Revealing Taboo

I’m going to take a risk revealing my evolving thoughts on friendships with women. It’s hard to avoid a  Taboo NG 2sexualized thought. What naturally enters my mind filters out quickly. A casual glance ends with an internal disapproval of my own objectification. I can open up and have a deeper awareness; the thrill of female company is a luxury. I have learned to exclude impulses before they interfere. There are alarm bells when attraction begins. I turn away from infatuation, satisfied by moments of thought and a smile which reminds me that the richness of my life is enough. Affection ebbs and flows, and I allow small waves of pleasure to roll over me at times. I can be present without to much natural distraction.

Within parameters, I can manage impulsiveness, and I am afraid of conditions that might alter a steady course. Sitting on the edge of pleasure and pain is thrilling enough. I don’t want to cross a line as stability is important to me. There’s enough evidence to suggest my insecurities are reasonable about self control. There is a biological basis for emotional needs around friendships. Interaction serves several purposes, and between genders, have instinctive influences that are difficult to counteract. Being honest is an indicator of openness and willingness to empathize, which is apparently an attractive quality!

I am open to allow any of my friends to confide their deepest feelings and experiences, because I want to know what motivates them, what informs their attitudes and perspectives. It has implications in my interactions with others. I also believe this is what friends do, without judgement.

I have been interested in the framework of relationships and friendships, to understand and clarify boundaries and why some situations would be threatening to the emotional stability I have worked so hard for. Unsuspectingly, I have been drawn into a battle with primal forces after several hours of reflection today, and through my imagining, setting off the fireworks of impulse I have been avoiding. It is not as much evidence of weakness as it is of frailty. Usually I look away quickly when I notice beauty in women, and divert my attention. I limit my exposure. It’s a tested method of control, but it’s harder to do when you think about for several hours!

Refinement through aesthetic appreciation should offset desire, whereas pop culture can revert us to drunken lechery. This Jekyll and Hyde transformation to lustful feelings is embarrassing but it grounds me in a strange way. Aspirations of emotional friendships may not be achievable. I need to see what happens. I am left with a thought for now: A lot of what I’m saying is never discussed. It’s taboo, uncomfortable. Maybe that will help me. I can see it as an exercise of understanding something hidden. Revelation is a good thing when it comes to self awareness.

Should I Expect Satisfaction from Grand River Hospital?

There’s a couple of habits in large institutions. First, they are risk averse. No one wants to make a mistake. We talk nonchalantly about Edison and the light bulb and innovation, the importance of taking risks, but that’s not the practice especially with those publicly accountable bastions of the community like hospitals.

Secondly, the individual is hoodwinked into thinking they can make a difference, but there is a pragmatic methodology that opposes this. It could be how an interview is structured, or not, or there is simply no valuable follow up or accountability to that individual who either has a valid point, or raises questions; these are the tools of risk aversion.

GRH%20emergMy Grand River experience continued recently, a full 6 weeks after the February incident that left me smouldering – having been verbally attacked and berated by an ER nurse in a follow up call at home after I had left the hospital without telling anyone. I had based my leaving on feelings of insecurity and even safety, and the assumption that if there was an issue with my case they would have contacted me. By the ER nurse’s abrupt correction, they didn’t do that at Grand River, and further more I had (somehow) wasted tax payer’s money by leaving.

Having left a voice mail on the hospital feedback line, I was told an administrator would get back to me within days. Time came and went; 6 weeks of time. I had long given up on Grand River’s complaint process, especially having gone through another awful experience at St. Mary’s, which I have also recorded – openly. You tend to want to forget these things and move on.

I was surprised and reasonably buoyed by the contact from the hospital to set up a call with two administrators within days. My only concern was that I didn’t have the time to prepare, as I had been while waiting for the first call that never came. I felt however, and trusted, that my integrity was intact, and with very little effort I could recount the shock and indignity at the ER nurse: the unprofessionalism, the downright abuse – or both.

I told the hospital previously that I am not comfortable with phone calls: I get tongue tied, my mind races too fast, and it’s difficult for me to get out an idea in an orderly manner. Actually it’s more like hit or miss. If there is any reason for conflict, correction, or contradiction, I get emotionally hijacked and lose all perspective; it’s a fear response, and discomfort more than anger. I get upset, stammer, and look for a window to jump from.

So there I was, in my office at work, speaking candidly to hospital administrators. On speaker phone, they began with their understanding that my ER experience came down to how the hospital handles overcrowding – the fact that I was moved out of a treatment room and into a chair in the hallway, where I was in the way of hospital operations, like food carts, (but not sufficiently in the way for any member of the ER team to check in with me – make eye contact, smile, say hello, you know…the general assurances that you haven’t been entirely forgotten.)

I objected immediately. This wasn’t at all the primary reason for my complaint. My complaint was because I received a call from the ER nurse at home, and she berated me, shut me down, objected to my questions about follow up, and was rude to me on the phone. So I corrected the administrators. At that point I found something out – several things actually. The ER nurse noted a follow up call on the file, but skipped the part about me wasting tax payer’s money. She also skipped the rudeness, and the denial of my assertion that on a previous occasion a doctor had called me, informing me of test results. I was amazed by the administrators’ admission that under a doctor’s instruction, a nurse can indeed update a patient who has left.

I proceeded with the phone call. I started to get the feeling we weren’t working with the same playbook. There was GRH Web Wait timessome slight questioning about my ‘recollection’ so I stated I made my notes within 24 hours of the incident, and that it was factual. I pulled up the notes – which are now on my blog. I referred to the notes directly – even reading passages like testimony on a witness stand. I was sympathetic about the usual wait-time complaints – never my issue, as stated on my blog. I even understood prioritization and having to shift people around if necessary.

However, I stressed that communication is necessary. Updating patients along the way is fundamental, and hospital experiences are not all about needles and bandages, scalpels and plaster casts. This treatment has to come along with information, and just as important courtesy, which alleviates the stress and anxiety of being in a hospital in the first place.

When I prepared to express concerns following the icident 6 weeks ago, I read broadly on nursing standards, hospital experience, and patients rights. It was interesting that the Registered Nurses Association of Ontario has advanced courses in compassionate care. Small things – that I didn’t receive – like standing in front of a patient, making eye contact, reflecting back what patients are saying; a virtual menu of best practices. Where were they at Grand River?

Turns out, patient experience and quality of care is a hot topic across the western world. Just do a preliminary search and you’ll find articles on patient-centred care, patients being ‘partners’ in health care, and more holistic approaches to services. Even patients rights – which, by the way, all three hospitals in Waterloo Region subscribe to in a standardized form – are set out, although in our neck of the woods they call them ‘values,’ probably for pragmatic reasons, and they are hard to find too:

As a patient or client, I value that:

I am provided with high-quality care and services that focus on my whole being – mind, body and spirit.
My family and I are treated with respect, compassion and understanding of our unique needs.
I am an active partner in my health care and as such am given reliable and current information so I can make informed decisions.
I can express my appreciation or concerns about my health care experience knowing that my health care providers are actively listening.

Notice the words, “I value that:” Doesn’t it kind of seem like a priveledge bestowed upon us by those holding all the power?

GRH20131118%20Overall%20patient%20experienceLook, I understand that hospitals have had trouble with wait times, levels of service, even ‘events’ as they are called where people have died from infections while in care. And I get that hospitals are putting standards into place across the board to alleviate health care system inadequacies. These are positive improvements and they have my unwavering support; I just seem to have fallen through the cracks on…a bad day?

I don’t want to be labelled a complainer, difficult, or be dismissed, but the result of the conversation with the administrators was, well, no result! I was thanked for my input. I am data for statistics I guess. And, I kind of felt my evidence was being filtered though a he-said/ she-said way.

What I really wanted was a road map of the improvement process: Where’s the flow chart that shows how a complaint is followed up? Who along the line reviews the complaint, and above all, what steps are put into place to correct the situation and ensure it doesn’t happen again? It would be easy to send a memo to staff reminding them to be more compassionate with patients. There are a number of quality improvement resources accessible on-line for compassionate care, even webinars and seminars, and there are best practices throughout the hospital community.

I am not satisfied. That I am left with no resolution is a failure.

Turquino Peak

There’s a Cuba story rattling around in my head that I’m struggling with to find a starting point. It’s based on a day trip to Turquino National Park, site of the Turquino Peak – at 6,500 feet, the highest peak on the island on the southern coast near Santiago.

This morning it was a typical travelogue: Flora and Fauna, breathtaking beauty, and the geography and biology from changing tree zones to salt weather dry landscapes. The terrain, the adventure, the snippets of insight like the onion field, and other tourists who didn’t arrange a guide turned away indignant.

But this is Cuba, and while some things are visible, like the mountain, they are also partially hidden unless you look:

How do I speak of the layers of human geography that have worked their way into the culture, language, and history? How do I represent Cuban life, in it’s desperation and opportunity, like the symbiotic relationship the Catholic church has with Santeria?

What about endangered species of wildlife like the Fernandina’s Flicker, a woodpecker with about 600 remaining nesting pairs, and plants affected by micro farming in arid soil that washes away in a hurricane along with coastal roads that the most affected rely on like a lifeline?

How do I mention colonial masters, the Spanish, French, British and Americans changing control like hands of cards, or the Soviet Union that centralized the economy and ownership before bailing in ’91, unleashing economic chaos?

What do you do with Fidel and Raul, national heroes and international pariahs?

Good contemporary Cuban writers live off the island, as freedoms were restricted and jail possible, but now political prisoner exchanges are more common and people are being let out, with twenty thousand visas being awarded each year. How do we find the artists and artwork in between the tacky souvenirs?

The small whitewashed homes along the road to Turquino – whose inhabitants can now somehow purchase – are interspersed with the Indian-style wooden huts with banana-palm roofs. The occasional river bed is a dry, rocky scar on the scrub-lands. Pigs and goats roam free, eating the crabs crushed by the occasional car locals call ‘coffee grinders’ for their reverse engineering.

Here, by the Caribbean sea, the coconuts grow yellow.

Moped Diaries

March 19 2015

Moped to Chiverico (Chee-ver-eeko). Along the winding Route 20 West from the resort, the tarmac reflects the afternoon sun’s heat. On one side, dry farmland reaches out to the sea. On the other, tiny homes, some of weathered mahaogany boards and Indian-style thatched palm roofs seperate the view from the Sierras to the North. The wind at our back helps my first time on a moped – ever. The instruction consisted of how to turn it on and off, and where the gas goes; they gave me a litre to start and told me I had to fill it up in town, 20 minutes away. Three minutes into the trip I notice my speedometer doesn’t work.

Along the road I pass locals on horses, horse and carts, bicycles, and on foot. Cars are sparse. Cubans wait every kilometer or so at the side of the road for “local taxis’, large diesel trucks or old pickups, and stand in them peering out their slit windows or sit on tailgates and sides unrestricted by safety. Occasionaly a truck stops ahead unloading its human cargo and spewing diesel, or worse, a mixture of gas and diesel that smells like kerosene and chokes my throat. I am learning to use my mirrors as the trucks have loud agrressive horns. Lynda hangs on tightly.

The sea closes in on the winding road now, around bends that reveal the stunning coastline: rocky inlets, small bays, and green seas. The Sierras loom closer, occasionally touching the road, their heavy rocks dotting the gravel road side.

I spot the gas station in Chiverico, not easy to see from the road. We turn in. The street is jagged stone with dips and holes and we come to a bumpy stop. I need the attendant to put down the kickstand. Four litres and a few pesos and, struggling to turn around, we’re back over the rocky path towards the centre of town.

Chiverico’s main street is a hundred yards from the sea. On the North side the small bright-white stucco buildings reveal a bank, a cinema, and an office of the communist party, with several restaurants like Mariposa (butterfly) – found in all towns. On the South side there is a public square and a bar, cafe, and food-stands that accept the CUC peso – the tourist dollar. Cuba is a country of two currencies. The CUC (locals call it ‘Kook’) is connected to the American dollar value and used by tourists. The national currency is what Cubans use. Their peso is worth a fraction of the CUC peso – something like 15 to 1.

Local taxis in Chiverico are horse-drawn carts with benches. They costs one national peso. There doesn´t appear to be regular stops and they fill the street, weaving in and out of pedestrians and trucks alike. Tourists aren’t regular in Cheverico. It’s not high season and we are stared at – local entertainment. It takes minutes to go through the main street and out of town so we turn back, take a left turn, and enter the back streets. The tiny houses sit on dirt roads, or worse, the rocky, bumpy streets when there are streets. We drive slowly, weaving side to side and balance uneasily. A youth is getting a haircut in a barber chair in the open air out front of a house. Children in school uniforms are everywhere. Locals sweep dropped leaves from their dirt yards. A larger street is busy with truck taxis and we pass the school letting out. Around a corner we discover concrete apartment blocks. These Russian-era fortresses are in all the larger towns and cities. Most have some kind of decorative form, wasted though in their obstruction of the landscape – they stick out coldly. We spend minutes here and circle back to the main road. That is Cheverico.

Back on the highway East, we laugh at the pigs, goats, chickens, and the dogs that cross in front – amusing and trecherous. The pigs look wild but locals call them ‘shiny’ pigs. There are two kinds of pigs in Cuba: shiny pigs, and Canadian pigs, the pink ones that are imported for tourists. There are Canadian and Cuban chickens too. Local animals are free range and without hormones. The animals are let out to roam the countryside in the morning and gathered by the farmers at night. I can’t figure out how you would know your shiny pig from your neighbour’s.

Picking up speed the wind presses against me. Air conditioning. I don’t tell Lynda but I get the bike up to full throttle on the straight-aways. I have a Monkeys song in my head. It seems appropriate – from one of those fun 60’s movies. The film I think has them riding mopeds…I don’t know the words – just the hook… “I’m a believer.”

Cuba Libre!

Let’s get this straight. This is a resort, not the anonymous urban hustle and bustle of Havana I fell in love with in 2013, with its diesel smell and uneven streets. Resorts in Cuba are a mixture of consideration and indifference – even farce. Everyone is playing a game. Inside the elevator the sign reads 10 personas. I like to think the resort is filled with personas caught somewhere between unrestricted freedom and social constraint.

There are the ones from the plane already in flip flops, their tans and ruddy noses carefully cultivated from prior visits south, who run strait for the lounge bar with their luggage still cold from 35,000 feet. You see them late at night in small groups of miss-shapen waists and open shirts. By day two they know the bartenders by name. They sport ‘bubba’ mugs of mohitos by the pool during the day. They live life large. So do their men…but in Speedos.

Many though crave privacy and speak in hushed tones. Couples whos routine lives need a routine stop in discount luxury. All-inclusives remove the complicated decision making of what to have for lunch or dinner. For a week their ‘adventure’ consists of a bus tour and a bottle of rum they won’t open back home. You see them strolling slowly around the resort in socks and sandals. They have limits.

Inevitably you’ll find the middle-aged adventure tourist who either came on a last minute “why not’ whim from their lives as teachers or marketing professionals, or they are obviously slumming. They pratice yoga. They wear Merrils and high-tech accessories, never speedos, and take side trips to markets in local towns, not being seen for entire days at a time until they pop up on the bus back to the airport. They pack lightly and smile confidently, knowing something we will never know.

For my part I deconstruct the group personas looking for individuation, re-branding them through careful observation. Broad-shoulders slinks away from her partner in her long clingy black dress. They can’t be married, their lives are so complicated back home. Lynda nudges me in complaint because they alone danced naturally, intimately – for a few seconds – to the lounge guitarist, before she floated to the bathroom. They were out of their Merrils now, looking as comfortable in casual dinner wear as they did around the pool earlier, flowing in sarongs.

El Senorita was more of a dilemma. She seemed at first to be the single woman looking for a group to connect with. Sixty anyway, she was joined on a bench after dark by a somewhat younger Cuban. For a moment we were distracted by an undertone whistle. It was familiar from other trips as a signal from young male hustlers looking to sell you anything after dark – a non-verbal shout to attract attention. Senorita got up and went to the bar. In seconds a young buck emerged from shaddows behind us, and, walking past the Cuban on the bench gave him a high five. To us it indicated they were in collusion and the Cuban on the bench had scored an adventure for the night with the older Senorita. It explained the small groups of fashionable Cuban men here and there on the grounds of the resort after dark. Look, whether it is romance or a cigar you are after, someone somewhere is looking to shill you out of your pesos. Good on El Senorita!

I probably look a sight worse to my fellow deconstructionist vacationers. For one I am neurotic enough to be hard to nail down. I have long straw-like hair for my age, and I wear the most obscure event and festival t-shirts like Rock and Rumble. I am forever changing clothes, like camouflage, because I brought too much, and I avoid the sun like Dracula. And, I prefer not to engage – giving only sideways remarks to Lynda as though she’s taking dictation on my scientific study. Well why not. I don’t party with my bubba mug and Speedos (anymore) and my own persona changes depending on my mood and anxiety level. In the end though, I appreciate the characters in my drama. They are after all just like us – trying to get through another winter back home; real people in all their glory, and perfect just the way they are. I feel safe here. Wait till the American’s return to Cuba.

Footnote: 6:00 am. Thursday March 19. Staff are watching a soap in the lobby bar. I can only pick out a word or two in the 1920’s period piece, “puta,” and “vamos.” The night bartender, housekeeping, front desk, and grounds staff hang out before the tourists awake, taking advantage of the soft couches and free coffees. Two of the characters on TV lock in a kiss that lasts for minutes as “Somewhere Over the Rainbow” plays languidly. Staff are glued to the small screen, chattering and laughing in Spanish; a dreamy moment of hapiness. Spanning the entire wall behind the bar and crossing the large open lobby to the ceiling two stories tall is a mural of the cathedral in Santiago with the Sierra Madres in the background, and wispy clouds reaching up to blue sky. In the mural the small, colonial style houses adorn the street scape with Terra-cotta tiled roofs in imitation. It is still dark outside. I like this place.

My Visit to St. Mary’s Hospital ER- March 3rd

“The friends that cared didn’t understand either. They tried to help. They suggested the gym and gluten free diets. They had forgotten how much Shiny Girl loved to run and thought she needed motivation. Shiny Girl wanted to scream “DONT YOU THINK I WOULD IF I COULD!!” Instead she smiled and thanked them for their advice. Shiny Girl went to doctors. They said she was depressed. When Shiny Girl said, “I think it is something else”, they scoffed at her. Why won’t you take the medication we are giving you? In Shiny Girl’s weakest moments, they refused to listen to her. They refused to look into other possibilities. With Shiny Girl’s last bursts of strength, she insisted. They finally did the tests half heartedly. With scorn, they scheduled the tests she had insisted upon. With each negative test, they challenged her. “When will you accept that this is all in your head?” they silently stared through her. When she asked for a test, they asked her what disease she was inventing now. They wondered if she was a drug addict or looking for a lifetime of welfare. They would not say it out loud, but their eyes screamed the accusations. As did their sighs when Shiny Girl begged for a few more tests. They did – They did them grudgingly, then shoved them to the side of their desk with the rest of the paperwork. NOW will you leave me alone, Shiny Girl? Shiny Girl felt as discarded and ignored as the medical files that bore her name. Shiny Girl became Complainer. “ – excerpt from another blog…

I took the route 25. Getting to the bus terminal was a repeat of going to work half an hour before. One foot in front of the other. I was exhausted. I had sat in my office chair and sent the e-mail saying I had to leave, then put my coat back on and walked out. I smiled at anyone I met. Better not to reveal the excrutiating nausea I was feeling, or the penetrating weakness. No time to explain. Just keep going; groggy.

The snow had started. I didn’t realize it at first. I didn’t realize much of anything focusing on my steps. At one point I thought I might need an ambulance to meet the bus. It was so hard to move. But somehow I was able to get up at the stop for the hospital, and shuffle off into the fast falling snow. In through the revolving door, I pressed the touch screen and scratched my name on the registration form. Number 24.

I had come to St. Mary’s because they had a good patient charter of values. I’d heard some things about the treatment being more patient centred – maybe even more compassionate. It fit my mental construct: priests walking the halls with rosaries. I know, a bit archaic, but since Grand River it made sense to chose the alternative. I even thought the day before that if I needed someone to talk to about my condition, there would be someone around a corner in a robe waiting to hear my confession. “I’m an atheist,” I would tell them, “but I think I should start talking about my end of days, do you have a while?” Maybe I could be a little religious if they wanted me to be, you know, if it helps.

I had foresight. I had weighed up going to the ER for a couple of days. I was off work the day before and had taken the time to write down my primary symptoms: Fatigue, dizziness, trembling, headaches, and added a couple more just to be safe: nausea and sweating. In hind-site I missed one: I had cramp in the large muscles in my legs; first the left, then the right, then back to the left again. It wasn’t that noticeable and sort of a distraction I thought was related to my diabetes. You get knee-buckling weakness when you have a low blood sugar. I had felt it before. And besides, I had written my note already, placed it in my wallet for safe keeping; just in case. It had my medication dosages, my history of bipolar and diabetes, and the other occurrences of the symptoms over the past couple of months: three times including Grand River.

I got out the note with my health card and registration form and sat down across from Triage. I could barely keep my eyes open; half shut more or less. I caught bits of conversation between the triage nurse and a patient – he was joking and laughing. I wanted them to finish so I could hear what number was next. 25. Good – it wouldn’t be long.

The day before I had thought about bringing a pillow. I knew how uncomfortable the seats would be and I knew I would be tired. I put my head back against a window, and my mouth stayed open. My head rolled forward until I could bring it back up again. I started to slide off my seat and struggled to stay upright. My eyes were nearly closed. I saw very little anymore and fought to keep them open. I wasn’t alert at all. I couldn’t focus my attention and my head just kept flopping back and forward, mouth open. I was so tired.

Shadows came and went in front of me in the bright waiting room. I mouthed the words help. I didn’t know what to do. One green blurry shadow went into a door in front of me and called my number in a woman’s voice. I motioned for her to come over, and I mumbled something about not being able to move. I could only say a word or two with effort, and my breathing was shallow. It was the start of the nurses voices; commanding and abrupt, like the one on the phone at Grand River two weeks before. It wasn’t a priest’s compassionate tone.

The shadow with the woman’s voice brought a wheelchair over and asked that I get in. She tried to support my arm but I slumped to the floor on my bum, my head still flopping around, mouth still agape. She said if I was able to hold on to my chair I should be able to pull myself onto the wheelchair. I wasn’t holding on to my chair actually, I had just discarded my arm and hand there – left them behind when I buckled – forgotten. More shadows. Two more I think. One in purple maybe. They were telling me to bend my knees. I didn’t understand. I was thinking slowly about their words but they kept talking. “Bend your knees, come on; ” abrupt, dismissive. I told them I didn’t understand.

I wanted to say “Please be nice,” but I was too afraid. I wanted to hear the words, “It’s O.K. We’re going to help you,” but they never came. Nor did the angels on clouds. “Get his belt,” one said. “He’s deadweight,” another stated. They gave up pulling on my arms and I felt my belt tighten, and then my pants did a wedgie as the shadows heaved me onto the wheelchair. “I’m not going to bother triage,” one said, coldly, “just wheel him in.”

At a point I actually felt embarrassed. It’s funny how you think of things in the moment. I was glad the waiting room wasn’t busy. What would the other people think? Drunk maybe? I thought that I was dressed casually but professionally, couldn’t anyone see I was not one of ‘those people’? I decided quickly I didn’t care. And that was probably for the better. I was not quite in the wheelchair, and, as the automatic door opened in front of us, my arm that draped over the side banged loudly against it. The shadow jostled me to come at an angle in order to fit.

“Put him in recess.” I thought I heard them say. Or it might have been “re-suss,” which is short for resuscitate. Apparently that’s the ER cardiac arrest unit with specialized equipment. I’m not sure though as I didn’t look around to notice. It was just bigger, and there were more of the shadows. They were trying to get me to stand up so they could put me on a gurney. I wasn’t able to move well and wobbled when they got me upright. I think I told them my arm was stuck between the wheelchair and the gurney frame. I don’t remember lifting my legs up at all but I was on the bed finally, with nurses moving around me. I could only make out one of them; red sleeves with blond straight hair. She seemed like she was in charge. No facial features that I can remember. My mind was going so slowly.

I was asked to help get my shirt off. They had stripped my jacket and sweater, my arms flailing everywhere. I pawed at my shoulder, grasping at the material, and sent my glasses flying somewhere as I pulled at my shirt. I think they helped. It was a confusing hurly burly of arms and commands all at once. I was crying. Not sure if it started in the wheelchair or on the gurney but it came anyway. I kept saying “I’m sorry. I’m so sorry.”

They slapped stickers on me. They poked and prodded. I could only hear one at the side, seemed to be sitting at a desk, in what seemed to be a scoffing tone, “He wrote a list.” She read the notes I had written faster than I could respond to questions. “He took a bus.” someone said. Sounded sarcastic to me. I could barely get a word out. I can only assume they found my vitals were stable as there was a kind of release of pressure at once after only a minute or two and one by one the shadows left. It all seemed to take less time than it did to get me out of the wheelchair. My eyes were still mostly closed, the lights were bright, and red sleeves was still doing something. I heard her say something like,” did you crash in the waiting room so you could get in here quicker?” I knew what she meant. It’s hard to remember the exact words but that doesn’t matter. “I would never do that,” I responded through tear-soaked eyes. My hair was a mess I think. At some point she put my glasses back on my face. I can’t be sure she believed me.

‘Where do we put him?” a voice said as they rolled me out of recess. “I don’t know,” and then something muffled. I was finally in a treatment area with a blue curtain. At least it wasn’t a hallway. Red sleeves came in and out, put an IV line in two different places “just in case.” I couldn’t really see anyway but felt the pinches. My blood sugar was normal too. The order to things is hard to remember now, but I met my priest.

Dr. Lyn was a little wisp of a thing according to Lynda. She asked if they should call Lynda and I wanted her to come. Dr. Lyn stayed in front of me to either side at all times; bonus points. I couldn’t make out her face, just that she had dark longish hair I think. They had turned the lights off and I was putty in the bed. She leaned on the side rails and spoke to me in a soft voice but clear. She told me they didn’t know what to look for but they would take some blood work anyway. It came back negative. I should have asked for what, but forgot. I was beyond tired. I was lulled by her mercifulness.

Dr. Lyn asked Lynda to speak outside the curtain. I strained to hear and made out something about my mental health history. I heard the words psychiatrist and referrals. They new about my history at Grand River and the crisis clinic in October. I didn’t know until later she had asked if I had been committed, or if I could harm myself. They usually ask me that directly. It’s always no. No! I mean, what were they thinking? Why would someone struggle against exhaustion, in a blizzard, get on a bus, get to a hospital, be treated like dead weight, get a wedgie and banged into a door, feel humiliated and ashamed, and then want to kill themselves? It wasn’t until I got home that I read the small piece of photo-copied paper Dr. Lyn had pressed into Lynda’s hand. It was only an address and phone number. 480 King Street West. I knew the address: Grand River’s mental health crisis clinic.

Someone has to say something right? Someone has to advocate for patients rights – do you think? I was too exhausted and afraid to simply ask to be treated nice, and if not for Dr. Lyn I may have been too afraid to let anyone know about my experience – even if she’s thrown me back in a loop where I don’t want to go; backwards, not forwards. In some ways she is a contradiction, offering compassion but no hope. For the first while after, I debated not saying anything to anyone. I would carry on as if it didn’t happen.

There are dozens and dozens of possible conditions that accompany ringing in the ears, extreme fatigue – which I have had for three days now – dizziness, muscle cramping, trembling, sweats, and nausea. I do know that this is getting in the way of living my life. I also try to be proactive, which isn’t much help in the health care environment where waiting is the norm. I have to wait four more days until I see my primary care physician. My endocrinologist wait is undetermined. I will have to wait to see other specialists now – in this case I would like a neurologist, not a psychiatrist – and I will have to exhaust tests. I can imagine in my mind that babies left in baskets on church steps get taken care of by God – at least right away anyway. There has to be hope.

My Visit to Grand River Hospital ER

Until I received the phone call at home from the nurse that attended to me, I did not consider initiating a complaint about my patient care at the ER. I feel my experience with care providers was highly stressful, confusing, and ultimately unprofessional; certainly not what I would expect.

I went in to the ER complaining of fatigue, confusion, trembling, and headaches, but also nausea, and difficulty remembering details like what I ate for breakfast. I had some blurred vision as well. As a type 1 diabetic, I noticed a difference between these symptoms and low blood sugars. This was like another episode I had a week ago that lasted all day, and my blood sugars were fine then.

I am also diagnosed as bipolar and on medication. I have a history of anxiety, ADD, and I work in a highly stressful environment. I didn’t mention that I have a learning disability of sorts. There is a measurable difference between my cognitive processing and verbal acuity. Though my verbal scores are in the normal range, my processing is high, and this difference means that it is often a challenge to speak, or to get out words at the rate of my thinking. It takes a lot of effort to communicate verbally.

I understand that a type 1 diabetic condition puts me at risk for many complications, and with any perceived emergency I feel its good judgement to attend an ER. I have infrequent and challenging access to my GP, and my endocrinologist, which takes time – usually that I don’t have – to set up. I prioritize and trust in the response from an ER; especially when I am afraid for my life.

I manage my time in great detail through electronic scheduling. I record blood sugars, and all of my necessary business actions in the same database, which runs my life every day. After years of trying to accommodate medications, I have adapted to patterns and habits where I am seeing change for the better.

I try to minimize conflict or negative situations as they suck the life out of me. I would rather move forward from a situation and put it behind me than find myself ruminating for days. I simply cannot afford the time or impact emotionally. I have multiple projects at work that require my attention, and adding to my stress is not good.

It takes me time to communicate effectively, and I have to prepare for conversations with written outlines that allow me to focus. Otherwise, I prefer to communicate in writing, though this is a big commitment of energy and time.

My Experience at the ER

I was prepared for the waiting room, and, after triage, settled in with reasonable high spirits. I had brought information on my condition and medications. I had to mentally prepare as I have anxiety and ADD influences that can trigger negative reactions. I understand wait times.

I was taken into the treatment area and put in bay 17, and required to remove my clothing, which I folded and placed on a chair.

The ER nurse came in and asked about my condition. I did my best to answer, though I realized I had memory gaps and was confused and slow to respond. At some point in the next hour I experienced a low blood sugar, and was given some apple juice and I was reasonably comfortable. The doctor came in as well during this time and asked me again what brought me into the hospital. I noticed that I was adding more information about things like occasional abdominal pain, which were not part of my original complaint, but had presented by that time. I think if I was there longer I might have mentioned my broken signal light on my car.

Somewhere in the following hour, I was directed by the nurse to put my pants on, that they needed the room, and I was to take a chair in the hallway. I understand triage and priorities – not a problem – but I was hurried out of the room. At one point, I had my shirt on the bed as I dressed, and the nurse tossed it back on the chair it had come from, and continued to push at a pace I was not responding well to because of my condition. I felt I was not moving fast enough for staff.

I was pointed in the direction of a large chair placed in the hallway facing the work station. There was no place to put my clothes, so I hung onto them in my lap, half dressed in gown and pants. There was no call button for an attendant. For what may have been an hour, I sat in that chair with my clothes, unsure of what to do. I started to worry. The nurse in charge of my care had gone on break. I wasn’t given an update on the process, let alone some kind of encouragement, or empathy for sitting in what I came to realize was a busy hallway with patients, relatives, gurneys and food carts rolling by – haphazardly coming close to hitting me.

I admit at first I was indignant, however I also felt empathy, and even humour, finally settling on a kind of retreating fearfulness of ‘what if’s.’ What if they don’t remember I am here? I actually had that once before. What room am I assigned to now? What if my information gets lost? What if I need something, who do I ask? This last one affected me the most as I often have to overcome fear when interacting with the unknown, mustering up a lot of courage to initiate a conversation. I found myself stuck in a dimension of inertia – like moss – in my chair. I was at last seen by a blood nurse, and a couple of samples were taken. We had a joke about the hallway. She said it was the hospital’s new open concept. I laughed louder than I needed to.

After the blood nurse left, in my mind, I wanted out. I was telling myself I could just go. There weren’t that many people around now so it was time to make my break. I asked someone where I could “get dressed,” and I was pointed to a washroom. Seriously? It stank of urine. Wretched. I took off my gown and looked for somewhere to hang it, finally settling on a handrail. I considered tossing it on the floor in dramatic fashion but, well, no one was watching except me.

Fully dressed, determined, and not looking into anyone’s eyes, I walked out through several sets of doors into the cold, sunny day, bused it home, and sat on the couch overwhelmed by the day’s events. In my mind, they would call me if there was anything wrong with my blood tests. That had happened at least once, several years ago now. I debated contacting the hospital, and looked up the feedback information. I wasn’t going to complain, but everything was running though my head at once. I repeated few times to myself, “Is it me now, is it me later, or is it me not at all.” Back in the hallway there was a large poster about improvements to “the patient experience.” The doctor had been distant, emotionless, and the nurse was formidable. I can understand, really I can. But then I got the phone call.

It was the nurse. She asked me why I had left the ER. I tried to tell her but my words didn’t come out right. I was still processing. I stuttered something about my discomfort, stress, and fear, not really wanting to have the conversation, and trying to minimize conflict. But the voice wasn’t listening. I was told that taxpayers foot the bill for incomplete diagnoses and it was a waste. I asked about the diagnosis and follow up, and I was told there wouldn’t be any. They don’t give information over the phone. I tried to argue it had happened before, but I was cut off and denied. I was hijacked emotionally. Not only was I called at home to be lectured to, I couldn’t escape the emotional stress of the hallway, or the suffering from the medical condition that I would never know about. Anger ripped through me, and, as I pulled the phone away from my ear, I asserted I would be calling the administration to complain. I hung up. That’s it, I am sure they would label me difficult somewhere in my file.

I like patterns. They are dependable. Anything out of a routine for me is hard to accommodate, but I must maintain my flexibility for my own sake. I am self-aware. I eat the same foods more or less, at the same team each day of the week, and I do my laundry Sunday afternoons and I promise to call my mother Saturday mornings – in my mind at least I have security. I notice things that are different, like the day long trembling with the confusion, weakness, and headaches; and I worry. Today I noticed a more malevolent pattern: You can’t escape the power of large institutions. There’s not only the indignation, confusion and anxiety, and conflict you experience behind their doors, but they will also track you down and give you their two cents in your own living room. You can’t hide. Be afraid…be very afraid.