Warf, warf

It so happens that I had a warfarin wobble just before setting off for Canada and after much sucking of teeth it was decided that maybe I should get a warfarin test while I was over here, just to be on the safe side.

Poked around in google and found a community support centre just down the road from where we are staying in Lower Town. So went down there on day 2 or 3 to see what was cooking. Passed a dental clinic on the way in which looked hopeful. Started to burble on about warfarin and the reception lady looked very puzzled. She clearly did not have a clue what I was talking about. So I stop, to find out that the sort of support they do is all to do with housing, employment and that sort of thing. Why don't I try a family health centre.

There is one of those just down the road where the reception lady does know a little about warfarin and fetches a lady doctor for me to talk to. Are you registered with us? No, I am on holiday. Well, if you are not registered with us we can't help you. Why don't I try the biolab a bit further down the road, in the basement.

Get there to find various people waiting and a nurse/receptionist who does know about warfarin. They also look up for X-rays. Her: where's my doctor's order for the blood test? Me: I haven't got a doctor. Haven't you got one of those natty little hand held machines that we use? Her: no, we don't do it like that. And we don't do anything without a doctor's order.

At which point one of the people waiting pipes up with 'why don't you try the walk-in centre down on Rideau?'.

So down to Rideau where there are a lot more people waiting. A good mixture. But after a palaver, the receptionist says that if I come back in an hour the doctor will see me. $100 please, no plastic taken. Two red notes slide into a folder; no sign of a till, a cash drawer or anything like that, but I do get a proper receipt which should be good enough for my insurer. I come back in an hour or so (after having discovered the Rideau Bakery mentioned on 11th October), and after a further half hour or so, during which time I read the notice about not more than one complaint to the consultation, I got to see the doctor.

He perused my yellow control booklet with interest. No we don't do things like this. No we don't have the little hand held jobs. What you need to do is go down to the biolab people and get a blood sample taken and then come and see me again. We made an appointment for the following week and off I go.

Some time later, having mislaid the all important control booklet, back to Rideau where they didn't have the booklet but they did have the doctor's order for the blood test. The thing I had taken was not the order at all. So not a wasted journey and later that day the control booklet turned up in one of the many places we are putting vital materials.

Some days later, back to the biolab where, as I now have the right piece of paper, I am quickly taken in hand by a very pleasant, efficient & competent Chinese nurse who does the business. A snip at $16 or so. She also remembered me as the chap with the funny accent from my first visit, more than a week previous.

Then the day after, that is to say, today, the third visit to the centre on the Rideau where there were even more people waiting than last time (including the odd stray like myself) and where the receptionist also remembered me as the chap with the funny accent. However, my result has not come through, so she phoned up the biolab and it came over by fax about 5 minutes later. About 10 minutes after that I got to see the doctor, who started by telling me that he used to do sea canoeing back in Haiti, where he came from. We got onto warfarin and I found that I was back in range, so no need to adjust the dosage or to see him again.

So off I go to celebrate by buying a copy of 'On the Road' by Jack Kerouac, an author of whom I have heard but never read, from the nearby second hand and rather scruffy bookshop. A flashy edition from Penguin, made for the American market, not for sale in the UK. A shop which was strong on English fiction and humanities, but weak on French, which was odd given that it was a predominantly French area. The owner told me in passing that there were fads for Kerouac and that last year he had sold maybe 20 of them, mainly to young ladies. Also lot of Plath. But that this year had been bad on both counts.

PS 1: the system is not as bad as it first seemed. But there is not much incentive there to do warfarin our way, that is to say mainly with nurses with special training & hand-held blood testers, backed up with a computer (which has been told a great deal about warfarin management) and, as a last resort, a doctor. Not the way to maximise revenue at all.

PS 2: I wonder how much of an extra burden having to be bilingual was. Not just in the regular, ordinary stuff we use day to day, but all the medical stuff too. Do doctors here get tested for language as well as for medicine?

Reference 1: http://www.bio-test.ca/.