Navigating a Medical Emergency in Portugal: What Every Expat Should Know

👋 Good morning friends! As Christmas approaches, I’m reminded of the medical emergency my family faced nearly a year ago—and what I wish I’d known about Portugal’s healthcare system then. Today, I’m sharing those hard-earned lessons with you, my dear reader.

What you can expect to uncover today:

🚑 A personal account of navigating Portugal’s National Healthcare System

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👩‍🔬 Thrilling news about our ‘Ask An ‘Expert’ collaboration

Let’s dig in!

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HUSTLE SPOTLIGHT

Navigating a Medical Emergency in Portugal Through The SNS: What Every Expat Should Know

Almost a year ago, just weeks before Christmas 2023, my husband didn’t get up one morning. There were no obvious signs of a serious illness—just a worsening headache over three days, paired with unusual irritability. But my worry spiked when he asked me if the kitchen was still flooded—a strange question, considering we’d never had a flood in the kitchen. And when he finally got up, he seemed disoriented by his own home.

Something was very wrong.

The Panic

I dropped my daughter at school, loaded my husband into the car, and headed to the local public hospital in Alcobaça.

In shaky Portuguese, I tried to explain that I was very worried about my husband, who—having gained some mental clarity—created a stark contrast between my panicked storytelling and his perplexed yet calm demeanor.

We were asked to take a seat in the waiting area, and when we finally saw a doctor a few hours later, she didn’t speak any English. My basic Portuguese failed me as I tried to convince the doctor of what I was sure had caused my husband’s confusion and strange behavior: a malfunctioning VP shunt.

I was certain of my diagnosis, but the doctor’s skepticism left me unable to articulate my thoughts in Portuguese. Fortunately, we have a friend—a doctor and chiropractor from the United States, with greater fluency in the language than myself—who arrived to help, calm and composed in the chaos I was clearly contributing to.

Together, we managed to convey the urgency of the matter, and my husband was eventually sent by ambulance—another few hours later—to the public hospital in Leiria for a CAT scan to determine the cause of his sudden confusion.

The First Wait

The ambulance arrived at Centro Hospitalar de Leiria before I did. After navigating traffic and chaotic parking, I arrived to find Wayne already in the emergency department. Despite multiple stealthy attempts, hospital security blocked me from entering, telling me to wait to speak with the head nurse. Hours passed (again!), and Wayne grew more impatient, sending me confused and frustrated texts.

By then it was 3 p.m., and the scan was scheduled for 9 p.m.

Ambulances arrived in a steady stream, feeding patients into an emergency ward with overwhelmed doctors and nurses. When I tried to speak to the head nurse, I was met with unveiled irritation.

After six grueling hours, with only three more to go before the scheduled scan, my husband walked out of the emergency ward, security holding the doors open for him.

He had checked himself out. And they had let him, not seeing any trace of the delirious man they checked in earlier that day.

We drove the 40 minutes home in heavy silence, and I knew we had just made an epic mistake.

Desperation

Before the break of dawn the next morning, it was undeniable something was seriously wrong. Wayne was hunched over, rocking himself back and forth like he was cradling a baby.

The emergency line operator on 112 spoke English, and soon an ambulance arrived at our gate. I printed a short paragraph with my husband’s details and medical history, including information about his VP shunt, in English and translated into Portuguese, and gave it to the ambulance staff, hoping they’d go straight to Leiria for the brain scan considering the details I provided them about the day before.

Two hours later, after dropping my daughter at school and heading to Leiria Hospital, I received a call from Wayne. When I asked where he was, he slowly replied, “I don’t know, but I think I’m in Alcobaça.”

I found him sitting in a waiting room where he’d been since the ambulance dropped him off. I couldn’t find the doctor.

We drove to Leiria in my car, completed the triage a second time, and begged the staff not to let a barely sane man check himself out again.

Wayne’s condition rapidly worsened over the next nine hours, though time dragged on excruciatingly slowly. When the CAT scan was finally completed, the staff’s attitude changed. Realizing the severity of the issue, they contacted a neurosurgeon in Coimbra, who responded swiftly: emergency surgery was required. NOW. They needed to send Wayne to Coimbra immediately.

The Relief

It took another two hours for an ambulance to arrive to transport Wayne to the Centro Hospitalar e Universitário de Coimbra, and when they finally arrived there, it was nearing midnight.

My friend—the chiropractor—stood by me as we waited outside the emergency entrance, exhausted and on edge. Around 1 a.m., the neurosurgeon called to say they were heading into surgery and advised us to go home, promising to call once it was over.

We made the long drive back, and I arrived home just after 3 a.m. when my phone rang. The surgery had gone smoothly, and the neurosurgeon reminded me that if there had been any further delay, Wayne likely wouldn’t have survived. Would he be okay? We had to wait until morning to see him and to be mindful of the time it might take for his brain to recover from the swelling.

Unable to sleep, I called the ICU at 6 a.m. to speak to Wayne. The voice I heard was so familiar that I felt like crying, relief washing over me.

Released three days later from the university hospital in Coimbra, Wayne had no memory of anything that happened during the days leading up to his surgery, or that he checked himself out of Leiria hospital! But he was alive, and we immediately went to pick our daughter up from school, uniting in a tearful, joyful hug under curious eyes from the classroom windows.

Summary: What I Wished I’d Known

Every emergency is unique, and I can't tell you exactly what to do in these situations. But here’s what I wish I’d known and done differently:

1. I wish I’d known our small-town hospital wasn’t equipped to handle a serious emergency. We could’ve gone straight to Coimbra or chosen a major hospital in Lisbon or Porto.

2. Better health insurance would have made a huge difference. Without it, we couldn’t afford private hospital care or a private CAT scan, and public hospital delays cost us precious time.

3. The strain on public hospitals is intense. Nurses and doctors work under impossible pressure with limited resources, and they deserve respect for that.

4. Expect language barriers. Few staff—from security to doctors—could speak English. Learn the language like your life depends on it… it just might.

5. It’s helpful to carry a short, translated note detailing any critical medical history. In an emergency, this could save valuable time if language is a barrier.

6. Know where your nearest emergency-equipped hospitals and private care facilities are located. Especially if you live in a small town, having this knowledge in advance can speed up your response in a crisis.

7. If you know someone fluent in Portuguese, list them as an emergency contact, or arrange to call them if needed. A language ally can make all the difference.

Closing Thoughts

The Portuguese public health system—though under strain—is equipped with knowledgeable professionals who, when given the resources, deliver life-saving care. Our entire ordeal cost just under €100 (excluding travel costs etc.), a testament to the affordability of healthcare through the Serviço Nacional de Saúde (SNS). However, I can't say for certain if we would have received this level of support without our Utente numbers, which are essential for accessing public healthcare in Portugal.

For those living here or planning a move, consider getting your Utente number as soon as possible.

This experience taught us the value of preparation—knowing which hospitals are equipped for emergencies, carrying essential medical information, and learning the language. It’s a small investment of time that can make a world of difference, especially when every second counts.

LOST IN LINGO

How To Answer Yes Or No

If you haven’t listened to any of the videos by Simpleton Portuguese you’re definitely missing out on quick, humorous language tips. In the short 2:21 video above, he explains how to sound more like a native when you answer questions. It’s the small things that add up.

Sentence of the week ✏️(based on the video above)

Está a praticar português todos os dias?

Translation: Are you practicing Portuguese every day?

Explanation: You should be practicing Portuguese every day. No explanation needed. 😉

Answer: Estou (I am). This is the temporary form of I am, because you can’t always be learning and practicing your Portuguese. There are situations in which your mother tongue is best suited. See below.

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Thanks for reading! 💌

Hustle on!

Angelique🧞‍♀️

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