Confessions of a Nomadic Hypochondriac
Ah, modern medicine. It’s been my constant companion for much of the 12 years since I left New York City to become a full-time expat, living in multiple cities, on five continents.
Welcome to the world of a nomadic anxiety-ridden hypochondriac.
For all of the traveling and self-diagnosing I’ve done (Google is my runner-up bestie, second to modern medicine), medical tourism actually has never been my thing. I have an Australian friend who once flew all the way to Buenos Aires, where I was living at the time, to have liposuction at a deep discount. I’ve secretly side-eyed him every time I’ve seen him since — while sneaking peeks at his midsection to see if the fat removal is holding up. The only two times I’ve gone to any kind of medical professional for fun while living abroad were when I had my teeth whitened in Bangkok.
Still, hospitals constantly end up on my travel to-do lists, though never for sightseeing reasons. Unfortunately, they haven’t been always as easy to find as the local churches/temples/castles/forts. How did hypochondriacs like me survive before Google Maps?
The Thai capital has been a key city in my global doctor tour. I was halfway through my first six-month stint there when abdominal discomfort that turned out to be a combination of growing-old pains, psychosomatic syndrome, anxiety, and too much spicy Thai food (translation: gas) sent me to BNH Hospital.
When I walked into the private medical center, which was in a lovely modern building near where I was living in Bangkok, the pain almost slipped my mind. I’m not sure what I was expecting, but I probably expected a hospital in Thailand to scream, or at least declare loudly, “Developing nation!”
BNH, however, might have been the poshest hospital I’d ever seen in real life. It was run almost like a five-star hotel, and the gorgeous nurses wore those sexy uniforms with the pointy hats that nurses in the U.S. probably haven’t worn since the ’70s. They even had specially packaged drinking water for guests — I mean, patients.
Little did I know when my adventures in hospital kicked off there in 2011 that I was beginning a medical journey that would unfold around the world, in 14 other countries. For my five or so previous expat years in Argentina and Australia, I’d managed to keep my hypochondria, if not always my anxiety, under control. Bangkok, though, unleashed its full force.
My hospital history
During the four and a half years I lived in Buenos Aires, I splurged on private insurance and a primary-care physician, Dr. Kaip. For my 15 years in New York City, two different employers had me covered. Though I still mostly managed to stay out of hospitals in both BA and NYC, the universe gave me a preview of things to come when sudden bizarre symptoms — cold and clammy hands, disorientation, heartbeat accelerating — sent me to the ER twice in a 24-hour period less than a week before my September 2006 departure from the U.S.
I was certain I was having a heart attack or a stroke, but the ER doctors at the now-closed St. Vincent’s hospital in the West Village assured me both times that I was in the throes of full-blown panic attacks. As a parting gift, a psychiatrist diagnosed me with panic disorder the next day and prescribed Klonopin to take whenever I felt another anxiety episode coming on.
“Do not mix it with alcohol,” the pharmacist warned as I reluctantly entered the world of benzos. Nobody told me that hypochondria and anxiety made for an equally dangerous combo, but eventually, I’d find out for myself.
In BA, I continued to take half a milligram of Klonopin as needed, which was usually no more than once or twice a week. I stayed on the safe side by scheduling regular appointments with Dr. Kaip to monitor my “borderline” blood pressure, for which my New York City primary-care physician, Dr. Andrilli, had prescribed daily doses of Atenolol several years earlier.
I also once went to a fitness center’s doctor for a stress test to fulfill the requirements for joining the gym. He told me my results were the best he’d seen in his entire career, which gave me peace of mind… for about a week.
Can’t fight this sinking feeling
Thankfully, I was able to get both Klonopin and Atenolol without a prescription at a pharmacy around the corner from my apartment in Palermo Hollywood, making life with anxiety and borderline blood pressure so much simpler. By the time I left Buenos Aires in 2011, my blood pressure was normal enough for Dr. Kaip to take me off Atenolol permanently.
Even with my blood pressure down, my hypochondria steadily surged after I departed Argentina for, first, Melbourne, Australia, and later, Bangkok. Within six months, it would be messing with my head on a daily basis.
Every twitch, every ache, and every pain would be potentially life-threatening and worth checking out immediately — if I could procure walk-in treatment, which, outside of Bangkok and Cape Town, I’ve rarely been able to do abroad. Thankfully, my travel insurance usually has picked up the bulk of my tabs, which have never exceeded $120 for any consultation I’ve had or single procedure I’ve undergone in Africa, Asia, and Europe.
Every twitch, every ache, and every pain would be potentially life-threatening and worth checking out immediately — if I could procure walk-in treatment, which, outside of Bangkok and Cape Town, I’ve rarely been able to do abroad.
Why the constant fear? That’s as much a mystery to me as the anxiety. I’ve never had a serious illness, nor have I stayed in any hospital for more than a few hours since I was eight years old and spent a week being examined by a neurologist in Kissimmee, Florida, for the vicious and constant headaches that continue to plague me 41 years later.
As a journalist, I can’t say my career is especially high-stress, which pretty much rules it out as the source of my chronic anxiety. I’m a long-distance runner, and I work out pretty religiously. To the casual observer, I might appear not to have a medical care in the world.
Yet, I keep ending up in the same place. As I’ve wandered all around the world, one continent, one country, at a time, visits to hospitals and medical centers have been, perhaps, the only constant.
Four things I’ve learned along the way:
1. Never try to beat the crowd at a public hospital by showing up first thing in the morning. Everyone has that idea. Waiting areas are more likely to be going on empty late in the afternoon, after 3ish.
2. Your chances of getting an English-speaking doctor improve if you go to a private clinic rather than a public hospital. You’ll pay more, but it will be worth it.
3. I do much better with female doctors. It’s a trend that began with the one who gave me my first prostate exam, in Cape Town. Maybe it’s maternal instincts, but with a few exceptions (like my stern, just-the-facts gastroenterologist in Kiev), my female doctors abroad have been better at soothing my fears than my male physicians.
4. If I ever get seriously ill outside of the U.S., I hope I’m in Bangkok, where I already have had EKGs, blood tests, urinalysis, an ultrasound, an echocardiogram, and an MRI. Over the course of six years, I’ve been treated there for the aforementioned stomach pangs, pounding headaches, insomnia, anxiety, and possibly psychosomatic chest pains that had me prepping for my own funeral.
Do you speak my language?
While I’ve been able to communicate using English with doctors in Africa, Asia, Australia, and South America, words have sometimes gotten in the way when I’ve sought medical care during my last 14 and a half months in Europe. I have run up against insurmountable language barriers and couldn’t get past reception at public hospitals in Berlin and Bucharest, and at private ones in Odessa, Ukraine, and Iași, Romania.
A psychiatrist at Saint Spiridon County Hospital in Iași threw me out of her office, even though I had a referral from an ER doctor, who had charged me $0 for blood tests and an IV drip of Valium and vitamins the previous Sunday afternoon, because I couldn’t communicate with her in Romanian. She was too busy (and cranky) to engage in my use of the translation app I’d downloaded to bridge the massive language barrier in Ukraine.
I suppose sometimes you do get what you pay for, which, according to the ER doctor at Saint Spiridon, is nothing in Romania’s public hospitals, even for non-nationals? Aside from her, not one person working at that one spoke a word of English.
The Polish doctor I saw in Kraków did, thankfully. After I listed a litany of medical complaints, some possibly imaginary, some probably not, he laughed, neither at me nor with me, but because the medical records I showed him were in three languages and two alphabets.
Then he wrote referrals for me to have a chest X-ray, a stress test, blood work, and urinalysis, along with a sertraline (Zoloft) prescription to add to the Xanax and Trittico anxiety protocol a psychiatrist in Belgrade had put me on eight months earlier.
Caught in a mind riot
Not being under the full-time care of any one physician and traveling around countries with different languages, alphabets, and laws regulating prescription drugs has been challenging in other ways.
Constantly moving and having to adjust to new routines and cultures probably isn’t the recommended lifestyle for someone living with chronic anxiety. In addition to Belgrade, Kraków, and Iași — where, for $27, Dr. Paviliu at Arcadia Hospital and Medical Center saved my mind, if not my life, with new Xanax and Trittico prescriptions after the mean psychiatrist tossed me out of her office — my mental affliction has led me to seek treatment in Bangkok, Prague, and Istanbul.
I tried to in Zagreb, Croatia, but the only medical attention I could get near my rental flat at 1am was in a trauma center. I hadn’t bumped my head in the night, so the doctor there couldn’t help, of course, but I enjoyed looking at his handsome face as he told me where I could go in the morning. I almost forgot why I was there.
The after-midnight doctor in Postojna, Slovenia, wasn’t as handsome, but when I went to him, alarmed by a sudden severe sore throat, he looked me over and assured me nothing sinister had befallen me. His excellent bedside manner couldn’t have been better value for money: “This one’s on the house,” he said, as I pulled out my money to pay.
No discount was needed for the less-than-$5 service I sought in Goa in the summer of 2017 for a terrible case of food poisoning. (Travel tip: Don’t use tap water to brush your teeth in India!) My medical adventure there went down on a Saturday morning at a place that looked like a 19th-century country hospital out of Little House on the Prairie, complete with barefoot toddlers running around and a stray dog. I almost expected a cow or a pig to stroll by.
My recurring tummy drama had begun six years earlier after a reflexologist in Kuala Lumpur, Malaysia, ended 60 minutes of delicious rubbing, pressing, and squeezing by asking if I had gastric issues. I wasn’t aware of any at the time, but the power of his suggestion eventually led me to BNH Hospital in Bangkok, where I had that first ultrasound. Subsequent doctors would address my stomach woes in three cities: Belgrade, where I had my second ultrasound, then Kiev, where I had a colonoscopy and gastroscopy and was diagnosed with gastritis after waiting 10 days for biopsy results, and, finally, Prague, where I had my third and most recent ultrasound. It was as clear as the first two had been.
In the Czech capital, a gastroenterologist prescribed Mutaflor, a pricey probiotic that finally made me feel normal again after six weeks of expensive but unsuccessful gastritis treatment in Kiev. The gastroenterologist in Kiev blamed my gastritis on stress, but the one in Prague suggested I might have picked up something in Istanbul, since that was where my digestive problems flared up and took over my life. Clearly, consistency hasn’t been my friend during my adventures in hospital.
Up to now, gastritis has been the most costly malady — real or imagined — that I’ve had while living abroad. The price sum of the various gastritis-related prescriptions I had filled in the Ukraine capital — seven in total — was a little less than half of the roughly $222 I paid for both the gastroscopy and colonoscopy.
As with Oxford Medical in Kiev, the excellent care I’ve received at private facilities in Europe often has required waiting days, or weeks, for an appointment, especially with English-speaking doctors.
In Budapest, though, I received same-day service in English for excruciating ear pain that was radiating up my scalp. A throbbing, stuffed-up ear had sent me to the ER about four years earlier in Cape Town, where a frosty doctor quickly examined me and left me in the care of a kindly nurse. It took two visits for her to remove a huge chunk of wax from my right ear, the same one that the ENT special in Budapest irrigated to a squeaky-clean and painless sheen in a single sitting.
Struggling down under
Interestingly, I had my most-negative medical experience during my two and a half years living and working in Sydney, despite my treatment there being exclusively in English and having private insurance coverage. One doctor dismissed my chest-pain complaints with bad jokes before diagnosing me with something called costochondritis, a condition that was more annoying than deadly.
He was a “mate” man who looked like he would rather have been on a footy field than baby-sitting me through my trivial medical issues. Where was Dr. Rawlings when I needed her?
Dr. Feelbad and the Raging Hypochondriac
An old diagnosis that still makes me sick to my stomach today.
His insensitivity was ghastly, but I gave the medical care down under negative reviews not just because of him. As a non-resident, I was ineligible for Medicare coverage, and since my employer didn’t offer any medical plan, I was at the mercy of private insurance. Mine was so crappy that I often had to pay most, if not all, of the cost for consultations and treatment out of pocket without reimbursement.
The various X-rays, the echocardiogram and stress test, and the MRI (which revealed I had something called a cerebellum ectopia) were all free of charge, but my Bupa insurance covered only a small fraction of the doctor’s appointments to get the referrals. And I had to pay the entire cost (around $1,000) for an overnight sleep study, after which a congenial doctor who looked like a Bollywood matinee idol diagnosed me with a mild sleep apnea.
The best medical attention I experienced in Australia wasn’t even for me. The ambulance took more than a half hour to arrive after my brother Alexi passed out mid-sentence during lunch at Cookie, my favorite restaurant in Melbourne. Once it did, the two EMTs were so comforting and efficient that I recovered from the panic I felt when Alexi’s head suddenly fell to his chest during his glowing review of the meal.
The ambulance took more than a half hour to arrive after my brother Alexi passed out mid-sentence during lunch at Cookie, my favorite restaurant in Melbourne.
His Canadian insurance (he lives in Toronto) no doubt footed more of the bill than Bupa would have had I been the one to lose consciousness for no discernible reason. (The case of Alexi’s mysterious fainting spell would go unsolved.) I happily would have traded the easy communication I enjoyed in Australia for the considerably lower cost I’ve paid pretty much everywhere else outside of the U.S.. And aside from the Polish doctor in Kraków, if they laughed, they waited until I was gone.
Well, actually, the staff at MediGroup in Belgrade didn’t wait, but then, their laughter had nothing to do with my health. I had multiple appointments there with both a cardiologist and a psychiatrist after walking in one afternoon with anxiety-related stomach and chest pains. The former didn’t speak a word of English, while the latter struggled to explain the one-year protocol of Trittico and Xanax she was prescribing.
Everyone, from the pretty nurse who translated for the cardiologist, to the guy who drew my blood, to the woman who took my money, treated me with casual familiarity. They asked questions about life in the U.S. and assured me everything would be OK while lavishing me with sympathetic looks. I didn’t even mind that they kept calling me my middle name, which I hate. By the time I left MediGroup following my final appointment (for the ultrasound), I felt like they were old friends.
Next stop: Bosnia and Herzegovina. Sarajevo wasn’t as kind to me as Belgrade at first, but after several misses, a doctor there finally gave me excellent medical attention for out-of-whack seasonal allergies. The role of translator was played by a customer who happened to be waiting on his wife.
By the next morning, I could breathe freely again, which usually has been the case post-treatment abroad — at least for a week or two. The occasional irregularity aside (cerebellum ectopia, gastritis, a slight sleep apnea, and an arrhythmia that has gotten me some concerned looks but no medication so far), I’ve been given multiple clean bills of health, in various languages and two alphabets.
Of course, I’m always up for a second opinion.