The moment you actually start making progress.
How navigating the health system in Portugal unlocked a new level of language fluency.
Olá! I’m Jessica, and this is Bubbles of Languages, where I share my journey as a self-employed, multilingual homeschooling mom & expat in Portugal.
I used to tell my students all the time: “The moment you really need to say something, and you have no other choice but to use whatever tools you have to express yourself, that’s the moment you actually start making progress.”
Easier said than done.
Because it’s extremely vulnerable to enter a conversation when you’re not sure you’re able to either make correct, intelligible sentences or to understand what the other person is going to say.
It’s like entering a battlefield without a shield or a weapon: your best strategy is often to dodge the whole situation.
Which is exactly what I do when I have to deal with Portuguese bureaucracy, or any official service.
You see, even in my native language, I don’t feel comfortable speaking to strangers.
Given the option, I’ll always choose to email. Even to order a pizza. I’ve gotten better over time, especially after working for a year in a lawyer’s office, but that doesn’t change the fact that I dread it and that I’d rather avoid it if I can.
When we first arrived in Portugal in 2023, we were lucky enough to live in Braga, a small city 30 kilometers from Porto, where there are major international universities and lots of expats — mostly from France, Brazil, and the US.
It’s safe to say that there were more people there who spoke English than in the entire French population.
My Portuguese was closer to a Spanish-Italian blob than anything else, but I tried.
The locals didn’t seem to mind: they listened to me patiently, helped me finish my sentences, and would congratulate me on my efforts. They never reverted to English, not to bother me, but to encourage me and allow me to practice, which I appreciated very much.
The admin part was more stressful, but with a bit of luck and very helpful locals, the process ended up being quite smooth.
Within two weeks, we had successfully retrieved our NIF numbers, signed a one-year lease for a fantastic apartment, and discovered the Loja do Citadão. (It’s like a supermarket for all admin stuff citizens need, including national security numbers, electricity, water, internet… everything!)
Within a month, we had our residency certificates and our non-habitual resident status (NHR) in order.
The only thing left was the health system. Since the four of us work and learn from home, we don’t get sick much, so I decided we’d cross that bridge when we got there.
And when we got there… I dodged.
When Miles, my son, fell and knocked his baby front teeth out, we visited a private dental clinic. The dentist spoke perfect English. We paid €80 for this emergency visit, which I found acceptable.
When he fell again and twisted his ankle, I briefly considered going to the public hospital emergency room until I saw on their website that the waiting time was approximately 9 hours.
Nine full hours with a toddler in a public hospital? I ditched the idea, hopped in an Uber, and went to a private clinic, Traufa Saúde.
There, we waited only 15 minutes to talk to a doctor who spoke a mix of English and Portuguese. We understood each other without any friction. The total bill was a bit less than €200 for an ER visit and an X-ray. That’s what I had expected.
Life was simple.
Speaking Portuguese was a nice option, but never an obligation. If I were having a migraine day and needed to run to the pharmacy for medicine, there was no need to perform: I’d ask in English, and there wouldn’t be an issue or judgment.
A pretty sweet spot for a lazy language learner like me: low-pressure but plenty of opportunities.
So when we decided last year to leave Braga for a smaller town in Central Portugal, I knew things would get more complicated.
Don’t get me wrong, Portuguese people are very open-minded, very language-oriented. Most younger people speak English. Many older people speak French because it used to be taught in schools as a second language. Everyone understands Spanish.
Again, very different from France, where people speak nothing but French.
However, in more remote areas where tourists don’t usually go, the locals expect you to speak Portuguese. Reaching an intermediate/advanced level is therefore no longer an option for us; it has become a key element to our integration and survival.
I’m not complaining, by the way. This is completely normal. I’m a guest in this country, and I should be the one making the effort to speak the local language.
But learning a language is a process that takes years rather than months, and when you live abroad, you sometimes go through situations that cannot wait for you to be ready.
A couple of months ago, I started experiencing some weird symptoms: dizziness, tingly fingers and nose, and a general lack of energy.
“I’m probably too stressed,” I thought, and took a week off.
Nothing changed.
“I’m probably not sleeping enough,” I concluded, and committed to my 8-9 hours sleep schedule.
Nothing changed either.
When I mentioned this to Claudia, my yoga teacher and physiotherapist—who speaks French and English, by the way—she insisted I get a general check-up and some lab work done.
I took some extra iron for a few weeks, hoping to dodge the whole situation again. But still, nothing changed.
So one morning, after one too many negotiations with myself, I walked to the local clinic—a private one, although it looked very public—to ask for a check-up.
I pushed the door (“empurrar a porta”, not “puxar”, as one might believe), and walked to the reception desk.
-“Olá, bom dia. Desculpe, não falo muito bem português. Você fala inglês ou francês?” (I’m sorry, I don’t speak Portuguese very well. Do you speak English or French?)
She briefly raised her eyes from her computer screen as if I’d asked her to cook me dinner.
-“Não, só falo português.” (No, I only speak Portuguese.)
There was no possible dodging this time.
-“Okay, vou tentar. Queria fazer um check-up. É possível ver um doutor?” (Okay, I’ll try. I’d like to do a check-up. Would it be possible to see a doctor?)
On her face, annoyance and irritation.
She tells me I have to come back at 4 pm, that this is how it works: we can see doctors for check-ups every day at 4 pm.
I find her rude. I vow never to come back here again.
-“Oh, muita obrigada. Tenha um bom dia.”
I got back home and started researching other private clinics nearby.
I found one that looked official and clean (which shows you how important an excellent website is): the CUF Clinic in Leiria. It’s 15 minutes away by car, the website is available in both Portuguese and English, and you can even book your appointment online. Eurêka!
The day of my appointment came. I took an Uber to the CUF Clinic. Just like their website, it was white, clear, pristine. But that did not appease my anxiety.
You see, I had no evidence that people here would speak English; I did not know how much it would cost; and on a deeper, truer level, I was terrified of being diagnosed with an incurable disease.
I took a few deep breaths, got my “senha” (a ticket you have to take before going to reception), and waited for my turn. When the receptionist called me, and I started my usual story:
- “Olá, bom dia. Desculpe, não falo muito bem português. Você fala inglês ou francês?”
- “Não, só falo português.”
Damn it.
But I was already in the water, and it looked like I had no other option but to swim.
- “Tenho uma marcação para uma consulta.” (I have an appointment for a consultation)
The lady asked for my NIF number, asked if I had private health insurance — I didn’t. She slightly raised her eyebrows, then asked me how I’d like to pay.
I understood everything except when she announced €89. Oteinta e nove euros? For a flipping routine consultation with a general practitioner that is not even a specialist?!?
I remained silent and paid with a tense smile.
- “Vá para a esquerda, depois entre no corredor. O primeiro à esquerda e no final do corredor. Espera là.”
I understood “left”, “corridor” and “wait there”.
I did not ask her to repeat.
After turning left and going inside the corridor, there were too many options to find my way, so I went back to the reception and asked someone else.
-“Não sei onde ir. Me pode ajudar, por favor?” (I don’t know where to go. Can you help me, please?)
The lady laughed, which instantly made me feel better, and she showed me the way.
So far, so good.
I sat down in the waiting room and texted my husband about how expensive the consultation was. “But at least the doctor’s likely to speak English,” he said.
She didn’t.
She was an older lady, and she took it upon herself to teach me a lesson. She spoke Portuguese slowly and offered me some corrections. I had to make an effort, she said, because even if there were many foreigners here, we were still in Portugal after all, her English was worse than my Portuguese, and I might as well enjoy the opportunity to practise.
I felt as if I were about to drown. But I kept swimming.
I told her my whole medical history in Portuguese, including the fact that I was adopted, that I didn’t know what medical heritage was lurking in the shadows. I spoke about my recent dizziness symptoms with more gestures than words, but she understood. I even spoke about the grief of losing my father because it felt relevant.
The whole consultation lasted about an hour. I left with a prescription for further exams and a newfound respect for the students who came to speak French with me week after week. This was so exhausting!
Obrigada, I said, but I did not take another “senha” to book my exams since it was now obvious I couldn’t afford it. I got back home thirty minutes later, had a sandwich, a cup of tea, and went directly to bed.
It took me about a week to get over the stress of that experience and to figure out my next steps.
At first, I thought I’d show up at my local Centro de Saúde (Health Center) and ask them what to do. Surely they’d refer me to specialists or labs where my tests could be almost free.
But then I learned on Reddit that the waiting time is usually several hours, that getting an appointment with a specialist could last months, and that I first had to ask for a número de utente and for a dedicated médico de familia, despite the notorious lack of GPs in the public system.
Even if this is something I’ll have to do eventually, I really did not have the energy for another situation with so many unpredictable elements.
So instead, last Monday, I showed up unannounced at a nearby private lab with an empty stomach and my prescription in hand.
This time, I didn’t bother asking them if they spoke English or French.
-“Tenho uma prescrição para análise. É possível fazer os testes aqui?” (I have a prescription for some analysis. Is it possible to do them here?)
Yes, said the lady.
But I wasn’t finished.
-“Me pode dizer o preço? Não tenho uma segurança privada.” (Can you tell me the price? I don’t have private health insurance.)
€120. Expensive, but I was so close to the end of the tunnel that I didn’t care anymore. I signed, paid, and confirmed that I wanted to get my results via email.
The room was full, but I waited only five minutes before the nurse came to call me. She spoke quickly, and I didn’t catch what she said.
- “Desculpe, mas não percebi; pode falar mais devagarzinho.” (Sorry, but I didn’t understand. Can you speak more slowly?)
At this point, I was impressed. How did I even say these words? Where had I learned them? I had no idea.
She spoke more slowly, asked me where I was from, and we chit-chatted for a few minutes. She asked me to do “xi-xi,” and I laughed inside, knowing how my kids would react when I’d tell them the pipi word in Portuguese.
As I waited for her to add all the labels on the right tubes, I noticed an ad for yearly checkups: Homem > 40 anos: €45. That’s when it hit me: you can actually show up with no prescription to these labs and simply ask for the tests you want!
I could have saved €89. We’ll call it the price of ignorance.
The results arrived via email a few hours later. It all seemed normal. Mind you, I’m not a doctor, but there was no way I’d pay for another consultation just to get those results interpreted.
Luckily, a few days later, I went to yoga, and it was Claudia who asked me to show them to her. “You have to see a doctor; you are positive for nitrites. You need antibiotics.” I thought these would go away if I drank enough cranberry juice. Plus I’d spent too much on health this month already.
She blinked and frowned at the same time, the way mothers do.
“So you didn’t go to the Centro de Saúde? Don’t you have private health insurance?”
Double negative. Private health insurance costs hundreds, I said. We can’t afford that.
The blink-frown again. “Don’t you have a Cartão Continente?”
Now I was the one blinking, but in confusion.
Continente is one of the national supermarkets, and the Cartão Continente is their loyalty card. What’s that to do with anything?
Well, it turns out that with this loyalty card, you get basic health coverage for free: a reduced price on consultations and medical acts + 10% of your bill is then added as cash back on your card, which you can use to buy groceries.
Not only that, but if you pay € 10 per month per person, you get the more advanced plan that gives you access to specialist consultations for around € 25 and online consultations for free.
If you’re also an expat in Portugal, the health care plan is called Keep Wells, and you can upgrade it online, with almost immediate effect: all you need is your NIF, a Portuguese phone number, address, and IBAN for recurring payments.
I purchased the healthcare plan for the four of us, and I’m now waiting for my health card number so I can book my next online consultation for free and get the antibiotic prescription I need.
It’s a huge win.
An equally huge win is having unlocked a whole new level of confidence when speaking Portuguese.
Since these events, I have started conversations with my yoga classmates, ordered food with full sentences, picked up the phone without sweating, and spoken to my French-speaking neighbour in Portuguese — she was very impressed. I even made a joke or two.
Like a teacher once told her English students: “The moment you really need to say something, and you have no other choice but to use whatever tools you have to express yourself, that’s the moment you actually start making progress.”
She was so right.
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