Watching And Waiting At St. Paul's

 

Recently I had the experience of being admitted to the emergency ward of the venerable St. Paul's hospital for a gallbladder attack. Having never had any surgery in my life it would prove to be an eye opener on how our health system functions. Sadly, it would confirm what many have already been saying about our most sacred of Canadian institutions. It's broken. 

The ambulance got to our apartment quickly and, after a mercifully quick diagnosis, I was provided with some morphine and a warm bed in a busy triage area. All around me were people in various stages of pain, disorientation, and distress. However, so far so good, now that I was settling down and my pain was under control. 

Later that night I was moved into a bed in the surgical ward and hooked up to an IV that provided my body with all sorts of essential fluids. With surgery possible at any time, no food or liquids were permitted. Things now settled into a waiting game broken up by CT scans, MRIs, blood work, and other diagnostic tests.

St. Paul's has 14 operating rooms but only one is set aside for emergency surgery. The others are booked months in advance for everything from heart transplants and other lung/cardiac surgery to hip and knee replacement, and cancer treatment. The emergency operating room also has to handle any issues with women in labour. Anyone needing emergency surgery has to wait in a line that's constantly being revised based on how acute the need. A person like me who is comfortably sedated in a surgical ward quickly slips to the back of the line when traffic accidents or other life threatening emergencies upset the order in the queue.

The bad news was it would take another four days before I finally got my turn and the doctors could remove my gallbladder (a procedure called a cholecystectomy). The good news is that advances in medical techniques meant that, instead of being opened up with a huge incision like my father had to undergo, they were able to use a surgical procedure called laparoscopy that allows the surgeon to make small incisions in the abdomen with the aid of a camera (a laparoscope). 

Everyone from the cleaning staff to the technicians, nurses, and doctors were wonderful. Friendly, upbeat, and professional there was nothing to complain about. The only problem is there weren't enough of them. Without people the whole system grinds to a halt, and a lack of staff is the main reason there is such a backlog of surgeries and why the operating rooms have only one shift. This is not just a problem at St. Paul's, it's the same problem at all the hospitals. But why is so hard to get medical staff in this country?

Part of the problem might be that the UBC Medical School admitted less than 300 students out of the 2,500 that applied. Or McGill that only admitted 215 out of 3,600 that applied. This year Queens decided to have a lottery for their 139 spots and 5,000 qualified students are expected to put their name in the hat. Clearly the demand for more doctors should indicate the medical schools in this country need to increase enrollment, but no. Finally, after 55 years, the first new medical school in Western Canada will be opening at the SFU campus in Surrey.

Not only are we not turning out enough medical students in this country, we are robbing other countries of their medical students. 16% of our surgeons, 25% of our specialists and 31% of our family doctors are coming from outside Canada. The situation isn't much different for nurses or medical technicians.

It's been 40 years since the Canada Health Act went into effect and provided universal care to any resident of Canada. Unfortunately for the Federal government, under the terms of the Constitution, health care is a Provincial responsibility. The only control the Federal government has over health care is by creating the terms by which it will pay for everything. In the meantime we have a mishmash of record keeping, policies, regulations and licensing that varies from Province to Province. There is no incentive for the Provinces to graduate enough medical staff, reduce emergency and specialist wait times, or clear the surgical backlog because the feds haven't applied enough pressure to demand measureable results. In the meantime we all watch and wait for change at our nearest hospital.

A Tale Of Two Cities/Pools

 

Between the slowly deteriorating Vancouver Aquatic Centre and the rapidly deteriorating Kits Pool, residents of the Westside might be wondering where they are going to be able to go for a swim in the near future. The Aquatic Centre was recently partially closed for roof repairs after a power washing of the moss (that appears to be holding the facility together) caused pieces to fall off inside. This was only a year or so after the front of the building fell off thanks to a rusted out frame. Meanwhile over at Kits Pool the cumulative damage of winter storms and high tides have destroyed the seawall around the pool and cracked the deck to the extent that it is leaking 30,000 litres per hour.

In spite of an architectual firm being hired to design a new Aquatic Centre and money raised to pay for its construction there is still no information as to where or when it will be constructed, never mind if it will get built before the old facility collapses. As far as Kits Pool goes there is no plan or budget whatsoever for its repair or replacement. Is it any wonder the public is fed up with the Parks Board?

Hopefully by selecting the same firm UBC used to redesign their swimming facility we might end up with something that takes advantage of the stunning oceanside location and makes use of glass and light instead of the brutalist bunker style design we've had to put up with for the past 50 years.

While there is hope the new Aquatic Centre may be built in the next 5-10 years, sadly there is no timeline for Kits Pool. For anyone wanting an outdoor, next to the ocean, swimming experience the only other pool is at 2nd Beach. Built in 1996 the public is still waiting 28 years later for the changing facilities, washrooms, and showers that have been promised and not built. Yet another example of Parks Board incompetence.

There is however another possible solution for combining an indoor and outdoor experience and for that we could look at what Paris has done in time for the 2024 Olympics. Here they have taken a 100 year old facility (built for the 1924 Olympics) and completely renovated it with a retractable roof. Swimmers have the best of both worlds (indoor and outdoor) and 90% of the construction waste will be reused or recycled.

A little wit and imagination can go a long way in solving problems if there is a will to look at options and take a lead in addressing issues instead of ignoring them until everything falls apart. Swimming pools are a vital component of city life and we need to demand more from our elected officials in how they are designed and maintained. Getting rid of the Parks Board is a start.

In The Long Run

 

Like most other homeowners in B.C. I recently received my 2024 Property Assessment Notice and the first thing I noticed about the taxable value (which is 4.5 times what I originally paid for the property) is that the land value makes up 85% of the total and the building itself is only 15% of the total. My apartment is in Vancouver's west end, where older buildings are selling for $1,000.00 per square foot and newer ones anywhere from $1,500.00 - $3,000.00 per square foot. However, according to various sources, the actual construction cost is only between $100-$300 per square foot and the rest is all land cost.

Clearly it isn't the cost of construction that is driving the insane prices that have plagued the Greater Vancouver area over the past 20 years, it's the land values. And when you consider that buildings only depreciate in value as they age, the numbers are even more disturbing. But, rather than point fingers at what may or may not be the forces behind this rise in property values, perhaps this is an opportunity to look at things a little differently in order to solve a problem that is vexing anyone who lives here.

Instead of trying to own the land, why not just lease it instead? It's the new model for any land the First Nations own and are developing. It's also the way the kings, queens, and assorted nobility in the U.K. do it. Go ahead and try to buy land in Mayfair or Knightsbridge, you can only lease. You can own your apartment or townhouse but not the land it sits on. For that you have options, like paying a monthly lease payment or having the lease payment built into the cost of the apartment. The lease can be 100 years or more and it can also be renewed when it expires. 

The trouble with leased land in Vancouver is there isn't much of it. Most of the land around the south side of False Creek is city owned land on lease to the various tenants but the vast majority of land is freehold. So how can we free up more land for leasing?

The proposed Jericho development is one place. Here the Musqueam, Squamish, and Tsleil-Waututh First Nations, who have bought the land, have formed a company called MST Developments and their plan is to develop the site with a mix of 13,000 rentals and leasehold condos. In keeping with their philosophy that nobody can really own the land, the First Nations are taking a long term rental/lease approach that will provide them with an income stream that lasts forever.

 

Perhaps another contributing factor to Vancouver's high land prices is the exceptionally low property tax rates. Raising the rates would not only provide the city with more revenue to support parks, recreation, and transit services, it would make the land less attractive to investors and lower the price. But with Vancouver property owners mostly land rich and cash poor perhaps a program, whereby the government buys back the land from individuals and then leases it to them on a monthly basis, would be a way to add more leasehold property to the available inventory and build up an income stream that would last into perpetuity.

Under this plan people could still buy and sell their home but without ownership of the land the price would be easily affordable to just about anyone. A brand new 2,000 square foot home would be no more than $600,000.00 and an older home would be considerably cheaper as it would be depreciating every year. Instead of thinking of a home as an investment it should be viewed as an affordable place to live and raise a family. Let the government and First Nations own the land it's the most cost effective solution in the long run.

Life & Death In Stanley Park

 

There have been a couple of sights in and around Stanley Park that have really caught the eye of the locals lately. One of them is the collection of sea lions, seals, and seagulls that have suddenly congregated around the end of Coal Harbour. They have all come for the herring which have mysteriously appeared and are providing a surprise Xmas feast. 

Herring used to be the most plentiful fish in B.C. until the commercial fishery nearly wiped them out in the 1960's. This had a profound impact on First Nations culture and the coastal ecosystem. Herring are one of the most important fish in B.C. as they are the principle diet of other fish, seabirds, and sea mammals and are critical to the diet of Chinook salmon which in turn are the primary food source of the Southern Resident Orcas. 

Herring spawn by the millions with each female laying 10,000 eggs or more, and when the males release their milt to fertilize the eggs they turn the ocean into a milky aquamarine colour that can stretch for miles along the coastline. Unlike salmon, herring are repeat spawners and once they have matured they can live for up to 10 years. However, just like salmon they have a homing instinct that allows them to return to where they were originally born.

A group called the Squamish Streamkeepers has been successful in re-introducing herring to False Creek using artificial spawning substrate panels for the eggs to lie on instead of eel grass, the native spawning substrate. In 2021 they expanded the program to Coal Harbour. But another key factor are dock pilings, which in the past used to be creosote which is basically toxic to herring. New docks, like the ones at the end of Coal Harbour, made out of concrete and steel provide a habitat that is more conducive to spawning herring. It takes 3 years for the eggs to hatch and mature at sea but it seems the program is a success as evidenced by the feeding frenzy going on. Hopefully they won't eat everything and the fish will have a chance to spawn.

Meanwhile over in the Park itself another type of harvest is underway, and one not nearly as positive, as workers try to cull all of the infected hemlock trees. Over the past 5 years an ongoing infestation of the Western hemlock looper moth has devastated the Stanley Park forest as well as many trees in North and West Vancouver. While it's a native insect that normally attacks trees in 20 year cycles, conditions have allowed the moths to persist way beyond their normal time frame and now a staggering 166,000 trees have to be cut down in order to prevent injuries from dead and dying trees.

According to the Forest Service the Western hemlock looper is one of the most destructive forest defoliators in B.C. They overwinter as eggs laid on the bark and then hatch in late spring. The larvae then feed heavily on the foliage of mature stands throughout the summer. The larvae are wasteful feeders gobbling up both new and old foliage and leaving behind partially consumed needles. In late summer the larvae pupate and are in flight until early fall.

Severe defoliation leads to top kill and tree mortality and if you walk through the Park you can see that almost every hemlock tree is nothing but black branches and the trees are all dying. It's a sad and depressing forest and a huge mess to clean up. Fortunately the Red Cedar and Douglas Fir trees seem to be spared. Most of the wood is being left behind as nursery logs but the branches and brush have to be cleared away in order to not become fuel for a forest fire which is increasingly becoming a real possibility.

So on one side of the Park we have what looks like a successful return of the herring while inside the Park the trees are dying at a furious rate. It's Life and Death in Stanley Park but it sure provides a lot of photo opportunities.