Flu! (¡Gripe!)…

Last month un gripe (the flu) took hold in our household. Now I’m not talking about your run-of-the-mill “man-flu” here; I haven’t been so sick for literally years. Within the space of just a few hours I went from feeling quite normal to being worried I was actually going to die. It was brutal.

Unfortunately, despite bringing the marauding microbe home, I wasn’t the worst effected. Poor G went down like a tonne of bricks a couple of days after me and ended up in hospital with pneumonia!

That was a hell of a shock. G is normally insanely healthy - he is never sick - but all of a sudden there he was laid-up in hospital in quite a precarious state. I’m not ashamed to admit that I was pretty scared.

Now that the concern has passed (although I can tell you, we’ll both be making sure we have flu shots each year from now on), I’ve been reflecting on the whole experience from the point of view of an extranjero experiencing hospital for the first time in Cataluña.

The treatment G got once he was in hospital was actually top-notch and we’ll both always be grateful for that. But the actual getting into hospital was another story.

In Spain, the Sanidad Pública (public health service) is run by the government of each Comunidad Autonomo (literally Autonomous Community, but best translated as “Region”). As I’ve mentioned before Cataluña has privatised much of theirs.

Our local heath centre is run by one of these private companies, which also runs a hospital just around the corner from the surgery. G ended up in that hospital after our local GP took one listen to his lungs and referred him straight there with a little note saying pneumonia was suspected.

Now I thought that with such a note he’d be taken straight into one of those urgencias (emergency-room) cubicles from where all necessary tests would be performed. Instead, what he endured was seven hours of being shunted from the rickety wooden benches of the waiting room (which was actually the drafty corridor of a building from the century-before-last) to each hospital department and back again to wait the hour or two for the results from each test.

When “one last” x-ray was suggested, “just to make sure”, I put my foot down. I told the doctor that G simply couldn’t be expected to spend another few hours in that corridor – what he needed was to be at home in bed. That’s when she told us that he’d not be going home that day, but instead would be ingresado (admitted to hospital).

What followed was a 20-odd hour wait (thankfully though, now in an emergency-room bed) for a bed on the ward. Urgencias is a pretty awful place to be trapped for the best part of a day and night. To make matters worse for G (and for me), I was only allowed to see him for about 10 minutes during those more than 20 hours.

Like I said, once he was in hospital he was really well looked after, and although the building certainly looked the 100-odd years it was, it seemed to have up-to-date equipment and facilities. I just couldn’t help being suspicious that things could have been better if the hospital hadn’t been run by a private, for-profit company.

Why did G have to spend so long in the emergency department when there was a huge, brand-spanking new hospital less than a kilometre up the road? Was it because that hospital was run by a different health provider and our hospital would not get the money from the Sanidad for his three days in hospital if they sent him up there?  

Of course, maybe all the hospitals were colapsado (overrun) that day. Maybe it was the result of the cuts to the health budget because of the crisis. Maybe it’s always been that way here in Cataluña.

Or maybe my “pinko-poofo” prejudice against privatising essential services was colouring my thinking. Indeed there have been plenty of news stories this winter of emergency departments in totally public-run hospitals in other Comunidades leaving people on gurneys in corridors for 30 hours or more.

But then again this is Cataluña, where for much of the last 30 years successive centre-right governments have been busy privatising public services more than anywhere else in Spain.

And despite the savings and efficiencies that privatisation is meant to provide, Cataluña is one of the Comunidades in which public service budget cuts during this crisis have been most acutely felt by its citizens and where, at the same time, public debt has grown more than just about any other.  It’s food for thought.

But credit where credit is due. Thanks to the care that G received once he was finally ingresado  he made a full recovery - and just in time for our wedding(!) But that’s a post for another day.

To the doctor! (¡Al medico!)

A Catalan tarjeta sanitaria (health service card)

The other day I went to the doctor in Spain for the first time.

It started off similar to what one would expect in Australia: up to the reception desk to announce oneself, give over the tarjeta sanitaria (health service card), get ushered into the sala de espera (waiting room). From here though, things started to deviate from my normal experience.

As in Australia, Catalan GP surgeries are run by private doctors or campanies who charge the public health system for their services. But you wouldn’t guess that from the look of my local surgery.

It was very clean, tidy and pretty modern, but exuded that typically continental-European public building ambience: austere, heavily utilitarian, devoid of creature comforts like magazines or pictures on the walls and everything- walls, seats, floor - a cool pale blue.

On entering the waiting area, an etiquette quickly became evident. In Spain, when you go into a shop or even get into an elevator, people tend to greet each other, with a “hola” or a “buenas dias”.

It turns out it’s pretty much the same at the doctor’s. And as in a shop or a lift, it’s the new entry who must start this off, which I was quickly prompted to do by the other patients looking me right in the eye as I walked in.

Back in Australia or London, I seem to remember always wanting to avoid eye contact with other patients at the doctor’s – and the feeling seemed mutual. Maybe us anglosajones feel that illness is a very private thing and we are a little embarrassed to be out in public (?) It seems that's not the case with Spaniards.

Not long after giving my greeting and taking a seat, the doctor came out and called my name. Brilliant, I thought, it’s my turn already. But as soon as I said “sí”, she called out another name, and then another. Turns out she was telling us our place in the order of things. I was after the person she named after me, who was after the person she named after them.

This roll call, along with all that eye contact, made me realise that the etiquette of the doctor’s surgery in Spain (or at least Cataluña) is pretty much the same as that of the market, which I wrote about some time back: it’s all about everyone being secure that everyone else knows their place in the queue!

After a while, my first and second queue-mates came and went. I stopped reading the newspaper (on my phone) and anxiously waited for the doctor to emerge once again and call my name. But she didn’t. I was confused. What do I do? Do I get up and walk into the consulting room or do I wait?

As I contemplated this dilemma, my name boomed out of the consulting room, in a tone that could only be described as slightly annoyed. Obviously, it was the former.

This was the first taste of what was to be my last lesson in visiting a Spanish GP: “bedside manner”- it’s all very much straight-down-to-business. I don’t remember a smile or even a “what seems to be the problem?”.  I was just shot a look that seemed to say, “start talking”.  

What followed was lot of banging on the computer keyboard as I rattled off my reason for the visit and, without the raising of even one eye from the computer screen, the barking of questions back at me.  I was a little taken aback.

It was all strikingly akin to scenes depicting visits to the doctor I’d seen in Spanish films, which I never quite believed.  I remember asking a Spanish friend about those depictions once and he told me “it’s always been like that here”. I didn’t quite believe him either. I owe him an apology.

Don’t get me wrong, she was very thorough and she gave me quite a lot of time and barked lots of questions about lots of things at me. I certainly felt that I was getting good care.  

It’s just I couldn’t shake the feeling that I was in the principal's office back at school!