Notes from the Clinic...Again

In my last post, I briefly mentioned the raging infection that was waging war on my delicate, ballerina-like size 11 boat feet. It was maybe a little worse than I was willing to admit, but I really wanted to get to this conference I was attending with my community counterpart. I had taxi´d myself back to the bus terminal, where I ran into my friend Louis, another Bocas volunteer.

¨Good GOD WOMAN! What is that on your feet?¨

¨Oh, does it not look good? It´s just a little infected...¨

¨You need to go to the clinic. That is, um, well-- I just can´t believe you haven´t gone yet.¨

But...but... I already bought my bus ticket. I hobbled off to buy a sandwich and contemplate the value of my health when I received a call from my biological brother James, who told me had he had been to the hospital with a septic foot infection, caused by some kind of strep bacteria. (Which he got when we went snorkeling. I officially retract my approval of that activity. Snorkeling is a dangerous, deadly activity, and you should never do it. Who wants to see fish anyway? They are ugly creatures and coral deserves to be in danger of disappearing forever. Coral is a dummy.)

¨You really should go to the clinic,¨ bio bro James advised.

Well. Septic foot infections and strep bacteria sounds kind of dangerous, so I called my Peace Corps doctor, Lourdes, for her advice.

¨Catherine, now more than ever, please please please go to the clinic.¨ Lourdes doesn´t play around, so I hopped in a taxi and headed to David´s Clinica Cattan, and after a five-day stay, I bring you:

TOP FIVE LESSONS LEARNED WHILE HOSPITALIZED IN PANAMA

Because, while my Mom can´t laugh about it, why can´t we? (Seriously Mom, stop reading.)

5. Medical confidentiality does not exist. Every nurse who took care of me told me that my compañera, Mary, who I have never actually spoken to, was also admitted to the clinic. ¨ She has diarrhea,¨ they said, while making the Panama diarrhea gesture. No such things as HIPPA here, people. Good thing PCVs share this information with each other anyway. When Mary was released, I heard about that too, and the nurse gave me a sly smile and said, ¨ She beat you.¨ Thanks for rubbing my interminable stay in my face. *Mary´s name has been changed because no one needs to know about her diarrhea.*

4. Panamanians like to make you feel lonely. Everytime my phone rang or buzzed, they began:
¨ Is that your Mom?¨ No.
¨Is that your boyfriend? ¨ No.
¨Is that a friend? ¨ No. It is my cell phone provider, offering me a promotion, THANKS FOR ASKING.
"So, you are here all alone? No one is coming to see you?" Yes, for the hundredth time and I didn´t mind until you started pointing it out every hour on the hour. My friends, Tyra Banks, Chandler Bing, Bree Van de Kamp, Paris Hilton and Dr. Derek Shepard, are on the TV. I haven´t seen them in months, and could you just leave us alone?

3. When I arrived and showed the doctor my foot, the only thing he said about it before he admitted me was "That is ugly." I did not hear from him again until the next day when he announced that it was a little bit more pretty, but still not good. The next night, the Mean Nurse who cleaned the wounds with such vigor that I cried myself to sleep, announced the infection on one foot was pretty, but the other one was still feojito, the dimunitive form of the word feo, meaning ugly. Apparently this is the only means medical professionals here have of assessing illness. James joked around that all their medical charts consist of are boxes that say Ugly or Pretty, and you check one, and makes notes in the margin. I am afraid to say I think he might be right.

2. There is no need to check on you, ask if you are comfortable, and if they forget to bring you dinner, that is okay and no one will apologize or find you a suitable meal. They did manage to change my sheets every day, once waking me at 4am to do it. Florence Nightingale would be thrilled. But basics such as providing me with water or meals were forgotten. One night when they didn´t bring my dinner, I eventually asked for it, and a wash of guilt swept over the nurse´s face. She came back in 20 minutes with cold broth and a cup of jello. Not enough, people. Not enough.

1. There is absolutely no reason to provide a patient with a diagnosis, any information about the medicine you are giving them, how long you expect them to stay, or what progress they are making.

I hail from the Massachusetts Bay Colony, home of Mass General, Brigham and Women´s and some of the top physicians and specialists in the world. I am not used to this sort of neglect and ambiguity when it comes to medical care. Everytime they put something in my IV (and oh, in five days there was a lot going into that IV), I would ask what it was, and the nurses would look slightly annoyed with me for asking, and offer a vague answer like "for the pain" or "for the swelling" or "to make you stop asking questions, gringita." Okay, they didn´t say that last one, but I think they wanted to. One time, the nurse came in with a huge tray of about 8 syringes filled with medicine, and started shuffling through them before she asked, "What´s your name again?" Good grief. Needless to say, I tried to double check as much as possible.

As far as a diagnosis, the doctor did not tell me what was wrong with me until Wednesday, my fourth day in the hospital. And you know? When someone has a FLESH-EATING STREP INFECTION in both feet, it is something you might want to tell them. Just as a rule. I didn´t realize how serious it was until that moment, and I kept thinking each day might be the day they let me out. Thanks for the memo, doc.

So yesterday they released me with a bag of medical goodies and lots of instructions about how to take care of my wounds in site. They are almost all better now, no swelling or redness, and about half their original size. Despite this list, I think they did a good job overall of taking care of me (by Panama standards...) and providing me with an outstanding amount of antibiotics to kill the infection. But I will say the experience made me appreciate American medical care, flawed as it is. We are used to doctors telling us what´s going on and how they will treat us. Not so much here in Panamania, but that doesn´t mean I will stop asking for information. Gotta be your own advocate. I go back on Tuesday to make sure they are healing and to yet again revel in the world-class medical care they provide. Let´s hope I don´t come back from that experience with enough material for another Top 5 list.