All things good, bad or indifferent must come to an end

Getty Images/iStockphoto

In the 10 years since I began blogging, I have posted on this site my insights, quibbles, news, analyses, complaints, observations and random thoughts.

The blog evolved from the darks ages, when I emailed (then e–mailed) a weekly newsletter about real estate in an effort to market my business as a broker.  Its name changed from “Service You Can Trust” to “I, on Cambodia.”

This post is my one thousand-four hundred-twenty-ninth.  This post

Insurance decision will cost an expat no matter what

Part 4: It’s gonna hurt

(In my three previous posts, I explain the complicated decisions expats must face regarding their healthcare, especially when the unexpected occurs.)

Source: The National Academies Press

When expats consider medical insurance, they quickly learn the decision about getting or foregoing it can be complicated.

What they don’t always accurately take into account is how the costs of insurance will grow and how risky the lack of it can be.

Having it is expensive. Not having it can cost a bundle too.  Worse, not having it can be dangerous.

With insufficient insurance, inadequate personal resources or both, a patient who is unable to receive quality care in his or her adopted country or another one could end up permanently maimed.  Or

Deciding where and which treatment to get took days

Part 3: Lucking out

(In Parts 1 and 2, you can read how I came to be self-insured and how I struggled to decide what to do about my injury.)

The proof is the putting in of my bionic bone

Bangkok made the most sense to be treated.  But which hospital, which doctor?

Online, I checked three reputedly very good hospitals in Bangkok looking for a specialist whose training was not confined to Thailand.

I found an orthopedic surgeon at arguably the best and most expensive hospital in the country, Bumrungrad, which is among several there favored by many expats and medical tourists. A middle-aged Thai who has had training in the U.S., Dr. Siripong Ratanachai, telephoned me twice and answered my emails quickly before

Being diagnosed, picking doctor not a walk in the park

Part 2: New York or Bangkok?

(In Part 1, I discuss how exposed to major expense are expats who elect to go without medical insurance tailored to living abroad.  I also explain what went into my decision on purchasing a policy.)  

One day after surgery. I thank drugs for my smile and the hospital for my fashion statement.

Let me say that I never have thought of myself as the fragile sort of person who could easily break a hip like so many older men and women who topple because their bones give out while they are upright.  For them, such a fracture is usually the cause, not the result, of a fall.

After all, as I am inclined to boast, I work out daily with a combination of lifting weights or sweating on an elliptical training machine.  Then there are walks of several miles most days as well so as to help me manage my weight.

I also enjoy hiking, frequently upward, on vacations, so I’m unusually fit for someone my age, I like to think.

I confess viewing with horror the prospect of being referred to as “elderly” should I be so described as the victim of a crime or a collision with a motor vehicle.

My level of fitness undoubtedly contributed to my uneventful and quick recovery.  My bones, according to my doctor, are strong.

I broke my hip on a Sunday evening in July, and an x-ray Monday morning

An expat’s dilemma: Would getting sick break my bank?

Injured construction worker is to be transported to hospital.  Source: Phnom Penh Post

Part 1: Decisions, decisions, decisions

It began with my absent-mindedly stepping on a wet tile floor and falling down hard on my right side.  It ended with important lessons not only for me but for many others, especially older individuals, who also choose the expat life.

In addition, the incident could prove illuminating to anyone who seeks some insight into the complexities of obtaining first-rate medical care overseas, whether tourists or expats.

One of the lessons that I learned reinforced the importance of my paying undivided attention to where I walk, especially if I am outside in Phnom Penh.  I walk for miles everywhere, in large part for my health, despite the dangers that pedestrians face here. We cannot navigate cluttered sidewalks and must always be on guard in a city where the multitude of cars and two-wheeled vehicles pays virtually no respect to the right of way of pedestrians in seemingly chaotic traffic.

Equally important, the whole experience of my fall taught me that I had made the correct decision about medical insurance when I retired to Cambodia from Manhattan at the end of 2013.

Having done my research before my arrival, I learned that

In Phnom Penh, home often is where the tuk-tuk parks

See you again in September

Hammocks are a tuk-tuk driver’s best friend.

Drivers ordinarily store their clothes and other necessities seats.

It is a common enough sight to see tuk-tuk drivers sound asleep with their bare feet sticking outside their vehicles, mostly rented for $100 a month more or less, when the sun is high.

Less frequently, a pedestrian may well spot drivers taking more than a short nap when it is dark.

There is a simple reason:

Homelessness is not surprising, but its face has changed

Visitors to Europe expect to see sites such as the Eiffel Tower, the Colosseum and remnants of the Berlin Wall.  Probably most also are little surprised to see homeless individuals on the street.

But the sight of homeless (presumably) whole families like the ones in three of my photos can be jarring.  I know that I was shocked to see

Surprisingly, New York City is loosening its grip on me

The Oculus, imposing portion of New York’s transit hub cum shopping mall that I photographed near One World Trade Center (also called Freedom Tower) in downtown Manhattan.

Thirty-five years.

That is how long I had made my home in New York City — only in Manhattan, from Washington Heights to Greenwich Village — in two long periods before moving to Phnom Penh toward the end of 2013.

How I loved New York over any other place I had lived such as Boston, San Francisco, Hartford and the Washington, D.C. area, where I went in my relative youth to work in the Pentagon and again, in 1995.  At that time, I worked in the U.S. Treasury Department before heading back to Manhattan in 2006 after having transitioned to real estate sales.

To my mind, Manhattan’s highlights run the gamut of the many clichés that you know as well as I do — energy, diversity, cultural opportunities, Central Park and, among so many other attributes, paradise for a food lover.

Things don’t always work out, but I remain optimistic

The other passengers have just finished eating delicious food. I didn’t even start.

A brothel, a baboon and a bone-rattling drive have been some of the lowlights of travels you can read about in my previous posts.  In this one, you’ll discover how this scuba diver was led to water and left mostly high and dry.  After my trip to Bhutan, you’ll see how the drawbacks of climbing every mountain became clear to me and will be evident to you as well.

Last of 4 Parts

Travel insurance definitely would have eased the financial pain of one my most recent travel disasters, a scuba diving break.  Logistics forced me to take three airplanes each way from my home in Cambodia and spend two overnights at hotels in Indonesia both before and after.

Given that I parted with an unholy amount of cash for the five nights of diving from an exceptional liveaboard boat that cruised from the island of Flores, I conceivably should have considered that something could go wrong.

What went wrong, to put it mildly, was

Airports often confound, and 2 in Moscow led us astray

In the previous post, you can see what happened to me in Morocco, France, Suriname and South Africa.  Below, my experiences were. . . different.  A rocky road, sex acts on a temple and an odyssey between two airports in Moscow make clear how travel to foreign countries inevitably delivers surprises.

Part 3

On a trip to Nepal in the late 80s, two of us thought it would be a good idea to hire a car and driver to visit Pokhara, the country’s second largest city 125 miles from Kathmandu.  After the Siddhartha Highway was completed in 1968, the city became a popular tourist destination.

According to Wikipedia, most of the tourists visiting Pokhara trek to the Annapurna Base Camp and Mustang.  A longish walk far short of a trek sounded like fun, though