Transcript: Show #21 | Feb 29, 2000

Maureen stands in a studio with windows and sofa chairs in the background. She is in her forties, has short, side-parted, curly blond-highlighted brown hair, and wears a brown suit with a brown shirt .

Maureen says WELCOME TO "YOUR
HEALTH."
I'M MAUREEN TAYLOR.

(music plays)
The opening sequence begins.

Clips of people of different ages flash on screen one by one against an animated blue sky background. First a baby boy, then a 10-year-old boy with short brown hair, a teenage girl with curly brown hair, a man in his thirties with middle-parted brown hair and glasses, and finally a woman in her sixties with long gray hair.

Maureen narrates
THIS WEEK, DOULAS, WHAT DO THEY
DELIVER?

A clip plays of a doula examining a woman as her husband looks on.

A husband and wife sit on a couch. The husband says I THINK SHE KEPT DEBORAH
MORE RELAXED.
AND THAT WAS THE MAIN THING.

Maureen says AGEISM IN HEALTH
CARE.
DO WE DISCRIMINATE AGAINST THE
ELDERLY?

A clip plays of Maureen sitting around a table with two men.

One of the men says MY FATHER'S CARE THAT HE
RECEIVED WAS REALLY SUB
STANDARD.

Maureen says AND BULKING UP.
WE'LL GET THE SKINNY ON SPORTS
SUPPLEMENTS.

The title appears on screen again and fades to Maureen standing in the studio.

Maureen says FOR MOST WOMEN, CHILD BIRTH IS
THE MOST INTENSE PHYSICAL
EXPERIENCE THEY WILL UNDERGO IN
THEIR LIFETIME.
AND ALTHOUGH YOUR PARTNER MAY
HAVE ATTENDED CHILD BIRTH
CLASSES WITH YOU AND ALTHOUGH
HE MAY MEAN WELL, SOME WOMEN
MIND THEY NEED ANOTHER WOMAN
BESIDE THEM TO HELP THEM GET
THROUGH IT.
THAT'S WHERE DOULAS COME IN.
DOULA IS THE GREEK WORD FOR
FEMALE SLAVE.
BUT TODAY THEY PROVIDE A
SUPPORTIVE ROLE FOR WOMEN IN
LABOUR.

The scene changes to a mother playing with her baby.

Maureen narrates
TO GET TO THIS... MOTHERS HAVE
TO ENDURE SOMETHING THAT LOOKS
MORE LIKE THIS...

Clips of women in the midst of labour flash by on the screen in quick succession.

Maureen continues
SURE, CHILD BIRTH IS SUPPOSED
TO BE A NATURAL EVENT.
BUT HOW COULD AN EXPECTANT
MOTHER NOT NATURALLY BE
TERRIFIED AT THE THOUGHT OF
SUCH PAIN?

The scene changes to Debbie sitting in her home. She is in her thirties with long, wavy brown hair. She wears a red blouse.

Debbie says THE FIRST BIRTH WAS HELL.

A clip plays of Debbie and her husband playing with their three young boys.
Maureen narrates DEBBIE AND ERIC ARE THE
PROUD PARENTS OF THREE BOYS.
AGED 5 TO 4 MONTHS.

Debbie says I GOT TO THE HOSPITAL AT 10
IN THE MORNING AND BLAKE WASN'T
BORN UNTIL 11:15 THE NEXT DAY.
AND, AH, THEY TRIED TO GET AN
EPIDURAL IN FOUR TIMES, AND
THAT DIDN'T WORK.
SO I-- I WAS DEVASTATED.
I THOUGHT, YOU KNOW, HERE THEY
ARE TELLING ME YOU'LL BE ABLE
TO RELAX AND SLEEP.
THEN SORRY WE CAN'T GIVE YOU
THIS.
AND IT WAS-- IT WAS
DEVASTATING.
IT WAS AWFUL.

Eric says SHE WAS HAVING GREAT
CONTRACTIONS, BUT WE WEREN'T
PROGRESSING AND THESE STRONG
CONTRACTIONS WERE WEARING HER
OUT AND SHE WAS IN A LOT OF
PAIN AND EVERYTHING THEY TOLD
ME TO TRY TO RELIEF THE PAIN
MADE IT WORST.

Eric is in his thirties with neatly cropped red hair and a trimmed beard. He wears a white and brown plaid shirt.

Eric continues
IT WAS LIKE NO.
NO.
THE ONLY THING I COULD DO IN
THE FIRST BIRTH WAS HOLD HER
HAND.
THAT WAS IT.
HOLD HER HAND.

Photographs of a pregnant Debbie flash on the screen.
Maureen narrates DURING THE SECOND PREGNANCY,
DEBBIE WAS TERRIFIED AT THE
THOUGHT OF ANOTHER LABOUR LIKE
HER FIRST, SO SHE AND HER
HUSBAND TURNED TO CHERYL
STEWART, A BIRTH DOULA.

The scene changes to Cheryl walking up to a phone. She picks it up and says HELLO.
CHERYL SPEAKING.

Cheryl is in her forties with short, brown hair that is side-parted. She wears a earth-toned button-down.

Cheryl says I ATTEND WOMEN AND COUPLE
WHO ARE EXPECTING BABIES.
I MEET WITH THEM PRENATALLY AND
ON CALL FOR THE BIRTH.
AND, UM, I ATTEND TO THEM POST
PARTUM AS WELL.
ASSISTING WITH BREAST FEEDING
AND ADJUSTING.
THE DOULAS PRIMARY ROLE IS
EMOTIONAL SUPPORT NUMBER ONE,
AND PHYSICAL COMFORT NUMBER
TWO.

A caption reads "Cheryl Stewart. Doula."

Cheryl continues
THEN INFORMATION.
WHEN THERE'S DECISIONS
TO BE MADE, DO THEY FULLY
UNDERSTAND ALL THE CHOICES
AVAILABLE TO THEM?
AND WHAT THEY WILL MEAN?
I FIND OFTEN COUPLES WILL
LOOK AT THE UNIFORM AND GO YES,
YES, YES AS IF THEY'RE
UNDERSTANDING INFORMATION.
AS SOON AS THE STAFF MEMBER
LEAVES, THEY TURN TO ME AND SAY
"WHAT DID THEY SAY?"

The scene changes to Debbie and Eric. A caption reads "Debbie Basser."

Debbie says THE DIFFERENCE WITH HAVING A
DOULA AT BIRTH WAS KNOWING THE
STAGES I WAS GOING THROUGH AND
KNOWING THE TECHNIQUES.
SHE TALKS YOU THROUGH YOUR
CONTRACTIONS AND HELPS YOU GET
THROUGH THEM.
AT THE TOP OF THE CONTRACTION,
YOU'RE AT THE TOP OF THE
MOUNTAIN. YOU’RE COMING DOWN THE MOUNTAIN.
THAT'S THE LAST CONTRACTION
THAT-- OF THAT ONE YOU'LL SEE.
JUST VERY CALM.

Back to Cheryl, she says DOULAS ARE A GREAT ASSET TO
PARTNERS WHEN THEY TAKE
ADVANTAGE OF THAT EXTRA PAIR OF
HANDS IN THE ROOM.
UM, SOME PARTNERS ARE A LITTLE
APPREHENSIVE THAT THE DOULAS ARE GOING
TO SORT OF SHOVE THEM OUT OF
THE ROOM OR STEP INTO THEIR
PLACE AND THEY WON'T HAVE A
ROLE.
THERE ARE NEVER ENOUGH HANDS
WHEN THERE'S A WOMAN IN LABOUR.
OFTEN PARTNERS DON'T KNOW WHAT
TO DO.
THEY HAVEN'T EVER
EXPERIENCED THEM FOR
THEMSELVES.

Clips play of various women in the midst of labour being helped by doulas.

Eric says I THINK SHE KEPT DEBORAH
MORE RELAXED AND THAT WAS
THE MAIN THING.
KEEPING HER RELAXED HELPED THE
BIRTH PROGRESS, INSTEAD OF
HITTING THAT WALL.
AND KNOWING THERE'S SOMEBODY
THERE IN THE ROOM CONSTANTLY.

A caption reads "Eric Basser."

Debbie says YEAH.

Eric says AH, THEY ARE THERE TO HELP YOU OUT.
WHERE AS THE NURSES HAVE THEIR
OTHER DUTIES.
THEY COME AND GO.
AND YOU MIGHT NOT SEE THEM
AGAIN FOR 10 OR 15 MINUTES.
CHERYL'S ALWAYS THERE TO HELP
YOU OUT WITH ANYTHING YOU NEED.

Maureen narrates DR. ELLEN HODNIT IS A
PROFESSOR OF NURSING AT THE
UNIVERSITY OF TORONTO.
SHE'S SO IMPRESSED WITH THE
RESULTS OF DOULA CARE, SHE'S
RUNNING A CANADIAN STUDY,
TRAINING NURSES AS DOULAS.

A clip plays of Dr. Ellen Hodnett typing at a computer. She is in her late forties with short, red hair with a subtle wave. She wears glasses, gold earrings, and a mint coloured shirt.

The scene changes to Dr. Hodnett in her office. A caption reads "Dr. Ellen Hodnett. Professor of Nursing, University of Toronto."

Dr. Hodnett says WE HAVE PRETTY GOOD IDEAS AS
TO WHY DOULA CARE IS EFFECTIVE.
AND ONE THEORY IS THAT DOULAS
HELP TO REASSURE WOMEN, REDUCE
THEIR ANXIETY LEVELS IN LABOUR,
REDUCE THE STRESS RESPONSE
DURING LABOUR.
IT'S THAT STRESS RESPONSE THAT
CAN INTERFERE WITH UTERAN BLOOD
FLOW AND CAUSE PROBLEMS FOR THE
FETUS IN LABOUR AND CAN
INTERFERE WITH THE
EFFECTIVENESS OF THE LABOUR
ITSELF AND THEREFORE BE MORE
LIKELY TO HAVE A PROLONGED
LABOURER-- OR DISTOTION WE CALL
IT AND THEREFORE A CESAREAN
DELIVERY.

Clips of nurses preparing woman for labour flash on the screen.

Maureen narrates
AN AMERICAN STUDY SUGGESTS THAT
A DOULA’S PRESENCE IN LABOUR
CAN REDUCE THE CESAREAN LABORS
BY UP TO 50 PERCENT, REDUCE THE LENGTH OF
LABOUR BY 25 PERCENT AND THE USE OF
EPIDURALS BY UP TO 60 PERCENT.
BUT SOME DOCTORS REMAIN
SKEPTICAL.
Dr. DAVID ROUSELLE IS THE CHIEF OF
OBSTETRICS AT YORK
COUNTY HOSPITAL IN NEW MARKET
ONTARIO.

The scene changes to Dr. David Rouselle seated in an seeing room. He is in his fifties with thinning light-brown hair. He is clean-shaven and wears glasses, a doctor’s coat, and blue scrubs. A caption reads "Dr. David Rouselle. Obstetrician."

Dr. Rouselle says I THINK THE DOULAS WOULD...
THEY HAVE TO BE ACKNOWLEDGED.
BUT THAT YOU HAVE TO
LOOK AT WHERE THEIR STUDIES HAVE
BEEN DONE iF THEY'RE DONE IN A
HOSPITAL WHERE VISITORS AREN'T
ALLOWED, WHERE THE WOMAN IS
LABORING BY HERSELF.
IF THEY'RE DONE WITH A LOWER
SOCIAL ECONOMIC PERSON
WHO'S YOUNG AND FRIGHTENED,
THEN I THINK ADDING THE DOULA
TO THAT PERSON'S LABOUR, AH,
HAS SOME GOOD IMPROVEMENT IN
OUTCOMES, LOWER CESAREAN RATES
AND LOWER NEED FOR PAIN RELIEF
AND SO FORTH.
I THINK WHEN STUDIES ARE DONE
IN A MORE TYPICAL CANADIAN
MIDDLE-CLASS POPULATION WHERE
VISITORS ARE ALLOWED AND
ENCOURAGED, WHERE THERE'S OTHER
SUPPORTS THERE AND MORE NURSING
AVAILABILITY, THE IMPROVED OUTCOMES
HAVEN'T BEEN QUITE SO
DRAMATIC.
MY OVERALL OPINION FOR DOULAS
IS THERE'S A GREAT POTENTIAL
FOR SOME WOMAN IN SOME LABOURS.
MY CONCERN WOULD BE IS THAT IF
THEY'RE EXPECTED TO TAKE AN
ADVOCACY ROLE THAT CONFLICTS
WITH THE HEALTH CARE PROVIDERS,
ESPECIALLY THE NURSES, CAN
HAPPEN.

Back to Dr. Hodnett, she says I DON'T THINK IT'S
SURPRISING THAT NURSES MIGHT
FEEL THREATENED BY DOULAS.
BECAUSE BY IMPLICATION THERE'S
THIS FEELING THAT MY CARE ISN'T
GOOD ENOUGH.
THIS WOMAN NEEDS TO BRING
SOMEONE ELSE WITH HER IN
LABOUR.
BUT USUALLY IT'S VERY EASILY
OVERCOME.

Back to Cheryl, she says OUR FUNCTIONS OVERLAP IN THE
CARING.
BUT THE NURSE HAS A LOT OF
CLINICAL RESPONSIBILITIES
AND THIS IS HER PATIENT.
AND, UM, WHAT SHE SAYS NEEDS TO
BE DONE.
DOULAS DON'T DO ANY PHYSICAL
ASSESSMENTS.
WE'RE NOT LISTENING TO THE
BABY'S HEARTBEATS.
WE'RE NOT TAKING BLOOD
PRESSURES OR DOING INTERNAL
EXAMINATIONS.
THAT IS NOT OUR TERRITORY.
THE TRAINING REQUIRED FOR
A DOULA
ISN'T TERRIBLY EXTENSIVE.
THERE'S, UM, A 16-HOUR TRAINING
PROGRAM WITH HANDS-ON SKILLS.
THERE'S A CERTIFICATION
PROCESS.
YOU NEED TO ATTEND A SET NUMBER
OF BIRTHS, HAVE REPORTS FROM
PHYSICIANS, MID-WIVES AND
NURSES AND CLIENTS.
TECHNICALLY, ANYONE CAN HANG
OUT A SHINGLE AND CALL
THEMSELVES A DOULA.
IT'S UP TO THE CONSUMEER TO
INVESTIGATE FURTHER WHAT THAT
MEANS.
MY FEE IS 300 DOLLARS.
IT'S A FLAT FEE.
SO THAT WOMEN FEEL FREE TO CALL
ME AS OFTEN AS THEY FEEL THEY
NEED TO HAVE INFORMATION OR
SUPPORT OR AN URGE TO BOUNCE AN
EAR OFF OF THAT THEY'LL CALL ME
EARLY IN THE LABOUR, NOT
THINKING THAT I'M CHARGING THEM
HOURLY FOR MY TIME THERE.
AND, UM, THEY'LL-- SAME WITH
POST-PARTUM.
I WANT THEM TO FEEL FREE TO USE
MY TIME AND EXPERTISE TO THEIR
ADVANTAGE.

The scene changes to Cheryl talking on the phone.

Cheryl says YEAH, I CAN COME.
I CAN BE THERE-- IT WILL TAKE
ME ABOUT HALF AN HOUR FROM
HERE.

Cheryl grabs several bags and walks out the door.

Eric narrates ON A PRACTICAL TERM, IF YOU
BUY A HOUSE, YOU HAVE A REAL
ESTATE AGENT WHO HELPS YOU OUT.
SOMEONE WORKING FOR YOU.
SAY IF YOU HAVE TO GO TO COURT,
YOU HAVE A LAWYER WORKING FOR
YOU.
SO WHY NOT HAVE A DOULA IN
THERE, IN THE ROOM?
LIKE, THIS IS THE MOST
IMPORTANT THING IN YOUR LIFE.
YOU HAVE TO HAVE SOMEBODY THERE
WORKING FOR YOU.

Back in the studio, Maureen says TO LEARN MORE
ABOUT DUES, YOU CAN VISIT
DOULAS OF NORTH AMERICA.

A caption reads "www.dona.com. 1-888-879-3199."

A blue slate appears on screen.

Maureen says HERE'S THIS
WEEK'S HEALTH QUIZ

On screen a title reads "Your Health Quiz."

The question reads "Which is better if you’ve strained or injured a muscle while exercising. 1. heat, 2. ice."

Maureen says WE'LL HAVE THE ANSWER AND MORE
ON SPORTS MEDICINE LATER ON
"YOUR HEALTH."

Back in the studio, Maureen says IS THERE AGEISM IN THE HEALTH
CARE SYSTEM?
ARE THE ELDERLY GETTING SUB-STANDARD
TREATMENT EITHER
BECAUSE OF SCARCE RESOURCES OR
AN ACTUAL BIAS AGAINST THEM?
RECENT STUDIES SHOW THAT PEOPLE
OVER 65 ARE UNDER TREATED FOR
MANY CONDITIONS, FROM ASTHMA TO
CANCER, AND CARDIO VASCULAR
DISEASE.
DR. WILLIE MALLOY IS A GERIATRICIAN AND
HENDERSON HOSPITAL IN
HAMILTON, ONTARIO.
DAVID GLOBERMAN IS AN ADVOCATE
FOR BETTER ACCESS FOR SENIORS
THROUGH HIS ORGANIZATION CALLED
THE RUNNING TODAY LIGHT
FOUNDATION.
WELCOME TO BOTH OF YOU.
FIRST OF ALL, DAVID, WHY ARE
YOU NOW ADVOCATING FOR THE
ELDERLY?
WHAT HAPPENED?

David is in his fifties, clean-shaven, with short black hair. He wears glasses, a grey suit, a white shirt, and a patterned grey tie.

David says WELL, BASICALLY THE GENESIS
OF THE FOUNDATION REALLY GREW
OUT OF MY FAMILY'S EXPERIENCE
WITH MY FATHER, WHO WE LOST
ABOUT THREE YEARS AGO IN
OTTAWA.
AND ESSENTIALLY, WE CAME TO THE
CONCLUSION THAT, UM, MY
FATHER'S CARE, THAT HE RECEIVED
WAS REALLY SUB-STANDARD.
IT DID NOT IN FACT MEET, AH,
UM, ACCEPTABLE MEDICAL
STANDARDS OF CARE.
AND BECAUSE OF THAT, WE FELT
THAT MANY OF THE EVENTS THAT
TRANSPIRED COULD HAVE BEEN
PREVENTED IF MY FATHER WOULD
HAVE HAD A PATIENT
REPRESENTATIVE REPRESENTING OUR
FAMILY THROUGHOUT, AH, UM, HIS
ORDEAL ESSENTIALLY.

Maureen says WHAT MADE YOU THINK
THAT HE WAS GETTING SUB-STANDARD
TREATMENT BECAUSE OF
HIS AGE?

A caption reads "David Globerman. Health Advocate for Seniors."

David answers WELL, BASICALLY, MY FATHER
WENT INTO HOSPITAL, UM, AT THE
AGE OF 85, WITH WHAT TURNED OUT TO BE
INTESTINAL OBSTRUCTION.
IN FACT, I HAD
ACCOMPANIED MY FATHER THAT
MORNING TO THE
HOSPITAL.
AND I HAD SUSPECTED AN
INTESTINAL OBSTRUCTION BECAUSE
OF THE FACT THAT HE HAD GONE
THROUGH SIMILAR SYMPTOMS IN THE
PAST.
AND ALTHOUGH MY FATHER
WAS TRIAGED AS URGENT, HE
WAITED ONE AND-A-HALF HOURS TO
ACTUALLY BE SEEN BY A RESIDENT.
AND WAITED FIVE HOURS IN THE
EMERGENCY DEPARTMENT TO
ACTUALLY HAVE THE OBSTRUCTION,
RELIEVED.
AND DURING THAT TIME, HE WAS
IN TERRIBLE AGONY.
HIS BLOOD PRESSURE WAS ABOUT
220 OVER 120.
AND A LOT OF HORRIBLE
SYMPTOMS, AH, ABDOMINAL
DISTENSION, THINGS LIKE THAT.
WE FELT THAT,
HIS CARE IN
EMERGENCY COULD HAVE BEEN...
SHOULD HAVE BEEN EXPEDITED.
YOU KNOW, WOULD HAVE BEEN
EXPEDITED IF HE HAD BEEN
YOUNGER.
NUMBER TWO, HE SHOULD HAVE BEEN
TRIAGED AT A HIGHER LEVEL, AS
EMERGENT RATHER THAN URGENT AND
SECOND PART OF THE CASE,
PROBABLY THE MORE PROFOUND PART
OF THE CASE, THAT ONCE HE WAS
UP ON THE WARD, WHICH WAS THE
SECOND DAY, I NOTICED
THAT HE WAS EXHIBITING THE
CLEAR SIGNS OF STROKE.
HE HAD ALL THE CLASSIC SIGNS
THAT
ONE READS ABOUT IN HEART AND
STROKE FOUNDATION LITERATURE.
SLURRED SPEECH, DIFFICULTY
SPEAKING, REDUCED LEVEL OF
CONSCIOUSNESS.
AND WE HAD-- MY FAMILY HAD
ASKED FOR A CAT SCAN.
TO, IN FACT, VERIFY MY WHETHER
IN FACT IT WAS A STROKE.
WE WERE TOLD BY THE FAMILY
PRACTITIONER THAT WAS IN CHARGE
OF THE CASE THAT A CT SCAN WAS
NOT NECESSARY.
THEY BEGAN TO TREAT MY FATHER
WITH A RANGE OF
ANTIBIOTICS.
AND WITHIN ABOUT TWO OR THREE
DAYS, HE REALLY WASN'T GETTING
BETTER.
NOW, DURING THAT TIME, ON
THAT THIRD DAY, WE
NOTICED THAT HE WASN'T BEING
FED EXCEPT FOR AN I.V.
WE HAD A FAMILY CONFERENCE WITH
THE PHYSICIAN.
AND WE ASKED WHY IS MR.
GLOBERMAN NOT BEING FED?
HIS RESPONSE WAS, AND THIS IS A
DIRECT QUOTE "YOUR FATHER IS 85
YEARS OLD, HE DOES HAVE
CONGESTTIVE HEART FAILURE."
WHICH MANY ELDERLY HAVE.
"AND HE DOES HAVE RENAL
FAILURE.
STARVATION IS NOT A BAD WAY TO
DIE."

Maureen says ALL RIGHT.
NOW LET ME GO TO DR. MALLOY ON
THIS.
DOES THIS STORY SURPRISE YOU?

Dr. William Molloy says IT'S SAD.
I DON'T KNOW IF IT'S THAT
UNUSUAL.

He is clean-shaven, in his fifties and bald save for brown hair around his ears. He wears a brown suit with a blue shirt and an amber coloured tie. A caption reads "Dr. William Molloy. Geriatrician."

Maureen says DO YOU THINK THAT
HEALTH CARE PROFESSIONALS DO
TREAT THE ELDERLY DIFFERENTLY?

Dr. Molloy says YES.

Maureen says WHY?
WHAT EXAMPLES HAVE YOU SEEN?

Dr. Molloy says WELL, I THINK WE LIVE IN AN
AGE OF SOCIETY WHERE EVERY SIGN
OF AGING IS UGLY.
GREY HAIR, WRINKLES, BALDNESS.
WE SPEND BILLIONS ON PLASTIC
SURGERY TRYING TO LOOK YOUNGER.
ON YOUR WAY HOME TONIGHT, I
DARE TO YOU FINDS AN OLD PERSON
ON A BILLBOARD ADVERTISING
ANYTHING.
GO AND LOOK AT TV ON THE ADS,
THERE ARE NO OLD PEOPLE.
LOOK IN THE OBITUARIES, AND IT
WILL BE A PHOTOGRAPH OF THAT
PERSON WHEN THEY'RE YOUNGER.
WE LIVE IN AN AGE OF SOCIETY
WHERE EVERYTHING OLD IS UGLY.
PEOPLE WHEN THEY'RE OLD, IF YOU
LOOK AT THE NEWSPAPERS, MOST OF
THE STORIES ABOUT THEM IS THAT
THEY'RE USING OUR HEALTH CARE
SYSTEM.
AND IN OUR HOSPITALS, WE
HAVE DOCUMENTS WHERE THEY
MENTION BED LOCKERS.
WE PHYSICALLY RESTRAIN PEOPLE
ROUTINELY.
EVERY HOSPITAL.
YEAH, THERE'S A HUGE AGIST
PROBLEM IN SOCIETY.
IT'S REFLECTED IN THE HEALTH
CARE SYSTEM.
IT'S ALL THESE OLD PEOPLE
BLOCKING OUR BEDS, AND, YOU
KNOW, IF YOU HAD A CHOICE,
LET ME ASK YOU, IF YOU HAD A
CHOICE, A HEALTH CARE
PROFESSIONAL.
A 10-YEAR-OLD KID OR
30-YEAR-OLD YOUNG PREGNANT
MOTHER OR AN 85-YEAR-OLD
PERSON.
WHO DO YOU GIVE THE RESOURCES
TO?

Maureen says YOU WOULD LIKE TO THINK
YOU'LL BASE IT ON WHO IS THE
SICKEST.

Dr. Molloy says I'M GLAD YOU THINK THAT.

Maureen says BUT YOU DON'T
THINK...

Dr. Molloy says NO.

Maureen says WHAT OTHER STORIES
HAVE YOU HEARD SINCE YOU
STARTED THE FOUNDATION?

David says WE'VE HEARD A TREMENDOUS
NUMBER OF STORIES.
SIN THE LAUNCH OF THE
FOUNDATION, OCTOBER 25TH, '99,
BECAUSE OF ALL THE MEDIA
ATTENTION, I'VE HAD TENS AND
TENS OF PEOPLE CALLING ME,
STORIES SUCH AS, AH, DNR ORDERS
BEING CHANGED BY FAMILY
MEDICINE.
AH, UNILATERALLY WITHOUT
CONSULTATION WITH FAMILIES.
I'VE HEARD THE STORY WHERE
AN 80-YEAR-OLD MAN WENT IN
FOR, AH, UM, INSERTION
OF A CATHETER TUBE INTO A
CAVITY TO FACILITATE DIALYSIS.
THEY DISCHARGED HIM THE SAME
DAY.
AND THE NEXT MORNING HE
WOKE UP WITH HIS ABDOMEN BLACK
AND BLUE, AH, TERRIBLE
ABDOMINAL DISTENSION AND THE ER
PHYSICIANS DID NOT WANT TO ADMIT
HIM INTO THE HOSPITAL.
WELL, THE MAN DIED ABOUT EIGHT
HOURS LATER OF PARATENITIS.
A LOT OF RUSHING TO JUDGMENT BY
PHYSICIANS.
AND I CERTAINLY DON'T WANT TO
PAINT THE ENTIRE MEDICAL
PROFESSION THIS WAY OR THE
ENTIRE NURSING PROFESSION OR
ALL THE OTHER SERVICES, BUT
THERE'S A STRATA WITHIN THE
SYSTEM WHERE THERE'S A RUSH TO
JUDGMENT.

Maureen says WELL, I MEAN, THE
POPULATION IS AGING.
A LOT OF US ARE GOING TO LOOK
OLD SOON.
OUR HEALTH CARE PROFESSIONALS
WILL BE ELDERLY THEMSELVES ONE
WOULD THINK.
WILL ATTITUDES CHANGE?
BECAUSE THEY'LL HAVE TO DR.
MOLLOY?

Dr. Molloy says I GIVE YOU ONE STATISTIC,
MAUREEN.
YOU KNOW WHAT A GERITRICIAN IS.
THAT'S ME.
I'VE DONE INTERNAL MEDICINE AND
I'VE TRAINED IN CARE OF OLDER
ADULTS.
THERE'S STUDIES SHOWING THAT
GERIATRICIAN DEAL BETTER WITH
FRAIL ELDERLY PEOPLE THAN
INTERNALISTS OR OTHER
SPECIALISTS.
THE FASTEST GROWING SEGMENT OF
OUR SOCIETY IS PEOPLE OVER 85.
THEY'LL QUADRUPLE AND INCREASE
5-FOLD.
200 MILLION AGED OVER 80 IN THE
NEXT CENTURY.
IN 1998 IN CANADA, THERE WERE
130 GERIATRICIANS AND 1900
PEDIATRICIANS.
THE ONTARIO MEDICAL ASSOCIATION
HAVE JUST COME OUT WITH THEIR
MANPOWER STATISTICS.
AND THEY HAVE SAID THAT WE
DON'T NEED MORE GERIATRICIANS.

Maureen says AND YET THAT MAKES
NO SENSE.

Dr. Molloy says WELL, TO THEM IT DOES.

Maureen says SO AGAIN, DO YOU
THINK IT'S THAT-- THAT, YOU
KNOW, THAT-- THAT BIAS AGAINST
THE ELDERLY?

Dr. Molloy says A HUGE BIAS.
THERE'S AN ENORMOUS BIAS AND
THE PROBLEM IS THAT WE'RE
CREATING A SUB SPECIALIST MODEL
OF MEDICINE.
WE'VE CREATED A MODEL OF
MEDICINE WHERE DOCTORS WILL
TREAT AN ORGAN.
ONE DOCTOR WILL TREAT THE
KIDNEY.
ANOTHER TREATS THE LIVER.
ANOTHER TREATS THE HEART, THE
SKIN, THE LUNGS, THE EYES, THE
EARS, VARIOUS BITS.
THE GERIATRICIAN TREATS
EVERYBODY, AND THAT THREATENS
PEOPLE.
THAT THREATENS THE
ORGANIZATIONS AND
BASICALLY THEY DON'T WANT THEM.

Maureen says A TOUGH QUESTION,
DAVID.
WHAT ARE WE SAYING HERE?
ARE WE SAYING THAT THE ELDERLY
SHOULD BE ELIGIBLE FOR ORGAN
TRANSPLANTS, DECISIONS LIKE
THAT.

David says I THINK THAT-- THAT THE
ELDERLY SHOULD BE-- I THINK
THAT A 75-YEAR-OLD WOMAN SHOULD
BE TREATED THE SAME WAY AS A
30-YEAR-OLD WOMAN.
I THINK THAT THE RANGE OF
TREATMENT IN-- AND
INTERVENTIONS SHOULD NOT BE
BASED ON AGE.
THEY SHOULD BE BASED ON
CLINICAL REQUIREMENTS.
UM, THE OTHER-- THE OTHER FOCUS
OF OUR FOUNDATION OR THE OTHER
VALUE OF OUR FOUNDATION OF
COURSE IS THAT THE PROGNOSIS OF
AN INDIVIDUAL IS NOT SOLELY
BASED ON THE DIAGNOSIS.
YOU HAVE TO TAKE INTO
CONSIDERATION THE EMOTIONAL,
SPIRITUAL MAKEUP.
THERE'S SO MANY STORIES OF
PEOPLE THAT HAVE BEEN WRITTEN
OFF, BUT ONLY TO BOUNCE
BACK AND RECOVER.
UM, THAT DOESN'T HAPPEN ALL THE
TIME.
BUT IT CERTAINLY DOES.
IT'S NOT AN EXACT SCIENCE.
I THINK THAT HAS TO HAPPEN TO
ANSWER YOUR QUESTION, I
DON'T KNOW WHETHER OR NOT
THINGS WILL CHANGE ON THEIR
OWN.
THE TODAY LIGHT FOUNDATION, I
THINK MOST PEOPLE WOULD AGREE
WITH US IS THAT THE
RESPONSIBILITY FOR HEALTH CARE
RESIDES WITH MANY DIFFERENT
PARTIES.
IT RESIDES WITH THE FUNDERS,
WITH THE SERVICE PROVIDERS,
WITH THE WITH THE
RECIPIENTS OF SERVICE.
WITH THE FAMILIES, WITH THE
PROFESSIONAL ASSOCIATIONS.
AND WITH THE MEDIA, OF COURSE.
AND I THINK THAT EVERYBODY HAS
TO DO THEIR SHARE, JUST AS ON A
HOCKEY TEAM OR A FOOTBALL TEAM,
TO MAKE SURE THAT THE VOICES OF THE ELDERLY
ARE HEARD.

Maureen says I'M AFRAID WE'LL
LEAVE IT THERE.
THANK YOU BOTH FOR JOINING US
ON THIS TOPIC.

They both say THANK YOU

A clip plays of a shirtless male lifting a barbell followed by bottles of white containers that reads "Creatine."

Maureen narrates
COMING UP, BODY
BUILDERS BEWARE.
WHAT YOU NEED TO KNOW BEFORE
TAKING A SPORTS SUPPLEMENT.

Back in the studio, Maureen says BUT FIRST, WHEN YOU GO TO YOUR
DOCTOR TO HAVE YOUR BLOOD
PRESSURE OR YOUR CHOLESTEROL
CHECKED, WHAT ARE YOU HOPING TO
HEAR?
THAT THEY'RE FINE?
THAT THEY'RE OKAY.
WELL, DR. IAN BLUMER SAYS WE
SHOULD STRIVE FOR BETTER THAN
JUST OKAY.

Dr. Ian Blumer appears on screen with a blue screen in the background that reads "Second Opinion." Dr. Blumer is in his forties, clean-shaven, with a receding hairline. He wears a black blazer with a red shirt.

Dr. Blumer says TRADITIONALLY , WHEN YOU GO
TO SEE THE DOCTOR, YOU'RE TOLD
THAT YOUR HEALTH IS OKAY.
YOUR BLOOD PRESSURE IS OKAY.
YOUR BLOOD SUGARS ARE OKAY OR
YOUR CHOLESTEROL IS OKAY.
BUT THAT DOESN'T CUT IT
ANYMORE.
WE HAVE TO DO BETTER AS
PHYSICIANS AND AS PATIENTS.
THE REASON WHY OKAY DOESN'T CUT IT
ANYMORE IS THAT IT'S VAGUE.
IS OKAY BLOOD PRESSURE REALLY
GOOD ENOUGH FOR YOU AS AN
INDIVIDUAL?
WHAT IS OKAY.
IS OKAY BLOOD PRESSURE 120 OVER
80, 140 OVER 100?
IT'S A MOVING TARGET.
IT KEEPS CHANGING WHAT WE
CONSIDER OKAY.
BECAUSE OKAY DOESN'T
NECESSARILY MEAN OPTIMAL AND IF I
WAS A PATIENT, I WANT MY BLOOD
PRESSURE TO BE OPTIMAL.
I THINK IT'S CRUCIAL YOU FIND
OUT FROM YOUR DOCTOR WHAT
OPTIMAL IS FOR YOU AS AN
INDIVIDUAL.
WHAT THE TARGET IS.
IF IT'S NOT ADEQUATE BLOOD
PRESSURE, THEN IT COULD BE
ASSOCIATED WITH A HIGHER RISK
OF STROKE OR HEART ATTACK OR
KIDNEY FAILURE.
AND IT'S NOT JUST BLOOD PRESSURE
I'M TALKING ABOUT, IT'S
CHOLESTEROL FOR EXAMPLE.
LOTS OF PEOPLE SAY MY
CHOLESTEROL OKAY.
BUT IS OKAY GOOD FOR YOU.
IS IT 5, 4?
WHAT'S YOUR GOOD CHOLESTEROL OR
BAD CHOLESTEROL.
LDL IS BAD CHOLESTEROL.
IS IT 3 OR IS IT 3.5?
WHAT'S THE TARGET FOR YOU?
IS THAT THE TARGET YOU'RE
ACHIEVING.
IT'S IMPORTANT TO WORK WITH
YOUR DOCTOR TO ACHIEVE
OPTIMIZED LEVELS AND YOU CAN'T
DO THAT UNLESS YOU'RE FULLY
ENVELOPED OF WHAT THE TARGET
IS.
ANOTHER EXAMPLE IS IF YOU HAVE
DIABETES.
WE KNOW FROM RECENT STUDIES THAT
BLOOD CONTROL HAS TO BE TERRIFIC IN
ORDER TO LOWER THE RISK OF
COMPLICATIONS.

A caption reads "Dr. Ian Blumer. Internist."

Dr. Blumer continues
LOWER YOUR BLOOD SUGAR, THE
BETTER YOU'RE LIKELY TO DO.
THE LOWER YOUR RISK OF BLINDNESS,
KIDNEY FAILURE, AMPUTATIONS, YOU
HAVE TO WORK AS A PARTNER WITH
YOUR DOCTOR TO FIND OUT WHAT
YOUR BLOOD SUGAR LEVEL TARGET
IS.
AGAIN, I WOULD ENCOURAGE YOU
NOT TO ACCEPT THE NOTION THAT
BLOOD SUGARS ARE OKAY.
WHAT IS OKAY?
IS A BLOOD SUGAR 7 BEFORE
BREAKFAST WHAT YOU'RE
TARGETING?
IF YOU'RE A DIABETIC, FIND OUT
WHAT YOUR TARGET IS.
AND WORK TOGETHER CLOSELY WITH
YOUR DOCTOR AND WITH YOUR
DIABETES NURSE EDUCATOR AND
NUTRITIONIST TO ACHIEVE THE
GOAL FOR YOU.
EACH PERSON HAS A DIFFERENT
GOAL.
AND IT'S IMPORTANT YOU STRIVE
TO ACHIEVE THE BEST GOAL FOR
YOU AS AN INDIVIDUAL.
THAT WILL LOWER YOUR RISK OF
COMPLICATIONS.
MORE THAN ANYTHING ELSE.
SO I'M AFRAID I'M ASKING TO YOU
TAKE A LOT MORE RESPONSIBILITY.
IT'S CRUCIAL YOU DO YOUR HOMEWORK
AND YOU FIND OUT WHAT YOUR
TARGET BLOOD PRESSURE IS.
IF YOU'RE DIABETIC, WHAT YOUR
TARGET BLOOD SUGAR IS AND YOUR
HEMOGLOBIN LEVEL IS AND YOUR
TARGET CHOLESTEROL LEVEL.
WHEN I SAY TARGET, I MEAN THE IDEAL TARGET
FOR YOU AS AN INDIVIDUAL.
IF YOUR IDEAL-- YOUR IDEAL MAY
BE DIFFERENT FROM YOUR
NEIGHBOURS IF YOU SMOKE OR HAVE
HEALTH PROBLEMS, YOUR IDEAL MAY
BE VERY DIFFERENT.
FIND OUT WHAT THE IDEAL IS FOR
YOU.
FIND OUT FROM YOUR DOCTOR AND
WORK TOGETHER TO ACHIEVE THAT.
DON'T EXPECT THAT YOUR
BLOOD PRESSURE IS JUST OKAY.
FIND OUT THE NUMBER AND WRITE
DOWN THE NUMBER.
IT'S EASY FOR YOU TO FOLLOW
ALONG AND MAKE YOU FEEL MORE
SATISFIED AS YOU ACHIEVE THAT
TARGET.
IF NOT, YOU CAN REVIEW WITH THE
DOCTOR WHAT CAN BE DONE
DIFFERENTLY IN ORDER TO HELP
YOU ACHIEVE THAT TARGET.
THE NOTION THAT OKAY IS
ACCEPTABLE IS NOT ACCEPTABLE
ANYMORE.
IF YOU'RE BEING TOLD THAT
THINGS ARE OK, I WOULD
RECOMMEND YOU FIND OUT WITH
GREATER PRECISION SPECIFICALLY
WHAT OKAY MEANS IN THAT
CONTEXT.
OKAY JUST DOESN'T CUT IT
ANYMORE... OKAY?

The health quiz appears back on screen.

Maureen says NOW THE ANSWER TO
THIS WEEK'S QUIZ:
WHICH IS BETTER IF YOU’VE STRAINED OR INJURED
A MUSCLE WHILE EXERCISING?
ICE.
HEAT MAY MAKE THE INJURY FEEL
BETTER, BUT IT CAN ALSO WORSEN
THE SWELLING.

Back in the studio, Maureen says,
AND NOW A LOOK AT SOME STORIES
MAKING HEALTH NEWS

She stands next to a t.v. screen. A coffin on its screen.

Maureen says FUNERAL
HOME DIRECTORS MAY BE EXPOSING
THEMSELVES TO TUBERCULOSIS.
A NEW STUDY SHOWS THAT CADAVERS
CAN TRANSMIT TD TO AN EMBALMER.
TD PARTICLES ARE SPREAD THROUGH
THE AIR, ENTERING THE MOUTH AND
NOSE AND THEN LODGING DEEP IN
THE LUNGS.
IN THE STUDY, DOCTORS
IDENTIFIED AN INDIVIDUAL WITH
ACTIVE TB WHOSE ONLY KNOWN
EXPOSURE THROUGH THE EMBALMING
OF AN INFECTED CADAVER.

The image on the t.v. screen changes to spotted mouse.

Maureen says
SCIENTIST INSIDE AUSTRALIA ARE
THINKING OF PUTTING A MEASLES
GENE INTO GENETICALLY MODIFIED
FOOD.
IT WOULD BE ALTERNATIVE TO THE
TRADITIONAL VACCINATION AGAINST
THE VIRUS.
RESEARCHERS HAVE ALREADY FED MICE TOBACCO
LEAVES THAT CONTAINED THE
MEASLES GENE.
THEY FOUND THE MICE DEVELOPED
ANTIBODIES AGAINST THE MEASLES.
NOW THEY'RE WORKING ON PUTTING
THE GENE INTO RICE AND LETTUCE.

The image on the t.v. screen changes to an ice cream cone.

Maureen says YOU KNOW THOSE HEADACHES YOU
GET WHEN YOU SWALLOW SOMETHING
COLD LIKE ICE CREAM?
WELL, A DOCTOR IN CINCINNATI
HAS COME UP WITH A WAY TO AVOID
THEM.
DR. ROBERT SMITH FIGURES THAT
THE CULPRIT IS A POINT AT THE
BACK OF THE PALATE WHERE WE
HAVE NERVES THAT CONTROL THE
DILATION AND CONTRACTION OF
BLOOD VESSLES.
DILATED BLOOD VESSELS ARE KNOWN
TO CAUSE SEVERAL KINDS OF
HEADACHES.
DR. SMITH SAYS THE SECRET IS IN
HOW YOU SWALLOW THE ICE CREAM.
EITHER ALLOW IT TO WARM-UP IN
THE FRONT PART OF THE MOUTH
BEFORE SWALLOWING OR SWALLOW IT
QUICKLY SO IT DOESN'T LINGER ON
THE PALATE.

A blue slate appears. It reads "Thirty Percent of the population suffers from ice cream headaches. Source: The Cincinnati Headache Center."

Back in the studio, Maureen says BASEBALL PLAYER
MARK MCGWIRE TOOK CREATIN AND
ANDRO.
OTHERS TURN TO SERIOUS STEROIDS
RIDES TO BULK UP.
BUT AS DR. ANDREW PIPE TELLS
US, THERE ARE THREE THINGS YOU
NEED TO KNOW BEFORE YOU TAKE
SPORTS SUPPLEMENTS

The scene changes to Dr. Andrew Pipe sitting in a room with a shelf full of sporting equipment. He is in his sixties with a receding grey hairline. He is clean-shaven and is wearing round glasses, a black blazer, and a red turtle neck.

Dr. Pipe says I THINK
PROBABLY ONE OF THE MOST
IMPORTANT THINGS THAT AN
ATHLETE TO BE AWARE OF IF THEY
CONSIDER TAKING NUTRITIONAL
SUPPLEMENTS IS TO RAISE THE
QUESTION AS TO WHETHER THEY NEED TO
TAKE THE SUPPLEMENT IN THE
FIRST CASE.
IT'S STILL THE CASE THAT MOST
ATHLETES ARE FAR BETTER OFF EATING
A BALANCED DIET AND HAVE NO
NEED OF SUPPLEMENTS.
EXCEPTIONS MIGHT BE YOUNG
FEMALE ATHLETES WHO ARE
MENSTRATING WHO HAVE A HIGHER
REQUIREMENT FOR IRON.
THE SECOND THING
I THINK IT'S IMPORTANT
TO REALIZE IS THAT SINCE 1996,
THERE'S NO REGULATION OF THE
QUALITY, THE CONTENTS OR THE
ACCURACY OF THE LABELING OF
NUTRITIONAL SUPPLEMENTS OR
COMPOUNDS PRODUCED IN THE
UNITED STATES
WHICH IS WHERE MOST OF THE
SUPPLEMENTS THAT ARE SOLD IN
CANADA COME FROM.

A caption reads "Dr. Andrew Pipe. Canadian Center for Ethics in Sport."

Dr. Andrew Pipe continues
THIS CAN CAUSE PROBLEMS FOR
ATHLETES WHO ARE TESTED FOR
PERFORMANCE-ENHANCING DRUGS IN
THE COURSE OF THEIR
COMPETITION BECAUSE WE KNOW THAT MANY OF
THESE COMPOUNDS OR SUPPLEMENTS
MAY CONTAIN BANNED SUBSTANCES
OR SUBSTANCES THAT ARE
CONVERTED IN THE BODY INTO
BANNED SUBSTANCES.
FINALLY, I THINK IT'S IMPORTANT
TO REALIZE THAT SOME OF THESE
SUBSTANCES CAN ALSO VERY
SERIOUSLY THREATEN YOUR HEALTH.
AN NBA PLAYER RECENTLY HAD A
NEAR-DEATH EXPERIENCE AS A
CONSEQUENCE OF HIS INGESTING A
SUPPLEMENT WHICH HE THOUGHT WAS
HARMLESS BUT WHICH IS SHOWN ON
MANY CASES IN THE UNITED STATES
TO PRODUCE NEAR FATAL
CONDITIONS IN ATHLETES SO THREE
POINTS: SUPPLEMENTS GENERALLY
AREN'T NEEDED.
SECONDLY, THEY'RE EXPENSIVE AND
CAN GET YOU AND MAY GET YOU
INTO TROUBLE WITH DRUG TESTING
REGULATIONS.
THIRDLY, THEY CAN VERY HARMFUL
TO YOUR HEALTH.

A blue slate appears with the title of the show.

Back in the studio, Maureen says AND THAT'S OUR
SHOW FOR THIS WEEK.
IF YOU HAVE COMMENTS AND
QUESTIONS, YOU CAN FAX US OR
GET IN TOUCH WITH US.
UNTIL NEXT TIME, I'M MAUREEN
TAYLOR.
THANKS FOR WATCHING.

A slate reads "Your Health, Website, www.tvo.org/yourhealth; e-mail, yourhealth@tvo.org, fax 416-484-4519."

Another slate reads "The advice given in the preceding program is of a general nature only. Viewers should consult their own medical professional for medical advice specific to their circumstances."

Another slate reads "Doulas Footage Provided By: Doulas of North America. In-Joy Videos. Superior Medical Limited."

The end credits roll.

Music, Andy McNeil,

Editors, Elizabeth Payne, Dean Henry, Marisa Gatto.

Story Editor, Susan Sutherland.

Director, Michael Smith.

Producer, Cathy Perry.

A production of TVO Ontario, copyright 2000. The Ontario Educational Communications Authority.

Watch: Show #21