Sunday, November 25, 2018

The Road To Redemption

drawing by Suzanne Dunaway
Stay with me on this one, it’s worth the trouble – all you need to know about Italy in a single story.
ENPAM (Ente Nazionale di Previdenza ed Assistenza dei Medici), the physicians’ pension fund, allows its members to pay in retroactively to cover the time they spent at university. This riscatto della laurea, “redeeming your degree,” lengthens your pensionable working life by six years and yields a healthy boost to your pension.
In one of those mysteries of Italian bureaucracy, ENPAM assured me early on that they would let me redeem all six years of Italian medical school, even though I’d only actually been enrolled for 11 months (taking courses not required for my American MD). I could never quite afford the riscatto, though – the cost crept up year by year slightly faster, in proportion, than my income.
In 2004 an office-mate tipped me off that there was a half-price sale on the riscatto della laurea. I leapt at the chance, and headed off for ENPAM central, a vast labyrinth. A receptionist pointed me toward the riscatto office, and after hiking up one corridor and down another for ten minutes, asking directions repeatedly along the way, I reached a corner room with the right number pasted outside. There a kindly official sat me down, patiently explained the riscatto, confirmed that the cost was temporarily 50% of normal, calculated my reduced monthly payment, handed over the sheet of paper with his scribbled calculations, and helped me fill out the application. After I had signed, he kept it.
Three months later my first bill arrived, for exactly double the figure he’d written down, and more than I had in the bank.
I phoned ENPAM the next day. The employee who fielded my irate call said the higher bill I’d received in the mail was correct. Half-price sale? What half-price sale? There had never been, nor could there ever be, such a “sale.” Who on earth had told me otherwise? I described the location of his office and the position of his desk. Long pause. Then, “Aaa, allora si capisce,” oh, that explains it. The helpful gentleman in question, she volunteered, had been off on prolonged sick leave and since returning to work was not quite right in the head…
In other words: an employee known to be incompetent had been allowed back on the job. Italian compassion. Once back, he was permitted to hand out major-league misinformation. Classic pressappochismo (literally more-or-less-ness, or sloppiness). And his colleague, gifted with Italian courtesy, had no compunction about telling a stranger all about it over the phone. A bad joke, with a worse punch line: the application I’d been misled into filing and then had to cancel counted as my once-in-a-lifetime chance at the riscatto. I was doomed to a pension without benefit of those six extra years.
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Sunday, November 11, 2018

Tests of Character

Drawing by Suzanne Dunaway
“Mother And Baby In Intensive Care After Doctors' Violent Brawl In Delivery Room Delays Birth”
Laura Salpietro, 30, had been rushed to hospital after her waters broke, but as she lay on a bed in agony, doctors argued over whether to deliver her first child naturally or by caesarean. Amazingly, the row then became violent, with punches thrown while her horrified husband Matteo Molonia, 37, looked on, pleading for the medics to stop and help his wife.
Daily Mail, byline Sicily, 2010
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The Italians I have known and loved are fun, funny, cynical, flirtatious, spontaneous, determined not to let their work interfere with their lives. It occurred to me, as I waited for the anesthesia to turn out the lights, that none of these were qualities I wanted when it came to my health care.
– Holly Brubach, New York Times Sunday Review, 2014

We all know what doctors are like. Compulsive sons of bitches, anal retentive, detached, perfectionist, tough on themselves, insufferable with others, models of dogged stick-to-it-iveness and preternatural calm. In Italy? Some yes, some no...
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