Czech Healthcare Adventure! Part IV

"The flu hit late that year" will officially be my "the sea was angry that day, my friends." 

I honestly thought the bacterial infection I had would have been the end of my health issues for the month, maybe even for the year. I was a hopeful adult child staring up into the cosmos over Brno after I should have been in bed hours before. This wasn't the "what am I going to do with my career" gazing that some of us do. I didn't want to become an astronaut or a president or a truck driver like I actually wanted to be at one point. I just wanted to be healthy. I'm not going to say the universe had other plans for me because the universe isn't capable of designing paths for people. But I did have a string of health-related events I'm hoping ends with the norovirus. 

Ah yes, the norovirus: amphetamine for bowels and gasoline for the highest of fevers. The antibiotics I took to clear the bacterial infection wasn't effective against the dormant virus and the contagion reared its pestilent head right after I crawled into bed last Friday. My body clamped up like a fleshy vice. I was freezing under my blankets but knew it was impossible due to the summer temperatures that have descended upon Brno and most of Europe. My spine and thighs were fraught a seething tension that only let up if I squeezed myself into the smallest of fetal positions, like a sore muscle engulfing my entire anatomy. I hadn't felt this sick since 2007 when my college boyfriend and I were horrendously ill. We slept in separate rooms to try to avoid spreading the collegiate-bound plague to each other, but it was only a matter of time before widespread damage was felt from the bedroom to the dining room floor where I was sleeping temporarily.

I called my mom via FaceTime from within my FEMA blanket shelter. I told her something wasn't right, even though my blood sugars had been back to normal for over a week. This was something else, an ugly side of science reserved for medical experiments during the thick of wartime and that sticky ambiguous film covering plastic toys for children under 5. She convinced me to seek help like I had two weeks before and I dialed 112 in hopes of a better result. 

Me: Mluvis anglicky?

Operator: Yes, do you need help?

Me: Yes, I need to see a doctor. 

Operator: What is wrong with you?

Me: I have a high fever and I can't untwist my body. 

I realized "untwist" was probably one of the last remaining vocabulary words a Czech bilingual speaker has yet to learn in English, but I continued. 

Me: I'm very sore in my back and legs. 

Operator: And where do you live?

I gave the woman my address and she spoke some Czech to a colleague just out of earshot. She returned to the phone with what seemed like good news.

Operator: We will send you a doctor. 

Me: You are sending me a doctor, or do I need to go to the hospital?

Operator: We will send you a doctor. Thank you goodbye. 

She hung up and I had zero idea what to expect. Who was going to show up at my house at 4am on a Saturday morning? Dr. Who? At first I thought it might have been one of those doctors with the reflective plate on their head and a stethoscope around their neck regardless of whether or not the situation required its use. Can an IV fit in one of those vintage leather doctor bags? Do they even still make those? I had a lot of questions which were soon met with disappointing answers. 

My doorbell rang. Like an old Czech babicka, I hobbled down the stairs draped in the blanket that's the exact same color of my favorite dog. I opened my door to two gruff EMTs wearing bright orange protective gear and a mullet that was a little late to the party. I greeted them with my typical salutation I've been using for the past six months. 

Me: English?

Them: Ne. Ceske? 

Me: Ne. 

So we didn't speak the other's respective language. We stared at each other while the birds chirped and greeted the day with a better sounding conversation. They spoke in Czech and then said to me, "Come. Insurance card. Passport." Okay, so it's not a totally lost cause. Usually when Czech people say they don't speak English, they understand some to an extent, or they only know certain important words, sort of like how I speak Czech. I went inside still wearing my blanket and got my bag, cell phone charger, Kindle, and any medication. I said goodbye to Patrick and told him I loved him before I locked my door. 

The EMTs motioned for me to get in back of a bright green and orange ambulance. Once I was inside on a stretcher, they attempted to remove the best blanket in the entire world. My fever was keeping my bones tight and close to my body, so any release of appendages was hurting pretty much everywhere. I pulled up the hood on my hoodie and crossed my arms. The EMT with the mullet sat down next to me and yanked my arm out straight. He could see me shaking from being cold but mistook it for being scared. With my arm in one of his hands, he used the other to press lightly in the air like to tell someone to take it easy. I told him "zima," Czech for "cold" and "winter." He nodded at my poor pronunciation. "Take off," he said pointing to my hoodie. 

I realized I didn't put on a bra before leaving the house. I had thought about it but it would have required more angular movements than I wanted to commit to. So I sat there with no blanket or hoodie literally freezing my tits off in a wife beater, my chosen attire for time spent at home. The mullet grabbed both of my arms and held them out straight in front of me. He was being more forceful than he needed to be. You'd think EMTs would show some finesse given their profession but this felt more like I was an action figure, simply being moved into whatever position they see fit. The guy started hitting both of my wrists, which hurt a lot considering my bones were already in pain. Each impact was like a shock to my skeleton and the norovirus was amplifying every sensation I was feeling physically. The EMT showed me a needle so that I knew he was going to draw blood. I'm a diabetic person with tattoos so I don't exactly have an aversion to needles, but this was different. Because of my fever, my veins weren't showing up at all, which lead to multiple attempts at finding them intravenously. He spoke to his buddy about what I assumed was his lack of luck. Eventually they found a vein in my right arm and he gave me back my hoodie to cover up. 

As soon as I draped myself and recoiled my limbs back in like a dying spider, the EMT pushed me back on the stretcher and took the hoodie he had just returned to me. With no warning, he yanked up my shirt and listened to my breathing. I couldn't even look at myself. I found other points in the ambulance to look at. Eventually he started pushing on my stomach and asking "yes" or "no," but I didn't know what kind of answer he was looking for. "Yes, it feels fine." "Yes, that hurts." I relied on facial expressions without making eye contact to convey the pain. I was sensitive to pressure since my stomach and bowels had become completely unreliable. Have you ever had a cat knead your stomach only to feel like you're going to totally shit yourself if you don't stop him right that minute?

The EMT recorded his results while I rolled over and pulled my shirt back down. I started crying. I'm incredibly tough with physical pain, but this was more than I could bear, especially with a fever. I was embarrassed and exposed. I didn't know these people and they weren't overly concerned with my general comfort inside this mobile ER. I just wanted to feel better but getting to that point seemed like a challenge. I want to communicate effectively, but how? I suppose it was my own fault for not learning enough Czech sooner, but even in the medical world, there are certain words in English that don't exist in Czech. I felt stuck and now I was actually scared. 

Mullet strapped me in the stretcher and told me "Hospital." Most of my responses at this point were either nodding or simply "thank you." The ride to Bohunice, the biggest hospital in Brno, only took 15 minutes. It was hard to tell where I was going since I was on an actual road and not a tramline for once. On arrival, they wheeled me down and into a completely empty ER. It was dark and poorly lit but all of the technology seemed up to date and identifiable. The EMT unbuckled me from the stretcher and told me to sit in a chair for a nurse. Finding someone who spoke even the littlest amount of English proved difficult, but I soon saw a nurse to whom I could speak in just words and not complete sentences. I handed her my passport, insurance card, and the paperwork I had with me from my last ER visit two weeks before. It was in Czech and possibly provided some answers as to why I was in the condition that I was, but in a more detailed fashion.

The nurse took my vital signs and told me initially I didn't have a fever. I was skeptical since on the surface I was burning up but inside I was freezing like the frigid hipster I am. The nurse yanked out my arm to draw more blood. She wrapped a rubber band around my bicep and knocked on my elbow ditch as if she was expecting someone to answer. When she inserted the needle, the pain got to me and I tried to retract but she looked me dead in the face and yelled "NO." Ah, okay. Sorry. It's not like I was trying to be difficult or to fuck up the end of her night shift. But that shit legitimately hurt. 

She then hooked me up to an IV and I tried with all of my stupid might to not flinch or move. I started crying again because I just wanted this to be over and I wanted some answers as to what the fuck was going on. I figured it was some kind of flu but wasn't aware of how severe. I kept my parents in the loop. My dad was in the hospital at the time as well with his own issues so we sent IV selfies to each other. After an hour, my bag had emptied and the nurse came out with my results. By this time I wasn't as shaky as I was and felt more like my temperature had returned to its rightful baseline. I definitely had a flu but my only instructions upon exit were to take ibuprofen to keep my fever down and drink lots of water to remedy the literal shit storm brewing within. She said it was good I wasn't vomiting, so I had that going for me!... She also urged me to have a friend come pick me up to take me home. I don't have a lot of friends here, and the friends I do have are carless or would straight up tell me to go fuck myself if I asked them for a ride home from the hospital at 8am on a Saturday morning. 

I paid the 90 crown ($4) fee for my discharge and plodded around the hospital wearing my blanket cape and smudgy glasses. Through a maze of linoleum and indecipherable signage, I followed my blip on Google Maps to try to find my way to the bus stop. The complex at Bohunice has many floors and many of the floors look exactly the same. It was quiet, like a medical ghost town since no one was working on Saturday morning. I followed signs to what I thought were exits but then they turned out to be offices. I pushed my glasses up my nose and tried to keep the sweatpants I bought for rehab above the edges of my slippers that I also bought for rehab. I didn't look my best.

I plopped down at the bus stop and realized I barely had any food at home, so before going home, I stopped at the grocery store up the street. Lots of Czech women do their grocery shopping first thing in the morning and somehow they all found the time to do their hair and make up beforehand. Enter the haggard fleece-draped biohazard who bought soy milk and crackers. I returned home to drink as much water as I felt comfortable and hung out with my kitty. Six days later I'm still tired and groggy but the wretched fever I had has been exorcised. I got three decent sized bruises as free souvenirs and my bowels are mostly subdued and no longer having sudden and lengthy surprise parties. 

I just want to be healthy. That's all I want. I mean I want everyone to be healthy and operating at full capacity, but I just want to be my best self and it's hard when your body won't let you do that. I don't know where I got the norovirus from. It could have been anywhere in Wroclaw and Vienna or somewhere in between. I missed the burning witches festivals and the 1st of May holiday in the Czech Republic where you're supposed to kiss the person you love under a cherry tree, but there's always next year. I'm going to roll over and kiss my cat instead.

Czech Healthcare Adventure! Part III

Over the weekend, I was turned away from a Czech emergency room. 

Yep. Turned away. 

For the last two weeks my blood sugar has been wildly unstable. I talked with my doctor numerous times to figure out what steps I needed to take to decipher what sorts of Enigma-like codes my body was signaling to me. Narrowing out possibilities is pretty much all I can do. It's a trial and error process since I can't ask my body what's wrong with it. If something is amiss, I'll usually see it in my blood sugar levels before anything else. 

I adjusted both of my insulin levels with no success. My next method of detective work involved going off certain medications. I thought the Czech version of American drugs were the culprit, but even that seemed strange since all of the essential ingredients are the same. Because I was going low at seemingly random times and more frequently, I was having to eat total garbage. When I'd go low again after correcting myself with Skittles or juice, the last thing I wanted to do was consume anything else, and having to do this often was causing havoc on my digestive system. I cancelled classes because my stomach was in knots after eating so much while trying to prevent myself from going low to the point of seizure or unconsciousness. Having a normal meal at scheduled times became rare. And then on Saturday night it was clear something was incredibly wrong. 

My body got to the point where it only had two modes of operation: not shitting at all or shitting way too much. I figured my digestive system was deteriorating from all the sugar I was having to eat to stay level. My teeth hurt from the increased amounts of acidity and I need to brush very gingerly. I became nauseous, sad, frustrated, and tired. I was exhausted from running out of my classes to drink juice and run back in, from having to carry around extra weight of food and drink when businesses were closed, and from the amount of phone calls I was having to make to try and get my questions answered. I was getting low multiple times a day and nothing seemed to work.

My blood sugar is usually supposed to be between 90 and 120, but these changing levels were causing me to go as low as 40. I'd be sweaty, shaky, unable to form a complete sentence, and extremely panicky. My students noticed, the other teachers I work with noticed, and having to explain an autoimmune disease in choice vocabulary to a non-native speaker proved to be very difficult. I was worn out from the questions and the onslaught of misinformation I needed to discredit. 

Then my kidneys started hurting. My joints in my hips and knees were inflamed with unidentifiable tension and I couldn't stand up straight without having to keel over and rest my weight on my knees. I wasn't able to lie down without bending into a fetal position and my stomach felt like it was infinitely expanding from having to constantly consume food. I told my mom about my symptoms and she suggested I go to the ER. Despite being in the Czech Republic for six months, I wasn't sure how to go about that. I knew where the hospitals and urgent care centers were, but what I didn't know was that some hospitals only specialize in certain things. It sounds naive and probably American to think that I should be able to go into any ER and be seen immediately, but I was totally wrong. 

Kisha, my closest friend in CZ, lives one bus stop away from me, and when I decided to go to the hospital, she walked up the hill at 2am and met me with my blood sugar at 60. I tried to eat but my blood sugar kept going down. I was frantic and crying. What should I bring with me? How long will I be gone? What if something is seriously wrong with me? What was the cause of all this? My dead pancreas couldn't spring back to life after being deceased for eight years, so why the random instability? 

I grabbed some snacks, my toothbrush, an extra pair of underwear, a roll of toilet paper, and my phone charger. We got a cab to the urgent care hospital that was just down the street from the school where we work. I was wearing my sweatpants and slippers I bought for rehab and tried to be as comfortable as I could, except my body was clearly fighting my every move. After arriving at urgent care, we spoke broken Czech to a few different staff members to try to locate the actual emergency room. In the US, an ambulance bay in a hospital is pretty obvious when you see it, but in the middle of the night with next to zero neon signage, it took some lengthy navigating of narrow cement hallways, outdated elevators, and stenciled warnings from the communist era. 

When we finally reached the door to the actual ER, I was resting with my hands on my knees and my lips were turning blue. I was sweating and shaking and was in serious need of help when a nurse appeared at the door. She crossed her arms and stared at Kisha and I as if she were surprised to see us. We explained in Czech that I was diabetic and my blood sugar was low, but through miscommunication she kept telling us she couldn’t give me any insulin. (I’ve had a few people ask me if they should give someone insulin when their blood sugar is low. DO NOT DO THIS. It will send them into shock even faster and they’ll most likely have a seizure. Insulin is what keeps blood sugar low, not raise it). We kept telling her I didn’t need any insulin when a doctor came out to see us. He rolled his eyes and spoke with her, and then she told us that they don’t help diabetic people here because this wasn't that kind of a hospital. This particular hospital was marked as urgent care but only for trauma related circumstances. While Kisha and I were trying to decide what to do, another couple came in and were also turned away. At this point I was heavily shaking and not realizing it at the time. I needed serious medical assistance and a hospital turned me away? What do we do now?

We went back outside to the entrance of the hospital and sat on the curb trying to get a cab late on a Saturday night. Our local cab apps for Brno weren’t working and “hailing” a passing cab here leaves you ignored and scoffed at. I finally bit the bullet and dialed 112, our emergency number. Luckily to work for 112, speaking English is a requirement, so I spoke with a representative and had the following conversation.

Me: Mluvis anglicky?

Rep: Yes.

Me: I’m currently at the hospital on Ponavka and I’m in a lot of pain and my blood sugar won’t go up. I’m diabetic and I need serious help.

Rep: You need to go to the hospital.

Me: …right. I went into the hospital at Ponavka and they turned me away.

Rep: And you need help?

Me: YES.

Rep: You need to tell the nurse you need help.

Me: I already did that. And they told me they couldn’t help me. A hospital. Told me they couldn’t help me. So now I’m trying to figure out what to do. That’s why I called this number.

Rep: Can you go back inside?

Me: …hang on.

Kisha and I walked all the way back up to the emergency room with a janky elevator ride and damp hallways. The nurse came back out to see us and once again looked surprised to see us one more time as if she had done something for us earlier. I said to her, “jedna jedna dva” and pointed at my phone so she knew who was on the line. The representative with 112 spoke with the nurse in Czech for a few minutes. She handed the phone back to me and the rep and I continued our conversation.

Rep: You need to go to another hospital.

Me: Even though I’m literally in a hospital? Right now?

Rep: Yes, you’re in a trauma hospital. They only treat serious injuries like broken bones.

Me: So what if that person with a broken bone is diabetic and they’re having some serious issues? Do they get sent away, too?

Rep: You can’t be treated there.

Me: Clearly.

Rep: You can go to the military hospital two kilometers away. They are open during the night.

I hang up the phone and Kisha looks at me completely dumbfounded. Urgent care turned out to not be as urgent as we needed it to be, and we were fairly astonished that hospitals can be picky with who they treat in a time of emergency. This surprise might be our “we grew up in the United States and we can get help anywhere” inhibition kicking in, but it seems ridiculous that in a supposedly developed country like the Czech Republic you can’t get the proper medical care when you need it. Sure, they’ll hand out health insurance like Facebook event invites, but they’re going to be super selective with who and what they treat.

Kisha and I dug into our phones and located the military hospital across the river. She told me my lips were blue and my face was sunken in and I started to get scared. I was sitting on the curb outside of a hospital that refused to care for me. A cab finally showed up and took us to the heavily gated military castle/hospital in another part of town. A small old Czech man was guarding the front gate with an old tv and rolled cigarettes, and he wore a uniform but it hadn’t been pressed or starched in years. Once again, in broken Czech, we explained through the metal gate that I was in pain and needed help. He gave us rudimentary but understandable directions on where to go after he let us pass through his barricade.

Our second emergency room had a door bell we had to ring for service. The entire hallway was empty, white, and clean with only two chairs available for patients, which could either be a good sign or a bad sign. The good sign being that they keep people healthy enough here to not have to need to see an internal specialist, the bad sign being no one actually comes for help. A haggard looking nurse opened the door to Kisha and I. She had clearly been sleeping and wasn’t up for having a conversation in Czech or English. I asked her if she spoke English and she nodded through her lucid dream. I explained I was in pain and couldn’t stand up right and that there was something wrong with my digestive system. I didn’t even mention I was diabetic because I was afraid of being turned away again, which is fucked up I have to leave out a pretty important detail to be seen by the Czech medical system. She held her finger up to give her a minute and she went back into her clinical abyss.

The two of us shrugged. After a minute the sleepy nurse returned and motioned for me to come with her. This was twice the progress I had made at the last hospital, so it seemed promising. The emergency room here was modern but it had common communist features in certain areas. While most of the medical technology was updated, their measuring systems, color schemes, and signage was a bit archaic. She sat me in a chair where I spoke with a Czech doctor who was stationed at a computer. At his station was a beer mug. A large glass of beer with about an inch of what I assumed to be beer. Because let’s just fuck this night up a little more. Maybe the tired nurse was drunk, who knows. I messaged Kisha over Facebook Messenger to keep her updated on my progress and about the speakeasy ER I was cautiously waiting in.

The Czech doctor spoke slow English with me so we could both understand each other. I explained I had some serious joint pain in my hips, knees, and back, that my blood sugar had been very unstable for about two weeks, and that my stomach was hurting from the amount of liquid and food I was eating to remedy the bouts of hypoglycemia. He asked which medications I was on and I wrote down a list and dosages, all of which are known here in the Czech Republic. The nurse brought me over to a gurney and told me to lie down. She tested my blood pressure, my slightly elevated temperature, and listened to my breathing. She pounded on my back exactly where it hurt and massaged my stomach for signs of pain. She took some blood and even started to smile a bit as she entered her professional routine. The nurse walked away and returned from an old medicine cabinet with a glass one of these:

“We need your urine.”

Totally unaware this hospital also doubled as a center for alchemy in the 1900s, I heaved myself off of the gurney and towards the door marked “WC.” Inside the bathroom that was also a storage closet, I held the glass cylinder and sized it up to the toilet I was supposed to be using. Everything in Europe was tiny except for this glass cylinder. I had to do some surveying measurements before actually peeing because I wasn’t even sure I was going to be able to follow the nurse’s instructions exactly as she had planned. I moved around in the small space, crouching and eyeing and analyzing and studying. How am I going to pee in this?

Eventually I managed without knocking any shelves over or causing a scene and returned to the desk with the elusive elixir. I noticed the beer mug on the desk again. Maybe that was someone else’s pee, I thought. Maybe in this hospital, as long as you’re peeing into anything made out of glass, it counts as a valid urine sample. Maybe a Czech mystic will appear and grant me knowledge on future philosophy. Maybe this was like rubbing a lamp to them.

The nurse gave me more tests. My torso was x-rayed for the pain I was in and I was given a sonogram with an amount of lube only suitable for wrestling. The staff was nice but quiet. I wasn’t talking much just because I didn’t know if they could understand me, but when spoken to in English, I made sure to return my speech at the same speed. After resting for a bit longer under a hospital blanket that was most likely flammable, the doctor came back and told me I had a bacterial infection to be treated with antibiotics. At least the mystery was solved about why I was barely functioning over the last two weeks. No more math or diluting dosages to ensure safety. I even got a shot in my ass for the pain I was in. I’m still unclear what it was, but as a tattooed diabetic person, I can handle needles pretty well. The pain in my hips and knees subsided and I felt less tension in my stomach than I had earlier in the night. So far so good. Kisha and I thanked the nurse and doctor profusely and left the hospital as the birds were going crazy in the early morning dawn.

We took one of the trams that were now operating in the early morning to the 24 hour pharmacy. Less than three minutes and five dollars later, we were walking out of the pharmacy with antibiotics in hand. Our adventure ended at the Tesco near Kralovo Pole. We bought cheese and more snacks just in case my blood sugar was still going low. I’m so lucky to have Kisha here with me. She initially friended me on Facebook almost a year ago when I had just decided to move to the Czech Republic. I was being given an absurd amount of misinformation from Czechs, EU nationals, and non-EU citizens about how I should immigrate properly as an American, and as a fellow American expat, she set the record straight for me. She answered all of my questions patiently and took the time to explain the visa process, the trade license, and what life is like in Brno. We had been talking for roughly six months before we had even met at a coffee shop near my house. I couldn’t have done this without her and I tell my parents that all the time. There’s no way I could have reached the level of success I’ve had in a foreign country without her help. She took time out of her evening to take me to the ER for the whole night and had the patience to battle Czech medical bureaucracy one hospital at a time. I’m incredibly thankful for her friendship.

A few days later, I’m at home taking a few days off of work because the antibiotics I was given are creating a great wave of Kanagawa in my stomach. I’m no longer in pain but I’m extremely tired and getting back on a normal eating schedule that doesn’t include pounding an entire bag of Skittles once a day is a bit of a challenge. I’m drinking lots of fluids and my parents text me every few hours to see how I’m doing. I emailed my doctor about what to do with my digestive system so now I’m taking probiotics and antibiotics. I wonder if there’s just “biotics?” If I can untether myself from the bathroom for a few minutes, I should be able to go back to work on Thursday. I only have a few more weeks left at the school before I start my new job next month, and I really didn’t need my body to give up on me this week. I’m starting to go a little stir crazy from spending so much time resting in bed but I’ve been hanging out with kitty and we started watching war movies even before I found out Gunny died.

And so ends our third Czech healthcare system adventure. To sum up: if you’re going to die, just make sure you die at the correct hospital.

Czech Healthcare Adventure! Part II

I've been on a real Bob Ross kick lately. My mom used to watch it when I was a baby and my grandfather painted along to his happy little creeks and cabins with roofs full of snow in his old age. There's a Twitch stream that plays all of the episodes, even the ones where Bob's son and his glorious mullet do a guest spot. I go to sleep at night listening to Bob describe a squirrel he rescued and named Peapod and his soothing ramblings about combining colors, techniques, and tales Florida and Alaska. It's very zen, something I've sought after for much of my life. 

YES, YES THEY ARE.

Today I went to my first "diabetologie" appointment. The Czechs are specific when it comes to medical care, meaning that instead of seeing an endocrinologist like I would in the US to treat Type 1, I see someone who specializes in only diabetes and not other endocrine disorders. It was a relief knowing I wouldn't have to explain my disease to a professional who may not know all of the ins and outs of dosages, regimens, numbers, and time tables. Unfortunately, this has happened before. It's like if you woke up during open heart surgery and told the doctor "here why don't you let me take over for a bit."

St. Anne's University Hospital, or"fakultni nemocnice u vs Anna v Brne" as I've learned to refer to but not pronounce, is a sprawling campus of old Soviet buildings, newer, pristine architecture, and baroque moldings near the center of Brno. The map I downloaded to find "Building J" was color-coded but also in Czech, so I did that thing where you walk one way while watching your location on GPS to see if you are indeed heading in the right direction. Building J did exist, however it was quite a hike around the campus to locate it. At one point I wondered if it was maybe like the Back Building in Mean Girls.

With a low ceiling and steel chairs lining the hallways, I wasn't sure if I was going to a diabetologist as much as I was going to be contacting any form of asbestos. These hallways had seen better days with their scuffed patterned floors and shredding yellow and orange wallpaper.

On Pinterest it might be referred to as"Shabby chic!" I found a hallway full of doors and outside each door was a vinyl bench with no form of support.

The door with my doctor's name on it had people going in and out of it so I figured this must be a good thing. They're not being wheeled out of the room with a respirator or a blue face. So far, so good.

Like if this room was a hospital.

I have now spent enough time here to know that when you see a chair or an area for waiting, that's where you wait, which sounds obvious but if you go further to investigate behind doors that aren't marked clearly, a woman named Petra may scold you in Czech until you just sit anywhere close by until you're officially retrieved. So I sat and waited outside. 

For Czech people, my last name is pronounced "Dawn-uh-hoo-ee." With the stress on the first syllable and no accessible diphthongs, I've learned to listen for various covers of my surname from people I don't know. A young nurse fetched me and my seemingly normal last name from the hall and brought me into a large examining room and office which didn't look like it belonged inside the semi-decrepit Building J. Brightly lit with new furniture, recently manufactured medical supplies and machinery, and surfaces free of dust or minerals, the nurse who spoke some English informed the doctor I had Type 1 and that I needed a new blood glucose meter and the appropriate test strips. Certain test strips only work with certain meters, and since I couldn't buy strips in Metric meant for an Imperial Measurement System meter, I needed a whole new kit. They spoke back and forth in Czech for a moment and then came the question: "Insurance?"

I signed up for state health insurance after my visa was approved, but my insurance card still hasn't arrived in the mail. I also didn't have anything on me that proved I was technically in the system, so in this circumstance, I basically didn't have insurance at all. I showed them my traveler's insurance, which only covers you in the event of a nuclear apocalypse or emergency treatment upwards of $200,000, but they shook their heads. They continued to talk in Czech as I brought out my bag of supplies filled with both types of insulin, spare needles, my glucose meter, and test strips. I could have just been some random person who came off the street, so I wanted to show them that I currently have the supplies needed for someone with Type 1. In broken English, the nurse said, "We give you a meter and test strips free, and in two weeks you come back when your insurance card comes, yeah?" 

Umm, fuck yeah. I smiled like an idiot and said "ano, ano prosim." Getting a free glucose meter and the accompanying strips in the United States means getting one from a diabetic friend or selling your first born and sometimes second born. One of the reasons people with diabetes let their care suffer during a financial crisis is because they simply can't afford the test strips, let alone the insulin. I test my blood sugar four to five times a day depending on when I'm eating and how long I'm awake. In the United States, a pack of 100 test strips without insurance is $129, meaning every 20 days, I'm out $129 if I actually want to manage and treat my disease instead of slowly die. Test strips are a HUGE inconvenience. You need them to figure out how much insulin to give yourself before meals and to find out if you really do have low blood sugar or if you're just imagining it. Getting 100 of them for free in addition to the hardware is a big deal. 

Woo! Czech glucose meter!

The nurse who spoke some English and another nurse who spoke zero English physically acted out how I'm supposed to use the meter. Even though I've been testing my blood sugar for almost eight years, I couldn't bring myself to stop their comedic safety demonstration. The Czech nurse poked her finger and said "owwwiiieeeee!" and then blew on it to exhibit the minor pain and inconvenience of pricking myself. "Into blood!" Aren't we all. They packed up my new kit and sent me into my doctor's actual office where he asked me some basic diabetes related questions: when were you diagnosed, at what age, what symptoms were you experiencing, how often do you go low, and which insulins are you on. I brought out my bag of supplies and showed him the insulins I use. One insulin I use is what's called a basal insulin and lowers me to a healthy "baseline" for 24 hours.

I use the other insulin before meals or when I'm consuming carbs, which can only be done every 4-5 hours. 

He recognized both pens and told me he would give me prescriptions when I came back in two weeks once my health insurance card had arrived.

Basaglar and Humalog, the two insulins I need to use.

Insulin pen with a teeny tiny needle.

Then my doctor told me, "I'm not going to charge you for today since you only needed a meter and there's no exam. When you come back in two weeks, your insulin prescriptions and the appointment will be covered. If you need any lab work done, that will be covered, too."

I was floored. I smiled at him and almost cried. Normally in the Czech Republic you need cash in hand, although not much, before any medical appointment if you don't have health insurance for your visit. I was expecting to pay something today, but not nothing. If this was the situation in the United States, I might need to start a GoFundMe to cover the costs of staying alive. I told him that it wasn't this easy in the US. "We know," he told me. 

Finally, a country that understands that staying alive is a basic human right. If we were brought into this world without consent, there should be an economic and social system in place to make sure we can be the healthiest capable people contributing to society. Why is that so hard to understand? If the US has such a hard on for being the greatest economy, shouldn't we have a healthcare system in place that takes care of the people who put forth the effort and time to stimulate a "great" country?

After gleefully leaving the hospital, I literally skipped back to the tram stop and went to teach for the afternoon. I showed the other teachers my new rig and spent the next few hours going over phrasal verbs, how "synonym" and "cinnamon" are two entirely different words, and the correct pronunciation of "hyperbole." I'll update again in two weeks after my next diabetology appointment. If the Czechs keep taking care of me like they are, I'm going to be here for a long time. 

Czech Healthcare Adventure! Part I

Today I experienced the Czech medical system as an uninsured foreigner! And it's fucking awesome! When I say uninsured, I mean that I am not yet on the Czech public health insurance that is offered to me as an American expat, the same insurance offered to Czech citizens. I currently have travelers insurance that I paid for upfront for the next four months while I'm waiting for my visa to be processed. This insurance protects me in case of an emergency and extends outside the Czech Republic, whereas the state insurance is only effective within the country itself. After my visa is approved, I'll be able to get on that sweet, sweet state system and reap a multitude of benefits as a diabetic woman with depression and anxiety and a reproductive system.

The one issue/non-issue with the travelers insurance is that hardly anyone takes it. I've scoured the internet for endocrinologists, gynecologists, general practitioners, and therapists who take my insurance, Ergo, with little to zero success. Then I searched for English speaking doctors who are accepting new patients. Google's reviews sent me to the guy I went to today and I've been smiling like an idiot the whole afternoon. Not to mention booking an appointment with him was incredibly easy. I chose a time slot on his website and I showed up.

I should note that depending on your affliction, you'll need to see certain doctors for certain things. For instance, I can't get my birth control from a GP, so I'll need to make an appointment with a gynecologist. I was unsure what the case would be for both my Wellbutrin and Cymbalta, a cocktail of which keeps my neurotic and anxious tendencies at bay. Who would I need to see for this? An actual psychiatrist? If today's guy couldn't do it, then I'd be able to get a referral. Just one more extra step.

Living in Královo Pole means I'm in this nexus of Brno tram lines and busses that can take me pretty much anywhere within two stops, and this morning I only needed to take one. I also stopped at the ATM to withdraw cash for my appointment since I'd have to pay out of pocket in case my insurance wasn't accepted, which it wasn't. I stammered a bit trying to figure out how much to withdraw. $100? $3,000?

I realized I got caught up in my "Americanness" because I was assuming a doctor appointment was going to put me into debt or at least reinforce a ramen-style eating habit until further notice. Americans are so used to sacrificing shit just to pay for their healthcare. If I lost my insurance while living in Seattle, my life would have become unsustainable and I'd be working just to afford all of my medications I can't go without. The numbers were staggering after looking at them. It was scary and it lit a pseudo political fire under my ass to protect myself. So here we are.

Dr. Otsar is located in an intricate webbing of tram lines near some of the universities. Lots of young people were milling about in their white sneakers while drinking Red Bull and snickering at what I assumed was me. I found the building and went up to the third floor. The waiting room had six Poang chairs from IKEA so I parked myself and hoped that someone would attend to me based on the absence of windows to the actual clinic. A robust redheaded woman came out of a very white closed door and barked Sit, you wait at me. So I sat and waited. Other patients were coming to and from the waiting room and were seen before I was, but I figured this was because I was new. One thing I did notice was that whenever someone entered the room, they were greeted.

Dobrý den!

It was like entering a room with a surprise AA meeting on the other side. I followed suit and did the same for whoever showed up. Normally in an American waiting room, you're sizing up the other patients wondering what's wrong with them and you feel fine after a minute or two but then you hear a loud sputtering wet cough that everyone will leave with by the end of business today so a really great experience overall. 

Dobrý den!

The redheaded Czech Trunchbull came back out and asked me for my ID and my insurance card. I gave her my passport and showed her a picture of my travelers health insurance card on my phone. She waved her hand dismissively at me and said No Ergo. You need pay cash. 300 crowns. Through a thick furrowed brow, she looked saddened or disappointed to tell me this.

300 crowns? What is 300 crowns? 

Czechs have a monetary system based in the hundreds or thousands for the average transaction, so even though the written numerals printed on the banknotes should have a comma in them, this was business as usual. 

300 crowns = $13.63

Am I actually seeing a doctor for less than what most airport sandwiches cost? Not to mention that, but this is WITHOUT insurance? How is this possible? 

I waited around for about an hour or so and when I was called back, I discovered the English speaking doctor who was praised on Google for speaking English spoke very rudimentary English. Armed with paper prescriptions and medical records, I entered what looked like what used to be an old Eastern European classroom with an exam table. Dr. Otsar was wearing a VERY tight and white v-neck sweater and equally tight white pants because I guess he wanted to give off a vibe that while sterile, he still has style. He took my height and weight in centimeters and kilograms and spoke slowly with me. He asked me

So what is your problem?

I lethargically explained I had just moved to Brno and was looking to establish care. I told him I have Type 1 diabetes and he looked amazed at me for a moment.

Inzulin dependenti, yes he said to me. I'm not sure if it's because he didn't expect me to live this long as an American with the shitty health insurance I had or what it was, but it was though I appeared to him as a miracle of modern science in this office with very thin windows and very fluorescent lights. I gave him my handwritten US prescriptions for my diabetes supplies as well as two bottles of Cymbalta and Wellbutrin. He explained that I need to see a diabetologist, a term I hadn't heard of prior to researching the Czech healthcare system, and he wrote me a referral to someone who he thinks might speak English. That'll do.

He then checked the time on his hilariously huge digital watch and turned his attention to my prescriptions for depression and anxiety. On the tram ride down, I imagined the questions I'd be asked involved my history with these disorders, how long I've been on the medication, who prescribed them to me in the United States, you know, typical doctor questions. Instead, he didn't ask me a single question. None. He pulled up his catalog of medications in some kind of a Czech formulary and gave me prescriptions for two months in less than five minutes. I think having the medications themselves with me helped the process along and I didn't have to explain, and very slowly, that without these scientific creations, I am not a functioning member of society no matter which country I'm located. His last order of business was ordering blood work for me on a sheet of paper much like what I'm used to seeing back home. He checked different boxes for which labs were needed and handed it over to me. Okay, 300 crowns. I pulled out a two-thousand dollar bill which sounds fucking ridiculous but that's what it is. He gave me change, thanked me for coming in, and told me to come back after I had been fasting for 12 or more hours to complete my blood work. This CAN'T be this easy. Can it? WITHOUT insurance? With zero insurance. $13 and I'm out the door? With a prescription for two months? 

I stopped at a cafe near my flat for a quick...bread with cheese and egg and salami and pickle on it before heading to the pharmacy. There are pharmacies everywhere noted by their big neon green crosses, like a beacon of a good healthcare system! The only other time I had been in a European pharmacy was when I got bedbugs in Vienna. I went into an apotheke near my hostel and mimed to a pharmacist using my fingers as pinchers that I had been bit and needed something to make me less itchy. He gave me a German ointment to slather around my wrists, ankles, and stomach and even though I was completely miserable, the experience was noteworthy for future reference. 

I entered a pharmacy chain called Dr. Max, which is very clean and green and pristine. Three pharmacists had their own workstations with a computer and a phone. There was no singular pharmacist up high, towering over everyone with malaise and discomfort underneath. It felt like walking into a mobile phone store. They each greeted me.

Am I on a game show?

I gravitated to the pharmacist closest to me.

We greeted each other with Dobrýden! and I slid the prescription across the counter like I was withholding something sinister when really I'm just a foreigner who doesn't speak much Czech trying to access prescription drugs. He did a few quick motions with the computer and turned back to me disappointed, much like the Czech Trunchbull had earlier. He spoke a bit in Czech and while doing so he realized I didn't understand, so I asked him 

Mluvíte anglicky?

In English, he said he was sorry to tell me that I would need to come back tomorrow for my prescriptions as they weren't in stock at the moment. The look on this guy's face was usually saved for parents who needed to tell their kids that beloved Freckles or Froofles "went to visit the happy little farm" while they were in school that day, or an American finding out that their health insurance costs were going cause them to go bankrupt. I almost was 180 degrees turned to leave when he told me that the costs were going to be 600 crowns. Fucking WHAT. So if we double our math from earlier, two months of two different prescriptions will cost around $27, which brings today's costs to about $40. Without insurance. In the US, today alone would have put me roughly a thousand dollars in the hole. 

It's been a few hours since my first healthcare adventure in the Czech Republic and I'm still blown away at the amenities and services available to me as a foreigner who has yet to access public health insurance. The language barrier is proving to be a bit jumbled but with the right terminology and speed at which words are spoken, it should solve itself as it did today. I was scared going into this morning. I needed to make an appointment and see someone about my prescriptions before they ran out, and even though I'm still unaware of when my visa will be processed or when my public health insurance will go into effect, I was still able to accomplish my business and more.

I will still need to navigate through the thickets of endocrinology (or diabetology?) and the gynecological bureaucratic systems, but considering I've only been here for a little more than two weeks, I've made significant progress. Right now I'm working on this post and kitty is curled up in my blanket I was using for a pillow. I lit a couple candles and I'm going to make garlic broccoli for dinner. I'm not beating myself up about high blood sugars; I've had a few meals where I've been over 300 but I'm chalking it up to the fact that I'm underestimating the carbiness or sacharidy of the fucking squishiest bread loaves in the world. Yeah, I'm insulin dependent. I'm insulin dependent as fuck.

I'll keep updating the further I navigate. But as an introduction into the Czech healthcare system today, I'm incredibly happy that I can be healthy here.