This was supposed to be a pleasant jaunt back to the UK for SOE: Resistance. Instead I’ve yet again ended up in the hospital. I landed very late at Stansted — 11:30pm — and had booked at the airport hotel for the night.¹ The next day I caught a bus to Victoria and the train down to Exeter to stay the night, and the following day I hopped on the player bus to South Devon and the game, and had things gone according to plan I’d have been on the bus back to Exeter, caught the train up to Birmingham, and then boarded the bus to Heathrow and my flight to Prague. Easy. In and out.²

And up until two days ago, that was all going swimmingly. I was still suffering from back pain, which put a damper on things, but I was having a great time at the game. And then on the final day I suddenly got a burning sensation in my chest and had to find my way to the safety team. Don’t worry: everything worked out. This is one of the few medical crises I’ve been through in the past six years that doesn’t have lingering effects³ but it did mean I spent the remainder of the weekend in the hospital, rather than finishing the game.

It’s a real pity, because SOE: Resistance was the best game I’ve played all year. You’re given the role of a potential spy recruited by the British War Office to infiltrate occupied Europe during World War II. And it got so much right. The characters were interesting⁴ and the things you did day-to-day were fascinating. The venue was decked out with period elements like a vintage Bentley. Most of the time was taken up with learning actual skills that would have been taught to agents during WWII — setting booby traps,⁵ learning cryptography, practicing guiding airplanes in for secret cargo drops, training with guns and grenades, getting skilled with radio transmission kits and morse code, and discussing ethical dilemmas you might encounter in the field.⁶

During all this we were divided into teams, and further divided into classifications: saboteurs (with more of an emphasis on explosives, physical combat, and stealth techniques), specialists (codes, surveillance, and tradecraft), and agents (a little of both). There was a kind of metagame going on where one member of each team was notified privately they were a mole, and the rest of us were tasked with trying to root them out.⁷ The final day was entirely given over to a final assessment, where each team ran through a series of assignments designed to test your skills in realistic assignments: break into an office and photograph documents, sabotage a railroad crossing, assassinate a target.

Like I said, this was all an incredible amount of fun. I’ll gladly sign up for another run if it’s available. I played an agent, and the track for specialist track is different enough that I’d love the chance to go through the codebreaking modules. The only potential negative I have to mention — if it even is a negative — is that I’m not sure it’s actually a larp.

Okay, so the game calls itself a larp and advertises itself as a larp and you get characters you pretend to be over the course of the game, so I’m trolling a little bit here. By most people’s definition this is a larp. And this is largely a semantic debate, not a practical one. SOE: Resistance was a great experience, for me, and however you’d classify it I’d happily recommend it to anyone who thinks it sounds neat from my description above.

But all those lectures and exercises and assessments take up a lot of time. On Friday, for example, the game starts at 8am and officially ends for the night at 11pm.⁸ And with the exception of an official two hours to socialize at the end of the day, the only time you have outside of classes and team meetings are breaks for food, which total about three hours. That’s a very slim amount of time to play on personal drama.

It’s made worse because a lot of that time gets eaten up by other things. Breakfast isn’t a great time to push plots, since everyone’s still waking up. In my group a lot of the time at tea and meals was consumed with discussions about the metapuzzle — speculating on the rules, running the math for scoring, and trying to suss out votes — which further ate into what time we had.

You may counter that all of this is conducted as your character, so every interaction offers an opportunity to play on drama. And that does come up. Some of the classes got into the moral dilemmas one might face as an agent in the field; in those I felt most clearly like I was larping. But I often find it’s difficult to solve puzzles or run exercises while playing a role; mental concentration pulls me out of my immersion so I effectively have to choose one or the other.

And this is exacerbated by the game. Your characters are ostensibly prohibited from discussing their backgrounds with one another, so while as a player you might want to spill personal secrets it’s harder to justify doing so. You’re also all there to complete your training and get into the field so people don’t want to cause trouble or do things that might jeopardize their success. And even if you’re trying to push your personal plots, doing so requires finding like-minded players to play off of. That can be tricky, with so much going on.⁹

While I was occasionally able to get immersed in my character, I was never able to do it very deeply or for very long. So does that mean it wasn’t a larp? If your definition is simply that all the players have characters and interact through them, sure, it’s a larp. But I’m realizing one of my unspoken assumptions is that there’s an opportunity for meaningful interactions.¹⁰ SOE: Resistance necessarily has less of that. At a minimum I think it’s fair to say the larp elements aren’t the core of the experience; you could probably play into them, but you’d be stealing from all the other bits, and those are the bits I enjoyed the most.

None of this is intended to detract from the experience in the slightest. Like I said, I thought the game was fantastic, well-designed and well-run. As a larp designer I think it’s a good reminder you can get a little too locked in to a particular style of game, narrowly focusing on character drama or NPC interactions or plot to the exclusion of other possibilities. There’s a lot of design space out there. We should explore more of it.

So my team was completing one of the exercises for our final assessment when what had been intermittent back aches turned into a strong significant pain in the dead center of my chest. It reached the point where even an idiot such as myself couldn’t deny I needed to drop out of the game. I ended up sitting with the safety team while they dialed an ambulance and fetched my stuff from my room.¹¹ I took some crushed up aspirin on the instructions of the operator and waited.

The biggest relief was when the paramedics arrived and ran the EKG. It showed no heart distress whatsoever. That’s not 100% conclusive, especially in someone with a history of heart problems, but it’s pretty close. If I hadn’t been through my health scare a year ago I probably would have stayed at the game¹² but just to be safe I accepted a ride to the nearest hospital to get checked out there, on the assumption they wouldn’t find anything and I’d be back that evening.¹³ The ambulance crew was genuinely lovely. Friendly, nice, and considerate.¹⁴ They gave me a tiny dose of morphine to help with the pain — it certainly did — and after thirty minutes of twisty country roads we were at the hospital. Where there was a line to get in. A long line.

I was an extremely low priority, not unreasonably, so I got to hang out in the ambulance and continue chatting with the EMTs. They fetched me a sandwich and a yogurt and after about an hour I got taken in to get blood drawn and have a brief exam with an ultrasound, then went back on the ambulance for a bit until there was space in the hospital for me to wait.

And this is where things really started going off the rails. By this time the chest pain had settled into a semi-severe stomach ache, and when the doctor returned they pointed out my eyes were really kind of shockingly yellow. That’s jaundice, and coupled with my blood work it almost certainly meant pancreatitis. I went from waiting for another round of tests before getting cut loose to being admitted to the hospital overnight, pending an ultrasound.

By the evening my abdomen had gotten incredibly sore and distended. I couldn’t stand up or move around. It wasn’t painful to lie on my back but I couldn’t lay on my side. Making matters worse I couldn’t eat after midnight pending the ultrasound.¹⁵ It really looked dire; they were talking about surgical options and suggesting I should plan to be in the hospital for a week or two. This turns out to have been catastrophizing on their part. By the next morning I was able to stand and eventually shuffle around a bit, then a few hours later I was able to move around without any pain. By early evening I was more-or-less back to normal.

Acute pancreatitis is far and away most commonly caused by gallstones. One of them gets dislodged from the gallbladder and ends up drifting down the bile ducts where it gets stuck and blocks useful chemicals like insulin and glucagon. It also blocks digestive enzymes, which shrug and start digesting the pancreas instead. As the surgeon put it, “This makes the pancreas angry.” And I actually have a history of gallstones. 25 years ago I had my primary care doctor recommend I have my gallbladder removed.¹⁶

The majority of gallstones clear on their own. They’ll stick you in the hospital for monitoring — pancreatitis can get nasty — but 80% of the time it just passes without intervention. There’s a reasonable argument you don’t need to be hospitalized at all, just put up someplace comfortable where you can fast or stick to a low-fat diet. It looks like that’s what happened here; one of my gallstones got loose sometime last week,¹⁷ by Friday it had blocked my pancreas causing increasingly dire symptoms which came to a head on Saturday, and by Sunday morning it had passed through my system and I’ve been steadily recovering ever since.

I’d like to be more certain of this timeline, but the hospital never managed to schedule the ultrasound. First they said it would be in the morning, then they said early afternoon, then they finally admitted in late afternoon it would have to be done on Monday. I had starved myself all day before I finally got something to eat at 6pm. On Monday the same thing repeated itself but I had already made it known I wasn’t going to stay for another night, so in the afternoon when they told me it wasn’t going to get scheduled until Tuesday I ordered some food from the kitchen, booked a train ticket, and prepared to leave. I spent the night in Birmingham and caught my flight to Prague the next day. I’m planning to take it easy in Prague for the next week, and stick to a low-fat diet to give my digestive tract time to reboot.¹⁸

I thought I’d have at least some interesting observations about the difference between Polish and UK hospital wards, but even there I don’t have much to offer. The UK system is better funded, certainly. But the UK system is also dreadfully overloaded. Making me starve myself two days in a row without getting the diagnostic ultrasound I needed was a definite low point, as was sitting in a ambulance for a few hours with a couple EMTs because the hospital was full.

You might imagine the equipment would be better in the UK, but it really seemed to be about the same. The Polish facilities were more run down, and the UK had significantly nicer curtains separating the beds on the wards.¹⁹ What little of the food I was permitted to eat was better and had significantly more options for vegans and vegetarians.²⁰ The nurses were far nicer in the UK.²¹ But where things really mattered — beds and IV drips and medications and monitoring equipment — things seemed pretty comparable to me. I’d definitely choose the UK over Poland for a hospital stay, given a choice, but that’s mostly for the language and secondary factors.²² In terms of actual medical care, I think I was treated all right by both.

Having been in hospitals in the United States, the United Kingdom, and Poland I think I can say there’s something about hospitals which is both widespread and infuriating. Most doctors and nurses and EMTs are genuinely invested in giving you the best possible care.²³ But they’re working within budgetary constraints, dependent on reduced government funding and/or market forces which limit what they can do. Okay, fine, that’s the system we’ve got.

But the vast majority of doctors, especially in hospitals, don’t seem capable of wrapping their heads around the idea that maybe the patient should have some input into those decisions. I’ve noticed it’s especially bad in the NHS, where as a tourist I’m not covered — meaning I’m paying for all these treatments, in the hope my insurance will reimburse me — but they don’t see any problem with having me stick around in the hospital day after day, under observation awaiting a test that they’ll schedule when they get around to it.

I was really hoping to get the ultrasound done early Sunday afternoon, which theoretically would have been in enough time to catch my previously booked train. Given how I felt then, and how I felt the next day, that would have been perfectly fine and I would have saved a whole day’s worth of hospital charges.²⁴ Instead, they gaslighted me the whole day about getting the test done and I never saw a doctor after the morning rounds to discuss my situation. Nurses would come around to inject something and I’d have to stop them to ask what it was. I’d mention “I have a flight leaving on Tuesday that I have to be on” and the nurse would respond “Well, we’ll see what the doctor thinks” as if they’re the one making the decision. Which they aren’t! They can recommend or approve various treatments, and god knows they know far more than I do about these sorts of things, but they’re so utterly blind to anything but the health implications of their decisions that you, as the patient, have to have the final word. That short-sightedness is marginally more understandable in the NHS, where there generally isn’t any monetary cost to the patient to staying an extra day or two in the hospital, but even then there are more dimensions than money and health to consider.

I still have no idea what this all is going to cost me. The day I left I was met by the hospital’s payment coordinator for overseas visitors, who politely and apologetically told me they could not produce any estimate of how much my stay was going to cost. They had to wait until I was discharged, at which point all the services I had incurred would be tallied up and assigned to categories and billed out. I then asked how, if I didn’t have any insurance, I would be able to decide whether to accept or refuse any particular treatment and they had no answer to that, other than to insist (three times!) it really wasn’t going to be all that bad, and they were sure my insurance would cover it in any case.

I’m not especially worried; my insurance is in flux but I’ve got a few options which ought to cover it. And the cost of getting your gallbladder removed in the private system in the UK seems to be around £5,000, which is a lot of money but not a retirement-ruining amount of money. I’d imagine a couple days in the hospital, without significant treatments, has got to be significantly less than that.²⁵

I think it’s all broadly reflective of how badly our moral and ethical intuition interacts with the systems we’ve constructed. I want to live in a world where none of this matters, where if you need medical treatment you have access to the best possible without question, where the resources generated by our society are put to use where they can do the most good for the most people. But in a capitalist system, over time everything becomes subordinate to the accounting systems. Your health and well-being will be reduced to a line-item on someone else’s profit/loss chart. And inevitably their bonus is going to depend on cutting it.

Prev: Bucharest (OTP) to London (STN)

Footnotes

¹ Say what you will about Stansted, and it really is a massive pain in the ass to get to, but if you’re landing late you’re within no more than a 10 minute walk of about five hotels and there were multiple food options still open so I could grab a late dinner.

² My logic, here, was that I had to stay somewhere for the week before my next larp, and Prague was going to be cheaper than the UK. Previously I’d have worried more about Schengen days, but having avoided the through the summer I’ve managed to bank enough to carry me through to 2025. Plus I finally got notification that my visa for Portugal was approved, so I’m just waiting to have that in hand. Which may take months, but that’s better than the years I’ve already been waiting.

³ Knock wood, and I am going to have to schedule a surgery at some point sooner rather than later.

⁴ They made a point of casting players as their own nationalities. I was playing a US citizen born to German immigrants who had been living in Berlin for the past decade, so I had a plausible reason to be an effective infiltrator as well as an excuse for being a New Yorker.

The only real exception to this rule were Swedes, who mostly played Norwegians.

⁵ Using actual switches with percussion caps and timed fuses. The TNT blocks were fake, but even they were the fake TNT blocks used for training classes.

⁶ Less the trolley problem than how much collateral damage is acceptable if you can also blow up a high-value target.

⁷ To clarify, this was done as a training exercise; there weren’t actual German spies running around. Or maybe there were; I didn’t get to finish the game.

I’m not entirely sure what the purpose of the mole hunt was, if it represented some actual exercises the SOE trainees would be given, or if it was intended to provide some additional play, or just increase the overall paranoia. I can think of a lot of ways it could be improved, but without knowing what the aim of it was I don’t know what to suggest. And since I missed the end of the game, I don’t know if there was a payoff I’m unaware of. My suggestions might range from “Make the rules more explicit” to “Make the scoring more transparent” to “Scrap it entirely.”

⁸ You can stay up later if you like, but with everything going I recommend getting some sleep.

⁹ One consequence of all this that I only realized in retrospect: secrets spread so much slower in this game than others I’ve played. You really have to push them into play quickly, because otherwise it’ll take forever to get back to you.

¹⁰ I’ve played escape rooms where you’re told you’re all escaping convicts and given a short rap sheet and instructed to break out of the warden’s office in an hour. We happily called each other “Buster” and “Spike” the whole time. Technically a larp.

¹¹ I really can not stress enough how fantastic the safety team was in this instance. Sitting through a possible heart attack while waiting for an ambulance is a very unpleasant experience, but I genuinely felt like I couldn’t have been sitting anywhere better with the possible exception of a Cardiac ICU.

¹² Ironically I’d have just ended up on an ambulance that afternoon anyway, so that worked out.

¹³ The only way to conclusively rule out a heart attack is a blood test, and they typically run your blood work then wait four hours to run it again. So I’d have ended up missing all of the last day, but would have theoretically been back in time for the afterparty.

¹⁴ We talked politics the whole way, which is maybe not the best idea if you’re having a potential heart attack.

¹⁵ Apparently digestion makes your gall bladder contract which makes it difficult to scan, although I’ve found at least one study which suggests fasting before an abdominal ultrasound is useless and potentially dangerous.

¹⁶ Their reasoning: it was likely to cause problems in the future, I had decent insurance, and the outcomes for laparoscopic surgery are fantastic when you’re young.

The specialist they referred me to ran some tests, said it wasn’t bothering me yet so they wouldn’t do the surgery, and charged me $450.

¹⁷ Causing my back pain

¹⁸ Although my hotel in Birmingham was right next to a BrewDog which offers two-for-one vegan food on Mondays and I’m a sucker for cauliflower wings and faux-chicken sandwiches. So that’s not going too great. At least I stuck to non-alcoholic beer.

¹⁹ There was an elderly gentleman in the bed next to me who was also having gallbladder issues, but significantly worse ones, to the point where they had to wear a catheter. And they were constantly getting confused about where they were and what was going on. They kept trying to get out of bed to use the bathroom, often in the middle of the night, occasionally tearing out their catheter and cannula to do so.

I was incredibly grateful to have had floor-to-ceiling curtains. There was apparently quite a lot of blood, given the nurses’ reactions to all this.

²⁰ Although if you were on a low-fat diet the only vegetarian option seemed to be a plain jacket potato with baked beans. That might have been my bad luck.

²¹ Amusingly, many of them were Polish.

²² The UK offered hot chocolate in addition to coffee and tea. As well as vegan sugar-free jello.

²³ Okay, maybe that’s not true of the nursing staff in Poland. Or maybe they’re just bad at showing it.

²⁴ Really, the only treatments I got were intravenous fluids, an anti-clotting drug (which required me to stop taking the anti-clotting drugs I was already on), and paracetamol. Everything else was monitoring.

And I’m not claiming any of that was superfluous or overkill, just that there’s a tradeoff (being careful and cautious vs. my money and time) and I wasn’t included in the decision.

²⁵ This is helped immensely by the fact that emergency care is free in the UK, so the ambulance ride and all the tests up to the point where they decided I wasn’t dying isn’t going to cost me anything. I didn’t start incurring a bill until they admitted me for observation. Although they certainly didn’t make that feel optional.

Of course I’m also aware that in the United States, the average cost of a hospital stay seems to be around $2,800/day. So we’ll see.