Wednesday, April 20, 2011

Off To Paid Work

I am off to paid work. I'm taking time off the blog to do one thing at a time.  I'll be off from April 20-May 20, 2011. I'll still be reading.  I'll still be writing.  But my blog posts will be nada.

You all have a ton of blog posts here to read. You will find the poems are very beautiful; my blog posts of them amateur.  Have fun reading or not reading them.

Life is short.  I'm off to get the boys ready for school. Then there is paid work. Then there is the work of being a mum. Then reading. Then writing.  I hope I know always which are the important matters of my life. This is a fun place to write in but my kids need my help for the last months of school and I won't have the time to help them --being at paid work so my blog time will now become help-the-boys time.

You all seem to be a nice bunch of folks out there. Go for a walk. Enjoy spring. Go plant a garden. Read poetry.

Tuesday, April 19, 2011

A Letter To The Alberta Progressive Conservative Party --Sent to the Minister of Health and Wellness


I listened with interest to your comments on CBC this morning regarding the government’s refusal for a public inquiry into doctor intimidation in AHS.  I am curious why the government is refusing to take the route of full disclosure of a public inquiry—through the mechanism of a judicial public inquiry.

I understand the costs would be greater. I don’t see a problem with this.  I do see a problem with the public’s lack of confidence in the way you are currently trying to resolve this issue.  As indicated by the information below a Health Quality Council inquiry is behind closed doors and do I currently trust the type of information I am receiving from my own party at this time? I regret to say that as  a Conservative voter—I do not. I am also not impressed with the types of control mechanisms that were in place to muzzle citizens in the past; and that may still be in place. I will find it very difficult to believe the results of this council and would like the government to bow down to the demands of the public and the Alberta Medical Association and your own party supporters-- like myself and do the right thing.

I am very unimpressed by the way my party has been trying to explain the clear evidence of doctor intimidation—as matters for the past –or as a problem of resources or just politics. I think I can think for myself and do not need to be fooled into believing such rubbish.  Why would this be a matter of resource allocation?  Does the government expect this voter to believe the Conservative party—acting through the hospital system-- fires heads of departments to save money and then uses the money saved to hire heads of the departments who do not protest about cancer treatment wait lists?  I am absolutely furious about this matter and yet, I understand you are all unaffected by the opinions of those who vote you into your jobs.  This is a pity. It reflects poorly on you all.

I think it would be a good thing if you all were sensible about this matter, just did the right thing and paid the bill  for a judicial inquiry.  If money is required to pay for this I think we can go to the oil companies and ask them to pay for more upfront for the use of Alberta’s non-renewable resources which they are currently getting for almost free.

The Wildrose Alliance Party is looking much cleaner to Conservative voters all the time.  I think you should all think about this.  Please don’t think that Conservative voters won’t look for alternatives at election time. They will. This is more than about party loyalty. This is about ethics and who we are as human beings. Please do the right thing. It is about time the Conservative Party did.

Sincerely,
Julie Ali

EDMONTON — Opposition parties plan to continue to hound the government daily with calls for a judicial public inquiry into allegations physicians were subjected to intimidation for speaking out, despite failing to gain unanimous support for another emergency legislature debate on health care Monday.
The Wildrose Alliance party led the call for that debate, citing the story of alleged intimidation of a Calgary physician as the “smoking gun.”
The party said a public inquiry is needed into “what is fast becoming one of the biggest ethical scandals in Alberta history.”
“We’ll continue to call until there’s a public inquiry as per what the doctors are telling us,” said Wildrose Alliance health critic Heather Forsyth, adding she has received an overwhelming number of calls and e-mails on the subject. “In fact, it’s spreading out to other health-care professionals, and quite frankly it’s what the public is telling us.”
Last week, Dr. Lloyd Maybaum said after he expressed concern in 2008 over the cancellation of 76 mental health beds for Calgary’s South Health Campus, he received a letter from Calgary region health officials that stated, “further communications of this nature without discussion and review with members of the executive of mental health and addictions will require … (asking) the executive to formally review your role as physician leader for psychiatry to the South Campus project.”
The letter from Dr. Michael Trew, then head of Calgary’s psychiatry area, continued, “This is not a matter of forcing you to be quiet, but it is a matter of teamwork and leadership.”
Maybaum’s story of intimidation follows others, such as:
-Dr. Abilio Nunes at the Grey Nuns Hospital, who had go to provincial court to resolve his case.
-Infectious disease expert Dr. Stan Huston at the University of Alberta, who in 2008 faced a complaint against him at the Alberta College of Physicians and Surgeons after he spoke about the abrupt departure of four top public health doctors in Edmonton.
-Edmonton thoracic surgeon Ciaran McNamee, whose statement of claim said he was dismissed in 1999.
-Liberal Leader Dr. David Swann, fired from his job as public health officer for speaking out about climate change.
-Dr. John O’Connor, who raised concerns about cancer in Fort Chipewyan.
Health Minister Gene Zwozdesky said he hadn’t read Maybaum’s letter and had no plans to discipline Trew for his threats to Maybaum. He said it’s difficult to know what happened three years ago.
“People have to speak out when they see the need to speak out,” Zwozdesky said.
He said 33 new mental health beds are going into the South Calgary campus.
“This government doesn’t get it, that this is not going away,” Swann said. “There’s a doctor a day coming forward. … Without a public inquiry this is not going to be put to bed.”
These days the legislature seems more like a courtroom than a political forum.
Opposition MLAs routinely file detailed legal documents alleging intimidation in health care. The government dismisses the cases as unproven and refuses to call a full public inquiry.
But the credible calls for an inquiry keep piling up: first from the United Nurses of Alberta, then the Alberta Medical Association, and now the 21,000-member Health Sciences Association.
Nurses, doctors, pharmacists, psychologists -there aren't many professionals left who aren't willing to step before a judge in a full judicial setting.
The government has a massive problem with these demands. An inquiry would run in public view right through their leadership struggle, and then into an election campaign this fall or next spring. It could even plague the next premier well into the following term, assuming the PCs win again.
Even worse, candidate Gary Mar, a former health minister, could be called to testify.
So could Iris Evans, Ron Liepert and current minister Gene Zwozdesky, who might yet run for the leadership.
Bodies will be falling out of ambulances before the Tories open themselves up to that nightmare.
So the Health Quality Council will investigate, the Tories say. That's it, unless the Council runs across evidence of wrongdoing.
But there's also an emerging half-promise, now echoed by candidate Alison Redford, that a full inquiry could be held later, depending on what the Council finds.
That would be very handy, since the inquiry would at least be delayed until well after the next election.
Meanwhile, the citizen jury watches, wondering if this health system really is crippled by dissension or just plagued by random employee-manager problems.
The government says the Council investigation can sort this out. I doubt it.
The Health Quality Council focuses on improving health care. Its reports are dry recitations of technical detail. The work is often very useful; but even if people die, the Council doesn't assess fault or blame.
When staff errors killed two patients in 2004 through mistaken injections of potassium chloride at the Foothills Hospital, the Council focused on how to prevent future errors, as if patients had stubbed their toes.
Another doctor-led study of that disaster, while establishing that lethal medical errors were made by health-care workers, didn't fault anybody but reporters, for the grievous sin of trying to find family members of the victims.
The remarkable thing about the current scandal, and what makes it so tough for the Council to handle, is that it crosses from the medical into the legal world.
And legal issues, one would think, are best handled in the ultimate legal forum of a judicial inquiry.
Doctors are suing health authorities, and now Alberta Health Services, for allegedly punishing them when they buck the system or advocate for patients.
In a previous-known case produced Wednesday by the Liberals, Grande Prairie surgeon Mohammed al-Ghamdi alleges that he was harassed and intimidated by the system.
The day before, the opposition revealed that Fort McMurray doctor Michel Sauve says he was punished by having privileges reduced.
Sauve had expressed support for local MLA Guy Boutilier after he was kicked out of the Tory caucus for criticizing health decisions.
This is turning into a sensational trial; the trouble is, it's happening in the wrong courtroom.
Don Braid's column appears regularly in the Herald

Read more: http://www.calgaryherald.com/health/Braid+Health+scandal+crossing+into+legal+realm/4652955/story.html#ixzz1KDbsQ8Fy

Alberta doctor backs up claims of intimidation


Dr. Stan Houston spoke up after four public health doctors departed

 EDMONTON — An Alberta expert on infectious diseases says one day after he spoke up about the departures of four public health doctors during a syphilis ­crisis, a top provincial health official filed a complaint about him with the regulatory college.
“I think that there’s a long-standing culture of intimidation, sometimes quite vindictive responses,” said Dr. Stan Houston, who spoke up about his 2008 experience to encourage other doctors to raise their voices.
“My intent was to raise concerns about systemic problems, not the professional abilities of specific ­individuals,” he said.
Houston said his story backs allegations made by Independent MLA Dr. Raj Sherman, that doctors have been muzzled and punished for speaking out about long waiting lists or babies dying from syphilis.
On Wednesday, top officials with Alberta Health Services wrote an open letter to all provincial physicians, saying they “must advocate without hesitation” since doctors “are required to bring (their) concerns forward.”
On Thursday, the Alberta Medical Association said it would support a judicial public inquiry if the government calls one.
The Health Quality Council of Alberta also revealed it has broadened its mandate so it can look at the ability of physicians to advocate for their patients and whether or not they face systemic intimidation. The council has already said it would review 330 cases of poor patient outcomes due to long emergency waits, as well as allegations that 250 people died while waiting on a lung surgery waiting list.
“How do we move to a system that not only permits criticism but also openly encourages all providers to share their issues and concerns in an effort to improve patient care?” Alberta Medical Association president Dr. P.J. White said in a letter to the province’s 6,500 physicians. “An open and full review is needed to clear the air and move forward.”
That would also help in ongoing negotiations for a new three-year agreement between doctors and the government, White said. In a March 14 letter to members, White said: “With negotiations (in) 2011, for the first time ever, government threatened the loss of programs and services to try and intimidate physicians.”
A tentative agreement was reached that would freeze wages for two years, but White said the government threatened to cut back important benefits and support programs by month’s end if that agreement hasn’t been accepted.
Over the next 90 days, White said negotiations will focus on coming up with a comprehensive physician engagement strategy that will guide professionals on how to deal with issues of quality and improving access.
That, in part, is what Houston said he was trying to do on July 29, 2008, when he spoke to The Journal about concerns that Alberta’s fight against sexually infectious diseases was losing ground after the loss of four public health doctors, whose contracts weren’t renewed by Alberta Health and Wellness. The doctors couldn’t explain why they left their positions because of non-disclosure agreements they had signed.
“While (Dr. Gerry) Predy (medical officer for Capital Health at the time) and Dr. Richard Musto (Calgary’s medical officer of health) are fantastic public health doctors, their lack of expertise in certain areas such as infectious diseases is leaving the public health department floundering at times,” read a July 30 Journal article, paraphrasing Houston’s opinion. Day-to-day decisions, such as how to deal with a pregnant woman with syphilis, were not being made, he said at the time.
That same day, Houston said he received an angry call from Predy about his words. Predy also called Houston’s dean and department chairman at the University of Alberta with “strong expressions of unhappiness,” Houston said.
Houston, an expert in infectious diseases, said he was also notified that Predy had filed a complaint with the College of Physicians and Surgeons of Alberta.
Seeking legal advice, Houston was told to remain quiet until the matter was resolved.
“I was advised by my lawyer … to avoid as far as possible, any public discussion of issues (about) syphilis and related issues,” Houston wrote in a detailed e-mail to The Journal Wednesday. “The upshot was that I declined to respond to several requests by the press for further information, which I think that as a citizen and a physician, I really should have been willing to answer.”
Predy declined an interview request from The Journal.
By the time the complaint was resolved in December — with Houston facing no repercussions — the syphilis outbreak had disappeared from public view.
“One cannot help but wonder whether greater public pressure at that time might have led to a more vigorous and effective response,” Houston said. “Ultimately, therefore, whatever the intent may have been, the ... outcome of the complaint was to muzzle legitimate discussion during the critical time period when the public’s attention was focused on the issue.”
Houston said the “current public and political brouhaha” over long emergency waiting times and cancer deaths has focused on acute care, while public health remains largely ignored.
“How are our syphilis rates doing? They’re not improving at all after five long years,” Houston said.
The council has broadened its mandate to look at potential intimidation in response to the heated health debate in the legislature and among the public.
“We’re prepared to look at that,” said the council’s CEO, Dr. John Cowell, noting the review will make recommendations for improvement within nine months, with updates released at three and six months.
“(Doctors) can bring their concerns forward with the full protection of Section 13” which grants anonymity.
The council is also setting up a blue-chip panel of well-known individuals to serve as an advisory group and sounding board for the investigative team.
Premier Ed Stelmach and Health Minister Gene Zwozdesky continue to insist a public inquiry is not needed to look into the allegations of intimidation, despite daily attacks in the legislature from the opposition.
jsinnema@edmontonjournal.com
twitter.com/jodiesinnema

April 15, 2011

AMA calls for inquiry into doctor intimidation

By CBC News
CBC News

The Alberta Medical Association is calling on the government to launch an independent inquiry into issues of doctor intimidation in Alberta's health-care system.

The Alberta Medical Association is calling on the provincial government to launch an independent inquiry into issues of doctor intimidation in Alberta's health-care system.
AMA president Dr. Patrick White issued a statement Friday afternoon saying that the AMA board of directors agreed at a meeting Thursday that an inquiry was needed to create an atmosphere free of intimidation and retribution, where doctors feel secure speaking out and advocating for patient care.
"The decision reflects concerns within the medical profession that it is time to clear the air," White said in the letter.
A number of Alberta doctors have recently stepped forward to allege they were intimidated by health-care officials for speaking out about patient care.
The allegations, exemplified in statements former PC and current Independent MLA Raj Sherman made in the legislature, prompted all four opposition parties and Sherman to call on the province to hold a public inquiry.
The government has already established a review of the health-care system by the Health Quality Council of Alberta and has insisted that is sufficient.
But the AMA said the HQCA review was "problematic" because of its non-public nature, and that "its inability to compel evidence could inhibit its effectiveness."
White said a public inquiry offers the best opportunity to change the provincial health-care culture and to address doctor disengagement from Alberta Health Services.
But he also said that if the HCQA review remains the only option, the AMA would co-operate.
The AMA offered some suggestions to improve the HCQA review, including removing barriers posed by non-disclosure clauses.
Alberta Health Minister Gene Zwozdesky said he's puzzled by the association's demand.
He said the HCQA review is the better way to go, since it will get results faster and won't cost as much.
"We're not doing a public inquiry. I'm not going to advocate for tying up $20, $30, $40 million of taxpayers' monies to do a public inquiry that would take two, three or four years to get accomplished, when we need some answers right now," he said.
Zwozdesky said the AMA recently said it wasn't going to make political statements, but that this development could be perceived as being political - even while the doctors are still in contract negotiations with the province.
The Alberta Liberals and NDP both welcomed the move by the AMA, and used the opportunity to reiterate their demands for a public inquiry.




One by one, they’ve come out of the woodwork – doctors fired or forced out by Alberta health agencies after breaking rank and speaking publicly, with some then labelled as mentally ill.
The allegations, made by about a dozen physicians, portray a culture of intimidation they say pervades Canada’s richest health system while raising questions of political interference by Alberta’s long-ruling Tory government. They also include claims of 250 cancer deaths hastened by mismanagement.

globefan

10:14 PM on April 20, 2011
This comment is hidden because you have chosen to ignore globefan. Show DetailsHide Details
Troubling article.. with a 1950's feel. We should not fear our own institutions.
 
  Name withheld

Stat

2:17 AM on April 21, 2011
This comment is hidden because you have chosen to ignore Stat. Show DetailsHide Details
 
Fear every institution, esp. the most powerful ones.


More News:


Former Alberta surgeon would testify  about
systematic intimidation if legally protected.

Edmonton Journal – Sun, 10 Apr, 2011 8:00 PM EDT
EDMONTON - A former top lung surgeon from Edmonton said he and others who have faced intimidation would be willing to testify about their experiences – but only with adequate legal protection.
Dr. Ciaran McNamee was Edmonton's leading thoracic surgeon in the 1990s. He was ordered to stop advocating for more health funding and was pushed out of his job at Capital Health, according to a statement of claim that has not been proven in court.
The Liberals and other opposition parties have pressured the government to launch a public inquiry into allegations raised in the legislature by Independent MLA Dr. Raj Sherman that 250 patients on a lung surgical waiting list died from 2003 through 2006. The provincial government decided it would have the Health Quality Council of Alberta investigate the allegation to determine if long waits contributed to deaths.
However, the opposition parties are united in their call for an independent inquiry, saying the council would not be able to offer protection to those willing to speak about the problems.
In a statement, McNamee wrote, "I and other physicians who have left Alberta likely would be willing to help, if invited, to give our account and opinion, but only in the context of where we are legally protected and this would be received in an unbiased fashion."
He went on to outline some problems with the Health Quality Council investigation.
One was that severance agreements prohibit any speaking about dismissal circumstances and the protection of the law is needed to make the details public.
Secondly, individuals who are on the council may have had previous relationships to Alberta Health Services. In addition, the hearings are "closed door" and thus there is no reasonable expectation that this will be an unbiased review or that it will result in substantive change.
Lastly, he said that if the hearings were truly open and indemnified, and by an authority legally empowered to hold people accountable, he suspects that many physicians such as himself would be willing to testify.
Official Opposition Leader David Swann said McNamee’s letter proves definitively that the Health Quality Council review ordered by government does not offer sufficient protection to health-care professionals who would like to speak out candidly about government mismanagement of public health care.
“With this letter, Dr. McNamee makes it clear that he and his fellow victimized health-care professionals will only come forward under the terms of the full judicial public inquiry we’ve been demanding,” Swann said.



Editor's note: Dr. Timothy Winton, former head of lung surgery in Edmonton, says legal assurances offered by the Health Quality Council review are not adequate enough to allow him to speak about health issues and practices raised in the legislature in recent months.
Winton, who is now working as a medical professor at the University of Alberta, has come under pressure from opposition politicians and others to come forward to speak to two issues under review by the Health Quality Council -the intimidation of doctors and the allegations that people died unnecessarily on lung cancer waiting lists between 2003-06.
The following is an unsolicited letter he sent to the Herald explaining why he will not testify:
I have followed with interest the debate regarding the government of Alberta's regional health authorities' management practices and health service delivery concerns that have been the focus of attention in the Alberta legislature and extensively covered in the provincial and national media for months.
Personally, it has been particularly difficult for my family and me to be forced to silently revisit a very challenging and difficult period in our lives. Our deja vu was initially provoked by public disclosure of serious allegations directed at me contained in a lawsuit.
This occurred despite the fact that I successfully defended my actions in the matter several years ago. Most importantly, at the time and since, I have maintained confidentiality as required at considerable professional and personal disadvantage. I was not a party to and hence have no knowledge of the settlement, presumably made between the corporate defendants, plaintiffs and related parties, which was referenced in the legislature and in related media coverage.
Recently, personal acquaintances, politicians, organizations and the media have requested I come forward and comment on the above as well as my unexpected withdrawal from clinical practice and the related management and program development leadership roles I previously held. This has made circumstances even more difficult. Suffice it to state that I continue to be bound by professional and personal confidentiality obligations.
I wish, however, to assure the honourable members of the legislative assembly, multidisciplinary colleagues in health-care delivery, education, research and administration with whom I continue to have the privilege of working, as well as the people of Alberta, that I have responsibly heeded their calls. I have come forward in confidence to the management and appropriate board members of relevant organizations to the extent permitted by confidentiality constraints.
With due consideration of my current personal, professional, legal and ethical obligations and limitations, I have provided perspective, identified legislative authority and process concerns and most importantly, notified the Health Quality Council that I am not in a position to testify.
Despite assurances advanced by the Health Quality Council, the premier and the health minister, I also remain constrained by contractual arrangements related to the roles and responsibilities I assumed when I arrived in Edmonton.
I recognize the interest in securing my participation and would welcome the opportunity to provide evidence in an appropriate forum where the root causes of increasingly contentious issues can be comprehensively evaluated in a manner in which the public has confidence. Expeditious re-establishment of public trust in the many vitally important public and private organizations involved demands no less.
Dr. Timothy L. Winton is a former head of lung surgery for Edmonton's former Capital Health Region and is currently division director of thoracic surgery at the University of Alberta.

Local doctor’s lawsuit new ‘intimidation’ case
Posted 9 days ago
MATHEW KLIE-CRIBB
Today staff
The Alberta Liberals brought forward another case of physician intimidation and potential corruption Tuesday, this time citing an ongoing lawsuit surrounding Fort McMurray physician Dr. Michel Sauvé.
Last year, Sauvé filed a statement of claim against Alberta Health Services and the Northern Lights Regional Health Centre.
"He alleges that he was inappropriately removed as president of the staff, that there was not a fair process, that the bylaws were violated, and that therefore there is no trust that can be felt by physicians in the system when arbitrary decisions are made from on high," said Dr. David Swann, leader of the Alberta Liberals.
Swann said the party revealed the existence of the case yesterday because it is a new lawsuit.
Sauvé is the latest in a growing list of doctors who have filed lawsuits over intimidation and mistreatment, said Swann, but of the cases his party has brought up this one is the most timely.
"It puts the lie to the premier's assertion that this is old, that this attitude of intimidation, or this culture of fear, is old," said Swann. "Some of the cases we brought up were up to a decade old for sure, but this is a continuing problem as we struggle under a system that's not well managed and doesn't like to hear about it," he said.
Fort McMurray MLA Guy Boutilier, who was kicked out of Ed Stelmach's caucus in 2008 for criticizing the government's track record on providing healthcare for seniors, said Sauvé is his doctor, and he's known him for 20 years.
"Dr. Sauvé has always done his job on behalf of our residents and I admire him," said Boutilier. "He has been subjected to the intimidation and bullying of this government, and it's another example, this time right in our own backyard," he said.
Although Boutilier is now a member of the Wildrose, he agrees with Swann that there needs to be a public inquiry into the numerous allegations of intimidation.
Swann said the current health quality council can deal with come concerns such as emergency room wait times and cancer lists, but it is not good enough.
"It has no power to bring forward witnesses and bring forward documents if people want to keep them hidden, or ministers who don't want to testify," he said.
Sauvé declined to comment on his allegations because they have not been proven in court.
"This is another courageous physician who is willing to step forward and talk about the threats and intimidation that he's experienced in the workplace," said Swann.
matt.kleicribb@fortmcmurraytoday.com

Fort McMurray doctor’s lawsuit alleges widespread intimidation

Tuesday, April 19, 2011

EDMONTON - A Fort McMurray doctor who has been a vocal critic of the Alberta government has had his medical privileges cut back and his reputation smeared without cause, a statement of claim alleges.
In the lawsuit, Dr. Michel Sauve, an intensive care and internal medicine physician, alleges Alberta Health Services, the former Northern Lights Health Region and various other defendants, including the Fort McMurray hospital, "intentionally (and) maliciously" cut back his privileges beginning in 2008, amounting to an income loss of $750,000, "in order to hurt, damage and harm" him.
His claims have not been proven in court and a statement of defence hasn't been filed.
Dr. David Swann, leader of the Alberta Liberals, said Sauve's story is yet another example of intimidation of a doctor who speaks out to advocate for patients.
"These are courageous leaders in a community (who) need to have the freedom to speak, need to be welcome to speak and honoured for speaking out, not dismissed and punished for trying to do their jobs and trying to act in the public interest," Swann said of Sauve and Sauve's former colleague, Dr. John O'Connor, who raised concerns about elevated cancer rates in the aboriginal community of Fort Chipewyan, downriver from oilsands industry.
In 2008, Sauve wrote a letter to the Edmonton Journal chastising the government for tossing Guy Boutilier from the Tory caucus after the veteran MLA said Stelmach had broken his promise to build a long-term-care centre for Fort McMurray's growing population. Sauve continued to speak out after he filed his statement of claim in April 2010, telling The Journal five months later that a staff bylaw proposed at the time would muzzle doctors. The bylaw encouraged physicians to advocate internally before speaking publicly about issues of public health.
"This is a well-respected specialist who is president of the medical staff there (in Fort McMurray) and has been harassed and (had) a miserable time with this," said Swann, who tabled Sauve's statement of claim in the Alberta legislature Tuesday. "It speaks to the culture of intimidation within the health services board that has followed the example of this government that brooks no dissent, that doesn't respect democracy, doesn't respect professional freedom and the ethical values to speak out on issues."
Swann and other opposition leaders continued to call on the government to launch a judicial inquiry into allegations that doctors can't speak out or criticize the health system when it their patients. The government continues to say the Health Quality Council of Alberta's review into the issue will do the job, even after the Alberta Medical Association threw its support and that of its 6,500 physician members behind an inquiry.
"This government doesn't want any truth or transparency about these issues," Swann said. "It wants to cover up the mismanagement, the intimidation, the dismissals and severance agreements."
Sauve's lawsuit alleges the hospital, health authorities and administrators put patients at risk by depriving them of his care, made his work environment "intolerably stressful" and "have undertaken to drive Dr. Sauve out of the community" even though they have "paradoxically blocked, sabotaged or otherwise prevented" the Fort McMurray doctor from finding similar employment elsewhere.
Sauve continues to work in Fort McMurray. He is seeking more than $1.75 million in damages as well as full hospital privileges and an injunction preventing any interference into seeking other employment.
jsinnema@edmontonjournal.com

"The Bet" from "Anton Chekhov Later Short Stories 1888-1903"

I've been mulling over this story for a while now. I'm not quite sure why.  The story itself is rather simple and the resolution of the "conflict" --although surprising -was an acceptable one. It was accepted as possible by this Reader.

So why was I not satisfied with just accepting the solution offered by Mr. Chekhov to the story's "problem"? Why did I want the story to have a meaning beyond what I thought it meant on first readings?  Why did this story not allow me to pack it away like winter clothes in spring? What was its meaning? Did it even have a meaning? And why was I needing meaning? Why did it personally bug me?


I like to have some sort of "meaning" attached like a tag to a story-product even when most stories these days appear to be some sort of random fragment cut out of a group of characters' lives and then freefalled onto a Reader's lap like an unknown piece of a puzzle.

I like to have an orderly life.  I like to have a sorting system-to first grossly sort the stories I read; and then,I try to fine-tune-sort them for a place in the ongoing puzzle I am making.  When a piece has recognized meaning--this gives me another piece of the puzzle of the meaning of my own life.

Meaning lets me make order of the world--even though I know that this order is essentially unobtainable and false. Outside the puzzle inside my head --it is chaos. In the story-puzzle in  my head--for the most part--things are in control---everything is under construction, work is moving along and deadlines are being reached.  Things are being built. I like this type of neural development--and each story that I "solve" is put into its proper place in the puzzle and construction of neural cities proceeds happily. You can tell I'm a bit of a control freak.

A story that has meaning might give a crucial piece to make clear one sector of the puzzle, it may simply add to the blue sky section that means nothing or it may just have to sit outside the done part of the puzzle as a piece that hasn't yet found its place in the puzzle yet. I dislike the story-pieces that do not fit into my puzzle and try to get them to fit into the internal mind order.


I don't like it when I cannot identify the story puzzle pieces. I don't like it when a story is not classifiable or when there is meaning --of some sort--and I cannot grasp it. It sits outside the fixed picture that is forming. It feels sometimes like Reader puzzle-failure.



So when I came across this story and did not know its meaning --and it stuck in my head--I went back to it several times--over the last year-- to look for its meaning--to determine whether it was really a puzzle piece that was to sit outside the finished puzzle section--or whether I could "identify" it and put it in the puzzle in my head.

I know this type of work is useless and pointless and I would be better off going back to paid work as I am going to go back to on Thursday but this is just the type of irrational human being I am.  I know all of this type of reading and writing life is an utterly unrealistic and reclusive way to live a life and, that real life isn't this way,but there you go. For some reason, I need to be in this place doing this work at this time in my life and I honor my own feelings in this matter over anyone else's.

I look at the story. Seems rather placid and calm.  A bet is made. The two people who engage in the bet seem civilized. The bet is carried off. End of the story.  So why  is this story bugging me? I have to go to another book and read about stories and their "meanings" to find what is bugging me about this story.

In the beginning of the book -"The Spirituality of Imperfection  Storytelling and the Search for Meaning"--in "A Note To The Reader" --the authors --Ernest Kurtz and Katherine Ketchum--tell me that "there are no new stories".  When we encounter a story--we use our own life experiences to freshen them up--I suppose to make them new to us--to make them "meaningful" personally to us.  Story interpretation requires both life experience and an attitude of willingness on the Reader's part to enter into belief--a childlike innocence as they refer to it. 

Thus in order to find meaning in a story--you need to be "both innocent and experienced in the presence of every story."  This is easier for me to do with poems than with stories because I am fluent in the language of poetry but I am not as fluent in the language of prose.  Also, poems tend to be a shorthand or telegraphic language--fast and pure;  while stories tend to be longer explorations that I slow down in, get tired of and give up on.  This isn't always true but I think poetry is an arrow and stories are balloon-like in getting to meaning--and I like the fleet over the slow mode of transportation of meaning best. 

I get impatient with print that is long winded. Even short stories can be long winded.  So I give up on them. I don't get the story.  Or at least not immediately.  But if I persevere --as this book suggests--meaning will arrive. But I have to be "ready to hear them".  And sometimes,the book says--- I also have to incubate them inside me--so they can grow big enough like a bacterial swab streak on a Petri dish--into visible colonies of meaning. The writers refer to this process of incubation--as having the story" float loosely within its vehicle, the better to lodge in each hearer's individual spirit"--rather like the inoculum in an initially clear broth culture ---growing up to prove their presence as a visible density of cells.

Page vii

 Some readers, with different memories, will recall different renderings of these stories; there are many favorite tellings of any tale.   But, in truth, there are no new stories.  Stories become "new" to us when something in our own experience makes us ready to hear them.   Story-listening requires a childlike wisdom that combines innocence and experience, and no one can be both innocent and experienced in the presence of every story.  And so not every reader will "get" every story, at least not "right away." Story, like the spirituality that it conveys, cannot be commanded or forced; it must float loosely within its vehicle, the better to lodge in each hearer's individual spirit.
**
So if a story is to make sense to us we need to have life experience but we still need to be willing to be child-like so that we can enter the make believe of language. And sometimes this retrieval of meaning just takes time --or it takes another book like this one to help me get to my own personal interpretation of Mr. Chekhov's story-which is my meaning of the story.

I have got up on the first step of the ladder that I am climbing to get to the personal interpretation of the story.  So why have I been going back to it ? What am I looking for in this story ? What I suppose I am looking for in every story--some way to make life meaningful.  It is a big thing to demand of any writer but Mr. Chekhov is up for the job of giving meaning (or taking it away) from a Reader's life--so let me enter the story yet again.


Mr. Chekhov starts the story in the present--going back to the day in the past when the bet was made:

Page 61
It was a dark autumn night.  The old banker was walking up and down his study and remembering how, fifteen years before, he had given a party one autumn evening.  There had been many clever men there, and there had been interesting conversations.  Among other things they had talked of capital punishment.  The majority of the guests, among whom were many journalists and intellectual men, disapproved of the death penalty. They considered that form of punishment out of date, immoral, and unsuitable for Christian States.  In the opinion of some of them the death penalty ought to be replaced everywhere by imprisonment for life.

**
In this way we are presented with the banker, 15 years after the bet was made. He is recollecting the party where he had made the bet with one of the guests.  They had been trying to convince him that it was better for a man, convicted of a capital offense-- to be incarcerated for life than to die. 

The banker was unconvinced and said that it would be better to die once than to die repeatedly --daily in a prison.   I have to think about the banker's point of view. Maybe his position is sensible.  Don't we all die repeatedly in our lives? And so wouldn't we die repeatedly in our lives in prison as well?  And in fact, are we not--in truth--- all of us not really free but in the prison of ourselves--constrained by our society to act and speak and write in specific prescribed ways and therefore not really being who we are and what little we have that is truly who we are is in fact-dying daily?

It is strange that a story about quick death or long death--is really about --for me --at this point in the story--about the death in life---and how both death and life might almost be the same matter.

Page 61

   “I don’t agree with you,” said their host the banker. “I have not tried either the death penalty or imprisonment for life, but if one may judge a priori, the death penalty is more moral and more humane than imprisonment for life.  Capital punishment kills a man once, but life imprisonment kills him slowly.  Which executioner is the more humane, he who kills you in a few minutes or he who drags the life out of you in the course of many years? “
**

The party goes on arguing the matter and it becomes a  “lively discussion” that so excites the banker that he makes a ridiculous bet with a lawyer who was adamant that life imprisonment was a bit better than dying--- for as he put it “To live anyhow is better than not at all.” The bet was for two millions in exchange for 15 years of imprisonment and the young lawyer accepts the challenge.

What I found rather surprising about the bet was that the banker had originally offered the money for an imprisonment period of 5 years and the young man had upped the length of the incarceration for an additional decade! And I had to think about the lawyer's position. Was it really better to  live--in any circumstances -than to die?   I'm not sure. I've seen many sick people and I am not certain of anything anymore.  I'm on the slippery slope here.  When does a human life become intolerable? When do we give up on a human being?  How does an ethical society deal for example --with people who are mentally ill who want to die --or even very sick people who want to die (euthanasia) or parents who want their children to die so as to end "their suffering" (murder)? This is a very valuable question to mull over. How about your own life? When would it be best to die--if you are very sick and suffering terribly and have no quality of life? Is the lawyer's position always the right one--that life is always a better choice than death?

I think the matter of life and death is always --like all the important matters of our lives --matters of love.  And sometimes, folks just get burnt out. This is where our society has an obligation -say in the case of a handicapped child whose parents want to end the child's suffering to offer resources to the family so that there is the least amount of harm done--so that the child can live--and the parents can live. A society is judged on how it takes care of its weakest and how it solves the riddle of how it takes care of its least capable members of society--such as the mentally ill.  

A society is also judged on how it treats the folks who kill other people.  So I guess this story interested me for all the questions that it pulled me into----and  because I had to think about my own feelings about these questions--specifically in this story-- on the matter of life and death and punishment. How do I feel about our obligations to the least capable citizens of our society?  

I would have to say that we must not give up on anybody. And if we cannot individually do the matter of helping our weakest, most stigmatized and most demanding citizens--then we must do it as a group--and have resources in place to help these people. We --who are intact now--can so easily become them.  The ones who are not intact. It is much easier for me to decide on what to do about say mentally ill folks, the handicapped child who cannot advocate for herself or the homeless drunk on the street---if I put myself in their position.  Perhaps, the lawyer is right--perhaps some sort of life--in prison is better than canceling the cheque for someone else.

The banker, thinking back on the bet is confronted by the person he was—a rather silly creature who was spoiled and extravagant.  Now, 15 years later, about to make good on the bet he wonders why he ever made the bet in the first place.  The incarceration of the lawyer has at least made him think over his own stupid behavior and he upbraids himself for his foolishness:

Page 62

   And now the banker, walking to and fro, remembered all this, and asked himself: “What was the object of that bet? What is the good of that man’s losing fifteen years of his life and my throwing away two millions?  Can it prove that the death penalty is better or worse than imprisonment for life?  No, no.  It was all nonsensical and meaningless.  On my part it was the caprice of a pampered man, and on his part simple greed for money...”
**
So here we have the truth –fifteen years later from the banker who made the bet.  He realizes he had been a “pampered man” and the man who had accepted his bet—had done it out of a “simple greed for money.”  So perhaps the bet was not wasted effort if the pair of them benefit from realizing who they are.

But is this what Mr. Chehkov is asking the Reader to discover in the story?  Or is it something else?  I have sat with this hope chest of a story for a year now--and I am still not married yet. Why does this story bother me? Is he saying in this story something other than the matter of realization of character--the true character of the banker and the lawyer-but also about the futility of any human endeavor?  I'm not sure.  I've already been bogged down thinking about life and death and how we treat the non law abiding members of society --so now let me go back to the story's basement to rummage around some more.

The young lawyer had been imprisoned in a lodge on the banker's property.  The man was allowed food, drink, music, books, letters, newspapers--all the useful details of a recluse's life-but no sort of conversation with anyone. All requests were to be mediated by written correspondence.  It sounds like the kind of life I would have enjoyed.
The banker thinks the man would last at most a few years and even suggests to him that he call off the bet but the lawyer refuses and enters his hermit like existence without any difficulty.  So how did he manage his 15 years of imprisonment in solitary confinement? Did he go mad?  

The prisoner learns to adapt to his circumstances.  The first years were difficult but by the sixth year of imprisonment he seems to have decided to do what I have decided to do--make the journey some sort of learning expedition.  

He spends a great deal of time learning languages and becoming erudite.  Then, in year 10, he turns to religion--probably seeking a spirituality that none of us can live without without turning to fruit leather.

At the end of his confinement--he was reading rather as I am reading now--here and there --like a horsefly biting stray available legs. Perhaps this is why this story bugged me.  The man is reading like he was was defragmenting--rather like the way I sometimes feel when I read these stories--maybe this story is a warning story to myself--that I should simply stick to being a robot:

Page 64

  In the last two years of his confinement the prisoner read an immense quantity of books quite indiscriminately.  At one time  he was busy with the natural sciences, then he would ask for Byron or Shakespeare.  There were notes in which he demanded at the same time books on chemistry, and a manual of medicine, and a novel, and some treatise on philosophy or theology.  His reading suggested a man swimming in the sea among the wreckage of his ship, and trying to save his life by greedily clutching first at one spar and then at another.

**

Am I doing the same thing as this poor man? Clutching at the straws of books to keep going in writing poems? Who knows?  Life is going to end in death.  And what we do in this life--what meaning we get from doing the life-- is the only real problem we need to solve.  All other problems are lesser problems. Some of us find the answer to the problem of our life's meaning--in work. I know many men who do this.These men do not often stop working after their careers end.  They do other forms of work.  Some men just die.  Without the work that gave their life meaning, life had no point and so they gave up. 

But if work--paid work--does not give your life meaning --and to be quite frank--I don't think that paid work should be given the responsibility to keep you going in life--and should only be a way to earn money to pay for bills--then how do you get meaning to get the raft of life afloat?

Lots of us have religion to fuel the craft. Still others employ some form of spirituality.  And money will be god for a few of us.  

But what if you want to use books to find the meaning of your life?  What if you think the answer is in books?  Is this what the lawyer was doing?  Trying to find the meaning of his life?  What did he find out then?

But before we go to the lawyer, Chekhov has us consider how the banker had spent his 15 years of life.  The banker, being an impulsive, undisciplined sort has lost most of his money. He had regretted the bet he had made and he cursed the lawyer for having endured his imprisonment to soon get the remnants of his fortune.

Page 65

"Cursed bet!" muttered the old man, clutching his head in despair. "Why didn't the man die?  He is only forty now.  He will take my last penny from me, he will marry, will enjoy life, will gamble on the Exchange; while I shall look at him with envy like a beggar, and hear from him every day the same sentence: 'I am indebted to you for the happiness of my life, let me help you!'   No, it is too much! The one means of being saved from bankruptcy and disgrace is the death of that man!"
**
And so we have a creature reduced to thinking of his life only in terms of currency; we have another creature in prison, also in disarray seeking for something as well in literature.  Both of them in some sort of dark night of the soul--that will liberate them at the end of the story to some sort of understanding of what the experience of the 15 years meant.  For the banker, it appears--that he is about to resolve his problem in a singularly ironic fashion--he is going to kill the man with whom he had made the bet on capital punishment.

The old man goes to carry out his work. He looks on the remnant of a man left in the prison cell. A sort of scarecrow--somewhat like I imagine I resemble to other human beings and from which state I must transfigure myself to normal for work on Thursday. Reading books tends you make you rather dusty.

This is how the lawyer, after 15 years-- appears to the old banker:

Page 66
  
  At the table a man unlike ordinary people was sitting motionless.  He was a skeleton with the skin drawn tight over his bones, with long curls like a woman's, and a shaggy beard.  His face was yellow with an earthy tint in it, his cheeks were hollow, his back long and narrow, and the hand on which his shaggy head was propped was so thin and delicate that it was dreadful to look at it.  His hair was already streaked with silver, and seeing his emaciated, aged-looking face, no one would have believed he was only forty.  He was asleep.. In front of his bowed head there lay on the table a sheet of paper on which there was something written in fine handwriting.
**
So is this what a hermit life produces?  Some sort of weird, aged creature fit only for further isolation?  Is this some product of a Romanian orphanage--in adult form?  Unfit for society, some sort of feral beast?  

The banker feels pity for the man.  He is curious about what he has written on the paper and picks it up to read it. The paper holds the dark night of the soul revealed and the end result.

In it the lawyer expresses how he had spent the last 15 years trying to basically find the meaning of life and he has come up empty.  He says -that while he hasn't experienced real life--outside--in fact-he has done this business in books--inside --in the same if not more vivid and expansive way.

He seems to feel that all of this learning has made him into a superior being. This superior being now has a judgment to offer the entire species. He basically says that all our wisdom is toast crumbs and worthless. He says everything about man is "illusory, and deceptive" and dying gets us all snuffed out so what is the point of our lives? 

I have to admit, he has some good points here. My husband told me just the other day that all the books I am reading will make my brain bigger but when I die, it will all have been a waste of time, and I had to admit, this too--gave me pause.  Am I wasting my life reading useless books that have nothing of them that will help me solve the meaning of my life?  Is this in fact what I am doing when I write poetry and when I read to bulk up the poetry?  Or are all these matters independent acts--that do not impinge on the search for meaning?--for no matter who you are --you are on this quest and you will eventually have to do this work--well, you will, if you want to have a book written before you die.

So here is this lawyer, at the end of reading for 15 years, now sitting here decided that it was all a waste of time. But was it a waste of time? I don't think so. Even if the endeavor is always futile, if you learn who you are, this understanding is perhaps-what each endeavor is all about--its reward so to speak.

For the lawyer makes a decision--he refuses the money he could have got from the banker. He is deliberately going to break the bet. And in fact he does break the bet. He leaves before the 15 years are completely up. So in my opinion --the 15 years of imprisonment --for this lawyer was not a waste of time. He changed. He metamorphosed from a larval form who wanted money for a stupid bet to a dragonfly--who is now able to make decisions independent of money--and who knows now his own estimation ---of what other men considers valuable--which is that these matters are now valueless to him.  It took him 15 years.  It took me 52 years. I would have say he had paid a smaller price for this knowledge in terms of life energy than I did.

What about the banker?  Well, he is happy of course he got off the hook. Did he find some different coinage from the dark night of the soul he went through?   I suppose he did but it wasn't as terrific as for the lawyer.He merely felt ashamed of himself.  Was this sufficient a change for me?  I suppose so. He is a man who has used the crutch of money for a long time and in general --I find--that those among us who use the crutch of money to keep themselves upright, cannot do without it.

So what is the meaning of this story to me?  I think that I may be in the position of this man at the end of my reading and find out that all of man's wisdom is kidney beans and gas. I may find out that I am as ignorant as I was at the beginning of reading these books.  I may find out that I too--want to flee from everyone and hide away forever as I am currently doing --and be as miserable a crank as this man who says:

Page 67

   "And I despise your books, I despise your wisdom and the blessings of this world.  It is all worthless, fleeting, illusory, and deceptive, like a mirage.  You may be proud, wise, and fine, but death will wipe you off the face of the earth as though you were no more than mice burrowing under the floor, and your posterity, your history, your immortal geniuses will burn or freeze together with the earthly globe.
  "You have lost your reason and taken the wrong path.  You have taken lies for truth, and hideousness for beauty.  You would marvel if, owing to strange events of some sorts, frogs and lizards suddenly grew on apple and orange trees instead of fruit, or if roses began to smell like a sweating horse; so I marvel at you who exchange heaven for earth.  I don't want to understand you.
   "To prove to you in action how I despise all that you live by, I renounce the two millions of which I once dreamed as of paradise and which I now despise.  To deprive myself of the right to the money I shall go out from here five hours before the time fixed, and so break the compact..."
***
The man is certainly bitter. But he is awake now. He is also changed.  He has been given the gift of knowing the truth about who he is.  And how he no longer is. The man who wanted money, now understands that money-like anything that we carry in our pockets is of no use to use when the door opens and we must go.

He has still learned more than many of us learn.  As the book "The Spirituality of Imperfection --Storytelling and the Search for Meaning" --points out--maybe there is no meaning--maybe we are here --in stories--to awaken and realize what lies in us and thereby --become who we really are:

Page 41

   A man of piety complained to the Baal Shem Tov, saying: "I have labored hard and long in the service of the Lord, and yet I have received no improvement. I am still an ordinary and ignorant person."
   The Besht answered: "You have gained the realization that you are ordinary and ignorant, and this in itself is a worthy accomplishment."

**
So perhaps --realization is what the lawyer and the banker got from their experience.  And perhaps realization is what I will get from my experience of reading stories like this--that I am an ordinary, ignorant woman who is constantly failing at life and at writing poetry and yet, as this book also points out--in that realization--there is riches.  The book also counsels us to not "fight the truth of yourself."

Page 40

    And above all, don't fight the truth of yourself.  The self "comes clean" when it is most exposed, most vulnerable to its own imperfection.  

**
A story that deals with a bet, but that also deals with the imperfection inside each of us. That deals with the realization of the imperfection. Then the decision of how to deal with the imperfection. And then the act that proved the lawyer --at least--has dealt with his imperfection of greed--by walking away from the goal--at the moment of realization of the goal.  Mr. Chekhov is a very sneaky writer. 

We are to approach our imperfections--even if it takes us 15 years--even if it takes us 52 years and we are to face them and do something about them.  Even if it means we lose the prize towards which we have been striving towards with all our energies. We must lose what we most want, if what we most want will make us divorced from our new realization of who we are.And in that loss, will come your peace.  I just hope I don't end up as grumpy as this lawyer.