My dad used to have a saying that went like this, “If we had some bacon, we could have bacon and eggs, if we had some eggs.”
I don’t know why, but today’s experiences in The Regional Hospital made me remember his humor. Certainly you have to keep a sense of humor to get through the bureaucracy in all organizations. A little more humor is required when there are language and cultural barriers that keep getting in the way.
With that lead-in, let me share with you my new experiences from today.
First let me say “Thank You” to the two blood donors that gave blood this morning. The Boquete Hospice and Health Foundation had one donor and another came as a result of one of my other requests. You do not realize how important it is to have a source for blood in case of an emergency.
Panamanians have plenty of family that can be organized on a moments notice. Foreigners don’t have that luxury.
There are multiple facets that I want to cover, so this post may be a little disjointed. I’m sure those that follow my blog may be thinking that this isn’t new and all posts are a little disjointed. Oh well.
Today’s events are related to the U.S. citizen that was transferred from Hospital Chiriquí to the Regional Hospital for a spinal operation. You may remember my post related to researching the use of Tri-Care that finally resulted in the Regional Hospital being the only option.
Then there was the admitting error, which neglected to record that the patient was diabetic and the difficulties getting the chart updated. After about three weeks in the hospital, all hurdles had been handled and the appliances for the spinal surgery were in the process of being ordered.
Prior to the order being executed, the hospital said the back surgery couldn’t be done because of a circulation problem that had arisen in the patient’s right leg. The non-diabetic diet the patient had been on for three weeks probably hadn’t helped the situation.
Last week, I talked to the nurse’s desk and learned that he was scheduled for surgery to remove the leg, but that was on hold for blood and paperwork. That prompted my request for blood donors. Today, I better understand the paperwork problem, which I will get to later.
Today, my Embassy letter didn’t work it’s magic and I was not allowed to go to the patient’s floor to check on the surgery schedule. The guard insisted I needed to talk to the Hospital Director first. OK, hurry up and wait for the Director to arrive.
After about 10 minutes, the Director arrived and I asked why the leg surgery for the patient had not happened, because I had been told last week it was to happen on Monday or Tuesday and I was now told it was being held up for 2 units of blood.
The Director said it should not have been held up for that reason and called the head of the floor the patient was on. The Director asked about the operation and was told it could be done now. I can feel my hand searching in my pocket for an aspirin to ward off a headache.
While I was there, I brought up the fact that this patient had been admitted with the admission records indicating he was not diabetic. The operation that was being scheduled was for a diabetic problem and I was concerned that the hospital’s procedures for patients that did not speak Spanish, might have aggravated the problem.
I told him I am always available to help, if there is a difficulty in situations like that. He took my card and dictated a memo, on the spot, asking all floors to contact me when they run into English language problems with U.S. citizens.
With that solved, I went back to wait on the two donors. I got a call and one of the donors had already gone to the blood bank and was having “paperwork” problems. I said I would be right up. The blood bank is on the second floor.
The donor had given the patient’s name and hospital number as I had posted in the donor request. However, the hospital had the patient’s name wrong on the computer and the donations couldn’t be given without identification documents for the patient. Luckily, the son had told me to keep the passport, so I left to go home to get the patient’s passport.
We had also been told that there was a cutoff of 10:00AM to get the blood donated. It took me about 15 minutes to get the passport and return. The attendant was now happy and the donors were being processed. The attendant told me to have a seat.
She then gave me a receipt. I thought it was the paperwork that needed to be delivered to the patient’s floor to get the surgery started. I signed as requested and then looked at it. To my surprise it was a bill for $230.86. I said, I hoped they didn’t expect me to pay that bill. She said, “Of course”. I told her I was not a family member and it should just be added to the patient’s account.
She said this bill had to be paid for prior to surgery or the blood could not be allocated to the patient. I asked what the charges were because the donors were providing the blood. Apparently, the charges were for the testing of the blood prior to it being accepted.
My hand goes in my other pocket searching for another aspirin. I asked how we were going to handle this, since I could not and would not pay. Another doctor from the blood bank came out to help resolve the problem. He told me to take the bill down stairs, pay a small amount ( a couple dollars) and they would stamp the receipt and bill the government for the balance.
Well, that probably works for Panamanians with a social security number. I go down stairs and the lady in the office told me it had to be paid in total and “Right Now”. I told her I was not the family. She said the family would have to come pay it. I told her the family was in the US. She sort of shrugged her shoulders. I told her I would call the U.S. Embassy and for her to explain it to them, because I didn’t understand. Hand goes in pocket again ( I must have an aspirin somewhere).
I call the Embassy and explain my difficulty and asked if they would talk to the lady. I tried to hand the phone to the lady and she refused to talk to the Embassy. My contact said she would call the blood bank.
The lady finally said she would write up a credit slip for me to sign and we could move forward. OK. whatever it takes. I am out of patience and have no aspirins.
She then adds up the receipt, I had brought from the blood bank, and informed me that they had added up the numbers wrong. It was not $230.86, but really $231.86. She sends me back to the blood bank to get a corrected receipt.
Luckily the blood bank is on the 2nd floor and not the 4th floor. With the corrected form in hand I go back to my new friend in the cashiers office. She had two other people in front of me. I got to the window and she accepted the form, had me sign two more documents and gave me a pink receipt to take back to the blood bank.
I am sure I am on hook to pay for this bill sometime in the future, but first things first. Let the operation begin.
I decide to go back and talk to the Director to better understand the $231.86 and how that aids the hospital in getting blood donors. He was in a meeting for a couple hours.
I decide to put that conversation off to another day. Instead, I go to another area to talk to a lady, I had met a few weeks ago, that works in one of the administrative areas of the hospital. I brought her up to date on today’s events. She called to check on the surgery schedule and found out that the operation was in progress.
I will call her a little later to get an update on the patient’s condition.
There are a few lessons, I learned from this.
First and foremost, I need to remember to carry around a couple aspirins.
Second, I need to relax and keep the type “A” personality from taking control, when frustration starts raising its head. Headaches can occur.
Third, if you don’t give up, you can eventually make things happen.
I should point out before closing, that these experiences are not limited to gringos. It is not some evil plot to make us want to leave this beautiful country. The exact same thing happens with Panamanians. They just accept it better and are never surprised with any barrier placed in their way.
Keep your fingers crossed that the patient does well in the operation.
UPDATE: I just received a call and he is back in his room. The surgery is supposed to have gone well. I will check on him tomorrow.