Location independent. Financially independent. Early Retirees. World travelers. Vagabonds. Home Free. Slow travellers.
In many ways, our unique lifestyle presented both special privileges and unique challenges as we faced the initial cancer suspicions, diagnosis, treatment, and further testing.
Editorial Note: I address these unique aspects here separately from the broader story Cancer section posts. I did this so that anyone else in this situation can hopefully benefit from our perspective without choosing to read all about our story. That means some overlap here from the other posts in this section, but also many things that appear in just one or the other area.
Privileges
Time Wealth. Financial Wealth. Health Wealth. Wealth of Possibilities. These are some of the types of “wealth” that Hale and I gained when we made our conscious decision to eschew the normal US dream of accumulating nice things and instead work hard, save hard, and be willing to live frugally so that we could retire before 50 and spend our money and time on experiences. We feel that decision makes us wealthy in all these ways and this feeling has only been reinforced by my cancer diagnosis.
If you are reading this as someone living or contemplating FIRE and/or long-term, full-time, international slow travel, you probably already comprehend how these wealths enabled us to have the three incredible care-free years we had playing in Aotearoa. But you may be curious how these wealths fit into our current, more restricted picture.
Wealth of Choices
We could CHOOSE whether to have surgery in New Zealand where we would pay out of pocket and benefit from being in a health system driven by care rather than profit. Or we could CHOOSE to have surgery in the US and pay only our out of pocket max and then have everything covered, reap the benefits of greater access to clinical trials and advanced treatments, and have the immeasurable benefit of being in the same country as family and friends. For that matter, we could have chosen to go anywhere in the world for surgery and treatment.
Within the US, we had endless options because we don’t own or rent a home. Though we chose to come back to the Portland area where my ACA insurance coverage was, we did debate instead going to a major US cancer center for the optimal holistic oncology setup. Our medical costs would have been much greater, but it was something we could have managed and our living costs would have been comparable. What stopped us was time and urgency – the tumor had to come out now and getting into a center without a referral is not easy or quick.
Now that the surgery is behind us, we can change plans and location on a dime because we have no stuff, no physical roots, and no commitments. Suddenly learn the cancer is worse than the doctors think and therefore I want to see a specialist? We can move to Texas and go to MD Anderson, or to Minnesota for Mayo, or to geographically preferable California for UCSF or Stanford.
Time Wealth
I have zero responsibilities other than healing and fighting cancer. I have the ultimate luxury of time each day to face this monster.
I can get out of bed and focus on what my body needs to recuperate from surgery. Then I can move on to spending that time rebuilding my body, which may take over six months.
I can spend as much time as I need to learn about the rare form of cancer that they think I have so that I know all the questions to ask my oncologist. I can devote time to learning ways to cope with anxiety and uncertainty.
I have time to write about this to share with others, which is proving healing for me as well. I can slowly process, accept, and learn to be grateful for a “good cancer” rather than being simply resentful that I have cancer.
I don’t have to stress about being away from or taking time off from a job. There’s not a team of dozens of people relying on me (as there were in my career) so I am not failing anyone by focusing entirely on myself right now. I don’t have to ask permission to take the afternoon for a nap. I don’t have to worry that I am letting down colleagues to attend a visit with my oncology therapist.
We don’t have a garden, a house or pets to care for that would not only take time but would also have to factor into our location decisions.
Health Wealth
We can locate ourselves somewhere healing, as long as it is within reasonable striking distance of the hospital and doctors’ offices. We chose to spend January and February (following my early December surgery) out on the Oregon coast exactly for this purpose. Sure, it’s a 2+ hour drive into the city for CT scans, bloodwork, postop appointments and doctor consults, but that’s worth it to be surrounded by nature which is our lifeblood.
Every morning I can walk (slowly and gently) for hours on the empty beaches and state park trails, doing what the doctor ordered to heal my body whilst also healing my mind and processing the madness of the last two months. Did you know that there is scientific evidence showing that the best place for mental health is where the ocean meets the forest? We can give ourselves this advantage.
Because we had been retired for three years when this hit, I was in better physical shape than I had been anytime in the decade before we departed. Pre-retirement, I spent far too much time working and didn’t prioritize my fitness over my career (although I was certainly more fit than the US average.)
Once traveling, we increased our weekend hikes to daily hikes and I added stretching to my daily routine. About six months in, I added weights, which eventually transitioned into directed strength building with a physiotherapist after a shoulder injury. And then I added Pilates, finally giving my core the attention it needed. Right up until the day before surgery, I had time to do my exercises to go in as strong as I could be. This was all possible because I had the time to exercise.
Being fit set me up beautifully for surgery. The nurse told me that I was a dream surgical candidate because of my lack of fat, reducing the chance of infection by well over 50%. My arms were strong enough to push myself up in bed in the weeks immediately following surgery when I couldn’t use my core at all. I craved being able to move again, and even on the worst early days, I clamored to get out of bed and baby step down the hall, which all studies show speeds recovery.
It will take months to regain my strength after this major surgery. My Pilates teacher advised me in advance that it would be four months before I could start again. But being job-free allows me to devote the time to slowly build back up, to schedule appointments with a physical therapist, and to not rush lifting by having to hoist a suitcase into an overhead bin for a business flight.
Financial Wealth
We don’t have financial wealth in the sense that many in the western world think about it, but the money we have in the bank is a key factor in enabling the other advantages that I have outlined above. On top of that, having a nest egg and a frugal lifestyle gives us the priceless privilege of not having finances dictate how we approach cancer.
Money is not the deciding factor in any of our decisions about getting the best medical care and providing the best personal care for me. Of course it is a factor. We retired early on a tight budget because living life was more important to us than accumulating for more luxurious spending in a later retirement. But it hasn’t been a deciding factor at all and we are so incredibly fortunate to be able to make choices based on the truly important factors.
All the hard work we put in and all the sacrifices that we made to save money for a life of travel is now paying off in ways we couldn’t have imagined – by giving us the wealth in time and dollars to deal with cancer. And you know what? Our financial, time, health and possibility wealth feels more valuable now than ever.
Challenges
Lodging
Unlike “normal people,” we don’t have a home. Yet, I like to plan ahead, which means that when we learned about the tumour, we had advance bookings for the next three months, including both vacation rentals and housesits. Cancelling rentals comes with financial costs and cancelling housesits comes with the emotional costs of guilt and worry that the pet owners have to start from scratch looking for someone to care for their furries while they are away. Both come with hassle and time.
Then there’s the flip side of where we will lay our heads now that those carefully crafted plans are eliminated. Add in the stress of finding accommodations in a rush at the last minute when “good” places are already booked. And if you’re reading this as a nomad, you know that many rentals don’t have comfortable couches that are conducive to resting and healing so I needed to hone in on those in the pictures.
As slow travellers, we already prefer longer stays which are always hard to find since someone usually books one Saturday night in the middle of an otherwise perfect month. Now, with post-surgery recovery looming and knowing I couldn’t help with cleaning or packing, we wished for these even more fervently.
Of course we weren’t looking for housesits during the initial few months, but once it looked like no chemo, we started to consider it as an option. I could definitely do with some puppy love right now, we could use a constant distraction and something to talk about other than cancer, and it would certainly help to keep our costs down while in the expensive US.
But, we needed to stay fairly close to Portland for doctor visits and tests. Or maybe we could go further afield and do blood draws and CTs at Kaiser facilities in California whilst warming our faces in the sun.
But what if one of my scans or other diagnostics showed something a month before a sit and I needed to be back in Portland for treatment? We can’t make a commitment to a pet owner knowing this is a possibility. So maybe just in Portland driving area? For now?
Transportation
The same challenges exist with how we get around. We had to move quickly from one car-dependent country to another.
We had bought a car for our time in Aotearoa New Zealand and planned to get the best sale price by listing it on TradeMe for a month before our flights to Australia. Our grand plan even included pre-booked, staggered car rentals to cover us for the last bit of our time after it sold.
Instead Hale drove it onto a used car lot and took whatever they offered him the afternoon before we flew out of the country.
And again, the flip side of reserving car rentals in the states at the last minute to start Thanksgiving weekend. Luckily Hale is a pro at renting cars from off airport and doesn’t mind switching out as needed to get better deals.
Soon the larger question loomed of if/when to buy a car in the states. At first we thought – yes, we’ll be here a long time getting chemo. Then we held onto hope – maybe they will take it out and it will be benign and we’ll be flying to Australia as soon as I am cleared for travel in January. Then we faced reality that even if I don’t need ongoing treatment, we need to be here at minimum for most of this year for ongoing testing, monitoring and investigations. So the search for a car to buy began – in the worst used car buying market in recent history and in a system that cares that you don’t have a permanent residential address.
Medical Costs
That dollar sign reference cues the medical costs section. As travellers, we are always faced with the question of health insurance. Do we carry it? Do we carry it to cover us on the road or only when back in the ridiculously expensive US system? Do we take a high deductible plan and see it as catastrophic coverage for emergencies and against something as unimaginable as healthy us getting cancer?
We had chosen the last option and thanks to President Obama and the Democrats, were able to purchase a solid plan with no maximum limits and full coverage (after meeting deductible and out of pocket maximums) at a very reasonable cost through the Affordable Care Act. Each year we signed up for and didn’t use our coverage, but were glad it was there as a backstop for us (not to mention that it allowed us to contribute to our Health Savings Accounts.)
Suddenly my high deductible plan was about to pay big dividends. The out of pocket maximum was punishing, yet it was laughably trivial in comparison to the full bill for testing, consults, surgery, hospital stay, and all the follow up visits to deal with various complications. We took a hit to our 2022 budget, but not to our entire retirement picture like we would have if uninsured. And thanks to the ACA, I was able to change to a higher premium, lower deductible for 2023 (which we exceeded with just 10 days of expenses in the new year!)
We can unquestionably advise other US residents who are traveling nearly full time outside the states that having a high deductible, low premium plan through the ACA is a very wise decision. Ours even covers emergency and urgent care outside the US so my visits to the Whangarei hospital were covered.
As I wrap up this section, I want to make our feelings abundantly clear: All these unique logistical challenges of facing cancer as a nomad pale in comparison to the privileges of facing cancer as a location independent and financially independent early retiree.
Reinforcing why we chose this life
What makes you realize that you have made the right choice in foregoing financial accumulation and career progression in favour of living the adventurous life of travel that you long for?
In 2019, as we danced along trails and beaches during our first few months in Aotearoa New Zealand, we realized it strongly from a “lucky are we to be truly living life” perspective.
Every sparkle of the sea and every magnificent Kauri tree reminded us of our good fortune to not be at our desks but instead out living our dream. We couldn’t pass a “Works End” construction sign without busting out laughing with joy.
In 2020 and 2021, the global COVID pandemic and politics made us appreciate our life outside the US, but even more made us appreciate that our financial independence, safe investments, and ability to live frugally meant we didn’t need to panic over this black swan event. Beyond that immense privilege, we weren’t tied to jobs and were instead able to live a high quality life despite the turmoil the world was in.
In 2022, hearing that I likely had stage 3 or 4 cancer and fearing I might not make it through the next year made life extremely precious in a new way. A cancer diagnosis makes many people stop and think about how short life is and how they want to radically change their lives to pursue their passions. We were already doing so!
And now in 2023, we are realizing new benefits that the flexibility of our situation gives us.
Ever since we first left the traditional path for our sailing career break in 2005, we haven’t regretted one minute of exchanging money for life. That experience is what drove us to do all we could in the intervening decade of “normal life” to get back out here.
Now, brushing up against mortality for the first time, I feel that certainty about our choices in new multitudes. Here we are, able to choose how to spend our days and our energy (within limitations) and that is an incredible gift.
Had I died on the surgery table or been given two months to live after surgery, I would have had zero regrets about how we had spent the three years leading up to my cancer diagnosis. That drives home more than anything just how happy we are with our choice to pursue this unusual lifestyle.
As a comic aside, it did cross our relentlessly frugal minds that while we are “stuck” in one place, should we get jobs and increase our financial cushion during this time of high inflation and low market returns? After all, one good thing about being back in the US is that we can legally work here. Those thoughts lasted a very short time! We’ve always viewed life as something that is finite, but now it is less easy to fall into the trap of taking health for granted.
In summary, it is hard for anyone who isn’t in the exact same situation as you to understand the unique advantages and difficulties you face.
Our medical team was great in recognizing that we weren’t the typical stable couple they usually treated and our traditional friends were stunned at how quickly we could turn our lives around.
But other nomads’ responses were uniquely spot-on. That gives me hope that this section will provide empathy to another location independent, early retiree, financially independent, slow traveller (or any of the above trendy labels) who faces a frightening medical diagnosis while on the road. If that is you – Kia kaha.
I also hope that those considering this lifestyle will have gained increased confidence that not only is facing a medical challenge doable once “out there,” but in my mind it is the infinitely preferable way to do so given all the unique benefits we are experiencing.