A visit to the emergency room
I don’t leave the Downtown Eastside all that often, at least not for more than a few hours. I really look forward to the couple of weeks each July when I get out of Vancouver with my family, but each year I realize that no matter how different the communities we visit seem from the Downtown Eastside, there is no getting away from the issues that drive our work here at Pivot.
This year we visited to a small community a couple of hours away from Vancouver. In my family, it seems like no vacation is complete without a visit to the emergency room. Nothing serious, but I wasn’t thrilled to be spending a beautiful Sunday waiting in the emergency room with my son. A man who had been in a car accident and woman in her sixties experiencing acute chest pains where wheeled in as we waited. In my lay opinion, staff were doing a pretty good job of prioritizing patients who most urgently needed a doctor. There was, however, one notable exception.
We had been at the hospital about an hour when a woman came tearing in. She told the woman on reception that her husband was “having an overdose” and that she needed help getting him out of the car. The woman on reception told her they could not help him inside unless he had come by ambulance. When it became clear that she was not going to get them to budge on that policy, she grabbed a wheelchair and sprinted back into the parking lot.
When she wheeled her husband in, all 250 pounds or so of him, his head was rolling back. His wife kept talking to him, telling him to stay awake, reminding him to breath, asking him questions to try to keep him responsive while she waited for the woman behind the window to finish her phone call.
The woman behind the counter barely looked at her as she asked for their address and phone number. She pleaded that he was slipping in and out of consciousness and he needed help. I expected a nurse or the doctor to coming running out, administer Naloxone and then take it from there. But no one came. The woman tried to keep the man sitting up in the small wheelchair, jostling him as he slumped, clearly afraid but not panicking.
After about an hour, a nurse came out, the woman started to tell her story, explaining that her husband was set for surgery for a serious illness in three days and that the doctor had changed his pain medication earlier in the week. She was quickly interrupted: “Did he take too much or something?” “Did he have a drug problem?” The woman had clearly had enough. She clearly related his diagnosis, his doctor’s decision-making process that lead to the change in medication, the name of the drug and the dosage. The nurse wheeled him away.
I tried to make sense of what had happened. Maybe he was never in danger and the hospital staff knew that. But if that was the case, why had they never communicated that to his wife. I though about how the woman had communicated with the staff and wondered if she had come into the hospital and said “my husband is waiting for surgery next week and he is having a bad reaction to his pain medication”, whether the response would have been different. Mostly though, the whole episode reminded me that our work on drug policy is not only relevant to the Downtown Eastside. It is also not only about changing the law. It is about changing the way we think about substance use and addiction and about reducing the stigma that increases harms.