Saturday, September 29, 2018

Misfortunes Trials

 
 
Waiting for the Ouch
Misfortunes Trials
 
Last month’s shenanigans served to remind me once again of the proverb about the nail.
“For want of a nail the shoe was lost.  For want of a shoe the horse was lost. For want of a horse the rider was lost … “
… and on and on until battle and kingdom are lost.  While it has many variations, it serves to show how seemingly unimportant acts can have grave consequences, especially in our day and age when blame appears to have replaced all sense of responsibility.  As the physical laws remind us that every action has a reaction, likewise every act has its consequence.  Thus, with Maria Elena’s caduta (fall) there were consequences and a price to pay.  There would be no way to dodge the responsibility.  Being so personal, affecting especially her, it would be between the two of us to resolve, since the “for better or worse” clause had clearly kicked in.  Ours became a singular purpose – get ourselves through the next 25 days.
By this point she had a cane, a wheelchair, crutches, a broken foot, and a cast she couldn’t walk on.  Because of where we live in the Borgo, Mare wanted to stay inside once she’d made it there.  At issue were the stairs leading to our door.  Because she did not have a walking cast, she could not put weight on her injured leg.  She also was not willing to learn to use the under-arm crutches we’d borrowed because of balance issues and arm strength.  I assured her that if she only tried, in a month, she’d be able to do an iron cross on Olympic still-rings.  It never happened; I apparently had not been persuasive enough.  The wheel chair was just fine, but by myself I could not get her up the seven or so stairs to our door.  To go out, I might have managed, it being downhill, but Marie Elena did not want to try especially absent a seat belt, and come to think of it, a helmet.  Getting her in and out of the house would have to be a two-man operation, and without pre-arrangement wouldn’t happen easily or often.  In any case, she was happy to stay inside.  I doubted she would make it, but she managed to get through the days.  We had WIFI and with her tablet she occupied her days reading or watching just about every movie on Netflix.  I was cook and bottle washer.  I did the shopping and learned not only how to make meals, like Risotto and Pasta a la Vongole, but even learned how to operate the washing machine.  I vacuumed, cleaned the house, made the bed, washed the dishes, and assisted whenever necessary - and to think I’d been able to avoid all that for 49 years.  It had been a long run, but little did I realize how much work was involved.  If convention were different and men were responsible for housework and all it entailed, I’m positive domestic work would be synonymous with sainthood.
Her tumble had upset our vacation plans a great deal.  Many activities during our long stay had already been paid for.  There were also visits by family and friends which were in jeopardy.  We had to cancel activities that would occur in the next 25 days for sure.  One included a stay by the sea with family members at a friend’s home in Santa Maria di Castellabate that we’d looked forward to for so long.  Any delay in Mare’s recovery, as for example not having the cast removed, would continue to ripple through our pre-planned events including trips to Ischia, Rome’s Trastevere district, Santorini, and Salerno.
After a few weeks, I became fixated on the cast.  Not necessarily verbally perseverating about it, though believe me, there was plenty of that, but certainly in my thoughts.  Although my particular intonation didn’t flow well, “Get the cast off” became a sort of personal mantra.  In addition to the fact that we were in another country, we were definitely in an altered state of existence, if not consciousness. 
When we’d departed the Melfi hospital it was our understanding that we could have the cast removed in Calitri.  That is what we thought we were told.  I should have been suspicious right off because the reason we’d gone to Melfi in the first place was because there were no orthopedic doctors in Calitri.  Who then would remove her cast?  I hadn’t thought it through.  I was too anxious to get us out of there after she got her cast and was released.
As the cast’s 25th day anniversary approached, we began to wonder about what was needed in order to return to the hospital.  Did we simply return to the ER?  Nothing had been mentioned in this regard.  When we talked with locals about how to proceed, we got different stories.  We could never get a straight answer or consistently the same answer, which seems to be a common occurrence in Italy.  This only motivated us to keep asking.
One story said that we needed an appointment to return to Melfi.  Another said we had to once again go to the local doctor who’d sent us to Melfi in the first place.  The local doctor would give us two “prescriptions”.  One for another X-ray, and if all was healed, another to remove the cast.  It seemed that the local Primary Care Physician (PCP), if that’s what they’re called in Italy, was always involved.  This was unlike our experience with PCPs at home who would hand you over to a specialist who in turn would handle everything until you were healed or dead.  No need to keep checking in.  There is a complex bureaucracy of paperwork in Italy, much like our experience with paying a bill, or better yet, depositing money in an account.  No way to do it on Internet, at least not yet.   
Others counseled that we needed an appointment.  We’d been to the ER and to return there was unnecessary.  To avoid language issues, we had friends call to schedule an appointment for us.  The phone numbers we were given, however, either never answered or didn’t work at all.  One number proved especially bizarre.  It simply rang and rang.  In fact, we later learned that that particular number could only be reached from a hard line, not a cell phone like we were using.  We had never heard of such an arrangement, especially in a wireless age. 
To compound the issue, her 25th day was on a Saturday.  Could we expect that an ortho doctor would be there on a Saturday?  I thought so, but you couldn’t be sure.  What if someone came to the ER with a broken arm or leg on a Saturday?  Would they tell them to come back on Monday because the orthopedic doctor was off for the weekend?  I had my doubts. 
We knew that an appointment was a long lead item and as days passed I feared that to get an appointment on the 25th day was slipping away.  After three plus weeks in the cast, I couldn’t imagine having to keep it on just because we couldn’t get an appointment, or if we got one, our appointment might be off in the future, another week or more away.  In any case, appointment or no appointment, we were going on the appointed day.
A few days before the 25th day, my impatience got the better of me.  I went to see the local doctor to try to explain our predicament, one mostly due to ignorance.  I used the translator on my cellphone to make my case.  He gave me two prescriptions.  One was for an X-ray, the other, if all was well, was for the removal of the cast at the Melfi hospital.  At last, it looked like we had a plan.
One day before the 25th day, D-Day, plans changed when with some much-appreciated help, I got Mare into our little Fiat, “Bianca”, and drove to the local X-ray clinic to see if she had healed.  It was not clear to me whether I was supposed to get the X-ray in Calitri or Melfi.  Why make the trip to Melfi if she’d not healed sufficiently?  If they took the X-ray there and saw insufficient bone mending, we’d just turn around anyway.  We learned that while there had been some “consolidation”, the fractures had not healed.  We were disheartened with depression close behind to say the least.  No need to visit the Melfi Hospital on Saturday after all.  We’d cross our fingers, lite some candles, and planned to wait a few more days.
While I had her in the car, in a knee-jerk reaction we immediately drove the 2.5 hours to the US Navy Hospital north of Naples.  When she had fallen I hadn’t thought about going to the base for help since we were on the other side of Italy at the time.  We didn’t expect much help from the Navy Base but had our fingers crossed, all the while harboring low expectations.  A look at her X-ray results and a second opinion would have been great.  How about a walking cast?  It was late on a Friday afternoon when we finally got there, 3:30pm to be exact.  It wasn’t a bank holiday but some sort of hospital holiday - no ortho doctor available, just a skeleton emergency room crew.  They also hinted that as a sort of professional courtesy, they didn’t want to interfere with treatment already underway by an Italian doctor.  By this point we were batting zero. 
About then, depression was setting in.  I’m not sure but desperation might normally follow depression.  In any case, as we drove through the Apennine mountains to Calitri, we wanted the thing off, even if we did it ourselves.  Since we had never had a broken bone experience, not even with our children, we weren’t sure how a cast was removed.  Did YouTube have a do-it-yourself video covering the procedure?  All I’d need was a hand-held Dremal type tool with a rotating saw blade about the size of a fifty-cent coin, then again I’m reminded that it was due to the lack of a fifty-cent coin that she fell in the first place.  On second thought, if I tried, I’d probably cut her foot, only adding to the problem and her misfortune.
A wine embargo went into effect.  Mare drank whole milk for the next four days!  Our thinking, it just might help.  On the 29th day, come what may, we decided to take our chances and drive to Melfi.  We’d take the risk of being rejected at the emergency room rather than continue to play phone tag trying to get through for an appointment.  At least if we were there, we could hopefully make an appointment.  We were off. 
As we were standing in the ER line, the male nurse from Calitri, the one we’d met on our earlier visit, told us to go directly to the orthopedic doctor’s office and wait.  Events were definitely moving faster.  We were used to the drill by then.  Even the bricks I’d sat on before were still there.  We took a number from the wall dispenser as if we were waiting at a supermarket deli.  When our turn to see the doctor arrived, we entered the office to discover a different doctor on duty.  We started anew, beginning with our latest X-ray disk, which as the previous doctor had discovered, he couldn’t open on his computer.  He too went off to read it somewhere else.  When he returned, he directed a nurse to remove the cast.  Heaven be praised!  I nevertheless wondered how this could be.  Based on the same data he’d seen, we’d been told in Calitri that it hadn’t completely healed.  Maybe 25 days was all that was allowed, and casts were habitually removed on the appointed day.  Had he even looked at the disk?  I’d hoped another X-ray, for an updated look at the situation inside the cast, would have been taken when we arrived.  This prompted me to present the prescription for the X-ray that I’d brought along.  His response, regardless of the language differences, was a universal snub.  He immediately dismissed the idea mumbling something that, much like his writing, was hard to understand.  It turned out to be a gibber of criticism.  It seems it was written on the wrong colored paper!  Oh, what do those rural doctors know?  We learned it should have been on reddish prescription paper, possibly some sort of fraternal collusion known only among orthopedic doctors not unlike some secret technique plumbers might only share among themselves.  Not a problem, in true snub for snub roguish fashion, I crumpled it up when he returned it to me and threw it in the basket.  In any case, we were off to the cutting room. 
On that familiar table once again, Maria Elena winced far more this time than when the cast had been applied.   There was no pain, just the anticipation of pain as the spinning saw blade cut through the plaster impregnated tape.  It took some time to remove her artfully decorated boot which over the weeks had become the repository of many a budding artist’s work and flamboyant “John Hancock” style signatures.  Back in the office, the doctor manipulated her ankle.  He tilted it up, then down, then rotated it left and right followed by turns first left then to the right.  With each movement he’d ask her if there was any pain to which she replied, heaven be praised again, “no”.  
We literally “got the boot” two hours after we arrived.  With Maria Elena back in her wheelchair, we rolled across the parking lot to a conveniently located orthopedic store.  It was there where we purchased the walking boot recommended by the doctor.  It extended to her knee and had enough dangling Velcro straps to compete with Medusa’s head teaming with snakes.  Rigid and walkable, it proved to be a big improvement over the cast.
But there was further beatific light ahead, a small garnish of therapeutic hope.  She would shortly experience the soothing recuperative powers from soaking in Greek waters.  It was not what the doctor ordered.  We’d never have been able to get him to write such a prescription, no matter the color of the paper.  Even if he had, it would have been as effective with the airline and hotel as that earlier directive to the Melfi hospital had been for the X-ray.  But that was where we were headed, sore foot, boot, wheelchair, and crutch notwithstanding.  We’d planned a get-away to Greece during our stay in Italy.  As if by some law of rare events, the springs beside the uninhabited island of Nea Kameni, located within Santorini’s ancient volcanic caldera, have warm pools thought to have medicinal powers that help alleviate skin problems and of all things, wait for it … “bone conditions!”  Could the gods be more merciful?  The reputed mythical nail now retrieved, the shoe back in place, I’d be the first to note when she got her foot back and the renewed giddy-up in her gait.
 
From that Rogue Tourist
Paolo