Intestinal Discomfort

The typical symptoms of Typhoid Fever, according to the CDC, are high fever, stomach pains, and loss of appetite. Aside from moderate stomach pains a few days in the past week, I didn’t really have any of the above indications, but lo and behold, I have Typhoid.

I’ll spare you the moaning and whining about the condition – it suffices to say that I reluctantly decided to go see a doctor today after being nudged by my roommate (who ironically had Typhoid about 3 weeks ago) and parents. I showed up, he looked at my tongue – which is apparently a bit yellow and a good indication of a bacterial infection – and then poked my stomach for a while. 30 minutes later, after a blood test, diagnosis confirmed. I have to go on Ciprofloxacin for 8 days, and I was told not to eat a relatively long list of foods because they will “upset my stomach.” I have to say, some of the items on the list seem awfully random - in addition to no fried foods and alcohol, I’m not supposed to touch peanuts, white bread, avocado, or unpeeled tomatoes. Huh?

More than learning that I have a weird bacterial infection that no one gets in the United States (as my friend Liz pointed out, “You have an Oregon Trail disease! And not a lame one like a broken arm.”), it was interesting to see the incredible contrast between healthcare in this private clinic in the Zona Sur and the Hospital de Clinicas. The difference begins upon walking in – unlike the dark, dirty, undecorated rooms in the Hospital, the waiting room in the “Trauma Klinik” had a formal, glass-fronted reception desk, artwork on the walls, colorful clean couches, and even an elevator.

Beyond the appearances, the treatment was much more informative and personal (obviously) than anything I had seen at the Hospital. The doctor asked me for a full history of my symptoms, which seems to be rare here, and then proceeded to discuss the actually pathology of the infection during the exam. Contrast that with the “get ‘em in, get ‘em out” methodology at the Hospital de Clinicas. Everything was also very fast – I called the doctor on his cellphone this morning to make an appointment, and 2 hours later I was in the exam room. I also had a blood test right after my exam, and the results were ready not 30 minutes later. In the Hospital de Clinicas, doctors evaluate patients for an external consult only when they are in bad shape, and then they often have to wait an entire day before they are seen.

What is most striking to me, however, is the informal way paperwork is done around here. After the exam, the doctor wrote me a prescription on a non-descript piece of paper, and then he gave me a handwritten bill right then and there, cash-only. And there was the same sort of informal system for the laboratory work.

As I was sitting in the clinic, I couldn’t help think to myself about to what level patients are informed of their conditions and tests here. In the Hospital de Clinicas, as I’ve mentioned before, there is a complete lack of communication between doctors and patients. But on the other hand, all of the papers, exam areas, and testing facilities are so visible that if people knew what they were looking at, they could easily get some sort of idea. In this clinic, there was a bit more privacy, but the testing equipment was in the same room as, and in plain eyesight, the room where they took my blood. And in the end, the doctor sat down with me and went over the data, number by number, so that I could actually view the process of making a diagnosis. Then think of the United States, where the exam rooms are completely separate from any of the diagnostic equipment, and patients are supposedly more informed by their doctors, but yet have to rely on hearing the words from a medical professionals mouth instead of viewing actual numbers or data.

In the end, is communication actually that much better in the United States, and how does this communication affect the quality of medical care? And can I only say this because I have had a rigorous education that has not only exposed me to biology and medicine, but has also taught me to question my surroundings?