Tommy Douglas, Not Dead Enough

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Dr. Kyla goes to the hospital...

We visited for about half an hour and I asked to use a washroom - big mistake. The second the French door was opened, the dog who had been aggressively barking when I knocked at the door, rushed in and grabbed my lower left leg. I was wearing black pants, the dog was black, and the corner of the room I was in was dimly lit. The family could not see that the dog was actually biting me.[...]

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Normally, if I get injured, I simply go to my vet clinic and put on a bandage or have a laser treatment or whatever is needed to be okay. Because I am running for Federal Parliament, I decided to go to the human hospital and see what it was like for people who do not practice medicine for a living. I also fully expected to be treated promptly and effectively.

I called my girlfriend and told her I was hurt, which hospital to meet me at and asked her to bring me some Tylenol 3's with Codeine. Thank God I did that, because I was not seen by a doctor for more than 5 hours. I knew a clerk who was working there and I'm sure that my visit was at least 3 hours faster than had I not known someone.

The front desk clerk was okay, but did not seem at all concerned for me, other than she did get me a wheelchair because as I walked around, it was causing a lot of bleeding. I was shaking and hyperventilating a bit; truthfully, in a bid to be seen as more urgently needing care than would have been belied by a calm exterior. Just because I was capable of being calm in that situation, did not make my need to be seen less urgent.

That was a good strategy, as they wheeled me to a triage waiting area and a triage nurse saw me within 20 minutes. Her body language and tone of voice gave the impression that I was a bother to her. Her only contribution was taking my temperature and blood pressure and putting the cheapest, scratchiest, most likely to stick into a wound, gauze on the leg so that no one had to see the laceration and punctures. Oh, she did verify my drug allergies to penicillin & Percocet. That would have been an excellent time to take the 3 minutes required to flush the wound to get bacteria and dog saliva out of it.

But they didn't. It gets worse.

We talked until my codeine wore off and I took another dose, realize I had been there, with a shredded leg, for over 4 hours and they had offered me nothing for pain, not even an ice pack. While my drug level was low, I realized that the 'golden period' for wound closure had already passed. I called Emily at work and had her get a 20ml syringe of sterile saline solution and to pull up some Betadine solution in with it.

Katie dropped that off for me, and I went into the bathroom, took off the horribly adhered bandage of cheap gauze and I flushed out my own wounds, using the toilet as a waste receptacle for my bloody body fluids. I had no choice but to replace the outer layers of the cheap gauze.

The very nice ER doc, did come around, only to be called away twice for long periods of time. He brought in a suture tray & opened it on an instrument table beside me. I did not see him put on his gloves, so I am not sure if they were surgical gloves or simply exam gloves. They were the same colour as the exam gloves the triage nurse wore.

After squirting some saline into a little sterile bowl, while holding the non-sterile bottle in his hand, he started looking for his syringe to flush the wound with. It was under the drape, so gloved in, he pulled the drape back, touched the outside, non-sterile packaging of the syringe and opened it, turning it out onto the 'sterile' field. I could have easily opened it aseptically for him. Then still with those gloves that touched the bottle and the syringe packaging, he fitted a teflon catheter to the end of the syringe, before flushing the wounds with only saline solution.

This was now 5 hours after the attack, the golden period for wound closure is 4 hours. Instead of a proper clean-up and surgical prep, he swabbed the open wounds with a chlorhexadine soaked plastic applicator. The skin surrounding the openings, not so much.

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4 hrs later, still have not seen a Doctor. The leg is noticeably swollen, I have been given nothing for pain, inflammation, nor infection.

After injecting local anesthetic and then disappearing until that anesthetic had mostly worn off, he proceeded to do the worst suture job I had ever seen done by a medical professional. I really like this doctor, I am not trying to get him into trouble. His lack of surgical skill is simply due to lack of training and practice. That he is allowed to suture people in the ER with no surgical training is of a concern to me.

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It looks like it was stitched up by a blind drunk, on a moving streetcar, in San Francisco.

At one point, I told him that the suture was too tight, because the tissue was obviously going to swell, and that I would handle that by pulling the first throw of a knot snug, then leaving a small 1-2 mm loop and closing all the other throws tightly. That allows the suture in the skin to loosen by a millimetre as the tissue swells from the trauma. He pretended to be listening and tightened the first throw even more and closely and tightly placed the other throws.

He then confirmed that I am allergic to Penicillin and Percocet and told me that he would write me a prescription for Clavulan. I said, "Um, no, because that is amoxicillin and clavulanic acid and amoxicillin is a penicillin." Guess it's a good thing I know that, eh?

My classmate, Bruce, from vet school, looked at the pics and noticed that he had placed granny knots and not the square knots that surgeons should use. This also indicates a complete lack of surgical suturing training. While placing the inadequate number of stitches, he was leaving 2 inch tails as he tied the knots. That meant that a surgery that should have taken half a package of suture, took an entire package and he still needed one more stitch, so a second, brand new package of suture had to be wasted, due to not conserving suture as any competent surgeon would endeavour to do. It doesn't decrease his paycheque, so what's the big deal eh?

I wonder how many millions of dollars in wasted supplies there are in human hospitals, just because there is no incentive to control expenses and utilize the materials efficiently.

There were only 3 sutures placed across that entire laceration, with no subcutaneous sutures to take tension off the skin. One was a simple interrupted pattern and 2 were horizontal mattress, interrupted sutures. All were placed so tightly that by morning, they were damaging and cutting through my skin. A far-near-near-far pattern would have been a much better choice for a wound with so much tension on the suture line.

I really liked the doctor, he had great bedside manner; what he did not have, was any surgical skill or training.

I recently had a similar experience with a physician not adhering to aseptic technique while injecting synovial protectants into my knee joint. That doctor, at Fowler-Kennedy, laid out his tray, opened the syringes and needles properly and turned them out onto the tray, then opened the Neovisc (which the packaging makes clear, the outside of the syringe is not sterile, only the contents are) dumped the non-sterile syringe onto the formerly sterile field. He then properly prepped my knee, put on sterile gloves and immediately broke sterility by picking up a bottle of lidocaine from the countertop and filling a previously sterile syringe with it.

When it came time to inject into my joint, he used one of his fingers as a guide to steady the shaft of the needle as it slid into my skin. How gloves were no longer sterile and injecting bacteria into a joint can have devastating consequences, up to and including amputation of the limb, or death, due to sepsis. I immediately went to the waiting room and cancelled all my future appointments. I gave the next 5 intra-articular injections to myself. They are really fun and satisfying to do, plus I'm in much less pain now with my knees.

It's no wonder there are so many hospital induced infections, is it?

A very nice, pregnant nurse brought me an illegally labelled bottle with 6 Tylenol 3 in it, and then applied a substandard bandage that didn't last until I got home.

kylabandage.jpg Behold the inferior bandaging skills of an ER nurse. She was also a lovely person.

The next time the codeine wore off, I was in more pain than I had been while to dog was clamping his teeth through my flesh. I took some photos of the poor suturing job, and was able to see that the 2 puncture wounds on the back of my leg not only had sutures that were way too tight, the way the needle bites had been taken, the sutures were pulling hard on my skin between those wounds, in addition to cutting through my actual skin at the wound edges.

By Tuesday morning, I couldn't take it any more. After I saw a few appointments, I had Katie surgically prep my leg, and I lasered it to promote healing. The suture lines were horribly inflamed and my skin was actively being strangulated by the way too tight sutures.

We prepared for self-surgery.

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I ripped out all the offending sutures and cut out the dead tissue, then closed my own leg wounds with sterile surgical staples.

kyla4.jpeg This is what it looked like that night, after I was on my feet all afternoon, doing 2 days worth of afternoon appointments.

We only broke sterility one time, and it was only at the very end of the stapling, when I could not see the area I was trying to staple, because it is on the back of my left leg, and I have to staple with my right hand. The one break in sterility was when I asked Katie to position the stapler. Her hands were no where near the incision or the actual staples, so it was okay at that point for her to steady the staple gun as I was getting fatigued.

This is a condensed version - read the full story at Kyla's Facebook page.


83 Comments

You get the dog put down....
I doubt you provoked his attack.

Lesson learned, in Canada take some First Aid training so that you can field surgery your own wounds.

Also learn to acquire medications and antibiotics from pet stores to treat yourself, and develop an online relationship with as many pharmacies in Mexico as you can find.

Your self-administered “Health bill” will come off your next pay check regardless.

"I wonder how many millions of dollars in wasted supplies there are in human hospitals, just because there is no incentive to control expenses and utilize the materials efficiently."

There is absolutely no attempt by management to cut costs where possible so where is the incentive for the rank and file employees to practise a little supply conservation?

This is the product of having a veritable endless supply of money to operate. And wasted supplies is only the tiny tip of the iceberg.

I'm curious as to where the ER doctor got his training.

National Health - free & worth every penny!

I feel for your pain. Most unfortunate.

However, I fail to understand the ongoing opposition to public health care. Could it be better? Yes. A mix of private public is probably in order. The wait times for chronic (non life threatening) conditions are way too long. That's where private could help. (Which we have now. A friend had back surgery in Vancouver last year...paid by himself.)

Maybe Alberta's health care is better that elsewhere because I'd rate the emerg services here as FIRST RATE. My wife and I are 68 and 70 years old. Over the past years we've attended emergencies a few times and received fast and appropriate attention .. always top-drawer. On New Year's Eve a few years ago I had symptoms of a heart attack (was not) and walked into emerge in our small-town hosp and was speaking to a doctor immediately. Two years ago, my wife had an AF event and I took her to emerg where she was rec'd within a couple of minutes, put in a bed in the emerg and saw a doctor within minutes. Last year I too was bitten by a dog (nothing like this) and walked into a rural clinic here in S AB and was attended to within minutes. Our rammy 11-year-old grandson is a regular attendee as well with hockey and boarding injuries...gets good service.

As noted, the wait times for knees and hips are way too long and we would be wise to allow more private access to services.

I have an American cousin who thinks the Canadian health system is poor. But his health care insurance is paid for by his past employers...which were public agencies. So his "private" health care is paid for with public tax dollars as is the health care for probably 30% of Americans (teachers, etc etc). That is a two-tiered private system which is worse than the Canadian system because it excludes tens of millions. And no matter how you do the math, consumers pay for the American health care system one way or another, VERY few Americans pay for private health care out of their own pockets.

My wife and I are comfortable, but live an a limited income and we simply could not afford medical insurance for private medical care.

CAS

I sustained a broken ankle 5 yrs ago and I was in a stretcher for 3 days in hospital, waiting for surgery because a big T.O. hospital has only one O.R. going for a service population of nearly 500,000 people. The day I injured myself. I was closest of Ottawa, but here was not a single bed available in the whole capital city of Canada's shitty healthcare system. I had to be driven home to get treatment. While in hospital, I dared not complain, because I am an MD and I know my complaints would have been viewed as unreasonable because I should know the system is bad. Well it is worse than that. My care would have been treated as malpractice in the U.S. SO malpractice standard medicine is commonly the level of care we receive in Canada.

Kate >

"I'm curious as to where the ER doctor got his training"

Would anyone really be surprised if it was U of Mumbai?

Kyla, you're awesome.

I wish I lived in your riding so I could vote for you when you run.

Good and bad water don't come from the same spring. Yet, Dr Kyla, running for federal office, is quite willing to take advantage of, and promote, other leftist social policies. Such as forcing us to tolerate, in law, homosexuality. To the extent of using those special rights to become a citizen of Canada.

I would be concerned about a double minded person actually making law. She may be a good vet, but would be a terrible lawmaker who hasn't thought through her core principles.

I took my +80 yr old parent to the emergency with a 103deg.F fever and semi lucid - I had to get a wheel chair from the emergency ward myself and get him into it, I got no help from staff. It took 1hr to book him and we sat in a waiting room for 3 hrs before they gave him a temporary place to lie down, he was dehydrating and constantly asking for water - which I had to get from a tap down a hall myself. All this and there were only maybe 6 other people in the emerg. at the time. - After 5 hrs he finally saw a doctor who diagnosed pneumonia and rushed him into a room in intensive care. After tests and other administrative BS 8 hrs. later, he finally was administered Antibiotics

Long story short, my parent never came out of the pneumonia coma, never recovered, and I'm left wondering if he would have survived if he had antibiotics when he arrived at the hospital

University of Phoenix, probably.

In some ways this sounds hard to believe in 2015 in Canada, the country that boasts of public medicare for all, where mentioning two tier services is a sacrilege.

Guess we're just lucky in this small Ontario town but our small hospital is staffed with doctors and nurses who give high quality care in all departments and none more than the Emergency department. Emergency doctors and nurses give exemplary care, wait times vary but the more urgent cases are taken first.
As a former nurse I take notice of their technique and service with a critical eye. There are more complaints about service and quality of care in the larger cities, whether its just a matter of case load management or poorly trained personnel, including doctors and nurses, it's not good or safe health care service.

Wait times for elective surgery or other procedures are off the charts across the board, all this with OR theaters being shut down because of mandated quotas on doctors doing surgeries and bed closures for their shortfall on the bottom line because. It isn't working and it won't work, meanwhile those paying and suffering will continue to pay the price in pain and cost.

My brother was told he had hemorrhoids for over a year until his colon cancer reached Stage 4 and he needed surgery and a colostomy.

My father-in-law was told he had C.Diff for almost as long until his rectal cancer required surgery.

Bro is three years clear, Da is facing new surgery for the cancer in his lungs and liver, and learning to live with a colostomy in his 70s.

Thanks, Tommy!

I see a some of our Canadian cousins are bragging about their national health care, and some are condemning it. I think the problem may be a function of the training and dedication of the staff. I think that pervades all healthcare systems, except those where the doctors and staff personally benefit from good practice. The worst case I've seen was a South Asian doctor moving between the contagious disease rooms and the infectious disease rooms without following ANY sanitary procedures. No gloves, aprons. protective suits, masks etc. The nurses were irate, but couldn't do anything to correct him. The hospital management didn't know c'mere from sick um. After all the doctors ruled the wards. After many patients died, families started removing patients to other hospitals and the hospital management went into full legal protective mode. I suspect that this probably happens everywhere, in all medical systems.

CAS...I work in EMS. Anyone in your age group that complains of any heart or B/P problems goes first.

That's why Canada's Liberal left is tripling down to bring in as much of the Third World as they can.

They're getting results.

I hope Dr Kyla doesn't put that image on her campaign ads. Yuk.

My favorite story about the Canadian health care system came from my favorite
columnist/writer/humorist Mark Steyn. In an issue of Imprimus (Hillsdale College,)
he covered the plight of a Canadian woman about to pop with twins and experiencing
a problem pregnancy. She needed to be admitted, but there was not a single
available maternity ward bed in the entire province. They ended up putting
her into a light plane and flying her to a hospital in small town Montana
or some such.

Steyn closed out the story by saying that the "Ultimate reductio (ad absurdum)
of socialized medicine was the 10 month waiting list for a maternity ward."

Mark Steyn is one of the greatest things to have ever came out of Canada.
He usually makes the opening segment of the Hugh Hewitt show every Thursday
at 6:00PM on KRLA. I rarely ever miss it!

CAS, lucky you didn't contribute $25,000 to your hospital like the gentle man around here. When they finally called him, the call fell on dead ears. I could write a book on "public health care bullshit" that has a effected my family. 2 deads

You don't assess health care by it's success's, you judge it by it's failures!!!!

Sure Dustoff, I agree ... potential heart issues get attention in "old" people. ☺

But in southern Alberta (vs large city) access is darned good for all ailments. The issue seems to be overcrowded city hospitals. Years ago, a geographer proclaimed that once cities get >250K then things go to hell for many services and quality-of-life parameters: transportation, time wasted getting around and obviously health care.

Last winter, my grandson was taken from the ski slopes via ambulance to a local hospital for suspected broken leg..was not..and he was treated fast. He has had 3 or 4 broken arms/collar bones etc in the past 3 or 4 years. Same service. Last year (as noted), I saw a doc within a few minutes of going to the clinic for the dog bite .. same when I got some metal in my eye one evening last summer. Fast service.

And, yes, I acknowledge these were in is small city/small towns. Seems to be a huge difference in level of service.

CAS

same deal mike but i live in ottawa, and damn, it was a friday night. i got the fill in ortho surgeon on saturday who performed a fairly complicated repair poorly. blood clots 48 hours later and another week in the same hospital and i made it home. the break was bad and i was off work for over a year. 7 years later and two more surgeries and 100+ xrays i went back to the same hospital and was told by the attending physician i had "an unresolved fracture" in my left leg and was sent home. frustrated and fed up i switched hospitals and 30 months later i was operated on again, and the repair was magnificent. turns out the pin in my leg was infected...for a decade. it depends on the hospital, my elderly parents get great care in our small town but have to drive to Ottawa to see a GP because there are none available in our town. its a cluster f**k and i doubt it can be fixed unless the whole thing is privatized.


If you want to understand how things got this bad, read this:

www.winface.com/amt/pc_health.html

In Ontario, "free" health care costs my wife and I $1500/year, it's called a Health Premium (brought in by Dalton McLiar). I get to see my GP every three years. I pay for some of the preventative tests (not covered), eye exams (not covered) etc. My mother was in hospital this past winter and I hope that when my time comes I don't have to go through her ordeal.

Socialized medicine provides crap medicine for all who can't afford private health care. And it will get worse as the baby boomers are starting to die off.

I'd love to read more but I absolutely REFUSE to ever sigh up for a Facepalm account.
So what province was this in?
You should try getting access to mental Health Services on behalf of a family member sometime. Lets just say I now know why there are so many people pushing shopping carts up and down alleys in Vancouver. It's frustrating even for a sane person.

He has been a doc for 8 years. Had a generic Canadian accent, was a white guy, looked like he should be on Gray's Anatomy.

I made it public, so you do not have to have a Facebook account to read it.

I live in London, Ontario. Small town hospitals are much, much better on client care, maybe because everybody knows you. In Ontario is is ILLEGAL to pay for any service that OHIP covers. I agree that a mix of public and private care is needed like Australia has.

In Australia, anyone who can afford it gets private health insurance. No one want to use the public system, but it is there for everyone. No one goes without medical care.

If you an't handle that I'm gay - cool, don't vote for me. We have no problems, but please stop lying and saying I used some sort of trickery to immigrate to Canada. I made far more money in the US and my life was damned good, in a place that does not get snow and had no state income tax.

You are 100% wrong! Don't you dare criticize the people who are going to great lengths to try to make this miserable POS health care system work for the patients. Our healthcare training is at the top most tier of the whole planet. It isn't the workers but the bosses who are the delinquent ones.

yes we mostly compare ourselves to the yanks. their stats tend to get a bit skewed by the Obaminites who drop dead via gunshots , mostly from their own kind .

What I would like to see in the ER:

A physician's assistant or a nurse practitioner should be seeing people immediately after the triage nurse. Actually, we might be able to do away with triage nurses completely, or they would simply direct traffic.

If a person has a broken bone or a painful condition, they could request and deliver pain medication immediately. That way, a person doesn't mind so much having to wait for the full exam and/or x-rays, etc. They could also flush contaminated wounds at that time and prescribe antibiotics if needed. Why wait 6-8 hours and let the infection get a head start?

In cases of suspected fractures, they could order the preliminary x-rays.

A nurse practitioner or physician's assistant could also easily be trained to suture lacerations. After the ER doc finishes his exam, he can order addition test, meds, or wound closure.

The ER doc would them walk away to see the next patient and the nurse practitioner or physician's assistant could do the suturing. They cost far less in salary and would do a better job, because they would not be as rushed as the docs are.

I wouldn't be so keen on small town hospitals. A colleague was skiing in the Collingwood area and had a bad accident, sliding on a steep icy patch and hitting a tree. The lower part of one leg was a mess. He got prompt service at the local hospital, except they told him they had to amputate his leg below the knee because it was beyond repair. He of course refused the treatment and arranged for transportation to Toronto. The Toronto hospital restored his leg and, despite limping for a year or so (he was about 60 at the time) he now walks perfectly and jogs every day.

Always get a second opinion, especially when they want to amputate.

Kyla - as long as you don't do it in the streets and scare the horses. My only interest is me and my family remaining disinterested. Good luck on the nomination.

good job on the surgery .

check this out

http://www.southpolestation.com/trivia/igy1/appendix.html

... and it isn't just the small-town hospitals. A recent case (moore v. getahun, 2015 ONCA 55) dealt with a botched cast at Scarborough general. How botched? Here are the observations of the second physician the unfortunate patient saw a couple of days later, after suffering permanent damage to his arm from the badly done cast:

[22] The trial judge also ruled that certain statements made by Dr. Orsini to the respondent’s father expressing strong criticism of the appellant’s treatment of the respondent were admissible as part of the res gestae, but not for their truth. The father testified that Dr. Orsini told him:

• “The cast never should have been put on, as it was far too tight… it killed the flesh in your son’s arm.”

• “[The appellant] didn’t set the wrist. He made it worse” and “managed to catch the nerve between the bones and damaged the nerve as well.”

• “Whoever did this butchered your son.”

Kyla: "when I could not see the area I was trying to staple, because it is on the back of my left leg, and I have to staple with my right hand. The one break in sterility was when I asked Katie to position the stapler. Her hands were no where near the incision or the actual staples, so it was okay at that point for her to steady the staple gun as I was getting fatigued."

I'm waiting for the complaints you inappropriately accessed the private health care system, thus depriving poor pets of socially just outcomes. Anyway, pets get better health care than many Canadians.

Having said that, in BC we've been lucky and have for the most part dealt with dedicated professionals. Maybe Ontario can learn some lessons from us. When I was in Ontario about 10 years ago my mom broke her hip right after my dad's funeral. Again the staff were awesome and tried their best to manage her pain. Then, 12 hours later, the orthopedic surgeon sauntered in, grumpy because he was supposed to go on vacation that night, then remarked "well a fracture of that kind isn't really all that painful." After watching my mother writhe in pain, losing the will to live before my eyes, I couldn't help thinking, "hey doc what if I body slam you against the wall, it wouldn't be all that painful!" My older sister, reading my body language, stepped in front of me and let the doctor know under no uncertain terms our mother was in pain.

There's always enough idiots in the system to gum up the works; sorry about your painful experience, Kyla.

"But in southern Alberta (vs large city) access is darned good for all ailments. The issue seems to be overcrowded city hospitals. Years ago, a geographer proclaimed that once cities get >250K then things go to hell for many services and quality-of-life parameters: transportation, time wasted getting around and obviously health care."

The 250,000 population warning is important. Perhaps, there is an administrative version of dividing larger centres into districts under that size that might help.

My city is about to start going over the 250,000 population mark and the quality of life parameters are going down hill fast.

The comment above about a "south-asian" doctor being totally incompetent and spreading infections needs to be dealt with and fast. It shows how quickly Canada can become a 3rd world country, if we don't reform our immigration system.

That the emergency room doctors are not properly trained is a bad sign, that he wouldn't have looked to improve his skills is another bad sign. Everyone should improve their skills and learning on the job, professionals more so.

Senior medical staff should catch that during case reviews.

As Dr. Kyla points out the cost in money wasted is high. The cost in unnecessary suffering, amputations and death is a true outrage.

We're told many advanced countries have a combined private/public system that puts pressure on the public one to remain competitive.

If it's any consolation the U.S. will see more stories like this one from Toronto(I presume) with Obamacare becoming the largest bureaucracy in America.

Now if we can get veterinarians, like Dr. Kyla, certified for human care, too. The problem would be solved overnight.

In our increasingly animal centric society, every strip mall has a vet. clinic!

Our medical system suffers from the bureaucracy's monopoly.

Lord Acton's proverb applies: "Power corrupts, absolute power corrupts absolutely."

That was a good strategy, as they wheeled me to a triage waiting area and a triage nurse saw me within 20 minutes.

Jeesms! 20 minutes? What if you had been having a stroke or something? Or do they do "pre-triage" before you see the triage nurse? I hope so.

Kyla, what you are describing here was actually a pretty good trip to the ER.

Frightening, isn't it?

I know some stories. This one doesn't even come close. I'm not belittling your pain, I know how serious a dog bite is. Its just that the ER system is so horribly broken this event doesn't even make it onto the bottom of the This Is Bad scale. You could easily have spent 12+ hours sitting in an ambulance in the parking lot, alone. Caught a raging infection from the wound while you waited. Lost the entire leg due to sheer appalling stupidity from a series of doctors and nurses who shouldn't be practicing ER medicine. Happens all the time.

Piece of advice, next time don't be nice to the benchy nurses. Make them do their f-ing job and don't give them an inch of slack. Because they will cheerfully let you die. They do it all the time. People die in ER that shouldn't, all-the-time.

The cause of this entire state of affairs is socialized medicine. Training suffers, skill suffers, doctors themselves suffer (horribly), and patients suffer. You get what you pay for. If you pay nothing, that's what you get.

For future events, I encourage one and all to have a relative in the medical profession, preferably a sibling or offspring. Mere friendship is insufficient to overcome the system these days, you need blood ties to make it work right. You need to know who to call, who owes who a favor, who needs a bribe, where the levers are. Its Soviet medicine.

Bare minimum to survive hospitalization is have a family member with you as long as possible every day, otherwise you may not get fed or medicated. I'm not kidding, and I'm not exaggerating.

If you just show up on a shutter at the ER, you're pretty much f-ed.

Would you agree that the system won't " work for the patients " until/unless the patients are the bosses, with no interference in the doctor patient relationship from the dead hand of the state, and the political class?

And I agree with your statement about those healthcare workers who try to make it work; a friend's sister is a RN now in administration in Ontario, and she struggles mightily to make it work (. Not to mention the anguish she feels at the human cost of the POS system, which she sees on a daily basis. )

Last post was a reply to Mike. Snafu.

Actually, in certain emergencies, vets can be conscripted as medics.

I can never understand why hospitals aren't funded through fees for services. Now the hospital has all the money upfront and the patient is a liability. If the hospital had no money upfront and had to earn it all by competing with other hospitals for patients they would quickly become an asset. Everyone in healthcare administration knows this but no-one follows through.

Heh! I get the feeling that people think there was a time when there was excellent healthcare for everyone and now it's ruined by commies.

Scar said: "I can never understand why hospitals aren't funded through fees for services."

Two reasons.

First and most important, fee-for-service encourages more services. In a single payer system, more services is -bad- because it costs more money.

Second, provincial budgets are made annually. Everything is planned ahead. If a hospital needs more than was budgeted, that is -bad-. Therefore they get their money at the beginning of the year and that's all they get.

There's a lot of HMO-style Diagnostic Related Group (DRG) bullsh1t that's being imported from the States to try to rein in costs as well. Calling it rationing isn't far off the mark.

Bottom line is, when people get stuff for free they TAKE MORE. When they have to -pay- for what they get, they only take what they need.

Fee-for-service is a model that works when the patient pays the bill. It does not work when somebody else pays, because there is no incentive to the patient to moderate his demands. Therefore the system is met with demands it can't service, therefore rationing, therefore Soviet level medicine.

In other news, sh1t rolls down hill.

Absolutely NOTHING can fix this system. Until the day when Dr. Kyla can go to a PRIVATE hospital and -pay money- to a competent surgeon to fix her wounds in a timely and capable fashion, we will be faced with "Kyla's Day At The ER" being a success story. Because at least nobody died.

I've heard far worse stories too. This was one I could absolutely testify to, because I lived it. If my former client and friend had not been working, I could have waited as long as 24 hours to be seen.

When I retire from practice in Ontario, I will always keep my New York license up to date, so I can order my own surgical supplies. My NY license costs $210 for three years. Ontario is almost $1200 per year.

From my own personal and professional experience, it appears that the Health Care system is quite consistent with most workplaces.
Some people give a sh!t and others don't. And this is apparent from the janitors up to the CEOs, civil servants and politicians. Oh, the last two will always have some brave new initiative to roll out, but really they don't care if your child, sibling, parent or grandparent is writhing in pain or slowly dying on the waiting list.

Sadly, in our current health care system, there is no mechanism to separate those who are diligent in their work and those who are not.

In Kyla's case, the pictures of those sutures and a blow by blow description of the lack of a sterile field should be distributed far and wide and the physician be precluded from earning an income until they can prove that they can perform the most basic of services. Seriously, you want this guy handling your heart attack or a car accident trauma case.

Until everyone cares for EVERY patient like it was THEIR family member, the system will not change.
Anyone that can't reach that standard should be canned.

A colleague of my Father was in his 70's in 1975 Minnesota, USA. He said he never went to a human doctor, only used Vetrinarians because "If they can diagnose patients that cannot talk, they can surely diagnose my problem." I lost track of him after my Father moved across country, but he made it to his 80's.

If I lived in Canada, I'd strongly consider getting to know a Vetrinarian, as well as several nurses and MDs. When I deal with Government Run anything, I know that the only way to make it work for me is to have friends that "help me out" and "know the system."

Free Healthcare is worth every cent.

The US treats every new born as best it can, even very premature babies. They also count them in their life expectancy statistics, which most of the other countries do not.

Could the US do better? Yes!

The US also leads the world in medical innovation. Mostly because people are willing to spend THEIR OWN MONEY to improve their lives. "National healthcare" does not have any incentive to do so.

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Recent Comments

  • Kyla: http://london.ctvnews.ca/video?binId=1.1807099 Link to the CTV story last night. read more
  • Bill Grant : A major impediment to finding good health care is an read more
  • Kyla: I would have been way better off to simply go read more
  • Kyla: Walk up clinics in this city have a bad reputation. read more
  • Iain: That is a nasty looking wound, but it is not read more
  • Canadian Friend: I am suspicious of people who think dogs are never read more
  • Kyla: Send me an email at DillardAnimalHospital (at) gmail.com to let read more
  • Kyle: Hi Kyla, Couple of things: I agree the wound closure read more
  • Janet in Newmarket: If you are having blood taken for lab tests, either read more
  • Kyla: Loki, I'm talking to the TV news reporter tonight at read more