Living abroad anywhere will inevitably lead to many unique experiences – that’s part of the fun of it, after all. Over the last three years in Bulgaria, I’ve experienced a number of firsts – my first (short, little) earthquake ever, my first holy-crap-this-is-an-earthquake-WTF-do-I-do-and-am-I-going-to-die earthquake, my first fire at work, my first fire in the building I live in, etc. but I feel like I’ve given myself a number of strange experiences in this past year from a king of bucket list mentality. In my first year, everything was a new experience; even shopping for food, buying appliances, or paying your cell phone bill was an adventure that I, for the most part, embraced. In my second year, I was totally over adventure-seeking; I just wanted to be able to buy goddamn contact solution without having to walk into an optika and ask for it, or send my own mail, for crying out loud. Now that I know my third year will be my last, I feel like I’ve taken on an attitude of, “Well, why the hell not?” when it comes to doing things that seem intimidating.
There was, of course, the trip to Tanzania this winter that yielded a lot of bucket list experiences, such as being injected in an airport in a foreign country. Then a few months ago I purchased glasses in Bulgaria. I never got around to writing about it, but this ended up being a far more involved procedure than originally intended, since the frame I picked out the first time ended up being too big for my astronomical lens prescription, which leads to 1) really thick lenses and 2) extreme distortion at the lens edges (a fact that I knew from opticians in the States, but had forgotten). They technically worked, but I decided to man up and ask the optician to cut down the same lenses (to avoid being charged twice) to put in a different, smaller frame. This required a lot of very crappy Bulgarian explanation on my part and not always fully understanding what Vyara, the optician, was saying to me, but I stuck it out and I did it, and now I have a pair of Bulgarian glasses that I like wearing.
I gave myself another bucket list-worthy adventure this past week. I’m returning to the States in the fall to get my doctorate, and the university requires a negative TB test within the past year prior to enrollment if you have ever lived in/visited for over 1 month basically any country that is not in North America or Western Europe. The medical forms are due in mid-June, and I don’t finish with work in Bulgaria until July. Originally I was just going to get the TB test done after I returned home sometime in July, before my medical insurance ran out; I even got permission from university health services to send that one form after the deadline. But then I thought: Well, why the hell not? Let’s go get a TB test in Bulgaria!
Here’s how I did it:
1 – I went to the school doctor and asked if the clinic that’s adjacent to the school would do it. Already, this is a procedural difference; in the U.S., I would’ve just called said clinic, but I called them about the yellow fever vaccine in December and the receptionist didn’t really speak that much English. I also didn’t know how to explain a PPD in Bulgarian, and while the school doctor doesn’t speak English, the school nurse does, and could translate for me. Living here, I’ve learned to use my personal resources when I have them. Anyway, the doctor said no, that I had to go to this special clinic downtown that specialized in lung diseases. (Classic Bulgaria – something that any doctor’s office in the U.S. would do can only be done in one location in the city center. Same situation as with the yellow fever vaccine, although I acknowledge that that one’s a little more of a specialized situation.) She was super helpful and gave me the address (from memory) and assured me that I wouldn’t need an appointment. “This is very common in Bulgaria,” she said, “for schools, for work, etc. So you can just go – it will be easy.”
2 – Again drawing on interpersonal connections, I then asked one of the bilingual administrative assistants in my building to help me call the clinic and ask about their hours. She did, and relayed to me that they were available for TB tests from 8:00-17:00 on Monday, Tuesday, and Friday (I’m guessing because of the 2-3 day wait period to return to have the test read). She also took it upon herself to recommend, hilariously, that I go in the morning, because “no doctor in Bulgaria is really going to be there all the way until 5:00 pm.” Lots of faith in their own compatriots, Bulgarians have.
3 – I decided to ignore Hristina’s well-intentioned advice because it wasn’t actually feasible for me to go in the morning on a Monday, Tuesday, or Friday. That very day happened to be a Tuesday and I happened to have no meetings after lunch, so I got permission to leave school early and go downtown. I wanted to leave myself plenty of wiggle room in case Hrisi was right and the doctors really did peace out early.
4 – The address of the clinic is ул. Св. Св. Кирил и Методиий 78 (Cyril and Methodius Street #78), which is right downtown, so I decided to take the metro. However, one map that I’d looked at online had the address pinpointed completely wrong, so I got off at Opalchenska, which is where Cyril and Methodius begins, but is basically the wrong end of the street. So I had a lot of walking to do, but I got there. It was a good thing I’d done some internet research, though, because when I got to the block where the clinic should have been located, numbers-wise, I saw only a cafe. Then I noticed a blue sign, which I recognized from one of the websites, on an open gate to a driveway next to the cafe. It listed not the name of the pulmonary clinic that the school doctor had given me, but a more generalized name of a hospital, with the address and the number 78. I hesitantly walked down the driveway, and there, behind the cafe, in what would be the loading dock area for a lot of restaurants, were two open doors that led into what could maybe possibly be a medical clinic.
5 – I entered the door on the right because it looked more promising. This is not to say that it looked at all promising, just that comparatively speaking it seemed to hold more potential than the door on the left. This led me into a vaguely office-like space with a booth at one end labeled КАСА / РЕГИСТРАЦИЯ. I went there and explained that I needed a проба за манту (basically just the Bulgarian transliteration of the Mantoux test, which is what a PPD is also known as outside of the U.S.). The woman at registration thought I was hilarious. It was kind of cute – it’s always nice when Bulgarians think you’re hilarious for speaking bad Bulgarian, instead of just getting pissed at you. She told me it was 6 leva ($4) for the test, and after I’d paid, she issued me a little receipt just like you’d get at the gas station convenience store and told me to go to the third floor, кабинет 27.
6 – I climbed the stairs. Helpfully, the floors are labeled, because the “first floor” is actually the third, so I had to go to the fifth floor to find the “third floor.” On the “third floor,” I got a little confused. Part of it was that this medical clinic in no way looks like a medical clinic in the American sense; it’s essentially an old apartment building that’s been converted. On each landing, you can either go left or right into what used to be apartments. What was the front door of each apartment has been removed so that it seems like more of an open, continuous space. Once you’re inside either the left or right apartment (I went to the right), there’s a hallway that goes around the corner. There are a few closed doors along this hallway with numbers over the door. Immediately to the left there is an open room with a couple of hard couches and other closed doors; a waiting room, essentially. However, all of the doors are padded on the outside (seriously, as if for an insane asylum, though I guess it is actually to muffle the voices within to preserve patient confidentiality) and only labeled with numbers and a brief, unhelpful description in Bulgarian (i.e. the ones around the waiting area are all labeled “Client Consultation”). They are also all closed, and I feel like a medical clinic is just one of those places where you don’t walk around randomly opening doors. So I stood outside door 27 for a little while, trying to figure out what I was supposed to do. You can’t knock, because the door is padded on the outside, so it doesn’t make any noise. Very tentatively, I tried the door, but it was locked. No one was around, either doctors or patients. The sign on the door had two words, one of which appeared to be the Bulgarian word for “Manipulation,” which just didn’t seem right to me as far as being a TB test site. I started to wonder if I’d misheard the receptionist, but I didn’t want to go down four flights of stairs to double-check. I also wasn’t sure if maybe I was supposed to wait and somebody would be notified that I was coming up and would come get me. So I sat in the waiting area for a little while and pondered my next move.
7 – I could hear muffled voices from a few of the “consultation” rooms bordering the waiting area. Then a man in plainclothes emerged from one and looked at me. Just when I was gathering the courage to ask him what I should do, he crossed to a different consultation room and went in, closing the first door behind him. So I was back where I started, growing increasingly nervous.
8 – A middle-aged couple arrived, somewhat out of breath from the four flights of stairs. They looked around, looked at me, went to door 27 also (which was out of sight from the waiting area, but I could hear where they were in the hall), and conferred with each other in confusion. I was gratified that the Bulgarians seemed just as perplexed by the whole thing as I did. I also decided they were totally going to be my key to how I figured out what I was supposed to do. Sure enough, a minute or so later, I heard a door open and a new voice entering the mix. There was a brief discussion, and then the woman came into the waiting area to sit. I got up and went into the hallway and saw the man entering room 27, and just inside the door I saw a poster (in English) describing the Mantoux test procedure. I also saw what the couple had figured out, which is that there is what looks like a light switch in the hallway that has a sign above it with the word “push” in Bulgarian and the numbers 27 and 28. It was basically a doorbell to alert someone that you were waiting for either room 27 or 28, and then the nurse would come out to deal with you. I just hadn’t seen it or registered it, because your eyes don’t really take in things like that automatically that aren’t in your native language. So I waited for the man to get his shot, and then when he came out, the nurse saw me waiting there as well.
9 – I explained to her that I needed a Mantoux test also, and showed her my payment receipt from downstairs (which in no way identifies what exactly has been paid for, just that a sum of 6 leva has been paid). She took me inside the office, and though she spoke no English, we managed to get my name and address recorded (by hand in a dnevnik, of course) and my right arm injected. Then she gave me this whole series of warnings about how to take care of the area, most of which I did not understand (the only one I fully understood was “no alcohol”), but after a failed series of clarification questions, I decided to just fake understanding and then Google the procedures when I got home. (Incidentally, no website that I found stated that you shouldn’t drink alcohol after getting a PPD. Also the care procedures are just really basic ones like, “don’t scratch it” and “don’t cover it”). She gave me a paper receipt and told me to return on Friday, and that I must bring this paper (she repeated this several times) when I came on Friday, even though when I examined it more closely later, the only information it actually has on it is my name, my address, and the date, plus a stamp from the clinic (Bulgarians love their stamps). Maybe somewhere it mentions that I came in for a Mantoux test, but I can’t find/read it. Anyway, I also showed her the form from my university and explained what it was, and she waved it off and said that I could bring it also on Friday for the reading. She was pretty brisk, but not unkind; when I thanked her as I left, she gave me a perfectly nice “моля” in return.
10 – When I returned to the clinic on Friday (much faster this time now that I knew to get off the metro at Serdika, not Opalchenska), the woman at reception was different and did not find me hilarious, but was quite friendly and waved me on up once she saw my totally meaningless but stamped paper from last time. The nurse in number 27 was also different and was equally brisk as the first one but way less nice. I could just tell she would not have been as patient trying to explain and re-explain my post-Mantoux procedures the way the first nurse had. She looked at my papers, looked me up in the dnevnik to verify my first appearance, then demanded to see my arm. She grabbed my forearm, yanked it toward her, peered at it, and then said, in Bulgarian, “There’s nothing there” in this really disgusted tone and then proceeded to grumble about nothing being there while she scribbled something on my meaningless stamped paper from last time. I was like, I’m sorry to be such a grave disappointment to you for not having tuberculosis. Then I asked her to fill out the university form, which she was TOTALLY pissed about. I mean, I get it – it’s sort of sketchy to fill out and sign a form that’s in a language that you don’t understand. But this is Bulgaria, where you can go to any doctor’s office and buy yourself an excuse note to get out of school/work for two weeks for bullshit “medical” reasons. And all that was required was the date of PPD injection, date of reading, the measurement of reading, and health care provider’s signature, phone number, and date. I mean, it had occurred to me that I could just forge the entire damn thing and the university would probably never know, but I was making a good faith effort here. At first she tried to argue that the meaningless stamped paper was my certification, so why should she fill in something else. I was just not having it, and insisted that she fill out the English form. I translated each of the blanks for her, but she was still super petulant about it and doing the whole Bulgarian “I don’t understand you if you don’t speak perfectly precise Bulgarian” thing. Since I didn’t know exactly how to translate “date of PPD administration,” I just translated it as “first date,” and she was all, “First date? WTF do you mean ‘first date’?” even though of course it’s totally obvious. Then the blank for the measurement is labeled “# of mm induration” and she wrote (-) in these angry slashes that sort of makes it look like the letter H. Or, disturbingly, the number 11 (which would be a positive result). I tried to get her to write a zero and she nearly took my head off. “There’s nothing there!” she yelled at me. “I write ‘nothing’ like this!” I pointed out that the blank was asking for mm, a universal abbreviation for millimeters, and explained that it was asking for “size” (I didn’t know the Bulgarian for “induration” or any other medical term, obviously), and she retorted, “How do I give a size? There’s nothing there!” Really, she seemed unduly put out that I didn’t have tuberculosis. Then I pointed out the blank for signature, and she demanded to know whether I needed her signature or the stamp of the clinic. I replied, “…both?” (I’ve been trained well in the dual stamp-signature policies in Bulgaria) and she angrily scribbled an illegible Bulgarian signature and snapped that I had to go downstairs to registration for the stamp. She thrust the form back at me, and I got the hell out of dodge, not even bothering to ask for the phone number or date, since I figured I could fill them in later, along with a “0” for the induration blank.
11 – Downstairs, the friendly woman at reception put a second stamp on my meaningless stamped paper from Tuesday and then when I asked for it on the university form as well, she scrutinized the form and then carefully placed the stamp over the (-) symbol in the measurement blank. I guess she figured this was the important thing to guarantee? No idea. She handed them back to me and went back to her Sudoku puzzle, and I went home.
So my plan is to now to scan and send both the university form and the meaningless double-stamped Bulgarian paper to my school for proof that I don’t have tuberculosis despite having the nerve to live outside of the U.S. or Western Europe. And if they express any skepticism about the validity of my test, they can call the clinic themselves and take their chances trying to explain in Bulgarian what medical record they need verified. Or read this blog post and decide that I really couldn’t make all of this up.