In ‘N Out Surgery

The Uber driver rolled to a stop at the co-ordinates he’d been given. It was a strip mall in the Maples district, a subdivision in the north end of Winnipeg, Manitoba. A realtor might charitably describe the neighbourhood as “emerging.”

Wait, thought Ron Robinson. Can this be right?

He and his wife, Lynn, looked around. A nail salon, an Asian grocery store, a Dollerama. Where was the surgical clinic?

The driver pointed to a plain brown door that said Medical Centre.” And with that he motored off, leaving the couple in the parking lot, amid the smells wafting from Asia House restaurant and a sinking feeling in their stomachs, to accompany the aching feeling in Ron’s groin. Behind that door, a surgeon he’d discovered online was scheduled to perform his hernia operation in about an hour. Twelve hours ago the couple was comfortably at home in Red Deer. And this time tomorrow they would be home again, with Ron in recovery mode, if a little lighter in the wallet.

It is a thing now, the quick-and-dirty medical junket, an inevitable product of the globe-shrinking convenience of the Internet Age.

In Ron’s case, it was the only option.

A couple of weeks earlier, while golfing, he’d felt a stabbing pain that got worse with every swing of the club. He couldn’t finish the round. Two days later, while cooking dinner, he felt the knife twist again down there, and he had to lie on the couch. His doctor confirmed what Ron suspected: sports hernia, bane of every active Boomer. It would require surgery.

Because a hernia isn’t a life-threatening condition — the operation is considered “elective”— he was looking at a wait time of many months. The problem was, a big cycling trip was coming up. Another couple was supposed to join them in Spain next month. The trip was a year in the making. If they went ahead with it as planned, and the hernia ruptured on some uphill grind, Ron was looking at an astronomical European hospital bill. (His travel insurance wouldn’t cover this now “pre-existing” condition.)

So he started exploring options.

What happened next involves the Joseph-Heller-level ironies of the Canadian medical system. Ron investigated private clinics in nearby Calgary. But Alberta health-care rules bump in-province patients to the back of the line. He tried Vancouver, but in British Columbia, provincial health-care rules bump in-province patients to the back.

He expanded his search. Finally, he found a clinic promising “accelerated care” in a “state-of-the-art” facility in Winnipeg that specialized in hernias. Recovery time: about two weeks. A cancellation had just come up for Tuesday. Ron snapped up the appointment. And then he booked a one-night stay in a hotel by the airport, the better to be home recuperating as quickly as possible.

“Originally I thought I might be able to pull the trip off by myself,” Ron says. But a hernia operation isn’t trivial. They go in with a knife or a laparoscope. You’re under general anesthetic. And, post-op, you require careful monitoring. It’s not a one-person stealth mission. So Lynn agreed to tag along as chief swabber and shoulder post.

Now, it must be said that the whole notion of private health care arouses suspicion in many Canadians, Lynn — and to some extent Ron too — among them. Any accommodation of a “two-tiered” system is widely regarded as a threat to our fair and beloved universal health care. The private-clinic route smacks of a bandit solution, and there’s some guilt involved, and not a little worry about quality control and accountability. You wouldn’t put your money in Fred’s Bank; should you trust Fred to fix your groin?

“Fred,” in this case, was surgeon in his early thirties. But he came off well in the over-the-phone tire kick. He specializes in hernias, which he also performs at the local hospital. Plus, he’s an instructor at the University of Manitoba. This clinic work is his side hustle.

And so it was set. Ron packed a toiletry back and baggy shorts. The next morning the couple hopped a plane to Winnipeg. They got a beachhead at the hotel. They arrived at the clinic around six. Those odours from Asia House were smelling pretty good; Ron had fasted all day.

The waiting room was empty save for one stressed-out-looking woman. Ron filled out some paperwork.

His surgery was scheduled for 7pm. But the surgeon was running behind. The current patient was taking longer than expected. Hernia surgery is supposed to be about a 45-minute endeavour; this guy had been in there for two hours.

The woman in the waiting room was the patient’s wife. Ron had learned enough about the procedure to take a guess at what was going on. Usually a hernia operation only involves one side; but while they’re in there, the surgeon takes a look around. If there’s wear and tear on the other side, too, it makes sense to take care of it. “It’s a two-for-one, it doesn’t cost any more,” Ron said, reassuringly. That’s probably what was happening. Her husband was getting the second side done. No worries.

Suddenly, a loud moan issued from the other side of the door.

“Oh my god!” the man’s wife said.

“It’s okay,” Lynn told her. “Breathe. Breathe.”

Ron picked up a magazine and tried to distract himself from the hollering.

Finally an attendant came out and told Ron to please gown up.

Inside, he lay on a table surrounded by three nurses, the surgeon and an anesthetist. To a Canadian, this doesn’t quite compute. It’s strange to get a hospital procedure anywhere but in a hospital. The anesthetist placed a gas mask gently over Ron’s mouth.

Out in the waiting room, Lynn was struggling. “I thought possibly they were harvesting some other organs,” she recalls. I mean, anything could have been happening in there.”

An hour later, the door to the waiting room opened, and the surgeon came out dressed in his street clothes and carrying a briefcase.

Wait, what? It’s done? “How’d it go?” Lynn asked.

“Textbook,” he said. And away he went, into the night.

*

“He’s been something for the pain,” a nurse told Lynn, as her groggy husband carefully got changed, “but within four hours he’s going to need something else.” She gave Lynn a prescription to fill. “And you’re going to need to check the incision. If there’s a bit of blood that’s okay. But if it saturates a whole towel you should probably take him to emerg.”

Lynn called a cab to take them to a nearby 24-hour drugstore.

They arrived back to the hotel just before midnight. Ron crashed like a baby.

Lynn, not so much. She thought her husband might throw up, or saturate his towel, or need more painkillers. She lay awake all night beside him.

In the morning, Ron rolled out of bed, refreshed, and went down and tucked into the breakfast buffet.

They checked out of the hotel and hopped on an airplane.

A phone machine awaited them at home. It was the local hospital. They had an opening to get Ron in for a consult, the message said. The date was April 25. Of next year.

“So that’s the regular system,” Ron says. “I could have waited until April for that consult, and then a few more months for the actual surgery,” he says. “But that would have kept me out of being physically active for a year. And then to get back to a decent level of health would maybe take another year — if I ever did.” In this particular choose-your-own adventure, that decision would have taken him off the trajectory of preventative health and put him on the vastly more expensive, misery-filled trajectory of reactive treatment: in other words: typical modern medicine.

The hernia operation in a strip mall in a sketchy part a distant city cost Cdn $7,000.

Worth every penny, Ron thought as he cycled through the Spanish countryside.