‘I mean, do you want to know the sex? Of the baby?’
Aha! ‘Um, well, can you tell? I mean, if you can see either way, maybe tell me, but otherwise don’t worry…’ For someone who’s paralysed by indecision over what to have for lunch most days, a choice on this scale is, frankly, terrifying.
The midwife pokes around a bit more: ‘Hmm … labia or scrotum … scrotum or labia…’ she muses, tilting the screen in my direction. All I can make out on the black and white fuzzy image is something that looks a lot like a blob of papier mâché mix. ‘What do you think?’ She asks. I have no idea. So she answers for both of us: ‘I think … scrotum.’
‘You “think”?’ Is this roll-out-the-blue-bunting time? Should I be buying books on how to raise boys? Will I need some sort of coaching to work out how the heck the only daughter of a single mum who went to an all-girls school can possibly parent a miniature male?
‘I am … 80 per cent sure there is a…’ She proceeds to do some elaborate charades to indicate that she thinks it’s a male foetus, including a particularly vivid mime for ‘penis’.
Once I’ve re-robed and mentally adjusted for the fact that it’s ‘80 per cent likely’ our child is male, we sit down to discuss The Birth.
‘So, pain,’ she kicks off.
I look around for an escape route but remember that the only door in here was locked in case of interruptions. Instead, I stare helplessly at government information posters showing the various things that can go wrong during childbirth and the alarming row of metal implements glinting at me from the windowsill. Just. Breathe. I coach myself.
‘OK,’ I quiver. ‘I’d like everything they’ve got, please.’
‘Right then,’ she sits, pen poised above my notes. ‘I will write, “oxygen as a last resort”.’
I wonder whether I’ve heard her right.
‘“Oxygen”? What about an epidural?’
What I’m really hoping for is some new out-of-body-experience-causing (but entirely safe) general anaesthetic to be discovered in the next three months that will render any agony obsolete.
‘The “princess stick”? Oh, we don’t like to use that if we can help it.’
‘Sorry, “princess stick”?’
‘That’s what we joke about epidurals!’
I’m not laughing. ‘Real Danes’, it turns out, don’t need epidurals. ‘Princessy types’ may have a mini-epidural if absolutely necessary but are only given half measures, ‘so you can feel enough pain to push,’ she tells me. ‘I will make a note in your file that you request this. Then when you arrive, they’ll know you’re an anxious mother-to-be.’ Brilliant. I’m already a princessy, anxious, Viking failure. And there are still months to go. Sheesh.
‘So I have to give birth with just half an epidural, gas and air?’
‘Oh no, we don’t do gas.’
‘What?’
‘We don’t think it’s very good. What we can offer you is a bee sting.’
This doesn’t sound promising, but I’m desperate.
‘OK…?’
‘This is where we prick you with a needle in the back of the hand so that you’re distracted from the big pain by a smaller, different pain…’ she trails off at this point, possibly put off by my expression that I suspect conveys something along the lines of, ‘If anyone does that to me, I will punch them in the face.’
‘…but perhaps we’ll just stick to air and the mini princess stick, for now…’
I leave, traumatised, and seek out cake with Helena C for consolation. I explain about pain-reliefgate and she nods knowingly, telling me that she gave birth to both her girls with nothing but an iron will and profanity-laden threats to divorce her husband. I’m in shock.
‘So are Danes quite anti-drugs?’
‘That depends,’ she tells me, ‘on the drugs.’
Danes, I discover, have the highest levels of antidepressant use in Europe according to the OECD. It’s thought that the increasing ‘work stress’ I learned all about back in February, as well as the use of medication in milder cases could explain the rising consumption levels.
‘Of course, we’re also fairly relaxed when it comes to non-prescription drugs, too,’ Helena C tells me. Jutland teens, I learn, tend to ‘dabble’ a fair bit because ‘it can be a bit boring growing up here.’
Danes demonstrated their liberalism in 2013 when the country’s first state-funded drug consumption rooms opened in Copenhagen. The initiative hit the headlines worldwide but most Danes didn’t get too het up about it and there are now rooms in each of Denmark’s main cities and some smaller towns too. Locals haven’t put up much opposition and police steer clear of the safe rooms, the theory being that giving users a safe place to take drugs will prevent deadly overdoses. The plan is thought to be working, although statistics to prove this are pending. The whole approach is in marked contrast to Sweden’s strict zero-tolerance policy – something that’s earned them one of the lowest illicit drug consumption rates in Europe but led to a high number of drug-related deaths, as addicts fear seeking help for overdoses.
‘So I can’t have a full epidural, but I can take smack?’ I ask Helena C.
‘It looks that way, yes,’ she tells me.
Strangely, the Danes’ liberal attitude to non-pregnancy related drugs doesn’t extend to remedies for the common cold, as I found out when Lego Man was laid up with man flu the week before last. There are no Lemsip or Night Nurse equivalents and my attempts to procure paracetamol were rewarded with a single, dolly-sized packet sufficient to soothe the fever of a very small hamster. This, I learn, is because a teenage girl took too many some years back and so the state clamped down on the amount that could be sold in any one transaction without a prescription. When something similar happened in the UK, the limit was set at sixteen in the shops and 32 in pharmacies. But in Denmark, it’s ten. Ten! Just enough to get you through a single day before you have to drag your delirious, fever-addled body back for more. There are, however, ways around this. During my last exchange at the local pharmacy, the woman behind the counter took pity on me and told me that she could only sell me ten without a prescription, unless it was ‘an emergency’.
I was just about to accept the micro-dose and be on my way when she lowered her chin and looked up at me knowingly. ‘Is it an emergency?’ She tilted her head and nodded slightly, coaxing me to agree.
‘Er … yes?’
‘So you’re telling me that this is an emergency?’ She asked again, nodding slowly.
‘Well, no,’ I started to panic under the pressure, ‘not really, it’s just man flu—’ The pharmacist shook her head furiously until I corrected myself: ‘I mean, yes, yes it is. It’s definitely an emergency.’
‘Great!’ She beamed, before handing over two mini packets. ‘Feel better soon!’
In spite of the odd generous pharmacist, Viking spirit dictates that Danes stick to natural remedies wherever possible when it comes to minor ailments. ‘We tend to make do with hot tea, hygge, and maybe some schnapps,’ Helena C tells me.
Ah, booze. I suspected it wouldn’t be long before this came up in a discussion about health in Denmark.
‘Danes drink a lot. And I mean A Lot,’ says Helena C. I tell her that this is something I’d gleaned during my first week here. There’s a running joke that the reason Danes seem so happy when they fill in Eurobarometer surveys is that they’re always drunk. Danes are among the highest drinkers in Europe, according to the World Health Organization (WHO), consuming 11–12 litres of pure alcohol per person per year. And Danish teenagers drink nearly twice as much as other Europeans their age (so say WHO reports). I can feel an empathy hangover coming on just thinking about it. Studies from the Danish National Centre for Social Research show that young people in Denmark are learning how to drink from their parents’ approach to alcohol, characterised as ‘controlled loss of control’. In other words, Danes are very ordered and controlled – until they’re not. Until it’s a planned party, or a Frida
y night, or there’s an event with schnapps involved. Then, they let their Viking tresses down and things get messy (and I’m British – I know messy). ‘It’s like we reserve the right to damage ourselves by drinking too much if we want to, and we don’t always think about the impact,’ Helena C tells me.
The same is true of sex here. Despite Denmark’s prowess as a nation of sexually liberated Scandis, as I found out back in July, Danes aren’t always careful. A recent YouGov survey placed Denmark in the top spot for STI’s in Europe and a recent survey from the Danish health authority found that only 56 per cent of 18–25 year olds used a condom the last time they slept with a new partner.
Another health contradiction is smoking in Denmark. Once I’d got over the shock of seeing people smoking while cycling on their daily commute to work, I began to notice that every second Dane I encountered was partially obscured by a small grey cloud. Danes smoke with zeal and tobacco use in Denmark has been found to be a contributing factor to approximately 14,000 deaths a year, according to WHO. The World Cancer Research Fund awarded Denmark another ‘first’ in 2012 when it was discovered that women here have the highest rates of lung cancer in the world, and Denmark also tops the overall worldwide cancer charts for all types of cancer in both sexes.
‘You see people smoking everywhere here, even outside hospitals,’ comments American Mom when I get her take on this as a fellow ‘outsider’. ‘I went in for a check-up with my daughter and there was this guy pushing past us on the way out, wheeling his IV drip, barely able to walk. Then the first thing he did when he got into the fresh air was to light up a cigarette. You’d never see that in the US.’ I confess to her that this is something you see a fair bit in UK.
‘That’s because your healthcare’s free as well!’ she rails. ‘You take it for granted, you think the state will sort you out!’
This last part is true – most Danes, and probably Brits too, do think that a free national health service will take care of them if they really need it. But are Danes taking their health for granted?
I ask The Viking what he thinks when he joins Helena C and me later on for dinner.
‘No! Not “for granted”, he scoffs at first, before ordering a beer and a burger. ‘OK, sure there’s a lot of smoking and drinking—’
‘—And unprotected sex,’ I add, helpfully.
‘—Yes, and that,’ he concedes.
‘—And drugs,’ adds Helena C.
‘Well, yes, we do them too…’ The Viking wasn’t expecting to have to field attacks from his countrywoman as well. But then Danes do love a good debate.
‘—And you eat a lot of fatty food,’ this last one slips out at the precise moment the waitress comes over and slides a juicy burger on to the table next to us. ‘Sorry,’ I murmur in their general direction.
‘OK, so maybe we’re not the healthiest,’ admits The Viking, ‘but we’re individuals, we should have the choice.’ He attempts to persuade me that, sure, Danes drink enthusiastically and smoke rebelliously, but that they’re enjoying it, so everything’s OK. ‘There’s no stigma, you can decide for yourself, see?’
‘I think what it really boils down to is that we know we’re covered whatever happens,’ says Helena C. ‘More so than in the UK, even, because we have extra social welfare to help us out if anything goes wrong – we’re looked after. This may make us a little complacent, I think.’
Attempts are under way to encourage Danes to take more responsibility for their own health. Some kommunes now bill patients who miss doctor’s appointments or cancel with less than 24 hours’ notice – something that they hope will also drive down doctor’s waiting times.
‘It used to be pretty bad,’ Helena C tells me. ‘People would just book a time to see a doctor then feel OK again and not turn up. It meant you could never get a time at some clinics and it cost the government a lot of money. Now, you have to remember to go.’
Since 2003, Denmark has also had an e-health database. Whereas the UK’s abandoned patient record plans cost British taxpayers £10 billion (or $17 billion) and counting, according to parliament’s public spending watchdog, the Danish system cost £6.6 million ($11 million) to set up and its reach is growing year on year. My yellow Danish CPR – or ID – card has a number on it that I use to log in to a special site that contains all of my medical records. There, I can choose which doctor or nurse I’d like to see, ask any questions and get repeat prescriptions. The medical bods can then access all of my information and history on the Danish Health Data Network via my personal ID.
‘Studies show that patients who are well-prepared and feel co-responsible and invested in their own healthcare feel happier and healthier,’ says Morten Elbæk Petersen, director of the country’s e-health database, Sunhed.dk, when I get in touch to find out more. Denmark’s answer to Hugh Grant (Four Weddings-era) is all floppy hair, Scandi cheekbones and tweed, but with nineteen years at the top of Danish healthcare, Morten is a man in the know.
‘The e-health system is a cheap way to make people feel comfortable and keep them out of hospitals,’ he tells me, ‘and we can then use the rest of the money in the government’s budget on roads, education etc.’
The plan to make Danes more accountable for their own health shows signs of working – if slowly. Despite the ridiculously high numbers of smokers I see out and about, OECD figures show that the proportion of Danes lighting up has more than halved from 45 per cent in 1990 to 20 per cent in 2010. The government is also tackling the country’s cancer problem by getting better at screening – with women aged 50–69 being offered mammograms every other year since 2007 and colon cancer checks every two years since 2014. Morten insists that Danish healthcare is in a good place: ‘In Denmark, we spend 12 per cent of our GDP on healthcare that works well, is efficient and is for everyone. In the US, for example, they spend 18 per cent of their GDP on healthcare but there’s no equality or sharing – so some people have nothing.’ The UK spends just 9.6 per cent, according to WHO figures.
There’s a lot of interest in the Danish system from the Obamacare lobby, and Morten regularly meets with supporters in the US, keen to find out more. But many Americans remain reluctant to share their personal information. ‘A lot of people still hate the idea of the public sector seeing or owning their data,’ says Morten. ‘Some people think the whole thing sounds too much like communism, that it makes you “unfree”. But actually, you’re freer and safer if people are well looked after – if you know your neighbour can get the treatment he needs if he gets sick, he’s not going to become desperate and rob you. Any time, anywhere access to personal clinical data empowers people – and for me there’s no doubt that there must be connections between this and Denmark’s high score on the happiness index.’
This is all sounding splendid. But could it work anywhere outside of the tiny land of 5.5 million people and 50 per cent taxes? Morten thinks so.
‘Australia is rolling out a personally controlled electronic health system like ours in a few years to their population of 20 million. There are five different states with strong boundaries there so in that way it’s like five Denmarks, all working together.’
Another area that Danes seem to excel in is research. A staggering number of new medical and pharmaceutical finds come out of Denmark and in the last week alone Danish scientists have made the headlines for new discoveries about asthma, vitamin B12 and preventing heart attacks, to name but three. ‘We have good databases that go back in time and provide resources for research,’ Morten tells me when I ask why this is, ‘plus the university hospitals here really are dedicated to research. Because it’s free to study, there’s always new work being done and so new findings and discoveries. And the results get used. Cures and treatments can go into practice very quickly in Denmark. This feeds back into the public who can see things improving due to the advancements in medicine and so people are happier to cooperate in studies and pay their taxes to fund the system – and so it goes on.’
Although I’m
still not sure that living Danishly long term is necessarily good for your health, I’m feeling reassured that things are heading in the right direction. I’m also beginning to get my head around the Danes’ libertarian attitude to life. They cherish their freedom to indulge every whim and really enjoy themselves, safe in the knowledge that they’ll be looked after if (or rather, when) anything goes wrong. It’s a bit like the school system and even the job market here – the individual has freedom within safe boundaries. Danes have a choice about what to do with their bodies, their minds, and their careers, but they agree to work together towards a collective goal: maintaining and championing The Danish Way.
To round off my month of medical discoveries, I call Niels Tommerup from the Department of Cellular and Molecular Medicine at the University of Copenhagen. I explain about my project and ask if he thinks there could be something else, something more fundamental, something in the genes that helps Danes to be so content.
‘As a geneticist, I’d say that everything is genetics, especially mood,’ Niels tells me. ‘Genetics affect your basic disposition, whether you’re optimistic or pessimistic. There are people out there who are just always happy. Even if you throw a brick at them.’ I’m hoping he hasn’t put this to the test during the course of his studies. But then the Danes are a hardy bunch.
So what does he make of the worldwide happiness studies that keep putting Danes at the top. Could the good people of Denmark just be naturally happier than folk from other countries?
‘Yes and no,’ is Niels’ diplomatic response. ‘It’s difficult to isolate genetics from cultural factors and the total genetic effect on well-being is estimated to be in the order of 50 per cent – i.e. the other half is contributed by the environment. But even if you say Danes are happy due to environmental and cultural factors, you can still ask: “Why did the Danes establish this culture? Is it something to do with the Danish disposition? Did the social democrat movement come about because we’re all related genetically, so that we feel obliged to take care of each other, just as you’d look after a poor relation in your family?” It’s a hen and egg situation.’ Danes love a hen and egg analogy. The few times I’ve suggested ‘chicken’ as an alternative, it’s scrambled their brains. ‘There’s also a study showing a correlation between the genetic distance within a country and its well-being, even when factors like GDP per capita are taken into account,’ Niels continues. ‘And Denmark is the country with the least genetic distance between the population, because we’ve had less migration historically.’ In other words, the Danes are an insular bunch who haven’t moved around or mated much with people from neighbouring nations and this has made them, weirdly, far happier than the rest of us. ‘A homogenous population is more likely to be more content and trust each other because we’re closely genetically related – like a family.’
The Year of Living Danishly Page 23