The pilot of the Life Flight air ambulance counts down the landing in feet. He yells out descending height in hundreds so that the attending doctor can buffer the patient to the inevitable bumpy, jarring landing. To my injured friend — with a minimum of several broken ribs — knowing when to hold her breath and bite her wrist to brace against impact was welcomed. The pilot didn’t tell me to fasten my seat-belt or stay seated or watch my head. He was totally focused on flying through the fierce tropical storm, countering the turbulence, to do the least amount of additional harm to his living cargo.

My recent beach vacation to the Bahamian island of San Salvador was full of eye opening reinforcement of tips I tell clients but often ignore myself. By writing them down, I hope to ingrain the smart ideas in my brain for future trips. Vacations are meant to be fun, but accidents still happen.

Jo on a scooter (courtesy Jo Giraudo)

It is now very clear to me that the U.S. does one heck of a good job protecting the well being of its citizens and tourists as they travel American roads and visit our towns. This became obvious when three of us rented scooters and took a two-hour tour. Caribbean islands just don’t have the resources to take care of their infrastructure. The condition of the roads got worse the further we got from the rental shack. In fact, the road just caved in with a three-foot drop at the accident site. Lesson #1:  Never rent a scooter on an under or lesser developed island or town outside the U.S.

If my friend had travel insurance, one quick call and I would have never experienced the frightening uncertainty an accident on foreign soil takes its victims through. Instead, the first phone call was by a local who had witnessed the two scooters dump their riders to the sunken pavement. Lesson #2: Always carry a credit card, copy of your health insurance card and passport plus the phone number of the local police.

Two of us were able to walk away from the mishap but our third friend was less fortunate. I had no idea the extent of her rib, shoulder, arm and internal injuries. A beat up Toyota arrived with a doctor and nurse from the only infirmary on the island. The next 12 hours I spent scrambling to get her off the island and to a hospital with an x-ray technician. Yes, they have a machine but no one to read the x-ray.

When I finally managed to pay for a med evac plane and crew to transport us to the closest hospital on Nassau, I had no idea when or how we would actually get home. Lesson #3: Alert your credit card company that you are going to be making charges in another country and make sure you have at least a $10,000 limit. We needed $15,000 to pay for all services because her health insurance was not willing to cover the expenses up front. Lesson #4:  Everyone asks for money upfront, so know how you can get your hands on cash or credit and know the exchange rate.

The front seat of an ambulance racing down the hectic roads of Nassau was a jaw-dropping carnival ride. They drive on the left and ambulances ride down the middle and the bikes go in and out and the three buttons make all those different ambulance noises depending on how aggressive the driver is feeling. He was the same guy that flew the Life Flight plane. Lesson #5: Ask that the patient be given pain meds at about 400 feet before landing so she feels none of this.

Doctor’s Hospital in Nassau has a good reputation. They wanted payment upfront and x-rays were taken within two hours. A very good doctor interpreted the results. Only fractured ribs, but an overnight stay was ordered for observation and pain management. So I headed off to buy a bed in a ward of the hospital. I could stay with my friend if we upgraded to a private room. Total cost would be just under $10,000.

They had the nerve to ask me if $7,000 sounded better as I rushed back to emergency to encourage my friend to “try to sit up, now stand up, now let’s walk out of here and fly home.” She totally agreed that our accommodations were laughably over valued and signed the papers saying she was being released against doctor’s orders. Five bags and two wild American women burst down the halls to the cab. “Ok my friend, take as many pain pills as you need to be able to sit up for the next 10 hours and I will get you home.”

Lesson #6 – Get to the airport at least two hours before your flight – especially in a foreign country. I know the ticket desk lady did it on purpose. When I reached the front of the American Airlines ticket counter to buy our seats, we had one hour before the flight. No, she couldn’t sell me tickets, I had to go across the hall to only that pay phone on the end and buy my tickets over the phone. What the??? OK – I went over there and the phone was out of order. When I returned she told me we had missed the deadline for loading baggage and would have to wait for the flight three hours later to Miami. She could, however, sell me those tickets.

I was relieved and grateful when we arrived at the Miami airport for a three hour layover before flying home to Atlanta. There is an aura about Americans and our way of doing things that inspires confidence and security when compared to countries that are struggling to provide basic amenities to their citizens.

We both were able to use our phones for the first time since the accident. Lesson #7: Have an international phone plan turned on while you are gone and know the roaming charges. I am considering becoming ham radio certified so I can make free calls overseas. A $200 radio would pay for itself quickly.

Her first call was of course to her girlfriend. What a total relief to hear her say that at 2 a.m. she would be waiting at baggage claim with rib buffering pillows and munchies. Lesson #8: Our best gifts to ourselves are the friends we nurture and keep. They can be called on at any hour and are happy to see us. This trip made me grateful for my home country as I had never perceived it and for my friends who lend me a hand when I need it.

Tip #9 : I cannot stress the importance of this enough – Travel Insurance is your best friend overseas.

Got a question for Jo? Email her at [email protected], or through [email protected].