Our health system is struggling: what I see as a doctor at the frontlines of a health traffic jam

This column is an opinion by Dr. Chris Christensen, a pediatric resident completing his training at the Jim Pattison Children's Hospital in Saskatoon. For more information about CBC's Opinion section, please see the FAQ.

On my way to a 24-hour shift at the hospital, I watched a traffic jam form at the entrance to the parking area. 

A driver in the front mistakenly tried to enter the staff parking lot. The gate wouldn't rise. Unfortunately, another car pulled in behind, then another, and soon there were 10,000 pounds of steel between the driver and an exit. 

We all waited, in various stages of patience, for the conga line of reversing vehicles to shimmy backward. 

It seemed so obvious: there are two lanes, one for visitors and one for staff. All you need to do is follow the signs. But what's obvious to me may not be obvious to others. The issue isn't with the individual drivers — it's a problem with the traffic system and flow itself." 

I know where I'm going because I've been here before. I have both the training and knowledge to look ahead. 

But those signs are easy to miss if you've never been here before. Look up at the wrong time and you'll soon be trapped at a metal barrier with problems piling up behind you.

As I enter Saskatoon's children hospital for my shift, I'll see a reflection of that same traffic jam.

I'll be greeted by colleagues who have been working through the weekend, keeping the ward functional. Hopefully they've had a few hours sleep, though I doubt it. 

Our attending staff has likely been up all night as well, though they'll come in and work another six to eight hours. Weariness and irritability are setting in after multiple days of the same relentless wave.

Most of our new patients have relatively uncomplicated issues, such as respiratory viruses. They will be here for a few days before heading home. 

Alongside them, there's another group of children with less-straightforward issues. These patients were dealt a bad hand, but often have emotional super heroes for family members. Their parents manage a mind-boggling series of medical complexities, and they will hold on for as long as possible. 

Finally, there is a group of patients with medical complications of Scrabble-level complexity. There may be a history of abuse or neglect, congenital syphilis or these children may not be immunized with probable meningitis. 

To me, those phrases aren't only medical diagnoses. They are underlying social failures manifesting as medical distress. And it's happening more and more.

Deeper fixes needed for crisis

We know the consequences of ignoring preventative medicine. The problem is we're setting up smaller and smaller traffic signs for our population to see, and they are being submerged in a sea of misinformation and confusion.

Sometimes we don't even bother to put up a sign, and then act shocked when the driver ends up lost and confused.

Our health-care system has been strained for some time now by the ongoing pandemic. This is neither news nor surprising. The fix is more complicated than hiring lost health-care workers or adding more beds.

• Sask. government unveils plan to hire, retain more health-care professionals

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I believe the solution is to finally address the social determinants of health that have locked some people into cycles of dependency. 

Consider the impact of proper prenatal care for an expectant mother who has syphilis. Proper care means treating the mother before she's pregnant. There's a window when a shot of penicillin matters the most, and it's long before her child is born. After that, we can only treat symptoms.

It's hard to act surprised when we cut a safety net and people start falling through.

Medical issues are stemming from poverty, violence, drug abuse or disenfranchisement. These issues will propagate from parent to child, like a many-headed hydra, unless a way out is provided.

We will spend $4.6 billion this year on health care in this province. We often spend it on putting out preventable fires that start from the smoldering ashes of poverty, addiction and marginalization.

Why aren't we listening to our own research? Because the answers are politically unsavoury. 

They require spending on mental health services to prevent the dirge of overdoses and eating disorders that are filling the pediatric hospital beds. They require investment in things like harm reduction sites, which still have negative connotations despite numerous benefits, and affordable housing to help break a cycle of poverty. The list goes on. 

The line in the hospital parking lot is only getting longer, and we are blaming the person stuck at the gate. We should be asking why so many people are getting lost. Two years in, and the nurses and physicians in the traffic jam are starting to go home. I'm beginning to understand why.

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