The following essay was published in the Summer 2014 edition of Transition Magazine, a Canadian Mental Health Association publication. Digital copy available here.
You are lying on the street in cardiac arrest. I am obliged to inform your unconscious, breathless body of my newly acquired First Aid training. This, for some reason, is supposed to reassure you, as if my knowledge to enter three digits on a phone grabbed out of a bystander’s pocket changes the fact that your heart has ceased. All I can do is Check, Call, Care, and call bystanders to action, but according to the brawny male firefighters who taught my First Aid course, this should be reassuring. The fewer bystanders, the better, they said. According to said firefighters, CPR and portable defibrillators are so effective that you—unconscious, vulnerable, responsibility of the provincial healthcare and social services systems—shouldn’t worry about what will happen if you don’t wake up, but rather, what will happen if you do.
The day after I became First Aid certified, I heard a piece on public radio that spoke to the misconception of the effectiveness of CPR. When it comes to the point where a human is in cardiac arrest, known as a Code Blue, healthcare professionals are obligated to administer life-saving procedures. When doctors are confident that CPR will not save a life, or will greatly reduce the quality of life that remains, they will often fake it, for it “looks and feels like a really gruesome way to usher someone out of this world.”(1) They go through the motions of CPR without actually trying to save the life. They do it so the patient can die. Slow Code—they even have a name for it. When family and friends are watching a loved-one slip away, they cannot understand a doctor who would stand by idly and let their family member die. CPR, in this case, is a system for the conscience of the bystander, not for the person in emergency. The professionals do this because the system of resuscitation is flawed.
A friend was recently in the hospital. He got into a fight with three men half his age, he told me. Others claim that while inebriated, he tripped, the side of his head the first part of his body that struck the ground. Skull fracture and brain swelling which led to brain damage and memory loss. I visited him regularly—I sat there as an idle bystander contributing to his deteriorating health by supplying him with cigarettes which he forgot he had, as he basked in the overwhelming nature of his life of abuse and addiction. We played cards as he mumbled through the imagined traumatic experience of being locked in a house with three family members who beat him until he bled from the ears.
When my friend is discharged, he will leave the hospital to no home and to a family who can no longer give him the support he requires. The hospital can’t keep him forever. The rehabilitation centre says he is too high-functioning—a man who cannot remember where he put his paintbrush or the names of his brothers. The province cares not for the marginalized. An ethically responsible governing body cares for the vulnerable, but my friend will end up homeless in a week, one inevitable head injury away from complete debilitation. He has never met his social worker. The social worker in his ward blankly stated that it isn’t her problem once he is discharged. The workers search on their computers and make phone calls in vain, aiming to satisfy the bystanders, knowing that whatever they do, it won’t save his life, because, whether or not they know it, the system of resuscitation is flawed. To those within the social welfare system, this is the most receptive the state will ever be—just another case file in the colonial shell game that is the Canadian welfare state.
Those who have not dealt with the system imagine that it works for all. They imagine that the cracks through which people slip are fairy tales told from faraway lands. They can’t imagine a circumstance where someone would be left out in the cold after a traumatic event, because, they think, this is Canada, land of universal healthcare and equal aid for all. This liberal notion of equality of opportunity fails to understand the systemic racism which is fundamental to the colonial state. The gaps exist on purpose. The system of resuscitation is intentionally flawed—it is designed to appease the conscience of the bystander. But unlike a medical Slow Code, it is flawed in its design to take resources and power out from the trained field workers through lack of programs that offer proper supports. Fifty-percent of the Saskatchewan provincial budget is devoted to healthcare and social services, totalling over $5.5 billion per year.(2) With such a significant portion of the provincial budget devoted to two departments of human services, the general populace can only assume that the dollars are sufficient and effective; however, gaps in the departments are purposeful and widespread.
Aboriginal communities have been stunted by the implementation of provincial and federal social assistance programs, contributing “to the persistence of individual and community economic dependency.”(3) These programs run on outdated living allowances, low earning allowances making a transition to employment impossible, and lack of adequate supports for Aboriginal people living in urban centres or dealing with HIV/AIDS. These programs run on cycles of poverty and death. A growing number of Aboriginal people have been forced from reserves to urban centres, where it is exceedingly difficult to live as a traditional Aboriginal person. It is a direct extension of settler colonialism, originally performed under the mandate of pre-confederation’s Indian Affairs, whose policies to ‘civilize’ Aboriginal populations introduced the residential school system. Residential schools were decentralized into the provincially-run Ministry of Social Services, a ministry which continues to perpetuate the same exterminatory mandate. Slow Code Colonialism—neocolonial institutions created to emphasize the desires of the bystander and ignore the needs of the sick. Neocolonialism is already the disguise for cultural eradication and is further masked as the unavailability of programs due to lack of financial support. Where supports exist, resources do not. My friend qualifies for a bed in a home for those with Acquired Brain Injury, but only after sifting through a waiting list of several months, and not if he continues to battle his addiction. Fairytale cracks become real. The ministry that originally took responsibility for my friend as a young boy sent to a residential school, now waives this responsibility and deliberately leaves him to flop around on shore, their program near completion.
I was taught to Check, Call, Care. As your consciousness flickers, as shock sets in, I brush your hair from your forehead and tell you it will be alright. I lean close to your face to check your respiration. You are not breathing. Since I do not have my recommended mouth-cover, I begin compression-only CPR. I tell a bystander to call for help. I break your ribs and bounce up and down on your sternum with my arms locked at the elbows. The paramedics arrive. They are trained in emergency and begin Slow Code CPR, feigning an attempt at revival because that is what bystanders expect of them. There’s nothing we could do, they say, but I am appeased because of their valiant attempts at resuscitation. What they don’t tell me is that they were thinking about football when they were supposed to be pumping blood through your chest. You somehow survive despite the Slow Code, but you wake up with broken ribs, brain damage and you are expected to survive when you have no place to live and no family to care for you. And the system of resuscitation wins in its purposeful defectiveness.
“Sir John A. MacDonald’s policy of starving First Nations to death in order to make way for the western expansion of European settlers,” along with the residential school system, “meets the criteria of genocide…by omission, if not by deliberate commission,” says a letter to United Nations Rapporteur for Indigenous People.(4) The policy of nineteenth-century Canada differs from today’s policy of intentionally defective programs of social service only in thin veils of supposed goodwill. There is no greater place to hide genocidal policy than behind a department of human services. The only other difference between Canada’s previous policies of starvation and the policy of today is the time elapsed in which the extent of the genocide could be fully understood. And time will again pass.
The only way to stop Slow Code Colonialism is through a remodel of the system of resuscitation. The Ministry of Social Services is just one of the administrative programs that force subjugation by stamping out hope and dignity through “a complex web of city agencies and institutions that [regard] the poor as vermin,” Chris Hedges explains.(5) These programs work together to perpetuate the accepted state ideology by operating under the guise of being a protective force. The police who mine for crime by making arrests in communities of lower economic status work as the frontline of the repressive arms of the state. The military who break up blockades of First Nations fighting for liberation form another wing of Slow Code Colonialism. These structures work to protect the status and wealth of white middle class Canada, while ensuring the poor Aboriginal populations live in abject poverty, utterly subordinate to those who control the state. These structures project an image, and behind this image is a bloated bureaucracy focused not on remedying social evils, but on keeping these injustices out of the field of vision of polite society.
The system must be remodelled to one that does not look to appease the taxpayer, but rather to adequately serve the marginalized. This starts when bystanders become involved and demand that governments stop these hegemonic structures of administrative programs such as Social Assistance, the judicial system, the police and RCMP, and unregulated resource development that make up the branches of colonization. This will dismantle the less visible forms of “a very active system of settler colonialism.”(6) It starts with education and partnership that leads to real reconciliation “grounded in political resurgence” that “support[s] the regeneration of Indigenous languages, oral cultures, and traditions of governance.”(7) The system will be reformed when the programs intended to assist people do just that, instead of control, institutionalize, and cripple. As with any cooperative and proactive social system or community network, a welfare system administered by those to whom it caters is a democratizing step to reconciliation and empowerment. Aboriginal participation in the development of such strategies and programs is necessary to eventually eliminate the economic gap.(8) These state apparatuses will require more than just reform to make them democratic, but will require revolutionary change encouraged by grassroots movements like protests at Elsipogtog and Idle No More.
First Aid isn’t as futile as it may have seemed at first. Although I still tread in the overwhelming nature of ignorance of how to respond to an emergency more serious than hunger pangs, I at least know that the symptoms for stroke, diabetic shock, and extreme inebriation are identical. I now know that the systems they taught me are evolving and changing because their legitimacy is still highly in question. I am no longer a bystander, but a person of direct action. The fewer bystanders, the better, they told me. With fewer bystanders, Slow Code Colonialism can shift to a more balanced paradigm of moral care for all.
1. Goldman, Dr. B, (writer). Goodes, Jeff, (producer). 2013. “Slow Code.” White Coat, Black Art. CBC Radio 1. (http://www.cbc.ca/whitecoat/2013/10/18/slow-code/)
2. Saskatchewan Provincial Budget Summary, Ken Krawetz Minister of Finance, Government of Saskatchewan, 2013-14 GRF Expense, p44. (http://www.finance.gov.sk.ca/budget2013-14/2013-14BudgetSummary.pdf)
3. Report of the Royal Commission on Aboriginal People. 1996. Ottawa, Indian and Northern Affairs Canada. Volume 2, Part 1, Chapter 5, Section 2.9 (http://www.collectionscanada.gc.ca/webarchives/20071211061313/http://www.ainc-inac.gc.ca/ch/rcap/sg/sh88_e.html)
4. Fontaine, Phil. Farber, Bernie. 2013. “What Canada committed against First Nations was genocide. The UN should recognize it.” The Globe and Mail. October 14. (http://www.theglobeandmail.com/globe-debate/what-canada-committed-against-first-nations-was-genocide-the-un-should-recognize-it/article14853747/)
5. Hedges, Chris. 2005. Losing Moses on the Freeway. New York, NY: Free Press, Chapter 1, p17
6. Simpson, Leanne. 2013. “Elsipogtog Everywhere.” October 20. Retrieved October 21, 2005 (leannesimpson.ca/2013/10/20/elsipogtog-everywhere/)
7. Simpson, Leanne. 2011. Dancing On Our Turtle’s Back. Winnipeg, MB: Arbeiter Ring Publishing, Back cover
8. Painter, Marv. Lendsey, Kelly. Howe, Eric. 2000. “Managing Saskatchewan’s Expanding Aboriginal Economic Gap.” The Journal of Aboriginal Economic Development. Volume 1, Number 2, p42