Publicly funded, universal healthcare: when it’s about me it gets real personal

Two weeks ago I was diagnosed with what my doctor characterized as an “intermediate stage” malignant melanoma.  Surgery was the only option, so within 10 days I was at Lions Gate Hospital in my home town of North Vancouver, BC, having a number of procedures.  It may have faults, but when the chips were down our Canadian public healthcare system came through in spades for me.  It was fast, it was efficient and I got the very best of care, no questions or insurance forms required.  In what now seems like an extremely ironic turn of events, only a few week ago I had engaged in the Obamacare debate with some friends from south of the border on the day the Patient Protection and Affordable Care Act was signed into law by President Obama.

                 

At the time I was simply lending my Canadian perspective to a very passionate debate on the merits, or lack thereof, of public health care.  One very well-educated, democratically inclined friend was carrying the torch for the benefits of public health care, against a strong tide of opposition.  She was happy to have me weigh in with my personal experience – even if south of the border we Canadians have a bit of a reputation as pinko socialists (but very nice polite ones!!).   She had had her own health scare and was appalled that her insurance company would not cover the cost of a diagnostic test (a mammogram) that would give the best early warning of breast cancer.  It seemed the insurer would rather wait for her to actually develop a life threatening illness than pay for a test that would allow early detection, less expensive care and a better therapeutic outcome (that’s insurance speak for “she lived”).  Maybe it’s me, but that just seems counter-intuitive.

Needless to say, at this particular juncture in my life I’m proudly waving the Maple Leaf for our public healthcare system.   Here is how my day in the public healthcare system went on Wednesday.   I was admitted at 7:00am into the Surgical Services Unit for day surgery.  After checking in, my first stop was Nuclear Medicine (like that inspires hope and confidence . . . seriously, can’t they come up with a better name) where I had shots of a radioactive tracer into the offending site on my upper thigh.   Stingy, but not too bad.   Then wait while the tracers dispersed through my lymphatic system, and no coffee to pass the time, damn it – I was not allowed to have anything to eat or drink.  Two hours later back to Nuclear for a Gamma Scan (again . . .about that name – did none of these people grow up during the Cold War?)   But the Gamma scanner is actually pretty cool.  It does a full body scan and where concentrations of radioactivity are picked up it creates a detailed 3D map of the lymphatic system in that area.  The scan takes about 40 minutes and it’s completely painless and trauma free – no sharp pokey things.  The 3D map is uploaded to the surgical suite where my surgeon used it to pinpoint exactly which lymph nodes had to be removed  – there were 3 of them.   I can’t even imagine what that scan cost, and  thanks to publicly funded healthcare I don’t need to worry about that.  I needed it so I got it.  When it is your body and your life involved, that is pretty wonderful.

Back in the surgical unit it was time to get suited up for the main act.  Lovely backless gown, “robe”and sexy matching green knit surgical stockings with little booties.   I’m sure I was looking particularly lovely – thank goodness cameras are not allowed.   It must have been quite a surprise for my nurse, who was only distracting me with idle chit-chat while she set up my IV, when I burst into tears when she asked “so what would you have been doing today if you weren’t here”.  Little did she know what a loaded question that was.   I should have been in Baltimore, packing the car and getting ready to head to Newport for a romantic long weekend with my sweetheart.   Surgery had NOT been on the program.  She decided that I’d had a rough enough day and it was time for some TLC, so instead of going back to the waiting room they found a spare bed for me in recovery, wrapped me in warm blankets right out of the warming thingamajig and suggested that if I asked for it, they would be able to provide “a little something for anxiety”.  I didn’t have to be asked twice! At the appointed hour my surgeon and anesthetist showed up, checked all the details for about the 20th time and autographed my leg; they actually have to sign their initials on the area they will be operating on.    The last thing I remember is the anesthetist putting a comforting hand on my shoulder, saying “just relax, I will take very good care of you” and then . . .nothing.  Going under a general is nothing like falling asleep.  One minute you are wondering if it’s actually going to work for you and the next thing you are waking up in recovery.  And thanks to an extensive pre-surgical consult for the first time ever I woke up and was not sick.  Not great, but not sick either.  What a relief.

Catching up on some comedies and prepping for NOLA next year.

I simply cannot say enough about the quality of care I received the whole way through this long, emotional and clearly stressful day.  Every single person I was in contact with was kind, soft-spoken, thoughtful and seemed genuinely concerned for both my health and immediate comfort.   I went in with the attitude that it was going to be a long day, there was no point being impatient, and I got that back in spades.  At every turn there was a comforting touch, a warm blanket or a thoughtful word.   Every single person treated me like an intelligent, if somewhat emotional, person.  Every procedure and outcome was clearly explained and I was asked constantly if I understood what they were telling me and whether I had any questions.  Maybe it was the shell shocked look on my face, but I think not.  I think we are just really, really lucky to have an amazing healthcare system, and that includes the people who work in it.  I truly cannot thank them enough for the kindness they showed me.   It really did mean the world and made a huge difference on a very difficult day.

I’m now 3 days post-op and – woo hoo – I get to have a shower today.  I also really need to go out, even if just for a coffee;  starting to get a little stir crazy, even with all the drugs.  Oh yes, the drugs  . . .started out on morphine but that makes me itch like there are bugs under my skin (I’d make a terrible heroin addict) so I am on to a new narcotic.  Not sure what it is, but it works like a charm. Pain – well so long as I take the magic pills every four hours it’s just fine.  Waking up in the morning is a bit rough, but I’m pretty good at getting one of those down and hardly even moving.   And the incisions, while fairly horrific to look at right now with all the staples, are healing nicely.  There is no doubt I will have a large scar on my leg, but given the alternative I’m just fine with that.

And all I can say to my amazing friends and co-workers is THANK YOU.  Your kindness and support has been overwhelming.  From all the messages wishing me good luck the day before surgery, the thoughtful gifts, cards and food you have dropped off and just simply the regular check ins to make sure I am OK – they all mean the world to me.  And my sweetheart has been a rock of support.  Safe to say that neither one of us imagined that our long-planned and much-anticipated holiday to Newport  would be so badly derailed, or that nine months into our relationship we would be dealing with a health crisis of this magnitude.  Having the ‘flu is one thing, dealing with a cancer scare is something else entirely.  You are amazing and we will make this time up.

I watched it the Wilco concert live streaming on NPR, here’s the hyperlink to the video archive.  Impossible Germany and California Stars in one concert – fantastic.

Medicine Heals the Body, Music Heals the Soul

It always happens when you’re not looking . . .you know, you are going along, minding your own business, getting (or in my case  romping) through the days and weeks of your life and POW – you get blind sided like one of those Batman shots.  And afterwards its really, really hard to remember what your life looked like before you answered that phone call.

Malignant melanoma.  At that point in the conversation,  seriously, you stop thinking, stop listening – stop breathing if truth be told.  It’s like someone has shone a really, really bright light in your face and everything around it just disappears.  The rest of the day is pretty much white noise  – I went through the actions, but truth be told I don’t remember a thing.

That was last Friday.   My beautiful daughter and I had a white water rafting trip planned for the weekend, the timing could not have been better.  The  10 on the Richter scale migraine Saturday morning was a bit of a kicker and we got to  Reo Rafting Resort slightly later than planned, but it was a fantastic weekend of camping and rafting.   Tequila shots in the hot tub . . . great way to warm up!

Fast forward to Monday, me and my denial.   I had somehow managed to convince myself over the weekend that I was going to see a surgeon for a simple office procedure and that I’d walk out of there with a few stitches and a sore leg, but I’d just carry on with my life.  And I had a lot of life to carry on with in the next 2 weeks.   A long-awaited and much-anticipated  10 day summer holiday with my love, just for starters.  Living on opposite sides of the continent is one heck of a long distance relationship – those 10 days were so  precious.  Time to just hang out at home and then a road trip to Newport, Rhode Island for a music festival.  Time – just lots and lots of time, something we never have.

POW – I got knocked right out of my denial in the next hour.  No office procedure, no “see you in 10 days to remove the stitches”.   No, it was the tough love talk.  As in “cancel all your plans, you are going in for major surgery as soon as we can get you in”.   “Hey Doc, can I postpone for a couple of weeks, I have a life to live?”  The deadpan answer –  “Not if you want a life to live”.   Sweet baby Jesus, didn’t see that one coming.  So next Wednesday, instead of packing the car for our road trip, I’ll be having three different surgical procedures, coming out the other end slightly radioactive and with a couple of rows of Frankenstein staples on my leg.  It’s really, really hard to fathom.

There is good news; although the melanoma sits right on a diagnostic threshold, the prognosis is cautiously optimistic that with aggressive surgery now it can be completely removed and no further treatment will be required.  This is how it plays out in my head:  I can count the number of “shoulds” and “likelies” and “usuals” in that consultation.  There was not a shadow of lightheartedness in that surgeon’s demeanour or conversation.  It’s a scene you somehow never see yourself in.  Really . . .never.   And on a moment by moment basis it’s back and forth, back and forth in your head –  “I have nothing to worry about” v. “I am senseless with fear that I have everything to worry about”  And I simply have not let myself walk down the “why now” or “why me” road, because it goes straight to ” Can you be too happy?  And if you are, do you have to pay?”  Is there a great, cosmic scale that says “you were so stupidly, ridiculously happy you took your eye off the ball and now – time to pay up”.

Deep into that darkness peering, long I stood there, wondering, fearing, doubting, dreaming dreams no mortal ever dared to dream before.   Edgar Allen Poe.

The other crazy, stupid good thing – my friends.  You are my family and as I have reached out to you, you have offered me your kindness, your support, your sensible advice and your caring.   Not knowing even slightly how I will face tomorrow, when I should be getting on a plane and flying East;  or this weekend, when I should be at Nick’s eating Maryland crabs, laughing late into the night on the roof deck and probably discovering a new favourite craft beer, you have come up with enough fun to keep me busy for three weekends.  I will need it all.  And I will be taking you up on your offers of domestic help, meals (hell yeah!) and being picked up for outings to stave off the boredom.

Sleep, always an easy and generous companion, has become elusive. Writing is therapeutic.  I had an amazing 3 hour kayak paddle in Deep Cove after work tonight.  And I’ve written for a couple of hours.  Time for some shut-eye.

Dawes  – “A Little Bit of Everything”.  Because  I love every single word of this song and I am so not done with my little bit of everything.