Tales of racism in ER unravelled in review
The allegation that emergency room staffers were playing a guessing game with the blood alcohol levels of Indigenous patients originated with a single posting from a health care worker in an online discussion board.
“When I worked at a rural hospital surrounded by multiple (Indigenous) reservations, we would play a guessing game typically on the weekends in the emergency department,” he wrote.
“We would routinely receive Indigenous people that were intoxicated. ... We would provide adequate care but we would guess at their alcohol levels when we ran the blood work. I used to think that this was normal as the culture of the department seemed to support the game and even the doctors would occasionally get in on the game.”
He wrote the post last April 27 on the discussion board for a training session highlighting concerns about stereotyping Indigenous people.
Like the other two dozen participants in the session, the former emergency room staffer made the posting under a pseudonym assigned to him by the organizers. But as was common practice with the San'yas Indigenous cultural training program, organizers later reviewed the postings for evidence of serious harm and systemic racism.
Six weeks later a program facilitator contacted the participant for more details about the alleged guessing game.
From her June 12 report back to colleagues:
“Participant shared experience of game with `Price is Right' rules where nurses, doctors and other staff would guess the blood alcohol levels of Indigenous patients coming to the ER.
“Introduced to the game as a new nurse 10 years ago at (hospital name deleted). Versions of this game are widespread across hospitals and (he) had directly seen it played in emergency departments at (hospital names deleted).”
The additional details were circulated over the next few days among administrators of the training program, overseers at the provincial health authority, and the Health Ministry itself.
The ministry convened a meeting of its adverse events committee, seeking a rapid response to the problem.
According to the minutes, “two participants advised that they had each made inquiries to several colleagues in different emergency departments about this allegation.
“These individuals all confirmed this game is played across the board and (is) an overall game played with all patients.”
Given what seemed like supporting evidence for the “game,” the provincial health authority decided to brief representatives of several Indigenous organizations.
A Health Ministry briefing note summarized the state of knowledge as of June 18:
“The issue is a `game' referred to as `Price is Right' being played with incoming intoxicated patients in emergency departments — guessing the blood alcohol level and betting on it. Allegation referred to Indigenous people being targeted.”
The briefing note named three hospitals and two health authorities as places where the game was being played and went on to say that three witnesses had confirmed the game was widespread.
On learning that two Indigenous organizations were preparing to go public about “the game,” Health Minister Adrian Dix pre-empted them with his own media conference on June 19.
“Last night I was made aware of serious allegations of racist and completely abhorrent practices in an emergency room or emergency rooms in B.C.,” Dix advised reporters. “The allegation is that a game is being played to guess the blood alcohol level of patients in emergency rooms, in particular with Indigenous people and perhaps others.”
Though the ministry knew the hospitals and health authorities where the game was allegedly being played, Dix declined to be drawn into any discussion of specifics.
Instead he announced he'd commissioned Mary Ellen Turpel-Lafond, a lawyer and former judge, to do a deep dive into the facts as part of a broader review of systemic racism in the health care system.
Dix's caution on the allegations about the game was entirely warranted. For as Turpel-Lafond disclosed in her report this week, when she and her team examined the allegations, they unravelled.
Participant X, the health care worker who made the initial allegation, clarified that it dated back a decade and he has had no direct involvement in an ER for nine years.
He disputed the allegation of “racism,” saying the “guesstimation” of blood alcohol levels did not entail “targeting” Indigenous patients in particular.
He never saw money change hands. “There's nothing to win, it's something to pass the time.” He denied ever having compared the guessing game to the Price is Right.
Participant X's clarification-cum-revision came as news to other officials who were interviewed. They hadn't realized it had happened almost a decade ago.
The testimony of the other two witnesses was discounted as well. They were simply talking about the routine practice of estimating blood alcohol levels as part of initial patient assessment.
“The eventual public and media accounts of the `game' that spurred this review were inaccurate,” wrote Turpel-Lafond in closing the matter.
“The review found no evidence to substantiate the allegation that the `Price is Right' game was being played in B.C. hospital emergency departments, and if such games did occur in the past, they are not occurring today.”
Turpel-Lafond went on to document evidence of systemic racism affecting Indigenous patients and staff in the health care system. She made two dozen recommendations for reform as part of a six-month review costing $600,000.
But her report also shows why the most shocking anecdotes need to be checked out before being made into an indictment of the whole system.