Emergency Medicine and Inside Information

As I have written, I am all for single-payer, socialized medicine, and while the recent sad news of the passing of Mr. Mark Blandford before he could receive proper medical attention shone a light on emergency medicine in Montreal, some important quirks still remain unknown to the public. Recently I experienced a similar, albeit significantly less dire, emergency situation.

(…)  some important quirks still remain unknown to the public.

On a school ski trip north of Montreal on January 29th my fiancée, a teacher, broke her arm while attempting to slow a child on a sliding ‘magic carpet’ plastic sheet thereby preventing him from hitting a wall of snow. She succeeded, but fractured her humerus in the ensuing collision.

Paramedics on site immobilized her arm as well as possible and a parent with the school group offered to drive her south to Montreal as an ambulance would have entailed a prolonged wait.

Take a number triage

I met her at the Lakeshore General Hospital’s emergency entrance where, alas, there was no one to direct us; no security guard, no triage nurse, just a screen with a message to take a number, much like a bank. With number in hand we took our place among many others in the waiting room. One key element of the ‘take a number’ system is to provide some indication of what number is being ‘served’. This is a delicatessen or bakery shop basic, yet no such information was posted in the hospital.

Although in much pain, thank God she was not bleeding.

Ten minutes passed, then twenty and thirty without even a preliminary assessment; worse, no numbers were being called. What if it had been a heart attack? Although in much pain, thank God she was not bleeding. I tried to ask a couple of people wearing hospital identity cards if we were at least in the right place, but they both pointed out that they did not work in triage,  From what I could see no one did.

Forty minutes without any human contact

After almost forty minutes with absolutely no human attention we opted to drive to the Montreal General Hospital. I was told by a family member, a retired nurse, not to go to the new MUHC Glen Campus as they do not handle trauma there and would in fact only refer us to the General. I found this odd given the alleged state-of-the-art multi-billion dollar hospital complex at the Glen, but at that point I was more concerned with getting treatment than with discussing the inner workings of emergency medicine. Once at the General the process began with a triage nurse assessing the situation within seconds of our arrival. That’s seconds not minutes.

Once at the General the process began with a triage nurse assessing the situation within seconds of our arrival. That’s seconds not minutes.

After a series of x-rays, as the doctor was applying a cast to my fiancée’s arm, he reiterated the now recurring theme that we had come to the right place, telling us that had we gone to the MUHC we would have been sent to the General.

It seems odd to me that hospital emergency rooms don’t all provide essential emergency services. This was a broken bone, not a rare neurological condition or a tropical disease. Moreover, it is downright dangerous that these inner divisions of labour are not made known to the general public.

Inside ‘trade secrets’ not known to public

I have since talked about this with several friends and acquaintances. Interestingly those who are involved in or are familiar with the healthcare system were not at all surprised, however not one of the ‘non-insiders’ was aware of the situation, and several required convincing it exists. So if you think you may have a  broken bone, don’t go to the MUHC, even if it is the closest hospital to you, rather make your way directly to the General.

It would appear that the days of rushing to the nearest hospital should you find yourself in need of emergency attention are gone. If patients are required to research which hospital emergency room provides the service they need, I believe it is incumbent upon those who run our healthcare system to make that information well known, and not a trade secret.

DCMontreal – Deegan Charles Stubbs – is a Montreal writer born and raised who likes to establish balance and juxtapositions; a bit of this and a bit of that, a dash of Yin and a soupçon of Yang, some Peaks and an occasional Frean and maybe a bit of a sting in the tail! Please follow DCMontreal on Twitter and on Facebook, and add him on Google+