After walk-in clinics, urgent and primary care centers and virtual care failed, Mark Laylen Young ended up in the emergency room with an infection that was initially thought to be a flesh-eating disease.
As Mark Layren Young lay in pain for days in a bed in a corridor at Victoria General Hospital, doctors looked at his inflamed leg and told him not to worry, that he wouldn't collapse.
“There was no question mark at the end of the sentence, but there was also no period,” he says. “The doctor just stared at the red, swollen elephant's foot in the room, as if he wondered if my real foot would ever reappear.”
The writer and filmmaker, who teaches writing at the University of Victoria, had tried multiple times unsuccessfully to treat the pain in his leg, and after leaving it untreated, it progressed to an extreme cellulitis (initially thought to be necrotizing fasciitis, also known as flesh-eating disease) that landed him in hospital last fall.
He chronicled his frustrating journey through Greater Victoria's walk-in clinics, urgent and primary care centres and virtual care in an open letter to one of his favourite comedians, Lewis Black.
“Dear Lewis Black, I don't remember exactly the joke you made on Victoria's show about how horrible it is to get sick in America and how great Canadian healthcare is,” Raylene Young wrote on his substack.com site.
“But as I sat in row five and nearly got a foot infection from the Canadian health care system, laughing at that joke, I wanted to share our medical wonderland adventure with you all.”
Raylene Young moved to Victoria in 2015 but keeps her family doctor in Vancouver. She said in an interview that she initially thought the pain and slight redness in her feet was due to arthritis or a gout attack.
“If I had any inkling that it could be this serious, I would have gone to the emergency room or at least travelled to Vancouver to see my family doctor,” he said.
Instead, he went to a pharmacist, who advised him to take some painkillers and see a doctor if the pain did not subside by morning.
The next morning, her foot was still red and painful, so Raylene Young tried to schedule an online appointment through Telus Health, but the service didn't have any doctors available.
Next, he tried the Urgent/Primary Care Center. He called the UPCC as soon as it opened and was told he was 12th in line, first on the waiting list, and would likely be called that same day. But that didn't happen.
Meanwhile, he kept logging into the Telus Health app, hoping a virtual appointment would open up, but to no avail.
He didn't try to call 811 to speak to a nurse because he felt their default recommendation was always to go to the emergency room, where he could be put on a wait for hours.
The next day, as the redness had turned a bit purple and spread down her leg, Raylene Young tried a few walk-in clinics, only to find they were all closed for appointments. “One 'walk-in' clinic had a sign on the door saying to make an appointment a week in advance,” Raylene Young said.
At this point, Raylene Young went back to a different pharmacist, who suggested a “more discreet” online virtual consultation option like Tia Health.
I was told an appointment would be made within minutes, but then I got a text message saying my appointment had been cancelled and that I needed to make an appointment at a walk-in clinic as I needed to be examined.
Without a diagnosis or tickets to see his favorite comedian, Lewis Black, Raylene Young decided to go to the show with his cane and get evaluated afterwards.
On the way home, his foot hurt when he stepped on the accelerator, and although his wife suggested he call 911, he opted to take a taxi to the emergency room at Victoria General Hospital.
After blood tests, the doctor gave him a “stern look” and asked Raylene Young if she knew what necrotizing fasciitis was. Young remembered well that Quebec separatist leader Lucien Bouchard had lost a leg to the “flesh-eating” disease.
Doctors quickly administered antibiotics via IV and rushed him for a CT scan, which diagnosed him with cellulitis likely caused by a small cut on his leg.
“I've definitely been scaredier in my life, but even now, several months later, I can't remember when it was,” he said.
After a night in the emergency room, he was wheeled into a bed in a hallway ward, where he would spend the next seven days. He was told to elevate his legs, and he did so while carrying his backpack containing his computer and his coat. He asked for an extra pillow, but was told “the hospital didn't have any left.”
The pain was excruciating, the drugs were as effective as Coke Zero and there was no privacy in the hospital hallways, but the moment Raylen Young was told he wasn't a cannibal, he felt like he could bear it all. “I can walk out of here on my own two feet. That's a victory,” he thought.
Raylene Young had no idea she could lose her leg to cellulitis. “I didn't think it was possible that I was going to lose my leg until doctors and nurses kept coming in and telling me, 'Don't worry, you're not going to lose your leg,'” she said.
After seven days, he was released from the hospital.
In a phone interview Friday, Health Minister Adrian Dix said he couldn't comment on the case for privacy reasons but was sympathetic: “Obviously, anybody who's had a bad experience in the health-care system, I'm concerned about their issues. That's why we're paying so much attention to primary care.”
Dix said the province continues to build out primary care and walk-in clinics, with 32 UPCCs and a network that have seen 2.7 million patients since 2018, noting that 550,000 people have been added to the provincial health service plan over the past three years as B.C.'s population grows.
But he acknowledged that while the state has “far more people” working in primary care, more needs to be done.
“There has never been this much investment in primary care and never been this much demand. The overall appointment numbers that we're seeing indicate that progress is being made, but that doesn't mean that in every situation, in every case, people won't face challenges. They do,” Dix said.
Now, Laylen Young is recovering. She has lost a lot of muscle in her right hip and leg, and her skin is patchy. “My legs still feel like a Rorschach test,” she said.
He goes to the Royal Jubilee Hospital outpatient clinic twice a week, where he receives mechanical leg massages to increase blood flow and reduce fluid retention, as well as physiotherapy. His long-term coverage through the Writers Guild of Canada is good, but only partially covers his aftercare.
Raylen Young said he was grateful to have been able to sleep in a hospital bed for seven nights while an “amazing” team of dedicated medical professionals “given me loads of antibiotics and did everything they could to get me discharged with the same number of limbs I had when I came in.” His GP called every day during his hospital stay.
He is grateful that much of his care was free, but said he could have lost his leg without access to emergency care.
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