This is my third and concluding letter on the closure of St. Mary’s Hospital.

Another sleepless night! Rumblings of unrest in the Royal Columbian Hospital doctors’ mail room - three of our young energetic orthopedic surgeons have resigned from our medical staff and relocated to greener pastures in the Lower Mainland. The loss of St. Mary’s operating rooms has threatened their ability to maintain surgical skills and earn income to cover overhead and support young families. I do not blame them. The ramifications are mind-boggling. Their loss decimates the orthopedic trauma on-call roster and the hospital’s ability to provide 24 hour emergency surgery coverage for the Fraser Health Authority. Without orthopedic coverage, neuro, thoracovascular and general surgery will be unable to provide emergency care to trauma patients - rare is the trauma victim to present without skeletal injury requiring surgical intervention. Without orthopedic coverage, the Royal Columbian Hospital will cease to function as a tertiary care hospital with trauma facilities. Accident victims would then face a life endangering ambulance ride on a congested freeway for downtown care. There will be needless loss of life.

Just as worrisome is the knee jerk loss of the orthopedic residency teaching program at the Royal Columbian. The loss of this valuable resource is ill-timed when the need couldn’t be greater with government’s announcement of medical school expansion to address a critical physician shortage.

The culminating blow would be the closure of the RCH Emergency Department - shades of St. Mary’s Hospital!

Dr. Les Vertesi, a veteran RCH emergency physician, provides an excellent analysis of our current health care dilemma in his 2003 publication, Broken Promises - Why Canadian Medicare is in trouble and what can be done to save it. It can be obtained via Internet, www.brokenpromises.ca or via e-mail info@brokenpromises.ca. It is an easy read interspersed with personal anecdotes. Dr. Vertesi chronicles the progressive deterioration of our premier health care system to our current chaotic shambles. He concludes with a prescription to save Medicare and the prognosis of a successful outcome. I must forewarn that it is not for the faint of heart or those who suffer insomnia. He makes a statement that regardless of intervention, the system may be beyond the point of salvage. It is a chilling thought.

Aviation accident investigators theorize that each mishap is preceded by a chain of events. Disruption of the sequence before a key link will avert disaster. Beyond that point, the flight crew assumes the role of passenger with the unenviable privilege of being the first to arrive at the scene. Do the politicians have the intellect and insight to prevent the implosion of Medicare? As Harry Chapin prophetizes in the closing line of his song Sequel........ I guess only time will tell.

Yours sincerely,

J. Albrecht, M.D.