June 04, 2006 GMT
(9) Bolivia: The Bolivian Hospital Experience

Bugs will rule the earth. There is no doubt in my mind. They are just waiting for the right time...the right conditions and then they will conquer all.

A week or so ago I was in a one hotel town...too late to go ahead. I checked in.

I awoke in the morning to find a blood sucking critter hanging on, gorging his swollen body with my precious blood. He had dined all night I am sure. A row of red marks marked his passage. I took his life that morning. It was an easy decision.

I did not know his heritage. I did not know his name. I feared the worst and counted down the days as I watched his marks fester and swell. The color changed from red to purple. I used my medications but they had no effect. Then by the eighth day I started to experience physical symptoms. My stomach was unsettled, my head light. I salivated and felt like vomiting but didn't.

It was time to make a move. Time to visit the hospital. I checked myself into Emergency.

The first room contained the Cashier. Unfamiliar with the procedures I joined the line-up for the cashier. People pushed and crowded in front of me...they merged in from the sides. After half an hour I had not gained an inch. Agressively I pushed the interlopers aside. They gave me a dirty look. Why were they more important than me? Sure it was there country but I was in front of them. I deserved to be able to maintain my position.

A lady wider than I was tall squeezed into the 6 inch gap in front of me. I had visions of the bug whose life I had snuffed. I let it pass.

Finally I was at the Cashier. "I need to see a doctor," I said. "I have been bitten by a bug." Silently, she motioned me into the hallway beyond the room. I joined the growing crowd of disabled and injured.

I looked to be the true physical specimen in this mottley lot. A man stood limply against the wall, his head bandaged to his brow; the right side of his face purple. A man limped in wearing sandles, his toes wrapped in a red stained bandage. A woman breast fed her baby. A young boy on a gurney was wheeled up and down the hallway periodically to spread the growing crowd. I looked oddly out of place.

An hour passed...an eternity. In this numberless game I wondered if my number would ever come up. No one even looked my way. A doctor stood in the doorway of his office looking for business. He had none. He kibitzed with the nurses and orderlies. Why not me?? Why not do something productive?? Finally a nurse took me over to him. This could have happened an hour ago.

I explained my situation. I drew him a picture of the bug. I told him I thought I had Chagas. "No, no" he said. "That is not a Chagas Bug". He drew me a picture of a bigger and uglier bug...a cross between a scorpion and a spider. "That is a Chagas Bug," he said, "not your little bug."

I wasn't convinced. "We will do a blood test he said," and wrote out the request. He marked "URGENT" on top of the paper and underlined it. "Take this to the Cashier" he said, and waved me out the door.

Back in the Cashierīs room, the line-up had swelled until it filled the room. I joined the fray, agressively beating off any interlopers within reach. The games continued. Half an hour later I was at the Cashier's Window. I passed the paper across to her. She pulled out a giant ledger and tried to price it. She could not find the codes. Finally she totalled everything up. It came to 75 Bolivianos.

I handed across the money. She pushed it back. "You cannot pay now," she said. My computer is down. "Take this to the laboratory and come back when you have had your test." I had a bad feeling about this. I looked around frantically. "Where is the laboratory?" She waved her hand like a wand. "Over there" she gesticulated. "Where?" "There."

An orderly took pity on me and led me down the passageways, through closed doors, around corners and passed abandoned, dirty rooms. My spirits fell. Did I really want to be a part of this?

We arrived at the Laboratory. I was first in line. I had beat the rush. I handed across the slip of paper. The nurse looked at it and passed it back. "I can't do anything with this," she said. "You did not pay". "Come back when you have paid." I looked at the orderly, he looked at me and we headed back to the Cashier.

Same scene, same place, different time. Finally, back at the cage, I explained the problem. "Oh, my computer is running now. You can pay." The price was now 80 Bolivianos. I donīt care...80, 90 a 100. Let's get this show on the road.

The orderly had disappeared...given up...gone somewhere else. I wandered through the maze of halls but could not find the laboratory. Finally, in desperation I stopped a nurse in a hurry and beckoned her to take me to my destination. She did.

The Laboratory room was filled to capacity. More jostling, line jumping, pushing and shoving. I beat my way to the front of the line. There was only one more person in front of me. Suddenly a male nurse appeared behind the window, shouting and screaming like a lunatic. "There are too many people here...too much work to do. I quit. There will be no more tests today. Everybody go home." He waved his arms frantically and then he slammed the window shut and disappeared.

We looked at each other in muted silence. Nobody said a word. We just sat in the waiting room. Eventually the crowd thinned out. People went somewhere else. People went home. People just gave up. Half an hour later nothing had changed. No one re-appeared at the window. Nothing was happening.

I left the room. I couldn't find the way back to the Cashier. I wandered through hallways and closed doors. Finally I ended up at the back of the hospital, on the opposite side of the building. I walked around the perimter until I finally reached Emergency again. I went back to the Cashier. I joined the long lineup and worked my way to the front. The cashier smiled at me as I reached the cage. "I want a refund," I said. "I want my money back. The technician at the lab has quit. There will be no more tests today."

A cross look passed over her face. She looked at my paper. She turned off her computer. She locked her cash drawer. She took my slip of paper, exited the cage and locked the door behind her. She grabbed my by the arm and led me to the laboratory. Only a few people remained in the waiting room. She walked up to the window and rang the bell...she pounded on the sill...she bent through the window and shouted down the hall. A nurse appeared from somewhere.

"What's going on", the Cashier shouted. "This man has paid for a service and needs to have this work done. Can't you see it is URGENT?!!" "But, But." "Get this goddam work done and do it now!!"

The window closed and the nurse appeared in the waiting room through a side door. "Have a seat, sir," she beckoned. "I will be right with you." I selected a chair and lowered my haunches to it. Before they touched metal, the nurse reappeared. "Come on," she said. "Let's get going." I sprang to my feet. The Cashier smiled at me and returned to her cage.

In five minutes flat, the nurse had dusted off a new syringe, jabbed my arm, drew blood, squirted a little around the room to ward off evil spirits and sent me on my way.

"Now what?", I said. "Come back at 3:30 and we will give you the results. "Today," I queried, not believing I had heard correctly. "Yes." "Where to, the Cashier?". "No, come here." "OK. Bye. Thank-you." I left in a daze. Almost 3 hours had passed.

I went downtown and bought an ice cream cone to cool off. I ordered a double.

3:30 appeared quickly. I returned to the hospital. They were in lock-down. A guard stood at the barred gate. "We are closed," he said. "Come back at 5:30." He spoke through the bars. "But, but, I had this work done," I sputtered. "They told me to come back at 3:30." I showed him the slip of paper. He opened the gate and let me in.

I now knew the hospital layout by heart. I took a short-cut to the laboratory. I was back at the cage. A stout, brusque lady looked up from her work. "What are you doing here?", she seemed to shout. "I was told to come here at 3:30", I responded meekly. "Get out. We are closed. Come back at 5:30 when we are open." She returned to her work.

I left muttering to myself. I really donīt give a fiddler's f--k when I get the results. Why, just why can I not get the same answer twice in a row?

I returned at 5:30. The hallway was jammed with people. The place was locked up tight. No one was around. The clock counted down the minutes. An orderly appeared and rang the bell. Nothing happened. Finally at 6:00 the same woman who threw me out earlier appeared at the side window with a box of test results. She began calling out names like bingo numbers. I never heard mine. At the end of the stack she said "That's it. If your name wasn't called come back tomorrow. Maybe we will have them then."

The crowd surged forward. Only a few had had their names called. Many remained, I among them. She pawed through the pile again. More papers were passed out. I looked at the recipients. Were they all medical students? They studied the test results and charts intently. They acted like they understood. I pushed close to the window, hoping she would find my paper before she got angry at me again. She pulled it out of the box and handed it to me.

I looked at my blood analysis with the percentage breakdowns. I looked at the graphs and charts and the spiked curve. It didnīt mean shit to me. Who were these people kidding anyway? They couldn't make any more sense of this than I could.

Now what? In a daze I staggered down the hall. I know. I'll go back to the Cashier. At the front of the line I handed her the paper. "What do I do now?" I asked. "Oh, you need a doctor," she said, and led me down the hall. I walked into the doctorīs office and we went through the results.

They have confirmed "NEGATIVE ON CHAGAS", he said. I already knew that. I had read that much. "What about all of these sharp spikes? What are they?" "I don't know you," he said. "I can't say if that is good or bad."

"Let me have a look at the bite. Where did the insect bite you?" "On my right testicle." "Where?" "You heard me." I dropped my drawers. The door to the Consulting Room was pushed open. People peered through the door. The doctor turned to close it.

He prescribed a cream and some antibotics to be taken over a period of four days. I hoped he was right.

Posted by Robert Bielesch at June 04, 2006 01:21 AM GMT

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