I waited 57 years to experience an illness severe enough to land me in the hospital. That’s living a pretty lucky life, to be certain. And when I recently did spend a very long 24-hours in a local hospital, it was an eye-opening experience on many levels. I expected something between squeaky-clean American and my idea of what a Mexican hospital might be like. As one can likely guess, the truth lies somewhere in-between.
I had been suffering lower abdomen pain for a week that had at first been misdiagnosed as an infection by a private doctor. When the infection did not “clear up” and the pain progressively became worse, I decided to head to my local IMSS office in Merida Centro to see what might be done. I have a National Healthcare card and pay annually for the right to be on the Mexican healthcare system, but I had never used it before. This would be a good test.
From the moment you enter the clinic on Calle 64 it is evident the departments are run with a clear mandate, very organized, and well-staffed. The building may not evoke the clean lines and antiseptic feel of U.S. healthcare facilities with their concrete, tile, and Formica surfaces, but if I had any trepidations about placing my life in the hands of the medical personnel there because of it, it was due to my own prejudices.
I began at the information desk, where a young woman helped me to begin wading through the many steps it would take to receive help (it is a bureaucracy, after all). She pointed me upstairs to “Urgencia”, or Urgent Care. When this stupid gringo couldn’t understand exactly where to go, a security guard walked me up the stairs to the correct department.
In Urgencia I handed the receptionist a printout of my problem I had translated into Spanish; I figured I was going to have to tell the story of the past week to many people, and in my pained state I thought it best to be clear and concise and not “uh” my way through my history, trying to string my broken Spanish into coherent sentences. When you feel like someone has a grip on your lower abdomen and is twisting and pulling for all they’re worth, you don’t want to screw around.
The woman input my data into the computer, then told me to take a seat and wait for the next medical practitioner. “Oh great”, I thought. “How long is THIS going to take?”
I could barely sit, and standing brought even less relief, so I was up and down, one second sitting in a splayed out position, the next walking back and forth in front of the four chairs provided for patients in my continual search for a position that would provide some comfort. There was no such position to be found.
In about 10 minutes (it seemed like an hour) the doors opened and I was ushered into the exam room. A male nurse took my blood pressure, checked my heart rate, and then pressed on my abdomen in several places to discern where was my pain. He input all the data into the computer on his desk and told me I needed to go to the hospital. Yeah, I kinda knew that, but was pretty relieved someone agreed with me. They sent me to the Administrative office to get a form approved that would admit me to the hospital. To the woman in Administration I must have looked like I was hopped up on some kind of drugs, what with the way I could not stand straight, or still, for even one second. I was also sweating profusely, which only heightened the effect. But she stamped my papers and I hit the street, grabbed a taxi, and headed for Benito Juarez Hospital on Avenida Colon. I had walked past the hospital a number of times, and the front of the Emergencia/Urgencia entrance was always teeming with people. I always wondered why they were outside instead of waiting inside.
From this point it all got really, really interesting. I suppose most Americans would be kind of shocked at the conditions inside the hospital; we have such an antiseptic point of view about how things should be in a hospital. But I had given up my “cushy” American life for life in Mexico, and I was determined to experience life here as the locals do. Besides, what choice did I have?
I approached the Urgent Care doors and noticed that no one was getting in without some type of form. I later learned it was because there are set visiting hours, even in emergency, so if you were not accompanying a patient at intake or helping them home after checking out, they figured you had no business being inside. And from the conditions I would soon see inside the hospital, I have to agree with that point of view.
From the entrance door I looked to my left and saw there was a waiting room with an information desk, so I proceeded there. I showed the woman at the desk my form and she pointed me to a window just at the door, which I hadn’t noticed when I entered. Another woman at the intake window took my form and stamped it, then motioned me to enter Urgent Care. I approached the door just as the security guard walked away for a moment. Upon seeing me standing there, a little girl, no more than 7, ran to the door and locked it. No gringos here! A few moments later the security guard returned, having seen the girl lock the door, and unlocked it, giving her a grimace as he did so. I wanted to stick my tongue out at her as I walked passed, but my illness, not my maturity, kept me from it.
I showed the guard my documents and he ushered me inside and to the left. I walked down a hallway and found a small room maybe 20 by 30 feet, with a tiny office just off the end of the hall. The room was packed with people. There were, maybe, a dozen gurneys with sick folk, one gurney shoved against the wall in the hallway with a man awaiting admission, perhaps another 30 people seated in chairs, and doctors and nurses running around, trying to take care of the crowd.
I was guided to a seat in the tiny office to await my admission. I held on to my papers until I noticed others placing their papers at the bottom of a stack on the counter. That’s when I figured I better place mine there, as well, if I wanted help.
The tiny office was no larger than 6 by 10 feet. There were four seats for incoming patients, two dirty, rusting shelving units on the floor with paper towels and medicines, and space for two more chairs, which were occupied by two doctors typing. That’s right. The doctors were typing their notes onto hospital forms using ancient portable typewriters. There were probably four typewriters floating around that office, so I figured that if you wanted to type your notes you had to bring your own typewriter. It was fascinating to see the doctors peck on the typewriters, spending at least 20 minutes on each sheet. I was both amazed and kinda horrified they did not have a computer system to enter their notes. (Well, they do, but that comes later.) All this typing finally answered my wondering how a typewriter repair shop I had recently passed stayed in business – it’s the medical profession! It also brought up other queries: If they still used typewriters for keeping documents, what might I expect in terms of medical care? Bloodletting? Leeches? Lobotomy?
The noise and seeming confusion in the room was a little off-putting. But I figured I would not be in this waiting area long and just needed to hang in there to get admitted to a room.
After about 15 minutes a woman came to the office and called out my name. I waved to her and followed her to her examining office. She read my notes and did a little pounding on my abdomen, then said she thought I had a kidney stone, but that they needed to complete some tests before they would know for certain. She gave me a hospital gown to put on and showed me to the men’s bathroom.
Now, let me say that in the two years I have lived in Mexico I have grown accustomed to a great many things that are different from what I am used to in the U.S. Bathrooms are one of them. Whenever I use a bathroom out in public it can range from neat and tidy, if old and worn out, to downright filthy. This hospital bathroom was the latter. There was a toilet with no seat and a shower stall. The shower was a lake of pee, and the toilet was full of blood. It did not flush. This is when it began to hit me that things might be different, here. There was a working sink, but no soap and nothing to dry the hands.
I put on the gown, and made certain my clothes did not touch anything in that bathroom. Thanks to removing one piece of clothing at a time with one hand and holding onto them in the other, I now have a new skill: I can put on a hospital gown and even tie it shut in the back with just one hand. (At least, I HOPE it was closed in the back. I wonder if that was what all the snickering was about out in the hallway.) Only 45 minutes later I was heading back to the waiting room office.
A nurse ushered me into the main waiting room where were all the other people waiting for medical care and told me to take a seat. I took one of the last remaining seats – one of four blue plastic chairs all attached to a metal frame. I wondered how long I might have to wait for a room.
About 25 minutes later a nurse came to my chair, pushing a cart of medical supplies. She was going to hook me up to an IV drip, just as every single person in the room had already been. After a few failures finding my veins – my mother and I both have notoriously difficult veins to stick – she finally found success on the top of my right hand. She took some blood for testing and then hooked me up to the IV drip. I would not be off that IV drip for the next 24 hours, right up to the last five minutes of my stay.
The nurse then gave me a sample jar and told me to go to the bathroom to give her a urine sample. Oh, no…that bathroom again…and so soon! For the first time in my life I actually preferred to pee in a jar rather than a toilet. I contemplated doing it right there in the hallway, but then figured this was not the best time to also check out the Mexican penal system. They also took me to X-Ray for a picture of my abdomen, but it proved to be of no help.
Back in the waiting room I waited for my tests to come back. I surmised I would not get a room until the tests came back with some information to warrant giving me a room. When might that be, I could only wonder. As I waited I began to look around the room. There were spaces for 6 gurneys. There were 12 in the room. There were also 36 seats stuffed in that space, and all were filled with patients. It didn’t seem any were going anywhere, and that’s when it hit me: I wasn’t waiting for a room – THIS was my room. This was an urgent care facility and you sit in a chair, if you can, or lie on a gurney, if one is available. We were all receiving our treatments right in this room.
During the next rounds the doctors confirmed I had two kidney stones and that I would have to stay in Urgencia until they passed. The good news is that all my other blood and urine levels were good, so all they needed to do was to dissolve those pesky little jagged edge stones that were wreaking havoc with my kidney. But how long would that take? I could only guess.
After accepting the fact that this was how it was going to be, I began to loosen up and see the positive side. Because about 40 patients could be cared for in the same room, things were much more efficient. The nurses and doctors were always in the room, so you never had to do more than raise your hand if you needed anything.
About 8 hours into my stay, my butt began hurting and I would stand, periodically, to try to restore blood flow to my nether regions. (Two weeks later I am still trying to massage some life back into my left butt-cheek.) Then they moved me to a chair in the back of the room. This chair was different. It was metal, with a metal seat that had many holes punched into it. It was like a seat you might have out of doors; the holes allow rain to flow through. But why was this needed in a hospital, in urgent care? Lucky me, I was about to find out.
The seat next to me was empty, for a few moments. About 20 minutes after I was moved, the nurses brought in a woman of, maybe, 75 years old. She was in bad shape. She could barely walk and when they sat her in the chair next to me, she did not leave it until she was moved to a gurney that finally opened up. But before that I learned why this Urgent Care method may not go over too well in the U.S. The woman in the next chair needed to go to the bathroom. But as I said, she could barely walk. So the nurses lifted her up and placed an absorbent pad on her seat. They then place a bedpan on the floor directly under her seat. Oh, God, no, no, no! Tell me this is not going to be what I think it is. You guessed it, she let loose and the overflow went through the holes in the seat bottom and I’m certain at least some of it actually went into the bedpan. I just closed my eyes, turned to my left, and envisioned fields of sunflowers and children running through. But I was brought back to reality when I heard the splash of liquid hitting the floor. Do I continue this charade and pretend I don’t notice the horror show going on six inches to my right, or do I grab my IV and make a run for it, hoping the two stones would eventually pass on their own?
It would be hours before anyone moved a mop under that seat. And when the woman moved to her gurney, in came the next patient to sit in that chair before anyone had a chance to clean it. That’s when I stood to look at my own seat bottom and wondered what might have taken place before I sat there.
The next few hours I began to take mental notes of the situation. It was not my favorite situation, to be certain, but I was also immensely interested in the way this hospital was operated.
To my left was a small corner of the room that was curtained off. Inside were bedpans and urine pitchers, all waiting to be emptied and cleaned. This is also where they placed any patient sick at their stomach. Apparently they just vomited on the floor. I could tell when just a few split seconds after hearing a woman in that corner of the room wretch, there followed the plop plop sounds of what in my mind resembled thick potato soup hitting the floor. And to top it off, this is also the room where the food was brought and dispersed from. I just told the attendant I wasn’t hungry.
To my left was a sink that seemed to be used exclusively for emptying leftover IV drip bags. Problem was, the sink leaked and the bags’ contents flowed under and behind my chair. I had to play tag with my backpack and keep moving it around to avoid the spill. It was a thick, syrupy-like concoction, and it dried up before it was mopped up.
The gurneys were old, the wheels rusted. The medicine cart the nurses used was begging for a cleaning. The walls were beat up and in need of repairs, and at least two of the overhead lights were not functioning. One was barely hanging from the ceiling; I thought any minute that light would be adding to the suffering of the poor woman on the gurney under it. And all the while you could hear the constant sound of those portable typewriters pecking, pecking, pecking.
I began to think I might turn 58 sitting in that chair, with little old ladies peeing in their seats, people on gurneys constantly moaning and crying, and me all the while pounding on my left butt-cheek to try to force some blood flow down there. Even Stephen King could not envision this.
I did not sleep that night. I have never been one to sleep sitting in a chair, and this was not the time to try to change my ways.
By about 4:00 AM I was feeling no pain. I surmised there was also a pain killer in my IV drip. At 8:00 I was taken to have a sonogram of my abdomen. A man came with a wheelchair to push me there. I protested that I could walk, but he would have none of it. And when he dropped me off in the sonogram room, he told me to wait for him after I was done.
The sonogram took only five minutes, and I was back in my semi-private room shortly thereafter. About an hour later, several doctors arrived and made the rounds to each of the chairs or gurneys to consult about and with each patient. When they came to me they said the sonogram indicated I had passed the stones and could go home. Yea! I got up to go change into my street clothes, but the doctor said it would be a few minutes; a nurse had to type my case notes into the one computer that was available to them. So that was it – they typed their original notes on a typewriter, then someone input all those notes into the main computer system. I guess it saves time from having to read to the nurse what they had written in their stereotypically bad doctors’ penmanship.
Two hours later I had the okay to go home. The nurses asked who was there to pick me up. When I said no one and that I would go home alone, they said that was a problem. They began discussing what to do when I said I could call someone to come pick me up. They said it had to be a family member, to which I responded, “no problemo” (Rosetta Stone, YES!). So I called Steve and told him he better run to the hospital as fast as he could to get me out of there. He took a cab and was there in 10 minutes. Only then was I taken off the IV drip. I returned to my bathroom oasis to change clothes while Steve went to the checkout window and got my meds and off we went.
All in all, it was quite the experience. And all in all I felt I actually received excellent care. They competently diagnosed my problem and eradicated it in 24 hours. What more could I ask?
Well, maybe a shower.