Bulgarian Medicine and Toddler Temper Tantrums

Today was an interesting introduction to the Bulgarian medical community. The U.S. Embassy (the only country who requires this, we’re told), requires that every adopted child undergoes a medical examination prior to issuing a Visa. So we ventured out to Vita Hospital in the eastern part of Sofia this morning for an 11 O’clock appointment.

With my experience in the Irish medical system, I assumed this was going to be a long day. In Ireland, I often saw an afternoon clinic of 20+ patients who were all told to arrive at 1PM. The system was first come, first serve and many waited hours to be seen. I loved our time in Ireland but the medical system, like our own, certainly needs repairs. I was even more concerned when the Bulgarian hospital's website indicated that physician's only see patients from 10AM-12Noon and 4-6PM daily, unless you're in labor, in which case they will make an exception!

The Bulgarian experience today was much different than I anticipated, however. The “hospital” seemed more like a clinic or a very small community hospital. Although I’m sure we were kept in the outpatient side of things, I honestly don’t see how they had space for inpatient care, operating rooms, or labs. It was simply another small-ish building in a long row of apartments at the end of a side street. There was no parking, no ambulance bay, and relatively little commotion. Of course, this is a private facility so the public hospitals may be much different, but it was certainly not what I expected.

My concern over waiting to see the doctor was heightened when our translator told us we had to see an Otolaryngologist (ENT specialist), an Ophthalmologist, and a Pediatrician. Imagine trying to get all that accomplished in one morning in The States! Even as a physician I understand the plight of the patient having to wait forever, and I can’t imagine seeing three doctors in one afternoon. But this experience was incredibly streamlined. We waited 5 minutes for the ENT doctor to finish with her previous patient and then we walked right into her office/examination room (all three physicians had a small room with a desk, computer, and the exam equipment pertinent to their specialty – very bare bones). She swiftly, yet thoroughly read through Olivia’s medical records, did a focused exam, and then sent us on our way. We arrived at the Ophthalmologist’s door and literally entered without a wait. Her treatment of Olivia was very similar to our previous appointment, and she thoroughly explained her one concern to us in broken, yet very understandable English. The pediatrician’s room was immediately next door, where we actually had to wait 10 whole minutes to be seen! His care and thoroughness was similar to the previous two physicians, and after completing all of our paperwork we left to pay our bill. The entirety of the visit cost 56 Leva, or about $37 USD. This wasn’t a co-pay, it was the cost of the entire experience. Amazing. Of course, from a physician’s point of view I can see that these physician’s don’t make nearly what we do in the U.S., which certainly makes it harder to recruit people to the specialty. However, I must say that our first (and hopefully last) experience with Bulgarian healthcare was a pleasant one.

Afterwards we took a taxi to the city center where we visited some of the sights we did not get a chance to enter on our tour. We walked around for a bit and while we were on our way to eat Olivia had quite the meltdown. She repeatedly screamed “No” at us and swatted Sally’s hand. One of us would scold her and she would immediately cry out to the other to “hold” and “comfort” her. When the other one scolded her as well, this made her angrier and it took a while for everything to calm down. Quite a scene….

The interesting thing we are learning in this process is that Livi is like any well behaved 3 year old who just has her moments. The problem is that most 3 year olds at least can understand why they are being scolded and what their parents are saying. So, this will be one of our unique challenges in the coming months. Despite this little experience, Livi has been a very happy, joyful, well behaved child, for the most part. More importantly, she seems to be adjusting well and we are absolutely thrilled to be spending so much time with her.

Tomorrow we head to the U.S. Embassy for our final set of appointments. I just hope I haven’t done anything too bad in my past to prevent us from getting a Visa…Pray that there are no outstanding warrants!