Medicine

Sofia is sick. Well, she seems to be doing much better, but she has been sick for the last few days.

Now normally when your baby is sick, you are troubled, concerned, and otherwise agitated at the horrible injustice in the world where a baby can be sick, and even question the existence of God - how could a just God let an innocent baby get a cold????

But I put aside my faith-shattering concerns for my daughter this time around because this presented to me a new opportunity to see Argentina from a different perspective: that of a consumer in the field of health sciences.

After the symptoms developed, and our friends and family had shared their opinions with us regarding Sofia's health (my Uncle in Hawaii recently sent me a very funny email that pointed out that Argentines know everything and have an opinion about everything else, and will share these with you whether or not you ask for it), we finally woke up one morning and knew we had to call the pediatrician. Now, she had seen her own pediatrician (a cousin), but had taken a turn for the worse, so it was time to elevate the level of care.

In the US, the sequence of events probably would have been something like this (and I'm using the model from Washington wherein our pediatrician didn't take insurance, which means he could limit the number of patients he has, which means you can call and actually see him the same day - this may confuse some of you in large health plans, but there was a time when you would be sick and call your doctor and you could see him or her that day rather than waiting six weeks, when you would need to see either a host of MDs to treat the now escalated illness or a mortician): Baby coughs; mom gets concerned; mom shares concern with dad; dad registers concern by commenting on how horribly fat Ronaldo (see Brazil's world cup team) has become; baby feels warm; mom gets further concerned and contemplates medicating baby; mom shares concern with dad; dad registers concern by wondering where all the beer in the fridge went and at the same time why he has gained a couple pounds - related?; mom hands baby to dad and says "Does she feel warm to you?" and dad grabs baby in a Hermann Trophy type pose on his way to the recycling bin to see if all of the beer has really been consumed; en route, dad notices his arm is feeling really hot - what could be so hot in the middle of winter on his arm?; dad looks at arm and finds his adorable baby - isn't she so cute? but why is she so hot?; dad says to mom "Honey, does the baby have a fever? And when did she start coughing?"; mom contemplates the ability to raise baby on her own while dad's body lies rotting under the porch; mom gets tylenol (or motrin, or paracetemol for those unconcerned by the FDA's unwillingness to approve it) and administers to the child, having concluded that dad is, unfortunately, a free babysitter and allegedly will have an important role in the child's life; baby continues to seem unwell - maybe even loses that cute giggly composure and instead adopts a "Hey - what the fuck is this whole sick thing? I'm not into this - why aren't you doing something to make me feel warm and fuzzy?" look; mom asks dad with a tone of why-am-I-even-asking-you "Should we call the doctor?"; dad replies "it's just a fever, it's not like she's sick or anything"; mom calls doctor (this is a vital part of the health science service delivery); doctor's service asks at what time the baby stopped breathing - "the baby stopped breathing!?!!???" replies mom - doctor's service asks if it's a life threatening emergency - mom makes the mistake of being honest - doctor's service schedules an appoint for 6 weeks, but promises to call if something opens up sooner; baby either continues to get worse, in which case repeat the previous, or gets better thanks to tylenol (or motrin or paracetemol or something else that mom does at this point after cutting dad out of the loop).

OK, wait, that's not right. I think for us in the US it's more like you call the doctor, talk to his nurse, she consults with doctor, she says "Try giving the baby some tylenol and keep a close watch. If she doesn't improve within 72 hours or gets worse, call us back and the doctor will want to see her." Or if the fever is really bad, he sees her right away. Or if there is some other symptom, like missing a limb, or demonstrating signs of being possessed. Then, when the fever doesn't improve or one of the symptoms she said to look out for arises (and I'm not being sexist here - our doctor is male and his nurse is female - I'm not judging it, just using this gender assignment that exists in actuality for the purpose of hyperbole), the nurse says "OK, Dr [name withheld for fear of lawsuit] wants to see her - can you bring her in today at 3:30?" And at this point I usually say to my wife "Thank God our doctor doesn't take insurance and he will see her the same day that we make the initial call!" (When we get the bill I say to my wife "WHAT THE $(*&% IS THIS???" Our doctor usually justs forwards his mortgage bill to us for routine visits, and for more sofisticated visits he forwards his child's tuition bill for Harvard. We are all very proud of how well he did last semester - he's thinking about law school.)

Argentina Health Services: So, the baby has actually seen her doctor, and received the initial review of "keep an eye on it" - in a nutshell. A lot more was said, but it was in Spanish, and you probably don't speak Spanish. It's times like when we are in the doctor's office that I think I don't speak Spanish either. But I'm told that's what he said.

So we kept an eye on it. This morning she woke up (again and again and again and again and again) with worse conditions, so we called our insurance company's urgent line. See, they have stickers for us for our phones - one with an urgent phone # and one with an emergency phone #. What's the difference? Good question. Under emergency, it says something like "If you call this number it means you have no plans for being alive by the time you get your medical bill." Urgent is described as "If you are a parent, you probably think it's an Emergency, but really it's just Urgent." So we called the Urgent number.

Guess what they said.

Go ahead - guess.

"Ok, we will send the pediatrician over - he will be there within 2 hours." (Again, the doctor really was male, so I'm not limiting the expectations of my daughters, just reporting the facts for the purpose of irony.) At which point, I said to my wife "Thank God our doctor doesn't take insurance and he will see her the same day that we make the initial call! Should I get more beer? Am I as fat as Ronaldo?"

I take the older daughter to school, and when I get back the pediatrican has come and gone. This is not because I dropped her off at College and came back by way of a short visit to see Sandusky in Australia (he's a person, not a thing - well, he's a personable thing). I took less than an hour to taxi to Isa's school, walk her to her classroom where she reluctantly let go of me after the teacher promised to play princess today, waited 10 minutes for the bus, and took the bus straight back. The guy was fast. I didn't even get a chance to stock up on beer. Nor to step on the scale. Oh - and he left his bill. $0. Now that's in pesos, to be fair, so let me convert that for you to US$ (or as it's said here, U$S). That would be U$S0 (zero - free - nada - zilch). Perhaps that's because the tuition for the doctor's kid is also U$S0. (Oh and our insurance premiums? So cheap I won't even go into it here.)

So I took the prescription to the pharmacy, got all the accoutrement I needed, and in a typical fashion complained about how much it was (prescription drugs were U$S0, and all other stuff was U$S70 - for things that I'm fairly certain would cost like U$S700 in Washington). Then I picked up some factura (pastries - more on that some other day) for U$S1, and went home to administer said prescriptions with said accoutrement to said baby per the said pediatrician-who-did-a-house-call-for-free's instructions.

Now it's 4 AM, the baby is sleeping great, has no fever, drank an entire bottle at 3, and I can't sleep. What is that about???? Well, I guess back in California it's only midnight.