I Spent a Full Day Getting My 76-Year-Old Body Audited. Here's Every Test — and What They Found.

Six years earlier, I had done something similar in Seattle. A program called the Cardio-metabolic Reboot through P4 Medicine (Predictive, Preventive, Personalized, and Participatory) — a full-day comprehensive workup, blood panels, imaging, specialist consultations, the works. It cost $5,200.

This past March, I did it again. In El Salvador. Same scope, same quality of care — better experience in some ways. The cost: $595.

That's not a typo.

I was in El Salvador on an extended stay — I spend significant time there, and it's become something of a second home. I saw that Hospital Diagnostico in San Salvador was offering a one-day comprehensive medical evaluation and jumped at it. The hospital is not a budget clinic. It's the facility that handles US Embassy staff. Highly rated, fully equipped, bilingual throughout. When I read what the day covered, I recognized the scope immediately — it matched what I'd done in Seattle four years earlier. I signed up.

I fasted from dinner the night before. At 6:30 in the morning, I walked in and was met by my concierge.

That detail is worth stopping on for a moment. I had a personal concierge for the entire day. Bilingual, calm, efficient — at my side from arrival to departure, managing the transitions between departments, making sure the day ran without friction. I have navigated plenty of American medical institutions. I have never had anything like this. He was genuinely there for me, not managing a waiting room.

We went straight to the lab. Blood draw, urine sample, done quickly. Then radiology for a chest X-ray. Then I was introduced to the radiologist.

The radiologist was a full medical doctor, and I want to describe this hour carefully because it was unlike anything I'd encountered in American medicine.

He had me disrobe and lie down on the table. Then he went to work with an ultrasound machine — methodically, unhurried, thoroughly. He started with my carotid arteries, both sides, taking photos and narrating what he was finding in real time. He told me the results directly: 12% occlusion on the right carotid, 8% on the left. Minimal arterial plaque at 76. He said they looked very good.

Then he kept going. Thyroid. Aorta. Liver. Bladder. Prostate. The arteries in my lower extremities. He photographed everything. Spoke perfect English. Was genuinely engaged with what he was seeing. I was on that table for close to an hour.

I've had ultrasounds in American hospitals. They're not like this. A technician runs the wand, takes the images, and leaves. A radiologist reads them later, off-site, and a report eventually surfaces in a patient portal. What happened in San Salvador was a physician using the tool himself, in real time, talking me through his findings as he found them. That's a different experience entirely.

After radiology, my concierge took me back to the lounge they'd set up for me, and they brought breakfast. I ate, looked out the window, thought about my carotid arteries.

Then the pulmonologist — a series of spirometer tests, measuring lung capacity and airflow at various intensities. Results came back strong. No flags.

Next, I had a choice: dermatologist or ear, nose, and throat specialist. I chose the ENT, partly out of curiosity and partly because I'd been carrying some allergy questions around. He examined me thoroughly and we talked through his findings.

Then the cardiologist. His staff wired me up and I got on the treadmill. Stress test — heart rate climbing, EKG running, cardiologist watching the readout in real time. When it was done, he sat with me for a full consult. Thorough, direct, no rush.

The one finding that warranted a longer conversation: a slightly enlarged prostate — typical for my age. The urologist and I spent about forty minutes going through the ultrasound images and my PSA reading of 4.07. He walked me through what's normal for a man my age, what to watch, what the numbers mean in context. It was the most thorough prostate conversation I've had with any physician.

Lunch appeared in the lounge somewhere in the middle of all this.

At the end of the day — and it was a genuinely full day — I met with the internist. He had everything in front of him: blood work, urinalysis, the chest X-ray, the full ultrasound report, cardiology, pulmonology. We went through it together for over an hour. At the end of it, he looked at me and said: "Tom. Whatever you're doing, keep it up."

What he didn't see: lifestyle diseases. No metabolic dysfunction in the blood panels. No cardiovascular red flags. Fasting glucose of 87. Resting blood pressure of 103/63. Lungs operating well. Carotid arteries with minimal occlusion. The prostate to keep an eye on — normal, not alarming.

I walked out of Hospital Diagnostico with my chest X-ray under my arm and a full set of printed reports covering every test. Not a portal login. Not a summary arriving in three days. Physical documents, in my hand, that afternoon.

Here's what I want you to take from this.

I'm not suggesting you fly to El Salvador for your next physical. What I am suggesting is that comprehensive, high-quality medical evaluation exists in this world at prices that don't require you to be wealthy or well-insured. The kind that gives you real data about what's actually happening inside your body. $595 for everything I just described. A hospital that handles US Embassy staff, staffed by physicians who trained at serious institutions, organized around the patient's experience in a way that American medicine, for all its resources, rarely manages.

Knowing your numbers is not optional if you're serious about your health. A fasting glucose of 87 tells you something. A resting blood pressure of 103/63 tells you something. Carotid occlusion percentages at 76 tell you something. These aren't vanity metrics — they're the biological score on a decades-long experiment. You need to know the score.

Medical tourism is one way to get it. I'm not the first person to figure this out. But if you're in your 50s or 60s, putting off a real workup because of cost or scheduling friction or the sheer exhaustion of navigating American healthcare — there are other options. I went to El Salvador for a month and came home with the most thorough physical of my life.

The concierge was a nice touch.

Next week I'll tell you where this way of thinking started. A cadaver lab at Stanford in 1973, a professor who told me something that didn't add up, and the question I've been following ever since. It explains why I ended up in El Salvador, why I question what I'm told, and why I'll keep doing both.

If you'd like that in your inbox, subscribe below. It's free. It arrives twice a week. And every piece comes from the same place this one did: something I actually did, something I actually found out.

I'm not a physician and nothing here is medical advice. This is a personal record of what I've tried, measured, and found. Run anything you want to try past your own doctor first.

Tom O'Connor is the founder of 75goingon50.com. He lives along Hood Canal in Washington State.