Friday, July 15, 2016

CHUL Quebec City

I grew up using two different national health care systems in Europe and medical care was always decent, free and not necessarily much of a deal. I was young and in good health so I had scrapes and bruises and teeth to deal with, all of which left me with a strong sense that national healthcare accessible to all is a human right. That belief hasn't changed and perhaps my experiences in Canada have reinforced that belief, so when you read the horror story I have laid out here not only is it all true, I also write it with a heavy heart as the Centre Hospitalier Universitaire Laval de Québec has let me down, and let me down badly.  
We entered the emergency room at 4 in the morning, my wife was in agony and our reception was as cold and uncaring as you will receive at the Key West hospital. If we need care we got to Marathon for that reason and we should have left CHUL at that point but we didn't as it's Quebec City's biggest and best. The staff only speak French so I was in best translation mode. This sign was prominent everywhere and as I struggled with the staff I wondered if native French speakers could get even more frustrated than I was:
Then there was this notice equalling about $1000 US. We paid of course after we got over the shock. Payment was to be a major issue during our three day stay in this nightmare hospital. When my wife eventually was taken for an ultra sound  to check her stomach ache the technician demanded payment there and then and threatened to deny her access to the service even though she was wheeled to ultra sound from her room in her gown. Not many people I know would have access to credit cards in that situation. They didn't care. Eventually they relented after I went to the office who told me the ultrasound was included in the thousand dollar initial payment. All this in French you understand.
I never did find the main hospital parking lot though I circled the building so I parked in the emergency room lot, which cost about twelve bucks a day. I've never seen charges for ER parking but nothing about CHUL surprised me. The payment method required paying at a machine in the hospital and taking the ticket as a receipt and using it to open the automated gate to get out. Instructions in French only please note...good luck if you only speak English.
I was starting to feel bad for the locals as it was clear they have to live permanently with totally substandard facilities in this city. What they were doing lining up at the business office of Castle Dracula I don't know but there they were. I got waylaid in the corridor and  a woman presented me with a bill for $80 in funny money ($60 US) for the ultrasound which in all good conscience seemed cheap enough - in the US you might get charged a thousand bucks. But I knew what to do so I took her to the office bizarrely named "perception" and made that woman tell the ultrasound vampire to go boil an egg. In the end the billing maven didn't have a clue and ultrasound squeezed me for the money- no one in this joint had a clue how anything worked, it was bizarre.
 My wife spent her time in the hospital and I was split between walking Rusty, tending to her needs, leaving Rusty in the car either in the shade or with the air conditioning on...One day I left him in the shade but left a window slightly cracked and the let terrorist escaped. Oddly enough I wasn't that panicked. I rode around looking for him and soon had to go back to the hospital for another bout of arguing over bills but I figured he'd get back to the car. He obviously knows how to stay safe on the streets.
My biggest fear is he will get picked up because he is so friendly. And hat indeed is what happened. The little bastard followed my trail into the hospital and snuck into the lobby and freaked out security who caught him and put him in a closet. They called the 800 number for Pet Home Again- amazing service- and I got an email telling me Bobo (his rescue name) was found. So many adventures! So exhausting!
Meanwhile back at the main event Layne was lying on a gurney in a corridor of the ER where a nurse with some English and a big heart was taking care of my wife. Luckily as I was only allowed to visit for ten minutes an hour and if I showed up later than half past the hour my visit was cut short, no exceptions, as everyone had to be out by forty minutes past the hour. It was crazy, bobbing in and out for eight hours like a yo-yo and Layne surrounded by French speakers only, in her hospital gown in a corridor of the hospital. It was Third World. I should have packed her up then and run for Vermont four hours away, but I didn't.
An anonymous male nurse appeared with a piece of green lace and managed miraculously to remove her tight wedding band without breaking it. This was the single best thing that happened to my wife in CHUL. After she was moved to a room she got zero attention from anyone. When I located her after paying $200 a day for a private room I found her sharing her private room with a man, both of the patients in hospital gowns separated by a curtain.  I guess you get what you pay for. Though when I complained about the mixed gender room I got Gallic shrugs and a that's how we do things here response. Believe me, getting well in Canada is a tough job.
I became convinced as I spent too many hours in CHUL that the drive to make Quebec French is a drive to deliberately isolate the province's 8.2 million residents from the outside world. French is a linguistic Berlin Wall that surrounds Quebec and the propaganda inside this enclave tells the people that they have it better than anyone else. On a continent where everyone else speaks English or Spanish, if you can only speak French you are stuck inside an impenetrable stockade exactly the way the Parti Quebecois wants it. The constant nagging in the US about English only seems redundant to me. We live in a world where everyone wants to speak English, the language of business and commerce, culture and Hollywood, and general hipness. Diplomats and the Academie Francaise cling to French and in Quebec that means no outside communication. there are 600,000 English speakers stuck in this North Korean hell hole and I wish them luck because minority status has not made Francophone Canada particularly friendly to non-members of their exclusive little club. I see no reason at all why English in public places is banned in Quebec unless it is an artificial effort to create a need for French which would otherwise die on the vine. 
Philosophy aside things got really ugly on day two. I got amd on the Evening of day one and demanded to see a doctor who appeared and we listed our complaints in English. After that explosion nurses actually brought ice chips to my wife, answered when she rang for help and started acting like they cared a tiny little bit.  After 30 hours in the hospital my wife had received no drugs other than a saline drip and no treatment. She was still in agony from what the ultrasound confirmed was an inflamed gallbladder. They scheduled surgery. Which got postponed. It turns out there is but one surgical team on duty at a time in Quebec City, the capital of Quebec Province, a city of half a million people. They serve three hospitals and travel to where the need is greatest. I am not joking. My wife's gallbladder removal was postponed repeatedly.
The hospital was chaotic, staff in the corridors made no eye contact, no effort to help people find their way, and the security guards were rude to everyone and defensive, as though they were patrolling a military installation, not as though they were there to help. No one came and spoke to my wife about her impending surgery, no one talked to her about her options. She laid in bed and cried, it was that bad. Doctor Claudia came by and was the only decent human being we met on that floor, other than the nurses' assistant who saw my wife crying and went to get her help. She tried to reassure my wife all would be well and made herself available anytime my wife needed help. I suggested she move to the US and make a life for herself helping people but I think she is committed to the people's nightmare that is Quebec.
The strangest moment in this saga came when my wife was finally wheeled in for surgery. I was out walking Rusty and I got a phone call from the anesthetist who told me he needed payment up front, him and the surgeon before they would operate. I was aghast, "This is worse than the US!" I protested. It's piracy. If I didn't have a credit card you'd just let her die? I ran back to the hospital. I went back to perception and told the woman I had to pay or the surgical team wasn't going to operate. She looked at me blankly. How much? she asked. I don't know I said. She said I have no idea what to do, I've never done this before. She made a call. Then she said meet your wife in her room, they have cancelled the operation.  It turned out the anesthesiologist was upset by my reaction and decided in a fit of pique to refuse to operate on my wife which sounds to me like the worst act of malpractice ever. Except this is normal for CHUL - Centre Hospitalier Universitaire Laval de Québec- as I discovered when I checked the Canadian Broadcasting Corporation archives. Look what I found: LINK 
I went back to my wife's half a private room and we had no idea what to do. I should have packed her up and driven four hours to Burlington's Vermont Medical Center. But I didn't. 
So far my wife had still not received any medicine and in hopes of an operation she had had nothing to eat or drink except ice chips for two days which isn't as bad as it sounds as she was pretty out of it with no appetite at all. The saline drip dripped but she had no electronic monitoring of her condition and her room looked like it belonged in the 19th century. They had no problem letting her occupy a hospital bed for no apparent reason and it seemed to me their theory was that she should lie there and if she got better go home, if not then cut her open. Florence Nightingale might have approved but I was getting into a steadily more outraged panic.
 The pictogram below shown to my wife by a very nice resident who spoke English was as technical as it got. This is how the operation works she said and we never saw her again.
The French dude got the window we sat and waited for something to happen. On the evening of the second day they  put a bag of antibiotics into her and a surgeon came by the next morning. He  had nothing to go, no print outs no charts no monitors, nothing but he said they don't usually operate after 72 hours. By policy on gallbladders. I was stunned. He spoke English so we explained the fracas with the first attempt but he was adamant saying if anything went wrong we might be stuck in Quebec for two weeks  at least. That was a reality check. I decided then and there we were getting out. MY buddy Jack Riepe suggested Vermont and I saw the wisdom. This fiasco was over.
 I galloped back to the hotel and gathered up our stuff, paid the $800 bill and fled. Le Dauphin was fantastic and I'd recommend it anytime. They speak English and are wonderfully kind with excellent facilities. It's the hospital I'd avoid. 
Through all this mess Rusty was fantastic, as unlike a Miami street dog as you could imagine. I took him for long off leash walks wherever I could, morning and evening and let him run. He stuck by me and never complained or made a nuisance of himself. He was the best companion I could hope for and without him I'd never have kept my balance.
With the car loaded I went back to the hospital where my wife asked the doctor if she could have her x rays and charts. Sorry the doctor said they haven't been transcribed and won't be ready for days. They removed her IV and left the room. Discharged. a nurse saw my wife hobbling down the corridor on my arm and took pity on her and brought a wheelchair. It was broken, of course, but we managed the trailing foot rest and got my wife to the car between us and that was basically that. End of hospital.
My wife groaned in pain as we bounced down the step that leads into the parking lot. It causes the ambulances to lurch like ships at sea as they arrive with their patients, one more torture inflicted on the poor souls who end up at CHUL. And so we staggered home  to the United States, gallbladder still inside and inflamed.
My wife's arms bore witness to the battering she took as they struggled to put one IV line in. They both looked like this and they stayed like this for days, a fond memory we took with us back to the US.  We left with zero paperwork from CHUL. It was the final bizarre touch to a grotesque experience.
Google maps played one last nasty trick on us as we drove the three and a half hours to the border. For some reason the best route involved gravel roads and dozens of badly paved railroad crossings so my wife was groaning in agony as we went. 
At last we started to see signs that the US was not far away, and I started to worry how long it would take to cross. In the event we spent an hour in line.
 I was never so glad to to sit in a line and know that real medical help was just 40 miles away.
The flag marks the spot. And by the way, no one ever checked Rusty's vaccination papers. Good boy.