The Golden Hour can be either a serene and beautiful interlude between darkness and light, or a desperate race against death. It all depends on whether one is a photographer, or a medical first responder.
It has long been a standard in emergency care of trauma patients that definitive treatment within the first hour is crucial. After that, the fatality rate goes way up. The clock starts ticking at the moment of injury, before the ambulance arrives, and well before the person arrives at the hospital.
Of all the reasons we want our hospital emergency rooms open, this is number one.
The person who has no family doctor and needs a prescription renewed can come back to the ER another day; ditto for the person with an annoying but not life-threatening medical condition. What the trauma patient has is that Golden Hour – nothing else counts.
The last thing we want is to waste precious minutes of that hour travelling to the next-nearest, or next-next-nearest hospital ER, because of temporary closures – or even worse, have someone arrive by private car in desperate condition, only to find the ER is closed.
Anyone who thinks this is an unlikely scenario should note that it has already happened, at a rural Ontario hospital not far from here. At the end of July, someone drove three teenaged stabbing victims the short distance to the hospital in Clinton, only to find the ER was closed. They had to go to another hospital 20 kilometres away. The situation could easily have ended in tragedy.
Stabbings are dramatic; that aching left arm, sweating and shortness of breath are less so, but also demand prompt attention.
We find ourselves wondering about the outcomes for people with signs and symptoms of a cardiac emergency, but who decide to wait until morning when the ER reopens rather than call an ambulance, or who decide to hop in the car and drive to the hospital, only to find the ER is closed again. People should not have to play Russian roulette with their health. A decision on whether to go to the hospital should not involve checking one’s computer or making phone calls to find out what hospital has an open ER.
The fact is, everyone knew this would happen. We had this giant “bulge in the hose” called the post-war baby boom, nearing an age when they would require a lot more medical care. We also had a whole generation of health-care professionals approaching retirement age. And we had successive governments more interested in balancing hospital budgets on the backs of nurses, initially with layoffs, and more recently with wage freezes, than in planning for future needs.
We also had COVID, but health care in rural areas had passed “serious” and was heading for “critical” long before the virus raised its ugly head. The situation has not improved.
The hospital ER closures in this area over the summer have made it clear that we have two levels of health care in this province – one for the cities mostly south of the 401 and the other for rural Ontario.
It might be time for the people of this province to send a clear message to senior levels of government that a lot of voters and taxpayers live in rural areas.
Those voters acknowledge distances in rural areas are greater, weather is more of a factor in travel, and there are too few people to make it financially feasible to have all the services people in cities have. We can live with that.
At the same time, there are certain basics that every taxpayer regards as a given, be they urban or rural.
Our children require access to a decent education. We all require fair access to the courts and police, as well as other emergency services.
The most important basic is emergency health care. Travelling three or more hours to see a specialist is something we can live with. That local ER is something we cannot live without – literally.
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Pauline Kerr is a Local Journalism Initiative Reporter currently working for Midwestern Newspapers. She can be reached at pkerr@midwesternnewspapers.com.
