Tuesday, September 1, 2009

My close-up experience of grandma-killing "socialized" medicine

I had a very interesting experience this past week. Last Wednesday night I had a TIA (transient ischaemic attack).

So (long-story-short) emergency was dialled (not 911!) and an ambulance arrived in a ridiculously short few minutes. The ambos checked me out, asked a few questions... and after a few seconds of discussion they decided to take me to a hospital a few km south with a specialty neuro unit - a public hospital.

I was in the hospital in minutes. I was assessed again in emergency; and then an emergency doctor saw me almost immediately. After a surprisingly short wait (though this was probably after 7pm) the neuro specialist had come in to check me out - and he had a few residents with him. Though my case was unusual, he had figured out the cause of the TIA instantly he saw me, and attempted to get the residents to figure it out too.

(It turns out that you can cough yourself into a stroke... if you cough so hard you tear your carotid artery, and then dislodge the clump of platelets that form over the wound - with more coughing. It sounds funny, but I have to stop laughing because it makes me cough more. His diagnosis was confirmed by later scans.)

I spent nearly 5 days in hospital, and over that time (beside the initial time in emergency) I shared wards with seven people in their 80s and 90s, as well as one slightly younger lady I didn't find out much about. Apart from a few hours in emergency, I was in the stroke ward (which is opposite the nurses station and has monitors at every bed) for most of the time, but my last few days were in the next ward along. [Each of these wards is only four beds - and they're usually not all full.]

Everyone, public patient or private, old or young, had CT scans, MRIs, ultrasounds, blood tests (and further tests depending on their particular case), along with regular monitoring. While I was in the stroke ward, I and my fellow patients were all visited by a stroke team, a physiotherapist, a speech pathologist, an occupational therapist, a social worker, and several others as necessary for the individual case (e.g. I also saw a respiratory team and a dietician - to work out how the hospital might cater for my unusual dietary needs and to assess my diet longer term). Everything was being done not only to get us well and able to function as best as possible, but to try to make sure we were able to remain out of hospital and either be able to care for ourselves or be properly cared for.

The staff were amazingly professional, competent, friendly and helpful, though usually very busy.

Was everything perfect? No, several minor things went wrong. I wouldn't expect everything to work perfectly in a large organization where the situation is so chaotic and constantly changing and the people so busy. What mattered to me was the way that the problems that did arise were dealt with. If you brought a problem to the attention of the nurses or doctors, it tended to get solved. They listened.

I was one of several private patients in a public ward (by choice). Being private meant I was free to choose my doctor (why would I choose anyone but the excellent specialist they had on hand?). We got a few trifling extras (like they supplied me with shampoo and soap which was handy the first day before I got organized wityh all my own stuff).

Were there shortages? Yes, now and then - I saw the nursing staff dealing with some kinds of shortage (like not enough kidney-dishes), but I never saw a moment where they let these difficulties impact the care of their patients.

Of the four people over eighty I shared time in the stroke ward with, three improved rapidly and went home within a few days, and the fourth was transferred to another facility her son worked at for some longer term care nearer her family. In the second ward was another TIA patient in his nineties who also came along very well and was likely to be able to go home soon.

So how was the time in the "socialized-medicine" public hospital?

The sun shone in through large windows overlooking million-dollar river views. There were bevies of committed professionals looking after us. There was lots of talking and laughing and joking. One old guy did a bit of tap-dancing. People, old and young(-ish), recovered and went home. Nobody killed grandma.

[It is interesting to think on this: We have just as much a problem with obesity here as the US does. We have less money (about 20% less per capita). But we live FOUR YEARS longer. Government involvement in health care - it's certainly not perfect - but it seems it saves lives. Lots of lives. Even grandma's.]

No comments: