I woke up at 4 am with a pain in my left elbow. It was a knotted, heavy pain like someone had whacked me with a hammer. I tried to ignore it and go back to sleep. The pain spread out from the tip of my elbow and dug into the meat of my forearm.
“Jesus fucking Christ!” I yelled.
I whipped the blankets off my chest and kicked outta bed. I clicked on the light and rotated my arm. My elbow was red and swollen. It looked like something had bitten me.
“That little bitch,” I muttered.
I was referring to the spider I’d found a week prior, living in the panels of my bed frame. I’d tried to squish him with the tip of a broom handle but he’d vanished into the wall. I figured he’d come back for revenge. This lit my ribs on fire and I started ripping apart my bed.
“When I find you I’m gonna tear your legs off and sprinkle ‘em on my salad!”
I heaved and pulled and flung. When I finished, I looked down at the mess I’d made. My mattress was splayed over a pile of books. My bed frame looked like an exploded tower of Jenga blocks. The spider was nowhere to be found. I curled my lip and reassembled everything.
After an hour of fitful sleep, I took a shower. As I hosed myself down, I noticed my elbow. It was now the size of a tennis ball. It hurt like a filthy knife wound, to boot. I toweled off and walked to the freezer. I spent the next four hours icing my arm and watching garbage.
Due to a string of cancellations, I only had a single private lesson that day. I showed up to it with sagging eye sockets and foul breath. My student shook my hand and asked me what was wrong. I flipped my arm over and showered her.
“Huuuaaannhh!” she gasped. “Vas happin?!”
“I don’t know. I think I was bitten by a spider.”
She thinned her eyes at my throbbing tomato. A light clicked on in her head.
“Dis no from spider. Dis from exercise.”
“Good God, really?”
“Yes. Did you do some verkout recently?”
“Yeah, fifty pushups last night before dinner.”
“And you do dis every night?”
I couldn’t let her know what a lazy fuck I am. It was bad enough I needed a bra more than she did.
“Most nights,” I said.
“Vell, you must have to injure it. I am athletic so I know. I really fink you should take elbow to doctor.”
Our lesson ended and I split to the nearest poliklinika (polyclinic). When I arrived, I went up to the skin doctor’s. I still wasn’t convinced the state of my elbow was from exercise. I showed the ladies at the front desk my swell-spot and they ooooohhhh’d.
“You should really go into surgery,” one said in Czech.
“Surgery?! Before we jump on that shit-wagon, can’t you just get a doctor out here to look at this?”
The lady scoffed and hit the intercom. A skinny ol’ prick with a shoe-brush-stash came out the back.
“What is it?!” he said.
“My elbow,” I whined, rotating my arm. “I think it was bitten by a spider.”
“That’s not a spider bite, that’s an inflamed joint! You should go into surgery.”
“For God’s sake, I’m not gonna have you guys slice open my elbow just because it’s puffy!”
The ladies started laughing.
“He doesn’t mean you should have surgery,” one said. “He means you should go to the Surgery Center at Karlovo Náměstí Nemocnice (Charles’ Square Hospital) nearby. It’s where they treat general emergencies like yours.”
I left the building and got on a tram. The whole way to the hospital I was tense. I thought back to the single time I’d been to Karlovo Náměstí Nemocnice (KNN). I’d gone in for a suspicious-looking freckle on my nutsack. The whole affair had taken five days. When I’d finally gotten to see a doctor, it was in a dirty little office with two other women. One of them was scrolling through pictures on her laptop. The other was fiddling with her cell phone. I walked up to my doctor and told her my problem. I asked if we could go somewhere private and she squinted at me.
“Are you kidding?” she said. “Drop your pants and lemme have a look.”
I bit my lip and did what she said. As I stood there with my cock out, the lady fished around for her otoscope (the ear thing). When she found it, she put it to her eye. I pointed to my nut-freckle and she leaned in close. As she did her examination, I could feel her breath against my balls. I almost started laughing. I turned around to see if the others were watching. Both were staring at my naked ass. The doctor finished up and popped her glove off.
“You’re fine,” she said.
Luckily, she was right. The freckle turned out to be nothing. Even still the examination of it at KNN had felt pretty unprofessional. Not to mention, it was embarrassing as hell. The one silver lining was that the whole thing had been covered by my previous healthcare plan. But due to “budget cuts” at my school I was kicked off that plan in September (2013) and was now on the one for “foreigners.” I was livid the day it happened. I had to trade in my clean green insurance card (the one Czech nationals use) for a laminated piece of toilet paper with a red stamp on it that read “Insurance for Foreigners.” Since that time I hadn’t seen a doctor with it. This meant my whole elbow-deal was hanging in the trees with fate’s dirty underwear.
As per usual, the clouds unzipped their flies and pissed on my head the second I stepped off the tram. I’d sprouted gills by the time I made to the Surgery Center. I waded up to the front counter and told the lady my problem. Her face tighten to a small V.
“It’s four o’clock!” she barked. “You should have come in the morning!”
“I’m sorry I had work. Plus, I don’t know the system here very well. I’m a foreigner.”
I gave her my ID and insurance card. She eyeballed them for a good minute.
“You’re from California?” she said.
“Well, ya speak nice Czech. Have a seat in the waiting room and we’ll get to ya.”
I took a chair amongst the injured. The state of the place was grim. The walls were yellow and the lights were flickering. Some dude with a busted ankle was groaning on a forgotten stretcher in the corner. A nurse the size of an iceberg finally called my name. I followed her to the back where the X-ray room was. She told me to hang my still-wet jacket and waddled into a glass booth.
“What do I do now?” I asked.
She scoffed and rolled her eyes.
“You put your arm on that table there and I X-ray it!”
I may sound like a pampered little twat saying this but I’m used to a bit of assistance in these situations. I mean, at the very least a lead apron and a seat. As it was, I got none of that. Just some walrus in a chef’s hat barking at me from behind the glass.
After half a dozen tries, the nurse got the X-rays she needed. She looked them over briefly and wrote me a slip. It said I had no big injuries. The source of my condition was simply listed as “zánět.”
Inflammation? I thought. Boy, that narrows it down.
I walked back to the crummy waiting room and parked it. Thirty minutes later, a girl from the doctors’ office called me in. She had curly blond hair and cherry lip gloss. A smiley face was pinned to her tit.
“So where’s my doctor?” I asked.
“You’re looking at her!”
My eyes nearly fell outta my head. I sat on the bed so I wouldn’t faint. Ms. Cherry laughed and went in the other room. She came back with two gloved hands and a syringe the size of a bike pump.
“Now I’m gonna drain your elbow, jooooo?” she said.
I nodded weakly and raised my arm. She grabbed it and stuck the needle to it. I sucked in deep and held my breath. Ms. Cherry snickered.
“You afraid of needles?”
“Not usually,” I said.
She shrugged and pushed the point into my skin. The pain curled my eyelashes. It felt like a beetle was eating its way through my joint. I wanted to scream. I bit down hard and bore it. The needle went deeper and deeper. Suddenly, I felt it stop. Ms. Cherry let go of the syringe and scratched her head.
“What’s the problem?!” I asked.
“Not sure. Normally I hit water by now but not today. Guess, I’ll have to go deeper, jooooo?”
I wanted to ring the little shit by her neck. I slouched forward and glared at the wall.
Ms. Cherry repositioned her mitts on the syringe. She slipped her tongue-tip up and pushed. The wall in front of me cracked. My nerves fired off like spooked pollywogs. I almost shit my pants. I slammed my fist into the mattress and growled. A second later, I felt cold. I looked over at Ms. Cherry and she was smiling.
“I’m there,” she said. “But you might not wanna watch this.”
At that point I didn’t give a crap. I tossed a few fingers off and gave her the green light. She gripped the syringe-bar and pulled. She pulled my eyeballs out with it. The pain tightened to a singularity. Then it expanded.
“There it is!” she said.
The tube swelled with bright orange liquid. It looked like alien blood. Once there was a good plug of it, Ms. Cherry stopped. She then drew the needle out.
“Seeee, now that wasn’t so bad,” she said.
I spent the next ten minutes gripping my elbow while Ms. Cherry debated with her colleague about what my treatment should be. They finally settled on two days in a bandage and sling with a check up the following Monday. They wrote me prescriptions for oral and topical inflammation-reducers and dressed my wound. The mucky ointment they used reeked like smoked meat. I thanked them for their time and they thanked me for mine. I left the hospital and walked out into the rain.
On Monday morning I hit KNN. My elbow was still swollen and immobile. I was hoping for better treatment and a new doctor. What I got was a longer wait and a teenager. The guy looked like Ferris Bueller in a lab coat. Only difference was someone had penciled in a mustache. I picked my eye with my middle finger at him and sat down. He quacked at me in rapid-fire Czech. I had to rehash everything that had happened to me. When I asked him his “professional opinion” of it all, he dropped his cell phone.
“It was probably just all those pushups,” he said, picking up the pieces.
“I just told you that!”
“Well, there it is.”
Another doctor came by and started chatting with him. Ferris ignored me and yacked it up. Ten minutes later, he had a nurse redress my wound. Then he punched out a slip and handed it to me.
“Two weeks, no pushups,” he said. “Oh, and keep taking whatever we’ve got you on.”
I followed the doctor’s orders. The pain went away a bit, but the swelling remained. This meant I had to walk around all day like an idiot with my sling on. When Friday finally came, I was ready to collapse. I returned from teaching that day at around 15:00. I entered my building and opened my mailbox. There was a letter in it from the tax department. I opened it hoping for a check.
“What the fuck?!”
It was a notice stating they’d pruned down my return. I crumpled it up and hurled it at the stairs.
I spent the weekend seething. That Monday I sought answers. My first lesson of the day was with a ministry lawyer. I told him my predicament and he laughed.
“Dey fuck you bouf kinds,” he said.
“How do you mean?”
“One to arm and one to vallet.”
“Yeah, tell me about it.”
“Me to tell you about it.”
“Oh, haha. Yeah sure.”
“Ok, in Czech Republic, it verk like dis …”
I won’t bore you with every tiny detail of what my student said. Nor will I make you suffer through a paragraph of his choppy English. In short, he explained to me that the reason my doctor’s visit was such a piece of shit was because hospitals (like many other public institutions here) aren’t getting the money they need to function properly due to widespread (political) corruption. This may not sound like news to any of you. And it didn’t to me either. What did though was my student’s way of illuminating the link between my crooked elbow and all those crooked pricks in office.
In a major city like Prague, there are three governmental “organs” that deal with our tax money. They are the Zastupitelstvo (City Government), the Rada (City Council), and the Magistrát (Municipal Authority). Now, when a public institution like, say, the crappy hospital I went to, needs to be reconstructed, the City Government kick starts something called “Veřejné Zakázky” or “Public Procurement,” whereby different construction companies bid for the job. Each company writes a price down, sticks it in an envelope and hands it to the clerks at the Magistrát. In theory, the company with the lowest price is contracted and Jan Q. Taxpayer saves a crown. In practice, however, members of the City Government and Council routinely take bribes from the more expensive construction companies, who end up doing the same job the cheaper ones would have. The result is, the politicians get paid, the contractors get paid, and we get fucked right between the knees.
So how does this relate to my elbow?
My student went on to explain that it’s not just the construction companies who are handing out bribes. Employees of public institutions looking to make their cushy jobs, cushier, will oftentimes grease the palms of the City Government as well. In the case of hospitals like KNN, a senior doctor gunning for director has only to bribe the right politician to get what they want. Once in power, this new hospital director will surely seek make their bribe money back (and then some). To achieve this, they’ll overstate the prices on equipment orders then go and buy crap (hence my miserable X-ray experience, etc.). Plus, instead of hiring experienced doctors, they’ll round up mostly fledglings fresh outta medical school cuz’ they can pay ‘em dirt and stick ‘em on five year contracts. And when I say “fledglings” I mean it, because unlike in America where everyone has to get a B.S. first, here in the Czech Republic, students can go straight into med school after graduating high school. At a guess, I’d say my doctors – Ms. Cherry and her colleague Ferris – were probably around the age of 24. Now, I don’t know about you, but when I was 24, I could barely keep my dick in my pants. Asking me to treat patients, even after six years of medical school, would have been like handing Iggy Pop a scalpel and inviting him to perform brain surgery on your grandmother.
To exemplify his point that the Czech Republic is indeed leaking with corruption, my student cited the case of Central Bohemian Governor, David Rath, who in 2012 overstated the cost of repairs to a local chateau called “Buštěhrad,“ by 7,000,000 crowns (roughly 350 grand). Naturally, he pocketed the cash. When the cops caught wind of this via phone recordings, they raided his house and found the 7 mil in a wine box. Under questioning, Rath played stupid. He claimed an anonymous stranger had given him the box, in which he had assumed was only wine. This response didn’t fly with the police. Upon further investigation of the man’s home, they found an additional 30,000,000 crowns. The source of this money is believed to be public tenders. Phone recordings indicate that these tenders were procured by Rath during shady purchases of medical equipment for three central Bohemian hospitals, one of which was run by a criminal colleague of his.
When my student finished his spiel, my head was swimming. I couldn’t believe how deeply and royally I (and the rest of the nation) was being fucked. I told him I was inches away from leaving the Czech Republic for good. He looked at me and chuckled.
“Ver vil you go? Back to America? Corruption is horrible der too. Plus, dee Healthcare system is much verse dan here, haha.”
I didn’t argue with him on those points. Still, I was curious if the US was actually below the Czech Republic on the Healthcare chain. I thanked him for the depressing convo and finished my day. When I got home, I looked around on the net. I came across a study carried out by the World Health Organization. It measured the “overall health system performance for 191 countries.” I scrolled through the rhetoric and found the chart. At the top of it was France. I flipped down further and found the Czech Republic. It was wedged in at 48, between Thailand and Malaysia. I went to click down, when I noticed the US. It was at 37, between Costa Rica and Slovenia.
“You silly bullshitter,” I said.
Now, I’m not a huge patriot by any means. In fact, most of what America does makes me sick to my stomach. I will admit however that the knowledge of having proven my student wrong did make me feel a tinge of pride. This got me thinking about my service in the Peace Corps. I wondered where Turkmenistan (my country of service) ranked on the Healthcare list. I scrolled way down and found it. It was at 153. While this is pretty low, I couldn’t imagine that there were 38 grades below it. As an active volunteer, I’d received OK Healthcare. But in my village, the Healthcare system had basically been one doctor that went from house to house with a syringe, pumping sick kids full of vitamin solution.
With memories of this weighing on me, I clicked down further. I passed through most of the Middle East, Asia and Africa. When I got to number 191, I looked right. There was the bottom fish all by its lonely.
Aside from a shitty song by Kanye West, I knew zilch about the place. I decided to investigate further. The things I read, especially those concerning the health of the country’s people, horrified me. Here’s a short but sobering list of them.
Sierra Leone has …
1. Among the highest rates of child mortality in the world (~20% in 2010).
2. A staggering infant mortality rate of 192 deaths per 1000 live births (2009).
3. A maternal mortality rate of almost 1 in 10 (2010).
4. Regular outbreaks of Ebola, yellow fever, meningitis, cholera, and Lassa fever.
5. A prevalence of HIV/AIDS, which is 1.6% percent above the world average.
6. An overall life expectancy of 57 years (2014).
7. And an entire generation of young adults, who are both drug-addicted and mentally ill because of atrocities they were forced to commit as child soldiers during the Civil War (1991-2002).
To deal with all this, Sierra Leone has a Healthcare system that is in shambles and a Mental Healthcare system that is virtually non-existent. In 2010, with the aid of the United Kingdom (the country’s former colonizer) and the United Nations, Sierra Leone tried to take action by launching “Free Health Care Medical Insurance,” which is “a system of free healthcare for pregnant and breast-feeding women and children under five.” While this plan was expected to save the lives of millions of women and children, many local women, especially those in rural areas, are unaware that they’re entitled to free medical care, and thus not using it. As a result, the country is still struggling greatly. It remains one of the poorest, most godforsaken places on earth.
After absorbing all this, I looked down at my elbow. It was bent up and swollen, but it was still there. Had I been born in Sierra Leone I might not even have my elbow ... or my damn life, for that matter, given the state of things. I sighed at this thought and crawled into bed. As laid there in pain, it came to me: Healthcare at its root, is a reflection of how much we as a people give a fuck about one another. So what does it say when the best we can do is ineptitude mired in corruption and the worst is one in five of our children dying before they see their fifth birthday?
Note: I reserve the right to occasionally alter the character names, descriptions, and/or event details in my posts for the purposes of identity protection and “fluidity of story.” If this puts a kink in your panties, read someone else’s blog, homey.