It took an optometrist to finally catch it. Swelling in my eyes indicated pressure in my brain, pushing against my optic nerve – the likely cause of months of headaches and vision issues I had been struggling to get diagnosed.
Thus began the most harrowing 48 hours of my life. The optometrist referred me to a next-day appointment with a neuro-ophthalmologist, who in turn sent me straight to the emergency department, where I received fast-tracked CT and MRI scans. By the following evening, I was on the operating table for emergency brain surgery.
The pressure had a relatively benign explanation (at least in the world of neurosurgery): I had developed hydrocephalus – an excess of fluid in the brain – and the cause was congenital. Within just a few days I was back home resting.
My whirlwind tour of hospitals and specialists gave me firsthand perspective on a health-care system that is extraordinary in a crisis, delivering some of the best care in the world. But too many of those crises, including my own, are made worse by the system’s shortcomings.
I work as a policy lead with the Public Policy Forum, an Ottawa-based think tank whose many projects include a year-long exploration of the health-care system. On April 5, PPF released a report that outlines a to-do list for reform-minded policymakers to address massive gaps in front-line care.
The report, authored by some of the biggest names in Canadian health care, is called Primary Care for Everyone. I am the “everyone,” one of the estimated 6.5 million Canadians who does not have a family doctor. If I had, my condition may have been discovered months earlier and been subject to less urgent treatment.
I needed to reach a state of crisis before I could find a way into the primary-care system.
To find a family doctor, I have registered on government waitlists, reached out to friends in health care, and directly contacted several clinics. Nothing has worked. This lack of access to primary and preventative care meant I needed to reach a state of crisis before I could find a way into the system.
When confronted with an emergency, our health care is truly world class; top neurosurgeons and a veritable army of specialists, nurses and orderlies delivered wonderful treatment from start to finish. And the pace of treatment was truly remarkable. Faced with an urgent case, the system moved at astonishing speed, and of course at no cost to the patient.
But once in hospital, I saw firsthand evidence of the evolving crisis in our health-care system. A shortage of beds meant I was moved frequently as the hospital tried to triage the varying needs of too many patients. In over three days in hospital, I rarely saw a doctor for more than a few precious seconds at a time.
Meanwhile, the nurses who delivered the majority of my care were stretched to a breaking point. The hospital’s latest desperate measure to counter pandemic-induced staffing shortages was to deny all vacation requests among nurses. While perhaps a necessary step, the policy had a predictable result – my nurses seemed more burnt out than ever, with no relief on the horizon.
Premier Doug Ford said last year that “Ontarians continue to have access to the care they need, when they need it.” My experience suggests he may be missing the point. It’s true that when faced with a crisis, some of the best health-care professionals in the world are available to care for us. But that system is at its breaking point. Poor access to primary care is compounding the problem, leading more of us to land in the emergency room than should ever need to.
None of us can know when our health might fail us. We need a system that does more than respond to a crisis. We need a system that doesn’t let so many cases reach crisis point.