Een revolutionair idee!
I have a backlog of roadtrip posts to do, but this one has been nagging at me – one of the most obvious cultural differences between the USA and The Netherlands…
Yup. Health care.
Pretty much everyone knows how much the US system sucks. It’s extortionately expensive, the system exists to keep people sick (that’s where the profits come in, of course), and getting adequate pain control is difficult or impossible. People who are dying of cancer are denied pain medication because they could become addicted. I leave it to my readers to ponder the utter stupidity of that idea.
Those of you who don’t know me well may need a little backstory on this: in October 2008, I injured my tailbone. Over the following two-plus years the pain became completely unmanageable, and my life became very small. I could no longer ride horses, which is my grand passion in life. Driving for even 10 minutes was enough to make me want to cry. I could not go to the office, I couldn’t go hang out with friends or attend parties or dinners because the drive was impossible. I became very isolated. I went for weeks without human contact – if I saw anyone other than my cleaning ladies it was unusual. This did not contribute to my mental health in any positive way. The American doctors were no help at all. They tried a couple of things and then sort of told me to just live with it, and gave me a prescription for large doses of …Ibuprofen. Over time, compensating for this injury also started to screw up the muscles in my lower back and pelvic girdle, causing intense pain and occasional numbness going all the way down to my toes. Then I packed up a three bedroom house without any help, handily finishing the job of completely destroying my lower back. When I got to the Netherlands in October, I had wheelchair assistance at the airport. I could not get out of bed without help. I could not tie my own shoes. I was effectively a cripple – and a depressed one at that. Chronic pain saps energy, both emotional and physical.
I have a number of friends with chronic illnesses that involve a lot of pain, and the gyrations and humiliations they endure to get even inadequate pain control enrage me. They get accused of drug seeking, or are told to lose weight (which is a whole other rant, how doctors can’t see past fat and how the doctors themselves are to blame for the embiggening of the US population), or are prescribed medication that is completely useless for their needs. I was lucky, in a way – I had a 14 year relationship with my doctor, and he trusted me enough to give me some Percodan for the last 6 months before I left. It wasn’t nearly enough to do the job, and he didn’t give me much, but at least he gave me some. I saved it for “emergencies” – essentially the days when I literally could not stand up. I arrived in the Netherlands with faint hope of anything changing.
That being said, one reason I chose to move here because of the Dutch medical system – it is not run as a profit-generating business, and is predicated on the idea that people should be made better, not kept sick. They have some very skilled doctors here and I hoped that maybe I could find an actual solution to my problem. I did not, however, believe that I would be given any relief from the pain.
Well. I was wrong.
Carel found me a doctor that had studied in the UK so his English was likely to be better than most, and conveniently his practice is also quite close – less than a kilometer away. I went to see him and explained my issue. He wrote me a referral to the pain center and a prescription for some Tramadol, which I was already taking. After the pain people had a look at me, I went back to him for a re-assessment of my pain medication. You could literally have knocked me over with a feather when he gave me a prescription for Fentanyl. If you don’t feel like looking it up, it is a synthetic opiate, approximately 100 times stronger than morphine. Guess what? It works. I’m careful with it, because I don’t want to over-use it. I don’t use it while I am working, either. But! I have adequate pain control. I didn’t have to beg for it. He didnt dismiss me with a “lose weight”. I didn’t have to buy it off the street. I expressed my surprise when I visited him today, and he looked startled. “Well, you are in severe pain. Pain is damaging. Why should you have to add that damage to the problem you already have? That helps nothing.” I just stared at him.
Uh, yeah. You Americans, read that two or three times. Compassionate treatment apparently does exist. My visit to the pain center bears this out. The teaching hospital in which it is located is *huge* (check out how big the actual building is). When I say “huge”, btw, I mean “huge” to the point of the interior having street names and addresses to help you find where you are going!
The Dutch subscribe to the idea that if people are not miserable, scared, and dehumanized, they will heal faster*, and so they designed the hospital accordingly. The doctors don’t rush you. They sit, and listen, and ask intelligent questions. It looks more like a mall or hotel than a hospital. From their website:
Buildings can make people ill, or have a healing effect. Research has shown that the hospital building affects the healing process. The exterior, the interior design, the atmosphere, the views, the use of color… all these affect the well-being of the patient. If patients are comfortable and positive then this is good for the healing process.
UMCG feels that patients have to be able to continue to participate in society. This is why the hospital has brought the outside world into its walls. The result is a city within the city, with a bookshop, a hairdresser, a chemist, a pharmacy, cafés, a travel agency and much more. There is even a supermarket. Patients who are capable of leaving their bed meet visitors, employees, students and local residents in the inner streets of the UMCG. This allows them to temporarily stop feeling like a patient.
Yup, it has restaurants…
fountains, plants, random art everywhere…
The patient rooms have balconies with nice seating, that overlook the atriums. That’s a fountain on the right side.
It doesn’t smell of fear and disinfectant. The only thing that really gave it away to me was the presence of a lot of people in white coats. I was staring around like a country bumpkin newly arrived in the big city. Unbelievable. And yes, I know things here are changing too, and not for the better, but this is light years ahead of the USA, still. And it doesn’t cost the earth, either. I am not afraid of going bankrupt due to my medical bills, which was a real fear in the USA. Yes, I pay high taxes. But hey, they’re used for something good, like helping people. Not for…oh, blowing up brown people. Grr.
Now if you will excuse me I am going to take some of my pain killer and go lie down for a while, and wish with all my heart that I could get this kind of help for my friends.
* Isn’t that the most revolutionary idea you have ever heard of? Isn’t it also as bleedingly obvious as the nose on your face? GET WITH THE PROGRAM, USA!