Dear readers: I expected some negative fallout from this post and of course I’m getting it. I’d like to make one thing clear: when it comes to rehab, addicts and alcoholics are free to talk about their own recovery. What I object to is the tattling nature of what the Toronto Star has done by speaking to others in Ford’s rehab facility. Every patient needs privacy, not just the mayor, and this sort of reporting puts everyone at risk.
Kevin Donovan, an investigative journalist with the Toronto Star, has angered many of us who monitor healthcare in Canada. At issue is the privacy of Rob Ford’s stay at GreeneStone, a drug and alcohol rehabilitation facility based in the Muskokas. Here’s how Donovan’s article begins:
Mayor Rob Ford pushed and scuffled with fellow rehab residents and was so verbally abusive that he was kicked out of his group therapy program, according to people who have knowledge of his two month stay at GreeneStone. These accounts of what one person referred to as “destructive behaviour” stands in stark contrast to Ford’s recent public statements that he…takes his recovery seriously. “Ford broke things, got into fights with other residents…[he] stopped people from sharing their stories, which is key to a successful rehab experience,” said another source. “Other residents felt intimidated. They felt he was a bully. He was always saying he did not belong there.”
Donovan goes on to describe his sources:
For this story, the Star has obtained accounts of Ford’s time in rehab from three people with knowledge of his time there, including a fellow patient, and from others, including a staffer, who provided accounts through an intermediary. Due to concerns over publicly breaching the confidentiality of the treatment facility, the sources asked that their names not be published.
Mayor Ford has been an ongoing target of a Toronto media unhappy with his conservative politics. However, as the entire English-speaking world now knows, Torontonians have other reasons for concern: his downward spiral into drug and alcohol abuse is well-documented thanks to his carelessness, the ubiquity of smartphones and a media willing to pay for scandalous videos. That Ford has been his own worst enemy is not in dispute. Neither is the fact that the Toronto Star, as evidenced above, has pushed past acceptable boundaries and violated his and his family’s privacy.
When it comes to health records, violations like it can be deadly. In my family’s case, my stroke-afflicted mother was put at risk by the words of the surgeon who had amputated her leg. In her discharge summary — the document that summarizes a patient’s stay in hospital — I, like Ford, was described as abusive. This was in reference to words I exchanged with the surgeon when I discovered he’d falsified a report. Of course that context was not described in the summary, so when subsequent doctors read about our disagreement, my mother was turned away from their offices with vague excuses. Our difficulties became particularly acute when a dedicated eldercare clinic, which provides transport for the disabled, precipitously dropped my mother as a patient. When our rattled social worker tried to investigate, she was stonewalled. Abuse, it turns out, is in the eye of the beholder.
To read more about my family’s experience, clickhere.
Rob Ford may very well have behaved badly at GreeneStone. The missing piece of the puzzle, however, is the context. Having volunteered at a rehab, I know patients are often volatile and staff are trained to deal with them accordingly. It’s quite likely that Ford wasn’t alone in behaving badly, if indeed he behaved badly at all. Taking the word of other patients is a risky affair and Donovan’s doing so is a sign of his naivete when it comes to the world of addiction and recovery.
Moreover, he implies that one GreeneStone owner, Shawn Leon, has a questionable background. Although Leon says he does not have a history of addiction, many rehab workers are recovering alcoholics and drug addicts, some of whom do have criminal pasts. However, when we consider that the majority of prison inmates in Canada are there for crimes committed because of drugs or alcohol, these troubled pasts make sense. Some of the most dedicated counsellors I’ve met through my volunteer work have spent time in jail. Take away the substances and what you’re left with, most of the time, are damaged but eminently decent human beings who have learned hard lessons. Donovan’s colouration of facts is misleading and nothing he reports counts as news for those of us familiar with addiction.
So I wrote to GreeneStone to ask them who spoke to the media. Here is our correspondence:
I’m wondering if the person who shared private information about
Mayor Rob Ford is going to remain on your payroll? The Toronto Star’s coverage, by
Kevin Donovan, is very troubling. I’d like to know if anything will be done
about the people who broke his anonymity.
Thank you for your email. GreeneStone takes patient care and
confidentiality very seriously. As an organization we take great strides to
protect patient confidentiality and have never spoken to the media about any
of our patients.
I believe the staff at GreeneStone when they say they take confidentiality seriously. They wouldn’t be in business if they didn’t. So who snitched? And why do Donovan and the Toronto Star believe that other patients are more reliable than Ford? Isn’t it possible that the patient Donovan spoke to simply dislikes Ford and is seizing the opportunity to do something about it? And what about the future? This breach of privacy makes the possibility of any subsequent rehabs, which the mayor may need, exceedingly difficult: what institution will go up against the Toronto Star and their willingness to pay and plant informants? How many high risk patients, who fear exposure, will leave and not get the help they need?
Donovan’s errors in judgement are a genuine tragedy for the Fords and their children. When it comes to rehab, it’s a time honoured tradition that the famous are granted space and time to deal with their addictions. Denying them their privacy — which the Toronto Star has done here — sets dangerous precedents for us all.
The Media, Snowden and Ford: I am a freelance writer based in Montreal. This article is about Edward Snowden and Toronto’s mayor, Rob Ford. I’m concerned about our mainstream media’s attacks on the mayor and his family: are reporters reporting news or trying to make it?
Close the blinds. I’d like to talk to you about privacy.
If you’ve ever had yours violated, you’ll know the feeling. The warm flush of exposure, like aPanopticon prisoner’s, settles in and you internalize the presence of a stern or threatening power. It happened to me when I was mischaracterized by a surgeon who had operated on my mother. Two paragraphs in her hospital record impacted my life and hers in ways I could not have predicted: angry that I had discovered a false report, the surgeon warned other doctors about me, making the search for medical after-care difficult.
That man’s words were more effective than any cattle-prod could have been. I became fearful, stopped complaining and, for a time, remained silent when further problems occurred. This is how privacy violations work.
So my concern over the narrative being woven about Rob Ford – a position that has exposed me to considerable abuse – is based more broadly upon my concerns about privacy. Ubiquitous smartphones are changing the way we communicate. Their video capabilities, I would argue, are changing the way we behave. Is this a good thing? I’m not so sure.
The rags to riches narrative is deeply embedded in our North American psyche: with hard work and a bit of luck, upward mobility can be achieved in a generation or two. It makes sense then that the Cinderella fairytale, in all its variations, is sold to us repeatedly by an entertainment industry that knows us well.
In real life, however, this narrative works differently. When boosted by technology, it can morph into an exaggerated version of itself, a version that requires a hero and a villain, a combination that endangers us all. Teenage sexting incidents, and the suicides they have caused, are harbingers of the dangers ahead: like 17th century stockades, public shaming is becoming the punishment of choice for those who consider themselves civilized.
Why is this important? There are many among us who would make great politicians, but having our lives closely scrutinized, by adrenaline junkies who are also reporters, keeps us from it. The melee around Ford is just one instance of reporters seeking to create their own Cinderella moment, a moment when they can best their fellow reporters (their stepsisters), out a bad politician (their evil stepmother), and marry a prince (garner princely attention and make their careers). That the focus of their story may be an individual’s personal turmoil makes no difference.
Even former journalists have become targets. Jane Purves, the Nova Scotia MP who beat a youthful addiction to heroin, went public on the eve of being outed by a media that conveniently ignored her past while she was one of their own, a reporter and managing editor of the Halifax Chronicle Herald. Similarly, Anne Robinson, of The Weakest Link fame, turned out an autobiography, Memoirs of an Unfit Mother, after having a long career as a broadcast journalist in the U.K. Once she appeared on American television, she too was pushed to the brink of exposure and pre-empted it by writing frankly (and quickly) about her alcoholism. One reason she wrote the book, she says, was to limit any further harm to her daughter.
There’s an obvious double standard here. Those in the media get a free pass when it comes to addiction, but the addictions of public officials, particularly those whose behaviour or politics are provocative, are considered fair game. Robyn Doolittle, the young reporter who wrote Crazy Town, The Rob Ford Story, is dining out on the media attention she’s getting, building her career not only on Ford’s misbehaviour, but also on the lack of privacy she’s now bestowed on his loved ones. Her inclusion of an unverified tape of Ford’s wife, which in most circumstances would raise ethical alarms, is being quietly accepted as verified, a fact that would have been inconvenient had Ford been a liberal and a well-behaved one to boot.
The media’s other omissions are curious too. Edward Snowden’s revelations about the NSA, which are unfolding at the same time, are disturbing because the agency’s spy power is far greater than most security experts thought. Governments of countries friendly to the U.S. were outraged by its violations and Snowden’s prediction, that young people being born today will not experience privacy, now seems plausible. So while Netflix suggestions and Facebook posts seem innocuous to us now, Zeynep Tufekci, a social media expert, believes surveillance techniques of the future, which will affect us all, will penetrate deeper and be harder to detect:
Internet technology lets us peel away layers of divisions and distractions and interact with one another, human to human. At the same time, the powerful are looking at those very interactions, and using them to figure out how to make us more compliant. That’s why surveillance, in the service of seduction, may turn out to be more powerful and scary than the nightmares of Nineteen Eighty-Four.
How does this apply to us here and now? Although Canadian politicians are still relatively accessible, the situation is different in the U.S. Barack Obama, like most presidents, has two narratives vying for control: he is a hero to some and a villain to others. At the moment he is mostly popular, however, because he is a brilliant orator and has gifted writers preparing his speeches. These are speeches that sound great, say little and obfuscate some troubling realities.
The obfuscation is both subtle and effective and creates a considerable distance between the hero and villain narratives. While Snowden’s disclosures hint at a vast network of surveillance, Obama himself seems to be standing a football-field’s length away from the epicenter of the crisis. That’s because his personal story — the story of the first black president — is a Cinderella tale with the heft and power to win almost any public relations fight. By following the media outpouring on the NSA, one senses, even now, that Obama will not be held accountable by history. And that’s because along with his “heroic” background, his PR people and image controllers are doing their jobs and doing them well.
This is not a system we want.
By contrast Rob Ford seems a difficult and combustible creature. His antics and appetites have provided late night comics with a lot of material and rightly so. But here’s what I think: Jon Stewart and Stephen Colbert, who have had Robyn Doolittle on their shows, can laugh at the mayor all they want: I’d rather have a politician with a vast network of flaws instead of a vast network of surveilling spybots. I’d rather have a politician who over-imbibes, gets caught and admits he was in a drunken stupor, than a slippery politician who evades responsibility with a consistent patter of empty rhetoric. I’d rather have a real human being, however awkward and embarrassing, instead of a haloed demagogue who holds court for appearances only.
We have a good thing going in Canada: we have a relatively transparent system that doesn’t allow our leaders to hide much to begin with. That’s why it’s easy to make fun of them. We are also tolerant of differences: we have had charismatic politicians like the pirrouetting Trudeau, who could be quirky and angry, delightful and sullen. When his marriage broke up in a very public way, even his enemies mourned along with him. When his wife, many years later, talked openly about her mental illness, we listened and forgave her. Now her son Justin may be our next prime minister. The Trudeaus are not a perfect family — they are certainly not the Obamas — but we Canadians are hardy enough to withstand those imperfections.
Our nation’s media needs to remember that and to stop delighting in the frailties of others, especially when those others are wives and children. Celebrating a book like Crazy Town tells me our politics are inching towards the cynical sort that produces wacky critics like Stewart and Colbert, the kind that also produces first families like the impossibly airbrushed Obamas.
Moreover, if we agree with the violation of the Ford family’s privacy, how can we claim both sides of the argument and defend our own? The sheer volume of the attacks on the mayor, however much he may deserve them, are becoming troublesome because they are shading into attacks on the democratic system that elected him and the system that protects our rights too. The principle of respecting others’ privacy is what’s at stake here, not whether we like or dislike the politician being tested by it.
In the interest of curbing the political relativism, I would suggest calling a moratorium on all attacks of the personal sort, but something tells me our nation’s media, and the reporters and editors who run it, would be loathe to comply, especially with subjects as worthy as Snowden and Ford. It’s clear they relish being our unofficial policemen, so I doubt that the more balanced kind of reporting seen in France, where personal lives remain personal, will become a reality here.
It’s too bad because our nation’s leadership, under our media’s jaundiced gaze, is becoming that much poorer for it.
If you like this post, please share it on social media and/or make a comment below. My site is designed to offer an alternative to the mainstream media: adding your voice may help journalists and politicians of all stripes remember what common sense looks like. Feel free to comment anonymously.
Why we all need Edward Snowden: In this post, I describe how my family’s information was used inappropriately by healthcare professionals in Canada. I look at this in the context of Edward Snowden’s revelations and other intrusive data mining. This is a longread at 2,500 words.
In a recent op-ed in The New York Times, Thomas Friedman commented on the NSA’s PRISM program:
That is why I’ll reluctantly, very reluctantly, trade off the government using data mining to look for suspicious patterns in phone numbers called and e-mail addresses — and then have to go to a judge to get a warrant to actually look at the content under guidelines set by Congress — to prevent a day where, out of fear, we give government a license to look at anyone, any e-mail, any phone call, anywhere, anytime.
Friedman’s comments represent one side of a polarized debate: the revelation of NSA information-gathering has triggered arguments about the rights of individuals, Americans and others, versus the rights of the U.S. government when it comes to protecting its citizens. Despite outcries from privacy advocates, the PRISM program now seems precociously standard when it comes to Homeland Security.
While the U.K. is known as a CCTV state, the U.S. has skipped that cruder technology and like China is now surveilling from within. Dissenters question how deeply the government needs to penetrate their lives because, unlike Friedman, they don’t believe authorities will get warrants to look at gathered material. It appears they’re right: If Edward Snowden is proof of anything, it’s that there are few if any controls.
The implications of Friedman’s words are obvious. Normal citizens living blameless lives have nothing to worry about. Suspicious patterns are what interest the American government, not screaming matches between divorcing spouses. However, if one parses Friedman’s words, it’s not hard to see the weakness of his argument. When he says he will “reluctantly, very reluctantly” trade off his privacy for security, his words suggest Americans actually have a choice. He also seems confident that private information won’t fall into the hands of others, outside the U.S. government, who wish to exploit it. He categorically ignores the reality of income inequality and the threat it poses to his government’s autonomy. The truth is that the concentration of wealth has created a global and de facto oligarchy, one where those with money, influence and powerful computers can bypass judges and warrants to mine and manipulate whatever data they want. Simply put: the very rich, as a group, have more power than most governments.
Seinfeld, Elaine and New York Doctors
A few years ago, an episode of Seinfeld covered a topic that was funny but substantive in its own way. Elaine, Seinfeld’s female foil, was having a doctor problem. She’d with quibbled with one and earned herself a bad reputation. When other doctors turned her away, she attempted, with her trademark insensitivity, to find out what they were saying. The script handled the conflict deftly: the real comedy lay in the neurosis of all navel-gazing New Yorkers. When it came to over-reacting, Elaine and her doctors were caught in a tie for last.
I remember watching the episode and wondering if a situation like it could happen in Canada, a country where doctors are tightly networked by government-run healthcare. At the time it was a theoretical proposition only; I’d never upset a doctor badly enough to find out. That changed in 2008 when my mother had a stroke in an Ontario hospital.
In brief, my mother’s stroke went undiagnosed and untreated despite my best efforts. The window of opportunity, when its effects could have been mitigated, came and went when nurses rebuffed my concerns, concerns repeated to them over the course of several hours. My contention that my mother’s consciousness had altered was dismissed because she was on morphine for a gangrenous toe. I was told it was the drug’s effects I was witnessing and that an alert to the hospitalist on duty was not in order. The stroke eventually took hold and she was left profoundly paralyzed on her left side.
Other calamities followed and the nadir of that experience occurred when I discovered my mother’s surgeon had falsified a report. After her gangrenous foot had been amputated, we were told a week would be needed before doctors could determine if the gangrene had been successfully treated. Our fear was that it would return to the site of her amputation.
It was a tense few days, as anyone who has ever waited for results can appreciate. When we were told to wait for her surgeon – who was slated to give us his verdict – we stationed ourselves in her hospital room. Three hours passed and nothing. Through the doorway we saw him making his rounds, but he didn’t attend my mother. Eventually I went to the nurses’ station and was told he’d left for the day. However, I was also told he’d completed my mother’s examination and she’d been given the all clear. To prove it, I was presented with her chart and shown his written entry. It was surprising because neither myself nor my mother’s partner had left the room between 4 and 7 PM; nonetheless, the surgeon reported he had examined my mother at 6 PM. When I asked the nurses how this could be, what followed was an interrogation worthy of Law and Order. Did we leave to use the restroom? No. Are you sure? Yes. Both of you? Yes. Did you leave to use the phone? No. Are you sure? Yes. Did you fall asleep? No. Are you sure? Yes.
So when I saw the surgeon the next day, and then overheard him joke about me, I let rip with a choice expletive. Little did I know that that outburst would cause me a world of grief, months later and in another province.
DNA and Electronic Medical Records
Back in the 1990s, when advances in genetics were changing landscapes in healthcare and policing, initiatives were also underway to transfer medical information from paper to electronic records. In 2010, the Ontario provincial government commissioned the following 30-second PSA.
As with many recent technologies, the proposed introduction of e-records raised concerns over the security of the information stored in them. The fear was that the private sector, and in particular the insurance industry, could use this information to discriminate on the basis of indicative pre-conditions and genetic guesses. While concern was greater in the U.S., which depends upon private insurers and HMOs to fund and provide care, there were concerns in Canada too. Information about one’s health could be used to discriminate in many ways: jobs, credit and even one’s marriage prospects could be affected.
The pursuit of happiness, considered a birthright in countries like Canada and the U.S., stood to be undermined by easy access to individuals’ medical histories. EMR (Electronic Medical Records) brought forth a host of ethical issues similar to euthanasia debates, currently ongoing in many countries, over the rights individuals have when it comes to managing that other personal resource, namely their lives. That debate offers a useful and informative comparison: the onslaught of the “grey tsunami” on government-funded healthcare systems is driving much global apprehension. Many countries, Canada included, are facing economic hardship because of healthcare expenses associated with ageing populations. So in this charged economic atmosphere, with all its fears and uncertainties, the over-valuing of those resources which can produce value (the employed) and the devaluing of those which cannot (the retired) is not so surprising. These days market forces are a bit like seismic shocks — their vibrations are being felt everywhere.
A Bad Outcome
After I swore at the surgeon, my mother and I had an extraordinary streak of bad luck when it came to managing her care. I brought her to Montréal to live with me until I could place her in a nursing home. She needed round the clock support and had to be monitored closely because of her blood pressure, which fluctuated dangerously. I cashed in her investments to pay for a live-in caregiver and, set about, immediately upon her arrival, finding specialists who could help me manage. Even with a sabbatical, it was gruelling work.
So imagine my surprise when we started being refused by doctors. In the first few months it happened three times; in two of those instances, the refusals were delivered outside of normal channels. That is, we were refused after initial appointments and in ways that did not follow protocol. It was only after the third refusal that, like Elaine, I started to wonder and worry.
The mystery wasn’t solved until a clerk, who had seen my mother and was clearly moved by our difficulties, called me back after yet another postponed appointment. He admitted he thought the specialist he worked for was avoiding us and then suggested my reputation may have been sullied by something written in my mother’s medical records. He also implied that phone calls had been made and received that to him seemed related to us. After hearing this, I found the offending paperwork and started approaching clinics with it in hand. I gave it to doctors straightaway, told them what they would find and then added that they could hear my side of the story if they were interested. It was a bold move, but also enough to change our luck.
I’m telling this story because I was unprepared for the fallout from my conflict with the surgeon. It meant that instead of having access to a devoted elder-care clinic and their gerontologist, we were forced to use our local emergency room. ER wait times at hospitals in Montreal can be anywhere from 8 to 12 hours. Obviously, this created hardships for my mother.
Do we need Edward Snowden?
While it’s no fun to live in a state of constant vigilance and suspicion, putting blind trust in our authorities isn’t wise either. After the difficulties I had with the Ontario and Québec healthcare systems, I started this website. Although I suspected malfeasance, beyond tepid evidence provided by that one clerk — that a document had occasioned phone calls and possibly refusals — I could not prove anything substantive. In the end, the problem was left for me to deduce, after myriad disappointments and a lot of wasted time. Like many people in my position, I was also reluctant to share my suspicions with friends, lest I appear unreasonable and paranoid. My sense of isolation, already acute at times, only grew.
And so imagine this: you apply for a mortgage, but are given excuses or offered unsustainable interest rates. You apply for health, home or car insurance and similar things happen. You aren’t being denied that mortgage or insurance, but for reasons unclear to you, your rates are higher and less amenable than rates offered to your brother or your neighbour or your friends. This mist of ill-fortune follows you around, and because you are unable to locate its source, your complaints and suspicions turn inward and affect your relationships with the people supporting you. After trying and failing, they withdraw. If they are close supporters, they may move out, divorce you and take your children. If they are less close, they may stop returning your calls, perhaps distance themselves in public. You slide out of the middle class and into a set of circumstances your background and education did not prepare you for. And why is this happening? Somewhere along the line, some information, possibly pertaining to your health or your earning potential or your credit management, has been crunched in a way that is unfavourable to you. Perhaps you made a comment online, offending someone with the power to affect your life, someone you don’t even know.
MOOCs and data mining
Recently, I have spent a lot of time writing about MOOCs (massive open online courses). My concern is that in their closed and for-profit incarnations they are an inferior form of education delivery, especially when it comes to the less advantaged students they seem destined for. I also fear that data mined from them can be used in the ways I’ve just described.
Daphne Koller, in her TED talk about MOOCs, explained how data gathered by weekly online assignments revealed how students completed their work. A graph showed that most logged on at the last minute to do assignments, without much online engagement earlier in the weekly interval. That information tells us, she says laughingly, that students like to procrastinate. Well, yes. It also tells us that Coursera is observing this phenomenon and that they likely have the names of students doing it. My question is, would banks and other lending organizations be able to purchase that information? And would Coursera inform their students?
In the early 1990s, I took part in the development of my province’s English exit test. The test goes like this: students are given three texts of about 2000 words each. They must choose one and write an analysis of 750 words. Their analysis is then graded on various elements measured at various levels of competency. Within categories of content, organization and mechanics, for example, are further subcategories which are measured too. Initially the Québec government stated the test would be pass-fail only and had been instituted, primarily, to make sure CEGEP professors were doing their jobs.
Almost 20 years on, the test has gone from pass-fail to a letter grade. That grade is now part of each student’s final transcript and is used by universities to decide admissions. In the event of a very tight race, universities can request even more finely-tuned data. The test evolved into this latest and more complex version because university admissions boards said they needed more variables to make accurate and subtle calculations when it came to admitting students. That may be true, but as most of us working in education know, that pattern of evolution is common. A reform is presented as beneficial for students, then morphs into something that’s beneficial for administrators. The locus of power shifts, in other words, away from students and towards those making decisions about them.
We need to keep this pattern in mind when people like Daphne Koller are up on the TED stage giggling about students and procrastination. Twenty years down the road, and with data-mining the norm, her observations might not be so funny. And that’s also why we need the blogosphere, critics and people like Edward Snowden. His actions make it easier for the rest of us to tell the truth too.
If you like this post, please share it on social media and/or make a comment below. My site is designed to offer an alternative to the mainstream media: adding your voice may help journalists and politicians of all stripes remember what common sense looks like. Feel free to comment anonymously.