hospital stories (part two)

Now, where was I? Oh yes: student's car, passenger side, biting the skin off my knuckles and gasping in pain / giggling in shock as we headed for the klinika. Ah, such golden memories!

Before I launch into my little hospital tale, though, I should probably do two things: first, I ought to caution you that I've been asked to include some injured-ankle photos, so be warned that puffy foot shots are approaching. And second, I think this will all make more sense if I give you some context relating to the health care system in this country. So to that end, here's a sampling of what ex-pats, travellers and others will tell you about Russian hospitals and Russian health care generally:

"If you're in need of a doctor you are in trouble. They [hospitals] are short on supplies. Their doctors are not as knowledgeable as Western doctors or as well trained ... You can purchase medicine on just about every street corner, Metro Station, etc., but some are not controlled by the Government and most are outdated or will simply make you sicker. Medicines that are no longer in use in the Western world are sent to Russia ... Medical insurance may be of not much use at the time you need it."
- Russian Women's Guide.

"Russian hospitals often reuse needles, and screening of blood supplies is inadequate. Americans resident in the Urals and Western Siberia regions may wish to maintain a private blood supply, stock extra needles, or, in the case of emergency, insist on intravenous fluids over whole blood transfusions until they can reach the West".
- U.S. Consulate General, Yekaterinburg.

Open heart surgery is routinely performed without heart bypass machines; there is so little blood that non-emergency operations are constantly postponed and, even so, doctors and nurses often have to give their own blood to patients; and painkillers are in such short supply that Russian hospitals echo with the sound of screaming patients."
- Hugh Gusterson, Unitarian Universalist Church, Livermore USA

"Russian doctors don't waste a lot of time and money on preliminary tests - they go straight to the autopsy."
- Yakov Smirnoff, Russian ex-pat comedian.

I could go on (and on), but I'm sure you've got the general idea. Mm-hmm ... not nice.

Some other themes that commonly surface in patients' accounts include being refused treatment because they've committed the mortal sin of being a foreigner, developing rashes from hospital bed sheets (usually followed by the nurses telling the patient they should've brought their own sheets if they didn't want a rash), endless waits for emergency procedures (of course) and rampant staph infection.

So ... having been a good little traveller and read up about all this stuff before coming to Russia, I'm sure you can appreciate why I was feeling just a tad nervous as Giorgy, Denis and I drove up to the klinika on the night of my little 'accident'.

Anf how was my experience at the pointy end of the Russian health care system? Well, to be honest, it wasn't nearly as horrifying as it could've been. That was 99% due to the fact that my local school organiser Giorgy (who's high on the list of My Favourite Muscovites) and my student Denis (the guy who had offered me the lift home) came with me to the klinika. Believe me, that's the best possible thing that could've happened. Apart from having not fallen over in the first place, obviously.

A few months ago my friend Astrid (also an M.F.M.) took a spill while she was walking in town by herself. With no friends around to help her, Astrid lay on the ground screaming for about five minutes (on a main pedestrian thoroughfare) before anyone stopped to lend a hand. So if I'd sprained my ankle this badly while I was just schlepping around Moscow – as opposed to right outside my school – well, there's no other way to say it: I would've been utterly screwed. I couldn't walk. I had no idea where a hospital was. And I got the impression that the one we went to wasn't actually the closest, but was selected by Giorgy and Denis because it was the best one open. I heard Giorgy say "Och'n kharoshaya klinika" (very good clinic) at some point in their conversation. Which means that, by virtue of their local knowledge, I probably avoided having a far ickier experience than the one I had. So I'm thinking that, as small mercies go, that was quite a McHuge one!

Anyway ... when we arrived it was immediately obvious why ex-pats are so scared of Russian hospitals. It wasn't that it was horrifyingly primitive or anything – just kinda dysfunctional and very unsympathetic to non-Russian folk. But again, I was okay because I had two native speakers there to help me.

Here's how it went: to start with, casualty seemed to be closed, so we had to go around to some dodgy back entrance of the hospital. There some guy gave us a wheelchair, but only at the top of the staircase. And Giorgy had to go inside to explain why we needed it. Koroche: there's no way I could've entered the place if I'd been there by myself.

So then I got wheeled in – looking like a person who was plainly in some serious agony, I'd imagine – and the doctor was called. He arrived ... eventually. And amusingly enough, his first question was not about my ankle at all, but about my documents. And his second question. And his third. And his fourth ... and so on and so on, while I sat there wincing in pain and Guardian Angel Giorgy handled the interrogation.

Then the doctor told Giorgy there are only one or two hospitals in Moscow that treat foreigners, and that we'd have to go there. (I understood this only afterwards, in translation.) Giorgy's reaction was along the lines of "What the *bleep* are you telling me, you moron? This person is seriously injured!"

The next thing that happened – and here again, I was too absorbed in the whole "oh my gods, this is killing me!" experience to notice at the time, so I had to be filled in afterwards on this – was that money changed hands. Yes, you read that correctly: Giorgy had to bribe a frikkin' doctor to treat something which, at the time, looked like a possible fracture.

I must admit it was amazingly effective, though. I mean, once the bribe was paid, suddenly everything changed. We went from implacably slow Russian bureacracy speed (marginally slower than forest re-growth) to fast forward. It was straight up to X-ray, straight onto the machine, immediate diagnosis, immediate prescription, and home via the chemist's. Once again, if I'd been on my own I wouldn't have realised that the doctor was merely waiting for me to apply a lubricating smear of roubles to the situation before proceeding. I have a knack of missing these things; there have been plenty of occasions when I've struggled to get something done, only to see a Russian person accomplish the same thing easily by knowing exactly when to start passing notes under the table.

Um, and then what? Oh yeah. On the way home I spoke on the phone with Giorgy's daughter Yulia, who speaks some English. She told me about a lot of the details I'd missed at the hospital, and translated the diagnosis. Then student Denis brought me into my building and up the stairs, and I sat on my bed going "ow" and waiting for the pain killers to kick in. Once they did, I must say I felt rather chirpy! It seems that, like the Germans (who sell some truly awesome over-the-counter pain killers), Russians evidently don't mess around with those sort-of-vaguely-effective-but-all-very-tightly-controlled-by-industry-regulators-and-therefore-not-really-helpful drugs you get in Australia. (Sorry, Jonathan.) I guess they can't afford to, drinking as much beer as they do in a country full of treacherous, icy footpaths. But whatever the reason, popping a few of the little green pills certainly made me feel a whole lot less like amputating my leg just to be rid of the damn thing :-)

I had a week-and-a-half off work, during which time spring decided to pounce, quickly melting all the patches of ice that had been lying around waiting for people like me to slip on them. Which means that if I'd gone one more week without losing my balance, I would've been fine. Grrrr! Still, it was good to miss some of the thaw, and kinda fun to emerge after ten days as though from a chrysalis, stepping out into a completely changed environment.

I have to say that, while this whole ankle business was rather unpleasant, it's been such an essential chapter in my Big Scary Russian Experience that a part of me is oddly pleased that it happened. (Or at least I will be pleased once I'm sure there's no permanent injury.) I mean, apart from getting my first ever ride in a wheelchair, I've now seen the inside of a Russian hopital – an environment spoken of with fear and trepidation by most ex-pats, as I mentioned earlier. So in a sense, being able to eyeball the klinika while remaining relatively safe (due to the presence of my two Guardians) was like sneaking a vicarious peek into a dark corner of Russian life seldom seen by 'Westerners'. Quite a privilege, in a weird sort of way.

Also, there were just so many humorous &/or surreal moments along the way, I really wish I could've filmed it all somehow. Like for example, you know I'm flatting with an English lad called Craig now? Okay, maybe you didn't. He's basically an okay guy (and he was very helpful in the days immediately following my injury), but he does eat like an English bachelor – meaning that overcooked, deep-fried chips and oven-blasted cuts of crumbed flesh have been the norm since my fellow-foodie Reinhard vacated Moscow and Craig moved in. So when Denis and I got to the flat, Craig had just cooked dinner and the usual charred-corpse-and-burned-oil smell was hanging in the air. Denis is an elementary student with not many verbs at his disposal, so when he tried to say "I think your flatmate's dinner might be burning" it came out as "maybe ... hmmm ... maybe your food, he's dead."

I thought "Oh stop it, Denis; I'm trying to balance on one leg here!"

Six days after I went for my unscheduled slide in the car park, I got a visit from the school doctor (who was billed as a fluent English speaker - yeah, right!). She was lucky she didn't come earlier since, as it happened, that was the first day I'd been able to have a shower. That's right: five days, no bathing. We've got one of those showers that's inside a bathtub, see, and there was simply no way I could get into the tub. Thus I was probably not the most pleasant person to be around during that period.

Anyway, the doctor came on day six, just after I'd torn myself away from the bathroom, where I'd spent a very long time standing under the shower going "Oooohhh, yeeahhh!". She poked and prodded and supplemented my growing stock of prescription goodies ... and then, with a conspiratorial smile, she produced from her bag something that she obviously considered to be slightly miraculous. "This", she said, "it is special Russian medicine", and flashed a tiny jar of something called "yod" at me.

Next she pulled out a swab of cotton, opened the yod and began applying it to the area around my ankle. It didn't take me long to realise that the stuff I was being swabbed with was in fact iodine, so I asked the doctor "Was this really invented in Russia?" She nodded with the same air of wistful pride that you see in the eyes and postures of Russian people when they talk about Yuri Gagarin or Mikhail Lomonosov.*

I've seen this kind of thing before – Russians believing they invented things that are clearly not Russian in origin. I don't quite know where it comes from, but it strikes me as something you might also come across in certain parts of North America. My guess is that it derives from a combination of ignorance about what goes on outside one's own borders, and that silly überpatriotism that leads a person to believe anything truly great must have been invented by somebody from their own country.

This is just one of many similarities I've noticed between the Russians I've met (or at least quite a few of them –  certainly not all) and the Americans (ditto). But let's not even go down that path. Suffice to say I've learned that it's pointless, for example, to confront an overly self-assured white Muscovite with all the evidence pointing to the invention of Mayonnaise by the French. You can bleat on about Duke Richelieu's capture of Port Mayon in Minorca, and the great victory feast subsequently prepared by his chef (featuring a new kind of egg-based white sauce, created specially for the occasion). You can draw attention to the obviously French character of the word "mayonnaise" – variously thought to relate to the Old French word moyeu, meaning "egg yolk", or to the verb manier, to stir. You can, in fact, do what you like; it won't make a single bit of difference. Russians are frighteningly obsessed with mayonnaise, so your self-assured Muscovite will just re-iterate the obvious: that anything so delicious simply must be Russkaya kukhnya. Same kind of deal with iodine, presumably.

Oh yeah, and the internet? Well, that was invented by Al Gore of course. But he probably stole the idea from a Russian ;-)

So anyway, yesterday was a month to the day since this particular chapter of my Russian Adventure began. Spring is going full-tilt now, taking temperatures up as high as 15 degrees. The snow is a distant memory, and greenery is re-establishing itself. Which, I might add, is not entirely peachy. It may seem like an odd thing to say, but looking back on the Russian winter is a little bit sad and anti-climactic. For one thing, it feels as though one of my main reasons for coming here is well and truly in the past. But also, when the snow melted away it revealed what lay underneath: mountains of discarded chip packets, chocolate wrappers and beer cans, tossed into parks and roadside fields by a people who like to claim a special relationship with nature. Presumably this is how some of them express their love for Mother Earth – by sharing with her their favourite kinds of junk food and alcohol.

Winter's recession hasn't stopped the corpses from piling up, either. I saw my fourth dead guy last night. At least, he looked dead. You can never quite be sure, and you don't really want to go up and ask. "Er, excuse me sir ...".

I obviously didn't expect Moscow to be an easy place to live. What I had hoped for was maybe some kind of atmosphere here, or a cultural experience that would make the unpleasant side of the city worthwhile. I've found this in the classroom on occasion, but outside of that I've been a little disappointed, to be honest.

In the Western media you always hear that Russia is a harsh place because of its poverty and inhospitable climate, or that the 'hangover of communism' is to blame for its problems. Well, here's my experience: those things may be true to an extent (though the last one is vastly overstated), but they're not the explanatory be-all-and-end-all. I mean, for poverty and destructive politics Moscow is no worse off than Washington, and as far as climate goes ... well, hey, I come from Australia, so what can I say? Hard to beat an Australian summer for sheer meteorological awfulness.

Here's what saddens me, though: at times, it seems to the outsider that a lot of Moscow's unpleasant side comes from the much-glorified Russkie lyudi themselves. Not all of them, obviously, but enough to make daily life more of a trial than it needs to be. So, while Moscow definitely has a 'specialness', a uniqueness and a specific kind of mystery you won't find anywhere else, it isn't enough to offset the difficulties of settling here as a foreigner. Unless you're into nightclubs, that is – there are plenty of those, and they're reputed to be pretty wild. I didn't come for the clubs, though. Nor did I come to hang out with other ex-pats in ex-pat bars. So maybe I came for the wrong reasons. Or maybe not.

All things considered, I've learned a lot from being here and it's an experience I wouldn't 'give back' for anything (if the laws of physics allowed you to do that sort of thing). But frankly, spring's arrival has signalled that my time in this vast metropolis is nearly over, and I'm quite comfortable with that.

Got one or two more Moscow stories to tell first, though. I hope you'll be back to read those when they surface. Bye!

* A pioneering Russian scientist, credited with discovering a lot of things that were later credited to Western minds. (Then again, with the Russian predilection for claiming foreign inventions as their own, who can tell?) Also an author and seemingly a bit of a national hero.

stories from the city, stories from the ... er, hospital

(part one)

And so here I am, back in Moscow. Okay, so it hasn't turned out to be my favourite city in the world, but it is a huge city, full of sights and sounds and parks and museums and galleries and libraries and so on. And on that last point, we all know that huge cities don't just have libraries; they are libraries. Someone famous undoubtedly once pointed out that every city is a living collection of stories – the stories of the people who live there now, of those who have in the past, and of events within its perimeters. In that respect, Moscow is truly a great city; it seems to breed stories as efficiently as sewers do rats.

Within days of being back, Moscow's unfolding narrative had started pressing on my cranial walls once more. It started on the day that Maya left. As it happened, I ran into a fellow teacher at the airport that day – a Scottish woman called Sarah – who told me about something quite incredible she'd seen just a few hours earlier. Approaching the bottom of an 'up' escalator in a Metro station, Sarah had noticed an opened but nearly-full beer bottle sitting on the ground near the end of the 'down' escalator. Then, before she knew it, a middle-aged woman dressed head-to-toe in a priceless fur coat and matching hat had swept off the escalator, leaned down, picked up the beer bottle, drunk its contents in a single motion, replaced it on the ground and kept walking.

And so, you might ask: what's her story?

On the way back from the airport to Rechnoy Vakzal (the station at the top of the Metro line), I found myself asking a similar question about a dirt-encrusted gentleman of Asian/Siberian appearance who sat next to me on the bus. Having boarded a few moments after me and paid his fare, he lurched about for a minute or so and then fell fast asleep on my shoulder. Which is normal enough I s'pose – it's happened to me on Sydney trains, and it isn't uncommon on the Metro. But when we arrived 30 minutes later at Rechnoy, this guy was still fast asleep ... and I couldn't wake him! He was out cold. I literally had to lift him from my shoulder and lay him down on the back seat before I could get out of the bus. He was breathing, but something definitely wasn't right there.

Then, when I finally got home that day, I was talking to my flatmate Craig about what I'd missed while I'd been away from Moscow. It was mostly the kind of news you'd expect – things that had happened at school, reports of more extreme weather and so on. But he also pointed me to another thread in The Moscow Tales which had me kind of amazed.

To summarise: one of the Top 30 "domestic lenders" in Russia is an Austrian-owned organisation called Impexbank. They have a vault on a city street called Ulitsa Berzarina – something like a huge storehouse to which couriers deliver hundreds of millions of roubles each day for counting, packing and delivery to bank branches.

Naturally, Impexbank performs regular 'sweeps' of the area around its vault. They do this using hi-tech, seismically sensitive equipment, similar to that which the U.S. military claim to have used when they were putting everything they had (or not) into smoking Osama out of his cosy little Afghani cave complex a few years back. During one of these seismic sweeps in February, bank officials discovered a hollow chamber in the ground beneath the vault.

Like many areas of town, the streets around Ulitsa Berzarina are full of free-standing lock-up garages. And as it turned out, the chamber found by Impexbank security was the final segment of a 50-metre tunnel that originated inside one of these garages, wound its way beneath the main road, and ended up directly under the bank's premises.

The tunnel was no mere rabbit-hole, either; it was lined by wooden planks, and electricity had been installed inside. Whoever was in charge of building it had put in a supreme effort to make this a workable subterranean passageway. The bank watched it for three days to try and discover the identity of the criminal mastermind(s) behind this ambitious project, but no-one turned up. Which leaves quite a lot unanswered, really – like, for example, having got this far, how did the diggers plan to get through the cement foundation of the building? And having accomplished that, what was their plan then? The completed tunnel would've brought them up in a changing room for security guards; did they know this? Were they planning to hide in the changing room lockers, leap out and surprise the guards in their underwear? On this and other issues, facts remain unavailable.

Possibly the best part of all, though: once the tunnel's builders have been identified by police, lawyers will have quite a struggle trying to find something in the Russian Criminal Code to charge them with. Tunnel-building isn't defined anywhere in the code as an illegal activity, and since the builders never actually connected their underground passage to the bank, charging them with an attempted bank robbery will be difficult. A 'crime expert' from Moscow University pointed out to the local press last week that anyone caught constructing such a passageway could easily say they were simply interested in tunnel-building for its own sake. They could feign ignorance about the bank vault, and this might be difficult to disprove in court. Funnily enough, the vault isn't terribly well-signposted; there are no neon signs saying "Impexbank City Vault: Millions of Roubles Delivered Daily" or anything like that. So maybe the accused will argue that it was all a coincidence. Unless the police investigation turns up a map with a big circle drawn on it, an arrow pointing to the circle and the words "BANK VAULT" next to said arrow, this 'crime expert' thinks our diggers might conceivably walk away uncharged. I'm finding it hard not to love that :-)

You might've noticed, though, that all of these stories are quite fragmentary – no tying together of threads, no satisfying denouements and happily/crappily-ever-afters. And this is the inevitable drawback, I s'pose, of participating in the unfolding tale of a great city. You rarely find out how the other sub-plots end, and you're left with a bunch of unrelated hairy scary tales that remain incomplete.

But since I don't like to disappoint, here's a tale whose ending you will find out about – and it's one of my own.

Last Wednesday as I was coming out of class, some of my students were standing around outside the school chatting. One of them – a very amiable guy called Denis – was heading into Moscow for some benzin, so he offered to give me a lift as far as Metro Prazhskaya. After doing my usual "guy from a country where they drive on the wrong side of the road" trick (where I head for the driver's side of the car instead of the passengers' side), I turned and went around the car, explaining to my giggling students why I'd made the error.

Any fellow English teachers reading this will know that talking to elementary students outside of the classroom can be an engrossing experience. As you spend more time with them, you become very aware of how native speakers incorporate sophisticated language into even the simplest conversations. You start to notice yourself doing it, and so you invent ways to 'grade' your language by avoiding, for example, tenses you know your students haven't studied yet, or conditionals (try not saying "if" or "when" or "unless" for half an hour), or the weird phrasal verbs that litter the English language and have to be learned one at a time.

This is quite an interesting mental exercise, and you do get better at it, but it takes a lot of brain power to maintain that awareness of every word and every grammatical structure you use in casual conversation.

So anyway, on this occasion I was so wrapped up in explaining my silly "wrong side of the car" mistake that I completely forgot about the treacherous conditions of that day. Which was a deeply stupid thing to forget, as it turned out. See, the upshot was this: there had been some rain, but it hadn't melted all the ice ... just made it extremely slippery. So, as I was heading towards the passenger door, rambling about how Australians drive on the left side of the road, I fell down flat on a patch of rain-slicked ice in the school car park.

Now, if the embarrassment of this situation was the only problem, it'd be okay. I mean, I've been spotted plenty of times being clumsy in public, so I'm more or less used to dealing with that. But no such luck this time; as I was falling, I felt my ankle twist violently one way and then snap back in the opposite direction. My immediate response was to get off the ice, pick myself up and try walking, just to assess the damage. And that's when I realised that I couldn't use my left leg at all. I think it was actually during the split second I spent falling forward into the arms of my student Sergei that it first started to dawn on me how serious this was.

The students phoned my local school organiser Giorgy, who was fortunately still upstairs in his office. Giorgy came outside, cast an eye over the situation and conferred briefly with my students. He then got into the back seat of Denis' car. As Denis turned the key in his ignition, I heard the word klinika pass between him and Giorgy in conversation. Unfortunately that left me in very little doubt as to what would happen next. I was clearly about to get my first look at the inside a Russian hospital.

... to be continued ...