The Patient Was…

The patient was in her early seventies, when she suffered a heart attack while on holiday. She had begun her trip as a vacationer and ended it as a patient. She hadn’t gone abroad expecting or seeking medical care, a phenomenon known as medical tourism, but she wound up receiving it in a relatively medically- unsophisticated foreign environment.

Medical tourism, traveling abroad specifically to receive medical care, has grown in popularity in recent years. The reasons people travel to foreign countries seeking treatments are varied, and include lower costs, easier access and availability of procedures, lack of local expertise, and domestic social stigma. Individuals from advanced societies may travel to equally or even less advanced ones, and people from developing nations travel, if they can, to more advanced ones.

Getting sick while traveling in a foreign country is not unusual, but most instances are self-limited and resolve themselves rather quickly. Gastro-intestinal problems are common, as are minor respiratory illnesses. If medical care is needed, local physicians are usually available, and pharmacies in many areas dispense commonly used medications without prescriptions.

What is uncommon, even rare, is for individual physicians to travel abroad to render care to specific individual patients in foreign countries.

In my clinical career of over thirty years, I have traveled abroad twice to provide medical consultation and care. On another occasion, I was invited, and agreed, to travel to Asia to render care to a patient presumed to have unstable cardiac disease; but a wise medical diagnostician intervened as I was preparing to travel and recognized that the patient had a pulmonary (lung) problem, and not a cardiac one.

The first of my international medical missions was to the Caribbean region. I had never been to any of the islands, and while a medical trip was hardly a vacation, I vowed to at least jump into the Caribbean Sea.

The patient was normally under the care of an internal medicine specialist in New York. She had no history of heart disease or, for that matter, any other serious medical condition, and her doctor saw no reason for her not to travel to the islands. When she sustained the heart attack, she was cared for at a local hospital; it was deemed too risky at the time to try to transfer her to a larger island or to the mainland.

Fortunately, her case was very straightforward. There were no complications at all.  As was common at the time following a heart attack, she was initially kept at bed rest for several days, then allowed to gradually get out of bed and move about. Finally, she was discharged but told to rest in her hotel for a couple of more weeks.

When it was deemed safe for her to travel back to New York., her physician wanted her first to be checked by a cardiologist from the U.S., and he asked me to fly down to see her. Money was no object, and first class travel and accommodations were arranged by the patient’s husband.

I arrived shortly before dinner time, and immediately went to see the patient in her suite. She was absolutely fine, and travel home was arranged for the next day.

The patient and her husband invited me to join them for dinner and I accepted, but said I had to do a few personal things first. They agreed to meet we in a short time.

What I did, of course, was quickly change into a bathing suit, dash across the sand, dive into the Caribbean Sea, dry off, and change back into dinner clothes.

We met on the terrace for cocktails, enjoyed a lovely dinner under a tropical sky, and flew back home the next, uneventfully.

I thought that this “reverse medical tourism,” a doctor traveling to care for a single patient, was a pretty good gig after all.