Health Care Advice from a Canadian

By John Ballard

Sara Robinson is a regular contributor at Dave Neiwert's place. She missed the president's speech the other nite due to a medical emergency. I'm sorry she had to go to the emergency room, but her account makes a timely read. 

Postcard From Canada: Why I Missed Obama's Speech

True confessions: I missed the health care speech. While the whole lefty blogosphere was watching and blogging and tweeting, I was sacked out in my attic bedroom high on a mountainside in Vancouver, sleeping off a narcotic haze and the exhausting aftermath of a long night spent in the emergency room at Lions Gate Hospital.

...

The health event was new to me, but pretty garden-variety as ER visits go. I had my first gallbladder attack. Not life-threatening, just the worst pain I can remember being in since the last time I was in labor. It started up just before dinner Tuesday night. At 2 am Wednesday, still awake and in worsening pain, I found my keys and shoes, stumbled down to the car (leaving the rest of the family sleeping), and drove the 25 blocks down to the hospital.

Four things in particular stood out about the hours that followed -- things that show just how different medicine is when the patients trump profit as the main priority, things that Americans need to understand if they're going to see through the chaos of this moment to the kind of future that's possible.

First, the waiting time between walking in the door and being admitted was literally about 45 seconds...

"It's really quiet tonight," I noticed, trying to look nonchalant while clutching my stomach.

"Actually, we're pretty full." This was my first visit since a recent remodel created a huge new ER ward...There were lots of people here -- but they were all already comfortably checked in and settled away in beds, rather than milling around the lobby waiting to be tended. In another three minutes, I was settled in, too.

Second: You don't realize how much politics -- in this case, the war on drugs -- has warped medical care until you see how differently non-American doctors and nurses deal with pain management. Since Canada sees drug abuse as a social problem, not a law enforcement one, it's stubbornly resisted several ham-handed attempts by the American government to get it to crack down on doctors who persist in seeing codeine and morphine as useful medications. While Health Canada does keeps tabs on individual doctors' prescribing habits, docs are given vastly more discretion in managing their patients' pain than their US counterparts are. If you're hurting, the docs here will calmly and generously prescribe painkillers -- good ones, serious ones, the yummy kind that really do the job. (And yeah, I guess that would explain why the whole ER ward was so eerily quiet, too.)

So it was that, minutes after my arrival, the ward nurse tucked me in and hooked me up to an IV drip with saline and anti-nausea medications. "Would you like some morphine with that?" she asked, in the same casual and pleasant voice with which a waiter might offer you cream for your coffee. My inside voice, battered after a long evening of agony, jumped up and hollered: "YESSS! Oh, HELL yes!" My outside voice sweetly smiled back: "That would be lovely." In moments, eight hours long hours of accelerating pain finally subsided -- and I went to sleep, waking only occasionally from my opiate bliss to find myself being wheeled out for this test or that as night turned to morning.

She continues with comments on privacy and the sense of peace that only comes from not worrying about the bill.

American disease management may never match her description of the Canadian system, but hopefully we will inch a little closer sometime soon.