Tuesday, October 20, 2009

Swine Flu Suspect at Downtown Clinic "Fast-Tracked" to Nowhere

BC is in the second stage of the H1N1 flu epidemic but staff at the Downtown Clinic near Oppenheimer Park don't seem serious about curbing it. That's the impression a Downtown Eastside resident got when she went to that clinic today with flu symptoms. "I walked out without even being diagnosed", she told me later from Canada Place where she was having tea at the Food Floor.

Yes, she was having tea at a tourist hub with swine flu symptoms, a hub where tourists are nervous enough about the flu that the occasional one is enjoying their vacation from behind a surgical mask.

The woman who had been to the Downtown Clinic today has had flu symptoms for days. She felt dragged out, had achy bones, and was sneezing for some time. Last night, she had diarrhea and her energy was so depleted that she could not even tidy up her apartment. She just collapsed on the bed at 9:30 p.m. and fell asleep. She felt much better today but was still "dragged out" and decided to get tested, she told me on the phone from Canada Place.

She had telephoned the Downtown Clinic and asked a male receptionist what the testing would involve. "Do I have to give a stool sample?", she asked. He checked with a nurse and came back on the phone to tell her that no stool or urine sample was required. "Just a sputem sample", he said, and then explained, "They'll just ask you to spit or they'll take a swab from the inside of your mouth."

Knowing that the wait time can be long at that clinic, she asked him, "If I come in, will I have to wait a long time to be seen?" "No," he assured her, explaining that upon arrival she should simply tell them that she had flu symptoms; they would give her a surgical mask, and take her to the back immediately. A nurse would see her, he said.

Was he lying?

When she arrived, a female receptionist directed her to a nurse, Arden, who had a wicket at the end of the reception desk. Arden gave this patient a surgical mask, and then put on blue rubber gloves and adjusted her mask so that it fit snugly around her nose. Then, using a sing song voice like they do on Romper Room, Arden told her to come to the back of the clinic. "You're being fast-tracked", Arden told her, chuckling. She corrected the patient's perception that she would be seen by a nurse though, telling her that the male receptionist who had told her that must have been mistaken, that a doctor would have to see her. She was told to sit or lie on the bed and that a doctor would be in to see her.

Looking back, the patient now believes she had been lied to twice by this time.

The patient waited and waited. Each time she saw a doctor approach, she would think, "Maybe that's the one who'll do the swab and then I can get out of here." She now knows she had as much chance of spotting that doctor as having an Elvis sighting.

Twenty-five minutes passed and she walked back to the front desk and asked Arden how much longer the wait would be. Arden told her, "You'll have to see Dr. C and she won't be coming to work until 1:30." The patient glanced up at the clock, it was 12:50 p.m."

"Why did you lie?", the patient asked Arden. You told me that somebody would be in to see me; you didn't tell me that the doctor I was waiting for wasn't at work.

The patient, having been to this clinic previously, knew that even when this doctor arrived for work, she would have other patients, those with appointments, to see first. "I could easily have been there until 3 o'clock," says the patient. Arden acknowledged to the patient, in front of another female staff person with brown/blond hair, that she should have told her that the doctor wouldn't be at work until 1:30 p.m. But then excused herself, saying, "It was mis-communication".

The patient doesn't blame staff for factors that were out of their control, like having a busy day. She blames them for "stringing me along".

There was a whole stable of doctors on duty in the clinic today, the patient points out. And lots of nurses too. She interprets the fact that she was assigned a doctor who wasn't around as a sign that H1N1 is not a high priority at the clinic. "They know people will get tired of waiting and walk out. I've seen it happen before when I've been sitting in the waiting room", she says.

The patient ripped off the surgical mask and walked out. Did they make any effort to accommodate you so that you would stick around long enough to get diagnosed, I asked. "No", she said. The only real initiative she saw staff show was in "protecting themselves from my germs", but none to prevent her from spreading those same germs in the community. In fact, Arden seemed to encourage the spread: after acknowledging a "mis-communication", she suggested that the patient leave the clinic and come back at a later time.

The patient doesn't see all the staff at the Downtown Clinic as "slack-assed" though. "There are some good doctors there", she says, "I've had two that I thought were way above average."

The patient knows two other people on the Downtown Eastside who had symptoms of H1N1. One guy was deathly ill and he looked up his symptoms on the internet and believes he had H1N1. He went to the flea market and spread those germs around. She knows another guy who was out walking around; he went to Pathways computer room and to the UBC Learning Exchange, saying, "I wouldn't want you to get what I have." She got it.

After leaving the Downtown Clinic, the patient was angry but not as weak as she had been. She was now operating on "an adrenalin rush" that had come somewhere between learning that she was being fast-tracked and learning that she had been assigned a doctor who was probably at home having lunch. "I didn't want to go home and stew," she said. "So I walked up to Canada Place to have tea." The food floor at Canada Place is frequented by Downtown Eastsiders having tea and coffee now that the Mcdonald's at Main & Terminal has closed for Olympics renovations.

Thousands of tourists go through the Canada Place Food Floor everyday. The Japanese tourists with the masks are clearly nervous about H1N1. And they should be nervous, about the woman at the table having tea.