The simplest things can be an EVENT in the islands. Today, I have decided to visit my Doctora. The preparations started early in the day. Like many others in the town planning to attend the same event, I showered, washed my hair, and dressed in a go-to-town outfit. A t-shirt and jeans, my usual daily attire, will just not cut it for this event. Other attendees will be mostly women, some with children. Dominican women, no matter their economic level, dress in their best for such an event, and also dress their kids well. The undeniable beauty of these women is always enhanced by the evidence of weekly salon visits for hair-styling and manicures.

The custom here is to NOT give appointments; you must go and wait and hope to be seen on the day. Usually the latter is the case, and I must say this beats the system in the north where you have to wait weeks, sometimes months, to see a doctor depending on a wait list.

I made sure to eat lunch before I left home and now I am sitting in the Doctora’s waiting room. She starts to see patients at 3pm. I had hoped to be her first today, but another person was here ahead of me and so I am #2. Even getting here by 1:40pm did not manage to guarantee me a first patient position.

The Doctora I am waiting to see is a specialist in her field with a well-earned reputation for excellence. I have seen her previously and know that she has grown children, and besides her practice, she teaches one day a week at a nearby university. Hair and nails are impeccable, jewelry underlining her success, stylish and attractive, she wears a pink and brown lab coat, color-coordinated with her office furnishings. She always welcomes me with a smile and a hug and says goodbye in the same manner. My family doctor in urban Toronto sometimes had a smile, but that is where the similarity ends.

I settle down for the lengthy wait – “no problem,” as one learns to say here. I have come prepared with a book to read and a notebook for writing, should I feel the urge as I do now to describe the scene around me.

A lot of other patients are here already and many waiting to see other doctors. This particular waiting area has space for the desks of 2 secretaries who sort and schedule patients for a total of 4 doctors. The clinic is not new but has had renovations over the years. The juxtaposition of old and new is in itself an interesting phenomenon, and one common in the islands. The waiting room is really an extended corridor. The area has been extended where possible so there is more sitting room for waiting patients but the secretaries, just as they did in older times, are really sitting at their desks in the corridor part of the space. There is a steady stream of people going to and from other areas in front of them.

The good humor of the secretaries is astounding. They take ID and insurance cards and validate these by phone, each call taking time while they are put on hold for the inevitable wait for a representative to respond. They hand-write documents with carbon copies, answer questions from waiting patients, field complaints, and in general, herd and care for the waiting throng. They do all this with serenity, confidence, and a welcoming smile and chatter for everyone including friends and acquaintances who pass by.

This is not a quiet society; people here expect noise and expect to be noisy. There are 2 television sets on and some background music coming from somewhere. People with phones are calling friends or their friends are calling them. Others are watching videos on their phones, or playing games, or listening to music. There are children bouncing around due to the local laissez faire philosophy of their parents. But “no problem” as I said earlier. I have time, something I never had in my former life up north. I love to people watch; there is so much energy here, so much color, and so much animation. The use of hand and face gestures has been elevated to an art form in the Dominican Republic.

Two seats to my right is what is obviously a pharmaceutical salesman, his black sample bag in front of him. He is waiting for a chance to do a quick sales call. One has to watch like a hawk to make sure he does not squirm in ahead of you when it is your turn. If he is a friend of the secretary, you are doomed anyway.

Imagine this: in my hands, I have the results of recent tests. On this island, one is allowed to preview one’s tests since the lab gives them directly back to the patient, unlike the northern practice of sending the secret results to the doctor ahead of time.

The doctor arrives at 2:45pm. At 3:10pm, Patient #1 is summoned into her office. I feel elated because I know I will be next. I stare down the drug rep so he will know I am watching him. I continue to write my observations of the scene, trying hard to avoid the toddler’s foot which wanders over my way as he squirms on his mother’s lap with the hope that he can climb over me and escape. This typical “hand-off” is expected, but disastrous if one is wearing white pants.

The waiting throng has increased and, of course, so has the noise. I think regretfully of the cappuccino I could have bought on the way in and I ask myself why I did not come earlier so I could have been in that #1 slot. But, no problem, I have time! I just hope my hearing is not diminished by the end of the afternoon. I try to think positive thoughts. Perhaps my husband will have come home a little early and will think about preparing dinner. At 3:45, Patient #1 is still in there. I am tempted to imagine all sorts of strange happenings. Has he decided to start a romantic relationship with the doctor? Or have they discovered they have family connections and are sharing memories?

The wait continues and so does the noise and also my imaginings. I cannot wait to see how #1 looks when he finally exits. Will his baseball cap still be on his head and backwards? Will his t-shirt be pulled outside his baggy pants? Will he look happy, sad, or serious? Just as I am about to lose all mind sense, the door opens at 4pm and I scramble to beat the drug rep to the door, but he sidles in beside me. I sit and he stands, but I must wait while he chats with the doctor and leaves her some new samples. She smiles at me, is charming to him, and finally it is my turn. I receive my hug.

She refers to her pink Apple laptop to review my medical history and to enter my new test results. Then, in her examining room just behind the wood screen, she can actually look at the blood sample she takes from me, under her own microscope, and checks to verify my blood coagulation time. Of course she checks blood pressure and prods my body in the significant sites with which she is concerned. She announces that my blood pressure is excellent as if I have actually made it happen myself. I return to the chair in front of her desk and she discusses my progress, making me feel like I am really a participant in my own care. Upon departure, she gives me a summary report printed directly from her computer. She tells me when she wants to see me again, giving me a lab order for tests before I come back. She also gives me a little folded note for the secretary which I know tells the secretary how much I have to pay over and above what the insurance covers.

It is now 4:50pm and I will be very late getting home. But, no problem, I have time, and thankfully so did the Doctora. Did I really get all that medical attention, personal care, and an amazing experience for the equivalent of $30 USD? Seems unbelievable, and yet it is true, making me appreciate my rock with all of its colors and noise all the more.

I decide to have that cappuccino on my way out.

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How does the medical care compare on your rock?