A quick post, this. I didn't make it to DC this week, as I'm plagued by what is either an infected leg or something quite different, a neural problem called Reflex Sympathetic Dystrophy. I wouldn't mention it, except that I know some of you folks out there are doctors, and might be able to give me some advice. The condition isn't very common, but it sure is painful -- or can be, if I let it get out of hand.
But I have had some experiences with the Canadian medical system because of it and a few other things over the years, and would like to post a couple of observations. The first is that it's pleasant, and probably delusively pleasant, to walk into a doctor's office and not to have to worry about the cost, even though I'm not covered by the national insurance. And Canadian doctors seem to be every bit as friendly and helpful as Canadian plumbers, carpenters, and electricians. I've liked all the ones I've met.
Not that there are a lot of doctors here, though. Price controls have driven many doctors to the States; and the generally lousy schools have done a poor job preparing young people (young men in particular) for careers in science. Most of the doctors I've met are not Canadian, and with that comes all the problems of transience, and sometimes uncertainty about the adequacy of their preparation. But even assuming that they have all been well-trained, there aren't enough of them, not by a long shot. The shortage shows up in personnel, and then it shows up in machines, available tests, even beds in hospitals. Let's say you live where we do in the summer, and you need a hysterectomy, or a gall bladder removed, or something that is not absolutely urgent, but that will cause you a good deal of pain. You wait. You may wait as long as a year; I've seen this happen. You wait for a bed to open up, sometimes in Halifax, 200 miles away. But you need to be ready on the day when the bed is available. So people are told when their number is about to come up, and if they're not there when it does, the bed goes to the next person in line. That means that people stay in motels in Halifax for a week or two when the date draws near. Folks around here will hold raffles or other fund raisers to help a neighbor defray the costs; it is a regular occurrence.
But then, you can't keep the bed, either, as long as you should. My sister, an infectious disease specialist in Pennsylvania, tells me that the argument in the States is over how long you should be without fever before you are discharged from the hospital for treatment for infection. My neighbor up here was discharged with a fever, and with intense pain in her surgical incisions (she was back in the hospital two weeks later; this woman waited nine months for her three operations, nine months of pain). Her husband, several years ago, was discharged from the same hospital after open heart surgery, though he had been complaining of shortness of breath. His wife was driving him home, 200 miles, and stopped at a different hospital to have him checked out at the emergency room. It was lucky she did, because had she gone home and put him to bed that night, he never would have woken again. His lungs were half full of fluid; he was almost drowning in pneumonia.
A friend of mine this year had a blood clot in his ankle, which traveled to his groin by the time they could perform an MRI on him. Shortly after that, a piece of the clot broke off and formed a pulmonary embolism. He is on blood thinners. That's all; a blood clot in the lung, periodic local monitoring of his blood thickness, and no follow up on the embolism. He will not know whether or not it has dissolved, or when. I suppose that if it jars loose and hits the vena cava, he will know, unless he's asleep when it happens. My sister tells me that in the States the standard procedure, for somebody with leg clots AND an embolism, is to insert a kind of porous umbrella into the vena cava, to let blood through but catch clots. Nothing of it, here. The man's legs continue to swell, and he's worried.
Please don't tell me that the average lifespan of a Canadian is thus and so, better than that of the American. Too many factors are folded into those statistics....