Read on Twitter
Horrific: Video captures patient crawling out of hospital after staff dismiss pleas for help
https://www.cbc.ca/news/gopublic/hospital-patient-crawls-out-mental-illness-1.5871307 #sdoh #medtwitter /1
https://www.cbc.ca/news/gopublic/hospital-patient-crawls-out-mental-illness-1.5871307 #sdoh #medtwitter /1
This is 45-year-old David Pontone, who went to Humber River Hospital in Toronto in 2018 with excruciating leg pain. Due to his diagnosis of bipolar disorder, and the fact that his initial imaging came back normal, he was told to go home as he was fine. /2
This type of dismissal of the medical concerns of people with mental illness or substance use issues is extremely common. I hold my breath daily when I refer my patients to specialists or to the ER, hoping their medical issues will be seen and addressed. /3
Part of this is absolutely about the unconscious (and conscious) biases healthcare providers hold - we are part of broader society that devalues people with mental illness, people who use drugs, people living in poverty, racialized people etc. /4
But another hugely important point (one that Vicky Stergiopoulous addresses in the piece) is the separation of mental health and physical health in our healthcare system. The nuance and complexity is often lost when we see people as having either one or the other. /5
That's where the structural part of the discrimination comes in. When medical training seeks to 'simplify' and is designed by folks who are predominantly able-bodied and without experience of or with mental illness, we end up unable to see past the mental health diagnosis. /6
This is that much more likely to happen if someone is presenting with an illness like GBS (a rare condition, one that doesn't present outwards visible signs) - but I think we can all agree that if this man did not have the bipolar label, he may have been re-assessed. /7
This is also what happens to racialized people, to women, to queer folks, to people experiencing homelessness - the willingness to go that extra mile, to believe people, to delve deeper - part of it comes from seeing their humanity, and part of it comes from power. /8
At the end of the day, we know as MDs that someone who is more marginalized is less likely to know the avenues to complain, to hold us accountable. We may go further for those who hold higher standards, know their rights, and know the system. This is a problem. /9
I'm glad this man had family that could support him, fight the system, and ultimately demand the video evidence of what occurred, to be shared with the world. It is the only way we will change our systems that often perpetuate so much harm without it ever being seen or known. /10
Would love to hear from folks that work in ER about ways to combat these structural issues- lots of thoughtful people on Twitter very aware of the problems @edwardcxie @HasanMSheikh @hayman_kate @DrCarolynSnider
