I increasingly hate visiting the United States. Actually being there is kind of hit or miss, depending on how my plans shake out — sometimes it’s great, sometimes it’s not — but I hate flying transatlantic in the first place, and I hate having to fly transatlantic back after what’s typically a very short visit. And more and more I’m weirdly anxious about leaving. I feel like I managed to escape back in 2018, and everything that’s happened since has only made me more and more apprehensive about coming back, like I’ll get trapped.

But I had an event to attend in Atlanta, so I was flying back for a week in New York and headed down south in the middle of it. I really don’t like Atlanta¹ so being there twice in one year made my skin itch. I was glad to get back to New York as soon as I could.² New York remains great, still the epitome of a city for me, and my only serious regret is I didn’t get out much at all.

I’m still not recovered from whatever I caught back in August.³ I’m honestly feeling fine, but I still have a slowly-fading hacking cough that sounds like I’m on the verge of death. I am not on the verge of death. My throat isn’t even sore any more. But it certainly makes people around me uncomfortable.⁴ It’s a disincentive to go out, and that piled on everything else meant I mostly stayed in a friend’s apartment and tried to take it easy.

I did take time away from everything to try and deal with some medical issues. I got both a fourth COVID booster and the flu shot.⁵ My former primary care doctor retired during 2020, so I had to find one. And having done so, hit it off almost immediately with them,⁶ and left the office with brand-new prescriptions for three months of all the medications I’m supposed to be on.

But this is where the insanity of the insurance system in the United States kicks in. I tried to get the prescriptions filled immediately, only to be told I could only fill one month at a time. I was told I could only fill a three-month prescription through the insurance company’s own mail-order pharmacy; I went online and discovered I couldn’t fill any prescriptions on it. I brought this up to the pharmacy, and they offered to request a “vacation override” — since I know I’m going to be out of the country, I can request more than a single month’s prescription. Unfortunately, you can only do it less than five days before you leave the country, and it requires preauthorization.⁷ Preauthorization, of course, takes 3-5 days.

So I did, and got approval for two of the three medications I need on a daily basis. For one additional month of each. The third requires some additional step, which would take another 3-5 days, rendering it impossible to fill before I left. I should point out that not only is my doctor unable to write valid prescriptions overseas but my insurance refuses to cover the cost of them. A big part of the scam of health insurance in the United States is making it so painful to access that people give up trying to use it. All three of the prescriptions I need are things I’ve been on for years, in some cases decades. I’ll need to be on them every day until I die. But it’s still a massive struggle getting a reasonable supply of them.

So I’m flying back across the ocean woefully undersupplied with medication. I’m waiting to board the flight to London⁸ more stressed out than you’d have thought for someone who just did a week of nothing. And sadly, my medical issues weren’t the most stressful thing I was dealing with.

My father had a stroke a little under a week before I was set to fly back to the Untied States. I found out when I got a slightly panicked text from my brother, who noticed the symptoms on a FaceTime call — my father lives alone in Ohio, my brother lives in New York — and wanted my advice. The symptoms were mild enough that it wasn’t entirely clear anything had happened at all, and my father was dead set against calling an ambulance or taking a cab to the hospital. So we settled on an agreement to see the doctor in a couple days.⁹

My father did, eventually, go in to see the doctor, where they confirmed it had been a stroke. Miraculously, it was about as mild as one could have hoped for; the delay in seeking treatment probably had little to no effect on the outcome. My father was admitted to the hospital for observation and testing, and cleared to be released the next day.¹⁰ My brother had flown out to help through this process, and eventually flew back to New York with my father in tow. That’s where we are at the moment. I had assumed I’d need to reschedule my flight back to Europe, but it doesn’t actually seem like it’d be all that useful. My father’s fine, hunkered down at my brother’s place with a couple grandkids to read to¹¹ and a set of appointments for rehab.

The main symptom of the stroke — nearly the only symptom, as far as we can tell¹² — is aphasia. Aphasia, if you don’t know, is an intermittent disconnect between your understanding of the world and your attempts to put language to it. Mostly this manifests as a block on what you’re trying to say; you’ll want to ask what time the bus comes but you just can’t remember the word for “bus” so you’re stuck awkwardly fumbling around.¹³ It can be more subtle, though, as well. I didn’t realize it works in reverse, so someone might say “Bus” and you’ll hear “฿Ʉ₴” and have to reverse-engineer what’s being discussed from context.

It could have been a lot worse. We’re hoping for most of the aphasia to clear up over the next month or so, especially with rehab. The doctors think it was caused by a blood clot, so they’ve adjusted the medications to reduce that risk in the future. It looks like we’ve managed to navigate the immediate recovery, which means we shortly get to turn to more difficult discussions about the future; my father lives alone in a vastly oversized house an 11-hour drive away from my brother and an 11-hour flight away from me most of the time. My father’s been making noises about selling it and moving into someplace more manageable for 20 years. But those discussions can wait. I’m happy just being grateful where things are right now.

The plan, before all this happened, was to have my father come out for the week in NYC for glamping, which is the reason I was staying so long in the United States in the first place. So glamping didn’t happen.¹⁴ But I got to hang out a bit with my father over the past week anyway.¹⁵ I need to do that more. Everybody should do that more, with everyone in your life you care about.

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Footnotes

¹ Massively segregated cities with horrifically bad public transit will do that. I discovered you can actually see Stone Mountain if you’re in one of the skyscrapers downtown, although mercifully the huge carving of the three Confederate generals isn’t visible from there.

² Although it meant flying back in the middle of thunderstorms over LaGuardia. You know it’s going to be a bad trip when they tell you on takeoff the turbulence at landing is gonna be bad. Although I really didn’t expect them to put us in a holding pattern in the middle of the fucking thunderstorm.

³ Although it’s still not COVID, for whatever that’s worth.

⁴ I’d blame that entirely on COVID, but honestly the percussive effect of the thing is enough of a Grim Reaper kind of rattle that I imagine it’d freak people out almost as much pre-COVID. It’s not improving by getting less severe so much as getting less frequent.

My flight back to London has me booked in the middle seat. I expect my seatmates will be less than thrilled. I’ll be masked up and packing lozenges.

⁵ They were offered at the same time, in a single jab. And weirdly, caused fewer side effects than any of the previous COVID shots I’ve gotten.

I’ve currently gotten five COVID shots over four different countries, which I’m sure isn’t a record but I like to think it’s pretty impressive all the same.

⁶ Finding a primary care physician in the United States is a nightmare. You have a huge list of doctors theoretically covered by your insurance, most of which theoretically are accepting new patients, but you know virtually nothing about them except their names and their board specialties. I picked one based largely on the fact that I could make an appointment online, only to get a message from the practice two days before my appointment telling me they were actually only accepting new infectious disease patients. Which, despite my cough, I wasn’t looking for. So they set me up with an appointment the next day with a different doctor’ I was relieved to find someone who took my medical history and offered treatment options that took into account the fact I was traveling all the time, without even giving me shit about it.

Bonus: they didn’t tell me to lose weight, even after I mentioned I was on medication for hypertension.

⁷ Preauthorization is a common trick insurance companies in the United States use to drive down costs by hoping you’ll die between the time you asked for treatment and when they finally get around to approving it.

⁸ Literally, Delta Flight 1. I guess something had to be first.

⁹ Yes, in retrospect, this was incredibly dumb and could have been disastrous. For future reference, call the ambulance.

¹⁰ Although insurance bureaucracy meant my father ended up staying most of the week waiting on, you guessed it, a preauthorization.

¹¹ In an odd bit of kismet, reading books out loud turns out to be great mental exercise if you’re recovering from a stroke.

¹² I mean, my father’s always been a little forgetful, and there’s the same essential tremor I’ve got which you’d probably assume was the stroke if you hadn’t been watching it develop over decades.

¹³ “When is the … you know, the thing … the thing, the big … that we need later, the … at the corner … that thing? When is it?”

¹⁴ I’m kind of bummed about that; it was a site on Governor’s Island and looked pretty sweet. It wasn’t cheap — I’ve still got the credit since we canceled so close to the check in date — and I haven’t a clue when I’ll have a chance to cash that in.

¹⁵ We went to the movies on Wednesday, seeing Marcel the Shell with Shoes On which was miraculously still showing at a matinee screening at the Angelica East.

It’s a great movie. Sweet and sad and funny and not nearly as saccharine as you might fear from the trailer. Maybe a little close to home given recent events, but maybe even that’s okay.