The pharma business

Before there were MBAs expounding on ROI, consolidators and in-licensors, financiers and bean-counters, and senior executives who arrived from HQ with incomprehensible directives, there were visionaries and coasters, mentors and a couple of nearly forgotten rascals, golfers and curlers by the busload, thin men in long white coats shouting “Eureka!”, and even one Belgian humanitarian named Janssen.

Through the years, however, there was never a category capable of defining Robert Lavoie of Montreal.

Bob Lavoie was not like everybody else. He created and built a worldwide brand, Ombrelle sunscreen, along with a portfolio of products and a sustainable national business, on his own, using scant capital. He began Dermtek Pharmaceuticals with little more than four wheels and a home office — along with his instincts, persistence, and the item that proved to be his ultimate resource, which was the stuff in his heart. He worked hard, played hard, and did not apologize for loving life.

He possessed the imposing physical form and the shaved pate of a TV wrestler, and the appraising, benevolent eyes of a starving artist. He approached the creation of medicines with an aesthetic sensibility. Efficacy is always a given, but if a product didn’t look right or feel right, or not live up to his vision, he would scrap the lot, take the financial hit, and begin again. He could never explain his style of perfectionism to Bay Street, but the good news was that as an independent business owner, he never had to.

He was, appropriately for the founder of a dermatology company, comfortable in his skin. When he once came across an ad for a hair restoration product that featured a bald father and his balding son under the headline, “Now You Don’t Have to Look Like Your Father,” he shook his head sadly. “What,” he wanted to know, “is wrong with looking like your father?”

His father met his mother in Bermuda during the 1940s, where he travelled to take an immersion course in English. The student, Jean-Louis Lavoie, was Quebecois; the teacher, Joan Marie Smith, was Irish. They married.

Bob entered the world via Quebec City in 1946. Jean-Louis was a tireless entrepreneur, which in post-war Canada meant you sold things door-to-door. One of the products he represented was a plastic overlay meant to be placed over a monochrome television screen, that purported to convert your black-and-white set into living colour. They cost a couple of bucks apiece, and Jean-Louis could barely keep up with the orders.

There could only have been some sort of Franco-Hibernian alchemy in the Lavoie household.

The five kids each became accomplished. Brenda is an acclaimed graphic designer; Jack writes, sings, records and performs music while running a large landscape-architecture business; Paul makes documentary films and founded an award-winning multinational ad agency; Michele Cherbaka made a career in nursing and helping others.

The Quebec City of Bob’s adolescence in the ‘50s and early ‘60s was characterized by Elvis on the radio, sock hops, and the genial prolonged boredom that marked the era. To pass the time, groups of lads would square off in the parks on summer weekends, emulating the “rumbles” observed in the movies and in the popular magazines. The usual tribal divisions were in place, and the goons from St. Patrick’s, the English high school, would enact scenes from West Side Story against the toughs from the rival École, who were happy to reciprocate the attention. Bob attended St. Pat’s, with his buddies Gerry Hickey and Dennis O’Dowd, and many good times were had across the cultural divide, taunting and punching, and receiving insultes et coups de poing.

Much later, Bob would wonder why he raised fists against the kids from the francophone high schools, observing, “I’m French myself.” He let the memory of cousin-whomping-cousin linger for another minute. “It’s crazy,” he concluded. “It doesn’t make any sense.”

That became one of his signature catch-phrases, and he’d use it to summarize current developments in commerce, medicine, gastronomy, music, and politics, all with the same verdict. It’s crazy; it doesn’t make any sense.

Bob’s first job was selling newspaper ads for the Quebec City Chronicle-Telegraph. Out somewhere trying to hustle up business, he came across a man who drove a very cool car. Bob thought to ask the man what he did for a living that enabled him to own a vehicle such as that. The man said, “Why, son, I’m a pharmaceutical representative,” and Bob suddenly saw what his future would look like.

He applied for a job at Westwood Pharmaceuticals of Belleville, Ont. and Buffalo, N.Y., which became the dermatology division of Bristol-Myers Squibb. They hired him, provided a not-especially-cool car and a heavy sample bag, and put him on the road to detail dermatologists. He became a top salesman and a familiar figure in the specialty across the country.

Seven years later, Louis and Sylvia Vogel invited him to join TransCanaderm, a Canadian startup in dermatology that licensed products from U.S. and European suppliers. Bob honed his skills, and company revenues soared.

Time passed and once again he developed a seven-year itch, and began thinking about launching a company that might develop and market its own line of original Canada-created skincare products. That idea would become Dermtek Pharmaceuticals. The company was born out of the rumpus room in his Montreal home in 1986.

He worked his tail off. He’d set off down an ice-covered Highway 401, from Montreal to Windsor, Ontario, to the accompaniment of Peter Gzowski droning on the CBC’s AM-radio stations, with Sebcur T samples in the trunk, and a bag of fresh grapes and plums as his seat-mate. He didn’t mind the solitude, and quite enjoyed the fruit. “It keeps you alert and energized during the drive. You’ve got to try it,” he would proselytize.

Some key dermatologists encouraged Bob in his mission. A group of west coast physicians, led by Drs. Stuart Maddin and David I. McLean, thought the world could use a better sunscreen, and believed that an agent known as avobenzone would be useful against a broad range of sun wavelengths. European regulators approved the Parsol 1789 version of the compound in 1973, but the U.S. FDA would drag its heels for the following 15 years.

Bob took advantage of the lull to create a Parsol 1789 formulation he trademarked as “Ombrelle.” Brenda Lavoie designed the distinctive branding and packaging. It became the first-to-market designer sunblock, and created an entire category.

David McLean recalls: “Yes, the formulation was good. The marketing was better. Brilliant package. Great outreach.”

The outreach part was pure Bob. He would turn up at random outdoor events in a decorated Range Rover, with his son Michel and his son’s friends by his side, and they would pass out product samples to an amused public. Today, this practice is known as “pop up” or guerrilla marketing, and there are graduate school courses taught in the discipline. But Bob was an early adopter, if not an inventor, of these methods, which occurred to him because he thought they might be effective, also because they seemed like fun. (Two more frequently-heard Bob exultations: “How fun is that?” “What fun!”)

If he was an Artist by temperament, and a Businessman by practical instinct, Bob’s third calling was Merry Prankster, ever in search of the legendary lost mine of joy.

He discovered it at the North Lake Fish and Game Club, established in 1896 somewhere near Pointe-Au-Chêne, Que. He found it again in his Nuns’ Island penthouse, and he hit the motherlode of fun in the Laurentians town of St-Sauveur, where he purchased and restored a mountaintop Modernist home that eventually became the centre of a family compound.

He sold Ombrelle to L’Oreal in 1997, for what was presumed to be a lot of money. The transaction changed Bob’s circumstances, but it didn’t change Bob. The deal intensified what was already an inclination toward generosity, and he thought nothing of handing over use of his cars or condo to anyone who expressed an interest. His wardrobe got a little flashier. He spent some time with the Nuns’ Island celebrity dentist, Dr. Elliot Mechanic.

A particular low-point for Bob was after Jean-Louis died. He met a friend for a drink at the West Island Holiday Inn. He hadn’t shaved, was exhausted, and he looked terrible. Then, abruptly, the mechanism that triggered the fun function kicked in. “Let’s go up to St-Sauveur, I’ll make dinner,” he suggested. His friend had some colleagues in tow, and he had promised to provide them with a meal. Bob’s solution was, “We’ll bring them along.”

So, the quickly assembled quartet shot up the Autoroute 15 at dusk. One hour later, Bob welcomed the strangers to his home and led a tour of the grounds. He began preparing supper: a fresh fish recipe he had learned from Dr. Wayne Gulliver of St. John’s, Nfld., paired with a few favorites from his wine-cellar. His mood brightened. Give Bob the opportunity to be generous, and he would grab it and run with it, and nothing made him happier.

Last summer, he married his soulmate, the love of his life, Dr. Suzanne Gagnon, near the big house in St-Sauveur. They were surrounded by their blended and extended families, including Suzanne’s mother, and Bob’s two closest high school friends, Dennis and Gerry, and their wives. It rained throughout the ceremony, making everyone draw even closer. The music summed up the occasion: C’est si bon. Non, je ne regrette rien.

A few months earlier, he had received the extremely rare Award of Honour from the Canadian Dermatology Association, in Saskatoon, which filled him with pride and emotion. Michel was excelling at his expanded role at Dermtek, and Bob’s daughter, Marie-Claude, was thinking about returning to the business after several years as a stay-at-home mom. Bob had just celebrated his 70th birthday, and (once again befitting the founder of a company that makes anti-aging products), he could have passed for being 15 years younger.

Lately, Bob had allowed himself a bit of reflection on what it all meant. Dr. Maddin mentioned Ombrelle in his 2015 book on dermatologic discoveries, and he gave Bob credit for popularizing a product that has protected millions of people from sun exposure, and has surely prevented casualties. Bob revered Dr. Maddin, kept his photo displayed in his home, and the words meant far more than just the obvious validation.

He seemed to cherish his family and his friendships even more recently. He spoke regularly of his grandchildren, and was pleased with a postcard campaign he devised that featured himself, and Michel, and Michel’s newborn son Brandon, all sharing the hereditary Lavoie grin and glabrous dome. Always affectionate, he now greeted both the females and males in his circle with ardent kisses. It was as if he woke up one morning in 2016 and it dawned on him that he had created two things he’d never counted on: a legacy, and a legend.

Bob died suddenly in his aerie, high atop Nuns’ Island, late in the evening on Friday, June 17, 2017. He had celebrated his 71st birthday a few days before. He spent the day chatting on the phone with friends, driving his Tesla, managing his business, and making plans. He was going to pick up his mother-in-law, Jeanne-D’arc Voyer, and drive her to St-Sauveur. Later that week he planned to be off to Fredericton, to attend his gazillionth meeting of the Canadian Dermatology Association. After that, to his cherished North Lake, where he had invited his friends Wayne and Mitch and their wives to unwind, and maybe catch a few fish.

His absence was felt during the CDA meeting. He always stood out during the receptions: the pro-wrestler’s body encased in an immaculate suit, and those kind pale eyes. Middle-aged doctors, who knew Bob since residency, learned the news and began to cry. This happened again and again.

Some will insist the pharma business should owe nothing to personalities. They will argue that the life sciences should only be about formulae and modes of action contained in product monographs — and never about the women or men who make or market the cures.

Bob Lavoie might have disagreed, but he was aware that he started out with a natural advantage: all that stuff in his heart that made him different and set him apart.

He invented some medicines and he made some money selling them, but he knew all about another thing that doesn’t have a DIN number, never gets included in formularies, doesn’t involve a listing fee, and never comes with an expiry date.

That would be love, an item you can only give away.

It’s crazy, is what Bob always used to say. It doesn’t make any sense.

Whatever you may think of how the sex trade is depicted — and if you do have a view, it’s really not for me to judge — Harvey Keitel’s performance in the 1976 movie “Taxi Driver” established anyone’s enduring idea of The Pimp in Society.

Here’s Harvey: A permanent image of pimp-as-everyman

Keitel, in his role of the procurer who went by the catchy street-name of Sport, walked the swaggering walk and talked the importuning talk, as the following dialogue snippet will make clear:

That was back in the Bicentennial Year, when pimps were pimps, long before this current digital age. Deserted street-corners used to be zones where illegal commerce might thrive, at least according to the movie archives. There was lots of room in the urban margins for Sport or any other ambitious sleazeball, along with branding opportunities a-plenty for those garbed in mack-daddy gear.

These days… not so much. We learn from this morning’s news reports that today’s savvy consumers of sex-trade services prefer the efficiency of beginning their quest not by seeking a human go-between, or a panderer, but by directly querying the Siri or Google search engines on their smartphones.

Which is logical enough, one supposes, except when you consider the propensity of Google and Siri to mess things up, as they surely will do through functions such as auto-correct. This has been the subject of various comedy routines, and the bane of anyone attempting to send simple text messages. The website damnyouautocorrect.com has scads of entertaining examples, such as: “Just leaving the optometrist. They diluted my puppies [sic] and I can’t see.”

Oh, how we laughed at the machine-generated malapropisms.

And perhaps Alvin Acyapan also found it all funny. But that would have been before Siri turned him into the first known example of an accidental ponce.

Mr. Acyapan is the owner of the Toronto branch of the “Meltdown eSports” chain of bars. Since opening a few months ago, he has provided a somewhat clean, mostly well-lighted place on Toronto’s College Street, where millennials may gather to drink craft beer and play videogames. The poor fellow couldn’t figure out why a succession of heavy-breathing chaps kept calling his business to make inappropriate inquiries about this act or that — until one happened to ‘fess up that the Meltdown phone number had been passed along courtesy of good old Siri. As in: “Siri sent me.”

No middle-aged technophobe dimwit, Mr. Acyapan quickly deduced that Siri was offering punters a half-baked algorithm. It seems that to Siri’s inexpert ear, “eSports” sounds much the same as “escorts.” As the astute publican tells the Toronto Star newspaper: “It’s only one letter difference.”

Because the Star employs a crack team of trained journalists, they had to check it out for themselves. So, a Star scribbler asked Siri to locate “prostitutes,” “escorts,” and “hookers” (all the while trying to figure out how to avoid telling his mom what he’s been up to at work.) True to form, Siri coughed up co-ordinates for Mr. Acyapan’s establishment.

Unlike Mr. Keitel’s depiction of Sport, Mr. Acyapan appears to be a good e-Sport about the matter, commenting, “I see the humor in it.”

Humor, for sure, but what he perhaps fails to see is the immediate economic opportunity.

After all, digital businesses have been trained to pay huge money to appear at the top of search-engine listings, and a top SEO ranking should be seen as a gift from the Internet gods. If Mr. Acyapan is any sort of entrepreneur, he will grasp that today’s commerce adapts at the speed of thought, and he will recognize the imperative to meet the actual, rather than perceived, needs of his potential customer base.

In other words, this represents a business school case-study dilemma for our times. Namely, if Siri wants to steer cash-clutching clients to your door, do you really want to be redirecting them across the alleyway? Especially in an enterprise with such low barriers to entry as the escort business, where the only fixed requirements are a white fur stetson, an ebony walking-stick, a couple of gold teeth, and plenty of bling. (I may be overlooking a couple of other accoutrements, but don’t tell me there is anything that can’t be efficiently outsourced, or else ordered through Ebay.)

Listen up, Mr. Acyapan. That could be opportunity knocking, importuning you to convert your kiddie bar to a knocking shop. Do not overlook the truism that many will be Googled and Siri-ed, but few will be optimized.

Remember, Mr. A., that one needs to pass law board exams to call oneself a lawyer, and it takes seven years of boring study to call oneself a doctor. But here’s a rare case where Siri is prepared to grant you an occupational designation without a scrap of effort — and all you need to do to begin this remarkable undertaking is to try to look plausible when you ask, as you must, “Do I know you?”

A great truism of Commerce is: You’re never in the business you think you’re in.

Successful organizations in other sectors – look at Starbucks as one random example – are able to see beyond the obvious, to understand what customers want, and execute. And what they want, it always turns out, is not necessarily the mug of coffee. It’s the overall experience, the gestalt.

Unsuccessful corporations, conversely, meander toward their graves complaining that they are misunderstood, even as the last of their customer base vanishes.

(One very recent, and amusing, illustration of the preceding was provided by the Toronto Star newspaper publishing group. Panicked that traditional readers and advertisers continue to reject their core product, the company’s brain-trust is desperately seeking alternative revenue-generators. The latest example is their new effort to sell their own brand of packaged coffee directly to newspaper subscribers. It’s reasonable to examine Starbucks as a potentially inspirational strategic case-study, but who could possibly conclude from the exercise that it’s a dynamite idea to slap on a green apron and literally do what the baristas do?)

One of the key questions we in the Life Sciences continue to ponder is, “What business are we supposed to be in, anyway?”

The answers, unavoidably, are complex.

We exist for the not-always-compatible purposes of returning sick people to health, and earning profits for investors.

We operate under rigorous regulatory scrutiny, and yet need to respond nimbly in real time to evolving public health concerns. 

We require robust and predictable economic performance in order to support ambitious research programs that will lead directly to new therapies needed for chronic illnesses. And we need to sell those remedies at a price-point that is acceptable to formularies and third-party payers.

And while reconciling each of those missions, we also need to maintain the goodwill of multiple constituencies that often seem to be permanently at odds with each other.

It’s one thing to give the people what they want, but there is also a required mandate to educate the public and the physicians who treat them. Over generations, patients have shown a strong willingness to spend their own money on nutritional supplements and natural products that have demonstrated dubious clinical efficacy. Yet preventative vaccines and curative pharmaceuticals are the ready subjects of conspiracy-theorists’ wacky speculation. (“What’s that, Mr. Trump? Vaccines caused an autism epidemic? If you say so, sir.”)

Small wonder, then, that there is little consensus among the best-intentioned Life Sciences managers regarding a logical course to follow. On the other hand, the worst-intentioned always seem to have a plan.

A year ago, we characterized Martin Shkreli, then the price-gouging CEO of Turing Pharmaceuticals, as an exemplar of our industry’s worst instincts and least defensible practices: the unacceptable face of the Life Sci sector. 

Therefore, we would not have anticipated that it might be the same Martin Shkreli who would lead the pharma industry toward a better understanding of how to transmute negative public sentiment into revenue.

He has proven himself to be a shrewd assessor of current monetization techniques. Acknowledging the axiom that you’re never in the business you think you’re in, he has astutely forsaken drug marketing, and instead entered a more promising endeavor, one with widespread interest. Creatively, he’s invited the public to bid for the right to haul off and punch him in the face.

Adding uncharacteristic philanthropy to his typical irony, he says he plans to use the funds from the opportunity toward the medical bills of a friend’s child. Regardless of motive, it’s plain that he understands public sentiment, as well as how to deliver a sought-after service. As this issue went to press, the top bid reached US$50,000. That will be a sum significant enough to capture the attention of companies’ new business development teams.

With barriers to entry being minimal and profit margins unsurpassable, it is a certainty that other pharma organizations will seek to copy Mr. Shkreli’s concept, and promote the availability of corporate officers for periodic sideline work as face-punch recipients.

As the potential to advance this fresh area of activity becomes more apparent, we would expect directors and shareholders to encourage the rapid development and deployment of in-house face-punching capabilities. Perhaps clinical trials should be initiated immediately, as it seems likely that data will confirm how administering a thump to the skull of executives such as Martin Shkreli may trigger feelings of contentment, if not euphoria, among patients.

Eventually it may prove a lucrative long-term strategy for organizations to bundle the annual cost of a patient’s drug regimen, with the ancillary right to deliver a cuff upside the noggin of a drug company representative. Should this become mainstream, our sector will owe a debt of gratitude to Mr. Shkreli, for revealing the actual underpinning of the pharma business in the 21^st Century.

Drugmakers previously regarded suffering a black eye from a regulator or a litigator as just another risk factor, among many. Thanks to Mr. Shkreli’s pathfinding, it could become the industry’s very ticket to reinventing itself. Indeed, getting punched in the head may reveal a clarified role for our industry, one that will reveal our true core competency. 

Sandra’s father worked for City Hall, as a safety inspector of the children’s rides at the nearby Canadian National Exhibition grounds. His daughter, an only child, became very popular with the neighborhood girls and boys for brief periods, when the prospect of accompanying Sandra for a free ride on the Flyer roller coaster was re-introduced at the end of each summer.

She finished high school and studied nursing at Women’s College Hospital, an 18-minute streetcar ride to somewhere culturally remote from where she grew up. She graduated in 1967, Canada’s Centennial year and the Summer of Yorkville Village, an approximation of Haight-Ashbury or Greenwich Village. The blocks surrounding Women’s College were not much like Parkdale, and had storefronts with signs that said The Colonnade, the Mynah Bird, the Penny Farthing, the Wreck Room discotheque, and the “elegant new” Sutton Place hotel.

Around that time, Sandra became Sandi, with an “i.” Married a man named Leckie, and they both quickly knew it wasn’t going to work out.

Left nursing — a job that will always wear you down, now as then — and took a sales position in the pharma business. She was good at it, in the way that trained nurses will apply their organizational skills and sense of humane purpose to tasks. Worked her way through the 1970s and early 1980s from bag-carrying positions at Parke-Davis into product management at Purdue-Frederick. Learned a bunch of things, including patient support programs, formulary and government stuff, career-survival during an era when women in the workplace were still being accepted by the old boys with bemused skepticism, or far worse. Out of the many duties a product manager might need to fulfill, Sandi really came to life when presented with responsibilities for advertising and marketing drugs. It matched her creative streak.

She took that talent and put it to work as an executive in the healthcare advertising business, with Terry Johnson, Rick Billinghurst and Dave Lindley at LBJ Advertising, and with Phil Diamond at Diamond Strategic Advertising. She might have been a model for several, if not all, of the characters in the “Mad Men” TV drama. She thrived in the work-hard/play-hard ethos of the ad biz, and elevated her peers through her unique attributes. She had been a good nurse because she was smart, diligent and empathic; she became a great healthcare marketer in part because she had been a good nurse.

In an environment where talent is capital, where outsized egos and personalities are a given, there were no surprises when Sandi determined she could create and run her own marketing company. She called it SpotLight Consulting, which will tell you something. Integrating her initials into the name made it clear who was in charge, but she balked at making the company eponymous. Sagely, the spotlight was reserved for making others look good.

SpotLight was an outstanding success in the late 1980s and early 1990s. Sandi became known around Toronto as the go-to person for marketing services, physician relations work, research projects, and the just-discovered universe of continuing medical education programs. She earned a reputation for instantly getting it, for offering creative enhancements, for delivering and then standing back to let the client take all credit for the success. One meaningful validation: Even her former employers made use of her new company for assignments, frequently on a private-label basis. Clients required her help in exotic European and American destinations, wherever medical meetings took place.

She did well enough at SpotLight to pay for a new townhouse in a quiet and orderly suburban neighborhood that might have been regarded as the anti-Parkdale. She gardened all spring and summer, began to plan Christmas decorations as soon as the fall flowers died, kept immaculate care of her home, planned and threw great parties in living color, set to Neil Diamond music on an expensive sound system.

However, many of the traits that made Sandi a superb person and businessperson could also be regarded as limitations. She was loyal in relationships, fiercely so, and in the commercial world this is not always reciprocal. She was unhesitatingly generous, and some took  advantage. She enjoyed working with and for her friends, and a couple of times disappointment resulted. She worked hard to be positive and encouraging (there, again, was that white-uniform training), and several may have chosen to take that optimistic reflex the wrong way, as something to be answered with cruelty. Her focus was on her clients, and not on her T2 Corporation Income Tax Return, and the thing is, you need to watch both.

SpotLight wound down around 2005, which was a painful process for Sandi, yet, paradoxically, a wonderful thing for one company, Chronicle, where she stepped into the role as Sales and Marketing Director. The benefit was twofold: she was a valuable resource to clients, and the Chronicle people also got to work with and learn from Leckie every day.

“I’m not young,” she warned on her first day in the new job.

“You aren’t old,” someone replied.

“That’s true,” she nodded, the nurse taking note of a clinical fact.

So, this is what the Chronicle people learned from the gift of spending time with her during the ensuing decade.

1. Be interested in people. Learn the name of the person who sells you your lottery ticket, and tell him your name. Find something you have in common.
2. While you’re at it, you might as well be kind. It takes less energy to be positive and helpful then it does to be an asshole, and occasionally something good might result.
3. It’s okay to love your work, to be good at it, to be smart and to take things seriously, especially if none of that stuff is fashionable. Look at it as a sneaky way of being a rebel.
4. The main thing is: Always be professional, because, you see, there isn’t any other way to be.

There were other instructions, naturally, but those all things fall under the categories of Business Strategies and Tactics, or Undergraduate Biology, or Stuff Already Described in Textbooks and on Websites. Leckie’s forte was well beyond any of those things. It will sound exaggerated, but she knew how to make policemen and authority figures disappear, just by smiling. Whoever did that? How was it even possible?

What was seldom obvious about her was how much of an effort it sometimes took for Leckie to be Leckie.

Remembering other people’s children’s birthdays and favorite meals, and being available to hear about other people’s bad day at the office, and spending money on little presents for those who might wonder why they were receiving gifts, all came at a personal price. She would recharge on a weekend at her friends Tom and Susan’s place in Muskoka, or for a couple of weeks in a rental apartment in Florida, or on an afternoon with a book in a folding chair at Cherry Beach. But it could not have been easy being Leckie 24/7, and it wasn’t. Through her most productive years, she found enjoyment in slot machines, and a glass of wine, and a cigarette to go along. That, too, was Leckie, though not the version of which she was most proud.

That Better Leckie was fascinated by everyday things, exhibiting both childlike wonder and adult charm.

She knew the charm was a magical commodity, but minimized it as her just need to “be terribly entertaining.” She beat the drinking, with courage, and for eight years helped a wide circle of people in her A.A. community. In the end, it was the cigarettes that got her, that stress-relief habit acquired back in nursing school. She died of lung cancer on August 14. A memorial will be held on November 8 from 1 to 4 pm, at the Florida Room of the Estates of Sunnybrook in Toronto. A fund is being established in her memory to enable children with severe skin diseases to attend a summer camp, Camp Liberte. If you’d care to contribute, please write to: health@chronicle.org.

It will astonish no one who knew her that she worked to her final day to plan every element, every last detail of her own memorial event, because it meant everything to her to think that her friends would be happy and think well of her.

Well, of course, she did. Of course, she did.

Of course, Sandi Leckie would.

It is no small achievement to lay claim to the title of Ultimate Despised Figure in the one business the public most loves to hate: to gain status as, in the critics’ view, the smelliest varmint in the skunkworks.

What does it mean to be worst of the worst? True to typical CEO form, some of the economy’s most successful leaders are known to rankle. (Look, you can’t please everyone.) Others drive harder and become magnets for hostility. (When you cook an omelet, you need to break a few eggs, friend-o.)

That said, there is nothing—but nothing—to prepare anyone for Martin Shkreli.

Mr. Shkreli is the founder of Turing Pharmaceuticals, although it would be wrong to assume that he follows any previously known tradition of drug company entrepreneurship. After all, Dr. Paul Janssen founded a drug company and became revered. Abe Plough started his company and won respect. No one is ever going to confuse Martin Shkreli with Dr. Janssen or Mr. Plough.

Mr. Shkreli is a Millennial, but hardly the sort found living on a futon in his mom’s garage. At 32 years of age, he has been a Wall Street macher for nearly half his life, having learned the trade of hedge fund management early on from mentors such as Jim Cramer, the famed stock-trader/TV presenter. Turing is already the second Life Sciences company Mr. Shkreli has created in four years, after Retrophin Inc. (More about those two organizations in a moment.)

Where Dr. Janssen made his reputation by creating therapies and Mr. Plough by selling them, such fusty, labour-intensive activities are anathema to Mr. Shkreli. He is the kind of opportunistic businessman who will spot and pursue situations that the traditionalist might be inclined to dismiss.

For ex­am­­ple, five years ago, he perfected what we will call the Shkreli Shuffle, a proud­ly braz­en money-making gambit previously uncommon in the annals of Life Sci fin­ance. In this unique procedure, Mr. Shkreli filed statements with the U.S. FDA urging the regulator to reject a new diabetes treatment, and a cancer detection test, apparently for the sole purpose of driving down the share price of the two publicly traded companies tasked with commercializing the wares. His investment house used the lull to short-sell the stocks. This was no service to patients who may have benefited from the timely availability of the products, or to the companies and their investors who suffered financial reverses from the delay. Conversely, Mr. Shkreli and his trusty balance-sheet made out just fine.

No one questions the man’s acumen—although several are investigating his compliance with securities laws. His first company, Retrophin, is suing his subsequent outfit, Turing, alleging trading violations; federal attorneys are reportedly contemplating charges.

Undaunted, Turing made headlines recently after buying the rights to pyrimethamine (Daraprim) from Impax Laboratories. The Rx is a warhorse used since 1952 to treat toxoplasmosis, cancer and AIDS, but Mr. Shkreli aimed to price it like a new biologic, quickly lifting the retail price to US$750 per dose, from US$13.50. Of course, various other drug companies have been quietly raising prices on older medicines for several years, to the accompaniment of muted grumbling from stakeholders. No whispered resentment this time. Nothing about Mr. Shkreli is ever destined to elicit a quiet response.

Patient groups raged at the news. Politicians railed. Chanting protesters encircled the Turing headquarters, equipped with placards. Social media commentators pilloried Mr. Shkreli, who unwisely responded with his own profane Twitter invective. In the process, the entire pharmaceutical and biotech sector was sullied, leading to Turing’s expulsion from the major trade groups, a sharp decline in the benchmark share price index of the entire drugmaking category, and new hearings about pricing, soon to be conducted by the United States Congress.

Pharma has never been a beloved industry among the public, but Mr. Shkreli has found himself tagged as the embodiment of each of his predecessors’ and competitors’ past and current sins. As a parvenu and a Wall Street guy new to the ways of the life sciences environment, he is not at all well positioned to contextualize, and his clumsy efforts to explain things have brought considerable disrepute and discredit to the biopharma industry and all within its orbit. Quoth he: “Dozens of drug companies have done what I’ve done.”

No, Mr. Shkreli. No, they haven’t.

It’s too easy to further demonize this fellow (not least because he physically resembles the actor who played Damien in the 1976 film, “The Omen.”) Thing is, if his flawed understanding, near-complete lack of judgment and unfortunate personality had not lit the fuse, another drug company executive likely would have been cast in the role of cartoon-villain. And when certain business practices relating to supply and pricing are indefensibly crude and ill-considered, it seems convenient to have a prima facie miscreant, a fraternity-brother approximation of J.R. Ewing, to serve in the capacity of human lightning rod.

That may be the logic behind PhRMA’s unprecedented disavowal of Turing, and BIO’s abruptly having tossed the company from its membership roster. More practically, though, they and we must owe a small measure of gratitude to Mr. Shkreli for his foolhardy pricing model, which served to define the outer limits of responsible behaviour by capitalists who make and sell medicine.

By rushing to undertake patently unacceptable actions, he has inadvertently performed a roundabout service to his industry peers, by encouraging each of us to assess and purge our more Shkreli-like impulses, and to come to terms with that unworthy inner voice that sometimes whispers dangerous entreaties. His contribution to our cause is as negative role-model, instructing us to disregard the little Shkreli that might sometimes stir inside the best of us.

BI is not the only pharma company that succeeds while maintaining its roots, and continues to carry out its mission in or near the locale where the founder set up shop. Think of the eponymous Laboratoires Pierre Fabre, the two-billion-euro enterprise which, since its beginning in 1962, remains nestled in the Midi-Pyrénées locale of Castres, population 43,000. Among other distinctions, Monsieur Fabre oversaw the town’s cherished rugby team, Castres Olympique. Since his death last year, the company is owned by a foundation that was established for the admirable purpose of providing safe drugs to the developing world.

It’s reassuring to think that the pharma industry was built by visionaries such as Herr Boehringer and Monsieur Fabre, and that there are still viable locales where the industry flourishes, such as Ingelheim-am-Rhein and Castres. And it seems especially important to take note of these names in 2014, which may go down as “The Year We Learned About Inversion.”

The word “inversion” may have several meanings: the anatomical (as in toenails, nipples), the chemical (referring to hydrolysis of carbohydrates), or the rhetorical (“You say what?”)

To be clear, the inversions that have made recent headlines have little to do with linguistics, and everything to do with international corporate tax codes.

Spearheaded by precedents such as the rock-bottom tax rate the multinational Valeant Pharmaceuticals group enjoys by maintaining its headquarters-of-record in the Province du Quebec, U.S.-based drugmakers earlier this year began a stampede to merge with foreign domiciled competitors. This was done for the purpose of tithing less to Uncle Sam, who demands a 35 per cent slice, and preserving profit for more appropriate purposes. (Here you might imagine Scrooge McDuck in his money-counting room, throwing stacks of currency up in the air because he likes the sensation as they fall back and land on his head.)

The flurry of inversions and attempted inversions reads like a roster of the most familiar names in our sector.

Pfizer, the industry leader, hoped to unite with AstraZeneca, and move its headquarters to the UK from New York City, where they’ve been ensconced only since 1849.

AbbVie proposed to buy Shire and transfer its charter from Chicago to Jersey (that is, the Isle of Jersey; not the place where Chris Christie, pictured below, governs.)

Mylan of Pennsylvania somehow figured that by buying Abbott Laboratories’s generics business, it could begin filing tax returns in Holland.

Auxilium Pharmaceuticals wants to merge with QLT of Vancouver — although Endo Pharmaceuticals now has its sights set on Auxilium. Endo inverted earlier this year through acquiring Paladin Labs of Montreal, at which point it shifted its head office to Ireland.

This most recent rush to beat the traffic out of town may have been touched off earlier this year when that wily old inverter, Valeant, began its takeover moves against Allergan. Currently Allergan hopes to head off the unwanted advance by linking with Salix, which is merging with Cosmo Pharmaceuticals SpA, an Italian drugmaker that maintains a tax address in Eire.

Head spinning? You’re far from alone. As Prof. J. Richard Harvey Jr., of Villanova University’s law school tells the New York Times: “There is likely a herd mentality going on where pharma companies are afraid they will be put at a competitive disadvantage if they don’t find a suitable foreign merger partner.”

Of course, as the professor might have added, part of the problem with a herd mentality is that the herd often plunges over the precipice, or else slams into a solid object. In this case, the collision came in the form of a to U.S. Treasury Department rules, just announced by Washington. To interpret the legislation: President Obama isn’t about to allow the inversion tactic to continue depleting his federal tax coffers, at least not when Congressional mid-term elections are only weeks away.

Regardless of where this issue now stands, it’s impossible to experience, without feeling cheapened or queasy, the spectacle of Life Sciences organizations anxious to make tracks from their communities, solely for the purpose of putting a slick move on the taxman.

We know the arguments on both sides. For C-level management of publicly traded companies, value creation for investors is, and must be, Job One. We all get that — just as we get that capitalism continues to create and bring to market many wonderful things that have enhanced human health, and therefore capitalism is to be entirely encouraged.

But the Inversion Insanity of 2014 shone a light on the unacceptable face of capitalism, just as it displayed the least lovely side of our industry. For, you can turn your back on your community through a simple directors’ resolution, and you can always reinvent yourself in a distant terrain. But, as Messrs. Boehringer and Fabre likely concluded back in the day, all you’ll leave behind is your soul.

Inversion begs the question: If you’re prepared to abandon your roots and identity just because it seems momentarily to be the prudent thing to do, what else are you prepared to abdicate? One traditional defence often issued to justify drugmakers’ high margins is, “Profits fund important research.” Now several of the companies that have championed inversion are also devaluing the importance of R&D programs. They may be likened to farmers who don’t care for the work of planting, regard harvesting as a sweaty and unpleasant chore, and see agriculture as a demeaning sideline to their main business, which is… what, exactly? Chasing away trespassers? Watching the Weather Channel?

What would you tell such rusticated connivers? Exactly what we now say to those of our friends who followed the herd of inverters:

Look. Why don’t you quit screwing around, and just do your damn job? And, while you’re at it, you may as well just pay your damn taxes.

Is it wrong to take pleasure

Those familiar with the man’s exploits may conclude that such feelings may only be, ah, natural.

Mr. Trudeau is the American author responsible for the perennially best-selling medical guide, Natural Cures ‘They’ Don’t Want You to Know About. The book is described on its dust-jacket as “an amazing journey through the behind-the-scenes world of corporate-sponsored health.” A more accurate account would be “an amazing attempt to convince gullible patients that it’s okay to not take their prescribed meds.”

The author expounds upon many unusual theories, among them: Botanicals cure diabetes. Suncreens are the cause of, rather than a means of preventing, melanoma. AIDS isn’t real.

Any skeptic who might wonder why those notions aren’t given greater credence in the scientific literature has unwittingly provided a straw-man to the canny Mr. Trudeau. The reason why natural cures aren’t better known is because ‘They’ Don’t Want You to Know About them. Or can’t you read the book title?

‘They,’ of course, are we — the minions of Big Pharma.

Observing that it’s much more lucrative to offer expensive lifetime treatments for chronic conditions, as opposed to providing a cure, Mr. Trudeau contends that drug makers “don’t want us to get well.”

‘They’ also appear to include the U.S. Food and Drug Administration, which he depicts as a corrupt band of villains that conspires with Big Pharma against the public interest. Continuing this theme, he posits that ‘They’ are enabled by licensed medical practitioners, each a willing dupe who, to quote the author, “[is] taught only how to write out prescriptions.”

It would be convenient to dismiss the purveyor of such unconventional views as a fringe crank shouting jeremiads to an alienated audience. Not so. In the 10 years since Mr. Trudeau’s book first emerged, he has sold 5 million copies, at 30 bucks a throw. He has also written a half-dozen sequels, each offering similar ideas.

Lest it be thought that a background in the lab or clinic be required in order to write a medical bestseller, Mr. Trudeau’s CV stands in stark contrast to the norm. His knowledge was gained in the automobile sales-lots and the neighborhood porches of suburban Boston, where he hustled sedans, and pitched vitamins door-to-door through a multi-level marketing scheme. His later disdain for doctors notwithstanding, he once pretended to be a physician, in concert
with some 1991 check-kiting and credit-card fraud incidents.

These youthful indiscretions resulted in two years behind bars in a federal lockup. For Mr. Trudeau, this provided a welcome opportunity to re-calibrate, to reinvent himself, and to reflect upon the future.

Let’s see, now. Future, future… Infomercials!

The future, he quickly came to see, was pitching products through the airwaves. After all, he may have reasoned, why yap one-on-one about mini-vans to meat-plant workers in the snow, or sweet-talk pensioners and hausfraus on their grubby doorsteps, when you can reach millions of anxious suckers instantly through the miracle of television?

And so, sprung from his cell, during the next two decades he unloaded an estimated 32,000 infomercials, providing hope for the balding, the obese, the forgetful, the pain-ridden, the impotent and the addicted. His remedies were either nostrums, or else vague descriptions of cures that could only be further explained once an additional payment had been received.

On the occasions when Mr. Trudeau was pressed for evidence to back up his claims, he followed the longstanding tradition of itinerant elixir vendors, and simply made stuff up on the spot. He insisted to a prominent TV journalist that his natural remedy for diabetes was validated through a 25-year research study by the University of Calgary. “Eh? What study?” responded the Canadian institution, to the inevitable flood of media inquiries. “You sure you want the University of Calgary?”

Undaunted by the denial, Mr. Trudeau was quick to deploy the bamboozler’s ultimate gambit, the triple lutz of flim-flam. He explained that the university must have knuckled under and shredded their disruptive findings, following the usual intimidation and threats from Big Pharma’s gunsels: “Nice little campus youse got here; too bad what might happen if youse was to publish dat resoich.”

In other words, there “They” go again, doing what they always do; that is, trying to shatter the dreams of the balding, the obese, the forgetful, the pain-ridden, and so on.

When the authorities, including the Federal Trade Commission and the Securities and Exchange Commission, stepped up their warnings, Mr. Trudeau became emboldened. “They” can’t silence me, he proclaimed, even as he paid millions of dollars to settle litigation brought against him by Washington and state agencies.

Finally, in late spring of this year, the jurisprudence system determined it had enough of Kevin Trudeau. Further to a district attorney’s comment that he is an “unrepentant, untiring, and uncontrollable huckster who has defrauded the unsuspecting for thirty years,” bailiffs accompanied the author to his new accommodations at the federal prison camp in Montgomery, Ala., where he is registered for an eight-year stay. He has filed a judicial appeal of his conviction.

This leads us to the point in this narrative where the minions of Big Pharma (a.k.a, “They,” or we) should exchange high-fives to celebrate the elimination of one particular scourge. However, the fall and rise and fall — and perhaps rise again — of Mr. Trudeau should present the Life Sciences sector with a valuable lesson.

For all his chicanery and gift of hornswaggle, this fellow is undeniably a gifted communicator who was able to speak compellingly and inspire overlooked segments of the public to form opinions on important health issues.

And, without question, a large part of the reason why Mr. Trudeau, and others, time and again are able to mislead and deceive tens of millions of people is because Big Pharma can’t be bothered to either learn or apply similar skills of persuasion. Industry’s disinterest and ineffectiveness when it comes to engaging the less sophisticated elements of the public is not a sin comparable to Mr. Trudeau’s serial hoodwinking. It only establishes the conditions under which quackery will always thrive.

The stagnant era of 2000 to c. 2014 was one the drugbiz might prefer to forget. It was a long, bleak period marked by diminished opportunities, few therapeutic breakthroughs, managerial inertia, added regulatory and legislative scrutiny and complexity, reticence on the part of payers to reimburse new products, and – most unforgivably, in the eyes of Wall Street – absolutely nothing to show for the sector’s extravagent use of investment capital.

(Regarding the last point, Pfizer’s share price on the first day of trading of the new millennium was $32.06. Fifteen years later, that is exactly the current price of the stock of the world’s largest drugmaker, nearly right to the penny. To compare: Apple, the IT giant, saw its value increase six-fold over the same period. During this identical time, McDonald’s restaurants increased its share-value by 250%, which only slightly lagged behind the performance of 3M, the conglomerate that divested its pharmaceutical holdings in 2006. All of which may explain why investment professionals lunge for the amyl nitrate jar every time the Pfizer name is mentioned.)

Now, however, evidence has begun to appear that the drugbiz may be shaking off its long spell of deep unconsciousness. As of this scribbling, roughly one trillion dollars worth of pharma industry mergers, acquisitions and product deals have been proposed during the past months, or are underway. Though this process of reawaking and reinvention is in its earliest stages, four trends have become evident, as the Life Sciences sector begins to reconstitute itself according to four very different designs.

Tribe #1: The value consolidators

Companies exercising this philosophy grow rapidly by acquiring traditional drugmakers, and by paying for the takeovers through quickly enacting cost-reducing efficiencies. Savings are found by clipping headcount, eliminating R&D programs, slashing tax-rates by relocating head offices to low-tax jurisdictions, and introducing rigidly parsimonious policies. Following thissuccessful playbook established by J. Michael Pearson for ICN/Valeant, adherents to this view (who are capable of becoming Valeant competitors) are Endo Health Solutions and Actavis. Among the familiar corporate names that have been subsumed by the insatiable three: Watson, Warner Chilcott, Forest Labs (Actavis); Paladin Labs, American Medical Systems (Endo); far too many to recall (Valeant.)

Tribe #2: The therapeutic-cluster rationalizers

Notwithstanding the Newtonian laws regarding uniform motion (“An object that is at rest will stay at rest unless an external force acts upon it”), the pharma sector has been frozen in the same spot for too long. This has made the drugbiz increasingly vulnerable to the demands of external forces, in the form of activist investors. Compelled to act, several drugmakers have taken steps to tighten their focus on specialty products within a defined category. This is the logic behind Merck’s decision to bail from the OTC arena, the just-announced product swaps involving GlaxoSmithKline, Eli Lilly and Novartis, as well as the thinking behind Pfizer’s $100-billion initiative to buy AstraZeneca. The diversification strategy Big Pharma persued for the past generation simply has not panned out. GSK, as one example, spread its efforts among absurd product lines such as the soft drink Ribena and the anti-flatulent Beano, before eventually wising up. The latest notion is that a focused approach to a selected number of specialty areas may offer a better success formula than attempting to allocate activities across a mismatched range of disparate fields.

Tribe #3: The bottom-dwellers

In a category where there is a glut of suppliers, no product differentiation, and price is the sole determinate of selection, generic drugs are now widely regarded as mere commodities, and this has upended the unbranded side of the business. Numerous suppliers based in the developing world continue to struggle with quality-control issues, but the impact of the U.S. Affordable Care Act, along with the rise of mega-retailers Wal-Mart and Walgreens as global retail pharmacy powerhouses, will ensure that only providers able to offer rock-bottom costs will continue to enjoy strong demand through the rest of this decade. What they may not enjoy is any sort of sustainable profit margin, as competition among foreign and domestic generic producers moves further into the realm of the cutthroat.

Tribe #4: The “dorm room” startups

Development-stage companies in the Life Sciences exist for the purpose of shepherding a compound from test-tube to bench, or early-stage trials, at which point Big Pharma has ritually stepped in, to sign in-licensing or product acquisition deals. Look for disruptive changes, as a result of economic and technological factors. The consolidators can only grow more ravenous for in-licensing deals, while the rationalizers have bet their future on dominating specific therapeutic areas. These circumstances will lead companies to chase collaborations with developers ever more fervently, with three elements fuelling the growth of a new generation of biopharma startup ventures: (1) The entrepreneurial spirit will be kindled among PhDs cast away from their comfortable Big Pharma employment; (2) The growing accessibility of sophisticated technology, and the advent of inexpensive new science tools and methods, and (3) The realization by venture capitalists of the potential of micro-startups. Investors remain transfixed by the simulacrum of Facebook founder Mark Zuckerberg (pictured above) single-handedly writing code in his Harvard University dorm room, and quickly converting his doodles into an enterprise worth $67.8 billion. Venture capital forces are keen to gamble that this bootstrap model of value creation will soon extend to the Life Sciences.

Eventually, your sorry old arse

Your human form, consistent with nature’s plan, is breaking down, or seizing up, or, to use the medical terminology, cacking out — almost as if all your biological parts were designed by the General Motors Corporation, which conspired to deprive you of some essential 59-cent meat-sprocket.

In Canada, these occasional thoughts of one’s mortality may lead one to proclaim, “Thank our merciful heavens for the Health Council of Canada, the federal-provincial coordinating agency created to establish nationwide standards for medicare.”

Actually, no one ever said any such thing about the Health Council of Canada, which set out in 2004 to achieve transformative change, especially regarding universal access to pharmaceuticals. In the end, it delivered only quantities of earnest bafflegab through a website, and was pretty much ignored.

And now it turns out the council was just as ephemeral as any other planned-obsolescence entity. We learned this after it ceased to exist at the end of last month (03/31/14), its decade-long mission finally expired. This is another way of saying that the federal government, which shelled out $41 billion in healthcare transfer payments to the provinces and territories over the past 10 years, couldn’t justify continuing to foot the bill for yet one more public-sector bureaucracy positioned somewhere between providers and patients, out in the thicket among the fixers, sneak-thieves, long-con hustlers, and academic grifters.

The passing of the council saddened only the Canadian Health Coalition, a brand new self-appointed group consisting of many of the familiar faces from the permanent floating dice-game. (Say, isn’t that Roy Romanow? Do you suppose his hair-dye is covered by medicare?)

The coalition’s seeming purpose is to restore the council, or recreate something very much like it — and if this sentence doesn’t cause your eyes to roll backward, you probably need to try to get on your ophthalmologist’s wait-list.

The coalition seems to be asking, “How will Canadians ever overcome the status quo, unless we put everything back exactly the way it was?”

That is all symptomatic of the hindsight view. Ten years ago, when the council came into being, Stephen Harper wasn’t Prime Minister, Facebook didn’t exist, same-sex marriage was illegal in most provinces, you could still fire up a cigar in a Duckworth Street pub, and the signs outside Trudeau Airport said Dorval International.

While the council was talking about the importance of change — and talking, and talking, and talking, and participating in long talk-filled luncheon sessions — the world was, of all the crazy things, changing.

As for healthcare in Canada? Hm, maybe not changing all that much.

So, you can call it blasphemy, but right now I’m shifting my attention toward the emerging trends in healthcare, and away from the various Canuck consortia devoted to assuring ever-increasing public funding to noodge for a cheap and dirty patch-over of a broken-down old scheme.

An example of these emerging ideas? Jamie Bartlett, writing in London’s Telegraph, finds something intriguing about the group calling itself the British Institute of Posthuman Studies (BIOPS), which, according to its mission statement, “…is a team of dedicated people who have come together to found the first think-tank in the U.K. that aims to popularize transhumanism, a thought movement where the most innovative, cutting edge technologies meet moral and philosophical concerns.” Or, as the Telegraph headline summarizes: “‘Transhumanists’ are planning to upload your mind to a memory stick…”

Ray Kurzweil is a Big Thinker who has been promulgating this sci-fi concept of Human 2.0 for years. He is currently on the payroll of Google in Mountain View, Calif., and is an enduring Jaggeresque rock-star of the Transhuman movement. It takes nothing to dismiss Kurzweil and his fellow visionaries as Silicon Valley kooks, and Bartlett’s inventory of their projects invites instant skepticism — including, as it does, “mind uploading, megascale engineering, molecular manufacturing, autonomous self-replicating robotics, cybernetics, space colonization, virtual reality, and cryonics.”

Pausing for breath, Bartlett asks, on behalf of all of us: “If we can upgrade ourselves with technology, why not replace the body entirely?”

Fair question, but my fellow Canadians will spot the problem, won’t you? Because, in Canada, as things stand, healthcare is the exclusive responsibility of our provincial governments. These are the same people who can’t be trusted to order up something as prosaic as an air-ambulance, or a medical-record storage system, or a skid of tongue depressors, without turning it into a carnival cash-grab for the politically connected and their patronage-hungry chums.

Therefore I don’t envision ever trusting the Ontario health ministry to go out and find a suitable upgrade replacement for grandpa’s creaky old grandpa-body. (“Look, lady,” the delivery man from the Ministry of Transhuman Affairs is bound to tell you. “It says right here on this e-form that I’m supposed to deliver your father’s clown to this address. I don’t know nothin’ about no clone.”)

You see, under our single-payer healthcare tradition, it’s always about the egalitarian high-minded doctrine of socialized medicine — right up to the point where it becomes time for the consultants to negotiate their per-diems. That’s when you want to keep one of your hands clasped over the other hand, with both tightly positioned over your wallet.

As it applies to Canada, the best that might be said of the BIOPS-inspired prospect of uploading minds to a memory stick is simply this: When it comes to the minds of various Canadian council and coalition and committee members, you sure won’t require a very big stick.

Toronto

One emphatic source of the World Class conjecture is the mayor of our fair city, the controversial Robert Bruce Ford. His Worship still lives a block or so away from the house where he grew up. This is where most of his family and all of his underemployed friends live. Do not blame the man for never wanting to pull up stakes. He and all his kin are ensconced in a nice-enough part of town, judging from the police surveillance footage of the mayor out running private errands at midnight, looking to score Creamsicles. Or whatever form of monkeyshines it may have been.

But, again, you hardly can condemn the man for parroting the phrase each of his mayoral predecessors used when they tried promoting tourism for our cold, smug, self-absorbed burgh. Perhaps the take-away message is simply that one should never make a big thing out of being cosmopolitan, when one has no clue what the word means.

http://www.youtube.com/watch?v=IfMSgnQremQ

By now you will have caught Mayor Ford’s sweat-drenched appearance on the Jimmy Kimmel TV program in Los Angeles. In Toronto, Ford’s detractors responded to the show with theatrical hand-wringing and expressions of fear that our World Classiness had been diminished by the lout, or his accompanying brothers, who go by the names of Daryl and Daryl. This continues the repeated warnings issued by a local scandal-sheet that Ford’s very existence is injurious to townsfolk, and a significant threat to regional prosperity.

Such overwrought declarations are in vain, judging from the affectionate response the mayor received in El Lay, which even precipitated a sudden rise in the value of the Canadian currency on global markets, in the wake of his visit.

How do you begin to make sense of this pronounced disparity of attitudes, across 39 longitudinal degrees?

Loved by the little people in Vancouver and Los Angeles, reviled by the taste-makers of his hometown: Is Rob Ford sui generis in the annals of democracy?

Land’s sakes, no. Along the continent’s west coast, in California, as in Washington, Oregon, Alaska, and British Columbia, there has been a longstanding tradition of the public embracing their eccentric politicians and public figures. These leaders have ranged from the somewhat loopy, to the batshit crazy.

Even the current 39th Governor of California, Edmund Gerald “Jerry” Brown, Jr., was previously awarded the sobriquet “Moonbeam” for his non-conformist ideas and lifestyle. Gov. Moonbeam’s predecessor was Gov. Arnold Alois Schwarzenegger, “The Governator,” a self-admitted abuser of anabolic steroids who had previously been photographed enjoying a spliff. Arnold famously fathered a child with Mildred Baena, the housekeeper who was employed in the mansion of the Gov and his wife, the newscaster Maria Shriver.

There is a pattern here. You might conclude that the political and personal behavior that resulted in Mayor Ford being judged dysfunctional by some factions in Toronto doesn’t come within a straitjacket’s clasp of qualifying as kooky, out west.

And that is instructive. Because, Toronto’s ongoing need to be regarded as World Class is in many ways comparable to Emperor Norton’s insistence on being held to be regal. The people of San Francisco, more than a century ago, were confident enough in their global standing that they could embrace the whimsy and humanity of having someone atypical and offbeat as a civic figure.

That quality of bigheartedness, I will argue, is one of the things that defines a community’s status among cities. You can easily connect the dots from Norton, to the Beat Poets, to the Summer of Love, all the way to Silicon Valley in the 21st Century.

Mayor Ford’s detractors, constantly fretting and squealing to each other about the city’s reputation, fail to qualify as admirable on just about every count. They are heirs of the pinch-featured moralists who exemplified the place formerly known mockingly as Toronto the Good, a pleasure-free zone of rigid formality, soul-crushing blue laws, and a level of condescending social stratification that seems out of step with this century, or the last.

Western locales pride themselves on maintaining the principles of laissez-faire reasonableness, while the east remains under the sway of a social reform movement that insists on telling other people how to behave, what to think, how to live. You tell me: Which do you think is World Class?