If not now, when?

One American woman. Twenty acres and a 1650 farmhouse in Tuscany. Random introspection and hilarity, depending on the day.

07 January 2007

So many stories

I know, I know. It's been a few days. I'm sorry. Trust me that even in the hustle of the first week of the year, there are stories backed up against stories in my brain, all clamoring to be told to you: Christmas day lunch at Il Cavalieres! Wine Tasting with the Cutest Farmboy In all of Tuscany! The Befana - the 'witch of the epiphany' who brings stockings for all the boys and girls on 6 January, officially ending the holiday season ....

but, alas, they are all photo-stories. And for reasons totally bewildering to my technological peabrain, for DAYS now, cranky Blogger website does not want to accept my photos. So, for now, I must regale you with the only non-illustrated story I have:

The Efficiency of the Italian Medical System.

(I don't blame you if you've just clicked over to someone more interesting, really.)

Actually, though - last week was a FASCINATING experience. Without making this into the 'blog sharing too much information about my medical woes,' let it suffice to say that I had no other choice than to go to the Siena hospital last week.

I had called the doctors office and explained - in awkward Italian - my issue. The secretary said, "oh, no. For that, you need to go to the hospital. Let me transfer you." A woman at the hospital answered the phone and made an appointment for Friday at 930 am. I asked her where I should go. To the best of my understanding, she said, "Building Eight-Four? Floor Minus Five. Room Number 7."

Which I'm sure, to anyone who had BEEN to the hospital and spoke Italian, would have been crystal clear. I was in a fog. But I vowed to just set off early and get it figured out.

The Siena Hospital is HUGE. And you can't park anywhere remotely close to it, even if I knew where it was that I needed to be. (A small prayer of thanks sent up to the heavens that it was a sunny clear day.)

After wandering vaguely, quite of my own accord (nod to A.A.Milne!), I realized my error... It turns out that it's "LOTTO four" - which I guess means, Lot 4, which I had interpreted as L'otto four -- meaning The Eight Four. And LOT four means, apparently, building four. So, okay. Building four. I'm in. Elevator, Floor Minus Five. And I see a sign marked 'secretary' for the department - so I go in, to make sure I'm somehow in the right place. Indeed! All I have to do is sit outside door number seven, and at my appointed hour, magically, they will call my name.

And they Do! And I enter! And it's a closet-sized room (think, dental exam room). With three people - a Dr. and two nurses - already inside, the Doctor sitting at the computer.

"Where is your request?" (they ask).
"Pardon? My what?"
"Your request" (waving a red form at me.)
"Oh, I'm sorry - I don't have one. I'm a foreigner with private health insurance, not the state system." (hoping that makes it all better.)
"But how did you make your appointment?"
"I called???"
"Well, we'll do the exam the same, either way. Take off your clothes."

(no pleasantries, no inquiry about what SPECIFICALLY I was there for, no polite - "go ahead and get undressed and I'll discreetly leave the room, the dr. will be with you shortly". Just - "take off your clothes, now, and make it quick, this system runs on time...")

And so, I disrobe in front of them quickly. And while I'm laying on the exam table, the Dr. begins the exam, and the nurses are barking questions at me: "Birthdate? City? Local address here? Family history of problems? Any medications? Last menstrual period?"

(THAT one threw me for a loop and sent me into a giggle fit. I didn't know the word for 'menstruate' in Italian. So the nurses asked the Dr. to translate into English. He didn't know the word in English, so he started to explain it to me, and then ... PANTOMIMED to be certain I understood. Oh, the hysteria of it ...!!!) Then he made idle chatter about how he had family in San Diego, he had been there once for a month.

Exam over, not 10 minutes. Despite the speed, the doctor was kind, spoke slowly, patient, reassuring, explanatory. Everything I've ever wanted in a doctor. I got dressed as he returned to the tiny desk with his computer and printer. He printed a copy of my ultrasound photo, printed a page with a descriptive diagnosis, signed it all with a flourish, and it was packaged into an envelope for me. And he handed me a red form and a 'questionnaire for foreigners'.

"Go with her to the payment booth, to make sure it's okay" he instructs the nurse.

At the payment booth in the hallway (something like a tollbooth, with the teller behind bulletproof glass), after waiting in line behind three people, I am told I need to go to the office of foreigners, floor minus one.

But when I get to floor minus one, there is nothing. I ask a secretary there. She has no idea. I retrace my steps to the tollbooth and say I must not have understood. She says, as if I am mentally retarded: 'It's the big ticket payment place! At the entrance! Near there! Go to floor Zero, Follow the orange line."

(I would like it noted for clarity that the previous directions I got were 'floor minus one' and said nothing about ORANGE LINE)

Elevator: Floor Zero. Sure enough, there's an orange line painted on the floor. Following it leads me through a rabbit warren of TWO AND A HALF BUILDINGS, down hallways, across suspended walkways. It ends at a door. I go through the door, and ask the first kind-looking woman I come across, "Foreigners' Office? A woman named Sabrina? Can you help me?"

Oh, yes. (bless her!) She takes me down a set of dark stairs. Past a bank of 10 bank-teller windows with digitized numbers flashing above them and a crowd of people clamoring waiting to win their turn at the bulletproof glass. We go out the door, into an underground tunnel/parking lot, and around the corner where there is a glass doorway with closed blinds and a tiny buzzer marked 'Ufficio Stranieri'.

She pushes the buzzer, and we're in. Down another 2 hallways, where the fabled Sabrina sits in a four-desk shared office the size of my tiny kitchen.

I wait 5 minutes for Sabrina to get off the phone. She looks at my papers, and says, "I don't know why they sent you here, you just need to pay."

"Okay, where do I pay?"

"Just outside the door, the ticket windows".

Aaah, YES. The DMV-come-inefficient bakery system. With easily 70 people crammed into a glorified hallway waiting for their Keno-esque numbers to be called, for the privilege of paying their medical bills.

I sigh deeply, and push the button to generate my automated number. A laser-printed ticket tells me I am 589.

I look up at the call board: We are on 542.

oh, nooooooooooooooooooooooooooooooo.

My crowd-hating self in enclosed spaces is already starting to itch. I have my diagnosis, my reassurance, in my hand. (YES, this is the third time I've debated just walking away - what would they do to me?!?!?! How would they find me??)

I cannot stand here for an hour waiting to pay my bill.

So I take a deep breath. Retrace, as if by feel, my steps two-and-a-half-buildings away, back to the original tollbooth, where I had seen her collecting red forms and money.

I wait in line, still three people long, but better than 40! There is a prominent sign on the tollbooth - "THE OPERATOR WILL TAKE A MANDATORY 15 MINUTE BREAK DURING OPENING HOURS". (and I'm *sure* that it will come to pass, just as I step up to the window, she will close for break, perhaps out of spite.)

Which would have made the story funnier - but, no coffee break. I tell her that I hadn't actually *needed* to go to Sabrina in the Ufficio Stranieri, and she had sent me back to pay. She is nonplussed. She punches my red form magically into the system, and ... voila ... a bill for 54.75 Euros. I pay in cash. She prints and signs the receipt with a stamp and a flourish (flourish abounds here.)

Exam time: 10 minutes.
Miles walked: easily 2.
Number of times I was going to just bail out and leave: 4
Number of times I wondered why I'm so compliant: 3
Time spent waiting in payment or question lines: easily 45 minutes. Could have been doubled if I had actually stayed in the "ticket window" system like a good sheep. I've decided that Italians aren't lazy or patient - they're just -- resigned that 'this is how it is'. At the end, I fought the urge to follow the orange line back over to the mystery ticket windows and tell them all that the tollbooth in Building Four, Floor Minus Five, had no wait - like Elliot in the movie E.T. with the frogs he released --- "ESCAPE! Go Now!!"
Clean bills of health: 1: Reassuring. Priceless.


Blogger serrin said...

I hope that by reading enough stories of Italian "beaurocrazy" I will be prepared to face it with good humour when the time comes.

But, dear, I do hope I don't get ill over there. If I do, I think I will take the plane to London instead!

Looking forward to the photo stories - I didn't know about the Befana, she sounds interesting!

2:09 AM  
Blogger Gil said...

Makes you wonder how many people just leave. You are to be commended on your patience!

9:14 AM  
Anonymous Judith in Umbria said...

Why do we do it? Because that's what keeps it cheap. You KNOW that it would have been a lot more in the USA, although there would have been magazines to read!

10:58 AM  
Blogger I'm Just a Girl said...

And I thought our health care system was confusing and maddening. It did sound rather DMV-esque...I'm glad you got through it okay and are healthy (and didn't accidentally shoot anyone along the way. You are more patient than I).

5:29 PM  
Blogger Viaggiatore said...

Believe me, I DID look at that paper in my hand a number of times, and ... never having been asked for a lick of identification ... said to myself, "why would I put myself through this hour of struggle?!?" But, I have to say, I'm one of those immigrants, damnit, who is determined NOT TO BE A DRAIN ON THE SYSTEM. Not to mention I'm generally a good cookie, who plays by the rules. But it does seem like a system ripe for exploitation, which probably means it is being exploited. Which is bad news all around - for those Italians who live here, for foreigners who play by the rules. I suspect it's somewhat like the failures of the US system on that front. Clearly, neither is perfect.

6:24 PM  
Blogger tallulah said...

After seeing my friend WITHOUT insurance get cancer and having no way of receiving healthcare and relying on vitamins and herbs instead.....
After seeing my son suffer through terrible toothaches becauase he needs a root canal and has no insurance.....
I would wait in line 3 hours (feeling a little resigned of course)to see a Physician if I knew that it would ensure that everyone in the U.S. could have basic health care.
It's a small price to pay don't you think?
Glad everything is ok and you have a clean bill of health!
Pantomiming your period? That is hilarious!

4:50 PM  

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