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Christmas was peaceful this year. I couldn’t wear shoes, so I couldn’t go anywhere. After the surgery my foot is healing beautifully, but shoes are cursed things!! So I lounged on the sofa, foot in the air reading books, watching movies and enjoying the Christmas tree. After two weeks of this life of resting I went to get my hair cut and I couldn’t believe how relaxed I looked in the disgustingly huge mirror lit with florescent lights. I haven’t looked this young and rested in 20 years. A life of leisure suits me.
Sveta Gora Nativity
Christmas was spent singing in Sveta Gora. After 4 years in this freezing church I have learned to layer with wool, wrap in scarves, double gloves and jump up and down when ever appropriate. I have also learned some of the traditional songs and I can even sing parts of them from memory in Slovene. It is a very good feeling.
"Holy Family at Sveta Gora"
We went to the Santuary of Madonna di Castelmonte [Stara Gora] for the winter solstice. Even though this mountaintop shrine is a religious monastery and the Cappuccini Friars might frown on acknowledgment of the pagan, it was a top of the world location to watch the shortest day of the year turn into the cold of night. Ancient Slovene tradition was to burn bon fires on the winter solstice because the fires and their warmth kept the life of the old sun Svarog from dying before the new sun Svarožic was born out of the longest night of the year, and they were also supposed to save the soil from freezing deeply in the winter. During the dark days people also feared attack from wolves, the wild man o f the night [ponocni mož], the woman from the mountain cave [Zlata baba] and other mysterious creatures. Even after Christianity became the dominant faith the fear changed to devils, and witches roaming during the long nights of a cold winter. We saw no bon fires, but as the burja wind can rise to over 100 miles per hour it is easy to imagine that the sharp blade of the wind along with the haunting sounds could conjure up the belief in many things to fear in the darkness.
Castelmonte rises high above the Friulian plain and has been a pilgrimage site since the 1100’s and a strategic point of protection of Friuli for centuries. In 1913 the Cappuccini monks were given guardianship of the shrine that was then attacked by German forces in November 1943. The church is a blend of the ancient with the painted dark skinned stone Madonna from the 13th century to the front façade and interior front walls that must have been rebuilt after the bombing with a style of the times. From the monastery the view is to the Adriatic Sea, the Dolimiti and Julian Alps and across the flat plains of Friuli. When the tourists are gone it must be the perfect place to meditate on the wonder of the creation. There are so many majestic hill top views in this area and I never tire of watching in silent meditation.
The Cappuccini monks wear dark brown hooded robes and the drink of the same name, cappuccino, is so called because the spike of foam is shaped like the hood [cappuccio] and the color of the coffee and milk mixture is the same color as the robe. Some even credit Marco d’Aviano an itinerate Cappuccin monk for discovering the drink, but that is probably just a tall tale unless he took his steam milk machine on the road with him. He is historically credited with gathering Protestants and Catholics to join together in stopping the invasion of Vienna by the Ottoman Turks in 1683. Supposedly following the victory the Viennese found sacks of strong infidel Turkish coffee left by the retreating army and since it was too strong for their refined tastes they diluted it with cream and honey, named it after a monk in a brown robe and convinced the whole world to drink it. But don’t drink it in Italy in the afternoon. Milk after a meal is not good for your stomach so just plain espresso is what you drink following a meal. Ordering a cappuccino after a meal is a sure sign of “tourist”, but pronunciation may have hinted “non local”.
The tall pink and blue building is the Šempeter hospital - on a clear day you can see Italy and the mountains.
On December 11 I had surgery on my foot. I had a node [or a horn as my doctor called it] on the top of my right foot at the big toe due to osteoarthritis [like a bunion]. The condition has been progressing nicely over time, but when we returned to Slovenia it seemed to become more pronounced and the pain became unbearable. The problem of course is shoes. When I am barefoot [as the Creator made me] or in sandals [to protect myself from broken glass] I had no difficulties, but shoes are the Devil’s tool and it got to the point that even my 25 year old hiking boots that are the most comfortable shoes I have ever owned could not come with in a mile of this foot. My plan was to have the surgery when we returned to Ohio in the spring but going barefoot in the winter, even in a Mediterranean climate, is not a reasonable thing.
I didn’t want to have surgery here because of language. My Slovene is really [and I mean really] not that good that I can discuss carving my foot with someone who doesn’t speak English. I mean, really it is hard enough to get a US doctor to give needed information in a language that I can understand and I think we speak the same language, so the thought of having surgery here when translation was the common language was just too frightening. The second reason was “socialized medicine”. I am a product of my culture that tells me that the US health system is the best, and I have heard all my life how terrible socialized medicine is. And even though I am a fervent believer in free universal health coverage for all American citizens I have been brainwashed to believe that truly the best care for my hurtin’ foot was at home. So it made sense that if I could choose I would have the surgery done in the US, but I was not able to walk!!!! So let me give you the real story of my experience and dispel some of the myths of universal health coverage…..
MYTH #1 YOU CAN’T CHOOSE YOUR OWN DOCTOR – Bob had a terrible cold the first year and took some days off from school, but to get paid when not teaching you must have a doctors statement stating that you should take time off from work [and in our experience doctors are highly preventative and encourage people to stay home and heal rather than work themselves to death]. He asked the secretary at school to recommend a doctor and he went to Dr. Maja Klemenc at the clinic across the street from the school. They had a great conversation in English, she gave him permission to stay home until he regained his voice and he has gone to her again for the same annual beginning of the school year condition. When I needed a doctor I asked the secretary to call the same doctor for me. I got an appointment immediately. At her office I signed a paper that designated that I was choosing her for my doctor and now she is my doctor. The choice was not different than moving to a new town and choosing a doctor by asking a friend for a recommendation, and was actually easier than when we moved to Ashland. When we first moved there, no doctors in town were taking new patients and so we had to drive 30 minutes to another town to find a doctor who was willing to take us.
MYTH #2 YOU HAVE TO WAIT A LONG TIME FOR TREATMENT – Qualifying statement: I admit from the beginning that my situation may be a little different because I am a foreigner and the doctors have become our friends. When I requested the first appointment I wanted to make it for the following week. The nurse in the office recommended that I come that very day [Wednesday] because this was on my foot and she didn’t want me to have more difficulties. Wow!! After the doctor looked at the foot she agreed to consult with our mutual friend and surgeon Dr. Igor Pavlin that same day and I needed to return the next day to see what they had agreed upon. The next day when I stuck my head in her office door she saw me, called me into her personal office, and told me to go on Friday to the hospital to see Igor while he was on duty.
On Friday I went to the hospital, Igor looked at the foot, sent me to x-ray, showed me the x-ray, took out his hospital calendar book and scheduled me for the following Thursday. Just like that!
Before the surgery I needed blood work and an ECG. Monday I went to Maja’s office, she told me to come back to her office on Wednesday morning. Wednesday the nurse [whose English is about as good as my Slovene] took my blood with the most gentle prick I have ever felt, I returned in the afternoon after the blood work was completed!!! and had an ECG in the office. I took all the results with me when I went to the hospital the next day.
MYTH #3 THE QUALITY OF CARE IS POOR - I have never had surgery like this and I take no medication so I can’t compare this experience with too many others, but Bob has had both of his hips replaced and he has spent a lot of time with doctors and in the hospital. I had blood drawn, shots, anesthesia, medication, an incision, and an overnight hospital stay. Every aspect was the most professional. The shots were gentle, the incision is clean and healing beautifully with no infection or swelling, the anesthesiologist offered me three options and together we chose the lighter general so that I did not have to have a tube over my vocal chords or a spinal. I woke up from the surgery with almost no pain, none of the hallucinations I have had with past anesthesia and I have suffered from no post surgery stress. It was recommended that I stay in the hospital over night and if I needed to I could have stayed longer. In addition they did not wake me up every two hours to take my vitals; instead if I was asleep they let me sleep. Plus they sent me home with documents that told me my diagnosis and test results and the procedures that were performed [some of these I can even read]. Compared to the care that Bob received at the “world renowned Cleveland Clinic” after his first hip replacement this was a visit to a health spa. Bob had a leaky catheter that I had to fix myself and clean up the spill because no one would come in response to his call button, each shift of nurses had a different opinion on whether he should wear the pulsing socks to prevent blood clots, his food was placed out of his reach when he was not allowed to get out of bed, his room was not cleaned for the weekend and we got him out of there as fast as we could so that he didn’t contract anything else. His surgery was fabulous, but the hospital care was very
MYTH #4 THE FACILITIES ARE POOR – The biggest difference between this Slovene hospital and US hospitals I have visited or stayed in is that here there are no fountains in the lobby [actually there is no lobby really], there is no original art work on the wall, the building is not new with glass sunroom enclosures, the room did not have a TV, I think there may not be a comfortable chair in the entire building, there is no insipid mood music playing constantly, the hallways are dark and the inside and the outside of the building really could use a new paint job with a designers eye. The food was unpleasant as hospital food is required to be, but this may be the condition of being a vegetarian in a meat eating nation [spaghetti topped with canned peas and corn in a light cheese sauce is even too bizarre for my imagination], but I did have fresh fruit and a fresh green salad. The building looks well worn, and probably needs a lot of renovation [the weather was torrential rain and they had some puddles in the emergency area]. The colors are really unpleasant; the walls are painted a Microsoft Word blue with Post-it-Note yellow or gold trim, and there were three different colors of blue in my room [walls, window trim, window frame, curtains]. Some of the equipment looked older than I have seen in Ohio hospitals, but everything seemed to work. Many of the rooms had 6 beds but I was in a single room [foreigner and not a Slovene speaker]. And I was never required to sit in a wheel chair; because I could walk out of the hospital they allowed me to do so. But none of these things are an indication of the care they are just the façade and even though it was difficult not to judge the care by the packaging I tried to break out of my American perspective.
Language was indeed a difficulty. My doctors both speak beautiful English and were very open to answering my questions and made certain that I understood everything. Unfortunately many of the nursing staff was either without English skills or were too shy to use them so I learned more Slovene and they learned a little more English. It is certainly not their fault that they couldn’t communicate with me and I was frustrated by my weakness, but I have grown so accustomed to most everyone speaking English that I was surprised how difficult it was to communicate. Fortunately I had no medical difficulties so it really wasn’t a problem, but I had people I could have called to translate if needed.
THERE IS NO MYTH ABOUT THE COST!!! My insurance, that I pay nothing for, covers 85% of the medical costs and I could have purchased an additional insurance to cover the additional 15%, but I didn’t know about it and we didn’t purchase it in time to allow for the 3 month waiting period. My first doctors visit cost me €2.20, my antibiotics cost €1.50, my lab tests were really expensive €3.84 and I don’t know yet my out of pocket cost for the hospital, but I am guessing it is a lot less than I would pay in the US. €1.00 = $1.33 UPDATE: 1/8/09 Today I received the bill - Total cost 2.062,18 - my portion 191,78
EXTRA BONUS TO THE SLOVENE SYSTEM – If I had needed to stay in the hospital it would have been encouraged until I was able to go home – if I had needed therapy it is possible that a stay in a health spa would have been prescribed and paid by my insurance - if I was younger maternity leave would be a year and if it was a difficult pregnancy I would have had paid sick leave prior to the birth
According to http://www.photius.com/rankings/healthranks.html - 2000 World Health Association Ranking System – the US is ranked 37th in the world in quality of health care – Slovenia is 38th – Costa Rica is 36th and Cuba is 39th – I could not find out what the criteria was for the assessment, but France and Italy are #1 and #2 and the US is 37th? Why do we fervently believe that our health system is superior?
When I return to the US I will sign up for American health insurance that will cost me over $200 per month with a $2,500 deductable, but 100% pay after the deductable. I can not use the US insurance in Slovenia with out paying for everything first out of pocket and Slovene insurance is not honored in the US. But this is a much better deal than the “excellent” State Teacher’s Retirement plan which cost me $400 per month [Bob has his own costs], $1,500 deductable and 80–20% pay. And I am one of the lucky ones because I can afford to pay this outrageous cost so that the insurance companies can throw away my money on CEO salaries and gambling on the stock market, and then beg the government to bail them out for their irresponsible behavior. Guess I get to pay for my insurance twice, but what about my son who can’t afford to pay????
If you haven’t seen Sicko made by Michael Moore you can watch the complete film on youtube and it is worth the 2:03:56 - http://www.youtube.com/watch?v=fANRr6JumJs