Never Give A Dialysis Patient an AK-47

ak47

I’d better warn you, I’m in a very, very bad mood this morning; it’s a bloody good job I don’t have access to weapons.

I had hoped that after the fiasco that was yesterday this morning would be better. Yesterday was awful; first the hospital car didn’t turn up at all for my cardiologyappointment/dialysis session and I had to make my own way via bus, ferry and tram across town from North to South Amsterdam and the hospital. Despite Amsterdam’s excellent public transport it’s still an hour’s tiring slog away.

I was particularly anxious to get there on time, because the cardiology tests are the only results I’m waiting for to get the go-ahead from the surgeon and a tentative date for a kidney transplant at the end of the summer. Not crucially important or anything, oh no. I was already late for an appointment I’d already had to rearrange three times over the past three months because of taxi non-appearance or ridiculous lateness.

I ‘d been so worried about the taxi company’s (ZCN Vervoerscentrale Rotterdam since you ask) previous unreliability I actually called them 30 minutes before the cab was due to check that transport was in fact arranged. Although I’d got the nurses to book it, I didn’t trust the taxi people one bit based on their dire past performance. I was right not to.

The dispatcher said yes, it’s all booked for 12.30 to be at the hospital by 1.20, geen probleme, the taxi’s on it’s way. Except it wasn’t.

12.30 came and went… then 12.40… then 12 .45… I’m getting panicky, it’s 45 minutes across town through mad afternoon traffic. Where the hell is this taxi? They’re cutting it more than a bit fine… I rang the dispatcher again to see what was happening. After waiting another 5 minutes through the ridiculous automated phone menu I’m told ‘What taxi? It’s not on my list. I know nothing.’

But I checked with you 45 minutes ago! You said it was booked! You lied! ‘It’s not on my list. I know nothing. Bye!’

I thought I had become accustomed and had learned to deal philosophically with crappy Dutch employees who can’t do their jobs competently, who can never be fired and know it, and who have no inkling or even the faintest glimmer of understanding even the concept of customer service. I’ve grown used to the ‘Customers? Who they? We run this company for us employees’ state of mind that’s so prevalent in Dutch business and public services. But flat-out, blatant lies have thankfully been relatively rare so far.

The reason I get so steamed is that the taxi service’s constant unreliability adds around 2 hours unnecessary transport time to each end of an already onerous 4 hour dialysis session three times a week. That doesn’t do a lot for my equanimity. It also means I can’t do anything at all on a dialysis day, even though it’s only a half day, because I can’t plan for their unreliability. It’s not as though it’s free, either.

I’d had more than enough of bloody, ass-covering Dutch employees at this point. You’re lying to me now? I don’t think so. I rang back and gave the dispatcher a full-bore blast of the concentrated bile that’s been building up in my roiling gut for months, as I’ve stood fuming in the rain outside the hospital, waiting hopelessly over and over again for my missing taxi home.

It felt good. But it didn’t get me my taxi.

I got there, in the end, but very tired and very late. By the time I got out of cardiology (the usual dull, unsmiling, mechanical Dutch experience these things usually are) it was dialysis time. I’d had nothing to eat all day and no time for even a coffee beforehand. Pissed off, knackered, hungry and with only a pack of fruit pastilles for sustenance, I felt the session would never end.

It wasn’t helped by the fact I’d been assigned the most annoying nurse, the one who thinks it’s her life’s work to to teach the foreigner Dutch even though I’ve asked her not to, and who refuses to communicate in English even though she’s perfectly able. It wasn’t helped either by the unnamed idiot who kept ringing my mobile, across the room in my jacket pocket, which I couldn’t reach because of being tethered to the machine by the big IV line in my jugular.

Argh! Even if I could’ve answered the damned thing it would have been pointless: anyone likely to ring me on my mobile should know by now that there’s no mobile phone coverage in the dialysis department. Who the hell was it calling?

My mood hadn’t improved by the time dialysis finished. When I finally got home, exhausted, pissed off, very hungry and with only a cold ham sandwich on crappy, dry Dutch bread to look forward to for dinner, I found that, as is depressingly usual when interesting bloggable stuff happens, not long after I set off for the hospital yesterday yet another cabinet minister had resigned and I was yet again elsewhere, out of internet and radio range.

Some days you just want to kick something.

I’d hoped that this morning would’ve been better but I got up to hear that racist prick Geert ‘Needs his roots done’ Wilders on the radio, crowing that he’s made big gains in the EU elections and now the housepainters who’re doing the outside of our houses are in and out to get through to the rear without knocking or even so much as a bye-your-leave.

I know I agreed with the foreman yesterday morning that they could come through to get access today, but I had no idea it would mean a constant stream of workmen in painty boots through my living room and kitchen from 7.30 am till lunchtime who’d keep leaving the inside door open, even though I’ve asked them several times to close it in case one of the cats (who’ve never really been in the Big Outside) were to get out and get themselves run over.

It really is a good job I have no weapons to hand. If one of the cats got out or I got any more pissed off, I think I’d go postal.

You Can Polder If You Want To. You Just Have To Want To.

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Should America follow the Dutch social model? Ask that of any US pundit, the conventional reply will be “Nooo, the socialism, it burrns! 52% tax!”

But just maybe, maybe they should think the unthinkable, says American exiled in Amsterdam Russell Shorto, in a fascinating article in the NYT magazine. Americans pretty much pay an equal amount in cumulative taxes, to much less effect:

…in talking both with American expats and with experts in the Dutch system, I hear the same thing over and over: American perceptions of European-style social welfare are seriously skewed. The system in which I have embedded myself has its faults, some of them lampoonable. But does the cartoon image of it — encapsulated in the dread slur “socialism,” which is being lobbed in American political circles like a bomb — match reality? Is there, maybe, a significant upside that is worth exploring?

It’s a biggish read but worth it as a primer on how the country works:

I spent my initial months in Amsterdam under the impression that I was living in a quasi-socialistic system, built upon ideas that originated in the brains of Marx and Engels. This was one of the puzzling features of the Netherlands. It is and has long been a highly capitalistic country — the Dutch pioneered the multinational corporation and advanced the concept of shares of stock, and last year the country was the third-largest investor in U.S. businesses — and yet it has what I had been led to believe was a vast, socialistic welfare state. How can these polar-opposite value systems coexist?

[….]

…water also played a part in the development of the welfare system… The Dutch call their collectivist mentality and way of politics-by-consensus the “polder model,” after the areas of low land systematically reclaimed from the sea. “People think of the polder model as a romantic idea” and assume its origins are more myth than fact, Mak told me. “But if you look at records of the Middle Ages, you see it was a real thing. Everyone had to deal with water. With a polder, the big problem is pumping the water. But in most cases your land lies in the middle of the country, so where are you going to pump it? To someone else’s land. And then they have to do the same thing, and their neighbor does, too. So what you see in the records are these extraordinarily complicated deals. All of this had to be done together.”

[…]

IF “SOCIALISM” IS THEN something of a straw man — if rather than political ideology, religious values and a tradition of cooperation are what lie beneath the modern social-welfare system — maybe it’s worth asking a simple question of such a system: What does it feel like to live in it?

Sholto answers that question by interviewing a number of other US expats, which is a bit lazy of him though he does admit it:

Indeed, my nonscientific analysis — culled from my own experience and that of other expats whom I’ve badgered — translates into a clear endorsement. My friend Colin Campbell, an American writer, has been in the Netherlands for four years with his wife and their two children. “Over the course of four years, four human beings end up going to a lot of different doctors,” he said. “The amazing thing is that virtually every experience has been more pleasant than in the U.S. There you have the bureaucracy, the endless forms, the fear of malpractice suits. Here you just go in and see your doctor. It shows that it doesn’t have to be complicated. I wish every single U.S. congressman could come to Amsterdam and live here for a while and see what happens medically.”

It’s not quite as simple as that – it’s all in Dutch, for a start – but close. I’ve experienced the health and social care systems of the US, UK and NL personally and up close, and the Netherlands’ is the one I’d go for every time. Once you get past the impenetrable bureaucracy, (which Shotto doesn’t really mention, but it is a massive obstacle) and the language/cultural issues, it seems to work on the whole.

It’s certainly rare to see anyone truly, visibly poor here, unlike in the US and the UK, and to be sick or disabled here is not the automatic life-sentence to poverty and exclusion it is there. Sholto goes on to back this up with numbers:

A study by the Commonwealth Fund found that 54 percent of chronically ill patients in the United States avoided some form of medical attention in 2008 because of costs, while only 7 percent of chronically ill people in the Netherlands did so for financial reasons.

Read more….

Enough said. Case proven.

Happy birthday to the frikandel

A plate of frikandel with fries

According to a press release put out by a well known Dutch fast food maufacturer, today is the fiftieth anniversary of the invention of the frikandel. The story is that on this day in 1959 Jan Bekkers invented this popular sausage like snack when he started up his fast food factory; he was also supposed to have changed his name at the same time to Beckers in order to be first in the phone book before his competition, his cousin. A nice story and I’ve chosen to believe it for the sake of this post, but it’s quite clear it’s only a story and the frikandel has a much longer history dating back to the eighteenth century at least.

If you’re never been to the Netherlands you’ll likely have never encountered this particular meaty treat. The picture above shows one to perfection: a long, skinless dark brown sausage made of mixed meats, deep fried and usually eaten with fries, often covered in a sauce mixture of mayonaisse, curry or tomato ketchup and diced raw onion. There’s no truth to the rumour it’s made of all the disgusting left over bits of animals (lips, buttholes and eyeballs being particular popular grossout ingredients), at least not since the Dutch food standards agency made this illegal. These days there are even proper halal frikandellen.

a FEBO snack bar

Honestly it tastes better than it looks and you don’t need to be drunk to enjoy; millions of Dutch kiddies grew up with a regular saturday evening meal of fries and frikandellen. Unlike its stable mate, the kroket, it has not yet been improved in order to chase the luxury market; it’s as decent and honest a fast food treat you can get. If you ever visit the Netherlands, do try one but take care not to take one from the vending machines at the FEBO, as you never know how long these have been stewing behind the glass…