The Jagged Stones of Dublin

This is a true story about my last trip to Dublin. It happened over two years ago. Some details may have blurred over time. You have my permission to laugh at my discomfort.

I was going to Dublin, Ireland for a payments conference. This was my second trip to Dublin. I love the pub food. I love the Guinness. And I love the people. I think we resonate on a similar frequency. There’s a blue collar, wise-cracking attitude that reminds me of growing up in the Midwest.

I treated myself to a chair massage at the Austin airport before boarding the plane. I’m a tall guy and I don’t fit very well on planes. So it helps to limber up before a dozen hours of tight quarters and cramps.

The flight was uneventful. Uncomfortable, sure, but same as it ever was. I put on my headphones to drown out the engine noise. I logged onto the WiFi and handled some work details. Made sure everyone had what they needed before I went offline for a few days.

I pulled out the kindle, did a little reading — The Name of the Wind, by Patrick Rothfuss. I had red wine with dinner. Then another glass. I fell asleep watching some low-grade action movie.

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When I got there I met a colleague, Ian, at the airport in Dublin. We grabbed a table at an airport restaurant to wait for others to arrive. I ordered an “authentic Irish breakfast” with coffee. Bacon, sausage, black pudding, eggs, tomatoes. I thought a big meal would help me reset my body to local time. But it didn’t quite sit right.

I was there to learn and make connections. There were five of us — Peter, Eoin, and myself from the payments team and Ian and Alx (yes, “Alx”) from the fraud team. We rented an Airbnb to save money and because we have fun together.

The conference went as conferences do. We attended sessions, asked questions, took notes, made connections. We shared new ideas. Lots of meetings with people from different companies.

My stomach didn’t feel quite right. But that wasn’t surprising. I was jet-lagged. I was following a strict low-carb diet. I didn’t hold back on the whiskey at cocktail hours. And I always had to be “on” to represent our company. So that ramps up the stress.

And my back hurt too. I have a bad lower back, so that wasn’t out of the ordinary. I felt the need to shift position a lot. Try sitting. Lean one way. Then another. Try standing.

We were at a dinner hosted by a payments company. It was a chance to get honest feedback from other clients. And of course it was also an opportunity to have good food and wine.

But the steak was awful. The salad was bitter. I couldn’t eat either of them. And my back was still bothering me. I thanked them for the dinner, said my goodbyes, and walked back to the Airbnb by myself.

I wasn’t sure what was going on. Maybe this was constipation? I never had that before, so I wasn’t sure. I stopped at a drugstore on the way home and bought constipation medicine while avoiding eye contact with the clerk. I think you’re supposed to be embarrassed if you’re constipated? I don’t know. This was new.

That night was awful. I was in terrible pain. It was diffuse. Maybe it was my back. Maybe it was my stomach. The medicine didn’t help. I couldn’t sleep. I kept feeling like I had to pee, so I’d go to the bathroom. But nothing. So after a while I’d go back to bed. I cycled back and forth dozens of times. I only got a few hours sleep.

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The next morning I awoke and got ready for another day of meetings and sessions. I was standing in the kitchen, bent over at my waist, letting my torso and head hang down, trying to find a position to relieve my back. My workmates gave me skeptical looks.

I said something like “We only have one more day. I just want to get to the conference and see if maybe I start to feel better.”

Alx said, “No, that was yesterday. Yesterday was your day to see if it would go away or get better. Today is the day you need to see a doctor.”

I saw the logic and truth in what he said. My reluctance had more to do with the impossibility of it. How? How do you go see a doctor in another country?

I’ve traveled all over the world for work. But the only time I’ve needed medical assistance was… well that was in Dublin too. Hmm. My ears never popped from the plane trip and I had terrible ear infections. The hotel sent for a doctor who did house-calls. He checked me over and prescribed antibiotics — which I had to get myself. That’s a whole other story, but let’s stay on topic.

My point is… how do you just go see a doctor in another country? Nobody even has phone books anymore. Do you just google “doctor”? Or is it “hospital”? Or maybe “clinic”? How does insurance work? Doesn’t Ireland have nationalized healthcare? Do they take in Irish citizens and leave foreigners to die in the street?

Luckily I had a crack team of work buddies getting me sorted. They found a clinic (a medical center) within walking distance. Couple kilometers, I think. So I said goodbye, wished them well at the conference, and resigned myself to a very different kind of day.

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It was a chilly morning as I plodded along. I approached the clinic and couldn’t see it. Huh. Google maps says it should be right here. I looked up and down the street and none of the signs said anything about “doctor” or “clinic” or “medicine.”

Maybe down that alley? I walked down the alley and yes, there it was. Just a solid door and a shaded window and a very hard-to-see sign above it. You couldn’t see into it. The setup discouraged scrutiny. Like a strip club. This did not instill confidence.

Well, this was the plan, and I had no other. So I opened the door. I saw steps leading down — maybe half a floor down. Bloody hell, that didn’t seem right. But here we were.

It was a tiny space. Room enough for the receptionist. I could hear the doctor talking in her office — every word quite clearly. I told the receptionist what was happening. I told her I had a history of back problems. She pointed me to the chair.

I recall hearing a loud conversation in Chinese. But that could be my memory playing tricks on me. Between that and the clinic setup I worried whether I was seeing a medical doctor or an acupuncturist.

That sounds pretty racist. That isn’t lost on me. But it’s better to acknowledge it than kid myself. Mostly my thoughts were about the pain in my back. Kind of on the right side, higher up than my “normal” back pain.

The doctor called me in — the normal medical doctor. I don’t remember exactly what she did. I think she just asked me questions. She said I needed to go to the hospital emergency room and gave me the address. She also gave me a note to give to them.

I thanked her and paid the fee on my way out. It was about $80. The hospital was pretty far away so I called an Uber.

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The car arrived and I got in. I think it was about a 40-minute drive. I wasn’t able to sit up normally. So instead I laid on my left side.

That poor Uber driver. He was driving someone from the clinic to the emergency room. And the guy in his back seat was complaining of pain and seemed on the verge of death. I can hardly believe he took the ride.

We had a conversation, but I don’t remember what we talked about. I mean, my back, obviously. Probably traffic. He was sorry the ride was taking so long. I’m sure he wanted me out of his car as soon as possible. Traffic seemed pretty light.

We arrived at the hospital and he helped me out of the car. The entrance gave me the impression of a loading dock. He asked if I needed a wheelchair and I said no. He got me into the door. Then he gratefully returned to the rest of his day.

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The next bit is a little foggy. Like an old videotape that turns into static for a few minutes. Or in modern terms, a zoom that keeps freezing and jumping ahead.

I’m sure I talked to someone behind a desk. I had to walk deeper into the hospital. I thought the place could use clearer signs. I remember having to wait in a chair in the hallway. There was a usual cadre of people waiting with me; a man with a patch over his eye, an old woman coughing into her handkerchief, people holding bloody bandages against wounds.

I finally talked to the intake nurse. I scrambled to figure out insurance as we talked. I read through my policy on my iPhone. I researched travel insurance from my company. I messaged my HR rep.

They brought me into the ER. They call it an ED, by the way, for “Emergency Department.” They put me on an IV with pain medication.

They poked and prodded me. They must have done some sort of ultrasound or x-ray. I was shuffled around from place to place, pushing my IV drip caddy along. Some other department for a test. Back to the ER. Back to the line in the hallway. Back to the ER. I felt very much forgotten. This lasted for a crazy amount of hours. Almost an entire work day.

Eventually it was late enough that it was morning time in Texas. So I called my wife and told her what was happening. She was understandably upset. She wanted me to fly home immediately.

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Finally I was brought into a the main ER office. I think there were several people in the room. A nurse. Two doctors.

“Ya got a buncha stones.” ‘Stones’ was pronounced like ‘stawns’, in a thick Irish brogue. This was the head ER doctor. He seemed young. Maybe my age or younger. He was surprisingly good-looking. I realized I could stand right next to him and most women wouldn’t see me. I felt jealous for no reason.

So apparently I had a lot of kidney stones. And one of them was blocking my ureter, which meant that kidney was turning gangrenous and dying. That’s bad. Any time a doctor mentions gangrene to you — that’s bad.

We all know the human body is disgusting and shameful. But bear with me for a brief explanation of anatomy. Kidneys filter waste out of your blood. You have two of them. They each have a tube, called a ureter, where they pass that waste into your bladder. And from there, if you’re a guy, you get to write in yellow cursive.

Sometimes, some of the minerals in that waste can crystallize into angry little stones with jagged edges. They get lodged in the walls of your kidney. That’s not good. But apparently one of them was dislodged and was now stuck blocking my ureter. I immediately thought back to that chair massage. J’accuse!

The doctors said I needed that kidney stone removed right away. I asked if I could fly home to the States. They were pretty clear that this was a bad idea. This could go bad, and you don’t want that to happen in the middle of a 12 hour flight. So, ok, we were doing this here.

They were going to “powder” the stone with a laser and then I would pass the fragments in my urine. They were only going to deal with the stone that was actively blocking my kidney — the one that could kill me. The rest I would have to deal with back in the States.

Then they said I had a choice to make. Apparently this was a private hospital. There was also a public hospital.

The surgeon would be the same at either hospital. He worked at both. But if I switched to the other hospital, I would have to go through admittance again (which took about six hours at the private hospital), and the doctor said I probably wouldn’t get a bed. I’d be sitting in a chair in the hallway all night.

I’m not frugal. I’m straight up cheap. But there is a limit. I gave it some thought, but… naw man, naw, that ain’t right.

So I was admitted to the hospital and brought to my bed. Surgery was scheduled for the morning.

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They put me in a shared room. There was a young guy in one of the other beds. Maybe early twenties. He was friendly, but I don’t remember his whole deal.

Alx, Ian, and Peter came to visit me that night. They had been carousing at some after-conference party but came to check on me. Eoin lived close to Dublin so he was already back home. Ian lived in England, so he was going home the next day. I wouldn’t see him again.

Alx, Peter, and I had plans to fly from Dublin to Amsterdam for another business meeting. My surgery meant we would miss our flights, so Alx had been working on updating our plans.

We decided that taking a long-haul flight immediately after surgery was probably a bad idea. So we booked another Airbnb for the next night to give me time to recover in Dublin.

After that, a long flight back home still seemed like a bad idea. But the flight to Amsterdam was pretty short, and we already had our hotel booked. We decided to rebook our flights to Amsterdam and shift our meeting one day later. The doctor said I was supposed to take it easy after the surgery and avoid lifting heavy things, but otherwise they didn’t give me many restrictions. That would keep us from having wasted a ton of money on our trip and also would give me another night in Europe to recover before the long flight home.

After they left, the surgeon visited me and asked if I had any questions. I realized I didn’t really understand the mechanics of it all. I had my suspicions and fears, but I had to ask.

“So, are you going to make an incision?…”

He responded reassuringly, “Oh no, we don’t have to do anything like that. We don’t have to make any new incisions. We’ll go through the urethra and use the laser on the stone and then it will pass naturally. We don’t need to make any cuts.”

This reassurance had the opposite effect. The wave function of possible futures collapsed to confirm my fear. They were going to shove a laser device up my pee-hole. Sweet Jesus.

The hospital wound down for the night. I read more of my book until I felt tired enough for sleep. I put down the kindle and pulled up the bed sheet. It was too thin. The hospital was cold. Hospitals are always cold. I tried to find a position that wouldn’t pull on my IV line. I closed my eyes.

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The next morning arrived. Alx and Peter showed up before surgery. Alx is a protective and loyal person who cares about his team and his friends. He will take on hardship to make life easier for others. He makes sure everyone is safe. He has red hair and a beard and he tells dad jokes.

He was in touch with my wife and my mom back home, giving them updates. They really appreciated it. But something about it rubbed me the wrong way. “Oh, your friend Alx is so nice.” “Thank your friend Alx for me.” “Thank God for Alx.” I was feeling irrational and petty.

Peter is a brilliant and curious person who has made a career out of ignoring his comfort zone. He has a hillbilly beard, a mischievous smirk, and a philosopher’s soul. Sometimes over late whiskeys we’d try to shock each other into existential crises. But mostly we’d end up laughing.

Today he looked smaller, like he was eight-years-old. Like his parents were telling him they still loved him very much, but they didn’t feel the same way about each other anymore.

The orderlies arrived. They pulled the curtain around my bed and prepped me. They manipulated my privates in very unsexy ways. And then it was time.

I gave a thumbs up to my friends as the nurses wheeled my bed into the hallway. The countdown was palpable. I was an astronaut being led to the launchpad. I was an airplane taxiing to the runway.

I joked with the nurses. Showing them I was a good patient. There’s no fear here. What a good boy am I.

The urologist who would perform the surgery joined us at one point. Any more questions? This is very routine. No worries here. He moved off again through some other route.

Like a plane on our way to the runway, we had to stop and wait a few times. At one point the anesthesiologist took over. Just him and me.

He said to me, “So, I have to ask you something. This is awkward.”

This was a troubling opener.

He continued, “How will you pay?”

…

…

This did not compute. SEGFAULT ERROR

I didn’t understand the question. Is he asking about my personal finances? Do I have to figure out how insurance works right now? Do I have to do something to convert Dollars to Euros? Is this a shakedown? I imagined an underground network of Irish anesthesiologists extorting foreign patients. Lessen hayr. We can do dis ting in one o’ two wayz… Oy bet yull be wantin’ de good stuff, won’tcha nahw?

I looked up from my prone position. “Do I need to pay you right now?… I don’t have any cash on me. All my things are back in the room. How much do you need?”

“No, I mean, like today. How will you pay.”

“Oh, I was just going to pay with a credit card.”

This seemed to satisfy him. And with that we were moving again.

I looked up at the ceiling as he wheeled me down the hallway. The perspective gave me the impression I was in an elevator shaft, descending through the floors. Every door we passed marked a new floor. Down and down we went.

It occurred to me how very alone I was. None of my family was around me. Maybe none of them were even awake. If something happened, nobody would be here. No one could get to me. My trip felt selfish. All of my work trips were selfish.

We arrived in the operating room. It was a bustle of activity and… things. It didn’t feel fresh and new. It felt more like a cellar with stuff everywhere. I recall glass block windows to the outside, but maybe that’s my mind playing tricks.

They moved me to the center of the room and told me to get out of bed and lay myself on the operating table. They drew a curtain across my chest so I couldn’t see the preparations. A nurse brusquely wiped my privates with wet sandpaper while half a dozen people watched.

In moments I would be unconscious. This was routine surgery. Nothing to worry about. Except that any surgery can be dangerous. Especially when they put you under. I would almost certainly be fine. Unless I wasn’t. Nobody thinks they’ll be the exception. But the world is big. Lots of things happen everywhere, all the time. And every day some unlucky people draw the short straw.

I confronted the possibility I would not wake up. I thought of my wife, my family, my parents. I appreciated how fortunate my life had been. I tried to let go of any anger, hatred, or resentment I might carry. I did my best to issue a writ of forgiveness and mea culpa in my soul.

Doctor Shakedown tied a new line to my IV. The moment blurred. The world contracted, moved away, left me falling. I slipped into the dark.