Hospital Diaries VI: The Overflow

---

Version française

---

This is part of a series. You can begin at Part I and follow the link at the end of each installment to read the next. 

I had been in the gurney hall for two days. Every move I made was painful and I still did not know what I was suffering from. It had all started with a gout attack but then I was told I had twisted my knee and had torn some ligaments. After being admitted to the hospital, doctors talked about arthrosis, spinal stenosis and a neurologist I nicknamed “the Seagull” insisted I needed back surgery.

Lying on my gurney I was pondering about how difficult it is to establish an accurate diagnosis. In all fairness I could not blame doctors for failing so far to identify the cause of my handicap. In a way, I felt it was like an evil genius, some kind of Keyzer Söze from the movie The Usual Suspects, was living inside my body, wreaking havoc at the expense of doctors/detectives who were completely baffled.

Only in literature and movies the issue is finding the “true” culprits. In real life, detectives and doctors are content to find a convenient suspect – all the best if it’s the real guilty party – to lay charges on, close the case and move on.

Those were my thoughts as I watched the hospital chaplain offer his sympathies to the family of a dying patient to whom he had just administered the last rites in one of the private rooms of the gurney hall.

At that moment an attendant showed up and began to place my personal belongings under my gurney. I was terrified she was going to take me against my will to the operating room for spinal surgery. I nervously asked her where we were going.

“I am taking you to your room sir.”

I could not believe my ears! Finally I was leaving the noisy gurney hall with its blaring bells and alarms! As I was profusely babbling my thanks to the attendant, she curtly said:

“I’m just doing my job sir.”

After I was wheeled into my new room, an orderly slid my body to a wider gurney with a thicker mattress. From the conversation the orderly and the gurney attendant were having, I understood that I was now in a place called the Emergency Overflow, a somewhat “underground” department set up for patients who had been residing in the emergency ward for at least 48 hours. This was the way the hospital had found to avoid the heavy fines that were imposed if the ministry of health’s performance goals were not met.

Mankind is obsessed with order, yet lusts for chaos. Maybe that’s why bureaucracy was invented. Bureaucracy is a form of labour organization purposedly designed to effectively achieve a cost-efficient use of resources in a rational way. However tremendous effort and considerable ingenuity are needed to get around bureaucracy’s cumbersome rules.

I owed my escape from the gurney hall to this paradox.

I was now in a no man’s land of a sort, some temporary quarters run by a minimal staff. From time to time a nurse would come by to take my vital signs and ask me to rate my pain on a scale from zero to ten and an orderly brought me my meals.

In Canada, hospital menus are designed by dieticians. Low-salt, low-fat and low-sugar meals usually taste like cardboard. If the food is not particularly tasty, it is however very healthy.

Everyday I had a visit from “the seagull,” the neurologist who was convinced I was faking my illness since I would not agree to have back surgery.

“Come on! Show me what you can do! Get up on your feet and walk!” the seagull would mock me.

I was nearing rock bottom. Having been confined to a stretcher for almost a week, I still did not know what I was sick from, my doctor was treating me as if I was imagining my ailment and I was taking painkillers that had no effect on my pain.

When my friend Lucide came to see me, she brought a bottle of Ibuprofen. I quickly took two tablets and hid the bottle in my bedside table hoping no overly conscious nurse would steal it away from me again.

While I was waiting for the medication to take effect, I told Lucide about my frustration and despair.

“Hmm… I saw three empty wheelchairs in the hall as I was coming to your room” said Lucide. “Maybe if we could borrow one and go to the cafeteria it would lift your spirits a bit.”

US president Franklin Delano Roosevelt (1882-1945) was confined to a wheelchair for the rest of his life after being struck with paralysis during a vacation at Campobello Island in New Brunswick. Still today doctors disagree about whether FDR suffered from poliomyelitis or Guillain–Barré syndrome.

My friend is a genius. I rang the nurse right away. After about 15 minutes of waiting, an orderly arrived and I asked her if I could have a wheelchair to go for a stroll with my friend.

“I’ll ask your nurse,” she replied.

Lucide and I continued our conversation for about 20 minutes and having no news from my nurse, I rang again. When the orderly returned, I asked her if the wheelchair I requested was coming.

“I’m sorry sir, your nurse is taking a break and I haven’t been authorized to give you a wheelchair yet.”

That was too much. The frustration that had been building up in me for the last week overflowed.

“Listen miss: are you telling me there is only one person in this ward who can allow me to go down to the cafeteria in a wheelchair to have coffee with my friend? This is a simple request! I’m not asking for a liver transplant! All I want is a wheelchair! This is not the third world, is it?”

My outburst took the orderly by surprise. She began to cry. Her sobs alerted her supervisor who rushed into my room.

“What have you done to my employee?” he enquired uneasily.

Ashamed, I told him what happened while a nurse was taking the orderly to the hallway to comfort her. Five minutes later, the supervisor came back with a wheelchair in which he helped me sit. Lucide wheeled me to the elevator to go to the cafeteria.

Still astounded by the drama that just happened I was nevertheless ecstatic to be sitting, moving away from the confines of my room.

Lucide and I got some coffee and I asked her to take me outside to smoke. It was a cold January night and at minus 20 degrees I was shivering. It was the first cigarette I had had in six days. It felt like I finally had found relief for my pain.

---

To be continued in Hospital Diaries VII: The Sweet-Smelling Ward

---

Hospital Diaries V: The Seagull

---

Version française

---

This is part of a series. You can begin at Part I and follow the link at the end of each installment to read the next.

When everybody around you is suffering, your own pain becomes less important. I quickly realized that my complaining and moaning weren’t providing any relief. I was only contributing to the overall noise in the gurney hall.

A nurse had taken away my bottle of ibuprofen and the painkillers that they had given me were totally ineffective. I was too stiff to move and the thin blanket covering me was not keeping me warm. I was in constant pain and felt helpless.

When another nurse came to check my vital signs, he noticed my distress and asked:

“How are you sir? Are you in pain? Can you rate your pain?”

I could not understand why nurses insisted on wanting me to rate my pain on a scale from zero to ten. I felt it was impossible to draw meaningful conclusions from such subjective impressions.

“It hurts a lot,” I answered.

“You were given a painkiller two hours ago,” said the nurse after looking at my chart. “Maybe it’s not pain you’re feeling but only discomfort.”

I was not in the mood to discuss semantics and I gave the nurse a spiteful glance.

Pain is a reaction to an unpleasant stimulus. Tolerance to pain can vary deeply between individuals. The most common tool used to measure pain is a standard scale graded from zero to ten. The accuracy of this tool is questionable.

“You’re probably right,” I said with sarcasm, “and I’m also very cold.”

“In that case I can help you.”

The nurse went away and came back with a warm blanket to wrap me in. I dozed off almost immediately.

During this first night in the gurney hall, my neighbour who had broken her back was transferred to an actual hospital room and I now had a new roommate who was retching loudly behind the thin curtain separating us.

When I woke up in the morning a tall slim man in a white smock was standing by my stretcher.

“I looked at your MRI results and saw that you have light arthrosis on two of your lower back vertebrae. That would explain your spinal stenosis and could be the cause of your paralysis.”

The hospital staff spoke in a strange language that I could barely understand. They also tended to show up unexpectedly and never introduced themselves. I found this extremely annoying.

“That’s interesting,” I said snidely. “Who are you sir and what do you do?”

“My name is Dr. Sharp and I’m a neurosurgeon. I doubt surgery on your spine would be beneficial. You don’t have severe arthrosis and I do not recommend this operation”.

Surgery is too often viewed casually by patients and doctors alike in the Western world. However there is something creepy in having masked strangers performing mysterious acts with sharp objects on sleeping people, don’t you think?

“Dr. Sharp, are you telling me I have arthritis?” I said confused.

“No. I said arthrosis. Arthrosis is a degenerative disease of the bone cartilage. Arthritis is a swelling of the joints. Arthrosis is a wearing down of the bone cartilage that often occurs with age.”

“And what is spinal stenosis?” I asked.

“Spinal stenosis is a narrowing of the spinal canal where the spinal cord is located. In your case, arthrosis may be the cause of that narrowing but as I just said I don’t think surgery will be helpful.”

“I’m relieved,” I replied. “Spinal surgery sounds risky.”

Unimpressed by my comment, the doctor gave me a blank look and added:

“In any case, I will discuss this with my colleagues and we’ll talk about it later.”

I was never to see Dr. Sharp again. I often wondered if that hospital didn’t hide some kind of “Bermuda Triangle” that mysteriously swallowed up doctors.

The Bermuda Triangle is an area of the Atlantic Ocean between Florida, Puerto Rico and Bermuda where many ships and aircraft have vanished. Some people believe that the Earth’s magnetic field is to blame for these incidents. This might also explain the shortage of doctors in hospitals.

That morning my friend Lucide called me on my cellphone to see how I was and to find out if I had been given a room. I took the opportunity to ask her to bring me some ibuprofen to relieve my aching body.

While I was on the phone a man with dark hair and bushy eyebrows rushed in.

“So, are you ready for your surgery?”

“What surgery?” I said, startled.

“Well, the operation on your spine to get rid of your nasty arthrosis, of course!”

“I thought this procedure wouldn’t be necessary! But first of all, who are you sir?”

“My name is Dr. Backridge and I am a neurologist. Who told you this operation would be unnecessary?”

“Erm... It was doctor... Huh... I can’t recall his name but he was some kind of brain surgeon who came to visit me this morning,” I said, befuddled. “You’ll probably find his name in my file.”

“I never read patients’ files, they’re totally unreliable,” the doctor said with a twitch. “So? Do you agree? Can I book the operating room?”

I felt cornered. I am not impulsive by nature and, right at that moment, I did not have all the information to make such a serious decision and weigh its consequences objectively.

The doctor was rocking nervously on his heels while tapping with a pen on a clipboard.

“Dr. Backridge, can you guarantee arthrosis is the cause of my illness?”

“A 100% guarantee? No, I can’t say that for sure but it’s a possible cause.”

“Doctor, I hope you can understand how I feel. Right now I can’t walk and I’m afraid that if I get this operation I will never be able to walk again.”

The doctor gave me a fierce look.

“Listen sir, don’t waste my time. If you don’t agree to this surgery, I can see only one explanation...”

“Which is?”

“You’re putting on an act! You’re faking!” he snapped.
.
He then turned and left abruptly, his white smock flapping behind him like the wings of a giant bird. He made me think of a seagull that comes out of nowhere, making a lot of noise, shits everywhere and leaves as he had come without ever accomplishing anything.

“I would not mind if this doctor got lost in the Bermuda Triangle,” I thought.

Seagulls have existed for at least 30 million years. This bird with the obnoxious squawking can be found anywhere there is a lot of water. It will eat anything but seems to enjoy feeding on human garbage.

---

To be continued in: Hospital Diaries VI: The Overflow

---

Hospital Diaries IV: The Gurney Hall

---

Version française

---

This is part of a series. You can begin at Part I and follow the link at the end of each installment to read the next.

A hospital is a strange world filled with machines and enigmatic people speaking unintelligible languages. For example, after only a few hours at the hospital, my vital signs had already been checked several times (I guess to make sure I was still alive), I had been incubated and rolled away on a stretcher through a maze of hallways to a “gurney hall.”

The gurney hall was actually a large square room of the emergency ward where patients waited either for a diagnosis or for a bed to become available. Along the outer walls, about 20 cubicles could accommodate two gurneys each, separated by a thin curtain. In addition, five glassed-in rooms were used to isolate contagious patients and the dying.

My cubicle neighbour was an unfortunate victim of a sporting accident, a 42 year-old woman who broke her back hitting a mogul while tobogganing with her children.

A toboggan is a runnerless sled used to travel over snow in Canada. It was designed by Natives to haul supplies and young children. Nowadays tobogganing is popular among Canadian children and their parents who have forgotten they are not as flexible as in their youth. Illustration: Dog-sledges of the Mandans by Johann Carl Bodmer. Source: Beinecke Rare Book and Manuscript Library, Yale University, public domain

A nurse showed up at my bedside bringing with her the usual equipment for taking blood pressure and temperature as well as a clipboard to scribble notes.

“Good morning sir, my name is Florence and I will be your nurse today. Are you in pain? Can you give me an estimate of your pain?”

Maybe I was confused because of my sufferings but I didn’t understand the question: for a moment I thought I was supposed to estimate my pain in Canadian or US dollars.

“On a scale from 0 to 10 could you rate your pain?” explained the nurse.

“It hurts a lot,” I muttered.

“Very well. Let’s describe your pain as an 8 then. I will bring you some painkillers. If you need anything, just ring,” she said showing me an alarm button tied by its wire to my gurney’s railing. She then disappeared with her machines.

The pain was excruciating. With every move I made I moaned. Soon my cries were joined by my neighbour’s whimpers and the wailings of other patients in the gurney hall, cascading into a tormented concerto accentuated by the bells and alarms of monitoring machines.

After an hour of waiting for the painkillers that Florence promised me, I remembered I had some ibuprofen in my shoulder bag. I swallowed two capsules and drifted into a restless sleep.

“Wake up sir! I brought your medicine!”

It was Florence who was handing me two caplets of acetaminophen and a glass of water.

As I was about to take the pills from my nurse, she noticed the bottle of ibuprofen on my bed.

“What’s that? Who gave you this medication?” she enquired as she picked up the muscle relaxant.

“Nobody, I answered, it’s the medicine I was taking at home to ease the pain and the swelling.”

“Did your doctor prescribe this?”

“Not at all, it’s available over the counter in any drugstore and it provides me with some relief,” I replied.

“Sir, you are not to take medication that is not prescribed by a doctor. I must report this right away.”

And she left taking with her my valuable remedy and the painkillers she was supposed to give me.

Stunned to see my medication confiscated, I uneasily managed to doze off.

When I woke up, a smiling bearded little man who looked like a leprechaun was sitting at the foot of my stretcher, tapping on my leg.

“Good day, how are you today?” he said.

Still in a daze, I felt like I had magically awakened in Middle-earth and that anytime Gandalf the Grey and Frodo Baggins would come to take me on some outlandish journey.

“Not very well, but who are you?” I replied.

“My name is doctor Ogham and I am a neurologist. Please tell me how you ended up in my hospital.”

One more time I explained the unbelievable story of a gout attack that turned into a sprained knee degenerating into overall paralysis. While I was talking, the practitioner was feeling my knees, my wrists and my hands, taking notes in the process and asking me to flex my limbs.

“I see, I see,” said the doctor. “But I could see better with a CAT-scan, an MRI, an EMG, some X-Rays... I’ll make the necessary arrangements.”

He then left as I was struggling to make sense of what he had just said.

One hour later, an orderly came to wheel my gurney to the nuclear medicine department to be irradiated with a scanner.

CAT-scans are 3-D images of the inside of a human body produced with an X-ray machine that looks like a giant bagel. In the last 25 years, medical imagery has become so common that the number of people exposed to radiation has been on the rise. This could explain the colour of the skin of the patient in the above photograph.

Several times in the next few hours I was to be rolled in and out of the gurney hall for tests.

Finally, I was taken to a room where Doctor Ogham hooked me up to an electromyograph, or EMG, that sent electric shocks to my nerves to see if my muscles would react.

Laying down as the neurologist was poking me with needles, I felt like a voodoo doll being subjected to some arcane ritual.

Voodoo is a complex religion which origins can be traced to the African slave trade. The voodoo doll, an amulet used to cast spells, became well known following the release of the 1932 Hollywood movie White Zombie. Fortunately, modern neurologists have little in common with voodoo witch doctors.

“This is strange, very strange,” said the good doctor, “Your muscles are reacting perfectly well. This does not look like a neurological problem, everything is working normally.”

Back to the gurney hall, I became acquainted with my neighbour who told me she was waiting for a brace to be made in order to stabilize her spine so she could sit up and move without risking any further injuries.

“Anyway, she said, they can’t keep me more than 48 hours in the emergency ward.”

“Why is that?” I enquired.

“That’s the maximum time allowed by the Ministry of Health. The hospital will be heavily fined if it goes over it. They better find me a bed quickly.”

Night had come. Lying shivering on my stretcher, I could feel the pain creeping back to my joints. How I wished the nurse had not stolen my ibuprofen!

I achingly reached for the alarm tied to my gurney’s railing. Bells were ringing and patients were crying in the gurney hall. Exhausted, I fell into a restless sleep waiting for a nurse to bring me drugs to ease away my pain.

---

To be continued in Hospital Diaries V: The Seagull

---