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When I arrived at Southlake emergency just before 4 p.m. Thursday, Oct. 5, the waiting room was packed without enough chairs for all there. I was triaged just like everyone else in the midst of COVID flaring up again locally among people actively coughing, being told to pull up their masks, throwing up, screaming, and babies crying — total confusion with a deli counter number service.
People were shuffled through a few registration stations and played musical chairs, with the highlight being someone cursing and being tackled by the security guards as she kicked open the doors and yelled, “This place f'ing sucks!” Guess she didn’t like the two-hour wait to get inside.
I am a 46-year-old woman who is immune compromised and in active chemo treatment for newly diagnosed triple positive breast cancer with lymph node involvement and was experiencing some severe side effects of my second chemo treatment. After calling the cancer centre nurse line and giving them the rundown of my active symptoms, I was instructed it was vital to visit the ER at Southlake for evaluation and care.
She said to let them know I was a cancer patient at Southlake's cancer centre and she would let my “team” know I was coming. I may have mildly assumed that meant some type of special treatment or they would at least be prepared. What happened when I arrived was anything but what I assumed or expected.
There were no notes in any file for them to know what I was there for and I had to explain it to at least seven different people in the many hours ahead of me. I sat nervously choking for air in my n95 mask, having to take sips of water to stay hydrated as chemo is very dehydrating, so I had thankfully come prepared with my water bottle and other needs.
I cried softly in my husband's arms and held my head in pain while I waited and waited and waited. I stood up for a few minutes multiple times, leaning against the corners of walls trying to distance myself from others, almost deciding to leave regardless of my pain until I heard them call 10 names, mine among them. I felt a sense of relief thinking I’d be taken to a waiting bed. I had been to this ER a number of times but long before the pandemic.
To my dismay I was taken to the “internal waiting room,” which is actually a huge padded room that used to hold mental health patients for evaluation, with several small rooms with locked doors with reinforced windows. I know this from being triaged in the hallway next to it years before when it was yellow zone waiting corridor.
I wondered where the mental health area was moved to because the way things were unfolding around me, I felt like it still was that.
Meanwhile, the cancer centre building was just yards away, sitting dark, closed and empty since 5 p.m. What a waste that it cannot be staffed and utilized at night to alleviate the need for a safe specialized space to provide thorough follow-up care for the centre's cancer patients most advanced in age.
All night I watched as nurses moved people around like chess pieces in an old chutes and ladders game that ultimately ends in an escape room. It was utter chaos and madness. I was herded around like cattle with everyone else to find chairs in overfilled rooms that I would refuse to sit in. These small numbered waiting areas used to be the treatment rooms… now instead of one patient, they stick upwards of six to eight in them, the rest of us are left lining the hallways, trying to stay out of each other's space. (I did not photograph the rooms and hallways due to privacy and respect of others)
I sat and cried in an empty lab chair and, at other times, stood against a wall in disbelief in two different areas. I begged for a stretcher after four hours of exhaustion and was lucky enough to be given one to lay my banging head on.
There is a definite shortage of help and the nurses station was left unmanned most of the night as the few that were there were busy running or swapping out for short breaks. I saw more police than nurses and more security than doctors.
People were everywhere and all looking for the same things… a nurse, a doctor, anybody…crying out in pain repeatedly, babies crying, coughing, throwing up, many people were actually helping each other. Many signed waiver forms to discharge themselves before either their tests or results.
But the saddest was seeing a nice young man next to me given an adult diaper and gown for his wheelchair-bound father and when he asked where his father could change they had no suggestions. He immediately pushed his dad's chair toward the exit, saying, “They are not doing anything for us here, we will try something tomorrow”.
As for me, I begged to be moved to a less crowded hallway where my IV line wouldn’t keep dropping onto the floor and was told I was lucky to have been given a stretcher as there are not many and, being that I am ambulatory, it was rare. So 13 hours in the ER — if that’s called luck, so be it.
As a cancer patient, I have been traumatized by what I was put through, what I witnessed and what was overheard. I threw up twice in a cardboard bowl that no one came by to get it and it sat until my husband found a biohazard bin to dispose of it. It is now unsettling to know that for the long duration of my active treatment, I could be left like this again in a hallway with no real assistance and maybe in even worse shape. From this, I am considering stopping my neoadjuvant chemo treatments and going for surgery to give my body a break.
All in, I spent 13 hours in the ER of Southlake hospital that night and absolutely nothing was done for me other than giving me tylenol, an IV of what they said was fluids but I later learned contained opioid pain medicine, in addition to my anti-nausea medication and a conflicting CT scan and differing opinions whether to admit me or not. They first said I needed surgery because my appendix was 9 mm, then changed that and stated I had colitis and needed antibiotics and fluids but forget to order them.
It took four hours to see a resident doctor and have the attending agree with her to order tests and have me hydrated through an IV. I had to request bloodwork. It took another hour to get a stretcher in the hallway, it took seven hours to actually get the IV of anti-nausea meds and other fluids, eight hours to have the CT scan, it took 10 hours to again see the next shift's attending physician. That is when I was given two different conflicting diagnoses and opinions on admission via being caught up among the shift change.
I was told I was being admitted in the 11th hour and a bed was trying to be found for me to get some rest in out of the hallway, then approximately 3:30 a.m.
After a two-hour void of not receiving any further treatment, and no antibiotics (apparently forgotten), and still in a loud hallway without a nurse in sight but now with the staff cleaning the floors with large electric machinery, I finally had enough and actually for the sake of my health knew I needed to go home and get proper rest so my husband flagged a nurse down and requested the papers I had witnessed countless others sign before me to discharge at my own risk at approximately 5:30 a.m.
Sadly, to add insult to injury, I was left feeling that I was sent there on bad advice because at the point they are at, unless you are in an active heart attack or have lost a limb or a ton of bodily fluid, there’s no real place for you in our emergency rooms. It’s definitely no place for a newly diagnosed and nervous cancer patient like myself. Too many people, indeed, are still using emergencie for the little stuff as it is and the ones who need a scan and bloodwork like I did to make sure there is nothing sinister happening suffer alongside them. Not to forget the people in much worse shape brought in by countless ambulances into these overcrowded spaces.
The fact of the matter is when you look around at the population increase and amount of new residential construction projects, York Region outgrew Southlake “Regional” Health Centre more than 10 years ago. The lack of staffing at Southlake is immeasurable and the lack of space is appalling. There’s not even enough beds to admit patients who need them. I wouldn’t say it was filthy but it definitely wasn’t clean. More staff is needed in all areas. More machines are needed. More stretchers are needed.
This story and others like it should be in the news every single day, not just for the patients but for what remains of the mostly young and overburdened staff.
Four-year residents and a skeleton crew of young, newly graduated nurses are doing more rounds than anyone to try and fill in the gaps in the health-care system, probably asking themselves if this career is worth the burnout and stress that is to come, or that trauma medicine isn't for them.
These young doctors and nurses I encountered are facing their own trauma of being caught in the cross-hairs of politics and witnessing the frontline collapse of the current health-care system and its lack of funding for more hospitals and walk-in clinics. They are really trying hard to do the best with what they have and are doing so under a great deal of stress, overworked and on little sleep.
So my story ends as it began…
I woke up still suffering with the adverse effects of chemo, including head pain, extreme fatigue, and very advanced GI discomfort plus an opioid cocktail hangover among other things and still need to be evaluated. The discharge nurse called to ask how I was doing and told her I was basically the same and was mad and disappointed, she empathized with me. (I wouldn’t want her job.)
My next plan was to go during walk-in hours to my family doctor's office in the hope of getting an urgent requisition for a GI specialist and to get a second opinion on the findings, with my next follow-up appointment with my oncologist two weeks' away.
Thank you for reading.
Bonnie Luciano
Markham
