On a hot and steamy October day I entered my aunt’s yard with caution. I had parked on the road since few people had room for a garage. The rusted gate creaked loudly. Two scrawny cats were playing in the tall weeds by the runoff ditch. I could hear hens cackling in the back yard and the occasional grunt of the pig. A mild wind was blowing and the fetid smell of farm animals mixed with outhouse odor hit me as soon as I stepped inside.

The natural vine pergola stretching over the yard from the house roof to the tall fence offered some shade in the scorching heat. The grape vines, turning yellow by now, had been picked of grapes. Nobody was in sight. I could see the vegetable garden in the distance. A tall pile of freshly dug potatoes and ruby red bell peppers on the grass served as playground for a tabby kitten.

I knocked on the front door. Stefan, my cousin’s 18 year old son, hopped to the door on crutches. In spite of the pain and misery, a big smile lit up his face. He had split his big toe open with an errant ax which had flown out of his inexperienced young hands. He had tried to help his grandfather cut wood for winter. Bleeding profusely, he was transported by bus to the nearest emergency room in town, about 5 miles away to the county hospital.

Stefan had been in a cast for six weeks and was anxiously awaiting the moment to have it removed. I promised to take him to the emergency room by car instead of the usual bus. The county hospital had not changed from the hospital I knew in the seventies. It looked just as dingy, dirty, and poorly lit. The low wattage CFL bulbs cast an eerily glow that gave me a headache. The paint was chipping everywhere, there were suspect stains on the linoleum floor which had seen better days and the walls were soiled by filth and bloody emergencies. The littered yard was occupied by several stray and mangy dogs.

After waiting hours in the crowded and sweltering hospital, Stefan was seen by a gruff doctor whose demeanor was less than friendly. The emergency room doctor called in a nurse to help him cut the cast. From the cloud of white dust, Stefan’s toe emerged. It was swollen, twisted, and the inexperienced stitching looked like the patchwork of Frankenstein’s monster. The doctor dismissed Stefan, telling him to stay off the foot for two more weeks and to walk on his heel. No advice to assist him cope with the swelling, no therapy, no boot to help him walk for two weeks, nothing. I was shocked! I tried to ask questions, the doc looked at me dismissively, and walked out of the room.

Proper care and treatment according to the Hippocratic Oath is costly. Medical care is free but it is only given properly if bribes are offered to doctors and nurses – walking around money, they call it. Stefan’s mom is poor like most Romanians who are still struggling to overcome forty years of communist oppression.

Medical care was given properly to the elites when the few, self-appointed apparatchiks, ran the communist country. If the masses wanted the same, they had to pay in a neat white envelope. I remember my Dad’s doctor. When he opened his office drawer to retrieve my Dad’s bribe, $5,000, cousin Mariana saw rows of envelopes with the patient’s name neatly written. My Dad had died and Dr. Arsene was returning the money at the request of the family. After all, he did not help Dad survive and burials were expensive.

Twenty-three years ago when my Dad passed away in Romania, communist medicine functioned on bribes and favored the elites in power. Omnipotent communists received proper care and the best medical treatment available at the time in hospitals built just for them.

Socialized medicine in Romania today, although dictated by the European Union standards, has not changed much. They have perhaps better equipment and somewhat better training. But bribery is still the way to receive proper and timely medical care.

How is an 18-year old supposed to walk to school on his heel for two weeks in order to protect his grossly swollen, mis-stitched, and improperly healed big toe?