Why I’ll Never Fear Medical Care Abroad Again.

My husband isn't the type to complain. The man has a background of fighting in octagon cages, wrestling, and ripping his own toenails out with pliers. Seriously, nothing takes this guy down.

So, when we were in Porto, Portugal and he suddenly doubled over in pain, clutching his side, I knew something was definitely wrong. It wasn’t until he started throwing up that things took a terrifying turn. He looked at me, pale as a ghost, and muttered, “I need to go to the hospital.”

My brain did a quick inventory of our situation. We were in a foreign city, on a weekend, with zero international health insurance. I ran to the front desk of our hotel. The younger woman at the counter looked at me with big, panicked eyes when I told her he needed a hospital.

She hit me with a question I wasn’t prepared for: “Do you need a public or private hospital?”

The fuck? I don’t know—I just need a hospital! She quickly explained: the public hospital was free, but we’d be there all night. The private hospital would cost us, but he’d be seen right away.

“Private,” I blurted out.

She called a taxi, explained the situation to the driver in Portuguese, and within 6 minutes, we were pulling up to the Hospital de Santa Maria. The cabbie wished us good luck, and we were off to navigate the Portuguese healthcare system.

The "Nuns and Needles" Experience

I immediately called my HR manager back in the States, only to be reminded—of course—it was the fucking weekend. She told me she’d have to make some calls, but I would have to wait until Monday, we were on our own for now.

We checked in, telling the desk we’d be paying out of pocket and had no insurance.. One kind gentleman translated for us, and within five minutes, my husband was called back. Five minutes after that, a doctor was in the room. She spoke perfect English, ran a few tests, and gave us the verdict: most likely kidney stones.

If you’ve had them, you know exactly what he’s going through.

While my husband was being hooked up to an IV by a nurse who didn't speak much English but was doing her absolute best, we had the most surreal moment of the night. This hospital used to be run by the church, and some of the nuns are still there. One came in, asked permission first, prayed over my husband in Portuguese, bowed to us, and went on her way. It was deeply human,, and unexpectedly comforting.

ER Visit Porto, Portugal

The doctor gave us prescriptions to be filled at a pharmacy around the corner and told us to call in the morning to schedule an ultrasound. I made sure that the doctor knew tomorrow was Sunday, and was told, “not a problem”. My husband was being discharged, with prescription in hand we walked through the hospital, back to the front desk to see what the financial damage was going to be.

The Bill

Now, the moment of truth. My husband and I were bracing ourselves. We’re Americans; so we’ve been conditioned to expect a bill in the (10) thousands of dollars for an ER visit, an ultrasound, and a cocktail of meds. Walking out to the reception area, we gave the man our details to pull up our invoice.

My husband handed his credit card to the man at the desk, and he said they were cash only. Oh, fuck. We were already doing the math in our heads, wondering how the hell we were going to come up with that much cash—the max you can pull from an ATM (debt) is like $400. Not to mention if we took a cash withdrawal from our credit cards, we were looking at all sorts of fees. At this point, it is what it is right? I took a deep breath and asked what the total was.

€ 182 euros.

“ Is that the co-pay?” I asked - and he gave me a weird look.

No. That was the whole thing, the ER visit, the meds, and the ultrasound.

I think we laughed out loud.

If you aren't feeling a bit of rage right now, you obviously aren't American. We could definitely swing 182 Euros, and pulling money out of the ATM was no longer a big deal. Our next challenge, getting to the pharmacy —the guy at the front desk called us a cab and told the driver our situation.. The pharmacist was a hero; she spoke English, and she even wrote instructions on the boxes in English so he would know exactly what to take and when. The cab waited for us, and then promptly delivered us back to our hotel.

In the States, getting a same-day or next-day ultrasound is practically unheard of. But in Porto? I called the hospital the next morning, panicked about how the communication was going to go over the phone, and thankfully heard a recorded message saying "Press 2 for English," I had a sigh of relief. Just like that, he had an appointment scheduled for two hours later that morning. Easy Peasy.

We taxied back to the hospital for the ultrasound. The department was efficient—there was a kiosk to sign in, a TV board showing our place in line, and an area to pay your bill., or ask questions. From entry to exit, the whole thing took about 45 minutes. The doctor viewed the results on-site, confirmed the stone had passed, and gave us a clean bill of health.

My husband and I joke about it now: if one of us ever needs surgery, it would honestly be cheaper to just buy two tickets to Portugal than to pay the bill here in the States.