The revelation that NDP Leader Jack Layton is again suffering from cancer has elicited an outpouring of sympathy and well wishes from the Canadian public, and appropriately so.
The parliamentary press gallery has also turned itself inside out speculating on how Mr. Layton's illness will impact the political fortunes of the New Democrats in the short and long term.
But the uncertainly surrounding Mr. Layton's current health status begs an even more fundamental question: Do public officials owe the public full disclosure?
In an era marked by a volatile cocktail of cynicism about politics, and when gossip flows as freely as news (via Twitter, Facebook, 24-hour news portals, etc.), the answer is: Absolutely. Unfortunately, what we have so far from the NDP is a cascade of opaque half-facts hidden behind a veil of compassion.
Here's what we know: In February, 2010, Mr. Layton revealed publicly that he had prostate cancer. He was treated at Princess Margaret Hospital in Toronto, but refused to say if he had surgery, chemotherapy, radiation or a combination. (His spokesman said he did not want to unduly influence the treatment choices of others, which is a pretty lame excuse for secrecy.)
Mr. Layton's recovery proceeded apace, but in March, 2011, he began to suffer hip pain. Tests revealed he had a fracture (the cause of which is unknown) and required surgery (details of which have not been revealed). Thus, during the spring federal election campaign, Mr. Layton added a fashionable accessory – a cane.
Then, on Monday of this week, Mr. Layton revealed that he has a "new, non-prostate cancer that will require further treatment."
It was a bombshell, particularly because the NDP Leader looked so gaunt and spoke in a weak, raspy voice. Mr. Layton said he began suffering "stiffness and pain" again in June and, retrospectively, journalists recognized he had not been well for a while.
During the Canada Day reception at Stornoway, the residence of the leader of the Official Opposition, the normally energetic politician remained seated. He did not participate in any of the events related to the visit of the Duke and Duchess of Cambridge. During the Gay Pride parade in Toronto, Mr. Layton – a life-long cyclist and runner – sat in a rickshaw and waved to the crowd instead of wading in. Then, on July 25, came his news conference.
So, back to the issue at hand: Has Mr. Layton been forthcoming enough about his health status?
Brad Lavigne, Mr. Layton's principal secretary, said the public already knows plenty. He told The Canadian Press that he has tried to balance the need to "provide the public relevant information" with "holding back information of a private nature."
Sorry, but the NDP has failed to get the balance right. The cameras don't need to follow Mr. Layton into surgery, but we deserve to know a lot more than we've been told to date.
Saying that Mr. Layton has a "new, non-prostate cancer" is far too vague. It's unacceptable fudging.
Does he have a second cancer that is unrelated to his prostate cancer? Or has his cancer metastasized – meaning it has moved elsewhere in the body?
These are important details. Today, men with prostate cancer have a five-year survival rate that hovers around 90 per cent. But when prostate cancer metastasizes, the survival rate drops below 10 per cent.
When prostate cancer spreads, it tends to move to the bones – the pelvis and hips in particular. Are Mr. Layton's stiffness and hip problems cancer-related?
If he has a second, unrelated cancer, what is it? The raspy voice and rapid weight loss suggests lung cancer. Lung cancer survival rates are dismal. But hoarseness could also suggest intense treatment for any number of cancers. (A hoarse voice is a common side effect of chemotherapy and some other cancer drugs such as Avastin, a colorectal cancer treatment.)
This, of course, is all idle speculation. But that's the point: Where there is an absence of real health information, guesswork inevitably fills the void.
Mr. Layton has lived his life in the public eye, as the son of a cabinet minister, a Toronto city councillor, a member of Parliament and Leader of the Official Opposition. He knows as well as anyone that public service entails sacrifices.
One of the things you sacrifice is your privacy. That ranges from having a pesky security detail to being available almost around the clock, and it extends to fighting your health-care battles a little more publicly than you might want to.
Mr. Layton should tell his political family – the electorate – what he tells his immediate family: what kind of cancer he has, the treatment he will undergo and the prognosis.
That is part of being a modern-day political leader.
There are those who will say: "How dare you? How dare you criticize a man who is fighting for his life?"
Mr. Layton is a big boy. He can take it. The last thing he needs is pity.
The NDP Leader has been an outspoken, eloquent critic of the culture of secrecy that has enveloped federal politics under Stephen Harper's Conservatives, as exemplified by everything from the refusal to release records on Afghan detainees to the reluctance to disclose that the Prime Minister required emergency-room treatment for a flare-up of his asthma.
Ask yourselves this question: If it was the Prime Minister who was undergoing cancer treatment, would we be satisfied with the vagueness of the information? So why should we accept this lack of transparency from the Leader of the Official Opposition (and potential PM-in-waiting)?
Mr. Layton is taking some time off from work for medical care. But during his sick leave he still has an opportunity to make a powerful statement about transparency and openness, and to serve as an inspiration for cancer patients at the same time.
Give us the details, Mr. Layton. It will help us better understand your predicament and prepare us for your return to work on Sept. 19 – just in time for the Terry Fox run.
Politicians and procedures
In the United States, full disclosure of politicians' health records is now the norm. The days when presidents could hide something as inescapable as a crippling case of polio, as Franklin Roosevelt did, are long gone. The details of President Barack Obama's annual check-up are made public; his HDL (good cholesterol) is 62, LDL (bad cholesterol) is 138 and his PSA is 0.7. John McCain, when he was running for president, released 1,200 pages of medical records to demonstrate he was fit for office.
While he was in office, Ronald Reagan underwent four surgeries – two to remove polyps from his colon, one to remove skin cancer from his nose, and one to extract a bullet after an assassination attempt. The media covered the procedures in excruciating detail.
But in Canada there is no such tradition of openness. In fact, secrecy is the norm.
For example, in 1991, then leader of the Official Opposition, Jean Chrétien, had surgery to remove a nodule from his lung (it turned out to be benign) and even his communication director was kept in the dark.
In December, 1994, Bloc Québécois leader Lucien Bouchard contracted necrotizing fasciitis (flesh-eating disease). It was days before the media learned that his leg had been amputated and he had come within a hair's breath of death.
In 2006, prime minister-designate Stephen Harper was treated in the emergency room of the Civic Hospital. Mr. Harper, who suffers from asthma, was prescribed antibiotics for a chest infection and sent home. The visit only became public because an Ottawa Citizen reporter was tipped off, and the PMO was irked.
Earlier this week, Jack Layton, leader of the Official Opposition, announced that he has "non-prostate cancer," his second cancer diagnosis in 18 months, but refused to reveal more details.
These, of course, are just the medical issues we know Canadian political leaders have suffered while in office. For decades, the occupants of 24 Sussex Dr. and Stornoway have taken unannounced vacations abroad, had enigmatic physical ailments and enjoyed a personal cloak of secrecy about medical matters that would not be tolerated south of the border.
André Picard