On January 2, 2018, I booked a one-bedroom apartment in Sydney for three nights across New Year’s Eve weekend. Yes, 52 weeks in advance. It’s not unusual to book NYE accommodation in Sydney really early, especially when some hotels are booked two NYEs in advance and it is majorly on your bucket list! More than a million visitors pack Sydney Harbour each NYE, so when I found an apartment with hotel amenities within walking distance, I put the money down. As the months went by, I purchased tickets for other things to round out our itinerary. An anniversary dinner in the Sydney Tower Eye, a dinner and cabaret show cruise around Sydney Harbour, and to top it all off: a ticketed NYE party at the Sydney Opera House Portside on December 31. All prepaid and nonrefundable, of course, although I bought an insurance policy for the Opera House tickets.
In the weeks leading up to the trip, my husband had ominously joked that he hoped his kidney stones didn’t act up and ruin the trip. Because he has been hospitalized at short notice more than once in crippling pain with stones, the joke wasn’t all that funny. But then something really unfunny happened that almost turned our once-in-a-lifetime trip into the trip that wasn’t.
Two days before the trip.
On the Thursday morning after Christmas, I had gone into the embassy to sign my government furlough letter, set auto-responses on various computer systems, and do a few hours of work with our acting section head before technically being offline during the indeterminate period of government shutdown. (The government shutdown had technically gone into effect over the weekend Australian time, but between the Christmas Eve, Christmas Day, and Boxing Day federal holidays, Thursday was the first ‘normal’ workday where we reported to acknowledge the furlough.)
In the afternoon, I put gas in the car so I wouldn’t have to fuss with it Saturday morning, grabbed lunch, ran a few errands, and hit the gym.
Upon arriving home, I took a shower, and went to the kitchen to make some dinner. V was there in workout clothes, and asked me to go on a walk with him. I said I had just showered and needed to eat, so he said he might ride his bike instead. I told him that was great and to have a nice time. I had bought him the bike several years before as a birthday gift, and he had always enjoyed riding it with nary an incident.
About an hour and 15 minutes later, it was 19:00 and I was watching something on Netflix when my phone lit up with a call from V. I immediately got a bad feeling. He almost never calls me when he is out exercising unless it is related to bringing back takeaway food. But we both had already eaten. I answered the phone and knew right away from his voice that my instinct had been right.
It turned out he had braked on a downhill portion of the bike trail, skidded out in some gravel he hadn’t seen, and had a crash. He was wearing a helmet, so fortunately no head injuries. But he said his hands, arms, and one leg were badly bleeding and he needed me to come get him. I asked him where he was. I couldn’t pin down the answer from his explanation, so I asked him to open Google Maps, take a screenshot of his location, and send it to me.
Once I had that, I was out the door within minutes. I drove the Nissan because I didn’t think his bike would fit in the back of the Holden. Fortunately, the Nissan he usually drives was gassed up too. It took me seven or eight minutes to get to where he was. He looked so sad standing there on the side of the road, bleeding down to his sock and shoe, with not a soul around.
The injuries to the arms and wrists were gross-looking, but not serious: road rash and small puncture wounds. But when I saw the leg, it was immediately evident to me that we needed to go to the ER; the leg gash was deep. I also questioned whether he might have fractured something because he was clearly in shock and like anyone in that condition, could not fully self-assess. I slugged the bicycle into the Nissan’s trunk, hurriedly lowering the back seats to make more room. I made a big illegal U-turn in the middle of the road. No one in either direction.
Luckily, the hospital was less than five minutes away. By 19:30 the triage nurse finished an initial flushing of his leg wound. And then we waited. And waited some more. I whipped out my government-issue BlackBerry that was ‘supposed’ to be turned off, and furlough be damned, wrote a detailed email to our embassy doctor. Bicycle accident. No alcohol or third party involvement. No head injuries. Unclear whether will be admitted. No request for embassy Letter of Payment Guarantee at this time.
Doctors and nurses came and went. IV antibiotics happened. X-rays happened. Paperwork happened. Arm cleaning and bandages happened. An email to my family to give them a heads-up happened. Me moving the car twice happened, until I wrangled it out of one of the nurses that parking enforcement had stopped for the evening.
An apologetic nurse appeared at V’s bedside and informed us that Australian Capital Territory (ACT) law requires a blood test to confirm that alcohol is not a factor in any crash on its roads, including bicycles. I knew V had not been drinking, and saw no need to make a point of our diplomatic status. He agreed to cooperate and give the blood. Sent another email to keep embassy doctor in the loop.
And then a doctor came and looked at the leg wound, just below the knee, under a harsh bright light. She said a plastic surgeon needed to see the wound. Photos ensued. An hour passed. More photos, closer-up this time. Sometime well after 21:00 the plastic surgeon texted her back and said an orthopedic surgeon should look at it. We waited.
Nurses trundled back and forth, shoes squeaking. An elderly lady had an extended consultation with a specialist about her double vision from behind a curtain. A young lady periodically curled into a fetal position and moaned, her boyfriend holding her hand. An older immigrant man was regaling a nurse with his various aches and pains. V was grinning and bearing it. I said a silent thank you for all the times he had ridden his bike in Uzbekistan without so much as a scrape. A medevac for this would have been a nightmare out of there, especially during a government shutdown. Thank God for this Canberran posting.
The orthopedic surgeon came down after 22:00 and had a look. He explained that the x-rays indicated that gravel was in the wound, and that it couldn’t be cleaned outside of a surgical theatre. My heart sank as I realized it would need to be operated on and that this ordeal would stretch into a second day before resolution. I had a variety of appointments and errands the following day to prepare for our Saturday morning departure that I would need to cancel, and as I considered that my brother had had many such wounds cleaned safely and properly in American emergency rooms and urgent care centers, I felt worried and irritated.
The doctor suggested V be admitted for the night to do more IV antibiotics, in preparation for an 07:00 surgery the following (Friday) morning. I asked the doctor whether him spending the night was actually medically indicated, suggesting we could spend the night at home, less than 10 minutes away, stopgap the treatment with oral antibiotics, and return at 06:45. V was not in much pain, and also wanted to sleep at home. The surgeon readily agreed there was not actually any real medical need for V to be admitted overnight. I said that we would be happy to pay if he really needed to be there, and that I would need to get the embassy involved, and the surgeon again confirmed it was not really necessary but “just the way” they typically do things.
I should say here that I do not (repeat NOT) come from a socialized medicine background. As much as I love Australia (and I truly love Australia), and appreciate the medical care I myself have received here, from an American perspective, there are times where I have found the system to be… a little bit of a shock.
Like when the surgeon suggested I take three months off work to recover from back surgery. (I took three weeks.) Or when I realized that trying to buy over-the-counter meds can invite the Spanish Inquisition from a well-intentioned pharmacist. Or when I was asked to lie in a hospital bed for four days on IV antibiotics. (Well, OK – that last one probably was necessary, but I just doubt it would have ever happened at home.)
To be fair, I have been impressed by the amount of depth Australian doctors go into during appointments, and how much more holistically they tend to approach patient care. But there have been times where I have found getting the third degree a little over the top, bordering on infantilizing, like the time a pharmacist insisted I have a doctor administer my arthritis injections that I have been doing myself for a decade. (I refused.)
On the opposite side, in my experience, the American medical system often shortchanges patient care – or encourages patients to shortchange their own care – with a “get what treatment you can afford or go bankrupt” mentality. There are some real inherent conflicts of interest in our system. I definitely believe that in the past, I have made choices about medical care that were more based on fear of financial hardship than medical need. I can think of at least three times in my 20s that I had a medical emergency and toughed it out because I was scared about how much an ER trip would cost.
Australians don’t seem to factor in cost when making care decisions because the state picks up the tab. (I’ll take the steak and lobster, thanks!) When they realize that we pay out of pocket for care here and then wait weeks (or months) for reimbursement from our U.S. insurance company, they quickly pivot to less expensive decisions (often accompanied by a look of pity). I have tried to find a happy medium so that I’m not half-assing care, but also not letting care expand into an exploratory no-holds barred billing free-for-all.
Now, lest you think I am a monster, I am not suggesting here that V should have just gone home, rinsed his leg, and cracked a beer. Even though I was freaked about missing the trip, I truly wanted him to have whatever he needed. I have ignored injuries that later turned into major issues, in one case life-threatening, and I was not about to let him do the same. I am not a doctor, and I don’t think I know better than a doctor.
But, I have seen arguably worse injuries than what he had treated faster on an outpatient basis, and I do believe that work expands to fill available space, as it were. A perfect blend of Australian thoroughness and American efficiency was what I was after. I was also not expecting it to become a late-night ordeal, let alone stretch into a second day.
Little did I know. By 23:30 we were home, expected back the next morning by 06:45.
One day before the trip.
Annoyingly, my alarm did not go off in the morning and I did not have time to take a good shower, resigning myself to sitting a second day disheveled in the hospital. V was feeling OK, but a little sore.
We were processed into the day surgery unit in fairly short order, but by 10:00 the hours were ticking by and we were still in the waiting room. Patients and their relatives were sprawled wherever they could find a spot, most looking miserable. My family and the embassy doctor pinged me steadily for updates. Lunchtime came and went. I tried to keep my demeanor cooperative, but when a nurse told me “it might not happen until tomorrow,” I got a little testy. V was sitting there with gravel in his leg, running the risk of an infection.
Checking in with the embassy doctor and nurses and asking lots of questions. Canceling my appointments for the day one by one because I refused to leave the hospital. Not drinking any water or eating in solidarity with all the pre-surgical patients who were fasting. Being glad for a moment that we were furloughed and not burning sick leave. All the while V sat patiently, without complaint. I don’t know how he did not drink water all that time – I would have been in a much fouler mood. I considered the irony: had V been admitted the night before, it would have cost us thousands of dollars extra, but he may have been operated on in the morning as an inpatient rather than waiting all day for day surgery.
After 13:00 a nurse came and told us he was next. Our moods brightened considerably, and I dared to hope. Within an hour he was on a gurney. The surgeon looked at the wound as anesthesiology prepped, exclaiming that there was already necrotic tissue. Trying not to fume, I told her that’s why we had been there for seven hours waiting our turn, and she reminded me that three dozen patients had already been through the operating theatres that day, and only two of the 12 theatres were operating due to the holidays. (Did I mention that Canberra essentially shuts down through December and January?!)
She went on to say that she might do a two part surgery, with the second part to follow in two days. (!?) I explained again in a near-panic that we were going out of town the next morning on a four day car trip and really wanted him to get the care he needed right away. Again, a two-part surgery magically turned into one procedure. All I wanted them to do was just clean the damn wound so it would not get an infection, especially with the risk of osteomyelitis (bone infection) in the knee or shin. Ugh.
I’d had some really unhappy moments that day where it seemed our trip was going into the tank, and I lost patience with my feeling that V’s needs were being alternately ignored and then belabored, but I tried to keep it together and be a good advocate. While V was in the operating theatre I finally drank a bottle of water and a coffee. I ate a sandwich like a wolf, sitting in an empty room out of sight of those still waiting. I saw the doctors apologize to one young lady and send her home, saying they just would not have time to get to her, and I felt terrible for her.
By 18:30, V was being released with a bag of antibiotics and by 19:00 I was home packing and doing laundry. Some 12th anniversary, we joked with each other.
The next morning, remarkably, we were on the road before 08:00. Clothes packed. Garden watered. Arrangements made with neighbors to look after the yard for four days as a heatwave broke over Canberra. I did not get to sit and clean out my phone, pay bills, back up my computer, do a grocery run so we’d have food for the apartment, or any of the other things I would normally do before going out of town, but I didn’t care. We were going!
All along I had been thinking that if I could just get to Sydney, everything would be all right and we could enjoy our holiday. Little did I know there were a couple more nasty surprises in store.
To be continued…