I asked what the noise was when we stopped at a traffic light. Although the creeping physical sensation clearly told me, my mind was not yet able to explain what had happened.
“We were hit,” said the driver.
It was the evening of my third daily dialysis treatment. This week required energy, practicality, and, as always, self-advocacy so I could flush out fluids and toxins in one piece. Were you in one piece? Moments before we got hit, I told the driver how long I’ve been alive now: It’s been five years since my double lung transplant. As the sharp force of the car behind us pushed my back forward, the black leather seats and air socks scrambled.
I located my body and started shaking my big toe. Then I moved outside, feeling my way back to the moment. The driver is gone. The sounds outside the car ran at each other like larger-than-life cartoon characters, and also louder. I gently ran my fingers over the rib cage to make sure everything was alright. In that moment I felt grateful for my meditation practice, which immediately began and took me into space as I explored whether my body was injured.
I was worried that the lung might collapse, and because trauma is the great buffer between experience and feeling, I was worried that pain might linger in that third space, waiting to connect. I felt my legs and got them out of the car so I could stand up. Then I saw the driver and the guy who hit us arguing.
Every week, three times a week, I fulfill my responsibility as outlined in the Health, Safety and Environment document. I’m ready to be taken with you and I’m respectful even when I want to scream
The driver, a calm and kind man, kept asking me if I was okay, but I didn’t know the answer. I fought so hard for life, anger swallowed me up. I felt like I might be going to Katie Taylor in anything close, so I quickly got back in the car. I heard the guy who hit us say, “I was just checking on my daughter, I’m sorry.”
When the driver returned he did not have the man’s details. It shook, so I suggested it maybe take a minute. We got the details and I called the dialysis center I just came from. It was an attempt to calm myself down. Even though I was starting to feel fine physically, I needed to know someone out there who agreed. We drove home.
The worst part about the free taxi system bringing patients to life-saving treatment is that it was only a problem from the start. Most dialysis patients who attend my unit are affected by this. There is a shortage of taxis nationwide, but that burden should not fall on patients.
The car arrived on time on the first day of dialysis. He was 45 minutes late on the second day. The driver, an older man, went to the wrong address. I understood that. On the third day the taxi company called to say there was a concert in Marlay Park meaning the car would be late. till when? nobody knows. late hour.
I have met some very nice and nice drivers who have discussed this with me. Drivers prefer non-contract jobs because they earn more or hate that the contract has already been negotiated at a discount. But bringing the patient to any medical treatment must be respected in simple ways: there must be clear communication, the car must arrive on time, the car must be clean, and the driver must make the trip on the basis that he is bringing someone for life-saving treatment.
Every time a taxi is late – especially when they call once and hang up – I remember how insignificant one can feel when faced with the Irish health system
This means, where possible, that it is not negative. Patients should not have to experience these problems. Sometimes the cars are so filthy that I have to get my feet off the ground the entire trip to avoid what appears to be an empty bowl of Dolmio sauce or an empty bottle. And sometimes the driver is amazing, the cars are clean, and the ride is a dream.
But this should be the rule, not the exception.
The contract is between what the health and safety guidelines for non-emergency dialysis transport call “patient/caregiver,” “hospital/unit,” and “transport provider.” Every week, three times a week, I fulfill my responsibility as outlined in the Health, Safety and Environment document. I’m ready to be taken with you and I’m respectful even when I want to scream. Screaming might be better. I never know if my driver will arrive on time. Sometimes I get a text saying they’re on their way and sometimes I don’t.
A study from the University of Ghent on dialysis transport found that some patients find it difficult to communicate with drivers because there are always different drivers. Some patients preferred continuity but others did not care as long as they returned home. Those who preferred continuity found the experience easier. Everything must be done to show patients an easy experience in Ireland.
The issue around time concerns patient dignity – the ability to own and delegate what happens to one’s body when and where. Every time a taxi is late – especially when they call once and hang up – I am reminded of how insignificant one can feel when faced with the Irish health system. And how, over time, these encounters build up and feel like self-effacement. Patients who are sicker than me – many of them are older, overweight and need support to move around – should not contend with this. Late patients mean that nurses have to stay later to finish treatment. Taxi tardiness is putting an already strained system on it.
Why should patients and health care workers put up with this?
The solution is to create a competitive contract in which more than one company is responsible for transporting patients. For example, if a taxi company cannot get patients to the hospital on time – due to pressure on drivers – patients should be empowered and facilitated to book in the taxi app. It’s simple: if the car is more than 10 minutes late, the patient can book elsewhere and be compensated. Make it a competitive contract. Prioritize vigilance and empathy when picking up patients, and wear a mask.
After the accident I did not hear from the taxi company. And even though I phoned what happened, a week later my great team didn’t know.
With the big taxi debacle, I’m left wondering who has the duty to care for the patient, and when it comes down to it, if they really care at all.