An Indigenous woman whose medical insurance card had been stolen walked into Montreal's McGill University Health Centre last February, only to walk out again when she was told it would cost more than $1,000 to see a doctor.
Kimberly Gloade, 43, died at home around two months later from cirrhosis. Now her family wants to know why no one at the hospital made it clear to Gloade that her inability to pay should not have stopped her from receiving medical care.
"We would have understood and wouldn't have felt the way we feel today if the health services — if the hospital she went to and the nurse at the administration — would have tried to help her," her uncle, Jason Barnaby, told CBC News from Burnt Church First Nation, N.B., where Gloade was from.
"If she would have passed [after receiving care], we would have understood and we would have thanked them."
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A coroner's report into Gloade's death notes that although her cirrhosis may have been too advanced to prevent her death, she died without having a doctor explain what was happening to her body.
"This is not about preventing a death, which may have been inevitable, but simply about the minimal accompaniment that decency requires in the face of death from a society worthy of its name," coroner Jacques Ramsay wrote in his report.
'Something obviously happened here'
The McGill University Health Centre (MUHC) has opened an investigation into Gloade's treatment. Its policy is to treat everyone who walks through the door, regardless of whether they have a health insurance card or whether they're able to afford hospital fees.
A hospital official said Gloade was triaged appropriately, but that it is unclear what happened next.
According to Dr. Ewa Sidorowicz, the MUHC's head of professional services, the hospital's investigation will examine if she was refused treatment and if it was made clear the hospital would treat her regardless of her ability to pay.
The MUHC's budget absorbs millions of dollars every year in unpaid medical fees. It's just part of business, Sidorowicz said, "so something obviously happened here."
Gloade's family believes stigma and racism may have affected the way she was treated at the MUHC.
While visiting his niece around Christmas 2015, Barnaby walked around the city with her and several friends. He said they were taunted by police officers.
"I'm 100 per cent [certain] that Kim's death, and Kim's treatment by the health-care officials in Montreal and by the police in Montreal, is not an isolated case," he said.
Sidorowicz said the MUHC's prides itself on its relationship with Indigenous people, adding it has developed "culturally sensitive programs for patients from the First Nations."
The hospital's investigation will examine whether those policies were applied in Gloade's case.
"We need to put ourselves into the shoes of anyone who walks into the door — to make them understand that no matter what their situation is, we will take care of them, and that's the bottom line," Sidorowicz said.
"There cannot be a misunderstanding about that. And if there was one, we are devastated."
Plea for help in unmailed letter
Gloade had been homeless in the past and was dealing with addiction, especially with alcohol, according to Barnaby, but was seeking help and had moved into an apartment.
There she often welcomed her street family, a group of friends she'd taken under her wing who called her "Mama Kim."
In early February, Gloade had her purse stolen at a laundromat, she told her mother in an unmailed letter her family later found in her apartment.
The letter also mentions her trip to the hospital with her boyfriend.
"Mom, it's me Kim! ... Sorry that I haven't called you in a while, but I've been having some problems with my health. To be honest, I can barely walk," Gloade writes. "I can't hide it anymore. I am really sick."
She wrote that once the couple got to the emergency room, she was told "it would cost us $1,400 to see a doctor. Imagine!"
She asked her mother to send her status card so she could try to get a new health insurance card.
"No ID in Montreal, you may as well be an immigrant in Alabama," she wrote.
Barnaby hopes his niece's death will spur government officials to appoint Indigenous liaisons in institutions like hospitals and courts to provide "a little more cultural awareness."
When Barnaby drives past Montreal, he stops by Peace Park, where Gloade once slept and where some of her ashes were spread.
"I sit there and I pray, and I talk to her," Barnaby said.