LJ Idol Week 11 - Wild Goose Chase
October 6th, 2004.
A lonely odyssey through the maze of the Italian health system, on a quest to remedy a condom malfunction with the morning-after pill, which in Italy was (and partly still is) commonly considered akin to an abortion attempt and therefore very difficult to obtain.
8.00 am. I call the consultorio of my nearest town (the Italian version of planned parenthood). After an endless waiting queue underlined by Vivaldi, I find out that today the gynaecologist is out sick, so they can't help me. I am told to try any ER.
8.15 am. I call the local hospital and ask if they prescribe emergency contraception at the ER. I am transferred to about seven different people who are basically clueless. Finally somebody tells me to just come in and try. I decide to go by car, because public transportation from where I live would take me more than an hour and I’d really like to get this over with as fast as possible.
9.00 am. After driving for 10 minutes and searching for a parking space for half an hour, I walk up to the ER reception desk and state my need. They direct me to the emergency gynaecology waiting room, which is already filled with quite a few women, some of them heavily pregnant, who might possibly have spent the night in there, judging from how they look (and smell).
I try to understand where I can get registered, but all doors are closed and no medical or other staff is visible anywhere. The other patients let me know, that from time to time somebody comes out and takes note of new arrivals. So I ask who is the last before me, in order to know when it will be my turn.
9.30 am. A nurse emerges from one of the visiting rooms with a piece of paper and names written on it, calling out two of them. I am not on that paper (obviously), so I follow her and enquire what I have to do in order to get on her list. She asks me what I want. I tell her. She shakes her head. “You are wrong here. You need to go to the second floor, to the obstetrics ward, the resident doctor will write out the prescription for that". Easy!
9.55 am. After erring around aimlessly for some time on the endless corridors of the second floor, I cautiously enter the OB/GYN ward, which appears to be the place where all the new mommies and babies are stored. A suspicious nurse descends on me and asks what I am looking for, so I explain that I have been sent up from the gynaecology ER to get the morning after pill. She nods and sends me to yet another waiting room densely occupied by a loud and colourful assembly of pregnant women and children of different ages.
I quietly sit down in a corner, feeling very different without a big belly or a kid. Fortunately I brought a book with me, so I take it out and start to read.
10.15 am. Another nurse walks in from time to time and calls the women to various examinations.
At a certain point she looks at me and asks me what I am waiting for. I tell her, in my best stage whisper.
She says "Please speak louder. I cannot understand you". I repeat "I AM HERE FOR THE MORNING AFTER PILL".
The previously very noisy room suddenly is filled with deafening silence. About 20 pairs of eyes all stare at me, and not a single friendly one among them. Some might just be envious that I will be avoiding what they are going through, and wish they had done the same. But most of them very clearly spell "ANTICHRIST" with their burning glares.
The nurse tells me gleefully, that it might take some time, since the doctor who is in residence is an obiettore and the only one who actually will write this prescription is doing the rounds after surgery.
I swallow, nod, and muse, how the practice of conscientious objection, originally used by those who refused to do military service based on their religious beliefs, has entered the Italian healthcare system after in 1978 it became legal to have an abortion until the 90th day of pregnancy.
Gynaecologists, nurses and other health professionals can decline to carry out any assistance pertaining to the termination of a pregnancy, based on their moral beliefs. Theoretically, this does not include emergency contraception, which is not abortive but preventive.
Alas, in practice, more than half of obstetricians regularly refuse to prescribe the hormones used to inhibit ovulation. Legally, a public health structure such as the hospital I am in, has the obligation to always provide at least one doctor who will offer the contraceptive and abortive solutions guaranteed by law. More often than not though, the righteous religious right makes that as difficult as possible. I had heard about this, but not experienced it on myself until now.
10.45 am. A new nurse enters the waiting room and looks around. I cringe in expectation. And right there it comes, loud and clear: “WHO IS THE ONE FOR THE MORNING AFTER PILL??”
All the heads turn pointedly into my direction. I nod with an embarrassed smile on my face. She tells me curtly that I will have to wait some more since the non-objecting doctor has been called to assist during a birth. I nod again and silently ask myself, why they don’t send the pro-lifers to do the birthing and leave the others to help us poor, fornicating sinners?
11.15 am. For more than an hour now I have felt the urgent need to go to the bathroom, but was afraid to leave, in case I actually might get called. I can't stand it any longer though, so I exit the waiting room and start searching for a toilet. The nurse I had spoken to first notices me and rather belligerently asks me where I think I am going. I stammer something about wanting to wash my hands and she silently points to a door in a corner (which, unsurprisingly, turns out to be very small, dirty and without toilet paper, soap and hand dryer). She watches every step I take. Could it be that she is worried that I am here under a false pretense, trying to abscond with a baby when nobody is looking?
11.30 am. Back in the waiting room, my seat in the meantime has been occupied by another big bellied fertility symbol and I tiredly lean against the wall with my book. Some of the kids decide to use me as a doorpost for a running and pushing game and continue to slap their hands on my legs. I try to ignore them, their mothers ignore them too while chatting loudly to each other. What I can't ignore are the poignant looks into my direction, evidently meant to convey deep sadness about my indifferent attitude towards the playing children. I probably should at least caress their heads or smile at them, in order to show that I am an actual human being, not an evil alien monster.
12.00 pm. Yet another nurse asks again for the person with the emergency contraception.
Most of the mothers in the waiting room were not present at the last autodafé, so my breathy answer causes new raised heads and this time even a few choice gestures against the evil eye.
I cringe and come close to telling them that I am sorry I intruded into this sacred temple of procreation, where new little human beings are presented and being cooed over ecstatically, tired but happy mothers smile wearily, accepting compliments and reverences, and proud fathers show off the fruit of their careless potent loins.
I want to excuse myself for invading this perfect world from my unholy planet. I just ache to become invisible or beam myself far away. But even more than that, I do not want to become one of them, so I keep quiet, and continue to read.
12.15 pm. The nurse who just talked to me comes in again. She gloatingly announces, that the doctor who would have to sign the prescription will not come back before 5 pm, and therefore I will have to leave, as the public visiting hours in this department end at 3 pm.
I desperately try to keep calm and make her understand what she already knows perfectly well, that I really need the medication soon, because the more time goes by, the less efficient it will be. She raises black pencilled eyebrows in the universal gesture of “what can I do! You should have thought of that before falling into a pit of sin!” and tells me to go back down to the ER. I try to explain that it was them who had sent me up here, at which she only nods and says she'll call them about it.
Fat chance, I think and morosely make my way downstairs again.
12.30 pm. I am sitting in front of the GYN-OB ER again. There is a much longer queue than before, and no nurse or doctor in sight.
Everybody seems to sport several officially looking sheets of paper and after a while, I find the courage to ask my next in line about them. It turns out, that there is a lot of bureaucratic paperwork necessary to obtain an urgent care visit in the first place. Without it, apparently they won't even take a look at you.
I consider returning to the administrative wing and get all those forms, when suddenly one of the doors opens and someone shouts out: "Where is that woman for the morning after pill?".
Different place, different women, same horrified reaction.
I get up and follow the doctor into the visiting room, where a harried looking kid, probably a student intern, proceeds to tick off a lot of embarrassing questions from a list in front of him. Such as, had I had sexual intercourse with more than one person over the last 24 hours. And why don't I want the possible outcome of whatever intercourse I had. I am again desperately trying to stay calm and answer curtly but courteously, because I need that pill. Finally, the boy gets to the end of his sheet, makes me sign it (which I do without even looking, I just might have signed whatever remains of my soul away).
Then it happens. Yet another nurse tells me to undress from the waist down and sit on a gynaecological examination chair which would have been more at home in a museum than in a hospital in 2004.
And finally, I do get a fast and cursory visit of my nether regions after all, and am apparently found healthy enough for the hormones and told to wait outside for my prescription. I start to feel cautiously optimistic.
Too early, as another hurdle appears on my road. I am now asked for my tessera sanitaria.
Which I don't have.
I don’t need an Italian health card, since I am insured in Germany and have an EU health card and number, which, theoretically, should be valid and accepted in every public health institution in this country too.
I did explain this what seems like several lifetimes ago to the nurse who registered me, but she must have forgotten to mention it to the ER doctors. This is not a tourist region, EU foreigners might just be a rare occurrence in the local ER.
And so now they don't know what to do with me. Where to register my visit, which forms to fill out, where and what to make me pay. After a few clueless phone calls, they send me out into the waiting room again, without prescription, until they decide what to do with me. I feel like crying.
2 pm. After sitting around for quite a while, I need the toilet again. When I come back, everybody seems to look at me. An apparently not pregnant woman (that is probably why she is not afraid to talk to me, the antichrist) tells me, that while I was away, the doctors had been searching everywhere for la straniera postcoitale.
The foreign postcoital woman. I am so exhausted that I nearly faint but I can’t stop laughing, while grave and judgemental stares continue to hit me like poisoned arrows. If I will ever write my autobiography, this is how I will call it. Bloody marvellous.
2:30 pm. Finally, a nurse emerges again and calls me in to finish the registration.
Miraculously, they have found a perfect solution to avoid paperwork of any kind: They write me up as homeless.
Homeless women don't need paperwork to get emergency contraception, so it seems. Even if they are foreigners. And they don't need to pay. Even for the pills. I feel guilty and put 50 Euro into a donation box for destitute women on the desk, thank everybody profusely, and then swiftly disappear out of the door with my precious prescription, towards the pharmacy on the other side of the road, victory over ignorant fanatism just a few steps away.
Only to discover that pharmacists too can be conscientious objectors in this country.
It will be after 4 pm and many miles by car, until I finally happen on a drugstore with a pharmacy that will fill in my prescription. Kindly, they also recommend a strong anti-nausea medication to go with it.
Because, I really do not need to have to repeat the whole absurd process again, due to my stomach deciding to expel the pill I have worked so hard to obtain!
Nothing but triple-strength condoms in my future, I swear to myself, while I clench my teeth and slowly sip ginger ale through the night.
A lonely odyssey through the maze of the Italian health system, on a quest to remedy a condom malfunction with the morning-after pill, which in Italy was (and partly still is) commonly considered akin to an abortion attempt and therefore very difficult to obtain.
8.00 am. I call the consultorio of my nearest town (the Italian version of planned parenthood). After an endless waiting queue underlined by Vivaldi, I find out that today the gynaecologist is out sick, so they can't help me. I am told to try any ER.
8.15 am. I call the local hospital and ask if they prescribe emergency contraception at the ER. I am transferred to about seven different people who are basically clueless. Finally somebody tells me to just come in and try. I decide to go by car, because public transportation from where I live would take me more than an hour and I’d really like to get this over with as fast as possible.
9.00 am. After driving for 10 minutes and searching for a parking space for half an hour, I walk up to the ER reception desk and state my need. They direct me to the emergency gynaecology waiting room, which is already filled with quite a few women, some of them heavily pregnant, who might possibly have spent the night in there, judging from how they look (and smell).
I try to understand where I can get registered, but all doors are closed and no medical or other staff is visible anywhere. The other patients let me know, that from time to time somebody comes out and takes note of new arrivals. So I ask who is the last before me, in order to know when it will be my turn.
9.30 am. A nurse emerges from one of the visiting rooms with a piece of paper and names written on it, calling out two of them. I am not on that paper (obviously), so I follow her and enquire what I have to do in order to get on her list. She asks me what I want. I tell her. She shakes her head. “You are wrong here. You need to go to the second floor, to the obstetrics ward, the resident doctor will write out the prescription for that". Easy!
9.55 am. After erring around aimlessly for some time on the endless corridors of the second floor, I cautiously enter the OB/GYN ward, which appears to be the place where all the new mommies and babies are stored. A suspicious nurse descends on me and asks what I am looking for, so I explain that I have been sent up from the gynaecology ER to get the morning after pill. She nods and sends me to yet another waiting room densely occupied by a loud and colourful assembly of pregnant women and children of different ages.
I quietly sit down in a corner, feeling very different without a big belly or a kid. Fortunately I brought a book with me, so I take it out and start to read.
10.15 am. Another nurse walks in from time to time and calls the women to various examinations.
At a certain point she looks at me and asks me what I am waiting for. I tell her, in my best stage whisper.
She says "Please speak louder. I cannot understand you". I repeat "I AM HERE FOR THE MORNING AFTER PILL".
The previously very noisy room suddenly is filled with deafening silence. About 20 pairs of eyes all stare at me, and not a single friendly one among them. Some might just be envious that I will be avoiding what they are going through, and wish they had done the same. But most of them very clearly spell "ANTICHRIST" with their burning glares.
The nurse tells me gleefully, that it might take some time, since the doctor who is in residence is an obiettore and the only one who actually will write this prescription is doing the rounds after surgery.
I swallow, nod, and muse, how the practice of conscientious objection, originally used by those who refused to do military service based on their religious beliefs, has entered the Italian healthcare system after in 1978 it became legal to have an abortion until the 90th day of pregnancy.
Gynaecologists, nurses and other health professionals can decline to carry out any assistance pertaining to the termination of a pregnancy, based on their moral beliefs. Theoretically, this does not include emergency contraception, which is not abortive but preventive.
Alas, in practice, more than half of obstetricians regularly refuse to prescribe the hormones used to inhibit ovulation. Legally, a public health structure such as the hospital I am in, has the obligation to always provide at least one doctor who will offer the contraceptive and abortive solutions guaranteed by law. More often than not though, the righteous religious right makes that as difficult as possible. I had heard about this, but not experienced it on myself until now.
10.45 am. A new nurse enters the waiting room and looks around. I cringe in expectation. And right there it comes, loud and clear: “WHO IS THE ONE FOR THE MORNING AFTER PILL??”
All the heads turn pointedly into my direction. I nod with an embarrassed smile on my face. She tells me curtly that I will have to wait some more since the non-objecting doctor has been called to assist during a birth. I nod again and silently ask myself, why they don’t send the pro-lifers to do the birthing and leave the others to help us poor, fornicating sinners?
11.15 am. For more than an hour now I have felt the urgent need to go to the bathroom, but was afraid to leave, in case I actually might get called. I can't stand it any longer though, so I exit the waiting room and start searching for a toilet. The nurse I had spoken to first notices me and rather belligerently asks me where I think I am going. I stammer something about wanting to wash my hands and she silently points to a door in a corner (which, unsurprisingly, turns out to be very small, dirty and without toilet paper, soap and hand dryer). She watches every step I take. Could it be that she is worried that I am here under a false pretense, trying to abscond with a baby when nobody is looking?
11.30 am. Back in the waiting room, my seat in the meantime has been occupied by another big bellied fertility symbol and I tiredly lean against the wall with my book. Some of the kids decide to use me as a doorpost for a running and pushing game and continue to slap their hands on my legs. I try to ignore them, their mothers ignore them too while chatting loudly to each other. What I can't ignore are the poignant looks into my direction, evidently meant to convey deep sadness about my indifferent attitude towards the playing children. I probably should at least caress their heads or smile at them, in order to show that I am an actual human being, not an evil alien monster.
12.00 pm. Yet another nurse asks again for the person with the emergency contraception.
Most of the mothers in the waiting room were not present at the last autodafé, so my breathy answer causes new raised heads and this time even a few choice gestures against the evil eye.
I cringe and come close to telling them that I am sorry I intruded into this sacred temple of procreation, where new little human beings are presented and being cooed over ecstatically, tired but happy mothers smile wearily, accepting compliments and reverences, and proud fathers show off the fruit of their careless potent loins.
I want to excuse myself for invading this perfect world from my unholy planet. I just ache to become invisible or beam myself far away. But even more than that, I do not want to become one of them, so I keep quiet, and continue to read.
12.15 pm. The nurse who just talked to me comes in again. She gloatingly announces, that the doctor who would have to sign the prescription will not come back before 5 pm, and therefore I will have to leave, as the public visiting hours in this department end at 3 pm.
I desperately try to keep calm and make her understand what she already knows perfectly well, that I really need the medication soon, because the more time goes by, the less efficient it will be. She raises black pencilled eyebrows in the universal gesture of “what can I do! You should have thought of that before falling into a pit of sin!” and tells me to go back down to the ER. I try to explain that it was them who had sent me up here, at which she only nods and says she'll call them about it.
Fat chance, I think and morosely make my way downstairs again.
12.30 pm. I am sitting in front of the GYN-OB ER again. There is a much longer queue than before, and no nurse or doctor in sight.
Everybody seems to sport several officially looking sheets of paper and after a while, I find the courage to ask my next in line about them. It turns out, that there is a lot of bureaucratic paperwork necessary to obtain an urgent care visit in the first place. Without it, apparently they won't even take a look at you.
I consider returning to the administrative wing and get all those forms, when suddenly one of the doors opens and someone shouts out: "Where is that woman for the morning after pill?".
Different place, different women, same horrified reaction.
I get up and follow the doctor into the visiting room, where a harried looking kid, probably a student intern, proceeds to tick off a lot of embarrassing questions from a list in front of him. Such as, had I had sexual intercourse with more than one person over the last 24 hours. And why don't I want the possible outcome of whatever intercourse I had. I am again desperately trying to stay calm and answer curtly but courteously, because I need that pill. Finally, the boy gets to the end of his sheet, makes me sign it (which I do without even looking, I just might have signed whatever remains of my soul away).
Then it happens. Yet another nurse tells me to undress from the waist down and sit on a gynaecological examination chair which would have been more at home in a museum than in a hospital in 2004.
And finally, I do get a fast and cursory visit of my nether regions after all, and am apparently found healthy enough for the hormones and told to wait outside for my prescription. I start to feel cautiously optimistic.
Too early, as another hurdle appears on my road. I am now asked for my tessera sanitaria.
Which I don't have.
I don’t need an Italian health card, since I am insured in Germany and have an EU health card and number, which, theoretically, should be valid and accepted in every public health institution in this country too.
I did explain this what seems like several lifetimes ago to the nurse who registered me, but she must have forgotten to mention it to the ER doctors. This is not a tourist region, EU foreigners might just be a rare occurrence in the local ER.
And so now they don't know what to do with me. Where to register my visit, which forms to fill out, where and what to make me pay. After a few clueless phone calls, they send me out into the waiting room again, without prescription, until they decide what to do with me. I feel like crying.
2 pm. After sitting around for quite a while, I need the toilet again. When I come back, everybody seems to look at me. An apparently not pregnant woman (that is probably why she is not afraid to talk to me, the antichrist) tells me, that while I was away, the doctors had been searching everywhere for la straniera postcoitale.
The foreign postcoital woman. I am so exhausted that I nearly faint but I can’t stop laughing, while grave and judgemental stares continue to hit me like poisoned arrows. If I will ever write my autobiography, this is how I will call it. Bloody marvellous.
2:30 pm. Finally, a nurse emerges again and calls me in to finish the registration.
Miraculously, they have found a perfect solution to avoid paperwork of any kind: They write me up as homeless.
Homeless women don't need paperwork to get emergency contraception, so it seems. Even if they are foreigners. And they don't need to pay. Even for the pills. I feel guilty and put 50 Euro into a donation box for destitute women on the desk, thank everybody profusely, and then swiftly disappear out of the door with my precious prescription, towards the pharmacy on the other side of the road, victory over ignorant fanatism just a few steps away.
Only to discover that pharmacists too can be conscientious objectors in this country.
It will be after 4 pm and many miles by car, until I finally happen on a drugstore with a pharmacy that will fill in my prescription. Kindly, they also recommend a strong anti-nausea medication to go with it.
Because, I really do not need to have to repeat the whole absurd process again, due to my stomach deciding to expel the pill I have worked so hard to obtain!
Nothing but triple-strength condoms in my future, I swear to myself, while I clench my teeth and slowly sip ginger ale through the night.