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The Current Transcript for October 10, 2018

Host: Anna Maria Tremonti

STORIES FROM THIS EPISODE

Prologue

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Fact, we enter medicine with our mental health on par with, or better than our peers. Suicide is an occupational hazard of our profession.

ANNA MARIA TREMONTI: They've chosen careers to try to heal others. But the results of a first ever survey on doctors mental health by the Canadian Medical Association suggest a significant portion of doctors, especially a new generation, residents, doctors still in training need to heal themselves. There are 48 percent of doctors more likely to experience burnout, 95 percent more likely than other physicians to experience depression. In an hour we'll hear from a resident physician who says the system has let her down. And we'll explore the consequences of all of this on patients. Before that, we're going back in time. The year was 1998 and the author Joyce Maynard, in her 40s, dared to write a memoir describing her relationship as a teen with a 53 year old literary icon; J.D. Salinger. The judgment was swift.

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I was called a predator. I was called a leech woman. The list is pretty long and some of them I couldn't actually say comfortably on the air.

AMT: So fast forward to this era of Me Too, how would Joyce Maynard be seen today. She joins me to talk about that in half an hour. So let's just stay with the generational divide in a generational difference of view. A group of young Americans is suing their federal government over inaction on climate change.

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VOICE 1: Addressing the climate crisis is of the most important things we have to do.

VOICE 2: Politicians, Democrats, Republicans are doing the best job of representing our future because of our government's inability to act.

AMT: The U.S. is not alone in its inability to act, and according to a new report, all of our governments and, by extension all of us, are on borrowed time. That's where we're starting. I'm Anna Maria Tremonti. This is The Current.

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Ottawa too 'timid' in its fight against climate change, says environment reporter

Guests: Kirsten Zickfeld, Mia Rabson, Katharine Hayhoe

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VOICE 1: There is a new report out about climate change and it is not positive.

VOICE 2: This just keeps getting worse. This is not something, folks, that we have to wait 10-20-50 years. Happening right now: the additional floods we're getting, the storms that are stronger, the droughts. They are going to become more frequent and more intense as the planet warms up.

AMT: Well on television news programs anchors have been doing their best to sum up the findings of the latest U.N. report on climate change. You may have missed it on the long weekend but the news 728 page report dropped Sunday. It urges world leaders to limit the global temperature rise from human caused global warming to just point five degrees Celsius from what it is now. That would be one point five degrees above the earth's pre-industrial levels. In a few moments, we'll discuss whether these warnings are getting through to people and whether they're getting through to Canada's political leaders. But first Kirsten Zickfeld was one of two Canadians selected to join dozens of experts from around the world to author the report of the Intergovernmental Panel on Climate Change, the IPCC. She's an associate professor in geography at Simon Fraser University. She joins us from our Vancouver studio. Hello.

KIRSTEN ZICKFELD: Hi. Good morning.

AMT: What would it mean for the planet, and for us, to limit the global temperature rise two point five degrees?

KIRSTEN ZICKFELD: So limiting warming to one point five degrees or do require an unprecedented transition in all aspects of our society. So it would affect the way we consume and produce energy, the way we move around. It would affect our diets. It would affect the design of our cities. So it would really have very profound effects on all aspects of our society.

AMT: And what would we have to do. Like you mentioned those areas, what, we have to stop some of this stuff to change it? Like how drastically would we change?

KIRSTEN ZICKFELD: So what the report makes for a clear is that we are at a critical juncture. So we only have a very few years to turn emissions around. So we need an approach that addresses all sectors of the economy and of after society. And just to give you a quick sample them in terms of energy, for example, we need to make sure that we decarbonise our energy system by mid century. So what the report makes for a clear is that we need to be carbon neutral globally by 2050. So in order to get there what the report suggests is that we need to reduce emissions by 45 per cent from 2010 levels by 2030 which is only 12 years from now. So what this would imply is phasing out all forms of fossil fuels. So oil, coal, but also natural gas. It would mean change the ways that we move around. So massive shifts from gasoline driven cars toward electric vehicles, flying less, using walking more, biking more, using more public transport. It would mean redesigning our buildings so both residential and businesses so that they use less energy when we cool on when we warm them. It would mean changing our diets so shift to a healthier diet rely less on meat, particularly red meat which emits a lot of greenhouse gas emission particularly methane.

AMT: I'm going to ask you if we do that, what differences would we see on the globe?

KIRSTEN ZICKFELD: We would see massive differences. So on our current path we're headed to four degrees warming by 2100. So did this would imply disastrous consequences?

AMT: Such as?

KIRSTEN ZICKFELD: Such as an increase in extreme events. So we would see more flooding, heatwaves becoming more frequent. We would see the intensity of hurricanes and other tropical storms increase. So for humans this would mean more heat related mortality. It would mean massive loss and agriculture productivity. It would mean hundreds of millions of people being exposed to unsafe drinking water. And so really by limiting warming to one point five degrees what this report makes very clear is that the benefits would be significant. So we would avoid heat waves becoming more frequent, we would avoid people being exposed to heat stress, we would prevent sea levels from rising as much as it would if we left climate change unchecked.

AMT: Well let me ask you then. Right now we're seeing a hurricane Michael barreling toward the U.S. coast. Is that considered an extreme weather event related to climate change in your view?

KIRSTEN ZICKFELD: So with extreme weather events we cannot say that the single weather event is caused by climate change. So what we can say is what we're seeing is consistent what we would expect because of climate change. And what would scientists say is that hurricanes would not become more frequent but actually more intense and especially last year the hurricane season showed many strong hurricanes. So this is consistent with what we would expect.

AMT: Do we have the political will and the capacity to do what you say needs doing?

KIRSTEN ZICKFELD: So we do have the technological capacity. We do have the means to address this. The cost of renewables has them has decreased massively over the past decade. And energy storage which we need to get with these renewable energy options also has become better, it's become more affordable. So I think the good news is we're really have the technical means to do this. And as you alluded to what is missing right now is the political leadership to initiate this transition. So what we really need is policies in place. So be it a price on carbon or be it regulations that really induce this shift away from fossil fuels and towards a more carbon free forms of energy.

AMT: Okay, Kirsten Zickfeld thank you for taking us through that. Thank you.

KIRSTEN ZICKFELD: Thank you.

AMT: That is Kirsten Zickfeld felt she is one of the lead authors of the special report on global warming by the IPCC, the Intergovernmental Panel on Climate Change. She's also an associate professor of geography at Simon Fraser University. She joined us from our Vancouver studio. Well this latest report arrives at a time when combating climate change represents a sore point between Ottawa and several provinces. Mia Rabson is the energy and environment reporter for The Canadian Press. She's been following this report and the political response. She joins us from Ottawa. Hi.

MIA RABSON: Good morning.

AMT: So let's look at this in the political context of Canada. Ottawa wants to bring in a carbon tax to help lower our CO2 emissions. How much pushback is it getting right now?

MIA RABSON: It's getting a lot of pushback. When they first started talking about this back, almost two years ago now in 2016, most of the provinces were either in favour of a carbon tax or had liberal governments that were willing to give Justin Trudeau sort of the benefit of the doubt at the time. Fast forward two years and several elections have happened and now you have, instead of just the Satchu infighting back, you have Ontario which cancelled its cap and trade program in July. You have New Brunswick which is already wary of a carbon price with the Liberal Premier sort of in flux but neither the Liberal Premier nor the Conservative leader who could become the premier want a carbon price and say they're going to fight against it. Manitoba backed out of their plan to introduce a carbon tax. Alberta has backed down on actually increasing their carbon price the same to the level at the federal government wants them to. So really what you're left with right now is British Columbia and Quebec on board and everybody else either a hard no or not sure yet.

AMT: Why do you think we're seeing so much opposition?

MIA RABSON: A Carbon price is a very politically delicate issue I guess. Nobody likes the word taxes. In fact you'll hear the Liberals will call it a carbon price. The conservatives call it a carbon tax. Everyone hates the word tax and it's a relatively easy thing to argue against. I mean this is the same fight we've been having for ten years. If you might remember back in 2008 the Green Shift under Liberal Leader Stephane Dion was all about introducing a carbon price. And that was immediately hailed as the tax on everything and nobody touched it for years. The Liberals ran on a campaign to bring in a carbon price and all of us were already supposed to be paying at least ten dollars a ton this year and even that has been delayed. The Federal Government's plan isn't now going to be in place until January 1st. So it's obviously difficult to bring in and it's politically delicate.

AMT: And are provinces like Ontario or Saskatchewan offering any alternatives?

MIA RABSON: Ontario says they will come up with a new plan. Right now they're relatively new government. They haven't put any specifics in place. The one program that they had that was being paid for through the cap and trade program, the green on program, to do retrofit it was also cancelled. Saskatchewan has things like carbon capture and storage on one of their coal plants and those kinds of things. So they have plans, they're not that specific yet and perhaps not as whole. But it's also probably worth mentioning that even with the carbon price and all of the other things the federal government is doing, we're still not doing enough to meet our current target. And our current target is about 200 million tons shy of what this latest report says it needs to be.

AMT: And do the provincial leaders agree? O=Is the disagreement in how to move forward or is the disagreement that there's a need to move forward on this>.

MIA RABSON: For the most part, the disagreement is in how to move forward. Most of the leaders have said climate change is real and mostly manmade. You don't hear very many people outright denying climate change anymore. Doug Ford has said that the premier of Ontario said it's climate change is real and that they will do something to address it. They just don't think that a carbon price, a carbon tax, cap and trade, whatever you want to call it, they don't think that it actually will work.

AMT: And to be fair, do we know whether it would work?

MIA RABSON: It's hard to say. There are some evidence in certain jurisdictions, British Columbia for example, that emissions do go down when you introduce a carbon price. British Columbia has seen an increase in emissions over the last few years but that was when their price was frozen. And that's one of the problems with a carbon price, is that it has to continue to go up over time in order to continue to have the same effect on behavior.

AMT: You've looked at the numbers of Canada where to do its share to curb global warming by a point five degrees Celsius above current levels. What would we as a country be required to do?

MIA RABSON: The IPCC report says that the entire world has to cut back to 45 percent less than what we emitted in 2010. So for Canada that means that we have to get to about 385 million tons. These are big numbers. But currently in one of the latest statistics we have is that we emit almost twice that. So we pretty much have to cut our emissions in half. And it's kind of the equivalent of shutting down the oil sands and all of our manufacturing industry which obviously is not on the table. But that's just sort of the scale of how much that those missions are worth.

AMT: We asked the officer if Catherine McKenna the minister of the environment and climate change for a response to this report and we got a statement and I'm going to read it in part. I'm quoting: "The emissions are down. We've created 700,000 middle class jobs and our economy is growing. Climate action should not be a partisan issue. It's time for conservative politicians to stop playing games with our kids future." What do you make of Ottawa's response?

MIA RABSON: Ottawa has been accused lately of being a little bit timid on this. They ran on a platform to deal with climate change and some of the environment groups who sort of bought into that a couple of years ago are very angry now that they're not moving fast enough. And they see now is not the time to be timid. This report in particular shows you have to be really courageous. And they think they are being slowed by conservative criticism by conservative pushback and their argument is that criticism hasn't stopped even though you're only being timid. So why not be more courageous. McKenna told me yesterday that they're not intending to raise their targets right now because, as I've mentioned, they can't actually meet them yet with the current float plan. They want to implement that plan first but they will raise ambition that once they get there. The problem is 12 years is not a long time and we've already spent three years waiting to introduce just a minor carbon price. These things take a lot of time.

AMT: And what do the federal Conservatives say?

MIA RABSON: Andrew Scheer interestingly is in India this week where he was selling to the prime minister of India that Canada will reduce regulations to get more oil to market which obviously flies directly in the face of this report. He did say he would leave the science to the scientists and that conservatives prefer a regulatory route, which was what they did when they were in office under Stephen Harper. But they've not given any specifics yet of exactly what those regulations would look like.

AMT: Mia, Thanks for your time.

MIA RABSON: Thank you.

AMT: Mia Rabson energy and environment reporter for The Canadian Press. She joined us from Ottawa. Well the IPCC report paints a dire picture of our planet if drastic changes are not made and it uses reams of data and numbers to make the case. My next guest says there's a better way to convey the dangers we're all facing. Katherine Hayhoe is a Canadian atmospheric scientist and director of the Climate Science Center at Texas Tech University in Lubbock Texas. We've reached her today in Boulder Colorado. Hi.

KATHERINE HAYHOE: Hi. Thanks for having me.

AMT: We just heard about the shifting political landscape in Canadian provinces and how these newly elected governments are vowing to fight carbon taxes. How do you make the case for a progressive climate policies when the issue becomes so political?

KATHERINE HAYHOE: Well today in the United States, and increasingly unfortunately in Canada as well, the number one predictor of whether people agree that climate is changing and humans are responsible is not how much we know about the science. It's simply where we fall on the political spectrum. But as the monitor isn't conservative or liberal or NDP, it doesn't give us that difference number depending on how we vote. And so we need to be making decisions informed by the best available science. But of course there are many solutions to that. So when people say, I don't like a carbon tax, my question to them is, what is your solution to reducing our emissions as soon as possible to avoid the most serious and even dangerous impacts?

AMT: So if we look at the divide, are there right wing politicians who are taking a leadership role on climate change?

KATHERINE HAYHOE: There absolutely are. In the United States, there are libertarian organizations, like the Niskanen institutes led by Jerry Taylor that have libertarian solutions to climate change. There are free market solutions. Bob Inglis is a former Republican congressman from South Carolina who leads the Energy Enterprise Institute. There are bipartisan solutions. There are 90 congressmen and women who have joined the bipartisan climate solutions caucus in the United States, where you can only join if you join with somebody from the other party. So there absolutely are solutions that cross the entire political spectrum and we need all of them on the table in order to fix this thing as soon as possible, as Kirsten was talking about.

AMT: So why is it so difficult to make people and their elected representatives understand what's at stake?

KATHERINE HAYHOE: Because people are more afraid of the perceived solutions than they are of the perceived impacts. Especially in Canada, many of us would say: 'Hey warmer is better. Less snow in the winter, warmer summers'. And the impacts on the other hand sound punitive, taxes, austerity, returning to the Stone Age. We've been told that the solutions are going to decrease our quality of life, but we haven't been told that actually the impacts are what's going to decrease our quality of life, and very very quickly, more quickly than many of us think.

AMT: And so if you wrote this latest report how would you framed it?

KATHERINE HAYHOE: Well at the same time I was reading the U.S. National Climate Assessment which is a very up to date summary of the science. But it goes much more into depth on specifically what is already happening in the places where we live, to affect our water resources, our food, our health, our cities, our coasts, bringing it home to the places where we live so we can understand that you know what we've always had hurricanes. But today we are seeing that hurricanes have so much more rainfall associated with them it's estimated that half the rainfall that fell during Florence, for example, most recently was due to human induced warming. We always see heat waves and droughts and heavy rainfall events but we're seeing those increasing. In the Northeast US, just south of Ontario, they've seen over a 55 percent increase in just the last 60 years and heavy rain events which of course in many cases lead to flooding. Bringing it home I think makes a huge difference helps us understand how it's not just about the polar bear. It's not just about people who live on low lying islands in the South Pacific. It's about us in the places where we live.

AMT: It's about what happens when a heavy rain happens and the sewers back up in your city.

KATHERINE HAYHOE: Exactly.

AMT: And so you say bring it home. You also you bring it sort of speak to church. You're an evangelical Christian and you use that connection as well to make your point, do you not?

KATHERINE HAYHOE: I do. Because science can tell us that it is real, for the first time in the history of the planet. It is us and the impacts are very serious. But what do we do with that information? That's where our values come in. And for us as humans living on this planet the only home that we have, we already have every single value that we need to care about a changing climate. We just haven't connected the dots. If we care about our kids health, if we care about the future of the economy, if we believe as I do that we have responsibility over every living thing on this planet which is what the Bible says. And moreover that we are to care for those who are less fortunate than us. Climate change disproportionately affects the poorest and most vulnerable in the world. And that is why I care.

AMT: Katherine Hayhoe thanks for your time today.

KATHERINE HAYHOE: Thank you.

AMT: Katharine Hayhoe is a Canadian atmospheric scientist and the director of the Climate Science Center at Texas Tech University in Lubbock Texas. We reached her in Boulder Colorado today. Let us know what you think. You can tweet us @TheCurrentCBC. Find us on Facebook. Go to our Web site cbc.ca/thecurrent. The news is next and then the writer Joyce Maynard was called a 'jezebel' and worse after she penned a memoir that included an account of her relationship at 18 with the then 53 year old reclusive novelist J.D. Salinger. Two decades on she looks back at that through the lens of me too. And if you were tuning in today to hear Stormy Daniels son. Fortunately she canceled that interview. We're not sure why. We'll reschedule. Stay with us. This is The Current time Anna Maria Tremonti.

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Author 'condemned' for alleging abuse by J.D. Salinger in 1998 says little has changed despite #MeToo movement

Guests: Joyce Maynard

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

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AMT: Still to come, who will heal the healer's when they don't seek help themselves. A landmark new survey of Canadian doctors and medical residents finds that burnout and depression are widespread, and too few medical professionals are reaching out for help with those issues. We'll talk about that in half an hour but first rewriting the story.

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Charlie Rose: Was the experience so powerful to be with Salinger that at every point you would look back and say: 'I'm glad I went to it. I understand the pain that I've endured because of the way it ended. I understand what I had to do to recover but simply it was worth it'.

JOYCE MAYNARD: You know I'm not a person. It's not my nature to indulge in regret and what might my life have been, I might done. But I can't truthfully say 'No I'm glad I did that'.

Charlie Rose: You can't.

JOYCE MAYNARD: No. I can't say that.

Charlie Rose: Because.

JOYCE MAYNARD: Because it was a deeply damaging experience.

AMT: That is Joyce Maynard speaking with TV host Charlie Rose two decades ago. She had just published a memoir about her life and it included her relationship with one of the most celebrated and mysterious authors of the 20th century, J.D. Salinger. His books, especially his 1951 novel The Catcher In The Rye, made J.D. Salinger a household name but he shunned fame and spent decades as a notorious recluse. Joyce Maynard was 18 when she moved in with a 53 year old Salinger. And when her memoir much later, 25 years later, at home in the world was published she was called a 'jezebel', a 'nymphet'. She was accused of taking advantage of one of America's great literary figures. Now, 20 years after that book was first published, Joyce Maynard has written an op ed in The New York Times about being demonized for daring to tell her story. She's looking back on her experience against the backdrop of the Me Too movement today. Joyce Maynard is a writer and the author of numerous books. Her latest, The best of Us, is out in paperback this month. She joins us from New Haven, Connecticut. Hello.

JOYCE MAYNARD: Good to talk to you. Anna Maria. I have to say those epithets that you quoted 'Jezebel' and 'nymphet' were actually among the more polite ones leveled at me at that point that I told my story.

AMT: What other words were used?

JOYCE MAYNARD: I was called a 'predator'. I was called a 'leech woman'. The list is pretty long and some of them I couldn't actually say comfortably on the air. When I published my memoir, At Home In The World, abook that's often referred to as the book about Salinger, it's really not a book about Salinger. It's a book about me. Salinger chose to make himself a part of my story and certainly altered it as a result. But at the time that I published that book, which was a full 25 years after the experiences that I recounted, I was absolutely condemned and excoriated. And 20 years later, I wish I could say that all had changed in the lives of women who come forward with difficult stories. But as we know from as recently as last week that's not the case.

AMT: You're speaking about Justice Kavanaugh.

JOYCE MAYNARD: Of course I am.

AMT: Well I hear you being interviewed by Charlie Rose.

JOYCE MAYNARD: Yes, there is irony there, isn't it.

AMT: Well yes he was fired from both PBS and CBS last year after numerous sexual harassment allegations involving younger female co-workers. So what went through your mind when you heard that news?

JOYCE MAYNARD: About Charlie Rose?

AMT: Yes.

JOYCE MAYNARD: Interesting, I remembered - I've been on his program twice. The earlier event for a different novel of mine, a novel called To Die For - When the interview was over and I was younger then, when the interview was over he kissed me on the mouth. And here is something that I'm not proud of but this is a complicated part of the story of women. I felt oddly flattered that I had pleased him you know. And I think I wouldn't feel that now. But that was my younger self and my good girl self. At the point that that happened I had not yet written At Home in the World which really was a turning point for me, as I think the moment always is when a woman finally says: 'No I'm not going to be the good girl anymore'.

AMT: Even the New York Times columnist Maureen Dowd called you that without 'that Leech woman'. That was her quote. And she compared you to Monica Lewinsky. This is like '98 that the Starr inquiry was on. I was in Washington at the time. And she did call you highly skilled predators, the two of you. And she wrote: 'If they were microscopic organisms we would call them parasites'. So it's an interesting point in time because we hear feminist leaders today acknowledging they should have been supportive of Monica Lewinsky. But at that moment in time everybody writing about these issues was writing about it as like making judgments on the women.

AMT: Yes of course. And I'm happy to say that at the time that that happened. I did not- I took umbrage to a great deal that was said about my book and about me personally. But I was not about to distance myself from Lewinsky. I won't be embarrassed to be in her company or the company of any woman wherever she's coming from who chooses to make that difficult and costly choice. I put Stormy Daniels right in there too. Whoever the woman is who comes forward and acknowledges an event in which a powerful man attempted to crush her and maybe almost succeeded, not entirely or she wouldn't be speaking, I'm I going to acknowledge the courage of that woman.

AMT: And you have been a writer for a very long time. How did the publishing of your memoir affect your writing career?

JOYCE MAYNARD: Oh it was devastating, I'll say. And I'd been at the point that at home and I'll give you just a little bit of history. I started writing this year actually marks the 50th anniversary of publishing my work. I published my first story in Seventeen Magazine when I was 14. So you can do the math I'm 64. I owe a great deal of that. Here's a Canadian story actually. I owe my career to my mother. My mother Verdell Bruiser Maynard who was born in Saskatchewan and raised in Manitoba, educated in Manitoba and Ontario. My mother was a woman of that generation who were denied so many opportunities for a career. My mother was educated at the University of Manitoba, University of Toronto and then got a Ph.D. at Harvard, Radcliffe, it was called that and she couldn't get a job. That was the story of so many women of my mother's generation. And so she made me her career, me and my sister and she was very good at it. She taught us how to be writers and launched us into the world and gave us this powerful tool. I remember my mother saying to me, when I was very young and I came home with some small what seemed like a heartbreak at the time, and she said Well at least you can write about it. And I always did. So I've been doing this a long time. And at the point that I met Salinger one of the many inaccurate things that were said about me at the time was that Salinger somehow made my career possible. Salinger sought me out because I already had a career. I'd published an article in The New York Times with a view.

AMT: You were on the front page of The New York Times Magazine.

JOYCE MAYNARD: I was a big picture on the cover. I think now that that photograph of me looking I was 18 but I probably looked 14 had a lot to do with his seeking me out.

AMT: Well we'll talk about that later. Keep going.

JOYCE MAYNARD: So he sent me a letter, so did a whole lot of other people. It was every opportunity that my mother had ever dreamed that I might have at that moment. I was a small town girl from New Hampshire and suddenly publishers and editors, and movie producers even, were seeking me out. But in among all those invitations was one very; different single page typewritten letter that said simply I read your story in The New York Times and I believe you're a real writer and I want to issue words of caution - This is very ironic in the context of what ended up happening - You will be exploited. I mean he went on to write this absolutely the most charming, endearing, funny letter and a letter that that had the effect - and I'm not alone in responding this way to this particular person's words - of making me feel that for the first time maybe in my whole life I was understood. I was known. And when I got to the bottom of the page, the one page, there was the signature and it was that of J.D. Salinger who, even in that year 1972, was already famously reclusive. I embarked on a correspondence with him. And for the rest of that semester at Yale, my freshman year at Yale University, all the rest of the world sort of disappeared for me. And I lived for the hour when the mail would be delivered to my Yale post office box and I'd hear again. It was really like getting a letter from Holden Caulfield. And of course when the semester ended the first thing I did was to go and visit the person who represented to me- I really thought he was my best friend. He was my mentor. He was my spiritual guide. And I went to see him.

AMT: He invited you.

JOYCE MAYNARD: He invited me and my English teacher drove me there, dropped me off.

AMT: Did anyone in your family expressed concern?

JOYCE MAYNARD: I'm very proud and moved to say my sister did.

AMT: Your sister by the way is Rona Maynard who becomes the editor of Chatelaine, now former editor of Chatelaine. So there's a Canadian connection again. .

JOYCE MAYNARD: Yes. She was 22. My mother, I adored my mother and I have to forgive her for this. But I I said earlier she was a woman who was denied her own career. And when I attracted - I her creation - attracted the attention of this great writer, it was a kind of confirmation of her. I think she lost sight of where she ended and I began.

AMT: So you say your sister raised concerns but you didn't listen.

JOYCE MAYNARD: No. You know even when a person has not listened to the concerns it is a good feeling many years after to know that there was somebody who had the appropriate response, words of caution.

AMT: So your life together with J.D. Salinger lasts 11 months. Just tell us a little bit about that time. What was the dynamic between you?

JOYCE MAYNARD: As as long as we knew each other only on paper, it was just about perfect, or I was perfect. And I exemplified this pure innocent spirit to him, he was pretty clear about that, who had not yet been sullied by the world. The day I moved in he said to me at one point: 'You're behaving like a teenager'. Of course it's kind of hard to refute that one because I was. I didn't dress right, eat right, read the right things, say the right things, listen to the right music. And my approach was to change myself in every way that I could to be who he wanted me to be.

AMT: Were you in love?

JOYCE MAYNARD: I didn't know what in love was. I hadn't really had a boyfriend before. I'd kissed one boy. I didn't know but now I can look back and recognize that it was something quite different. I worshipped him.

AMT: And he liked that.

JOYCE MAYNARD: Well that was the only thing that was acceptable. But he didn't like too much after a point. I regularly displeased him and that was a terrifying thing to displease him.

AMT: Why did your relationship end?

JOYCE MAYNARD: I didn't I didn't recognize this at the time but the book that I had written while I was with him was going to be published. And although I had put the brakes on just about everything to do with promoting that book. I had canceled the book tour I was going to go. It was going to bring an enormous amount of attention my way, and therefore his way. Word had gotten out at Yale and then beyond that I was living with him. A reporter from Time magazine called us up everything that Jerry despised. And I think he wearied of me and maybe I was getting too old. I'm not kidding when I say that. So about three weeks before the publication of that book looking back we were on a vacation to Florida with his children. It wasn't actually just a vacation. He wanted to consult a homeopathic physician about my problems, my sexual problems, according to him. And on that beach in Florida, he turned to me and he said: 'You know I'm done with this'. And he put two 50 dollar bills in my hand and he instructed me to go back to New Hampshire and clear my things out of his house and go away.

AMT: And you were devastated.

JOYCE MAYNARD: Oh yes. Oh yes he said some other things before he got to the end of that speech. But you know, if any man said to me today the things that he said to me then I would think a great deal less of a man. But an 18 year old who looks at this man as you know a kind of god figure, thinks only of herself.

AMT: You find out later that you are not the only teenager J.D. Salinger was writing to. What impact did that go on you?

JOYCE MAYNARD: Oh well you can imagine probably. I didn't discover this until years later. And and then it began to sort of cascade. The first girl that I heard of came up just by accident. I was at a party in New York City for the publication of some book of mine then a woman came up to me and she said: ;Oh I know about you. You're the one who slept with Salinger'. She said: 'You know my au pair girl had a bunch of letters from him'. I remember sort of you know my knees giving out. Because for all that time, even in spite of everything he'd said to me and my recognition of the fact that he would never had anything to do with me again, I still hold him in this in this place of a kind of reverence. And I believed that I had once been this very special chosen girl. And at first I heard only about that girl. The big event that caused me to revisit what had happened, took place a full 25 years after Salinger sent me away when I was in my early 40s. And it was because my daughter Audrey was turning 18. I had a kind of - I'll call it a sort of like a landmine exploding in my life, detonating after the fact, long after the fact, and I began to look - really for the first time - I looked at the experience from the point of view of the girl. I had never felt that I was worthy of anything better than I had received. But when I imagined my daughter, my 18 year old, going through such an experience, all loyalty and sense of obligation to protect shifted to the girl. And that was when I gave myself permission to write the forbidden story which became my book At Home in the World.

AMT: So essentially with that kind of underlie it was a bit of a predator then.

JOYCE MAYNARD: The very word that Maureen Dowd used about me.

AMT: And so you do. You write this book. You've already got a career. You're writing. But like how does the publishing of that book affect your career at that point in time?

JOYCE MAYNARD: Utterly. I was, at a rare literary event that I was invited to and mostly I just wasn't invited anymore to anything, as I got to that took the stage - it was a very big event, an important event - and as I took the stage to speak one entire row of very well-known and highly respected writers, male and female, got up on mass and walked out of the room. That was the kind of thing that happened again and again. I remember I was I was going to go to some party of writers and a friend called me up and said I've been asked to let you know it wouldn't be a good idea for you to show up.

AMT: Because you had dared to show the human side of this great writer and the human side wasn't so pretty.

JOYCE MAYNARD: It's just bizarre now. But yes I will say that it was years before I got a book contract again. That book, although it was written about widely, people didn't buy it particularly. People didn't read it. In fact sometimes even critics would say: 'I'm not going to read this book. It's trash'.

AMT: So if you re-examine the book in the context of Me Too, what would be different today?

JOYCE MAYNARD: Well not as much as should be. I mean of course I do believe if that book were published today that it's just not the fashion anymore for a person like Maureen Dowd to call me a 'predator'. But in much subtler and more insidious ways I would say less has changed than we like to believe.

AMT: How has the Me Too momentum changed your own thinking about what you went through with Salinger?

JOYCE MAYNARD: Will tell you it's interesting. It's over 20 years ago now that I wrote that book. I've lived with that story for a very long time. I'm 64 years old. I have spoken about it, thought about it, and I like to say moved on from it. It's not the only story of my life, that's for sure. But I did discover a kind of aftershock that was much stronger and more painful than I knew. And I think that's probably true for a lot of women who think they've dealt with an experience of, if you want to call it abuse, emotional abuse, a trauma for sure. And I'll name two traumas very separately. One was what happened when I was 18 and equally painful what happened when I was 44 and dragged over the coals, as I was for speaking. That was sort of a real injury. It triggers. I found myself amazingly raw when I read the new round of Me Too testimony last fall and through the winter. And I know I'm not alone when I say that when I listened to Dr. Christine Blasey Ford give her testimony I wept. I wasn't expecting to but I guess I have to say this. I believe that we live in a culture that has enormous fear and hostility towards women, towards 50 percent of the species. I guess I have to say that. I think maybe there's a certain freedom in acknowledging it just you know this is what we're up against. This is what we're dealing with. And if I were raising a daughter today - and my daughter is this well launched into the world as a strong brave powerful young woman - but if I were raising a daughter today I feel I would have to say that to her. The world will not be greeting you with open arms. That's not what the story of a young girl going out into the world is and better to know it. It doesn't mean you need to be fearful and defensive and hopeless, but know what you're up against. Interestingly I'm now living a life where I am very much around that age group of person again because I've gone back to college. I dropped out of Yale to be with Jerry Salinger. I regretted it for a very long time, decades and this last winter I made the decision to reapply to college. So I'm in New Haven Connecticut as a sophomore at Yale and my classes are filled with young women the age that I was then. And of course I have to say these are Yale sophomores. So they are already a pretty powerful bunch.

AMT: Yes but when you were at Yale the first time around you were a powerful bunch too. Do they know who you are?

JOYCE MAYNARD: Some of them do. Some of them do. I'm not making a big thing of it but a few of them who are journalists have sort of the word has gotten out a little bit and they invite me to lunch. They want to interview me and I don't I don't want to do that. I want to have my experience not be writing about it right now.

AMT: And in terms of the Me Too movement, and again, women have spoken up and you spoke up and didn't like nobody wanted you to but at this moment in time, there's a lot of people who are empowered and speak up but they are still vulnerable on some level.

JOYCE MAYNARD: For sure and I will say there's a huge difference. You know you mentioned that the you know the young women in my class at Yale, what would have been the class of 75 and who I ended up not graduating with them were also a very strong group. They were. But those were years when it was really taken for granted that if a teaching assistant made a pass at you, you didn't report that to anybody, you were sort of flattered in the way that I was flattered by Charlie Rose's Kiss even years later. But change happens slowly. It didn't happen with the Harvey Weinstein case all at once. And I don't know a bunch of movie stars saying that their career as a star was maybe affected by their rebuffing the overtures of a producer is one thing. When it gets to women working in the factory, women working in a job, in a supermarket, then we'll know that we've really gotten somewhere. I I don't know if that if that is happening yet.

AMT: We have to leave it there. But it's interesting to hear your perspective on all of this. Thank you.

JOYCE MAYNARD: Good talking with you.

AMT: Joyce Maynard a writer and the author of numerous books. Her latest, The Best of Us, is out in paperback this month. She joined us from New Haven Connecticut. Let us know what you think of what she had to say. Tweet us @TheCurrentCBC. Find us on Facebook. Go to our Web site cbc.ca/thecurrent. Click on the contact link and stay with us in our next half hour diagnosis is burnout. We will hear from doctors and medical residents who have grappled with burnout or worse, after a new report says the issue is real and deadly serious in Canada. I'm Anna Maria Tremonti. This is the current on CBC Radio One, Sirius XM, online on cbc.ca/thecurrent, on podcast and on your radio app.

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Medical residents vulnerable to depression and burnout, survey suggests

Guests: Dr. Brian Goldman, Dr. Murray Erlich

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AMT: Hello I'm Anna Maria Tremonti and you're listening to The Current. Too many Canadian doctors say they are burned out, depressed, possibly even thinking about suicide. For the first time the Canadian Medical Association has surveyed doctors across the country to get a better sense of their mental health. And while most of them report good mental health overall, one in four say they've experienced burnout. Moreover a third of the physicians who responded to the survey screened positive for symptoms of depression. Yet only a small percentage of doctors, 15 percent, say they've actually reached out for help in the last five years. G. Gigi Osler is the president of the Canadian Medical Association.

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The results of the National Physicians Health Survey are worrisome because we are seeing individual, hardworking doctors doing their best to stay strong and resilient, yet still are reporting high rates of burnout. Any culture that has a sense of bravado where that culture values self-sufficiency and being stoic, not talking about your emotions your feelings, not reaching out for help will only drive bring out further underground, because people talk about it and they won't reach out for help.

AMT: And there is one particular group in the survey that is even more vulnerable to the problems of burnout and depression, the next generation of doctors: medical residents. They have graduated from medical school. They are receiving they're on the ground training before becoming full-fledged doctors. According to the CMA, there are 48 percent more likely to report burnout, 95 percent more likely to screen positive for depression than all other physicians. My next guest is a medical resident in Vancouver. We have agreed to keep her name confidential because she has concerns about how this may affect her future career. Hello.

MEDICAL RESIDENT: Hi there, how are you?

AMT: I'm fine. Thanks for asking. I'm wondering what you think of those numbers? Are you surprised to hear those numbers for residents?

MEDICAL RESIDENT: I'm not surprised at all actually.

AMT: What do you see among your fellow residents?

MEDICAL RESIDENT: So among my fellow residents I see a lot of burnout and a lot of symptoms and signs of depression and unfortunately sometimes not a lot of support even when we do reach out.

AMT: So how bad can it get?

MEDICAL RESIDENT: So I'll I guess I can tell my own personal story and of my fellow residents at the time. For instance we have a particularly difficult rotation internal medicine in our residency. And every year residents take stress leave on this rotation, not that we are aware when we first enter it. And when I entered into medicine I just felt very unsupported and I found myself going to my site director, are various people for seeking help and I didn't know that other residents were going through this as well. So as it was said that doctors are supposed be very self-sufficient. So you essentially blame yourself and go 'I'm not working hard enough' or 'I am not doing enough'. So I went through this and I experienced the symptoms of depression and it kind of carried through actually to the next rotation [unintelligible] even though it was much more supported. And I blamed myself in the back of my head and it really affected me. Next thing I know by the end of the year three residents had taken stress leave on that exact same rotation and we didn't see any changes even though my residency cost is fairly vocal.

AMT: So when you talk about support, first of all, you would have liked to have known that you weren't alone.

MEDICAL RESIDENT: Yes. Yes.

AMT: And what kind of support would you have wanted if it had been available?

MEDICAL RESIDENT: Well so our program in B.C. actually says that counseling is available if you ever need to talk to phone confidentiality, because it's a big concern for residents to not look like we are weak or that we're complaining because sometimes we're so scared to be labeled unprofessional. So actually a lot of people I know reached out to that counseling service to talk to them. Unfortunately they only had one counselor available. I think it was starting May and the waitlist on this list is about two months. And I myself recall that, when I reached out to this counseling service, I actually booked an appointment seeking help and it was canceled a few days before it. I think now our program has hired another counselor. But it was very concerning that such a large program for all of the residents only had like one counsellor available for those months. I wondered how people were doing without even that support.

AMT: And you talk about the stress. Is it the workload? The pressure? Tell me what it's like to be on that rotation. What your hours like? What are you facing?

MEDICAL RESIDENT: So essentially we have to get up and go to work at 7:00a.m. And then we'll work sometimes until 6:00p.m. 7:00p.m. But then we'll have these 24 hour shifts where we work from 7:00a.m. all the way the next day till 10:00a.m. as per union rules. Unfortunately again there's even certain rotations that will ask you to stay until around 1:00p.m., which is frustrating on its own because then you feel like the rules don't apply. And as a resident you feel scared to sometimes say things because you don't want to affect your evaluation but that onus is on us, essentially.

AMT: So it's the pressure along with the fatigue.

AMT: I always like to say that residents go into residency wanting experience. We don't mind hours at all. We love the hands on experience. We wouldn't mind working 24 hours in any way. I think it's a fact that when you go to a rotation and you're not supported. Then you have the stress of 'what if I do something wrong? What's going to happen? Will I be able to seek help when I need it?' Whereas if you know that you have a safety net for instance I remember I worked a weekend - I think it was 15 hours every day and I had worked two against before that - but Doctor is working with was so supportive and he said: "Call me whenever you want. Even if you think it's not an important question. I will not mind". I didn't call him but I was not fatigued at all on that particular rotation and that is something a complaint that I need as well and so did various residents. We have supervising physicians telling us: "Don't call me unless someone's dying". And that really was what was contributing to the fatigue especially since it was in my first three months of residency and I was on a specialty rotation of internal medicine. So to deal with such sick patients not knowing there's a safety available, there technically is, but feeling like you should not use it, sometimes it's just bad for patient care and bad for mental health.

AMT: I was just going to ask you, how did this affect your relationship and your ability to work with patients?

MEDICAL RESIDENT: I would say that what happened was that I felt like I had to really rush through patients because there was so much workload. So I felt that that connection decreases and if you're not aware of what you're feeling I think inside a very important patients can tell. They're feeling either nervous or fatigued. I think they can definitely see it on your face or the way you are interacting with them.

AMT: And - you know we aren't using your name - how much of a concern is stigma, talking about these things?

MEDICAL RESIDENT: It's a really big concern for a lot of residents. For instance there is aresident who is very upset about the situation as well. And she's - in our program you can switch over to another program later on - and she said: "Don't worry guys. I'm switching over to another program now I'm going to make all my complaints known openly because I know that you're scared to do so". Because we're scared of being labeled for instance, 'unprofessional'. Because professionalism is a competency in residency that we have to fulfill. But it doesn't have a clear definition. So they could essentially do that to you at any time. Or 'argumentative' because you want to show that, not even show, that you want to also let them know that you are available and that you're willing to do anything to be a better physician.

AMT: And you spent a lot of years getting there.

MEDICAL RESIDENT: Exactly you had that fear. Although it seems like it might ridiculous, but so many years, so many student loans. And will this complaint that I'm making, or this stand I'm taking - number one - even make a difference? And - number two - will it affect my career? And unfortunately the other thing is that we don't have a lot of time. So we want to know that our complaints are heard. But to tell you the truth, our experience in this particular rotation or even our program is that there hasn't been much change. Even though there's been a lot of suggestion.

AMT: Well I'm going to pick up on that with my next two guests. Thanks for speaking with me.

MEDICAL RESIDENT: Of course.

AMT: That is a medical resident in Vancouver. We agreed to withhold her name because she does have concerns about how this can affect her future career. So as we heard it, it can be difficult for residents and physicians to be public about mental health challenges. According to the report out today from the Canadian Medical Association, shame is a major reason why doctors do not seek help for their problems. Many also don't believe the situation is serious enough to warrant getting help. To talk more about the findings of this report and the implications of those findings I'm joined by two people with a lot of experience with this issue. Dr. Brian Goldman is the host of White Coat Black Art on CBC Radio One. He's an emergency room physician. Dr. Murray Erlich is a retired psychiatrist, now a certified life coach. In both capacities, he has done work with physicians who struggle with burnout and who struggle with mental health issues. They join me in our Toronto studio. Hello to both of you, welcome.

DR. BRIAN GOLDMAN: Hi Anna Maria.

DR. MURRAY ERLICH: Good morning.

AMT: I'm wondering where we start there. Brian Goldmann, what were you thinking as you listened to my last guest?

DR. BRIAN GOLDMAN: Well a lot of things. She sounded burned out to me. Certainly all the things that she talked about; the duty hours, the fatigue and the fear of speaking up, the fear of being labeled as a complainer. And I guess the thing that stood out to me more than anything is that she said that people are taking stress leave on every rotation in that internal medicine program. That tells me there's something about that program; lack of resources and they're being overworked. You can add other things; having conversations, emotionally fraught conversations with patients every day, breaking bad news, asking about what we call goals of care which is allow natural death, do not resuscitate, dealing with death itself and other emotional issues. It's a tough job and it's particularly visited on residents. I'm not surprised about that at all.

AMT: Murray Erlich does it sound familiar to you based on what you've heard from other physicians.

DR. MURRAY ERLICH: It sounds very familiar. I think it's a very common story which really rang true. Some things that stood out in what the resident said were things like the need to be self-sufficient, to be stoic. I believe in the culture of medicine where we're taught to look confident even when we're not confident, to not show vulnerability. She said that she didn't know others were going through the same thing. And I've heard that a great deal. People who've come to see me have this imposter syndrome where they think they're not cutting it. They could be very capable. They could be doing fine. And yet they feel really badly on the inside. They feel their juggling in some way or other. And they look around at the their colleagues and everybody looks fine.

AMT: Except they may be holding the same thing back.

DR. MURRAY ERLICH: Exactly. They may be fine, which would be great, but they may be feeling just as badly or even worse and nobody can tell from one another.

AMT: Brian Goldman, tell me more about what you took away from this new survey. What are the most striking findings for you?

BRIAN GOLDAMN: I guess we've already talked about one of the major features that it's residents. That people in the first five years practice and in residency training who are more likely to report burnout, depression and more likely to have suicidal ideation. And another thing that struck me are the gender differences, that women physicians are more likely to report burnout and in the survey screened positive for depression. Another part of the survey says that there are high levels of resilience. I'm not sure what that means by the way. I think a lot of definitions for resilience out there. To me it's being able to kind of reflect and gain some perspective when I make a mistake or when I have an emotionally fraught situation at work.

AMT: Dr. Erlich I should note that the majority of doctors who answered this survey said their mental health was generally okay, but how big do you think mental health and burnout issues are among Canadian doctors?

DR. MURRAY ERLICH: Well it's good to hear that a lot of doctors were saying they were okay, but if you look at the numbers in this survey, I believe overall 30 percent reported burnout, 34 percent on a screening tool reported some symptoms of depression. There have been many other studies on burnout that have shown similar or sometimes higher numbers. I think the numbers are very high and a great concern. Thankfully, there is growing awareness in medical communities. Awareness like speaking about it here right now because there's a real great need.

AMT: Well let's talk about the causes for this. I've got another clip of Dr. Gigi Osler, the president of the Canadian Medical Association.

SOUNDCLIP

If you are the only doctor in small towns, and let's say rural Manitoba, you're going to have a lot of extra pressures on you that you wouldn't have if you were in a group practice in Winnipeg. For example if you're the only doctor who looks after your patients when you need to take a holiday.

AMT: Brian Goldman, what do you think?

DR. BRIAN GOLDMAN: That's certainly tracks with what I've read and what and what I know about burnout and other emotional issues. Certainly practicing in a rural area. Anybody who's overworked, anybody who feels as if they have more to do than they can cope with, that they're constantly feeling time pressure - and that time pressure can be as subtle as every time you go into the waiting room to bring a patient into your clinic - apologizing for being late and 'I'm sorry I'm sorry I'm sorry'. How many times are you going to say that before there's something wrong with the system or if you find yourself arriving early every day and staying hours after to do paperwork, increasing bureaucratic demands especially to get diagnostic imaging, to get C.T. scans and other studies dealing with patients who aren't getting better. And I would say that a lot of physicians in particular went into medicine to make the save, to put the chest tube in, to shock the heart and they're finding that they're seeing an increasing number of chronically ill patients who have complex illnesses that are beyond the ability for instance of a family physician to manage and of 10 or 15 [unintelligible] at a time in the office. And so there's a lot of deeper issues but I suspect that this is visited on rural physicians more than others.

AMT: And it's interesting as well and we talk about wait times. A physician who has to tell their patient they have to wait because they can't make that process move any faster. That's real stress as well I would guess.

DR. BRIAN GOLDMAN: That's right. And they have to manage the expectations of patients and they're watching television. Everybody believes that it's getting better and better. There's better technology, more cures, better medications. And at the same time we have this growing list of people who are living longer and longer with complex - we call them co-morbidities - complex chronic illnesses that are largely incurable. That doesn't mean they shouldn't be treated or managed. Maybe at the medical school level they're recruiting people for the wrong kinds of patients for the current era.

AMT: We should talk about that another day another day. Murray Erlich, you have your own story to tell about physician burnout. What happened to you?

DR. MURRAY ERLICH: Well I myself have had more than one episode of burnout, mild in the past. I think the first time I had a bit of burnout was during my clinical clerkship was which was my fourth year of medical training, when we were working in the hospital full time. And I didn't have a word for it back then. Burnout was not in the vocabulary like it is now. But I was worn out. I'd been working way too many hours. I managed to somehow, like many people in medicine do - just put my head down, ignore myself and just keep pushing through, no matter what. And then a couple of times through the years, when there was a lot on my plate, whether it was professional and or personal or I'd taken on some kind of project, I'd get worn out for a while a bit burnt out and then take some time to recover. But a few years ago, along with my usual work, I'd had some personal stressors, some deaths around me. My father and a couple of close friends died in a very short time. Right around the same time one of my daughters was diagnosed with celiac disease and there was a great deal on my plate. And plus the, as Brian was saying, that dealing with people with chronic illnesses people in psychiatry, in my case people with chronic depression that might not get better, chronic suicidality, acute suicidality and having that impact you, having to carry that for years and years. And so I started having trouble sleeping. I was waking up too early in the morning. I was getting five, five and a half hour sleep. And this went on for maybe two and a half years. I was just getting more and more tired and I was trying to do many things to try to help myself, exercise, socialize et cetera. And it was just getting worse. I did, like many doctors, I did whatever I could to protect my ability to practice. So I reduced my hours. I was very careful about things like writing prescriptions. I made sure if I was going to focus it was going to be at work. I was going to give it everything I could. Outside of work I was dragged out. People noticed I was different. I wasn't thinking so clearly. I was having trouble making decisions. And I would say by about mid-2016 it starts to become clear that this was not very good. And around the end of 2016, maybe January 2017, I decided that I needed a change and that I decided to retire from psychiatry.

AMT: If you would had help, if you had had more support, if there was something in place would you still be practicing as a psychiatrist today do you think?

DR. MURRAY ERLICH: Well I did seek help probably later than I should have, like too many doctors.

AMT: Because you are supposed to know how to help yourself. But that's not so easy.

DR. MURRAY ERLICH: No. And you know speaking of stigma, here I was working with the, kind of working with the Ontario physician health program who would refer many people to me for treatment. And so I'm treating other people who are struggling, including with burnout and I had the same concerns of speaking up. And perhaps I shouldn't have. But I did have those concerns.

AMT: That was your reality.

DR. MURRAY ERLICH: Yes.

AMT: Yes. Brian on White Coat Black Art you actually looked at this. You spoke to Dr. Shelly Dev, an intensive care physician who started to experience burnout after she had to cope with the death of her father. Let's listen to what she said about how that affected her.

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The ability to be compassionate and kind and about other people. I don't think it disappears or go away. I don't think we become callous and I don't think we turn into bad people. I think that we get tired and I think we need to refuel that tank of compassion and kindness. I look at that time, I look at someone who was so pushed to deliver and to provide and not restoring themselves. What ends up happening is we all feel the need to cope and coping takes many different forms. Sometimes it comes off as dark humor. It comes out in angry moments. It comes out in confrontations and it sometimes it comes out with feeling this intense sense of isolation and disconnection.

AMT: Brian Goldman what do we know about how things such as burnout or poor mental health effects patient care?

DR. BRIAN GOLDMAN: It affects that in many ways. As Murray Erlich was saying, he was very careful with prescribing. Not Murray but in general physicians are burned out. Health professionals are burned out are more likely to make mistakes. They may not catch their mistakes. They may not care about the mistakes that they make in the same way. We've spoken about empathy and when you see higher scales of burnout or higher burnout scores that translates into lower empathy for patients. And so patients are going to feel that, it would be less likely to...

AMT: and that matters. We've all had those conversations, it matters a lot.

DR. BRIAN GOLDMAN: And you know I think patients know when they're speaking to a burnt out physician. They may not be able to put their finger on it. There's something about it. There's a vacuousness and emptiness to the encounter that somebody here in this room doesn't care.

AMT: Yes I've got another clip of Gigi Osler about the culture of medicine and what needs to change. Let's listen to her.

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Our leaders have to understand the state of Physician Health and the need for change. I often use an analogy that you'll hear when you're on an airplane during the safety demonstration. They tell you to plug your own oxygen mask first before you help others. For physicians I always say looking after yourself isn't selfish, looking after yourself allows you to continue looking after your patients.

AMT: So what advice would you give doctors on how to stay healthy mentally, Murray Erlich? What would you tell them to do?

DR. MURRAY ERLICH: I think what we just heard from Dr. Osler is very important. The willingness to actually make yourself a priority, to say 'no' to things that that you don't want to do. And sometimes we do, we say yes when we really mean no to take on work or other things that there may be pressure to head a committee or supervise people or whatever it is. And if it's too much or if it's not something you really have your heart into, I think it's important to say 'no'. And I agree that it's not selfish it's self-care. And I think physicians need to learn more about self-care for their own sake and the sake of their patients. I also think it's important to recognize that it's not that one is ok or one is not ok. Like well or unwell and okay, good enough, strong person or somehow a weak failure for a person. I think for most all of us as humans we have strengths and we have vulnerabilities. And I think for physicians to recognize that we can have many strengths and still acknowledge our vulnerabilities and places where we're not functioning okay does not mean there's something terribly wrong with us or we're failures.

AMT: Brian Goldman I'll give you the last word before we go.

DR. BRIAN GOLDMAN: I think we have to get rid of the Superman/Superwoman model of physicians and that includes the leadership. And that means changing the culture. Changing the culture that is so that you can say no. And so that you can admit that you make mistakes and that you're not perfectly presentable at all times. You're human being, we are all human beings. I think that's probably the biggest change that that has to happen. I think we're hitting a brick wall where if we go beyond trying to be more super, take on more tasks, double our knowledge in our heads then we're just going to keep hitting this brick wall until we do something about it.

AMT: Thank you both for talking about this.

DR. BRIAN GOLDMAN: You're welcome.

DR. MURRAY ERLICH: Thank you.

AMT: Murray Erlich is a retired psychiatrist now a certified life coach in both capacities. He works with physicians who struggle with burnout and mental health problems. Brian Goldman is an emergency room physician. He's also the host of CBC Radio's White Coat Black Art. That's our program for today, stay with radio 1 for Q. Oscar winning actor Sally Field is on Q today. We're going to leave you with climate scientist Katherine Hayhoe you heard her in our first half hour. She was talking about the latest U.N. report on climate change. This past summer she started something big with a tweet. After observing that she got about a thousand people to watch her climate change seminar on YouTube, she sees her 11 year old playing a popular video game Fortnite and it racks up 10,000 views in 48 hours and she has an idea; why not talk climate change where young people are watching on video game streaming services like Twitch. Well people took her up on it and there's now an online channel called ClimateFortnite. We're going to leave you with how it sounds. Climate science grad student Henri Drake playing with eighth grader Shane and grad student Miriam as they play fortnight, they talk climate here we go. I'm Anna Maria Tremonti thanks for listening to the Current.

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HENRI DRAKE: So this is one thing that a few people on Twitter asked actually: are there any comparisons we can make to climate change and the game of night? So I mean we are on an island with limited resources. There is this like storm that's closing in. What do you what do you guys think about that? What do you think, Shane?

Shane: I'd say this is kind of a metaphor. I don't know, I am not very good English. But we can use the storm like, say when a storm runs over trees and bushes that's all of our resources and once it gets to the very bottom, once it closes in fully that's when our earth has nothing left.

HENRI DRAKE: Yes. Miriam what do you think about the comparison?

MIRIAM: I mean I think that's cool. I would go with more of an optimistic kind of thing and that this is- I would go more with like how many people are into Fortnite now and if we get everyone excited about [noise] just like stop pressing controls and let my hand wrestling keyboards. It's terrible idea. I think if we get them to be excited about climate change as we can get them about Fortnite, I think we can probably do some good.

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Wednesday October 10, 2018 Full Transcript

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