Accessible care

Issue: BCMJ, vol. 45 , No. 10 , December 2003 , Pages 482 Editorials

My story starts on a Wednesday evening in mid-August. I arrived home from work with two bags of groceries and 20 minutes to spare until friends arrived for dinner. Betty the boxer (front cover, September 2001 BCMJ) looked unwell. She then started to have syncopal episodes. Aforementioned friends arrived for dinner and helped with the diagnosis. The vet was called, who herself was away at her island cottage. Arrangements were made for Betty to be seen urgently by another vet colleague and dinner was cancelled.

Betty received the best of care. She was in shock by the time she arrived at the clinic. After a history and physical exam she was wheeled into another room where she had an ultrasound. The diagnosis of a belly full of blood and a mass in her spleen seemed ominous, but without urgent surgery she would be dead in hours. A full pre-op workup proceeded, including a chart X-ray and cross match. By 11 p.m. she had had her operation and a transfusion. She spent 2 days in puppy ICU—with all the usual lines and monitors. The pathology result, devastating as it was, was back within 24 hours. She was discharged home after 5 days with palliative care instructions and as I write this her tail still wags. We take each day as it comes.

I live part of the time up Indian Arm. It was in July that my neighbor boated over one evening to ask a personal favor. His brother had been ill and to the emergency department a few times. He had been told to get a family doctor, and a specialist consultation was pending in the next few weeks.

My neighbor’s brother (I’ll call him Fred) was seen by my associate the following Tuesday. Doug came by my desk at the end of the day to tell me what a pleasure it was to have met Fred, but he had that sinking feeling Fred had an ominous problem.

Urgent ultrasounds were booked, followed by urgent CTs and biopsies. Even with the best of phone calls and arrangements it took 2 weeks to get a diagnosis. Before any treatment could be initiated, his condition deteriorated rapidly and his care became palliative. He was admitted to the palliative care ward and passed away within days. It is ironic that this same palliative care ward is scheduled to close shortly due to fiscal pressures in the health authority.

My story might sound like I am advocating for private medicine. I am not. I just want a health care system that can be easily accessed when people are desperately ill.

—HMO

Heidi M. Oetter, MD. Accessible care. BCMJ, Vol. 45, No. 10, December, 2003, Page(s) 482 - Editorials.



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