I have had more medical tests in the past 3 months than probably the last 20 or 30 years combined. Mammograms, ultrasounds, bloodwork, MRI. Even a bone scan.
My wonderful family doctor, Meaghan Wilson, ordered the bone scan when I told her of experiencing upper back pain. It felt like the occasional discomfort from my scoliosis, but was more frequent, longer lasting, and more intense. I also told her about my beloved friend who is living with bone metastases from breast cancer. The idea that the cancer might already have spread truly terrified me. Dr. Walker, the surgeon, told me gently that this was unlikely, but he did not dismiss my concern.
I'm happy to report that the bone scan is clear, except for osteoarthritis in various places in my spine, knees and left wrist. I was never so happy to get a diagnosis of osteoarthritis.
The day of the bone scan felt like my first day of being in new, strange and unfamiliar territory. Though I was literally being put into the scanning machine, metaphorically, I also felt like I was being inserted into the medical "machine." All for a good cause, but still. It was also my first day of medical leave. I was adding a new identity on top of the many I already am: cancer patient.
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There are two hospitals in Kingston, Hotel Dieu (colloquially known as "the Dew") and the Kingston General. Hotel Dieu is an "urgent care" day hospital, while KGH has emergency care and in-patients. The ultrasounds and the Breast Cancer Clinic are at Hotel Dieu while the high tech imaging (bone scan and MRI) is at KGH. Although both hospitals are under the same administration, the "vibe" at each is very different. I'm sure there are many reasons for that. If I had to choose, I'd rather go to "the Dew," even if the lineups are longer.
The day of the bone scan felt like my first day of being in new, strange and unfamiliar territory. Though I was literally being put into the scanning machine, metaphorically, I also felt like I was being inserted into the medical "machine." All for a good cause, but still. It was also my first day of medical leave. I was adding a new identity on top of the many I already am: cancer patient.
I rode my bike to the 8:30 AM bone scan appointment. KGH is literally on the Queen's campus, but it struck me how separate these worlds are, at least for those of us who are not students or faculty in health sciences. I parked my bike in front of an engineering building and watched students with uncoiffed hair, clutching coffee, mount the stairs.
Not far away, on another set of stairs, 4 or 5 men of indeterminate age, who appeared to be patients, were smoking. Close to the hospital door, in contravention of official policy, a woman with long dark hair, a colourful feather earring, and an IV in her arm, sat in a wheelchair smoking. She had fresh white bandages wrapped around the stump of her above knee amputation. She nodded and smiled, saying, "You are looking bright and perky this morning!" I smiled back and said, "Thank you."
Please allow me a small rant:
Surely the fact that there are people in this very wealthy country who have lower limbs amputated for reasons other than traumatic accidental injuries is a stunning indictment of our lack of care for those who are poor and poorly housed or homeless, disproportionately Indigenous people. A 2017 article published in the Canadian Journal of Public health was the FIRST study of the incidence of lower limb amputation in Canada. Diabetes was the main cause (65% of cases)—which also disproportionately affects Indigenous people, though the authors didn't bother to point that out. When health care researchers leave out the social and political context of disease (usually in a misplaced belief in "objectivity"), it reinforces the dominant idea that individuals are solely responsible for their diseases. But we know that when some groups of people are disproportionately affected, there are larger, structural factors at play.
How many people do YOU know who have had lower limb amputations? I don't know anyone personally. The fact that this is a condition of those living in poverty probably accounts for the fact that we have so little research about it. Thanks to Evelyn Forget, the incredible health economist (who is a sociologist at heart) from Winnipeg, who told me her painfully poignant observations of how embarrassed poor people are to take off their shoes in a medical exam. Add ill-fitting shoes, lack of socks, and possibly inadequate access to bathing on top of diabetes-induced neuropathy (nerve damage) and poorly controlled diabetes—it is a recipe for small injuries to become infected and then gangrenous.
But, I digress.
As you may know, in my 20s and 30s, I was, first, a dietetic intern at the Vancouver General Hospital, and then, a dietitian in 3 different places, Port aux Basques NL, Victoria BC, and in Toronto, at St. Mike's Hospital. Unsurprisingly, the experience of being in a hospital as a patient is quite different than being a health care provider. Some days as a health care provider were distressing, but mostly, especially as a young person, it was easy to shake it off at the end of the day (NB: I'm talking about the "old days," in the last century, when health care was not as pressurized, and well before the pandemic). As a patient, I feel much more sensitive and vulnerable. Small gestures and words have big impacts, in both directions.
As a healthy-appearing, healthy-feeling person, with my bike bag slung over my shoulder that day at KGH, I really felt as if I didn't belong as a patient, surrounded by so many who were obviously, clearly frail and unwell. As a student of health sociology during my Ph.D., I remember being struck by the rather basic but profound sociological notion that the medical diagnosis of disease (and even terminal illness) and the patient experience of illness and well-being often do not overlap.
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