Going into hospital

Would you have the patience to be a patient in an Italian hospital

A ward to the wise - beware of the toilet!

Going into hospital is something that no right-minded person can look forward to but I believe that the whole experience can be positively or negatively affected by the attitude and behaviour of each individual nurse, doctor, surgeon and consultant that the patient comes into contact with.

In December 2007 my left leg flared up again but this time with an infection. The whole of the leg from just above the knee went bright purple and I was really convinced it was amputation time. I had a fever which peaked at over 41C. Even my GP who 'does have other patients with fewer problems, you know' couldn't argue with me going into hospital as an inpatient so my wife packed my overnight bag and I went in.

After the fiasco last time about going into hospital, we had been to see a Patient Liaison Manager whose duty was to ensure that patients received an acceptable standard of care and, to repeat my phrase of earlier, to see that their experience was a positive one. He was to meet me at outpatients where I would be admitted into the main hospital.

I didn't relish going to Outpatients again and, sure enough there were the same sorry old faces on duty including the two worst doctors from last time (one male and one female). Yes, they remembered me too and they were no less obnoxious although with our representative being on-hand, they had to restrict themselves to simple surliness. There were no detectable rude remarks about my going into hospital but I think there were a few puerile jokes being bandied about by some of the doctors.

Having completed the paperwork, I was manhandled by several burly orderlies onto a gurney which had been brought specially to Outpatients to cope with my weight. This was then pushed around the hospital, into a lift and up to my room which was on the top floor. By this time I was almost out of it because of my fever. I remember sitting up on the bed shivering with cold asking for blankets and just getting a blank look from the nurse who didn't seem to be able to do anything except look in my ear (why?). In the end my wife took charge and I was wrapped up in two over blankets still shivering with fever.

A succession of doctors and nurses passed by me - most attending to the other occupant of my room (there were only two beds per ward - if that is what it was). They took my temperature and peered briefly at my dark purple coloured leg which was probably hot enough to warm a pizza up on. None of them were particularly interested and, eventually, I was given two paracetemol and, basically, ignored. When I asked for some water to wash the tablets down with the nurse looked puzzled and told me that there was none available unless I cared to buy a bottle from the machine down the corridor. A (brand new) hospital and no water!

This combined with my previous experience suggested that going into hospital wasn't likely to be a better prospect than I had feared so my wife stayed with me until quite late but it was snowing and I was afraid she would not be able to get the car up the drive to our hillside home. I was left alone apart from my neighbour (who was a diabetic and in a semi-comatose state as a result of an insulin reaction) and his wife who danced attendance on him as he endured the nausea and constant abdominal pains. Unable to sleep, I noticed how little help was grudgingly given by the nurse on night duty.

In all this time I was not given a hot drink or even examined despite my dangerously high temperature of 41C. A meal of tepid pasta and meat was left for me and I managed to force down some of it. The bed was too hard for me (my joints are distorted by my weight when placed on a hard surface for any period of time). At about 3am the back support gave in and collapsed thus rendering it impossible for me to even sit on the bed any more, never mind actually sleeping. I asked a nurse to fix it - she said she didn't know how and came back with a colleague who giggled a couple of times before shrugging her shoulders and telling me there was nothing she could do about it.

As a result, I had to spend the rest of the night sitting on a plastic chair that was not suited for my weight and which cut off the circulation to my legs - just what I didn't need.

The morning after going into hospital my wife arrived early having wisely spent the night in our office in Foligno rather than risk the journey up into the now snowy mountains where our home is. She quickly fixed the bed for me so that I could get a few minutes sleep.

Then I had the joy of seeing each consultant, doctor or surgeon as they did their rounds. This consisted of generally ignoring my leg in favour of trying to 'sell' me an operation to stitch up my stomach. Remember I came in with a severe (and still untreated) leg infection and lymphedema - I do not have an eating disorder. For the record (and apart from its complete irrelevance) this operation has a lousy success record with many of its survivors wishing that they hadn't because of the hideously unpleasant side-effects that come with it. As soon as I started to argue about not having the operation this gave them the opportunity to disown me "Well, if you won't accept the treatment ...". It all got rather unpleasant at about this time as some of the characters who had laughed at me 2 years before came around to gawp and offer their irrelevances.

The climax came when one young nurse asked to talk privately to my wife. I knew something was amiss when I saw that her face had gone much the same colour as my leg (which still hadn't been treated). Apparently word had gone around the hospital that they had admitted an exceptionally heavy man and this had created a full-scale panic among the higher echelons of management. So much so, in fact, that this nurse had been instructed to advise me that I was forbidden to use the toilet as it might be dangerous for me. I was supposed to request a bedpan and somehow the two nurses on duty would then be expected to manhandle me on and off of it plus all 'additional' functions. If I was to stay in hospital, it was going to be a condition that I didn't use the toilet. This sent me begging to ask my wife for some paper and pencils so that I could put up a sign saying 'Beware of the bog' or 'Warning - this toilet is dangerous' or even 'Abandon hope all ye who enter'. The possibilities seemed limitless.

So, here I was, nearly 20 hours after going into hospital with what is considered to be a life-threateningly high fever, still not having received any treatment (unless you consider being asked 'Have you always been fat?' by each passing doctor to constitute treatment), not having had a hot drink or hot meal (breakfast was essentially non-existent although my wife managed to bum two biscuits and a cup of the most unbelievably weak tea off of a lady with a trolley who just wandered past our ward without coming in and offering a drink to each patient) nor any prognosis beyond being told to have an entirely irrelevant and dangerous operation on my stomach (you recall I went in with a leg infection?). On top of that I wasn't allowed to use the toilet.

It was time to go and I discharged myself amid a certain amount of rancour.

My overall experience of going into hospital in Italy for a normal person would suggest the following:

A ward is much smaller than you might expect - you will be isolated from other patients.
Nurses have very little power and only perform the most menial of functions and then grudgingly. They are not often seen on the ward - a patient has to summon them first.
Providing meals and drinks to patients is not seen as being the province of the hospital.
As a result of 1, 2 and 3 the expectation is that the patient will be supported by his or her family with at least one of them on duty 24 hours a day.
As a consequence of 4, the concept of an official visiting time is meaningless - family members can march in at any time; even in the early hours of the morning; in fact they are expected to.

If you are facing a stay in an Italian hospital and you don't have much or any family support then you must make sure (if you can) that you can be entirely self-sufficient (plenty of squash, things to eat, clothes, books etc) as it is not deemed to be the function of any nurse, doctor or orderly to assist you with your day-to-day needs as a patient.

I hope you have a better time than I did if you are going into hospital.