I went back to Lisbon for the week, largely for medical reasons. Quotidian ones for once, which was a nice change of pace. When I was here last in March I got a significant resupply of my medications¹ but those were dwindling. I’m now restocked through the end of the year.

I was staying in a different neighborhood this time, one less touristy² but more upscale. I didn’t tourist. I had blocked my time for medical appointments, and other than that kept a low profile. I did see the latest Deadpool movie³ but otherwise busied myself in some personal projects.

I’m now flying off to the Nordics for Medieval Week in Gotland, a short vacation I’ve been looking forward to since the possibility was first raised back in February. I’ve no idea what to expect but I know a number of people in and around Sweden planning on swinging by and I’m hoping to hang out with friends and see some jousting and take a break from stressing out about everything for a little bit.

When I started traveling, I didn’t really think about medical insurance; I was covered under a policy in the United States which at least nominally included travel. This was probably monumentally stupid but from my point of view the degree to which you have to worry about health insurance is the degree to which your country has fucked it up. Which, yes, the United States has fucked it up, but I decided I didn’t want to deal with it and once you’ve crossed that bridge it’s a lot easier to decide not to deal with it on the other side of the ocean.

And honestly, despite my various medical incidents and a couple of plague years, that gamble hasn’t turned out particularly badly. I’ve been managing to keep the prescriptions I needed topped off either by filling them in the US when I’ve been passing through or by hitting up local doctors when necessary. For most of my travel I’ve paid out-of-pocket, because it’s a colossal hassle and in general the treatments and medications I’ve needed have been about the same cost, without insurance, as it would be in the United States, with insurance.⁴

My heart attack last year changed that calculus. Much of the aftermath was simply me charting a course from one doctor to the next. I’m now finally past the point where it felt like every appointment was life-or-death, where I’d get tossed on a treadmill and they’d see if my heart imploded while there was a crash cart nearby. I’m finally settling in to the idea that I’ll have something approximating a regular doctor where I get regular checkups. This feels adult™ which I hate, but I hate it less than having another heart attack.

Having a regular medical cadence isn’t quite feasible yet.⁵ Until Portugal issues me a visa⁶ I can’t get on the health rolls so my medications aren’t subsidized. That wasn’t a problem when I was on medication for high blood pressure and low dose antibiotics, all of which are dirt cheap, but now that I’m taking a panoply of super-expensive heart drugs it adds up incredibly quickly.⁷

But that’s where I’m at right now. While in Lisbon I actually went to a normal doctor for a normal, routine medical complaint like normal people do.⁸ I’m hoping to follow up remotely, and then schedule treatment the next time I’m back. Which with any luck will be in late autumn, post-visa, and I’ll have all the time in the world to deal with it properly.

Health care is a basic human right. It’s no less important because you don’t always need it. All of our bodies are going to break down eventually, either because we pushed them too hard or treated them poorly or because we got unlucky. It’s something of a relief to be moving someplace where that’s more widely accepted.

Next: Stockholm (ARN) to Birmingham (BHX)
Prev: London (LHR) to Lisbon (LIS)

Footnotes

¹ Many of which now qualify as “life-saving” and I’ve been assured by many, many medical professionals I should do my best to avoid skipping doses.

² Although it was close to El Corte Inglés with the fancy international supermercado in the basement so there were lots of expats wandering the streets.

³ More of the same, if you liked the first two. I mostly did, and snickered at this one few times, but there’s a limit to how much mileage you’re gonna get out of me from the decidedly gentle ribbing of the corporate conglomerate that funded the project and is collecting the receipts.

⁴ There’s a lot of complicated reasons for this, but lack of regulation and corporate greed is the core one. I guess that’s not very complicated at all.

⁵ Not unless I’m prepared to move back to the States on a semi-permanent basis, which I’m doing my best to avoid.

⁶ Still waiting. Maybe by November?

⁷ To put some numbers around this, it appears my medications would cost me about 3€/day if I were a resident of Portugal. They’re about three times that since I’m not, and even that is about three times less expensive than I was paying in the United States, largely because I had a $5,000 deductable that didn’t kick in since I had the misfortune of needing it in the last three months of 2022.

⁸ My left pinky finger won’t extend fully. Okay, maybe that’s not “normal” but it doesn’t hurt and doesn’t impact my life so it feels refreshingly low-stakes.

I had time to get an MRI for it, which was scheduled at 10:40pm on a Friday. The machines are so incredibly expensive and in sufficiently high demand that a lot of places have taken to staffing them at odd hours.