Opinion

No need for super heroes. What we need is the will to fix our health-care system

While movie producer Kevin Feige needs to take advice from no one, including me, I am hopeful that Victor von Doom is the next big threat in the Marvel Cinematic Universe (MCU) now that Thanos the Mad Titan has been dispatched in the Infinity Saga.

Doctor Victor von Doom made his debut in The Fantastic Four #5 back in 1962. The monarch of the fictional nation of Latveria, Doctor Doom has been portrayed as both a supervillain and antihero, and is most frequently depicted as the archenemy of the Fantastic Four.

Doctor Doom was ranked #4 by Wizard on its list of the 101 Greatest Villains of All Time and #3 on IGN‘s list of the Top 100 Comic Book Villains of All Time.

If I was on that list ahead of Doom, I would be very nervous.

OK, so I know what you’re going to say. Why is a palliative care physician writing about Doctor Doom? Isn’t that a bit on the nose? And perhaps a tad morbid?

Maybe. But humour me and hopefully the point will present itself.

A story I find uniquely fascinating is Doomworld. In a six-part series of comics published in 2010, Doctor Doom enters the kingdom of Wakanda to access its vast supply of Vibranium that he needs for his plans of world domination. Vibranium is a precious metal and source of great national pride, as such protected at all costs (sounds a lot like Canadian health care).

As a final failsafe, it is guarded by the Egyptian god Bast, who demands a “purity test” for all who seek Vibranium. Doom succeeds in acquiring the precious metal because he “has seen the future as a sorcerer and thus has seen the world led to ruin in countless futures” except in “one single glimmering” scenario in which he rules with an iron fist and saves the world.

There is one particular exchange between Bast and Doom that resonates with me.

Doom: “My methods are a means to an end. No different than weeds being pruned in order for an orchard to flourish. Those who stand in the way of my vision oppose me because they fear me, but more than that they fear what I represent. Change.”

Sound similar to health care in Canada?

Bob Bell is a former Deputy Health Minister for Ontario and orthopedic surgeon. Along with Anne Golden, Peter Alofs and Lionel Robins, he is publishing “Fixing Health Care,” a Globe and Mail series addressing 10 common problems faced by patients in the public health system across Canada.”

Like Doctor Doom, Dr. Bell is simply seeking a better world, in this case, a better Canadian health-care system.

I look forward to reading and debating the solutions proposed by Bell et al. Their first recommendation about primary care spurred a vigorous debate online. Other topics include national pharmacare, standalone surgical centers, eReferral, etc.

This is not the first time or last time the topic of health care will be subject to debate. Panels have been stuck. Articles and reports have been written. I enjoyed Danielle Martin’s “Better Now: Six Big Ideas,” Jeffrey Simpson’s “Chronic Condition” and Andre Picard’s “Matters of Life and Death.” I have even posted some of my own.

Some may accuse Bell and his group of “villainy.” His motives are often considered nefarious by some health-care providers. But, like Doom, he is simply seeking a better world, in this case, a better Canadian health-care system. Like Doom, he is often misunderstood and misrepresented. Doom is a fervent protector of his country, Latveria, and Bell is a proud Canadian who has worked in public service for many years.

I had the pleasure of working across the table from him during the 2017 Physician Services Agreement (PSA) negotiations from 2017-2019. As lead for the ministry team, he was a hard negotiator but one I respected. We didn’t always agree then and I am certain we may not see eye-to-eye now (dude is like 6-foot something while I am 5-10 if try I real hard). I welcome new ideas and revisiting some old ones, too. I look forward to reading the complete series and am interested to see what new ideas Bell might have.

But even more so, I am interested in knowing if Canadians are truly invested in change. The system is currently set up to get the results it does, and it will continue to do so until we acknowledge and accept the need for change.

Health care in Canada is often referred to as “the third rail.” A political hot potato. Doctor Doom would have the will to grab that rail, hold on and attempt to bend it.

The conclusion to Doomworld is strangely prophetic. Having acquired the Vibranium, Doom crafts an invincible armour and army of indestructible Doombots. In the climactic battle, Doom goes head-to-head with T’Challa, the Black Panther and protector of Wakanda. Doom’s hubris proves to be his downfall. T’Challa is able to tap into Doom’s armor and sacrifice all Wakandan vibranium, rendering it permanently inert. Though Doom believes that Wakanda can’t survive without the Vibranium, T’Challa believes that he has, in fact, just saved his people and changed their future for the better.

In this case, Vibranium could be seen as an analogy for our health-care system. Do we preserve it in its current form at all costs or do we have the courage to make the necessary changes, no matter how painful those changes might be?

Who is right? Do we have the will to do that which must be done? Superheroes won’t provide us the answer. It will be up to Canadians to stay informed and stay involved.

Doctor Doom makes his presence felt on Dr. Cargill’s desk.

The comments section is closed.

3 Comments
  • James Murtagh says:

    “…I am interested in knowing if Canadians are truly invested in change. The system is currently set up to get the results it does, and it will continue to do so until we acknowledge and accept the need for change.” Let’s be clear…the question is not whether Canadians are invested in change…it is whether politicians and health professionals are invested in change. For decades, the overwhelming majority of Canadians have left it to politicians and health professionals to design, renovate and operate the health system. In my 35-years in healthcare, the greatest obstacle to substantive change was…politicians and health professionals. Most of the politicians and health professionals I’ve worked with have been great people, but in their corporate incarnations (parties, cabinet, medical associations, unions etc) they are intensely self-interested and, therefore, unable to embrace anything more than incrementalism. Twenty percent of Canadians have no primary care physician; others wait so long to see a PCP that they may as well not have one. Walk-in clinics now require appointments. Community labs close without warning for a day or longer. Wait times for diagnostic tests or procedures are long and, perhaps more importantly, patients have no clear info about when they will have access. I could go on. Are Canadians invested in change? Anyone in doubt doesn’t know, at a deep level, what it is to be a patient in Canada today. The real question is how radical are the vested interests prepared to be? And, for what its worth, I don’t think standalone surgical centres even move the needle when it comes to radical!

  • Jon Johnsen says:

    Nicely done Darren. While I follow the comic book world vicariously through my son, I have a slightly better grasp of the health care world. I think your rhetorical question is key: Are Canadians truly invested in change? I think when people view change in the health care system they think of all the new things they are going to get: pharmacare, dental care, the latest procedures, unfettered access to their family doctor etc. They don’t care to see the things that the system may need to stop doing to be effective. It’s a complex problem that too many people have had simple solutions for. I will admit that I have limited stomach for working on the system paralysis that exists currently. I’ll leave Dr. Doom and the Wolverine to fight it out!

  • Darren Cargill says:

    Just to be clear. We still need super heros to save us from:
    1) Skrull invasion
    2) incursions
    3) Kang the Conquerer (he’s coming)
    4) planet eaters like Galactus
    5) villainous team ups like the Sinister Six

    But we should be able to figure out our health care system without Supes.

Authors

Darren Cargill

Contributor

Dr. Darren Cargill is a fellow of the College of Family Physicians of Canada, the Royal College of Physicians of Canada, and American Association of Hospice Palliative Medicine. He is the past medical director for the Hospice of Windsor and Essex County and lead physician for its community-based Palliative Medicine Program. He is one of only two certified hospice medical directors in Canada and has his designation as a certified Canadian physician executive.  He received HPCO’s Larry Librach award in 2017 for excellence in leadership and advancing palliative care through mentorship.

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