Saturday, 23 March 2013

The Accidental Medical Tourist

Somehow, John and I managed to do virtually all of our pre-children travel without ever having to take an aspirin or buy a tube of antibiotic cream. However, since the arrival of our delightful children, now aged 19 and 16, we’ve made unexpected visits to hospitals and medical clinics in France, Italy, the Caribbean, the US and now, Fiji.

Our first encounter with a foreign medical service was in the South of France when one of the children, probably due to bad parenting, was allowed to toddle very quickly on an uneven cobbled surface in a walled medieval town resulting in a head gash that spurted blood in such a spectacular fashion that people actually said “Mon Dieu!” when we ran past them back to the car. Of course by the time we saw the slightly impatient doctor, who I just know was inwardly tutting about over-protective American mothers, Alex’s wound didn’t look so gory and only required a couple of butterfly bandages. We had to pay approximately £35 for his care, but by some miracle of bureaucratic magic and our trusty E111 card, we received a refund cheque from the French Government a few months later.

The only other thing I remember about that day was that I accidently threw the rental car keys into large rubbish skip with a couple of really juicy peach stones and actually had to climb inside to retrieve them. Of course John thought that this was hilarious. I did not.

The next foreign medical encounter of note was in St Croix in 1999. We all had some horrible lurgy over the Christmas holidays – a combination of fever, coughing and vomiting. We arrived at the airport for our departure looking like a family of zombies. The flight to Miami from London was memorable only because when one of the children was presented with their end of flight breakfast, an episode of projective vomiting ensued. Not surprisingly, no one in the remaining ten or so rows took up the offer of breakfast.

Unfortunately, Anna did not get better. In a pattern that was to repeat itself, Alex complained about being sick more, so while Anna was slowly going off in the corner, we expended our parental energy on Alex. By the time we noticed Anna was really sick, she was really, really sick and ended up in having to be admitted to the hospital. John and I had previously avoided going to the hospital when we lived in St Croix in the late 80s and early 90s, except once when John was bitten by a dog and was told by the receptionist to go home and put a bandage on his bloodied finger.

I cannot tell you how frustrating it was to be sitting in the reception of accident and emergency filling in insurance forms while Anna hung limply in John’s arms. However, in the West Indies, polite protocol is of upmost importance - just ask the tourist who arrived the same time as us with his foot wrapped in a bloody towel demanding to be seen by a doctor immediately. According to John, he was still sitting in the waiting room about ten hours later. Anyway, once you got past the horribly dirty A&E reception, a fairly modern hospital with competent doctors awaited you.

This was the first and last time that we accompanied John a work trip as we also infected John’s work colleagues, preventing them from diving for a good part of the trip. Having said that, the experience bonded the relationship between them and by the end of the trip they were engaged to be married. Amazingly, they were not put off having children and now have three of their own.

In 2001, we took the children to Italy to see some mid-winter sunlight which was sorely lacking in the north of England. Unfortunately, they both had colds and Alex basically could not eat without severe ear pain. This was horribly ironic, because one of the main reasons to travel to Italy is to eat. We had a lovely sunny day out at Pompeii when Anna started to fade in an alarming way.  By 3am she was in such a state that I was wandering the streets of Naples looking for a taxi as our bizarre hostel had no night clerk. Eventually I found some guys guarding market stalls, who kindly interrupted their game of throwing rocks at pigeons to find me a taxi and give me a blanket to wrap Anna up in.

When we finally found a hospital with an A&E department, we were sat in a triage room with Anna sitting on the examination table. The doctor, obviously an eminent one by the looks of his young (mostly good-looking female) entourage, arrived looking like he just woke up and smelling like he’d been asleep in an ashtray. He pulled up a chair in front of Anna, folded his hands together, as if in prayer and rested his head on his hands. Everyone sat expectantly. There was a slight discomfort in the room when we realised that he’d actually fallen asleep. Then completely unexpectedly, he looked up at Anna, all wild-eyed and shouted in English, “What’s wrong with you?!” I don’t know who was more terrified – me or her.

We high-tailed it out of there pretty quickly and in my non-existent Italian explained to the waiting taxi to take us to another hospital - any other hospital. In the end, we were looked after by a very good doctor who, after a chest x-ray and a thorough examination, prescribed a mountain of medicine (which was the only thing that we had to pay for). When we got back to the UK, we went straight to the GP, who confiscated most of the medicine and told us that he was sending the thick black drops that I’d been squirting up Anna’s nose for the previous week to the pharmacist for “safe disposal”.

I skip other stories to come right up to date, where the main protagonist in the story is John. Or rather, John’s gallbladder. A very acute attack of cholecystitis resulted in us having to go the public hospital in Suva as the private hospital currently does not have a night time emergency care. It’s all kind of a blur, but the short version is that John received excellent clinical care in a hospital that, like public hospitals all over the world, is over-stretched and under-resourced. Fortunately, we were in the privileged position to be able to move to the private hospital after a few hours and John is now waiting patiently for his gallbladder to calm down so that the professionals can remove the wretched thing.

I must come clean and confess that, as an American that worked and/or partook in the UK National Health System for over twenty years, I write this blog as a true believer in socialised medicine, or in less controversial terms, universal access to healthcare. In the post-Millennium Development Goal world, there will have to be an emphasis on increasing social justice to tackle entrenched inequities in both rich and poor countries alike. My medical travels around the world have only strengthened my resolve that this not only must happen in relation to healthcare, it can happen. Call me deluded if you like. I prefer the term optimistic.