Going private: take two

Iwas scheduled to be at the clinic at Westmount Square in downtown Montreal at 9 a.m. Thursday morning. It seemed the worst possible time for an appointment, yet the estimated travel time—according to Artificial Intelligence in the form of the WAZE application—was an hour and 45 minutes. We decided to give ourselves an extra half hour, and we left at 6:45.

I went in with my wife and daughter; their return trip—without me—would be easier if they were two. None of us is accustomed to coping with Montreal traffic and an extra pair of eyes to help with navigation would be welcome.

As it turned out, the traffic nightmare we had anticipated never fully materialized. We didn’t hit traffic until just after we crossed the Richelieu River—just as WAZE predicted. Following its advice, we shunted onto a service road for a dozen or more kilometers before rejoining Highway 20, which at that point was again flowing well. We similarly followed its advice and got onto the Island of Montreal via the Victoria Bridge, despite our unfamiliarity with it.

We were at the clinic’s surgical center almost 20 minutes before our scheduled time, and it was a few minutes after 9 a.m. before someone came to fetch me from the waiting room.

Entering the surgical center was much like stepping into a hospital emergency ward: beds with accompanying monitors behind curtained cubicles, a slightly constricted hallway with all manner of medical aids and apparatus everywhere. Perhaps a dozen or more nurses and orderlies in hospital garb scurrying around.

Everyone who stopped by my bed began by introducing themselves— Hanna, Rémi, Alesia, and several others. A nurse took a minute to find a suitable vein and plugged me into an intravenous bag which, I learnt later, hydrated me and also administered antibiotics and a sedative. Another nurse, armed with a clipboard, had a slew of questions—allergic reaction to medication? diabetes? sleep apnea? These were all questions I had previously answered. More than one person verified my name, date of birth, and surgical procedure.

Dr. Adam Hart, the surgeon I’d met three weeks before, stopped by long enough to tell me that I could relax for a while and that he’d be operating on me in about an hour. He was followed by the anesthesiologist whose visit was equally brief and who asked if I had any questions. Someone came with a release form to be signed.

I knew I’d be at the clinic for two nights and I had brought a book to read, but I’d read no more than a few pages when a nurse arrived with a heated blanket which she draped over my shoulders to walk me to the operating theatre. There, again, my name, date of birth, and purpose of my visit were confirmed.

The nurse who brought me to the operating theatre asked me to sit on the rather narrow operating table. She produced a pillow out of thin air, put it in my lap and asked me to lean forward. She had her hands on my shoulders, as if to keep me from toppling off the table. I felt my hospital gown, made of relatively thick, warm, and colourful material, being lifted off my back. Suddenly, a very cold cloth was swiped across my lower back. I knew that I was going to be given an epidural; a needle was going to be poked somewhere into my spinal cord. The cold cloth, I reasoned, was the equivalent of a dentist swabbing my gums before inserting a needle to freeze a tooth. I felt the cold cloth a second time.

When my eyes opened, I found myself stretched out on my bed in my curtained cubicle. I felt fine, if a little drowsy. Neither of my legs seemed able to move, although within the next little while, first my good leg and then the operated one regained movement. A nurse arrived and placed her hand on my thigh, knee, calf, shin, and foot asking each time if I could feel her hand.

By 4 p.m. or so, both legs could move easily although, stretched out in bed, I did little more than flex my ankles and bend my knees. At 5 p.m. a physiotherapist arrived and explained to me how to sit on the edge of the bed and get onto my feet. With a walker and two people at my sides, I walked up and down the short hallway.

A visit to the bathroom was in vain. My brain said I should go but my bladder failed to listen. The special container put in the toilet bowl to measure the quantity of urine produced was removed. The nurse encouraged me to drink water.

Back in my curtained cubicle, I was again hooked up to an IV drip which now only provided hydration. I was also fitted with a blood pressure cuff which regularly took readings. The most recent one, the nurse told me, was 139/85—good numbers for me. During the operation, she informed me, it dropped considerably. The other thing being monitored was the oxygen in my blood. This was being done through a small clip attached to a fingertip. In my case the readings ranged from 97% to 99%. The nurse told me that a reading of 92% or less would prompt her to contact a doctor. She went on to tell me that she had seen readings as low as 40%. Allowed to go unchecked for five minutes, she said, such a reading would be fatal.

I learned from the nurse that I had been brought to the operating theatre at 10:24, that Dr. Hart began surgery at 11:05, and that the artificial hip was installed and the incision sutured by 12:00. I was the third of six operations performed by him that day, of which five were hip replacements and one a knee replacement. While he was the only surgeon operating that day, he was working with two different teams in two different rooms.

When my supper was brought to me—a chicken and rice dish—it was on a proper plate with metal utensils. The meal was unexpectedly good.

Dr. Hart came by just before 7:00 to ask how I was. He told me not to be concerned if I saw traces of blood around the waterproof bandage on my leg, but that if I noticed any liquid dripping from the bandage, to immediately get to a clinic or a hospital.

After his visit, I was walked to the bathroom and I urinated for the first time since 9 a.m. that morning. It has been years—if not decades—since I’d gone that long without urinating.

Then, quite suddenly, it was quiet. The hustle and bustle of the day gave way to the two nurses who would watch over us through the night.

Much as my first attempt at using private health care was a fiasco, I can only be glad that I made a second attempt. During the three weeks and two days that separated my first meeting with a surgeon and my operation, communication with the clinic—in either official language— was easy and fruitful. Perhaps the best example came after a relatively long telephone conversation one afternoon. The same evening, I sent an email asking to be called the next day as I had more questions. Not 20 minutes after sending the email, the phone rang. It was the clinic, asking if they were calling too late.

Private health care—while not my first option—proved, this time round, to be excellent.