________________________________________
From: Ryan Meili from A Larger Scale <[log in to unmask]>
Sent: Wednesday, July 19, 2023 2:31 PM
To: Dennis Raphael
Subject: A Larger Scale


“Medicine is a social science and politics is nothing more than medicine on a larger scale.” Rudolf Virchow  ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌
Open in app<https://open.substack.com/pub/ryanmeili/p/a-larger-scale?utm_source=email&redirect=app-store> or online<https://substack.com/redirect/2/eyJlIjoiaHR0cHM6Ly9yeWFubWVpbGkuc3Vic3RhY2suY29tL3AvYS1sYXJnZXItc2NhbGU_dG9rZW49ZXlKMWMyVnlYMmxrSWpveU9EZ3pNamN4TENKd2IzTjBYMmxrSWpveE16TTJPVEV4T0Rjc0ltbGhkQ0k2TVRZNE9UYzVNVFE0T1N3aVpYaHdJam94TmpreU16Z3pORGc1TENKcGMzTWlPaUp3ZFdJdE1UWXhOamMxTXlJc0luTjFZaUk2SW5CdmMzUXRjbVZoWTNScGIyNGlmUS5sV09fY1d1NWRYcjVWVnBmVlRoWmkzbndHQXF6Vk5WYlZUUmU5aXh1a0cwIiwicCI6MTMzNjkxMTg3LCJzIjoxNjE2NzUzLCJmIjp0cnVlLCJ1IjoyODgzMjcxLCJpYXQiOjE2ODk3OTE0ODksImV4cCI6MTY5MjM4MzQ4OSwiaXNzIjoicHViLTAiLCJzdWIiOiJsaW5rLXJlZGlyZWN0In0.Dn8G8U7rnSGfkGBjhzl8jMQj4d-FT11WKEei7mmGpP0?>
A Larger Scale<https://substack.com/app-link/post?publication_id=1616753&post_id=133691187&utm_source=post-email-title&isFreemail=true&token=eyJ1c2VyX2lkIjoyODgzMjcxLCJwb3N0X2lkIjoxMzM2OTExODcsImlhdCI6MTY4OTc5MTQ4OSwiZXhwIjoxNjkyMzgzNDg5LCJpc3MiOiJwdWItMTYxNjc1MyIsInN1YiI6InBvc3QtcmVhY3Rpb24ifQ.lWO_cWu5dXr5VVpfVThZi3nwGAqzVNVbVTRe9ixukG0>
“Medicine is a social science and politics is nothing more than medicine on a larger scale.” Rudolf Virchow
Ryan Meili<https://link.sbstck.com/redirect/742aac96-5972-4202-9a52-5bcf8ac9b66c?j=eyJ1IjoiMXBzcXYifQ.BHhQtb7UIKOdqVEHoW7i9PGCtYikGkeqYAG1qaRUplI>
Jul 19
[https://substackcdn.com/image/fetch/f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F0b5f8af9-8bca-486e-b258-7f03999fb5cc_420x382.jpeg]<https://link.sbstck.com/redirect/742aac96-5972-4202-9a52-5bcf8ac9b66c?j=eyJ1IjoiMXBzcXYifQ.BHhQtb7UIKOdqVEHoW7i9PGCtYikGkeqYAG1qaRUplI>

[https://substackcdn.com/image/fetch/w_36,c_scale,f_png,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack.com%2Ficon%2FLucideHeart%3Fv%3D4%26height%3D36%26fill%3Dnone%26stroke%3D%2523808080%26strokeWidth%3D2]<https://substack.com/app-link/post?publication_id=1616753&post_id=133691187&utm_source=substack&isFreemail=true&submitLike=true&token=eyJ1c2VyX2lkIjoyODgzMjcxLCJwb3N0X2lkIjoxMzM2OTExODcsInJlYWN0aW9uIjoi4p2kIiwiaWF0IjoxNjg5NzkxNDg5LCJleHAiOjE2OTIzODM0ODksImlzcyI6InB1Yi0xNjE2NzUzIiwic3ViIjoicmVhY3Rpb24ifQ.OdY55A4Dl1nlii5EpI0V851jvzHJWRq3b2x5Q3vRfQQ&utm_medium=email>
[https://substackcdn.com/image/fetch/w_36,c_scale,f_png,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack.com%2Ficon%2FLucideComments%3Fv%3D4%26height%3D36%26fill%3Dnone%26stroke%3D%2523808080%26strokeWidth%3D2]<https://substack.com/app-link/post?publication_id=1616753&post_id=133691187&utm_source=substack&utm_medium=email&isFreemail=true&comments=true&token=eyJ1c2VyX2lkIjoyODgzMjcxLCJwb3N0X2lkIjoxMzM2OTExODcsImlhdCI6MTY4OTc5MTQ4OSwiZXhwIjoxNjkyMzgzNDg5LCJpc3MiOiJwdWItMTYxNjc1MyIsInN1YiI6InBvc3QtcmVhY3Rpb24ifQ.lWO_cWu5dXr5VVpfVThZi3nwGAqzVNVbVTRe9ixukG0&utm_source=substack&utm_medium=email>
[https://substackcdn.com/image/fetch/w_36,c_scale,f_png,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack.com%2Ficon%2FNoteForwardIcon%3Fv%3D4%26height%3D36%26fill%3Dnone%26stroke%3D%2523808080%26strokeWidth%3D2]<https://substack.com/redirect/2/eyJlIjoiaHR0cHM6Ly9yeWFubWVpbGkuc3Vic3RhY2suY29tL3AvYS1sYXJnZXItc2NhbGU_dXRtX3NvdXJjZT1zdWJzdGFjayZ1dG1fbWVkaXVtPWVtYWlsJmFjdGlvbj1yZXN0YWNrLWNvbW1lbnQiLCJwIjoxMzM2OTExODcsInMiOjE2MTY3NTMsImYiOnRydWUsInUiOjI4ODMyNzEsImlhdCI6MTY4OTc5MTQ4OSwiZXhwIjoxNjkyMzgzNDg5LCJpc3MiOiJwdWItMCIsInN1YiI6ImxpbmstcmVkaXJlY3QifQ.xHlNvOn_-n3eXbkaCT15NxqBx7qtpUX3OIMt5x_tglY?&utm_source=substack&utm_medium=email>
<https://substack.com/app-link/post?publication_id=1616753&post_id=133691187&utm_source=substack&utm_medium=email&utm_content=share&action=share&triggerShare=true&isFreemail=true&token=eyJ1c2VyX2lkIjoyODgzMjcxLCJwb3N0X2lkIjoxMzM2OTExODcsImlhdCI6MTY4OTc5MTQ4OSwiZXhwIjoxNjkyMzgzNDg5LCJpc3MiOiJwdWItMTYxNjc1MyIsInN1YiI6InBvc3QtcmVhY3Rpb24ifQ.lWO_cWu5dXr5VVpfVThZi3nwGAqzVNVbVTRe9ixukG0>
Share


Welcome to “A Larger Scale” my substack journal on many matters, but particularly on what matters most: our health and wellbeing. I am a family doctor with a special interest in underserved populations, infectious diseases, poverty and politics. My clinical and community work can be described as a diverse global health practice, describing a range of work with underserved communities – inner-city residents, refugee newcomers, Northern First Nations and people in the developing world – people with their own specific histories and challenges but shared factors of health conditions related to poverty and inadequate access to quality health care. This work is challenging and rewarding, though often frustrating as well. Factors like how much money people make, how far they went in school, and whether they have safe places to live and good food to eat, and whether they belong to groups that are or have been discriminated against and oppressed, have an enormous impact. What makes the biggest difference in our health isn’t doctors and hospitals, its politics.

A Larger Scale is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber.

Upgrade to paid<https://substack.com/redirect/2/eyJlIjoiaHR0cHM6Ly9yeWFubWVpbGkuc3Vic3RhY2suY29tL3N1YnNjcmliZT90b2tlbj1leUoxYzJWeVgybGtJam95T0Rnek1qY3hMQ0pwWVhRaU9qRTJPRGszT1RFME9Ea3NJbVY0Y0NJNk1UWTVNak00TXpRNE9Td2lhWE56SWpvaWNIVmlMVEUyTVRZM05UTWlMQ0p6ZFdJaU9pSmphR1ZqYTI5MWRDSjkuUWRNWHBCRFJzTnB3UzVqOWViek1POFEtTHNiS0JkVk9ubEFOU3A0U19nNCZ1dG1fc291cmNlPXBvc3QiLCJwIjoxMzM2OTExODcsInMiOjE2MTY3NTMsImYiOnRydWUsInUiOjI4ODMyNzEsImlhdCI6MTY4OTc5MTQ4OSwiZXhwIjoxNjkyMzgzNDg5LCJpc3MiOiJwdWItMCIsInN1YiI6ImxpbmstcmVkaXJlY3QifQ.4dmPSzPhYBLx0gv2xvCnCHwKOvmn77Jvsu8UHoU6wzA?&utm_medium=email&utm_source=subscribe-widget-preamble&utm_content=133691187>

First post: the past

The title of this substack comes from the above quote by Rudolf Virchow, the late 19th century pathologist and politician who most clearly articulated how social conditions determine health and the responsibilities of health care providers to treat the political roots of illness. My interest in the root causes of ill health also led me to try the practice of medicine on a larger scale, making house calls on doorsteps across Saskatchewan and in the people’s house. I served for five years as Member of the Legislative Assembly (MLA) for Saskatoon Meewasin, four of those as leader of the Official Opposition New Democratic Party (NDP), taking the party through a general election and the greater part of a pandemic. That role of family doctor and party leader during a major health crisis was so apt a blend of politics and medicine as to be almost too on the nose. Once the worst was over, it was time for me to move on, not without regrets and disappointments, but certain of the choice.

[https://substackcdn.com/image/fetch/w_1168,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F8ccf9c56-31d8-4f33-949b-ed4b037fd0f8_1598x888.png]<https://link.sbstck.com/redirect/8dd7fc5e-83a9-4d6a-a259-7636db0c190e?j=eyJ1IjoiMXBzcXYifQ.BHhQtb7UIKOdqVEHoW7i9PGCtYikGkeqYAG1qaRUplI>

Since then, I've returned to many loves. First and foremost is family, I'm married to Mahli Brindamour, a pediatrician, and we have two sons, Abe (11) and Gus (5). Whether it’s coaching Gus in cross-country skiing and softball, losing to Abe in chess, or talking about whatever pops into our minds on a walk with my wife in the evening, it’s a joy to be more present in their lives.

The second love is medicine. During the pandemic I renewed my license, pitched in at assessment centres, vaccine blitzes and on the hospital wards, and did weekly clinics at the Lighthouse, a homeless shelter in downtown Saskatoon. That connection with frontline care helped me to stay connected to the people that were the reason for getting into politics in the first place.

After new experiences, and a few years away from full time practice, I am gently re-entering medical life. I’ve joined the TB control team as a tuberculosis consultant in Northern Saskatchewan, helping with the response to recent outbreaks of that persistent scourge. I am also doing night shifts at the Royal University Hospital, have started back in the inner city at the West Side Community Clinic, and am assisting at the REACH refugee clinic started by Mahli and her friends. It’s a piecemeal practice, one where I play supporting roles and navigate chaos. I’ve been pleased to discover I didn’t lose much in the time away, I’m nearly as good at the things I was good at before I left, and just as bad at the things I was always bad at. I learn from my colleagues and my patients and I ask for help a lot. And I try to remember that the reverse of Virchow’s statement is true, that medicine is politics on a smaller scale and where and how we choose to care is a reflection of our values.

Of course, I continue to be frustrated by the ways that a long list of current and historic injustices makes people sick. Life in the legislature further cemented the central role of political choices and culture in determining health. Involvement in provincial politics made my view of that truth both wider and narrower. Wider, and deeper, as I became more connected with a broad range of policy areas - education, economic development, agriculture, housing, justice reform and more – and came to know the details of the issues and know by name the people affected and advocating for change. The concept of Health in All Policies<https://link.sbstck.com/redirect/78781a76-6752-4854-b811-385fd0ea482d?j=eyJ1IjoiMXBzcXYifQ.BHhQtb7UIKOdqVEHoW7i9PGCtYikGkeqYAG1qaRUplI> shone through, as it was evident that each of these sectors has profound impacts on the health and wellbeing of Saskatchewan people. It was a privilege and an education to move beyond health care and listen to and speak up for those who are working to make the province better in their own field and community.

At the same time, provincial politics in general, and the way it is practiced today, also narrowed my scope. Issues beyond the borders of our small trapezoid on the prairies became someone else’s problem. So much time was taken up with the next day’s press conference or caucus meeting, with the theatrics of conflict, that there was little left to advance a more systemic view of organizational and political change. Leaving politics, while it returns me to a smaller, more local life, a life where I don’t see as much of the province and my family sees me in the house and not on the news, also allows me to see a larger world. Which returns us to the title of this substack. I continue to be deeply interested in politics and in pushing for wise policy choices that improve people’s health. Stepping away from the duties of a provincial leader leaves me room to explore issues of national and international significance, as well as the local and personal in ways that are less constrained by the message box.

That larger scale means a larger map as well. When I went into medicine, my hope was to practice where the need is greatest, with the poorest and most vulnerable. In training I was able to spend time in South and Central America, India and Africa. The most profound connection was with Mozambique, where I returned several times as part of a University of Saskatchewan project, providing clinical care in a rural hospital and helping to train Mozambican and Canadian health workers. The work of the late Dr. Paul Farmer, who said that “The idea that some lives matter less than others is the root of all that’s wrong in the world,” has been an inspiration to Mahli and to me. We are taking advantage of this time of transition to return the love of working in the developing world, joining with the organization co-founded by Farmer: Partners in Health<https://link.sbstck.com/redirect/74bd1b78-7cc2-4c22-b098-8d2234c4b85c?j=eyJ1IjoiMXBzcXYifQ.BHhQtb7UIKOdqVEHoW7i9PGCtYikGkeqYAG1qaRUplI>. We plan to travel to Lesotho in Southern Africa next winter and spend several months working in a tuberculosis hospital, providing care in remote clinics, and learning all we can from the patients and care team there. You can read more about the work of PIH in Lesotho here<https://link.sbstck.com/redirect/2ca32308-cba9-4912-8062-f430f8454f9a?j=eyJ1IjoiMXBzcXYifQ.BHhQtb7UIKOdqVEHoW7i9PGCtYikGkeqYAG1qaRUplI>.

The last of the loves to which I’m grateful to return is what you have in front of you, the exploration of ideas through writing. In my first book, A Healthy Society: how a focus on health can revive Canadian democracy<https://link.sbstck.com/redirect/078c53e1-57b6-401a-8dcb-ee2fcf0893e5?j=eyJ1IjoiMXBzcXYifQ.BHhQtb7UIKOdqVEHoW7i9PGCtYikGkeqYAG1qaRUplI>, patient stories illustrated the effect of politics on health and point the way toward creative solutions to our problems. My brother Miles is a professional narrator, and with his help I recorded an audiobook version of A Healthy Society that will be released in August on Audible and Amazon.

This fall, UBC Press will release my new book, A Healthy Future: Lessons from the Frontlines of a Crisis<https://link.sbstck.com/redirect/016b93b5-159b-4cad-b660-29d9d6d7df47?j=eyJ1IjoiMXBzcXYifQ.BHhQtb7UIKOdqVEHoW7i9PGCtYikGkeqYAG1qaRUplI>. Broken up into five waves, this new book peers through the confusion of the recent past to clearly describe what we’ve all been through. Once again, the stories of real people lead the way. From the tears of Saskatchewan’s Chief Medical Health Officer<https://link.sbstck.com/redirect/80f938d3-f02c-4a54-8c56-941b3986b329?j=eyJ1IjoiMXBzcXYifQ.BHhQtb7UIKOdqVEHoW7i9PGCtYikGkeqYAG1qaRUplI>, Dr. Shahab, as the fourth wave raged out of control to the stories of people we lost like Fred Sasakamoose<https://link.sbstck.com/redirect/76ac7cf7-db76-42de-bf67-b21d9f0c2c9c?j=eyJ1IjoiMXBzcXYifQ.BHhQtb7UIKOdqVEHoW7i9PGCtYikGkeqYAG1qaRUplI> or Alice Grove<https://link.sbstck.com/redirect/e26f82ed-5f71-4f7d-8358-1131341217ae?j=eyJ1IjoiMXBzcXYifQ.BHhQtb7UIKOdqVEHoW7i9PGCtYikGkeqYAG1qaRUplI>, and those who still deal with the health effects of COVID like Matty Cardinal<https://link.sbstck.com/redirect/953e5421-d2de-4e9c-bbdc-f11bee112b75?j=eyJ1IjoiMXBzcXYifQ.BHhQtb7UIKOdqVEHoW7i9PGCtYikGkeqYAG1qaRUplI> and Ken Roth<https://link.sbstck.com/redirect/0a1a4dab-d695-454f-ae60-f326264826b3?j=eyJ1IjoiMXBzcXYifQ.BHhQtb7UIKOdqVEHoW7i9PGCtYikGkeqYAG1qaRUplI>, (we meet the human face of what is too easily blurred in statistics and line graphs. I share my own stories and reflections as well, like the experience of leaving my dad’s hospital bed in the ICU in Regina, where I learned from the nurses that our mismanagement of COVID had them doubling up patients in the ICU rooms, to go straight to the legislature to grill the premier about why this was happening. The mix of personal and patient accounts with the political and public health events of the day charts a path to important conclusions on how we can use this time of crisis to build a healthier Canada at any time. Watch this space for excerpts, updates on upcoming events, and ways to get your copy.

As for this substack? Well, it’s a work of works in progress. An exploration. I will be posting excerpts from the books and connecting them to the news of the day. I also hope to use this space to share stories, to explore topics beyond the usual, including calls that connect to deeper values. You can expect stories from the field and political observations, serious debate and occasional silliness. Audio, video, interviews, guest authors; I’ll be exploring varied ways to use this platform to invite people into the conversation. Other duties as assigned. Please subscribe<https://link.sbstck.com/redirect/699f131e-5f25-4bf7-807f-6d54fb29ba28?j=eyJ1IjoiMXBzcXYifQ.BHhQtb7UIKOdqVEHoW7i9PGCtYikGkeqYAG1qaRUplI> to receive each installment and consider inviting a friend as we take a larger scale view on politics and on how to build a healthy future.

To receive new posts and support my work, consider becoming a free or paid subscriber.

Upgrade to paid<https://substack.com/redirect/2/eyJlIjoiaHR0cHM6Ly9yeWFubWVpbGkuc3Vic3RhY2suY29tL3N1YnNjcmliZT90b2tlbj1leUoxYzJWeVgybGtJam95T0Rnek1qY3hMQ0pwWVhRaU9qRTJPRGszT1RFME9Ea3NJbVY0Y0NJNk1UWTVNak00TXpRNE9Td2lhWE56SWpvaWNIVmlMVEUyTVRZM05UTWlMQ0p6ZFdJaU9pSmphR1ZqYTI5MWRDSjkuUWRNWHBCRFJzTnB3UzVqOWViek1POFEtTHNiS0JkVk9ubEFOU3A0U19nNCZ1dG1fc291cmNlPXBvc3QiLCJwIjoxMzM2OTExODcsInMiOjE2MTY3NTMsImYiOnRydWUsInUiOjI4ODMyNzEsImlhdCI6MTY4OTc5MTQ4OSwiZXhwIjoxNjkyMzgzNDg5LCJpc3MiOiJwdWItMCIsInN1YiI6ImxpbmstcmVkaXJlY3QifQ.4dmPSzPhYBLx0gv2xvCnCHwKOvmn77Jvsu8UHoU6wzA?&utm_medium=email&utm_source=subscribe-widget-preamble&utm_content=133691187>

You're currently a free subscriber to A Larger Scale<https://link.sbstck.com/redirect/c613f2dd-c927-41f4-94fa-a998c1498b71?j=eyJ1IjoiMXBzcXYifQ.BHhQtb7UIKOdqVEHoW7i9PGCtYikGkeqYAG1qaRUplI>. For the full experience, upgrade your subscription.<https://substack.com/redirect/2/eyJlIjoiaHR0cHM6Ly9yeWFubWVpbGkuc3Vic3RhY2suY29tL3N1YnNjcmliZT90b2tlbj1leUoxYzJWeVgybGtJam95T0Rnek1qY3hMQ0pwWVhRaU9qRTJPRGszT1RFME9Ea3NJbVY0Y0NJNk1UWTVNak00TXpRNE9Td2lhWE56SWpvaWNIVmlMVEUyTVRZM05UTWlMQ0p6ZFdJaU9pSmphR1ZqYTI5MWRDSjkuUWRNWHBCRFJzTnB3UzVqOWViek1POFEtTHNiS0JkVk9ubEFOU3A0U19nNCZ1dG1fc291cmNlPXBvc3QiLCJwIjoxMzM2OTExODcsInMiOjE2MTY3NTMsImYiOnRydWUsInUiOjI4ODMyNzEsImlhdCI6MTY4OTc5MTQ4OSwiZXhwIjoxNjkyMzgzNDg5LCJpc3MiOiJwdWItMCIsInN1YiI6ImxpbmstcmVkaXJlY3QifQ.4dmPSzPhYBLx0gv2xvCnCHwKOvmn77Jvsu8UHoU6wzA?&utm_source=substack&utm_medium=email&utm_content=postcta>

Upgrade to paid<https://substack.com/redirect/2/eyJlIjoiaHR0cHM6Ly9yeWFubWVpbGkuc3Vic3RhY2suY29tL3N1YnNjcmliZT90b2tlbj1leUoxYzJWeVgybGtJam95T0Rnek1qY3hMQ0pwWVhRaU9qRTJPRGszT1RFME9Ea3NJbVY0Y0NJNk1UWTVNak00TXpRNE9Td2lhWE56SWpvaWNIVmlMVEUyTVRZM05UTWlMQ0p6ZFdJaU9pSmphR1ZqYTI5MWRDSjkuUWRNWHBCRFJzTnB3UzVqOWViek1POFEtTHNiS0JkVk9ubEFOU3A0U19nNCZ1dG1fc291cmNlPXBvc3QiLCJwIjoxMzM2OTExODcsInMiOjE2MTY3NTMsImYiOnRydWUsInUiOjI4ODMyNzEsImlhdCI6MTY4OTc5MTQ4OSwiZXhwIjoxNjkyMzgzNDg5LCJpc3MiOiJwdWItMCIsInN1YiI6ImxpbmstcmVkaXJlY3QifQ.4dmPSzPhYBLx0gv2xvCnCHwKOvmn77Jvsu8UHoU6wzA?&utm_source=substack&utm_medium=email&utm_content=postcta>


[https://substackcdn.com/image/fetch/w_36,c_scale,f_png,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack.com%2Ficon%2FLucideHeart%3Fv%3D4%26height%3D36%26fill%3Dnone%26stroke%3D%2523808080%26strokeWidth%3D2]Like<https://substack.com/app-link/post?publication_id=1616753&post_id=133691187&utm_source=substack&isFreemail=true&submitLike=true&token=eyJ1c2VyX2lkIjoyODgzMjcxLCJwb3N0X2lkIjoxMzM2OTExODcsInJlYWN0aW9uIjoi4p2kIiwiaWF0IjoxNjg5NzkxNDg5LCJleHAiOjE2OTIzODM0ODksImlzcyI6InB1Yi0xNjE2NzUzIiwic3ViIjoicmVhY3Rpb24ifQ.OdY55A4Dl1nlii5EpI0V851jvzHJWRq3b2x5Q3vRfQQ&utm_medium=email>
[https://substackcdn.com/image/fetch/w_36,c_scale,f_png,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack.com%2Ficon%2FLucideComments%3Fv%3D4%26height%3D36%26fill%3Dnone%26stroke%3D%2523808080%26strokeWidth%3D2]Comment<https://substack.com/app-link/post?publication_id=1616753&post_id=133691187&utm_source=substack&utm_medium=email&isFreemail=true&comments=true&token=eyJ1c2VyX2lkIjoyODgzMjcxLCJwb3N0X2lkIjoxMzM2OTExODcsImlhdCI6MTY4OTc5MTQ4OSwiZXhwIjoxNjkyMzgzNDg5LCJpc3MiOiJwdWItMTYxNjc1MyIsInN1YiI6InBvc3QtcmVhY3Rpb24ifQ.lWO_cWu5dXr5VVpfVThZi3nwGAqzVNVbVTRe9ixukG0&utm_source=substack&utm_medium=email>
[https://substackcdn.com/image/fetch/w_36,c_scale,f_png,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack.com%2Ficon%2FNoteForwardIcon%3Fv%3D4%26height%3D36%26fill%3Dnone%26stroke%3D%2523808080%26strokeWidth%3D2]Restack<https://substack.com/redirect/2/eyJlIjoiaHR0cHM6Ly9yeWFubWVpbGkuc3Vic3RhY2suY29tL3AvYS1sYXJnZXItc2NhbGU_dXRtX3NvdXJjZT1zdWJzdGFjayZ1dG1fbWVkaXVtPWVtYWlsJmFjdGlvbj1yZXN0YWNrLWNvbW1lbnQiLCJwIjoxMzM2OTExODcsInMiOjE2MTY3NTMsImYiOnRydWUsInUiOjI4ODMyNzEsImlhdCI6MTY4OTc5MTQ4OSwiZXhwIjoxNjkyMzgzNDg5LCJpc3MiOiJwdWItMCIsInN1YiI6ImxpbmstcmVkaXJlY3QifQ.xHlNvOn_-n3eXbkaCT15NxqBx7qtpUX3OIMt5x_tglY?&utm_source=substack&utm_medium=email>


© 2023 Ryan Meili

To leave, manage or join list: https://listserv.yorku.ca/cgi-bin/wa?SUBED1=sdoh&A=1