My one-year-old son had already been sick for five days with a high fever when, on Sunday, November 20, I heard a familiar crackle from his lungs and saw his skin pulling at his neck and under his ribs as he struggled to breathe. These are sure signs of respiratory distress, that your kid is in danger.
I live in Plateau-Mont-Royal in Montreal with my partner, Willy, and our two boys, a three-year-old and a one-year-old. Earlier this year, my littlest guy was diagnosed with asthma. And this time, our emergency medication—that miraculous blue puffer—was not working.
On Monday, at around 6:30 p.m., I took him to the emergency department at Montreal Children’s Hospital. On both previous occasions I’d taken him there for respiratory distress, we were triaged in a timely manner and were seen within hours.
This time, it was a different picture. At reception, the nurse looked at my little one for a couple of seconds and told us to sit in the waiting room, where we would get called for registration. Not even triage. Registration, which puts you in the queue for triage, which in turn puts you in the queue for a doctor.
The waiting room was mobbed. There were no seats. Parents were sitting on the ground with sick kids in their arms. The room was filled with sick children, all crammed on top of each other—coughing, puking, crying, moaning. To make room for us, a woman rearranged her family, seating a kid on her partner.
After an hour and a half, we still hadn’t been called to registration. Emergency rooms obviously don’t work on a first-come, first-serve basis, for good reason, but I had a one-year-old with asthma who was struggling to breathe. This is usually a high-alert category. Did the nurse, with her seconds-long visual exam, know something I didn’t? Other parents were also struggling with the delays, and, naturally, some asked staff for updates. While people were calm and polite, there was an overall air of disbelief—glances passed from desperate parent to desperate parent, helpless.
Then there was an announcement over the intercom, scolding parents for asking staff about wait times—and informing us that the average wait for all but the sickest children was now 20 hours. I thought, We can’t spend an entire day here. So I took my sick kid and went home.
On Tuesday morning, at 8 a.m., right when the phone lines opened, we called to get him in at an emergency clinic at my health centre, and were assigned an afternoon appointment. We’re lucky to have this option. It’s only available to us because we have a family doctor; more than a million Quebecers do not.
My partner brought our little one to his appointment at 2:30 p.m. Over the last few days, we’d watched his vital signs go up and down, the frightening retraction (pulling skin) come and go, the fever peak and dive. His temperature, at its highest, hit 41 degrees. His breathing went up to 60 breaths a minute. But he was relatively stable during the brief appointment, partly because we’d given him meds shortly before.
The doctor examined him, found that his vital signs were okay and that it was probably just a virus. He wrote us a referral to a semi-private clinic to get an X-ray the next day, and told us to bring the baby back to the ER if he got worse.
That evening he got much worse: crying, retraction, flopping around, rapid breathing. His temperature spiked again. I knew the situation was dangerous. We took him to Jean-Talon Hospital, which according to my online research was operating at 67 per cent capacity, the lowest we could find at ERs across the city. I called first to see if they took kids, and we arrived at around 7 p.m.
This time, we got through triage and registration in good time. But in triage, we may have been victims of the same problem that we had at the doctor’s appointment: the nurse was seeing a five-minute snapshot of my kid’s state, and one that my partner and I had been managing with emergency asthma meds. It’s possible that keeping my kid comfortable meant we weren’t getting the proper diagnosis and treatment. But what’s the alternative? Let him deteriorate?
We sat in a waiting room at Jean-Talon, in a little plastic chair, for five hours. The waiting room wasn’t particularly crowded. I could see six examination rooms, but it looked as though only two were in use. Hardly any patients were being called in. And when the nurse did finally call out names, the people often weren’t there. They had given up, I guess. Exhausted, I took stock of the situation. The faces surrounding me in the waiting room had been almost unchanged for five hours. We left after midnight, again, without seeing a doctor.
On Wednesday, I cancelled work to stay home with my little guy. At this point, he was in bad shape, just flopping and wailing, flopping and wailing. A friend drove us to the X-ray around 11 a.m. I called my health clinic to ask reception to prompt the doctor to check the results. The doctor called me back within five minutes. Pneumonia. My asthmatic child had pneumonia. Pneumonia that should have been diagnosed and treated when I presented at the ER two days before—and which, in pre-pandemic times, probably would have been.
Now we had a diagnosis, and only needed treatment. The doctor sent a prescription for antibiotics to our Pharmaprix and instructed me to start them that day. My partner and I were figuring out who’d go to the pharmacy when a staff member called and they said they didn’t have any antibiotics because of a shortage in Quebec. He said the pharmacy would contact the prescribing doctor to ask for an alternative. I asked how long it would take—would it happen right now? He said, no, it wouldn’t be immediate—the pharmacy had to contact the clinic, the doctor had to contact the pharmacy, and so on.
In my arms, my kid was burning hot, alternating between crying and nursing, struggling to breathe. He wouldn’t let me put him down for a second.
“This is crazy,” I said to the pharmacy employee, and tried to explain the urgency of the situation. He sneered and asked if I wanted to try to find the drug at another pharmacy. I was enraged. I’m sure he was stressed because of the strain on the health-care system, but—as I none-too-calmly informed him—he was not as stressed as someone with a one-year-old who can’t fucking breathe.
After maybe 30 minutes, someone from Pharmaprix called back. She’d found a place that could make the prescription from raw materials. It was in Youville, about a 20-minute drive away. My partner left work, jumped in a Communauto and waited an hour for this out-of-the-way little pharmacy to mix our baby’s meds.
We were finally able to give our child the medication he needed. Following a three-day nightmare, including two attempts at going to the ER, a delayed life-threatening diagnosis and a mad scramble to find antibiotics, our one-year-old is slowly getting better.
But none of this should have happened. It wasn’t a particularly complicated diagnosis or treatment—but at every step we ran into walls, from outrageous waits to medication shortages to burned-out health workers. If this madness continues, children are going to die here this winter. I believe that. My asthmatic one-year-old had pneumonia and couldn’t breathe properly—let me emphasize, he couldn’t breathe—and we still couldn’t get seen.
A lot of people are blaming long hospital wait times on an uptick in children’s respiratory illness. That’s a contributing factor, sure, but it’s not the full story. For the public system to improve, we need to invest in it. Instead of incentivizing people to become doctors and nurses, we’re torturing the ones we have. Quebec and Canada need to address the structural problems that have caused this failure of essential social infrastructure—a disaster that was waiting to happen.
—As told to Mathew Silver