Socialized medicine is the one thing you’re not allowed to say anything good about—at least not in this country. But how bad—or good—can it be? Well, I recently found out, and here’s my report. Notice I just report the facts. I’ll let you draw the appropriate conclusions.
It all happened on my recent trip to Milan. I was traveling with the Drayspooles, Fern and Irving, an older couple I often vacation with. The three of us have reached the age where the adventures of youthful wanderlust, like Alpine hikes and trekking through museums, no longer appeal. Now we just eat and shop, period. Milan is the perfect place for this; to us the Duomo is merely that big church next to La Rinascente department store.
We had been out to dinner the night before at Aimo e Nadia, a 3-star restaurant, for a meal that included Italian swordfish with pistachios and capers, lemon marmalade, turnip tops and ricotta Marzotica. It was a blissful experience that set Irving back $700. Around three in the morning I woke up. No, it was not indigestion. My heart wasn’t beating right. I knew just what it was: an atrial fibrillation episode. At daybreak it wasn’t any better. We called my doctor in Sarasota and he said, “Go to the hospital.”
A hospital in a strange country in a language you don’t speak, other than “Quanto costa?” It’s one of those situations where you can only put yourself in God’s hands and hope for the best. Soon we were in a taxi, headed for the Regina Elena Policlinico, the Bellevue of Milan, a big, ancient public hospital. The emer-gency room didn’t really have a waiting room, but in the hallway a nurse named Giuseppe did some rudimentary tests and I was told I would have to stay for a while.
My home for the next two days was the Sala Observazione, a big ward where they keep the patients they can’t quite figure out what to do with. It was a long room with tall, frosted-glass windows and enormously high ceilings, crammed with 25 or 30 people on gurneys. They were all wearing the clothes they came in with. There were no bedside tables, no TV, no buttons for the nurse.
My roommates were a cross section of Milanese society. There were a lot of old ladies, who would cough, moan, rasp, wheeze and cry. (People cry a lot in Italian hospitals.) There were young men who had been in fights or fallen off their motor scooters. There were stoic middle-aged men who stared straight ahead and didn’t move for hours on end. And then there was the crazy old man who was suffering from dementia. He would yell and call out and thrash around. Naturally, they put him next to me.
And by next to me, I mean really next to me. Our gurneys were six inches apart. He would reach out and grab my arm and then try to hoist himself onto my gurney. Several times he almost made it. He’d be straddled midway between the two, yelling that he had to “fare pipì,” and I’d be screaming for the nurse, who would finally run over and tell him to fache pipi in his pannolino, that’s what it’s for. This went on for hours.
A feeling of déjà vu began to form. I’d been here before. It all had a dreamlike familiarity, like I’d been plunked down in a world that was frightening, grotesque and funny, all at the same time. Like…a Fellini movie. Yes, that was it. Now I knew where Fellini got all his ideas. In the Sala Observazione.
We even had a dwarf. Across from me was this very small person who didn’t have any legs. I couldn’t tell if it was a man or a woman, but I’m guessing woman. It was blind, with withered sockets instead of eyeballs. Bright red hair. When it started to scream, as it often did, the old lady sitting next to it would gently slap it on the mouth.
The night I spent at Regina Elena was the longest one of my life. Sleep was impossible. The activity slowed down as the hours passed but never completely stopped. The crazy old man was released—at 2 a.m.—and he was replaced by a woman who had a mink coat draped over her, instead of the regulation hospital blanket.
Because I was placed next to the nurses’ station, I had a lot of time to watch the nurses. They were young, equally male and female, and a very fun-loving crew. The boys had some sort of boxing competition going on; they were constantly practicing their footwork and trading punches. There was a lot of snacking, both with food brought in from the outside and treats stored in the medicine cabinet. It looked like a great job. They did everything in groups.
Around four a.m. I watched four of them change a diaper. Enrico shone his flashlight on the wall and began making shadow puppets with his fingers. The other nurses laughed and laughed.
I finally dozed off but was awakened around dawn to find one of the firemen who drive the ambulances holding my wrist and saying, “Che bello.” “Grazie,” I replied. Then I realized he was talking about my watch. Was he trying to steal it? I’ll never know. But just to be on the safe side I stuffed my wallet, plus my passport and all my euros, down the front of my new Armani underpants.
At 7 a.m. they opened all the windows—this was the week it was five degrees in Milan—and played loud rock ’n’ roll music. Then all the patients got their diapers changed or were unhooked from their machines and allowed to go to the toilet. Then the breakfast lady wheeled her cart in. She was dressed in a heavy coat and a shower cap. She called out your name and asked you what you wanted. I begged for a glass of water, as I hadn’t had one in 12 hours. “Water?” she scowled. “For breakfast? How about tea with milk?” “No, water,” I begged. “You don’t have water for breakfast,” she said, and went on to the next name on her list.
Italian men sure love their mothers, at least when their mothers are in the hospital. As the morning progressed, every old lady had a son come to visit, each bringing her something to eat. They would hold hands, hug, and cry. The doctors then made their rounds, and it was becoming clear that I was in a tug of war between Dr. Pimples (as the Drayspooles and I referred to the serious young woman with bad skin) and Dr. Aldo, the suave Italian intellectual. Dr. Pimples wanted me to stay a week for more observazione; Dr. Aldo thought I was well enough to travel, at least on a plane that had a defibrillator. Mercifully, Dr. Aldo won the argument.
Once I found out I would be released that afternoon, I started to worry about how I was going to pay. I was sure there was going to be an enormous bill. Maybe the Italian taxpayers got a hefty discount, but an American tourist?
I gradually came up with a plan. I would pay part of the bill, the least I could get away with, then immediately leave the country. As long as they never got my credit card number, I figured I was safe. I reached into my underpants and surreptitiously counted my euros. Almost 300. Would that be enough?
The hour of reckoning came. Dr. Aldo gave me my records and discussed the state of my heart. We shook hands, and I could wait no longer. “Uh, how do I pay?”
Dr. Aldo recoiled in horror. “I’m not interested in money,” he said.
“But the tests. The shots in the stomach. . .”
“Go,” he said, making shooing motions. “Go, go. Buon viaggio.”
The lessons here? First of all, the doctors were great. My cardiologist said they did exactly what they should have done. The nurses were another story. They seemed more like custodians than healthcare professionals. Twice I watched as they moved a patient on a gurney, forgetting the patient was hooked up to a heart monitor. In both cases the monitor crashed to the floor. And I found there was a little too much reliance on diapers.
They also give you those shots in your stomach. The first time this happened I recoiled in horror, trying to come up with the Italian words for “What on earth are you doing?” I must say, I was learning the language in record time. Do you realize the word for “urinal” is “papagallo?” Enrico, the nurse, kept asking me if I wanted a papagallo, and I kept saying no, wondering why on earth I would want a parrot.
On the other hand, there was a feeling that we were all in this together. The other patients were amazingly respectful of each other and took everything in stride—crazy old men, screaming dwarfs, freezing weather, the food (which was inedible). I never heard anybody complain or whine. At these prices, how could they? And one last lesson—bring your mink. You’re going to need it.