A Visit to an Italian Doctor's Office

While studying in Italy at the Tuscia University, I started to feel sick and thought I may have a sinus infection because I was living in an apartment where mold was growing on the brick ceiling, I was allergic to mold and had the symptoms of sinus pain and ear pain.

I told Frankie, the Italian lady of USAC in charge of housing and other “problems”, about my dilemma. She gave me a doctors name and asked if I needed directions and for her to come along to help translate. “Of course,” I exclaimed. The Italians in Viterbo do not speak much English at all. Some of them speak a little. I thought the doctor would probably be one of the “little English” speakers.

So Frankie and I made the journey through a neighborhood outside the city walls, past yellow and faded orange homes and apartments, across the weedy sidewalks to a three-story building.

“It’s on the second floor,” she said. There was no elevator. So we climbed the steep steps. I imagined a really sick person trying to see the doctor and climbing all those stairs. No ADA here, I thought.

We walked past a small cubbyhole, with a white folding door that looked like a bookkeeper desk. We walked into a room that had green walls and orange chairs. It was a waiting room.

Frankie said, “I need to get the key.” I was trying to figure out why she needed a key, when she returned, unlocked a non-descript door in the room, and behind the door was a bathroom that was stuffed in a broom closet space.

I walked around the waiting room looking at all of the hand sketches of Rome that were placed behind glass in 3 X 5 inch wood frames. All the frames were closely spaced apart at the same level in the room across the four walls.

The doctor passed the hallway with a slim woman with long wavy brown hair following him, walked into his office with her and closed the door. Frankie said, “Oh, they’ll be in there for awhile”.

So we waited. I again was wondering how she knew that. I remember the same lady discussing something standing around the cubbyhole reception desk as we passed by. Maybe Frankie overheard her conversation?

Then after a while the door opened to the doctors office and the lady stepped out, and the doctor followed her. He then motioned to Frankie and me to come into his office, and sit in the chairs facing his desk.

The doctor was wearing a pressed blue striped shirt and grey pants, had salt and pepper wavy hair, and parted to the side. He was over 6 feet tall, large for an Italian, I thought. We saw an old, worn, large wood desk in the center of the room, and tall windows on the back wall that illuminated the room. A white, mini refrigerator stood to the side of the desk near our seats piled with small white boxes. The doctor motioned for us to sit down. Frankie and I took our seats in front of the desk. Our chairs looked like they had once belonged to a formal dining room set, light blue crushed velvet pads that sagged when we sat on them.

I noticed a very unstable white vinyl-padded table with small metal legs and a paper sheet draped over it sitting the corner near my chair. I wondered what it was for, especially if he asked us to sit down, instead of asking me to sit on the table, like they do in the U.S.

 The doctor took his seat behind his desk. He said “hello” in English. Then Frankie told him what my symptoms were. She said, “he is learning English and is taking a class, but he can only say Hello, Goodbye and Thank you.”

HIPA rules went right out the window. Oh wait, this is Italy.

He pulled a small black tool thing with a small light on it out of his pocket. He walked around the desk and faced me. He spoke some Italian. I looked at Frankie. She said, “he wants to check your ears since you are complaining of ear pain.” I said O.K. So he puts the pointed black thing in my ear with the light and looks in. He is pressing it so hard against my ear canal that the pointy black thing starts hurting. I backed up in my chair, so he got the idea that it was painful.

Then he took the light and told me to say ah, except of course in Italian, but his gestured an open mouth with his tongue out. So I did what he said and he looked in my mouth. No tongue compress? Never mind.

Then he said some words to Frankie, and she said, “Now bend over”. “What!” I exclaimed. “He wants you to bend over” she said. “No!” I said

I stood up. She looked at me, then the doctor, then back at me. “He wants you to bend over and touch your toes.” “I can’t touch my toes!” I said.  The doctor was now standing behind me. I had a quick internal conversation with myself “O.K. he wants you to bend over, he is standing behind you. Well Frankie is here and she wouldn’t let anything happen to you.”

So I thought, O.K. let’s see what happens. So I bent over, with my head bent forward and my shoulders bent forward. “Bend over more”, she said. The doctor was still standing behind me. So I bent over more. Then she said I could stand up again. The doctor spoke to her in Italian, and she then said, “How does your face feel?” I said, “It hurts!” Then she told the doctor and he spoke, then she said, “Yes you have a sinus infection.” Really, no kidding!

Then he wrote me a prescription for some decongestant, but no antibiotics. He said I could get those when I returned. I still had two weeks left to go in Italy, so I was not fond of the idea. I protested, but I could see it was going nowhere. It appeared that the doctor’s decision is final in Italy.

Then I looked at the prescription and said, “I could not find a pharmacy that was open. It’s Friday yet none were open. All of them had a sign on the door saying there was some type of audit going on.”

“Ah, yes”, said Frankie, “they are on strike today.” “What!” I said. “Yes”, Frankie said. The government was trying to add an additional tax on the pharmacies, so the workers went on strike”. “When will they be off strike?” I asked. She could not say, but it should only be for a couple of days.

So I looked at the doctor and Frankie, and said, “so what will I do?” Frankie spoke to the doctor in Italian, and then he started lifting, reading and looking through the small boxes, first the ones in his desk drawer, then the ones on the back credenza. I realized they were sample prescription drugs. Then he walked around us to the small, white refrigerator and looked through the boxes on the fridge in frustration.

Then he left the office and I could hear him riffling through more boxes in the front cubbyhole office. Then he came back with a package with two powdery filled vials. He spoke to Frankie and then she said to me “take these for two days, then maybe the pharmacy will be open”. I said ok.

Then he spoke to her and she said, “Your fee will be 50 Euros, if you get a receipt, and 20 euros if you don’t get a receipt”.

I was so shocked I had to ask again, “You mean if I pay 20, I walk out with no receipt, and if I pay 50 I get a receipt?”

My financial mind was clicking away as I imagined what a high tax rate this doctor probably had to be offering services on a cash basis, under the table. Also, I knew I could get reimbursed for the fee if I submitted a receipt to my insurance company.

I asked for the receipt, and I watched as the doctor frowned and made out a paper receipt.

We then got up and walked out, down the steep stairs and across the neighborhood.

I said to Frankie, “what was that white table for?” She said, “Oh, he also does gynecology.”

Then it occurred to me what the patient in his office before me had to endure!

I wondered how many “specialties” a doctor can have in Italy. And I also pondered how often doctors had to update their medical certifications. Can any doctor say, “Now I do orthopedic surgery?”

So I asked Frankie what her doctor does for his patients, “Oh, he is a regular doctor, but he also performs physical therapy for his patients”.

I imagined some young, Italian, med students standing around a dartboard. “What will your specialty be, Mario?” Mario throws a dart at the dartboard, and hits a piece of paper with the words ‘Ophthalmology’ on it. “Great, Mario, you’ll practice ophthalmology!”

The powdery white stuff that I had to mix with peach tea tasted awful, but it worked.