Timmy and Polly see an allergist every few months. We have been there twice already since we came back: the first time just for general check-up, since it had been 6 months since we had been there (HMA), and the second time was for Polly's skin test. Here is what one might expect from a trip to a 'specialist' doctor here.
The allergist is a nice lady and seems to be knowledgeable. Her hours are 8 AM until 1:30 PM on weekdays. The clinic is located on the campus of the Oblast Children's Hospital (oblast is similar to a small state or a large county), several blocks from our house. Unfortunately, there are no buses that run that way, and we either walk (25-30 minutes one way) or take a taxi ($1.5) to get there, it depends on the weather and if the children are well. We got to the clinic, and I was surprised at the long line to the check-in window. Usually there are a couple of people in front of me, but this time there were 15-20. The line moves slowly, because there are no appointments made by phone: one comes, the lady behind the glass asks your child's name and address and whether the parent remembers the child's file number. Then she proceeds to locate that file among thousands of files on the shelves. I made a point of remembering Timmy's and Polly's numbers, and I get praised every time. There were two or three ladies working behind the glass, and the line took 20 minutes for me to get there. She gave us two slips of paper with appointment time written on them, but first, she said, go to room 100. Oh, no! Not room 100! I remembered that room from the first time we went to see the allergist. In fact, no matter what doctor you get to see, you have to check out at room 100 first. It is nothing but a station for getting the child's current weight, height, blood pressure results and his body temperature. Things one would get done by a doctor's nurse in the US. Anyway, this procedure should not and would not be dreadful (even waiting in line for 15 minutes just to get in would not be too bad), if it were not run by the most grouchy and child-unfriendly nurse I have met in my life. Yes, she works at a children's hospital, too. I forgot to mention that the reason we had to go to that room is because it's been over a year since our kids' weight has been checked (it is needed for prescriptions). Back to room 100. Remembering the criticism that we got the previous time (the nurse was not happy with our kids' imperfect Russian), I asked Timmy and Polly to speak only Russian inside room 100.
Finally, it was our turn. The nurse was the same lady from last year. There was another mother with a child sitting on the examination bed (the child had a thermometer under his arm). The nurse commanded Timmy to take his boots off, while telling Polly to sit down and wait. "Boy, stand on this rug! No, don't stand on the dirty floor with your socks! Mother [addressing me], I do not know WHAT you are teaching your children! Come, boy, stand on the scale. Mother, your boy's responses are too slow for his age. How old is the girl? Five? Well, her responses are age-appropriate." Whew! They both were weighed and their blood pressure was measured. Meanwhile, the other lady with a boy had the thermometer go off. The lady was just about to take it out, when the nurse instructed her, "Wait for another minute. I will tell you when to take it out. Just because it beeps does not mean that it is done. It needs another minute." I had to say something, "Usually, when it beeps, it means that it is done." The answer came quick, "No, it doesn't. Some people like you mistakenly think that. But if you read the instructions, they say to wait another minute!"
We finally were done with room 100 for another year. Down the long dark corridor, and up the stairs to the third floor. Many people are crowding a narrow, although brightly lit, hallway. I call out, "Room 309?" A lady answers, "You will be in line after me." Even though we got our slips of paper with appointment times written on them, it is first come-first serve. We wait another 20 minutes. There are some chairs available, but they are not sufficient to accomodate everybody. Eventually Timmy and Polly sit down while I wait, leaning on a wall. There are 5 doctors' rooms in this wing of the building: two allergists, an ear-nose-throat doctor, and two other specialists. Parents and their children, from babies to teens, wait their turn. There is also an elevator that does not work and a nursing room. All parents look tired. Some look sad, some do not, but there is not one happy face there. Clearly, if they are there, something is wrong. Somehow medical system here sucks all life juices out of parents. In the US you go to the doctor to get the problem fixed, and then you move on with your life. Here when you have to go to a doctor it is more of a sentence. Something is wrong, and you will have to carry this burden the rest of your life. There are no guarantees that the treatment will work. There are no assurances that everything possible will be done to return the patient to the normal way of life. Quality of life with a health issue is not an option here. If you have a medical issue, you will spend hours and hours seeing the doctors who want to keep you under their vigilant control. The patient is never trusted with information and decision-making. Some doctors' appointments are free, some are not, it all depends on a particular case.
After a long wait, we make it into the allergist's room. The doctor is behind a desk, so is the nurse. They are friendly and willing to help. She examines the children, asks questions, very much like an American doctor would. The only difference is that she never leaves her place behind the desk. The children go to her to get looked at. The doctor wants to Polly to get some bloodwork done. Can it be done at the clinic? Yes, and it costs 10 grivnas ($1.25). I need to go pay at the register and bring the check to the lab along with the doctor's orders. We can get it done right away! The doctor wants to have Polly get a skin test in a few weeks, so we set a tentative date. We say good-bye and go down, down the stairs to the first floor, then a long walk to the register. "I need to pay 10 grivnas for the blood test," I tell the lady in the window. She looks at the orders. "Correct. Here -- start filling this out." She hands me a blank piece of paper and a pen. A sample is right there, on the table. "Please accept my free-will donation for the improvement of the hospital." Do I have to write this? Yes, those are orders. I copy the sample and sign my name. It's not much a free-will donation, is it? The lady sighs, "They put me here, and this is my job. I am just a worker." I take my receipt, and we all go back the long dark corridor and up the stairs to the second floor. The room that we need is locked. There is a paper attached: 'The nurse is in room 205." We go down the hall to room 205. It is locked, too. Another piece of paper is pasted onto the door with another room number. Locked. What do we do? We wait and wait. After about 10 or 15 minutes of waiting, I knock on a door, "Do you know where the nurse from room 203 is?" The lady answers, "She is in room 205." "It's locked." "Have you tried room 210?" "Yes." Then she might be in room 206." I go there, and, sure enough, the nurse is there. I am speculating, but it looked like she was just chatting there. (She is the only one working in her lab room, so she probably gets bored.) She comes out and is immediately surrounded by several people (they have been waiting, just like me). Despite the fact that it was I who brought her out from beyond reach, people push me aside and try to get what they want, mostly test results. The nurse seems like a nice young lady, but is utterly unorganized. She spends another 10 minutes talking with people about their results. We wait. She finally tells us to go inside and wait for her there. Timmy stays outside, while Polly and I go in. Polly is finally getting a clue that she will be poked. This has been the hardest consequence of her staying at the hospital a year ago when she had pneumonia. Jamie stayed with Polly at the hospital: Aggie was little and still nursing, I did not want to take her there. Anyway, the two nights that they spent there were more than enough for both of them. Polly, poor Polly! The doctors here strongly believe in administering medicine through shots vs. pills. Yes, there is a value of a shot to get the meds into the bloodstream fast, but after that, can't we use more humane methods? And if a patient indeed needs an IV and there are no IV in the hospital, can't we think of better ways than sticking a 4-year old child in a vein on her hand twice a day? In addition to her getting 6 shots in her bottom every day? The doctor wanted to keep Polly there for a couple of weeks. Jamie put his foot down after two nights. They were able to go home after I promised the Dr on the phone that I will finish administering all the antibiotics they have started. I had to do 6 shots a day for a couple of days, then it went down to 4 until it was done. She got sick with another pneumonia/obstructive bronchitis 6 weeks after that. And 6 weeks after the second time. Three times altogether. The second time we did not go to the hospital. We stayed home and did shots, but not as many. The third time we caught it early and used pills. It turned out that Polly has asthma, and this underlying inflammation of the lungs readily triggers pneumonia, obstructive bronchitis, etc. When Dr. Jon observed this in while we were in the US for HMA, he immediately put her on an inhaler. I keep wondering why the allergist here did not do it, even though she was well aware of the sicknesses.
Needless to say, Polly has a bad feeling about needles after all that. As we were in the lab waiting, she got more and more upset and nervous. I did my best to comfort her. The nurse came in after another 5 minutes and started to get things ready. A phone rang. She answered. From what I heard on our end, someone from the clinic was asking about some test results. She found them and was giving the numbers over the phone. We were waiting. Polly was miserable.
Finally, the conversation was over. But the phone rang immediately again. I thought it would never end. She seemed completely oblivious to the fact that the child in my arms was suffering emotionally and wanted to leave. Finally, she approached Polly with a needle. You guessed the reaction. Polly screamed and tried to get away. The nurse stepped back. I think she was waiting for her to calm down. I told her that it was not going to get any better and that we would have to get it done. I held Polly tightly as she drew the blood. Finally, it was done. "I am surprised that she reacted like this," she said to me. "Children much younger than she come here, and they are fine." "My daughter has been to a hospital," I replied. "She knows what it is."
We were FINALLY done! Two and a half hours later we were ready to go home. I bought the kids some munchies to hold them over until we got home for lunch, called a taxi and went home. What a long day at the clinic!
Polly went to see the allergist again a few weeks later for a skin test and to talk about the blood test results (they were fine). There was some crying, but as soon as she realized it was not really a shot, she calmed down. The doctor recommends getting some bloodwork done to determine possible food allergies (they only have a small selection for skin tests available). I do not think I am going to subject my child to this kind of torture anytime soon. Only if it is absolutely necessary. Until then we will eliminate the foods that we suspect she is allergic to.
