Manitoba leaders worm their way into history with 'coulda, woulda, shoulda' pandemic response

I couldn't bring myself to write any two-year anniversary reflections on the pandemic. I hate this milestone. To me, it is an anniversary of leadership failure at virtually every level of our government.

For some, public health measures are about comfort and personal autonomy; for others, they are life and death

A patient with suspected COVID-19 is brought into a resuscitation bay in the adult emergency department at Health Sciences Centre in Winnipeg in December 2020. (Mikaela MacKenzie/Winnipeg Free Press/The Canadian Press)

This column is an opinion by Dr. Jillian Horton, a Winnipeg-based physician and author of the national bestseller We Are All Perfectly Fine: A Memoir of Love, Medicine and Healing. For more information about CBC's Opinion section, please see the FAQ.

Who is the leader who called us all "worms"?

So many of our elected officials govern with such a general contempt for humanity, you'd be forgiven for generating a long shortlist.

Maybe it was former Manitoba premier Brian Pallister, who once wished happy holidays to the atheist infidels. Maybe it was Premier Heather Stefanson, who said it's time for Manitobans to look after themselves.

Or maybe it was then-Manitoba health minister Cameron Friesen caught on camera, referring to me and the 199 other doctors and scientists who wrote to him in November 2020, pleading for action on the brink of a crisis in our health-care system.

It wasn't any of them, actually. It was a great leader. A real leader. The kind we almost don't recognize anymore.

I couldn't bring myself to write any two-year anniversary reflections on the pandemic. I hate this milestone. To me, it is an anniversary of leadership failure at virtually every level of our government — a heart-wrenching deep dive into a cesspool of indifference and incompetence.

Two years in, despite more than 1,700 Manitobans dead and solemn-faced admonitions from our government officials that it's time for us to "learn to live with COVID," there is, as many others have pointed out, little evidence they have learned much of anything.

Chief Provincial Public Health Officer Dr. Brent Roussin said recently that mandate-free Manitobans are now "empowered" to make the choices that are right for themselves and their family.

While I sympathize with the many challenges Dr. Roussin has had to contend with these last two years, this statement is hard to reconcile with the mantle of public health.

COVID is airborne, but general members of the public are not easily "empowered" to know anything about the quality of the ventilation and filtration in the spaces where they work, send their children to school or seek medical care.

Patients and at-risk elders aren't "empowered" with the knowledge that their care providers are fully vaccinated.

And none of us are "empowered" to make personal choices based on the degree to which COVID is circulating in our community, since the province has eliminated the comprehensive testing and data sharing that tells us how much disease is circulating.

Worse still is the language of "anxiety," as if whether or not you think restrictions should carry on is just about desensitizing yourself from fear. This is particularly absurd, as patients who face chronic and life-altering diseases are some of the bravest people I have ever known.

Yes, for some, the public health measures are an issue of "comfort" and personal autonomy; for others, they are a matter of life and death. But the fears of immunosuppressed patients are often portrayed as being roughly equivalent to a phobia of clowns, with the suggestion being that one should simply try to relax at the circus.

What a depressing development for a province that calls itself "Friendly Manitoba."

But of all the things our leaders have said in the last two years, perhaps the most illuminating has been the repetition of this mantra: "Coulda, woulda, shoulda."

Pallister started it, Stefanson kept it going, and recently, Fort Whyte PC candidate Obby Khan ran with it, repeating the point as if he had just completed an exceptionally bad franchise training module.

'Coulda, woulda, shoulda'

Watching him speak, I found myself thinking about a fundamental aspect of modern medical culture: critical incident analysis.

Critical incidents are unintended events that result in death, disability, injury or harm to patients. These incidents can be reported without blame, to support a culture of learning and openness. Events must be meticulously reviewed so we "look at what can be done differently and what improvements can be made to the way health-care providers work."

In 25 years of medical education and practice, I have never yet heard a physician respond to a question about a critical incident with "Coulda, woulda, shoulda."

As long as we aren't sociopaths — and sociopathy does exist in medicine, although less frequently than in politics — our reactions are usually on the opposite end of the spectrum. We lie awake at night, haunted by that one mistake, that one decision, the death or disability that could have been prevented.

For most of us, the grief and shame of having caused harm is unbearable; a physician's risk of suicidal ideation is highest in the weeks after someone has made a complaint about their care.

A critical care physician talks to a family member of a COVID-19 patient in Ontario. Doctors are haunted by the idea they might have made a mistake, Dr. Jillian Horton writes. (Evan Mitsui/CBC)

This context is one of the reasons why I was stunned by Premier Stefanson's indifferent and heartless response to questions in the legislature about the death of Krystal Mousseau — a young Indigenous mother of two who died in an attempted out-of-province intensive care unit transfer during the horrifically bungled third wave.

Mousseau's death was subsequently declared a critical incident. But when Manitoba NDP Leader Wab Kinew said "Krystal Mousseau's life mattered," Stefanson responded with the totally excellent news that one of her own children had recently won a hockey game.

This is much more than a clumsy "Coulda, woulda, shoulda." It is pathological.

So who called us all worms? It was one of the greatest leaders of all — Winston Churchill.

It wasn't an insult thrown at the non-believers or the citizens who couldn't pull themselves up by their bootstraps. Churchill was talking about humility. His point was that he too was a worm.

And yet, there was a caveat, because Churchill knew that his greatest gift was his power to inspire, to bring people together, to unify a nation, not just his friends or the people who could do him political favours.

"We are all worms, but I do believe that I am a glow-worm," he said cheekily.

Well, two years into this debacle, our leaders have little to glow about. Manitoba, like so many of our provinces, feels more like a George Orwell Worm Farm, where some worms are more equal than others, and leaders slither away from accountability with a "Coulda, woulda, shoulda."

"Leaders," indeed.

Not so much glow-worms as pinworms.


Dr. Jillian Horton is a specialist in internal medicine and writer in Winnipeg. Her first book, We Are All Perfectly Fine: A Memoir of Love, Medicine and Healing, is a national bestseller.


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