Tuesday, May 19, 2015

Adventures in Belarusian Health Care

I've taken a couple weeks away from blogging, but a nearly severed finger tends to obstruct even the most disciplined writing regimen. Here's the story: I was attending the May 9th Victory Day parade with Clark, Will, and Ace when I noticed that folks were climbing atop a mobile rocket launcher for photos. So I hoisted myself upward and did the typical tourist thing, taking silly "look at me" pix. As I began to navigate my way back to the ground, I remember thinking, "This is much higher than I expected. I'm gonna have to let myself drop a couple feet. The landing will hurt a bit, but not too much. I can handle it."

I dropped and felt the expected lightening bolt of pain upon impact, but not where I anticipated. Turns out, as I fell from the vehicle I caught my wedding ring onto a hunk of metal and damn near peeled my finger off. Steadying myself and spotting red splotches on the ground, I stared at the digit that now resembled a mushroom cap. The thin gold band was cut and corkscrewed in and out of my skin. I said to the ashen faced people nearby: "I can handle it. I can handle it." Then as the pain started to dial up, I told Clark, "I think I've got a real problem here. I think I need help." Clark jumped into action and flagged down a soldier who directed us to an ambulance across the parade route.

At first the medics drove at what seemed like a leisurely pace. "Great," I thought, "a frickin' tour of the city." But as my breathing grew more pronounced, the driver kicked on the siren. "спасибо," I whispered. "I can handle this." The driver sped up. Elena X. Karpovich met me at the hospital, wrangled the insurance paperwork, and got me seen by a doctor: a young guy - maybe thirty, possibly younger. I vividly remember how he laid out a piece of brown butcher paper and positioned a big scalpel next to my finger. I thought, "Well, shit. This is it." I was sure he'd amputate. Instead he snipped some chunks of flesh and unhooked the ring from inside my finger.

His priorities, naturally, were the mechanics of the job, not my feelings. Thus when he cut a piece out of the gold band to ease its removal, I felt like I should cheer him on: "Yeah, cut it, cut it." He stopped and stared at me strangely. Then he spoke; the words were English, but the sentiment was all Russian.

"Don't speak."

A few minutes later, as he was injecting the wound with jabs of anesthetic, I started to recite a mantra to help myself manage the pain.

"This is a good pain. This is a good pain…"

Once more, he stopped and stared into my eyes:

"Don't speak." 

So, yeah, at first I thought he was a jerk. But I gradually came to appreciate his no-nonsense style. He knitted together dozens of stitches where the ring had been and up both sides of my finger (I later asked him how many, but he'd lost count). The doctor also developed a long-term treatment plan that involved him going well beyond the call of duty to ensure that I received excellent follow-up care. And with two subsequent meetings, he grew kinder and more patient with me.

A few days later, Elena transitioned me to a local clinic. There another doctor and nurse changed the bandage every couple days, checking to see if infection had set in. That meant me donning surgical slippers, walking into a treatment room, and waiting for the inevitably sharp pain as the nurse would gingerly remove the old bandage. Afterward I would sign a form and pay at the desk. All communication at this point was in Russian.

Elena, always calm and almost impossibly nice, endured many phone calls when I needed the doctor to translate his instructions. And day by day my finger began to feel better. I wore a splint for more than a week, getting it removed only yesterday. Oh, and what about the cost? Well, that annoying insurance that folks must pay at the Minsk airport covered my emergency care, and the subsequent clinic visits cost 96,000 BY Rubles each: the equivalent of $7.00 a visit. A pretty good deal if you ask me.

The EMTs, doctors, nurses - and most definitely Elena X. Karpovich - helped me through a scary time. Health care in Belarus is by no means a perfect institution, neither for visiting Americans, nor for local folks who lack an embassy representative. And each stage included plenty of hassle. But good people cared for me throughout the process, and I am grateful. Indeed, during my last visit with the ER doc, I learned how close he thought I'd come to losing my finger. At once, his scary instruction "Don't speak" made more sense. He was concentrating on each snip and every suture to keep me whole.

I await a visit with my primary care physician to check on infection and determine when the stitches can be removed. I hope she'll give me good news. But no matter what happens next, I am thankful for my adventures in Belarusian health care.

1 comment:

AMT said...

Wow! I can't believe it. It's terrifying to think about how much pain you must have been in and how close you came to losing your finger. I'm glad that you got immediate attention and had some kind, if stern, doctors.
What a way to spend the last two weeks of your trip.
I do hope you actually do get a plaque made!