Chapter 9: ¡Salud!

“I miss Greg,” said the ancient woman with a walker, gazing towards me but not particularly focusing on me, and I knew exactly of whom she spoke. We were standing in a long line at a Duane Reade pharmacy counter in Greenwich Village, and it was barely moving. Greg was the former pharmacist at that location who was always efficient, kind, and attentive. I missed him, too, and I wondered what my medical care would be like in Spain.

In a pre-COVID-19 world, people often debated why the life expectancy in Spain was among the highest in the world — 39 spots ahead of the States, according to the United Nations. Was it the so-called Mediterranean diet or the single-payer healthcare system . . . or both? The “right to health protection” is enshrined in the Spanish Constitution, and the government intelligently husbands its resources. In order to obtain our long-term visas, Kate and I had to present proof that we had paid for a full year of private health insurance up-front.

When we moved to Madrid, one of my first tasks was to visit a pharmacy — one of the few permissible reasons people are allowed to leave their homes in Spain during the confinimento y encerrada. Brightly marked by large emerald green neon crosses, one already senses from two blocks away that visiting a pharmacy in Spain will be a different experience than going to a Duane Reade or CVS in New York.

As in most American cities, pharmacies are ubiquitous in Madrid, but they are much smaller and often located in the middle of a nondescript block. Upon entering, you will not find Cadbury eggs, Scrubbing Bubbles, or WD-40. More old-fashioned chemist than present-day drug store, the employees wear immaculate white lab coats and conduct themselves more like nurse-practitioners or physician assistants than store clerks.

They also seem to have university degrees in patience.

On my first trip, I was looking for a liquid multivitamin with iron. I bungled the word for iron — blurting out “con ferro,” my brain’s bizarre conjuring up of the periodic table’s abbreviation (Fe). The woman at the counter looked at me blankly, but kindly. I then tried the pathetic “iron,” only pronouncing it “earROAN,” as if that would help. And because her English was better than my Spanish, she replied, “ah, hierro.” This was someone going the extra mile. She vanished into the back for a few minutes and came out with a made-in-Germany concoction in an old-fashioned brown glass bottle. I felt well taken care of.

The following week, emboldened by all this kindness and a little concerned that my prescription meds would run out before it was prudent to go to a doctor, I decided to venture out again. This time, I scribbled the key Spanish words down in the little notebook I keep in my pocket. I would explain that I had a prescription from my doctor in the States. Could my doctor fax it or email it to the pharmacy? I brought the plastic bottle too, which clearly stated “3 refills.”

When I arrived at the pharmacy, the pharmacist came to the protective banker’s window, took one look at my bottle, nodded, and went into the magic area at the rear of the store. Out she came with a box of the medicine. No prescription or proof of health insurance necessary, and the price was only 10€. I wondered if this was expediency under the present health crisis or whether no prescription for my medication would ever be required. I didn’t ask, and I practically skipped home.

Being me, as soon as I set my bag down in the apartment, I took to the Internet, searching Spanish health care and prescription medications. While some in the United States claim the European regulatory state is too burdensome, here was an example of market efficiency. In Spain, one does not need a prescription for many medications that require one in the States. Even birth control pills are over-the-counter. Whether that has contributed to the low European birth rate is a topic for another day. And while I have been coy about the name of my medication, I can divulge that it was definitely not The Pill.

©2020 Kay Diaz