I have seen the wizard!

 seen the wizard!
 and he lives in Chile!
Yeah... this was a long time ago, but it's a story that bears being told because it continues, first, and second, it's one of the examples of what Chile and every other country in the world does better than the US. Naturally, I can only be talking about healthcare.

Most of you know (I THINK) that my always-broken-out chin is a form of rosacea. Dermatogolists in the US just told me it was rosacea, and gave me a prescription for antibiotics, which could help for a while, but not entirely. And other than the mystery of totally clear skin in Asia, my skin breaks out with ot without meds, forever & ever amen.

Naturally, when a doctor in the US tells you you have something you haven't really heard of, you do research on your own because the doctor either: doesn't tell you what the hell what you have means/is caused by/how to treat it, etc., or gives you only a tiny amount of information. Such indepedent research will usually lead you to other sufferers, some of whom inevitably go the way of aliens building the Great Pyramids, as in, some weirdos, attributing the problem to some unscientific/seemingly unrelated thing as the source. Hence, years ago when I looked up rosacea and found a support group, I read, scoffed, and dismissed the naturalists, who all swore that borax was the natural aid for a skin problem caused by mites. I took my pills, applied my gels, and hoped for the best, just as my doctors told me to do. It helped, but never all that much. After time, I'd need the prescription renewed. But once I lost my insurance and was getting ready to leave the US, there simply wasn't time, or money.

Once I was in Chile, the ever-resourceful Rita had the name of a dermatologist here that a doctor she knows in Boston recommended to her. Scheduling an appointment was one of those major accomplishments when you're living in a country where you're not fluent in the language that you feel high from for weeks. But getting to the clinic and finding that without insurance, the ENTIRE COST of your visit is only CP$44,000 or US$88, is kind of astounding. I confused the kind cashier by asking how much more it was at the end. Because after they do... anything in the US, it's considered surgery (popping zits? Actually considered surgery in the US) or a special treatment that would hike up what you owe AFTER the visit (if you don't have insurance).

Dr. Guardia spoke very good English, and saw me in his office. He immediately blew my mind by having me stand right in front of him so he could look at my skin with a large magnifying glass with a light. Never in my life has a dermatologist ever looked that closely at my skin. He stared at my chin for a bit and made a sound of surprise. This is when he told me aliens HAD actually built the Great Pyramids. Or almost, because what he actually said was, "You have a lot of mites on your chin, hence the rosacea." He proceeded to tell me that rosacea is inflammation caused by the demonix mite, which is one of those millions of microorganisms that everyone has on their skin. The skin on my face is particularly hospitable to them, so I have a lot more on my face than most people, and the high concentrations of the mite cause inflammation. Which is what rosacea is. Huh. HUH! First time anyone who wasn't a weird deranged online hippy had suggested anything of the kind to me.

He prescribed me an antiflammatory, rather than the usual antibiotics from US derms, a gel I had been prescribed often in the US, and another cream. He said it was a long process to get rid of them that requires patience. He asked me to come back in 2 months, and at that time, we'd see how the current regimen was working, and tweak if necessary.

----------------------------------------------------------------------------------------------------------------------
So I wait two months. In this time, Rita also goes to see the doctor, which is when I learn how Chile ensured that Chilean healthcare still has those added nonsensical, illogical, irritating steps that is part of living here. The doctor sent her to get blood drawn. The procedure goes as follows: she goes to the lab; the woman doesn't wear gloves as she draws her blood to test; and then it is explained to Rita that the bloodwork will be processed in 7-10 days, at which time Rita must return to the lab (1 floor down from the doc's office in the clinic), get the results, and WALK THEM UPSTAIRS TO THE DOCTOR HERSELF. Yep, Rita has to make a special, 1-hour-each-way-trip to the clinic, just to walk her test results upstairs to the doctor herself. It cannot be interoffice-mailed, emailed, walked up by the lab personnel nor by the doctor or his staff. The patient themself must do it.

No matter how many times I repeat it, I am floored anew by this ridiculousness. I am still waiting for such inefficiencies to stop being a shock to me.

--------------------------------------------------------------------------------------------------------------------

At the start of December I saw Dr. Guardia again, where he again blew my mind by doing shit no Western doctor ever did. After the magnifying glass inspection, he said that the number of (apparently it's not demonix, it's demodics, or something like that) on my face has DEFINITELY reduced, but there's still excessive activity. He wanted to know how many exactly, so he sent me to the derm offices labs FOR THEM TO COUNT THEM. That doctors CAN do this isn't surprising, with all the technology we have today. That a doctor would CHOOSE to do it, in this case, was the shock, since again, never has anything of the sort been suggested or done in the US.

So basically Dr. Guardia told the lab to test a square cm of my chin to see what the concentration is. She very thoroughly scraped one of the inflamed bumps, put it on a slide, and sent me to wait in the lab's waiting room. 10 minutes later, she brought me an envelope, which I walked directly back to Dr. Guardia. The official number was 7, when 1, maybe 2, is normal. Meaning there are about 7 mites on 1 square cm of my chin, whereas you have like 1 or so.

He added one more cream that I put on Saturday & Sun nights, and I go back just before my birthday, and just before I leave Chile. At that time, should it appear we need bigger guns, he'll prescribe a new pill that, as usual, requires I don't become pregnant because its potency is dangerous to fetuses.

So that's where we are now. The new cream does seem to be creating more inflammation, or at least my skin is worsening in the inflammation department. But we'll see, because before this new cream, my skin was the best it has been, other than when I was in Asia. (He had no explanation for that.) I'm still enamored by the not-the-US system where I get one, to ME, affordable price to see the head of dermatology at one of the Chile's best clinics, who treats the problem and me far differently than US docs, explains shit, and gives me a road map to how we'll work on this over time. Finally, Chile is soundly beating the US at something!