Thursday, March 16, 2006


In The Dragons of Eden (ISBN 0-345-32508-7), Carl Sagan talks about the parts of our brain and what they do. When he describes the limbic system he refers to draqons and our reptilian nature; aggression and ritual.

I'm married to a special unit nurse who works in the PACU (post anesthetic care unit). In more sensible times it was called the Recovery Room. It's the room outside the operating suites where they take patients to recover from surgery. The nurses who work there are often not remembered at all by patients, who are still groggy with anesthetics. When the nurses and anesthetists have brought the patients to a state of normalcy, they are either sent to one of the floors, or home. The nurses who work there are paid $30.00 an hour. The recovery room is open from 7:00 a.m. to 11:00 p.m. In cases of emergency, they call in two PACU nurses, open the Recovery Room and staff it for as long as it takes to recover the patient.

It's hard to get operating room time for patients, and what with one thing and another, sometimes operations are scheduled after 11:00 p.m. as emergencies when really they aren't emergencies...... So, call in two nurses, open the PACU and pay them. Pay mileage. Pay time and a half for the first four hours. Pay double time for the next four hours. Lots of money, not to mention wear and tear on nursing staff and their families. Keep in mind that the average age of these nurses is in the late forties, so generally speaking they are an experienced, but elderly bunch.

So last night, I and the Flower of Acadie stayed up till 11:30 p.m. waiting to see if she would be called in by the last of the day staff (3:00 to 11:00 p.m. shift) to continue on into the night with a case. Shiver me timbers but there was no call and I and the Flower were off to bed by midnight. Aaaaaaaaaaaaahhhhhhhhhhhhh. Tee-hee and all that stuff. At two a.m. the cat threw up in his kennel. We hadn't combed him enough and he's changing his coat with the approach of spring. The Flower got up and cleaned up the mess (his kennel is on her side), then put the cat out of the bedroom to roam. At two thirty a.m. I got up and let him back in and put him to bed in his kennel. At three a.m. the phone rings and they tell the Flower she'll have to go in to care for a post-op laparotomy. I get up, scrape the frost from the windshield, warm up the van and put a can of diet coke and some cookies in a bag which I hand to the Flower. The Flower's hospital is a pepsi cola only hospital, about which more later.

I continue on to the den, fire up the computer, put on headphones and listen to an album while combing through EBay looking for bargains. At five a.m. a pair of headlights illuminate the back yard. The Flower is home. She tells me that she and her partner were there for fifteen minutes, by which time the surgeon had decided that his tummy operation was a serious case and needed to go the Intensive Care Unit after surgery instead of the Recovery Room. Fair enough she said. He couldn't know what he'd find in there and it was nobody's fault that she and her partner were called in needlessly. The Flower spent a bit of time pacifying me. She said that ICU beds were very expensive places to send people and doctors were loath to send someone there if it wasn't absolutely necessary. However, when cross-examined, she admitted that ICU nurses were paid the same as PACU nurses. She allowed as how the ICU was staffed and ready twenty-four hours a day, including doctors and nurses. Yes she admitted, all of the beds, equipment and monitors were already paid for, just like the PACU. Over breakfast the Flower explained hospital politics to me.

The ICU guards its position in the hospital hierarchy very jealously. They do not accept patient overflow from the PACU/Recovery Room. They do not accept patients unless they are bona fide emergency-near-deaths-door patients. This means that it's possible to have an empty Intensive Care Unit, fully staffed and waiting and still have to call in PACU nurses and pay them.

And so you wonder what it is about the Canadian medical system that's costing so much money?

Limbic thinking. Buried there under the neo-cortex is the limbic system, fully staffed with reptiles, responsible for aggression, territoriality and other political behaviour. A lot of things are done in hospitals that don't make sense unless you consider politics and reptilian thinking. Accounting and planning are functions of the neo-cortex and they should hold sway in a modern scientific establishment like a hospital; but when the reptiles come out, hissing and aggressive, homo sapiens knows enough to run like hell and take cover, because a hospital is an hierarchical entity, and here, the reptiles still rule.

What the hell, we were up anyway, so we had those delicious little breakfast sausages made by Tony's and buttermilk pancakes with good Canadian maple syrup. For us, it's going to be a pretty good day, but not for you. Not you Nova Scotia tax payers. The hospital is going to spend your money like a drunken sailor who found someone else's wallet. Good luck.


Post a Comment

<< Home