Health care in crisis, or just another day of great care at the ER
Iwas about half an hour away when my wife called to tell me to hurry over to my parents’ apartment. My mother was waiting to be taken to a doctor’s appointment. My father was going to take her, she explained quickly, but he had to go to the Royal Jubilee hospital emergency ward because his arm had gone numb.
My first thought was the lead story in the Victoria Times Colonist I had skimmed before heading out to run some Saturday morning errands.
“Overcrowding at Royal Jubilee hits highest level.”
My family emergency was running into the emergency at the emergency ward.
Around the same time the day before, seven ambulances had been stacked up outside the emergency ward while the hospital staff struggled to find beds for patients who had already been admitted. Patients were spending the night in gurneys in the hall.
After some juggling of roles — my sister got to my mother first — I joined my father in the inner waiting room at the Royal Jubilee emergency ward. I have been here before, usually with my children when they were younger. This was the first time with my father, who despite his age — 84 — is one of the most aggressively healthy people I know.
“The good news,” he said, “is that they didn’t hustle me off for immediate treatment.”
Good news because it meant that he was in no immediate danger. Most of his symptoms were already gone. It also meant he was put in the queue with the other less critical patients in emergency where the signs — quite reasonably — make it clear that the order in which people are treated will not necessarily be based on the principle of first come, first served.
We spent about six hours waiting in the emergency ward. What struck me most was not the crowding that had made the news, although most of the chairs were full, or the length of time it took to see a doctor for people who were at least, as we were, in a state of high anxiety, if not suffering physical pain.
What struck me most was the calm, brisk but business-as-usual attitude all of the staff brought to a place where an emergency is not the rare event it is for most of us, but the stuff of daily life. This is not the emergency ward of television dramas, but of the real life drama that is playing out over decades in Canada as our health care system grapples with ever- increasing demands and resources that never quite keep up.
Yet here on the front lines, the most prominent feature is still great care.
When my father did float to the top of the pile a couple of hours later, the doctor who treated him showed no sign of the emergency in the emergency ward, no sign of the work piling up. He calmly confirmed my father’s own diagnosis, the concern that had persuaded him to go to the hospital rather than a clinic or his own doctor; the suspicion that he had suffered a transient ischemic attack, or a mini- stroke.
Next came a wait of another hour or so for a CT scan followed by another couple of hours for the results to land in the hands of the doctor at a moment when they were free.
Again good news, no permanent damage but a prescription for followup to try to ensure that the mini- stroke did not become a precursor for the real thing. A life- altering stroke resulting in brain damage would mean my father could no longer care for my mother and that living at home by themselves would no longer be possible.
In the meantime, we were exposed to more of other people’s private lives than I’m sure they were comfortable with in the congested waiting room.
At one point, a hospital case manager sat behind us and after first apologizing about having to pry into an elderly woman’s personal affairs in such a public place, tried to find out whether she was going to be able to take care of herself after leaving the hospital. She left with a prescription for vitamins, the name of a doctor who takes patients and an urging that she look into home support services.
In the lobby nearby, the Tim Hortons continued to serve. Such is health care in Canada. Crisis, uncomfortable compromises, coping, coffee and doughnuts.