Italy has a perfectly fine public health system, but it doesn’t encourage audience participation. Here’s Ralph’s story. One year ago he wobbled into my office barely on the mend from food poisoning, the sitting-on-the-toilet-holding-a-bucket-to-barf-in kind, that had started 10 hours after having a burger and shake at one of Rome’s forty-one McDonald’s. Obvious food poisoning, and a menace to other customers.
Being a good citizen I set out to make a formal report so an investigator could be dispatched to start testing those Big Macs. After dialing a dozen health department numbers trying to find out how, I finally found someone who knew the correct answer: forget it, Dottoressa. In the UK a physician who suspects restaurant-acquired gastroenteritis is legally obliged to report it, and in the US it’s strongly advised. In Italy, the physician can’t do a thing – by law, I was told, only the injured person him- or herself can do the reporting.
When I passed this information on to Ralph, he proved to be an even better citizen than me. He tracked down the address of the proper office and trotted over there the next day. The man behind the desk heard him out then said, “OK, before we start our investigation we need your receipt for that meal.” My patient made the Italian both-palms-up gesture of astonishment: “You must be kidding. There's no way I'd have held onto the receipt for a fast-food hamburger I ate a week ago.” Employee: “What, no receipt? You threw it away on your way home? Sorry,” he said, tossing the report in the trash. “We can’t take your complaint if we don’t first have proof you ate that night at McDonald’s.”