I’m taking another stab at healthcare here, no pun intended.

Well after complaining about the questionable care I received on multiple occasions here, I spoke with several Spaniards who carry private insurance in addition to their public health benefits. I was told to go to another health center; one that is very large and with a better history of decent care.

But do they wear name tags? I said sarcastically to one of my Spanish friends. They said they didn’t know for sure.  Now if I asked an American, they could spit out an answer in a second as we are used to name badges on all medical personnel.  Identifying oneself verbally and with a badge so you know you’re not talking to the cleaning lady is mandatory. Are they open during siesta time? I asked. My Spanish friends rolled their eyes at me. Just kidding I piped…

After the debacle with several visits to the previous unnamed private health/hospital center, I decided ok I’ll try again plus I’m almost out of my Enbrel, the very expensive shots for Rheumatoid arthritis. I need a Spanish script for the local pharmacy to order it.

So, I go online to the new health center everyone said to go to. Surprisingly it had a very easy web page to navigate. And interestingly, it offered online consults by video, chat or phone for anything even if you have NEVER been there before. Really? I heard this was true across Spain but was not sure. In the states video and telephone calls are only for previously established patients except for some “online only” doctors that you pay for very generic information as it’s a business.

Anyway, I made an appointment for a face-to-face visit with an internist to follow up on my kidney infection from last month that had been treated by the other place.

We drove there and it’s one building with the hospital attached. About 72 beds (I looked it up). Small by standards in most large cities in the US but modern outside. But then again, I’ve been in modern before, if the staff suck, all the shiny equipment in the world won’t help.

Inside was an immaculate lobby, with soft white walls accented with the teal color. There was a large circular help desk like a clock in the middle with 12 people behind each glass window. Wow, that’s a lot of help desks I thought. I bet it empties at siesta time. Sorry, I’m being sarcastic.

Interestingly to my left, there was a huge wall poster with every private insurance they take at the top and what specialties are covered down each column. That was cool, as I never saw this in the US. But it’s a great idea. So I quickly checked if cosmetic dermatology was covered by my insurance. I need some Botox as my forehead wrinkles are getting worse from aggravation frowns.

Anyway there were signs in the lobby on where to go, (yea!)That was good, as on my last visit to an un-named hospital  I wandered for 20 minutes and no one would help me.

We go upstairs and check in again and the girl had a name tag, wow what a concept, things were looking up so far.

I then find out a mistake was made; the doctor (Dr) I was to see was not on my insurance. And it would be $125 today. Hmm, that was a snag. (Of course, in the US you wouldn’t have gotten this far. You can’t even get an appointment unless your insurance is pre-checked otherwise try $250-400 to see a specialist).

Then she said I could take another doctor if they had time, for $30. Only $30? Well ok. I hope that $30 doesn’t mean I’m getting someone on their first day out of medical school.

We sat down, with no pre-visit paperwork to fill out. Unlike in the US, there is basic medical history and medication form you must complete before seeing the nurse who then puts it all in a computer before you see the doctor(and she does your vitals too). Well, here as yall know you don’t see a nurse before a visit (that I’ve ever seen in over 10 visits)  but you might after depending on what the doc wants to be done.

It still bugs me a little that the dr won’t know my history before I enter. So I know I have to be concise in what I want as the Dr. will know nothing about me till I sit in front of her. That makes me a bit anxious, as I have a medical history that looks like a “train wreck.” I know what medical staff think when they see a mile-long list of medications and two pages of diagnoses; get some coffee, it’s gonna be a long visit…

How can I tell this new doc all that in one sitting? I can’t and I don’t know how to say train wreck in Spanish.

In five minutes, someone comes out calling my name, and said, “go to door number 34” I look down the hall and there were what looked like at least 20 light grain wood doors on both sides of a very long hallway with a few chairs outside each door. Outside each door was a sign; “box 10”, Box 5…etc. I wondered why they call it “box’ instead of a door.  Pick a number, any number, and get “a doc in a box,” I thought. What box is your doc in? I wanted to ask a lady sitting next to me. But I had no time to ask dumb questions.

I looked around, people were going in and out of the doors, and no one knocked on the boxes first. I wonder how many forget what number box they are to go to and barge in on a Dr giving someone a shot in the ass. Or what about a dyslexic reversing their box number? Or an elderly person with dementia who thinks one of those doors is the bathroom? That can’t be good.

So, I turn the silver knob and walk in already expecting to have a shitty experience as I have so many times before with medical care here. Yes, I have an attitude problem, I’m not looking for issues because issues always find me. So what’s behind door number34? Let’s see, I added 4+3= 7. Is seven a good number in numerology? Never mind, I’m grasping at straws for good luck.

There sits a thin white coated young female doctor at her desk with two chairs facing her. Her lab coat was crisp, not wrinkled like a previous doc I dealt with, and she smiles. Ok, I’m wondering is it a trick? I sit down and she speaks English. Score. I wanted to ask her about being a doc in the box. But she might not get it.

I notice her office is small with an exam table off to the right. No disposable medical paper on it so I’m guessing she doesn’t use it often. Her desk is neat and clean and organized. She introduced herself and yes, she had a badge, but it was turned and I couldn’t see her name. Ok. But since she smiles, has a badge, and looks clean and neat, I gave her 10 points and decide not to ask about the box jokes.

We talk, and I tell her my issues; recent covid with a kidney infection, had antibiotics, etc. and by the way, I have rheumatoid arthritis, Sjogren’s, and had ass cancer 9 years ago thanks to being married to an asshole. She didn’t catch the joke. Damn if I could just speak Spanish.

She types like lightning. Good thing cause I have more to say than she has time. I tell her I need a specialist as I need meds etc. and to make sure my kidneys are ok since the infection. But first, will I have to buy my own pee cup? Sorry I digress.

She explains normally they don’t do anything as follow up but since I’m special, i.e., code for “train wreck,” She ordered an abdominal and kidney ultrasound and some labs. Then made me a referral for a rheumatologist etc.  She printed the referral and orders and handed them to me and said to see the nurse in the hall.

Now, do you notice anything missing here?

Just like 9 out of 10 Dr and hospital visits, I’ve made; she didn’t get vitals on me or examine me at all.

That is still a pet peeve for me. How do you see a patient for the first time who will become your regular patient and take no vitals or examine them? Like one Dr. I asked many months ago, why don’t you take vitals? He said why? is something wrong with them?  Don’t get me started.

Ok I let it go, she was nice and smiled and I wasn’t having symptoms of a stroke. Besides I can take my own vitals. Maybe next time I’ll bring my own on a sticky note, better yet I’ll bring my own blood pressure cuff too.

Out the door, we go and there is a nurse (I think) behind a small desk in the middle of the hall. She was a pleasant busy appearing slightly portly Spanish woman with a white scrub top. She smiled and made the appointments. That’s three smiling people so far. That’s another 10 points.

My ultrasound (US)was the next day at 8:05 am.

It was the fastest ultrasound in history.

We arrive at 0745 and check in. I sit outside in front of doors number 1 and 2. I’m called, and the nurse leads me into a small dim room and has me get on a table next to the ultrasound machine that appeared very modern, which was good.  Unlike another un-named Dr. who had one that looked like a 30-year-old star trek-looking contraption with buttons and a condom-covered roller ball on a cord hanging off it.   Anyway, the bed had the disposable paper on it, and I was told to wait and have my shirt pulled up to expose my belly.

In walks a tall slender Spanish man easy on the eyes. He sits down and types in the machine.  He does not identify me. I say hola come estas? He looks startled that I talked. Maybe he thought I was a mannequin in there so he can train on my plastic belly?  He mumbled “ok” then immediately squirts the cold goop on my belly and starts the ultrasound saying nothing. He moved it over, up, and down, had me take a deep breath, then in two, maybe three minutes I’m done. He says “terminando” bye bye and walks out. I tear a piece of paper off the bed and wipe the goop off myself like a good self-serve patient.

I got up and looked at the machine. My medical report was still on the screen.  My name is at the top thank God, and all the photos of my US are right there. I look at them and see nothing abnormal. I was tempted to scroll closer to the photos and thought better of it. With my luck, some alarm would go off and someone would fly in and yell, “no! no senora!! Like a taxi guy did when I opened his trunk and got my own suitcase out. Apparently, that’s a big no-no. No wonder they call us ugly Americans.

So, I subtract 10 points on this visit. He never asked my name. Not identifying the patient bugs the shit out of me. And none of them do it here. SO FAR. But then I gave him back 5 points for being easy to look at.

Oh well, I wonder what box my next doc will be in.

I’ll let you know how it goes.

Somewhere in Spain