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Trip Report Trip Report: My Encounter With the Italian Hospital System

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If, as it is said, one of the benefits of traveling to another country is learning about and experiencing another culture, then I experienced that benefit in a rather unusual way last fall when my wife and I were on vacation in Verona.

Our first night in Verona I awoke about 1 a.m. to a racing heartbeat in my chest. I knew that I had a mitral valve problem that would have to be fixed at some time in the future, and I also knew that having atrial fibrillation (a fast and irregular heartbeat) would be a possibility for me. So my wife and I got dressed and went down to the desk, where the night clerk called a cab and told the driver to take us to the emergency room.

We arrived around 2 a.m. at the general emergency room (Pronto Socorso Generale), a large, rectangular room mostly filled with people sitting on hard, plastic chairs. On the wall at one end was a television screen playing the news. At the other end, near a set of double-doors, was an open widow, behind which sat a man who looked like the only hospital employee in the room.

I went to the window and attempted to explain to him, in a combination of English and my minimal Italian, what my trouble was. I also gave him a copy of our emergency medical form consisting of a list of my current medications as well as information about my current medical situation, recent tests, and previous surgeries. We always carry a copy of this when we travel, and for this trip, I had also printed the information into Italian, courtesy of Google Translate.

The staffer took some basic information from me, looked over the medical form, and then motioned me to go through a nearby door which opened onto a small room. When I got into the room, the same staffer took my temperature, blood pressure, and pulse rate, and then gave me a small piece of paper on which was written the word “verde” (green) as well as a number. He then motioned for me to go out into the large room and wait.

We sat down and then noticed a large, computerized message board hanging on one of the side walls. Down the left column of the board were rectangles of either red, yellow, green, or white. To the right of each rectangle was a number. (We now knew what the information on the paper I had been given referred to.) Finally, the third column of each row contained the time when the person entered the ER.

At intervals, a staffer would open the double-doors next to the desk and call out a color and number (the one at the top of the list on the message board), and whoever had that combination would disappear behind the doors.

We finally figured out that the color-number combination was part of a triage system. Red numbers (which always bounced to the top, no matter when the person arrived at the ER) obviously meant that the person was in extreme need of immediate treatment. Next came yellow, then green, and then white. Some of those with white numbers had been waiting since 10:30 the previous evening. Evidently, some of them had also given up and left the building, since they did not respond when their number was called.

I thought the system was good, since it allowed everybody to know where they were in the line and that those in most need were being seen first. Moreover, at certain points, the board would flash a sign “Emergency in Progress, Waiting Time Longer” which warned those in the waiting room that the regular routine would be interrupted.

Finally, around 3:30 a.m., my color-number was called and I too walked through the double-doors. We were taken into a room with a doctor sitting at a desk as well as a couple of other males who might have been nurses or technicians. The doctor asked some questions and read my medical summary. Technicians took some blood, did an EKG, and an echocardiogram. At the conclusion of all this, the doctor said he wanted to monitor me for two hours, so I was put in bed in a large room with a number of beds separated by curtains. There was a desk down from my bed and on the other side of the room where various medical personnel would come and work for awhile and then leave.

After a little more than two hours, the doctor came back. My condition, he said, wasn’t periculoso (dangerous); nevertheless, he wanted me to stay in the hospital for a couple of days just to make sure, after which, he said, we could go on and enjoy our vacation. I decided to agree to be admitted, at least “for now.”

Next: The Clinical Decision Ward

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