Let me preface this tale by reassuring you that the medical facilities our family will be going to for routine care will be FAR different and much more on par with US medical facilities than what we experienced for this exam. If we happen to have a life-threatening or serious medical condition develop, our medical insurance here pays for us to be evacuated to Europe or the US.
So...let's start at the beginning. Our driver, Younes, dropped us off a little early at the appointment, so we decided to pass the time with a coffee break at a nearby cafe. Most Moroccan cafes are dominated by men, so the scene looked something like this:
We ventured into one of these typical, male-dominated cafes and were pleased we didn't draw too many stares. I had a cup of café allongé (the closest to American coffee I've found here). Afterwards, we sauntered over to the doctor's office, which was labeled with a teeny sign about the size of my hand that was barely noticeable from the street. Our husbands had been to the same office about two weeks earlier and drove back and forth multiple times before finding it. We were amazed that our driver had found it on the first try!
Anyway, we walked up a flight of stairs to a little entryway, where a man with two thumbs on one of his hands was standing at a small desk. He motioned for us to sit in the waiting area, just beyond the foyer. We sat. And sat. Waiting is part of the Moroccan experience. I've learned that by now! We chatted for a quite a while, getting to know one another better. I noticed the time. It had been 45 minutes already. I noticed an array of magazines haphazardly strewn on the coffee table, including several issues of the Moroccan medical journal of nephrology (I would have never guessed such a journal existed!) among other things, all written in French. I noticed the unusual decor - bright purple trim and matching painted light fixtures paired with almost fluorescent green vinyl couches that looked like they had been there since the '70s. After about an hour, a man whom we assumed was the doctor, came running into the office, huffing and puffing. He was clearly flustered, was out of breath, and had sweat dripping from his brow. Within a few minutes, he waved us into the examining room. All three of us, together in the same room. HIPAA laws don't apply here! :-)
We were led into an examination room. It became evident that sanitation was not a priority. All kinds of medicine bottles, tongue depressors, cotton swabs, plastic models of the human heart, drug advertisement brochures, and you name it was piled upon a table in the room.
On closer examination, I saw some sort of a used cotton swab lying on top of the pile, covered with some sort of yellowish substance. I glanced over at the examining table and saw some ancient-looking electrical medical equipment. I had no idea what it its purpose was.
After a quick introduction, in French, he angrily asked where we had been for our appointment on Monday. Fortunately we had a native French speaker along with us, Marie, and she was a huge help to us with translating back and forth during our visit. Marie seemed confused, as did we, about what he was talking about. There had been no appointment scheduled on Monday. Perhaps he was trying to use this as an excuse for his late arrival? Not sure.
Next he told us he studied medicine in Germany. He proudly showed us a faded picture of himself as a much younger man, standing with a group of about 10 people that was framed and hung on the wall of the exam room. He went on to tell us about some of his fellow interns in the picture, something about a woman from Russia, a man from India, and then he found out that Marie also speaks German. His face immediately lit up. From that point on, he used a mix of German and French to converse, clearly excited to have someone with whom he could practice his rusty German.
Then the exams began. Chris was the first one to go. She hopped up on the table, which looked like this:
The doctor began to ask her a series of random questions, such as: Where is your family from? Do you or anyone in your family have diabetes? How many children do you have? Are you still having your period? He then checked her blood pressure and knee reflexes.
Marie and I were standing on the side of the room, clearly uncomfortable with the lack of privacy. Then I heard the doctor undoing Chris' belt buckle of her pants, and I almost lost it. What in the world is he doing? I couldn't help buy wonder. Shocked by the lack of privacy and what might happen next, I almost burst out laughing from how ridiculous the situation was from my frame of reference as an American. I looked over at Marie, and she turned away and faced the wall, covering her mouth. I bit my tongue and looked away, not wanting to see what might happen next. It turned out he was only palpitating Chris' abdomen. As Chris later said, maybe he wanted to see if my ovaries were still there?!
Next it was Marie's turn. He again took her blood pressure and checked her reflexes. He felt her pulse. He commented on how slow her heart rate and low her blood pressure was. He told her he would need to have her take a blood test. Remember, this was a medical exam to see if we should be granted residency in Morocco. What in the world does blood pressure and heart rate have to do with that? Besides, having a low heart rate and blood pressure is generally thought to be a good thing. Marie is very athletic.
My turn. I looked over at my two comrades and gave a deep sigh. He did very little checking on me - just my blood pressure, heart rate, and reflexes. He asked if I had diabetes in my family. Did I play sports? Do I have children? Where is my family from? When I mentioned my grandfather had immigrated from Germany to the US, he again lit up.
"Where in Germany?" he asked. "Hamburg," I answered. "Most Americans come from Düsseldorf," he said. Hmmmm...I thought. That's news to me! :-)
After our exams, he showed us into his office in the next room. We sat by his desk and were amazed by the mess. Papers, drug samples, plastic anatomical models, old medical textbooks, advertisements from drug companies, and much more all lay in a mess across his desk, bookshelves, and tables. I wondered what would be next.
I had a strong desire to go to the restroom to pee, but I was holding it after Mike told me that he had to do a urine test to check for drugs. I didn't want to empty my bladder prematurely!
The doctor came into the office and sat behind his desk. He took out a pad of paper and asked for our passports. He began scribbling a message on the pad, copying our names down. Good, I thought. Looks like this is almost over! I really have to pee!
The doctor talked to Marie. "I have to get a blood test because of my heart rate and blood pressure," she informed us. More talking. "Oh, and my Vitamin D level. He thinks it's low," she said.
Then he picked up the phone and called someone, talking in a mix of Arabic and French. Later we found out more. "It looks like we all three have to get a blood test," she informed us. "Apparently he thinks we all need to have our vitamin D levels checked."
What?! I thought. We all looked at each other in disbelief. You've got to be kidding me! What in the world does this have to do with getting a residency permit? Not wanting to create waves and further slow down this lengthy process, I went along with it.
I asked Marie if we were going to have to do a urine test. She asked the doctor. Apparently not. I excused myself to the restroom, and this is what I saw:
I used a Kleenex as a barrier between my hand and everything I touched. Unbelievable that this is inside a medical facility!
When I went back to the office, a woman in a lab coat had entered the room. She must be the phlebotomist, I thought. She led each of us, separately this time, back into the examination room. She had trouble getting the needle into Marie's vein, squirting blood all over the place. Yuck. After a few minutes of clean up, it was my turn. I was surprised to see the technician had everything in a medical kit. I was unable to determine whether everything was sterile, but I thought that surely Chris and Marie would have already complained if it wasn't. I look away at the smell of alcohol to sanitize my skin. I felt the prick of the needle and a wave of nausea came over me. I'm usually pretty tough with blood draws, but the lack of cleanliness of the facility and the strong emotions of the experience made my stomach turn. Was I going to throw up? No, but I definitely felt queasy and light headed.
I carefully returned to the office room and sat down. The doctor wrote more on some papers. 200 dirhams each for today's office visit. We paid. Could we have a receipt? More writing. It will be another 1200 dirhams for Marie's blood test (more involved) and another 600 for Chris and me. We told him we would have to pay later. He agreed.
Glad to have this ordeal behind us, we left he office, walking by the waiting room as we left. I saw patients waiting. I couldn't help but wonder what their ailments were and feel worried about their well being in such a facility. This is commonly the case for developing countries, I know. Having experienced it myself, I felt a wave of gratitude for the medical care I am privileged to enjoy.
We promptly walked out of the building, and I felt the collective sigh of all three of us. The relief was palpable. That's one experience I was very glad to have behind me!
