Winnipeg Free Press - PRINT EDITION

An insider's take on the HSC 'MASH unit' Blog of the Week: The Power of Words

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I'm not in the excuse-making business, but I do like to impart information that can give people an opportunity to have informed opinions.

After reading CBC news reporter Ryan Hicks' analysis of the Brian Sinclair inquest, it occurs to me it's doubtful anyone will shine a light on the back story. Hicks' article centered on the inescapable issue of alleged racism and prejudice in Manitoba's health care system.

Sinclair was the homeless, wheelchair-bound, aboriginal man who was found dead in the emergency waiting room at Health Sciences Centre some 34 hours after he arrived.

"It's all to do with racists," Sinclair's sister, Esther Grant, told reporters covering the inquest.

Chief Medical Examiner Dr Thambirajah Balachandra told the inquest he believes issues with the triage system were to blame for the tragic circumstances surrounding Sinclair's death.

"Even if Snow White had gone there, she would have got the same treatment under the same circumstances," he testified.

Dr. Marc Del Bigio, a neuropathologist who conducted examinations on Sinclair's brain and spinal cord, stirred controversy when he penned an email indicating, "We should not lose sight of the fact that this man's problems were self-inflicted." Dr. Del Bigio went on to explain decades of solvent and inhalant abuse were major contributory factors in Sinclair's death and that societal blame should only go so far.

Kathy Mallet, co-director of the Community Education Development Association, an aboriginal advocate for more than 30 years, believes Del Bigio's "blame the victim mentality" symbolizes the underlying prejudice experienced by aboriginal patients.

"Addiction is a symptom of a problem," she said. "A much deeper, deeper problem." She went on to raise the issue of the impacts of the colonization process on aboriginal people and her belief Del Bigio lacked awareness and as a result, oversimplified the situation.

So where does the truth lie?

Would Snow White have died in that ER room, as Dr. Balachandra suggests, or was racism and prejudice a primary cause, as Grant and Mallet want you to believe?

I'm not an expert on health care in Manitoba, but I have spent hundreds of hours in the Health Sciences Centre Emergency Department as a front-line patrol officer working the downtown beat. Trips to "HSC Emerg" form part of the daily routine of most Division 11 patrol officers who work the mean streets in the heart of the city. Those trips require seemingly endless hours of downtime with both victims and suspects as they go through the process: triage, treatment, discharge or admittance.

When I try to describe the experience, I frequently draw a correlation between the ER and the chaos and intensity of a Korean MASH unit -- scores of injured people suffering from a variety of injuries that often include stab wounds, lacerations, broken noses, head trauma, the occasional gunshot wound and more. However, unlike a MASH unit, the victims of these injuries often present a special challenge in that the majority of them are intoxicated or high on some type of drug.

I've also seen dozens of "frequent flyers" sitting in the ER, sleeping off the lingering effects that come with the overindulgence of alcohol or drugs. Many are people looking for a safe, warm place to sober up or waiting to catch a ride to the Main Street Project.

Because of this reality, it's not all that difficult for me to imagine how someone who appeared to be sleeping in the HSC Emergency Department could be overlooked.

What I saw at the HSC during my police career was a professional, ethnically diverse staff desperately trying to do the best job they could in the face of the great challenges that come with serving the medical needs of citizens who reside in the violent crime capital of Canada; doctors and nurses who worked exceedingly long hours and who undoubtedly suffered from varying degrees of sleep deprivation as they endured the rigours that came with working shift work; overburdened people working in an industry that placed increasing demands on its employees in the "do more with less" era of bureaucratic philosophies.

I also saw aboriginal people receiving extraordinary care and compassion from doctors and nurses at the HSC and question the notion racism contributed to the unfortunate death of Mr. Sinclair.

As tempting as it might be for Grant and Mallet to play the race card, such a conclusion comes with inherent risk. Once that conclusion is drawn, the doors to all other possibilities are closed.

Did Brian Sinclair die because of prejudice and racism inherent in Manitoba's health care system, or is it more likely he fell victim to an overburdened, "do more with less" bureaucracy that lacked the proper protocols to ensure patients like Sinclair didn't fall through the cracks in a chaotic emergency department?

The death of Brian Sinclair has many moving parts and involves a laundry list of players and social agencies that may be found culpable to some degree.

Snow White, aboriginal or not, people shouldn't die in hospital ERs.

I hope Judge Preston can ferret out the truth and point the finger in the right direction.

James Jewell retired from the Winnipeg Police Service after a 25-year career. Follow his blog at jgjewell.wordpress.com. He also runs The Police Insider at thepoliceinsider.com

Republished from the Winnipeg Free Press print edition August 25, 2013 A10

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