Saturday, August 27, 2011

Hacienda Hospital

Here we sit at the brink of our fifth year in Oaxaca. It was the place I dreamed of moving to, assumed it was impossible to make a living in, and now has become home.

But I don't want everyone to think living here is all wine and roses (or mezcal and bougainvillea, to make that cliche local). I tend toward the sunny in most aspects of life, and living in Oaxaca is no different. But yesterday was a litmus test. Steve had hernia surgery at a private clinic here. When you decide to go under the knife in Mexico, you know you've made the commitment. I was nervous, even though I know that the health system has been far more personalized and accessible here. It's a cultural leap, seeing how other countries deal with medical care.

The first surprise--they said I had to spend the night in the clinic with Steve. I asked everyone I knew why this was so. They said there are no nurses, that I'm the one to judge when Steve will need painkillers or use the bathroom or whatnot.

It shocked me. And then it turned out that was wrong. There are so many nurses, and they are so attentive (keep in mind we were in a private clinic, albeit an extremely cheap one, so I cannot compare the care we had to that of patients in the IMSS public care system). We hardly got a chance to rest or sleep with their constant checking.

But there was one key thing missing at the clinic, which I came to think of as a hacienda/hotel for sick people. No nurse call button, and no phone. That was my role--to take the few steps to the nurse office (this clinic had all of five rooms, each one for one patient and a sleepover buddy) to ask for anything Steve might need.

Another interesting contrast: You have to beg to leave. There is none of the HMO-induced pushing your out of your room, or bed, though Steve really really wanted to get out of there. Again, this might have to do with being in a private clinic, though my Oaxaca friends have had long stays in the IMSS hospitals as well.

The system also tends toward over-care. They kept Steve IV tube in much longer than necessary, saying "Why not? This way he doesn't have to swallow the pain medication." I told the staff he wanted the IV out, that he'd rather swallow pills, but no go.

One last surprise--when the doctor came in to consult Steve, he first came over and kissed my cheek. Maybe because Steve knows him socially, but still such a surprise to get a full Oaxaca greeting from a doctor.

For those wondering about clinics and options in Oaxaca, I'll close with one final bit of gossip that tantalized my imagination, for no clear reason. Story has it that our clinic, which was spotless and plain, is the cheap-but-nice option, and that there is another elegant, super high-care hospital in Oaxaca where many of the fresas (yuppies) and retirees go. It would have cost us 35,000 pesos for the surgery and hospital stay rather than the 20,000 we spent (about $1,600 to $1,700). You have to wonder what the extra $15,000 buys you.

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