“Never go to a doctor whose office plants have died!”
Erma Bombeck
Inspiration to write comes when you least expect it. It’s Tuesday morning, and I am in the waiting room of a medical clinic in Torino, Italy, to get a thyroid prescription refilled. I’m anxious, but hoping the visit is quick, and the doctor is generous with his prescription pad.
I have copies of my health history, prescriptions, reports and doctor notes. Either the doctor is going to appreciate my thoroughness, or I’m going to scare the hell out of him with some very interesting doctor notes. My doctor in California recorded everything I ever told her in those nice office “chats.” You could follow my life events in disturbing detail: a case of jock itch, bunions, a misdiagnosed trigger-finger, the risk of hemorrhoids with vegetarian diets, chronic heartburn, and a healthy discussion on STDs for mature individuals. I’ve never had an STD, but apparently 48-year old widows are at a higher-risk than widows over 60. I think that is terribly unfair. Individuals over 60 should have equal opportunity to catch an STD just like the rest of us. I’m a bit embarrassed, but this is my first experience with Italian healthcare, I have no idea what to expect. Let’s see how this goes!
The women who check me in are pleasant. When I approach them to discuss my situation, they are friendly and show genuine concern for my needs. They assign me a number and inform me the doctor will see me shortly. There is no discussion of insurance or financial responsibility. They appear to be unconcerned despite me informing them I am not covered by the national health plan and will pay for my visit. Their lack of concern gives me the impression this medical clinic is driven by care and not economics. I take my number, find a seat and open up my MacBook. I need to capture this experience in words.
There’s a smoking section outside the entrance to the clinic. When the door opens, a faint smell of smoke wafts into the waiting room and mixes with the smell of disinfectant. A radio station plays loudly over the speakers. It offers up hip-hop, electric dance, and pop. The song playing now has a repeating line, “Get up off your ass…thump…Get up off your ass… thump…Get up off your…Get up off your…Get up off your ass…thump!” I’m not sure everyone in the waiting room understands the words, but I let a laugh burst forth. In California, the only people saying, “Get up off your ass!”, are the frustrated patients talking to the office staff. Here everyone is orderly and patiently waiting for their number to be called. I am deep in thought on my MacBook when I hear my number called, “Settantatre, Settantatre!” That’s me, 73.
The doctor meets me at the door, greets me warmly in English and escorts me down a hallway. We enter the exam room, which looks more like a business office. As I enter, I immediately scan the room for familiar signs to calm me: doctorate degree from Oxford-check, family pictures on the desk-check, no painful probes in the immediate vicinity-check. There are two chairs on one side of a desk facing the doctor’s chair and a large monitor and keyboard standing ready.
We sit and discuss the reason for my visit. I subdue my habit of rambling and just give him simple answers. I explain my status as a pending citizen and my need for a simple prescription refill. I hope to avoid my elaborate medical history, when he says, “I’d like to your physician’s notes from the United States?” Oh shit, here we go!
I sheepishly show him my documents, lab reports, prescriptions, and less enthusiastically, my physician’s notes. He reaches for the notes first and begins reading. This is going to take a while. I wait and watch his eyes for any signs of shock or amusement. This guy has a poker face. He reveals nothing other than an occasional faint twitch in his right eyebrow. After what feels like twenty minutes of silence, he simply says, “Ok, so Italy has a different philosophy than the United States when it comes to medical care. Where do you want me to begin?” I have no idea what is about to unfold. Either I’m going out of this office in a biohazard suit, or he’s going to school me on everything I never wanted to know about medical care.
We have a lengthy discussion about my thyroid. Thankfully, he doesn’t ask about about jock itch, hemorrhoids, STD risks, etc. His only advice to me is when it’s time for a colonoscopy in Italy, choose your doctor wisely. Apparently, the Italian health system likes to keep you wide awake during the procedure. Seriously? He tells me that the US overmedicates everyone. I agree with him in hopes to show solidarity. He informs me of the dangers of ibuprofen, aspirin, and his particularly dislike of acetaminophen (Tylenol) mixed with alcohol. I happily volunteer that I never touch the stuff…Tylenol that is.
We talk about my former career in health care, his education and the different approach to medicine in Europe. After what seems like minutes, I look at my watch and realize it’s been over an hour! This discussion was a medical visit, an educational overview of European health care, downed with a chaser of psychotherapy. I thank him, and he walks me back to the waiting room and writes my prescription. He wishes me a good day and leaves. I have my prescription, a healthy view of the Italian health care system, and comfort that when I need medical care, I’ll be in good hands with this doctor.
In 2000, Italy was ranked by the World Health Organization as #2 in developed countries for overall efficacy among 152 participating countries. France was #1. The United States ranked #37. (https://www.who.int/whr/2000/en/) A primary care doctor in Italy earns on average $84,000, 1/3 of the average in the United States at $230,000. (https://www.expatfocus.com/destinations/italy/guide/salaries). Thank you for following The Spaghetti Diaries. Please subscribe to receive notifications of my latest posts.
You are an incredible writer. I felt like I was there with you! congratulazioni per il tuo viaggio! Che cosa ti manca di più da qui …. perché sarei felice di spedirti Trump !!! A Hahahaha. Be happy Lucca!!!
On Fri, May 3, 2019 at 8:58 AM The Spaghetti Diaries wrote:
> Luke Lombardo posted: ” Never go to a doctor whose office plants have > died!Erma Bombeck Inspiration to write comes when you least expect it. It’s > Tuesday morning, and I am in the waiting room of a medical clinic in > Torino, Italy, to get a thyroid prescription refilled. I” >
Grazie mille, bello! Il mio viaggio è un’esperienza senza parole! Ogni giorno è una nuova scoperta. Mi manca il cibo messicano e la famiglia e i miei amici!
Lucca,
Thanks for the inner view of the Italian healthcare experience! Visit 1 a success and I trust the colonoscopy experience in the coming years will be equally painless.. pun intended.
Love you and keeping living your life in 🇮🇹!!
Lisa
I thought you would appreciate it! The music alone rocked the entire experience. And yes..I think I’ll have a group chat during the colonoscopy just in case I need a diversion from the process. 🙂 And everybody breathe…… Love you both and sending big hugs from the homeland!
This is one of my favorite parts of your blog, a fun and succinct way of explaining the cultural differences in typical, mundane events. Who recorded “get up off your ass”? You know I’m a geek for the soundtrack of our lives. kiss kiss
Thank you…my beautiful friend!!! When I find the soundtrack…to “Get Up off Your Ass”..it will be my anthem and we will sing it in Italy together! (sans hospital). I have to say, I never heard the song by the expression..is priceless on so many levels. Sending love to you! Kiss Kiss backatcha!
Luke
I’ve got some good news and bad news. First the good news: you continue to show bravery, wit and a knack for storytelling that makes these posts must reads in the Sears household.
Now the bad news: Given your reception, the music, length of appointment, lack of standard Dr. office accoutrements, and relative inexperience with the Italian language I have to inform you that you just completed an interview for DJ at a gay Italian Disco. Oh well, things could be worse!
Mike
Mike, I am still laughing out loud. I thought it was an appointment for a prescription refill, but now I realize you are right. I have been hired as a go-go dancer at the local discotheque! No wonder they handed me something that looks like a slingshot and a Costco sized box of plastic wrap. Oh I wish I had figured that out sooner. They mentioned something about 20 euros per hour. I thought that was the doctor rate. 🤔🤔🤔.
Thank you for following the blog and tell the Sears family hello from Italy!
Excellent as always! As someone who will be on thyroid meds for life, I can certainly understand what a relief it was that the prescription will be filled. What a wonderful doctor to take that kind of time with you to give you a heads up of things to come!
Veronica “V”!
Thank you thank you thank you!! He was a great doctor..considerate, compassionate, and a bit humorous too! If you have to go..find a good one, right? Thanks for your comments and sending hugs to you!
I have known you as long as I have been with Lou. So about 14+ years. But not until the last 2+ years have I kinda got the inner working of the real Luke. Which is very much like Lou. So I laughed as I can see/ almost feel the “crazy” running through your head during this doctor visit! 🙂 Keep writing and keep being you! Love you tons!
R.T.Aanes
Thank you!! Your friendship and support helps make the real “Luke” very happy! I’m sure you have had similar cultural WTF moments…we share those in common! Thanks for your encouragement and we should both keep writing! It’s what we love! Sending love back dall’Italia!
Another adventure, another story, another winner! Keep entertaining us while you explore Italy and their health/medical care … but feel free to stop short of STDs.
Thank you! Each day is something wondrous! And yes, STD’s are specifically excluded from my current health insurance plan 🙂
Enjoyed your blog. Interesting. Crazy enough, I look for plants in doctors offices. I cringe when I see they are not being taken care of. 🤣 Need your thyroid meds. ML 😊
I am happy that you enjoyed the post, and there’s nothing crazy about looking for signs of life in a doctor’s office! Green plants are signs of life and love…dead plants..not so much :). And another interesting note, my thyroid meds in Italy cost me about $10 WITHOUT insurance.
WOW on the thyroid meds. I pay $107 for a 3-month supply, with insurance.
Sounds like you are in a great, beautiful place. Enjoy! 😊ML
Thanks, well written and fun to read. If it ever comes down to it, I will be paying cash for an anesthesiologists!
Thank you, Antonio. And yes…anesthesia is your best friend during a colonoscopy!
Thanks for the blog entry!
Since you mentioned colonoscopy, I thought I’d pass on the following experiences. (We are in Le Marche.) When we mentioned to our medico di base that one of us was due for the procedure, she was a little hesitant given that the last one was clean. But she said that we were free to get one, no referral needed. Interesting.
So, we went down to the recommended local private clinic. Almost all prenotazioni there are done with a lady at a sportello, but not colonoscopies. So we headed down to the basement to wait behind a door. After 5 minutes or so the door opened and a staff member in scrubs led us to a small room. After about 5 minutes of animated small talk (e.g., how beautiful California was when he visited there – we get that a lot), the appointment was made for a month out. However, in a very serious voice he said he had to inform us that the procedure would cost €130! My wife and I looked at each other in disbelief, checking to hear that we got the number right. We did. We then asked him about anesthesia. He laughed and said that of course they use anesthetics (similar to what we’ve seen in the US). And by the way please use this new improved prep formula that requires only 1 lt of water rather than 4.
This was a private clinic, so we don’t know if the experience would be the same at a SSN facility. And the procedure hasn’t happened yet so our viewpoint might change in future.
It sounds like you had a great experience as well! I am a few years out from the “C” word – but I’ll be sure to investigate. And the cost differential, is staggering. No wonder why our expenses are so crazy in the United States. I worked in health care for 25 years, and never have been made more aware of the disparity of the system as much as I have in the last three months. Good luck with your “C”..and thanks for following the blog!
I’m working on that equal opportunity! Love your writing Luke and you too.
Ha!!!! There is still time! Thank you for following and I hope all is well in your part of the world today! Big hugs..Dave! Sending love to you too!
You lost me at ‘Being wide awake during a colonoscopy.’ 🤔Lol. And the dangers of Ibuprofen and Tylenol? 💊
Anyway, thanks for an inside view of what a doctor’s visit is like in Italy.
( Not having insurance. I never find myself at a Dr’s office) ( Except an eye doctor every 20 years). Interesting to know what happens in one.
Love your writing style.
Miss You Luke. 💋💜
Bri Bri!! Yes, I’m not surprised. Who wants to talk about colonoscopies? 🙂 Thank you so much for reading and I hope you are doing great. Miss you too..and our coffee talks on El Paseo. XOXO to you and stay beautiful and well!
Hi there! I am in the desert this week and just read your latest. I am living vicariously through you!! I really enjoy your journal. 🙂
Thank you!!! I hope you are enjoying the beautiful weather. Thanks for reading and for the compliments, JR!