On protecting my anonymity

I went to see the doctor this morning. Like all the doctors I've ever encountered, doctors in Spain make you wait. This is obviously because a doctor's time is much more valuable than mine or, indeed, yours. In truth, nowadays, nearly everyone's time is more valuable than mine in a financial sense but, as usual, I seem to be straying up a branch line.

I've been to the doctor a few times over the years in Pinoso but not to the point that it's second nature to me. I was quite decided to be decisive today. The last time I was there there was a little printed list stuck up with sellotape outside the doctors door. The appointments were arranged in 15 minute blocks. Inside the fifteen minute block there would be three names; three people had the same appointment time. I couldn't remember whether the system was first come first served or whether the list order gave the order. My decisiveness amounted to no more than asking rather than muddling through.

I was stymied on two counts. First of all there were three Britons, a couple and a single, outside my assigned door and they were people that I knew. Conversation was to be struck. The pair were in with "my" doctor before me so, until they moved, there was no hurry. They weren't sure where they were in the running order so I asked the people waiting on the plastic chairs. It was an easy conversation. I had the same time as a young woman but the system is first come first served. "It has to be that way now," said someone. "There used to be a list but the data protection act has stopped that". "Ah", said someone else. "That's why the nurse now calls people by numbers rather than names I suppose". "No matter", I said, "Spaniards like to talk". I was relieved that they sniggered rather than stringing me up by my thumbs.

I suppose that the data protection thing is to do with consent to use personal data now being clear and certain. Just because I want to see a doctor doesn't mean that I gave anyone permission to release the fact that I am there. Maybe I want to remain anonymous. Actually as I booked my appointment using an application on my phone I suppose that the list would have contravened that rule about data on a person not being used for another purpose. Maybe I should read the data protection stuff more carefully. When we visited Jumilla Castle a few weeks ago I was asked to send an email with certain details. Nothing too Edward Snowden but name, address, email and my ID number. The woman on the phone said it was for data protection. Odd though, now my data is protected they know all sorts about me whereas before they would just have known that Chris and Maggie were on their list for castle visiting.

Breathing Space

A pal had to go to accident and emergency yesterday. He was having trouble breathing and he suspected he had something lodged in his windpipe. He asked me to go as a translator. Perhaps his difficulty in breathing had clouded his judgement!

He was seen by a doctor inside about 15 minutes of arrival. He was taken to a cubicle with a bed after that first consultation. There were a couple of routine tests, blood samples, blood pressure, temperature and whatever it is they do when they put electrodes on your chest, hands and legs to get one of those wiggly line graphs. A few minutes later and he got a chest X-ray and then he was shifted onto an observation ward. Somebody came to do the blood pressure and temperature stuff again. This time they were a bit worried about the oxygen levels in his blood so they fastened him up to oxygen administered through one of those clip in the nostril jobs. Then it all slowed to a crawl.

The patient wasn't. He thought they were taking ages and not doing much. Impatient rather than patient. I thought it seemed pretty good. Presumably someone was looking at the various tests and deciding what to do. We'd been there about four hours, a bit less maybe, when I had to go to get to work. Before I went, they told me that my chum would be moved to a room and that they would have a look for the obstruction the next morning. I got a WhatsApp this morning from him to say that they'd taken some food out of his windpipe today.

The lunctime TV news reported that eight out of ten Spaniards are very happy with the service they get from the Spanish health system. Their main complaint is that the waiting times are too long between GP and specialist at around a month. I'd go along with the 80%.

It's my arm doctor

As I remember it the, "it's my arm doctor" quote was some sort of running joke. It had to be delivered with a broad Scots accent. Something to do do with the housekeeper, Janet, from Dr Finlay's Casebook.

If you have any idea what I'm talking about then you'll be old. In turn that probably means you see the doctor more frequently than you would like. Our Saturday morning coffee group is a right little hot bed of knee replacements, cataracts, stomach protectors, heart bypasses, pain relief and epileptic fits. Actually, until I fell over frothing at the mouth, having bitten off large chunks of my tongue, I felt a bit out of the conversation. Obviously I go to the doctor's from time to time but the visits have been thankfully few and far between.

Yesterday I helped a pal with his visit to the doctor. The idea was that, as I speak a few more words of Spanish than he does, I could act as a sort of translator. It wasn't that difficult. A couple of questions from the white coated doctor, a bit of tapping on the computer and out of the office in under three minutes with a prescription and an order for a blood test.

Today it was my turn. Three months since my "event" and I had a follow up visit with the neurology department at Elda Hospital. "Right oh", said the white coated doctor, (all doctors in Spain wear white coats as far as I can see. It's like British doctors have stethoscopes though one must be easier to wash and cheaper than the other.) "the electroencephalograph is clear, anything to tell us?" - I complained about a few aches and pains but said basically no. She was nice about my Spanish and she gave me the alta, the up, the opposite of the baja, the down, the equivalent of a sick note. No more treatment, no more check ups, free to drive. In the clear more or less, with certain provisos, given that collapsing in a supermarket is not a sign of robust good health.

Speaking to people about their experiences with the Spanish health system  brings a mixed bag of responses. The few times I've used them they seem to have been first rate but not everyone agrees. I'm a great believer in normal distributions, the idea that most systems are made up of the reasonably competent with far fewer poor or excellent performers. I have no complaints about the health care I've received at all. In fact I would rate it as cracking.

It was strange. Going to the local surgery yesterday I asked someone how the system worked. It was really simple but I didn't know until I asked. Today, at the hospital, I walked in to the outpatients area and there were hundreds of people sitting on hundreds of chairs. I hadn't the faintest idea where to go or what to do. The woman I asked on Patient Services was dead helpful. She rang to check I was booked in and then walked me to the chairs by the right department. Once I was settled in I realised that the people were clustered around various areas - gynaecology or cardiology or whatever. The system was crystal but to me it initially looked chaotic. As I waited I noticed that there were other people as lost as me, people asking others how the system worked, whilst others, who knew the routine, were like fish in water. I suppose we humans learn routines very quickly.

I had a similar sort of thought as I was leaving. In the entrance area there were all sorts of people from lottery ticket sellers and the people who run the various stalls and stands to the hospital staff and habitual attendees - the  accustomed regulars and the lost novices. It was gratifying to think that, at least for the while, I can number myself amongst the bewildered and lost.

Pooh!

The health people send you a little packet through the post. Inside there's a sort of flat tube with some liquid in it with a cap that incorporates a stick. You collect a sample of your own faeces (I decided not to use the simpler, better word). You open the tube to reveal the stick and then you stick the stick into the faeces sample a few times before sticking the stick back into the tube and sealing it all up. That provides whoever it is who deals with these things a sample to check to see if you possibly have gut cancer.

Once you have your sample you take it to the collection point, in my case the local health centre, and leave it in the "assigned urn" between designated hours. The sample gets analysed and they send you a letter if it's an all clear or make an appointment to see you if it's not.

Now there are certain Spanish words or phrases that just won't stick (sic). For instance there's a phrase that is to do with changing the subject that uses the name of the river that flows through Valladolid, the Pisuerga. Try as I might I can never remember the name of that damned river. Certain words become fashionable for a while - I still remember farrago of lies being used over and over again in a story about Harold Wilson and Marcia Falkender. I'd never heard the word before and I haven't heard it since but, at the time, it was everywhere. At the moment a verb that is being used regularly to do with the Catalan politicians in prison is acatar which means to respect, observe, comply with or defer to. I must have looked acatar up at least ten times and so far I still haven't internalised the meaning. On a much simpler scale the word for a notice or a sign - the written or printed announcement sort of notice/sign - is not a simple translation in Spanish - there are three or four words that are used to describe specific sorts of signs and there is a similar sort of sounding Spanish word - noticia - which has nothing at all to do with notices which is dead easy to trot out mistakenly.

So I go to the health centre with my pooh stick and I see no designated urn. I wander around a while sort of waving the green tube thing in the hope that someone will point me in the right direction. Nobody does so I queue at the reception desk. There are only a couple of people in front of me but the bloke on the computer takes an age to process anything - he must have trained in a Spanish bank. I stand and wait. It's frustrating because the answer will take two to three seconds. I see two other people, Spaniards, with their green tubes and I tell them I'm waiting to ask where the urn is. Eventually it's my turn, I ask and the receptionist nods his head at a yellow plastic container that's tucked behind the reception desk. It has no notice/sign on it. The receptionist is brusque in the extreme with his nodding and I'm not happy. I can't remember exactly what I said but the gist of it was that if somebody had the gumption to put a notice on the stupid yellow box then three people would not be standing around wasting their and his time. Except of course that I couldn't remember the right word for a notice and the whole righteous indignation thing fell apart.

A weekend in Elda Hospital

It must have been the price of the cat food in the Día supermarket that triggered it. I was there picking up a few essentials before going out for lunch. My eyes went funny, as though each one was switching on and off at random, and the next thing I know is that I didn't know much.  I didn't know where I was. I was confused. It took the ambulanceman to explain that I had passed out and they were about to take me to Elda hospital and only later did I remember the detail of the strange visual effects. I wonder how much disruption I caused in Día and whether I'll ever be able to shop there again?

Maggie turned up at the ambulance not long after. She wasn't with me in the supermarket so my guess is that the emergency number strip on the lock screen of my mobile phone did its job. The police found it and were able to contact her. My second guess is that the description given of my sack of potatoes impersonation in the supermarket to the 112 emergency dispatcher meant that he or she sent a specialist ambulance with a doctor on board but, when the crew found me basically recovered, they transferred me to a less specialist ambulance for transfer to hospital. Apart from thinking on my own mortality on the journey to the hospital, I've often suspected that I will not reach a ripe old age, the journey was uneventful.

It was pretty routine in the hospital too. They dressed me in one of those funny back opening gowns, checked my heart, did a CT scan and a couple of x-rays as well as taking blood samples and then wheeled me off to an observation ward with lots of beds where they hooked me up to a drip. Maggie sat with me. Her poor friends, denied their promised posh meal, camped out in the waiting area of the hospital. Not long after they moved me to the Neurology ward to a room I was to share with Pepé. He was having a lot of trouble breathing and they had some machine pumping oxygen to his lungs. I would have found out more but my Spanish collapsed completely. I could not utter a single coherent sound and I was soon much more concerned about my Spanish than I was about whatever was supposed to be wrong with me.

I lay in my bed and every now and then someone would come and take my temperature, my blood pressure and check my blood sugar levels - there was even a 6am raid for some serious blood samples. The results and readings were always normal and, apart from a quite nasty headache, which still hasn't completely gone, and a general weakness when I started to try to move around I felt absolutely fine. In fact I began to feel a bit of a fraud. As I settled in, and as they let me exchange the gown for pyjamas, the food started to arrive - dinner, breakfast, no elevenses though, lunch, afternoon snack and back to dinner. The food wasn't great and they had a particularly tasteless line in soups cum gruels but I thought it was good that they fed me at all. The food and the constant stream of nurses, cleaners and auxiliaries were a break in the routine of lying there, trying to listen to a podcast that I found much, much harder than usual to understand. I finished my book, La uruguaya by Pedro Mairal but I was hard pressed to follow even the gist of the last few pages and as to understanding what the string of visitors were saying to Pepé's wife I had absolutely no idea. When I did utter a few words to try to be pleasant people would just stare at me blankly and uncomprehendingly. I soon limited myself to weak smiles and multilingual grunting.

Visitors can stay with people in Spanish hospitals all the time and there is probably an expectation that someone will be there to do a bit of the caring for a patient. Pepé's wife, Ana, stayed with him overnight and through the morning though someone, usually a daughter, came and took the midday shift so that Ana could go home and get changed and get something to eat. She was back by the early evening to take over again. Maggie came to see me and she would have stayed too but I shooed her away. I was able to feed myself, straighten the bed etc. and, when I was given the say so, go and get a shower. I saw absolutely no point in both of us being confined to barracks. The permission to get a shower came from a doctor who came to see me on Monday morning. You don't have a tumour, you didn't have a stroke, you don't have diabetes and it wasn't a heart attack so now we're going to do a resonancia. I supposed, though I never asked, that they were looking for signs of a fit or epilepsy. In the meantime, said the doctor, feel free to get out of bed, sit in the armchair and have a shower.

And that's what happened. No breakfast for me on Tuesday, en ayunas, fasting, and then off for an MRI scan. Into one of those tunnel things with quite a loud noise. I thought it would be horrid but, in the end, it was just boring. I asked how long it had taken when I came out and the answer was 25 minutes. About an hour later the doctor came to see me again. The resonancia found nothing, we can't find anything, all we can think is that it's your lifestyle - too much alcohol, to much smoking - so cut it out and be good. Now you can go home. I did flick to the last page of the medical report they gave me and it said not to drive for six months. I asked someone on the desk what this meant. It's all a recommendation she said and that's where we left it. Not being able to drive would be a serious blow for someone living in Culebrón.

They looked after me well. They came and got me in the first place. They treated me quickly. They found me a bed. They spent presumably large amounts of money on trying to find out what was wrong with me and they gave me food to eat, clean sheets and pyjamas to wear. I am so glad that I demanded legal contracts so many times from so many employers so I had a right to that healthcare.

Just as I was writing this I've been trying to decipher the medical report. Even if my Spanish were brilliant I don't think that I could understand it but it seems to cover all the things they said I didn't have. The big thing is that I had convulsions - Wikipedia equates those with epilepsy. Alcohol and tobacco use are also highlighted and the last line says chronic small vessel ischaemia (in Spanish) which Wikipedia tells me is basically a mini stroke. Maybe it's a bit belt and braces - we didn't find anything but it could have been any of these.

Well, at least this time. I got to blog about it.

Doctor, doctor

I know that the NHS, the British healthcare system, is a politically hot topic nowadays and I suspect there have been several changes to it since I left but, for someone who lived in the UK till 2004, the Spanish healthcare system and the British ones are basically similar.

The main difference is that you have to have paid into the Social Security system, or be the dependant of someone who has, if you are to get anything out of the Spanish system. Emergencies are always treated - though I'm not sure whether there might be a corresponding bill afterwards if you haven't contributed. Pensioners from any EU country are covered by the system here but the payment actually comes from the home country.

Dentistry is not included in the Social Security cover and there is a system of charging for prescriptions with various discounts which take account of your age, any disabilities and income but, in general, get sick and paramedics, nurses, doctors and an impressive array of medical hardware will come to your aid.

I've not been a big user of the system. An infection here and an injury there but the last time I spent any time at a doctor was in Cartagena four or five years ago. I have this idea that I can tell when it's something serious and when it isn't so, most times, I just wait for the malady to disappear and, touch wood, up to now there has been nothing serious.

Pinoso, as you know, is a really a village, rather than a town. A few souls short of 8,000. Nonetheless, it has 24 hour emergency medical cover. Our health centre is modern and operates at full swing on weekday mornings and early afternoons and then has a quieter afternoon/evening session. I don't actually know the opening hours but I know the principle well enough.

The last time I went to the doctor was on a Saturday afternoon when there is a just a skeleton, out of hours, staff on call. My stomach had been painful for a long time and the pain didn't seem to be going away and I didn't like it. Finally I was persuaded to go to the doctor in "emergency" hours. The doctor laughed, gave me something akin to imodium and sent me on my way. I felt suitably foolish.

Regular readers will know we have a couple of newish house cats and a visiting street cat  - a big white job. Having tried to scare him away we have now taken to trying to feed him so much that he leaves our two alone. A risky strategy I know. He is grateful for the food though. He goes into a frenzy as the food approaches and chows down in a noisy and very animated way. Tonight as I gave him a handful of the dried food he bit me. Nothing serious, he just mistook me for chicken flavoured biscuits, but he got a clout on his backside in retaliation.

An hour later and my hand was feeling very strange, A sort of pins and needles. I've heard about cat bites. A friend was very close to losing his finger after a bite from the family pet. Once again I rang on the out of hours bell at the health centre. Once again I was treated as a sort of idiotic time waster. They gave me a tetanus jab and told me to go back tomorrow if my hand swells up but basically they were miffed that I'd interrupted whatever it was that they were watching on the telly.

It's excellent that we have the emergency service though. Even if they do laugh at me.

Vile bodies

People tell me they are never swayed by advertising. Not me; I see an ad for something that looks useful and I'm there. That spray to stop the water stains on the glass shower screen, for instance, is great.

I saw an advert for some stuff to stop fungus growing on your toe nails. I hadn't realised that I had fungussy feet till I saw the advert. Gross. I just thought it was, well something else. So adverts are informative too. My feet and hands tingle a lot, it's not exactly painful but it's not nice either. The last time I asked a doctor about it he or she (I forget which) told me it wasn't anything that showed up on tests, none of those normal but nasty things like diabetes. Their expert advice was that I put it down to getting older, grin and bear it. Last night on the telly I saw an advert where some people were grimacing as they twiddled their feet or shook their hands. The advert described circulation problems being eased by their medication. It looked like me.

I went to the chemist today and asked for the circulation stuff by name and, whilst I was there, something for the fungus and a box of aspirin. The forty three euros price was a bit of a shock but not exactly a surprise. Prescription drugs are charged at different rates depending on your circumstances. Don't quote me on this but I think that the very rich have to pay 60% of the cost, normal level workers either 40% or 50% and pensioners 10%. Some people are exempt of all charges. The prices for these prescription drugs always seem reasonable to me, I remember some antibiotics were about 3€ so the full price must be around 7.50€. Mind you I don't need stuff every week nor have I ever needed anything exotic. On the other hand over the counter stuff, the throat sweets, the cold remedies, the antiseptic creams and the like are exactly the opposite. "What!?" - "Eleven euros for some crushed paracetomol with a lemon flavour?" That's why the price didn't surprise me.

Like I say I don't go to pharmacies very often. Thankfully I go to the doctor's even less. There is a free health service here just as in the UK, at least it's free for me because I pay my social security and so I'm covered. British pensioners are covered by the health system too through EU legislation. There is a registration process, which I hear is pretty lengthy, but, in the end, it allows the UK to pay the Spanish Government for any treatment given to UK pensioners without the individuals having to pay. Lots and lots of Spaniards believe that older Britons come to Spain specifically to take advantage of the healthcare system and no number of official statistics will ever persuade them otherwise. There are lots of people who aren't entitled to free healthcare and there are lots of contradictory reports about the right to healtcare and to emergency treatment because rules keep changing about either excluding or including non legal residents, about including or excluding the long term unemployed etcetera. Often in these news reports there is no link made between health care rights and payment. I suspect, though I don't know, that although nobody will be left to bleed to death that doesn't mean there won't be a big bill afterwards.

Just to round off, neither everyday dentistry nor eyecare are included in the free system. I'm talking about fillings or a crown and getting yourself some nice new specs, not about cataract operations or jaw rebuilds. Opticians are just as bandit like as in the UK. I was quoted 936€ for a pair of specs and ended up paying about 500€. Dentistry seems pretty inexpensive to me. There is a lot of competition which keeps costs down so that a decent crown costs around 180€ and a filling is in the 30-40€ bracket.

I'm sure that pretty soon, as the months and years roll by, I'll become much more au fait with Spanish healthcare.

Getting off the stool

A warning: This blog will contain lots of rude and crude words. Do not continue if you are easily offended.

I've not been to the doctor very often whilst I've been in Spain. I did have to go though - years ago - because I had a problem with my waterworks, a certain pain when I urinated. As I walked into the doctor's office I apologised for not knowing the doctor words for certain actions and parts. Consider that I were talking to you about my bathroom habits. The verbs would be shit and piss, I'm sorry. They would not be defecate, micturate and urinate; I would not talk of motions, stools, faeces, movements or waterworks and I find the half way words like pee and pooh (does it have an h?) much more embarrassing than the Anglo Saxon words. At the doctor's though it's all bowels and penis.

Maggie has been pruning trees in our garden, she started with the almonds. She learned how to do it from a range of  YouTube videos. She preferred the one where the demonstrator didn't say that you had to get rid of all the shit in the middle of the tree. Gardeners don't have the same reputation as rappers for bad language so I presume it must be an everyday sort of word for at least one gardener.

We saw a Pat Metheny concert in Cartagena a while back. Maggie loves Pat. We were on the front row and Pat dropped a plectrum within arms length - at least my arm was long enough to requisition it for the good of the people. Someone else tried the same thing later, with another plectrum, and was berated by one of the roadies "Would you like it if I came around your house and stole your shit?" The translation would be nothing more than stuff.

Shit is a multi-purpose word. There are lots like it in Spanish, words that are more or less friendly, vulgar or attacking depending on tone of voice and situation. This includes the direct translation of shit. You can be complaining, you can be being rude, you can be describing a process and you can be no different to a Pat roadie.

The Valencian Community seems to be worried about my shit. More accurately they are worried about the health of my bowels. This is good; at least I think it is. They have a campaign for men and women between the ages of 50 and 69 to check whether we may have bowel cancer or not.  First they sent us a letter and when we sent back the "Yes, we'd love to participate" card they sent us a little stick inside a container. You don't need to be able to read Spanish to understand the instructions in the images above. The black thing is a turd. Once the stick was back inside the sealed container it was off to the collection point in the local health centre. Actually Maggie took it whilst I went for breakfast at Eduardo's. I wonder if it will be a person or a machine that has the job of checking the, presumably, thousands of samples? Whilst most of us will get a standardised "no problem" letter some will get the "please pop into the health centre" version.

Back at Eduardo's everyone wanted to know where Maggie was. When I explained one of the Brits retorted with - !Ah, playing Pooh Sticks." I thought it was clever.