspect of going to the gym then.

AMT: Right and we start to see more of this issue of the body beautiful, don't we? And as we keep moving forward and you go from Europe to America, where does the idea of the modern fitness club spring up?

ERIC CHALINE: Yes. The modern fitness club appears first in Southern California on and around Muscle Beach, which was quite a famous place in the 1930s and forties, where young people who obviously had good bodies because they went to the beach, would come and show off. They would do weight training. They would do Olympic lifting. They would do acrobatics. To cater to them and that hedonistic lifestyle, gyms started to open in the area. You have the first chains opening up and then gradually spreading nationwide and ultimately worldwide.

AMT: When did the gym start being primarily a boys club?

ERIC CHALINE: With the aerobics revolution, so you’re talking Jane Fonda. No pain, no gain.

AMT: That's right. She would do the videos, right? She had the leotard.

ERIC CHALINE: Well, she started with the book and then it was, the video was the one that really made it. I think it’s still the biggest selling exercise video of all time. For those people who are too young, you can go to YouTube and there she is, in leotards. Splendidly.

AMT: So how much is going to the gym actually about health? What other factors have driven us to the gym over its history?

ERIC CHALINE: Quite honestly, I'd say health was very low down on the scale of the reasons why people would want to go. In ancient Greece, people went because they trained to be warriors and they went because they wanted to be more attractive. The cult of the body beautiful starts with the ancient Greeks.

AMT: Well, you actually point out that there was real erotica there as well, right? There was a lot of same sex.

ERIC CHALINE: Exactly. It was the focus of classical Greek same-sex culture. That's where older men met younger men.

AMT: And you draw the line to gay liberation in modern times to gyms.

ERIC CHALINE: The gym plays a very important part in contemporary gay culture. Lots of gay men are very body conscious and as a result will go to the gym. And in fact, it's influenced straight culture. Younger straight men go to the gym. Maybe they don't realize that they owe their participation to gay men originally.

AMT: But this type of exercise was not always seen as medically healthy. It was actually seen as detrimental, was it not at one point?

ERIC CHALINE: That's right. In the 1930s, people definitely thought that women shouldn't weight train, that they would become over masculine. But they also thought that athletes shouldn't weight train because it would actually damage their bodies. Doctors discouraged weight training.

AMT: And so how is the concept and popularity of the gym affected how we think about health now?

ERIC CHALINE: If your aim is purely to improve your health, you don't have to go to a gym. Going to a gym is reshaping your body in a certain way.

AMT: In fact, you say that in many ways it's become a place of almost worship.

ERIC CHALINE: In a slightly lighthearted way, I suggested that the gym has taken over from the church. People in past generations used to be avid churchgoers and now we’re avid gym goers.

AMT: And we have special clothes. We have special rituals.

ERIC CHALINE: Special clothes. Special food. You know we eat our protein bars and have our protein shakes afterwards. We have all kinds of rituals connected to going to the gym.

AMT: And that's where we get the title too, eh? The Temple of Perfect.

[Crosstalk]

ERIC CHALINE: The Temple of Perfect. Yes.

AMT: Eric Chaline, thank you. Very interesting to follow that history all the way back. Thank you.

ERIC CHALINE: Thank you very much.

AMT: Eric Chaline, Eric Chaline, author of The Temple of Perfection: A History of the Gym. He's in London, England.

SOUNDCLIP

VOICE 1: What are you up to now?

VOICE 2: Now it is 12 for two minutes. See, I start to feel it, but a little bit hard is okay.

VOICE 3: When I hold these, it tells me how much my heart rate is going. I have like a history of like heart disease and stuff in my family. I'm just trying to nip it in the bud, I guess a little bit. It seems to me like the bare minimum I guess I could do. Yeah, initially I wasn’t sure if I would make it a regular thing or not. It's one of those things where you just keep going even though you don't want to and it gets better, I guess. I have so many of my friends telling me that running is like maybe one of the worst things you could be doing but it's the only thing I can find myself kind of motivated to do.

VOICE 2: Ooh. Oh yeah. A little bit slow down. Oof. [exhale] It’s good.

AMT: What is it about hearing other people working out if you're not? Some of those YMCA treadmill runners still going, hoping among other things to add years to their lives. But before you feel guilty, those who study people who live to be very old are discovering exercise is not part of the formula.

AMT: This is what you call natural movement.

DAN BUETTNER: Yes. Moving naturally.

AMT: So their daily routines, are they going for long walks?

DAN BUETTNER: Not intentionally. So walking is a form of transportation. So they'll live in places where every time you want to go to a friend's house, it occasions a walk or it's something people look forward to. In Okinawa, we studied these moais, these committed circles of friends and their way of winding down the day was to get together and take a walk and talk about the issues of their lives. And it's a big paradigm shift in the way we heard from our previous guest—treadmills being a punishment. Indeed for these people, walking was something they look forward to so they’d actually do it for 100 years. It was fun. Makes a big difference when it comes to longevity.

AMT: So but you're describing people whose lifestyles are different from those that most of us in urban areas lead. If you're living in an urban area, you're working a sedentary job. Is it possible to have all that natural movement at a level that would keep us healthy?

DAN BUETTNER: You can have an enormous impact with how you design the built environment. If you clean up parks, you make sure there are sidewalks without dangerous cracks in there. There's bike lanes. You can raise the physical activity level of a city by about 30 per cent. You know this also requires that you make driving slightly more inconvenient and walking more convenient and it's amazing how it drives people out from behind the steering wheel onto their feet. So we spend all this money lurching after physical activity when we really should be focusing on shaping our environments so that walking or movement is the default rather than something we race to after we're done sitting in our offices for eight or nine hours a day.

AMT: So beyond city planning and lobbying city hall, can you give us some specific examples of how those of us outside blue zones can get more movement into our lives?

DAN BUETTNER: Well, the first and most powerful would be to move to a walkable neighbourhood.

AMT: So pack up and move, you're saying.

DAN BUETTNER: The average adult moves about 10 times in their lives so you have 10 chances to move. Secondly, I would investigate how to get to work by public transportation. We know that people who just take the bus to work get about 19 minutes of physical activity spread out during the day and their chances of cardiovascular disease drops by a bottle of per cent. Also making sure you have comfortable shoes and a bicycle that works. And the third and most important one is to buy a dog or adopt a dog. We know that dog owners have about half the rate of obesity is non-dog owners and that's probably because the dog needs to get walked every day. So therefore too, the human gets walked as well.

AMT: And are there other ways that we should make life less convenient for ourselves even inside our homes?

DAN BUETTNER: Well, if you live in a multi-storey house, I would argue to put your TV on the top floor. So if you want to get a snack at occasions, at least going up and down those stairs. Every instance when you can have a hand tool instead of an electric tool, move it to hand. Take out garage door openers. All of these things provide dozens of little nudges throughout the day to get us to move and that adds up a lot more than we think.

AMT: So physiologically, how does moving naturally make those blue zone residents live so long?

DAN BUETTNER: They get enough movement in their twenties and thirties and forties and fifties. And actually, when you get into your sixties and above, you want to think about exercise differently. It's not just about you know cardiovascular or lifting weights. It's also about avoiding accidents. The beauty of moving naturally, i.e. walking and gardening, is they’re low impact. You're less likely to fall down and break a hip. Setting up your life so you're nudged into general physical activity every day is a strategy for your entire life from age 10 to 100. So in none of these places were you meeting spry 100 year olds who can stand on their head or waterski. Did they ever say at age 50, well, goddarnit. I'm going to get on that longevity diet or buy a treadmill or call an 800 number and order supplements. They just lived their lives in environments where they were nudged to move all day long. Fruits and vegetables were the cheapest and most accessible foods. Their kitchens were set up so it was easy for them to cook those foods or social networks were such that they reinforce those behaviours.

AMT: So should we stop going to the gym?

DAN BUETTNER: Well, for a tiny slice of people, the gym and the treadmill is a good idea. But the problem is we spend so much effort in marketing messaging, deluding people into thinking if you get on your treadmill or you go to the gym, that's what you need. People who join a gym, the vast majority of them have quit within nine months and almost all of them have quit within two years. So if it's a longevity strategy, does not work.

AMT: So you're telling me maybe we should walk to the gym, touch the front door and walk home. [laughs]

DAN BUETTNER: Yeah. Well, I'd rather see you move to a neighbourhood where there's a cafe that you like. You have neighbours who share your interests. And see, these are periods of movement you're going to do all day long mindlessly. I'm not going to use up your self-control. I think we need to think about our physical activity as a reward, as something enjoyable and something we look forward to doing, not something that we regard as self-flogging.

AMT: Dan Buettner, thanks for your thoughts. Really interesting.

DAN BUETTNER: [Chuckles] I loved it. Thank you.

AMT: Dan Buettner, National Geographic fellow and the author of The Blue Zones: 9 Lessons for Living Longer from the People Who've Lived the Longest. That's among other books on the Blue Zones that he's written. He is in Minneapolis and we do want to hear from you on this. What are your views on exercise? Pleasure or punishment? I see some people are already getting on Twitter and saying that explains a lot—the treadmill was an instrument of punishment in prisons. Is activity built naturally into your everyday life or do you have to pencil exercise into your schedule in a gym? Let us know. You can tweet us @thecurrentCBC, post on this segment on our Facebook page or e-mail us by clicking on contact at www.cbc.ca/thecurrent. And while you're there you can enjoy a video compilation of treadmill fails—a reminder that the treadmill remains a torture instrument for anyone who has ever tripped at full speed. That's our program for today. Stay with Radio One for q. Tom Power speaks with Toronto-born photographer Chris Buck about his new book of celebrity portraits. That book is called Uneasy. Now a reminder about our Facebook Live conversation: it comes up later today in advance of our public forum on missing and murdered Indigenous women. This is our fourth public forum. It is going to be held in Toronto. It will focus on children and youth. We have already handed out the tickets for this event tonight but you can join me and two of my guests on Facebook—3 p.m. Eastern, noon Pacific—to ask my guests questions. CBC Thunder Bay reporter Jody Porter and Rebecca Benson, a member of the two-spirit community. Find us at www.facebook.com/cbcthecurrent. Now, we’ll leave you with some more thoughts. We were talking about why there's good reason exercise can sometimes feel like punishment. Since music tends to make sweating it up and sweating up a storm more enjoyable, we are going to leave you today with one of the most popular songs to work out to, according to the digital music service, Spotify. This is Kanye West with “Power”. I'm Anna Maria Tremonti. Thank you for The Current.

[Music: “Power” – Kanye West]

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February 22, 2017 full episode transcript

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