Mind the gaps: Woman dies in ER
Cross-posted from my other newsletter, WHERE’S THE HARM.
A Nova Scotia woman died in her local ER on Dec. 31. And we’re not surprised.
Canadian emergency departments are known by many as places of neglect. People who use drugs (PWUD) and other poor and marginalized folks have known this for… EVER. And, today, it seems like many more of us (“normies” and “freaks” alike) are feeling the crush1.
Canada’s healthcare system is taking a beating in the press for being in the worst shape, with the most neglectful, deplorable conditions (for healthcare workers, staff and patients alike) than we’ve (supposedly) seen in decades.
Doctor burnout is at an all-time high. And seemingly regular (privileged/English-speaking) people are dying as they wait to be admitted for care.
Have you ever wondered if you’d die of starvation waiting in the ER? And no one would notice? I have. I’ve been detained at my local ED for 12+ hours without so much as a fruit cup or snack bar. And then I was sent back home in the wet clothes I’d come in with.
Good thing I saw the social worker that time. In Vancouver hospitals, the social worker is sometimes the only route to a taxi cab ride home, or even a bus ticket. Often, we need to know in order to ask. And many folks don’t/won’t/can’t ask for help.
“The system is broken,” says Hoffman’s husband. But his statement assumes there is a system in the first place.
Systems are interconnected networks of parts that (are designed to) work together to form a whole.
Canada’s healthcare situation is not that. Most of these points do not seem concerned with the other parts, meaning we can’t have interconnection. Instead, what we have are touchpoints, or siloes. And despite the adage (or wish) that “every door is the right door,” most points (in my experience) are often wrong.
Or maybe they’re not wrong. Maybe whoever works there decides what is wrong, and what is right, for whichever patient stands in front of them. And perhaps they do this without even asking any questions.
Here are some ways we think Canada’s healthcare could start feeling more like a system, and stop deterring people from visiting when they are in need of care:
Provide free food: A complementary snack bar or cafe2 could help distract folks from long/hellish wait times, meaning they might be less likely to complain/get frustrated and leave. And those who can’t afford food will get some nourishment (which helps people stay calm, and stay alive).
Ask questions: If you are a healthcare worker, consider asking more questions than the patient in front of you does. If they say nothing, consider this gem3: “How can I help you?/What do you need?” Before they walk away, consider asking, “Can I help you get to where you are going next?/Do you know where you are going next?”
Be a helper: Assume that your job is to help people (which, if you are a healthcare worker, it is). I’m serious. Take that idea and try to embody it. What does it feel/look/sound/act like? Be that.
Listen to patients: Especially when they are screaming in pain. Pain is a signal that something is wrong. Listen to it. Be the conduit for patient pain. If this feels like too much, consider dropping something else. What else are you a conduit for? What else is eating up your time and energy? Whatever it is, is it more important than channeling patient pain, and getting it to the right end? I mean, what else are you there for?
This list isn’t rocket science. And it doesn’t have take a review panel and a lengthy document outlining recommendations — often without any idea of how to implement its proposed changes — to change things for the better.
This list also isn’t meant to disrupt/revolutionize every aspect of our broken healthcare non-system. But maybe, over time — and with repetition and patience — a short list of seemingly simple, yet powerful, acts can cause a rumble that reverberates through our bodies, helping us to finally feel more connected and less alone.