CMAJ contributor 2016 to 2022. Patient advocacy journalism since 2022. Covers healthcare failures, pharmaceutical regulation, veterinary medicine, and the gap between what clinical guidelines say and what practitioners do. Has read every Health Canada adverse drug reaction database entry for the last five years.
Beats: healthcare, veterinary medicine, pharmaceutical regulation, patient rights, consumer protection
Contact: m.saunders@printmag.org
A patient gets a call the day before their appointment: it is cancelled. The choices offered are two days from now, or nine months away. Nothing in between. That is not one clinic having a bad week. It is the shape of a system that has run out of the middle, where care is either crammed into a gap that opens by luck or pushed past the far edge of the calendar.
Four hours just to get through intake. Eight hours from arrival to discharge. No diagnosis at the end of it, and a stack of follow-up appointments to chase instead. Canada's health care is rightly praised for being free at the point of care. Free is not the same as accessible, and the hospitals are overflowing.
On October 20, 2025, a 72-year-old woman called her insurance company to withdraw $2,500 from her own Registered Retirement Income Fund. She was told it would arrive within a week. It did not arrive. Nine case numbers were opened over the following month. Callbacks were promised and not made. The company cited connection problems, on their end. Three months later, the company sent her a letter admitting it was their fault, offering $5,000, and requiring her to sign away every legal right she had in exchange.
On April 1, 2026, a Guelph veterinary clinic administered vaccines to a dog at the scruff of the neck, an interscapular site. Veterinary medicine has known for decades that this site is associated with vaccine-induced sarcoma, a form of cancer. Industry guidelines recommend avoiding it. After the injection, a mass formed. Over three procedures, 2.17 litres of hemorrhagic fluid were drained. The clinic filed an adverse reaction report with the vaccine manufacturer. That report is an acknowledgement that the injection caused what followed.
The country's diagnostic instruments compress, into a single five-letter acronym, a cognitive style that includes some of the most generative kinds of attention available to the species. The acronym is then used as a basis for prescribing a stimulant whose effect is to make the person more like the kind of person the diagnostic instruments were originally built to describe. There is a name for this in industrial psychology. The name is conformity through pharmacology.
In late 2021 the federal government required its 267,000 workers to be vaccinated, and those who refused were put on leave without pay. The number affected was small, around two thousand, under two per cent. The mandate was lifted in mid 2022. And the courts, for the most part, never ruled on whether it was lawful, because by the time the cases were ready, the policy was gone. This is a fair look back at a hard question the country chose not to answer.
In the spring of 2020, Canada sent soldiers into long-term care homes that the virus had overwhelmed. What they wrote down, cockroaches, force-feeding, residents left calling for help, was so severe the province took control of five homes. A retrospective on the report that made the country look, and the question of whether anything changed.
