Some 20 years ago, at the start of the Health Reform, we citizens were called upon to choose a GP. I was very busy and saddled my wife with the task. As soon as I retired, my conscience started gnawing at me that I'd taken one of my fundamental civil rights rather lightly.
Most of my peers had become active on all sorts of public issues, whereas I still considered that a risky pursuit, even though, as a former lawyer, I shouldn't have had to worry about anyone easily pulling a fast one on me. I decided to check up personally on our personal doctor.
Stalin himself is supposed to have said that checking up is the highest form of trust – today's Zero-trust.
However we dress it up or hide it behind terminology, it's clear that checking up is plain mistrust.
The name of our GP had been hanging for ages next to our health insurance booklets on our "Miscellaneous" board – Dr Kamenov.
My wife and I had never visited him and hadn't seen what sort of goods he was when either of us was ill. I began with a review of the current state of our Healthcare. On Google I found out that the GP was the first rung of the system. He navigated /I'd thought – like a GPS/ his patients, when needed, to specialists at an MBAL /Multi-profile Hospital for Active Treatment/, if he couldn't sort them out at his DKTs /Diagnostic and Consultative Centre/, which replaced the polyclinics where, when I was young, the old folk took their samples for testing and had their blood pressure measured.
The National Health Insurance Fund /NZOK/ apparently paid the MBAL for the procedures carried out on you. In my opinion, under the free healthcare we had rejected as inefficient, it made no difference, but now, with our monthly Health Insurance contributions, it turned out we'd even be quids in if we went to the MBAL with a referral often.
I stopped reading and pondered the term Personal doctor. I had to stifle a laugh at the thought that in the old days the prettiest girl in the village was said to be the most Personable lass. Perhaps Dr Kamenov was the most personable one in our DKTs, tee-hee, and that evening I fell asleep in rather high spirits.
The next day I was perfectly serious and got to thinking. In my view, your Personal doctor ought to know at least something of your family tree – the anomalies and hereditary burdens in it.
It would come as no surprise if, in the ultra-technological 21st century, his database also held information about my great-grandmother Pana, famous in our neighbourhood for being addicted to cigarettes and for running two shops while knocking back little glasses of rakia. All this while my great-grandfather Dimitar was grazing their herd of cows. He, for his part, was a total teetotaller. In the neighbourhood people called our family Pana's lot, not Dimitar's.
I was set on seeing the doctor by appointment, which would give us the chance to get to know each other at leisure. I wanted to share with him my observation that I took after great-grandmother Pana, with all her vices, while my brother took after great-grandfather Dimitar and his puritanism, and for the two of us to mull it over a bit together.
I realised this was an overly maximalist scenario, but it would certainly have meant what mattered most to me – that the doctor was humane and sociable, and a top mark would have been in the bag for him. I'd also prepared a gloomy scenario – if he behaved carelessly and rudely, I'd fly off the handle:
"Doctor, as of tomorrow consider yourself dismissed as my personal doctor! Hand over my entire 'file' at once! I am a former lawyer and I know the law very well. I wouldn't advise you to mess me about, nobody has ever managed it so far!"
For the in-between scenarios I planned, should anything in his behaviour or the nurse's not be to my liking, to put them in their place immediately.
Booking an appointment with the GP was done through the "Superdoc" portal. The first free slot was in 25 days' time, which struck me as a clear sign that he was rather competent, and I confirmed. The day before the appointment, Superdoc reminded me by SMS. To me it was unnecessary, but evidently our Healthcare system was now standing firmly on its own two feet.
On the day in question I set off for the nearby DKTs, determined to conduct the test slowly and methodically. On the way I fine-tuned minor details – my steps as I walked in to see him, the timbre of my voice, my facial expression, type of smile, etc. On the doctor's desk there was a large sign: "User fee – 2.90 leva." The nurse pointed it out to me with eyes like indicators. I swallowed my question: "But surely the Health Fund…" I paid up like a lamb, not like a lawyer.
She sat down behind the computer, stared at the screen and started questioning me about my personal ID number, first name, surname, sex, nationality, citizenship, chronic illnesses and so on.
To keep my end up, I asked her without malice: "Excuse me, but I've been your patient for 20 years and three months, and you ought to have these things in your database."
She answered a little crossly:
"They've given us new software and we've had to upload the whole database again."
I threw in, to help her loosen up a bit:
- "And do I have to answer about my sex too?"
- "That's the form, sir!"
The doctor, instead of listening intently to my answers and taking notes, was studying his fingernails, as though my wife had just remarked that, like mine, they weren't entirely clean and that she didn't care for men like that one bit.
His phone rang. I expected: "I can't talk. I have a patient right now," but he started nattering away. I had the feeling he wouldn't even let the caller get away just like that.
The nurse didn't let up with her questions to me. Every now and then she'd ask him too – whether to put this in this box or the next one. He wasn't sure either and would answer her: "No, not here, further down /further up/" or: "Oh, whatever – sod them," after which he'd shoot me a brief reproachful look, as if I were the author of this idiotic crossword. With his help, in a mere 12 minutes she entered everything into the boxes on the screen. Every now and then she'd roll her eyes upwards and was clearly applying the "eeny-meeny-miny-mo" method. At one point she huffed and hit "Enter" hard.
Kamenov wrapped up his conversation "in a hurry" and asked me: "What are you here for?", which reminded me of Smirnenski's line: "I know not what I was born into this world for…", but I didn't continue the verse out loud, merely mumbled politely:
"Well, I…. just to get acquainted, seeing as I'm a long-standing patient of yours…."
"By law you're entitled to a free preventive check-up once a year. Now we'll do an ECG."
He pointed to the couch and asked the nurse whether she wanted a coffee. He was out of the door before he'd even heard my little joke that I'd like one too, or my remark: "But what's so free about the check-up, when 'your nurse' took 2.90 leva off me at the door?"
I'd meant that as a delicate invitation to "break the ice". The nurse festooned me with electrodes and started fiddling with the cardiograph. Something didn't seem to be working, and she kept saying: "Tsk-tsk-tsk." At one point she sighed: "At last!", but I couldn't tell exactly what she meant – the machine or the doctor, who had just burst in with two coffees.
The cardiograph started spewing out paper. The nurse picked the electrodes off me like baubles off a Christmas tree and sat down to drink her coffee.
It was a convenient moment to hint that I was no mug, by mentioning that by law I was also entitled once a year to blood and urine tests and to a test for "occult bleeding" in my stools, as it said on Google. And to ask what on earth that was, because it frightened me. After which, one thing leading to another, we'd get round to my hereditary burden from my great-grandmother Pana.
I decided to wait for them to finish their coffee in peace, but soon I began to have the feeling that it was going to turn out the same as when I was a lawyer.
The judge always adjourned the case because a witness hadn't been properly summoned, or because of the absence of the plaintiff or the "complaintiff", long before we ever got to the brilliant closing speech I'd spent ages preparing. And that's exactly what happened now. The GP folded up the ECG and told the nurse to put it in a folder.
She started fussing: "Folder – folder – where are the folders – ah, yes, here they are!"
She went looking for a marker: "Marker, marker – where have I put those now – ah, here they are!"
Just as she was about to write something with it, the screensaver decided to have a laugh at her expense. She wasn't one of those who ask their boss about every little thing, and she revived the screen herself – with her elbow, I think – and started repeating my file number to herself, just in case – 565-397. I still remember it myself, also just in case.
In my view, the time had come for the doctor to prove that the stethoscope round his neck wasn't merely decorative and to listen to my chest with it. He seemed startled by my thoughts and made me lift up my jumper.
In our old polyclinic the elderly doctor would tap on my chest for ages and make me breathe deeply or else hold my breath. Perhaps he was hard of hearing, but this doctor heard what interested him straight away, and I waited tensely for his verdict, which was not long in coming:
"That coffee from the machine downstairs – they've gone and buggered it up!"
The nurse took up the subject. I couldn't join in, since I hadn't drunk any of that coffee. I felt hurt that to them I was just a box in the database and that I was probably surplus to requirements here by now. Just as I was opening my mouth to say my piece, the doctor stared long at his watch, as if he'd only just bought it, and finally pronounced in the voice of the Tsar Liberator:
"You are free to go!"
"Excuse me, but you haven't said anything about my health."
"And you haven't complained about anything." After a moment he added wearily:
"Your ECG is fine, considering your age."
"And what's my blood pressure?"
"It's all in your file. And it's more or less normal."
"Er-erm… In your opinion, what would be the most useful thing I could do for myself?"
"Come back again in a year."
I hummed something like "goodbye" and slunk out. At first my feelings were like a storm-and-thunder scene in a horror film.
Yet again I hadn't said the right thing to the right person at the right time. I calmed down a little at the thought that at least I now knew what my personal doctor looked like. Little by little I began to pay more attention to nature.
The birds in the trees were giggling away without giving a hoot about the Healthcare system. Just as well they hadn't heard my thoughts of a moment ago – they weren't fit for their ears. The sun peeped out from behind the clouds to remind me that the trees were already in bud, as were the colourful little miniskirts striding about among them.
It seemed out of place to think negative thoughts. Before the spring, even the gods ought either to keep quiet or say only pleasant things.
Bulgaria is chock-full of natural beauty, pretty women included. Maybe we Bulgarians ought to live somewhere without these extras for a while, to sort our lives out better – but then what sort of life would that be?
I decided to paraphrase the Shopi motto: "Wha' for should I fret come springtime, when it'll pass anyhow?" Resignedly, I summed up that both the doctor and I had simply been looking after our peace of mind, i.e., in the words of Aleko Konstantinov, we were rascals.
My GP test had ended in a draw. After the storm in my teacup, the water was at the halfway mark. I left it to decide for itself whether it was half full or half empty.
Once again I'd shown my old weakness – having unrealistic expectations before everything.
Life is as it is, not as we want it. And we are not as we want to be, but as we really are. Still, it was better to dream than to grumble. Today I'd done a good job.
