Friday, July 29, 2011

The Hunt for Boston Cremes


One thing that has surprised me about my time outside of the U.S. is the sudden, urgent desire to eat certain foods. These foods are, usually, things that I know to be nearly impossible to find in Brazil or so out-of-the-way and expensive that it's only worth getting once. I can't help it, though. I get obsessed and check every webpage, ask every neighbor and read every restaurant review I can find just to get that certain "fix". Anyone who knows me, understands my love affair with food. I like to think that I'm a pretty healthy eater. However, my cravings here have channeled the junkiest of American-style junk food. I'm not sure what this says about me, my body or my mental state but, it's been interesting to discover what things are truly "international" and what just doesn't translate across cultures.

Some easy-to-find comfort foods:

KFC- I LOVE, LOVE, LOVE fried chicken. Luckily, KFC has taken hold in Rio and doesn't appear to be letting go anytime soon. And with all the fatty sides I want!

McDonalds- The most international of national fast food chains, this place is almost as easy to find in Rio as it is at home. Hamburgers and fries are so, so common.

Ice cream- Brazilians have an insane sweet tooth. You can find tons of places with a plethora of flavors that still haven't been dreamt of in the U.S.-- sweet corn flavor in a waffle cone, anyone? It's super tasty.


Some you-will-spend-your-life-searching-for-the-real-thing-in-Rio comfort foods:

Mexican food- Ironic, yes I know. Brazilians simply don't get the beauty of tortilla chips, fresh salsa picante, guacamole and sour cream. Forget about Chipotle-style burritos and quesadillas on the cheap. There are Mexican food places but the salsa is more like ketchup and not spicy, the guacamole is runny and the sour cream is more toward heavy cream. All in all, very unsatisfying and supremely disappointing.

Doughnuts- This has been my latest quest. For some reason, I have been absolutely dying for a Krispy Kreme-style glazed doughnut. I was shocked to discover that Brazilians-- the lovers of all things sweet-- are not even aware of the fatty goodness of a good doughnut! After a great deal of research, I found one place, ONE, in the whole city that had them. A kiosk in the malls in Tijuca and Barra called Cafe Donuts. While I failed in my search for a simple, glazed doughnut, I did manage to have a passable Boston Creme. It was enough to hold me over until my next U.S. visit.

Bagels- Again, for a nation that adores bread in almost all shapes, sizes and flavors-- no bagels? Really? Out of all the hundreds of cafes in the city, not one sells bagels-- and forget about cream cheese. Lox? You're dreaming. I recently found a blog that gave me hope; Daily Life In Rio mentions the existence of one place that claims to have bagels. I'll have to check it out and judge for myself. Often, places here say that they "have" something but, when it arrives, it's far from the real thing.

While Brazilian food is undeniably yummy, sometimes you just want a little taste of home, you know? I'm off to get a bucket of Original Recipe and a gallon of Neopolitan! Woo hoo!

Until next time...

Saturday, July 9, 2011

Vomit, X-rays and Patience


There are many things I could say about Brazilians as a people but one thing is for sure, they are patient. Brazilians wait in some of the most outrageous, incredible and ridiculous lines I've ever seen. They wait in long lines for everything-- paying bills at the post office, doing transactions at the bank, anything having to do with the government, etc. Most Brazilians also wait several hours for even the most routine medical attention.

Recently, I was able to experience this last example firsthand. For the past week, I've been battling a terrible gripe (flu). I can't remember the last time a cold had me so messed up for so long. Finally, I gave in and decided to go to the doctor. However, being a poor grad student on a (very) limited fellowship abroad, I opted to give the public health system a try. Brazil has a dual system of healthcare-- public and private. All citizens are entitled to completely free healthcare under the public branch (that dirty word, socialism). Those who can afford to opt out and receive private healthcare usually do, which considerably lessens the strain on public facilities. My previous experiences with Brazilian healthcare have all been in the private sector which is first-rate in every way. I had no idea what to expect from a public place.

Since my condition was not an emergency or very serious, I chose to go to an UPA. These facilities can be compared to something like an Urgent Care Clinic in the U.S. Generally, they operate 24 hours and specialize in minor procedures-- most serious, emergency cases are transferred to the nearest hospital. I scoped out the place the night before and asked the receptionist a few questions...

I'm a foreigner, can I still be treated here? --Yes, of course.
Do I have to pay to see the doctor? --No.
For blood work? --No.
For prescriptions? --No, we have an in-house pharmacy.
So, it's all free?? --Yes, of course. Where are you from anyway?
The U.S. --Oooooh, that explains it. I've heard a lot about how it is there.
Yeah, it's probably all true.
(looking around at the full and over-flowing waiting area)
So, how long is the wait usually?-- (smile) I couldn't really say.
You can't or you don't know? --Don't know. It's always different. But it's never fast.
I see. Is there a better time to come? --Early. Really early.
Like, 6am? -- No, like 2 or 3am.
Oh, ok.

I decided to come back the next day, bring a book, pack a snack and just wait like a good Brazilian would. I got there around 11am (I'm REALLY not a morning person, especially when I'm sick). I went to reception, they checked me in and then told me to wait to be called to another desk to get registered. I sat in the front of the room and immediately noticed that huge flat-screen TVs were being used to indicate who was next in line to see the doctor. A person's name would flash on the screen and a tinny, computer voice would call their name out loud. Beneath the name, the room they were supposed to go to would be written out and spoken as well. Cool system, very efficient. Unfortunately, the computer voice was not used to foreign names. When my turn came, the voice simply said a few syllables from my name and then called out where to go. It sounded something like: Neee-cooo--eh--Mah--ree--Caaah--eeew. Somehow the last syllable of my name received the most emphasis. A resounding "eeeeeewwww" echoed through the room as I jumped up ashamedly to register at a desk in the back of the room.

After about 5 minutes of giving my full name, showing my U.S. driver's license, relaying my address, phone number and fielding the normal questions that follow, "Ohhhh, you're an American?", I was done. I sat back down and waited for the next step-- an intake evaluation with a nurse. As I sat back down, I took a look around to see who my fellow sick-os were. The vast majority of the room (which was about half full) were elderly patients or sick children with exhausted-looking parents. The room was long and rectangular with the usual fluorescent medical lighting. The adult patients ranged from the clearly homeless to several that appeared pretty well dressed. All in all, a very mixed bag. The staff was brusque but friendly and they seemed to all be working diligently. Most people were watching a large TV on the side wall that was broadcasting daytime shows on cable. After quickly taking in the room, I pulled out my eReader and started Water for Elephants. A few pages in, I noticed the distinct smell of pee. To my left, an elderly man was seated beside me and I quickly ID'd him as the source of the unpleasant odor. I changed seats.

My next seat was equally ill-chosen (not that there were many open places); I was stuck behind a lady that was coughing like she had consumption (and not covering her mouth) and beside an old lady that, out of the blue, decided to fill me in on her condition. She persisted in asking my advice although I tried to emphasize as much as possible how I was not, in fact, a doctor but a patient like her. I finally managed to shrug my shoulders enough times to satisfy her and returned to my book. About an hour or so later, I was called by the computer ("eeeeewww") to meet with a nurse.

The nurse did a standard intake evaluation on me (about 10 minutes total). She asked me my age, nationality, habits, symptoms, existing conditions, etc. Then, she checked my blood pressure and looked in my mouth and ears. Finally, she asked me how tall I was and how much I weighed. Ummmm, oopsy. Hadn't thought of this. Brazil's on the metric system so, I apologetically said, "I don't know" to both questions. She enjoyed a long, inquisitive frown and then said, "What do you mean?", with an emphatic "Are you dumb or something?" tone. I explained my funny conundrum (which she did not find funny) and she huffed. This meant she had to do extra work-- weighing and measuring me. This did not please her. But she did it and then turned me loose, informing me that my next stop would (finally) be a doctor.

I decided to use the restroom before I sat down again. I went to reception and asked where the bathrooms were. I walked down the indicated hallway and entered the ladies room. Of the two stalls in the bathroom, one was empty. I opened the door and was greeted by a technicolor display of vomit. Orangey-streaked-with-red (blood?) vomit was splayed across the toilet seat and up the wall behind the toilet. Ok, no, no, no. I waited to use the next stall; praying 1) it wasn't as bad as that, and 2) that no one walked in and tried to use the vomity one, thinking I did it or something. I peed quickly and....oh, great. No soap in the dispenser and no paper towels either. Thank god for anti-bacterial gel! Never leave home without it.

Traumatized, I returned to my seat. Maybe 10 minutes later, two men come running into the UPA. One is supporting the other--- who's holding a rag to his head as blood streams down his neck onto the front of his shirt. They're immediately taken to registration as I eavesdrop to get the story. Bloody guy is a roofer and works with his brother (the guy who brought him in). Brother guy accidentally dropped something off the roof onto bloody guy's head, who was on the ground at the time. Bloody guy gets rushed to the "sutures" room (how ominous does that sound?). In the blink of an eye, the "Grey's Anatomy" moment was over.

An hour and a half later (and halfway through my book), I get "eeewww"ed to go see the doctor. My lady doctor was pretty and young, which surprised me somehow. She re-capped the information from my intake and asked me a few more questions about my condition. She told me she wanted me to get an X-ray to help her diagnose what the problem was. This also surprised me a bit. She promised me it would be really fast and the room was right down the hall. I went to the room and got called in by the tech-- who was a young, attractive guy. Oh, great! Here I am getting a chest X-ray....wait, shit! I have an underwire bra on! Does that mean I have to take it off? How do I say that? Is that weird? A thousand things start running through my head. I'm barely listening to the guy as he tells me to remove my earrings and any clips I might have in my hair. Finally, I get the gumption to ask him about the bra. He gave me a "WTF?" look and said (deadpan) "Unless you're gonna put it on your head, there shouldn't be a problem". It was then my turn to give a funny look. He figured it out what the miscommunication was right away and said, "It's a head X-ray. Your doctor ordered a head X-ray. To check your sinuses." Ooooohhhh!

While I blushed for being the idiot I am, he quickly did the X-ray and told me to go back to my doctor. Upon return, she looked at the scans and concluded I didn't have a sinus infection, bronchitis or pneumonia. Simply put, I just had a bad case of allergies. Almost four hours, four "stations", half a book, two granola bars and two X-rays later....I had my diagnosis and a mild antihistamine medication. But it was all free.

I'm certainly not an expert in healthcare so, it's difficult to evaluate my experience with a "socialist", "universal" system like Brazil's. In terms of time, it was a total bitch. Conditions were....eh, basically what you'd find in an emergency room in the U.S. The nurses, physicians and techs seemed competent and interested, at least somewhat, in my well-being. You can't beat the cost, of course. However, it did make me wonder how things would've gone had my condition been more serious. Would the facilities have been sufficient? Would the care have been what I needed? In the end, there's no way to know. I do know, now that I've seen the other side of the coin, is that it wasn't bad. In any case, all Brazilians have some access to care so, in that way, they've already got one up on us. Hopefully, the future will see some changes for the U.S. system; we just need to be patient :)

Until next time...