The last thing anyone wants to read a blog about is someone else's medical problems. I will try to keep these details to a minimum. The last 3 weeks I've spent trying to figure out what's wrong and get treated, though, has been an adventure into the medical underworld of Cairo (I mean this facetiously, I'm not buying paper bags of pirated drugs) and, more generally, into the confusion and frustration of trying to get the right kind of care in a foreign city.
I have already recounted my early October experience of receiving injections from the purple t-shirt man in the back closet of my local pharmacy. Unfortunately, those proved ineffective, as did the antibiotics that followed. When I started to feel worse instead of better, I visited one of the AUC doctors at the university clinic. She produced some giant pliers covered in cotton balls and antiseptic and shoved them down my craw with a flourish. Then I was sent on my merry way with prescriptions for a smorgasbord of sprays, pills, and gargles. None of these really seemed to work either, despite how wide she had cast the net. Commenting on the fact that I had lost much weight as a result of my inability to swallow easily, the doctor laughed - "I am old and I got fatty. I need to get tonsillitis so I am not so fatty." Then Dr. Susan sent me to an ENT specialist at a well regarded private hospital called Mostashfa El Salam (Peace Hospital). There is at least one good thing about the system as it's working for me, notably that AUC pays for all my prescription drugs and hospital visits, which by now would really be racking up.
It's worth pointing out that Egypt has both public and private hospitals. Public hospitals are generally considered to be pretty scary places, but of course they provide a very necessary function in the community because they are way, way cheaper. It costs perhaps 20 LE to see a doctor at a public hospital (~ $3) while it costs 120 LE ($20) for a consultation at El Salam. Especially if you're making repeat visits, which most people are, that's a really hefty sum for someone with a low-middle to low income. Then of course you add on blood tests, which cost me about 155 LE ($25) at the private hospital, and any medications. Fortunately, medications are incredibly cheap compared to what they cost us at home. Never mind insurance, a round of antibiotics often costs less than $10, and prescriptions generally aren't needed. (This makes me feel pretty sad about the astronomical cost of prescription drugs in America.) Anyway, at the end of September, the doctors' union announced a nationwide strike of all but emergency care physicians in public hospitals, protesting their pitiful government pay and demanding better working conditions. The strike is still ongoing and the doctors are asking that 15 percent of the national budget, instead of the current 5 percent, be directed to health. Several young doctors confirmed that the minimum wage for those in public hospitals, which is required for a few years after finishing medical school, is less than $20 a month. Of course, they all work several side jobs in private clinics to make ends meet, but this means that very little focus is given to the needy patients in the public hospitals.
Fortunately for my personal condition, the private hospital was running as usual. As soon as I walked in, I had a flashback to my one previous stay at a Cairo hospital. Rewind to 2006, when I got a nice pair of rear-end injections at one such hospital after a gruesome, McDonald's lettuce-driven bout of food poisoning. This time, when we finally found a check-in window (perplexingly labeled "Private" and "Contracts" rather than "Check-in"), I was told that the doctor with whom I thought I had an appointment was not working that day. Strange, I thought. (Or, actually, WHAT?!) Dr. Sherif Rafaat was here yesterday, but Dr. Sherif Magdy is here today! said the man at the desk. They have the same name and the same degree, you will be fine. Well, in that case, take me right on up! It turns out appointments don't really exist - you just wait in line, first-come first-serve. Fortunately that night there were only 3 or 4 others waiting. Dr. Sherif, his head decked out in some kind of giant headlamp, was not interested in small talk, taking my vital signs, or anything of the sort. He opened my throat, looked inside, and told me I had glandular fever. Within 5 minutes, he had written me up some papers for blood tests and drugs and shooed me out. In another building, my roommate and I were sent from unmarked window to unmarked window for paperwork, bloodwork, and more paperwork. A short while after I returned home that night, I received a text message from an unknown number who I suspect belonged to the man working at the check-in desk, though I can't be sure. "Hi my friend hope you better now and you will recovery soon rest a bit."
The steroid I was prescribed worked well and fast. The antibiotic, as it turned out.... not so much. On day 2, I developed a grotesque allergic reaction and an AUC doctor came by for a home visit. His nurse administered another injection from a big black case. I napped all afternoon and it was great. My roommate discovered that our blender worked, although it was filled with dead cockroaches, and whipped up some fresh carrot juice. In the evening, I returned to Dr. Sherif #2. This time, I was Number 14 in the assembly line. While we waited, an hour and a half or so, I observed that stacks of medical records were piled up around our feet in the waiting area. Hmmm. When my number was called, Dr. Sherif was annoyed with me. Why had I not brought the test results? With all due respect, the bloodwork guys had told me that the entire point of this appointment was to get the results from him. How preposterous! he said, not actually using the word preposterous. He was about to leave for the night, so I'd have to come back on Sunday with my results and wait in line again to see him. We trekked over to the lab then and there, and picked up my results. Sure enough, they were positive. Go back and see Dr. Sherif now! said the blood man. He refused to see me. I insisted they call him and see what I should do. He was annoyed. You'll be fine in 2 days, bye.
And that is where we stand now. On the one hand, I'm very lucky that I'm in Cairo, where there are many doctors, even if they are annoyed by my requests for information about my problems. I could, after all, be out in some village somewhere. Still, I find myself wishing there was a warmer doctor-patient relationship, with some small talk and a thorough investigation into one's medical history, allergies, and feelings. Things here are cut and dried. Open your throat. Get tests. Buy the drugs. In the long run, I think I will come to see it as an adventure, just as my first (dramatic, but much briefer) Egyptian hospital experience has provided fodder for six years of stories. It's also true that visitors rarely have to navigate these systems and institutions, so I guess I'm becoming more of a local. For better or for worse.
I have already recounted my early October experience of receiving injections from the purple t-shirt man in the back closet of my local pharmacy. Unfortunately, those proved ineffective, as did the antibiotics that followed. When I started to feel worse instead of better, I visited one of the AUC doctors at the university clinic. She produced some giant pliers covered in cotton balls and antiseptic and shoved them down my craw with a flourish. Then I was sent on my merry way with prescriptions for a smorgasbord of sprays, pills, and gargles. None of these really seemed to work either, despite how wide she had cast the net. Commenting on the fact that I had lost much weight as a result of my inability to swallow easily, the doctor laughed - "I am old and I got fatty. I need to get tonsillitis so I am not so fatty." Then Dr. Susan sent me to an ENT specialist at a well regarded private hospital called Mostashfa El Salam (Peace Hospital). There is at least one good thing about the system as it's working for me, notably that AUC pays for all my prescription drugs and hospital visits, which by now would really be racking up.
It's worth pointing out that Egypt has both public and private hospitals. Public hospitals are generally considered to be pretty scary places, but of course they provide a very necessary function in the community because they are way, way cheaper. It costs perhaps 20 LE to see a doctor at a public hospital (~ $3) while it costs 120 LE ($20) for a consultation at El Salam. Especially if you're making repeat visits, which most people are, that's a really hefty sum for someone with a low-middle to low income. Then of course you add on blood tests, which cost me about 155 LE ($25) at the private hospital, and any medications. Fortunately, medications are incredibly cheap compared to what they cost us at home. Never mind insurance, a round of antibiotics often costs less than $10, and prescriptions generally aren't needed. (This makes me feel pretty sad about the astronomical cost of prescription drugs in America.) Anyway, at the end of September, the doctors' union announced a nationwide strike of all but emergency care physicians in public hospitals, protesting their pitiful government pay and demanding better working conditions. The strike is still ongoing and the doctors are asking that 15 percent of the national budget, instead of the current 5 percent, be directed to health. Several young doctors confirmed that the minimum wage for those in public hospitals, which is required for a few years after finishing medical school, is less than $20 a month. Of course, they all work several side jobs in private clinics to make ends meet, but this means that very little focus is given to the needy patients in the public hospitals.
Fortunately for my personal condition, the private hospital was running as usual. As soon as I walked in, I had a flashback to my one previous stay at a Cairo hospital. Rewind to 2006, when I got a nice pair of rear-end injections at one such hospital after a gruesome, McDonald's lettuce-driven bout of food poisoning. This time, when we finally found a check-in window (perplexingly labeled "Private" and "Contracts" rather than "Check-in"), I was told that the doctor with whom I thought I had an appointment was not working that day. Strange, I thought. (Or, actually, WHAT?!) Dr. Sherif Rafaat was here yesterday, but Dr. Sherif Magdy is here today! said the man at the desk. They have the same name and the same degree, you will be fine. Well, in that case, take me right on up! It turns out appointments don't really exist - you just wait in line, first-come first-serve. Fortunately that night there were only 3 or 4 others waiting. Dr. Sherif, his head decked out in some kind of giant headlamp, was not interested in small talk, taking my vital signs, or anything of the sort. He opened my throat, looked inside, and told me I had glandular fever. Within 5 minutes, he had written me up some papers for blood tests and drugs and shooed me out. In another building, my roommate and I were sent from unmarked window to unmarked window for paperwork, bloodwork, and more paperwork. A short while after I returned home that night, I received a text message from an unknown number who I suspect belonged to the man working at the check-in desk, though I can't be sure. "Hi my friend hope you better now and you will recovery soon rest a bit."
The steroid I was prescribed worked well and fast. The antibiotic, as it turned out.... not so much. On day 2, I developed a grotesque allergic reaction and an AUC doctor came by for a home visit. His nurse administered another injection from a big black case. I napped all afternoon and it was great. My roommate discovered that our blender worked, although it was filled with dead cockroaches, and whipped up some fresh carrot juice. In the evening, I returned to Dr. Sherif #2. This time, I was Number 14 in the assembly line. While we waited, an hour and a half or so, I observed that stacks of medical records were piled up around our feet in the waiting area. Hmmm. When my number was called, Dr. Sherif was annoyed with me. Why had I not brought the test results? With all due respect, the bloodwork guys had told me that the entire point of this appointment was to get the results from him. How preposterous! he said, not actually using the word preposterous. He was about to leave for the night, so I'd have to come back on Sunday with my results and wait in line again to see him. We trekked over to the lab then and there, and picked up my results. Sure enough, they were positive. Go back and see Dr. Sherif now! said the blood man. He refused to see me. I insisted they call him and see what I should do. He was annoyed. You'll be fine in 2 days, bye.
And that is where we stand now. On the one hand, I'm very lucky that I'm in Cairo, where there are many doctors, even if they are annoyed by my requests for information about my problems. I could, after all, be out in some village somewhere. Still, I find myself wishing there was a warmer doctor-patient relationship, with some small talk and a thorough investigation into one's medical history, allergies, and feelings. Things here are cut and dried. Open your throat. Get tests. Buy the drugs. In the long run, I think I will come to see it as an adventure, just as my first (dramatic, but much briefer) Egyptian hospital experience has provided fodder for six years of stories. It's also true that visitors rarely have to navigate these systems and institutions, so I guess I'm becoming more of a local. For better or for worse.
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