DJ Strouse

November 2008, Los Angeles, California
A wine glass shatters and a friend jumps back in fright, pinning a large piece of glass between the arm and her chair, slicing a deep wound in her forearm. The exact circumstances are unimportant, but the result is that we are on the curb awaiting an ambulance. She is bleeding profusely and were we not in an urban location with such easy access to a hospital, I would have been very worried (hindsight would indicate that I was unduly optimistic).

The medics show up soon. My friend is clearly terrified. She has had little experience with medical emergencies and is genuinely fearful for her life. She is pale and in tears and her state of mind is clearly visible to anyone who bothers looking at her. As the medic saunters up, he asks to see her arm. She pulls away the towel covering her wound and he leaps back, whistles, and says, “Oh yeah, it’s bad.” My friend howls in further terror.

We hop in the ambulance and are soon being led into the emergency care division. I glance back to my left and notice a large waiting room full of sad-looking locals. They are complaining of headaches, stomachaches, and lack of care. I’m grateful than we won’t have to wait behind all those people for care (again, my optimism was unfounded).

I anticipate admittance into an emergency room within minutes; obviously, my friend is losing blood fast. We’re assured that a doctor will see us soon. We had entered the hospital at roughly 9pm.

At 4:30am, seven and a half hours later, my friend was admitted to see a doctor.

July 2009, Torino, Italy
The jagged edge of the can lid slices effortlessly through my palm. Despite weeks of practice opening cans of beans (the cheap staple in my Italian diet), I still don’t have the hang of it. I curse my carelessness and vow to not pay more attention when handling sharp objects. My hand is bleeding surprising fast for such a small wound. I examine it and realize that while small in length, its a fairly deep cut. It doesn’t hurt much so I wrap my hand in toilet paper and descend to the breakfast room where I will pop my beans in the microwave and sprinkle them with curry goodness. My hand quickly bleeds through my ad-hoc toilet paper bandage. I apply another. I go through the majority of a small room of toilet paper throughout breakfast but the bleeding seems eventually to have stopped. I grab my backpack and head into the city for a stroll in the park and a visit to one of my favorite restaurants.

After a great walk and incredible lunch, I’m browsing a market just outside the restaurant. The restaurant is actually a giant “mall for foodies” that not only uses fresh produce from all over Italy in their dishes but offers these products and more for the interested diner (more about this place in another blog post). I discover an incredible table of strange cheeses resembling organs and take out my camera to snap a picture. As I pull my camera down, I realize my wound has reopened – and it’s bleeding fast. Luckily, I packed another roll of toilet paper, anticipating this possibility. I wrap my hand and continue through the market and back towards the park.

After another hour or so, my hand is still bleeding. By now, my toilet paper supply is dwindling and I wander into the Borgo Medievale (a mock medieval village for tourists) to ask if I can borrow some bandages. The woman at the desk suggests I go to the hospital.

The hospital?? Is she nuts? It stopped bleeding once; it’ll stop again! Besides, I’m in a foreign country and I have no idea whether my insurance will cover the steep medical charges I’m bound to encounter at the hospital. Furthermore, I’d rather not spend my entire Sunday in a waiting room.

But emergency medical care is free in Italy, she tells me. I’m surprised but still reluctant. I agree to sit in the lobby of the Borgo Medievale for a bit to see whether the bleeding slows when I’m not walking around. After 20 minutes, it does not. I agree to let her call a taxi to take me to the hospital. Twenty minutes later, I’m walking through the entrance.

The registration area is vaguely reminiscent of that from the hospital back in Los Angeles and I’m immediately regretting coming to the hospital. On a positive note, there don’t seem to be that many people waiting, and most of those that are waiting seem to be family members of people receiving care.

Within moments, I’m called into the initial triage room where my hand is disinfected and bandaged. After considerable gesturing and miming, I have conveyed what happened and they lead me to a second waiting room just next to the surgical facility. After about twenty minutes, I’ve bled through my bandages and dripping on the floor seems imminent. Another waiting patient encourages me to notify a nurse. I can’t imagine they’ll be sympathetic after my previous experiences in Los Angeles but I give it a shot.

I’m immediately led into the surgical room. No one speaks perfect English but through the combined English/Italian language overlap of a Russian nurse, a South American doctor, and me, we’re able to communicate. Within fifteen minutes, the smiling doctor has sewn two stitches into my right palm.

Still not convinced as I get up to leave, I ask the surgeon what the cost is to me. He laughs. “This is Italy; you don’t pay anything.” When I gawk and tell him that is unheard of in the United States, he asks how much such service would cost in the US. I’m not sure but vaguely recall paying $60 or $70 for stitches when I was in 2nd grade. At the very least, I remember being charged for every single piece of medical paraphernalia used on or distributed to me. He tells me that this is not the way his country works and hands me a veritable first aid kit of supplies to change my bandages over the next week. He then asks that I return the following Sunday to have the stitches removed. I tell him I can’t because I’ll be climbing a mountain and he pushes the return day back to Tuesday. I leave the hospital astonished. The check-in time on my record is 5:07pm. The check-out reads 5:57pm, just 50 minutes later.

When I return the following Tuesday to triage (the only location I know how to get to), it’s clear that I should go somewhere else to have the stitches removed. I don’t speak enough Italian to figure out where. The only English-speaking nurse in triage walks me around the hospital and stays with me as translator until I’m seated in a room with another surgeon ready to remove the stitches. She could have treated me like a number, as a case to process as quickly as possible or pass along to someone else. Instead, she treated me like a human being that she could assist.

Lessons from Abroad
I do not know what is wrong with the American healthcare system or how to improve it. It is much a too complicated problem for me to profess to have solved on limited anecdotal experience. But I do believe two things:

(1) If there is anything that a government should be responsible for providing its citizens, it is free, prompt, and professional emergency medical care. One of the most basic reasons societies emerged is to assist one another in times of medical emergency. When this need is not met, a government has failed in one of its most fundamental roles.

(2) If there is one place where people need to be treated as human beings, and not numbers, it is the hospital. In times of medical need, humans are in their most vulnerable and confused state. They know not how to help themselves and are entirely reliant upon others. When they are treated like numbers, abandoned for long periods of time under the veil of uncertainty, every moment is spent in terror and anguish. But when they are treated as human beings and made to know exactly why they are waiting or what the doctor is going to do next and why, it can fill them with an unbounded sense of pride in humanity (something I personally had not felt in a long time).

Italy may have its inefficiencies, but I know where I’d rather be the next time I’m in an accident.

Tags:   medical system · philosophy6 Comments