Wednesday, February 23, 2005

READER RESPONSE -- More on Canadian health care

Posted by Craig Westover | 10:10 AM |  

Note: When I first interviewed Dr. Lee Kurisko for a column on the failings of the Canadian health care system, he told me about his brother, who is suffering from advance stages of cancer. When Dr. Kurisko left Canada to practice medicine, little did he know that the health care system that prevented him from adequately treating his patients would, in a metaphoric sense, extract its revenge on his familiy.

Below, Dr. Kurisko's mother, Joan Skelton, writes about her ill son's experience with the Canadian system. It's a very moving piece that appeares in today's, a leading Canadian online news source.

An aberration in a natural pattern

With so many other grieving parents, I weep at this variance. I am 25 years older than he is. I should be dying, not him.


On Christmas Day, my 48-year-old son was taken to Emergency, gravely ill. I watched his eyes rolling back into his head, his lithe, runner's body arching in reaction to pain, his speech slurred from a malfunctioning tongue, his eye drooping. Only morphine would control his pain.

He had actively been in the medical system for three months with golf-ball size lymph nodes, head, face and neck pain, blocked ears, difficulty swallowing, weight loss and fatigue. His treatment was a stent in his ear, then the recommendation of two weeks of bed rest because of "exhaustion" and "viruses," finally antibiotics for "sinusitis" and Percocet. Percocet! Then, a CT scan showed the possibility of a tumour. Appointments were made for weeks hence.

In Emergency, we were told no MRI's were performed on Christmas Day. Ever. With great family pressure, a MRI was performed on Boxing Day. The diagnosis: No tumour. "Sphenoid and left ethmoid sinus disease." The diagnosis, even to laymen, was not logical.

A copy of the MRI was obtained and my radiologist son from Minneapolis flew in. While I set the table for dinner, he sat at a computer table reading the fateful MRI. With sadness, he informed us his brother's problem was not a sinus infection. It was a baseball-size tumour in the nasopharyngeal area, extending back to his C1 vertebra and eating into his skull. No wonder he had pain. With dread, it fell to one brother to inform the other he had advanced cancer.

No one at the hospital questioned his interpretation of the MRI or his diagnosis. Another more extensive MRI confirmed it. After seeing an ear, nose, and throat specialist, a consultation at a cancer centre was arranged, but not for 10 days because New Year's Eve Day fell on the regular assessment day, a holiday at the oncology unit. However, despite an appointment card being issued by the ENT specialist, no appointment was made at the oncology unit! "Holidays," was the explanation for the error. No apology. More delay.

Moral of the story: Don't get sick on statutory holidays. Educate one of your children to become a radiologist in order to catch diagnostic mistakes. Be a squeaky wheel. My son and his wife are gentle, uncomplaining people; my son a stoic. Generally healthy, at arm's length from the faults of the Canadian medical system, they trusted it. Had my son's cancer been caught when the first subtle symptoms appeared last March, his chance of survival would be more than 80 per cent. Depending on the type of cancer, it may now be as low as 20 per cent. Despite the magnitude of the problem, despite the bungling, he had to wait three weeks for treatment to begin.

A huge cost to the system was incurred as it scrambled in slow motion to rectify its errors. Consider, too, the human cost. His unnecessary suffering. The strain, no matter what the outcome, on his wife, his three young children, his law firm, church, his friends. His father and me. Consider the possible loss of this unique window of consciousness that is life; his life, his never-to- be-replaced life. So often we forget how unique and special each individual life is.

I have moved from secret weeping, to anger, to depression. I have seen the death of my parents, my friends, my dogs, all with the realization these events were part of the grand and mysterious scheme of things, part of a pattern. To see a child dying is unnatural, aberrant, not part of the pattern. With so many other grieving parents, I weep at this variance. I am 25 years older than he is. I should be dying, not him.

Yet, if the universe is infinite, the death of a child may not be part of a pattern, but it is certainly one of the infinite possibilities.

Realizing my depression, I also realized my attempt to escape life would help no one. I forced myself to return to tai chi, to stretching and skiing and my writing. We began a search for a place to which we could move temporarily to be with my son and his family. Whatever I do, though, has lost its joy: the mind-body meld of tai chi, the enclosure in the swirling arms of snow-laden trees while skiing, the thrill of capturing a thought in the written word, all this has gone.

At least four health professionals made grievous mistakes in the care of my son. Were they irresponsible? Negligent? Incompetent? Unlikely. Undoubtedly, they are over-worked, tired, stressed out, scratching to maintain a semblance of sanity in a system that would suck out their soul, if they let it. Such is our Canadian health-care system.

Joan Skelton lives outside Thunder Bay, Ont.; her ill son lives in southern Ontario. She is the Mother of Dr. Lee Kurisko of Minneapolis.