A Cautionary Tale

Bali: Beautiful coastline, not such beautiful hospitals

Insurance companies. Tossers aren’t they? Slippery, mendacious, faceless behemoths who are quick enough to take your premiums but equally quick to wriggle out of their obligations should you be unfortunate enough to need to claim. All, arguably, valid statements but having heard the story of my flatmate Greig and his recent ill-fated trip to Bali, I’ve started to appreciate that one day an insurance company might just save your life.

The story begins in the heady days of the summer of 2008. Shoppers were busy indulging in the last days of credit-fuelled hedonism prior to the economy imploding, Gordon Brown (remember him?) was busy enjoying his short-lived political honeymoon and Greig was busy getting kicked by a horse. The horse in question had already been responsible for breaking several of Greig’s brother-in-law’s ribs in a previous assault which, to my mind, makes it a prime candidate for a trip to the glue factory but they seem to be more tolerant of these equine misdemeanours in Scotland.

Anyway, using the sort of logic whereby you deal with an alarming noise coming from your car’s engine by turning up the stereo to drown it out, Greig chose to ignore the pain in his leg which began that day and never truly subsided; a ticking medical time-bomb that ultimately nearly proved fatal.

Spot the Difference

Fast forward two-and-a-bit years and Greig is in Bali, enjoying the last day of a week’s holiday with his friend Vivian in a restaurant. It had been an enjoyable few days and Greig and Vivian were busy taking some final pictures before flying back to Australia that evening. At one point Greig crouched down on his knees to take a photograph from a slightly different angle and found that he had some difficulty getting back on his feet again. He also noticed that one of his legs had turned completely white. It’s worth pointing out that Greig is a ginger Scottish man so the fact that the lightening of his skin colour was noticeable was a cause for immediate concern. The change in skin tone was accompanied by a shooting pain in his lower leg and after a few minutes of procrastination, they decided that a trip to hospital was required and jumped into a taxi.

The first doctor they saw took one look at Greig’s leg, shuddered and sent him off to a better hospital, after relieving them of £200 for the consultation, naturally. This was the first of many, many medical expenses; initially Greig and Vivian were able to settle them on their credit card but, for reasons that will soon become apparent, the insurance company had to step in and this is the reason for my Damascene conversion to their virtues.

At the second hospital Greig underwent two ultrasound scans (£500 each) which identified a blood clot in his left leg that was apparently causing the flow of blood to be restricted to his calf and foot. They immediately diagnosed deep vein thrombosis and put Greig on a course of Warfaran (£250 per day), a coagulate which, it was hoped would thin the blood and dissolve the blood clot.

This was obviously a major inconvenience especially as Greig clearly wouldn’t be able to fly until the clot had been cleared and certainly not that day but fortunately both Greig and Vivian were between jobs at the time so work was not an issue at least. They therefore accepted their fate; Greig was admitted to hospital (£550 per night) and Vivian returned to the hotel as they both prepared for a few more days in Bali.

The Indonesian Ritz

Comically, three days after Greig began his stay in hospital, he had some well-needed company when Vivian was also admitted after suffering an unfortunate reaction to some hair dye. Laurel and Hardy have got nothing on those two.

Five days and another cancelled flight later, it became apparent that Greig was not responding to the treatment so the doctors ordered a CAT scan and things began to take a turn for the serious.

The doctor informed Greig that the CAT scan had identified an aneurysm on the back of his left knee and this was the actual cause of the restricted blood flow to his lower leg; this was the legacy of the horse-inflicted injury. The doctor informed him that this would need to be immediately removed or Greig risked amputation, paralysis or even death and, oh, the operation will be £10,000 which we need before we will start and, just to be difficult, we don’t accept bank transfers.

Prior to this Greig, in order to stop them worrying, had kept his parents in the dark with regard to his ongoing medical plight but this turn of events meant that he had little option now but to ring them and drop the bombshell. You can only imagine the reaction of Greig’s dad at the other end of the phone line upon hearing that his only son might at best be returning home with a wooden leg, at worst in a wooden box. Fortunately Greig’s parents are reasonably well off so were able pay the £10,000 on their credit card. Another hasty phone call to Scotland was made when, twenty minutes before the operation was due to start, the surgeon informed Greig that they would be undertaking a slightly different procedure than first anticipated and that the new procedure would be another £3,000.

Unfortunately it would appear while £13,000 may get you an operation in Indonesia, it does not necessarily guarantee a decent anaesthetist as Greig actually woke up mid-way through the surgery. He came round just as the surgeon was cutting the light-bulb sized aneurysm from his leg but, whilst he was conscious and could feel pain, he was still sufficiently anaesthetised to stop him alerting the medical staff. A situation that could literally be described as a waking nightmare.

To rub salt into the wound (not a standard medical procedure in Bali but it wouldn’t be a complete surprise), it quickly became apparent that the surgery had, in fact, been a complete waste of time (and, obviously, money). The basic premise of the operation had been to remove the aneurysm and then divert the artery, via an artificial plastic vein, to a working vein further down the leg and return the flow of blood to Greig’s foot. It doesn’t exactly take Quincy to work out that diverting the artery to a vein that is completely blocked with congealed blood is not going to work does it?

It was clear that they had reached the limits of medical ‘expertise’ in Bali and with Greig’s prognosis deteriorating by the hour, the decision was taken to transfer him to the nearest hospital that would be able to treat him with some degree of competence. Unfortunately the nearest such institution was in Singapore and Greig’s condition did not allow them the time to wait for the next charter flight so, naturally, a private jet was called for (£40,000)

Air ambulance Singaporean style

and Greig headed swiftly to Bali airport. The patient was accompanied on this trip by fifteen different people including four whose sole occupation were to hold umbrellas over his stretcher whilst he was being loaded onto the plane as well as the obligatory nurse who, helpfully, instantly fell asleep the minute they were aboard.

Two hours later they arrived at the Mount Elizabeth Hospital in Singapore and Vivian (she was still with him at this point) asked the doctor if Greig would be allowed to fly home in the next day or so. The doctor looked at her quizzically before pointing out that there was still a very real chance that he could lose his leg, suffer major paralysis or even die.

The situation was still very much critical.

Another five hour operation followed in which the Singaporean surgeon attempted to remove the pointless plastic vein inserted in Bali and basically re-wire Greig’s left leg with veins removed from

This is what £76,000 buys you in Singapore

his other leg. This time round the operation was much more successful or, more accurately, just ‘successful’ and Greig settled into the £5,000 per night intensive care to begin his recovery with his leg held together by 130 staples and 20 stitches.

The following period is slightly sketchy in Greig’s memory which he attributes to the major loss of blood he suffered at this time including one occasion where he was talking on Skype to his parents and failed to notice that his leg had completely opened up and blood was literally flooding out of it – the drugs prescribed at the time inhibited the ability of the blood to clot – and the first of two blood transfusions was swiftly administered. The second transfusion followed a slightly less sympathetic episode when Greig, against doctor’s orders went out drinking and the alcohol reacted unfavourably with the Warfaran causing another massive haemorrhaging of blood.

One month and £76,000 worth of Singaporean medical expenses later Greig was allowed to fly back to Australia with the conditions attached that he had to travel in Business Class and be accompanied by a nurse – total cost: £11,000.

The result of the injury and subsequent surgery is going to be with Greig long after the insurance company has paid up the total claim which will be in excess of £150,000: He now has to undergo six months of intensive physiotherapy, cannot have any exposure to cigarette smoke whatsoever and can only fly business class for the rest of his life as his leg must be kept elevated at all times when flying.

There’s two real morals to this story that I can see – as I always suspected horses are inherently malevolent and untrustworthy animals and secondly, whilst those two adjectives could also be applied to insurance companies, it’s well worth paying a bit more for a better policy. It’s a dangerous world out there.

24 Hour Party People

Only schooners, unfortunately

Whilst recently getting my daily intravenous shot of UK news, I was slightly perplexed to notice that the government will shortly be repealing the 24-hour licensing laws and stopping pubs from serving alcohol round the clock.  Perplexed because I never came across a single pub that was open 24 hours.  Not one.  Not only did I never stumble across (or indeed out of) one but I don’t know of anyone else who found one of these, presumably, mythical establishments.  Was the whole thing an elaborate practical joke by New Labour or, more likely, a tool to divert our attention away from the latest catastrophic military intervention that we were embarking on?  I think we should be told.

Things are very different in Sydney, however – 24-hour drinking is very much a part of the social scene here.  There are some variations from council to council but I can guarantee that, if you are anywhere in central Sydney at any time of the day, you are never more than fifteen minutes away from a cold one.  How good is that?  Very is the answer you’re looking for.  It has to be pointed out that this liberal attitude (a surprisingly rare thing in Australia) to licensing does come at a cost namely zealotry from bouncers on an unprecedented scale.  In no particular order, these are some of my favourite denials from bouncers in Sydney:

“Not tonight boys, you look like you’ve had a few too many”.  This was said at 8PM on a Saturday evening when the people on the receiving end of the denial had had literally nothing to drink.

“Only three of you can come in”.  This was aimed at a group of four but, bizarrely, the bouncer refused to identify which one of us was persona non grata.  Admittedly this was at 2AM on a Tuesday so probably for the best that we were refused.

“Had a drink have we boys?”  This was stated at 1AM on a Friday night to which the appropriate answer would be “No you fucking knucklehead, I’ve obviously been sitting at home sipping apple juice all evening before lowering ourselves to visit your dingy little cess pit”.  Clearly the recipient of that denial didn’t take the opportunity to deliver that line though or I doubt he would have lived to tell me the tale.

To be fair though, unless you happen to encounter a particularly idiotic bouncer (which, lets face it, are a global phenomenon) and you always carry your ID (even I, in the autumn years of my youth, have been ID’d on a number of occasions here), you are sure to be able to get a drink somewhere at 5AM on a Wednesday which can only be a good thing.

Many Happy Returns

Church-type activities aside, is there a more excruciating ceremony than the singing of happy birthday?  It’s a legitimate question and not one that I am asking just because I happen to be hurtling towards a particularly unwelcome milestone myself.  I have recently been working for a company where it is a monthly tradition that all the staff who are celebrating a birthday that month gather in the middle of the office and the section manager leads the rest of the department in a rendition of the aforementioned song.

It’s impossible to tell who is more embarrassed – the birthday victims who are subjected to a very public reminder of another year passing and spend the duration of the singing carefully avoiding eye contact with anyone else in the room or the singers who try to deliver the words without drawing too much attention to their congenital inability to hold any sort of tune.  On particularly ugly occasions after the song has, to the relief of all concerned, come to an end, some bright spark might even launch an attempt at “hip, hip, hooray” or, even worse, “for he’s a jolly good fellow”.  It makes me wince thinking about it.  The fact is that nobody enjoys the occasion so why bother doing it?  Public executions were banned for much the same reason.  Don’t get me wrong – I’m all for celebrating a colleague’s birthday if they so wish – four hours in the pub at lunchtime is always welcome – but not by joining in with the forced jocularity of twenty adults tunelessly serenading them.

A few years ago I was in a club where, midway through the night, they actually stopped the tunes and asked everyone there to sing happy birthday to the DJ who was on the decks at the time.  No doubt this was an emotional moment for the DJ and one that he will tearfully recount to his children in years to come.  For everyone in the club it was five minutes of irritation before the music came back on and they could get back to the serious business of getting off their heads.

There’s a time and a place for singing Happy Birthday and that is at a party for a five year old nephew surrounded by discarded wrapping paper and jelly and ice cream, not in an office surrounded by filing cabinets and humiliation and certainly not at four in the morning in a nightclub.  Don’t get me wrong – I’m not advocating making the song illegal per se just completely socially unacceptable like drink driving and reading the Daily Mail.

Is that really too much to ask?