That primary health care is fraying at the edges is not news. Family physicians are exhausted, waiting to see a specialist is long, and many elders are feeling abandoned. New contracts for family doctors will help but cannot resolve a system that is not a system but only a way to pay doctors and hospitalization. Time to redesign the entire system while preserving its public nature.
Nevertheless, we should feel reassured that response to catastrophic illness remains strong as evidenced by the exemplary community response to Covid by doctors and nurses and as exemplified by the following story.
On December 19th, while raking gravel in Roberts Creek on the Sunshine Coast, I felt a searing excruciating pain between my shoulder blades, way more intense than the pain of a heart attack. Moreover, the pattern was unlike heart attack pain. I was suffused with sweat and immediately prostrate. Fortunately, my son-in-law Avi Lewis was with me and called 911. The ambulance team arrived quickly, and I was taken to Sechelt Hospital, where I was met by Dr. Adetunji Oremakinde.
Desperate times calls for desperate measures
We both agreed that I was probably having a high aortic aneurism tear, and if I was not quickly evacuated to the care of a skilled cardiothoracic surgeon, I would not have survived. The CT scan showed the dissection. (Thanks to the many other community members for developing funding of our community CT scanner which was sent electronically for formal reading by the radiologist at Lions Gate Hospital). Not waiting for the formal report, Dr. Oremakinde began arranging transport.
Problem: it was snowing like hell so the helicopter could not fly, and the last ferry to Vancouver had left. In consequence arrangements for other means of transport began, settling on the Canadian Coast Guard Hovercraft.
The hovercraft was based at the Vancouver airport and had to come all the way around UBC past Atkinson鈥檚 point to Gibson鈥檚, where the Sechelt Ambulance with me inside waited.
The team accompanying the hovercraft was the same emergency medical team and nurses who would have normally been in their highly specialized ambulance, helicopter or medical transport aeroplane.
In the middle of the epic snowstorm, the hovercraft began its return trip, this time reversing up the Fraser River to a few blocks from Royal Columbian Hospital. At the dock waited the teams鈥� intensive care ambulance, taking me directly to the operating room, where the surgical team had anxiously been awaiting my arrival, knowing that the death rate increases about 2-4 % per hour. Fewer than 50% survive this type of aortic dissection. At surgery Dr Daniel Wong removed a large dissecting aneurysm and replaced it with a Dacron tube.
What I had is a degenerative genetic disease, requiring full assessment of all family members, children through old age. This fact also motivated me to write because some of you may be part of a family where a member might have died suddenly and unexpectedly. Adults at risk can be screened by serial CT scans. Kids at risk can receive genetic testing well before the problem emerges, and the aortic defect permanently repaired.
Recovery so far has been uneventful (terrible term). The Royal Columbian nursing and medical staff were amazing. Dr. Brian Muth, a family doctor refugee from Nelson BC, runs a warm and collaborative ward. I am recovering temporarily in Vancouver under the care of my wife Bonnie and our kids, Seth and Naomi and grandkids of course. With gratitude, my health has been improving daily, and we are anxious to return to our home in Roberts Creek as soon as we can set up appropriate home care, which is not so easy, for two disabled seniors.
Michael C Klein CM, MD, FCFP CCFP FAAP (neonatal-perinatal)
Emeritus Professor
Family Practice & Pediatrics
University of British Columbia
Sr. Scientist Emeritus
BC Children鈥檚 Hospital Research Institute, Vancouver
mklein [at] mail.ubc.ca
Author: 鈥淒issident Doctor鈥攃atching babies and challenging the medical status quo鈥� (Douglas & McIntyre, 2018-19)
