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Friday, April 11, 2014

ONTARIANS MUST BE FIRST IN OUR HOSPITALS

 
THE LONG WAITS AND TRAUMAS OF  SUNNYBROOK HOSPITAL

Sequels are all the rage in entertainment. So let me produce one in hospital care, which is never entertaining.
 This is a 2014 follow to my six-page series called Hospital Hell which appeared in the Toronto Sun and my blog in the summer of 2011.  I wish I didn't have more material but damn it...
I didn't plan to write about this because Mary may be long-suffering but even loyal spouses don't exactly like their husbands writing about their bottoms.
Except I just saw a headline that fills me with dismay: City Hospitals Want More Medical Tourists. The first paragraph in the Star story infuriated me. "Toronto hospitals are unapologetic about raising money through medical tourism and international consulting and, in fact, plan to do more of it in future. And Ontario's health minister says that's OK with her."
Well, not with me. And I heatedly discussed this with the minister, Deb Matthews, in 2011 after my difficulties in being flown back to Canada in a medical ambulance because every hospital here claimed there was no bed for me.
 I don't forget $85,000 in hospital bills for eight days in two U.S. hospitals because of that. As far as I am concerned, and no one I've discussed this with, including doctors, disagrees, I really don't give a damn about foreign aid when it comes down to a question of whether a hospital bed is waiting for me and my family, or is occupied by some rich foreigner.
It is important to realize that I have OHIPERs, the people who pay the bills,  on my side. We don't pay over 40% of the provincial budget on health to squirm waiting for non Canadians to get out of our hospital beds. Charity, health care and OHIP must begin at home.
There are too many painfully waiting for "elective" surgery to acccept the idea that foreigners can get to the few empty beds and vacant ORs first because hospitals will make more from them than from what OHIP will pay  for looking after Canadians.
It doesn't reassure me that Matthews insists that Ontarians must come first and that hospital's international work must not compromise their access.
It already happens.
This is my latest bitter proof. More than three months of anguish began for Mary as 2013 ended in frozen darkness thanks to incompetent response from Hydro to winter.
Off we went to emergency at Mount Sinai because of a rectal prolapse, which is as ugly and awkward as the words. The rectum stretches and protrudes, a curse that strikes mainly women.
Not the way you want to spend the penultimate day of the year in an ER overflowing with need. Yet the hospital's ER chief was around, despite the holidays, and Mary was helped after seven hours and armed with dismal info of what the future held.
Except you need a specialist to function as the gatekeeper to check you out and either operate or recommend a surgeon. It took 16 days to see the specialist who had operated on Mary a few years ago on a similar problem. He announced without even looking that he didn't do this kind of operation. It would have been nice if we had been told that before we got the emergency appointment because of the information from Mount Sinai. I wouldn't have had to skid around the frozen University hospital corridor  in rush hour.
At least he gave us the name of a specialist at Mount Sinai. Phoned and despite the obvious need,  Mary was given an appointment two months later. And she was told in effect not to complain because it could have been a wait of four months.
So I appealed to Bernie Gosevitz, our incredibly busy and able GP who is familiar to Toronto because of Andy Donato's cartoons and columns by his many other patients/journalists, particularly around a huge fund-raising dinner in his honour last year.
Bernie put us in touch with Dr. Ted Ross, associate professor of surgery at U of T, and a colorectal expert who may be busier than Gosevitz, which I didn't think possible.
Dr. Ross did valiant surgery on his appointment book and Mary got in to see him early, meaning only a month had elapsed after the dread day when an ordinary chair turned into an instrument of torture.
So the operation was scheduled. Turned out the first delays were a grim harbinger. Surgery was booked for March 25. Dr. Ross gently explained that Mary was lucky it wasn't in late April because he just couldn't get enough time in the operating rooms of Sunnybrook, the health science centre and giant parking complex on Bayview Ave.
Ross' examination of Mary was my bitter introduction to Sunnybrook's parking charge of $4.75 each 30 minutes, where there seems to be more private security handing out tickets than docs in the emerg of Ontario's leading trauma centre.
Some days, the main trauma in that busy hospital is probably in parking.
Back we came 81 days after Mary's miserable experience began to Sunnybrook for the pre-op interviews, anxious questions and tests.
Just before Ground Zero Day, so to speak, Mary went through the nasty cleansing ordeal faced by all patients needing surgery on their bums, or for procedures such as colonoscopies. By the time we arrived in the OR holding pen, 86 days after all this began, she was so tired that she slept after the anesthetist counselled and lines were inserted in her arms. Since she hasn't had uninterrupted sleep since the start, and a simple bathroom visit is a tedious ordeal, her snores were welcome.
I didn't sleep. I had foreboding, as patients  around us may have returned from operations but nurses  talked about delays.  Finally, Mary and I and several staff were alone.  Dr. Ross arrived to say the hospital had decided it had run out of time for the day and shut down all the ORs. Her operation was cancelled. There had been extra delays due to two ORs needing additional care because of contamination from isolation patients with hospital infections, one with the deadly C. difficile, the other with MRSA, which has now become so common that it was inflicted on me for the three months I spent in four hospitals in 2011.
Naturally Mary was frustrated and I felt like punching a bureaucrat. But imagine how Dr. Ross felt! He said he had been there for six hours and only had been able to operate for two.
After $48 in parking charges for the first two visits, I had enlisted my son Mark to bring us to the hospital. Now he was off working because he didn't expect a call until evening.There was no  answer to my phone calls.
Mary wasn't about to wait in the hospital, not when just sitting had become an ordeal. Because of the prolapse and arthritis, she needed a cane or walker just to hobble to the bathroom. So she struggled to a cab and demanded to be taken home.
We just couldn't catch a break! Royal Taxi has the exclusive deal with the hospital and provides small cabs with rude drivers. The cabby didn't help when I tugged Mary into the cramped backseat with great difficulty.  At the end of the $70 ride, he refused my VISA card, then said there would be an additional connection fee if I insisted. By some miracle, I actually had enough cash.
 (I have complained about cabby 2517 to VISA. I tried to do so to the licensing commission. First the special city info number, 311, gave me the wrong number. After I found the right number, I phoned six times over three days and never got an answer. No wonder our cabs are sloppy.)
The operation was rescheduled for April 8, now 100 days after that first grim run to Mount Sinai. By some miracle, that day started smoothly because we had had sort of a "dry" run, Mark had stayed from his job in China to help and we actually made it to Sunnybrook  and back without taking out a second mortgage for parking.
It even looked like the operation could be early. Then hours evaporated. I paced. I listened for gossip, like two weeks before when someone said they had 25 patients in the ER and no beds and Mary was cancelled at the OR door. Now I was getting ready to push her bed myself into the nearest OR.
Thank heavens! They took Mary away and for the first time in 100 days, we had real hope. Bliss was Dr. Ross telling me more than two hours later that everything had gone fine. I felt like kissing him but Sunnybrook probably would have charged me with sexual assault.
My sister, Joanne, a veteran head nurse, was incredulous when I told her they only planned to keep Mary for the night. We hoped Dr. Ross would give a day or so of reprieve. But the hospital phoned at 8.40 a.m. and told me to collect her. By the time I had survived the rush hour, and arrived, nurses had phoned three more times because there had been stabbings and they needed four more empty beds at least for starters.
Yet Minister Matthews lets the hospital establishments say there's plenty of elbow room to let foreigners buy their way in to service. That bugs me more than the fact that the Canadian Medical Association and other groups have said for several years that hospital parking charges are hurting medicare, yet no changes have happened.
Unfortunately, Mary and I may be fans of medicare but we have been victims of what happens when you need a bed or an OR for "elective" treatment where you are not going to expire if medicrats drag their feet.
After my 2011 Hospital Hell series, the health minister phoned to tell me she was having officials and the industry investigate my complaint that Canadians face horrendous medical charges while waiting to return from U.S. hospitals because Canadian hospitals put such patients at the bottom of their wait list because, after all, they already are in a hospital.
Since the vultures that control travel insurance will cheat, steal and prevaricate rather than pay your bills or make you suffer first if they finally do pay, you want to get back to Canadian hospitals ASAP.  They're often better and they're nearly free,  except for the parking.
In my case, TIC Travel Insurance officials dreamed up phoney excuses not to pay my $85,000 American medical bill,  based, they said, on evidence from my doctor's files. Except Gosevitz said they were wrong. It took 55 letters, six months, legal threats, appeals to the ministry and a newspaper series to force TIC into paying. (Those initials still make me feel like vomiting.)
 By the time the ordeal ended, I had two U.S. collection agencies after me and had to wear an awkward  therapeutic air pump every minute of every day for a year. The cost to taxpayers was enormous because I required 129 home visits from CCAC community nurses because of the deep bed sores that inadequate care at St. Joseph's gave me.
 It took 11 months after I was first incarcerated in two American and two Toronto hospitals before the operation at a fifth hospital, Western, and then another one the next day in the sixth hospital,  St. Mike's, tidied me up and restored me to reasonable health.
Believe it or not, it all started when I became ill on the way home from Florida because one of the more trivial body parts, my gall bladder.
There are enough problems for Ontario hospitals to solve before they hunt for "medical tourists." Administrators should be forced to sign a certificate for every foreign patient they accept stipulating that there is no one from Ontario that day waiting for admission.
Enforce it by fining every offending hospital. For starters, confiscate their parking revenue for the day.  As for the minister and hospital CEOs who think everything is okey-dokey, let them wear adult diapers for 100 days as both Mary and I have had to do because of their incompetence.




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