Hello, Doctor

My father used to be strong and healthy. Used to be. I only remember him sick once in my childhood, when I was already a teenager. He also once had a broken foot, but that was it. But the work he did when he was a child, teenager, and young adult finally caught up with him; stonemason, breaking up stones and carving them. But without any protection, so all the stone dust finally settled in his lungs. What also caught up with him was a smoking habit of over three hundred cigarettes a week. I remember sitting on the floor in the darkened living room with only the bluish light from the black and white television making the smoke cloud glow. I would end up lying on the floor on my stomach to avoid the cloud which would hang lower as the evening progressed. I tried to escape from that cloud as a teenager by spending the evenings in my room with the door closed. The mother of a friend thought I was a smoker, and never quite believed me when I said it was my father. My clothes reeked like an old-fashioned political convention of many moons ago, where delegates would blow smoke in each other’s faces.

Since his retirement to Spain, he has visited the hospital quite a few times. Mostly for pneumonias, though sometimes for mechanical problems. Usually the illness announces its arrival a few days before, with a cold, runny nose, and cough. This time there was no warning. So here we are, in a hospital room, feeling better, but now having to counteract the infection and get it out of his lungs. The system here, though, is not quite smooth. The ambulance first took him to the local clinic, where the doctor stabilized him and gave the order to send him to the Emergency Room of the hospital that serves our area. That one is in Santiago. After arriving here, and passing through triage, we joined the growing line of the sicker patients waiting to be put in a cubicle. That line forms in the center hallway leading to the cubicles. That line is against the law. The law says that hallway must not be obstructed in any way. Also, that patients have the right to prompt attention. We were in the hallway for almost three quarters of an hour. As patients were slowly assigned a cubicle up ahead, more patients on stretchers and in wheelchairs, joined behind us. Eventually we were assigned a cubicle, a hospital pajama, and a stretcher. Blood was taken, plenty of blood. Questions about why we were there were answered, and that was about all. Until well into the evening, the only medication my father got was a drip bag and two inhalations of a bronchial medication. The major sin of the Emergency Room is massification. The design of the area is too small. The architects simply envisaged the area as a small hospital department, and not the most used area. The area of specialist doctors is fine, because people only go with an appointment. More than anything there the problem is lack of doctors and not space. But the Emergency Room will always be the one place people with health problems will go to get answers, even if they only have a hangnail.

You can find almost anything in an E.R. We’ve seen a few things the times we’ve been in there. A patient who had been brought to the common hospital and was awaiting a bed over at the psychiatric hospital. He had to be fastened to the gurney and had to have three security guards hold him down while he shouted “Cuanto es dos más dos? X!” Of the three security guards, one was worthy of the title, one had a beautiful paunch, and the other was rail thin with no muscle that could be intuited. We’ve also seen the Guardia Civiles guarding a doorway. And also intervene in a fight between rival Gypsy clans after a car accident. There’s been an entire Gypsy family being dissuaded from remaining all together at someone’s side. (Only one family member or friend can accompany a patient.) On the darker side, we’ve also seen sobbing family members. We’ve also heard screams, probably from a disoriented elderly person who was being treated for something serious. And the constant complaint, mostly during the dead hours of the night, “Ay, miña naisiña. Ay, mamá.” Not that there are dead hours in the Emergency Room. Even at three in the morning you can hear the nurses’ carts and complaints from a patient who’s being poked awake for treatment.

The good part about being admitted to the floor is that, while each room has three patients, it’s quieter, and treatment is prompt. Most of the nurses are comprehensive and caring. (There are a few thorns scattered about, though.) The only problem is that life remains upset while you have to come and go. My father has no mobility problems and has full use of his intellect and senses. I only remain with him at night while in the E.R., where the attention is more medical than personal. Because the custom in Spain is for a family member to sometimes be all day and night with a patient. In the United States there are visiting hours and then family members have to leave. Here, family members are encouraged to remain. It’s a habit that comes from years of poor hospitalization, when family even had to bring patients food from home. Now, the habit is still encouraged because it keeps personnel spending down. That way two or three nurses per shift can attend maybe fifty patients. Nursing auxiliaries come in during the morning and early afternoon when patients are washed and rooms are cleaned. But at night there’s a minimum of people at the control desk.

So here we are, waiting for health to come back, trapped in this web of a health system. The good thing is we pay for it with our taxes and whatever we need we don’t have to pay for up front, or very little. But the quality is sometimes less than par. I suppose it’s normal with all the cutbacks ordered by the European Union that only made the recession worse for the regular people. And for whomever needs to visit a public health doctor.