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on just about every street corner, Metro Station, etc., but some are not controlled by the Government and most are outdated or will simply make you sicker.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.