I spent Thursday afternoon preparing to spend the weekend in western Ukraine with my partners-in-crime: Brian and Ian, two CMCers interning for the Danish Refugee Council. I wasn’t really sure what the weekend would entail other than two 14-hour train rides in what Ian referred to as the “proletariat class,” loving on Afghan refugee children, and some sight-seeing here and there. I searched for an ATM that would accept my MasterCard, purchased water bottles and snacks, and began to pack. About an hour before we were going to leave for the train station, I start to feel funny. Really funny. At first I considered getting on the train anyways. The city we’d be in was close to the Slovakian border, and I figured if I needed medical care, I’d rather get it in the EU. The hotel we booked had AC and wifi, so if I just needed bed rest, I’d be more comfortable there. However, I knew that if I got on the train, I’d essentially be trapped there for fourteen hours, and that wasn’t a place I wanted to be sick.
I called my dad at work. He searched around for one of the emergency doctors, and I spoke with him for a few minutes about my symptoms. His message was clear: It could be a UTI, but it could be worse. Either way, you need medical attention, since without treatment the infection can hit your bloodstream and go septic. Go to the doctor. Don’t wait.
I called the number of the US Embassy listed on the website for emergencies, and couldn’t get through. (Umm...?) Luckily, I’d met some American Marines who work at the embassy the weekend before, and I got the embassy’s actual number, and was patched through to the nurse on duty. She directed me to a hospital that was considered the best in Ukraine, and told me the doctors should speak English. I get in the cab and go. The boys, gentlemen that they are, offered to go with me, but I wouldn’t hear of it. In my head, it still couldn’t be that big of a deal, and I didn’t want them to cancel their trip (which, for them, was work-related) over this.
I got to the hospital, and the reception staff doesn’t speak English. I try pointing, but that doesn’t work. The only relevant word I know in Russian is “emergency,” but I can’t describe any of my symptoms in Russian. Finally, they bring out a doctor, and his English isn’t great, but it’s better than my Russian, and it’s enough. I tell him I think I might have a urinary tract infection. He orders a blood and urine sample. The former he was going to take from my finger, but he had me do the latter first. He took one look at the sample and said, “You need an IV, so let’s not bother ruining your pretty fingers, we’ll take the test from your arm.”
Before I got the IV, we got into a bit of a spat because I had heard horror stories of hospitals re-using needles in Eastern Europe, and I didn’t want them to poke me with anything I didn’t see come out of the package. At first the doctor thinks I’m joking. “Oh, don’t worry, you see that sink right there? We just washed it [the needle]; it’s very clean.” I must have looked terrified, as he quickly added, “No, no, single-use needles, we haven’t re-used needles in a very long time in this country.” I insisted I wanted to see it come out of the package. “What kind of country do you think this is? We had single-use needles even in the Soviet times!” I’d clearly hit a sore spot, but this is one of the few instances where I’m not going to feel an ounce of guilt for being the ugly American. Finally, the doctor has the nurse get a new needle. She looked quite confused, and the doctor told me, pointedly, “You see? She is young enough that she doesn’t even KNOW there was a time when we re-used needles.” Each time I needed a new shot, he made the same joke about washing the needles in the kitchen sink, and, each time, I was not amused.
I was lying in the hospital bed being pumped full of saline solution and antibiotics when my urine test results came in. “Ploha,” the doctor says. “Ochen ochen ploha.” Very very bad. He tells me he is surprised I am only now coming in because, given how advanced this looks, I’ve probably had this for at least a couple months. This comes as quite the shock because I’d felt fine until about 9pm that evening. The blood test came in about an hour later, and those were also ochen ochen ploha. The infection had hit my bloodstream, just as the American doctor warned could happen. As the doctor upped the dose of antibiotics, frantically rechecked my vitals, and shot me full of painkillers, he told me that I was about to go septic, and if I had waited until morning to come in, I could have died. In my head, I noted that if I had gotten on the train with Brian and Ian, the train that wouldn’t have arrived in Mukachevo until 2pm, I almost certainly would have.
I asked the doctor what kind of bacteria I had, where I could have gotten this infection, if he knew where exactly this infection was. He told me they didn’t test for the type of bacteria, as it would take a week for results to come in. He explained that, “in our country,” they give broad treatments, and then order more tests if the patient doesn’t respond. It saves money, he said. The entire ER visit was about $100, so money isn’t my first concern, and I told him that I wanted him to order the extra tests. I didn’t want to still be sick in a week, but then need to wait another week for the test results to come in because he didn’t order them this week. He deferred, saying I would see a urologist the next day, and he would decide whether I needed them or not.
The next day, I asked the urologist where I had this infection. “Who knows? Maybe your bladder? Maybe your kidneys? It’s very advanced though, so I think it’s your kidneys.” I’m alarmed by the lack of curiosity. Shouldn’t he be testing to find out for certain? As if he read my mind, he added, “I’d give you the same medicines regardless.” He also doesn’t think I need a specific test to determine what kind of bacteria is causing this, as the antibiotics he’s prescribing should kill it anyways. Like the ER doctor the day before, he says that this is how they do things in Ukraine, and 95% of the time, it works. My mom would later explain to me that this is what many American doctors would do for patients with MediCal or other insurance programs for the poor.
I thought back to last summer, when it seemed as though the quality of American healthcare was at the forefront of everybody’s mind. One fact that came up constantly was that Americans spend more than most other countries for healthcare, and it was open for debate why that was. One explanation that was frequently offered is that American doctors will test more aggressively than doctors in other countries, and Americans are more likely to seek medical attention for minor issues. I’ll say in my defense that, less than 24 hours after the doctors told me I had been close to dying, this isn’t exactly a “minor issue.” But I wanted more testing. I wanted to know what kind of bacteria. I wanted to know where. I might not have been able to do anything with the information myself, but I wanted the doctors to want to know. But if they were going to prescribe me the same meds regardless of the bacteria, regardless of which organ was infected, does it really matter? To me, once the words, “You could have died,” escape the doctor’s lips, I deserved all the extra precautions of having a backup plan in case I didn’t respond to treatment. But what if it hadn’t been as serious? Would I have still insisted? I can’t help but think I probably would have.
***
I’m home from the hospital. They sent me with half the pharmacy, it seems. No fewer than six types of pills to take every day, an herbal tea with anti-bacterial properties concocted for those with kidney ailments, and a chamomile soak for my bath. The last item confused me greatly. “Is it tea,” I asked the pharmacist in Russian. “No, it’s for bath.” Knowing some languages have different words for tea made from the tea plant, and tea-like beverages made from something else, I decided to press further. “Do I drink it?” “No, it’s for bath.” “Bath?” “Yes. Not shower, but bath.” She made some scrubbing motions. “Clear?” “Umm…. Yes… I take a bath with it?” “Yes.” “Ok….”
I spent two days in bed. I napped, I sweated through 100+ degree heat, and I finished one novel, read all of another, and then read the Perry v. Schwarzenegger decision. I got up only to take my medicine, go to the bathroom, grab the occasional slice of bread and cheese, or brew myself another pot of my kidney-tea. On Sunday, I finally had the energy to stand up long enough to take a shower and to actually prepare myself a meal. Today, Monday, my boys came back from their trip, and I left my apartment for the first time to get lunch, groceries, and wifi. I’m taking baby steps getting there, but I AM getting better, and I am NOT going to die in Ukraine, if for no other reason but the fact that I refuse to.
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