The Doctor's Diagnosis

Unmade Bed at 6 PM
Originally uploaded by Blue Dragonfly Girl

My awesome friend Ilene, who's interning in South Africa, was recently forced to her bed by a primary and secondary sinus infection. So, I'm wondering, if perhaps in some sort of misguided subconscious attempt at solidarity, my body decided to join hers in feeling miserable...

Yesterday evening I finally agreed that a visit to the Pronto Socorro [emergency hospital], was a prudent idea.

My symptoms began at the beach four days earlier and included a headache, a fever that would come and go accompanied by chills and shivering, nausea, loss of appetite and an aching body. Not the best of times for a six-hour car ride back to Porto Alegre, but so it goes. On Thursday, my fever went down, but I started coughing and my chest felt tight.

On Friday, I was just absolutely exhausted. I put in a little time at my internship (due to some mis-communication, ending up at the farthest location all by myself where I attempted some reading). Later in the day I knew something wasn't right when my boyfriend accidentally elbowed me in the ear as we got up from a couch and I couldn't prevent myself from bursting into tears. "I think I need a nap," I said and fell asleep with Cipote as soon as we returned home.

That evening I checked my temperature and I had a fever again.

I'd been traveling. There were mosquitoes. Who knew, really, what this could be? Dengue? Malaria? Better not to wait any longer.

So, I don't have to keep calling him "my boyfriend" I'll use the alias he chose (perhaps unwittingly?) back in January: Samosa.

Samosa, A. and I, prepared with snacks, water and reading material crossed the street to the pronto socorro. Ready for a long night.

We made it past the door-woman, who would have preferred that I went to another hospital because she really didn't think this was an emergency. But, a nearby nurse, upon hearing of the travels, deemed that it could be, and gained us admission to the line.

"What's been going on?" said the lady who took my passport and was entering it into the computer. "Well, I've had a fever for four days and..."

The lady held her hand up, "That's enough," she said indicating that was good enough for entrance into the facility. I laughed. A. and Samosa reminded me not to smile so much. Gotta look serious about this illness business. All my information from my last visit came up.

Crazy, huh? I mean I have NEVER gone to an emergency room in my life and here I am in southern Brazil and this is my SECOND visit in less than 2 months?!?

We were directed to a second waiting room and eventually A. was allowed to come in with me to help when the intern questioned me. This was invaluable. The intern would have been ready to send me out the door but with some of A's coaxing words to him and the supervising doctor, they agreed to run some tests.

Up we went to the third floor. I thought walking the flight of stairs would be okay, but man was I winded. "Hmmm, perhaps that scary elevator is the way to go after all" I said. A vibrant, curly-haired nurse gave me a cup to pee in. Then, she took my blood. She chatted with me about where she wanted to go in the US: New York and Orlando ("I have to go to Disneyworld") and I admired the vampire figure on the door.

Then, down we went to the second floor for chest x-rays. Here there were two male nurses who seemed to be playing the role of good-nurse bad-nurse. One scowled and told us we wouldn't get the results until tomorrow morning...if we were lucky. He seemed mad just that we asked how long it might take. The other said it would be likely sooner than that and that we could go sit out in the waiting room until they called me name.

Ah, yes, when I appear after they call, "Alison" I still get weird looks. Spelled "Alisson" it's very definitely a man's name here and I don't ever fit the part. Luckily, I got good nurse for the x-rays.

A. chatted with the other patients in her friendly-way and learned about their lives. Most people's injuries served as a reminder to me that whatever I was going through, it wasn't that bad.

We waited about an hour for the x-rays to be read. The results spoke about a concentration of something in the right lung.

Then we took the elevator back to the third floor for the blood and urine results. These were unintelligible to us. We had no idea what to expect. Enough to make a person nervous.

We took all this new material back to where we began and waited for it to be interpreted by the doctor.

"You know," I said to Samosa, "It's one of those situations where of course you want to be well, but if you're well then it doesn't explain why you feel so awful."

A. and I peered over the doctor's shoulders as he read the results. "You have pneumonia," he told me, "You have to stay home for a week."

I felt angry and upset and ready to cry. Later an email from my mother described my problem perfectly. It wasn't exactly the pain of being sick, which of course is no picnic in the park. It was more that, "Being stopped so abruptly in your well-planned and scheduled life is damn hard."

As I processed this news (at least I didn't have dengue or malaria!), I was amused to overhear the intern asking the doctor, "Don't they vaccinate against pneumonia in the States?" in evident surprise that I, as an American, could come down with this illness. I smiled thinking how impressive this was -- this whole experience in the emergency hospital, which was FREE for me, even as a foreigner. I didn't think they realized that I probably wouldn't have even gone to the ER in the United States. Oh, USA, can't we figure out a better health care plan for our country?

And so I'm still raging against the fact that I'm not allowed to go to my internship next week and I feel awful that Samosa has to spend his last week in Brazil as a nurse to me as opposed to being a tourist. However, on the plus side I'm in the best of hands (A. and Samosa are awesome) and A's apartment is the best place I could imagine to recuperate.

Also, it feels really good to finally have an explanation why the last four days of my life have felt so impossibly challenging.

Vespas Brasileiras, Part II

Chairs
Originally uploaded by Blue Dragonfly Girl

Yesterday I got to experience two Brazilian systems: the federal police and the hospital pronto socorro (essentially a hospital version of the United States emergency room).

One took 4 hours.

The other took 20 minutes.

When I walked into the federal police building, I was given a Ficha Estrangeira (Foreigner ticket) with the number 32 printed on it. I was there because I was required to register with the police within 30 days of my arrival.

I sat down in what felt like an airport seat staring at the backs of people's heads. Frequently people's names were called, but no numbers. It took a while for me to figure out that two different systems were occurring simultaneously. Brazilians (whose names were being called) were here for passport related stuff. The estrangeiros (foreigners) were here to register, among other things.

It took at least 30 minutes for a Ficha Estrangeira number to be called. Number 9.

"Oh damn," I thought, "This may take a while."

And indeed it did. I'd been planning a nice lunch and instead I was spending it eating crispy, cheese-flavored fried things from the vending machine.

I finished the book I was reading.

In between staring into space, I even started reading my Portuguese-English dictionary.

I made friends with a woman who was born in Afghanistan, moved to India when she was 7, came to Brazil with her abusive husband, learned Portuguese and with the support of a neighbor divorced her husband and is now here working to support her two teenage children (who are both in school). And she never was given the opportunity to learn how to read and write. She was number 40. She got someone's attention and explained her situation to him -- that she was afraid she might lose her job if she stayed here all day. She got helped.

I was especially interested in how many very young (early 20s?) women were working here and how casually they were dressed. Tank tops and flip flops and too-tight pants. 

It was always amusing when someone came out to call a new number saying "Estrangeiro número 17" essentially, "Foreigner number 17."

3 hours after I arrived, my number was finally reached. I jumped up and practically ran into the room. The man took out a list and started telling me all the things I needed to register. "Yup, got that," I kept saying. He looked surprised. "How did you know you needed all this?"

"The university told me." Inwardly I was thinking how grateful I was to the university because if I had to wait 3 hours just to be told, "Go get this stuff and come back and wait again another day," I might have exploded.

He sent me back outside to fill out an application form, which I filled out, making some less than educated cases, which later had to be corrected when I returned to his desk. For example, instead of putting down my passport number, I put down my flight number from Houston. "Huh?" said the man, "What on earth is this number." I blushed.  Uh, perhaps my brain was a bit muddled after all that waiting?!

Then I was sent back outside to wait some more.

A different man came and handed my passport back to me with a little strip of paper with an official stamp, some numbers, a bar code and my photograph. Then he took me into a small room and coated my fingers in thick black ink for fingerprinting. Luckily, they had stuff in the ladies bathroom that got it off.

And that was it. Exactly 4 hours later I was free to go.

----

So...needless to say, although a visit to the doctor seemed prudent because the rash from the wasp sting on Sunday was continuing to grow in size (after all, I have no idea what these Brazilian wasps are capable of), I kept putting off going.

I walked over hill and dale to register for the World Social Forum (post to come about this), even got on a bus by myself (woo hoo!), wandered around the indoor market downtown and then, since nighttime was fast approaching made a move for the hospital.

I didn't know exactly what would happen or even if they'd accept me because this wasn't really an emergency in my mind. And I also didn't know how much they'd charge me. I wasn't thrilled about that prospect either.

I brought along my international insurance information just in case that could do something. Though I doubted it.

I went to the information desk. They told me to go sign in. I handed the guy my passport and he clicked away on his computer and asked me for my address and my phone number.

Then he said, "Follow the yellow line to room number 6." I did with "Follow the Yellow Brick Road" playing in my head.

The doorman to room number 6 directed me to sit in the waiting room nearby. "Here comes the waiting," I thought and started to send a text message to A. since she lives nearby.

Before I could finish it the doorman was calling out my name. Incidentally, "Alison" is a man's name here in Brazil, so everyone is a bit confused when I respond to it (such as the lady in the shoe store when I presented her with my credit card. "But you can't be Alison?" she said reading the name on it).

Inside, room number 6, I was asked simple questions about why I was there and what had occurred.

"Where are you from?" asked the doctor after finishing the medical questions.

"The United States."

"And how long have you been here?"

"Two weeks just about."

"Wow, you speak such good Portuguese."

I didn't mention that I'd studied the language for about 2 years, so I better speak decent Portuguese. I like to bask in the lie that I could have picked up all this Portuguese in 14 days time.

Then I was directed to another waiting area. This one was filled with unhappy looking people. There was one woman who could barely sit and was moaning in pain.

A few minutes later a nurse/doctor motioned for me. "We're going to do an injection," she said and directed me to the other side of the room, past sick people in hospital beds, to a small space behind a curtain.

She pulled out a needle.

"Where?" I said.

She smiled. "Your bunda [bottom]."

I winced considerably because it felt that the needle would never end.

"Hurts, doesn't it?" she said kindly (if that's possible).

"Yup!" I agreed.

She motioned for me to go sit back down.

The moaning lady was still there across from me, half in her seat, half out. 

Then the first doctor spoke to me again. She said that if the shot hadn't been enough that I should go pick up a prescription that she'd written on my form.

"Tomorrow morning," she said emphatically, "Not any sooner."

"Okay" I agreed. 

The doorman asked me if I was ready for the liberação (liberation). I laughed and said yes - I felt ready for liberation - and he opened the door for me.

Oops, he wasn't joking. Literally, I had to go to a window marked "Liberação" to give them my medical form and sign out.

No money charged.

Wow.

I looked at my watch and all of this had transpired in approximately 20 minutes.

Wow.

Now of course, I should preface this by saying that I've heard stories that not all visits to the pronto socorro are so easy. However, this experience is a far cry from what would have happened had I shown up in an emergency room in the United States with an allergic reaction to a bug bite.

Truth is, I wouldn't have gone in the first place.

And good news too! Today the rash has subsided quite a bit.

Woo hoo for painful shots in the bottom!