The Doctor Is In

Since coming to Spain in 2001, I’ve been fortunate to enjoy good health, the only problems being those typical of my age – a rise in cholesterol and a rise in blood pressure.  In spite of my overall good health, I’ve had to call for an ambulance three times.  The first was in Barcelona and the second two times were here.  In none of the cases did the problem turn out to be a serious one, and that first time it was in fact something quite mundane and frankly, too embarrassing to go into.

Last spring I went for a mammogram -- the first time in a couple of years.  I didn’t make the appointment for this exam.  I had received a letter in the mail telling me that from the age of 50 to age 69, all women should have a mamografia done every two years and that would I please be punctual and show up wearing clothing that was easy to remove and wear no deodorant or talcum powder.  My appointment was scheduled for Monday 4 April at 18:48.  This free service was brought to me (and all women aged 50-69) by The Program for the Detection of Breast Cancer of the Catalan Health Service, i.e., government-run health care.

On the appointed day I drove to the Hospital de Tortosa Verge de la Cinta in Eve’s car that she generously let me borrow, mine still being at the mechanic’s waiting to have the vroom, vroom problem repaired.  (Although it took months, that surging problem was finally repaired to the tune of 1500 euros.)  I arrived early which I always choose as the alternative to pushing it and possibly arriving late, even though with my Spanish driver’s license, I can probably speed a fair amount with impunity.  The Catalans are generous with their provision of free health care, but if you come late for an appointment and miss your turn, they sometimes make you go through the arrangements for making another one.  Anyway, it isn’t polite to be late.

Tortosa is not my favorite city.  Although the largest river in Spain runs through it, it has very little of any riverside amenities and overall is rather rundown and drab.  But it does have its points, which include a few renaissance and modernist buildings and what was a Moorish castle on an overlooking hill, now a (Spanish) government-run Parador.  The hospital sits on the next hill, and so from there, you have a lovely view of the tiled roofs of Tortosa and La Suda, the castle plus what remains of the old defense walls of the city.  On a clear day, you can see the whole valley across to the mountains of Els Ports.

I passed my health card at the sensor – all that is required to sign-in for appointments with doctors and technicians – and took a seat in the center of the x-ray waiting room, in one of several banks of individual seats.  I was followed in by two women, one who took a seat against the wall and the other who remained standing at the opposite wall.  The span between them was the width of the room, but neither that, nor the signs posted asking people to maintain silence, prevented them from pursuing their conversation at full volume, making it impossible for me to read the book I had brought with me.  “Maribel has died, did you know?” asked the one who was standing.  There was some animated conversation as to who Maribel might be, but when it finally became clear, the seated woman realized that no, she hadn’t known that Maribel had died.  And she was only about 60.  Smiling throughout their conversation (which I thought a bit odd, given the topic), when they had finished, the seated woman’s face fell into a frown.  With the frown came silence.  And soon after I was called in.

There is little or no room for modesty in Spanish medical offices.  You tend not to have a private place to remove your clothes, and sometimes you remain with nothing to cover yourself once you are disrobed.  Other times you are examined half dressed (or half undressed, depending on how you want to look at it) which is even more weird than being naked.  But this wasn’t my first time, and I’m getting used to it.  Or at least I know what to expect.  Besides, I was alone with the technician – a young woman – with the door to the waiting room locked.  So I took off my clothes from the waist up and then proceeded to stand there giving the technician my information, date of last mammogram, change of address, things like that.  The mammogram (there are actually four shots taken) took a very short time (and didn’t hurt), the technician checked to make sure the images were viable, and then told me I could get dressed and go.  They would send me a letter with the results.  I don’t know how long the whole thing took, but my appointment had been for 18:48 and I was outside walking on the street back to my car before 19:00.

This week I went for a gynecological exam/pap smear.  This exam was also in Tortosa but at the clinic below rather than the hospital above, and the clinic is so ugly it doesn’t warrant a photo.  They say you should have a pap smear every three years.  Here the examining room was separate from the doctor’s office, but they didn’t ask me to take off my clothes – just remove my underpants.  I was wearing a dress.  The nurse said just to hike it up.

The exam went the same as these always do, but with the addition of a sonogram at the end.  That was a surprise and I don’t know if they only do that for older women or if it is standard procedure; it wasn’t standard procedure all the other years of my life.

I thought since I was left wearing my dress and bra that the doctor was not going to do the breast exam, but he did.  The nurse wanted me to hike my dress even further up but I found it preferable to remove it.

This appointment had been scheduled for 9:45 am, and I had arrived a few minutes early, taking a book with me because when you go to see a specialist, you never know how long you might have to wait.  By 10 am I was dressed and walking on the street back to my car, albeit that my freshly ironed linen dress had become a crumpled mess from having been scrunched.

Neither this exam nor the mammogram, nor the three calls for the ambulance cost me anything.  I simply don’t understand why so many Americans react with panic when the idea of national health care comes up.  I think it’s super.

Any thoughts?  Leave a comment below!

Birding in Catalunya

Steve West has been interested in birds and birding since he was 7.  He visited the Spanish Pyrenees for the first time in 1983 with the University of East Anglia Bird Club, and came to live in Catalunya in 1988 to teach English and learn Spanish.  Eventually he turned his lifelong interest in birding into his profession and so, for over twenty years he has been writing books and leading birding tours.  His company is called Birding in Spain.  To do a tour, previous birding experience is not required: interest in good wines, cuisine, historical and cultural places of interest, monuments, or a visit to Barcelona will augment the experience nicely. 

Steve came to L’Ametlla a few years ago to give a talk on the local birds of the area to a group of non-birding English speakers.  His talk was a great hit.  So I asked him to provide some information on Birding in Spain for the blog and he sent me the following:

“Birding is one of the top growth outdoor activities in the United States, and has a long tradition in the UK. Birding in Spain is about birds, and different ones from those that can be seen in the UK or in many parts of Europe. There’s a lot to be said for birding in Spain, particularly this part of Spain, but it’s not just about the birds. There’s splendid scenery, good weather, longish winter days, good food and wine, and all in a very birder-friendly country.

“Flocks of Greater Flamingos, rare Audouin’s and Slender-billed Gulls, all the species of herons, egrets and terns that can be seen in Spain, the handsome Collared Pratincole and a great variety of breeding, wintering and passage shorebirds. Now, that’s not bad for any birder’s starters, and that’s just some of what can be seen in the Ebro Delta in a single day!

“If you start in this delta on the Catalan coast and then take a short drive inland to one of the nearby Mediterranean massifs, perhaps els Ports, or perhaps the Montsant range, then your already considerable bird list will grow even more. Tranquillity reigns in these scenic rocky havens for Mediterranean wildlife; a land of olive and almond groves, small farming villages and numerous streams and rivers that have worked through the rock to cut out a number of v-shaped gorges. Here you might see the Spanish Ibex, as well as an interesting variety of birds including Griffon and Egyptian Vultures, and Golden and Bonelli’s Eagles. Splashes of Mediterranean colour come with Bee-eaters, Golden Orioles and Hoopoes, all of which are relatively common.

“Now that you’ve ventured away from the coastline there are some very good reasons to go even further inland. The foremost of these is the steppeland around Lleida, on the western fringe of Catalonia, and quite unknown to most “normal” tourists. Informed birders come to these plains to set eyes on an exciting selection of steppeland birds, which are rare or non-existent in most other parts of Europe. Among these are larks, Little Bustards, Black-bellied and Pin-tailed Sandgrouse, Great Spotted Cuckoos, Rollers, and a long etcetera. Another bit of good news is that the good road network presents few impediments for making such plans.

“The northern edge of these plains are guarded by the imposing Pre-Pyrenees, sheer calcareous rock faces that reach up to 1,600 m in altitude and harbour enough new discoveries to warrant the birder’s undivided attention for at least a day.  Then if you really want to go the whole hog just continue northwards into the high Pyrenees, real alpine mountains with their own character and stamp, and very little to envy of the better-known Alps. These high mountain peaks, forested slopes and green valleys are home to some special birds like the Citril Finch, Black Woodpecker, Wallcreeper and Lammergeier, to name just a few.

If any of this interests you (or someone you know), check out Steve’s Birding in Spain website for information on tours and books as well as lots of photos and information on where to spot various species going out on your own.  You can also reach Steve by email at steve@birdinginspain.com or phone (34) 97 321 0757.

All photos by Steve West:

Flamingos and Mussel Beds in the Ebro Delta

Montsant

Aiguestortes National Park in the Catalan Pyrenees

Dangerous, Forbidden, Illegal

I watch the news, in part, to make some sense of the world but instead I become more bewildered.  On some level I don’t expect international news to make sense; war, natural disasters, and politics don’t.  But I do hope for coherence in the happenings closer to home and yet the local news is as full of nonsensical stories as the international and political.  Take a few stories from the local Catalan news of the last week:

To Fine or Not to Fine

Catalunya has many wonderful beaches, although to be honest, I don’t think the sand is as nice as the fine white stuff in California.  In fact, at many beaches the sand is imported!  (And since these sandy beaches aren’t natural, the sand washes away at the first big storm – usually once a year – obligating the local governments to spend good money buying more sand.  But that’s another story.)  However, the backdrops tend to be beautiful, often small cliffs and pine trees or small villages.  The water is bluish-green, and since it’s the Mediterranean, there are hardly any waves making a pitiful spectacle of the poor souls who try to surf those little ripples.

Nevertheless, danger lurks.  There might be riptides, boats, jellyfish, but the most likely danger comes from storms when all of a sudden there are waves and undertows.  To warn bathers of potential dangers and quality of the water, an assortment of flags are flown.  Blue marks the best conditions while red means do not enter.

A little further up the coast towards Barcelona, near Tarragona, there is a small municipality called Coma-Ruga where three bathers have died in the last three weeks – one each week.  All three entered the water where signs indicated it was prohibited to bathe.  At Coma-Ruga, much of the beach is safe, but there is a small section near the port that is dangerous and always off limits to bathers.

Unfortunately the people who died did not heed the warnings.  These are not the only deaths off the Catalan coast this summer, but it is unusual for so many to occur in one small place.  After the third death the city council held a meeting to discuss what to do about the problem.  In nearby Tarragona, someone imprudently bathing where there is a red flag can be fined 500 euros.  After all, when people go to bathe in unsafe waters, it also endangers the rescue people who have to go in after them.  The idea of a fine was discussed by the Coma-Ruga city council, but they decided against it.  The news report didn’t state why.  So it will continue, red flags, people will enter the water, accidents may happen, and rather than pay a fine of 500 euros, those who disobey may pay the ultimate fine.

Verboten!

What is definitely not permitted is selling on the street (or in flea markets) without a license.  There are a few poor souls who have been salvaging other people’s junk from trash cans and selling the items at flea markets for years in order to survive.  These are people who are down and out but who have done what they could to sustain themselves and not hurt anyone while doing so.

The City of Barcelona will not tolerate this kind of economic activity.  They have no license.  They are forbidden to sell and the police are out in force to ensure that they don’t get away with it.

Although I no longer live in Barcelona, I would prefer that the police devote themselves to other people: People who break laws that actually hurt or disturb others.  Like those who drink outside of bars, in the street, shouting and having a good time to the detriment of all those who live in the surrounding apartment buildings.  That was the main reason I moved out of Barcelona.  The laws were there to protect you, but no one enforced them.  Now they’re too busy persecuting penniless people who sell junk out of trash cans, and leave the noise-makers to carouse at will.

When I lived in Barcelona, I called the police once to complain about the noise.  I had to sign the complaint, even though what I was complaining about was illegal as the police could very well see (and hear) for themselves.  In fact, they had foot patrols, but noise infraction was apparently not one of the things they were charged with enforcing.

I signed once, but did I want to sign a second time and a third?  And probably a fourth and fifth, etc?  There are bars in Barcelona that have received hundreds of complaints and still function with no fine and no closure.  Some people don’t like it when you complain.  Your name and address go onto the form.  Revenge can happen.  You can have the law on your side and still lose.  No, I didn’t continue complaining.  I moved away.

Illegal Police Station

In Creixell, yet another small town on the southern Catalan coast, the city hall had a new police station built.  Unfortunately they ran short of money and never paid the final amount due to the builder.  No final payment, no signoff on the building permits.  No final signoff, no way to have the utility company hook them up.  So for the last few months, since it opened, the police station at Creixell has been hooked up to electricity by means of an electrical cable that runs from the station to the nearest street lamp.  No legal hookup, no electric bill!

Books: A Bygone Spain

If Spain interests you, three books come to mind that you may want to read.  All three are non-fiction, one is a history and the other two are memoirs that gently take you back to an earlier age.

The history is Barcelona by Robert Hughes.  I read this before my first visit to Barcelona and have reread it twice since.  Although I can remember what I ate in Seattle on a trip there with Uri in about 1972 (salmon grilled on alder wood – simple but unforgettable), I don’t tend to remember facts I read in history books.  But it doesn’t matter because I get the gist of it and that’s good enough for me.  In spite of my faulty memory, I have managed to remember many things from this interesting book.

Anyone wanting a background not only to the history of Barcelona but to the history of Catalunya is advised to read this book.  Hughes knows his subject well.  In fact, the book is used in a course on Catalan culture for English-speakers at the University of Barcelona in their summer program.  In it, among other topics, you will find a discourse on the caganer, the little figure found in most nativity scenes at Christmas who is squatting and shitting.  Apparently Catalan culture is full of scatology, however, for all the information Hughes presents, the origin of the caganer remains obscure.

The two memoirs are of a bygone era.  The first, Two Middle-Aged Ladies in Andalusia, by Penelope Chetwode was written in 1963 and tells the more recent tale of the two ladies, Mrs. Chetwode herself and La Marquesa, the mare she rode through the countryside of Andalusia in the early 1960s.  Mrs. Chetwode was enamored of Andalusia.  It seems that everyone she met treated her as the marquesa, instead of the horse.  Although she wrote well, I found her attitude to be patronizing and some of her details to be doubtful, although I suppose it is possible that at late as 1963 all the peasants in the South of Spain were still eating their meals, fork in hand, out of the common pot or paella pan.  After all, they do still share wine flasks.  She was quite taken with the custom, marveling that thus there were very few dishes to wash up. 

Mrs. Chetwode was a devout Catholic and it is perhaps that, in addition to the adoration she commanded from the local peasants, that endeared Spain to her.  She attended mass at every village, dined with every priest, and became a great fan of Franco, the Spanish dictator who preserved and promoted the Spanish Church.  I wondered if she would have liked him quite as much if he had been the ruler of England.

The Two Ladies is well written and engaging, if not sometimes annoying, but it offers no competition to Laurie Lee’s As I Walked Out One Summer Morning.  Lee was a poet.  His views are humane and his writing is lyrical, simple, and elegant.  Published in 1969, As I Walked Out tells of how in 1934 Lee left his home in Stroud, Gloucestershire and walked to London.  He was 19 years old.  After one year, he got on a boat and sailed to Spain.  Once landed, he saw Vigo, Segovia, Madrid, Toledo, Cordova, Seville, Granada, doing all his travels by foot.  He didn’t make it here to Barcelona because the Spanish Civil War began and he was repatriated.  But he was infected with a lifelong love of Spain and he did come back later to join the Republicans in the International Brigades.  But that’s another book.