Can you tell me? What's ailing me?

It is October 21^st and I had my first appointment with my primary doctor here in Italy. 

I had had an initial appointment with another doctor when I first arrived.  I did that out of necessity because I have some chronic conditions that require daily medications.  I wasn’t particularly impressed with the doctor.  She didn’t speak of word of English, which is fine, but she acted like she was afraid of me and wanted to know if I spoke French.  Sure…Bonjour.  Merci.  I took French 50 years ago in high school but not a lot of it has stuck since I never had occasion to use it.  (Although I have been brushing up via Duolingo lately)

Well, here I am, three years later, five years into the “remission” of my rheumatoid arthritis symptoms.  It was a particularly dry and hot summer and I was uncomfortable.  I blamed it on the heat.  That is, of course, until the summer heat gave way to Fall and cooler temperatures and I still felt lousy.  Increased pain. Increased stiffness.  Crippling fatigue. Getting crabby.  I need to see a doctor.

The last time we signed up for the healthcare for the year, we chose another doctor recommended by a friend.  He also speaks no English….but, nevermind.  This is Italy, after all.

I made an appointment and arranged to have my Italian teacher (who is half Italian, half British and raised in England) to come with me.

Off we went today to UTAP…the center of medical offices in the town. UTAP is down the road from the supermarket and Cafe Franco.  To the west are lovely views of the mountains.  It is located in a ridiculous building that is three stories with many, many steps and one little elevator that sometimes doesn’t work. 

Pre-Covid, this is where I walked once a month to renew my prescriptions.  I had to go to the “first floor” which in the US is the second floor…and wait in line to reach a lady at a desk who would take my health pass and my medications and enter them all in the computer and then issue me a number on a little post-it sticky pad sheet and then go sit and wait. 

Just a big room with plastic chairs lining three out of four walls…a Madonna sitting in one corner…Catholic country, you can’t escape it…..and open space in the middle for the line, which sometimes would wind out the door.  Eventually, a lady would emerge from a side door to the right with a fist full of papers and start calling out numbers.  Venti.  Venti uno.  Venti due.  And then you would dutifully march up with your sticky pad and receive your prescriptions.

Covid changed all that.  Covid changed everything.  After that…and to my somewhat horrified delight, we had to telephone for our scripts.  Delighted I didn’t have to make the trek, wait in line, wait again and slog home, but terrified of the telephone.

I practiced what to say.  It mostly went well, sometimes not so well, depending on who was on the other end of the line.  There are one or two very nice ladies who don’t freak out when they hear an accent…and are patient enough to listen and….omigod! They understand me!  There are others who simply hang up or pretend they cannot hear you.  Luck of the draw. As I get more comfortable with the process and the language, the whole procedure goes pretty well most of the time.  Then they send the scripts via email.  You can either print out the bar codes at home or take your phone to the pharmacy and the scripts get filled. (no charge)

To see a doctor, one would go to the 2^nd floor (the third floor in the US) and check in with the secretary and also get a number.  The room has rows and rows of attached seats, much like an airport where the patients wait. There was an LED monitor on a wall which informed those waiting what number each doctor was ready for.  Most internist doctors’ offices were located there. 

Well, back to today.  The elevator was working and I pressed two. Up it went to “one” and then the light went off and I was alone in the pitch dark in a little metal box suspended between two floors.  I was momentarily terrified but then the doors opened and there was my teacher…..(she went up the many stairs) but we were on level one. 

The room where I used to get my scripts has been emptied…no chairs, no Madonna….one desk where there used to be two and the end…and at the entry door  an ad hoc “office” was set up.  Plexiglass barrier….double desk…computer…printer…other office stuff…..I began to slowly pull myself up the stairs to level two when I heard “Signora!  Signora!’…that would be me…..and my teacher explained that the elevator works for level two when they tell it to. 

Ok…back to the elevator…..up to two.  All the airport seats are empty.  In fact, the whole place is empty, like a ghost town.  The once bustling office with two stations and telephones, printers, computers, records….is dark.  “Chiuso.”  The doctors’ offices are there, with their names and hours printed on papers beside the doors.  We cannot find the doctor I am supposed to see.  ?????

So, my teacher goes back downstairs…oh….no…his office is down here.  No worries, we will send him up when he gets here!

Well, for whatever reason, we still had to go back down and see him in a small room that was behind another room on level one. 

He was right on time.  Jeans and a thick knit crew neck sweater.  He’s probably in his forties…he is slim but has a tiny paunch…what they now refer to as a “dad” body…his hair is so close cropped it hardly exists.  He has a nice face, a ready smile….he is told that I ‘speak Italian and I understand if you speak slowly.”  He tries. Hahahahhaa…very hard for Italians to speak slowly…hahaha.

I have a 30 year history of rheumatoid arthritis.  He said what I truly expected a good doctor to say…”You need a specialist.”  Damn it!!!  Why do you have to be a good doctor??!!!!! 

What this means is…the odyssey begins. 

The huge advantage of having my teacher/friend/translator with me was that she managed to finagle me to have my initial bloods drawn here at UTAP rather than at the hospital, which is up a tremendous hill and a labyrinth in and of itself.  My bloods will be drawn in early November. 

As an American, I will have to pay an initial fee for the first blood draw.  All of 60 euro.  My teacher was astonished.  Why should you have to pay?  No!  There must be a way around this!

I had to explain to her it is because we are not part of the EU…it’s fine, 60 euro is NOTHING compared to what I have had to pay in the US for certain blood tests…calm down…it’s nothing. I will pay with a smile on my face. Happily.

Now, her next challenge is to make an appointment with the specialist.  She tells me her husband also needs to see a rheumatoid specialist, so she would have had to arrange something one way or another. 

As far as I know, the specialist is in Pescara, the large beach town and administrative center of this province.  It is about a 25 minute ride.  We don’t have a car, but, as my teacher told me, she would have to take her husband anyway, so maybe the two of us can be seen on the same day?  I was given the name of a particular rheumatologist from another friend (who is now the “vice mayor of our town!) That seems to be how things work here, friend of a friend, word of mouth, call this one, get a name.  Otherwise, the convoluted bureaucracy can become confusing and frustrating.

There is also a little matter of some abdominal pain, which we mentioned, but that got lost in all the other talk, so I am in limbo with that.  Not sure if it is an old umbilical hernia coming back to haunt me or the gallbladder acting up.  I was hoping to avoid an emergency room but between questions in both Italian and English and scripts for blood tests and appointments for blood tests….well. Plus it’s a bit odd having a companion with you at a doctor’s visit. 

Meanwhile, I am still at square one and the saga continues……. 

I can't get no satisfaction

 Ah, life in Italia!  Fantastic food, clean air and water, beautiful surroundings, nice people and so many things that just don't make any sense whatsoever.

Let's see if I can explain this.  

We have Wi-Fi.  Obviously...I wouldn't be here on this blog without it!  Ok...we used to get bimonthly bills which we paid at the Post Office (Yes! You can do that here!) Sometimes going there is a pain, due to weather or long lines, but it is still pretty convenient. 

But, why don't I just go online with my bank and arrange for automatic debit?  Ahhhhhhh, well......THAT is not so easy.  You can't.  You just can't.  I could pay them individually online, but it is not possible to set up a "payee" for automatic debiting in this country.  Why?  Beats me, I have no idea, but people mumble things about security and blah blah.  

In order to set up automatic debit, you have to consult a rather unpleasant gentleman in the Post Office.  I've tried and I've mentioned this fellow before.  The last time he claimed that the "code" (what code?) was incorrect and it could not be done. 

That was then and this is now.  And now instead of bimonthly bills, we have monthly bills that arrive via email, making the little trek to the post office a tad less convenient than it was before. These emails usually arrive at the very beginning of every month. 

All was chugging along as it should until October.  No email.  I checked my "junk" file....nothing.  Hmmmm.  I could call their customer service line, but I know from past experience that they speak very quickly and like all customer service lines, you have to "enter #2" here and "enter #1" there before you can get through to a person and I tend to get nervous on the telephone to begin with, so we went for help.

Aldo is a guy who is a wine merchant with a small cafe around the corner.  He lived in the US for decades, so he is fluent in English as well as his native Italian.  He called the customer service line and found out several things.  One, they seem to be changing the billing cycle yet again, so the bills have not gone out as yet.  Ok...we are not in arrears.  Wait!  Yes we are!  There is a......TWO EURO (!!!) balance on the account and for whatever illogical reason, unless we pay the two euro right away, with a credit card, our bill WILL be withheld and our service disconnected.   WHAAAAAATT?

Fine, I whipped out my international credit card for Aldo to read to the guy on the phone,  Number, name, expiration, code.  Nope.  Not going through.  Why?  It's an international card, I have used it in multiple places over the last three years.  Try again.  Nope.  No good.

My husband then pulled out his AmEx card, good "all over the world."  No, sorry, no good.  

So Aldo pulled out HIS OWN card and paid the damned two euro with his.  His worked.  All is well in Wi-Fi land again and absolutely NONE of this makes any sense at all. Why were we never informed about this two euro?  Why was it not just forwarded onto a subsequent bill?  We will never know. 

Well, fascists are not very welcome here, we are in little to no danger of being victims of a random shooting, it is very unlikely to flood and there is universal health care. 

Sit down, have a glass of wine...it's a lovely evening...ah, Italia!

I heard there was a secret chord...

 I came late to the appreciation of Leonard Cohen.  Well, perhaps that isn't really true.  I was enamored of several of his songs way back in the 70s, but I had no idea who he was and I never bothered to find out.  They were songs.  Songs I liked a lot.  "Suzanne" and "That's No Way to Say Goodbye."  Who wrote them?  I couldn't tell ya.

Life plunged on and I heard some others of his songs, still never registering from whom they came.  I was travelling on the big highway of the USA...highway 80, and in a Starbucks somewhere.  All the stops look the same, so I have no recollection of which one it was, but a song was playing.  Starbucks offered CDs for sale and the one playing was "featured."  I literally lingered inside with my coffee just to hear it to the end.  To the end..."Dance Me to the End of Love"...this one by Madeleine Peyroux.  I was mesmerized.

I was an habitual viewer of NCIS while living in NYC and New Jersey.  On Tuesdays, after a stressful, interminable day at the hospital, I would fervently wish that I would be on a train, and another train and catch a bus home, if all went well, without unforeseen disasters, just to be able to sit down by 8pm and watch an episode.  One episode, at the very end, where everything was tied up  neat and tidy, there was a scene of a man singing a song.  It sounded, perhaps, vaguely religious, but....not entirely.  And it, too, was somehow hypnotic.  I later learned it was Cohen's "Hallelujah."

The truth is, I really only learned about him with his death.  Suddenly, there was so much to read about him, so much to understand.  I regret I had not known sooner.

I am currently obsessed with "Hallelujah."  I was walking on the passaggiata the summer or fall before Covid hit and there was a mother and child in the playground that runs along the side of the walkway.  The little girl was on a swing and singing "Hallelujah."  That was when I realized that the song had been co-opted by the religious.  Certainly, a six year old child could not understand the metaphors and nuances of that song....no, of course not.  They changed it.  They changed the lyrics to suit their purposes.

There are allusions to religious figures in the song...the word itself (hallelujah) appears to come saddled with religious baggage.  It doesn't have to, and it doesn't in this song.  It is an....epiphany, of sorts...an offering of gratitude, perhaps....a celebration....but not of a religious figure or a single flavor of god.  

I read that Cohen had many, many, seventy or eighty...verses of this song and finally honed them down to 4 or 5.  I would love to read the others.  It is a song about a songwriter who is an unsung hero.  The artist painfully self aware that he does not have the recognition he deserves.  It is also about sex.  It is also about loneliness, love and loss.  It most definitely is not about a church..any church...THE church. It makes me angry that that section of society copped this song, changed it and yet, if not for that, the song might never have become well known.  How ironic. 

I had been listening to Cohen's own version of it......and then I discovered KD Lang.  She knocks this puppy right out of the ball park.  Close your eyes and listen.  Hallelujah.

KD Lang "Hallelujah"