The uncut truth behind so many cancelled surgeries

In normal times — and we can scarcely remember them — the Queensway Carleton Hospital did 30 to 40 cases of elective surgery every day.

In this pandemic period, the number is between two and five, meaning it is postponing in the range of 150 surgeries a week, for about five weeks now, with no resumption to normal numbers in sight.

The numbers at The Ottawa Hospital would be even higher, as it annually handles more than 51,000 surgical cases, or roughly 1,000 a week. Add in the Montfort and the Ottawa Heart Institute, and it adds up to a world of ongoing hurt.

I’m now a statistic. On April 27, I was due for a hip replacement on the left side. Monday morning, I was told the elective surgery was postponed, to a date to be fixed later, probably months from now.

In the scheme of things, this is not much. People are dying, or hanging on in ventilators, alone, away from their families. They deserve the system’s full attention.

But not to be forgotten are all the little people — and there would be thousands — who are casualties of a system suddenly thrust into emergency mode by clearing the decks of non-essential treatment. Who measures their suffering?

We discovered last week, for instance, that acute-care capacity across Ontario hospitals is at about 64 per cent, leaving considerable room for a COVID-19 surge. Did we clear out too much space? Possibly, but that is the much wiser option than not having enough, which would be disastrous.

It is so long ago we spoke of field hospitals in parking lots. Fortunately, that doomsday is likely not on our calendar.

Tragically is not this hip’s demise.

As many middle-agers know, from the onset of pain to the relief of joint-replacement surgery can take about two years. On bad days — and nights — given a shot of whiskey and a sharp saw, you’d swear you could cut the damn thing off yourself.

But most days, it’s bearable.

You take the stairs one a time, if need be, get up and down slowly, and thank God for giving us our daily bread of naproxen. So I can wait.

There are others out there, however, like cancer patients, living in a world of worry.

Jeanne Ward, a late-career high school teacher, was diagnosed with Stage 2 breast cancer in late February. She was to have a lumpectomy and a lymph node biopsy on April 1 at the General campus of The Ottawa Hospital. Once the scope of pandemic preparation became clear in mid-March, she received a call on March 24 saying the surgery would be postponed.

“Quite disappointed,” was her reaction, she said Monday.

But then came evidence a giant system like cancer care can be quite nimble when it wants to be. Ward said her doctor offered the option of having the procedure done at the Winchester District Memorial Hospital, with a different surgical team.

Worried what a delay might mean for the cancer’s advance, she agreed. The surgery, she said, went “beautifully” only a week later than planned and she’s now recovering at home (but, amazingly, still teaching online).

“I was really quite ecstatic that I had the opportunity to catch the cancer early,” she said. “We didn’t want it to spread, so the earlier the better. I just felt very blessed.”

She said a followup appointment on May 12 should lay out future treatment. So, maybe the system isn’t blind?

There was encouraging news from provincial authorities Monday that, overall, the COVID-19 disaster is trending towards the “best-case” scenario and we may not need all the ICU capacity that was vastly expanded in the last month. Already, in fact, eyes are looking at returning the health-care system to something approaching normal.

Matthew Anderson, president and chief executive of Ontario Health, told reporters at a Queen’s Park briefing that experts are already looking at how to stage a return to regular operations.

Based on past efforts and current modelling, he offered hope.

“We can now start to look at how (to) bring back the rest of the health-care system. In particular, we’re looking at our elective procedures, when can we start to bring those online, how would we do that, and in what order.”

This is encouraging news for cancer patients and all those living in pain made worse by delayed treatment: the limpy, the gimpy, those so sore they look forward to the sweet sound of the saw.