Sunday, September 30, 2007

Nothing beautiful about cosmetic surgery
Sept. 28, 2007

We ought to be grateful for people like Krista Stryland and Micheline Charest, whose sad deaths present an opportunity for all women to reflect on the demons that send us searching for happiness through surgery.
Stryland died last week in Toronto of a heart attack after undergoing liposuction, in which a thin, sharp instrument is rammed repeatedly into your body to break up pockets of fat. Charest died in Montreal in 2004 following six unconscious hours on the operating table being sliced, diced and skinned in the pursuit of “beauty.”
Death is merely the worst-case scenario on a laundry list of ugly possibilities when it comes to cosmetic surgery, mind you. So I’m grateful too to celebrities like Cher, Joan Rivers, Burt Reynolds, and legions more. One glimpse of their mannequin-like faces is all it takes to remind me of the mighty price people pay for thinking they can get one over on the aging process.
We can talk all we like about whether general practitioners should be allowed to call themselves cosmetic surgeons and start operating on people in their private clinics, as happened to Stryland. That seems to be the major theme in the news coverage of her death this week, and it’s certainly an important point in provinces that haven’t sorted that out yet (B.C. already has).
Or we can cut to the chase and ask ourselves what in hell is going on with us.
Why do more than a quarter of a million Canadian women undergo some kind of cosmetic “enhancement” procedure every year in an attempt to feel more attractive? Why do Canadians spend more than half a billion dollars annually having ourselves tightened, tucked, lasered and poisoned in the elusive - and ultimately hopeless - pursuit of youth?
The self-loathing that characterizes so much of the female experience in this day and age has now spread to men, who once seemed virtually immune to such dangerous vanities. But while the number of men seeking solace through cosmetic surgery may be on the rise, 85.5 per cent of the Canadians undergoing the procedures in any given year are female.
Men tend to come looking for a better nose, or less droopy eyelids. Women have different goals: Less fat; bigger breasts; fewer wrinkles. The procedure that Stryland was undergoing, liposuction, is the most requested cosmetic surgery among Canadian women, accounting for a quarter of the total surgical market.
Cosmetic enhancement has become so popular, in fact, that a loan company in Toronto now more or less specializes in lending money to people wanting to be operated on. Medicard lends money to people facing a bill for an unfunded medical procedure, three-quarters of whom have are people wanting cosmetic enhancements.
In 2004, Medicard surveyed 1,000 doctors doing that work. The survey produced some of the first hard numbers specific to the thriving cosmetic-enhancement industry in Canada.
The numbers are pretty frightening. Almost 25,000 Canadians a year are having liposuction. Some 17,000 women a year get their breasts enlarged. More than 100,000 doses of the botulism toxin are injected annually into people happy to pay for the privilege of getting rid of a few wrinkles by having their facial muscles paralysed.
Cosmetic procedures overall rose almost 25 per cent in Canada between 2002 and 2003, Medicard reports. In the U.S., the growth in the industry is staggering: close to 11 million Americans now undergo cosmetic procedures in a typical year, an increase of almost 500 per cent in the past decade.
Our sisters down south are even more enthusiastic than we are about putting themselves in harm’s way for the sake of false youth and beauty. Women account for 91.4 per cent of the U.S. market, which now drives an industry worth close to $12.5 billion.
Why are we doing this to ourselves? We like to blame the fashion industry, or Hollywood, or all those magazines endlessly haranguing us to lose 10 pounds by Christmas/summer/next week. The cult of youth, the anorexic runway models - what can a girl do but try to keep up?
But we wouldn’t respond to the negative messaging if we were confident in our own skins. If we weren’t so tragically uncertain about our own worth, all the images in the world of skinny, airbrushed, smooth-skinned 20-year-olds wouldn’t ruffle us a bit.
Were we whole to begin with, we wouldn’t be here wondering why a happy, fit young mom would die for the sake of a little less flab on her belly. We wouldn’t be borrowing money by the thousands to get our faces cut up and our breasts filled with plastic pouches.
Perhaps the patriarchy had something to do with all of it way back when. But we’re long past the time for laying the blame on anyone except women themselves.
If we stopped buying the magazines that exist to make us feel inadequate, there soon wouldn’t be any. If we quit buying teeny-tiny vials of vastly overpriced creams to dab on our unstoppable wrinkles, we could feed the planet with the money saved. If we aged with grace instead of desperation, whole industries would collapse overnight.
Just say no, ladies. There’s no beauty to be found at the end of a knife.

Monday, September 24, 2007

U.S. corporation takes another piece of B.C.'s human service work
Sept. 21, 2007

For better or worse, the bulk of B.C.’s back-to-work programs for people with disabilities are now under the control of a large, aggressive American corporation.
The ink is barely dry on the Aug. 3 agreement that saw the sale of the local company that has run the programs up until now - WCG International - to Arizona’s Providence Service Corp. So it’s much too soon to speculate whether clients will notice any difference, or to assume that it’s automatically a bad thing when one more big U.S. company takes over yet another aspect of B.C.’s human services.
But man, I get cold shivers down my spine when I think about how easily British Columbians are giving this stuff up, all of it without a whisper of public debate. Providence in particular is a heavy-duty acquisitor of government social-service contracts, and delighted to be gaining its first foothold in Canada.
Providence bought WCG less than a month after the Victoria company had secured the better part of $18 million in contracts with the Ministry of Employment and Income Assistance. Of the eight contracts awarded in B.C. for services to people with disabilities, WCG secured four of the most lucrative ones - Vancouver Island north and south, the Fraser Valley, and northern B.C.
WCG has run welfare-to-work and the Triumph disability program for several years now, so no surprise it got the contracts. First hired by the New Democrats in the mid-1990s to get people off welfare and back to work, the company has continued to do very well under the Liberals.
It’s difficult to gauge the success of the venture overall, given that the only absolute measurement is whether fewer people are receiving welfare. We don’t know if their lives have been improved because of that, or if they managed to maintain whatever job was found for them. External factors - a booming economy, for instance - complicate things even more.
So all that can be said with certainty about this past decade’s efforts is that 230,000 fewer British Columbians are on welfare now compared to 1995, and that companies like WCG have played a key role in that.
That our streets, hospitals and jails are now overflowing with people who are no longer receiving welfare - well, that’s a subject for another day. For now, let’s stick to the sale of WCG, and what it means to have a U.S. monolith now calling the shots in great swaths of the province.
Providence founder Fletcher Jay McCusker was running for-profit reform schools when he “saw an opportunity” in the mid-1990s to expand the business.
Governments throughout the U.S. were losing interest in providing social services, but in many cases were required by federal law to continue the work. Meanwhile, social need was growing. For the private sector, those factors pointed the way to a “recession resistant” industry, notes the Providence Web site in its section for investors.
Providence now has a workforce of more than 7,000 operating a soup-to-nuts list of social services in 37 states. The purchase of WCG marks Providence’s first foray into work programs for people with disabilities, but its other offerings run the gamut: probation services; domestic-abuse counselling; foster care; parole supervision; child and youth behavioural programs. Florida’s entire child-protection system is now run by Providence, under a contract the company touts to potential investors as “economically insulated.”
In the topsy-turvy world of profiting from human misery, worsening economic conditions are actually “market drivers” for companies like Providence. There’s a financial interest in maintaining poverty and suffering.
With all the social problems the U.S. is experiencing, that means there’s nowhere to go but up. The emerging industry that Providence defines has the potential to thrive in times of economic downturn.
And if two years in a row of “double-digit returns” aren’t enough to convince wary investors of that, Providence offers a grim array of statistics to verify the growing dependency on its services. More than 40 million Americans now living in poverty. Almost five million adults released every year on parole. Two million children needing protective care. Half a million kids in foster care. High-school dropout rates at 33 per cent and rising.
The company adds that it is “further driving revenue growth by expanding into select geographic markets, including Canada.” We’re a prime market, as it turns out - lots of “liberal benefits” for job training and government interest in offloading the provision of social services.
Do we want to go in this direction? Is there even time to ascertain that before all is lost?
Providence is voraciously expanding its empire by buying up businesses like WCG and signing management contracts with not-for-profits. In an age when bigger is always assumed to be better, each acquisition positions Providence to snap up even more government contracts.
“Most of our competitors are small, local, not-for-profit kind of United Way agencies. This has historically been very parochial - that is, they are interested only in their community and providing services to their community,” McCusker said in a recent interview with the Wall Street on-line magazine “The more we do, the more credible we become with the state procurement people.”
He’s right. And it really scares me.

Monday, September 17, 2007

Add one more homeless man to Victoria streets
Sept. 14, 2007

For more than a year now, I’ve watched Roland Lapierre cobbling together at least some semblance of a normal life aboard his tidy little raft on the Gorge.
Once homeless on Victoria’s streets, Lapierre had found a way out. I’d see him sitting in the sunshine on his patchwork raft –reading the paper sometimes, or having a nap – and would send good thoughts his way for having the creative mettle to come up with his own solution.
I wondered how long he’d get away with it. The answer came this week. The City of Victoria has ordered Lapierre to leave the little bay where he anchors, off Banfield Park near the Selkirk Trestle.
In a city that knows no end to people living homeless on its streets, add one more.
The city is within its rights, of course, and I can already hear the “slippery slope” arguments taking shape in defence of rousting Lapierre. We can’t have people thinking they can just pull up a raft somewhere on the Gorge and live for free.
But the city’s action does beg the question: What now?
As pleasant as it may have looked from a distance, life couldn’t have been easy for Lapierre in his teeny-weeny waterfront home. It would have been cold out there a lot of the time, and there wasn’t much room on board to do anything other than sit very still or lie down.
But I loved seeing him on his raft as I made my way through the park. I have great admiration for people who are able to figure their way out of problems, and Lapierre had managed his way out from under a really big one.
One of my favourite travel destinations is Mexico, where there’s no shortage of desperately poor people coming up with innovative ways to survive. I wish for a better social safety net for all of them, but in the meantime appreciate the relative freedom they’re given by Mexican authorities to scratch together a life.
Homeless people have to live somewhere, after all. So while it isn’t pleasant to realize there’s an old, sick woman selling one-peso packs of gum out of the bus shelter where she lives on the road into your holiday resort, at least it’s honest.
The Capital Region, on the other hand, continues to pretend there is no poverty - just insufficient motivation. The street issues get more and more visible and we keep telling ourselves it’s just because there are too many lazy bums out there.
They gather in Cridge Park, and we roust them as vagrants. They find some crappy apartment building that no one else will live in, and we send in the health squad to shut the place down.
We tear down their makeshift tents on a daily basis in Beacon Hill Park. We throw out the sleeping bags they leave behind in our downtown doorways. We fence off another alley in another part of town. We send more police into the streets to move people along.
To where? Wake up, people. Ousting Roland Lapierre isn’t going to make or break the homeless issue in the region, but it’s one more perfect example of how we got here in the first place.
We can’t have it all ways. We can’t cut social supports and then be surprised that our problems are growing. We can’t abandon social-housing efforts and then insist that people get off our streets. We can’t slash mental-health care and then wonder where all the crazy people came from.
Lapierre didn’t choose to live on a raft because he wanted to get one over on the city. He did it because it was a vast improvement over camping out in some cold, dirty gap between buildings, where anybody and everybody is free to give you a hard time, rough you up, and steal your stuff.
Lapierre’s story could have had a happy ending - one where he gets the bad news about having to pack up his raft, but at the same time gets as much help as he needs in finding a more suitable place to live.
That approach would also work for tenants of buildings condemned as unfit, like the apartments on Carleton Terrace that were shut down this summer. But like Lapierre, those people have been left to their own devices as well. The streets await.
In Lapierre’s case, the city tried to be nice about it, offering him a job and even a more distant anchor. But for someone with chronic and severe mental illness - and who I suspect swims back and forth to his raft - neither are workable alternatives.
The city acted after fielding complaints from 15 people. I hope they also complained about the much larger boat anchored next to Lapierre’s raft for several weeks this summer. I hope the concern about “third party” use of the foreshore extends to the rich as well as the poor.
“I thought I had found a way,” Lapierre told the Times-Colonist this week. But his eviction was the final blow. He won’t be “fighting anymore.”
Watch for him looking sufficiently brought down to Earth in a doorway near you. Some victory.

Monday, September 10, 2007

No big-city jams - but now's the time to take on Victoria traffic
Sept. 7, 2007

I noticed in this week’s Times-Colonist that the paper is planning a series on commuting in Greater Victoria. They’ve put out a request for commuter stories, so allow me to be among the first to weigh in.
I’m one of those lucky folks who are able to pick their own start/stop times for work, at least to the extent of avoiding the worst of early-morning and late-afternoon traffic.
So I won’t pretend to know what it feels like to be a frustrated commuter fighting her way through heavy stop-and-go traffic every day. But I do get caught in the crush fairly often anyway, because it’s hard not to if you’re driving anywhere near one of the region’s trouble spots at the wrong time of day.
Civil engineers, physicists and flow experts have been trying for decades to figure out traffic jams, the reasons for which go well beyond the superficial explanation of too many cars crammed onto too few roads. The latest theories view traffic as an element, capable of changing its form under certain conditions.
On a slow time of day on a wide-open road, the theory goes, traffic is comparable to a vapour or gas. Cars travel with ease at whatever speed each driver chooses. With more cars on the road, it manifests as water – still flowing, but at a much more fixed and inflexible rate that makes it harder for drivers to switch lanes or make quick adjustments.
And when the commuter rush is on, traffic turns to ice, leaving you and your car frozen in place.
Sometimes there’s an obvious explanation for the freeze: A stalled car; a poorly planned on-ramp; an accident. But not always. Traffic can slow to a crawl and then speed back up again for no particular reason.
“All of a sudden to go from free flow to stop-and-go – this remains one of the mysteries of our time,” traffic expert Hani Mahmassani of the University of Texas commented to the Washington Post when asked about the phenomenon.
While an overload of cars can’t explain everything, it’s definitely a factor. Traffic simply can’t flow as smoothly on a road originally built to carry 100 cars an hour once development has quadrupled the number of vehicles using the route. The “Colwood crawl” exemplifies that particular problem.
But traffic volume isn’t the whole story, as anyone can attest who has experienced the late-afternoon McKenzie/Trans-Canada Highway jam. Why is it that traffic travels at regular speeds through all sorts of busy intersections around the region – including those on either side of McKenzie - yet frequently slows to a stop at that one?
Sometimes the culprit is bad planning. I suspect the reason that westbound traffic piles up on the Bay Street Bridge at various times of day is because some planner made the big mistake of putting in a single shared lane for vehicles coming off the bridge at the Tyee Road intersection regardless of whether they’re trying to turn left on Tyee or drive straight through.
That shared lane means nobody travelling west across the bridge can move forward until cars turning left on Tyee have negotiated their turn across a fairly steady stream of oncoming traffic. With the lack of an advance left-turn arrow complicating the situation even more, traffic can sometimes back up all the way to Bridge Street and beyond.
In the years when I drove from Gordon Head into the downtown every day, I discovered the hard way never to attempt a left-hand turn across McKenzie in the morning, when a mass of University of Victoria commuters was making its way to school and work.
A morning traffic jam caused by doughnuts and coffee was shaping up in the same neighbourhood just as I was moving out of the area last year, the result of Tim Horton’s devotees trying to turn left off Shelbourne into the restaurant’s drive-through.
Now that I live in Esquimalt, a whole other group of problem roadways has emerged.
A late-afternoon trip from this side of the water to any area remotely close to the West Shore, for instance, is simply not on. Nor do you want to be heading out on Interurban or Wilkinson roads when commuters start flooding back home to Peninsula communities in mid-afternoon. (I don’t know how so many people got jobs that let them head home at 3:30 p.m., but that’s when the crunch starts.)
Then there’s that funny little spot where Blanshard Street morphs into Vernon, at the intersection with Saanich Road. Whatever mysterious forces are at work there, I now know to factor in the delay of getting through that intersection when heading out of town to catch an afternoon ferry.
Even the worst commute in the Capital Region has nothing on the best day in Vancouver or Toronto, mind you. Hard-core commuters from the big city would tease us mercilessly even for considering our little 15-minute holdups as “traffic jams.” But all big problems start small.
Got your own stories to share? I know the TC would love to hear them –

Monday, September 03, 2007

More cuts to mental-health supports betray the lie of "community care"
Aug. 31, 2007

These are the first words I’ve written about the closure of Laurel House. Given that it’s closing for good in three weeks, that’s pretty late to be taking up the cause.
The problem was that I had a job in the non-profit sector up until very recently, which made it difficult to go shooting my mouth off about decisions being made by another non-profit.
In fact, I caught an earful a couple months ago just for sending an unhappy e-mail to other non-profits letting them know that Laurel House was closing and our community would be losing yet another resource for people with chronic mental illness. I learned the hard way that I’d have to keep my own counsel on the subject for the time being.
Me and my 800 words aren’t going to change a thing at this late date. But a lament for Laurel House is in order just the same.
If you’ve read the flurry of letters in the paper these past few weeks, you have the gist of the story. A beloved drop-in program in a Fernwood house that supports a couple hundred people with chronic mental illness is to be shut down and replaced with new, short-term programs focusing on “rehabilitation.”
It’s good news for people with lower levels of mental illness, who could go a long way with a little rehab help.
But for the people whose illnesses are more profound – the ones who loved Laurel House because it was the only place where they felt accepted for who they were – the closure is devastating. They don’t need a rehab program. They need a place to go where somebody isn’t always trying to “fix” them.
On the surface, the Capital Mental Health Association appears to have made an independent decision to close Laurel House. But I can’t shake the suspicion that the move has less to do with the will of the CMHA as it does with trying to hold onto almost half a million dollars in annual program funding from the Vancouver Island Health Authority.
Non-profits have to bend themselves into all kinds of uncomfortable positions when it comes to maintaining funding. Perhaps the CMHA risked losing the entire $500,000 unless they scrapped Laurel House in favour of more rehab-focused programs.
Whatever the real story, I find the association’s public position on the issue pretty unpalatable. In response to a fairly scathing opinion piece in the Times-Colonist last week written by one of several health-care professionals opposed to the closure, CMHA board president Karla Wagner wrote a letter to the editor noting that some clients were just coming for the cheap lunch anyway.
“They are understandably upset that the lunch will no longer be served, but in its place will be expanded nutritional guidance and a community kitchen to achieve economies of scale,” wrote Wagner.
“We will be teaching people to fish, rather than giving them fish.”
Oh, please. I’m all for the concept of giving people a hand up instead of a handout, but sometimes a person just needs someone to give them a damn fish – or at the very least, a friendly face to sit beside while they eat it. “It’s lonely sitting in a bachelor apartment,” noted one Laurel House regular.
And when you’re barely scratching by on an $800 monthly disability cheque, what’s so wrong about appreciating a one-dollar lunch? Have we no compassion left for chronically ill people who may never be able to get out there and land a paid job?
I’ve got a good friend who has relied on the kind folks of Laurel House for more than 20 years. Some days, she’s plain worn out from trying to “better” herself from an illness that will be with her for the rest of her life.
She must have done a dozen programs in the six years I’ve known her, some of which have admittedly been very helpful in stabilizing her illness. But Laurel House was the gentle background noise to all those programs – the place where she knew she was always welcome, free to pursue the painting and sculpture that makes her happy, and able to make her own choices around what she’d do that day.
Neither she nor any of the Laurel House regulars were asked about the changes that are now underway. They were just called to a meeting one day and told how it was going to be. Apparently drop-ins for the mentally ill are out of step with modern psychiatric theory - these days, it’s all about short-term, work-focused programs.
That the new programs will be run by an occupational therapist rather than the psychiatric nurse who headed up Laurel House says it all. God knows what will happen to the poor souls who just don’t have it in them to rehabilitate themselves any further.
Once upon a time when B.C.’s largest psychiatric hospital was being emptied in favour of a new kind of “community care,” we vowed we’d take care of the thousands of British Columbians who were ousted from Riverview. The closure of Laurel House is just the latest in a long string of betrayals of that promise.