Americans’ Phobia of Socialized Medicine

I am baffled by the people I encounter in this country who think that “socialized medicine” is evil. I’m not sure how they arrive at this conclusion. It seems that, for some, anything they can label “socialist” is automatically frightening. But we have state-run fire and police departments and military (among many other things), and the vast majority of Americans would agree that these areas of common human endeavor are best run by government.

Why, therefore, do so many instantly discard the idea that governments can effectively provide health care? Other countries’ governments are managing national health systems quite well. Do we have so little faith in the abilities of our own government?

I’ve seen socialized medicine working for my own family. I lived in Italy for 17 years (my Italian husband is still there), and have written about my (mostly positive) experiences with Italy’s national health system.

My father lives in England with his British wife, and the UK’s National Health Service (NHS) has done very well by them. Just a few weeks ago, Dad had a $60,000 operation – paid for by the British government, and he’s not even a citizen! – to implant an electronic device which interrupts pain signals from his body to his brain: a last-ditch remedy for ten years of extreme, chronic pain due to arthritis. And it’s working.

In Italy, my mother-in-law had a mastectomy within days of a tumor being discovered, and her chemotherapy and related medications were free. When our daughter broke her arm, a compound fracture requiring surgery, the surgery, hospital stay, and follow-up care were free. When I had my own cancer scares, all the tests were done within days, and I paid less than 100 euros for the biopsy. I’ve been under treatment for glaucoma for years; with my doctor’s prescription in Italy, the medicine costs 2 euros a month.

Because health care is universal in these countries, medical privacy need not be a huge concern: you’re going to get treated, no matter what you’ve got. Whereas, in the US, you must jealously guard information about any chronic or genetic condition you may have, for fear that it will damage your chances for employment and insurance.

The Problem of Choice

Some Americans fear that a government-run health system would limit their choices, which is likely true. But is that such a bad thing? Too much choice can be as bad as too little, especially when it requires so much time and knowledge to understand what’s on offer and make an informed decision.

One of the most difficult transitions for me in moving back to the US has been precisely this. I’m an intelligent and highly-educated person, but simply comprehending my health insurance options (and, thank Sun, I have options!) has been largely beyond me so far. I have insurance, but that’s about all I know, pending further study that I haven’t had time for. I can imagine how overwhelming this must seem to someone much younger (or older) and/or less experienced than I.

In Italy, things are a lot simpler. You choose a family doctor from a limited list of local practitioners, most likely someone whose office is convenient to your home. When you’re sick, you visit that doctor during his/her office hours (some by appointment, some you just sit around and wait). If you need a specialist or tests, the family doctor writes an authorization and you schedule an appointment, which will be available later or sooner depending on how busy your local providers are and how urgent your medical situation is. I once scheduled a routine mammogram 8 or 10 months in advance, but when I needed one in a hurry for a suspicious lump, it was performed within 24 hours. (NB: Bi-annual mammograms are free for all women over 45. Socialized health systems are big on preventive medicine, because it makes economic sense.)

And if you want choice in Italy, you can pay out of your own pocket to go to whatever practitioner you like.

Of course, no system is perfect. Malpractice can happen anywhere. My father-in-law was probably killed in Italy by an anesthesiologist too old to be administering an epidural. My aunt’s botched hiatal hernia operation (in Austin, Texas) led to ten years of agony and, eventually, her death. Malpractice suits are rare in Texas, so she never got the money needed to help fix what the doctor screwed up. Penny-pinching by the Medicare system (America’s version of national health, available only to the elderly and used only by those who have no choice) likely exacerbated her problems and also contributed to her death. Being poor and uninsured limits your choices far more than a national health system does.

Given all this, I don’t understand why so many Americans have such a knee-jerk negative reaction to nationalizing health care. Can anyone explain this to me?

The Land of Illness

Another “country beginning with i” which is unfortunately very familiar to me is Illness. I have spent a lot of my life being ill.

Perhaps the earliest memory I have (of any kind) is of green bathroom tiles, and myself screaming. I had a high fever, so my parents thrust me into an ice-cold shower. An icewater bath was what you were supposed to do when small children had very high fevers, to get the body temperature down and avoid convulsions and brain damage (I don’t know if this is still medical wisdom today – Ross never had a fever that high).

That was probably during my third or fourth year, when we lived in Beaumont, Texas, downwind from the chemical refineries – an extremely polluted environment which led to my father finding me on the sofa one morning, unconscious and barely breathing from pneumonia.

Sometime during 1966 (the year I turned four) we moved to Hawaii, where my dad was trained in Vietnamese language etc., to go to Vietnam as a civilian (with the US Agency for International Development). We used to have photographs of our departure, with me at the airport in pajamas and a bathrobe. I don’t know whether my parents dressed me that way because I was ill, or because they figured I was going to sleep on the flight anyway…?

One of my few memories of the year in Hawaii is of the hospital waiting room, a huge, airy space with enormous tanks of colorful saltwater fish (or maybe everything looked so big because I was so small).

It was probably in that hospital that I was given a chest x-ray, lying on a table in one of those stupid hospital gowns that doesn’t close in the back, with my bare buttocks resting on cold stainless steel. When the plates were developed, I overheard an agitated consultation among the doctors. Something was very wrong, and I was scared, thinking I had done something wrong. (I always thought everything was my fault.) There was something on the x-ray, a mysterious white patch high in my lung. Finally someone realized that the hospital gown had been closed with a safety pin in back, which showed up as a glaring white blob on the x-ray. I assumed that was my fault, too. If people were mad, it was somehow always my fault.

Accounts differ as to whether I had pneumonia twice as a child, or just one pneumonia and various bouts of bronchitis. Living five years in Bangkok, even then one of the world’s most polluted cities, didn’t help. I don’t remember specific illnesses during those years, except once when I had a flu or something. After several days of not eating, I woke up ravenous at 4 am. Not wanting to disturb my parents, I went down to the kitchen and made myself a bowl of cereal with milk and a glass of Hawaiian Punch. Half an hour later I vomited pinkish stuff (the punch) all over the bathroom, to my mother’s great irritation: “You’re still sick! Why did you eat?”

We seemed to spend a lot of time at the army hospital in Bangkok, mostly for the endless vaccinations required to keep us safe in the tropics (yellow fever, typhoid, typhus, cholera, gamma globulin – I knew them by name even then). I hated and feared shots so much that I would run away, hide under a table, and/or kick the nurses. My worst nightmare was the rabies series that the American kids recounted to each other in round-eyed horror: “Forty shots, one every day for forty days. In your stomach!” I stayed well away from stray animals (well, mostly) for this reason, so it was a vicious irony that, when my own cat scratched me, someone decided that I had to have rabies vaccinations – but only five, in alternating arms.

Pittsburgh was still very polluted when we moved there in 1971 or ’72, though it was starting to clean up its act, but I don’t remember suffering any pollution-related illnesses during that time. I did have endless and very painful ear infections. I got chicken pox, which was fun because I shared it with my friend Vivian. One year, I spent Thanksgiving in the hospital. I had woken in the middle of the night, vomiting. I went on vomiting til there was nothing left in my stomach, and dry heaving after that. My dad took me to the emergency room. The doctors suspected appendicitis, and admitted me. It took two nurses and two burly Australian interns to hold me down to get an IV needle into my hand.

I felt better the next day, but they kept me in the hospital and on IV over the Thanksgiving weekend, in a ward with a dozen or so other kids, including one with very impressive big red stitches right down the middle of his chest, from heart surgery. On Thanksgiving day we were joined by a boy who had eaten a huge meal, then gone out and played football and got his stomach stepped on. I resented his waste of the Thanksgiving feast that I had missed. I was dismissed from the hospital after a few days. My appendix seemed to be fine (though I worried about it for some time afterwards), and no one ever figured out what had been going on.

We moved to Bangladesh in 1976, and all (my father, stepmother, and myself) went through the usual tropical stuff – lots of it. Giardia, a particularly nasty parasite, has the endearing symptom of flatulence that reeks of rotten eggs (plus diarrhea, of course). The first place we lived in, an apartment over my dad’s office, had only Asian-style squat toilets. It’s exhausting, squatting for hours. The floors were of speckled terazzo concrete; when tired enough, I could see faces and forms in the random patterns of speckles.

I somehow managed to avoid getting any of the big stuff in Bangladesh, even though we had a friend with acute hepatitis staying with us (we called him the Yellow Terror), and, since I was home all the time, I did most of the caretaking. He had his own bathroom, and I washed my hands carefully in Dettol (a disinfectant) every time I left his room. We also had extra gamma globulin vaccinations. By this time I had more or less conquered my fear of needles, but gamma globulin is a thick, globby serum – the American doctor friend who gave me the injection likened it to trying to blow ice cream through a straw; there was a lump of the stuff in my thigh for days.

Then came another night of mysterious vomiting. Fortunately, a UK-trained Bangladeshi physician ran a tiny private hospital at his own home. My dad rushed me there in the middle of the night, and I stayed for several days, enjoying the attention. In hindsight, I think that was the cause: attention deficit. My father and stepmother were both very busy with their jobs of saving the world (or at least a few small corners of Bangladesh), I was homeschooling myself and spending most of every day alone. I was bored, depressed, and very lonely – and it took a night of vomiting to get anyone to notice. No organic illness was ever discovered in that case, either.

In July of 1977 I went off to boarding school in India – another not-too-healthy place, especially during the monsoons. The Woodstock school nurse, Mrs. Law, had her hands full. There were the usual tropical illnesses – “Delhi belly” and other dysenteries, standard flus and colds, the occasional mini-epidemic of hepatitis. Twice a year we were all sent up to the dispensary for vaccinations. I was impressed by the injection gun Mrs. Law used, which shot the vaccine under your skin without need for a needle – though you had to have three shots at a time to get enough in there.

Mrs Law was a dragon about letting people stay in the dispensary. It was at school level, 500 feet up the hill from the dorms, and her logic was that, if you had survived the walk up the hill, you were well enough to be in class.

To be believed to be really ill, you had to persuade the dorm supervisors to send you up the hill in a dandy, a sort of rigid hammock slung on poles, carried on the shoulders of four men. There was no driveable road from the dorms in those days, so that was our “ambulance”. Mussoorie’s early settlers and Woodstock students used to travel this way routinely, but I found it terrifying, bouncing and swaying up the narrow paths, and I think I only did it once in four years, no matter how ill I felt.

Still, I occasionally managed to convince Mrs. Law that I was sick enough to stay in the dispensary even if I had arrived there on my own two feet (a fever would always do the trick). Staying in the dispensary was a mixed blessing. Sure, it meant missing classes, but there wasn’t much to do, especially if there was no one else in the room with you (or whoever was there didn’t feel like talking). There weren’t enough books, and they never changed. The only book I liked was a charming novelization of the story of Noah, with talking animals and quarrelling sons (but no drunken nakedness), so I read that one every time I was in the dispensary.

Dispensary food wasn’t any better than the generally horrible school food, and often worse if you were on a special bland diet.

The good thing about the dispensary was Dolma, the gentle and patient Tibetan nurse, who would sometimes even give backrubs. I was in there so often that we became friends and, after she left Woodstock to get married, she invited me for a special tour of Happy Valley (the nearby Tibetan colony) and showed me her wedding pictures. (Dolma and her husband are both on Woodstock staff now, so I still see her from time to time.)

Another thing I liked about the dispensary was the location, the top floor of one of the Quad buildings. Each floor of the building had a wrap-around balcony. I was in the dispensary once when, unusually for the months we were in school, it snowed in Mussoorie. All the patients wrapped up in blankets and went out on the balcony to watch the snow fall silently through the dark pines.

Really sick kids (and staff) went to the nearby Landour Community Hospital. I was glad I only ended up there once. It was terribly boring (nothing to read but old magazines) and the nursing sisters in their starched white caps always seemed angry. The food was even worse than school food, which I would not have thought possible. And, as in all hospitals, it was impossible to sleep, with nurses coming and going in the wards all night.

Females and males were kept in separate wards, so the nurses were furious one night to find me out of bed, conferring with schoolmate Zafar in the hall. He was also in hospital, and we were agreeing that we had not liked being asked, upon admission, to declare our religion. I was particularly irritated because when I said “none,” they put me down as Christian. (In hindsight, their main concern was dietary: Christians will eat anything.) Zafar and I decided that we should roam the halls until caught, then tell the sisters that we were worshippers of Baal, looking for babies to sacrifice. (We never actually did this, which was probably a good thing; the sisters didn’t share our sense of humor.)

That hospital stay was due to another mystery illness, tentatively diagnosed at the time as amoebic hepatitis. To this day I have no idea whether that was correct. I may or may not have residual liver damage from it.

Once when I was ill, towards the end of my first year at Woodstock, after a dispensary stay I was sent out of boarding with the Kibblewhites, a staff family from New Zealand. David was the vice principal and Sally my English teacher, and they have three kids, who were very kind about welcoming me temporarily into the family. It was probably another case of just needing some parental attention. I missed my parents terribly that first year, even though my situation in Bangladesh was not one I would willingly have returned to. So I stayed with the Kibblewhites, saw how rhododendron jam was made, and learned to use a handkerchief (before that, I sniffled a lot, which drove Sally crazy; I now think of her whenever I hear someone sniffling, and get just as irritated as she did!).

One day David came home with a telegram. “How are you feeling?” he asked. “Oh, I don’t know.” Although I was back in classes, I didn’t want to be sent back to the dorm. “Do you think you’re well enough to go down to Delhi and see your father?” he asked with a grin, and gave me the telegram. My dad was coming through India on a business trip and would stop over to see me. I instantly felt a whole lot better.

After the first year or so at Woodstock, I was acclimated to the local bugs and was rarely ill. By my fourth year I could drink the tap water in Mussoorie with no ill effects (though I wouldn’t have tried that in Delhi, or now). Other newcomers went through the same cycle that I had: “Sitting on the toilet with a bucket on your knee,” as our dorm supervisor Mrs. Silver cheerfully described it (she was also a nurse).

I first began to notice allergies a few years into college, at the University of Texas in Austin, an area famous for its allergens. But they weren’t too bad then. To really get sick, I had to go back to India, the year I studied in Benares. My previous Asian antibodies had worn off by then, or were not sufficient to stand up to the filth of Benares. Lots of hours on the squatter toilet, and I remember at least once feeling that I would just like to die and have it over with. I lost a lot of weight that year.

The entire group of us went to Kulu-Manali, in the mountains of Himachal Pradesh, for a “vacation,” where we were roughing it in a mountain cabin with a dugout latrine set off a ways down the hillside (no fun to get to in the middle of the night). Naturally, almost everyone got sick. Mat and I became friends while lying next to each other on the floor in our sleeping bags, swapping fever and chills and delirious conversation.

I came back from that year with some residual problems and had tests done while I was living near Washington, DC, though I don’t recall anything definitive being found. Though it was probably not related, I also began to suffer regular sinus infections – they became so familiar to both me and my doctor that I would just call him up and describe the symptoms, and he’d prescribe antibiotics over the phone.

But I must have built up some antibodies again in Benares, because in 1988 I made two trips to Africa and never got sick. Except, during the second trip, morning sickness. I was pregnant when I moved to New Haven to live with and marry Enrico. Strangely enough, my pregnancy was the healthiest time of my life. No complications, I felt great (after some nausea in the first trimester), and everything proceeded to a normal birth. I stayed only two days in the hospital, which I was glad to escape because, as noted, I cannot sleep in hospitals. (Not that I got much sleep at home, either, with a newborn baby.) I probably passed on lots of antibodies to Ross by breastfeeding her: until elementary school or later, she was far healthier than the average of her classmates.

We then lived 13 years in Milan, another of the world’s most polluted cities. I had constant sinus infections, occasional bronchitis, and worsening seasonal allergies (I did allergy vaccinations for a couple of years, with no tangible result). There wasn’t much my doctor could do for all my respiratory problems, except prescribe increasingly-powerful new antibiotics as the bugs in my sinuses grew resistant to all the ordinary stuff. She told me once that I have the lungs of a smoker – and I’ve never smoked in my life.

One year, in desperation, the doctor sent me to the terme (thermal spa), a traditional Italian health cure. Italy has many sources of naturally hot water, bubbling up from deep underground springs, some rich in minerals and considered to have curative properties. In the early decades of the last century there was a boom in the popularity of these watering holes: huge, gorgeous establishments were built, crosses between hospitals and resorts, in full Art Nouveau style. Some are still operating (Saturnia, San Pellegrino and Salsomaggiore), and are worth a visit just to admire the decorations.

The first year I went to Tabiano, a small town without much to recommend it beyond the (depressingly modern) terme facilities. There I absorbed hot mineral water in various formats: inhaled as steam, and squirted forcefully through my nostrils into my sinuses. Which is exactly as disgusting and painful as it sounds, but it was effective. Between that and a quiet week alone at a hotel with no responsibilities at all, I was cured, at least for the remainder of that year. The following year I did it again, at Salsomaggiore – a much prettier spa and more interesting town, and Enrico stayed with me part of the time.

Enrico has some (older) cousins living in Milan who swear by the terme – they go there for a week or two every autumn, and never get sick all winter. Unfortunately, going every year is not an option for me, especially as terme treatments are no longer covered by the national health service. My two spa treatments helped for a while, but weren’t sufficient to break the cycle of allergies, sinus infections, and bronchitis.

Unspoken between me and my doctor all those years was the real, necessary cure: to move out of Milan. I could never get her to state this baldly; perhaps she assumed that we would not be able to do it.

In 2003, a rare (for me) flu turned into pneumonia. I was in bed for weeks, and it took three rounds of antibiotics to clear up completely. I’d had enough of Milan’s pollution, and we had the opportunity to move to Lecco for Enrico’s job (professor of mathematics at the Politecnico di Milano, which has a branch in Lecco).

We moved that summer, and I’ve been better since then – fewer sinus infections, and nothing more serious until this year. Unfortunately, I’m now commuting into Milan most days to a ground floor (therefore more polluted) office in which the boss smokes cigars (yes, this is illegal, even in Italy – but who’s going to rat on the boss?). That, plus stress, travel, and allergies, is probably what led to the bronchitis I got in April, which spilled over into a sinus infection in May, and still (after four rounds of antibiotics) isn’t entirely gone. I am sick and tired of being sick and tired!

Health Care

By the time we arrived in Austin, Rosie had been moved from the Austin Heart Hospital to the “rehabilitation” wing of St. David’s hospital, where she had previously passed two four-month periods. I hadn’t been to that particular wing before; when I visited in November, 2003, she was in St. David’s intensive care. Both times I was impressed by the kindness of the staff. Rossella observed that, while the people who cared for her in the Lecco hospital were competent, they weren’t particularly nice, and always seemed to be in a hurry. The St. David’s staff were busy, but they took time to be nice about it, even a little too nice at times: “Hi, I’m Keith, I’ll be taking you down to radiology this evening” – he sounded like a waiter.

The St. David’s staff were always careful to explain what they were doing and why, sometimes too simplistically. The doctor used a medical baby talk that didn’t tell us much: “The tests on your liver showed results in three areas that we’re not happy about, so we want to investigate some more.” If she’d been a little more specific, we probably could have handled the information. I suppose in rehab they’re accustomed to dealing with confused old people who are easily overwhelmed by medical details; Rosie is sharp as a tack, no problem there.

I was surprised at the number of different kinds of staff it takes to run that wing. Not just doctors, nurses, and orderlies, but also nurse practitioners and a case manager, occupational therapists and physical therapists. Having been through it all so many times, Rosie has no patience with the therapists. She knows by heart their “use it or lose it” speeches: “If you lie in bed and don’t use your muscles, soon you won’t be able to use them, so we’ve got to get you up and moving.” Up and moving is what you don’t want to be when you’re nauseated for reasons the doctors can’t even explain, but when Rosie refused to get up, the therapists would threaten her with: “We’ll have to discuss this with your doctor.” These strong-bodied and strong-minded young women had to learn the hard way that they are dealing with a woman who, while frail in body decades beyond her 76 years, is far stronger in character than anyone they’ve yet had to deal with. Faced with Rosie’s stubbornness and her son Guy’s constant, protective presence, the therapists eventually withdrew from battle. They remembered her from last time, and doubtless will remember her this time as well.

Most of the staff love Rosie, though, and who wouldn’t? In spite of years of severe illness, repeated surgeries and hospitalizations, she manages to maintain a sense of humor and a joy in people that are rare anywhere in life, let alone in a hospital ward. As one of the nurses put it: “We’re sorry you had to come back, but we’re glad to see you.”

You Want Me to Put that Where?!?

Cultural Differences in Medication Methods, US and Italy

There are cultural differences between Italy and the US even in seemingly small things, such as how medicines are administered. I got through a childhood of many, many medicines without ever using a suppository – except once. That once is still imprinted on my mind as one of the more humiliating, not to mention uncomfortable, experiences of my life. So I was unpleasantly surprised to find that suppositories were routinely prescribed for Rossella‘s childhood fevers. I guess the logic is that it’s easier to ensure that a small child gets the correct dosage that way, but it wasn’t fun for anybody.There are even adult-sized suppositories, though I’ve never heard of anyone actually using them. But then I don’t suppose that’s something you’d discuss in casual conversation…

The favored medicine format for adults is the bustina (little envelope), of a powder which is mixed with water, forming a fizzy and more or less palatable decoction. Beyond that, it’s plain old pills – none of these wimpy American capsules or gel caps, just swallow it down and quit complaining.

Then there’s my once new, now old, friend – the aerosol. This is a machine with a noisy little motor that compresses air. You attach a rubber tube to it, then a glass “nebulizer” into which you put liquid medicine. The final glass piece, connected by a rubber joining ring, can be a nasal “fork” (in two sizes), a mouthpiece, or a soft plastic mask that covers nose and mouth. The compressed air is forced through the nebulizer, where it mixes with the medicine to create an aerosol which you then breathe in – excellent for getting the medicine to where it’s actually needed for respiratory problems. A beneficial side effect, for people like me who often won’t sit still long enough to rest even when we need it, is that you are tethered to the machine for the half-hour that it takes to inhale all the medicine. But that’s a drawback when you have to treat a small child.

Because I am often clumsy and drop things, I was initially nervous of handling all that delicate-looking glass, but it turns out to be not as delicate as it looks, and in any case you can buy replacement parts at the pharmacy.

Another area of cultural difference in medicine is how you obtain it. It pays to make friends with your local pharmacist, because, once she learns to know and trust you, she will often let you have things that technically are supposed to be available only by prescription – very handy when you know exactly what you’ve got and how to treat it, but can’t get hold of your doctor to write the prescription.

You do eventually want to get the prescription so that you can get some money back. Most pharmacies will sell you something on an emergency basis, then refund your money when you come back with the official prescription form which allows them to charge it (in whole or in part) to the national health service.

Apr 27, 2004

Mike Looijmans says re. suppositories: “The Dutch words for those are many, and translate into things like “ass grenade”, “plug-in” and “stick-up”. I cannot even recall the official word for them…”

He and others rightly pointed out that they’re often used for children (and sometimes adults) when they might be expected to throw up any medicine taken orally.

Hospital Stay

I have suddenly landed a temporary but demanding job: nursing my daughter. Ross fell off her horse Sunday afternoon, onto hard ground, and broke her humerus just below the shoulder joint.

The emergency room was humming – it was a beautiful day, everyone was out getting hurt. Just before we got there, an ambulance had brought in a young man in motorcycle leathers, who looked pretty severely injured. According to a conversation I heard among the nurses, Lecco gets a lot of motorcyclists – and accidents – on sunny weekends. Another young man had been out hiking in the mountains, slipped on a patch of ice, and banged his head and chin.

They quickly got Ross through an initial examination and x-ray, drew blood, then took us up to a room on the orthopedic ward. Ross was trembling when the anesthesiologist came to talk to her; given recent family horror stories with hospitals, we were all terrified that she had to go under anesthesia. But those stories took place in the US and the UK. So far, I have no complaints about Italian health care. [later on, we had an Italian horror story to add to the family history]

The anesthesiologist gave her a sedative, and off we went to surgery. Ross told me later that, by the time they actually got her into the operating room, she was giggling and wondering why she had been so scared. She lay there looking at all the bustle around her, wondering if they had a machine that goes “ping!”

We had arrived at the emergency room at 5:15; by 7:15 she was under. The surgeon had to pull the bone back into place, and then put in three wires to hold it while it heals; Ross is also wearing a sling-and-strap to hold her arm against her body. Her right arm. No drawing in art school for a while.

Giulio (owner of the private stable where we now keep Hamish) and Viola (his daughter, Ross’ classmate and riding buddy) came racing down from their ski weekend to be there, and passed the time during surgery regaling me with stories about their numerous family sports injuries (they ride and ski, Giulio and Viola compete seriously at both). As Giulio pointed out, it’s lucky this happened right before Christmas vacation, so Ross won’t miss too much school.

Giulio also demonstrated the usefulness of the small-town grapevine: when he heard the name of the surgeon, he called his sister-in-law, who happens to work at the hospital as an orthopedic surgical nurse. She said that we were lucky: this surgeon’s a good one. And she came by the next morning to see us in person. If we need any inside information on this case, we’ll know where to get it.

There was a spare bed in Ross’ room, so I was allowed to stay with her. The first night she was in a lot of pain, understandably, but since then has bounced back with most of her usual energy and sense of humor. They let her out yesterday (Tuesday), and today she’s gone back to school (the doctor said there was no reason she shouldn’t, as long as her arm doesn’t get bumped). She’ll need to have the bandage changed every 3 or 4 days, to ensure that no infection enters where the wires are; those will come out after 25 days, and she has to keep wearing the sling til then. So I’ll be accompanying her to doctors a lot, as well as helping her dress, wash her hair, etc. As I said, it’s a job. But that’s what moms are for.

Jan 19, 2004

Rossella‘s arm has healed well. The wounds (from the surgery) were so clean that her bandage needed changing only three or four times over the month. Last Tuesday we went in for a final x-ray and, seeing that everything looked fine, the doctor pulled out the wires, using a pair of common (even somewhat rusty) household pliers. According to Ross, it felt weird, and the idea was gross, but it didn’t actually hurt.

So now she’s down to band-aids over the holes, and only needs to wear the sling at night. We’re trying to schedule physical therapy; in the meantime, she can use her right arm again, as long as she avoids swinging it out from the shoulder – no dancing the Funky Chicken..

The hospital staff were amused: Ross is the only patient in their experience who wanted a picture (while the wires were still sticking out – her arm looked like a construction site), and to keep the wires as a souvenir. But, as they noted, this attitude coincided with the Clockwork Orange t-shirt she was wearing.

Of course she wanted to keep the wires; she couldn’t wait to tell her schoolmates: “Piercing? Hah! I’ll show you REAL piercing.”

Apr 27, 2004

Ross has healed up fine from breaking her arm in December, and is back in the saddle of her beloved Hamish. She’s had some moments of fear, but is gradually feeling comfortable riding again (it was totally up to her to do so; her father and I might have been just as happy for her to give it up now).