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Alone and in Pain, This ER Patient Was Left at a Bus Stop

Advocates say stigma and mistreatment are ‘rampant’ in hospitals across British Columbia for people who use substances.

Moira Wyton 18 Feb 2022TheTyee.ca

Moira Wyton is The Tyee’s health reporter. Follow her @moirawyton or reach her here. This reporting beat is made possible by the Local Journalism Initiative.

It was just after 4:30 a.m. Pierce Sharelove was at a bus stop outside Victoria’s Royal Jubilee Hospital emergency room, wracked by back pain, grief-stricken by the recent death of his brother and barely able to move on his own.

But the 61-year-old was not making his way into the Victoria hospital on the morning of Aug. 6. He was trying to get home.

Still holding a prescription for the painkiller hydromorphone a hospital doctor had written minutes earlier, Sharelove had been asked to leave by nurses at the triage desk while he tried to phone friends to get a ride home. None had answered. It was the middle of the night.

He made it a few metres outside the entrance, where he collapsed in pain. Security was called, and when he explained, the security guard put Sharelove in a wheelchair and pushed him about 150 metres to the bus stop outside the hospital.

But the buses wouldn’t run for almost two hours.

A cab had been called by the emergency department, but the driver refused to take him home because he didn’t have his wallet with him or a taxi voucher from the hospital. Sharelove spent at least an hour sobbing and cold at the bus stop he had been wheeled to before a police officer was called and drove him the few minutes home.

All he could think was, “I am voiceless, I am utterly powerless,” Sharelove said in an interview with The Tyee.

“It was humiliating enough. I’m out in public and my body was starting to convulse and I couldn’t stop crying, it was guttural. It wracked me to the core of my being.”

Sharelove says he was abandoned by staff at Royal Jubilee Hospital after he was discharged and traumatized by their failure to secure him a ride home that morning, despite not being violent or disruptive.

‘It’s so dehumanizing’

Advocates say stigma, dismissal and mistreatment are “rampant” in hospitals across British Columbia for people like Sharelove who use substances.

“Any hospital I’ve ever been to, as a substance user I’ve been stigmatized and judged,” said Guy Felicella, a peer advisor at the BC Centre on Substance Use.

Over the nearly two decades Felicella was using heroin, he spent more than a year total in hospital, including multiple stays for bone infections and overdoses. After one overdose more than a decade ago, he said hospital security removed him from the hospital bed despite his protest he wasn’t ready to leave.

Felicella collapsed on a concrete bench outside St. Paul’s Hospital and slept there that night.

“If you’re anybody with a condition that’s substance-use related… you know that going to hospital is really hard,” he said. “It’s so dehumanizing.”

The allegations from Sharelove, who suspects he was stigmatized as a substance user who has required emergency care in recent months, add to growing concerns and accounts of mistreatment and physical harm against other marginalized people at the hospital.

An injury, then snowballing pain

Sharelove’s ordeal began in October 2019. He was volunteering with a youth hockey program in Victoria when he herniated three discs in his spine while lifting a net into place. After being assessed in hospital, he was directed to take it easy, but the pain worsened and surgery was scheduled for March 2020.

Through pandemic delays and poor access to followup care, Sharelove’s pain snowballed. His scheduled surgery to correct the damage was delayed, and then put off again due to COVID-19. In the meantime, he didn’t have a family doctor to help manage his pain and no pain medication prescription.

Sharelove’s provincial disability assistance due to chronic depression provides a living stipend far below the poverty line, which means he didn’t have coverage for sufficient physical therapy to address the pain. He could barely do laundry on his own or walk around, and his support system of friends and family in town was limited.

So Sharelove reluctantly turned to the only relief he had at his disposal, one he knew would work. He began using meth almost daily to manage the pain.

A former peer advocate and regional advisory member for mental health and addictions in Nelson, Sharelove says he started using methamphetamine recreationally with friends in 2017 as he explored his sexuality and became more involved in the gay and queer social scenes.

Sharelove said he had stayed away from using opioids for his back injury because he was worried about becoming dependent.

“I wasn’t able to do anything I was used to doing. I couldn’t walk around the block,” he said of how the pain affected his quality of life. When he finally had his surgery in June 2020, it wasn’t the end of the injury — or his pain. Sharelove says he received little instruction for followup care and recovery, and had no support with the tasks he was advised against doing, such as household chores.

“I was forced to do too much, too soon,” he said.

He suspects his lack of support made it more difficult for his body to heal.

As a result, Sharelove had called 911 “in screaming pain” a number of times, and was treated and brought home by taxi after receiving anti-inflammatory injections.

Just a few days after his most recent hospital visit, Sharelove called 911 in pain again on Aug. 6 and shuffled out of his apartment, without his keys or wallet. He was wearing only thin pants and a long-sleeved shirt as he was helped into the ambulance.

Sharelove waited in the emergency department for nearly five hours in physical pain and emotional distress. Two days earlier, he had learned his brother, Steve Bowes, had died by suicide in Nelson and the grief was overwhelming as he sat alone.

The doctor who eventually saw Sharelove that day prescribed him 15 hydromorphone tablets, an opioid stronger than morphine, for sciatic pain. Sharelove says the doctor seemed sympathetic to his grief and was patient with him as he sobbed during the assessment, but the visit ended quickly and there was no followup plan.

“He didn’t finish his job. He gave me a prescription, but where was the continuity of care? And was some judgment factored into that? I don’t fully know,” Sharelove said. “The judgment I can only assume was because I was in the emergency many times before and I told them the truth, that I was using meth and yes, I had injected.”

Hospital security wheeled him to a nearby bus stop on Richmond Street.

Security left him lying on the bus stop bench, Sharelove says.

He slid to the ground to avoid the hard metal of the bench, and laid there for what he estimates was at least an hour, sobbing into the sidewalk in pain and for the loss of his brother.

“It just comes out of my gut. I was wailing. It took everything out of me,” said Sharelove.

Eventually, a hospital staffer on her way to work stopped to help and called 911 to get Sharelove back to the hospital. An ambulance never came, but police arrived after being called to a disturbance around 6 a.m. By then a passerby had dropped off blankets to keep Sharelove warm.

A Victoria Police Department spokesperson confirmed an officer drove him home and helped him up the stairs into his apartment after realizing Sharelove was in need of help.

“I can’t even express how humiliated and destroyed I was,” Sharelove said.

‘Island Health does assist as needed’

No one was made available for a Tyee request to interview a hospital administrator in charge of the Royal Jubilee emergency department about these allegations.

In an emailed statement to The Tyee, a spokesperson for Island Health said that a non-disruptive patient organizing a ride home would not be asked to leave the premises.

“After patients have been clinically assessed and discharged, transportation is their responsibility but Island Health does assist as needed. This includes providing taxi vouchers and bus tickets,” the statement said.

The health authority did not say why Sharelove did not receive a taxi voucher because it could not comment on individual cases due to privacy concerns.

“Emergency departments are extremely busy care areas and to ensure staff are able to safely provide care to patients seeking emergency care, individuals who have been assessed as medically safe for discharge by a medical professional cannot remain in the emergency department,” the statement said.

When Sharelove first spoke with The Tyee last August, he was in hospital at Victoria General, where he had been admitted just days after being discharged from Royal Jubilee and left on the bench. He received another surgery to further relieve his pain and spent nine days in hospital recovering.

“I clearly needed more serious care, and [Royal Jubilee] just brushed me aside,” he said.

‘Overworked, you start to lose that compassion’

Grant Mackenzie, director of communications at Our Place Society, says experiences like Sharelove’s are not uncommon among low-income and unhoused people in downtown Victoria.

“We certainly see a lot of people who don’t trust hospitals because of how they’ve been treated,” he said in a previous interview.

A lack of primary and community-based health care means unhoused and marginalized people are more likely to call 911 when they need medical care, rather than being able to access a clinic or a family doctor, Mackenzie added.

Providing adequate followup care and taking lots of time with patients in an emergency health-care environment is “unrealistic in the current situation,” said Mackenzie. “We’re facing a dramatic shortage of nurses. And anybody, when you’re overworked, you start to lose that compassion.”

That fatigue, compounded by stigma commonly held against former and current substance users, can mean people are seen as less deserving of care, which puts them at greater health risk — including of overdose, Mackenzie said.

Felicella says for those who go to hospital often for care for substance-related concerns, compassion from health-care workers stretched thin by the pandemic can wear out even faster.

“Working in the ER has got to be pretty traumatizing, seeing car accidents, heart attacks, overdoses,” he said. “Compassion fatigue is one thing that can happen to anyone… once that starts to happen, you start getting angry. That’s when it all goes sideways.”

“But someone doesn’t have to be drug-free to access proper health care.”

Sharelove is sympathetic that security staff were just doing their jobs when they asked him to leave, but he questions why he was discharged in such distress and without a way home.

He is considering filing a complaint with the provincial Patient Care Quality Office once he is feeling better so no one else has to go through what he did.

Since he received the surgery he needed at Victoria General, Sharelove has returned to help with the hockey program. He’s gone back to writing poetry and making music, and performed at a few open mic nights and as a busker around Victoria.

He was even able to return to Nelson earlier this fall to visit his family and grieve the loss of his brother.

“I really needed to be with my parents and have people there who I knew loved me,” said Sharelove. “It’s been a long, lonely journey.”  [Tyee]

Read more: Health, Rights + Justice

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