Pain, Life, and Death
Ministerial Meandering
Pain, Life, and Death.
I really wish I didn’t have to write this, but it’s been brewing inside of me for at least ten of the sixteen years I’ve lived in this country. Most of you know - from your own bitter experience, as well as my personal opinion - that I have very little, if any respect for the medical (and often nursing) ‘professions’ in this country. I wish it were not so.
To enter into life is to enter into the possibility of pain. Even if you were to wrap yourself in cotton wool and hide away in a cave for the duration of your life, you would be subject to pain of some sort at some time. Let us accept, then, that pain is a factor in our lives. Usually - and early on - it is a lesson that tells us that repeating the same thing that caused the pain is likely to result in the pain also being repeated; therefore, don’t do it again. Thus we learn that pain is avoidable, if we are careful or consider other options.
However, my tirade today is aimed at those who should know better - the medical and nursing ‘professions’. I use inverted commas because I believe that the idea of medicine or nursing retaining their status as ‘professional vocations’ - in this country, at least - is highly suspect for the majority, as they have become money and time focussed. I get the impression that some nurses have managed to retain their sense of vocation, and when I have met them, they stand out from their peers like diamonds.
When I arrived here from South Africa, and registered with the Medical Council of British Columbia, there was to be a day of ‘orientation’ lectures. All of these were concerned with how to turn your practice into a successful business; none of them were about maintaining standards. Consequently, the young, often arrogant, newly qualified doctors that Canadian medical schools are churning out - with not even the barest minimum of basic scientific knowledge, as the teaching syllabuses are woefully inadequate - are more concerned with how to make a buck than deliver proper medical care to their patients.
Fortunately, there are some who have not fallen into the trap of avarice, but they are few, sadly, and often from abroad.
In hospitals, doctors and nurses no longer do ward rounds together, so to ask a nurse what is happening to a patient is to be met with a cursory, ‘You’ll have to ask the doctor.’ When is he doing his rounds? ‘I’ve no idea.’ Add to this that no written notes seem to appear or be available when you ask if a nurse might consult them. But let me return to pain.
Pain in the hospital setting should be rare and controlled. In the context of malignant disease or any form of terminal illness, it should not exist. The idea that nurses can only give analgesics (pain-killing medication) after a certain number of hours has passed is an archaic idea, cruel, and stupid. All pain-killing drugs should be written up to be given as necessary - or by the patient themselves - and not by the clock. How many times have I heard unthinking or ignorant nurses say that they cannot give more morphine - because the patient ‘might get addicted’? The patient is dying, for God’s sake! - who the hell cares if he or she dies dependent on his or her morphine? The whole idea of pain control is to erase the memory of pain, so that the patient is not lying in bed, scared of the moment when the drug wears off, because they know they won’t be given any more relief for another 2 hours. That is both unacceptable and malpractice - yet it is commonplace in our hospitals here. It is shameful. In the same way, one of our own is currently dying of untreatable malignancy, and is barely conscious - and yet he is being maintained on oxygen! All this does is prolong the agony for him and his family.
Whatever happened to competence, compassion, and common sense in medicine and nursing? It seems to be almost completely lacking in British Columbia.
Philip+