It’s been almost two years since I’ve been seen at a hospital. The last time was in that November of beatings and kidnapping when my lower back was in very bad shape. I learned a hard lesson on that occasion: given the choice between the Hippocratic oath and ideological fidelity, many physicians prefer to violate the privacy of their patients–often compared to the secrets of the confessional–rather than to oppose, with the truth, the State that employs them. The examples of this pouring forth on official television in recent months have strengthened my lack of confidence in the Cuban public health system. So I am healing myself with plants that grow on my balcony, I exercise every day to avoid getting sick, and I’ve even bought myself a Vademécum–a Physician’s Desk Reference–should I need to self-prescribe at some point. But despite my “medical revolt,” I haven’t failed to observe and investigate the growing deterioration of this sector.
Among the recent hospital cuts, the most notable have to do with resources for diagnostics. The doctors receive greatly reduced allocations for X-rays, ultrasounds and MRIs which they must distribute among their patients. Anecdotes about fractures that are set without first being X-rayed, or abdominal pains that become complicated because they can’t do a scan, are so common we’re no longer surprised. Such a situation is also vulnerable to patronage, where those who can offer a gift, or surreptitiously pay, obtain better medical care than do others. The cheese given to the nurse and the indispensable hand soap that many offer the dentist noticeably accelerate treatment and complement the undervalued salaries of those medical professionals.
A thermometer is an object long-missing from the shelves of pharmacies operating in local currency, while the hard currency stores have the most modern digital models. Getting a pair of glasses to alleviate near-sightedness can take months through subsidized State channels, or twenty-four hours at Miramar Optical where you pay in convertible pesos. Nor do the bodies who staff the hospitals escape these contrasts: we can consult the most competent neurosurgeon in the entire Caribbean region, but he doesn’t have even an aspirin to give us. These are the chiaroscuros that make us sick, and exhaust patients, their families, and the medical personnel themselves. And that leave us feeling defrauded by a conquest–long brandished before our faces–that has crumbled, and they won’t even let us complain about it.