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Doctors face drunk deluge

Whitehorse General Hospital has been "inundated" by drunk and drug-addled individuals since Raymond Silverfox died in RCMP custody, says Dr. Rao Tadepalli, president of the Yukon Medical Association.

Whitehorse General Hospital has been “inundated” by drunk and drug-addled individuals since Raymond Silverfox died in RCMP custody, says Dr. Rao Tadepalli, president of the Yukon Medical Association.

Mounties responded to the in-custody death, which occurred in December of 2008, by introducing a rule: anyone held in the drunk who vomits twice will be sent to hospital.

Now the hospital is swamped with severely-drunk individuals, said Tadepalli. And he offers a grim prediction: unless the emergency room is soon expanded, “you will have more alcohol-related deaths.”

Silverfox, a 43-year-old First Nation man from Carmacks, died after spending 13 hours in the drunk tank. During that time he vomited 26 times and soiled himself.

Guards offered mockery rather than help, until someone noticed Silverfox was no longer moving.

He died a short time later in hospital from acute pneumonia and blood poisoning. Pathologists believe these infections were brought about by Silverfox inhaling his own vomit.

The public has responded with revulsion to these disclosures, made during a coroner’s inquest last week. The RCMP has expressed contrition. “We have failed you and we have failed ourselves,” Supt. Peter Clark said this week.

And the territorial government, while shooting down a Liberal proposal for a public inquiry, has promised more soul-searching to come, through future reviews of RCMP policy.

But none of this has changed the number of severely drunk Yukoners who require medical attention each night. And, right now, there’s no place for them to go but the emergency room.

“Will we have deaths?” asks Tadepelli. “Yes, because there’s no facility to take care of them.

“Where are you going to keep them? Detox can’t hold them. They certainly can’t do IVs and if someone is defecating, has soiled himself, is covered with vomit and puke - he needs a cleanup. He needs an IV line. He needs antibiotics. He needs replacement of body salt. He needs treatment of seizures. He needs protection to his airway.”

Some have suggested Whitehorse needs a detoxification centre staffed by doctors and nurses. But this would be too costly, said Tadepalli. Instead, he wants a bigger emergency room for Whitehorse General.

Currently, the emergency room only has six beds. The trauma room has one.

This isn’t enough when approximately one-quarter of emergency room patients during a typical night may require such treatment, said Tadepelli. These severely drunk patients cannot be quickly discharged.

But the emergency room expansion won’t come cheap. A current proposal being kicked around by the Yukon Hospital Corporation would cost $50 million, chair Craig Tuton recently told the legislature.

This package would also include a bigger waiting room, to help separate the elderly and infirm from Yukoners with infectious diseases. Currently, frail patients run the risk of contracting a fatal flu simply by taking a seat in the waiting room, said Tadepelli.

And the hospital would receive a bone-density scanner, a digital X-ray machine, and possibly an MRI.

These upgrades “must be done within two years,” said Tadepelli.

All this would presumably be bought with borrowed money. The hospital corporation is already borrowing $67 million to build a new medical residence for visiting health professionals in Whitehorse and new hospitals for Watson Lake and Dawson City.

These projects have become political controversies. The opposition parties have accused the government of mortgaging the territory’s future with these debts.

The government is betting that Watson Lake and Dawson City will become boomtowns in the coming decade thanks to new mines. While the opposition agrees replacements are needed for both communities’ aging medical facilities, they question whether 24-hour, acute-care facilities are the best choices.

At least one doctor shares these concerns. Dr. Tony de la Mare has worked in the Yukon since 1972. From 1995 to 1998, he served as chief of staff for Whitehorse General.

“I don’t think it’s a good idea, personally,” he said of the new medical facilities.

He’s concerned the territory’s health funding will be spread too thin by the additional millions that will be spent on staffing the new hospitals. “If the feds want to raise the profile of the North ... then that’s a different scenario. But I’m not under the impression there’s money for that at the moment,” he said.

But Tadepalli supports the new hospitals. “We’re of course aware of the financial implications,” he said.

But he’ll let the politicians and bean-counters worry about how to squeeze more health money from Ottawa. That’s not his job.

Nor is it up to him to say what level of health care is adequate for rural Yukoners. “It’s not my position to say what people deserve,” he said.

He does believe the new hospitals should improve the quality of life for residents near Dawson City and Watson Lake. It would save patients undergoing chemotherapy a long drive to Whitehorse, for example.

Better long-term care will be a boon, too.

“If you’ve lived your life in Watson Lake, what’s the point of spending the last year of your life in Whitehorse?”

And besides offering emergency rooms, the facilities will house doctors’ offices, pharmacies and community nursing units.

“These are community health centres, as far as I’m concerned,” he said.

Regional hospitals may also take some of the strain off Whitehorse General. Case in point: “As I talk to you, the hospital is full,” Tadepalli said Wednesday.

It’s impossible to say whether 24-hour acute-care will be needed in the regional facilities. But it’s best to be prepared, said Tadepalli.

“Do we want accidents to only happen during the morning, then?” he asked.

“I cannot predict the future, and I cannot tell you this will be a successful idea. We need to work positively and hope for the best. I don’t believe in predictions for five to 10 years.”

Tadepalli doesn’t hesitate when he’s asked which would be his priority - new regional hospitals or expanded medical facilities for Whitehorse.

“I’m selfish. Of course I want Whitehorse General Hospital as a priority.”

But his bigger wish was that health care wasn’t so politically divisive.

“I wish that people could work together.”

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