Budapest Cowboy Meets Socialized Medicine

Fifteen ago I served as a Peace Corps volunteer in a modest Central European country called Hungary. Its main exports are sunflower seeds and astrophysicists. Hungarians are an old people, and they have lived through many historical peaks and troughs. One of the recent upward trends was the transition of their country from a socialist state to a free-market one in the 1990s, with all of the liberty induced individual rights and responsibilities that flow from such an arrangement. Since we Americans are presently transitioning in the opposite direction, and, rather unbelievably, Obama’s Democrat administration intends to force feed us the bitter elixir of socialized medicine, I thought it opportune to share my first-hand experience being served as a patient of the State.

First, meet Mihaly, an older gentleman that worked at the high school where I taught English. We were colleagues and friends, the more so because he worked in the school’s tech lab that contained a desktop computer with e-mail. Mihaly detested all forms of socialism and spent hours explaining the reasons why. In sum, Mihaly had weathered the brutality of national socialism (Nazism) as a boy, soul crushing communism as an adolescent, a failed attempt at Hungarian independence as a young man, and, later, that certain brand of communism-lite called socialism in Central European countries. Between classes he regaled me with stories of tyrannical party members, crumbling public services and rather naughty police, and I shared stories of high schools in Appalachia with no internet service. One day the old man leaned in towards me as if to tell a dirty joke:

“Hey, what’s the difference between socialism in practice and socialism in theory?”

I shook my head.

“In practice the theory doesn’t work!”

Now to the story. During my time as a Peace Corps volunteer in Hungary, I joined an American football team sponsored by the U.S. Embassy in Budapest. The embassy donated all the equipment to start the team - silver helmets with blue stars on the sides, Wilson shoulder pads, and look-alike Dallas Cowboy uniforms – all recently expunged from an American military base in Germany after the Clinton administration outlawed organized football for U.S. soldiers. While most former Peace Corps volunteers from that part of the world will tell you that their most memorable times were picking grapes in the Fall, working beside their Hungarian colleagues, or courting the same, my most memorable time was playing quarterback for the Budapest Cowboys.

Admittedly, Hungary is the only place in the world where I could actually be a starting quarterback. It is also the only place in the world where many of my Peace Corps colleagues could even enjoy the chance of dating such beautiful women. Fortunately for me, Hungarian boys that grow up kicking soccer balls grow up to be men that instinctively throw pigskin like girl scouts. There was no contest for the position.

My Cowboy teammates consisted of several Hungarian security staff from the embassy, a gang of muscle-headed teenagers still in high school (none my own, thankfully), a handful of curious professionals who couldn’t make the local recreational soccer clubs, and a recently returned university exchange student who’d studied a year in the U.S. A lone Canadian banker coached the team, and he was returning home shortly. Not an American foot had touched the field.

We practiced twice per week, Wednesday and Sunday evenings, and since there were other clubs sprouting up throughout Central Europe (as the American military sent its football equipment eastwards), we actually had a short schedule of teams to play. Sadly, while preparing for an upcoming game against the Bratislavan Steelers, I broke my ankle. Scratch that. Gyorgy (who preferred George while performing American football) broke my ankle. I was teaching a close-in tackling drill where each player takes a turn as tacklee then tackler. Our opponents, not having a qualified quarterback (ahem), generally ran the ball nine plays out of ten, so we needed to master tackling a back barreling through the line of scrimmage.

Have I mentioned that it’s somewhat difficult to teach former soccer players to put their noses between the numbers? After several consecutive broken tackles during the drill, the assistant coach (me! Can you believe it? My high school coach wouldn’t.) stepped in to demonstrate. “George, ugyan kerlik!” I dropped my whistle on the grass, strapped on my helmet, and lined up from George across the line of scrimmage.

“Hoot-hoot!” said the substitute quarterback. George ran towards me with the ball, and I executed, at about three-quarters speed, a perfectly formed tackle, nose between the numbers, that Mike Ditka would have applauded. George got up somewhat resignedly, like he might go back to playing soccer. I motioned for him to hand me the ball; it was his turn to show me what he’d learned. The quarterback said “hoot!-hoot!”, and I sprinted past the center, ball tucked in, thighs pumping, head down, straight toward George.

George clearly did not grasp the lesson. He remained perfectly upright, wrapping his arms around my helmet and shoulder pads when we collided. I continued to make forward progress as George slipped onto my back. I was still struggling forward when George lost interest and dropped off me directly onto my left ankle. Then I fell. Tackled by a third-string soccer player.

The mere thought of injecting myself into the miasma of Hungary’s healthcare system terrified me enough to limp to the subway in the hope that the ankle would be better in the morning. It wasn’t. It was swollen and blue and hurt like hell. “Basz meg!” [now you know a very bad Hungarian curse word.] I’d have to call in sick and go to a doctor’s office. Fortunately for me, the tenant on the first floor of my block-designed apartment complex was a doctor. Unfortunately for doctors in socialist countries, they live in apartment buildings with high school English teachers.

The sun was up, so I memorized the necessary Hungarian phrases to explain my situation and hopped on one leg down three flights of concrete stairs. Knock.Knock.Knock. The good doctor answered. I explained the predicament in my best Hungarian, pointing repeatedly at my swollen and colorful ankle for emphasis. He replied that he’d see me in my apartment in half an hour. Then he shut the door.

There was nothing to do but hop one-leggedly back up the concrete stairs and wait. About an hour later there was a tentative knock on my door. I asked him to enter. “Gyere!” He stumbled in puffing on a cigarette. He bent over my raised purple ankle, poked twice., grunted, and then shook his head, sadly. The good doctor clearly had things on his mind this morning, and doctoring wasn’t one of them. Taking the cigarette from his mouth, he informed me that the injury to my ankle was beyond his expertise. Did I have an auto? No, Peace Corps volunteers are not allowed autos. He would then notify the state ambulance service to take me to the nearest emergency room.

“Where’s that?”

“The State General Hospital in Budapest, of course.”

An ambulance for a broken ankle seemed a bit melodramtic, but all my Hungarian friends had their cars at work by now. Besides, the good doctor explained that the state ambulance system made regular rounds through the towns outside Budapest picking up the lame and wounded twice per day, and it was due in less than an hour.

Two state EMTs eventually arrived and watched me hop down the stairs. Incredibly, when they opened the rear door of the ambulance, a thin, wrinkled arm rolled out of a stretcher inside. It was attached to an equally thin and wrinkled senior citizen.

“Is she dead?!,” I whispered in horror.

They had picked her up in the village outside my town, and, “no, she’s not dead. She’s just tired.” The EMTs lifted me into the ambulance, and I lurched into a jump seat next to another injured fellow, this one with bloody gauze around his head. He’d taken a nasty fall he explained as we bumped along uncomfortably to the next town where we picked up two more walking wounded. One gentleman had cut his hand seriously enough for stitches, it was clear to see from the blood, and the other had what I could only fathom to be chronic hemorrhoids, based on the uncomfortable manner in which he lay on a second stretcher. The crowded ambulance was a collective foreshadowing of events awaiting us at State General.

The EMTs unloaded us downtown according to the seriousness of our injuries. I was second to last to go, just before the still sleeping granny. The staff placed each of us onto individual stretchers and wheeled us into a cavernous foyer where we were promptly abandoned. A sign above the long desk opposite the bustling hallway announced, “Korhaz Elimeres,” which may be safely translated as “abject bureaucracy” in Hungarian.

I wasn’t bleeding, bandaged or bitching, so no one bothered me much on my stretcher in the hallway. After about an hour, I felt being paid a bit of attention to and asked a passing nurse in my best Hungarian if she wouldn’t mind pushing me to the sign in desk. Still ensconced on my stretcher, I got the attention of an admissions nurse who, before a carefully phrased word could spring from my lips, quacked, “Betegsegi Bisztositas!” I smiled dumbly, not knowing that particular phrase, and started my genial, text book introduction again before she interrupted.

“Betegsegi Bisztositas!”

She must have recognized my foreignness because she took a deep breath of patience and Lysol and repeated the words like I had the Hungarian language skills of a seven-year old (which was rather magnanimous really). The following exchange in Hungarian went something like this:

“Ma’am…I don’t have…that…betegi bisztothing….”

“But you must have the state-issued health insurance card!”

“It…I don’t have.”

“Everyone must have the state health insurance card!”

“I am teacher of English for U.S. Peace Corps. I have a…thing. Which is this!”

Mightily did I lay before her a slightly worn business card issued to volunteers containing very important diplomatic telephone numbers.

“Where is it? You do not have the state-issued health insurance card?”

“I need telephone, yours? I know someone with knowledge of…things.”

“Will they bring your state health insurance card?”

I called the Hungarian staff doctor at the Peace Corps office in Budpest. She got on the phone with the truculent admissions nurse and explained how the state hospital would be renumerated for treatment of my injury. No, thank you, I didn’t think she needed to come down to the hospital. A tactical error, in hindsight.

The admissions nurse did not know the correct administrative procedure for my suspect brand of health insurance, so she sought assistance, abandoning me at the admissions desk on my gurney. Eventually, another admissions nurse approached me and helpfully asked for my betegsegi bisztositas. After a diplomatic exchange in baby Hungarian bureaucratize, it was decided by the three of us that it was likely permissible, though problematic, to have me rolled into the waiting room while the question of the betegsegi bisztositas was sorted out.

The admissions nurse then rolled me down the hallway into an industrial-sized waiting area containing all the human suffering in Budapest and environs on that particular Thursday afternoon. The noisy, crowded, malodorious place contained about one hundred people in chairs and on stretchers in various stages of actual or shared misery. This is where the state collectively herded the wounded. The injured moaned and children cried and loved ones consoled – and very occasionally – someone was whisked away by a nurse. Dante once wrote about such a scene.

Hungarians produce some of the top scientists and doctors, but their healthcare system was a sad place for human dignity. For the next three hours, the only person that paid me a peppercorn of attention was a feverish boy of ten who sneezed on me occasionally. Eventually, other patients with broken bones were being seen, so I got a nurse’s attention. Another hour later, two nurses x-rayed my ankle and rolled me back to the hectic waiting area. Yet another hour of shared woe later, two attractive nurses appeared before my stretcher and rolled me into an open bay for quick, simple procedures. Patients and staff wandered about freely. “Okay, ” announced a doctor fluctuating between Hungarian and English, “Your ankle is break-ed. I must put ankle in cast. Cast will reach here (chopping just below the knee). Take off jeans or I cut off the leg.”

I took off jeans.

Thirty minutes later, still in my white fruit of the looms, I had a monument to American football plaster cast on my leg, but no way to put on my jeans. The staff didn’t offer me a hospital gown. In fact, all I got was a swift, and rather mordifying, push into the crowded waiting room on the stretcher, still in my tighty whities. I sat paralyzed on my gurney for a brief moment, precious Levis folded in my lap, before quickly inserting my unhampered leg into my jeans and covering myself with the rest. No one seemed to notice my minor case of personal bodily indignity. They were physically suffering after all. I waited silently with them in the malevolent waiting area on the stretcher, in my underwear, until the state ambulance arrived to make the return trip towards my town two hours later.

After dropping off several sufficiently stabilized patients en route, the state ambulance service reached my town just before dark. It had taken the entire day to get a cast. News travels quickly in small towns, and word had gotten out about the English teacher’s trip to the hospital. Several of my kind-hearted students and their parents were waiting outside my apartment building with food and wine when the ambulance arrived with me in tow, still in my tighty whities. The driver opened the doors to the thoughtful crowd, and I had no choice but to exit, trying to keep the denim covering the right places, which wasn’t easy on crutches. There may have been snickers, but I was utterly resigned after the day’s minor indignities to care. To test that theory, my students and their parents felt altruistically obligated to see me safely into my apartment on the third floor. I swallowed what modicum of dignity remained, handed my crutches off, and started the three-story hop in front of my students and their parents clad in my underwear.

Mihaly summed up socialism – and socialized medicine - best. “With socialism everybody is poor together with no chance to live better…unless you’re in Parliament, of course,” he added with a wink.