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Dr. James Maskalyk, pictured here in February 2018, is an emergency room physician at St. Michael's Hospital in downtown Toronto.

The doctor’s briefing for March 27 started with a wobbly camera and a vulgarity.

On March 31, he opened with a quick summary of the current COVID-19 situation: “All is bananas, everywhere. Doesn’t it feel like that?”

Five days later, he appeared in a pink velvet jumpsuit and gave the date as “the eleventy-seventh blursday of bejebuary. … I’ve lost track of time and have no sense of what’s going on in the world except everything is all COVID all the time, including my life.”

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The pandemic has become all about briefings. The fate of lives and businesses hinge on the latest solemn pronouncements from some level of officialdom. Exchanges are stiff. Word choice is careful. They teeter between projecting authority and anxiety.

James Maskalyk’s appearances are about as close to solemn as the Dalai Lama is to Donald Trump.

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As an emergency medicine physician at one of the country’s busiest hospitals, St. Michael’s in downtown Toronto, for nearly 16 years, Dr. Maskalyk has as much solid information to share on the science and treatment of COVID-19 as anyone. He describes the rigorous procedure for donning and doffing personal protective equipment, identifying potential COVID-19 sufferers and even carrying out risky intubation that requires him to get within inches of an infected person’s mouth.

But viewers on Facebook Live watch him as much for his life expertise as his medical expertise. Topics veer off in all directions: kindness, sex, alcohol, existentialism, exercise, computer modelling, economics, death and so much more.

After a 10- to 20-minute update on coronavirus and related matters, he leads a guided meditation for another half-hour or so. All told, it’s a light-hearted course on surviving plague times from someone who’s seen the desperation of a full-blown epidemic up close.

“I know that feeling of being overwhelmed quite well,” he said in an interview.

During a 2011 Médecins sans frontières mission at the Dadaab refugee camp in Kenya, he witnessed new arrivals surge from 1,000 a week to 1,000 a day, swamping camp resources.

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He became a meditation devotee to cope with his experiences in Dadaab and elsewhere in the world. For years, he’s been bringing the approach to St. Michael’s as a wellness co-ordinator for other staff.

“Particularly at a time like this, when there’s so much stress and risk in emergency medicine, he’s really helping us balance out the wellness side," said Dr. Joel Lockwood, a colleague who trained under Dr. Maskalyk. “He’s our calm ship in rough waters.”

In mid-March, he began appearing regularly on Facebook Live to contextualize the data coming from public-health officials. “When you describe the situation from the ER, that is a literal place people can identify with,” he said. “When you’re talking about 18,000 cases in Canada, we can’t really understand that. Is that a lot? A little? I still don’t know."

At a time of platitudes and bromides, viewers have flocked to the authentic insider’s view.

“The thing I find refreshing about James is that this is not coming from a bureaucrat, or a public-health official. It hasn’t gone through layers of bureaucracy to get to us,” said the writer Marni Jackson, one of Dr. Maskalyk’s 1,000 or so regular viewers on Facebook Live. “This is a doctor in the ER who seems to be telling it the way it is. I find it very trustworthy.”

yesss. back once again with the ill behaviour. going to answer a few clinical questions, tell you what came up in the ER yesterday, comment on the new testing strategy, some steps i use to try to stay healthy in case i get this f thing. then we gonna meditaaaaaate, because that’s a big part of it. x. i’ll be back here apr 10 6 pm with with tales from the night shift. x.

Posted by James Maskalyk on Wednesday, April 8, 2020

Dr. Maskalyk describes meditation as a powerful weapon against the despair COVID-19 has wrought. “When you’re faced with this invisible, intractable, unstoppable thing, people’s fear goes way up,” he said. “But when you’re actually sitting there [meditating], it’s suddenly not so bad.”

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An underlying hopefulness also sets him apart from official public-health messengers. He asks viewers to envision the celebrations that will mark the end of COVID-19 – dancing and embracing and partying. “I want to see the Roaring Twenties, that’s what I want on the other side of this.”

He sees this moment as a kind of bardo, the Tibetan Buddhist idea of an in-between state sandwiched between life and rebirth. It’s a transition place, where the mistakes of the past can be edited from the future. “This is the biggest time for insight,” he said. “Business as usual led to this thing in the first place. After this, there can only be health for all.”

His concept of universal health includes giving homes to the homeless, providing top-notch care to prisoners and then taking Canada’s approach to countries that need it.

“I’m not looking forward to going to work and having breathless people for whom we have no cure, even though I’m proud of the opportunity, whatever it looks like," he said. "But this growing that we’re doing as a city and as a population where we’re extending care to as many people as possible, that’s what’s beautiful about this.”

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