The Best Place To Get Sick In Rural Norway

Patrick McCue
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“What is it you want to study again?” Leena checks.

“Physical therapy.”

Her eyes light up. “Then I’ll have to introduce you to Karin,” she says, adding another name to the list that already has me confused and exhausted. Drizzle is being blown around by a stiff wind, and the scent is familiar to my Iowan nose. Leena pulls her scarf closer to her face, if not because of the wind, because of the smell of manure.

Leena is standing next to a broad red barn. In front of us is a field and on the right, a swath of golden grass in front of a hodgepodge of buildings—rose, purple, yellow, and gray. It looks like someone has squashed these wooden houses together willy-nilly.

Leena Stenkløv is the project director for the Fosen District Medical Center in the rural town of Brekstad, and she was the first string I could grasp after months of trying to talk to someone, anyone, in the Norwegian healthcare system. When I told Leena I was interested in physical therapy and was from a rural area in the United States not too different from rural Norway, she insisted I accompany her to the small town across the fjord from Trondheim, where I am studying.

The Fosen Medical Center is one-of-a kind in Norway. Help your neighbor: That’s how the Fosen model works. It is the same iconic spirit of a town coming together to reap a large harvest or to raise a barn in middle America. I might be an ocean away from Iowa, but Brekstad’s open fields and collaborative spirit remind me of home.

Leena starts me at the top. She peeks into Atle Hestnes’ office, then opens the door to reveal me standing at her side.

Atle leans forward in his chair with a proud, mischievous smile, as if he just pulled a quick one by a whole lot of people. When he first arrived in Brekstad, he tells me, he was the sole physician for two communities and the military base. As he talks about his first years in Brekstad, Atle shakes his head. “I didn’t sleep much. I didn’t have time to think about much.” If something happened in another town, like the time the doctor in Hitra had a slipped disc, Atle added more patients to his 50 daily visits.

Before I leave Atle’s office I explain to him why I want to become a physical therapist. “I love the idea of the power of touch,” I say. “How you can do so much with simple gestures.” Atle’s mischievous smile warms with a nod. Taking the time to make such a simple gesture was paramount, he said, even when he saw 50 patients a day. Atle rests his hand on a patient because knowing there is someone right there is comforting. There is no medical need for the touch, Atle says smiling, but it helps.

Down another hallway, Leena leads me into an empty room with an unmanned reception desk. Astrid Røstad will be here soon, Leena assures me, but right now she is with a patient. She is the sole nurse for the specialist clinic. She schedules the patients, schedules the doctors, and she assists the specialists—all of them.

Astrid displays her mobile phone, telling me she’s on top of everything, before she shuttles me around the clinic. We round a corner, and facing me is a guillotine-like contraption her husband built for the UV light therapy clinic—the antidote to days that are quickly waning as winter approaches. “He isn’t in healthcare,” Astrid says. I’ve already figured the piece of equipment isn’t standard medical issue. She removes a screwdriver from the device, lowering the UV lights from face level to the floor. “We couldn’t treat feet before,” Astrid says. “Now… ” her smile is proud as she replaces the screwdriver.

“What do you think?” Leena asks.

“That machine, you would never see that—” I am interrupted by a giant man in fatigues and goatee standing in the middle of the hallway. He is looking up at a small placard hanging from the ceiling, his nose almost touching the sign.

“Do you have a screwdriver?” he asks me.

“I don’t,” I say apologetically, as if I clearly should have slipped one into my pocket this morning. I forget to mention the one holding Astrid’s contraption together, but the military man just shrugs and turns back to the sign.

My mind stuck on the giant in the corridor, Leena whisks me away to Morten Jensvold, whose thick forearms project out of his short-sleeved shirt as he pulls the chair out and slouches into it. Morten tosses his head back and raises his furrowed eyebrows just above his glasses. He carries the fatigue of 18 years working on a rescue helicopter, which could be found somewhere between Norway and Iceland on any given night.

Now, finally with an office job, he can rest. Even more difficult than his years on helicopter duty was the year that preceded it, when Morten worked as Åfjord’s only doctor. Not far from here, Åfjord is notorious for having trouble holding onto physicians—a common affliction for Norway’s rural towns. Morten’s year was far longer than the week-long stays by some doctors. “No,” he says when I ask. “I couldn’t do it again.”

“A week?” I ask. Yes, a week.

Happy here, Morten stresses the need to replicate the Fosen model across rural Norway. There is a “tsunami of old people” coming, Morten says, and small-town doctors with a lack of resources are forced to send their patients to the regional hospitals “The Fosen model can work, it can,” Morten says, eyes closed, holding onto his last words. It can.

I step back outside, breathing in the familiar smell of manure and bracing myself against the wind. Whether in Brekstad, Norway or Norway, Iowa—not far from my home—that great American spirit, that Norwegian tradition of helping your neighbor, isn’t consigned to the past. It turns out it’s the future.



Posted on 2/26/2009 by

James Seifert

James Seifert

That Patrick McCue is an outstanding writer!! When he writes he packs it with color. He not only educates, but he entertains...all at the same time. We need more of him!

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