White Coat, Black Art

It may seem counterintuitive, but hospital ERs can be risky for elderly patients, as the chaotic environment can quickly lead to delirium and decline. An innovative geriatric multidisciplinary ER team at St. Mary's Hospital in Montreal is getting elderly patients discharged safely and quickly, preventing harm and reducing hospital admissions.

“Pistol” Pete Pearson took ‘magic mushrooms’ illegally to ease his end-of-life distress, and is angry that Health Canada denied him access through the Special Access Program. Meanwhile, UHN psychiatrist and leading psilocybin researcher Dr. Joshua Rosenblat suggests its efficacy may stem from enhanced neuroplasticity—and it might be available by prescription sooner than later.

"Pistol" Pete Pearson underwent psilocybin-assisted psychotherapy to ease his end-of-life distress, and calls it a game-changer. Rather than cursing the things he can no longer do, he's grateful for the time he has left. Psilocybin is still illegal in Canada, but Health Canada has invested millions into research by UHN psychiatrist Dr. Joshua Rosenblat. He advises against using psilocybin illegally, like Pete did – but says legalization may be just around the corner.

Pete Pearson, 74, is not ready to die. He was diagnosed six years ago with idiopathic pulmonary fibrosis, which has an average survival rate of 2-3 years after diagnosis. He knows he's on borrowed time, and has been dealing with anxiety and depression. That’s why he's seeking approval from Health Canada to use psilocybin as part of a treatment called psychedelic-assisted psychotherapy. His son Blake, who is also a family doctor, believes it can help his dad live the rest of his life to the fullest.

Leanna Scott has always gone out of her way to help others — which is why she decided to become a surrogate. She carried a child for a couple from the Netherlands who chose Canada because of its altruistic surrogacy laws and strong health-care system. As demand grows, Canadian surrogates like Leanna are increasingly sought after by intended parents both here and abroad. Pamela White, a Canadian researcher who teaches law at the University of Kent, says it's time Canada has a discussion around its surrogacy laws.

Lung cancer is Canada’s deadliest cancer—and about one in four cases now occur in people who have never smoked. Toronto father Winhan Wong knows this firsthand: a lingering cough nine years ago led to a stage-four diagnosis. Thoracic surgeon Dr. Christian Finley explains why lung cancer is rising among never-smokers, the stigma around diagnosis, and how a national action plan aims to save lives.

Growing up, Mykayla Whitmarsh was told to make eye contact, sit still and laugh at friends’ jokes. Now 24, she’s part of a growing group of young women diagnosed in adulthood with “AuDHD” – autism and ADHD. After years of struggling, she advocated for herself, was diagnosed at 22, and now shares her daily life @autisticayla on TikTok.

William Hume knew he was dying, which is why he applied and was approved for medical assistance in dying (MAID). But in his final days, his daughter Stacey says her dad wasn't able to receive MAID at an Edmonton hospital run by a Catholic health-care provider and had to transfer to another facility. He died before that could happen. Dr. Andrea Letourneau, a critical care specialist and MAID provider, says forced transfers are a terrible practice that forces patients to go through extra hoops in order to receive the death they want. 

Millions of Canadians are without a family doctor or nurse practitioner in Canada. But Denmark, a country where 98 per cent of its population is attached to a primary care provider, could have some lessons for us. We travelled to the Scandinavian country to see how the Danish system works for patients and doctors, and the differences are startling.

At 24, Kyle Brymer went to the ER with altered speech, facial drooping, severe headaches and confusion. The doctor blamed Kyle’s symptoms on his post-grad academic workload and even his partner Kirstie. In a few days, he went back to the ER – and this time, the stroke was unmistakable. Strokes in young people are on the rise in Canada, with one in 20 affecting someone under the age of 45. And even a decade later, Kyle says he’s still "not back to normal."

Overwhelmed by hot flashes, brain fog, and a frozen shoulder, Aidan Brame turned to a private clinic when the public system couldn’t help. Her experience highlights why more Canadians are paying for menopause care, and what it reveals about gaps in the health system.

One stretcher. More than 80 patients waiting. Paramedics arriving with patients while admitted patients await transfer. That was the reality for registered nurse Jayme Hack during a recent shift at Edmonton’s Royal Alexandra Hospital. Along with colleague Valerie Evanishen, she offers a frontline view of the relentless pressure inside one of Alberta’s busiest emergency rooms. ER physician and former politician Dr. Raj Sherman puts it bluntly: ERs are the canary in the coal mine and “the canary is dead.” He says we can, and should, do better when it comes to emergency medicine.This is an extended version of the radio broadcast.

Dr. Michael Antil left North Carolina in 2023 with his wife and kids, driven out by an increasingly conservative political climate and COVID-era hostility toward doctors. Now a family physician to over 2,000 patients in Toronto, he’s repeatedly been denied permanent residency, lost in a maze of paperwork and immigration red tape. Canada needs doctors—so why is this so hard?

You may think you're burned out at work, or with life in general. But what does burnout actually mean? Christina Maslach, Professor Emerita of psychology at UC Berkeley, was one of the first researchers in the world to study burnout, and co-created the Maslach Burnout Inventory over 40 years ago, a diagnostic tool that's still widely used today. She explains the distinct phases of burnout, why it's so pervasive in healthcare, and why a spa weekend isn't the cure.

Cardiologist, scientist and bestselling author Dr. Eric Topol's latest book "Super Agers" distills decades of research on how to make us healthier for longer. Topol says that humanity is on the cusp of developing treatments to help tame cancer, dementia and other chronic diseases… just as political forces in the U.S. are shutting down that research.

This holiday season, many of us will be taking to the skies to visit family or escape to warmer climes. So we’re sharing a recent episode of our sister podcast, The Dose, which asks: “What do I need to know about in-flight medical emergencies?” Dr. Vincent Poirier, associate professor of emergency and aviation medicine at McGill University, senior medical advisor for Air Canada and medical consultant for Air Transat, explains what happens when a medical emergency occurs on board and how passengers can help prevent them.

B.C. emergency room physician Dr. Kaitlin Stockton took the rare step of suing her regional health authority, alleging her job was threatened after she and other doctors warned patients about unsafe, overcrowded ER conditions. The lawsuit has since been resolved to both sides’ mutual satisfaction. Dr. Stockton hopes her experience will empower healthcare workers and patients to speak up about patient safety.

Quebec family doctors have struck a tentative agreement with the province, but Dr. Marina Lagodich has made up her mind. When the CAQ government rushed through their healthcare overhaul, Bill 2, in late October, it was the last straw. December 17 will be her last day practicing as a Quebec doctor. Across the province, doctors have criticized the bill, saying it encourages “fast food medicine.” Health policy expert Steven Lewis says although the Quebec government’s means are extreme, it’s hard to argue with its aims: to solve the “disgraceful” primary care crisis.

Ottawa family physician Dr. Nili Kaplan-Myrth faced a long wait for surgery after post-menopausal bleeding, and has seen her patients endure the same. Dr. Nick Leyland, president-elect of the Society of Obstetricians and Gynecologists of Canada, explains that gynecologists have limited operating room access, fewer perform surgery, and ovaries are valued less than testicles in the surgery hierarchy. Also: what’s being done to improve care for women nationwide.

Miles Randell, an advanced care paramedic, is trying to do something different for frontline health-care workers who need a supportive work environment. He says years of working as a paramedic in Vancouver led to post-traumatic stress that left him unemployable. And that the help he needed wasn’t there. So he created TEAAM (Technical Evacuation Advanced Aero Medical), a non-profit that deploys helicopters to provide advanced life support in some of the most rugged locations in B.C.’s wilderness. But TEAAM is also a workplace where health-care workers are encouraged to regularly check in and talk about work stress after a call. 

Dr. Paxton Bach has spent years trying to help people navigate a broken system. Inconsistent approaches to withdrawal management, long wait times for detox and recovery programs and a system that struggles to address the social determinants of health have caused too many of his patients to fall through the cracks. So he and a team at St. Paul’s Hospital in downtown Vancouver are trailblazing a new model of care that’s set to roll out across B.C. It’s called Road to Recovery, and it’s helping doctors like Bach answer the question: How can I keep you alive until tomorrow? 

Like many of Canada’s rural and remote communities, Mackenzie, B.C.’s hospital struggles to staff the ER. But once a week, a doctor hundreds of kilometres away fills in virtually. Many provinces like B.C. are using virtual care in ERs in an attempt to keep the doors open. But critics are concerned about patient safety and the need to balance virtual with in-person care.

When care at a hospital or clinic falls short for you or a loved one, how do you raise concerns that get results? We asked listeners for stories about making complaints in health care and were flooded with them. Dr. Rob Robson, an ER physician, patient safety expert, and health-care mediator, helps us unpack what works and what doesn’t when you want your voice to be heard.

Until recently, Jeremy Auger’s diabetes was unstable. Then he met endocrinologist Dr. David Campbell and the team with the diabetes mobile clinic in Calgary. The roving clinic brings care directly to people who are homeless or have low incomes. For patients like Jeremy, it’s a lifeline that helps prevent devastating complications.

Obesity has more than tripled in Canada since 1981. In their new book “Food Intelligence,” Canadian co-authors Julia Belluz and Kevin Hall - an award-winning health and science journalist, and a prominent researcher on metabolism in the U.S. - argue that it’s not because of a collective loss of willpower. Instead, they say the foods we buy and eat have become more calorie-dense, delicious and addictive over the last 40 years. 

More with Kevin Hall! Until recently, Hall was the U.S. National Institutes of Health’s key researcher on the connection between ultra-processed foods and obesity. He took an early retirement due to increasing censorship of his work. He talks about his groundbreaking study with former “The Biggest Loser” contestants, the link between Big Tobacco and Big Food, and why Canadian scientist expats like him may soon be looking to return home. 

When his wife died of endometrial cancer, Charles Kinch refused to accept that the care she received was the best she could get. His complaint, at first dismissed, has now sparked major changes in how cancer patients in British Columbia are treated and supported.

Like many Canadian small towns, Carberry, MB had become a healthcare desert. In 2023, the small ER closed and the last doctor left. Carberry embarked on the fight of its life to get healthcare back. Just days before the first of two new MDs starts work, Dr. Brian Goldman visits Carberry to learn about the Herculean efforts it takes for one town to reinstate healthcare, and make sure they don't lose it again. 

For three decades, Dr. Brian Day has been at the centre of the debate around private health care in Canada. Despite losing his court battle to bring it to B.C., Day still wants to see more private, for-profit clinics. The orthopedic surgeon and owner of Vancouver's Cambie Surgery Centre says competition from the private sector could push the public system to deliver faster and better care.

Ottawa’s Montfort hospital sees twice the number of patients for mental health emergencies as the Ontario average. And as this number increased in recent years, the everyday environment of the ER waiting room – chaotic, loud and overstimulating – became an ever larger trigger, causing distressed patients to flee or harm themselves or others. In the new Mental Health Emergency Zone right off the main ER, everything has been designed for de-escalation, and staff and patients are seeing dramatic results.

Gurleen Kaur Chahal is one of the inaugural students at Toronto Metropolitan University’s new Peel Region medical school, designed to serve the area’s diverse population. She's determined to be part of the solution for the kinds of struggles her multigenerational Punjabi household has faced accessing care.

After a seemingly innocuous question about pi, Allan Brooks tumbled down a ChatGPT rabbit hole. Three weeks later, he emerged, after spending 300 hours in a spiralling 7,000-prompt exchange with the chatbot. Dr. Keith Sakata, the psychiatrist whose viral thread on X breaks down the phenomenon known as “AI psychosis,” says the built-in sycophancy of large language models like ChatGPT needs to change before more harm is done.

How much would you be willing (and able) to pay to get your knee or hip replaced? Calgarian Linda Slater's knee pain became unbearable during her two-year wait to see an orthopedic surgeon. She drained her retirement savings to pay $30,000 for a new knee at a private Toronto clinic. Dr. Rick Zarnett, an orthopedic surgeon who works out of both a private clinic and public hospital, says the system needs to improve so patients can get surgery sooner.

Companies are spending big bucks advertising weight-loss drugs like Rybelsus, seeing huge potential in capitalizing on the popularity of Ozempic. But in Canada, so-called "reminder ads" can give only the name of the medication, not what it's for, telling people to ask their doctor for details. Ad man Terry O’Reilly says it can result in bad ads that turn people off, and pharmaceutical policy expert Barbara Mintzes says reminder ads can lead to overtreatment and high costs, doing more harm than good.

As a rapper, Bishop Brigante was no stranger to on-stage battles. We met up with the then-45-year-old when he was battling Stage 4 colon cancer, which he said was caught too late. Bishop wanted Canadians to have easier access to colonoscopies and said advocacy had given him newfound purpose.

 Many women report difficulties with orgasms, low libido or pain around intercourse. And given that many have never even learned much about their genitals, they don’t always know where to get help. A cadre of Canadian doctors specializing in women’s sexual health is trying to change that. They’re helping patients boost pleasure, while empowering them to get to know their sexual anatomy.

Attracting a family doctor to work in a community is challenging, with fewer physicians choosing family medicine. That's why Cheryl Gnyp, the recruiter for Castlegar, B.C., needs to stand out. She uses the board game Operation and specialized coffee as part of her 10-minute sales pitch to potential recruits at conferences. It can take years before a doctor starts working in the community, but she’s in it for the long haul.

Judith Morrison needs a kidney. While she's on dialysis, her sister Catherine is putting out a public plea for a living donor. But the search has been hard. And if they do find a donor, the sisters say that person will have to go through a long and opaque testing process. A process that experts say needs to be improved across Canada because the demand for kidney donations is high.

One morning as she arrived for her hospital shift, Winnipeg nurse Jennifer Noone was assaulted outside the staff entrance, leaving her with a bad concussion and PTSD. Rather than stay silent, she took the unusual step of having her assailant charged with assault. Manitoba Nurses Union President Darlene Jackson says there needs to be more and better security and violence should not be accepted as just part of the job.

At 28 years old, Dr. Soania Mathur was building her medical practice and expecting her first child. Then, she was diagnosed with Young-Onset Parkinson’s Disease. She tried to ignore her diagnosis for a decade, but as the symptoms progressed, she had to close her practice. Now, the self-described "Unshakeable MD" uses her experience as both a patient and a doctor to advocate for especially young people living with Parkinson's, as up to 10% of patients are under 40.

How far would you go to test your body in extreme heat? Ironworker apprentice Britnee Miazek travels hundreds of kilometres to Brock University in St. Catharines, Ontario for a gruelling experiment to see how her body deals with high temperatures. She wants to find out why she stopped getting her period while working in sweltering conditions on a coke oven. Researchers are hoping to find answers for Britnee, and understand more about the long-term health effects of working in an increasingly hot environment.This episode is part of a CBC collaboration called "Overheated" where White Coat, Black Art, What on Earth, and Quirks and Quarks explore how heat is affecting our health, our cities and our ecosystems.

When Kalpit Sharma started smoking high-THC weed several times a day, he thought he was just “living his life” as a university student. But then, he started hearing voices. Researcher Dr. Daniel Myran shares the science behind stories like Kalpit’s – and why young men are particularly at risk for concerning mental health outcomes.

We're replaying this episode in honour of National Indigenous History Month. Former senator and chair of the Truth and Reconciliation Commission Murray Sinclair spent the last months of his life at St. Boniface Hospital in Winnipeg. He found comfort in the music of Quinton Poitras, a Métis musician with Artists in Healthcare Manitoba who played his favourite songs. Niigaan Sinclair says that even though his father was in a lot of pain, the music helped him feel joy in the moment.

Dr. Theresa Tam steps down this week after eight years as Canada’s chief public health officer. Best known for leading the COVID-19 public health response, Tam tells Dr. Brian Goldman in a sit-down interview that Canada urgently needs a national vaccine registry to better manage outbreaks like measles, and must do more to support science and fight misinformation.