Check Your Priviledge

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“Check your Privilege”[1] came to my mind one day last November as I listened to panellists discussing the status in Canada of physician-assisted suicide, or ‘medically assisted death’; the label currently in favour with the medical community.[2] I have watched the evolution of this debate since it emerged in the early 1990’s with the Sue Rodriguez challenge to the current law. At that time, the Supreme Court confirmed that it was illegal for a physician to assist a patient in suicide. Now over twenty years later, our government will move to make available assistance in ending one’s life, under carefully circumscribed conditions.

I am no longer willing to argue, as I once did, for or against. Moreover, in taking a step back, I see how this debate has emerged and developed, and this causes me to offer the opening phrase, “Check your privilege”. Here is why:

I started my professional health care career in 1970, but had been working in and around hospitals for 8 years before that. I have watched how over the last forty-five to fifty years technology and illness care have taken over the system, driven hard by pharmaceutical and business interests, at the expense and to the denigration of health and wellness care. Medically assisted death is a natural progression in a system where it has become hard to die. Inevitable disease processes are interrupted and prolonged by all manner of technological and pharmaceutical interventions.

While these can be beneficial and allow for extension of life, I believe it is the overuse of interventions that impels people to the notion that they must, or can only avoid illness progression by deciding the time and means of their dying. I don’t blame them. Interviewing doctors and nurses who work with dying patients in intensive care, I learned that the care they give is often driven by the availability of the technology, and that none wants such care for themselves. The lure of technology makes it easier to keep treating than to make the decision to stop. Patients and families, as long as the medical ‘experts’ offer more treatment, usually, in hope, are reluctant to refuse it.    So it is our wealth, our ‘privilege’ that has brought us to this place of needing to be able to stop the (advanced medical) process before it becomes unbearable.

While listening to the panellists, I couldn’t help but think what a wealthy first world issue this is. In many parts of the world and even among Canada’s First Nation communities, basic health care is not always available. As Syrian and other refugees flee for their lives, what would they think of this issue?

I realize that it will unfold in Canada as it has in other jurisdictions, and that assistance to end one’s life will be available through our medical system within a short time. But this will not begin to address the issues around the allocation of medical resources, or questions around the best ways to provide care to an aging population.

From my years as both a nurse and hospital Spiritual Care Provider, I find two things: Most people are not in a hurry to die, and even though we ourselves may think we would not want to live with certain limitations, when people have them, they still cling to life. I have known people who are confined to a chair and completely dependant on others, who feel life is worth living just to feel the sun and wind on their face whenever they manage to get outside.

Many people, regardless of religious beliefs, do not fear death itself; they do however fear the process – pain and suffering. Important also is that suffering is not limited to physical pain, but physical pain can be heightened when emotional and spiritual needs are not addressed.

The pressing question is this: How can we ensure appropriate support and care without either prolonging or adding to, a person’s pain and suffering? We just had an election in Canada. The many ’polls’ never failed to state that Canadians view ‘health-care’ as a priority. Our health-care system does not need more money, more resources allocated to the existing system. What we do need, is wiser use of the resources we do have, with more and better attention paid to research-based health and wellness support. Check your priorities Canada!

[1] Privilege is still the idea that society grants unearned rewards to certain people based on their race, gender, sexuality, etc — checking your privilege means acknowledging the role those rewards play in your life and the lives of less privileged people.

[2] This discussion follows as a consequence of the Supreme Court’s unanimous ruling in 2014, supporting, under certain circumstances, based in Canada’s Charter of Rights and Freedoms, a person’s right to decide to end their own life, and the right to not be opposed in this, by the medical system; rather, to be assisted by it.

Naughty but Safe – Confessions of a Cyclist

a Roman bikeEarly one morning this past summer, I was in the bike lane heading east across the Bloor Street Bridge, just west of the Castle Frank subway station. An out-of service TTC bus sped past; the side of the bus hugging the white line at the edge of the bike lane. It was so close and so fast that my heart either momentarily stopped or skipped a beat. At the next intersection, the bus was idling at the red light. I gently tapped on the door. It opened. I immediately noticed that the driver was not wearing a uniform and was comfortably dressed in shorts. He had grey hair and wore a frown. I said in the most non-confrontational gentle voice I could muster,

“I really need you to know how terrifying it is for me when you come so close and fast as you pass me.”

In an angry voice, he replied,

“You cyclists, you have four feet over there and sit on the white line. Why don’t you stay at the curb where you belong?”

I did not point out that had I been “on the white line,” I would now be under his bus not standing beside it talking to him. I did say:

“Well, sir, sometimes the road is so full of potholes that I have to go around them. Please, I just need you to hear how frightening it is for me when you come so close.”

“Well, if it is so frightening get on the sidewalk.” The door closed in my face and the bus took off.”

I got back on the bike but felt shaken by the encounter. I don’t know if he was a regular driver or someone taking the bus somewhere it needed to be. Not that he would have heard, but I might also have remarked, that had I been lying under his bus, it would not only ruin his day, but both our lives. It was his anger that unsettled me and it made me wonder – if he, a professional, is that angry on the road, how many other “angry” and rushed drivers share our streets?

Several weeks before that encounter, I had just crossed a busy intersection on my bike, and ridden onto the sidewalk for the short stretch to a pathway that takes me towards my daughter’s house. This is a familiar route and I use the sidewalk here to prevent having to cross the busy roadway where there is no intersection. An elderly couple was walking arm in arm, as if for support, towards me. Sensing their fragility, I got off my bike, stood still and waited for them to pass. As the gentleman went by he said in a tone of reprimand:

“Naughty, naughty!”

Without missing a beat, I blurted out:

“Naughty but safe.”

This phrase characterizes how I ride my bike around Toronto. For the most part I stay where I am expected to ride – in a designated bike lane or on the side of the road.

I know many drivers dislike cyclists on the road and for sure many pedestrians dislike sharing a sidewalk with a cyclist. While I recognize it is illegal for me to ride on the sidewalk, at times cars parked – illegally – in bike lanes force me there. There are frequent complaints of cyclists going through stop signs and red lights. I also do this. Here is why: I’d rather be naughty and safe than dead or injured. If I go through a red light or stop sign when the intersection is clear, I have a head start on the cars beside me; they can more easily see me ahead of them, and I can stake out my territory at the side of the road. And because the roads are in such disrepair, I am often forced into the middle of the traffic lane. Bikes and their riders are more fragile than cars when confronted with potholes.

I will admit one more transgression. I go the wrong way on a one-way side street, if it means avoiding a busy main street or is a shorter distance to where I am heading. Shaw Street in Toronto in the only main street I know that has dual bike lanes on a one-way street. While other cites, such as Vancouver and Paris utilize this strategy for safer cycling, it is underutilized in Toronto.

My desire is for cyclists and drivers to respect one another for the benefit and safety of everyone. I have had the joy of cycling in many European countries where there is much more regard and support for pedestrians and for cyclists. Many cities have car-free zones where cyclists and pedestrians happily co-exist. While cycling in Berlin I experienced both buses and cars holding back to let me move into traffic when the bike lane was blocked for construction. In many places there are separate lanes for cyclists, off the roadway altogether so that cabs and other vehicles cannot block them; on shared pathways, a white line separates bikes and pedestrians. Simple, and it works. I felt safe, respected, even relaxed as I peddled through this world-class city.

I have been cycling in Toronto as an adult since 1979. I love the sense of freedom, the chance for exercise and the ease of parking and getting where I want without traffic tie-ups and adding to pollution. In the mid-eighties, I rode around downtown with my young daughter in a little seat behind me. I never felt we were unsafe.

All that has changed. There are many more cars, people appear in more of a hurry and are more distracted in spite of the law prohibiting use of hand held devices. At least ten years ago I realized I needed more help to keep me safe. I wear an ugly lime green, with orange stripes, reflective vest; I’ve had strangers ask if I’m a crossing guard when I step away from the bike; I have multiple lights and reflectors woven into my back carriers. I want to be seen and I no longer engage in risky behaviour. I also say a prayer for myself: “Keep me safe and sensible.”

More and more cyclists are appearing each year; more designated bike paths are being provided. The more there are, the safer it becomes for all of us. However, we are now heading into the cold, often wet, darkest time of the year. I will keep cycling despite these conditions and only personally stop when there is snow or ice on the roads. So will others. All of us need to take heed and slow down ensuring safety for all.

Reading My Life

journal“Read at your own risk” is the inscription on the inside cover of my personal journals. When I started writing on loose-leaf paper in my late twenties, little could I have imagined that almost forty years later I would have accumulated so many notebooks. The early writing is sparse. I was in my first marriage and the relationship was not going well. My husband accidentally let it slip that he had “snooped.” It no longer safe to record my true thoughts, feelings, and even some activities. Before my marriage ended, I became so desperate to have this place of complete honesty that I bought a steel box in which to lock the pages.

These first entries were set in a binder. I progressed to lined notebooks. In the mid nineteen-eighties a friend gave me a book titled “Journeying Through the Days 1985.” Each day of the year was allotted a half a page of blank space. Under the day and time was a short scripture verse. Sunday was given a full page, and opposite was a beautiful picture from nature. Through the four years I used these journals, I stapled in extra pages. I needed more space. I went back to notebooks, finding I preferred the ones with spiral spines. The motley collection now rests in two large cardboard boxes in my basement storage.

So why have I kept a journal all these years? I quickly discovered that I could write exactly what I was feeling and thinking. Putting painful, hurt feelings on the page diminished their intensity within me. This was particularly helpful through challenging major life changes such as divorce, remarriage, and step-family life. While in therapy and at other times, I have recorded dreams that encourage deeper reflection. I wrote about important details of events that I did not want to forget, and this helped me to process them.

My journals became a place of solace, and, I would like to think, emotional, spiritual, and psychological growth. They may have prevented me from ever becoming a “mental health patient”, needing psychotropic drugs to manage my life. I discovered that the things that had upset me even as recently as the prior week or month, were of less importance than the energy I had poured out on them at the time. I could see patterns in responses and behaviours that I was not always proud of. I could see that I let situations or other people have more power over me than was warranted.

Over the years I have periodically picked up a journal from ten or so years earlier, and read my life as I had expressed it then. I began to see how easy it is to forget details of not just painful but also of joyous things. I recently re-read the scant but important notation following the birth of my daughter. I had forgotten the precise times, and quick succession of events. The memory flooded me with pleasure. I copied it and sent it to her. I can also acknowledge that I have learned a few things about myself, how I relate to others, and who I am in the world. It is a humbling reminder that I continue to be a “work in progress.”

Professionally, I have recommended journaling to others as a spiritual practice. Inevitably two concerns arise: Some feel they cannot trust others not to peek – hence my opening line, but tucking it away in a safe non-tempting place can also help. Early in my second marriage, my husband also started keeping a journal. Fortunately we have sufficient trust that I know he would not look at mine. Besides, being my closet confidant, he has heard much of what is there.

So why write at all when you have the opportunity to express the story to another? Sometimes I need to repeat things, if only to myself. Or perhaps I wish, or need, to say them first to myself before sharing with another. At four in the morning when sleep is elusive and anxiety or fears have invaded the treadmill of my mind, there is no one else who can listen. Other times I write to hear myself think, or to express feelings over and over until they dissipate.

Most importantly, my journal never talks back to me or tells me it’s bored or has had enough. It’s just there to accept all of me, all the bumps, bruises, joys, and sorrows, without judgment. It doesn’t say “you should do this or that,” rather it asks me to listen to myself, to my heart, and to clarify what it is I want or need to do in a particular situation.

The other repeated concern with keeping a journal is what to do with them when you die or can no longer keep track of them. Several years ago my husband went away with his notebooks, had a final look, and then burned them. I thought I might do the same. However, while recently reviewing some from the nineteen-eighties, I realized I couldn’t destroy them. They are the most honest witness to my life through all the years. I’m not keeping them so that anyone else will ever read them. I am keeping them so that from time to time over the rest of my life, I can see and remember details I have forgotten and will again forget.   All of my life matters – at least to me.

I am less worried about someone reading them after my death.   No one else will have the time, patience or interest. I can only take them ten pages at a time. Some pages are not worth the read. In places I can’t read my own writing. In parts the ink has faded. Even I get bored after a short time, and want to get on with my life now. Maybe I need to change the inscription inside the front cover to say “reading may put you to sleep.”

Regardless, I will keep writing with the beautiful fountain pen my husband gave me the first year of our marriage, as long as I have the strength in my hands, heart and mind.

Facilitator, Educator, Counsellor, Artist