Dutch Bedside Manner: ‘You’re Dying.’

I’ve read that a positive mental attitude can boost your health. Dutch research seems to have concluded it’s better to admit we’re all dying. Perhaps it’s because many Dutch people pride themselves on their directness. Back home I learned, “Don’t talk about religion and politics in mixed company”. Here, it’s not uncommon to start a conversation with: “You’re from America? Your foreign policy is a joke, and your president is a war criminal”. Nice icebreaker.

In medicine, the same Dutch directness applies. It starts with Dutch insults, which go medical right away.

In America, we may tell someone “Get lost.” In the Netherlands you may hear “Krijg de kanker” or “Get cancer.”
The British say: “Get stuffed”. The Dutch say: “Krijg de typhus” or “Get typhoid fever.” On a softer note, the Dutch also say “Krijg de Kleren” which means “Get the clothing”. That one always made me laugh. But then it was explained to me it actually means “Krijg de Cholere” or “Get cholera”.

The worst insult in America is “Go give yourself an orgasm”, to which I always say “Thanks!” Compared to the Dutch, we are hopelessly outclassed.

With such a cultural fixation on terminal diseases, you’d think Dutch medicine would be quick to prescribe, well, medicine. You’d be wrong. According to De Volkskrant: “Dutch doctors prescribe the least amount of antibiotics in Europe.” In America, we’re pretty sure that all Dutch people are drug-dealing, drug-doing, baby-killing, grandpa-murdering homosexuals. Yet – if that was true – then you could get drugs from, say, the Dutch health care system, which I’ve found to be virtually impossible.

Many conversations I’ve had with Dutch doctors start out with a frank discussion of symptoms, as if to imply that I shouldn’t need to be bothering him at all.

My doctor will ask: “What do you think is the cause of the problem?”

It’s like a medicine quiz.

“We think our daughter has an ear infection,” I’ll say.

The doctor: “You are right.”
I half-expect to win a prize.

Then comes the next question: “And what would you like me to do?”

I’ve heard this question more than once from Dutch doctors: “What do you think I should do?” It’s not the best way to inspire confidence. My first reaction is always, “You’re the doctor. Don’t you know?” I’ll ask for some medicine. And he’ll look at me like I’ve said something deeply offensive.

The Netherlands is a country where you can get smart drugs over the counter, no problem. And weed? Hash? Over the counter, no problem. But if you want to get antibiotic medicine to heal your body, Dutch culture says, “Get out of here, you sick, disgusting freak”.

And then there’s Dutch bedside manner. My most memorable case was during my wife’s first pregnancy. About a month before the due date of our first child, my wife got a strange feeling. Normally, she’d been feeling the baby move or kick every day. But there were a couple of days in a row that she felt nothing. As a first-time mother, she got super-nervous. We got super-nervous. So, on a Sunday, we decided to go in to the hospital.

If I can recommend a day of the week to go to a Dutch hospital, I would not recommend a Sunday. There was only one obstetrician on duty, so I explained that my wife was super-nervous, and we just needed a consultation. Just someone in a uniform to tell us everything was okay. We waited.

We were visited by an obstetrician-in-training, who made an ultrasound scan of the baby and paused as she held the wand over my wife’s belly. Then we got the famous directness: “Either I’m reading this wrong, or your baby has serious birth defects. It could be a misshapen head. I’ll go get the doctor now (and be gone for as long as possible)”. We were scared stiff.

She literally left me holding the ultrasound wand in my hand. I decided to keep smiling. I thought I’d make the best of it: “What the hell, I’ll give myself an ultrasound”. I introduced my wife to my food baby. That helped us calm down a little, but it felt like forever before the proper obstetrician came in. Without a word to us, he instructed the trainee that you’re supposed to measure from the outside of the line, not the inside. He left – still without a word to us. The trainee said, “Your baby’s fine”.

We decided to have the baby at home.

Greg Shapiro
2014 Summer

← Back