The Pain Sets In
Have you ever been in so much pain that your screams scream? If you don’t know what I mean then you have definitely not felt the pain I just went through. First, congratulations. It is the kind of pain that wipes your mind of every single thought. Second, I hope you never do.
In the past, I have felt some pretty excruciating pain but it was always dulled by a loss of feeling or shock. I would have given a king’s ransom to lose feeling throughout my body rather than go through what I just did.
The pain I experienced was multifaceted; joint, muscular, sleep deprivation, inconsistent medications, unnecessary roughness, and stiffness.
I felt like someone was digging nine knives into my head slowly. My neck felt like it was radiating a dull pain, almost like someone kept driving over it. It seemed like I had a 1000 pound weight stuck on my forehead whenever I tried to lift my head. My knee felt like it was in a bench vice being tightened every few seconds as a punishment for merely breathing.
But, these words have little to do with the pain I felt in my body and more what exasperated it to new heights I pray to all things holy never find me again.
I experienced the purest form of paranoia and disharmony with my environment which led to unrest that I never knew existed inside of me. In short, I was in total disarray with ungodly amounts of pain and part of it was caused by our broken healthcare system at the Health Sciences Centre (HSC) ER. Even I, an advocate for Health Care Workers (HCWs) felt hostility growing inside of me.
To Go or Not to Go; A System Burning
We, the people of Manitoba, have constant abstract conversations about healthcare. We say it sucks, talk about our ER’s being overcrowded, complain about wait times, and we always end off with, “that’s just how it is”. We’ve come to accept that our ER’s are hell on earth and as we do with most things, we turn our inability to affect change into a punchline.
What I learned staying in the HSC ER for days is that this is how HCWs feel as well. From doctors to janitors, nurses to health care aides, the consensus is that it will only get worse as time marches on. Everyone has lost hope and feel like the system is beyond repair.
I’ve spent years building up my health so I didn’t really experience the full weight of Manitoba health care until recently. Suddenly struck with numerous ailments, barely able to move, I watched the wait times at ER’s and urgent care on my phone from my bed. I convinced myself I could get better with bed rest at home because the alternative seemed much worse.
I couldn’t sit for longer than a few minutes so a 6–18 hour wait for medical attention seemed not only impossible but like it would do more damage than good. The mere thought conjured up images of torture, and that is the first real problem. We all know how bad it is and I may have died had I waited to go in. I didn’t know the extent of my condition but for all the horror stories I heard, I (like many others) hesitated when I should have acted.
But finally … I couldn’t take it anymore. My pain was so crippling that I couldn’t sit, stand, or lay down. It took me half a hour to get out of bed and then I’d just fall to the floor anyway. So, I called my dad and hobbled my ass into the Concordia urgent care, which eventually led me to the gates of hell.
Hell is a place or distant underworld where lost souls pay for eternity through fire and pain. Screams can be heard, rest is never afforded, and those demons who oversee this place of damnation can be cruel unlike known to the flesh. Separated from God, no soul in hell shall know happiness. Hell is a place of torture and pain meant to shatter what is left of a person.
That is the most direct definition of hell that I could find. I argue, that the HSC ER may be worse. Sure, we’re not burning in an eternal flame but the rest stands and while hell is an abstract place we do not know to actually exist, HSC’s ER is here, on earth. It could be so much better but we have our collective heads up our asses regarding our priorities to the point where we let this place become even more hellacious than that place Lucifer reigns over.
Waiting in Hell
The first observable issue was that there is no accounting for individual circumstance in waiting rooms. I clearly stated and showed that being in a seated position was excruciating for me. I could not stand, and demonstrated as much. Laying down was still painful but a slight reprieve so I didn’t have to writhe and fill the room with grunts. Others waiting, clearly did not have these problems. But, of course, with only a few reclining chairs, the first people there got to bask in comfort. I ended up seated in a crappy wheelchair with no padding for nearly 4 hours. I grunted, hollered, and could not sit still. The pain was incredible and only worsened by the seat I was given.
Eventually, my dad spotted a nice recliner opening up and jumped on it. My last hour waiting was much easier. My symptoms were not exasperated because I could put the seat back and lift my legs with the recliner. The immediate relief was so stunning to me.
It seems to me that the waiting room is where the first of Manitoba’s problems start in the hospital. With no accounting for circumstance, what could be a fairly easy and pleasant first impression is a cold and systematic ordeal.
My last takeaway from the waiting room was something that I carried with me for the rest of my experience; the theme of hostility. The waiting room is a hostile environment. Because of the long wait times, patients are hostile with each other because someone is ahead of them for treatment. Intake is hostile with patients because they’ve been beaten down by patients before and that has affected their psyche greatly. Patients are hostile towards paramedics. I actually overheard someone say, “Look, another stretcher. Add an hour to our wait time. Assholes.”
Hostility is probably the biggest part of this entire problem, as it is compounding and we do absolutely nothing about it.
As I was dealt with at intake I felt like cattle. The nurses had nearly no reaction to my answers and just seemed to be rushing through so I could be out of their hair. Every question I had was rebuked. I asked about pain meds and they said they could give me Tylenol. I informed them that Tylenol hadn’t worked for the past few days to which she replied, “You want it or not?” I realise it’s all she’s authorised to offer and we’ll get to that later but at the end of the day, this is a problem that shouldn’t exist.
After finding some comfort, I was forced into an even more uncomfortable chair than the wheelchair. I’ve come to realise that nothing is designed for anyone over 6’ tall in hospitals, which I guess makes sense because there’s only 4 or 5 of us on earth, right?
This all took place at the Concordia Urgent Care, and after an exam I was told I had to go to the HSC ER. Here, in lies our next problem. Our former government broke up ERs and Urgent Care. The thought was that there are some clear lines drawn in terms of care but those lines don’t actually exist.
I read online that ERs are now for those close to death or at the very least missing a limb, or serious situations which require immediate attention even though immediate attention is impossible. Urgent Care is for people like me. I wasn’t dying, but I was in agony.
Turns out, in this case the difference was Concordia doesn’t have an MRI and HSC does. Why, in a province with months long waits for MRIs do we have any hospitals without one or more? That’s just bad business; not understanding the basic fundamentals of supply and demand. I’m sure there are more than a few politician’s perks we can cut out to get some new MRIs.
Hallway Medicine
Here is where the story takes a turn. I was sent from Concordia to HSC ER for an MRI that wasn’t even ordered. As a result, I experienced, for the first time in my life, hallway medicine. Our government has assured us this isn’t a reality but in fact, I learned it is the norm.
What does hallways medicine look like?
Hours long waits on a stretcher in a hall by a door to the frigid outdoors and another door that keeps hitting the top of your bed as security and HCWs rush past. They play Tetris with stretchers while nurses and staff change out regularly so no one knows your name. You almost get kicked out because record keeping is basically a clipboard that no one can find.
You are forced under bright lights (even if you have sensitivity to light) and have to listen to dozens of conversations happening around you. Some patients are inmates handcuffed to beds, others are people that refuse to wear pants and piss on everything, and of course, Winnipeg famous meth heads. The screaming and hostility in this hallway was just a precursor to what I would experience in the ER.
I writhed all day in that hallway, having the occasional conversation when I would get a moment’s reprieve. A paramedic said with a roll of his eyes, “Welcome to hallway medicine … that doesn’t exist.” Upon speaking, he told me they all had to sign an NDA with their jobs on the line if they ever speak about the conditions in Manitoba’s hospitals. As my stay continued I definitely learned why. I really wish I had worn my Meta glasses and recorded everything but alas you don’t think of these things before you head to the hospital.
The hospital had no open beds. The ER had no open beds. The hallway had a few. At one point our hallway was at max capacity and there was conversation about loading me back into the stretcher van. Thankfully, neurology showed up!
They pulled me into a room and did an assessment. Once done, they said they’d need to confer with their colleges and come back. “Hang tight, we’ll be back soon.” Those were their words as they left the room. About five minutes later, a nurse took my stretcher back out into the hallway despite my telling her that the neurologists would be right back. Her exact words to me were, “I doubt it.” She was indifferent, emotionally mute, and you could tell, so exhausted that she wasn’t completely present. Her eyes were completely dead.
I waited about 20–30 minutes until neurology came back into the hallway because they couldn’t find me in the room they had left me. Again, I was taken into the room. They delivered the news that there were concerning signs but they weren’t too sure of what just yet. I did feel generally cared for by this group of doctors. One was clearly sleep walking and unnecessarily harsh with his exam but I survived.
Hell is an ER in Winnipeg
I was then told I would be admitted but would have to wait in emerg “for a bit”. When I asked for them to define “a bit” they became uncomfortable and said, “In Manitoba, you never really know.”
The first area I went to was short of pleasant but not quite hell. The nurse was attentive and the space felt like it was almost a room. I was receiving hydro drip/IV and it did help to ease the pain a bit. I, at the very least was not writhing to the point of foaming at the mouth. I remember questioning in my mind how this one nurse could be so on top of her game. She flew around the ER with grace and authority, making the job look easy. Another nurse told me she was fresh, and if that’s what nurses look like with some R&R, ladies and gentlemen, we need to give these people some R&R.
That didn’t last long though as I was told I was not a high priority patient so I was to move by yet another nameless HCW that looked like they were mid-makeup for an episode of The Walking Dead. You could tell he’d seen too much, experienced too much, and probably couldn’t remember why he decided to work in health care in the first place.
He wheeled my stretcher into what I suspect was once a hallway that now had curtains and random objects separating the patients. Honestly, this space felt like a torture chamber.
Under certain conditions what I experienced is defined as cruel and unusual punishment. Prolonged exposure to light, sleep deprivation, loud noises, irregular medication, a constant lack of safety, etc are all forms of torture used in war. What was I being punished for? I guess living in Manitoba and having pain.
I had rotating neighbours that would scream and yell constantly. Visiting hours didn’t seem to matter for some, but were strictly upheld for others. Separating us was a curtain and a door being propped up. I produced a scary season event called Fear, and one side of my “room” looked like a set I would have built.
All of this, on top of the constant codes and announcements over the PA which became less professional and more irate as time grinded on each day.
The nurses station was directly to my right and it was loud! I know things about these nurses that should be private. Patients would stand outside of my curtain and talk about having sex in back alleys, robbing homes, and shooting up before going out for a smoke and occasionally smoking right next to me. Sometimes employees would notice and stop them, sometimes not. Sometimes they’d try and the patients would tell them to fuck off. My chart did show clearly that I am deathly allergic to nicotine but I suspect that there wasn’t even time to get a full read of anyone’s charts. The conversations around me rarely died down.
The top ⅓ of the curtains were translucent (for some reason) and all around me were bright lights that were never dimmed or turned off. The light was so bright that they hurt the eyes because I had incredibly powerful headaches. I guess I could have looked away … if I could have moved my neck or head but I was stiff as a board. The few times I did try to move into a position to get out of the light, there was a light in that direction and it was too painful. I spent much of my time there with my eyes tightly shut.
The space was tiny and dirty and when I finally found a setup that worked for my leg, which could not be bent, they changed it back. It did not matter how much pain the positioning of the “room” they wanted caused me, it had to be that way. For some reason, in this case, procedure mattered.
There were zero noise or light protocols in emerg. Anyone could do anything they wanted. Sure, I could turn off the lights above my bed but they weren’t all that bright so it really didn’t make a difference. Because I couldn’t turn my head I had to stare into bright lights day and night.
It could be 2pm or 2am, it really didn’t matter. Time stood still in there. By the time I had gotten to the HSC ER, I was running on 3 nights of 0 sleep. I spent 4 nights in this part of the ER and I could not sleep at all. So this means I went 7 nights without sleep, save for 15 minutes here or there, but the second my leg, neck or head moved, I would wake up in pain.
I did manage to get eye covers and headphones but I didn’t feel safe with them on. People kept banging into my section with stretchers and bodies several times, exasperating my injuries. Random people would show up in my space with little to no understanding of where they were. Staff told me belongings were regularly stolen. I felt like I had to be ready for anything.
I feel I should say that as a pretty big guy, I am not used feeling unsafe but in the state I was in, I could not defend myself or my belongings. Anything that could have happened to me, I’d have to let happen. Luckily, the incidents were minor and from the stories I was told, luck truly was on my side.
What was extremely distressing at this time was my delivery mechanism for my medication kept changing. It was now well established that hydro drip/IV was the only pain medicine that worked but sometimes I would get just T3’s, others I would get oral hydro. This inconsistency led to a lot of pillow biting and unnecessary writhing.
I had never felt anything like this in my life. The medication was very inconsistent to the point where it felt like there wasn’t even a real system at place. This caused arguments because the communication was inconsistent as well. I would ask where the IV meds were and was told the doctor changed the way the medicine was delivered. 10-minutes later I would ask a different HCW and they would just switch it back to IV.
Health Care Workers: Demons or Inmates?
Reading through my written word you must think that I have incredible hostility towards HCWs and that I blame them for the hell I went through. That couldn’t be further from the case.
Lights, sound, setup, and other issues I’ve discussed are administrative issues. The HCWs that I encountered were clearly as burnt out as me. Probably more. I went on 7 nights no sleep. I was hallucinating, the room spun, and I didn’t feel in control of my faculties.
Some of these HCWs were there at 1pm and still at 1am. They looked like they could pass out at any moment, scrubs covered in unidentified substances, shoulders down, shuffling because to lift their feet is to expend energy they didn’t have, and most notably sickly looking.
How are these people expected to provide any level of quality care when they can barely stand or function?
When the staff actually had time to care, they were great. Specialists from various disciplines tried to figure out what was wrong with me. Nurses regularly took my vitals and checked to see how I was doing, but any system crumbles when the waiting room is full, the ER is full, and the hospital is full. It crumbles when there is no segregation of care and we expect our HCWs to know everything about every ailment from infections and disease, to injury and addiction. Even the hallways were full! Is this what we pay 50% of our hard earned money to the government for? Do they really expect us to put up with this much longer?
What I saw was an ER staff that have been beaten into submission to the point that they don’t even know how to express themselves anymore.
Were some of the nurses and doctors rude? Absolutely. Were some overwhelmed? I would go out on the limb and say that they all were to various degrees. But I don’t know that the blame can be placed on them. Think about the most impossible and stressful situations at your job; now add screaming, bodily fluids, pure disrespect, injuries, blood, inmates, a lack of resources, and a hostile environment. How well would you perform? We all have our limits.
A few even confided in me that that they fear showing any vulnerability in the HSC ER because they feel like that is an opening for patients to treat them poorly, accuse them of pushing big pharma’s agenda, or even displaying violence. Imagine that. You take a job because you are empathetic and you’re too scared to show empathy.
A paramedic was talking near by stretcher when I was getting a dose of hallway medicine. He told a corrections officer that he was a rural paramedic and always dreamed of working in Winnipeg. He got his wish and now he wants nothing more than to leave. Working in Winnipeg has ruined his relationship, given him PTSD, and made it impossible to be the same man he once was. He feels stuck and worse, broken by the system.
Many patients had very little oversight because the ratio of patients to HCWs is disturbing. Some of these patients had zero interest in the care being administered but seemed to enjoy being pricks. They berated them, called them names, threatened and screamed at them. These patients would pick away at HCW’s very souls. I suspect not much was done because what could be done? You can’t throw the patient out and we know it. So, they take the abuse. One nurse came back to the station by my “room” and told another nurse that the patient she just saw threatened to choke her to death. Both then spoke about whether either have leads on new jobs. It’s no wonder so many nurses become aestheticians.
I am a patient man but after only a few days I wondered how HCWs handle the constant disrespect they deal with. And, how do we as the general public expect them to be at the top of their game being treated lesser than? The irony behind coming to a place to get help and then threatening the very people trying to help you is not lost on me.
Winnipeg, We Have a Problem
As a business owner, I know that systems and processes are essential to the success of any operation. How many successful systems are in place when pens are a hot commodity, computers are freezing, and over the PA you regularly hear desperate calls for HCWs to stay late? If this were a company, to be frank, it would be dissolved already. It’s not working. That’s just the facts.
In the greatest display of health care hell, I was told the night before that I would be transferred to the Misery for an eye exam at 9am. At 8am, the stretcher service was going to be late. Moments later, they were there. My pain meds were quickly administered and off I went. While at the Misery my pain became the worst it had been through a combination of factors. Upon return to the HSC ER, I was foaming and writhing but could not get any care. It must have been too busy. I don’t know how long I was in agony for but I did text my girlfriend asking for help. 7 days, no sleep, and the worst pain I’d ever felt had me full on out of my damn mind. I finally was sent upstairs to a room (still with no pain meds) only to later get a contact high from the patient sharing my room smoking crack. I’ll never forget the taste and smell. Thanks crackhead, I can no longer say I haven’t done hard synthetic drugs. After a few hours they found me a new room and the experience has been pretty amazing since.
What we have here is a hostile environment that could explode at any moment with an ungodly amount of carnage. Politicians, the board, the administration, and management have failed at every turn to provide an environment that is functional, and even reasonable. It is unsafe, it is a powder keg, and if just one patient decides to truly lose it, or a few HCWs have a total breakdown, or systems continue to erode, there is real danger of catastrophic loss of life.
Honestly, I can’t stress this enough — something is coming.
You can’t have a system this fractured function on luck forever. The HCWs are too tired, the patients are too hostile, the hospitals are too full, and it’s only getting worse. Imagine, someone leaves gas on because they’re so exhausted they forget, or a patient decides that enough is enough and brings in a deadly weapon. Imagine we get a major illness ripping through our community that doubles our intake, or some other crisis level event for any sustained amount of time.
The staffing shortages are very clearly taking a long term mental health toll on the staff. I’ve overheard conversations between nurses and even doctors speaking about how they know that the situation is a ticking time bomb. They are shocked that there isn’t more loss of life and that they do not want to be around when the other shoe drops. But yet, here we have government after government thinking they’ll top up the staffing shortage. How exactly? Your entire staff is broken. What good is bringing in a few people to a broken system, trained by people that are on their last leg?
These are people that have jobs which are a calling and they can’t justify answering that call for very much longer. What we have to ask ourselves is what do we do when they don’t?
There are many situations while I was here where I could have seen the scales tipping just slightly in the wrong direction and the entire ER collapsing in on itself.
Right now, the conversation politicians and administrators seem to be having focus on losing one or two people in a few departments, but they should be concerned about losing hundreds. An essential service with no plan is a government not doing their job.
Think about the wait times at the hospitals already. If we lose an entire ER or Urgent Care Centre do our wait times start getting registered in days, rather than hours? People will die.
What if another COVID-19 hits? We already know there are more anti-vaxxers than there were in 2020. This means more sick people for the next one. What’s the plan of attack there? Is Wab going to go work an ER?
We are one COVID-19 level situation away from the total meltdown of our healthcare. But yet, we turn this all into a punchline.
Repent and Rise
It’s simple: healthcare is the one service that should never see cuts. It’s the one service we all need at some point, must be constantly evolving and improving as it faces new challenges, and must be ready for anything.
That constantly evolving piece is extremely important. Our city faces a drug problem that is (from my understanding) unprecedented. COVID-19 tested our systems and they failed. RSV is extremely prevalent this year and by its nature comes with ebbs and flows. We have an ageing population. Violence and poverty continue to rise. Homelessness is either more in our faces than ever or on the rise. All of these issues and more affect health care. So, I ask, if the system isn’t evolving, how do we expect this to work?
When I was a kid I had my fair share of injuries. I don’t see much change from then to now except that the system seems more fragile.
What we have here is a problem that humans have with most things; we are not all that good at long-term thinking. Politicians are terrible at it; they just focus on the next four years and getting votes (but that’s a story for another day). Administrators are terrible at it because they have to maintain strained budgets. HCWs can’t possibly be bothered because they’re already so busy and beaten down. The problems feel too big to solve so Band-Aid solutions are applied. With health care in Manitoba, we’re basically putting Band-Aids on a damn holding back billions of gallons of water.
And I know, this isn’t an HSC or a Manitoba problem; healthcare is suffering nearly everywhere. But doesn’t that tell you something? That means everything that’s being done isn’t working and it’s time to switch things up. It’s interesting to me that when I bring this up, some people just say, “but it’s not just here.” Yeah, and? So we shouldn’t even attempt to solve this problem? We should wait for the disaster to unfold? Japan appears to be elevating and evolving their care. Hell, most things in Japan look straight out of 2100. Norway seems to be doing pretty well. Anyone think to talk to this Norwegians and ask for some tips?
I am, by no means, the man with answers but I do have a few suggestions based on what I’ve seen.
Imagine, a waiting room broken up into areas. If you can’t sit or stand, here is a recliner. If you can’t help but make noise due to pain, here is a separate area that diffuses those noises. Maybe coloured wristbands denote what section you can use.
Resident doctors should be allowed to administer basic clinical triage in the waiting room such as stitches, proper pain medication, calming meds for out of control patients, and basic diagnosis. Not only would this cut down on wait times, but it would likely remove many from the queue, freeing up beds beyond the waiting room. There was a guy that waited 5 hours at Concordia and I heard that after 5 minutes with a doctor, all he needed was a laxative.
We need dedicated facilities that offer specific support. Mixing everyone into one environment is a cocktail for disaster. Where this is most evident is with addictions and substance abuse. These people have a specific kind of care that is needed and their volatility is often a large reason for hostility in the ER.
Modular design to space like in Japan would probably benefit our health care system. Imagine shipping containers outfitted for emergency care that could be shipped to different facilities at times of need.
I’d imagine that if we could bring the dignity back to health care through various programs, we would see more people wanting to enter the system. HCWs need to be able to live healthy lives to function. Shift work is not healthy, 12–16 hour shifts regularly is not healthy. Patients and HCWs don’t sleep properly and sleep is an essential component of care.
It is very clear there are not enough facilities to run tests and provide the technology needed to turn people around quickly. We need more MRI machines, that is for damn sure. I don’t care if you have to privatise it with quotas for provincial testing at a set rate, but some action needs to be taken.
These sterile environments should be a place of peace and healing. From the waiting room through my entire ordeal, the hospital felt more akin to torture than a place of health. The last thing anyone who’s sick needs is a Coke and a bag of Doritos. We definitely don’t need reality TV and daytime talk shows on mute. Has anyone stopped to think for just a second what these choices do for the patient? The answer is absolutely nothing.
Start small and work your way up, but make changes and make them wide sweeping. I know it’s not easy and I know we have no money, but everything worth doing is hard as hell. We need some out of the box thinkers in charge of health care, and we need them stat or our hellacious health care system will flat line.
Then what?
