Everybody's a doctor

One of the advantages of a cross-cultural marriage and/or moving around a lot is that if gives you the chance to put your own culture into perspective. The basic attitude of people in the Netherlands (my country of birth) regarding health issues - from how to give birth, to when to use of over-the-counter drugs for headaches and the flu - is non-interventionist. I had never really given this much thought, however, until I started going to Spain (my wife's home base) regularly, where attitudes are at the other end of the spectrum, their view being that you should medicate as soon as you have the slightest symptom of anything. In the beginning, I suspected that Spaniards had difficulty distinguishing medicine from candy, that's how bad things seemed to me. 

But then I found out that the average level of knowledge of medical issues is indeed higher than in the Netherlands.  Truck drivers, secretaries, housewives and waiters alike have a much more extensive knowledge of the human anatomy and of the symptoms and treatments of common ailments such as arthritis, gout, the flu, etc. I am not sure which is cause and which is effect, but Spaniards are also perfectly happy to disagree with their doctor's diagnosis and the prescribed treatment. They have no compunction whatsoever in experimenting with medication, with or without help from their pharmacist, who is not free of this cavalier attitude. Everyone gleefully varies dosages, combines drugs and even - and here is where I draw the line - diagnose other people's ailments, and insist in treating them, using their own prescription drugs (which may or may not still be within their "best by" date). In Spain, everybody's a doctor. But interestingly enough, although average use of medicines is much higher in Spain than in the Netherlands, I have not heard of any significant differences in the rates of problems related to the use of medicines.  

So where does that leave my non-interventionist attitude? Well, it helped me come to the conclusions that (1) it is probably a good idea to know you own body, and have patients be more actively involved in the process of getting better. In that sense, Spaniards are way ahead of the Dutch. (2) It may not be necessary to stick so very strictly to dosage indicators (but personally, I am not taking any chances) and (3) Over-the counter medicines should only be used to combat symptoms if these symptoms stand in the way of getting better, as a way to break through vicious circles. If however the symptoms are your body's way to tell you to slow down, you should listen.

The above has also prompted me to rethink our attitudes towards illness and the job. At the moment, to many people, it still seems like a matter of honor to continue working, even though you are sick, even though we know that this may only prolong the illness, and possibly lower our productivity. More importantly, if the illness is contagious, there is a good chance of lowering the productivity of our colleagues as well. But for the species as a whole, exposure to infectious diseases is not a bad thing, as long as the strains are not so virulent as to wipe out the whole human race. Of course I realize that future of mankind means doodly squat to someone who risks losing their own life, or that of loved ones, and I fully understand the Mexican government's decision to impose a stay-at-home period, as a way of combating the swine flu. But the jury is still out on the decision to keep with a mild flu at home (such as was the case with my children this week), to avoid them contaminating/infecting others. It reminds me of the obsession with cleanliness: for a long time, people did their utmost to avoid all bacteria and virusses, and to do the same for their children. Now, the pendulum has swung back a bit: people are less worried, and realise that a limited amount of contact is nature's way of giving vaccinations.