Dancing in the Fountain: Spanish approach to healthcare

Dancing in the Fountain: Spanish approach to healthcare

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Karen McCann discusses the Spanish approach to healthcare compared to the US and some of the natural remedies that still persist in southern Spain.

I had to consult a Spanish internist regarding my cholesterol, which had tested a little high just before I left the US. My American physician was recommending a popular cholesterol medication that had perilous potential side effects for the liver, and I wanted a second opinion before I committed to a lifetime on this worrisome drug.

My new doctor in Spain asked the usual questions: “Do you smoke?” No. “Do you drink?” Yes. “How much?” I was a little startled to add it up; what with all the wine and beer served at lunch and dinner, I confessed that I had about two drinks a day.

Where his American counterpart would have immediately handed me a referral for the Betty Ford clinic, this doctor just smiled and said, “Oh, that’s nothing. In fact, we have to get that up!” I think he was joking. He ordered a blood test, and two weeks later we met to discuss the results.

“Your cholesterol is a little elevated,” he said, not sounding too worried about it. “To bring it down, I’d like you to drink more red wine and eat more dark chocolate.” I agreed to that rigorous regimen, but if he wanted me to start smoking, I was going to have to draw the line.

I mentioned that I’d heard Spanish ham was also good for lowering cholesterol. “Yes, it is,” he said. “Not all ham, of course.” We shared a little chuckle; how silly was that notion?

“No,” he went on, “the only ham that lowers cholesterol is the best ham, jamon Iberico, from pigs that are raised on an acorn diet. You see, because their diet is strictly vegetarian, they do not generate cholesterol. So it is very good for you.”

That almost seemed to make sense, until I reflected that other animals – cows, for instance – also have a strictly vegetarian diet, and they’re positively bursting with cholesterol. But who was I to argue with my physician? I promised to increase my consumption of jamon Iberico, red wine, and dark chocolate. To hedge my bets, I also started eating oatmeal for breakfast every morning.

Eventually my cholesterol levels dropped to the point that there was no more loose talk about liver-threatening medications. Was it the oatmeal, the wine, the chocolate, or the ham that did the trick? Who knows? Who cares? I’m doing my best to consume all of them on a regular basis.

But a year after the house call, I caught another horrendous respiratory infection, this one characterised by a deep, persistent cough. So I went to the pharmacy in search of some serious drugs. The pharmacist sold me a strong cough syrup guaranteed do the trick, and I took it home, where I made the mistake of reading the little paper insert that described all the side effects and contraindications. (I am convinced they hire Stephen King to write these things; they’re like mini horror movies, with all their talk of dizziness, loss of consciousness, uncontrollable trembling, bleeding from various parts of the body, and death.)

I wasn’t seriously alarmed until I came to the part that said while taking this medication, you should not consume alcohol, orange juice, or grapefruit juice. I could avoid citrus beverages easily enough but would I have to refrain from all alcoholic forms of holiday cheer? I went back to the pharmacist, showed him the paper, and asked his advice.

“You should avoid alcohol while you are taking this,” he said, nodding sagely. “Well, you could have one beer. Two beers would probably be okay. In fact, you would be fine with three beers. But if you really want to...” – he mimed nonstop chugging – “then stop taking the cough medicine.” What a practical solution!

“And drinking orange juice and grapefruit juice?” I asked. “Stay away from them,” he said firmly. “They can be harmful.”

You have to love a country that feels beer is better for a cold than orange juice.

Spanish healthcare
Spanish health remedies

The Spanish cherish many medical beliefs that you won’t find in the annals of the Journal of the American Medical Association. For instance, during cold and flu season, I am often advised to place a cut onion beside the bed at night to help clear my sinuses. Somewhat surprisingly, it actually does help, but it isn’t going to replace antihistamines any time soon.

For general cold symptoms, many Spanish women prescribe garlic, lemon, and honey in herb tea. And the most important health tip of all: never, ever have houseplants in your bedroom, because they can kill you.

Rich and I were totally unaware of our peril, and we could not understand why Luz and Toño got such strange looks on their faces when, as we first showed them around our newly furnished apartment, they saw the bonsais and potted flowers Rich had artfully arranged around the window area of the guest bedroom.

“But, Rich,” said Luz, “what do you do with the plants when guests sleep here?”

“Nothing. Why?”

“But everyone knows that plants give off oxygen during the day,” she said earnestly, “and they take it in at night. When plants draw in oxygen during the night, they can use up all the air in the room, and the person can’t breathe. It can be very, very dangerous.”

While I struggled to keep a straight face, Rich, who is a Master Gardener and generally acknowledged as a horticultural expert, tactfully explained why the plants’ nocturnal oxygen consumption was so miniscule that it could not possibly affect the air supply of humans in any meaningful way. To be fair, the health hazards of houseplants hogging the night oxygen were once commonly feared in the US as well. American friends in their mid-80s remember similar warnings from their childhoods.

Modern scientific research may have torpedoed this notion 70 years ago, but it remains afloat in Andalucía. That’s why in Seville, you never bring plants or even cut flowers to a hospital patient.

Spanish approach to healthcare: out in the open

But overall, Spain has a well-deserved reputation for making good basic care readily accessible to everyone in the community. We were pleasantly surprised at the quality and efficiency of care. The clinics might not have the abundance of equipment and amenities common in their American counterparts, but they are modern, clean, and orderly, and treatment is seldom rushed or impersonal. On the few visits we’ve made to friends in the hospital, we found the staff professional and the atmosphere considerably more tranquil than in US facilities.

For most of us, the first point of entry into the Spanish health system is the pharmacies. I love going to them. You stand at a little wooden desk and describe your symptoms to everyone within earshot. The pharmacist makes a recommendation, then disappears into the back room, giving the assembled neighbours time to discuss your condition, tell how their Aunt Carmen was a martyr to it, and talk about how their grandparents used to cure it with vinegar, hot salt water, or garlic.

If I’m with a friend who has a baby along, everyone feels free to dispense advice about whether the child needs a cap, more blankets, fewer blankets, or adjustments to the clear plastic sheeting that goes over the entire baby carriage, blocking out the air – a common practice in Spain that would be considered child abuse in the US.

When the pharmacist returns with a packet of medication, it usually costs about EUR 3 and works just fine. If you’re looking for a simple pain reliever, the pharmacist will sell you a packet of 12 paracetamol for the equivalent of a dollar. When was the last time you bought any American medicine for a dollar?

One of the unexpected side effects of our living-abroad cycle is that during the eight months of the year I’m in Spain, I almost never see any doctors or dentists at all. Except for the occasional minor emergency, such as my bronchitis, I never even think about medical care. Of course, as soon as I get back to the US I cram in all my appointments as quickly as possible, and that can be a bit hectic.

There’s been so much written about the role of stress in causing, exacerbating, and prolonging illness that I can only conclude that anything that reduces stress is good for our well-being. In fact, I now believe that avoiding doctors eight months of the year should be part of everyone’s health regimen, right along with dark chocolate, ham and red wine. Are those things really good for the body? I have an official medical opinion on that, and I am sticking with it. I know for sure that they’re good for the soul. 

 

Karen McCann / Expatica

Karen McCann

Karen McCann is an American expat living in Seville, Spain. Her blog, Enjoy Living Abroad, provides stories and survival strategies for those living and traveling in foreign lands. Her transition to expat life is chronicled in her book Dancing in the Fountain: How to Enjoy Living Abroad. Her three-month train journey became the Amazon best seller Adventures of a Railway Nomad: How Our Journeys Guide Us Home. She shares her packing secrets in the small guide Pack Light. For more, visit her website EnjoyLivingAbroad.com.

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