I landed back in Lisbon after a whirlwind tour of the US — a family reunion in Michigan, an art show in Chicago, and an AI conference in San Francisco. It was a week before my 55th birthday. I got home, and within minutes of walking through the door, my world came crashing down — literally and figuratively. A very large photo frame that had been taken off the wall and left standing on a shelf came down crashing on my hand as I kicked the shoe-shelf door shut on entering the house. The glass broke and cut straight through the tendons. I initially thought it was a simple cut, bleeding profusely.
What followed over the next eight hours I'd rather forget — and exactly why I'm writing this down, so it stays remembered on my terms. These are my notes for family and friends on the less instagrammable aspects of life in Portugal.
Life catches you off-guard no matter how prepared you are. And trust me, I was prepared for the usual stuff. I'd stored the numbers, knew which private hospital was closest, had an insurance agent on WhatsApp. None of it made the next few hours painless — but all of it mattered.
CUF: The Private Hospital
I stopped at a pharmacy literally in the next building. The pharmacist took one look and told me to go to the emergency room.
We called an Uber to CUF, one of Lisbon's better private hospitals, in Cascais. My insurance agent — a Portuguese-French guy who is genuinely a godsend — was texting me support in real time, which was absolutely not his job.
At the ER, things were less chaotic than back in Chicago, and they prioritized me over other patients. I was assigned staff who could speak English. After a wait, a doctor examined me. My index finger wasn't lifting — which usually means nerve or tendon damage. When I told her, she realized the seriousness: this needed a plastic surgeon, and CUF didn't have one on call. She started making calls. Twenty minutes later, she'd found one — at a public hospital.
The Transfer
Twenty-five minutes and twenty-five euros later, we landed in another ER. It was packed, but the system moved with surprising precision. I was prioritized due to my wound and a large bandage.
I didn't have my número utente — the Portuguese healthcare number. "Never mind," they said, and signed me in on my resident card instead. The English-speaking triage nurse gave me an orange band. Portugal's system runs red, orange, yellow, green — red being closest to dying. Orange got me into room eight within fifteen minutes.
The doctor unwrapped CUF's bandaging, and the bleeding started right back up. My surgeon spoke excellent English, cleaned the wound, and told me we were headed into emergency surgery.
The Surgery
Local anesthesia, antibiotics and painkillers through an IV, X-rays. Then a second surgeon walked in — calm, clearly senior, quietly directing the first. For the next hour and a half, they worked on my hand: a tourniquet cinched around my arm to stop the blood flow, the wound opened, the severed tendons found and stitched back together, the skin closed over it. I watched all of it. The pain from the tourniquet was unforgivable.
This is a less graphic image, three weeks after the surgery.
At some point the lead surgeon told me, in her serious English, that this was a more serious accident than I'd let myself believe. That's when it landed. Not "recovery," not "inconvenience" — the actual possibility of losing function in my index finger. Tears rolled out of my eyes on the table, realizing what that actually meant for an artist and a typist. A frame falling off a shelf, and suddenly my life had a different shape than it had four hours earlier, arriving off a flight from Chicago with no idea what was waiting at home.
Today, typing these sentences slowly with my left hand — almost six weeks after that surgery — I have full realization of how different life is without the essential motor skills of my right hand.
Coming Home: The Blur of Recovery
We walked out of the ER around 9 p.m. like zombies — a full twenty-four hours since we'd left home in Chicago, between the flight, the time change, and the surgery. I don't know how we survived that day.
The next two weeks are mostly fog. Hand elevated at all times, antibiotics, painkillers that thankfully weren't as necessary as I'd feared. I asked the doctors the same questions on repeat — not out of unkindness on their part, I think, but because they were working an emergency room in their second language, with patients like me needing more reassurance than English words could carry. I slept for what felt like days, jet lag and trauma doing similar things to a body. So did David, while handling everything else.
Now I am in the sixth week after surgery. Friends and family visiting from the US have cheered us up and provided welcome distraction. Forced stillness, it turns out, is its own kind of studio.
Atelier
In these six weeks, I was able to complete development and testing of Atelier — an audio-first companion and agent for artists — and push it to beta testing. Claude Code proved to be a remarkable tool for that. The disability, in a strange way, pushed me toward audio-first features I might otherwise have deprioritized.
I also took the app for a full ride: completing two paintings end-to-end, documenting and blogging the entire process entirely hands-free. The Three Graces has gone to the framers.
Portuguese Healthcare: What I Actually Learned
I have private insurance, and I was genuinely impressed — by both the private and public systems. People do wait long hours for non-urgent care, and I won't pretend otherwise. But every doctor and nurse I interacted with was compassionate and deeply professional. For anyone living here, or thinking about it, here's what I'd pass on:
- The doctors are excellent. Every single one I met knew their work cold.
- Private and public hospitals, used together, work. CUF got me stabilized and referred; the public hospital did the surgery that saved my hand.
- Scope your hospitals in advance — like a cruise ship safety briefing, know your nearest exit before you need it.
- Learn survival Portuguese. A few plain words, not full sentences, are often the difference between being pushed back and being heard.
— Satish · Estoril, Lisbon · 2026
