Lest Your Adventures Land You in the Hospital

By: Katrina Ausley

This morning Jamie, Darlene, Jade and I found ourselves at the top of a large hill waiting with heightened anxiety for a bus that we dearly hoped would get us down to the Central Market in time to meet our fellow travelers. As luck would have it, the bus came at the last possible second and we headed out for a day filled with educational opportunities, more so than I could have imagined when I left home this morning.

Our first stop of the day was at the San Juan Hospital and Medical School. We were all ushered into a conference room with our translator and coordinator Cindy, Mireia (a journalist and student at the school), and a doctor who allowed us to ask questions about the services provided at the hospital.

Due to my background working with patients who experience suicidal ideation and self-harming behaviors, I was curious on how the mental health care system in Spain viewed involuntary commitment (such as the United States using Baker Acts). I learned that in Spain, people who are suffering from these behaviors or ideations are first taken to the main hospital and assessed for risk. Once a doctor determines that the patient needs to be involuntarily committed, they can hold the patient for roughly 48 hours while also sending a recommendation to the courts.

The courts will then send someone out to consider the recommendation and decide whether the person will need long term involuntary commitment. I also asked whether mental health care is covered by their universal health care system. The doctor appeared confused when the question was asked and then promptly replied that “of course mental health care is covered.” I found his confusion and answer fascinating. I am an avid advocate for mental health care coverage in the United States, but unfortunately have seen a great deal of gaps in terms of insurance coverage for those suffering from mental health related issues. The fact that this question seemed so absurd to this Spanish doctor further strengthened my resolve to advocate for more services when we get back to the United States.

After our group discussion with the doctor, we were given a tour of the hospital. I started to notice some telltale signs that I was not having a lucky day. This was exactly what I was thinking about as I sat, legs out in front of me on the ground, after tripping down some of the stairs. I got up and told myself to be more careful and headed to the library with the rest of our group.

The library in the Medical School seemed much different from the ones that I have studied in during my college career in the United States. Instead of row after row of overcrowded bookshelves as far as the eyes can see, there were only a couple handfuls of shelves, and many of them were somewhat barren. We were told that with the invention of the internet and the use of school books, libraries here did not carry as many books as we were used to seeing. We explored the books that were there and then headed to our next tour stop, the recording broadcasting studio (see the “Bulls on Air” blog post).

After the conclusion of the radio show, Dr. Carrion found a hospital social worker who was willing to answer our questions about the role of social workers in Spain. She explained to us that social workers have the option of specializing in health, general social work, or education.

She specialized in health and discussed some of her responsibilities at the hospital. Her area of expertise was in relation to substance and alcohol abuse. She stated that when a client comes to the clinic, she and the psychiatrist discuss what actions should be taken and then the psychiatrist makes the final call.

As we began to exit the hospital, I managed to slip on another step.

After the hospital visit, everyone went home for lunch. Jamie, Darlene, Jade, and I accidently got on a bus going in the wrong direction and were kicked out of the bus at Las Rambles while the driver went on break. Once his break was over, the driver let us back on the bus and we made it home.

Vale, our host mother, had made a wonderful lunch with pasta (gluten free for me), salad, and fresh watermelon for dessert. Unfortunately, my roommate and good friend Jamie was feeling under the weather and opted out of lunch for an early siesta. When it came time to head back to the Central Market, I decided not to wake her up and went back into town with Darlene and Jade.

The group met with Dr. Carrion and Dr. Joshi to discuss what we learned and what we were enjoying about the trip. Everyone seemed a little tired from the heat and all the walking, but the discussion was interesting and I enjoyed being able to hear the opinions of my constituents.

Eventually the meeting ended and I went to a café with Linda, Besima, Nathan, and Spencer. I sat sipping fresh squeezed orange juice as we discussed what we were enjoying about the trip and how the culture in Spain differed from our own. The weather was beautiful and I felt completely relaxed. I decided I wanted to check on Jamie, so I said adios to my friends and began the walk home.

I got lost on the way to the bus stop. I’m not sure how that happened. At this point I had taken the bus down this way several times but I had yet to take it back up. I walked in the direction I thought I remembered taking home, then changed my mind, then walked some more until finally I had been walking around the city for an hour and had no idea where I was. No problem.

I just had to find the #13 bus. I walked confidently up the street in front of me (and down the street, and over a street, and so on) until I finally found the #13 bus and quickly jumped aboard.

It took me a while to realize that I was taking the bus in the wrong direction, and by “a while” I mean that I realized it when the bus driver kicked me out of the bus at Las Rambles, which was the last stop (again).

I made it home safely and am looking forward to tomorrows new adventure.

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