>A few months into our move to São Paulo, we learned that my Brazilian mother-in-law needed a kidney operation. I accompanied her to a private hospital for her initial visit with the doctor who was to make a recommendation for treatment. >While we waited for her turn to register, a woman passed out snacks. In the lobby of the doctor’s office, they provided coffee and biscuits. >These were my initial clues that the medical system is different in São Paulo. >A few days later she received a call from the hospital where she was to have her surgery. Here is what they asked her: >What is your religion? >Are you a vegetarian or do you eat meat? Will you be having a guest sleep in your room at night, and if so, do they prefer a high or low pillow? >Do they prefer a hard or soft bed? >How many visitors will you be having and how many parking spaces would be needed? >Do you prefer to be attended to by men or women? Our systems are terrible. We're not even third world country quality.