Our visit to Lisbon last fall ended not with a bang but something more akin to a whimper. After a full day exploring Belém, we stopped for cervezas and some snacks before we returned to our apartment to change for dinner and a night out. I started feeling a little unsettled but figured I was just a bit dehydrated. An hour later or so I was experiencing symptoms which had me concerned, and the group decision was that I’d better seek medical advice and attention.

We immediately tried to contact our apartment’s property manager for suggestions as to where to go or whom to see. He had provided us with his contact info when we checked in and told us we could contact him at any time. Unfortunately, he did not respond, so we searched online for nearby hospitals and called an Uber to get us there. First lesson learned: Not every “hospital” has an emergency room; some are “convalescent” hospitals for recovering surgical patients and others. Luckily, the gatekeeper there hailed a cab to take us to the nearest ER, and off we went.

The next five hours provided an interesting, eye-opening experience of a health care system different in ways both good and bad from what I navigate at home. Of course, it’s easy now to review the episode so academically, but at the time, seeking help when unwell in a place where there were few fluent English speakers (and I have no Portuguese) and in what appeared to be a rather worn-down and ancient facility, my husband and I were pretty shaken and concerned.

It was only afterwards, on the 1 a.m. ride back to our apartment, that we learned from our Uber driver that there are both public and private hospitals in the Portuguese health care system, and we understood from his comments and attitude that we should have sought out a private hospital. That helped me understand why it seemed some of the staff looked at me with bemusement as if wondering, “What the heck is she doing here?” . . . and also why we seemed to be the only foreigners in the place. Another lesson learned: Have at least a rudimentary understanding of the levels of care and how to access them in any destination you plan to visit.

After checking in, filling out a few very basic forms (no health history or anything) and paying 18 euros as an admission fee (the clerk was very apologetic that we had to pay), we were told to go to the (very grimy) waiting room and wait for my name to be called to be triaged. With about 20 people already in the room, we figured we were in for a very long night, but after only 10 minutes I caught what I thought was my name in the midst of a stream of Portuguese over the loudspeaker. (“Vanikiotis” gets mangled in all sorts of ways all the time, so I wasn’t positive.) We found the right cubicle, where we managed to communicate my symptoms and concerns to a lady on a computer who then told us to return to the waiting room and again wait for my name to be called to see a doctor.

In the meantime, I sought out a restroom, which turned out to be distressingly dirty (for a hospital!), was out of toilet paper (thank goodness for tissue in my purse) and had no sink (found one back in the waiting room). I should describe the building: We found a plaque later which indicated the Hospital San José had been built in the late 1700s (after the great quake and tsunami destroyed much of Lisbon), and it looked it. High arched spaces with peeling paint were divided by partitions into “rooms,” dingy linoleum floors were offset by a few large, blue-tiled murals in grand stone staircases, and computer cables snaked across floors and around pillars, plugging into seemingly overloaded power strips.

After a not-unreasonable time, I again detected what I thought was my name and a number amongst a stream of announcements over the loudspeaker. We poked our heads into a small examine room matching the number we’d heard, where a doctor waited. After saying my name, confirming we were in the right place, the doctor began speaking . . . in Portuguese. Oh, no! When he saw the panicked look on my face, he switched to English, asking, “You’re not Portuguese?” It turned out he would not be the only person that night who would look at my name and decide I must be Portuguese (because why would a foreigner be here?).

He asked some questions about my symptoms, my general health and chronic conditions and did a brief physical examine which DID NOT include checking my temperature (though he asked if I thought I had a fever), taking my pulse, respiration or blood pressure. He told me what his diagnosis was and how he would treat it and directed us to where I would have my blood drawn for testing and receive an IV to deliver hydration and some medications. This was a communal space with a ring of about 20 (uncomfortable) plastic chairs, side by side, filled with an assortment of people of all ages receiving IVs or other forms of treatment. I prayed that none of them were contagious (not at all confident about that). A team of three very capable nurses oversaw the patients, and the doctor handed me over to one of them, telling her what he wanted her to do for me.

Next came a phlebotomist to draw my blood . . . without gloves. I think he cleaned his hands with sanitizer before he did so, but I can’t be sure. Yikes! When the nurse finally came to set up my IV, she DID have gloves on (I had planned on insisting), and she was the first to ask if I had any allergies before inserting the needle.

To make a long night shorter, the doctor came back a few hours later after the IV was done, reviewed my blood test results, confirmed I was feeling better and my symptoms had subsided, suggested a bland diet for the remainder of my trip and a visit to my health care provider when I got home. We asked if we needed to check out somewhere or pay a bill, and he said he was only concerned with healing people and did not deal with any of that. With no one manning a desk that we could find, we called for our ride and gratefully made our way back to our accommodations.

A few months after returning home, we received a bill from the hospital. The lab work, the medications and the consult with the doctor totaled a whopping 130 euros.

A few final lessons to share from our unexpected hospital visit in Lisbon: 1) There are efficiencies undertaken which may seem like short cuts which don’t necessarily mean a lower standard of care, and they can help shorten an emergency room visit. 2) Most people, especially health care workers, are kind and compassionate and go out of their way to help strangers in a foreign place. 3) Always keep tissue in your pocket or purse!

— Patty Vanikiotis, associate editor/copy editor