I could fashion myself a modern day Nellie Bly – sacrificing myself to investigate the Danish Healthcare system – from the inside. Dun, dun, dun. Dislocating your ankle, tearing both ligaments required to locate it and fracturing your fibula – on purpose – might be reason enough to get me committed to Nellie’s “human rat-trap” of an insane asylum back in 1887 NYC. But this is no Blackwell’s Island. And on purpose, this accident was not. Boo. And OUCH. Serious ouch. Suddenly the charm and beautiful view and streaming light pouring through our 5th floor apartment seem a wee bit less inspiring and a helluva lot more daunting to access. Our recent “car-free” life choice presenting itself as an inconvenient truth, but we’re committed. For now.
Here in Copenhagen, there is no 911 and we had to retrain the children. Here, you dial 112 for life-threatening emergencies, but 1813 for all other potential emergency room visits. Requisite over-the-phone triaging complete, I am directed to immediately make my way to the nearest hospital. Sans car. Barely a little older than a year, the 1813 line was executed in January 2014 as an effort to eliminate long waiting room spans sitting in discomfort. I have no basis for comparison pre-1813, as this is our first foray into the Danish healthcare system. Months back, we received our precious Danish CPR card and number (similar to an American Social Security Number, but utilized for all aspects of life here in Denmark. That # becomes your library card #, your health record #, your bank account access #, your access to your new mobile telephone #, and right now my medical ID bracelet #. Some feel it might be big brother’s #.) With that number, came pre-assigned doctors based on our address, which we had not yet the need to make a visit.
Within our limited and current frame of reference, this new 1813 system seems to work. Once we got there that is. Hopping down all those stairs, even with assistance, was not an option – much, much too much jarring and corresponding PAIN. We improvised a sling of sorts out of my husband’s wool scarf to hold the quickly swelling leg in a tolerable position while I carefully and slowly scooted down on my bum, one stair at a time. Making it to the bottom landing (on my bottom) I now had to make it the 15’ from the stairs through the building’s front door to the taxi waiting out front. Being carried on the shoulders of my husband and eldest son (he is taller than me remember?) didn’t work as it created more swinging of the hurt appendage than I could bear. Some quick-thinking and my son hustled back up to our apartment and grabbed the roller desk chair that had recently come into our possession. Our new (read old, from someone else’s trash) chair that was prophetic to have procured, came at the persuasive insistence of my wee lass who NEEDED a desk chair for her non-existent, but dreaming-of-desk-to-be. [Side note: Did I already clarify that our new home was not furnished upon takeover and no furniture was placed in the crate of our American goods relocating with us. Good thing too – as the crate is STILL NOT HERE. That’s another story.] A healthy dose of anti-bacterial cleaner and the “roly-chair” was a life-saver a few nights back. Slightly challenging for the small, used, plastic wheels over the cobblestone sidewalk, but into the taxi I was delivered with care.
What do “roly-chairs” have to do with the Danish healthcare system? Well besides being my initial transport – just wait. Upon arrival and astute interception by our Danish taxi driver’s part – Nej, I don’t think you are supposed to check in at the Rigshospitalet – you are probably supposed to go to the Bispebjerg Hospital. Oh. Is that what she said on the phone? I thought I had clarified (in my haze of pain) that she was checking me into the closest hospital for our address. Yes. She was. Just not the one that I thought. Rigshospitalet – quite close to us and near the big park where we play – accepts only traumas as evidenced by the active heli-pad on top that we hear more than you’d guess while playing nearby. So second shout out of thanks to the cabbie who got us to the correct destination despite our terrible Danish and slight anxiety. (First tak [thanks] goes to my son for the “roly-chair” creativity and application.)
Hej! Hello, we answer upon arrival at Bispebjerg. Did you call 1813? Yes? Ok. CPR #. (Did I tell you that there is no direct word for PLEASE in Danish? Lots of ways to say thank you, but no please. Mull on that.) Intake continuing – can I see your leg? Oh. Ok. What did you do? (A question that will be repeated again. And again. And again. Why is my answer never an exciting thing either… thinking back to my plethora of ER room visits, they remain none of them from doing anything very exciting.) Laundry. I was doing the laundry after dinner. As a public service announcement to any and all reading this, I would urgently recommend that you secure your darling new area rugs to your high polished, beautiful parquet hardwood floors lest they cause you to slip and try to correct and otherwise shred your ankle in a pathetic attempt to catch yourself. You have been warned. Yep. That’s it. I slipped. And fell. HARD. I could get up, but barely.
Eyebrows raised. That’s it? She doesn’t SAY that, but she says that. With her eyebrows. Why wasn’t your rug secured? (She didn’t really say that either.) Danish incredulity. I’ve seen this look before. I’m getting used to it. I don’t take it personally anymore. They don’t mean it personally. So clearly, my situation looks far worse than better and I am “fast-tracked” to ortho triage. Story relayed again. Eyebrows raised again. But Danish efficacy kicks in and I am administered pain-killers, x-rays, grim assessments, an IV, an ankle relocation complete with thigh-high temporary cast and some seriously sexy stretchy white cotton skivvy shorts.
Say that 7 times fast. Seven times as long (by the end more like 77 times as long) is what I waited to have the surgery they assured me I required to reattach those pesky loose ligaments. Here is the first glaring contrast to the American health system. I was admitted to the hospital at 23:00 on a Saturday night. I was discharged the following Thursday at 13:00. I have never been in the hospital that long – even after a cesarean section. With several push-backs on my “soft” surgery time, which they had been very clear from the beginning, that because I was not an emergency case anymore, stabilized in my glamourous temp cast, I could wait. Jesting with me after last notification of push-back, my nurse says that’s why they call you a patient right? Requires patience. More than one nurse said this to me. But how do you say patient in Danish I asked? Patient, he answers. Ok – so it’s the same, but how do you say “patience” in Danish. Tålmodighed. So! It’s not a Danish thing – the “patient-patience” correlation. Oh but it is. He assured me.
Danes are a socialized country, as you know. Every aspect of society is theoretically based on the idea of “the whole.” How does something benefit, impact and/or profit the whole. No one person is better or more deserving than any other in this theory. This doesn’t always translate in the day-to-day here. Despite the somewhat flattened socio-economic strata when compared to the United States – there are still marked and obvious differences in opportunities and lifestyles. But I have seen it in action in several arenas – how the “whole” supplants the singular. It was definitely an undercurrent pushing my little broken raft into a Danish healthcare eddy. You will be operated on when it is best for the whole. Yep. Patience. Got it. Roly-chair to the restroom? Please? Oh you don’t say please. Tak?
So two days I waited to be taken to surgery. Not only waited, but was not allowed to eat or drink as pre-op procedure. Which would be fine – if you knew that pre-op was moving to op and then on to post-op. But no. Two days in a row, I fasted and thirsted. On my bedside table a little sign Faste og Tørste made sure no one accidently fed me or watered me. Directly translated it means “fixed and thirsty.” Two days I was fixed and thirsty, only to be told at around 20:00 that the last case had been taken to surgery and I would not be operated on that day. In Denmark, there is a work-life balance that dominates their culture, something many other countries express envy over. It is often mentioned as one of the reasons why Danes are the “happiest people on the planet” (I’m still assessing that one). How this work-life balance translates in my scenario is that there is no surgery done between 10pm and 8am, unless of course it is truly an emergency, then some doctor’s work-life balance gets put off that day. Lucky me though, I get dinner now. Three hours after dinner was already served, mind you. Ummm.
Traditional Danish smørrebrød (open faced sandwiches) can vary dramatically in texture, taste and tolerability for one not accustomed to such delicacies. Lox on rye bread (rugbrød) quite good and much better than mayo’d ham salad or canned cod roe loaf (you heard me) or leverpostej (liver paste) is all I’m saying. But eat I tried and patience I mustered, all the while my American incredulity growing that I was still hanging out at the hospital on the state’s dime awaiting surgery. This would never happen, your insurance wouldn’t pay for it in U.S. Good or bad. Riding a roller coaster of emotion, daily. Back and forth, back and forth. To the toilet too. Roly chair from the bed to the toilet. And don’t call it the restroom – why do you Americans call it the “restroom”? Are you really resting in there? What’s in there? A toilet is in there. You go to the toilet. (Actual interaction with snarky, but hearty laugh inducing, needed smile-producing male nurse.) But luckily Danes do call it a toilet because the night nurses who didn’t speak Engelsk and I could both understand that word.
This patient did ok. Pain management was working and nurses were very attentive. The language barrier only impacted me hypothetically (thanks to our cabbie) and I wouldn’t have been able to read anything the non-Engelsk speaking Kiosk gent was proffering or enjoy any of his treats due to strict IV fasting diet awaiting surgery. The language barrier was maybe even beneficial for the elder Danish gentleman that I shared a semi-private room with for the first two evenings. He was there first. He got the window. He could chat freely with his wife and family knowing that I had no idea what he was saying. It wasn’t immediately apparent if he knew English, as he respected my space (very Danish) and only said a quick Hej or Farvel when scooting past on his walker to do his rehab in the hall. As it turned out – he did know English – which he revealed only when the physical therapist, who came to work with him, spoke to me in Danish. You have to speak English to this one, my roomie clarified. AH! You DO know English! Ok. But before we were able to chat any further, I was rolled down the hall to a new room and new roommates. Apparently men and women co-sleeping (with privacy curtains of course) was a relatively new adaptation in Danish healthcare – only allowed in the past few years. I will admit my surprise at first, but it was fine. Respectful and fine. (And he snored less than my husband. Sorry babe!)
Waking up on my third day in Bispebjerg Hospital with my new roommate Irma, it was now St. Patrick’s Day. March 17th is not a holiday celebrated in Denmark – minor events locally, but really more of a pub-marketed drinking fest. And while Danes do love another reason to drink, there was no wearing of the green at the hospital, no corned beef and cabbage on the menu. I am very aware that the St. Paddy’s Day I have grown up with is a truly American creation, but being an American McMillen by birth, a holiday that my family has cherished wholeheartedly. A lucky visit from the doctor – the first one to actually speak with me since the initial assessment that my leg’s new contrapposto alignment might need rectifying. I’m on the schedule! It’s my lucky day! Kiss me – I’m Irish! But – don’t get your hopes up, you could be moved again, barring any 80-year-old hip breaks that would supersede me, something more about patience, we’ll keep you posted, yada yada… I’m on the schedule! At 15:00 today on the schedule. So I can drink for a few more hours. Did I say that the nurses were attentive? When Pernille found out that it was my family’s holiday, she brought my pre-op protein liquid in a celebratory wine glass. Cheers. For good cause it would turn out.
Rolled into surgery and back with a sleek new black boot, dinner and another night’s rest are in order. Seems Irish eyes are smiling. The following day, now Wednesday after my Saturday night admittance, thinking I have confirmed a discharge, I ring my family for a borrowed-car-ride home. Alas, says the next doctor, the last x-ray shows that the bones, which have been screwed to my ligaments, may not be in correct alignment and only a CT Scan can prove one way or another. Another means I can exit the hospital (the next day) and one way means corrective surgery to correct the original corrective surgery. Back on the roller coaster. Bring me the roly-chair to the toilet – I think I may puke. What I may have failed to mention, which has been backstage coloring my personal emotional slate this entire time, is the fact that previously scheduled to occur exactly one week after my initial accident, was an exodus of epic proportions – a cross-continental journey to reunite with my extended family in Hawaii for Spring Break. Believe me, I shared this with every single care-giver that I encountered while in Bispebjerg. And I am aware of how very first-world a problem this can sound. You have insurance right? The airlines will give you money back because of your surgery? You can change it? No. I can’t change it. Walking the fine line between making myself the “ugly American” pushing my needs ahead of the “whole” – I simply wanted it to be known that more than a tropical vacation of steady vitamin D infusion and flower leis – I needed to fill the emotional prescription of seeing a family that I missed spending Thanksgiving with, that we did not share Christmas with. That New Year’s was rung in thousands of miles and 9 hours apart. That birthdays (firsts and twelfths and thirty-sevenths and forty-fourths) have occurred, red velvet cakes and German Chocolate ones lovingly prepared; corned beef shared; all separately and in galaxies far far apart. All tolerable, because we knew in four or so months, we would all be together again in Hawaii. In reality, it may be the only time that we see part of the family for an entire year – possibly more. The possibility that a not-so Freudian slip could null and void the months and months of anticipation, expectation were turning into desperation. I could not get it out of my head how MY accident would impact my children if we were unable to take the trip and reconnect with cousins and aunts and uncles and grandparents. Hot roly-chair of emotions all OVER the place.
Ok. Thursday. Yesterday. Long story long. I know. Bear with me. But I was in there for nearly a WEEK. My CAT scan is back. It is not good. I need surgery again. And it will be next week. Cue tears on my part, not difficult at this point, desperation seeming quite desperate. Luckily my escalating emotion was quickly tempered by my husband, who merely asked – might it be possible to make that the week AFTER next? Already becoming well versed in how to maneuver in the Danish team-oriented business setting, this new option was not necessarily all about how it benefitted ME. (Or us.) But how it could work within the whole. Doctor did some checking and conceded that it would be possible. Heavy sigh. Roll me up on outta here doc! Erin Go Bragh! Erin is going to Hawaii! I may be back in the hospital for Easter and on, but right now I will take it.
As for your take-away – my hard-hitting assessment of the Danish healthcare system and my part in its whole – I’m still culminating my answer. I will have more time to experience it in a few weeks. Yay me. As for the wonderful Danish people who cared for me as part of their whole – mange tak! Seriously. A special shout-out to Gitte and Dr. Gustafsson (who weirdly had the same birthday as me, as well as namesake) for carefully and quickly assessing me. Charlotte for the lovely temp cast and initial adjustment – not as bad as I thought it was going to be. Pernille and Louise and Måysa and Nina and of course Bent (but not broken) – and the rest of the nurses who helped turn my anxiety into calm, my pain into comfort and my sadness into laughter. Karsten and Frederick in anesthesia who sensing my stress eased me into the process and out again with grace and true care. And for my new neighbors Helene and Becky who lent cars, brought food and magazines, took children – TAK! Thank you for being my new village. And for now, whether the Danish healthcare system is BETTER or worse than the U.S. or any other for that matter – I cannot definitively say. Maybe Nellie Bly I am not. But I can tell you that despite the warning that the Danes don’t cultivate a service culture, my care and service this past week was beyond compare and I can only attribute that to the Danish healthcare system and the Danes themselves. Tusind tak! Now roll me some sunscreen.