The trauma team treat a patient in the emergency department at Sunnybrook Health Sciences centre in Toronto, Ontario Tuesday, November 19, 2013.Kevin Van Paassen/The Globe and Mail
This is part of The Globe's three-month series on the challenges facing Canadian hospitals. Follow @Globe_Health, tweet with #thehospital or email thehospital@globeandmail.com to join the conversation.
As soon as I heard fire on the morning news, followed by a report of a young woman being pulled out of a basement apartment in critical condition, I guessed she would be going to Sunnybrook Health Sciences Centre, the tertiary-level trauma facility in Toronto. If she survived the ambulance ride, and I sincerely hoped she would, I knew she would be whisked into the emergency department and up to the high-level burn unit on the seventh floor.
After several weeks hanging about the hospital, shadowing doctors and nurses and trying to navigate the maze of corridors and departments, I have become sensitized to any mention of Sunnybrook, the way I began noticing ginger-haired strangers after I surprisingly (to me anyway), gave birth years ago to a daughter with a shock of copper coloured hair.
At the hospital, I have seen patients in pain, despair and confusion, but the overwhelming emotion is hope – hope that babies too small to breathe on their own will thrive, hope that knee replacement surgery will reduce pain to a fading memory, hope that the results of the cancer tests will be negative.
Hope that all will be okay, if not today, then soon.
Most of us show up at a hospital emergency department some time in our lives. I don't remember my first visit, but it was probably after I fell down the basement stairs of my parents' suburban bungalow when I was five and did a header onto the cement floor six steps from the bottom. Now that I think about it, my son took a similar tumble down the narrow cellar stairs of our urban Victorian when he was about nine months old. We both survived our falls and our experience in the hospital. Over the years I have headed to a downtown hospital emergency department with a toddler screaming in the night from an ear ache, complied with an orthopedic resident's directive to hold my child's broken and dislocated arm while he yanked it back into place, and had all manner of cuts and broken parts fixed.
Nobody in my immediate family has suffered a stroke, a serious burn, or been mangled in a traffic accident. We are lucky. Others aren't. But it may be our turn tomorrow or next week or the year after next, so I'm keeping my fingers crossed that doctors, nurses and paramedics are alert, trained, caring and caught up on their sleep.
Considering that close to 60,000 patients show up at Sunnybrook's emergency department every year, the place was surprisingly calm and quiet on a weekday afternoon, the day before the news flash about the fire in the basement apartment. Because Sunnybrook is a tertiary-level trauma centre, things pick up during rush hours and particularly on Friday and Sunday afternoons in the summer when frustrated and tired motorists make risky manoeuvres on the highways to and from cottage country, or in the early weekend hours when parties and drug deals go sour and gun shots pierce the pre-dawn stillness.
Even so, the tranquility of the ED belied the noise and commotion of television serials like ER and Grey's Anatomy. Partly, that is the design. The trauma and traffic casualties arrive by ambulance in a separate bay from the walking wounded. The ones with sprained wrists, bellyaches, blinding headaches or persistent cold and flu symptoms arrive by bus, or are dropped off by family members while they fight the more pressing battle of parking at a cost of nearly $5.00 for half an hour.
While ordinary human dramas played out in the triage chairs, the all-news channel on the ED television set was consumed with Mayor Rob Ford's antics. The newsreader broke away from City Hall to cover the guilty verdict for an anesthetist from another hospital convicted of forcing oral sex and other sexual assaults on sedated patients undergoing day surgeries. Trying to imagine how he could have executed such acrobatic transgressions (while playing his role in a tightly orchestrated surgical team) was so befuddling that I almost missed the news flash that an industrial accident had occurred on a building site several blocks away.
Firefighters had been called to rescue a construction worker who had been injured while trying to repair a leaky basement. The trench in which the man was standing had collapsed, burying him up to his shoulders. Will he end up here, I wondered, and asked my Sunnybrook escort if we could head to the trauma department.
Indeed, some time later he did arrive by ambulance – breathing, conscious, but suffering from pain in his chest, pelvis and legs. As I watched from behind a glass barrier, the man was treated by the trauma team, led by Dr. Mike Brzozowski. He was stable, not showing signs of shock, and he didn't appear to have any broken bones, according to a series of x-rays. Still, they sent him for a CT scan in an adjacent unit to be certain. I hoped he would be home for dinner, sore, but intact.
As I walked back from trauma to the ambulatory zone, I noticed that a couple of the patients I had watched coming into the ED had been moved into the more acute care zone for further tests and perhaps admission to the hospital. Meanwhile, Rob Ford continued to rant, new patients kept arriving with their dizzy spells and their breathing issues. Unbeknownst to me or anybody else at Sunnybrook, the young woman living in the basement apartment still had many hours left before the fire broke out and changed her life. I don't know what happened to her, but I hope she is recovering.
Follow me on Twitter: @SmartinGlobe
Your input
We want to hear about health care in your community: What works, what doesn't, and what you think we should do about it. Share your experiences – and ideas for change. Follow @Globe_Health, tweet with #thehospital or email thehospital@globeandmail.com to join the conversation.