Yvonne Monteverde from Copenhagen, Denmark
Tuesday, Jan. 5, 2010
On Monday, our core course, Human Health and Disease, we were able to draw blood first on dummy arms and then on each other. I thought I would be too nervous to do it, but I found a very superficial vein on my partner and she did not bruise the next day! She actually drew my blood out carefully and I barely felt it. Not the case with some nurses I've been with in the states. I guess there tends to be a progression from being careful to efficient, as with any job. It's relatively simple, apply a tourniquet, prepare the skin with alcohol, yet finding the vein is probably the most difficult part. Once inside, you can pinch the vein ever so slightly to penetrate it and have the blood run through the tube into the vial.
I’ve been thinking a lot lately about how many different perspectives it requires becoming a competent health care worker. This may sound naïve but the truth is it requires a lot more than a dedication to hard work and compassion. The classes here at DIS, definitely target health care issues one would not think about. I’ll be the first to admit, I did not read about scarce resources or if a fetus is considered a person. I was more concerned, during EMT shifts anyway, with the practical: how can I fix this? How can I make my patient most comfortable? One must be a very compassionate individual, yet knowledgeable about health economics and politics. I personally loathe learning about them, but in order to know as a doctor how many resources you can realistically allocate in your hospital or with your patients. Not everyone will be pleased or be able to be treated. You must be educated on new implementations, and what to bring up to politicians. If a crisis comes up, politicians will rely on your knowledge as a physician in order to make a reliable implementation.
As a doctor you will be faced with ethical dilemmas, and it is here where a good knowledge of ethics is essential. If a parent decides to save one premature healthy twin, while let the other die due to a bad prognosis, what are you to do? What issues in your hospital will you be able to deal with, and which ones cannot be handled due to the budget?
It's no wonder people ask me if I'm sure I want to become a doctor.
At the same time, anatomical labs are so much fun! To label things the descending aorta makes for great knowledge! Our medical student assistant took us to the University of Copenhagen’s medical school, Panum Institute, where we saw different body parts and were quizzed on our guesses.
The one question that surprised me was: how old is this fetus? Slightly bigger than a kitten, with fingers and hands fully formed. I guessed probably 6 months since it was rather developed. It was actually three months old, and for many countries, that is the time frame when it is decided whether to abort or not. Many people in my class were surprised to find out a fetus had developed so much in so little time, including myself.
Drawing blood from my partner and friend, Magz. "It didn't hurt!" She claimed.
We were able to keep our own blood vials after practicing. It was a bit nerdy, and creepy. With my friend Jon.
Tuesday, Jan. 5, 2010
In my Health Economics and Policy class, we were able to visit Parliament (after going through security of course) and visit a member of the Danish People’s party. Because it was after hours, we were not able to see parliament in action, but he took us on a tour of where major discussions were held, where President Obama will visit when he comes to Denmark to discuss climate change. Apparently the press also has a room and they may follow you around Parliament, except in your office. What I thought most interesting, were the constant “open” elevators going up and down. You could simply jump in, and that’s exactly what members of parliament did.
Once inside a meeting room, he discussed with our class how implementation occurred, what his job was, which included talking to people from different interest groups about what issues to prioritize. He spoke to us about how more and more privatization in Denmark is taking place, and he disagreed with it. The system here works as follows: if you are not able to have an operation before a certain time period, you are welcome to go to a private clinic for the operation. The problem, he emphasized, is that private hospitals are reimbursed excessively by the Danish government for these operations. He felt that if there must be private companies, to have them be a separate entity, and not overcharge their fee for service. I asked him what he felt was not being emphasized enough in discussions, and he mentioned prevention of diseases. Although we learned in class that government's most important health priorities include cancer treatment and budget allocation, prevention was just not enough.
Monday, Nov. 2, 2009
Came back from my long study tour this past weekend. We went to Berlin and Poznan for a week. Along with cultural sites visited, we visited many hospitals to see how the system differs from Denmark. There were many surprises to be had!
Berlin is a city full of somber rich history. Our first stop on the outskirts of Berlin was the Sachsenhausen concentration camp. We were given audio guides and an hour to explore the entirety of the camp. I did not make it to some parts of the camp but other parts I had to see. We went to the royal church which used to be limited to the royal family. It was huge!! We went inside and also went to the top of the cathedral and got a nice view of Berlin. The statues atop of the cathedral were kept underwater during WWII to protect them from possible destruction. After that, we went to Parliament building for lunch. Needless to say, the meal and view was amazing. Afterwards we were allowed to explore the top of the building on this dome where you could actually see parliament meetings-don’t worry, we needed to go through security check clearance.
We saw the Berlin TV tower, and almost ate there, but couldn’t get a reservation. But we did get to go to a Bike tour of the city, in which we saw sites such as Checkpoint Charlie, a part of the Berlin Wall, Hitler’s Bunker, and a security tower for soldiers attempting to shoot those trying to escape West Berlin.
Poznan on the other hand, although not on everyone’s tourist destination, is a very fun city. Poznan’s nightlife was quite lively for a Wednesday and Thursday night. It was definitely more homogeneous than Germany and Copenhagen.
On the last day, I was able to do an ultrasound on a woman who was pregnant. Another group of people were able to see a C-section. I was able to see the baby’s heart beating and spine, liver, and his head, extremely low on the belly of the mother. The mother of course was very willing because there are no regulations in Poland about patient privacy really, at least not in the hospital we went to. Because many American or International students study there and the patients are much more willing to let their privacy be invaded. They let you do what you would not normally do before medical school in the states. Funny how I’m calling the US the states now. It was a surreal feeling, and very motivating as well. The day before, we were led to an operation room and saw an endoscopy live, so I saw the stomach of an 8 year old along with his esophagus and duodenum. He was crying but sedated, probably just because of the fear.
The hospitals were definitely different from the states, starting with the facilities. Berlin’s Charite hospital definitely sacrifices money for facilities to put their money into excellent and respectable health care. Even people who are unemployed in Berlin, need to pay their insurance, no excuses. Poland’s operating room was definitely different, with about 7 people in a crowded room eating their lunch in the same room and answering cell phones, is definitely something you do not see in the states. Poland doctors are also not respected and need to work one to two jobs extra just to manage their living expenses. The doctor we talked to mentioned she had worked overtime, but the government of Poland did not enough funds to pay all the extra hours she had worked, so they paid her half as much money. A real shame because this doctor was very well educated. Many pediatric patient rooms were also crowded with up to 4 kids in one dreary room, whereas in a Children’s hospital I visited in Denmark, there were toys and paintings in the entrance, which provided the patient with more comfort.
Although the above countries have limited funds for healthcare, they try not to compromise anything and treat to the best of their ability by educating their doctors. Another note to think about, at times there was a lack of hygiene in the Polish hospitals, definitely not as much gloving or sheets atop the operating table, reuse of equipment. Compared with the states, are we obsessed with hygiene that we create excess waste? Is it worth it? Is it that important to make a patient comfortable in a hospital? Does this really a difference in how well patients are treated?
Monday, Sep. 28, 2009
My name is Yvonne Monteverde. I’m actually a senior studying abroad in Copenhagen, Denmark. I’m a Philosophy major, and Japanese Studies minor and taking Pre-med requisites “on the side” as I like to call it. I am part of an organization called Health Occupations for Multicultural students, which was changed from CHE the Chicano/Latinos in Health Education to include a more diverse student population who are interested in health care careers, EMT on campus, and traveled to Honduras last spring break with Global Medical Brigades to translate and deliver medical supplies.
My choice to come to Denmark was not because of the location. I would have actually preferred to go to Africa or another place not Europe, because everyone goes to Europe, but the program Medical Practice and Policy, part of the Danish Institute for Study Abroad was what attracted my attention. I later learned that the location was perfect for learning about public health because of Denmark’s welfare system. Healthcare and education are free! I concluded that Denmark was definitely the perfect place to see the differences, and pros and cons of socialized healthcare.
The whole ideal behind the welfare system in Denmark, as I learned in my culture class, is because Denmark is a small country; they feel a “tribal” sense of community. Everyone is connected to everyone else in some way. The only downside to this system is the high taxes involved. 50% of all Danes’ income goes to taxes as well as when you buy groceries, that 9.25% sales tax that we complain about in California, is 25% here! Danes have mixed feelings about this, some are content with the system and find a great sense of security. The more rich of the bunch, are turning towards privatized healthcare. But in general, most Danes I’ve met are pretty happy with their system. Healthcare here is mostly public, and unlike the states, the best doctors in Denmark, are in the public system as opposed to the private system. Few people have private health insurance because everyone is covered, from cradle to grave, with health insurance.
As part of the DIS MPP program, you are taught by doctors in Denmark pretty much beginner medical school topics. The most interesting part of the program is actually seeing what you learn about hospitals and healthcare in Denmark-in action! Two weeks ago, we had what they call a “study tour” in which we traveled to Western Denmark and visited a children’s hospital and how they are sustaining neonatal children using a technique called CPAP. We also visited other hospitals seeing MRI machines, their research centers.
All that was fascinating because I haven’t actually had the chance to shadow any doctors, but my favorite part of the trip, was definitely the General Practitioner’s office we visited. General practitioners act as a “gate-keepers” here to the hospital. They do everything! Go to one GP for all your needs, whether it’s a cold, a gynecological visit, or pediatrics, you do not go to different doctors for all these services, a one stop. And if you or your GP feels you need specialized hospital care, they refer you to a specialist. Both communicate and your GP knows all about you.. This particular GP office had their own emergency room and laboratory for blood samples. It’s pretty efficient and convenient, in my opinion.
All in all, I will let all of you know more details as I learn about universal healthcare in Denmark.
The Fountain at Gammel Torv on the famous (and longest) shopping street in Europe,
Strøget. I am living in a Folk high school with 15 other Americans, 20 Danes, and 20 Europeans. Folk high schools are native to Denmark for "enlightenment of the people," and young Danes go take classes for no grades. Simply to learn.
MRI machine at another hospital at the University of Århus. They were doing research on a dog who had possible alzheimers and looking at differences in brain activity.
Rigshospitalet-->The national Danish hospital in Copenhagen. It is the biggest and most well known hospital in Denmark. It is also where my main core course is held, Human Health and Disease. We have patient contact, all the time! It also boasts a Helipad.
The neonatal intensive healthcare unit at the Hans Christian Andersen Children's Hospital in Odense, Denmark. Premature babies are born with underdeveloped lungs, and are placed here for treatment with CPAP, continuous positive airway pressure, for ease of breathing while their lungs develop.