Neonatologist manages wife's trauma in Zimbabwe

[bky3c]

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Since many of us like to travel, often to remote places, I thought it might be worth discussing this here. I think we learned from Jim Dahle's (White Coat Investor) recent mountain rescue that the best plan is to travel with another competent emergency physician within a reasonable distance of a major medical center. Obviously that's not always possible, and even with that, Dr. Dahle and his climbing partner sure went through a lot.

While reading this, I found myself trying to think of what could have been done differently. Not blaming the victim at all, because this could happen to anyone, and thinking clearly is much harder when it's your spouse involved. A working cell phone would have been helpful; I don't always have one when I travel, but I'll make that a priority now. I always get travel medical insurance, and I was under the (perhaps naive?) impression that the company had a 24/7 service to coordinate care. Now I'm not so sure. But if so, maybe one phone call could have prevented a lot of frustration. A medical kit would have been helpful, but not as much if it's the physician who's injured, and any major trauma patient is still going to need definitive care.

I assume a lot of the laissez-faire attitude reported here is because they see much worse on a regular basis, and I don't know anything about the emergency system in Zimbabwe, but I'm guessing their trauma training is different from ours. I don't know how you deal with that when you're in the middle of it, aside from polite persistence and waving cash around if you have it.

So What Exactly Happened?

As many of you may or may not know, Kendall was recently run over by a car in Victoria Falls, Zimbabwe. It’s been a long time posting on the blog, but I know a lot of you have many questions regard…

thesmallworldfamily.com

TL;DR: Neonatologist's wife is the "ped" in an auto-ped in rural Zimbabwe. Seems to be okay aside from a large heel deformity, but meets trauma criteria based on mechanism. After numerous delays in care and demands for immediate cash payment (or wire transfer, on a Sunday), patient is transferred to South Africa for definitive care. Osteo developed after return to US; patient is still recovering. Travel medical insurance covered everything retroactively, but finances were a major source of delays in care.

 

[HemorrhagicShock]

Because I wasn't going to waste my life reading all of that, here's what AI summarized it to:

On June 19, 2022, in Victoria Falls, Zimbabwe, Kendall was run over by a car, sustaining severe injuries, including a nearly detached heel. Her husband, a doctor, faced a chaotic 28-hour ordeal to get her proper care. The local "hospital" lacked basic equipment, delayed treatment, and demanded cash payments, which were complicated by a lack of cell service and closed banks. X-rays revealed no fractures, but her foot injury required urgent surgery. After repeated payment issues, including credit card denials and wire transfer delays due to a U.S. holiday, a medevac to Johannesburg was finally secured with her uncle’s credit card. At Netcare Milpark, a Level 1 trauma center, Kendall received proper care, though concerns about infection and her COVID-positive status lingered. The ordeal highlighted the stark contrast between a cash-based, under-resourced medical system and Western healthcare.

And because I wanted more detail on the payment stuff, I asked for some more detail there:

Kendall’s husband faced repeated payment issues in Zimbabwe’s cash-based medical system after her accident. The “hospital” and clinic demanded immediate cash payments ($40 for ambulance, $400 for X-rays, $760 for initial care, $260-$330 for additional bills), but they didn’t accept credit cards, and their card readers were often “broken.” He lacked sufficient cash, and U.S. ATM limits capped withdrawals at $400/day. Medevac to Johannesburg cost $17,200, but the company required a wire transfer, impossible on a Sunday with U.S. banks closed for Juneteenth. Credit card attempts failed due to no cell service for verification codes and Capital One’s app server being down. Alternative cards from family also failed. They considered a wire transfer via relatives in the Philippines, where banks were open earlier due to the time difference, but this wasn’t needed. At 9:30 PM, Kendall’s uncle’s credit card finally processed the medevac payment, securing the transport after 12 hours of financial hurdles. At Netcare Milpark, a $38,000 hospital estimate was paid via credit card after an initial denial, succeeding on a second machine.

I love AI so much, it saves so much of my life and time.

I don't have much to say about the story beyond your points, and would also like to add don't travel to ****-hole areas to do risky activities without phones, money, and/or technology to offset risk (which is extremely easy to plan for if you put forethought into it)

 

[DeadCactus]

The author's writing style reminds me of physicians and patients I have met. It's hard for me to not feel like he was an impediment to care as a certain type of personality often is.

The question though is how much planning are you willing to do for travel and how much are you willing to do specifically for medical contingencies? Are you willing to buy travel insurance? Are you willing to figure out the logistics of how to use it beforehand? Are you willing to carry cash back-up or have a plan for how to get large sums of cash? Does your credit limit high enough to cover something like this? Do you let your card companies know you are travelling? Are you willing to research hospitals along your itinerary so you have a preplanned place to go? Are you willing to pre-research medical transport options? What about planning where you would evacuate to for definitive care? Pack and bring a medical kit? Do you make a communication plan? Do you spend time to register with the embassy and get the emergency number? At how many hours of research do you shrug and just roll the dice?

Ironically, I think EM physicians can sometimes be particularly bad about this type of planning. We're a little too used to adapt and improvise and maybe overconfident in what we can pull-off in the moment. Apparently, intensivists are even worse.

 

[HemorrhagicShock]

The author's writing style reminds me of physicians and patients I have met. It's hard for me to not feel like he was an impediment to care as a certain type of personality often is.

This is EXACTLY why I turned to AI within 2-3 lines of reading it.

It reeked of self-importance, with a hint of condescension. Overly detailed to show off competence, but clouding the overall message and picture.

Physicians are always and will always be their own worst enemies.

 

[sloh]

The author's writing style reminds me of physicians and patients I have met. It's hard for me to not feel like he was an impediment to care as a certain type of personality often is.

The question though is how much planning are you willing to do for travel and how much are you willing to do specifically for medical contingencies? Are you willing to buy travel insurance? Are you willing to figure out the logistics of how to use it beforehand? Are you willing to carry cash back-up or have a plan for how to get large sums of cash? Does your credit limit high enough to cover something like this? Do you let your card companies know you are travelling? Are you willing to research hospitals along your itinerary so you have a preplanned place to go? Are you willing to pre-research medical transport options? What about planning where you would evacuate to for definitive care? Pack and bring a medical kit? Do you make a communication plan? Do you spend time to register with the embassy and get the emergency number? At how many hours of research do you shrug and just roll the dice?

I don't have much to say about the story beyond your points, and would also like to add don't travel to ****-hole areas to do risky activities without phones, money, and/or technology to offset risk (which is extremely easy to plan for if you put forethought into it)

Haha better to just live somewhere you love so you don't ever feel the need to travel. I hate the wilderness, camping, outdoor sports (god forbid I tear an ACL or achilles tendon), bugs, insects, too much sun aging my skin.

 

[HemorrhagicShock]

Haha better to just live somewhere you love so you don't ever feel the need to travel. I hate the wilderness, camping, outdoor sports (god forbid I tear an ACL or achilles tendon), bugs, insects, too much sun aging my skin.

You hit it right on the head, I have zero desire to travel at this point in my life because I feel zero need to "escape" my life to take a "break" in some foreign hell hole.

Hilarious how people save up to drop $30k to go on some foreign vacation to Paris or Monaco or wherever.

Why not just optimize the life around you so you're effectively living in Monaco or Paris or whatever that idealized lifestyle is that you want to escape to.

I think so many people create their own problems, and the guy in the story above is a great example of it.

 

[hoot504]

You hit it right on the head, I have zero desire to travel at this point in my life because I feel zero need to "escape" my life to take a "break" in some foreign hell hole.

Hilarious how people save up to drop $30k to go on some foreign vacation to Paris or Monaco or wherever.

Why not just optimize the life around you so you're effectively living in Monaco or Paris or whatever that idealized lifestyle is that you want to escape to.

I think so many people create their own problems, and the guy in the story above is a great example of it.

Bruh have you been to Paris?

I dropped $30k going there (Nice too). Can’t wait to do it again, actually, and my life stateside is plenty optimized.

 

[Rimmit]

The author's writing style reminds me of physicians and patients I have met. It's hard for me to not feel like he was an impediment to care as a certain type of personality often is.

Hi! I'm actually the author.

That was actually mainly written to help decompress right after it happened, and was primarily for friends and family who were bombarding me with texts asking what happened. It ended up going viral though at the time that I published it, but the main intent was really to help convey the insanity of what occurred to our friends and family and help me decompress from the events. This was the first article written on our short lived blog in 4 years, and was really just more of an informational thing for my family and friends. Hence the name "So what exactly happened?" as that's what I kept getting bombarded with.

I would agree that I impeded my wife's care, in that I was not more assertive when I should have been. Anyone other than me woulda been a better advocate than me in pushing to get her what she needed. I kinda just let them do their thing of the most part only really helping when they asked me too, such as when they needed me to find something for her something to throw up in as they had no emesis basins, ask me to don some lead to help move her during the X-rays and hold her in a lateral position, help hold her arm as we rebandaged it with the used bandage, hold her down while she writhed in pain as they irrigated her wound with no anesthetic or sedation,etc.

There was only one instance where I showed frustration and it was at the very end when I asked them to give her pain meds 10 minutes early as my wife was in massive pain, but they wanted to wait an extra 10 minutes as it was ordered Q4H and we had 10 minutes to go. am one of the easiest going and calmest people I know, and was just as calm during this whole endeavor. You can ask my nurses, peers, wife, etc and they will easily concur with that assessment in that I am one of those avoid conflict like the plague kinda people. I also argued with him very shortly about the need for X-rays before calling for transport, but that was the only time I remotely got involved in the medical decision making process. I kind of wish I wasn't as laid back as maybe I coulda gotten my wife some slightly better care if I pushed harder for them to have a sense of urgency. Without a doubt my biggest weakness as a physician is not being more assertive at times, as I need to do a better job of advocating for my NICU, but I am a "spineless jellyfish" per my wife, and really only meet conflict if it comes at me head on and I have no other option.

Either way, those are the decisions I made, and I can't go back and change them. Only god knows if I had been a better advocate if her outcome would have been better.

I love AI so much, it saves so much of my life and time.

I don't have much to say about the story beyond your points, and would also like to add don't travel to ****-hole areas to do risky activities without phones, money, and/or technology to offset risk (which is extremely easy to plan for if you put forethought into it)

I love AI as well. AI though really doesn't do the world's greatest job of giving the whole picture sometimes, as in this case, but does a decent job of giving the basics. But doesn't really emphasize the fact that I was dragged to an ATM machine by the secretary of the hospital so I could pull out the maximum amount I could that day, and then further driven to the lodge we were at so I could get whatever cash my parents, and I had in our rooms. The AI cuts out a lot the intricacies of what actually happened which is a huge part of the frustration.

We had a decent amount of cash, but no one travels with 17k in their pockets unless you are a gambler going to a casino typically. It's just not the most advisable thing to do. We were traveling with 2 people in our party with usable cell phones, and we were in theory together the entire time during the trip. Didn't think we'd get separated, but we definitely know better now for sure. This just happened to slip through the cracks, as this was before we joined our guide for our safari tour, as if this had happened while during the actual tour portion we would have had more of an advocate that was more used to dealing with these situations. This was the days prior to the start of that, so just terrible timing. Either way, lesson learned for sure, and I definitely have working phones on me and my wife at all times and a little more cash now, but I'm still not packing 10k in my wallet.

This is EXACTLY why I turned to AI within 2-3 lines of reading it.

It reeked of self-importance, with a hint of condescension. Overly detailed to show off competence, but clouding the overall message and picture.

Physicians are always and will always be their own worst enemies.

I'm sorry you didn't find it worth reading. Most people who read it did find it intriguing, and at the time I initially published this it went viral, but I can totally get that it is very long and I recommend most people to read it on the beach, when they're bored, or in parts when they are going to bed. TBH, it was never meant to be that long and started out as as short facebook update to let people know what happened, but again it was written primarily as an explanation to our friends and family, and so much happened I kept bouncing around in my head trying to explain everything as so much was happening so fast. The facebook update kept getting longer, and it eventually became a massive article. Every time I said something I'd get more questions, and it was hard to keep up with everyone's questions as you can imagine.

Thanks for the feedback. There really wasn't a message or picture I was trying to convey so that's likely why it's clouded. It was meant to be therapeutic and as a decompression from all the trauma at the time. It was written IIRC about 5 days after it happened and I couldn't accurately tell our friends and family what happened, so I just wrote it down as best as I could. I am not a professional author by any means, but just could not find anyway else to let our friends and family know what had truly occurred. Most asked for a sequel about the fallout, which I did write, and TBH, the day we left Joburg could be a thriller movie in and of itself with almost as much drama as the first day, but I just kept that to myself as I wrote it to again decompress for the craziness on our repatriation day back to the US, which was ironically the 4th of July.

I do appreciate your opinion and it definitely has a lot of detail. The main reason why it's so detailed is because I am accurate to a fault. I never want people to think I'm exaggerating for the sake of telling a story. I'm the same way in real life, and in documentation, and probably detail things too much when people don't care as I don't want there to be any miscommunication.

While reading this, I found myself trying to think of what could have been done differently. Not blaming the victim at all, because this could happen to anyone, and thinking clearly is much harder when it's your spouse involved. A working cell phone would have been helpful; I don't always have one when I travel, but I'll make that a priority now. I always get travel medical insurance, and I was under the (perhaps naive?) impression that the company had a 24/7 service to coordinate care. Now I'm not so sure. But if so, maybe one phone call could have prevented a lot of frustration. A medical kit would have been helpful, but not as much if it's the physician who's injured, and any major trauma patient is still going to need definitive care.

I assume a lot of the laissez-faire attitude reported here is because they see much worse on a regular basis, and I don't know anything about the emergency system in Zimbabwe, but I'm guessing their trauma training is different from ours. I don't know how you deal with that when you're in the middle of it, aside from polite persistence and waving cash around if you have it.

Hindsight is always 20/20 and as physicians we are the epitome of second guessing the decisions made before, after, and during a major event or adverse outcome. We did not do a RCA on this just for the record. LOL. All I can say is I did the best I could given what I had to work with at the time, and have definitely adjusted some things with how we travel based on that. I can guarantee, more than anyone in this forum, have second guessed everything I did more times than I can count.

I definitely have a working cell phone when I travel, two now actually, both me and my wife, and now also have multiple banks of credit cards to make sure I can try different banks and brands in an emergency situation.

I did give the travel insurance phone number to the transport team when they denied payment, and they said they called, but the insurance company was no help. I probably should have called myself to confirm, but at the time I was just trying to make a payment, as in an emergency, as you know, the more people involved, the more red tape there is. We were also always one step away from making payment, so the fastest way to move my wife, was to just get that payment accomplished. If we call we will have to get the transport approved by someone, likely an physician, which takes time. They have to review the chart to ensure it's an appropriate transport. They need to find if that's the closest option that can handle the case. If it's on my bill, and I'm paying and getting reimbursed later, it just happens NOW rather then going through the red tape for a transfer.

Really the main issue, is you have to pay first, and care later. I mean if they are dragging me (literally taking my arm and dragging me into a car, to take me to an ATM machine while my wife is laying on the bed so I can get them money from the ATM machine), that is gonna slow down care. There's just no way around that.

I'm just glad we had travel insurance. Took me 10 months to the day after the accident, but I got back all the money we spent in Zimbabwe and Joburg. Once we got to SA we were finally able to get travel insurance to start paying the bills and I didn't see another bill after we got to SA.

I think so many people create their own problems, and the guy in the story above is a great example of it.

Ultimately, you can create your own problems where ever you are, for us we might as well see the world while making our problems.

We love to travel, and while what happened is unfortunate, it was definitely an adventure, and taught some great lessons. Thankfully my wife is well enough again to where we're back jet setting again. Just did a RTW trip to all 12 Disney parks in 16 days over Christmas break and my wife was able to walk 90 percent of it!!! Had another disaster there due to Air France, which sadly was not covered by travel insurance as travel insurance does not cover airline stupidity, but we got through it like we always do and no one was injured, and no permanent damage was done. This time it was written about by The Points Guy, so you can read about that debacle here if you like which is hopefully a little less detailed.

How to lower your chances of getting denied boarding on a flight to China - The Points Guy

Air France denied boarding to a TPG reader's family by mistake on a flight to China because of a supposed visa issue. Here's how our ombudsman resolved the issue, plus tips for making sure the same thing doesn't happen to you.

thepointsguy.com

I hadn't written anything on my blog since the accident but did blog our last trip we took as I got some requests to blog about it. It's in much more detail there or just AI summarize it if you like. I'm big into points and miles and most people specifically ask for all the details, so you're likely not the target audience for that.

I know this is again crazy long, just like that article. If anyone has any questions I'd love to hear them. I've had a lot of time to reflect on this over the last almost 3 years now, especially things we coulda done differently in the moment. There's a couple things I thought of, that may have expedited things, but ultimately, I'm not sure how much it woulda made a difference in the end due to the limitations of the Vic Falls Airport, and the red tape to get to Joburg, but it may have.

Thanks for reading at least the small bit that was not AI summarized, and thanks for the feedback. I'm not in the professional writing business, but if I ever write another crazy story like this, which I hope I don't, I'll definitely work the feedback into it.

 

[HemorrhagicShock]

Hi! I'm actually the author. How did you find this article just out of curiosity? Do I know you?

That was actually mainly written to help decompress right after it happened, and was primarily for friends and family who were bombarding me with texts asking what happened. It ended up going viral though at the time that I published it, but the main intent was really to help convey the insanity of what occurred to our friends and family and help me decompress from the events. This was the first article written on our short lived blog in 4 years, and was really just more of an informational thing for my family and friends. Hence the name "So what exactly happened?" as that's what I kept getting bombarded with.

I would agree that I impeded my wife's care, in that I was not more assertive when I should have been. Anyone other than me woulda been a better advocate than me in pushing to get her what she needed. I kinda just let them do their thing of the most part only really helping when they asked me too, such as when they needed me to find something for her something to throw up in as they had no emesis basins, ask me to don some lead to help move her during the X-rays and hold her in a lateral position, help hold her arm as we rebandaged it with the used bandage, hold her down while she writhed in pain as they irrigated her wound with no anesthetic or sedation,etc.

There was only one instance where I showed frustration and it was at the very end when I asked them to give her pain meds 10 minutes early as my wife was in massive pain, but they wanted to wait an extra 10 minutes as it was ordered Q4H and we had 10 minutes to go. am one of the easiest going and calmest people I know, and was just as calm during this whole endeavor. You can ask my nurses, peers, wife, etc and they will easily concur with that assessment in that I am one of those avoid conflict like the plague kinda people. I also argued with him very shortly about the need for X-rays before calling for transport, but that was the only time I remotely got involved in the medical decision making process. I kind of wish I wasn't as laid back as maybe I coulda gotten my wife some slightly better care if I pushed harder for them to have a sense of urgency. Without a doubt my biggest weakness as a physician is not being more assertive at times, as I need to do a better job of advocating for my NICU, but I am a "spineless jellyfish" per my wife, and really only meet conflict if it comes at me head on and I have no other option.

Either way, those are the decisions I made, and I can't go back and change them. Only god knows if I had been a better advocate if her outcome would have been better.


I love AI as well. AI though really doesn't do the world's greatest job of giving the whole picture sometimes, as in this case, but does a decent job of giving the basics. But doesn't really emphasize the fact that I was dragged to an ATM machine by the secretary of the hospital so I could pull out the maximum amount I could that day, and then further driven to the lodge we were at so I could get whatever cash my parents, and I had in our rooms. The AI cuts out a lot the intricacies of what actually happened which is a huge part of the frustration.

We had a decent amount of cash, but no one travels with 17k in their pockets unless you are a gambler going to a casino typically. It's just not the most advisable thing to do. We were traveling with 2 people in our party with usable cell phones, and we were in theory together the entire time during the trip. Didn't think we'd get separated, but we definitely know better now for sure. This just happened to slip through the cracks, as this was before we joined our guide for our safari tour, as if this had happened while during the actual tour portion we would have had more of an advocate that was more used to dealing with these situations. This was the days prior to the start of that, so just terrible timing. Either way, lesson learned for sure, and I definitely have working phones on me and my wife at all times and a little more cash now, but I'm still not packing 10k in my wallet.


I'm sorry you didn't find it worth reading. Most people who read it did find it intriguing, and at the time I initially published this it went viral, but I can totally get that it is very long and I recommend most people to read it on the beach, when they're bored, or in parts when they are going to bed. TBH, it was never meant to be that long and started out as as short facebook update to let people know what happened, but again it was written primarily as an explanation to our friends and family, and so much happened I kept bouncing around in my head trying to explain everything as so much was happening so fast. The facebook update kept getting longer, and it eventually became a massive article. Every time I said something I'd get more questions, and it was hard to keep up with everyone's questions as you can imagine.

Thanks for the feedback. There really wasn't a message or picture I was trying to convey so that's likely why it's clouded. It was meant to be therapeutic and as a decompression from all the trauma at the time. It was written IIRC about 5 days after it happened and I couldn't accurately tell our friends and family what happened, so I just wrote it down as best as I could. I am not a professional author by any means, but just could not find anyway else to let our friends and family know what had truly occurred. Most asked for a sequel about the fallout, which I did write, and TBH, the day we left Joburg could be a thriller movie in and of itself with almost as much drama as the first day, but I just kept that to myself as I wrote it to again decompress for the craziness on our repatriation day back to the US, which was ironically the 4th of July.

I do appreciate your opinion and it definitely has a lot of detail. The main reason why it's so detailed is because I am accurate to a fault. I never want people to think I'm exaggerating for the sake of telling a story. I'm the same way in real life, and in documentation, and probably detail things too much when people don't care as I don't want there to be any miscommunication.

Hindsight is always 20/20 and as physicians we are the epitome of second guessing the decisions made before, after, and during a major event or adverse outcome. We did not do a RCA on this just for the record. LOL. All I can say is I did the best I could given what I had to work with at the time, and have definitely adjusted some things with how we travel based on that. I can guarantee, more than anyone in this forum, have second guessed everything I did more times than I can count.

I definitely have a working cell phone when I travel, two now actually, both me and my wife, and now also have multiple banks of credit cards to make sure I can try different banks and brands in an emergency situation.

I did give the travel insurance phone number to the transport team when they denied payment, and they said they called, but the insurance company was no help. I probably should have called myself to confirm, but at the time I was just trying to make a payment, as in an emergency, as you know, the more people involved, the more red tape there is. We were also always one step away from making payment, so the fastest way to move my wife, was to just get that payment accomplished. If we call we will have to get the transport approved by someone, likely an physician, which takes time. They have to review the chart to ensure it's an appropriate transport. They need to find if that's the closest option that can handle the case. If it's on my bill, and I'm paying and getting reimbursed later, it just happens NOW rather then going through the red tape for a transfer.

Really the main issue, is you have to pay first, and care later. I mean if they are dragging me (literally taking my arm and dragging me into a car, to take me to an ATM machine while my wife is laying on the bed so I can get them money from the ATM machine), that is gonna slow down care. There's just no way around that.

I'm just glad we had travel insurance. Took me 10 months to the day after the accident, but I got back all the money we spent in Zimbabwe and Joburg. Once we got to SA we were finally able to get travel insurance to start paying the bills and I didn't see another bill after we got to SA.


Ultimately, you can create your own problems where ever you are, for us we might as well see the world while making our problems.

We love to travel, and while what happened is unfortunate, it was definitely an adventure, and taught some great lessons. Thankfully my wife is well enough again to where we're back jet setting again. Just did a RTW trip to all 12 Disney parks in 16 days over Christmas break and my wife was able to walk 90 percent of it!!! Had another disaster there due to Air France, which sadly was not covered by travel insurance as travel insurance does not cover airline stupidity, but we got through it like we always do and no one was injured, and no permanent damage was done. This time it was written about by The Points Guy, so you can read about that debacle here if you like which is hopefully a little less detailed.

How to lower your chances of getting denied boarding on a flight to China - The Points Guy

Air France denied boarding to a TPG reader's family by mistake on a flight to China because of a supposed visa issue. Here's how our ombudsman resolved the issue, plus tips for making sure the same thing doesn't happen to you.

thepointsguy.com

I hadn't written anything on my blog since the accident but did blog our last trip we took as I got some requests to blog about it. It's in much more detail there or just AI summarize it if you like. I'm big into points and miles and most people specifically ask for all the details, so you're likely not the target audience for that.

I know this is again crazy long, just like that article. If anyone has any questions I'd love to hear them. I've had a lot of time to reflect on this over the last almost 3 years now, especially things we coulda done differently in the moment. There's a couple things I thought of, that may have expedited things, but ultimately, I'm not sure how much it woulda made a difference in the end due to the limitations of the Vic Falls Airport, and the red tape to get to Joburg, but it may have.

Thanks for reading at least the small bit that was not AI summarized, and thanks for the feedback. I'm not in the professional writing business, but if I ever write another crazy story like this, which I hope I don't, I'll definitely work the feedback into it.

Because my eyes and brain immediately shut down upon seeing your walls of text, I used AI (again) to summarize your reply so I could get the gist of it:

• Purpose: Article written to decompress and inform friends/family, not meant to go viral.
• Self-Criticism: Admits to not advocating enough for wife’s care due to calm, conflict-averse nature.
• Regrets: Wishes he was more assertive; only showed frustration once over pain meds.
• Criticism Response: Article’s detail was therapeutic, not self-important; appreciates feedback.
• Financial Issues: Hospital demanded cash; taken to ATM/lodge to gather funds.
• Lessons: Now travels with phones, more cash, varied cards; insurance slow but reimbursed.
• Insurance Struggles: Insurance unhelpful during crisis; prioritized quick payment to avoid delays.
• Hindsight: Adjusted travel habits but doubts major outcome changes due to systemic issues.
• Continued Travel: Resumed traveling, e.g., 16-day Disney trip; faced unrelated Air France issue.
• Feedback Welcome: Open to questions, hopes to improve future writing.

I really didn't mean to come off as insulting or anything, apologies there, and appreciate your explanation of how it was written more as a catharsis than anything else. This puts it in perspective - I hope everything is going well for everybody, especially your wife.

In case you're looking for feedback: Brevity is the soul of wit.

 

[Rimmit]

Because my eyes and brain immediately shut down upon seeing your walls of text, I used AI (again) to summarize your reply so I could get the gist of it:

I really didn't mean to come off as insulting or anything, apologies there, and appreciate your explanation of how it was written more as a catharsis than anything else. This puts it in perspective - I hope everything is going well for everybody, especially your wife.

In case you're looking for feedback: Brevity is the soul of wit.

I never said I was witty! lol.

Again, sorry for the wall of text, I was just trying acknowledge that your criticisms are valid and why a lot of those criticisms occurred.

Agree with you on brevity. I am just bad at it primarily because I am conflict averse, and I find the overwhelming majority of conflict comes from not understanding or just misunderstanding someone's point of view, and therefore, it takes a lot of words to ensure I see your point of view.

This goes for the hospital environment as well. 95% of conflict I've found can be resolved with better communication.

I will say though that the original article truly cannot be summarized by AI and it misses sooo many points. Some misses for example:

• Financial Issues: Hospital demanded cash; taken to ATM/lodge to gather funds.

What happened there is that as I was in the process of tending to my wife and awaiting the transport team, I was physically pulled to a car by my arm, and driven to an ATM machine where the guy watched me try higher values until I got to one that the ATM would let me pull out. I was then driven to our lodge to pick up more money from our in room safe, and borrow some from my parents. It's not as simple as "taken to atm/lodge to gather funds." It loses a lot of context. One is an interesting story that would NEVER happen in the US. The other just sounds like a trip to the gas station to get some cash.

Or:

• Continued Travel: Resumed traveling, e.g., 16-day Disney trip; faced unrelated Air France issue.

That was actually a round the world trip where we went to all 12 Disney parks on that trip. Vastly different than going to WDW for 16 days. AI can really miss the point sometimes, and it misses big in it's synopsis.

Thankfully, my wife through some serious PT is 95% back to normal. Has most mobility back in her ankle, and can do almost all ADLs and walk a good amount. So that's a win! Thanks for asking!

To say we created our own problem isn’t totally fair, as no one can predict having a car jump a lane and run over your wife. I also just think there are problems everywhere, so if you're gonna make them, might as well do them doing something you love to do, which for us is travel.

I can totally understand if you don't like to travel and that's great for you! We just choose different and that's ok!

I also appreciate the apology. It's much easier to criticize when you don't know the whole story or the person, or using AI that doesn't really do a great job of summarizing or giving the actual tone of an article.

I say "HI!" to the AI when you summarize this as well!

 

[Rimmit]

So What Exactly Happened?

As many of you may or may not know, Kendall was recently run over by a car in Victoria Falls, Zimbabwe. It’s been a long time posting on the blog, but I know a lot of you have many questions regard…

thesmallworldfamily.com

TL;DR: Neonatologist's wife is the "ped" in an auto-ped in rural Zimbabwe. Seems to be okay aside from a large heel deformity, but meets trauma criteria based on mechanism. After numerous delays in care and demands for immediate cash payment (or wire transfer, on a Sunday), patient is transferred to South Africa for definitive care. Osteo developed after return to US; patient is still recovering. Travel medical insurance covered everything retroactively, but finances were a major source of delays in care.

Just out of curiosity how did you find this article? Do I know you?

 

[WhatJobDoIPick]

You hit it right on the head, I have zero desire to travel at this point in my life because I feel zero need to "escape" my life to take a "break" in some foreign hell hole.

Hilarious how people save up to drop $30k to go on some foreign vacation to Paris or Monaco or wherever.

Why not just optimize the life around you so you're effectively living in Monaco or Paris or whatever that idealized lifestyle is that you want to escape to.

I think so many people create their own problems, and the guy in the story above is a great example of it.

This is a weird take.

 

[southerndoc]

I worked in Zambia for a bit. Zambia had more than Zimbabwe did. We had an x-ray machine, ultrasound, and EKG. Frequently were out of antibiotics (start a kid on one antibiotic, have to switch on day 3 because of new shortages). Severe lidocaine (lignocaine) shortage. Remember suturing up a guy's face using ice to numb up his face. Opioid pain medications are rare. No CTs, no dedicated specialists. Needing an orthopod was a trip to Lusaka. I imagine Vic Falls, Zimbabwe would require someone to go to Harare, but I'm not even sure Harare has the equipment.

Trauma centers and trauma specialists were non-existent when I was there. Most cities don't have ambulances. Just pickup trucks. Backboards? Yeah, right. To qualify for ICU level care in Livingstone, Zambia, you were on oxygen. There were no ventilators (even in the OR the anesthetist manually bagged the patient).

Anytime you travel to a third-world nearly bankrupt country, always always always get evacuation insurance no matter how healthy you are.

 

[Rimmit]

I worked in Zambia for a bit. Zambia had more than Zimbabwe did. We had an x-ray machine, ultrasound, and EKG. Frequently were out of antibiotics (start a kid on one antibiotic, have to switch on day 3 because of new shortages). Severe lidocaine (lignocaine) shortage. Remember suturing up a guy's face using ice to numb up his face. Opioid pain medications are rare. No CTs, no dedicated specialists. Needing an orthopod was a trip to Lusaka. I imagine Vic Falls, Zimbabwe would require someone to go to Harare, but I'm not even sure Harare has the equipment.

Trauma centers and trauma specialists were non-existent when I was there. Most cities don't have ambulances. Just pickup trucks. Backboards? Yeah, right. To qualify for ICU level care in Livingstone, Zambia, you were on oxygen. There were no ventilators (even in the OR the anesthetist manually bagged the patient).

Anytime you travel to a third-world nearly bankrupt country, always always always get evacuation insurance no matter how healthy you are.

Yep! Sounds about right, although the “ambulance” did impressively have a backboard, and that was about it.

Thank goodness we had all the insurance and it paid out in the end, just a hassle getting out of Zim to Joburg. The driver of the vehicle eventually visited us in Joburg and he said if we had picked Harare instead of Joburg to get transported to, they just would have chopped of her foot. He said Harare doesn’t have much either.

 

[bky3c]

Just out of curiosity how did you find this article? Do I know you?

The TPG article included a link to your blog. No, we don't know each other.

 

[Rimmit]

The TPG article included a link to your blog. No, we don't know each other.

Didn’t know if the KY in your name was for Kentucky as I trained in Louisville for 10 years.

Thanks for taking the time to read it, as it is long, but despite its length I know thousands of people have read the whole thing.

It’s definitely an intriguing and cautionary tale for those that do actually read the whole thing and don’t just use AI to summarize as an AI summary leaves soooo much out.