Accompanied by LA cop Harry Bosch, I made my way to the cruise ship's medical centre for another round of treatment. Harry and I were to get to know one other well over the coming days.
The simple, rather small, rash on my lower legs had been brought on, I reasoned, by walking at least 16km in a day when the temperature sat around the 30-degree mark. But when it hadn't retreated a day later, I decided to visit the ship's doctor.
If you're a reader who skips to the end first, let's just say the rash was never formally identified but I did step out of the clinic much lighter – in the pocket.
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My hopes of being given a topical ointment and sent on my way were dashed as the middle-aged doctor fired questions and handed me to Manuela the nurse for intravenous antibiotics. Really? For a (self-diagnosed) heat rash? Turns out "Doc", as his co-workers called him, was treating me for phlebitis, or vein inflammation which can cause blood clots. Yikes.
Day 1 was 30 minutes' worth of IV, plus shots, through a double shunt line of anti-nausea medication and a diuretic, that stayed in my arm right through the "enrichment lecture" I attended afterwards. Back upstairs the surroundings were again sumptuous, rather than workaday, and the bathroom nearest the lecture theatre, which I got to know well, no exception.
I was told to return that evening for another half-hour of antibiotics. "Come early," the nurse said, "and I'll get you started before the clinic opens."
What she meant was, come before the clinic opens to passengers. In the waiting area there were crew members already in line, including one bleeding through his first aid bandage. It's easy to forget when you're ordering lobster from a smiling waiter that there's another, invisible, crew doing the grunt work.
Day 2 and again Doc poked and prodded at my rash (he never seemed to believe it wasn't sore) and decided maybe it was cellulitis and an extra antibiotic was required – which meant another hour in the clinic. He also demanded I go to an emergency room during that day's stop at Zeebrugge, just outside of Bruges, to check for blood clots, and absolutely no walking.
Which is when I rebelled, slightly. No shore hospital and I would go into town. "Okay, minimal walking only." But with temperatures still high I did take it easier – fortunately I'd visited beautiful Bruges twice before, so didn't feel short-changed.
The only thing to do while the drip dripped was to read, chat to Manuela, on her last cruise after eight years at sea, and eavesdrop on others arriving in the clinic, including an older American who had uncapped his medication a bit forcefully and lost two tablets down the hand basin. "I brought the exact amount with me," he said, "so I'd like two more please."
It wasn't that simple. He had to see the doctor. "But I have my prescription and the container with my name and the name of the medication on it." He had to see the doctor. "But …". He had to see the doctor.
According to Cruise Lines International Association, in 2018 14.2 million Americans went on a cruise – and America is a litigious society. The medical team's caution came as no surprise and, unfortunately, neither did the eye-watering cost of the medication and treatment (ship's clinics are classed as emergency treatment centres, which doesn't help). And that is why, dear reader, you must never, ever leave home without travel insurance.
Day 3 was disembarkation in Amsterdam. Again Doc instructed me to go straight to an emergency room. When I told him I was being met by a friend, Harry, who was a GP, his face lit up. "He will take you to hospital, good." Harry took us to the beach.
Manuela's farewell gift to me was five days' of oral medication and two thick A4 envelopes – one of notes for my doctor, and the other paperwork for an insurance claim.
And then finally, just for a moment, Doc and Manuela dropped their severe, professional manner. Doc pointed to his framed practicing certificate hanging crookedly on the wall and he and Manuela burst out laughing. "He says he should really straighten it, but it doesn't matter because it's out-of-date anyway." (His up-to-date one was, apparently, in a drawer.)
As for the final denouement. A (free) scan by Dr Harry showed everything was normal, no clots. And the rash? Perhaps exercise-induced vasculitis exacerbated by the heat… and it hasn't happened again.