In the Slammer!

(Written May 11, sixth day in Brazil.)

Well, coming to Brazil I really didn’t expect to have an intimate look into the Brazilian healthcare system, but alas, here I am, in the slammer, otherwise known as the hospital!

It all started on Saturday night, quite suddenly, when I developed terrible diarrhea and cramps in my abdomen. I quickly became dehydrated and was hurting all over. I couldn’t really sleep because I had to go the bathroom every 20 minutes or so. I developed a fever in the middle of the night, and experienced severe chills and my typical delirious dreams. On Sunday, I was supposed to go to church at Itapagipe Presbyterian. Of course, I was so sick, I just left a note for Marlene and Serio explaining that I just wanted to stay in bed. However, one of the ITEBA professors, Tania, has a day job as the secretary to the Minister of Health, and insisted that I go to the doctor. I obliged, since she was willing to go with me.

We caught a bus for a ten minute ride to what turned out to be a hospital. (Of course, if I had thought about it, I would have realized it had to be a hospital, because it was Sunday, and I could only be seen in an emergency room.) This was a public hospital, which I suppose is what almost every “typical” Brazilian uses. In other words, it’s not a pleasant doctor’s office, but rather resembles what most urban hospital emergency rooms in the U.S. look like—dirty, chaotic, crowded. Tania spoke very briefly with the receptionist and just walked back into the examination area. A few minutes later she came back and out sat with me for just a few minutes before a nice lady came out and asked me to come back. I felt bad because I was skipping over about thirty people who obviously had been waiting a long time.

They took me into what looked like the “receiving” room when getting outpatient surgery. The woman was seated behind a desk and asked me questions about my symptoms and general health. She took my blood pressure and pulse and wrote all this information down. At that point I thought I’d be seen by a doctor in the examination room. We went into the examination area, which was incredibly chaotic. It had 6 beds divided by curtains and was very small. One guy was lying on a table getting oxygen. A kid on the other side had an i.v. drip, but he seemed fine otherwise. There were a couple of young kids/babies who were wrapped up in blankets. There was no exam table for me to use, so I just sat in a chair. After a few minutes, Tania said that we should just wait outside, because I was going to be referred to another place for my tests. Little did I know that I was now on their radar as a suspected swine flu case.

Although I shouldn’t have been, I was astonished at the general appearance of this hospital. Being in a tropical climate, there was a lot of rust on anything made of metal – tables, chairs, doors. The bathroom in the waiting room didn’t lock because the latch was broken. There was no soap in the bathroom. The sinks only ran cold water. Outside, there were just about as many people waiting as inside. A couple of upholstered chairs had been dragged outside, and obviously had been sitting there for a while, because they were soaked from the rain. We sat in them anyway, because otherwise we would have had to sit on the concrete curb or in the waiting room where the smell wasn’t so good. I guess it was the little things, too, that caught my attention. Orderlies came and went through various swinging doors. Everyone seemed to have the run of the place. At one point, a little girl went looking for her mommy and walked right through into another corridor of the hospital. The mother had to run after her.

I sat and waited, sometimes outside, sometimes inside, until I was to be picked up. It took about an hour and a half until a ride came along. I thought it would be Sergio to take me to another hospital facility to have tests done. I (mistakenly?) misunderstood Tania to say that it would take only 20-30 minutes to get the tests, and that would be that. When the ride came, it was Marlene in a car with three other adults and one child, none of whom I knew. The car was about the size of a Civic, but we managed to cram myself and Tania in with the others. Images of clowns in tiny cars came to mind. We went back to the Casa, where I was happy to lie down after sitting in the heat at the hospital. Did I mention, there was no air conditioning at the hospital? This was another startling difference. They had windows open everywhere. Environmental cleanliness seemed not to be much of a consideration. Yet, with our hermetically sealed hospitals and clinics in the U.S., we still seem to have a worse problem with staff infections and such in hospitals. Maybe there’s something to be said for fresh outside air.

Again, I misunderstood Tania to say (perhaps—or perhaps she was just telling me what she thought was going to happen) that I wouldn’t have the tests until the next day. She attended to me sweetly, patting my hand and rubbing my head. By this time, I was feeling much better, although weak because of dehydration and not eating anything all day. At about 6:30, after it was already dark, she came to get me to go for the tests, which, of course, I was surprised about. You can imagine my surprise when I found an ambulance in the parking lot waiting to take me to the hospital! Marlene and Tanya both came with me. While sitting in the back of the ambulance, the EMT immediately gave us all surgical masks to wear. She took my blood pressure again, and took my temperature. Again, an interesting difference.—they still use mercury thermometers, and take the temperature in the armpit.

We arrive at a hospital downtown (I have no idea where it is actually) and were escorted through what seemed to be an empty building. To tell the truth, my first impression was of a prison, because the waiting room at the emergency entrance was open to the outside with bars instead of windows. We took a (small) elevator to the fourth floor. The door to the room I was supposed to enter was locked, so the person had to go looking for a key. She found a key to the room next door, which turned out to be the anteroom to the room I am in now—a private (read: quarantined) room. More b.p. checks. More temperature checks. A doctor (male) came and listened to my chest and heart. He said I would have to be here a while, and I again misunderstood (?) how long. I thought perhaps the tests would take a while because it was nighttime on a Sunday holiday. During the course of the next few hours, I was first hooked up to an i.v. drip, which I was happy to have for rehydration. The only problem was that the i.v. pole is made of steel and doesn’t have wheels, so going to the bathroom is a weightlifting exercise. A young fellow then came in with a portable x-ray machine that looked like something out of the 1950s. It was rusty and cumbersome, made all of steel. He took one x-ray with me in bed, which, by the way, is REALLY uncomfortable. (I just have to keep reminding myself that I slept on logs while hiking the Appy Trail ☺) I wondered what kind of picture he would get, with the film being between me and an uneven mattress. He left for a while (20-30 minutes) then came back with another film. Perhaps the first one didn’t take? Anyway, he made a few small adjustments to the machine and took another x-ray. An hour later, a fellow came in to do swabs. He swabbed both nostrils (which really hurt!) and my throat twice (which made me gag). All this time, Marlene and Tanya were waiting in the other room, where nurses were sitting, as if guarding me. They had taken my passport earlier, and I wondered if it was because they didn’t want me to try and escape ☺

Finally came the real news. I would have to stay here for 48 or more hours under observation. Groan!! Tania kept trying to keep me from worrying, saying I could use the time to study Portuguese. In fact, except, for the mattress, it is more comfortable here than at the Casa, because I have a TV and an air conditioner. But the bed has no pillow, and I have one sheet. No toothbrush. No towel. I asked about those, and they said I should use my cell phone to call and ask for them to bring me mine. In fact, I didn’t have a cell phone, but Marlene had already gone to the Casa to get my medicines and cell phone in anticipation of my imprisonment here.

I watched Snakes on a Plane dubbed in Portuguese.

I perused my dictionary and lamented the fact that I can’t seem to understand anyone’s speech.

They brought me a bun, banana, and some coffee. I ate the banana.

I went to sleep around midnight, feeling better than I had all day.

This morning, Marlene sent a bag with my toothbrush, a towel, a book, a pencil, and my computer. Yay! I’m now in hour number 23, and haven’t gone crazy yet. The view from the balcony (which I can’t access because there are bars on the door!) is lovely. I’ll have to continue the story, talking about today, tomorrow. My battery is running low. I hope Marlene remembers to send my power cord.