Bloodletting: Room 12

First, and foremost, I would like to thank the people who have inquired about my health over the past few weeks. When people in town (and, lord knows it ain’t the people at work!) see me these days without my neck brace and ask how my neck is, I reply by telling them that I am 90% better. The reality is that all pain has gone and it is only a few specific actions that result in instantaneous numbness of my arm and thumb (which is no longer constantly numb enough for me to notice) that I may or may not be able to live with. For example, anything that requires me to lean my head forward, like tying my shoes, brushing my teeth, or taking a bucket bath, causes the neck muscles to flex and put pressure on the disk/nerve combination. Luckily, as soon as I stand up straight, all numbness subsides and I move on with my day. By this point any options of surgery have been all but ruled out - obviously good news. A couple of weeks ago my Peace Corps doctor wanted to speak with a local doctor to discuss what sort of physical therapy options the local hospital could offer. She told me that there was a hope that I could get some neck muscle strengthening routines that could be beneficial for the long-term recovery. She also mentioned something called “cervical traction”. That sounded a little scary, but appeared to be a collar you put on that can be inflated to gently stretch the muscles. The fact that after explaining the procedure to Lenara, she admitted she couldn’t translate close enough to discuss it with the doctor, it was a good thing my doctor was willing to make the call to this local traumatologist. The short of it is that my doctor did speak to the traumatologist who told her that this hospital has nothing remotely resembling cervical traction and she should look to hospitals in the 4-6 hour roundtrip range for me to get such a thing. Since the treatment gets done several times, but only for a few minutes at a time, this seemed like a colossal transportation nightmare (taking a 3 hour bus to Simferopol for a 7 minute procedure. Returning on another 3 hour bus and repeating multiple times a week). For obvious reasons, we are in a “wait and see and hope for full recovery on its own” pattern. Bottom line, thanks to everyone for the well wishes. Even to Lenara who sent me the following email with a photo of a top bunk on a train so I knew which method NOT to travel by. I literally laughed out loud.

"Сим, have a good trip !!! take care of yourself !!!!!, Ленара”

Now, to my newest medical saga, and reason I sat down to write this post in the first place. They say that a picture is worth a thousand words. Unfortunately, my latest medical escapade took place inside the above referenced hospital where me whipping out a camera to capture the scene would be inappropriate to say the least. I will now give my best attempt at “painting” a picture for you. Just know that as bad as your mental picture is…the reality is oh, so much worse.

This is our hospital. And the outside looks better than the inside! 

As happens from time to time, I recently had an earache. It only lasted for a day, but I could tell there was a problem with my ear. I have had ear infections in the past and my experience is pretty much the same every time. I get an earache. I hope it will go away in a few days. It doesn’t. I go to the doctor. They use one of those flashlights with the black plastic cone tip to look in my ear. They say, “yup, infection, take this script for 10 days.” Ten days later, I am right as rain. In fact that has pretty much been the routine for my annual or bi-annual ear infections for at least the past twenty years or so. Well, the first part went as always, where I had the earache and hoped it would go away. After a few days I called my doctor in Kiev to describe the problem, hoping she would just tell me to take my medical kit penicillin for ten days. Wrong. She tells me that this is something that I indeed need to consult a physician on. Ordinarily, volunteers just go to Kiev, get the check up and meds and move along. I on the other hand, live too far from Kiev for such a course of action and am told to find an ENT doctor in our hospital. OK, I think. It’s a hospital, there has to be an ENT on staff, right? Today is Tuesday. Lenara and I head over to the hospital (technically the polyclinic which is part of the hospital complex) and ask the receptionist which room the ENT is in. Upstairs, Room 8. We go up and see the door is closed. Do we knock? No, we do what everyone else who needs to see the people in Room 8 does, we just walk right in. This is not like a department where you go in to see a sub-receptionist to discuss seeing the doctor. No, you walk into a single room with 2 desks, 1 bench, and 3 individual chairs. The desks each have a nurse at them, there is a woman in obvious pain laying on the bench, and two of the chairs have additional patients getting god-knows-what done to them. Lenara speaks with the nurse behind the desk who reports that the doctor does not work until Thursday at 11:00am. The nurse looks at me and continues to speak with Lenara. As we leave, they both assure me there is no other person on the premises who can look at my ear (I hope the woman lying in pain didn’t have to wait until Thursday!). As we leave, Lenara asks me if I understood what the nurse said about me. I admitted I did not. “She said it was no wonder you have an ear problem, your wool hat does not fully cover you ears!” I explained it was probably best that I don’t understand things like that as they occur, lest I begin to question the mental capacity of the hospital staff. Lenara and I stop back at the main reception desk (which is way too kind of a description- think token booth in a subway station). She too confirms the 11am start time on Thursday, grabs a piece of notepad paper and writes my name, year of birth, and town I live in. Adding the date 15.11.2012 as the date of the “appointment”, in quotes because they do not give slots, anyone who needs the doctor is expected to just show up and wait their turn- post office style.

On Thursday morning Lenara suggests leaving a little early to go to the clinic. I couldn’t agree more and get ready at American early 10:30. She was thinking more like 10:55. That is Ukrainian early. We get to Room 8 at 10:58 and we are, in fact, the first people in line. Right in front of all of the “on time” Ukrainians. Remember that black, cone shaped, attachment to the flashlight I described before? Well, I see one on the table. Only it is neither black nor plastic nor an attachment for a flashlight. As I stared at it for a moment I decided it was either made of wood or metal with a strangely rusty patina. I chose to look elsewhere. Lenara explained my issue to the doctor who put on her headband with the giant metal reflecting disc. I swear I have never actually seen anyone use one of those before! She then switches on the desklamp sitting next to me. It has a loose connection and the light flickers on and off as the cord is jiggled. She finally gets it to stay on and shines it directly towards her face. She picks up the wood/metal cone that I don’t even want to think about the cleanliness of. I am going to assume that this establishment is more of a wipe-down-with-rubbing-alcohol kind of place. They can’t afford to keep the lights on in the hallway- I shudder to consider how they would afford an autoclave. Anyway, using the maybe yes/maybe not sterile cone and tilting her head to aim the reflection from her forehead into my ear, she peers in remarking to Lenara that it looks “wet”. (hmmm, I wonder what kind of description that is for an ear canal?) She then compares it to the unaffected ear. The doctor orders a swab to test for infection and writes a “prescription” on another piece of note paper. Not script paper, just note paper.

My prescription. It says the name of the medication. Take 2-3 drops, 3-4 times a day in right ear. And you thought reading a doctor's script is difficult in English?

We then have to go down to Room 4 to get an ear swab. After giving the nurse there our paperwork, we are instructed…and this is where it gets complicated…that we need to go to the laboratory located in another building in the hospital compound where we will get a bill for the services to be performed. Then, we need to take the bill and actually GO TO THE BANK to pay the bill! (the hospital has no cashier!) Then we will return to Room 4 with the proof of payment to collect the tools for the swab, then go back to Room 8 where the original doctor will actually took the swab. Today being Thursday, the test results will not be available for 3 days- or Monday in my case. Before we leave, I confirm I can buy my eardrops over-the-counter.
The bill for all services today ran me US$3 + $0.50 fee for the bank to accept my payment. And while I am all for cheaper medical care, there is something to be said for getting what you pay for and in this case $3.50 seems just about right. I weep for the future, should I ever require serious medical attention in this town. Thankfully, my appendix is already gone!!