As I back my minivan out of the garage, I roll down the window. My husband, post-call after a night of anaesthetizing patients for emergency surgeries, is blowing leaves around in the yard with his new toy. The kids are at school. All is well on the home front.
“If I get arrested, I’ll put the bail on the Mastercard and try to be home by morning!” I yell.
“What?” The leaf blower is loud.
It occurs to me that bail might be a business expense.
“I’ll put the bail on the Visa if I get arrested!” I correct.
“OK, sweetie, sounds good, have fun!”
My province is beautiful. Close to the equinox the larches turn to gold and the fields in the south reflect a soft light that imbues a sense of belonging. As I leave the city in late afternoon the mountains on my right give a backbone to my mission. I’m going to see if I can lend a hand with all the people dying down south.
I love this place like no other; it is my home on Treaty land. Yet it is being taken from me, insidiously devalued by ideology, greed and abuse of power. Some who feel similarly have left, exiled to a province more in line with their values. I think of Tibet—such raw, captivating beauty, and its rightfully belonging to peaceful people. Yet the bloodshed.
I don’t want to leave.
The powerful here tell us that this is what we asked for. They weave a repetitive tale that vilifies everyone except themselves, and then claim that—you guessed it—if you’re not with them, then you must be an NDP partisan. I never cared about politics until it really impacted my patients. Doctor that I am. How radically leftist of me to advocate on their behalf.
I drive through fading autumn light to the windy city. There, a few specially trained volunteers walk alongside the people they care about, people who have been so deeply dehumanized by history and society that their very lives no longer matter. The brave volunteers, many grieving their own enormous losses, somehow find energy to set up a tent in the park. It’s a small tent, in a small conservative town, with a small conservative police force. So small against the full- moon-lit prairie sky that it all seems insignificant.
The volunteers walk me through their simple setup. It’s good. They are there in case someone is poisoned by fentanyl. We run through a simulated overdose. Their approach will work. They have the necessary skills and equipment. They can save lives here and now.
As we talk under the glow of their inviting orange tent, we are watched by five police officers, two park security guards and a small cluster of bored-looking protesters. A bylaw officer approaches.
“Who owns this tent?” he asks.
A fatigued and committed leader steps forward to receive his punishment: A $300 fine for erecting a tent without a permit.
I ask the officer to explain why I can set up a tent in a park for a birthday party and never even be approached by bylaw, let alone fined. He stares at me.
His colleague explains that there are certain “exemptions.” Like being a first responder to an emergency. I ask if a physician is exempted, responding to her patients at high risk of death in a public health emergency?
“Why? Are you a physician?”
“A real one? Like, a practising doctor?”
The volunteers in the tent try to contain their laughter. Later, they explain that they had been treated as nuisances, as though they were doing this risky and difficult job for fun. The disconnect is jarring; they are there to save lives, not to cause a disturbance. What should be taken more seriously than that?
The officers gather themselves to educate me: The difference is that the volunteers’ tent is attracting “negative attention.” I ask: What about all the positive attention? I think the tent is filling a critical gap. And those two other doctors, and that lawyer over there, and the university professors who support this…? Many people’s lives have been forever changed by losing a loved one to the opioid crisis. Parents who desperately wish someone had been there for their child. Albertans who understand this reality and don’t want more people to die.
I have personally treated delightful individuals who entered the system of care through supervised consumption and ended up in recovery, on a wellness trajectory defined by themselves. Any of the folks sleeping in the park tonight might follow the same path… if they survive.
Those in charge of health in our province expect law enforcement to treat the tent as “illegal.” Yet they closed the “legal” version in this city, which delivered vital community services, including cleaning up garbage and making sure people don’t catch HIV and hepatitis C. Now, you can’t save lives whether legally or not. You’re just not allowed to.
Our political leaders say they’re approaching addiction with a “fair” and “firm” hand. The echoes of paternalism and colonialism ring so loudly with this statement that I’m certain I’ve travelled centuries back in time.
We had solutions to improve access to addictions services. These have been defunded.
They blame the pandemic for skyrocketing opioid death rates. Although all walks of life have indeed seen worse mental health and increased substance use since March 2020, experts had already devised a variety of solutions to improve access to addictions services across the province. Shovel-ready. These innovations, including virtual and mobile services, have now been defunded. Anyone who expresses disappointment at this loss—or the direction of policymakers generally—fears being penalized, losing funding or being fired. I know I do.
The overdose crisis is not a new viral pandemic we’re “learning to live with,” and we are certainly not “all in this together.” The carnage caused by poisoned drugs has been with us for many years now, and has stolen thousands of mostly young lives, leaving in its wake shockwaves of anger and unbearable grief. This, despite humanity knowing exactly what to do to prevent the deaths. If we knew as much about COVID-19, we would see immediate implementation amidst fanfare and celebration.
There is little to celebrate here on this cold September night. We try to do the things that science says are effective, that our professional ethics expect, that our consciences endorse. But we’re told we cannot do those things, and the police stand directly between us and the people for whom we care.
The person ultimately in charge of mental health care here insists the citizens of Alberta want it this way. I’m a lifelong Albertan, and I don’t want it this way.
Doctoring in my beloved province, in the service of a beloved patient population, has landed me here: at risk of harassment, legal offence, personal affront and worry that I might not be home in the morning to take my kids to school.
A woman in the park decides to go to detox, and the volunteers make it happen immediately. I hope that woman, a mother herself, is able to go home after treatment. In my mind I imagine a joyful return to whatever constitutes her version of a husband with a leaf blower on a suburban lawn, playing through twilight with a bunch of neighbourhood kids.
Dr. Bonnie Larson leads the Street CCRED Collaborative at the O’Brien Institute for Public Health at the University of Calgary.