Sick in Toronto
Would you enjoy living in a sick, soulless city devoid of any kindness or compassion? How about being diagnosed with cancer in such a city? This is my story. [Originally posted on Feb 25].
"This is a great country because of this city. Without Montreal, Canada would be hopeless. It’s where the cool kids hang out."
—Anthony Bourdain, The Layover, S1; Ep 6 (December 26, 2011)
“We consume, as we produce, without any concrete relatedness to the objects with which we deal; We live in a world of things, and our only connection with them is that we know how to manipulate or to consume them.”
—Erich Fromm, The Sane Society (1955), p. 134, Sect.C.2.b, “Alienation”
Here to start things off is Pink Floyd’s “Money,” the lead track on Side 2 from Dark Side of the Moon, released on 01 March 1973.1
We were at the InterContinental on Yonge Street. We had spent the night before our planned move-in date. On Friday morning of November 30, 2012, my mobile phone rings at 7:30 in the morning. We were ready to go for breakfast, again in the hotel dining room, chiefly because it was convenient. The caller is the owner of the moving company. The conversation goes something like this:
“Where are you? My men are waiting for you at the apartment building.”
It is only 7:30; we are going to grab some breakfast and be there at 9, as we originally had planned. Ok?”
“No; my men are waiting. It is costing me money.”
“I understand, but we are hungry and we need to eat breakfast. We will get there as soon as we can.”
“Get there as soon as you can. My men are waiting, doing nothing.”
He hung up the phone. We went downstairs for breakfast, mindful that our movers were waiting for us. We paid our hotel bill. We then went upstairs, got our bags and loaded the car. It was a 15-minute drive to our apartment building, where we would meet our movers.
I was not prepared for what I saw when we got there. It was an old, tired-looking building that had the look of an American tenement. It was actually many buildings connected to one main building, which was called Building A and where the rental office was located. Our apartment was located in Building D.
The building manager finally showed up at 10. He called himself Sam. We went into his office, where we signed the lease and handed him $6,600 in cash for five months’ rent and one month security deposit. This is the way Sam did business. (There is no security deposit in Quebec.) We rented the place sight unseen, from our residence in Montreal. That was our mistake, and it would turn out to be a major one.
The movers had a difficult job moving our belongings to our apartment, with a maze of hallways and interconnecting doorways leading to a small antiquated elevator. We were three floors up. The three men worked diligently and by 4:30 pm they unloaded the last set of boxes. It took them six hours; in a typical apartment building, it would have taken half the time. I felt bad that they had to work extra hard, simply because of the labyrinth layout of the building and of the small antiquated elevator.
An unpleasant food surprise
Neither was I prepared for the food. One of the first meals we got was pizza, a harmless and safe choice. I mean in Montreal, I had pizza from dozens of places, including Pizza Hut and many independent places. Some were just good; a good many were excellent and a few over-the-top amazing. I had my favourites. So, when we picked up a pie from Pizza Pizza, a chain restaurant, we were expecting at least good enough. That is not what it was. It was greasy and unappetizing. It was inedible. Il avait le même goût que la boîte en carton dans laquelle il était placé. Après réflexion, je pense que c'est peut-être pire. Le carton aurait meilleur goût
So, strike this chain off my list. And so many others. The problem is that Montreal is a food haven, a place where food is taken seriously, to look at, to savour and to enjoy. I did not find this at all in Toronto. Here food is fuel. A disappointment, to be sure. On top of many such disappointments and surprises, but not of the good and happy kind.
Another surprise: It’s cancer
But now allow me to proceed to the chief reason my landing in Toronto became memorable, indelibly etched in my mind. On Tuesday December 18, 2012, at around 5:45 pm, the attending physician got my CT scan results of my lower abdomen and back. She said the words that no one wants to ever hear. I was at North York General’s Urgent Care Centre on Finch Avenue West, which is now a rehab facility. The doctor said that I had an obstruction of my lower colon, a tumour, which was likely malignant. I had cancer, which explained why I was unable to go to the bathroom for five days and why I had such unbearable pain. The doctor gave me an envelope of my tests and said I should rush over to North York General Hospital on Leslie Avenue.
This is what we, my wife and I did, after my wife arranged for her sister to babysit our two boys. I do not remember everything that happened that Tuesday evening, December 18, 2012, but I do remember that the ER was packed with people and it was very noisy. Eventually, I was seen by a doctor, and eventually placed in a room. It was way after midnight. My wife stayed with me overnight, and she seemed more distraught about my medical news than I was. I know now that I was in shock about the news, and I did not have time to take it all in, in particular what follows in my story. (Below is a photo taken of me in the hallway of the apartment building sometime in April 2013. It was taken by S.L. Levy, an old-time friend, who came for a visit. I call it Cancer Warrior.)
Canada has universal healthcare, but it is administered by the provinces, in accordance with the provisions of the Canada Health Act. This means no one covered in one province can be refused care in another, and I wasn’t. The problem, in my case, was that I was still covered by the Quebec regime—the Régie de l’assurance maladie du Québec (RAMQ) for three months, and had to undergo a waiting period of three months, before I would be covered by the Ontario Health Insurance Plan, or OHIP, as it is called here. I was residing in Ontario for only three weeks when my cancer was diagnosed. I would be covered by OHIP only at the beginning of March 2013.
This was not a problem for me, and it should have not been a problem for anyone else. But it was a problem for the surgeon. The problem for the surgeon was two-fold: 1. the reimbursement rate was lower in Quebec than it was in Ontario; and 2. he said that he did not want to fill in the Quebec paperwork to be reimbursed for his services. I can’t recall him saying why. But what became clear was that greed, avarice or the desire for more money coloured his decision. He certainly did not think about me or putting me at ease. No, his chief concern was maximizing what he ought to get paid.
So is extortion by a public hospital employee acceptable in Toronto? I got the feeling that it was. I was too tired and ill post-surgery and to complain to anyone; I now wish I had. But I was new to Toronto and was not familiar with the system. The few people here to whom I told my story seem unfazed by what I said and offered no response, other than shrugging their shoulders. Again, extortion would seem acceptable to some people here. Perhaps many. After all, Toronto is an expensive city in which to live. Who cares how you make your money? Right?
The price of greed
A little aside, if I may. Greed, I would say, is an illness that might be acceptable in our society, and yet we can all witness its ill effects. The unchecked and unmitigated desire to acquire money, property, wealth and to dominate and control people is, in my view, a mental illness. The classic American film, Citizen Kane (1941), directed, produced and starring Orson Welles, who also co-wrote it, shows the illness well, replete with all its attendant consequences; you can view the original trailer [here]. What we see time and again is that such avarice and the need for acquisition is a replacement, and a poor one at that, for love. A surfeit of love. Being aware of the illness is a good first step toward healing and recovery, toward saneness. That it is so common today, and so accepted in our society, says much about our modern capitalistic society. I think that you understand now where this is going and why I bring it up. I would recommend an older book, by Erich Fromm, The Sane Society (1955).
Back to the hospital. So, the surgeon asked for my credit card or that of my wife, so he could get paid Ontario rates for the surgery. Even though I was terribly ill and in pain, I had the wherewithal and fortitude of mind to say no. He asked, but on further reflection I would say a more accurate word is “demand” payment up front. Many times before the surgery and after. Now, I must ask if anyone else had had an experience like this lying in pain in a hospital bed—in Canada or anywhere else where universal healthcare esists, like in Britain, France or Australia—where the surgeon demands money before he would do surgery? Is this even common in America, with its private healthcare system? It might be, but I never heard a story like mine when I lived with my family in the U.S. for five years.2
I had my surgery on the late evening of Thursday December 20, lasting into the wee hours of Friday. The surgeon removed a tumour the size of an orange. Thankfully, it was Stage III colorectal cancer, and not Stage IV. I did not think about it at the time, but I was taking a big risk refusing his demands. He was quite angry, and the surgery could have ended differently. I am glad that he was professional enough to not let our disagreement affect his work.
Post-Surgery Recovery
Or maybe he thought he would give it another shot. On Monday December 24, after being in the hospital for six days, and four days post-surgery, the surgeon signed my discharge papers. I was going home and I was glad I was. But before I left, he once again asked for my credit card. It was surreal, like I was in a bad dream, a world of nonsense, like Alice in Wonderland, after going down the rabbit hole.3 Again, I gave the same answer. No. I was queasy to my stomach. I just wanted to go home. I wanted to get away from his incessant demands for money; I wanted to get away from the cold confines of the hospital; I wanted to get away from the cruelty that surrounded me. Cruelty that came in the shape of a dollar bill. It was surreal.
When my wife called the hospital ombudsperson to complain on the day of my release, her response was, “I work for the hospital. They pay me.” Right. I get it. So is extortion by a public hospital employee acceptable in Toronto? I got the feeling that it was. I was too tired and ill post-surgery and to complain to anyone; I now wish I had. But I was new to Toronto and was not familiar with the system. The few people here to whom I told my story seem unfazed by what I said and offered no response, other than shrugging their shoulders. Again, extortion would seem acceptable to some people here. Perhaps many. After all, Toronto is an expensive city in which to live. Who cares how you make your money? Right?
But I do.
I ended up filling the paperwork for the doctor to be reimbursed by the Quebec health services, in accordance with the agreement between the two provinces and the rate set by Quebec. I remember that the surgeon got paid quickly, but not at the rate he demanded. I did see him a few weeks later. He did not mention anything about his demands. But I subsequently changed hospitals for my chemotherapy. I never saw this doctor again, one who views extortion as normal, making money by any means, even if it means strong-arming a cancer patient.
There were more surprises, in the midst of my chemo treatments, which started in February 2013, including bed bugs in our apartment and three chemical treatments that did not alleviate the problem (n.b.: I might write more, in a future post, on how I wanted to avoid such chemical treatments while in the midst of my chemo treatments—and thus requested a safer and more effective option, heat treatment—but was unsuccessful in convincing the building manager). Add lice that our two boys picked up from summer day camp the first summer here in Toronto, heating (a lack thereof the first winter) and a murder in our building, apparently from a drug deal gone wrong. There was also a murder a week or so before we moved in the same building; it took place on the stairwell next to our apartment. And the noisy neighbours. This was not the Ritz.
There were the constant fire alarms. There was also the time in November when I was awoken at three in the morning to the smell of smoke; I opened all the windows, awoke my wife and my two boys, called 911, yelled fire in the hallway and went downstairs to the Building A entrance-way to let the firefighters in. Police came also. I do not remember if they ever discovered the source of the smoke. We returned to our apartment three hours later. Just another “normal” day in Toronto. An exhausting one. So many days like that here that it has become normative. Yet, I know that it shouldn’t. I refuse to consider this as normal. Common, yes; normal, no. We decided to (finally) move after suffering for almost two years
The last surprise
If Montreal is where the cool kids hang out, as Anthony Bourdain notes, what can we say about Toronto? Not cool kids, but the buttoned-up bean counters, the accountants and the bankers. The mean uncaring kids adults, the ones who view money as salvation. This is Toronto, which cares about things and consumption more than it does people— what Erich Fromm would not describe as a sane society. 4
Montreal, too, is a consumer capitalistic society, and suffers its own illnesses, but they are minor compared to Toronto, and more treatable. Montreal still retains a level of humanity and soulfulness. Toronto, however, is further along in its sickness, in its devotion to money and its commitment to acquisition, thus making it more difficult to treat and a prognosis of recovery less than likely. It would take an awareness that most here lack, including the surgeon at the hospital. He is as much a victim as I am, of our sick society, except one is aware of it and the other is not.
If trials and tribulations are supposed to build character and better your resilience, then I have had more than enough of both. I can use something different, some reprieve from difficulties. I was not being serious there; I do not think suffering is necessary to “build character.” Too much can debilitate and destroy the mind & body and put you in a downward spiral of despair. What can prevent it is love and acceptance, friendship, good relationships and honesty, all of which is never in great supply. One accepts what one finds and gets. There is also books, and in particular, great literature.
There is some good news, though. My writing has improved, which is what pain and suffering will do, if you do not allow it to defeat you. Not that I would ever advocate for pain and suffering being at all necessary to gain understanding. It is not. It never is, nor can it be.5
I will end with a song from The Alan Parsons Project, “I Wouldn’t Want to Be Like You,” the second track on Side 1 of IRobot, released on 8 July 1977.6
Merci et à bientôt
Born at 315 ppm
Now at 425 ppm
This song was added fot the reposting, replacing a photo of Toronto’s office towers. It is money that chiefly and wholly defines Toronto, where a perfect storm of selfishness, greed and complete lack of awareness meet. This is normal for Toronto, but not for me.
I added this paragraph in now, mainly because I am still painfully bothered by how unreal it was, in Canada, to be asked for your credit card at a hospital for surgery legally covered by universal healthcare. And, yet, this surgeon did not care about the pain I was in or his lack of ethics. His concern was monetary gain. Thus, his actions, although repugnant, introduced me to the ethos of Toronto.
Added this part to emphasize how bizarre and cruel I found my whole hospital stay, so much so that I would think twice before agreeing to ever go to a hospital in Toronto. It was bad enough that I faced a cancer diagnosis, but to be bullied, as I was, I now view as a traumatic experience.
Can you imagine the cumulative effect of so many negative experiences in such a short period of time? Can you imagine what happens to a soul who has so many negative experiences without receiving any follow-up empathy or compassion? Or even acknowledgement that this is not normal? I do; and I have only negative associations with this city. I have only negative feelings about Toronto. The true motto of the City of Toronto is, We don’t fuckin’ care; you’re on your own, buddy!
Thank goodness, thank my lucky stars, for Arya the Cockatiel, my faithful and beautiful companion who keeps me sane. Thank goodness for the birds and squirrels and for Nature, who work their beautiful magic on me. I cherish them.
My biggest fantasy is that in two years, after my youngest son finishes high school, on June 30, 2026, I will see the moving truck leave our driveway. What joy that picture brings me. What happiness.
Added for emphasis post-facto.
This song was added for the reposting. It nicely captures my sentiments. Besides, I have liked this song and the music of Alan Parsons ever since I heard him almost 50 years ago.
Oh my goodness, I can hardly believe what I’ve just read! That’s awful! What a horrible experience; I am thankful you are here to tell your story.
Dear Perry,
I am so sorry you went through this. Canada, in general, seems to have a very interesting medical "system." It's only private here in the U.S. for those who can afford it now and for government workers. They get the best care. Part of the "system." We have two grown children who work for the government and many friends. It's 10x better for them. When we got Obama Care in the U.S. we lost our private healthcare and it was affordable at $1,000/month (not really, but you catch my drift). We are low middle-class. Work hard for everything. John owns his own business so we are a liability and we have to pay, pay, pay, pay, despite 40 years in business. He is 62 still working 60 hours a week physically. Our monthly is $1,600 and we can barely scrape it up. I tried to see a doctor 3 weeks ago and was told soonest they had was 3 months away. So the e.r. became suddenly real last Friday and yes, I now remember my John asking me if I had my credit card as my heart rate was 49, before I threw up again. It was surreal. What we are going through in modern day countries is what we vote for. We think it will be better "for everyone," but it's just a worse "system." I don't think there's anything good on any side anymore. Although I can say that National Health in England saved a few of my relatives and I had good care "in and out" in hospital over the weekend.
As for Toronto, my dad never cared for it. He loved Calgary! One of my favorite cities is Montreal. I love it there, the food, street art, Mt. Royal Park. Cities do have certain vibes. Economies shift, cities shift. Some cities maintain their priorities, because there is a certain set of people that keep it that way. It's usually the artists! I have a good friend in Toronto and a few friends here on Substack from Toronto who are lovely. Cities have controllers and they mostly are the ones making or breaking cities.
I'm very sorry for all you have had to endure, very grateful you are here, and glad you wrote it. I find writing is the only way through these days. oxox