I can’t really say I woke up - it was more of a “be more awake than before”. Those examination stretchers are not made for sleeping comfort. It also got really loud around 6 am. Parents who had stayed up all night with a sick baby, fearfully listening to barking coughs and labored breathing, had finally packed up their child as dawn approached and brought him to the ER. They needed my stretcher for another child. Didn’t need it. People came in and out. We were very, very hungry. I needed coffee. At around 7, I called Doug and asked him to bring something for us on his the way to work. 90 very long minutes later, he arrived with hot coffee and sandwiches.
Alan seemed much better this morning. His fever was completely gone. He read his book and smiled, like a different child. I had a fleeting image of a world without antibiotics and then very purposefully pushed this thought out of my mind. Better not to go there just now.
We waited. Waiting gets really long and boring if you don’t exactly know what you are waiting for. We were told we’d be transferred to the Lung Ward later that day. People continued to drift in and out. The night doctor, the nice female one who spoke good English, came and looked in on Alan. She told us, again, that we’d be transferred to the other ward and that the treatment would have to be continued for quite some time. “He’s very, very sick”, she added. But maybe, she suggested, it would be possible to have the treatments in the hospital and go home for the night.
“He needs good, healthy food”, she said in a way that suggested that good, healthy food was not an option at the hospital. I asked whether there was any food to be had and she said that in the ER, there is no food. (Well, I guess that is true all over the world, no?)
I later found out that there is a kind of on-board sale of food going on three times a day. A help? Technician? Cook? Well, a person comes with a trolley full of food three times a day and yells “Food” in the hallways of the wards. Patients (or their caretakers if they are not ambulatory) go into the hallways and return with food on plates. There are no bedside tray tables. There are little dresser/nighttable kind of things but they don’t have a tray and eating is a precarious thing. I am also not clear on whether the food is free or whether you have to pay for it. We never bought anything from them, Alan being a very picky eater. But sometimes, when we came into the hospital in the mornings, it smelled very, very good. (You walk past the kitchens in the basement.)
At around 9:30, a pretty red-headed nurse popped into the room. She spoke quite good English, and she told us we’d be going to the Lung Ward now. I never did find out her name but she has a quick smile, and a very sunny demeanor, and the kids adore her. She brought us to the Lung Ward. We had to walk. In the US and in Germany, you’d get a wheelchair and would not walk on your own. In Pristina, you walk. In fact, you walk out of the ER, down the steps, around the corner, up the steps, into the Lung Ward.
My first impression was… chaotic. Lots of people, too many. Rundown equipment, touching attempts to brighten up the space with colorful stickers and pictures on the walls. Dreary hallways, grimy floors, old beds with sagging mattresses and altogether too many people on the beds and in the rooms. Three, four beds to a room. There were only six rooms, and I would later find out why: when USAID remodeled the ER, they re-purposed three rooms from the Lung Ward for the ER to make it bigger and more impressive. They pulled up a wall to separate the two wards - this way, (official) visitors to the ER would only see the shiny new remodeled rooms and would not wander accidentally into the run-down, old, tired Lung Ward. That’s why you have to leave the ER physically to get to the Lung Ward, although they are right next to each other in the same building.
The nice nurse ran off to get sheets and pillow case. We had not known that it's better to bring your own blankets, pillows, and sheets. I very determinedly did not think about what that meant. The first sheet she brought was ripped, so she had to get another one. All the while, Alan was very, very quiet. He took it all in, and the contrast to a German hospital must have been all the starker because he just had been in a German hospital with his tonsillectomy. The little dresser next to his table was obviously once donated from some office. It was old, dirty with the kind of grime that the years bring with them and which you can't ever get off again. Let's call it patina. The room was full of people - there were two sick babies, their moms, and some visitors, the nurse, us - all in all maybe ten people. It was crowded and too close for my German space-conscious self, but the Kosovar moms immediately started talking to us and their warm smiles made us feel awkward and judgmental. It was all they had, and they shared it. Who were we to judge?
Alan, my Alan. He looked to me and whispered, "I wonder what that little girl has. She looks awfully sick!" That's Alan in a nutshell for you.
The nurse came back with a doctor, and then another doctor, and yet another one. They listened to Alan's chest, looked at his x-ray, listened to his chest some more. They asked a lot of questions about his birth weight, about his development, his height, weight, and how he got sick. And, oddly, whether I'd had "an abortion before this child". Whatever that is important for, I do not know.
"He is very, very sick", they said to me. I would hear this so many more times, I wondered whether we came across as negligent or careless.
"He needs treatment", the doctor said. For how long? "Well, we'll see. One day, and then we see." It turned out that this young male doctor was nice, competent, and not very good in English. Then the doctor tore off a piece of paper, scribbled something down, and gave it to me. "You go to pharmacy", he said. "Buy this, bring back here."
Yes, I was a bit bemused. Surely, they had medication at the hospital, no? No, it turns out, they had not. Any kind of medication has to be bought by the patient (or his/her ambulatory caregivers). So I went and looked for a pharmacy and found one and bought Alan's meds - antibiotics for IVs. I brought them back and they hooked him up, and I held his hand for a bit.
At about 1 pm, I had to leave him alone - Leah was about to come home from school, and I had to make and bring back food for Alan, supervise homework, and get dinner on the way. Alan was getting really hungry, having eaten all the sandwiches and apple slices and nuts that his Dad had brought for him.
We returned later that day, all of us, to bring tomato soup, strawberries with milk, water, juice, and lots of unhealthy comfort food for him. I did not stay overnight with him - the bed was too small for that, and we both would not have slept well at all.
So our days passed between Alan in the hospital and me ferrying back and forth, bringing food and entertainment, siblings and books. Alan was remarkably good about all of this. Much better than I might have been.
After three days, they did release him - not officially, no. Officially, he was still in the hospital but in reality we went there in the mornings to get his treatment - antibiotics and steroids now - and then we returned back home. Every day was a bit better. He was still sick, no doubt about that. He still had dark circles under his eyes but he was so much better than he was. The treatment, no matter that it was administered in a dire setting, was definitely helping.
Alan, in the meantime, made sure that everybody fell in love with him. The nurses adored him anyway, and the moms fell for him because he walked around in the rooms, distributing rainbow loom bands to toddlers who were bored out of their mind, or were poked by needles, or were just plain miserable with sickness. Every single one of those kids perked up when they got a bright, flexible rainbow loom band as a gift from Alan, who spent his afternoons making them. He was forever distributing cheer in these rooms, and was loved for it.
One really bad thing were his veins. Oh, why do have our kids to inherit our worst features? Those bad veins that are hard to find, even harder to poke, and which simply shut down after a day or two? Poor kid, he got poked so many times, he looked like a needle cushion in the end. Every day we returned for the treatment - sometimes, we had a little exam room to ourselves, most of the time we were unceremoniously packed onto the bed of some other small patient. This was both extremely upsetting and very charming - everybody shared. You have no bed, you lie in mine. Nobody would ever do that in Germany.
It took us 15 days of daily treatments. They took a second x-ray after ten days but while markedly improved, the pneumonia was still there. So we had another five days of IVs, and today, we were put on oral antibiotics for another five days. Then, he should be clear.
He's still weak, and not very resilient. After six weeks of hospitals and recuperation, his body is not used to activity anymore. A short walk on the weekend exhausted him to the point of tears. We will have to take it very slowly.
Can we recommend the QKUK Klinkika e Pediatrisë?
It's not, as one of the nurses told us again and again, an American hospital. The standards are very low when it comes to comfort, modern appliances, and doodads. There are no electric beds that you can adjust to your liking. There aren't even bed-rails for the kids. There are no call buttons for the nurses. Or phones on the nighttables. Or TVs on the walls. Only some rooms are equipped with oxygen lines, in others, you'll just get hooked up to a giant oxygen tank that they cart in for you. On our second to last day, they ran out of IV tubing and we had to go to the pharmacy and get some.
Was I appalled by the structural conditions? Yes. Was I shocked that multiple people shared a bed sometimes? Yes. Was I really, really desperate when we arrived to dark, crumbling buildings and is the parking situation abominable? Absolutely. Do you have to walk across the entire hospital grounds to get an x-ray because the radiology is in an entirely different building? In the rain, and in the cold, with peumonia? Yes, you do.
But the nurses are fantastic - caring and competent and cheerful. They took care of Alan, and fussed over him, and drew little hearts on the tape when they had to poke him oh so many times to get a needle in. One nurse told me that when she came back from a 3-day-break, her first question to her colleagues was how Alan was doing. They told us over and over again that we were "a very good family" and oddly enough, that comforted me. They told us stories, about how those beds have not been exchanged in the past 25 years. How one nurse's son plays basketball for Turkey in Istanbul at age 15, and how she misses him so very much. And they apologized over and over again for the condition their ward was in.
The doctors really know their stuff. They did (correctly) conclude that Alan's pneumonia was a hospital acquired aspiration pneumonia stemming from his previous surgery. Right there on the first day, they asked me whether he had aspired anything. It took a while (between the language barrier and my missing medical knowledge) to figure out that yes, he did, probably, during surgery. They implemented a regime of treatments that healed my kid and got him up on his legs and smiling within a very short time period. We owe a huge thanks in particular to Dr. Hasani who was our primary doctor, who speaks very good English, and who did everything right.
I would not want to go back in a hurry. And yes, I would prefer a more modern hospital and doctors in my own language. But I would know that in an emergency, we would not be alone and we would be taken good care of. And that's a good thing to know.