The Spanish health care system has a pretty good reputation and most of my experiences with it confirm that. First of all, it’s free, which, coming from a country where a ten-minute consultation with your GP costs €70 for all but a minority, that’s a major bonus. Staff are generally caring and kind and referrals are reasonably prompt. In addition, prescription medications are heavily subsidized. Overall, I’m pretty happy with the health care system in my adopted country.
But…it’s different. The culture of care is unlike the one I grew up with and over the years I’ve had quite a few experiences that have jolted me because the processes and procedures are just…well…different.
Towards the end of last year I experienced a funny sensation in my left leg for a few weeks – pain in my calf, heaviness in my entire leg, occasional pins and needles throughout my leg. It’s something I’ve had on and off over the years and, being a bit of a hypochondriac, I always convince myself that I have deep vein thrombosis. But the pain always goes away before I do anything about it. This time, however, it lingered and, as the weekend approached, it worsened.
By midday on Saturday I’d convinced myself that I’d be dead by nightfall and I decided to go to the doctor. Being a Saturday, the health centre in the village was closed and I had to drive the 22km to the nearest 24-hour centre.
I was surprised to find the door to the health centre locked when I got there. A note stuck to the door had the centre’s phone number, so I called it. Before I had two words out, the grey metal door to my right opened and I was ushered in to the treatment room immediately behind the door. I tried to avert my gaze from the old man, shirt open, lying on the consulting table, being treated by a male member of staff. The woman who had opened the door to me turned out to be the doctor.
“Sit there,” she said, pointing to a chair only two metres from where the other patient was being treated. Shouldn’t he have some privacy, I thought. Shouldn’t I? I sat with my back to the man, trying not to listen as he was prepared for the ambulance that was to take him to the hospital, forty minutes away.
The doctor sat behind her desk and began her consultation with me. But before we got two sentences into it, there was another knock on the main door. The doctor opened the window beside her desk and shouted out, “Come in through the grey metal door.” There was no response, so she got up, walked around her desk, and let a middle-aged couple in. The treatment room was beginning to feel decidedly overcrowded.
The doctor directed the couple to the waiting room, but left the door between it and the treatment room open.
“I’ll have to see your leg,” she instructed me, after I had explained my symptoms and she’d asked me some preliminary questions.
With the door to the waiting room still open, the old man still on the treatment table and the male staff member beside him, and the grey door to the street now open to allow the ambulance crew in, I stood up, unbuckled my belt and dropped my jeans to the floor, my pink-knickered arse towards the old man. The doctor had a feel around my leg and asked me some more questions. She was sufficiently concerned to immediately send me to A&E at the big provincial hospital.
I didn’t want to go on my own, so I phoned a friend to ask if he’d drive me. Then I drove home, packed a few things in a bag, and was soon on the road to the hospital. The waiting room was large and airy and pretty comfortable as waiting rooms go, which was just as well, because I had a three hour wait.
Finally, my number appeared on the screen. I was to go to consultation room six. I walked into consultation room six to find a woman lying half-naked on the treatment table. “Go next door,” one of the staff told me. I went to consultation room seven and the woman sitting at the desk asked my name.
“You’re not Rosario?” she said, looking confused.
At that moment an extremely tall, very bald, bespectacled young doctor appeared at the door behind me.
“Martina?” he asked. “Ah, here you are. Follow me.”
I followed him to the other side of the corridor and into a large room that contained a number of beds. On one bed lay yet another old man, with his shirt open and his large belly on display. I tried to look anywhere but at the old man while the doctor consulted a computer and tried to find which room I was supposed to be in.
“Stay here,” he said and set off down the corridor, leaving me stranded. I looked at the television monitor and saw that I was assigned to both consultation rooms six and nine. Just then, the doctor popped his head out of room nine and indicated that I go there.
The brightly lit consultation room was cold enough that I commented on it to the young, dark-haired (and, admittedly, handsome) member of staff sitting behind the desk. The tall, bald doctor, whose white coat was askew and whose trousers didn’t reach to the top of his colourful socks, asked me where I’m from.
“Ireland,” I said.
“Ah, Holland,” he replied, a common mistake which must have something to do with the weird way I pronounce ‘ir’ in Spanish. I corrected him.
“Let’s do this in English, then,” he said, and switched to flawless English far superior to my Spanish.
I told him my symptoms and he asked me some further questions.
“I’m going to have to see it,” he said.
By now, the tall, bald doctor and the dark-haired, handsome doctor were both standing in front of me, as I sat on the consultation table. There didn’t seem to be anywhere for me to go to remove my trousers in a dignified manner, or a curtain to pull around to spare my blushes. I guessed I’d just have to get on with it.
With both men standing mere inches away from me and facing me, I removed my shoes and then my socks. A number of thoughts flashed through my head as I started to drop my trousers. 1. I haven’t shaved my legs in about two weeks. 2. I haven’t moisturized my legs in probably the same length of time. 3. Why am I wearing my mother’s hand-me-down knickers today? (Calm down…she hadn’t worn then…or so she swore to me)
With my trousers removed, I sat back on the table and the tall bald doctor proceeded to examine my hairy scaly left leg, pointing to a bruise on my thigh (I walked into the kitchen table) and another on my shin (an ungraceful scramble out of the dinghy). He talked his colleague through the examination and then used a very impressive hand-held ultrasound device that he plugged into his phone to look below the surface.
He assured me that all was fine. I didn’t have DVT, but I did have some damage to a surface vein. “Does that put me at greater risk of DVT?” I asked.
“Imagine your deep veins are the motorway,” he said, “going up to your heart and lungs. You have damaged a small country road. So, there’s not much to worry about. But, as you know, sometimes we get off the motorway and take a country road instead. So, yes, there’s a little risk.”
What a cool doctor. I felt sorry for him that he’d had to touch my troll-like leg. He’d asked me about my work and, as I got dressed – again, undignified and in front of the two of them, almost losing my balance as I put my right leg into my jeans – he gave me some sage advice. “Disco dance while you work. It’ll keep your legs moving.”
And that was it – undignified, lacking in privacy, lacking in an concerns about a woman patient stripping in a consultation room in front of two men and no female staff member present. I could have done anything to those two lovely doctors!
I returned home feeling reassured, and having learned some valuable lessons – disco dance while working and never, ever, leave my legs unshaved and unmoisturized again.