Blogger’s Note: Before we begin –  a spoiler alert: This story has a happy ending. However, to get the full effect as experienced by those who lived this story, try to forget this fact as you read it.

Routine blood tests a month and a half ago returned a sharply increased PSA. (For those few of my readers who are neither men above a certain age, nor women married to men above a certain age, a high PSA is an indicator of prostate cancer. In one of those quirks of nature that make internal medicine so fascinating for practitioners and so nerve-wracking for those they practise on, a high PSA is neither a necessary nor a sufficient indicator of cancer, but it is, as these things go, pretty reliable.) Certainly, as these things go, my level was about four times as high as it needed to be to raise a reddish flag.

A visit to my urologist followed fairly quickly, with all of the usual attendant indignities. (For those few of my readers who are neither men above a certain age, nor women married to men above a certain age, let me just say that a family blog is not the place to elaborate on those indignities.) When the urologist referred me for a prostate biopsy, things didn’t sound good. When he learnt that the hospital was demanding an MRI as a pre-requisite for the biopsy, despite my having undergone an MRI less than two years ago, he was, frankly, annoyed at what he saw as a completely unnecessary delay. His annoyance, to be honest, didn’t make Bernice and I feel any happier.

However, we were able to arrange the MRI fairly quickly. The scan was analysed in reasonable time as well, and we were then, and only then, able to schedule the biopsy, which I had a month ago. We were told to expect the results in four-to-six weeks, which, of course, meant that we would receive them only once we were in Portugal. This didn’t really worry us, since we knew that we could schedule appointments as easily from Portugal as from Israel, and our ever-increasing familiarity with scheduling medical appointments strongly suggested that we would be back home before any earliest appointment we would be able to schedule.

Our family doctor then advised calling the lab after three weeks.. This was good news! A shorter waiting time for the results was obviously better, and to receive the results when we were at home, and to have a chance to digest them before going to Portugal, seemed better than receiving them there.

A couple of weeks ago, I contacted our delightful insurance agent, to arrange travel insurance for the trip. He set up a three-way call with the company we have used in all of our recent trips, and I went through the depressing list of my pre-existing conditions and medications. Our agent had previously confirmed that, as I suspected, I needed to mention the suspicion of prostate cancer, even though the biopsy results were not in.

Neither this company, nor the second one we tried, would insure me without either a clear biopsy result or a doctor’s letter, confirming that there was no reason why I should not fly. Of course, no sensible doctor would set himself up in this way to be sued by the insurer for all medical and repatriation costs if, God forbid, anything should go wrong.

Bernice and I then discussed with our agent the possibility of excluding my prostate from the medical cover, and, between ourselves, Bernice and I discussed flying with me uninsured.

Three weeks after the biopsy, and just over a week before our flight, I phoned the path lab, to ask whether the result was in. It wasn’t, but the receptionist was very sympathetic when I explained my position, said she would try to hurry the process, and asked me to phone again immediately after Shavuot. (Because, of course, Shavuot last week stole two days from the lab’s working week.)

When I phoned last Thursday morning, the results were still not in. The receptionist asked me to phone again at 3pm. As it happened, my cousin’s son was visiting Israel from England, and we had arranged to meet him and another cousin in Jerusalem at 3pm. As Bernice parked the car, I phoned the lab, to be told that the result would be ready in an hour or an hour and a half, and I should phone back at 3:40. I didn’t really understand why, if the results would not be ready then, but I didn’t query this.

I was, by this stage, feeling increasingly helpless and frustrated, There seemed to me to be a cosmic coordination of events designed just to thwart my attempt to get my results in time to get travel insurance, and there seemed to be nothing I could do. I had thought I might not be able to function while waiting to phone again. However, we had such a good time with my relatives that I actually lost track of the time, and did not phone the lab back until after 4pm, by which time it was closed and all I got was a recorded message.

The lab, of course, does not work on Friday, so I would only be able to contact them again on Sunday, the day before we flew.

At this point, our agent declared his determination to find a solution somehow. He set up a conference call with the director of the insurance company who signs off on all of the policies. After our agent had told the director what a wonderful person I was, and had told me what a wonderful person the director was, we got on famously.

He first asked me what I would do if my urologist advised me against travelling. I said that I would not travel, and he was rather more impressed than I felt my answer warranted. He assured me that many people were not that sensible. At some point, I asked about excluding the prostate from the cover, and he told me, in no uncertain terms, that I should never, ever, consider an exclusion cause, because I would not believe the lengths to which an insurance company was capable of going in order to prove that a totally unrelated medical condition that arose was, in fact, a consequence of the prostate trouble.

After further discussion, during which he proved to be a truly delightful man, he said that, whatever the situation, whether I had a result, or did not have a result, and whatever the result was, provided my urologist said I could travel, then they would insure me. When I then asked what the maximum cost of that cover would be, he obviously could not give an exact figure, but the ballpark he gave was more reasonable than I had expected.

He further said that, if there wasn’t enough time for me to produce a letter from the urologist stating that there was no reason I should not fly, and if I told him that the urologist had said I could fly, then he would accept my word.

Reassured by this conversation, I called the path lab on Sunday morning, and learnt that the results were in. Of course, the lab would not share those results with me. I asked them to confirm that they had sent them to my urologist, and was shocked to learn that they had only sent them to the doctor who carried out the biopsy, with whom I had no contact. I immediately phoned my urologist’s clinic, to confirm that they had requested the results. However, that clinic is closed on Sunday, so all I got was a recorded message.

I also immediately WhatsApped my family doctor (as he had requested) to tell him the results were in and to ask him to request the results, which he did. I asked him if he would share the results with me when he received them, but he did not respond to that message.

By the end of Sunday (yesterday), I was a nervous wreck. I had, by that time, packed, with a sinking heart. Part of me was convinced that packing would prove to be a waste of time since my urologist would tell me that I needed to start treatment for cancer immediately. Part of me wanted to pack as much as possible for the kids because who knew if I would ever be able to fly to Portugal again. Part of me was very worried about flying without insurance. All of me was feeling that I was coming apart, and was increasingly frustrated by a medical system that seemed to be not responding to my requests. I felt I was trapped in a Kafka novel.

This morning, I phoned the urology clinic. When I told the receptionist the results were in, she started trying to schedule an appointment with the urologist for this Thursday. When I explained that I was flying today, and really needed to speak to the urologist on the phone before mid-afternoon today, she said that the doctor never gave biopsy results over the phone. When I pleaded with her, she went off to speak to the urologist, and returned to tell me that he would check the results and phone me later in the day.

The insurance agent and I agreed that, if I had heard nothing by 2pm, we would arrange insurance for Bernice. Bernice and I spent a couple of hours this morning doing the last-minute packing and straightening the house, growing increasingly fragile and, on my part at least, fractious. I didn’t know whether pestering some combination of the lab, the urology clinic and my family doctor, would be counter-productive. Eventually I phoned the lab, to learn that they hadn’t received a request from my urologist, and that they had also sent the results to a urology professor in the hospital, with whom I had made an appointment for after our return from Portugal, expecting that I would, by then, be needing some treatment. I have no idea why they thought he was the referring doctor.

In a panic, I then phoned the urology clinic to ask them to request the results. The secretary explained that she could not do that, but put me through to the nurses’ station, since the nurses could make such a request. The nurse I spoke to explained that she could not make a request that overrode or bypassed my urologist, but he very kindly went into the clinic’s computer system and was able to tell me that he could view the results. Of course I asked whether he could share them with me and, quite rightly, he said that he could not.

My mind was at least now put a little more at ease. A little later, our taxi arrived. I hoped I would not have to conduct in the taxi what was, Bernice and were certain, going to be a difficult conversation with the urologist. The urologist didn’t phone. We made our way to the railway platform, just missing one train. With a 30-minute wait, I hoped the call would come while we were in the relative anonymity of the railway platform. It didn’t. The train arrived. Still no call. We reached the airport. As we readied ourselves to go up to the departure lounge, Bernice and I resigned ourselves to the fact that we were not going to get an answer before we flew. Obviously, the urologist would wait until he had seen his last patient and, by the time he phoned, we would be in the air.

Just then, my phone rang. It was the urologist. His opening question to me was, on reflection, bizarre.

“So, what did you want to ask?”

If I hadn’t been on the brink of a nervous breakdown, I might have mustered an answer along the lines of: “I wanted to know what made you go in for urology?” Instead, all I said was: “I wanted to know the results of my biopsy.”

“It’s all clear. There’s no cancer. You’re fit to fly.”

I don’t know exactly what expression was on my face, but I don’t think Bernice had any idea what I had just heard. I quickly thanked the urologist, and told him that, despite having  prepared myself for a whole range of possible answers, that one had been completely unexpected. And then, I had the unadulterated joy of sharing the news with Bernice.

As we queued for the hand luggage security check, our agent called, and we had a conference call with the insurers, whose clerk made me go through my entire medical history, again. He obviously had to contact the director, to receive confirmation that my word about being cleared to fly could be accepted. The director was, of course, not to be found, and on another call, so it was about fifteen minutes before our four-way conference call could close the deal.

By the time we got to the gate for our flight, Bernice and I both felt completely drained, but already about 2000 feet high. Now, a couple of hours later, as I write to you halfway to Portugal, from the discomfort of economy class on a Boeing 737, I am so looking forward to a month with the family in Penamacor. This time more than ever, it is going to feel like a real holiday.