My family tells me I’m “impossible” when it comes to picking out a gift for me. I am rarely able to offer even a single helpful hint. Instead, I plead with them most years not to buy me “more stuff”. I don’t want stuff. One only has to visit the average yard sale to witness the inevitable future graveyard of all that stuff. Bread machines. Crimping irons. Chia pets. Any kind of candle. Aside from absolute necessities of life (like groceries or my crafting supplies!), there are few things I now need, or even want.
Well, there are things I need and want, but hardly any come from a store or in gift boxes. Here’s what I really truly want Santa to bring me this year. . .
1. I really want my daughter-in-law Paula to have a safe, uneventful pregnancy and a healthy first baby due in early April. After years of painful challenges, Paula and my son Ben are cautiously thrilled about this miracle baby – perhaps Ben more so than Paula because he wasn’t the one who has spent four months puking. But things are looking up as she has gradually been able to keep food down and feel more like her usual perky self. She’s been such a trouper! Every Tuesday, we review with great excitement their phone app that tracks how Baby Beans is progressing week by week. We’re all keeping fingers crossed that she’s over the pukiest part now, and will enjoy a no-drama pregnancy from now on until we welcome this precious new baby in person this spring.
2. I want the threat of COVID-19 to finally go away. I want my family and friends to stay healthy. And before it’s over, I want politicians to stop talking and start working on the shocking healthcare issues revealed during this pandemic – like the appalling state of many longterm care homes (over 75 per cent of all COVID-19 deaths in Canada so far have been among LTC facilities, especially in those run by for-profit companies). Two privately-owned Ontario facilities received $157 million in Canadian government COVID-19 aid so far, but then paid $74 million of that to their corporate shareholders instead of ensuring improved resident care.
I want municipalities to run their own non-profit LTC facilities, greater funding of longterm care, optimal minimum staffing and care time requirements as a national policy, fewer shared rooms, liveable full-time wages AND benefits instead of hiring only part-time so you can stiff them on benefits, and more comprehensive (unscheduled) official site inspections, and I also want people around me to wear their damn masks!
3. I want to see mandatory reporting of diagnostic error. When I was sent home from the ER in mid-heart attack with an acid reflux misdiagnosis – despite textbook heart attack symptoms of central chest pain, nausea, sweating and pain down my left arm – those who sent me home were not required to report this diagnostic error after I was later correctly diagnosed in the same ER. To my knowledge, there is no mandatory reporting of diagnostic error in any medical jurisdiction. How is that even possible? Medicine is the only occupation in which, when bad things happen to end users (aka patients), the only official response is to not talk about it. No need to document, no discussion at Grand Rounds, no opportunity to teach lessons learned to medical school classes.
Meanwhile, we no longer have voluntary hard hat usage on construction sites or voluntary safety checklists by airline pilots before takeoff. That’s because other industries are light years ahead of medicine in considering workplace errors as serious issues affecting public safety.
About $7 million a year is spent researching diagnostic error.(1) That’s less than the $10 million spent each year on smallpox research, and that disease that was eradicated half a century ago. And no wonder – it’s hard to research diagnostic error when those who make the errors aren’t compelled to provide any data.
Dr. Gordon Schiff, at Boston’s Center for Patient Safety Research at Brigham and Women’s Hospital, recommends “a national database in which patients and physicians could detail the onset of symptoms, when the diagnosis was made, whether it was found correct, and if not, why not, and all that followed so learning could advance outside the arena of malpractice lawsuits.” A national database? Now that’s what I want for Christmas!
4. I want physicians to listen to women when we tell them we’re sick. Despite ongoing research confirming a pervasive gender bias throughout medicine, including in cardiology, many docs appear to be dismissive and even downright offended by the accusation that such bias exists. See also: “There is no gender bias in medicine. Because I said so. . .” – and next week’s Heart Sisters blog post with a shocking example of this bias.
If you are a sucker for punishment, read Maya Dusenbery’s awesome book on the history of women’s health care called Doing Harm: The Truth About How Bad Medicine and Lazy Science Leave Women Dismissed, Misdiagnosed, and Sick – (full disclosure: I was interviewed for her chapter on women’s heart disease) – but a cautionary warning: Take your blood pressure meds before you open this book!
5. I want to see more people giving the gift of life. Become a regular blood donor. Register to be an organ donor. Support your local hospital’s COVID-19 fund. Donate to Doctors Without Borders, whose mission is to provide life-saving medical humanitarian relief (my own family physician spent 14 years of her career working overseas with this amazing non-profit organization, which I’ve always thought says a lot about her as a person). Even better, sign up to become a monthly donor to support a local charity of your choice, wherever you believe the need is greatest. Even just a few dollars per month can really add up by allowing these charities to plan on a reliable income stream to depend on. These important grass root groups have taken a catastrophic funding hit this year because of the pandemic. So if you can, please consider helping them.
Meanwhile, whatever you find under your own tree this Christmas, and no matter how different this year’s holiday season feels compared to any other, I hope you’ll take many moments to enjoy the lights, sounds, traditions and spirit of a special season.
Take care, and please stay safe this holiday. . .
1. Newman-Toker DE et al. “Rate of diagnostic errors and serious misdiagnosis-related harms for major vascular events, infections, and cancers: toward a national incidence estimate using the “Big Three.” Diagnosis (Berl). May 14, 2020.
Image: Bev Gulbrandsen
Q: Is there something on your own wish list this Christmas that doesn’t come in a gift box?
– All other Heart Sisters articles about living through COVID-19