Physician author speaks about opioid crisis in rural America

William Cooke, author of “Canary in the Coal Mine,” spoke in Minnesota State’s Ostrander Auditorium Thursday about the opioid crisis.

MSU Masters of Social Work professor Nancy Fitzsimmons recommended the book to her students after finalizing the required reading list after she found out Cooke, a physician and author, would be coming to campus. All eight of these students chose to read the book and attended Cooke’s speech.

“We’ve been talking a lot about the social determinants of health as a framing for the class. So the talk today from Dr. Cook really resonated thinking about what impacts people’s health and the choices that people really have. You only have choices when those opportunities are made available,” Fitzsimmons said.

Olivia Rivers, MSW student, said she and her classmates “fell in love with it” and she resonated with Cooke’s “care and compassion” that shows through his desire to help anyone regardless of their resources and challenges.

Undergraduate student Al Worrall also read the book and attended the speech for their psychopharmacology course.

“The most memorable part of the book for me was when he was really going into detail about how Christians need to show compassion towards those with addiction. That is incredibly important that he’s fighting from a Christian background,” Worrall said. “Although I am not Christian myself, I think it is an excellent perspective and I think it can bring a lot of good.”

One of Cooke’s main points was the concept of making good choices and how those born into poverty or have limited resources are limited in the choices they have. 

The book is named for the caged canaries coal miners would use to detect toxic gasses. A dead canary indicated danger. Austin, Iowa, where Cooke traveled to practice medicine in the early 2000s, is the metaphorical canary warning the world of an unprecedented opioid crisis and HIV outbreak that would soon become the most severe in rural American history.

In his speech, Cooke chronicled his life from his birth in Appalachia to an undereducated family, many of whom struggled with addictions, including his mother and grandfather. According to him, he struggled in school and with teachers who told him to “try harder,” without giving him guidance on what, specifically, he needed to succeed — a sentiment that parallels the stigma attached to addiction and recovery.

After graduating from medical school, he moved to Austin, Iowa to practice medicine, a town that would be severely hit by an HIV outbreak caused by needle sharing and a lack of medical infrastructure, according to Cooke’s speech.

“Healthcare disasters don’t just happen; they develop right before our eyes, unseen or ignored until it’s too late,” Cooke wrote in “Canary in the Coal Mine,” which is available free in ebook form through the MSU library.

Write to Carly Bahr at

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