Michel Does Spain: Who Cares for Xpats After Surgery?

Michel Does Spain… as Florence Nightingale

As most of our friends know, Mr E is an adrenaline junkie.

Whatever he does, he does with obsessive fervour. Whether riding the Ducati, racing around a track or training in the gym, everything must be tackled at full speed and maximum impact—usually to his own detriment, as I can attest after 30 years.

He never listens. But then, what man does?

When my predictions inevitably come true, the outcome is nearly always the same: damaged discs, metal pins, screws, plates or some other piece of engineering more commonly associated with the construction industry.

And then, of course, there is an operation—with me doing Florence Nightingale.

I do not take the role lightly. I attack nursing with my customary routine, discipline and rigidity. However, I draw the line at the uniform, despite the annual requests.

There are many things I will do, but I don’t do that.

Peter Pan takes a morning stroll

In January, despite knowing that walking caused him considerable pain and discomfort, Mr E embarked upon daily expeditions along a paseo.

Now, there are two things Mr E hates with a passion: early mornings and anything that reminds him of his age.

So, when challenged by a walking companion 20 years his junior—who wanted to lose some much-needed timber—he naturally accepted.

Mr E approached walking with the same obsession normally reserved for racing motorcycles, while ignoring his pain and refusing to admit that, at his age and at that hour of the morning, none of it was remotely pleasurable.

The inevitable result was that Mrs E—the voice of reason to his Peter Pan—had to take him to see a surgeon.

Sure enough, he had seriously damaged at least two discs in his back.

Fast-forward to last Wednesday, when we took him to a private hospital in Málaga. The surgeon, a very nice young man—but then, at our age, anyone under 50 looks young—came into the room to explain the procedure.

This was, naturally, after I had virtually offered one of my kidneys and several other useful body parts to pay the bill, as the operation was not covered by our health insurance.

The surgeon confidently assured me that Euesy would be safely ensconced back in his room within four hours.

I therefore began preparing his surroundings with the military precision and OCD tendencies for which I am renowned.

Everything was cleaned to reduce the risk of infection. His food was ready—he always wants chicken on integral bread with plenty of butter after an operation. There was a flask of tea, another of coffee and enough biscuits to feed three playschools.

His new pyjamas were laid out. From Dunnes, of course. Nobody does hospital pyjamas quite like Dunnes.

His iPad was charged, his new book and reading glasses were in the drawer, his favourite sweets were within reach and every conceivable need had been anticipated.

But four hours came and went.

Whiter than the hospital sheets

After six hours, the surgeon appeared at the door looking whiter than the sheets on the bed.

He told me to sit down.

You can imagine the panic that surged through me.

Thankfully, Mr E was alive, but the operation had been far more extensive than anyone had anticipated. The two screws the surgeon expected to insert had become eight, accompanied by four supporting frames.

For one brief, shameful moment, I wondered exactly which of my remaining bodily parts would be required to settle the final bill.

Then my thoughts returned to Mr E: the pain he must be experiencing and the long recovery that would surely follow.

When they finally wheeled him back into the room, my heart cried for him. He seemed to have aged dramatically during those six hours. His face was contorted with pain despite the medication being administered.

I washed him down as best I could, made him comfortable and eventually settled him for a few hours’ sleep.

After my police escort home—which is most definitely a story for another day—I walked the precious Pomeranians and began reorganising everything around what I presumed would be an extended hospital stay.

The hospital had offered me a bed beside him. During our 30 years together, apart from the times when I have been in intensive care, that is what we have always done.

It is simply who we are.

I remember one occasion when we were both wearing matching Mickey and Minnie Mouse pyjamas—from Dunnes, naturally. Steven climbed into my hospital bed for a cuddle until a particularly officious nurse arrived to administer my medication and unceremoniously banished Mickey back to his own bed.

She was not a woman to be argued with.

The two-cheeseburger emergency

As I rearranged my life and made plans for the Pomeranians, Mr E made his nightly “Goodnight, Euesy” telephone call.

He informed me that under no circumstances would he remain in hospital any longer than originally arranged.

Assuming he was still delirious from the anaesthetic, I knew better than to argue. I listened with half an ear, sent him all our love from El Nido—our nest—and wished him good morning.

Michel Does Spain considers hospital care on the Costa del Sol and asks who supports xpats recovering from surgery without family nearby.

Yes, it was after two o’clock, but when a man is worried, we all know that sense and rationality leave the building.

This is where the story becomes more serious.

Mr E had undergone major spinal surgery. He could only lie flat. He needed a straw to drink his tea or water and could not stretch to reach anything.

So, when he telephoned the following day requesting two cheeseburgers—along with the usual list of demands that indicates he is feeling particularly vulnerable—I once again set off along the hospital trail, this time without the police escort.

When I entered his room, I was shocked.

The room was dark and smelt unpleasant. His bed linen had not been changed. He was still wearing his operating gown. He had not been washed or properly fed.

My first emotion was heartbreak at the sheer pathos of the situation.

I fed him, removed the surgical gown, bathed him and helped him into clean clothes. Between us, we somehow managed to get his corset on and sit him in a chair.

This was no easy undertaking for a 40-kilo waif attempting to support approximately 90 kilos of almost entirely dead weight.

I then stripped the bed, cleared the room and removed the dirty towels and linen.

And that was when the protective lioness took over.

“The family does that”

I marched to reception with my very best Spanish poised at the tip of my tongue, ready to make a formal complaint.

But I was stopped dead in my tracks.

A nurse explained, very kindly and as though speaking to a slightly confused child, that much of the basic personal care I expected was normally carried out by the patient’s family.

“It’s Spain,” she said.

And, in one sense, she was right.

Spain has traditionally been built around strong extended families. When somebody is ill, relatives arrive. They wash, feed, comfort and care for the patient. It is part of the culture, and it is one of the many things I love about this country.

But what happens when there is no family?

We are foreigners. We are xpats and immigrants who have made Spain our home, but many of us do not have an extended family living around the corner.

This is not simply an issue affecting the elderly. I know people in their 40s who live here alone. Some chose independence; others found themselves alone through bereavement, divorce or the unpredictable turns life takes.

Who washes them after surgery? Who changes their clothes, helps them eat or makes certain they can reach a glass of water?

Which organisation can they call? And what happens when money is not available to employ somebody privately?

Even if you can afford help, do you really want a complete stranger talcum-powdering your most intimate bits immediately after major surgery?

The lack of cleanliness was another matter entirely. That, I was told, was the result of staff shortages. Fewer people want to clean hospitals when they can earn considerably more cleaning private homes—or reinvent themselves as online life coaches.

Somewhere along the way, we appear to have lost sight of the most basic, fundamental and necessary jobs upon which all of us ultimately depend.

This was our personal experience in one hospital, and I am certainly not suggesting that every hospital or medical team in Spain operates in the same way. The surgeon and medical staff did their jobs, and we remain profoundly grateful for the treatment Mr E received.

But the experience exposed a worrying gap in support—particularly for foreigners facing hospital treatment alone.

Florence returns to El Nido

Thanks to some enterprising manoeuvring by the colourful son, together with the support of one of the Costa del Sol’s best-known medical services, Helicópteros Sanitarios, Mr E—with his 33 clamps, eight screws and four frames—is now safely ensconced in his beautifully clean bed at home.

Mrs E is on full nursing duty, while simultaneously operating as cleaner, caterer, medication supervisor and chief executive of corset management.

Two Pomeranians provide security, surveillance and entirely unnecessary barking.

His road to recovery may be longer than anticipated, but his surroundings are comfortable, his chicken sandwiches are buttered correctly and no one is rationing the biscuits.

His experience will undoubtedly be more pleasant.

But what about those who do not have a Mrs E?

That is the question I cannot dismiss, and it is one I intend to investigate once the madness of the summer heat has subsided.

The Costa del Sol needs a dependable, affordable support service for people undergoing surgery without family nearby—somebody to advocate for them, visit them, help with personal care and ensure that the basics are not forgotten.

Because nobody should be left frightened, hungry, unwashed or alone simply because their family lives in another country—or because they have no family at all.

As for Mr E, once he is fully recovered, I hope he will finally accept that Peter Pan and Tinker Bell are getting a little too old to withstand his adrenaline addiction.

I am not optimistic.

There is already talk of a future hip operation. But by the time that particular drama arrives, I hope the hospitals are once again spick and span—and that the Costa del Sol has an organisation ready to provide a Florence Nightingale for everyone who does not have their own.

Although I must warn them now: the uniform remains strictly optional.