Self: What do you guys usually do for lunch?
Italian Person: Oh, yeah nothing special. At least it's summer, and there's always prosciutto and melon.
The other day I was complaining to an Italian Person about being out of lunch ideas and hating having to come up with something to put on the table every day. So I asked her:
Self: What do you guys usually do for lunch?
Italian Person: Oh, yeah nothing special. At least it's summer, and there's always prosciutto and melon.
Once upon a time I was in Italy just to visit. As you may have noticed if you have come to Italy just to visit, you don't need a visa on your passport to get in: you can come here to visit or to work for up to three months without a visa. Why? Because Italy and America said so (in a treaty).
During my visit, we wanted to add me to my husband's bank account so a client could pay me for a translation with an easy bank transfer, but we needed a "fiscal code" (a financial identification number specific to me) to do it. It's like a social security number. This is easy to do. In fact, any American who buys property or inherits money here has to get one. So off we went to the local branch of the tax authority (like the IRS) in one of Italy's biggest cities. The following scene ensued:
Bureaucrat (looking at my passport): I need to see your visa. I don't see a visa.
Self: I don't have a visa, I'm American.
Bureaucrat: It doesn't matter who you are, you need a visa.
Self: I can't have a visa, Italy doesn't give visas to Americans for visits under three months.
Bureaucrat: ....I need to see a visa.
Self: I can't have a visa.
Bureaucrat: Then I can't give you a code.
Self: I would like to see the director.
The director arrives.
Director: We can't give a fiscal code without seeing a visa.
Self: Americans don't need a visa. Under the treaty we can work or stay here for three months without a visa.
Director: Well if you want a code you'll have to get one.
Self: I can't get one. This is something my president and your president decided; there's nothing I can do about it.
Director: What do you want it for?
Self: So that I can duly report income from a translation I'll be doing while I'm here.
Director: What for?
Self: Because your agency, the tax authority, requires it.
Director: Well there's nothing I can do about it. I need to see a visa.
Self: Are you saying I should get paid under the table?
Director (of the TAX AUTHORITY): Well, we all do what we have to do, no?
(Then the director walked to the door, opened it, and held it open until we left)
So what did we do? We drove to a town an hour away, went to the local branch of the tax authority, asked for a "fiscal code," and got one in under half an hour.
I said to my three-year-old, who has lived all her life in Italy:
"Hey, do you want some cheese?"
She replied, after looking at the plate, "No thanks, I don't like pecorino."
The other day my father-in-law asked about my ethnic background, so I told him, "I'm half Irish and half Italian."
Then he started describing the ethnic background of my husband. It turns out that, as Italians count it, he's not 1/8 French and 7/8 Italian, as I once thought. He is 1/8 Piemontese, 1/8 Calabrese, 1/8 Emiliano, 1/8 some place that used to be Italian but is now Swiss, 1/8 French, and I can't even keep track of his other 8ths which, in any case, all mean ITALIAN.
It's complicated over here.
The other day I was listening to a major Italian radio station, RDS. Right after playing Bruno Mars, the DJs played clips from listeners who had called in to answer the question, "what smells do you love or hate the most." A LOT of Italianness ensued.
First of all, no one called in with smells they hate (what??). Second of all, here were the first four calls, in order:
1) The smell of "wild boar meat sauce and polenta after a long day of skiing." Yes, that's an exact quote.
2) The smell of "pure marseille soap. The one Grandma used to wash your sheets." Yes, THAT's an exact quote.
3) The smell of bread. This one caused extensive reminiscing on the part of the DJs about bread with all their favorite companaticos.
4) The smell of the glue in the notebooks you had to bring to school as a child.
Go on, admit it, Italians are cute!
In this world there are tragic healthcare stories, and this is not one of them.
No, I am well aware that the story you are about to read goes in the category of "stupid and annoying." Still, it is worth describing in all its stupid and annoying, gory details.
First, there are two things you need to know ahead of time.
Number 1), the punchline: despite everything, I will not get an epidural. Like everyone else, I will arrive at the hospital, ask for one, and a nurse will make up some absolutely bogus medical mumbo jumbo reason why I can't have one, and they will refuse to give it to me (see that? see how your foot twitched like that? that's a sign of potential nerve-labor, and an epidural is absolutely out of the question for women with nerve-labor...). So there's that.
Number 2): this is not the story of me being unlucky. Nothing out of the ordinary has happened at all. Everything you are about to read is pretty much exactly how the Italian State has ordained that things should be. That is, stupid. And annoying.
Ok, here we go.
If you want to have an epidural during a labor and delivery in Italy, you need to be pre-approved for one at least two weeks ahead of time (baby premature? guess you're SOL. LOL). The scientific and medical reason for this is to save money on all the people who for whatever reason, fail to get pre-approved.
Pre-approval depends on you having two blood tests and then taking the results to have them looked over by a qualified doctor. Who is qualified to read a blood test that says "yes your blood coagulates" or "no your blood does not coagulate?" (because this is clearly not something you would know ahead of time...). ONLY an anaesthesiologist, of course.
So here's whatcha gotta do. Actually let's not be theoretical about it. Here's what I did. Note that for every visit I had to pay a babysitter, take a half-day off of work, and pay for cabs, buses, and trains (should I mention being almost nine months pregnant) to go back and forth... Also note that this is ONLY what I had to do for the epidural approval. Every other blood test, ultrasound, swab, pee sample, and so on involved a separate and equally long and convoluted tragicomic tale. In the last four weeks of pregnancy (when I have two major work deadlines), I have to make SEVEN trips to various doctors and labs to do what an American doctor does in your last two pre-delivery check-ups in the US.
Back to my story:
I called a friend who is a doctor (the only successful healthcare stories in Italy start this way). She happened to mention this two-weeks-ahead-of-time rule that my doctor apparently had no intention of mentioning. I go to see my doctor (VISIT 1) and ask about it. He writes a prescription for a blood test and a separate prescription to make an appointment with the anaesthesiologist to read the results. I go home. I call the number to make the appointment. And then I keep calling it for two weeks, without getting through to anyone. The August vacation answering service is on for the first week (this is mid-September). During the second week I get two promises to call me back and one time I am put on hold for an hour during which no one seems to remember me, but someone DOES remember to hang up on me precisely at 4pm, when the service closes.
The problem is, I can't get the blood test done until I know when the appointment is, because I have to make sure I have the results in hand before the appointment, and if the state-run blood test people can't get me the results in time I will have to go pay a private place so I can get them in 24 hours...
So I go in person to the hospital to schedule the effing appointment (SECOND VISIT). I get there at 3:08 and they are open until 3:30. But since apparently they have interpreted "open until 3:30" to mean "at 3:30 I, employee, should be halfway to Fiji," they will not let me in. I call the number again from the car, and this is where I sit on hold for an hour until they hang up on me at 4pm. I guess the phone people get to go to Fiji, too. Jerks...
The next day I go back to the hospital again (THIRD VISIT). I take a risk and get the blood test first because you can only get blood tests until 10am because THAT makes sense (if they can't get me the results on time, I will have to go BACK to my doctor for another prescription for the same test, then go BACK to a faster, private lab and pay to have the same test run again...). Then I go to a different part of the hospital and wait in line to make a reservation for an appointment. The lady behind the counter ACTUALLY asks me why I am wasting her time when I could have just made the appointment over the phone...
Whatever, she gives me the appointment, so...SUCCESS! Buuuuut, it's before the results of the test will be available. Luckily, it's only one day later, and the totally un-reassuring lady behind the counter reassures me that the test results will probably be available.
On the day of the appointment with the anaesthesiologist, I go back to the hospital (VISIT FOUR). First I have to go wait in line at the lab to see if my results are proooooobably there. They are! Yes! Then I have to wait in line for the anaesthesiologist to tell me whether my blood coagulates or not (eye roll).
I get called in to see the anaesthesiologist, who can't be bothered to look up and who looks at his phone while holding out his hand, apparently for me to insert the test results into them. I do so. After a while he gets around to leafing through them. "Where's such-and-such test?" he asks. Such-and-such test is not there. Why? Because the only doctor authorised to write the prescription for the tests did not know that I needed it, since he neither runs the tests nor reads the results of said tests. Because he's only a doctor, so what does he know, right?
"What do I have to do?" I ask.
"When you come in to deliver the baby, you can ask them to first run this blood test, and then, after you get the results of the test, if they check out, you can ask for an epidural..."
"How will I get them to run the test? On what authority?"
"I made a note of it, so the attending doctor can run it then if he or she wants to..."
This guy could not give two F's less...
"Wait a minute," I say, "this is kid number 3. How much time do you think I'm going to have after I come in to deliver the baby to sit around and wait for a blood test result. It'll be over before the results are in. This isn't a test I can just do right now?"
"Sure, you can do it now. You just have to schedule a visit with your gynaecologist [VISIT 5], ask him to write a prescription for the test, go to the lab for a blood draw [VISIT 6], collect the results [VISIT 7], and bring them with you to the delivery."
"But aren't you a doctor? Can't you just write the prescription for me?"
"...Does it matter that I've already had an epidural and anyway I had all these tests done and got approved for a second epidural just a year ago?"
NOT APPROVED. The saga continues.
So, to make a long and Faustian story short, I will have to make SEVEN TRIPS to different locations to get scientifically unsound pre-approval for an epidural they will never give me. I am living in a wretched game of telephone, where I have to be the go-between for multiple doctors each of whom is only allowed to do one tenth of the things a doctor should be able to do, but also won't talk to the other ten doctors I need to put together one single doctor-task.
My sister lives in Bolivia, and when I told her this story she said, "Yeah! Bolivia is just the same!" I think I will just send that one sentence to whoever is in charge of the healthcare system: "Bolivia is just the same!" Good job, Rome.
After my fight with Italy yesterday, today I went to a mini-mart. There I bought a bottle of superior Piemontese wine for 3 euros, a stockpile of bronze-cut artisan top-quality pasta for 76 cents a bag, and a melon that is currently perfuming our entire apartment.
If Italy were a person and this were a rom com, tonight would have been the kiss-and-make-up scene. Instead it was the drink wine and eat melon and pasta and make up scene.
Italy > a rom com.
One of the odder consequences of having so many people involved in the world of healthcare in Italy is that the people on the peripheries of that world develop rigid and totally unhinged convictions about human biology and feel authorised to inflict them on you, wretched civilian, with all the authority of being healthcare workers. There are a lot of stories to choose from here, but the most fun one happened today:
I went to have a routine blood test done to look at my glucose levels. It's a standard pregnancy thing that I've had to do before, except rendered annoying because of THIS and also because in Italy you have to do the long version: three blood tests over three hours, after drinking a bottle of nastiness. All on an empty stomach.
But at least I had my laptop and could get some work done on impending deadlines while Husband had the kids.
Or so I thought.
But then I ran into one of those seemingly competent and authoritative figures that were the subject of an earlier post: the Italian Bad Bureaucrat.
This particular one was a receptionist in a center for blood tests. She checked me in and told me:
R: "You can't eat, drink, or read."
R: "That's right. Absolutely no reading."
Self: "What? I have to sit here for three hours, why this uncommon form of torture?"
R (rolling her eyes like 'you moron'): "Ma'am, you are here for a glucose test. Glucose means sugar. This is a test for sugars in your blood. If you read the mental activity will metabolise the sugars and it will cause the test results to be inaccurate."
This left me in a quandary, because the waiting room had about seven seats in it all guarded by this one lady who had just told me no reading...
In an improbable but very Italian twist ending, there was another woman there for a glucose test, and she happened to be a scientific researcher in the field of blood (doing research on DNA). "Can you believe that about the 'reading metabolises the sugars' thing?" I told her. "They just made it up!" I expected someone who was an expert in the field to be even more indignant than I was, and maybe even to go set the record straight. But instead, like all Italians when it comes to the flagrant abuses of the State, this one laughed and said, "Yeah, they totally made it up."
Then she sat back and didn't read for three hours.
The Italian in Winter does not allow a fifteen foot seawall put in place to protect all the beach bars that are closed for the season to prevent them from having their aperitif on the beach on the one warm, sunny in late January...
The Italian in Winter who owns a beach bar does not allow the fact that his bar is closed for the season, or the fact that he and his waiter are going to have to haul chairs and tables up a fifteen foot pile of sand interfere with the fact that he MUST open his doors for the one warm, sunny day in late January...
It happened. I saw it. Here's proof:
Lately I took my friendship with a certain Italian Person I have known for years to the next level. Here is how it happened.
We were sitting and making small talk, when suddenly she drew her chair over closer to mine, leaned in, and took me into her confidence, asking in a half-whisper:
"But REALLY. I've always wanted to know. How DO you Americans get by without a bidet?"
I'm an American living in Italy and making gross generalizations about it.