Late yesterday afternoon, I finally got through to the general practitioner an American had recommended to me. The doctor answers the phone and I hear barking dogs, laughing kids, and the clatter of family life in the background. I’m immediately caught off guard because this is not what you hear when you dial a doctor in America . (“XYZ Medical Clinic—Can you hold?” or “For an appointment with Dr. X, please press 1, for a prescription refill, please press 2, if you’re a lawyer or pharmaceutical representative, please hang up now.”)

I think I have the wrong number, but this is the right number and that’s the doctor on the other end. I’m caught off balance and so I sound like a nervous sixth-grader talking to an adult, my voice turning statements into questions: “Hi, I, uh, need to make an appointment? I, uh, have atrial fibrillation, and I, uh, just moved here? From America ? And I need an EKG? Can you do that?” DUH. The doctor kept her cool, and in accented English asked me if I wanted to come in Friday morning. I’m astounded. I don’t have to wait at least a week or two for a routine EKG? Is this possible—an appointment tomorrow? Belgium is seeming like a good place.

When I arrived at the doctor’s office this morning, the waiting room was empty. I didn’t know whether to be happy or suspicious. Either she doesn’t overbook her schedule (hallelujah!) or all her patients have died (uh-oh). Because I’m a little nervous, I’m wearing my favorite faded Levis—they’re like an adult blankie (No, I don’t suck my thumb when I wear them but they’re so soft they calm me down). Because I was raised to be uptight and proper, I feel a little sheepish that I haven’t at least worn khakis and a black sweater and dressed up a tiny bit for the doctor. I shouldn’t have worried. The doctor comes out to greet me in khakis, Keds, a white t-shirt and navy blue zip cardigan—blonde curly hair held back by a headband, light blue eyes with just the right amount of crinkles at the corners, and no makeup. I’m thinking she should model for Eddie Bauer. This is a good sign.

Her set up is typical for a Belgian medical office. There are no sign-ins, no receptionists, no nurses, no paperwork to fill out, no insurance cards to be copied, no divulging social security numbers, places of employment, next of kin, and the medical history of your whole family tree. Dr. Gelderblom has a desk and a lap top in her combination examining room/office which is all yellow and blue and blond woods, like the best of Swedish design.

Being an anal retentive goody-goody, I have copies of the highlights of my medical records organized in chronological order: my last physical, my blood work, and three reports from my cardiologist and an emergency room physician and radiologist who saw me last year. I hand them to her as I sit in a chair and she takes her place behind her desk.

I’m thinking—this is the part where I have to fill out the five-page medical history and sign multiple waivers of liability. Instead, she asks for my Belgian ID card so she can copy my address down. Then she says, “Tell me about your medical history.” I’m used to checking off boxes and filling out forms, so once again, I’m caught off guard, but this time I recover quickly so I don’t do a repeat of yesterday’s weak-kneed adolescent performance. I recite why I’m there, tell her about my cardiology issues, the medications I take daily, a quick summary of surgeries, and an aside on my chiropractic treatment. She doesn’t take any notes, just listens. She asks me if I have children. (Oops, forgot about those pregnancies! Really, being a mother is central to my existence. It’s always on my mind. I love my kids, honest I do!) She asks about my family medical history, and I give her the grim news on cancer and cardiovascular disease. (What can I say—we’re AMERICANS! What isn’t overcome by cell mutations gets clogged up and kills us. That’s life in the good ol’ USA .)

Finally she opens up the tidy little file folder that I’ve carefully labeled with my name and scans my lab work and reads the summaries from the cardiologist. She commends me on my fabulous cholesterol (153—applause please!) and then chuckles over the cardiologist’s assessment that I may need to take prescription blood thinners by the time I’m 60. “Isn’t he an optimist!” she laughs. She thinks I’ll see that Coumadin prescription long before I’m 60. Me, I’m loving my cardiologist in Richmond for giving me the best case scenario. (You go Dr. Caven! If we wish hard enough, it will happen!)

She concludes I need to see a cardiologist here, not just a general practitioner. She taps a few lines into her laptop and then grabs a form letter and fills it out by hand, puts it into an envelope, calls a cardiologist, and makes me an appointment.

She also writes me a prescription for flu vaccine. Yes, flu vaccine. Here in Belgium , you go to the pharmacist, pick up your own vaccines, and then go to the doctor who loads it up and injects it. She tells me to get my vaccine in October and to store it in the refrigerator. (She has no clue this is a BAD IDEA—my kids would pour it over pancakes, sprinkle it with cinnamon, and eat it. Nothing is safe in my refrigerator.)

She then listens to my heart and takes my blood pressure, which is 100/50. She asks me if it’s always that low. I tell her no, of course not--it’s actually been LOWER, 80/60 to be exact. I am Dead Man Walking. She wonders that I’m not light-headed. I tell her I’m often so drowsy I can’t function, and I sleep a lot. Between the medications I take, my health history, and the naturally low blood pressure, it’s no surprise.

The best part of this visit is yet to come. We sit down at her desk and she writes me a receipt (by hand) and gives me the bill for this 30-plus minute consultation. I think she says 90 euros as she hands me the bill. It’s actually 19 euros (less than $25). I’m shocked. Thrilled even. I can’t wait to see what the cardiologist charges!

Life is good! I have a doctor I like, a cardiologist in waiting, and a lot of euros left in my pocket. I ought to celebrate with a big bowl of ice cream--after all my cholesterol levels can take it. But since I’m ever the good patient, I decide on some dark chocolate—I’m convinced the antioxidants are keeping me healthy.

September 16, 2005