An in­sider’s take on the HSC ‘ MASH unit’

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SundayXtra - - OPINION - By James Jewell

I’ M not in the ex­cuse- mak­ing busi­ness, but I do like to im­part in­for­ma­tion that can give peo­ple an op­por­tu­nity to have in­formed opin­ions. Af­ter read­ing CBC news re­porter Ryan Hicks’ anal­y­sis of the Brian Sin­clair in­quest, it oc­curs to me it’s doubt­ful any­one will shine a light on the back story. Hicks’ ar­ti­cle cen­tered on the in­escapable is­sue of al­leged racism and prej­u­dice in Man­i­toba’s health care sys­tem.

Sin­clair was the home­less, wheel­chair- bound, abo­rig­i­nal man who was found dead in the emer­gency wait­ing room at Health Sciences Cen­tre some 34 hours af­ter he ar­rived.

“It’s all to do with racists,” Sin­clair’s sis­ter, Es­ther Grant, told re­porters cov­er­ing the in­quest.

Chief Med­i­cal Ex­am­iner Dr Tham­bi­ra­jah Balachan­dra told the in­quest he be­lieves is­sues with the triage sys­tem were to blame for the tragic cir­cum­stances sur­round­ing Sin­clair’s death.

“Even if Snow White had gone there, she would have got the same treat­ment un­der the same cir­cum­stances,” he tes­ti­fied.

Dr. Marc Del Bi­gio, a neu­ropathol­o­gist who con­ducted ex­am­i­na­tions on Sin­clair’s brain and spinal cord, stirred con­tro­versy when he penned an email in­di­cat­ing, “We should not lose sight of the fact that this man’s prob­lems were self- in­flicted.” Dr. Del Bi­gio went on to ex­plain decades of sol­vent and in­halant abuse were ma­jor con­trib­u­tory fac­tors in Sin­clair’s death and that so­ci­etal blame should only go so far.

Kathy Mal­let, co- di­rec­tor of the Com­mu­nity Ed­u­ca­tion De­vel­op­ment As­so­ci­a­tion, an abo­rig­i­nal ad­vo­cate for more than 30 years, be­lieves Del Bi­gio’s “blame the vic­tim men­tal­ity” sym­bol­izes the un­der­ly­ing prej­u­dice ex­pe­ri­enced by abo­rig­i­nal pa­tients.

“Ad­dic­tion is a symp­tom of a prob­lem,” she said. “A much deeper, deeper prob­lem.” She went on to raise the is­sue of the im­pacts of the col­o­niza­tion process on abo­rig­i­nal peo­ple and her be­lief Del Bi­gio lacked aware­ness and as a re­sult, over­sim­pli­fied the sit­u­a­tion. So where does the truth lie? Would Snow White have died in that ER room, as Dr. Balachan­dra sug­gests, or was racism and prej­u­dice a pri­mary cause, as Grant and Mal­let want you to be­lieve?

I’m not an ex­pert on health care in Man­i­toba, but I have spent hun­dreds of hours in the Health Sciences Cen­tre Emer­gency Depart­ment as a front- line patrol of­fi­cer work­ing the down­town beat. Trips to “HSC Emerg” form part of the daily rou­tine of most Di­vi­sion 11 patrol of­fi­cers who work the mean streets in the heart of the city. Those trips re­quire seem­ingly end­less hours of down­time with both vic­tims and sus­pects as they go through the process: triage, treat­ment, dis­charge or admittance.

When I try to de­scribe the ex­pe­ri­ence, I fre­quently draw a cor­re­la­tion be­tween the ER and the chaos and in­ten­sity of a Korean MASH unit — scores of in­jured peo­ple suf­fer­ing from a va­ri­ety of in­juries that of­ten in­clude stab wounds, lac­er­a­tions, bro­ken noses, head trauma, the oc­ca­sional gun­shot wound and more. How­ever, un­like a MASH unit, the vic­tims of th­ese in­juries of­ten present a spe­cial chal­lenge in that the ma­jor­ity of them are in­tox­i­cated or high on some type of drug.

I’ve also seen dozens of “fre­quent fly­ers” sit­ting in the ER, sleep­ing off the lin­ger­ing ef­fects that come with the overindul­gence of al­co­hol or drugs. Many are peo­ple look­ing for a safe, warm place to sober up or wait­ing to catch a ride to the Main Street Pro­ject.

Be­cause of this re­al­ity, it’s not all that dif­fi­cult for me to imag­ine how some­one who ap­peared to be sleep­ing in the HSC Emer­gency Depart­ment could be over­looked.

What I saw at the HSC dur­ing my po­lice ca­reer was a pro­fes­sional, eth­ni­cally di­verse staff des­per­ately try­ing to do the best job they could in the face of the great chal­lenges that come with serv­ing the med­i­cal needs of cit­i­zens who re­side in the vi­o­lent crime cap­i­tal of Canada; doc­tors and nurses who worked ex­ceed­ingly long hours and who un­doubt­edly suf­fered from vary­ing de­grees of sleep de­pri­va­tion as they en­dured the rigours that came with work­ing shift work; over­bur­dened peo­ple work­ing in an in­dus­try that placed in­creas­ing de­mands on its em­ploy­ees in the “do more with less” era of bu­reau­cratic philoso­phies.

I also saw abo­rig­i­nal peo­ple re­ceiv­ing ex­tra­or­di­nary care and com­pas­sion from doc­tors and nurses at the HSC and ques­tion the no­tion racism con­trib­uted to the un­for­tu­nate death of Mr. Sin­clair.

As tempt­ing as it might be for Grant and Mal­let to play the race card, such a con­clu­sion comes with in­her­ent risk. Once that con­clu­sion is drawn, the doors to all other pos­si­bil­i­ties are closed.

Did Brian Sin­clair die be­cause of prej­u­dice and racism in­her­ent in Man­i­toba’s health care sys­tem, or is it more likely he fell vic­tim to an over­bur­dened, “do more with less” bu­reau­cracy that lacked the proper pro­to­cols to en­sure pa­tients like Sin­clair didn’t fall through the cracks in a chaotic emer­gency depart­ment?

The death of Brian Sin­clair has many mov­ing parts and in­volves a laun­dry list of play­ers and so­cial agen­cies that may be found cul­pa­ble to some de­gree.

Snow White, abo­rig­i­nal or not, peo­ple shouldn’t die in hos­pi­tal ERs.

I hope Judge Pre­ston can fer­ret out the truth and point the fin­ger in the right di­rec­tion.

WAYNE GLOWACKI / WIN­NIPEG FREE PRESS AR­CHIVES

An am­bu­lance at Health Sciences Cen­tre’s emer­gency en­trance.

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