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['the civilized explorer']

The Civilized Explorer

A Medical Emergency on Guadeloupe

Driving back to our cottage after seeing the total eclipse, I idly thought even if it had meant permanent eye damage, I still would have watched the eclipse. That night, my right eye started weeping. I must have inadvertantly touched something irritating during the day and then got it in my eye. Daniele, the owner of our rental cottage, thought it must be an allergic reaction. We bought some anti-allergy eye drops at a pharmacy and I went to sleep expecting my eye to be normal in the morning.

I awoke to a horrible sight. My right eye was swollen almost shut, the surrounding skin was reddish, warm, and inflamed up to my eyebrow and down to my cheek. My eye had secreted so much in tears and disgusting yellow junk that my eyelashes were stuck together. After washing my eyelashes, I could open my eye. It looked even worse, the entire white was bright red. I sat down, stunned. I had to see a doctor. And it was Saturday morning. Back home in the US, there would be few places to find a doctor on duty. I had no idea how the French medical system worked, let alone how in worked in the Caribbean. I also worried about language difficulties. I expected Guadeloupe was large enough to have good medical care available, but how would I communicate? We can read a French menu and converse about general tourist stuff, but neither of us knows the language well enough to describe the history of my problem.

We returned to the pharmacy where we had purchased eye drops the night before. As we learned repeatedly, the sight of my eye garnered assistance even with our paltry knowledge of French. Yes, a doctor was available on Saturday morning, just 2 blocks down the street.

The front door to the doctor's office was open onto the waiting room, which consisted of 10 plastic chairs around the perimeter and a door with a sign that said, "Knock and then wait." We got the last 2 chairs and waited. After awhile, a patient exited and the doctor accepted the next person. Our wait was no more than 45 minutes.

When it was my turn, Phil and I entered her office and saw that the back door opened onto the beach. Not a bad office location! Her English was as good as our French, so communication was a struggle. She examined my eye, saying oo la la! a lot. Just about with every breath, actually. I became more concerned. She wrote prescriptions for an antibiotic cream and an eye wash. This was the more difficult communication for us and the doctor finally sighed, "merd!" in exasperation. We laughed, translated the word into English for her, and we all relaxed. She finished with the admonition that if my eye was not better by that evening, I would have to go to the hospital that night. My concern went up several notches. I had been hoping I was over-reacting, but the doctor was even more concerned. This was not a good sign for a person like me who worries incessantly. The fee was 125 francs. We had only 100 francs in cash; since she did not accept credit cards, we agreed to return later that day with the remainder. Stunned by the flexibility of payment and the fact that payment did not come up until we were finished with the medical stuff, we returned to the pharmacy, got the prescriptions filled (134 francs) and returned to our cottage.

I did not get better. My left eye started showing the same symptoms. We talked of going home early. We reluctantly agreed that we could not attend the Carnaval dinner with Brazilian dancers that we had reserved. And this day was our 11th anniversary. I was despondent.

Through all this, Daniele, kept checking on me. About 6 pm, we could not stand it anymore. We asked if Daniele could accompany us to the hospital (as she had previously offered). She said yes. I couldn't have been more thankful.

There is one hospital in Pointe- a- Pitre. There are guards at the front gate. Daniele explained our situation and waved us through. I was sitting in the car thinking, "It's Saturday night at the only emergency room on the island. I only hope it's early enough that we won't have to wait for hours and hours." We struggled to find the Emergency Room entrance. Like many hospitals in the US, it was conveniently located on the far side of the property and the entrance door was in the back of the building.

The emergency room was moderately busy - it seemed like most of the people waiting had accompanied a patient. Daniele talked to the clerk who directed us to Ophthalmolgy. I wondered, "Is there really someone on duty Saturday night?" We set off in search of Opthmology. The hospital has several wings. Because the building sits on a hill, each wing has a main entrance on a different floor. Daniele did not know the layout of the hospital, so we found the AIDS unit, OB/GYN, the front lobby, and another bank of elevators. We could not find anyone to ask directions. We continued wandering. I started to think we would eventually find the morgue. We passed X-ray, and I realized that the reason I knew which departments we had passed was that medical terms in English and French are based on Latin. This came in useful later. We turned a corner. There it was! The morgue.

We eventually found Ophthalmology. A woman was just leaving the first examination room so Daniele started talking to her. Daniele pointed out my eye (by this point, a somewhat unnecessary act). The woman immediately sat me down in the examination chair and expertly washed out my eye. She asked questions through Daniele. I could make out some of the French, mostly the phrase, "ask her... ." We got to a word that Daniele could not translate. We gestured, until I thought she was asking if my eye had a burning sensation. I remembered a word used at work to describe drug side effects, pruritis, which means a burning rash. So I said pruritus with as good a French accent as possible. It worked - we understood each other.

The woman then left the room. Phil asked Daniele, "Who IS that woman?" I laughed -- I was so anxious and so happy to have someone look at my eye, I had never thought of that basic question. It turned out she was a nurse -- she returned with a book of phone numbers and called the on-call doctor. She talked really fast to him, all I could make out was "tres, tres, tres, tres rouge" a few times. Again, I had that sinking feeling in my stomach. This really is a problem, I'm not needlessly worried. Great.

The nurse and Daniele talked for awhile after the phone call. Throw out the antibiotic drops. If they have not worked by now, they will do no good. Wash out my eye every few hours. Use another eye drop which is a general soother. Come back tomorrow at 9 am, that's when the opthalmologist will be in. Sunday morning. The doctor will actually be at the hospital. I could not believe it.

I spent the night feeling depressed and sorry for myself. I worried that both eyes would be swollen shut in the morning. I was miserable.

Sunday morning, my eyes were about the same. Phil and I returned to the hospital alone. Our experience was much the same as the night before (except we didn't get lost in the hospital). To get past the guards, I simply took off my sunglasses and pointed to my eye. Thank god my problem was so noticeable! The opthalmologist was there, talking to another staff member. He immediately grabbed me, put me in another examination room full of all the equipment I know from eye exams in the US. As he looked at my eye through the magnifying glass, he sighed once, "oo la la." Great.

After some observation, he placed a drop of an orange oil in my eye. He said it contained a steroid to stop the inflammation. The oil would stay in my eye longer than drops. He prescribed steroid eye drops and antihistamine eye drops. He also did not know much English and at one point, ran out of the room and came back with a staff member who did. We asked if pharmacies were open on Sundays. Yes, but he did not know which ones. The police have a list, we should ask them! After hearing we planned to be on the island for another week, he urged me to come back before we left, if my eye did not improve.

The nurse then came in and said she needed some information for my paperwork. Feeling great relief at having the steroid already in my eye and knowing I had just had an exam of the same high caliber I would have had at home, I was now curious about payment. I know France has a socialist government, but I am not a citizen. She asked for my passport and my home address. She wished me well and said that was all she needed. I was speechless. Now, three months later, I just received the bill - only 165 francs ($30)! Amazingly small compared to an equivalent US visit.

We asked the guards at the gate about pharmacies -- just follow the car ahead of us, they are going to an open pharmacy. We meandered through Point- a- Pitre and found the place. I went in while Phil double- parked. The presriptions were only 120 francs -- so cheap that it was below the minimum amount to charge -- and I had no cash. This time, my inability to speak French was useful; they just let me charge it. And I had almost picked out some nail polish to buy to meet the minimum.

The eyedrops worked wonderfully and both eyes were back to normal in two or three days. I remain very favorably impressed by Daniele's graceful help. We discovered on Sunday that she had a dinner party at her home on Saturday night and had left her guests in order to accompany us to the hospital. I have a completely different perspective on socialized health systems. I had assumed them to be impersonal and unnecessarily rigid, based on the fact that they are run by a government. I found the opposite to be true. It was such a delight to be able to walk into a doctor's office and the hospital and be asked first about my health. In every instance, payment was an afterthought. My last observation is that the price of a doctor's office visit was about the price of a bottle of wine at a restaurant -- perhaps this is the sign of a truly civilized society?

| Guadeloupe 1998 | French West Indies | Calling the US from the French West Indies |