A Crash Course in Spanish Healthcare (Literally)

It’s been a while since my last update, and that’s not because I’ve run out of things to say. Quite the opposite. It’s just been… a lot.

Some of it has been joyful. The arrival of our new cat Rea was wonderful, and we travelled to the US for some family time at Thanksgiving.

Some of it has been hard. I won’t go into it here, but the recent loss of our dear friend David in Lisbon weighed heavily.

And some of it has been literally painful, in the form of a very undignified injury that has become our first real test of the Spanish public healthcare system.

Let’s start with the cats.

Lexie and Rea were playing together one evening when Lexie, in a moment of peak chaos, got her head stuck in the handle of a woven basket. She completely lost it. She was galloping in a panic through the apartment, howling and dragging the basket behind her like some kind of wicker death trap. I had about two seconds to react. I dove after her, managed to grab her mid-flight, and got her free.

Lexie was fine.

My knee? Not so much.

I landed hard. Really hard. The kind of hard where you just wait there for a moment, doing inventory. I also managed to tweak my already-sensitive hip (the one that eventually needs work) and by that evening, my entire leg was throbbing. Thankfully, I had some leftover Tramadol from my last surgery, and I was able to hobble through the next few days.

It started getting better — slowly — but was still bothering me when we left for our previously planned trip to Boston for Thanksgiving. By the end of that week, it was almost fine… until I stepped off the airport shuttle bus the wrong way and tweaked it again. Same knee, only worse. Just in time for a 12-hour journey home.

Fun!

When we got back to Valencia, Kristie finally convinced me that enough was enough and that it was time to see a doctor.

So, we headed to what I thought was the right clinic. This was the place where my assigned doctor had sent me previously for some tests. But unfortunately, that clinic doesn’t do urgent care. They sent us to the general hospital.

And this is where things got educational.

Urgent care here is a multi-stage process. First, you check in. Then you wait for triage. Then you wait for a consultation. The consultation doctor ordered an X-ray (to make sure nothing was broken), so off we went to radiology. Then we waited again for a second consultation, to review the results.

The good news: no broken bones.
The bad news: soft tissue damage doesn’t show up on X-rays.

The doctor said I needed an MRI to figure out what was really going on. But here’s the catch: urgent care can’t schedule that. Only your assigned primary care doctor can. I was sent home with painkillers and told to make a follow-up appointment.

I scheduled a phone appointment. To his credit, my doctor actually called a few minutes early. But: he needs to see me in person before making any new referrals. (Fair enough, honestly.) At this point, I’m headed to see him in the morning, and we’ll see how it plays out.

Things can go one of two ways:

Option A: Best Case
I already have a referral appointment with an orthopedist, but it’s not until April. Given the secondary injury, the doctor can decide that this needs priority attention. He changes the status of my case to preferente (urgent), which gets me an earlier appointment with an orthopedist, who can then order a rapid MRI and move things forward quickly.

Option B: The Long Game
The doctor decides it’s not urgent (or not urgent enough), and schedules the MRI himself, which could take a month or more. If that happens, we’ll likely go the private route. We have insurance, and while I want to work within the system as much as possible, I’m not willing to live with this kind of pain for weeks waiting on an appointment.

If the private MRI shows something significant, I’ll bring the results back to the doctor and try again to have the case upgraded.

I’ll be honest: the public healthcare system here works, but it’s not exactly streamlined. You don’t just get a referral and show up for a test. For example, my doctor previously wrote orders for some routine clinical tests (bloodwork and so on) which have to be done at a completely different clinic. To schedule them, I have to physically go to there just to make the appointments. (There is an app for prescriptions and requesting primary care appointments, but not tests.)There is almost no chance of getting same-day service. And depending on how things are booked, I may have to return on different days for each test.

It’s functional, but definitely not frictionless.

Still, I’m impressed by the care itself. Almost everyone I’ve encountered has been professional, competent, and kind. And aside from a few small charges (under €2 for pain meds), everything has been free. No co-pays. No bills. No insurance cards. Just your SIP card and your ID.

What happens next depends on how tomorrow’s appointment goes. I’m hoping we can shift into the “preferente” track and get this figured out quickly.

In the meantime, I’m walking, but using a cane, definitely slower and with more wincing than usual. And I’m still trying to live the rhythms of Spanish life, even if I’m doing it with a bit of a limp.

There will be an update once we have more clarity. In the meantime, we’re doing what we always do: learning the systems, navigating the bumps, and trying to live well in a new country, bruises, bureaucracy, and all.

Oh, and Lexie? She still loves that basket.

We’ve hidden it.