There was and is so much wrong with the public hospital system at the time I was using it (Dec 2016 until now, ongoing) that it’s difficult to separate out into categories each of the system’s major failures.
I’m going to try though.
The first category that keeps on making itself felt can be summed up as “the tyranny of the majority”.
The tyranny of the majority
Here is what the medical staff in a public hospital assume about patients in the category “heart problem that requires surgery”.
Heart problem that requires surgery =
Now that they have placed you, the patient, at the same level as a toothless medieval peasant, they expect from you:
The medical professionals use all these assumptions as the basis for their Standard Patient template, which is what they see no matter which actual human patient they are talking to.
They are not remotely interested in finding out whether or not the human being in front of them corresponds to their template. In fact, they actively ignore any signs from the patient that s/he is NOT a carbon copy of their assumptions.
Based on this invisible template, they have concluded that they can and should tell you only what you (ignorant peasant that you are!) want to hear. They dodge specific questions, sometimes by simply walking away while you’re asking them. (And please note that I am not talking here about moronic questions like “Doctor, am I going to be all right?” or “Doctor, exactly how successful is this operation for people with my profile?” These are indeed the kind of questions that invite reassurance, not a factual answer. Such questions are the medical equivalent of “Does my arse look big in this dress?” The only sensible answer to this question is “Of course it does, dear. You have a big arse.”)
The questions I have been asking have included: “Does my heart beat at all, or is it dependent on the pacemaker 100% of the time?” If, as in my case, the answer is something along the lines of “Your heartbeat starts off reliably in the atria, but does not propagate to the ventricles at all, which is why you need a pacemaker – to ensure the ventricles do their thing” then I would expect to receive this explanation, not have the doctor dodge around it, as has so often happened in my case. Questions about the pacemaker in particular seem to invoke a knee-jerk reaction of omertà in medical staff.
If you had a highly complex piece of kit implanted in your body, which enables your heart to function adequately, and without which you would presumably be dead, wouldn’t you want to know exactly what it does and how it works? Of course you would! Miraculous thinking, living in la-la land, or choosing denial rather than reality have never been my modus operandi. According to shrinks, this makes me a mentally healthy individual.
But the public health system seems geared exclusively to people who are mentally unhealthy, i.e. wish to exchange all the harsh realities of life with happy-ever-after fantasies. I think there is something extremely fishy about assuming that most patients are like this. I would like to see some hard proof to support their poor opinion of mental health in the general public.
Even after the week of Hell I spent in the CHUV’s “Soins continus”, when I was severely shocked and sleep-deprived, and heading in the direction of Post Traumatic Stress Disorder, I still knew the difference between the real world and la-la land.