When you think of hospitals, you probably picture places staffed by nurses and people like me. The image is far from complete. There are countless others who toil in healthcare's shadows. They have job titles like service assistant, lab technician and respiratory therapist. Explaining what they do can be hard to do at cocktail parties. But make no mistake: these are people who look after you with skill and compassion. And sometimes, they mean the difference between life and death.
This week, we walk in the shoes of the unsung heroes of health care. We tell their stories - doctors and nurses need not apply. I visit a hospital where I meet a professional who keeps your breathing when seconds count. I talk with a clinic receptionist who cheers you up as you wait nervously for test results from your doctor. I chat with a case manager who - more often than not - finds a way to keep seniors and others with chronic illness and disability living at home. We also meet a hospital employee who stayed at her post at the hospital when others were fleeing for their lives.
To listen now, click on the link below or download the podcast. Or, tune in Saturday at 11:30 am (12 noon NT) and again on Monday at 11:30 am (3:30 pm NT) on CBC Radio One.
It was hard not to be affected by news reports of the fire that occurred in and around Slave Lake last May - which caused an estimated seven hundred million dollars in damages, destroyed 400 homes and led to the evacuation of the town's 7,000 residents. For the injured and the sick, the one place that couldn't close was the hospital. Angel Muller is a unit clerk at Slave Lake General Hospital, who worked those frantic hours when the fire was starting to engulf much of the town.
"We never received an evacuation order," Muller told WCBA. "So there was a lot of confusion. I was the one answering the phones, just basically trying to reassure the families of the patients that we had in the facility. Everybody was very worried, of course. Where were they going to go? What was going to happen?"
But this was a disaster with a difference. Like Muller, many of the people working in the hospital that day had homes in the path of the fire.
"It was very scary," said Muller. "There was about two and a half hours that I was not able to contact my family at home. We knew at that point that the town was on fire and that authorities were in the process of trying to evacuate the areas most at risk."
I asked her how she kept working with that sort of doubt in her mind.
"I think you sort of numb yourself a little bit and just deal with matter at hand."
Muller only knew her family was okay when they showed up at the hospital. "They came in at seven thirty - just as we were in the process of evacuating everyone," said Muller. "I gave everybody a hug and the hospital let me go on my way with my family."
There's a worrisome footnote to this story: the fire in Slave Lake destroyed the homes of eleven of the town's thirteen doctors. Late last month, it was reported that five of those MDs announced that they're leaving -- citing the fire as a major factor. The town is just beginning to work on a plan to replace them.
Most of us take breathing for granted. Not so if you arrive at the hospital blue and breathless with severe asthma, heart failure, pneumonia or chronic obstructive pulmonary disease. Time was, it was usually up to an anesthesiologist, critical care specialist or an ER doc like me to pull you back from the brink - with the able assistance of a professional you probably haven't heard of called a registered respiratory therapist. We call them RTs. More and more, they've acquired enough of their own advanced skills to make them difference makers in their own right. Recently, I caught up with Melanie Deremo, a bright RT at Toronto Western Hospital.
Melanie took me to the Intensive Care Unit, where she showed me how she deftly manages a large variety of patients with severe breathing difficulties. Like all RTs, Melanie does everything from putting patients with heart faliure on Bipap to changing tracheostomy tubes to running increasingly complex ventilators. In the middle of the night, she and not the doctor on duty, may be the one called upon to intubate (insert a breathing tube in) a critically ill patient.
Like most physicians I know, that kind of responsibility weighs heavily on her.
"I remember a lady coming in," Deremo told WCBA. "She was an emergency nurse, and so she did know what was going on. She was getting very sick, and she said 'don't let me die.'"
"It was very scary because you could see her deteriorating. We tried everything that night, and she did die later that night. It's very heart wrenching."
It's comforting to know registered respiratory therapists like Melanie Deremo feel that keen a sense of responsibility when they hold your life in their hands.
Our next unsung hero is known in health care as a case manager. The National Case Management Network defines case management as "a collaborative client-driven process for the provision of quality health care and support services through the effective and efficient use of resources. Case Managers support the clients' achievement of safe, realistic and reasonable goals within a complex health care, social, and fiscal environment."
Elizabeth Antifeau trained as a nurse. But she made a mid-career switch to become a case manager. Now, she leads a team of case managers who look after seniors and other people with special needs in communities small and large in BC's interior. She prides herself on keeping people from having to go to a hospital or a nursing home in the first place.
To Antifeau, a case manager's job description isn't complete without adding the phrase 'rule breaker'. On WCBA, she talks about arranging for outside workers to break their usual routine and pick up a client's garbage off the front porch instead of forcing the client to bring it to the curb.
She has lots of stories like that. At a recent conference, Antifeau talked about a client with dementia whose favorite restaurant was getting shortchanged because the client would often forget to pay the bill. "I approached her son who lived away to set up an account with the restaurant owner so she never had to concern herself with it."
"The client delighted in hearing the owner assure her the bill was all taken care of, which supported her independence to enjoy a meal in a familiar setting without social embarrassment."
There are professionals who look after you in the hospital and those who keep you safe in the community. For our final story, we turn to an often unappreciated person who keeps things running smoothly at your doctor's office. You probably call them receptionists. But increasingly, they're known as clinical assistants. They aren't health professionals, but some do measure you're blood pressure and your heart rate. And keep both from rising too much while you wait to see the doctor.
We talk with Kandise McNeillie, a highly regarded clinical assistant at the Albany Clinic in downtown Toronto.
Take a moment to appreciate the many hard working people who may not have prestigious letters after their name but still deserve your gratitude and mine.