Call me overly cautious if you like, but while I might spend wait time reading a magazine in a dentist office, an optometrist office, or even the offices of most medical specialists, I will not touch one with a barge pole in the waiting room of a GP. I don’t think I have any unusual aversion to germs, and seem to have pretty good immunity, but when I glance around to all the people sniffing, snorting, sneezing, snuffing onto hands and newsprint, I can’t help but think that the out-of-date magazines, particularly in the humid weather of this summer, might make ideal camping ground for all kinds of sub-visual critters.
If you want to see the worst side of automobiles, visit a repair shop, or even the extreme of a junkyard. If illness, human damage, and just general germs are your passion, let’s face it, that stuff is in abundance in medical facilities like doctor’s offices and hospitals– our locations for salvation from illness and damage, but many times dangerous places to be in, particularly as the patient.
Many wonderful things take place in our hospitals, many dedicated people work there, fantastic technology makes breakthroughs that never could have taken place even a decade ago, but danger unfortunately lurks in the long tile corridors as well.
Two women in Windsor area hospitals had breasts removed when they actually didn’t have cancer, bringing this issue to the front pages again. Interviews showed one woman as understandably devastated, while the other seemed to be letting her lawyer do the significant talking, and rightly so.
Investigations are taking place, and promises that “this will never happen again” are being loosely made. Of course, it will happen again, though probably not there.
Hospitals are extremely complex places, filled now with technology that I can’t imagine people have the time to fully master, too frequently under-staffed, buried in paperwork, and pulled and pushed by administrations focused on budgets and public relations. Since health care takes major bites out of any provincial budget, it shouldn’t be surprising when cost-cutting is the focus for politicians and senior staff. As societies we set up situations for problems, and we shouldn’t be surprised when they occur.
The current stat is that 24,000 people a year in Canada die from “adverse events” at hospitals, this out of almost 90,000 who experience unwanted extras on their visits. These are people who like all of us see the hospital as a place of safety and healing, and then they, or their grieving relatives, find it tragically wasn’t so. This is not dying as an obvious result of their medical issue, but events like getting infections they didn’t arrive with, misdiagnoses, clerical and other errors, pharmacology mix-ups, falls, and the ultimate horrors of surgical mistakes. That’s a lot of people dying, apparently more than the number of people who die from breast cancer, motor vehicle and other transport accidents, and HIV– combined!
In the States, from which we often feel statistics can be transferred (divided by 10), actor Dennis Quaid has started a personal campaign to stop medical errors, following the near-death of his twin babies after being twice given the blood thinner Heparin at adult dosages. In one TV interview, he compared the US hospital error death toll to “twenty 747’s falling from the sky every week, week after week– and few people paying attention.”
The value of his comparison is that if such a situation with 747’s existed, there would be an immediate uproar, and investigative panels would be instantly formed to investigate and recommend changes. It would be an intolerable situation for the general public. No one would fly. People would take to the streets.
Not that investigative panels don’t exist; they certainly do, and probably every hospital has its own to investigate “adverse events”, but many have complained about the pervasive attitude of secrecy and protectionism that seems to be more of a mantra for hospital panels than frank admission of guilt and open efforts for remedy. We all hear the news stories of the few “bad doctors” around—the radiologists who rack up years of bad readings, the surgeons who leave trails of operations with tragic complications—stories that frequently leave us scratching our heads with the question, “Why was he allowed to practice this long? Didn’t someone in the hospital know?”
Although the Windsor women would seem to have solid cases for lawsuits following the unneeded removal of their breasts, in Canada many patients don’t follow through on lawsuits against doctors and hospitals. We know it’s dificult to get doctors to testify against doctors, and Canadian doctors pay into the Canadian Medical Protective Association, a malpractice insurance agency with $2 billion in its defense fund to fight suits against its clients. “Settlements” are the common route, unless patients are willing to gird themselves for the long haul. These settlements generally take only months, and average in the tens of thousands of dollars, rather than the few court cases that drag on for years (but occasionally arrive at settlements in the millions).
Many comedians have used the line “I hate hospitals—there are too many sick people there”, but in reality it’s not that funny. We hear of the “superbug infections”—things with abbreviations like MRSA, VRE, and ESBL— that, while they can certainly be caught in the normal world, are mainly acquired in hospitals. It’s certainly scary to learn that in Canada you have a chance as bad (from some reports) of one-in-ten of getting an infection while in hospital. Thankfully many of these are successfully fought, and the apparent damage is limited to longer hospital stays. Scattered through the statistics, however, are those who go in for simple surgeries and never come out alive.
It’s not an area where we have much control. If trouble strikes, we can wake up staring at a hospital ceiling with someone, hopefully masked, leaning over the bed. As we age, the stays are longer and the odds for trouble climb. For the majority, it will thankfully be a trip without complications. Get it over with, follow the doctor’s orders, and get out as soon as you can.
It’s a dangerous land. And I’ll pass on the battered 2003 Maclean’s magazine in the waiting room. Thanks anyway.
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Gives me the creeps. In a Dr. waiting room I looked through a Martha Stewart magazine, licking my fingers to turn the pages. Later it was your dear wife Ellen who suggested that it probably wasn’t the best idea. Needless to say I’ve discontinued that practice and lived to tell (for now until the next Dr. visit).
Francis, if you like interesting material to read, check out Malcolm Gladwell’s work. There is a particular essay in his last book (What the Dog Saw) in which he writes that mammography and searching for breast cancer is a crapshoot at best and that most times doctors are guessing at telling whether there are “friendly” or “bad” lumps. If they get it right it is usually a guess.
I’m not saying that there aren’t other goof-ups that shouldn’t happen, but in the cases of detecting breast cancer it can be difficult. On the other hand, what happened in Newfoundland the other year (I can’t remember all of the details) regarding the women who were told they had breast cancer and were misdiagnosed, now that is madness. Things like that (which i assume you are blogging about) are a total shame and needless.