Better the devil you know?

Last Friday, the New Democratic Party leader Jack Layton called a press conference and announced that he is suffering from prostate cancer. He revealed his family history, exhibited an optimistic attitude, said there was a treatment plan and, with that openness and frankness, all speculation was laid to rest about his illness.

Mr. Layton's attitude was in direct contrast to that of Premier Danny Williams, who went to the United States for heart surgery and left Kathy Dunderdale, the Deputy Premier, to tell the province at a press conference he was seriously ill and could be incapacitated for up to three months.

Perhaps Mr. Layton learned his lesson from Danny Williams. It cannot be imagined that Mr. Williams would have opted for a surrogate spokesperson had he realized the furor his decision to boycott Canada and go to the United States would cause. Could Mr. Williams, even in his wildest imagination, have thought that he would become the poster boy for the American healthcare debate?

Obviously Mr. Williams can do as he wishes with his body and his money. The way our society is set up, people with money can travel to other countries and pay for anything they desire. Mr. Williams is hardly the first person to go to the United States for treatment.

In an ideal society, people would not be treated differently because of money. But we don't live in an ideal society - we live in a society where money talks. We have been convinced that if we pay for something, it is better than something free.

Do we ever ask whether this is true? Unless Mr. Williams has had a procedure that is new and unavailable in Canada, it is highly doubtful that the treatment in the United States would be any better than treatment in Newfoundland and Labrador.

The reason for this opinion is that any procedure is entirely dependent upon the person performing the task. When people are factored into the equation, you pay your money and takes your chances. Mr. Williams would probably be better off here. In this province, he is a big fish in a small pond; in the United States, he is a very small fish in a big pond.

In the end, it all comes down to this; get someone on a day when they are feeling good and all will be well; get them on a bad day, and who knows? Still, everything is relative to the top down system, even in Newfoundland.

That reminds me of my first time assisting in an operating room, many moons ago.

(It also reminds me of my first autopsy, a Portuguese seaman who died at sea, but that is a story for another time.)

It was my privilege to be assigned to work with a top notch, well-known surgeon ... one in whom the whole province placed great store.

This was to be my greatest moment! Having devoured the medical books and with the procedure down pat, it came as an overwhelming shock when the man sailed in without a word, made a few cuts without a word and left without a word, leaving me, a trainee, to mop up, literally. No assistant needed was his rule, not the exception, apparently. It was baptÊme du feu, for me.

A legitimate question, of course, is how much my perception of my first operating room experience is worth? Assisting was to be my defining moment. For the surgeon, it was just another day.

We have had good medical services in Newfoundland and Labrador, and not only in the city. Doctors and nurses have devoted their entire lives to the rural areas of the province. Sometimes when the city couldn't provide a service, rural doctors stepped up to the plate. People's lives were changed in small outport hospitals, such as Twillingate, where Dr. John Olds pioneered life-saving and life-changing surgery.

Back to the future ... you might say that at least in the United States the equipment will be better in the well-known hospitals. But is there any guarantee that an organization that is operating a business for profit would keep everything up to date?

But what if the hospital does have state-of-the art equipment? We have seen, with the recent breast cancer event, that new equipment and procedures don't mean much if the operators aren't trained. Sometimes, it might be better if we stick to the tried and true.

Sadly, and sometimes happily, we are at the mercy of human beings at every turn in life. That is just as true in the United States, for all our impressions that they are superior, as it is for our own little corner of the world. Bigger is not always better!

Dr. Olds' reputation came from word-of-mouth, not well thought out indoctrinating advertising campaigns. We know he was good because of the results of his surgery, not because of hype.

Marcel Proust said, "Illness is the most heeded of doctors; to goodness and wisdom we only make promises; to pain we obey." Let's wish Premier Williams and Mr. Layton peace, comfort and freedom from pain throughout the coming days!