The Witch Strikes
When, on Thursday last, I woke from an afternoon nap essentially unable to move, my first reaction was to begin to organize a rational, intellectual response to an experience that was so sudden and so crushing that reason had little to say about it. Though I found I couldn’t roll onto my side in bed without excruciating pain, couldn’t stand without screaming, couldn’t walk a few steps to the bathroom without clutching the wall for support, and though the entirety of my lower back seemed to have melted while I slept, only to resolidify in some hideous deformation, like the trunk of an olive tree, what I told myself was that it was nothing serious, that the event was not, so to speak, meaningful.
What I was experiencing wasn’t what we’ve come to think of as denial, in the pop-psychology-infected shorthand we use to describe—or to stab gracelessly at—complex emotional states. Or to put it perhaps more accurately, it wasn’t denial of the pain or of my inability to walk, all of which were practical problems that were extremely present in my mind. If it was denial, it was a denial of significance, of consequence, because the consequences were too terrifying to consider.
I took a handful of aspirin and stood, as best I could, under a boiling hot shower. When I got out, I thought I was moving a bit more easily, and I decided to lie down again to rest until evening. We do our weekly shopping on Thursdays, and it’s one of my jobs to prepare the shopping list on the basis of the weekly menu that we hash out during Thursday breakfast. In bed, I finished the menu. When M came home several hours later, I was worse than before, and I began weeping as soon as he walked through the door. “I don’t know what’s wrong with me,” I sobbed, “What have I done to myself?”
Because, in those hours, the initial “it’s just a backache, you’ve just pulled a muscle” voiceover had given way to other, more insistent voices. I’d had plenty of time to imagine permanently disabling conditions, surgery, tumors. Of course, to begin with the most pragmatic considerations, we can’t afford any of them—not the treatments or interventions or the lost time from work. But what had ground me up and flung me back onto the shore was a glimpse of myself as old, incapacitated, and unable to earn a living. “If I stay like this, I won’t be able to … we won’t be able to go … I’ll never again ….”
For me, a “safety net” literally doesn’t exist—I have no insurance, no savings, and I can’t access the Italian healthcare system for reasons of citizenship (about which more later). Frankly, living in this way is another form of denial, though it’s the kind of denial you need to get up in the morning, work, get the shopping done, plan what to do on the weekend, buy a book that interests you or go to the movies (or, for that matter, spend money for anything that isn’t strictly survival-related). It’s the denial that’s required to conduct life in the midst of undeniable vulnerability. And it is paper-thin.
The next morning I was no better, and M convinced me to go to the Emergency Room. I expected to pay for my treatment, even though I didn’t expect it to be (relatively speaking) all that much: Medical-care costs in Italy tend to be much lower than they are in the U.S. (which means chiefly that they’re hugely inflated in America). And so began a day full of the ironies and contrasts that make Italy what it is.
When we arrived at the ER, we realized that M couldn’t drive to the front door. (Of course not. Why would you make it possible to drop a patient off in front of the emergency room? If you didn’t come in an ambulance—they are allowed to enter—you can damn well walk.) So he dropped me at the curb and went to park, and I hobbled painfully to the “Accoglienza” or reception area. I stood in line, trembling with the effort of standing upright and trying to “breathe” the pain into some manageable state, when a nurse noticed me and offered me a wheelchair. It was an amazingly kind gesture—something, in my experience, you couldn’t necessarily count on in the ER of an American hospital.
We got through the paperwork and the various waits and then the visit with the doctor, which took place in a large room that doubled as a kind of administrative office, with computers and supply cabinets along the walls. There was talcum powder all over the floor, which was vaguely disquieting, and three people other than the doctor—nurses or aides or I don’t know what—were crowded into the space. They helped me undress and dress and one of them later gave me a shot of muscle relaxant in the rump, along with a clap on the shoulder when it was done. They were all kind, if slightly impersonal; no one volunteered much information, but then no one rushed me either, and they answered all my questions when I asked them.
I came away with a diagnosis of “lombosciatalgia” (or lumbar radiculopathy or just plain sciatica, if you like), a prescription for several weeks’ worth of injection drugs (diclofenac and thiocolchicoside, both nonsteroidal anti-inflammatory drugs), which we bought with no trouble at the local pharmacy (syringes and needles included—in the U.S., not even if you showed up with your own personal DEA agent in tow) and a medical order for an MRI (called, here, an RM—risonanza magnetica). Total cost: zero. The doctor had kindly graded me “GREEN,” which meant I had need of emergency services and was entitled to have them without charge.
And then there’s the bad news. The MRI is going to cost from €200 to €275, and follow-up visits and any therapy I need will be “a libera professione,” which means, I pay. There was some talk about whether it would be possible to get a temporary SSN (National Health System) card, which would give me access to low or no-cost services, so before we left the hospital, we went thither and yon like Jason (with M ferrying me in the Wheelchair named Argo) to the “Office of Relations with the Public” and the Radiology Department and the “Office for Immigrant Assistance,” each of which had some different version of epic events to sing. Today, M did his web research and found, first: YES, foreigners waiting for their “stay permit” to arrive can be issued a temporary health card; and then, second, NO, you first have to be registered with the Camera di Commercio and have a Partita IVA (a sort of taxpayer identitication number); and then, third, MAYBE….
On Monday, we’ll make some more phone calls and, in the meantime, M is giving me my shots and I’m trying not to be grumpy or despondent, neither of which is especially easy. Hearing M at work—making supper or running the vacuum—while I’m in bed doing nothing is a sensation, very nearly a physical one, that’s so unpleasant that the pain of getting up and trying to help him is hardly worse. (Though I think we put an end to all that this afternoon, when he told me, “If you really want to help me, keep your ass in bed.” Ah, it’s love!)
But that’s nothing compared to being pushed around in a wheelchair for hours, not for fun but because you really can’t walk. There are lots and lots of experiences I haven’t had in my life, and being conveyed in a wheelchair was one of them. Now that I’ve done it, I never want to do it again. Aside from the fact that there’s a terrible metaphor in it—the living are all behind you, speaking—there’s the sensation that your horizontal dimensions have tripled while you’ve lost half your height. You’re a kind of Dumbo: people scatter as you come forward but doorways are too small. You tend to collect papers, scarves, and backpacks in your lap (the person pushing you has his hands full, after all) and you must speak loudly if you want anyone to notice you’re a person and not, say, a minibar being shifted to the doctors’ lounge.
Through it all, I kept thinking that I’d been an idiot not to do what Margaret Atwood told me to, years ago. Back in the early 1990s, when she appeared as part of the City Arts & Lectures series in San Francisco, an audience member asked her whether she had any advice for writers. “Yes,” she said, after a thoughtful pause. “Be sure to do your back exercises.”