Doctor Mom is a physician who lives in Ontario
It’s March Break, which means last chance to do winter activities for some families in Canada. Unfortunately, I’m not Winter Fun Mom so I booked Son #2 - the only person in our family who is interested in winter sports - on a bus-in snowboarding camp. On day 1 I warned him to be careful and to try not to injure himself. On day 2 I forgot to warn him. So at 2pm on day 2 I got a call from the snowboard instructor to tell me that my son had fallen and would soon be on his way to hospital in an ambulance.
I know I should be more encouraging of adventure and more accepting of risk-taking in my boys. And I’m not UNfun Mom, by any means. Yet years spent as an Casualty doctor and then an anesthetist rather reduced my tendency towards happy-go-luckiness. And having lived my entire adult life with the sport-limiting and general functional consequences of knee injuries incurred in childhood means I’m loathe to encourage risk of traumatic injury in my own children.
But it’s the way that hospitals operate that really makes me want to avoid having to visit to them. I even refused to give birth to my children anywhere but at home, much to the annoyance of my husband. For patients and relatives hospitals are frequently places of indignity, frustration and tedium. Although individuals are often kind and friendly, a public hospital system is frequently inhumane. And Emergency is the zenith of surrender-all-control nightmares. My sons have no concept of this because they have been largely healthy and injury free (and having a doctor mom means that sometimes mom makes the call that a doctor would make so you don’t have to go to the doctor); They don’t have the antibodies to hospitals that their mom has. But one does now!
Son #2 – who is 9 years old - was brought to the hospital’s emergency department at 3pm in the afternoon and his dad and I arrived shortly afterwards. We found him alone in an examination room lying on his back wearing a stiff collar. The novelty of going to hospital had already worn off. He’d dropped the buzzer he’d been given. He was feeling caged and ready to whine.
There followed 90 minutes of restless wriggling, some drinking of water through a straw, and lots of “I’m soooo booooored!”
I was encouraging. It won't be long. Emergency departments are busy. Waiting is normal.
At 5pm we let our son press his call button to ask if he could go to the washroom. The nurses said he couldn’t sit up or walk so he peed in a bottle.
With the help of an audiobook and some mental math problems we weathered another 90 minutes of absolutely no attention from anyone although we could see many staff milling around outside the door of the exam room.
“Have you got a joke for us?” we asked Son #2.
“Sure,” he said, “Knock knock!”
“Not a doctor!”
We laughed; it was better than the alternative reactions to our situation.
After Son #2 – who is 9 years old, remember - had lain on his back staring at the ceiling for nearly four hours without seeing a physician or being sent for imaging, we said it was okay for him to press his call button again so that we could ask when he was likely to be examined by the doctor. The nurse said he was next on the list to be seen, and that there were only two doctors and one was ‘seeing urgent cases and busy saving lives’.
The second doctor, it turned out – because later when he did come to examine our son we put two and two together – was sitting at the desk right outside our exam room door, and there he continued to sit For 45 Minutes, slowly enjoying a venti Starbucks and a sandwich…! Folks, forgive me, but that’s the medical care equivalent of the server peeing in the soup of a restaurant patron who dares to complain about the slow service! Everyone who works deserves a meal break – even doctors – but have the grace to take it out of sight of the patients waiting for you to see them!
Not that we had even complained; by the time we asked politely when our son might see a doctor we had been in that airless exam room for 4 hours and our son, who had been staring at the ceiling, was crying with boredom for us to let him go home.
Also worth mentioning is that Son #1, aged 13, was alone at home. We’re lucky; he’s resourceful. He fed the pets and took himself to a local restaurant for dinner.
At 8pm the doctor, fully victualed at last, came into the exam room. He did not greet my husband or me, or even acknowledge us. He began taking a history from my son. He removed the hard collar from my son’s neck and asked him to sit up.
And then a code was called and he left. I immediately jumped up to put the collar back on my son, but the doctor called to the nurse tell her to tell me no. He told her to allow Son #2 to sit up. Then he left.
Was I worried about my son’s neck, which had been so carefully immobilized for several hours? No, not really. I’d already examined him myself and come to the conclusion that the neck injury – if he had one - was minor. But as a medical parent it’s not for me to make that call. Was I furious? You bet! What kind of a system triages a child to be not-a-priority and then leaves him lying on his back in a stiff neck collar for four hours without coming to explain to either the child or his parents what’s going on?
I turned to my husband and said, “This is absolutely unacceptable!” At which point the nurse asked me if I didn’t understand what a ‘code’ was. So I had to go for a walk to cool off and to avoid becoming ‘a verbally abusive patient’.
We waited another hour but the doctor didn’t come back. I’m sure he was busy and that there were lots of priority 1 and 2 cases that were taking up his time. There were certainly lots of people in the waiting room when we left; it was a busy night in Emergency.
And the outcome of this evening of fun was simply, and anticlimactically, that we left.
After Son #2 was free of his neck support and allowed to sit up it was nigh impossible to prevent him from walking around. The waiting started to become ridiculous. He began to beg to be taken home. He was tired and hungry and wanted to get enough sleep to be able ‘go to camp tomorrow’. Husband and son both turned to me. Could we please just go? Suddenly Doctor Mom became The Doctor. In the face of an indefinite wait to see a physician I had to make the physician’s call. It was somewhat less than ideal. I believed my son was okay. But there was a small chance I’d be responsible for making a mistake. I didn’t want that responsibility. But I took it so that we could all have our human dignity back. We paid the $15 parking fee and drove home for an hour in a snow storm, relieved to be free - and everyone was too tired to eat any dinner before going to bed.
“What did you learn from this experience?” I asked Son #2 on the way home, thinking he might say that he had learned that it makes sense to be really cautious when participating in winter sports.
“Next time I fall I won’t say I’ve hurt my neck or my head even if I have,” he replied.
This is not the outcome that the health service should want, but, sadly, reluctance to seek care is the result that does follow the delivery of care that is not kind or dignified for the patient.