Monday, November 10, 2014

Please Leave, Doctor; I'm Feeling Nauseous

Going Home

Last week, I wrote about the level of nursing care I received post-surgery; this week, in Part 3, I give an impressions of an unsavory incident that took place while I was recovering in hospital.

I wanted to be released; I wanted to go home; it was Monday December 24th, 2012. It was, however, up to my surgeon to give his consent. Later that morning, with my wife by my side, the surgeon (an Indo-Canadian in his late 30s; he had told me he was from Montreal, my home town) confidently walked in, and the conversation quickly turned to money and my paying “his bill.” It seemed that I would not be officially released until some “arrangement” was made then and there. That this conversation was taking place in Canada, which has mandated universal healthcare (or Medicare) since the 1970s, surprised me. But not this surgeon.

Here’s why. I had recently moved from another province, Quebec, and thus I was not yet covered by the Ontario healthcare regime (called OHIP), which had a mandatory three-month waiting period. Even so, I was still covered by Quebec’s medicare regime, in accordance with universal healthcare in Canada and the portability provision contained in The Canada Health Act (1984). The problem was not access to medical services, which was legally mandated, but of fair compensation. Or, in plain language: money.

The “problem,” according to the surgeon, was that the rate of re-reimbursement was lower in Quebec than it was in Ontario; this makes perfect sense, since the cost of living in Ontario is about 40 percent higher than it is in Quebec. The surgeon neither wanted to fill out the requisite forms to be reimbursed by Quebec, nor even consider receiving less money for his surgical services.

Here is how one part of the conversation went:
Surgeon: You can pay me by credit card right now.
Me: I don't have a credit card on me.
Surgeon: Do you have cash?
Me: No, that would be absurd, wouldn't it? Why are you so concerned about being paid?
Surgeon: I checked with other doctors here and they said that Quebec will not reimburse me.
Me: That’s not possible. I am still covered by the Quebec medicare regime, and if they do not pay you, I will.
For some unfathomable reason that I still do not understand, he still was not satisfied, and kept asking me for money. Right then and there. After what seemed like 30 minutes, I felt nauseous and went to the bathroom. I said. “Please leave, doctor; I'm feeling nauseous.” When I got out of the bathroom, the surgeon was still there, sitting on my bed, talking to my wife. He finally left after a few more minutes. I did not have the time or the energy to think how callous and arrogant he was: my goal was to return home.

I got dressed, which took some time; but more important, I was bothered and agitated that such a vulgar incident took place in a hospital, and so soon (a few days post-op). My wife, a nurse, suggested that she would place a call to the hospital ombudsperson, which she promptly did. Although the woman was pleasant, she promised nothing and did nothing. I was not surprised, having now become used to what this hospital and its employees viewed as their chief priorities; patient care did not, it would seem, rank near the top of the list.

I was soon officially released and went home; I was 10 kilograms (22 pounds) lighter, losing approximately 15 percent of my body mass. Prior to having a few nibbles of food and a few sips of liquid that day, I had not eaten for ten days, or had more than a few sips of water in the last six days, having been classified as NPO (Latin: non per os or nil per os, nothing by mouth), Nevertheless, I survived, having been fed, by intravenous.

Upon arriving home and the for the next two days, I vomited seven or so times; my poor wife had to clean up my mess. A week or so later, after receiving his bill, I did the surgeon’s administrative work, filling out a reimbursement form for him; he was duly and quickly paid at the scheduled rate, the Quebec government informed me by letter. I have not heard from him since. He might be a good surgeon, but his bedside manner leaves something to be desired. In fact, it left a sour taste in my mouth, and, more longer lasting, another lesson in the foibles of human nature.

This concludes a first-person account of my six-day stay in hospital; I have written a weekly account of my chemotherapy treatments, and then monthly post-chemo recovery posts, which can be found on My Cancer Journey.

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