Hers: The American Patient
My Emergency Room Adventure in Spain
I can’t count the number of people who asked me about healthcare when I announced my departure. What about health insurance? What if you get sick in a strange country? What about medication? What if you’re on one of your crazy dangerous adventures and you end up in the emergency room? What if someone tries to cure your broken leg with tiger claws and baby’s breath?
It’s almost like medical care is one of Americans’ biggest fears about traveling long-term. Which, let’s face it, is actually funny considering how broken our healthcare system is, how much insurance companies charge for how little they cover, and how low our healthcare ranks compared to the rest of the world (not even in the top 30 according to WHO, and absolutely last compared to 10 other high-income nations).
Unsurprisingly, it happened. I needed a doctor in a foreign country. And it wasn’t a complete disaster.
Before leaving, I’d had the most complete physical of my life. The woman drawing my blood announced wide-eyed that she’d never taken so many vials from someone. Everything seemed well enough in order, other than some major effects of stress (which I assumed the trip would assist with).
For the stress, the doctor — and I should mention here he’s a holistic health doctor, a D.C. rather than an M.D., and I’d never seen a doctor of this kind before— had recommended a natural adrenal support supplement, something that could be purchased at any health food store or GNC. I didn’t have a chance to pick one up before leaving, so my first week in Spain, a good friend in Malaga accompanied me to a natural pharmacy. With her help, I procured an adrenal support supplement, and took it for the first time the following morning with food.
The day passed uneventfully, but after dinner, my body began feeling strange.
“Perhaps it’s indigestion, getting used to the food,” I mused. As bedtime neared, though, my discomfort increased.
I attempted to sleep, but started experiencing intense pain on both sides of my back. After tossing and turning for a couple hours, I decided to read while waiting out whatever this was. The pain increased. Its location appeared to be right where I imagined my kidneys to be (where, it turns out, they actually are located).
The supplement crossed my mind, and I wondered where my adrenal glands are. I’d imagined them near the thyroid for some reason, but a quick google search showed that the adrenals, in fact, sit atop the kidneys.
The supplement seemed the clear culprit. However, I couldn’t be sure whether or not my condition was dangerous and required a visit to the doctor. Online research failed us on the matter, so we resorted to a remote consultation with a doctor in the US via chat.
We found the doctor even less helpful than online research. He asserted simply that I should see a real doctor, that the supplements probably weren’t necessary for my body, and that sure, I should go to the emergency room if experiencing a lot of pain. He also lectured us about supplements not being monitored by the FDA, which we were already aware of but which didn’t apply because this supplement was bought in Spain. Meanwhile, no decrease in pain.
I’ll be honest; I was scared about my health. But it was a Sunday by then, and I was more scared of seeing a Spanish doctor, particularly in the emergency room. We’d heard about Spain’s public health facilities. Oh, and the biggest problem: I didn’t have travel health insurance.
While I kicked myself for not being prepared for this, Dave found a global travel insurance that activated immediately, covered pre-existing conditions, and was extremely affordable (essentially unicorn insurance). I signed up right away and used the online portal to search for a provider, despite my doubts about the coverage. However, the search of Malaga yielded quite a few legitimate-looking results.
One of the hospitals claimed the doctors spoke English. I texted my Spanish-American friend in Malaga, carefully informing her we were headed to the hospital. She approved; this private hospital had great doctors who spoke English.
Upon our arrival, the registration line extended out the door onto the sidewalk. A toddler with curly hair ran around screaming and crying, but everyone else stood relatively patient in line talking. People smoked cigarettes within 2 feet of the door, causing smoke to blow directly into the hospital waiting room.
Registration proved to be a huge pain. The receptionist didn’t speak English, so I handed him my phone to provide the insurance information. He asserted that the hospital needed a “guarantee of coverage” from the insurance company. I’d not heard of such a thing, but he handed me a paper with the hospital’s email address and waved me away to tend to the next patient. The insurance company expressed equal confusion over the phone when we called, but shot off a quick email to the hospital with a sentence promising coverage anyhow.
Hospitals make me anxious. I’d venture to guess they make most people anxious: being surrounded by sick, wounded, and upset people, plus potentially lengthy waits in uncomfortable conditions. The Spanish hospital made me extra anxious; I had no idea what the procedures would be like.
Once registration finally got straightened out, the receptionist handed me a scrap of paper with a number with my initial before it (M364). The wait to enter a triage room only took a few minutes. My triage nurse spoke English, thankfully, and kindly explained the process as she recorded notes on my case and measured my vitals (including my temperature… with a thermometer under my armpit).
After a wait of 40 minutes or so, M364 flashed on the screen again, directing me to Caja 1 (box 1). On my way to the “box”, I gingerly stepped through a construction site. Yes, you read that right. In the hallway just outside the room with my doctor, three men tore apart the doorway with drills, hammers, and the like.
And then it happened. My worst fear of the Spanish hospital came true. I had arrived on a hard molded plastic chair across from a doctor who spoke almost no English, attempting to explain my unknown ailment. The added distraction of construction noises essentially next to me made it feel like some sort of reality show- maybe a Spanish version of Punk’d, where foreigners struggle to overcome ridiculous obstacles to basic medical care.
Thank goodness for Google translate. We used it on our phones, while the doctor used it on her computer. She’d take a blood sample and a urine sample, she communicated, we’d wait 2 hours for the results, and go from there. A bit of confusion, miscommunication, and a long wait.
Finally, my blood drawn, I was released with instructions to return in an hour and a half.
M 364 on the screen. I’d never felt so excited to be represented as a number. Stepping over more construction (the workforce had increased to 5 by this time), I nervously lowered myself onto the plastic chair in the doctor’s office once again.
This time, she began her halting Spanglish explanation clearly frustrated, yet kind. I answered her in Spanish this time. She paused, a smile on her face.
“You mean you have been able to speak Spanish this whole time? Why have we been speaking English?!” she exclaimed (in Spanish, of course) as she threw up her hands. “Because I’m not very good in Spanish, and I don’t know medical words,” I sheepishly replied. “Your Spanish,” she reassured me, “is far better than my English.” She was right, despite my complete lack of medical Spanish knowledge.
The doctor explained that neither the blood test nor the urine test showed any sign of infection. I asked her whether I might have had a kidney stone (trying out piedritas, “little rocks”, to just see if it would communicate my message- turns out the word actually is piedra, or “rock”). She shrugged, stating that it could have been possible, but she didn’t think I’d have them on both sides simultaneously without a history of them.
After struggling through more Spanish to express concern about either bladder or kidney stones, I was astonished to see her walk out of the room and return with a portable ultrasound machine. She looked at all my major organs herself, pointing them out on the screen, and assured me they all looked fine.
Finally, she shrugged and (not very assuredly) posited that the culprit was potentially a kidney infection that started to subside with the one day of antibiotics I’d already taken on my own. She prescribed a full course of antibiotics plus prescription-strength Ibuprofen. On the prescription she printed out, she included a Google translated version of the dosage instructions. Feeling somewhat relieved about my situation (not being in kidney failure is always nice), I set off on the next adventure: the pharmacy.
The pharmacist on the corner took a look at my prescriptions, and without asking for insurance, put all the medications on the register for me. I cringed, waiting for the total, ready to take off the Ibuprofen depending on the price. €6.40. Really. For less than USD $10, without insurance, I received all the medication I needed.
Mentally and physically exhausted, I found myself collapsing into bed and crying in gratitude upon arriving back to the Airbnb. It finally hit me that I’d done it: I’d communicated effectively with a doctor in a foreign country about a health emergency. I’d made it through the surprises of insurance, smoke in the hospital, construction outside the doctor’s room, unfamiliar procedures, and communication barriers. And, most shockingly, I don’t have a hospital bill at all, much less one that requires most of my income for the next year.
On this undefined global adventure, I’m continuously surprised at how many huge problems I and others worry about are completely manageable. After this experience, I have much more confidence about handling any medical issues that might arise. This truly is doable.
