“[Butterblogger] are you OK? Are you OK? You passed out,” is the first thing I remember when I came to.
I had woken this morning with a headache and some gastrointestinal symptoms. So I medicated and ate breakfast and was feeling great. My symptoms were truly minor.

Our hotel brings a breakfast tray to our room every morning, based on what we ordered the night before. I ate it without problem. Still, it would have been nice if they had brought water, because I was already under-hydrated to start the day, but I was certain I would be fine.
Was that some nausea I felt? Perhaps it was, so I took zofran just in case.
And with that Lisa and I reclaimed the car from the garage and headed out. We had two options: Pompeii and then get to Naples before going to Rome, or just go to Naples then Rome. With rain threatening, we had decided to prioritize Naples and pizza, and so began the drive to Salerno, far at the eastern end of the Amalfi Coast, where we were to return the rental (I didn’t want to drive into Naples for the return). From there it would be an easy train ride to Naples.
Curiously enough, with all the twists and turns of the Amalfi Coast it would have been faster to take the long distance route, and leave the coast as quickly as possible, mostly heading north. It wouldn’t take much longer, and I wanted the drive, however, so we headed in the more easterly direction, completing the Coast.
It was a fun drive to start, but somewhere along the way I was starting to feel worse. I felt chills. I blamed the oysters from 2 nights ago.

An hour into the 90 minute drive I pulled to the side of the road and took another dose of zofran for the nausea, and I even took an antibiotic. With systemic symptoms I suspected something bacterial and wanted to be aggressive.

I was feeling substantially better when we finally deposited the rental car and bought our tickets for the train to Rome. But I’d also made an executive decision: We were definitely not going to Naples. I wasn’t feeling well enough for it.
We stood on the platform and I remember feeling as though I would vomit, so I leaned my head against a great stone column. And I remember looking at the trash container thinking that it would be a good target if I needed a place to throw up. And then I remember seeing the train pulling into the station and feeling relieved.
I just needed to hydrate. I just needed to get on the train. I just needed to sit down. I just needed to get to the hotel in Rome. So many things I just needed.
The next think I knew I was laying on the ground and my mouth hurt. Lisa was standing over me and strangers were staring. “You split your lip,” she said, “You hit your head hard. It was really loud.” I also noticed a piece of my right incisor had gone missing. I wanted to find it, but I couldn’t.
They had called the ambulance, I was informed. So I lay there on the ground enjoying the sensation of the cold brick against my back.
I felt absolutely awful.
The train pulled away. We had missed our train to Rome.

The EMS arrived and sat me up. I scanned the ground in a futile search for my missing piece of tooth but couldn’t locate it anywhere. They checked my blood pressure and blood sugar while I gave up on the tooth. They then helped me onto a wheelchair and took me to an ambulance. We rode to the hospital, where I lay on the stretcher in the waiting area so I could get my COVID test.
Sitting there I was more alert and had the wherewithal to pull up my travelers health insurance card on my phone, but the EMS tech said I didn’t need it. “In Italy, healthcare is free.”
I was moved to another room where they did an EKG and vitals again. In the U.S. we use stickers for our EKG electrodes. Here they use metal suction cups. It feels old-school, but it gets the job done and is less wasteful.
I was taken to another waiting area, where I slept for an hour or two, and then I was moved to the ER pod where I finally saw the physician. The setup seems to be one physician overseeing a room of about 10 patients. The doctor mostly seems to sit in a central area, shuffling papers and directing traffic.
We had no translator. Consequently, relying on his limited English and my limited Italian, the ER physician took a history of sorts and performed a physical and had somebody look at my lower lip. I asked if it was a plastic surgeon and he scoffed at me. No, a general surgeon.
I was provided with an iodine soaked gauze to hold on my wound.

An IV was placed and I dozed on my stretcher in an unnumbered bay until I was wheeled off for a chest X-Ray, head CT, and echocardiogram.
I was taken back to my bay where I crawled back in the bed and slept more. I was so exhausted and I felt awful. When they offered me food I declined, accepting only a bottle of water, which I barely drank due to nausea. My mouth hurt – I couldn’t have eaten.
The tests came back and they apparently looked good, so the doctor had the nurse hang 500ml of saline.
The surgeon later returned and took me to the other side of the ER where the lighting was better. I asked for local anesthetic, and asked again. I asked for it at least three times in different ways. The nurse hesitated, but the surgeon would not speak to me. He completely ignored my existence as a human being and just stitched.
It was disgusting.
Back in my bay, I texted a few updates, but was completely drained. I asked for a blanket but instead had to cover myself with my jacket. Long after I received a blanket.
And I tried to sleep.