Showing posts with label hospital. Show all posts
Showing posts with label hospital. Show all posts

Sunday, June 03, 2012

The Cost of Healthcare

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People wonder why healthcare is so expensive in the US. Ron had his 2nd cataract surgery here in Budapest, the second eye. He was so thrilled with the results from the first surgery. Now he only needs to wear glasses for reading. However, each time one of us is in the hospital (I have had a different type of surgery here), I cannot help but notice how much the doctors do for a fraction of the pay of American doctors and the roles of the nurse are extensive.

Compare an American Nurses station in the US with a typical one in Budapest.




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Saturday, September 12, 2009

26 Hours

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6:15 am Got up, showered, dressed and walked to the hospital to meet with the surgeon. I told Ron not to bother going with me. I assumed that they would not allow the surgery without the microbiology results, so there was no point in his joining me. I expected to be home again within the hour. 7:15 am As I walked up to the hospital, I ran into my surgeon outside. I told him about the problem with lab work. He asked if I had a print-out of the others. He said it was no problem, we could go ahead with the surgery. Again, mixed emotions. He took me upstairs and personally took me to the registration, so he could translate. Registration consisted of giving them my lab results and medical card. I was registered within three minutes. The surgeon then took me to my room, one of the newly remodeled ones with only three beds in it. One was occupied. He explained that he had to go on rounds and would be back for me. The nurse came in to ask if I had any allergies. The dietitian asked if I was on any special diet. They all did their best to communicate without much English. We did fine. The bed had no electric equipment for adjustments; just the head hand cranked up and down, but it was perfect so no adjustment was needed. We had our own bathroom with a shower in the room. It was beautifully tiled. 8:15 am My doctor came in and said they would be coming for me shortly. Minutes later, a young man came with a concave gurney that looks more like a hammock. He said "Undress!" followed by "NOW!" I got on the gurney and he wheeled me off down one hall, then another. There were so many twists and turns. Looking at the ceiling, I had flashbacks to movies like Coma for some reason. Within three minutes, he had me completely shaved. No foam, no soap, nothing to soften the hair, just swipe, swipe, swipe with the efficiency of a barber. 9:15 am This same young man takes me from the anterior room into the surgery suite, a much smaller room than I anticipated. He lifted me off of the gurney onto the surgical table. I was more concerned about his back than my nakedness. Draped in sheets, the doctor and nurses arrived and started rearranging sheets, blocking my view. The anesthetic was a local. Three needles into an area already hurting. The doctor explained what I would feel, when I should tell him the pain was unbearable, that I may feel pressure, and I may smell burning flesh when they cauterize blood vessels. This is one of the times when knowing self-hypnosis comes in handy. 10:15 am The surgery is over. The young man again lifts me off of the surgical table and puts me on the gurney. When we reach my room, he one more time, lifts me into bed. Then he put a large cloth bag under me while putting a kilo weight wrapped in a towel on my surgical area. PAIN!!! Within minutes, the nurse came in with a pitcher of tea and a cup. 11:15 am Ron found me though he had no idea where the hospital was or where I would be. I was groggy, I think from the trauma of it all. He left and planned on returning later. I fell asleep immediately. 12:15 pm My friend Laszlo came to visit. While he was here, they served lunch. A large bowl of soup was handed over to him to put on my bedside table. No covering on the soup, just a large bowl. The nurse handed me a spoon and a plate with two large pastries. Ron returned and the three of us talked for a while, but I was wiped out and Laszlo left us. I went down with Ron for a cigarette, but ran into my surgeon who told me I needed to be flat for the rest of the day. A new roommate arrived for the middle bed. 1:15 pm to 5:15 pm I slept, waking for minutes at a time, trying to read my book, but could only last about 10 minutes and then off to sleep again. The only interruption was the doctors doing rounds. The head doctor spoke English and asked me how I was feeling. My surgeon gave my history and explained the procedure to the rest of them. 5:15 pm The nurse arrived to hand each of us a thermometer. I start to put it in my mouth, but she motions it goes under my arm. Moments later, she places a plate on my table. I was thinking how wonderful it is that we get an afternoon snack. Actually, it was dinner. One roll, one scallion, two slices of lunch meat, and a cube of margarine, but no silverware. I ate it and went back to sleep. 6:15 pm My roommate from the middle bed went home. I am curious how he managed that so fast. The nurse returned for the thermometer. It was 37 degrees on the dot, but I have no idea what that is in Fahrenheit. 7:15 pm to 10:15 pm I could not stay awake. As much as I wanted to try to stay awake for fear of being up all night long, I could not do it. At 9:00 pm, the two night nurses came in to check on us. Both male, they pulled my covers down, rearranged the weight after telling me I had to take my sweat pants off. Ugh! My dinner dish is still by my bedside. I was wishing I had brought my phone to call Ron to bring more food; I was hungry. Instead, I drank the grapefruit juice he brought, the tea they gave me and one of the candy bars I had asked him to get for the nursing staff. In between everything, I continued to sleep. 11:15 pm I was awakened when the nurse brought in a new patient for the middle bed. Why he was arriving at this hour was beyond me. They set up an old fashioned IV pole. Once he was changed they started him on an IV. Since I was nearest the window, I had it open all night long for the cool air. Neither roomie seemed to mind. The comforters were quite thick and warm, but the fresh air felt great. Being on a busy street, it was noisy, but it did not seem to disturb any of us from sleeping. 12:15 am to 6:15 am As concerned as I was about sleeping, I slept the night through, waking up for moments at a time to try to process the weird dreams, but tiring of that quickly and falling off once again. 7:15 am This time I thought I was awake for good. The anticipation of my doctor coming to release me, was building. He does not normally work weekends, but was coming in for me. Just like in the USA... ha, ha, ha!!! Anxiety wears me out. I was back asleep within minutes, not waking until the nurse came in with thermometers again. 8:15 am My doctor came in, took me to the examination room, changed my bandage and gave me instructions. No walking until Monday at least when I see him again to take the drainage tube out. No shower unless I can keep the bandage dry. Stay flat on my back or sit only. Gravity is not my friend. When I came out, Ron was in the hallway looking for me. We took a taxi home. Overall impressions: The staff was magnanimous providing for a non-Hungarian speaker. Although antiquated by American standards, I felt safe, comfortable and well cared for during my short stay. I find it difficult to understand how so many thoughts can be crammed into thousands of dreams in this many hours.

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Wednesday, September 02, 2009

Another Medical Adventure

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I had to go to the local doctor for blood work, a nose swab, and urine test for my surgery next week. I did attempt following my surgeon's instructions by going two weeks before hand, but the local doctor was on vacation until today. After sitting in the waiting room for a half-hour, the nurse told me to go in. I sat in the chair and the doctor was on the phone, so I did not speak so as to not disturb him. He kind of glanced my way, but did not acknowledge I was there. He hung up the phone, rubbed his eyes and held his hands over his face for a good five minutes. When he let them drop to the desk, he fully noticed I was there with a vague impression of actually seeing someone. I said "Good Morning", he repeated "Good Morning" in a monotone. I continued with "How are you?", to which he repeated "How are you?". For a minute, I thought we were doing English lessons. Then after a pregnant pause, he said "I thought I was alone. I did not know you were there." I always suspected I could turn invisible when in restaurants and wanting a waiter's attention, but it never worked in a doctor's office before. He looks over the sheet that the other doctor had given me, get a swab kit, does the swab and then hands me a test tube for the urine sample. BUT, I cannot do it there. I have to run home, catch it in mid-stream, then collect the rest in a bottle of my own choosing to bring to the lab at the hospital. The clincher was that I had to have it to the lab by 9:30 am, but as he was talking it was already 9:10 am. I had to break into his further instructions on how to find the hospital, saying I have been there a zillion times, in order to finish this amazing race I was now a contestant in. Ran home, did the sample, ran out and made it to the hospital by 9:29 am, but did not know where to take the sample. I found this little old lady that looked like she should have retired thirty years earlier, but was still wearing a uniform of sorts. She was kind enough to walk me over. It was the same place I had to get the blood work done, but the receptionist was anything but receptive. After a long spiel in Hungarian which I tried interrupting to tell her it was all lost on me, she finally went for an English speaker. The phlebotomist had me sit in front of her with my arm dangling. After disinfecting, she stabbed me like a serial killer with the needle. The cotton she gave me to hold over my wound filled with rich red blood in minutes. I had to go to the bathroom. Holding the paper she gave me in my mouth, I struggled to see what I was doing, while blood poured down my arm. From here, I had to turn in the nose swab, but forgetting it was in my bag, I was sent down to the Ear, Nose, and Throat doctor, where I dropped my medical card into the door slot and waited to be called. Then remembering I had the swab, I gave it to the nurse who told me to bring it upstairs, but in my anxiety, I said they sent me here. She had the doctor fill out another form and sent me back upstairs to return it for the lab to process. Some results will be ready tomorrow, but the nose swab needs to culture for five days. I hope that is not five working days or it will not be ready for my surgery on Friday. Cultures don't take the weekend off, so I guess I am safe.

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Thursday, August 06, 2009

Anxiety + Relief = Mixed Emotions

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My final doctor visit today to get cleared for surgery. Because I could pick my own date, I chose September 11th out of the air. There was a bit of strategy involved, but not much. We have a friend coming to visit that we have not seen for over ten years; it would be shameful to disrupt her stay with a hospital visit. She is a nurse manager, so she may have found it novel. Anyway, she leaves on the 3rd. I wanted a Friday to recuperate over the weekend, so I could go back to school on the following Tuesday. I begged the doctor to let me go home the same day, but hospital "law" (his word) is an overnighter. Now that I have a date, there is plenty of time to alternate between repression and consuming fear.

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Tuesday, August 04, 2009

Jibs and Jabs

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I returned to the doctor again today. During that thirty minutes I waited for the doctor, when I was really trying to concentrate on my Joanne Harris book, The Evil Seed, I could not help but observe the staff. After spending twenty years in a medical setting, I am still intrigued by how things are done in different places. As I am sitting there, a man arrives with a metal cart with large covered metal bowls of various sizes. It was unclear whether this was the staff's breakfast, the patient's lunch or organ transplant delivery. Here one never knows. So, he pushes his cart to the side of the nurses' station, where two women, presumably nurses push up a cart of their own. Cart races down the hall? Exchange carts? Not that either. The three of them took everything off of the one cart and put it on the second cart, allowing the man to take his own cart back to where he came from. Now I was sitting right next to them. The carts were identical. Unless you had a the Hubble telescope, no one could tell them apart. Cart envy? Who knows? After waiting thirty minutes, the doctor comes up to me like he is going to share a big secret. He asked me to come back on Thursday, baecause he had to return to the operating theater. Hey as long as it is not me in the operating theater, I am fine with that. Then I got to thinking, will it be me in there soon? Will there be a bunch of interns and residents staring at me from a bird's eye view? That thought made me a bit nervous until I realized I will never see any of them again...hopefully. Though this seeing the doctor every two weeks has become a habit. We may have to continue this long after the surgery.

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Thursday, July 02, 2009

Doctor Appointment - Going Solo

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Back to the doctor again today, this was my first solo trip. My knight in medical armor, Laszlo went to the US, leaving me for fend for myself. Knowing this from the last trip, I committed building markers to memory to find my way back, but something went amiss. Knowing I could take a different bus than I had been, which stop was not quite clear. The street the hospital was on just happens to be smack dab in between two stops, so either way was a walk. Success, found the street, found the pharmacy (visual marker), found the guards shack (visual marker), found the bufe (snack bar - visual marker). I was sailing high. No problemo! Walked around the jutting out building, found the building in the back and raced up the stairs. Yahoo! We did not take the elevator the last time because it was not working, but I chanced it this time. Two choices, pressed 1. Get off to enter the wings, but all I see is Cardiology. Run down the stairs, Psychiatry. Perhaps later, but not now. Down the stairs again, ground floor, construction only, nothing else, not even workmen. Perhaps I missed a sign, so up the stairs again. First floor, no. Second floor, same thing. The signs never changed since I was there last. Surely they had time in those five minutes to change things around. We know how sneaky people can be in heatlhcare. Feeling panic at being late for my appointment of 'come any time between 9 and 10 am', I ran out of the building almost assaulting a women in white, with hopes she was a nurse or someone in the know. She did not speak English. I had my doctor's name on my mobile phone calendar, so I showed her. After a smile with a nod of the head, she had me follow her. She took me quite a ways in a different direction, but all of the time, I am thinking she is making a mistake. Then she calls to this elderly man who is wearing shorts and old sandals. She then gestures for me to follow him. He was jabbering to himself before being called upon to be my escort. Perhaps, I was to escort him to the psych unit since I can now find it by myself. Being a trusting soul, I go with him now knowing what a homeless person's puppy feel like. Suddenly, I recognized the building, though it looked similar to the one I had left minutes before. Finally, I could stop reciting fractured Shakespere, Laszlo, Laszlo, where art thou Laszlo? Mr. Mumbles was attempting to use the elevator, but I knew it would take until my next appointment to show up, so I ran up the stairs yet again. I may need that cardiac unit after all. Finally, I found the place I needed to be, took a seat, and waved at the doctor when I saw him, just like I said I would do. I had to sign in with the nurse at the desk who was very forgiving that we could not communicate. The doctor came by and said he would see me in five minutes. He actually did. I was examined, given two more prescriptions and was out in less than an hour. July 21st, we will try this again. I hope my visiual clues are intact for then.

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Monday, June 22, 2009

Hungarian Medical - The New Drama Series

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Walking into the 'hospital' was an intellectual experience; the emotions did not kick in because I am so talented with repression, refusing to accept that this is my future. We had to walk up the stairs to the second floor, because the sole elevator was not working. Those in wheelchairs must have a real joy ride going down the stairwell. For one brief minute, the nurses station looked almost familiar. The women, presumably nurses were wearing white uniforms being busy, but not looking like they were doing much of anything productive at first glance. Then I noticed that they were cooking lunch in the little back room. I thought it was their lunch until they filled the top of a cart and delivered bowls to the rooms of patients. As we were sitting there waiting for the surgeon to call me, I started checking off the violations that the US Joint Commission on the Accreditation of Healthcare Organizations (JCAHO) would find here. The nurses and doctors were all wearing open toe shoes, with socks, but open toe still. The food was prepared on the floor with no door and exposed as it was transported down the hall. Mental note: Do not eat while here. With anxiety building, I waited for the doctor to call my name, though it was difficult to tell whether the men in the green scrubs were doctors or orderlies. Then a bastardized pronunciation of my name was called out by this young man who introduced himself. He speaks English. Bingo! I won the jackpot. He is young and I can communicate with him. The tension eased as fast as a racehorse stung by a bee. After another brief exam, he explained that prior to surgery, I have to rid myself of an infection that he found. After giving me two prescriptions, we made another appointment for July 2nd and then surgery will be arranged for the end of July. Laszlo kept telling me how lucky I am. I hit the jackpot.

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Monday, June 08, 2009

Lab Rat in Medical Maze

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My friend Laszlo was kind enough to assist me with getting the lab work I needed to have done prior to surgery, so we met at 10:00 this morning to beat the rush. Appointments are unheard of, so imagine this scene. There is a pack of starving dogs, though regardless of their hunger, the alpha dog order biological trait is still ingrained in their nature. Suddenly, without warning, a fat juicy steak appears. Inherent instincts be damned, they all charge for the meat fighting off competitors with all means possible. When we arrive at the hospital, we have to return to the doctor's office to get the referrals for labs. Why he could not give them to me when I went the first time is anybody's guess. Outside the office is long bench, reminiscent of the bench outside of the principal's office in my elementary school. Sitting in order of our arrival, we are fourth in line. People are chummy and chatting amicably. Then the ominous music starts playing in our heads, something is about to happen...the door suddenly opens with the nurse making her first appearance of the morning. Vroom, the four waiting without any warning turns into a mob of twenty and the nurse is attacked from all sides deciphering all claims of "I was here first". An hour and half later, we get to see the doctor who really does not need to see me at all, but the nurse has to fill in empty fields on the computer to print out a half dozen pages or lab requests. The other nurse gives me to test tubes to fill with bodily fluids that need returning to some other place. I am told not to touch the tops of either. First task, find a men's room to carry out the task, but the one I find is a fraction the size of an airline toilet. Alone, I am trying to juggle two tubes, one with a blue cap, another cap less. Twisting the blue top does not produce any results, but pulling it off does, allowing the powder inside to fill the air like fairy dust. Opps! Logic led me to filling the capped one first, capping it and sticking it in my pocket while filling the second. This worked fine until I was finished and then tried to get myself back together in a presentable fashion. I had my shirt hanging out, so left my fly open until the tubes where turned in, to surreptitiously finish my project. Next was getting my blood drawn. For this we had to go to a different building, a block down the street. Waiting fifteen minutes was not a major problem, but when she started pulling out tubes with different color caps, I started worrying. Red, Orange, Yellow, Green, Blue, Violet, and Grey. Was she drawing blood for labs or devising new torture for the rainbow aficionados? Seven tubes did not satisfy her, she still needed to prick my finger for yet a few more drops of life sustenance. After all of this, she handed me two of the tubes, with cap colors that I would never have chosen given the chance, to bring to yet another lab to be left for analysis. From here, we had to find the EKG lab, another thirty minute wait. It has been years since I have had one, so was confused when the tech put these large hair clip type things on my ankles and arms, but the gooey, sticky juice on my chest with leech like sucking devices. She told Laszlo that the results looked good. It seems all of those times I thought I was having a heart attack was just anxiety. The pile of papers the doctor's nurse gave us was finally dwindling down, but there was more fun and games to follow. Off to radiology for a chest x-ray with thirty more minutes of waiting, fifteen more to make sure the film was a good one, and we were good to go to the next test. I had to have a nose swab. We had to find the ENT (Ear, Nose and Throat) doctors. As the clock was approaching 12:00, too bad, they are closed now until 2:00, so we went for lunch. By 1:45, we were back and in line, not that it mattered much, but we missed their calling my name three times. They pronounced it Yam-mesh (James) Ree-on (Ryan). Neither one of us caught it, but a lovely young woman sitting next to us happened to see my paperwork and drew our attention to the fact. I was able to see a female doctor who has a certificate in English on her wall showing she was honored by the Lion's Club as a Lioness of Distinction within the Pride for her work with the deaf and blind.

After poking in my nose with expanding tweezers spreading each nostril to look like Carl Malden's appendage, she took a cotton swab that had to be a foot long and mined inside each hole until my brain started tickling. My throat was easy, but the ears, oh the ears, now here is a problem. She asked if I wanted my ears cleaned while I was there. Sure, an added service is like getting your car serviced and being asked if you want a free wash and wax while you are there.

The nurse took me to a sink, where she filled a syringe the circumference of a cola bottle with warm water and shot it in my ear. I thought for sure I would spout water out of my mouth like a fountain. She held a tray catching the debris that flushed out, which was kind of funny, since it did sound in my head like a sink draining. The sounds Laszlo was making were not pretty, arousing my curiosity. It seems my ears were as dirty as an archeological dig site. What came out looked like a non-filtered super long cigarillo.

Four hours later, we were finished with our medical adventure. I have to return in two days to get my blood test results, but all of the others will go directly to the doctor. Why I have to carry around bring my EKG report and retrieve the blood labs myself is a mystery that will go unexplained. Once this is accomplished, it is back to the doctor’s office to schedule an appointment for surgery. The life of an ex-pat is never filled with dull moments or experiences.

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Friday, May 22, 2009

Persistent Caller, Surgery, Persistent Caller Again

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After close to eight years here, our phone has rung only a handful of times with legitimate calls. When telemarketers call, all we have to do is interrupt their spiel by saying "Do you speak English?" They either hang up or have the courtesy to say no, before hanging up. When we return to the States and for those living there, you should learn some short phrase in an obscure language to use this trick. Yesterday, I felt like a switch board operator with the number of calls that came in. "Have you got a room?" was asked by a minimum of six callers to the land line, two e-mail requests, and the guy who tracked me on my mobile. For the curious, he showed up at 9:00 am as I had requested.

An American from CA, Randy is about my age and rather a hottie. Seems he got off of the train in Budapest and was bombarded by the throngs of people offering a place to stay. He chose one not having any plans and then thought better of it after he was escorted to their domicile. It was the guy from the home stay who allowed him to use his mobile to call me, but charged the poor guy 3,000 Huf for the 3 phone calls. Randy paid it not knowing better. Our professional photographer guest was leaving the room at 10:30, but I had an acupuncture appointment for 10:00 and then a medical appointment right after. Poor Randy would not be able to get in the room until I returned early afternoon. He was complaining about being exhausted, not sleeping well the night before, so I offered him a siesta on the sofa while he waited, gave him keys, and he left. There was a minor mishap on the way to the doctor. The acupuncturist was unusually fast today so I set off to meet Laszlo who had to go to my doctor appointment with me to translate. We had to run to to catch the doctor his hours were over, but when I left the acupuncturist, I realized I had forgotten the address of the hospital at home. Trying to call Laszlo was futile; my mobile battery was dead.

I ran home, charged it for ten minutes, while using the time to clean the room for Randy and change the sheets. I did not have Laszlo's number anywhere, but on my mobile. When finally getting through, he met me at the bus stop, but said he called the doctor's office. Since it was Friday, the doctor may be leaving early, though his hours were only until 1:00 pm as it was.

When we arrived, a young woman came in after us, but said the doctor was not taking any new patients. She was trying to pull a tricky one over on us to shorten the line. Within fifteen minutes, I been told to strip in front of the doctor, two nurses, and Laszlo, without the aid of a screen, a curtain, a wall, or an amour plate. The doctor proceeded to do a sonogram of my parts, first guncking them up with sonogram lube, telling me to wipe myself off like I did the spilling, and continued on to another area. I did get a souvenir photo. By they way, it is going to be a boy.

Most parts cleared inspection and some did not. I have to have surgery, not my favorite word in the English language. Having Googled all possible combinations, I knew that I should expect this. What I did not expect was that what is an out-patient surgery in the US, will keep me hospitalized here for overnight or for two days. Procedures are important. I need to get all of my labs done a week ahead and then surgery can be scheduled. This whole thing will have to wait for Ron to return, but I can plan the lab work toward the end of his vacation. Ron goes on vacation to the States, I go on vacation to the hospital. Is this equality? When I was a medical social worker, I used to have a female patient who used to call her hospitalizations a "poor woman's vacation". Actually, this is most likely my penance for Ron's having to spend nine days at my father's house moving our things.

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Saturday, March 07, 2009

Oh Dad, Poor Dad

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Last Thursday, I received a call on my mobile, 'caller unknown'. When I answered, I did not recognize the voice. It was only the "Bub, is that you?" that made it click in who was calling. Hearing my brother's voice after, what has it been now, two years, it was like those dreaded calls in the middle of the night. Every cell of your being knows to stand at attention. Something not good is coming your way. Yes, Bub is my nickname for my brother. When he was a baby, it was his first word and attempt at brother. The name stuck, though brotherhood had not. After more than dozens in the high plurals of attempts to be close, it just never was on his agenda. I threw in the towel, gave up the ghost, and all of the other related cliches. So when I heard his voice, I thought it was time to find out I have been orphaned. Orphaned at my age is humorous, but when the last of the immediate family goes, there you are alone. It does not matter how many loved ones you have, significant other included. With family there is a different history and a different reality. My or our father is in the hospital. I had been calling him for two weeks leaving messages on his machine. Sometimes, he just cannot make it to the machine in the number of rings before the machine gets it. The woman recording on his answering machine and I have shared a great deal by now. Some evenings, I would call repeatedly thinking he would eventually make it to the phone, but these weeks it did not happen. Finally, my brother called to let me know, because he happened to check the machine while getting things for 'our' father. The timing was interesting. I had just messaged my nephew on Facebook asking if he knew where his grandfather was. He messaged back saying he had not heard anything other than he was having problems with his leg. It seems his father does not communicate much with him either. That must have set the wheel in motion, because an hour later, I received an e-mail from my brother and then the phone call. They thought that my father had a stroke, but nothing shows on MRIs or CT Scans. The only clue is left sided weakness that is still unexplained. They have repeated the tests daily to look for differences, but have found none thus far. For the first four days, my father was reportedly cranky and anti-social. Anyone who knows him, knows this is the antithesis of his normal self. On the fifth day, a young nurse came in to say "I am here to 'draw' blood" to which my father replied "I don't see a red pen in your hand." We had told him for years, if we could can his corn, we could wipe out the Iowa corn farmers. It is a good sign.

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Saturday, December 29, 2007

Please, No More Temples

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We have a new driver today, Somat, the tuk-tuk driver who will ferry us around for a reasonable $8.00 for the day. First things first, we went hunting for breakfast and when we returned our smiley driver was waiting. After a greeting, he thanked us for giving him work again today. Each driver seems to have their own ideas of what should be seen in the temple area, but none of them take into consideration that this may not be your first day. When Somat gave his ideas, Ron had to pre-empt them with the fact that we had already been to each of the places he suggested. He took us to Angkor Thom, the oldest city in the empire. Inside the city walls are the Byron temple with 216 faces, the terrace of the elephants and the terrace of the leopard king.

Really we were at a loss for where else he should take us; each of us were getting templed out. When he suggested something, we admitted we had been already our first two days. When tour books recommend a seven day pass, saying you need this much time to ‘do justice’ to the area, I have to strongly acquiesce that this is beyond my capabilities for maintaining an interest. After two days, I could have finished off seeing temples and have been perfectly happy, but with the choices of 1, 3, or 7 day passes, there seemed to be a need to utilize that third day. If nothing else, the drive around the area is worth observing. The descendants of the area are still living there and by western standards their conditions are deplorable. However, it does not keep the people from smiling and waving as you pass them by.

By 12:30, we were ready to return to the hotel. Somat seemed unnerved that we did not use him as long as he anticipated and I suspected he feared of losing out on his full $8.00. When I gave him a $10.00 and told him to keep the change, his reaction was better than seeing a child’s on Christmas morning. He bowed three times and told us how happy we have made him giving him work for the day. We arranged for him to pick us up again for this evening.

The staff at our hotel is absolutely adorable. One of the young men who attends the desk in the later afternoon has a book My First Book of Animals. He is trying to learn animal names and has his book open and is studying every time we come in. The young women who work the morning shift are all smiles and cheerful each time they see us. When they hand us the key to the room, they hold it on two open palms. They are the sweetest staff we have come across. None of them can be over 25 years old, yet I wish we could take them with us to do training for other staff in other parts of the world, starting with Budapest.

The Blue Pumpkin called to us to check e-mail, upload the blog and have a real brewed coffee. The afternoon is not the time to go. They have six tables on the patio and four on the first floor. They were all occupied. They do have two other levels, with tables and full wall and deep white leather sofas where they serve you on breakfast tray tables. However, I was scouting for a plug to electrify my computer; the battery only lasts for 1 ½ hours. The closest I could get was one table away where a woman and her son were busy writing out postcards. They had a stack that even at the impoverished rates here, would cost a king’s ransom to mail. They must have had fifty cards in their stack, but they were prepared with pre-addressed mailing labels. I quit sending postcards ten years ago, so it was beyond my comprehension why anyone would send so many unless they were from Luxembourg and promised one to each citizen in the country. When a table near a plug finally became available, I was working feverishly and then the WiFi stopped. I thought it was my computer, but then realized I was working on battery power once again. It was a few minutes later that Ron noticed all of the lights were off. The woman working behind me noticed too and asked a waiter. He said sometimes the electricity goes out for an hour and at other times for hours on end. There is never any way of knowing. Looking out the window, we could see the lights were off in all of the shops across the street also. With no Internet, it was time to leave and go shopping instead, carrying my laptop along the way.

At 7:15 pm on Saturdays, Dr. Beat Richner gives a cello concert for free at the Children’s Hospital. Somat was waiting for us at 6:30 and gave us his award winning smile when he saw us leave the hotel. Although the traffic was horrendous, we were still early to the magnificent complex where children are cared for from neo-natal onward. Bright, modern, and well designed we went to the auditorium, but it was freezing cold, so waited outside until it was time.

Dr. Richner is a Swiss medical doctor who worked in the Kantha Bopha I children’s hospital in Phnom Penh before the Khmer Rouge took over. After their fall, King Norodom Sihanouk asked him to restore Kantha Bopha I children’s hospitals in 1991; it reopened in 1992. Since then, Dr. Richner through fund raising has since opened more hospitals including this one. In 2008, the fifth children’s hospital will be opened. Their annual statistics are impressive: 600,000 visits by sick children, 55,000 hospital admissions by severely sick children, 9,000 surgeries, 100,000 vaccinations, 5,500 births. They sum this up by stating that each month 2,800 children would end up dying if it were not for these hospitals.

The concert was a combination of concert and fund raising event. Dr. Richner would play a song on his cello with expertise, and then gave us statistics of the hospitals. He stated that Princess Anne from Great Britain who is Chair of the Save Our Children Foundation came to see the hospitals. She said she believed the technology used was too advanced for Cambodia. She told him that the technology should be on par with the economic status of the people it was serving and the technology here was better than they had in Britain. He said he told her that is why the Brits go to France for health care. Dr. Richner stated he has heard the same comments from the World Health Organization and they will not assist in funding since the technology is above the standards for the country. However, Dr. Richner argues that if they were on a level of the country’s economy, they would not be saving lives. He returns to Switzerland twice a year to perform a concert and fund raise. The auditorium was packed full and he received a standing ovation when he was finished.

Outside was a jungle of tuk-tuks waiting for their fares, but we did not have to worry. Somat was waiting close at hand ready to escort us to the correct tuk-tuk. Our ride there and back and his choosing to wait an hour and a half for us to reappear cost us $3.00. I gave him a $5.00 bill and he again did the triple bow with unadulterated humility. If anyone reading this blog should come here, look for driver 6325. You will not be sorry.

Dinner tonight was a diversion; we ate at the Mexican restaurant. Mexican food in Cambodia is about equal to Mexican food in Budapest. It was as good as it gets when you are not close to any authentic Mexican food outlets. As we were sitting on the patio, two little girls about 7 and 9 years old, came up to us selling bamboo and reed bracelets. We told them we did not need bracelets, but one little one persisted. She and Ron went round and round with bantering. She asked where we were from and Ron said Hungary. She immediately piped up with “That is in Europe”. He then said we were originally from the U.S. and she responded with “Washington, D.C.” is the capital. He then started throwing out other countries and she responded with the correct capital. Then she went back to bargaining for the sale of her bracelets. When he held strong that we did not have a need for them, she suggested they play three games of Tic-Tac-Toe. If he won 2 out of 3 games, she would leave us alone. If she won, we would fork over the money and get bracelets in return. The results were 1-1 with one null game, no winner. So to break the tie, our young sales woman suggested three goes at Rock, Paper, Scissors. We now have 10 thin bracelets and five thicker ones. It was worth the $5.00 for the entertainment value. I am now wearing one of the thin bracelets since I was assured it would bring me good luck. Actually, I am wearing it as a reminder of the harsh circumstances children have in different parts of the world that many of us are not even aware of. She is out selling cheap little bracelets until god knows what hour and still has the ability to learn country capitals. What would her life be like if she could get a proper education without having to spend her evenings out hawking goods?

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