Thursday, September 3, 2015

Post surgery: listening

Whew. I’m home. Glad that's done. With surgery out of the way I have two stages of treatment down and two more to go. I feel ok and am up and around. I never needed pain meds. I can even lift my arm over my head. I could have gone home to eat supper the same day if I hadn't need my heart monitored for 24 hours. Thank you to God for bringing me this far, and thank you to his people for all the praying and messaging and emailing that has shown me so much care. With time to spare, a pad to write on, and Robert gone home to get overnight stuff, so I started writing.

Sunday Robert and I went back to our other home for a bit. We found out Katie passed her Z license for driving 18 wheelers. Yay! Emily starts her full time job today. And Ben and parents are flying to Alberta this week for Marg's dad's wedding (he's in is mid-80's. Go Aaron!) Marg handed me a thick letter from the hospital, and I wondered what it could be because I knew it wasn't a bill (no more hospital bills in Canada!) Canadians might not be surprised by what it was, but I certainly was...a 95 question survey! I'm not even halfway through my treatment regime, and I'm filling out a 10 page survey.  (Maybe someone figured I needed something to do in the hospital.)  I finished the whole thing in a snap because every question was a variation of just one: is the medical staff listening to you?

Yep, they are. My surgeon came in after surgery to check on me and answer any questions. She acted as if she had all the time in the world. She is a calming person. When I was about to go under, she didn't ask me to count. First she took her mask off so I could recognize her. She asked me about my kids, and then when I started getting confused about Elai's age, she just looked in my eyes until I drifted away. When I awakened, the thing was done. I imagine heaven is a bit like that (minus the dizziness from the anesthesia), a sudden awakening, an awareness of events missed, an entry into a new stage of life. After answering my questions, my surgeon left but popped her head in the door a minute later to ask what level of Tylenol I wanted prescribed, two or three? I had no idea. Listening is all very well if the patient has knowledge enough to opine.

This much listening would not happen in Oaxaca, at least not in the public hospitals. They don't place a premium on patient input partly because many patients have almost no knowledge of modern medicine, so how do you include them in the decision making? This would be especially true of Indian patients, and then it looks like sheer racism. Our Colombian friends visiting last week told us about trying to get care for their son in a public Panamanian clinic. They adopted him from the Indian tribe they work with, and there is a noticeable difference in skin color. The doctor asked the mom why she was bringing in an Indian child and didn't want to treat him. Wouldn't touch him. She told him he was in the wrong line of work. I can't imagine facing illness, or worse, facing your child's illness, with those kinds of hurdles to jump.

It's hard for us in Canada to imagine racism this overt in countries with Indian minorities. Here we listen to patients a bit more, no matter their skin color. It probably wasn't always this way. I wonder how far back in the medical profession we'd have to go back to find doctors being authoritarian or condescending or downright racist. What has been the process to bring us to 10 page surveys and doctors asking patients what pills they want? It's a cultural thing. In Oaxaca, authoritarian leadership is often a preference, a safe place. It seems obvious to me as an outsider that Oaxaca should change that and be more like Canada, handing out listening surveys, but as an outsider it might not be my place to decide what Oaxaca needs to be changing right now. That might be someone else's business. I wonder what seems most obvious to Oaxacans that Canadians should change? I bet it's not so obvious to us.

I know! Let's send them a survey.



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