There are those who firmly believe that if you do the crime, you do the time, and it doesn’t matter if the prison time you serve is cruel and inhumane; in fact, the worse it is, the happier they are. If you’ve broken the law, they believe, you deserve whatever you get. The worse the punishment, the less likely you’ll be to reoffend.
Never mind research that’s shown not only that prison time doesn’t work as a deterrent but that people tend to come out more likely to offend than when they went in; or that racial and cultural minorities are significantly over represented in prison systems; or that disproportionate numbers of prisoners (compared with the general population) suffered child abuse or neglect, including sexual abuse, undiagnosed and untreated concussions, learning disabilities, and ADHD than in the general population. Many people still believe prisoners get what they asked for by committing crimes and that should be the end of that.
Except it’s not, because it’s one thing to deprive people of civil rights and something entirely different to deprive them of human rights. And when you deprive them of basic human rights for long enough, eventually they will fight back—and the consequences could be dire.
Catherine Fogarty’s (class of 2018) Murder on the Inside: The True Story of the Deadly Riot at Kingston Penitentiary (Biblioasis, 2021) details exactly how dire the consequences were on April 14, 1971, when prisoners at Kingston Pen decided they’d had enough and started a riot to protest their living conditions. Fogarty writes in the Introduction:
The early 1970s was a time of great political and social upheaval, and what was happening in our prisons reflected that change. Deteriorating prison conditions and the increasing awareness of basic human rights were creating a combustible penal environment … Prisoners wanted to be treated like humans instead of numbers and they were demanding to be heard.
But what began as a rallying cry to the outside world for prison reform and justice quickly dissolved into a tense hostage taking, savage beatings and ultimately murder. For four terrifying days, prisoners held six guards hostage as they negotiated with ill-prepared prison officials and anxious politicians, while heavily armed soldiers surrounded the prison and prepared for an attack.
The deadly ingredients had been brewing long before that fateful night in April. The warden … had alerted his superiors in Ottawa that the prison was dangerously overcrowded and understaffed. … But the danger signs were not heeded, and the years of mistreatment, bitterness and distrust ultimately created a human volcano …
“When the rebellion finally erupted,” Fogarty continues, “it made headlines around the world” ultimately costing the lives of two men and changing the lives of many more.
Canadians often think of our history as “boring,” but Fogarty’s telling of this pivotal event is anything but. Researching and writing the book took five years, numerous trips to Kingston, hours in Ontario’s provincial archives and Queen’s University archives, interviews with dozens of retired correctional officers and family members of those who had died, and even interviews with some of the surviving prisoners.
The year 2021, when the book was published, marked the fiftieth anniversary of the riot, yet fifty years after prisoners demanded to be heard and treated humanely, she asks, “what have we learned? Our country still struggles with fundamental questions related to incarceration and basic human rights. Cruel injustices continue to happen in our prisons every day.”
Fogarty’s book offers “a peak behind the curtain of a correctional system that is still deeply flawed in its philosophy and practices. The Russian writer Dostoyevsky once said: ‘The degree of civilization in a society can be judged by entering its prisons.’ But how are we to judge” she asks, “if we are still not even allowed to see inside?”
As the daffodils come into bloom this year, I am reminded that April is Daffodil Month, the Canadian Cancer Society’s awareness and fundraising month for cancer. And then I can’t help thinking of the heart-wrenching memoir I recently finished reading, Still, I Cannot Save You: A Memoir of Sisterhood, Love, and Letting Go (McLelland and Stewart, 2023) by Kelly S. Thompson.
The book opens as Thompson, an officer in the Canadian military, waits to meet her sister in a shopping mall. Christmas music plays in the background as Thompson wonders if, this time, her older sister Meghan will show up. Meghan, we learn, is an addict and as such unpredictable and unreliable. And she also survived cancer as a very young child. She’s also thin, and three inches shorter than her younger sister. Genetics or the impact of cancer and chemotherapy on the development of a three-year-old? Impossible to know.
As the years move forward, Meghan sobers up, finds a man, has a child, and marries the baby’s father, an abusive alcoholic. Thompson is medically discharged from the military due to her own bout with cancer. She too marries, learns she can’t have children, lives with depression.
Through it all, the sisterly closeness that eluded them through Meghan’s addiction slowly returns. Just when they are closer than they’ve ever been, and as Meghan welcomes another child, she’s diagnosed with cancer again, this time a large sarcoma that had been hidden behind the growing fetus.
With all the tragedy and hardship this family faces – both parents have survived cancer and the girls’ mother is coping with MS – it’s amazing that Thompson is able to write with humour about what must have been one of the darkest chapters of her life. At one point, Thompson sets about dying her sister’s hair in an effort to help her feel attractive. After letting the dye do its work, they head into the bathroom to rinse it out.
“Alright, let’s hose you down,” I said, gesturing to the bathroom.
“How am I going to keep my pyjamas clean?” …
“Just go in there naked. I’m your sister, what do I care? I’ll be in my bra and underwear anyways. Don’t want to get soaked.” …
She gingerly stripped down to reveal a padded Depend, convenient after having a child. Her breasts were pendulous, filled with milk, nipples white with colostrum. I could not take my eyes off them. “Well at least your boobs look great.”
She gave her chest a gentle shimmy. “Yeah, I’m a regular porn star.” We giggled at this as I helped her shuffle into the bathroom, shocked at how she was rail thin yet simultaneously puffy. She sat on the supportive bathing chair and then leaned forward as I set to work with the extendable shower head, releasing a stream of inky brown from the tendrils that dangled over her face. That is, until I dropped the shower handle, cracking off the cover and sending water everywhere in a zealous spray, cascading blotches of dye across the walls, Meghan, and the bathroom. The incontinence brief hung limp with liquid and mascara ran down my face, pooling within the brown sludge at our feet.
“There’s a porn movie in this somewhere,” Meghan said, laughing so hard she was gasping and clutching at her misshapen stomach.
“What’s with you and porn today? Besides, I don’t think anyone in porn is wearing a diaper.” I was laughing too hard to control the shower handle …
“Oh, you’d be surprised,” she said. And then we laughed even harder.
I devoured this book in a couple of days. You should too, but make sure you have a box of tissues at hand.
Edited to add: I belatedly learned that Kelly S. Thompson is not an alumnus of the MFA program but a mentor! Oh well, I’d always figured once I was running out of books by grads I’d start reviewing books my mentors and directors—there are plenty of those too. Now if the grads would just take a pause from being so prolific …
When my two older children were small, I had a dream. We would, as a family, put our belongings in storage, take two years off work and school, and travel the world. As time passed, I reduced it to a year travelling Europe. Then it was a six-month road trip around North America.
None of that ever happened. We did, after I’d had significant windfalls, have six weeks in Cabo San Lucas when our older kids were four and six, and a month in Costa Rica when our older two were leaving home and our youngest was 12. And since my divorce, I’ve had a month in Ireland and three weeks in Scotland. I love to travel.
So, when I heard that Esmeralda Cabral’s (class of 2019) book, How to Clean a Fish and Other Adventures in Portugal (U of Alberta Press, 2023) was all about a five-month sabbatical she and her husband took with their family to Portugal, I was intrigued.
Cabral, a Portuguese Canadian, spent most of her childhood in the Azores, which I can only imagine as idyllic, so the opportunity to return to the land of her birth was too good not to take advantage of. And everything she writes about it makes me jealous. As one can imagine from the title, a lot of the book focuses on food, a delicious and important part of Portuguese culture. Here’s an excerpt from a tale early in the book:
One of my favourite things to do in Costa was to browse in the market. I often went alone in the morning, while Eric [husband] and Georgia [daughter] did their work at home. I would stop and have a coffee at the counter of one of the coffee shops on the way, and sometimes I’d have a pastel [an egg custard tart] too. I’d go to the bakery to buy a loaf of bread or a few buns [mmm, Portuguese buns], and then head to the market, where I would talk to the vendors and fulfill my need for conversation. …
At a small stand right inside the north entrance, a woman sold mostly verduras, or greens. She didn’t seem to have much to sell on any given day and what she had looked a little wilted, but I usually bought something from her—lettuce, if nothing else. She would smile and greet me as I entered the market, and I found it difficult to get past her without buying anything. I would stop to talk to her, and then the woman from the next stall (who had much better-looking produce) would join in our conversation. From her, I’d buy potatoes, kale, carrots, and whatever else looked good. ….
Farther down in the fruit stall area, there was the man who sold what I deemed to be the sweetest oranges. … The crisp, peppery smell of citrus in this part of the market often permeated my nostrils and filled my head with memories of my childhood in the Azores. … I remember looking forward to Saturday morning walks to the orchard with my father because it felt like I was going to work with him. We’d come home laden with bags of oranges and lemons and sometimes bananas too, and my mother would promptly make fruit salad. …
Past the fruit stalls was a large, partly closed-off area full of tables with fish and seafood displayed on mounds of ice. Women in oil-cloth aprons called out their catch of the day and competed for customers. I didn’t go in there very often because I felt conspicuous in my ignorance … and I was intimidated by these women, all of whom were loud and looked strong and confident. … I wasn’t yet brave enough to buy fish as I had no idea how to clean or cook most of it. … One day I’ll buy fish there, I’d think to myself.
And of course, one day, she finally did, and the woman in the market cleaned it for her and told her how to cook it. And it turned out just right.
The whole book is a series of memories, with picturesque descriptions of the scenery and the food and the people, many of them including food images so precise that reading made me hungry, and all of it interlaced with memories of Cabral’s childhood. It’s a gently written book that left me wanting to revisit that long-ago idea of putting my life in storage and heading out to see the world again.
Sue Harper’sWinter in the City of Light: A Search for Self in Retirement(self-published, 2019, class of 2016) is about exactly what the title suggests. After years of teaching, the author and her partner retired. A talented artist, her partner knew exactly who she would be in retirement. Harper wasn’t quite so sure.
Within a few years of retiring, they went on an adventure: a winter in Paris, where Harper’s partner attended an art course at the Sorbonne. Harper imagined that, during the days when her partner was at school, she would explore the most exciting city in the world, waiting for inspiration to strike, and then withdraw to the small apartment they’d rented and churn out book manuscripts.
It didn’t work out that way. On her own all day in a strange city, Harper had to face her fears, not only about going out on her own to explore the city, but about whether the author she’d thought was inside her was struggling as hard to get out as she’d always thought. About midway through the book, Harper writes:
When we retire, we have lots of time to doubt ourselves. While the imposter phenomenon is destructive, it’s also difficult to overcome because no one talks about it. One of the researchers who labelled this phenomenon, psychologist Dr. Suzanne Imes, says little can be done to change the imposter’s feelings about herself. She is convinced she’s the only one who feels this way and fears that if she told anyone else she was a phoney “she would meet with criticism or at least very little understanding on the part of others.” …
It’s funny. I never felt fraudulent when I was writing textbooks, teaching, or helping other teachers, even when I earned promotions at work. My doubt seems strongest when I go to school. I’ve tried to pinpoint the reason for this. Was it because I always compared myself to my brother, who scored in the ninety-ninth percentile on the university entrance exams? Or maybe I couldn’t forget my father’s comment when I showed him my 88% in music: “What happened to the other 12%?”
Ouch.
The point is that retirement is something we do in the winter of life, but we can never forget that winter can also be a turning point in a journey back to light. And ultimately that’s what Harper’s time in Paris became. Overcoming her imposter syndrome enough to complete the Master of Fine Arts program in Creative Nonfiction Writing at University of King’s College in Halifax, she also completed a book manuscript describing her own journey.
Full disclosure: I met Harper through the University of King’s College MFA in Creative Nonfiction program and later copy edited her manuscript. I haven’t quite made it to retirement myself, but it’s likely when I get there I’ll go back and read it again to help myself face my fears and make my winter a time of new beginnings, as she did.
With International Women’s Day here in a couple of days, I thought I’d focus this week’s blog post on Lauren McKeon’s terrific book on what’s ailing feminism.
Although I started calling myself a feminist when I was 13, I confess that my commitment to doing so has wavered over the years. Not because my belief in principles like equal pay and reproductive rights has faltered, but because my willingness to embrace the movement that champions these values has sometimes been shaken by feelings of exclusion.
Maybe that’s why I enjoyed reading The F Bomb: Dispatches from the War on Feminism (Goose Lane, 2017). Author Lauren McKeon (class of 2017) writes passionately and compassionately about some of the concerns women like me have had over the years with feminism as a movement. I’ve always believed that changing the world begins with understanding our opponents, yet I often feel dismissed for saying we need to understand people who I think are clearly on the wrong side. I suspect those who dismiss me (and sometimes “unfriend” me on social media) think I’m saying we need to have compassion for them when what I’m really saying is we need to comprehend where they’re coming from (compassion optional). History’s best generals know you can’t fight a war without having respect for and insight into the way your enemy thinks. In political circles, it’s called “oppo research.”
The F Bomb is incredibly well researched and intelligently written. Its arguments are organized to build from a simple question — where is feminism failing? — to a beautifully argued conclusion. It’s also a perfect vehicle for McKeon’s award-winning journalistic chops. Here’s a sample from the epilogue:
As we wade further into the opposing but jointly skyrocketing feminist and anti-feminist movements, I hope we can learn to listen more to the other side. I don’t exactly mean we should have a tea party with Hitler, Mussolini, and, oh heck, even Trump. Crumpets, tea, and fascism! But I do believe we have to let go of our liberal superiority, the belief that clearly reprehensible views aren’t powerful enough to gain mass traction. We’ve seen they obviously are. It means acknowledging that people who we don’t think have any right to be unhappy—the white middle class mainly—are miserable, hurting. What’s worse, they believe the cause of their pain is the policies of the left. Unless we understand why, it will be impossible to counteract and confront the ripple effect of damage that pain has caused. We can’t fight what we so arrogantly ignore. …
I believe it is possible, still, to fight with compassion and humility. Not just possible, actually, but essential. At its heart, feminism is not about making your life better and more equitable; it’s about making everyone’s lives better. … We must embrace criticism and change. We must live our politic. We must make some fucking room.
To my mind, McKeon hits squarely on a remedy not just for what can make feminism more welcoming for people who often feel they just don’t belong but for what’s ailing so much in the world today. And this is even truer as I write now, as Donald Trump is a couple of astonishing months into his second term as US president, than it was when The F Bomb was published a few months into his first term. If we can’t understand the people who elected him, how can we ever hope to reach them?
With Ramadan starting February 28, I thought this week’s blog post would give a nod to the Muslim faith. I’m not sure what I expected when I started reading Halal Sex: The Intimate Lives of Muslim Women in North America (Viking, 2023) by Sheima Benembarek (class of 2020), but what I found was so much better than anything I imagined.
As a baby boomer who grew up in the seventies, I always thought of myself as a person who didn’t have too many sexual hangups. As a middle-class white woman who grew up in a secular Christian household, I had many preconceived notions (largely wrong) about Muslim women. So, it was a surprise to me to read the stories of a half-dozen Muslim women who are forging their own paths sexually.
Hind is a self-described niqabi—she wears the full body-covering niqab, with only her hands and eyes showing, which she chose because she tired of being subject to the male gaze. I’m guessing many if not most Western women think of the niqab as a sign of women’s oppression. I let go of a friendship years ago because the person in question said outright that she had no respect for women who wore even a headscarf for religious reasons because they were submitting to male oppression. But the male gaze can be oppressing too and I understand the perspective that covering up might have a freeing effect.
Regardless, underneath her niqab, you never know what colour HInd’s hair might be—turquoise, maybe—as she practices a form of self-expression that’s meaningful to her. She’s also in an unusual marital situation—divorced from her first husband, now sharing her second husband with another woman (her idea), but living separately and independently because she doesn’t get along with his first wife. Her husband spends two days a week with her and the rest of the time with his other wife and children. (I could deal with such a relationship.) She has an abundant sexual appetite but her first husband didn’t, which was one of the reasons they went their separate ways. And despite the conservatism of her faith, she’s very open in talking about sexuality and educating young people in her community about it.
Benembarek writes skillfully about a half-dozen women who are expressing their sexual identity in their own ways. Like Azar, a nonbinary transgender Sufi, which Benembarek describes as the hippy group of Islam. And Bunmi, a black bisexual Texan Muslim of Nigerian heritage who gave up the headscarf and can now be found roller skating and smoking a joint. And Eman, who’s “one half of a popular Jewish-Palestinian lesbian comedy duo who, after marrying, combined their last names and professionally call themselves the El-Salomons.”
And then there’s Khadijah who,
sashays back and forth in her cherry red pleather thigh-high boots, watching herself in the floor-length mirrors in front of and behind her. It takes practice to stay up on those eight-inch heels and even more practice to confidently swing around on a pole in them. The boots are made of polyvinyl chloride, a durable type of plastic; she wears stockings to avoid sweating profusely and to ease the labour of peeling them off. Her brown curls are conveniently out of the way and up in a messy bun, and she adjusts a sheer black cape that’s not long enough to conceal her frilly black high-rise panties. …
Khadijah worries her pole dancing isn’t as sophisticated as the other women’s; she has more experience in burlesque. She’s the only woman of colour dancing in the studio that afternoon, and the combination of leather and black and red fabrics suits her. The stern yet sultry look she’s putting on does too.
None of these women are what would come to my mind if you had asked me to describe a Muslim woman before reading Halal Sex. But then, if there’s anything I love in any book, it’s the opportunity to learn. For me, Halal Sex was all about learning.
Every year for Christmas, everyone in my family puts together a wish list. For the past several years, my list has included whatever books have been published by graduates of King’s University’s MFA in creative nonfiction, minus whichever of those I’ve already read. The list keeps growing—it now includes more than 50 books, of which I’ve read about half—so which ones appear under the Christmas tree is increasingly a surprise.
For Christmas 2023, one of the books was Laura Pratt’s Heartbroken: Field Notes on a Constant Condition (Random House Canada, 2023). I started reading it soon after Christmas. But then a new relationship I was in, for which I had high hopes, ended abruptly and I didn’t have the heart to continue.
I picked it up again in the summer when I was travelling. Overall, the trip didn’t go well. There was a death in the family right before I left, I had my phone and wallet stolen while I was on a train to northern Scotland, and my sailing charter around the Inner Hebrides was cut short because of gale-force winds, including the tail end of Hurricane Ernesto. Not my best trip ever.
Reading Heartbroken was a high point while confined below decks to escape the weather. With my own sad relationship a few months into the rearview, Pratt’s book helped me deal with the dregs of my feelings about it. The back cover sums the book up this way:
“When Laura Pratt’s long-distance partner of six years tells her ‘it’s over’ at a busy downtown train station, she is sent reeling, the breakup coming out of the blue. He, meanwhile, closes himself off, refusing to acknowledge Laura and her requests for explanation.
“In the following days, months, and then years, Laura struggles to make sense of the sudden ending, alone and filled with questions. A journalist, she seeks to understand the freefall that is heartbreak and how so many before her survived it, drawing on forces across time and form, and uncovers literary, philosophical, scientific, and psychological accounts of the mysterious alchemy of how we human beings fall in love in the first place, and why, when it ends, some of us take longer to get over it, or never do. She weaves this background of cultural history with her own bracing story of passionate love and its loss, and offers some hope for arriving—changed, broadened, grateful—on the other side.”
What I enjoyed most about this book was the way Pratt weaves together the story of her all-encompassing loss with minute details of a vibrant and passionate love affair unfolding in a club in Toronto, an apartment in Montreal, the Laurentian Mountains, the streets of New Orleans, and anywhere else the couple’s whimsy took them. And then she enlivens the lyrical quality of her own prose with snippets of poetry, fiction, and research on everything from stages of grief to the history of love and the science of memory. In a chapter on happiness, she writes:
“And so we fed on each other, writing and playing and fucking, a thousand points of light. And we did it all inside the exquisite torture of a long-distance relationship, the inherent privation, privilege, and prolonging of which cannot be overstated. Extraordinary circumstances breed extraordinary experiences and our intermittent encounters were feverish. I was overheated as I brushed my hair in the airport bathroom on those brilliant Thursday evenings, my sparks glancing off the tiles. I was beautiful and couldn’t wait to show him, to step out of those sliding doors and into the Montreal evening and his Toyota. To light up the sky with our happiness.”
This was a beautiful, heartbreaking book. I recommend it to readers of all ages who have loved, whether or not they have also lost.
PS. Closing in on a year after my four-month relationship ended, I still find myself wrestling with what went wrong, waiting for the day I can simply say “It was fun while it lasted” and leave it at that.
I wanted to respond to this column by The Globe and Mail health columnist André Picard last week—a bit off topic for my blog but not for me personally, as will become clear.
My son is a pediatrician. He graduated from St. George’s University School of Medicine in Grenada. There are many stereotypes about doctors coming out of Caribbean schools being less qualified than those trained in Canada. They are false. All doctors working in Canada must demonstrate the same capacity by passing stiff exams at each of four stages: entrance into medical school, entrance into residency, entrance into the profession, and board certification.
A candidate who fails at any one of these stages may not go onto the next and may therefore not qualify to practice medicine in Canada. Candidates who were educated, trained, and have worked in countries where the medical system is significantly different than our own must undergo rigorous education and training to practice up to the standards that make Canada’s medical system globally enviable. But in terms of qualifications, these candidates are not the same as candidates who were educated and trained in systems that may operate on a slightly different model but produce physicians that are equally as qualified as those who attend Canadian medical schools.
I can’t speak to medical schools in England, Ireland, and Australia, where the quality of medical care is similar to ours in Canada. I can only speak to what I know about as a result of the fact that my son attended a Caribbean school, a school that has overcome significant prejudice to become a prestigious medical school in its own right.
So, what’s the educational difference for physicians who graduate from a medical school in Canada or one in the Caribbean?*
First, it’s important to note that medical schools operating in the Caribbean are, for all intents and purposes, USian schools. Students do their first two years at campuses in the West Indies, where the cost of building, operating, and maintaining a medical school is lower than in the US or Canada. They then go onto internships, their first shot at hands-on practice under the strict guidance of experienced physicians, at USian hospitals, where the standards of care are very similar to our standards in Canada.
So, what’s the difference that gets students from basic sciences through internships to graduation and residencies (the second stage of hands-on practice)? It’s basically that Canadian and Caribbean schools use a different operating model, as do medical schools that operate within the geographical US.
In Canada and the geographical US, a student’s credentials for admission to medical school must be the crème de la crème of each year’s pool of applicants. But as Canadian and US-based medical schools operate on a pass-fail basis, once a candidate has been accepted, it’s unusual for them to flunk out.
And the overall credentials for any pool of applicants are influenced by more than quality. For example, the makeup of a particular graduating class might be heavily influenced by economic conditions at the time they applied. This was the case, for example, during the 2008 recession, when jobs were so scarce that people in many fields were accepting positions well below their qualifications and at lesser pay than they might have been offered months earlier (I knew some of them).
At that time, many young people went back to school to improve their qualifications. (I was working in international education at the time and had direct knowledge of this.) Suddenly, for reasons having nothing to do with their qualifications, the pools of candidates increased, and many applicants didn’t make it into schools that might have accepted them just months earlier.
I don’t know if Caribbean schools experienced a bumper crop of applicants at that time, but it would make sense that they did because of their operating model. To gain entrance, one must pass the same rigorous exam as is the basic requirement for all students, but other entrance qualifications may not be as stringent. For example, a student might have just barely passed their exam, might have less volunteer experience in their application, or might not have done as well in the interview.
Does that mean students graduating from these schools are less qualified than those graduating from Canadian schools? Not at all. Caribbean schools operate on a model that accepts students from around the world whose entrance qualifications may be lower than required by Canadian schools. But then, unlike in Canadian schools where it’s near-impossible to flunk out, their progress is graded at every turn.
This gives the students an opportunity to improve on any deficiencies in their entrance requirements and repeatedly show that they deserve their spot in the school. It also contributes to a very high attrition rate, which can top out at around 60%.
This is not cheap for students. At the time my son completed his education, the cost was $400,000 USD, easily four times higher than a Canadian school. And students who flunk out don’t get a refund on what they’ve paid for their year.
The most-qualified applicants are offered significant scholarships to encourage them to attend. However, given the schools’ global focus, the largest scholarships typically go to students from majority world** countries who couldn’t otherwise afford to attend but who will take their education back to their home countries to improve life there—a fair system if I’ve ever heard of one.
After finishing their two years of basic sciences, students complete their internships at hospitals in the US. In contrast to students who attend Canadian or US-based schools, this gives them an opportunity to do part of their internships at different hospitals, working under different doctors and different systems and exposing them to a wide range of perspectives, which I see as a bonus to this system.
In other words, students who make it through the rigorous program of studies at Caribbean-based schools are at least as qualified as students who attend school at a Canadian or US-based medical school, if not in some ways more so.
Yet the column I linked to at the beginning of this post was titled “International med school graduates are an untapped resource, as well as a complex challenge.” In it, Picard writes:
“It’s important to note that there are two types of IMGs. The first are Canadians who study medicine abroad in places like Grenada, Ireland and Australia, usually because they weren’t accepted to Canadian schools. They argue they have a “constitutional right” to compete for residency spots on an equal footing with Canadian grads if they pass Canadian exams.
“The second type of IMGs are those educated in other countries who emigrate to Canada. If they do so before residency, they have little chance of getting a spot. (The exception is grads from countries like Saudi Arabia, who “buy” residency spots but must return home after training – a topic for another day.)
“We limit the number of doctors we train because money isn’t unlimited. We already have 97,384 physicians in Canada, and spend $32.5-billion annually paying them. Rationing is a reality.
“If we want more doctors, then one avenue is to open more residency spots for IMGs. A report last year from a group of independent senators recommended adding 750 spots, essentially doubling the current number.
“Of the group of IMGs who have trained and worked in other countries before emigrating to Canada, some of them could start work tomorrow while others do not have the appropriate qualifications. The challenge for regulators is to figure out who’s who.
“The path to practice has many hurdles: demonstrating you graduated from a legitimate medical school, having your credentials verified, passing Canadian exams, showing competency in English, having your competency tested and finding a job.”
I agree that ensuring the IMGs who lived, trained, and worked in other countries before coming to Canada must be carefully vetted before working as physicians in Canada, and doing so can be complicated. But when it comes to Canadian students who simply went overseas to train in systems that operate on a slightly different model but graduate physicians who are equally as qualified as those who study at Canadian schools, as demonstrated by the rigorous screening they must go through before practising in Canada, I fail to see the challenge. As the first link in the above quote (to SOCASMA, the Society of Canadians Studying Medicine Abroad) notes:
“Currently, provincial Ministries of Health allow Canadian medical schools to control selection for entry level training jobs called medical residencies. Canadian medical schools have used this power to exclude qualified Canadians from competing against their graduates for these positions.
“Canadians who have studied medicine anywhere but Canada and the U.S.A. are prohibited from competing against their peers who graduated from Canadian and American medical schools. They can only compete in the IMG (international medical graduate) stream, and only if they agree to enter into return of service contracts. The IMG stream is a very limited opportunity stream.
“In British Columbia, only 4 out of 65 medical disciplines are available to Canadians who have international medical degrees despite passing the national medical knowledge and clinical skills exams.
“Canadians, who choose to study overseas, and other international medical graduates, are treated as second class citizens when it comes to competing for positions in one of the most prestigious callings in Canada. The two-class system of medical residency selection currently in place is an affront to the fabric of Canadian society. This type of class system feeds the growth of a culture of entitlement and it feeds prejudice, both of which are destructive to a free and democratic society. It also prevents Canada from hiring the most qualified Canadian physicians. This impacts access to health care and the quality of health care for all Canadians.”
The blocks to this stream of IMGs practising in Canada are, to avoid mincing words, stupid. At a time when 6.5 million Canadians lack access to a physician, the rules and regulations that categorize Canadian graduates of fully accredited medical schools abroad along with physicians who graduated from medical schools that cannot hold their own in the Canadian system are, not to put too fine a point on it, stupid.
I fully understand and agree with the need to ensure physicians practising in Canada are qualified to practice at a level commensurate with our own graduates. But the existing system miscategorizes graduates of a system where the only differences are that a) Canadian students study outside our borders, b) students who under perform can flunk out at any stage of the game, and c) students pay for the full cost of their education themselves rather than having it subsidized by Canadian taxpayers.
This creates disadvantages that affect all of us. It needs to change. 6.5 million Canadians who don’t have a physician of their own can’t afford for it not to change.
(*There may be other differences between schools in Canada and other countries, such as Ireland or the UK. For example, some countries do not require doctors to complete an undergraduate degree before applying to medical school, as we do in Canada, but admit students directly from secondary school into a pre-med program and from there into medical school.)
(**I prefer the terms majority world and minority world countries to value-laden terms like firstworld and third world or developed/industrial world and developing world.Majority and minority world reflect the reality that the world’s wealth is concentrated in the pockets of the minority populations of a few countries, while the majority of the world lives in poverty that most of us in countries like Canada and US can’t even imagine. I like the way these terms, which I first encountered in a magazine called The New Internationalist and which I highly recommend, force people to stop and think about what’s really going on in the world.)
Continuing my meander through the 50+ books published out of the MFA program in Creative Nonfiction at University of King’s College …
If you’re a parent, you know what it’s like to be out somewhere, anywhere, when your young child suddenly needs a toilet … and there are none to be found. This was the repeated experience Lezlie Lowe (class of 2016) had when she had young children, and it was what she chose to write about when she undertook her master’s degree in creative nonfiction.
An easy-flowing read replete with really good bathroom humour, No Place to Go: How Public Toilets Fail Our Private Needs (Coach House Books, 2018) was an eye opener for me. I’ve raised three children, but I’d never thought of all the reasons people need public restrooms. The text on the back of the book mentions some of the people being failed by a global lack of attention to one of people’s most basic needs. People like “the homeless who, faced with no place to go sometimes must literally take to the streets,” a problem that became even more pronounced during the Covid pandemic. And “people with invisible disabilities, like Crohn’s disease, who stay home rather than risk soiling themselves on public transit.”
That one got me. I have Crohn’s disease, which flared up right around the time I started the MFA program. It was embarrassing having to get up and go to the toilet several times during morning lectures and mentor groups, but at least we were in a building with toilets nearby. If I’d been at home … let’s just say I would have stayed at home all morning.
But public restrooms fail a lot of people, like girls who need a bathroom right now when their period suddenly gushes through their pad or tampon. And trans people, who face bigotry every time they use a public restroom. Women are habitually underserved by bathroom stalls that are equal in number to men’s urinals. Several studies calling for “potty parity” argue that, considering clothing differences, menstruation, and anatomy, women’s washrooms should have twice as many stalls as men’s have urinals.
Parents of children still in diapers become very aware of the need to find a clean and dry place to lay a child down for a change, especially if it’s a messy one. And don’t get me started on pay toilets. I thought these monstrosities were things of the past until I went to Scotland during the summer of 2024 and found myself without the appropriate coinage to answer nature’s call in a public mall.
There are solutions, and Lowe writes about one of the best: “The Portland Loo is a vandalism-proof, twenty-four-hour flush-toilet enclosure. An anti-tech fix for on-street public bathrooms. The Loos are simple, oval-shaped rooms with a toilet. They’re spacious enough to fit strollers, wheelchairs, and even bikes. In contrast to the high-tech entrances, timers, and air-conditioning systems at work in conventional APTS [automatic public toilets] like those in Toronto and New York, Portland Loos are naturally lit and ventilated and completely off grid. They also happen to be an example of the successful use of crime prevention through environmental design—louvred sides allow people on the outside to see that there’s someone inside while maintaining privacy, and exterior handwashing sinks get people right out after they use them.” Best of all, they’re designed for everyone. Free to use, taxpayer supported. A true public service.
It may just be the phenomenon that once you become aware of something, it seems to start popping up all around you all the time, but it seems to me that the tide toward more and better public toilets is slowly turning. And Lowe’s book might very well have had something to do with that. I can’t think of a better reason to be a writer.
I’ve long been intrigued by rules and expectations around gift-giving. In my family growing up, gift-giving was uncomplicated. You bought or made something you thought the recipient would like.
Your only expectation in giving it was that the recipient would appreciate the thought that went into it even if they didn’t appreciate the gift itself. And if there was something specific about the gift that didn’t work—it was the wrong size, or you already had one—it was not a personal sleight for the recipient to exchange it for something that worked.
I had no idea gifts could be used to hurt people until I was an adult. Then I met my husband’s mother. I don’t recall her giving me anything for Christmas or my birthday for the first three years I was with her son; why would she? We lived together (unmarried) and I was the wrong faith (atheist). She didn’t like me.
We got married on December 7, 1983. For Christmas that year, we flew from Vancouver, where we’d moved after my mother had a health crisis, to Kingston, where my partner had grown up and his mother still lived. It was our first Christmas with his family since he’d moved away from them two years earlier.
For Christmas, my MIL gave me a nightgown and a housecoat. The nightgown was an odd choice because she knew I slept in the nude; I ignored the obvious hint. I did need a new housecoat, and I tried to be grateful for this one (and wore it until it wore out) even though it wasn’t at all my style.
A few days later, I saw both garments on sale at Woolworth’s, the nightgown for $9.99 and the housecoat for $19.99. This would have been a day or two after my husband’s birthday, for which she gave him a plush, Pierre Cardin housecoat with the $60 price tag still pinned into the neck. (This was 1983, when $60 was worth about a billion in today’s dollars.) I’m not sure how she could have given me a more obvious message that marrying into her family did not mean that I was on the same level as anyone else in the family, a message my husband confirmed was likely exactly what she meant. After that, she only gave me gifts if my husband pushed her to. A few years later, he told her that he’d taken to sharing his annual birthday cheque from her 50/50 with me. Shortly after that, she stopped sending him anything.
One family member on my side was an absolute genius at buying gifts. She loved flea markets and kept her eyes open year-round for gifts her loved ones, especially the young children, might enjoy. She didn’t always hit the mark, but even when she was miles off base, we all valued her gifts because we knew she put a tremendous amount of thought into them. Unfortunately, she and her partner were not always as good at receiving gifts. I think they assumed that because we always showered them with praise for the gifts they offered, knowing this meant a great deal to them, they assumed that they always hit the mark. They further assumed that if others didn’t hit the mark with them, that meant they weren’t trying very hard.
They were not easy to buy for. But on one occasion, I thought I really had gotten it right with a colourful wall hanging in a particular South American folk style. The look of disappointment on their faces when they opened it said everything. At some point, they said they didn’t want to exchange gifts anymore because they couldn’t afford it, and I’m sure that was part of it. But I think it was also that we could just never figure out what they’d appreciate, and they grew tired of that.
In the past few years, I admit I’ve begun to tire of gift giving. Our annual Christmas wish list has turned into a list of hyperlinks to exactly the gift the individual wants. I’ve never been a fan of buying gifts because I like them regardless of whether I think the recipient will like them. But neither am I a fan of people being so particular about what they want that all the mystery and surprise of gift-giving is gone. I
This brings me to the latest issue, which started with one person refusing a gift. They had a reason, which I didn’t understand, but it was a cash gift, so it was easy enough to redeposit. Months later, when I thought the reason for refusing the gift had passed—my bad for not checking my assumptions—I brought back gifts from a trip that I planned to give everyone for Christmas. I needed to give one of the gifts a good deal sooner than Christmas because it would spoil.
The intended recipient took pains to refuse my gifts in a very polite text. But I still found their refusal … confusing. I ended up giving the spoilable item to someone else. As to the other item, the would-be recipient suggested that I enjoy it myself. But I would never buy something at that price point for myself. So, I’ve decided to keep it for them. It will only improve with age. If they won’t accept it before I die, I’ll leave it to them in my will.
I have to say again that the person who refused my gifts was not in any way rude in the way they refused them. Yet I’ve still spent a lot of time puzzling over my own hurt response to this. It’s been suggested to me that no one is obligated to accept a gift, which is certainly true. It’s been suggested that my difficulty in accepting this refusal is the opposite of showing love. It’s been suggested that I shouldn’t allow gift-giving to become a source of conflict.
I’ll be perfectly honest in saying I don’t know what’s right, but the whole situation led me to thinking about gift-giving in general. So I did a bit of research (emphasis on “a bit”).
Gift-giving goes back millennia and serves a variety of purposes: gifts to gods in exchange for a bountiful harvest or an edge in battle. Gifts to leaders of other clans or tribes or nations to establish friendship and trust. Gifts at weddings to bless the marriage with fecundity, at births to pray for long and happy life, at anniversaries and birthdays to express a wish for more of the same.
The most famous anthropologist to study gift-giving was Marcel Mauss, who wrote an essay, appropriately called “The Gift“, that examines the ways gift exchange builds social and economic relationships. Mauss’s student, the famous Claude Lévi-Strauss, posited that structures such as kinship systems, commerce, and gift exchange are similar across cultures. Other anthropologists and psychologists have noted that in building social and economic bonds—yes, the value of the gifts exchanged is part of it, in much the same way that the food served and clothing worn at a state event are part of it—gifts form part of the glue that binds cultures, and individuals, together.
A web page called “The Psychology of Gifting” lists a half-dozen reasons why people give gifts: to build and reinforce relationships, to show love and devotion, for symbolic communication, to receive something in return, to help others, or to find a mate. It also lists four main types of gifts: those that are symbolic of the giver and receiver, those that are symbolic of the giver’s knowledge of the receiver, those that are symbolic of the occasion, and those that contain an array of significant meanings.
There’s a reason virtually every national capital in the world has an inventory of gifts received from other nations, gifts no one will ever use because they belong to no one person and that’s not their function. Such gifts are offers of friendship and trust, offers for two nations to let down their guard and establish mutually beneficial relationships.
Similarly, personal gift-giving is an act of both reaching out and welcoming in. We let down our guard, show our vulnerability. In giving a gift, we hope the recipient will receive it in the spirit in which it’s intended. The harder we work at finding the perfect gift, the greater our anticipation of the recipient’s pleasure—and the deeper our disappointment if it’s not received with the joy we’d hoped for.
When people don’t show their appreciation for a gift, much less when they simply refuse it, it hurts. And it hurts all the more because the gift-giver’s guard is already down. Rejection of the gift feels very much like personal rejection.
Sometimes in a scenario like that, people express their hurt by getting angry and looking for explanations. What happened to what they thought was a mutually trusting and caring relationship? And that hurts even more.
What’s especially interesting to me about this situation is that I, as the person whose gift has been refused, am considered the one who’s at fault. Why am I making something out of nothing? Who am I to make the other person feel bad? If only I would have accepted the rejection without saying anything, everything would have been all right. There’s no responsibility on the person who refused the gift to recognize how that might have felt to me. There’s only a responsibility on me to accept the rejection graciously.
I still believe gift exchange, whether it’s interpersonal or international, is valuable.
It left me wondering, briefly, if gift-giving is worth it, if letting down one’s guard is worth it.
I still think it is. Although I’m still feeling hurt about the current situation, which has ballooned out of all proportion at a time of year when, in my culture, we’re supposed to be appreciating one another, I still believe gift exchange, whether it’s interpersonal or international, is valuable. Just as I think, and history demonstrates, that gift exchange serves many valuable purposes, talking through misunderstandings in gift exchange provide an equally valuable opportunity to communicate about our differences and similarities and come to new understandings.
But to do that, both parties need to agree to set aside hard feelings and listen to those they’ve hurt. That’s never easy. But another thing I’ve always believed is that the harder things are to do, the more worthwhile they’re likely to be. So I’ll wait until the other party is ready to talk, and then I’ll listen and hope they’ll do the same.
