Category Archives: Uncategorized

On ECT and The Variability of Bodily Experience

By Marvin Ross

ECT or shock therapy has to be the most contentious treatment in all of medicine, in part, due to its depiction in films which is highly negative. My initial view of it was coloured by my favourite aunt when I was a kid. She had what in those days (1950s or 1960s) was a nervous breakdown. Her husband had died and then her brother (my father) died suddenly of a heart attack.

One of her symptoms was unusual pains in her chest and back for which no organic cause could be found so her physician nephew had her admitted to a private sanitarium rather than the infamous Toronto Hospital for the Insane at 999 Queen St W ( actually the Ontario Hospital and now the Center for Addiction and Mental Health). She underwent a series of ECT treatments and was eventually discharged.

After discharge, she confessed to me that after each treatment, the staff asked her how she felt and if she was still experiencing the pains. She told me that if she said yes, she got more shocks so she told them she was fine, the pain had gone away and she was discharged. But, she told me, she still had the pains. I can’t recall how long after but she died of a stroke. I’ve always wondered if they had missed atherosclerosis as diagnostic skills were quite primitive in those days as was treatment for heart and stroke compared to today.

Fast forward to the late 1990s and I was a regular visitor to the psych unit at our local hospital. One of the patients was a young mother with schizophrenia who, I was told, attempted to kill herself and her young children. She was getting ECT. A few months later, I was picking up a coffee at the hospital snack bar when an attractive woman said hello to me.

“You don’t recognize me, do you” she said.

“I’m so and so and this is the new me post ECT. I was discharged, I feel really well and I’m here for an outpatient visit with my psychiatrist”

Psychiatric Times just ran an interview with the author of a new book called Electroconvulsive Therapy in America: The Anatomy of a Medical Controversy by Jonathan Sadowsky, PhD. The one question he was asked that I found very interesting was this:

“Patients have both attested to damage it has done and expressed gratitude for the relief and hope it can provide.” How do you explain this seemingly paradoxical disparity in the experiences and opinions of patients?

The answer was what I have tried to say about medical treatments and recovery in schizophrenia in general but not as elegantly as this author. This is what he had to say:

“The human body is not a mass-produced machine, where given inputs such as therapies produce automatic and predictable results. Most clinicians and lay people know this but often act as if they don’t. One result of this mechanistic conception is resistance to the variability of bodily experience. But this variability is easy to show.”

And so, some people do well and others do not just as some drugs work well for some people and in others not only don’t work but have horrific side effects. We are all different and good clinicians have to recognize (and do) that trial and error is required to find the correct treatment for any given individual.

In a recently released study out of the Karolinska Institute in Sweden, it was found that there is considerable variability in the efficacy of anti-psychotics to prevent relapses in patients with schizophrenia. This study involved 29,823 patients aged 16 to 64 years with a median follow-up of 6.9 years. It was also a naturalistic study where each patient served as his/her own control to avoid selection bias. Long-term injectable antipsychotics, paliperidone and zuclopenthixol and the oral clozapine had the lowest risk of rehospitalization.

Going back to ECT, another recent study found that remission rates for patients with severe mood disorder are lower among those who have had ECT as inpatients. Earlier studies had shown that ECT leads to better remission rates in people with major depressive disorder and results in reduced mortality.

The bottom line is that despite the bad press that ECT and other treatments may have in the media or among the general population, many will experience positive outcomes. Keep an open mind.

The Doctor gives us one hundred years.

By Dr David Laing Dawson

What an interesting time to be alive. I had grandparents who drove some of the first mass produced automobiles; parents who listened to the radio, took penicillin, and flew in planes; I grew up among a generation of boys who dismantled cars and rebuilt them to drive when we got our licenses at 16; we watched television going from black and white to colour, and analogue to digital, from large boxes to thin screens; we bought 64K computers; watched the first messages pass through the internet and modems; watched portable phones, libraries, laptop computers, arcades, cameras, pagers, slide rules, and calculators merge into this ubiquitous instrument we call a smart phone; we learned to say double helix, and then genome; we saw small amounts of data stored on microfiche evolve into terrabytes of data stored in something smaller than a thumbnail; my son and daughter work in the high tech industries; my grandson is studying artificial intelligence at University; and Stephen Hawking tells us we need to colonize another planet or two within 100 years or risk extinction.

If he is right, then the generations alive today are humans who have links to the early days of mass production in the industrial revolution, to the beginnings and early evolution of modern science, medicine, and agricultural practices, right though the digital age, space travel, and on to the destruction of the planet.

Our dramatic success over the past few generations (give or take some stupid wars, genocides and catastrophes) is leading directly to the demise of our species, all within a dozen generations. That is impressive if sad.

Hawking includes possible “acts of God” in his list of destructive forces (direct hit by a large meteor) but most scenarios include one form of suicide or another (pandemic spread around the globe, nuclear holocaust, the consequences of over population, and global warming).

Biologically our evolution has spanned millions of years. Until the industrial revolution our social evolution had been almost as slow and incremental. Capitalism, democracy, science, medicine, and technology have jet propelled (literally and figuratively) this social evolution the past 150 years.

Before then we were creatures surviving within a complex ecology, our population very slowly increasing, subject to the whims of weather, drought, wars, and pestilence. We had minimal effect on our planet. We could build a boat, a city, a canal, and a damn, but the oceans and forests continued, the rivers, deserts, and most of our earth’s life forms persisted. To survive through those centuries we needed to expand, explore, conquer, and exploit.

Not now.

Now quite suddenly we are the shepherds of our own destiny as a species, a life form. To survive we must all cooperate. We must give up notions of magic and Gods and competing feifdoms. We must stop population growth through all humane means of birth control. We must husband our planet’s resources rather than exploit them. We must have in place an international program ready to act instantly when the next pestilence arises. We must stop talking about economic growth and replace this with equitable economic distribution. We must stop destroying our oceans and forests. And of course we must either reduce our CO2 emissions or figure out how to capture them.

A tall order. Especially when some leaders of our fully industrialized nations want to pull us back to an age of competing xenophobic fiefdoms. A hundred years is but a blink of a galaxy’s eye.

Time For US Healthcare to Catch Up With the Rest of the Civilized World

By Dr David Laing Dawson

Watching CNN, the reports, the discussions, the arguments, the experts, the talking heads, the Democrats and Republicans, Obamacare, The Affordable Care Act, Repeal and Replace, phase 1, phase 2, pre-existing conditions, medicare expansion/contraction – the whole exhausting American Healthcare discussion – two things come to mind:

The first is the obvious. For God’s sake just adopt the Government single payer option. Join the rest of the advanced nations. It is cheaper. It is better. Per person you already pay more in taxes to support your limited medicare and all the other complicated subsidies than we in Canada pay for the whole shebang. We are healthier. And it would free up a lot of administrators, accountants, politicians, and lawyers to do something useful.

The second was a little more subtle. All this exhausting time and energy arguing about, and designing, some polyglot public/private health care system is really not about health. It’s about an insurance scheme that will pay doctors and hospitals for medical fixing of acute illnesses and accidents. Medical fixing is just a part of being and staying healthy.

If you could settle on a single payer option then much of that time, energy, administrative overload could be better used to address health in all its complexities: prevention, social determinants, secondary prevention, tertiary prevention, maintenance, management of chronic illness, diet, obesity, lifestyle, addictions, mental health….. at the moment a kid with Cystic Fibrosis in Canada will outlive her counterpart in the US by 10 years.

There is one other aspect to the current American “health care system” of which I have lately become more aware. While the main concern remains large segments of the American population receiving no medical care apart from Emergency visits, or able to afford only partial treatment of acute and chronic illnesses, there is another side to this coin:

Over investigation and over treatment for those who can afford “the best”. Your celebrities often get shitty medical care, from Marilyn Monroe, to Michael Jackson to Prince to, apparently, Donald J. Trump. This is also true of many of your highly specialized for profit residential treatment facilities. Many offer some real medicine mixed with a lot of flimflam, with length of stay and investigations determined by the money available.

For Profit has no business in medical investigation or treatment. Inevitably it means many will do without and many will get too much. And the burden, ultimately, still falls on the taxpayer.

Parenting Kim Jong Un and Donald J Trump

By Dr David Laing Dawson

As every parent knows for a threat to be effective the child must believe his father or mother will make good the threat if he does not comply. The child also knows that when the threat is outrageous (“you will be banned from all electronics for life.”) it is also hollow. Still, some children do not listen to threats even when they are consistently followed by reasonable consequences. This is often true of ADHD children, and those for whom the compulsion is too great (OCD) or the aversion to change too strong (ASD).

By the time children are teens the plot thickens. Now they are watching themselves through the eyes of their peers, not just their parents. Now they are clinging to new visions of themselves as capable, independent sentient beings with newly formed logical thinking processes. They are more apt to defy the threat if to comply would undermine this developing sense of self.

And then we have adults. And now for a threat to work it must overcome all the above plus pride if this all occurs privately and secretly, and much more if the threat occurs publicly (shame and loss of face), and more so still if the threatened figure is a man or woman whose sense of self, if not his very existence, depends on the adulation of the crowd.

There are public figures in this world whose behaviour we would like to change. Perhaps there are some of these whose sanity, whose internal stability and strength is sufficient to bring about a good response to threat.

Kim Jong Un is not one of them.

Please do not threaten this man. Never publicly threaten him. He will not respond as you wish him to.

Actually, Donald Trump may just be the right President for the task of soothing North Korea. He could invite Kim to Mar a Lago for a Korean BBQ and treat him like royalty. Let him expound. Set up a private communication system. Help him be more of a hero to his people by feeding and housing them better. Then privately discuss reducing his nuclear arsenal for something in return.

Of course this would require Donald to keep his own ego in check. Vain hope.

Could it be time for Canada to step in here. Are you listening Justin? Making Kim look weak and foolish before his own people could get millions killed. We need a Mike Pearson way of intervening now.

And all of you, including Pence and others saying that your patience is at an end, pay heed to the words of a much smarter man than yourself:

“Talk, talk, talk is better than war, war, war.” – Winston Churchill.

Birds and Squirrels

By Dr David Laing Dawson

I woke up this morning and saw through the window that a mid size but rather colorless bird was pecking at a dead branch. Down, peck, peck, up, look around, down, peck, peck. Was it eating grubs, termites, ants?

A black squirrel scampered along the top of the fence. And I wondered, “Do squirrels ever stroll?”

These observations and the queries they evoked sparked a small pleasure, a small sense of well being.

They also tell me that I am not depressed, that is, depression is not impairing the scanning, inquisitive function of my brain. Nor is my brain under the kind of threat that forces a dramatic reduction in its field of awareness.

I also know that unless I rear up and threaten both the bird and the squirrel I am nothing to them. I do not exist at this moment within their sphere of awareness. And this means, at least with respect to the squirrel and the bird, I am not psychotic. My brain has not created a false narrative regarding my relationship with squirrel and bird.

Do squirrels ever stroll? Do birds ever eat leisurely?

Depression impairs the ability of the brain to scan, focus, inquire, be concerned about, all but itself, its sense of dread, and the unwellness of its own body.

Psychosis impairs the ability of the brain to fathom its boundaries and relationships with others and then, because it is an imperative that we do so, because it is a primitive imperative that the brain find a way of organizing data to determine friend from foe, kin from stranger, threat from security, it applies the band aid of a simple false narrative.

Do squirrels ever stroll? Do birds ever eat leisurely?

The Brain, Cognition and Illness

By Dr David Laing Dawson

The aware, receiving, perceiving, organizing, planning brain.

Two recent writings got me thinking about this. The first was a comment from Mr. Summerville, in support of the absolute discharge of Mr. Vince Li, that Mr. Li showed “no signs of cognitive impairment”. The second was the raw honesty of Mr. Bowers when he writes that when he took a shotgun upstairs with the intention of killing his grandmother he was “bat shit crazy”.

I suffered one of those nasty strains of flu this winter. At the time it seemed to affect every organ in my body. Including my brain. That is my brain was aware this state of body sickness was impairing some of its functions as well.

I guess it’s tricky. We are aware when our stomachs aren’t working as we would wish them, when our prostates and kidneys are not quite right, when perhaps our livers are acting up, our eyes, our inner and middle ears, our calf muscles are balking. Well, really, it is our brain noticing these things. But when the brain is acting up, not quite functioning smoothly in one of its functions, there is no one left to tell us. That is, no other organ in the body is prepared to tell us that the brain is a little off. “Liver here. Brain, your thinking is off.” or “Brain, your medulla oblongata is a little sluggish this morning. Your perceptions are clouded.”

I have also suffered, by my own count, three depressions of clinical severity so far in my life. Perhaps the cause of these can be traced to my circumstances each time, perhaps my genetics, perhaps to my childhood, probably a combination of genetics and circumstances. But each time it happened I know my brain was impaired, not functioning well, not scanning, perceiving, reviewing, interpreting as it normally does.

You can find a list of the symptoms of “depression” in the DSM and on many a website not to mention TV advertisements for the latest antidepressant. But of course the organ experiencing these symptoms is the same one reading and hearing about them.

It is often family members and close friends who notice first. You are not yourself, they say. Or “the spark has gone from your eyes.” And always when I treat someone for depression and they improve, it is family members who notice the improvement first. The patient tells me they don’t notice any change, though I see his or her eyes are livelier, his face a little less strained, and the corners of his mouth more agile. And the mother or wife points out he came down for dinner, engaged in conversation, laughed at a joke. The brain of the patient hasn’t noticed these changes yet, because… well because its perceptual, interpreting, responding, scanning apparatus is still partially impaired.

Liver illness impairs the functioning of the liver. Mental illness impairs the functioning of the brain, and that can be some or many of its functions. Mental illness is a brain illness.

So let’s go back to Vince Li. His brain was absolutely definitely impaired at the time of his crime. And at this point if he is not terrified of relapsing, and thus wanting help for the rest of his life to keep himself from relapsing, if he does not himself (his brain) understand and want all safeguards in place to keep himself from relapsing, if he thinks he can just change his name and move on, then his brain is still impaired in some of its functions. If this is the case then his perceptual, cognitive, judgmental processes are still impaired.

Contrast that with the Blog written by Mr. Bowers. He has fully recovered from being “bat shit crazy” and he is fully aware he never wants to go there again, and he is fully aware (the perceptual, organizing, planning, monitoring, cognitive processes of his brain are functioning well) that he needs help and vigilance to never go back to that place again.

Trump Speak

By Dr David Laing Dawson

The collection of laughable, inane, grossly inaccurate, and stupid things that Donald Trump says grows by the week. They have become the fodder of late night talk shows and the target of journalists’ disdain. Satirists don’t have to satirize; they merely repeat what he says.

On the internet one can also find several collections of odd, funny, nonsensical things that came out of George W. Bush’s mouth. George occasionally mangled syntax; he created the odd neologism, mixing two words to make a third; he put his adjectives in the wrong place; he stumbled over language and grammar. One could make the case that he is a little dyslexic, or simply not gifted in the spoken language department.

He was on the Ellen DeGeneres show recently and he said, “…I’m going to use a big word now – symbiotic…” Ellen said, “Wow, four syllables..” The audience laughed, George smiled. And I rather liked him for a moment.

These days the journalists, the pundits, the comedians, the talk show hosts, pounce on the words of Donald J. Trump and point out their inanity, their inaccuracies, their wrongheadedness, and their untruthfulness. But beyond what he says and tweets, a true revelation of the depth of trouble we are in can be found in the way he says what he says. That is, not so much in the simple meaning to be found in his tweets and statements but the meaning hidden in the structure and form of his sentences (or lack thereof).

Whatever the subject, the reference point is himself. Whatever the subject, no matter the population actually affected, how it affects Donald is supreme. Whatever the subject, his words imply that he is supreme; they always imply that he is supreme.

Below is a list of things Donald J. Trump has tweeted or said. Let me point out what is happening in the first two. These two statements followed briefings by experts on the two subjects at hand. In them Trump indirectly admits that perhaps he didn’t fully understand the complex subject before, but then he quickly points out that “nobody” does. He has to say this to retain the fiction in his own mind that he is brilliant, superior, supreme, that he knows all there is to know, and all that anybody can know.

This is a very dangerous level of narcissism.

“It’s an unbelievably complex subject, nobody knew that health care could be so complicated.” (Health Care Policy)

“It’s a very complex subject. I’m not sure anybody is ever going to really know.” (climate change)

“I know words; I have the best words.”

“I will build a great wall — and nobody builds walls better than me, believe me –and I’ll build them very inexpensively. I will build a great, great wall on our southern border”

“I’ve never had any trouble in bed, but if I’d had affairs with half the starlets and female athletes the newspapers linked me with, I’d have no time to breathe.”

“I love the poorly educated.”

“He was a war hero because he was captured. I like people who weren’t captured.”

“All of the women on The Apprentice flirted with me – consciously or unconsciously. That’s to be expected.”

“I am totally in favor of vaccines. But I want smaller doses over a longer period of time.”

“Sorry losers and haters, but my I.Q. is one of the highest -and you all know it! Please don’t feel so stupid or insecure, it’s not your fault.”

“Cher is somewhat of a loser. She’s lonely. She’s unhappy. She’s very miserable. And her sound-enhanced and computer-enhanced music doesn’t do it for me.”

When was the last time anybody saw us beating, let’s say China, in a trade deal? I beat China all the time. All the time.”

“I think the only difference between me and the other candidates is that I’m more honest and my women are more beautiful.”

“Part of the beauty of me is that I am very rich.”

“I dealt with Qaddafi. I rented him a piece of land. He paid me more for one night than the land was worth for two years, and then I didn’t let him use the land.”

“Number one, I have great respect for women. I was the one that really broke the glass ceiling on behalf of women”

These quotes (and much of what he says and writes in tweets) boldly display:

  1. An appalling lack of understanding of issues/technologies/events/history/the world…
  2. An appalling lack of awareness of his own shortcomings and deficits.
  3. An appalling (and child-like) lack of awareness of a world beyond himself.

He could do great damage to the world within four years if he stays energetic, active, engaged, provocative and disruptive.

But clearly he has a short attention span and he doesn’t particularly like to read, work, study, or listen. So while he is watching cable news, golfing and dining at Mar a Lago, some contemporary Rasputins (Bannon for one) will be able to do great damage to the world.

We are about to find out just how solid and resilient and principled American Democracy really is.

 

 

 

 

Popular TV and Mental Illness Misrepresentation

By Dr David Laing Dawson

Currently two serial TV shows of the thriller/spy genre feature major characters who suffer from bipolar illness. Both usually take their medication and acknowledge that it keeps them stable. So far so good. They are successful likable characters and thus could be seen as antidotes to stigma, to the usual poor representation of mental illness by film and television. But in both story lines the characters go off their medication in order to decipher a complex conspiracy. They become manic, paper the walls of their rooms with clippings, photos, lists, time lines, arrows, connecting lines, question marks.

Voila. The unlikely pattern becomes clear to them. And once again the myth of madness and genius being one and the same is exploited for entertainment.

Our brains are organizing machines. They are always looking for patterns, recognizable and logical patterns. In a state of mania and hypomania, aroused, alert and scanning for such patterns, the brain does indeed find them more readily, that is, the brain invents them. The manic person sees connections and patterns where none exist, and to make this connection the manic brain often invents forces, and powers and conspiracies that are pure fictions. This might result in an interesting piece of art, a fascinating stream of consciousness, or even an entertaining performance, but it is a dysfunctional state and it does not result in valuable insight. The usual result is loss of employment, loss of community, loss of reputation, and eventually loss of freedom.

To portray mania as a form of genius does great disservice to those who actually suffer from this illness.

Of course mental illness does not discriminate so we are as likely to find that it strikes a brilliant mind as often as that of an oaf. And that is not a pattern either. Just statistical probability.

We are Now in Big Trouble

by Dr David Laing Dawson

The other evening Mr. Tapper of CNN came out directly and asked the following question: Does Mr. Trump know the difference between the truth and a lie? Does he say these things as strategic gambits, all the while knowing they are falsehoods, in some cases outrageous falsehoods, or is he incapable of knowing the difference? This dichotomy suggests either he lies nastily and without regard for any semblance of truth as a political strategy, a gimmick, a distraction, or he is incapacitated.

Neither answer is very reassuring. And if this is an incapacity what is the nature of it?

There is a simple and consistent answer to this question. Pathological narcissism.

Trump’s lies are responses to that which his inflated ego cannot accept. All information, evidence, facts that suggest Trump is not supreme, the best, the most popular is unacceptable to him and therefore must be denied or rebuffed with “alternative facts”. Any successes or glory he does achieve must be revisited, replayed, exaggerated over and over again.

The fact Donald Trump’s narcissism is extreme enough to require this level of denial of reality (the size of the crowds, the “3 – 5 million illegal votes”, murder rate, wire taps) means it is incapacitating. He is incapacitated.

His lies, his tweets, are not even bounded by plausibility. They will continue, grow more outrageous, and dissolve in a wild lashing out.

Unfortunately Kim Jong Un and the excited commentary on American television may be providing Mr. Trump a way to lash out and destroy. And then, which I am sure aligns with an image in his head, he can stand akimbo in his great black coat upon the scorched battlefield like a Vulcan God.

Follow Up – Education More Important Than Ever

By Marvin Ross

I’ve been contemplating a personal follow up to David’s blog on the importance of public education but I’ve been procrastinating. I decided to write it after having lunch with someone who was complaining that a grandchild was being sent to a private school at a cost of $25,000. His argument was that the local school the child goes to is quite good and he will have to be driven to the new school where he will lose contact with all his friends in the area.

The ability to play with other kids on the block, walk to and from school with them, and to hang out is an invaluable educational tool. I grew up in a Toronto that was just starting to break free of the grip of the Loyal Orange Order – a Protestant fraternal group that celebrated the defeat of the Catholics at the Battle of the Boyne in 1690. Most important jobs were reserved for Orangemen who proudly marched on Yonge St every July 12 behind someone outfitted on a white steed playing King Billy to celebrate the victory of William of Orange over Catholics.

Toronto was just beginning to see an influx of immigrants from all over the world at that time. Up to then, the main immigrants were Jews and Italians. The elementary schools were becoming mix of ethnicities and we all mingled and played together (with the occasional fights that were settled easily). As English Protestants ruled, classes began with the Lord’s Prayer and the singing of God Save the Queen. Once a week, some kindly minister conducted a class on religion.

Jews could be excused but I stayed as did most of the others as I recall. This invariably led to our existence being recognized by the holy man who talked about religion in general rather than his own denomination. We learned about and from each other. Groups of kids from different backgrounds would share experiences outside of class. I can still remember our comparing what we ate for Christmas dinner (which I didn’t have) and being intrigued because my best friend was Japanese and they ate octopus.

As I progressed through the years, more diverse people began showing up in class. At this time, most Blacks were descendants of those who came via the underground railroad but we were soon joined by people from the Caribbean. In elementary school, I went to a drop in centre across the street from our house run by the African Episcopal Methodist Church. One year, I was one of the three wise men in their Christmas pageant. Of new arrivals at that time, the most exotic was a new Algebra teacher called Mr Gupta. No one had ever seen a South Asian before but what was most remarkable was that his two sons were in his class. They were math whizzes much to our disgust.

I don’t want to give the impression that there was no racism as there was but it was slowly beginning to break down thanks to the children from large groups of people from diverse places. We mingled together in school, played and fought together on the playgrounds in the neighborhood and began to develop understandings of each other. In her book on growing up in Toronto as a child of Holocaust survivors (When Their Memories Became Mine: Moving Beyond My Parents’ Past), Pearl Goodman describes how playing with the neighbourhood kids and dealing with them in the local school, helped her contend with the views and trauma her parents had from their experiences.   The outliers were Jewish kids in the area who were sent to Jewish parochial schools rather than the public schools. They were quite different from us and even talked differently with the sing song accents so familiar to those whose first language was Yiddish.

During that time, there was even a radio program hosted by the Minister of Citizenship, Jack Pickersgill, who gave his audience information about the various immigrant groups (called New Canadians), who were flooding into the country. The Governments attempt to help them gain acceptance

Education was a prime reason that fear and distrust of others began to break down. Aside from the fact that most kids in my high school could swear in Yiddish (as Jews were the largest group), tolerance and understanding was starting to emerge in all areas. A holdover from the War was the fact that high schools in those days all had cadet corps affiliated with various regiments and often our teachers were called by their military rank. My history teacher was a major.

My school was affiliated with the Queen’s Own Rifles, an old and respected regiment that landed at Normandy on D-Day and fought its way north to help in the liberation of Belgium and The Netherlands. We had to go on a Church Parade one Sunday to the regimental church and when we got there, the Sgt had us all lined up. His command was Jews and Catholics, fall out and we did and spent the church service in the basement playing foot hockey while the poor Protestants had to endure a religious service.

Education helped us integrate and learn to understand and tolerate each other and is very crucial today more than ever. And it is this understanding and respect for each other that results in US Muslim Vets offering to stand guard to protect Jewish cemeteries from vandals or Toronto Jews standing guard at Mosques to show solidarity.

It has always been important for us to learn about and accept others as equals and that process flourishes when we all go to school together.