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I just returned this week from Barcelona and Madrid with anew appreciation for the fact that role–reversal for healthcareprofessionals can be a very important learning experience.This vacation to Spain was really more of a personalpilgrimage to revisit the home where I had lived for overthree years, as well as a country that had captured my heartas no other. My husband and I planned it in conjunctionwith a lecture tour sponsored by the Flying Longhorns ofthe University of Texas, and we were to join our group inBarcelona and visit Pamplona, Zaragoza and San Sebastianbefore moving on to Madrid. Within two days of arrivingin Barcelona, I became the accidental patient in Barcelonaand witnessed for myself the plight of those who are trulyvulnerable and dependent on others for relief from pain andanxiety.
This saga is reminiscent of roles of the American movieactor, William Hurt, who perhaps coincidentally starred inboth “The Accidental Tourist” and lesser film in which heplayed a top–flight physician who suddenly found himselfin the excruciating position of being diagnosed with cancerin his own hospital, only to discover the realities of the patients’experience with our healthcare system and medicalattitudes. Viewed from the larger than life pulpit of the silverscreen, we appreciated the moral justice of his fall fromgrace and metamorphosis from the self–assured, swaggering,white–coated expert to the take–a–number–and–wait,desperate and frightened patient, crowded among turbanheadedcancer patients in a grimly lit waiting room.
The stage for my own two–week experience was thestunning and beautifully dynamic elegance and pride ofBarcelona, the capital of Cataluña, a self–proclaimed nationwhere architectural genius, Antoni Gaudi’s influenceis evident everywhere. Immersed in this cultural mosaicwith a soundtrack of the Catalan dialect mixed with CastilianSpanish, it took me two days to notice blisters on myright hand. These symptoms spread quickly up my arm tomy shoulder and back. We changed hotel rooms twice andbecame familiar with all the local farmacias where caringstore clerks served as my surrogate physicians. Finally, thepain under my thumbnail became so intense that I couldnot sleep, and I found myself sobbing in the Cathedral ofMontserrat. Thinking at first that I must be having a catharticreligious experience, I took Tylenol and got back on thebus. The first part of being an accidental patient is that youdon’t realize you are ill.
The next series of attempts at seeking relief remind memore of a Woody Allen movie, as the tour guide directedme to a Perruquia to have my thumbnail attended to by amanicurist. Come to think of it, if you recall Reece Witherspoonbursting into a nail salon in an emotional meltdown,exclaiming, “Quick, it’s an emergency!” in “Legally Blonde,”it was more like that. Next, we called a private doctor, whocame to our room for $300. After listening to our proverbial18–second average explanation, the doctor diagnosedthe problem as an airborne virus. The treatment? Topicalointments and codeine. Even though I knew his diagnosiswas not correct, I was grateful to have seen a physician. Thenext day, our hotel manager moved us to a suite and sentme to the Barcelona Hospital emergency room. I was separatedfrom the tour guide and my husband at the door andwas taken by elevator to wait on a bench or wheelchair (mychoice) with people who seemed to be near death. I was immediatelyreminded of Dante’s “Inferno.”
After an hour, my name was called, and I explained toa technician that I had severe pain in my thumb and mighthave a fungus under it; I also explained the insect bites. Hejust walked away. The sign on the wall said, “Triage,” andwas clear in any language. As I saw patient after patient getwheeled off the elevator with tracheotomies and on ventilators,I thought I’d better ask when I’d be seen. The answerwas, “cuatro o cinco horas.” I left.
We then turned to the Internet and found a private clinicon the Blue Cross/Blue Shield website, Quiron. Again, ourtour guide escorted me to help translate, and a physicianwith a dismissive attitude diagnosed the arm lesions properlyas Varicella–Zoster Virus, but totally ignored the throbbingpain in my thumb, which was now more than twice aslarge as my left. The next day, we returned to the clinic, thistime on our own with no interpreter – the pain was enough.At that point, I met a physician who listened to me, called ina specialist for a consultation and diagnosed a severe infectionand virus, as well as provided X–rays, gave an injection,bandaged my thumb, treated my pain and prescribed antibiotics.She even returned twice with alternative antibioticsprescriptions if I needed them. Her treatment was caringand effective, and the American physician I saw yesterdayconcurs with her clinical judgment.
This unlikely, even comical, medical experience of minehas humbled and helped me better understand the extremevulnerability, fragility and need of even the most educated ofour clients and patients. Pain, whether physical or emotional,is so debilitating and disorienting that patients rely onus for both compassion and patience. Clearly, our expertiseand training is foundational, but in the long run, our respectand commitment for the patient to provide the very best andappropriate care possible are what set us apart.
