Wednesday, July 19, 2006

My first experience at a hospital

America, it appears, could learn a thing or two from Egypt. At least, when it comes to medical treatment.

Three days ago I woke up with a pounding headache, the likes of which I had never experienced before. Moving my head just a few inches in any direction inevitably led to a deep throbbing around my cranium. The time delay was about 5 seconds, just long enough to believe that maybe, just maybe I was past the worst of it. I was nowhere near past the worst of it.

I attempted to go to class, more proof if any was needed that my stubbornness directly borders the absurd (there is certainly no buffer space). By 2 pm, I gave up, went home, and went to sleep. I woke up at 4 in much worse shape.

Getting out of bed was nearly impossible. When I attempted to get out of bed, the pain was bad enough to cause a spewing of sexual and scatological terminology. I began to freak out. Were these the first signs of an impending stroke?

I got back into bed. Maybe I could wait it out. The prospect of going to the hospital, where I would know no one, and know nothing about the system was more distasteful to me than the pain. I have dealt with physical pain in my life. The Egyptian hospital system is another story. It appears I prefer possible death to an uncomfortable situation.

I called my roommate and told him the situation. He would have said something like "you’re a fucking moron," were it not for his struggle to live in the path of Jesus Christ. Instead, in a concerned voice, he told me I should reconsider and get in a cab. Finally, I conceded.

What would I find at the hospital? Egypt has a booming economy, but it’s still a part of the third world. My health plan, offered by the American University in Cairo, costs 80 dollars for the entire year. The brochure claims it covers all hospital expenses up to 25,000 Egyptian pounds (about 4,500 dollars). Given such a low premium, what would the inevitably low cost of care provide? Would the hospital be clean? The Ministry of Health released the results of a survey two weeks ago that found that only 8 percent of Egypt’s doctors wash their hands before and after each examination. To state the obvious, I was a bit worried.

What I found at Peace Hospital (Musteshfa al-Saleem) was the opposite of what I had expected. A receptionist immediately pointed me to the emergency ward. The receptionist in the emergency ward took my insurance card, inquired about my symptoms, and then asked me to have a seat in the waiting room, which was clean and cool. Within 5 minutes – for emphasis FIVE MINUTES – I was speaking with a doctor. A short 10-minute exam ended when I was given a shot of painkiller in the ass. I was given a prescription for antibiotics and anti-inflamatories. The whole operation, from walking in the door to walking out, took about 40 minutes. I paid zero dollars.

My headache had not gone away by the time I left (it would a few hours later) but I began to believe that a small part of my head pain was now being caused by confusion. What kind of a hospital lets you see a doctor within 10 minutes? Where was the paperwork? What about co-pays? The doctor had even given me his cell phone number, in case my symptoms did not improve. My head pounding, searching for answers, I came up with only one theory: Egyptians, living in such poverty and backwardness for so many decades, have still not learned that the most important mark of civilization is a healthcare system that is impossibly complicated, incredibly expensive and infuriatingly time-consuming and petty. Maybe someday they’ll learn.

Two days later, I’m still a bit baffled. The antibiotics are actually working. I feel much better. I have not received any letters requesting payments. I suppose the letter from the insurance company denying coverage has only been processed, and will reach me via email in the next day or two. If that letter does not come, I will be forced to face the prospect that the Egyptian healthcare system works better here than it does in the states – at least for the middle class, for minor problems.

I also had a second thought: The third world has plenty of reasons to detest the West. Plenty. But one small thing that it has to be thankful for is the investment private and public companies of the first world have put into pharmaceutical research and development. Had I been without health insurance, the pills that I received would have cost me about 5 dollars. I don’t think 5 bucks goes a long way into paying for lab work and clinical trials. (If you are an expert on this topic and know I’m wrong, please email.) As Americans struggle to pay for their own prescriptions, Egyptians are able to get theirs filled cheaply because someone else put up the money for R&D. Because of cheap drugs, many Egyptians (though certainly not all) are able to live longer, healthy lives.

But aren’t all these Egyptians stealing from all those poor American and European corporate executives and their companies’ shareholders? Hmm. I don’t think I’ll get a headache over it.


At 2:03 PM, Blogger Len Rodberg said...

Very nice account of your experience, and reflection on the American counterpart system. I and my PNHP colleagues are doing our best to bring the US system up to the standard of the Egyptian system, but we've got a long way to go.

I'm glad you had a smart doc as well, who knew how to treat your symptoms.

Be well.


At 3:01 PM, Blogger Nelson said...

If you're interested in how R&D departments at universities can help people in the developing world, you should check out Universities Allied for Essential Medicines... it's a student group trying to get universities to license generic drug makers in the developing world, to oversimplify their mission.

At 11:06 PM, Blogger CML said...

perhaps they don't treat the uninsured so they don't bother to clog the ERs? they certainly aren't forced to give medical care to illegal immigrants that can't/don't pay for their care. (had you not had insurance, perhaps you would have had to go to a local overcrowed clinic??perhaps the state pays the liability insurance premiums of their doctors and so they have more doctors? or perhaps they don't allow frivolous lawsuits and they have more doctors willing to practice emergency medicine? perhaps they aren't forced to give 80 useless and expensive tests (driving up the cost of care) to protct themselves from lawsuits? perhaps they don't have experimental treatments for rare illnesses and the cost isn't spread to all patients? perhaps they aren't over-regulated by federal, state and local government agencies adding 50% to the cost of care? perhaps they only have hospitals in large cities and tens of thousands or more outside those cities are without basic medical care in Egypt? perhaps if you need a heart, liver, kidney, lung transplant you can't get them there if you can't pay for them??

don't be so quick to knock the medical system of the U.S. It may not be a pefect system... but it is good.

At 5:35 PM, Blogger Razam the egyption said...

hi , Reuben
this is your egyptian friend Razam,
if u meant "The Peace hospital" located in ma3ady -maady- then you are completely wrong about your illustration because that hospital is not for middle class egyptians -as u said- but for the upper class egyptians , and it is not a governmental hospital but rather its a private hospital exits for rich people , the second point i want make it clear is that , i am egyptian citizen as do my parents but i dont have a midical insurance
and i dont know how to get one , the midical insurance supported only at the governmental hospitals
and if u want to be treated at a private hospital u have to pay a lot.

I was playing Backgammon once at a cafee , suddenly a long thorn of wood shocked my thumbnail and stayed there under it , i felt a horrible pain so i ran to a hospital
, AL-Agoza hospital specifically and if u dont know already it is a governmental hospital , i had to wait until finishing the paper work -about 20 minutes - and i had to pay 10 pounds to them just to have them informing a doctor ,after that they told me that the docter is in a surgery , so a nurse came to treat me with some scissors but she hurted me and made me bleeding , after one and half hour of painful waiting the doctor showed up and looked to my thumbnails and said "what i can make to u , i cant make a surgery for just this trivial thing" , then he worte a prescription and push me out , in the next day i went to see a private doctor after one look he said "this thorn must be pulled out or i may be poisoned ",i said to him "go ahead and do it" , he had to pull out about half of my thumbnail to get to the thorn , it was a painfull process but after i did that i felt much better. i visited the doctor twice to chek the cut , tow weeks i completely get cured.

So Reuben , what can u say about that?


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