One morning in 2009, Brian Goldman interviewed Michael
Wansbrough in the doctors’ lounge at Toronto’s Mount Sinai Hospital. They
discussed a pill the two had used to get through long night shifts. Modafinil,
the generic name for a drug originally developed to treat narcolepsy, has been
approved for shift workers, but it’s still a controversial way to stay awake. “Well,
as an alternative to coffee, it seemed like it was worth trying and from what I
could ascertain, nobody had died from modafinil,” Wansbrough said. “Now I know,
from further research, that the lethal dose of modafinil is less than—or more
than that of coffee, so…forgot what I was talking about.”
“You haven’t finished a night shift now, have you?” asked
Goldman.
“I’m actually quite tired and I could probably use 100
milligrams of modafinil,” admitted Wansbrough. “It’s not something that you
want to bring up with other people for the fear that they will think that
you’ve got an addiction problem.... What are people out there going to think?
They’re going to think, ‘Here’s a pill-popping doctor.’”
When the interview aired on White Coat, Black Art, Goldman’s CBC Radio show, many listeners
were angry and concerned that physicians were using drugs to manage long nights
at the hospital. So the next week, Goldman responded by arguing that the
practice was safe and backed by research. And in his book, The Night Shift, he argued that it’s unfair for the public to
insist doctors don’t take pills to stay awake while still demanding that they
not make mistakes. “Do you want me clean, or do you want me to know the
difference between diazepam and diltiazem?”
An insomniac and a father of two, Goldman pulls night
shifts in the emergency room and still hosts his show, acting as the “house
doctor” for CBC Radio. Juggling his two careers requires dedication—and gives
him a lot of reasons to use the drug. But he says that he leads a carefully
balanced life, for the most part, working several night shifts a month at the
hospital and toiling at CBC during the day, while still finding time to spend
with his wife and children. Since money certainly isn’t what attracts a doctor
to journalism, Goldman says what makes it all worthwhile is the feedback from
listeners, especially when he pulls back the curtain on the medical industry,
often to the chagrin of those on his side of the gurney.
White Coat, Black
Art is not the
55-year-old’s first venture into journalism. He’s been in radio and television
for 24 years, and has written for The
Globe and Mail, the Toronto Star
and Maclean’s since he was a resident
at Sunnybrook Hospital in the early 1980s. As an intern at Toronto’s Hospital
for Sick Children, he wrote most of an unpublished novel about a patient who is
in a psychoanalyst’s waiting room. In 1981, the Globe published his first article, which was on estrogen receptors
and breast cancer. He took a radio documentary course at Ryerson University and one of
his projects, a 27-minute doc on prescription drug trafficking, aired on CBC
Radio’s Sunday Morning. From there,
Goldman worked as a medical reporter for CBC’s The Health Show and The
National before becoming the senior production executive at the Discovery
Health Channel.
When Goldman left Discovery Health in 2002, he continued
to work as a columnist for CBC Radio syndication, but felt lost about what to
do next. In 2005, he wrote a proposal for a book called Medical BS, an exposé of the medical industry. Publishers thought
it was too negative, so when CBC Radio put out a call for show proposals, he
sent it in. And 10 episodes of White
Coat, Black Art aired in the summer of 2007. Chris Boyce, the executive
director of radio and audio at CBC, oversaw the program’s development and was
initially skeptical about its appeal for a larger audience. “But I stopped
looking at it as about a doctor and the medical profession,” he says, “and
started thinking about it as a really compelling storytelling vehicle for
stories about health and medicine.”
The first couple of seasons addressed why doctors were
often late for appointments, explained the origin of the white coat in medicine
and broke down how the emergency room works. After that, Boyce was concerned
the show might not be sustainable—until Goldman showed up with five pages of
new ideas. The show has since explored more complex and contentious issues such
as euthanasia, pain and addiction and doctor-patient boundaries.
Although listeners keep tuning into White Coat, Black Art, some doctors aren’t so keen on it. Irvin
Wolkoff is a Toronto-based psychiatrist who has hosted House Calls, a syndicated show, and Love 911, which aired on the Life Network (now Slice). He has also
been a columnist for the Toronto Star
and CBC Radio. Wolkoff says the medical industry needs an insider who can be
critical and offer insight to the public, but he is sometimes uncomfortable
with the way Goldman exposes the industry and doesn’t like the way the show
panders to an anti-science, anti-medical audience. “The villains are always the
same: big medicine, Big Pharma. I don’t need a show where it’s just an endless
litany of things being done wrong or badly,” he says. “The title says it all:
black art…. I don’t do any witchcraft.”
Still, he’s glad “a real doctor with real journalistic
skills, who can keep politics and ideology at bay and stick to the facts” is
doing the show. Having worked in journalism since the mid-’80s, Wolkoff argues
the best health reporting comes from doctors trained in journalism, since they
know the research and science better than those without a medical background.
But even doctors must be careful not to oversimplify or falsify for the sake of
a dramatic headline.
Despite his criticisms,
Wolkoff believes he and Goldman have a lot in common. Both put aside other
interests—performing and writing—to concentrate on med school, but both have
found a way to combine journalism and medicine that allows them to reach a
large audience. “When you’re seeing patients, you can do good, one person at a
time,” he says. “When you do broadcast, you can touch millions of people.”