Monday, June 17, 2024

Nightmare at IMSS: husband with Covid opens window into the bureaucracy

My husband Alejandro has officially been diagnosed with Covid-19 and it has been nothing short of a nightmare.

For months now, health authorities have been telling us to take Covid seriously. But how seriously do they take it? If my husband’s case is any indicator, I have a big question mark.

Because of life decisions over the past 17 years, I live very much like most middle-class Mexicans — read: my Mexican husband and I do not have the economic resources that many expats have. We make do with resources such as IMSS, the Mexican government insurance system.

I learned long ago to skip them for the little stuff. I am fortunate to be able to pay for a doc when I have an earache or such and thus can skip the long waits that usually come with IMSS.

But one constant praise IMSS always got was that the doctors were good, even if the administration was horrible. IMSS was best used for minor emergencies and major medical issues that needed attention right away, like a car accident. And to be fair, I had used the Urgencias satisfactorily, getting treated better as a human being than in my local clinic.

I have to rethink all of that now.

We both fell ill near the beginning of the month, but with different symptoms. At our local clinic on different occasions, he was diagnosed with tonsilitis and I with an upper respiratory infection. Neither of us were tested for Covid; it was not considered necessary. Again, to be fair, October is the beginning of the cold and flu season, and all of these illnesses share symptoms.

After our treatments, we both were getting better. Since the clinic’s Covid section cleared us, I even went to Guadalajara to do some research. I felt tired there, but more worrisome was coming back the following Monday to find my husband sick again. He was coughing and had a fever on and off.

Back he goes to the Covid squad, who then told him he had bronchitis. He received new antibiotics and stuff for his lungs. They did not believe he had Covid, but since he is 60 and mildly diabetic, they gave him the test anyway. We were told to wait five working days for the results — which meant a week.

His condition got somewhat worse but never critical. As we approached the date that his test results were due, he was actually getting better – he had more energy and was eating some. Nevertheless, he went back to the clinic to check and get a doctor’s note to extend his time off from work.

Neither of us anticipated what came next: I start getting frantic calls from him and the clinic to tell me he needed to be hospitalized and that I needed to go to the clinic NOW. This is where the nightmare begins.

Over the past 72 hours, I have lost track of how many times I have been told that “this is serious,” but …

  • At the clinic, we waited over five hours for a “special ambulance” to take my husband to our assigned hospital. During that entire time, I had no communication with Alex or his doctor at all after the first statement saying he needed to go to the hospital.
  • At the hospital emergency room, I got all kinds of misinformation about how I could visit my husband and get updates on his condition. By the time I said goodbye to Alex before going upstairs, all I knew for certain was to return to the hospital at 1:00 p.m. and bring a clear plastic bag with toiletries and even toilet paper. No one had taken my phone number or email. My head was so fuzzy from the stress and not eating all day that I had not thought of it.
  • At the hospital on that first day, they let only one family member enter. I went in, and there were signs everywhere at Reception with rules: talking to the patient only via video call system entirely within the hospital. No use of the internet. Updates on the patient’s condition once a day only – by email.
  • I ask the receptionist to check that they have my contact info. The woman looks at me like I’m an idiot but finally agrees. But the name and room number is not enough to pull the file; I must have his IMSS number, and I’m an idiot for not having his carnet (a 20th-century relic of a booklet that serves as both ID and a medical tracking document).
  • Now I’m in a dilemma. I can go and get the IMSS number — and miss my chance to talk to Alex, or I can talk to Alex and risk not getting back in time with the number so that they can take my email. No one will help me work this out. It is my fault for not having the carnet.
  • Luckily, I get a call to tell me my brother-in-law was outside. We decide to switch places. I will go home and get the information, and he will wait and do the call if I do not get back in time. I get the number, but he has to do the call and give my email to the receptionist. The waiting time is two hours to get one minute to talk to Alex.
  • I suspected that I would not get the promised daily email on Thursday — and I am not disappointed. I have no idea how he has been for the last 36 hours, no idea what treatment he has had and no idea of a prognosis.
  • We won’t even go into the fact that the staff assumes that I am supposed to speak perfect Spanish. Maybe it is too much to ask for an English speaker, but no one has any patience for someone struggling to understand.

One day later …

A light at the end of the tunnel: on Friday we finally have some news, but from my husband, not the system. As I suspected, my email was entered wrongly. It was re-entered, and I immediately got an email that allowed me to enter a website IMSS has set up to “inform” patients’ families.

The information given was laughable, basically his name, his IMSS identification information, in what area of the hospital he is being treated, his bed number, the date of his last checkup by the doctors, and a one-word description of his condition: “serious.”

The receptionist was able to give me the results of his most recent vital signs check (not even available online), but no idea of context.

The real and best news today came from my husband himself. He is responding well to treatment and the only reason he is still in the hospital is that he still needs supplemental oxygen. His doctor feels that he can likely go home after three days or so.

For some reason, after seven months of pandemic, the government cannot figure out how to put that information online. My one minute with Alex was taken up almost entirely by this explanation, but I admit I feel much better.

covid ward

In case you are wondering: no, I have not had a Covid test. The doctor at the clinic said that as long as I do not have symptoms, I do not need one.

Yes, that is ridiculous, but I would not take one now even if they asked me. I will just assume I had/have it, go out as little as possible and when Alex is better, assume I am in the clear.

Overall, this system creates a very strong sense of isolation, both for the patient and for the family. There is no news, and I cannot have anyone with me to help deal with the bureaucracy.

To put some salt in the wound, on the day Alex was admitted the Mexico City government sent him a message on his cell phone, saying his test results were ready. The following day, someone called. I cackled and gave the guy an earful. He hung up almost immediately after hearing that Alex was in the hospital.

One serious problem is that most Mexicans accept this as normal. Alex’s family and friends tell me so and, yes, while it is “disgusting,” as one put it, there is nothing to be done. I also saw this attitude at both the clinic and the hospital, with family thanking low-level administrators as if they were gods.

I have no doubt that the way IMSS isolates patients to such an extreme has something to do with its lousy treatment record with hospitalized Covid patients.

OK, one more shot at being fair. This situation is not what I have seen at IMSS hospitals in the past. This is my first rodeo in having a close family member in the hospital, but Alex’s experience with his family over the years always had meant having someone in the room with the patient, with IMSS taking advantage of this by having family doing a lot of the work other countries use orderlies and aides for.

But from here on in, I will have to be within shouting distance of Saint Peter before I let them admit me. I refuse to put Alex through anything like this, and I refuse to be cut off from the few people who can give me support emotionally and linguistically.

Leigh Thelmadatter is Mexico News Daily’s culture writer.

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