Friday, March 2, 2018

The Bahamian Medical System: A View from the Ward - or - Shelagh’s Big Break: Part 1


In the summer of 2015, Shelagh and I went on a Disney cruise at the request of our then 4-year old granddaughter.  We sailed on the Disney Dream and had a blast.  Afterwards, Shelagh requested another Disney cruise as a present for her 70th birthday.  Being a faithful, loving husband I arranged to make that happen, along with one day each at the Epcot and Magic Kingdom.

I got in touch with Cousin Michelle, the world-famous Disney travel agent, to make the arrangements.  Working with Michelle made everything frightfully easy…I don’t think our phone call lasted more than 30 minutes and we arranged everything I wanted: the right stateroom, the right hotel on the Monorail with a room overlooking the park so we could see the fireworks without having to brave the crowds on the way back.  It was perfect.  When Michelle asked if I wanted trip insurance I fortunately said, “Yes.”  And that’s what this post is about: the need for that insurance.

A really cool part of our Disney experience was that when we packed our bags, we put Disney’s tags on our luggage and when we dropped them at the airport, we wouldn’t have to handle them again until we arrived back in RVA.  In this scenario, Disney picks them up at the airport and delivers them to your stateroom.  And when you disembark, you pack, leave the bags outside your stateroom and then pick them up at your home airport.  Pretty neat, in a “I have people to do that for me” sort of way.

We got aboard, unpacked, pigged out at lunch (as one can do on a cruise), went through the mandatory evacuation drill then headed up on deck as we set sail.  We departed Port Canaveral at the same time as the Carnival Sunrise.  The sun was shining and the warm sea breeze blew in our faces with its welcome saltiness.  Brown pelicans were diving for fish all around us and dolphins frolicked just ahead of our bow.  It was wonderful.  We did other cruise-ish things, but I’ll spare you those details.







The next morning, the day of Shelagh’s 70th birthday, we were pigging out at breakfast (as one can do on a cruise) as the ship docked in Nassau.  We’ve been to the Bahamas a couple of times and set our sights on just two things for our day excursion, both within walking distance of the port: conch fritters and the Queen’s Staircase.

The Queen’s Staircase is 66 steps, carved out of the limestone by slaves.  They were built in the 1790s and later named in honor of Queen Victoria.  The steps were used to access Fort Fincastle.  Fort Fincastle, also built in the 1790s to guard Nassau and its port, offers a wonderful view from its walls.  Or so they say.

We climbed the Staircase and paid for admission to the Fort.  Shelagh and I wandered around the grounds before going to the top.  As I was entering the main building, I heard behind me the distinctive and all too familiar sound of Shelagh succumbing to gravity.

The first time I was present when Shelagh had a skirmish with Newtonian physics and lost was on our honeymoon in Scotland, coincidentally enough, at a castle.  She failed to negotiate the last of some steps she was descending.  I was just a bit too far behind her to do anything about it and watched helplessly as she landed on all fours.  She was OK, but she made an “Ooof!” sound that was unique to her.

The familiar ooof sound she made at Fincastle was followed by a very atypical loud groaning.  I wheeled around and went back out to see her on the ground and writhing in quite a bit of pain.  She had missed a single step down.  As I approached her, doing a scene survey, I caught sight of her injury.

Now, I’ve always known that Shelagh is just the loveliest creature, lovely all the way down to her bones.  That day I got visual confirmation of this: she had a compound fracture of her left ankle.  It’s a good thing I’m a paramedic because that thing was pretty gross.

The staff at Fort Fincastle called New Providence EMS.  While waiting for the squad to arrive, Shelagh was well composed once she figured out that squirming made it worse.  There were many well-meaning bystanders who wanted to help in typically not really helpful ways but I was able to fend them off by identifying myself as a paramedic and Shelagh as a nurse.  They were happy to leave us to ourselves when they got a load of the ankle.

New Providence EMS bandaged and splinted her ankle and took us to Princess Margaret Hospital (PMH), whose ambulance entrance is probably less than 300 yards from where Shelagh fell.  


Princess Margaret Hospital
The squad took her to the trauma room and sent me out front to get her registered.  As she sent me to registration the attending paramedic, Miss Carey, said she would make sure the patient representative knew about us.  That was of little comfort.  I am normally a fairly laid back, roll-with-the-punches guy but here I am, waiting to register my wife in a foreign emergency department for treatment of an injury that could cause her to lose her foot while our ride is going to leave in about 5 hours with all our stuff.  My anxiety levels went through the roof.  I could get back to the Dream in about 10 minutes on foot to tell them about our plight and to sort things out, but I wasn’t about to leave Shelagh alone in this environment.

After what seemed like an eternity in the waiting room but was probably only 20 minutes, my name was called.  Miss Sherman, the patient rep, took me back to her office.  I explained what our situation was and she said they handled this sort of thing all the time.  She called the RH Curry Company, port agents for Disney Cruise Lines in Nassau, and told Adrian Albury, the agent on duty, about us.  Adrian showed up shortly and we went out into the parking lot for further discussions.  He explained how these things normally work and put me in touch with Corey Konczal, Disney’s Medical Operations Manager.  Corey said before deciding a course of action we’d have to wait and see if the doctor thought it was severe enough to admit her.  I told him she was definitely getting admitted and described how much bone was exposed and the disturbingly odd angle at which her foot and leg came together.  He no longer needed to hear from a physician…compound fractures need immediate surgery.  He spoke briefly with Adrian again, who said something to the effect of, “OK. I’ll take care of it.”

Suddenly, the magic of Disney sprang into action and came to my rescue.

Adrian took me back to the ship.  As we boarded, he explained to the crew that Shelagh and I were debarking for a medical emergency and they took it from there.  Since we weren’t just day-trippers in Nassau anymore, we were going to need passport clearance and landing cards, so I gave our passports to a crew member for processing.  I was then taken to our stateroom by a lovely Serbian lady named Mirjana who helped me pack all our stuff.  We worked quickly but had a nice conversation and I learned she had just received her Bachelor’s degree in nursing and would be taking her licensing exam in a few weeks.  We left the stateroom and went to the ship’s Guest Services area where there was a short wait for Malisa (from Thailand) to bring me the stamped and validated passports and the landing cards.  I was taken back down to the gangway where Adrian was still waiting for me.

Adrian then started making hotel arrangements for me.  As he was doing that, I had a chance to chat briefly with a Nepali crew member named Rabin.  I asked where in Nepal he was from and his face lit up when I said I had been to his hometown of Kathmandu.  It turns out that he did a brief stint in the army as a Gurkha.  My short chat with him reinforced my belief that while the Gurkhas are generally considered the fiercest warriors on the planet ("If a man says he is not afraid of dying, he is either lying or he is a Gurkha."), they are the nicest, funniest savage killers you’ll ever meet.

Adrian booked me in to the hotel and took me to the Bahamian Customs Office.  As we were going in, a taxi driver asked Adrian if a cab was needed and Adrian said yes and that we’d be right out.  He was right.  Because I was with him, all we had to do was go in, they put customs stickers on our suitcases and my backpack and we waltzed out.  Elapsed time in Customs was less than two minutes.  As we exited the building, Adrian pointed to the taxi driver and said, “Go with him. You can trust him, he’s old school.”  Even though my encounter with Adrian was brief I understood that this was the highest-order compliment.

The hotel room booked for me was at the British Colonial Hilton.  It is, to say the least, swanky.  How swanky?  Put it this way: A James Bond movie was filmed there.  Twice.  The British Colonial appeared in both Thunderball and Never Say Never Again.

The British Colonial Hilton's lobby
The British Colonial Hilton's private beach from the 5th floor balcony

Adrian said the hotel was in a good neighborhood and right across the street from the US embassy.  When I got to my room I looked out the window and saw…McDonalds.  Not what I was expecting, but not totally inaccurate, either.

McEmbassy
I sat down briefly to gather my thoughts before I returned to PMH.  What had just transpired was an absolute whirlwind of activity.  It was rapid fire, but well-rehearsed.  To make things right for me, certain activities had to happen in a particular order and with all due haste.  All these things happened, on my behalf, in less than 3 hours, relieving me of half of my problems…and I was just along for the ride.  From my perspective it was nothing short of a miracle, nothing less than the Magic of Disney.  I have an overwhelming amount of gratitude for the people who helped me, not just those who are named above, but also all the others who I didn’t see who were acting on my behalf.  Thank you all!


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