This Might Hurt A Little


My room in Missoula’s ER. Clean but comes at a price.

The afternoon of September 10 found me merrily making a Dorset Apple Cake (recipe supplied from D, my baking guru back in London) when I felt a twinge in my bladder. “Hmmmm,” I thought, “I hope I’m not getting cystitis. That would truly suck.”

My Dorset/Montana Apple cake

My Dorset/Montana Apple cake

Over supper that night, the pain and the pressure and the need to go to the loo increased rapidly. I had congratulated myself on bringing my Potter’s Antitis from London, which for the last ten years has worked miracles ‘down there’.

Well, not this time. These Yankee urethra-decimating bacteria are in a whole other league. By midnight I was bleeding so much, and felt so feverish and ill that I rang Missoula’s main hospital. I was in so much pain that when the nurse asked me to rate the pain, I ranked it at 7.5 with childbirth at ten.

“Wow”, she said.

After listing my symptoms, she then gave me four hours to get myself to the hospital as it seemed pretty clear to us both that these bacteria were heading for my kidneys.

J and I woke E and bundled her in the car. I checked in and then J headed back home with E. There I was alone in a new city in the hospital in the middle of the night in pain. What do you do in these situations? You take a few snapshots.


I liked the colours of these…

pink scissors

… and these.

While I waited in my own private room (I know, amazing!) two parallel thoughts kept racing through my brain. On track one was: “This place is so CLEAN and QUIET… where are all the drunk people and junkies and cyclists with bleeding heads you see at the Royal London at 1:00 a.m?” I was almost relieved when a young inebriated woman was brought in to the room next to me. When the doctor asked her to sign the waiver that would allow them to treat her and bill her, she shouted, “How can I sign that f***ing thing when I’m not sober?” So they got the nurse to sign for her. I wondered if this were legal and then thought, yup. This is the American healthcare system. Anything is probably legal.

st patrick's

There were so many empty rooms…. I guess that’s what you are paying for?

Along with all my marvelling at the sparkling floor and the pristine instruments and the shiny bathroom, the other parallel train of thought was chugging along: How much will this all cost?

As someone who has only ever lived in Canada and the UK, I have never in my life had to access health care that needed to paid for in this way. Of course in the UK we pay with our taxes, but it seems a drop in the ocean compared to the sort of bills people get here. I was seen quickly and diagnosed. I was asked if I wanted a pregnancy test to which I relied “No.” Every time I was asked if I wanted anything (a blanket, a blood test, an extra urine culture) I countered with, “How much will that cost?”, to which I was told, “Oh, sorry I have no idea.” So, like any sensible person, I said no to any further tests. I did find out that the bacteria lining my bladder was e coli. But I had to fight to get the information from them for free. The staff were lovely but probably not used to being asked so many questions. I was sent off with antibiotics and painkillers that turned out to be so good, I almost started liking Big Pharma. Almost.

clinic room

The walk-in clinic. So clean you could eat off the floor… well, almost.

That night was OK but the next few days I felt down and still in pain. The antibiotics hadn’t quite done the job. So what next when you are uninsured? I called around to find out the cheapest way of seeing a doctor. The thing I have learnt on this crash course is that anything to do with hospitals, clinics, doctors, nurses, or treatment is run like a weird secret cabal. No one can tell you how much anything costs until AFTER you’ve had it done. As a guy I met here said, “It is the most expensive and least transparent body in the world”. And he’s right.

It’s also insanely complicated. The names for things sound like double speak. A ‘Health Care Provider’ is a ‘Doctor’. A ‘Provider’ is someone who evaluates and diagnoses patients. A ‘Primary Health Care Provider’ is a ‘GP’. And then there is the whole gamut of insurance names and terms. Some doctors only work with some insurers. Some hospitals only work with some insurers, but are staffed with doctors who work with several insurers. If you’ve been seen in a hospital using one kind of insurance, then you can’t see a doctor who works for a different insurer. Well, you can, sometimes. Ach. I still don’t understand the nuts and bolts of it all except to say that the doctors seem great and the insurance companies seem truly evil, just like Michael Moore said in his film ‘Sicko’.


The poster for Michael Moore’s ‘Sicko’

In short, when it’s the middle of the night and you are bleeding profusely from where you should be peeing, you are sweating, shivering and in pain and someone starts saying things like, “When you get your Primary Health Care Provider, through Gateway or peripheral assessment, any coinsurance or copayments will be organized then. That is unless you have a Group Purchasing Arrangement,” you just want to cry. At least I do. In fact I did.

So the darned infection didn’t clear and after many phone calls, I found out that there are walk-in clinics in Missoula. They are the cheapest option and you pay up front so at least you know what the damage will be. J took me to the nearest one and again it was clean and efficient. I was seen quickly by a doctor. She was nice but again spoke in terms I found impossible to understand. She also offered me a pregnancy test, which I politely refused. She explained that the antibiotics she was prescribing were known to go into breastmilk and no tests have been done on that. I assured her I wasn’t pregnant, thus once again, saving a few bob. I was sent on my way after paying $135.00 for ten minutes with a doctor who dipped a urine sample and wrote out a prescription.

So far I have spent $55.00 on drugs and $135.00 on the walk-in clinic. The bill for my lovely stay in the Emergency Room just arrived to the tune of $610.00. I got a discount of 5% for paying quickly and all in one go. Oh how I long for the NHS.

The second round of antibiotics worked. It was called Levofloxacin. I was loathe to take it as the list of side effects is like something from Monty Python:

  1. Confusion
  2. Feeling that others can hear your thoughts or control your behavior
  3. Seeing, hearing, or feeling things that are not there
  4. Sensation of burning on the skin
  5. Severe mood or mental changes
  6. Trembling
  7. Unusual behavior

So, my cystitis seems to be clearing up, but I might be rendered completely insane. I feel there is a metaphor here.

Our Obamacare kicks in October 1st. J has been trying to sort it out since we first arrived in the US at the end of July. He has spent hours, days, weeks on the phone and on their website. The incompetence has been astonishing, so much so that J keeps saying he is becoming a Republican. My timing was off for getting sick and now we’re paying for it, big time.


4 thoughts on “This Might Hurt A Little

  1. Sabrina

    I am so sorry you were ill! God it sounds awful. Whilst in Vegas recently I had a debilitating migraine and needed help. I called the concierge in our fancy hotel and had an in-room doctor at my side administering a jab of Percocet and one of something to stop me throwing up, prescribing Vicodin (more-ish as fuck), more anti-vomit meds and anti-migraine meds IN LESS THAN AN HOUR! He was with me for about thirty minutes. My bill was $500. However Great Britain came to the rescue as my travel insurance (free through my bank) is paying for all but $50 (including the prescriptions which amounted to over $250). I don’t think there is a lesson here, so let me just reiterate that I’M SORRY! xxS

  2. Wow J. That makes things…pretty darn clear about the difference between living in a country where health care is your right and where it is a privilege. Crazy that the wealthiest country in the world can’t take care of it’s own people. Imagine the people who fall between the cracks! Glad to hear you’re getting better. Love to all of you…xo s

  3. Hi Joanna, Great post though too bad you had to go through so much to experience this aspect of American life. I thought after about the inebriated woman who really did have a point! A fellow colleague was just in NY and had debilitating back pain so she asked at the front desk, and they called a doctor to her hotel room. He gave her a cortisone shot and then gave her a bill for $2400 U.S.
    It was their first trip away from kids since marriage, and she couldn’t believe that A. she was incapacitated before they’d actually had any holiday, and B. one jab cost thousands of dollars, way more than flight and hotel to NY.

  4. Hi Kate, Yes, it’s crazy here. The health of every citizen (except people with good work plans and wealthy people) is basically at the mercy of insurance companies. It is the most unbelievable system in the world! I am still reeling from my experience and it was mild compared to so many others. I keep hearing stories of elderly people or people with debilitating illnesses spending 5 hours a day for years on end haggling with insurance companies over bureaucratic details in order to be able to get the drugs that will allow to sleep without pain. I mean, it is INSANE! I don’t know why Americans don’t mass protest. blah blah blah… we all know it, but it’s so weird to be up close and personal to such a barbaric system…. Ugh. And I fear the good old NHS is being dismantled as I type. I keep signing petitions and writing letters to my MP to demand that we don’t allow the UK to go down this path… but they are. It’s crazy. The NHS is such a treasure. Jxxx

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