Showing posts with label hospitals. Show all posts
Showing posts with label hospitals. Show all posts

Thursday, July 25, 2024

On the power of explanation

It’s the same with almost anything. The first time it’s all a bit hit and miss; the next time it’s usually better. I’ve just realised what you’re thinking about. That’s probably true too, but that wasn’t where I was going. I was thinking more about the tram in Alicante as an example. I’ve ridden on the tram a few times, but it’s nearly always several months, or even years, between the rides. I knew there was a button to buy a ticket for the central zone, but I couldn’t find the damned thing amidst all the text on the machine. It turns out that it’s TAM, Tarifas Zona A Metropolitana. I'd only just worked out the system as we pulled into our destination station. I even wondered about not paying.

Years ago, I had a "neurological incident," and after a few days in hospital, I ended up going to the neurology outpatients department at Elda Hospital. The first time I turned up in the outpatients area, where they have lots of the specialist services, I thought I’d descended into the seventh circle of Hell. There were people everywhere. After a while, though, I worked out the system and, despite the hustle and bustle, I realised that it all made perfect sense.

I had to go to the ear, nose and throat (ENT) department recently. They’re in the same part of the hospital as neurology, and I’d remembered enough of the drill to be completely unfazed by the experience. I just sat down, near the appropriate door, read my book, and waited to be called, quite sure that would be the system.

Obviously, some situations are more important than others. The ticketing system for the queue at the Foreigner's Office isn't that different from the ticketing system for the delicatessen counter in the local supermarket. One, though, is essential if you wish to stay in the country legally, and the other makes for a tasty snack. It obviously helps if, like Lizarran or Wetherspoons, the organisers put up big notices to explain the system.

After my visit to the ENT people, the unpronounceable otorrinolaringología department (easier to say otorrino), I needed more tests. They said they would phone me. Nowadays, I know that great big long phone numbers aren’t some prince from Equatorial Guinea trying to steal my money, but a call from either Corte Inglés or the Health Service. I presume it's a number based on a central "switchboard" and various extensions. As I have no current dealings with the department store, the choice was easy. I used to get flustered by these calls; nowadays, I’m much better at keeping it slow and steady. I was, of course, driving when they rang, but I remained cucumber like - I asked questions: Is that 8 in the morning or the evening? When I went through a sort of confirmatory checklist with time, place, department, etc., it was the person ringing me who wasn't quite sure. "I'll ring you back with the department," she said. And she did.

So I’m there, in the specialist outpatients clinic before the cock has crowed. The gatekeeper is quite a strangely shaped woman who speaks a language that escapes me. Pointing and the odd word of comprehensible Castellano makes me plump for an information window. I wait there, I show my health card, and I’m given some bits of paper. Most of the other people have similar bits of paper. Being among a group of people all going through the same process makes it easier. I can see that the first port of call is for a blood test. As I wait, someone wearing white scrubs, leaning out of a door further down the corridor, shouts, “Anyone for cardio? You can do it in any order.” I look at my bits of paper; one has “cardiogram” written on it. The penny drops: three bits of paper, three tests.

I do my cardio, the ECG, but the conversation between the two women, as they push my results into an envelope, “We’ll let them sort that out,” isn’t that reassuring.

I go back to blood tests. I always confound blood nurses; I appear to have no veins. I can only presume that ancient ancestors lived in Transylvania and developed the feature as an anti-vampire measure. At one point, I have three medical people giving me different instructions: “Make a fist, raise your arm, tense your arm, relax.” I make the vampire joke; they grimace, but the blood eventually flows. More than once in the past, blood has been taken from the veins on my hand or between my fingers.

Last one: X-ray. I’m waiting, I'm reading. Another person in coloured scrubs asks me what my name is. Ten minutes later, she asks me if I’m waiting for an X-ray. I say yes. She asks me why I didn’t hand in my piece of paper. I could say because nobody asked me, or because that isn't the same process I've just followed in two other departments within five metres of where I am now sitting. But I don’t, and I get my X-rays easily enough.

Only once, in a medical situation, have I ever got snotty about this. In Huntingdon, in an NHS hospital at 9 p.m., I told some doctor-type, who was only speaking to me in single words, that “right” and “trousers” did not amount to instructions, and that while he may go through the same routine thirty times a day, I didn't, and he should show more respect to his patients. He needed to be a bit more Wetherspoons, a bit more Lizarran, and a lot less Alicante tram.

P.S.: I asked Microsoft Copilot to draw the picture. AI obviously has trouble with the spelling of anestesiología.

Wednesday, April 05, 2023

Local languages

One disadvantage of living in a foreign country is that, often, the country you choose to live in doesn't speak a language you understand. It's one of the reasons why migrants, fleeing some terror regime, don't stop when they get to the first safe place. They keep going heading for somewhere that speaks a language they do.

Most of we rich foreigners who move here want to be good immigrants. We try to learn a bit of Spanish before we arrive. We try to learn more as we live here but, in this area, and in others, we find that a lot of the information is in a different sort of Spanish. In Pinoso, which is in the Valencian Community, it's called Valencian. Although nobody speaks Valencian directly to we foreigners we see and hear it everywhere

The current Spanish constitution says:

1) Castilian is the official language of the State. Every Spaniard has the duty to know it and the right to use it (Castilian is the language that is known worldwide as Spanish)

2) The other Spanish languages will also be official in their respective Autonomous Communities in accordance with their statutes

3) The richness of the different linguistic forms of Spain is a cultural heritage that will be the object of special respect and protection.

So Spanish, Castilian is spoken throughout Spain. Catalan is spoken in Catalonia, the Balearic Islands and the Valencian Community (where the variant is called Valencian). Galician is spoken in Galicia and some areas of Asturias and Castilla y León. Basque is spoken in the Basque Country and Navarre. Aranese (a variety of Occitan which is another Southern European language) is spoken in a specific region of Catalonia.

I fully understand why people speak Valencian. It's a local language, it's the language of the land. My Yorkshire accent shows where I'm from too. But it does make life trickier for we incomers. Often it's easy enough to catch the gist of Valencian if you speak Castilian, but it makes it all harder work. I also wonder sometimes if there is a bit of exclusivity about it. Back in 2010 the Regional Government did a language survey in their territory. They found that nearly 50% of the population speaks Valencian "perfectly" or "quite well" (in some of the Castilian speaking areas that figure was as low as 10%) and about 25% said they write Valencian "perfectly" or "quite well" (6% in the Castilian speaking areas). There are around 50 nationalities living in Pinoso. Only one of them naturally speaks Valencian. 

The strength of feeling behind the various regional languages, Basque, Catalan etc., varies a lot in the different regions. Sometimes it's simply another language, something of local pride and heritage. Sometimes it's considered to be one of the building blocks of an independent nation downtrodden by an uncaring and power crazed Castilian speaking government based in Madrid. This is particularly reflected in schools where classes may have to be taken in the local language. Sometimes opting to take classes in Castilian might disadvantage pupils in other areas of the curriculum. It's all very complicated and the stuff of hundreds of arguments around dinner tables, on bar stools and in WhatsApp groups.

One of the manifestations of this linguistic plurality/chauvinism is in relation to local government workers - from librarians and teachers to surgeons and town hall clerical staff. Where there is a local language a public job profile usually includes a language profile. Even where the local language is not a specific requirement having it will bring quicker promotion and greater opportunity in general. In some communities nearly all the government jobs require the local language but all the communities have ways around this for the times when there are skills shortages. It can still be a huge stumbling block. 

I know someone, a health professional, who has always spoken Valencian at home but couldn't take the promotion offered to her until she had passed the official Valencian exam. As Spanish exams tend to penalise errors rather than reward knowledge, her everyday Valencian cost her points. It took her a lot of studying for her to pass the exam. Recently three Spanish nurses working in Catalonia used TikTok to complain that their careers were stalled by the need for a high level (C1) Catalan language qualification. The nurses used a very common, everyday, swear word which gave the Catalan authorities a good excuse to talk about potential disciplinary and legal action against the nurses. The Health Care chief in Catalonia said "We must guarantee care in our local language". There was no mention of their nursing skills.