Our Trip to Siena

If I had a category for overshares, this post would probably go in it…. But here goes.

Our trip to Siena last time, ten years ago, was an overnight and for some reason, this time, we booked it as an overnight again. We were having some regrets about that but figured that we’d arrive in the early afternoon giving us most of the day and evening to explore before we had to check out the next day and hit the road for our next stop: San Gimignano. When Melissa came to Italy with her friends before me she talked about a few things they loved: the trains, the sandwiches, the food, the David in Florence and she talked about her fascination with the preserved finger and head of Saint Catherine in Siena. And for whatever reason, when we came here last time, we didn’t go inside the Duomo where they reside. So I even said to her in Florence: “when we get to Siena, I need to see that finger”.

Last fall, I was diagnosed with a heart condition you’ve probably seen on commercials: Afib. I’m healthy, I’ve lost a lot of weight over the past ten years (and kept it off) and am now at a relatively healthy one. I’m middle aged but relatively young and have no other risk factors so, aside from the occasional discomfort of your heart racing and fluttering like an over caffeinated college student taking a final exam on no sleep, lots of no doze and pumped full of coffee, because my stroke risk is lower than if they put me on some of the meds they would prescribe if I had more risk it’s been well managed. I’m in good company. Lots of people have Afib: Joe Biden, Larry Bird, Miley Cyrus, Gene Simmons, Howie Mandel, Ellen Degeneres, Barry Manilow to name a few. And I’ve had many people tell me that they have it or their spouse, father, mother, uncle or cousin has it since being diagnosed. So that helps, I’m not alone. But, I’ll be honest, it’s been an adjustment. It’s scary and it sucks and I cut back on booze to nearly none (I usually had a medium sized vodka martini and maybe two glasses of wine or beer a night, occasionally more, sometimes less) as that, they figured, was my trigger. But, as we hit the road my nearly no booze crept up to one or maybe two and very very occasionally three drinks in a given day if I had a glass of wine at lunch. Most commonly it was now two drinks. And we are talking red wine except for an occasional beer. No scotch or whiskey or gin or any other hard liquor I rarely drank anyway. I guess this is my body’s way of saying: “hey buddy, you missed last call and it’s closing time”. And let’s be honest, I’ve had my share plus of drinks in my lifetime, so easing back on the gas a bit won’t hurt.

In any event, with reduced booze, and that being only wine, I was having occasional monthly short episodes of Afib and it seemed manageable. And the distance between drinking anything and an afib bout didn’t seem to correlate at all so we had kind of figured maybe alcohol isn’t really the trigger, or at least my trigger. And maybe it isn’t, the jury is still way out on that and based on what we’ve read and discussed with both my cardiologist and other medical friends they aren’t really sure what causes it and since alcohol was my only risk/discernible trigger we determined that this was probably it. So, we thought, this is no big deal and we are making it work with light to moderate wine intake and a monthly bout for 20-30 minutes is not something to get too stressed about… until…

A week ago, I had an episode that lasted five hours. I came out without even taking my “pill in a pocket” (as I have all other times) but it was exhausting. So, I figured it was time for a purge and a cleanse. It sucks to be in Tuscany and not drink any wine, but things really and truly could be a lot worse. You’re in Tuscany for godsakes after all, you whiner.

So, we set off from Florence, on the train, to Siena and my heart went into overdrive. So much so, I started to really worry and was willing the train to move faster than it’s scheduled time. Upon arrival in Siena, I explained to our taxi driver, in broken Italian and he in broken English, to take me to the hospital, Melissa to the hotel then bring her back to the hospital.

So into the Pronto Soccorso (ER) in Siena I go. I looked this hospital up, as I was Googling symptoms of other heart issues on the train and getting more scared, and it’s a teaching hospital, it looked big and I thought: it could be worse.

For those who know me well, they know I’ve sampled a few ERs in my day. So, while I’m no expert and never want to be more of one, I believe I know a thing or two about how they operate.

This one was excellent, just like in the US, except I was the one not speaking the primary language. Just the word “heart”, got me straight back for triage. It was an all hands on deck experience. Competence surrounded me. I was scared. But. As the time between visits from nurses or doctors lengthened, despite the heart monitor galloping up and then racing back down for what seemed like forever, I knew that I wasn’t a huge concern of theirs. They put me on a med drip to get my heart back to normal, much like my pocket pill would have done, but I was too scared to not think something else could be up to just try that. It took a long time, I was there for at least a couple of staggered shift changes and when things settled down on my insides they kept me for observation for another few hours. This was excellent care. It was excellent service and it was exactly what I would expect in an ER in the USA, a good one anyway.

So, when I went to check out and asked where I pay and they looked at me like I was an insane person I thought: really? Nothing? Perhaps a statement will come in the mail, though I’m not sure they took my address down as the paperwork doesn’t have it on there. So maybe this was just a gift back to the tourist of two months from the socialized healthcare system for his tourist tax dollars. My total expense, to date, for a very high quality experience was €17 for some of the rescue pills they told me I should take if it recurred.

This is not some kind of political statement at all. Having worked in healthcare for the better part of my career I am well aware of the challenges of trying to offer “free” healthcare to everyone in a country the size of the United States. I guess I am just sharing the experience so that fellow travelers will not be scared of seeking care in a foreign country, at least a westernized one.

The main thing we learned (or I should say were reminded of) through this experience is that, despite a lot of evidence to the contrary on the nightly news, the vast majority of people are good. The cab driver shut off his meter while he waited for Melissa at the hotel and fought off four or five other parties wanting his cab while she was inside, checking in. The night nurse at the ER waited with me to make sure my cab showed up when I was leaving. The many doctors and nurses, whether they could speak any English or not, who came in and checked on me and were almost as elated as I was when my heart stopped trying to outrun the roadrunner… almost. People are kind and people are good.

So, yet again, I didn’t see much of Siena in our brief walkabout before checking out and going to retrieve our rental car. So I guess I’ll see that finger next time. Because there will be a next time.


  1. David, have been following you and Melissa’s adventures and so happy you are feeling much better.

    Continued safe travels and thanks so much for allowing me to live vicariously through you.

    Take care.


  2. I’ve been following you as well and am so happy you are feeling better and so glad you had such good care! Safe travels to you and Melissa!


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