Last spring, I must have looked incredibly pitiful. Typically, it would take me 10 minutes – maybe less, if I hurried – to walk from my apartment to the university campus. With full blown psoriatic arthritis, the trip was considerably longer and more arduous: as much as 45 minutes from start to finish. I can remember several times where someone I didn’t know pulled over their car and offered me a ride up the hill to work. Sometimes I would have to stop and catch my breath as the waves of pain threatened to overwhelm me. Eventually, instead of walking less than a mile, I started driving my car to work.
I knew that my students noticed; one or more would jump up and help every time I started to pass out papers to the class. My colleagues thoughtfully took the elevator with me and gave me rides home. Friends scheduled meetings in my office or in places I could walk to (well, limp to) easily. My rambunctious sixth-graders would run back and check on me if I took too long to get out to the creek outside their school.
I didn’t mind explaining to everyone the reason for my problems. “I have psoriatic arthritis” is an easy enough sentence to say. It’s much harder to come to terms with what that sentence means or how (whether you want it to or not) it defines your entire life.
I don’t write about my experiences with arthritis to portray myself as a saint. In fact, a lot of the time I was anything but saintly – angry at myself, at Art (as I called my condition), at the world, at the cruelty of genetic diseases. I write about my situation because I see healthcare in Qatar through its lens.
All of that being said, I notice two major differences between my doctor visits in the US and in Qatar.
First, seeing a doctor is incredibly convenient in Qatar. In the US, it took me three months to see a rheumatologist – all while I was in agonizing pain, as noted above. In Qatar, I called on a Sunday and had an appointment by Wednesday. A couple of weeks ago, I went up to the hospital on a Saturday at 8:00 without an appointment. By 8:15, I was talking to the doctor. Another time, I went up to my employer’s health clinic planning on asking them to recommend a dermatologist. In 20 minutes, I was talking to one.
For someone who doesn’t have a debilitating condition, this situation is pretty nifty. For someone like me, this situation minimizes my chronic pain, which is worth far more to me than I can tell you. I can’t be a productive worker or, indeed, a functioning human being, without prescription medication.
The second difference is that doctors in Qatar are much less likely to have extensive conversations with you about your health and your life. In the US, my doctors (particularly the rheumatologist I mentioned above) were very good at talking with me about not only my symptoms, but also the way my health affected my everyday life. In Qatar, the doctor visits are more purpose-driven: I come in with a medication or treatment in mind, I ask my doctor for it, he or she gives it to me.
Early in the stages of my disease, I felt confused and unmoored; my body was responding to the world in ways it never had before. Everything was out of my control. I could read the Wikipedia pages and the clinical trials of the prescription drugs whose names were being bandied about, but what mattered most to me is that someone would take the time to talk to me and answer the (sometimes very stupid) questions I had – questions that weren’t always about medicine or about my disease, but ME.
I can’t quite articulate what I think about these differences, nor can I give anyone a clear answer about which healthcare system is best. (Well, I could, but I freely admit that such a post would be less evidence-based and probably offend a few of my faithful readers.) What I do understand, after living four months overseas, is how important it is that a healthcare system be structured to listen to and validate the suffering (no matter how large or small) of its patients. Neither system gets it completely right, and if my experiences are representative, perhaps they could both learn from each other.