shift: sick or not sick, diagnostic backlogs have us all on the edge

a few years ago the mom of one of my son’s friends came by to drop her boy off for a sleepover.standing at the bottom of my porch stairs, she stood with one foot up on the bottom step, her hands pushed into the back pockets of her jeans. she was making random conversation about the garden as a ladybug landed on her shiny brown hair.“i, uh, got some not great news this morning,” she said, sitting down carefully on the stairs with her back to me. her son came out of the house to ask for ten dollars for a pizza and she stood up quickly with a fast smile.“here,” she said in an exaggerated happy voice. as she fished through her purse, the sleeve of her shirt rose up her arm exposing the white plastic hospital band around her wrist. “take twenty,” she said. “life is short, darling.”as we watched the excited gaggle of ten-year-old boys float down the street in search of pizza and candy, she sat back down on the bottom step explaining that a mammogram that morning showed a small mass in her left breast. the doctors were pretty sure it was malignant. her happy voice was tired, crackly and strained.she told the story of how she had cancer as a toddler that required high doses of radiation to her chest — developing breast or lung cancer later in life is always a concern.“i have always known the risk,” she said. “i am so very lucky they caught it early.”the diagnosis kicked off months of gruelling chemo. even though the lump was in the early stages, my friend’s oncologist was relentless in treating it. he had seen how quickly these kinds of lumps can turn nasty. after six months, when it looked like a recurrence was more than possible, my friend opted for a double mastectomy.on a slow walk one morning after the surgery, she winced each time she swung her arms — the inches long scars on her arms where the surgeon took skin to smooth out the wounds on her chest were still red and tender.“this is going to be over soon,” she said with a smile. by the way the look on her face darkened for a minute, i could tell that she didn’t feel completely out of the woods. “i feel like i am at the edge of a landslide, waiting. if they hadn’t been watching me…”she didn’t need to finish the sentence. over the years i had known many people who lost their lives because they didn’t keep up with check-ups or follow up on a symptom — but even more for whom an mri or blood test came too late. and that was before a pandemic rendered our healthcare system virtually inaccessible.since covid began its insidious creep across the globe, we have watched the devastating impact on our ability to care for people. from overwhelmed hospitals, burned out doctors and nurses and policies that restrict caregivers from visiting their people in hospital, to deadly virus outbreaks in long-term care, cancelled surgeries and delayed diagnostic tests, it’s not a good time to be vulnerable, sick or love someone who is.this week, ctv news published a story about a woman who, because of a family history with breast cancer, has spent her life diligently getting routine mammograms in the hope of catching the deadly disease early. last year, checkups and other procedures were put on hold as hospitals scrambled to keep up with covid patients. in september, after noticing a change in one of her breasts, she had to wait until january 2021 for a mammogram. by february, she received a diagnosis of stage 4 breast cancer. and while she was able to have the lump removed in april, later that month — after complaining of severe leg pain — doctors confirmed that the cancer had spread to her bones. the prognosis is grim.sadly, she’s not the only one left facing death, or a lifetime of pain because of a late diagnosis — the story takes a look at four other canadians who have been devastatingly failed by an already stumbling system, and there are thousands of others. so what do we do now?well, we worry. a lot.“we don’t get sick is what we do,” a colleague guffawed as he told me about an mri he needs for what he calls his “bum knee.” now walking with a cane, the soonest appointment he could get was october 2022. “it’ll be my year of pain,” he said.oh man.for sure, it’s been an unprecedented bunch of months with extraordinary pressure on medical professionals. and no doubt, it must be difficult for them — as people who have pledged to “do no harm” — to watch people fall through the cracks that covid has etched into the quality and timeliness of healthcare. still, one has to wonder (incredulously) how — after almost 24 months — we still haven’t figured out how to meet the (growing) health needs of canadians. where are our governments and policy-makers?hospitals say they are “playing catch-up” — which would almost be fine if we were talking about a shortage of bandaids or stethoscopes. but these are lives — real, breathing, bodies that are backlogged — and well, simply “catching up” is not good enough.it’s the landslide thing that my friend was talking about all over again. and it’s discouraging. make no mistake, sick or not yet sick, every one of us is on that tenuous edge.we better figure out how to get ahead soon, before more lives are lost.this story appeared in the healthing weekender. click here to subscribe.