By PETER GZOWSKI
Saturday, July 28, 2001
Although the weather eased off by about Wednesday, this was a tough week at the Breathing Academy, even -- maybe especially -- for those of us in day school, where there was an unusual amount of absenteeism. On a couple of days, the air in and around Toronto was too putrid for even a lot of people with breathing problems to get to the place where they are trying to do something about their troubles.
(If you're looking for other overtones of irony in attacks of heavy smog -- Central and Atlantic Canada have been suffering and in Ontario we're headed for a record in smog warnings this year -- consider this: One of the Ontario Environment Ministry's pieces of advice is to turn down your air conditioner when a smog alert goes out. Helpful as it would be in the long term -- if everyone obeyed -- it is to the clients of the Breathing Academy a little like telling a drowning man he should stop struggling for shore and have a glass of water.)
The Breathing Academy is my affectionate name for the West Park Healthcare Centre, an institution in northwest Toronto that once bore the Dickensian title of the Toronto Hospital for the Consumptive Poor. (Let's not forget this city also used to have a Hospital for Incurable Children.) Later, it housed the Weston Sanatorium.
Although it still treats tuberculosis (the Weston San is where tubercular Inuit were once shipped), it has, since about 1980, specialized in rehabilitative medicine, most notably in the field of respiratory rehab. This is the work for which it is known and widely respected all over the country, if not around the world.
I learned about West Park the way far too many people do, at the same time I first heard the initials COPD.
That was not quite two years ago, when a respirologist told me, although I had recently quit smoking, I had chronic obstructive pulmonary disease, a catch-all for both chronic bronchitis and emphysema. (Nearly all emphysema is caused by smoking.)
COPD is the fourth-leading killer disease of the elderly. It's headed toward third as the smoking generation -- that which survives -- grows old and as women smokers, who used to be far outnumbered by men, move into God's waiting room.
The most conservative estimate, for it's based only on the number of people who told the census taker they'd been diagnosed "by a health professional," is that 750,000 Canadians suffer from it. But doctors in the field think it's half again as high as that.
Why isn't it higher on the public agenda?
For one thing, says Dr. Roger Goldstein, the head of West Park, few people have heard of it. For another, and laugh if you will, we sufferers would make pretty sorry picketers. It's hard to carry a placard when you have tubes up your nose and are pushing a rollator in front of you, a kind of baby buggy with an oxygen tank instead of a baby.
West Park's clientele -- the word "patient" is seldom used -- includes people with many infirmities other than COPD. There are amputees learning to walk again. The aged who need help. Adults with muscular dystrophy zooming around on their "sip-and-puff" wheelchairs (operated by breathing tubes), including a couple taking university courses by sip-and-puff computers. People with ALS (amyotrophic lateral sclerosis or Lou Gehrig's disease). People building themselves up for transplants or acquainting themselves with life with a new pair of lungs. And others who, with their families, are being prepared for life at home on a ventilator.
It can be a heart-lifting place to be, staffed by professionals who seem driven by the single desire to be both friendly and helpful. The live-in population would make an interesting and moving case study of people pondering the difference between quantity and quality of life.
For us COPDers, though, I think Goldstein omits one ingredient in his list of why our affliction isn't higher on the public radar screen: guilt.
No one at West Park ever blames you for the smoking that almost certainly took you there in the first place (though they won't take you in if you still do it).
And I don't think a cigarette company would ever get a thank-you note from any of us (though the only people I've ever thought of suing are Humphrey Bogart and Edward R. Murrow). We know, don't we?
But the muggy air is a different question.
The day school I attend now (again, my own affectionate phrase) is an out-patient program. For many of us, it's a continuation of what we were working on in our live-in days: learning how to use and strengthen muscles to help do the work of our failing lungs, or just reinforcing the changes we need to make in our lives and lifestyles.
For others, it's an introduction to what all of us need: medications (including oxygen), guidance on dealing with our limitations, including new ways to do everything from getting dressed to having a shower (usually in the other order). It all helps, believe me, and though we're using up some health dollars now, we're building lives that will help to pay at least some of it back.
So when the air gets so bad you can't even make it to class, you get angry. About the squabbling over the Kyoto protocol on greenhouse gasses. Gas-guzzlers carrying one person to work. Factories that belch noxious smoke.
All it would take for a little relief is some evidence of political guts, even if it means standing up to the corporate mentality of profits uber alles, and not only here at home. Maybe there was a difference between George W. Bush and Al Gore after all.
Maybe some of the leaders should go to West Park for a while and talk about quality of life. If we could quit smoking, anyone can.