A Break in Bangkok: Why I'll Never Travel Without Insurance Again
THE MOMENT, THE HORROR
CRACK! An unnerving sound reverberated throughout the dense Bangkok neighbourhood, invading open windows of surrounding apartment blocks; bouncing off walls of condominiums; and echoing back through the fence of the inner city football pitch. Everybody heard it. But only I saw it.
Seconds earlier, I was chasing an elusive round object around the artificial turf, trying to stop a fellow expat soccer team from breaching our goal line in formidable heat of South-East Asia. The ball had hung in the sky, mimicking the position of the early evening sun setting across the city. As it dropped, I knew I had to clear it. I lurched to strike it with force. Bodies came together, and that’s when it happened. CRACK! I'd kicked something, but it wasn't the ball.
Now sitting on the turf, I looked down to see something I’d never seen before, and never want to see again. My left leg pointing north; my lower left leg, pointing north-west with a lump in my shin - protruding bone. Horrific!
In that moment, a thousand thoughts passed through my head like a thunderbolt - many were questions: “What the fuck just happened? How the fuck am I gonna get this fixed? Can this be fixed? How much will it cost? Does my insurance cover it? Will I walk on this foot again? Will I lose this leg? And so on, and so on. Scary questions with even scarier answers. Among the debris of the exploded bombshell of mind chatter, one thought became clear: “That should not be like that!”
Without hesitating to consider the possible pain and damage I might be about to cause, I reached down and pulled. My lower left leg, broken into two pieces, dangling from its previously connected bone, comfortably moved inwards, returning from its westerly diversion and back to its northern course. The lump in my shin disappeared. And, despite that fact I had just suffered the most horrific injury I’d witnessed ever with my own eyes, I felt an overwhelming sense of relief. Relief that there was no resistance, no broken skin, no crunching or cracking. My leg eased back into place, whole once more. I no longer had to look at the terrifying, gruesome reality, as long as I kept hold.
Among the debris of the exploded bombshell of mind chatter, one thought became clear: “That should not be like that!”
In an instant, all the other lads crowded around me. “What happened?” There was no blood and no bruising. Nothing. Just one hysterical Englishman sitting on the plastic grass yelling obscenities, while carefully supporting his lower leg with two hands like it was an oriental tea tray ready to be served. What they failed to see was that I wasn’t holding my leg; I was holding a grenade with the pin removed. One sudden movement would cause catastrophe.
Among the players were three friends and compatriots who all helped me through the ordeal and whom I'll be eternally grateful to. Andrew used his excellent Thai language skills to translate my incessant, incoherent clamouring into a clear message to staff at the football pitch to call an ambulance. William kept me calm with some words of reassurance.
Poddy, more well travelled and aware of the logistics of the situation, appeared holding a business card. “Which hospital do you want to go to? This is a good one, but it’s expensive".
There was no blood and no bruising. Nothing. Just one hysterical Englishman sitting on the plastic grass yelling obscenities
That’s when the reality of the situation really hit me. Not only had I sustained a shocking injury that I had never experienced before, but I had done it in a foreign country which had a different culture, a different medical system, different practices, different standards, different everything.
The idea of choosing a hospital and paying expensive medical bills were both alien concepts to me. In the UK, we have the National Health Service (NHS), a medical system that is mostly paid for by the public through taxation. The NHS is 'free at the point of use', meaning you don't pay for any treatment at the time you receive it as it has already been covered by the taxpayer. So, if you break your leg, an ambulance takes you to the nearest NHS hospital where you get a whole range of treatment including assessments, drugs, scans, operations without handing over any payment. But this was not the U.K; this was Thailand. This was not my humble hometown, this was Bangkok where millions of people have the choice of multiple hospitals of varying price ranges, all of which I knew nothing about.
As my arms were starting to feel tired and beads of sweat tumbled off my face, locals started to emerge from the surrounding neighbourhood, drawn out by the commotion. For the rarest of moments, the Bangkok human zoo was turned on its head. The local brown faces, living the simple life on the precipice of poverty, typically much the fascination of wealthy white western tourists, were now the camera wielding voyeurs looking for a photo of the unfortunate farang (foreigner).
Not only had I sustained a shocking injury that I had never experienced before, but I had done it in a foreign country which had a different culture, a different medical system, different practices, different standards, different everything.
Among the paparazzi, I looked up to see a teenage boy, wearing scruffy shorts and a stained vest, carefully putting on a pair of rubber gloves. Feeling an intense mix of vulnerability, confusion and despair I yelled,“Who the fuck is this? Get me to a hospital! NOW!" The kid just laughed. At that point I thought he was hallucination or a fucking mirage.
It turns out this kid wasn't paramedic (no shit!) or even a figment of my imagination but he was a part of a neighbourhood watch group who mobilize when an incident happens in the area. I would like to take this brief moment to apolgise to Mr Rubber Gloves for my outburst. Although, given his fit of laughter, I don't think he took offence.
Finally the real paramedics arrived. As they unfolded a stretcher and prepared a splint, I was terrified. I realised the moment to release my leg had finally come after holding on to it for what felt like an eternity. My medical team was ready. At least, I thought they were ready. With the splint in place, I reluctantly let go. My leg remained still. My foot dropped. About twenty people gasped simultaneously. Around me, faces frozen with shock exchanged glances in disbelief at what they had just seen. It was at that moment that my hysteria was understood, translated with absolute devastating clarity in a way that no verbal language could. Like the moment of impact, I would be lying if I told you that this was the most pain I have ever felt; because it wasn’t. When you hit your shin against a coffee table; that hurts! This wasn’t pain; just pure shock.
With my leg back in the temporary safety of my hands, the paramedics lifted the splint a couple of inches, and for the first time in the past 30 minutes, my hands were finally free and my leg was safely supported. Now, where to go?
Needless to say, when you’re in a foreign country with your leg in two pieces, you’re not in the best place to be making decisions with calm consideration. Money is, and was, not a factor. I just wanted the best treatment, whatever it cost. "Worry about it later". So when the paramedic asked me where I wanted to go, I said let's go with the expensive place on the business card, BNH hospital. After all, it was the only hospital I knew.
Arriving at the hospital, I was immediately put on a morphine drip and handed an ambulance bill. Another kick in the shin. Next on the shopping list was a trip to the x-ray theatre to help the docs assess the extent of the damage, and to tell me what I already knew: left leg broken in two places; a clean break of the tibia and fibula.
I was met by a young surgeon who told me I had two options. First option, was to put my leg in a cast which would hold the leg fracture in place while the bone healed. Appealing points - cheap. Unappealing points – if, after 12 weeks of wearing an itchy, bulky lump of plaster, the leg heals out of alignment, the surgeon will break the leg again and we have another go. At this point, option 2 seemed extremely appealing and I hadn’t heard what it was yet.
The second and recommended option, was to get a steel pin in my leg. Apparently, as the surgeon recounted, former Premier League footballer Djibril Cisse had broken both his legs in his career. Ouch! Yet with this surgery, poor ol' Djibril had recovered from the breaks and returned to play professionally on both occasions. "If it’s good enough for Djibril Cisse, it’s good enough for me."
The only catch was the cost, somewhere in the region of £8000. I had some form of insurance through my work but I had no idea if, or to what extent, it would cover this. One thing was certain, I didn't have £8000. Not even close. It was time for the worst part of all; calling home.
"If it’s good enough for Djibril Cisse, it’s good enough for me."
The pain of breaking two bones was nothing compared to the inner anguish I felt about telling my parents. I had to tell them I had sustained a serious injury thousands of miles away and to get the surgery I needed would cost eight grand which I didn't have and I had no idea if my insurance would cover it. This news was way off the worrying scales.
As soon as my dad answered the phone, I broke down into teary mess. I hate to make my parents worry that I might be in bother or can't look after myself. It's also important to me that while living life overseas I have their blessing to do so, and nothing jeopardises that. The old man was certainly not best pleased, initially angry that I might have done something stupid to end up in this situation mixed with a deep concern for my well-being. Once I was able to pull myself together and recount the tale, my dad told me to go ahead and get the surgery and we could figure out the money later. I felt so grateful and lucky that my family were there to support me but I hated the fact it had come to this.
The next series of traumas began by learning that I couldn’t receive any further treatment until I paid the hospital deposit, the Thai Baht equivalent of £3000. As I'd never been to BNH hospital for anything, even a sniffle, they needed some evidence I had money.
My first attempt to pay with my Bangkok Bank card failed because it was the wrong type of account, and therefore I needed to pay in cash. Then, I learned that the daily ATM cash withdrawal limit was way under what I needed. Next, I had to spend a torturous 30 minutes listening to the bank's automated telephone messages all the while hooked to a morphine drip with my leg in two pieces. I've certainly had better days.
With my withdrawal limit lifted, the final hurdle was getting the cash. Obviously I couldn't pop to the nearest ATM myself. So, I sent my trusted friends Andrew and Will out on to the streets of central Bangkok's Sala Daeng, passed the beggars and the go-go bars to withdraw three thousand quid's worth of Baht from my Thai bank account. What could possibly go wrong?
Of course Andrew and Will returned to the hospital with the cash without getting robbed or going on a 3-day bender so the operation was scheduled for around 6am the following morning. A spinal tap and a steel pin later, the operation was a success. I spent a week recovering in a private bedroom at BNH hospital being bathed by young female nurses and eating food that would not have seemed out of place in a fancy restaurant. At this point I was resigned to the fact that I would be paying off the hospital bill for years to come and just relieved that my leg was on the mend.
On the fifth and final day of my stay at BNH, a member of the hospital’s finance department, a young guy wearing a smart blazer nervously fumbling the papers of a clip board, knocked on my door and reluctantly shuffled into the room. "Sorry Mister, English not good. Er...you pay this". He pointed to a number on the page, 46,000 baht which in April 2014 was around £800. Expecting another zero to be added to my conversion, I pointed at the number again and asked him to confirm. "Yes, Mister, you pay this". I'd broken my leg in two places and just received a hospital bill of £800 and yet at that moment I was absolutely overjoyed. My Bupa insurance through my employment had covered over £7000 of the bill. What a relief!
REASSURANCE OF INSURANCE
The anxiety that I felt, not knowing if I could get the treatment I needed, then not knowing if I could pay for it, was huge. It really is the last thing you need when you're dealing with something as traumatic as breaking your leg in a foreign country and all the challenges that brings. In the end, I was extremely lucky. I had good insurance through my employer and I received world-class treatment, but it could have been so different.
I now look back at times in the past when I travelled without insurance and wince at some of the fine messes I could have gotten into. Breaking a leg and receiving a bill for £8000 is bad enough, but some people end up in far more serious conditions and receive eye-watering medical bills that take years to pay off. Needless to say I'll never travel without travel insurance again, and neither should you.
I had good insurance through my employer and I received world-class treatment, but it could have been so different.
If you're British and departing from a UK airport, there are lots of options for cheap travel insurance. Martin Lewis' Money Saving Expert site has is all covered. If you're living overseas I would hope you have health insurance through your employment.
However, what should you do when you go on an overseas trip while living abroad? While being an expat in South Korea and Thailand, I had medical coverage within both countries, however I took trips outside of those countries without insurance on numerous occasions. Perhaps it was absent mindedness or naivety. Whatever it was, it was stupid. Thankfully, nothing happened to me then as I would have been in a whole world of trouble. All I'll say is it's lucky that I never joined in any impromptu football matches in Pyongyang. Who knows where I would've ended up?
So, if like me, you're an expat starting an overseas trip from overseas, you can use World Nomads. World Nomads specialise in insurance for travellers. I've never had to claim from them myself, but I've been told by other travellers on numerous occasions that they have paid out. I used them last year for a trip to Myanmar, starting and returning to Japan. They gave an instant quote and I found the whole process to be quick and easy. Of course, it's easy to not bother getting insured, save £40 and think nothing bad will ever happen to you, until it does. Knowing that in the event of some freak accident, I'd be covered was worth it every penny. So, insure yourself and have safe travels.