“The doctor doesn’t speak English,” the secretary at the policlinico warned me in very good English. “I speak some Italian,” I told her in especially bad Italian. It was early in the day, those were the first words I’d spoken to another person. Thus it is, always. My mouth and brain are not ready for speech for the first hour or so after waking. It is possible, though how likely I do not know, that the same mish-mash would have erupted from my mouth in English.
I had been to see the doctor the secretary referred to in November when my face suddenly broke out in a bacterial rash. It was ugly and sudden and spread like fire. He recommended the same ointment I had coincidentally brought with me from the States, the one I used the last time such a rash occurred, seven or eight years ago. I went to my farmacia for a fresh tube in case what I had was expired. The lady there was familiar with the brand, but had none in stock. She checked to see when it would arrive on order. “None available in Italy until March,” she told me. “You’d better go right now to all the other pharmacies, see if one of them still has it.” I had no difficulty understanding her; urgency is a elegant translator.
Anyway, as I was instructed to do by the immigration interceder, Alessandro, last March, I bought my way into the National Health System for 2017 in early January (for about $150 – because I am here on a student visa, it’s not free). To do that, I had to specify a doctor, and since the fellow I’d gone to at the policlinico was the only physician I knew, I specified him.
Last July, my doctor in Scranton suggested I have a blood test in January, so once I was in the system, I walked down to the policlinco for an appointment. That’s when the secretary warned me about language issues. She had a slot open for the next day. It’s always like that, and it always surprises me; I go almost anywhere for an appointment, and there is invariably something available within twenty-four hours. Advantages of a small town? Must be.
My doctor is reputed to be very good, he’s kind and courteous, and he speaks no English. Why should that be a problem? I know enough Italian to get by, even though I lack a medical vocabulary. The issue, however, quickly became apparent; he mumbles. And possibly has an accent. “Mumble” may not be fair. How am I to know what mumbling sounds like in Italian? But whatever the reason, I could understand almost nothing. When that happens, I can speak almost nothing. So, we got off to a great start.
“I registered with National Health,” I told him right away, before he had mumbled anything to render me mute, “and was told I should make an appointment for a physical.” He blinked as if I’d just spoken Chinese. I don’t think it was my words, I think it was that we were operating on parallel assumptions about what “a physical” meant, or perhaps how Sanitaria works. He mumbled something. I pretended to understand based on two words I thought maybe I had recognized. “At any rate, my doctor in the US said I should have a blood test in January.” That he understood, and he told me how to proceed. His explanations included references to several places identified by initials. My confusion worsened. He called the secretary.
While waiting, I also asked for prescriptions for the three medicines I am obliged to take thanks to genetics. When you have a prescription, medicine here is free, and even though at full cost all mine together run at about 30% of what I pay in the States (with insurance), free is free.
The secretary arrived. I explained, in Italian, that I was trying to determine where the initialed offices the doctor was talking about, were. She translated into an Italian the doctor could understand, and told me his response in English. The conversation continued in this odd way for awhile. At some point I mentioned again (I forget in which language) that I had registered for National Health the week before. The doctor raised his brow, looked in his records, discovered my name, and threw the prescriptions he had written away; since I was registered, all that could be done electronically.
Eventually satisfied that she had accomplished what was needed, the secretary left, and I was back to relying on speculation. The doctor asked something like was there was anything else I required. He had explained how to pay and make an appointment for my blood work, and that I should ask his secretary for the printout I would take with me to assure the proper tests were made. So, I told him all was well, and returned to the front desk to fetch my various bits of paper.
Lacking among them, however, were my prescriptions. The secretary sighed and called the doctor who named one of the three. When, after the lone prescription had been printed, I noted that I was still missing two, she sighed again. Counting in my mind the pills remaining at home, I responded that the other two could wait until the appointment I would presumably have when the test results came in.
Today, I went for blood work. The ladies who handle paperwork and payments are cheerful, funny, and an utter delight. When I stumble my way through a sentence that wants words I would be hard-pressed to remember in English, let alone Italian, they laugh with great exclamations of feigned emergency, and everyone waiting their turn laughs, too.
The nurse who drew blood was a recipient of my early-morning Italian, as well, so attempted to answer my opening sentence in English. It was charming, as her English is worse than my even my groggy Italian. I vocally appreciated her effort. We locked hearts and proceeded in a terrible mix of whatever language seemed useful. She painlessly drew blood. I complimented her on that. She smiled. We laughed a goodbye.
In all of this, there are several lessons. That more needs translation than words, is one of them. I never did have what I would properly consider a physical, for instance. Maybe that will come when we look at the results of the blood work. I’ll inquire. Any one of several friends will be able to fill me in – if I remember to ask. Another lesson is that I am more annoying when I pretend to decipher mumbling than when I repeatedly ask for clarity. The purpose of language is not to seem to have communicated, the purpose is actually to have communicated. Anything less is a genre of rude. Finally, the heart speaks more clearly than the mouth. Put your heart forward for both listening and speaking, and the words fall into proper alignment. That’s a lesson that can be carried into the world at large, no matter what the cultural context. Grazie.