Wednesday, October 13, 2010
This is the healthcare system of newsweek's 'best country in the world'
My bad experiences with the Finnish medical system start when I was fourteen, almost fifteen, and I became ill with pneumonia. As strange as it seems, due to extenuating circumstances, I was alone in Finland, a place that was new and exotic to me.
Finland has systems. And people abide by those systems without realizing that elsewhere in the world, people function in very different ways. So, armed with my life experience of a simple formula (1. Go to hospital, 2. See a doctor, 3. Get medicine and get better) that had worked so well in the past, I braved the winter winds and went to the nearest health centre.
Here’s what the lady behind the counter told me: “Sinun ois pitänyt soittaa ja varata aika ensin.” ("You should have called and made a reservation first.")
I didn’t understand at all. So there would be no doctor for me? I went home and lay in bed with pneumonia for two weeks.
Since then, I’ve avoided healthcare in Finland as much as possible. I’ve saved my medical concerns for when I’m in Thailand. This hasn’t been hard to do, since I only lived in Finland for three years. Needless to say, though, all other run-ins with healthcare in that period were equally unfriendly and unkind.
I’d been gone so long by March 2010, that I’d managed to forget how awful my experiences with Finnish healthcare had been in the past. And I thought, well, now, with a Finnish partner and a fresh perspective, surely things aren’t really that bad?
In April, our one-year-old son started vomiting. Every day, once or twice. At first, we went with what the doctor said and thought maybe it’s just some gastro-intestinal infection or virus. But it just continued and continued. We went to numerous doctors, public and private, who all kept insisting that it was just some GI, even after a month of it. Finally, our own health centre agreed to run some tests for allergies and celiac disease.
I had done my own research and insisted that, as we have no history of food allergies or of celiac disease in our family, I thought that was unlikely. The symptoms looked like gastro-esophageal reflux disease to me. Our doctor, however, insisted that it MUST be celiac disease. To complicate matters, this doctor retired, leaving the case with another person who was constantly having to consult some doctor in some other department because she didn’t really understand much about pediatric medicine.
The testing took another month, and of course, he came out clear of allergies or celiac disease. It was only at that stage that someone on the other end of the phone (I don’t to this day know who it was) suggested that maybe it’s reflux. Two and a half months after I had made that suggestion. And at stage, we started taking Losec MUPS, and gradually, the problem went away. It wasn’t until June that we got to see a pediatrician (other than private ones, who had all maintained that it was just a GI).
This experience is what confirmed to me that there really is nobody who listens in the Finnish healthcare system. You get referred to one doctor, then another, who all insist on their own agenda, and who simply will not listen to you.
Around the same time, I started developing panic attacks – another ‘old friend’ from my teenage years that I had forgotten about. My panic attacks accompany a sense of depression and helplessness. They stem from a sense of nobody listening, of being alone. I start seeing horrible images in my head – mostly of myself dying, or killing myself, in a different manner and a different situation every time – but sometimes also of my loved ones being killed in various brutal ways.
So around June, hoping it would make me feel better, we started enquiring our maternity nurse about the possibility of making a birth plan and meeting some of the staff that would be around for my delivery. We were told that birth plans were not customary in Finland and we should only start asking about hospital tours after my 32nd week of pregnancy. I also tried contacting psychologists, because I thought that I quite possibly need help untangling the mess of my teenage years in Finland in order to overcome the panic attacks, but of course, everyone was on holiday.
In the meantime, my fear of not being listened to simply got progressively worse. I tried all sorts of avenues to find out what is customary and what isn’t in a Finnish birth, and it seemed that everyone I asked had a different story to tell. I wanted to get some concrete information so that I could make decision to go back and deliver in Thailand, where I had already delivered once, and where I knew I could trust the doctors and nurses, since it would be the very same individuals I’d be working with since the beginning of my first pregnancy.
It wasn’t until my 28th week check-up in early August with an ob-gyn that the doctor realized something was wrong and asked my nurse to refer me to a psychologist for therapy. She explained that I would first have to get a diagnosis from a psychologist before I could be referred to this service called the ‘pelkopolikliniikka’ (fear polyclinic?) since I wasn’t actually afraid of any of the physical pains associated with giving birth. She also explained that this person should be able to help me work through my other fears.
And so on August the 19th, I finally went to see a psychologist. My partner had given her a heads-up, so she knew the rough outline of my case. I was under the impression that I’d be working with her for some time, so I opened up to her and told her about my experiences. It wasn’t until the end of the session that she said she was retiring. I could see her one more time, and then she’d refer me to some new people. Needless to say, for me, the trust was broken, and the subsequent meeting a week later was meaningless.
It wasn’t until October the 1st that anyone was able to arrange any time to see me. At that stage, it was already quite pointless in my opinion. Three weeks away from my due date, too late to travel to Thailand even if I wanted to, what were they thinking to accomplish? Psychological cures in three weeks? It seemed absurd to me that I had been bounced around from one place to another from June, and nothing had been accomplished. Finally, when someone who could help me for a sustained period of time was found, I only had three weeks left myself.
That same afternoon, I finally had my first appointment with the ‘fear polyclinic’. I explained all this to the doctor who received us, in tears, again, for it’s no easy matter to pour your heart out to a stranger, and after ‘listening’, she said, “Ok, let’s do an ultrasound to see that the baby is ok.”
Excuse me? I was happy to see the baby, sure… but… I had a sense of being stuck in a healthcare version of Kafka’s ‘The Castle’. After the ultrasound, we tried to gently guide the topic back to what I was actually afraid of, and so we were referred to the birth ward upstairs.
The communication between two floors of the same building was no better than between different health sectors. The midwife who received us was under the impression that I was someone who needed a tour in English (The English language tour was full) because I didn’t understand Finnish. When we told her that I could understand Finnish if she preferred to speak in Finnish, her response was to get agitated and say “Well, then why don’t you just join the Finnish birth ward tour then?”
So that was the end of the road, I thought. They aren’t going to help at all. The fear polyclinic has once more confirmed that nobody will listen to me. At this stage, I was in tears, and my partner got agitated and asked her what the policy really was in cases from the fear polyclinic. It was then that it was clear that she had misunderstood, and so she promised she would ask her supervisor to give her special permission to arrange an out of working hours appointment for me. She said she really wanted to help, and that she would call us on Monday (it was Friday afternoon then) to make the arrangements.
We didn’t hear anything from her all week, and finally, a week later on Monday, my partner left two messages asking her to return his call, and nothing happened. On Tuesday, he called again. The midwife had gone on a two-week holiday. I guess the upside is that I don’t have to get upset the moment I see her at the maternity ward and I don’t have to ask for another midwife should she be assigned to me because she won’t be there.
fon @ 2:21 AM link to post * *