Confusion, division and mayhem

I met Pierre Elliott Trudeau in the late eighties in Montréal while strolling one late afternoon up the Rue de la Montagne with Luc Deschienne, a well-known Québec surgeon. A vaguely familiar figure was walking down the road, his arm round an attractive woman.

“Hey, Pierre,” said Luc.

“Luc! Comment ça va?” I recognized Pierre. We four went into the Hotel de la Montagne and sat at a table beside a huge wooden elephant and ordered drinks. The conversation (relying on my eight-week school exchange at Paris’s Lycée Henri Quatre) revolved around Québec politics; my main contribution to the chat was to ask Pierre where he got the name “Elliot.”

“My mother’s name was Grace Elliot,” he said. He knew it was a name from the border country of Scotland.

Pierre was unpopular in Alberta at the time due to the National Energy Program (1980-85) but said he was impressed by Premier Peter Lougheed – “a clever politician.” Although unpopular, Pierre was more respected in Alberta than son Justin.

Why is the Canadian population in a confused state? Perhaps five reasons: 

Firstly, the pandemic itself. After two years, we have many cases of “post-pandemic stress disorder” or “lockdown blues” – recognized by our public health people, at least in the West, as serious collateral damage with its biggest effects in lower income families living in cramped conditions. These officials have struggled to walk a line between protecting health and the hospitals and avoiding damage to livelihoods, all the time attacked by armchair experts, Hindsight Harry’s, ship’s lawyers, and after-the-event Wise Willie’s pontificating on what should or should not be done.

Secondly, increased division of opinion and anger over the vaccination mandates. The chances of coercing someone who has given the finger to vaccination is next to zero by now. None of my unvaccinated friends and acquaintances have budged despite my earnest, patient, accurate, and empathetic going over the data. This group, perhaps 10 -15 percent of the souls in this country, in the broad character spectrum of human bloody-mindedness, is a highly distilled bunch of the most doggedly obstinate people. A tiny minority may be bent on sedition. They are never going to submit to vaccination. Ever. Calling them ignoramuses, feardies, numpties, homophobes, racists or Nazis does not help. It’s time to accept differences rather than calling names – unless a highly infectious and more lethal variant turns up.

Families have split over vaccines – the hold-out son, bitterly resented by the vaccinated sister and parents; the unvaccinated daughter-in-law forbidden to attend a Christmas celebration; the opinionated but usually tolerated unvaccinated cousin sent to Coventry. Friends have parted ways following arguments about the merits of vaccination compared to the magical efficacy of cattle de-worming vet medications. Colleagues have argued and fallen out over the real value of masking and social distancing. A vaccine mandate nine months ago might possibly have been useful, I don’t know. But now? For truckers? The evidence? Can a reader explain this to me? Looking for variants? It seems past time for a re-think of mandates what with omicron and its sub-lineages infecting large numbers of both the vaccinated and non-vaccinated but contributing to a boost of anti-SARS-coronavirus-2 immunity.

“Following the science” has become a sheep-like trope trotted out at every opportunity as evidence that the speaker is educated rather than merely being informed by someone who may or may not be educated. They are not “following the science”; they are following information – at best they are following data – and following what is politically and journalistically useful.

One of the great clinical oncology researchers, Bernard Fisher, once said at a meeting in Pittsburg, PA, some years ago: “Americans have become one of the most informed populations in the world – and one of the least educated.” There was much laughter as the relative truth of this aphorism sank in.

The pathway of following the science is not an information superhighway. It’s more like Robert Frost’s poem The Road Not Taken – a path through dense woods with forks, obstacles, obscuring undergrowth, divergences, and parts where the pathway is no longer visible. As more people tramp down the path, the way becomes clearer, obstacles are removed, but there are still people who want to explore that lightly walked forking-off trail – a road less travelled – who then discover it might be a better way to exit the woods. And that better way will require confirmation and will always be further modified and improved. 

Science is a system of thinking, evolving over at least the last two millennia, requiring accurate empirical observations of components of the existing universe and seeking commonalities in these observations that can be grouped together and which by inductive thinking can lead to novel ideas (hypotheses) which, upon testing, lead to fresh theses or principles. Highly consistent observations can be used by deductive thinking to produce reliable predictions. Both systems of thinking must be reliably reproduced by other independent scientists. Self-skepticism and awareness of self-bias is critical in the interpretation of observations and experiments.

Science is never settled. If it appears or claims to be settled then, according to scientific philosopher Karl Popper, it is not science but something else such as religion, politics or simple opinion. According to Popper, only if theories (even when useful, like Newtonian physics) can be disproven or fine-tuned do they qualify as “science,” being temporarily useful only as part of the inexorable progress on the way to discerning an always elusive final truth.

Medical science is the applied science of causation, diagnosis and treatments of disease with our theories regularly being disproven or shown to be faulty and falling by the wayside or subtly shifting like desert sands in the wind. 

Thirdly, fatigue, anxiety and resentment over the challenges to Canada’s Disney-story history. We’ve been going through a significant societal revolution this last decade, particularly so in the last two pandemic years. I don’t resent being called a “settler” – because that’s what I am – or even a “colonial exploiter” since I was born in India at the end of the Raj. But if I were from a third or fifth or more generation Canadian from a pioneer family who worked hard in the re-shaping of this land and its prosperity, I would be shaking my head as to what is happening. Re-telling the story of Canada’s history incorporating the injustices and tragedies which occurred is being done, and the result will be good in the long run, but it takes time with give and take on all sides. The colonial approach of military-backed governing involved a certain low-key, brittle ruthlessness which is the way of all colonizations. We can see China making the same mistakes today.

Fourthly, Justin Trudeau has had a tricky job over the last two years, and he’s handled it by supporting the efforts of the medical/scientific establishment. It’s been a successful strategy, but by the end of January this year, it was wearing thin. In my talking to people across the country, there is a significant fatigue of the Prime Minister. Even his invoking the Emergency Measures Act engendered a suspicion that it was being called for political motives rather than public safety. It is in no way comparable to his father’s invoking the War Measures Act in 1970. 

Two years of our thespian Prime Minister, the cottage parliament, his dismissal of the protests of the truckers to the mandates as “unacceptable” and failure to meet with their representatives was unhelpful – it might have done nothing, but it may have led to an earlier resolution. Did we really need the Emergency Measures Act after the Ambassador Bridge was cleared? This Act has not been applied to Alberta and the RCMP have cleared vehicles, one containing weapons and ammunition – so far without violence.

The days of The Charge of the Light Brigade are long over. Troops will not take the word of a bungling general and go charging into the Russian guns merely because an order has been given. Some members of the police forces are themselves antipathetic to vaccine mandates and are friendly with the truckers, never mind the huge technical difficulties of arresting a driver locked in the cabin of his 50-ton truck. They are not going to enthusiastically arrest people with whom they may agree. The tension between Ottawa politicians and the police was obvious. 

Finally, there are so many questions around this omicron pandemic and its management. Questions like: What’s the comparative efficacy (both immediate and longer term) of the DNA-derived vaccines versus the m-RNA vaccines? We have no large comparative trials. Given the different start times of the vaccine studies during different phases of the viral waves, the variability of trial entry criteria, definitions of clinical status, and outcomes criteria, we don’t know. While we can generally trust the medical and scientific departments of pharma companies (they’re dead in the water if there’s any jiggery-pokery) the marketing departments are a different matter. The Pfizer marketing department is likely poised to propose a loyalty card with a free pizza after, say, a third booster injection.

I believe it’s time to call a cease-fire on the vaccine avoiders: time to accept that some have different opinions that you and I don’t agree with. Time to accept that they may have reasons for acting as they do. Time to get on with our lives and live with this virus because it will certainly be back but might become just another seasonal bug that can be mitigated by vaccinations, anti-viral drugs and public health precautions.

However, a different matter is billing the unvaccinated who require hospitalization and treatment. They have egregiously delayed the vaccinated their surgeries, transplants, consultations and treatments. Invoicing really should be brought in. It’s not a big deal – and is nothing like blaming lung cancer patients for smoking because vaccines aren’t addictive.

I’ve previously mentioned that we invoice patients here in Alberta for days spent in an acute-care hospital following approval for transfer to a chronic care unit when that unit is full and unable to take the transfer. We really must stop considering billing the unvaccinated “un-Canadian.” Americans don’t have these sappy ideas that it’s the wrong thing to do – your medical insurance increases. It just makes sense.

Editor’s note:

The views, perspectives and opinions in this article are solely the author’s and do not necessarily represent those of the AMA.

Banner image credit: Ana Krach, pixabay.com