Thursday, Dec 29
After feeling sick for all day on Wednesday, I decided I needed to go to the doctor.
This was a day we could sleep in but in spite of that we awoke early to birds chirping in the courtyard and roosters having a crowing competition and we couldn’t get back to sleep. I gathered the necessary items and went to the nearest “square” to get Wi-Fi and download some past prescription details from my Walgreens account. I had no idea how Cuban medicine worked, but I had heard good things about it and knew I needed something or I would be quite sick in a few days.
After about 20 minutes of trying, I got about 5 minutes of decent Wi-Fi and took some screenshots of past prescriptions to help me know what to ask for at the pharmacy. Based on what my primary care doctor usually does, I decided to try to get some prednisone to calm down my asthma, and some penicillin to combat the sinus infection. When I arrived back at the casa I had to wait for the water delivery men who was using the front stairs to pour water from about 10 approximately 10 gallon jugs carried on the back of a cart into her 3 approximately 3 gallon jugs. I suspect this water is what they drink, but we only drank bottled water with intact caps.
I also still wanted to find a store to buy a skirt to replace mine that had disappeared in the laundry in Trinidad, but the lady who served us breakfast at our homestay offered to do some laundry for us, so I thought I might be okay without one if needed. The top priority now was getting me well.
After a bit of a walk and passing the pharmacy twice without knowing it (see, I told you it is a confusing town) a nice Cuban man walked us the 1/2 block to the “international pharmacy” (the Cubans use a different set of pharmacies). With Vince’s help I asked the nurse in white to buy some prednisone and penicillin. She looked at me with a puzzled look and asked if I had a prescription. When I said no she said I would need to see a Doctor to get one. I was trying to figure out what to do with that information when she asked where we were from. Upon hearing we were from the States she said with our travel insurance papers they could call a doctor to come to our casa or there at the pharmacy to consult and determine what I needed.
We talked with the nurse in whites (including the standard old-style nurses’ hat) until the female doctor came, about 5-10 minutes. She was also dressed in whites.
Nobody washed their hands; I don’t even think there was a sink. She listened to my chest with cheap stethoscope, looked in my ears with clean but reusable covers (a different cover for each ear) for the old otoscope which she plugged into the wall (she had to jiggle the connection because the wall socket was loose). The nurse took my temperature under my arm with a glass thermometer, and the doctor asked about my symptoms. Vince got to use a different set of words on this day, but he did fine. I sure was glad for his Spanish skills. I showed the doctor the list of meds and vitamins I take daily. I told her about my migraines, my hypothyroidism, and my asthma. She said I needed to get lab work and chest x-ray done. I was expecting a long travel and a longer wait for results but they both assured me it would be very quick. The doctor tore off a rectangle piece of dot matrix printer paper, stamped it, and hand wrote the order for lab test and x-ray. We then waited for about five minutes on Steve to get back with the insurance papers. While the doctor waited at the pharmacy, the nurse walked us 3 or 4 confusing and busy city blocks to the clinic where the blood test and X-ray would be taken. She gave the papers to the appropriate people and we waited. Within 5 minutes it was my turn at the lab.
We went into the lab room where the lab tech opened a fresh lancet which she used to prick my finger. Then she pipetted some blood from it and smeared some on 2 slides. There were sinks here, but still nobody washed their hands. No gloves had been used up to this point, and none were used now. There was also no sharps container anywhere to be seen, but there was a biohazard sign on the inside door.
After the labwork was drawn, the nurse walked us across a beautiful courtyard to the radiology department. There they told me to take off my bra but leave my shirt on as there was no robe, and they showed me the bathroom to do this in. The sticker for designating the right side of the X-ray (versus the left) was old and dirty. It had obviously been in use for a while. They used a clean and working but not at all new x-ray machine for one front-facing X-ray and I went back into the bathroom to change. The x-ray machine looked like it was old, probably from the 1980’s. Remember how I said in an earlier day’s blog that the USSR used to help out Cuba but that fell apart when the USSR fell apart? I got the distinct impression that their medical equipment was from this time period. I’m quite sure with the looks of the age of the machine that I received a larger-than-normal-by-modern-standards dose of radiation. I did notice there was no TP or TP holder in the bathroom, but it was clean with a clean sink and a bar of soap. Nobody had yet (to my knowledge at least) washed their hands, though, or used any hand sanitizer.
We waited in the courtyard for the X-ray print to dry. Nothing was digital. They gave me the print of the film and we crossed back to the lab. We heard the click-clack of typewriters (not a computer was seen anywhere the whole time) as we waited. After a short time the nurse got the lab results (also handwritten on a plain small piece of paper) and we went back to the pharmacy to see the Dr who was still waiting on us there. The Dr said according to the lab work I didn’t have a virus, and my bacterial numbers were within normal limits, but elevated somewhat. She explained that the lab work meant I wasn’t very sick yet but would get sicker. And the chest X-ray (she held it up to see in the sunlight) showed some spots from my asthma. She assured me several times that they had the medicine I needed, which made me think that often that’s a problem they deal with.
She prescribed a cough syrup, a substance similar to Vicks vapor rub, and amoxicillin tablets after asking about any drug allergies and checking the package insert to make sure the amoxicillin wouldn’t interact with my thyroid meds.
The nurse told me a couple of pressure points that were good for pulmonary problems, though the Dr didn’t seem to really think that was important. They gave me great instructions, checked to make sure I understood everything, and gave me a handwritten copy of the prescription and instructions. The doctor also gave us her card with a phone number should I need any more care for the rest of the trip until I went home. After all that, a well-dressed lady came and checked paperwork, forms, passport numbers, etc, and left.
I signed two papers and we were almost done. In all, for the consultation, lab work, and chest x-ray, it took about 2 hours, part of which was us talking about how medicine works in the US, and I’m sure she would have worked quicker had we been more quiet and less distracting. I walked out with an interesting experience and solutions found. The medical people were all competent and kind. They were not well-supplied, and they worked with old equipment. Everything smelled of disinfectant and was clean, though everything badly needed a fresh paint job. It would have made me feel better for me had they washed their hands or used sanitizer, and it would have made me feel better for them had they worn gloves and had an easily accessible sharps container.
The Cubans are quite impressed with their level of medical care. From what I understand, medical care is all free (though we all know nothing is ever really free) except prescriptions which are affordably priced. Each primary care doctor is responsible for the people on certain blocks, so there is no choice in who your doctor is, but Cuba doesn’t seem to care too much about providing its people with choices, so this is not surprising. They do have the highest numbers in the world of per capita number of doctors. These doctors are actually one of Cuba’s main exports, which sounds strange, but Cuba sends its doctors to other countries and the other countries pay Cuba for their services. Our doctor this day had spent some time in Ghana. A favorite destination of these doctors is Venezuela who (until recently at least) trades oil for them. They also have a good amount of “medical tourism” in which people from other countries travel to Cuba for cheap plastic surgeries and such. It was strange to have a doctor spend 2 hours on me, waiting for me while we did the lab work and x-ray.
Happy with the experience (me for getting help, Vince for his successful use of Spanish, and Steve because it all had all gone smoothly) we went back to our casa to rest and do Vince’s quizzing. I took my new meds, and we enjoyed the cool A/C and rested.
We did notice our laundry along with some others was in the “dryer” in the courtyard of the house.
At about 4:00 Vince was finished with his studying and it was starting to cool off, so we went to visit some art galleries and get dinner. We went back to the town square with the Martha Jimenez sculptures and behold, there was the man with the newspaper sitting next to his statue. His name is Norberto Subirat and he is now 83. He loves to talk and told us (through Vince interpreting) all about his son who lives in Rochester, NY. He is obviously a religious man and said God helps him to be strong enough to come meet people. He has visited his son in the States before and hopes to do so again. When Steve told him that he is a pastor the man jumped up and gave him a very warm hug and, looking a bit surprised, said he felt the Holy Spirit of God. He was very warm toward us, talking a lot about God. Steve slipped some money in his pocket and with a “Dios le bendiga” we left him there to greet other people and went to dinner.
After a dinner we wandered about looking for another artist’s shop that our guide had pointed out, but after much wandering of the confusing streets, we gave up and went to a square to get on the internet and check on the kids and emails.
Click here to continue the journey to Day 8.