The Big Box

When we made the decision to retire in Costa Rica, I did my homework. I researched the requirements for residency, and had the application process well in hand before leaving the States. The requirements are onerous, seemingly designed to induce hair pulling and angst. We had to provide reams of documents, have each one notarized, then notarized again by the Pennsylvania Secretary of State, and finally, delivered to Costa Rica via the embassy in Washington DC. The process was exhausting and expensive.

That was in the spring of 2009, and I’m still waiting for my residency, though Jack finally got his, allowing us to join the Caja, the national health care system.

While Costa Rica is a medical tourism destination, with reasonable prices for procedures, we were happy to join the system, because under it, we can receive free health care and free prescriptions at a cost of sixty dollars a month.

The Caja is suffering right now, which means long waits for appointments, sometimes to the detriment of sick people. We’re not ill, but we needed routine blood tests. One of our concerns was our cholesterol levels, which we hadn’t had tested since stopping our meds when we got here.

On our initial visit, we received an EKG, and got referrals for our blood tests and other exams we both needed. For the other tests, like mammograms, bone density, eye tests and appointments with specialists, we would have to make the trip to San Jose, to the large Caja hospitals, a distinctly daunting process. We decided to start locally, and take it from there.

Negotiating the Caja is daunting for those of us with less than stellar Spanish skills, but we finally figured out where we had to go and made appointments at the local Caja hospital, where they drew our blood and accepted the tiny containers they’d issued to collect urine and stool samples.

We were lucky on our initial visit. Our doctor spoke English. But on our return visit, to receive the results of our tests, the doctor spoke only Spanish. I said, in Spanish, that I was worried, because of my limited Spanish skills. She said, no problem, you understand, and proceeded to deliver our results.

Both of us had cholesterol levels a little above normal, but neither of us would require medicine. I needed an adjustment on my thyroid medications, and I’m pretty sure I understood her directions to take the pills fewer times each week. She wrote a referral for another blood test for me in six months and told me to go to the hospital right away and make the appointment.

The tests had revealed an anomaly in Jack’s EKG, and she wanted him to see a specialist right away, so we headed off for the hospital. A sweet little old lady volunteer checked our papers, and led the way to the line where I would make the blood test appointment.

One of the great things about Costa Rica is that they give preferential treatment to oldsters, so when we approached the line, the guard saw to it that I went to the front. Next, our volunteer escorted us to a narrow hallway, parked us in front of a closed door, and told us to go in when it opened.

I opened my Kindle and transported myself to Ethiopia, via my novel, Cutting for Stone, but Jack isn’t as easily distracted, and wondered aloud at frequent intervals why nobody was opening the door, and why TV noises were emanating from it. “Are they watching cartoons in there?” he asked. Once, someone stepped out of the door, made a phone call and darted back in, without making eye contact with us. Jack was starting to steam.

The second time the door opened, the same routine followed, but this time, Jack managed to catch the eye of someone inside the office. By this time, we’d been waiting for about an hour and a half.

The young man came out, and we showed him our paper. He said we were in the wrong place, and took us to the right one, but it was closed for the day. Jack was loaded for bear by that time, and it was all I could do to prevent him from exploding.

A week later, when we finally felt prepared for another frustrating go at the system, we were able to make an appointment for next month, easily and quickly. We’re fine with that, if not exactly looking forward to another exciting Caja experience. If we have to wait for hours, that’s fine, since we’re retired and have all the time in the world. No matter how frustrating, it’ll still be better than going bankrupt paying for treatment in the States.