November 2013 – The Anxious Traveler

If you’ve ever had to visit an ER or doctor in another country, you know how critical it is to have an emergency medical card, and several supplemental documents, with you at all times (or at least in your hotel room). Some of this medical and personal information seems pointless to write down since you can reel it off the top of your head, but most of it isn’t — and you don’t want to be kicking yourself for not having the contact info you need when you’re ill or injured so far from home.

Your emergency medical card (or page, printout, etc.) and supplemental info should include your critical health and personal data, and definitely not be left to the last minute since it can take surprisingly long (as in, upwards of eight hours!) to gather and list all the information. Sound boring and tedious to put together? It is — but hopefully the following can help.

Your card should include the names, phone numbers, and addresses or email addresses for the following:

1. Family member or close contact remaining at home;

2. Your doctor at home, your pharmacy, and your health care provider;

3. Travel insurance (and any medevac insurance) information;

4. Place(s) of lodging at your destination;

5. The U.S. Embassy or consulate in your destination country;

6. A list of your medications, including generic and brand names, reason for taking each, dosage information, and how often taken;

7. All medical conditions or allergies you have; and

8. Documentation of any immunizations required by the country you’re visiting.

Items to attach or keep with this card include:

1. A copy of your medical insurance card (keep the original in your wallet);

2. At least one insurance claim form (note that you shouldn’t have to navigate through the member services department of your HMO to get insurance claim forms; the travel clinic should carry them);

3. A signed letter from your physician describing your general medical condition(s), and all current medications;

4. The list of urgent care services and doctors that you have researched in each country (or, more likely, had your physician or travel agent research for you); and, if you’re traveling off the beaten tourist track:

5. The name of any medication conditions, and medications, written in the local languages of the areas you plan to visit. For translation services, try asking your travel clinic first since your main care practitioner may not know where to send you within your HMO or PPO. Note that it’s unwise to use a free online translation service since the software may misunderstand (or not understand at all) complex medical and technical terms and any abbreviations.

Keep the card and all supplemental documents somewhere where they won’t get wet or stolen (to be on the safe side, include one copy in your purse or smaller bag, and one in your checked luggage). Tell anyone traveling with you about the card and supplements, and their location(s).

While you’re busy compiling all this information, don’t forget to fill out the page inside your passport with the name, address, and telephone number of someone to be contacted in an emergency (you’d be amazed at how many people forget to do this).

Finally, before you go, be sure to register your destination countries, visit dates, and hotel addresses in your country’s traveler enrollment program. For Americans, this would be the U.S Embassy’s STEP (Smart Traveler Enrollment Program) system at https://step.state.gov/step/. If you do need urgent assistance from an embassy, STEP will already have your basic information on file.

Canadians should go to http://travel.gc.ca/travelling/registration, U.K. citizens should go to https://www.gov.uk/browse/abroad/travel-abroad, and Australians should go to https://www.orao.dfat.gov.au/orao/weborao.nsf/Homeform?Openform .

Prepare your card BEFORE your trip — and not while you’re killing time on the train!

At some point in our lives, most of us will develop a phobia. Some of us will develop a few of them, actually. Phobias come in so many forms, and many of them are so common, that most of us don’t have a problem talking about them — and they kind of ride along with us through life, like a minor sore on the back of our head. We even joke about phobias; they’ve become part of the popular culture. Claustrophobia. Agoraphobia. Arachnophobia. Many of us would rather talk in terms of “our phobias” instead of “our fears” or “our anxiety.” Phobias, being very specific in nature, usually have a good justification — something that most people can relate to and talk about without needing (or wanting) to go into three hours of miserable backstory of how they “got this way.” I have a real phobia about… yes, that just sounds so much healthier to describe the things that, well, freak us out.

Can you name your phobia(s)? Probably. But can you name all your fears? That’s undoubtedly a longer list. We develop fears before we can even spell the word, after all. And fear is an overused word. I fear this, I fear that. Technically speaking, “fear” is an unpleasant emotion caused by the belief that something is dangerous, likely to cause pain, or a threat. An emotion. Interesting. So what exactly, is a phobia?

Well, there are lots of long-winded definitions. But a phobia is basically a fear that impairs your life. Your unpleasant emotion had mushroomed into an aversion.

If you fear something, you can do it, see it, or live with it anyway. If you have a phobia about something… you can’t. You avoid it at all costs, even if you know you’re overreacting.

So would you still rather talk about your phobias than your fears?

The fact is, we can function just fine through life with a phobia or two. We can also live normal lives with a number of fears. But how do we tell when a particular growing fear has become a phobia? When does that fear lead to a condition where we’re shutting down a small part of our life — or making our lives more difficult?

I knew a woman from Toronto who wouldn’t drive at night, for any reason. She had to travel back and forth to Miami a lot for her job, and one fall afternoon her flight got delayed and she landed in Toronto at 7:30 pm. It was a calm, dry evening, and she was staring at her car in the lot, debating. She just had to drive to her small farm about 55 miles outside the city — a route that she knew well. Could she do it? No. She wasn’t even thinking about what had caused her fear, and eventually her phobia: a friend hitting an animal at midnight some years ago, and waking up in a ditch paralyzed. All this woman could think was: NIGHT: DRIVE: NO. Could she have taken a cab? You bet. But she walked to the nearest airport hotel, and put herself up for the night. Did this woman have a phobia?

I’ll compare her to a guy I sat next to on a flight from Casablanca to Lisbon last month. He was originally from Mali, mid-20s, loved to fly — and could tell me everything about the Boeing 767 we were on, bragging about the safety features as if he’d designed them himself. He admitted, though, that he had a real “hang-up” with flying over populated areas, and explained that’s why he loved our particular flight — because it was “all ocean.” I had to inform him that no, we were going to fly — pretty low, I might add — over the entire city of Lisbon before landing. He didn’t believe me until we blazed right over the Ponte 25 de Abril bridge, close enough to tell SUVs from cars.

Well, this guy went into a bit of a panic. Switching seats with me, so he could be in the aisle seat, didn’t help. But what could he do? Nothing, except live through his phobia, and wait for the plane to not suddenly clip a building or a power line. I thought about how, sometimes, not knowing everything about what we’re going to do is sometimes good, because you can end up looking your phobia right down the throat before you’re wound up in that anticipatory dread that helped turn the f-word into your aversion in the first place.

I didn’t tell the man this. I asked him to think about what our plane must look like to the people on the bridge, and the roads leading to the airports. Some of them had to fear that our plane would crash, inexplicably, into their paths, and end their ultimate journey. But they were still driving down there, even though there were plenty of places to pull over. They weren’t stopping.