Pronto Soccorso

If you have to have a medical emergency, try not to have it in Palermo, Sicily

I think I shall revise my maxim about what one must see, beyond the sights, to really experience a country. Before it was just to eat the cuisine (naturally) and to watch some local TV. Recently, I've added shop in the local market and/or K-Mart equivalent.

However, I am increasingly of the opinion that to this list we must add one other activity without which no country experience is complete: a visit to the emergency room of the local hospital.

Now of course I don't mean a visit for drastic reasons requiring an ambulance and IV drip. I mean relatively minor yet still annoying ailments, such as Frances' flu on that rainy night in Rome, or the vicious Scottish germs I waged a bedridden battle against on Santorini.

Or, of course, Jay's recurrent sinusitis that's been worsening over the past few days ever since we spent that night atop the volcano (long story).

So after a lengthy walk through some of the more bombed-out sections of Palermo—I know of no other European city that still has whole blocks of broken and charred buildings destroyed in World War II still rotting in the very center of town—down city streets that have become dirt roads, back and forth and in spiraling circles as we got repeatedly lost, and then across several dusty, wind-swept squares, we finally stumbled across Palermo's Ospedale Civico.

We went into the Pronto Soccorso (first aid, or emergency room) wing, where we read a huge sign on the wall instructing non-EU nationals seeking care to go to the "Ticket Office" down the hall and around the corner. At the Ticket Office, they seemed boggled as to why we would have come to them, professed to know nothing about the large, multilingual sign regarding their services that dominated the emergency room, and sent us back to Pronto Soccorso.

While waiting in line, we noticed that the symbol for "Emergency Room/First Aid" is a green circle with a hand inside it and the international medical Greek cross superimposed in the middle of the hand. The hand, however, had only the stub of an index finger remaining.

This did not bode well.

The Pronto Soccorso people took Jay's name, I described his symptoms as best I could (not knowing much medical terminology in Italian), and they tore out a sheet of paper for us that had Otonoria (or something like that) checked off, telling us to proceed to that department.

They sent us scurrying down a tree-lined boulevard past broken-down hospital buildings that were sporadically signposted as to what was inside each (interestingly, the ward for "ambulatory rehabilitation" was in a building way at the end of the road at the top of a steep flight of stairs—incentive, I guess). By asking around, we finally got pointed toward the building with the mysterious Otonoria in it (no sign, though), and we entered.

The dimly lit halls were semi-empty, but occasionally a doctor-type in the requisite white coat would bustle out from some door and duck quickly into another. We asked again about Otonoria and were told "primo piano," first floor.

The elevator was out of service, and I only mention this because the stairs were half-filled with scaffolding as well (ospedale chiuso per restauro?). At the top of the stairs was a room edged with tiny plastic chairs atop which perched the members of what appeared to be several extended families that looked as if they'd been waiting since 1952.

They sat there, unblinking, like refugees from a Fellini movie, the men in old wool suits the women swaddled in black shawls, the kids in forth generation hand-me-down oversized button-down shirts and grubby overly short corduroy pants. None of them was showing any sign of life. I resisted the urge to check for cobwebs.

The rooms also featured two, unmarked doors. We tried one, it was locked, so I knocked. It opened a crack and I could see and hand on the knob and a bit of red sleeve. I asked "Otonoria?" and the hand responded, "L'altra porta," (the other door) before quickly pulling the door shut. We knocked on the other door and it clicked open on its own, we poked our heads inside and saw two female nurses down a short hall, one chatting on the phone. "Otonoria?" The blonde waved us in.

I handed her the slip of paper with Jay's name on it and the word "Otonoria" checked off and proceeded to explain the situation again, reiterating that we were Americans on vacation.

The two nurses examined the paper for a minute, then asked Jay to sit down in a dilapidated dentist's chair, next to a table with various medical instruments that looked as if they belonged in a museum strewn about and an uncapped, half-filled syringe lying on its side.

One nurse went to see about rustling us up a doctor, then returned to say he was operating, and would be down "subito" (which translates literally as "immediately," but in Italy rarely implies such haste). I asked how "subito" and got the thrust lower-lip and shrug of shoulders Boh' in response.

There were a few moments of silence, which Jay broke with the observation that there were no sharps containers and that used syringes were just tossed in the Hefty-lined trash cans along with the rest of the waste. I pointed out the historical medical instruments and he sort of edged away from them.

The nurses were nice, and engaged us in conversation. They pointed out that I was too young to have such gray hair, and one came over to paw at it. A third, overweight nurse with curly black hair arrived, She was swathed in green hospital garb and spoke only Sicilian dialect.

She commented loudly that there was a word for graying early in Sicilian, and said it. One of the other nurses corrected her by repeating the proper Italian version of the word, but she reiterated the Sicilian one before lighting up a cigarette and getting on the phone to yell at someone on the other end for a few minutes. The blond nurse looked at us and shrugged her shoulders and the other one made the Boh' face again.

They hung around as if there was nothing in particular for a nurse to be doing around a hospital but sit and chat. The Boh' nurse asked how young I was, to be having such gray hair, and the blonde immediately answered "he's 25." I said yes, exactly, how did you know? The other nurse exclaimed "25!" then the loud overweight nurse got off the phone stared at me for a moment, and then asked loudly if I was in any movies. I said no, and she said I should go to Hollywood and be in movies. The Boh' nurse said yes, I looked like "that Leonardo di Caprio guy" (she's the fourth Italian woman to see this specious resemblance; two years ago I apparently resembled Hugh Grant, which still quite a long shot but a bit more credible as far as the general shape of my face goes). The blond nurse agreed that yes, I could be in movies. The loud, overweight nurse lit a second cigarette and announced that if I went to Hollywood some director would see me and put me in a movie. They she nodded as if having made some grave pronouncement and pushed through the door, leaving only a cloud of smoke and a large space of silence behind her.

Jay said I should study the poster next to me that had all the parts of the inner ear on it, just in case he got an ear infection later. The blonde nurse asked how old Jay was and he replied "Vent'uno" (21). Both nurses threw their arms up in the air and the blonde turned to the Boh' nurse and repeated "Ma vent'uno, solo vent'uno anni!" The other nurse said "Ma e piccolo, solo un piccolo."

"What did she say" asked Jay.

"She said you were 'piccolo,' a little one." This bothered Jay.

"Little!" he exclaimed. "I'm a good foot and half taller than any of these Sicilians!" He still hasn't gotten over it, I think.

Eventually, the doctor showed up, spurring a flurry of Important Activity among our previously sedate nurses. He smiled and firmly shook hands with each of us twice and I began to explain the symptoms all over again. He nodded gravely, taking it all in, and asking a few questions.

When he asked if Jay had a fever, all of a sudden his face lit up as he remembered a medical word he knew in English. "Faren'eit" He exclaimed. "In inglese, Faren'eit, no?" Yes, I agreed, we Americans used the measurement and term of Fahrenheit, but Jay's Fahrenheit was doing just fine.

The doctor escorted Jay over to another chair (he looked distinctly relieved to be out of the old dentist's chair and away from those antique instruments), and proceeded to put some metal device in Jay's nose and begin cranking the nostril open. Jay later reported that this felt not good at all.

The doctor kept asking both Jay and me questions as he roughly examined Jay's head, tsk tsking the fact that Jay's left nostril is blocked from having been broken. Then he asked Jay to open his mouth and stick out his tongue.

The tongue stud made its appearance.

The doctor released Jay's jaw and jumped back. "What's that!?" The nurses gasped and the blonde one giggled, saying with glee "Ma, e` un piercing."

"Un cosa?" asked the doctor, flummoxed. The Boh' nurse went out into the hall and returned with the loud, overweight nurse (cigarette-less now) and a fourth, never-before-seen nurse to come look at "il piercing." The blond nurse was meanwhile explaining the concept of piercing to the doctor, while the Boh' nurse and the never-before-seen nurse discussed the different parts of the body they had heard one could pierce, giggling at the ribald parts.

The doctor cupped his fingers together and bounced his hand questioningly as he turned to me "But how does he eat?" he asked me.

"Mangiare bene," responded an amused Jay.

Both of our original nurses turned to me "But did you ever ask him why he did it?"

"Boh'," I replied, then realized they needed something more. "He's my brother in law," I said, which is kind of true.

"Ah," they started nodding, as if that explained everything.

The loud, overweight nurse, having had her fill of staring at Jay's tongue, bustled out again as the doctor tried to figure out how to get around the stud in order to grab Jay's tongue with his gauze.

The doctor started asking about medicines, and I dutifully informed him that Jay is allergic to all forms of penicillin. Luckily, the doctor recognized the name of the antibiotic Jay said he's used effectively before, so he carefully wrote out a prescription, shook all our hands again, and strode majestically out of the room.

Immediately, as if someone had stripped out their spines or flipped off a switch, the nurses went back to lounging against the tables in a bored but resigned fashion. I asked were was a farmacia where we could get the prescription filled, and one pointed out the window for me across the dusty piazze and said "over there, behind that building."

We thanked the blonde, Boh', and never-before-seen nurses and they smiled cheerily and sent us off with a chorus of "Ciao, ciao, ciao" and watched us leave, crossing the room ringed by the dusty extended families, down the scaffold-filled staircase, across the tree-lined drive of the hospital, and down the dirt-road city streets past bombed-out buildings to find an open farmacia and get started on our day in Palermo.

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