Ducking Donald, The Aftermath: “NHS on the Table”

During his State Visit, President Trump said yesterday that, when it comes to the “phenomenal” trade deal that he wants to do with the UK, “everything is on the table.” This includes our National Health Service. My own recent experience makes me hope fervently that we will not agree to privatise or sell off any of our NHS.

         I have the good luck to have both British and American passports, and because I taught for two years at Harvard and paid into US Social Security, the latter comes with Medicare Health Insurance. Until February 2nd 2019, I was ignorant of Medicare, and of my need of it.

It was a stroke like any other vulnerable oldie’s stroke, except that it happened on the Saturday when Trump had been expected to come to Mar-a-Lago for the first time since Thanksgiving; and I was staying four doors away from the so-called winter White House.  Angie spotted my bizarre behavior first: she is the Jamaican woman who cared for my dear old friend, the celebrated food writer Barbara Kafka, until Barbara’s death last June. Angie alerted my host, Ernest Kafka, that I had gone doolally and couldn’t work my phone. Ernie, a retired Freudian analyst and M.D., instantly diagnosed a stroke, while Greg, who runs the household, dialled 911.

There were two Palm Beach ambulances/fire engines crashing the security barrier set up in our drive, minutes – perhaps only seconds –  later. They asked the usual questions: “Can you raise your right arm?” “Can you repeat: ‘the early bird catches the worm’?” (“No, but I can visualize it,” I somehow muttered. ) I felt I was the subject – the star even –  of a Hollywood action movie, as uniformed, equipment-bearing paramedics whizzed through door and courtyard, along with armed men and women from the Palm Beach Sherriff’s office, plus the young, comely, gun-toting Secret Service guys, all intent on heaving me into the ambulance.

This was last February 2^nd, and the third year in a row that I had spent most of the winter at the same century-old house in Palm Beach, as a guest of my close friend, Ernie, who rented this splendid two-storied, marble-floored gaff –  precisely four doors to the north of Mar-a-Lago. Since the President had had his tantrum about the government shutdown resolved in time for him to get in a couple of holes of golf on Saturday, and watch most of Sunday’s Superbowl football match, it looked as though the POTUS would fly to West Palm Beach airport.  He never got here, but the usual security apparatus had been put in place, with the concrete V-shaped “Jersey barrier” closing off all traffic to the north of us, and the tent with its sniffer dogs, giant bomb-inspection dentist’s mirrors and slalom-course obstructing the blocks to the south.  Thus the troupe of siren-blaring, miracle-working paramedics negotiated the Secret Service barriers in the drive of our S. Ocean Blvd. house, getting me to JFK Medical Center at Atlantis well within the one-hour “golden” window in which the Emergency Room neurologists could save my life and most of my wits. I was given the miraculous, clot-busting TPA (tissue plasminogen activator).

Moved from ER after a few hours, I spent a bit more than two days in the Intensive Care Unit, looked after chiefly by Nurse Amy, who made certain to relay to me the Secret Service guys’ affectionate get-well wishes. I recovered my speech rapidly, almost immediately – very good luck as the stroke was in the part of the brain that processes language. In the ICU, of course, all my many (British-prescribed) medications were stopped. Though I was conscientiously reducing the enormous dose of codeine I’d been taking for post-operative pain following a big-deal surgery at the end of last July, I knew I was still addicted. With the help of Nurse Amy and her colleagues, two day’s-worth of Cold Turkey did the trick, with the pleasing consequence that, in the end, I lost ten per cent of my body weight. (With a pleasing symmetry the only food I was offered in the ICU was a cold turkey sandwich, made edible only because Nurse Amy was able to find a sachet of salt.)

There were comic moments, and touching ones. I was entranced by the physical appearance of those looking after me: the young surgery nurse, wearing scrubs and mask, whose features I could not see, but whose whole-body tattoos I could detect peeping out of his trousers and shirt, culminating in a curly-haired Gandhara Buddha near his left wrist; and enchanted by the skinny six-foot-six “transport” guy, named Chavez, who told me he was the “best driver in JFK” as he boogied my hospital bed through the corridors to one scan after another. I was astonished when he told me he had a fraternal twin called Lopez. “Do you look like each other?” “No, man, Lopez he big!” There was the stunningly handsome Hispanic scan-technician whose haircut I gawped at, as it involved some perfectly orthodox grooming, a cow-lick, and a man-bun I can only describe as a pom-pom. And there was the delicately beautiful young woman nurse, who told me how thrilled she was to be going to her first Don Giovanni, at the Palm Beach Opera. 

It was common knowledge that, in case of a presidential emergency, the JFK Medical Center was the go-to hospital. After about 48 hours in ICU I was moved to an enormous single room on the 4^th floor, so big I thought it was probably the Donald’s designated suite. I was nursed brilliantly, except for a battle with one nurse with defective language skills, which meant she couldn’t ask anyone how to silence the screaming alarm that went off intermittently for several sleepless hours of sheer hell. Fortunately, this provoked an “episode” (of rage, I think), recorded on the bank of heart monitors, which gave the team of neurologists and cardiologists their Eureka moment. They had discovered the cause of my stroke: atrial fibrillation, and at my bedside that morning was a five-strong group of elated cardiologists; for a moment I thought they were going to applaud, or sing the “Hallelujah Chorus” for a diagnosis achieved in less than 24 hours. (Bad luck in one way, as only hours before I had had a message-sending “loop” surgically implanted in the skin above my heart; it was now redundant.)    

Not only was the hospital care superb (thank you Drs Casanova, Amaez and Rosenfeld), but money was never as much as mentioned – until I recovered more of my stroke-addled memory, and recalled that I have dual nationality, an American passport, and U.S. Medicare Part A card covering the hospitalisation. Needing only one more night as an in-patient, I was discharged rapidly, though with a prescription for a thirty-day supply of Eliquis, the wonder drug that cost nearly $500 at a Palm Beach Costco (but, on my return, supplied to me completely free by the British National Health Service). My ignorance of Medicare was mitigated a little because, in buying my cheap air ticket online from Expedia, I had opted to pay a small amount extra for travel insurance.

Despite having received letters from both the lead cardiologist and lead neurologist stating unequivocally and explicitly that the cause of my stroke was atrial fibrillation, the insurers have so far refused to pay the remaining $10,000 or so of the bills, which they say was caused by a pre-existing condition. It seems clear to my wife and me, that the matter was being handled at an inappropriately junior level, and that the insurers are trying to fob me off with a routine, but ridiculous excuse, as their own explanation of my stroke has been contradicted by the two chief doctors who treated me. I’ve filed an official complaint against the insurers, Allianz; I still have recourse to the Financial Ombudsman; and there’s always the law. It wasn’t exactly a doddle to return to London Heathrow in a wheelchair, especially as my suitcase was now seriously overweight with medications and equipment; but a sympathetic customer-support agent sagely advised me that, given the penalties, and the discomfort of steerage,  it would cost relatively little to upgrade to business class. And so I was delivered, rested, into the soothing, secure, and free at point-of-use bosom of the British NHS.

As for Trump himself, I diligently took a straw poll of the attractive, good-natured, heroic people who saved my life and gave me back my marbles. I met no Trumpists among them: the universal, charitable opinion of these good people, these benevolent health US professionals, was that the President is unwell.