Picking up where I left off yesterday is hard. There is such a mix of things I want to say: my feelings about being here; my observations of the place, the people, and the process; my thoughts on Brazilian television; my frustration with my memory and the language. I guess I’ll proceed in that order.
There’s no doubt that I am locked up. I have a “guard” who is a nurse in the ante-room all the time. Of course, he or she is always at my disposal if I need anything, and they are incredibly friendly, but nevertheless, they won’t let me leave. It’s hard for me to be out of touch with family and friends, although Jennifer called last night, so at least I know that they know how to get in touch with me. Tanya, Fabricio, Marlene, Sergio e Ana, and Marilene each called and are worried about how I feel being locked up in the hospital. I think they must expect me to be more distressed than I actually am. I do have moments when I feel quite frustrated, and sometimes a little bit scared in case the doctors or nurses get something wrong, or misplace my tests, or just decide to let me rot in here. Since I have been misled (scratch that, since I have misunderstood) so many times during this little adventure, I sometimes wonder if the realities of Brazilian red tape will strangle me. But those moments are few and far between. Since I’m really a loner, being cooped up in here really isn’t all that different from what I experience normally, except that I don’t have the distractions I would have if I were at home. I guess I worry most about what others are feeling for me. I would like to say to them that this experience is going to be worth thousands of tellings over the years and will allow me to feel like a superman to those uninitiated into the perils of foreign travel. Of course, you all know how much fun I’ve gotten over the years retelling my stories from my trip around the world. Not to mention that I might be able to get a lecture to the pre-health society out of it. Another way I’m trying to deal with it emotionally is to imagine that God made this happen so I would be sequestered and forced to study language harder. If I had stayed at the Casa, I would have spoken mostly English over the past few days with the group from Yale, and what good would that have done me? George always likes to say that “god always gets you back.” Well, in my case, “God always gives dentention to those who haven’t done their homework!”
My observations are best made in the form of a list. My format will be to list first the things that I see that seem different (and perhaps wrong) around me, things we take for granted in the U.S. health care system. Next I will list those things that make this place sufficient for its purpose, and perhaps even better than what we have at home.
So-called “deficiencies”:
• Open electrical boxes and exposed wiring.
• Rust stains all over the floor from the steel equipment/furniture.
• A plywood bed with a piece of plastic as a mattress (it has a little foam inside, but collapses and doesn’t support the body.
• A flat, short, metal bed with no pillow and no way to sit up except against the hard metal head rail.
• A cardboard box (albeit clearly marked) for hazardous wastes.
• A door that will not shut all the way.
• “French” door to a balcony that will not shut all the way.
• An air conditioner (which I love!) above that door which has about a six inch gap on three sides with no insulation. It drips water on the floor in the room, and they insist I keep one side of the door open so it doesn’t get too cold in the room. I guess the temperature controls can’t be adjusted.
• The door to the balcony opens to another door of steel bars, which more than anything make this place feel like a prison.
• The only light is overhead fluorescent. I have to get out of bed to turn it off.
• Standing water on the balcony. I don’t know if mosquitoes can reach up to the fourth floor to breed, but since I’m in a ward devoted to the treatment of infectious diseases (there were posters warning about dengue fever all down the hallway), it is ironic nonetheless.
• No baseboard molding. Tile walls meet a linoleum floor. The crack between seems like it would be a breeding ground, as water is regularly swished around the room with a mop and from the air conditioner.
• This morning, my nurse asked me for some basic information—parent’s names, birthdate, home state, etc., which he wrote on a napkin with my pencil and, presumably, took to a bookkeeper somewhere.
• They don’t use iodine for sterilization. My i.v. needle was inserted after only a few swishes with alcohol.
• When they took away the drip, leaving the i.v. in my hand, the nurse used a syringe on the tube, then set it down on the bed next to my leg while she did something else. It was at least a one-use syringe and ultimately went in the cardboard box.
• The drip was sometimes fast and sometimes slow. After a while I started controlling it myself so I wouldn’t have to pee so much.
• There’s no tray table for food, and the food is brought either on flimsy styrophone plates, in a plastic bag, or in an aluminum tv tray. I have to eat in bed because…
• There is no chair!!!
• The bathroom is between my room and the anteroom. The toilet is next to a space where there is a showerhead and a (broken) drain in the floor. (I’ve never seen a floor drain in Brazil that wasn’t broken. They’re all made out of plastic! For a country that exports the most aluminum of any country in the world, except perhaps Australia, Brazil sure doesn’t seem inclined to use it.)
• No place for the toilet paper except on top of the paper towel dispenser, which is directly under the shower. It didn’t matter, because I didn’t get toilet paper until the second day anyway.
• No hot water anywhere. There is an “on demand” water heater on the shower head, a typical method for providing tepid water in “winter.” The wires to the device (remember this is ON the showerhead) are exposed.
• No place to hang clothes or towels. (I did receive a towel on the second day, along with a gown that would have worked for someone half my size and half my height.)
• The cleaning products—a bucket and a wooden T with a rag that serves as a mop—are kept in the bathroom below the sink.
• If I need a nurse, I have to knock or yell. There is no call button.
The “good stuff”:
• I have air-conditioning and a TV, neither of which I have in my room at the Casa.
• There are sanitary soap dispensers in both my room and in the bathroom.
• There is a sanitary paper towel dispenser in both the bathroom and in my room. (No trash can in the bathroom though. I’ve been flushing my paper.)
• They check on me every three hours or so, but are very nice to let me sleep in within reason. Each time the nurse comes in, they are very friendly. By the way, I have two male nurses and two female nurses on different shifts. They always check my blood pressure, take my temperature, and let me know the results. They always make sure I have plenty of liquids (bottled water and CocoMania coconut water which is used as a natural way to stop diarrhea). Also, I get lots of delicious fruit smoothies and juices of various sorts, which, unlike in the U.S., aren’t sweetened with anything—just juice, just fruit.
• A healthy and substantial lunch of chicken (awfully dry, though), rice, mashed potatoes, and veggies. Dinner is a bun and a piece of chicken. Breakfast is a toasted bun and a little container of jam, juice, and yogurt. I get bananas and water every time they check on me.
• The TV is on a cart, so since there is no remote and no cable, I can adjust the rabbit ears and change channels and volume easily enough from bed.
• Doctors and nurses alike are very sympathetic to my situation, and are encouraging.
• NUMBER ONE GOOD THING: All this is costing me nothing!
As a non-professional in the medical field, I am curious as to what American health experts would say about the lists above. Which items are really bad, which are innocuous, and which are improvements over our own health system? Clearly, because the Brazilian system is a public system, they don’t have the money for niceties like lounge chairs and remote controls. But is it really worth the crazy health insurance system we have in our country just to have a few niceties? Of course, some of the “bad” things above may reflect poor training of nurses and a lack of oversight (e.g., electrical/building/health code enforcement), but perhaps our preoccupation with these kinds of things are simply a result of the U.S. being such a litigious society. There is a remarkable absence of attorneys in Brazil as far as I can tell. I have seen only ONE law office as I’ve been riding around town. Obviously there are more than that, but where? I can only presume that there aren’t hoards of university graduates hoping to get into civil litigation because no one is inclined to sue over things like open electrical boxes or the absence of a pillow. This has really made me think a lot about the value of a public health system versus a private health system, and I’m not sure how I would come down on the issue. I’ll have to think about it some more.
Brazilian TV…what can I say. It is remarkably free of irony and seems extremely earnest. There is an abundance of news, religious programming, and issue-based interview talk shows (more like McNeil-Lehrer or Charlie Rose than Oprah). The religious programming is either straight-and-narrow Catholic dogma or megachurch “enterpreachment” or “preachotainment”. One program was almost like a religious stand-up comic. Most of the mega-church programs, one of which comes out of Ilheus of Jorge Amado fame, include a portion where healing is performed. The news is not as sensational as it is in the U.S. In other words, it still seems to be trying to report, not to sway or influence. The format is similar, with top stories such as the flu (which included me, although not by name!!), damage from the rains, interviews with politicians and government officials, reports of crimes, weather, and sports. An interesting item I’ve seen on two news programs is a listing of job openings around the city such as receptionists and other low-level professional jobs. If I were to total the number of jobs listed on TV, it would probably amount to 20-25 positions. This, of course, is an absurdly low number in a city that has an overall unemployment rate of, I would guess, between 25 and 50%. Just like in America, commercials are loud and annoying. They aren’t as sophisticated in terms of production and design. In other words, they still focus on the products themselves. Lots of the products being advertised on TV are for items that the vast majority of people could not afford, such as big screen TVs, fancy bathroom fixtures, etc. There are a lot more public service announcements on Brazilian TV than in America, and lots of focus on what’s coming up in the world of the arts. There’s no doubt that “high art” (modern dance, drama, symphonic music) are readily available here in Salvador, but I haven’t figured out where to see them. I am torn between wanting to see this stuff, which I would do for my own entertainment, and focusing on the “people’s art” (samba, arrocha, copoeira, etc.) which I need to do for my career. The final word on Brazilian TV—last night I watched American Pie 5 with Portuguese closed captions (all profanity dubbed with the word "drugs!) It was impossible to even follow their talking even with the words right there on the screen. Which leads me to…
…my continuing frustration with language. I wish I had started keeping track of how many times I look up certain words. I would say that probably some words I’ve had to look up 100 times since the year 2002 when I first started attempting to learn Portuguese. Even when I’ve JUST looked at a word in my flashcard program, used it in a sentence, tried it out in different contexts imagining that I’m talking to friends, I can STILL forget it within a period of five minutes. As I’ve said before, speaking can be done more or less easily because one can make oneself understood with a 500 word vocabulary. But listening and understanding is still SOOOO hard, and I really despair sometimes of ever really being able to do it.
Finally, a word about how I’ve been passing my time. It is really interesting that, despite having NOTHING ELSE TO DO, I still feel like I don’t accomplish as much in a day as I would like, whether in terms of writing, studying, or reading. What does this say about me? I guess I’d have to admit that the problem is NOT that there are too few hours in the day, but rather that I have unrealistic expectations of what I can accomplish in a day. I’m a strange person in that I LOVE to laze around (in Portuguese: preguiço), but don’t allow myself to place value on simple relaxation.
So, into a third day of imprisonment. Before I leave, I need to learn the name of this place, so I can mark it on Google Maps as my home for three days.
(Found it!)
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