13.01.10. Toughing it out in Tuscany (and Tpavia).
Tuesday night, 12:15 am. I’m sipping the coffee and nibbling the cookies I should have been sipping and nibbling in the ER. A week ago I injured my ankle in an ill-fated leap into melting snow, and tonight the reckoning came.
I had never planned on going to the hospital. Ankles, in my experience, do not break but twist and sprain. In one particularly severe instance I witnessed an ankle completely detach, when Pittsburgh Pirates catcher Jason Kendall stepped rather poorly on first base. But that was Major League Baseball. Normal people stick with twists.
As twists go, mine was a dandy. You see, it was snowing that day in Tuscany. People (such as Frances Mayes and Michael Ondaatje) tell you that Tuscany is beautiful—and it is, but so is the Marche—and “we” take that to mean that it is beautiful while under the Tuscan sun, when the earthy colors of summer pull you to the land and transform the region’s fields into one large tilled hammock. But it snows there, too, on occasion, and then it becomes Narnia. Thin indistrict roads wind through hectares of white-capped grapevines and trees bowing in snow. As the snow builds around you, you think if you could just burrow to the bottom you might find something truly special.
And so one night on the road slanting down from Casole d’Elsa I left Inge and Maarten, my two traveling companions, and leapt to the grassy slope below. Its snowtop seemed pure and the pitch would be steep enough to send me rolling ten meters before bringing me to a wet, contented stop. But you see, it had been raining that day. The snow by now was like the film on unstirred gravy or old milk. I soared for a period, then just as my flight was getting to the good part I crashed down. I hit wood or rock and yes, perhaps I thought my ankle had detached. I was halfway down a slope of melting snow, and I couldn’t see Inge or Maarten.
That I did make it back up, back a few kilometers to our “agriturismo,” and then across the next few days to Volterra and Arezzo and Prato is a testament to my firm belief in sprains and, more recently, in swear words. According to a Keele University study, swearing increases pain tolerance (in this study, test subjects were able to keep their hands in ice water longer when directed to repeat swear words). Separated from my traveling companions on the road back from Casole—I believe they ascribed my lagging to my “doing the poet,” as some of my friends say here, and so left me alone—a road with slushy pavement that did in fact send waves of crud at me when cars passed, my muttered cursing was key to my survival. My ankle throbbed, but I held off the worst tiger-bite pain.
When I came back to Pavia three days later I felt stupid for leaping onto a grassy bank that, looking back, had very little snow on it. But I was content to wrap my ankle in a knee-sock and accept my pain as punishment. What, though, I asked myself a few days later, is that blackish-blue stripe running forward from my heel—the stain from my knee-sock, or a bruise? Why, I asked, is my right ankle still birthing mangoes?
But ankles don’t get broken. All of my sprains from baseball and frisbee healed by themselves after ice and rest. Perhaps this ankle was particularly angry because I had neither rested nor iced it?
Finally last night I went to the collegio medic, an advanced medical student, and explained to her my situation. (Mostly. I did take a few days off my estimate of when I’d hurt my ankle. I couldn’t help it. Who among you has not fibbed to a doctor about chocolate consumption or alcohol intake? Let ye cast the first stone.) I was secretly hoping she would take one look at my ankle and say, “You fool, go to the hospital!” She didn’t say that in so many words, but gave me a topical cream and directed me to go to the hospital should the pain continue or worsen. Apparently that wasn’t a clear enough mandate for me. It was not until this afternoon when I spoke with Maarten and two female friends of his, one whose mother is a nurse, that I got the message. They basically took one look at my ankle and said, “You fool, go to the hospital!” Despite my 23 years and extensive past health issues, that’s the directness it takes when I’m away from Mother and Grandmother—two strong female presences to take their place as surrogates. So thank you, Laura and Marta, for being Mom and Grandmom tonight.
So. Hospital. Great. (After one last English lesson at 7 pm.) So do I go to the one on 13th and Hilyard? Or the new one in Springfield? Simple a-to-b tasks like going to the clinic become much more complicated when away from home in a place like Pavia. It is a developed city in a developed country, but has few taxis, few late buses, and older streets unfriendly to the wandering infirm. Modern buildings like hospitals, too, by definition lie outside the historic city center. But Frodo Baggins did not delay his journey to Mordor for lack of the true path.
(Before leaving, I did take care to properly prepare. I’ve been to Eugene ERs, and things having to do with ankles or non-essential organs take a while. The existence of national healthcare in Italy would seem to bring in even more people. So I packed: 1 book, just begun; 2 oranges, market-fresh; 1 thermos Columbian Roast Starbucks Via; 1 partial bag cookies; 1 sample jar pure Italian honey; 1 packet Nutella; 1 iPod; 150 euro; 3 major credit cards; 2 superfluous torso layers for use as overnight pillow.)
It was two minutes past 10 pm when I reached the main piazza. True to my worries, the bus routes that pass by the hospital outside of town stopped running at 8 pm. The closest taxis were at the train station, usually a ten-minute walk away. I did at least have the help of a crutch I borrowed from a friend in the collegio who had recently hurt his knee. I ambled along, and as I crossed fairly comfortably these last few kilometers I felt silly to be going to the emergency room. I felt sillier still when couples and cars gave me a wide berth, and when I found myself behind an old, bent lady with a cane. I was a foot taller and a half-century younger and strong of muscle and heart, but this crutch slowed me to her pace and bent me, too, though not double. If I were more of a man—or maybe less of one—I would have thrown my crutch away.
A taxi was waiting at the train station. “I would like to go to the hospital, please,” I said.
“Which part?” The driver was maybe the age of the lady with the cane, but more resistant.
“The main part, down that way to the left I think.”
“But where?”
I believed I had found the only cab driver who didn’t know where the hospital was. “Just past the big roundabout. It’s the main hospital. Don’t you know it?”
“Yes, it’s you who doesn’t know where you want to go. [Because he said this in formal language, it did not sound quite so insulting.] Is the problem bones, heart, flu...”
“Ah, I think I broke my ankle.”
“Pronto Soccorso.”
From now on I will only go to the ER via taxi. We had our initial difficulties, but my driver proved his worth when he pulled straight into the ambulance entrance where a nurse stood waiting. The nurse was in his late twenties, at his ease, and probably likes to play foosball on his breaks. While I contorted out of the taxi, he brought out a wheelchair, and in we went. I tell you I’ve seen calmer rooms, but I really can’t remember when. Four or five people milled about, and three employees sat behind an undisturbed reception desk. I was rolled up to check-in, where I presented my passport, then rolled into an inner hallway. Perhaps three other patients were scattered along the corridor. A pair was elderly and recumbent on gurneys, but I saw no blood and heard no wails. The hallway had a generally faded look, free of fancy machinery, but neither were there cracking walls or mice. I was in a superbly adequate 1980s hospital.
Once in the inner waiting area I pulled out my cookies and coffee and notebook and prepared to write this essay. I ate one cookie before a nurse approached. “Bravasi?” she asked. “Bradley,” I said. American names often mutate over here, so she could have meant me. Indeed: “Okay, same thing,” she said, and grabbed the handles of my wheelchair to push me into the nearest room. A moment later she reconsidered. She walked down the hall, and returned pushing one of the old men on gurneys. Bravasi. After he came back out, my foosball nurse came and pushed me into the room where a probable doctor sat at his desk. I explained my injury, this time giving the full version, and he sent me for an x-ray.
Outside the x-ray room I pulled out pen and paper and began my ER inventory. I had written “2 oranges, 1 coffee” when a lady sneaked up from behind and wheeled me in. That was probably why the old, bent lady was still out walking the streets with her cane—she wouldn’t stand for people coming up from behind to push her around. She still had her honor.
There’s not much else to say. Within minutes I was holding a printout with my results: no evident fractures. I didn’t get to see the x-rays with a laser pointer presentation, but did soon have my ankle wrapped and ready, thanks to another able nurse who according to his colleague spoke English but didn’t try it on me. They told me to use a “bastone canadese”—or “Canadian crutch”—for five days, they called me a taxi, they wheeled me outside. The driver who showed up was the same who dropped me off not an hour and a half before.
Only as I left my wheelchair behind and struggled into the taxi did I fully realize I hadn’t been charged anything. They had neither asked for insurance nor presented me with a bill. It is possible, even probable, that my American passport and Italian skills and student status combined to grease my passage through the ER—my US passport absolutely helped me move ahead at the immigration agency earlier this year when everyone else was from Africa, Asia, and the Middle East. But I just don’t think they would have made me pay no matter who I was. Maybe if I actually had broken something.
My current wrapping has brought my ankle back to the size it was right after I injured it. But below all the gauze and tape, the pain is minimal. My precautions will certainly aid in the healing, but after a week, my ankle really is almost healed. My belief in sprains remains.
I now add Policlinico San Matteo to my list of hospitals confronted and overcome. But it’s an empty victory. The Italian healthcare system didn’t put up much of a fight. It’s 1:30 am. My coffee’s finished. There are still some cookies. But I didn’t get to the honey or Nutella. I was looking forward to my night picnic in Pronto Soccorso. Maybe that’s sick. But I can’t help doing the poet.◊