Treating kiwis II

Some other stuff I’ve learned

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Hidde is back from New Zealand (NZ) and can’t shut up about it. To make him do so, we forced him to finally write this last article full of insights he delusionally thinks he picked up over there. It’s still fun though!   

My last report was a while back, partly because there was no deadline to write for, partly because I was way too busy learning heaps and having fun. Who wants to write  when you can go sailing, beer in hand, during a spectacular sunset? Yes, my life there was great. Still, after six years of mind numbing training “how to be a professional”, I’ve picked up a bloody habit: reflection. Here is some of that about both my medical and travel experiences in NZ. 

Pathology goldmine
I have to get this out of the way, because I just can’t get over how unhealthy people can be! I had the most mind boggling talk with a guy my age (26!) whom I could easily use like Leonardo di Caprio uses his horse ánd have room to spare for a comfy bed. Yes, he was that fat. Obviously, he also had type 2 diabetes and hypertension, leading to kidney failure. I’m going to let that sink in for a while by starting a new paragraph.

So I tell the bloke that at the rate he's going, he’ll need dialysis within a few years. ‘Aw yeah, a friend of mine gets that too.’ ‘So does he like it?’ ‘No it’s bloody awful.’ ‘So, are you taking your meds?’ He, without a change of facial expression, says: ‘No’. Me: ‘How about losing some weight?’ ‘Aw yeah would be nice’... This baffling back and forth went on for a while.

Sure, there are some unwilling patients in the Netherlands. It’s just the combination his unwillingness ánd him being mortally ill because of his lifestyle. I’ve never encountered this so severe over here. Not to mention the amount of times I’ve seen similar instances over there. 

In short: the general shitholery of the place I worked (poor, drugs, gangs, teenage pregnancies etc.) provided me with a lot of experience. It’s a goldmine for people who want to see pathology. Also because people hardly ever go to the doctor for “nothing”.

Studying medicine in NZ
Part of the fun I had was working with Kiwi medical students, also in their final year. So of course I wanted to know: what’s it like to study medicine in NZ? I discovered that, like everything else, their system is similar but different. They too study for six years: three bachelor years filled with theory and three years of practice. 

After medical school though, it’s pretty much mandatory for them to work on multiple hospital wards, in different specialties, for two years. Personally, I’m all for a broad medical education but this seems to be a bit much. Additionally, we are less troubled by the phenomenon of black wednesday in NL. In short: the day a lot of junior doctors start working which magically correlates with a rise in mortality rates. (To be fair, I only know of this happening in Britain which has a similar system) 

Another big difference is their first year, which functions as a selection program. It’s notoriously tough, thereby selecting both bright and hard working people. Weirdly they focus mostly on general biology and chemistry rather than specific skills a doctor needs. What if we had a similar selection process in our first year, but focused it more on other features of a good doctor? It would seem like a fair way to select medical students, although the competition between people might get nasty. 

Free healthcare is great, just don’t die in the meantime
The Dutch healthcare system is often seen as one of the best, if not the best, in Europe. Of course we complain about it, we’re Dutch. By the way, couldn’t it very well be that the reason why stuff is great here, is because the fact we do complain? Still, sometimes it’s important to realise how good it is here, even compared to other first world countries, like NZ. 

Before some get wrongly offended: on the whole I think NZ has good social security. Having a practically free public system is of course great. The thing is though, the private sector is so much better! Especially in terms of waiting lists and in hospital comfort and this of course heavily divides rich and poor. A striking example: Calling the orthopedic surgeon about the exact same case through the public system results in a possible acceptance of the referral in 5 months time. Calling privately suddenly makes the earlier harsh voice tell you cheerfully how delighted he/she would be to see miss Osteoarthritis next week. 

‘Yeah, nah. Should be alright.’
Kiwis are quite laid back people. If I had a dollar for every time someone met my question whether something would function properly with: ‘Yeah, nah. Should be alright’, I could have eaten another Ferg Burger. The same goes for questions whether something will be done on time or even if something will be safe. 

Another weirdly common NZ phrase I loved was: Sweet as bro! When something is amazingly awesome. And no, I did not forget an s (it’s not “ass”), they’re just too lazy to finish the comparison (it’s sweet as …). Another one you heard constantly: All good bro, in response to ‘thanks for…’. Notice how “bro” is used a lot, or is used “heaps” as they’d say. For me, the biggest problem was calling a sweater a jumper. 

Some stuff on traveling
Finally, let me tell you about how great traveling New Zealand is. It’s fucking great! There you go, all done, just go for it bro. If you’ll let me continue, I might just go all typical backpacker on your ass, saying stuff like “travel is so important, it leaves you speechless and makes you a storyteller”. Or: “If you’ve been there, you’d know what I mean.” 

Furthermore, I might force my own traveling tips on you. For instance that in my “humble” opinion traveling New Zealand by car is the only way to go really. At the very least I’d start showing you only the nice pictures I took and tell you all the cool stuff I did, just to poke your eyes out. 

Much the same, but different
My conclusion about New Zealand is that, as a first world and, in a cultural sense, Western country, it’s much the same, but different. Which for me made it a heck of a lot of fun to find and describe those little differences. Doing so makes you think about the way you yourself go about things in medicine, but also in general. Right and wrong might be less clearly separable than you think. 

Lastly, the question I get asked all the time: “could I live in NZ?” ‘Yes and no’ is the only answer I can honestly give people, albeit a most annoyingly and pedantically philosophical one. Yes, because, come on, it’s awesome there: heaps of freedom in the way you practice medicine while living in paradise-like nature all while doing the most spectacular activities ever! No, because of family, friends and the realisation that despite (or because?) all our complaining, the Netherlands is pretty great and beautiful too. But by God, it’s so freaking wet and COLD returning here in February!