Anita and I spent the whole day yesterday at the Archie and Irene Verspeeten Cancer Centre at London’s Victoria Hospital. I was getting my third round of chemo, hooked up to an IV on site from 8:30 am to 4:00 pm.
Being there reminded me of something Anita posted about on Facebook, and which I’ve discussed with several friends and with various members of my Bipolar treatment team. You see, this is the very same hospital where I was locked down on the Psych Ward for seven weeks in the spring of 2024. And, as Anita pointed out, the two experiences couldn’t be more different. We think the example speaks volumes both about society’s contrasting attitudes to physical versus mental illness, and about the success of research in those two domains.
Let’s start here. There is a Cancer Centre, and it’s proudly named after a family. The signs are plastered everywhere and there’s also a splashy centre-specific website with pictures of the donors. (See here: https://www.lhsc.on.ca/verspeeten-family-cancer-centre/about-verspeeten-family-cancer-centre.) The physical space is impressive: the atrium is beautifully decorated, with three floors of hanging plants, an aquarium, and even an electric piano for patient use. The centre also has its own information booth, staffed by paid employees. Most telling for me: there’s a gong near the exit doors which patients clang when they have completed their treatment regime; the whole building hears the noise and claps supportively in response. Well, and of course there’s a dedicated Tim Hortons! In contrast, psychiatry is split across about four locations at Vic, on different floors, in different wings. The closest thing to a welcoming atrium or info booth would be the pat-down screening and bag check by the specially trained, albeit pleasant, security guards! No donors have sponsored anything, as far as one can see. And no one celebrates with them when a patient gets released.
In the Cancer Centre, everything is massively well-organized. There are assigned numbers for those waiting in line, so staff don’t have to call out actual names on the PA. (A privacy measure.) There is a TV monitor with those numbers, to tell readers what stage the cancer patient is at that day (e.g., waiting, meds being prepped, etc.). I have my personal “patient navigator”, Jennifer, who co-ordinates all the care and all my many doctors’ appointments. Patients are given bespoke printed itineraries for the weeks ahead. The Cancer Centre is also awash in volunteers. There’s easily a couple of dozen at any given time: accompanying patients so they don’t get lost, administering the weekly check ins (on site-specific iPads), bringing free snacks around, driving patients to and from their appointments at no charge, etc. On the psych ward, it’s nearly impossible to figure out where your family member is being housed. We patients have our real names on our doors. No one – not the patients, not the nurses, not the social workers – tend to know for sure what is coming up, even on the day in question. When it comes to treating mental illness at Vic, the old cliché applies: far from well-organized, the right hand doesn’t know… Granted, and finally, I did meet one volunteer while on the Psych Ward. That guest had been a patient on the ward and had returned to lead a group discussion. But that was only one time, for half an hour, over a span of seven weeks.
The informational resources for families are radically different too. Near the lobby/reception area, there’s a cancer library, with comfortable leather chairs and dozens of pamphlets to take home. Our radiation oncologist had written a patient-friendly book on cancer care… and he gave us a free copy! Off-site, there’s a dedicated phone line that operates 24-7, which can connect you directly to an oncology nurse. And, of course, there are recommended websites galore. In fact, after Anita signed up with Wellspring before I started treatment, she got a call a week later to make sure she could navigate their site, and to see whether she had any questions. In sharp contrast, Anita found nothing locally or digitally aimed at caregivers for those with mental health conditions. (For reasons we don’t understand, the focus for caregiver information seems to be squarely on addictions).
One last comparison, not specifically about the hospital, but rather a telling detail about the larger contrasting systems of health care. This one really struck Anita. When I went on a Western-funded sick leave for my Bipolar years back, and then transitioned onto partial long-term disability paid from our insurance company, the rigmarole was awful. So many forms. So many questions. Worst of all, in the end we needed a lawyer’s help, including a (very expensive) report from a third-party psychiatrist, to get Manulife to continue paying me — because the agent’s attitude was that remaining part time solely due to my Bipolar symptoms would be “a lifestyle choice” as opposed to a medical issue. (Yes, that is a quote.) In contrast, I haven’t had to do any paperwork at Western to go on fully paid leave this time. I didn’t require any signatures from any doctors. One quick informal phone call with Human Resources, explaining my diagnosis, and the whole process was done and dusted. I’m pretty sure that Manulife won’t try to wriggle out of longer-term coverage either, on the grounds that my malignant esophageal cancer is a “lifestyle choice”!
What explains the massive differences? It’s not all prejudice and stigma. There’s a genuine and obvious history of successes in treating cancer: one can readily see that all the money directed at research therein has noticeably improved care. Taking my own example, not too many decades ago, my diagnosis would have been a death sentence. Just in the last ten years, the cure rate for my kind of tumour has risen from about 20% to about 40%. And the treatment protocol specific to esophageal adenocarcinoma, which now avoids radiation, was updated in Canada just a few months ago, based on rigorous European clinical trials. All that progress creates an upward spiral: governments and donors think of cancer funding as money well-spent and they continually add to the pot. In contrast, we are still very much in the dark when it comes to treating mental illnesses like Bipolar. There isn’t even consensus on which symptoms go with which diagnoses, let alone agreement about treatments. That can be legitimately off-putting for potential funders. Nonetheless, Anita and I think societal attitudes towards mental health play the most important role. What families want their name associated with treating something as taboo as madness? Who completes treatment on the psych ward and wishes to immediately return there as a proud volunteer? Not even I myself have gone back to Victoria Hospital to lend a hand with psychiatric care, and I’m supposedly enlightened.
Anita and I are toying with writing up an Op-Ed piece on these issues, so we’d value any comments from readers of the blog. What do you all think?