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The Current Transcript for December 19, 2024

Host: Matt Galloway

Prologue

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VOICE 1: According to a new lawsuit, a potato cartel conspired to make your frozen fries 47 per cent more expensive. Stay safe out there. They have eyes everywhere.

[Audience laughs]

MATT GALLOWAY: In the grips of big potato, the suggestion that just a few companies control the spud market should sound familiar to Canadians. In a moment, why a lack of competition for everything from agriculture to air travel has been able to take hold in Canada. Also, this morning...

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DOCTORS MANITOBA VOICE: Come to Manitoba. It's beautiful, it's friendly, and you can practice medicine in the way that you were educated, and in the way that you believe is true and just.

MATT GALLOWAY: At a time when millions of Canadians are struggling to find primary care and there's actually been a drop in the number of family doctors practising. Manitoba has put out the welcome mat. The province is trying to attract physicians from south of the border uncomfortable with a second Trump presidency. In 30 minutes, a look at the pitch, and how other provinces are trying to lure doctors back into family medicine. Plus, scientists are usually trying to accelerate research, not prevent it from happening. In an hour, why a group of scientists called for a stop in the development of so-called mirror molecules, synthetic mirror images of organisms that exist in the natural world. They could lead to drugs with longer-lasting effects. They could also create bacteria that could end all life on Earth. Not good. But as scientists talk about that, we'll talk about Canadians gathering to mark the holidays, and complaining about high grocery prices, mobile phone providers, and airline fees. So, we begin with why so many services in Canada are owned by so few companies. Good morning. I'm Matt Galloway, and this is The Current.

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‘Potato cartels’ and competition in Canada

Guests: Keldon Bester, Vass Bednar

MG: Been to the grocery store lately? Even noticed the price of frozen French fries going up? Maybe, though, you resisted those tater tots because they cost too much for your grocery budget. Could be that there's something nudging those prices up: An alleged potato cartel. There are three proposed class action lawsuits in the United States, accusing four companies of price fixing and a multibillion dollar frozen potato market. Two of those companies are Canadian: McCain Foods, which has close to 80 per cent of the market in this country, and Cavendish Farms. These cases haven't been tested in court. Both companies deny the claim. But a new report by the Canadian Anti-Monopoly Project finds that Canada's food system is indeed highly concentrated. And that goes well beyond potatoes. Keldon Bester is a co-author of the report. He's the organisation's executive director. He's in Saskatoon. Keldon, good morning.

KELDON BESTER: Thanks for having me.

MG: What is a potato cartel?

KELDON BESTER: Well, a potato cartel is a lot like any other cartel. It's companies coming together. And rather than competing to determine price and quantity, they're deciding amongst themselves and sort of segmenting the market of their choosing. So, this frozen potato monopoly is just a, rather, cartel is just one of the most recent ones that we've seen come to light in the Canadian and international food system.

MG: People might be surprised to hear the words potato cartel put together. What exactly are the companies that I mentioned accused of doing with, with frozen potato product prices?

KELDON BESTER: Exactly. The companies are accused of, sort of instituting a bit of a lockstep price increases over a period of time higher than they would have been naturally. And so, the main function of a cartel is to enforce discipline among companies that might otherwise compete. So, whereas if one company had raised their price and the other companies could decide whether to match or to try to compete on price, what the claimants are accusing the cartel of doing, or the alleged cartel, rather, is instituting these sort of lockstep price increases, leaving consumers with really no choice.

MG: What has that done allegedly to the price of French fries, or those tater tots that I mentioned in the introduction?

KELDON BESTER: Well, what it's done is it's increased that price relative both to the sort of generic basket of goods and as well to what the theoretical competitive outcome would be. And so, this was similar to what we saw earlier in Canada with the bread price fixing scandal. You, when you looked back and the price of bread and baked goods had really risen much higher at a much faster rate than the rest of the basket.

MG: And these are big names that that are being included in this class action lawsuit or these class action lawsuits, right? I mean, these are familiar names in this country.

KELDON BESTER: Absolutely. I mean, as you mentioned, McCain on its own has about 80 per cent of the Canadian market, which raises an interesting question that we have in Canada. You know, sometimes our markets are so concentrated that there really is just one or two major companies. And it raises the question of, you know, can you have a cartel with yourself in effect?

MG: The companies say that they are going to fight this. Cavendish has said that the allegations are baseless. McCain says it disputes any allegation that the company violated antitrust laws or other laws with respect to the sale of frozen potato products. Is there any evidence I mean, we're talking about these class action lawsuits in the states. Is there any evidence of this alleged price fixing happening here in Canada?

KELDON BESTER: Well, the biggest piece there is the crossover. And we see this with another class action lawsuit that was successful in the U.S. around canned tuna. Those same companies, two of them accused of participating of, found to be guilty of participating in the U.S., about 75 per cent of the canned tuna market in Canada. So, I think we should keep a really close eye on these cases, especially where firm, the same firms involved are operating in Canada.

MG: How much concentration is there in Canadian food if we go beyond this product of, of frozen potatoes?

KELDON BESTER: You know, there's really astounding levels. Canadians are pretty familiar with the idea that we have, you know, three major grocers that account for about 60 to 70 per cent of the market. But the further you go up the supply chain, and the worse it gets. You know, two companies control practically all of beef processing in Canada. You know, one company is responsible for, you know, about half of fertiliser in North America. A single company is about, again, half of farming equipment in Canada. And, and the story gets more intense and global the further you go up the supply chain, all the way to seeds, chemicals. So, there really is an astounding level of concentration.

MG: Why is that the case? We're going to talk more about the concentration of, of many of the things that we rely on, you know, just in the hands of a few big companies. We'll speak about that in a moment. But when you look at the food system, why is our food system so concentrated?

KELDON BESTER: Well, for a very long time, Canada and other countries believed that if we allowed companies to consolidate, to merge, they would be able to become more efficient, and that those cost savings would be passed on to consumers at the end of the day. But what we forgot is that competition is the process that actually forces companies to share those benefits with, you know, other suppliers and consumers further down the line. So, what Canada and a lot of countries are really reckoning with today is a system that is now dominated by a very small handful of firms. And the process to reverse that power is extremely difficult.

MG: What has to happen to address this, do you think?

KELDON BESTER: Well, you know, the first sta--, first stages we've already taken, thankfully, is we've strengthened our competition laws, and we've begun to understand that this concentration can be problematic. The next step is to go after these what we call abuses of dominance. These individual actions, whether they're cartels or predatory pricing or, you know, a whole range of conduct that dominant corporations engage in. But to really reverse the process, we need to start thinking about breaking up some of these concentrated markets. And in Canada, we're not there yet. But I think with more and more of these cartels coming to light, we should really consider how that, how that should happen.

MG: Keldon, good to talk to you with us. Thank you very much.

KELDON BESTER: Thank you.

MG: Keldon Bester is executive director of the Canadian Anti-Monopoly Project, and co-author of its report, "From Plow to Pantry: Monopoly in the Canadian Food System."

MG: Vass Bednar has co-written a new book on this issue. It's called, "The Big Fix: How Companies Capture Markets and Harm Canadians." She's executive director of the Master of Public Policy Program at McMaster University in Hamilton, Ontario. Vass, good morning to you.

VASS BEDNAR: Good morning.

MG: When you hear Keldon describe the degree of concentration in this country's food system, how reflective, we'll talk about specifics, but broadly, how reflective is that of the economy overall?

VASS BEDNAR: I mean, it feels like you can find it everywhere, kind of different supply chains. You look into rocks, you peek underneath. I should say, too, that I'm on the advisory board of the Canadian Anti-Monopoly Project. It makes me feel like concentration is kind of endless and maybe has come to characterise our country in this really kind of strange way that we're starting to push back again.

MG: So, the cliché is that Canada is three companies in a trenchcoat. And in the book, you talk about just in the introduction how we have three, these are your words, we have three major telecommunications companies, five grocers, a few big banks, two major airlines, one train company. But it goes beyond that as well, right? Veterinary services, funeral services, movie theatres. It feels like much of the life of Canadians is controlled by just a handful of companies.

VASS BEDNAR: It does feel that way. I think there are not just, I think it's not just concentration. It's also kind of tactics and strategies that companies use regardless of their size.

MG: Well, there's also this issue. People may think, well, no, I mean, there's other grocery stores. I can go to a number of different grocery stores. But you look at the issue of a false competition, right?

VASS BEDNAR: Yeah. We talk about this kind of illusion of rivalry that we dress up by borrowing a term from professional wrestling. So spoiler alert, those feuds are, tend to be fabricated, right? And we sort of say that a lot of companies are engaging in a little bit of kayfabe. You know, they're going through the motions of competing, as you see with cartels, right? There's an illusion that there's robust competition there. But when you kind of peek behind the curtain or other clichés, it's not really there. And when we worry about price fixing, of course, a lot of people go back to that bread price fixing scandal. But in some of the research I was doing for the book, I kind of went nuts in a class action database that Canada has. And we've had cases of price fixing in weird places like chocolate, drywall, telescopes, car tires, LCD screens, right? Like, there's a lot of places where people have been trying to sort of use the courts as a, as a complement to the Competition Bureau's core work.

MG: How did we get to this place, where we are three companies in a trenchcoat?

VASS BEDNAR: You know, and that doesn't do justice to trench coats. [MG: No.] Trench coats are beautiful. Okay. How did we get here? I mean, in the book, I think we're pretty, we're pretty generous. We sort of point back to the culture. We kind of blame the '80s, right? That culture then of, you know, get out of the way, kind of light touch, minimal regulation. And this you know, what was more widely held, right? That if we left the market to be as quote unquote "free" as possible, we would be able to reap those benefits. A sort of, sassier, almost more depressing potential answer I've been chewing on recently is like, could it be that in some instances, culturally in Canada, we have just seen it as almost polite or good to say to our top competitors, "Let's divide this up. You know, you take this geography. I'll take that geography." "Hey, just so you know, our prices slightly going up." I'm not saying this is, has come to characterise the country, but we've been thinking about it for so long, right? Why? Right? How could we ever think this was good? And part of how we got here is that we've been told for a very long time as Canadians that geography is our destiny, right? Our population, we don't have enough people, they're, you know, dispersed in weird ways. It's expensive to ship. Sometimes, we see companies pouting about bilingual labelling requirements. I mean, really, I think in this globalised economy, and especially in an increasingly digitised or digital economy, we can sort of start to shirk those geographic reasons and not accept that, you know, having a handful of companies in a variety of sectors is actually beneficial.

MG: I mean, people get pinched for this. People will complain about, you know, higher prices, etc.. But you suggest in the book that this is also a democratic issue.

VASS BEDNAR: Right? I mean, look, rules are set by us. We make, and remake markets all the time through public policy, right? Through the instruments that we have. And it's really a captivating illusion, this idea of free markets. We point out in the book that most markets that we think are free, we, we point to that as the absence of government regulation. But these, without government regulation, we find that markets are actually highly regulated, that private companies act as de facto regulators. They set the rules. Amazon has set many rules for small businesses, medium-sized businesses that want to sell with them. They've set the terms of competition, and they've set them largely in their favour, and they're rewarded for that. Is, you know, is that how these systems should work, or can they be more effective? And we're of the mind that they can be more effective.

MG: You say in the book that 88 per cent of Canadians want more competition. I mean, if you go onto the Internet, not that it is, you know, a representation perhaps of the truest thoughts of people, but you will find a lot of unvarnished rage from people who feel jerked around by their cell phone company, or their airline, or the cost of groceries. Where does that anger? Well, where does it go and what results does it get, do you think?

VASS BEDNAR: I love that question of where it goes. I mean, yes, more memes, right? More rage, more Reddit threads, more kind of calling out companies. Tim Wu, who's Canadian by birth, and who was one of the architects of President Biden's historic executive order on competition. He said this last year at a competition bureau's annual summit. Sorry to be so boring. It just really stuck with me. He said that it's really important to pay attention to the direction of public anger, right? That it's not necessarily the source of the richest policy solutions, but that it cannot be ignored. And I think that's sometimes, the little ways we kind of get dinged. Things like junk fees, right? Or Air Canada now saying, "Starting in January, you have to pay $35 if you want to bring a carry-on bag." Like, these annoyances do enrage us, and they kind of add up. Where do they go? I mean, they have to translate not just to the policy changes that Keldon was shouting out, but to that enforcement. We have to see that, frankly, the state has our back, that we send that message, that we are able to enforce, that we enforce quickly, and send messages to other companies. And you've got to imagine that the potato cartel, two words that I never really, you know, had on my bingo card, I wouldn't be saying out loud, sends a message that we are noticing, right? That it's not just consumers and suppliers, but that the government is noticing the coincidence of these price increases in tandem. And we're able to articulate those harms and that we're going to do more of an investigation.

MG: So, noticing is one thing. Change is something else. What has to be done to change this, to improve competition in Canada?

VASS BEDNAR: I mean, a stronger voice for a Competition Bureau, right? Back to that culture of being kind of polite, demure, mindful. When we're doing preliminary investigations at the Bureau, I don't know why I included myself there when the Competition Bureau is, we don't say anything, right? And the rationale for that is, you know, we don't want to affect a company's perception or investments or deals that they're doing. But the other part of me says, "should we not know?" "Hey, we're doing a preliminary investigation on Amazon," "Hey, we're going to check out this merger." If you don't find anything, if we're not moving forward, let people know. But there's this kind of undercurrent of activity at the Competition Bureau that no one can ever really know about unless they bring a case forward. And that kind of makes it seem that the Bureau's not crazy busy, kind of working for people. A second thing that's just kind of really small and occurs outside of government public policy, we shout out journalists. So Denice, my co-author, Denise Hearn, is a dual citizen, and I get kind of jealous of her because right now, she's living in the U.S. and there are a range of reporters that have a dedicated beat on corporate power and we're just sort of starting to get that in Canada. But we've seen these fascinating fast follows where from reporting and news stories, we're seeing investigations, we're seeing policy changes, right? Because again, we're surfacing important ideas. And that makes me very encouraged to sort of see government responding quickly. And I just really think we need more of that.

MG: Should government, this is something that you tease out in the book. Should government look at, at breaking up some of these companies? This is the subject of discussion in the United States, [VASS BEDNAR: Yeah] particularly right now around Google. Would that create more competition if one company, which has so many, you know, different elements in its hand, was forced to, to divest, divest some of those elements?

VASS BEDNAR: I will say in the case of grocery, you know, it's an open question, right? If what we don't like in the digital economy with a firm like Amazon is the power imbalance of owning and operating a marketplace, then is that something where there should be a structural separation for grocers, right? Maybe grocers need more blindness when it comes to directly competing through their private label products. Maybe there needs to be some spinning out there where private labels are a totally different vertical, and there's more of kind of a data wall between the companies.

MG: Or we need, or we need, you know, businesses [VASS BEDNAR: Yeah] from elsewhere to be able to operate [VASS BEDNAR: Yeah] in this country.

VASS BEDNAR: That would also be great. And, you know, when people say we need more competition, it's kind of like, what kind, and to what end? One of the things I'm kind of stressing about right now is the future of Canada Post as a crown corporation. And if we're going to see a move to kind of blow it up or get rid of it or privatise it in the way that in the U.S., there's a move to privatise UPS, you know, what we lose from potential public price anchors. And that's something that has, Canada has historically done very well. That could be something else that we do see more of in the future. We're starting to see more of it with municipal broadband. Again, change doesn't happen overnight, but it's happening. That market is being remade, and I think that's really smart and savvy.

MG: Just two final things. One is for people who say and they believe in that ethos of the 1980s, you know, Ronald Reagan saying, you know, the words that you don't want to hear, "I'm from the government. I'm here to help." That they say the government should get out of business and not be interfering with business. What would you say to them?

VASS BEDNAR: I talk to them a lot, both in my mind, you know, on panels in real life through the book, I sort of try to remind people that smart regulations benefit everyone, right? But I'm hopeful that Canada in the future will continue to be smart. And what that means is having different ministries, and different orders of government care about competition and understand the implications for competition of different policies that they put in place. Because I think that's part of that question you asked me earlier, which is how the eff did we get here? Right? And maybe that's because competition was an afterthought, if we were even thinking about it at all.

MG: So, should people, just finally, should people, the people who are steaming about the cost of their French fries or their cell phone bill, should they feel hopeful that we will see more fair competition, or the right kind of competition that will help them coming?

VASS BEDNAR: They should feel hopeful, but they should keep the pressure up. I think in this next election, we'll see a lot of ideas, hopefully great ones about, you know, how to improve markets in this fall economic statement. We've seen more interventions that are a little bit more superficial about helping with prices, and they're not structural. But don't feel, it's okay to feel demoralised. But, you know, some people are being kind of driven crazy, right? All these junk freeze, dynamic pricing, personalised pricing, surge pricing, your Pringles can getting smaller, less soap in your shampoo. It's just like, "What is going on here?" And it's all about market power at the end of the day, and it can be fixed.

MG: We'll leave it there. Vass, thank you very much.

VASS BEDNAR: Thank you.

MG: Vass Bednar is co-author of the book, "The Big Fix: How Companies Capture Markets and Harm Canadians." Your thoughts on the lack of competition in this country. Do you feel that rage that she was talking about? And if so, what do we do about this? You can email us: thecurrent@cbc.ca. Your CBC News is next. And then, Dr. Alison Carleton moved from Iowa to the small northern community of Winnipegosis, Manitoba. And her favourite thing about practising in Manitoba... .

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DR. ALISON CARLETON: Up here, the best thing is that the government pays me. Two weeks later, from when I see a patient, the money's in the bank. In the States, the private insurance companies would wait [Music: Theme fading in] three months at least to pay you, and then they wouldn't pay you everything you billed.

MG: We'll hear why the province is heading south to recruit doctors from the United States, and how other jurisdictions are getting creative in attracting and retaining family doctors. That's coming up in six minutes. I'm Matt Galloway, and this is The Current. Stick around.

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Manitoba tries to recruit U.S. doctors worried about Trump

Guests: Dr. Alison Carleton, Dr. Danielle Martin, Andre Picard

MG: Hello, I'm Matt Galloway and you're listening to The Current.

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VOICE 1: I do not have a family doctor, and I've got a lot of medical issues from injuries resulting from my military service.

VOICE 2: My son is 58 years old. He is a brain cancer survivor. He lives on his own. He manages fairly well, but he is going deaf. He definitely needs hearing aids. The government will pay for his hearing aid, provided that this document is signed by a family doctor, which he doesn't have. I don't know what to do to be able to get him his hearing aids. All he needs is a signature.

MG: Those are callers to CBC Radio's Cross Country Checkup, talking about trying to manage life without a GP. It is an all too familiar reality across Canada, trying to find a family doctor. With shortages in most communities, 6.5 million Canadians find themselves in that position. And it's a position particularly pronounced in Manitoba. That province has the fewest family physicians per capita in Canada. Doctors Manitoba, the organisation that represents all doctors in that province, saw an opportunity, and that opportunity they saw in American politics.

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DOCTORS MANITOBA VOICE: When we saw the clouds forming, I suppose as the U.S. election approached, we knew that there may be some physicians that might be looking for a different environment in which to work. Come to Manitoba. It's beautiful, it's friendly, and you can practice medicine in the way that you were educated, and in the way that you believe is true and just between you and your patients.

MG: Doctors Manitoba started a recruitment campaign for physicians in the United States, concerned about U.S. President-elect Donald Trump's health care policies. The group has placed ads in several U.S. states, particularly those where governments have targeted issues like abortion or gender-affirming care. Dr. Alison Carleton is part of the Doctors Manitoba promotion campaign. She is a family physician herself who left Iowa in 2017, and moved to the small community of Winnipegosis, about a four-hour drive northwest of Winnipeg. And that is where we have reached her this morning. Dr. Carleton, good morning.

DR. ALISON CARLETON: Good morning.

MG: Why did you leave the United States to come to practice in small town Manitoba?

DR. ALISON CARLETON: Well, initially, primarily, it was a financial decision. The way we were paid in the States, the income was not keeping up with the expenses. The trajectory was clear. And in addition, we started looking after the 2016 election because we could see that, we didn't think we were going to be long-term happy down there as well.

MG: Tell me about that. I want to get to the financial part, but from the election in 2016 of Donald Trump, what specifically about that shaped your decision to leave the U.S.?

DR. ALISON CARLETON: One of the niche markets in our practice was gender-affirming care. And that was going to be threatened, as well as the fact that my wife and I are a gay couple. And that also was going to be affected because his government was representing a less accepting society than we preferred.

MG: And so as a practising doctor, did you feel like you would be freer to practice in Canada? That, I mean, when we heard in that promotional campaign from Doctors Manitoba, the idea that you can be true to the kind of care that you want to offer. Is that what you felt that you would be able to do in this country?

DR. ALISON CARLETON: Well, I didn't know that before I came here, but it is definitely true. There are certain rules around pregnancy termination, for example, that it has to occur before a certain age. And I have not heard that here. Now, I'm not, you know, I'm not a gynaecologist, so I don't actually do that. But I've never been told that, "No, we can't offer that service for a governmental reason," you know, because of regulations. Around here, we take care of patients based on what we know is right for patients, based on our training and our evidence-based medicine.

MG: You mentioned the financial piece as well, which is interesting because I think the assumption perhaps and maybe it's wrong, but the assumption, given the nature of the U.S. system, that it is a privatised system, would be that doctors would make more money in that privatised system than they would here. You say that that wasn't the case.

DR. ALISON CARLETON: Absolutely not. With private insurance, number one, people have to have the insurance, which means they have to be employed. But private insurance does not pay what you bill. In Manitoba, we are paid what we bill. And not only that, but the money's in the bank two weeks later. In the States, private insurance pays what private insurance agrees to pay. When I was in solo private practice in the States, which was a dream of mine to do in a small town where you can be part of the community, we could take private insurance, we could take cash. I would have had to employ a whole another employee just to deal with the Medicare, Medicaid system down there. So, I wasn't even able to see those folks on Medicaid.

MG: You moved to a very small community where, I mean, they'd lost their hospital. You'd said that in some ways, they were pinching together care. And there is a very acute family doctor shortage in many places across this country, including in Manitoba. How does that impact your practice? Are you overwhelmed with people who are looking for a family doctor?

DR. ALISON CARLETON: Well, there's certainly plenty of business, and that's another big difference from the States. You know, down in the States, everybody is vying for those patients who have private insurance. And the people who don't have insurance, or have Medicaid are ending up in the emergency rooms. So here, my practice is much more broad and I'm taking care of everyone because everyone has public insurance. And that's a value that Canadians hold to take care of everyone, that that's not a value down there. And so, I'm seeing so much more variety in my practice, and I see more need here. Coming to the small community was influenced because they said, "We need you here and we want you," and to be wanted and needed. And especially as a gay couple, you know, that was just like so compelling. It's like, "Wow, it's a beautiful little town. And they want us, and they need us."

MG: There is, just before I let you go, there is this pitch to doctors like yourself who are living in the United States, but maybe are looking for a change in location to try to fill a gap, but also to give them different opportunities. What would you say to American doctors who are looking for a change?

DR. ALISON CARLETON: This is a great change. It's been so good. You know, the other thing that I don't think people realise is that when we were in the States, especially in private practice, we were working long, long hours. We worked six days a week. We'd get to the office at 7:30 or maybe earlier, and we were there an hour or two after closing routinely. We did not have a life outside of what we were doing. Now, I know that my practice here isn't reflective of every practice in Manitoba, but around here, they close at 4:30. It's like, "Whoa, we might actually have a life." And we do. And yet, we still help take the load off of the other doctors nearby by seeing patients here that don't then have to go to the walk-in clinic or to the emergency department. So, I'm still helping the system, even though I can also have a life outside of medicine. It's wonderful. You know, and, and Canadians have these three-day weekends almost every month that comes to everybody. Right? It's, it's really great.

MG: Dr. Carleton, good to talk to you about this. Really interesting to hear your story about, about why you made that shift and how where you are now in Winnipegosis feels like home. Thank you very much.

DR. ALISON CARLETON: You're welcome. Thank you.

MG: Dr. Alison Carleton is a family doctor in Winnipegosis, Manitoba, who came to Canada from, as you heard, the United States.

MG: Like Manitoba, other communities and governments across this country are trying various things to address the family doctor shortage. Dr. Danielle Martin is a family physician and chair of the Department of Family and Community Medicine at the University of Toronto. Andre Picard is the health columnist for The Globe and Mail. They have both spent a lot of time thinking about and writing about the primary care crisis in this country, and possible solutions to that crisis. And so, we brought them together today to talk about what's working, to address the shortage, what isn't, and what we might want to do to make a meaningful dent in it. Good morning to you both.

DR. DANIELLE MARTIN: Thanks for having us.

ANDRE PICARD: Good morning.

MG: Danielle, I think most Canadians, just from personal experience, are familiar with this, familiar with the lack of primary care, but it's worth articulating just how acute that crisis is. What do we need to know?

DR. DANIELLE MARTIN: Well, the sheer numbers, of course, are staggering that 6.5 million Canadians do not have a family doctor or any access to primary care, nurse practitioner, or anything else. And of course, even among those Canadians who do have a family physician or a regular place of care, many of those people report real trouble accessing the care that they need when they need it. And so we have, we have, you know, layers of problems. And those numbers are not equitably distributed. So, if you live in a rural community, if you're in an urban underserved environment, if you're a new Canadian, if you're low income, you are more at risk. And of course, in a, in a just and fair world, I mean, in a just and fair world, every single resident of this country would have a family doctor. And I don't think any of us should be prepared to give up on that goal. But where resources are tight, it does seem extra unfair that the resources are distributed the way that they are and.

MG: The numbers aren't getting any better. There was this report that came out earlier this week from the Canadian Institute for Health Information saying that the number of family doctors practising in this country is actually declining.

DR. DANIELLE MARTIN: While it's, you know, a bit of tricky math there. You know, we have more people practising, but the population is growing, and we're sort of barely holding our own. But one of the important findings in that CIHI report, which I think speaks to some of what underlies the crisis that we're in, is that even among those of us that are practising family medicine, doing as much direct care as many hours per week as we always have, that we're seeing fewer patients. And that speaks to the really significant increase in the complexity of the work and the administrative burden. In other words, in other words, the amount of time we're spending in the office doing things other than seeing a patient. And that underpins not only the perception that people have of trouble accessing their doctor. It also underpins the career choices that our new graduates are making, or even our established doctors are making as some choose to take their amazing medical education, and apply it somewhere else in the system. Because the work of family medicine has become heavier.

MG: So, one of the reasons why we wanted to bring the two of you in here, and it comes out of what's coming out of Manitoba, is that this is a problem that is overwhelming for so many people. But there are things that are happening across this country to try to address it. You wrote a piece this summer with the former federal Health Minister, Dr. Jane Philpott, in which you talked about this crisis being an opportunity. That can be a bit of a cliche, but what do you see as an opportunity in this?

DR. DANIELLE MARTIN: I mean, we have been saying for decades in Canada that the days of the solo practice doctor with the black bag have come and gone, and that what we actually need is teams, team-based care, not only with physicians working together so we can support each other, but working with nurses, nurse practitioners, pharmacists, social workers, that full interprofessional team that is much better suited to care for an ageing population with the rise of complex chronic illness, and also that allows for the Work-Life flexibility that our, our new graduates want and deserve and expect. And so, you know, thi--, this is the moment then of crisis to say, "Well, instead of continuing to try to plug these holes in the same old way, maybe it's time to actually move to interprofessional, publicly funded, team-based primary care for every single resident of this country." And I have to say, I feel really lucky to be a family doctor, not only because I continue to think it's the greatest job on earth, but also because as a leader in family medicine, we are in this moment right now where I, I feel, sadly, the crisis has become acute enough that we now get to move from a conversation about crisis to a conversation about hope. And that is the conversation I want to have.

MG: Andre, you see this across the country in the work that you do and writing about this. And we talked about what's happening in Manitoba, looking at this recruitment campaign. We on this program have covered other recruitment campaigns inside Canada, they're smaller cities and towns offering incentives. Trenton, Ontario was giving people $100,000 if they would set up a full-time family practice. Other communities are offering gym memberships. What, what have you seen across the country, and have those sorts of recruitment campaigns actually worked?

ANDRE PICARD: I think, you know, these programs are great. They draw attention to the problem, but they're really Band-Aids. I think what Danielle said is really key, that we need this larger structural reform. Physicians have to practice differently if we're going to recruit the numbers and more importantly, retain the physicians that we need in Canada. So these little things here and there, they're going to draw couple of people, but we're not going to have the mass, the people we really need to care for Canadians unless we make this commitment. Every Canadian is going to have a family doctor and then, we create a system that does that. You know, primary care is the, the foundation of all, of medicine. If you don't have primary care, everything else crumbles. And that's what we're seeing in Canada. We're seeing this ripple effect of the lack of family doctors right across this system.

MG: Is it fair to worry that, and this is different from Manitoba because they're trying to recruit south of the border, but you see these campaigns across the country. "You should come and work in Manitoba if you're living in Ontario," "You should come to Alberta if you're living in Atlantic Canada," "You come to B.C. because..." Do you worry that that can exacerbate the crisis because you're moving scarce resources just from one place to another? You're not adding anything to the resource pile?

ANDRE PICARD: Yeah, there is a sense of moving the deck chairs on the Titanic. And you know, the reality is there is very little movement. If you look at the CIHI data, it's a few hundred people move around the country. That's not the issue. The issue is getting people where they live, where they want to practice. We know that if you train people in towns, that they tend to stay there in practice. So in Canada, all of our medical education, almost all of it happens in cities. So, it's easier to drive doctors to cities. We're seeing this, I think, more innovative things like training people in the north. And NOSM is a great university in Sudbury, the University of British Columbia has campuses in the north, northern B.C. That's more the kind of things we have to do rather than these little one officer recruitment campaigns.

MG: Where have we seen, and you've written about this, where have you seen, even on a smaller scale, success in cities or in communities in addressing the family doctor shortage?

ANDRE PICARD: I think success again comes back to what Danielle said. It gives people a practice where they can have work-life balance, work in a team, feel valued. They don't have to worry about too much paperwork. The paperwork is overwhelming for, for family physicians in many cases. So, it's creating that team atmosphere, It's creating, it comes down to the work environment. You know, there's a sociologist in Toronto, Pat Armstrong, who said the conditions of work are the conditions of care. We're not taking good care of our doctors. And as a result, we don't have good care. This matters to the population.

MG: Danielle, we've seen in Nova Scotia, for example, a centre set up to accelerate the certification of internationally-trained doctors in British Columbia. They have had some success in addressing the family doctor shortage by saying, "We're going to pay you more, we're going to pay you a bunch more money so that you weren't tempted to go elsewhere or get out a family practice." What should we take from this?

DR. DANIELLE MARTIN: All of these are, you know, partial contributions to solving the problem, of course, where we have internationally-trained doctors in Canada who've come here from around the world. We want to figure out how to accelerate appropriate recognition of their credentials. We also want to be careful not to run around the world, poaching other people's health care workforces. So, we have to be ethical in the way that we approach those, those questions. But, you know, this, this thing about expanding training and increasing numbers reminds me a lot of the MRI, CT scan conversation in Canada. You know, we look at the numbers and we say, "Wow, the wait times are too long for MRI scans. We better buy a bunch more machines." And then, we're all surprised when the wait time doesn't decrease for, for MRI scans. And the reason, and the same thinking applies to pumping more people into a system without fixing the system at its core. So, what we are finding in medical education is we can train more family doctors, but if we graduate them out into a system that is not good to work in, they simply will not practice family medicine.

MG: Is that what you're hearing? I mean, you said that this is the greatest job in the world. But we've also talked to people, including Jane Philpott and others, about what's happening in those medical schools where people aren't going in to family practice, that they see, they see other opportunities, and perhaps that's compensation, perhaps it's work-life balance. It's all of those things, and they're not going in that direction.

DR. DANIELLE MARTIN: That's right. So, I mean, we can fill our residency programs and we actually do see people, you know, choosing family medicine, but then, they graduate and they say, you know, the thing about a family doctor is they're the Swif--, Swiss Army knife of the health care system. A family doctor can work in an emergency department, can work on a hospital ward, can work in palliative care, can work in sports medicine. You know, you can put a family doctor pretty much anywhere in the health care system and they will add value, which means that the job opportunities are everywhere right now. And so, to say to somebody, "Please commit to 1200 lives. Roster these patients, care for them from cradle to grave, and you're going to do at least 20 hours of additional administrative care per week. You can't take a maternity leave or a holiday because you're not going to be able to find anyone to cover your practice, and you're going to be fighting to try to get access to specialist care or imaging or whatever it is for your patients every day." It doesn't feel really attractive. What is magical in the work of family medicine is the 1 to 1 in the room with the patient, building that relationship, feeling close to that person, and feeling that you can make a difference in their, in their health over time. The more we can get people in that magic, the more they will want to practice family medicine. The more we, we, the more we create layers of other stuff around their day, the less they're going to want to do it. And so, you know, we can't just keep pumping people on to the conveyor belt, and expecting that they're going to fall off the other side and do what we want them to do. We, we need to fix the practice environment if we want to fix family medicine.

MG: Andre, in the absence of this, you've written about the solution that Quebec floated and then, kind of back-pedalled on this idea of reassigning GP's from healthy patients to sicker, more needy patients. What do you make of that?

ANDRE PICARD: Well, I think, you know, as a trial balloon, that didn't go over very well. But we have to remember it was a theoretical exercise, and I think it did ask some important questions. You know, I think realistically, we're not going to do that. There would be a political outcry. But that study did say, you know, we have inequity in Canada in who has access to care. It's a lot of people who are healthy, who have access to doctors, those who really need it. Elders with five chronic conditions, they have more and more difficulty getting doctors. I think we have to give some thought to who accesses medical care and how and when. And we don't like to talk about, that's very uncomfortable. And Canada's Medicare system is fundamentally supposed to be equitable, right? It's, no one should be denied essential care because of an inability to pay. But it happens every single day. We're violating our number one philosophy. So, we have to re-think how the system works, how you're allowed to access the system, especially with these grave shortages.

MG: Which is why people can feel like, you're about to say something. Go ahead.

DR. DANIELLE MARTIN: Well, I just I think the other aspect of this and I agree 100 per cent with you, Andre, that we have to have those, you know, uncomfortable, difficult conversations about who's getting what and why and how power is functioning in our systems. But like, the thing about primary care is we know that if you have a system that is based in high quality primary care, and this has been shown around the world in research, you end up with better health outcomes, more equitably and at lower cost. But that assumes primary care at the population level. You know, family medicine and primary care are not just an individual health intervention for, you know, every, every individual person who walks into the waiting room. They are population-level interventions. And so, what I thought was so interesting about that, you know, trial balloon that got floated in Quebec was that it missed the most important thing about primary care, which is that it only works when everybody has it. It doesn't actually work when some people have it, and some people don't.

MG: What I was going to say in just in the last couple of minutes and I'll start with you, Andre, is, is in the absence of real change, people and it's not just the 6.5 million people in this country who are waiting for primary care. But people can feel like the system is crumbling around them, and they worry about their own health, but they worry about the health of the system broadly. For people who are desperate, looking for a family doctor, do you think there's any relief coming, Andre?

ANDRE PICARD: I think there has to be. I think we're really at that tipping point where people are so worried that we have to act. And I agree fully with Danielle. Until every single Canadian has a family doctor, the system is not going to be adequate. It's not going to do its job. It has to be the foundation. But I think it is a time to be hopeful. We, we can't forget, you know, we talk about the problems all the time. But if you're in the right place at the right time in Canada, you get fabulous medical care. We don't have medical issues. We have access problems. We have structural issues. Everything is fixable. So, I, that, that's the message of hope I try to deliver is "This is fixable, and we have to not be, you know, give up hope at this point."

MG: Danielle, last minute to you. Is it fixable? Is there reason for people, not just those 6.5 million, but you think of them, the 6.5 million people who don't have a doctor and they're showing up at the emergency department, is there reason for them to be hopeful?

DR. DANIELLE MARTIN: It is absolutely fixable. You know, Marshall Ganz was here visiting from the U.S. and recently said to me, you know, "You keep talking about how this is a complicated problem to solve. I've been listening to you. I do not think it's complicated. I think it's just hard," and that is different. You know, we actually know what we need to do. We know where we need to invest, and what we need to invest in. We need teams. We need central intake for speciality services. We need to implement AI scribes in family practices to reduce the documentation burden. We need to stop requiring forms and sick notes for silly stuff.

MG: And you see evidence of those things being addressed?

DR. DANIELLE MARTIN: I see them coming and I see, you know, when people say to me, "I can't find a family doctor, what should I do?" I say, "Call your MPP." This is our moment that this, the things that we need to do now are political. And it's about where we're going to invest, and how we're going to restructure our system to make those investments count so that everybody has not just a family doctor, but a publicly-funded primary care team. I think we can do it and I think we can do it soon, quickly if we create that political will.

MG: That's a great place to end. Thank you both for being here.

DR. DANIELLE MARTIN: Thank you.

ANDRE PICARD: Thank you.

MG: Dr. Danielle Martin is a family physician, Chair of the Department of Family and Community Medicine at the University of Toronto. Andre Picard is the health columnist for The Globe and Mail. This is a story that touches people right across this country. Your thoughts on this? The absence or the shortage of family doctors and primary care [Music: Theme fading in], what that's meant for you, but also that idea: Is it fixable? Is there hope on the horizon? Email us: thecurrent@cbc.ca. Coming up after your regional update, we're going to talk about scientists not accelerating research, but hammering the brakes on it. I'll tell you why they would do such a thing. Coming up in 90 seconds.

[Music: Theme]

And scientists warn of ‘mirror life’

Guests: Kate Adamala, Henry Greely, Karin Marley

MG: Hello again. I'm Matt Galloway, and you're listening to The Current. You know, it sounds like something maybe an episode of Star Trek. A group of scientists is calling for a halt in research that could lead to something called "mirror life." Those scientists worry that these synthetic organisms that create these mirror molecules in this field of research could present an unprecedented risk to all life on Earth. That sounds rather serious. Kate Adamala is one of the scientists. She's a synthetic biologist, founder of the Build a Cell Initiative and genetics professor at the University of Minnesota. She's in Minneapolis. Kate, good morning.

KATE ADAMALA: Good morning.

MG: Let's start with the basics. What do you do? What is a synthetic biologist?

KATE ADAMALA: Synthetic biologist is someone who makes things out of biology that biology doesn't naturally do. And we do that so we can expand that diversity of what we can get out of biology: Better medicine, better drugs, better ways of making molecules, basically making anything that the natural biology didn't think of doing.

MG: And so, the mRNA vaccine during the COVID pandemic is an example of that, right?

KATE ADAMALA: Yes. That's one of our poster child examples of a successful synthetic biology project.

MG: Okay. So now that we understand that, what is, what is "mirror life?"

KATE ADAMALA: Mirror life is the idea that you could make a cell that looks exactly like a normal bacterial cell, but all molecules in that cell would be pointing the opposite direction. So, every biological molecule point one way or the other, it has a physical conformation in space. And there are two possible conformations for every molecule. And life is very particular about what direction all our molecules point. There is one confirmation that all life uses, and it's possible to imagine making a cell where all molecules point the exactly opposite direction. That's why we call it "mirror life," because it would be like a molecule that looks like it's helping to murder.

MG: You told the New York Times this is inherently incredibly cool, this idea. What is, what is cool about it to you?

KATE ADAMALA: It's cool because it would create a second tree of life. All life that exists on Earth right now came from the same roots, came from the same tree of life. It's all related. And if we were able to make mirror life, we would be able to literally build or grow a second tree of life. It would be one of the biggest scientific discoveries you can ever think of, it creating another life form.

MG: Why would somebody want to do that?

KATE ADAMALA: Because we wanted to do that for the same reasons why we don't want to do it right now. So, we thought that it would be a great medicine. We thought that because immune system wouldn't freak out about it, we would be able to make cell-based therapeutics that would not create adverse immune response. And we also could use it for biomanufacturing. We could use it to make molecules with biology in bioreactors that are not susceptible to external contaminations because we thought that it would be orthogonal to viruses, to predators. And these are exactly the reasons why now, we understand we shouldn't be making it because it would not only be silent to immune system when we want it, it would always be silent to immune system. So, it could be a pathogen that we couldn't fight, and it could also be, if released into the environment, it could just grow. Predators wouldn't care about it, viruses wouldn't care about it. So, it would grow uncontrollably.

MG: Because it doesn't exist in the natural world.

KATE ADAMALA: Yes. And the natural world doesn't know about it because everything in the natural world relies on this concept of molecules pointing the right way. Everything you sense with your molecular sensors, with your receptors on your cells has to be of the right conformation. It has to point the right way to be detected. And if it's pointing the wrong way, it just won't to be detected.

MG: So, the worst case scenario about this, I mean, it does sound like some sort of doomsday scenario is that it could end all life on Earth. Is that correct?

KATE ADAMALA: It would take over all life on Earth. It would grow uncontrollably. It would grow persistently, and we would have no way of eating it, fighting it in the environment. So, the consequences for the environment could be catastrophic. And that's why we think this should not happen. This should not be made.

MG: How unusual is it for scientists to stop themselves, to hammer the brakes on research in this way?

KATE ADAMALA: Unfortunately, it's very unusual. As far as we know, we're the first group of scientists that were actively working on this huge project that now are saying, "We should not be doing it." I think this should be happening more. People who do research should also be looking at safety and security considerations more often. And we're hoping this is a start of something bigger than just this project that people who do research will start considering more the consequences. And perhaps, we'll be hearing more about different projects that are being stopped internally from the ground up by people that are actually doing it.

MG: How difficult was it for you to get to this place? I mean, scientists will often push for more research. You yourself, in that letter that you wrote calling for the halt in this, said that life is fascinatingly mysterious. And that part is why you got into this work. So, how difficult was it for you, captured, captivated by that mysterious nature of the work to suddenly say, you know what, this is actually too dangerous and we can't do this?

KATE ADAMALA: It was easy once I understood the consequences, but I'm still sad about it. I still think I would love to do it because it's just so inherently fascinating. It would be the biggest scientific discovery I can ever think of. But I also have a self-preservation instinct. I don't want to do it because I understand that this could potentially be catastrophic.

MG: What sort of reaction have you had from others in the scientific community for calling for, I mean, it's not just a pause or slowing down this research. You've just said the research shouldn't go forward at all.

KATE ADAMALA: Yes, we believe it shouldn't go forward at all because there is no way to do it safely. We, the, the responses we were getting are mostly positive. People agree with the premise of it that, yes, this should not happen. Some people point out that we're too far away from actually being able to make mirror life to even make a big deal out of it. There's this concept called information security, is you don't want to talk about threats because then, someone else can bypass your safeguards and go and actually do it because, you know, because they're stupid, because they're evil. We believe that...

[cross-talk]

MG: Stupid or evil or that that may, or that they see that it could be a huge discovery.

KATE ADAMALA: It could be a huge discovery, but there's no way to do it safely. [MG: Yeah.] And that's why, you know, I still believe this would be a huge discovery, but there is no way to do it safely. And I think that should be the priority. We, we're obviously driven by curiosity, driven by applications. We want to do the cool things, but we also want to do it safely. That's the main driving force of science, is to make people's lives better, not worse.

MG: Do you worry about the evil person doing this? In a way, if somebody goes rogue, this is, you said this would be one of the greatest scientific discoveries of all time. Do you worry that somebody would just go rogue and do it anyway?

KATE ADAMALA: That's the advantage of us talking about it so early. Right now, the technology is not quite there yet for one person to go and make a mirror cell. This was a very dynamic area of research. A lot of people were working on it, and we still don't have all the technologies that we need to make a mirror cell. And that's why we chose to speak up right now, because we're hoping that if we stop work right now, we will never get close enough that one rogue actor or even state rogue actor could actually reach. It needs this huge community effort. And if most of the community agrees not to do it, then a single person could decide to do it for whatever reason is not going to be able to because the technology just is not there. You cannot do it alone.

MG: So, just finally, what happens now with this idea? I mean, the idea exists in people's mind, but does it just go in some sort of box, and you bury it in the ground and it's never heard from again?

KATE ADAMALA: I hope we will hear about it because I hope we will have robust discussions about a few things. One is: How do we actually make it not happen? So, we're already having some of those discussions. How does international law apply to it? How do we make everyone agree to not do it, never catch it again? And also, we're having discussions about what we can do because mirror life is a very narrow example. It's just one example of what we can do with those kind of molecules. And there are many different things that we can do that are still safe. We can still get some of those benefits of the drugs and biomanufacturing platforms just without that living mirror cell. And we're having a lot of discussions about it right now on: How do we actually do it? What do we do that is safe? So, I hope we'll be hearing about it because it's a cool topic, just not a living mirror cell.

MG: This is so interesting, the process of it, but also just kind of wrapping your mind around stopping something rather than proceeding with something. Kate, thank you very much.

KATE ADAMALA: Thank you.

MG: Kate Adamala is a synthetic biologist and genetics professor at the University of Minnesota.

MG: My next guest is an ethicist who has weighed in on many biomedical advances over the past few decades. Henry T. Greely is a Stanford law and ethics professor, chair of the Steering Committee, the Centre for Biomedical Ethics, and the author of the book, "CRISPR People: The Science and Ethics of Editing Humans." He's in Stanford, California. Good morning to you.

HENRY GREELY: Good morning.

MG: What do you make of this, this call by scientists not to pause, not to slow down research, but to completely stop and outlaw the research that could lead to the creation of mirror life?

HENRY GREELY: So, I think the call is an excellent thing. I'm very much in support of it. I would note it is fairly narrow, as Kate said, near the end of her interview. It's to not make a living cell using this approach. They do call for continued research with mere molecules, and they do leave open the possibility that there may be evidence that this isn't as unsafe as it currently appears to be. But I think this is a really responsible thing. I would note, though, that it is not the first time that scientists have done this.

MG: I was going to ask, I mean, part of this, the intrigue around this is sure, the mirror cells, but it's also the fact that scientists themselves are saying this is too dangerous for all of us. We need to nip this in the bud. When has this happened before?

HENRY GREELY: This coming February will be the 50th anniversary of the Asilomar meeting on Recombinant DNA. This was a meeting called by scientists who were working on the very first ways to move DNA from one organism to another. They were able to do that successfully, and then they got worried. What happens if we move something into a bacterium, into an E.coli and it turns out to be dangerous and it gets out and it hurts people? So, they called for a moratorium, and they held a big meeting at a conference centre in Monterey, California, called Asilomar, where they said, you know, we shouldn't do this unless or until we discover we're confident that it can be done safely. That led ultimately, the moratorium held. It led ultimately to some regulations both in the United States and around the world. And the tool has been used for the last 45, 50 years. But there was that pause while people stopped to say, is this going to be safe or not? That's, I think, the most famous example. There's, there's another more recent example that's a little less, a little less successful. Jennifer Doudna, the UC Berkeley scientist who invent--, who was one of the people who led to the discovery of CRISPR, a method for editing DNA back in early 19, early 2015, called a small meeting to talk about the possible consequences of using it to edit human genomes, edit human DNA. That meeting led to an article in Science, which led to an initiative by the American National Academies of Science and the Royal Society of Britain, which led to a bunch of different international organisations opining on whether and how this should be done. There was a consensus that it shouldn't be done. That really arose from Doudna herself's starting point to say, "I'm worried about what this what could this could be used for." The bad news is: A rogue scientist did go ahead and do it. A Chinese scientist named He Jiankui announced in November of 2018 that two babies had been born whose embryos he had edited. Now, I think he expected to be a hero. Instead, he was viewed as a villain. The Chinese government sentenced him to three years in prison. Many countries have outlawed this, and no one has done it since then. But there is the possibility of rogues going ahead. Probably not in this case, for the reasons Kate pointed out. This is too hard, too complicated, too many moving parts, too much money involved. So, this one, I'm less worried about. But there are areas where even a consensus of scientists can't necessarily stop a, stop research from happening.

MG: How do you go about regulating that? I mean, are there, whether it's self-regulation or international organisations to oversee this, to say, "This is what we have decided is in the best interest of all of us?"

HENRY GREELY: Yeah, that's really hard. At the national level, you can do it. Or the regional level, like the European Union. Internationally, international law is very slow. Treaties are very hard to get, and it's very hard to get clear treaties that are well enforced. Look at something like the Nuclear Non-Proliferation Treaty. Big deal. That hasn't worked perfectly. I think efforts by groups of scientists, by scientific organisations like National Academies, the Canadian Academy, and among others can help set guidelines that will create a culture that will say, "Do this, don't this, don't do this." Funding agencies should be involved. Journals, high impact journals should be involved in saying "We're not going to publish this.".

[cross-talk]

MG: Even in the face of this, even in the face of remarkable temptation, again, if you go back to, to the CRISPR story, he did think he was going to be seen as a hero. I mean, he was portrayed as a villain, but he thought he was going to, that he would be hailed as somebody who had, had this remarkable breakthrough. That has to be incredibly tempting.

HENRY GREELY: I think he still believes that. I think he sees himself as Galileo, who will be vindicated in the future. He's wrong, but the temptation will be strong. But remember, they're not that many, [inaudible] going to be that many cases where a single rogue can do that. And I think this particular area of mirror life is one where the single rogue actor is not going to be able to do very much.

MG: Do you, do you see this is part of a story of unintended consequences in some ways that we create something that we don't think of, of the long tail of it?

HENRY GREELY: So, I think this is the good side of that story. I think this is the story of we start to create something, but then we do start thinking about the long tail and we decide, you know, we really shouldn't do this. If you think back over the last 100 and some odd years, probably the biggest change in our world has been made by the automobile. It's changed everything about how we live, it's changed our air, it's changing our climate. But nobody's stopped 120 years ago and said, "Huh, this Model T, what's this going to do to us today?" We are, I think, more sensitive to that. Are we perfectly sensitive to it? No. Are we perfectly able to predict the future? Certainly not. But we're paying more attention, and I think that's a great thing.

MG: This is a good news story in some ways, then?

HENRY GREELY: I think so. [MG: Yeah.]

MG: This is really, really interesting. I'm glad to have the chance to talk to you about it. Thank you very much.

HENRY GREELY: Thank you.

MG: Henry T. Greely is a Stanford law professor, director of the Centre for Law and Bioscience, also chair of the Steering Committee of the Centre for Biomedical Ethics. He was in Stanford, California.

[Upbeat acoustic guitar music playing]

MG: This is The Current on CBC Radio. My name's Matt Galloway. Last week on the program, we talked about cookbooks. If you missed it, you can find the conversation on our website: cbc.ca/thecurrent. There, you will find a list of our guests' favourite cookbooks of the year, something you might want to give to somebody else. Something you might want to just keep for yourself. We invited you to write in to tell us about your cookbook stories. We promise to give away a few of the books, drawing some names from a hat. If you're getting a book, you already know. Well, we've got so many wonderful stories, pages and pages and pages and pages of e-mails that our senior producer, Karin Marley, is here to read a few of your letters. Karin, good morning.

KARIN MARLEY: Good morning, Matt. Yes, lots of cookbook fans out there, and so many nice stories. So, Lilac Milne wrote from Vancouver, "When my husband and I were first dating 12 years ago, he suggested the idea of cooking through a cookbook together. I, not knowing much about cooking, chose a book based on the nice photographs. It turned out to be the cookbook of a famous upscale New York restaurant called Candle 79. We committed to cooking every single recipe, no matter how elaborate or how obscure the ingredients were. The recipes sometimes took days. Later, when we had completed the cookbook, we went to New York together and made a point of visiting the restaurant. Candle 79 is no longer around, but what a memory to taste the familiar food made by the very chefs who wrote the recipes. It was on that trip that my husband proposed to me. We went on to cook through six more cookbooks together, and my husband now cooks with our nine-year-old daughter."

MG: I have friends who do this, who cook through cookbooks. They just go all the way through and it's from beginning to end. And then, you start another book. [KARIN MARLEY: Wow.] What a great idea. This is from Donna Lindell in Toronto, "I first started baking with my son when he was about six years old. We would stand on either side of the kitchen island and mirror the making of Christmas cookies. When he was 10, he was tested for learning differences. Turns out he scores low in reading comprehension, and has trouble processing auditory information and instructions. But then, something magic happened: On his own, he took up baking, not just at Christmas, but on the weekends. We made sure he had child-friendly cookbooks on the shelf. Every weekend, he would bake. He started venturing out, finding his own recipes online. Printing them off to make his own binder of favourites. He seemed to find peace in baking. It settled his anxiety. It was math and science and reading comprehension and process. It was learning from mistakes. He worked hard to figure out why his egg whites didn't peak or why something was off. His recipes became more complicated in grade six. He tried mille feuille and Baklava. When his girlfriend in Grade seven came over for dinner with her dad, he made chocolate souffle. For his 13th birthday, we got him a KitchenAid mixer. It's his. I have never used it. He comes home tomorrow for Christmas break in his second year of university, where he's taking a degree in food and agricultural business. He'll start making Christmas cookies. He's been making them for years now. Baking gave our son so much: Researching recipes, processing, math, learning how to course correct, and how baking truly is the language of love and appreciation."

KARIN MARLEY: Mille feuille at 13. Wow. [MG: Oh my goodness]. This one is from Gillian Hurtig, "Growing up, my mom and dad owned a bookstore in Edmonton. Our home was full of books of all kinds, and new cookbooks were constantly being brought home. How funny and sweet was it then? That when I was 22, in 1983, and moving to Toronto, my mother, instead of bequeathing me one of the many books we had at home, created a handmade cookbook full of not only her, but my friends', sisters' and her friends' recipes. I took it to Toronto, then over the years, back home to Edmonton, back to Toronto and New York, and finally Vancouver, where I still use it. My mother passed away at the young age of 55, and the book remains one of my cherished belongings."

MG: Annalee Rudi from London, Ontario, says her story, "is a cautionary tale about family, cookbooks, pride and mysteries." She writes, "My grandmother was a beautiful and warm Scottish woman who taught me to cook and bake many things. But like most of her family, she kept a lot of recipes close to her chest, and the more famous dishes were always steeped in mystery and intrigue. Every five years or so, the whole family would get together and make a family cookbook comprised of new and old favourite dishes. This whole process may seem like quite a wholesome and inclusive way to share memories and great food for future generations. However, the massive and glaring problem was that most of them never submitted the proper and complete recipes. They made it a personal rule to always exclude the one thing that made the recipe so good or adjust the amount of seasoning so that the flavour profile was off, or leave out a specific technique or product that pulled it all together. Heaven forbid anyone actually be able to recreate the shortbread that great-grandmother Ailsa was known for. Or the raisin scones from Cousin Betty. When my grandmother passed away, I was gifted her much coveted box of original recipes, the unabridged, unaltered originals that we all knew and loved. One particular recipe that stood out was her recipe for oatmeal cookies. They were incredibly delicious and somehow extremely mind bogglingly thin. For years, we couldn't comprehend how she was able to roll out the dough to close to an eighth of an inch. Every time anyone tried to do it, the dough would break apart. Stick to the rolling pin, and we just couldn't get there. I finally found the original recipe and I went line by line, comparing the two. Lo and behold, everything matched. In frustration, I finally turned the page over and there was a little addendum that said, 'Remember to use the pantyhose.' I sat there and stared at this line, completely puzzled until it occurred to me. She put the pantyhose on the rolling pin. Well, I jumped up and grabbed a new pair of pantyhose and got to it, and nearly cried as I was magically able to roll out the dough thinner than ever because of the magical pantyhose trick."

KARIN MARLEY: My mother also makes the most delicate oatmeal cookies, but she does not use pantyhose. I think it's some sort of mom magic.

MG: Mom magic is real.

KARIN MARLEY: It's true. A few people told us about recipes that didn't turn out as planned. This is from Sita Kumar in Vancouver, "I love rice pudding. I bought Isabel Allende's lovely Aphrodite cookbook and saw a recipe for it. Isabel Allende. How could I go wrong? I tripled the recipe because, well, I wanted to eat that much. I really did. This pot of rice had my name on it. When I made the recipe, it was the biggest pot of sweet milk with cooked rice you ever could imagine. Huge and not yummy. It did not come together, and thicken up. It was just milk with sugar and a ton of rice. I ate it day and night for four days, possibly nine. But I'm trying to forget to not waste. I never attempted rice pudding again."

MG: Here's a success story. This is from Sarah Neu, "I have always made, been a terrible cook. I've tried to learn from many cookbooks in the past without success. Someone gifted me the book Salt Fat Acid Heat by Samin Nosrat, and I read it cover to cover. It was so fascinating. I was invited to a potluck, and decided to try to make the spicy fried chicken recipe from the book. It was a huge success. Everyone still talks about the fried chicken I made to this day. I had never made something where people actually enjoyed it, and it was a wonderful feeling. It is still the only thing I can make, but I am hopeful for the future." That is a book that should be on everyone's shelf, but it's great.

KARIN MARLEY: And finally, this one is from David Hathaway, "My wife and I were married at the tender age of 21 and quickly realised that neither of us knew much about cooking, but we were determined to be self-sufficient and independent. So, my wife became the family baker while I took on the job of family cook. Fortunately, my first step in that learning experience was to buy a copy of Jehane Benoit's 'Enjoying the Art of Canadian Cooking.' A dog eared, yellowing book printed in 1973 that I still have today. Canadians of a certain vintage may recall Madame Benoit from her regular appearances on CBC Television in the 1960s and '70s. It always feels special to consult recipes written by a Canadian for Canadians, especially at this time of year, when I will soon bake the annual tourtiere. And my daughter is following in her mother's footsteps as the family baker of butter tarts."

MG: Delicious. Thank you very much, Karin.

KARIN MARLEY: You're welcome.

MG: Karin Marley, senior producer at The Current. Do you have a cookbook that you love, love, love?

KARIN MARLEY: I mean, we always just go back to the Joy of Cooking. Straight up, we have never done the squirrel recipe.

MG: Keep us posted on that. There are squirrels. [KARIN MARLEY: Yeah.] Karin Marley is the senior producer of The Current. Thanks to everybody who wrote in with your stories. If there's anything you hear on The Current that you want to comment on, do get in touch. We read, as we say, all of the mail, and some of it ends up right here on the radio. E-mail us: thecurrent@cbc.ca. That is The Current for this Thursday, the 19th of December. Q's up next on CBC Radio One. This is a tune to get you moving in the kitchen. Fred Wesley and the JB's, Breaking Bread. I'm Matt Galloway. Thanks for listening to The Current. We'll see you tomorrow.

[Music: Breaking Bread by Fred Wesley and the JB's]

Thursday, December 19, 2024 Full Transcript

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