23 July 2010

Good Medicine

This week I had my first experience with the Swiss medical system thanks to a lingering malady which shall remain nameless because it's so embarrassing. OK, OK, apparently I've got gout, the so-called "rich man's disease" because guys who get it tend to overdo it with organ meats. Other than a little paté I politely nibbled at my mother-in-law's last Easter, I haven't touched any organ meats since I was old enough to tell my mother no thanks to liver. So I have no idea why I got hit with this painful condition, which, for two weeks has made my right foot feel like little sharp-toothed monsters are chomping on my toe joints.

This led me to overcome my fear of a doctor's visit conducted in French, and visit the little clinic in the town down the hill.

My sweet wife who was tired of my grimacing and not helping around the estate called to make an appointment for me, and here's where the differences between the Swiss and American health systems began to show themselves. They told her no appointment was necessary, and that if the doctor on duty didn't speak good enough English, one of the nurses would help translate.

When I got there, the man at the reception desk took my brand new Swiss insurance card. Everyone living in Switzerland is required to have health insurance, which has the added benefit of keeping out those rabid American Tea Party people who believe that that kind of government regulation is tantamount to communism, which they equate with the gulags.

In the U.S. I had paid $200 per month for an individual plan that didn't cover medications, vision or dental, nor pre-existing conditions such as my bad back or chronic cynicism. Nor did it cover mental health conditions caused by the stress of having a health plan that didn't cover most of the things I needed.

In Switzerland, I have an individual plan that costs the equivalent of $268, and it covers 80 percent or more of the cost of everything, even including the bones broken if I leap off a building because I feel invulnerable with my super amazing insurance plan.

In the clinic, with no appointment, I waited about 5 minutes before a nurse led me into the examining room and took my vitals. She clearly wasn't one of the nurses who would translate if the doctor didn't speak much English, but my French held up OK, plus it helped that my foot was conveniently swollen. She drew blood, and I then I sat there for about 20 minutes while the blood was analyzed right there at the clinic. Back in Hawai‘i where I used to live, you wait three days to get results from a blood test.

When the doctor came in, the first thing he said (in French) was that he was sorry but he didn't speak very good French. He's Italian, practicing in CH for reasons I clearly didn't grasp because it seemed to have something to do with the fact that his guitar-playing son likes Jimi Hendrix. I asked if he spoke English, and he said "leetle beet," which was the last English he used, though he did drop in the odd Italian word. When I complimented his French, he said that was only because I didn't speak French well enough to understand how bad his was. Point taken.

The only English I spoke was "ouch!" when he pressed on my toe. In French, the word is "aiy." (Does it seem weird to you too that there are different words for the response to pain? I guess, as toddlers, when we slammed our little fingers in the cabinet door, we could have been taught to say "aiy!" or "asparagus!" or most anything.)

Anyway, Señor El Dottore and I understood each other pretty well, and after plenty of poking and prodding -- perhaps he was trying to learn the exact pronunciation of that English word I kept repeating -- he concluded that I probably have la goutte, and wrote a prescription for an industrial strength anti-inflammatory.

He also asked if I eat the kind of organ meats that commonly cause gout. I tried to think of how to say, "No, that bloody stuff makes me hurl," but ended up just saying no, and that I eat mostly fish, chicken and some pork. But I'd read that alcohol can be a contributor to gout, so I confessed that I do enjoy wine. He smiled, shrugged and said, "C'est normal." I added that I usually drink a glass or two with lunch, and two or three glasses with dinner -- about a bottle a day. Another smile and shrug. "C'est normal," he repeated -- then added I should leave the corkscrew in the drawer for a few days.

I'm going to love the Swiss medical system.

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