We are aware how the paramedics, our first line of rescue from accidents or medical emergencies, rush the sick and/or injured to hospitals. Once in, they line up patients, most hooked up with monitors, on the stretchers against the walls of corridors of hospitals and run to the nurses’ station to announce a patient’s arrival and complete the required paperwork. The paramedics wait until they complete the handover of a patient to a nurse. That completes their work.
Those who go to an emergency department on their own, or brought in by friends or family members have to wait for hours in the waiting room except those suffering a heart attack, stroke, or an open bleeding wound. These persons have to wait for hours and hours before they get checked initially by a nurse, then by a medical professional – likely a doctor on duty (mostly an intern). After the initial diagnosis, a person either goes home with or without a prescription or kept for further observation; if latter, the nurse or doctor instructs that person to lie on a stretcher in the emergency ward.
The next phase which is critical includes care, medical attention, and the treatment needed for a patient brought in or registered for admission for observation and/or treatment in the emergency ward. And that’s where lies the problem.
Patients, with or without hooked monitors, have to wait for hours and hours, lying on the stretchers placed against walls of corridors, hoping a doctor would soon check them and prescribe the required remedy. While they are waiting, nurses check their vital signs including the blood pressure, body temperature, pulse rate or heartbeat per minute, and body’s oxygen intake. And if they are in a severe pain, nurses may offer them just a regular Tylenol or some other light or standard painkiller as they can’t give any stronger medication until a doctor has examined and prescribed it. We commonly call this kind of care as the “Hallway Treatment.” Patients can remain on stretchers in the hallways for hours or even days – depending on how full the hospital’s emergency ward is, how many doctors are on the floor and how busy they are, how critical a patient or his/her injury is, etc. And if that patient requires a blood test, then the time to get the results further adds to the waiting time. That patient may also remain in the emergency ward if there is no room available in any other ward of the hospital.
Seeing or experiencing is believing. Even though I had read and watched all about this kind of hallway care in the newspapers and on television news, I hadn’t experienced this “waiting in a hallway situation” until the evening of February 11, 2020 – the day I slipped like a rolling ball on a patch of black ice while picking up a meal from someone’s home in Orleans around 7.30 p.m.
As I slid and fell hard on the icy walkway, hitting mostly the top of my back and softly the back of my head, I couldn’t get up at all. With back hit hard, I felt the reflexive pain in my upper chest and its cavity. I believe I lost consciousness for a moment. As I lay down on the icy surface, my first thought was what if I had hurt or broken any of my patched arteries, usually left after an open-heart surgery, and the four stents implanted in my arteries around the heart? Since I couldn’t lift my body up, and I too didn’t want to move because of the fear of causing any more damage to my heart, I kept lying on the icy surface and wanted the paramedics to come and help me. Thank goodness, I was wearing a thick waterproof winter jacket, covering a part of my bums, that saved any freezing of my back. My cotton pants were getting soaking wet, though.
Luckily, I had my cell phone with me attached to my belt around the waist and could access it. I opened it up and pressed the number of the resident who had closed the door right after I had picked up the bag containing meal and asked him to come out quickly and call the paramedics. He came out in a panic and didn’t really know what to do or how to handle the situation. I again instructed him to call the paramedics. I gave him my phone to dial 911 and insisted upon him to call for medical help.
While I was lying on the icy, snow covered walkway of his home, he called 911. In the meantime, his mother came out and wanted him to lift me up and take me inside the home. She worried that lying on a sheet of snow would worsen my pain and/or injury. I told her and her son not to move me. I desperately wanted the medical help.
While he was on the phone, he had to answer the 911-receptionist why the number associated with the phone he was using didn’t match the address the help was being called at. When he told the receptionist that the phone belonged to the injured person who was just picking up the food from his home, and had fallen, she asked him how old I was. He paused and repeated the receptionist’s question. I told him I was seventy-eight-and-a- half years old. The receptionist told him the paramedics and ambulance would be there in a few minutes.
Since I could see the road from the spot I was lying, I was so relieved to see the paramedics’ car stopping in front of the house within 5-6 minutes. Two paramedics came out of the car, one carrying his medical kit along with the standard full gear.
The one who was carrying the box, placed his box on the icy surface and began checking on me. He asked me preliminary questions like how did I fall, where exactly I fell, where was I hurt most, was my head bleeding or swelled, did I feel if I had fractured my ribs or damaged my spinal cord, or pelvis, and so on. While he was asking questions and making me talk to stop me falling into any unconsciousness, he ran his open palm at the back of my head, removed my scarf around the neck, and unbuttoned my shirt to run his palm over my chest, touching its cavity, heart area, and top of the shoulders, trying to feel if there was any sign of a lump or fracture or bleeding. He apologized for baring a part of my upper chest in the freezing cold and tried to calm me down by telling me that the ambulance would be here shortly. He would examine me fully inside the ambulance. While he was talking, I could see the ambulance stopping behind the paramedic’s car.
As soon as the ambulance parked, the driver and his co-worker opened the rear doors and pulled out the stretcher. They rolled it up on the driveway, closer to the spot where I was lying, gently lifted me up and put me on the stretcher and covered me with blankets. They rolled me back to the inside of the ambulance. Once inside, the one who was checking on me spoke to the driver. They talked about carrying me either to the Montfort Hospital off Montreal Road or to the Ottawa General off Smyth Road. The guy who had been initially checking me spoke to someone on the phone and got instructions to take me to Montfort.
While we were on the way to the Montfort Hospital, the paramedics took off my winter jacket and scarf, and in the fully lighted area, checked me all over again in the enclosed and warmer environment. He kept talking to me about my pain, its intensity on a scale of 1 to 10, and asked me about my name, address, age, height, weight, ailments I was suffering from, medicines and supplements I was on, and the OHIP card number.
I pulled out the wallet from my left pocket of my pants and gave him my “Medic Alert” card that I always carry with me. He copied all the information from the card to his form, including the OHIP card number. Then he confirmed with me; I was a heart patient, having had open-heart surgery, followed by four stents implanted. Also, I was suffering from hypothyroidism, prostate issue, and had cataract surgery done on both eyes. Then he confirmed all the medicines and supplements I was taking. Finally, he asked me how was my pain. I told him it was excruciating – around 10 on a scale of 1 to 10. He told me not to worry as we would be at the hospital within a few minutes. As he stopped talking, I called my younger daughter, Shelly, who was at some get-together in Rockland, and told her I was calling her while being driven to the Montfort Hospital as I had badly fallen on the icy steps of the house from where I was picking my food up.
As soon as we reached the covered ambulance parking area of the emergency section of the hospital, the guy who now had all the information about me joined the driver and his co-worker. The latter two opened the doors of the ambulance, and brought the stretcher down, placed my jacket and scarf near my feet, still covered by the snow-boots, and rolled me inside the hospital. They placed my stretcher against the left side wall, near the entrance to the hospital. The guy with my information left me and walked away to the nurses’ area to report about my arrival with details about my condition. I looked at the clock on the wall of the corridor. It was 8.12 p.m.
There begins my waiting time, with one eye on the clock. And how did it go?
I could see the clock ticking away as I wait for a check-up by a doctor and the recommended treatment of severe pain in my chest, its cavity, and the rear upper part of back including the shoulder blades. I lay on the stretcher, with one eye on the clock on the wall, ticking seconds into minutes, and minutes into hours, between 8.12 p.m., February 11th, and 7.15 a.m. February 12th. How did the hospital’s emergency staff treated the frail old man with unbearable pains in his chest and the rear upper back is worth noting?
Time and activity:
Tuesday, Feb 11th.
08.12 – 08.30 p.m. A nurse arrived to confirm all the information that she had received from the paramedic. She put an ID white paper band around my left wrist, again verifying that I was there because of severe pains resulting from a hard skid on an icy walkway.
08.30 – 09.30 p.m. My older daughter, Sharon, showed up near my stretcher. She came to see me after her sister, Shelly, informed her about my fall and being in the hospital.
09.30 – 10.00 p.m. An orderly came over, mumbling, “Let’s move you away from the entrance door”, and rolled my stretcher to the main corridor and placed it against the long wall – just next to the side entrance to the big hall, likely the working area of nurses and doctors.
10.00 – 10.30 p.m. My younger daughter, Shelly, arrived. She greeted Sharon and then turned to me, asking what happened and how my pains were. Now both of my daughters were there, concerned about my well-being. Also, I had one nurse temporarily assigned to me as she asked me, “How was I feeling?” from time-to-time.
10.30 – 11.00 p.m. I insisted upon Sharon to go home as she had two kids under 4 years of age at home, likely sleeping in the care of their dad. After she left, I told Shelly as well to go home as both girls had to go to work the next day. She didn’t agree and insisted on staying with me overnight.
While my daughters were there, a nurse came over and gave me a regular Tylenol, telling me, “I may not give you anything else without a doctor’s orders.” She also gave me an injection in the arm with comforting words, “This will reduce some of your pain for sure.”
11.00 – midnight hour. Now that Shelly was with me, pacing, walking, standing against the wall, or sitting on a chair near my bed’s footrest, a man, in a light blue plastic overall and wearing a cap of the same colour, came over to me and asked, “How are you feeling? How are your pains?” “Terrible,” I replied feebly and added, “I want someone to x-ray my back and chest to see I have no fracture or broken my ribs, or damaged my spinal cord or pelvis.” He poohs-poohed my request and told me he would do something better than that – he would order a blood test first. Later a nurse came and drew a blood sample from one of the center veins of my right arm. A little later, another nurse came and took an ECG of my heart.
February 12th:
12.00 – 01.30 a.m. Since I had eaten nothing after my breakfast on Tuesday morning, I was now feeling hungry. I told the nurse who has been occasionally attending me for the last few hours. “What would you like to have?” she asked, ” I can bring you a muffin and an apple juice.” I told her to look for an egg salad sandwich, if she could, as I didn’t want to eat a cold bran muffin. After a few minutes wait, she brought an egg sandwich, one-half of which I ate and the other half I put aside. Around 01.30 a.m., I asked the nurse attending me, “How much longer do I have to wait for some doctor to check on me as I have been lying here for over five hours?” She replied, “Tonight the average wait time is ten hours as there are so many people coming in and there are just three to four doctors working in the emergency ward. You have to wait for another five hours before any doctor could see you.” That meant that someone would check on me by 06.00 a.m. or after at the earliest. I had to suffer from the severe pains, especially in my chest and top of the back. The pain compounded by frustration was really testing my nerves.
01.30 – 02.30 a.m. Just after 02.15 a.m., an orderly came over and softly mumbled, “Let’s move you in the emergency ward where a doctor could check on you.” He moved my stretcher away from the wall and rolled me to the emergency ward. Once he placed my stretcher at the marked area near the wall with all the monitors and equipment on stands, with their wires hooked in black and red power plugs, he drew the blue curtains on both sides of the stretcher and its footrest. Now I was in a make-shift emergency room, aligned in a row of other beds with or without patients. While he was fixing up my stretcher, I could see the clock on the facing wall. It was 02.30 a.m. That meant that after over six hours of waiting, I was finally lying in the emergency ward for a treatment. Now I had to wait for the doctor. I kept lying on the stretcher, whereas Shelly sat on a hard wooden chair placed near my stretcher. We spoke to each other occasionally, closed and forcibly kept open our tired eyes. Naturally, we both were tired, bored, and getting very restless as the wait was draining us completely.
02.30 – 04.00 a.m. Around 3.30 a.m., I heard a lady doctor’s footsteps entering the area of a female patient, lying on the stretcher on my left. She had fallen while descending stairs of her basement and had hurt her knees badly. She was likely brought in to the hospital ahead of me as my stretcher was next to hers in the hallway. She also had been rolled into the ward ahead of me. She too was accompanied by her young daughter; the latter lay on the floor to rest or take cat-naps. I could see her get up when the doctor stood near her mother’s stretcher. I could hear the conversation between the doctor and the patient explaining how she fell off the stairs and how painful and swollen her knees were. She wanted some immediate relief. While they were talking, I was mentally preparing myself to speak to the doctor, presuming I would be the next one to be checked during her current round of the ward. I felt relieved too that I didn’t have to wait for ten hours; rather I would be done in 8 hours. How wrong I was? I heard her walking away after checking and recommending the treatment to my left neighbour. I was quite incensed and distraught over her action. I immediately got up and went to the nurses’ station and asked one nurse, who was walking in the ward, “How come the doctor who was here a moment ago didn’t see me?” Since that nurse was a French speaking, she likely didn’t understand my question and asked me, “What … you want … I am serving someone,” and she left me. I went to the washroom and came back to my stretcher. Now I was getting restless and wanted to leave that damn room.
4.00 – 7.15 a.m. Nothing happened. Even when the clock struck the hour of six, I had a glimmer of hope that some doctor would eventually show up to check on me. I had waited for the full 10 hours as suggested by the nurse. That hour too passed with no doctor in sight. I couldn’t tolerate any longer. Suffering with severe pains, I was running out of my patience and wanted to give someone a genuine piece of my mind. Shelly was equally getting frustrated as the poor girl had been working all day Tuesday and wasn’t able to sleep all night. She looked haggard. She had a work-related meeting at 9 o’clock (i.e., Wednesday, the day she worked from home). We waited till 7.15 a.m. as the shift of doctors and nurses changed at 7.00 a.m. We thought another doctor might show up at the beginning of his/her first round to look after patients left unchecked by the night-duty doctors.
At 7.15 a.m., I got up from the stretcher, placed scarf around my neck, and zipped up my winter jacket. Shelly was all ready to walk out. At 7.20 a.m. Shelly and I walked out of the emergency ward right by the nurses’ station. No one asked us a question about who we were or why we were walking out of the ward. We just walked up to the parking lot and drove to Orleans.
On the way, I kept cursing the doctors, the hospital’s negligence to pay particular attention to the pain, suffering, and ailments of the frail elderly – granted, not at the expense of caring for patients who had been brought in on account of a heart attack, stroke, or any other serious injury/illness requiring immediate attention – as we older folks are the most vulnerable, and unable to bear serious pains for too long. We elderly people need prompt attention, treatment, and care as we no longer have the stamina and energy to suffer severe and lingering pains, especially exacerbated by unnecessarily longer wait times. We ought to be cared at the earliest opportunity. Unfortunately, our current health system is not providing the care and treatment the elderly deserve. Some doctors already treat the elderly as discarded and spendable. And this problem will get even worse over time because of our steadily rising numbers – a demographic reality that our governments, social and health policy makers have to reckon.
Since I was still suffering from the unbearable pains in my upper back and chest, especially its cavity, we decided to drive to the Orleans Urgent Care Walk-in clinic off Place d’ Orleans Boulevard. I desperately wanted a doctor to check me; wanted him/her to take x-rays of my painful areas to ensure that I had broken no ribs or damaged spinal cord or pelvis. I knew I wouldn’t get any appointment with my family doctor that quickly. Seeing a doctor at a Walk-in clinic was the only way to get a prompt treatment.
This clinic opened at 8.00 a.m. Also, this had the facility to take x-rays and conduct other standard tests, if required. We were near this clinic a little before 8 o’clock. So we waited out at the nearby Tim Horton’s. While Shelly had gone to fetch two cups of coffee and a bagel for herself, my cell phone rang. It displayed a call from the Montfort Hospital. A nurse from the emergency ward was on the other end.
She wanted to know where I was as she had gone to check on me in the ward. She had started her shift at 7 a.m. and was going over the list of patients still in the ward, including me. I told her I left the ward at 7.20 a.m. in utter disgust and frustration as no doctor bothered to check on me over 12 hours in the emergency ward. I desperately wanted a doctor to check on me and I thought seeing him/her at a Walk-in clinic was the best option I had. She apologized for what had happened to me, explaining that there was only one doctor on the floor last night. This was contrary to what the nurse attending on me last night told me that there were 3-4 doctors on duty in the ward. I couldn’t believe her explanation that there was only one doctor taking care of patients in the emergency ward. Then she added a typical and commonly used excuse, “You know it was one of those busy nights when a steady flow of patients had swamped the ward,” and on and on. As I was boiling mad inside, I didn’t want to pursue any conversation with her. She was just a nurse working there and had no control on how the system runs. She was just trying to defend her peers and doctors’ negligence and irresponsibility, besides the public reputation of the hospital. I told Shelly the gist of my conversation with the nurse when she got back with her coffee and bagel.
Shelly dropped me at the Walk-in clinic at around 8.40 a.m. The waiting room was already full of patients. I took the number and waited to be called by the receptionist. A little after 9.30 a.m., the receptionist called my number. I walked up to her desk with my OHIP card in my hand (as per clinic’s instructions to patients – as the first thing the receptionist does is to run this card over the online system to claim the charges) and explained her why I was there. I told her I was in severe pains and was coming from the emergency ward of the Montfort Hospital after waiting there for 12 hours. She was sympathetic and instructed me to wait until called in by a nurse.
Around 10.15 a.m. I heard a nurse calling my name. She wanted me to go to Room #1, close the door after entering it, and wait for the doctor. I removed my snow-boots as instructed by the nurse and followed her to the room. After about 15-20 minutes, another nurse came in and took my vital signs including the body temperature, blood pressure, heartbeat, and the level of oxygen intake. She wanted to note all of my major ailments and prescription drugs I was taking (though the clinic’s records contained all such information as I had been visiting this clinic in medical emergencies). While she was working on my vitals and recording other details, I told her I was coming straight from the Montfort Hospital’s emergency ward as no doctor there could check on me after almost a 12-hour wait. She promptly replied, “If you were in a hospital across the river (i.e., in Gatineau, Quebec), you would have waited for 20 hours. You are lucky that you had to wait for 12 hours at Montfort.” She showed her professional empathy to me and told me, “A doctor will see you soon.” She left me alone in the room and closed the door.
No doctor showed up in the room. In the quiet and closed room, I kept looking at the walls, the medical equipment in the room, and all the charts on varied health issues including major ailments and their preventive measures. I read and re-read all the charts to kill time. Since the room was closed to the work-area of doctors, I could hear their conversations, including the ones they had with patients in adjoining rooms in the corridor. I had no clue about who would check on me among the two or three doctors working at the clinic that morning. I overheard one doctor talking to several persons (likely a doctor, nurse, or someone in the administration) at the Montfort about me and how I had left the emergency ward.
Now I could put together the reason no doctor had come over to check on me. Since I had left the hospital’s emergency ward without a proper discharge, I likely was carrying some risk of suffering more physical damage to myself and no doctor outside the hospital’s emergency ward would want to check on me in that situation. Eventually, after more than an hour’s wait in the room, I opened the door and walked up to the doctors’ work-station and asked one, “Is there any problem? I have been waiting for the doctor for more than an hour. This is rather unusual in the Walk-in clinic. How long do I have to wait?” The doctor replied calmly, “You are the next one on the other doctor’s list. He will come see you after he’s done with the patient he’s checking now. I am sorry you had to wait that long.” Quietly, I came back to Room #1 and closed the door.
As the noon-hour struck, a nurse came in and wanted me to move to another room as she needed Room # 1 to examine another patient – since this room had more medical accessories hooked up on the walls than the room I was moving to. After I entered that room and looked around, I was right. I sat there, looked around the mostly empty walls and a few hanging charts on health issues that I had read in the previous room.
At 12.30 p.m., I heard a knock on the door, and lo-and-behold, finally a doctor entered the room. I was just ready to vent out my anger and give a little sermon to him about how to take care of patients, especially when they are in severe pains. But I controlled and acted normally. Since he had all the information about me, including the reason I was there, how I had played truant at Montfort, and my painful body areas. He asked me how I was feeling and about the intensity of pains. I requested him to have some x-rays taken just to ensure that I didn’t suffer any fracture in my ribs or back. He wrote me a requisition slip and directed me to go to the next room for x-rays.
By 1.15 p.m., I was back to see the doctor. Thanks to the technology, he had received all the x-rays of my chest, ribs, lungs, upper back, and the spinal cord. He told me he wasn’t a radiologist, but he could still draw the key conclusions from x-rays. He went over these, one-by-one, with me and told me that there was no sign of any fracture. He informed me that a radiologist would examine these x-rays in the next few days, and if there was anything serious, he would be in touch with me. In the meantime, he wanted me to take a regular Tylenol as a painkiller.
Before leaving him, I couldn’t help asking him, “What took you all that time to examine me? I had to wait for over 2 hours and I don’t think that’s the norm here at this clinic.” He grinned and replied, “Well, waiting for 2 hours here was far better than 12 at the hospital.”
What an attitude? As a doctor, he should have shown some compassion, empathy, and understanding of a patient’s condition. I didn’t think it was worth arguing with him and walked out of the clinic.
It was after 1.30 p.m. that I called Shelly to pick me up and drive me to the place where I had left my van the previous night. I had already called the homeowner and had given him an approximate time about meeting him. He saw Shelly dropping me at his driveway. He came out and gave me the keys, also apologizing for what had happened last night. Since I was in pains, I didn’t want to talk with him any longer. I drove the van to my home, half-bent on the driver’s seat, as I couldn’t sit straight up.
As soon as I reached home, I took a Tylenol #3, a powerful painkiller with codeine. I continued to take it until Friday, February 14th – the day I finally got examined by my family doctor. He recommended me to a much more powerful painkiller containing morphine.
Since I was angry and frustrated over what I had experienced and was still very painful, I tweeted to Ms. Christine Elliott, Ontario’s Minister of Health and to The Ottawa Citizen complaining about the lack of care at the emergency department of the Montfort Hospital and our messed up health care system – especially for the elderly. I am still waiting for her response.
Does anyone care about how we get treated under the current health care system? The bottom line is we are all just numbers in the system.
Tags: Elderly, skidding on ice, emergency ward, wait time, lack of medical care, Montfort Hospital, walk-in clinic, lack of empathy.