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The Current Transcript for July 26, 2016

Host: Laura Lynch

STORIES FROM THIS EPISODE

Listen to the full episode

Prologue

[Music: Theme]

SOUNDCLIP

The authorities have come out and said that this was a 27-year-old refugee from Syria. Now they also said that his application for refugee status here in this country was rejected.

LAURA LYNCH: It seems it's Germany's turn. Though not on the same terrible scale as the attacks in France, a week of violence and death in Germany had some there scared and others asking questions about whether the country was right to welcome so many refugees last year. In fact the man who blew himself up in a suicide attack on Sunday wasn't part of that group, having arrived here before. But that's not stopping some from raising concerns and blaming German Chancellor Angela Merkel. Then later…

SOUNDCLIP

And he was, obviously, sort of, sweaty and had just finished a long case and he sat down and he's like phew, if I never operate on another Indian it will be too soon.

LL: What that doctor didn't realize when he said those words was that he was sitting beside an Indian. Dr. Nadine Caron, Canada's first First Nations general surgeon says she was shocked and hurt when she heard those words and it wasn't the first or last time she says she's experienced racism inside hospitals and in the world of medicine. A conversation with a woman who has broken barriers and sees the need to do more to improve the health and lives of indigenous people. I’m Laura Lynch and you're listening to the summer edition of The Current.

'Refugees welcome' policy faces backlash after Germany attacks

Guests: Heather Lafleur, Nina Schick, Marcel Dirsus

SOUNDCLIP

REPORTER 1: Several people are wounded, at least four seriously after a stabbing attack on a train in Germany.

[gunshots]

REPORTER 2: The first shots rang out here, outside a McDonald's in a middle-class neighborhood in north Munich.

[police sirens]

REPORTER 3: A 21-year-old Syrian asylum seeker has been arrested after he attacked people in the street in the town of Reutlingen and he's left one person dead, another two wounded.

[police sirens]

REPORTER 4: Just after 10 last night, police rushed to the site of what turned out to be a bomb explosion. Police say the bomb killed a man who was carrying the device. He was a Syrian who arrived here in Germany two years ago and who had his request for asylum rejected.

LL: Ten victims killed, dozens injured in four separate and violent attacks across Germany in under a week. First on July 18^th, an Afghan refugee used an axe to attack passengers on a train before he was killed by police. ISIS claims it inspired the assault. Last Friday, a German teenager shot and killed nine people before then shooting himself dead. Then on Sunday, a 27-year-old failed asylum claimant blew himself up outside a bar in a town north of Munich. That same day, a Syrian refugee with a large knife killed a woman in a restaurant and injured a number of others. Germany, it seems, has entered a new era of insecurity. And German Chancellor Angela Merkel is facing a growing chorus of accusations that she compromised the nation’s security by letting in more than one million refugees last year. According to a poll released last week by the German national broadcaster ZDF, at least 77 per cent of Germans believe a terrorist attack is imminent. To get a sense of what life is like in Germany these days, I'm joined by Heather Lafleur. She's a Canadian who has called Germany home for the last 12 years and she's in Munich. Hello.

HEATHER LAFLEUR: Hello, Laura.

LL: First there was this axe attack on a train and that was just north of where you are. What went through your mind when you heard about that?

HEATHER LAFLEUR: Well, I think immediately shock. As you mentioned in your intro, there has been—for all of us, we’re sort of living with thoughts that we've—all the stories that we've heard coming out of Paris and Brussels and that always being in the other people's backyards and so this story hit close to home being not far from where we live here in Munich. So, sort of tapping into, I think sort of a subconscious feeling that a lot of Germans are experiencing right now.

LL: That was one thing and then as the week went on, there were three more attacks as I mentioned. As all of this was unfolding, did your level of anxiety increase?

HEATHER LAFLEUR: Well, I think the first attack… I think most of us were shocked but then thinking of okay, it's an isolated incident. And then Friday with that whole horrible scene that played out here in Munich, all of us were then completely in panic mode. The night played out, the information and the details came out as it not being an ISIS-related attack. But then the weekend giving us time to recuperate from the story and then having these horrible things happen again on Sunday, it's all seeming to be a little bit too much in the forefront and causing a lot of people to be very very concerned for the safety of all of us.

LL: As you said, the shooting happened in Munich and that was so close to you, it's where you live. How is all of it affecting your day to day life?

HEATHER LAFLEUR: That's a very good question. I mean, I'm a mother of two children who are under the age of 15 and they are out and about in the city all day. I, myself, I’m commuting in and out of around the city, my husband as well. So for all of us, you have to live your life and it's not really something that we're programmed to think about, the terror, it's not really a daily component of our life. So even though you have this incredible shock moment where something like that does in fact happen, here in our own city, it's not something that we then will wake up the next morning and then continue thinking on. It’s something that slowly starts to creep into your mind about what type of decisions do you do in your day. Should you go to the movie theatre on Sunday or should you just stay home and watch a movie?

LL: So what did you decide to do? Go to the theatre or stay home?

HEATHER LAFLEUR: Well, on the Saturday following the event on Friday night, I actually stayed home. My daughter had wanted to go into town and get some things into the city centre for summer holidays that are coming up but I just didn't feel comfortable doing that. And on Sunday, my youngest daughter had wanted to go see the latest Spielberg film and of course I said I'm going to take her. So I'm not going to give in to that because my naive train of thought is to think well then, haven't they won, in terms of us not being able to have those freedoms that are so important to all of us?

LL: And what are the conversations like with family and friends? Are you talking about this a lot?

HEATHER LAFLEUR: Of course. Most people are very concerned. Most people think that Germany has actually—we’re coming quite late to the table. We've seen our neighbors and I have family in Paris so I've been involved in these discussions already. How do you live your life knowing that maybe more and more is going to start to happen? I think that discussions also for the upcoming Oktoberfest, which is for Munich-based people, a huge coming together and celebration of life in all of its forms and I think most people that I know will most probably avoid it this year and not go, just concerned that there's no possible way that they could secure such a massive event where over six million people are coming in and out of the grounds.

LL: You've lived in Germany for 12 years now. I'm wondering what you see is different about the Germany today versus the Germany that you arrived in.

HEATHER LAFLEUR: Well, I mean I arrived in Europe almost over 20 years ago. I was in Zurich for seven years beforehand. And being in Zurich and then coming to Munich, I was always very sort of confronted by the homogeneity of Europe, Central Europe, growing up in Montreal and living in Toronto, being surrounded by much more of a multicultural melting pot. So coming here, it was kind of a change for me. I mean, I still had a lot of connections with Europeans and working with international working partners but that’s starting to change. You're starting to see more of a mixture of people on the streets. I mean, as you also mentioned, we've taken over a million and a half refugees in one given year in our country and you would think that you'd get off the plane and you would see them everywhere. They're not though. They're being integrated quite well. They're being put across the city in different neighbourhoods and they're not being annexed out on to their own. So I think that to Germany's credit, they've done an amazing job at integrating the people that have come through.

LL: But I wonder if that—what you think—I sense in you that there's a sense of German pride about this project, whether you think that view might shift now because of the violence.

HEATHER LAFLEUR: Well… yes. I mean unfortunately, I think that last summer I was actually in Canada watching the news as people were coming over the borders and being welcomed at the Munich train station. And me as a Canadian and also kind of a proud sort of new German, was happy to see that, whereas my husband was sort of horrified at the naiveté of what could we possibly be thinking with letting in so many people without having an idea of all of their backgrounds? That’s sort of something that I think in terms of German consciousness, Germany wants to go out of its way to show that we actually are—Germans—are actually sensitive to minorities and have this history of wanting to prove to the world that we can be a good and welcoming nation. So that's where I think it's starting to—the past year, there's been lots of discussions locally but now with these horrible events that have hit us all within one week, of course it's naturally going to come to the forefront.

LL: Heather Lafleur, I thank you for your time.

HEATHER LAFLEUR: Thank you, Laura.

LL: Bye-bye.

HEATHER LAFLEUR: Bye-bye.

LL: Heather Lafleur is a Canadian who has lived in Germany for the last 12 years. She was in Munich. Well, the attacks there have sent shock waves through the country, leaving some Germans wondering if the country's “refugees welcome” policy has been a mistake. And we have two people now to talk about this. Nina Schick is a communications director with Open Europe, which describes itself as a nonpartisan and independent policy think tank. She is a German and Nepalese citizen and she is in London. Marcel Dirsus is a lecturer at the University of Kiel in northern Germany where he's working on his PhD. Mr. Dirsus has a scholarship for security politics from the Konrad-Adenauer Foundation, the political foundation associated with the Christian Democratic Union and that is Chancellor Angela Merkel's party. And Mr. Dirsus joins me from just outside of Osnabrück, Germany. Hello to you both.

NINA SCHICK: Hi.

MARCEL DIRSUS: Hi.

LL: Nina Schick, let me start with you. Why do you think Germany has seen so many attacks over the past week?

NINA SCHICK: Well obviously, this is a whole plethora of issues coming together but I think what might happen now is that the chancellor, because she is so closely associated to you know, the suspension of Dublin last year in the opening of Germany's borders, that whatever the motivations of the attack—and you know, it became very clear soon after the Munich attack happened that this wasn't a politically motivated attack—she will be blamed. Because the scale of change that we saw in Germany having 1.1 million people coming in within a year and not being able to control who they are, where they're coming from, not being able to separate whether they're refugees or economic migrants, that's something that I think has really put Germany under pressure. And you really see that in the sense that after Merkel basically suspended Dublin and said the borders are open, soon afterwards, Germany was one of the first EU countries to shut its borders to put those temporary controls in place. So I think that what we're seeing is really a collective angst in German society, wondering whether or not it was the right thing to do, even though most people, I believe, really did want to help last year. But perhaps that was a naive sentiment given the pace of change and the scale of immigration into the country and I think we're going to see that debate now playing out politically in Germany both domestically, but also on the EU level where Chancellor Merkel has really upset a lot of her European allies because of this move last year.

LL: Marcel Dirsus, I wonder, do you understand how some might believe that the problems Germany is experiencing now are because Chancellor Merkel allowed so many refugees to come into the country?

MARCEL DIRSUS: Yeah. I mean I can definitely understand it. You know, from the point of view of many people, the way it looks is that last year, Germany was a stable country with no terror attacks, with very little instability. And now, after the influx of these refugees, you have these attacks and you have that instability. So I can certainly understand why people might think that is the case but I think what is happening is that people are throwing in a lot of things that are not necessarily all related. So, in Germany now, we don't necessarily talk only about refugees. It's always called out—refugees, Islam, immigration, terrorism. And specifically when we look at the events of last week, we have to be careful when we say that this is necessarily all about terrorism because of course, some of it was but some of it wasn’t.

LL: Yes and in fact, the attack—the most deadly attack—was carried out by a young man who was born in Germany. Nina Schick, does that make a difference to people?

NINA SCHICK: I think that you have to take… I agree with what Marcel is saying, but you have to take in the European context, what's been happening. We had obviously the horrors of Paris and Brussels and I think there was a feeling that you know, Germany would somehow be next. So I don't think people are necessarily going to make that rational division in partitioning blame, you know. And if there are more attacks like this, which you know realistically, is very possible if you look at what Europol has been saying, if you look at what the German security agencies have been saying, saying that there are many terrorists coming into Europe disguised as refugees. So the logical consequence from that is that there may be more terror attacks like this, that this may be the new normal. And if people are scared, then they're not necessarily going to have a rational conversation about this and I think this is where politicians made a failure last year. If you don't take along the public and explain to them why you're doing something and you just say well, we should do this, if you make policy based on emotion rather than controlling it and thinking about the long-term consequences, then you inevitably lose public support and already—it’s very interesting, today there was a poll out of 27 countries and in that poll Germany was now the nation that's most concerned about immigration and integration. Eighty-three per cent of Germans say that this is their foremost concern, up from 35 per cent last year ago. So yes, I agree. It's a whole plethora of issues being bought into one. Nonetheless, I think—

LL: Well, I just want to turn to Marcel now. Marcel Dirsus, Nina talked about this being an emotional decision to allow these refugees in. How important was it for Germany to prove to the world that it could provide refuge to those in need, as a sort of a hangover from the Holocaust in World War II?

MARCEL DIRSUS: I think it was very important. I think not only because of the Holocaust but even if you look at more recent history. If you look at the way that Germany was treating Greece for example, over its debt issues, there was a certain image of Germany being a cold and ruthless power and also a country that abused its power with its neighbours for its own interest. And this was an opportunity to show solidarity, not only to the people who were fleeing a devastating civil war, but also to those nations that had borne the brunt of the crisis. So countries like Lebanon, countries like Turkey, which have taken a huge number of refugees even though they don't have the same capacities as we do. And even over in Europe, you know, it's not like we, you know, we made these refugees appear. A lot of them were already in European countries and some of these European countries simply couldn't cope. So Angela Merkel made the extraordinary decision to open the borders but I think it was first and foremost an act of solidarity in extraordinary times.

LL: But was it naïve?

MARCEL DIRSUS: I don't think it was. It's a funny discussion in Germany always because people criticize Merkel for being very calculating and being overly analytical and not really standing for anything, not really having a vision. This was certainly an instance where she made up her mind, she took a decision and she went through it. I think it's too early to really say whether it has been a success or not. Quite clearly, there are difficulties but I think nobody would have said that there would be no difficulties. So I think when people talk about this, you know, imminent apocalypse that is supposedly about to happen in Germany, I think that's misguided.

LL: In fact, I was looking at the Der Spiegel English website and they were using that term apocalypse. Nina Schick, do you think that's an exaggeration?

NINA SCHICK: Of course it's an exaggeration. But nonetheless, I think emotions are running very high and I think you'd be disillusioned to say or in denial to say that this isn't someone going to affect the public debate or the political debate. And the reason why I say that Merkel—obviously I agree with Marcel, she's a very calculating politician and she made the decision and she went through with it but I do think that she did not realize the scale and that's very clear to me. Whenever I go to Berlin and I talk to politicians there, many politicians—her own party—are very very critical of her and indeed, her Bavarian sister party last year was threatening to take the government to the highest court in Germany to sue them over Merkel’s refugee policy. And despite the fact that Merkel said famously we will manage and continued espousing her policy publicly, if you look at what was happening with the policy, she was rowing back furiously. First of all, shutting Germany's borders, second of all, trying to—with her coalition partners—have curtail—who could come to Germany and who couldn't, who could be deported back and to which countries. Thirdly, pushing, all of a sudden, for a European solution and what this manifested as is a mandatory binding quota whereby EU countries would agree to take in an allotted number of refugees. The eastern and central European countries have not forgiven Mrs. Merkel for this and in fact, Hungary and Slovakia are suing the EU, at the EU’s highest court for this and in fact, Hungary is having a referendum on this in October. So you have a febrile environment whereby Mrs. Merkel is not only losing political support domestically with her Bavarian sister party and also the rise of the populist AFD, which was basically a nonexistent political force until last summer, and then also, you see the consequences of her having burnt political capital by trying to share the burden on the EU stage amongst her EU partners. I'm not saying that's a good thing or a bad thing I'm just saying these are the political events as they've happened.

LL: Mr. Dirsus, do you think Angela Merkel is in trouble here? She had been riding quite high in the polls.

MARCEL DIRSUS: She has. Again, this is an interesting question. So just before these attacks happened, it looked as if her political party was stabilizing in the polls, specifically in relation to the Alternative for Germany, the nationalist party that Nina was just talking about. Now, it's too early to say what is going to happen in the polls and I can see two things happening. One thing is exactly what Nina was describing, so, that people will blame Merkel because she is personally and closely associated with this policy. The other option that I can see is that people say in these turbulent times, we need calm and steady leadership and this is something that Angela Merkel embodies. And the other thing that I would say is that the other political parties, so the parties to the left of Angela Merkel, were also supportive of letting in these refugees. So you don't have a situation whereby the government was in favour of letting them in and everybody else was opposed to it but all the major political parties in Germany were in favour of this.

LL: I just want to briefly make the distinction between what Canada's refugee policy has been in welcoming in Syrians and what Germany has experienced because there's a big difference. Canada was able to screen and vet refugees and take them from camps and bring them to Canada, while Germany actually opened its doors on its borders to the flood of refugees who are coming in, therefore not being able to pick and choose, so to speak. And I wondered—either one of you—is that going to end? Is there not going to any longer be that welcome mat in Germany?

NINA SCHICK: Well, I mean, very famously Merkel was one of the key architects of this controversial deal, EU deal with Turkey whereby basically Turkey agreed to take back all irregular migrants from Europe or from Greece and then for each one that Turkey took back, one refugee would be resettled in Europe and that is all obviously what they were trying to get at. They were trying to be able to control those coming in, to be able to vet them properly, and I have to say that Canada's policy is very much like the UK’s policy as well. We can argue about the numbers. The UK is only taking 20,000 by 2020 but the debate here, in the lead-up to the Brexit vote, was very much influenced by the fact that Germany didn't take this controlled approach and I think, you know, obviously that has had massive political implications on the EU stage.

LL: Mr. Dirsus, just very briefly, we just have a few seconds left. Does Germany have to close the doors?

MARCEL DIRSUS: Well I think, you know, Nina is right in saying that to a degree, Germany already has and everybody—even people who support this policy—would say that this is not something that can happen every year. You know, the system is designed for maybe taking in a fifth of the number of people that we took in last year.

LL: Okay. We’re going to have to leave it there. Thank you very much to both of you.

MARCEL DIRSUS: Thank you very much for having us.

NINA SCHICK: Thank you.

LL: Nina Schick is a communications director with the think tank Open Europe and she was in London. Marcel Dirsus is a lecturer at the University of Kiel. He was near Osnabrück, Germany. Well, coming up in our next half hour, my conversation with Dr. Nadine Caron about the trials and tribulations of being Canada’s first female First Nations general surgeon. I’m Laura Lynch and you are listening to the summer edition of The Current.

[Music: Sting]

ENCORE: Meet Dr. Nadine Caron, Canada's first female First Nations surgeon

Guests: Dr. Nadine Caron

LL: Hello, I’m Laura Lynch and you’re listening to the summer edition of The Current.

SOUNDCLIP

As Indigenous people, we hear a lot about how we're not well, how we don't achieve, how we don't graduate from high school, how we don't want to put secondary education. And this was just such a different example for me to be surrounded by, that not only had other Indigenous women gone through medical school before me, but they had excelled.

LL: That was Dr. Shannon Waters. Today she is the medical director at the Vancouver Island Health Authority, but as a young Aboriginal woman working her way through medical school she didn't have a lot of people she could look up to, that is, except for Dr. Nadine Caron. Not only was Dr. Caron the first Indigenous woman to graduate from the University of British Columbia's medical school, she did so at the top of her class. Dr. Caron then went on to become Canada's first female First Nations general surgeon. Now, along with being a surgeon she's also an associate professor at UBC’s northern medical program and co-director of UBC Centre for Excellence in Indigenous Health. And in June, Dr. Caron added another accolade to the list. The Dr. Thomas Dignan Indigenous Health Award, given out by the Royal College of Physicians and Surgeons of Canada. Dr. Nadine Caron spoke with me that day about her trailblazing career and her hopes for young Indigenous students. Here is that interview. Hello.

DOCTOR NADINE CARON: Hello, Laura.

LL: Well, that is a lot of firsts. What does it mean to you to have all those firsts next to your name?

DOCTOR NADINE CARON: It’s, first of all, an honour, particularly when you're talking about something like The Thomas Dignan Indigenous Health Award from the college. I was really just blown away by that. Other things are a little bit more complicated though when you, sort of, dive into them and what they mean. And I've always challenged people when they come up and say, their immediate response is congratulations. And I wonder, is it congratulating me from graduating from medical school or finishing my surgery residency or is it really filling a gap where society has failed? There's nothing special. You know, I went through medical school with a whole class of incredible colleagues and friends and is it something where society just hadn't had a First Nations woman graduate from UBC School of Medicine yet or First Nations female general surgeon in Canada yet. And at some point I think we have to make sure that in order for it to have a true impact of being the first of something you have to make sure that you challenge those around you and those that ask to make sure they realize that not having someone before you may be something to ponder and to consider.

LL: So, if you were the first then and then I think that it is legitimate to ask what kinds of challenges or barriers did you have along the way?

DOCTOR NADINE CARON: Right. Well, I think it's a challenging road to go into medicine and to go into surgery. But I think that we've worked hard, particularly at UBC. We started a couple years ago the Centre for Excellence in Indigenous Health and one of the things we're doing is exactly that, sort of, taking a look at what was hard and how do we fix it for the next generation of students and trainees coming through. And one thing I know that we're doing is trying to make it so that when you are having challenges and you are having difficulties and you do want someone who can understand, particularly that side of things – being First Nations or being Indigenous or being a minority or having other elements in your life that you're trying to hold onto to have someone to turn to, to have someone to –talk to, to have someone that validates your concerns and your fears I think is really, really important in my year there was no other Indigenous student in the class. That was hard because you had to, sort of, looked out.

LL: But why was it hard? What were you facing that you would have liked to have had someone else to talk to about?

DOCTOR NADINE CARON: I think part of it is it's often when you're working with Indigenous populations. And my real link is with First Nations because, being Anishinaabe myself, that's where I sort of connect to and the lens that I look through. When I saw, particularly first hand, issues in the healthcare system where it led our First Nations people down, our communities down, that when it really triggered me there was no one around that got triggered in the same way that it touched so personally and so passionately. And I was often told, like, Nadine, you’re overreacting or why does that always trigger you? Why do you always get upset about that? And even as a faculty member and in academia and out in the world there, I often get told that that'll never happen. Don't dream so big. It's sort of a message that you get repeatedly throughout because there's not too many people that see it through your lens. And, like I said, at UBC, which is the world that I'm most affiliated with, they get it and they understand it and so I'm starting to see a difference now. And then I do look back and realize what I did not have.

LL: You are well aware and we've done many stories about the state of Aboriginal healthcare, both on and off reserve, big challenges, big problems - what do you say the major failings have been?

DOCTOR NADINE CARON: Oh my goodness. I usually break it down into sort of different elements. One is the access to health services. Another is the utilization of health services. Access means that a lot of our Aboriginal Peoples and communities have to travel significant distances. They don't have access to health services. They aren't aware of the health services that are there. And the quality of the health services that they get can be impacted. And, I'll say it. They can be impacted by culturally, insensitive, unaware, or frank racism within the health care system. I've witnessed myself. I felt it myself with family members.

LL: What happened?

DOCTOR NADINE CARON: Oh, it's just what you see when you walk down a hallway in an emergency room or you overhear what’s being said by other healthcare professionals in a doctor's lounge or in a surgery.

LL: They’ve said things to you or about other patients?

DOCTOR NADINE CARON: You know what? No one's ever said anything to my face, partly because I'm so protected by the white coat. You know, why would you say that to someone with an MD after your name? But when you're around a corner or they don't realize who you are or they don't know that you're First Nations, then they open up with their thoughts and those thoughts can be incredibly shocking at first, hurtful, and just, in a way, sometimes unbelievable even though you hear them time and time again.

LL: I'm sorry. It probably isn't easy for you to say, but can you give a couple of examples of the kinds of things that you've heard?

DOCTOR NADINE CARON: Oh gosh. I've been all over the country in different hospitals, so I know that I'm not going to identify a particular hospital or clinic or office, but I hear people laughing at the inability for a First Nations person to understand what's been said. I hear people really frustrated with someone who shows up late or unprepared for an appointment or for a procedure and not recognizing that all you have to do is ask a simple question and ask them why and it will blow them away. It's heart-breaking, but it's so important I understand. And I think that's why, again, I'm fortunate in the sense that being a First Nations physician I can ask the why and I and I get these answers where I can understand and say, you did the right thing not coming in. You know, that funeral is really important to go to, or that's not your fault that that transportation wasn't organized. We’ll look into it. The system failed you there. It is hard. Some of them are so personal, literally personal. I remember this one time, it was many years ago, and I was at a hospital that I don't usually work at and didn't usually work at, but I had the crew of surgeons that I worked with and other colleagues that I worked with that knew me. So, I was sitting at lunch in the doctor's lounge with them and a surgeon came in. And he was, obviously, sort of, sweaty and had just finished a long case and he sat down and he's like phew, if I never operate on another Indian it will be too soon. And it was interesting because all my colleagues around were very uncomfortable, obviously, because they knew that I was First Nations, but this individual did not. He didn't in any way target this towards me or didn't mean to hurt me. And so my colleagues were uncomfortable. It was very awkward. I did what my mom used to tell me when I was a kid, you know, count to ten before you do anything. And so I sort of waited a few seconds and then I said well, you know, if you don't want to operate on an Indian when you get paid you probably don't want to eat with one for free. So I slowly gathered up all my stuff and got up and walked away. Eventually what happened was, slowly, one by one my other colleagues at that same sort of big lunch table got up and moved away from the table too. And what was interesting is it was about four years later, I was talking to him and he came up to me and he said do you remember that day? And I knew exactly what he was talking about. And I said yeah, yeah. I remember. And he said I'm so sorry. And I said yeah, you know, what are you sorry for? Are you sorry because you hurt my feelings? Is that what you're sorry for? And he said no. He goes, I knew if I said sorry right away for hurting your feelings that you would never have accepted that. He said it took me a long time to realize every time that I saw a First Nations patient or an Aboriginal patient that I had to be so careful and I had to check myself and I had to realize that I needed to respect every person. I shouldn't jump to conclusions and I shouldn't make assumptions. And he said it's taken me years and every single time I see an Aboriginal patient I think of that interaction that we had and so now I feel like I can say sorry because I think I've changed. I feel like I can actually say sorry for more than hurting your feelings, but for the way that I used to be. And I bring up that one, I guess, because in a way it came about with an apology. That whole apology that Aboriginal people in Canada are waiting for, I got one of those.

LL: I can hear in your voice the kind of emotion and pain that you can recall so vividly even though this happened such a long time ago. I know it was hard for you to share, but I thank you because I think it's something that listeners, people need to hear.

DOCTOR NADINE CARON: Well, if there's one person out there that is touched by it that maybe changes, then it was worth it.

LL: You vividly outlined what you see as some of the problems and challenges. So, what needs to change?

DOCTOR NADINE CARON: Well, I think, in a lot of ways, the pathway to changing, a lot of those are outlined in the Truth and Reconciliation Commission’s calls to action. For example, we were just talking about issues in the healthcare system where it's really almost on one to one and how an individual is respected and valued and understood. So, in the TRC, they called for cultural competency now or even moving towards cultural safety and cultural humility training for healthcare providers, not just nurses and doctors, but across the board, making sure that the actual quality of care that an individual receives regardless of their background is optimal.

LL: Do you think this Centre for Excellence in Indigenous Health at UBC can play a role in that?

DOCTOR NADINE CARON: We certainly hope so. That’s within our mandate. We targeted first the medical school because they were doing their new curriculum. And it was very exciting when the medical school took on absolutely mandatory training in cultural competency and cultural safety for their medical students. So, that's been going on now for two years and that was a big step forward for UBC and I think a real leading role in terms of how post-secondary institutions can take responsibility for the professionals that they're training. We're trying actively at UBC to increase the number of Aboriginal healthcare providers. So, we're out there and we're trying to recruit students that want to enter the health professions, whether it's medicine or other entities like nursing, pharmacy, dentistry, midwifery, you name it. We need more Aboriginal representation so these individuals can become leaders and they can show the Aboriginal youth out there. If it's a Métis doctor, they can say, look, you too can do it. A First Nations nurse, look at what I'm doing and I love what I'm doing - that role-modelling and mentoring.

LL: You've also set up this biobank. It sounds really interesting. What is it? What is the aim of it?

DOCTOR NADINE CARON: The Northern Biobank Initiative just underwent or it's just starting its phase two, recently, up here in the Northern Health Authority in BC. And what a biobank is is basically collecting biospecimens or, to make it easier, something that would otherwise be collected, such as a tumour after a cancer operation or blood, and instead of just sitting in the basement of a hospital, we bank it and we put it in a place where we know it's there and we have, what we call, annotated clinical data. We know it's from a 62-year-old man or a 42-year-old lady. It's all de-identified so we don't know who it was or any information that can identify that individual, but then if research questions come up, then, all of a sudden, if we can create that biobank, the Northern population will be able to be part of this significant research that's being done. Being a cancer surgeon I certainly see a significant change in how we diagnose and treat cancer patients because of this research and it's just been concerning that our Northern population hasn't had the opportunity to be part of it. A significant part is, the major partner in this entire initiative, is the First Nations Health Authority here in BC. And they're really exploring whether this is something their communities would want, is this something their communities would benefit from. And if it is, then how do their communities want this to be created?

LL: There is another area I want to address with you. The Truth and Reconciliation Commission, which you talked about before, made some other recommendations around Indigenous health. One of them is to recognise traditional healing practices and as a doctor and in the Western system, how does a move like that sit with you?

DOCTOR NADINE CARON: Right. You know, I get asked that a lot, particularly since I don't know if there's anything more concrete in the Western medicine than a surgeon where if there's a lump, you cut it out, kind of thing. And then all of sudden, there's the traditional healing practices of our Indigenous people in Canada. I fully support that. I think it's so important to ensure that when you are working with an individual patient with, whether it's a disease or, in my case, often new diagnosis of cancer, that you're not—you know, when I go to the operating room and I do an operation to take out, say, half of the thyroid or a thyroid because of thyroid cancer, I don't just take the thyroid to the operation. [chuckles] I take the entire person. I take their family, their community, everyone who wants this to be a safe operation, a successful operation. But, most importantly, that individual has beliefs, has values, and you have to ensure that all of that is respected so that they can trust you and you can trust that they know what they're going to the operation for and that it's safe. And so I completely agree that our First Nations people and our other Aboriginal people in Canada really need to be respected. If this is another area where they turn to for their health and for their treatments, then we need to work with them, in collaboration with them, to just make sure that what are they doing? What do we propose? How will it fit together? Instead of feeling like you have to choose.

LL: Well, but what if a patient does come to you and say, no, I don't want your treatment. I want to use traditional healing practices only.

DOCTOR NADINE CARON: And I do have patients that do that. I think part of it is that as a First Nations surgeon I probably get more First Nation patients referred to me and we have, I think, great discussions. My role as a surgeon is to share where my expertise is after decades of experience and training. But I'm not an expert in traditional medicine. So they often share what they're planning on doing to the degree they feel comfortable with and I tell them what the pros and cons are of the surgery. I let them know what my thoughts are. I always say, you know—I very rarely have someone who says they don't want surgery, they're only going to do traditional medicine. And if they only want to do traditional medicine, our final thoughts are can we stay in touch? You can always change your mind and come back to see me. I think, overall, we have to realize that these are choices. Any healthcare is a choice. I don't have a right—particularly in an area where I am not an expert—I have only to learn from my patients in traditional healing practices. My job is to do the best I can to explain what a surgeon can do and absolutely respect the individual behind that. They are so much more than a surgery patient and I can't lose sight of that.

LL: Have you ever had a patient who refused your treatment and survived on traditional healing practices?

DOCTOR NADINE CARON: I have some patients who have survived longer than I ever would have expected with traditional healing practices. And I don't know how to explain it, except to be 100 per cent honest and say I'm not an expert in traditional healing practices. But I can respect an individual’s beliefs even if they're different than what I've been trained in. And I think that's so important. I think it will help an individual trust the Western medical system and realize that we're not here to judge, we’re not here to force someone to change their mind or force them to choose between one or the other. We're here to do whatever we can, whatever they choose in the options that we give them and we're here to support them through a path, even if they end up not choosing our path.

LL: We've covered a fair bit of territory here, but I just wanted to ask you, with everything that you've talked about, how far away do you think Canada is from providing the kind of care and treatment and research that the Indigenous communities need?

DOCTOR NADINE CARON: Hmm. You know what? It spends on the day and it's early back here in the morning in Prince George so I haven't even gone into my clinic. That's a better question to ask at the end of any given day because sometimes I'm so optimistic. I have incredible colleagues in the Western medical system that just wish they could work more with the First Nations communities or do go into First Nations communities in northern BC and are absolutely blown away by the health that they see in these communities because they see individuals in their own space. And then on other days, I experience things in the hallways or hear things that are unintended to be heard and you just hang your head and you realize that it’s why thing like the Centre for Excellence in Indigenous Health exist. It's why the TRC is going to be such a powerful document. It's why as an Indigenous physician, I celebrated when the Trudeau government said that they were going to adhere to those calls to action and they believed in them and they understood that they came from thousands of courageous voices. And so I think in the end, it's just like anything else. We're not there yet but we don't even have the right to stop trying to get there.

LL: Dr. Caron, congratulations on the latest first and I thank you very much for your time.

DOCTOR NADINE CARON: Thank you so much, Laura. A pleasure to talk.

LL: Bye-bye.

LL: That was Dr. Caron speaking to me in June. She is the first female First Nations general surgeon. She’s also an associate professor at UBC’s northern medical program and co-director of the UBC’s Centre for Excellence in Indigenous Health. And in June, she was awarded the Thomas Dignan Indigenous Health Award by the Royal College of Physicians and Surgeons of Canada. Now, we would like to hear what you think. You can add your voice to any story you hear on The Current and get in touch with us @thecurrentcbc. That’s our Twitter account. Mine is @lauralynchcbc. Post on Facebook at CBC The Current or email us through our website www.cbc.ca/thecurrent and click on the contact us link. Later this week on The Current, we’ll be replaying Anna Maria Tremonti’s interview with author Neil Strauss. For his many readers, his book The Game became the bible on how to become a pickup artist. Today, Strauss has second thoughts about being a pickup artist guru and he writes about it in his new book The Truth. Here is Neil Strauss on when he knew the game was over. I’m Laura Lynch. Thank you for listening to the summer edition of The Current.

SOUNDCLIP

There was a moment where my life changed. I’ll never forget it. It put the entire game into kind of context for me, where I was kind of with a therapist with this group of other guys who are sex addicts who had all also cheated on their wives or—all on their wives, actually. And she looked through my kind of childhood experiences and saw hey… After looking through them all, she said here's why you can't be in a relationship. And I go, why? And she goes, because your mom wants to be in a relationship with you. And I sort of, this cold wind blew over me, it sounded so ridiculous. And then she said there’s a name for what you have. It's called emotional incest. And the word was just so shocking in my brain that I can't even comprehend it yet, something recognized as truth and despite that intense word I just used. And what I realized was—and it was true of so many people in the game and so many people who write these kinds of books—is that they had a certain relationship. Basically I’ll explain what that is briefly, which is that the idea is that a parent should take care of a child's needs, but what happens often is the child takes care of a parent's emotional needs. If you have a depressed parent and you want to cheer them up or overanxious parent and you want to sort of make them feel better or they’re in my case, besides both those things, is your parent has a troubled marriage or divorce and they're using you to kind of confide that in, that will harm your relationship with that sex of person especially when they get needy and so I found a lot of people had a childhood swallowed up by that sex of parent that they were attracted to. And it's fascinating and shocking and really counter-intuitive, yet so many people that I find that are cheating and struggling with commitment and monogamy and all these other things, I'll ask them about that relationship and it's almost always the case.

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July 26, 2016 full episode transcript

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