December is upon us. The Dutch refer to the phenomenon of the “decembermaand,” because here, we celebrate three times: Sinterklaas, Christmas, and New Year’s Eve. It is a busy and stressful time for many. The weather is cold and wet. In other words, our health is often wanting.
I remember my first winter in Berlin as an American university student. I went through many a general practitioner, yearning for a doctor who would give me antibiotics for the flu. Most German doctors would confirm that I was ill and send me home to drape a towel over my head and hover above a pot of boiling water. When I finally found a younger doctor who gave me penicillin, I rejoiced. The next year I showed up for my flu shot like a good American, and he commended me. He said that it was unusual for the younger German generation to vaccinate against influenza.
Imagine my surprise when I moved to the Netherlands soon after and met the seven-year-old granddaughter of the couple next door. When she visited her grandparents during school hours, I asked her if she was home sick. “Sick?” she replied. “I’m not sick! I just have a cold.”
Ten years of Dutch life have passed since then, and my attitude toward illness, treatment, and antibiotics has changed significantly. As I write, three of our four kids are down with aches, congestion, or fever. Only one, however, has stayed home from school this week – the youngest. My seven-year-old daughter has an earache. When I asked her this morning whether she wanted to stay home or go to school, she said: “Well, my ear hurt all yesterday, and I was at school, and I was fine.” Off she went.
In another country and other culture, she or I may have acted differently. Different cultures reflect different attitudes toward illness. I see young American parents post on Facebook posting about flu shots for the whole family. Meanwhile, here in the Netherlands, as in my last adopted country, Germany, the flu shot is a ritual primarily associated with the older, senior citizen population.
In America, I also used to think that antibiotics were a normal course of treatment for any infection. Every doctor’s visit ended with a prescription in hand. In the Netherlands, I have learned that antibiotics only help in the case of infection instigated by bacteria. This may be obvious to others, but it is something I have only learned here, where antibiotics serve as a last resort.
Here, I have learned to let my children’s immune systems run their course. I have learned that most fevers break on the fourth day; that my kids can play and take part in family life with fever; that the bigger picture of my child’s particular situation is more relevant that the horror stories parents pick up through hearsay and social media. I do not discount the possibility that a doctor can misdiagnose meningitis, and I mourn for the families where this has been the case. At the same time, I have learned to practice “informed doubt” – to use my reason and instinct to assess my children’s situation instead of to panic at the possibilities lurking behind every new symptom.
After the doctor listened to my toddler’s chest this morning, he announced that her lungs were clear. “It’s just a cold,” he said. I walked out the door, reassured, even though her breathing was rapid, her fever was high, and she was miserable. Ten years ago, I would have felt short-changed, angry that the doctor did nothing.
My most useful resource in the last decade has been a small, paperback pamphlet of fifty-six pages in length: Kinderziektes published by pharmaceutical company Glaxo-Smith Klein. I picked up a free copy in a waiting room years ago, and I still use it with my fourth child. The most helpful aspect is the paragraph at the end of each section, labeled “When do I need to call the doctor?” The answer is this: always a lot less sooner than I found customary before living in the Netherlands.
While watching a doctor’s intern look up a symptom one day, I noted the title of the book that she kept pulling off the shelf. Later, I ordered my own copy of Kleine kwalen bij kinderen (Minor Child Illnesses), which has since saved me many a diagnosis at the doctor’s office.
Finally, I rely on the knowledge that medical staff here take children seriously. My husband and I do not call the off-hours Huisartsenpost in the weekends as often as we used to. Four children onward, we know that the chances of the doctor wanting to see the child “for good measure – better safe than sorry”— are very high. If we are in our pajamas, it is pouring rain, and our sick child is sleepy, we only call the doctor on weekends if we are certain it is necessary.
Otherwise, we wait until Monday. Most of the time, the worst is over by then, and we are all the better for it.
Anastasia Hacopian, Ph.D., is a Californian American of Japanese and Iranian descent. She studied German language and literature in Berkeley and Berlin before following love to the Netherlands. She is married to a Dutchman and is the mother of four children. Her essays have been published in the Dutch newspapers nrc next and Trouw, as well as the VARA op-ed website, joop.nl. She also writes for medium.com (@ahacopian) and her own websites, anastasiahacopian.com and anastasiainolland.com.