Some Odd Things About The Current Doctor Crisis In Canada

First I will state that I did work as an RN in western Canada, mostly BC, but have not been working in the system since around 2009. But as far as some of the things reported in the news this past couple of years, all I can say, is that in many ways, I could see it coming. And I am very glad to be out of such a dysfunctional system.

The profession of nursing was so steeped in my conscience, because I was forced into nursing by a high school teacher before I turned seventeen. Therefore my own perspective and observations are probably not average, but on the cynical side.

At the time, I had plans of going into English literature, liberal arts, and anything language oriented. I had graduated early, and was academically inclined, but unfortunately, was without parental protection. So I was overtaken by the teacher’s plot for my life, which included him making very strange, false claims of adopting me. I was not up for adoption, and was just months away from graduating, therefore it was an impressionable time of my life.

The teacher colluded with my older brother, and together they created a very difficult situation for me, and a long term stratagem as well. But anyway, it is what it is, and that’s how I ended up becoming a nurse. I did fix a chicken’s leg with a Popsicle stick once, so maybe I did have an aptitude for it.

In reality, I really wanted to get a post-secondary education, so I went along with it, thinking I would be able to switch to something else soon after. Once I graduated, and was out in the work force, I got married, had kids, and had to work. So that’s what I did. But I always really wanted to get out of nursing, pretty much from the beginning. The teacher plot hung over me like a bad smell.

There were many things about the profession that I did like. I met some great people, and learned a fair bit over the years. It was rewarding to be there for people during a time of crisis.

One thing for certain, is that it has always been busy in hospitals, especially in the more densely populated areas. The short staffing in nursing has been a serious problem for at least thirty years. There were 12 hour shifts where you could barely get a bathroom break, let alone eat. Many nurses would duck into the utility room and drink ginger ale. I always kept a pack of peppermint life savers in my pocket, and often that was lunch and dinner combined. Talk about unhealthy, but the pace was incredible at times. We would make sure the nurses who were pregnant, breast feeding, or diabetic would get their breaks. It was the best we could do as far as priorities went

During those years, I worked with several young nurses, and most of us were very fit. We ran, cycled, swam, walked, rowed – whatever. Almost all of us were very active overall, so the system definitely got their work mule mileage out of us.

The older nurses were no slouches either. They were efficient, and did more paperwork than marathons. The paperwork was the most important part of the job, but when you are in the thick of things, it is not always easy to get it documented right away. If something ended up in court, especially in labour and delivery, as a nurse, you could get scapegoated and raked over the coals, if you did something and forgot to chart it.

Or if you noticed something, charted it, but failed to notify the doctor, you would not stand a chance under cross examination. Some nurses got dragged into stressful court cases, where they deliberated for hours over what the clock on the wall said, versus some other watch or clock they may have used to document the timelines of what happened.

At times, nurses who simply walked by or answered a call bell, got pulled into an emergency situation that ended up in court. They might have been a float, doing a fifteen minute break relief. They soon found out, they were in the wrong place at the wrong time. They would have barely known what was going on, or what led up to the situation, yet they had to sit through hours of getting grilled over the nitty-gritty nuances, and all the details of what exactly happened when the shit hit the fan. It went on for hours on end, and they were treated like they were  dumb and incompetent. But truthfully, under some of those circumstances, they were just confused and transient witnesses. Yet they got treated with dripping sarcasm for the slightest discrepancy in their charting or testimony.

Luckily I only had to go to court once, over an MVA in a northern community ER shortly after I graduated. I was so nervous, but the nervousness quickly wore off and turned to mind numbing boredom. I had to sit through multiple other court cases for two full days, as it was a small northern community, and that’s how they did things.

The case I was supposed to testify about, was the last to be heard. It was the most serious case of all of them by far. One of the cases I listened to was about open liquor in a car. Another was an assault in a bar. Another was some scuffle with the cops over liquor, that made absolutely no sense. Another was over a bag of marijuana, which was years before it was legalized. The guy tried to argue that the cop did not know what it was. He claimed it could have been anything. It could have been hay or alfalfa from feeding animals. It was kind of comical.

But the one that got me, was the testimony of an off duty conservation officer who watched a guy try to catch a fish with his hands. He hid in the bushes and watched him for several hours. When the poor man finally caught the fish, which I thought was almost a miracle – the officer sprung out of the bush and arrested him. To top it off, he was off duty. I was flabbergasted by his obsession over something so trivial in the middle of nowhere, when he was not even working.

Apparently it is, or was illegal to catch a fish with your bare hands. I was thinking, what? I mean, I could see it if he used a net when you were only supposed to use a hook, or something like that. But nope. The way this overzealous fish cop interpreted it, and quoted the law with much assuredness, was that the man was fishing with an illegal apparatus. Sheesh after all that…I think he deserved the fish!

Finally after all those petty cases, it was my turn. I walked timidly up to the judge, and he told me the case was postponed, and being sent to another higher court, or something along those lines. He then dismissed me, with a wave of his hand, and off I went. A bit stunned, after all the weirdness of it all, I could hardly believe it. And luckily, I never heard another word about it.

The gist of it was that two men picked up a hitchhiker and then ploughed into the back of a slow moving vehicle. The hitchhiker was killed, but neither of the men remembered which one of them was driving, and nor did they recall picking up a hitchhiker. I think it took months to identify who he was.

In later years I did get called in to give testimony in court cases that were pending, like in a hearing. In those instances I was fortunate enough to have had good recall and charting, so I never had to deal with getting grilled without being able to explain exactly what happened.

In another very bizarre situation, a man died in the hospital, and for some reason the doctor was afraid he would be blamed for the death. So he called in the ambulance. He told the ambulance drivers, who were not trained paramedics, but simply local farmers who volunteered to drive the ambulance to transfer him to a hospital in the city. They did what they were told and off they went.

But when they got there with an obviously dead patient, they got turned away. They were told to take him to a morgue at another location. They found a place that would take him and left him there. But apparently the next day, when the hospital administration found an unexplained dead person in the morgue, they called someone and sent him to another location.

Meanwhile, the family members came to visit, and could not find him in the original hospital. They were told he had been transferred. But where was he sent? And why had they not been notified? As it turned out, his body was lost for several days, and the family was fuming. Who could blame them?

The health care system is an old fashioned hierarchy. The doctors, like any profession, have a range of different personality types among them. Some of them were very egotistical. Others were quite pleasant. If they were insecure, they got mad if you were two steps ahead of them. That was the most difficult part. I could not figure out how some of them got through medical school. I am sure they felt the same about some of the nurses.

The specialists were by far superior when it came to intelligent discourse. If you demonstrated that you were on the ball, they treated you with a lot more respect than most GP’s did. Overall, I much preferred to work with specialists.

The thing about health care, is that things get thrown at people who are supposed to know what to do, yet the health care professional may never have seen it before. So there is a level of anxiety for all those who work in a fast paced environment. You are afraid of making a mistake with deadly consequences. There can be a lot of fear and anxiety if you are a key player, yet are in an emergency situation you have never seen or dealt with before.

The doctors always made much more money than nurses, no matter what the levels of experience were. In particular, they got paid huge sums for being on call, often without getting called in during the night. A nurse who was on call got around $3.00/hr., while a GP on call in a rural location got over $100.00/hr., plus several other perks. So the discrepancy has always been considerable. This was almost twenty years ago, so I am sure it is much higher for doctors now. Of course it depends on where they work.

When the system has to resort to using agency nurses, it adds a huge expense to the health care system. They pay a higher rate of pay, and the agency takes several dollars an hour for every hour, every single nurse working for them makes. Plus they are all short term placements, so travel, accommodation, insurance, and orientation all must be paid for. It is more than double the cost of a union nurse.

What is very odd to me, is the fact that eight doctors have recently died in Canada, with very little follow up on this very odd occurrence among the profession. They were all working, career oriented, motivated, and several were very fit. I think it sent a shock wave, a wave that should have gained more momentum, investigation and answers for a stunned public. Busy, and sometimes overwhelming workloads in health care is nothing new. But people did not drop dead in the past like is happening now.

In fact, until now I cannot even recall cases of young doctors dropping dead. The odd time there would be an accident or heart attack. I remember years ago, a 39 year old nurse finished a 12 hour shift in maternity, and by morning reported that she felt unwell. She was not sure if she would be able to come in for the next night shift, and died within hours after going off shift. We were told she had an atypical viral pneumonia.

Therefore, I can only imagine the dismay and fear that must have taken root in the various workplaces following these deaths. We kind of always thought the doctors were the untouchables, and would not be blind sided by something that came from within the system. It seems very odd.

Now just a few months later, another Canadian doctor is charged with murdering four patients. It is another thing that shocks and floors the average person, especially those who work in the health care system. This too – is unheard of until now. His defence is that all the patients had covid. Wow.

In 1980-81 at the Toronto Sick Children’s Hospital, a nurse, Susan Nelles, was charged with killing babies, after it was discovered there was a 625% increase in deaths over this time frame. The Grange enquiry became one of the biggest murder investigations in Canadian history. Apparently they deduced that the babies had been given lethal doses of digoxin, a cardiac drug. Nelles was on shift for 24/45 deaths, so they placed her under intense scrutiny and investigation. Another nurse was implicated and tainted for life by this investigation as well.

It turned out the cause of death was later revealed to be from the introduction, and use of rubber stoppers in the IV lines. Unknown to the facility at the time, the rubber stoppers accumulated toxins. In many cases, the infants were very tiny and fragile. Therefore a bolus of these toxins when the IV line was flushed or speeded up, could have easily caused their death.

There was no solid evidence to indicate the babies had been intentionally poisoned. What an absolutely horrible thing to have to go through. It caused the accused nurses entire families an incredibly stressful burden that dragged on and on, for what seemed like ages. Thankfully, in the end, it was not as sinister as they made it out to be.

In Winnipeg’s largest hospital, in 1994, there was a five year long investigation following a surge of baby deaths. In each case, they went for cardiac surgery, and twelve of them died unexpectedly. Some nurses stuck their necks out and sounded the alarm bell. They were mostly concerned about the cardiac surgeon, and it took a great deal of risk and persistence before they were finally heard.

The outcome however, was not a murder charge. They found two key contributing factors. One was a problem with the system, and the other attributed it to the inexperience or lack of competency on the part of the surgeon. The nurses were right in that case.

One would think that like the other high profile mysterious deaths in our Canadian health care history, the deaths of eight doctors, albeit for seemingly random reasons – would be sufficient to generate a nation-wide investigation and enquiry. If they did such huge enquiries over the baby deaths, shouldn’t the system care about doctors too? These are unusual, suspicious sounding deaths, and may have been caused by the very system they work for. I know life is not fair – but good grief.

Another thing this country has never seen before, is the number of doctors who have been discredited, and penalized over their views on covid, or the vaccines. It does not matter how much education they have, how much evidence they present, how much experience they have, how sincere and dedicated they are – if they go against the flow, they are slandered beyond repair. This too – is absolutely unprecedented among doctors in Canada. Normally they stood up for each other, and would not do any back stabbing, no matter what. They valued their careers and reputations, and did not mess with anyone else’s career. The Colleges in the different provinces were always reluctant to investigate any concerns about doctors. Now all of a sudden, they are doing what appears to be witch hunts, over what is supposed to be evidence based medicine.

In the past couple of years, we have seen things develop within the health care system that have never occurred before. I can only imagine how much turmoil they must be facing, along with the increasing number of ethical dilemmas they are dealing with now. It must be absolutely gruelling, when combined with a heavy workload, and so many sick patients.

In a sense, no one has their back now. They lost something, and they must have a massive churning of cognitive dissonance, as they navigate these latest developments. They have to deal with extensive political interference in direct patient care. What a nightmare. To top it off, it all goes straight to the media, so they can put their twist on it, before there is a proper investigation. This too is unprecedented. Normally, the media exposure in health care was avoided like the plague. Now it IS the plague.

I think the crux of it, is the political interference in direct patient care. After all, they are the doctors, and that’s what they went to school for. The politicians are purely political, and that’s what they campaign for. To bring this element of trespass, or encroachment into a delivery of care that was once considered sacrosanct and private, with trust being central to the doctor patient relationship – was unheard of until now.

Yes the politics within the health care system have always been a pain. But the conflicts involved staffing levels, pay structures, building deficits, unions, etc. As long as a doctor was functional, no one questioned or showed disrespect for their decisions. Even if a doctor did some really dumb stuff, they never got called on it. They maybe got shamed by the specialist who had to bail them out of whatever debacle they created, but that was about it.

Luckily, on a personal level, I have been able to stay away from doctors most of my adult life. I hope it stays that way, because now is not a good time to get sucked into the system for any reason. I realize many people want and need a doctor, so I hope I can be one less person to make demands on them, and the wildly faltering system.

Otherwise, I don’t know what to think. I feel very sorry for doctors who have been vilified for speaking out about their observations. They would only do so for reasons of patient advocacy. There is clearly nothing to gain. They are doing it for ethical reasons, and in my opinion, should be applauded not punished.

Other than the political interference in direct patient care, I think the fact there is no open investigation over deaths within the system – is a big cause for concern. After the initial shock wave over the doctor deaths, before there could be any coroner’s report, or autopsy reports – there was immediate denial in the media, claiming the deaths were not related to adverse vaccine reactions. How can they rule it out before doing an autopsy, and finding out the actual cause of these deaths? It is unheard of, and people within the system know it is highly unusual.

In the days following the death announcements, MSM reported that one had cancer, another was also “very sick for years” etc. They literally glossed it over.

For any doctor who is close to retirement, or those who have invested enough to get out of the system, or the country – one can see why.

Medicine is both a science and an art. There are brilliant doctors, and there are duds. But they do deserve respect for the amount of education, and gruelling regime of on call protocols, etc. They were placed on a high pedestal of trust, and enjoyed a certain amount of autonomy in their practices. Now, the entire realm of medical ethics is muddied and unstable.

In my opinion, hard work is not that stressful. What is by far the most stressful, is the ethical dilemmas, and divisive polarization within the system. It adds stress galore, and for some, there is no escaping it.

Our minds seek answers. We try to make sense of things. Doctors are used to certain accepted patterns of conduct, which remained consistent in the old fashioned hierarchy for many years. They gave the orders. Some of them talked nicely. Others barked. But they had a position of authority, and were allowed to figure things out for themselves, unless they chose to call in a consult, or the patient asked them to.

They must be spinning. For those early in their careers, they must be wondering what is next. There is no cushy future as they might have anticipated at one time. Meanwhile, it’s not business as usual. It is something else entirely. The oddities are increasing.

They are facing not only things they have never seen before in their practices, but also things they have never seen before in politics. I hope most of them survive this uphill battle. They too are only human, and whatever happens to them affects everyone. Treat them with respect, even if they have differing views.

An open enquiry to find the truth of those deaths, as well as to stop the vilification of those who do enquire about untimely or unexpected deaths, is in order.

The baby deaths in our health care history were investigated. Because they were delved into, they came up with reasonable and plausible explanations for those deaths.

Surely, we haven’t lost our way so much in this country, that we would close the door on open enquiries about  suspicious deaths in health care. Let’s hope not. Open enquiry is a good thing – even if we don’t like the answers. Denial is not an option.

Copyright Valerie J. Hayes and Quiet West (2022). Unauthorised use and/or duplication of this material without express and written permission from this blog’s author/owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Valerie J. Hayes and Quiet West with appropriate and specific direction to the original content.