Pushing back at health care’s pressures

June 30, 2012

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So, my mother recently had brain surgery. Then it was the bum’s rush out of hospital. No need to wait, to monitor, to make sure. Keep ’em rolling. Free the bed.

Such are the system’s pressures.

What if something goes wrong back home? Call 911. This is what I was told.

I hesitated. Maybe I rolled my eyes. Brain surgery isn’t a broken pinky. I must have looked bewildered. For sure I wasn’t marching to the prescribed tune.

Let me back up. My mother — she’s actually my long-time stepmother — is Ruth. Due to a fall weeks earlier, she had a subdural hematoma. That’s a brain bleed that can bring a stroke or worse.

With a splitting headache, Ruth arrived at St. Joseph Hospital’s emergency on a Tuesday evening. After a CT scan and transfer to Hamilton General, she had surgery less than 24 hours later .

The wheels of Hamilton’s hospital system had moved remarkably. Ruth dodged a potentially deadly bullet thanks to all involved. It was quite something to observe. None of us should take such medical expertise for granted, considering how things go around this planet.

In Uganda, where I live eight months of the year, folks routinely perish from far less, both in and out of so-called hospitals. Poorly paid doctors are absent while trying to earn a living in private clinics. Nurses may or may not be trained. Medicine is often scarce.

“We’re living in God’s mercy,” is what a Ugandan once told me. Indeed, Africans can be alive, laughing beside you one minute, dead, in the ground, the next.

Of course, Ontario isn’t sub-Saharan Africa. But is there a disturbing parallel?

The problem at Hamilton General came when, post-operation, Ruth’s blood pressure didn’t stabilize. It was “labile,” that is up and down. It was as high as 190/107 on one arm, just minutes before I was told Ruth could be discharged. It would settle, I was told. She was ready.

I was also told Ruth’s family doctor could prescribe blood pressure medicine on Monday. That’s not good enough, I finally said. It’s less than 48 hours after surgery. It’s Friday, going into the weekend. She’s going home to her 80-year-old husband who’s limited in his own mobility.

Isn’t more monitoring needed? And no medicine? What if something happens? That’s when I was told about 911. Of course. 911. How reassuring.

I waited for hours to speak to a doctor involved. None showed. Later, an internist new to the case phoned. Then a nurse called to tell me the facts of life. “We’ve done our job.”

Thankfully, there were also sensible voices around that led me to wait until Saturday morning to bring Ruth home, with blood pressure stabilized and prescription in hand.

Interestingly enough, in the midst of all this, an automated call came to my home phone from Doug Weir, president of the Ontario Medical Association, asking for the “doctor in the house” — my wife — to help fight the hundreds of millions of dollars in health-care cuts and clawbacks currently being bulldozed along by Ontario’s government.

My wife and I are busy with other things, namely helping to navigate changes in Africa.

But I couldn’t help but wonder, where are Ontarians heading? To simply “live in God’s mercy?” Do we have our own role in this divine mercy?

Surely health workers, that is “healing” workers, do. In the front lines of human drama, their jobs are often thankless and the most stressful anywhere. How much more when facing these systemic pressures, which, to all appearances, will only get worse?

And yet, there she was, that very tired and kind nurse who, when Ruth left the hospital, gave her a gentle hug. That’s tangible mercy.

Putting shaky protocol, and risk, above common sense and one’s own professional ethics, is not.

Which is why, if you soon find yourself in a similar place, remember it’s fine to question. It’s fine to give some reasonable pushback.

This isn’t about my mother. It’s about any of us.

Conversely, you can do exactly what you’re told. Let me know how that works out. And, after your call to 911, tell me whom you might have to bury.

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June 30, 2012 • Posted in ,
Contact Thomas at [email protected]


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