Emergency

Of all the things I didn’t plan to do yesterday, pretty much the last thing I would have put on my list was spending the day in Nanaimo General Hospital. And yet that is exactly what I did. Colour me furious and appalled.

My neighbour Pat rang me yesterday morning. He’d been up most of the night with a terrible gut ache – so bad he’d considered calling for an ambulance in the middle of the night, but he didn’t want to wake anyone up. I should say at this point that Pat is 97 years old. Pretty damn spry for his age, but still. Anyway, as soon as the doctor’s office opened yesterday morning he called to make an appointment, then he called me and asked me if I could give him a ride, as he didn’t think he could drive. Of course I said yes.

His regular doctor was away, so he saw a locum, who did what tests she could on the island (including an ultrasound), then came to the waiting room to talk to me. Pat, she told me, needed urgently to get to the hospital in Nanaimo for more tests. Yes, I told her, I’d had a feeling he might need to go to the hospital.

This is where the day began going to shit. Turns out she was not suggesting, as I’d assumed, that he should be taken in an ambulance and admitted immediately into hospital. He wasn’t, she said, bad enough to require an ambulance. Oh, I thought, the realisation dawning on me that she was asking if I could and would take him to the hospital emergency room. Pat has family in Nanaimo (not that I have any idea how to contact them), but none on the island. If not me, who? Well, obviously it needed to be me.

We were provided with an assured loading pass for the ferry and set off. We got to the hospital just after noon.

I’d made a couple of false assumptions about what would happen.

The first was the assumption that the locum had called the hospital to let them know we were coming. (Whether or not this would have done any good I have no idea, but it seemed an obvious assumption to make.)

The second was the assumption that the emergency room would have some sort of damn triage system.

There were a dozen or so people there when we arrived. A volunteer took our name. More personal than just taking a number, I suppose, but telling him Pat was a 97-year-old man in dire pain didn’t seem to create any sense of urgency. None of the other people in the emergency reception looked to be in particularly bad shape.

When we’d been sitting there for an hour without seeing anyone, I called the doctor’s office on the island to check on my first assumption. No, the locum had not contacted the hospital to tell them to expect us. Why the fuck not. I couldn’t help wondering, although I didn’t say.

When we’d been sitting there for two hours without seeing anyone, I stood up in the middle of the emergency room, asked for everyone’s attention, then said I was there with a 97-year-old man who was in so much pain he was in danger of passing out and asked if anyone would be willing to let him be seen before they were seen. Everyone raised their hands.

At that point, both of the nurses at the check in desk had disappeared to deal with – you guessed it – an emergency. However, Pat was the first person seen when they were back at their posts.

We handed over the note from the locum, I explained what tests had been done and said rather emphatically that he urgently required more tests.

And that’s when we caught a break. One of the nurses asked Pat if he had a grandson named Will. Yes, Pat said, he did. “I’m his girlfriend Amy!” she said, grinning. Amy discovered, perusing his records on the computer, that his two contact numbers were his middle daughter who lives many hundreds of miles away in Hundred Mile House (yes, that’s really the name of a town) and his eldest daughter, who died two years ago. She suggested adding the number for his youngest daughter Tina, who actually lives close to Nanaimo. Pat told her she never answers her phone or responds to messages left. Amy offered to send Tina a text.

Two and a quarter hours after we walked in the door, we made it to the next holding pen, another waiting room where Pat’s chart was handed over and he was told to wait to be called. The money on my parking meter was about to run out and I really needed to find some lunch that wasn’t hospital food, so I told Pat I was going to have to leave for a bit, that I’d be back in an hour. I would have been, too, if I hadn’t got lost trying to find my way back to the hospital and then lost again in the hospital trying to find my way back to emergency from the parking lot I’d had to use because the emergency lot was full.

Pat was dosing in his wheelchair when I got back. In the intervening hour and a half he’d been taken off for various tests and was awaiting more. He’d been given some pain medication (thus his ability to dose off) and he’d spoken briefly to a “tall, skinny lady doctor” who hadn’t told him much of anything. A nurse came and took him off for a CT scan. I thanked heaven that I’d brought my book with me when we set out for the doctor’s office that morning.

When the nurse returned with Pat all I could get out of her was the fact that this was the last of the required tests, that the blood work was back and being reviewed and that a doctor would see us. When? She had no idea.

Just before five o’clock a young (by my standards) woman breezed into the waiting room and embraced Pat: his granddaughter Lainey, who’d been contacted by Tina, who’d actually read her text message from Amy. (Apparently, like failing to listen to the messages on her answering machine at home, Tina doesn’t always check her text messages, so it was lucky she’d seen Amy’s.)

Lainey wasn’t just there checking in. She was there for the long haul. She was also a trained paramedic, so able to properly understand what the implications of whatever the diagnosis turned out to be. Pat’s pain medication had long since worn off, so the first thing Lainey did was demand he be given more, which he was.

Her disdain for Nanaimo General Hospital in general and its Emergency Room in particular knew no bounds. She told me about one incident she’d witnessed there: a couple came in late one night with their four-month-old baby and were told to take a seat and wait. The father lost it completely and screamed, “My baby’s turning blue” (which indeed it was) “and we need to see a fucking doctor now!” That did wake the staff up and the baby was seen immediately, but, as Lainey pointed out, one glance should have told anyone that the baby need immediate attention. Basic rule of triage, she said, is you see to the very young and the very old first. Well, yes, but that assumes there’s any basic fucking triage happening, which there most certainly wasn’t in the emergency room yesterday.

At 6:15pm we were taken into a consulting room where we were joined a few minutes later by the tall, skinny lady doctor. (I’m surprised Pat failed to include “with an awfully loud voice” in his description, because that doctor really did seem to be shouting.)

It turns out Pat had a bowel blockage and was to be admitted for treatment. All things considered – especially his age – they wanted to avoid surgery. So, he’s in hospital now with a tube down his nose. Hopefully this least invasive treatment will work. Fingers crossed.

Whatever happens, nothing will alter the fact that a 97-year-old man was forced by a ridiculous system to endure excruciating pain for hours and hours.

He probably should have called for an ambulance in the middle of the night.

The locum should have sent him to the hospital in an ambulance, which would have resulted in him being seen far more quickly. At a minimum, she should have called the hospital and told them to expect us.

The emergency room should have some sort of basic triage. (If I hadn’t asked the other patients to step aside, it probably would have been another hour before Pat even made it to the check in desk.)

This is bull shit.

If anyone ever tells me I need to go to the Emergency Room at Nanaimo General, I will ask them to just put a bullet in my head.