How I Navigated the Italian Health Care System

By Forrest Murphy

By the tenth day of my study abroad trip to Urbino, I had been forced to seek medical attention three times. I was in a clinic, a doctor’s office and the emergency room of the Urbino hospital.

Despite possessing an almost complete lack of knowledge regarding how to speak Italian, I eventually made a full recovery and was able to experience everything Urbino has to offer. By sharing my story, I hope to provide everyone studying in Urbino a way to navigate the health care system and avoid the anxiety that I experienced when I realized I was half the world away from home and needing the help of others unlike myself.

My first day of class at the University of Urbino, I sat down in a chair by the window, hoping to catch a breeze to offset the lack of air-conditioning in the room. One of my journalism professors, Dan Malone, then proceeded to start taking a seat next to me when I noticed a spider in his chair. I briefly stood up to point out the arachnid to him and subsequently went to sit back down when I missed the seat, falling to the ground as my back scraped against the edge of the wooden chair.

The pain felt as if I had gashed open my back as I dashed outside the classroom, clenching my fists in pain. My professor followed me out of the room and quickly took me to the University of Urbino’s Lingua Ideale office. Daniele Gramolini, chief executive officer of the study abroad spinoff, accompanied me to a local health clinic.

When we arrived, Gramolini walked up to the front desk and proceeded to convey, in Italian, what I assumed was my identity and what had happened. The two of us were immediately taken back to one of the physicians present where I was examined as Gramolini told the doctor about my accident.

The doctor explained to Gramolini, who in turn translated to me, that I had suffered a superficial abrasion on my back. This was news I could live with, as I had earlier believed I had completely cut open my back. I was bandaged and advised to not take a shower for two days (potentially the worst news I could receive) as to not aggravate the injury.

I made a full recovery, but this was only the beginning.

Three days into my stay in Urbino, I felt an all-too-familiar scratchiness in my throat, a harbinger of things to come. I knew strep throat was hijacking my body and I had always been helpless to stop this kind of attack on my own. I attempted to find one of the University of Urbino’s translators to come with me to a local health clinic, but wanting to start treatment as soon as possible, I headed out toward the clinic before any of the university’s staff had arrived for work that day. I knew I would be alone, but nothing was going to deter me from seeking treatment while I was trying to enjoy by far the most scenic landscape I had ever personally laid eyes upon.

I arrived at the clinic that third morning at 8 a.m. with U.S. passport and proof of health insurance in hand, as healthcare providers in the United States commonly ask patients for that as soon as walking in the door. However, I was asked for neither. (This was a welcome surprise to me as an American.)

I later learned from Dr. Marilyn Robitaille, director of International Programs & Study Abroad at Tarleton State University, that this was because healthcare in Italy is socialized and that the European Union health insurance plan had been extended to me through the university’s insurance for study abroad students.  She stressed, that insurance through my university’s study abroad program is essential for students traveling in foreign lands.

“There are aspects of coverage included in the system insurance that are not included in local insurance,” she said.

I proceeded to “play a game of charades” with the secretary at the clinic’s front desk as I made various visual efforts with my hands and kept repeating the words “studente americano” and “medico” to try and establish who I was and that I promptly needed a doctor as I was certain I had contracted strep throat. I believe she understood that I needed a doctor, less because of my visual cues and broken Italian speech but because I’m certain I looked as sick as I felt. She handed me a bright, neon orange colored cue card with a “2” on it and directed me to a waiting room.

There was one other individual in the waiting room, an elderly woman who had an equally brightly colored cue card with a “1” on it.  I assumed that she would be seen by the present physician first, and then I would be called in after. After 20 minutes of pretending to read an Italian architecture magazine when in reality I was just staring at the pictures inside, I began to wonder when I was going to be seen. The elderly woman in front of me was never called to see the doctor, but had disappeared from the waiting room all the same.

After an additional five minutes of waiting I stood up and walked down the hall to a door marked by a nameplate with a moniker I don’t remember except for the fact that the abbreviation “Dr.” preceded it. I opened the door, where a silver haired doctor waved me in. The elderly woman who had been in front of me was nowhere to be found. I realized in this moment that patients in Urbino are supposed to pay attention to the actual doctor’s office as they are not called, but rather let themselves in as soon as the patient in front of them leaves.

I said a half-hearted “Buongiorno” and sat down. The doctor asked me a question that I interpreted as him asking me what was wrong. I grabbed at my throat and cringed as I swallowed, and then placed my hand upon my forehead and used my other to fan my face as to indicate I had been dealing with a fever. This proved to be enough as the doctor swabbed my throat and spoke the words in English, “strep throat.” He pulled out a prescription form and wrote down the name of an antibiotic that I recognized as “Augmentin,” which I had taken to treat bouts of strep throat in the past. He also drew on the prescription a picture of a pill under a shining sun and an additional pill under a crescent moon. I understood that he was telling me to take one pill each morning and one each night before bed. He then smiled and politely waved me out as I felt a sense of good fortune for receiving a correct diagnosis from a doctor who did not speak my own language.

From here I walked roughly half a mile up the road, gripping my prescription sheet as if it was my golden ticket to restoring my study abroad experience to its former glory. I reached a local pharmacy I had passed on my way to class each morning, one of several either in or near Urbino’s city center. This part of my experience with the Italian healthcare system was welcomingly straightforward. I walked in to the pharmacy and handed the pharmacist my prescription sheet without having to explain anything. She returned with my antibiotics as well as a bill for 10 euros. I was taken aback by how cheap the drugs were as well as the complete lack of wait time.

My road to recovery had begun. Or at least I thought.

Nine days into my trip, I collapsed outside my classroom from a shortness of breath and was taken to the hospital emergency rom.  This is where my experience with the Italian healthcare system took a sour turn.

I had my vital signs measured quickly enough upon my arrival and then was released from the observation room. Directed to a small, opaque colored waiting room, capable of holding probably no more than 20 people, I felt a sense of anxiety and unfamiliarity creeping up on me after six hours of waiting for answers. It’s not that I hadn’t grown accustomed to long waits inside hospitals in the United States; I was just used to waiting in large waiting rooms with air conditioning and a look and feel of modernity to them, all of which were absent in the Italian hospital.

Anxiety evolved into fear when I finally was seen by doctors. In a foreign land, especially a hospital where no one speaks your language, every word uttered by medical staff sounds like a potential death sentence.  When I attempted to ask questions about my condition, I was repeatedly talked-over by medical staff or received a look of incomprehension. At this point, my fear and weariness was coupled by growing frustration. I believed that I had been diagnosed with a worse medical condition than I actually had and that I was going to be given experimental drugs to combat it.

In reality, I was diagnosed with inflammation of my pericardium, a double-walled sac which holds the heart (a common ailment my Italian doctors told me, and not as serious as it sounds). My prescribed “experimental” drug? Ibuprofen, a common anti-inflammatory drug I had taken countless times in the past for minor health issues.

The day as a whole was overwhelming, exhausting, and terrifying. My only saving grace from having a complete mental breakdown was having my journalism professor Dan Malone and Daniele Gramolini with me. Having others that cared about me by my side at the hospital bed made all the difference in a room stuffed with five other patients.

Fast forward to the next day. I felt 10 times better physically and 100 times better mentally. I was scheduled on this, my tenth day of my trip, for a check-up at the same hospital at 8 p.m. to have a simple blood test done.  I arrived at 7:30 p.m. for good measure, thinking I would be released sooner.  Instead, I sat in a cramped waiting room overflowing with patients for the next three hours waiting for my bloodwork results (which I often receive instantly after having blood drawn in the United States).

At the end of my journey within the Italian healthcare system, I felt conflicted. Free care at health clinics and cheap prescription drugs were completely unrealistic to me before traveling to the country shaped like a boot, and these were welcome changes.  However, overcrowding, inadequate space, and a lack of modernity at Urbino’s hospital put a dent in my previous satisfaction with the healthcare system.

The language barrier in Urbino can feel intimidating, especially in the case of medical care.  With the right preparation however, a physical ailment doesn’t have to derail your visit to Urbino.  Below are several steps you can take to ensure a healthy stay in the city.

  1. Think about the types of questions a doctor’s office would ask you during a visit, and the responses you would give.  For instance:  What is your name?  What is your nationality?  Are you a student?  What hurts?  Type these questions as well as answers specific to you into Google Translate and save them before leaving for Urbino. This will ensure that you have prepared responses to rehearse speaking as well as an ear for questions a doctor or nurse will probably ask you.
  1. Think about what important medical information your own doctor knows about you. What illnesses have you contracted in the past or have currently? What illnesses do you feel you are more susceptible to? What allergies to medication do you have? Put this information in the same document, in English and in the language of the country you are traveling to.
  1. Be aware that units of measurement for medication dosages in a foreign land might not be the same as your home country.  To ensure that you take the correct dose of whatever medication might be prescribed to you by a doctor in Urbino (or any over-the-counter medication you buy at one of Urbino’s local pharmacies), download a unit-converting app on your smartphone or tablet.  “Units Plus Converter,” available in the app store is a good choice for this purpose.
  1. Perhaps most importantly, don’t let fear of not being understood prevent you from receiving needed medical care. While the medical staff may not speak your own language, my experience with the doctors and pharmacists in Urbino was positive. They are there to help you with whatever medical treatment you might need.

Becoming sick could ruin the experience of studying abroad.  However, many medical ailments can be easily diagnosed and treated. This can help ensure that lasting memories of your trip to Urbino aren’t of being bedridden for weeks, but out exploring the beauty of an Italian city that looks lost in another time.

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