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!