A Taste of Emergency Health Care in Holland

by Madeleine Kando

I went to see my ninety-eight year-old mother-in-law in Holland last week. She lives in a small community called Mierlo where I usually drive around in circles for the good part of an hour trying to find her house in an endless maze of identical looking villas. While my Dutch sister-in-law, Lise and I were shopping for dinner, her cell phone rang. It was 'Oma' who said that she had just fallen and hurt her arm. Lise was quite calm about it, asked her if it was serious and that we were coming back to see.

Oma was in a chair holding her right arm which she had wrapped in a towel. A large piece of skin had been scraped off when she fell and her arm looked like a raw, bloody piece of sirloin. Lise immediately called the local hospital. Since the emergency room there was closing at five (the Dutch are very particular about not working after five), they referred her to the hospital in the next town over, which was only a ten-minute drive. (that's the nice part about Holland, it’s so small that everything is pretty much accessible, like on the Little Prince's planet.).

She made an appointment for us to arrive there at six. This is was the first of many surprises in the Dutch 'emergency health care' system. You don't just rush to the emergency room unannounced. You call, tell them what time you will be coming and there will be someone there to expect you.

We drove to Geldrop, parked the car in the 'emergency room' parking lot and walked in. We waited about twenty minutes and a tall, young and very handsome doctor came out. We all followed him into the treatment room like little ducklings following the daddy duck. He had a trainee in there that was just as young, tall and handsome. It made me doubt my previously held opinion that Dutch men aren't the best looking breed in the world. Maybe Dutch medical schools screen for looks as well?

Anyway, he was incredibly charming, efficient and had none of the pedantic style that often comes with the territory. I was so impressed with the whole thing, I was just standing there in the corner, my mouth gaping. After he cleaned out the wound, I watched him put back the hanging flaps of skin with a small pair of tweezers, which an attending nurse had pulled out of the drawer. He neatly covered the raw piece of meat and explained that skin makes for a perfect band-aid. He didn't use penicillin, shots, ointments, disinfectant... nothing. He covered the whole area with two pieces of non-stick gauze, wrapped Oma's arm neatly with regular gauze and taped it together with what looked like scotch tape.

I couldn't help myself. I had to ask him about the penicillin. He was very clear on that subject. No, he would not use penicillin, even if it got infected (which he said it might), because he had very rarely seen this kind of wound become 'gangrenous'. (I guess they only use penicillin as a last resort here).

That was it. No fuss, no extra wrapping, no face masks, no medication..

He gave some instructions on how to take care of the wound: Oma's caregiver who comes to visit her every morning to keep an eye on her, (compliments of her socialized medicine health insurance package), should change the bandage every day and her primary care physician should make a house call twice a week (a house call!). He reassured her that she would grow new skin over the next three weeks or so.

'Good-bye', he said, as he politely shook our hand one by one. And off he went to his next heroic life-saving case. I could see the emerging traces of a permanent frown on his young handsome face, probably carved there by the many terrible things he had already witnessed in his young doctor's career.

Well, I don't know about you, but it seems to me that Holland is one of the best places to injure yourself and end up in the emergency room. The emergency care in this small Dutch community is far above average and the doctors on-call look like they were cut out of a fashion magazine. I wonder how many of their female patients fall on purpose just to be able to come and undergo their treatment?leave comment here