Wednesday, June 19, 2013

Puny in Paradise




I haven’t blogged lately, mostly because we’ve maintained such a frenetic pace over the last two days or else I was so dead-dog tired when I did have time that I couldn’t write without nodding off.  But I’m also nursing a sinus infection which has me at about 60% at the very time I most want to be 120%.  I suspect it was the airline air on dear old Air France.  But the air in Athens may have contributed as well.  Athens is a gorgeous city but it is down in a bowl, a plain defined on the east by Mt. Pentele, on the west by Mt. Helikon, and on the north by Mt. Hymettus.  All storied places, Pentele (ancient Pentelikon) as the source of some of the most beautiful marble in the world, Mt. Helikon as the home of the Muses, those nine lovely damsels who attended Apollo, god of music, and each of whom was patron goddess of some branch of the arts, and Mt. Hymettus for less felicitous reasons, namely, as the site where bees feasted on hemlock nectar and produced a delicious honey which contained a powerful neurotoxin which would put you under in less than an hour if you were so gullible as to buy it without checking the provenance.  When the Greek philosopher Socrates was sentenced to death by the Greek version of the Tea Party he chose to drink hemlock poison and we have a gripping description of his last moments.  The south side of Athens opens to the sea by way of the famous port of Piraeus, but onshore breezes often trap the smog in the rest of the bowl creating a different form of toxic stew.  
This sinus infection is not that big a deal, the main symptoms are constant drainage that has made my throat so raw it feels scalded, and the necessity of hacking and constantly clearing my throat, a habit which I’m sure has endeared me to no end to my fellow travelers.  And as luck would have it, we’re now on the ferry headed out of the Greek port of Patras to the Italian port of Brindisi, down on the heel of the boot, where another bus will pick us up and take us, via a delightfully circuitous route in order to see parts of gorgeous Puglia, to Sorrento.  On the Bay of Naples.  Which is down in a basin.  Defined by mountains on three sides.  Where an onshore breeze often traps the smog and turns the air smutty.  Don’t misunderstand, the Bay is absolutely gorgeous and the Sorrentine Peninsula that defines its southern limit is one of my favorite places on the planet.  But almost every time I’ve stayed there I’ve developed an eye or sinus infection.  Not the most therapeutic locale for me right now, in short.
Mind you, the air in Naples is considerably worse than it need be, especially considering that Italy has some of the most stringent environmental laws in Europe.  But once again our friends from the Mafia (called Camorra in this area) make sure that the laws are flouted on a regular basis.  These sleazebags know that when life is chaotic and dysfunctional, people who feel helpless instinctively turn to the biggest bully on the block for protection or validation.  So our friends make sure that the goons have job security by creating as much chaos and dysfunction as possible and then offering to protect the weak from the very mess they created
In any case, my first stop in Sorrento will be to a local farmacia.  As I mentioned in an earlier blog, the health-care professional of first choice for any Italian is his local pharmacist.  These guys are highly trained and they can diagnose probably 80% of the ills that come their way, and have tremendous leeway to prescribe many drugs that could only be obtained in the US with an expensive trip to a doctor and an equally overpriced prescription.  They are easy to find, you simply stroll down a commercial street until you see a flashing neon green cross, the Greek-style cross à la American Red Cross.  Only green.  Go in and ask if the pharmacists speak English and they will protest that they speak only a little and proceed to speak almost flawlessly.
Over the years that we’ve taken various tour groups, the Italian medical system has come to our rescue any number of times.  There was Rachel, for example, who had explained before we left that she had certain food allergies.  We had been very careful in alerting the restaurants in advance of her problem and they had been wonderful in accommodating her.  The Italians want you to enjoy their food and it hurts their pride when you don’t.  But one restaurant in Florence slipped up with a paté that had shrimp in it.  Poor Rachel’s lips began to swell after two bites (thank God she had no anaphylactic issues) and within 10 minutes she looked like one of those grotesque women who’ve pumped too much silicone into their poor suffering lips. Think Cher or Joan Rivers on a bad day. No problem, I simply scooted down the street, I swear I think less than a block, found a pharmacist who set us up with some Benedryl and within an hour Rachel was back to normal and her typical happy self.  Let’s see, then there was Chris with pinkeye, Jeannine with, let us say, digestive issues... I could probably sit and think of half a dozen others, including mine and  Sandy’s numerous ailments  All handled quickly, efficiently, relatively cheaply, and with a minimum of fuss.
Doubtless the most serious situation we’ve faced was that of a wonderful young lady named Ella who was scurrying with us through the Termini Station, the main train/subway station in Rome, trying to make the train for the Vatican, and slipped and sat hard on her rumpus. No major problem there, she had adequate though by no means excessive padding, but she reached out to brace her fall and jammed her wrist.  Needless to say the whole group came to a standstill as we tried to minister to Ella, but that left arm was very sensitive.  One of the kids went to find some of the subway personnel, who in turn quickly sent their first-aid specialist who examined the wrist, tried to flex it, watched Ella wince and pronounced it probably broken.  Oy!  What now?  Not to worry, the first-aid specialist summoned an ambulance which arrived in less than 10 minutes (fortunately we were very close to the main hospital in northwest Rome) and Ella and I climbed in and headed to the hospital while the rest of the crew made their way, much more slowly, to the Vatican for the museum tour.  
Once we reached the hospital my job was to try to calm Ella while we waited for the ER physician.  You should understand that Ella has had serious arthritis since she was a preteen, though, like so many quiet heroes I’ve taught over the years, you’ll never hear her complain of it.  Still, it made the situation that much more tenuous.  And Ella was (and is) a champion equestrian who was scheduled to travel to an international equestrian camp in Canada two weeks after our tour.  Tough to contemplate for a sixteen-year-old with a wrist in a cast.  So the usually stoic Ella was understandably a bit sniffly.  All I could do was to encourage her not to borrow trouble, it would probably work out fine in the end.  Which, strangely enough, was exactly the right advice.  Within 10 minutes we saw the physician and he whisked her away for a full panoply of X-rays, and in less than 20 minutes from then the pictures had been developed, the ER doc had read them and announced that it was simply a badly sprained wrist.  Prescription: a sling plus a good dose of an analgesic with codeine in it followed by extra-strength acetaminophen for as long as she needed it.  The look of joy that Ella’s face showed was positively seraphic.  I attended her to the pharmacy and we filled her prescriptions, we walked back to the hotel and Ella went to her room where, after her dose of codeine, she slept like a baby for 8 hours and woke up happy as a clam.
Oh, I forgot a slight detail.  When we asked how we should pay since Ella had excellent insurance and ample cash, we were stunned to hear that she owed not a penny.  Even the dose of codeine was supplied free by the hospital.
I know II may raise some hackles here among some of my more conservative friends, but I have to believe one of the reasons you’re reading this blog is to have the perspective of someone who’s traveled around a bit and observed some of the good and bad.  I hear all the time that America has the best health-care system in the world and that European health care is a disaster.  Neighbor, I’m here to tell you, it just ain’t so!  By any measurable standard Italy has one of the best health care systems in the world.  In fact, in the most recent comprehensive study of world health care Italy came in at number seven.  The much-vaunted system in the US was number 32.  So here’s what I know:  Do the Italians like to complain about their health care system?  Oh heck yeah, Italians’ favorite sport is complaining about anything to do with the government.  Futbol is a distant second.  Here’s another news flash from Dave:  after 40 years of the educational enterprise I’m willing to go out on a limb and say ALL humans love to bitch.  It’s just what we do!  Meanwhile, when people talk about what a great system we have in the States, apparently they mean by that the best for THEM since they are medical or insurance types and we have by far the most expensive health care in the world.  Guys, private hospitals and insurance executives are making out like bandits at our expense! I’m not just blowing smoke here.  Sandy and I have toyed with the notion of retiring part time in Italy and one big consideration is the fact that Medicare is not portable across borders.  But there are several excellent European insurers who will insure each of us with the same or better coverage for about $170 per month.  Compare that to the $420 we and/or the state now pay for coverage which becomes more limited all the time.  Plus the amount we pay to the feds for future coverage. And we are two of the lucky ones who have insurance!  So in effect we are paying three times more and not getting a darned bit better care and in some ways far worse.
Surely it’s obvious to even the most recalcitrant nabob that the current U.S. system is unsustainable.  It is bankrupting our most vulnerable citizens, slowly, insidiously, sucking the lifeblood from our economy and making any attempt at responsible retirement planning a cruel joke.  I don’t have an ax to grind here, my father was a physician who despised the idea of socialized  medicine.  But at the same time he also despised the rampant commercialism he saw among the younger colleagues he brought into his practice.  To him medicine was a true calling; the most withering critique he could pronounce on a doctor was “He’s an entrepreneur.”
Is Obamacare the answer? I don’t have a clue but I admire him for trying to do something, anything about the current morass.  Would European-style single-payer care work in the U.S.?  I suspect it would but we’d have to suck it up  and dispense with some of the frills unless we were willing to pay more out of pocket, as they do in Italy.  But we already have had and continue to have our own ‘mafiosi’ with vested interests in maintaining the chaos and dysfunction in our current system for their own selfish ends.  And a depressing number of our mafia dons sit in the hallowed halls of our legislative bodies, most notably Congress. Spreading chaos and dysfunction.  Nothing will get done until we peons throw these bums out.  In the meantime, surely we can refrain from disrespecting the Italian system.  It’s pure slander and it’s immoral.  And we might even put aside our jingoistic chauvinism and learn a few things from Italy.
      Update:  Finally had to suck it up and go to the local ER for help since not even an Italian pharmacist can prescribe antibiotics without a doctor's prescription,  Sat in the waiting room for 1 hour 15 minutes, was seen by a very nice female physician who spoke some English and between her bad English and my bad Italian we did just fine.  Ten minutes later I walked out with prescriptions for Augmentin and a steroid.  Total cost:  zero.  Walked half a block to a pharmacy where a nice female pharmacist who spoke good English filled both prescriptions for 17 euro.  Best news of all:  took a taxi to the hotel where Fat Boy was just in time for dinner!