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www.lawtimesnews.com Law Times / January 14, 2008 Page 7 Immortal? Not me! "enjoy yourself, it's later than you think, enjoy yourself, while you're still in the pink, the years go by, as quickly as a wink, enjoy yourself, enjoy yourself, it's later than you think." — Enjoy Yourself, music by Carl Sigman, lyrics by Herb Magidson I have enjoyed writing A Bencher's Diary for the last 12 years, and as long as you read me, and the Law Times wants me, I plan to continue. I have always realized, however, that all good things eventually come to an end, and as I am the type of person who tries to plan ahead I always thought about what I would say when the day came to say goodbye. I never thought that day might come so soon. While I hope to continue writing this column, I no longer have the certitude about my future that I once had. You see, I recently learned I am not immortal af- ter all. A few years ago I wrote about my encounter with Bell's palsy ("What, me disabled?" Law Times, Apr. 18 and May 9, 2005). My unanticipated ac- quaintance with Mr. Bell left me with some permanent after-ef- fects, for which I receive weekly therapy, but I made the necessary adjustments in my practice and personal life and soldiered on. A few months ago, however, I began experiencing soreness in my chest. After my unwise denial of that worrisome symptom did not make it disappear, I trooped over to my doctor who sent me for an electrocardiogram. The ECG revealed pathological atrial fibrillation, and I was referred to a cardiologist. Given a choice, I would prefer to meet a cardiolo- gist at a party, rather than at his or her office. Instead of my heart beat- ing normally and forcing all the blood that enters it to exit as it should, my heart quivers and blood pools at the bottom, where it can clot and ultimately cause a stroke. The cardiologist arranged for an echocardiogram, a stress echocardiogram, and a return visit. One of the drugs he pre- scribed was warfarin, an antico- agulant medication that reduces the ability of your blood to clot. It is not a soothing thought to know that warfarin was origi- nally developed as a rat poison. If, contrary to the infamous arti- cle in Macleans, you are not a rat and you take warfarin, you must go for a weekly blood test so that the clotting factor of your blood can be ascertained and your daily dose of warfarin regulated. Numerous medical ap- pointments and tests totally disrupt your professional life, and as my atrial fibrillation has proven persistent I will under- go cardioversion as soon as my clotting factor remains at the proper level. Cardioversion attempts to restore normal heart rhythm through electrical shock. It's like the procedure Jack Nicholson underwent in One Flew Over the Cuckoo's Nest, except, instead of putting your head between elec- trode pads, one of the pads is put on your chest and one on your back. Mercifully, you are anaes- thetized. When Rob Martin was a bencher — and a good one, for he was an independent soul — he ran into a serious health challenge. When he returned to Convocation he solicitously reminded his fellow benchers how important it was to lead a balanced life. I wish I had taken his words to heart then. Now that I am compelled to do so, I am more watchful of my diet, and, come rain or shine, walk for at least half an hour each day. My cardiologist advises that the cause of atrial fibrillation is not known, but it often oc- curs as one grows old. I am an exception to that rule as I am only a young fellow of 64. My own opinion is that cumulative stress over the years, both in one's personal life and at the of- fice, is the culprit. See Chronic Stress and the Heart in the Jour- nal of the American Medical Association (JAMA), Vol. 298, No. 14, Oct. 10, 2007 (www. jama.ama-assn.org). That article scientifi cally confi rms what we all anecdotally know to be true. Stress goes with the territory of being a lawyer, but from talk- ing to other sole practitioners, and from the correspondence I receive, I am struck by the par- ticularly stressful existence of sole practitioners and how many of us ultimately suffer from heart disease. From my own experi- ence, I know that, day in, day out, ever since opening my own sole practice, tension has been a constant companion in my life. As I have an inquisitive nature, I researched atrial fi brillation on the web. One authoritative resource I perused was the Merck Manual, the bi- ble of the medical profession (www.merck.com/mmpe/index. html). On the one hand, it's prudent to be informed; on the other, notwithstanding the faith and trust you may have in the Almighty and in your doctors, your tranquillity is disturbed by "knowing too much," by as- certaining the inherent risks of the procedure you are about to undergo and what else may lie down the road. So while putting my affairs in order — hopefully sparing the Law Society's trustee serv- ices the pleasure of doing so — I am writing this column to thank the Law Times and the editors I have had the pleasure of working with: Beth Marlin, Gail Cohen, and now Gretchen Drummie. They have allowed me to independently inform you and express my views. Above all, I thank you, my readers. The Niagara of pro- fessional material and publica- tions that pours into our offi ce is astounding. I am grateful for the time you take to read this column and often to send me correspondence. May you be successful professionally and personally, and, above all, may you be well. Gary Lloyd Gottlieb, a Toronto lawyer, is a Law Society of Upper Canada bencher and a Toronto sole practitioner. His e-mail ad- dress is glgqc@interlog.com H ealth Minister George Smitherman is a highly effec- tive and generally unworried Liberal partisan, but it is clear from his reaction to the ongo- ing controversy surrounding Brampton Civic Hospital that he is concerned about where the issue is headed. Take the interview he did for the grit house organ the Toronto Star. He was pre-empting the next- day release of a report by the On- tario Health coalition attacking the private-public partnership (P3) that built the new Brampton Civic Hospital and will fund 32 more hospitals in coming years. The coalition — along with Toronto city hall, one of the last Ontario bastions of old-time so- cialism and union toadyism — has a track record of genuflecting before the monopoly state as the deliverer of public services. The city was a key ally of the Liberals against the Conservative government of Mike Harris when it also raged against the P3 process and what it liked to call the priva- tization of health care. The Liberals called P3s, in their usual rabble-rousing way, the "Americanization of our hos- pitals." The Liberals promised to end P3s, which they technically did by renaming them Alternative Service Financing and Procurement, and by tossing in a couple of caveats, particularly by retaining owner- ship in state hands. But in essence everybody except the Liberals ac- knowledges they are still P3s. The health minister, who is thin-skinned about criticism, is clearly uncomfortable with be- ing subjected to the same kind of rhetoric from the coalition as it once directed against the Conser- vatives. Hence his pre-emptive inter- view strike, in which he dismissed the coalition as "more irrelevant by the day." But the very fact he did the interview shows how seriously he took the critics. He suggested that, "They have a lot of rhetoric . . . (but) at a cer- tain point in time people have to start to question their motives." The coalition and others have linked the P3 nature of the new hospital to recent medical troubles at the building that led Smither- man to appoint a provincial super- visor less than three months after the new building opened. But Smitherman called the whole issue of private financing of the hospital building a red herring. "Because the building has a mort- gage, it makes people sick?" He then added the kicker that the coalition "has a mindset . . . that's mostly about fighting a battle that's long, long, long since been decided." By this, Smitherman presum- ably means the socialization of Ontario medicine, and in that he is mainly correct. Thanks partly to the efforts of the Liberals, private-sector involve- ment in medical care has been so thoroughly demonized in Ontario that Smitherman was able in 2004 to get away with telling us that if we wanted an MRI we'd have to line up for it and get permission from higher authority. No private-sector clinic was go- ing to be allowed to offer a scan in exchange for presenting an OHIP card, no matter how desperate a person might be. Better we go to the U.S. and offer cash on the line. Nurses, of course, now all but work for the government, which explains in many ways their in- creased belligerence in contract negotiations. Meanwhile, doctors are increasingly forced by payment schedules into almost civil-service- like contracts. Even hospitals, as Brampton Civic demonstrates, are increas- ingly government clones. The questions about medical care at the facility may be real or may be a function of the critics using the hospital as a club with which to beat up on the Liberals about P3s. Anyone who's been around Queen's Park has seen the scenario a hundred times: the manipulation of tragedy — or even the inven- tion of events — as a mechanism to push other agendas. The public sector unions are particularly good at these antics. So the timing of the "troubles" at Brampton Civic is a bit suspi- cious, considering that Brampton Civic is essentially the reincarna- tion of the old Peel Memorial Hospital in new surroundings. But that doesn't make Smither- man's life any easier. The percep- tion of a problem is his current reality, especially since the local hospital board has in effect been displaced by Smitherman's sent-in supervisor. True, the minister was quoted in the media as saying that he was "uninterested" in the Coalition's views because the people of Bramp- ton had spoken "loud and clear" in the provincial election Oct. 10 by making "every elected [local] MPP from the Liberal Party." But all that does is confirm that the reputation the minister acquired, during his first term, as a braggart and a bully is soundly based. The issue, and Smitherman's testy reaction, hoists the Liberals upon their own petard, a phrase that in Shakespeare's day meant blown up by your own gun. You cannot continually tell people that responsibility for their health belongs to the government, and solely to the government, and that everything connected to health care must be state-run and state-owned, and then expect to duck responsibility when the in- evitable screw-ups occur. Derek Nelson is a feelance writer who spent 19 years at Queen's Park. His email is jugurtha@ rogers.com COMMENT Bencher's Diary By Gary Lloyd Gottlieb LT Pre-emptive strike by Smitherman REPRINTS Been in Law Times? Want a record of it? Promote your law fi rm by ordering reprints of articles from the voice of the profession — Law Times! Reprints are great for: • Firm promotional material • Use on your web site • Training and education • Suitable for framing $175 - $225/reprint We provide a color PDF and unlimited reproduction rights. For more information or to order reprints, please e-mail Gail Cohen at: gcohen@clbmedia.ca LAW TIMES Inside Queen's Park By Derek Nelson LT LT-Jan 14 08.indd 7 1/10/08 8:07:01 PM

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