Tuesday, December 01, 2009

On Swiss Mental Health




I told you it wasn't over.

Since I started working at the hospital in April, I suddenly acquired a long list of ridiculous, extraordinary and sometimes hilariously terrifying situations that I’ve been through. But to tell you the truth, I just need to give you the example of the past 2 weeks to sum them all up.

In those two weeks, my four patients were comprised of a schizophrenic, a drug addict, a dying woman that wasn’t aware of her fate, and a 91 year old woman.

Sure that sounds bad on paper, but let me assure you: it’s much worse in reality.

The drug addict is perhaps the most interesting of them all. First thing she told me after I introduced myself was “I hope you’re better than the last one. That guy gave me nothing for the pain during the night. NOTHING. Doesn’t he know that I’m in pain?! You better give me something. And it better be enough!”. How charming.
Turns out the colleague did give her something. In fact, he gave her everything that was prescribed. So I moved on. Except the patient didn’t.

I was careful. I made sure I gave her everything that was prescribed, and reminded her she had to tell me when she was in pain so that I’d give her additional medication when required. Until one day, she asked me for another dose of morphine, and I asked my colleague to give it to her, since I had to go have lunch before the personnel restaurant closed. Bad idea.

So she didn’t get her morphine in time. I get to the room after my break, she cries like she’s going to die. “Nobody cares for me or my suffering! It’s like it’s irrelevant for you all! I can’t take it any longer!”, she shouted and sobbed while I held her hand. That’s when her roommate, the schizophrenic, goes “Mr. A, I lost my headphones!”, she shouted. She shouted because she had her headphones on. So I told her “You’re wearing them, miss M.”. “Oh, you’re right! Thank you Mr. A!”. At this point, the drug addict stopped crying. She tightened her lips, paused, breathed, and… resumed crying. It is then that the schizophrenic decides it’s an appropriate moment to ask me “Mr. A? Can you come here and wash my head?”. “Miss M., it’s not a good time. I’ll be with you as soon as I can.”.

I somehow managed to calm her down, despite arguments like “Most people here are STUPID.” and “WHY DID YOU LOCK ME IN HERE WITH A LUNATIC?!”.

The next room, where my other two patients resided was heaven, compared. Except when the dying woman started to make long term plans for when she got out of the hospital. When you know someone’s going to die before year’s end and you can’t let them know, it almost feels unbearable. You feel kind of stupid because you’ve got to lie. Sometimes, you even feel like shit.
The 91 year old woman was even better at that last part. She was extremely nice to you, and most importantly, almost completely sane. In fact, she was even able to walk around freely and manage her stuff. But for some reason, when you came to take her blood sugar (take a tiny blood drop from the fingers with a really small needle), she always gave you the middle finger to take blood from. ALWAYS. She smiled, lifted her hand, and showed you the middle finger. After one hell of a day, that felt nice.

The two weeks ended up alright. By the end of it all, the 91 year old was replaced by an 86 year old with a broken leg that... peed a lot. The dying woman “sort-of-knew” she was going to die. The schizophrenic had found her headphones multiple times, and the drug addict was at peace with me. Sort of.

“Oh, A. does a better job than anyone else here, and he’s nice. He does a great job… most of the time.”, she tells to her husband right in front of me.

You bitch.

Posted by Atlantean at 12:14 PM | 1 fish  

Tuesday, November 10, 2009

Measure of a Man




I guess it eventually comes to everyone, that day where your reflection in the mirror faces the reality of the self. This battle has been announced within myself for a while now, and my recent birthday just pushed things further.

About a month ago, my boss called me to her office, looked me in the eyes and asked “So, where do you believe you stand, as of now?”. My final evaluation, the day that would decide whether I stayed in that hospital or if I would be sent back to Portugal, had come. I didn’t really know what to respond. I told her what others had told me.

What is the measure of a man? Is it the number of hearts he conquers or that he breaks? Is it the roughness of his skin, or the gentleness of his touch? The quick-sand lengths he walked through or the price of his shoes? Is it the number of fights he won, or the number of opportunities he lost? Is it his ambition or his results? Both?

I’ve grown from a pre-teen with a sickening tendency of over-analyzing, over-reading his possessions and experiences. I had my share of illusory complete comprehension of the world. A time I felt at peace, and enough of a smart ass to claim human understanding as my domain and specialty. I’ve grown from arrogant to self-skeptical, from believing I was rich to embracing my own spiritual poverty and other imperfections.

As I arrived to adulthood, I almost couldn’t get over of how much I had changed since I was a child. To this day, it is disturbing in so many aspects.

Then I find myself here. I know less of the world than I used to. I understand people less than I believed I did. Before, I felt I lived inside this room filled with wires, complex thoughts that crossed essences in too many ways and moments. I used to think that was beautiful, and that it was a sign of how much I had grown.

Today, I look in the same room, and it feels empty. I no longer seem willing to add complexity to everything I do and see. Every understanding of my surroundings is more ambiguous, more volatile.

I take more of the heart than of the mind, I ask more questions, I search for a smaller amount of answers. Out of my own will, I leave blank spaces of wonder, plant seeds of fascination and passion for the trivial and the unusual.

And so it feels like a regression. I almost feel stripped from direction, but I know who I want to be. I lack the life project of an adult, a down-to-earth plan to conquer his place on earth.

But the world in its own, the unanswered questions and my imperfections line up for a fool’s dream, an intangible racing heart and hungry mind.

What is the measure of a man? Is it how much of a child he has left within? If traditional adulthood claims the departure from this mindset, I’ll be forever deprived of its taste.

In my maturing age, I can’t help but feel that I’ve come all this way just to return to innocence. And against all odds, it feels right.

Posted by Atlantean at 8:25 PM | 2 fish  

Wednesday, October 21, 2009

On Drugs

 

So I thought I’d leave the retrospective posts behind, and just tell you about Switzerland as I share some recent experiences here.

Switzerland is quite the place for drug addicts. No, seriously. You get to see containers for syringes and needles spread throughout town. They also occupy spots that are crossed by the townsfolk quite frequently, both in daylight and night-time. Most importantly, the town does give you the sense that it has accepted the existence of this “social group”, if you can label it like that.

But there is something disturbing about this. For example, imagine walking around town and, in one of the most populated shopping streets, notice a guy, sitting on a bench, face down, jaw slightly open. A can of beer in one hand, vomit on the floor and on the black coat he was carrying. The man is asleep under the shinning sun. This man clearly wasn’t okay. He was sleeping, but you don’t need to be an expert to understand that he needed help.

Supposedly, I have the moral and ethical obligation to act in this circumstance, but I simply felt too lost. I’ve never knew what to do in my country, let alone in this place. Not to mention that my then-primitive French would most likely not get me very far. Four hours later I cross the same place, the man is still there. No one gives a crap, or they’re just as scared as I am to approach the man. But people don’t hesitate to pass by him and shake their heads as a sign of shame.

Then I go to a pharmacy to buy a tourniquet. I bought one and I had to order a second one for a colleague of mine, so I had to go to the pharmacy twice, and both times they tried really hard to sneak in the most important question of all: “Why do you need a tourniquet? Is it for personal use, or…?”.

Immediately I felt the urge to wide open my eyes, crack an unstable smile and rub my arms, answering “Personal. I need it to get my smack into my veins!”.
But I just said “I sometimes need to take blood from my patients. That comes in handy.”. This is followed by a quick “Oh sorry! I see, yes, you certainly need one!”. But what strikes me even more is the fact that they turn to the colleagues and go “Oh, it’s ok! He’s a nurse!”.

I get it that buying a tourniquet at a pharmacy isn’t something you see every day, in fact, they actually had to ask and search around the pharmacy to even tell me if they sold them. But what if I wanted it for personal use? How would you dodge that bullet? How would you tell me you couldn’t sell it to me? If I wasn’t buying it for a professional reason, in what way wouldn’t it be ok?

Glad I didn’t tell her I was actually planning to strangle someone with it.

Posted by Atlantean at 8:00 PM | 2 fish  

Friday, October 09, 2009

Check your Swiss Happy Meal

The next few days followed the progression of the wind. Decreasing, weakening, becoming gentler. It wasn’t any easier to start a conversation, but there were no doors I could escape to. Only confrontation.
And that’s what I did, how I met V and M. Two French colleagues from the same world, but who crossed there ways there. I invited them to grab a drink, and we did. V brought his girlfriend, M brought Ml, all french-speaking, none English-speaking. A terrible combo for me, but one that felt necessary. I didn’t understand half of what was being said: the speed, the accents, pushed me away. I quickly remember the awful afternoons I spent in french class listening to audio tapes of french people speaking on the street, on the phone, and many other contexts that simulated real situations. I had gotten pretty good at it in the end, and I did great in the final exam on that level. But sadly, 6 years had gone by, 6 years where I didn’t have a real chance to practice. It’s like I felt the ability was there, but always too far away from me to reach it once again.
This wasn’t the only hard moment for me, but there were also some pretty funny ones. And very weird ones, like the McDonalds reporter incident.
This guy comes up to me on the street, him wearing a microphone and a big backpack, told me he was a radio reporter, and the rest of the conversation went something like this:
Reporter:  A condom was found in a Happy Meal at a McDonald’s.
Me: …
Reporter: …
Me: …and? You want me to what, comment on that?
Reporter: Yes! Give me your thoughts!
Me: …Ok… Well, I guess it was some sort of very bad joke started off by some employee.
Reporter: What do you think of McDonalds after hearing this?
Me: I, I guess I can’t blame them. It’s not like they can watch over what their employees do every second. So I guess the incident doesn’t change my view on the company.
Reporter: Why do you think someone did it?
Me: Like I said, I think it was a joke.
Reporter: I think Ronald McDonald liked to fuck burgers!
Me: … Well, you are certainly entitled to that opinion…
Reporter: It makes me happy! *smiles*
Me: …and that’s what matters! Goodbye now! *big smile, walks away*
Reporter: Wai-… *left hanging*

I came to this country under the impression that they were more civilized than us, Portuguese. I was wrong. Either that or Portugal is actually very awesome. People here were supposed to be educated, cultured, slightly more serious, rigid and efficient. And that conversation was the first bucket of cold water that hit my face.
A few weeks later, when trying to get my bills directed to my bank’s online service, another stupid situation emerged.
I wanted to get my health insurance bill online, I didn’t want to wait for a letter to arrive so I could pay. I was ready to let them drain the money directly from my account, and for that, you need a form (hint: in Switzerland, you need a form for everything.). You are supposed to take this to the bank, and they should sign it and send it to the company, in this case, my health insurance company.
My bank happens to be/run the post office. So that’s where I went. I told them what I wanted to do:
Me: I’d like to get this form signed to clear authorization for my healthcare insurance company to drain the money need to pay the bills.
Bank Lady: I see. So for that you’ll need an envelope. Do you have the address?
Me: … Yeah, it’s right on the form. So you can sign this for me?
Bank Lady: Oh, I’m not signing.
Me: … If I may ask, why not?
Bank Lady: You need to send that to your insurance company.
Me: but I just got it from them. Why would I send it back unsigned?
Bank Lady: You send it to them, and they’ll send it back to us, we’ll sign and we’ll send it.
Me: … so why can’t you just sign it right away and send it right after? Kind of redundant if I send it back like this.
Bank Lady: We don’t have the instructions from the healthcare insurance company.
Me: But they’re printed out on the form, right here! Are you sure that’s how it’s done?
Bank Lady: I’ll ask…
(moments later)
Bank Lady: OK, it’s like I told you. You can leave the letter in that box over there, with the company’s address written on the envelope.
Me: So you won’t sign?
Bank Lady: Correct, we won’t.
Me: Wait, you do realize that if I sent it back, they’ll just send it to you like it is for you to sign it and send it back, instead of you signing it right now and sending them instantly?
Bank Lady: But that’s not how it’s done.
Me: OK, if you’re sure about this…

Two weeks later I get a letter com my insurance company calling me an idiot in fancy language, not understanding why I sent the form back signed by me, but unsigned by the bank. Dumb silence ensued.

The Swiss turned out to be slightly crazy and traumatized. But more on that later.

Posted by Atlantean at 10:46 PM | 0 fish  

Friday, October 02, 2009

Running amongst the waves

The 6 months flew by, and I barely shared anything about my life in Lausanne. Is there a logical reason for such thing? No, there will never be. But there is no time like the present to start sharing.

First contact is quick and deadly. I got out of the plane, and I ran towards the train station to get to Lausanne as quickly as possible. I found my way through the metro station towards the hospital. And just like in the first time I rode it, I wondered why was it that the stop-sound of the metro hinted at the sound of a tired horse. And me, scared as a little boy in his first day of school, stood empathic with such sound as I dragged my bags towards the big building that would eventually become my workplace.

I fought through crowds coming in and out of the hospital, and found my way in the office where they would handle the keys to my apartment. Or so I thought. Instead, they called someone who would meet by the apartment’s door. I was early, and they contacted said someone immediately. When I got there, I met a tall looking south-african cook, who had been waiting for hours for the same thing I was. He too, would start working at the hospital. He did tell me his name, but his accent and foreign French made it as hard to memorize as it was to pronounce. I haven’t seen him since.

Later I got the keys, and as I looked at the tiny, tiny apartment, I couldn’t help but to feel disappointed at the conditions I’d be living in.

Time showed me it wasn’t so bad. As you start filling the emptiness with your belongings and decorations, it doesn’t seem so cold, so raw, so crude.

My first instinct was to unpack and get my backpack to go shopping for the so-called “essential goods”. I got enough things to cook on my first day, and when the night knocked at the window, the frightened boy in me fell asleep asking himself “What will become of me?”

Enduring, the first day of integration came, and by that day I’d meet one other Portuguese nurse, and two French nurses that would be the stepping stones of my social environment in the country.

Integration was straightforward, but also unnecessarily long. 3 days of talking in a presentation hall didn’t exactly give me much, but the opportunity to fool around with other colleagues. Much of those brief interactions created no lasting bonds.

There was always Alexandra, my beacon of light in all this mess. But I barely resorted to her. As stubborn as I am, I continued to cling to the one I knew the best, myself. Despite the insecurity I hold over my own resources, I knew I would survive. And I did.

Many, many things tried to knock me down in the first days: the need I felt to evade French when asking and answering questions, seeking people to talk to, seeking familiarity. It really feels like waves trying to throw you down. And because you know you can’t stay on such a violent sea of doubt for too long, you run. You run like it meant the difference between your life and death.

And if I look back into it, it really did mean that.

Posted by Atlantean at 12:16 PM | 1 fish  

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