Getting Personal

At the beginning of the year I took the bureaucratic leap into the Italian health care system. While it was not excruciatingly complicated, it was quite time-consuming. First, I had to go up the hill to the main health office to wait in line in order to declare my intent, show the proper residenza paperwork and obtain the enrollment form. Then I had to go to a specified bank in town in order to pay the required fee, as I am not a dependent worker who has an employer paying the subscription for me. Once I had the receipt, I took that back up the hill to once again wait in a long line, give my personal data and become enrolled. The clerk informed me that my tessera (enrollment card) would arrive in the mail in about two months.

When I returned from my trip to the US I found a letter from the health system and thought my card had arrived surprisingly quickly. Instead, it was a letter informing me that, as a new member, I was entitled to a free PAP test. It listed an office address, date and time. I called the number provided to confirm the appointment, figuring that as it had been more than 20 months since my last exam, I ought to have it done, though I admit I was little hesitant about introducing myself to nationalized healthcare in such an intimate way.

Male readers may want to stop here. The rest deals with what is delicately labeled as “female issues”.

As all you feminine readers well know, a pap test is not usually a major ordeal, but the whole set-up is a bit uncomfortable in general. Cold, sterile room; paper gowns; metal tables; and, of course, stirrups. Ah, it’s fun to be female, isn’t it? My gynecologist in New Mexico was very nice but always behind schedule. After checking in at the reception desk, I’d be freezing in the scanty, back-closure gown for nearly an hour awaiting her entrance to perform the deed. Outdated magazines can only go so far to keep you occupied in such a state, then sighing and clock-watching sets in. Just when I was about to get dressed and stalk out, she would enter, all smiles and apologies, and get down to business.

The exam was just a tad different here. I arrived at the appointed time slot at the address provided. The building contained many closed doors, presumably offices or exam rooms, but I had no way of knowing as they were all unmarked. No reception desk for checking in, no one around to ask. I stood about a minute trying to figure out where I needed to go, then latched on to a nurse as she came out of an office, before she could flee for lunch. I told her I was here for the pap screening but didn’t know which office I needed. She told me to simply take a seat and wait. “Uh, but how will they know I’m here? Don’t I need to check in somewhere?” I asked ignorantly. No, no. They’ll come for you, she responded. Va bene. Pretty soon, a few other women trickled in and just sat down, each clutching the same letter that I had received. We all smiled at each other weakly, but no one attempted to converse.

About five minutes later a woman yelled out of an office down the hall, “AVANTI!” Basically meaning, whoever is first, come on down. I entered the office and sat in front of her desk while she took my letter and started to input the information. No matter how hard she tried, the spelling of my last name, Schneider, completely defeated her. Not for the first time did I rue the day I changed my name upon marriage. Italians cannot grasp all those consonants in a row. Then she had a hard time finding my inscription in the computer system. Meanwhile, a nurse had entered who seemed very kind, and helped her find it. I thought she’d be the one conducting the actual exam, but she departed with a friendly “arrivederci”.

Once the clerk finished the paperwork and I had signed it all, she instructed me to strip down in the nether regions. “Uh…where?” I asked, looking around the office. “Over there,” she bobbed her head in the general direction of the filing cabinet. I was a little confused but got up and peeked around to find an exam table set up, within the office space, with only a shabby filing cabinet shielding it from view. I suddenly longed for the cold, sterile exam rooms I used to complain about, but obligingly did as I was instructed and hopped up on the table. No gown, no covering, just…uh, out there. Then, the not-so-friendly clerk abandoned her computer terminal, walked over and slapped on a pair of latex glove and set about performing the exam, the details of which I won’t go into but which you all know well enough (except to say that the usually-metal speculum was plastic). She mumbled something that I didn’t understand and asked her to repeat it, which she did but just as hastily and garbled as the first time, so I have no idea what she was communicating. I didn’t much care at that point, and quickly got dressed and left, the clerk/nurse instructing me to tell the next lady-in-waiting to come in.

All told, the process took only fifteen minutes, a far cry from the hour wait I had in my plant-festooned and brightly-lit gynecologist office at home. And I guess the procedure and outcome are the same, only free. My first welcome to the Italian health care system was a relatively painless, albeit very personal, one.