All I want for Christmas is not in a gift box

by Carolyn Thomas       @HeartSisters 

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?

See also:

Christmas lights amid the dark of COVID

– All other Heart Sisters articles about living through COVID-19

14 thoughts on “All I want for Christmas is not in a gift box

  1. Wonderful post, Carolyn, and I also hope you get everything on the list.

    Biggest thing on my own list, I am praying for a huge Christmas miracle: that both my adult sons will find great jobs that they really like, with benefits. The older one just completed a Masters in Math with hopes for a job in academia. The younger one lost his job at a restaurant in March due to the pandemic and has been out of work ever since. They are receiving help from us and from their grandmother, such as having food, a rent-free place to live, and bills covered, and honestly it is a burden but what else can we do? Mostly I worry about their mental health — anxiety and depression and not knowing what to do other than keep applying for jobs, which they are doing, but the applications mostly seem to go into a black hole and nothing comes of them. In the best of times they have struggles knowing what to do with their lives. There are numerous health issues and neither has a romantic relationship either. My younger son recently asked me if I was ashamed of him for not doing better in life. Makes me cry!

    Also just want that we and all our friends should stay Covid free. So far only two people I know have gotten it and they are fine today so I am grateful for that. I hope it’s not selfish of me to wish for this.

    The last thing I want is for Trump and the Republicans to JUST STOP and step down and let someone in there who can DO THE JOB. This constant baseless harping about a stolen election is causing so much anxiety and stress and contention in our country at an already stressful time. Praying that the transition to Biden’s presidency goes amazingly smoothly despite all the lies and shenanigans!

    Liked by 1 person

    1. Hi Meghan! I hope your wishes come true in the coming year, too. As a Mum, isn’t it just our nature to want only the best for our kids, and to suffer along with them when they’re not doing well? I hope once the pandemic settles down, and businesses start hiring again, your sons’ job-hunting efforts will pay off! Who knows, they just may end up in jobs they never saw coming if they stay open to the possibility, something entirely new and different?

      Meanwhile all of us hope that we and our families and friends will stay COVID-free – and no, that is not a selfish wish at all!!! It would be unusual NOT to have that as #1 on everybody’s wish list! Lots of promising news with the vaccines now, so who knows – if we can keep the spoiled brat idiots from gathering where they’re not supposed to be, we just might make it out of this…

      I and all of my friends/family here in Canada share your wish to see the end of Mr. Trump in your country. It’s so tiresome, his relentless tantrums about the ‘rigged’ election, and even attacking Republican politicians who admit he’s wrong, for somehow conspiring with the Dems to spoil ballots. It’s the rant of an insane weakling. But he will be gone soon – and that fact alone means a more promising start to 2021, doesn’t it?

      Take care, stay safe out there. . . ♥

      Like

  2. Hi Carolyn,

    Well, that is a wonderful list. I hope it all comes to be.

    How exciting about the new grandbaby. Hoping all goes as smoothly as possible on that front. Do keep us posted.

    I had no idea medical diagnostic errors were not reported, at least not to the extent they could/should be. That makes no sense at all. And gosh, we all want the darn virus threat to go away. The death toll numbers are staggering, and sadly, it does seem we are becoming a bit numb to them, here in the US anyway. And you’re so right, women do need to be listened to when they report symptoms of illness. In fact, they need to be listened to more, period! And #5 – so important.

    Hoping you have a holiday season that brings you many moments of peace, joy and contentment. You take care and stay safe and healthy too. xo

    Liked by 1 person

    1. Thanks Nancy – such a nice overview of my whole post! I wish you and your family a happy holiday, however you are planning to spend it – all while taking care and staying safe.

      PS I always love seeing your name in my comment inbox! ♥

      Like

  3. As I read your story which is so similar to mine, i cringe and tears form because it happened to me this April.

    I too was sent home from the Nanaimo Emergency after waiting by myself (because of covid) for 3 1/2 hours, the Emerg doctor sent me home with GERD (acid reflux). My symptoms were horrible chest pain, short of breath, dizzy, no strength. I hike a lot and it started to happen while I was hiking. I was back in the next morning after crying in pain all night to my husband. Back to the ER, and this time 5 1/2 hours of sitting alone, now it is in my jaw, down my arm and I feel like I am dying. I could hear the nurses behind me gossiping and talking about covid, hair cuts, recipes etc. And ignoring me trying to raise my hand to get their attention. I finally stood up and walked to their desks. I stopped a nurse and told her I think I am dying.

    I remember being told by a doctor that I was having a heart attack and had to sign for a shot, and if he was right it would help but if he was wrong, it would kill me. I told him i could not make that decision without my husband.

    The ER doctor contacted Dr Robinson cardiology at Royal Jubilee in Victoria and a emergency helicopter was sent for me. At the Royal Jubilee, I was stabilized and the next morning received two stents one on top of the other because the RCA had frayed so badly. This procedure was done by a student cardiologist and it was very painful.

    I have since been back to the Nanaimo ER because of problems with medication and symptoms, and each time I as an older woman have to fight to be respected and treated like a human being. I registered a complaint with Island Health and Patient Services, but nothing was done as far as talking to staff and the doctor who sent me home.

    We also just lost a friend who was diagnosed and treated with severe anxiety but died soon after with a massive heart attack … same hospital.

    More than anything I want to see changes, and yes people fired in Island Health.

    Liked by 1 person

    1. Scotsrish, I’m completely gobsmacked by your story. I hardly know where to start – except to say that I have trouble imagining a MALE patient with “horrible” chest pain sitting in any ER waiting room for 3 1/2 hours (and then – worse! ) – 5 1/2 hours next day!

      Also, that Nanaimo doctor who told you you were having a heart attack and needed the shot (“…if he was right it would help but if he was wrong, it would kill me.”) Are you KIDDING me?

      Who speaks that way to a person having a heart attack?!?!? Was he making what he thought was a “joke”?

      You also raise an interesting point that should be taught in med/nursing school: all healthcare professionals should be acutely aware that while we the patients are patiently waiting, we can hear you. We hear you chatting with your friends, your lighthearted gossip – while we are suffering. This is not only disrespectful and unprofessional – it’s downright rude to behave as if your patient is invisible. I wrote about this kind of behaviour here several years ago (“Would It Kill You To Treat Your Patients With Respect?”) And I’d have the same reaction if two clerks at the grocery store were busy chatting about their boyfriends in front of me – just as if I’m NOT standing there. The difference: that’s not a life and death scenario.

      Gossipy chit chat among ER staff also suggests to patients that what you are suffering is not even worth anybody’s time. Now, these nurses could have been on a well-earned break (I have to add this because of all my nurse-friends!) but in my experience, the staff break room is rarely within the Emergency Department. And if it is, it needs to be moved.

      What really galls me (aside from that horrific observation that we “older women have to fight to be respected and treated like a human being”!!!!) is that this happened to you in APRIL of this year?!! Since my own misdiagnosed heart attack in 2008, I have been told by many people, including cardiologists and nurses, that what happened to me back then could NEVER HAPPEN NOW, because clinicians are more aware of women’s heart disease now, or because we have improved diagnostic tools now, etc etc.

      So when I hear about you and your experience THIS YEAR, it makes me insane.

      I’m so sorry you had to go through this, I’m sorry that Island Health did not respond appropriately to your complaint, and I hope you are feeling much better now.

      Take care, and please stay safe. . . ♥

      Like

      1. Thank you so much Carolyn – I was so excited to get your reply. If not for your book, (which took me quite a while to find) I would have been near crazy. Thank you so much for writing it – it became my buddy every night.

        Before this I had volunteered for the Hospital Auxiliary for years. Every year we donated over half a million dollars, plus bought equipment, built operating rooms, added CT and MRI scanners, put in the wifi, helped build the maternity building.

        I really like my cardiologist in Victoria and she has really educated me on what female patients go through, plus the hardships that female doctors endure.

        Once again thank you Carolyn you are a breath of fresh air. You need to write another book …The medical industry and being female.

        (NOTE from CAROLYN: – some content here has been removed at the reader’s request)

        Liked by 1 person

        1. Hi again Scotsrish – thanks for this additional information (which I appreciate knowing, but agree with you that some content is better left between me and you so, as requested, I removed a chunk).

          I did want to acknowledge the Hospital Auxiliary volunteers you mention: almost every hospital has such a band of hardworking volunteers and the money they raise (usually through running the hospital gift shop or other fundraising options) is AMAZING! I’m glad you have a cardiologist you like here in Victoria. I always tell my “Heart Smart Women” presentation audiences that if you’re going to have a heart attack, you should really try to have it in Victoria – we probably have more cardiologists per square city block than most cities (because cardiologists like to live in a beautiful historic town on the ocean, with a teaching hospital, research facilities, a university, theatres, great restaurants, schools – and where you can golf or garden 12 months of the year.) I once wrote about the day I inadvertently discovered what life would be like if you were a heart patient living in northern or rural parts of our province! It’s a shocker! See: Why You Should Hug Your Cardiologist Today (just kidding about the hugging – NO hugging at this time, of course!

          Thanks also for your kind words about my book – I appreciate it.

          Like

          1. I also saw your article about statins especially regarding women. This really hits home as women can have some very harsh and debilitating side effects from the heart meds given.

            I rarely ever took so much as a tylenol so when I was shown the exit after my heart attack and two stents I was also handed a bag of pills with 6 meds I had to take daily. It was horrible, the side effects were making me crazy and so sick. I had side effects that said call your doctor but when I did I was told to hang in there as in time they would decrease. Ticagrelor was one of the harshest plus the horrible statins. I wish there was a site or forum where we could exchange our experiences with surgery, meds and side effects. With COVID it is next to impossible to share and yet so many of us hearty’s and strokers need this badly. Have a wonderful New Year.

            Liked by 1 person

            1. Hello again – there IS in fact a federal government site here in Canada where we can and should report ALL side effects (not only of prescription drugs but vitamin supplements, medical devices even medical marijuana). Here’s the link: https://www.canada.ca/en/health-canada/services/drugs-health-products/medeffect-canada/adverse-reaction-reporting.html

              READERS: if you’re not in Canada, just do a Google search in your area for a government site that collects data about side effects.

              Ticagrelor (also known as Brilinta, an anti-platelet drug commonly prescribed after a cardiac stent) has a number of known side effects e.g. shortness of breath, bleeding more easily than normal, including nosebleeds, heavier periods, bleeding gums and bruising. These are unfortunately also the known side effects of Plavix and most other anti-platelet drugs because that’s their job – to help prevent the blood from creating dangerous clots inside our arteries. Usually, it’s a time limited drug, just until the body adapts to this foreign object inside the heart (e.g. usually one year post-stent). Trouble is, if heart patients weren’t taking anti-platelet meds after a stainless steel stent is implanted inside our hearts, the blockages would almost always re-form causing subsequent heart attacks.

              Still, it’s important for all prescribers to hear from each person experiencing severe side effects that affect one’s quality of life. Sometimes the dosage can be tweaked to find that sweet spot between dangerous cardiac risks and bad side effects. I’ve observed that doctors may be dismissive about women’s complaints of drug side effects (especially if the drug’s manufacturer and sales reps assure docs that these side effects aren’t “common”) but when ENOUGH patients start reporting significant side effects, we know that changes are made, drugs taken off the market, doctors pay attention.

              Best of luck to you… Take care and stay safe out there…. ♥

              Like

  4. May all your Christmas wishes come true. I have two more.
    1. That I am remembered and told/shown that I am. And that I do the same to others.
    2. That COVID doesn’t get to me, physically or emotionally here in my apartment, 10th month of confinement.

    I fear panic, debilitating anxiety. A fellow resident broke the guidelines, went to a family Thanksgiving gathering, came back, now has COVID. So close to getting a vaccine. Maybe it will deter some thinking of leaving for Christmas.

    Please take good care of yourself.
    Joan

    Liked by 1 person

    1. Hello Joan – two excellent Christmas wishes. I hope they both come true for you.

      I also hope that the spike in COVID cases we’re seeing now post-Thanksgiving will convince people NOT to travel for Christmas. Honestly, what are they thinking? But we cannot control what other people do or don’t do – we can just make the best decisions for ourselves that we possibly can.

      I heard an elderly man interviewed on the radio this week who told his family to stay home for Christmas dinner this year, so that he would be alive for their Christmas dinner together next year. Those are smart instructions.

      Take care, and stay safe. . . ♥

      Liked by 1 person

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