Saturday, September 5, 2009

You can't buy Tylenol at Kroger here!

Kroger Doesn't Exist Here . . .

Kroger doesn't exist here, of course, but there are supermarkets, huge box stores like WalMart, 7-11 type stores, modern gas station stores on the highways and the like. What do they have in common?

You can't buy any over-the-counter medicines in any of them - that is, not even an aspirin, Tylenol, Advil, and maybe no Band-Aids or Bactine (I have to check).

To buy any of those things, in addition to all prescription medicines, you have to go to a FARMACIA, all well-marked by the requisite standardized lighted green crosses, spaced every so many blocks (a minimum of 250 meters apart) in every city and town as established by law; and depending on the population density (
2,800 - 4,000 inhabitants per pharmacy, approximately). FARMACIAS are open after hours, all night, and on Sunday only when it is their turn to be 'de guardia' or on duty, also as established by law.

There is no chance in Spain of the convergence of Walgreens, CVS, Rite-Aid and a Kroger Pharmacy at the same intersection as happened near my house in the USA. (The Rite-Aid eventually folded.) There are no franchised chains, nor is there freedom to open a new pharmacy if you want to. On the contrary, the number of pharmacy licenses is strictly limited by the (national) Ministry of Health (though some community and regional exceptions are allowed) and only a licensed pharmacist can own a pharmacy, many of which are passed down from generation to generation, keeping the lucrative resource all in the family.*

A key word here is control. Pharmacies are tightly controlled. Medicines are tightly controlled. [Only now, after being a regular in Spain off and on for 3 decades, do I see on TV a few ads for over-the-counter medicines like Immodium. Neither Boniva, Zoloft, Crestor nor any other prescription med is allowed to advertise.]

Pharmacy customers are also tightly controlled, a fact which infuriated me the first 15 years I came to Spain. Now I am used to the drill.

Here's how it goes: you go into the pharmacy, which has one or two pharmacists and perhaps an assistant at the counter. Around you on display are Nivea face creams, Roc anti-cellulite lotion, toothbrushes and maybe mouthwash. But that's about it.

You can't browse diarrhea remedies or foot fungus creams or types of vitamin C. You can't browse anything. When it's your turn at the counter (there is always a line), you describe your pain or lesion, your chief complaint and the frequency of urination, as applicable, in earshot of anybody yearning closer to see what ails the foreigner and if she can get the vocab right.

Next, the pharmacist goes to the back and pulls out some unguent in a tube, or a box of blister-packed pills, either of which might or might not require a doctor's prescription (she will sell you either). She tells you the price (on the label as established by law). You pay and leave the doctor-druggist to attend the next patient-customer.

If you have the nerve, the balls, and a little knowledge of what ails you and the indicated medications for a cure, you ask her if there are alternative medicines or alternative strengths. Then she might bring out one or two other options, or she might not (there is a line, remember). In no case will she ever bring out the 23 cold remedies on the shelf at Walgreens even if she does have them, which she probably does. So.

What are the core issues here? I'm still working through that. Certainly consumer freedom of choice and free easy access to information are involved.

There also seems to be a cultural disconnect between the Spanish mindset and the USA mindset (mine, at least) in these regards. To wit: my 31-year-old niece and her older sister are both pharmacists. We had the freedom-to-browse-analgesics discussion one year recently, but we never did intellectually intersect. I was huffy and snidely sure that I have the God-given inalienable right to browse through Tylenol, Excedrin, Advil, Aspirin and their various permutations and generic equivalents. They were just as sure, and incredulous to hear the contrary, that everybody (including me) is too ignorant and uneducated about drugs to make wise and safe decisions for self-medication.

Everybody, that is, except for pharmacists!! HA!!

*In 2006 the European Union called the Spanish restrictions counterproductive to the provision of an adequate supply of medications to the public. The Spanish professional associations of pharmacies responded that, per capita, Spain has as many, or more, pharmacies than other European countries and that the price of medications is lower in Spain than in most countries.

Monday, August 31, 2009

On the Baldosa in Galicia Spain

It's 12:10 during the day here. This is a critical temporal crossroads on the Baldosa (one of the numerous pedestrian streets of bars and cafes in Vilagarcia de Arousa, a small city in Galicia in northwest Spain on the Atlantic coast) and in all of the thousands of bars and cafes in Spain, a country where hanging out is more popular even than futbol (soccer).

At noon, which is an odd time here between breakfast and lunch (lunch is at 2:00), half the people just got going and are having their breakfasts of cafe con leche and churros (long fried donuts) or croissants or other sweet carbs. The other half are having beer or coke or water or wine and some kind of free tapas that come with, the aperitivos.

The point is that everybody is having SOMETHING and talking passionately and gesturely to SOMEBODY. Passersby join their friends, and cousins as if by design, but actually just because it's what they do. There are kids running in and out and the clinking of real coffee cups and silverware and drinks served in glasses made of glass and women talking loud and men, and horns honking nearby and police whistles and grandparents and babies, louder and LOUDER as the pre-lunch crowds rise and swell. Crescendo. Fullness. By 2 pm not one place left to sit. Still they come. They stand.

At 3 pm the whole street of round tables and metal chairs is empty. It is low tide now.

Today is the LAST day of August and this is Spain, Galicia, Vilagarcia at their raucous summertime best.

Friday, August 14, 2009

The morning of the departure

'Profound' is not a word I would use to describe my mind right now. I am thinking of underwear, which won't show and which would show under white pants. I'm thinking of how to 'look nice' many days in a row, over THERE, without my whole mess of stuff that is here. Why would that matter? I can't remember, but it always has mattered when we go there. So I have just clicked into that nagging 'have to look nice' mode, which is not what I do here too often, despite all my accoutrements and especially now that I'm not working much.

What does that mean? I don't know, maybe nothing. Is that a theme of this trip? My theme? I remember one time years ago when we took our cars to be repaired at a local Texaco station - several times a week because they were old clunkers (yes, they would qualify for Obama's plan, I guess) and we couldn't afford to take them to a dealership. We got to know the whole family that ran the place including an awesome young dad, Robbie, who was always covered with grease, dressed in Texaco blues, had hugely curly hair, smoked long cigarettes, and was hyper as hell in a Southern drawl. That's how I saw him in my mind and in the grease pit. One day, though, I happened to be in the 'office' and saw his brand new family photo proofs from Olan Mills (What happened to Olan Mills?). But wait, it wasn't Robbie in those pictures: it was somebody scrubbed down, in a suit and tie, hair slicked back, wife and kids in organdy and shimmer. What did that mean? I don't know, maybe nothing. But it at least means that they were in the 'have to look nice' mode when they went to Olan Mills - and they did look nice, but not exactly. I remember it jolted me back then to see the outlandish contrast and, even now - 25 years later, it makes me flash into my teenage angst mode when I earnestly wallowed in all the variations of the 'who am I?' question.

Now the connection between the existential angst mode and the 'have to look nice' mode might be a stretch. But this morning, after sleeping 5 hours, and before coffee, it seems just right.

I am going to Spain where I will try to look nice and figure out who I am. HA!

Tuesday, August 11, 2009

The night before the night before the night before

It's not the night before Christmas: it's several nights before my 65th trip to Spain. Well, maybe it's not 65 trips, but it's a bunch of them. My thoughts range from the ridiculous (Why do different cultures exist?) to the sublime (What kind of shoes can I take that I can walk in ALL day and look 'dressed'? Still no answer to that 30-year-old question.)

My first trip to Spain . . . was around 1970, just about when Ramon Sender*, a Spanish author, published La Tesis de Nancy, sometimes referred to in English as 'Letters from Nancy' (Cartas de Nancy). Poor Nancy - a naive sweet innocent dumb doctoral student from USA- writes home to her cousin about her 'intellectual' experiences in this new land in the south of Spain, Sevilla. She's particularly taken with the kindness of the men, who are particularly taken with the opportunity to escort a real live Americana, not nearly so numerous back then under Franco as they are now when nobody looks twice at a foreigner because there are so many. Mutual misunderstanding in hilarious episodes, at least on one level, is what drives the novel. On another level, it's a frank bicultural analysis by a man who had one leg in each land - kind of like Jorge and kind of like me.

What does that mean? I don't know. Maybe nothing.

*Ramón J. Sender was born in Chalamera, Huesca Province in the autonomous region of Aragon in Spain. In 1923 he was obliged to serve in the Spanish military and take part in the Spain Morocco Rif War, which lasted from 1919 to 1926. Later that year he returned to Madrid, where he worked as a journalist for El Sol, a paper critical of the current government. In 1926 he was imprisoned for writing Casas viejas. When the Spanish Civil War began in 1936, Sender immediately enlisted to help resist Franco. While he was at the front, the enemies of Sender went to his house and shot his wife and his brother. He had been an anarchist and then a communist but after the Spanish Civil War he reneged on this ideology and sought asylum in France in 1938. He left Spain for New York after the Spanish Civil War in 1939, and then relocated to Mexico like many scientists, artists and intellectuals. He became an American citizen in 1948, and he lived in the United States until 1972, when he returned to live in Spain for several years before dying in San Diego, California in 1982. Sender's son is composer and writer Ramon Sender. His grandson is Chicago-based designer Sol Sender, best known for the development of the Obama campaign logo.