Whenever you deposit a female loved one in a hospital, the other half is overcome by a feeling of uselessness. It's almost an affront to our masculinity. Men should be there for their wives when the going gets tough. Instead you entrust her well-being to that of total strangers, often in an ambience well below the standard of care and cleanliness she's used to at home.
Perhaps it's even worse when you deposit your heavily – about-to-burst – wife at the door of an unknown institution after nine months of excitement. Suddenly, having contributed to the situation at hand, having cared for her over the previous nine months and watched the gestation of a new life, everything is out of your hands. Yet somehow, seemingly miraculously, in a few days time that one person wandering into the hospital – waving a wistful farewell – will have a little bundle in her arms.
Most hospitals in any country are not really pleasant places, even if you opt for the highest standards of privatised pristine care. My own experience of hospitals is incredibly slender and for that I count myself lucky. Hence, until this year at least, conversations ran along these lines:
"Have you ever been in hospital?"
"Yes, to visit an elderly friend once".
We take good health for granted and like most things in life, it's only when we lose it that we realise its importance.
This year, however, brought a different experience. My 80-year-old mother fell out of bed in Portugal and almost froze to death. Turned out she either had pneumonia as a result of the fall, or maybe the pneumonia had precipitated it. She was taken to Faro Hospital in the Algarve. There, stripped of the "essentials" that my mother uses to keep the ravages of time at bay – varnished nails, manicured hands, the Mrs Thatcher hair-do – she became, perhaps for the first in my eyes, an old woman.
Suddenly there was a grey-haired granny, her voice frail and subdued, her withered hands shaking and uncertain, being fed by nurses in this impersonal environment. A woman opposite, probably at least 15 years younger and totally delirious, howled through the day and night. Occasionally the pauses punctuating the expressions of pain or frustration would be long, sometime short, but it was a continuous onslaught. Anyway, fortunately my mother recovered and is now home.
To pay or not to pay?
My wife last gave birth in a Portuguese hospital, Lisbon's Santa Maria hospital in 2005. This time, in Sofia, she opted for Sheinovo. I was a trifle worried. Three years earlier my father-in-law had been in hospital in Sofia. It turned out his illness was terminal. I have to say I was appalled at the brusque and insensitive treatment meted out to my mother-in-law during this period.
Before admission we were faced with a dilemma. A paediatrician friend of the family had recommended a particular doctor at this hospital to deliver the little fellow. The system works as follows. If you choose the surgeon, then you pay. The sum in question was 800 leva. As in all matters financial, it appeared that we had been unlucky. The rate for choosing a surgeon had been hiked from 350 leva to the new figure of 800 the week before my wife's Caesarean was due. Apparently, following disagreements and protests, the Health Ministry had reversed its earlier decision to cap these payments.
My wife had been assured that the woman in question was extremely competent. Yet coming from the NHS in the UK , where absolutely everything is totally free at source (funded out of general taxation), I resented this strange, subterranean system. What did payment guarantee? Perhaps the question was best asked in reverse. Non-payment did not necessarily mean you were entrusting your wife to the howling wolves but the implication was that paying for a doctor ensured a smoother bedside manner and a higher standard of care.
As it turned out, the decision was made for us anyway. By the time we had finally made up our mind – and we had decided to pay – it was too late. The surgeon of our choice already had her schedule for the following week and we were not on it.
My wife shared with two other mothers, also non-paying. They were supposed to have natural deliveries but had experienced problems. They complained to my wife that the doctors had been excessively rough with them to "facilitate" the new arrival. Apparently doctors had been pressing them on their stomach and "poking" them in certain places that were, unfortunately, not as painless as the poking endured by Facebook users. Eventually they resorted to Caesareans but they emerged dissatisfied with the doctors concerned.
I make this point because my wife was actually very satisfied with her treatment, which maybe proves the point that, perhaps unlike in the UK where there is a kind of uniformity of service – in Bulgaria it's more variable. My wife spent five days in Sheinovo in total, including the night before delivery. She was given an epidural anaesthetic the morning after her admission and all went smoothly. Later that afternoon I was in the hospital to take a photo of the little fellow. I'll spare you the slush.
The main difference between the Portuguese and the Bulgarian experience was that in Lisbon, on the first night after delivery, the baby actually sleeps in the room with the mother – on a separate cot, of course, but at arm's reach. At Santa Maria hospital my wife had been left alone with the baby while recovering from the operation and the effects of the anaesthetic. In Bulgaria, the babies are kept away from the mother overnight. Then they are brought in bright and early the following morning for feeding. The nurses encourage mothers to start breastfeeding but bring in bottles just in case. My wife said that, on the whole, although she missed seeing her baby, she preferred the Bulgarian way.
When we left Sheinovo, accompanied by the little fellow, we were ensnared by a professional photographer who immediately started snapping away without any preliminary inquiries. This was a set-up and although we did not mind paying 30 leva (the fee requested for 10 quality photographs) it occurred to me that many Bulgarian parents, facing a period of austerity and rising expenses, could have done without this.
Nevertheless, mindful of the fact that I had "saved" 800 leva, I agreed and we posed happily. Nothing of the kind had occurred in Portugal in 2005 but back then my wife had been given – just like all departing mothers – a present of a delightful little basket full of baby wet wipes, skin creams, shampoos and the cutest little comb you ever saw. It was, I suppose, designed to instil in new mothers a proper standard of care on the "start as you mean to continue " basis. Portugal, I should add, is, like Bulgaria, one of the EU's poorest members. So I should imagine this must have been pretty taxing on the state budget. No such present in Bulgaria, of course.
The real world
The experience of hospitals is always a great equaliser. Irrespective of an individual's affluence, income or social status, you are all, once you have picked a certain hospital, in the same bed so to speak. We saw some well-to-do Bulgarian mothers and also some very poor Roma. Within the hospital, however, one assumes that paediatricians, surgeons and doctors will apply a rigorous standard of care to all new born babes, that small matter of the 800 leva payment notwithstanding.
Once you leave the hospital, out in the big world, suddenly income and lifestyle differentials hit home hard. I did wonder what kind of homes some of the mothers were going to.
As a postscript I should add that some of the nurses in the hospital had the usual Bulgarian to-die-for figures and kitschy style of dress and makeup. I rather like that aspect of Bulgaria, quite a contrast to the UK and Portugal where nurses and public sector workers look rather dowdy. Despite the antiquated buildings, peeling paint, the generally inadequate toilets and mediocre sustenance (my wife was encouraged beforehand to bring her own water and biscuits) life ain't so bad in Bulgaria!