Grab a cup of coffee and settle into a comfortable chair, this is a long one. This is the story of “Allison Gets a Colonoscopy in Panama”.
I had no intention of sharing this on Panama Pause with 244 friends, family and strangers. But it was an interesting experience so for the sake of cultural education, I will swallow my embarrassment and tell you the tale.
Five years ago when we lived in Oregon I was having lots of digestive issues and in an effort to diagnose them I had a colonoscopy. Based on what they found they suggested I have another one 5 years later. Fast forward 5 years and here we are in Panama. How convenient! Just what I want to do in a small town in Panama where I do not speak the language fluently. Yay!
I got a recommendation from a friend about a private clinic in Chitre, which is the biggest town near us but still only 50,000 people. At a recent visit to the OB/GYN (what is it with me and below-the-waist doctors???) I got another recommendation for a doc at that same clinic, so I figured it was a good sign. The clinic does not seem to have a main phone number and I wasn’t sure I could communicate my needs on the phone so the next time we were in Chitre I stopped in at the clinic to find the doctor’s office and make an appointment. I asked a few people where the doc was and no one seemed to know until I stumbled into a waiting room with a secretary who could help me. She said this doc didn’t have a secretary but I could call him directly and she gave me his cell phone number. This is very common here: you get cell phone numbers for people you do business with- the pharmacist, the phone repair guy, the worker at the local grocery store, etc.
So the next day I call the doc but he doesn’t answer so I decide not to leave a message and just try later. He called me back a few minutes later. This is also pretty common – you call someone and hang up if they don’t answer but they call you back anyway. So he calls me back and we arrange for an appointment the following Thursday at 5 p.m. I ask where his office is at the clinic and he says just to ask someone when I get there. Of course. For the same reason Panama has no official postal system and no addresses, he can not describe where his office is. I should have expected that.
So the next Thursday I get there at 5 to hunt down the doc’s office. I ask the secretary at a busy waiting room and she directs me out the doors to the right, which leads me first to a parking lot and next an empty field. Uh, no. So I find the lady who gave me the doc’s number and she says to wait in her waiting room because the doc comes through these doors. That’s also very common here: docs work in several different towns so they usually have patients arrive and sometime later they arrive and see everyone. So I park myself in a chair and wait. It was air conditioned, the TV was on and there was some darn good people watching. I noticed for the second time (the first of which was at the OB/GYN office) that people tend to come to doctor’s appointments with their whole family. Not even a mom bringing her kids because she has no caretaker, but a mom bringing her two kids and her mother and father. Really? Why couldn’t the grandma and grandpa stay home with the kids? Who knows.
Anyway, my 5 p.m. appointment time came and went and at 6 p.m. the people in the waiting room were dwindling and the secretary was turning off the lights, yet there was no sign of my doc. I asked the secretary if she thought he was coming and she said she didn’t know. I asked if she could call him and she said she had no phone. So I gave her mine and she called him. He said he was arriving at that moment. 10 minutes later (“at that moment” = 10 minutes later) he walked in at the same time my phone was ringing. Turns out that was his system for identifying which was his patient – whoever was reaching for their phone as he was calling. I’m not sure why he couldn’t just look for the only gringa in the room but I like to think that it’s because my Spanish was so darn close to perfect on the phone that he mistook me for a Panamanian. HA! Anyway, we met and he took me up to his office which was upstairs off of another (deserted) waiting room. His office was no bigger than a broom closet, which was good because it meant that it cools off quickly when you turn the AC on. We discussed my need for a colonoscopy, I filled out no forms, and he suggested I have it Saturday (two days later). Uh, no. I needed a little more time to wrap my head around this! So we scheduled it for the following Friday, which was the day before yesterday.
The prep for a colonoscopy in Panama is no more pleasant than the prep in the USA. The only difference is that the tension is higher because at any moment you might have a power outage and if the power goes, so does the water, and the ability to flush a toilet. No es bueno. But thankfully I made it through the prep unscathed with full working toilets.
I was told to check into the clinic at 2 pm and my procedure would be at 3 pm. I had no expectation that we would really stick to those times so Daniel brought his kindle and I arranged for Marta to cook dinner for the girls, who were at home in Pedasi.
I check into the clinic and they take me to a room, which I had mistakenly expected to be private. Uh, no. I had a roomie (and another bed for a third) and there were no curtains separating us. It was like summer camp with the multiple metal beds, plastic covers on the mattresses, etc. And my roomie had 4 family members with her. I felt like a loser with no one to accompany me! I banished Daniel from the room when I saw it was 1) 10 feet by 10 feet and 2) filled with strangers and 3) the temporary home to an older lady half dressed lying on a bed. I thought it’d be more comfortable for all of us if he wasn’t there. He went to another section of the hospital to find a waiting room with AC.
So I get changed into a gown that opens in the back (which is even more awkward when you have a roomie and her 4 family members in the room) and I got hooked up to a hydrating IV. And then I wait. Roomie’s family members multiplied as time went on and at one point I counted 11 people in our room. So I kept myself entertained by trying to eavesdrop on their conversations. There were multiple conversations at one time and a number of people on the phone. That’s common here: people talk on the phone in full earshot of everyone else. Or they play videos on their phone. Or they let their phone ring. There seems to be no working “ringer off” button in this entire country. At this point Daniel had my phone and I was regretting giving it up so early on in the process. I asked the nurse to tell the tall gringo to come in if she sees him but evidently she did not go searching hither and yon to the air conditioned waiting room because he did not show up.
At some point several hours later there was a flurry of activity and the doctor arrived. It was at that point that I realized that Roomie was also seeing my doc and unfortunately she was here first. So she gets wheeled away in the wheelchair and I’m happy to at least be seeing some progress. I dozed and decided to use the bathroom while I had the privacy.
Sidenote: earlier in the visit I had changed my clothes in the bathroom and noticed there was no toilet paper. OK! But then I saw Roomie use the bathroom and she got some TP out of a cabinet in the room. OK! So I guess that’s where they keep it. But her family members put it back there when she was done. So when she was out of the room for her procedure I decided to get it out but then I realized it was with her personal items! She brought her own TP! How come no one told me it was BYOTP??? I decided to steal a few squares from her, I didn’t think she’d notice.
So finally a flurry of activity again and Roomie is being wheeled back into the room with her posse, which seems to have grown while she was gone. A few minutes later the wheelchair arrived for me. Now, you can imagine that based on my procedure I am not wearing any undergarments and remember the aforementioned gown that opens at the back. This means my bare butt is on that wheelchair. Who else had a bare butt on this wheelchair??? Have they washed it since the previous bare butt???? Well I figure if Dan can get MRSA from a vasectomy in the USA I have just as good of a chance of getting – or not getting – some contagious skin disease in Panama. So off I went to the surgery room in the wheelchair that may or may not be clean.
Everyone was very nice, the procedure was straightforward and I was under sedation so I don’t remember much of it. I do recall loving my anesthesiologist and repeatedly thanking him for taking good care of me. He probably gets that a lot from the drugs. Maybe not so often from a gringa, though. Anyway, I’m all done and back I go to the room. By this time the doc had hunted down Daniel and he was waiting for me in the room. At our initial visit I had told the doc that my husband would be accompanying me and he doesn’t speak Spanish so anything the doc needed to communicate while I was under sedation might be faced with a communication gap. He said he spoke English.
At this point while I’m recovering Daniel tells me the doc may think he speaks English but for all intents and purposes he does not. So I knew I had to clear the cobwebs out of my head so I could hear the results in Spanish. Thankfully it was an easy conversation. My results were all normal, and he gave me 4 pictures (not posted below), and a written evaluation. The funny thing is that on the various forms that I eventually signed my name was spelled 3 different ways. Note to self: do not have a baby in Panama. I’m pretty sure you have a good chance of going home with a different one, or at least one with a different name than you chose. We actually know a Panamanian guy whose last name was misspelled on his birth certificate and it created a whole bunch of problems down the road.
The doc said I should have another colonoscopy in 3 years (really? can we agree on 5 please?) and I was all set. I recovered a bit more, they removed the IV, and off we went to the lady in the front to pay. We had to wait awhile for her to receive the bill from the doc but finally another flurry of activity in the form of stapling and printing and stamping and the gal said she was ready for us to pay. At this point we learn that the procedure is $175 more than we were quoted. There was a bit of a stand-off with mucho tension and a very mad Daniel had to go wait in the car while I paid the bill. I am not sure if they hiked the price for the gringa who desperately wanted to go home, or if the doc really just quoted me the wrong price. But they had us where they wanted us so I paid it in order to be done with the entire experience. Total cost: $900. Not exactly 3rd world prices but then again I didn’t get 3rd world service either (bare butt on wheelchair notwithstanding). I think it’s still cheaper than if we had done it in the USA.
We arrived home at 8 p.m. to a nice dinner, which I ate and then promptly went to bed. And my colon lived happily ever after. The end.