On a recent trip to Greenland I was in the company of a nurse who regaled me with stories of patients who regularly complained bitterly about not getting a chocolate at night before they went to sleep.
This nurse and I amused each other with stories about health care all over the world. Not long afterwards, I found myself enjoying healthcare in an extremely rural facility in Kazakhstan, in the middle of absolutely nowhere, and it was a lesson in thin mints indeed. I’d like to have a talk with Mr. Thin Mint.
I was on an extended horseback riding trip, we were in our second week. For whatever reason, my third horse (we were moving through the mountains from ranger station to ranger station and using their horses, so this was a new mount for me) decided he was having none of me. After tossing me off once already, he threw me at the full gallop. I got up, tried to remount. I realized that something far more serious was going on, and the group van was called.
Our American leader, Jen, was the only one with medical experience. I did a series of yoga moves, she checked me, but we couldn’t isolate the problem. However in no time I was in agony. I crawled into the van in a fetal position and we drove 25km to the closest, Soviet-era facility for miles around.
It was a huge, empty building. Tiny village. One doctor. An x-ray machine from the fifties. No one spoke English. We did tests, and the good-hearted young doctor said I had busted a piece of bone off a vertebrae. Didn’t sound too bad. After a heap of paperwork, I was admitted. @e found a very capable English speaking translator, contacted World Nomads, my insurance company, and I was left on my own. The idea was that I’d be medevaced out in a day or two. Well, that was the plan at least.
I was put in a big room of four beds. The sheets were so rough they exfoliated my skin every night. Care consisted of one pain shot every four hours, period. Kai, my translator, made a sign for me which read: “May I have a pain shot please?” There was no wifi. There was no phone signal. An ancient phone was the only way anyone could call so I had to hobble down the hall to respond.
And this hospital was a Bring Your Own. BYO toilet paper, soap, hot water, towels, meds (except for pain medication), bandaids, toiletries, light source, locks (the doors didn’t lock, nor was there a curtain across the big glass windows) showers or any source of privacy. Staff smoked in the bathrooms, the doors to which could not be locked. I took a “shower” standing naked at the sink, washing my hair, being regularly interrupted, using ice cold water, my own soap and supplies, and thank god, a towel I had brought for camping. My bath mat was a foul cleaning rag.
“Food” consisted of cold congealed white substance, with a slab of margarine, served early in the morning, along with quite serviceable tea. After three days of this, I began to get very sick, so I had to dip into my own medical kit for medicines to treat myself for nausea and illness. Luckily I had a big bag of KIND bars and Justin’s Almond Butters. That was my diet, bolstered by yogurt and whatever, Kai, my translator, could purchase for me.
I also had cashews and a huge bag of chocolates. I would sneak down to the nurse’s station and hand out goodies. This brought a great many giggles and shy smiles. These women couldn’t possibly afford such luxuries. This ensured that when I waved my “Injection please” sign, I had a shot within thirty seconds. Another morning, after being invited, I brought my iPad down and we looked at photos together, and the women shared their food with me, which was a hell of a lot better than what the kitchen was providing.
One morning I woke up at 4 am, swung my legs out of bed and nearly impaled the ball of my left foot on the syringe left on the floor by the nurse who’d given me my shot the night before. This led me to wonder about the sanitary practices of the nurses, and whether anyone was even sterilizing the needles in the first place.
Old men had a habit of wandering in my room uninvited and unannounced, determined to show me their surgical scars, usually strategically located below the belt. There was no way to keep them out of my room. My translator, Kai, taught me that in their culture they felt it was perfectly acceptable especially since he was in my room and was speaking to me.
Kai would visit twice a day to ensure I had everything I needed. He’d score yogurt and fruit, and we’d talk for hours. A mining engineer, his English was impeccable, and a kinder man doesn’t walk the Earth.
As it turned out it took five days for World Nomads to locate an adequate ground ambulance company to transport me the eight hours to the nearest airport. After five days at this hospital, at 3 am, we were packed and ready to go. A nurse with a pencil flashlight bundled the lot of us (there were six) down the blackened hallway (no lights) into a tiny blackened elevator (no lights) and out in the early morning. I was told to find a comfortable position because the eight-hour drive was going to be over very rough roads.
On the way, when I had to pee, the driver would slam on the brakes, I would crawl out, hike into a ditch and pee behind a bush. With a broken back.
When we finally got to Ust, got past the interminable paperwork, and I was handed over to the uber competent care of American-trained, Istanbul-based Dr. Joseph Choi, I was almost in tears. I was so grateful. Two hours later I had a huge container of fresh fruit and a Caesar salad delivered to me on our jet, en route to Dubai.
When we got to Dubai, I finally found out that I had fractured four vertebrae. Not just broken a chip off one.
I laughed regularly and heartily the five days I was at this hospital, even when I took the shot of the syringe. My first response – especially since I didn’t in fact spear my foot- was “this is going to make a GREAT story!”
I often thought of my nurse friend in Greenland. The American patient who demanded his thin mint on his pillow at night.
The simple truth is that given the options, I was intensely grateful for what I did get. The kind nurses, being stabilized and kept largely pain free for five days, being kept safe and dry until I could be airlifted out, being in good company, I was lucky. I could sleep and rest and do my yoga, I had food and water and I had damned good people working hard to get me out to excellent care.
Until we have the experience of what care is like somewhere else we cannot possibly appreciate what we have. There are aspects of Western health care that I don’t respect, such as the lack of focus on prevention. But when it comes to being able to properly diagnose a problem, and fundamental sanitation principles, we’ve got that down. And I must say, we do have better food. In Dubai, I had people checking with me three times a day to make sure I was happy with my food, and did I want more watermelon? Yogurt? Tea? Coffee? Ice cream? Do you like our doctors? staff? us?
Gratitude is a wonderful thing. As someone who chooses to take some big chances all over the world, and on occasion I pay a big price for it, I have had a taste of healthcare in some pretty interesting places. Mr. Thin Mint might might want to consider his options. I know what some of them are.
And I for one am very, very grateful.