Thursday, August 20, 2009

My brain and the Ontario health-care system

Special guest post by Paul E. Barber

Ed. note: The following was written by a friend and colleague of mine here in Toronto. It is a response to the various right-wing attacks on Canada's, including Ontario's, health-care system -- one in which there is a real "public option," one in which basic government-funded coverage is universal. Supplementary private coverage can be provided through one's employment or otherwise acquired in the market, but there isn't a two- or multi-tier system that divides us based on how much money we have. There is choice -- I selected my family doctor, for example -- but we all go to the same hospitals. At the very least, there is health care for all. And excellent health care, as Paul explains in this very personal piece. I encourage you to read it in full. -- MJWS

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You may have seen the stories about the television ad with first person testimony from a woman who claims she had a brain tumour and was unhappy about her care in the Ontario health-care system, part of the ongoing assault on "Obamacare." Five years ago, I actually had a brain tumour and dealt with the Ontario health-care system. The truth about our system is much different than the misinformation spewing forth over the Internet and the airwaves. This is my story.

I am not the type of person who would be described as a hypochondriac. I am more likely to dismiss aches and pains as of no consequence. Thus when I developed some peculiar head and neck symptoms in early 2004, I did not pay much attention to them at first.

Even when I called for an appointment with my GP in March, I was asked by the receptionist if it was urgent and I said no. The GP said he was puzzled by my condition and referred me to a neurologist. I saw him in early April. His assessment included some physical tests, all of which I passed with flying colours. This is perhaps not surprising, as throughout this period I was regularly
Scottish country dancing, a physically and mentally demanding form of exercise that no doubt kept me in decent shape.

I did have some blood pressure abnormality. The neurologist concluded, not inappropriately, that I should see a cardiologist and said he would recommend that my GP refer me. Shortly thereafter, I had an appointment for early May.

A week or so later, we were invited by close friends to a delightful Saturday evening dinner. I didn't think I had drunk too much wine, but my wife was driving, so it didn't matter. When I woke up the next morning -- it was Sunday, April 17 -- and felt quite sick with a headache – I thought I had a hangover.

However, unlike all previous hangovers, this one did not disappear by Sunday afternoon – I remained very ill and in bed. By the afternoon of Wednesday, April 21, we finally concluded, after consulting my GP on the phone, that I should seek emergency treatment the next day if I showed no improvement.

Late that night, unable to sleep because of a splitting headache, I got up to take some strong headache medication. The last thing I remember was reaching up to the cabinet containing the pills. My wife then heard a crash as I hit the floor. I had collapsed and gone into a convulsion.

This is the point where we discovered just how fast and effective our health system could be. The complaints you hear directed at Canada's health system about waiting times for treatment are simply without foundation. As you will see from what happened next, my experience says quite the opposite.

The next thing I recall I was being carried downstairs by some fire fighters who responded to the 911 call and had made it to our house ahead of the ambulance. I was taken immediately in the ambulance to the Mount Sinai Hospital emergency. I drifted in and out of consciousness and don't remember much from that period, but a CAT scan done in the wee hours of Thursday, April 22 revealed a large mass in my brain.

A few hours later, I was admitted to the Toronto Western Hospital neurology ward (which has an
international reputation for excellence). I had a brain tumour and needed surgery. The doctors were optimistic that what they didn't get with surgery could be dealt with by chemotherapy and radiation. They assumed I had brain cancer, but they said it would be a few weeks after surgery before tests could determine the exact nature of the tumour. The medical staff could scarcely believe that I had actually been at work the previous Friday.

Hooked up to an IV and rehydrated, I began to feel a little better. However, I discovered that I had lost considerable sensation on my right side. I could not hold a cup of water without dropping it, a very distressing discovery.

Early the next morning, Friday, April 23, I had an MRI. This marvellous machine provided a precise three dimensional portrait of the tumour. That evening, my neurosurgeon,
Dr. Taufik Valiante, came by the hospital room to discuss my case. He felt I needed surgery in the near future, although not necessarily right away (he thought I might have to wait a week). However, he cheerfully went off to check on the availability of the space and personnel needed to do the surgery, and found we could do it the next day.

Just 60 hours or so after my collapse, on Saturday, April 24, , I underwent five and a half hours of surgery to remove a large brain tumour. The surgery left a large scar running across the top of my head, now just barely visible through my thinning hair. Twinges in my right hand and stiffness in my lower right leg are the only long-term consequences of my experience. I have an MRI every couple of years (I just had one) to check that the tumour has not returned.

Despite the extensive nature of the surgery, it was performed so skillfully that I felt able to leave the hospital and go home the following Tuesday – April 27. And the next day, Dr. Valiante called with the news that the tumour was benign, a slow-growing
pilocytic astrocytoma, generally thought of as a brain tumour one sees in children. I would not need any further treatment. In less than a week, the system had me on the road to full recovery. My wife recalls this period as a blur of unfolding events.

By the way, I did see the cardiologist a week or two later while still recovering from surgery. She did a few tests and pronounced me fine.

As you can see from my story, the delays encountered in my care were entirely of my own making, not wait times in the health-care system. Once it kicked into gear, I received incredibly fast, world-class health care. Apart from my initial ride in the ambulance and my hospital phone, the only other cost to me was the rental of the hospital TV set. A couple of days after the surgery, I remember watching a Toronto Blue Jays - Minnesota Twins game, featuring a first-rate performance by then Blue Jays starter Ted Lilly. Full value for my money spent on the TV and full value for my tax dollars that pay for our health-care system.

Our experience with Canada's health care system has been first-rate. This includes the cancer care my wife is currently receiving, which has included a sophisticated procedure whereby she successfully received a transplant of her own stem cells at the wonderful
Princess Margaret Hospital in Toronto. She did not have to wait for that complex operation either: it was performed upon completion of the essential preliminary treatment.

On another occasion, my son dislocated his shoulder playing a pick-up game of ice hockey. He called me at work to help him get to the hospital. When we entered emergency, the triage nurse gave Alex a quick inspection and then instantly whisked him away for treatment. Once again, no waiting.

I think our experience with health care is comparable to that of most Canadians. Our system may not be perfect, but we are more than happy with how it has treated us, and,
like other Canadians, we would not trade it for the American system.

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