Health care in Quebec Part 2: Lie down and suffer in the snow

By 5:20 this evening I was making my way to my car, having just disembarked from the train in my hometown of Roxboro. We’d been pounded by a sizable snowstorm that dumped at least 20 cm of snow on the ground. Most of that was on my car, so I gradually scraped the snow off my Honda. 

By the time I got to my back window, I noticed a woman crouched next to a woman lying on the ground in the parking lot. No one else approached them. As I got nearer, the woman lying on the ground was in obvious pain. It was only much later that I saw the extent of her injury by seeing her foot rest at a very awkward angle to the rest of her leg. The woman crouching next to her had just phoned for an ambulance. 5:22. The woman who came to help, Huguette, had been informed by the 911 operator that the ambulance was on its way.

Well, it wasn’t. She called again after 20 minutes. The same assurance that it was coming. A few minutes later, the injured woman, Marie-Lynn, phoned as well, crying in pain. Huguette comforted her, I stood a watchful eye for the ambulance, another passenger on the following train offered some blankets from his car. All we needed was one damn ambulance.

Should we move her to the back seat of my car, so she would at a minimum not freeze lying on the ice and snow? The 911 operator advised us against that. But after a while – as in close to one hour – Marie-Lynn couldn’t take the cold any longer so we lifted her into my car with only a few screams of agony. Still no flashing lights, no one but concerned passengers getting off the train asking Huguette and I the obvious, Did you call an ambulance? Yes, three times in fact.

After an hour her husband arrived, who ironically enough used to be an ambulance driver during the war in Lebanon. After he called 911 – our fourth call – he finally gave up and asked me to help her into his van so that he would take her to the hospital himself. A few more screams and she was settled in the van, exhausted and in agony.

It’s easy to be critical of a health care system that provides free medical care. I understand that today was an exceptional day. However, anyone looking outside their window this morning could say with reasonable authority that today would be a bad day. As such, there was no excuse for emergency services like ambulances to be caught off guard.  The roads (and parking lots) are veritable skating rinks. By the time I left Marie-Lynn and her husband, one hour and twenty-five minutes had elapsed since our first phone call. If she had been alone with no one around her, what would have been her fate? Is it reasonable to accept a delay of nearly an hour and a half for an ambulance (assuming it even came by)?

No, I don’t think so. The right to the highest attainable standard of health is a human right. While that doesn’t mean that States must ensure that everyone is healthy all the time, it nonetheless has obligations to help realize that right. The right is defined in Article 12 of the International Covenant on Economic, Social and Cultural Rights. It clearly specifies that States must take steps to achieve the full realization of, among other things, “the creation of conditions which would assure to all medical service and medical attention in the event of sickness.” Our health care system is mature enough for those conditions to have been created. Clearly, today’s experience shows me that they do exist, but not with sufficient availability, and not for everyone.
I hope Marie-Lynn has a good night in the hospital. She’s probably still in the waiting room. But at least she’s there, thanks to her husband, the former ambulance driver.

Health care in Quebec: Sit down and wait

I made my way to the clinic close to my house by 7 this morning. It opened at 7:30, and by the time I arrived there with my oldest son Boy 1, there were already 8 people waiting in front of the door. My son fell in gym class yesterday, threw up from the shock, and stayed home the rest of the day, sitting quietly on the sofa watching children’s shows I find impossible to watch. Too bad they don’t watch too much SpongeBob anymore.

I expected the wait at the clinic to be a few hours, and brought work with me just in case. However, as usual when I am stuck in a waiting room, I find it difficult to concentrate. It didn’t help matters that the second gentleman in line, who’d injured his foot playing soccer, was writhing in pain and found every excuse possible to stand up and hop painfully on one leg, moaning audibly and squirming his face in exaggerated pain. He was one of those classic “I’m in pain, everyone look at me and feel sorry for me” guys. He definitely chose the wrong crowd: WE’RE ALL SICK, MAN, THAT’S WHY WE’RE HERE. To use an expression I heard yesterday, “Suck it up, man.”

When the doctor finally saw my son two hours later, one of his first questions to me was, “Why didn’t you come here yesterday?” I told him I thought my son’s wrist was only sprained. That’s part of the truth: I did think it was a sprain. After all, he never even cried yesterday. I broke my left arm, oddly enough, 30 years ago this week when I was almost the same age as my son. Back then, I most certainly did cry. But there was another, unvoiced reason why I chose not to go yesterday: I figured the wait would be too long. Arriving at the clinic at noon yesterday would have meant an automatic 4-hour wait. By heading for the clinic first thing in the morning, we were lucky to be out of there after three and a half hours. After the initial consultation with the doctor, we had to go upstairs to a radiology clinic for x-rays, followed by a return to the doctor downstairs, who then told us to go to the children’s hospital to get a cast put on, so another 25 km away. This didn’t happen when I broke my arm…

Once at the children’s hospital, my car safely parked in a jam-packed lot for an exorbitant 16$ (and to think the parking lot staff had a huge “tips” bucket by the window of their booth), we were told to “wait a short while” in Waiting Room 2. “Wait a short while” means two hours in a hospital in Quebec. “Might take a while” is three to six hours and “It will be a while” means you’re better off going home and trying again tomorrow. I’m fortunate to have a son like Boy 1 who was very quiet, never complained, and like me, just sat most of the time. But once in a while he would ask me questions:
  • “Why do we have to wait so long? Does everybody here have broken bones like me?”
  • “Why do we have to go to different places for x-rays and for the cast?”
  •  “Why is there only one guy in the whole hospital who sets the casts?” (He said that after we were told to wait at 1:30 for his cast, only to be told a minute later that the man setting the cast was out to lunch and would be back at 2 PM.)
  • “Why aren’t there more doctors?”

Indeed, why are there not more doctors. The public health care system in Canada, while it does have its advantages over other systems like the one in the US, is still plagued by excessive waiting times in hospitals and clinics, a shortage of doctors, and in Quebec, lower salaries for doctors, thereby making the prospect of practicing here less attractive than in other provinces. The Quebec government recently proposed adding a new “tax” in the form of user fees for health care services in Quebec, a move that is being strongly opposed by many. Looking at how things are now, I can’t help but wonder how effective additional user fees will be. They may be able to pay for useless electronic signs like the one I saw in the hospital this afternoon. It flashed: “Waiting times are between 3 to 6 hours.” Thanks for flashing that in my face every five seconds, it makes the time pass that much faster.

Eight hours after we left the house, my son was getting his cast set around his arm. While the clinic and hospital we went to had their share of junky old technology littering the corridors, I was surprised (but perhaps shouldn’t have been) that the plaster room where my son got his cast had a new cast-dispensing machine that offered polymer-based casts in an assortment of colours. All you had to do was choose your favourite colour, slide your credit card down the side, and poof, your cast, wrapped in a package, tumbles to the bottom of the machine like your favourite chocolate bar in a vending machine. While the machine is fancy, I much would have preferred having a qualified professional offer me the basic service of setting a cast on my son’s arm closer to my home. Is that too much to ask for in a metropolitan city in Canada with a population of about 4 million people? Why is access to health care so poor?

Will things change anytime soon? Let’s see, my best response would have to be “It will be a while.”