Wednesday 2 December 2015

Polish hypochondria

I was in Warsaw briefly at the weekend and tuned in for a while, as I do, to TokFM. There was a doctor on the air, talking about migotanie przedsionków*. What is that? Growing up in a Polish household in England, the only medical problems any of my parents' friends ever had (or died of) were serce (heart), rak (cancer) or, more occasionally, wylew (brain haemorrhage). That's it. Then there were childhood illnesses - ospa (chickenpox), odra (measles) and świnka (mumps), but other than that, there was only grypa ('flu) to worry about.

Polish medical vocabulary is a mixture of Latin, Greek and barnyard; from the highly scientific to that which can be observed by the simplest of peasants. Only after moving to Poland did my Polish medical vocabulary suddenly start to blossom. I had no idea what trzustka (pancreas) was - nor indeed how to spell it. Nor that śledziona is spleen. And przewlekłe powikłania are 'chronic complications'. And what's a męczyca wielka?

The language thing is a big barrier when a patient faces a doctor - one reason why many Poles in the UK will rather fly back to Poland for treatment from a Polish doctor even if they are entitled to be seen by the NHS. Similarly, in Poland I've only ever been seen by English-speaking doctors (at Medicover); last time was in 2008 when I did my shoulder in and was told that I had a "partially severed rotator cuff". Great! I understood immediately, and what I needed to do to recover (I passed on the cryotherapy). If a doctor cannot communicate effectively with you, the placebo effect doesn't work, as I explained to Pani Zosia who'd paid good money to see a Filipino faith-healer who spoke only Spanish, and the only result for her was a blinding headache that lasted a week.

Poles of all ages are more prone to hypochondria than stoic Britons, who'd retire to bed with a hot drink and an aspirin and have a good night's sleep. Poles - and to a great degree this is stoked by the endless procession of ads for over-the-counter (OTC) pharmaceutical products constantly bombarding them - have a greater belief that Something Can And Must Be Done in case of ailment. Any ailment. The typical ad "50% mężczyzn po pięczdziesiatce nawet nie wiedzą że mogą mieć Mucholiopsypsypozę" - aimed at prompting a rush of concerned males to their nearest pharmacy - has become a household joke. This cultural difference between Poles and Britons is to do (as Geert Hofstede posited) is to do with uncertainty avoidance. Britons are more comfortable in the space between being well and feeling poorly than Poles are (you never hear Briton complaining about the negative effects of fluctuating air pressure ('ciśnienie, Panie') or seasonal change ('przesilenie wiosenne'). Not feeling on top of the world? Go to a pharmacy and buy something for God's sake!

A Polish entrepreneur settled in Scotland last week told me of a recent visit to Poland, during which he called into a pharmacy. He was amazed to see several shelves of medicines marked Nowości ('New Products'), around which crowded a group of interested consumers. "Never mind what's wrong with me, what have you got?" I've seen this phenomenon before. During a rare visit to a pharmacy (to buy Amol), the lady in front of me, after paying for about five or six OTC medications, asked Pani Magister if there's anything else that she could buy. [Note: pharmacists by law must have a Master's Degree in Pharmacy, hence the need to address them per Pan/Pani Magister.] The pharmacist, to her credit, sensing a professional hypochondriac, laughed off the question and bid the lady good day.

According to a pharma-sector exec I spoke to a while back, across the whole of the EU, only the Spaniards buy more OTC remedies per capita than the Poles.

Back to the radio ads. After each one, there's the statutory warning to read - and act upon the information printed on the leaflet included in the packaging: "Przed użyciem zapoznaj się z treścią ulotki dołączonej do opakowania bądź skonsultuj się z lekarzem lub farmaceutą, gdyż każdy lek niewłaściwie stosowany zagraża Twojemu życiu lub zdrowiu." If you can say this in one go, you're future as a voice-over man for Polish commercials is assured. It's not just the radio. I'd say that between 30% and 50% of ads aired during commercial breaks on TV are for OTC medications or 'dietary supplements'.

The latter is a useful work-around for the dodgier end of the pharma trade; to avoid all those clinical trials and faffing around with the Office of Registration of Medicinal Products, Medical Devices and Biocidal Products (URPL) applying for approval - just call what you sell a 'dietary supplement', and the regulator's off your back. There's even a dietary supplement you can take with your meals to stop sweaty hands!

Another type of health/diet ad commonly encountered in the Polish media - though never, ever, on the British media, is aimed at women and concerns bloating (wzdęcia). Not to be mentioned in polite conversation. A woman suffering from bloating can take the relevant dietary supplement, and after the right amount of gases released, she's down to Size 12 from a Size 16. This message is reinforced by a silhouette of a woman rapidly going down two dress sizes. [Imagine this TV ad. Voice-over man (in broad Lancashire accent): "Feelin' bloated? Take Bloato!" (sound effect of wind being passed as silhouette animates from obesity to slenderness)]

I tend to avoid pharmacies. Blessed with good genes, my recipe for good health is 1) walk 10,000 paces every day, 2) eat five portions of fresh fruit and veg a day, 3) drink alcohol in moderation, 4) avoid all sugar (cakes, biscuits, confectionary, ice cream etc) except that found naturally in fruit, 5) be very, very thankful that you are healthy and pray that you may continue to be so.

Back to the doctor on TokFM. He was still talking about migotanie przedsionkówwhen I switched the radio back on 15 minutes later. If you think you may have it, pop into your doctor and he will prescribe something for it.

*Migotanie przedsionków = Atrial fibrillation, in case you were interested.

This time three years ago:
Blogging resumes as Orange gets its act together

This time four years ago:
The meaning of Clarkson 
(or - the fuss that kicks off when a British media pundit recommends shooting government officials)

This time five years ago:
A bad day on the railway

This time six years ago:
In which I walk to work

This time eight years ago:
Act 1, Scene 1, a blasted heath

5 comments:

DC said...

Be happy you can, for now, live in a fool's paradise. Any smart European will be against expanding trade agreements witg the US. This week, a treatment for Hepatitis C was released that costs 84,000.usd for the course of treatmeant. Do you really think you are so imune from such extortion, even as negotiations progress?

Helena said...

As we say in our family,Poles(from Poland) -like being ill.
As to bloating aids ,there are various treatments to help which are advertised on tv in UK eg buscopan,treatments to aid evacuation(ie body wastes) eg .dioctyl. Just we don't have the 900 mph voice telling us to read the label.
If you have atrial fibrillation ,it canbe serious and pre empt a stroke so best to monitor!!!!!!!!!!

Michael Dembinski said...

@DC: US healthcare "providers" of the fee-for-service type will never find a foothold in Europe. They are grotesquely inefficient and just won't compete. I wouldn't worry about such scare stories.

@helena rymaszewska: If you start monitoring one thing, you monitor it all and quickly succumb to... acute chronic hypochondria!

Bernd said...

Good observations, and I also found it quite strange to see that they sell a huge choice of medicine even in our canteen.

Michael Dembinski said...

Seeing the way Polish doctors dish out prescriptions reminds me of the ancient Greek physician, Eutakeonades.

[Joke, get it?]