People always asked us when we were living in Panama, “What’s the medical care like?”  And my answer was generally, “It depends on what you can pay for just like in the States.” 

There are basically three health systems in Panama.  The national system serves mainly the Indigenous and folks with no or little income.  It’s almost free.  The Social Security system is for those who have worked and paid into Panama’s social security program.  Both of these systems usually have long lines and often doctors will prescribe medicine that is unavailable except at private, obviously more expensive, pharmacies.  Most of the doctors working in these government systems also see private patients.  Being a medical doctor in Panama is a long, hard job.  Docs live comfortably but most certainly are not getting rich.  Private sector doctors typically charge $20 per visit: that’s not copay, but the full charge.  Specialists run $60. 

Hospitals vary greatly.  The best hospitals are in Panama City.  We watched the cost of hospital services rise considerably, not just because of the devaluation of the US dollar (Panama’s official currency) but also what seems like just greed.  There are some local insurance programs but over the years we saw the benefits constantly decrease and the price increase.  Of course, your US insurance and Medicare aren’t acceptable in Panama since it’s not the US.  There are some International Insurance policies which work well if you retire to Panama early enough (like in your 50s!) but are pretty much cost-prohibitive if you are coming down in your mid 60s or later.

On the whole in the 18 years we lived in Panama we lucked out.  It took some doing, but we were able to find some good doctors who served us well.  Aside from mostly tests, we had little in hospital experience.  My wife did have a stent put in by a really good cardiologist at probably the best hospital in Panama City.

But we made it and lived to tell about it.  My big concern was always, “What happens sin an emergency?”  Where we lived in Boquete there was no US-style 911 emergency service and the nearest hospital was 45 minutes away in David where they would have needed to round up the appropriate doc anyway.  “Which ever one of us is well pulls the other one into the truck and races down the hill to the emergency room in David” was pretty much all we had.

So, given our advancing ages, reliable medical care in a language we understood, was a key factor in our moving back to the US.  Little did we know …

If the same thing that happened to me earlier this month, had happened to me in Panama, I wouldn’t be here.

To say leaving Panama and moving our stuff and three dogs to Washington, finding and buying a house and truck, and downsizing to a house a third the size of our place in Palmira … to say that was “stressful” is a major understatement.  And I was going back to work.  After a two-year Covid “pause” my favorite little cruise ship, the yacht-like PEARL MIST, was resuming operations and I had a six-month contract to be on board sharing the excitement with our guests and telling them about all the places we would be visiting.

I was all packed and rushing around to get the Airporter from Anacortes, WA, where we ended up, to SEATAC airport in Seattle: ready to go.  When I started shaking and my body turned to rubber and I ended up on the floor with my wife trying to drag me into the bed.  Aware of that magic first hour for heart and stroke victims, Nikki called 911.  It took about 15 minutes for two fire department ambulances and four EMTs to arrive.  I’m told they spent another 20 minutes once they got me into the ambulance restarting my heart twice before heading to the hospital. 

Apparently, I flatlined three more times in the ER room.  They put in a temporary pacemaker and the next day installed a permanent pacemaker which they can monitor and reset regardless of where I am in the US if I’m in range of a cell tower.  Which is why, once I get “clearance” to drive I can return to my normal activities and rejoin the ship now scheduled for August 20 in Milwaukee doing the last of the Great Lakes trips and the St Lawrence New England Fall Foliage cruses through November.

My wife and I know how to make grand entrances even in the hospital.  When Nikki came to visit me in the hospital, just outside the door to my room she slipped and fell breaking her leg in two places. So, we are two old invalids trying to keep each other going.  Fortunately, I have two wonderful daughters who have been amazing!  One daughter lives two hours away in Seattle and the other about 45 minutes away in Sedro Woolley.  Since I’m not allowed to drive until August we are “housebound” and have been assigned home care visits by nurses and physical therapists.    For the most part our dogs have been cooperative and it turns out that we bought in a small, but very caring neighborhood.  Not, I grant you, the best way to introduce yourself to the neighborhood, but such is life.

Maybe we made the move “just in time” … who knows.  But I do know that had this all happened in Panama, I wouldn’t have made it.  So, if I knew then what I know now would we still have moved to Panama for 18 years?  Absolutely!  If we’ve learned anything in this Covid nightmare it is to evaluate risk and reward.  Yes, I’ve wanted to eat inside restaurants, but after looking at the crowd and the percentage of unmasked people, I make a decision: risk vs. reward.  Life is full of risk!  I risked getting out of bed this morning but it is a beautiful day in Anacortes – sun and blue sky!!  My yard is blooming with azaleas and rhododendrons.  We’re alive!  I’ll take a walk today.  And my wife is happy because today is International Tea Day!

We had a great adventure in Panama and even knowing what I know now, it was worth the risk.  We did it!  And I think, given our ages, it was time to downsize and to move back “home” although admittedly right now “home” seems more like Panama than Washington.  But I’m thankful to be here and to be alive.