What 4 Days of Medical Care Cost Me in the Dominican Republic vs. 3 Months of Waiting at Stanford

I went to Santo Domingo for what was supposed to be a relaxing long weekend.

I had been worldschooling with my kids in Cabrera for a few weeks already, and a friend I'd met during my stay and I decided to take a weekend together to explore a different part of the Dominican Republic. The plan was simple. Long lunches. A chocolate making tour. Wandering Zona Colonial with no agenda. A break from the routine.

We arrived Friday afternoon, checked into our hotel right in the heart of the colonial zone, did the chocolate tour, and had a beautiful evening. I went to bed thinking the weekend was off to a perfect start.

The next morning, just after sunrise, I woke up to my six-year-old son Hasan passing out in the shower and going limp in my arms.

The next 48 hours rearranged the way I think about healthcare.

Within minutes of calling for help, paramedics were at our door. It felt like forever in that hotel room every minute holding a limp child feels like an hour but in actual minutes, they arrived fast.

Nobody asked for insurance. Nobody handed me a clipboard. They did their checks, made an assessment, and told me exactly where to take him.

By the time we got to the ER, Hasan was starting to come back to himself. The doctors saw him quickly, evaluated him, and gave us referrals for a CT scan and a neurologist consultation. The wait that afternoon was long and I am not going to pretend it wasn't but but when we went to check out, they charged me nothing.

Nothing.

I know they hadn't done very much at that visit. But in the States, even getting that far with a same-day ER visit with referrals to a specialist would have come with a bill in the thousands. And the referrals themselves wouldn't actually work the way they did here. Back home, a referral means you wait months for an approval, then more months for an appointment, and the appointment itself might end up being a waste of time. The whole process is designed to slow you down.

The next day, we walked into a center and got the CT scan done. When I was unsure about adding an MRI on top of it, we simply walked into the hospital where the neurologist worked and did the MRI too. Yes, we waited hours to see her. But by the end of that day and a half, we had completed both scans and had a real sit-down with a neurologist who walked me through everything in a way I could understand with my friend gently translating the medical pieces when I needed it.

Total time from first phone call to a full neurologist consultation: under 48 hours.

Total cost for everything: about $300. The MRI alone was $75.

I have been thinking a lot about what was missing from that experience in Santo Domingo. The things that were absent are the things I now realize I had been bracing myself for my entire life as an American patient.

Nobody handed me a stack of forms before they handed us care.

Nobody told me a specialist was unavailable for months.

Nobody made me feel like a foreigner who was going to be a problem.

I flew back to California carrying a strange mix of relief and confusion. Hasan was okay. We had answers about what to monitor. But we didn't have a final answer about why it had happened, and I wanted a follow-up with a specialist back home.

So I did what any parent in my position would do. I called my primary care doctor, made an appointment, and asked for a referral. He put one in. The referral went into the system. And little did I know, that referral would take months of waiting just for an approval let alone an actual appointment.

It is mid-May now. We are still waiting.

The earliest available neurology appointment was three months out.

Three months.

That was three months ago. He still has not been seen.

He is okay. We have been monitoring him closely. But the question of why this happened in the first place remains unanswered, and the system that is supposed to help me find that answer has put us in a queue and forgotten about us. I have been trying to get through to someone almost every day, and the frustration is constant. I'm not alone in this and I know I'm not but that doesn't make it easier.

I want to be clear about what I'm not saying.

I'm not saying the Dominican Republic has perfect healthcare and the United States has terrible healthcare. Every system has gaps. Every system has tradeoffs. There are absolutely things the U.S. system does that few countries in the world can match and when you can access them.

I'm not saying everyone should move abroad. That's not realistic for most families and it's not what I'm suggesting.

I'm not bashing American doctors. The doctors in this country are extraordinary. They are also stuck inside a system that increasingly does not let them practice the way they want to practice.

What this is is a story about what happens when you travel abroad with your kids and start to see things you never noticed at home. You start to notice that other countries treat human beings as human beings first and patients second. You start to notice that "how much will this cost" is not always the first question asked at a hospital. You start to notice that being able to access care quickly is not a luxury reserved for the wealthy in every country and in some places it's just how the system works.

You start to notice that a lot of what you have accepted as normal is actually a choice. A choice we keep making as a country. A choice that is costing families.