Saturday, January 8, 2011

What health care means to my wife - London Free Press

Only once have I seen my family doctor in a state of despair.

It happened a couple of months ago, when his normally cheerful demeanour gave way at the end of one of my wife's regularly scheduled medical appointments.

He shook his head, then conceded that there are times he feels like closing his practice or moving stateside. All the while, he tried hard not to display any disloyalty to his profession, his colleagues, his patients and the system that pays his wages.

He felt stymied.

A decade ago, Jacquelyn was active and mobile, despite a gymnastic injury to one knee that later required surgery. It slowed her a bit, but not much. She has always been adventurous: travelling to England for the chance to play her harp in Canterbury's cathedral, floating above the city in a hot-air balloon, riding a horse at a nearby stable.

Then a lower-back injury and a deteriorating knee began to take their toll. The first required many months of bed rest; the second got a referral from our family doc to an orthopedic specialist. After many weeks of waiting to see him, the diagnosis was swift and abrupt: Go home. The condition of the knee wasn't bad enough, compared to his other cases, to warrant any attention.

Fast-forward to now: It may have been the knee, the theory goes, that caused premature wear and tear in the opposite hip, which now requires replacement and which likely threw the ignition switch on a case of fibromyalgia.

In any event, Jacquelyn has seen her mobility decline drastically. At first, she resisted use of handicapped parking spaces, arguing that there were plenty of others worse off than she, but as dependence on her cane grew, she relented.

Last fall, about the same time that X-rays confirmed severe degradation of her hip joint, she went from one cane to two. The family doctor made a referral to another orthopedic surgeon. Time frame for that consultation: unknown. Time frame for surgery: even more unknown.

Her mobility dramatically decreased. On many days Jacquelyn doesn't venture downstairs. Extreme hip pain sometimes keeps her from sleeping for days.

We are at the halfway point of this column, so I'll stop now with medical details. My point is not to write so much about Jacquelyn as to take issue with the state of a health-care system that knowingly and consciously permits patients to go from active living to the point where they become imprisoned in their homes because the system can't adequately cope.

This is not a pity plea. If that's your reading of it, stop now and move along; there is plenty of other material on these pages.

Both Jacquelyn and I are aware of the need to live with life's circumstances and the genetic cards we're dealt. We're in our 50s and we're aging. We're fortunate to have a family doctor in the first place. In many respects, we are more fortunate than many other Canadians.

Neither she nor I believe that, in Ontario's health-care system, there should be any special treatment or queue jumping (though we know it happens). And that's precisely the point. What Jacquelyn has experienced is what we've all come to accept as commonplace in health care in this province.

We all know patients who have similar experiences. On her occasional ventures outside the house, she's heard from random individuals (mobility challenges appear to spark a lot of informal conversations) and medical professionals about waits that last years.

She's heard about lost decades and missed life opportunities. She's heard warnings and stories of grief and miserable surgical failures - but also of life-changing, restorative successes.

No reasonable person expects our overburdened health-care system to snap to the immediate, individualized attention for every would-be patient. But for those caught in indeterminate waits for procedures that could radically alter their quality of life, a line gets crossed when overwhelming pressure on the system becomes deception.

When websites provide wait times for medical procedures that are easily gerrymandered (they measure, after all, only the distance between consultation and surgery). When TV commercials cheerfully tout the many health-care options available to Ontarians. When the local LHIN, the health minister or her minions tweet about their remarkable successes in improving health care.

Or when a family doctor, in a moment of weakness at the end of his day, whispers heartfelt despair about that fact that a patient, despite what is medically possible, can't access timely treatment. And that to indicate anything else would be a bald-faced lie.

http://www.lfpress.com/comment/columnists/larry_cornies/2011/01/07/16804411.html