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Cutting through the Matrix @ the 100 Mile Emergency Room
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I was blessed to spend 8 hours in the 100 Mile Hospital ER the other day interacting with the people and observing the care of my mother’s unstable ankle fracture. I am always on the look-out for miracles. Anyone remember the good-luck, bad-luck who knows story?
Nobody would be surprised to hear someone say that the Health Care System in general is at it's breaking point. But this is the story about how the whole “illusion” of function is held together at the Interior Health operation.
Arrival at the Hospital: the ambulance attendants were great fellas and they had this funny idea that they could take their Ambulance up the 4x4 road where we were located despite being told not to. Luckily, they were intercepted and didn’t proceed to a spot my loaded 4x4 tracker could barely make it in.
Anyhow, being that I was trained in how to stabilize and monitor an ankle, we got to the pavement and decided not to wait for the Ambulance because of the additional movement and subsequent assessments that would ensue.
The attendants were awesome when they found us at the ER door, they helped us get from the truck into the wheel chair to the ER, with no-non sense assessments. They joked that I forgot to re-check the pulse in the technical window while I was driving the 15 mins to the ER, and it was a good kick in the butt for me to brush up my skills. They reassured me and helped us … the one guy made a wisecrack about getting to take off a woman’s pants! Phew, we still have a sense of humor in the Cariboo. Check.
They got my mom into the ER and I came around the front about 20 minutes later. She had been given some pain relief which “removed her filter” she kept looking at the guy over by the counter and saying “is HE the doctor?" "Are you sure he’s a doctor or is he a nurse, or is he clean-up?” Of course he could hear her! So I politely prodded him on her behalf, “you are the doctor correct?” Somewhat incoherently he responded yes. Near the end of our 7 hour visit we learned that this Doctor had been on hour 33 of 36 when he began treatment. Imagine working an easy job after 3 days of being awake? WHAT the heck was he doing ER doctoring for 36 hours?!?!? The first attempt was made and the cast was placed, x-rays taken. Didn’t work. Second attempt same result. My mom was awake the whole time and the second time was given too much Ketamine. That was a horrid experience which we will both have to live with for the rest of our lives. Pure gratitude to the nurse who held her hand while the other one came and retrieved me to help ground mom down.
At this point something had to give, we had been there for far too long. Another doctor had just arrived. By happen-stance I watched him walk in the door and tell the others he was actually coming on shift as the doctor. This was just as they were setting up for reduction attempt number 2 of 3.
In this moment, I suddenly realized the illusion we were swimming in!
Almost none of the staff actually work in this Hospital. The "team" was a revolving door of strangers.
I was sitting in one of the ER chairs, and the lovely x-ray technician came and sat beside me. She began to tell me her story. She was up from Vernon for a 12 day shift, there is only one x-ray tech who works 7 day shifts here. Originally, this visitor to 100 Mile Hospital had ties to Enderby, she had witnessed the loss of the hospital there under the “early reign” of Interior Health and the subsequent losses that community experienced. In brief she told me:
“We worked so hard to maintain what we had, my sister told me how desperate they were up here so that’s why I came up, I’ve been trying to retire for quite some time. We do everything we can, it’s not the people we do everything we can to make it work"
I asked her where her replacements were, why she figured she wasn’t blissfully passing on her mastery to a young apprentice right now? “Well, let me tell you about the education bureacracy as an example - there are x ray tech’s slated to graduate in May, but they won’t even be able to do their exams until September and then they’ll need to apply for work and start learning the job”. She is ready to retire but has not trained her replacement(s). And she may never get the chance. Who will take her place? How does someone learn HOW to do something? They have to do it. They have to practice. It is in the doing, the flow state, that we achieve new skills and talents and grow our abilities. It takes a Village to raise a child and it takes an orchestra to play a concerto. The system Interior Health has created has robbed of medical people of both community based teams and their access to flow! How absolutely absurd.
I suddenly realized, out of the 5 staff, for certain 3 of them did not actually work at the 100 Mile Hospital. What an elaborate illusion!
Definitive care in the IH medical system was in that moment revealed for what it is… delusional. There we were, still in 100 Mile Emergency, 10 nerve needles, two doses of Ketamine, two ankle reductions, two casts and the ankle was still not stable. Thank the Heavens, the freshly arriving Doctor, while young, was well experienced enough to be able to act decisively (despite having no orientation to the ER or other staff at all). All the while the exhausted Doctor was still deliriously recommending Ketamine for my mom, against her wishes!
The fresh Doc looked me square in the eye and said to me “we can do it without, it’s not necessary, it’s your choice. I’d like to put her under with Propofol and actually get this done”, I knew then I could trust his advice and I said “thank-you for being clear, I understand and I want no Ketamine she is to have Propofol only”.
We broke through and the miracle finally arrived she went under at 8:55pm and minutes later the fracture was reduced and cast, my mom was awake and relieved, holding my hand at 9:11pm after 7 hours of agony.
In the end there are so many questions:
Will my new friend, the x-ray technician, get the chance to pass her hard earned wisdom on to as many replacements as possible before she retires? All things considered, it seems unlikely.
Will that poor exhausted doctor have to work more shifts like that? How long can one last like in that work situation? How much worse did the exhaustion he was in make my mom's unstable ankle?
Will the young doctor who arrived and took charge in a totally foreign environment without a functioning team get the recognition for the courage he had in that moment to act as a real leader in those moments of chaos?
There is nobody to blame for anything in this story, except ourselves for our own lack of awareness. We must look past the symptoms, blaming people is absurd. What we have is an illusion, a dystopian matrix we are told is "the best Health Care System in the world". We must cut through it to find the truth of what we are now presented with IN REALITY here in our Little Village so we can create real systems for real people! Those Doctors, the technician and the nurses, my mom and myself all deserved better that day. And what did my mom say to me as she was coming out of her wretched second Ketamine dose? She was yelling, “I’m in the Matrix, how do I get out. Help! Oh my god what is real, I can’t tell. Where am I, I am in the Matrix. How do I get out?” And boy, was she oh so right about Interior Health - wasn't she?
Couldn’t make this stuff up if I tried.
My advice? In an Emergency call ahead and ask how long the ER Doctor has been on shift that day before deciding what direction to turn on Highway 97… We need to gather community minded medical teams and begin to coalesce REAL community based approaches to Health, Care and Well-being for people.
THANK-YOU from the bottom of our hearts to all of the staff! I wish there was more we could do to make your work environment more supportive of you and all people. Just know we are doing everything we can from the outside! Being in there with you has been a profound experience for me. Mom has now successfully had surgery at Vernon Jubilee.