When Sean* first started noticing symptoms of an ear infection in September 2013, he took the day off work to get it checked out at the clinic. He had experienced painful symptoms for several consecutive days, to the point where waiting it out no longer seemed to be the best option. But he expected that one day off work to be enough.

“My first visit [to the clinic], I was three days in [with the infection],” Sean said. “I waited until I felt like it was pretty obvious [….] I saw a doctor after waiting about two hours, which is standard for a clinic [….] He looked at it for maybe two seconds, and said ‘I don’t really see anything wrong with it.’”

But to Sean, there was something wrong.

“It was really sore,” Sean recalled. “My ear canal was swollen—you could try to put a Q-tip in, but it wouldn’t pass.”

A story like Sean’s is not uncommon in the medical field. Patients visit clinics frequently with symptoms they claim are correlated with a certain disease they found on the internet, and doctors dismiss it upon inspection, assuring patients that they just need to wait it out. With something like an ear infection, which can often clear up on its own, patients seeking treatment will often end up going home empty-handed, asked to weather the storm.

But in Sean’s case, the storm had grown more and more menacing within the next week. He returned to the clinic, and this time, the doctor told him, “There’s definitely something wrong here.” 

He was sent home with a bottle of eardrops without a complete explanation of what he was given, then asked to leave in a hurry.

Anyone who has attempted to visit a walk-in clinic may have experienced something similar. With issues that don’t send people immediately en route to the emergency room, they can expect long waits or frustratingly inflexible intake hours. For the clinic Sean visited, it seemed not unlike standing in a Black Friday queue outside a department store, waiting for the doors to swing open.

“You call the night before and there’s an automated system,” Sean explained. “You call after 7:30 p.m., and you get assigned to a slot for the next day. Usually if you call anytime past 7:40 p.m., you’re not gonna get a slot. It’s that busy.”

But when every resident or temporary resident of Quebec is covered under the Health Insurance Plan and a trip to the clinic costs nothing, why seek out alternative options such as expensive private health care? According to a Canadian Community Health Survey from 2013, 25.1 per cent of Quebec residents do not have a regular doctor, compared to the national average of 15.5 per cent. However, a Statistics Canada health report also published that there has been anywhere between 30 to 40 per cent of an increase in out-of-pocket expenditures on health care, depending on income quartile.

So Sean, after trying the ear drops for a couple days and still experiencing pain, went back yet again to the same clinic.

“So now we’re at the third visit,” Sean explained. “I go back to the clinic, and the third doctor said, ‘There’s nothing wrong with your ear.’”

Sean didn’t give in so easily, though. He had three clinic visits under his belt and an inflamed ear exhibiting no real improvement, so the doctor agreed to invite another doctor to come in to inspect it. The second doctor suggested giving Sean another set of eardrops. The result?

“They didn’t work.”

In between this process, Sean also went to a family doctor for an unrelated health issue. The family doctor told him that there was definitely something wrong with his ear, so he gave Sean both pills and drops. 

Those worked—at first.

“A couple weeks later, I was getting different symptoms,” Sean said. “Now, my ear was not just swollen and in pain, but there was [also] fluid [coming out of it].”

His family doctor gave him painkillers to address the pain, while referring him to an ENT—an ear, nose, and throat specialist. But, as many people have experienced firsthand, booking an appointment with a specialist is not a next-day affair. Sean wasn’t able to see the ENT until two months later.

“[The ENT] took a look at my ear, and he said, ‘I see some scar tissue, and I’m gonna have to get a camera in there,” Sean recalled. “So I’m gonna need you to call my secretary and make an appointment for February. This was in October.”

By February, the infection had spread to Sean’s sinus, to the point where he had reddish-orange fluid dripping from his nose. To some, it may have been a cue to visit the emergency room. But Sean was hesitant to do so.

“At this point, I already had an appointment with the ENT [scheduled], and I had already taken so many days off work,” he explained.

So instead, he kept waiting. Yet any hope for a successful visit with the specialist was quickly dashed upon arrival. 

“When I finally got there, he had two students—that’s not usually a problem—except he didn’t look me in the eyes the entire time,” Sean said. “There was no communication with me [….] He ended up finding that there was scar tissue from the infection in my eardrum. So he went in and pulled it out with a pair of tweezers and sent me on my way.”

Sean said that although some of the most alarming symptoms—the bloody pus and unidentified fluids—have waned, he still felt the repercussions from spending months with an infected ear, even a year after his very first visit.

“There’s still random swelling,” Sean said. “I’ll wake up in the morning and it’ll be red and throbbing. My sense of smell was damaged for quite a while [….] I can’t distinguish smells like I used to [….] I actually saw my family doctor after all this […] and he said, ‘Well, yeah, your ear is damaged. There’s some scarring [there]. It looks like it’s been through hell.’”

Sean’s story is a middling case on a strangely warped spectrum of symptom severity, and it raises plenty of questions and concerns about boundary lines. When does a condition become alarming enough to head straight to the emergency room? When does it qualify as dismissible enough to be sent away from a walk-in with a nasal spray or antibiotics in hand but nothing more? What happens when a medical issue escalates to the point where everyone is left thinking, “If only we had caught it earlier?” And what is the case for those who did try to catch it early on, as Sean attempted with his very first clinic visit?

Sean emphasized that not all of his health care issues have been difficult—he recalled a past trip to the emergency room, where he was effectively and properly treated within two hours. 

In his experience, Sean had done his best to utilize the health care system as it stood—but between all the clinic visits and specialist referrals, he still struggled to feel properly cared for and treated. Ultimately, he was forced to rely on the way the system had herded him from one location to the next, all without fixing the reason for his initial visit. 

The health care system isn’t perfect, and an ear infection—among other medical issues that can arise—does not have a one-cure-fits-all solution. Sean explained that it was hard to know for sure where the underlying issues were for any of his seven visits to clinics, doctors, and specialists. He couldn’t attribute the lack of treatment to anything in particular. But he stood by his statement from the beginning—that even when doctors were telling him that nothing was wrong, it was clear to him—and others around him—that something wasn’t normal.

“My friends were looking at my ear and going, ‘Dude, what’s wrong with your ear? It looks really messed up,” Sean said. “I don’t know if it was that [the doctors] were in such a hurry to get me out of there that they didn’t notice, or it didn’t look severe enough, or [if] they saw that another doctor [had] increased the treatment for it [already]. I don’t know. I really don’t know.”

 

*Sean’s last name has been omitted for anonymity purposes.