Slovak Hospitals: A Personal Experience

IT WAS something I ate in Prague, a delicious-looking day-old slice of cake that I bought at a respectable grocery store in a new shopping centre. I was spending several weeks away from Bratislava, doing research in the Czech capital on the history of Slovak media.
What I didn't see in the cake was a thin line of cream. That cream dissolved my digestive system. In a week I used a month's worth of toilet paper.

IT WAS something I ate in Prague, a delicious-looking day-old slice of cake that I bought at a respectable grocery store in a new shopping centre. I was spending several weeks away from Bratislava, doing research in the Czech capital on the history of Slovak media.

What I didn't see in the cake was a thin line of cream. That cream dissolved my digestive system. In a week I used a month's worth of toilet paper.

When my US supply of over-the-counter medicines dried up, I called a medical service. A doctor came to my apartment within the hour and diagnosed the problem. He gave me medicine to kill the unwanted bacteria, more medicine to slow the speed with which food went through me, and outlined a recovery diet.

After several days I still felt ill. Over the next two weeks I did my best to ignore it. Then I returned, as scheduled, to Bratislava. Back in my Lamač apartment, I felt dizzy but blamed it on not having eaten for eight hours.

I fixed a light meal. I also weighed myself: I had lost six kilograms in the two weeks since being attacked by the unfriendly bacteria. This is not good, I thought.

The dizziness returned, only worse. I could not stand up. Finally it dawned on me that maybe I needed serious medical attention.

My neighbour across the hall was not home, so I managed to drag myself up the stairs and knock on the door. I explained I needed an ambulance.

I retreated to my apartment and waited. Finally the ambulance came. My neighbour put a few articles in a plastic bag for me to take, then the ambulance swept me to the emergency room at Dérer hospital on Kramáre.

The questions started. The doctors asked about insurance coverage and the whereabouts of my family and friends. My wife was in the US and my daughters were in the Philippines and Germany, and while I had friends in Bratislava, I didn't have any close friends.

I told them my research grant attached me to the Department of Journalism at Comenius University. The hospital promptly informed them where I was, perhaps assuming that I would need to validate my absence somehow.

Then I was assigned to the infectious diseases department.

Two nurses, a man and a woman, came to take me, on my back on a gurney, to the infectious diseases department.

From the outside, the Dérer Hospital looks as if it is a collection of several buildings. What you do not see are the dimly-lit, connecting tunnels below street level through which run various pipes and wires, and through which some water trickles. The tunnels are angled upward or downward, depending on where you are.

At my room I was presented with a pair of pajamas. The tops had only two buttons, one of which wouldn't stay in the buttonhole.

During the next 24 hours, I accustomed myself to my new surroundings. There was no telephone, no television, no radio, only four walls in rectangular form.

I didn't mind the spartan surroundings. I was exhausted and slept a lot. Nurses occasionally checked my blood pressure. I ingested a few liters of liquid by IV.

A big glass of unsweetened black tea was at my bedside and I was instructed to drink often. Since I can speak reasonably good Slovak, I could chat a little with the nurses when they came into the room.

Late in the afternoon of the first full day, nurse Jana Vallová, unbidden, brought me a couple of Slovak magazines to read. She apologised that they were several months old, but that was all she had been able to scour up.

On the morning of the second day a box of dry toast (diétny suchár) was placed on my table, along with a cup of black tea.

I mentioned to one of the nurses that the bathroom needed more toilet paper.

"Uh. Didn't you bring your own?" she asked.

Seeing that I was desperate she mentioned that one of the junior nurses went out from time to time to buy supplies. I could send some money with her.

On the afternoon of the second day Nurse Vallová brought me two books to read.

She apologized that she didn't know what I was interested in. She handed me a Slovak edition of Mario Puzo's The Godfather and a Reader's Digest collection of stories about supernatural events.

When the doctor completed his examination of me on the morning of the third day he told me I could add bananas to my diet. It would be good if I could start drinking some mineral water, too, uncarbonated, he added.

"When will they bring the bananas?" I asked.

I should have known. I needed to supply my own.

One of the nurses proposed that I could ask the junior nurse to buy me a phone card on one of her missions so I could use the phone in the hallway and call someone about the bananas.

I reached the daughter of my landlady, whom I had been meeting for coffee once a month to pay my rent. She agreed enthusiastically to bring the needed items and asked if there was anything else I wanted.

She came that afternoon with all the desired goods. But she couldn't come to the room itself. Visiting was done through the windows. She stood outside on a passageway that ran the length of the windows. We chatted through the opening for a while. Then she left. I wondered what she thought of my one-button pajama tops.

On the fourth day I was allowed to have rice for lunch. All the tests had been running negative, the doctor said. The Prague doctors had killed the bug that had disabled me. They simply hadn't been able to heal the after-effects, which had been considerable.

The rice was extremely well-cooked and was served in the water in which it was cooked. I didn't eat it; I drank it. Slowly.

On the fifth day the nurse had taken note of my one-button pajamas and volunteered to bring me another pair. The buttons on the top of the new pair were much better, and I thanked her. Later I realised that the new pair was lacking a crucial button on the fly.

The doctor decided that I could continue with a more challenging diet. For lunch I had potato soup, carrot puree, ground beef (ground after cooking) and well-mashed potatoes.

The nurse scraped up some silverware for me to use. I was supposed to have brought my own.

On the sixth day it was decided that I could go home if I was confident that I ccould prepare the recommended diet for the next week. I stayed for lunch then took a cab home.

Several days later I returned to the hospital to pay my bill. The stay for six days came to 18,000 crowns, a little less than $600. There was no charge for the ambulance.

In the US, $600 would barely cover the ambulance.

I was impressed by the professionalism of the nurses and doctors during my hospital stay. They took good care of me and started me on the way to recovery. If I had realised some of the supplies I was going to need, I would have made sure that I had them with me.

The socialised healthcare under communism accustomed Slovakia's citizens to "free" healthcare. As the lack of basic supplies demonstrates, that can't continue. Investments will be needed to provide modern, quality care with good facilities. The challenge will be to provide this care and yet still make healthcare available at a cost the people of Slovakia can afford.

Owen V. Johnson teaches journalism and history at Indiana University.

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