Archives for January 24th, 2007

Maribor Hospital: Like chaos physics, but without the physics.

My daughter recently had a tonsillectomy requiring her to stay overnight at Maribor’s hospital. Although I’m generally a fan of Slovenia’s healthcare system, the evening turned out to be a lousy and traumatic and changed my outlook significantly.

People here love bitching about the hospitals, but I have to say that the doctors I’ve encountered so far have been universally smart, competent and fantastic at what they do. The problems, as far as I can tell, are on an organizational level. Basically, there is no organization. It’s chaos. And it starts right from the beginning: To see a specialist, you first have to go to your physician, who will give you a paper authorizing you to get examined. Securing an appointment can take weeks, or even months, if you’re unlucky. And you can count on spending most of your appointment day in the waiting room.

If you want to see the worst place in Slovenia, go check out KrÅ¡ko a Slovenian hospital waiting room. To which I should add: I don’t mind waiting. In fact, I love waiting. I always have something to read. What I don’t like is being damned, and that’s what you are there. The way the system works is like this: You and a thousand people show up in the morning. You try to find the right door among hundreds of identical doors. Then you take out your almighty zdravstvena kartica (health card) and wait for the nurse to emerge. This is always the worst part because the nurses appear briefly and rarely, and the sooner they get your card the faster you get in. So, of course, a thousand people want to get their card in quickly. And so you stand in front of the door, sometimes for up to an hour, you learn to appreciate the notion of Hitchcockian suspense. You and everyone else know the door is going to burst open at any minute, but you don’t know when.

At any rate: back to my daughter’s overnight stay. The first thing that surprised me is that, despite there being a one-year waiting list for tonsillectomies, she was the only kid in the room. It was just her and nine, freshly made, empty beds. The nurses later explained that the backlog is caused by the fact that they can’t handle more than three kids at a time, so they did the obvious thing and set the maximum limit to three. Of course, that doesn’t explain why there were no kids the day before my daughter arrived, and just her when she did, but I think it all ties in together with what I said before about organizational deficiencies.

Either way, there is a nurse stationed in the room throughout the day.¹ At around 10 p.m., the nurse leaves the room and a night nurse takes over. This one doesn’t come into the room itself, but stays down the hall and monitors the area.

And now the real pain begins. I was told that I could go home and sleep because: a) the kids are usually so drugged up that they sleep through the night anyway, and b) the night nurse was just down the hall and would hear if something was up. A little boy from Carinthia² had come later that day and his mother cheerfully left him in overnight. I felt a bit silly staying and was seriously considering going home. I decided to first wait and get a sense of how the night nurse was and how my daughter was sleeping.

The first warning bell tinkled when the night nurse didn’t show up. I was guessing (hoping?) that she would make a quick appearance at the beginning of her shift. But she didn’t. She came in an hour later to tell me that they would now turn off the lights, and that I could freely go. I told her I would probably leave soon and just wanted to make sure things were okay. I then quietly sat in the dark and dozed a bit. Thirty minutes later I heard some whimpering noises — coming from the other bed in the room.

The little boy had woken up and seemed to be asking for the toilet. He called out a few times, but no one came. I was curious to see how fast the nurse would come in, so I made a mental note of the time. But she didn’t come. I considered helping him myself, but if something had happened to him (if he fell, for instance) I’d have unwillingly entered a world of pain.

After ten (10) minutes, I got up and went to get the nurse. I found her reclining on a chair in the lounge, reading VeÄ?er, and chatting with some other staff. I told her, very politely and in Slovene, that the “little boy was awake.”

She gave me a funny look, then turned to her friends and spat:

“This guy’s trying to tell me how to do my job.”

I couldn’t believe it. I really couldn’t. But she wasn’t done with me yet. As we walked back to the room together, she accused me of waking the boy up. Quoth the raven:

“This is what happens when you watch TV in there or have a light on. You wake up the kids.”

In other words, it was my fault the boy was awake. I was the careless, negligent one among us. I’ve always been worried that my Slovene would fail me in moments of anger, but praise be to Allah for keeping my tongue loose that night.³ I immediately shot back that I wasn’t watching TV, hadn’t turned on any lights, and that the boy probably had to use the toilet.

And of course I was right. Unfortunately, the boy had pissed all over himself in the meantime. I felt bad for not having gotten the nurse sooner, but in a way he was lucky I was there at all. If I had gone home he probably would have soaked in his own urine for many more minutes, if not hours. Needless to say, I resolved to stay in the hospital for the rest of the night. I sat down and closed my eyes, listening as the nurse cleaned the dirty sheets and changed the little boy’s clothes.

1. This also surprised me. One nurse can only handle three bedridden kids, but a kindergarten teacher is expected to handle 15 fully active crazy kids? How is that possible? [back]
2. For some reason Carinthian accents strike me as Croatian. I regularly mistake Carinthian Slovenes for Croatian-Slovenes. I don’t know why this is, but for most of the day I assumed he was part Croat. [back]
3. I was especially relieved to hear myself using the double-negative correctly, i.e. nisem niÄ? gledal! which is literally “I didn’t nothing watch.” Getting my English brain to accept double negatives has been a huge challenge for me. [back]