Transcript
Transcript: Reflections by Dr. Alika Lafontaine
[00:00:00 Montage of a series of images. Text on screen: Leadership; Policy; Governance; Innovation.]
Narrator: Public servants, thought leaders, and experts from across Canada are reflecting on the ideas shaping public service, leadership, policy, governance, innovation, and beyond.
[00:00:16 Text on screen: Review and Reflection; Produced by the Canada School of Public Service.]
Narrator: This is the Review and Reflection Series produced by the Canada School of Public Service.
[00:00:26 Dr. Alika Lafontaine appears full screen and is seen from different camera angles throughout the video.]
Taki Sarantakis: Welcome to another installment of the Review and Reflection series of the Canada School of Public Service, where we talk with interesting Canadians to, not only try to get to know them a little bit better, but for you to get to know your country a little bit better through those interesting Canadians.
Today we are with one of my favourite Canadians, Dr. Alika Lafontaine. Welcome, Dr. Lafontaine.
[00:00:51 Text on screen: Dr. Alika Lafontaine, Physician and Past President, Canadian Medical Association.]
Dr. Alika Lafontaine: Thanks for having me.
Taki Sarantakis: Where were you born, sir?
[00:01:01 Overlaid aerial image of Regina, Saskatchewan.]
Dr. Alika Lafontaine: I was born in Regina, Saskatchewan. My dad's from a small town called Lestock, about 100 people. I think it's still 100 people. And my mom's a first-generation immigrant from the island of Tonga.
Taki Sarantakis: And did you grow up in Regina?
[00:01:15 Overlaid image of Dr. Lafontaine's parents' wedding photo.]
Dr. Alika Lafontaine: I did. My dad, after he married my mom, ended up moving to Regina and setting up a life there.
Taki Sarantakis: And what was Regina like when you were growing up?
[00:01:23 Overlaid image of Dr. Lafontaine as a child.]
Dr. Alika Lafontaine: Regina was slow. I think that was one of the things that I both appreciated and was hyper-aware of. There were always bigger cities that were busier.
Taki Sarantakis: Like Saskatoon?
Dr. Alika Lafontaine: Saskatoon. Saskatoon and Regina have had an ongoing rivalry just because of the river.
Taki Sarantakis: The sports teams.
Dr. Alika Lafontaine: Exactly, yes. But Calgary was a place that a lot of folks that I grew up with ended up going. Lots of people came out east. It's interesting, in the prairies we always call Ontario east when east is probably a lot further than that.
Taki Sarantakis: And when you were growing up in Regina, on the prairies, what were your first memories of the rest of Canada? Was it Toronto? Was it the Montreal Canadiens? What did Canada outside of the prairies mean to a young boy growing up in Regina?
[00:02:23 Overlaid image of the Saskatchewan Roughriders logo.]
Dr. Alika Lafontaine: Yes, in Regina we had the CFL Roughriders. I actually had a—
Taki Sarantakis: Did you have the Rough Riders or the Roughriders?
Dr. Alika Lafontaine: Roughriders.
Taki Sarantakis: Because there was a league of 9 teams, and 2 of them were called the Rough Riders.
Dr. Alika Lafontaine: Yes.
Taki Sarantakis: Which was always fascinating to me, as a Canadian.
Dr. Alika Lafontaine: Yes, we're the one that matters because it's the only one still around. Yes, but football was big in Regina just because that's what was there. So, I got to know other provinces through fans across the country. We did a lot of moving around Saskatchewan. My dad did a lot of travelling for his work, and he'd often bring us along. And as we started to get into other artistic endeavours, we started to see parts of the country that we'd never been before.
Taki Sarantakis: And do you remember your first hero when you were a little kid?
Dr. Alika Lafontaine: I think my first hero was my parents. I know that's sometimes a ready answer, but back in those days you didn't have social media. You had the newspaper, you had magazines targeted towards kids, and they had things that you read in the library. I didn't come from a home situation where we had cable TV and other things. We just picked up whatever came over the airwaves. So, usually things like CBC News and SCTV and things like that. But yes, my world was really small when I was small, and so my parents ended up being people that I really looked up to.
Taki Sarantakis: Now, when you were in grade 1, you had what a lot of people would view as a very traumatic experience. And I've heard you say this in public a few times, so I know I'm not delving into something that's overtly private but talk to us about what happened to you in grade 1, what your parents were told, what you heard, and what that meant to you.
Dr. Alika Lafontaine: Yes, I think one of the reasons why trauma hits you really hard is because there's a buildup. There's things that you expect, and there's things that you wanted to do, and because of the trauma, all those things are kind of ripped away. My parents both believed deeply in the strength of education, how important it was.
My dad had been the first person on his side of the family that went off and got a master's degree. My mom, though she never went to college, came overseas and as a first-generation immigrant, completed high school, which was an enormous achievement for someone who immigrated to a place that – she didn't speak English as her first language.
And so, both of them looked at education as a way for us to move from where we were at, which, to be honest, was a nice, comfortable, lower-income home, really safe because my parents filled it with lots of love. But we didn't have a lot, and they wanted to make sure that we get opportunities that they didn't. And so, all through my childhood, I would hear them talk to my older siblings, and they talked to us about how important education was. It was going to take us somewhere.
And when school administrators sat down with me and my parents after months of trying to have me go through the reading curriculum and them just getting very, very frustrated with it, at the time, the belief was if you couldn't do what they asked you to do, there was just no doing. It was just over. And they said really definitively to both my parents that I would never graduate high school, that that was it.
Taki Sarantakis: And so, at this point, you're like 6 years old, 7 years old?
Dr. Alika Lafontaine: It was a period. So, early grade school. I think when they sat down with my parents, I was 8 or 9. I mean, I was old enough to know that it was going on, but not old enough to really comprehend what was going on.
Taki Sarantakis: And how did your parents react to that?
Dr. Alika Lafontaine: They were both really upset going into that meeting. My dad, because of his education, he knew how teaching worked, and he had his own ideas about what my capacity was. So, both him and my mom came in ready for a fight, to tell you the truth. And the air was sucked out of the room the moment that they were told that that was kind of it for me.
And I still remember what it felt like to sit in that chair and think to yourself, "Oh yes, your parents are fighting for you." And, like I said, looking up to them as my heroes and seeing them hear that and just have that energy taken out.
Taki Sarantakis: Did you feel the weight of the quote-unquote system pronouncing your fate, your future?
Dr. Alika Lafontaine: I think what I noticed at first was the reactions of my parents. It wasn't common for me to see my parents get in a fight with any type system and just be in a state of shock. I think they were going through a lot of really powerful emotions, and I was just soaking that up because I was a kid.
I do remember a loss of security though. I had always gone to school and really walked in with the feelings that my parents had put in me, which is this is your path to somewhere better. And I remember sitting there just thinking, what am I going to do?
Taki Sarantakis: Now, you're Indigenous in Regina, which is not an unusual situation. It might be unusual in Toronto back then, or Montreal back then, but in Regina it wasn't, and it isn't unusual. Did you think that had anything to do with the pronouncement?
Dr. Alika Lafontaine: I think it was the way that things went for people who struggled with learning. But as someone who teaches and someone who teaches now, as someone who works a lot with medical students and residents and other colleagues, I realize that there's a band of influence that you have as a teacher. You can decide whether or not someone who's struggling is deserving of your time, and you could decide the opposite.
And I do think, looking back, that elements of racism were probably woven in, but it was part of the story of Indigenous kids. I mean, that's what we were supposed to do. We were supposed to not succeed if we were labelled with the problem. That was kind of it.
Taki Sarantakis: So, obviously you overcame – I wouldn't call it your problem, I would more call it your label. You overcame the label. You not only finished high school, you then went to university, and then you went on even beyond that. You went to medical school. Did anything from that grade 1, grade 2, grade 3 experience stick with you? Did it become a chip on your block? Did it become, "I'm going to show them?" Or did you put that in a different context?
Dr. Alika Lafontaine: I had a huge chip on my shoulder. And I think that's one of the interesting things about trauma is trauma breaks you, but it also makes you push back against whatever's pushing you down. And one of the clear memories that I have around the time that my parents were going through absorbing all of this information was this idea in my head, "What's wrong with me?"
And I think when you go through life feeling like there's something wrong with you, one of the ways that you can react is just really pushing back and trying to prove to the people around you.
And I think that was a driving force, especially early on. I wanted to show everybody I was smart enough. I wanted to show them that although they pushed me into a category, that's not where I wanted to be. And I chased after awards, and I chased after marks.
And for a significant period of time, I think that was helpful. But there comes a point where it's not helpful anymore. And I eventually hit that point.
Taki Sarantakis: Yes, I guess it's a little bit analogous to at one stage it might fuel you, which is a positive thing, but at another stage it might define you, which is a negative thing. And it sounds like you used that negative experience as something that launched you in a better direction. Is that fair?
Dr. Alika Lafontaine: It did. When I was at a period in my life where fighting made sense, having a chip on your shoulder was a huge opportunity to prove people wrong.
[00:11:25 Overlaid image of the University of Saskatchewan.]
Taki Sarantakis: So, now you're in medical school and you're thriving. Presumably you're liking it. Tell us how you became your particular discipline. You're not only a doctor by training, you also, to me anyways, appear to be somebody who is a particular type of doctor. And I've heard you make different jokes about the type of doctor you are, what you get to do as that type of doctor. First of all, tell us what your specialty was, why you picked it, and why you seem to enjoy it so much.
[00:12:02 Overlaid image of Dr. Lafontaine, dressed in surgical scrubs, on duty in a hospital.]
Dr. Alika Lafontaine: I'm an anesthesiologist by training. Anesthesia was not what I originally intended on doing. I had put it in my head, once again, that I was going to show everyone how hard I could work and how I could succeed. So, I just picked the hardest thing that was out there. I think it shifted between being a type of doc that focused on doing cancer surgeries, or a cardiac surgeon, whatever was the hardest thing that I had in mind.
When I finished my undergrad degree and then went into med school, I ended up connecting with a neurosurgeon in Regina. His name was Krishna Kumar, and he was a force. He was a man of small stature but enormous personality. He'd walk into a room, and it was very clear he was the kind of person that fixed things, and everybody knew it. He was very grandfatherly to me. I think part of it was I knew how computers worked, and he didn't, and so I'd make his presentations, and he was always in a different country presenting.
And I spent a couple of years with him, and I thought I was on the road to becoming a neurosurgeon. And then I met my now wife, and she told me that if I was a surgeon, we were done. She had had a previously bad experience with a friendship where they had gone into a surgical specialty and then just they had lost touch with them.
Taki Sarantakis: Is it because it overwhelms you?
Dr. Alika Lafontaine: I think a lot of it was just the demands of the specialty. No matter what you're going to, there's always a cost to be paid. And there's a pretty high cost for surgical specialties.
And so, after that ultimatum, I was kind of lost. Dr. Kumar was super supportive. He told me to focus on the things that were most important, which nudged me in that direction. But I was aimless for quite a bit. And I ended up connecting with a family friend who had been trying to get me interested in anesthesia for quite a while. I followed him around on another call, and I still remember the night.
We had a really, really boring day. And then we went off to sleep in the cubicles that they put aside for trainees in the hospital. My beeper goes off at 3:00 am because there's a code blue. And we both go sprinting up 4 flights of stairs to get to this room. My hands are shaking, full of adrenaline and stuff.
And we walk into this room that, for lack of a better word, was just pure chaos. 20 people in the room; no one seems to be coordinating anything; there's vomit on the patient's shirt; the IV had been pulled out, so they're leaking from one of their limbs. He walked in, knelt down, started the IV, rotated to the top of the bed, and quietly started telling people what to do. And I watched that chaos evaporate, and suddenly there was order.
And I remember in that moment I said to myself, "That is what I'm going to do."
Taki Sarantakis: That's very cool. Tell us about anesthesia a little bit. So, I think colloquially we say it's "putting somebody under". Any of us who have had any type of surgery, Dentistry, anything like that, have probably had anesthesia. Talk to us a little bit about what it means to put somebody under, how dangerous that is, how you know that the person is ready for their heart surgery or their gallbladder surgery. Tell us a little bit about that seemingly magic thing that the medical profession, thankfully for the rest of us, has seemed to have tamed and mastered.
[00:15:54 Overlaid image of an Anesthesiologist administering anesthesia to a patient.]
Dr. Alika Lafontaine: When you're learning about anesthesia, one of the things that you're often told is that the majority of it is pretty boring, and then there's small elements that are just pure terror.
And I would say, in practice, that's probably accurate. When you have a smooth day, it's a smooth day. People tend to react pretty reliably to medication unless there's some sort of chronic disease or other issue that modifies the way your body reacts.
In those moments where things don't go along with the way that you think, it does involve a lot of rapid critical thinking.
Taki Sarantakis: And — forgive me— that could be heart rate, that could be blood pressure, so there are telltale signs that something—
Dr. Alika Lafontaine: Yes, you could give a little bit of medication and have an outsized result. They could stop breathing when you don't think that they should stop breathing; their blood pressure could crash to life-threatening levels. In traumas, you could do things and make the bleeding worse or have other types of issues pop up.
And so, in those moments, I think, are my favourite parts of anesthetic practice. When I first started, I was really chasing after that adrenaline rush. I think now that I've been in practice for 15 years, I sit there and am happy to just have a boring day.
Taki Sarantakis: You crave boring because that means you're a master.
Dr. Alika Lafontaine: Yes. And I find that every day is an opportunity to make an impact in someone's life. There's no feeling like walking into a room where a mom is mid-labour and they ask for pain relief, and you do your thing. You start the epidural. Moments later, they're completely comfortable.
And being able to change pain consciousness, having someone with blood pressure problems or bleeding out or other things, it's a really exciting part of medicine.
Taki Sarantakis: Yes. And if you think about it, it's almost the foundation of all surgical interventions. Absent this, and somebody else can't go in and fix the particular that, whether it's having a baby, whether it is doing an intervention on your heart or your liver or your pancreas, or what have you.
Now we're going to leave medicine for 10 minutes. We'll probably come back. Let's go to 2008. There's some strange contest that you won in 2008. Tell us a little bit about that contest. What was it? How did you win it? Tell us a little bit, because it's an interesting little tale.
Dr. Alika Lafontaine: So, there was a writing competition with essays where people would send into this group that would judge people's visions for Canada. And in the year that I was looking at the competition, it morphed into a TV show.
[00:18:56 Overlaid image of a CBC program guide featuring its TV show "Canada's Next Great Prime Minister", hosted by Alex Trebek.]
Dr. Alika Lafontaine: And so, it was on CBC, it was called "Canada's Next Great Prime Minister". And I believe my season was the third round of moving to this television event.
[00:19:02 Overlaid images of Alex Trebek welcoming Alika Lafontaine on stage; Alika and the other contestants standing at lecterns on stage.]
Dr. Alika Lafontaine: And so, people compete to get on the show through writing in, and then on the show they go through several rounds where they'd be judged by former Prime Ministers.
Taki Sarantakis: The actual real former Prime Ministers?
Dr. Alika Lafontaine: The actual real former Prime Ministers, yes.
So, we watched the show the year before I competed, and I was watching it with my brother, and we were both sitting there and we turned to each other and we're like, "We could win this show." And it didn't hurt that there was a cash prize, but we made a commitment to each other that we're both going to enter this next year.
Taki Sarantakis: And at this point, are you a medical doctor?
Dr. Alika Lafontaine: I'm in anesthesia residency at this point. So, I had started anesthesia a year before, so I'm now in my second year. And when I competed on the show, I'm in my third of 5. And yes, we both entered. He had timed out; he was too old. And so, I ended up moving on. We ended up having multiple months where we had to debate on Facebook and build a following.
Taki Sarantakis: What was your essay?
Dr. Alika Lafontaine: My essay came out of a conversation that I had heard between my dad and a sitting MP at the time, named Rick Laliberte. And he was the MP for the North, and they were talking about a 3rd seat of government for Indigenous peoples. And it was everything from where it was going to be, to what it would do. And I just found it a fascinating concept. And so, that was the idea that I moved forward with.
Taki Sarantakis: And what was the reception? I guess we can go back and watch it on TV but tell us a little bit about what you remember. What did the former Prime Ministers say to you? What did you say to them?
Dr. Alika Lafontaine: You know, they were gracious with us, and they asked us reasonable questions. There was, in the third round, your big question that you got asked by all of the Prime Ministers.
[00:21:06 Overlaid image of former Prime Minister Paul Martin.]
Dr. Alika Lafontaine: And in my round, it was Mr. Martin that ended up asking me about something that had been on his mind, which is the Clarity Act. And I still remember how upset he was with my answer because, in the Prairies, democracy to us is a 50% plus 1.
Taki Sarantakis: And populism, populism, populism, populism.
Dr. Alika Lafontaine: Populism, populism. Obviously Quebec-Canada relations are way more complex than 50% plus 1.
And I think, looking back, it was the flattening of the problem that I think got him so upset. And so, I gave him the answer to his question, which was, "Should Quebec be able to secede in a 50% plus 1 situation?" And I, of course, said "Yes, because that's what democracy is." And he slammed his fist down on the table. He turned red. I'd never seen a Prime Minister mad. That was my first experience.
Taki Sarantakis: Good for you, you made a Prime Minister mad.
Dr. Alika Lafontaine: Yes, Yes. And he stood up, and he said, "Over my dead body would Quebec ever leave." So, it just kept on getting worse. And I remember standing there thinking to myself, "What am I going to do?" Because I felt like I was doing quite well in the competition up until then. And advice that I'd gotten earlier was if you get in a fight with the Prime Minister, you should really say something patriotic.
And so, I took a minute just to collect myself. And I've watched the tape a few times on this, and I'm quite surprised that I kind of kept it together, but I told Mr. Martin, "If Quebec wants to leave Canada, we shouldn't be thinking of all the ways we can force them to stay, but instead ask, why would someone want to leave the greatest country in the world?" And I held my hands up to the audience and the room erupted and I got a standing ovation as a result. And the audience was actually who judged the winner, so I ended up winning the competition. Yes.
[00:22:56 Overlaid image of a CBC News article titled "Saskatoon doctor declared Canada's Next Great Prime Minister".]
Taki Sarantakis: So, we're going to come back to politics, but we're going to go back to medicine for a little bit. So, now you are a doctor, you are at a hospital, you are practicing, you look around, and I'm not sure if you start this initiative or if you join it, but you're certainly a big part, you're a catalytic part of something important in Indigenous health services. Tell us about that part of your life.
Dr. Alika Lafontaine: So, obviously there's crises happening across the country. That's true today as it was yesterday. And there was a particular crisis affecting 3 communities in southeastern Saskatchewan that my dad had been involved in. And all throughout my academic career, he's always turned and asked questions about what was going on. And I ended up getting pulled into a conversation around why these communities were suffering so much. And it was very inward looking. Everyone was asking what's wrong with me.
Taki Sarantakis: What were the 3 communities?
Dr. Alika Lafontaine: Key, Cote, and Keeseekoose First Nations. They're close to the towns of Kamsack and Yorkton in southeastern Saskatchewan. And that question really hit me hard because that obviously was a question that I'd asked myself about myself ever since I'd been labelled developmentally delayed.
And I had finished my residency. I was in practice. I was getting quite a bit involved with quality improvement and patient safety initiatives and really swept up in this whole, we're going to change medicine at [inaudible] omentum. And I noticed that none of those programs were even being talked about, when it came to First Nation, Inuit, and Métis communities. And it was introducing those ideas that I think sparked a shift in the conversation.
What used to happen is communities would declare a crisis and then it would be a competition between who had the biggest crisis as far as who got attention. We shifted that instead to a conversation around, do people have access to the same services? Do they have the same sorts of infrastructure? Why is the clinic in a town 100 kilometers away when it's a larger population of First Nations?
And that conversation really caught fire. Those 3 communities, to their credit, helped to expand it out to more than 150 First Nations. And it really became a way for people to talk about problems in a different way. And communicate with government in a way that was much more equal and much less an argument about how bad the crisis was.
Taki Sarantakis: It's interesting because if I draw a parallel with your earlier experience that you conveyed to us vis-à-vis Prime Minister Martin, very similar. You inverted the question and said, "That's not the real question. The question is something else." Is that a good way of putting it?
Dr. Alika Lafontaine: I think I get that from my dad. My dad always enters into conversations, and if it's very outward looking, he's very inward looking. And if it's very inward looking, he always looks to the outside. Because I think in entrenched problems, the solutions are always outside of the current conversation. If the current conversation was going to take you to those solutions, then it would've already. And so, yes, I think that's something that I was lucky enough to pick up from them.
Taki Sarantakis: Now we're going to fast forward a little bit and your world, vis-à-vis people that know you, starts to go from outside the borders of Saskatchewan to the borders of the country of Canada.
[00:26:54 Overlaid images of Dr. Lafontaine being interviewed on CBC's Power & Politics.]
Taki Sarantakis: And you become the President of the Canadian Medical Association. Talk to us a little bit about that.
Dr. Alika Lafontaine: Oh geez, that was a wild experience. I remember when they were talking about having a person come from Alberta. I'd been involved in medical politics ever since I had moved to Grand Prairie. So, it's probably going into the 10th year that I had been the representative from the North and participated in the ups and downs of Alberta medical politics: signing contracts and negotiations and all these other things.
And I was actually approached by a now sitting senator, Senator Gigi Osler.
[00:27:29 Overlaid image of Senator Gigi Osler.]
Dr. Alika Lafontaine: She was president of the CMA in 2019, and she said, "Alika, you've got to run." And I told her, "I'm really happy where I am." I was striving with the Indigenous Health Alliance. I felt like I was having a big impact.
And we had serial conversations and then the pandemic started to creep in, and the weight of all of the crises coming to a head: under-resourcing healthcare systems, aging infrastructure; not having enough workforce because people are making cuts; the stresses on education, everything. And she said to me, "You could really make a big difference if you were part of this space. I think you have something unique to bring."
And, like a lot of things, I threw my hat in the ring and didn't really think further than that. I didn't have a whole lot of confidence that I was going to win, but I knew I was going to try as hard as I could.
[00:28:34 Overlaid image of Dr. Lafontaine as he takes his role as President of the CMA.]
Taki Sarantakis: And I think you were the first Indigenous head of the Canadian Medical Association?
Dr. Alika Lafontaine: I was.
Taki Sarantakis: What did that mean to you?
Dr. Alika Lafontaine: I've been the youngest of things and obviously have had struggles that other people have struggled with. But it probably was the highest profile, most profound kind of "first".
The Canadian Medical Association was organized a few months after Confederation. It's almost as old as Canada itself. And the CMA was part of the founding of the World Medical Association, which came out of World War II when we had established conventions around medical experimentation and other things. Lots of things came out of the CMA. Federal government programs; Canadian Blood Services came out of the CMA.
And so, to be the first person to step into that space, it was quite overwhelming. I knew that there was a whole lot of opportunity, but I also knew that I was picking up a history that was very harmful to the place that I came from. I knew people in the healthcare system that suffered from racism and had really bad things happen to them, as a result of it.
Taki Sarantakis: Now, you mentioned it, and let's get into it with more specificity here. COVID, the pandemic. That dominated your time as President of the Canadian Medical Association. Let's talk a little bit about that period, because that was a period where we started learning about doctors and chief medical doctors and chief public health officer and pronouncements. And we started seeing a little bit – and this is always something that's personally fascinated me – the interaction between knowledge/science and politics/power and how those worlds, if not collided, they certainly had to interact and intersect. Talk to us what it was like being head of the Canadian Medical Association during a global pandemic.
Dr. Alika Lafontaine: I'll maybe start with talking about power. One of the things that I've been acutely aware of ever since I was young is my own relation to power. And, as a kid, I was powerless, right? And so, as a person who works in the healthcare system, people who come into my OR and receive an anesthetic, they have power until they don't. Once I start giving you those medications it's done. You are—
Taki Sarantakis: Literally falling asleep?
Dr. Alika Lafontaine: Yes, you're literally at the whim of the people in the room, hopefully making good decisions on your behalf.
And I think in COVID, I recognized how a lot of structures of power really flattened and then transformed into something different. People don't always remember the Wait Time Alliance that came out of the late 2010s. All the provinces and territories were starting to work together on different things, although some people were kind of winding out and trying to do things by themselves again, because the crisis has kind of ebbed. And so, COVID came along at a time where the norm was actually collaboration: having people around the table looking for those absent voices. And then, within a very short period of time, it snapped into a command-control structure. Which made sense, because it was a crisis.
And I think that command-control structure really eliminated the majority of those spaces where people felt like they were on equal footing. And it was strange, as a provider, to see how my voice went from one that was a part of the conversation to one where I had no idea what the conversation was. And I was strictly being told to do certain things by folks who I had never been reporting or accountable to before.
And so, when I think about patients and what they were going through during that time, I imagine the experience was 100 times worse. Not only do you not feel like you're being told and walked through what's going on, you feel like this command control structure is stripping away all the parts of your life that you felt you had control over.
Taki Sarantakis: Right. That there's, let's call it no agency or no volition or no other things in that vein. Now, you were also in hospitals during COVID. Tell us one of your better memories, in terms of hope-affirming, and some of the things that we maybe don't want to see again.
Dr. Alika Lafontaine: I'd say the most hope-affirming moments were when people showed up in situations that were clearly not what they had trained for.
[00:33:28 Overlaid image of medical staff racing into the Emergency department of a hospital.]
Dr. Alika Lafontaine: Showing up without proper access to protective equipment; showing up and not knowing who was going to come to the door, their state or other things. Early on in COVID, and I think people sometimes forget this, people had very, very severe illness.
[00:33:38 Overlaid image of medical staff in full body Personal Protective Equipment tending to a patient in the ICU.]
Dr. Alika Lafontaine: And folks that you didn't think were supposed to get sick that way. When I think about the most heartbreaking situations, I had quite a few patients that I participated in their care where they obviously were having symptoms, but they couldn't bring themselves to acknowledge what was happening.
And to have people my age, or the age of my younger or older brothers, sitting there as they're gasping saying, "I don't need this treatment, there's nothing wrong with me." And then seeing their vitals shift in ways that are 100% predictable based on what you knew was going on. That was heartbreaking. I'd never seen, in my career, a situation where there was such a dissonance between what patients would accept as far as what was going on, and what was happening right in front of us. And that just got worse.
Taki Sarantakis: Yes. Now, before we move into our last topic, let's stay with COVID for a moment because you're not just a medical doctor. You weren't just at the CMA. You're also, it seems to me, a little bit of a student of society and a little bit of a student of public policy.
I think COVID has a long tail and it has a series of long tails for Canada. What are some of those tails as you see them? How has COVID changed the body politique to a pre/post-COVID Canada?
Dr. Alika Lafontaine: Yes, I would say that the effects of COVID that are most profound was that it stripped away the polite veneer of what was over our politics.
I think, as Canadians – at least I grew up in an environment where politeness often outweighed saying what was actually going on, which is fine in the midst of things being stable. And when COVID hit and we all entered into that shared crisis, where we all had to react in a similar way and where people were at different points in their life. I mean, if you had a strong social network and suddenly you were locked in a room with everyone and you got along with them, that's great.
But for a lot of folks, that was not what was happening. You had the elderly who had no one visiting them anymore. You had young folks who were supposed to enter into the greatest times of their life in college.
[00:36:12 Overlaid image of medical staff in full body PPE helping a patient in the ICU have a video chat with their family.]
Dr. Alika Lafontaine: Now suddenly they're interacting with people over Zoom and making zero connections hundreds of kilometers away from home, not to speak of socioeconomic gaps and other access to things.
And so, I think what it shifted for people is to realize that that politeness was just a veneer and that underneath it all, there was significant gaps between people's lived experiences. Now, I think social media has made this all worse than it actually was, as far as lived experience. But it really forced people in a position where you moved far away from people that you were supposed to build relationships with.
And I think there's a lot of built-up resentment for folks who feel that they were harmed. And you know what? That's not unreasonable when you look at what actually happened.
Taki Sarantakis: I think I took a similar but slightly different lesson away from COVID which was, I think in the back of my mind, and maybe others shared this thought too, was like, "If something really bad happens, everybody's going to come together. Our politicians are going to coalesce like they did in, I don't know, mythically in our heads around World War II or during the Great Depression. Or if an asteroid hits part of the Earth, we'll all overcome whatever our differences are, and we'll come together and we'll deal with thing", was actually the exact opposite. The crisis put us, as you said, deeper into our respective corners. And instead of coming together, we continued to even highlight our differences more. Is that a fair way of saying it?
Dr. Alika Lafontaine: I think that's a very fair way of saying it. And I think for myself, when it comes specifically to the political question, I think I was disappointed that folks who I thought were going to bring us together at times scored easy points to try and consolidate support or other things. There was a lot of good things that happened during COVID, as far as leadership at all levels of politics, but there were some very significant stumbles that I think we're still trying to heal the divides that resulted from those.
Taki Sarantakis: Yes. Now, the last part of our conversation, in addition to being a doctor, in addition to being a former head of the Canadian Medical Association, you are now an author. Tell us about your book.
[00:38:48 Overlaid image of Dr. Lafontaine's book, titled "The Outrage Cure".]
Dr. Alika Lafontaine: Yes. So, the book actually evolved out of some of the conversations we're having right now. I had a falling out with a very close friend. And it was related to expressions of anger and outrage that happened during the Freedom Convoy.
[00:39:02 Overlaid image of three of the multitude of trucks that occupied most of downtown Ottawa for three weeks, starting January 29, 2022, known as the "Freedom Convoy".]
Dr. Alika Lafontaine: And, as part of the CMA, I was doing press related to the budget and related to COVID. And we had never talked about the Freedom Convoy. And the truth is, we never talked about it again after the conversation happened. But it ended up creating this existential feeling in both of us that we couldn't trust each other anymore. And that broke a decades-long friendship. And the book is really writing about my search for answers to try and find my way back.
Taki Sarantakis: Now, in your book, which I haven't read yet, but I've heard you talk about it, you talk about almost a bit of a continuum between anger, outrage, and indifference. Spend a moment or two on each of those things, starting with anger.
Dr. Alika Lafontaine: So, anger is an emotion that you feel when things are not going the way that you want them to. You have some sort of issue that you need to solve. And anger can reside in a lot of different places. A lot of times our anger is inward. People don't know about it. But in big, shared problems, our anger is something that we call out to other people because we need their help.
Now, when anger doesn't get answered, we start to question why is it not being answered. And as I unpack some of these ideas, thinking through experiences in my own life, I've realized that I've been through cycles where I've been very angry and I start to question whether or not people knew what they were doing or whether or not they were going to make decisions in the right kind of way, whether or not they were ethical.
And once we start questioning people's competence and credibility, that takes us down a downward spiral where we stop being angry as a call for help and we instead become outraged because we want to see reform. And that reform can take the role of having people fired from positions, it could be exposing people for not answering our call.
And as we go through these cycles over and over again – and they are cycles, because issues pop up, and then they ebb, and then they get worse again – eventually, we start to realize that nothing's going to change, no matter how much we're upset. And as we destroy those relationships around us, there comes a point, I think, where people start to question what's the point in fighting at all. And as a result, they move into indifference.
Now, that's linked closely to biology. When you think about our threat detector in our mind, our limbic system, that's really how we interpret harm. And so, as we go through those emotions, the stimulus of what's happening to our limbic system gets more and more dysfunctional until it shuts down. And so, our biology tracks our psychology.
Taki Sarantakis: So, to paraphrase, would it be accurate to say anger is a quest to fix something within a system; Outrage is kind of like, "I'm not sure I want this system at all. I don't think this system can be fixed. I want to throw away this institution, this hospital board, this type of democracy." And indifference is like, "You know what? I'm checking out. I am opting out of the world as I see it, and I am reverting into me and my little world."
Dr. Alika Lafontaine: That's absolutely correct. It takes us from a position where we're connected to people to being isolated and alone again.
Taki Sarantakis: Yes. Reminds me of a book that, when I was in grad school, we used to talk about a lot, Exit, Voice, and Loyalty.
[00:42:40 Overlaid image of a book, titled "Exit, Voice, and Loyalty: Responses to Decline in Firms, Organizations, and States", by Albert O. Hirschman.]
Taki Sarantakis: Which was any human being in any type of situation has 3 fundamental choices, whether it's a job or a marriage or a country or what have you.
Voice is when you try to say, "Hey guys, let's try to fix this." Loyalty is when you put your head down, you say, "I know it's stupid, but we're just going to keep going. I'm going to be quiet and whatever happens, happens." And exit is, "I can't do this anymore. I have to leave." So, very similar ideas.
Now, our last question. We talked about it. You entered an If I Were Prime Minister contest. You won. Do we see you in electoral realms in the future? And I ask not so much because being in politics is one of the ways that we contribute, but I see your affinity for public policy and I feel your, "I want to help reform the system". Some people think that that's the ultimate way to reform the system, which is to go in front of your peers, seek elected office of some sort, and have your hands on the levers of the state. Is that something that you think we might see one day? Your wife willing?
Dr. Alika Lafontaine: Yes, that's a good caveat at the end. I think politics definitely needs a lot more people. I would say that I was very interested in politics in the past, and then there was a period of time where I thought to myself, "How can anyone be a part of this?" And I think we're exiting that phase into a phase where it really feels like we're building up things again.
I think that there's an enormous need to have people who are part of government, elected and otherwise, who are really focused on those shared systems that we have together – healthcare, education, justice, all these things. It's a really scary time to be a Canadian citizen right now. I think it's a scary time to be anyone in the world right now. And those decisions, I think, are going to put us on a path that we're going to be stuck on for the next 40, 50 years.
Would I be a part of that? I think I would. But, in the meantime, I think there's a lot of places outside of politics where you can have enormous impact. I think that's one of the reasons why I wrote the book. I was trying to figure out answers to a problem that I had that I realized a lot of other people were struggling with, too.
And I think that's the interesting part whenever you engage in these kinds of conversations is you start to realize that what you were trying to figure out in your own head, a lot of other people were trying to figure out, too.
Taki Sarantakis: Our very last question. Most of the people in the audience watching and listening to you are public servants. Close us off with, I don't know if we call it wisdom or reflections or some thoughts that you would wish to convey to federal public servants.
Dr. Alika Lafontaine: I think I'd really convey that there's this narrative, in a lot of different places, that what you do doesn't matter. That somehow you can be replaced by an algorithm or some sort of automated decision-making.
I think at the core of systems that matter, and systems that actually make a big difference, are the people in it. And it's because what we're yearning for, I think, when we have shared problems is human judgment, human connection. And I really hope people in the public service, as we go through this period of time where there's a lot of instability, don't lose sight that even if other people don't see their value, there's an intrinsic value to what you do that's independent of people's opinions. I can't tell you how frustrated I've been when I try and pick up the phone and I get a call bot, and I can't connect with the person.
And I can't tell you how important and meaningful it is when someone shows up. I actually had a friend at the World Medical Association meeting that I was just at run into a problem with their passport. And they called up the office that was local in a country far away from here. And that person showed up on a weekend. And they talked about that experience the entire time back over the 12-hour flight.
I hope people in public service realize that if you feel unseen, people do see you. What you do does matter. And it's always going to matter.
Taki Sarantakis: Dr. Alika Lafontaine, what an absolute treat it has been to spend this time with you. What an honour and what a joy. And thank you for spending some time with us today.
Dr. Alika Lafontaine: Thanks for having me.
[00:47:58 The CSPS animated logo appears onscreen. Text on screen: canada.ca/school.]
[00:48:04 The Government of Canada wordmark appears.]
