by Mike McHugh
GUANACASTA, COSTA RICA—I learned a lot about this country in the nine days I’ve spent here so far. That includes an area that I had little interest in finding out about, particularly from personal experience. That would be the country’s medical system.
It started one evening at the hotel pool, which featured the longest, twistiest water slide I’d ever seen. My wife, unable to resist the challenge, sailed down the chute like an Olympic sledder, barely making a ripple when she plopped into the pool. Following such a performance, I, being her husband, had to follow suit in order to defend my masculinity. Unfortunately, my style more resembled a sack of construction debris tumbling down a garbage chute. I hit the pool flailing, the surface of the water pulling my left shin in a direction that my knee didn’t want it to go. By the next morning, the knee felt like a Costa Rican farmer had been wailing on it with his machete. Our trip leader, Eddie, declared it a medical emergency and arranged an appointment at an urgent care clinic along the road to our next stop. The bus dropped my wife and me off, the other vacationers waving joyously as they sped off to the next resort. For my part, given how things work at clinics back home, I contemplated whether I’d get out of there in time for the flight home five days hence.
To my surprise, within ten minutes the front desk had taken my information; a nurse checked my vital signs, and I was sitting in front of a young female doctor. I wondered if the place had a drive-thru. I told her my situation; she felt around the knee and pronounced that it wasn’t serious. “What, no machines?” I asked. “You can’t walk into an American clinic without being tested on a dozen machines, and that’s if you come in with a hangnail.” “No, senor, we don’t need machines for this,” she assured me. I was awed. The malpractice lawyers in Costa Rica must all be standing around in food lines. She handed me a prescription and gave her instructions. It was mostly the usual—rest, medication, ice packs, etc. Then she gave me that stern doctor look and pointed her finger, “and Senor McHugh, no horseback riding!” I hadn’t even mentioned to her about that very thing being on our agenda the next day. It was as if this were a common problem around here with knee patients, wanting to gallop right out of the clinic and into the sunset. “What is this place, Dodge City?” I wondered. A nurse then ushered me to the front desk. I gritted my teeth as they prepared the bill. “That will be $85 American, Senor McHugh.”
“Eighty-five dollars!” I gasped. “Si, medical care is not cheap here in Costa Rica. Our doctors are very well trained,” the receptionist replied. “No,” I corrected. “I was expecting a much higher bill. You can’t get a cotton swab in an American clinic for $85.” We did encounter one small problem with the country’s medical infrastructure when my wife went to the pharmacy next door. Even though the prescription was only for ibuprofen, they didn’t have any. “I can’t believe this place! First it’s ‘Gunsmoke’ and now Monty Python,” I told her, recalling the sketch about the empty cheese shop. We did find the ibuprofen, and I sat out the next day’s horseback ride as ordered. I dared not do otherwise, fearing that with so efficient a medical system, the doctor probably had me tailed. My immobility had its good points, though, as my wife began waiting on me hand and foot. I spent the next to days hoping the doctor had underestimated the recovery time.