So I said I'd write from time-to-time about some of the experiences from our year+ in Lesotho. We'd been there just a short while when Lorena got the call to go back to the United States for her naturalization ceremony (yay!, but great timing INS...). While she was in Dallas, Sebastian got awfully sick. There were lot of long days that month, but this was the longest...
Scarcely a month since we’d left the United States, there we were, my 18-month old son and I, searching for the tourist office in the Bloemfontein bus station, precious seconds ticking off the clock. I thought back to our goodbyes in Texas – this wasn’t exactly what my parents had warned would happen to us, but it wasn’t far off.
And what a time for my wife to be away – back in the States for her naturalization. All the years we’d gone through her citizenship process together. We’d asked them to move the date up to before we left the country. But that logic didn’t mesh with Immigration bureaucracy. So mommy was back home.
It was nearing 5PM, and the office was sure to close any minute. We were about as lost as lost can be, exhausted, reasonably filthy, a sad sight to see.
And my son was really sick.
Typically a robust picture of health, Sebastian had been stricken first with viral symptoms – a fever, some congestion, a bit of vomiting. But things had taken a turn for the worse the day before, when his fever wouldn’t come down, and he started having trouble walking. When that night he became unable to stand, I called my neighbor in panic. A fellow American expat physician, working as I was with the Pediatric AIDS Corps (Baylor International Pediatric AIDS Initiative) in Lesotho, she came to the house and looked Sebastian over. Probably just a viral illness, a bit more aggressive than typical, but we both felt he needed to get to the hospital. The nearest one well-equipped was over the border in South Africa’s Free State, a two hour drive to Bloemfontein.
Feeling it not safe to make the journey in the dark, we waited until daybreak. One thing after another slowed us down, and it was early afternoon before we were able to get a ride.
We’d been to Bloemfontein a couple of times already on short weekend shopping trips, stocking up on the sorts of things needed by a family with a one-year old relocating to Lesotho. I’d seen many guest houses and lodges, even a few hotels. It would be easy finding a place. My director in Lesotho had called a colleague in Bloemfontein. He had a busy schedule, but would see Sebastian in the casualty department after he finished his day, sometime around 7PM. We’d find a place to put up, in case he wasn’t admitted, then make our way over to see the doctor.
I knew nothing at the time of the fanatical hold in which rugby holds the South African nation, particularly the denizens of the Free State. Evidently, there was a major Cheetahs (the local professional team) match the next day, and every accommodation was fully booked. A big match, too, at the state university.
I’d learn to scour the calendar in the future, watching for such times, planning our family outings to the Mimosa Mall around them.
But I hadn’t learned that at this point, so Sebastian and I trudged from lodge to lodge, receiving the polite “sorry, but no” at each. Many curious scratches of the head – didn’t I know about the game?
Finally, I think the combination of Sebastian’s pitiful face and my desperation egged a proprietor to make a kind suggestion. Look, there’s nowhere to stay in town. But there’s a tourist office in the bus station. Be careful walking over there, but perhaps they can help you out. Sometimes a lodge will call in late with an open room. Its worth a look.
But where was that office? We’d made three rounds of the station, and it just had to be closing time soon. My heart was sinking, thinking of a possible nighttime ride back to Lesotho. Or worse.
We decided to go down to the basement. A light radiated from behind some construction materials and we approached. Poked our heads in, and there it was.
But, indeed, it was closing time. Halfway between her desk and the door as we walked in, handbag in grasp, an older lady with a stern disposition looked over the top of her spectacles at us.
Can I help you sirs?
I’m so sorry, I know you’re about to close, but…
I told her the story. And she looked at Sebastian.
Please have a seat. Let’s see what we can find.
I can’t say that I understand Afrikaans, but I think I caught enough of a very long conversation between this very sweet woman and the party on the other end. She begged, she cajoled, she reassured the other woman we’d be fit as guests. And the little boy, you just have to see him…
Its done, she said. One of the lodges has a room in the back. It’s a very small room, they use it for their visiting family. But you can have it for tonight.
Thank you, thank you, thank you, and I picked up Sebastian to leave.
No, she said, snatching Sebastian, I’ll take you myself.
And she did. The room was perfect, all we needed. We’d be set for the night.
She smiled as she walked off, then conversed with the lodge owner. They both looked at us shaking their heads and shrugging. Poor little boy, his father has taken him so far from home…
The hospital was a short walk, and we made it to casualty just as the clock ticked 7. Doctor would soon be here, the nurse said, let’s get you checked in.
Strangely, as the day had gone along, Sebastian had been slowly getting better (of course, your child always does when you make a daylong trip across the Free State and almost end up sleeping rough). He was smiling, and wanting to play. The nurse had to settle him down.
About 8 o’clock, the doctor walked in the room. He was clearly tired, at the end of a long day. But he couldn’t have been nicer, or more thorough with Sebastian.
He took a full history, examined him head-to-toe. Sebastian had a bit of residual wobbliness, and had just broken out in a fine, red rash, seemingly as we were sitting there.
Baby measles, he told me, roseola. We see an aggressive strain here, worse than you see in the States. Sometimes with a meningitic or almost encephalititic picture, as Sebastian had had. Occasionally have to admit children to the hospital with it. But your son will be well in a couple of days.
We’ll let you go home. Do you have somewhere to stay? Good to hear.
Bring him by my office in the morning for another check. If he’s better, you can go back to Lesotho.
He took a minute to ask about the condition of the medical profession in the States. Many of his colleagues were there now, and in Canada, Australia, and the UK.
He nodded affirmingly as I went over some of the good and the bad. We’re having our troubles here, too, he said. Things aren’t as they used to be.
He told me about all he and his colleagues, the ones still in Bloemfontein, do in their daily work – lecturing at the medical school, taking turns covering as attending on the extensive public services in town, keeping up their private practices.
Its getting tougher each year to do, he said. There are more and more changes being imposed, new policies, concerns over the quality of education new physicians are receiving.
Then he smiled – what can we do? He stood up to leave. The nurse brought Sebastian’s clothes and wished us good night.
What about a bill?
Nobody had asked me for anything. There had been no papers to fill-out, no forms to sign, no impression of one or more credit cards taken. I’d just used a room at the casualty department, and an hour of a nurse’s and doctor’s time. It was nearly 9PM.
No worries, he told me. You’re coming by the office tomorrow. You can settle up then.
By this time, in the States, I would have forfeited every last piece of my personal identifying information, and at least a couple of forms of payment. Whatever “co-pay” I would have owed on my insurance would have been collected prior to seeing the doctor, and not necessarily politely.
And if I had no insurance, I wonder if I would have gotten anywhere near this far. Quite frankly, most of my countrymen in such straits don’t.
The nurse smiled, then went back to work. And the doctor, finally, headed home.
I dressed Sebastian quietly, somewhat embarrassed. Happy he was fine, but more than a wee bit melancholy.
As we rush into the future, our medical systems and culture increasingly distancing patient and physician, with all we feel we’re gaining with standardization and quality assurance, reams and reams of rules and regulations, mountains of paperwork, and dictates for seemingly everything – with all we think we’re gaining, how much, indeed, have we lost?
When was the last time I’d seen a patient examined before their method of payment?
When was the last time I, personally, had so cheerfully and thoroughly evaluated a patient, without regard to time, much less agreed to meet at 8 o’clock after a long day?
How many of my colleagues back home would have seen Sebastian like this, on a handshake promise of being paid? How many times had I done something similar?
And never mind how would lost travelers, particularly foreigners like us, be treated back home? Our reputation for friendliness and open arms – pride of our schoolteachers when we were kids – seems just another distant childhood memory.
Alas, we left the hospital and returned to our room. In the morning, after checking-in with the doctor, we went to the airport to catch a flight to Johannesburg.
And what a time for my wife to be away – back in the States for her naturalization. All the years we’d gone through her citizenship process together. We’d asked them to move the date up to before we left the country. But that logic didn’t mesh with Immigration bureaucracy. So mommy was back home.
It was nearing 5PM, and the office was sure to close any minute. We were about as lost as lost can be, exhausted, reasonably filthy, a sad sight to see.
And my son was really sick.
Typically a robust picture of health, Sebastian had been stricken first with viral symptoms – a fever, some congestion, a bit of vomiting. But things had taken a turn for the worse the day before, when his fever wouldn’t come down, and he started having trouble walking. When that night he became unable to stand, I called my neighbor in panic. A fellow American expat physician, working as I was with the Pediatric AIDS Corps (Baylor International Pediatric AIDS Initiative) in Lesotho, she came to the house and looked Sebastian over. Probably just a viral illness, a bit more aggressive than typical, but we both felt he needed to get to the hospital. The nearest one well-equipped was over the border in South Africa’s Free State, a two hour drive to Bloemfontein.
Feeling it not safe to make the journey in the dark, we waited until daybreak. One thing after another slowed us down, and it was early afternoon before we were able to get a ride.
We’d been to Bloemfontein a couple of times already on short weekend shopping trips, stocking up on the sorts of things needed by a family with a one-year old relocating to Lesotho. I’d seen many guest houses and lodges, even a few hotels. It would be easy finding a place. My director in Lesotho had called a colleague in Bloemfontein. He had a busy schedule, but would see Sebastian in the casualty department after he finished his day, sometime around 7PM. We’d find a place to put up, in case he wasn’t admitted, then make our way over to see the doctor.
I knew nothing at the time of the fanatical hold in which rugby holds the South African nation, particularly the denizens of the Free State. Evidently, there was a major Cheetahs (the local professional team) match the next day, and every accommodation was fully booked. A big match, too, at the state university.
I’d learn to scour the calendar in the future, watching for such times, planning our family outings to the Mimosa Mall around them.
But I hadn’t learned that at this point, so Sebastian and I trudged from lodge to lodge, receiving the polite “sorry, but no” at each. Many curious scratches of the head – didn’t I know about the game?
Finally, I think the combination of Sebastian’s pitiful face and my desperation egged a proprietor to make a kind suggestion. Look, there’s nowhere to stay in town. But there’s a tourist office in the bus station. Be careful walking over there, but perhaps they can help you out. Sometimes a lodge will call in late with an open room. Its worth a look.
But where was that office? We’d made three rounds of the station, and it just had to be closing time soon. My heart was sinking, thinking of a possible nighttime ride back to Lesotho. Or worse.
We decided to go down to the basement. A light radiated from behind some construction materials and we approached. Poked our heads in, and there it was.
But, indeed, it was closing time. Halfway between her desk and the door as we walked in, handbag in grasp, an older lady with a stern disposition looked over the top of her spectacles at us.
Can I help you sirs?
I’m so sorry, I know you’re about to close, but…
I told her the story. And she looked at Sebastian.
Please have a seat. Let’s see what we can find.
I can’t say that I understand Afrikaans, but I think I caught enough of a very long conversation between this very sweet woman and the party on the other end. She begged, she cajoled, she reassured the other woman we’d be fit as guests. And the little boy, you just have to see him…
Its done, she said. One of the lodges has a room in the back. It’s a very small room, they use it for their visiting family. But you can have it for tonight.
Thank you, thank you, thank you, and I picked up Sebastian to leave.
No, she said, snatching Sebastian, I’ll take you myself.
And she did. The room was perfect, all we needed. We’d be set for the night.
She smiled as she walked off, then conversed with the lodge owner. They both looked at us shaking their heads and shrugging. Poor little boy, his father has taken him so far from home…
The hospital was a short walk, and we made it to casualty just as the clock ticked 7. Doctor would soon be here, the nurse said, let’s get you checked in.
Strangely, as the day had gone along, Sebastian had been slowly getting better (of course, your child always does when you make a daylong trip across the Free State and almost end up sleeping rough). He was smiling, and wanting to play. The nurse had to settle him down.
About 8 o’clock, the doctor walked in the room. He was clearly tired, at the end of a long day. But he couldn’t have been nicer, or more thorough with Sebastian.
He took a full history, examined him head-to-toe. Sebastian had a bit of residual wobbliness, and had just broken out in a fine, red rash, seemingly as we were sitting there.
Baby measles, he told me, roseola. We see an aggressive strain here, worse than you see in the States. Sometimes with a meningitic or almost encephalititic picture, as Sebastian had had. Occasionally have to admit children to the hospital with it. But your son will be well in a couple of days.
We’ll let you go home. Do you have somewhere to stay? Good to hear.
Bring him by my office in the morning for another check. If he’s better, you can go back to Lesotho.
He took a minute to ask about the condition of the medical profession in the States. Many of his colleagues were there now, and in Canada, Australia, and the UK.
He nodded affirmingly as I went over some of the good and the bad. We’re having our troubles here, too, he said. Things aren’t as they used to be.
He told me about all he and his colleagues, the ones still in Bloemfontein, do in their daily work – lecturing at the medical school, taking turns covering as attending on the extensive public services in town, keeping up their private practices.
Its getting tougher each year to do, he said. There are more and more changes being imposed, new policies, concerns over the quality of education new physicians are receiving.
Then he smiled – what can we do? He stood up to leave. The nurse brought Sebastian’s clothes and wished us good night.
What about a bill?
Nobody had asked me for anything. There had been no papers to fill-out, no forms to sign, no impression of one or more credit cards taken. I’d just used a room at the casualty department, and an hour of a nurse’s and doctor’s time. It was nearly 9PM.
No worries, he told me. You’re coming by the office tomorrow. You can settle up then.
By this time, in the States, I would have forfeited every last piece of my personal identifying information, and at least a couple of forms of payment. Whatever “co-pay” I would have owed on my insurance would have been collected prior to seeing the doctor, and not necessarily politely.
And if I had no insurance, I wonder if I would have gotten anywhere near this far. Quite frankly, most of my countrymen in such straits don’t.
The nurse smiled, then went back to work. And the doctor, finally, headed home.
I dressed Sebastian quietly, somewhat embarrassed. Happy he was fine, but more than a wee bit melancholy.
As we rush into the future, our medical systems and culture increasingly distancing patient and physician, with all we feel we’re gaining with standardization and quality assurance, reams and reams of rules and regulations, mountains of paperwork, and dictates for seemingly everything – with all we think we’re gaining, how much, indeed, have we lost?
When was the last time I’d seen a patient examined before their method of payment?
When was the last time I, personally, had so cheerfully and thoroughly evaluated a patient, without regard to time, much less agreed to meet at 8 o’clock after a long day?
How many of my colleagues back home would have seen Sebastian like this, on a handshake promise of being paid? How many times had I done something similar?
And never mind how would lost travelers, particularly foreigners like us, be treated back home? Our reputation for friendliness and open arms – pride of our schoolteachers when we were kids – seems just another distant childhood memory.
Alas, we left the hospital and returned to our room. In the morning, after checking-in with the doctor, we went to the airport to catch a flight to Johannesburg.
Mommy was coming home!
Epilogue
Sebastian and I became rugby fans, and even now, back in the States, still are. We root over the internet for the Free State Cheetahs, and, I must disclose, even snuck into a British bar here in Houston (the only place we could find the game on) to watch the World Cup Final recently.
Sitting quietly in the back, trying hard to keep our celebration unnoticed, I raised a beer, and he a chocolate milk, technically to the Springboks, but, really, to the doctor who became my son’s pediatrician, and nursed him through a more serious hospitalization a few months later.
To the people of Bloemfontein who took care of us when we were in need.
To hospitality and gentle manners.
And to a way of taking care of patients that lives on, having found a way, for the moment, of eluding extinction.
