Matters of Life and Death. André Picard

      Introduction

      I’ve had the privilege of being a reporter and columnist at The Globe and Mail for more than thirty years. Although I did a stint on general assignment (as all rookies must) and was preoccupied with Quebec politics during the tumultuous pre-referendum era, most of my time has been spent writing about health issues.

      I don’t have a background in medicine or health. I studied business administration, with a specialty in accounting, and then journalism. I also worked for several years in the student press. I stumbled into the health field quite by accident. When I began working at the Globe as a summer intern in 1987, AIDS was just beginning to become a mainstream news story. It was a time when many people—most of them gay men—were dying in large numbers, when treatments were virtually non-existent and when discrimination was rampant. It was also a time of much anger and many protests. Militant groups like ACT-UP (AIDS Coalition to Unleash Power) not only challenged scientists and politicians to do more in response to the out-of-control epidemic, but they forced media to rethink how they write about health care. At the time, medical reporting was very deferent: scientists published research in august journals, and those findings were reported, mostly uncritically. The notion that patients would have an opinion, let alone a legitimate one, was largely unthinkable. AIDS activists demanded to be heard, and that forever changed health-care delivery—and health journalism.

      Of the thousands of stories I’ve written over the years, a handful have left an indelible mark on me. One of them was the story of a man admitted to St. Michael’s Hospital in Toronto for treatment of a bacterial infection. He had not been tested for AIDS, and his condition was in no way related to a sexually transmitted disease. Yet because he was openly gay, the hospital affixed a sign above his bed—printed in bold type on bright pink cardboard, no less—reading: “Warning: risk of blood and body fluid contamination.” When I visited him, I reached out to shake his hand, and he burst into tears. That was because many physicians and nurses had refused to touch him; his meals were left at the door because staff would not enter the room. After that story ran, St. Mike’s apologized publicly and changed its policy so such discriminatory signs were banned. It went on to become one of the leading centres in the country, if not the world, for treating people with HIV-AIDS.

      That encounter taught me two invaluable lessons. First, good health care requires a lot more than medicine and technology; it’s about treating people with dignity and respect, and without judgment. Second, if journalism is going to be useful and impactful, it needs to look beyond the theoretical findings of scientists and the technical abilities of physicians and focus on the patient experience in the real world. Put another way, health policy and health politics matter as much as medicine. And what distinguishes my writing—stories and columns alike—from that of other health journalists is that I focus on policy rather than medicine.

      The most impactful journalism I have done in my career is coverage of the tainted-blood scandal. This came about, as many good stories do, from asking a simple question. In the 1980s, the crude shorthand we used to remember the groups at high risk for HIV-AIDS was the “4H Club”—homosexuals, Haitians, heroin users and hemophiliacs. Each of those groups was getting extensive coverage, save one—hemophiliacs. A little digging revealed that people with clotting disorders, who routinely injected blood products to control their symptoms, were at extremely high risk. So too were people who underwent surgery. The numbers were mind-boggling: testing showed that almost half of all hemophiliacs had contracted the AIDS virus along with thousands of surgery patients. But very little was written about the risks of transfusion of blood and blood products, and what was written turned out to be based largely on egregious lies. The Canadian Red Cross stated publicly and repeatedly that the risk of contracting HIV from blood was “less than one in a million,” and Health Canada, responsible for regulating the safety of drugs, went along unquestioningly. Yet before testing was implemented, after delays designed to use up stocks to save money, the risk was as high as 1 in 266. Tainted blood turned out to be the worst public-health disaster in Canadian history—and one of the worst in the world. More than twenty-four hundred hemophiliacs and transfusion recipients were infected with HIV-AIDS, and another twenty thousand or so contracted hepatitis C from blood and blood products. The revelations in The Globe and Mail led to a public inquiry, headed by Mr. Justice Horace Krever, and compensation of almost $5 billion to the victims and their families.

      Yet the real tragedy of tainted blood is that the carnage was in large part preventable. Sadly, despite the enormity of the scandal, it was covered only retrospectively; it went virtually unnoticed for almost a decade after the first victims started dying. In 1994, I was invited to address a conference of the Canadian Association of Journalists on the topic, “Could the media have done a better job covering the tainted-blood tragedy?” I said this: “We journalists are guilty of the same ‘crime’ as the main players in the blood system … a failure to inform the public. Like them, we have excuses, but collectively our mistakes have cost hundreds, maybe thousands, of people their lives. There can be no excuse for that. We cannot be forgiven. But we can learn from our failures by never repeating them again.”

      Over the years, I have covered many issues, from AIDS