It was much longer than I had hoped to write more in this blog. I am now out on the other side of the health care system again and gearing up for another year of new grad students (and old ones) and new medical students. I have to say, going through the surgery of bilateral TMJ replacements was probably one of the hardest things I have done in a very long time. Post operative care didn't quite go as smoothly as I had hoped, particularly with pain management but now that I am 9 weeks post op, all is pretty good. Nice to be pain free for the first time in 21 yrs. Quite the freedom!
I do believe I still got pretty optimal care. Knowing I wasn't going to be broke after this surgery is pretty amazing considering the challenges we are facing in providing a publicly funded health care system. Sure, they get you out as soon as possible but I still believe nothing beats your own bed anyhow. I also had amazing care at home through loving family and awesome friends. This is pretty critical in one's ability to go home and recover. However not everyone has a supportive spouse or great friends who can make time out of their day to visit or go shopping for something. In this day and age, this type of support may be the critical factor in how patients manage at home with sometimes quite complicated post operative care plans. Sure, we have nurses who do home visits. These can be quite superficial and short depending upon the demand on the nurse to make it to all her patients.
What are other resources in the community that patients can tap into during these challenging post operative periods when they might not have other personal support? Some might say that the health care system is already stretched enough and social workers are running off their feet. People need to help themselves. Maybe this is true but many patients don't have the emotional reserve to seek out help. Pain and disability from illness or diseases zap the energy from people to a point that reaching out for help is exhausting.
Health care in the form of hospitals originated in temples in Ancient Egypt. In ancient Greece, temples dedicated to the healer-god Asclepius, known as Asclepieia, functioned as centres of medical advice, prognosis, and healing, where procedures were often done under an induced sleep known as enkoimesis not unlike anesthesia(1).
The declaration of Christianity as accepted religion in the Roman Empire drove an expansion of the provision of care. Following First Council of Nicaea in 325 A.D. construction of a hospital in every cathedral town was begun. In Turkey, the "Basilias", resembled a city and included housing for doctors and nurses and separate buildings for various classes of patients (2). There was a separate section for lepers (3). Some hospitals maintained libraries and training programs, and doctors compiled their medical and pharmacological studies in manuscripts. Thus in-patient medical care in the sense of what we today consider a hospital, was an invention driven by Christian mercy and Byzantine innovation (4).
Other religious groups have also taken care of the sick such as Jews, Muslims and Buddhists. This idea of taking care of the sick world wide stems from a "God-inspired" notion that we need to take care of our community around us. We have a moral and ethical obligation to provide care. Although our Canadian health care system is no longer tied to any religious affiliation, many faith groups still work to provide support to the physically and mentally unwell, alongside the government system. As our system becomes more secularized and funded through governments rather than churches or temples do we miss an element of care that was once there? Where is the role of spiritual care? How does this link in with physical care?
We teach that physicians need to consider the whole person: physical, mental, emotion and spiritual. Health care originally was inspired by a spiritual call to care but what do our students learn about spiritual care in our secular, politically correct system? Not really sure. Should we be teaching more or just rely on the few spiritual care staff in hospitals.
I believe my vastly improved health comes from all the aspects that make me whole. I got great physical care in the hospital and at home, was mentally and emotionally supported over and over, and spiritually encouraged by those friends have a similar faith. If any one of these was not provided, I don't believe my healing would be so dramatic.
1. Risse, G.B. Mending bodies, saving souls: a history of hospitals. Oxford University Press, 1990. p. 56
2. Catholic Encyclopedia (2009) www.catholic.org/encyclopedia
3. Roderick E. McGrew, Encyclopedia of Medical History (1985), p. 135.
4. James Edward McClellan and Harold Dorn, Science and Technology in World History: An Introduction (The Johns Hopkins University Press, 2006), p.99,101.
