My family had just arrived at a seaside village on the east coast of Spain, where I was sitting on a white sand beach looking out at the implausibly blue water. The scene was straight out of a Mediterranean daydream, and yet I was panicking. 

My head was throbbing and had been since I’d slammed it into the bottom of a metal hotel safe a few days earlier. The pain and pressure had been keeping me up at night, along with the anxiety that came from Googling my symptoms. I’d tried every kind of medication I could find, but nothing could ease the pounding in my skull. 

After returning to our Airbnb, my husband urged me to make a telehealth appointment through our international health insurance. (As an American family living in France for the year, we were required to purchase this as part of our visa application.) A few minutes later, I described my symptoms to a Spanish doctor via chat using Google Translate. Hearing how long the pain had persisted, he advised me to see a doctor to rule out a brain injury. 

I frantically researched doctor’s offices nearby, but the remote region had limited options, and I wasn’t even sure how or where to secure an appointment. So, instead, we decided to go to the nearest emergency room.

Leaving our son with his grandparents, my husband drove us to a small city about 35 minutes inland. As we pulled into the hospital’s parking deck and then walked toward the front desk, I was struck by how similar it looked to hospitals in the U.S. My husband, thankfully fluent in Spanish, took the lead as we checked in, but the receptionist switched to English when she realized that I didn’t speak Spanish. 

The receptionist asked for proof of our public healthcare coverage, but I explained that I have private international travel healthcare coverage — essentially expat insurance. She apologized, explaining that I would have to pay out of pocket for the ER visit and then request reimbursement from our insurance company since I hadn’t secured prior approval for the hospital visit.