Picture of Kirsten PatrickKirsten Patrick is Deputy Editor at CMAJ


Yes I did wake up at 3 am today and think, “I’ll just check the U.S. election results…” and boy do I regret not going to bed earlier because there was no sleeping after that. Since 3am I’ve read at least a hundred articles analyzing the election’s outcome. I’ve been openly “with her” throughout the campaign. I’m a UK citizen living in Canada so nobody cares, but I’m a woman and the misogyny that the campaign has brought into sharp focus has upset me greatly, so I care. It means I’ve been zipping back and forth through the stages of loss for the past few hours.

Shock, Disbelief…unfortunately there’s no room for Bargaining with this one; it’s much more final than Brexit; there’s a scary president and a Republican-controlled House and Senate and that’s the end of it….so, back to shock. Anger? I generally don’t see the point of being angry at large swathes of the population; it’s a bit nonsensical. But I do feel deeply upset that hate-talk and lies appear to appeal to so many, and that many efforts that I view as being positive for population health – like increasing access to health insurance and negotiating the recent climate change agreement – will probably soon fall down the priority list in U.S. policy.

Can I move on to Acceptance? At first, acceptance seems unthinkable, but then I realize that it is inevitable. I…we…must accept in order to move forward usefully. So what does acceptance look like when you find the status quo unacceptable? What is moving forward? How do I, and others who are similarly floored and dejected by what these events represent, pivot to meet the new reality in the world order and make sure that good work is not reversed?

Did I steal the title of this blog from Air Canada’s Olympic marketing campaign? I thought so…but then I remembered that President Obama said the same at the end of a speech in the Canadian Parliament in June. The Economist magazine recently called Canada ‘the last liberals’. Of course ‘we’ are not. We represent a mix of ideologies that happen to coexist more harmoniously here than most other places, perhaps. As an immigrant to Canada I see that tolerance and extending kindness are part of national identity. I’ve lived in two countries as an immigrant. Living in the other one was hard. I remained pretty much an outsider for 13 years. In Canada I have experienced nothing but warmth and welcome. It has been much more conducive to mental health, believe me!

And that’s my segue into talking about the health effects of the US presidential election campaign and last night’s result. In the short term, because of the divisive rhetoric that’s been delivered, many in America will be feeling afraid. If the aftermath of Brexit is anything to go by, a sector of the population will feel empowered to act out in a negative way, causing further harm, fear and division. There are going to be adverse mental health consequences, for sure. Further down the line, depending on political activity in Washington, there may be reduced access to health care coverage and reduced access to women’s reproductive services, followed by the important knock-on effects of those. Bothering me a great deal is Trump’s promise to pull the U.S. out of the Paris Climate Change agreement as soon as possible, and since the U.S. represents such a large percentage of global greenhouse gas emissions, not to mention air pollutants, that would be disastrous. The health effects of poorly mitigated climate change will be devastating and not just for Americans but for all people, including Canadians, and particularly our kids and those yet to be born. I’m concerned too about a worrying trend towards ignoring or mistrusting science and believing anything that sounds good. Trump has showed anti-medical-science leanings particularly on vaccination issues, which scientists are experiencing as unhelpful. With all the hard work it takes to ensure adequate knowledge translation in medical science the last thing we need is the ‘leader of the free world’ to be anti-science.

But this is not the time for more rhetoric. It’s time for more understanding, empathy and warmth. It’s time to reach out and break down barriers, to take extra care to include the marginalized. When things look bleak or difficult I often return to a Henry James quote that I first heard as a teen from a Presbyterian Minister:

“Three things in human life are important. The first is to be kind. The second is to be kind. And the third is to be kind.”

If I can’t fix the big things I can concentrate on being kind in my dealings with the human beings I meet. I like cynicism, cutting wit and satire as much as the next person, but they seldom serve me as well as being kind. For all our knowledge, medicines, procedures and policies, we in the health profession know that good listening, communication and advocacy is often the most important part of any patient-professional interaction. Engagement is key. Let’s stay engaged. Let’s take the one-person-at-a-time approach to shore up the failings of the big-picture approach. Let’s give ‘more Canada’.