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Audible Bleeding: Medicine & Politics: A Vascular Surgeon's Perspective

by York N. Hsiang

Vascular surgery and the changing Canadian healthcare system

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AlbakiReads Editorial

Vascular surgery and the changing Canadian healthcare system

York N. Hsiang charts the development of vascular surgery in Vancouver from 1976 to 2020 alongside changes in Canada’s healthcare system. The account connects the growth of a surgical specialty with debates over physician numbers, nursing education, operating-room access, patient payment, and hospital administration. Its opening image of “audible bleeding” introduces the urgency of vascular surgery, while the broader subject is how policy and institutional decisions affect the availability of medical staff, tests, and surgery. Written in accessible language, the book brings together a professional history and a critique of healthcare in Canada.

Good fit for readers who enjoy

  • Readers seeking an accessible introduction to vascular surgery and its development in Vancouver.
  • Those interested in Canadian healthcare policy and the organization of medical services.
  • Readers curious about a surgeon’s perspective on healthcare institutions and access to care.

Themes

History of vascular surgeryCanadian healthcare policyMedical staffing and access to careHospital administration

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Book overview

In the operating room, when there is unexpected massive bleeding like a raging inferno, the emergency responders are the vascular surgeons.

 

But is there bleeding that even vascular surgeons fear? The answer is yes. A former trainee told me to fear two types of bleeding: if the bleeding is coming from you, and audible bleeding. Audible bleeding is when the flow or volume of blood loss is so great you can hear it.

 

Audible bleeding occurs when the aorta is opened (deliberately or not), even temporarily. The gush of blood is like water from a firehose. Bleeding is also audible when the blood loss is so great, it flows out of the patient, off the OR table, and strikes the floor below. If you hear it, something must be done. Quickly.

 

This book chronicles the development of vascular surgery in Vancouver, Canada, from 1976 to 2020, in parallel with the hemorrhaging of healthcare in Canada. From short sighted government attempts to regulate the number of doctors, closure of nursing schools, restriction of OR time, suppression of a nation-wide patient pay health plan, and the rise of hospital administration, these changes have led to serious deficiencies in doctors, nurses, and efficient access to necessary tests and surgeries. Written in easy-to-understand language, this book is for readers wanting to know more about the newest surgical specialty and for those wanting a behind the scene look into the myriad of problems of healthcare in Canada.

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