Saturday, April 16, 2011

Emergency Rooms in Toronto and Their Non-Emergency Policies

This is not my usual fashion article, but I feel I have to do this, and I can only hope that someone will hear me.

On Thursday April 7th, 2011 my 19 months old baby got sick. While at work, I was called by the manager of the day care he attends to advise me that my baby was sick, and to summon me to come and pick him up. Since my son started attending day care last November, he got sick a few times; and each time I was called by the day care staff to come and pick him up. Now, when I see their caller ID on the phone, my heart stops, because I know they are going to deliver bad news. They don’t make courtesy calls. The only reason they call is to let me know that my baby is sick and I have to come and pick him up. They don’t give me any options, I can’t argue with them that I am at work, I MUST go there and pick up my child. So on the said day, this is what happened – I got a call from the day care, I was summoned to come and pick him up, I took a day off from my work and I took my baby home to attend to his health. He had stomach flu.

By the next day, Friday that is, he felt better, so he attended the day care with no troubles. Thank God, I didn’t get any phone calls from the day care anymore and I could work in peace. But over the next weekend he felt worse, especially on Sunday, when his stomach flu symptoms worsened – watery diarrhea, vomiting, nausea, fever, shaking, stomach ache. Here I am, on Sunday afternoon at 4pm, with my baby sick, when my family doctor is not available, when any walk-in clinic in the city is not open anymore. So my only option was to go to the Emergency Room of the closest hospital – North York General Hospital.

I have never gone to any emergency room in Toronto before, primarily because I knew about long waiting times; and until recently, I have successfully avoided going to the emergency room for any health problems my family has had in the past. But this time I was not so lucky, as it was on a weekend, too late in the afternoon for a better option. So here I am, with my sick baby and my husband, at North York General Hospital Emergency Room. Before getting there, I was silently praying in my car for a reasonably short line; I was genuinely hoping that maybe not so many people in Toronto were sick and in need of emergency care that day; but of course, no such luck. When I got there, dozens of people were already waiting in the line.

First, we needed to register at the front desk. Fairly promptly. Then we were advised we would be called to a triage room. Only two triage rooms for whatever the number of patients. After about 40 minutes, we went to triage. Then, registering for the actual doctor consultation. And then – God help you, we will call you and you will be seen by a doctor. When I tried to ask about average waiting times, the nurse muttered something about “it’s very busy, maybe a couple of hours”.

So we took a sit in the waiting room, and waited. And waited. And waited. While sitting there and waiting, we saw different degrees of suffering. We saw a lady in her sixties who could barely breathe or stand. When she entered the room, in a shaking state, a staff told her “to stand in this line to get registered at the front desk”. That sounded ironical, because the woman was unable to stand, literally. I couldn’t figure out what exactly was the severity of her condition, but she was in a really bad state. However, for several minutes, nobody paid her any attention. Finally she was given priority and taken to be seen by a doctor.

Then I saw another guy (or maybe before that, I don’t even remember) who came there helped by a couple of his buddies. The man was in his thirties, and he had an excruciating pain in his arm. He seemed to have suffered an injury due to some sporting activity, like soccer. When their group arrived, there was nobody at the front desk or at the information desk. Just like the lady before, he had to wait a too long time for his condition just to get acknowledged by someone from the staff.

Four hours passed, and nothing, nobody called us. My baby was starting showing signs of deep exhaustion, and I don’t even try to complain about me or my husband. So I went to one of the triage rooms to ask about our turn. The nurse from there showed me her computer screen – there were about a dozen people in the queue in front of us, but that could change any time for priority reasons. There were 3 doctors attending to patients. So I went back to my sit – at least I knew where I stood.

Some half an hour later I went to triage to inquire about the line again. This time, there was a different nurse in the triage room. So I kindly asked her where I stood, but her response was not as kind. She refused to give me an exact answer; more than that, she raised her voice at me. I insisted on asking how much more time I should expect to wait till I get to see a doctor; she told me maybe another two hours. Another two hours??? I couldn’t believe it!!! I had already been there for almost 5 hours!

I gathered there was no point to argue with her. Some time later (after 5 full hours of waiting there) I asked the same question, but of the lady from the registry, who was free at that moment. She sent me off to triage for an answer. That moment I lost it and broke into tears. While crying, I told her that I had been there for 5 hours and this is just not right. Then a security lady approached me and tried to calm me down. She was asking me “to stop yelling, because yelling does not improve anything”. The thing is that I was not yelling, I was crying. The woman, accidentally-on purpose, mistook my crying for yelling. She kept saying that she knew it was frustrating, but I should try to calm down. Only I didn’t need them “to know”, I needed them to act. Their “knowing” didn’t cure my baby instantly and didn’t make him feel any better. I needed a doctor to consult my baby, not them to know that it was frustrating.

It was 10pm, and for another unknown number of hours we had no chance to be seen by a doctor. By their standards, my baby’s case was not emergency enough. So after 5 extremely long hours of waiting for nothing, we just gave up and left, without any doctor seeing my baby. When we were exiting the room, the same security lady asked me with irony: “What, you’re not waiting anymore?” “No, I have been waiting here for 5 hours, I can’t wait anymore”. Unless I decided to move in, there really was no point to wait any longer.

When I got home close to 11pm, I was boiling of aggravation inside and out. I couldn’t believe I had to go through all of this. Why on earth do they call themselves an emergency room??? In my book, emergency means 5 minutes, not 5 hours.

The next morning, on Monday April 11th, my baby was feeling a bit better, so I took him to the day care, and my husband and I went to work. But during the day his symptoms worsened again. No wonder, since no doctor had seen him the night before. The manager of the day care called us to let us know about our son’s condition. Also, she made her case in pointing out that we should take a better care of our baby, almost accusing us of irresponsibility. Well, since my child care provider has such a fine sense of justice, she would be better advised to go to North York General Hospital Emergency Room and tell the staff from there that they are irresponsible for keeping me waiting for nothing for 5 whole hours, not us for being completely powerless in a long line in a so-called “emergency room”.

I had to take another afternoon off from work (yet again!), to pick up my child. This time I took him to my family doctor. But I wasn’t satisfied after this visit either. My doctor saw him. I mean, literally, just “saw” him, like in “I acknowledge your presence in my office, nice of you to visit”, nothing else. Due to the fact that my child is under 2 years of age, no actual treatment for his diarrhea has been recommended. My 19 months old son was expected to heal by himself, and his symptoms were expected to go away by themselves as well. I begged for something, anything. My doctor kept shrugging: “He’s under 2 years old, no prescription drugs are available for him. What can I do, what can I do?” Well, you’re the damn doctor, you should know better what you can do!!! Whatever home and non-medical remedies I have been trying for the past 5 days, it was just not working. Finally, after an extra hour spent in his office, I was recommended some over-the-counter medication.

But my son’s condition didn’t improve overnight, so the next day I took him to SickKids Hospital Emergency Room, where a pediatrician could see him. I really hoped this time would be different in terms of waiting, since it was a medical facility dedicated to children only (vain hopes, of course). I got there in the morning. The triage and registry process was much faster than at North York General Hospital. But after that, the same obscenely long waiting. They always tell you “maybe two hours”, but make no mistake – there is no such thing as two hours in an emergency room. Two hours would actually be nice, kind of waitable. After 3 hours, I asked a nurse about where I stood. She explained me very nicely that my baby was assessed in the second category of emergency (out of three categories), and at that moment there were 5 people in front of me (2 in the first category, 3 in the second, or vice-versa, I don’t remember); but that could change any minute, depending on the new incoming patients. 20 doctors. Ok, that should make a difference, as opposed to the only 3 doctors from North York Hospital. And I couldn’t help but notice the careful way she spoke to me, comparing to the other one from North York, who practically yelled at me when I insisted on finding out what was going on.

After another hour, I asked again – 5-6 people in front of me. Uh-uh, nothing changed in the last 60 minutes, at least not for my baby. Also, I was told that other people had been waiting for even longer – and this was supposed to make me feel better or what??? This was supposed to instantly cure my baby? And what baffled me the most was how come the waiting times were just the same, with 20 doctors? With so many doctors, one would think, the line should go just like that, but no! I was already starting feeling sick after so many hours, on top of the fact that my baby was sick, but nobody was going to give me, an adult, any medical care, since it was a children’s facility, right???

Then I tried a different approach. I asked the nurse why I wasn’t told that I should expect a much longer time, due to the fact that my baby was assessed in the second category of emergency, and not in the first one, in the first place? Her answer was that they never do that, because if a patient wants to see a doctor, they will see a doctor, but no “when” mentioned. Oh, so now they are politically correct. They will never say to a patient’s face that they shouldn’t stay there, if they wish to see a doctor. Now, after 4 hours, they’re telling me that I will get to see a doctor, sometime in the near future. But I really would have preferred them to be honest with me, rather than being politically correct, and tell me from the very beginning something like: “Don’t expect to be seen by a doctor in the next 10 hours, because by our standards you are not an emergency case". Neither their politically correctness nor their nice speaking won’t help me and won’t cure my baby, but their honesty would be much more useful, so at least I could know what are my chances.

And so, after 4 hours wasted there (two times in a row!!!), I gave up and left. I can’t live in an emergency room, can I? Thank you for nothing.

By the end of the week my child got well, finally. Now he is ok, but NOT thanks to the doctors, and certainly NOT thanks to the emergency rooms.

From time to time I get phone calls from political parties asking me about my voting intentions. They are very careful to attract voters, but next time when they call me, I’ll ask them what are their strategies to improve the public health care system and the emergency room policies. And let’s make it clear – just because it happens in every single emergency room across the country, it doesn’t make it right. Unless you are shot, have a heart attack or have been in a car accident, nobody deigns to even look at you in an emergency room. This is unacceptable, as “the understatement of the year” as it may sound. As for me, after this distressful experience, now I seriously question my trust in doctors, and I will never ever go to an emergency room again. Ever.


  1. Of, Victoria, imi pare tare rau ca ati trecut prin asa ceva. Sper sa fie ultima data.

    Si, de asemenea, imi pare rau sa aud ca si Canada incepe sa-si arate coltii. Auzisem de la multe persoane ca sunt foarte superficiali acolo si atunci cand mergi la medic doar se uita la tine si iti spun ca esti in regula. Mi se pare ridicol...

    Nu exista sistem perfect, asta e clar. Oriunde ai fi pe pamantul asta, exista macar un "domeniu" unde lucrurile nu merg cum ne-am dori. Sigur sunt si tari unde nimic nu mai merge cum trebuie, dar nu cred ca ne consoleaza cu ceva.

    Eu sunt de principiu impotriva spagii, dar chiar ma gandeam la situatia ta... cred ca intr-o astfel de situatie, tare bine ar fi fost sa putem rezolva lucrurile cu o mica spaga, mai ales cand e vorba de copilul tau si stii ca ai face orice pentru el.

    Apoi, legat de day-care, ma gandeam la ce zicea fostul meu sef. Ca nu degeaba in Romania e concediul de maternitate de 2 ani, ca un copil are nevoie sa creasca langa mama sa in primii 2 ani. Nu stiu insa daca altundeva in lume se respecta chestia asta. Si cu siguranta nu in Occident, unde sistemul te pune sa alegi: familie sau serviciu, ca amandoua mai greu. Nu stiu care sunt solutiile in astfel de situatii. Mi-e greu sa ma pun in situatia unei mame. Acum insa le inteleg pe femeile din SUA care aleg sa stea acasa cu copiii...

    Eu am mers la gradinita abia de la 5 ani si a fost cea mai oribila perioada din viata mea. Pentru mine nu exista experienta mai urata. Ca sa nu mai zic, ca fiind sensibila, ma imbolnaveam des. Si acum cunosc astfel de cazuri - baietelul se imbolnaveste foarte des, il tin acasa o saptamana-doua si cand se reintoarce la gradinita se imbolnaveste iar. Cumplit!

    Nu ati reusit sa gasiti o bona buna si sa aiba grija de el acasa? Stiu ca e la fel de inspaimantator sa lasi copilul in grija unui strain, insa stiu ca sunt agentii a caror selectie e foarte riguroasa cand vine vorba de babysitters.

    Va doresc multa-multa sanatate!

  2. Buna Americanca, multumesc pentru mesaj. Si eu sper sa fie ultima data, pentru nu mai intentionez sa mai merg vreodata la Urgente aici in Toronto.
    Nici eu nu stiu de alte tari care sa aiba 2 ani concediu de maternitate, cum a fost in Romania pana anul acesta. Acum nici romanii nu mai au 2 ani, Boc le-a luat si acest ultim lucru bun care a existat in Romania pana acum. Incepand cu ianuarie 2011, au scurtat concediul de maternitate la 1 an.
    Am o prietena in Romania, care a nascut in 2009, si care a intrat in concediu de maternitate de 2 ani (inca mai e in concediu). Ma bucur foarte mult pentru ea ca a apucat concediul de 2 ani, nu cum au patit mamicile care erau insarcinate intre vechea si noua lege; care si-au planificat familiile cand contau sa aiba 2 ani de concediu, si la nastere s-au trezit ca au doar 1 an.

  3. Si cat priveste bona, intr-adevar nu e un lucru simplu, sa dai copilul pe mana cuiva strain. Am avut o bona la inceput, cineva pe care cunosteam bine, dar numai timp de 2 luni, de cand ne-am pus pe lista de asteptare la gradinita si pana cand s-a eliberat un loc pentru copilul nostru. Asta si a fost intelegerea noastra cu bona -- va sta cu el pana cand va putea sa mearga la gradinita.

    Intr-un fel, gradinitele sunt ok din anumite puncte de vedere -- il ajuta pe copil sa se dezvolte ca fiinta sociala, sa nu fie prea timid, etc. Sunt avantaje si dezavantaje atat cu gradinita, cat si cu bona.

  4. Imi pare rau, Victoria, trebuie sa fi fost tare frustrant. Bine ca s-a facut sanatos. La urgenta o fi cum o fi, dar ma surprinde faptul ca doctorul de familie nu i-a dat chiar nimic sa se simta mai bine.
    Mie imi dadea bunica-mea ceai concentrat de menta cand aveam probleme asemanatoare si chiar ajuta, dar nu eram chiar bebelus, nu stiu ce efect are asupra copiilor foarte mici.

  5. Catintherain, nici macar nu este prima oara cand mi se intampla asta. Cu vreo luna inainte de incidentul cu emergency room, a mai avut odata diaree. Nu l-am dus atunci la urgente, dar am mers la farmacie sa ii iau ceva pentru diaree. Ghici ce mi-a zis farmacista -- ca are sub 2 ani si nu se da nimic la copii de varsta lui pentru diaree. Mi se pare penibil. Bun, nu-i dai unui copil mic medicamente puternice, dar ceva potrivit pentru varsta lui trebuie sa existe.

    Asa i-am dat si eu ceai de menta, l-am hranit la greu cu orez, dar acestea n-au avut evect imediat, a durat zile in sir pana s-a facut bine.

  6. Ugh, Emergency Rooms are awful - I had to go one time and waited and waited. It wasn't like there were pregnant ladies or gunshot victims. It is particularly hard with a baby, because there are few urgent care centers where you can take them if they have a middle of the night earache. IF you want to get seen at an ER, go with your ailment, and then chop off your finger. That should bump you up by at least an hour. :)

  7. Hi Kristen, welcome to my blog and thank you for stopping by. Now I've learned my lesson about emergency room. I guess I had to go through this experience to see how it really is.

  8. Imi pare rau ca a trebuit sa treci prin asta. Credeam ca in alte tari e mult mai bine ca in Romania, aveam impresia ca numai la noi se intampla asa ceva...
    Si asta cu pastilele la copiii sub 2 Romania nu cred ca e valabila..Nu am auzit de asa ceva.

  9. Mihaela, da, asa stau lucrurile aici cu urgentele. Nicaieri nu exista un sistem perfect, fiecare societate are bubele ei, iar ceea ce se intampla in departamnetele de urgente din spitalele canadiene este clar o tara a societatii de aici. In SUA se intampla cam la fel.

    O alta problema care ma deranjeaza, si de care nimeni nu se sinchiseste, este ca doctorii fac mai multe programari decat pot sa onoreze. Cand merg la doctorul meu de familie, niciodata nu intru in cabinetuil lui atunci cand am programarea, ci dureaza cel putin o ora pana intru in cabinet, si asta pentru ca doctorul tot timpul intarzie cu programarile; are de exemplu 6 programari intr-o ora, dar poate vedea doar 4 pacienti in acel intreval de timp. Si atunci de ce ma mai obosesc sa imi fac programare din timp? E aiurea.


Thank you for your comments!