Oh Canada!

1pa·tient \ˈpā-shənt\ Etymology: Middle English pacient, from Anglo-French, from Latin patient-, patiens, from present participle of pati to suffer; perhaps akin to Greek pēma suffering
1: bearing pains or trials calmly or without complaint Source: Merriam-Webster Dictionary

Have you ever thought about how weird it is to call sick people "patients?" I have often wondered in the last ten years if it is meant to be a subliminal message to all of us who have the somewhat debatable good fortune to be part of Canada's socialized medical system.

I had been raised with the notion that it was one of the great things about our country...essentially free access to healthcare for all Canadians. As I grew up I started to hear about problems with wait-lists and the like but it wasn't until my beloved and very elegant grandmother, 89 at the time, spent 48 hours in the hallway of an hospital emergency room because there were no beds available and then was actually released before she was even admitted, only to return a few days later because surprise! she still needed medical attention--that I realized that our system had some profoundly serious flaws.

Soon after I became an active participant in the not-so-wonderful world of doctors and hospitals: wait lists and wildly powerful receptionists who could rebuff or re-book as they so desired; doctors who could not always offer what they hoped or even promised; incredibly caring people and incredibly calloused ones.

In 2000, in the months leading up to my 40th birthday, I had three surgeries in less than 12 weeks plus 16 days of radiation plus countless hours in countless other heathcare providers' offices receiving complementary treatment. Partly due to my personality, partly due to the fact that my cells were behaving like a jet-lagged, nap-needing, not-yet-nursed toddler, and partly due to the fact that I would have far rather been at home with my just-turned three and five-year-old children, I was anything but patient.

I've been having flashbacks to those times almost ten years ago because I am still waiting to find out when I will begin chemo and I am reminded of all of the razor's edge moments of attempting to be perfectly im-patient. Too far over the edge and those will the magic say-so will not tell me what I want to hear; too patient and weeks can go by waiting for the phone to ring only to be phoned to be asked why I had missed my long-awaited appointment for a test--a test that unfortunately no had told me had been booked.

One needs to be skillfully squeaky but never stridently shrill. Effective and karmically-neutral navigation of our medical system calls for skillful means, a sincere interest in being relational and mindfulness that any boon to me means bypassing other ill people.

My mind has been pretty calm while I wait for for the chemo-commencement call, but my body's been very actively misbehaving. Even though I just had fluid drawn from my lungs just over a week ago, it had returned by yesterday morning to the same extent as when I had the fluid drawn. I had emailed my oncologist, Karen Gelmon, on the weekend to let her know that it was coming back and then again yesterday morning, asking "At what point do I be concerned?" Karen G. had told me that if the chemo is effective that it would really aid with this fluid build-up but there was still no word on when that might begin.

I tried to have a nap yesterday afternoon and when I lay down I had the sensation that my throat was closing. That got my attention. I tried calling my GP but she was gone from the office until Thursday. I tried calling my oncologist's assistant but there was no answer. I decided to page my GP and started to pack a backpack with toothbrush, reading material, water etc. just in case I might need to go to Emergency. I didn't hear right back from my GP, Karen B., so I also kept calling Karen G.'s assistant and finally got through. She said that she would email her to call me. By now the kids were home from school and we were all on tenderhooks as we waited to hear.

Karen B. called and said that she felt that I would be fine overnight so long as I slept upright and that she would make some calls to get me in to have a fluid tap today. We were mid-conversation when another call came in and I quickly looked at the phone display which read "Canadian Cancer Society." I told Karen that I would call her right back. Thinking that it was my oncologist, I answered the incoming call only to hear a man's voice: "Hello, I'm calling from the Canadian Cancer Society. Can we count on you to canvas your neighbours in April to raise much needed funds for cancer research? It would just take..." "No," I replied. In that crazy-making telemarketer way, he continued with his spiel as if I had not just given him my response. "...a few hours of your time and...." "I have metastatic cancer and I said NO!" and with that he thanked me and wished me a nice day.

I grinned thinking about the tremendous comedic timing of that call. Last summer after my surgery, as I clawed my way back to health or at least the experience of healthy in a living-with-mets way, there were hilariously absurd things happening to me on a daily basis. Kelly and I would often be hysterical talking about them and we concluded that "you just can't make shit up this good," that real life is truly funnier than anything a novelist could dream up. But I digress.

I called Karen B. back and she said that I could go in right away to the Cancer Agency to have the procedure or they could find me a time in the morning and then I received a call from my oncologist, Karen G, saying that they couldn't actually fit me in the next day and that I should come in right away and they could do it. I called Charlotte and Zack's godmother Laura and she and her wonderful husband Tom said that they would be right over to hang out with the kids, get them fed, sit on them 'til their homework was done and off I went.

By the time I arrived it was almost 5:30pm. The normally teeming-with-people building was practically deserted. I went up to the 5th floor as directed and met with the doctor who was going to do the procedure, thanking him for staying late to do it. All went well with the fluid draw. The last step was to have a chest x-ray to make sure my lung hadn't collapsed. They said that x-ray would be ready for me in about 15 minutes and that I could go wait in the lounge. by the time I went to x-ray it was about 7:30pm. There was a young woman sitting at the desk in the dark. I apologized profusely for causing her to stay so late. "Oh, don't worry about it, " she said, "I just came back."

So what's the take-away from all of this? Sure, our medical system is structurally flawed but it is chock-full of fantastically caring and competent doctors and nurses, technicians and assistants. I am in good hands and I also squeak real good.