Thursday, 20 September 2012

Stark Contrast

I am taking a fourth year course in First Nations Health.  The instructor recently asked us to journal our reflections about one of the readings.  I have decided to share that journal with you here.  Enjoy!



Stark Contrast
In this journal, I will be comparing my experience as a social service worker helping one of my clients experiencing appendicitis with the reading about Renee Smith dying as a result of a ruptured appendix.  I was shocked when I read that Renee died of complications from appendicitis.  Not too long ago, I helped save the life of a woman with appendicitis, whom I will refer to as Kathy. There are similarities between Renee and Kathy because both belonged to marginalized groups of people.  Renee was a First Nations girl, and Kathy was a homeless woman.  However, there is a stark contrast between how Renee was treated by medical personnel at the hospital and what happened to Kathy. 
In Renee’s case there had been neglect right from the time she entered the hospital the first time and the nurse gave her pain killers, and she was allowed to leave the hospital.  The next day when Renee came back to the hospital in worse condition, she was admitted with acute abdominal pains.  Renee was not started on IV medication even though she had not been able to retain any fluids due to vomiting and diarrhea. Renee died due to peritonitis from a ruptured appendix.  By contrast, Kathy came and spoke to me about not feeling well.  Kathy told me that she had been vomiting and felt nauseas.  Kathy was bent over in pain and I asked her about the pain.  She told me that it was going through to her back.  My biggest concern for Kathy was that she was dehydrating because she was vomiting.  I also knew from having experienced gall stone pain previously that the type of pain she was experiencing was indicative of something more serious than stomach flu.  After some talking, she finally gave me permission to call Emergency Services on her behalf.  The ambulance was there within fifteen minutes and they took her to St. Paul’s Hospital to be admitted.  The doctor ran some initial diagnostic tests on her and they discovered that she had appendicitis.  Kathy had her appendix removed within 10 hours of being admitted to the hospital. Kathy recovered quickly from her operation, and was back at the shelter within a few days.
My training is in social service work.  I am not trained in medicine, but even I understand the importance of replenishing lost body fluids.  I do not understand how doctors and nurses could overlook the fact that Renee was losing more body fluids than she was able to replenish.  The least that the medical staff could have done was to put her on IV medication while the diagnostics were being done.  In Kathy’s case, being put on IV was one of the first things the medical personnel did to help her.  In Renee’s case, the diagnostic testing such as an X-Ray was either delayed, or not even done as in the rectal exam to confirm the diagnosis of appendicitis (131).  Kathy was fortunate to have medical personnel who were attentive to her needs.  I think that Dr. Mills sums up well when she uses the following description at the Inquest, “She [Dr. Mills] criticized the treatment Renee had received and said that on a scale of one to ten, with “one” as the lowest, Renee’s care deserved a “two” and “reached the level of malpractice” (Speck, 131) [emphasis mine]. 

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