Living and Dying by the Rules

In Hong Kong it can be frustrating trying to get things done given the mindset of people who have responsibility without authority.

A general culture of terror pervades the city; anyone asked to do something even the tiniest bit different from the established guidelines shrivels into a ball like a wounded caterpillar for fear of reprimand.

Were it not so, then a man having a heart attack on the doorstep of a hospital may not have died.

You read it right, he was just outside but did not receive immediate assistance. Here's why:

The incident took place at 2.43pm on Saturday when the man was taken by car by his son to the hospital's Wai Ming Block. The father, who had heart disease, had collapsed by the time they arrived. The son laid him on the ground and went inside to ask the receptionist to call a doctor, but he was told to call 999 instead. The receptionist did not call 999 or the accident and emergency department.

A doctor who chanced upon the man alerted the accident and emergency department and tried to resuscitate him. An ambulance did not arrive until 3pm and delivered the patient to the accident and emergency department at 3.09pm, 26 minutes after he arrived at the hospital. He was pronounced dead at 3.26pm.

[Emphasis mine]

The hospital is standing behind the receptionist:

Under such a stressful situation, [she] performed well and to the best of her ability. The colleague had done her best because there was no other staff member around and she had her other duty. There are no clear guidelines for our staff as to what to do when an emergency takes place outside our institution.

In plain English, she was unable to think for herself. But it's not really her fault: Hong Kong's education system prizes memorisation over critical thinking. Add to that the quickness with which people fall back on "The Rules", and you have a recipe for disaster.

The chairman of the Patients' Rights Association called the incident cold-blooded, but I wouldn't go that far; a large part of the blame falls upon the hospital administrators for not having the foresight to realise that on occasion sick people might not make it into the building. While you can't prepare for every contingency, that one would seem obvious.

Does this mean the man might have lived had things been different? Perhaps not, he did have a bad ticker; immediate response may not have helped. But maybe a person not paralysed by uncertainty would have taken a few seconds to flag a doctor, giving the man at least a chance to survive.

While I hope that I'll never need emergency medical treatment, I pray that if I do it will be after this "cannot do" mindset has changed.

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