I’m still looking at the hospital bill.

Last evening, Irene came into the living room from the bedroom doubled over in pain. She was obviously in agony with her hand on the lower left quadrant of her back. I recognized it immediately – kidney stone. I’ve been there five times myself. If you have ever had one, you know how excruciating the pain is. If you haven’t, well, you wouldn’t believe it.

OK, g, I say to myself, what can you do here? Nothing. Not a damn thing. About the only thing that can be done for kidney stones is to hammer the patient with some kick ass pain meds and wait for it to pass, assuming it’s small enough to do so. Had we still been in the states, I could have tapped into my supply of meds from my past experiences with this particular malady. Unfortunately, we destroyed all of that before we left, as the aduana (customs) frowns on you bringing Oxy, Percoset, Toradol, etc., across the border. We have Tylenol. Not gonna do squat for this kind of pain.

We’ve only been here a week and I don’t know where the hospital, or a doc in the box, or anything like that is. To complicate matters, it’s Sunday. She’s in agony; I’m feeling worse than helpless, closer to useless. I start searching online for a hospital with an emergency department in San Carlos. I can’t find one. I do find something called “Rescate San Carlos” (http://www.rescatesc.com/). It’s some sort of rescue service. They should be able to tell me where the hospital is. I call and the phone is immediately answered by a bi-lingual gentleman who informs me that here is no hospital in San Carlos. The nearest one is in Guaymas, about 24 kilometers away. I ask for the address. “Señor, do you know Guaymas well?” I tell him I don’t. He says they can come pick her up and take her there. Great – bring it, I don’t care what it costs, just get her there.

What seems like forever passes. I call again. They can’t find us. Our only address here is the marina name, and the condo number. The marina has three buildings of condos and no useful system of identifying which condos are where. I describe the location as best I can. I hang up and say the hell with it, c’mon baby. We hobble her out to the car. I’ll find the hospital. I get her into the car and as I’m about to close the door I see the red lights flashing in the street. I flag them down and they pull into the lot. Two young men, both EMT’s, get out and assess her situation. One is on the phone with a physician, feeding information and getting feedback. He tells them to take her to the hospital in Guaymas, as there is no clinic in San Carlos open on Sunday with the radiological facility she will need. As they are loading her into the bus, I ask for the hospital address. “Just follow me” he says. At this point I would like to thank the U.S. Government for the advanced driver training they gave me when I was working executive protection details. It came in handy last night as I followed the driver through San Carlos and downtown Guaymas at mostly 130 kph (about 80 mph) through mostly 40 kph (about 25 mph) zones. It was good he told me to follow him, because, even with a dozen gps’s, I would never, ever have found this hospital. It’s in a little neighborhood in the Centro next to an ancient Catholic church, where, at the moment, the entire neighborhood is gathering for an evening service.

We get into the ER and she is taken to a little suite like room. The suite is set up for two patients with the doctor’s office, literally, fifteen feet away. The suite is attended by the physician, three nurses, and a handful of nuns from the church next door who, apparently, come over to hang out and help out. Things move quickly and efficiently. I’ll leave out all the details but they were caring and efficient. There was not a radiologist in the hospital at night so they called one in from home. The lab work was done right down the hall. They were fantastic. In about three hours we were on our way home with Irene medicated, feeling much better, and a prescription for meds and a referral for a urologist.

Back to the first line – the bill. While I was waiting for Irene to get back from radiology, I realized that the ambulance guys left without any more information than I had given them on the phone. The person at the desk had only asked for her name, age, allergies, and any medications she was taking. No one had asked about insurance or who was going to pay for all this, something that was always the first or second thing that happened when I was in ER’s in the States. So I start tallying things up in my mind. I have read for a long time that health care is good and much cheaper than in the U.S. I know from visits to hospitals myself for this very condition, hospital bills had been three to four thousand dollars. Fortunately, we had great insurance and my co-pay would end up around 350 bucks. However, our U.S. health insurance won’t direct pay outside the country; we have to pay and then file a claim for reimbursement. So I’m thinking, OK, let’s say it’s half what it would cost in the U.S., that’ll be about two grand. Not a problem, except we ran out of the house with just what was in my pockets. I don’t carry that much around. So, after we get released, we go out to the front desk. The young woman working is tallying everything up on the computer – ER, Physician, Meds, Lab, Radiology. It’s taking a while. Irene is standing there barefoot so I tell her I’ll go to the car and get her slippers while the bill is tallied. When I come back Irene tells me “twenty-seven”. OK, I think to myself, 27, 000 pesos – that’s about 1400 bucks. Less than I thought, but more than I had one me. I don’t see a credit card machine on the desk so I’m wondering how this is gonna play out. Irene said there was some money in her wallet. I looked and told here yeah, but only 3000 pesos. She looked at me like “what’s wrong with you” and said we only need 2700. I must have looked at her like I was confused, but she, being drug addled, was much more astute than I. The woman handed me a series of invoices and said they totaled 2674.24 pesos. I paid cash and we went home.

So what does that amount to? Here’s a breakdown:

Hospital charges (meds, ER, supplies, etc) 850.44 pesos ($45.23 US)

ER physician: 300 pesos ($15.95 US)

Radiology: 300 pesos ($15.95 US) and remember, they called this guy in from home.

Laboratory: 1223.80 pesos ($65.08 US)

Grand Total: 2674.24 pesos – $142.22 US. I’m pretty sure I was charged about that much for two Tylenol in the ER in North Carolina when I tried to cut my thumb off!

Bottom line – the care was excellent, the cost minimal. The hospital was on par with any I have been in in the U.S. They had a crash cart in the suite with all the modern doo dads that you would expect to find in an ER. The people were caring, about us, and each other. (There was s shift change while we were there and they all hugged each other goodbye.) Oh, and you may have noticed, there is no charge shown for the ambulance. I looked them up this morning. Turns out they are a volunteer, non-profit operation. They maintain four fully equipped ambulances and a building with a clinic and the do it on donations and bake sales and such. Basically, they work for tips. We will be tipping large.

While following the ambulance, all kinds of things were going through my mind. Maybe coming here was a mistake, we’re not 20 anymore. Nope – I think we did just fine.

g.