In the two weeks since I last communicated with you, I have had an unwanted but unique insight into one patient’s experience of the health care system. The patient was my husband. On December 28, he was admitted to the Civic site of the Ottawa Hospital, his respiratory infection having developed into lobar pneumonia.
I am not certain I could have convinced him to go to the Emergency Room for an assessment had the presentation not included left-sided chest pain – the one warning sign most men his age will not ignore. Fear of a heart attack in older men is more compelling than laboured breathing, sweating and shaking chills, nausea and vomiting and the respiratory tract infection that he had been experiencing. The assessment in the Emergency Room was straightforward and thorough but, in due course, my husband was admitted to hospital for intravenous antibiotics and fluids since dehydration had become a complicating factor.
Having been admitted to hospital just as the first snowstorm of the year hit, the course of Andrew’s treatment was uncomplicated and his symptoms resolved within one day. In fact, I had expected him to be discharged after twenty-four hours but the schedule of ward rounds was thrown off both by the holiday and by the weather.
When I visited him on the first day, while he was much improved, he was also clearly shaken by his experience of how unwell others around him were. He had been kept awake by patients shouting and screaming, their suffering so severe that my husband wondered how the nurses and other ward staff actually endured the stress of these situations, day after day and night after night. He marveled at their cheeriness with him and their professionalism and care for the woman in the next bed who was unresponsive to her caregivers’ ministrations.
The unit where he was cared for is one of the hospital’s Clinical Teaching Units in Internal Medicine. He was impressed on the one hand by the care he received but shocked by the crumbling infrastructure around him. Again, his thought was for how difficult this must be for the people who worked there every day.
My husband is a lawyer, an intelligent man with an eerie capacity for intuition. To cope with situations that are emotional, he seeks to understand them. What he observed were professionals who did not allow difficult working situations to interfere with the care they provided. Each time I visited him, he told me how much he admired me for the work that I did. It was clear that he had not completely realized the degree to which deteriorating health care equipment and decreased staffing are a factor in health professionals’ work lives. I suspect that no patient does realize this until they experience firsthand the degree to which our hospitals do not look like the facilities in General Hospital or Grey’s Anatomy.
What is perhaps more important from my perspective is that my own descriptions of the conditions and circumstances have not truly communicated the degree of concern that I have about how much health care support systems have deteriorated in the years that I have been practicing medicine. Staffing has been systematically decreased, equipment has not been replaced appropriately, buildings have been left to crumble and food and cleaning have been outsourced to the point that these do not meet the standards for nourishment and cleanliness that most health care professionals would want for themselves.
For the first day after he returned home, Andrew spoke to all those who enquired after his health about the state of the hospital and the stress the staff experienced at work. Several times, he was overcome with emotion when describing his experience. He had clearly been traumatized by the realization of what being in a hospital was like for a patient.
It has taken me fully a week to process my own thoughts about Andrew’s experience. I have always believed that the only reason Canada’s health care system continues to provide good care has to do with the people who provide that care. As funding decreases, they do the best they can to remain cheerful with patients and to overcome deteriorating conditions. In fact, we have gotten so good at doing this that it is possible that we are not expressing sufficiently well how urgent the need for change is. In my view, I have regularly spoken at home about my concerns about dwindling resources but it took an actual hospitalization for my husband to realize how dire the situation is.
I am hoping that my husband’s story will serve as a cautionary tale that it is only the health care professionals holding our system together. I was not at all surprised by the conditions he described, which is only another indication that I have learned to adapt. It is time for those of us devoted to health care to stop adapting to situations that traumatize the people we are caring for. They are clearly also traumatizing for us.
(Note: I dedicate this to the health care professionals at The Ottawa Hospital who cared for my husband – especially his doctors and nurses.)