Medical Meanderings: From dodgy diagnostics in the U.K. to a tree-filled quad in the Alpine Republic. A tale of two cities.

When a sympathetic African priest materializes at your Viennese hospital bedside, murmuring what sound like last rites, it’s forgivable to assume your time is up. “I’m fine”, I assured him. “Yessss, yessss,” he nodded, uncertain.

My English GP calls it “a rare and nasty immune disease”: It began with a tiny rash I noticed while swimming at the Porchester baths in West London. I discounted it as a result of the toxins left in a flat I was renovating – mold, rot, nicotine, and fleas from furniture-chewing dogs. The spots arrived a few days later and cratered, red and black lesions mottling my body below the waist, thankfully avoiding a rather sensitive area. The agonizing itching began that night. My skin was on fire. My legs looked like horror movie prosthetics.

I needed serious medical help

My maternal grandfather was one of the first wave of NHS  (National Health Service) GPs in the late 1940s, providing an essential safety net, especially for the self-employed – an estimated 15 percent of the workforce. However, the reliance on emergency services by the desperately underinsured has overwhelmed public health care systems, turning them into political footballs, as happened recently in the Brexit referendum fiasco. Among the many disastrous consequences, Brexit threatens the European Health Insurance Card, a lifeline for the millions of post-financial crisis Europeans forced to migrate for work.

With high hopes of a diagnosis and drugs, the next morning I exposed my legs to a randomly assigned doctor at my NHS surgery. After a cursory few minutes, staying safely behind his desk, he decided it might be insect bite related. I felt rushed, on a medical conveyor belt. He sent me away with a cortisone cream prescription, and the unsettling sensation I might be contagious. I was now patient zero in the London hot zone.

Two days later, with increasing desire to scratch my legs to ribbons, and disease-induced depression and exhaustion setting in, I revisited the surgery. “Wow,” exclaimed Doctor #2. Diagnosis? “No idea”, he replied breezily. I left anxiously clutching more cream and a prescription for some antibiotics. I felt no one was listening to me. At midnight, in desperation I called the emergency hotline at the Chelsea and Westminster Hospital, and was patched through to a weary consultant dermatologist. He finally put a tentative name to my affliction: vasculitis. That’s a disease in which the immune system attacks itself, causing painful damage to subcutaneous blood vessels and organs.

Finally someone cared

The good news? It was not the plague. The bad news? This rare disease, affecting fewer than 10 per million, could result in a lifetime of dialysis, blindness or worse.

The night shift dermatologist was surprised I had not been immediately referred to a dermatologist. With smartphone photos of my legs, he would secure a referral to the first available. I dispatched the photos to my surgery with a strongly worded letter, and, covered in cortisone cream, returned to Vienna.

By the time I had received an apologetic call from Doctor #2, a concerned Viennese dermatologist had already gouged a biopsy out of my leg, confirmed the seriousness of the condition and urgently booked me into a hospital. Finally someone had time to care.

My Austrian SVA medical insurance (€42 per month) fully covered my week at the Krankenhaus Hietzing, a weathered grande dame of a building whose endless waxed corridors resembled a Kubrick film set. Elderly patients glided silently past on their walkers, harried doctors appeared briefly for morning rounds, briskly competent nurses administered every test known to man. My room had soaring ceilings, huge windows to a tree-filled quad, and three beds. The homeless man in bed three, a dead ringer for Walter Huston in The Treasure of the Sierra Madre, was facing likely amputation of his gangrenous feet and hands.

Of queens, priests and tulips

My week consisted of multiple daily antibiotic IVs, CT scans, a sonogram, lung tests (using a breathalyzer), drugs that caused projectile vomiting, and food that was oddly devoid of most useful nutrients. My anxiety was relieved tremendously by an Austrian doctor friend who double-checked my reports and ensured I had undergone all necessary tests, including an eye scan at the Donauspital. With a disease as potentially life altering as this, it’s reassuring to have inside help.

Friends brought or messengered everything from a portable WiFi modem and fluffy pillow, to healing chakra oil and suspicious Mexican Quaaludes. Valentine’s dinner was a picnic in the ward, shared with a friend and my joke-cracking chief pathologist: “So the Queen Mother is in the kitchen searching for a gin and tonic, and finding her mostly gay male staff tipsy, declares, ‘You queens are drinking, while this queen is still thirsty.’ ” Surreal but funny.

As I checked out during a hectic morning emergency surgery, the same pathologist handed me my Entlassungsbrief (discharge letter): Diagnosis still unclear, despite the battery of tests, noted in detail. “Please, dear sir, come back in a week for a checkup.” A week later, my English GP concurred. “We must make a management plan. It is critical to take this seriously.”

Stress may have been partly responsible. Maybe I imagined the African priest. I told him he should be more concerned about old Walter Huston, silently staring at the tulips I left behind. Or the new mysterious chap in bed two with his face swathed in bandages.

From my comfy hospital bed in Vienna, I had supervised a flat renovation a few thousand miles away, made plans for new projects and written two articles. I was managing just fine.