Fifteen hours in a city full of hospitals.

In 2021 I was living in Roma Norte, close to the middle of Mexico City. I woke up one morning with a fever and a cough and the specific dread that came attached to those symptoms that year.

I called my travel insurance company. They told me there was one hospital within reach that had English-speaking staff, gave me the name, and that was the end of the conversation. It was about forty-five minutes away. I passed hospitals on the way there.

I am not going to name the place, because the people inside it were not the problem. It was 2021. Their emergency room was full of people who were actually sick, some of them much sicker than me, and the staff were triaging a pandemic with what they had.

At intake, they asked for my medical history. In Spanish.

I had been sent across a city for English and then asked for the one thing I could not produce in any language. My history was not lost. It was detailed, current, and sitting in systems in New York, Ohio, Kentucky, Chicago, Mexico City, Dallas, and Denver — built up over years by doctors who knew me well. It just was not available to the person standing in front of me, and there was no mechanism by which it was going to become available in the next fifteen hours.

Fifteen hours is how long I was there.

The diagnosis, at the end of it, was rhinovirus. A common cold.

Two decisions got made about me that day and both were made blind. An insurance company sent me across a large city based on what its list believed about which hospitals speak English, and the list was not very good. Then a care team worked me up from nothing, because nothing was what they had been given. Neither decision was careless. Both were made from a picture with most of it missing.

I think about that room whenever someone tells me interoperability is a solved problem. My record existed the entire time I sat there. Every allergy, every prior visit, every medication anyone had ever prescribed me. Captured, coded, stored, backed up. It simply could not travel, and I could not carry it, so for one long day none of it was real.

That is what we started Valinor to fix. Not the moving of data, which mostly works now. The part where a person walks into a room and everything already known about them arrives with them.

Carol, from the last post, never left the country. She drove from Michigan to Florida and her record still failed to follow her. Mine failed across a border and hers failed across a state line, and the reason underneath both is the same one.