My early professional life was short on patients but long on learning experiences.
Over dinner I asked an anesthesiologist friend of the family what anesthetic was preferred in Italy for childbirth. “Il grido,” he replied, “The scream.” As though it were an explanation he continued, “Remember that the book of Genesis says women shall bring forth children in pain.” Even today, most public obstetrical wards don’t offer either epidurals or painkillers.
I learned from patients’ horror stories that Italian surgeons didn’t use local anesthesia when they sewed up lacerations, or prescribe strong analgesics after surgery; cancer patients got morphine only when death was days away. Patient activist movements have improved things a bit by now, and since the turn of the millennium I can even prescribe the equivalent of Percocet. But those ER docs are still doing their stitching without lidocaine.
I learned from personal experience that a physician who goes to a drug store to buy morphine in Italy, to keep in the office for emergencies, is seen as a drug addict. The first time I filled in a triplicate prescription for 4 vials and handed it to a pharmacist along with my medical license he looked at me crosswise and said they were out of it. So was a second, a third, and a fourth. Being treated like a criminal makes you feel like one, and for years whenever it came time to replace my expired vials I would put on my best clothes, as I would to go shopping on Via Borgognona, and even so my heart would pound. I can only imagine how hard it must be for cancer patients who need to buy morphine for their own use.
Shortly after I moved to Rome Giovanni Agnelli, C.E.O. of Fiat, nicknamed “Rake of the Riviera,” fell and broke his hip. His personal physician, according to the front-page story in La Repubblica, was treating him at home with the leg under traction. I was floored – from what I knew bed rest with traction had been ditched years earlier in favor of immediate surgery, which had patients up and around in days with fewer complications. What I found astonishing was not that an Italian doctor might be behind the times, by now no news to me, but that the richest man in Italy would be under the care of an ignoramus. Lesson: loyalty trumps competence. P.S. A week later buried on page 17 was a one-line report that Agnelli had been flown to New York for surgery.
Susan, you're a gifted story teller and pack in lots of information. A very good read, and I look forward to your continuing blog!ReplyDelete
thanks so much, hope it lives up to your expectationsReplyDelete
In bocca al lupo for your new blog. Already the first post had some eye-opening information. Keep up the good work!ReplyDelete
About morphine: when my mother, who was in stage 4 cancer which had spread, was in NYC, her doctor was on vacation and couldn't renew her prescription for morphine. She called his replacement, who said she had to go into the emergency room at a hospital and wait there for a doc to see her and prescribe the medicine (which took hours). I found that outrageous, since she was in great pain at the time.ReplyDelete
A rotten story with moral: doctors are shits. You're reminding me of when I first came to Italy, age 22, I had an early-type IUD that gave me excruciatingly painful periods. Couldn't get any proper painkiller for love or money.ReplyDelete
Lol! I can foresee your posts will make me laugh and cringe with shame in equal measure...ReplyDelete
and occasionally swell with pride?Delete
I had the same "we are out of stock - suspicious look" experience once. After that (not being a fan of formal clothes) I always went to buy narcotics in a pharmacy where they know me. Being friend of someone is the key!ReplyDelete
It's the key to everything in Italy, isn't it?Delete
Ohhhhhh yessssss! ☺Delete
Susan, loved reading your post. So happy you have started this blog to share your stories! All the best to you.ReplyDelete
Merhaba Ceylan, teşekkür ederim! are you still in Istanbul?Delete
When I fell and broke my hip in 2013 the surgeon I got, who told me he was the best in the area for this kind of job, gave me a week in bed with traction before operating. I assumed it was the right thing. then I had a month or so of living in a rehab facility, and total of 12 weeks on crutches. Was I in a different situation? Has the thinking changed (they were quite generous with the painkillers which made it less intolerable)?ReplyDelete
Hmmm. This was definitely not standard procedure. Generally speaking the rule for surgery after hip fracture is as soon as possible, aiming for within 24 hours (http://www.clevelandclinicmeded.com/medicalpubs/ccjm/march05/whinney.htm , https://www.nice.org.uk/guidance/cg124/chapter/Recommendations#timing-of-surgery) When surgery is delayed for a couple of days for logistical reasons some hospitals apply traction while the patient is waiting, in the hope that it will reduce pain, but there's actually no evidence it works (https://www.ncbi.nlm.nih.gov/pubmed/22161361).Delete
Susan, love having your lively mind on paper ( so to speak). I know there will be some harsh surprises, but look forward to reading all you will share! This is a great idea.ReplyDelete