MONTREAL — Some Montreal doctors added a dose of realism Saturday to the fiery debate south of the border that asked if Canada’s “socialized medicine” killed actress Natasha Richardson after she hit her head skiing on Mont Tremblant March 16.
“Canadacare may have killed Natasha,” screamed a headline in the New York Post. “Was Canada’s healthcare the problem?”asked another in the Chicago Tribune. The implication “is totally unjustified,” said Paul Saba, an emergency room doctor at Lachine Hospital and co-president of the Coalition of Physicians for Social Justice. He flatly rejected the notion that a lack of funding for overall public health care contributes to fatal head injuries like the one that claimed the life of Richardson.
Saba stressed he was not commenting specifically about Richardson, but “any patient’s refusal of treatment is crucial” to the outcome. So is not wearing a ski helmet, he added. Richardson, 45, wasn’t wearing a ski helmet when she fell around noon and was walking and talking afterward. She also refused an ambulance that came for her about 45 minutes later. Another ambulance was called about 3 p.m. and she arrived at the Centre Hospitalier Laurentien in Ste. Agathe, 42 kilometres away, nearly four hours after her fall. Two hours afterward she was transferred by ambulance to the trauma centre at Montreal’s Hepital du Sacre-Coeur, 83 kilometres southeast of Ste. Agathe. An article in U.S. newspapers by Cory Franklin, a physician who lives in Wilmette, Ill., took sharp aim at the lack of CT brain scanners in some Quebec hospitals and the lack of helicopter ambulances.
“With prompt diagnosis by CT scan, and surgery to drain the blood, most patients survive,” Franklin wrote. “Could Richardson have received this care? Where it happened in Canada, no. In many American resorts, yes.” But a simple phone call Saturday to the radiology department at the Centre Hospitalier Laurentien revealed that the hospital is in fact equipped with a CT scanner. It was not known, however, whether the device, which can cost $1 million, was used on Richardson. As for the need for a medical helicopter, Saba said that while it would be helpful in longer-range cases, it might not have saved the actress.“You have to do a cost-benefit analysis,” Saba said. “It takes time to get the helicopter’s medical team assembled, get the helicopter to the location of the patient, pack in the patient and fly the helicopter to Montreal.” But Michel Garner, head of the emergency department at Sacre-Coeur, said Mont-Tremblant is a two or two-and-a-half hour drive from Montreal. Ste. Agathe can be an hour’s drive away, he noted. “I’m certain some patients would benefit” from a helicopter system, he said. Paul Brunet, president of the Council for the protection of patients, said the question of whether a medical ambulance would have made a difference was moot. “If she had worn a helmet and accepted to see a doctor would there be any talk of this need for a helicopter?
Disclosure: I was injured in a skiing accident in Breckenridge Co. about 7 weeks ago. I thought I had only tweaked my knee but I hit my head (“had my bell rung”) and came to quickly (around 30 seconds). I have many years of abusing my body through sports and I am no stranger to pain, so I shook it off, collected my gear and finished the run. The next morning I was admitted to a local trauma center where I learned that I had completely severed the ligament (ACL) that runs under the kneecap. How I was able to to finish the run or walk that evening remains a mystery to me. But the staff was more concerned about my head injury… I wasn’t. The health care I received couldn’t have been better or more expensive. I guess the point I am trying to convey is that we all have choices and decisions to make at the time of an injury. I probably (definitely) made the wrong decision, yet I was lucky. Miss Richardson was not so fortunate. And in case you’re wondering, no, I never even considered wearing a helmet.
Killed by socialized medicine because there was no helicopter sent in for someone refusing a ground ambulance or to be treated? Sounds about right.
McCullough–hard to seek treatment when you feel good enough isn’t it? Still makes sense, why mortgage the house to be treated when 99.99% of the time there is nothing in fact wrong?
All actually a care for socialized medicine that EVERYONE can afford==and than millionaire actors can turn down if they wish.
She wasn’t wearing a helmet, and she refused initial treatment. Sad, but those are the most damning reasons she died.
About the only thing Quebec is studying to improve is bringing in air ambulances like we have in Ontario. That would have shortened a little of the time, but most of the time wasted was unfortunately due to the patient’s wishes.
Total BS. She REFUSED to be taken to the hospital! The ambulance crew can’t force her to go. By the time they were called the second time — TWO HOURS LATER — it was too late.
#1 bobbo- “McCullough–hard to seek treatment when you feel good enough isn’t it? Still makes sense, why mortgage the house to be treated when 99.99% of the time there is nothing in fact wrong?”
Yes I blame it on (or credit it to) every sports coach I ever worked for. “Shake it off, you pussy” was the mantra, and we did. Sometimes you can, other times it’s disastrous.
It was her decision to refuse help. End of story.
[Where ya been Jäger? – ed.]
Jag==end of story? Many a part of it. Whats important is that the general populous learn that head injuries can be this symptom free yet still so deadly. Same with certain chest, leg, and arm pains that don’t “raditate” from the heart. Take an aspirin and head (sic) for the emergency room in the latter case, DON’T take an aspirin and head for the ER in the second case.
Course, in the good old USA, absent blood and a complaint of pain, you will be triaged to go home if you can’t pay for a CT scan at the local vets.
Can’t the best healthcare system in the world do any better?
Well, I thought it was very sad. We should be forgiven for life’s mistakes in our death.
Canada, with its socialized medical system, has a lower infant mortality rate than the U.S. So a grown woman who refuses treatment and unfortunately dies really is in no way a condemnation of the Canadian system. If you’re an American without health care, like I was for many years, you know that a flawed universal system is significantly better than none.
A CT should have been available, and given the “nobody pays” arrangement, mandatory, before she could sign out.
(Maybe I don’t pay attention, but ski helmets?)
Once she got home, and started to feel like she had a problem (remember that the initial ER staff could have influenced the “walk it off” decision), it was impossible to get her to a place where suitable treatment (a head injury should have been extremely obvious, and the nature of the _potential_ injury known to those who responded) could be arranged.
The lack of CT capability at the initial treatment center appears to be due to appropriate staff and hardware. Same for the ambulance situation. This isn’t 1950….
And, while triage may be necessary in many instances, this was a single accidental injury in an environment where “any means possible” should have been the way to go.
Socialized medicine means the lowest possible standard of care for everybody, regardless of ability to pay. Which sounds fine until you figure out that accountants and MBA’s are making medical decisions. I’m on Medicare, and have Medicare “D” drug coverage. The bean counters declare that a certain drug, which works for me, and my personal physician prescribed, and likes, is too expensive, or they’re getting a big enough bribe, and it’s off the list. Either I switch to something else (which may be less effective, or have more side effects), or pay for it IN FULL….
(We won’t talk about the former day job’s attempt to foist an HMO off on their employees. Way too many staffers went to school in Mexico…. The “under 40” crowd really don’t care, most of the time, but the older folks knew better…. One of our guys, btw, died of Leukemia because the bean counters at our insurance company refused to pay for a second round of chemo that probably would have saved him. That could become the norm….)
Regards
#11–pedro==just because I think it is “important:” it was poor KNOWLEDGE on Richardson’s part and failure to follow protocol on the medical personnel’s part.
Does anyone know what the protocol “is” for head injury in Canada/USA/good practice? I can imagine it might be that if knocked unconscious IN ALL CASES, a ct scan to be performed==but what of mere bumps with no complaint or concern by the victim? I can see in the former than medical personnel should push, really push for the ct scan. Not so convinced where the line should be for mere bumps where the patient has no complaint.
One of the many examples where: “Knowledge is power if you have the money to implement it.”
I live in Australia, which, as it happens, also has universal medical care.
Unlike the statement from #10-Stu Mulne, “Socialized medicine means the lowest possible standard of care for everybody, regardless of ability to pay.” we here in Oz have excellent universal care. My daughter has just had a CT, I’m on a special care regimen and my wife has special care regimen too, and we all are well cared for on Medicare!
We are also cared for with an income due to our inability to get gainful employment (i.e. nobody will hire us because of insurance liability) with a Disability Pension and my daughters are on Youth Allowance to pay them through secondary school (12 to 18 yrs old).
I say “patooy!” to the USA experiment, it clearly does not work for the disaffected and poor in society.
No.
My wife is an ER resident and almost every night since the accident she has seen 4-5 people worried that they hit their head.
#10, actually, there IS a CT scanner at the first hospital she was sent to. That has been confirmed by several journalists.
The issue isn’t the lack of a helicopter, but rather the lack of decent care at the local centers, since it isn’t ‘cost effective’.
#17–Mikey==how do you define “decent care?” Care you get whether you want it or not? Care based on what happens 2 hours later?
How?
#10.
She never went to an initial ER did she? Just the mountain staff, and then refuses further treatment. Anyhow, can’t have a CT scanner every 20 miles in a country as vast as Canada, or the US for that matter.
They are currently building a wing for a CT scanner here in Whistler, which will be a big help. Mountain bike crashes are the biggest concern.
Agreed Canada’s socialized medicine is pretty good, just don’t be an American looking for serious medical help way away from the big city on a Sunday, literally without a pocketful of cash.
RBG
#15–jgerhardt==nice startup of a website there. Yours or someone elses? Anyway, hope to follow it a bit and see if over the years the evidenced humanity changes at all. That seems to be the pattern?
What is the protocol for patients showing up in the ER with a head bump? No loss of consciousness, no blood, no pain, no headache: “I bumped my head but it doesn’t hurt any more.”
What would a good ER doc want to do?
What is an ER doc allowed to do?
What’s the world coming to when every medical clinic in the country doesn’t have an expensive CT scanning equipment all ready and waiting for the rich folks to bump their heads?
Canada’s health care system SUCKS! @#10 – you mention the infant mortality rate in US VS Canada. It is easy to mention 1 statistic but not mention any others. How about the mortality rate for those with cancer? You conveniently leave that out. How about the fact that there are more MRI machines in the CITY of Philadelphia than in the ENTIRE COUNTRY of Canada? The Canadians that say their health care system is good have do so because they have nothing to compare it to. They have never experienced the US system so they don’t know what they are missing. Canadians also call their health care free. It is not free. They pay every week and the payments are deducted from their paychecks. Even those unemployed get the payments deducted from their welfare checks (this is exactly the same as US employees who split the costs with their employers). They call it free because they don’t actually write a check for it.
If I need an MRI in Canada, the wait is 4 months. In the US, I can go the same day or the next day at the latest. Dealing with the Canadian system is like dealing with the department of motor vehicles here in the US – you are just a number, you wait and wait and get shitty service.
I work in both the US and Canada but I always wait until I am back in the US to get any medical treatment. To get an accurate view of the Canadian system vs the US, you need to talk to people who have experienced both.
To get an accurate view of the Canadian system vs the US, you need to talk to people who have experienced both. /// Or just talk to an American who can’t get healthcare at all outside of an Emergency Room==ie, no healthcare, only emergency care.
The number of MRI units or CT Scanners is a measure of input, that is, more a measure of waste and excess capacity rather than quality actually received. Look to health statistics for the actual health care provided.
The New York Post???
Nuffsaid.
The NY Post is a piece of shit corporate rag that is obviously using this story to scare stupid idiotic Americans (that means 99.99%) against universal health care.
Using the death of a well known person in order to attempt to defend corporate profits… is just plain beyond the pale.
Whatever loser posted this story is the biggest and stupidest piece of shit imaginable. Then again, I’ve come to expect no less form this idiotic site.
Could it be that somebody’s testing the waters for a future civil suit? Sounds probrable. People die regardless of how much is spent on emergency care, she could have improved her probrabilities had she cooperated and gone with the ambulance that was sent for her. Had Canadacare had more resources they may have improved her probrability of survival by some miniscule percentage, but it’s insignificant compared to what she could have done to improve her own chances. For some reason Americans have the idea that more expensive is always better. Had she been skiing in Vail, she probrably would have died for the same reasons. There however, the lawyers and insurance companies would be wringing their hands in greed and fear.
You can’t give care to someone who doesn’t want it.
That’s true both in the US and in Canada.
It was her, unfortunate, judgment and our belief in the fundamental right to refuse treatment that caused the death, not the health care system.
End of story, why bother even posting this here?
A more interesting question would be: does socialized healthcare increase risky behavior?
#30–SL==and the less interesting answer is: “by design, no.”
Risky medicine is what the USA practices==no primary care for 40 Million people, no primary care for pre-existing conditions, no medicine if you can’t afford the co-pay, and so forth. That all makes American Medicine much more risky than any socialized system which is why we have worse medical outcome than any other country without its head up its ass.
WHAT, NO REFerences to the song blame canada?
#31, the explanation of your answer has nothing to do with the question I asked.
I’ll restate the question – does the perception of no-cost medical treatment increase the likeliness of people to engage in activities that will later require them to seek medical treatment?
30,
Good question. As a recipient of socialized Canadian health care, my buddies and I are regular injectors of draino. Great high and any problems I just go the emergency room.
What we’ve recently been doing is running across the 401… but NOT during rush hour since it’s pretty much gridlock. We wait for the 10-11 am lull in traffic when the cars get up to a respectable 120KM. Great fun. The drivers like it too since we can all go to the hospital if we want… FOR FREE!!!
I’m thinking of starting a group that’s going to do mass train jumping… wait for the subways to enter the station and have a row of buddies waiting on the tracks and we all jump up one at a time with a 1 second delay between each. It would be an AWESOME event! And, if anything happens… FREE HOSPITAL STAY!!!
Another thing about Canada, which you might not know, is that we don’t have jobs or families that require responsibility so we all spend our time trying to injure our ways into the hospital.
Do I even have to indicate the end of sarcasm?