Last Sunday, I woke up with my eyelids basically swollen shut and more congested than I have ever been. I’d been waking up puffy and congested almost the entire week prior, but I didn’t want to deal with a doctor. But Sunday, it was just so bad—I freaked out. On top of it all, I was in Niš, a city in southern Serbia—a three-hour bus ride away from Belgrade, my host family, the American Councils office, and any reliable medical clinics. This was the first time I was confronted with some kind of medical issue while in Serbia, and I wasn’t sure what to do.
After reading some horror stories about Niš’ hospitals, I was hesitant to visit a doctor—one online review literally translated to “If you’re looking for a place to die, come here.” I frantically texted my American Councils contacts who made an appointment at local clinic in Belgrade for later that day. I anxiously walked to the Niš train station, bought my ticket, and braced the three hour, bumpy, bathroom-less bus ride back to Belgrade.
We arrived, and I immediately started walking to the clinic. I checked in, struggling to explain my insurance information in Serbian. My eyes were less puffy than they were this morning, but still not looking great, and when the doctor saw me, she immediately identified them as the issue. She walked me through various tests she wanted to do, and very confidently asserted that I just had severe allergies.
I didn’t disagree but told her that I wanted tests for sinus infections as well, just in case—I’ve had a few in the past and these puffy eyes were one of my symptoms. She looked at me confused and began using phrases like “medically-trained opinion” and “in my medical experience.” I realized that I had accidentally disrespected her by asking for more tests: here, a doctor’s word is final, and one shouldn’t question it. Of course, I meant nothing by it—I just wanted to be sure it wasn’t something I needed antibiotics for. She, however, took it to mean that I didn’t trust her opinion.
I noticed how differently Americans and Serbs approach health and medicine. In the states, we’re very much encouraged to ask doctors questions and request tests if we’re that concerned (even if this is sometimes taken too far with WebMD diagnoses). If you asked your doctor for something or question their diagnosis, you’re a concerned patient. In Belgrade, however, it’s seen as undermining and questioning a doctor’s ability should you inquire about tests or treatments outside of what they prescribe.
Medical and patient norms, like anything else, are culturally-informed. In Serbia, education, and higher education in particular, is highly valued. So, when someone addresses some more educated than they are, the assumption is that the ‘smarter’ person is correct. When a patient addresses a doctor, they should automatically defer to the doctor’s opinion—they went to school for longer, they know the absolute best. For me, it was difficult to find the line between being respectful but also ensuring that all of my concerns were fully addressed. I tried to explain myself to my doctor: I wasn’t trying to cause problems, but I was indeed stressed about some specific issues. She seemed to understand, although she wasn’t particularly happy about my numerous questions. I left the clinic with prescription allergy medication, bloodwork to confirm I didn’t have an infection (despite protest), and an appointment with an allergist. Most likely, I had an allergy to a Serbian pollen that just wasn’t common in the States.
To me, one of the most intimidating parts of studying abroad is preparing for unforeseen medical issues—you may not speak the language fluently enough to navigate a hospital, perhaps there are no translators, maybe you’ll have some weird reaction to a foreign medication, the list of irrational, unknown fears is endless. In my case, I put off going to a doctor both because my symptoms weren’t that bad in the beginning, and because I was uncomfortable going to a new clinic in a new city in a new country. I don’t think these are frivolous concerns—medical stuff is always scary, even in the most familiar settings. But I realized first that Serbian clinics were probably fine, and second, that part of living abroad is learning to navigate new medical systems, new transportation, new banks, new institutions in general. Even though I wish I didn’t have that allergic reaction (seasonal Ambrosia allergies, it turns out), it feels like I figured out another part of this city and life here. Cultural immersion is more than trying new food and hanging out with locals—it means learning all parts of a new place, including the institutions that help shape local life.
By: Eva Isakovic
Program: Balkan Language Initiative , Belgrade, Serbia
Term: Fall 2019