Sickened by hospital

August 4, 2008

Dear Sir,

Many of us have been aware for some time that our hospital is in a dire state. Before my recent two-night stay, I'd heard stories of overwhelming unprofessionalism, systematic neglect, poor hygiene, rampant racism, and an emergency facility so ineffectual and lacking in a sense of urgency that it fails in almost every possible interpretation of a duty of care to its clients. The words I'd heard most in connection to KEMH were unsettling: 'disgusting', 'terrifying', 'a disgrace'.

Having now experienced it, I find no words can overstate the deplorable level of "care" to which Bermudians are exposed.

I visited the emergency department twice in two days; the first in the middle of the night, frightened and in the worst pain of my life. My expectations on arrival were simple and realistic: I did not expect a comfortable environment nor even compassion – my only desire was a competent staff to make the pain go away and ensure my safety from relapse. Neither of these basic needs was met.

During the three-hour wait, I asked that a TV blaring the most obnoxious televangelism be changed to something inoffensive. The security guard spat back, "It doesn't offend me", while fixing me with a look suggesting disregard for a crucial aspect of the message of neighbourly love.

Once I was eventually seen, by a doctor whose manner said everything about how unmoved she could ever be by the outcome of my case, it would be a further hour before a nurse shuffled in with medication (the shuffle seems to be a hot trend among KEMH staff of every rank: it's about half the pace of a slow amble), enough to dull pain for only three hours, though no pharmacy would be open until the following morning. I assumed this meant I did not need admittance; this had unfortunately not been true.

When my condition worsened over the next few hours and the pain became unbearable, a private doctor directed me back to A&E for immediate IV medication. This meant another two and a half hours spent staring at a chipped and dirty waiting-room wall, a notice informing me of my rights "to receive emergency care, to be treated in a considerate and respectful manner, without discrimination of any kind, to receive the best quality care in accordance with pre-established standards" (a dry joke, I assume: what standards, and established by whom?)

In the knowledge of exactly what a filed complaint would achieve, this stung like a slap. Below it the relative accompanying me was crying, upset by the overt disrespect and apathy of the nurses whom she had petitioned for help, many deliberately intimidating her, one of which simply turned their back and pretended she wasn't there.

Upon eventual admittance, I was taken to Cooper Ward, to an unventilated four-bed room reeking of stale urine. Despite my repeated requests, nothing was done about my neighbour's evidently soaked mattress, so we lay in a stench like a never-cleaned public restroom.

Though ours was the room nearest the nurses' station, three paces from where staff clustered laughing around birthday cake or gossiping loudly about patients and their families, it took them on average ten minutes to respond to our call-button requests, when they did at all. When a patient presses the call button, an intermittent double-beep goes off in the nurses' station which can be heard throughout the floor, continuing until the call is answered, either in person, or when they don't feel like walking a few steps, someone barks 'CAN I 'ELLLLP YOU' over an intercom, and if you don't reply – as I was often unable to due to the nature of my injury – they hang up and don't come. If the patient is having a seizure, choking, passing out, or cannot speak for whatever reason, I repeat: they hang up and do not come.

When you've fallen out of favour by having the temerity to ask for what you need, knowing it will otherwise not be forthcoming, "accidental" hangups are frequent. But the nurses' contempt for duty extended further than people they merely found annoying, to people they were bored with as well.

An elderly gentleman stationed across from me had been buzzing for help over half an hour – measurable by the unanswered beeps – when a school-age trainee shuffled in and dismissively told him to wait 'two minutes'. Over 20 minutes later, someone grudgingly helped him to the restroom without apology. I suspect it is a matter of policy at KEMH never to apologise to patients, as it's too much like an admission of incompetence. Grunting or laughing seems to be the official recourse in this culture of contempt, where personnel believe they are doing you a great favour and take pains to project it. The old gentleman later lost bowel control due to this same neglect. That night, someone in a farther room had been calling out for help for a half-hour before I went to the nurses on her behalf. Walking back down the hall, I heard them laughing unreservedly, and five more minutes would pass before a male nurse snapped: "What do you want?"

What troubled me throughout my stay is what would happen if I had been unable to speak up for what I needed, very ill, unconscious, or – heaven forbid – if my life depended on urgency and competence. I have no doubt that in the absence of a body willing to examine professional standards and insist upon accountability, the very worst neglect could have occurred, and nobody would ever know nor be able to prove it. Any of us could die in their care, and inquiry would produce nothing but reams of internal paperwork testifying their discharge of legal duty.

Everywhere the gears of action are jammed with copious handwritten notes and orders, most printed at a labored pace I have not observed since primary school. The idea of efficiency or professional rigour, of the personal or institutional accountability I have taken for granted in my years abroad as a baseline requisite of the medical profession, were not only absent but actually laughed at, openly and in the manner of those who know their jobs are in no danger, especially from the likes of me. KEMH's culture of apathy is a fearsome and disturbing thing I had never expected to witness.

My fury at this experience will not abate, as it would over a simple personal affront: this was an offence to my health and a consistent violation of rights professed in the hospital's own charter. I implore everyone to consider how terrifying it would be to lose control of your health; then imagine how your fear would be compounded in having no choice but to put yourself in the hands of incompetents you wouldn't trust with a pedicure. The bill for this appalling service was in excess of $2,200.

I want to sign my name to this but sense it is inadvisable, and suddenly I feel a bit ill again.

SICKENED

Warwick

Conscription not the way

August 4, 2008

Dear Sir,

After reading the letter dated July 30, 2008 by LCpl Soares, I felt it necessary to make a slightly different argument, perhaps one that has not been expressed very often. While I think there are aspects that are correct with Mr. Soares' argument, I also find faults with his reasoning.

Perhaps discipline was a benefit earned by Mr. Soares and he was able to learn some valuable lessons from the Bermuda Regiment. However, I would counter that there are many more young soldiers who do not gain that great asset by being forced to join the military service.

I can recall one young man, whom I will not name, who was so unruly during his tenure in the service that they actually discharged him two years early. When I questioned a superior officer on this he remarked that this particular soldier couldn't march, dress, or perform any of the necessary acts that are required and thus was discharged. Imagine the huge drop in morale when this word spread through the platoons. What kind of lesson was learned?

Conscription is not the only way in which we might be able to fill the ranks of the Bermuda Regiment. I know several people who have signed on for the Bermuda Police Service, Paramedics service and Fire service. None of those public services fill their staff through conscription. Given the reasoning of Mr. Soares, this is an impossibility.

I would propose that these other services are filled because they provide decent wages and benefits for their staff as well as proper tools for use in their jobs. Perhaps I'm wrong, but I feel there is a reason why we don't have very many foreigners coming to Bermuda to join the military and we have several coming here to become Police officers and perform other public services.

I would also say that the loudest objectors are people who have never served because they don't want to have to serve. Of course, this is true since they honestly don't want to be forced to do something that they do not want to do. To provide an analogy, how hard would one protest being forced to ride on a vessel with the appearance of it sinking at any given moment. Now, imagine that this vessel has no motor and the sails are full of holes. Then imagine that the officers on that vessel only have two more years of "experience" than you. Once you've seen all of this you are told that you must spend three years on this vessel. How much would one protest being forced into this scenario? I would imagine quite a lot.

The Bermuda Regiment needs to be completely reassessed. We are incredibly short handed in patrolling our waters. We rely too heavily on the friendly citizens and their personal or commercial crafts to help one another out on the water.

The Police do not have enough staff in their marine division to patrol our waters effectively, although they do an admirable job with what they have. The Guardian is under utilised but there are talks of the Regiment helping with some of the patrolling and being trained to man The Guardian. Why not take things a step further?

I propose that we move further away from land platoons and more towards a marine force. I would propose that we train our young men with a knowledge in something that they might be able to actually use after they leave the island. Why not teach them about navigation and maritime skills that they would be able to take and use on a commercial vessel after they've served a tour in the military service? We should be presenting young men and women with a viable option to serve in the military and earn a decent wage and be provided with good benefits.

Provide people who serve in the military with a free education at Bermuda College and not just a free ride at getting their high school equivalence diploma but a decent education on top of that. We need to empower our youth with knowledge they can use later in life. Not just with knowledge of how to polish boots and fire a weapon that they should never have in their hands again after they leave the military. Of course, they should learn to use their weapons in the military. That is probably one of the few fun things that I personally experienced and it is a necessary part of military life.

Conscription is not the way forward for our military service. We are not a nation under attack internally or externally. Forcing young men to go to Warwick Camp under duress and making them fill the ranks will not make them better men.

Educating them and helping them to learn skills that will help them succeed in life will help to make them better men. We need to attract them to a military service. Not force them to attend a military service so that they learn how to avoid work and hide in places their superiors can't find them.

TIMOTHY STEINHOFF

Pembroke