David

By way of background, my wife and I returned about three and one-half weeks ago from an anticipated 10-day trip to Bali. Obtained a great airfare on Cathay from San Francisco, via Hong Kong, back last June. We live in the western USA and are both professionals, in our mid-50s. We are fairly well travelled, throughout the world. I frequently use fodors.com to plan trips, although it has been quite sometime since I last posted on this website.

Departure from San Francisco to Hong Kong occurred as scheduled. The trip on Cathay Pacific (in economy) was actually quite pleasant. We took the daytime flight (departing San Francisco at about 130 p.m.) and arrived in Hong Kong at about 630 p.m the following evening. As our departure to Denpasar was not until the next morning, I booked us into the Novotel Citygate, about 5 miles from the Hong Kong airport, for the night. Instead of waiting around for the free hotel shuttle, we simply took a cab from the airport to the hotel, and arrived at the check-in desk within a matter of minutes, after clearing customs and immigration in Hong Kong.

The Novotel Citygate was quite nice. We had slept pretty well on the flight so went to the lobby bar for a couple of glasses of wine and a light dinner. Excellent. The room was very nicely furnished, with incredibly comfortable bedding, and we slept well that night. The next morning we took the hotel's free shuttle to the Hong Kong airport for our Cathay check-in and flight to Denpasar.

Flight to Denpasar was full, but uneventful. Arrival in Denpasar was on-time and we quickly cleared customs and immigration. Upon exiting the airport, I turned right and went directly to the taxi arrangement stand for a cab to Sanur and the Bali Hyatt where we had reserved a room for the next five nights. Following a very uneventful, 30-minute drive (95000 Indonesian Rupiah, plus tip), we arrived at the Bali Hyatt.

Although an older property, the Bali Hyatt suited our needs perfectly. The landscaping is superb, as are the hotel's two pools. As we are not particularly interested in the beach, we concentrated on the pools, although plenty of people were at the hotel's beach. We stayed on the Regency Club level and took full advantage of the breakfast and afternoon cocktails each day. The Bali Hyatt's Regency Club couldn't be nicer, nor the staff more accomodating. Absolutely wonderful. Interestingly, however, we only ran into two other Americans while at the Bali Hyatt. The place is packed with Eastern Europeans.

During our stay at the Bali Hyatt, we explored Sanur, dined in local restaurants, and toured (with a private driver and guide, arranged by the hotel) portions of Bali. We absolutely loved the Bali Hyatt, its staff, facilities and amenities. Couldn't have been any nicer. One day, we took the hotel's free shuttle to the other Hyatt on Bali, as Nusa Dua, and enjoyed that as well, although in Nusa Dua you could just as easily be in any planned development community on earth. I will say, however, that the beach at Nusa Dua (despite the fact that we are not generally "beach" people) was absolutely georgous. Incredible.

From the Bali Hyatt we took a taxi to our next stop, Ubud. Although the hotel attempted to arrange transportation for us, at a cost of $45.00, they readily acquiesced to our request for a regular cab, at a cost of only about $22.00 (plus tip). In Ubud, we stayed at the Komaneka at Monkey Forest Resort.

The Komaneka was simply incredible. We were in a room with a plunge pool, overlooking a ravine filled with tropical vegetation. The staff was wonderful and very helpful. The breakfasts were excellent. The place is the type of place where dreams are made.

Our first two days in Ubud were mostly spent exploring the city. We visited the palace, temples, markets and botanical gardens, walking everywhere. We shopped. We ate in the local restaurants and drank. We "plunged" in our plunge pool and had a great time.

For the third day in Ubud I booked a bicycle tour through the hotel. I had seen a brochure and both my wife and I thought the tour would be fun. The tour operator picked us up at the hotel at about 730 a.m. and we joined four other couples for what we expected would be a fun and informative day. From the hotel we proceeded into the Bali highlands, to the edge of the volcano where breakfast was served. We started to get to know the other couples on our tour (from England, Switzerland, Russia and the Netherlands). Our guide was very informative and enthusiastic. From our breakfast place, we went to the spot where they assigned us our bicycles (and helmets) and we started off on our all-day trip. For the first three hours we stopped at villages, rice fields, temples and other sights. The trip provided a fantastic insight into rural Bali. The guide couldn't have been more informative, nor the sights more interesting and beautiful. It was a great trip.

As the bicycle trip was mostly downhill, the heat was not a particular problem, although I remember being thankful that the sun had retreated behind a cloud. I also remember being at the end of our group, just ahead of my wife, and turning a very sharp corner while thinking to myself "boy, you're going fast." The next thing I knew, I heard a crash behind me, along with a scream. I slowed my bicycle, turned around, and noticed my wife had crashed and was laying in the middle of the road.

I immediately turned around and went to my wife's aid. She couldn't move out of the road and appeared in shock. I moved her bicycle off to the side of the road and tried to get her up and off of the road. But she couldn't move. I then had to hoist her off the road, onto the side of the road in order to permit the limited traffic on the road to pass. After a few minutes, during which I simply thought she'd catch her breath and all would be O.K., she still couldn't get up and onto her feet. Fortunately, we were being followed by the van associated with our bicycle tour group and the van stopped. The driver of the van helped me get my wife into the van (with difficulty as moving her caused great pain). We spent a few minutes trying to figure out what might be wrong. Then, the van driver began driving us toward the place were we were supposed to have lunch that day, as part of the tour. Upon arrival at the lunch spot, my wife still could not move and I asked the driver if he could return us to Ubud and to a hospital or clinic. He did so, although Ubud was about 20 miles away.

At the Ubud clinic (not hospital, simply a clinic) no one spoke English. They're probably still laughing about the idiot American man who accompanied his injured wife and, when English didn't work, attempted to speak with them in broken French and German (which they also didn't know). They put my wife on a stretcher and took her into an x-ray room where, with an x-ray machine which must have been 40 years old (and which caused all the lights to go out in the clinic when they turned it on), they x-rayed her hip and leg. 40 minutes later, after the x-ray film was finally developed, it was clear that she had broken her femur and pelvis during the fall. She also complained of a sore arm, but the x-ray in Ubud showed no break in the arm (the fact that she broke her arm was later confirmed three days later in Singapore with better x-ray technology). The clinic doctor spoke no English (neither did anyone else), but the x-ray was clear --- she was in trouble and we needed some help.

Somehow, someway, the clinic managed to get her on a different stretcher and into an ambulance (a mini-van, actually, which held a stretcher) and off to the BIMC hospital in Kuta/Denpasar (between the two). There, English was widely spoken and the x-ray equipment was much better. By the time of our arrival at this hospital, it was about 400 p.m. and, after initial treatment and analysis, they called in a local orthopedic surgeon who, although helpful, advised that he could not repair her injuries himself. He stated that he had neither the skill nor the equipment there for her injuries. I (stupidly, I guess) asked him if I could get her back to the United States. The answer was "no." Our only options were evacuation to either Western Australia or to Singapore. The doctor recommended Singapore and I remembered reading, probably in either "Time" or "Newsweek" a few years ago, about the outstanding quality of health care available in Singapore. So we chose Singapore.

Meanwhile, all of our things were back at the hotel in Ubud. As my wife was, by now, somewhat comfortable in the BIMC hospital (lots of pain medicine, along with weights hanging off her leg), I left the hospital that evening for a harrowing taxi ride (about 40 miles) back to the hotel in Ubud. The cab driver was burning incense and listening to the latest "Bollywood" tunes throughout the ride. Meanwhile, he drove what seemed like 100 miles per hour, through monsoon rains like I've never seen before.

Upon arrival back at the Komaneka in Ubud, I told the staff at the front desk what had occurred. They provided me with a computer with which I got in email contact with family back in the U.S.A. Most importantly, however, I was able to get in contact with our local health insurers in an attempt to ascertain what I should do next in an effort to evacuate my wife to Singapore and to some decent, competent medical treatment.

The insurance companies were amazingly, and surprisingly, helpful. The terms of our policies required that they arrange the evacuation. So throughout the night I was on the phone with their representatives in New York and in Toronto. Call after call after call. Finally, by morning, they had arranged an air ambulance from Denpasar to Singapore, accompanied by both an Indonesian doctor and nurse, for my wife. There was no room on the air ambulance for me, nor for our bags, so I was told I'd be on my own.

But the air ambulance transfer could not occur without me first providing a written credit card authorization. For hours and hours they attempted to fax the credit card authorization form to me at the hotel. For some reason, the hotel's fax machine would not accept the incoming fax. Then, they attempted to send it to me as an email attachment, but I could not open it. In complete frustration, I called them again and told them that I simply had to get packed and back to the hospital and that I'd be back in touch with them. By the time I finished packing our things it was about 730 a.m. and I was heading out of the hotel.

As I was leaving the hotel, the entire hotel staff was assembled in the entrance/lobby to tell me how sorry they were to have heard the news of my wife's injury. I paid the hotel bill and they presented me with the most incredible flower arrangement imaginable (more than 40 roses, plus orchids, etc.) to take to my wife. They also gave me a big chocolate cake, which they had prepared for us the day before, as the day of the accident happened to have been my birthday. The cake said "Happy Birthday, Mr. David."

Stuggling with the suitcases, the flowers and the birthday cake, the hotel arranged a private car and driver to take me back to the hospital. Eventually, I arrived back at the hospital at about 845 a.m. and learned that throughout the night the hospital staff had arranged a transfer to Singapore themselves (at one-third the cost of the air ambulance arranged by our insurers in the USA and Canada). This hospital arranged transfer was to depart the hospital (via ambulance) at 630 p.m., for the 830 p.m. flight (on Garuda Indonesian Airlines) to Singapore. Upon arrival in Singapore we were told we'd be met by an ambulance.

Throughout her stay at the BIMC hospital in Denpasar/Kuta my wife was very comfortable and she was very well taken care of. I was somewhat annoyed by the fact that every time they wanted to do something for her they felt they had to ask for my permission and provide me a price quotation. First it started off with "Sir, your wife needs some pain medication but it will cost you 75000 Indonesian Rupiah per pill." Then, when I heard "sir, we believe your wife will need to spend the night here in the hospital but it will cost you an additional 5.5 Million Rupiah" I wanted to say "WTF, you think I'm going to have her spend the night on the curb, and without pain medicine, in the monsoon rain with her injuries?" but I restrained myself. But my nerves were quite raw throughout all of this, you must understand.

Anyway, the transfer to the airport occurred as scheduled. I had to check in as a regular passenger and my wife, along with the doctor and nurse, somehow went another way and onto the airplane. My wife was on a stretcher which, once on the plane, was situated in the back of the plane, over three rows of folded-down seats. The doctor, nurse and I sat across the aisle from my wife. Throughout the flight, the doctor administered nearly continuous pain medication to my wife who now has very little memory of the transfer from Denpasar to Singapore (thankfully).

Upon arrival in Singapore, an ambulance awaited us on the tarmack. I had to clear immigration and customs (and collect our bags) and I waited on the curb, outside Changi airport's baggage claim, for the ambulance. It eventually arrived and off to the hospital it rushed us. We arrived at the hospital at about 100 a.m. and they were expecting us. My wife was taken into a private room (where I was able to stay with her the entire time during her stay in the hospital --- this was fortunate as I had not had time to consider where I'd be staying in Singapore). About an hour later, at about 200 a.m., an orthopedic surgeon arrived to advise that he'd scheduled her for hip replacement and pelvic repair surgery the next night at 630 p.m. That night was rough for my wife, but the next day was absolute torture as they weaned her off the massive doses of pain medicine she'd been given in Indonesia and throughout the air evacuation. Meanwhile, we'd said our "good bye" to the Indonesian doctor and nurse and, now, the folks in Singapore took over.

Like I said, the next day was torture for my wife. By about 300 p.m. the pain was nearly unbearable for her. The only thing I could think of doing was to try to imitate the lamaze exercises we learned together 25 years earlier when our son was born. Only I had forgotten that labor pains come and go. Unlike labor pains, this pain wasn't going away. It was only getting worse.

Finally, the time arrived and they took her down to surgery. By about 1000 p.m. they called me and I went into the recovery room. Having had no experience with such things I was (frankly) shocked by my proximity to what was going on at the time. Not an experience I desire to repeat again. I stood there as they worked on her, post-op, and brought her to a state where she could return to the room, at about 1130 p.m. that night. By this time a full 60 hours had elapsed since the bicycle accident.

Throughout that night she was coming into (but still mostly out of) consciousness. It was not pleasant for me, but probably not unpleasant for her (a good thing). She remembers none of this. The next morning she was attached to all sorts of drip bags, morophine drips, blood transfusions and drain bottles. Not pretty. Again, she remembers very little of this. Fortunately, a catheter was connected so that was not a problem.

Gradually, she became more herself over the next two days. On the third day following the surgery they got her up out of bed. And to the restroom for the first time. Attempted to get her to walk with a walker. Provided exercises to do in bed, including breathing exercises to clear the lungs. Each day saw improvement. On the fifth day following surgery, she was walking (very, very carefully) with a quad cane.

Throughout all of this, the doctors showed up precisely on time each day. If they couldn't make their designated visitation times, they would appear the evening before to apologize for the fact that they would be late the next day. Incredible. The nursing staff was similarly incredible. They couldn't do enough for my wife, nor could they do it fast enough. Absolutely like nothing we've ever seen before.

After about a week, I asked the doctor about returning to the USA. I actually had already booked us seats and wanted his blessing on my plans. He stated that he thought my anticipated departure date was reasonable (assuming no unanticipated complications arose) and we worked toward this goal. Finally, after 11 days/nights in the Singapore hospital, we departed for San Francisco, via Hong Kong, on Cathay Pacific. Wheelchair assistance in each airport was pre-arranged and we learned how to inject my wife with anti-coagulants throughout the flights. We arrived in San Francisco as scheduled, rented a car, and drove home, four hours away.

Throughout the Singapore phase of this ordeal I was responsible for figuring out how to pay for all of this. Although I recalled that our health policies covered all of this, they were unable to confirm coverage while we were in Singapore. Therefore, I was responsible for paying cash for everything. Actually, they took VISA, and I've never had as big a bill as we returned home from this trip with. The insurers were, however, helpful in advising of what they anticipated costs would be (thus permitting me to increase my VISA credit limit from the hospital in Singapore) and in advising what sort of documentation they would require to substantiate our claims upon our return. But I was responsible for paying for all of this, before we could leave the hospital and return to the USA.

So I paid it all and, within two days of our return to the USA, I had assembled detailed claims for our insurers. To make a long story short, all was paid for, minus a $200.00 deductable, applicable under the terms of my wife's policy. They even covered my transfer from Denpasar to Singapore, along with the cost of me staying in my wife's hospital room with her. Amazing. But, I've since learned, the total bill (including the $8000.00 transfer from Denpasar to Singapore) was only about one-fifth of what it would have been in the USA. So they got a deal, I suppose.

Anyway, nearly five weeks after the accident and my wife's surgery, she'd doing quite well. She has not yet returned to work, but will in a couple of weeks. She's walking fairly well (better every day) and is without pain, although the leg and hip are somewhat sore at the end of the day and sleeping continues to be somewhat difficult. Has this experience killed our desire to travel? Not a bit, although we might be a little more selective/careful with respect to our activities at our next destination. And we probably won't be skiing this winter up at Lake Tahoe. But we've already got tentative plans for a two-week trip to Malaysia next year, in 2009.

Hope you enjoyed this story. We did love Bali (until the accident) and will return someday. You know what? We travel fairly frequently. I always expect to get ripped off by a cab driver somewhere, maybe to be shortchanged by a waiter or to be assigned the worst room in a hotel. But in all of our travels (and we've been nearly everywhere), it never occurred to me that we'd experience something such as this. It never entered my mind that this could happen to us. Honestly.

dogster

Wow David. There but for the grace of God... eh? Every travellers nightmare - and a great read.

Thanks for posting it, pal. I do wish you both well. Yes, BOTH of you. I reckon your ordeal was as horrible as your wife's. Wow. Impressive that you battled your way out of it the way you did. Scary stuff.

Bella_Bluebell

Hi David - I hope your wife continues to recover well. I think it must be very frightening to deal with a medical emergency when you are abroad. I have done that bike ride - it is beautiful I agree - and my husband had me in fear as he mountain bikes and was going at a hell of a pace. Thank goodness your wife had a helmet on. It sounds as if you held it together incredibly well and were a rock for your wife, it must have been so incredibly difficult to see her in so much pain. Best wishes to you both
BB

Gpanda

Glad to hear that your wife is progressing well. The report was frightening. You seemed to handle the severe challenges with unbelievable equanimity. It's amazing that your insurance covered everything.

DonTopaz

Yikes.

tengohambre

That is a harrowing tale. Very glad things worked out, considering everything. It is also another example of how just about anything can happen anywhere. Good luck with continued recovery and future travels.

David

Yes, Gpanda, the insurance coverage (along with the speed with which they processed the claims) is amazing. I'm an attorney and, frankly, I was well into gearing up for what I anticipated would become a multi-year battle with them. But they certainly surprised me.

On other notes I forgot to mention in the original post --- neither my wife nor I can overcome (at least not yet) the fact that an entire (and very large) cast of characters, 11000+ miles away, entered our lives in such a significant (and intimate) way throughout this situation and that we'll never likely see or encounter them ever again. I'm sure the passage of time will ease the fact that we both keep finding ourselves drifing off to Singapore time and thinking about them and what they did for us, in a real time of need. Additionally, after that long in a hospital, you do get to know the staff (somewhat) and our discovery (face-to-face) of the level of economic displacement in the world (which we knew of, intellectually, at least) is staggering. Many of the hospital's staff were from elsewhere (i.e., Burma, India, Bangladesh, Brunei, etc.), working in Singapore under long-term contracts in an attempt to make a better life (economically) for themselves. All had left family and friends behind in their home countries. Many spoke excitedly of having "only" two or three years remaining under their contracts, when they could return to their home countries and families. For lack of a better phrase, I call it "economic displacement," the enormity of which is truly staggering. And economic displacement doesn't even consider the level of displacement occurring as a result of tyrannical governments, natural disasters, etc. Simply stunning, to us at least. Anyway, despite all the problems (and there are plenty of them) here in the USA, we are beyond blessed with what we have, and we know and appreciate it. This trip, with our experience in particular, really hammered that fact home for us. Unlike any other trip we've previously taken.

cruisinred

Wow, what a horrible accident. But glad to hear that your wife got great care in Singapore and is recovering well.

Two questions, if you don't mind. Why did they need to reduce her pain meds?
And, did you take out travel insurance for the trip, or were you covered by your home insurance plan?

rhkkmk

very interesting report...it could happen to any of us...
glad the boss is getting back on her feet....

David

Cruisinred --- The Singapore doctors advised they needed to reduce the pain meds, after the air evacuation from Denpasar to Singapore, to prepare for the general anaesthesia she'd be receiving during the surgery. At least that's what they told me and, believe me, she was pretty high throughout the stay in the BIMC hospital in Indonesia and the air evacuation. In fact, I questioned why we needed to be accompanied by an Indonesian doctor (and nurse) but soon discovered that the doctor kept administering IV pain medication, nearly continuously, throughout the evacuation. Thank goodness. And as for insurance, we had no special travel insurance --- it was all covered by our personal policies --- we were lucky this time, although special travel insurance would have speeded up the transfer from Indonesia to Singapore significantly and would have also eased many hours, days and weeks of worry/concern over whether this really was covered under the terms of our personal policies. I'll be looking into special travel insurance on future trips.

Kathie

What a tale! Thanks for sharing it with us. My best wishes for your wife's speedy recovery.

I have a question which may be helpful to any of us should we find ourselves in a similar situation. First, did you have a separate med evac policy or was your night of trying to arrange the evacuation on the phone with your regular medical insurance or with travel medical insurance? If you had a separate med evac or travel medical insurance policy, can you share the name of your insurer?

Craig

Thanks so much for posting this. My wife and I have been members of DAN (Divers Alert Network) for several years just to get the evacuation insurance. Even though evacuations are covered by my group health plan, I feel its necessary to have a back-up. The $44 cost of the annual family membership is worth it for the piece-of-mind. Your story confirms my worst fears about dealing with the health care insurance bureaucracy during a stressful situation far away from home. I am glad to hear that everything worked out well for you and that your wife is on the road to recovery.

Shanghainese

David - Thanks so much for sharing the unfortunate details of your trip, gives us lots to think about. Glad to hear your wife is recovering so well, and season greetings to both of you.

Femi

I found your post reassuring. We rarely hear about when things go wrong (I mean really wrong) on trips. It's good to know you received care that was just as good (in some instances better)than in the US.

Kathie

David, you and I were apparently posting at the same time, so you answered my question about insurance.

Like Craig, we carry the Med Evac insurance through DAN, but do not carry any additional travel medical insurance.

marya_

David, thank you for sharing this harrowing story. We all worry about the possibility of such an experience when we travel abroad for extended periods so it is extremely helpful to read how you managed throughout this ordeal.

Last year, my husband wasn't feeling well here in the US before boarding a flight for Asia so he (thankfully) went to the hospital instead of the airport. A nightmarish journey through a complicated quintuple bypass and long hospitalizations followed. I tell you this for two reasons. First, it was a lonely and agonizing process to be the spouse even on home soil so I am filled with admiration for your coping ability under such challenging circumstances abroad. Second, my husband has made a full recovery and is back in the routine of 2-3 week trips to Asia every other month.

Best wishes to your wife for continuing recovery so that you may resume travel planning together. Thanks again for your generosity in sharing this story.

anatoleschadenfreude

As an obsessive cyclist and man fond of Bali and Asia, this is an amazing story. Bikes are great, but the damage is also great when it happens. Your wife was so lucky to have you there to guide her thru all this. I am also so pleased that you illustrated your own humanity in recognizing the people who helped you.

atravelynn

And not what you expected when you left home. It turned out amazingly well. The send off by your Bali Hotel staff is quite touching.

Hopefully your bad luck while traveling has all been used up.

skittle

Hi David
Pleased to hear you wife is on the mend. We were in Bali at around the same time. I would have liked to go on the bike ride but my husband said" I don't think you ride well enough, I don't want you to end up in some Bali hospital." Wow, By the Grace of God go I.
One question. We take travel insurance everywhere we go O/S because our medical insurance does not cover us. Does everyone have to find the money to pay and then claim it back? If so, if this accident had happened in the US we may need to have access to a lot more than what you could put on a credit card.

jenskar2

David -- thank you for sharing your experiences and all best wishes to your wife. I think you've kindly given many people who follow this forum more confidence in the medical care they can expect in Singapore if something major happens, and that is a real gift.