Monthly Archives: October 2014

So many, well trained, vigilant people only NOW paying attention to Ebola

There is a brutal ‘inside truth’ of the news business that a former colleague once shared with me that burned partly because of the inhumanity of its indifference and the stark reality of its evidence on the making and receiving end; in the news business ‘one dead local white kid is wroth a 1000 dead Ethiopians.’

There are many wicked painful realities that face the world, the whole world, on a regular basis. Sometimes it hard to filter which ones are the most pressing. Perhaps its that we employ a pond ripple approach, the closer we are to the rock that hits the water, the more the ripple moves us directly. This seems to be the case with the increasing spread of Ebola.

A brutal and unforgiving disease, it only seemed to matter regionally here, even as it grew and spread in Africa during the current outbreak. Available for consideration for those of us ‘comfortably away’ but the cause of a few dead others that my colleague described, not yet worthy of concern.

Now that a couple of nurses in Dallas were diagnosed, a few in Spain, and others in various countries outside of the initial zone, the various cracks in what is assumed to be an ‘advanced healthcare system’ and system of people flows is being painfully exposed.

But were these cracks always there?

Why did we not see them until faced with our own mortality?

Are there things that exist in invisibility in perpetuity that we can never see until or unless the circumstances are right, or do they not come into existence expect out of the elements that assemble in invisibility but that require external intervention to be stirred together to create anew?

I’ve been thinking about systems and cracks today.

I looked up a few different Coroner’s and Provincial Inquest findings – it’s amazing how many cracks there are and how many egregious things occur right before our very eyes – eyes bounded by rules, responsibility limits, and liability versus morality conditions.

I have a friend, a nurse, who left the comfort of his home and the love of his wife and 3 small children, and went off to Africa to help in the Ebola impact zone. It is my hope that he sees these cracks and is able to take the care needed to help himself and that will allow him to continue to help others.

The life and death of conflicting invisibilities

I listened to a sad but fascinating story on the CBC Radio program White Coat, Black Art this morning (a rebroadcast of a show from one year ago today). The host, Dr. Brian Goldman, interviewed Dr. Maria Anderson DeCoteau about her father’s experience of care after having a heart attack.

The story included a confluence of invisibility factors; racism, professional vs. lay knowledge, insider/outsider treatment, advocacy, ‘proper channels’, and ‘voice’ in the face of ‘power.’

Presenting with a heart attack, her father was deemed to be the stereotype of a ‘drunken Aboriginal’ person – by assumption not by evidence. This lead to a series of ‘othering’ that created and continues to create differential spaces of invisibility where some people get care and other people get ‘proper care.’ In the end, thankfully, Dr. DeCoteau’s father received the right kind of care to sustain his health, but not until she was able to step in and help guide the situation.

What this suggests is that a construct of invisibility isn’t just useful for thinking about things, but that it can and must also be operationalized as a remedial tool. When one looks for ‘invisibility’ gaps, one can often find ways in which to intervene in broken systems and disordered thinking – taking us from unconscious incompetence through to conscious incompetence, conscious competence and finally to the ultimate goal of ordinary ‘unconscious competence’ – doing it because it’s just what we do in order to treat everyone equally and well.