Nothing too serious

I’ve always been a small-town girl. A country girl. I love rural life. I love that everyone knows everyone, people stop to say hello, people remember things about you and ask after you and your family. Of course, that can make life a bit claustrophobic at times, a bit like living in a fish bowl. But I’ve never had a craving to live anywhere other than in small close-knit communities.

A minor accident recently tickled me about just how small and close-knit we are on the Rio Guadiana.

Mammy came for a five-day visit on New Year’s Day. Late in the afternoon on the 2nd of January, a misstep in the cockpit of a friend’s boat (carrying my laptop and not looking where I was going) led to a twisted ankle, the pain of which caused me to faint (I’m such a wuss). The next morning my ankle was purple, painful and had swollen up like a balloon.

As I hobbled up to the shower block to take a shower, old Manuel was sitting on his usual bench, contemplating the river. ‘What happened?’ he asked and told me to go to the doctor immediately. He said the health centre would be open for the remainder of the morning and sang the praises of our lovely GP, Umberto.

Taking Manuel’s sage advice, I hobbled, post-shower, the 200 or so metres from the shower block to the health centre (Sanlúcar really is tiny). Along the way I met, if memory serves, five people. And, because Sanlúcar is so tiny, I knew them all. Each one gave me a concerned look and asked what happened. I gave each a brief account as I hobbled on my way.

At the health centre I was first in line and had only sat down when the door to the consultation room opened, the previous patient departed and I went in. Umberto confirmed a sprain and ligament damage, but was confident my ankle wasn’t broken. He recommended not walking for up to five days and keeping my foot raised. ‘Sit back and watch lots of TV’, he advised.

Walking down the corridor to check if the nurse was free to strap up my ankle, he left me sitting in the consulting room with the door open. The health centre had suddenly grown busy. An old man, to whom I’ve spoken once or twice, poked his head round the door. ‘Happy New Year’, he said, ‘What’s wrong with you?’, and I described my injury, grateful that I wasn’t in for treatment for an embarrassing rash, or the morning after pill or to be tested for an STD!

Moments later a friend’s mother-in-law saw me sitting there. ‘We’ve all been ill over Christmas’, she said. Only her 90-something year old mother had not succumbed to the flu that had laid low every other generation of the family. ‘And what about you?’ she asked. And for, could it be the eighth time in ten minutes, I recounted the fall, the sprained ankle, my mother’s few days of relaxation now jeopardised by having to wait on me hand and foot as I rested my swollen ankle.

When called, I hobbled down to the nurse, who bandaged my ankle from toe to knee. The size of the bandage seemed excessive, but would certainly look the part as I lay around for the next few days watching movies while I was served cups of tea and slices of Christmas pudding!

Before I left the health centre I met one more woman, who I knew from a Spanish conversation class I used to attend last year. Once again I recounted the episode and could now add the GP’s diagnosis, the size of the bandage and the recommended recovery method.

Stepping onto the street, I heard Julian’s unmistakable voice in the shop next door, so I popped in to tell him the GP’s diagnosis, and in so doing had to once again recount the whole tale, this time to Irene, the ever cheerful and lovely octogenarian shopkeeper.

Hard as it is to believe, I met no-one on the short walk back to the boat and, indeed, saw no-one other than my immediate family for the remainder of the day.

Late the next morning there was a knock on the boat and four friends boarded with bottles of wine as they planned to help me drink my ankle back to health. We drank, ate cakes, and Roy (my sailing partner from last summer) confiscated Katie’s guitar and he and Mammy sang together.

I had planned to take Mammy out for lunch that day, but given my incapacitation, she decided to take Lily and Katie out for pizza to the beach bar on the other side of the river. The three of them took the ferry across the river, from Spain to Portugal, walked to the beach and into the bar. And what was the first thing Rogerio, the proprietor, asked when they walked in the door? ‘How’s Martina’s leg?’.

You just have to love small town life!

(P.S. My ankle remains stiff and sore. Walking makes it feel better. Not moving for extended periods makes it feel worse. Inclines and steps hurt, sitting seiza or crosslegged is painful. I’m still wearing an ankle support 24 hours a day. Lesson learned: watch where you step!!)

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Adventures in Spanish health care

I’ve recently had to engage with the Spanish medical system. I have some health issues typical of a woman my age which are causing physical discomfort and emotional stress. I’ve had these problems before, just never all at once, and never so acute. After a couple of weeks I decided to see a doctor. You will recall in a previous blog I reported that I’d decided to give up learning Spanish. Well, that decision’s come back to bite me in the bum, let me tell you, although I’m not sure how much ‘Yo me llamo Martina’ would get me when describing a range of gynaecological symptoms.

First of all, I had no idea where to go. Jessica (pronounced Yessica) at the marina office directed me to the local health clinic, and wrote me a note in Spanish to hand in when I got there. I thought the note said I wanted to see a doctor, but perhaps not. I went through the diccionario and Google Translate, finding the words to express what I wanted to say. Every pharmacist we have encountered in Spain speaks excellent English, so I naively expected a doctor to do likewise. I appreciate that a doctor in the UK or Ireland would never be expected to speak Spanish or any other language that a patient might present with, so why should I expect English from a Spanish doctor?

The next day I trotted off to the health centre. I was already an emotional wreck (hormones or stress, or a combination of the two? Who knows?), and as I queued up at the reception desk I hoped it would be a simple process. I was called forward, but could not make myself understood to the woman on the desk. ‘English?’ she asked, and when I said ‘Si’, she directed me to her colleague sitting next to her. Great, I thought, this woman will speak English. I also fleetingly wondered what would have happened if I had said ‘No, German, Mandarin, Japanese, Swahili’. Did they have a whole army of bilingual reception staff, ready to jump to the aid of foreign idiots such as myself?

I waited while the English expert dealt with a patient and I then stepped forward. She didn’t speak any more English than her colleague, but was armed with a pink-covered Smart phone through which we communicated. For what seemed like minutes, she painstakingly typed text onto her phone. I expected an in-depth question about my medical condition, and was somewhat disappointed and surprised when, after her labours, she showed me her phone screen which read ‘How long in Aguadulce?’ She took my name, my address, asked me a variety of questions. I was aware of the long queue building up behind me, and felt embarrassed and annoyed at myself for taking up so much time. Then she asked for my passport. I didn’t have it. I had completely forgotten to bring it along, despite regularly needing it in Spain to carry out mundane tasks, sometimes even needing it to pay for groceries by debit card. As I said, I was feeling pretty emotional already, so when she told me she couldn’t make an appointment for me without my passport I burst out crying, in front of this long queue of people. What a wreck. I turned and fled the building.

As I walked down the street, sobbing like a fool, it suddenly occurred to me that the last time I was this weepy was in the early days of my pregnancies. My symptoms could easily be pregnancy signs – the cramps and discomfort, my clothes feeling too tight across my lower abdomen, my hysterical emotions. So I went to a pharmacy and bought a pregnancy test. And from buying the test until taking it – a matter of twenty minutes or so – I imagined carrying a little mini-me in a sling again, breastfeeding, nappies, a baby sister for Lily and Katie….

The test was negative.

Two days later I returned to the health centre, this time armed with my passport and with more phrases and words to use when I saw the doctor. I queued up again, steeled myself against my own emotional outbursts, and told myself to ‘man up’ (difficult at the best of times, but impossible when ones issues are gynaecological). After a long and painfully slow conversation with the receptionist, I was given a card and she ushered me away.
‘El medico?’ I asked.
She had registered me with the clinic, but hadn’t realised that I also wanted to see a doctor. So she made an appointment and sent me upstairs to a waiting room.

I didn’t have to wait long. In fact, I saw the GP ten minutes before the time on my appointment card, something unheard of in Ireland or the UK. I walked into a large dark office and sat in front of a man in his late 50s. He spoke as much English as I speak Spanish. Using the phrases I had written in my notebook and hastily flicking through the diccionario, I managed to tell him very little. He looked at me blankly.

So I asked him for a piece of paper and drew sketches of my body and my symptoms. But I don’t know if he got it. The impassivity on his face never wavered as I manically played Pictionary on his desk. Maybe he thought I was asking him out for lunch – the uterus I drew looked uncannily like a gherkin and meatball sandwich with the bread curled up at the edges (this is both a testament to my appalling drawing skills and the state of my uterus the last time I saw it on an ultrasound scan).

He focused on one particular symptom – the only one for which we had some mutual understanding. When he said the symptom, I was beside myself with excitement that we understood each other. So we went with it, even though I’m convinced it is a minor and background symptom. He made an appointment for some further tests and told me to return to the reception desk.

At the desk I was handed a different appointment time, causing me all sorts of confusion, and a clear plastic bottle and told (I’m not making this up) ‘pee-pee’.

I left feeling very confused. The GP had given me a November 27th appointment for something or other and the receptionist had given me a November 12th appointment. Were they two different appointments? Or had the reception changed the GP’s appointment? And what were these tests anyway?

Before going back to the boat I dropped in to see Jessica in the marina office. I laid my woes out for her. The appointments were mostly meaningless to her, but she asked to keep my papers and promised she would phone the health centre. She phoned me later that day and asked me to come by so she could relay the information. There were, in fact, two appointments. The first, a blood test, would take place on the 12th. I was expected to fast from the night before and bring a urine sample. She didn’t know the English translation for the November 27th test. With a straight face she told me I would have to lie down with no pants on and spread my legs. And then she made a gesture with her fingers that will be burned on my brain forever. They say laughter is the best medicine, and Jessica’s deadpan account of what I would be expected to do tickled me.

A few days later I arranged a phone consultation with my family GP back in Ireland. There is no delicate way to put this – that man has more gynaecological knowledge of my mother and my maternal aunts than any man really should. It was great to talk to him, to be able to tell him without hesitation about my symptoms, and for him to know my entire medical history and place it within the context of my maternal family history. He confirmed what I thought it might be – or rather a list of things he thought it might be. His advice? ‘Get your ass on a plane, come home and get it sorted’.

This morning I had my blood tests. There was more confusion at the reception desk at the health centre as the panicked receptionist (a different woman this time) tried to explain something or other to me. Eventually, she got up from her desk and walked me along the corridor until she found someone who could speak some English. When this woman translated what the receptionist was trying to tell me, I realised that the woman’s panic was unnecessary. Had she shown me the piece of paper she was clutching in her hand I would have quickly seen that she was trying to tell me about a follow-up appointment with the Pictionary-averse GP next week. She then directed me down a corridor and returned to her post.

I wasn’t sure what to do. There were people standing in a queue and other people sitting on waiting room seats. Should I sit and wait to be called, or should I join the queue? I decided to join the queue. It was a right decision. The queue moved quickly and soon I was inside a busy room that was a blood-taking conveyor belt. I was asked for my urine sample, which was placed beside lots of others, and then told to wait my turn. Four nurses worked at two tables, taking blood at lightning speed, from this long queue of patients. The man in front of me had his blood taken and was quickly out the door and then it was my turn. I sat down next to two squirming six year old twins, both sitting on their mother’s lap, each having their blood taken. I sat down at my station as my nurse was still dealing with the previous patient’s blood sample. None of the nurses wore gloves nor did they wash their hands between patients. Back home, I’m used to having a needle inserted and then samples of blood drawn directly into sterile vials, attached to the needle one after the other. This morning, the nurse drew only one sample of blood, and then squirted it into each of the vials. With so many people having their blood taken at once, so many vials of blood flying around, and the lack of prophylaxis, I walked home wondering about cross-contamination and about the mixing up of samples. After that experience I’m expecting the GP next week to tell me I need to have my prostate removed.

It’s been a trying few weeks, as I’ve been torn between returning to the UK or staying in Spain. But having given it a great deal of consideration, having weighed up a range of options, and having considered the consequences of either option, I have, for the time being, decided to stick with the Spanish health system. So it’s back to Google Translate and Jessica for me, and another game of Pictionary next week.