‘At the end of the narrow side you have to go up a rubble path. Then you will find it automatically. It’s a hut in the meadow between the horses’, says the assistant. In the summer in this rural practice I have enough time for medically not strictly necessary visits. After a fifteen minute drive I park my old battered Volvo next to an even older one. An 80-year-old walks out of a stable with a wheelbarrow full of hay and a bandaged hand. ‘Who are you?’ ‘The doctor.’ ‘Do you want coffee?’ “Have a glass of water.”
Usually, espresso wimp, I get a stomachache for a day from the coffee of old men living alone. He stops with the coffee pot in his hand and puts me on a chair. For the next half hour I hear stories about horse breeding, the changes in the past eighty years of living in a farming village, and his life history. “I’ve been to the zoo once in my life.” ‘Amsterdam?’ “What am I supposed to do there now?”
He almost chokes with laughter. I don’t have to look at his hand, the district care has already done that. The pills are also doing well, they are in separate day boxes. ‘Will you come back? I have more stories.’
A week later he comes to the office on his own. ‘Can you remove those warts on my neck? The nurse said you probably would; my own doctor thought it was nonsense.’ I actually think so too, but I quickly rid him of a few old age warts. “Will you come again before you leave?”
Until recently, so-called social visits by general practitioners were common. Evil tongues say doctors do that to buy a new car. They will probably be there, but most keep an eye on them and see if there are problems with vulnerable elderly people. And they do it to hear stories. Because with those stories in your head, as a doctor you understand not only that one patient better, but often also his family and even the village.
Visits are in danger of dying out. Doctors sit behind the phone or their screen. They answer emails, do video consultations and make phone calls. That takes less time, but I find them boring. Most GPs don’t have time to listen to life histories. According to research by knowledge institute Nivel, general practitioners have started to do more consultations and fewer visits in corona time, especially with the chronically ill and vulnerable elderly. Fortunately, the number of visits for vulnerable people has increased somewhat in recent months. These visits are good for the patient and for the doctor himself it is an effective remedy against burnout.
In between the polder observation, I did consultations in the Amsterdam Red Light District. There you can again walk over the heads and pizza slices that have fallen on the street. My old horse breeder is right. What should you do in that big city?
I’m going to bring him the paper today. He’ll probably ask if I’ll come again.