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