A trip to the emergency room - and the followup

Last week, my wife complained she needed to get some medication for a recurring condition that is not common to menfolk.  She spoke with one of her friends who suggested she go to the emergency department at Espanola, the health provider we deal with here.

We’re from Canada, and for the past few years in Ontario, a trip to the emergency room requires you to bring enough food and clothing for a good campout.   I thought that was a very poor idea to go to emergency here, but we went anyway.  To my surprise, the lineup wasn’t long.  After a very quick interview process.. as in.  your name and what do you think your problem is and wait a minute–and it really was a minute.  The doctor saw her, wrote a script and a request for a test and away we went.   This particular provider also has its own pharmacy so we went downstairs, filled the script and went home.

The next day she went for the test, and was again, in an out in about 20 minutes.  If this was Toronto, we might still be waiting to see the doctor in the emergency room.  You see, emergency rooms in the Toronto area are really for emergencies, as in life and death.  If you’re not in iminent danger of expiring, you shouldn’t be there.   Come to think of it, during the SARS crisis, many of us thought we may very well hasten that up by going to the emergency room. 

She was told to come back for the test results in a couple of days, and she did.  This time there was a long lineup of people waiting in the emergency… but she saw the doctor who saw her and he saw her and he took her immediately, said the prescription he gave her before wouldn’t work on this germ and gave her another one.  15 minutes in and out. 

Well, that was last week and this weekend, after taking the medication, her problem hadn’t cleared up.  In fact, it had become worse, so we went back to emergency this morning.   Today, there was a lot of people waiting but my wife just walked up to the doctor, told him he made a mistake and he agreed and wrote her another script, 15 minutes.  As of now, it appears this drug is working and hopefully, no more trips to emergency. 

My observations after the past week….  that emergency here is not as terrifying and as difficult as it is back home.  That you dont have to be near death to be seen and if you’re balsy enough to talk to the doctor, he’ll take you out of order.  And no one will complain if you’re to the point, not chatty, and fast.  The care here is competent.  The bells and whistles of a US or Canadian emergency room aren’t there.  The walls could use a good painting.  But the place is clean and the staff courteous and the care good.  

Unfortunately for my wife, she’s paying for all the years we lived in Canada and she was never sick.  She’s being punished for that… plagued by a variety of illnesses… which seems like just a run of bad luck and nothing more serious.  We’re looking forward to when it’s over.  Sometime in the next week, I’ll go over her other experiences.. and one of mine - which in retrospect is quite funny but I wasn’t laughing at the time

Driving and automobiles in general

Somewhere, on one of the other wonderful blogs about Uruguay, there was a great article on one person’s take on driving here.  I think it was a ‘her’ and I think this was a ‘0 to 100′ observation, (she’s talking about her experience from the viewpoint of someone brand new to Uruguay).  

My wife and I have been driving her for over 20 years, albeit for a few weeks a year, (on my part) until recently.  So our observations will be slightly different, perhaps a little more conservative. 

First of all, there is nothing threating or dangerous about driving in Uruguay.  Neither of us is aware of any place in Montevideo, (the biggest city), where driving could result in anything serious happening to you that couldn’t happen to you wherever you drive now.  There is no ‘really bad’ part of town you could wander into and come out less than whole.  There is no really insane traffic circle or otherwise impossible to understand and chaotic place to find yourself.  The worst that could happen to you is you will become disoriented and/or lost and that simply requires patience until you find yourself somewhere near a landmark you can fix your position from.  It may sound a little sick, but the few times that has happened to me, (never to my wife), it’s quite nice.  Adds a little excitement to an otherwise, calm to the point of boring, (we love boring), life. 

Like many other countries, Uruguayan drivers are aware of the rules of the road, but dont pay a lot of attention to them.  The main rule is if you have a relatively dent free car, make it a priority to keep it that way.  Since most cars here are not relatively dent free, and perhaps yours is, you need to be the one avoiding being kissed, as the locals call it.  When I’m driving (like a local), and creating a lane where there really isn’t one, and a ‘not so nice’ car gets near us, my wife always alerts me, fully knowing we’re the ones with something to lose.   Also… never challenge buses or taxis.  Regardless, you lose.  Some years ago, bus drivers started getting bonuses if they went accident free for a year.  Not because of repair or litigation costs to buses… but to make the public feel safer.  The could literally hit you or cause you to hit someone else with impunity. 

In all the time we lived in Toronto, we had 3 small accidents between the 2 of us.  In the past year, we’ve had 3, (all mine :-), and they were a real learning experience.  In one, I scraped the side of a car in a parking lot trying to squeeze by him, with a dozen cars honking behind me.  How I managed to that, to this day I still dont know.  Sometimes I think he backed up while we were going by him.  It was raining.  My wife refereed the dispute.  My spanish isn’t up to it..  Besides that, a gringo will always pay and pay more.  In the end, we took our car to a family friend who runs a body shop.  A scrape to the entire side of a new Peugeot was a whopping USD$200 to repair.  We had him take his car to our guy and he quoted USD$95.00.  He didn’t want to get the repair done we negotiated USD$50.00 cash and he was happy. 

The 2nd mishap was in Punta Carretas Shopping, the outside parking lot.  I hate to pull into tight parking spaces forwards.  Just a habit from home that I cant break.  My wife admonishes me for this, but I hold fast.  A couple of months ago, we were there on a day when there was a space available topside.  It was real tight so I asked my wife and daughter to exit the vehicle and I backed it in.  Everything was going real well, plenty of room on both sides and then a really strange sound, like a box being crushed… and then I realized, it was the rear window of the station wagon that was being crushed.  I stopped and got out and to my horrors, there was a huge fire hose box, protruding into the parking space at least a meter.  I turned to my wife and there was that look in her eye.. the one all husbands get a chill thinking about… ’you moron’….  Fortunately, we had that window filmed the month before and we were able to drive around for a few days before we could get it fixed.  Same mechanic.  Maybe we should put him on retainer. 

The 3rd, (and most recent and last for a while we hope), occurred at a red light.  We were stopped on a slight incline, first car, waiting for the light to change.  Just as the light changes to green, we hear a crunch from the rear right.  My wife, (always the wife), gets out to survey the damage.  The girl behind us has hit us, (no we didn’t roll back - we have an AUTOMATIC).  Now, being a Canadian, (with extensive US driving experience), I’m feeling pretty confident that she’s in the wrong.  I mean, WHENEVER you’re hit from behind, it’s the person behind at fault - right???  Wrong.  This is Uruguay.  She’s screaming that the light turned green and we should have been long gone.  She even WAITED for the light to TURN green, insinuating we should have gone BEFORE the light turned green.  Well, this isn’t NA… and there’s no point getting insurance or police involved for a smashed rear quarter panel complete with lights.  As she put it, she had more damage than we did so we should be happy.  The next day we went to guess who?  The body shop guy.  Total repair charge?  USD$125.

Insurance here is interesting.  We’ve owned cars here for most of those 20 years.  Mostly Peugeot’s, (family bias - my nephew is a mechanic - but not a body guy - he only fixes things that break by themselves, not the ones we break).  Until we moved, we bought used cars here, worth about $10K.  We never purchased collision.  Only 3rd party, theft and believe it or not, fire.  For that, we pay about the same we paid back home for that and collision.  Want to invest in Uruguay… buy stocks in an insurance company.  The one we deal with, Royal Sun Alliance, left Ontario some time ago complaining they couldn’t make any money.  At the rates they charge here, I can see why. 

The other intersting thing about insurance here is the limit.  In Canada, (I would assume the litigation-happy US is much higher), liability of $1mil and $2mil isn’t unusual - or costly.  Here it’s much, much less.  That’s because awards here are much, much less than back home.  And there’s a tremendous inequality between poor, working class folks and those more financially fortunate in Uruguay.   If you’re not financially blessed and you are injured by someone who is, and he’s clearly in the wrong, good luck getting much out of it.  Even if you hire a lawyer, there’s a good chance your lawyer will find it financially more rewarding to work something under the table with the person who hit you than represent you the way you’d expect in Canada or the US. 

Cars are expensive to buy.  The taxes are horrific.  Many people buy used cars.  A ‘0′ km purchase is an uncommon event.  Car dealers seem to do OK on markups - not volumes.  We went looking for a new Peugeot 307 SW and honestly, we saw all the dealers (and some who weren’t dealers) in Montevideo and with a single exception, they all quoted the same price and there was no negociation.  We ended up buying from a ‘non’ Peugeot dealer who, we found out later, can buy a car from the Peugeot distributor at the same or almost the same price that a Peugeot dealer could .  In fact, when our salesman called the distributor, he was told, ’so you got my customer did you’.  Turns out, distributors are also car dealers here and we’d been to see him the day before.  Canadians purchasing ‘automatic’ cars in Montevideo sort of stand out–hard to forget. 

While we’re on the subject, it’s interesting the way you buy a car here.  After the ‘negotiation’ (or negotiation-like process) above, you have to give the dealer a deposit.  Then he asks you to go to the duty free compound for you to take a look at it to make sure it’s what you want.  Clearly, honesty and ethics aren’t associated with car dealers’ in the public’s mind.  At least, that’s what I thought.  In fact, that may be true but it’s not really the reason you do that.  You do that because YOU HAVE TO PAY FOR THE CAR IN ADVANCE.  And who in their right (or wrong) mind would pay USD20K-USD100K on a promise you might get a car in a few days - HERE, (in fact, maybe anywhere). 

My wife says I’m a very trusting person, sometimes she even uses a derogatory term to describe that aspect of my character.  But in this case, my line in the sand had been drawn.  We told the dealer that there was no way we’d give him the money in advance.  We’d pay him when he gave us the car.  Well, guess what.  The main reason they do this is because, unlike business in the 1st world, most car dealers (not distributors) here dont have the money to risk to bridge the car until the purchaser pays for it.  

I guess the dealer wanted the sale because he said he has never done this before but he would take it out of duty free and we could do the deal at the showroom.  Turns out he talked the distributor into taking it to their showroom and the salesman met us at their dealership.  We showed up with a certified cheque and gave it to him after we saw the car.  The process was pretty informal at that point, like back home.  They showed you how the windshield wipers worked.  Then they gave you the keys and out you go.   One odd thing that we noticed.  The purchase document shows us buying the car from a person, not a car dealer.  We think it’s the owner of the dealership.  Probably some kind of tax-saving angle.  Perhaps they sell the car personally because there was no personal income tax in Uruguay until this year.   

Insurance had to be arranged the day before.  Fortunately we already had an agent.  We put the car on our existing policy, which because we’d been accident free for 5 years (or something like that), we got a 30% discount.   If you buy a used car, you have to take it to the insurer (they have shops around the city) to note all the damage to it so you cant claim for a dent that came with the car when you bought it.  That requirement is waived for a new car. 

Keeping warm at night

Our new house was built with radiators fed by a woodfired boiler.  Over the years it changed to coal and then gasoil.  This year, we changed it to a natural gas, heat exchanger  for both hot water and central heating.  The original rads were 80 years old but like the Timex commercial, still ticking.  We added modern, aluminum radiators to heat the 3rd floor. 

With the cool nights, we decided it was time to get it going.  We called the company that installed it and after a few missed appointments, they showed up this morning.  There were 3 or 4 of them, crawling around the house, moving things around and looking very intense.  Mid day, we started to hear strange noises coming from the rads and a short while later, my wife told me she felt some warm air coming from the rad next to her computer.  Success!!! 

Shortly before 4pm, the owner proclaimed that everything was done, except they couldn’t add the electric element to the water heater (backup in case Bolivia (or Argentina) cuts off gas to Uruguay, and simutaneously, doesn’t shut down electricity from the country’s main dam).  They said if they installed it, that would void the warranty.  I believed them because from personal experience, if you change the end of the wire on a an applicance, to fit the one of a dozen different kind of a/c plugs in this country, there goes your warranty.  The country’s distributor had to install the element to maintain the warranty.   So that’s to happen on Monday (Uruguayese for Wednesday). 

When I finished watering the lawn, (another story), we decided to check out the radiators.  First challenge was to figure out how to use the thermostats.  We had ’smart’ thermostats in Toronto but I had them pulled out the first time we went to use them.  We are used to, and prefer, the ones you set the temperature and there’s an on/off switch and an AC/Heat switch.  The ones we have here are even more complicated than the ones we pitched back home.  But considering the cost of energy, and the fact we have grown to like sleeping in the cold, we decided to give these ‘computerized’ thermostats a try. 

Well, either I am mentally challenged, (which is possible after a year out of the office), or they dont work the way the manual says they’re supposed to.  The technician set them for 21 degs (Celcius - remember we’re in a metric country), 7/24.  We’re dressed in sweaters today so we wanted to lower it to 19.  The manual says push the hold button, the word ‘hold’ comes  up on the LCD, then push the temperature button up or down, which I did to 18.  At that point, the system will hold the 18 degrees indefinitely.  I felt quite proud of myself, because I’m the kind of person who never reads manuals.  My philosophy is if you need a manual to explain something, it’s too complicated and you’ll need to consult the manual every time you use it.   That’s the same reason the clock in my car is always an hour off for 6 months of the year. 

My proud period didn’t last very long.  15 minutes later, I noticed the boiler was still going.  In fact, no matter what temperature you lower the system to, it maintains 21 degrees.  Maybe it has decided 21 degs is the right temperature for older people and for our safety and benefit, it wont allow us to lower it? 

I sent a text message to the architect and told him to deal with it Monday.  Now we’re sitting here writing this post and something else is whacky.  The aluminum rads sound like something between Niagara Falls Jr. and a babbling brook.  I vaguely recall noises like that when I was a pre-schooler and we had steam heat.  I’ve now sent two text messages. 

It’s weird but sitting here at 21 degrees feels hot.  Maybe I’m just mad. 

Morning radio show - from home

Yesterday, I went to immigration to renew my cedula at the Geant store, (the fastest place to renew).  The process went without a hitch.  In and out in 20 minutes.  This time without messy hands.  The solution they had worked really well.  Took all the ink off instantly. 

The office is in a mall so I took a walk into the Geant store and decided to check out the electronics section.  I noticed a nifty little device called an FM transmitter.  You plug it into your computer and it will broadcast whatever you’re listening to as an fm station.  You play what you want to hear on your computer and you hear it on your radio. 

I have a laptop in the kitchen and a radio in the kitchen and I got the idea to put the radio station I used to listen to in Toronto at breakfast on my laptop.  Well, here I am, eating breakfast in Montevideo and listening to CHFI-FM, my old local radio station.  My  most interesting observation has been the commercials.  They’ve hardly changed in the year since we’ve been here!!!  

A house or an apartment?

We lived in a condo (apartment) for the first year we here.  Recently we moved to a house.  We haven’t been in the house long enough to be certain we’ve seen it all, but we’ve seen enough to make a comparison pretty accurate. 

• Pros for apartments
  Security - if you have a 24 hour dooman, b&e is near to impossible, except for entry via the roof top.. which makes penthouses a little less secure than most higher floor apartments
• Comfort - if you have radiant heating (central losa), the building is responsible for your heating needs.  Because it heats your ceiling, (and by proximity, a bit of the floor), running it for a few hours in the evening is enough to keep you nice and toasty most of the winter.  The heat is extremely even and if care was taken with your windows, you’ll be comfortable everywhere in the apartment. 
• Trash - if you are in a one apt per floor building, you’ll have a garbage chute in your kitchen.  if there are more than one, you’ll have the chute near the elevator.  No need to walk to the corner or have a garbage can. 
• Assistance - if you have 24 hour portero, he will help you with groceries, bring your mail to you and run interference for you with undesirables. 

 Cons for apartments

• Stuck in the elevator or worse… During a power failure, unless your building has a generator, you’ll be looking for the portero to get you out of the elevator if it breaks or there’s no power.  If you’re in a building with one elevator, and it breaks, you’ll be climbing stairs for at least a few hours. 

Pros of a house

• More privacy for yourself…  in a house you can get a layout that affords privacy if you’re one of those that need it. 
• No community rules… you do your own thing
• Earth…  usually, there’s a pretty nice back yard with a parilla just waiting for you and a load of wood. 
• Garden…  you can grow what you want, for the whole year if you’re ambitious. 
• Driveway… u can have parking and a driveway

Cons of a house

• Beggars…  Poor people knocking on your door or ringing your bell asking for clothes and food.  They’ll take money if you have neither to spare. 
• Mail.  Unless you custom make you’re own mailbox, you’ll buy a cheapo Chinese plastic mailbox.  When it rains, it leaks.  One day, you’ll come out and find someone took it the night before.  They’re small.  Even No. 10 envelopes get folded.  A mazine wont fit.  It will end up in front of your house, on the ground. 
• Security…  Not really sure if it’s less secure than an apartment but it would seem so because unless you live in Carrasco with a guardhouse on the corner, you are solely responsible for your own security, which normally starts at your front gate.  My wife feels it’s scarier in a house at night…  If you do NOT wish to be broken into, invest heavily in (or rent one that has) iron bars and multiple, strong and well secured, locks.  It doesn’t have to look like a NYC apartment, but it should be close.  Of course, bars can be bent and cut, but that’s much rarer than smash and grab as much as you can in 5 minutes.  Burglars with ropes and cutting tools are a very small % of criminals in Montevideo. 
• Maintenance… You’re responsible for not only the house and the grounds, but also the sidewalk.  The law here requires you to maintain the sidewalk, not the city.  So if the pavement cracks, you fix it. 
• Gawkers… If you’re close to the street, (our bedroom’s sitting room window has a ‘0′ lot line), Urugyans, (being a curious lot), will come right up to your window, press their nose against it, cup there eyes with their hands, and stare for as long as it takes to scan the interior.  On the positive side, everyone will talk to you if you happen to be outside, welcoming you to their community. 

A nice morning in the immigration office

When you are accepted for residency in Uruguay, you are given a Cedula (ID card) good for one year.  It is Cedula Provisoria and your status is ‘Residencia en tramite’.  Usually, your application is finalized within one year and you go from en tramite to ‘definitiva’ (phonetic–sorry).  I say usually because in my case, they didn’t like my salary entry so it delayed the whole thing about 3 months.  Because of that, I had to rewnew my Cedula before April 28.  And therein lies the problem and the story behind the post.     

The Direccion Nacional de Identification Civil (the folks who handle the Cedula), had never seen this before so they told me to go back to Migracion and ask them to ‘authorize’ my request for a new Cedula…  They were nice about it.  Even gave me a ‘get out of jail free’ card, (a piece of paper that says I dont have to wait in line when I come back).  This morning I went to migracion. 

It opens at 9:15.  Get there at 8:30 and stake out a place near the front door.  If you’ve got the time, go there the day before and scope it out.  By 9:15, there are a half dozen people there for the same thing and when the door opens, they WILL rush in.  Today I was late… bad boy.  Even if you’re not front of the line, you can still gain an advantage by knowing exactly where to go and get your number (see scope out above).  You need a number for everything in this place.  You want to dash half way to the back, slightly to the right and look for a paper ticket dispenser on the wall facing you which says, ‘Numeros.  Seccion Residencia’ .  Be careful when you take a ticket.  If not, you’ll end up with several and everyone will hate you.  If you’re one of the first 3 getting the ticket, you will probably get to see an ‘officer’ in the next 10-15 minutes.  In the past, I’ve never seen more than 2 of them working but today, it was busy and there were 3 and they really were working.   There were 9 applicants (or is that supplicants) ahead of me today.  In the past, I was always in the first rush so I had no idea what to expect the wait time would be but I figured on average 25 minutes a person, 3 officers working 75% of the time, about 2 hours.  I was pretty close. 

This room handles 2 types of service.  The immigration service - assuming that’s what you’re there for.  And permissions for minors to travel.   Not likely what you’re there for.  Immigrants sit in the seats facing the back of the room.  Parents seeking permission to get their kids out of the country without both parents, (or no parents), sit facing the side of the room.  While you’re waiting for immigration, you are amazed at how fast the other side moves compared to yours.  There’s a lot more laughing going on over there too.  Not much lightheartedness on the ‘migracion’ side. Wonder why (chuckle)…

While waiting I was listening to the folks around me.  Lots of different languages.  Reminded me of sitting in a restaurant in downtown Toronto minus the Mandarin.  Today, it was mostly Spanish followed by German and some Portugese (Brazilians I suppose).  The Hamburg delegation, (no offense meant) was large.  Around 5 people   Some applicants had ‘handlers’ or perhaps translators..  Some wore suits and ties.  Most were young ladies, casually dressed.  I noticed the well dressed men took much longer to process their clients.  Maybe that’s how they fund their attire…. Not sure if that’s the the chicken or the egg.  There were 2 pleasant nuns and a rather impatient looking man from Russia.  The locals or near locals talk to each other… It’s not the clipped, near formal conversations we have in North America with strangers.  Uruguyans (and near Uruguayans) will have a real conversation with you.. as if they’ve talked with you before..  When someone gets up, it’s not uncommon for someone waiting to come up to the officer and ask them a question, out of turn.  No one seems to mind.  Like back home, cell phones are repeatedly going off.  You can use your cell phone in this office, as you can in most government offices but you can NOT use a cell phone anywhere near a cashier.  So stay away from areas that handle money everywhere in Uruguay when using a cellphone.    

 Photocopy everything you take with you.  Chances are they will want copies.  They’ll wait for you to go get one.. but the other people waiting will not be happy with you.  Cedula renewal is YOUR responsibility.  The government doesnt mail you a month or 2 before expiry.  Call for an appointment 4 to 6 weeks in advance.  Like me, you can do the ‘last minute club’ but it’s not recommended.  You can call directly or go to a Red Pagos office and they’ll do it for you.  There’s a fee.  Not much.  If you waited too long and need an ‘urgent’ appointment, the fee doubles and you may have to call for a few days.  Like the airlines, cancellations are received and those become available for the ‘urgent’ appointment offering.    The best place to get your Cedula renewed is at the Geant store.  Once you have your appointment, you’re in and out in 15 minutes.  Except for unlucky folks like myself.   Once you enter the door to the facility, you have to speak/understand Spanish.  They dont allow your ‘handler’ to come with you.  But at that point, it’s very straightforward.. and hand signals work just fine.  Cedulas are heat sealed pieces of paper which the government emphatically and fanatically manages. The first time I got mine, the paper actually had a defect.  My girl looked horrified and called the manager who had to call the ‘director’ over to void it.  This is a very, very serious business.   Your first cedula is good for a year.  Subsequent are good for 5 or 10 years.  At 60 you win the jackpot.  It’s for life..  At the end of the initial process, they take your fingerprints.  Want to look like a pro?  Bring some handiwipes with you. 

When the immigration officer has finished with you, fingerprinted you, whatever, you’re not done.  You or your handler has to take the paperwork to the front, on the right and get it stamped/approved and then it’s over to the cashier.  This process appears different for different folks, but one way or the other, you’ll end up in both places.  Except for the cashier, you need to get another paper ticket. 

If you dont speak Spanish, you must have a translator with you.   There is one bathroom in the facility.  It’s clean, but bring your own paper.  When I checked it out, in addition to having no paper, there was no paper holder.  So I assume this is a permanent condition.  The computers are old but function quite well.  There were no disruptions today, or any other time I was there.  Perhaps because so much of the process is paper, it doesn’t matter.  The furniture is spartan and clearly, the government’s use of taxpayers dollars in Uruguay is not as obscene as it is in North America. 

Immigration officers are for the most part, nice enough and pretty efficient.  I can never figure out why they leave their desk after they talk to you for a few minutes and disappear into the back for 5-10 minutes, but they do.  Depending on how complex your process is, they may do this a few times.  When I applied originally, I distinctly remember them going several times.  Today, they only disappeared twice.  The 2nd time for quite a while.. over 10 minutes.  They always come back with some kind of paper..  Today they came back with 2 papers. 

By 12:30 I had my authorization to go back to the Geant mall and square one.  Tomorrow we will see if that’s all I need or maybe they send me somewhere else.  I’ve come to the point in my life here where I expect to be surprised…  When I’m not, I’m sometimes disappointed.   Not sure which it will be tomorrow.  We’ll just have to wait and see.