Head Tale

I recently had the chance to interview Dr. Ryan Meili, author of “A Healthy Society: How A Focus on Health Can Revive Canadian Democracy“.

After some back and forth discussion, we decided that the best way to do this would be for me to prepare a few questions then send them by e-mail so he could reply as his busy schedule allowed and at whatever length he preferred.

Now, my biases are pretty well-known – I was a relatively early supporter of Ryan’s campaign for the leadership of the provincial NDP in 2009, an active volunteer for that campaign and have continued to be in regular contact with him and many of those who were also involved in his campaign.

(See my old blog for much of my writing about Ryan, that campaign and subsequent events since then. My new blog also has some Ryan-related posts including the “What If?” post referenced in the interview below.)

I am also unabashedly hopeful that he will once again throw his hat in the ring for the next leadership contest – although he saw right through my ruse to get him to officially declare. 😉

Even as a big supporter of Ryan and his potential as a political leader (I didn’t feel I was being hyperbolic or tongue-in-cheek when I said that I thought Ryan has the potential to be “A 21st Century Tommy Douglas“), I wanted this interview to not be filled with complete softball questions (okay, maybe one step up from Larry King and Ryan Seacrest anyhow!)

I’m not sure if my questions met that test but I was happy to see that Ryan’s answers were thoughtful, substantive and give a bit of insight into who exactly Ryan is – his family life, how he got into medicine – that readers may not have known about him before.

I hope you enjoy this interview and it makes a nice companion piece to his book which I highly recommend that you pick up if you haven’t already.

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I want to start by saying congratulations on the book! Even though you went with Purich Publishing, a press best known for their academic titles, I think you’ve created a true rarity – a scholarly book that is also very engrossing and hard to put down. A big part of that is because, between the statistics from various government reports and evidence from University research studies, you include stories – your stories and the stories of the memorable patients you interact with regularly. [Interviewer’s Note: It’s a small province and I’m proud that I have a long-standing connection with Purich Publishing, going back to when I designed their very first web site as part of a “Borrow a Geek” program we ran when I worked at the Saskatchewan Publishers Group.]

1. As a first question, can you talk a bit about the process of writing the book – how long did it take? Was there anything that was difficult about the process? Anything that surprised you? How did you find the publisher? And what about writing a book appealed to as opposed to some other form – a documentary film or a web site or whatever?
After the 2009 leadership race, a number of people suggested I write a book about my experiences. That didn’t sound very interesting to me, I haven’t achieved anything worthy of a memoir, but the idea popped up again while I was on a bus between towns when working in the Philippines. Mahli (my wife, a resident in pediatrics) and I were helping in a rural clinic in a town that had been affected by a recent typhoon. We were once again struck by how much the determinants of health (in this case environment and housing in particular due to the displacement and destruction from the storm) impact upon people’s health and how limited the clinician’s reach is in helping people when their larger circumstances are working against them.

This led me to reflect on what got me into politics in the first place, the frustration of working to treat people’s illnesses without affecting the real causes. I then thought about using stories from my practice experiences in inner-city Saskatoon, Mozambique, rural Saskatchewan, Brazil etc. to illustrate the effect of the social determinants in the lives of patients. By the time our bus arrived at its destination I’d sketched out the main argument and an outline of the chapters.

That was the easy part. Going from a general sketch to a fully fleshed out book took another year and a half of finding time in the margins of life to collect the stories and try to weave a coherent narrative that tied them together with the policy ideas in the book.

Over that period I also sent proposals to various publishers. There were a few outright rejections and unanswered queries. I also received interest from a few publishers with longer timelines to publication that would have made the book less relevant. Purich had the right mix of common interest, publishing experience, and turnaround time to make them the best choice and I’ve really enjoyed working with Don and Karen and the rest of their team.

As for why a book, writing is the medium in which I tend to express myself most clearly. Since I was just a child, making up stories in treasured Hilroy notebooks, I would dream of being an author someday. Along the way, between journaling on my travels, some attempts at fiction and poetry, and publishing a handful of academic and editorial articles, I’d gained some experience in putting ideas down on the page. I also feel there is more longevity, more staying power for ideas that have been developed to the point of making a worthwhile book. And, on the personal side, it’s certainly a thrill, a dream come true, to see my name under the title of a real book.

2. You talk a bit in the book about your run for the provincial NDP leadership. I wrote a blog post on how events may have unfolded in an alternate universe where you, not Dwain Lingenfelter, won the leadership. I’m curious how *you* think things may or may not have turned out differently had you won?
I enjoyed your blog post, and it is interesting to engage in the what-ifs. The truth is, there’s no way to know what would have happened. I agree with you that the NDP would have had a tough election with me as leader, just as we did with Dwain. We have seen the ways that he was attacked, and some mistakes that were made by the party under his leadership. We don’t know how I would have been attacked, what mistakes I would have made, but I’m sure there would have been some. I suppose the one real difference that is clear, is that there was probably too much emphasis on winning in 2011 during the last leadership. People weren’t really ready to admit that it was a rebuilding time and that a victory was unlikely no matter who was at the helm. As a result, rather than continuing to rebuild we are, to a certain degree, starting from scratch.

3. Perhaps as much as anyone I’ve met in my life, you are someone who is actively engaged with wider society at an enormous number of levels – from your family to the local community, from the provincial to the national scene as well as globally. I’m curious how you prioritize these multiple obligations – are some more important than others or do you view them as all equal?
In recent years my interests and responsibilities have grown. Aside from being married with a young son, I have a busy family medicine practice that includes obstetrics, and also have administrative, teaching and research duties through my role as head of the Division of Social Accountability at the College of Medicine. Add to that HIV research, my work with Canadian Doctors for Medicare, involvement in political and advocacy campaigns, and this book, truth be told, it’s a bit of a juggling act, and there are times that balls get dropped. I try to put family first; it makes no sense to be trying to be a good citizen by being a bad father or husband. After that, I have a duty to my patients that takes precedent over the rest of the activities, but I am very grateful to have a position that allows for some of the bigger picture thinking and action that informs the day-to-day practice.

4. As a follow-up to that last question, I’m curious how fatherhood has shifted your world view or approach to the work you do, if at all?
You often hear of people deciding to work for social change because of the world they want to leave for heir children. This is an admirable sentiment and one that I can certainly relate to as a parent. At the same time, I was doing this kind of work a long time before Abe was the remotest twinkle in my eye. He will be, already is, a privileged kid in any ways. My hope has always been to work to do my small part in building a healthy society, so that everyone’s kids have a chance at a good life, not just the lucky ones. Fatherhood hasn’t changed that at all. It has changed how I spend my time, with more of it devoted to the care of one small person rather than big projects. I’m grateful for that, partly because it’s good for me to have to be present and take care of someone else’s immediate needs rather than have my head in the clouds, but mostly just because it’s fun and I like the kid. A lot.

5. Many of your examples in the book come from your roots in this province. Do you think there is such a thing as “Saskatchewan values”? If so, how would you define this?
Like any place, Saskatchewan has good and bad parts of its history. The finer parts, those that reflect the best side of our province, are when we have faced hardship through collective action. In many ways, this has defined our view of ourselves. And that’s something in which we rightfully take pride. I have seen similar actions, and self-concepts, in communities around the world, however, and so I don’t think this is a uniquely Sask phenomenon. I also see these values being challenged as during boom times we lose some sight of what it’s like to struggle and take on more of an “every man for himself” mentality. It would be dangerous to assume that because we have the history we do that our Sask values will resurface to combat this. Values and beliefs are like muscles. If they aren’t exercised and put into practice, they can atrophy.

6. In some ways, I’ve always thought you would be an ideal federal candidate. Does that level of politics have any appeal to you and if so, how does it compare to your interest in provincial politics?
I’ve tended to be more interested in provincial politics in recent years. There’s something about the scale of change at a Saskatchewan level that seems more manageable than trying to do things federally. Up until very recently, it also seemed like the only level at which a social democratic party had any chance of forming government. The egregious excesses of the Harper government, as well as the Orange Wave that doesn’t seem to be receding anytime soon, are happily calling the latter point into question.

7. Obviously, being a doctor defines your life in many ways. When did you know medicine was the choice for you?
In some ways, it seems my life has become so defined by medicine that it’s hard to remember a time before I was a physician. At the age of 19 I was a bit lost to say the least. I ended up dropping out of university and taking some time to try to figure out what to do in my life. After a lot of reading and soul-searching, I decided that the best way to spend my few years on earth was in the service of those most in need. Medicine seemed like the right combination of my skills and interests and so I pursued it. I persisted despite initial rejections to medical school, and I think it was the right choice. Of course, just like with the previous what-if question, we can never know what another path would have led to, but the study and practice of medicine has been a rich source of challenges and opportunities, frustrations and joys. Given the choice I’d do medicine again without question.

8. You are often portrayed as being on the far-left of the NDP yet in the book, it sounds like you’re espousing a post-partisan approach to politics where people of all political stripes need to find their common ground rather than choosing sides like spectators at a hockey game. Your dad is a card-carrying member of the Sask Party, you’ve gone on John Gormley to promote your book. I’m curious what your take is on Brad Wall and how the Sask Party has governed so far?
Wall et al have made some mistakes and done some things right. It would be worthy of a whole series of posts to discuss what those are, but I think the main point is that we need a different approach than the hyper-partisan one we so often see now. When a party criticizes everything their opponents do, even when it’s what they would have done in the same place, the criticisms are seen as a reflex, not something based in real consideration. Using the local example, if the Wall government does something positive, the NDP should praise it for two reasons: 1) because strategically, if all you ever do is criticize, it ceases to have any meaning to the casual observer and 2) because if it’s a good thing to do, who cares which party did it? Our goal is a better province, not the election of a particular political party. Now as an NDP member, obviously I think that’s the far more reliable vehicle to a better province, but that’s not the point. The point is to remember the goal, not the vehicle.

9. Any time I interview someone, I always like to ask a fun double-pronged question to end: What’s your favourite book of all-time and what are you reading right now?
I love Franny and Zooey by JD Salinger. The writing is whip smart and funny, but with enough profundity to make it worth the trouble. I’ve read it a dozen times.

I recently finished In the Realm of Hungry Ghosts: Close Encounters with Addiction by Dr Gabor Maté. Maté is a Vancouver physician who works with patients on the Downtown East Side. He uses their stories, and stories of his own struggles, to flesh out the roots of addiction and the power of the experience of being addicted. He then explores the science behind addictions and some of the approaches we could take as a society to better address this growing problem. His style of “narrating the evidence” through patient stories is similar to my approach, though of course he does a far better job. Given how highly I think of his work, I was particularly pleased that Dr Maté was kind enough to lend a supportive quote to A Healthy Society. [Interviewer’s Note: Great book – I highly recommend it as well. In fact, I kept thinking of this book as I read Ryan’s book.]

Bonus Question: I’ll go into Jon Stewart mode and let you make history here if you want to announce that you’ll once again be seeking the Leadership of the Provincial NDP party!
Thanks, but am still wavering between hide and seek. I’ll let you know as soon as I do.