10,000 steps with hardly moving

Back in April I suspected that I needed a small surgical operation so I made a doctor's appointment. It was a telephone appointment and my doctor said she needed to see me to make a diagnosis. So we met. She agreed with my self diagnosis and she referred me to a surgeon. That's how the family doctors work here in Spain. They basically act as gatekeepers, dealing only with common ailments, passing patients on for anything at all out of the ordinary. So they don't remove warts themselves, they confirm that you have a wart and send you on to someone somewhere who will remove the wart. Often the second doctor, the specialist doctor, confirms the diagnosis of the first doctor and then sets the wheels in process for whatever the next step is. You say my throat hurts, the GP sends you to the ear, nose and throat department where an ear nose and throat doctor tells you that you have polyps (if you have). You are then given another appointment somewhere where someone will cut them out (or do whatever they do with polyps). Actually you never want to need to go to see an ear, nose and throat doctor because the Spanish word for one is an otorrinolaringóloga (woman) or otorrinolaringólogo (man) which is obviously unpronounceable.

In my case I got to see the surgeon a couple of weeks later. He confirmed the GP's diagnosis and said he would schedule surgery. Something like three months later the health authority writes to me and says they are a bit backed up and that they are contracting out some surgery to private hospitals; would I like to go private? To be honest I don't care whether it's private or state. Good, bad and indifferent doctors work everywhere. Nonetheless I sign on the dotted line.

Later someone rings me from the private hospital and gives me a time to turn up for an appointment. He speaks to me in English. His instructions suggest that I'm going to be the only person at the reception. I can imagine the spotless, gleaming white building and the friendly, smiling receptionist when I walk across the silent entrance way or maybe it'll be like that Cottage Hospital where Alastair Sim uncovered the killers. Cosy with roses around the door.

The hospital in Elche is big and on an industrial estate. There are lots of entrances and lots and lots of people; not particularly gleaming and certainly not cosy. I go to a reception desk. There are three people on the desk all wearing badly tailored corporate grey suits. The man is flirting with the woman to his left. I wait. A little later I tell them who I am and that I have a 10.30. They ask me what I'm there for. The truth is that I don't really know. I was told that I'd talk to a doctor but what sort of doctor was not made clear. I try being generic - it's to talk to someone for the first time about a surgical procedure but apparently that's not enough - I suspect they do a lot of cosmetic surgery and I suppose they do want to mistakenly increase the size of my breasts. So I have to tell them what's wrong with me. Not that they care but I don't really want to share my haemorrhoids, warts, polyps or bowel cancer with someone I've only just met.

I'm sent to outpatients, consultas externas. There they ask for ID and (basically) who is going to pay. A different man in a very similar grey suit at a very similar reception desk sends me to a basement. I'm getting better at this. Before I abandon my spot in front of his desk I ask him what it is that I need to say I'm there for and what the process is when I get to where I'm going. 

"I'm here for pre-operative tests," I say (though I stumble over the Spanish pronunciation of preoperatorio).  I know I'm talking to medical types because they are dressed in white down to their super clean crocs. The blood woman takes no notice when I suggest to her where she will find a vein. After two failed attempts she says "Left hand side you say?". I don't think she understands my joke about personal anti vampire measures either. I'm sent to another room with another woman in white. I ask the woman why I'm getting an ECG. "Your name is Roy something or other?," she asks. When I deny being Roy she pulls all the sticky pads off me and sends me back to reception. I ask which reception.

It's the same man. "Hello again," I say, "where now?". "You're going to speak to a surgeon, wait outside consult room 20, they will call you". The quality of information is improving.

The surgeon takes as long to make her diagnosis as my GP did, as long as the state health service surgeon did, that's two or three seconds. She asks me the same questions too. She gives me a date in November. Not exactly a week tomorrow then. "You'll need to speak to the anaesthetist" says the surgeon, "Go back to reception and make an appointment".

The grey suit and I are nearly old friends now. "The surgeon says I'm to make an appointment with the anaesthetist". "Is this the date of the operation?," asks the man in the grey suit, pointing to the 15/11 scrawled on the top of the information sheet that warns me of the multiple ways I might die or be forever maimed under the surgeon's knife. "Yes", is my quick witted return. It must be the first time he's ever seen that sort of paperwork. "Our booking system doesn't stretch that far into the future. Give us a call in late October and we'll give you an appointment then".

So that's my first taste of private medicine and I can't say that I noticed any difference to the public health systems I'm more used to. The first encounter is always chaotic but you get there in the end and, the second time, you know just a little bit more about where to go and what to do. You can spot the people with chronic health conditions in hospitals, they're the only ones, staff aside, who look confident about where they are going.

Nothing and nothing else

I haven't done anything very interesting for a while but that won't stop me.

I went to stand outside the Town Hall yesterday evening. Every first Friday of the month at 8pm - a reminder that violence against women needs to stop. I've done it a few times. Nobody notices but I should be there. Afterwards the group often puts on a film. I haven't been to that for ages but I did go last night. The film was called Frances Ha and it wasn't bad at all. The interesting thing was that it was introduced by a couple of young women who I think were still at school. They were speaking in Valenciano which means that I caught about as much as I would if I were in a Belshill pub late at night talking to an 80 year old local who was a boxing contender in his youth. The young women talked about similarities in style to Jim Jarmusch and Woody Allen, about the handheld camera movements and the framing of the scenes. I was impressed. I don't think the majority of the students I've encountered across the years would know who Jim Jarmusch is or be interested in finding out.

I spent a bit over six hours in Elda hospital the other day. The friend of a friend had a terrible stomach ache. The local health centre sent her by ambulance to the nearest big hospital and I met her and her partner there to do the Spanish. It's the fifth time I've been to Urgencias, A&E, in the time I've been here either as patient or companion. Everything followed the "normal" pattern, the one I've seen every time, stabilisation, admission, a first consultation with a doctor who decides a course of action in this case a bunch of tests. Then a bit of a wait. This time that became a longer wait. Then they needed the emergency bay and my couple had to wait with her wheeled bed parked in a corridor. The staff were grumbling and complaining about the situation but all that NHS, abandoned in the corridors, stuff came to mind. Not that there weren't a bundle of staff around all the time but it was a corridor.

I listen to a podcast called ¿Qué? done by a couple of people who work on the English edition of el País, a Spanish newspaper in the same class as The Guardian and the New York Times. The podcast is in English and they welcome feedback. I've tweeted them, I've emailed them. I've been mentioned in the podcast a couple of times. In fact I listen to a number of podcasts and several broadcast radio programmes. I sometimes comment on those too. Last week, when a Saturday morning programme was talking about punctuality I made some comment about the late running of Spanish TV. As they read the comment out the presenter said Chris has written again. It's the same with a few podcasts and radio shows, multiple responses, "Hi Chris, nice to know you're still listening". Twitter and Facebook and email and what not almost persuade you, one, that you, one, knows these people as real people rather than disembodied voices.

Round midnight

It was just after ten and I was putting away my paperwork at the end of the class when a WhatsApp message pinged on my phone. It said that Maggie was helping a couple of friends out with a bit of a medical emergency. One of them was having trouble breathing and, at the local health centre, they needed someone who understood Spanish. Maggie stepped into the breach.

Later it was decided to transfer the ill person to the nearby hospital in Elda for tests and what not. We ended up going too and so, around midnight, we found ourselves hanging around in the Urgencias, the Accident and Emergency of the local hospital. Nobody was watching the telly high on the wall, someone was throwing up on the pavement outside, the drinks and snack machines were doing a slow but constant trade. The main activity though was waiting; staring at mobile phones or talking in small groups. Nobody looked rich, nobody looked well dressed, one woman was even in her dressing gown and nightie - when things happen quickly I don't suppose there is time to spruce yourself up. Quite a few of the men were in shorts despite it only being 11ºC.

It reminded me of so many places with old plastic chairs or faded and lopsided posters on the walls, dole offices for instance, but, more than anything, it brought to mind my occasional overnight coach trips from Petrer to Madrid and on to Salamanca and Ciudad Rodrigo. A motorway service station and an A&E waiting room when the world has slowed down for the day are surprisingly similar places.

No particular news on our pal as I write- stable but not fixed.