Sunday, May 13, 2007

Soliloquy – Who cares?

It is not often I go down the path of personal reflection, but this has been a week… I have now had hands on experience of just how little the health care system of this country (Australia) cares about positive health outcomes. This is longer than I like and perhaps not the right forum, but I do need to express it.

I have a neighbour who is a stroke victim (we will call him SV). I boarded with him for a while but did not get on well. Prior to the stroke this guy was an acknowledge criminal, he retained the control freak nature which had kept him out of serious trouble.

The fact is, I found him sleazy and amoral, attributes which were not compensated for by his disability. I refused to join in his daily 2 hour drinking sessions, not because I don’t enjoy a drink, I’m just fussy about the company.

I rejected his behaviour, my brother and his girlfriend (a nurse) despised much about the man, but were obviously more caring than I. So Saturday a week ago SV was found in his apartment confused and obviously unwell – he had soiled the apartment fairly comprehensively.

We called for an ambulance and he was taken away. The hospital was not happy as he had signed himself out at least twice before, and they assumed the issue was alcohol related. They did not look further and even dumped his medications, including blood pressure and antibiotics.

So evidence based medicine was displaced by presumptions. By Tuesday he had been moved to a small rural hospital, but had still not seen a doctor apart from the ER doc. He wanted to come home, though how he was going to cope we did not know. But we worked out his issue was stress driven, that he was in deep financial trouble.

Though fairly confused SV knew he had to sort some banking out, and quickly. Not to resolve the bigger problems, but at least meet immediate pressures. We communicated all this to the medicos, but they still seemed to believe they were drying him out.

Come Friday and the hospital phoned to say he signed himself out and was coming home in a taxi. Knowing we were unable to care for him adequately, the next few hours were spent calling every resource we could find. Three strikes! No one was the slightest bit interested, on a Friday afternoon, in SV who was just seen as a trouble maker.

Worse! No one was interested in the stress it was putting on us, supposed, carers who really did not know how to cope with all this. Eventually we gained the attention of the community carers SV uses. It was reluctant and not very helpful.

5 am Saturday the community nurse rolled in in response to SV’s emergency button, then 30 mins later and ambulance rolled in. SV could not get out of bed to go to the bathroom and two burly ambos and a large nurse couldn’t figure out how to move him. My grumpy brother had to show them how to do it. Don’t know or don’t care?

The ambos went and SV stayed, then we spent the morning sorting out his immediate finances. During that process he was visibly relaxing and decided he really needed to go back to hospital. But it was up to two boofhead blokes and an off duty nurse to get him ready.

The nurse/brother’s girl friend was concerned about the smell. She had just cleaned up a death in hospital the previous night and was concerned about the smell of SV, it smelled like death. But we got in and showered him and found he was covered in shit and had not been bathed for a week in hospital.

Where is the care? Where is the dignity and basic humanity. I don’t like the man, but I am highly offended that the professional health system is so ready to dismiss on presumption then let a sick man literally stew in his own juices!

Then came the issue of getting him back to hospital. The ambos were not interested, nor was the hospital. So another couple of hours went by as we badgered the system. My brother tends to have a short fuse and is quick to tell them they are all effing C’s. Not helpful but we were stressed.

Through all that badgering, and later on the phone to the hospital, I gained a reputation for controlled verbal violence. I did not call anyone names, did not give cause to be cut off, but I was unrelenting and not willing to simply give in. When a nurse at the hospital explained that she was only an RN (Registered Nurse) as some sort of excuse I coldly told her I was not the minister for health but I still wanted answers.

I don’t like being this angry. I don’t like having to care about people I don’t like or even caring for ones I do like. Each to there own. The fact is I have enough issues of my own to deal with just now. Caring for someone elses issues doesn't really appeal.

But we did it. SV is now back in the system, for better or worse, and sort of proud that he made a good decision. Given no one in the system is interested in SV’s real issues, still, I don't really begrudge the time out from my own.

I will try not to avoid the bulk of the next few weeks of politicking on these issues. I don’t do health issues as a rule, don’t enjoy them at all. But there are wider issues involved, politically, about where our society is really heading.

The moment core issues, such as welfare, health and education,. Are taken over by money or religion we loose the plot. Once it is no longer about people then why even bother? I thought I didn’t care – now I find the system cares even less.


Anonymous said...

I really want to say something profound but am coming up empty.

Now that I've reached an age where I'm starting to have health problems (nothing really serious, but chronic stuff that *does* require the attention of the health system), I'm getting a real lesson in just how little the system cares. The quickest, lowest effort method of getting your on your way seems to be the order of the day.

SV's situtation (and your's by extension) sounds tragic but is unfortunately not uncommon. It's about time people realized that the perception of a system that cares, largely put forward by television, is outdated, and the system needs to realize that dispensing a drug and sending people on their way is not solution for real health issues.

Cartledge said...

Thanks kvatch. Sounds pretty profound to me...