Wednesday, September 14, 2005

Hospitals from Hell

During my pregnancy here in Georgia, I have been doing all my prenatal visits through the US Embassy Health Unit. I was very lucky because a Navy doctor, who was here to do med support for the SSOP Marine operation in Tbilisi, was coming into the health unit every Tuesday to help out while we were waiting for our new Nurse Practitioner(NP) to arrive. The Navy doc was trained for OB work - he was even certified to do C-Sections. Unfortunately, his tour is up this month and he is headed back to the states. So, since I have at least 2 more prenatal checks before I head back to the states I just assumed that the NP would take over my care. I assumed wrong.

The NP is a lovely woman but she has little to no OB experience and she doesn't seem quite keen on gaining any. As a matter of fact, one of the first things she has done since arriving here was to find a local Georgian OB/GYN who speaks English. When I went to visit the NP last week to discuss some issues I was having with this pregnancy, her response was to make me an appointment with the Georgian doc.

So, on Monday I went to the Georgian doc, with me was Dr. Levan, who is the Embassy's Georgian staff doctor. He is fluent in Russian, Georgian and English and I figured if I needed anything medical translated, he would be my guy. Dr. Levan picked me up at 10:45 and we headed to a local hospital where the Georgian doc has his offices. When we pulled up in front of the building, the OB's nurse was waiting for us. She asked us to follow her inside and, a bit nervous, I did so.

First stop was the elevator. Normally the elevator ride to a doctor's office wouldn't really merit a mention. But this was a special elevator ride. You see, when we approached the elevator, I noticed that the door was propped open with a stick. It seems the elevator operator had to run out and no one is allowed to go anywhere in the elevator without her. So we waited a few minutes and finally she comes back. With a bag of pears. I guess she really, really wanted a pear. She takes the stick out of the door and then puts her hand out and everyone in the elevator gives her money. It cost 20 tetri (about a dime) to ride the elevator to the 6th floor. Once everyone had paid up, she pushed in the buttons and the door closed and the lights in the building all went dim as the electricity was sucked up by the elevator. At this point, as you may be able to imagine, I was about to pee my pants. I'm not a huge elevator fan in the first place - due to my claustrophobia. We arrive at the 6th floor and the doors open. And then the nurse cautions me to watch my step. You see, the elevator does not actually line up with the floor. So I have to step up and out of the elevator to actually get to my destination.

Relieved that the elevator ride is over, and thinking that the worst is behind me, I follow the nurse and Dr. Levan into the waiting room of the Dr.'s office. This waiting room consists of 2 metal chairs, a sink, and a closet that holds all manner of operating gowns. Privately, I am questioning the sterility of the gowns in the closet when the door to the inner office/exam room opens and the Georgian doc comes out and invites us in.

Now, I am expecting an actual exam room. I am mistaken. In this inner office there are 2 desks with chairs, an extra chair and a leather (or possibly vinyl...I didn't look too closely) couch with rips in the cushions. I sit in the chair on the other side of the desk from the doc, Dr. Levan takes a seat at the other desk and the nurse has a seat on the couch and we discuss my pregnancy. Eventually the doctor decides he wants to examine me and he invites me to lay down on the ripped sofa. I know I must have had a look on my face like "you have to be shitting me!" because the doctor motions to me again, more insistent. I get on the couch, cringing inside as I lie back. The doc pokes at my belly a little and tells me everything is normal and helps me sit up. He refers me to a cardiologist for a consult (I have mitral valve prolapse and the way this baby is lying is pushing everything up into my chest, thus making my heart prolapse much more noticeable) and as we are saying our good byes, he is called into the delivery room. He reaches into his desk and pulls out a surgical mask from a pile he has there, puts it on his face and dashes out. I just hope he stopped at the sink in the waiting room and washed his hands.

Don't misunderstand me. I think the doctor is qualified, intelligent and he seemed to be quite a decent guy. But the quality of his surroundings leave a lot to be desired. I won't even describe the pictures I saw of women in the delivery room. I just couldn't do them justice.

The next day, Dr. Levan picks me up again and we head to the cardiologist. If I had thought the OB hospital was bad, well this one was worse. We pull into a small dirt courtyard - I asked Dr. Levan where we were as I did not recognize any of the surrounding buildings. When he tells me we are going to the cardiology hospital I am taken aback. None of the buildings look habitable, much less like hospitals. We walk across the courtyard to a concrete entrance way, once inside, the smell of mold and mildew, a deep mustiness, fills my nostrils. We climb 2 flights of crumbling stairs, all the while I'm marveling at the dirt and mold crawling up the walls and the people smoking on the landings. I ask Dr. Levan again if he is SURE this is a hospital. He tells me to wait and see.

We enter the building on the second level, make a quick right and walk through a set of double doors and I am astounded. This whole section has been remodeled. It was like walking out of the middle ages and onto the set of ER. New flooring, walls, ceiling. All brand new state-of-the art equipment. Everything is fastidiously clean. I am amazed that this actually exists in this building which from the outside seems to be held up by dirt and mold.

I meet the cardiologist, who is a highly credentialed doctor and quite a nice guy to boot. He does an echo cardiogram of my heart and tells me that everything is fine. The only real cure for my problem is to delivery this baby and get the pressure off of my esophagus, thus lessening the acid reflux that is making my mitral valve so much more noticeable. I thank him, pay my 30 Lari (about 16 bucks) and we leave.

When telling friends about my experience with Georgian hospitals, I like to joke that it's like an episode of that documentary "Scared Straight". If you recall, in "Scared Straight" a bunch of teen trouble makers were taken into a maximum security prison to meet with inmates who were on death row or who had life in prison sentences. The goal was to, as the title implies, scare them straight. I say visiting a Georgian OB/GYN hospital is like being scared celibate.


At 9/14/2005 9:26 AM, Blogger Maximus said...

Eek :O that reminds me of dh's visit to a Macedonian hospital for her perforated eardrum. Cleaniless was apparently not high on their list of things to do, he said.

At 9/28/2005 5:35 AM, Blogger Regina said...

Oh my! I think I would be booking an earlier flight back to the states LOL.


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