Not So Fun Times in Belgrade

Well, I guess it was inevitable that I would see the darker side of the Balkans via the socialist health care system. The only saving grace from this miserable experience is that it was not me having the knee operation (already had my fair share of ongoing medical issues) but unfortunately my girlfriend. At least now I can write knowing the worst is behind us but a long road of recovery is still ahead of her to rehab her knee back into shape and for me to always remain encouraging, patient, a slow walker and accepting that I'll either need to head off and do some of our previously shared activities solo or just put them on hold for awhile (in theory this would not be too hard since Winter is approaching).

Before jumping into the hospital experience I must provide some background to understand the full scale of the medical mess that exists over here for all non-expat types that can't get evacuated to Europe. Originally, her accident began over 6 months back in the States where she fell twisting her knee severely but not requiring surgery. So supposedly after 6 months of care and limited activities everything should have been back to normal. Not! All it took was one afternoon of roller blading with her niece when she did nothing more than push her leg out to the side for a pop and splintering pain to make it very clear that whatever had happened was now torn and would require ACL surgery to fix.

Since the local hospital has no equipment or trained doctors for something like this she went to a private clinic that I have also been to a number of times for X-rays. They were able to take her and get film of her knee and a consultation with a young doctor (I too have seen). The diagnosis was obvious but the film didn't show enough to know if she would need both ACL and meniscus surgery. So consultations were made and a surgery consult/reservation made with the Austrian doctor who flys in every month or so to do these more advanced procedures. So after waiting several weeks with one postponement of the date (completely changing many of our plans), he arrived and was able to see her. As surgery was postponed for yet another day we decided to have a quiet night in before she would not be able to walk. Then they called to inform her the machine broke and they could not do it and would need to reschedule for sometime the middle of next month when the doctor could return. We heard rumor that this is (sickly) sometimes their strategy to get people to fly to Austria to receive treatment at a much higher rate (despite the fact the 1 clinic here was already charging more than Belgrade). So with no set date, weeks of waiting, and her mild level of pain and limited mobility, we decide to give up on what little healthcare there is in Kosovo and make plans to go to the State hospital in Belgrade, a place she has not been since before the war and generally speaking a city few Albanians like to go to anymore.

Fortunately a friend of mine is a doctor in Belgrade who connected Pranvera to the best doctor in Serbia who does these types of procedures. Since it is a state hospital they can only see patients on Tuesday and then will decide when/what surgery to do. Another week of waiting and she took an overnight bus to meet with the doctor, who confirmed the initial diagnosis and told her she would be scheduled for operation that Friday, which was actually perfect since ironically I had a business trip in Belgrade and was driving there on Thursday and she could also stay with me in the hotel. But of course they changed this the next day requiring her to return there with her mom again that next night for a Thursday operation. But upon arriving to process all the unbelievable paperwork, pay in cash for the surgery and a minimal 2 week stay they told her she would need to wait 1 more day (as it was originally scheduled). It was also at this point when her doctor came straight out to ask her for a bribe to complete the surgery, otherwise hinting it might be postponed again. Emotionally shattered, Pranvera complied, had to put her mom back on the bus and waited for me to arrive to give her a place to rest while I had my business meetings.

We at least had 1 fun night in Belgrade with a great meal out, snacking on some McDonald fries and walking around the city. Finally the next day it happened but not until making her wait an extra 4 hours of lonely anticipation in a very depressing, run-down, antique hospital and a room that could have resembled a prison cell except for the big window she had. No pillow on the bed, disgusting bed sheets, no phone, TV, call button for nurse assistance, place to lock you valuables, etc etc. (things I take for granted and can't imagine not having when you are already in a great deal of pain with NOTHING to do). So once I finished up my meeting I went to the hospital to wait for 4 hours before they brought her up from intensive care. Of course the nurse did not speak any English so it was 1 hour before another patient was able to tell me the surgery was complete but didn't know when/if she would be returned to her private room that night (which was only 1 of two--rest were with 3-6 people). I had brought her some water, flowers, fresh bed sheet and a blanket to replace the contaminated one they provided.

All I can say is that seeing her face as soon as she emerged from the elevator confirmed I had done the right thing. I didn't leave her side for the next 6 hours until she finally dozed off to sleep so I could return to the hotel and try and get some rest myself. She was still heavily drugged but conscious and coherent and had a bit of a tired smile. She told me about the surgery and showed the many bruises in her arms from all the needles they had stuck her with while one last one remained with the IV drip (oh and they left an extra in her other arm just in case). So, once she was situated we pretty much didn't see any nurses the rest of the night until I had to start chasing them to come and help her out with the pain medication. Once the drug from the operation started to wear off she suffered through spasms of leg pain for most of the night. They weren't doing very much to manage this and only after hours of pleading did they finally call the doctor to get approval for an extra injection and sleeping pill to help through the first night. I can safely say for the both of us this is something neither of us ever wants to repeat again.

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As she faded to sleep it was time for me to sneak out and catch some rest myself back at the hotel. So the nurse let me off the floor and locked the door behind me. Mind you I had only walked the route once earlier which now looked completely different with most the lights off and no one around. I felt like I was in the middle of some horror film with creepy sounds, outdated medical equipment sitting in the hallways, flickering lights and that smell...Finally I rounded a corner to the familiar main doors only to find them locked. What? Hospitals here close? So I continued on to certainly find someone to let me out. Eventually a nurse emerged from a nap in the break station with a puzzled look and several exclamations that I couldn't understand. Even my charades were no good in asking for assistance so I had to call my Serbian friend who explained on the phone my situation and the nurse said she would call security to let me out. Whew. Now I was able to call and cab and would soon be on my way. 15 minutes later I was still waiting so I went back to the nurse who didn't know what was going on so she eventually decided to get rid of me and let me jump out a small first floor window into the courtyard only to see my cab reversimg from the dark entrance. As I sprinted to catch him he was looking over his shoulder and only noticed me as he spun the car around and I jumped in, startling him a bit. Finally to bed. Oh, not before the car driving in the lane next to us ran over a black cat... ugh.

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The next day was a bit better for her. She had eventually gotten some sleep and the pain was mildly less. We were able to enjoy the gourmet meals of watered bread, mashed potatoes, soup, butter or maybe even a vegetable. Since everyone shared the showers you needed to make a reservation and then get the nurse assistance. They wouldn't clean your sheets so fortunately I had brought her some new ones so we could get rid of the blood stained one. Hours and hours of talking, games, napping etc kept us busy for the rest of the weekend. Wanting to avoid getting locked in again I spent Sat night out with some friends having a nice dinner and drinks. Sunday I was lucky enough to catch a lift back to Pristina with another friend who had been in the city for the weekend as well.

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Only to repeat all this the next weekend as well. But a bit worse. First the shuttle took 7 hours getting me late in Belgrade after visiting hours were over. The friend's apartment I was going to crash at was still out of town for the night so I needed to find a hostel or hotel. An hour/half and 5 hotels later I finally found a place to crash for the night. No dinner. But had a nice breakfast and was back at the hospital again as if I never left. Pranvera was looking much better than the previous weekend and we were able to take some short walks around the halls, chat with some of her patient friends and enjoy each others company. Her wound had gotten mildly infected so she was on antibiotics and not able to focus on her rehab, which is why she was still there 10 days later. Although the hospital was know for good doctors they were short supplied on everything else. And to say the least the conditions did not appear at all sterile. I joined my friends again for dinner and then spent a quite night in a Belgrade apartment. Back at the hospital again for most of Sunday but before returning on the bus I had the pleasure of feeling like I was back at camp as I was laying fully clothed on the bed next to Pranvera talking since the chair resembled something from a torture chamber. And the nurse came in to say this was not allowed after the other patients were out in the hallway giggling and had a bratty 19 year wheel chaired girl push open our door and roll away.

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Now that she has finally returned to her home and receiving the support of mom's cooking, nieces running all around and a revolving door of guest, rehab should start soon and we hope to be dancing in 3 months... pak unga pak.