Ideas - Why hospitals stopped being hospitable

Episode Date: November 26, 2025

Hospitality — and hospitals. Two words that share a root, but whose meanings often seem at odds with each other. IDEAS traces the historical roots of hospitals, the tension between hospitality and discipline that has defined hospitals throughout their history, and what it means to create a hospitable hospital in the 21st century. *This is the third episode in our series, The Idea of Home, which originally aired on June 15, 2022.People you will hear in this podcast: Rachel Kowalsky is a pediatric emergency physician at New York—Presbyterian Weill Cornell Medicine in New York City. She co-created a website called Our Break Room to share poems and stories for healthcare workers. Joshna Maharaj is a Toronto-based chef and activist, and the author of Take Back the Tray: Revolutionizing Food in Hospitals, Schools and Other Institutions.Kathy Loon is executive lead for Indigenous collaboration & relations at Sioux Lookout Meno Ya Win Health Centre (SLMHC) and a member of Slate Falls First Nation. Carole Rawcliffe is professor emerita of medieval history at the University of East Anglia. She specializes in the history of medieval medicine and early hospitals. Kevin Siena is a professor of history at Trent University. He specializes in the history of medicine and the history of hospitals in England in the 16th, 17th and 18th centuries. David Goldstein is an associate professor of English at York University, where he is also the coordinator of the creative writing program. He is the co-editor of Early Modern Hospitality. This episode also includes a clip from a 2016 CBC Radio interview with Maureen Lux, professor of history at Brock University and the author of Separate Beds: A History of Indian Hospitals in Canada. 

This program is brought to you in part by Spex Savers. Every day, your eyes go through a lot. Squinting at screens, driving into the bright sun, reading in dim light, even late-night drives. That's why regular eye exams are so important. At Spec Savers, every standard eye exam includes an advanced OCT 3D eye scan, technology that helps independent optometrists detect eye and health conditions at their earliest stages. Take care of your eyes. Book your eye exam at Specsavers today from just $99, including an OCT scan.

Book at specksavers.cavers.caps are provided by independent optometrists. Prices may vary by location. Visit specksavers.cavers.cai to learn more. This is a CBC podcast. Welcome to IDES. I'm Nala Ayyed. Illness or injury can suddenly turn the world into a frightening place. A person's often prompted to come to the ER by fear. Going to the emergency room means scrambling out the door at any hour. Often they leave home in a hurry, so they haven't brought their sweater, and it's cold in the ER, or they haven't brought a snack, and they're waiting a long time.

They haven't brought diapers for their baby. Whenever we go to the hospital, we're of course seeking medical attention, but we're also looking for something else, hospitality. The meaning of hospitality is something that we talk about a lot in emergency medicine because we're the front door of the hospital. So how would you describe how hospitable the average hospital is today? So the average hospital is very minimally hospitable. For sure, we have lots of hospitals offering excellent medical care and attention. The trick is that it is such an isolated experience. Maybe you don't get to spend as long recuperating in a bed. You don't have as many human touch points, right? You clearly are not getting fed, A, good food or B, good food that you actually need to encourage the healing depending on what is going on in your body. So the hospitality is shocking. low.

Today on Ideas, the third installment in our series, The Idea of Home. This episode explores the complex borderlands between hospitality and hospitals, and we begin with the words themselves. So can you remember the first moment that got you thinking about the relationship between the words hospitality and hospitality? hospital. Yes, I was walking through the halls at the Scarborough Hospital. I kept seeing the word hospital, but the chef inside of me was obviously registering the hospitality. And then, like, in the middle of that sort of, you know, rather gloomy hallway, I was like, wait a minute,

wait a minute, what is this all about? These words are so close. What is this all about? And I literally went into the office that I had and looked it up. Right? I was, like linguistic roots of the word hospital is what I was chasing. It comes from hospitium or a refuge, a place where you can go and stay. It's also from the Latin root hospice. The word for stranger or foreigner. So to me, the hospital is a place of caring for that stranger or foreigner. My name is Rachel Kowalski.

I'm a pediatric emergency medicine physician, and I work at New York Presbyterian while Cornell medicine in New York City, hospitality means caring for somebody, sheltering them, nourishing them, making them feel better. My chef eyes know hospitality, and the definition around hospitality is being the relationship between guest and host. And it really emphasizes the idea

that it doesn't matter who arrives at your table. My name is Joshno Maharaj. I'm a chef and activist and new author. I've just written a book called Take Back the Tray, rethinking of food service in public institutions, hospital schools and other public institutions. This is, I think, one of the most beautiful things about hospitality. It's regardless of the face, whether they can pay like it does not matter.

A guest is a guest. First, it's sort of beautiful to find the connection. But then I was like, my goodness, look at how far we have gone. The earliest hospitals in medieval England were radically different from the hospitals we know today. These are places which really offer hospitality. These are for anyone who needs succour and help. My name is Carol Ralkiffe,

and I'm Professor Emeritus of Medieval History. at the University of East Anglic. And I specialize in the study of medieval medicine and hospitals. One of the premier functions of all these places is to care for the soul as much as the body. They grow out of monasteries. There are sort of institutions of the church, of the Catholic Church in the Middle Ages.

They're not specifically medical until a bit later. My name is Kevin Siena and I'm professor of history at Trent University up in Peterborough, Ontario. I specialize in the history of medicine and the history of hospitals in England in the 16th, 17th, and 18th century. These are institutions which offer care for travellers and the needy and the disabled, the aged, the blind, the sick. And it's quite hard really to make a distinction because in this period a lot of people would be malnourished and therefore they would be quite sick but really only need a few good meals and then they might be able to go on their way again.

So just to give you one example, the hospital in Norwich, which is where I am today, let's say it's 1280 and you're arriving at the hospital of St Giles and queuing up outside the gatehouse. If you were sick or you looked to as if you were malnourished and you need of food. Then you'd been taken in. You might be given a bed for the night, or if you were sick, you would stay there till you got better or you'd die.

And if the weather's cold, and I like this ruling, this is the ruling of the founder, Bishop Walter Sutton, you'd be allowed to go inside and have a warm meal by the fire. And it's pretty cold in these days, now it's cold with Canada, though. But I think people would have welcomed the food in winter when they were sitting by the fire.

Food, in a medieval context, is medicine, because people were very much influenced by the ideas of the great Greek physician Galen, and he maintained that you are what you eat. Flammatic bile comes about from sleep, drinking water, the consumption of seafood, food and moist diets in general, and viscous edibles that consist of thick particles. Blood is generated by eggs, fowl, and all those foods that are both wholesome and easy to cook. And so if you go in, if you're malnourished, then you go into the hospital of St. Gars in Norwich, the sort of diet that you would receive would be part of your treatment. And it would include fish, it would include herring.

They didn't know about it on with the three, but they didn't know it was nutritious. They would have had what is called potage, which is a kind of thickish porridge, which has got vegetables and bacon in it, and it's very, very nutritious. They would have had home-baked bread, which was made on the premises, and home-brewed beer or ale. They would have had eggs from the hospital's hems. They would have had milk and milk products from the hospital's cows. They would have had bacon because the hospital had.

had pigs and it had little pig styles, which we know were thatched. There would also have been herbs because these are grown in great profusion by the sisters, the hospital sisters, in their herb garden. And they also had orchards where they would have had fruit. Now, I don't know about you, but that's not a bad diet. And it's a lot better than the pre-packed sandwiches with curly white bread that you can be delivered in an NHS. hospital today. So given the choice, I think some of us will be voting 14th or 15th century, don't you? I just love the notion of from the hospital's chickens that lay the eggs or the

hospital's pigs, right? Or the herbs that grow in the garden, it just makes so much sense. And I love the history of it because that the message is important, which is we used to know how to do this. So with that picture in mind, having heard that what sounds like a utopian hospital food setting, paint me a picture of the typical food tray that's served for those who have not experienced it. Yes, the luckies, indeed. A food served in a Canadian hospital today. What does it look like, smell like? Right. So the look is like a plastic, that very familiar plastic cafeteria style tray. Maybe there's a sandwich. It will be made on very highly processed bread.

There may be a little salad on the side. Maybe it's a green salad. Not likely. More likely, it's like maybe a packaged coleslaw that is in that really recognizable ice cream scoop. But I think that the industrial dishwasher really kills all the magic in these dishes. So the water just is like memories of warmth, right? But there'll be a tea bag and some sort of sad hot water and a little like sweetener packet because there definitely won't be any sugar. You will choke it back because you know you need to eat something.

and you will be wholeheartedly unsatisfied. For Joshna Maharash, the lackluster food in hospitals, isn't just an irritation. It's a form of in-hospitality that chips away at people's dignity and well-being. The father, father of a dear friend and colleague, but also a good friend of mine, he and his family have run restaurants here in Toronto for some 45 years or something wonderful like that. And unfortunately he got really sick and has spent his last days in the hospital, but I thought to myself, this man has put so many plates of food down in front of other people, offering such gracious hospitality and that at the end of his life, you know, when he got so sick, when he needed, his body and his spirit needed some of that hospitality back, it was just not there for him. And that breaks my heart to think about. It's such a disrespect in a regular sense to people, but to somebody who's life was devoted to serving people good food. It is, oh, it broke my heart to find and to know that those were his last meals

because, unfortunately, he did pass away a few weeks ago. Of course, the people who ran hospitals in the Middle Ages didn't offer their hospitality solely out of the goodness of their hearts. The idea of if you were a founder is that you provide a hospital because it will benefit your immortal soul. And if you're founder, you are necessarily rich. And so it's a bit tougher getting into heaven than if you're poor. So you need, if you like, you need a deposit account in the great treasury of marriage, and put it that way. And this takes us back, again to the fact these institutions are religious,

to the fact that they are following the comfortable works. And these are works which are set out and described by Christ in Matthews, Chapter 25. For I was hungry and you gave me something to eat. I was thirsty and you gave me something to drink. I was a stranger and you invited me in. But of course, we had to remember that attitudes change. How many families fell by that consumption?

How many householders did that sickness carry away? Did one in a thousand escape it? The plague pamphlets of Thomas Decker. Well, I think it's really interesting to look at similar situations. to what we're facing now, which is, for example, a disease that is ravaging a huge area, in this case the world. In the early modern period, we're talking mostly about the bubonic plague. And the way in which societies respond to that upheaval is really interesting to me. And for the most part, they respond negatively. They respond out of fear and out of

sense of trauma and protection. My name is David Goldstein. I'm a professor of English literature at York University, where I also run the creative writing program. And I work on issues related to food and literature, to hospitality, and early modern literature, including Shakespeare, Milton, and their contemporaries. In the early 17th century, there was a particularly bad, episode of Plague in London. And the pamphleteer and dramatic poet, who is a contemporary Shakespeare's, Thomas Decker,

writes a moral fable about, I think, about hospitality and also about just an almost eyewitness account of what happened. A man is traveling outside of London, trying to escape the plague. He comes to an inn. he's let in but only he has to kind of stand outside of the door 30 feet I mean there's social distancing back then as well as now all of the doors are shut this inn is the only place that will let anyone in the casements were shut more close than a usurer's greasy velvet pouch

the drawing windows were hanged drawn and quartered not a mousehole left open. He starts to feel sick. He tries to come back the next morning to get a little more food, and now he's shut entirely out. They say, look, if you have symptoms, I'm sorry, but we can't, you know, symptoms. And wherever you quarantine is out of here. The host and hostess ran over one another into the backside, the maids into the orchard

quivering and quaking and ready to hang themselves on the innocent plum trees. for hanging to them would not be so sore a death as the plague. So he starts walking and gets sicker and sicker, and he runs across a man who sees in what dire straits he's in, and just helps him. This man takes care of him until he dies, promises to bring all of his important belongings back to his wife and children in London, gives all of these items to his loved ones, and then he himself dies.

The bringer of these heavy tidings, the very next day after his coming home, departed out of this world to receive his reward in the spiritual court of heaven. I think it's meant more as a morality tale. In the most extreme circumstances, when plague is at your door, you still have to open it.

Otherwise, there's no more society. There's no more community. Community during times of plague is also a major theme in Giovanni Boccache. 14th century collection of stories, the decamarin. Bocchio wrote the decamarin in a similar moment that Thomas Decker was writing, but a century and a half earlier, the plague has hit Florence. And what are people going to do?

Well, the people who have money race out of the city and go to their country homes. If this sounds familiar, you know, it is. It's always been happening. And Bocchio starts the narrative by saying, this was a period in which the virtue of hospitality collapsed. The bonds between humans were no longer there. Diverse fears and conceits were begotten in those who abode alive, which well nigh all tended to a barbarous conclusion,

namely to shun and flee from the sick. And yet the book is about 10 people who get together to protect community and to tell each other the stories of human community, some of which are really positive, some of which are really negative, all kinds of different. But it's the panoply of the human experience that gets retold and therefore saved up, right?

Almost like a time capsule. Like, this is awful. We may not survive it, but maybe there will be another generation that does manage to make it through and they'll have these stories and they'll be able to use them to kind of rebuild civilization.

But the society rebuilt after the Black Death took a radically altered view of hospitality. The Black Death has an amazing impact on these ideas about hospitality and hospital. And we need to remember that the Black Death is not just one epidemic in 1748-50. It comes back regularly, time after time, after time. With a result that the population of England

doesn't just fall, but remains at a sort of zero growth level for a very long time, with the result that there's a lot of food to go around and there are a lot of jobs. And Parliament and other elite institutions become very worried that people may not be playing the game. You know, they may be vagrant, they may be begging when they can actually work. And therefore, the idea of supporting anyone who's a vagrant becomes particularly abhorrent. Vagabonds, idle and suspected persons, shall be set in the stocks for three days and three nights and have none other sustenance but bread and water, and then shall be put out of town. The Vagabonds and Beggers Act 1494.

And so the institutions that at one time were found it for anybody, we find that the masters are actually turning them into private hospitals. And the bed that were at one time set aside for the court actually made a vote. of paying patients, which is something which, of course, exercises us today. It's the privatisation of the NHS, but it's happening at an earlier day. For example, here in Norwich, at the Hospital of St. Giles, in the 1540s, this is turned into a refuge for the deserving poor who are resident, and it completely stops handing out meals and clothing and support for the vague and poor. There's a real shift because by this date, you do not want to

encourage sturdy beggars. Idleness becomes the cardinal sin. And there's this sense that the poor are poor because they are lazy. And the sort of healthy beggar is like the poster child of this whole rhetoric. You don't give them poorly either. You know, they're out on the road. As one English politician had it not that many years ago, it's on your bike. I grew up in the 30s with an unemployed father. He didn't riot. He got on his bike and looked for work, and he kept looking to be about it. You have to go and find work elsewhere.

When the Reformation came to England, ideas about hospitality and the role of hospitals shifted once more. When Henry VIII breaks from Rome, he affects what's often called the dissolution of the monoclellan. and by that he basically takes control of, he seizes all the church property. So what happens in London is that the king grants to the city of London these five hospitals. But in this new secular system, not everything about hospitals changed. Hospitals remain charged with that mission of hospitality. They are still seen as broad institutions that have a Christian, duty to look after the poor. The Reformation changes things, but these people all remain basically

Christian. But the reality on the ground is that every year, more and more people are moving into London, and the problem of poverty is getting bigger in scale, but also more anonymous, because you do have people who are coming from elsewhere. And that is going to force a more sort of discriminating attitude among people who are running institutions and a place like London, to really wonder whom should we be hospitable to or for? You know, should you be hospitable to just everybody? Or is there a way in which they start to define the community in terms of insiders and outsiders? And there's a sense that they have a duty to be hospitable to their own.

Like the parish system of the poor law is very important in this regards. The poor law was set up to fund institutions, which had now become the responsibility of state, like hospitals and workhouses. The workhouse or workhouses of such parishes shall be for their common use, and the said commissioners... And under the poor law, each parish raised its own taxes. Each of the said parishes shall be separately chargeable with and liable to defray the expense of its own poor.

Parishes in London start to become embittered about their tax dollars paying for people who are just showing up. I mean, definitions of hospitality in the period continue to say something along the lines of entertaining and relieving strangers. But on the ground, they're starting to discern who's in and who's out. And you get the growth of slightly ever more harsh, cold attitudes towards those strangers. It's interesting to hear that in the context of years gone by when it resonates with us, this sort of idea of, you know, loving thy neighbor, welcoming your neighbor becomes a lot more fraud when you're talking about all of a sudden a whole bunch of people who are new to the neighborhood. Absolutely. And when we tend to think

about immigration, we tend to think about people traveling across national borders and over oceans, but you have the very same dynamics happening just between different parts of England and people coming from other parts of the country are not always so welcome, especially when people are, they want their taxes to be lowered. Some things never change as well, right? There's also a darker thread

to the history of hospitals and hospitality, where the impulse to offer help competed with the state's desire for social control. And where religious beliefs meant punishing sin, not welcoming strangers. Kevin Siena studies how patients with syphilis were treated in London hospitals in the early modern period. The tension is quite fascinating because they do treat them. You will get hospitals later in the 18th century that just won't treat them at all. They are kind of private hospitals.

They're trying to raise money. And so they worry that if they treat syphlytics, people won't give money to the hospital because they're seen as supporting sin. But the biggest hospitals in London, Barts and St. Thomas's, they're treating patients right from when the earliest records survive from about the 1550s. So they are extending care to these people, but they offer them care in this sort of segregated way, this sort of stigmatized way. they're not allowed into the main hospital, they can't go into the chapel and all these sorts of

rules. And then most dramatically, at St. Thomas's, they whip them. They publicly flog these patients. In 1599, there's an order that reveals that when the patients are discharged. When they've recovered. Yeah, which is crazy to us, right? The hospital is there to heal their body. And then right at the end, they harm their body. And it's clear that this is public. And they say that this is so that others will know not to follow in their footsteps. So what does that tell you about the tension between this want and this desire to offer hospitality and the desire to discipline and control people's sinful behavior? There's a double edge to this story all the way through of discipline on one side and care on the other.

And if you neglect either of those, you really are missing the story. And the tension between those can be found at every one of these institutions over hundreds of years. When you think about these tensions that we've talked about, between hospitality and discipline, insiders and outsiders,

how much of that, do you recognize any of that as being inherited, in the hospital system in Canada today? Yes. I mean, certainly, as you get into the 19th century, I mean, the story, this system takes to the seas, I did work on early Toronto. And what's fascinating is they reject the poor law in Toronto, in upper Canada, what becomes Ontario. They accepted in Halifax and Nova Scotia. And so there is a sense in the 1790s still in Nova Scotia that they're going to continue this sense of an obligation, a civic obligation to the poor and just accept that

law. Yet in Upper Canada, they think that a right to relief makes people lazy. They accept the entirety of English civil law except for like two laws and one of them is is the poor law. And so you get institutions like you get a workhouse in Toronto, but they don't accept single mothers, you know, they don't accept women of ill repute. And so I think that tension between hospitality and discipline remains. It is an inheritance to the new world where there's a sense that this should be on the givers terms, that the giver of charity, the host, to think of hospitality, right? The host gets to decide the conditions under which hospitality is given, who the recipients of hospitality shall be, who shall be hosted and who will not be hosted.

And so that tension is something that is going to be there for 19th and 20th and 21st century Canadian scholars to have to work through. You're listening to ideas on CBC Radio 1 in Canada across North America on Sirius XM. in Australia on ABC Radio National and around the world at cbc.ca.ca slash ideas. You can also hear ideas on the CBC Listen app or wherever you get your podcasts. I'm Nala Ayed. This program is brought to you in part by Specsavers. Every day, your eyes go through a lot, squinting at screens, driving into the bright sun, reading in dim light, even late-night drives.

That's why regular eye exams are so important. Severs, every standard eye exam includes an advanced OCT 3D eye scan, technology that helps independent optometrists detect eye and health conditions at their earliest stages. Take care of your eyes. Book your eye exam at spec savers today from just $99, including an OCT scan. Book at specksavers.cavers.cavers.cairists. Prices may vary by location. Visit specksavers.cavers. to learn more. There are two kinds of Canadians, those who feel something when they hear this music, and those who've been missing out so far.

I'm Chris Howdy. And I'm Neil Kuxel. We are the co-hosts of As It Happens, and every day we speak with people at the center of the day's most hard-hitting, heartbreaking, and sometimes hilarious news stories. Also, we have puns. Here Why As It Happens is one of Canada's longest running in most beloved shows. You can find us wherever you get your podcasts. You're listening to The Hospitable Hospital, the third installment in our special series, The Idea of Home.

Hospitals are supposed to be a place to seek help and safety in the midst of crisis. But there's another side to the story of hospitals, one defined not by hospitality, but by institutional discipline and state control. There's a double edge to this story all the way through of discipline on one side and care on the other. Take Canada in the mid-20th century. As more and more Canadians gained access to care through the new Medicare system, the federal government expanded the so-called Indian hospitals,

a separate health care system for indigenous people, which ran parallel to the residential school system. They're rather like nodes in a large, web of incarceration, segregation, segregation, marginalization. Historian Maureen Lux is the author of Separate Beds. She spoke to CBC's Kevin Sylvester in 2016.

Regardless of the conditions in the hospitals, the bureaucrats always understood that patients were better off in hospital than they would have been at home. It was very much the same justification that was used to take children from their homes and put them in residential schools and keep them there despite all the problems with disease and abuse. In accounts of how Indian hospitals were originally set up,

concepts like hospitality and welcome don't come up. Tuberculosis had dropped significantly in Canada. And the fear, at least as explained by sanatorium directors, the fear was that tuberculosis on reserves would spread to cancer. clean, healthy communities. The rhetoric and the discourse around this became more and more shrill as the 1940s went on.

And like the syphilis wards in 16th century London, these hospitals sometimes disciplined their patients. In children's wards, too, you might be struck by the use of restraints. Some hospitals employed straight jackets to keep children in bed. Others tied their wrists and ankles to the bed itself. It's no wonder so many of them tried to run away. Yeah, but the Indian health regulations of 1953 made that a crime too. So the cops would sometimes go out and pick them up?

Return them to hospital in chains, yep. The level of care in these hospitals, was there ever a suggestion at the beginning that it was going to mirror the level of care that you would get in a, I don't know, a normal hospital in downtown Edmonton? for example. The premise, indeed the promise of Indian hospitals, was always that they would cost half of what it costs to hospitalize someone in a community hospital. Sometimes these parallel hospital systems operated within the same town. We had two hospitals in Sulacote. The general hospital

was provincially funded and that's where non-native people went. The native people went to a federal hospital because, well, it was federally funded. And that was built in 1950s. It was called the Sulacote Indian Hospital initially. It was a sanatorium for the tuberculosis outbreak that was happening in the area. So you had right up to the 1990s, you had a segregated health care system. My name is Kathy Loon. I'm the executive lead for Indigenous Collaboration at Minoiaan Health Center.

We're on the traditional territory of the Ojibuiz of Laxou, in Sulco, Ontario. In 1988, there was a hunger strike in northwestern Ontario, here in fact, in Sulaco. Five people from Sandy Lake First Nation were protesting the deteriorating health conditions in northwestern Ontario. What were the health conditions back then? Within the past 100 years, which is not very long, two generations, You had a dramatic change of lifestyle changes in northwestern Ontario, where we went from a hunter-gatherer society to living on reserve. So that when you change your lifestyle like that and eat the foods that was available at the northern store,

there were health consequences. So the health consequences were rising, but the funding or programs offered by the federal government, to the clinics, to the First Nations, was very inadequate. And that's what they were protesting, because we had an extreme rise of illnesses such as diabetes, heart problems, cancer rates in the area. To end that strict, they agreed to a study. The Scott McCain-Bain Health Panel was struck in 1989, following that,

Four parties came together, the federal government, the provincial government, the town of Siligot, and Nishnabayaski Nation representing the 28 First Nations in northwestern Ontario. Out of those negotiations came the hospital where Kathy Loon now works. It serves a vast area in northwestern Ontario. It's the size of Germany for sure. And 28 of our first nations come from fly-in. only communities. The hospital is designed to be truly welcoming for indigenous patients. If you look at Sulkot Minoyahu and from the air, you'll see an outline of the medicine wheel. We have four directional poles surrounding the hospital that are blessed certain times of the year. We have the chiefs that Gatchewa Healing Room in the Healing Room.

We provide teachings as well as other ceremonies such as drum nights. The room can be used for meditation or conflict reservoirs. and I keep a supply of ceremonial medicines in there. Culture is taken into consideration on the grounds, as well as the architecture of the building, as well as the programs that we have. So we have different elders and residents that visit patients or advocate for patients,

And that's really important in this area because a lot of our patients come from remote communities from the First Nations of North, and they're here for a long time. So getting a visit from an elder is very good for them. Also, our language supports program, we provide interpreter service in Ojibwe, Oji Kree, and Kree 247. And the interpreters and the elders and residents also provide the cultural bridge. here at the hospital, because most of our staff are non-native, and most of them are not from the area. Were there some basic lessons about hospitality that you learned while you were growing up in Slate Falls, First Nation? Anything that stands out for you, even now? Food.

Food. Everybody has culture. In fact, we teach this in another program that we offer, and how to work with and speak to people from other cultures by looking at your own culture. And one of the biggest discussions in there is food. And food is such a safe topic. People like talking about their cultural foods. Food is a huge part of hospitality for me. And that might be just my background.

My dad is Guatemalan, and my mom is Ashkenazi Jewish from Lithuania. And every family gathering and every religious holiday is related to food, a lot of food. I think about that a lot, actually, when I work and the nurses always tease me because I always show up with leftover Halloween candy that my kids didn't eat or something from the school fundraiser or boxes of candy, you know, whatever I have around. I think it's just a way to acknowledge that a person is human and has human needs and human hungers. And it kind of acknowledges that as a shared thing between a doctor and a patient, we're both human. We both need the same things. And also just on a really basic level, what do you need? Are you freezing?

I'll bring you a blanket. We've got lots of gram crackers. and juice. Sometimes we even have meals. When we first started actually cooking food in the hospital, people in the, like, the staff would walk into the kitchen be like, what's going on in here? Because they could smell roasting chicken skin. They could smell mushroom soup. Ideally, everything that's on your tray, you can see clearly how it looked when it came out of the ground. And there will be a note on that tray from the kitchen, from the farm, with a wish for good health. We can have notes with the people who pulled the vegetables out of the ground.

They are happy to send that message, right? Farmers are over the moon at the idea that the food that they grow will actually be served to sick people, to students. Like, we don't remember how happy people are to be in a community to take care of each other. What's the most vivid example you can remember of hospitality and action in a hospital? So there is the Meno-Yawin Health Center in Sioux Lookout. For whatever lovely coincidence, my parents lived in Sioux Lookout for a few years. My mom was a pharmacist, and she wanted to spend her last working years doing something more interesting than her suburban life. So they moved up, and my dad was quite sick.

He actually spent his last days in Sioux Lookout, but specifically at the Meadow Yawin Health Center. And so I went to visit them, and I learned about their country food program, which is a food program that they have specifically for indigenous patients, where a provision is made to offer indigenous patients access to their traditional foods. So we're talking about wild game and proteins, but there's also berries and different green old wild rice and different grains. A lot of our patients have been here for a long time. So when you serve them their own traditional foods, you make them happy. I'll give you an example.

giving moose meat to an elder that's been here a long time. Of course, they'll comment on the food, the taste and all that, but if you, if you sit down, they'll start telling you stories. Stories of their moose hunt back in their younger days or certain years, how the weather was. If you can take them back, even momentarily, like half an hour or an hour, back to a time where they were healthy, where they were out in the land. They were at their most healthy, physically, their most strongest spiritually and emotionally. You've done your job, if you can do that. The Michim, or traditional foods program at Menoyawin Health Center in Sioux Lookout is unique in Canada. We're the only hospital that can serve traditional foods to clients, meaning we serve uninspected

well-meat and games to our patients. We know exactly where it came from. Just like your beef, when you're eating roast beef, that cow has been documented long before it was born. And we try to mirror that or we try to match that as best we could. And you don't pay these hunters. They're not paid. No, it's all donated. So we can't purchase traditional foods. That's against the law.

So what happens is we're in a position of asking people for. from a very economically depressed area to donate foods. Well, it became very challenging. So we had to develop partnerships in the area. We partner with the Hunters and Anglers Association here in Sulakot, the Trappers Association, but as well as local organizers for the fish tournaments in the area. The Sulacote Walleye Weekend, it's called. We get about half a year's supply of fish that's donated from the anglers that participate in that tournament, as well as the Laxol Masters, it's called, in Near Falls.

To do this program, we need about 1,200 pounds of fish per year, two moose here and caribou when we can get some, which is not very often. We need about 20 beaver, over 100 geese, ducks and partridges. when we can get them in rabbits as well. And I thought to myself, how beautiful that one, there's a living example of how to put this together and how to, one, and know who your guests, your patients are and then anticipate what their needs are going to be when they're there. But how lovely for all the rest of us here

to have it be a connection to indigenous culture that opens up some of this, you know, that pulls down the walls of this bureaucracy and opens up some possibility and precedent for doing these kinds of things in other hospitals. A lot of your patients come from a long way away, and they leave home, obviously, to come see you and to be a patient at your hospital.

And it sounds like a lot of what you do at the hospital is kind of trying to bring some feeling of home to them. Is that about right? Yes. Every room has a window, which was another thing really important to First Nations people, that the patients can look out the window and see nature because nature heals, the land heals.

We have a particular room where we care for victims of sexual assault And I was thinking one day, wouldn't it be amazing if this room were beautiful? If it were green and had plants and whatever music would make the person feel comfortable. Lighting was different and it wasn't crinkly paper on the table. I, like, imagined what... what I would want for it to be in that room and wrote it into the story. Rachel Kowalski,

the pediatric emergency room doctor in New York City, is also a fiction writer. In a short story called The Lion's Tooth, she imagines creating the best possible healing space for victims of sexual assault. Everywhere, around me I could see lights, not just the stars. There were glowing lamps or candles or fireflies in every window. The entire city shone with light. The sky was changing. Orange light filtered through the

clouds to the east. Now I could see all the way to the city's outskirts. The buildings blurred and receded, yielding green mountains and a rushing riverbed that wound its way through. I would love for there to be those green mountains in that river bed and have all the stuff in the room disappear. But the pandemic brought the dangers of the outside world crashing into hospitals everywhere. and made the idea of hospitality a lot more complicated. Our elders-in-residents program, that has been suspended because the elders themselves are, you know, vulnerable.

But like any other hospital in Canada and certainly in Ontario, we're on a crisis with the staffing level. So we've had to really concentrate on providing core services only. No, COVID has done a number on us. As a doctor in New York City, Rachel Kowalski was at the epicenter of the first wave of COVID-19. Queens in New York is the worst infected district in what is now the world's worst infected city. And the doctors and nurses don't really. know what's hit them. The virus hit, it hit harder than anyone could have imagined. It hit

New York City first before there were any systems in place to evaluate it, to care for it. It was just there. How is it? Hell. Biblical. I kid you not. Workflows were changing every day. And every day you would get a terrifying email about so many doctors have died in Italy. Near Milan, soldiers called in overnight to transport the bodies of the dead from Milan to other cities and provinces because local authorities have been overwhelmed, funeral homes, cemeteries, there's no more room. So how did things change in terms of hospitality? Well, every person became suspect of having the virus, particularly when we didn't have a way to test. You really didn't know. so everyone you know had to wear a mask everyone you know whether or not they wanted to I guess people had to begin to follow the rules whether or not they wanted to and that's

definitely in conflict with a space of pure hospitality where it's all about the guests and making that person feel comfortable and honored you could say like from a public health or epidemiology point of view, you sort of switched from the guest to the many guests and had to think about population health. And it was, you know, for that reason that you have to wear a mask no matter what. And we can only have one parent at the bedside no matter what, which is incredibly difficult to enact because parents, when their child is ill or injured, parents want to be by that child. So sending one into the waiting room, or they couldn't even wait in the waiting room. They had to leave and just drive around the city or drive home and be on FaceTime.

Those were some of the worst conversations I ever had. Our black population has a legacy of being separated from their parents going all the way back to slavery, but also coming forward into mass incarceration. And we take care of refugees who have lived in fear of being separated from their children. So it's not just a matter of inconvenience. You're actually tapping into these horrible traumas that are kind of embedded into people's psyche. So sending someone away from their child was very, very hard. Responding to that big decline in morale, we started this series of poetry, prose. brief videos that we would send to faculty and staff by email, and then we would post them on the

website, our breakroom.org. We actually sent a couple of poems out that had to do specifically with hospitality and feeling welcome. We sent Roommies, the guest house, and we sent David White's The House of Belonging. The House of Belonging by David White. I awoke this morning in the gold light, turning this way and that, thinking for a moment it was one day like any other. But the veil had gone from my darkened heart, and I thought, we are a house. We're a house where strangers meet one another. And the belonging is in many ways created.

It's made. We make that. And I thought, this is the good day you could meet your love. This is the gray day someone close to you could die. This poem brings together, this could be the good day, this could be the day that you die. Both things are true. There's a pandemic, but also the sun is shining. and it's a beautiful day.

This is the day you realize how easily the thread is broken between this world and the next. And I found myself sitting up and quiet, you know, we know that everything is temporary. But right now we're in this world. Right now we're here.

With other people. All the angels of this housely heaven ascending. You know, he ends with that towards the end of the poem. This is the bright home in which I live. This is the bright home in which I live. This is where I ask my friends to come.

This is where I want to. We do ask people to come. You can come here and we're going to care for you. So when guests arrive, we have to make good on that invitation. You know, we have to honor it. As I belong to my life, there is no house like the house of belonging. On Ideas, you were listening to The Hospitalable Hospital. It's the third installment in our series, The Idea of Home. The series is produced.

by Pauline Holdsworth. Readings by Tom Howell, Matthew Laysen Rider, and Greg Kelly. Lisa Ayuso is the web producer of ideas. Technical production, Danielle Duval. The senior producer is Nicola Luxchich.

The executive producer of ideas is Greg Kelly and I Nala Ayat. For more CBC podcasts, go to cBC.ca.ca slash podcasts.