Ming Quon was at home, standing under a warm shower late on Jan. 24, 2007, when a sudden, sharp pain in his head nearly knocked him over.
He yelled for his wife, May Quon. Just a few hours earlier, he had been doing the cha-cha-cha with her at a dance class.
By 11 p.m., he couldn't make it to bed; he was staggering, his face as white as a sheet of paper.
"I usually don't have headaches, I knew something was wrong," Mr. Quon, 55, said in an interview from his home in York Region, north of Toronto.
"It felt sharp and extremely achy."
An ambulance pulled up to the front steps of their suburban brick house. Mr. Quon, who teaches electrical technology at a community college, was taken to York Central Hospital, where he was diagnosed with a subarachnoid hemorrhage, caused by a ruptured aneurysm.
But that was only the beginning of his troubles.
More bad news was to come: No Ontario hospital that provides neurosurgery could take him.
Unwittingly, Mr. Quon found himself smack in the middle of a health-care shortage, one that has forced 164 patients with broken necks, burst aneurysms and other types of bleeding in or outside of the brain to Michigan and New York State hospitals since April, 2006.
That includes 69 patients sent so far in fiscal 2007-2008, according to Health Ministry figures.
Although Ontario has the worst problem by far, it is not alone.
British Columbia has sent four patients with spinal-cord injuries to Washington State hospitals for care from May to September, 2007, though the recruitment of more staff and opening of new beds have helped alleviate the problem. Saskatchewan has sent patients to neighbouring provinces, including Alberta, for specialized neurosurgical services.
In Ontario, patients face barriers to receiving care at every turn.
There is limited access to teleradiology and operating-room time. There are too few intensive-care beds, a short supply of neurosurgically trained intensive-care nurses to staff them and too few neurosurgeons.
For Mr. Quon, it was "a scary thing," said his wife, a registered nurse who works at an insurance company.
Ms. Quon said her husband spent about 15 hours in emergency as staff worked to find a hospital that performs neurosurgery.
Bruce Harber, York Central Hospital's president and chief executive officer, could not comment on the case, due to patient confidentiality.
But he wrote in an e-mail: "We at York Central Hospital work closely with CritiCall [an emergency-referral service for physicians] to ensure that these patients are transferred to the most appropriate and available regional centre."
When Mr. Quon was finally referred to a Buffalo hospital, his wife raced home to grab passports, threw on a pair of slacks, forgetting to change out of the pajama top she was still wearing.
Treatment at Millard Fillmore Gates Circle Hospital came in the form of neurosurgery about 17 hours after Mr. Quon suffered his subarachnoid hemorrhage.
He underwent a craniotomy, an operation to open the skull, then had a small metal clothespin-like clip placed on the aneurysm's neck, to halt its blood supply.
He also had two endovascular coil embolizations, a minimally invasive procedure where a long, thin tube is inserted into the femoral artery near the groin, up to the aneurysm.
Small platinum coils then fill the aneurysm to prevent it from further expansion and rupture.
Michael P. Hughes, vice-president of public relations and government affairs for Kaleida Health, which includes Millard Fillmore Gates Circle Hospital, could not speak about Mr. Quon's case, due to patient confidentiality, but said his institution is seeing an increasing number of Canadian patients.
"I'm glad he had a positive outcome," Mr. Hughes said.
