I had a bad fall while on vacation in California and needed the help of my family to fly back to Canada. I broke my wrist and fractured my pelvis, and have written about it in this blog (here, here, here, and here). My experience in negotiating all the people, facilities, bureaucracies, and systems associated with healthcare in both the US and Canada makes me very grateful for my personal support system. I am also very glad that I am able to communicate in English. It must be a nightmare for people for whom English is a second language or not spoken at all.
It is very easy to become disempowered in a hospital setting, to feel obligated to go along with all the decisions made on one’s behalf, and to accommodate the routine practices of the staff. It’s not exactly institutionalization, but something like it. I know that I can ask questions of anyone, but not everyone feels they can do that, so I recognize the advantages I have in that regard.
The treatment I received in the US met my immediate needs but the medical personnel seemed to be overwhelmed by the requirements of the insurance system. That resulted in extraordinarily detailed documentation, multiple conversations about insurance, and discharge from the hospital as soon as the limits of my insurance had been reached. It seemed to me that while creating some efficiencies, the insurance system has also created a counter-productive insistence on unnecessary procedures and red tape.
The contrast in Canada was immediately apparent to me when I arrived back in Edmonton. After showing my provincial health card to the admitting clerk, there was no further discussion about insurance. I was surprised at how much stress I was relieved of because of this. I had not realized how much of a burden it had been until the weight was lifted.
All of the healthcare professionals who treated me were knowledgeable, professional, and kind. I am grateful for all of them and am pleased to report that I am recovering well. I am seeing a physiotherapist every two weeks and now am back to almost full strength. Every day I can walk further and climb more stairs. My wrist and hand still need to be strengthened and to develop more flexibility, but they are much better than they once were. I can almost make a fist now!
The conversations that I had related to the fall and injuries are illustrative of the variety of concerns of the professionals I have encountered along the way. Here are a few that have stayed in my mind:
Ambulance EMT: Which hospital do you want to go to?
Me: I have no idea.
Ambulance EMT: Are you with Kaiser?
Ambulance EMT: Oh, good. We’ll take you to the nearest hospital then.
[When a person is affiliated with the Kaiser Permanente healthcare consortium, they are required or expected to use only their facilities.]
Emergency Room Nurse
Emergency Room Nurse: Where are you from?
Emergency Room Nurse (sneering): Oh. You have socialized medicine.
Me (surprised at her disdain): Yes. It’s great!
Air Canada Customer Service Agent
Me: How do I arrange for medically necessary flights?
Air Canada Customer Service Agent: Contact your travel insurance provider. They know the system. They will arrange everything.
Me to Travel Insurance Agent: I need to fly back to Edmonton with my daughter-in-law.
Travel Insurance Agent (several days later): Have you booked your tickets yet?
Me: No. I was told you would do that.
Travel Insurance Agent: No. You have to do that.
[I found much confusion about what I could expect from the insurance company. Fortunately, my son, daughter-in-law, and roommate took over and got everything arranged on my behalf. I simply didn’t have the patience or mental clarity to do it myself.]
Me: I need a prescription to claim the costs of rental of a hospital bed and a wheelchair.
Family GP: Yes. I have seen your records. What happened?
Me: I jumped off a wall.
Family GP: Why?
Me: Well it was only a low wall. I had been planting in a raised flower bed and jumped down when I had finished.
Family GP (smiling): Yes, but why?
Me: … I wish I knew.