3.07.2007

A Real Pain In The Ass

I have a gimpy back. I've struggled with a spinal disc injury for the past few years, and about a month ago I felt a twinge in my leg while playing floor hockey with some co-workers. Knowing from past experience that this was potentially the start of something a whole lot more serious, I took a few days off. But the discomfort didn't go away as quickly as I'd hoped, so despite my previous experience with the Swedish medical establishment, I decided I'd need to have someone look at it.

First stop: Vårdguiden, the main point of contact for medical referrals in Stockholm. I must admit I was a bit hesitant to call them after remembering that I'd received this lovely flyer from them in the mail a while back:


Yikes. Although it says so (ryggskott means "backache" in Swedish), this picture doesn't exactly scream "back health" to me. I find it roughly as motivating as a picture of, oh, I don't know... Jeffrey Dahmer in a tutu or something.

Nonetheless, I call them and, a lightning-quick three weeks later, I have an appointment to see an orthopedist.

I arrive at 9:00 sharp. I am the only person in the waiting room. The receptionist is talking on the phone, ignoring me completely despite the fact that I am standing about two feet away from her.

For the next five minutes, she chats away on the two phone lines alternately, one pressed to each ear. No eye contact. In fact, she makes no acknowledgment whatsoever that I'm actually standing there. Damn... did I accidentally put on my invisibility cloak instead of my regular jacket this morning?!? Even the most harried receptionist at any medical facility I'd ever visited in the States would have put the calls on hold—at the very least the ones that came in after I'd been standing there in front of the window for several minutes—and made at least some indication that they knew I was there.

Here in Sweden... not so much.

Having literally nothing better to do, I take the opportunity to study the receptionist and her body language (you know, social intelligence and all that). She is middle aged, rather less than svelte, and seems to do... everything... in... slow... motion. Her appearance does not exactly exude "professional" (nor "hygienic," for that matter): greasy, unkempt brownish-grey hair, matted down onto her sallow skin by what appears to be several cups of cooking oil; teeth the color of faded newspaper; and a wide, empty face that is a portrait of weary, profound boredom. It's five minutes into the workday and already she looks like she'd rather be anywhere else than here, dealing with, you know... actual people.

Finally, she puts down both phones at the same time. Still no eye contact. Refusing to speak anything other than Swedish (it says here that doctors in Sweden speak good English, but apparently that doesn't extend to clerical staff), she wearily pushes some papers toward me, asking for something but not really listening. On one point, however, she is alert, whip-smart, Large, and In Charge: she positively insists that I show some legitimation. Nej, she says, just having my personal number won't do—mama gotta have a pit'cha. Not wanting to feel illegitimate, I wipe her spittle off my face and dig my US driver's license out of my wallet. For a moment I am thinking that I will have to schlep all the way home and get my passport, but after a bit more supplication I finally manage to convince her that I am, in fact, myself. Although I am fortunate enough to have been assigned a real, honest-to-goodness personnummer, this Swedish obsession with ID totally mystifies me—it seems as though the paramount consideration is to make sure no one "steals" medical care, perhaps by waving around their old college fake ID or something. Though, as will be apparent in a moment, it is an impenetrable mystery to me why they think anyone would actually want to do this.

Anyway, I write my local address and telephone number on a few forms, and she shoos me away toward the row of chairs with a perfunctory wave. I sit down to wait.

Ten minutes later, a plodding step in the hall, a key goes into a nearby door, and I hear a muffled "hello" aimed in the general direction of Olive Oyl from the doctor's exam room. I check my watch and realize that the doctor has arrived fifteen minutes late for his first appointment of the day. A few minutes later he comes out to greet me. He is not at all out of breath, gives no tangible indication of having been in a hurry, and certainly does not bother to acknowledge that he is late.

The examination is brief and unremarkable—other than the fact that he tests for nerve impairment by dragging a mostly non-rusty nail along the outside of my leg. I guess the whole "sterile exam instruments" thing hasn't made its way to Sweden yet. It isn't painful and thankfully he doesn't push hard enough to break the skin, but as I sit there I can't help but wonder where else the nail has been. I also find myself wishing I were wondering about something else.

As he sits at his desk scribbling on a notepad, I offer to show him my most recent MRI—which I dutifully had sent to me from back home in trying to prepare for this visit—but he dismissively waves it away. "I do not look films. Only interested with the back," he says.

Abruptly, the exam is finished, and the good doctor is assuring me that there's nothing at all to worry about. As he hands me the prescription, he says, "take this for a week and you forget all about your back pain." The following is a word-for-word transcript of the ensuing conversation:

Me: Gosh, that sounds great. What is this wondrous preparation I'll be taking?

Dr. Naildragger: It is—how you say?—you have word in English, "spasitories?"

Me: (life heretofore free of self-inflicted rectal discomfort flashes before eyes) Uhhh... yes... why?

Dr. N.: Seven days and you feel better. Please pay receptionist on way out.

As he shoos me out of his office and back into the waiting room, I'm still trying to process the fact that an ostensibly licensed medical professional has just instructed me to stick something up my ass to deal with my back pain as I hand my credit card to Miss Spic-and-Span.

SnS: No card.

Me: Umm... what?

SnS: No card. Cash only. Bankomat downstairs.

Hoooooooookay. Never mind sterile instruments; I'm starting to think I should be thankful that there is actually indoor plumbing in this office.

When get back from the cash machine, the receptionist has to go into the doctor's office—interrupting his examination of the patient after me—to get change. (Apparently she is not to be trusted with the petty cash. I wonder why.) In the meantime, I go across the hall for a moment to get a drink of water. When I come back for my change, Miss Congeniality is back at her desk with one of the phones pressed to her ear again... and picking her nose with her free hand. Up to the first knuckle. In full view of the people in the waiting area.

See if you can guess which hand she used to hand me my change.

Needless to say, my back is no better, but the next time someone lectures me on the virtues of socialized medicine, there may well be a scene of unimaginable violence. Afterward, though, I'll at least be able to recommend some effective medicine for the pain.

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