Friday, August 14, 2009

A kilo of cure

I start out of a weary sleep to see an indistinct white form standing next to my bed. My mind races: who is this person and why is she in my house?

”Good morning, sir. I will just take your vitals.”

It’s my second night at the hospital in Iloilo City. The nurse takes my blood pressure and temperature and leaves. I roll over, careful not to dislodge the IV sticking out of the back of my left hand, and check the time on my phone. Two-thirty in the morning. It’s my second vitals-check since midnight, and I’ll have another one before the sun comes up.

I started having pains on the right side of my chest on Tuesday, but for an hour or so they were only minor. I went ahead to work, but the pain got worse, dull and throbbing and spreading to my head, and breathing became increasingly difficult. Lying down didn’t help; sitting made me feel faint.

My center rushed me to the hospital, no doubt terrified by the thought of an American dying on their watch. Straightaway I was put in a bed in the ER, where my temperature and blood pressure were taken every few minutes by a different nurse, who always asked for the same information: name, age and symptoms. Coordination is not a strong point here. Nor is keeping the patient informed – I didn’t find out until the second day that I’d also had a fever when I first arrived. Sometimes as many as five or six nurses would crowd around my bed at once, pinching my toes and asking if I was Canadian.

Over the course of three days I met with at least four doctors, two of whom I never saw again, and none of whom gave me any solid information. They were at least polite and reassuring, with the exception of the first, who imitated a brick wall quite ably. Part of our conversation, after I mentioned my headache, went thusly:

DOC: Have you had a headache before in the same place?

ME: Yes.

DOC: So you have a chronic frontal headache.

ME: No, I mean I’ve had headaches there before. I have headaches sometimes in different places. It’s not chronic.

DOC: When was the last time you had a headache?

ME: Uh, maybe three weeks ago.

DOC: So you’ve had a chronic headache for three months.

ME: No, three weeks. And it was just one headache.

Straightaway she signed me up for sinus x-rays to discern the cause of my chronic headache.

The ER was quietly strange. My mind exaggerates the scenes of emergency rooms of true third-world countries: full of dim bare lightbulbs and the moans of the suffering, doctors running up and down the corridors without enough time to change their blood-splattered scrubs, small children whimpering in dirty corners, forgotten, as their parents or siblings are thrown onto operating tables.

My experience was nothing like this, of course; the most exciting thing that happened in my twenty-plus hours in the ER was someone smoking a cigarette in what was clearly a no-smoking area. Yet the ER had an odd kind of calm chaos about it, an institutional disorganization that left me totally clueless as to what was going on and why things were happening the way they did. My superfluous IV was stabbed in double-quick – well, after a short episode involving the not-so-reassuring phrase “Sir, I’m just going to insert it again” – yet I didn’t get any medication for the pain (which to be honest was the only thing I really wanted at that point) until I had been lying there for at least five hours. There were a thousand nurses in the place and every single one came by my curtain-lined cubicle to introduce themselves and get my vitals. I had numerous tests, all administered at apparently random times and without regard to previous tests – my blood was taken three times – and didn’t find out about the results until much later, if at all.

At one point a nurse loaded me into a wheelchair and started rolling me out of the ER for chest x-rays. He stopped, left me in the wheelchair in the middle of the ER corridor, and started pawing through a bag of snacks somebody had left at the nurses’ station. After several minutes of checking out the snacks and chatting with other nurses he finally got back to wheeling me to the x-ray room.

No rooms were available that night, so I stayed in the ER. I actually got more sleep on that night than the second because – oddly, I thought – the night nurses didn’t bother checking up on me until I was sequestered away in a private room.

It’s standard practice in the Philippines to have another person, a friend or family member, watch over you at the hospital. This person is called a kasama (companion) or bantay (watcher). The kasama picks up medication, arranges for billing and does other jobs a bedridden invalid can’t be expected to handle personally. A kasama is absolutely necessary because very little is explained to the patient, and it’s difficult to seek out answers when you’re restrained by an IV. Everything is done in such a strangely unfocused, inconsistent, seemingly thoughtless manner: nurses replaced my IV bag several times, but one time – only one time – my kasama had to go buy a new bag and bring it back. Because of prearrangements made by Peace Corps, I never received a bill for my tests – except for one blood test. Why only one? Why not none or all? My food was brought to me in plastic trays marked “Merfe” and often consisted of foods engineered specifically to be impossible to eat with only one hand. A group of nursing students – the hospital is attached to a college – came by my ER bed and requested an interview with me because “Your case is so very interesting, sir.” “And you’re the only foreigner in the joint” was unspoken but understood.

I escaped on Thursday, having recovered sufficiently for them to discharge me. No diagnosis, of course, just vague references to “some kind of viral infection.” “You just need rest,” my final doctor assured me. Hence those frequent early-morning vitals-checks, I guess.

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