Health and Safety in Coast Rica
Back in New York (it seems like an eternity ago now) when it was way below freezing pretty much every day. I came home to the apartment and accidentally slipped on the first step of the landing. My whole weight landed on my arm and I heard and felt a bit of a crack and a crunch. The pain was intense but it subsided pretty quickly so I thought nothing of it. I think I have a pretty good tolerance for pain, as Dani points out quite often, when I come home with blood gushing from various wounds and don’t seem to even acknowledge them let alone with the severity that she would. Regardless, I carried on, oblivious to the fact that something might have come undone or a bone been fractured, after all it only hurt a bit when I reached backwards and I don’t do that move that often so on I went as normal for the next five months!
This blog isn’t supposed to be about me by the way, and certainly not a call for attention, I am fine. Unless of course you want to lavish me with sympathy, it is always welcome. This is more to express my general satisfaction and amazement regarding the health services on offer here.
Recently the pain started to move further down my arm and become a regular annoyance. Daniela has a best friend in Palermo who has studied and trained as a sport scientist and understands physiology and sport related injuries. She diagnosed the issue straight away and recommended various treatments, ice packs and rest mainly. But it continued to worsen, I am a terrible patient, so we decided, or rather Daniela did, to take a trip to a clinic an hour away and have it looked at.
We arrived at the clinic at the designated time to see the doctor and, after a preliminary check for blood pressure, heart rate and temperature and the giving of various particulars to a rather pleasant looking receptionist who spoke excellent English, it was back to the waiting room to while away some time until the doctor was free to see me. I, being used to A&E waiting rooms (I have two children after all!) was preparing myself for the obligatory long wait while people, arriving after me, got to see the doctor first. I have never understood that? But I was wrong.
The doctor called me right on time! An amiable and courteous young fellow who also spoke perfect English. He gave me a thorough examination, well, except for the rectal probe at least. It seems that these are obligatory in the UK after a certain age, or is it the pleasure the GP takes in the moment? I don’t know, but it isn’t pleasant. This doctor had an inkling straight away as to what the problem was so I was referred to get an ultrasound and possibly an X-ray to confirm his suspicions. Still no rectal probe. Things were looking good. The ultrasound equipment was an hour away. But we have a car so that was no problem. He made us an appointment and we had plenty of time to get there. We would have got there if we had had to rely on a public bus! So off we went to Nicoya and after a very pleasant coffee and a quick look around and some shopping we arrived at the other clinic.
Here they were expecting us and I was seen pretty much straight away by a very nice doctor who did the ultrasound. The kit they had was modern and very flashy, I was kind of expecting out of date apparatus held together with clingfilm and gaffa tape, requiring a good kick to get it going but I was pleasantly surprised that they had all the latest appliances.
The doctor recommended an X-ray to make sure that no bones were actually broken. So we waited another ten minutes and then I had the X-ray which I found incredible. I am a geek for technology after all. The image was up on the screen in a nano-second and the wonders of my internal skeletal structure were there, clear as day. A big shout out to Mrs Curie for her selfless and, ultimately, unfortunately, fatal contribution to the field of medicine.
After this it turned out that another X-ray was needed of the other shoulder to use as a comparison. Nothing but thorough they are. After 56 years on this planet my body has taken some severe abuse, nothing feels symmetrical any more and so I would assume that this was the reason. Or, maybe, they were just surprised at how out of shape I was compared to the other well toned, lithe, seventy year old surfers they usually get to see. I can still feel the bewildered eyes on me now. I have never broken a bone. Not one. But I remember seeing a chiropractor once who was amazed at how lopsided I was. He asked me dozens of questions about life style, accidents, everything. But it turned out it was because I played the double bass in a band for ten years. All that time leaning in one direction had made me a bit wonky. The double bass is a cumbersome beast to carry around!
The second X-ray was just as quick, and she let me take some photographs for all my doctor friends to help diagnose the problem. They haven’t yet. I don’t think they care any more whether I am lop sided or not. Maybe its all the pictures I post of beautiful sunsets and idyllic beaches in paradise? I think they’d rather I just died or got swept away.
Anyway, I was given a dozen pages of reports and photos of the ultrasound as a reward for my endeavours and suffering the pain of a thousand knife cuts for so long. Last time I saw an ultrasound was when my daughter was in her mothers womb, so it was pleasing to find that I wasn’t pregnant after all. I got a nice little gift of a CD rom of the images too which I shall enjoy looking at in greater detail later. Another bonus was that I got to see whether I had any shadows on the lungs. Being a smoker this is always a concern. We live in fear, it’s true, but, thankfully, it looks like they are clear, now the doctor friends can chip in and tell me that actually I am dying a slow and horrible death!!??
The original doctor, (remember him?) got the reports straight away by email and sent us his final diagnosis via WhatsApp. They actually make use of technology here, embrace it even. Turns out I have various damaged tendons, swelling and liquid on the shoulder a compressed thingumabob and, by the way, your heart is missing, only six minutes to live. Sounds pretty ominous but apparently he thinks some physiotherapy is the way to go? What a service? And a relief.
All in all the two doctors visits, ultrasound and two X-rays came to an even £100. And I have a CD Rom too! I think that is a bargain. I would rather pay as you go, after all that’s how we do pretty much everything these days. It’s a much better system. At least I am not burdened with the tax bill year on year of a badly run and inefficient system! But I think here I wouldn’t really mind. It seems well run, well managed and most of all pleasant. I cannot remember a time when I actually had a good time in a surgery.
There is also a free service here too. For those who can’t afford the treatments. And it is available to all except tourists. It is a great system and has a very good reputation. They get the same level of treatment as everyone else but at no cost. Obviously they pay taxes and some pay a little more than others when they can afford it. But it is exemplary. And I now have the greatest respect for all they do and how they do it. Good for them.
So if you are heading to Costa Rica for a vacation any time I can put your medical anxieties at rest by saying that you will receive a first class treatment in any situation and a better and friendlier service than pretty much anywhere in the world.
P.S.
After living in the UK all my life and spending countless hours in A&E (did I mention I have two kids?) I can attest to the fact that, though free, the NHS isn’t the speediest mechanism to deal with. It is overworked and underfunded too, there really is no surprise. My mother has had to wait weeks sometimes months for a follow up consultation for known heart problems? I would be happy for her to jump the queue!
I know that if you pay extortionate amounts into BUPA you can get to see the necessary clinicians a lot quicker but most can’t afford that on minimum wage can they? This is just one of the many reasons why I am no longer living there. I can’t stand the inequality, inefficiency and unpleasantness of it all.
Daniela disagrees. She has had first hand experience of the health system in the UK and says that compared to Italy it is an amazing service. I disagree too. Compare anything to Italy and you’re bound to feel privileged, even if you came from Ethiopia.
